Flapless implant placement: a case report.

Full-thickness periosteal flap elevation for implant placement is often accompanied by potential marginal bone loss and/or soft tissue recession around the implant due to compromised blood supply to underlying bone. To preserve the blood supply to underlying bone, implants can be placed with a flapless surgical procedure. This procedure also provides numerous other benefits, such as decreased trauma, short recovery time, less pain, reduced rate of infection, and improved patient compliance. This report presents a case of flapless implant placement in the mandibular posterior region that achieved optimum results and caused minimal discomfort to the patient. The advantages and limitations of this procedure are also discussed.

Narrow ridge management with ridge splitting with piezotome for implant placement: report of 2 cases.

Narrow dentoalveolar ridges remain a serious challenge for the successful placement of endosseous implants. Several techniques for this procedure may be considered, such as guided bone regeneration, bone block grafting, and ridge splitting for bone expansion. The ridge split procedure provides a quicker method wherein an atrophic ridge can be predictably expanded and grafted with bone allograft or allograft, eliminating the need for second surgical site. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. Piezosurgery is a relatively new technique for osteotomy and osteoplasty that utilizes ultrasonic vibration which allows clean cutting with precise incisions. This case series describes reports of 2 such cases in which narrow mandibular ridge splitting was carried by mean of piezotome with immediate placement of implants in the osteotomy site. Five months later, the implants were uncovered followed by impression and restored with impant- supported porcelain-fused-to-metal crowns.

A comparative evaluation of wear of enamel caused by ceramics with different fusion temperatures.

Dental ceramics are the most used esthetic fixed Prosthodontic restorative material today. However, dentists remain suspicious about their potential abrasivity. Lower-fusing ceramic materials developed, are claimed to be wear friendly. This study was conducted to compare the wear of enamel of extracted teeth against one conventionally used ceramic VMK-95 (fusing temperature 930 °C) and two new lower-fusing ceramics-Omega 900 and Finesse with fusing temperatures 900 and 760 °C respectively, used for metal-ceramic restorations. Metal disks were prepared from ceramic alloy and divided into three groups of 10 disks each on which VMK-95, Omega 900 and Finesse ceramics were applied respectively. Ceramic disks and tooth specimen were mounted on custom-made wear simulator and subjected to predefined masticatory test. Each tooth specimen was profiled by laser triangulation sensor before and after masticatory test. Difference in height was calculated. The results showed that mean loss of height of tooth was least against Finesse (0.3431 + 0.0177 mm) followed by Omega 900 (0.4076 + 0.0135 mm) and VMK-95 (0.6177 + 0.014 mm). Statistical analysis revealed statistically significant difference between VMK-95 & Omega 900 and VMK-95 & Finesse. The difference in loss of height of tooth against Finesse & Omega 900 is statistically insignificant (P < 0.001). The results of this study indicate that lower-fusing dental ceramics cause less wear of opposing enamel.

Rehabilitation after surgical treatment for retinoblastoma: ocular prosthesis for a 6-month-old child.

Maxillofacial prosthetic (MFP) rehabilitation can be especially challenging in a young, precooperative, or behaviorally compromised child presenting with an enucleated eye. Retinoblastoma is the most common intraocular malignancy in childhood and is one of the most common pediatric cancers. Treatment consists of enucleation (or removal of the entire globe) followed by placement of orbital implants. Unrestored anopthalmic sockets exhibit growth retardation and can lead to facial disfigurement. This report describes the challenges faced during rehabilitation of a 6-month-old girl with an anophthalmic socket due to enucleation for retinoblastoma. The objective of the MFP team was to provide a custom-built, acrylic ocular prosthesis in as comfortable and atraumatic manner as possible. The case was a success and underscores the value of a multidisciplinary dental approach for the treatment of children with very special needs.

Design-computer-aided manufacturing guided implant-supported prosthesis in a fibular graft reconstructed mandible: A 7-year follow-up of a case.

Reconstruction of functional occlusion in case of a large surgical defect of the mandible involving partial mandibulectomy remains a significant challenge to the maxillofacial surgeon and prosthodontist. Removable appliances and the conventional implant-supported prosthesis are precluded in this case due to the absence of normal anatomical contours of the bone. In recent years, due to the advancement of technology, bone graft reconstruction with computer-guided rehabilitation of the functional occlusion has been advocated to reverse the debilitating effects of the hemimandibulectomy defect. This clinical report describes the prosthodontic management of fibular graft reconstructed mandible by computer-aided design-computer-aided manufacturing guided implant-supported prosthesis.

Elongated styloid process: an unusual cause of neck pain and difficulty in swallowing.

An elongated styloid process is an unusual source of craniofacial and cervical pain. This condition is characterized by a dull, nagging pharyngeal pain and a palpatory finding in the tonsillar fossa. Eagle described it for the first time in 1937 as Eagle's Syndrome and divided it into two subtypes: the "classic syndrome" and the "stylo-carotid syndrome." The syndrome generally follows tonsillectomy or trauma. Diagnosis is confirmed by radiological findings. Palpation of the styloid process in the tonsillar fossa and infiltration with anesthetic are also used for making a diagnosis. This article presents a case report of a patient with a history of throat pain that was relieved after surgical treatment.

Effect of Ti: Sapphire and Nd: YAG Lasers on Shear Bond Strength at the Zirconia - Veneering Ceramic Juncture.

Introduction: This study was conducted to assess the impact of nanosecond and femtosecond lasers on shear bond strength at the zirconia - veneering ceramic juncture. Materials and Methods: The first 60 samples of partially sintered zirconia cylindrical discs measuring 7 mm diameter and 4 mm height were milled and sintered. Then they were randomly divided into three groups namely group C (control, n=10), group N (Nd: YAG laser, n=10), and group T (Ti: sapphire laser n=40) which was further divided based on the duration of laser irradiation, into 4 subgroups (n=10 each) which were 30 seconds, 1 minute, 2 minutes and 3 minutes. Surface treatment was done on sintered zirconia discs based on the group. Following the treatment, the discs were ultrasonically cleaned followed by liner application (IPS Emax Zirliner, Ivoclar-Vivadent) and veneer ceramic layering (IPS e.max Ceram, Ivoclar-Vivadent) of 1.5 mm height. Each sample underwent shear stress in the universal test machine on the mounting jig, and bond strength was evaluated. Data were assessed using ANOVA followed by Tukey's post hoc multiple comparison analyses. Results: According to one-way ANOVA, there was a significant difference in shear bond strength between the groups. Tukey's post hoc pair wise comparison test showed a significant difference (P value = 0.001) in shear bond strength of all pairs except group C and group N. The results of repeated measures, ANOVA (related and dependent groups) and Tukey's multiple pair wise comparison test showed that there was a significant difference (P value = 0.001) in shear bond strength at 30 seconds and all other groups. Conclusion: Ti: sapphire laser irradiation for 30 seconds can be used as potential surface treatment to increase shear bond strength at the zirconia-veneering ceramic juncture.

Antibiotic prescriptions in pediatric dentistry: A review.

Most commonly prescribed drugs in pediatric dentistry are "Antibiotics." Among Dentists, there is a trend toward overuse of antibiotics for nonindicated clinical conditions. This insufficient knowledge of the appropriate clinical indications for antibiotic prescriptions promotes the overuse of antibiotics and contributes to the emergence of antibiotic resistance among children. According to the various surveys done on the dental students, dentists and pediatric dentists on the antibiotic prescribing practices, overall, adherence to the professional clinical guidelines was low. There was a wide variation in dosages for all the antibiotics prescribed and for prolonged periods which were inconsistent with the recommendations. This paper reviews the current literature from the year 2000 to 2019. An electronic literature search was conducted in MEDLINE/PubMed, EBSCO host, and Google Scholar databases. The data was also collected manually from comprehensive textbooks. Some recommendations were also based on the opinion of experienced researchers and clinicians. Thus, this review aims at highlighting clinical indications, dosages, and duration of therapeutic antibiotic prescriptions for orofacial infections in the pediatric outpatients and at the same time creating an awareness, regarding the necessity of strictly adhering to the clinical guidelines for antibiotic prescriptions.

Prevalence and Severity of Temporomandibular Disorders among the Orthodontic Patients Using Fonseca's Questionnaire.

OBJECTIVE: The purpose of the study is to determine the prevalence of TMDs among the 12-18 years and 19-30 years patient age group requiring orthodontic treatment by using the Fonseca's questionnaire. MATERIAL AND METHODS: A total of 390 patients who visited the orthodontic department for treatment were asked to fill Fonseca's questionnaire. The results were analyzed for both the age groups and the percentage values were compared between males and females, different types of malocclusion and presence of TMDs. RESULTS: In the 12-18 years age group, around 18.75% of the males and 12.28% of the females were having some degree of TMJ dysfunction. In the 19-30 years age group, around 30.32% of the females were found to have some severity of TMJ dysfunction as opposed to 19.23% of males. In the 12-18 years age group, around 11% of Class I, 16% of Class II and 50% of class III patients were having some degree of temporomandibular dysfunction. In the 19-30 years age group, the results showed that around 24% of Class I and class II patients and 50% of Class III patients presented with some degree of TMD. In the 12-18 years age group around 15% and in the 19-30 years age group, around 25% of the patients presented with some degree of TMD ranging from mild, moderate to severe. CONCLUSION: The study concludes that significantly more number of females presented with TMDs as compared to males in the 19-30 years age group. As the age increases the presence of TMDs also increases because of the significant presence of TMDs in the 19-30 years age group as compared to 12-18 years age group.

Association of midline discrepancy with tempromandibular joint disorder. A systematic review.

AIM: The aim is to evaluate the association between midline discrepancies and tempromandibular disorders (TMDs). METHODS: Literature search was performed by using various search engines to include human studies in English. TMDs include a wide variety of signs and symptoms such as pain in and around TMJ, jaw muscles, clicking and locking of jaws, pain during mandibular movement and restricted mandibular movements. The etiology is multifactorial, including one or several of the following factors like severe malocclusions (increased overjet, retroclination of incisors, cross bite, CR CO discrepancies etc), stress and psychological factors, structural abnormalities as possible etiology. There are controversies concerning the association between different traits of malocclusion and TMDs. The aim of the present study was to find out any association between signs and symptoms of TMDs with midline discrepancies, which represent an important trait of malocclusion. RESULT: Of the seven studies evaluated in this systematic review for investigating the association between midline discrepancy and TMD, six had moderate grade (B) of evidence. Four studies of moderate grade evidence (B) showed a significant association between the presence of midline shift and TMDs, and the remaining studies (two) had non-significant association. Only one study had a strong grade of evidence (A) and interestingly it denies the presence of midline shift to be a causative factor for TMDs. So, it can be concluded that the results are inconclusive regarding the association of midline discrepancies with TMDs. Nonetheless, this requires concrete evidence which necessitates further long term research into this aspect.

Work-related musculoskeletal pain among dentists in Madhya Pradesh, India: prevalence, associated risk factors, and preventive measures.

Dentists are at risk for developing musculoskeletal problems. This provided the impetus for a study of prevalence, distribution, and the associated risk factors of these problems in the dentist population of Madhya Pradesh, India. The data were analyzed from 213 dentists of Madhya Pradesh, India, who fulfilled the inclusion criteria and gave their consent for this cross-sectional study. Subjects were assessed by a special questionnaire using demographic details with working conditions. Chi-square test was used for the statistical analysis of the data. Of total 213 participants, 83.10% had at least one musculoskeletal pain in the past 12 months. Low back pain was most frequent (57.75%) followed by neck pain (31.17%) and wrist pain (17.84%). The pain was significantly prevalent among the group who worked in direct vision, without assistant, in standing position or following none of the fitness regimen.

An in vitro study on effect of Delmopinol application on Candida albicans adherence on heat cured denture base acrylic resin: a thorough study.

BACKGROUND: Denture-related stomatitis is probably the most common form of oral candidiasis and its reported prevalence varies widely ranging up to 65%. In this thorough study, we evaluate the effect of Delmopinol application on Candida albicans adherence on heat cured denture base acrylic resin. MATERIALS AND METHODS: A total of 40 specimens of heat-cured acrylic resin were made, 20 specimens were contaminated before Delmopinol treatment and 20 specimens were contaminated after Delmopinol treatment. The each specimen in each tube was individually transferred to a spectrophotometer at 530 nm wavelength in order to measure the turbidity degree, through the transmittance. Aliquots of 10 µL of each tube was then collected and inoculated into agar sabouraud plates containing 500 mMol/L of sucrose, which was incubated for 24 hours at 37°C, in order to check microbial growth. RESULTS: Mean of the turbidity Degree of contamination after Delmopinol application (1440.80, colony-forming unit [CFU] [×10 6 /ml]) was significantly higher than the mean of the turbidity degree of contamination before Delmopinol application (550.85 CFU [×10 6 /ml]). CONCLUSION: Heat-cured acrylic resin shows greater reduction in adherence of Candida albicans by contamination after Delmopinol application as compared with contamination before Delmopinol application.

Speech aid prosthesis.

Velopharyngeal defects are common problem encountered in dentistry, different prosthetic designs can be used; however, the prosthesis should be comfortable and function properly. Surgical treatment is the treatment of choice, but there are few patients who are not able to receive the surgical intervention; in such cases prosthetic management is considered using speech bulb prosthesis to overcome nasal twang and nasal regurgitation.

Prevalence and distribution of selected developmental dental anomalies in an Indian population.

The purpose of this study was to determine the prevalence of developmental dental anomalies in an Indian population and to statistically analyze the distribution of these anomalies. The study was based on clinical examination, evaluation of dental casts, and panoramic radiographs of 1123 Indian subjects (572 males, 551 females), who visited the outpatient clinic at Government Dental College, Indore between November 2009 and September 2010, after obtaining their informed consent. These patients were examined for the following developmental dental anomalies: shape anomalies (microdontia, talon cusp, dens evaginatus, fusion, taurodontism), number anomalies (hypodontia, oligodontia, anodontia), structural anomalies (amelogenesis imperfecta, dentinogenesis imperfecta) and positional anomalies (ectopic eruption, rotation, impaction). The percentages of these anomalies were assessed for the whole group and compared using statistical analysis. Among the 1123 subjects, a total of 385 individuals (34.28%) presented with the selected developmental dental anomalies. The distribution by sex was 197 males (34.44%), and 188 females (34.06%). Out of the total 1123 individuals, 351 (31.26%) exhibited at least one anomaly, 28 (2.49 %) showed two anomalies and 6 (0.53%) displayed more than two anomalies. P values indicated that the dental anomalies were statistically independent of sex. On intergroup comparison, positional anomalies were significantly most prevalent (P < 0.05) in the Indian population. The most common developmental dental anomaly was rotation (10.24%), followed by ectopic eruption (7.93%). The next common group was number anomalies. The most common number anomaly was hypodontia (4.19%), which had a higher frequency than hyperdontia (2.40%). Analyzing the next prevalent group of shape anomalies, microdontia (2.58%) was found to be the most common, followed by taurodontism (2.49%), dens evaginatus (2.40%) and talon cusp (0.97%). Dentinogenesis imperfecta (0.09%) was the rarest, followed by amelogenesis imperfecta (0.27%) and fusion (0.27%).

A holistic approach to management of fractured teeth fragments: a case report.

Fracture of anterior teeth is a relatively common outcome of trauma to the teeth. If the fractured teeth fragments are recovered by the patient and brought to the dental office within reasonable time, the fragments may be reattached to the tooth structure. This article presents a case of a 20-year-old man with fractured maxillary central incisors and left maxillary lateral incisor. The fracture involved two-thirds of the crown, compromising the pulp. The procedure used was reattachment of the fractured fragment with bonding system and dual-cure composite resin cement. The techniques described in this case report for reattachment of the fractured fragments are reasonably simple, while restoring providing long-lasting esthetics, improved function, positive psychologic response with a very conservative approach.

Hypohidrotic Ectodermal Dysplasia: Prosthetic and Endodontic Management.

Individuals affected by ectodermal dysplasia syndromes have abnormalities of the glands, tooth buds, hair follicles, and nail development. Oral finding in ectodermal dysplasia patient are significant and can include multiple abnormalities of the dentition such as anodontia, hy-podontia or malformed and widely spaced peg like teeth, loss of occlusal vertical dimension, protuberant lips and lack of normal alveolar ridge development. This clinical report describes a combined surgical, pedodontic, and prosthodontic approach for the treatment of a patient with hypohidrotic ectodermal dysplasia.

Prosthetic rehabilitation of necrotic maxilla sequelae of faulty denture: report of a rare case.

Faulty complete denture can lead to deleterious effects on residual ridges. These deleterious effects are further severed if patient is systematically compromised as in Diabetes mellitus. Decreased resistance to infection, vascular changes, and altered tissue response seen in uncontrolled Diabetes when coupled with faulty denture prosthesis can even lead to gangrenous necrosis.Prosthodontic management of edentulous patient with maxillary defect is a challenging task because there is reduced denture bearing surface compromising adhesion, cohesion and peripheral seal thus affecting retention adversely; reduced support area for denture; air leakage due to poor stability; retentive deficiencies and movement of prosthesis during function. Prosthetic rehabilitation for these patients can be accomplished with minor modifications in procedures like incremental shaping technique for taking impression, modifications in jaw relation, tooth arrangement, and fabrication of hollow bulb obturator along with atraumatic and meticulous care during all the procedures.This clinical report describes a case of gangrenous necrosis of premaxilla caused due to a faulty previous prosthesis; and its prosthodontic management.