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Showing posts from October, 2016

Walking 6 Year Molar

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A 30 year old male patient reported to our dental hospital with chief complaint of pain in the lower left back tooth. Patient gave us the history of a restoration done three months ago. The restoration was fractured ten days before reporting to the hospital. Clinical examination revealed the fractured restoration on the occlusal surface of mandibular left first molar. Intraoral periapicalradiograph shows radiolucency involving occlusal enamel and dentine.  Radioopaque restorative material is seen on the pulp chamber. In radicular aspect there are two mesial and two distal separate roots with separate root canals. Mesial roots are departed from each other towards mesially and distally. This gives the appearance of walking tooth. There is root dilaceration in one of the distal roots. Patient was advised for an endodontic treatment of mandibular left first molar. Read more.........................

Best materials in the treatment of periodontitis

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Recently scientists evaluated the healing outcomes of Intermediate Restorative Material (IRM) and mineral trioxide aggregate (MTA) materials as root-end seal of teeth with apical periodontitis. They found that both the methods are effective in the treatment of periodontitis. Teeth with previous conventional endodontic root-canal treatment may present persistent symptomatic or asymptomatic apical periodontitis. Such teeth could be a subject to periapical surgery using a modern technique with an expected good outcome. However, uninstrumented teeth with a need of conventional endodontic treatment can also benefit from such a surgical procedure. In a long-term perspective the orthograde retreatment of the root filling offers a more favorable outcome, 83% versus 72% for periapical surgeryafter 4-6 years. In contrast to that a meta-analysis from Kang et al. revealed a significantly higher success rate for periapical surgery in a short term perspective (less than 4 years) compared

Is there any relation between periodontal diseases and preterm birth?

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Preterm birth is the greatest contributor to infant death and longterm neurological morbidity. Despite all the medical efforts to reduce the preterm birth, the rate is still high relatively high; according to the Centers for Disease Control and Prevention, preterm birth affected about 1 of every 10infants born in the United States in 2014. Prevention and treating the underlying causes of preterm labor would be more successful than treating existing preterm labor.  Maternal infections are responsible for between 30%-50% of preterm births. Remote subclinical infections have also been considered as causes of preterm labor. Periodontal disease being an inflammatory disease triggered by microbial biofilm has been identified as a risk factor for preterm birth. The purpose of this study is to determine if a relationship exists between periodontal disease and preterm birth. Read more...............

Wettability of Irrigants used in Root Canal Treatment

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The main objective of dental root canal treatment is to achieve a canal system free of microorganisms. The irrigant solutions used during treatment have the purpose of eliminating bacteria from infected root canals and promoting dissolution of the pulp tissue (a dense connective tissue). For decades, researchers have searched for antimicrobial agents that can effectively debride the root canal system. Until now the ideal chemical substance remains unknown. Among the solutions available for root canal irrigation, two are the most commonly employed and one was more recent introduced as a promising irrigant. T he firstis the sodium hypochlorite (NaOCl), a halogen substance, which has pronounced antimicrobial activity and tissue solvent capacity. Second is the chlorhexidine (CHX), which is a cationic bisbiguanida with antibacterial property, derived from its electrostatic attraction by the microbial cell wall, which damages the cell osmotic balance. CHX also has substantivity due

Oral Health Status in Jordanian Children with Cancer Undergoing Chemotherapy

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Although malignancies are rare in children and make up less than 1% of all cancers diagnosed, they represent the second most common cause of death in childhood. Leukemias and lymphomas constitute approximately 40% of pediatric neoplastic diseases, while solid tumors make up the remaining percentages. Leukemia is the most common hematological  tumor in children. In Jordan, leukemia also is the most common childhood malignancy.  The incidence has been (32.2% for females and 28.1% for males) among childhood cancers, followed by brain and central nervous system tumors (18.8% for males and females), and lymphomas (16.2%). Today, more than 80% of children diagnosed with cancer are alive 5 years after diagnosis due to the advances childhood cancer therapy.  Direct treatment of malignancies involves chemotherapy, radiotherapy and bone marrow transplantation. PDF Link...........

CBCT Assessment of Dental and Skeletal Changes Using the Damon versus Conventional (MBT) System

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The evolution of the shape of the human dental arch is distinct when compared to other primates, while hominid evolution has demonstrated that the arch form in man is parabolic. For over 100 years the size and shape of the ideal dental arch has been used for diagnosis and treatment of malocclusions and two diverging methods of therapy: extraction versus non-extraction. Proponents of non-extraction treatment have indicated that extractions result in a detrimental result in profile and smile esthetics, large buccal corridors and faulty final occlusions. Recent reports indicate that extraction therapy does not negatively impact on soft tissue , nor does it negatively affect smile esthetics . If the current state of evidence points in the direction that extraction therapy has no detrimental effect in facial esthetics and provides a superior occlusion to non-extraction treatment, one would expect a greater predominance of patients treated with the extraction of teeth to successfully

THE NEW BEST RESIN COMPOSITE FOR ROOT CANAL TREATMENT IS FOUND.

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Following an endodontic treatment, if the remaining tooth structure is not adequate for the stable retention of a direct core build-up material, insertion of post into the canal is a treatment option to retain the core. The post can be metal, fiber, or ceramic. Metallic posts have poor stress distribution due to differences in the elastic modulus of metal and dentin, which can occasionally cause root fracture and the potential discoloration of surrounding soft tissue. The use of glass fiber posts has advantages, such as more rapid treatment and better biocompatibility, aesthetics, corrosion resistance, and similar biomechanical properties to dentin.  When loaded, adhesively luted endodonticreinforced with glass or quartzlead to better homogeneous tension distribution than rigid metal or zirconium oxide ceramic. Moreover, it has been reported that, compared with traditional metallic cast posts, glass fiber posts decrease the likelihood of irreparable root fracturesT

Oral Health Problems among Diabetic Patients ? Part of Dental Professionals in Diagnostic and Therapy

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Sickness-changes within the oral cavity are to be considering both as the complication of the diabetes as well as the reason of the difficulty in the metabolic compensation of the illness. Every chronic hyperglycaemia, aside from its reasons, leads to the activation of the process of not enzymatic glycation of proteins, poliolic route and the oxidative stress. The chronic hyperglycaemia and related inflammation leads to the disturbances in the balance between the metaloproteinase system and their inhibitors (MMP/TIMP), what becomes a reason of the pathological reconstruction of the vascular wall,the proliferation of the endothelium and arteriogensis . Inflammatory focus in the human body, including the oral cavity, can on one hand be the reason of disturbances of the metabolic control of the diabetes, from the second hand – can accelerate the development hyperglycaemia related vascular complications.  Many authors think that fundamental role in the occurrence of complications

Microflora of Orofacial Space Infections of Odontogenic Origin in Children ? A Bacteriological Study

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Oral cavity is an ideal niche for the growth of microorganisms. Despite a great advance in the pediatric dental care, infection of the oral cavity remains the major problem in today’s dental practice. Although we live in an era of antibiotics, odontogenic infections are still a common problem with which a dentist must deal. Orofacial space infections of odontogenic origin are very common inchildren and most of them originate from necrotic pulps, partially erupted teeth,or traumatized teeth. However, Seow  has reported that developmental abnormalities like dens evaginatus, dentin dysplasia, dentinogenesis imperfecta and familial hypophospatasia can lead to space infections. Infections in the jaws of a child may spread rapidly because of the wide marrow spaces and also due to the bones of developing children are less dense than adult bones .  An intraosseous infection can also cause complete destruction of the permanent tooth germs and if undiagnosed may reach the critical g

Autogenous Demineralized Dentin Graft for Third Molar Socket Regeneration

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The management of the osseous defects distal to the second molars as a result of the surgical removal of impacted wisdom teeth can be a challenge. The reasons for third molar extraction are varied like pericoronitis, decay, risk of damage to adjacent teeth, cyst or tumor formation, or to facilitate orthodontic treatment. The postextraction bone loss, a physiological phenomenon will take place with alveolar resorption and the subsequent formation of bone within the socket follows osteoblastic differentiation of osteoprogenitor cells. This phenomenon continues for a period of weeks. However, studies have documentedthat the bone volume following extractions decreased by 50% within 12 months,and two-thirds of this resorption took place during the first 3 months afterextraction. Bone resorption will result in a loss of socket width three-dimensionally that subsequently hamper the native alveolar ridge contour. Therefore, maintaining 3-dimensional alveolar bone volume is required for idea

The Use of a Dental Dam during Implant Placement

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In 1864 Dr. Sanford C. Barnum introduced rubber dams* to dentistry. Dental dam isolation is accepted as a standard procedure during endodontic treatment and has been endorsed by many professional organizations including the American Association of Endodontists, the European Society of Endodontology, and the American Academy of Pediatric Dentistry. In a recent ADA News interview withformer AAE President Gerald Glickman, the importance of the use of dental dam during endodontic treatment was emphasized. Despite its acceptance in endodontic and other dental disciplines, the use of dental dam is not mentioned in dental implant literature. The benefits in endodontic would be expected to also apply during implant placement: improved visualization and reduced risk of ingestion or aspiration of irrigation solutions and small instruments. Additional benefits would include improved view of the operating field by retraction of soft tissues and enhanced visual contrast, and patients are

Bond Strengths of Metal, Ceramic and Polymer Brackets in Combination with Different Enamel Preconditioning Methods

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The introduction of adhesive systems for orthodontic bonding has dramatically decreased a time consuming step in fixed appliance therapy. Since the introduction of the adhesive technology by Buonocore in 1955 and the first report of its use in bracket placement by Newman  in 1964, there have been considerable developments in all areas. Enamel etching was first performedwith 80% phosphoric acid but soon changed to a 37% solution, which was routinely accepted by the end of the last millennium. Subsequently the introduction of self-etching primers has again brought a dramatic change in etching technology.  Not only were new etching agents such as polyacrylic acid and maleic acid introduced, but the etchant was combined with the low viscosity composite matrix which potentially enhanced the penetration of the etching relief. Alongside the etchants, adhesives have also evolved. Whereas initially Newman  advocated the use of an epoxy resin, polyacrylic resins filled with different an

Influence of Repeat Pours of Addition Silicone Impressions on the Dimensional Accuracy of Casts

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Making an impression represents a critical step in processing and fitting of a dental prosthesis. The definite impression should be accurate to fabricate restoration with ideal marginal fit, internal fit, interproximal contacts and occlusal contacts.The impression materials are used to register or reproduce the form and relations of the teeth and the surrounding oral tissues. Dimensional accuracy andstability are the primary requisites of an impression material. Accuracy of an impression depends on properties of impression materials like thermal contraction, polymerization shrinkage, presence of volatile by products, elastic recovery, bulk of material and impression technique use. Other factors which influence the accuracy of an impression are tray material, space between tray and tooth preparation, storage conditions, relaxation of stresses caused by the use of non-rigid trays, excessive seating pressure, too slow removal from the mouth or an impression removed before the polymeriza

Herbal Formulation (Tooth Paste): Anti-Precancerous Properties

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Toothpaste can be employed as a vehicle to improve and prevent oral health of individuals and population. Different modalities of treatment are offered for different dental and oral diseases, but the major drawback of these conventional drug therapies are side effects associated with their use. This has led to the interest in the discovery of novel anti-infective natural compounds. The formulation is based on polyherbal extracts which display no side effects on the oral cavity as well as other body organs. To confirm the performance of thetoothpaste formulation, the technology (Oral Sure, Orange Herbs Pvt Ltd, India) was evaluated in vivo on 20 patients (oral leukoplakia, oral lichen planus, submucous fibrosis and erythroplakia). Valid diagnostic tests were evaluated for diagnosing oral pre-cancerous lesions. Pain control and lesion healing were the two main clinical variables for evaluating improvement of oral leukoplakia, oral lichen planus and oral submucous fibrosis. B

Non-Surgical Management of Periapical Cystic Lesion- A Case Report

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It has been reported that bacteria lodged in the root canal system plays an important role in the development and maintenance of periapical lesions. Thus, the elimination of these bacteria is of great importance for apical and periapical healing after endodontic treatment.Although chemo-mechanical preparation of root canals is able to reduce the number of bacteria, an intracanal medicament with antibacterial action is required to maximize the disinfection of the root canal system in infected cases. The need for intracanal medication increases in those cases where bacteria are resistant to routine treatment, and where the therapy cannot be successfully completed due to the presence of pain or continuing exudates. Since its introduction in 1920, calcium hydroxide has been widely used in endodontics. It is a strong alkaline substance, with a pH of approximately 12.5. In an aqueous solution, calcium hydroxide dissociates into calcium and hydroxyl ions. Various biological properties

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. CAvalues 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 estimation to

Application of KT method in removing wisdom teeth

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The Kinesio Taping method is a technique that facilitates the natural healing by providing stability to muscles and joints. Recently dentists are using this method for removal of wisdom teeth. The surgical removable method is low risk method with post-surgical symptoms such as pain, swelling and trimus.  When a patient underwent a routine removal of third molar via general anaesthetic, a post-surgical lymphatic drainage application of KT was applied. Reduction in post-surgical symptoms was observed and time for recovery was also decreased. Removal of third molars (3M) is a routine procedure that is performed daily within dentistry affecting over 75,000 patients in the UK per year and up to 5 millionin the United States. Research has demonstrated that common symptoms associated with 3M are namely pain, swelling, discomfort and morbidity being the most common symptoms. Currently, there are a number of approaches including advances in dentistry surgical tools, analgesics and han