iosr-JDMS   Volume-6 ~ Issue-4

Abstract: Aims- Periodontal disease, a chronic bacterial infection of the oral cavity is a novel risk factor for various systemic diseases. Among the systemic diseases, end stage renal disease has been shown to affect not only the general health of the patient but also oral and periodontal health. This study was conducted to gain an insight on the influence of renal dialysis on periodontal health. Materials and method- 234 patients undergoing renal dialysis (60 % male, 40 % female) were included in the study. The study group was divided into 4 age groups confounding systemic evaluation was conducted. Periodontal disease status was measured by CPITN. The collected data was analysed using SPSS.Inc Chicago ,USA (11.5) software. Results- Prevalence of moderate to severe gingivitis and moderate periodontitis were seen in renal dialysis of patients. Conclusion- The deteriorating general health causes negligence of oral health. The population needs comprehensive oral and periodontal care in consultation with nephrologist and oral health professionals.

Keywords – chronic renal disease, haemodialysis, periodontitis, CPITN index

[1]. Fergerson CA, Whyman FA, Dental management of people with renal disease and renal transplantation. N Z Dent J 1998;94, 125-136
[2]. Craig R.G . Interactions between chronic renal disease and periodontal disease. Oral Dis 2008, Jan 14(1), 1-7
[3]. Kardachi BJ, Newcomb GM. A clinical study of gingival inflammation in renal transplant recipients taking immunosuppressive drugs. J. Periodontol 1978;49;307-10
[4]. Naugle K, Darby ML, Bauman DB, Lineberger LT, Powers R, The oral health status of individual on renal dialysis. Ann Periodontol 1998; 3;197-205.
[5]. Fisher M.A, Taylor G W, A prediction model for chronic renal disease includes periodontal disease. J. Periodontol 2009; 80; 16-23.
[6]. Fisher M.A, Taylor G W, Papapanov PN et al, clinical and serological markers of periodontal infection and chronic kidney disease. J. Periodontol 2008;79;1670-1678.
[7]. Kshirsagar AV, Moes KL, Elter JR et al, periodontal disease is associated with renal insufficiency in artherosclerosis risk in communities (ARIC) study. Am.J.Kidney Dis 2005;45;650-657.
[8]. Kshirsagar AV, Craig RG, Moes KL et al, Periodontal disease adversely affecting the survival of patients with end stage renal disease. Int;2009;75; 746-751.
[9]. Borawski J, Wilczyńska-Borawska M, Stokowska W, Myśliwiec M. The periodontal status of pre-dialysis chronic kidney disease and maintenance dialysis patients. Nephrol Dial Transplant. 2007 Feb;22(2):457-64.
[10]. Farhad Atassi, DDS, MSc, FICOI ,Abdullah R. Al-Shammery , BDS, MSc ,Saeed Al-Ghamdi , BDS . Gingival health among individuals on haemodialysis in a Saudi population, Saudi Dental Journal, Vol. 13, No. 2, May - August 2001.

Abstract: Introduction: Recognizing dental and skeletal developmental stages from cephalometric and panoramic radiographs is very useful to assess physiologic maturity without resorting to any special radiograph. Objectives: 1. Dental age determination from panoramic radiograph using Demirjian method. 2. Skeletal age determination from lateral cephalometric radiograph using Hassel and Farman method. 3. To evaluate the nature of interrelationship between Chronological, Dental and Skeletal age. Methods: The sample for study consisted of 160 radiographs (80 panoramic radiographs and 80 cephalometric radiographs) of 40 boys and 40 girls randomly selected from various schools of Ahmedabad, Gujarat, India in the age group of 6 to 13 years known chronological age. Data was collected and analyzed. Results: A strong correlation exists between Chronological and assessed Dental age in both genders of 7-12age. (r = 0.8) A moderate correlation exists between Chronological and assessed Skeletal age in both genders of 9-13age (r =0.4) A moderate correlation exists between assessed Skeletal and Dental age in both genders of 9-13age (r =0.6) Conclusions: Significant strong correlation was found among Chronological and assessed Dental age. Girls showed an early maturation over boys of the same age group.

Keywords – Chronological age, Dental age, Maturity indicators, Radiographic evaluation, Skeletal age.

[1]. Brent Hassel, A.G Farman: Skeletal maturation evaluation using cervical vertebrae. Am J orthod Dentofacial Orthop 107, 1995, 58-66.

[2]. Demirjian A,Buschany R, Tanguay R, patterson K: Interrelationship among measure of somatic, dental and skeletal maturity. AJO Jan. 1986: 433-438

[3]. William G, Van Olmen A, Spiessens B, Charls C: Dental Age Estimation in Belgian children: Demirjian's Technique Revisited. J Forensic Sci 46(4), 2001, 893-895.

[4] Bhavna Gupta , Rajesh Anegundi: Comparison Of Dental Age of Hubli Dharwad children by Moore's method with the Skeletal and Chronological age. The internet journal of dental science.6(1), 2008.

[5]. Chertkow.S: Tooth mineralization as an indicator of pubertal growth spurt. AJO Jan, 77, 1980: 196-215.

[6]. Suleekorn Krailassiri, Niwat Anuwongnukroh, Surachai Dechkunakorn: Relationships Between Dental Calcification Stages and Skeletal Maturity Indicators in Thai Individuals. Angle Orthod 72(2):2001, 156-166

[7]. Tancan Uysa;, Sabri llhan Ramoglu, Faruk Ayhan basciftci, Zafer Sari: Chronological age and skeletal maturation of the cervical vertebrae and Hand-wrist: Is there a relationship? Am J orthod Dentofacial Orthop 2006: 130:622-8.

Abstract: Background: Patient satisfaction is one of the important studied aspects of health care. Measuring satisfaction reliably, however, is an ongoing challenge, thus objective of the study was to assess patient satisfaction in CGHS Dispensaries. Methodology: This cross sectional study was conducted over one year period in CGHS Dispensaries at Kolkata. A multistage sampling method was followed. Total number of respondents was 412. A self administered predesigned, pretested , semi structured questionnaire was used. Likert scale was used as scoring system in the questionnaire for patient satisfaction evaluation. Results: The overall level of satisfaction( moderate & very satisfied)in this study was 36.9%. Majority of the total respondents (84%) agreed/strongly agreed regarding the inadequacy of facilities like toilet , drinking water, sitting arrangement in the dispensaries. About (72.5%) of the overall respondents agreed/strongly agreed to the fact that doctors treating them were attentive, overwhelming majority of the total respondents (88.4%) was of the opinion that overcrowding was a problem in the dispensaries. Statistically significant association was found between patient satisfaction and per capita income in this study .Conclusion: The overall recommendation is that CGHS should strive to maintain the standard it has in order to keep patients satisfied with the services they receive.

Keywords - CGHS Dispensaries , likert scale, patient satisfaction..

[1] Haldar D, Sarkar A.P, Bisoi S, Mondal P :Assessment of client's perception in terms of satisfaction and service utilization in the central government health scheme dispensary at Kolkata. Indian J Commun Med 33:121-6,2008 .

[2] Roberts J.G and Tugwell P ; Comparison of questionnaires determining patient satisfaction with medical care. Health Serv Res. 22(5): 637–654,1987 December.

[3] Prasad B, Gupta VM. A qualitative assessment of antenatal care provided by auxiliary nurse midwives. Indian J Public Health 43: 140-3. 1999.

[4] CGHS Compendium ,www.mohfw.nic.in/cghs.htm,(accessed on 15th March,2008)

[5] Luthans - F, Organizational behavior (Mcgraw Hill Series in management,5 edition ,1989).

[6] Khandalwal, A , Human Resources Development (Oxford and IBH New Delhi,1988)

[7] Srivastava R.K. Assessment of Utilization of RCH Services and Client Satisfaction at different level of Health Facilities in Varanasi District. Indian J Public Health 53(3):183-189,2009 July- Sept.

[8] Akoijam BS, Konjengbam S, Bishwalata R, Singh TA: Patients' satisfaction with hospital care in a referral institute in Manipur. Indian J Public Health 51(4):240-3, 2007 Oct-Dec.

[9] Mahapatra P, Srilatha. S, Sridhar.P; A Patient Satisfaction Survey in Public Hospitals .Journal of the Academy of Hospital Administration: Vol. 13, No. 2 (2001-07 - 2001-12).

[10] Kumari R. Study on Patient Satisfaction in the Government Allopathic Health Facilities of Lucknow District. India Indian Journal of Community Medicine Vol 34: Issue 1, January 2009.

Abstract: Gingival hyperpigmentation is mostly caused by the physiologic deposition of melanin by melanocytes. Melanin pigmentation of the gingiva is completely benign and does not present a medical problem. In "Gummy Smile" Patients, melanin gingival hyperpigmentation causes an esthetic problem and physiologic disturbances. Many methods are now available for depigmentation of the gingival. This paper reports two cases of gingival hyperpigmentation managed by surgical method.

Key Words: Gingiva, Melanin, Esthetic, Depigmentation.

[1]. Dummet CO : First symposium on oral pigmentation. Journal of Periodontology, 1960; 31(5): 345-385.
[2]. Kauzman A, Pavone M, Blanas N, Bradley G. Pigmented lesions of the oral cavity: review, differential diagnosis, and case presentations. J Can Dent Assoc. 2004;70:682–683.[PubMed]
[3]. Meleti M, Vescovi P, Mooi WJ, van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:606 616.[PubMed]
[4]. Hedin CA, Pindborg JJ, Axéll T. Disappearance of smoker's melanosis after reducing smoking. J Oral Pathol Med. 1993;22:228–230.[PubMed]
[5]. Almas K and Sadiq W. Surgical treatment of melanin pigmented gingiva: An esthetic approach. Indian journal of Dental Research 2002; 13(2): 70-73.
[6]. Rosa DS, Aranha AC, Eduardo Cde P, Aoki A. Esthetic treatment of gingival melanin hyperpigmentation with Er:YAG laser: short-term clinical observations and patient follow-up. J Periodontol. 2007;78:2018–2025.[PubMed] .
[7]. Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol. 2008;35:250–254. [PubMed]
[8]. Roshna T, Nandakumar K. (2005). Anterior Esthetic gingival depigmentation and crownlenthening: Report of a case. J Contemp Dent Pract, (6)3;139-147.
[9]. Perlmutter S,Tal H. (1986).Repigmentation of the gingiva following surgical injury Periodontol, 57:48-50.
[10]. Begamaschi O,Kon S,Doine AI,Ruben MP.(1993). Melanin repigmentation after gingivectomy :A five year clinical and transmission Electron Microscopic Study in Humans.Int Journal of periodontic's and restorative Dentistry, 13(1):85-92.