Customizing the Emergence Profile Around an Immediately Loaded Single Implant in the Esthetic Zone: A Case Report.

An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.

Geminated Supernumerary Premolar Impacted in the Palate: A Report of a Rare Case and Review of the Literature.

Supernumerary teeth are dental anomalies characterized by the presence of an excessive number of teeth in relation to normal dentition. Among these, the supernumerary premolars have a prevalence of 0.29% to 0.64%, making it a very rare finding. On the other hand, gemination is a developmental disturbance in the shape of the teeth where a partial cleavage of a single tooth germ results in the formation of a singular root and a singular pulp chamber but two partially or totally separated crowns. Although these anomalies as individual entities are fairly common in clinical practice, the occurrence of both anomalies in a single tooth is an extremely rare occurrence. We hereby report a rare case of impacted geminated supernumerary premolar in a 45-year-old female patient. A thorough search of the literature revealed that only four cases listing this anomaly have been reported in the literature thus deserving a mention. In addition to the case presentation, the authors have also reviewed the existing literature on this anomaly.

The Palatal Elevation Technique (PET) for Intra-alveolar Extraction of Grossly Decayed Maxillary Third Molars.

Intra-alveolar extraction of maxillary third molars always poses a challenge to dental practitioners owing to limited accessibility and minimal space for dental forceps application. Dental elevators facilitate the extraction of such teeth. In the traditional technique as described in the literature, the elevator is always introduced from the mesiobuccal aspect of the tooth to engage the space between the interdental bone and the offending tooth to use it as a fulcrum. However, certain situations prevent proper application of the elevator from the buccal aspect of the offending tooth to bring about luxation. One such situation is a grossly decayed third molar tooth, especially from the mesiobuccal aspect with destruction of the tooth substance extending below the cementoenamel junction. Another such situation is observed in patients presenting with thick and inextensible cheeks but a good interincisal opening. In either situation, it becomes very challenging to achieve a good purchase for luxation of the offending third molar. The authors have therefore described a modified technique of tooth elevation, the palatal elevation technique (PET), using the palatal bone instead of the buccal bone as the fulcrum which was observed to be effective in such situations. In the authors' view, PET is simple and quick and can effectively be employed as an alternative to the traditional technique of tooth elevation in all cases that require an intra-alveolar extraction of maxillary third molars.

Intra-alveolar extraction of linguoverted mandibular premolars - the Shetye technique: a technical note.

Extraction of premolars for orthodontic purposes may prove challenging when the tooth is blocked or lingualised. The standard buccal approach may prove difficult in such cases. A novel technique was used for 16 patients with healthy linguoverted mandibular premolars using maxillary extraction forceps. The ease of extraction increased and resulted in uneventful postoperative healing in all patients. The authors suggest this as a preferred technique for extracting mandibular premolars in linguoversion.

A retrospective epidemiological review of maxillofacial trauma in a tertiary care centre in Goa, India.

PURPOSE: Trauma accounts for the leading cause of morbidity and mortality worldwide in the present day and may rightly be called the new pandemic. The prominent nature of the face exposes it to various traumatic injuries. A timely, prompt diagnosis along with employment of correct and quick treatment greatly improves the outcome for these patients. The aim of this retrospective study was to analyse the characteristics of maxillofacial injuries over a decade. METHODS: The data were collected manually from the medical records of patients who reported to the tertiary centre from 1 January 2011 to 31 December 2019. All injured patients irrespective of age/gender with complete hospital records of clinical and radiographical diagnosis of maxillofacial injuries were included. The demographic data, etiology, site and type of injury, and seasonal variation were analyzed. Data were tabulated into six age groups (0-7 years, 8-18 years, 19-35 years, 36-40 years, 41-59 years, and >60 years). Five etiological factors, i.e. road traffic accidents, falls, assaults, sports-related, and occupational accidents, were further evaluated based on genders. Facial injuries were classified into six types: panfacial fractures, mandibular fractures (subcategorized), midface fractures (subcategorized), dentoalveolar fractures, dental injuries, and soft tissue injuries. The monthly and seasonal variation of the injuries was also charted. Data were expressed as frequency and percent. RESULTS: A total of 10,703 injuries were included from the tertiary centre from the period of 2011-2019, including 8637 males and 2066 females, with the highest occurrence of the injuries between 19 and 35 years. Road traffic accident was the principal etiological factor of the maxillofacial injuries in both genders (80.5%). This was followed by falls (9.6%), assaults (8.0%), occupational accidents (1.2%), and sporting injuries (0.7%). Midface fractures amounted for 52.5% (5623 fractures), followed by mandibular fractures (38.1%). CONCLUSION: The current study describes a change in the incidence of injuries along with variation in the demographic data. The implementation of safety gears and stricter traffic laws along with public awareness may aid in the reduction of maxillofacial injuries.

A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study.

OBJECTIVES: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the infl uence of systemic comorbidities on treatment outcome in diabetic patients. MATERIALS AND METHODS: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed. RESULTS: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group. CONCLUSION: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.

The Local Effect of Alendronate with Intra-alveolar Collagen Sponges on Post Extraction Alveolar ridge Resorption: A Clinical Trial.

INTRODUCTION: Extraction of teeth is followed by resorption of the residual alveolar ridge that continues throughout life resulting in loss of alveolar height and width. Of the numerous techniques that have been used to arrest post extraction alveoloar ridge resorption, the placement of a graft material inside the socket immediately after extraction has been mostly followed. Type 1 collagen is one of the commonly used graft material that prevent resorption by providing dimensional stability to the socket. Bisphosphonates are an anti-osteoclastic drug that prevent resorption by disrupting the membrane ruffling of the osteoclasts. Alendronate a bisphosphonate, is primarily used in diseases with bone loss. It has been used to reduce active bone resorption significantly without interfering with bone mineralization and quality. The need for the study is to examine the inhibitory effect of alendronate on residual ridge resorption when applied locally in combination with type I collagen on alveolar bone immediately following tooth extraction. MATERIALS AND METHODS: Twenty patients with age between 30 and 65 years were selected from the out patient department of The Oxford Dental College and Hospital. The patients were divided into two groups. In the first group after extraction of teeth from premolar to midline the sockets were irrigated with saline and sutured. On the left side type I collagen sponge was placed and sutured. In the other group the right side was treated the same way after extraction as in first group where as in the left side sockets type I collagen soaked in 20 mg/ml of alendronate was placed and sutured. Patients were evaluated clinically for any local irritation as well as radiologically with orthopantomograph X-rays were taken immediately after the extraction, 1 month after extraction and 4 months after extraction to determine the amount of bone loss prevented. RESULTS: The statistically significant bone loss prevented by the collagen alone was 22.8 % and in collagen with alendronate group was 44.38 % at the end of 4 months. CONCLUSION: Type I collagen soaked with alendronate when placed in the socket immediately after extraction of teeth prevents post-extraction alveolar ridge resorption.

Evaluation of mechanical resistance after fixation of mandibular condylar fracture with single and double miniplates: a comparative in vitro study.

OBJECTIVES: To evaluate the efficacy of two plating system in comparison with single plating systemTo study the biomechanical behaviour of single and two plating system when compression load is applied. MATERIALS AND METHODS: Twenty hemimandibles were divided into two groups A and B of ten each. A subcondylar fracture was created. Group A was stabilized by single adaptation plating technique and group B by double adaptation plating technique and both the groups were tested for stability by using universal testing machine. RESULTS: Higher mean displacement was observed in Group A compared to Group B, but the difference in mean displacement between the two groups was not statistically significant (p > 0.05). Higher mean load was recorded in group B compared to group A and the difference in mean load between them was found to be statistically significant (p < 0.001). CONCLUSION: The present study demonstrated that double adaptation plating technique had greater resistance to compression load than single adaptation plating technique and it shows more favorable biomechanical behavior.

Mandibular metastasis from a pulmonary squamous cell carcinoma.

Metastatic tumors to the jaws and oral tissues are rarely encountered, accounting for less than 1% of all malignant tumors affecting the mouth. Although, metastasis to the mandible from a pulmonary carcinoma is extremely rare, when it does occur it mimics more common pathoses such as odontogenic cysts, osteomyelitis, space infections making its diagnosis even more challenging. Metastasis should be taken into account especially in patients with chronic history of smoking and sudden onset of paresthesia. The rarity of such cases has also resulted in there being no definitive consensus on managing them.