Publications

AIM: To evaluate and compare the salivary pH and oral clearance rate following the use of four different commercially available antitussive lozenges, in order to assess their potential impact on oral health.

MATERIALS AND METHODOLOGY: A total of 40 healthy young adults were randomly divided into four groups (n = 10 each): Group I - Strepsils, group II - Koflet, group III - TusQ, and group IV - Vicks. Baseline unstimulated saliva samples were collected 1 hour after breakfast. After lozenge consumption, stimulated saliva samples were collected at 5-minute intervals up to 30 minutes. Salivary pH was measured using a calibrated digital pH meter. Oral clearance time was determined based on the time required for the salivary pH to return to baseline. Data were recorded and statistically analyzed.

RESULTS: All groups showed a salivary pH drop after lozenge use, with TusQ having the largest drop (3.73) and Koflet the smallest (5.74) at 5 minutes. pH levels gradually increased, with no significant differences between groups by 30 minutes. Koflet maintained higher pH at most times, while Strepsils had higher pH than TusQ at 10 and 15 minutes. Oral clearance time was shortest for Koflet (12.7 ± 2.34 minutes) and longest for Vicks (19.4 ± 2.67 minutes), with Koflet significantly different from the others.

CONCLUSION: The study concluded that different commercially available antitussive lozenges significantly influenced salivary pH and oral clearance time, highlighting their varying potential to impact oral health. Products with lower pH and prolonged clearance times may pose a higher risk for enamel erosion and caries, emphasizing the need for careful consideration when using such lozenges frequently.

CLINICAL SIGNIFICANCE: This study highlights the significance of evaluating the erosive potential and oral clearance time of commonly used over-the-counter lozenges. Lozenges with low pH, high acidity, and extended oral retention can increase the risk of dental erosion and caries, particularly in vulnerable populations. The findings emphasize the need for dental professionals to advise patients on safer alternatives and urge manufacturers to create more tooth-friendly products. How to cite this article: Wankhede SD, Vishwakarma PK, Dodamani AS, et al. pH Modulation and Salivary Clearance Rate of Different Antitussive Lozenges in Adults: A Randomized Clinical Trial. J Contemp Dent Pract 2025;26(5):458-461.

AIM: The present study evaluates the marginal adaptation, shade matching, and patient satisfaction of polychromatic feldspathic porcelain laminate veneers compared to hybrid ceramic multicolor laminate veneers.

MATERIALS AND METHODS: A total of 26 patients required one side veneer to restore discolored, fractured, or maligned anterior teeth. Patients were divided into two groups according to the type of restoration used. The Comparator group included patients receiving multicolor feldspathic (TriLuxe forte) laminate veneers Intervention group included patients receiving Multicolor hybrid ceramic laminate veneers (multicolored Vita Enamic). After final cementation, Marginal Adaptation, Shade matching, and Patient satisfaction were evaluated according to the modified USPHS criteria, after 3-, 6-, and 12-month follow-up intervals.

RESULTS: Marginal adaptation and patient satisfaction showed a statistically insignificant difference (p > 0.05) between both tested groups at all intervals, whereas, color stability had a statistically insignificant difference (p > 0.05) between both tested at T0 and T1, but there was a statistically significant difference (p-value 0.05) between both tested groups at T1 and T2; however, that difference was clinically insignificant. Both groups showed acceptable marginal adaptation, suitable color matching, and color stability with high patient satisfaction.

CONCLUSION: After 1-year of follow-up, TriLuxe forte and multicolored Vita Enamic laminate veneers showed successful marginal adaptation, shade matching, and patient satisfaction. This indicates that both materials can be recommended to be used as anterior single or multiple veneer restorations in clinical situations for optimum esthetic outcome. How to cite this article: Naji KF, Al Ansary HE, Elnaggar GAE, et al. Marginal Adaptation, Shade Matching, and Patient Satisfaction of Polychromatic Feldspathic Porcelain vs Polychromatic Hybrid Ceramic Laminate Veneers. J Contemp Dent Pract 2025;26(5):433-447.

Leukocytoclastic vasculitis (LCV) is an immune-mediated single-organ vasculitis. It is a self-limiting disorder. Common triggers are drugs, infections, malignancy, or underlying autoimmune conditions. Here we discuss the case of an obese, middle-aged hypertensive female who presented with painful right lower limb swelling and productive cough for the last 5 days. She underwent medical and surgical management and was treated as a case of cellulitis with bilateral pneumonia. During the treatment course, she developed a nonblanchable petechial rash, which initially was attributed to the antimicrobial agent (piperacillin-tazobactam), but the culture report of the purulent sputum provoked the broadening of the differential diagnoses to include alternate causes for the rash, which proved to be a diagnostic dilemma.

A 19-year-old girl from a consanguineous marriage showed signs of delayed motor developmental milestones since infancy, a protuberant abdomen, and failure to thrive. She suffered from cor pulmonale as a result of restrictive lung disease, pulmonary hypertension, and chronic interstitial lung disease. Diagnosed with resistant rickets elsewhere, she was on treatment with Joulie's solution. Physical examination revealed an undernourished state and features of rickets. Laboratory results were suggestive of proximal renal tubular acidosis (RTA), dyslipidemia, postprandial hyperglycemia, and elevated alkaline phosphatase. Skeletal X-rays confirmed rickets, and an abdominal ultrasound showed hepatomegaly. Whole-exome sequencing identified a homozygous missense variant in the SLC2A2 gene (p.Glu486Gly), confirming Fanconi-Bickel syndrome (FBS). Management included phosphorus, bicarbonate, vitamin D supplementation, dietary changes, and conservative care. Follow-up showed improvement in height. Fanconi and Bickel (1949) initially reported the rare disorder known as FBS, which is attributed to mutations in the glucose transporter 2 (GLUT2) transporter gene. Due to its autosomal recessive inheritance, genetic counseling and prenatal diagnosis are essential. To the best of our knowledge, this is the first reported case in the world of a novel genetic mutation causing FBS.

Crohn's disease (CD) is a chronic, recurrent, transmural inflammatory disease with lesions anywhere in the gastrointestinal (GI) tract. Takayasu arteritis (TA) is an idiopathic, chronic, granulomatous inflammatory panarteritis that involves the aorta and its branches, known as "pulseless disease." Crohn's disease and TA are both associated, as both are granulomatous disorders, and multiple cases of simultaneous occurrence of both diseases have been reported. Here we are reporting a rare case of simultaneous CD and TA in a young female who had a large enteroenteric fistula between the colon and jejunum and total occlusion of both subclavian arteries with reformed collaterals. The patient was managed with IV antibiotic, IV fluid, and steroid. This unique presentation underscores the importance of considering a potential association between the two conditions in patients presenting with GI symptoms and vascular symptoms.

Immunoglobulin M (IgM) paraproteinemia is usually associated with either lymphoplasmacytic lymphoma (LPL) or Waldenström's macroglobulinemia (WM). Manifestations due to IgM paraprotein include hyperviscosity, acquired coagulopathy, cryoglobulinemia, vasculitis, and cold antibody-mediated autoimmune hemolytic anemia. These manifestations are seen in variable percentage of patients with LPL/WM. IgM myeloma constitutes only 0.5-1% of all myeloma cases. We describe a middle-aged female who presented with 5C's: cryoglobulinemia, coagulopathy (acquired von Willebrand disease), cold autoimmune hemolytic anemia, clot (thrombosis due to vasculitis), and cloudy vision (hyperviscosity syndrome) attributable to IgM paraprotein, but was diagnosed later with IgM myeloma. IgM is an important differential diagnosis of WM. The current case highlights such diagnostic challenges and their therapeutic considerations.

Paragonimiasis is a parasitic infection endemic in the northeastern states of India. Because the infection is largely restricted to endemic areas, suspecting and establishing a diagnosis are challenging in nonendemic areas. Here, we describe a rare case of paragonimiasis in a nonendemic area. We highlight the importance of meticulous history as well as the practical issues in establishing the diagnosis. We also describe the management and outcome of the patient.

Addison's disease is a rare endocrine disorder causing adrenal insufficiency and inadequate cortisol production. A 56-year-old chronic smoker presented with recurrent vomiting, abdominal pain, and severe hyponatremia. He had a 20 kg weight loss over 2 months, generalized weakness, dizziness, and hyperpigmentation. Laboratory tests showed hyponatremia (108 mEq/L), hyperkalemia (6.1 mEq/L), low fasting cortisol (0.65 µg/dL), and elevated adrenocorticotropic hormone (ACTH) (705 pg/mL). Imaging revealed bilateral adrenal enlargement and lymphadenopathy, confirming Addison's disease with adrenal crisis. Immediate IV hydrocortisone led to clinical improvement, stabilizing blood pressure and electrolyte balance. He was transitioned to oral steroids and discharged in stable condition with counseling and an emergency medical information card. This case highlights the need for early recognition and prompt treatment of adrenal crisis to prevent fatal outcomes. Increased clinician awareness can facilitate timely diagnosis and intervention, improving patient prognosis and reducing mortality risk.

Cryptogenic organizing pneumonia (COP) is an idiopathic interstitial lung disease affecting the distal airways, characterized by the development of granulation tissue that obstructs the bronchioles and alveoli, leading to respiratory failure. This case report describes a 63-year-old female patient with a history of diabetes, hypertension, and hypothyroidism who presented with persistent productive cough and dyspnea, initially treated as community-acquired pneumonia. Despite empirical antibiotic therapy, the patient's symptoms persisted. Further investigation, including high-resolution CT (HRCT) scans and a CT-guided lung biopsy, revealed fibrotic exudates, interstitial fibrosis with inflammatory infiltrates, and epithelioid granuloma. A diagnosis of COP was made after multidisciplinary discussion, and corticosteroid therapy was initiated, leading to significant clinical improvement and resolution on repeat imaging. This case highlights the importance of considering COP in patients with nonresolving pneumonia and underlines the efficacy of corticosteroids in its management. It also emphasizes the need for a multidisciplinary approach combining clinical, radiological, and histological assessments to reach a definitive diagnosis. Early recognition and appropriate treatment are crucial in preventing complications such as fibrosis and respiratory failure.

Isolated acute cerebellar ataxia is a rare neurological complication of enteric fever. It usually presents with speech and gait abnormalities. Cerebellar ataxia is generally masked by various other neurological complications, such as delirium. Here, we report a case of a 24-year-old male with no known comorbidities, who presented with complaints of high-grade fever, slurred speech, and unsteady gait, which was broad based. He also had abnormal cerebellar signs. Initial laboratory investigations showed thrombocytopenia, and blood cultures detected Salmonella Typhi. cerebrospinal fluid (CSF) examination and brain imaging were unremarkable. The patient recovered with ceftriaxone, and a final diagnosis of enteric fever with encephalopathy was made.