Journal of Nepalese Society of Periodontology and Oral Implantology

Oral Hygiene Status among Denture and Non-denture Wearers in a Tertiary Health Care Centre: An Analytical Cross-Sectional Study

Swagat Kumar Mahanta — 2023-12-31

Introduction: Establishing good oral hygiene has been essential in achieving and maintaining overall physical and emotional well-being throughout life. With the use of dentures, it is believed to worsen the health of the oral cavity if not properly maintained.

Objective: To compare the oral hygiene status among denture wearers and non-denture wearers.

Methods: An analytical cross-sectional study was conducted from September to October 2023 in the outpatient department of the Dental Department in Dhulikhel. Convenience sampling method was used. A sample of 120 patients was divided into two groups: denture wearers and non-denture wearers. Data were collected and entered into the Microsoft excel and further analysis was done in the SPSS v20. Oral hygiene status, halitosis, and tongue coating were evaluated and compared between the groups.

Results: The Simplified Oral Hygiene Index (OHI-S) scores were comparatively higher among denture wearers (3.09±0.92) as compared to non-denture wearers (2.47±0.82). The majority of the denture wearers 26 (43.3%) had poor oral hygiene status. Tongue Coating Index (TCI) scores were almost similar among both groups. The organoleptic score was higher among denture-wearer participants (1.35±0.51) as compared to the non-denture wearers (1.15±0.44).

Conclusions: Wearing a denture has an impact on the oral hygiene status and halitosis of an individual. Post-denture delivery instructions and regular follow-ups are recommended to maintain proper oral health.

Cementoenamel Junction: Morphological Characterization in Nepali Population

Bhoj Raj Adhikari — 2023-12-31

Introduction: Cementoenamel junction (CEJ) represents the anatomic limit between the crown and root surface and is defined as the area of the union of the cementum and enamel at the cervical region of the tooth. However, the type of CEJ in the Nepali population is not well documented.

Objective: In the present study, the authours attempt to characterize the morphological type of CEJ in the Nepali population.

Methods: This is a descriptive cross-sectional study using a total of 300 CEJs from the Nepali population visiting the Kathmandu University School of Medical Sciences, Department of Dental Surgery, Dhulikhel Hospital (KUSMS-DH) between January 2023 to August 2023. Extracted teeth were sectioned to 250μm thickness and observed under the light microscope to determine the type of CEJ.

Results: Most of the samples presented type I CEJ. Type I, II, and III CEJ were seen in 149 (49.67%), 103 (34.33%), and 48 (16%) of the samples respectively. Additionally, 110 (73.34%) of the samples showed similar types of CEJ in both the buccal and palatal sides of the same tooth while 40 (26.66%) had different types of CEJ within the same tooth.

Conclusions: Type I CEJ is the most common in the Nepalese population. The type of CEJ shows variation within the same teeth in different areas.

Prevalence of Tooth Loss due to Periodontitis in Patients Visiting Tertiary Care Hospital

Sachita Thapa — 2023-12-31

Introduction: Epidemiological studies have been showing that caries is the main reason for tooth loss. But nowadays, it seems to show an increasing trend of tooth loss due to periodontal reasons rather than caries. The retention of natural teeth can improve the quality of life by maintaining the ability to chew and digest food. Thus, directly or indirectly periodontitis leading to tooth loss affects quality of life.

Objective: To determine the prevalence of tooth loss in periodontitis patients.

Methods: A cross-sectional study was done in Department of Periodontology and Oral Implantology from June 2023 to September 2023 after obtaining ethical clearance from institutional review committee. Study participants were patients diagnosed as periodontitis according to world workshop in periodontics 2017 classification and prevalence of tooth loss was recorded according to the history of mobile tooth. Poor prognosis and hopeless prognosis were counted as to be extracted tooth in the study. Collected data were entered into the excel sheet and further statistical analysis was done using SPSS v.20.

Results: Mean of tooth loss due to periodontitis was found to be 3.74±3.285 and tooth to be extracted is 1.94±1.884.

Conclusion: As the age increases number of tooth loss increases, likewise current smokers have more amount of tooth loss than that of former and nonsmokers. Likewise, mandibular anterior region was most common for prevalence for tooth loss.

Demonstration of Urease Activity in Subgingival Plaque Sample of Periodontitis Patients in a Tertiary Care Center of Nepal

Simant Lamichhane — 2023-12-31

Introduction: The urease activity is produced by many oral and gastric microorganisms, which have demonstrated systemic implications as well. Urea can be detected both from saliva and gingival crevicular fluid, which could suggest that the oral cavity can act as an extragastric reservoir for many microbes leading to serious systemic diseases.

Objective: The main objective of this current study was to find out the urease activity in human dental plaque.

Methods: An analytical cross-sectional study was conducted from September to November 2023 in patients visiting the Department of Periodontology and Oral Implantology. The urease activity was detected using a rapid urease test (RUT) kit from a hundred cases diagnosed with periodontitis. All systemically healthy patients excluding patients on ongoing proton-pump inhibitor therapy were selected for the presence/absence of periodontitis as per the 2017 World Workshop classification. Data were collected and entered into Microsoft Excel, and further analysis was done using SPSS v.20.

Results: Out of 100 patients, urease activity was found positive in 85 (85%) patients. Regarding gender and age, the urease activity was not much different and was not statistically significant (P value= 0.163 and 0.382 respectively).

Conclusions: The results of this study suggest there is a high urease activity in dental plaque samples whose removal is essential to prevent our body from systemic threats like bacterial endocarditis, gastric carcinoma, etc. caused by urease-producing microorganisms.

Prevalence of Alveolar Antral Artery in Patients Visiting Tertiary Care Center: A Cone-beam Computed Tomography Study

Gitanjali Subedi — 2023-12-31

Introduction: Intra-osseous anastomosis between the posterior superior alveolar artery (PSA) and infraorbital artery is termed as Alveolar Antral Artery (AAA). It is considered a common anatomical point of interest during lateral sinus floor elevation because of the risk of intra-operative hemorrhage.

Objective: To determine the prevalence of AAA along with its diameter and distance from the floor of the maxillary sinus.

Methods: A total of 250 Cone-beam Computed Tomography (CBCT) images scanned with a Dentium Rainbow CBCT machine were included in the study. The study design was a descriptive cross-sectional study, done from archives of the Department of Oral Medicine and Radiology at Dhulikhel Hospital from June 2023 – October 2023. Using the multiplanar capabilities of the software, the prevalence, exact location, and diameter of the artery were determined in relation to the floor of the maxillary sinus. Data were collected and entered into Microsoft Excel and analysis was done in SPSS version 20.0.

Results: The artery could be identified in 197 (78.8 %) of the cases on the right maxillary sinus and 185 (74 %) of the cases on the left maxillary sinus. The mean diameter of the artery on the right sinus was found to be 1.24 mm and 1.10 mm on the left. The mean distance from the floor of the sinus was 10.22 mm on the right and 8.52 mm on the left side.

Conclusions: One significant anatomical feature in the wall of the lateral maxillary sinus is the alveolar antral artery. Preoperative CBCT scans are useful diagnostic tools for conditions that may affect this artery and for reducing surgical complications in suspected cases.

Social Impact and Self-Perception of Malocclusion among Adolescents in a Tertiary Centre of Eastern Nepal

Nidhi Giri — 2023-12-31

Introduction: Malocclusion, defined as an improper relationship between teeth in the opposite jaws, has been a prevalent disorder in recent decades. There has been an increased concern about dental appearance during childhood and early adulthood.

Objective: To assess the social impact and self-perception of malocclusion among adolescents and to investigate whether the types and severity of malocclusion have any effect on adolescents’ social acceptance.

Methods: A total of 301 participants were chosen from middle and high school with ages ranging from 12 to 19 years. After completion of the questionnaire to assess social impact, all the participants were examined using the Index of Orthodontic Treatment Need (IOTN).

Results: Malocclusion severity has a negative correlation with satisfaction with dental appearance (σ: -0.385; p-value: <0.001). Similarly, the severity of malocclusion has weak positive correlation with treatment needs (σ: 0.156; p-value: 0.007) and social impact (σ: 0.171; p-value: 0.003).

Conclusions: Different subjective domains of social impact and self-perception are influenced by the severity of malocclusion among adolescents visiting tertiary care center in Eastern Nepal.

Medical Professionals – Referral Ambassador to the Periodontal Clinic

Sunita Kharel — 2023-12-31

None

NSPOI at 10: A Legacy of Advancing Oral Health in Nepal

Bhageshwar Dhami — 2023-12-31

None.

Minimal Intervention Approach for Complicated Crown- root Fracture using Reattachment procedure: Three Years Follow-up

Sita Shrestha — 2023-12-31

Crown-root fractures are commonly encountered in dental practice, and their management poses a challenge to clinicians. With the advent in adhesive dentistry, reattachment of the fractured segment became a viable restorative alternative. Reattachment is a conservative treatment option that allows for immediate restoration of function, esthetics and phonetics. This case report presents a minimal intervention approach to the management of a complicated crown root fracture. The tooth was endodontically treated followed by esthetic reattachment of the fractured fragment using composite fiber post. The patient was followed up for three years, and clinical and radiographic examinations showed a successful treatment outcome.

Aesthetic Gingival Recontouring

Alina Bajracharya — 2023-12-31

The dramatic appeal of a face, especially caught in a smile or laugh, lies in the interplay between the lips, teeth, and periodontium. Any deviation from the ideal form alters perceived attractiveness. Excessive marginal or papillary soft tissue because of inflammation, altered passive eruption, and a myriad of other pathologies distorts dental silhouettes. Modification of the gingiva, then, instead of tooth structure, often resolves cosmetic deformities. In this case report, we discuss about aesthetic crown lengthening, that aims to reduce excessive soft and hard tissues to establish a natural smile with harmonious proportion between the teeth and the dentogingival complex.

Treatment of Intrabony Defect using Xenograft and Collagen membrane-A Case Report with Clinico-radiographic Evidence

Victory Thapa — 2023-12-31

Periodontal regenerative procedures attempt to increase the periodontal attachment, bone level and reduce pocket depth in order to improve the immediate and long-term clinical results of periodontally compromised teeth. Guided Tissue Regeneration (GTR) membrane and bone graft materials or their combination has been used for reconstruction of periodontal apparatus. After reflecting a full-thickness flap, thorough debridement and root planing were accomplished in the present case. A bioabsorbable collagen membrane was placed over the xenograft filled defect to treat an intrabony defect. The one-year-follow up showed improvement in clinical parameters with radiographic evidence of bone fill.

Immediate Implant Placement and Immediate Loading in the Aesthetic Zone: A flapless Approach

Savvy Pokharel — 2023-12-31

Replacing missing or failing teeth with implants can be a clinical challenge, especially in the aesthetic area, because patients expect an esthetically ideal prosthesis besides the osseointegration of implants. In this regard, immediate placement of implants with immediate loading is preferred by the patients, for the fewer surgeries involved and the immediate restoration of the potential edentulous sites. This article aims to present a case report of immediate placement of implant and immediate loading of the maxillary right lateral incisor.