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May-August 2014 Volume 4 | Issue 2
Page Nos. 61-108
Online since Wednesday, October 15, 2014
Accessed 114,071 times.
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EDITORIAL |
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Prevention: The best management approach |
p. 61 |
Kundabala Mala DOI:10.4103/2229-5194.142933 |
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INVITED REVIEW |
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Patient record and communication in interdisciplinary dentistry |
p. 62 |
Surbhi Sawhney, Mala Kundabala, Neeta Shetty, Manuel Thomas DOI:10.4103/2229-5194.142934 Well-maintained records and good communication are essentials tools in modern dentistry. The right components of a dental record and appropriate communication skills by far provide a step forward in quality dental treatment. This article discusses the importance of both, good records and communication skills, in interdisciplinary dentistry and provides an overview of the components involved.
Clinical Relevance to Interdisciplinary Dentistry
- Clinical relevance to interdisciplinary dentistry- The overall management of a dental patient requires a holistic and interdisciplinary approach, involving areas such as management of records and establishing a chain of communication. The various factors and components that support the same are discussed.
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REVIEW ARTICLE |
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Short implants: A new dimension in rehabilitation of atrophic maxilla and mandible |
p. 66 |
Sanath Shetty, Naushad Puthukkat, S Vidya Bhat, K Kamalakanth Shenoy DOI:10.4103/2229-5194.142935 Insufficient alveolar bone height is a common clinical situation encountered more in the posterior jaws. Advanced surgical procedures such as bone grafting, sinus lifting, and nerve repositioning are required to overcome this condition and make implant treatment possible for such patients. Prolonged healing period, increased morbidity, and longer duration of the implant treatment accompanies these procedures. Short implants are considered as a viable alternative in patients with reduced alveolar bone height to avoid more invasive surgical procedures. They simplify the implant treatment, reduce patient morbidity, shorten the duration of treatment, and make it less expensive. In the past, when machined implants were used, rehabilitation with short implants showed increased failure rate in comparison to longer implants. With the improvements in the surface topography of implants, which increase the bone implant contact, and use of adapted surgical protocols similar survival rates as that of regular implants have been reported even with short implants. Various methods to increase the functional surface area and decrease the stress on the prosthesis have greatly contributed to the increased success rate of short implants.
Clinical Relevance to Interdisciplinary Dentistry
- Successful outcome of implant treatment depends on the coordinated efforts of various specialties
- Proper technique of implant placement by the surgeon and prior planning of the prosthesis by the prosthodontist is essential
- Maintenance and periodic evaluation of periodontal health are necessary.
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ORIGINAL ARTICLES |
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Atraumatic restorative treatment for dental caries among pregnant women attending primary health centres: A small scale demonstration |
p. 71 |
Ramya Shenoy, Animesh Jain, M Kundabala DOI:10.4103/2229-5194.142937 Background: ART consists of a simplified, low-cost technique that uses only hand instruments in the removal of carious tissues to reduce contamination and viability of microorganisms. This technique requires immediate restoration of the cavity with adhesive restorative material, namely glass ionomer. Since ART approach causes lesser anxiety than the traditional restorative procedure, it may be a very useful tool for providing dental treatment to pregnant women. Objective: The present study was carried out to assess the pregnant women's response to undergo ART in Primary Health Centre set up and clinical evaluation of restoration at 6 month interval. Methods: Pregnant women visiting Primary health centres (PHCs) for prenatal check- up were examined. Those having cavities were restored using ART after taking informed consent. These were followed up telephonically 24 hours later and examined at the end of six months. Results: Of the 308 pregnant women examined, fifty teeth of forty five subjects (83%) were restored using ART. Out of that 45 (90%) were one surface restoration and five (10%) two surface restorations. None of the subjects felt pain during the procedure, 24 hours later or at the end of six months. All the subjects were satisfied with the treatment. All one surface fillings were intact and one out of five, two-surface filling was broken which was replaced with new restoration. Conclusion: This study demonstrates that the patients were satisfied with the ART which can be undertaken at lower cost. Together with preventive and promotional activities, oral health status of pregnant women who visit PHCs can be improved.
Clinical Relevance to Interdisciplinary Dentistry
- Being based on the contemporary philosophy of minimum intervention and maximum preservation of the tooth structure, atraumatic restorative treatment (ART) has been considered a feasible treatment option for moderate to deep carious lesions and can be applied to the entire population.
- As ART approach causes lesser anxiety than the traditional restorative procedure using dental rotary instruments, it can be used among target groups like children and pregnant women to treat dental caries.
- This article is an attempt at demonstrating the effectiveness of ART in pregnant women attending primary health centres. This could be utilized for preventive care in low resource and low-cost settings
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Public knowledge and acceptance of dental implant treatment in Malaysian Population |
p. 76 |
Shivani Kohli, Shekhar Bhatia, Arvinder Kaur, Tiviya Rathakrishnan DOI:10.4103/2229-5194.142938 Aims: Due to the high success rates and predictability of dental implants, their usage in the rehabilitation of partially dentate and edentulous patients is increasing year by years. The aim of the survey was to assess the patient awareness, source of information and acceptance of dental implants as a treatment modality for replacement of missing teeth among the Malaysian population. Materials and Methods: A nationwide survey was conducted among the patients visiting various dental outpatient departments of hospital and private dental clinics using a self-explanatory questionnaire. The questionnaires were prepared in English and Malay language to enable better understanding and completion. Results: Among the 1013 response retrieved, 772 were aware of dental implant treatment. Among the 81% of the respondents who knew dental implants can be used to replace missing teeth, 19.5% opted not to receive dental implant treatment. About 81.8% of the respondents expressed that dental implant treatment was unaffordable. The cost and associated surgery was a major disadvantage and deterrent to this modality. The dentists were the main source of information regarding the dental implant treatment modality, followed by friends and electronic media. Conclusion: The survey concluded that 76.2% of the Malaysian population was aware of dental implant treatment in Malaysia, mainly from dentists. Having dental insurance would most definitely raise the willingness of respondents for receiving dental implant treatment.
Clinical Relevance to Interdisciplinary Dentistry
- The practice of implant dentistry requires an interdisciplinary approach that integrates the knowledge, skills and experience of different disciplines of dentistry comprising of prosthodontics, periodontology and oral surgery into a comprehensive treatment plan.
- Interdisciplinary therapy is the best way to consider all factors for a successful outcome and to avoid complications in implant dentistry.
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Effect of single and multiple consecutive applications of all-in-one adhesive on tensile bond strength to dentin |
p. 81 |
Aravelli Swathi, Thumu Jayaprakash, V Chandrasekhar DOI:10.4103/2229-5194.142942 Aim: The purpose of this study was to evaluate the effect of single and multiple consecutive applications of all-in-one self-etch adhesive on the tensile bond strength (TBS) to dentin. Materials and Methods: Tetric N-bond self-etch all-in-one adhesive was used in the study. Thirty extracted human mandibular molars mounted in self-cure acrylic resin and with the occlusal enamel removed were divided into three groups based on the number of applications of adhesive. Group 1: Single layer of adhesive was applied, and light-cured for 10 s; Group 2: Two layers of adhesive were applied with intermediate curing between each layer; Group 3: Four consecutive layers of adhesive were applied with intermediate curing between each layer. Resin composite build-ups were made, and TBS was estimated using a universal testing machine. Results : There was an increase in TBS when two layers of adhesive were applied compared to single and four layer applications ( P < 0.001). Conclusion: Bond strength with two consecutive applications of all-in-one self-etch adhesive was significantly higher than with a single application, but application of further coatings caused a decrease in bond strength.
Clinical Relevance To Interdisciplinary Dentistry
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- Self-etching adhesive systems are used in the various procedures in different specialties of dentistry such as for restoration of routine tooth preparations; gingival recession and cervical lesions, the root surface desensitization; core build-ups made of light-curing composite; cementation of indirect restorations.
- Self-etching adhesive systems allows practitioner to place restorations in a more simplified manner with decreased postoperative sensitivity.
- After application, these products create very thin coatings, which may be oxygen inhibited and hence poorly polymerized leading to decreased bond strength.
- Simple changes in bonding technique, such as applying two layers of all-in-one adhesives can lead to the larger increase in initial bond strength.
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Efficacy of Ledermix as a root canal medicament in symptomatic teeth: A clinical study  |
p. 85 |
M Kundabala, S Jagadish, S Ramya DOI:10.4103/2229-5194.142944 Intracanal medication is adjunct to cleaning and shaping in reducing postoperative pain and tenderness in symptomatic teeth. The present clinical study aimed to investigate the effectiveness of Ledermix paste as intracanal medicament in symptomatic teeth using the eugenol as control. Access cavity was prepared for 30 symptomatic teeth,Intracanal medicament was placed. Incidence of post access pain and tenderness were evaluated. Ledermix showed faster action than eugenol in reducing symptoms i.e.within 72 hrs.
Clinical Relevance To Interdisciplinary Dentistry
- Intracanal medicament is very important to control the infection and symptoms even after the root canal therapy for better prognosis
- With good longacting intracanal medication ,prognosis of post-endo restoration will be better and it helps in clinical success of the cases.
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CASE REPORTS |
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Pulp regeneration using nanohydroxyapatite as scaffold in an immature central incisor: A 10-month follow-up |
p. 89 |
Shanti Swarup, Arathi Rao, BS Suprabha DOI:10.4103/2229-5194.142945 Tissue engineering has emerged as the fastest new concept in endodontics especially in immature teeth. In the present case report, pulp regeneration technique was done on a nonvital immature central incisor using nanohydroxyapatite. The case was followed-up to 10 months, and the final result was a completely resolved resorption of both the root and adjacent bone and also with thickening of dentinal wall. Capping the blood clot with mineral trioxide aggregate have been recognized as the protocol for successful regeneration. However, the main concern is that the clot may tend to disintegrate thus weakening the scaffold. Nanohydroxyapatite helped to support the clot and thus prevented it from collapse. Nanohydroxyapatite also underwent almost complete dissolution by the end of 10 months.
Clinical Relevance To Interdisciplinary Dentistry
- Pulp regeneration is one of the latest techniques that have provided excellent success in an immature nonvital tooth.
- One of the reasons for failure of this technique is the disintegration and collapse of the clot that is formed.
- Scaffolds are used to support the clot and in the present technique, nanohydroxyapatite is used.
- Nanohydroxyapatite also underwent almost complete dissolution by the end of 10 months.
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Complete anterior open bite of an adult treated with prosthetic rehabilitation |
p. 93 |
Shilpa Reddy Admala, Naveen Reddy Admala, LR Surender, Swathi Aravelli DOI:10.4103/2229-5194.142947 Smile makeover is one of the most common reasons for patients seeking dental treatment. When such treatment is planned, the clinician should integrate an interdisciplinary approach to achieve acceptable dentofacial aesthetics and functional occlusion without compromising periodontal health. Every dental practitioner must have thorough understanding of the roles of the various disciplines in producing an aesthetic makeover, with the most conservative and biologically sound interdisciplinary treatment plan possible. The treatment objectives for this patient were to correct the appearance, keeping in mind that the patient wanted dentofacial improvement in a short span of time. Hence, it was planned to correct the smile by prosthetic camouflage, that is, by placing ceramic crowns. This treatment option was considered to be the best suitable for the patient because of time constraints and also the stability for orthodontic open bite correction being low and having a high tendency to relapse.
Clinical Relevance To Interdisciplinary Dentistry
- When a smile makeover is planned, the clinician should integrate an interdisciplinary approach to achieve acceptable dentofacial aesthetics and functional occlusion without compromising periodontal health.
- The dentist should skillfully integrate various disciplines to intervene with the tissues as minimally as possible and keep them biologically sound.
- In the following case, orthodontic open bite correction was the best suitable option. However as the patient wanted a significant dentofacial improvement in a short span of time, his dental health was improved with periodontal and endodontic therapy and smile correction done by a prosthodontic camouflage, that is, by decreasing the posterior teeth crown height and bringing anterior teeth into occlusion and rehabilitating it to functional occlusion.
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Prosthetic considerations for an esthetic rehabilitation: A confluence of art and science |
p. 97 |
Shobha J Rodrigues, Vidya K Shenoy, Thilak Shetty, Abhinav Sharma, Shruti Yakhmi, Sameen Dalwai DOI:10.4103/2229-5194.142948 Developments in adhesive dentistry have provided the dental profession with new restorative materials and technology to restore esthetics and function to the missing anterior dentition. This phenomenon has been both a boon and a bane to the profession. Over the counter products, media-driven treatment plans, as well as dentists eager to please, have formed a triad with little regard for the risk/benefit calculus of dental rehabilitation. Interdisciplinary treatment planning, knowledge of available restorative materials, sequencing treatment modalities, and adequate communication between the disciplines involved are a key to a successful treatment outcome when pursuing restorative rehabilitation.
Clinical Relevance To Interdisciplinary Dentistry
- This clinical report describes the challenges faced in the prosthetic rehabilitation of a partially edentulous patient to achieve a successful restoration in terms of biomechanics, function, and esthetics.
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An innovative approach in management of a tooth with perforating internal resorption |
p. 101 |
R Kaveti Hanisha, Surabhi Rairam, K Kumar, P Indeevar Reddy DOI:10.4103/2229-5194.142950 Internal resorption is a rare lesion in permanent teeth. Managing perforating internal resorption is a great challenge for dentists. This report presents a successful surgical treatment of a maxillary central incisor that had an extensive root perforation due to internal resorption utilizing mineral trioxide aggregate and glass ionomer cement as perforation repair material and fiber post to reinforce the tooth strength.
Clinical Relevance To Interdisciplinary Dentistry
- Endodontic, periodontic and prosthetic approach was done to stop resorption, for better visualization and reinforcement of tooth structure respectively.
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Necrosis of gingiva and alveolar bone caused by accidental sodium hypochlorite seepage during endodontic treatment |
p. 105 |
GS Sajjan, CD Dwarakanath, N. V. D. Nalam, Satya Kalyani Singamsetty DOI:10.4103/2229-5194.142952 Sodium hypochlorite is an effective intracanal irrigant when used judiciously with rubber dam isolation. Inadvertent contact of sodium hypochlorite may lead to severe necrosis of soft tissue. A case of gingival and alveolar bone necrosis caused by accidental leakage of sodium hypochlorite under the rubber dam during root canal preparation was reported. After initiation of root canal treatment, during the second visit patient complained of pain in the gingiva surrounding the tooth. Accidental seepage of hypochlorite into gingiva and underlying bone led to the necrosis of these tissues. The patient required surgical intervention which led to successful recovery.
Clinical Relevance To Interdisciplinary Dentistry
- Sodium hypochlorite (NaOCl), the widely used irrigant in Endodontics has many complications following it inadvertent use
- Necrosis of soft tissues and underlying alveolar bone is a rare, potential complication after NaOCl irrigation that requires an interdisciplinary approach
- Teamwork of periodontists, endodontists and prosthodontists is important for the successful management of such complications.
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