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Ramachandra SS, Sime FB, Naicker S, Han P, Lee RS, C Wallis S, Roberts JA, Ivanovski S. An in vitro dynamic bioreactor model for evaluating antimicrobial effectiveness on periodontal polymicrobial biofilms: a proof-of-concept study. J Periodontol 2024; 95:384-396. [PMID: 37724702 DOI: 10.1002/jper.23-0086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/12/2023] [Accepted: 08/03/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND The aim of this study was to investigate an in vitro dynamic bioreactor model by evaluating the antimicrobial effect of clinically relevant amoxicillin doses on polymicrobial microcosm biofilms derived from subgingival plaque. METHODS Biofilms from pooled subgingival plaque were grown for 108 hours in control and experimental dynamic biofilm reactors. Amoxicillin was subsequently infused into the experimental reactor to simulate the pharmacokinetic profile of a standard 500 mg thrice-daily dosing regimen over 5 days and biofilms were assessed by live/dead staining, scanning electron microscopy, and quantitative polymerase chain reaction. RESULTS Following establishment of the oral microcosm biofilms, confocal imaging analysis showed a significant increase in dead bacteria at 8 hours (p = 0.0095), 48 hours (p = 0.0070), 96 hours (p = 0.0140), and 120 hours (p < 0.0001) in the amoxicillin-treated biofilms compared to the control biofilms. Nevertheless, viable bacteria remained in the center of the biofilm at all timepoints. Significant reductions/elimination in Campylobacter rectus, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, and Peptostreptococcus anaerobius was observed among the amoxicillin-treated biofilms at the 96 and 120 hour timepoints. CONCLUSION A novel in vitro dynamic model of oral microcosm biofilms was effective in modeling the antimicrobial effect of a pharmacokinetically simulated clinically relevant dose of amoxicillin.
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Affiliation(s)
- Srinivas Sulugodu Ramachandra
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Preventive Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Fekade Bruck Sime
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Saiyuri Naicker
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Pingping Han
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Center for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Ryan Sb Lee
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Center for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Steven C Wallis
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason A Roberts
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Division of Anaesthesiology, Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Sašo Ivanovski
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Center for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Ramachandra SS, Wright P, Han P, Abdal‐hay A, Lee RSB, Ivanovski S. Evaluating models and assessment techniques for understanding oral biofilm complexity. Microbiologyopen 2023; 12:e1377. [PMID: 37642488 PMCID: PMC10464519 DOI: 10.1002/mbo3.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
Oral biofilms are three-dimensional (3D) complex entities initiating dental diseases and have been evaluated extensively in the scientific literature using several biofilm models and assessment techniques. The list of biofilm models and assessment techniques may overwhelm a novice biofilm researcher. This narrative review aims to summarize the existing literature on biofilm models and assessment techniques, providing additional information on selecting an appropriate model and corresponding assessment techniques, which may be useful as a guide to the beginner biofilm investigator and as a refresher to experienced researchers. The review addresses previously established 2D models, outlining their advantages and limitations based on the growth environment, availability of nutrients, and the number of bacterial species, while also exploring novel 3D biofilm models. The growth of biofilms on clinically relevant 3D models, particularly melt electrowritten fibrous scaffolds, is discussed with a specific focus that has not been previously reported. Relevant studies on validated oral microcosm models that have recently gaining prominence are summarized. The review analyses the advantages and limitations of biofilm assessment methods, including colony forming unit culture, crystal violet, 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide inner salt assays, confocal microscopy, fluorescence in situ hybridization, scanning electron microscopy, quantitative polymerase chain reaction, and next-generation sequencing. The use of more complex models with advanced assessment methodologies, subject to the availability of equipment/facilities, may help in developing clinically relevant biofilms and answering appropriate research questions.
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Affiliation(s)
- Srinivas Sulugodu Ramachandra
- Centre for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
- Preventive Dental Sciences, College of DentistryGulf Medical UniversityAjmanUnited Arab Emirates
| | - Patricia Wright
- Centre for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
- School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
| | - Pingping Han
- Centre for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
- School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
| | - Abdalla Abdal‐hay
- Centre for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
- Department of Engineering Materials and Mechanical Design, Faculty of EngineeringSouth Valley UniversityQenaEgypt
- Faculty of Industry and Energy Technology, Mechatronics Technology ProgramNew Cairo Technological University, New Cairo‐Fifth SettlementCairoEgypt
| | - Ryan S. B. Lee
- Centre for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
- School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
| | - Saso Ivanovski
- Centre for Orofacial Regeneration, Rehabilitation and Reconstruction (COR3), School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
- School of Dentistry, Faculty of Health and Behavioural SciencesThe University of QueenslandBrisbaneAustralia
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Ramachandra SS, Manchery N, Gupta VV. The aggressive periodontitis quandary: An appeal for naming consistency among researchers and clinicians. J Am Dent Assoc 2023; 154:104-106. [PMID: 36481000 DOI: 10.1016/j.adaj.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 12/12/2022]
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Ramachandra SS, Abdal-Hay A, Han P, Lee RSB, Ivanovski S. Fabrication and characterization of a 3D polymicrobial microcosm biofilm model using melt electrowritten scaffolds. Biomater Adv 2023; 145:213251. [PMID: 36580768 DOI: 10.1016/j.bioadv.2022.213251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/19/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
The majority of current biofilm models or substrates are two-dimensional (2D) and support biofilm growth in the horizontal plane only. Three-dimensional (3D) substrates may support both horizontal and vertical biofilm growth. This study compared biofilm growth quantity and quality between highly porous 3D micrometric fibrous scaffolds and 2D film substrates fabricated from medical grade polycaprolactone (mPCL). Melt electrowriting (MEW), a high-resolution additive manufacturing technology, was employed to design orderly aligned fine (~12 μm) fibre-based 3D scaffolds, while 2D films were fabricated by a casting method. The 3D scaffolds with a controlled pore size of 100 and 250 μm and thickness of ~0.8 mm and 2D films were incubated in pooled saliva collected from six volunteers for 1, 2, 4, 7 and 10 days at 37 °C to facilitate polymicrobial biofilm formation. Crystal violet assay demonstrated greater biofilm biomass in 3D MEW scaffolds than in 2D films. Biofilm thickness in 3D scaffolds was significantly higher compared to the biofilm thickness in 2D films. Both biovolume and substratum coverage of the biofilms was higher in the 3D scaffolds compared to 2D films. Polymeric bridges, pores, and channels characteristic of biofilms could be demonstrated by scanning electron microscopy. 16S rRNA sequencing demonstrated that the polymicrobial biofilms in the 3D scaffolds were able to retain 60-70 % of the original inoculum microbiome after 4 days. The MEW-fabricated 3D fibrous scaffold is a promising substrate for supporting multidirectional biofilm growth and modelling of a polymicrobial microcosm.
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Affiliation(s)
- Srinivas Sulugodu Ramachandra
- School of Dentistry, Centre of Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia; Department of Preventive Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Abdalla Abdal-Hay
- School of Dentistry, Centre of Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia; Department of Engineering Materials and Mechanical Design, Faculty of Engineering, South Valley University, Qena, Egypt; Faculty of Industry and Energy Technology, Mechatronics Technology Program, New Cairo Technological University, New Cairo - Fifth Settlement, Cairo, Egypt
| | - Pingping Han
- School of Dentistry, Centre of Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Ryan S B Lee
- School of Dentistry, Centre of Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Sašo Ivanovski
- School of Dentistry, Centre of Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia.
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Han P, Moran CS, Sulugodu Ramachandra S, Walsh LJ, Ivanovski S. Antibody response to BNT162b2 mRNA vaccine in gingival crevicular fluid. J Periodontol 2023; 94:77-87. [PMID: 35771077 PMCID: PMC9350298 DOI: 10.1002/jper.22-0152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/16/2022] [Accepted: 05/30/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND This prospective cohort study aimed to evaluate the antibody responses in non-invasive gingival crevicular fluid (GCF) and unstimulated whole saliva to the SARS-CoV-2 Spike unit 1 receptor-binding domain (S1-RBD) protein following administration of the mRNA BNT162b2 vaccine. METHODS This longitudinal study recruited 37 participants with no prior COVID-19 exposure (eight people recruited prior to the COVID-19 pandemic - labeled pre-COVID, 16 vaccinated and 13 non-vaccinated participants). An enzyme-linked immunosorbent assay (ELISA) was used to determine antibody levels against S1-RBD in saliva (n=90) and GCF (n=80) samples obtained at 1 and 3 weeks after dose 1, and 3 days, 7 days, and 3 weeks after dose 2. To determine previous SARS-CoV-2 infection status, anti-nucleocapsid (N) Ig levels were determined in samples from the pre-COVID (saliva as reference), non-vaccinated (saliva and GCF), and vaccinated (saliva and GCF) participants at 1-week post-dose 1 using ELISA. RESULTS Salivary levels of anti-N antibodies measured in samples from vaccinated and nonvaccinated participants were comparable to those in pre-COVID saliva samples collected between October 2018 and September 2019, thus confirming that all study participants had no prior SARS-CoV-2 infection. Overall, the levels of anti-S1-RBD antibodies peaked at 3 weeks after dose 2 in both saliva and GCF for all three immunoglobulin isotypes. Notably, the concentration of anti-S1-RBD antibodies in GCF was significantly higher than in saliva at all time points. CONCLUSION This study establishes GCF and saliva as viable alternative non-invasive sources to monitor levels of antibodies following vaccination, with GCF demonstrating feasibility as a biofluid source for the detection of antibodies against SARS-CoV-2 S1-RBD antigen.
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Affiliation(s)
- Pingping Han
- The University of QueenslandSchool of DentistryBrisbaneQLD4006Australia
| | - Corey S. Moran
- The University of QueenslandSchool of DentistryBrisbaneQLD4006Australia
| | | | - Laurence J. Walsh
- The University of QueenslandSchool of DentistryBrisbaneQLD4006Australia
| | - Sašo Ivanovski
- The University of QueenslandSchool of DentistryBrisbaneQLD4006Australia
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Xiang E, Gómez-Cerezo MN, Ali Y, Ramachandra SS, Yang N, Dargusch M, Moran CS, Ivanovski S, Abdal-Hay A. Surface Modification of Pure Zinc by Acid Etching: Accelerating the Corrosion Rate and Enhancing Biocompatibility and Antibacterial Characteristics. ACS Appl Mater Interfaces 2022; 14:22554-22569. [PMID: 35533291 DOI: 10.1021/acsami.2c00918] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Zinc (Zn) has recently been identified as an auspicious biodegradable metal for medical implants and devices due to its tunable mechanical properties and good biocompatibility. However, the slow corrosion rate of Zn in a physiological environment does not meet the requirements for biodegradable implants, hindering its clinical translation. The present study aimed to accelerate the corrosion rate of pure Zn by utilizing acid etching to roughen the surface and increase the substrate surface area. The effects of acid etching on surface morphology, surface roughness, tensile properties, hardness, electrochemical corrosion and degradation behavior, cytocompatibility, direct cell attachment, and biofilm formation were investigated. Interestingly, acid-treated Zn showed an exceptionally high rate of corrosion (∼226-125 μm/year) compared to untreated Zn (∼62 μm/year), attributed to the increased surface roughness (Ra ∼ 1.12 μm) of acid-etched samples. Immersion tests in Hank's solution revealed that acid etching accelerated the degradation rate of Zn samples. In vitro, MC3T3-E1 cell lines in 50 and 25% conditioned media extracts of treated samples showed good cytocompatibility. Reduced bacterial adhesion, biofilm formation, and dispersion were observed for Staphylococci aureus biofilms cultured on acid-etched pure Zn substrates. These results suggest that the surface modification of biodegradable pure Zn metals by acid etching markedly increases the translation potential of zinc for various biomedical applications.
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Affiliation(s)
- Enmao Xiang
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
| | | | - Yahia Ali
- School of Mechanical and Mining Engineering, The University of Queensland, Brisbane, Queensland 4072, Australia
| | | | - Nan Yang
- School of Mechanical and Mining Engineering, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Matthew Dargusch
- School of Mechanical and Mining Engineering, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Corey S Moran
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
| | - Saso Ivanovski
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
| | - Abdalla Abdal-Hay
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
- Department of Engineering Materials and Mechanical Design, Faculty of Engineering, South Valley University, Qena 85325, Egypt
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Priyadarshini V, Ramachandra SS, Ganganna A. Awareness and Attitude Among Physicians’ About Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ): A Cross-sectional study. Curr Drug Saf 2022; 18:361-367. [DOI: 10.2174/1574886317666220514160507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 11/22/2022]
Abstract
Background:
An invasive dental procedure is considered as one of the risk factors for osteonecrosis of the jaw, especially among patients on bisphosphonates. This study aimed to determine the awareness and perceptions of medical practitioners regarding bisphosphonate-related osteonecrosis of the jaw (BRONJ), and their attitude towards dental referrals of such patients.
Methodology:
Methodology: This cross-sectional questionnaire-based study was conducted with medical practitioners in and around Mysore city, Karnataka, India, who commonly prescribe bisphosphonates. The sample included orthopaedic doctors, physicians, endocrinologists, and oncologists- divided based on the duration of practice and speciality. Data on the type of practice, awareness of BRONJ, referral to a dentist before/during therapy, and patient education about adverse effects were collected and analyzed. A p value ≤0.05 was considered statistically significant.
Results:
Among 58 practitioners, 84.5% (49) were aware of the association between bisphosphonates and BRONJ. While 56.9% (33/58) believed dental procedure to be a risk factor, 55.2% (32/58) did not recommend screening of the oral cavity by a dentist before initiation of bisphosphonate therapy. A majority (65.5%) of them educated their patients about adverse effects. Mean knowledge scores varied with specialization (post-graduation vs super specialization= 1.43 vs 2; p = 0.01) but not with the duration of practice (<= 10 years vs >10 years= 1.57 vs 1.4; p= 0.24).
Conclusion:
The practitioners in our study were oblivious to dental procedures' role in the osteonecrosis of the jaw, highlighting the need of continuing education programs regarding BRONJ for medical and dental professionals. Clinicians who are updated about evidence-based practices and working cooperatively in teams may reduce the incidence of medication-related osteonecrosis of the jaw.
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Affiliation(s)
| | - Srinivas Sulugodu Ramachandra
- Ivanovski Tissue Engineering and Additive Manufacturing group(iTEAM)
University of Queensland, 288, Herston Road, Herston
Australia
| | - Aruna Ganganna
- Department of Periodontology, JSS Dental College & Hospital, Bannimantap, Mysuru 570015
JSS Dental College and Hospital
India
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Majid H, Ramachandra SS, Kumar S, Wei M, Gundavarapu KC. Influence of Grafting on Pocket Depth and Dentin Hypersensitivity Around Third Molar Extraction Sites: A Split-Mouth Randomized Controlled Trial. Compend Contin Educ Dent 2022; 43:e5-e8. [PMID: 35019665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study evaluated the effect of alloplastic bone grafts in osseous defects following surgical removal of horizontally impacted third molars by comparing the periodontal measures distal to the second molar in grafted and nongrafted third molar extraction sites. Materials and Methods: A double-blind, randomized, controlled clinical trial was designed on subjects with bilateral horizontally impacted mandibular third molars. Grafting consisting of alloplasts at the third molar extraction sites was compared with nongrafted sites. This study assessed 54 randomized sites in 27 patients who were selected using a split-mouth design. The predictor variable included the change in pocket depth distal to the mandibular second molar and associated dentin hypersensitivity around the second molar, assessed preoperatively and at 3 and 6 months after third molar surgery. The data regarding pocket depth reduction was statistically analyzed using paired t-test. The data concerning reduction in dentin hypersensitivity was statistically analyzed using chi-square test. Results: Six months after third molar surgery, mean pocket depth distal to mandibular second molar decreased significantly at the grafted sites compared to the nongrafted sites. The reduction in dentin hypersensitivity of mandibular second molar was statistically significant for the grafted sites at 6 months, compared to the nongrafted sites.
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Affiliation(s)
- Haydar Majid
- Lecturer, Faculty of Dentistry, SEGi University, Petaling Jaya, Malaysia; Diplomate, International Congress of Oral Implantolgists
| | | | - Saurabh Kumar
- Senior Lecturer, Faculty of Dentistry, SEGi University, Petaling Jaya, Malaysia
| | - Myint Wei
- Senior Lecturer, Faculty of Dentistry, SEGi University, Petaling Jaya, Malaysia; Fellow, International College of Continuing Dental Education
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Han P, Liu C, Staples R, Moran CS, Ramachandra SS, Gómez-Cerezo MN, Ivanovski S. Salivary SARS-CoV-2 antibody detection using S1-RBD protein-immobilized 3D melt electrowritten poly(ε-caprolactone) scaffolds. RSC Adv 2022; 12:24849-24856. [PMID: 36128389 PMCID: PMC9429024 DOI: 10.1039/d2ra03979f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
Sensitive detection of immunoglobulin antibodies against SARS-CoV-2 during the COVID-19 pandemic is critical to monitor the adaptive immune response after BNT162b2 mRNA vaccination. Currently employed binding antibody detection tests using 2D microplate-based enzyme-linked immunosorbent assays (ELISA) are limited by the degree of sensitivity. In this study, a 3D antibody test was developed by immobilizing the receptor-binding domain on Spike subunit 1 (S1-RBD) of SARS-CoV-2 onto engineered melt electrowritten (MEW) poly(ε-caprolactone) (PCL) scaffolds (pore: 500 μm, fiber diameter: 17 μm) using carbodiimide crosslinker chemistry. Protein immobilization was confirmed using X-ray photoelectron spectroscopy (XPS) by the presence of peaks corresponding with nitrogen. Self-developed indirect ELISA was performed to assess the functionality of the 3D platform in comparison with a standard 2D tissue culture plate (TCP) system, using whole unstimulated saliva samples from 14 non-vaccinated and 20 vaccinated participants (1- and 3- weeks post-dose 1; 3 days, 1 week and 3 weeks post-dose 2) without prior SARS-CoV-2 infection. The three-dimensional S1-RBD PCL scaffolds, while demonstrating a kinetic trend comparable to 2D TCP, exhibited significantly higher sensitivity and detection levels for all three immunoglobulins assayed (IgG, IgM, and IgA). These novel findings highlight the potential of MEW PCL constructs in the development of improved low-cost, point-of-care, and self-assessing diagnostic platforms for the detection and monitoring of SARS-CoV-2 antibodies. Our work developed a 3D SARS-CoV-2 antibody detection platform in non-invasive saliva samples using S1-RBD protein-immobilized 3D melt electrowritten poly(ε-caprolactone) scaffolds.![]()
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Affiliation(s)
- Pingping Han
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
| | - Chun Liu
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
| | - Reuben Staples
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
| | - Corey S. Moran
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
| | - Srinivas Sulugodu Ramachandra
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
| | - Maria Natividad Gómez-Cerezo
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
| | - Sašo Ivanovski
- The University of Queensland, School of Dentistry, Brisbane, QLD 4006, Australia
- The University of Queensland, School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), Brisbane, QLD 4006, Australia
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Ramachandra SS, Gupta VV, Muttalib KA. Case sharing - an approach for improving clinical experience to cases of advanced complexity among undergraduate dental students. J Oral Biol Craniofac Res 2020; 11:1-4. [PMID: 33344152 DOI: 10.1016/j.jobcr.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/03/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction/Problem Clinical experience in cases of advanced complexity/rare cases is limited among undergraduate dental students. This commentary narrates a module termed "case sharing", wherein a small group of undergraduate dental students treat/assist, document and present advanced or rare cases to their entire cohort in eight weeks. Approach Undergraduate students perform procedures of straightforward and moderate complexity, and later assisted the clinical specialists during procedures of advanced complexity. students document these cases with clinical photographs and case notes to make presentations that were uploaded in the faculty's online management system to be reviewed by the entire cohort. student groups presented their cases with their entire cohort. an independent assessor assessed the groups for their organization of the case, information collected on the topic, critical analysis of the case, defending the diagnosis and treatment plan, teamwork and presentation skills. Evaluation Students reported improvement in the depth of knowledge on particular diseases/procedures, a better understanding of holistic management of advanced cases, improved rapport, team spirit and communication among group members. they also reported difficulties in recruiting and completing the procedures within eight weeks. Discussion Apart from improving the clinical experience of undergraduate students, the module provides an opportunity for the development of teamwork, communication skills, and ethical presentations among students, which are invaluable to the faculty to meet its programme learning outcomes. case sharing provides a platform for holistic learning and serves as an alternative learning method aside from didactic lectures and routine clinical supervision.
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Ramachandra SS. Letter to the editor: RE: Risk of periodontal disease in patients with asthma: A nationwide population-based retrospective cohort study. J Periodontol 2019; 89:517. [PMID: 29572836 DOI: 10.1002/jper.17-0482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 10/22/2017] [Indexed: 11/05/2022]
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Dicksit DD, Sulugodu Ramachandra S. Sale of tobacco products among minors in a satellite township near Kuala Lumpur, Malaysia. An observational study. Tob Induc Dis 2018. [DOI: 10.18332/tid/83984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ramachandra SS, Gupta VV, Mehta DS, Gundavarapu KC, Luigi N. Differential Diagnosis between Chronic versus Aggressive Periodontitis and Staging of Aggressive Periodontitis: A Cross-sectional Study. Contemp Clin Dent 2018; 8:594-603. [PMID: 29326511 PMCID: PMC5754981 DOI: 10.4103/ccd.ccd_623_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Differentiating between chronic periodontitis (CP) and aggressive periodontitis (AgP) is challenging. The aim of this study was to assess the variations in diagnosis between CP versus AgP and the staging of AgP based on the disease-staging index for AgP among periodontists, specialists in oral medicine, and general dental practitioners (GDPs). Materials and Methods Fifteen cases diagnosed as either CP or AgP were included in a "case document" and sent electronically to 75 respondents. Case document included a detailed history with periodontal charting, clinical features, images, and radiographs for all the cases. Diagnosis and staging for the case (if diagnosed as AgP) were requested. A reordered case document (cases in a different sequence) was again sent to respondents after a gap of 1 month. Statistical analysis Descriptive statistics including frequency and percentage were calculated. Pearson's Chi-square test was used to analyze the data collected. Results For the "case document," 10.17% of the responses were different from those of the authors for diagnosis, whereas 4.48% of the responses were different from those of the authors for the staging of AgP. The agreement in the overall responses was in the range of 0.69-0.84, which was considered good. Comparison of the responses for diagnosis showed statistically significant (P = 0.009) difference between specialists in oral medicine and GDPs. Conclusions Variations exist among respondents regarding the diagnosis of CP versus AgP. Staging of AgP based on the listed criteria showed low variations.
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Affiliation(s)
| | | | - Dhoom Singh Mehta
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | | | - Nibali Luigi
- Centre for Immunobiology & Regenerative Medicine, Centre for Oral Clinical Research, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Arora S, Ramachandra SS, Squier C. Knowledge about human papillomavirus (HPV) related oral cancers among oral health professionals in university setting-A cross sectional study. J Oral Biol Craniofac Res 2017; 8:35-39. [PMID: 29556461 DOI: 10.1016/j.jobcr.2017.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 12/03/2017] [Indexed: 01/07/2023] Open
Abstract
Introduction Scientific literature suggests that human papillomavirus (HPV) infection may be associated with oral squamous cell carcinoma (OSCC). However, knowledge regarding HPV-OSCC link among oral health professionals (OHP) has been insufficient. So, the aim of this study was to assess the knowledge about HPV associated OSCC among OHP working in dental faculties in Malaysia. Methodology Ethical committee of the University approved this study. A validated, pre-tested questionnaire was sent electronically to 224 OHP. Questionnaire collected information regarding demography, knowledge about HPV-OSCC link, HPV vaccine, and willingness to educate patients about HPV OSCC link among the participants of this cross-sectional study. Data collected was analysed using "Stata/IC-13" and was summarised using descriptive statistics like frequency, percentage, mean and standard deviation. Results Out of 179 participants, around 39% of the participant's opined virus was not a causative factor for OSCC. Around, 44% replied posterior portion of the tongue/oro-pharynx was the commonest site for HPV related OSCC, whereas 29% replied that lateral border of the tongue was the common site for HPV related OSCC. Forty one percent educated patients regarding HPV infection being a causative factor for OSCC. HPV vaccine can prevent OSCC was stated by 70% OHP. Only 12% were aware of the availability of HPV vaccine in Malaysia. Majority (99%), agreed that there is a need to offer continuing education programmes to dentists highlighting advances and preventive strategies in the fight against OSCC. Conclusion Substantial increase in awareness is required among OHP regarding HPV-OSCC link.
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Affiliation(s)
| | | | - Christopher Squier
- Department of Oral Pathology, Radiology & Medicine, College of Dentistry & Dental Clinics, University of Iowa, USA
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Kumar Singh A, Sulugodu Ramachandra S, Arora S, Dicksit DD, Kalyan CG, Singh P. Prevalence of oral tori and exostosis in Malaysian population - A cross-sectional study. J Oral Biol Craniofac Res 2017; 7:158-160. [PMID: 29123992 DOI: 10.1016/j.jobcr.2017.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/31/2017] [Indexed: 10/18/2022] Open
Abstract
Introduction Oral tori and exostosis are non-pathological bony protuberances seen on the alveolar surfaces of the jaw bones. These are commonly seen on the palatal surfaces of the maxilla [torus palatinus (TP)] and around the premolars in the lingual surface of the mandible [torus mandibularis (TM)]. The aim of this cross-sectional study was to determine the prevalence of tori/exostosis in the Malaysian population. Methodology A total of 2666 patients were examined for the presence of tori and exostosis in the maxilla and mandible and were categorized into TP, TM, and exostosis (facial/labial). Collected data was analysed for obtaining descriptive statistics. Results 882 subjects were noticed with oral tori/exostosis among the population studied with a prevalence rate of 33%. TP was seen more in females (35%), compared to males (20%), and this difference was statistically significant (p value < 0.001). Highest prevalence of TP was seen in Malays (43%), followed by Chinese (31%) and Indians (21%), which was statistically significant (p value < 0.00). Discussion High prevalence of tori and exostosis was seen in the population studied. Though harmless, in certain circumstances, their presence necessitates changes in the denture design during fabrication of prosthesis, which the dentist should be mindful.
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Affiliation(s)
| | | | - Shelly Arora
- Faculty of Dentistry, SEGi University, Selangor, Malaysia
| | | | - C G Kalyan
- Faculty of Dentistry, SEGi University, Selangor, Malaysia
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Yaldrum A, Ramachandra SS, Arora S, Gujjar KR, Dicksit DD, Squier CA. Knowledge, attitude and willingness to counsel patients regarding e-cigarettes among academic health professionals in Malaysia. Tob Prev Cessat 2017; 3:6. [PMID: 32432181 PMCID: PMC7232795 DOI: 10.18332/tpc/68748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Ali Yaldrum
- SEGi University, Faculty of Dentistry, Selangor, Malaysia
| | | | - Shelly Arora
- SEGi University, Faculty of Dentistry, Selangor, Malaysia
| | | | | | - Christopher A Squier
- University of Iowa, College of Dentistry & Dental Clinics, Department of Oral Pathology, Radiology & Medicine, Iowa, U.S.A
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Ramachandra SS, Dopico J, Donos N, Nibali L. Disease Staging Index for Aggressive Periodontitis. Oral Health Prev Dent 2017; 15:371-378. [PMID: 28831460 DOI: 10.3290/j.ohpd.a38746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Major advances in the knowledge about the aetiopathogenesis of aggressive periodontitis (AgP) have been achieved. An ever increasing number of scientific articles related to AgP are published every year contributing significantly to the knowledge of this unique and complex disease. AgP has been classified into localised and generalised forms based on their extent and disease progression with distinct clinical and radiological features. A classification of AgP based on severity (mild, moderate and severe) exists; however, it is not easily applicable. Therefore, studies on AgP do not categorise the disease based on severity. A disease staging index for AgP is proposed based on clinical and radiological features, as well as risk factors. Based on the presence or absence of risk factors confirmed by longitudinal studies, cases of AgP can be divided into low risk, medium risk and high risk profiles for disease progression. Clinicians can devise a broad treatment plan for their AgP cases based on this staging. More frequent recall intervals are proposed for patients at medium and high risk for disease progression. Ten cases of AgP with 10-year follow-up were used to validate the staging index by retrospectively assigning prognosis and associating it with tooth loss. The use of this staging by researchers would increase external validity of research on AgP. Long-term analysis of AgP cases are needed to validate this staging index longitudinally.
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Arora S, Ramachandra SS, Abdullah F, Gundavarapu KC. Interleukin 1β (+3954; -511) Genotype Polymorphism and its Association with Severe Chronic Generalized Periodontitis in the Malaysian Population. Contemp Clin Dent 2017; 8:102-105. [PMID: 28566859 PMCID: PMC5426139 DOI: 10.4103/ccd.ccd_1177_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction: Single-nucleotide polymorphisms (SNPs) in interleukin 1β (IL-1β) gene have been known to be associated with increased susceptibility to chronic periodontitis among various ethnic populations. SNPs are more commonly observed at loci + 3954 and − 511. The aim of this study was to evaluate the role of IL-1β gene polymorphism at loci +3954 and − 511, and its association with severe chronic generalized periodontitis among the ethnic Malay, Chinese, and Indians within the Malaysian population. Materials and Methods: Saliva samples from 120 subjects (60 cases and 60 controls) in the age group of 25–50 years were collected for isolation of genetic material using Norgen technique. Clinical attachment loss of ≥5 mm was considered as severe chronic generalized periodontitis. SNP's at loci +3954 and − 511 were identified and analyzed using Kompetitive Allele Specific Polymerase Chain Reaction Genotyping System (KASP™). Differences in the allele/genotype frequencies were assessed by Chi-square test (P < 0.05). Results: On the comparison between cases and controls of IL-1β genotype polymorphism (+3954 and − 511), the difference in the genotype frequencies was statistically insignificant in all the three ethnicities. The genotype frequency in both groups in all three ethnicities of the Malaysian population was similar. Conclusion: IL-1β genotype polymorphism at +3954 and − 511 was found to be not associated with severe chronic generalized periodontitis among the three ethnicities in Malaysia. Studies with larger sample size should be done to confirm the findings of this study.
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Affiliation(s)
- Shelly Arora
- Faculty of Dentistry, SEGi University, Selangor, Malaysia
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Malhotra N, Gupta VV, Ramachandra SS. Diagnosis: the difficult part! Dent Update 2016; 43:986. [PMID: 29155545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Singh R, Ramachandra SS. Resective or Regenerative Periodontal Therapy: Considerations during Treatment Planning: A Case Report. N Y State Dent J 2016; 82:46-49. [PMID: 30561962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Successful long-term management of molars having advanced periodontal disease with secondary endodontic involvement is a challenge to the periodontist. Several treatment options exist for the periodontist based upon various factors. A patient with a deep periodontal pocket on the right mandibular first molar reported for dental treatment. Periapical radiographs revealed bone loss extending to the apex of the mesial root. The treatment plan included scaling, root planing, endodontic therapy and periodontal surgery for the involved tooth. During periodontal surgery, resective and regenerative treatment options were evaluated and explained to the patient. Considering the prognosis of the case, risk-benefit ratio and the patient's choice, regenerative periodontal therapy was performed. The case has been followed for two years, with gain in clinical attachment and radibgraphic bone fill. The authors discuss factors to be considered when choosing regenerative periodontal therapy over resective periodontal therapy.
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Simon SS, Ramachandra SS, Abdullah DDF, Islam MN, Kalyan CG. Lessons learned from the disruption of dental training of Malaysian students studying in Egypt during the Arab spring. Educ Health (Abingdon) 2016; 29:124-127. [PMID: 27549650 DOI: 10.4103/1357-6283.188753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Political crisis and worsening security situation in Egypt in late 2013 resulted in Malaysian students who were pursuing their dental education in Egypt being recalled home to Malaysia. The Ministry of Higher Education in Malaysia took steps to integrate these students into public and private universities in Malaysia. METHODS We used a questionnaire and informal interviews to learn from students returning from Egypt about their experiences transitioning from dental schools in Egypt to Malaysia. RESULTS We discuss the challenges students faced with regards to credit transfer, pastoral care, the differences in the curriculum between the dental faculties of the two nations, and the financial implications of this disruption of their training. DISCUSSION We live in a fragile world where similar political situations will surely arise again. The approaches used by the Malaysian government and the lessons learned from these students may help others. The perspectives of these students may help educators reintegrate expatriate students who are displaced by political instability back into the education system of their own countries.
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Affiliation(s)
- Sibu Sajjan Simon
- Department of Dental Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | | | | | - Md Nurul Islam
- Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
| | - C G Kalyan
- Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
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Abstract
BACKGROUND AND OBJECTIVES Various extraction protocols have been followed for successful orthodontic treatment. The purpose of this study was to evaluate the extraction protocols in patients who had previously undergone orthodontic treatment and also who had reported for continuing orthodontic treatment from other clinics. MATERIALS AND METHODS One hundred thirty eight patients who registered for orthodontic treatment at the Faculty of Dentistry were divided into 10 extraction protocols based on the Orthodontic treatment protocol given by Janson et al. and were evaluated for statistical significance. RESULTS The descriptive statistics of the study revealed a total of 40 (29%) patients in protocol 1, 43 (31.2%) in protocol 2, 18 (13%) in protocol 3, 16 (11.6%) in protocol 5, and 12 (8.7%) in Type 3 category of protocol 9. The Type 3 category in protocol 9 was statistically significant compared to other studies. Midline shift and collapse of the arch form were noticed in these individuals. CONCLUSION Extraction of permanent teeth such as canine and lateral incisors without rational reasons could have devastating consequences on the entire occlusion. The percentage of cases wherein extraction of permanent teeth in the crowded region was adopted as a treatment option instead of orthodontic treatment is still prevalent in dental practice. The shortage of orthodontists in Malaysia, the long waiting period, and lack of subjective need for orthodontic treatment at an earlier age group were the reasons for the patient's to choose extraction of the mal-aligned teeth such as the maxillary canine or maxillary lateral incisors.
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Ramachandra SS, Mahdey HM. 'Don't bite off more than you can chew'. ACTA ACUST UNITED AC 2016; 42:688. [PMID: 26630869 DOI: 10.12968/denu.2015.42.7.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ramachandra SS, Singh AK. The other side of facial cosmetic surgery. ACTA ACUST UNITED AC 2015; 42:687-8. [PMID: 26630868 DOI: 10.12968/denu.2015.42.7.687a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26-28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed.
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Affiliation(s)
- Daniel Wong
- Faculty of Dentistry, SEGi University, Selangor, Malaysia
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Rana R, Ramachandra SS, Prasad UC, Aggarwal P, Dayakara JK. Recurrent pyogenic granuloma with a satellite lesion. Cutis 2015; 96:E27-E30. [PMID: 26367761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pyogenic granuloma (PG) is a tumorlike growth of the oral mucosa or skin that is considered to be an exaggerated conditioned response to minor trauma. It usually is painless, bleeds easily, and is considered to be nonneoplastic in nature. Pyogenic granuloma predominantly occurs in the second decade of life, mostly among young adult females. Clinically, it is a smooth or lobulated exophytic lesion manifesting as small, red, erythematous papules on a pedunculated or sometimes sessile base that usually is hemorrhagic. We report the case of 30-year-old woman who presented with a PG in the anterior palatal region during pregnancy that recurred with a satellite lesion 1 year following surgical excision.
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Affiliation(s)
| | - Srinivas Sulugodu Ramachandra
- Faculty of Dentistry, SEGi University, No. 9 Jalan Teknologi, Taman Sains, Kota Damansara, Petaling Jaya, Selangor, Malaysia Pin-47810.
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Affiliation(s)
- S S Ramachandra
- Faculty of Dentistry, SEGi University, No. 9, Jalan Teknologi, Taman Sains Selangor, Kota Damansara, PJU 5, 47810 Petaling Jaya, Selangor, Malaysia
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Abstract
Ideal alveolar ridge width and height allows placement of a natural appearing pontic, which provides maintenance of a plaque-free environment. The contour of a partially edentulous ridge should be thoroughly evaluated before a fixed partial denture is undertaken. Localized alveolar ridge defect refers to a volumetric deficit of the limited extent of bone and soft-tissue within the alveolar process. These ridge defects can be corrected by hard tissue and/or soft-tissue augmentation. A 30-year-old male patient was referred to the Department of Periodontology for correction of Seibert's Class III ridge defect in the lower anterior region. Granulation tissue/connective tissue present at the base of the defect was removed after elevation of full thickness flap. MucoMatrixX, an animal derived, collagen based soft-tissue graft was sutured to the labial flap and bone graft was placed into the defect. If a soft-tissue graft material could be used to replace the palatal grafts, then all the possible complications associated with donor site would be eliminated and above all periodontal plastic surgery and ridge augmentation would be better accepted by patients.
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Affiliation(s)
- Ritu Rana
- Department of Periodontology, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India
| | | | - Manesh Lahori
- Department of Prosthodontics, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India
| | - Reetika Singhal
- Department of Periodontology, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India
| | - K D Jithendra
- Department of Periodontology, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India
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Sulugodu Ramachandra S. Low levels of caries in aggressive periodontitis: A literature review. Saudi Dent J 2013; 26:47-9. [PMID: 25408595 DOI: 10.1016/j.sdentj.2013.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 10/30/2013] [Accepted: 12/03/2013] [Indexed: 12/20/2022] Open
Abstract
This article is a traditional literature review on caries levels in aggressive periodontitis. Aggressive periodontitis generally affects systemically healthy individuals aged <30 years (older individuals can also be affected) and is characterized by a young age of onset, rapid rate of disease progression, and familial aggregation of cases. Dental caries is caused by the dissolution of enamel by acid-producing bacteria present in the plaque biofilm, especially when the biofilm reaches critical mass due to improper oral hygiene. The association between caries level and aggressive periodontitis has long been debated. Initial research indicated that caries levels were high in patients with aggressive periodontitis, but high-quality studies have consistently shown that caries and aggressive periodontitis are inversely related. A recent in vitro study showed that Streptococcus mutans was killed more readily in the saliva of patients with aggressive periodontitis and Aggregatibacter actinomycetemcomitans positivity than in patients with A. actinomycetemcomitans negativity. Other mechanisms possibly explaining the inverse relationship between caries and aggressive periodontitis in cases of Down's syndrome are also discussed in this literature review. The usefulness of caries level in the diagnosis of aggressive periodontitis in developing countries such as India, where the disease is diagnosed primarily on the basis of clinical and radiographic features and familial history is also discussed.
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Dadlani H, Ramachandra SS, Mehta DS. Spontaneous correction of pathologically migrated teeth with periodontal therapy alone. J Indian Soc Periodontol 2013; 17:531-4. [PMID: 24174739 PMCID: PMC3800422 DOI: 10.4103/0972-124x.118331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 07/17/2013] [Indexed: 11/12/2022] Open
Abstract
Pathological tooth migration is a characteristic sign of an advanced form of chronic periodontitis. The etiology of pathological tooth migration is complex and multifactorial. Usually treatment of pathological migration includes a multidisciplinary approach. However, in some cases, spontaneous repositioning of the pathologically migrated teeth has been reported following periodontal therapy alone. In the present report, following periodontal surgery, there was a spontaneous repositioning of the migrated teeth and restoration of dento-facial esthetics. The treatment options in cases of pathological tooth migration, based on the severity, are also discussed.
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Affiliation(s)
- Himanshu Dadlani
- Department of Periodontics, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
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Baliga V, Gopinath VPK, Baliga S, Ramachandra SS, Jithendra KD, Shetty S. Intraoral manifestations in a patient with Epidermal nevus syndrome. J Contemp Dent Pract 2013; 14:762-765. [PMID: 24309363 DOI: 10.5005/jp-journals-10024-1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM To report rare findings of oral and periodontal manifestations in a patient with Epidermal nevus syndrome (ENS). BACKGROUND The ENS describes the rare association of an epidermal nevus with abnormalities of central nervous system,ocular and skeletal abnormalities. Reports of oral involvement have been few. Also, most of the intraoral lesions have been reported in patients with nevi that do not fulfill the criteria for the diagnosis of ENS. CASE DESCRIPTION This report describes a case of ENS that, in addition to cutaneous manifestations showed skeletal involvement and intraoral manifestations such as the extension of the nevi on the face intraorally involving the labial mucosa, hypoplasia, hypodontia of teeth and severe periodontal destruction. CONCLUSION Patients with extensive epidermal nevi and systemic abnormalities should be suspected of having the ENS. Evaluation and management of patients with ENS requires a multidisciplinary team approach involving the dermatologist, pediatrician, ophthalmologist, neurologist, genetist, plastic surgeon and orthopedic services. Although uncommonly described in association with ENS, significant intraoral lesions do occur. Periodontal manifestations as in our patient, which to our knowledge has not been described in association with ENS so far, may also be present. CLINICAL RELEVANCE Alteration of the response of periodontal tissues to dental plaque in the presence of certain systemic diseases has been reported, but not in association with ENS. Severe periodontal destruction due to exaggerated response to dental plaque was seen in the present case. Hence, emphasis on oral hygiene maintenance in such patients is essential. Patients with ENS must be evaluated periodically as they show a persistent predisposition for the development of tumors.
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Affiliation(s)
- Vidya Baliga
- Reader, Department of Periodontics, Sharad Pawar Dental College and Hospital, Sawangi (Meghe), Wardha, Maharashtra, India, e-mail:
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Ramachandra SS, Rana R, Jithendra KD. Digital radiography during implant osteotomy. J Calif Dent Assoc 2013; 41:469. [PMID: 24024290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Ramachandra SS, Hegde M, Prasad UC. Gingival enlargement and mesiodens associated with generalized aggressive periodontitis: a case report. ACTA ACUST UNITED AC 2012; 39:364-6, 369. [PMID: 22852514 DOI: 10.12968/denu.2012.39.5.364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED This case report describes the management of an 18-year-old female who presented with generalized aggressive periodontitis, gingival enlargement and a mesiodens. Diagnosis for aggressive periodontitis was determined based on history, clinical findings and radiographic examination. Treatment included oral prophylaxis, extraction of the mesiodens and elimination of infectious microorganisms, using a combination of surgical intervention and antimicrobial therapy with long-term maintenance. CLINICAL RELEVANCE Presence of gingival enlargement in cases of aggressive periodontitis may be clinically confusing; hence, the diagnosis should always be based on the patient's history as well as the clinical and radiographic findings.
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Das M, Upadhyaya V, Ramachandra SS, Jithendra KD. Periodontal treatment needs in diabetic and non-diabetic individuals: a case-control study. Indian J Dent Res 2012; 22:291-4. [PMID: 21891902 DOI: 10.4103/0970-9290.84307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Diabetes mellitus is a chronic metabolic disorder of the carbohydrate, protein and fat metabolism, resulting in increased blood glucose levels. Various complications of diabetes have been described with periodontitis being added as the sixth complication of diabetes mellitus. The aim of this study was to assess periodontal status and treatment needs (TN) in diabetic patients and to compare the findings between diabetic and non-diabetic individuals using community periodontal index (CPI). MATERIALS AND METHODS We evaluated the periodontal status and periodontal TN in diabetic and non-diabetic individuals in Guwahati, Assam. A total of 459 (223 diabetic and 236 non-diabetic) individuals were assessed. A person was considered to be diabetic when his blood glucose levels were above 140 mg/dl under fasting condition and 200 mg/dl 2 hours postprandially. Periodontal status was assessed using CPI. RESULTS Periodontal destruction was found to be increased in diabetic individuals, with periodontal destruction increasing with increased blood glucose levels. The necessity of complex periodontal treatment also increased with increasing blood glucose levels. CONCLUSIONS Individuals with diabetes are more prone to periodontal destruction, and hence, regular periodontal screening and treatment is essential in these individuals.
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Affiliation(s)
- Manas Das
- Department of Periodontics, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India.
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Rao M, Ramachandra SS, Bandyopadhyay S, Chandran A, Shidhaye R, Tamisettynarayana S, Thippaiah A, Sitamma M, Sunil George M, Singh V, Sivasankaran S, Bangdiwala SI. Addressing healthcare needs of people living below the poverty line: a rapid assessment of the Andhra Pradesh Health Insurance Scheme. Natl Med J India 2011; 24:335-341. [PMID: 22680257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. METHODS Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. RESULTS This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. CONCLUSION An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme.
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Affiliation(s)
- M Rao
- University of East London, London, UK
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Ramachandra SS, Baliga V, Prasad UC. Peripheral odontogenic fibroma associated with a dilacerated maxillary central incisor: a case report. Compend Contin Educ Dent 2011; 32:e120-e124. [PMID: 23738522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The authors report a case of a 16-year-old male with peripheral odontogenic fibroma (POF) in the anterior maxilla associated with dilaceration of a tooth in its vicinity. A solitary, exophytic and sessile growth was present between the maxillary right central and lateral incisors and extended from the labial mucosa to the palatal gingiva. A periapical radiograph of the maxillary right central incisor revealed a shortened and dilacerated root. The growth was excised and sent for histopathologic examination. A diagnosis of POF (World Health Organization type) was rendered. The clinical and microscopic features are discussed.
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Sharma S, Anamika S, Ramachandra SS. Peripheral ossifying fibroma: a clincal report. Compend Contin Educ Dent 2011; 32:E86-E90. [PMID: 23738938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Peripheral ossifying fibroma (POF) is a common solitary gingival overgrowth thought to arise from the gingival corium, periosteum, and periodontal ligament. Commonly used synonyms for POF include calcifying fibroblastic granuloma, peripheral fibroma with calcification, peripheral cementifying fibroma, and calcifying or ossifying fibrous epulis. Because it is possible to misdiagnose POF as pyogenic granuloma, peripheral giant cell granuloma, or odontogenic tumors, histopathological examination is, therefore, essential for accurate diagnosis, and differential diagnosis is important because of POF's tendency to recur. This article presents a case of peripheral ossifying fibroma in a 15-year-old female along with the clinical, histopathologic, and radiographic features and treatment details.
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Affiliation(s)
- Shivani Sharma
- Department of Periodontics, Subharti Dental College, Meerut, Uttar Pradesh, India
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Ramachandra SS, Mehta DS, Sandesh N, Baliga V, Amarnath J. Periodontal probing systems: a review of available equipment. Compend Contin Educ Dent 2011; 32:71-77. [PMID: 21473303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The periodontal pocket, one of the definitive signs of periodontal disease, is the most common parameter to be assessed by dental clinicians. Periodontal probes have been the instruments most commonly used to locate and measure these pockets. Regular use of periodontal probes in routine dental practice facilitates and increases the accuracy of the process of diagnosing the condition, formulating the treatment, and predicting the outcome of therapy. Advances in the field of periodontal probing have led to the development of probes that may help reduce errors in determining this parameter used to define the state of active periodontal disease. One such advance is the emergence of probes that purportedly assess periodontal disease activity noninvasively. The selection of periodontal probe depends on the type of dental practice: a general dental practitioner would require first- or second-generation probes, while third- through fifth-generation probes generally are used in academic and research institutions as well as specialty practices.
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Ramachandra SS, Ramachandra SS, Rao M. Need for community water fluoridation in areas with suboptimal fluoride levels in India. Perspect Public Health 2010; 130:211-2. [PMID: 21086815 DOI: 10.1177/1757913910379188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dr Srinivas Sulugodu Ramachandra, Senior Lecturer at Kanti Devi Dental College, Dr Srikrishna Sulgodu Ramachandra, Assistant Professor at the Public Health Foundation of India, and Dr Mala Rao, Director of the Indian Institute of Public Health, argue that oral health is being neglected in the world’s second most populous country
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Baliga V, Ramachandra SS, Baliga S, Jithendra KD. Extra buccal cusp. Dent Update 2010; 37:339. [PMID: 20669715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ramachandra SS, Hans MK, Shetty SB. Vertical root fracture--a diagnostic dilemma. Dent Update 2010; 37:338. [PMID: 20669714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ramachandra SS, Baliga V, Jithendra KD. Peg-shaped mandibular central incisor. Dent Update 2009; 36:439-441. [PMID: 19824184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ramachandra SS, Patil M, Mehta DS. Implants placed into extraction sockets: a literature review. Dent Implantol Update 2009; 20:1-8. [PMID: 19216316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Jithendra KD, Bansali A, Ramachandra SS. Failures in periodontal therapy. Bangladesh J Med Sci 1970. [DOI: 10.3329/bjms.v9i4.6680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Studies have shown that modern periodontal therapies are effective in maintaining a healthy natural dentition as well as controlling periodontal disease. Numerous treatment strategies and various techniques have been designed & described to treat periodontal disease. Most of these procedures had drawbacks which were identified, leading to the modifications of the original techniques which lead to better treatment options, but still very less emphasis has been laid on failures. Without a regular program of clinical re-evaluation, plaque control, oral hygiene instructions, and reassessment of biomechanical factors the benefits of treatment are often lost and inflammatory disease in the form of recurrent periodontitis may result. So, this review describes the most common failures noticed in periodontal therapies and also discusses the possible solutions to reduce the incidence of failures in periodontal therapy.Key words: Periodontal therapy; risk factors; failures.DOI: 10.3329/bjms.v9i4.6680Bangladesh Journal of Medical Science Vol.09 No.4 July 2010 pp.193-198
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