Self‑perceived oral health and whole salivary immunoglobulin G levels in habitual gutka‑chewers and nonchewers

Objective: To assess self‑perceived oral health and whole salivary immunoglobulin G (IgG) levels among habitual gutka‑chewers and nonchewers (controls).Materials and Methods: Fifty gutka‑chewers and fifty controls were included. Demographic data and self‑perceived oral health status (pain in teeth, pain on chewing, bleeding gums (BG), bad breath, loose teeth and daily oral hygiene protocols) were collected using a questionnaire. Unstimulated whole saliva (UWS) was collected and unstimulated whole salivary flow rate (UWSFR) was determined. Whole salivary IgG levels were determined using standard techniques. Odds ratios were calculated for oral symptoms and group differences in protein levels were compared using one‑way analysis of variance (α <5%).Results: BG was more often reported by gutka‑chewers than controls (P < 0.05). There was no significant difference in UWSFR and self‑perceived pain in teeth, pain on chewing, bad breath and loose teeth among gutka‑chewers and controls. IgG levels were significantly higher among gutka‑chewers than controls (P < 0.01). Among gutka‑chewers, whole salivary IgG levels were comparable individuals with and without self‑perceived oral symptoms. Among controls, IgG levels in UWS were significantly higher among individuals who had BG than those who did not (P < 0.05).Conclusions: Self‑perceived oral health is worse and whole salivary IgG levels are higher in gutka‑chewers compared to controls.Key words: Alveolar bone loss, areca, inflammation, smokeless, tobacc

Concepts for prevention of complications in implant therapy.

The use of dental implants is nowadays a well-accepted and highly predictable treatment modality for restoring the dentition and reestablishing the masticatory function of edentulous and partially edentulous patients. Despite the high predictability and excellent long-term survival rates reported for implant therapy, complications may still occur and can jeopardize both short- and long-term success. The present paper provides an overview on the most important aspects related to the etiology, prevention, and management of complications associated with implant therapy. Data from the literature indicate that a number of factors, such as surgical trauma, implant diameter, type of implant-abutment connection, abutment disconnection and reconnection, presence of microgap, and implant malpositioning, can substantially influence the biologic processes of bone remodeling and biofilm formation, thus increasing the rate of short- and long-term hard- and soft-tissue complications. Other factors, such as excess cement at cement-retained prosthetic restorations, abutment mobility, and infections (e.g. peri-implant mucositis and peri-implantitis) caused by bacterial biofilm, are further causes for complications and failures. More recent evidence also indicates that besides the need for sufficient bone volume surrounding the implant, the presence of an adequate width and thickness of attached mucosa may improve biofilm control and limit crestal bone resorption. Furthermore, emerging evidence points also to the pivotal role of human factors as one of the most important causes of complications in implant dentistry. It can be concluded that clinicians need to consider all biologic and biomechanical factors affecting implant placement and survival, as well as undergo adequate training to improve their surgical skills to control and prevent implant complications. Careful patient selection and control of environmental and systemic factors, such as smoking, diabetes etc., coupled with an accurate surgical and prosthetic planning, enable a better prevention and control of infections