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  1. Fulltext The Effects Of Alcohol-free 0.12% W/N Chlorhexidine Gluconate Mouthrinse On Oral Health
    Uma, S., Swaminathan, D.
    Ann Dent, 2001;8(1):-.
    MyJurnal
    CWorhexidine gluconate, a dicationic bisbiguanide agent, contains anti-plaque properties. Most chlorhexidine gluconate mouth rinses presently available contain alcohol in varying concentrations. The role of alcohol in these mouth rinses is to act as a preservative and solvent although it may have deleterious effects on the oral epithelium on long term usage. Recently, an alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse (Oradex®) has become available in Malaysia. This clinical study is aimed at determining the effects of this alcohol-free product compared to a placebo. A group of 60 meticulously screened subjects were assigned into two groups of 30 each. The first group started using the test product for 2 weeks followed by a washout period of 4 weeks. After this duration, this group used the placebo for a further 2 weeks. The 2nd group underwent similar protocol as the 1st except that this group started with the placebo. Measurements consisting of the following scores were recorded at baseline and after 2 weeks for each group: Plaque, Gingivitis: Papillary Bleeding, Stain and Calculus. Full mouth prophylaxis was carried out for all subjects after measurements at baseline as well as after the 2-week period. They were told to rinse with 15 ml of the designated mouth rinse twice daily for thirty seconds each after tooth brushing. The results of this study indicated that there was significant improvement in the plaque, gingival and papilla bleeding scores compared to the placebo. Stain and calculus scores were significantly increased for the test product when compared to the placebo. In conclusion, this study showed that alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse is effective in reducing plaque and gingivitis but causes staining and calculus formation.
  2. Fulltext Inhibition Of Stain By Some Commercially Available Oral Hygiene Products
    Swaminathan, D., Moran, John, Addy, Martin
    Ann Dent, 1996;3(1):-.
    MyJurnal
    Side effects such as abrasion of the dental hard tissue have been frequently observed following the extensive use of mechanical cleansing. As promising antiseptics like chlorhexidine produces extrinsic dental staining on long term usage, there has been increasing interest and research generated towards chemically based stain removing agents. This invitro studyexamined whether some commercial oral hygiene products could inhibit chlorhexidine derived stain independent of any mechanical cleansing action. Perspex blocks were soaked in triplicate in chlorhexidine solution for 2 minutesand stain inhibition by these products was determined by further soaking the blocks in productl water slurries for 2 minutes and finally in tea solution for I hourly periods. The optical density (OD) of each specimen was determined at each hourly interval by spectrophotometry at 395 nm and the mean values obtained. At the end of the study, most of the products inhibited stain compared to water control and there was a variation in the stain inhibitingefficacyof the products. It is thus concluded that oral hygiene products like dentifricesand mouthrinses can inhibit chlorhexidine derived extrinsic dental stain to a variable degree through a chemical action by contained ingredients.
  3. Fulltext Tissue response of type 2 diabetics towards non-surgical periodontal therapy: a retrospective, comparative study with non-diabetics - a preliminary investigation
    Goh, Y.C., Lau, S.L., Ramanathan, A., Swaminathan, D.
    Ann Dent, 2013;20(2):24-28.
    MyJurnal
    The purpose of this study was to assess the tissue
    response of Type 2 diabetic subjects towards non surgical
    periodontal therapy as compared with matched, nondiabetic
    subjects. This was a retrospective, comparative
    study using periodontal case notes of 40 subjects attending
    undergraduates’ periodontal clinics (20 diabetics, 20 nondiabetics),
    who were selected based on the inclusion
    and exclusion criteria. Response towards non surgical
    periodontal therapy was assessed through three clinical
    periodontal parameters, namely plaque score, gingivitis
    score and number of periodontal pocket ≥5mm at the
    baseline and after initial non surgical periodontal therapy.
    Data obtained was then analyzed by SPSS Version 12.
    Both diabetic and non-diabetic subjects showed significant
    improvements (p-value = 0.021; 0.000; 0.001 and 0.010;
    0.014; 0.001) in all three parameters after the therapy.
    However, when comparison was made between the two
    groups, there was no significant difference (p-value = 0.913;
    0.892 and 0.903) in any of the parameters. Periodontal
    conditions improved clinically in both diabetic and nondiabetic
    subjects after non-surgical periodontal therapy.
    Therefore, both groups responded similarly towards the
    therapy and thus it can be postulated that well-controlled
    diabetic status does not have a significant effect on the
    outcome of periodontal therapy.
  4. Fulltext Medico-legal implications of dental prenatal age estimation with reference to a case report
    Nambiar, P., Paul, G., Swaminathan, D., Nadesan, K.
    Ann Dent, 2000;7(1):46-50.
    MyJurnal
    The estimation of age of human foetal remains is of great medico-legal importance. When the remains are intact and fresh, various morphological features such as crown-heel length, weight, appearance of ossification centres particularly around the ankles and knees and other parameters could be used to make a reasonable estimation of the period of gestation. In cases of criminal abortion, infanticide and child murder the question of age of the foetus, viability, live birth and a separate existence become very important. In practice, often at the time of detection, the remains are decomposed or skeletonised. In such a situation the examination of developing teeth will provide a reliable answer pertaining to the foetal age, the possibility of a separate existence and even the period of survival after birth. The.age determination from dental examination is possible from approximately 10 weeks intrauterine up to old age. The presence of neonatal line (birth line) in both dentine and enamel indicates live birth and a separate existence. It is possible that the time period of survival can be estimated by measuring postnatal deposition of these hard tissues. An intact human foetus that has undergone mild to moderate putrefaction was studied. The study of the morphological features and the ossification centres suggested that its approximate age was around nine months intrauterine. It was not possible to decide whether it was a live birth and had a separate existence. The examination of the developing first deciduous molar of the mandible suggested the approximate age was around 30-32 weeks intrauterine. The importance of examination of developing teeth in foetal remains (including neonates), particularly associated with putrefaction or skeletonisation is emphasized.
  5. Fulltext A retrospective study to evaluate the effect of type 2 diabetes mellitus on the severity of periodontal disease. A preliminary investigation
    Ismail, N., Mohd Ali, S. S., Swaminathan, D.
    Ann Dent, 2013;20(1):8-12.
    MyJurnal
    A preliminary investigation to assess the relationship
    in the severity of periodontal disease in diabetics when
    compared with non-diabetic subjects. Materials and
    Methods: A retrospective, comparative study using
    periodontal case notes of 40 subjects (20 Type 2 diabetics,
    20 non-diabetics) who were selected based on the
    inclusion and exclusion criteria. Severity of periodontal
    disease was assessed through number of periodontal
    pocket ≥5mm. The results were compared between
    subjects whose age, gender and plaque scores are matched
    with the test group. Data obtained was then analyzed by
    SPSS Version 12. Results: When comparisons were made
    between test (Type 2 diabetic) and control (non-diabetic)
    groups, there were no significant difference (p>0.05) in
    the severity of periodontal disease. However, there was
    a clinically mean difference between the two groups.
    Conclusions: This preliminary investigation indicated
    that the severity of chronic periodontitis, as indicated in
    periodontal pocketing, increased in diabetic patients when
    compared to non-diabetics clinically, although it was not
    statistically significant. The finding of this investigation
    was thus not conclusive as it was only a retrospective
    study using patients’ case notes. However, the results
    are now being further investigated with a proper clinical
    trial which examines periodontal parameters and diabetic
    status (HbA1c) of the subjects to determine the association
    between periodontal disease and diabetes mellitus.
  6. C-Reactive Protein Levels and Periodontal Diseases During Pregnancy in Malaysian Women
    Ahmad A, Nazar Z, Swaminathan D
    Oral Health Prev Dent, 2018 7 22;16(3):281-289.
    PMID: 30027167 DOI: 10.3290/j.ohpd.a40759
    PURPOSE: To investigate the association between plasma CRP levels and periodontal disease during pregnancy.

    MATERIALS AND METHODS: Fifty-six pregnant women attending the Antenatal Clinic, UMMC for their first antenatal check-up consented and were recruited for this study: 28 subjects with diseased periodontium (test group) and 28 subjects with healthy periodontium (control). The test group underwent nonsurgical periodontal therapy and the control group was given oral hygiene education. Periodontal parameters and CRP levels were evaluated at baseline and 6 weeks. Pregnancy outcome data were recorded from the Antenatal Clinic, UMMC.

    RESULTS: Plasma CRP levels in the test group were statistically significantly elevated compared to the control group (8.55 ± 5.28 mg/l vs 5.66 ± 2.91 mg/l). After nonsurgical periodontal therapy, a statistically significant reduction in the CRP level in the test group (2.06 mg/l) along with statistically significant improvement in periodontal status in both groups was observed. The mean birth weight for infants of both groups showed no statistically significant difference.

    CONCLUSIONS: Plasma CRP levels in pregnant women with diseased periodontium were statistically significantly reduced after nonsurgical periodontal therapy. However, no association between CRP levels and adverse pregnancy outcome was observed.

  7. Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report
    Taiyeb-Ali TB, Zainuddin SL, Swaminathan D, Yaacob H
    J Oral Sci, 2003 Sep;45(3):153-9.
    PMID: 14650580
    The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy.
  8. Fulltext Identification of Gingival Crevicular Fluid Sampling, Analytical Methods, and Oral Biomarkers for the Diagnosis and Monitoring of Periodontal Diseases: A Systematic Review
    Nazar Majeed Z, Philip K, Alabsi AM, Pushparajan S, Swaminathan D
    Dis Markers, 2016;2016:1804727.
    PMID: 28074077 DOI: 10.1155/2016/1804727
    Background. Several studies in the last decades have focused on finding a precise method for the diagnosis of periodontal disease in its early stages. Aim. To evaluate from current scientific literature the most common and precise method for gingival crevicular fluid (GCF) sample collection, biomarker analytical methods, and the variability of biomarker quantification, even when using the same analytical technique. Methodology. An electronic search was conducted on in vivo studies that presented clinical data on techniques used for GCF collection and biomarker analysis. Results. The results showed that 71.1%, 24.7%, and 4.1% of the studies used absorption, microcapillary, and washing techniques, respectively, in their gingival crevicular fluid collection. 73.1% of the researchers analyzed their samples by using enzyme-linked immunosorbent assay (ELISA). 22.6%, 19.5%, and 18.5% of the researchers included interleukin-1 beta (IL-1β), matrix metalloproteinase-8 (MMP-8), and tumor necrosis factor-alpha (TNF-α), respectively, in their studies as biomarkers for periodontal disease. Conclusion. IL-1β can be considered among the most common biomarkers that give precise results and can be used as an indicator of periodontal disease progression. Furthermore, paper strips are the most convenient and accurate method for gingival crevicular fluid collection, while enzyme-linked immunosorbent assay can be considered the most conventional method for the diagnosis of biofluids.
  9. Histologic, histomorphometric, and cone-beam computerized tomography analyses of calcium sulfate and platelet-rich plasma in socket preservation: a pilot study
    Cheah CW, Vaithilingam RD, Siar CH, Swaminathan D, Hornbuckle GC
    Implant Dent, 2014 Oct;23(5):593-601.
    PMID: 25192162 DOI: 10.1097/ID.0000000000000148
    To assess dimensional changes and histologic/histomorphometric aspects of grafted sockets using either calcium sulfate-platelet-rich plasma (CS-PRP) or CS alone in socket preservation procedure.
  10. Fulltext Effects of nonsurgical periodontal therapy on clinical response, microbiological profile, and glycemic control in Malaysian subjects with type 1 diabetes
    Buzinin SM, Alabsi AM, Tan AT, Vincent-Chong VK, Swaminathan D
    ScientificWorldJournal, 2014;2014:232535.
    PMID: 25147841 DOI: 10.1155/2014/232535
    The association between diabetes mellitus and chronic periodontal disease has long been established. Most of the researches linking these two very common chronic diseases were based on type 2 diabetes mellitus and chronic periodontal disease. However, this study was conducted to investigate the association between type 1 diabetes and chronic periodontal disease in Malaysian subjects. Forty-one Malaysian subjects, of which 20 subjects were type 1 diabetics and with chronic periodontal disease (test group) and 21 subjects with only chronic periodontal disease (control group), were included in the study. Periodontal parameters and plaque samples for microbiological evaluation were done at baseline, 2 and 3 months after nonsurgical periodontal therapy. Blood samples were taken from only the test group and evaluated for HbA1c at baseline and 3 months after periodontal therapy. There were no statistically significant difference in periodontal parameters between groups (P>0.05) and no significant improvement in the level of HbA1c in the test group. Microbiological studies indicated that there were significant reductions in the levels of the tested pathogens in both groups. The results of our study were similar to the findings of several other studies that had been done previously.
  11. Peri-implant soft tissue integration of immediately loaded implants in the posterior macaque mandible: a histomorphometric study
    Siar CH, Toh CG, Romanos G, Swaminathan D, Ong AH, Yaacob H, et al.
    J. Periodontol., 2003 May;74(5):571-8.
    PMID: 12816287
    Today, one critical goal in implant placement is the achievement of optimal soft tissue integration. Reports thus far have demonstrated successful soft tissue preservation in delayed loaded implants placed in anterior jaws. The aim of this study was to histomorphometrically examine the soft tissues around immediately loaded implants placed in the macaque posterior mandible.
  12. Fulltext The influence of socioeconomic and demographic variables on willingness to donate cadaveric human organs in Malaysia
    Rasiah R, Manikam R, Chandarsekaran SK, Thangiah G, Puspharajan S, Swaminathan D
    Medicine (Baltimore), 2014 Nov;93(23):e126.
    PMID: 25415665 DOI: 10.1097/MD.0000000000000126
    The growing shortage in human organs has raised serious concerns. To address this problem, we examine in this article the association between demographic and socioeconomic factors, and respondents' willingness to donate cadaveric organs using a large survey of Malaysian adults aged 18 years and above.A convenience sampling method was used to extract information from a total of 10,350 participants from Metropolitan Kuala Lumpur over the period of April 2, 2013 to February 29, 2014. In addition to analyzing the data using incidence of willingness to donate by demographic and socioeconomic factors, we carried out logistic regression analysis to estimate the odds ratio of respondents' willingness to become cadaveric organ donors controlling for age.About less than a third of the participants pledged to donate their organs upon death with women (35.6%) showing a higher incidence compared with men (33.2%). The Chinese (35.7%) and Malays (35.0%) pledged to contribute more than the Indians (31.6%) and the logistic regressions show that Malays (adjusted odds ration [OR] = 1.18) and Chinese (adjusted OR = 1.21) are more likely to donate than Indians (reference group). The results by religion were significant among Muslims and Hindus but not Buddhists. The likelihood of Muslims donating was the lowest (adjusted OR = 0.26). Income was also highly significant but the relationship with willingness to donate was negative. Against tertiary education, all other occupations were significant. However, the respondents with primary education enjoyed the highest adjusted OR (5.46) whereas that of secondary (0.48) and higher secondary (0.83) education was low. Among occupations (against supervisory, clerical, and direct workers), it was significant only among the unemployed and managers with adjusted OR of 1.50 and 1.58, respectively.Sex, education, ethnicity, religion, and income are important demographic and socioeconomic influences on the likelihood of Malaysians willing to become cadaveric organ donors. The Malaysian evidence suggests that awareness programs should be targeted at men, Muslims, Hindus, Malays, and the rich more than the others.
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