International Journal of Contemporary Dental and Medical Reviews
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Modulators for orthodontic tooth movement
Get PDFBackground: Orthodontic tooth movement (OTM) is an interaction between the mechanical forces applied on the tooth and the response of biological tissues of the oral cavity to those forces. Bone has the ability of self-repair as well as it can adapt to changes in the mechanical needs of the body. The triggering factor for OTM is a strain on the periodontal ligament (PDL). Mechanical forces applied in orthodontic treatment cause the physical distortion of PDL and alveolar bone cells resulting in activation of inflammatory pathways, such as the prostaglandin pathway. Osteoclast formation has seen to be increased after the activation of T-cells, whereas the food derivatives such as sulforaphane and natural isothiocyanate are observed to promote osteoblastic activity. However, these agents get flushed by blood circulation rapidly. Although, there is a possibility that the agents that enhance bone formation and bone resorption can accelerate tooth movement and shorten the time of orthodontic therapy. Aim: The objective of the review is to highlight the inflammatory process involved in the orthodontic treatment as well as bone remodeling, ultimately to understand how modulation of the inflammatory process of the immune system with the help of external agents can enhance the OTM. Conclusion: The advantages of inflammatory mediators can be utilized in orthodontic therapy that can give a novel perspective to orthodontic treatment. However, this demands a thorough understanding of the biology of oral tissues at cellular as well as molecular level as our knowledge is limited in this perspective. Therefore, more studies and research work should be motivated in the field of oral biology to bring better treatment outcomes in less amount of time. Clinical Significance: The understanding of concepts related to inflammatory processes as well as bone remodeling will help us to develop modulators in future that will resolve the problem of extended treatment time involved in orthodontic treatment. Hence, the knowledge of cellular biology can be applied to make orthodontic more efficient by reducing the treatment time as well as events of relapse
Aesthetic bite for the management of temporomandibular disorders: A case series review
Get PDFBackground: Oral appliances (OA) are the most widely used treatment approach for temporomandibular disorders (TMDs): They are designed to relieve or prevent degenerative forces on the joint, the articular disk, and dentition. Classical OAs, however, are cumbersome and esthetically unpleasing: A more esthetic and functional appliance might improve treatment efficacy and shorten treatment time. Aim: The aim of this case series is to introduce an esthetical device for the management of TMD. Methodology: Three adults between 43 and 60 years old with a diagnosis of intra-articular TMD were included and were instructed to apply the device throughout the day and night. The patients were recruited at the same private dental clinic and each one signed an informed consent for both treatment and inclusion in the study. We evaluated and compared four clinical parameters (mandibular excursion, mandibular opening pattern, muscular and articular pain, and TMJ noises) between time 0 (T0) and 1, 2, 3, 6, and 12 months of using the device following the protocol of diagnostic criteria for temporomandibular joint disorders (DC/TMD). A magnetic resonance imaging exam was conducted to investigate tissue changes between T0 and 3 and 12 months of therapy. Conclusions: For all four parameters, we observed considerable improvements in all patients, who noticed the positive effects of the therapy themselves. The results suggest that this esthetic device was an effective treatment to manage TMD in the described cases, also increasing patients’ quality of life. However, studies on a larger scale are required to prove the effectiveness of this device. Clinical Significance: This case series aims to highlight the potentiality of an esthetic device used for the management of TMDs. This is because a more esthetically pleasant and comfortable device increases the time of usage, thus improving the positive effects of the device on the TMD
Comprehensive review on alveolar osteitis
Get PDFBackground: Dry socket also termed as alveolar osteitis is a post-extraction complication encountered more frequently. The socket exhibits exposed bone and lacks blood clot. The patient with dry socket complains of severe pain after 24–72 h of extraction. Various risk factors such as smoking, surgical trauma, age, sex, medical condition, and radiotherapy are involved in the pathogenesis of dry socket. Primary aim of treatment includes relief of pain. Aim: The aim of the study was to review the occurrence of post-extraction dry socket, its etiopathogenesis, predisposing factors, preventive method, and treatment options for dry socket. Conclusion: Dry socket is the common complication encountered after the extraction of 3rd molars and causes severe pain. With the known risk factors, preventive measures the occurrence of dry socket can be avoided. Treatment includes palliative care such as irrigation, debridement, curettage, and packing the socket with eugenol to relief pain. New agents such as plasma rich in growth factors and GECB can also be used. Clinical Significance: In the routine daily scenario, dry socket can be encountered in any surgical or non-surgical extraction cases. To avoid the occurrence of dry socket, proper knowledge about its cause, the clinical symptoms of dry socket, preventive measures, and the precautionary steps to be taken should be known. One must also be aware of the treatment to be done when the patient comes up with dry socket
Glide path establishing instruments – An overview
Get PDFBackground: Mechanical preparation of a root canal system plays a key role in providing a successful and a more predictable endodontic treatment outcome. The intricate anatomy of root canals often poses a challenge for clinicians in aiding this objective. The preparation of a glide path provides a basis for effective cleaning and shaping, enabling all the subsequent instruments to move smoothly through the canal till the apical constriction, unhindered. A reproducible glide path enhances clinicians’ efficacy in understanding root canal anatomy, thus reducing the likelihood of procedural errors. Aim: This review article illustrates the importance of glide path preparation and also explains the numerous glide path instruments available over the years. Conclusion: Glide path is the key to radicular rotary safety. It is a pre-requisite to achieve the rationale of endodontics. Clinical Significance: Preparing a glide path increases the life span of rotary instruments, reduce the risk of procedural errors, providing the clinician a more detailed route map of the canal anatomy
Dental management of children with cerebral palsy - A Review
Get PDFBackground: According to American Academy of Pediatric Dentistry, special health care needs (SHCN) is “any physical, developmental, mental, sensory, behavioural, cognitive, or emotional impairment or limiting condition that requires medical management, health-care intervention, and/or use of specialized services or programs. Oral health is an inseparable part of general health. Throughout the lifetime, individuals with SHCN may be at a greater risk for oral diseases. Aim: The aim of this paper is to discuss dental management of child with cerebral palsy (CP) in detail. Conclusion: Children with SHCNs have a considerably higher prevalence of oral diseases as compared to otherwise healthy children. The role of the pediatric dentist is to improve oral health wellness and to encourage parents and caregivers for good home oral health practice. Clinical Significance: This paper will help the dentist to understand all the aspects related to dental management of patients with CP and apply it in clinical practice
A comprehensive review of new innovations in dental implant imaging techniques
Get PDFBackground: Over the past three decades, dentistry has undergone considerable development in all of its branches. The need for more accurate diagnostic methods have become inevitable with these progresses. Advanced imaging methods such as computed tomography, cone beam computed tomography, magnetic resonance imaging have also found space in modern dentistry from the traditional intra-oral periapical X-rays. Aim: This paper is intended to explore recent developments in imaging technology and its applications in various dental disciplines. Conclusion: The three - dimensional visualization has made the complex cranio-facial structures more available for analysis and early and precise diagnosis of deep rooted lesions. Clinical Significance: Moving from analog to digital radiography has not only made the process easier and quicker, but has also enabled image storage, manipulation (brightness/contrast, cropping of images, etc.) and recovery
Comprehensive review on tooth avulsion and its management
Get PDFBackground: Of all the dental trauma injuries, avulsion is a serious problem and the prognosis of treatment depends mainly on the measures taken at the time of injury. Appropriate management of avulse tooth is necessary. Guidelines are important for providing best possible treatment for avulsion. Permanent anterior teeth avulsion occurs rarely and usually affects children about 7–8 years of age. On reimplantation or splinting of these teeth, inflammation, severe resorption, or ankylosis are seen which ultimately affect alveolar bone development and these reimplanted teeth sooner or later have to be extracted. Aim: This review aims to educate people as to what precautions to be taken for avulsed tooth and the line of treatment. Conclusion: There have been numerous researches done and number of guidelines laid down for the management of avulsed tooth. This review article has compiled all the treatment modalities and will help to identify the best treatment modality to be chosen for the treatment of avulsed tooth. Clinical Significance: By considering the evidence-based treatment modalities, the prognosis of treatment of avulsion can be enhanced. Incidence of inflammation, ankylosis, resorption, and tooth loss could be reduced
Prevalence of oral fluorosis in Luangwa district of Lusaka Province, Zambia
Get PDFBackground: A fluorosis is a chronic form of hypoplasia of the dental enamel initiated by consumption water with high fluoride content during the time of tooth formation. Excessive ingestion of fluoride can result in fluorosis (mottling) of enamel which presents as opaque or white areas, lines, or flecks in the enamel surface. These teeth are more prone to dental caries and can be cosmetically disfiguring when they occur on anterior teeth. In spite of this fact, no study has been conducted to measure the prevalence of fluorosis in Luangwa district of the Eastern Province of Zambia. Aim: The study was to determine the prevalence of fluorosis and its treatment needs among the population affected in Luangwa district in the Eastern Province of Zambia. Methodology: A cross-sectional study was conducted with outreach descriptive survey and was conducted on patients that attended dental care during the mobile hospital outreach that was conducted in Luangwa district of Lusaka Province of Zambia. Results: Out of the total of 195 subjects examined, 56 (28.8%) patients were seen in Luangwa district clinic, out of which 1 (1.78%) had fluorosis. In Mwavi, at the secondary school, 71 (36.4%) were seen and 29 (40.84%) had fluorosis. At Luangwa Secondary School, a total of 68 (34.87% of the total subjects) were examined and out of that 7 (10.29%) had fluorosis. An aggregated total of 37 (18.97%) subjects of the 195 seen had fluorosis. Conclusion: The survey could elicit the presence of fluorosis in the Luangwa district of Lusaka Province. The baseline data suggest that the subjects who were seen from the clinic in the cannabidiol exhibited low levels (1.78%) of fluorosis because the water they consumed was treated by the local authority as compared to high prevalence of fluorosis in other sites outside the district where the water source was primarily river and wells which lacked treatment. Clinical Significance: This pilot study suggests the need to conduct a larger research study on the prevalence and impact of fluorosis in the population. This would help to plan future upstream dental public health programs
Hybrid layer evaluation of all-in-one adhesive with single and multiple applications
Get PDFBackground: Earliest commercial versions of self-etch bonding systems were hydrophobic, which did not allow them to adapt to hydrophilic dentin. The adhesive must be hydrophilic in nature as it should be able to diffuse and penetrate in an aqueous environment. The tested self-etching adhesive (Tetric N-bond) contains acid monomers, often mixed with water, to make the adhesive systems sufficiently acidic to form hybridized complex. Single layer application of self-etch adhesive results in a layer that is too thin for successful photopolymerization. Aim: The purpose of this study was to evaluate the effect of single and multiple applications of all-in-one self-etch adhesive on hybrid layer. Materials and Methods: Tetric N-Bond self-etch all-in-one adhesive was used in the study. Fifteen extracted human mandibular molars mounted in self-cure acrylic resin with the occlusal enamel removed were cross-sectioned to obtain 1 mm thick dentin disks and then divided into three groups.• Group 1: Single layer of adhesive was applied and light cured for 10 s;• Group 2: Two layers of adhesive were applied with intermediate curing between each layer;• Group 3: Two consecutive layers of adhesive were applied with light curing after application of two layers. Resin composite build-ups were made and hybrid layer evaluation was done using scanning electron microscope.Results: There is no significant relationship between increase in number of adhesive layers and thickness of hybrid layer. There is no significant relationship between curing each layer and curing of two consecutive layers of adhesive. Conclusion: No significant relationship exists between increase in number of adhesive layers and thickness of hybrid layer. Clinical significance: Self-etching adhesive systems allow practitioner to place restorations in a more simplified manner with decreased postoperative sensitivity. After application, these products create very thin coatings, which may be oxygen inhibited and hence poorly polymerized which can be overcome by simple changes in bonding technique, such as applying two layers of all-in-one adhesives
Pterygoid implant: Option for rehabilitation of the atrophic posterior maxilla
Get PDFBackground: The anatomy of the atrophic posterior maxilla presents many limitations to implant placement. Factors affecting implant placements include poor bone quality and quantity, location of maxillary sinus. Posterior cantilevers on implant prostheses produce complications, such as prosthesis fracture, screw loosening, loss of osseointegration, and crestal bone loss. Pterygoid implants are an alternative to grafting solutions for posterior maxillary rehabilitation. Aim: This systematic review describes various implant treatment options for posterior maxillary rehabilitation. It highlights the use of pterygoid implants as a graftless solution with its anatomy, technique of placement, and advantages. Conclusion: Pterygoid implants have high success rates, less bone loss, and good acceptance by patients thus being an excellent alternative to treat patients with severely atrophic maxilla. Clinical Significance: Pterygoid implants avoid the need for sinus lifts and grafting procedures. They allow anchorage in the posterior atrophied/resorbed maxilla, achieving proper stability, and high rates of long-term succ