Introduction: When a nonsurgical endodontic treatment is ineffective, surgery is necessary. This entails putting a retrofilling to seal the tooth's apex. Exposing the lesion, performing a curettage, exposing the root apex, resecting it, preparing the root end, and lastly filling the cavity with the proper material are all steps in endodontic surgery. Thus, the aim of this study is to compare the apical microleakage of four root-end filling materials in cavities prepared using ultrasonic retro tip in in vitro conditions. Materials and methods: An in vitro study was conducted on 60 extracted single-rooted teeth and was cut at the cementoenamel junction (CEJ). They were biomechanically prepared and obturated. Apical 3 mm root-end resection was done using a diamond disc. Root-end cavities were made using an ultrasonic retro tip. Teeth were separated into four groups and filled with SuperEBA®️ ethoxy-benzoic acid (EBA; Keystone Industries, New Jersey), mineral trioxide aggregate (MTA), Biodentine (Septodont, France), and TotalFill Bioceramic Root Repair Material (BC RRM; FKG Dentaire Sàrl, Switzerland). The samples were kept in methylene blue dye and split longitudinally. The degree of dye penetration was observed under a stereomicroscope and scored. Finally, the results were analyzed. Results: TotalFill BC RRM and Biodentine showed the least apical microleakage (p <0.05). Group 1 samples had the highest mean microleakage, followed by Group 2, Group 3, and Group 4 samples. Conclusion: All of the sample groups showed some evidence of microleakage, but not all of the samples showed leaking. SuperEBA (Group 1) demonstrated the highest microleakage when compared to the other groups.
Piezosurgery is a relatively new method derived from the Greek term “piezein” which means “to press tight or to squeeze”. Tomaso Vercellotti an italian physician invented it. He teamed up with Mectron Medical Technology, a medical device company was founded by Italian engineers Fernando Bianchetti and Domenico Vercellotti. It is a technique conceived to overcome the limitations of traditional bone cutting instruments in order achieve the most effective treatment with minimal amount of morbidity. It is used for bone removal and bone recontouring procedure on the principle of ultrasonic vibration. Piezoelectric effect generates an electrical charge when subjected to mechanical stress.
The occurrence of invasive fungal respiratory superinfections in patients with COVID-19 has gained much attention in the post-COVID era. The elucidation of invasive fungal sinusitis with osteomyelitis as a rare aggressive infection that requires prompt diagnosis and treatment to prevent fatal consequences has been noteworthy. Cone-beam computed tomography findings in those patients are central to early diagnosis and management. Here we report a case of post-COVID mucormycosis with osteomyelitis of the maxilla in a 72-year-old woman with a history of recently diagnosed diabetes mellitus.
Introduction: The mouth and teeth are vital in facial aesthetics and the face as a whole is the most critical individual component determining one's physical look. As dentists, we need to be aware that this might significantly alter the care given to a patient since the patient's and the dentist's ideas of beauty may be quite different. This study sought to ascertain how the general public, general dental specialists, and orthodontics all rated the attractiveness of patients who had received orthodontic treatment using a visual scale, as well as how the facial reference could be used to gauge the improvement in smiles. Methodology: The attractiveness of 80 continuously treated patients was assessed by comparing their pre- and post-treatment posed grin images. The attractiveness of participants' smiles was evaluated using the Visual Simple Scale, which measures affect, and the Graph of Facial Stylish Reference, which measures objectively. "Making a Jazzy Face Chart" - The analysts were able to fairly evaluate changes in elements such as the symmetry of the smile twist, the position of the gingival peak of the front teeth relative to each other, the height of the incisal edges of the front teeth, the width of the connector band of the front six teeth, and the general tip of the front teeth by referring to photographs taken during treatment. We put the Visual Basic Scale to the test by having five male orthodontists, five male general dental specialists, and five male laypeople rate how much of an improvement they noticed between the before and after photos of a patient's smile. Results: According to the findings of the first section of the research, orthodontic treatment generally leads to an increase in all indicators. Some instances, however, demonstrated worsening in characteristics such as grin arc consonance, gingival zenith location relative to each other, and incisal edge height. The second half of this research revealed that the opinions of orthodontic specialists, general dentists, and the general public varied with regard to the beauty of a smile. Conclusion: Based on this research, we can say the following: Orthodontic treatment led to improvements in many of the variables that contribute to smile attractiveness, factors include the interproximal width of contact area, the height of the incisal margins of the front teeth, and the location of the gingival zenith in relation to one another, to name a few. The results of this research support the idea that the aesthetics of the smile should be assessed at the last stages of orthodontic treatment when fine adjustments are being made.
Formation of black triangles due to the loss of interdental papilla is one of the utmost perplexing esthetic problems of the periodontium. Many surgical and nonsurgical treatment options have been researched upon to obtain complete papillary fill, but minimally invasive procedures have always been the choice of treatment both for the operator as well as the patient. This article describes the use of injectable platelet-rich fibrin (i-PRF) as a novel nonsurgical technique for the reconstruction of deficient interdental papilla. This is probably the first article that describes the use of i-PRF for the nonsurgical treatment of black triangles. Six sites with the presence of deficient interdental papilla in four patients were selected for this case series. After completion and reevaluation of scaling and root planing, autologous i-PRF was injected at the base of the interdental papilla using the insulin syringe. Photographs obtained before the treatment and at 1, 3, and 6 months after the intervention were assessed by Image J software along with clinical measurements. The use of novel nonsurgical injectable PRF technique allows clinician to successfully treat deficient interdental papilla.
Pigmentation of gingiva not just hampers esthetic appearance but also effects the psychological status of an individual. Although there are wide variety of depigmentation techniques available, there is still a great deal of opinion to choose the appropriate technique. Hence, the aim of this review is to understand the process of pigmentation and its therapeutic modalities so that we can avoid re-pigmentation to the minimal degree possible.
INTRODUCTION: Orthodontics and dentofacial orthopaedics play an important role in reconstruction of child with cleft lip and palate (CLP). In layman term, cleft palate can be defined breach in continuity of the palate. DISCUSSION: Generally, midfacial irregularity and maxillary retrusion are the commonly seen problem after the surgical correction of CLP patients, which occurs mainly because of intrinsic factors, functional or adaptive factors influencing the position and growth of normal and abnormal part and iatrogenic factors due to effect of treatment procedures. The principle of NAM is “negative sculpturing” and “passive molding” of the alveolus and the soft tissues. Orthodontic techniques are used to mold the maxillary, alveolar, and nasal tissues of an infant with CLP. Despite all the hard work that goes into every case, one aspect seems to be missing among many dentists across the globe is proper documentation of their cases. A proper documentation has many advantages. From start of the treatment planning in diagnosis to follow-up and for patient satisfaction point of view, standardization of clinical record play vital role in management of cleft lip and palate patents. CONCLUSION: The orthodontist play an important role in reconstruction of cleft lip and palate patient from birth to adulthood and provides both esthetic and functional treatment. knowing proper documentation not only improves diagnosis and treatment planning for orthodontist but also improve their future clinical practice.
Implant dentistry has seen rapid progress in recent years leading to its application as standard treatment modalities. While selecting treatment plan, bone mapping and selection of implant is very essential for a successful implant practice. In case of an atrophic ridge where bone height is less, then selection of short implant could be a good treatment alternative, as it is a conservative treatment option because it prevents the need of sinus lift, alveolar nerve repositioning, and bone grafting. This article will discuss about how? when to use short implants along with their advantages, disadvantages of short implants in details.
Introduction Dental rehabilitation of partially or totally edentulous patients with dental implants has become a popular treatment modality with reliable long-term results. These days’ new methods are being used to improve the quality of osseointegration. Platelet Rich Fibrin (PRF) is a second generation platelet concentrate which is a new biotechnology, it has been suggested to be of great use in implant dentistry as it can enhance the quality of osseointegration. Various studies show that it improves healing of both hard as well as soft tissues. Aim To compare the quality of osseointegration using platelet rich fibrin over conventional implant placement. Materials & Methods 40 dental implants were placed in total for this study. 20 implants each were placed with PRF (Goup A) and without PRF (Group B) in the osteotomy site. After three months CBCT was done to evaluate and compare the quality of osseointegration between the 2 groups measured in gray value using the Galileos Implant Software- Sirona. Result Mean values obtained were ≈1928 in group A (with PRF) and ≈1734.6 in group B (without PRF). Independent Samples T-Test showed a significant p-value of 0.013 ( p-value>0.05). Conclusion Results from our study show that PRF can play a promising role in the quality of osseointegration when used as a biomaterial in oral implantology. Our study provides a basis for future research with larger sample size and longer follow-ups to elucidate this outcome further.
Background: Oral submucous fibrosis (OSF) is an insidious, chronic, disabling disease, in which there is lack of perfusion due to reduced level of the vasculature and this is said to be responsible for the epithelial atrophy seen in OSF. The degree of vasculature of the affected mucosa and its effects on the epithelial thickness remains controversial till date. Aims: This study attempts to analyze the role of angiogenesis in OSF and its progression using vascular endothelial growth factor (VEGF) and CD34 markers. Materials and methods: The study samples for the present study comprised of 10 cases each of early OSF, moderately advanced, advanced OSF, and 10 cases of normal oral mucosa were used as controls. All the cases were subjected to immunohistochemical staining with VEGF and CD34 markers. Results: Among the different grades of OSF, we did not find any noticeable difference in VEGF expression although we found a upregulation in microvessel density (CD34) in early and moderately advanced OSF followed by a downregulation in advanced OSF. Conclusions: As the disease progresses, there is an increased production of the extracellular matrix component (collagen I and II and fibronectin) and results in fibrosis. Subsequently, it leads to the reduction in the level of corium vascularity and results in hypoxia which ultimately causes reduction and constriction of the vascular channels. This sequence of events alerts us to the relevance of early disease diagnosis and management in an irreversible pathology such as OSF.
Background: Cleaning and shaping of the pulp canal is one of the most important steps of endodontic therapy. Serious complications occur by the apical extrusion of bacteria during the instrumentation procedures. Both crown-down (CD) and full-length linear motion (FM) techniques are routinely used as a component of taper rotary instrument procedures for achievement of thorough cleaning and shaping of the pulp canal space. Hence, we aimed for this study to assess the change in the amount of apically extruded bacteria using CD and FM instrumentation techniques produced by differences in taper between the instruments used during biomechanical preparation of root canals. Materials and methods: The present study included assessments of 132 extracted maxillary central incisor teeth. To achieve a uniform teeth length of 21 mm, the height of the tooth crown was reduced for preserving the coronal portion of teeth. A modified glass vial model was constructed for the estimation of amount of bacterial extrusion through the apical region. For filling of each pulp canal specimen, 20 mL of Enterococcus faecalis suspension was used followed by the use of a number 10 K-file for carrying the bacteria down the lengths of pulp canals. All the contaminated teeth specimens were divided into six study groups with groups I to III containing specimens prepared in the CD manner, while groups IV to VI contained specimens prepared in the FM manner. Six teeth were taken as negative control with three specimens with each technique, and another six specimens were taken as positive controls. Cultivable bacterial counts were determined by evaluating 100 mL saline solution from each vial followed by its inoculation on blood agar. All the colony-forming unit (CFU) values were log-transformed (base 10), and the results were analyzed by Statistical Package for the Social Sciences software. Results: A significantly lower quantity of CFU values was observed during CD instrumentation procedures with 0.02 files in comparison with all other study groups. However, while comparing both the instrumentation procedures when different taper files, other than 0.02 taper, were used for biomechanical preparation of root canal, nonsignificant results were obtained. Conclusion: With 0.02 taper preparations, significantly less amount of extrusion of bacteria is associated when done with CD technique. Clinical significance: No change in the amount of apical extrusion of bacteria will be seen by changing the type of instrumentation procedures. Amount of bacteria extruded can be minimized using 0.02 taper. Key words: Bacteria, Instrumentation, Taper.
Introduction: Gender estimation from dismembered human body parts and skeletal remains in cases of mass disasters, explosions, and assaults cases is an imperative element of any medico-legal investigations and has been a major challenge for forensic scientists. Aim: The aim of the present study was to estimate the gender by using index and ring finger length ratio, hand and foot index along with the correlation of both the hand and foot index to determine the vital role of all the indices in establishing gender identity. Materials and methods: A descriptive cross-sectional study was done on 300 subjects (150 males and 150 females). Various anthropometric measurements like hand length, hand breadth and hand index, Index Finger Length (IFL), Ring Finger Length (RFL) and IFL/RFL ratio as well as foot length, foot breadth and foot index were estimated in millimeters (mm) with the help of sliding-anthropometric caliper. The data was analysed using independent t-test and Pearson correlation coefficient test. A probability value (p) of ≤ 0.05 was considered statistically significant. Results: The index and ring finger ratio was found to be higher in females as compared to males. The hand and foot index was more in males than in females. The index and ring finger length ratio, hand and foot index between males and females was found to be statistically significant for both hands and feet. A statistically significant correlation was determined between hand indexes versus foot index. Conclusion: This study can be useful to establish the gender of a dismembered hand or foot when subjected for medicolegal examination.
Introduction: Endodontic treatment removes all pathogens, such as Enterococcus faecalis from pulp and root canals. The aim of this study is to assess the usefulness of sodium hypo-chlorite (NaOCl) in removing E. faecalis from the root canal used with three different irrigation methods. Materials and methods: This study was conducted on freshly extracted maxillary incisors. After biomechanical preparation, root canals were injected with E. faecalis. Three groups were made which contained 30 teeth in each group; 2 mL of NaOCl solution was used for irrigation followed by agitation with K-files in group I; 2 mL of NaOCl solution was used for irrigation and ultrasonic agitation was done in group II. In group III, an alternate irrigation with NaOCl and 3% hydrogen peroxide was done. The fourth group (control) was irrigated with sterile saline solution. E. fae-calis bacteria were sampled to the root canals with paper points and were transferred to tubes that contained 5 mL of brain heart infusion broth. Tubes were incubated and the presence of broth turbidity was suggestive of bacteria remaining in the root canal. Results: All three groups showed no statistically significant difference. However, difference existed between experimental groups and control groups. Conclusion: The author concluded that all three methods of application of NaOCl were effective in disinfecting the root canal than the saline solution. Clinical significance: No single irrigant has 100% efficiency. Thus by this study, a best irrigating solution with maximum properties can be established.
Background: The complete denture teeth arrangement that gives maximum denture stability, comfort, esthetics, and function have been studied since several years. Many occlusal schemes have been advised in which the lingualized occlusion, balanced occlusion, and monoplane occlusion are advocated most popularly. The purpose of this study was to compare the pressure values on the supporting tissue using three diff erent posterior occlusal schemes: Balanced occlusion, lingualized occlusion, and monoplane occlusion in simulated dentures. Materials and methods: The simulators used in this study, composed of the maxillary, and mandibular clear heat cure acrylic resin edentulous models. Pressures on the supporting structure under the complete denture were measured using eight strain gauges placed on the model surface on the buccal and lingual slopes of the ridges on the molar and pre-molar region. Pressure on the supporting structure was measured and signals from the sensors were amplifi ed and recorded by the multi-channel electronic strain indicator. Results: The mean pressure which was obtained at each measurement point was compared by one-way ANOVA test. Conclusion: Overall monoplane occlusion had lesser pressure values compared to completely balanced and lingualized occlusal scheme. Lingualized occlusal scheme was found to transfer stresses from working side to non-working side to stabilize the mandibular denture.
The aim of the study is to compare the efficacy of different irrigation systems comparing irrigation with syringe and needle (Dispo Van), Max-I-Probe needle (Dentsply Maillefer), EndoActivator (Dentsply Maillefer), and EndoVac (Sybron Endo) in removing the smear layer generated at apical third. Instrumentation was done in 40 extracted premolars using different irrigation regimes (Group 1, saline and syringe; Group 2, Max-I-Probe needles with NaOCl and ethylenediaminetetraacetic acid (EDTA); Group 3, irrigant activation with EndoActivator using needlesNaOCl and EDTA; and Group 4, irrigation with EndoVac using needles NaOCl and EDTA). The percentage of debris was seen with scanning electron microscope (SEM) and evaluated using one-way analysis of variance (ANOVA), Kruskal-Wallis test, followed by Mann-Whitney test for significance. The mean score ± standard deviation for the conventional group was 2.8 ± 0.42 with median value of 3.00 (2-3). The results for the Max-I-Probe needle group were 2.3 ± 0.48 with median value of 2.00 (2-3) The mean debris score for EndoActivator group were 0.8 ± 0.42 with median value of 1 (0-1). The mean debris score for EndoVac group were 0.4 ± 0.52 with median value of 1 (0-1). EndoVac and EndoActivator performed much better than other available systems in removing the smear layer from apical third. So they should be incorporated as a regular part of the irrigation regime.
To evaluate the bonding of composite to glass ionomer cement (GIC) using two different bonding systems. The occlusal surface of 30 teeth was flattened and they were divided into three groups. In Group A, composite (Filtek" Z350 XT, 3M ESPE, USA) was bonded to GIC (Fuji II, GC Corporation, Japan) after initial setting of the GIC being employed as a total-etch adhesive(AdperSinglebond 2, 3M ESPE, USA). In Group B and C, self-etch primer(Adper" Easy One, 3M ESPE, USA) was employed to bond composite to GIC before and after initial setting of GIC respectively. Shear bond strength and nature of fracture of specimens was determined. One-way analysis of variance (ANOVA) was used. Group B showed higher bond strength than Group A & Group C (p<0.01). Group C showed the least bond strength. Bond strength of composite to GIC was significantly higher for self-etch primer group employed on unset GIC.
Distraction osteogenesis has become a very popular technique, as the ability to reconstruct combined deficiencies in bone and soft tissue makes this process unique and invaluable to all types of reconstructive surgeons. We document a case in which an intraoral tooth-borne distractor was designed and segmental alveolar distraction was performed in a large alveolar defect in a patient with bilateral cleft lip and palate. Cosmetic dentistry was performed to attain a pleasing result. This article aims at highlighting the use of distraction in large defects in which bone grafting only is not a suitable procedure.
Objectives: To assess the null hypothesis that there is no difference in the rate of dental development and the occurrence of selected developmental anomalies related to shape, number, structure, and position of teeth between subjects with impacted mandibular canines and those with normally erupted canines. Materials and methods: Pretreatment records of 42 subjects diagnosed with mandibular canines impaction (impaction group: IG) were compared with those of 84 subjects serving as a control reference sample (control group: CG). Independent t-tests were used to compare mean dental ages between the groups. Intergroup differences in distribution of subjects based on the rate of dental development and occurrence of selected dental anomalies were assessed using χ(2) tests. Odds of late, normal, and early developers and various categories of developmental anomalies between the IG and the CG were evaluated in terms of odds ratios. Results: Mean dental age for the IG was lower than that for the CG in general. Specifically, this was true for girls (P < .05). Differences in the distribution of the subjects based on the rate of dental development and occurrence of positional anomalies also reached statistical significance (P < .05). The IG showed a higher frequency of late developers and positional anomalies compared with controls (odds ratios 3.00 and 2.82, respectively; P < .05). Conclusions: The null hypothesis was rejected. We identified close association of female subjects in the IG with retarded dental development compared with the female orthodontic patients. Increased frequency of positional developmental anomalies was also remarkable in the IG.
Objective: The aesthetics of the patient can be improved by surgical reconstruction of interdental papilla by using an advanced papillary flap interposed with subepithelial connective tissue graft. Materials and methods: A total of fifteen sites from ten patients having black triangles/papilla recession in the maxillary anterior region were selected and subjected to presurgical evaluation. The sites were treated with interposed subepithelial connective tissue graft placed under a coronally advance flap. The integrity of the papilla was maintained by moving the whole of gingivopapillary unit coronally. The various parameters were analysed at different intervals. Results: There was a mean decrease in the papilla presence index score and distance from contact point to gingival margin, but it was statistically not significant. Also, there is increase in the width of the keratinized gingiva which was statistically highly significant. Conclusion: Advanced papillary flap with interposed sub-epithelial connective tissue graft can offer predictable results for the reconstruction of interdental papilla. If papilla loss occurs solely due to soft-tissue damage, reconstructive techniques can completely restore it; but if due to periodontal disease involving bone loss, reconstruction is generally incomplete and multiple surgical procedures may be required.
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