Mechanized scaling with ultrasonics: Perils and proactive measures

Mechanized scaling for plaque removal is a routine procedure in the practice of periodontics. Though it appears innocuous by itself, there are retinues of hazards associated with it on various organ systems in the body. Some of these unwanted effects and measures to avoid or ameliorate the same are elaborated here. Exposure to ultrasonic scaling is inevitable before any other treatment procedure. Aerosol contamination, vibrational hazards, thermal effects on the dental pulp, altered vascular dynamics, disruption in electromagnetic device, diminished hearing and dental unit waterline contamination are some of the probable off-shoots a patient has to bear. Uses of barrier devices, proper attention to usage of equipment, protection for ear and water treatment are few of solutions for the same. Though documented evidence for the existence of all effects is lacking, it is never the less significant for the overall safety of the patient. A conscientious clinician should therefore inculcate the available steps to overcome the hazards of ultrasonic scaling

Dental unit water lines decontamination with the aid of nanotechnology

Aim: This article reviews the issue of dental unit waterline (DUWL) contamination which affects all the clinical and hospital settings. The contaminating microorganisms commonly isolated from these settings and the most pathogenic among them have serious consequences. Over the years several measures are inculcated for decontamination of water, their advantages and shortcomings have been addressed. Options using nanotechnology which are available in the market are described briefly. Materials and Methods: A manual and electronic search was conducted. Google and PubMed were searched for relevant material from studies up to 2013. Medical Subject Headings words looked for were "Nanotechnology," "Water purification," and "Biofilms." Reviewed findings were summarized by topic, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for reporting. Seventy articles were shortlisted for articles pertaining to our topic of discussion. A systematic approach was followed by two independent reviewers and included eligibility criteria for study inclusion, data extraction, data synthesis, and drawing of conclusion. Results: Dental waterline contamination is widespread in any type of dental setting having serious implications on clinicians and patients alike, especially elderly and immune-compromised. Hence, international bodies like center for disease and control and American Dental Association have come up with stringent measures for maintenance of water quality. A gamut of procedures has been tried to overcome this problem ranging from chlorinated products, water filters to the usage of distilled water. The use of nanoemulsions, nanofilters, nanomembranes, etc., and their applicability for routine usage is discussed. Conclusions: Biofilm formation in DUWLs is inevitable with the subsequent release of part of microbiota into the otherwise sterile dental settings. These consequences can be quite serious on clinicians and dental patients. Though conventional measures in water decontamination have been partly successful, the quest for more foolproof methods has led to the use of latest technology, i.e., nanotechnology. The most practical option has to be chosen based on the ease of their usage

Clinical Assessment of the Effects of Low-Level Laser Therapy on Coronally Advanced Flap Procedure in the Management of Isolated Gingival Recession

The aim of this randomized, controlled split-mouth clinical trial was to assess the effect of LLLT on wound healing after modified coronally advanced flap (MCAF) procedure for treatment of isolated recession-type defects. Fifteen patients with isolated bilaterally symmetrical gingival recessions (Miller’s Class I or Class II, or a combination of both) were enrolled in this study. After a modified, coronally advanced flap technique was implemented, a diode laser (810 nm) with a power of 120 mW irradiated the inner surface of the flap and the outer surface of the flap (low-level laser therapy—LLLT) after suturing for 5 min. This was repeated for the following four consecutive days. Descriptive statistics, a Kruskal–Wallis test and a Mann–Whitney test were performed to analyze the data. A p-value of less than 0.05 was considered statistically significant. The mean recession depth decreased from 3.33 ± 0.9 mm (baseline) to 0.2 ± 0.3 mm (3 months) and 0.4 ± 0.2 mm (6 months) in the test group. The mean recession width decreased from 3.8 ± 0.7 mm (baseline) to 0.2 ± 0.3 mm (3 months) and 0.5 ± 0.3 mm (6 months) in the test group. Due to minimal pain and discomfort, patient acceptability was quite high

Regeneration of Intrabony Defects with Nano Hydroxyapatite Graft, Derived from Eggshell along with Periosteum as Barrier Membrane under Magnification—An Interventional Study

Intrabony defects can be treated by various approaches. Use of GTR along with bone grafts is said to enhance the outcome. The periosteum has been claimed to increase the regeneration. The egg-shell-derived nano hydroxyapatite (EnHA) has shown a scope as alloplastic graft. Thus, the following study was undertaken to combine the periosteal pedicle along with EnHA for the treatment of intrabony defects under magnification to achieve optimal bone regeneration. A total of 21 patients, having intrabony defects with ≥6 mm probing depth (PD) and two or three wall defects as detected on CBCT, satisfying inclusion criteria were enrolled. The sites were randomly allocated as Group A, B and C (n = 7). The following parameters, defect density and defect fill in CBCT (at baseline and 6 months), PPD, RAL, Plaque index (PI), Gingival index (GI) and Gingival Bleeding Index (GBI) were recorded at baseline, 1, 3 and 6 months. p < 0.05 is considered as statistically significant. Bone density and bone fill values were found to be much higher in pedicle with EnHA and EnHA alone group and the values showed statistically significant results. The current clinical research showed that periosteal pedicle along with EnHA and EnHA as stand-alone therapy gave superior results compared to OFD alone, which is an innovative and feasible treatment option