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Language Journal of Clinical and Experimental Dentistry. 2012. Vol. 4, no. 5
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- Film and digital periapical radiographs for the measurement of apical root shortening(2012) El-Angbawi, Ahmed M.F.; McIntyre, Grant T.; Bearn, David R.; Thomson, Donald J.Objectives: The aim of this study was to compare the accuracy and agreement of scanned film and digital periapical radiographs for the measurement of apical root shortening. Study design: Twenty-four film and digital [phosphor plate sensor (PPS)] periapical radiographs were taken using the long-cone paralleling technique for six extracted teeth before and after 1mm of apical root trimming. All teeth were mounted using a typodont and the radiographs were recorded using a film holder and polysiloxane occlusal index for each tooth to ensure standardization during the different radiographic exposures. The film radiographs were scanned and the tooth length measurements for the scanned film and digital (PPS) images were calculated using Image-J-Link 1.4 software (http://rebweb.nih.gov/ij/index.html) for the two groups. The accuracy and agreement among the tooth length measurements from each group and the true tooth length measurements were calculated using intra-class correlation (ICC) tests and Bland and Altman plots. Results: A high level of agreement was found between the true tooth length measurements and the scanned film measurements (ICC=0.979, limit of agreement 0.579 to -0.565) and the digital (PPS) radiograph measurements (ICC= 0.979, limit of agreement 0.596 to -0.763). Moreover, a high level of agreement was found between the scanned film and digital (PPS) radiographs for the measurement of tooth length ICC=0.991, limit of agreement 0.411-0.231. Conclusion: Film and digital (PPS) periapical radiographs are accurate methods for measuring apical root shortening with a high level of agreement.
- Chronic idiopathic hyperphosphatasia with unusual dental findings: a case report(2012) Sreejan, Cheriya K.; Gopakumar, Nair; Subhas Babu, GogineniChronic idiopathic hyperphosphatasia(CIH) or juvenile Paget disease is believed to be a distinct disease characterized by an increase in the serum alkaline phosphatase, cortical thickening and bowing of the long bones, especially the femora. It is a rare autosomal recessive bone disorder, with excessive bone resorption and bone formation. Skeletal malformations in the legs may cause problems in walking and may eventually result in short stature. The radiographic appearances include widening of the diaphyses, vertebral osteoporosis, acetabular protrusion, and thickening of the skull vault. Intensive bisphosphonate treatment prevented the development of deformity and disability but there is no published data on long-term efficacy. Bisphosphonate therapy showed suppression of bone turnover, doubling of trabecular thickness with no mineralization defect, and no osteopetrosis. We report a female of 21 years, a case of chronic idiopathic hyperphosphatasia congenital form, with a history of fracture, short stature and malformed teeth. She had a waddling gait, bone deformities, kyphoscoliosis and curvature of her limbs.
- Profile of patients hospitalized with odontogenic infections in a public hospital in Belo Horizonte, Brazil(2012) Sette-Dias, Ausgusto César; Maldonado, Amália Jorge; Aguiar, Evandro Guimarães de; Roque de Carvalho, Maria Auxiliadora; Magalhães, Paula PrazeresObjectives: We aimed to evaluate the profile of hospitalized patients presenting with odontogenic infections requiring intensive care and to identify predictive factors of worsening of the disease. Study Design: In this retrospective study, 119 consecutive medical records were assessed for data regarding odontogenic infections. The variables examined were age, gender, etiology, time from onset of infection to hospital admission, hospital stay, complications during hospitalization, and anatomical sites affected. Results: Most patients were female (64.7%) and the mean age of our study group was 28.3 years. Average length of hospital stay was 7.3 ± 6.3 days and the mean time from onset of infection to hospitalization was 6.9 days. Lower teeth corresponded to the initially affected site in the great majority (72.3%) of the cases and the mandibular third molar was the most commonly first infected tooth (31.9%). Post-surgical infection was involved in 21.8% of the cases. Systemic conditions were reported for 18.5% of the patients, mainly hypertension, but they were not determinant for admission. The main reasons for hospitalization were dyslalia, dysphagia, and dyspnea, either as single or associated signs (96.6%). Antimicrobial therapy was administered alone or combined with surgical drainage to 64 (53.8%) and 53 (44.5%) patients, respectively. Conclusions: Overall data generated by this investigation on the profile of severe odontogenic infection patients in our region are similar to those reported by other researchers. Conversely we found a higher prevalence of the disease among women in disagreement with previously published results. Such a kind of study may improve our knowledge relative to the disease and also reveal the regional scenario regarding severe odontogenic infections. Consequently it may contribute to the designing of strategies that may lead to a more efficient oral health care system what ultimately would culminate with the prevention of more severe outcomes from the disease.
- Endodontic management of three-rooted maxillary second premolar in a patient with bilateral occurrence of three roots in maxillary second premolars(2012) Chauhan, Raju; Singh, ShwetaThe possibility of bilateral maxillary second premolars having three separate roots is quite low; however, it must be taken into account in clinical and radiographic evaluations during endodontic treatment. A correct clinical and radiographic diagnosis based on knowledge of root canal anatomy and critical interpretation of radiographs is necessary for a safer and successful endodontic treatment of these teeth. Failure of root canal treatment can occur due to missed roots/canals and often diagnosed when patient experiences continuous post-operative pain and discomfort. This case report describes the root canal treatment of a three-rooted maxillary second premolar in a patient with bilateral occurrence of three roots in maxillary second premolars.
- Periodontally accelerated osteogenic orthodontics (PAOO) - a review(2012) Amit, Goyal; Pankaj, Bhatiya; Suchinder, Singla; Parul, BansalWith an increasing number of adult patients coming to the orthodontic clinic, the orthodontic professional is constantly looking for ways to accelerate tooth movement. Surgical intervention to affect the alveolar housing and tooth movement has been described in various forms for over a hundred years. However, it is the spirit of interdisciplinary collaboration in orthodontics has expanded the realm of traditional orthodontic tooth movement protocols. Periodontal accelerated osteogenic orthodontics (PAOO) is a clinical procedure that combines selective alveolar corticotomy, particulate bone grafting, and the application of orthodontic forces. This procedure is theoretically based on the bone healing pattern known as the regional acceleratory phenomenon (RAP). PAOO results in an increase in alveolar bone width, shorter treatment time, increased post treatment stability, and decreased amount of apical root resorption. Tooth movement can be enhanced and cases completed with increased alveolar volume providing for a more intact periodontium, decreased need for extractions, degree of facial remodeling and increased bone support for teeth and overlying soft tissues, thereby augmenting gingival and facial esthetics.The purpose of this article is to describe the history, biology, clinical surgical procedures, indications, contraindications and possible complications of the PAOO procedure.
- Effects of ultrasonically activated irrigants with or without surfactant on smear layer removal after post space preparation(2012) Turker, Sevinc Aktemur; Yilmaz, Zeliha; Ozcelik, Bahar; Gorduysus, Melahat; Altundasar, EmreThe aim of this study was to compare the effects of different NaOCl and EDTA formulations with/without ultrasonic use on smear layer removal and root canal surface characteristics after post space preparation. Study design: After post space preparations, forty-six teeth were subjected to different post space irrigation regimes; G1, 17% EDTA; G2, 17% EDTA+Ultrasonic activation; G3, EDTA-T; G4, EDTA-T+Ultrasonic activation; G5, NaOCl; G6, NaOCl+Ultrasonic activation. Specimens were examined under scanning electron microscope and scored for debris and smear layer removal and dentinal tubule opening and statistically analyzed with Kruskal Wallis and Dunn's test. Significance value was set at p<0.05. Results: EDTA and EDTA-T groups showed significantly better efficiency than the other groups in the each parts of the samples in terms of smear layer removal (p<0.05). In terms of dentinal tubule opening, EDTA, EDTA+Ultrasonic and EDTA-T groups had significantly better efficacy than the other groups in the middle and coronal parts of the samples (p<0.05). Conclusions: Ultrasonic activation did not significantly improve the efficiency of the irrigants.
- Shaping ability of Mtwo and Twisted File rotary systems in curved root canals(2012) Urro Torres, David; González Rodríguez, Paloma; Ferrer, CarmenObjective: To compare the straightening of root canal curvature, the apical transportation, the loss of working length and the working time using two rotary systems. Study design: Sixty buccal root canals with angles of curvature between 30 to 99º were instrumented with Mtwo and Twisted File rotary instruments. A series of pre- and post-operative radiographs were superimposed to determine the straightening of root canal curvature and apical transportation. The loss of working length and working time were also calculated. Results: All data were analyzed by means of the Student´s t-test and Mann-Whitney U-test. No statistically significant differences in the straightening of root canal curvature, apical transportation, or the loss of working length were found between groups. There was a significant difference in working time between angles of curvature when using the Mtwo system. Conclusion: Both rotary systems showed minimal changes in the original root canal curvature.
- Matrix metalloproteinase gene polymorphisms and oral cancer(2012) Pereira, Andresa Costa; Dias do Carmo, Elaine; Dias da Silva, Marco Antonio; Blumer Rosa, Marco AntonioSince oral squamous cell carcinoma (OSCC) is the most prevalent malignant cancer in the oral cavity, several researches have been performed to study the role of important enzymes in this disease. Among them, the matrix metalloproteinases (MMPs) are highlighted, due to the fact that they are proteinases responsible to degrade many extra-cellular matrix components, making possible the invasion of neoplasic cells. Important tools in cancer prognosis have been utilized aiming to correlate high levels of MMPs and OSCC, such as immunohistochemical, zymographic and mRNA detection methods. However, these techniques are usually applied after cancer detection, characterizing a curative but not a preventive medicine. Trying to make interventions before the development of the disease and making possible the identification of people at high risk and, analysis of modifications in MMP genes has been a chance for modern medicine. Recently, polymorphisms in MMP genes have been related to different neoplasias, including OSCC. Despite investigation is beginning, MMP gene polymorphisms seems to have a promising future in oral cancer research and some of the present results have shown that there are MMP polymorphisms related to an increased risk for developing oral cancer.
- The "TORONTO PROSTHESIS", an appealing method for restoring patients candidates for hybrid overdentures: a case report(2012) Montero, Javier; Macedo de Paula, Carla; Albaladejo Martínez, AlbertoThe implant is a therapeutic resource in constant evolution, and the different types of implants and techniques have been increasingly used in cases of both fully or partially edentulous patients. In some cases they provide more conservative treatment, and in others better stability, retention, and function. To achieve a satisfactory result, there are several factors that should be taken into account: the type and quality of the bone, bone density, the placement location of implants, retrievability of restorations, the patient's motivation, and economic issues. Trainees should be aware of the limitations of the techniques that can be used for successful prosthetic rehabilitation. This work describes the prosthetic rehabilitation of a fully edentulous mandible treated with dental implants using the 'Toronto Bridge' technique for restoring both function and aesthetics. This type of prosthesis is a screwed-in mesostructure with milled abutments for the cementation of single or multiple suprastructures. This device could also be named 'abutment-hybrid overdenture' The main advantages and disadvantages of this protocol are discussed.
- Oral Rhabdomyosarcoma: a review(2012) Tandon, Ankita; Sethi, Kanika; Singh, Anand PratapRhabdomyosarcoma (RMS) is a rare malignant soft tissue neoplasm comprised of cells derived from the primitive mesen¬chyme. About 35% of RMS arises in the head and neck, are are classified as parameningeal and non-parameningeal forms. These are the most common soft tissue sarcoma of the children, adolescents and young adults. Their etiopathogenesis and its molecular relevance have been emphasized. The first line of treatment is radical excision and this is usually supplemented by radiotherapy. It is believed that adjunct combination chemotherapy may greatly improve the prognosis. Inadequately treated tumours grow in an infiltrative manner and recur in a high percentage of cases. Bone does not constitute an effective barrier to the growth of the tumour and bone invasion is a frequent finding in head and neck rhabdomyosarcomas.
- Prevalence of oral mucosal lesions in psoriatic patients: a controlled study(2012) Darwazeh, Azmi MG.; Al-Aboosi, Mustafa M.; Bedair, Ahmad A. BedairObjectives: This study aimed to investigate and compare the prevalence of oral mucosal lesions in a group of psoriatic patients and healthy subjects, and its correlation to multiple clinical parameters. Study design: 100 psoriatic patients and 100 closely matched controls underwent clinical oral examination. Oral lesions were diagnosed according to the criteria proposed by the World Health Organization (WHO). The patients filled the Hospital Anxiety and Depression (HAD) questionnaire and the Dermatology Life Quality Index (DLQI). The severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). Categorical variables were evaluated using Chi-square test or Fisher's exact test with overall significance set at p< 0.05. Results: Oral mucosal lesions were diagnosed in 43 (43%) psoriatic patients and 17 (17%) control subjects (p=0.000). Comparing psoriatic patients to control subjects the prevalence of fissured tongue (FT) was 35% vs. 13% (p=0.000); geographic tongue (GT) 17% vs. 9% (p=0.09); combination of FT and GT 5% vs. 5% (p=1.00); oral candidosis 3% vs. 0% (p=0.81); leukoedema 1% vs. 3% (p=0.62); physiologic melanin pigmentations 4% vs. 1% (p=0.37) respectively. The clinical type of psoriasis, duration of the disease, method of disease management (medicated vs. non-medicated for psoriasis), smoking habit, psychological status or the disease severity did not influence the prevalence of FT and GT. Psoriatic patients who experienced 'very large' to 'extremely large' adverse effect of psoriasis on their quality of life have significantly higher prevalence of GT (p=0.04). Conclusions: FT is significantly more common in psoriatic patients compared to controls; hence studies investigating the nature of this relationship are warranted. Oral health care providers should be aware of the predisposition of psoriatic patients to oral candidosis.
- Does mechanical locking-base ceramic brackets reduce cracks at debonding?(2012) Atashi, Mohammad Hossein Ahangar; Kachoei, MojganObjectives: Debonding of chemically bonded ceramic brackets has been mostly led to enamel damages. This study aimed to evaluate enamel cracks followed by debonding ceramic brackets with mechanical retention. Study Design: Sixty extracted human premolar teeth were randomly divided into two groups. Metallic brackets and recently available ceramic brackets with mechanical retention were bonded to the teeth in first (MB) and second (CB) group respectively. After a week, the brackets were debonded using a pair of bracket-removing pliers assembled to a testing machine. Optical stereomicroscope and trans-illumination techniques were used to calculate the cracks and measure their length before bonding and after debonding. Paired t-test, independent t-test and McNemar's test were used for statistical analysis. Results: Metallic brackets showed higher mechanical bond strength compared to ceramic brackets with mechanical locks. In both groups, higher numbers of teeth with enamel cracks and a significant increase in the length of enamel cracks were evident subsequent to debonding. Inter-group deference in the number of teeth with cracks and the length of enamel cracks before or after debonding was not significant. Conclusions:The risk of producing enamel cracks after debonding of ceramic brackets with mechanical retention is the same as metallic brackets.
