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   Table of Contents - Current issue
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September 2018
Volume 9 | Issue 6 (Supplement)
Page Nos. 195-390

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EDITORIAL  

Competence and transformation of oral Streptococcus sobrinus in dental caries p. 195
SG Damle
DOI:10.4103/ccd.ccd_689_18  PMID:30294143
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ORIGINAL ARTICLES Top

A comparison of oral midazolam-ketamine, dexmedetomidine-fentanyl, and dexmedetomidine-ketamine combinations as sedative agents in pediatric dentistry: A triple-blinded randomized controlled trial Highly accessed article p. 197
Astha Jaikaria, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Kartik Syal
DOI:10.4103/ccd.ccd_818_17  PMID:30294144
Introduction: It is common to encounter a patient who is anxious to the magnitude that precludes the possibility of provision of dental treatment. This study aims to evaluate and compare the sedative effect of oral combinations of midazolam-ketamine (MK), dexmedetomidine-fentanyl (DF), and dexmedetomidine-ketamine (DK) in a group of uncooperative children requiring dental treatment. Methodology: This was a prospective, randomized, triple-blind study where 36 children who were 3–9 year old with American Society of Anesthesiologists –I status and presenting early childhood caries were randomly assigned to: Group A – 0.3 mg/kg of M and 5 mg/kg K, Group B – 2 ug/kg of D with 3 ug/kg of F, and Group C – 2ug/kg of D with 5 mg/kg of K in 1 mL honey. Patients' blood pressure, heart rate, and oxygen saturation were recorded from the start of the procedure till discharge. Patients' behavior, sedation status, and wake-up behavior were evaluated with Modified Observer Assessment of Alertness and Sedation Scale and ease of treatment completion by Houpt scale. Results: Hemodynamic changes were statistically insignificant in all three groups. 72.8% of patients in Group A and 58.3% of patients in Group B were successfully sedated during treatment. Behavior improvement was seen in all three groups during treatment with statistically insignificant difference in behavior scores produced by Group C. Ease of treatment completion was moderately better with Group A. Conclusion: Oral DK has a comparable sedative property with oral MK combination. Oral DF promises to be a potential sedative agent for children due to its successful anxiolysis.
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Comparative evaluation of antimicrobial efficacy of silver nanoparticles and 2% chlorhexidine gluconate when used alone and in combination assessed using agar diffusion method: An In vitro study p. 204
Seetharam Charannya, Dasarathan Duraivel, Krishnan Padminee, Saravanan Poorni, Cruz Nishanthine, Manali Ramakrishnan Srinivasan
DOI:10.4103/ccd.ccd_869_17  PMID:30294145
Context: Silver nanoparticle (AgNP) is a potent antimicrobial that is widely used in several fields of medicine. Chlorhexidine (CHX) gluconate is a well-known agent used in dentistry to eliminate oral microbial flora. Aims: The aim of this study is to evaluate the efficacy of AgNPs, 2% CHX gluconate, and the combination of two solutions against endodontic pathogens such as Enterococcus faecalis, Klebsiella pneumoniae, and Candida albicans. These organisms are frequently found in the root canal space and their persistence may lead to endodontic failure. The synergistic effect of the two solutions has been evaluated in this study. The antibiotic gentamycin was taken as the control group. Settings and Design: Agar well diffusion method was used and minimum inhibitory concentration of AgNP was found to be 15 μg/mL. AgNPs were synthesized from the aqueous plant extract of Cassia roxburghii. The combination of CHX-AgNP solution was stirred together by a glass rod. The values were tabulated and subjected to statistical analysis using the SPSS software version 20. One-way ANOVA test was used to compare within the groups and between groups. The level of significance was set at 5%. Results: CHX-AgNP combined solution exhibited the highest efficacy in comparison to these solutions used alone. They showed the highest efficacy against C. albicans among the three organisms tested. Conclusion: The present study demonstrates the antimicrobial efficacy of a novel mixture of CHX-AgNP solution, and it may be developed as a promising antimicrobial agent against endodontic flora.
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Evaluation of serum leptin and adiponectin in obese individuals with chronic periodontitis p. 210
Ramanarayana Boyapati, Srikanth Chintalapani, Arpita Ramisetti, Shyam Sunder Salavadhi, Radhika Ramachandran
DOI:10.4103/ccd.ccd_1_18  PMID:30294146
Objectives: Studies have reported changes in leptin and adiponectin levels in the gingival crevicular fluid, saliva, and blood serum of obese patients with periodontal disease. The aim of the study is to evaluate serum leptin and adiponectin levels in obese and nonobese individuals with chronic periodontitis and to deduce a relationship between the clinical parameters and the inflammatory biochemical parameters. Materials and Methods: In this case–control study, a total of fifty individuals were selected based on the body mass index (BMI): Group I of obese individuals with chronic periodontitis and Group II of nonobese individuals with chronic periodontitis. Periodontal parameters used in this study were plaque index, gingival index, probing pocket depth, and clinical attachment level. The effects of obesity and periodontal status on serum leptin and adiponectin levels of both groups were statistically analyzed using an independent t- test. Results: Statistical analysis showed that the effect of BMI on serum leptin and adiponectin levels was statistically significant (P < 0.01), and the effect of chronic periodontitis on the serum leptin and adiponectin levels was also statistically significant compared to nonobese individuals (P < 0.0001). However, there is no statistically significant correlation between serum leptin and adiponectin, which indicates that both are independent to each other. Conclusions: In obese individuals with chronic periodontitis, serum leptin levels were significantly high compared to nonobese individuals and serum adiponectin levels were significantly lower in obese individuals compared to nonobese individuals with periodontitis, though both the parameters were independent of each other.
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Comparative evaluation of apical transportation and canal centric ability in apical region of newer nickel-titanium file systems using cone-beam computed tomography on extracted molars: An In Vitro study p. 215
Ekta Pansheriya, Manish Goel, Kapil Dev Gupta, Ravish Ahuja, Rupinder Deep Kaur, Vishal Garg
DOI:10.4103/ccd.ccd_17_18  PMID:30294147
Background: Objective in root canal preparation is to develop a shape that tapers from apical to coronal, maintaining the original canal shape. With advent of instruments manufactured from nickel-titanium (NiTi) alloys, there was a significant improvement of quality of root canal shaping, with predictable results and less iatrogenic damage. Aim: The aim of the study was to evaluate the canal centric ability and apical transportation in apical region of newer NiTi file system in root canal using cone-beam computed tomography (CBCT) on extracted molars. Materials and Methods: Root canal of thirty extracted human permanent teeth with mature root apices with 20°–40° of curvature were collected and divided into three groups after initial bio-mechanical preparation: Group 1: canal prepared using ProTaperNext (PTN) file system; Group 2: canal prepared using Mani silk system; and Group 3: canal prepared using V-taper file system. All samples were scanned before and after biomechanical preparation using CBCT. The data collected were evaluated using the Kruskal–Wallis analysis of variance test and Mann–Whitney U-test. Results: It was observed that in apical region Group I (PTN) showed significantly lower mean apical transportation and canal centric ability as compared to Group II (Mani Silk) and Group III (V-taper). Conclusion: It was concluded that PTN rotary system has no canal transportation and maintained centric ability in comparison to Mani and V-taper rotary file system in apical region of curved root canal.
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Prevalence of pneumatized articular tubercle using panoramic radiography and cone beam-computed tomography: A retrospective study p. 221
Supriya Girish Bhalchim, Shraddha C Jugade, Easwaran Ramaswami, Ajas A Gogri, Sonali G Kadam, Hemant R Umarji
DOI:10.4103/ccd.ccd_64_18  PMID:30294148
Context: In 1985, Tyndall and Matteson first described the air cells that occur in the root of zygomatic arch and in the articular eminence of the temporal bone but do not extend beyond the zygomaticotemporal suture. Aims: The aim is to study the prevalence and patterns of pneumatized articular tubercle (PAT) retrospectively using two different imaging modalities, i.e., digital panoramic radiography and cone-beam computed tomography (CBCT). Subjects and Methods: Total 3000 panoramic radiographs belonging to 1291 females and 1709 males and CBCT scans of 200 patients belonging to 62 females and 138 males were studied retrospectively and investigated for radiographic features of pneumatized articular tubercle. Results: Prevalence found by using panoramic radiography is 1.96% and by using CBCT is 12.5%. Conclusions: This research scrutinizes the prevalence of pneumatized articular tubercle and establishes the prevalence of the same among the studied population, using panoramic radiography and CBCT.
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Evaluation of antimicrobial efficacy of nanosilver solution, sodium hypochlorite and normal saline in root canal irrigation of primary teeth p. 227
Farasat Moradi, Roza Haghgoo
DOI:10.4103/ccd.ccd_95_18  PMID:30294149
Background: Bacteria are the main etiological factors in the development of dentinal caries and its progression to pulpal and periapical disease. Enterococcus faecalis is the bacterial species most frequently recovered from the root-filled teeth. Aim: This study aimed to evaluate the antimicrobial effectiveness of nanosilver (NS) solution as an endodontic irrigation solution of primary teeth against E. faecalis. Settings and Design: Thirty-six canals of primary teeth were selected for this ex vivo study. Methods and Materials: Thirty-six canals of primary teeth were prepared up to the file #35 and all of the specimens were sterilized. Then, root canals were inoculated with a suspension containing E. faecalis bacteria. The teeth were then randomly divided into three groups. Antimicrobial effectiveness was evaluated immediately after dividing into groups by counting colony-forming units on brain heart infusion broth plates. Statistical Analysis: Data were analyzed using Kolmogorov–Smirnov, Welch, and Dunnett's T3 tests. Results: Sodium hypochlorite showed the highest antimicrobial effectiveness against E. faecalis and showed significant differences compared with normal saline and NS solution (P < 0.001). Conclusion: Based on the results of this study, solution of NS particles can be used as an alternative to other root canal irrigating solutions.
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Comparative evaluation of retention, cariostatic effect and discoloration of conventional and hydrophilic sealants - A single blinded randomized split mouth clinical trial p. 233
Jayashri Prabakar, Joseph John, I Meignana Arumugham, R Pradeep Kumar, D Srisakthi
DOI:10.4103/ccd.ccd_132_18  PMID:30294150
Introduction: Pit and fissures are approximately eight times vulnerable than the smooth surface caries lesion. Sealants are effective in preventing, arresting, and progression of pit-and-fissure occlusal caries lesions. The failure of sealant resin-based retention is mainly attributed to the moisture contamination. To overcome this drawback, UltraSeal XT® hydro, a moisture-friendly sealant, has been introduced. Aim: This study aimed to compare and evaluate the retention, cariostatic effect, and discoloration of conventional Clinpro™ 3M™ ESPE™ and hydrophilic UltraSeal XT® sealants among 12 to 15-year-old schoolchildren for 3 months. Materials and Methods: A single-blinded, randomized, split-mouth clinical trial was conducted among thirty schoolchildren aged 12–15 years. Sealants used in the present study were Group I – Clinpro™ and Group II – UltraSeal XT® hydro. Sealants were provided in the school by two operators based on the computer-generated random sequence and the study participants were evaluated after 3 months for sealant coverage, caries incidence, and discoloration using Color, Coverage and Caries sealant evaluation system. Sealant coverage between the two sealants was compared using Mann–Whitney U-test and Z-test for proportions. Results: A total of 47 teeth (78.3%) with UltraSeal XT® Hydro had the sealant covering in all the fissures compared to Clinpro™ 3M™ ESPE™ which was 46.7% (28 teeth) and the difference was observed to be statistically significant. Conclusion: Hydrophilic UltraSeal XT® Hydro yielded better sealant coverage (retention) compared to the conventional Clinpro™ 3M™ ESPE™. No difference was observed with regard to cariostatic effect and discoloration.
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Evaluation of marginal adaptation of a self-adhering flowable composite resin liner: A scanning electron microscopic study p. 240
Chava Gayatri, Tanikonda Rambabu, Girija Sajjan, Pravallika Battina, Medapati Suseela Priyadarshini, Beesetty Lakshmi Sowjanya
DOI:10.4103/ccd.ccd_156_18  PMID:30294151
Background: “Self-adhering composite resins,” are claimed to eliminate the need for a separate acid etching and bonding agent application step, thus simplifying the direct restorative procedure, both regarding the technique sensitivity and the duration of treatment. Aim: The aim of this study is to evaluate the marginal adaptation of self-adhering flowable composite (Dyad flow) in comparison to the conventional flowable composite (Tetric N-flow) under scanning electron microscope (SEM). Settings and Design: This in vitro study was conducted on 44 extracted human maxillary premolars. Materials and Methods: Box-only Class II cavities on the distal surface were prepared with the dimensions of 4 mm buccolingual width, 2 mm mesiodistal depth, and gingival margin at the cementoenamel junction. They were divided into two groups of 22 teeth each and were restored accordingly: Group I – Gingival floor lined with Tetric N-Flow and were restored with Tetric N-Ceram; Group II – Gingival floor lined with Dyad flow and were restored with Herculite Precis. After thermal cycling, the sectioned tooth-restoration interfaces were evaluated for the marginal adaptation under SEM at ×200 magnification. Statistical Analysis Used: The resultant data were statistically analyzed by applying Chi-square test, using the SPSS (version 16.0) software. Results and Conclusion: There was no statistically significant difference between the study groups regarding the marginal adaptation. The marginal adaptation of the self-adhering flowable composite when used as a liner in Class II restorations was comparable to that of the conventional flowable composite.
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Molar incisor hypomineralization and its prevalence p. 246
Sisira Padavala, Gheena Sukumaran
DOI:10.4103/ccd.ccd_161_18  PMID:30294152
Background: Molar incisor hypomineralization (MIH) is the hypomineralization of systemic origin of one to four permanent first molars, frequently associated with affected incisors. It is presented as demarcated enamel opacities of different colors, occasionally undergoing posteruptive breakdown. The characteristic feature of MIH is the clear demarcation between the affected and sound enamel. There is asymmetry of defects present in the molars and incisors where one molar or incisor can be severely affected, while the contralateral tooth may be clinically sound or have only minor defects. Aim and Objective: The aim of this study is to evaluate schoolchildren of 7–12 years of age with at least one of the first permanent molars fully or partially erupted from randomly selected government and private schools in Chennai using the European Academy of Pediatric Dentistry (EAPD) criteria for MIH, to determine the prevalence and characteristics of MIH. Materials and Methods: The dental examinations were performed in the classroom using a mouth mirror and explorer under a headlight. Teeth were wiped with gauze when necessary to remove plaque or the food accumulations. Surfaces that were examined were the buccal, lingual, palatal, and occlusal surfaces of permanent first molars and labial surfaces of upper and lower incisors. A single examiner was involved to avoid interexaminer bias. All the data were collected and scored using the EAPD criteria for MIH. Results: A total of 22 (12.9%) children out of the examined 170 had MIH. Conclusion: Distribution of MIH was more in males, more in 9 years of age. A total of 13 children had first molars affected and 9 children had both incisors and molars affected. Molars were affected more than the incisors. Mandible was affected more in comparison with the maxilla. Right side was affected more than the left side. The distribution of MIH was more in government schools compared to private schools.
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Physical properties of heat cure denture base resin after incorporation of methacrylic acid p. 251
Kotha Sujitha, M Bharathi, S Lakshminarayana, Afsar Shareef, B Lavanya, V SivKumar
DOI:10.4103/ccd.ccd_172_18  PMID:30294153
Introduction: Heat cure acrylic resins are the most commonly used denture base materials. The important limitation is they may act as reservoir of microorganisms. The adherence of microorganisms can be reduced by chemical modification of the surface charge of denture base resin. Incorporation of methacrylic acid (MA) in the denture base resin gives a negative surface charge. A denture base having a negative surface charge may hinder the initial adhesion of microorganisms through repulsive electrostatic forces. Aims and Objectives: The present in vitro study was performed to determine the effect of addition of antimicrobial agent MA on the flexural strength and surface roughness of heat cure denture base resin. Materials and Methods: A total of 90 heat cure acrylic specimens were prepared. Of 90 specimens, 30 were prepared as Group I control group without addition of MA. Groups II and III specimens were prepared by adding 10% and 20% MA, respectively. Using universal testing machine and surface roughness tester, flexural strength and surface roughness of specimens measured. Results: In the present study, decrease in the flexural strength was observed when the concentration of the MA increased in the denture base resin. A slight increase in the surface roughness was observed as the concentration of MA increased.
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Burning mouth syndrome: A comparative cross-sectional study p. 256
Maryam Rabiei, Ehsan Kazemnezhad Leili, Leili Alizadeh
DOI:10.4103/ccd.ccd_175_18  PMID:30294154
Background and Aim: Burning mouth syndrome (BMS) may be defined as a burning sensation in the oral mucosa usually unaccompanied by clinical signs. Multiple conditions have been attributed to a burning sensation. The aim of this study was to determine the role of age and sex in BMS. Materials and Methods: A total of 195 consecutive patients with BMS and 95 healthy patients without burning sensation were recruited in this study. Patients with BMS had experienced oral, burning sensations for at least 6 months without oral clinical signs, and with a normal blood count. Multiple logistic regression analyses were utilized to define the main predictors. Results: Menopause, candidiasis, psychological disorders, job status, denture, and dry mouth were significantly frequent in BMS patients. Multivariate logistic regression indicated age (odds ratio (OR) =1.12, 95% confidence interval (CI): 1.08–1.15, P < 0.0001) and sex (OR = 3.14, 95% CI: 1.4–6.7, P < 0.002) significantly increase the odds of BMS. Psychological disorders (OR = 3.39, 95% CI: 1.2–9.5, P < 0.02) and candidiasis remain as predictive factors. Ultimately, age was defined as a critical predictor. Moreover, we can therefore predict that a 60-year-old woman with psychological disorders is 25 times more likely to suffer from BMS than a man 10 years younger who has no psychological disorder. Conclusion: Age and sex were the main predictors in BMS. Psychological disorders and candidiasis were significantly associated with the occurrence of BMS.
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Comparative study of the effect on apical sealability with different levels of remaining gutta-percha in teeth prepared to receive posts: An in vitro study p. 261
Kaveri Baruah, Nitin Mirdha, Bobbin Gill, Nirmala Bishnoi, Tarun Gupta, Queentaj Baruah
DOI:10.4103/ccd.ccd_196_18  PMID:30294155
Objective: The objective of this study is to compare the apical sealability of mineral trioxide aggregate (MTA) Fillapex and Endosequence BC sealer at three different lengths of remaining gutta-percha after postspace preparation. Materials and Methods: A total of 80 freshly extracted human maxillary anterior teeth were decoronated, biomechanically prepared, and randomly divided into four groups; Group A and Group B served as positive and negative control with 10 teeth each. The teeth in Group C and Group D (with 30 teeth each) were obturated with gutta-percha using MTA Fillapex sealer and Endosequence BC sealer, respectively. Teeth in Group C and Group D were further subdivided into three subgroups depending on the length of remaining apical gutta-percha, i.e., 3, 4, and 5 mm after postspace preparation. Apical leakage was assessed using dye penetration method under stereomicroscope. Results: In both the Groups C and D, there was overall no statistically significant difference in leakage; however, Group C showed slightly more leakage than Group D. There was a statistically significant difference in leakage at 3 mm and 5 mm level in both groups. Conclusion: Although less microleakage occurred, the bioceramic sealers could not totally eliminate leakage.
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Effect of preetching on microleakage with all-in-one adhesives using calcium-based desensitizers: An in vitro study p. 266
N Tulasi Priya, Harikumar Vemisetty, Keerthi Sudireddy, Jayaprada Reddy Surakanti, Amulya Vanapatla, Anil Kumar Maradi
DOI:10.4103/ccd.ccd_208_18  PMID:30294156
Objectives: The aim of this study was to evaluate the effect of calcium-based desensitizers on the microleakage with and without preetching enamel in Class V cavities restored with all-in-one adhesives. Materials and Methods: Class V cavities were prepared on the buccal surfaces of 100 extracted human premolars. A total of 100 box-shaped cavities were divided into five groups (n = 20). Group 1 – no desensitizer was applied and Groups 2 and 4 – desensitizer (CCP-ACP and Novamin) was applied, respectively, followed by the application of G-Bond and restored with composite restoration. Groups 3 and 5 are same as Group 2 and 4, but preetching of enamel was done for 3 s after desensitizers application. The teeth were thermocycled and the specimens were examined for microleakage using methylene blue as a marker. The teeth were sectioned buccolingually and evaluated for microleakage under stereomicroscope and the scores obtained were analyzed with Kruskal–Wallis and Mann–Whitney tests. Results: Statistically significant difference existed between Groups 2 and 3 (P < 0.05). There was also statistically significant difference between Groups 4 and 5 (P < 0.05). Groups 3 and 5 showed significantly less microleakage (P < 0.05). No statistically significant difference in microleakage values was observed between the two desensitizers CCP-ACP and Novamin. Conclusion: The application of calcium-containing desensitizers with selective etch enamel technique in all-in-one adhesives could be considered an advisable procedure to minimize microleakage.
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Efficacy of intraosseous local anesthesia for restorative procedures in molar incisor hypomineralization-affected teeth in children p. 272
Uma B Dixit, Amil V Joshi
DOI:10.4103/ccd.ccd_252_18  PMID:30294157
Background: Treatment of teeth affected with molar incisor hypomineralization (MIH) in young patients is challenging due to chronic subclinical pulpal inflammation caused by porous enamel and exposed dentin. Hypersensitivity of the teeth and difficulty in achieving local anesthesia due to altered nerve potential affects the successful completion of the treatment. Aim: The aim of the study was to compare the anesthetic efficacy of the intraosseous (IO) anesthetic technique with conventional local infiltration technique in anesthetizing first permanent molars (FPMs) affected by MIH for restorative procedures in children. Materials and Methods: This randomized controlled clinical trial recruited 54 MIH-affected mandibular or maxillary FPMs requiring restorations or stainless steel crowns. The teeth were randomly allocated to two equal groups to receive either IO injection or buccal infiltration (control), both using 4% articaine. Onset, time required, and pain experienced for administration, need for repeat, efficacy of anesthetic technique, heart rate, and postoperative complications were recorded in both the groups. Collected data were subjected to statistical analysis. Results: Onset was significantly faster and pain experienced during administration was significantly lower with IO technique. Need for repeat of anesthesia was significantly more with infiltration (44.4% vs. 7.4% in IO, P = 0.004). Local infiltration failed to produce profound anesthesia in 74.1% MIH-affected teeth. IO anesthesia profoundly anesthetized 88.9% MIH-affected teeth. Anesthetic efficacy was significantly better with IO anesthesia (P < 0.001). Postoperative complications were significantly lower with IO anesthesia (P = 0.003). Conclusion: IO local anesthesia was found to be an effective and safe technique to achieve profound anesthesia in MIH-affected teeth in children in comparison to local infiltration.
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Assessment of survival rate of dental implants in patients with bruxism: A 5-year retrospective study p. 278
Rajkiran Chitumalla, KV Halini Kumari, Abhilash Mohapatra, Anuj Singh Parihar, KS Anand, Padmavathi Katragadda
DOI:10.4103/ccd.ccd_258_18  PMID:30294158
Background: Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The present study was conducted to assess complications in dental implants in bruxism patients. Materials and Methods: This 5-year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2016. Among these patients, 124 had bruxism habit. Dental radiographs or patients' recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit. Results: In 240 males and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw-type and 130 cemented-type fixations had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented-type fixation and fracture of ceramic (85) in screw-type fixation. The difference was statistically significant (P = 0.01). Forty-two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among genders was statistically nonsignificant (P = 0.21). Conclusion: Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications.
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Effect of laser etching and spark erosion on retention and resistance of partial veneer crown copings luted with adhesive resin cement p. 283
Chandra Govindaraj Sarath, Sivanesan Karthikeyan Jagdish, Krishnan Murugesan, Balasubramaniam Muthukumar
DOI:10.4103/ccd.ccd_280_18  PMID:30294159
Purpose: There has been less focus on methods to improve the clinical performance of partial veneer crowns. In this study, we wanted to explore the potential of two new surface treatment modalities (laser etching and spark erosion) for improving the longevity of partial veneer crowns. Material and Methods: Conventional partial veneer crown preparation was done on 90 extracted premolars by a single operator. All the samples used in the study were divided into three groups. Group A were samples to be treated by sandblasting alone, Group B were samples to be treated by sandblasting followed by laser etching, and Group C were samples to be treated by sandblasting followed by spark erosion. Each group consisted of two Sub Groups: Sub Group I-Retention test group, Sub Group: II-Resistance test group. The prepared teeth were randomly allotted to the three groups and subgroups using lot method. Partial veneer crown copings were fabricated for testing retention and resistance. Castings in each subgroup were luted with resin cement to their respective tooth preparations. Retention and resistance testing of samples were done with the use of an Instron Universal testing machine. Results: The two surface treatments, laser etching and spark erosion (Groups B and C) of metal copings significantly improved the retention and resistance compared to sandblasted surfaces alone (P ≤ 0.05). Retention and resistance of copings which were sandblasted and spark eroded (Group C) were found to be highest among the three groups (P ≤ 0.05). Conclusion: Within the limitation of this study, it can be concluded that the combination of spark erosion and sandblasting significantly improves the retention and resistance values of partial veneer crown. This study helps to provide better knowledge about the surface treatment required for success of partial veneer crowns.
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Dermatoglyphic analysis in parents with cleft children: A comparative study p. 291
D Jaya Harika, E Sridevi, AJ Sai Sankar, K Pranitha, Srinivas Reddy Gosla, G Bhanu Kiran
DOI:10.4103/ccd.ccd_288_18  PMID:30294160
Background and Objective: There were studies in the literature which showed the altered dermatoglyphics in the cleft children. But it would be beneficial if probable expression can be proved in prior generations, so that genetic counseling and other preventive measures can be undertaken. The aim of the study is to determine variations in dermatoglyphics of prior generations which would serve as bench markers to predict the occurrence of cleft in off springs. Materials and Methods: A total of 400 parents aged between 25-45 years were selected and divided into two groups - Group A consisted of parents with cleft children and Group B comprised of parents with at least 2 healthy children who met the inclusion criteria. Dermatoglyphic prints were collected by ink method and evaluated for pattern types, total ridge count and palm prints were evaluated for a-b ridge count, atd angle and asymmetry. Results: Significant difference was observed between Group A and B with reference to pattern types; TRC and a-b ridge count and atd angle. Absence of t point was variably noticed in the mothers of affected children. Conclusion: Dermatoglyphics can be used as tool to study the developmental instability of cleft anomalies and provides data to assess the genetic etiology of clefting.
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Association of stress, salivary cortisol, and chronic periodontitis: A clinico-biochemical study p. 299
Vishnu Teja Obulareddy, Vijay Kumar Chava, Sreenivas Nagarakanti
DOI:10.4103/ccd.ccd_289_18  PMID:30294161
Background: Periodontitis and stress are among the areas of increasing interest over the past two decades. Early detection of these diseases plays a crucial role in successful therapy. Cortisol is a protein which was found to be consistently associated with both. Aim: The present study was aimed to evaluate saliva cortisol levels (SCLs) in chronic periodontitis (CP) patients with and without stress. Materials and Methods: In this cross-sectional study, saliva samples were collected and cortisol levels were determined using ELISA method in 92 participants. The participants were divided into four groups based on periodontal condition (number of teeth present, plaque index (PI), bleeding on probing (BOP), probing pocket depth, and clinical attachment level) and stress levels into Group 1 (no periodontitis and no stress), Group 2 (with periodontitis and no stress), Group 3 (without periodontitis and with stress), and Group 4 (with periodontitis and stress). Results: Overall, 92 adult participants (41 males and 51 females) were included in the study. Participants with stress and periodontitis have high mean SCL when compared to other groups (Group 1: 15.01 ± 2.62, Group 2: 31.92 ± 6.80, Group 3: 34.47 ± 13.47, and Group 4: 60.13 ± 6.68). Group I shows a significant negative correlation of cortisol to BOP, stress to PI, and stress to cortisol level, whereas there is a positive correlation of SCL to PD in Group 4 which is not statistically significant. Conclusion: SCL showed difference among the groups. SCL were associated with both CP and psychological stress. Increase in inflammation and stress levels enhances the SCL.
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Unrevealed caries in unerupted teeth: A prevalence study p. 305
Sapna Konde, CS Sri Darshini, Manisha Agarwal, Preetha Peethambar
DOI:10.4103/ccd.ccd_291_18  PMID:30294162
Background: Preeruptive caries are an abnormal, well-circumscribed, radiolucent area, occurring within the coronal dentinal tissue close to the dentinoenamel junction of unerupted teeth. OPGs are commonly taken in children for assessing the dental age and eruption sequence. It can be used as a good diagnostic source for detection of PEIR defects. Aim: The aim of this study is to determine the prevalence of Preeruptive intracoronal dentin radiolucencies in unerupted permanent teeth from orthopantomogram. Settings and Design: A total of 1000 standard orthopantomographs of children below 12 years of age were collected and examined. Methodology: The OPGs were examined for PIER defects in the unerupted teeth. The prevalence of PEIR defects was assessed with respect to age, sex, tooth, and the arch involved. Statistical Analysis: The data obtained were tabulated and analyzed. The prevalence was calculated in percentage. Results: The participant prevalence was 13.6%. The teeth prevalence was 1.20%. The majority (38.9%) of defects were seen in the in the mandibular first premolar. Almost half of the lesions were located on the mesial side (52.3%), with a size less than one-third of dentine thickness (53%). Conclusion: PIER defects constitutes an important part of anomalies associated with unerupted teeth and thus needs a proper understanding of its prevalence, etiology, manifestations, and complications. These defects are usually overlooked by clinicians while interpreting radiographs; however, it is of utmost importance to promptly diagnose these defects thus preventing further complications.
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Candidal species identification in malignant and potentially malignant oral lesions with antifungal resistance patterns p. 309
Rahul Bansal, Shambulingappa Pallagatti, Soheyl Sheikh, Amit Aggarwal, Deepak Gupta, Ravinder Singh
DOI:10.4103/ccd.ccd_296_18  PMID:30294163
Objective: Candidal species identification in malignant and potentially malignant oral lesions with antifungal susceptibility. Materials and Methods: Oral candidal carriage, strain diversity, and antifungal susceptibility of Candida were checked for the patients having oral cancer or precancer reporting to the clinics for 1½ year. Statistically significant patients were selected and a control group was taken. A total of 105 individuals were selected and divided into three different groups. Salivary samples were taken from all the individuals. Candida detection was done using Sabouraud's agar and candidal species detection on CHROMagar. In vitro antifungal sensitivity was done using antifungal disc diffusion method. Results: Candida was isolated from 88.6% of patients with oral cancer and 45.7% in oral precancerous group. C. albicans was the predominant species found in 100% of oral precancerous and 71% in oral cancerous patients. Other Candid a species found were C. tropicalis (9.7%) and C. krusei (19.6%). Antifungal susceptibility showed 4.3% sensitivity to fluconazole and 100% sensitivity to amphotericin B and nystatin. Conclusion: Oral Candida carriage was higher in oral cancerous group and majority of them were sensitive to amphotericin B and nystatin.
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Dental caries experience, dental anomalies, and morphometric analysis of canine among monozygotic and dizygotic twins p. 314
V Anu, GS Arsheya, V Anjana, George Karen Annison, MR Lakshmi Aruna, A Priyanka Alice, B Angeline Aishwarya
DOI:10.4103/ccd.ccd_345_18  PMID:30294164
Background: The study of twins is a well-known and a unique method that is used to investigate the genetic contributions to physical features and diseases in human. Aim: To estimate the relative contributions of genetic and environmental influence to observed variations in different dental features or traits. Methodology: Thirty twins in the age group of 15–30 years were selected for the study, and the dental caries experience scores, dental anomalies, and morphometric analysis of monozygotic (MZ) and dizygotic (DZ) twins were compared. Results: MZ twins unlike DZ twins showed within-pair resemblance in decayed, decayed missing and filled teeth (DMFT), and molar relation. No morphometric analysis parameters and dental anomalies had significant mean difference between the groups. Decay, filling, DMFT, spacing, mandibular irregularity, open bite, and mesiodistal width of the right and left canine showed a higher positive correlation in MZ than DZ twins. Heritability estimate was low for morphometric analysis parameters. There is genetic dominance in decay, DMFT, spacing, molar relation, and diastema. Pearson's correlation revealed a positive and statistically significant correlation among all morphometric analysis parameters for MZ twins, but not DZ twins. Dental caries has a higher concordance rate (87.5%), correlation (71.6%), and heritability (87.8%). Conclusion: Most of the dental parameters are significantly heritable with up to 85% of the variance attributable to genetic factors. Environmental factors play a major role in developing malocclusion and causing dental caries. Morphology of canines can be used as a supplementary tool to determine zygosity.
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Comparison of surgical outcome after impacted third molar surgery using piezotome and a conventional rotary handpiece p. 318
Pritika Srivastava, Premalatha Shetty, Sameep Shetty
DOI:10.4103/ccd.ccd_354_18  PMID:30294165
Background and Aim: One of the most commonly performed surgical procedures by oral and maxillofacial surgeons all over the world is the removal of impacted teeth. The most critical and important steps in third molar extraction are bone cutting or osteotomy. Many techniques are used for this purpose including chisels and mallet, rotary instruments, and ultrasonic-based bone cutting instruments. Piezotome is newer and innovative device for osteotomy based on piezoelectric vibrations. Piezotome is considered very efficient in performing osteotomy because of its selective cutting; being inert against soft tissues, including nerves and blood vessels. The aim of this study was to compare the surgical outcome of third molar surgery using conventional handpiece and piezotome with all other criteria remaining same for all the individuals. Materials and Methods: All patients reporting to the Department of Oral and Maxillofacial surgery, Manipal College of Dental Sciences, Mangalore, for impacted mandibular third molar removal were screened. A total of 30 patients with same Pederson difficulty index for bilateral impacted third molar were selected for the study. The study involved the use of piezotome on one side (Side A) and rotary technique (Side B) on the other side for osteotomy on the same patient with an interval of 1 month. Therapeutic management was same for both the sides. Operating time was recorded in each surgery. Patients were examined postoperatively on 1st, 3rd, and 7th day and pain, edema, trismus, paresthesia, and dry socket were evaluated and compared on both the sides. Data collected were analyzed statistically. Results: The mean operating time was 48.13 min in piezotome (Side A) and 32.90 min in conventional handpiece (Side B) which was statistically significant (P < 0.001). Furthermore, there was statistically significant difference (P < 0.001) in the level of pain (P < 0.001), number of analgesics taken (P < 0.001), and trismus (P < 0.01) on 1st, 3rd, and 7th days postoperatively. There was no statistically significant difference in edema between the two sides. Paresthesia was present in one patient (3.3%) in Side B, while no paresthesia was present in Side A. No incidence of alveolar osteitis was reported on both the sides. Conclusion: Operating time with piezotome was more than that of conventional handpiece, but the postoperative responses such as pain, trismus, and edema were less in piezotome. Hence, despite being a slower procedure, piezotome can be an effective alternative for osteotomy in impacted third molar surgery. We recommend using piezotome for bone cutting and conventional rotary handpiece for tooth sectioning in order to obtain favorable outcomes as well as decreasing the operating time.
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Comparative evaluation of antimicrobial efficacy of platelet-rich plasma, platelet-rich fibrin, and injectable platelet-rich fibrin on the standard strains of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans p. 325
Prabhdeep Kour, Pushpa S Pudakalkatti, Ancia M Vas, Swetalin Das, Sreeshma Padmanabhan
DOI:10.4103/ccd.ccd_367_18  PMID:30294166
Context: Platelet concentrates are commonly used to promote periodontal soft- and hard-tissue regeneration. Recently, their antimicrobial efficacy is also explored. Various platelet concentrates have evolved which differ in the centrifugation protocols. Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) have been found to have an important role in periodontal pathology. Aims: In this study, PRP, PRF, and I-PRF are compared for their antibacterial effect against Pg and Aa. Materials and Methods: Blood samples were obtained from ten systemically and periodontally healthy individuals. Platelet concentrates were prepared using standardized centrifugation protocol. Antimicrobial activity was examined on standard strains of Pg and Aa using well diffusion method. Statistical Analysis Used: Means for the width of zones of inhibition were calculated along with standard deviations, and the comparison was made using Wilcoxon signed-rank test. Results: In case of Pg, I-PRF had the widest zone of inhibition which was significantly wider as compared to PRF. Furthermore, PRP had significantly wider zone of inhibition against PRF. In case of Aa, PRP had wider zone of inhibition which was significantly wider as compared to that of PRF and I-PRF. Conclusions: All the three platelet concentrates PRP, PRF, and I-PRF have antibacterial activity, but PRP and I-PRF are more active as compared to PRF. I-PRF being autologous and easy to prepare can be a very useful adjunct to the surgical therapy in bringing down the bacterial count helping in wound healing and regeneration.
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Comparative evaluation of frictional resistance of silver-coated stainless steel wires with uncoated stainless steel wires: An In vitro study p. 331
Priyanka K Shah, Padmaja Sharma, Santosh Kumar Goje
DOI:10.4103/ccd.ccd_405_18  PMID:30294167
Background: Silver is known for its antimicrobial activity. Silver coating effectively reduces Lactobacillus acidophilus and Streptococcus mutans count, thus reducing chances of dental plaque and caries. This silver coating may have effect on frictional property of orthodontic wires. Aim: The aim of this study is to evaluate and compare frictional resistance of silver-coated and uncoated stainless steel (SS) wires. Methods: Forty SS wires were divided into four groups of 10 each: Group 1 – 0.017 × 0.025 inch SS wires (silver coated), Group 2 – 0.017 × 0.025 inch SS wires (control), Group 3 – 0.019 × 0.025 inch SS wires (silver coated), and Group 4 – 0.019 × 0.025 inch SS wires (control). Surface modification of wires was carried out by the thermal vacuum evaporation method with silver (10 nm size) using vacuum-coating unit model. The frictional resistances of all forty wires were checked on forty 0.022 × 0.028 inch slot central incisor brackets (SS wires and brackets from American Orthodontics, St Paul, USA) mounted on metal plates using universal testing machine. Results: There was no significant difference found in frictional resistance between silver-coated and uncoated 0.017 × 0.025 inch SS wires group (P = 0.854). Statistically significant reduction in frictional resistance was observed in 0.019 × 0.025 inch coated SS wires in comparison to uncoated wires (P = 0.032). Conclusion: Overall silver coating either did not affect the frictional resistance (0.017 × 0.025 inch SS wires) or reduced it (0.019 × 0.025 inch coated SS wires) compared to uncoated wires. Findings suggest that the use of silver-coated SS wires in routine orthodontic practice can be implemented after further in vivo human clinical trials.
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Neovascular pattern in wound healing after zinc oxide and Curcuma longa rhizome extract dressing application p. 337
Nilna Naila Faiga, Priyawan Rachmadi, Asti Meizarini
DOI:10.4103/ccd.ccd_435_18  PMID:30294168
Introduction: Zinc oxide-eugenol dressing is widely used in the dentistry field. Eugenol in wound dressing acts as an antibacterial and analgesic agent but known to cause hypersensitivity reaction and allergies. Curcuma longa rhizome extract could perform as a substitute of eugenol as its active compounds have an anti-inflammation, antioxidant, anticancer, and antibacterial properties. It has also been shown to have proangiogenic and promote wound healing. This study aimed to discover the number of neovascular in the wound healing process after the application of zinc oxide and C. longa rhizome extract wound dressing. Materials and Methods: Full-thickness excision wound of 6 mm × 6 mm was made in the dorsal of 32 Wistar strains Rattus norvegicus, before being equally divided into eight groups (n = 4): four control groups (C3, C5, C7, and C14) without any dressing and 4 treatment groups (T3, T5, T7, and T14) were dressed with zinc oxide and C. longa extract wound dressing. The rats consecutively sacrificed on day 3 (C3, T3), day 5 (C5, T5), day 7 (C7, T7), and day 14 (C14, T14) to observe the neovascular pattern and number using H and E staining. Obtained data were analyzed using ANOVA. Results: The neovascular growth in both control and treatment groups have the same pattern, while the number of neovascular in treatment groups significantly higher than the control groups (P < 0.05). Conclusions: Wound dressing combination of zinc oxide and C. longa extract can increase the number of neovascular in the wound healing process, while the optimum duration of application is 14 days.
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Cephalometric characteristic of skeletal Class II malocclusion in Javanese Population at Universitas Airlangga Dental Hospital p. 342
I Gusti Aju Wahju Ardani, Maria Laurentia Sanjaya, Jusuf Sjamsudin
DOI:10.4103/ccd.ccd_465_18  PMID:30294169
Introduction: To describe the cephalometric characteristic of skeletal Class II malocclusion in Javanese Population at Universitas Airlangga Dental Hospital. Methods: A total of 118 lateral cephalograms of preorthodontic patients with skeletal Class II malocclusion were obtained from Universitas Airlangga Dental Hospital. The lateral cephalograms were analyzed using digital cephalometric analysis to determine the ANB, mandibular length, facial axis, Y-axis, sella to nasion-mandibular plane (SN-MP), and lower anterior facial height (LAFH). Correlation between mandibular length and other variables was analyzed using Pearson correlation test with P < 0.05. Results: There was an increase of ANB, Y-axis, SN-MP, and LAFH. While SNB was decrease and mandibular length was shortened. There was a significant correlation between mandibular length and other variables, such as facial axis, SN-MP, LAFH, and ANB. Conclusions: Skeletal Class II malocclusion in Javanese Population at Universitas Airlangga Dental Hospital was characterized by short mandibular length and large ANB mostly not by the increased of SNA but by the lack of SNB. The length of mandible correlated with facial axis angle, lower anterior facial height, and mandibular plane angle.
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Flexural strength of surface-treated heat-polymerized acrylic resin after repair with aluminum oxide-reinforced autopolymerizing acrylic resin p. 347
Shraddha Hareshwar Tamore, KS Jyothi, Seshagiri Muttagi, Amit M Gaikwad
DOI:10.4103/ccd.ccd_483_18  PMID:30294170
Background: A fracture of denture base in situ often occurs through a fatigue mechanism, which over a period of time leads to the formation of small cracks, resulting in fracture. Aim and Objective: To evaluate the flexural strength of repaired heat-polymerized acrylic resin, with different percentage of aluminum oxide (Al2O3) added to the repair resin and effect of two different surface treatments on the flexural strength of repaired heat-polymerized acrylic resin and also to evaluate quantification of filler particles using scanning electron microscopy. Materials and Methodology: Fifty specimens of heat-polymerized acrylic resin were prepared according to the American Dental Association specification no. 12 (65 mm × 10 mm × 2.5 mm). Al2O3<50 nm particle size was silanized using metal alloy primer before incorporation in polymer. Two different percentages of Al2O3nanoparticles, that is, 1% and 1.5% were added to autopolymerizing acrylic resin which was used as repairing material. Results: The study showed that repair resin incorporated with 1.5% Al2O3in the group surface treated with silicon carbide paper improved the flexural strength of denture base resin. A proper filler distribution and deep penetration within the polymer matrix were observed by scanning electron microscope in the same group.
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Assessment of relation of orofacial structures with pharynx among males and females: A lateral cephalometric study p. 354
Virendra Vadher, CH Sudheer Kumar, Vaibhav Khare, Ravi S Nande, Sonia Sharma, Versha Jain
DOI:10.4103/ccd.ccd_564_18  PMID:30294171
Aim: This study aimed to determine the correlation between orofacial structure and oropharyngeal airway space. Materials and Methods: It comprised of 160 individuals aged 14–24 years (males: 80 and females: 80), in which digital lateral cephalograms were taken. Linear and cephalometric analyses were performed in all cases. Results: Ba–PNS, apw2–ppw2, hy–apw2, distance between tongue and posterior pharyngeal wall (t–ppw), and Hormion perpendicular and anterior nasal spine-posterior nasal spine (ANS-PNS) showed significant difference between males and females (P < 0.05). Other distances such as Ba–ad1, Ba–ad2, Ptm–ad1, Ptm–ad2, PNS–ppw1, and apw4–ppw4 were statistically nonsignificant (P > 0.05). Conclusion: Linear and cephalometric measurements showed that Ba–PNS, t–ppw, Hy–ppw2, distance between Ho perpendicular and ANS-PNS plane, and apw2–ppw2 were higher in males as compared to females. Lateral cephalograms are useful in orthodontics in performing tracings in individuals with a potential risk of malocclusion.
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CASE REPORTS Top

An innovative appliance for the simultaneous treatment of premolar space loss and lip sucking habit p. 358
Neil De Souza, Sergio Martires, Paul Chalakkal, Godwin Clovis Da Costa
DOI:10.4103/ccd.ccd_135_18  PMID:30294172
The active lingual arch (LA) and the lip bumper (LB) are popular appliances used for maintaining or increasing arch length. This article highlights an innovative appliance that incorporates the LA and the LB, indicated for the simultaneous treatment of space loss and lip sucking habit.
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Efficacy of lesion sterilization and tissue repair in primary tooth with internal resorption: A case series p. 361
Bhaswati Chakraborty, Anupama P Nayak, Arathi Rao
DOI:10.4103/ccd.ccd_243_18  PMID:30294173
Lesion sterilization and tissue repair (LSTR) treatment involves the use of a triple antibiotic mixture in a suitable vehicle, which is used to disinfect root canal systems. This report highlights three cases where LSTR therapy using triple antibiotic paste was attempted in primary molars exhibiting gross periradicular pathosis and internal resorption. Follow-up examinations revealed reduction of periradicular pathosis and reversal of internal resorption in all the three cases. This case series opens a perspective on the use of LSTR therapy as an alternative option to extraction in treating primary teeth with gross periradicular pathosis and internal resorption.
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Rhinoscleroma: Report of an erratic palatal swelling p. 365
Mandakini Subhash Mandale, Jyoti Dilip Bhavthankar, Jayanti Govind Humbe, Nivedita Nishant Kaorey
DOI:10.4103/ccd.ccd_282_18  PMID:30294174
Clinicians come across cases of palatal swellings that present with ambiguous features. They may vary in their etiology from numerous infectious and noninfectious causes to a wide array of neoplasms. Accurate diagnosis of such lesions is vital for their prompt and precise management. Rhinoscleroma (RS), as its name suggests, is a persistent, specific, granulomatous disease that results in sclerosis of the affected organ – most frequently the nose. Although its occurrence in the adjacent sites has been reported, the clinical findings did not offer much deviation from the expected. Reported here is a case of RS involving the palate which not only detoured from its usual site and course of spread but also gave off a confusing façade in terms of its clinical presentation.
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The efficacy of low-level laser therapy in treating oral papilloma: A case reporting a lingual location p. 369
Narjiss Akerzoul, Saliha Chbicheb
DOI:10.4103/ccd.ccd_431_18  PMID:30294175
Oral papilloma is a benign proliferation of the stratified epithelium, which results in a papillary or verrucous exophytic mass, which can be induced by human papillomavirus. These oral mucosa lesions are most often asymptomatic and have small progression. Laser-assisted surgery is common nowadays with several advantages including successful hemostasis, devoid of sutures, wound sterilization and minimal postoperative pain, and edema. The aim of this report is to present the oral papilloma in a 40-year-old female patient and its treatment with soft-tissue laser. The lesion was excised with diode laser, and the healing was uneventful in a follow-up visit after 1 month. Oral papillomas can be found in young adult patient's oral cavity, and laser dentistry can be used by dental clinicians to treat these kinds of oral lesions and should be considered as an alternative to conventional surgery.
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Childhood pemphigus vulgaris: Report of two cases with emphasis on diagnostic approach p. 373
Varun Surya, Priya Kumar, Sunita Gupta, Aadithya B Urs
DOI:10.4103/ccd.ccd_461_18  PMID:30294176
Childhood pemphigus vulgaris (CPV) is a rare entity with clinical features and management primarily similar to those of adults; diagnosis may be difficult due to clinical similarity to other disorders such as herpetic gingivostomatitis which is more prevalent in this age group. We report two cases of CPV with emphasis on diagnostic approach. While treating such patients, it is imperative to diagnose CPV in the early stages to prevent serious morbidity and to adjust drug dosage to minimize side effects.
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Combined periodontal-orthodontic treatment of pathologic tooth migration: A case study with 10-year follow-up p. 377
Naresh Kumar, Pravesh Jhingta, Kehar Singh Negi, Vinay Kumar Bhardwaj, Deepak Sharma, Arun Singh Thakur
DOI:10.4103/ccd.ccd_480_18  PMID:30294177
Pathologic tooth migration is a change in tooth position resulting from disruption of the forces that maintain teeth in a normal position in relation to their arch. The disruption of the equilibrium in tooth position may be caused by various etiologic factors. Loss of attachment apparatus along with a non periodontal related condition such as excess occlusal force, a progressive migration of tooth may take place. Mostly this migration can be associated with aesthetic damage of the smile line. To solve these issues, a combination of periodontal and orthodontic treatment is often needed. In this presentation a 23-year-old, systemically healthy, non-smoking female presented with the complaint of bleeding gums, mobility and increased space between upper and lower front teeth causing un-aesthetic appearance and low self esteem. She was treated with interdisciplinary approach of orthodontic and periodontal intervention. Improvement of facial esthetics contributed to the self-confidence of an adult periodontal patient with pathologic tooth migration. Follow up at 10 years post treatment confirmed the good choice of treatment planning and the tendency to improve the results over time. Periodontally compromised orthodontic patients can be satisfactorily treated, achieving correction of the malocclusion and a marked improvement in esthetics when an interdisciplinary approach is used.
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Surgical management of hyperdivergent Class II malocclusion with vertical maxillary excess: A 2-year follow-up p. 382
Nayeemullah Khan, K Moina Adeni, Ratna Parameswaran, Devaki Vijayalakshmi
DOI:10.4103/ccd.ccd_484_18  PMID:30294178
Skeletal Class II malocclusions with vertical maxillary excess (VME) present with an amalgamation of several problems pertaining to psychological, esthetics, and function. The optimal treatment plan in such cases includes a synchronized orthodontic-surgical approach through superior repositioning and setback of maxilla by means of Le Fort I osteotomy and augmentation genioplasty. This case report describes a multidisciplinary approach in the successful management of a patient with VME to achieve superior esthetics and function.
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Surgical management of complex odontoma associated with agenesis of a molar p. 388
Avani Jain, YM Karuna, Mohan Baliga, BS Suprabha, Srikant Natarajan
DOI:10.4103/ccd.ccd_789_17  PMID:30294179
Odontomas are mixed odontogenic tumors composed of mineralized tissue of ectomesenchymal origin. These are usually detected in routine radiographs and may have a variable etiology such as local trauma, genetic mutation, or infection. They are classified into two main types: complex and compound. Complex odontomas are rare and they rarely erupt into the oral cavity as they lack periodontal ligament. This is the report of one such case of complex odontoma where an 11-year-old girl reported with an asymptomatic swelling, in relation to the left angle of the mandible. The case report highlights the clinical and radiographic findings, investigations done to arrive at the diagnosis and the treatment rendered. This report is of clinical importance because of its rare association with the agenesis of a molar tooth.
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