Current Issue (Volume - 4 | Issue - 1)

An evaluation of hardness of commercially available provisional restorative materials: An in vitro study

Published on: 9th January, 2020

OCLC Number/Unique Identifier: 8514677712

Statement of problem: Provisional restorations play a critical role in the success of restorative treatment so they must maintain their integrity in the oral environment throughout the diagnostic and restorative phases. Purpose: The aim of this study was to compare and evaluate the hardness of four different materials used fabrication of interim restoration. Material and methods: Ten samples with dimensions of 10mmx10mmx2mm were fabricated from four interim materials (DPI, Tempron, Protemp 4 and Transcan). Hardness of samples was measured using Fischer scope hardness tester. Result: The highest mean hardness was found in Heat polymerizing acrylic resin group. ANOVA test indicated F value to be 2201.01 which was highly significant (p < 0.001). Conclusion: Heat polymerizing resin and bisacrylics may be considered in a long term provisional fixed prosthesis.
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Trends in Teledentistry

Published on: 18th March, 2020

OCLC Number/Unique Identifier: 8567880367

Socioeconomic barriers appears to be the greatest threat to dental care apart from considering the geographic location of the population. Access to need of care becomes primary consideration and through teleconsultation it is possible to overcome these barriers. As oral cavity being gateway to entry of health problems, dental treatment becomes a pivotal in health care system. Tele medicine and Tele dentistry becomes effective in treatment of health problems, reducing the chances of late stage detection of the abnormalities. It allows us to utilize our time better and screen more patients. This article aims to provide amazing technology of Tele dentistry involving all the dental specialties to reach all the populations of the society.
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Bifid Mandibular Canals: A case report and mini review

Published on: 3rd April, 2020

OCLC Number/Unique Identifier: 8875582681

he presence of bifid mandibu¬lar canals is an unusual but not rare occurrence. The mandibular canal containing the inferior alveolar artery, vein, and nerve, originates from the mandibular foramen and terminates at mental foramen [1-4]. In radiology, mandibular canal’s appearance has been described as “a radiolucent dark ribbon between two white lines”[5]. White and Pharoah defined it as “dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone that bounds the canal” [6]. Understanding of its anatomic variations is very important due to its clinical implications in various oral and maxillofacial treatments like removal of wisdom teeth [7], mandibular implant placement [8], in bilateral sagittal split osteotomy procedures and during fixation of mandibular fractures. Presence of bifid or multiple mandibular canals forces the clinician to change the treatment plan. Ignoring this variation can cause several complications intra or postoperatively or even result in failure of treatment. For instance a bifid canal if ignored during surgical removal of third molar or dental implant placement can cause prolonged pain even after administering local anesthesia and also severe bleeding if the accessory canal is encroached [2]. Bifid mandibular canals may originate from the mandibular foramen independently or might bifurcate from a single canal during its course inside the mandible [8]. Bifid mandibular canals have been by classified by multiple authors according to anatomical location and configuration, on panoramic radiographs and computerized tomography. According to Carter and Keen [1], inferior alveolar nerve can be arranged as- Type I: single large bony canal, Type II: canal is lower down in the mandible and Type III: canal separates posteriorly into two large branches. Nortje, et al. [9] gave patterns of duplication as- Type I: duplicate canals from a single mandibular foramen which can be of same size/ lower canal smaller/ upper canal smaller. Type II: short upper canal up to the second molar areas. Type III: two canals from separate foramina, joining at molar area and Type IV: supplemental canals joining the main canals in the retromolar areas. This report describes a case of a bilateral Bifid Mandibular Canal suspected by a panoramic radiograph and confirmed by a CBCT prior to a dental treatment.
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Tooth erosion and the role of pepsin reflux

Published on: 24th April, 2020

OCLC Number/Unique Identifier: 8634381019

Objective: The purpose of the study was to evaluate if there is a link between salivary pepsin levels and tooth erosion. Also, to determine if gastroesophageal reflux disease (GERD) is responsible for much of the tooth erosion seen by dentists. Background: Pepsin is only produced within the stomach. If found within other parts of the body [for example within saliva or sputum samples], the only mechanism by which that would be possible is via the reflux of gastric contents. One of the causes of dental erosion is thought to be due to direct contact between tooth surfaces and acidic substances and digestive enzymes present in gastric refluxate. GERD is a common condition, with its prevalence seemingly trending higher in recent decades. It is reportedly a known cause of tooth erosions. From the hypothesis, there was an expectation to see patients with dental erosions to have pepsin detected [and perhaps at high levels] and to see patients without dental erosions to have no or low levels of pepsin. Method: Three saliva samples were collected [on waking and 2 post-prandial] from 50 anonymous participating patients (26 females, 24 males) from a single dental practice. Extra information was collected related to lifestyle, Reflux Symptom Index (RSI – reflux questionnaire) and tooth erosions. These samples were analyzed for the stomach enzyme pepsin using the validated medical device Peptest. Results: There was no correlation between positive pepsin levels and the presence of tooth erosion during this study. There was a statistical difference between the on waking pH vs. positive pepsin levels and post prandial pH vs. positive pepsin levels. The average pH was lower for on waking and post-prandial samples with positive pepsin, suggesting that the saliva was acidic and gastric reflux had occurred. Conversely, the average pH was higher for on waking and post-prandial samples with negative pepsin. There was no statistical difference between pH vs. tooth erosion in the on waking and post- prandial. Conclusion: Patients identified as having tooth erosion did not have higher levels of pepsin detected, suggesting that pepsin was not associated with dental erosion in these patients.
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Behaviour management during dental treatment!!!

Published on: 28th April, 2020

OCLC Number/Unique Identifier: 8878760522

Behavioral dentistry is an interdisciplinary science, which needs to be learned, practiced and reinforced in the context of clinical care and within the community oral health care system. The objective of this science is to develop in a dental practitioner an understanding of the interpersonal, intrapersonal, social forces that influence the patients’ behavior. The clinician must acquire knowledge to develop appropriate behavioral skills with an improved quality of communication and management of patients. Behavior dentistry also teaches to develop a recognition and understanding that the body and mind are not separate entities and focuses on patients’ social, emotional and physiological dental experiences. Behavior is an observable act. It is defined as any change observed in the functioning of an organism. Learning as related to behavior is a process in which experience or practice results in relatively permanent changes in an individual’s behavior. Self-perceptions of dental-facial appearance begin with aesthetic values shared within families and based generally on social norms, but that they may be strongly influenced by peer values and specific experiences of individual children, particularly those involving social responses. Theories incorporating concepts of social comparison and self-efficacy suggest that individuals evaluate themselves in comparison with others in their social environment. Children who perceive themselves to be attractive will reflect those perceptions in their behaviors and generally will receive confirming social responses. The comparison group may express an attractiveness norm that reflects negatively on the individual’s behavior. This, in turn, can affect the individual perceived sense of self-efficacy or adequacy within that group and lead to behaviors that reflect more negative beliefs about the self, thereby inviting still more negative social responses. Patient cooperation is the single most important factor every dentist must contend with. Major considerations are • Regularity in keeping appointments • Compliance in wearing removable appliances • Refraining from chewing hard and tenacious substances that are likely to distort or damage the teeth or crowns • Maintenance of oral hygiene. Laxity in following these instructions may lead not only to compromised treatment but also to slow progress of treatment, loss of chair time and frustration. What may be more interesting to the Dentist than the shaping of self-perceptions in the shaping of behavior that will ensure a successful result of treatment, that is, the patient’s adherence to prescribed routines for self-care and other regimens during Dental treatment. It is helpful in this regard to know that most patients expect improved dental-facial appearance as an outcome of treatment, but there is much more to know about factors influencing cooperation. Poor motivation can also contribute to non-compliance. The regulatory loop requires a motivational system to adjust behavior to coincide with the recommended regimen. A patient may recognize that the regimen is not being followed and yet simply not be motivated to correct the discrepancy. Poor motivation can also result from a lack of concern over the long-term health consequences of one’s behavior and/or a lack of belief in the treatment. Cognitive approaches that emphasize the personal relevance of the regimen or address misconceptions about the treatment may enhance motivation. Several approaches may be useful in treating poor compliance. Providing incentives or rewards for compliant behavior might be a useful strategy to enhance motivation. The cause of noncompliance is multifactorial and strategies to improve compliance must be tailored to fit each situation. Current Dental research focuses on a critical aspect of the feedback; specifically, the input received by the comparator that quantifies the actual amount of adherent behavior. Likewise, Patients, parents, and clinicians need a way to ascertain this information.
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Determination of calcium in the tooth structure by using flame emission spectrophotometer

Published on: 15th May, 2020

OCLC Number/Unique Identifier: 8595799073

Calcium is the most common element in the tooth’s structure. In addition, calcium is one of the elements that are effective in maintaining dental health. As a result of calcium deficiency, the tooth becomes brittle and begins to rot. Calcium deficiency usually occurs in acidic beverage consumption and during canal treatment. A study was conducted to determine the degree of calcium removal in the root canal dentin after 17% EDTA, 17% EGTA, 15% EDTAC and 1% tetracycline-HCl treatment; later with or without 2.5% NaOCl [1]. Extracted single-rooted human teeth were bisected longitudinally and the root halves (n = 100) were isolated with nail varnish, leaving the root canal exposed. The samples were immersed in the test solutions for 1 and 5 minutes, after which the amount of calcium ion (Ca2+) release into the solutions was determined by flame photometry. The calcium ions (Ca2+) present in hydroxyapatite crystals are one of the main inorganic elements of dentin [2]. It has been reported that some chemicals used for endodontic irrigation are capable of causing alterations in the chemical composition of dentin [3-6]. MethodsDetermination of calcium in the tooth’s structure is very important. Calcium determination, Flame Emission Spectrofometry and inductively coupled plasma optical emission spectrometry (ICP-OES) methods can be performed. These methods can be analyzed in a short time without interference effects. In both methods, the calcium in the tooth is stimulated and the emission intensity it emits is measured as it becomes basic. These emission intensities are directly proportional to the calcium concentration. Also, in these methods, calibration graph or standard addition method is used for calcium determination. The roots were then bisected longitudinally, and the pulp tissue was removed with a toothbrush. All root halves (n = 100) were dehydrated in a sterilizer at 120 °C until they reached a fixed weight, as verified by consistent readings using a precision scale (Sartorius, Gotingen, Germany; precision = 0.0001 g). Thereafter, the specimens were covered with two consecutive layers of nail varnish, leaving the root canal surface exposed. The samples were randomly distributed into the following treatment. Groups: Group 1: 2.5% NaOCl Group 2: 17% EDTA Group 3: 17% EGTA Group 4: 15% EDTAC Group 5: 1% Tetracycline-HCl Group 6: 17% EDTA _ 2.5% NaOCl Group 7: 17% EGTA _ 2.5% NaOCl Group 8: 15% EDTAC _ 2.5% NaOCl Group 9: 1% Tetracycline-HCl _ 2.5% NaOCl Group 10: Distilled water (negative control) In each group, the specimens were immersed in a magnetic stirrer bath containing 10 ml of test solution for 1 and 5 minutes. In groups 1 and 10, the same samples (n = 10) were used for 1- and 5-minute treatments. Calcium is measured between 10 and 1000 ppm (mg/L) with Flame emission intensity. Calcium at a lower concentration cannot be measured. Inductively coupled plasma optical emission spectrometry (ICP-OES) is a widely used method recently. ICP-OES is an advanced high-end method of flame emission spectrophotometer. In this method, the energy source required for excitation is provided by plasma and its temperature is between 4000 and 10000 ⁰C. There is a certain wavelength of light to which each element is stimulated. The wavelength of the light used for calcium is 455,531 nm. At this wavelength, a calibration graph is prepared from standard solutions of calcium. Calcium in the tooth is measured using the calibration chart. The sensitivity of this method is high. Calcium analysis in ppm (mg/L) and ppb (µg/L) concentration can be analyzed with ICP-OES. In this method, the analysis takes minutes. Therefore, it is used in routine analysis. ConclusionUsing these methods, you can easily analyze the calcium found in the structure of the tooth. Also, disinfectant like hypochlorite used during canal treatment increases the calcium release of the tooth. Therefore, the released calcium can also be analyzed using these methods. Here, each sample takes at least 5 measurements and gives the results in accordance with the scientific representation.
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Applications to reduce the amount of excess cement for cement-retained implant supported prostheses: Mini review

Published on: 12th June, 2020

OCLC Number/Unique Identifier: 8620529291

Cement-retained implant-supported restorations has been preferred by many clinicians due to its ease of production, low cost and similarity to dental supported restorations [1]. In the literature, many complications caused by residual cement, ranging from acute severe bone resorption to implant loss, have been published as a case report/ series [2-7]. In another study [8], residual cement was seen in 81% of implant cases that are clinically identified as peri- implantitis. Hence it has been indicated that a strong relationship has been determined between residual cement and development of chronic peri-implant infection [9].
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Stress evaluation of maxillary central incisor restored with different post materials: A finite element analysis

Published on: 21st July, 2020

OCLC Number/Unique Identifier: 8639114755

Introduction: With the availability of different post systems and various studies on the strength of teeth restored with posts, the controversy as to which post systems provide better stress distribution of post and longevity of tooth has not been resolved. The purpose of this study was to compare the stress distribution of three different post materials using finite element analysis. Materials and nethod: Three dimensional finite element models of central incisor, three posts with crown were constructed on computer with software. Posts of three different materials (Ni-Cr post, Glass fiber post, and Zirconia post)with zirconia crown were virtually generated and a force of 100 N was applied at an angle of 450 on the palatal surface of the crown. Von Mises stresses were evaluated on the cervical, middle and apical third of the root. Results: The maximum stresses were seen on the cervical one-third in each post material indicating that this region is more prone to fracture in tooth restored with posts. Among the three materials tested, Ni-Cr post showed maximum stress generation followed by Zirconia post and glass fiber post. The maximum stresses generated by the posts were 11.4 MPa, 10.58 MPa and 4.11 MPa respectively. Conclusion: The less rigid post material like glass fiber post can be used in an endodontically treated anterior teeth.
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A Simplified approach for fabrication of custom tray for Facial prosthesis

Published on: 4th September, 2020

OCLC Number/Unique Identifier: 8872699033

Maxillofacial defects are very common and can be due to congenital defect, trauma, infections and neoplasms of facial region. These defects can be restored using different materials and retention methods to give a life like appearance. Rehabilitation of facial defect is a very challenging task. Every good prosthesis needs a skillful hand and it all starts with making a good impression of that defect and to proceed with the same. The aim of present paper was to present a simplified approach for the fabrication of custom tray to take facial impression of the patient with maxillofacial defect.
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Stability of facial soft tissue contour and bone wall at single maxillary tooth gap in early implant placement with contour augmentation: A case report

Published on: 23rd December, 2020

OCLC Number/Unique Identifier: 8872696999

Stability of esthetic implant buccal soft and hard tissue contour using freeze-dried bone allograft in early implant placement with contour augmentation.
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