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Table of Contents
May-August 2012
Volume 2 | Issue 2
Page Nos. 67-146
Online since Tuesday, September 4, 2012
Accessed 189,235 times.
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EDITORIAL
Citius, Altius, Fortius
p. 67
Kundabala Mala
DOI
:10.4103/2229-5194.100596
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INVITED REVIEW
Occlusion: The gateway to success
p. 68
Bhuvaneswaran Mohan, Dhanasekaran Sihivahanan
DOI
:10.4103/2229-5194.100597
Success of our clinical procedures is not a single-day entity, but instead survival on a long-term basis. The clinical longevity of our work is dependent on so many factors and when we have a closer look, all these ultimately depend on the occlusal stability. The word occlusion itself creates aversion for almost all and very conviently we try to avoid the occlusal principles thinking that we have to bother about the principles only for tempeoro-mandibular joint disorder patients. In an irony, it is true that the principles of occlusion have to be applied in our day-to-day practice to be successful. This article aims to simplify the principles of occlusion so that the readers develop interest in this most rewarding subject. Also, the clinical implication of the occlusal concepts and the treatment modalities are explained to give the readers an insight into how important this subject is for our day-to-day practice.
Clinical Relevance to Interdisciplinary Dentistry
Important to understand the principles of occlusal harmony, to have a better approach to clinical examination, treatment panning. And problem solving for any restorative cases.
The failure to embrace sound occlusal principles leads to a plethora of fringe-type treatment modalities and unnecessary overtreatment.
If the signs of occlusal disease can be easily observed at the earliest stages, the progression of the damage can be intercepted.
Not respecting the dento-facial system may result in restoration, prosthesis, or periodontal treatment failures, along with relapse of orthodontic and orthognathic surgeries.
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REVIEW ARTICLES
Scope of photodynamic therapy in periodontics and other fields of dentistry
p. 78
V Shivakumar, M Shanmugam, G Sudhir, S Pavithra Priyadarshoni
DOI
:10.4103/2229-5194.100598
The advancement in science and technology in the medical field amends a path for embedding new treatment modalities to the challenges presented by the viable diseases. The increasing use of lasers in dentistry and medicine reflects the great advances in this technology during recent decades. A. The gold standard for the non surgical treatment of periodontal disease remains mechanical periodontal debridement. The mechanical periodontal treatment has to be often sustained with various anti infectious means, such as antiseptics or antibiotics. Antimicrobial agents used systemically or as a local drug delivery further suppress the periodontal pathogens, increasing the benefits of conventional mechanical therapy. The emergence of resistant microorganisms and a shift in the microflora after extended use limit the use of antimicrobials. This created the foundation for our modern use of chemotherapy and emergence of photodynamic therapy. The oral cavity is especially suitable for photodynamic antimicrobial chemotherapy (PACT) because it is relatively accessible to illumination. A search was initiated to locate original research articles, review articles, and case reports pertaining to the key words: photodynamic therapy, periodontal treatment, photosensitizer, wound healing, laser, photodentistry. Electronic database was selected and articles were retrieved from PubMed and Google This article presents an overview of photodynamic therapy as it represents a novel therapeutic approach in the management of oral biofilms.
Clinical Relevance to Interdisciplinary Dentistry
Photodynamic therapy is a non invasive treatment modality which can be used in all the major specialty treatments in the field of dentistry.
Inflammation, soft tissue and bone healing, postoperative pain, and post treatment tooth hypersensitivity can be managed in pedodontia, oral surgery, peroidontics, endodontics, and conservative dentistry.
Antimicrobial photodynamic therapy reduces bacterial contamination, especially during the surgical procedures.
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Significance and clinical relevance of biologic width to implant dentistry
p. 84
Sangeeta Dhir
DOI
:10.4103/2229-5194.100599
The concept of biologic width forms the basis for a successful peri-implant soft tissue integration around titanium implants. The purpose of this review is to evaluate the present knowledge about this important zone that forms the basis for a successful implant.
Methodology:
Electronic search of the Medline/PubMed was done using the search words and MeSH Headings including, biologic width, peri-implant soft tissue, crestal bone loss, platform switch, biologic width and dental implant, implant abutment junction. Hand search of the prosthetic,implantology, and the periodontology journals was also undertaken for the collection of the data.
Clinical Relevance to Interdisciplinary Dentistry
Implant dentistry involves an interdisciplinary treatment approach of prosthodontics, periodontics, and surgical aspects.
A profound knowledge of the biologic response and the underlying anatomical/histologic aspects of the bone and the overlying soft tissues is critical for the success of the implant.
Biologic width is a healthy self-limiting zone around implant. It acts as a mirror for the underlying health of the supporting tissues.
Violation of the biologic width generates a revoking response from the tissues, which then tries to accommodate at the stake of the crestal bone.
This review article tries to demystify the conveniently overlooked biologic zone and the affecting factors/variables responsible for the viability of this zone.
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ORIGINAL ARTICLES
Clinical evaluation of the efficacy of bioactive glass and strontium chloride for treatment of dentinal hypersensitivity
p. 92
Suryaprakash Ananthakrishna, Tumkur Naryanappa Raghu, Sunil Koshy, Naveen Kumar
DOI
:10.4103/2229-5194.100600
Objective:
Bioactive glass is a calcium sodium phosphosilicate material (24.5% CaO, 24.5% Na
2
O, 6.0% P
2
O
5
, and 45% SiO
2
) that was originally developed as an implant material to regenerate bone and recently adapted for use in oral care products (NovaMin
®
, NovaMin Technology Inc.). NovaMin reacts rapidly with saliva to release sodium, which increases the salivary pH, as well as calcium and phosphate, creating the ideal conditions for tooth remineralization. NovaMin has been shown to occlude dentinal tubules and remineralize dentin; therefore, it could be used in the treatment of dentinal hypersensitivity. Thus, the aim of this study was to compare
in vivo
the effect of NovaMin and 10% strontium chloride containing dentifrices on dentinal hypersensitivity in a 6-week clinical study.
Materials and Methods:
Forty subjects were evaluated clinically for dentinal hypersensitivity using air blast method (dental air syringe) and cold water method, along with subjective perception of pain (0-10 scale) at baseline and at 2, 4, and 6 weeks. The subjects were then randomly divided into two groups and each group was treated with one of the two test dentifrices.
Results:
There was a general decrease in dentinal hypersensitivity levels in both the groups over 6 weeks, but there was a statistically greater difference in hypersensitivity at 2, 4, and 6 weeks in the group treated with DenShield
™
(NovaMin containing dentifrice) when compared with the Senolin
®
(strontium chloride containing dentifrice) group.
Clinical Relevance to Interdisciplinary Dentistry
Dentin hypersensitivity is common problem experienced in clinical dental practice.
It can occur due to changes in the crown, which involve removal of enamel as a result of attrition, abrasion, or erosion. Alternative causes of pain include chipped or fractured teeth, cracked cusps, carious lesions, leaky restorations, and developmental grooves.
It can also occur due to exposure of root dentin as seen in gingival recession which is caused by chronic trauma from tooth brushing, acute and chronic inflammatory gingival and periodontal diseases, and acute trauma, as with periodontal surgery.
The problem of dentin hypersensitivity is of concern to the general dental practitioner, the endodontist, and the periodontist, as the treatment requires a multidisciplinary approach very often. Correction could involve desensitizing dentifrices, restoration, crowns, and root coverage.
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Evaluation of the influence of flowable liner and two different adhesive systems on the microleakage of packable composite resin
p. 98
Muliya Vidya Saraswathi, George Jacob, Nidambur Vasudev Ballal
DOI
:10.4103/2229-5194.100601
Aim:
The aim of the study was to evaluate the microleakage of a packable resin composite using two adhesive systems (self-etch and total-etch) with and without a flowable liner.
Materials and Methods:
Class II cavities were prepared on 50 human molars, with standardized dimensions. The teeth were divided into five groups. In group I, the cavities were total-etched with phosphoric acid and bonded with an Adper single bond and then restored with a packable resin composite. In group II, the cavities were total-etched, bonded with an Adper single bond and a flowable resin composite was placed as a liner and restored with a packable resin composite. In group III, self-etching adhesive was used instead of total-etch and a procedure similar to group II was performed. In group IV, a procedure similar to group III was performed, except with the placement of a flowable resin composite liner. Group V served as a control where neither adhesive nor a flowable liner was used. All the samples were placed in a dye for 24 hours and examined for leakage.
Results:
Packable resin composite, when used alone with self-etch adhesive, demonstrated minimum microleakage when compared to the total-etch system (
P = 0.30). The lining of class II cavities with a flowable resin composite, followed by packable restoration, demonstrated higher leakage values than when the packable resin composite was used alone (P
= 0.001).
Conclusion:
The use of a self-etch adhesive system was superior to the total-etch system when the cavities were restored with a combination of a flowable resin composite liner, overlaid with a packable resin composite.
Clinical Relevance to Interdisciplinary Dentistry
A flowable resin composite can be used as a liner material between dentin and a packable resin composite to reduce microleakage.
Use of a proper adhesive system is one of the key factors in reducing microleakage in packable composite resin.
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An assessment of prosthodontists' attitudes to the shortened dental arch concept
p. 104
Pradeep C Kumar, Seema George
DOI
:10.4103/2229-5194.100602
Aim:
To assess the attitudes and experiences on the Shortened Dental Arch (SDA) concept from an exclusive sample of specialist prosthodontists.
Materials and Methods:
A questionnaire containing different statements with regard to the SDA concept was designed for this study. This was prefaced by a short explanation of the SDA concept. It was sent to a random sample of 51 specialist prosthodontists.
Results:
The response rate was 64%. Most of the respondents indicated experience with the SDA concept ranging from recent to ten years. Patients' reactions on the proposal of shortening their dental arch were quite varied, from either clear objections to no objections, or, initial objections that were withdrawn on explanation. Chewing ability, appearance, and oral comfort consequent to an SDA were rated as sufficient or satisfactory by the respondents.
Conclusion:
Overall, the specialist prosthodontists had a positive attitude toward the SDA concept. However, they had reservations about the management outcome of SDA.
Clinical Relevance to Interdisciplinary Dentistry
Prosthodontists had an overall positive attitude toward the SDA concept. In patients with caries and periodontal disease confined mainly to molar regions, active shortening of the dental arch should be considered.
The SDA concept could be considered as a strategy to reduce the need for complex restorative treatment in the posterior regions of the mouth.
Periodontally healthy and intact or restored anterior and premolar regions are a prerequisite to the success of SDA concept application.
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Evaluation of intake of green tea on gingival and periodontal status: An experimental study
p. 108
Neeraj Deshpande, Anshula Deshpande, Salma Mafoud
DOI
:10.4103/2229-5194.100603
Objectives:
Green tea is a popular health drink routinely consumed by many people. In the past, various studies have demonstrated the beneficial effect of green tea extracts on periodontal diseases, but very few studies have correlated the daily dietary oral intake of green tea to the periodontal status of patients.
Materials and Methods:
This randomized, controlled, investigator-blind trial was undertaken to correlate the periodontal status with daily dietary intake of green tea. The subjects were divided into three groups using block randomization method depending on the type of therapy received, viz., scaling and root planing alone, scaling and root planing along with green tea intake, and green tea alone. The clinical parameters were recorded at baseline, 3 and 6 months.
Results:
The results of the study demonstrated the positive and statistically significant (P < 0.05) effects of oral intake of green tea on periodontal disease.
Conclusion:
This study has reaffirmed the beneficial effects of green tea on periodontal diseases for prophylactic as well as therapeutic purpose.
Clinical Relevance to Interdisciplinary Dentistry
Green tea is a popular drink with beneficial effect on oral mucosa.
It has been shown to have anti-cancer properties.
Green tea has beneficial effect on periodontal diseases as well as bone resorption.
Future studies related to green tea may provide a new direction to research in various disciplines of dentistry due to its antioxidant properties.
The present study highlights the beneficial effect of oral intake of green tea on periodontal diseases.
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CASE REPORTS
Supernumerary teeth: Review of case series
p. 113
Vijaykumar G Biradar, Surekha M Angadi
DOI
:10.4103/2229-5194.100604
Supernumerary teeth are the teeth present in addition to the normal set of teeth. They may be single, multiple, unilateral or bilateral, erupted, or unerupted and in one or both jaws and may or may not be associated with other disease or syndrome. This article reviews case series of supernumerary teeth with no associated disease or syndromes.
Clinical Relevance to Interdisciplinary Dentistry
Multidisciplinary approach is necessary to meet the treatment challenges of supernumerary teeth.
Supernumerary teeth can be managed either by removal/ endodontic/ orthodontic therapy or by maintaining them in the arch and frequent observation.
Removal of supernumerary teeth is recommended where there is compromised esthetic and functional status.
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A pragmatic combinational approach to full-mouth rehabilitation
p. 116
Mantena S Raju, Sruthima N. V. S. Gottumukkala
DOI
:10.4103/2229-5194.100605
Restoration of a partially edentulous geriatric patient's mouth with complete esthetic and functional reconstruction may present numerous problems to the dental professional. The major concerns include centric relation, esthetics, phonetics and the patient's occlusal vertical dimension. Taking this into consideration this article tries to explain in detail the step-by-step procedure in treatment planning, surgical and prosthetic aspects taken to completely rehabilitate a 65-year-old partially edentulous patient using a combination of implants, fixed and removable prosthesis. The completed treatment was successful both subjectively and objectively, with the patient reporting good results even after 2-years post-treatment.
Clinical Relevance to Interdisciplinary Dentistry
A multidisciplinary approach to provide improved esthetics, function and occlusal stability.
A combinational approach by a team of prosthodontist, periodontist and an endodontist helped in attaining diagnosis and a desirable outcome.
Restorative phase had an amalgamation of removable, fixed and implant-supported prosthesis.
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Rehabilitation of three siblings with Papillon-Lefevre syndrome
p. 122
Gouri V Anehosur, Harikishore Bhat, Ramesh K Nadiger, Venkatesh S Anehosur
DOI
:10.4103/2229-5194.100606
Papillion-Lefevre Syndrome is a rare autosomal recessive disorder characterized by severe early onset periodontopathia and palmoplantar hyperkeratosis leading to premature loss of primary and permanent dentition. PLS is caused by mutations in cathepsin C (CTSC) gene. It is transmitted with an estimated frequency of one to four per million individuals. In this case report, we present clinical and other relevant investigations of three siblings with symptoms typical of Papillion-Lefevre Syndrome. The three siblings were born of a second-degree consanguineous marriage, where the parents were first cousins. All the siblings reported with mobility, eventually leading to loss of teeth and masticatory inefficiency. All showed hyperkeratosis of palms and soles, with youngest sibling showing mild to severe form of severe generalized periodontal destruction. The elder two siblings were given dentures. The youngest sibling is undergoing periodontal therapy and has received partial dentures for missing teeth.
Clinical Relevance to Interdisciplinary Dentistry
PLS is a rare autosomal disorder which needs to be diagnosed early.
Timely intervention of periodontal therapy helps in decreasing the loss of teeth at an early stage.
This facilitates growth of jaws and eventual successful placement of implants.
Dermatological treatment and psychological counseling are also mandatory
Helps to educate the parents and family members. Needs team approach for successful outcome.
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Fabrication of custom made eye prosthesis for anophthalmic paediatric patients: 2 case reports
p. 128
Kaushal K Agrawal, Priyanka Mall, HA Alvi, Jitendra Rao, Kamleshwar Singh
DOI
:10.4103/2229-5194.100607
The loss of an eye is an emotional and psychological setback to the patient. After enucleation, evisceration or exenteration of the eye, the goal is to replace the missing tissues with an artificial prosthesis and restore the facial symmetry and normal appearance of the anophthalmic patient. In case of pediatric patients, the team approach of the ophthalmologist, the maxillofacial prosthodontist and pedodontist are required to rehabilitate the ocular defect, that improves not only the patient's comfort and cosmesis as well as maintain the near symmetrical bony orbital wall and eyelid development. This article illustrates two different cases of pediatric patients where the eye was surgically removed and ocular prosthesis was fabricated.
Clinical Relevance to Interdisciplinary Dentistry
A few case reports are mentioned in literature for prosthetic rehabilitation of anophthalmic pediatric patients. The presented case reports stressed the use of custom made eye prosthesis than prefabricated one for pediatric patients. As patient grows, the size of eye socket changes, hence periodic enlargement of the prosthesis is necessary for a growing child to aid in the normal development of the lids and the soft tissue lining the orbital bone. The custom made prosthesis can be adjusted whether needed at recall visits.
The presented technique is simple and less time consuming.
This technique is least depended upon artistic ability of dentist.
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SHORT COMMUNICATIONS
Guided surgery for a simple and predictable implant placement
p. 132
Venkateswara Allu Reddy, Vahini Reddy, Chaitanya Kumar Reddy Gade
DOI
:10.4103/2229-5194.100608
The dental implant procedure has a long and proven track record to be one of the most predictable in terms of treatment outcome. This procedure has integrated itself as a part of routine treatment plans in dental offices because of increasing popularity and patient acceptance. In order to uphold this success, optimum diagnosis and treatment planning is crucial. Hence, computerized tomography aided imaging and template-guided surgery plays an important role in pre-placement planning and helps ensure positive outcomes. This article describes the benefits of computer-guided surgery as compared with conventional implant placement procedures, along with a case report.
Clinical Relevance to Interdisciplinary Dentistry
Implant therapy requires a multidisciplinary approach.
The prosthodontist needs to plan the situation with the end prosthesis in mind.
The periodontist needs to preserve the already compromised bone.
The surgeon needs to navigate the implant into critical areas.
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Public-private partnership to enhance oral health in India
p. 135
Sangeeta Chavan, Umesh Kemparaj, Om N Baghele, Arpita Rajdha
DOI
:10.4103/2229-5194.100609
In spite of great achievements in oral health globally, problems still remain in many communities all over the world, particularly among developing countries. The distribution and severity of oral diseases vary within the same country or region. In India, though health care is provided individually through public and private sectors, till now the oral health has not reached its summit. One of the strategies to improve oral health is through encouraging public-private partnership (P3). P3 can play a pivotal role with each sector contributing significantly to improve oral health outcomes. One of the major advantages of encouraging P3 is that when public and private sectors come together, they overcome each other's weaknesses and work like a potent bullet to slay oral problems.
Clinical Relevance to Interdisciplinary Dentistry
The prevention, early detection, and management of diseases of the dental, oral, and craniofacial tissues can be integrated with health care.
To promote oral health, improve the quality of life, and eliminate oral health disparities.
To increase the understanding of how the signs and symptoms of oral infections can indicate general health status and act as a marker for other diseases.
To enhance oral health literacy and boost knowledge of the value of regular, professional oral health care.
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A pre-prosthetic soft tissue augmentation using a simplified technique
p. 138
Tanya Jadhav, Jothi Varghese, Jyoti Hassija, GS Bhat, KM Bhat
DOI
:10.4103/2229-5194.100610
Despite the increased demands for single tooth implants, many patients still opt for fixed partial dentures to close the edentulous spaces
.
Prior to the replacement of missing teeth, aesthetic and physiologic corrections of edentulous areas are critical pre-requisites. This case describes a simple method to enhance a localized buccal ridge defect and create an emergence profile in relation to the maxillary right premolar region, prior to the construction of a fixed partial denture. This technique involved using a connective tissue and platelet rich fibrin membrane for soft tissue augmentation, so as to obtain a natural form and maintain a healthy periodontium.
Clinical Relevance to Interdisciplinary Dentistry
Role of pre-prosthetic periodontal surgery to achieve improved aesthetics.
Use of Connective tissue graft and PRF for a more predictable outcome. This simple technique enabled the simultaneous preparation and augmentation of the ridge.
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An innovative approach for treating vertically fractured mandibular molar - hemisection with socket preservation
p. 141
Vineet S Agrawal, Sonali Kapoor, Nimisha C Shah
DOI
:10.4103/2229-5194.100611
Vertical root fracture has been described as longitudinally oriented fracture of the root extending from the root canal to the periodontium. The most predictable treatment option for vertical root fractures would be extraction in case of anterior teeth, and hemisection or root amputation of the involved root in the multi-rooted teeth. Following extraction, socket preservation procedure helps to retain the available bone and soft tissue for better function and aesthetics. This case report describes the treatment of a vertically fractured mandibular molar by hemisection with socket preservation surgery followed by restoration with a fixed prosthesis.
Clinical Relevance to Interdisciplinary Dentistry
Combined periodontics, endodontics, prosthetic and restorative innovative approach for management of vertically fractured teeth.
Interdisciplinary approach combining surgical technique with endodontic and prosthetic rehabilitation.
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LETTERS TO EDITOR
Periodontal considerations determining the design and location of margins in restorative dentistry
p. 144
Vijendra P Singh
DOI
:10.4103/2229-5194.100612
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Labial-cervical vertical groove
p. 145
Joseph Thomas
DOI
:10.4103/2229-5194.100613
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Acetal resin as an esthetic clasp material
p. 145
E Prashanti
DOI
:10.4103/2229-5194.100614
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© Journal of Interdisciplinary Dentistry | Published by Wolters Kluwer -
Medknow
Online since 1
st
February, 2010