A Systematic Review on Sleep Related Disorders and Periodontal Disease

BACKGROUND: Periodontitis has been implicated in many systemic diseases such as diabetes, cardiovascular diseases, hypertension, stroke, Obesity, Kidney disorders. Recent scientific evidence has revealed a relationship between sleep related breathing disorders (SRBDs) and periodontal diseases. There has been a recent scientific evidence on population based studies reflecting an association between periodontal diseases and OSA.  AIM: The tenet of the study was to find out interconnect between obstructive sleep apnea and periodontal disease. METHODS: A systematic review of clinical trials assessing the relationship between OSA and periodontitis was carried out. An electronic search based on internet search sites (From 2000-2016) by PubMed, MEDLINE, SCOPUS, EMBASE, Google scholar, CINAHL, and Web of Science (WoS) were used. Studies which met the inclusion criteria were further analysed to find out the outcome of the study. RESULTS:  A total of 174 potentially qualifying studies were screened. Out of them 10 studies  fulfilled the inclusion criteria which were further analysed. In our study 10 studies (2000-2016) from Jordan, Tokyo, Turkey, Saudi Arabia, India, USA, South Korea, Taiwan, Australia were shortlisted. Out of them 5 were cross sectional studies, 4 were case control, and 1 was meta-analysis. The sample size in the studies ranged from 66 to 30,120 adult falling in age range of 18 to 75.  The indicators for OSA used were as positive Epsworth sleepiness scale (ESS), Berlin Questionnaire, STOP-bang questionnaire, Apnea-Hypopnea index, Polysomnography (PSG). And the indicators for periodontal disease were Plaque index (PI), Clinical attachment level (CAL), Pocket Probing Depth (PPD), Gingival Bleeding Index (GBI). Majority of studies showed positive correlation between OSA and periodontal disease. CONCLUSION: Recent evidence and literature suggests that there exist a strong  interconnect between OSA and periodontal disease. Dentist play a pivotal role in diagnosis and timely management of OSA cases so as to halt progression of sleep apnea and periodontitis

Tumour stage, treatment, and survival of women with high-grade serous tubo-ovarian cancer in UKCTOCS: an exploratory analysis of a randomised controlled trial

Background: In UKCTOCS, there was a decrease in the diagnosis of advanced stage tubo-ovarian cancer but no reduction in deaths in the multimodal screening group compared with the no screening group. Therefore, we did exploratory analyses of patients with high-grade serous ovarian cancer to understand the reason for the discrepancy.// Methods: UKCTOCS was a 13-centre randomised controlled trial of screening postmenopausal women from the general population, aged 50–74 years, with intact ovaries. The trial management system randomly allocated (2:1:1) eligible participants (recruited from April 17, 2001, to Sept 29, 2005) in blocks of 32 using computer generated random numbers to no screening or annual screening (multimodal screening or ultrasound screening) until Dec 31, 2011. Follow-up was through national registries until June 30, 2020. An outcome review committee, masked to randomisation group, adjudicated on ovarian cancer diagnosis, histotype, stage, and cause of death. In this study, analyses were intention-to-screen comparisons of women with high-grade serous cancer at censorship (Dec 31, 2014) in multimodal screening versus no screening, using descriptive statistics for stage and treatment endpoints, and the Versatile test for survival from randomisation. This trial is registered with the ISRCTN Registry, 22488978, and ClinicalTrials.gov, NCT00058032.// Findings: 202 562 eligible women were recruited (50 625 multimodal screening; 50 623 ultrasound screening; 101 314 no screening). 259 (0·5%) of 50 625 participants in the multimodal screening group and 520 (0·5%) of 101 314 in the no screening group were diagnosed with high-grade serous cancer. In the multimodal screening group compared with the no screening group, fewer were diagnosed with advanced stage disease (195 [75%] of 259 vs 446 [86%] of 520; p=0·0003), more had primary surgery (158 [61%] vs 219 [42%]; p<0·0001), more had zero residual disease following debulking surgery (119 [46%] vs 157 [30%]; p<0·0001), and more received treatment including both surgery and chemotherapy (192 [74%] vs 331 [64%]; p=0·0032). There was no difference in the first-line combination chemotherapy rate (142 [55%] vs 293 [56%]; p=0·69). Median follow-up from randomisation of 779 women with high-grade serous cancer in the multimodal and no screening groups was 9·51 years (IQR 6·04–13·00). At censorship (June 30, 2020), survival from randomisation was longer in women with high-grade serous cancer in the multimodal screening group than in the no screening group with absolute difference in survival of 6·9% (95% CI 0·4–13·0; p=0·042) at 18 years (21% [95% CI 15·6–26·2] vs 14% [95% CI 10·5–17·4]).// Interpretation: To our knowledge, this is the first evidence that screening can detect high-grade serous cancer earlier and lead to improved short-term treatment outcomes compared with no screening. The potential survival benefit for women with high-grade serous cancer was small, most likely due to only modest gains in early detection and treatment improvement, and tumour biology. The cumulative results of the trial suggest that surrogate endpoints for disease-specific mortality should not currently be used in screening trials for ovarian cancer

Tumour stage, treatment, and survival of women with high-grade serous tubo-ovarian cancer in UKCTOCS: an exploratory analysis of a randomised controlled trial

Background: In UKCTOCS, there was a decrease in the diagnosis of advanced stage tubo-ovarian cancer but no reduction in deaths in the multimodal screening group compared with the no screening group. Therefore, we did exploratory analyses of patients with high-grade serous ovarian cancer to understand the reason for the discrepancy. Methods: UKCTOCS was a 13-centre randomised controlled trial of screening postmenopausal women from the general population, aged 50–74 years, with intact ovaries. The trial management system randomly allocated (2:1:1) eligible participants (recruited from April 17, 2001, to Sept 29, 2005) in blocks of 32 using computer generated random numbers to no screening or annual screening (multimodal screening or ultrasound screening) until Dec 31, 2011. Follow-up was through national registries until June 30, 2020. An outcome review committee, masked to randomisation group, adjudicated on ovarian cancer diagnosis, histotype, stage, and cause of death. In this study, analyses were intention-to-screen comparisons of women with high-grade serous cancer at censorship (Dec 31, 2014) in multimodal screening versus no screening, using descriptive statistics for stage and treatment endpoints, and the Versatile test for survival from randomisation. This trial is registered with the ISRCTN Registry, 22488978, and ClinicalTrials.gov, NCT00058032. Findings: 202 562 eligible women were recruited (50 625 multimodal screening; 50 623 ultrasound screening; 101 314 no screening). 259 (0·5%) of 50 625 participants in the multimodal screening group and 520 (0·5%) of 101 314 in the no screening group were diagnosed with high-grade serous cancer. In the multimodal screening group compared with the no screening group, fewer were diagnosed with advanced stage disease (195 [75%] of 259 vs 446 [86%] of 520; p=0·0003), more had primary surgery (158 [61%] vs 219 [42%]; p<0·0001), more had zero residual disease following debulking surgery (119 [46%] vs 157 [30%]; p<0·0001), and more received treatment including both surgery and chemotherapy (192 [74%] vs 331 [64%]; p=0·0032). There was no difference in the first-line combination chemotherapy rate (142 [55%] vs 293 [56%]; p=0·69). Median follow-up from randomisation of 779 women with high-grade serous cancer in the multimodal and no screening groups was 9·51 years (IQR 6·04–13·00). At censorship (June 30, 2020), survival from randomisation was longer in women with high-grade serous cancer in the multimodal screening group than in the no screening group with absolute difference in survival of 6·9% (95% CI 0·4–13·0; p=0·042) at 18 years (21% [95% CI 15·6–26·2] vs 14% [95% CI 10·5–17·4]). Interpretation: To our knowledge, this is the first evidence that screening can detect high-grade serous cancer earlier and lead to improved short-term treatment outcomes compared with no screening. The potential survival benefit for women with high-grade serous cancer was small, most likely due to only modest gains in early detection and treatment improvement, and tumour biology. The cumulative results of the trial suggest that surrogate endpoints for disease-specific mortality should not currently be used in screening trials for ovarian cancer. Funding: National Institute for Health Research, Medical Research Council, Cancer Research UK, The Eve Appeal

Effect of local drug delivery in chronic periodontitis patients: A meta-analysis

Periodontal diseases are multi-factorial in etiology, and bacteria are one among these etiologic agents. Thus, an essential component of therapy is to eliminate or control these pathogens. This has been traditionally accomplished through mechanical means (scaling and root planing (SRP)), which is time-consuming, difficult, and, sometimes, ineffective. From about the past 30 years, locally delivered, anti-infective pharmacological agents, most recently employing sustained-release vehicles, have been introduced to achieve this goal. This systematic review is an effort to determine the efficacy of the currently available anti-infective agents, with and without concurrent SRP, in controlling chronic periodontitis. Four studies were included, which were all randomized controlled trials, incorporating a total patient population of 80, with 97 control sites and 111 test sites. A meta-analysis completed on these four studies including SRP and local sustained-release agents compared with SRP alone indicated significant adjunctive probing depth (PD) reduction for 10% Doxycycline hycylate (ATRIDOX), minocycline hydrochloride (ARESTIN), tetracycline hydrochloride (PERIODONTAL PLUS AB), and chlorhexidine gluconate (PERIOCHIP). Essentially, all studies reported substantial reductions in gingival inflammation, plaque scores, and bleeding indices, which were similar in both the control and the experimental groups. Use of antimicrobial sustained-release systems as an adjunct to SRP does not result in significant patient-centered adverse events. Local drug delivery combined with SRP appears to provide additional benefits in PD reduction compared with SRP alone

Determining the Factors Associated with Knowledge and Practice Regarding Artificial Intelligence in Dentistry Among the Dental Professionals of North India

Human cognition has is an intriguing dimension for researchers and developers. To understand and map out this structure, a broader term has been coined. Artificial Intelligence is a branch term for all the developing systems, furnished with human intelligence. Even though Artificial Intelligence can be useful in field of dentistry and can be of help in dental office but is not used extensively. A gap exists in the knowledge regarding application of Artificial Intelligence in Dental offices. Therefore, the present study was carried to determine the factors associated with knowledge and perception regarding use of Artificial Intelligence in dentistry among the dental professionals

Prevalence of periodontitis and its association with smokeless tobacco (SLT) Use amongst the adult population of Greater Noida, India - A cross-sectional study

Context: Smokeless tobacco (SLT) has been consumed in India since times immemorial. It is the need of an hour to emphasise about awareness and harmful effects of SLT in relation to periodontium. Aim: The aim of the study was to access the prevalence of periodontitis and its association with SLT amongst the adult population of Greater Noida, India. Settings and Design: Hospital-based study and cross-sectional design. Methods and Material: This cross-sectional study included 512 SLT subjects between the ages of 18 and 79 years. The study was carried out from December 2019 to January 2022. A self-designed questionnaire was used for recording demographic details, forms of SLT, frequency, duration of use, and sites of retention of SLT products. The clinical periodontal parameters such as periodontal pocket depth (PPD) and clinical attachment level (CAL) were recorded in a given point of time. Statistical Analysis Used: Chi-square test and logistic regression analysis. Results: The prevalence of periodontitis among SLT was 81.6% with the highest occurrence of Stage III Periodontitis (35.4%). The use of SLT for ≥10 years [odds ratio (OR) = 3.05, 95% confidence interval (CI) 1.86–6.27] showed threefold the risk for periodontitis compared to others who consumed SLT for 4–5 years. Gutkha consumers [OR = 2.56 (95% CI = 0.75–3.48)] were 2.56 times more prone to have periodontitis as compared to other forms of SLT. Conclusions: Periodontitis is positively associated with SLT use. Awareness, timely intervention, and periodic screening in the SLT users will help to prevent the progression of periodontitis

Bioengineered membranes-past, present and future in tissue regeneration

Regeneration of soft and hard tissue defects, although not impossible, is not always a predictable outcome. Tissue Engineering has shown to be successful in regenerating such defects with the objective of development of a new functional tissue structure which is either scaffold-based or not. Currently, the barrier membranes are being used as a physical barrier for the growth of unwanted epithelial and connective tissue cells while promoting the growth of desired cells like those of periodontal ligament and bone cells, which is quite appreciable. But due to the various drawbacks of the conventional membranes, TE has led to the development of functionally enhanced membranes processed by a variety of techniques and materials which overcome the demerits of the currently used barrier membranes. The objectives of this review are to compare the resorbable and non-resorbable barrier membranes used in tissue regeneration, their properties, applications, merits and demerits and future advances

The study and design of intelligent agent in dentistry: Where are we lacking?

Introduction: Artificial Intelligence is a branch term for all the developing systems, furnished with human intelligence. Even though Artificial Intelligence can be useful in field of&nbsp; dentistry and can be of help in dental office but is not used extensively. A gap exists in the knowledge regarding application&nbsp; of Artificial Intelligence in Dental offices.&nbsp; Therefore, the present study was carried to determine the factors associated with knowledge and perception regarding use of Artificial Intelligence in dentistry among the dental professionals. Methodology: A cross sectional study was carried on 362 dental professionals of North India. A non-probability Snowball &nbsp;sampling was used. A The face validity and content validity was done for forming the questionnaire &nbsp;of the present study. The final questionnaire consisted of 13 variable, structured, close-ended questionnaire in English of which 7 were knowledge-based, 4 were based on attitude and 2 based on practice.&nbsp; SPSS version20 was used for statistical Analysis. Frequency, percentage was calculated. Chi-Square test was applied to determine factors associated with knowledge attitude and practice of Artificial Intelligence. A spearman’s correlation and Multiple logistic regression was run to assess the corelation between knowledge and practice of AI by the dentist. Statistical significance was kept at p value&lt;0.05

To evaluate the effect of Vitamin B complex on wound healing – A clinical and microbiological study

Background: The purpose of this study is to explore the effect of vitamin B complex supplementation following periodontal flap surgery on clinical and microbiological parameters. Materials and Methods: A randomized controlled trial on 10 patients with periodontitis in split-mouth design was undertaken to find the effect of vitamin B complex supplementation with open flap debridement on periodontal wound healing. Multiplex polymerase chain reaction (PCR) for Tannerella forsythus and Porphyromonas gingivalis was done using subgingival plaque samples at 0 and 90th day. Results: The results showed a significant reduction (P < 0.01) of clinical (plaque index, gingival index, gingival bleeding index, probing pocket depth, and relative attachment level) and microbial profile in both treatment groups, whereas on intergroup analysis, more reduction in all clinical parameters were observed in the test group, but statistically, the results were insignificant