Academia Journal of Medicine (AJM) is an open-access; freely accessible, online and print Bi-Annual peer-reviewed international journal publishes a wide spectrum of advanced research in different fields of clinical medicine, covering etiology, diagnosis, therapy and prognosis aspects. Online ISSN: 2663-8290 | Print ISSN: 2663-8282
Indications for Zygomatic Implants: A Narrative Review
Zygomatic implants represent a reliable graftless solution for the rehabilitation of patients with severe maxillary bone deficiency. Originally developed for maxillary defects following tumor resection, their clinical indications have expanded considerably with advances in surgical techniques and prosthetic protocols. This narrative review aims to summarize and critically discuss the contemporary indications for zygomatic implants based on evidence synthesized from recent systematic reviews and key clinical studies. Severe maxillary atrophy remains the most common indication, followed by avoidance of bone grafting procedures, management of failed grafts or implants, oncologic and traumatic defects, congenital anomalies, and medically compromised patients. Despite high reported survival rates, zygomatic implant therapy is technique sensitive and requires careful patient selection and surgical expertise. Standardization of indication criteria and high-quality prospective studies are needed to further refine clinical guidelines.
Regenerative Endodontics: Biological Basis, Clinical Protocols, and Outcomes
Regenerative endodontic procedures have emerged as a paradigm-shifting approach in the management of immature permanent teeth with pulp necrosis, offering a biologically driven alternative to traditional apexification techniques. Unlike conventional approaches that merely create an apical barrier, regenerative strategies aim to restore functional pulp like tissue within the root canal system, thereby promoting continued root development, dentinal wall thickening, and apical closure. The biological foundation of regenerative endodontics rests upon three fundamental pillars of tissue engineering: stem cells, bioactive scaffolds, and growth factors. Stem cells of the apical papilla, surviving within the periapical region even after pulp necrosis, represent a critical cellular resource capable of differentiating into odontoblast-like cells and contributing to the formation of mineralized tissue. Clinical protocols have evolved considerably since the earliest case reports, with contemporary guidelines emphasizing thorough canal disinfection using minimally cytotoxic irrigants and intracanal medicaments, followed by the intentional induction of a blood clot scaffold through periapical instrumentation. Bioactive materials such as mineral trioxide aggregate and bioceramic cements serve as coronal barriers, providing a biocompatible seal that supports tissue regeneration. Reported clinical outcomes include resolution of periapical pathology, continued root lengthening, increased root wall thickness, and apical closure, although the histological nature of the regenerated tissue remains a subject of ongoing investigation. This narrative review comprehensively examines the biological underpinnings, contemporary clinical protocols, and documented outcomes of regenerative endodontic procedures, while critically evaluating current controversies, limitations, and future directions in this rapidly evolving field.
Regenerative endodontics; revascularization; stem cells; apical papilla; tissue engineering; immature teeth; pulp regeneration
Tobacco and Tobacco-Related Oral Lesions: Current Concepts and Updates
Tobacco use remains a leading preventable cause of morbidity and mortality worldwide and is strongly linked to numerous oral mucosal lesions, ranging from reversible keratotic changes to Oral squamous cell carcinoma. Both smoked and smokeless tobacco damage oral tissues through chemical, thermal, and immunologic mechanisms. Emerging products such as electronic cigarette and heat-not-burn device present new challenges for dental professionals. Tobacco-related lesions include smoker’s palate, tobacco pouch keratosis, oral leukoplakia, erythroplakia, oral submucous fibrosis, and OSCC, many classified as oral potentially malignant disorders. Early detection is essential to reduce malignant transformation and improve prognosis. Advances in molecular biology and salivary diagnostics, including biomarker and immunologic testing, have enhanced early identification. Dental professionals play a vital role in screening, patient education, tobacco cessation counseling, and timely intervention to improve overall oral and systemic health outcomes.
Tobacco, Oral potentially malignant disorders, Oral leukoplakia, Oral submucous fibrosis, Smokeless tobacco, Oral cancer
Clinical Outcomes Of Curcumin And Ornidazole Gel As Adjuncts To Nonsur gical Periodontal Therapy
Background: Local drug delivery systems are frequently used as adjuncts to scaling and root planing (SRP) to improve clinical outcomes in the management of chronic periodontitis. Curcumin, a naturally derived anti-inflammatory and antimicrobial agent, has emerged as a potential alternative to conventional antimicrobials such as ornidazole. Aim: To comparatively evaluate the clinical efficacy of curcumin gel and ornidazole gel as adjuncts to nonsurgical periodontal therapy in patients with chronic periodontitis. Materials and Methods: This randomized split-mouth clinical study was conducted on twenty systemically healthy individuals of both sexes aged 30–45 years, diagnosed with chronic periodontitis and presenting with bilateral periodontal pockets ≥5 mm. Following full-mouth scaling and root planing, curcumin gel and ornidazole gel were locally delivered into periodontal pockets in symmetric quadrants. Clinical parameters including plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline and at 30 days post-treatment. Results: Both treatment groups showed significant improvement in all clinical parameters at the 1-month follow-up. However, sites treated with curcumin gel demonstrated a statistically greater reduction in PPD and PI, along with superior CAL gain, compared to sites treated with ornidazole gel. Conclusion: Within the limitations of the present study, curcumin gel showed more favorable clinical outcomes than ornidazole gel when used as an adjunct to scaling and root planing. Curcumin may therefore be considered an effective and biocompatible adjunct in the nonsurgical treatment of chronic periodontitis.
Curcumin, Ornidazole, Local drug delivery, Scaling and root planning
Evaluation of White Spot Lesions Following Fixed Orthodontic Treatment: A Clinical Study
Background: White spot lesions are a common undesirable effect associated with fixed orthodontic treatment due to prolonged plaque accumulation around brackets and bands. These lesions represent early enamel demineralization and may compromise esthetics and long-term oral health. Aim: To evaluate the prevalence and severity of white spot lesions in patients following fixed orthodontic treatment. Materials and Methods: This clinical study was conducted on patients who had completed fixed orthodontic treatment. A total of 60 subjects were examined immediately after debonding. The presence and severity of white spot lesions were assessed using visual examination under standardized lighting conditions and scored according to the International Caries Detection and Assessment System (ICDAS). The distribution of lesions was analyzed with respect to tooth type and surface involved. Statistical analysis was performed using descriptive statistics and chi-square test. Results: White spot lesions were observed in a significant proportion of patients following fixed orthodontic therapy. Maxillary anterior teeth showed a higher prevalence compared to posterior teeth. The majority of lesions were classified as early enamel changes without cavitation. A statistically significant association was found between treatment duration and occurrence of white spot lesions (p < 0.05). Conclusion: White spot lesions remain a prevalent complication following fixed orthodontic treatment. Early detection and preventive strategies are essential to minimize enamel demineralization during orthodontic therapy. Clinical Significance: Regular monitoring, patient motivation, and the use of preventive measures such as fluoride applications can reduce the incidence and severity of white spot lesions during fixed orthodontic treatment.
White spot lesions, Fixed orthodontic treatment, Enamel demineralization, Orthodontic brackets, ICDAS, Preventive dentistry
Case Report on Capillary Hemangioma of the Maxillofacial Region
Capillary hemangiomas are benign vascular proliferations that commonly present in childhood but can persist or appear in adulthood. This case report discusses a rare presentation of an extensive capillary hemangioma involving the maxillofacial region. The patient presented with progressive swelling over three months, with significant facial asymmetry. Diagnosis was confirmed through clinical, radiological, and histopathological examination. The lesion was surgically excised, with post-operative recovery documented. This case highlights the clinical presentation, diagnostic approach, and surgical management of capillary hemangiomas in the maxillofacial region. A comprehensive discussion is included to explore the histopathological features, pathogenesis, differential diagnoses, psychosocial considerations, and therapeutic approaches including current advancements and consensus guidelines.
Capillary Hemangioma, Vascular Tumor, Maxillofacial Swelling, ISSVA classification, Surgical Excision, Immunohistochemistry, MRI, Psychosocial Impact
Comparative Evaluation of the Efficacy and Onset of Local Anesthesia Using Buffered 2% Lidocaine with 1:100,000 Adrenaline and Non-Buffered 2% Lido caine with 1:100,000 Adrenaline in Dental Extraction – A Clinical Study
Aim: To comparatively evaluate the onset time and efficacy of buffered 2% lidocaine with 1:100,000 adrenaline and non-buffered 2% lidocaine with 1:100,000 adrenaline in patients undergoing dental extraction. Materials and Methods: This randomized, single-blind clinical study was conducted on 40 patients indicated for simple dental extraction. The patients were randomly divided into two groups (n = 20 each). Group I received non-buffered 2% lidocaine with 1:100,000 adrenaline, while Group II received buffered 2% lidocaine with 1:100,000 adrenaline. The buffered solution was prepared by adding 8.4% sodium bicarbonate to the anesthetic solution immediately before administration. The onset time of anesthesia was recorded using a stopwatch from completion of injection to the first subjective sign of numbness. Pain during injection and pain during extraction were assessed using a Visual Analog Scale (VAS). The need for supplementary anesthesia was also recorded. Statistical analysis was performed using the independent t-test and Chi-square test, with the level of significance set at p < 0.05. Results: The buffered lidocaine group demonstrated a significantly faster onset of anesthesia compared to the non-buffered group (p < 0.05). Pain scores during injection and during extraction were significantly lower in the buffered group. Additionally, fewer patients in the buffered group required supplementary anesthesia. Conclusion: Buffered 2% lidocaine with 1:100,000 adrenaline provides faster onset and improved anesthetic efficacy with reduced pain perception compared to non-buffered lidocaine during dental extraction. Its use may enhance patient comfort and clinical efficiency in routine dental practice.
Buffered local anesthesia, lidocaine, onset time, dental extraction, pain perception
Comparative Evaluation of Shear Bond Strength of Glass Ionomer Cement, Resin-Modified Glass Ionomer Cement and Alkasite Restorative Material to Human Dentin: An In-Vitro Study
Background: Durable adhesion between restorative materials and dentin is essential for the longevity and clinical success of restorations. Conventional glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), and alkasite restorative materials are widely used because of their fluoride release, chemical bonding potential, and simplified clinical application; however, their comparative bonding performance remains inconclusive. Aim: To compare the shear bond strength (SBS) of conventional GIC, RMGIC, and alkasite restorative material to human dentin. Materials and Methods: Thirty extracted human premolars were sectioned to expose flat mid-coronal dentin surfaces and randomly allocated into three groups (n = 10): Group I—conventional GIC, Group II—RMGIC, and Group III—alkasite restorative material. Restorations were placed according to manufacturers’ instructions using a standardized cylindrical mold. After storage in distilled water at 37 °C for 24 hours, specimens were subjected to shear bond strength testing using a universal testing machine at a cross-head speed of 1 mm/min. SBS values were calculated in megapascals (MPa) and statistically analyzed using one-way analysis of variance followed by Tukey’s post-hoc test (α = 0.05). Results: Alkasite restorative material demonstrated the highest mean shear bond strength (14.06 ± 1.87 MPa), followed by RMGIC (11.52 ± 1.74 MPa) and conventional GIC (8.94 ± 1.58 MPa). The differences among the three groups were statistically significant (p < 0.001). Conclusion: Within the limitations of this in-vitro study, alkasite restorative material exhibited superior bonding to dentin compared with both types of glass ionomer cements. Conventional GIC showed the lowest shear bond strength.
Shear bond strength; glass ionomer cement; resin-modified glass ionomer cement; alkasite; dentin adhesion; restorative dentistry
Effect of Immediate Versus Delayed Chlorhexidine Rinse on Post-Extraction Pain: A Randomized Clinical Study
Background: Chlorhexidine mouth rinse is routinely prescribed after tooth extraction to reduce microbial load. However, the optimal timing of its use remains unclear and may influence postoperative pain. Aim: To compare the effect of immediate versus delayed chlorhexidine mouth rinse on post extraction pain following simple tooth extraction. Materials and Methods: Sixty systemically healthy patients undergoing simple tooth extraction were randomly allocated into two groups. Group I used 0.12% chlorhexidine mouth rinse immediately after extraction, while Group II initiated the rinse 24 hours post-extraction. Postoperative pain was evaluated using a Visual Analog Scale (VAS) on postoperative day 1 and day 3. Statistical analysis was performed using the independent t-test with significance set at p < 0.05. Results: Patients in the immediate rinse group reported significantly higher pain scores on postoperative day 1 compared to the delayed rinse group (p < 0.05). By postoperative day 3, pain scores decreased in both groups, with no statistically significant difference observed. Conclusion: Delaying the use of chlorhexidine mouth rinse for 24 hours after tooth extraction reduces early postoperative pain. Avoidance of immediate rinsing may help preserve the blood clot and enhance patient comfort during the initial healing period.
Tooth extraction, chlorhexidine mouth rinse, postoperative pain, timing, oral surgery
Knowledge, Awareness, and Practices Regarding Oral Cancer Screening Among General Dentists: A Cross-Sectional Study
Background Oral cancer is a major public health problem in India, with high morbidity and mortality largely due to late diagnosis. General dentists are often the first healthcare professionals to examine the oral cavity and thus play a critical role in early detection through routine oral cancer screening. Aim: To assess the knowledge, awareness, and clinical practices related to oral cancer screening among general dentists. Materials and Methods: A descriptive cross-sectional questionnaire-based study was conducted among 150 general dental practitioners. A validated, self-administered questionnaire comprising demographic details, knowledge, awareness, and practice-related questions was distributed. Data were analyzed using descriptive statistics and chi-square test to assess associations between variables. Results: Out of 150 participants, 62% demonstrated moderate knowledge, 24% had good knowledge, and 14% had poor knowledge regarding oral cancer screening. Although 78% were aware of oral cancer screening methods, only 46% reported performing routine oral mucosal examinations for all patients. Lack of training (48%) and time constraints (41%) were identified as major barriers. A statistically significant association was observed between years of clinical experience and knowledge scores (p < 0.05). Conclusion: While general dentists demonstrated fair awareness of oral cancer screening, gaps were observed in routine screening practices. Structured continuing dental education programs and hands-on training are recommended to enhance early detection and reduce oral cancer burden.
Oral cancer, Screening, Knowledge, Awareness, General dentists, Early detection
Effect of Sugar-Free Chewing Gum on Salivary Flow Rate and Dental Plaque Levels: An Observational Study
Background: Saliva plays a crucial role in maintaining oral health by neutralizing acids, providing antimicrobial action, and aiding in mechanical cleaning. Chewing sugar-free gum has been suggested to stimulate salivary flow and reduce plaque accumulation, but clinical evidence remains limited. Aim: To evaluate the effect of sugar-free chewing gum on salivary flow rate and dental plaque levels in healthy adults. Materials and Methods: A Clinical trial was conducted on 40 healthy adult volunteers. Participants were instructed to chew sugar-free gum for 10 minutes, three times daily, after meals for 7 days. Unstimulated and stimulated salivary flow rates were measured at baseline and after the intervention. Plaque levels were assessed using the Plaque Index (Silness & Löe) at baseline and post-intervention. Data were analyzed using paired t-tests, with significance set at p < 0.05. Results: Chewing sugar-free gum significantly increased stimulated salivary flow rates (p < 0.01) and led to a significant reduction in plaque scores (p < 0.05) compared to baseline. Conclusion: Sugar-free chewing gum effectively stimulates salivary flow and reduces plaque accumulation. It can be recommended as an adjunct to routine oral hygiene, particularly in individuals with low salivary flow or at high risk of dental caries.
Salivary flow, Den tal Plaque, Sugar-free
Evaluation of Oral Hygiene Status in Patients Using Clear Aligners Versus Fixed Orthodontic Appliances
Background:Orthodontic appliances can adversely affect oral hygiene by promoting plaque accumulation and gingival inflammation. Fixed orthodontic appliances are associated with increased plaque-retentive areas, whereas clear aligners, being removable, may facilitate better oral hygiene maintenance. Aim:To evaluate and compare the oral hygiene status in patients undergoing orthodontic treatment with clear aligners and fixed orthodontic appliances. Materials and Methods:A comparative clinical study was conducted on 60 orthodontic patients divided into two groups: Group A comprised 30 patients treated with clear aligners, and Group B comprised 30 patients treated with fixed orthodontic appliances. Oral hygiene status was assessed using the Plaque Index (Silness and Löe) and Gingival Index (Löe and Silness). The collected data were statistically analyzed using the independent t-test. Results:The mean plaque and gingival index scores were significantly lower in the clear aligner group compared to the fixed appliance group (p < 0.05), indicating superior oral hygiene and gingival health among aligner-treated patients. Conclusion: Patients treated with clear aligners demonstrated better oral hygiene status than those treated with fixed orthodontic appliances. Clear aligners may therefore be considered a favorable treatment option for patients where maintenance of periodontal health is a priority.
Clear aligners, fixed orthodontic appliances, oral hygiene, plaque index, gingival index
Validation of the HEART Score in Patients with Undifferentiated Chest Pain: A Prospective Cohort Study
Background: Chest pain represents one of the most common and challenging presentations in emergency medicine, requiring rapid differentiation between life-threatening cardiac conditions and benign etiologies. The HEART score was developed to risk stratify patients with chest pain for major adverse cardiac events (MACE), yet validation across diverse populations and healthcare settings remains essential for confident clinical implementation. Methods: A prospective observational cohort study was conducted at our tertiary care hospital over 20 months, enrolling 892 adult patients presenting with chest pain suggestive of possible acute coronary syndrome. HEART scores were calculated at presentation, and patients were followed for 6 weeks. The primary outcome was occurrence of MACE, defined as acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, or all-cause mortality. Results: The mean age was 54.8 ± 14.2 years, with 58.4% male patients. The mean HEART score was 4.2 ± 1.8. MACE occurred in 142 patients (15.9%). The area under the ROC curve for MACE prediction was 0.867 (95% CI: 0.838–0.896). Low-risk patients (HEART score 0-3) experienced MACE in 2.1% of cases (8/386), intermediate-risk (score 4-6) in 18.4% (68/370), and high-risk (score 7-10) in 48.5% (66/136). A HEART score ≤3 demonstrated 94.4% sensitivity and 65.7% specificity with negative predictive value of 97.9%. Conclusion: The HEART score demonstrates excellent discriminatory ability for predicting MACE in patients with undifferentiated chest pain, effectively identifying low-risk patients suitable for early discharge and outpatient management.
HEART score; chest pain; acute coronary syndrome; major adverse cardiac events; risk stratification; emergency department; validation study
Comparative Evaluation of Retention of Different Luting Cements for Im plant-Supported Crowns: An In Vitro Study
Background: Retention of implant-supported crowns is a critical factor influencing the long-term success of implant prostheses. The choice of luting cement plays an important role in determining the retentive strength, retrievability, and clinical performance of cement retained implant restorations. Aim: To comparatively evaluate the retention of implant-supported crowns cemented with zinc phosphate cement, resin cement, and resin-modified glass ionomer cement using a universal testing machine in an in vitro setting. Materials and Methods: Thirty implant–abutment–crown assemblies were fabricated and divided into three groups (n = 10) based on the luting cement used: Group I—zinc phosphate cement, Group II—resin cement, and Group III—resin-modified glass ionomer cement. Standardized full-coverage metal crowns were cemented onto prefabricated titanium abutments following manufacturer instructions. All specimens were stored in distilled water at 37°C for 24 hours. Retention was evaluated by applying a tensile load along the long axis of the implant using a universal testing machine at a crosshead speed of 1 mm/min until crown dislodgement occurred. The maximum pull-out force required was recorded in Newtons and statistically analyzed. Results: The highest mean retentive strength was observed in the resin cement group, followed by resin-modified glass ionomer cement, while zinc phosphate cement demonstrated the lowest retention. Statistical analysis revealed a significant difference in pull-out force values among the three groups (p < 0.05). Conclusion: Within the limitations of this in vitro study, resin cement provided superior retention for implant-supported crowns compared to resin-modified glass ionomer cement and zinc phosphate cement. Selection of luting cement should consider the balance between retention requirements and the need for retrievability in implant prosthodontics.
Implant supported crowns; Luting cements; Retention; Pull-out force; In vitro study
Utility of NEWS-2 in Predicting ICU Admission from Emergency Department and Mortality Risk: A Prospective Cohort Study
Background: The National Early Warning Score 2 (NEWS-2) is a standardized clinical tool designed to detect acute deterioration in hospitalized patients. Its utility in predicting critical outcomes directly from the emergency department (ED) remains an area of active investigation. Methods: A prospective cohort study was conducted at a tertiary care hospital over 18 months, enrolling 847 adult patients presenting to the ED. NEWS-2 scores were calculated upon arrival, and patients were followed until hospital discharge or death. Primary outcomes included ICU admission within 48 hours and 30-day in-hospital mortality. Receiver operating characteristic (ROC) curve analysis, logistic regression, and survival analysis were performed. Results: The mean age was 58.4 ± 16.7 years, with 54.3% male patients. The mean NEWS 2 score was 5.8 ± 3.4. ICU admission occurred in 127 patients (15.0%), and 30-day mortality was 8.7% (n=74). Patients requiring ICU admission had significantly higher NEWS-2 scores (9.2 ± 2.8 vs. 5.2 ± 3.1, p<0.001). The area under the ROC curve (AUC) for predicting ICU admission was 0.847 (95% CI: 0.812–0.882), and for mortality was 0.891 (95% CI: 0.854–0.928). A NEWS-2 score ≥7 demonstrated 78.7% sensitivity and 81.2% specificity for ICU admission prediction. Conclusion: NEWS-2 scores at ED presentation demonstrate excellent discriminatory ability for predicting ICU admission and mortality, supporting its implementation as a triage and risk stratification tool in emergency settings
NEWS-2; emergency department; ICU admission; mortality prediction; early warning score; critical care; triage
Pneumonia Severity Assessment: CURB-65 versus PSI in Predicting Admission Need and Mortality — A Prospective Comparative Study
Background: Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide. Accurate severity assessment is crucial for determining appropriate disposition and treatment intensity. The CURB-65 and Pneumonia Severity Index (PSI) are widely utilized scoring systems, yet their comparative performance in diverse clinical settings continues to be debated. Methods: A prospective cohort study was conducted at two teaching hospitals over 24 months, enrolling 634 adult patients with confirmed CAP. Both CURB-65 and PSI scores were calculated at presentation. Primary outcomes included requirement for hospital admission and 30-day all-cause mortality. Receiver operating characteristic (ROC) curve analysis and comparative statistics were performed. Results: The mean age was 62.7 ± 18.4 years, with 56.8% male patients. Hospital admission was required in 412 patients (65.0%), and 30-day mortality occurred in 58 patients (9.1%). For mortality prediction, PSI demonstrated an AUC of 0.842 (95% CI: 0.798– 0.886) compared to 0.814 (95% CI: 0.766–0.862) for CURB-65 (p=0.089). For predicting admission need, PSI showed superior discrimination (AUC 0.812 vs. 0.758, p=0.012). PSI risk class IV-V had 87.9% sensitivity and 72.4% specificity for mortality, while CURB-65 ≥3 showed 79.3% sensitivity and 78.6% specificity. Conclusion: Both scoring systems demonstrate good predictive accuracy for mortality in CAP patients. PSI shows superior performance for determining admission need, while CURB-65 offers comparable mortality prediction with greater simplicity. Clinical context should guide score selection.
community-acquired pneumonia; CURB-65; Pneumonia Severity Index; mortality prediction; hospital admission; severity assessment; prognostic scoring
Effect of Ice Pack Application on Post-Extraction Pain and Swelling: A Ran domized Clinical Study
Background: Post-extraction pain and facial swelling are common complications following dental extraction and can adversely affect patient comfort. Cryotherapy using ice pack application is a simple, economical, and non-invasive method used to reduce postoperative inflammation; however, its clinical effectiveness needs further evaluation. Aim: To evaluate the effect of ice pack application on postoperative pain and facial swelling following dental extraction. Materials and Methods: This randomized clinical study included 30 patients requiring routine dental extraction. The patients were randomly allocated into two groups with 15 patients in each group. Group I (Ice Pack Group) received extraoral ice pack application intermittently for 20 minutes during the first postoperative hour, while Group II (Control Group) received standard postoperative care without ice pack application. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 6, 12, and 24 hours, and facial swelling was evaluated using standardized facial measurements at 24 and 48 hours post extraction. Statistical analysis was performed with the level of significance set at p < 0.05. Results: Group I demonstrated significantly lower mean pain scores and reduced facial swelling at all postoperative evaluation intervals compared to Group II (p < 0.05). The reduction in pain and swelling was more pronounced during the first 24 hours following extraction. Conclusion: Extraoral ice pack application is an effective adjunct in reducing postoperative pain and facial swelling following dental extraction. Its routine use can enhance patient comfort and postoperative recovery.
Cryotherapy, Ice pack, Dental extraction, Postoperative pain, Facial swelling
Intraoral Vascular Malformation of Right Cheek: A Case Report
This is a case report of an adult untreated vascular malformation of the cheek, involving the masseter muscle, which underwent recent enlargement. After consideration of different treatment options, intraoral excision of the malformation was done including intramuscular dissection. There was no recurrence on short term follow up.
Comparative Evaluation of Chlorhexidine, Herbal Mouthwash (Amarantha), and Probiotic Mouthwash (Oralvit) on Plaque Index: An Observational Study
Background: Dental plaque is the primary etiological factor for gingivitis and periodontal diseases. Mouthwashes are widely used as adjuncts to mechanical plaque control. Chlorhexidine (CHX) is the gold standard, whereas herbal and probiotic formulations are gaining popularity due to their safety and patient acceptance. Aim: To compare the Plaque Index (PI) reduction produced by 0.12% chlorhexidine, a herbal mouthwash (Amarantha), and a probiotic mouthwash (Oralvit Probiotic Anti-Plaque) in an in vivo population. Materials and Methods: An in vivo comparative study was conducted on 45 participants aged 18–40 years with mild to moderate plaque accumulation. Subjects were randomly divided into three groups: Group A (0.12% CHX), Group B (Amarantha herbal mouthwash), and Group C (Oralvit probiotic mouthwash). Plaque Index (Silness & Löe, 1964) was recorded at baseline, day 7, day 14, and day 28. Results: All groups showed significant reductions in plaque scores over time. CHX demonstrated the most rapid reduction at day 7, while the herbal and probiotic groups showed progressive reductions, with comparable efficacy to CHX by day 28. Conclusion: Chlorhexidine remains the most effective short-term antiplaque agent. Herbal and probiotic mouthwashes show comparable plaque reduction over longer durations and may serve as effective alternatives for long-term use.
Chlorhexidine, Plaque, Probiotic Mouthwash
Role of Ayurvedic Therapies in Chronic Kidney Disease Management: A Case Study on Integrating Traditional Healing
Chronic Kidney Disease (CKD) is a progressive condition characterized by the gradual decline of kidney function, often resulting in end-stage kidney disease (ESKD), which necessitates kidney replacement therapy. While conventional treatments focus on managing these risk factors, Ayurvedic interventions have gained attention due to their holistic, individualized approach, which aims to restore balance within the body and improve kidney function. This case study evaluates the impact of Ayurvedic interventions combined with conventional treatments in a 56-year-old male patient with CKD, hypertension, and Type 2 Diabetes Mellitus (T2DM) who visited Jeena Sikho Lifecare Limited Hospital in Derabassi, Punjab. The patient presented with symptoms including general weakness, lower back ache, itching, and frothy urine. After a course of Ayurvedic treatment, significant improvements were noted in kidney function, including a reduction in serum urea and creatinine levels, as well as an increase in GFR. The patient’s symptoms, including general weakness and itching, improved markedly, and his weight decreased. The results indicate that Ayurvedic therapies, such as Ayurvedic formulations and detoxification practices, could play a supportive role in managing CKD by improving renal function and alleviating symptoms. This study highlights the potential of combining traditional Ayurvedic treatments with conventional treatment in managing CKD. However, further research with larger sample sizes and controlled clinical trials is required to establish the effectiveness of Ayurvedic approaches in CKD management and integrate them into mainstream healthcare.
Chronic Kidney Disease (CKD), Glomerular Filtration Rate (GFR), Ayurveda, Panchakarma, Hypertension, Type II Diabetes Mellitus (T2DM), Vrikka Vikar, Vataj pandu
Copyright (c) 2025 Academia Journal of Medicine
Case Study on Ayurvedic and Panchkarma Intervention for Chronic Kidney Disease in an Elderly Patient
Chronic Kidney Disease (CKD) is a progressive disorder affecting kidney structure and function, often complicated by Type 2 Diabetes Mellitus (T2DM) and hypertension. Early stage CKD is frequently asymptomatic, and management can be challenging, particularly in resource-limited settings due to high costs and limited accessibility of conventional therapies. This case report presents a 67-year-old male patient with CKD, T2DM, and hypertension, treated at Jeena Sikho Lifecare Limited Hospital, Derabassi, India, using a personalized Ayurvedic regimen combined with Panchakarma therapies. Following 12 days of inpatient treatment, the patient demonstrated marked clinical improvements: drowsiness, pedal oedema, eye vision and urine got better. Vital parameters showed gradual stabilization, with body weight decreasing from 83 kg to 76 kg and blood pressure stabilizing from highs of 180/90 mmHg to 120/80 mmHg. Laboratory investigations indicated significant improvements, with hemoglobin increasing from 7.3 gm/dL to 10.0 gm/dL, urea decreasing from 280.12 mg/dL to 100 mg/dL, creatinine declining from 6.10 mg/ dL to 4.5 mg/dL, and total RBC count increasing from 2.61 Mill/Cumm to 3.54 Mill/ Cumm. Uric acid stabilized at 7.1 mg/dL. Renal function assessed by GFR improved, with global GFR from 14.2 to 19.8 ml/min. This case highlights the potential of Ayurveda as an effective, accessible, and affordable approach for managing CKD Stage IV and associated comorbidities, demonstrating improvements in symptoms, vitals, laboratory parameters, and kidney function over a short inpatient treatment period.
Ayurveda, Chronic Kidney Disease (CKD),Glomerular Filtration Rate, Panchkarma, Vataj Pandu, Vrikk Vikar
Ashmari Chikitsa: An Ayurvedic Case Study on Renal Calculi
Mutrashmari, commonly known as renal calculi or kidney stones, is a significant health concern characterized by the formation of stones in the urinary tract. Ayurveda classifies it as one of the Ashtamahagada due to its complexity and challenges in treatment. It arises from an imbalance in Vata, Pitta, and Kapha doshas and is influenced by factors such as improper diet, sedentary lifestyle, dehydration, excessive calcium intake, metabolic disorders, and genetic predisposition. Clinically, it presents with severe pain, dysuria, oliguria, hematuria, nausea, and vomiting. This case study evaluates the impact of Ayurvedic management in a 34-year-old male diagnosed with Mutrashmari at Jeena Sikho Lifecare Limited Hospital, Hyderabad, Telangana, India. Following two months of Ayurvedic treatment, a comparative USG revealed a reduction in stone size, with the right kidney calculus decreasing from 4.6 mm to 2 mm and the left kidney calculus reducing from 3.7 mm to 2.7 mm. The patient experienced significant symptomatic relief, including reduced pain and improved urine output. These findings support the efficacy of Ayurvedic interventions in renal calculus management. However, further clinical trials are required to validate these results and establish standardized treatment protocols.
Mutrashmari, Asthamahagad, Renal Calculi, Ayurveda, Mutravaha Srotas, Shodhana and Shamana therapies
Distraction in Pediatric Dentistry: A Scoping Review
Distraction techniques play a vital role in managing anxiety and fear among pediatric dental patients. This scoping review aims to explore the various distraction methods used in pediatric dentistry, emphasizing their effectiveness and incorporation into clinical practice. The review encompasses a range of distraction strategies, including visual, auditory, and interactive approaches, to assess their impact on children’s emotional responses and cooperation during dental treatments. By synthesizing existing literature, the findings highlight the benefits of distraction in alleviating anxiety, improving patient experience, and enhancing treatment outcomes. The review also identifies gaps in current research and suggests directions for future studies to optimize the application of distraction techniques in pediatric dental settings.
Distraction techniques, Pediatric dentistry, Anxiety management.
Incidence of oral potentially malignant disorders requiring surgical excision in young vs elderly populations
Aim To compare the incidence and clinical presentation of oral potentially malignant disorders (OPMDs) necessitating surgical excision in younger and older populations, and to assess age-related variations in lesion characteristics, surgical outcomes, and potential risk factors.Methods Across-sectional observational study was performed on 100 patients who underwent surgical excision of oral potentially malignant disorders (OPMDs). Patients were categorised into two groups: young (n=40) and elderly (n=60). Demographics, risk factors, lesion characteristics, histopathology, and postoperative outcomes, including recurrence and malignant transformation, were documented. Statistical analysis encompassed descriptive statistics, Chi-square tests, and logistic regression; a p-value of <0.05 was deemed significant. ResultsYounger patients were more likely to chew areca nuts, while older patients were more likely to smoke and drink alcohol. OSMF was more common in younger patients, while non-homogeneous leukoplakia and erythroplakia were more common in older patients. Younger patients were more likely to have mild dysplasia, while older patients were more likely to have moderate to severe dysplasia. Recurrence transpired in 16.7% of elderly patients compared to 5% of younger patients (p=0.04), and malignant transformation was noted exclusively in the elderly cohort (6.7%). conclusion younger patients with OPMDs mostly have OSMF and mild dysplasia, while older patients have more advanced dysplasia, recurrence, and malignant transformation. To get the best results, you need to do risk assessments based on age, come up with preventive measures, and keep a close eye on things.
Oral potentially malignantdisorders , Oral submucous fibrosis, Leukoplakia, Dysplasia, Age related differences, Surgical excision
Current research suggests an emerging value of 3D printed guides use in the endodontic field. Computer-aided design and manufacturing technologies can be used to create 3D printed guides with endodontic clinical applications. Computer aided design (CAD) and computer-aided manufacturing (CAM) technologies can leverage cone beam computed tomography data for production of objects used in surgical and nonsurgical endodontics and in educational settings. The aim of this article was to review all current applications of 3D printing in endodontics and to speculate upon future directions for research and clinical use within the specialty. Documented solutions to endodontic challenges include: guided access with pulp canal obliteration, applications in auto transplantation, pre-surgical planning and educational modelling and accurate location of osteotomy perforation sites. Future research directions should include clinical outcomes assessments of treatments employing 3D printed objects.
Endodontics; 3D printing; Guided endodontics
Revolutionizing Pediatric Endodontics: A Review of Innovative Rotary Files
Pediatric rotary files, designed for the endodontic treatment of primary and immature teeth, have gained attention for their efficiency and safety. This review examines the literature on various types of pediatric rotary files, highlighting their design features, biocompatibility, and clinical outcomes. Studies indicate a reduced treatment time and improved shaping ability compared to manual techniques. The review also discusses the importance of selecting appropriate files based on tooth anatomy and the age of the child. Overall, pediatric rotary files prove to be a promising tool in modern pediatric dentistry, providing effective and minimally invasive treatment options.
Pediatric Endodontics, Rotary Files, Pulpectomy
Maternal Chronic Periodontitis as a risk factor for preterm birth and low birth weight: A hospital-based case control study
Background: Preterm birth (PTB) and low birth weight (LBW) are main causes of neonatal morbidity and mortality worldwide. Evidence suggests a potential link between maternal chronic periodontitis and adverse pregnancy outcomes. Objectives: This hospital-based case-control study aimed to assess the association between maternal chronic periodontitis and the risk of preterm birth and low birth weight in postpartum women. Methods: A total of 540 postpartum women were enrolled, comprising 270 cases (PTB and/or LBW) and 270 matched controls (term and normal birth weight). Demographic data and obstetric history were recorded. Periodontal status was assessed using the Clinical Attachment Loss (CAL) index, Gingival Index, and Community Periodontal Index of Treatment Needs (CPITN). Results: No significant differences were observed between groups regarding age, gravidity, or educational status (p > 0.05). However, periodontal indicators were significantly worse among cases. The mean CAL score was higher in the case group (4.18 ± 1.05) than controls (3.8 ± 0.83; p = 0.002). Gingival inflammation and CPITN scores also showed significant differences (p < 0.001) Conclusion: Maternal chronic periodontitis is significantly associated with preterm birth and low birth weight. Early diagnosis and management of periodontal disease in pregnant women may play a role in improving perinatal outcomes.
Periodontitis, Preterm birth, Low birth weight, Pregnancy, Case control study, CPITN.
Low-Level Laser Therapy in Periodontology: A Review
Low Level Laser Therapy (LLLT) has emerged as a promising adjunct treatment for periodontal diseases, characterized by its anti-inflammatory and analgesic effects. This review assesses the efficacy of LLLT in managing periodontal conditions, high lighting its mechanisms of action, clinical applications, and outcomes. Studies sug gest that LLLT promotes tissue healing, reduces pain, and enhances the effective ness of conventional periodontal treatments. Furthermore, the review discusses the optimal parameters for laser application, including wavelength, energy density, and duration. Through an analysis of current clinical trials, this review aims to provide a comprehensive understanding of LLLT as a viable option in periodontal therapy.
TO EVALUATE THE CARIOGENIC POTENTIAL OF NATURAL AND ARTIFICIAL MILK BEVERAGES BY STREPTOCOCCUS MUTANS BIOFILM MODEL IN PRIMARY TEETH : AN IN-VITRO STUDY
Background: Dental caries remains a prevalent chronic disease in children, influenced by diet, microbial activity, and oral hygiene. Milk is a widely consumed beverage with both protective and cariogenic potential, depending on its composition and sugar content. This study evaluated the cariogenic effects of natural and flavoured milk beverages on primary teeth using an in vitro Streptococcus mutans biofilm model. Materials and Methods: Sixty caries-free primary teeth were sectioned into enamel slabs and randomly allocated into six groups: cow, buffalo, goat, strawberry-flavoured, vanilla flavoured milk, and saline control (n=10 each). Enamel slabs were inoculated with S. mutans and exposed to the respective beverages three times daily for three days. Baseline and post exposure surface microhardness were measured using the Brinell hardness test. Percentage surface hardness loss was calculated, and data were analyzed using one-way ANOVA with Tukey’s post hoc test and paired t-tests (p<0.05). Results: Baseline microhardness was comparable across all groups (p>0.05). Natural milk types (cow, buffalo, goat) caused moderate enamel demineralization, whereas flavoured milk beverages led to significantly higher microhardness loss (p<0.05). Tukey’s post hoc analysis confirmed that sweetened milk groups exhibited greater cariogenic potential compared to natural milk and the control. Conclusion: Natural milk poses a lower risk for enamel demineralization due to its buffering capacity and absence of added sugars. Sweetened milk beverages significantly increase cariogenic risk, particularly with frequent consumption. Limiting sugary milk drinks and promoting proper oral hygiene are essential strategies to reduce caries risk in children.
Dental caries, Milk beverages, Primary teeth, Streptococcus mutans, Enamel microhardness, Cariogenic potential
Correlation Between Tooth Form and Personality Traits Using the Visagism Concept: A Cross-Sectional Study.
Aim:The Visagism concept enables dental clinicians to design restorations that go beyond conventional aesthetics by incorporating psychosocial aspects such as the patient’s emotions, identity, behavior, and self-esteem. This holistic approach aims to align dental restorations with an individual’s personality. So the study aims to evaluate the potential correlation between smile patterns and personality traits based on the principles of Visagism. MaterialsandMethods:A cross-sectional study was conducted among 100 participants aged 18–30 years affiliated with a dental college. Temperaments were assessed using a validated self-reported questionnaire. Standardized frontal-view photographs in centric occlusion were taken to determine tooth shapes. The temperaments identified via questionnaire responses were compared with those interpreted through tooth morphology based on Visagism principles. Statistical analysis was performed using IBM SPSS software version 22. Results:Among the participants, the melancholic temperament was predominant, accounting for 47%. A statistically significant correlation was observed between tooth form and temperament (p < 0.01), indicating that specific personality traits were reflected in dental morphology. Conclusion:The study supports the concept that facial and dental characteristics are influenced by personality traits. Incorporating Visagism principles in aesthetic dental treatment can aid in selecting tooth forms that harmonize with a patient’s personality, thereby enhancing treatment satisfaction.Clinical Significance: Integrating Visagism into clinical practice promotes a multidisciplinary and patient-centered approach, enabling dental professionals to create restorations that resonate with the patient’s psychological and emotional profile, ultimately improving esthetic and functional outcomes.
Aesthetics, Discrimination , Facial harmony, Smile, Personality Traits, Tooth Shape, Visagism