Periodontal Disease and Pregnancy Outcome

Periodontal diseases are silent infections that often go undiagnosed until irreparable damage occurs to the teeth and oral structures. These chronic oral infections are characterized by the presence of a biofilm matrix that adheres to the periodontal structures and serves as a reservoir for bacteria (plaque). Response of the body toward the bacterial challenge of dental plaque can lead to bone loss and the migration of the junctional epithelium, resulting in periodontal pocketing and periodontal disease. This bacterial insult can result in destruction of the periodontal tissues that precipitates a systemic inflammatory and immune response leading to the release of several cytokines and immunomodulatory agents, which may affect systemic conditions and diseases. The influence of periodontal infection on systemic disease and conditions documented include coronary heart disease (CHD) and CHD-related events such as angina, infarction, atherosclerosis, and other vascular conditions; stroke; diabetes mellitus; preterm labor, low birth weight delivery, and preeclampsia; and respiratory conditions such as chronic obstructive pulmonary disease. Adverse pregnancy outcomes, including preeclampsia, preterm delivery, and intrauterine growth restriction, and fetal demise affect a significant number of pregnancies and are a major source of both maternal and neonatal morbidity and mortality. This chapter highlights the two-way relationship between periodontitis and adverse pregnancy outcome

A Split Mouth Randomized Clinical Comparative Study to Evaluate the Efficacy of Gingival Depigmentation Procedure Using Conventional Scalpel Technique or Diode Laser

Introduction: Dark or black coloured gingiva is an esthetic concern especially in subjects with high lip line or gummy smile. Gingival depigmentation procedure is a type of perioplastic surgery where the gingival epithelium is excised with various techniques to lighten the colour of the gingiva. The aim of this study was to compare the clinical efficacy of gingival depigmentation procedure with conventional scalpel technique and diode laser application.Methods: This split mouth randomized study was conducted on 12 subjects (18–40 years of age), exhibiting melanin hyperpigmentation of gingiva. The anterior labial sextant of maxilla and mandible were divided into two halves involving three anterior teeth i.e. central incisor, lateral incisor and canine on each side. The divided areas were randomly allotted for depigmentation procedure either with scalpel technique or diode laser operating at 980 nm wavelength. Various parameters such as bleeding, pain, difficulty of procedure and wound healing were assessed and compared between the two techniques. The level of melanin pigment was assessed with Dummette Gupta index and photographic analysis with the help of adobe software. The subjects were followed up to one year to see for recurrence of melanin pigmentation.Results: Bleeding during surgery, pain score and difficulty of procedure assessed by the operator were statistically higher for scalpel technique as compared to laser technique. Wound healing did not show any statistical significant difference between both techniques. Gingival depigmentation procedures with scalpel as well as laser technique were effective when compared preoperatively and at consecutive postoperative visits, and this was statistically significant. Comparison of melanin depigmentation procedure between scalpel and laser technique did not show any significant differences at all postoperative intervals.Conclusion: The findings of the present study suggest that gingival depigmentation was effective with both scalpel and laser techniques. However, the laser treated sites showed reduced pain experienced by the patient and better operator comfort. Slight melanin repigmentation was observed in three subjects treated with scalpel depigmentation procedure at the end of one year

Short and Long Term Oral Hygiene Maintenance Protocols for Traumatic Dental Injuries

Traumatic dental injuries (TDIs) occur when a person undergoes trauma due to variety of reasons. Traumatic injuries are part of the growing up years and can have ever lasting wounds with scarring on the affected individuals. Treatment and rehabilitation of the teeth with traumatic injuries are essential for long term survival of the teeth. Immediate care, appropriate diagnosis and treatment with comprehensive follow-up are essential for a favorable prognosis of the affected teeth. A coordinated effort from different specialties including general dentist, oral radiologist, pediatric dentist, periodontist, oral surgeon, orthodontist and endodontist is essential for success of the treatment. Team efforts involving these different specialists will help the patient to receive successful long term outcome. Proper oral hygiene maintenance during and after traumatic dental injury, is required to stop the deterioration of the tooth and periodontal structures. The caregiver in children and the adult with traumatic dental injuries should be educated and guided about the proper oral hygiene techniques especially in the areas with dental injury. Dentist must be aware of the treatments rendered to the teeth with trauma and should have up-to-date knowledge of the oral hygiene measures to be inculcated in the subjects with dental trauma. This chapter highlights the oral hygiene measures to be followed by the subjects with TDIs and also includes measures to be followed by the dentist in such a scenario

A retrospective study to assess and correlate maternal periodontal status with term of pregnancy and weight of newborn

Background: Periodontitis is an inflammatory disease affecting the tooth supporting structures; studies have shown that it also affects the systemic health and conditions like pregnancy. With this background the present retrospective study was conducted to assess and correlate periodontal status of pregnant women with their pregnancy outcome.Methods: A total of 150 pregnant women two days postpartum were examined for periodontal status using following parameters: Oral hygiene index- simplified (OHI-S), modified gingival index (MGI), probing pocket depth (PPD) and clinical attachment loss (CAL). The level of education, body mass index (BMI), gestational age and weight of the baby were recorded and correlated with the periodontal status.Results: Out of 150 women, 83 (55.3%) women suffered from gingivitis and 67 (44.7%) had periodontitis. The incidence of preterm low birth weight babies was seen in 65 (43.33%) women. Body mass index, education level and periodontal disease were significantly associated with preterm low birth weight infants.Conclusions: A significant association was found between periodontitis and preterm low birth infants. The promotion of early detection and treatment of periodontal diseases in women before and during pregnancy will be beneficial. This will minimize the cost of post natal care and morbidity in the new born

Evaluation and Comparison of Two Commercially Available Mouthrinses in Reducing Aerolised Bacteria During Ultrasonic Scaling When Used as a Preprocedural Rinse.

Objective:To compare and evaluate the effect of 0.2% chlorhexidine gluconate and commercially available herbal mouthrinse in reducing aerolized bacteria when used as a preprocedural mouth rinse.Materials and Methods:A total of 45 patients were selected and randomly divided into three groups. Group I consisted of 15 patients who rinsed with distilled water for 60 seconds. Group II consisted of 15 patients who rinsed with 0.2% chlorhexidine mouthwash (Clohex®) for 60 seconds and Group III consisted of 15 patients who rinsed with herbal mouthwash (Hiora®) for 60 seconds. Aerosols produced during the oral prophylaxis procedure were collected on blood agar plates by exposing the plates at patient’s and dentist’s chest area and the exposed plates were incubated at 37°c aerobically for 48 hours. The number of colony forming units (CFU) in aerosol and CFU in the saliva were counted and statistically analyzed. Results:Reduction in the bacterial load using 0.2% of chlorhexidine gluconate mouthwash is found to be significant at both patient’s and dentist’s chest area in aerosol produced during scaling followed by herbal mouthrinse.Conclusion:The results of the present study clearly indicate that pre-procedural rinsing with 0.2% chlorhexidine gluconate was significantly more effective than herbal mouthrinse in reducing the aerolized bacteria during ultrasonic scaling. Therefore a pre-procedural rinse can significantly reduce the risk for cross contamination

A Two-Year Prospective Analysis of Mandibular Fractures in Western Population of Maharashtra, India

Introduction: Trauma to the facial region causes injuries to hard and soft tissues of the face. Injuries to the maxillofacial region are increasing in frequency and severity because of the increased number of road traffic accidents (RTAs) and increased number of violence. The purpose of this study was to evaluate age, gender distribution, etiology, and pattern of mandibular fractures in Western part of Maharashtra population. Materials and Methods: The study was conducted in the Department of Oral Medicine and Radiology for a period of two years from June 2013 to June 2015. Clinical examination of all trauma patients was done and diagnosis was made based on signs, clinical features, and confirmed by orthopantomographs. Results: Totally, 193 patients were detected with different types of mandibular fractures. Study group involved 77.2% males and 22.8% females with a male to female ratio of 3.3:1. Majority of patients were in the age group of 21–30 years followed by 31–40 years. Trauma due to RTAs were more common followed by assaults and fall. Parasymphyseal fractures were most common type followed by condylar fracture and fracture of angle of mandible. Conclusion: Males were most commonly affected by trauma than females with a predominant age group of 21–30 years. Majority of trauma were due to RTAs with parasymphyseal as most common type of fracture

Temporomandibular joint ankylosis

Trauma to the chin is the most common cause of temporomandibular joint (TMJ) ankylosis along with other causes which include infections and inflammatory destruction of the synovial lining of the joint. Inflammation of the joint may be primary resulting from infection of the joint itself or may result from extension of neighboring infection. The clinical features of ankylosis are limited mouth opening, with no pain and joint sounds, and marked deflection of the mandible to the affected side. This article highlights the clinical and radiographic features of TMJ bony ankylosis

Radiographic location of mental foramen in a randomly selected population of Maharashtra

Introduction: Mental foramen is usually the anterior limit of inferior dental canal, which is located in the body of mandible between the inferior and alveolar margins. The accurate identification of the position of the mental foramen is important for both diagnostic and clinical procedures on the mandible. Objectives: To determine the most common type and position of the mental foramen in a selected population of Maharashtra. Materials and Methods: A total of 448 orthopantomographs showing mental foramen bilaterally were considered for this study. The type, position, and symmetry of mental foramen on contralateral sides were noted in both the gender. Frequency and percentage of type, position, and symmetry of mental foramen were calculated statistically. Results: The majority of mental foramen were of separate type (n = 554, 61.8%) followed by the continuous type (n = 342, 38.2%). The most common position of the mental foramen was position 4 (n = 554, 61.8%) followed by position 3 (n = 289, 32.2%). The mental foramen were bilaterally symmetrical (n = 246, 54.9%) and asymmetrical (n = 202, 45.1%) in radiographs. Significant differences were observed in position between the right and left side in both the gender. Conclusion: The separate type of mental foramen was most predominant and the most common location was position 4 followed by position 3

Mathematical Model for Inverter Power Output in PV Parks

Solar photovoltaic (PV) parks have proliferated all over the world as a result of the growing demand for electricity, and especially electricity from renewables. As these parks become larger and complex, it becomes increasingly important to develop accurate and efficient mathematical models that can be used to predict their performance and optimize their design. The inverter is an essential component of a solar PV system that converts the DC power generated by the solar panels into AC power that can be used by the grid or by local loads. This research paper presents a comparative study between a pre-existing reference model and a mathematical model, developed specifically for predicting the AC power output of photovoltaic systems. In addition, a hybrid model is included for comparative analysis. The performance of each model was evaluated using real-world data installed at Glava Energy Centre in Hillringsberg, Sweden. The reference and hybrid models showed similar trends in their calculated versus actual values, but the hybrid model outperformed the reference model slightly. The actual power values were found to be similar to the simulated values in all three models. However, the mathematical model was more specific and sensitive to the inverter under consideration, resulting in a comprehensive and accurate representation of the inverter's behaviour. The models take into account the inverter's characteristics, as well as environmental elements like temperature and solar irradiance that affect its performance. The results showed that the mathematical model outperformed the other models in terms of accuracy and reliability, achieving an R2 score of 0.9226, 0.9936, 0.9789, and 0.9736 for the months of February, April, July, and October, respectively. The mathematical model also had the lowest root mean square error (RMSE) and mean absolute error (MAE) values compared to the other models. The results of this study demonstrate the value of mathematical modelling in the design and optimization of solar PV parks and provide a framework for the development of more complex models in the future

Mathematical Model for Inverter Power Output in PV Parks

Solar photovoltaic (PV) parks have proliferated all over the world as a result of the growing demand for electricity, and especially electricity from renewables. As these parks become larger and complex, it becomes increasingly important to develop accurate and efficient mathematical models that can be used to predict their performance and optimize their design. The inverter is an essential component of a solar PV system that converts the DC power generated by the solar panels into AC power that can be used by the grid or by local loads. This research paper presents a comparative study between a pre-existing reference model and a mathematical model, developed specifically for predicting the AC power output of photovoltaic systems. In addition, a hybrid model is included for comparative analysis. The performance of each model was evaluated using real-world data installed at Glava Energy Centre in Hillringsberg, Sweden. The reference and hybrid models showed similar trends in their calculated versus actual values, but the hybrid model outperformed the reference model slightly. The actual power values were found to be similar to the simulated values in all three models. However, the mathematical model was more specific and sensitive to the inverter under consideration, resulting in a comprehensive and accurate representation of the inverter's behaviour. The models take into account the inverter's characteristics, as well as environmental elements like temperature and solar irradiance that affect its performance. The results showed that the mathematical model outperformed the other models in terms of accuracy and reliability, achieving an R2 score of 0.9226, 0.9936, 0.9789, and 0.9736 for the months of February, April, July, and October, respectively. The mathematical model also had the lowest root mean square error (RMSE) and mean absolute error (MAE) values compared to the other models. The results of this study demonstrate the value of mathematical modelling in the design and optimization of solar PV parks and provide a framework for the development of more complex models in the future