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Table of Contents
January-March 2020
Volume 11 | Issue 1
Page Nos. 1-103
Online since Monday, July 13, 2020
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EDITORIAL
Operational research – Putting ideas into practice: The research of improvement
p. 1
Girish Malleshappa Sogi
DOI
:10.4103/ccd.ccd_531_20
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REVIEW ARTICLE
Meta-analysis of risk association between interleukin-17a gene polymorphism and chronic periodontitis
p. 3
PK Sasikumar, Sheeja S Varghese, Thanga Kumaran, Sakthi Saranya Devi
DOI
:10.4103/ccd.ccd_448_19
The association of genetic polymorphisms with periodontitis has been studied extensively. The interleukin-7 (IL-17) is a group of cytokines, which comprises six different molecules (IL-17A, B, C, D, E, and F). Among this, IL-17A is the most commonly understood cytokine, and its polymorphism plays a critical role in inflammatory diseases and periodontal inflammation. The present study was aimed at pooling the data available for meta-analysis and to evaluate whether IL-17A (rs2275913) polymorphism is associated with the susceptibility of chronic periodontitis.
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ORIGINAL ARTICLES
Effect of chemical disinfection on surface detail reproduction and dimensional stability of a new vinyl polyether silicone elastomeric impression material
p. 10
Monika Khatri, Sneha S Mantri, Suryakant C Deogade, Abhilasha Bhasin, Shivkumar Mantri, Neetu Khatri, Priyanka Jain, Deepak Chauhan
DOI
:10.4103/ccd.ccd_9_19
Background:
Surface detail reproduction (SDR) and dimensional stability of elastomeric impression material play a crucial role in fixed prosthodontics.
Aim and Objectives:
The aim of this study was to compare the effect of chemical disinfection on SDR and dimensional stability of polyvinyl siloxane (PVS) and polyether (PE) with a new vinyl polyether silicone (VPES) elastomeric impression material. Materials and Methods: A stainless steel mold was made to fabricate the study specimens for nonaqueous PVS, PE, and VPES elastic dental impression materials. Single mix impression techniques with light- and heavy-body consistency of all three materials were used to prepare the test specimens. The specimens were immersed in glutaraldehyde (Cidex) 2.45% and sodium hypochlorite (Hypo) 3.0% disinfection for 15 min (T1) and 12 h (T2) immersion after which dimensional stability and SDR were recorded using stereomicroscope and digital Vernier caliper.
Statistical Analysis:
The data were analyzed using the one-way ANOVA, paired
t
-test, Kruskal–Wallis test, and Wilcoxon signed-rank test. Results: Dimensional stability at the T2 time interval showed a highly significant difference for control and glutaraldehyde groups (
P
< 0.001), whereas a statistically significant difference for Hypo group (
P
< 0.05). SDR of the three materials when compared at T1 time interval showed a statistically significant difference (
P
= 0.015). A comparison between two disinfectants at T1 time interval revealed a highly significant difference (
P
< 0.001), while at T2 interval significant difference was obtained (
P
= 0.009).
Conclusion:
VPES impressions display acceptable dimensional stability and SDR for clinical use with immersion disinfection. Although some statistically significant differences in linear dimensional stability and semidefinite programming were observed among VPES, PE, and PVS, but the clinical impact of these differences is minor considering the overall accuracy of casts which was high.
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Comparative evaluation of ion release in bonded and nonbonded stainless steel brackets with use of different mouthwashes: An
In vitro
study
p. 15
DP Shruthi, GS Patil, DR Prithviraj
DOI
:10.4103/ccd.ccd_46_19
Background:
Orthodontic treatment is a long-term procedure that involves the usage of brackets and archwires which are mainly metallic in nature. This study evaluated the levels of metal ions release from bonded and nonbonded orthodontic brackets after immersion in distilled deionized water and three different types of mouthwash.
Materials and Methods:
Eighty premolar stainless steel brackets (3M, Unitek) were divided into Group A (bonded brackets) and Group B (nonbonded brackets). Each group was further subdivided into four subgroups to analyze the release of ions from three different types of mouthwash along with the control group. All the samples were incubated at 37°C for 45 days, and immersion solutions were tested in inductively coupled plasma-optical emission spectrometer for the release of free metal ions.
Results:
Mean ion release in the bonded bracket group was less than that of nonbonded bracket group. Ion release in control subgroup of both groups was 0.18 ± 0.08 μg/dl (A1) and 0.17 ± 0.06 μg/dl (B1); in Phos-Flur mouthwash subgroup was 0.12 ± 0.06 μg/dl (A2) and 0.13 ± 0.05 μg/dl (B2); in chlohex mouthwash subgroup was 0.13 ± 0.06 μg/dl (A3) and 0.14 ± 0.06 μg/dl (B3); in Hiora mouthwash subgroup was 0.10 ± 0.06 μg/dl (A4) and 0.12 ± 0.05 μg/dl (B4).
Conclusions:
The mean ion release was the highest in deionized water (control group) followed by chlohex, Phos-Flur, and Hiora in both Group A and Group B. Ion leaching from bonded brackets was less compared to nonbonded brackets in all different mouthwashes except in the control group. However, this difference was statistically insignificant (
P
> 0.05) between all the groups.
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Imaging characteristic of 11 lesions of odontogenic keratocyst in the indian subpopulation: A cone-beam computed tomography experience
p. 20
Shilpa Padar Shastry, Padma Pandeshwar, S Padmashree, N Naveen Kumar, Swati Garg, CJ Sanjay
DOI
:10.4103/ccd.ccd_140_19
Background:
The clinical feature and radiographic appearance of orthokeratinized odontogenic keratocyst (OKC) are not characteristic, which may lead to the misdiagnosis. The radiographic appearance of OKC may range from a small unilocular radiolucency to a large multilocular radiolucency, resembling other odontogenic cysts and tumors.
Aim:
The aim was to illustrate the characteristic feature of OKC presented on the digital panoramic radiograph and cone-beam computed tomography (CBCT), which may provide great value for the differential diagnosis and the treatment planning and also to compare the various radiographic features of OKC in CBCT and digital panoramic radiograph.
Materials and Methods:
Digital panoramic and CBCT records of seven cases, with 11 lesions of OKC were analyzed retrospectively from the patients' database from our institute (2014 to 2016), which was histopathologically diagnosed as OKC.
Results:
The mean age of the patients was 24.1 years, and the female-to-male ratio was 3: 4. Six of 11 lesions were localized within the mandible, and five lesions were in the maxilla.
Conclusion:
The presurgical assessment with radiological information is extremely important for treatment planning, and CBCT provides us with an accurate and faster three-dimensional representation of a lesion at a lower dose and cost, but the role of panoramic radiograph cannot be refuted.
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Comparative evaluation of the amount of gingival displacement using three recent gingival retraction systems –
In vivo
study
p. 28
Siddique Mohammed Qureshi, Nayana Shriram Anasane, Dilip Kakade
DOI
:10.4103/ccd.ccd_311_19
Background:
Gingival retraction cord is the most commonly used gingival displacement material; however, it causes discomfort and produces damage to the periodontium. Various new gingival retraction materials have been introduced to overcome these problems. This
in vivo
study was conducted to compare the efficacy of three recent gingival displacement materials in achieving gingival tissue displacement.
Materials and Methods:
A total of 10 subjects was selected and 40 samples were made for the study. Samples were divided into four groups depending on the materials used for gingival displacement. The schedule for gingival displacement and impression making followed Latin block design. On day 1, baseline impression was made without gingival displacement. On day 2, day 22, and day 42 impressions were made after gingival displacement on intact maxillary right central incisor with any one of the three agents. The amount of gingival displacement was then measured as a distance from the tooth to the crest of the gingiva in a horizontal plane using stereomicroscope.
Results:
Statistical analysis was performed using one-way ANOVA test. The amount of gingival displacement obtained by all the experimental groups was more than the control group (
P
< 0.01). Among the experimental groups, astringent gingival retraction paste showed the highest value for gingival displacement (0.50 mm) followed by the stay-put retraction cord (0.48 mm), whereas expasyl (0.34 mm) showed the least value.
Conclusion:
Within the limitations of this
in vivo
study, astringent gingival retraction paste showed the highest value for gingival displacement followed by stay-put retraction cord whereas, expasyl showed the least value.
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The assessment of golden proportion in primary dentition
p. 34
Deepika Mamidi, Aron Arun Kumar Vasa, Suzan Sahana, Vasanthi Done, Siragam Pavanilakshmi
DOI
:10.4103/ccd.ccd_320_18
Background:
Golden proportion is a constant ratio that exists in nature, responsible for the esthetic appeal of parts in the human body. The study was aimed to assess the existence of golden proportion in primary dentition by evaluating the average width and height ratio of maxillary anterior teeth.
Materials and Methods:
A total of 200 children comprising equal number of males and females aged 3–7 years with all deciduous teeth present were randomly selected. Each participant was photographed with head upright and occlusal plane parallel to floor. Distance between the participant and camera was fixed at a working distance of 60 cm. The digital images were analyzed using imaging software (Adobe V7), the perceived widths of maxillary laterals were divided by widths of central incisor and that of canines were divided by perceived widths of lateral incisor. Maxillary arch impressions were made and casts prepared. Measurement of each anterior tooth was done using digital calipers. The measured width of lateral incisor was divided by width of central incisor and that of canine was divided by measured width of lateral incisor. Perceived and measured widths were tabulated separately.
Results:
The mean measured lateral incisor-to-central incisor ratio was 0.80. The mean measured canine-to-lateral incisor ratio was 1.32. The mean perceived lateral incisor-to-central incisor ratio was 0.75. The mean perceived canine-to-lateral incisor ratio was 0.90. The mean measured width-to-height ratio of central incisors was 1.14. The mean perceived width-to-height of central incisors ratio was 1.08. No significant statistical difference was observed between measured widths, perceived widths, measured width-to-height ratio, and perceived width-to-height ratios for both the sexes. There was strong correlation between these ratios and golden ratio (0.62).
Conclusion:
The study revealed that the golden proportion was inconsistent in terms of relative tooth width in primary dentition.
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Incidence and distribution of jaw pathologies among 0–15 years age group at a tertiary rural health-care center of Maharashtra: A retrospective study of 10 years
p. 39
Parul Tandon, Seemit Shah, Anuj Dadhich, Harish Saluja, Himanshu Chauhan
DOI
:10.4103/ccd.ccd_328_18
Objective:
This study was undertaken to investigate the prevalence of intraosseous jaw lesions among pediatrics (0–15 years of age) in a rural health-care center of Maharashtra and to determine the most common types of lesions and their distribution according to gender and anatomical site involved.
Study Design:
Histopathological data were collected from a database of lesions classified as intraosseous jaw lesions dated between January 1, 2005, and December 31, 2015, from the archives of the Department of Oral and Maxillofacial Surgery, Rural Dental College, Maharashtra, India. All the cases of jaw cysts and tumors among children under 16 years of age group were segregated and scrutinized further under the headings of type of pathologies, anatomical locations where they are most commonly seen, and the age/gender most pertinent to these pathologies.
Results:
The present study revealed that 114/3896 jaw lesions were pediatric jaw pathologies, of which odontogenic cysts were 67/114 and jaw tumors were 47/114. Among the cysts, 70% were developmental cysts and 30% were inflammatory cysts. The majority (71.6%) of the jaw cysts were found in the mixed dentition phase (7–15 years). Among the jaw tumors, 55% of them were categorized under odontogenic tumors and 45% were under fibro-osseous lesions. Similar to intraosseous jaw cysts, tumors of jaws were more prevalent under the age of mixed dentition, which was found to be 87%. Male predominance was seen and the overall male:female ratio was calculated as 1:0.52 and 1:0.5 for cysts and tumors, respectively. Mandibular posterior segment was found to be the most commonly encountered anatomical site in both the groups of cases.
Conclusion:
A large number of cases were recorded, which led us to a path of interrogation through which the reason for increased incidence was extracted, and it was agreed that though the pathogenesis remains the same in every individual, routine health checkups and early diagnosis may reduce the incidence and aggressiveness of pathologies, respectively, which was lacking at the rural area.
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Effect of adhesion boosters on the shear bond strength of new brackets bonded to a debonded tooth surface – An
In vitro
study
p. 46
Vidya Madaparambil, Vincy Antony, Vineeth Menon, Mohamed Nayaz, Gazanafer Roshan Mohamed Jasim
DOI
:10.4103/ccd.ccd_461_19
Context:
Effect of adhesion boosters on shear bond strength of orthodontic brackets.
Aim:
The aim is to evaluate the shear bond strength and adhesive remnant index (ARI) score of new brackets bonded to a debonded tooth surface with and without the use of adhesion boosters.
Settings and Designs:
In vitro
comparative study.
Materials and Methods:
Adhesion boosters: Enhance LC (Reliance, Itasca III) All Bond 2 (Bisco, Schaumsburg) and the Composite adhesives Transbond XT (3M UNITEK) Enlight (ORMCO) were used in this study. One hundred and eight extracted maxillary first premolar teeth were bonded with light cure composite to etched tooth surface. The brackets were then debonded with debonding pliers after 1 week and it was polished with low speed tungston carbide bur and rubber cup. The teeth were divided into six groups and they were etched, washed, and dried again. New brackets were rebonded to the tooth surface using composites with or without adhesion boosters. Then, the shear bond strength value was calculated for each bracket with a universal testing machine. ARI scores were also evaluated.
Statistical Analysis Used:
One-way ANOVA and least significant difference
post hoc
test was used for the association between variables. Probability value (
P
< 0.05) was considered statistically significant.
Results:
The results showed a statistically significant difference between the groups with a
P
< 0.001. There was no significant difference in ARI scores between the groups (
P
= 0.15).
Conclusions:
Both the adhesion boosters significantly improved the shear bond strength of orthodontic brackets. There was no statistically significant difference in the ARI scores.
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An
in vitro
Comparative evaluation of the sealing ability of five different root-end filling materials under confocal laser microscopy
p. 51
Fatinder Jeet Singh, Lovejeet Ahuja, Gurpreet Kakkar, Ashish Kakkar, Abhinav Garg, Akshita Mahajan
DOI
:10.4103/ccd.ccd_662_18
Aim:
The purpose of this
in-vitro
study was to compare and evaluate the best sealing ability of five different root end filling materials i.e. Silver Amalgam, RMGIC, Cermet Cement, MTA Angelus and Biodentine using ConFocal Laser Scanning Microscope.
Methods and Material:
90 extracted caries free, maxillary incisor teeth were collected and were root canal treated using standardized technique. Apical root resections followed by retrograde cavity preparation were done with ultrasonic retrotip. The teeth were divided into six groups depending upon different root end filling materials (Amalgam, RMGIC, Cermet cement, MTA, Biodentine) and one control group and apical leakage was observed under confocal laser scanning microscope.
Statistical Analysis Used:
The data was analyzed by ANOVA and
Post Hoc
test. Results: The mean dye penetration of different groups were Group I (Control Group) 0.00±(0.00) mm, Group II (Silver amalgam) 3.00±(0.00) mm, Group III (RMGIC) 1.84±(0.26) mm, Group IV (Cermet cement) 1.83 (0.25) mm, Group V (MTA) 1.25±(0.12) mm, Group VI (Biodentine) 0.26±(0.21) mm.
Conclusion:
It was concluded that Biodentine exhibits best sealing ability followed by mineral trioxide aggregate, followed by Cermet Cement and RMGIC, whereas silver amalgam exhibited least sealing ability.
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Derma fillers: Ray of light in black triangles – A pilot study
p. 55
Shalini Kapoor, Anjali Dudeja
DOI
:10.4103/ccd.ccd_693_18
Background and Aim:
Open gingival embrasure often poses complex functional and esthetic problems. Interdental papilla reconstruction is among the most challenging periodontal treatments. Hyaluronic acid (HA) gel injection, a noninvasive technique with immediate papilla reconstruction, has been recently proposed. This minimally invasive therapeutic procedure has shown predictable esthetic outcome, thus, gaining rapid acceptance as an esthetic treatment modality in dentistry. The aim of the study is to evaluate the clinical application of derma fillers (HA gel) for the reconstruction of the interdental papilla in the esthetic zone.
Materials and Methods:
Six patients were included with interdental papilla deficiency. After the induction of local anesthesia, 0.2 ml of 0.2% HA injection was given at baseline, 3 weeks and 3 months. Measurements of the black triangle were done clinically using acrylic stent as a reference. The application of HA gel for the reconstruction of interdental papilla was found successful at a 6-month period.
Results:
The study showed a significant gain in papillary volume, and esthetics improvement was notable. A statistically significant result was obtained in context to papilla fill.
Conclusion:
Interdental papilla reconstruction with injectable HA gel is a promising minimally invasive treatment option for interdental deficiency in small areas.
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Association of wnt9b rs1530364 and wnt5a rs566926 gene polymorphisms with nonsyndromic cleft lip and palate in South Indian population using deoxyribonucleic acid sequencing
p. 60
Rohit Jain, RM Dharma, MR Dinesh, BC Amarnath, Manjunath Hegde, KM Pramod
DOI
:10.4103/ccd.ccd_90_19
Context:
Nonsyndromic cleft lip with or without cleft palate (CL/CP) is a common congenital facial malformation without any other structural or developmental abnormalities.
Aims and Objectives:
To test the association of Wnt9B rs1530364 and Wnt5A rs566926 gene variants with the nonsyndromic CL/CP patients in South Indian population.
Methods:
Deoxyribonucleic acid (DNA) samples of 25 subjects with nonsyndromic cleft lip and palate (NSCLP) and 25 unrelated controls collected from the department were used for the study. Group A: DNA samples of 25 subjects NSCLP (P1–P25). Group B: DNA samples of 25 unrelated controls (C1–C25). The extracted DNA samples were subjected to polymerase chain reaction, and later, these amplified products were subjected to DNA sequencing. Results were documented in the form of electropherograms.
Results:
The results indicated that there is a strong association between the presence of Wnt9B rs1530364 gene with the incidence of NSCLP. This study also suggests that the likelihood of NSCLP is higher in subjects having CC (
P
= 0.02) genotype for Wnt9B gene variant rs1530364.
Conclusion:
We can conclude that Wnt9B gene variant rs1530364 can be considered as genetic marker for NSCLP for our population.
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Comparative evaluation of efficacy of 4% tulsi extract (
Ocimum sanctum
), fluoridated and placebo dentifrices against gingivitis and plaque among 14–15 years school children in Davangere City, India – A triple blinded randomized clinical trial
p. 67
Bhuvaneshwari Gangadharamurthy Nadar, GV Usha, Nagesh Lakshminarayan
DOI
:10.4103/ccd.ccd_109_19
Context:
Gingivitis is the most prevalent periodontal disease among adolescents. The most important factor associated with gingivitis is plaque accumulation. Mechanical plaque control through tooth brushing and mouth rinsing are the most commonly used preventive methods. Aims: This study aims to assess and compare the antiplaque and antigingivitis effect of 4% Tulsi leaf extract dentifrice, fluoridated and placebo dentifrice (PD) among 14–15-year-old school children in Davangere city.
Materials and Methods:
A triple blinded concurrent parallel trial. A sample of 84 participants with a baseline mean gingival index score of at least 1.0 and mean plaque index score of at least 1.5 were randomly selected. Participants were divided into three groups by block randomization and concealed random allocation method was used to distribute dentifrices. Postassessment of plaque and gingivitis was done on the 21
st
day.
Statistical Analysis Used:
Wilcoxon signed rank test for within group comparison and Kruskal–Wallis ANOVA for intergroup comparison was used. Results: Significant reduction in the plaque and gingival scores between the groups was observed on the 21
st
day (
P
= 0.001). Maximum reduction in gingivitis (
P
= 0.001) and dental plaque (
P
= 0.01) was seen in 4% tulsi dentifrice group compared to PD.
Conclusion:
Antiplaque and antigingivitis efficacy of 4% tulsi and commercially available fluoridated dentifrice remained the same after 21 days.
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CASE REPORTS
Interproximal papilla volumization using vestibular incision subperiosteal tunneling access technique in esthetic rehabilitation
p. 76
Santhosh B Shenoy, Vinaya Bhat, Parvathi B Kottakkunnummal, Shahira , Chethan Hegde, Biju Thomas
DOI
:10.4103/ccd.ccd_33_20
An accurate diagnostic and interdisciplinary approach is essential for obtaining suitable, conservative, and predictable results in areas with high esthetic demand. Patients reporting with an improper prosthesis that has a black triangle pose a challenge for soft-tissue esthetic rehabilitation. Re-restoration of such cases with conventional fixed prosthesis would be undesirable due to imbalance in pink and white esthetics. This case report describes an interdisciplinary approach to maintain the existing midline diastema and correction of black triangle in the interproximal area between abutment and pontic in the esthetic zone. Minimally invasive vestibular incision subperiosteal tunneling access technique with connective tissue graft was planned for reconstructing the interdental papilla, followed by prosthetic rehabilitation of edentulous site with fixed partial denture using loop connector design to maintain the midline diastema. Postoperative result showed a comprehensive, pink and white rehabilitation to meet the patient's esthetic demand.
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Primary oral tuberculosis - A case report
p. 79
Priyanka Sachdeva, Sukhdeep Singh, Nitin Bhagat
DOI
:10.4103/ccd.ccd_416_19
Tuberculosis is a chronic granulomatous disease which affects the lungs in majority of the cases. Oral manifestations of tuberculosis (TB) are seen both in primary and secondary stages of the disease but are most commonly associated with secondary TB. Primary oral TB is a rare entity and thus may pose a diagnostic challenge. This case reports isolated primary TB of the lower lip associated with an intraoral long-standing nonhealing ulcer present in a 12-year-old child. The diagnosis was confirmed by histopathological, hematological, and radiographic investigations. The lesion resolved with anti-tubercular treatment regimen. The case highlights the importance of clinician awareness toward oral lesions, which may present themselves without any symptoms and/or signs of systemic disease.
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A novel approach to recreate, rehabilitate, and restore the facial defect with a partial facial mask – An interesting case report
p. 83
CK Anulekha, Kolapally Swetha, N Sudhir, Ramu M Reddy
DOI
:10.4103/ccd.ccd_155_19
Facial defects resulting from neoplasm, congenital malformation, or trauma can be restored with facial prosthesis using different materials and retention methods to achieve the life-like appearance and facilitate function. A facial prosthesis can re-establish esthetic form and anatomic contours for midfacial defects, often more effectively than by surgical reconstruction. For successful results, a lot of factors such as harmony, texture, color matching, and blending of tissue interface with the prosthesis are important. This case report describes a novel approach to rehabilitate a patient who had underwent partial rhinectomy as a result of hemangiopericytoma of the nose. This article explains the construction of partial facial mask, which restored the defect involving the left lateral aspect of the nose, medial aspect of the left eye, and the part of the cheek.
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Prosthetic rehabilitation of a maxillary defect caused by ameloblastoma of rare occurrence: A clinical case report
p. 87
Harini Kallathappa Shivakumar, Sounyala Rayannavar, Deepa Suraj Chougule, Smitha Sharan
DOI
:10.4103/ccd.ccd_233_19
According to WHO statistics, individuals of the Indian subcontinent have the highest prevalence of orofacial cancer. Surgery, radiation, chemotherapy, or combination therapies are commonly administered treatment modalities for the treatment of oral cancer. Rehabilitation after surgical resection of the maxillary area is often a challenging task for maxillofacial prosthodontists. The size and location of the defect usually influence the amount of impairment and difficulty in prosthetic rehabilitation. Communication between nasal and oral cavities causes difficulty in swallowing and speech and gives unesthetic appearance. Obturator prosthesis is commonly used as an effective means for rehabilitating hemimaxillectomy cases. This article presents a case of acquired maxillary defect due to ameloblastoma with unfavorable undercuts, which was successfully treated by an immediate obturator following surgical resection and followed by a one-piece closed hollow bulb obturator, by utilizing the remaining palate and dentition to maximize the support, stability, and retention, which acts as a barrier to the communication between the oral and nasal cavities.
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Treatment modalities for early management of class III skeletal malocclusion: A case series
p. 91
Heena Sarangal, Ritu Namdev, Swati Garg, Natasha Saini, Parul Singhal
DOI
:10.4103/ccd.ccd_393_19
The characteristic features of Class III malocclusion are present at an early age, usually between 3 and 5 years of age. If left untreated, the Class III malocclusion or severe anterior crossbite may worsen, with the majority of these patients ultimately requiring orthognathic surgery as adults. The treatment in all developing Class III cases should be undertaken as soon as the abnormality is diagnosed to prevent it from becoming permanent and resulting in a full-blown Class III malocclusion. It provides more pleasing facial esthetics (the lip posture and facial appearance), thus improving the psychosocial development of a child. Various treatment options available for the management of developing Class III malocclusion are as follows: (1) functional appliances such as reverse twin block, Frankel appliance, and the removable mandibular retractor; (2) orthopedic appliances such as chin cap and face mask; and (3) orthodontic appliances, namely removable maxillary expansion plate or fixed orthodontic appliance with expanded upper arch wire. A treatment plan may be chosen depending on the amount of maxillary growth restriction, mandibular plane angle, the soft-tissue profile, and the age of the patient. This article discusses the various treatment options and the decision-making for different clinical cases based on the clinical features with a description of four different treatment approaches.
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Pinhole surgical technique – A novel minimally invasive approach for treatment of multiple gingival recession defects: A case series
p. 97
Manvi Chandra Agarwal, Geetika Kumar, R G Shiva Manjunath, S S Sai Karthikeyan, Shiva Shankar Gummaluri
DOI
:10.4103/ccd.ccd_449_19
Gingival recessions are one of the most prevalent periodontal diseases. Hypersensitivity and esthetics are the major concerns associated with recession defects. There are various treatment modalities for its management, but recently, minimally invasive techniques have gained much importance because of lower patient morbidity and comparable results when compared to conventional techniques. This case series represents a 6-month follow-up of a recently introduced pinhole surgical technique where the percentage of root coverage was found to be statistically significant.
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Maintenance of gingival profile in the esthetic zone using natural tooth pontic
p. 101
Chaitanya Adurty, Ramanarayana Boyapati, Cheruvu Ramya Naga Shivani, Susmitha Karyamsetti
DOI
:10.4103/ccd.ccd_431_19
The extraction of periodontally compromised teeth in the anterior esthetic region is a challenging situation due to patients' psychological and esthetic demands. Irrespective of the replacement of missing teeth with the final prosthesis, the first line of management would be to provisionally restore the teeth at the earliest. Routine treatment options for replacement are time-consuming and expensive. Using the patient's natural tooth as a pontic offers the benefits of the same size, shape, color, and preservation of the gingival architecture. Using the patient's platelet concentrate (platelet-rich fibrin) facilitates early wound healing and preservation of the alveolar ridge shape following tooth extraction. With minimal or no preparation, the technique can be completed at the chairside, thereby avoiding laboratory costs. This case report details the procedure with a follow-up of a case where the natural extracted tooth of the patient was used as pontic to replace a missing anterior tooth.
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© 2010 Contemporary Clinical Dentistry | Published by Wolters Kluwer -
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Online since 10
th
March, 2010