Diode laser as an additional therapeutic measure in reducing red complex bacteria in chronic periodontitis

Magister Chirurgiae Dentium - MChDThis mini-thesis assessed whether a diode laser with a wavelength of 810 ± 10nm can be utilized as an adjunct to conventional management (i.e. scaling, root planing and polishing) of chronic periodontitis during initial phase therapy. Ethical approval and study registration (Reg no: 14/9/6) was finalized prior to commencement of the study. A split mouth randomised control trial was performed on 25 participants (who presented at the Oral Medicine and Periodontology Department of the University of the Western Cape) diagnosed with active, chronic periodontitis. In order to standardise the split mouth design the quadrants 1 & 4 were assessed together as a set and quadrants 2 & 3 were assessed as a set. A set of these quadrants were randomly assigned to either the test or control quadrants after conventional management was performed in all four quadrants. The base line bacterial colony collection (Micro-IDent®-11, Hain Lifescience GmbH, Nehren, Germany) and the clinical parameters were assessed prior to the commencement of conventional management and were reassessed at the 6 week re-evaluation visit. The set of test quadrants were treated with the diode laser as an adjunct to the preceding conventional management. The control quadrant only received the conventional management. Evaluation of the results demonstrated that the diode laser produced no statistical decrease in the bacterial parameters in the periodontal pockets and resulted in a statistical increase of C. showae (Cs) and T. denticola (Td). The clinical parameters resulted in no statistical difference for any clinical parameter, with the exception of the reduction in BOP that was statistically significant (p< 0,05) with the laser as an adjunct. It is the recommendation that within the limitations of this study, that the utilization of the diode laser (810 ± 10nm) as an adjunct at the initial visit had no statistical effect in the reduction of the bacterial parameters nor resulted in an overall improvement of the clinical parameters

In vivo study of aerosol droplets and splatter reduction in dentistry

Oral healthcare workers (OHCW) are exposed to pathogenic microorganisms during dental aerosol-generating procedures. Technologies aimed at the reduction of aerosol droplets and splatter are essential. This in vivo study assessed aerosol droplets and splatter contamination in a simulated clinical scenario. The coolant of the high-speed air turbine was colored with red concentrate. The red aerosol droplets and splatter contamination on the wrists of the OHCW and chests of the OHCW/volunteer protective gowns were assessed and quantified in cm2. The efficacy of various evacuation strategies were assessed: low-volume saliva ejector (LV) alone, high-volume evacuator (HV) plus LV, and an extra-oral dental aerosol suction device (DASD) plus LV. The Kruskal– Wallis rank-sum test for multiple independent samples with a posthoc test was used. No significant difference between the LV alone compared to the HV plus LV was demonstrated (p = 0.372059). The DASD combined with LV resulted in a 62% reduction of contamination of the OHCW. The HV plus LV reduced contamination by 53% compared to LV alone (p = 0.019945). The DASD demonstrated a 50% reduction in the contamination of the OHCWs wrists and a 30% reduction in chest contamination compared to HV plus LV. The DASD in conjunction with LV was more effective in reducing aerosol droplets and splatter than HV plus LV. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

COVID-19: Focus on masks and respirators – Implications for oral health-care workers

The emergence of the novel human coronavirus (Severe acute respiratory syndrome coronavirus 2; abbreviated as: SARS-CoV-2) generally known as COVID-19 is a global health concern.1 On 11 February 2020, the World Health Organization (WHO) named the novel viral pneumonia as “Corona Virus Disease” (COVID-19). The International Committee on Taxonomy of Viruses (ICTV) suggested this novel coronavirus be named “SARS-CoV-2” due to the phylogenetic and taxonomic analysis of this virus.2 Thus, both terms are utilised interchangeably in the literature. Undoubtedly, COVID-19 will change the way we practice dentistry with vast implications for Oral health-care workers (OHCW) and practice staff. Additionally, if rigorous safety protocols are not implemented based on a risk assessment outlined by the CDC, the dental practice can potentially become a nexus for disease transmission due to the high volume of aerosol production on a daily basis. Personal protective equipment (PPE), staff training and practice disinfection protocols have now especially become important in the light of the current pandemic. This is not a fight that one profession can fight alone, it requires joint efforts, it requires all stakeholders, it requires foresight and it requires us to put the health of the communities above all else

Oral medicine case book 76: Methotrexate induced mucosal erosions and ulcerations

A 71-year-old male was referred from his general practitioner to the Oral Medicine Clinic at the University of the Western Cape, Oral Health Centre, Tygerberg campus, on account of a six-week history of recurrent oral ulceration

Oral medicine case book 74: marijuana-induced Oral Leukoplakia

A 55-year-old male presented at the Oral Medicine Clinic of the University of the Western Cape, Oral Health Centre, Tygerberg Campus, for the evaluation of a persistent white patch on his right edentulous mandibular ridge. He had been referred from the Prosthodontics Clinic where he was seen for complete denture rehabilitation. The patient had no significant medical history and informed us that he had been smoking marijuana five times a day for more than twenty years and consumed alcohol occassionally. He had never worn a dental prosthesis and did not use tobacco in any form.DHE

Oral medicine case book 52: pleomorphic adenoma of the upper lip

A 46-year old female presented at the Oral Medicine Clinic complaining of a large and painless swelling of her upper lip. The lesion had slowly enlarged over the past year and was causing an increasing aesthetic and speech impairment. Her medical history revealed nothing of note. Extra-orally, the patient presented with a swelling involving the right side of the upper lip and extending from the right alar of the nose, to the right commissure (Figure 1). The intra-oral examination revealed a firm and well circumscribed mass in the upper right labial mucosa, opposite the upper second incisor, canine and first premolar. The mass was approximately 2x3 cm in size and the overlying mucosa was of normal consistency and colour for the region (Figure 2). A fine needle aspiration biopsy (FNAB) of the mass was performed (Figure 3).Department of HE and Training approved lis

Oral Medicine Case Book 57: Orofacial granulomatosis

A 17-year old female presented at the Oral Medicine Clinic with the complaint of persistent swelling of the upper lip and anterior attached gingiva, causing her discomfort when eating and talking. The swelling started approximately ten months earlier. At the time she was seen by her physician who prescribed an antibiotic that gave mild symptomatic relief, but no clinical resolution. She was also seen by an oral hygienist on three occasions with no improvement of the gingival swelling. The patient also reported that she had been diagnosed with depression and type 2 diabetes approximately two years ago and was currently using Citalopram (a selective serotonin reuptake inhibitor) and Glucophage (metformin hydrochloride, an anti-hyperglycemic drug). Extra-oral examination revealed a firm, swollen and superficially cracked upper lip with a red granular appearance. No enlarged cervical lymph nodes could be palpated. Intra-orally, the anterior maxillary and mandibular gingivae were hyperplastic and erythematous, with a granular surface (Figures 1, 2 and 3). The differential diagnosis included contact allergy and granulomatous disease, including mycobacterial infection.DHE

Oral medicine case book 50: HIV associated Kaposi sacoma

A 33-year-old female of African descent was referred to the Oral Medicine Clinic from a neighbouring rural clinic. The patient presented with painful nodular lesions on her gingivae and hard palate, having noticed the enlarging lesions two months earlier when they started to impair her speech and mastication. She reported that she had been diagnosed with HIV infection two years earlier and had been on antiretroviral medication for the past eleven months. The patient had a recent history of pulmonary tuberculosis and cryptococcal meningitis. At the time of the initial examination, her CD4 count was 230/µl (normal levels in adults: ±1000 cells/µl) and the laboratory report indicated viral load failure, i.e. the patient was no longer responding satisfactorily to the HAART therapy.Department of HE and Training approved lis