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Pulpectomy procedures in primary molar teeth
Hany Mohamed Aly Ahmed
January-April 2014, 3(1):3-10
Premature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars. Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention. Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased in roots programmed for physiologic resorption that show close proximity to developing permanent tooth buds presents a critical endodontic challenge. This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth. In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed.
  130,972 10,368 6
Hepatitis B and C infection: Clinical implications in dental practice
Saniya Setia, Ramandeep Singh Gambhir, Vinod Kapoor
January-April 2013, 2(1):13-19
Health-care workers have an occupational risk of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV). Since dental healthcare professionals have numerous patients and are exposed to blood, they are likely to have the maximum risk. HBC and HCV are transmitted by skin prick with infected, contaminated needles and syringes or through accidental inoculation of minute quantities of blood during surgical and dental procedures. HBV can be prevented by strict adherence to standard microbiological practices and techniques, and routine use of appropriate barrier precautions to prevent skin and mucous membrane exposure when handling blood and other body fluids of all patients in healthcare settings and pre-exposure vaccines. Despite many publications about programs and strategies to prevent transmission, HBV and HCV infections remain a major public health issue. Oral clinical manifestations can be observed, such as bleeding disorders, jaundice, fetor hepaticus, and xerostomia. The most frequent extrahepatic manifestations mostly affect the oral region in the form of lichen planus, xerostomia, Sjögren's syndrome, and sialadenitis. The present paper highlights some of the important oral manifestations related to hepatitis B and C infection and various post-exposure protocols that can be undertaken to minimize the risk of infection.
  47,007 3,717 -
Techniques in the removal of impacted mandibular third molar: A comparative study
Vibha Singh, Khonsao Alex, R Pradhan, Shadab Mohammad, Nimisha Singh
January-April 2013, 2(1):25-30
Objective: Surgical removal of impacted third molar is one of the common surgical procedures carried out in Oral and Maxillofacial Surgery set up. This study aimed at clinically assessing the three different surgical techniques (lingual split, using chisel and mallet, buccal approach techniques, using rotary instruments used in the removal of impacted mandibular third molars. Materials and Methods: The present clinical study comprised of 150 impacted mandibular wisdom teeth. Patients were divided in three groups and bone covering the third molar was removed by the Lingual split technique using chisel and mallet, Buccal approach technique using chisel and mallet, and Buccal approach technique using rotary instruments. Results: Surgical time was significantly increased in bur technique. Trismus was significantly increased in lingual split technique and bur technique from buccal approach technique using chisel and mallet. Post-operative nerve injury was significantly higher in lingual split technique. Dry socket was more in patients of bur technique. Conclusion: In this study we found that lingual split technique using chisel and mallet is found to be better among all three techniques used followed by buccal approach using chisel and mallet and the buccal approach technique using rotary instruments.
  45,204 2,997 5
Management of patients taking rivaroxaban for dental treatments
Adrian Curto
January-April 2017, 6(1):1-4
There are several novel anticoagulant drugs that are being increasingly used as an alternative to warfarin and acenocoumarol. Novel oral anticoagulants have emerged in recent years to overcome some of the drawbacks of classic oral anticoagulants. Rivaroxaban, dabigatran, apixaban, and edoxaban were approved by the Food and Drug Administration and European Medicines Agency. This paper examines the available evidence regarding rivaroxaban and sets out proposals for the clinical guidance of dental practitioners treating these patients in primary dental care. Literature search was conducted through May 2016 for publications in the ISI Web of Knowledge, PubMed, and Cochrane Library using the keywords, "rivaroxaban," "dabigatran," "apixaban," "edoxaban," "new oral anticoagulants," "novel oral anticoagulants," "bleeding," and "dental treatment." For patients requiring minor oral surgery procedures, interruption of rivaroxaban is not generally necessary while a higher control of bleeding and discontinuation of the drug (at least 24 h) should be requested before invasive surgical procedure, depending on renal functionality. Their increased use means that oral care clinicians should have a sound understanding of the mechanism of action, pharmacology, reversal strategies, and management of bleeding in patients taking rivaroxaban. Currently, recommendations are based on poor quality scientific data and clinical trials are required to establish best evidence-based practice guidance.
  43,110 1,304 -
Evolution of root canal sealers: An insight story
Sanjeev Tyagi, Priyesh Mishra, Parimala Tyagi
September-December 2013, 2(3):199-218
Attainment of ideal root canal treatment comprises various essential factors such as proper instrumentation, biomechanical preparation, obturation, and ultimately depending upon the case, post-endodontic restoration. Main objective of the treatment is to get absolute rid of microbial entity and prevent any future predilection of re-infection. In order to achieve that, proper seal is required to cut down any chance of proliferation of bacteria and future occurrence of any pathology. Although gutta-percha has been the standard obturating material used in root canal treatment, it does not reinforce endodontically treated roots owing to its inability to achieve an impervious seal along the dentinal walls of the root canal. Gutta-percha does not from a monoblock even with the use of a resin-based sealer such as AH Plus because the sealer does not bind to gutta-percha. As a result, a monoblock is formed (consisting of Resilon core material, Resin sealer, bonding agent/primer, and dentin). Another reason of Resilon being a better obturating material could be that the removal of smear layer by ethylenediaminetetraacetic acid (EDTA) after biomechanical preparation may have allowed the root canal filling material and root canal sealers to contact the canal wall and penetrate in the dentinal tubules, which may increase the strength of roots. New silicone-based sealers like Roekoseal automix and the most recent GuttaFlow have some affirmative results regarding solubility and biocompatibility, as compared to other sealers. Methacrylate resin-based sealers and mineral trioxide aggregate (MTA)-based sealers have opened a new horizon for sealers.
  31,601 7,224 20
Management of third molar teeth from an endodontic perspective
Hany Mohamed Aly Ahmed
September-December 2012, 1(3):148-160
Third molar teeth are subject to many dental complications because of their most posterior location, aberrant occlusal anatomy and abnormal eruption patterns. Owing to these anatomical limitations, their extraction remains the treatment of choice for many dental practitioners. Despite being a common dental procedure, minimum intervention and retaining every functional component of the dental arch are of prime importance in contemporary dental practice. As such, this review aims to discuss the application of this conservative approach on third molar teeth from an endodontic perspective. The internal and external root anatomy of maxillary and mandibular third molars and their relation to the surrounding vital structures are described. These anatomical landmarks are then correlated to the decision making for endodontic treatment strategies of third molars. In addition, the recommended guidelines that should be followed while commencing endodontic treatment in third molars are outlined.
  35,818 1,804 4
Biological width: No violation zone
Ashu Sharma, GR Rahul, Bhawna Gupta, Mozammil Hafeez
September-December 2012, 1(3):137-141
Maintenance of gingival health is one of the keys for the longevity of teeth, as well as for the longevity of restorations. The concept of Biologic width has been widely described by periodontists and restorative dentists. An adequate understanding of relationship between periodontal tissues and restorative dentistry is paramount to ensure adequate form, function and esthetics, and comfort of the dentition. While most clinicians are aware of this important relationship, uncertainty remains regarding specific concepts such as biologic width and indications and applications of surgical crown lengthening. These violations lead to complications like gingival inflammation, alveolar bone loss and improper fit of the restorative component. This review gives the wide aspect of the complex question of biologic width and represents an attempt to answer some of the demands in relation to it. The article also discusses the possible methods to assess biologic width, problems that occur after improper margin placement in the periodontium and the alternative procedures for prevention of biological width violation.
  23,937 2,494 1
Management of C-shaped root canal configuration with three different obturation systems
Deenadayalan Elumalai, Ashok Kumar, Rajendra Kumar Tewari, Surendra Kumar Mishra, Syed Mukhtar-Un-Nisar Andrabi, Huma Iftekhar, Sharique Alam
January-April 2015, 4(1):25-28
Unusual root canal anatomy always poses a diagnostic and treatment challenge. Identification of such variation is important for the success of the root canal treatment outcome. The C-shaped root canal configuration is one of the aberrant morphology of molar teeth, commonly the mandibular second molar. In this configuration, the canals are connected by slit or web. The presence of fin, slit and web makes through debridement obstacle for the clinician. This case reports present successful management of C-shaped mandibular molars with three different obturation systems.
  23,213 1,781 -
Oral psoriasis: A diagnostic dilemma
Saif Khan, Sufian Zaheer, ND Gupta
January-April 2013, 2(1):67-71
Psoriasis is a chronic, genetically linked, scaly, and inflammatory disease of the skin. Oral manifestations of psoriasis are rare and are often difficult to diagnose. A 35-year-old female presented with gum bleeding, chronic irritation, intolerance to salt and spicy food, and frequent occurrence of painful mouth ulcers with a fissured tongue. Examination of the oral cavity showed desquamations on the buccal mucosa with pedunculated and exophytic growths and also slight gingival enlargements in the anterior segment. The exophytic growths along with gingival enlargement were excised and sent for histopathological examination, which revealed them to be psoriasis. Oral psoriasis is a rare entity and might be confused with other oral mucous membrane dermatoses; hence, it should be considered under differential diagnosis of oral mucous membrane disorders and confirmed histopathologically.
  21,345 1,252 2
A critical review of the management of deep overbite complicated by periodontal diseases
ND Gupta, Sandhya Maheshwari, KC Prabhat, Lata Goyal
January-April 2012, 1(1):2-5
Traumatic deep overbite complicated with periodontal problems is a challenging problem for a periodontist as well as for an orthodontist. A thorough and systematic approach to periodontal and occlusal examination, etiological factors, diagnosis and treatment planning is essential for better treatment results. In such cases prevention of disease is better than its treatment therefore.
  19,776 1,785 -
Endodontic management of horizontal root fractures in maxillary central incisors
Kothandaraman Sathyanarayanan
January-April 2014, 3(1):75-78
Root fracture implies fracture of cementum, dentin, and pulp. These injuries are relatively infrequent as they constitute <3% of all dental injuries. When a root fracture occurs horizontally, the coronal segment may or may not be displaced. This article illustrates two varied treatment options for horizontal root fractures in maxillary central incisors. In the first case, endodontic treatment was performed using a mineral trioxide aggregate (MTA)-based sealer. In the second case, repositioning and splinting of the teeth allowed revascularization and preservation of teeth vitality. A 12-month follow-up period was reported for the two cases.
  17,478 1,551 -
Guidelines to enhance the interpretation of two-dimensional periapical radiographic images in endodontics
Hany Mohamed Aly Ahmed
September-December 2015, 4(3):106-112
Radiology is an indispensable tool in the clinical practice of endodontics because most structures that harbor diseases are invisible to the naked eye. As a result, the use of periapical radiographs before, during, and after root canal treatment is essential in order that anatomical details, canal length, obturation quality, and tooth and bone pathology can be identified and monitored. The purpose of this article is to discuss the guidelines that should be followed to enhance the interpretation of periapical radiographic images in endodontics and to facilitate the identification of root and root morphology, relationship of the teeth to the surrounding anatomical structures and pathological changes in the radicular and peri-radicular areas.
  15,592 2,777 -
A simplified model for biomedical waste management in dental practices - A pilot project at Thane, India
Om N Baghele, Subodh Phadke, Ashish A Deshpande, Jayant P Deshpande, Mangala O Baghele
September-December 2013, 2(3):235-240
A lot of biomedical waste (BMW) is generated in dental practices, which can be hazardous to the environment as well as to those who come in contact with the materials, if not dealt with appropriately. Most of the rules world-wide are not specific for dental BMW management and hinder easy understanding by dental practitioners. Because of lack of clear-cut guidelines either from Dental Council of India or Government of India or Indian Dental Association (IDA) on disposal of dental wastes, this article is designed to explore and review on these issues and formulate a simplified scheme. The guidelines by the Maharashtra Pollution Control Board from the directives of The Ministry of Environment and Forests, Government of India through BMW (Management and Handling) Rules, 1998, (BMW-MH-98), similar guidelines being followed elsewhere in the world, the local BMW disposal company's rules and the IDA's Clinic Standardization Program guidelines. We developed and implemented a simplified waste segregation protocol for practicing dentists and dental hospitals. A methodological dental waste segregation protocol was required considering its disposal and ill-effects on health and the environment. The simplified scheme provided a good model to be followed in developing countries like India. The scheme improved understanding among dentists because of its self-explanatory nature.
  14,536 1,479 -
Dental enamel roughness with different acid etching times: Atomic force microscopy study
Bruno Bochnia Cerci, Lucimara Stolz Roman, Odilon Guariza-Filho, Elisa Souza Camargo, Orlando Motohiro Tanaka
September-December 2012, 1(3):187-191
Objective: An important characteristic of human dental enamel not yet studied in detail is its surface roughness in mesoscopic scale. This study evaluated quantitatively and qualitatively the surface topography of acid etched enamel with different etching times. Materials and Methods: Ninety-six human maxillary bicuspids were randomly distributed into three groups (n=32): T0 (control), pumiced; T15, 35% phosphoric acid etched enamel for 15 s; T30, 35% phosphoric acid etched enamel for 30 s. Roughness measurements Ra, Rz and root mean square (RMS) and 3D images of enamel's topography were obtained with atomic force microscopy (AFM), which is a powerful technique to obtain direct measurements on microscale features. Results and Conclusions: Roughness variables Ra, Rz and RMS presented statistically significant differences to all groups (P<0.000), with values increasing with etching time. This increase was greater from T0 to T15 than from T15 to T30. Enamel surface alterations T15 to T30 occur mainly due to increase in height and deepening of prisms central region.
  13,946 1,471 10
Maxillary ameloblastoma extending into the maxillary sinus
Nidhi Dwivedi, Vineet Raj, Shaleen Chandra, Akhil Agarwal
May-August 2013, 2(2):182-186
Ameloblastoma is a benign but locally aggressive odontogenic tumor. Worldwide, maxillary ameloblastoma is rare, but its late detection renders adequate treatment difficult. Majority occur in the mandible with about 5-20% occurring in the maxillary bone. Here we report a case of plexiform ameloblastoma of the left maxilla in a 30-year-old male. The tumor was presented as a radiographically solid mass filling the left maxillary sinus and clinically as a maxillary swelling. The radio-pathological features of this tumor and the possibility of its sinonasal epithelium origin are discussed.
  11,581 878 1
Dentigerous cyst associated with an impacted maxillary mesiodens
HC Baranwal, Pushpendra Kumar Verma, CD Dwivedi, Ruchi Srivastava
January-April 2012, 1(1):50-53
A dentigerous cyst is a developmental odontogenic cyst, which apparently develops by accumulation of fluid between the reduced enamel epithelium and the tooth crown of an unerupted tooth. When observed with erupted and complete permanent dentition the diagnosis is 95% dentigerous cysts, and only 5% are associated with supernumerary teeth. Mesiodens is a supernumerary tooth situated between the maxillary central incisors. We report the case of a dentigerous cyst in association with an impacted mesioden in an 18-year-old male patient. Radiographically, the cyst appeared as an ovoid, well-demarcated unilocular radiolucency with a sclerotic border. The present case report describes the successful management of a dentigerous cyst by surgical enucleation. Careful evaluation of the history and the clinical and radiographic findings, help clinicians to diagnose the condition accurately, identify the etiological factors, and administer the appropriate treatment.
  11,067 646 -
Current interpretations and scientific rationale of the ozone usage in dentistry: A systematic review of literature
Anil Kumar, Sharnamma Bhagawati, Prashant Tyagi, Prince Kumar
September-December 2014, 3(3):175-180
In the era of antibiotic resistance, a naturally occurring substance is needed to completely cure the infection without any toxic side-effects; a responsibility that "O 3 or Ozone" seems to implement sincerely. Ozone gas has a high-oxidation potential and has the capacity to stimulate blood circulation and the immune response. It is a great supplement to conventional therapeutic dental modalities. Treatment may be achieved by increasing the resistance of the tooth against the microbial activity and reducing the extent of microbial activity. In addition to the recent materials and techniques, the therapeutic actions of ozone may provide beneficial results by reducing the demineralization of the tooth. Its bactericide, virucide and fungicide effects are based on its strong oxidation effect with the formation of free radicals as well as its direct destruction of almost all microorganisms. This potentially beneficial agent has been used in dentistry also. Ozone has a wide application in dentistry which includes treatment of carious lesions, root canal disinfection, wound healing impairments after surgical interventions, plaque control, disinfection of dentures, etc., The purpose of this article is to summarize the mechanism of action and different modalities of ozone therapy in the practice of dentistry.
  6,384 5,046 5
Oral manifestations of dengue fever: A rarity and literature review
Vinay Kumar Bhardwaj, Nishant Negi, Pravesh Jhingta, Deepak Sharma
May-August 2016, 5(2):95-98
Dengue is a viral infection with fatal potential complications. It is also called break-bone fever. Worldwide, dengue infection is the most common mosquito-borne viral disease. It is caused by vector Aedes aegypti and represents a major public health issue in more than 100 tropical countries. This may be associated with a variety of mucocutaneous manifestations, which may be of help in early diagnosis. Dengue viral infections are characterized by abrupt febrile illness, but can also lead to significant morbidity and mortality. Hence, it requires an early and correct diagnosis. Gingival bleeding is the most common oral manifestation of dengue infections. Many biochemical assays and hematological investigations may aid in the further diagnosis and treatment of the fatal disease. Although oral lesions are uncommon in dengue infections and if occur, may be mistaken for platelet abnormality or hemorrhagic disorders. This review emphasizes the significance of oral lesions as it may be the early indicators of dengue hemorrhagic fever.
  10,798 585 2
Orthodontic treatment in an endodontically treated maxillary incisors
Orlando Motohiro Tanaka, Jorge César Borges Leăo Filho, Robert Willer Farinazzo Vitral, José A Bósio
January-April 2013, 2(1):72-75
The purpose of this study was to analyze the effect of orthodontic movement on non-vital teeth, illustrated with a clinical case. A review of the literature shows it is controversial as to whether or not orthodontic forces can be initiated and sustained without the resorptive process occurring. Induced resorption during tooth movement depends on multiple factors, which require the close attention of the dentist to ensure an accurate diagnosis and correct mechanotherapy with respect to the periodontium. The orthodontic treatment described here was performed on a woman 36 years of age with endodontically treated teeth. This case demonstrated that the biomechanics follow biological principles and thus prevent deleterious effects on the components of the periodontium and the bone and maintains the integrity of the root length.
  9,639 1,326 -
Diabetes mellitus: An endodontic perspective
Pishipati Vinayak Kalyan Chakravarthy
September-December 2013, 2(3):241-245
Diabetes mellitus (DM) is a complex metabolic disease, characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. In patients with DM, several aspects of the immune system are compromised and wound healing is impaired. Studies indicate increased prevalence, severity of periapical lesions and a decreased success rate of endodontic treatment in diabetics, suggesting that diabetes may serve as a disease modifier of periapical lesions. A reciprocal relationship exists between glycaemic control and chronic periapical lesions. Treating infections of pulp and periodontium will improve glycaemic control and help in healing of lesions similar to non-diabetics. To provide competent care to patients with DM, dental clinicians must understand the disease, its treatment, and its impact on the patients' ability to undergo and respond to endodontic treatment. This review article is a detailed assessment of the literature on DM and its implication on pulp and periapical diseases, and their treatment outcome.
  9,455 1,465 1
Change in salivary pH following use of homeopathic medicines: A preliminary study
Priya Subramaniam, Krishna Kumar
January-April 2013, 2(1):31-36
Objective: Homeopathic preparations are popular and well accepted by parents and children. These preparations are easily available and are prescribed for acute and chronic conditions. However, their sugar content may affect oral health. Aims and Objectives: This preliminary study assessed salivary pH following administration of homeopathic medicines commonly prescribed for children. Materials and Methods: Forty-five normal and healthy children were divided into 3 groups of 15 children each: Group 1 was given a placebo, group 2 was given chamomilla (2x), and group 3 was given arsenicum (2x). Each child was given 2 pellets to be placed below the tongue and allowed to dissolve completely. Unstimulated saliva samples were collected at baseline, and following 5, 15, 30, and 60 minutes of administration. The saliva samples were suitably transferred to the laboratory for recording of pH using a digital pH meter. The titratable acidity of both homeopathic medicines was assessed. Data was subjected to statistical analysis. Results: Mean salivary pH at 15 minutes was 5.40 in group 1, 5.16 in group 2 and 5.42 in group 3, which was significant. (P=0.000) At 30 and 60 minutes, pH in groups 2 and 3 remained lower than that of group 1. The titratable acidity of chamomilla and arsenicum was found to be 0.14 mmol and 0.018 mmol, respectively. Conclusion: There was a significant reduction in salivary pH at 5, 15, and 30 minutes in groups 1 and 2. In all groups, salivary pH did not return to baseline values even after one hour of administering the homeopathic pellets.
  9,411 543 -
Treatment of localized gingival recessions with free gingival graft
Mehmet Saglam, Serhat Köseoglu
January-April 2012, 1(1):10-14
Mucogingival therapy is a general term describing nonsurgical and surgical treatment procedures for the correction of defects in morphology, position, and/or amount of soft tissue and underlying bony support around teeth and dental implants. The free gingival graft is a reliable mucogingival surgical procedure for increasing the zone of attached gingiva at the buccal or lingual aspect of a single tooth, or groups of teeth, or for covering areas of gingival recession. In this review; using free gingival grafts for treating localized gingival recessions have been outlined in the light of current knowledge.
  8,396 1,302 -
Gerodontology - Orodental care for elderly
Vinay Kumar Bhardwaj
January-April 2012, 1(1):15-19
Changing demographics, including an increase in life expectancy and the growing numbers of elderly, has recently focused attention on the need for geriatric dental care. Ageing affects oral tissues in addition to other parts of the human body, and oral health (including oral mucosa, lips, teeth and associated structures, and their functional activity) is an integral component of general health. Oral disease can cause pain, difficulty in speaking, mastication, swallowing, maintaining a balanced diet, not to mention aesthetical considerations and facial alterations leading to anxiety and depression. Certain strategies should be adopted for improving oral health of the elderly, including the management and maintenance of oral conditions, which are necessary for re-establishing effective masticatory function. Oral health is often neglected in the elderly and oral diseases associated with aging are complex, adversely affecting the quality of life. Although majority of oral health problems are not usually associated with mortality, nearly more than half of the deaths due to oral cancer occur at an age of 65 years plus. This review of geriatric dentistry, which is dedicated to geriatric physicians, geriatric dentist and specialists in oral medicine, emphasizes on age-related oral changes in elderly patients and efforts to summarize the effects of aging in hard and soft oral tissues.
  7,142 1,756 -
Indirect bonding: A literature review
Sertaç Aksakalli, Abdullah Demir
January-April 2012, 1(1):6-9
With the increased interest in recently years, indirect bonding became more popular. This technique enhances clinician's ability to communicate with patients and parents more and enhances chair-time savings. There are many kinds of indirect bonding and new techniques were presented to literature recently. There are so many steps and applications in indirect bonding. So all these are opened to modification and also modified too. With any new development, there will be some trepidation. There is always a natural fear of unknown. In indirect bonding, there were doubts about bond failures but studies revealed that there is no significant difference between direct and indirect technique on bond strength.
  7,213 1,667 2
Nanodentistry: New buzz in dentistry
Madhurima Mikkilineni, Anitha S Rao, Muralidhar Tummala, Soujanya Elkanti
May-August 2013, 2(2):109-113
There is an unavoidable development in the progress of science; nanotechnology has been part of the mainstream scientific theory with potential medical and dental applications since the early 1990s. Dentistry is undergoing another change with the help of nanotechnology combined with nanomaterials, biotechnology and ultimately dental nanorobotics. Nanodentistry will make possible maintenance of comprehensive oral health by employing nano tissue devices which will allow precise controlled oral analgesia, dentine replacement therapy, permanent hypersensitivity cure and complete orthodontic realignment etc., all in a single office visit, covalently bonded diamondized enamel and continuous oral health maintenance through the use of mechanical dentifrobots. There is an increase in optimism that nanotechnology applied to dentistry will bring significant advances in the diagnosis, treatment and prevention of disease. This article enlightens about potential applications of nanotechnology in dentistry and to illustrate their potentially far reaching impact on clinical dental practice.
  7,167 1,613 2