Determination of Palatal Soft Tissue Thickness and Safe Zone for Palatal Soft Tissue Harvest Using CBCT: A Retrospective Study.

Aim: Our decision to conduct this study was motivated by the dearth of knowledge on geographical variations in the thickness of the palatal masticatory mucosa. The aim of the present study is to comprehensively analyze the palatal mucosal thickness and indicate the safety zone for palatal soft tissue harvesting using cone beam computed tomography (CBCT). Material and Methods. As this was a retrospective analysis of cases previously reported to the hospital, written consent was not acquired. The analysis was carried out on 30 CBCT images. Two examiners evaluated the images separately to avoid bias. Measurements were done from the midportion of the cementoenamel junction (CEJ) to the midpalatal suture in a horizontal line. Measurements were recorded from the maxillary canine, first premolar, second premolar, first molar, and second molar and were marked in axial and coronal sections at distances of 3, 6, and 9 mm from the CEJ. The relationship between palate soft tissue thickness in relation to each tooth, palatal vault angle, teeth, and the greater palatine grove was evaluated. Differences in the palatal mucosal thickness according to age, gender, and tooth site were evaluated. Categorical data were presented as frequencies and percentages. Numerical data are presented as mean and standard deviation values. They are explored for normality using Shapiro-Wilk's test. Data are normally distributed and are analyzed using one-way ANOVA followed by Tukey's post hoc test for independent variables and paired t-test for repeated measures. The significance level is set at p ≤ 0.05 for all tests. Statistical analysis is performed with R statistical analysis software version 4.1.3 for Windows. Results: For sex and nationality, there was no significant association (p > 0.05), while for age, cases 35 years and older had significantly higher mucosal thickness than cases younger than 35 years old (p < 0.001). For all teeth, the association was statistically significant (p < 0.001). For the canine and first premolar, cases with deep angles had significantly higher mean values than those with moderate angles (p < 0.001). For other teeth, cases with deep angles had significantly higher mean values than other angles (p < 0.001). Conclusion: Palatal mucosal thickness varied significantly from the canine to the second molar; the most appropriate site for graft harvesting is the canine to second premolar area which is 9-12 mm from the midpalatal suture aspect and is considered a safe zone for harvesting palatal graft.

Oral Hygiene Practices and Awareness of Pregnant Women about the Effects of Periodontal Disease on Pregnancy Outcomes.

Objectives: Adverse pregnancy outcomes, such as preterm low birth weight (PTLBW), is a severe public health issue that needs to be dealt with by educating the general female population, dental practitioners, and gynecologist. One of the major contributing factors is periodontal disease, which accounts for about 18.2% of all PTLBW cases worldwide, and prevention of the same could reduce the occurrence of PTLBW babies. This study aimed to assess the oral hygiene practices and awareness of pregnant women about the effect of periodontal disease on pregnancy outcomes. Methods: A descriptive cross-sectional study was conducted where 400 pregnant women after consent were requested to complete an anonymous, self-administered, structured questionnaire with twenty-one close-ended questions. Results: Only 5% of participants in this study reported that gum diseases during pregnancy lead to preterm labor or low birth weight babies. About 70.7% of pregnant women mentioned that they did not use any interdental cleaning aids, and 54.5% did not use mouthwashes. Conclusion: Tooth brushing practices among pregnant women were good; however, there was an overall lack in the use of adjunctive aids. The study highlighted a deficiency in the awareness of pregnant women regarding the association between periodontal disease and adverse pregnancy outcomes.

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study.

INTRODUCTION: Nasal septal deviation (NSD) and concha bullosa (CB) are associated with airway obstruction in mouth breathers. Mouth breathing is associated with alterations in maxillary growth and palatal architecture. The aim of our study was to determine the effect of the presence of CB and NSD on the dimensions of the hard palate using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective study was conducted using CBCT scans of 200 study subjects. The study subjects were divided into four groups based on the presence of CB and NSD. Septal deviation angle (SDA), palatal interalveolar length (PIL), palatal depth (PD) and maxillopalatal arch angle (MPAA) were measured in the study groups. RESULTS: The presence of NSD and CB was associated with significant (p < 0.001) differences in the palatal dimensions of the study subjects. The PIL and MPA (p < 0.001) were significantly reduced (p < 0.001), whereas the PD was significantly increased (p < 0.001) in study subjects with NSD and CB. There was no significant change in the palatal dimensions between the unilateral and bilateral types of CB. Among the palatal dimensions, the PIL had the most significant association (R2 = 0.53) with SDA and CB. There was a significant correlation between the palatal dimensions and SDA when CB was present along with NSD. CONCLUSION: Based on the results of this study, it can be concluded that the presence of NSD and CB have a significant effect on the palatal dimensions and, therefore, they may be associated with skeletal malocclusion.

A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography.

BACKGROUND: Accessory maxillary ostium (AMO) has a major role to play in the aetiology of maxillary sinusitis. Mucosal thickening is one of the key radiographic features of chronic maxillary sinusitis. The aim of this study was to identify the location of the AMOs and investigate the association between Mucosal Thickening [MT] and AMO using Cone Beam Computed Tomography [CBCT]. METHODS: CBCT scans of 400 maxillary sinuses from the records of 200 patients who seeked various dental treatments at the Thumbay Dental Hospital, Gulf Medical University, Ajman, United Arab Emirates were evaluated. The incidence, anatomical position and maximal length of accessory maxillary ostia (AMO) in the maxillary antrum were reviewed using CBCT by two examiners. The association between MTs and AMOs were also analysed. RESULTS: Among the 200 CBCT scans, 131 belonged to male patients and 69 scans belonged to female subjects within the age group of 18-65 years (mean age 41.32 years). AMOs were found in 142 maxillary antra (35.5 %). The inter-observer reliability for using CBCT to detect AMO was (k = 0.83). There was no significant difference in the frequency of AMOs when the age (P = 0.19) and gender (P = 0.54) distribution were considered. Sinuses with AMOs, showed significantly greater frequency of MTs (p = 0.001). AMOs with maximal length of less than 1mm were most commonly observed (51.40 %). AMOs with larger greater maximal length were associated with higher degrees of MT. The location of the AMOs, were not affected by the degree of MT. CONCLUSIONS: The study demonstrates a clear association between degree of MT and occurrence of AMO in the maxillary sinus. However, the location of the AMO is independent of the degree of the MT. There is a greater probability of finding an AMO in the maxillary sinus if the MT in the sinus is more than 3 mm.

Analysis of inferior nasal turbinate width and concha bullosa in subjects with nasal septum deviation: a cone beam tomography study.

BACKGROUND: In individuals with nasal septal deviation (NSD), compensatory hypertrophy of the nasal turbinates occurs as a protective mechanism of the nasal passage from dry and cold air. NSD associated nasal turbinate hypertrophy is usually recurrent, requiring repetitive imaging. Therefore, a multiplanar imaging modality with a low radiation dose is best suited for long-term follow-up of this condition. This study aimed to evaluate the association of width of inferior turbinates and presence of concha bullosa with the degree of NSD using Cone beam computed tomography (CT). METHODS: The CBCT scans of 100 patients with NSD were selected as per convenience sampling and were evaluated by two maxillofacial radiologists. The width of the non-hypertrophied inferior turbinate (NHT) on the convex side of the NSD, and hypertrophic inferior turbinates (HT) on the concave side of the NSD were measured at three locations. The septal deviation angle (SDA) and the presence of concha bullosa (CB) were determined. RESULTS: A significant difference was observed in the anterior, middle, posterior, and mean widths between HT and NHT (p < 0.001). There was a significant difference in the widths of the HT and NHT among different types of NSD. A strong positive correlation (r = 0.71, p < 0.001) was found between SDA and the mean width of the HT. Age (P = 0.71) and gender (P = 0.65) had no significant difference among different types of NSD. Regression analysis revealed that the presence of CB (p = 0.01) and middle width of the HT (p < 0.001) are significant predictors of SDA and type of NSD. CONCLUSION: The results of the present study reveal that the middle width of the HT and the presence of CB influence the degree of NSD. The present study results recommend the use of CBCT as a substitutive low radiation dose imaging modality for evaluation of NSD, CB, and associated inferior turbinate hypertrophy.

Assessment of alveolar bone level and furcation involvement in periodontal diseases using dental cone-beam computed tomography (CBCT): a systematic review / Avaliação do nível ósseo alveolar e envolvimento da furca em doenças periodontais usando a Tomografia computadorizada de feixe cônico odontológica: uma revisão sistemática

The advent of CBCT has contributed significantly to dental imaging. In the field of periodontics, CBCT provides a multi-planar view to assess the alveolar bone in three dimensions. This helps the dentist to make measurements at any location that could significantly improve periodontal diagnosis. Objective: The aim of this systematic review is to evaluate the accuracy of using CBCT in the assessment of alveolar bone level and furcation involvement in periodontal diseases. Material and Methods: PubMed, LILACS and Google Scholar databases were searched for literature related to the application of CBCT in periodontal diseases. Keywords used for the search were CBCT, furcation involvement, measurement and their synonyms. Results: Fifteen full-text English language research papers were eligible for the systematic review using the PRISMA guidelines. Conclusion: From the results of the systematic review it can be concluded that conebeam computed tomography imaging technique offers significantly reliable images of the furcation involvement and height of the alveolar bone. (AU)

O advento da Tomografia computadorizada de feixe cônico (TCFC) contribuiu significativamente para a imageologia. No campo da periodontia, a TCFC fornece uma visão multiplano para avaliar o osso alveolar em três dimensões. Isso ajuda o dentista a fazer medições em qualquer local que possa melhorar significativamente o diagnóstico periodontal. Objetivo: O objetivo desta revisão sistemática foi avaliar a precisão do uso da TCFC na avaliação do nível ósseo alveolar e do envolvimento da furca em doenças periodontais. Material e Métodos: As bases de dados PubMed, LILACS e Google Scholar foram pesquisadas na literatura relacionada à aplicação da TCFC em doenças periodontais. As palavras-chave utilizadas para a pesquisa foram TCFC, envolvimento da furca, mensuração e seus sinônimos. Resultados: Quinze trabalhos de pesquisa em inglês com texto completo foram elegíveis para a revisão sistemática usando as diretrizes do PRISMA. Conclusão: A partir dos resultados da revisão sistemática, pode-se concluir que a técnica de imagem por tomografia computadorizada de feixe cônico oferece imagens significativamente confiáveis do envolvimento da furca e da altura do osso alveolar.(AU)

Comparative Evaluation of the Marginal Adaptation of Cast Ni-Cr Copings, Direct Metal Laser Sintering Co-Cr Copings, and Computer-aided Design and Computer-aided Manufacturing Zr Copings: An In-vitro Study.

Background and purpose Marginal adaptation is critical for the long-term longevity and clinical success of dental restorations. Improper marginal adaptation may lead to oral fluids, resulting in microleakage and cement dissolution. The present in vitro study aimed to evaluate the marginal adaptation of nickel-chrome (Ni-Cr) copings, cobalt-chrome (Co-Cr) coping, and zirconium (Zr) copings, produced with different manufacturing procedures. Material and methods A total of 45 copings were fabricated on a standardized metal die by using a two-stage putty impression and poured with die stone. They were divided into three groups of 15 each: A, B, and C. For group A, Ni-Cr copings were fabricated by conventional casting procedures; for group B, Co-Cr copings by direct metal laser sintering (DMLS); and for group C, zirconium copings by computer-aided design and computer-aided manufacturing (CAD/CAM) systems. Four areas around the tooth surface, namely, the mid-mesial, buccal, distal, and lingual surfaces, were digitally analyzed for marginal adaptation under the scanning electron microscope. Results The mean marginal gap for group A on the mid mesial, buccal, distal, and lingual surfaces was 79.67, 83.27, 90.67, and 89.13 µm, respectively. The mean marginal gap for group B on the mid-mesial, buccal, distal, and lingual surfaces was 38.13, 46.20, 45.73, and 42.20 µm, respectively. The mean marginal gap for group C on the mid mesial, buccal, distal, and lingual surfaces was 36.73, 31.73, 29.00, and 30.53 µm, respectively. Conclusion The marginal adaptation of CAD/CAM Zr copings is more accurate when compared to the DMLS Co-Cr and Cast Ni-Cr copings on a standard master die.

Shear Bond Strength of Ceramic Bonded to Different Core Materials and Their Pattern of Failure: An In Vitro Study.

Introduction In metal-ceramic restoration, most of the bond failures between the ceramic layer and the metal coping is the chipping of the ceramic layer, thus exposing the metal surface, which compromises the aesthetics. Hence, this leads to the introduction of zirconia-based restorations in dentistry. However, even zirconium coping has the common complication of delamination or porcelain chipping from the zirconium core. Hence, the shear bond strength between the commonly used core materials and ceramic requires investigation to facilitate the materials in clinical use for longevity. Therefore, this study was conducted to compare the shear bond strength between different core materials and ceramic layering to find out the best core material for ceramic bonding. Materials and methods A total number of 45 samples were made as per ISO standardization (base 5 mm diameter and 1 mm thickness, step with 4 mm diameter and 4 mm in length). These samples were divided into three groups, Group A: Nickel-chromium, Group B: Cobalt-chromium, and Group C: Zirconium. Ceramic layering was layered on the top surface of each sample until an ideal height of 4 mm was obtained, and it was subjected to shear bond strength using a universal testing machine with a 50-KN load cell. This was followed by analyzing the nature of the fracture pattern using scanning electron microscopy (SEM). Results  There were no significant differences found for the shear bond strength among group A and group B. The zirconium (group C), however, had significantly lower values than both group A and group B. The microscopic examination also revealed that the failure between the coping and the ceramic layer primarily occurred near the interface with the residual veneering porcelain remaining on the core. Conclusions It was found that the shear bond strength of the metal-ceramic group is better than the zirconium ceramic group, however, the fracture between the copings and the ceramic layering is found to be similar for both adhesive and cohesive failure.

Oral and periodontal features of autosomal recessive syndromes: a tabular review / Características oral e periodontal de síndromes autossômicas recessivas: uma revisão tabular

Objective: To systematically review the data and results of case reports of autosomal recessive syndromes associated with periodontitis. Material and Methods: An internet search using Google and PubMed search engine and keywords- autosomal recessive, periodontitis, syndromes, periodontium and gingiva was carried out. Full-text articles in the English language of all the case reports and reviews that were published in journals from the year 1966 to 2016 were obtained and evaluated and presented in tabular form. Abstracts and articles published in other languages were not included in the review. Results: The data available from the clinical trials were analyzed and presented under broad headings of, systemic features, dental features, periodontal features and laboratory findings presented in tabular form. Conclusion: Many autosomal recessive syndromes with dental component also present with changes or alteration in the periodontium thus stressing the fact that thorough periodontal examination is important during the medical evaluation of patients with syndromes (AU)

Objetivo: Analisar sistematicamente os dados e resultados de relatos de caso de síndromes autossômicas recessivas associadas à periodontite. Material e Métodos: realizou-se uma pesquisa na internet usando os sites Google e PubMed com as palavras-chave: autossômica recessiva, periodontite, síndromes, periodonto e gengiva. Os critérios de inclusão foram restritos aos artigos em texto completo em língua inglesa, relatos de casos e revisões publicados em periódicos de 1966 a 2016. Resumos e artigos publicados em outras línguas não foram incluídos na revisão. Resultados: Os dados extraídos de cada estudo foram agrupados da seguinte forma: as síndromes associadas a características sistêmicas, aos achados dentários e aos achados periodontais, apresentados no formato de tabelas. Conclusões: Diversas síndromes autossômicas recessivas que apresentam alterações dentárias também podem apresentar alterações no periodonto, ressaltando assim, o fato de que o exame periodontal completo é importante durante a avaliação médica de pacientes com síndromes (AU)

Diagnosis of herpes simplex virus-1 keratitis: comparison of Giemsa stain, immunofluorescence assay and polymerase chain reaction.

PURPOSE: To evaluate three different diagnostic tests against the gold standard of viral isolation, in the diagnosis of HSV-1 keratitis. METHODS: Corneal scrapings from 170 patients with clinically suspected HSV keratitis were tested by; 1) Giemsa staining procedure for the presence of multinucleated giant cells and lymphocytes, 2) immunofluorescence assay for HSV-1 antigen, 3) polymerase chain reaction (PCR) for HSV-1 DNA and 4) virus isolation by shell vial culture in SIRC (Rabbit corneal epithelial cell line). The results of the former three tests were compared among 14 cases that were culture positive and 156 cases that were culture negative for HSV-1. RESULTS: The sensitivity of PCR was 100%, while IFA and Giemsa had sensitivities of 85.7% and 57.1% respectively. The specificity of PCR, IFA and Giemsa were found to be 67.9%, 85.3% and 85.9% respectively. CONCLUSIONS: In the present study, a combination of PCR and immunofluorescence assay appears to be the most suitable choice of tests for diagnosis of HSV-1 keratitis, while detection of MNGC by Giemsa staining procedure may give us a presumptive diagnosis of suspected viral infection.

Comparison of an immortalized human corneal epithelial cell line with Vero cells in the isolation of Herpes simplex virus-1 for the laboratory diagnosis of Herpes simplex keratitis.

BACKGROUND: Herpes simplex keratitis (HSK) is a sight threatening ocular infection often requiring a specific and prompt laboratory diagnosis. Isolation of Herpes simplex virus (HSV-1) in culture provides the most reliable and specific method and is considered as the "Gold Standard" in the laboratory diagnosis of HSK in spite of its low sensitivity. Using "cell lines of corneal origin" for virus isolation may be beneficial under such circumstances, since these cells have been shown to be excellent substrates for the growth of HSV-1 isolated from the cornea. We report a comparative study of a novel human corneal epithelial cell line (HCE) and the Vero cell line in the isolation of HSV-1 from corneal scrapings employing a shell vial assay. METHODS: Corneal scrapings were obtained from 17 patients with a clinical diagnosis of HSK. All the cases were confirmed by virological investigations (PCR and viral antigen detection positive, n = 15, PCR positive, n = 1, Viral antigen positive, n = 1). Scrapings obtained from 10 patients with infectious keratitis of non-viral origin were included as controls. All the scrapings were simultaneously inoculated into shell vials of HCE and Vero cells. Cultures were terminated at 24 h post-infection. Isolation of HSV-1 was confirmed using an indirect immunofluorescence/ immunoperoxidase assay. RESULTS: Virus could be isolated using both or either of the cell lines in 10/17 (58.82%) patients with HSK. HSV-1 was isolated from 10/17 (58.82%) and 4/17(23.52%) specimens in HCE and Vero cells, respectively (P = 0.036). None of the controls yielded HSV-1. While all the 10 (100%) strains were isolated in HCE, Vero yielded only 4/10 (40%) strains in the shell vial culture (P = 0.014). CONCLUSIONS: HCE showed a statistically significant difference in the virus isolation rate with respect to Vero cells. HCE may be an excellent alternative cell line for the isolation of HSV-1, especially from corneal scrapings, for the laboratory diagnosis of HSK.