Choice of Surgeons in Retractors used in Cleft Lip and Palate Surgery: An Original Research.

Background: To ensure optimal exposure and enable precise tissue manipulation, cleft lip and palate abnormalities require surgical repair utilizing retractors. Different retractors may affect surgical outcomes; however, this is not yet evident. Examining surgeon preferences for retractors in cleft lip and palate surgery and assessing their impact on patient outcomes were the goals of this study. Materials and Methods: The patients who underwent primary cleft lip and palate repair were retrospectively analyzed. This study evaluated three widely used retractors: the Langenbeck, Gelpi, and Moult Mouth Gag retractors. This study looked at demographic information, surgical results (including scarring, aesthetic outcomes, and wound healing issues), and surgeon preferences for retractors. Results: The study identified differences in surgical outcomes related to various retractor types. Both Group A (Langenbeck retractor) and Group B (Gelpi retractor) demonstrated similar favorable results, such as little wound healing issues, less scarring, and pleasing cosmetic results. The wound healing issues, scarring, and cosmetic outcomes were all worse in Group C (Moult Mouth Gag retractor). Conclusion: Retractors were not always preferred by surgeons doing cleft lip and palate surgery. The type of retractor had an impact on the surgical results; the Moult Mouth Gag retractor performed less well than the Langenbeck and Gelpi retractors. These results highlight the value of using evidence-based criteria to select retractors more effectively and enhance surgical methods for better patient outcomes in cleft lip and palate repair.

Clinical Evaluation of Two Distinct Materials for Implant-Supported Interim Fixed Partial Prostheses: An Original Research.

Aim: This study aimed to evaluate the clinical efficacy of posterior resin implant-supported fixed partial dentures (FPDs) made from two different computer-aided design and computer-aided manufacturing (CAD-CAM) materials: polymethylmethacrylate (PMMA) and polyoxymethylene (POM). Materials and Methods: Twenty-one patients received a total of 49 interim implant-supported FPDs. The same participant received PMMA and POM as part of the control and experimental groups, respectively. The restorations were evaluated 1 week, 3 months, and 6 months after placement. In addition, their functional wear and color stability were assessed. Nonparametric statistics (α = 0.05) were used to analyze the data. Results: The study found that PMMA outperformed POM in surface and color parameters, with more fractures occurring with internal conical connection implants. The color stability analysis showed ΔE*ab values of 7.18 for PMMA and 8.8 for POM, with no significant differences. After 6 months of operation, both materials showed a significant increase in wear, but no significant differences were found within the materials. Conclusion: The study found that PMMA interim implant-supported FPDs outperformed POM in surface and color parameters, while polymer posterior implant-supported FPDs with internal conical connection implants were more fracture-prone.

Evaluation of Failure in Single-Piece Implant Systems: A One-Year Follow-Up Study.

Objective: This study's goal was to assess the failure rate and peri-implant complications of single-piece implant systems over the course of a one-year follow-up. Materials and Methods: Patient records were examined retrospectively. 150 single-piece dental implants were analyzed. Clinical results, implant features, and demographic information were gathered. Implant failure, which is characterized as the total loss of osseointegration, served as the key outcome indicator. Patient satisfaction and peri-implant problems were secondary outcomes. Data analysis employed descriptive statistics. Results: During the one-year follow-up period, the failure rate for single-piece implant systems was 6.7%. The two main factors leading to implant failure were found to be poor osseointegration (60%) and biomechanical overload (40%). 20% of the cases had peri-implant problems, such as peri-implantitis. 85% of the panelists felt that single-piece implants had satisfied their patients. Conclusion: A 6.7% failure rate in single-piece implant systems was seen in this one-year follow-up investigation. The major causes of implant failure were found to be poor osseointegration and biomechanical loading. In 20% of the cases, peri-implant problems such as peri-implantitis, were noted. There was great patient satisfaction. These results highlight the significance of regulating occlusal forces, optimizing osseointegration, and applying preventive measures to ensure the long-term viability of single-piece implant systems.

Isolation Systems and its Effectiveness in Oral and Maxillofacial Surgery: A Systematic Review.

Introduction: The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an isolation technique. There is still room for evidence-based discussion over how rubber dam use affects the durability and caliber of dental restorations. In this review, the effects of rubber dam isolation vs alternative isolation techniques for dental restorative procedures are compared. Materials and Procedures: An extensive online search in the various databanks of the EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "isolation, oral surgery, dental surgery, retractors, rubber dam, and methods of isolation." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of bias, meta-analysis was carried out. The outcome was measured as the successful restoration at the end of follow-up period representing the thorough isolation. Results: A total of 1342 people were involved in six studies from across the world that were carried out between 2010 and 2015. High bias risk existed in all the studies. Five investigations compared the rubber dam vs cotton rolls. Due to discrepancies in the data supplied, one study was omitted from the analysis. Three of the four trials that were still running showed restored survival rates with all having a follow-up of at least six months. The survival of the restored composite teeth for six months in rubber dam isolation with odds ratio of 2.29, 1.38, and 1.00 at the end of six months, one year and one and half year respectively. However, the evidence was very low and speculative. The isolation was seen effective in the primary teeth specifically for the proximal lesions. None of the included studies discussed side effects or provided information on the treatment's upfront costs. Conclusion: The application of rubber dams in dental techniques may result in successful outcome compared to cotton rolls, according to some low-certainty evidence revealed in this research. Other times, the evidence is really ambiguous. It is necessary to conduct additional, high-quality studies investigating how rubber dam use affects various restorative procedures.

Comparative Evaluation of Three-Dimensional Plating Systems in Maxillofacial Trauma: An Original Research.

Introduction: Many advanced techniques and materials have been introduced in the recent years with the advent of the new designing technology. Hence, in our study, we aimed to compare in maxillofacial trauma, the three-dimensional (3D) plating systems. Materials and Methods: We piloted a prospective clinical study among 50 subjects of both genders with mandibular parasymphysis fracture. We compared the 3D miniplates with the two-dimensional (2D) miniplates where the subjects were divided into 2 groups equally. The clinical parameters were compared at different times of follow-up after the surgery. Results: We observed that there was a similar distribution of the genders and the side of the fracture of the parasymphysis. There was a significant difference between the groups for the mouth opening while there was no significant difference for the sensory deficit. The subjects recovered better with the 3D mini-plates. Conclusion: The mandibular fractures can be successfully treated with the 3D miniplates that help in a quick and efficient recovery.

Evaluation of Soft-Tissue Grafting in Peri-implantitis - An Original Research.

Introduction: With the increased application of the implants for the restoration of the lost teeth, the peri-implantitis cases are seen on a rise. Hence, we conducted a study retrospectively to evaluate, among the peri-implantitis cases, the success of the soft-tissue grafting. Material and Methods: We piloted a retrospective study among 50 subjects of both genders who underwent the soft-tissue grafting for the treatment of the peri-implantitis of a total of 69 implants. The clinical parameters noted were at the baseline and at various years of follow-ups. The data of the clinical parameters were noted, and the data thus noted were compared deliberating P < 0.05 as significant. Results: Thin soft-tissue biotype was noted among all the subjects, with the increased width of the keratinized mucosa. Significant lowering of the probing depth, bleeding on probing, and the mobility of the tissue were noted. Conclusions: We can conclude that soft-tissue grafting Is a benificial method for the peri-implantitis treatment.

Low-Level Laser Therapy Role in Surgical Extractions: An Original Research.

Introduction: Low-level laser therapy (LLLT) has been of interest in the clinical application in dentistry. Hence, we evaluated the LLLT on the wound healing in the mandibular surgical extraction. Materials and Methods: We conducted a prospective clinical study with 50 male subjects, equally distributed as controls and cases. Routine surgical extraction was done for control group, and in case group, LLLT was applied after the extraction. Evaluation was done for various parameters and after comparison the P value was less than 0.05 which was considered as significant. Results: Significant difference was seen between the groups for the socket depth on 7th day, swelling on 1st, 3rd, and 5th days, and pain on all the days. Conclusion: LLLT can be successfully used for the surgical extractions.

Various Assisted Bone Regeneration in Apicectomy Defects Systematic Review and Meta Analysis.

INTRODUCTION: In the endodontic surgery, the common applications are the procedures that apply regenerative methods. There are various methods that help in the regeneration after the endodontic root end cutting or apicectomy. The outcome of the apicectomy depends on the procedure and the material. Hence in the present study, we intend to conduct the systemic review and meta-analysis of the various assisted bone regeneration in apicectomy defects. MATERIALS AND METHODS: The study was conducted by the online search of the data that included the studies for the regenerative procedure in the endodontic surgery in patients with various periapical pathologies. The data search engines were Scopus, Web of Science, Google Scholar, and PubMed. The risk of the bias was calculated. The study participants were divided into case and control groups. Case group had undergone the regenerative surgery for the persistent periapical lesions, while the control group had not undergone the regenerative surgery for the persistent periapical l. The clinical and the radiograph outcomes were compared between the control and the case groups. Meta-analysis was done and the subgroups were evaluated. RESULTS: From a total of 1561 articles, only 11 were finalized for the study to conduct the meta-analysis. The bias was noted for majority of the studies most of which were clinical trials. It was observed that the regenerative methods used in the endodontic surgery have significantly improved the outcome. The application of the expanded polytetrafluoroethylene only has no significant effect; however, application of the autologous platelet concentrates or collagen membranes only had good outcomes. The combination of the materials showed a significant outcome than when applied alone. CONCLUSIONS: From this meta-analysis, it is evident that regenerative procedures are beneficial in the endodontic apicectomy procedures. The materials used in these procedures will augment the outcome. A better prognosis is expected if the combination of the materials is used.

Functional Role of Inorganic Trace Elements on Enamel and Dentin Formation: A Review.

Calcium and phosphate are the major components of hydroxyapatite crystals that form the inorganic portion of the teeth. Apart from these, certain elements are present in little amounts in enamel and dentin of the human teeth. Although they are required in minute quantities, their absence may alter healthy development of enamel and dentin and may result in developmental tooth defects as well as dental caries. Furthermore, excessive intake of some trace elements may inversely affect tooth development and health. The exact of effects that trace elements have on teeth and oral health is still an unexplored territory. The present paper reviews the presence of trace elements in teeth and their role in tooth health and development.

Prevalence of Titanium Hypersensitivity in Patients with Titanium Implants: A Systematic Review and Meta-analysis.

BACKGROUND: With increase in exposure to titanium in daily life and its use in medical procedures, there is a greater chance for developing titanium hypersensitivity. Our aim and objective is to examine whether patient patients with titanium implants had a greater incidence of titanium hypersensitivity or not. Titanium is widely considered to have good biocompatibility. A passivating surface layer of TiO2 is formed when exposed to air which gives it good corrosion resistance. These properties along with its high strength, lightweight, and improvements in smelting technologies have led to its widespread use as an intraosseous and periosteal implant in dentistry and orthopedics. MATERIALS AND METHODS: Only case-control studies were used for the meta-analysis. Studies with a sample size of <5 were excluded. Cutaneous and epicutaneous tests were used in the study. RESULTS: Three studies met the inclusion criteria. Titanium hypersensitivity is more prevalent in patients with titanium implants. CONCLUSIONS: It is also used in a variety of medical devices such as pacemakers and insulin pumps. Moreover, our external exposure to titanium is increasing. It is used in aerospace, chemical, and automobile industries. It is also used in jewelry, home furnishings, and in making sports and marine equipment. Titanium implants increase the possibility of developing titanium hypersensitivity, and thus, it should be considered as a major factor in unexplained implant failure where other causes have been excluded.

Efficiency of Laser versus Bur in Impacted Mandibular Third Molar Surgery: An Original Research.

INTRODUCTION: In oral and maxillofacial surgery, their clinical application has largely been restricted to soft tissue. Hence, the aim of this study was to assess the feasibility of erbium-yttrium aluminum garnet (Er: YAG) laser in bone cutting for removal of impacted lower third molar teeth and to compare its outcomes with that of surgical bur. MATERIALS AND METHODS: The study comprised forty subjects requiring removal of impacted mandibular third molar, randomly categorized into two equal groups of 20 each, who had their impacted third molar removed either using Er: YAG laser or surgical bur as per their group, using standard methodology of extraction of impacted teeth. Clinical parameters such as pain, bleeding, time taken for bone cutting, postoperative swelling, trismus, wound healing, and complications were compared for both groups. RESULTS: Clinical parameters such as pain, bleeding, and swelling were lower in laser group than bur group, although the difference was statistically not significant. However, postoperative swelling showed a significant difference in the two groups. Laser group required almost double the time taken for bone cutting with bur. Trismus persisted for a longer period in laser group. Wound healing and complications were assessed clinically and there was no significant difference in both the groups. CONCLUSION: Based on the results of our study, the possibility of bone cutting using lasers is pursued, the osteotomy is easily performed, and the technique is better suited to minimally invasive surgical procedures. The use of Er: YAG laser may be considered an alternative tool to surgical bur, especially in anxious patients.

Is Open Reduction and Internal Fixation Sacrosanct in the Management of Subcondylar Fractures: A Comparative Study.

PURPOSE: This paper is intended to compare and evaluate the better treatment option in the management of subcondylar fractures of the mandible. MATERIALS AND METHODS: This study included 20 patients who were diagnosed clinically and radiologically to have sustained an isolated subcondylar fracture of the mandible. They were divided into two groups randomly. Group I included 10 patients who underwent treatment by intermaxillary fixation alone followed by active physiotherapy in the form of conservative management. Group II included 10 patients who underwent treatment by surgical intervention for open reduction and internal fixation under general anesthesia following elastic guidance. Factors such as maximal mouth opening, pain scores, and deviation of mandible on mouth opening were taken into consideration and evaluated. RESULTS: It is observed that the patients in Group I had weight loss and restrictions in their social well-being in the early recovery phase, in addition to delay in return to function. In spite of the early return to function, patients in Group II were subjected to all kinds of surgical complications such as transient facial nerve injury, infection, and unesthetic scar. The maximal mouth opening and deviation of the mandible on mouth opening remained almost the same in both groups. CONCLUSION: A regular follow up of operated patients post trauma is essential to obtain morphological and functional recovery. When the respective advantages and disadvantages of both treatment options were compared and evaluated, it was observed that patients treated by closed reduction had a better clinical and psychological outcome.

Multiple radiolucencies in the mandible: A diagnostic dilemma.

Diagnosis and treatment planning of maxillofacial pathologies is an art. It requires careful evaluation and correlation of clinical presentation and radiologic investigations. When the pathology concerned is an intraosseous lesion, the radiographic findings assume a significantly more important role. While carrying out the radiographic assessment, we rely on typical findings regarding the number, location, and appearance of radiolucent areas which point towards certain types of pathologies. Whenever these findings are atypical or at variance with the clinical presentation, it creates a diagnostic dilemma for the clinician. We report a case of a 34-year-old man who presented with a simple clinical history but multiple radiolucencies on the radiograph.

The study of placentrex and hydrocortisone as an adjunct treatment in oral submucous fibrosis.

BACKGROUND: Submucous fibrosis with a high incidence rate in the Indian subcontinent is a devastating disease affecting the oral cavity and oropharynx. AIMS AND OBJECTIVE: To evaluate the efficacy of injection placentrex and injection hydrocortisone in oral submucous fibrosis patients in increasing mouth opening, burning sensation, and improve the mucosal lining. MATERIALS AND METHODS: We recruited 60 patients with Stage II and Stage III of the ailment, who were randomly divided into Group A and Group B. They were administered submucosal injections of hydrocortisone and placentrex along with physiotherapy and oral iron, nutrients, and B-carotene supplements over a period of 2 months. INTERPRETATIONS AND RESULTS: The pinnacle rate of the incidence was found in the age group of 30 to 40 years among both the genders. Statistically significant difference (P = 0.0001), that is, 5.19 ± 1.33 in Group A and 11.69 ± 1.26 mm in Group B was noted in the mean mouth opening values. Statistically significant difference in burning sensation was noted to be better in Group A than in Group B. DISCUSSION AND CONCLUSION: Overall hydrocortisone seems to be a better regimen for improving the mucosal health and increasing the mouth opening as compared to placentrix regimen. Although Placentrex is better than hydrocortisone in reducing burning sensation.

Rare case of gemination of mandibular third molar-A case report.

Fusion and germination are the anomalies that occur due to some developmental eccentricity during the time of morpho-differentiation of the tooth bud and have a close resemblance to each other. The gemination is an attempt of the division of a single tooth into two and, hence, appears as an enlarged single tooth while the tooth count is normal when the affected tooth is counted as one. Its exact pathogenesis is ambiguous. This anomaly has been observed mostly in deciduous dentition as compared to that in permanent dentition. Gemination is rarely associated with the third molar and, hence, the terminology is arguable when this condition is seen in relation to the third molar. In the present article, a case of germination of mandibular third molar has been reported.

Massive radicular cyst involving multiple teeth in pediatric mandible- A case report.

Radicular or periapical cysts are one of the most commonly occurring odontogenic cysts of the jaws. The present article reported a case of a 12-year-old female with the chief complaint of swelling and pain on the right lower back tooth region. The radiographic examination revealed the presence of a well-defined radiolucency surrounded by a corticated border with respect to the right mandibular 1st, 2nd and 3rd molar. The case was managed by complete enucleation under general extraction with the extraction of right mandibular 1st, 2nd and 3rd molar. The success of the surgery was apparent by the uneventful healing during the follow-up period and evidence of complete healing after 1-month follow-up. Early diagnosis of the lesion would have lead to a less aggressive treatment plan.

Shaping Ability of 2Shape and WaveOne Gold Files Using Cone-Beam Computed Tomography.

AIM AND OBJECTIVE: The aim of this study is to evaluate the apical transportation, centering ability, and volume of removed dentin of WaveOne Gold (WOG) and 2Shape with the use of cone-beam computed tomography. MATERIALS AND METHODS: Freshly extracted mandibular teeth with sample size of thirty were carefully chosen and instrumented using the 2Shape and WOG rotary files. Preoperative and postinstrumentation cone-beam computed tomographic scans were done to accomplish mesial and distal dentin walls' measurements and volume of removed dentin calculations, apical transportation, and centering ratio. Statistical analysis was performed and confirmed by independent t-test. Statistical significance was set at 5%. RESULTS: When shaping ability of 2Shape and WOG was evaluated, it was reported that there was no statistically significant differences noted among the groups in relation to the total volume of removed dentin, apical transportation, and centering ratio. CONCLUSION: It can be concluded that 2Shape and WOG preserved the original canal anatomy well and did not eliminate excess dentin during shaping and cleaning. Rotary nickel-titanium files which work on the principle of rotary movement attained an outcome analogous to that of the rotary files working on reciprocating motion in relation to alteration in angle.