Effect of Implant-Abutment Connection and Abutment Angulations on Peri-implant Stress Levels: A Finite Element Analysis Study.

INTRODUCTION: Placement of an implant in the maxillary anterior region is challenging due to the angulation of bone in this area. Angled abutments may be used to achieve proper restorative contours. The present study was undertaken to examine and compare the stress levels of implants in the maxillary anterior region having different types of internal connections and different abutment angulations. MATERIAL AND METHODS: Implants with three types of abutment connections, internal conical, Morse taper, and internal hex, were modeled using SolidWorks software. Three abutment angulations of 0, 15, and 30 degrees were used for each type of implant. A 100 N axial load was applied to the implants, and the stresses on the implant, abutment, and bone were analyzed by finite element analysis. RESULTS: Among the straight abutments, the most stress was in model 3A (62.60 MPa). The stress value among angled abutments was highest with 30-degree angled abutments. The value was highest in model 3C (94.83 MPa). Internal hex connection showed the highest stress levels in all degrees of angulation of the abutment, and Morse taper connection showed the least amount of stress in all three abutment angles. The most stress concentration was seen in the cortical bone on the buccal surface in the implant-abutment junction. CONCLUSION: The Morse taper design of implant exhibited the least-highest stress levels on the alveolar bone. The stress levels increased with the increasing angulation of the implant or implant-abutment connection.

In vitro Analysis of Surface Roughness Produced by an Air Polishing Device and Conventional Root Planing on Cementum: A Profilometric Study.

Context: Tooth surface polishing is an integral part of periodontal therapy. Enamel and cementum show a smooth surface clinically after debridement with the naked eye, but numerous surface irregularities can be detected microscopically. Air polishing is safe and effective when used by trained professionals. Aims: The aim of the study is to evaluate and compare the surface roughness of cementum by using an air polishing device and conventional root planing with hand instruments. Materials and Methods: A total of 45 extracted teeth stored in saline were divided into three groups randomly - Group A (conventional root planing), Group B (hand instrumentation and air polishing), and Group C (air polishing alone) - with 15 samples each. Samples were evaluated for surface roughness by using profilometer. Six parameters were checked for surface roughness. Statistical Analysis Used: The data were collected, charted, and analyzed using one-way ANOVA with post hoc LSD method for pairwise comparisons. Results: Least amount of surface roughness was achieved with Group C when compared with Group A and Group B. These differences were statistical significant (P < 0.0001). Conclusions: Air polishing can effectively smoothen the root surface by removing surface irregularities which are produced hand/ultrasonic instruments. Profilometer can be effectively used to measure the surface roughness.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity.

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Occupational exposures to bloodborne pathogens and its underreporting in dental teaching environment in an Indian dental school.

INTRODUCTION: The aims of this study were 1) to find out the prevalence of occupational exposures to contaminated biological material among undergraduate students and interns; 2) to find out how many cases of occupational exposures to bloodborne pathogens are reported; and 3) to know the reasons for non-reporting of occupational exposures. MATERIALS AND METHODS: The study was conducted in a Dental School in Navi-Mumbai, India. An anonymous self-administered questionnaire was formulated. 210 dental students were given a questionnaire out of which 150 students attending clinical postings in their third year, final year, and internship responded. Approval was obtained from the Institutional Ethical Committee. RESULTS: The study revealed a very high prevalence (66.7%) of exposures among the students. Only 12% of the students reported the exposures to the staff. Students from III year and final year BDS (Bachelor of Dental Surgery) had mean exposure of 2.40 as compared to 1.94 among interns. 46% of the students stated that they did not report about the exposure because they thought that injury was of minor nature. CONCLUSION: There is a very high prevalence of occupational exposures among students which are not reported. There is a need for the development of a post exposure protocol which has to be strictly implemented. The principle of infection control has to be emphasised to the students periodically and they should be encouraged to report incidences of exposures to biological material.

A study of the reasons for irregular dental attendance in a private dental college in a rural setup.

UNLABELLED: The mouth is regarded as a mirror and the gateway to health. Integration is required between the dental practitioner and the patient, if good dental health is to be attained. Various treatment modalities of late frequently require appointments, which are more than one in number for completion of the entire treatment program. This study was taken up to determine the impact of reported dental attendance patterns of patients on the oral health and treatment quality in teaching hospitals and also on the quality of life in rural areas. AIMS AND OBJECTIVES: 1. To assess the reasons for irregular dental care in the patients attending the clinics in teaching hospitals. 2. To assess the satisfaction of the patient as regards the treatment rendered in the teaching institutes. 3. To correlate the gender of the patient with the regularity in the recall attendance. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted using a systematic random sampling method and every alternate subject was selected from the patients attending the OPD of Department of Periodontics and Community Dentistry. The data was collected using the interview method with the help of a structured, pretested questionnaire. RESULTS AND CONCLUSION: Out of 288 patients, 94 failed to attend the recall appointments. In these 94 patients, various reasons for not attending recall were assessed and lack of time was found to be the most common reason for non-attendance. Relationship between age and reasons for not reporting was found to be significant (P < 0.01). Patient satisfaction survey showed that 51.54% of the patients were satisfied with the dental treatment rendered. The present study also showed that males are more prompt in attending recall appointments as compared to females. A positive and significant correlation between literacy and patient reporting status was found (P< 0.01).

Periodontal status following treatment of impacted maxillary canines by closed eruption technique: an overview and case report.

UNLABELLED: Delayed tooth eruption is a common problem in many orthodontic patients. This delay may lead to other problems, such as injury to the adjacent tooth, non-vitalization, mucogingival and esthetic problems, etc. Multidisciplinary management is essential when the canines of orthodontic patients have failed to erupt on time. This involves combined surgical and orthodontic intervention. This overview and case report presents special considerations required in treating such cases. METHODS: A combined surgical and orthodontic treatment approach is essential in dealing with such cases. The type of surgery depends on correct localization of the canine along with evaluation of certain criteria to determine the correct method for uncovering the tooth. RESULTS: Success of the treatment in such cases should be defined as long-term desirable esthetics and sound periodontal condition. Thorough treatment planning based on specific criteria would ensure this. CONCLUSION: A multidisciplinary approach, atraumatic surgery, and judicious use of orthodontic forces can ensure an excellent result in form, function, and esthetics in cases with delayed canine eruption.

Papillon-Lefevre syndrome: A report of two cases.

Papillon-Lefevre syndrome is a rare (1-4 cases per million) autosomal recessive disorder showing predominantly oral and dermatological manifestations in the form of aggressive periodontitis affecting both primary and permanent dentition and palmoplantar hyperkeratosis. Genetic studies have shown that mutations in the major gene locus of chromosome 11q14 with loss of function of cathepsin C gene are responsible for Papillon-Lefevre syndrome. This report presents two siblings with classic signs and symptoms of Papillon-Lefevre syndrome. The exact cause for periodontal destruction in patients with Papillon-Lefevre syndrome is not known but it is thought to be due to defect in neutrophil function, immune suppression and mutations in cathepsin C gene.