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Maxillary Cemento-Ossifying Fibroma in a Male Patient with End-Stage Chronic Renal Disease
Get PDFAims & Objectives: The cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion with controversial features that occurs most frequently in the mandible of female individuals. The presence of chronic renal disease (CRD) is a predisposing factor for the occurrence of soft and hard tissue lesions in the oral cavity. The aim of this report was to describe clinical, radiological and histopathological characteristics of an unusual case of COF who was also presented with CRD. Case Description: A 41 year-old male patient undergoing chronic hemodialysis was referred because of the painless, slow growing, firm mass in the maxilla. Cone Beam Computed Tomography disclosed a well-circumscribed lesion containing numerous ring-shaped and curvilinear ossified nodules in the left premolar-molar region. Patient was operated under local anesthesia. The histopathological examination revealed irregularly shaped bone and cementum-like hard tissue calcifications contained within hypercellular fibrous tissue stroma, leading to a final diagnosis of cemento-ossifying fibroma. Conclusion: The clinical characteristics and radiological appearance of maxillary COF is unspecific and its relapse potential is unpredictable. A reliable classification at the cellular level is required to support evidence based clinical decisions, particularly in the presence of systemic conditions such as CRD
Reducing The Pink White Ratio for Better Aesthetics -A Perio - Restorative treatment approach to manage gummy smile of periodontally compromised teeth
Get PDFAbstract: Assorted periodontal treatment procedures aimed at reinforcing weak teeth and clinical crown lengthening procedures for placement of better restorations bid periodontics a vital role in multi disciplinary dental clinical practice. However in additional clinical crown length demanding restorative cases, gingivectomy could be made more effective by combining it with subtractive osseous surgery of underlying alveolar bone. This combination gives a functional aid in restorative dentistry and also is used in the correction of excessive gingival exposure during smiling commonly known as’ gummy smile’. In such cases, the concerned teeth are root canal treated and more clinical crown length is attained with gingivectomy extending even apical to the free gingiva to a predetermined level subject to the availability of attached gingiva and alveolar bone. This is followed by resection of exposed alveolar bone to achieve maximum clinical crowns for the teeth, placing the marginal bone level at least 3 mm apical to the new gingival margin. The gingival margins are tightly sutured to the bone tooth interface. The area is allowed for complete healing with new gingival sulcus, and teeth are then prepared to desirable level for receiving more aesthetically pleasable crowns in its new position. This less discussed face of periodontal surgery and its combination with two restorative speciality aimed at achieving the best aesthetic rehabilitation for patients with excessive gingival exposure during smiling is presented here in detail with 6 completed illustrative clinical case reports. The indications of this interdisciplinary clinical practice involving Endodontics, Periodontics and Prosthodontics, its area of application and limitations are also highlighted
Sub Epithelial Connective Tissue Graft Surgery For Root Coverage On Teeth With Advanced Gingival Recession - 2 Case Reports
No full textUnaesthetic appearance of denuded root surface resulting from iatrogenic or periodontal disease is one among the most demanded but less managed complaint in periodontics. Periodontal plastic surgeries and regenerative surgeries are the treatment options for such conditions. The extent of gingival recession in relation to mucogingival junction and the width of remnant attached gingiva are key factors that decides the fate of these surgeries. Two such cases are presented here wherein sub epithelial connective tissue graft was used to manage localized gingival recession extending up to the root apex. In spite of the proclaimed challenges of unfavorable factors governing the prognosis of such surgeries, 5 to 8 mm wide zone of attached gingiva was achieved in both the cases. The pre surgical preparation and the surgical technique where modified to suite the challenges of compromised condition of teeth. The stepwise illustration of the complete procedure is presented in detail.  
Aggressive Osteoblastoma of the Mandible: A Case Report
No full textOsteoblastoma is an osteoid and bone forming tumor of bone. Histologically, It is characterised by the presence of numerous active osteoblasts. Here we report a case of 19 year old female, who presented with painful swelling in left posterior mandibular region. Radiological picture disclosed a well-circumscribed lesion with patchy radiopaque internal structure. After complete excision, the histopathological diagnosis was an agressive osteoblastoma of the mandible. The major problem in diagnosis is the differentiation between agressive osteoblastoma and a number of lesions with similar clinicohistological characteristics including osteosarcoma
Benefits of live microorganisms (Probiotics) in periodontal health
No full textProbiotics are dietary supplements containing potentially beneficial bacteria or yeasts. They are administered in different quantities that allow for colon colonization. These products help in stimulating health promoting flora and also suppressing the pathologic colonization and disease spread. The use of probiotic plays an important aspect in dentistry too ever since the oral infections occupied the prime space among the other infections effecting the humans. This concept of microbial ecologic change both for medical and dental changes has accumulated a lot of evidence in recent times. But to date, no substantial literature and use has been postulated. There are claims that probiotics strengthen the immune system to combat allergies, stress, exposure to toxic substances and other diseases. There are reports of their beneficial use in HIV infection and cancers, mostly, the colo-rectal carcinomas. Their use in pre malignant and malignant oral disorders is yet to be probed. Strains of genera lactobacillus and bifidobacterium are the most widely used probiotic bacteria. Keywords: Probiotics, lactobacillus, bifidobacteriu
Comparative evaluation of microleakage of tooth coloured restorative materials after exposure to 33% hydrogen peroxide-An in-vitro study
No full textAim-To determine the effect of hydrogen peroxide on tooth structure and to compare microleakage of composite, Giomer and Ormocer after exposure to 33% hydrogen peroxide.Materials and methods-90 intact human mandibular premolars were selected and divided into two main groups-test and control. Test group was exposed to 33% hydrogen peroxide. Class V cavities were made on both facial and lingual surfaces of all and divided into three subgroups according to the restorative material. Subgroup I was restored with composite (Filtek Z350 using Adper Single Bond 2), subgroup II-Giomer (Beautifil II using FL Bond) and subgroup III-Ormocer (Admira using Admira bond).Teeth were sealed and immersed in dye. Microleakage at enamel and cementum margin was evaluated under stereomicroscope.Statistical Analysis- Statistical analysis was done using Kruskal-Wallis, Mann-Whitney and One way Anova.Results stated significant microleakage in test group. Microleakage was more at cemental margin than enamel margin. Ormocer proved to be the best material followed by Giomer and composite.Conclusion-More microleakage was observed in test group as compared to control group. Bleaching procedure affected cementum more than enamel.Keywords- Microleakage, hydrogen-peroxide, Ormocer, Giomer, composite
A comparative evaluation of the efficacy of Citric Acid, Ethylene Diamine Tetra Acetic Acid (EDTA) and Tetracycline Hydrochloride as root biomodification agents: An in vitro SEM study
No full textAim: To compare the efficacy of Citric Acid, Ethylenediaminetetraacetic Acid (EDTA), and Tetracycline Hydrochloride as root biomodification agents. Materials and Method: 15 freshly extracted teeth were used for the study. The teeth were root planed and specimens obtained from the cervical 2/3rd of the root. Each tooth root provided four specimens to be treated by the control (Saline), Citric Acid, EDTA and Tetracycline Hydrochloride, for a total of three minutes using the passive burnishing technique. The specimens were then observed under a scanning electron microscope (SEM). The specimens were evaluated for presence or absence of smear layer, total number of tubules visible, number of patent tubules and diameter of patent tubules. Statistical analysis was performed using “Paired t test”. Results: All the three test groups effectively removed the smear layer in comparison to the control. The number of patent tubules present in the Citric Acid and EDTA test groups was significantly higher than those in the Tetracycline Hydrochloride test group. However, the average diameter of the patent tubules was greater in the Tetracycline Hydrochloride group compared with Citric Acid and EDTA groups. Conclusion: All three agents appeared to be equally effective as root biomodification agents. However, in clinical practice EDTA might be more beneficial owing to its neutral pH and high efficacy in removing the smear layer and opening the dentinal tubules
Esthetic Posterior Restorations Utilizing the Double Inlay Technique
No full textThe Insertion of tooth colored adhesively bonded posterior restorations in proximal cavities extending beyond cementoenamel junction requires a technique sensitive procedure. Should esthetic aspect deserve more prominent consideration, the concept of double inlay technique a two-part restoration provides an alternative. This procedure incorporates the advantages of cast restoration at the critical cervico proximal cavity margins and the esthetic and stabilizing properties of the adhesively bonded restoration technique in visible areas. This article describes in detail the construction of double inlay with a case repor
Beauty in a smile: How to perceive it?
No full textAims and objectives: The purpose of this study was to evaluate the impact of change in different smile parameters on the perception of smile esthetics. Methods: A pleasant smile of a bollywood actress was digitally altered to several degrees - gingival margin of maxillary teeth, dental midline, and buccal corridor. Four groups of 5 evaluators each—orthodontists, prosthodontists, artists, and laypersons— evaluated the images using a visual analog scale. Results: Change in buccal corridor was perceived by orthodontist group at 3 mm, others were not able to perceive any change. Orthodontist group perceived the midline shift at 2 mm whereas prosthodontist and artist beyond 2 mm and layperson perceived not at all. Gummy smile was liked by laypersons, the prosthodontist group liked it upto 2 mm whereas the artist and orthodontist liked it only when 1 mm was increased. Conclusion: Laypersons, orthodontists, prosthodontists and artists have different perceptions of attractiveness when evaluating different aspects of smile. 
Bar soaps in dental clinic might be a bacterial reservoir
No full textAims and Objectives: As the number of patients undergoing dental treatment is on the rise, it becomes essential to know the standard of sterilization protocol followed there and thereby to prevent the cross infection that can result. Thus the present study was undertaken to know whether the bar soaps, used in dental clinic environment can harbor bacteria or not and if so to culture and identify thebacteria.Methods:The study was carried out in 25 different private dental clinics in Chennai. The samples were collected from in use bar soaps, using cotton swabs and immediately introduced into the sterile test tube containing 2 ml normal saline. They were then was inoculated into each of blood agar and MacConkey agar plates and incubated at 37˚C overnight. Colony counts were done and reported as Colony Forming Units (CFU) / ml. The colonies of various morphological features were stained with gram stain and identification was done by standard procedures.Results: Of 25 samples, positive culture was seen in 23 samples. The organisms seen were Pseudomonas, Acinetobacter, Enterobacter, Straph aureus and Straph epidermidis with CFU ranging from 102-106 CFU/ml.Conclusion: It can be understood from our study that dental clinic must be treated like a hospital environment and hence adequate infection control protocols must be followed to prevent cross infection