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Showing posts from September, 2016

How Do Dental Materials React On Tooth brushing?

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Besides the wear from occlusion, the influence of tooth brushing with and without toothpastes on teeth and dental materials has been in focus of interest for many years. Due to the wide range of test methods, comparisons of the results from different studies are difficult.Different methods have been used in order to evaluate abrasion. Both the quantitative aspect, i.e. how much of the surface that has been abraded, and the qualitative aspect, i.e. the roughness of the surface after brushing have been considered. Weight and Volume loss techniques and radiotracer techniques, are examples of quantitative techniques, while profilometer techniques  and light reflection techniques are examples of qualitative techniques. The development of novel composite fillings started when methylmethacrylate wasintroduced into dentistry during the 1930s, which in the beginning was a denture-based material hardened by heat curing. During the 1940s researchers were able to cure methacrylates by a cold cur

Retrospective on Treating Periimplantitis

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1st European Workshop on Periodontology in 1994 defined Periimplantitis as the inflammatory reactions in the hard and soft tissues, with loss of supporting bone, surrounding a dental implant exposed to the oral environment. A successful dental implant is defined as immobile when tested clinically. Vertical bone loss is less than 0.2 mm annually following implant first year of service, as well as, the absence of pain, infection, neuropathies, and parasthesia . There are a number of reasons for an implant to fail. They include a) Implant overstressed due to hyper-occlusion b) Apical pathology from adjacent tooth c) Retained cement on cementation of prosthesis d) Residual bacteria left from either endodontic, periodontal pathology The aim of this article is to present most common causes of periimplantitis and to show treatment for each of these. Somecauses can be prevented by careful use sound clinical skills and others byprevention of chronic inflammation, recognizing earl

Computer Guided Implantology: For Optimal Implant Planning

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Recently, dental implants have considerably contributed towards the rehabilitation of partially edentulous patients. It has become a predictable way of tooth replacement. In order to improve treatment outcomes, extensive research aroused from Branemark protocol where he described the original two-stage surgical protocol. Currently, the concept of prosthetic driven Implantology is gaining attention. It focuses on non-invasive surgical and restorative techniques.The angulation, depth and size of implant depend on the prosthetic outcome. Any discrepancy associated withimplant malpositioning can cause peri-implant bone resorption, soft tissue lossand unaesthetic appearance. As rightly stated by Buser et al, correct placement of the implant is based on a three dimensional assessment of the site including mesiodistal, buccolingual and occlusogingival direction. With meticulous planning within these dimensions and maintaining a minimum of one thickness of 1.5 mm around implant, ach

Salty Taste Threshold in Hypertensive Patients Taking Certain Types of Anti-Hypertensive Medication Compare to Healthy Individuals

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Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Normal blood pressure at rest is within the range of 100–140 mmHg systolic and 60-90 mmHg diastolic. High blood pressure is said to be present if it is often at or above 140/90 mmHg . Antihypertensive therapy is used to treathypertension and to prevent the complications of high blood pressure, such asstroke and myocardial infarction. Among the most important and most widely used drugs are thiazide diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, and beta-blockers. Oral complications due to adverse effect of antihypertensive drugs include xerostomia, alteration of taste gingival hyperplasia, and lichenoid reaction. Taste is the sensory impression of food or other substances on the tongue and is one of the five traditional senses. Taste is the

Vitamin D and its analogue in treating Periodontal diseases

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Vitamin D has the ability to eliminate microbes through diverse mechanisms and biphasic effect on gingival epithelial growth. In concentrations less than equal to 10 nM cell proliferation occurs and in 100 nM suppressed cell growth , whereas Vitamin D analogue shows anti proliferation. Vitamin D and its analogue are involved in wound healing, by activation of vitamin D receptors and increased production of human cathelicidin LL-37. Increase in LL-37 results antimicrobial effect and reduce pro-inflammatory cytokines. These characteristics of Vitamin D proved to be beneficial in treating periodontal diseases. A variety of pathways for the “perioprotective” function of vitamin D have been elucidated. An important property of vitamin D is its ability to induce the antimicrobial peptide, human cathelicidin LL-37, and increase expression of the genes coding for microbial pattern recognition receptors. LL-37 has the ability to eliminate microbes through diverse mechanisms, which might

Occupational Hazards among Dentists

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Occupational hazard refers to a risk or danger as a consequence of the nature or working conditions of a particular job. It can also refer to a work, material, substance, process, or situation that predisposes, or itself causes accidents or disease, at a work place. The history of occupational hazard awareness can be traced back to the 18th century when Bernadino Ramazzini, who is referred to as the father of occupational medicine, recognized the role of occupation in the dynamics of health and diseases.Occupational health should aim at the promotion and maintenance of the highest degree of physical, mental, and social well being of workers in all occupations; the prevention of deviation from health among workers caused by their working conditions; their protection from risks resulting from factors adverse to health. Healthy practitioners are particularly important for a successful dental practice and well-being of the patient. Occupational health hazards are not uncommon, altho

Correlation between characteristics of saliva and caries resistance

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Down syndrome (DS) is a genetic disorder caused by a trisomy of chromosome 21 with an incidence of 1: 800 to 1:1000 births. In India, it has been reported that the incidence of Down’s syndrome occurs in 1 per 700 births. The syndrome is characterized mainly by mental retardation, cardiovascular, hematopoietic, and musculoskeletal and nervous system anomalies, as well as other phenotypic abnormalities. Numerous oral manifestations have been describedin DS individuals including low incidence of dental caries, high incidence ofperiodontal diseases, mouth breathing resulting in dry mouth, fissured tongueand lips, high incidence of mucosal ulcers, candidiasis and acute necrotizingulcerative gingivitis. Children with Down syndrome may have different dental characteristics such as congenitally missing teeth and microdontia. Often, the teeth are in Angle’s class III relationship with posterior cross bites due to underdeveloped midfacial region.  The tongue has deep fissures and appea

Transient Paresthesia after Surgical Removal of Embedded Supernumerary Tooth

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Paresthesia is a sensory pathology which clinically manifests as numbness, pricking, tingling and burning. However it can informally referred to any abnormal sensation. Due to its anatomical location which is more superior position in the jaw compared with the other parts of the inferior dental canal, the mental foramen region is a common area for nerve damage to occur. Therefore, extra caution should be taken in proper evaluation of the anatomical position of mental foreman that can be situated in critical mandibular regions. There are multiple factors that can cause nerve injury including mechanical, chemical and thermal components. Mandibular paresthesia or dysaesthesia for the inferior alveolar nerve/ mental nerve distribution can be associated with local or systemic factors. The local factors are divided to endodontic and surgical etiology. The endodontic etiologic factors are the severe endodontic infection involving the nerve and the iatrogenic sequelae of endodontic thera

Water Pipe Use and the Awareness of its Effect on Oral Health in Riyadh, Saudi Arabia

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The World Health Organization (WHO) states that forms of tobacco use, including cigarette smoking and water pipe (WP) use, cause a large and growing public health burden. Each year, universal tobacco use is estimated to kill about 5 million people, and is the cause for one in every five male deaths, and one in every 20 female deaths of individuals over age 30. By 2030, it is estimated that yearly tobacco deaths will rise to 10 million. Some argue that the public health burden caused by tobacco use in the Middle East has reached epidemic proportions. Nicknamed“Shisha,” “Muassel,” and “Nargilha,” water pipe smoking (WPS) is especiallypopular among the young populations of the Arabian countries, Turkey, India, Pakistan, China, and Bangladesh . A recent study conducted in Jordan showed that among university students, WP use was as prevalent as cigarette smoking, with current use of 30% and 56% respectively, while a survey of students from four universities in Lebanon showed that WP

Rapid Correction Of Rotation With Modified Rotation Tie

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“Tooth rotation, is defined as mesiolingual or distolingual intraalveolar displacement of the tooth around its longitudinal axis”. Number of factors are involved in the rotation of teeth like space inadequacy, abnormal tooth eruption sequence, and undesirable forces exerted by the tongue and lips or any above combination. Biomechanical principles involve application of single or couple of force for correction of rotation. Rotated teeth can be corrected by removable, semifixed or fixed appliance depending upon the severity of rotation. Removable appliance containing z spring along with labial bow and semifixed (whip appliance) can treat mild rotations. Fixed appliance is a treatment of choice for severe rotations of teeth. Derotation can be done by number of ways with fixed appliances 1. By engaging NiTi archwire into bracket slot. Because of its superelastic nature and creating 1st order couple as it regains its original shape. 2. Offcentered brackets bring slight ove

Unilateral Maxillary Lateral Incisor Agenesis with Mini Implant Prostheses

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Many terms can be used to describe missing teeth. Anodontia is the complete absence of teeth; Oligodontia or partial anodontia means absence of six or more teeth; hypodontia denotes missing teeth, but usually less than six and often the size and shape of remaining teeth are altered as well, congenitally missing teeth or agenesis is defined as teeth that failed to develop or are not present at birth. Agenesis of any tooth can cause dental asymmetries, alignment difficulties, and arch length discrepancies but when the missing tooth is in the anterior region of the maxilla, the discrepancies can be quite noticeable. The maxillary lateral incisor is the second most frequently missing tooth after the mandibular second premolar even though Muller et al. found that maxillary lateral incisors experience the most agenesis (not including third molars).  Agenesis of the maxillary lateral incisor is also linked with anomalies and syndromes such as agenesis of other permanent teeth, microdont

Internal Validation of Subjective Bayesian Model of The Occurrence of Alveolar Osteitis Cases, Generated by Expert in Kinshasa Hospital/DRC

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An operations of oral surgery is relate primarily on the teeth, soft tissue and bone. Despite the advance of restorative dentistry and prosthetic rehabilitation techniques as well as periodontics, the dental extractions still a very common surgical practice in Africa. In certain conditions, despite the perfect knowledge of the practitioner and mastering of the surgical plan, the surgical operations can be delicate and difficult to predict some complications during or after surgery. In the postoperative, the most frequent complications of dental extraction are inflammatory or infectious such as alveolar osteitis (AO), which includes the dry and suppurative alveolitis . This study was initiated to identify 7 groups’ factors of occurrence of AO by a mathematical model of Bayer, which is based on the opinions of experts who use the qualitative data . Clinical interest will be to help the clinicians use a mathematical model for the 7 predictive factors of AO such as non-modified facto

Periodontal Intrabony Defects and the Treatment with Enamel Matrix Derivative

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The intrabony defects are considered the main consequence of periodontal disease, presenting itself as a challenge to the clinician. These represent locations that, if untreated, are at an increased risk for disease progression. Although resection surgery has been used a treatment option to their elimination, the treatment of choice is periodontal regeneration . Reports of guided tissue regeneration (GTR) as a periodontal procedure appeared more than 20 years ago. The rationale behind this therapy is to achieve regeneration of tooth supporting structures, or cementum, periodontal ligament and alveolar bone. This is different from conventional periodontal surgery that achieves healing by repair. Another way to approach periodontal regeneration is to mimic the process that occurs during development of periodontal tissues. After the discovery of the presence of a layer of enamel matrix between the peripheral dentin and cementum underdevelopment, along with the ability of this

Decontamination of SAE Surface: An In Vitro Study

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Titanium is the preferred material for dental implants because of its mechanical strength and protective oxide layer, which is naturally formed and regenerated immediately in presence of air and/or aqueous media, providing protection against corrosion. Due to these characteristics, in terms of roughness and porosity in the microscopic range (depending on the treatment surface), commercially pure titanium (CP Ti) or the alloy TiAl4V are unique for osteointegration providing stability of the implant to survive the mechanical requirements of the oral environment. Although, maintenance has been suggested after placement of the implant to ensure a favorable environment for osteointegration to occur and continue. Such procedures are designed to diagnose and treat inflammatory responses as known as peri-implantitis, an inflammatory process around an implant, characterized by soft tissue inflammation and loss of supporting bone in the peri-implant area. The presence of bacterial biof

Low Level Laser Therapy in Modern Dentistry

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LASER is an acronym for: Light Amplification by Stimulated Emission of Radiation. Laser therapy has a long history of medical applications and has begun to show great promise in dental applications. There is evidence that laser therapy is a useful adjunct to conventional routine dental care and is rising in popularity among dentists. Lasers are devices which generate electromagnetic radiation that is uniform in wavelength, phase and polarization. They can be classified as a high-powered, low powered, surgical or therapeutic. There is evidence that lowpowered or therapeutic laser have analgesic, anti-inflammatory and biostimulatory properties on live tissue. Laser technology has the unique advantage of improving treatment techniques as well as aiding in the healing process. Some of the major benefits associated with Laser Dentistry are: 1. Laser assisted procedures performed on soft tissue may not require suturing through a process called tissue welding. This is a proces

Variations between Visually Estimated and Actual Convergence Angles of Tooth Preparations

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Missing teeth and lost or defective tooth structures can be restored by various types of fixed prostheses, the retention of which can be achieved by many ways. The most important retention technique is minimizing the convergence angle (CA) to an optimal taper that allows proper seating and retention of the dental prosthesis. The CA, measured in degrees, is defined as the taper of a crown preparation or the angle formed between opposing axial walls when teeth are prepared for crowns or fixed dental prostheses.  This term is best described as the total occlusal convergence . CA values ranging from 4 to 38 degrees have been measured in the literature by various methods, including using a tool-maker microscope, geniometer, three- dimensional (3D)laser scanner, white-light 3D scanner, digitizer, AutoCAD photographs, Lava design, 3D-inspection software, and a protractor to measure a traced silhouette from a photo of the projection of dies. Only one study mentioned using visual estimati

Endodontic-Periodontic Lesion

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Stable Osseo integration between insert strings and the encompassing negligible bone gives the mechanical base of an insert for day by day biting movement. The string configuration was parameterized by shape and decrease. String shapes includedsymmetrical, square, and buttressed . String decreases were separated into barrel shaped and funnel shaped profiles. Nine varieties of the string configuration were created to numerically assess their geometric and mechanical consequences for the peripheral bone. Endodontic-Periodontic Lesion The three most regular oligomers utilized as a part of dental composites are bisphenol. A diglycidyl ether methacrylate (bis-GMA), urethane dimethacrylate (UDMA), and triethylene glycol dimethacrylate (TEGDMA).   • Furthermore, siloranes were recommended as other options to methacrylate’s as grid gum components for dental composites as a result of their physical properties.   • Pitch composites are ordered as indicated by different attributes, fo

A Study Based on Dental Awareness, Knowledge and Attitudes among the Medical Practitioners in and Around Kanpur City (India)

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The mouth is a mirror of health or disease, a sentinel or early warning system. As the gateway to the body, a constant barrage of invaders like bacteria, viruses, parasites, and fungi, challenges the mouth. Many systemic diseases have oral manifestations. These lesions develop on the oral mucosa, tongue, gingiva,dentition, periodontium, salivary glands, facial skeleton, extraoral skin and other related structures .Thus oral cavity is an important diagnostic area not just because it contains derivatives of all of the primary germinal layers, and includes tissues not demonstrable anywhere else in the body, but also because of its role played in diagnosing a number of systemic diseases just because of their oral manifestations. In the event that the integrity of the oral tissues is compromised, the mouth can become a source of disease or pathological processes affecting other parts of the body. It can also become a source of contagion by means of contaminated fluids or materials

Comparision between Conventional Radiography (IOPA) and Digital Radiography

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Diagnosis is the process of assessing a patient’s health as well as ensuing opinions formulated by clinicians. Oral diagnosis is the art of using scientific knowledge to determine the nature of oral diseases and distinguishing it from other diseases . Radiography is a well established procedure in daily dental practice and is still the most basic and an important diagnostic tool available. Radiographs play an integral role in the assessment of periodontal diseases. Conventional bitewing and intra oralperiapical radiographs are commonly used to detect alveolar bone loss associated with periodontal disease. They provide unique information about the status of the periodontium and a permanent record of the bone throughout the course of the disease. However, the quality of an X-ray sensitive film can be affected by multiple variables such as improper exposure, underor overdeveloping and poor fixing.   Over the past few years, systems that can generate radiographic digital images with

A Comprehensive Approach to Sexual Assault Investigation

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Sexual violence is a widespread problem. When the word heinous crime falls upon your ears the first name which pops in our mind is rape. Undisputedly the most gruesome and heinous of all crimes against any women. Even since civilizations came into existence to curb the crime, administrators and law makers have tried relentlessly by making appropriate laws related to it, but in vain. The biggest problem faced is the proper investigation and potential misuse of these laws by unscrupulous elements, limiting the penalties attached to it. Many assaulters get less or no jail term due to less knowledgeof doctor which causes loss of evidence during physical, sexual examination of rape victim. Detecting sexual abuse requires a high index of suspicion and expertise. Odontologist should be aware that oral or dental injuries may be result of physical or sexual abuse that sometimes can be confirmed by laboratory findings. Moreover, injuries inflicted by one's mouth or teeth may leave clu

Predicting Transmitted Light Radiant Exposure of Fiber Dowel Cross Sections from Dowel Diameter and Length

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Fiber dowel retention is required for the success of foundation restorations and overlying fixed prostheses. Many factors affect dowel retention, including the depth of cure of the cement used. Lightor dual-cure resin cements are commonly used with fiber dowels. Both cement types require light to initiate polymerization, resulting in varying degrees of conversion, or depth of cure, depending on light intensity and degradation along the length of the root canal system. Reports have shown that some dual-cure cements do not reach adequate degrees of conversion in the absence of light. The use of translucent dowels has been recommended to improve the degree of conversion in dark areas of the root canal that cannot be reached by curing light. Several studies have examined the effects of light curing on the degree of resin cement conversion. Few reports on light intensity at various locations on different fiber dowels have been published. A few reports have described the effects of