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Anaphylactic shock management in dental clinics: An overview
Ronak S. Nanavati, Malay Kumar, Tapan G. Modi, Hemant Kale
January-December 2013, 5(1):36-39
Anaphylaxis is among the emergency clinical events specifi cally related to local anaesthesia, leading to morbidity and mortality. Hence, our aim is to update knowledge of dental professionals about management of this entity with appropriate emergency management, by giving proper pharmacotherapy to prevent further auto immune reaction thus, saving their lives.
  23,126 1,583 -
Principles of occlusion in implant dentistry
Mahesh Verma, Aditi Nanda, Abhinav Sood
December 2015, 7(3):27-33
Dental implants require different biomechanical considerations from natural teeth. Also, with one of the criteria for long-term implant success being “occlusion,” it becomes imperative for the clinician to be well versed with the different concepts when rehabilitating with an implant prosthesis. All endeavors must be made to reduce the overload and noxious forces on implants during mandibular movements. The occlusal rehabilitation schemes for implant-supported prostheses are derivatives of the occlusal scheme for natural dentition. The implant-protected occlusion (IPO) scheme has been designed to ensure the longevity of both prosthesis and implant. The article reviews the concepts of IPO and their applicability in different clinical scenarios.
  13,842 2,304 -
Aggressive periodontitis: A review
Vaibhavi Joshipura, Umesh Yadalam, Bhavya Brahmavar
January-June 2015, 7(1):11-17
The purpose of this review is to highlight the current etiological and therapeutic concepts of aggressive periodontitis which is rapidly progressing and aggressive in nature. It leads to destruction of periodontal tissues and loss of teeth. We need advanced diagnostic techniques to learn about current disease activity and rate of progression. We also require strategies to keep the disease under control with proper maintenance regime and prevent tooth loss, because it can result into complicated prosthetic rehabilitation in a very young patient. The evidence suggests that aggressive periodontitis is influenced by microbiological, genetic, and host factors. This paper reviews clinical, microbiological, immunological, and genetic aspects of pathogenesis of aggressive periodontitis, as well as diagnostic criteria of the disease and appropriate nonsurgical and surgical treatment options.
  13,616 2,273 3
A novel tissue engineering technique for regeneration of lost interdental papillary height
Rutuj Surana, Vaishali Ashtaputre, Satish Doiphode, Kiran Kharat, Purshottam Rakhewar, Maya Mhaske
May-August 2010, 2(2):86-91
Open interdental spaces caused by papillary gingival recession are one of the most common problems faced in dentistry. Surgical and nonsurgical periodontal treatments for regeneration of lost papillary height have been reported with limited success. The present study reports effectiveness of autologous cultured fibroblast injections, a tissue engineering technique for papillary regeneration. A black triangle caused by Tarnow's and Nordland's class I papillary gingival loss was reported in maxillary anterior region of a young male patient. An autologous gingival biopsy was cultured in a biotechnology lab for the growth and expansion of fibroblasts. Cultured fibroblast suspension was injected into the receded papilla twice at an interval of 5 days. Follow-ups were recorded on the 6th day, 15 th day, at 1 month and at 2 months. Complete fill of black triangle was noted at the end of 2 months. No inflammatory or immune reactions were noted at the site of injection. Autologous cultured fibroblast injections are safe, efficacious, and an acceptable treatment option for the regeneration of lost papillary height.
  10,559 814 -
Histopathologic bodies: An insight
Meena Kulkarni, Tripti Agrawal, Varsha Dhas
January-April 2011, 3(1):43-47
The histopathological analysis of the tissue includes a detailed study of cellular and nuclear structures and their altered presentation in a given pathology. This is carried out by using a large spectrum of staining procedures and a variety of microscopic techniques. One of the specific and interesting features is the observation of various histopathological bodies seen in different pathologies. The presence of histopathological bodies is often an important diagnostic-aid in identifying the underlying disease. Hence, the present article is an attempt to compile different histopathological bodies seen in various diseases with special emphasis on pathogenesis, microscopic and ultramicroscopic features of the same
  9,989 1,345 2
Efficacy and safety of dexketoprofen tablet in treatment of acute dental pain in Indian patients
Pankaj Chivte
May-August 2009, 1(2):85-90
Background: Dexketoprofen is the pharmacologically active enantiomer ofracemic Ketoprofen, and is indicated for the treatment of acute pain. Objective: To record the efficacy and safety of Dexketoprofen 25 mg Tablet in treatment of acute dental pain. Material and Methods: This was an observational, prescription event monitoring study in clinical setting. Indian male or female patients between 18-65 years of age who would be undergoing oral surgery consisting of extraction of the impacted or semi-impacted third molars or have acute dental pain and willing to comply with study were included. Patients were treated with Dexketoprofen Tablet 25 mg (Infen-25) every 8 hours preferably 30 min before meal. Efficacy was analyzed by decrease in pain on VAS (Visual Analogue Scale) and investigator's overall assessment of efficacy of therapy. Adverse events, if any, were noted. Results: Data of 3318 patients were analyzed. Mean baseline pain intensity on VAS decreased from 7.74 to 7.02, 5.48, 4 22, 3.31 and 2.52 at 10, 20, 30, 45 and 60 minutes, respectively, after drug administration. Investigators' overall assessment for efficacy was good to excellent in 96.5% patients, while investigators'Dexketoprofen was very well tolerated. Conclusion: Dexketoprofen Tablet provided rapid onset of action, with good tolerability and very high patient and investigator satisfaction.
  10,246 435 -
Maxillary sinus augmentation
AB Tarun Kumar, Ullas Anand
December 2015, 7(3):81-93
Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants), which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.
  8,881 988 2
Virulence factors of Aggregatibacter actinomycetemcomitans - A status update
Rajvir Malik, Radha Changela, Prerna Krishan, Shalini Gugnani, Deepika Bali
July-December 2015, 7(2):137-145
Periodontitis is a chronic infectious inflammatory disease characterized by the destruction of tooth. The contribution of bacteria to the disease progression is poorly understood probably due to the multifactorial background of this disease. Aggregatibacter actinomycetemcomitans is part of the normal flora in many healthy individuals, but is also a major etiologic agent in some aggressive forms of periodontitis. The genetic diversity among different isolates of Aggregatibacter actinomycetemcomitans is great and its ability to express and release virulence factors varies. Aggregatibacter actinomycetemcomitans, a pathogen not only in periodontal but also in some nonoral infections, possesses several virulence determinants which contribute to its ability to colonize the oral cavity, persist in the periodontal pocket, resist and evade host defenses, cause destruction of soft and hard tooth-supporting tissues, and interfere with host tissue repair after infection. Authors conducted a comprehensive search through PubMed/Medline databases to compile the available literature till June 2014, for the purpose of detailed insight into the bacteria. The search was designed to identify appropriate articles related to virulence factors of Aggregatibacter actinomycetemcomitans, and the articles were independently screened for eligibility.
  8,795 985 1
Bleeding disorders in dental practice: A diagnostic overview
Abhirup Goswami, Amitava Bora, Gautam Kumar Kundu, Samiran Ghosh, Anupam Goswami
July-December 2014, 6(2):143-150
Dental health care workers are increasingly called upon to provide quality dental care to individuals whose bleeding and clotting mechanisms have been altered by inherited or acquired diseases. This provides an opportunity for the dentist who is trained in the recognition of oral and systemic signs of altered hemostasis to assist in the diagnosis of the underlying condition. A number of dental procedures result in the risk of bleeding that can have serious consequences, such as severe hemorrhage or possibly death, for the patient with a bleeding disorder. Oral care providers must be aware of the impact of bleeding disorders on the management of their patients. These disorders must be recognized from history, clinical examinations, and laboratory investigations, if indicated, prior to surgical procedures including those in dental surgery to prevent bleeding related complications. Safe dental care may require consultation with the patient's physician, systemic management, and dental treatment modifications. The purpose of this article is how to identify these patients with bleeding disorders.
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Clinical considerations in restorative dentistry - A narrative review
Ashwini Tumkur Shivakumar, Sowmya Halasabalu Kalgeri, Sangeeta Dhir
July-December 2015, 7(2):122-129
The relationship between periodontal health and the restoration of teeth is intimate and inseparable. Human teeth are designed in such a way that the individual tooth contributes significantly to their own support as well as collectively the teeth in the arch. Decay on the proximal surfaces occurs mainly due to the faulty interrelationship between the contact area, marginal ridge, the embrasures and the gingiva. An adequate understanding of the relationship between periodontal tissues and restorative dentistry is paramount to ensure an adequate form, function, aesthetics and comfort of the dentition. For long-term survival of restoration, both functionally and esthetically, certain biological considerations are very critical to preserve the health of the periodontium and thus must be given due importance in clinical practice. While most clinicians are aware of this important relationship, uncertainly remains regarding specific concept such as biologic width and its maintainces.
  7,550 1,136 -
Perforation repair with artificial floor technique - A microleakage study
Pradeep Chaudhari, Vasundhara Shivanna
May-August 2009, 1(2):65-75
In endodontic practice one of the most common procedural accident is furcation perforation. Many materials and techniques have been tried to repair the furcation perforation. The purpose of this study is to evaluate the effect of calcium sulfate and hydroxylapatite matrix on the sealing ability of resin modified glass ionomer cement to repair the furcation perforation. The result of the study showed that the microleakage was least when perforation was repaired with resin modified glass ionomer cement over hydroxylapatite used as an internal matrix. And it was maximum when perforation was repaired with resin modified glass ionomer cement without any internal matrix material.
  7,591 594 -
Soft tissue and esthetic considerations around implants
Joann Pauline George, Sangeeta Dhir
December 2015, 7(3):119-131
The health of the peri – implant tissues play an important in the long term outcome of dental implants. The absence of keratinized gingiva (KG) may be a risk factor for developing recession or peri –implantitis. However there is still ambiguity in the need for keratinized gingiva around dental implants. The preservation and reconstruction of soft tissue around dental implants is an integral component of dental Implantology. There is no long-term evidence whether augmented soft tissues can be maintained over time and are able to influence the peri-implant bone levels. Among the various soft tissue augmentation techniques Apically positioned flap with vestibuloplasty , Free gingival grafts and Connective tissue grafts are documented as the most predictable methods to increase the width of KG. Autogenous grafts increase the soft tissue thickness and improve aesthetics compared to non-grafted sites. The aim of this review is to critically discuss the need for KG around implants and the techniques to preserve and augment KG. It is difficult to arrive at a definitive conclusion due to scarcity of well designed studies in literature. Reliable evidence is lacking to suggest the ideal soft tissue augmentation/preservation techniques. Long term randomized controlled clinical trials are needed to provide a clearer image.
  7,073 1,094 -
Ridge augmentation in implant dentistry
Manoj Goyal, Neeti Mittal, Gopal Krishan Gupta, Mayank Singhal
December 2015, 7(3):94-112
Dimensional changes in the alveolar ridge after extraction often compromises on achieving optimal implant stability and placement of implants in the right prosthodontic positions. These situations demand augmentation of the residual ridge to achieve successful implant placement and long-term survival. Although the available literature speaks of an overabundance of techniques and agents for ridge augmentation, there is a relative paucity of quality evidence to guide the selection of suitable techniques and material. Henceforth, this paper is an endeavor to develop and describe an evidence-based decision pathway for the selection of suitable techniques for various clinical situations. Additionally, a descriptive overview of various techniques and materials is presented.
  7,151 881 -
Peripheral giant cell granuloma: A comprehensive review of an ambiguous lesion
Kaustubh P Patil, Ketki P Kalele, Vinayak D Kanakdande
July-December 2014, 6(2):118-125
Peripheral giant cell granuloma (PGCG) is a non-neoplastic, tumor-like reactive lesion occurring exclusively on gingiva/alveolar crest. It is thought to arise from the periodontal ligament or the periosteum. Clinically, it bears resemblance to pyogenic granuloma, peripheral ossifying fibroma and many other peripheral lesions seen in the oral cavity, thereby histopathology is mandatory for the diagnosis of this lesion. The lesion although being relatively common, but still carries a lot of ambiguity. The ambiguity is in terms of its etiology, growth potential, biological behavior (recurrence), histogenesis of its cells and its treatment. The entity further holds significance because of its notorious behavior and its high tendency to recur. The present paper describes recurrent PGCG with a comprehensive insight of the literature on its etiology, clinical, radiological, histological, ultrastructural and molecular aspects. Special attention is given on the histogenesis of cells and their types as also on the differential diagnosis and treatment of this lesion.
  7,135 718 2
Histological and clinical evaluation of gingival healing following gingivectomy using different treatment modalities
Ajita Meenawat, Sunil C. Verma, Vivek Govila, Vivek Srivastava, Karan Punn
January-December 2013, 5(1):31-35
Gingival enlargement is a commonly encountered problem in clinical practice. The treatment of choice is gingivectomy. The wound healing takes place by secondary intention and is associated with significant patient morbidity during the healing period. Newer techniques like the use of laser can be employed to enhance patient comfort during procedure and better healing of the gingivectomy sites. Laser use is beneficial as it requires minimal anaesthesia, lesser surgical time and good post-operative healing.
  7,055 723 -
What after MDS?
Vijay Deshmukh
January-June 2014, 6(1):6-6
  6,699 515 -
Comparative evaluation of Subepithelial Connective Tissue Graft (SCTG) and Acellular Dermal Matrix Allograft (ADMA) in the treatment of localized gingival recession- A clinical study
AB Tarun Kumar, DS Mehta
May-August 2009, 1(2):8-16
Gingival recession is the one of the commonest clinical features of chronic periodontitis and poses a great esthetic and functional problem to the patient. Several treatment modalities have been described in the dental literature to treat the localized gingival recession. In the present study, the efficacy of subepithelial connective tissue graft (SCTG) and the acellular dermal matrix allograft (ADMA) was evaluated and compared in the treatment of localized gingival recession. Nine patients with bilateral identical Miller's class I or II were selected and randomly assigned to treatment with either SCTG or the ADMA. Six months follow-up result showed significant clinical outcome in both the treatment groups in terms of improvement in recession depth, root coverage percentage, probing depth, clinical attachment level and the width of keratinized tissue. However on comparison between the two groups, no significant difference was found in relation to any of the parameters. Hence, it can be concluded that both the techniques (SCTG & ADMA) are equally effective in the treatment of localized gingival recession and restoring the esthetic and function.
  6,808 381 -
The orthodontic periodontal interface: A narrative review
Gurkeerat Singh, Puneet Batra
July-December 2014, 6(2):77-85
The purpose of this review is to highlight the orthodontics and periodontics interface in clinical practice for optimized treatment outcomes. Orthodontic treatment aims at providing an acceptable functional and esthetic occlusion. Tooth movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, due to the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems.Esthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases, should be considered in orthodontic treatment planning. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal clinical problems are discussed along with the role of light forces and self-ligating brackets.
  6,036 830 2
Oral Pathology in Clinical Dentistry: A systematic approach
RV Subramanyam
July-December 2014, 6(2):72-76
The dental clinician frequently comes across lesions that involve the hard and soft tissues of the oral cavity. Most of these conditions do not pose a diagnostic problem for the dental surgeon. However, the clinical dentist is sometimes accosted with a lesion, the diagnosis of which is not only challenging, but influencing the choice of treatment. This review article provides a systematic and logical approach for diagnosing common lesions encountered in the dental practice.
  6,005 596 -
Bone grafting of alveolar socket and ovate seat pontic preparation for natural emergence profile for anterior bridge - A case report
Vijay Deshmukh, Kamlesh P Talesara, Amrita Kishore
September-December 2009, 1(3):13-18
Alveolar atrophy following tooth extraction remains a challenge for future prosthetic restorations. Immediate implant placement and postextraction alveolar bone grafting are two methods that are used to prevent significant postextraction bone loss. Grafting is one of the most common methods of socket preservation widely used to prevent the collapse of oral tissues following extraction so that an excellent esthetic prosthesis can be provided particularly in the anterior maxillary region. The present report describes the management of a maxillary tooth extraction socket using a socket preservation technique involving placement of an osteoconductive slowly resorbable grafting material & resorbable collagen membrane in the extraction socket also called as Bio-Col socket preservation technique followed by a provisional restoration to preserve the tissues & interdental papilla for the placement of future final ovate pontic anterior bridge to give the illusion of the tooth emerging from the gums. This technique resulted in a successful prevention of alveolar bone loss following tooth extraction & maintainence of tissue contour & density which provided a good tissue base for the fabrication of Ovate pontic giving excellent esthetic results.
  5,843 492 -
Is pulpotomy obsolete? A clinical study on the success rates of indirect pulp capping and pulpotomy in the treatment of deep dentinal caries in primary second molars
KB Vidya, Shruthi B Patil, Rajesh T Anegundi
January-June 2015, 7(1):24-29
Background and Objectives: Traditionally, there are two treatment modalities for vital primary teeth with deep carious lesion, which include indirect pulp therapy (IPT) and pulpotomy. Enormous research and review in vital pulp therapy gave rise to a question, if primary tooth pulpotomy is obsolete, and should IPT replace pulpotomy? IPT has shown higher long-term success rates than any pulpotomy procedures other than mineral trioxide aggregate (MTA). Hence, the objectives of this study were to evaluate the success rates of IPT using calcium hydroxide and MTA pulpotomy clinically and radiographically. Materials and Methods: Eighty primary second molars were selected and randomly divided into two therapeutic groups of 40 each. Group 1 were treated with IPT using calcium hydroxide paste and Group 2 were treated with conventional pulpotomy using MTA paste followed by stainless steel crown. Follow-up evaluation was done at an interval of 6 weeks, 3 months, and 6 months. Results: The follow-up evaluation revealed 100% clinical success in teeth treated with MTA pulpotomy and one radiographic failure of internal resorption detected at 3 months. There was 100% clinical and radiographic success with teeth treated with IPT. Though there was one radiographic failure with MTA pulpotomy, it was not statistically significant (P > 0.05). Conclusion: Indications being the same for both the procedures why not opt for IPT which offers several advantages over pulpotomy like fewer potential side effects, non-invasive, decreased chair time, child cooperation, and cost-effectiveness.
  5,831 479 1
The effect of 17% EDTA and MTAD on smear layer removal and on erosion of root canal dentin when used as final rinse: An in vitro SEM study
Vishal A Mahajan, Abhay I Kamra, Sonali S Dahiwale
September-December 2010, 2(3):113-118
Background: The aim of the present study was to evaluate and compare the ability of a mixture of tetracycline isomer, citric acid and detergent (MTAD) and ethylene diamine tetra-acetic acid (EDTA) in removing the smear layer along with their effects on peritubular and intertubular dentinal structures by scanning electron microscopic (SEM) examination. Materials and Methods: Thirty recently extracted maxillary and mandibular single-rooted human teeth were divided into 3 groups and prepared to an apical size of 30. In Group 1, 2, and 3, MTAD, EDTA, and distilled water were used, respectively, as a final rinse solution to remove the smear layer. The specimens were subjected to SEM evaluation for the presence or absence of the smear layer and degree of erosion using a scoring system. Results: The result showed that MTAD shows better smear layer removing ability and does not significantly change the structure of dentinal tubules. Conclusion: MTAD is an efficient solution for the removal of the smear layer, especially in the apical third of root canals, and does not significantly change the structure of the dentinal tubules.
  5,743 530 1
Porphyromonas gingivalis : Its virulence and vaccine
Nymphea Pandit, Radha Changela, Deepika Bali, Priyanka Tikoo, Shalini Gugnani
January-June 2015, 7(1):51-58
Background: The microbial florae in adult periodontitis lesions are comprised of anaerobic rods with Porphyromonas gingivalis as one of the major components (Slots 1976; Slots 1979; and Tanner et al., 1979). P. gingivalis is a black-pigmented gram-negative anaerobic rod and a secondary colonizer of dental plaque requiring antecedent organisms. The presence of this organism either alone or as a mixed infection with other bacteria and with the absence of beneficial species appears to be essential for disease activity. It is a predominant member of the subgingival microbiota in disease. It possesses and "excretes" numerous potentially toxic virulence factors. Aim of this study is to perform a systematic review of studies on P. gingivalis and its virulence factors with a special focus on its vaccine. Materials and Methods: An electronic and manual search based on agreed search phrases between the primary investigator and a secondary investigator was performed for the literature review till January 2014. The articles that were identified by this systematic review (total of 190) were analyzed in detail, which included the study of inference and conclusion. Conclusions: Within the limits of this systematic review, it can be concluded that P. gingivalis induce immune inflammatory response in periodontitis subjects. Therapeutic vaccines need to be developed and studied for their efficacy in controlling periodontitis.
  5,443 714 2
A clinical study on mobility of teeth as assessed through their damping characteristics and progress of periodontal disease using advanced diagnostic aids: Mobilometer and florida probe
Yogesh Doshi, Ameet Mani, PP Marawar, Pratishtha Mishra
January-April 2010, 2(1):12-19
Aims and Objectives: Decision regarding the option to treat tooth mobility should be based on the etiology and detected severity of tooth mobility. The most widely used method of mobility assessment is to tap the tooth between two extreme positions. The study was designed to evaluate the association of Periotest values (PTV) with the amount of bone, clinical attachment loss, and various clinical indices. The aim of the present study was to evaluate the association between bone loss and Periotest values. Also we evaluated the effects of attachment loss and tooth position on the Periotest values. Materials and Methods: A total number of 60 patients between the age group of 18 and 55 years were divided into subjects with healthy periodontium (Group A), and those with Chronic Generalized Periodontitis (Group B), having a generalized pocket probing depth of 3 - 8 mm, respectively. With the help of the Periotest, Florida probe, and radiographs the assessment was carried out. The data was statistically analyzed using the Student's unpaired t-test. Results: It was found that the values were highly significant in the incisor, premolar, and molar areas. However, the value was found to be insignificant in the canine region. The anterior teeth showed higher PTV compared to the posterior teeth; and the mandibular teeth showed higher PTV compared to the maxillary teeth. There was no association between the clinical indices and Periotest values. Conclusion: The study showed that tooth mobility was dependent on bone support as well as the clinical attachment level.
  5,388 574 1
Autogenous bone grafts in periodontal practice: A literature review
Nymphea Pandit, Inder Kumar Pandit
January-June 2016, 8(1):27-33
To improve the long-term prognosis of teeth, the treatment of periodontal diseases has evolved from resection to regeneration. Regeneration of the supporting structures of the teeth involves the use of a variety of materials of natural and synthetic origins. The ultimate aim of a true connective tissue attachment to the cementum, however, is difficult to achieve and a few of the materials have shown promising results. Autogenous bone graft obtained from the same individual has always been considered the gold standard because of its high osteogenic potential and virtually nil side effects. The present paper describes the use of autogenous grafts in the periodontal practice. The compilation of the data was done by PubMed search since the first use of the graft in periodontics.
  5,065 843 1