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Language Journal of Clinical and Experimental Dentistry. 2011. Vol. 3, no. 5
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- Oral manifestations of Type I Neurofibromatosis in a family(2011) Khan, Mubeen; Ohri, NeeraNeurofibroma is a benign peripheral nerve sheath tumor. It is one of the most frequent tumors of neural origin and its presence is one of the clinical criteria for the diagnosis of neurofibromatosis type I (NF-I). Neurofibromatosis type I is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (café au lait spots and neurofibromas) as well as bone malformations and central nervous system tumors. Diagnosis is based on a series of clinical criteria. NF-I presents with certain definite oral manifestations which confers to the dentists a major responsibility for accurate diagnosis and report of the disease. The paper aims to highlight the role of an oral diagnostician in first recognition of NF-I in a family via manifestations in the oral cavity
- Gingival calcifying epithelial odontogenic tumor: case report and review of the literature comprising a period of 44 years(2011) Studart Soares, Eduardo Costa; Gurgel Costa, Fábio Wildson; Silveira Esses, Diego Felipe; Alves Filho, Eugênio Paccelli; Negreiros Nunes Alves, Ana PaulaCalcifying epithelial odontogenic tumors are rare odontogenic neoplasms that account for approximately 1% of all odontogenic tumors. The extraosseous variant is extremely rare, with only few cases being described in the literature. To our knowledge, only 22 cases have been reported over a period of 44 years. Therefore, the aim of this study was to present a critical literature review comprising the period from 1966 to 2010. In addition, we discuss the clinical presentation, diagnosis, and subsequent treatment of a patient with a gingival calcifying epithelial odontogenic tumor in the anterior mandible. This study shows that even though being an extremely rare neoplasm the gingival calcifying epithelial odontogenic tumor should be included in the differential diagnosis by general dentists of gingival lesions due to its clinical similarity to other oral hyperplastic or reactive lesions. A conservative surgical approach can be adopted in view of the nonaggressive behavior of this tumor. Recurrence is low and the prognosis is excellent
- Endodontic management of single rooted immature mandibular second molar with single canal using MTA and platelet-rich fibrin membrane barrier: A case report(2011) Kathuria, Ambica; Chaudhry, Sarika; Talwar, Sangeeta; Verma, MaheshAn immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontists. Endodontic treatment options for such teeth consist of conventional apexification procedure with and without apical barriers. Various materials have been tried as apical matrix in the past. This article demonstrates the newer concept of using platelet rich fibrin membrane as an apical matrix barrier for stabilization of MTA in root end apexification procedure. Platelet Rich Fibrin is an autologous fibrin matrix containing a large quantity of platelet and leukocyte cytokines, which enhance healing by release of growth factors. This case report represents successful management of a case of an immature mandibular second molar with single root and single c-shaped canal. The unusual canal morphology was diagnosed with the help of a CBCT scan. Faster periradicular healing and complete resolution of symptoms occurred with combined use of MTA and PRF membrane as an apical barrier
- Diagnostic efficacy of panoramic mandibular index to identify postmenopausal women with low bone mineral densities(2011) Devi, B.K. Yashoda; Rakesh, Nagaraju; Ravleen, NagiObjectives: The aim of the study was to compare and assess the accuracy of panoramic mandibular index (PMI) and antegonial index (AI) in the panoramic radiographs of postmenopausal women with normal and low skeletal bone mineral densities( BMD) diagnosed by using dual energy x-ray absorptiometry ( DXA). Study Design: In panoramic radiographs obtained from 40 post menopausal women( 20 normal and 20 osteoporo tic) aged between 50-75 who’s BMD has already been assessed by a DXA, the mean was calculated for PMI and AI index values measured in the right and left mandibles. The PMI and AI index values were evaluated using the student’s t test. The correlation between the observers for indices was calculated by Pearson correlation coefficient test. Results: A statistically difference was shown between the PMI values in the osteoporotic group and normal group (t = 13.280, p < 0.001); however, AI showed no significant difference between the groups. For PMI, the area under the receiver operating curve (ROC) analysis in identifying women with low BMD was 0.821 ( Standard error: SE = 0.0676), 95% confidence interval (Cl) = 0.668 to 0.924) which was moderately accurate. Conclusion: PMI values were found to be smaller among female patients with osteoporosis, compared with normal patients in the present study. Our results suggest that PMI has a better efficacy in identifying postmenopausal women with osteoporosis in comparison with AI.
- Prevalence of Dentine Hypersensitivity in a General Dental Practice in Greece(2011) Chrysanthakopoulos, Nikolaos AndreasObjectives: The aim of this study was to estimate the prevalence of dentine hypersensitivity in a sample of patients visiting a general dental practice. Study design: The study population consisted of 1,450 patients, 690 males and 760 females, aged 18-69 years. All individuals were clinically examined and answered questions regarding variables such as gender, age, educational level, occupation status, teeth affected and any factor that initiated the sensitivity. The clinical examination involved assessment of sensitive teeth per patient, while the amount of buccal gingival recession associated with the sensitive teeth was also recorded. Statistical analysis performed by using methods of descriptive statistics and chi square-test. Results: Two hundred and sixty four patients were diagnose as having dentine hypersensitivity, giving a prevalence rate 18.2% . Prevalence rate for hypersensitivity in females (19.34%) was significantly higher (p=0.0015) than males (16.95%). The mean number of sensitive teeth per patient showed a peak in the 40-49 year age group in males and in 60-69 year age group in females. The commonest teeth affected by dentine hypersensitivity were the first and second premolars, the canines and the first molars of maxilla and mandible. The majority (85.9%) of sensitive teeth had at least 1-3 mm of gingival recession while the most commonest pain-initiating stimuli was the consumption of cold drinks (56.1%). A statistically significant difference recorded between dentine hypersensitivity and educational level (p=0.00094). Conclusions: The prevalence of dentine hypersensitivity in the adult sample of the present study was 18.5%. There was also a tendency for the patients with sensitive teeth to come from higher social classes
- Gingival bleeding reduction using a carbamide peroxide based tooth paste with lactoperoxidase(2011) Domínguez Moreira, Sabrina; Llena Puy, María Carmen; Forner Navarro, Leopoldo; Martínez Canut, Pedro; Amengual Lorenzo, JoséIntroduction: The combination of carbamide peroxide, thiocyanate or enzymes such as amynoglucosidase or gluco-oxidase is able to reduce gingival inflammation. Objective: To evaluate antiseptic efficacy, in relation to reduced gingival bleeding, of a new dentifrice containing carbamide peroxide and lactorperoxidase. Materials and method: A sample of 32 patients, with periodontal pockets of more than 3mm in the vestibular area and 4 mm at interproximal sites, was divided into two groups of 16 and 17 patients respectively. Group A used a dentifrice containing 3% carbamide peroxide and 5% lactoperoxidase plus 0.022% sodium fluoride for three weeks followed by a control dentifrice with only 0.022% sodium fluoride for another three weeks. Group B used the same dentifrices but in reverse order. Efficacy was assessed by measuring the bleeding sites at the start of the study, and after application of the first and second dentifrices. Results: After applying the toothpaste object of this study, group A showed a significant reduction in bleeding sites (p<0.05) and a slight non-significant increase when the control toothpaste was applied (p>0.05). After application of the control toothpaste, group B showed a significant reduction in the average number of bleeding sites and after application of the study toothpaste the group showed a greater reduction in the average number of bleeding sites, which was also significant in relation to the first phase (p<0.05). Conclusions: Reduction of gingival bleeding by the carbamide peroxide based dentifrice with lactoperoxidase was found to be superior to the control fluoride dentifrice.
- Cardiovascular disease versus periodontal disease: chronic systemic infection as a link(2011) Alonso González, Rocío; Perez-Hernandez, A.; Silvestre Rangil, Javier; Silvestre Donat, Francisco JavierObjective : Analysis of the alleged connection between the periodontal and cardiovascular disease, with reference to periodontal pathogens as a risk factor for heart disease. Researching method : A research was carried out at Medline/Pubmed. Included criteria and researching strategy. The articles selection has been made taking into account key-terms appearing either in the title or in the summary. Experimental studies in animals, clinical prospective studies performed with a minimum sample size (>30) and studies written in English have been included. The rejected criteria were the following: clinical retrospective studies and/or studies carried out with a low sample size (n<30). Results : Within systemic diseases related to periodontal ones, the alleged link between periodontal and heart and circulatory disease has been one of the most investigated in recent times. Different authors consider the existence of a link between the diseases as such, inappropriate and implausible since both the diseases have risk factors in common (age, gender, smoking, diet, oral hygiene and diabetes). However, speculations about the origin of the diseases were raised when it was demonstrated that some bacteria species, bacteria proteins and lipopolysaccharide are present at the plaques of atherosclerosis that obstruct the coronary arteries. The mechanisms of this connection have been analyzed following an actualized review. Conclusion : Most of the experimental and clinical studies ensure that a positive association between periodontal disease and heart disease has been found, once the con-founder factors have been eliminated
- Oral Myiasis: a review(2011) Sheikh, Soheyl; Pallagatti, Shambulingappa; Singla, Isha; Kalucha, Aman; Aggarwal, Amit; Kaur, HarkamalMyiasis is the infestation of tissues, organs of living vertebrate, animals and humans by certain dipterans fly larvae which feed on the host’s tissues and body fluids, often causing extensive damage to the host tissues if left untreated. Oral Myiasis is a rare pathology and is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis. It arises from invasion of body tissues or cavities of living animals by maggots or larvae of certain species of flies. It occurs in tropical areas with poor living conditions and insufficient public and personal hygiene. Mouth-breathing during sleep, alcoholism, mental handicap, cerebral palsy and hemiplegia may facilitate the development of myiasis. The commonest clinical manifestations of myiasis infestation include inflammatory and allergic reactions. Ear, eye and respiratory tract infestations are also frequently encountered. Human myiasis may affect the skin, bones, intestines and body cavities. Treatment consists of manual removal of maggots, broad spectrum antibiotics and oral therapy with Ivermectin
- Corticosteroids use in controlling pain, swelling and trismus after lower third molar surgery use in controlling pain, swelling and trismus after lower third molar surgery(2011) Ata-Ali Mahmud, Francisco Javier; Ata-Ali Mahmud, Fadi; Peñarrocha Oltra, David; Peñarrocha Diago, MaríaObjectives: A study is made of corticosteroid use in controlling pain, swelling and trismus after lower third molar surgical removal. Material and methods: A Medline search and review was made of all randomized and controlled clinical trials on the effects of corticosteroids upon pain, swelling and trismus after lower third molar surgery. The review was limited to those studies published in the last 10 years. Of the 20 initially considered articles, 6 were finally excluded. Results: A total of 14 articles were included. In 5 of the studies, corticosteroid use resulted in statistically significant reductions in pain after third molar removal. In 7 of the 11 articles that analyzed the effect of corticosteroid use upon postoperative swelling, such treatment was seen to be effective. In 8 of the 11 articles that analyzed the effect of corticosteroid use upon trismus, significant benefit was observed. Conclusion: The results of the analysis of the benefits derived from corticosteroid use in relation to pain, swelling and trismus following third molar surgical extraction, and the few side effects observed after the short-term use of such medication, point to corticosteroids as a treatment option to be taken into account in such patients
- Magnification in apical surgerymusing the endoscope: a review(2011) Maestre Ferrín, Laura; Peñarrocha Diago, María; Peñarrocha Oltra, DavidObjective: A review is made to determine whether the use of the endoscope in endodontic surgery offers advantages in clinical practice, and whether it improves the clinical and radiographic outcomes of the procedure. Material and methods: The main search terms used were: endodontic surgery, apicoectomy, apical surgery, endoscope, and magnification devices . The authors searched the Medline database for articles published up to 1 September 2010. The review included experimental studies comparing endoscopic microstructural findings with the findings of the naked eye or other magnification devices, as well as prospective clinical trials comparing endodontic surgery with or without the use of an endoscope, or comparing the endoscope with some other magnification device. Results: Two experimental studies on the capability of the endoscope to identify microstructures and three prospective clinical trials were included in the review. The experimental studies showed the endoscope to be highly precise in application to intraoperative diagnoses in periapical surgery. There were no significant differences in the prognosis of periapical surgery when performed with or without endoscopy. Likewise, there were no significant differences among the use of endoscopy, magnifying lenses or the microscope. Conclusion: Experimental studies have demonstrated the usefulness of the endoscope in identifying microstructures during periapical surgery. However, further randomized and controlled clinical trials are needed to determine whether these advantages in clinical practice imply improved outcomes for periapical surgery.
- Costochondral Grafts in the treatment of Temporomandibular joint ankylosis: a Clinical Study(2011) Bansal, Ashok; Jain, Shivani; Arora, Srimathy; Gupta, Shipra; Singh, Varsha A.; Prashar, DeeptiBackground: Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic block (arthroplasty) without interposing any material (gap arthroplasty) or interpositional arthroplasty using autogenous or alloplastic materials. The objective of this paper was to note the potential of the costochondral graft (CCGs) as an interpositional material and to see whether they induce normal growth potential in the reconstructed mandible. Materials and method: The ankylosed temporomandibular joint was reached by a preauricular incision with or without angulation and exposed. In the first 4 cases, arthroplasty was done using a bur. The bony mass was detached of its muscle attachments and removed. In the 5th case, condylectomy was performed. In all cases, this was followed by immediate costochondral grafting. Results: The maximal incisal opening in the pre-operative period ranged from 0- 2mm and in the immediate post- operative period from 15- 20mm. at the end of the follow up period it ranged from 20- 35 mm. The increase in SNB angle, SND angle, ramus length and mandibular body length all showed linear growth of mandible on the side where costochondral grafting was done. Conclusion: The articular reconstruction with costochondral grafts for the treatment of TMJ ankylosis is efficient in relation to post- operative maximal incisal opening, recurrence and articular function.
- Attitudes of general dental practitioners towards biopsy procedures(2011) Murgod, Vinita; Angadi, Punnya V.; Hallikerimath, Seema; Kale, Alka D.; Hebbal, MamataObjectives: A dentist is required to detect and recognise oral lesions and inform the patient accordingly by providing a diagnosis and adequate treatment plan. Biopsy serves as an important aid in achieving this goal; however, its use is not so widespread in general dental practice. The objective of the present study was to explore the attitudes of general dental practitioners in Belgaum city towards biopsy for diagnosis of oral lesions. Material and methods: A self designed questionnaire was administered to 74 general dental practitioners in Belgaum city, in the southern region of India, consisting of several items addressing the socio-demographic and professional aspects and their attitudes towards oral biopsy procedures. Results: The response rate was exceptionally high i.e. 90.54%. All the dentists felt that biopsy was an important tool in diagnosis of oral lesions but many still did not venture to undertake it on their own and preferred referring it to a specialist or higher care centre. This was mainly due to lack of experience and patient factors. There were also conflicting results regarding referral diagnostic pathology services and preservation of the biopsy specimens. Conclusion: This emphasizes the need for higher levels of importance to be placed on this aspect in undergraduate and postgraduate dental curriculum. Organisation of specific training or continuing dental education programmes to enhance their practical skills could aid in increasing the utility of this important tool in diagnosis of oral lesions
- Non-surgical management of chronic periodontitis with two local drug delivery agents-A comparative study(2011) Gill, Jaspreet Singh; Bharti, Vipin; Gupta, Harinder; Gill, SharanjeetBackground: The selective removal or inhibition of pathogenic microbes with locally delivered antimicrobials when combined with scaling and root planing is often an effective approach for the managment of chronic periodontitis. Aim: To compare the clinical efficacy of tetracycline fibers and a xanthan based chlorhexidine gel in the treatment of chronic periodontitis. Methods and materials: Thirty systemically healthy patients in the age group of 30-50 years suffering from generalized chronic moderate periodontitis were selected. For each subject, two experimental sites were chosen that had probing depth >5mm and were located in symmetric quadrants and the sites were randomized at split mouth level with one receiving tetracycline fibers and the other chlorhexidine gel. Plaque score, bleeding score, probing pocket depth and relative attachment level gain was recorded on day 0 and at the end of 3 months. Results and conclusion: In both groups, there was statistically highly significant reduction in all the clinical parameters i.e. plaque score, bleeding score and probing pocket depth and relative attachment level gain was seen at different time intervals. Local delivery of tetracycline and chlorhexidine is a safe, easy and efficacious method along with scaling and root planing in the treatment of chronic periodontitis. Inter-comparison of both local drug delivery agents with respect to clinical changes shows that tetracycline fibers are better than chlorhexidine gel for treatment of chronic periodontitis. Nevertheless, long term studies with more samples are suggested to further evaluate and compare the efficacy of both materials.
- Radiological assessment of peri-implant bone loss: a 12-month retrospective study(2011) Flichy Fernández, Antonio; Ata-Ali Mahmud, Francisco Javier; Palma Carrió, Cristina; Peñarrocha Oltra, David; Conejero, J.; Peñarrocha Diago, MaríaIntroduction: Following dental implant loading, marginal bone loss after one year must be evaluated to check correct maintenance of the bone levels. Objectives: To assess implant treatment success and quantify marginal bone loss 6 and 12 months after loading. Material and method: Sixty-one MIS® implants with a 1.8 mm machined neck were placed in 26 patients. Implant success was based on the criteria of Buser. Radiological controls were made 6 and 12 months after loading, measuring bone loss mesial and distal. Results: Twenty-two patients with 56 implants were included: 32 in the maxilla and 24 in the mandible. Two implants failed in two patients during the osseointegration phase (both in the maxilla), yielding an implant success rate of 96.4%. After 6 months, bone loss was 0.80±1.04 mm mesial and 0.73±1.08 mm distal, while after 12 months bone loss was 0.92±1.02 mesial and 0.87±1.01 distal. Conclusions: Bone loss 6 and 12 months after machined neck implant placement was within the normal ranges described in the literature.
- Cytomorphometric analysis of squames from oral premalignant and malignant lesions(2011) Hegde, VedaObjective: Oral cytology is becoming increasingly important in the early diagnosis of oral cancer, including epithelial atypia. The aim of this study is to assess the whether the cytoplasmic diameter, nuclear diameter and their nuclear to cytoplasmic ratio are reliable parameters in exfoliative cytology in detecting premalignant and malignant lesions. Study design: Cell and nuclear diameter were measured from the squames of normal buccal mucosal and of oral leukoplakia, oral submucous fibrosis, oral lichen planus which were histologically benign and oral squamous cell carcinoma were measured using an ocular micrometer disc. The nuclear to cytoplasmic ratio in each of these were deduced from the values obtained and compared with the controls which were age, sex and site matched. The data were evaluated using statistical methods, namely‘t’ test and analysis of variance. Results: We obtained a statistically significant reduction in the mean cytoplasmic and nuclear diameter in all the four groups. The nuclear to cytoplasmic ratio revealed to be significant only in group 1, 2 and 4. Conclusion: The present study suggests that a decrease in the mean cytoplasmic diameter of exfoliated buccal mucosal cells could serve as an early indicator of dysplastic change especially in lesions which appear histologically benign.
- Dental caries experience and salivary Streptococcus mutans, Lactobacilli scores, salivary flow rate and salivary buffering capacity among 6 year old Indian school children.(2011) Sakeenabi, B.; Hiremath, S. S.Objectives: The aim of this study was to assess the possible relationship between salivary cariogenic microflora, buffer capacity, secretion rate and caries experience among 6 –year- old school going children in Davangere city, Karnataka, India. Study design: A total of 196, 6 year old school children were selected by a two- stage random sampling method. Parents were interviewed regarding sociodemographic details. Clinical examination of children was conducted to assess dental caries experience and stimulated saliva was collected to assess S.mutans levels, lactobacilli, salivary flow and buffering capacity of saliva. Difference in proportions was tested using Pearson 2 test, and also analysis of variance (ANOVA) was used to evaluate difference between the groups. Dental caries experience was correlated with salivary factors using Spearman’s correlation coefficient. Results: Out of 196 children, 96 were boys and 100 were girls. Overall 97 (49.49%) children were caries free ( dmft, DMFT = 0) and 99 (50.51%) children presented with caries (dmft, DMFT > 0), out of which 42 (42.42%) were boys and 57 (57.58%) were girls and there was no significant diffrence between two groups (p = 0.086, two sided). The mean dmft and dmfs score for the overall group was 3.20 and 5.43 respectively. The mean DMFT and DMFS score was 0.23 and 0.25 respectively. Statistically significant difference (Independent sample t- test) (p <0.05) was found between mean ft and mean fs scores between sexes. A highly significant correlation was seen between the mean caries score and salivary variables. Conclusion: To conclude, high levels of salivary microbiological counts in correlation with the caries data stress the importance of these factors and urge the necessity of elective preventive programs in this region
