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Showing posts from August, 2016

Periodontal Diseases

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Periodontics and Prosthodontics: Open Access is self-financed and does not receive funding from any institution/government. Hence, the Journal operates solely through processing charges we receive from the authors and some  academic/corporate sponsors.  The handling fee is required to meet its maintenance. Being an Open Access Journal, Periodontics and Prosthodontics: Open Access does not collect subscription charges from readers that enjoy free online access to the articles. Authors are hence required to pay a fair handling fee for processing their articles. However, there are no submission charges. Authors are required to make payment only after their manuscript has been acce pted for publication. It is a bacterial infection of the tissues around the structures of the teeth. It is also called as a gum disease. It is the main cause of the tooth loss in adults because this disease is usually pain less and we cannot identify if we have this disease. There are some specifi

Osteoporosis and Periodontal Disease: Association and Mechanisms

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Periodontal disease and osteoporosis are multifactorial in their etiology and involve a large strata of the population in India and all over the world. Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of the bone scaffold that results in increased bone fragility and susceptibility to fractures. In osteoporosis, the bone mineral density (BMD) is reduced, bone micro-architecture is disrupted and the amount and variety of non-collagenous proteins in bone is altered while, periodontitis is an inflammation of the supporting tissues of the teeth, usually leading to loss of bone and periodontal ligament and is a major cause of tooth loss and edentulousness in adults. Systemic loss of bone density in osteoporosis including that of the jaw may provide a host system that is increasingly susceptible to infectious destruction of periodontal tissues. Loss of alveolar bone is a prominent feature of periodontal disease while sever

The Role of Dentistry in Sleep Medicine

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Patients have benefitted greatly from the advances in cosmetic dentistry and implant surgery. So what’s next? In recent years there has been a growing interest in Sleep Dentistry and the role that dentists can have in improving the airway. The spiralling increase in sleep disorders & associated problems has lead to a questioning of how these could be prevented and how best to treat established conditions. Nasal breathing has long been accepted as being far  more efficient than mouth breathing.  Functional orthodontists have, for many years, been aware of the useful role that they can play but this has not been accepted in more traditional circles. At the present time there is no robust data, however clinical experience does support changes in the airway. The cause of malocclusion is, as yet, unknown and is almostcertainly multi-factoria l. Yet there are some factors which are common to most cases of crowding. These are a small maxilla and a retrognathic mandible. Developi

Oral & Maxillofacial Surgery

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Dental Anatomy: Dental anatomy is a field of anatomy which deals with the morphology of teeth, their location, position, and relationships without the use of a microscope. It includes development, appearance, and classification of teeth. It is also concerned with the naming of teeth and the structures, of which they are made, due to which dental anatomy is also considered as taxonomical science. Oral Histology & Embryology: Oral histology is the microscopic study of Oral Mucosa, structure variation in relation to functional requirements, mechanisms of keratinization, clinical parts of gingiva, Dentogingival & Mucocutaneous junctions & lingual papillae. Embryology is the study of prenatal development throughout the stages before birth. Oral Physiology: It is the science which deals with the function of oral structures. Mainly it concentrates on the research on biological processes in the oral and maxillofacial regions. It gives idea about orfacial dysfunction

Incorporation of Hydroxyapatite-Silica Nano-Powder for Enhancement of Glass Ionomer Cement (GIC)

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Hydroxyapatite is a naturally occurring mineral form of calcium. These days, nanohydroxyapatite has been used as filler in some of dental biomaterials to improve its properties. Improvements in their compressive strength, diametral tensile strength , flexural strength , toughness, bonding and fluoride-release properties  have been reported after the addition of HA into the material. In particular, a few studies have been conducted in School of Dental Sciences, Universiti Sains Malaysia (USM) to improve the hardness ofCGIC . In this case, nano-hydroxyapatite-silica (HA-SiO2) was synthesized by one pot technique  and incorporated into commercially available CGIC Fuji IX GP (GC International, Japan).  It was found that the addition of nano-HA-silica into CGIC (HA-SiO2-GIC) increased the hardness of CGIC by 73% compared to the use of conventional GIC alone. It is believed that the nano silica particles fill the voids between the hexagonal HA particles, and subsequently enhance the

Challenges in the Management of Malaria in Nigeria: A Healthcare System Preview

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Malaria remains a huge global health burden with more than 90% of fatalities occurs in Africa and about half a million infant mortality each year. Malarial infection is of particular concern as it is a disease that can be both treated and prevented. Nigeria, biggest country by population in Africa, is responsible for about 25% of global health burden. While all local and international efforts aim to implement Nigeria’s current National Strategic Malaria Plan [NMSP 2014-2020] to have Nigeria free of Malaria by 2020, the current healthcare system in Nigeria remains a major system bottleneck to achieving such challenging objective but yet still achievable. This report on Nigeria’s current malaria situation aims to highlight healthcare system challenges that face Nigeria as a country, and possible plans that integrate both local and international initiatives to reach 2020 with a malaria-free country.The studies used in this review were retrieved from CINAHL Plus, MEDLINE, ProQuest a

Oral Hygiene

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Oral hygiene is the practice of keeping the mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, periodontal (gum) diseases and bad breath. There are also oral pathologic conditions in which good oral hygiene is required for healing and regeneration of the oral tissues. These conditions include gingivitis, periodontitis, and dental trauma, such as subluxation, oral cysts and following wisdom tooth extraction. Teeth’s cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, gum disease, and tooth decay. Severe gum disease causes at least one-third of adult tooth loss. Tooth decay is the most common global disease. Over 80% of cavities occur inside fissures in teeth where brushing cannot reach food left trapped after every meal or snack and saliva or fluoride have no access to neutralize acid and remineralise demineralized teeth, unlike easy-to-clean parts of the tooth, where fewer cavities occur.

Small Diameter Implants (SDIs) in Fixed Restorations:Clinical Cases Considerations During 4 Years Follow-Up

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Minimally invasive dentistry is a reality that in the last several years has involved all branches of dentistry. In implantology these minimally invasive techniques have revolutionized the standard treatments and are showing a high possibility of increased practice. Some examples applied in implantology include digitalradiology, CT reconstructions, and their evolution with maximum reduction  of radiation dose – CBCT Cone Beam to cite an example - and the software for three-dimensional reconstructions (advocated by Ganz already in 1995).  The digital dentistry has and is continuing to contribute  significantly to the growth and spread of minimally invasive dental treatments. These minimally invasive technologies have also stimulated the development of minimally invasive surgical techniques. Ten years ago, we were not talking about flapless or a sinus lift with crestal approach, whereas today minimally invasive procedures have achieved highly successful performance and predictabi

Nursing Staffs Knowledge about and Skills in Providing Oral Hygiene Care for Patients with Neurological Disorders

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Several hospitalized patients with neurological disorders depend on nursing staff for their daily health care. Due to several functional limitations of the limbs, oral motor impairments, neglect, apraxia, and hemianopia, oral hygiene self-care is difficult to perform and therefore adequate oral health is difficult to maintain. Next to that, oral dysfunction related to oral motorfunction , mastication, swallowing and saliva control may be affected and does not always recover completely during rehabilitation. Due to both physical and oral dysfunction, adequate oral health may be threatened, because the affected functions hinder this population when performing daily oral hygiene self-care. Consequently, the responsibility for completing oral care in neurological patients often falls to the nursing staff. Oral health has not been given priority in nursing practice, because there are competing priorities regarding the care nurses provide, but it should become a task with higher priori

Prosthodontic Management of Children with Ectodermal Dysplasia: Review of Literature

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Introduction: Ectodermal dysplasia (ED) is a large group of heterogeneous heritable conditions characterized by congenital defects of two or more ectodermal structures and their appendages: hair (hypotrichosis, partial or total alopecia), nails (dystrophic, hypertrophic, abnormally keratinized), teeth (enamel defect or absent) and sweat glands (hypoplastic or aplastic). Thurnam published the first report of a patient with ectodermal dysplasia in 1848. The term ectodermal dysplasia was not coined until 1929. In 1971 only eight forms of ED were known. Now approximately 200 different ED have been delineated; about 30 have been identified at the molecular level with identification of the causative. gene.   Classification: There are several classifications given by different authors. Some are based on clinical features and others on genetic component of the disorder. Clinically there are two major types of EDnamely hidrotic and anhidrotic (hypohidrotic form). The hidrotic f

Treatment of Condylar Hypoplasia and Occlusal Cant Using Simultaneous Maxillomandibular Distraction Osteogenesis: A Report of 2 Cases

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Introduction: Unilateral condylar hypoplasia can be either genetic (or congenital) or acquired. In the genetic group, the early differentiation of tissues and or developmental processes are affected, congenital hemifacial microsomia, micrognathia, Treacher Collins syndrome, Pierre Robin syndrome, Crouzon syndrome and cleft lip and palate exemplify the genetic group. In the second group i.e., acquired condylar hypoplasia, the etiology is either due to local factors like trauma, mandibularinfection, spread of infection from middle ear disease and radiation or due to systemic factors like infection, dietary and endocrine causes.  Acquired condylar hypoplasia may develop after the loss of one or both condylar growth centers in very early stages of life and is sometimes accompanied by ankylosis. When an affected side fails to grow downward and forward , a three dimensional asymmetry is produced. The mandibular skeletal midline deviates to the affected side, a lack of vert

Oral Health Status and Treatment Needs of Young Adults in Udaipur, India: A Cross-Sectional Study

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Oral health is understood as a dentition which is comfortable,functional, and with such an appearance that allows thepeople to perform their social functions and daily activities without physical, psychological or social inconveniences. Oro-dental diseases are among the most widespread diseases around the globe. Although not an important cause of mortality, these may have sometimes serious repercussions upon the general health of people.oral diseases in adults negatively impact their employability and systemic health. In developed countries,more young individuals now tend to preserve their natural teeth and the proportion of adults with functional dentition hadincreased markedly. Such changes in oral health are oftenascribed to the population’s changing living conditions and lifestyles, effective use of oral health services, implementation of preventive oral health care programmes , development of regular self-care practices and use of fluoride toothpaste. Incontrast, many developin

Effects of Caffeine on Salivation

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Introduction: Saliva has an important homeostatic role in the oral cavity. Hyposalivation can lead to diseases such as caries and mucous membrane candidiasis as well as difficulties in speech, mastication and deglutition. Like all exocrine secretions, salivary production is under the control of the autonomic nervous system, but physical factors such as hypovolemia and dehydration can also playa role . Thus, various systemic conditions, medications, and psychological factors can affect salivary output . Caffeine, a natural derivative of coffee beans and tea leaves, is a methylxanthine with proven activity on the central nervous system and the smooth muscle cells of the cardiac, respiratory and digestive organs. Its effects mostly parallel the adrenergic pathway and include increased arterial blood pressure and cardiac output, and decreased gastrointestinal muscle tone. Following this teleological path, it would be expected that caffeine had a significant, dose-dependent effect

Non Syndromic Form of Bilateral Bimaxillary Bull Teeth- A Case Report with Challenges in Pediatric Dentistry

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Genetic and Rare Diseases Information Centre (GARD),National Institutes of Health (NIH) and Orphanet, Europeanrare diseases database considers enlarged pulp chambers withroot dilacerations in primary teeth as a rare disease.Witkop defined bull teeth or taurodontism as teeth with largepulpchamber s in which the bifurcation or trifurcation aredisplaced apically and hence the chamber has greater apicooclusalheight than normal teeth and lacks cervical constrictionat CEJ. Bull teeth was first described in 1908 by Gorjanovic-Kramberger in a 70,000 year old pre-Neanderthal fossil,discovered in Kaprina, Croatia. Bull teeth were a frequentfinding in early humans and is most common today in Eskimos,possibly as a selective adaptation for cutting hide. The term‘taurodontism’ was however first stated by Sir Arthur Keithin 1913. The origin of this term is from Greek “tauros” whichmeans “Bull” and “adontos” which means “Tooth”. Theorigin of the word taurodont is from a combination of Latin and Gr

Laser Dentistry in oral health

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Laser dentistry are used to reshape gums and remove bacteria during root canal procedures. Biopsy or lesion removal. Lasers can be used to remove a small piece of tissue (called a biopsy) so that it can be examined for cancer. Lasers are also used to remove lesions in the mouth and relieve the pain of canker sores. Laser dentistry is very common and researches and case studies are in abundance. Lasers have been used in dentistry since 1994 to treat a number of dental problems. Yet, despite FDA approval, no laser system has received the American Dental Association's (ADA) Seal of Acceptance. That seal assures dentists that the product or device meets ADA standards of safety and efficacy , among other things. The ADA, however, states that it is cautiously optimistic about the role of laser technology in the field of dentistry. These lasers are different from the cold lasers used in phototherapy for the relief of headaches, pain, and inflammation. Related Journals of

Evaluation of Association between Maternal Periodontal Disease and Infant Preterm Low Birth Weight: A Case Control Study

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The theme of World Health Day 2005 was healthy mothersand children. It is essential that women are able to go through pregnancy and child birth safely, that the outcome of pregnancies is successfulin terms of maternal and infant survival and well being. However, despite the advances in obstetrical prevention, diagnostics, and therapy innumerable  challenges persist.  Preterm low birth weight (PLBW) is still considered to be the greatest problem in obstetrical medicine  and remains the leading cause of  morbidity and mortality among the newly born children.  Preterm birth (PTB), which refers to the delivery of a new born child before the 37th week of pregnancy and low birth weight (LBW), which refers to the birth of a newborn child with a weight less than 2500 gms are grouped under the term of PLBW . PLBW children seem to have a higher risk for a strain of acute and chronic disorders that impair systemic health throughout their life.The prevalence of LBW in the United States

An Update on Current Remineralizing Agent

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Dental caries is a dynamic process which occurs when demineralization exceeds remineralization. But progression of dental caries is a slow process and during early stages noninvasive intervention can convert the lesion to inactive state from an active state. T his principle is the key to preventive dentistry. Dental hard tissues are continuously undergoing cycles of demineralization and remineralization. A drop in pH of oral cavity results in demineralization which if continued leads to loss of minerals from tooth structure resulting in dental caries. The reversal can occur if pH rises resulting in deposition of calcium, phosphate and fluoride Worldwide contribution of dental caries to the burden of oral diseases is about 10 times higher than that of periodontal disease, than other common oral conditions . Owing to its globally high prevalence, dental caries is a 'pandemic' disease characterized by a high percentage of untreated cariouscavities causing pain, discomfort and

Use of the Free Gingival Graft as a Pre-prosthetic Procedure

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Introduction: One objective of periodontal plastic surgery is the creation ofadequate vestibular depth and an increase in the keratinized tissue. The keratinized tissue provides increased resistanceto the periodontium, contributes to the stabilization of the gingival margin position , and aids in the dissipation of physiological forces that are exerted by the muscular fibers of the alveolar mucosa. Improvement of oral hygiene was seen with the increase in keratinized tissue.The free gingival graft (FGG) is known to be one of the most common and predictable methods for augmenting gingival tissue dimensions, and FGG was applied as a preprosthetic procedure in two cases. In the first case, FGG was used to overcome the patient’s discomfort and to achieve a better condition around the abutments and pontic area for the fixed prosthesis. In the second case report, the modified FGG technique was used to achieve a greater increase in keratinized tissue using less donor tissue by placing t

Ridge Preservation Following Tooth Extraction Using an Absorbable Gelatin Sponge

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It is well-known that the alveolar bone collapses after extraction and that the reduction in width may be approximately 50 % of the original dimension after 12 months due to the pronounced resorption of the buccal wall. Socket grafting offers a predictable, simple way to conserve the buccolingual and mesiodistal dimensions of the future implant site, and various bone-grafting materials using various techniques have shown promising results .The rationale for socket augmentation at the time of extraction involves reducing    crestal bone loss, encouraging socket filling, minimizing horizontal ridge resorption, and ultimately reducing or eliminating the need for further ridge augmentation. In this report, an absorbable gelatin sponge was used in the socket preservation procedure and the patient was later treated with dental implantation using the flapless approach. A 47-year-old male patient visited the dental clinic for evaluation of the lower right molar area. The patient had a non

Miniscrews and Mini-Implants Success Rates in Orthodontic Treatments: A Systematic Review and Meta-Analysis of Several Clinical Parameters

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Introduction In most orthodontic treatments anchorage is necessary to control the reciprocal forces of tooth movement. Usually this control is realized applying a force to a group of teeth or through extra-oral structures, e.g. neck or cranium. However, these techniques have important restrictions, often related to the patient’s cooperation. Orthodontic mini implants represent indeed a great resolution to these limitations. Their clinical advantages consist in versatility of placement site, easy insertion and removal, minimal anatomic limitations, minor surgery, increased patient comfort, immediate loading, possible use in young patients, and low costs. Unlike osseointegrated implants, these devices are smaller in diameter, have a smooth surface, and are designed to be loaded shortly after insertion. The stability of miniscrews has become an issue because it does not depend on osseointegration but mechanical locking of the threads into bony tissues, and consequently they can ho

Perception of Teachers towards Traumatic Tooth Avulsion and Its Management amongst School Children

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Dento-facial trauma remains one of the important health problems faced in childhood and causes a lot of pain and distress. It is very necessary to impart first aid care to reduce the severity of outcomes. The prognosis  of such cases are entirely dependent upon correct and prompt emergency management and correct referral, which has to be provided by the lay people available at the site. School and home are the most common locations where traumatic dental injuries are prevalent. Falls, sports ,collisions, physical leisure activities, being struck by an object and traffic accidents are the common listed causes of traumatic dental injuries. Amongst these, fall is most common etiological factor. It is evident that these young children are predisposed to falls due to immature motor coordination andhence are potentially at risk of sustaining dental trauma  .Among the dental professionals, it is accepted that promptand adequate management of traumatic dental injury isimportant factor for

Attitude of Patients towards Orthodontic Treatment: A Questionnaire Survey

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Orthodontic treatment is a lengthy procedure and knowledge of patient perception towards orthodontic therapy can play a vital role in the successful completion of treatment. This study was designed to determine  experiences & perceptions of patients towards orthodontic  treatment and to categorize those attitudes.A cross-sectional questionnaire based survey was conducted among 72 patients who had completed orthodontic treatment during a period of 1 year. Nineteen items questionnaires were used to collect the data which was analyzed by using SPSS software version 13.

Comparison of the Onset of Action and Behavioral Responses to Intranasal and Sublingual Routes of Midazolam Sedation in Children - A Randomized Controlled Trial

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Young children with serious oral illnesses and non complianceoften test the patience and skills of the Pediatric dentists.Children aged 3 to 7 years with severe pain and pathology aremore anxious and have difficulty in communicating properlyto the dentist . Pain and the treatment procedures assuch influencethe behavior of the children in the dental office.These children require local anesthetic drug administration to alleviate the pain.  The reaction of the child to local anesthetic drug administration can be a sign of emerging perception which further affects the behavior of the children in the dental office. Pharmacologic behavior management might be needed to manage them. Moderate sedation as described by American Academy of Pediatric Dentistry (AAPD ) refers to drug induced depression of consciousness during which patients respond purposefully to verbal commands. Transmucosal sedation has gained a lot of importance in pediatric dentistry in the last decade. The term transmu

A Interdisciplinary Concept of Oral Rehabilitation in a Nonsyndromic Autosomal Dominant Oligodontia with a Novel Mutation of PAX9. A Clinical Report

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Agenesis of one or more teeth is one of the most common of human developmental anomalies . Oligodontia is a very rare condition, has a population prevalence of 0.03% to 0.07% and occurs most frequently in females at a ratio of 3:2. The most frequently missing teeth are the maxillary lateral incisors, followed by the  mandibular second premolars and the mandibular central incisors  . The etiology of tooth agenesis may vary from physical obstruction or disruption of the dental lamina, space limitation and functional abnormalities of the dental epithelium or failure of initiation of the underlying mesenchyme . It may also occur as part of a systemic genetic syndrome  or can also be due to an isolated condition (nonsyndromic oligodontia) like mutation in LTBP3 , or mutation in the homeobox gene MSX1 or paired domain transcription factor PAX9. The absence of permanent teeth may cause several clinical problems and the inconvenience to patients will vary, depending on the age, specific teet

Macrolide Resistance Genes and Virulence Factors of Common Viridans Streptococci Species Colonizing Oral Cavities of Patients in Jordan

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The viridans group streptococci (VGS) are the most common pathogens isolated from human dental plaque. They arecapable of causing several infections as well as invasivediseases; dental caries, purulent infections of oral and otherbody sites such as blood sepsis and infectiveendocarditis,despite the fact that they are generally considered to be of lowpathogenic potential. In particular,  VGS are a frequentcause of native valve endocarditis  in immunocompetentindividuals and endocarditis or sepsis in patients withneutropenia. It is well known that streptococcalendocarditis isa life- threatening disease that requires a long period ofeffective treatment.Recently, VGS have attracted attention due to their abilityto act as reservoirs for antibiotic resistance genes and totransfer their resistance factors to more pathogenic organismslike Streptococcus pneumoniae and Streptococcus pyogenes[2,6]. In thepast, VGS werenearlyuniformly susceptible toβ-lactamantimicrobialagents,aminoglycosides,tet

Vascularised versus Non Vascularised Autogenous Bone Grafts for Immediate Reconstruction of Segmental Mandibular Defects: A Systematic Review

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The mandible is very important for facial aesthetics and is also responsible for mastication and speech. Resection of the mandible is often indicated in the treatment of some infections, odontogenic tumors, severe trauma and oral cancer that represent a great challenge for surgeons because of the complexity and unique anatomy of the mandible. The main target of reconstruction of discontinuity defects of the mandible is to restore  cosmetics, maximize function, mastication and preserve appearance  and quality of life. Treatment of segmental mandibular defects is considered a complex process. Various techniques of reconstruction, ranging from simple bridging plates to composite free flaps have been adopted; each has its advantages and disadvantages. Till now, autogenous bone grafts is still considered to be the gold Standard and the most preferred method in reconstruction of such defects. There are various forms of the autogenous bone grafts either vascularised, non vascularised or ped

A Histo-Pathological Study of Liver in 118 Cases of Cirrhosis

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Liver diseases and cirrhosis contribute to 23.59% of mortality in world and ranks 27th as major cause of death in world and it is 2.74% of all the causes of death in India but still the exact prevalence of cirrhosis is not known because the disease is often silent so 30% to 40% of cases are discovered at autopsy, indicating that in substantial proportion of people, the disease goes undetected during life. There are various etiologies if cirrhosis and all these causes leave specific imprints upon the liver so as to be identified histologically. Due to varied etiologies  like alcohol which being the commonest, obesity diabetes , hepatitis B, C, all these don’t offer any frontline diagnostic tool nor any treatment modalities to  cirrhosis. Histology only remains a full proof diagnostic tool by which one can hope to identify various causes so quite right fully liver is called as “the custodian of milleu interior”, therefore autopsy study is a need of an hour. I our study we found 118

Clinical Evaluation of a Papain-Based Gel for the Chemo-Mechanical Removal of Caries in Children

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Recent paradigm  shift in restorative dentistry emphasizes the need of minimal intervention and maximum conservation of tooth structure while treating carious lesions . Chemomechanical caries removal (CMCR) is one of the developing treatment modalities in the field of minimally invasive dentistry involving the application of a chemical solution to the carious dentine thus  enabling the exclusive removal of carious tissue  in the demineralized zone and preserving the underlying sound dentin . A plethora of CMCR methods have been experimented and developed over the years. Early studies involved using a solution, GK-101, containing the active ingredient, N-monochloroglycine (NMG)  Later, the GK101 system was modified by replacing the glycine with aminobutyric acid (N monochloro- D-2 aminobutyrate) for the purpose of enhancing its efficacy (GK101E), commercially introduced in the early eighties as a two-bottle system, called Caridex  Several clinical trials showed a high rate acceptabili