Oral medicine case book 53: radiation - induced xerostomia

A 76-year old male presented at the Oral Medicine Clinic, complaining of a persistent feeling of a dry mouth, subsequent to having undergone surgery, chemotherapy and radiation therapy for nasopharyngeal carcinoma, 18 months previously. Other than the cancer, he had no systemic problems of note and was otherwise in good physical health. Upon further questioning, the patient reported that the dry mouth condition was affecting his quality of life and that he was losing weight due to difficulty in eating. He further emphasised that his mouth felt dry within five minutes of rinsing his mouth with the palliative agents suggested by his dentist and oncologist. The regimen he followed to relieve his symptoms included glycerine BP oil, Candacide© (a nystatin containing product), Biotene© mouth spray and mouthrinse (these products contain lactoperoxidase, glucose oxidase, lysozyme and lactoferrin), Orbit© sugar free gum and an increased frequency of water intake.Department of HE and Training approved lis

Review of the radiographic modalities used during dental implant therapy - A narrative

The introduction of digital x-ray receivers which replaced conventional films was a significant radiographic development that is commonly used in daily dental practice. Dental implant therapy (DIT) is a sought after dental therapeutic intervention and dental radiography is an essential component contributing to the success of treatment. Dental radiographs taken in daily practice are generally conventional two-dimensional images and/or three-dimensional images. Ideally, the choice of radiographic technique should be determined after a thorough clinical examination and comprehensive consideration of the advantages, indications, and drawbacks. Digital three-dimensional modalities that have emerged over the last decade have been incorporated into DIT with the assumption that treatment outcomes will be improved. These modalities are constantly being reassessed and improved but there is a paucity of published information regarding the assessment of variables such as dosages and dimensional accuracy, suggesting that further research in these matters is necessary. This is crucial in order to obtain evidence-based information that may influence future radiographic practices. In this narrative, the authors present the most commonly used dental radiographic modalities currently used in DIT

Oral medicine case book 68: Oral ulceration caused by rifampicin-resistant tuberculosis

A 53-year old female was referred by her local general medical practitioner to an oral medicine specialist for the management of a persistent ulcer on the left side of her tongue. The lesion had been present for at least three months and was not responding to treatment by topical antiseptic agents. The earlier removal of a molar in close proximity to the lesion, in an attempt to exclude the possibility of traumatic ulceration, had also yielded no beneficial effects. Upon examination, the patient appeared clinically healthy but presented with a history of emphysema due to chronic cigarette smoking. The emphysema was currently being managed by oral inhalation steroids. Even though smoking cessation had previously been advised, she failed to comply and was currently still smoking more than 10 cigarettes per day.DHE

Dental implant imaging: What do South African dentists and dental specialists prefer?

To document the types of imaging modalities that are commonly prescribed during dental implant therapy in South Africa. The radiographic preferences were obtained from practitioners via an electronic survey that was disseminated during local dental conferences, electronic channels (e.g., email lists) of multiple dental schools and local dental scientific societies, and personal interviews. The survey consisted of multiple-choice questions which were designed to investigate the most common radiographic prescriptions during various treatment phases of implant therapy. The responses of one hundred and forty-two participants (General practitioners and dental specialists) practising in different South African provinces were collected and assessed. Principally, panoramic radiographs combined with cone beam computed tomography (PAN + CBCT) followed by CBCT, as a single examination (ASE), were the most preferable modalities during the implant planning phase (39% and 29%, respectively). During and directly after the surgery, periapical radiographs (ASE) were the most preferred (87% and 65%, respectively). The most widely preferred radiographic examination during the planning of implants was panoramic radiographs combined with CBCT. Periapical radiographs (ASE) were favoured during, directly after the treatment, and during the follow-up of asymptomatic patients by the majority of participants. However, CBCT (ASE) was preferred in the follow up of symptomatic patients. Factors related to extra anatomical information and superior dimensional accuracy provided by three-dimensional volumes (e.g., CBCT volumes), were the most indicated influencing factors on the radiographic prescriptions during implant planning

Platelet - Rich Fibrin (PRF) - The effect of storage time on platelet concentration

The aim of this study was to determine whether storage time had a significant effect on the platelet concentration of platelet-rich fibrin (PRF). Three blood samples were drawn from each participant into a sterile blood sampling tube. Two of the blood samples were centrifuged to form PRF. The third non-centrifuged sample was used to measure the baseline blood platelet concentration. After PRF had formed, it was removed from the respective test tubes at different time intervals i.e. immediately after centrifugation (Group A) and after 60 min of storage time in the blood collecting tube (Group B). The residual blood from each group was tested for platelet concentration and compared with the baseline reading (as an indirect measure of the platelet concentrate of PRF). The PRF produced in Group A (PRF A) had a mean platelet concentration of 274 + - 57.8 X 109/L, whereas the PRF of Group B (PRF B) was 278 + - 58.2 X 109/L. A statistically significant difference was seen between the groups (p < 0.001).DHE

An in-vitro analysis of the antimicrobial efficacy of herbal toothpastes on selected primary plaque colonizers

Plaque associated oral disease affects a considerable portion of the population and is considered one of the major causes of tooth loss. In most cases toothbrushing only removes a limited amount of dental plaque and other chemical agents are required to reduce the bacterial load. Aims & objectives: The purpose of study was to determine whether there was any significant difference in the antimicrobial activity of 4 herbal toothpastes against cultures of 3 primary plaque colonizers. Methods: A total of 5 toothpastes were tested for their antimicrobial efficacy against Streptococcus mutans (NCTC 10920), Streptococcus sanguinis (NCTC 10904) and a non-specific α-heamolytic streptococcus by agar diffusion method. The data were collected and analysed using one way ANOVA and Tukey’s multiple comparison test significant at p<0.05. Results: Dentazyme® herbal toothpaste showed the greatest ability to inhibit bacterial growth for all the tested organisms (p<0.05). Nature Fresh had the lowest potential for antimicrobial activity. Conclusions: Dentazyme® Herbal toothpaste was the only herbal toothpaste to inhibit the growth of all the bacteria tested and had similar antimicrobial efficacy to a triclosan containing toothpaste (Colgate® Total®)

In vitro antimicrobial comparison of three commercially available chlorhexidine-based oral rinses

INTRODUCTION: Commercially available chlorhexidine (CHX) formulations differ in their CHX concentrations (0.2% and 0.12%) as well as in various additives including alcohol, antimicrobials such as cetylpyridinium chloride and antidiscolouration chemicals such as ascorbic acid and sodium metabisulphite. AIMS AND OBJECTIVES: To compare in vitro the antimicrobial efficacies of three different CHX preparations (Corsodyl ®, Curasept® and GUM® Paroex®) using 0.2% and 0.12% CHX concentrations as controls METHODS: A disk diffusion test was performed using pure cultures of the organisms Streptococcus mutans and Candida albicans, and mixed cultures (facultative and strict anaerobes) prepared from oral rinse samples of 14 study participants. The means and standard deviations of the diameters of inhibition zones were calculated. RESULTS: A statistically significant difference (p value = 0.0001) was found only in Candida albicans cultures between the mean inhibition zones of the CHX preparation disks. Pure CHX preparations and Corsodyl® showed higher antifungal efficacy than Curasept® and GUM® Paroex Conclusion: Both CHX preparations (0.12% and 0.2%) and the 0.2% CHX preparation containing alcohol (Corsodyl®) have more potent antifungal properties against C. albicans than alcohol-free 0.12% CHX preparations such as Curasept® and GUM® Paroex®.DHE