Hemisection: A Silver Lining for the Mandibular Molar

Hemisection of mandibular molar refers to a procedure involving sectioning a multi-rooted tooth with its crown portion followed by the removal of the sectioned tooth with unfavorable prognosis. Hemisection helps in retention of the tooth which otherwise would have undergone extraction. This case report highlights hemisection of mandibular molar with advanced furcation involvement and concomitant endo-perio lesion. This case report also aims at focusing attention in proper diagnosis, treatment planning and management of teeth with advanced periodontal involvemen

A Comparison of Clinical Efficacy of Dentifrices Containing Calcium Sodium Phosphosilicate, Nanoparticle Hydroxyapatite and a Dentifrice Containing Casein Phosphopeptide Amorphous Calcium Phosphate on Dentinal Hypersensitivity- A Comparative Triple Blind Randomized Study

Aim : A considerable number of agents are effective in the treatment of dentin hypersensitivity. This3 month randomized clinical trial compares a dentifrice containing Calcium Sodium Phosphosilicate, Nanoparticle Hydroxyapatite and Casein Phosphopeptide-Amorphous Calicium Phosphate. Materials and Method : Eighty teeth were selected in each group. The volunteers selected at baseline had a history of dentin hypersensitivity caused by gingival recession or after scaling and root planing. Patients were evaluated for dentin hypersensitivity using visual analog score and Schiff test. Patients were required to have a visual analog scale score of ‡2 to be included in the study. After sensitivity scores for controlled air stimulus and cold water at baseline were recorded, subjects were given toothpastes randomly and sensitivity scores were measured again at 2nd week, 4th week, 2nd month and 3rd month. Results : All three groups showed reduction in sensitivity scores at 2weeks, 4 weeks and at 3 months for air stimulus and cold water. The nanoparticle hydroxyapatite group was found to be significantly better in reducing the visual analog scale score as well as Schiff test score and at any time point for both measures of sensitivity. Conclusion : The Nanoparticle Hydroxyapatite group showed comparable reduction in the symptoms of dentin hypersensitivity

Idiopathic Gingival Enlargement - A Case Report

Background: Idiopathic gingival fibromatosis is a rare hereditary condition that has no definite cause. The pathogenesis of gingival fibromatosis is still unknown but an increase in proliferation of the gingival fibroblasts as well as increased collagen synthesis may be involved. In modern times, a mutation in the son of sevenless -1 (SOS-1) gene has been suggested as a possible cause of isolated (non-syndromic) gingival fibromatosis, but no definite linkage has been established. A twenty four year old patient presented with gingival enlargement since one year. Based on clinical and radiographic examination, laboratory tests, and thorough oral hygiene instructions, an external bevel gingivectomy was performed to remove excess gingival tissue. There was recurrence within two months following the surgery. The exact cause of the gingival enlargement was not identified, although amelioration of the fibrotic, enlarged gingiva was observed which recurred within two month after performing conventional gingivectomy. Recurrence of gingival fibromatosis in such patients can also be attributed to genetic predisposition

A Case Report of Ridge Augmentation using Onlay Interpositional Graft: An Approach to Improve Prosthetic Prognosis of a Deficit Ridge

Background: Periodontal therapy has developed beyond the scope of the treatment of periodontal pathoses. Periodontal plastic surgery consists of the reconstructive procedures designed to enhance the both function and esthetics. Deficient ridges pose a severe problem to the restorative dentist in restoring the natural form, function and esthetics of the prosthesis replacing the natural dentition. Depending upon the severity, location of these defects and the prosthetic option chosen, hard and soft tissue ridge augmentation or non-surgical approach or a combination may help to address them. The present clinical report describes a soft tissue ridge augmentation of a localized ridge defect in maxillary aesthetic region using onlay interpositional graft followed by fixed partial denture

Comparative evaluation of the efficacy of closed pocket debridement with diode laser and periodontal open flap debridement: A clinical and microbiologic study

Context: Different techniques are used for periodontal therapy, viz. scaling and root planing, subgingival curettage, gingivectomy, and full- or split-thickness flap procedures with or without osseous recontouring. Most of the said periodontal surgeries are invasive and associated with pain and secondary discomfort, thus leading to a quest for newer techniques such as laser-assisted closed pocket debridement techniques for periodontal therapy. The present study was designed to compare the efficacy of closed pocket debridement with diode laser and periodontal open flap debridement as assessed by clinical and microbiological parameters. Materials and Methods: Twenty patients in an age range of 20–54 years and with pocket depth of ≥5 mm and ≤7 mm were included in the study. The plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and colony forming units (CFUs) of the periodontal pathogens namely Porphyromonas gingivalis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and streptococci were compared in patients undergoing closed pocket debridement with diode laser (Group I) against open flap debridement (Group II) at baseline and after 3 months of the procedure. Results: There was a statistically significant difference between the PD reduction in Group I and Group II (P = 0.02), with Group II showing greater reduction in PD. Furthermore, the mean value of CFUs after 3 months of the procedures in Group I was significantly less as compared to Group II. Conclusion: The laser-treated group (Group I) was found to be better in terms of decrease in clinical PD as compared to Group II. The bactericidal effect of the diode laser was, also, clearly evident by a greater reduction of CFUs of periodontal pathogens in Group I as compared to Group II

Know your adjuncts

Introduction: Knowledge of oral health is a prerequisite for psychological and physical health. The two most prevalent oral diseases, dental caries and periodontal diseases, are largely preventable through professional and self-care activities. With a boom in over-the-counter self-care products available for better oral health, it is imperative to know the awareness with regard to them, among the general population. The objective of this study was to survey the awareness regarding the use of interdental aids and chemical plaque control among the general population. Materials and Methods: A questionnaire comprising 17 close-ended questions was handed down to the 473 patients at the outpatient department of DY Patil School of Dentistry, Navi Mumbai, to gather information regarding their awareness and technique of using interdental aids and chemical plaque control. The collected data were statistically analyzed using the SAS software. Results: According to the analysis done using the SAS software, 58% lacked awareness of inter dental aids whereas 14% were not aware of mouth rinses. At the same time, 98% had no knowledge about water irrigation devices or the side effects of mouth rinses. Conclusion: The study indicated that as compared to oral rinses, the awareness among the masses regarding the use of interdental aids and their helpfulness in prevention of dental caries and periodontal diseases is lacking. There is a need for a dentist to take the front seat in patient education in terms of mechanical and chemical plaque control adjuncts

A novel approach to treat peri-implantitis using sticky bone: A case report

Dental rehabilitation using implants sometimes lead to complications which ultimately leads to implant loss. With respect to peri‑implantitis, the non‑surgical mechanical therapy has not demonstrated to be equally effective. Therefore, surgical therapies have been proposed for treating peri‑implantitis. The aim of this procedure was to evaluate efficacy of using sticky bone - demineralized freeze dried bone allograft (DBDFA) + I-prf in management of a peri-implant defect. A full thickness flap was reflected, exposing the defect. Mechanical debridement of implant surface was done with Teflon curettes. After degranulation, implant surface was rinsed with 10% povidone iodine for 10 minutes. DFDBA + I-PRF was used to completely fill the defect and it was covered using a collagen membrane, Healiguide. 6 months post operatively, radiograph showed bone gain around the dental implant. DFDBA + Prf along with Healiguide shows promising results in treatment of peri-implantitis

A novel and easy technique for restoring grossly decayed mandibular molar with a modified cast-post

The article addresses the difficulty of restoring a grossly carious molar tooth, where very little tooth structure is left after caries excavation. When enough sound tooth structure is missing for satisfying the ferrule effect, a clinician can follow this technique and easily restore such teeth. A step by step procedure, including instrumentation and materials and a new impression technique, is described in detail, with clinical photographs. This technique results in the fabrication of a robust and extremely retentive post and core on which to place fixed prosthodontic restorations. A 2 and half year study showed that the tooth well in function with no signs of any problem. The author has restored around many decayed molars using this technique. Over a period of three years, no failure was reported. With an increasing demand on the dentist for restoring a structurally compromised teeth, this technique provides the patients with a robust prosthodontic solution

Pancreatico-Pleural and Bronchial Fistulae and Associated Pseudocysts: Case Series

Context Pancreatico-pleural fistula is rare complication of chronic or acute pancreatitis. Previous studies have reported imaging features and various management options of this condition including conservative/medical management, endoscopic treatments and surgery.This article reviews the myriad of imaging appearances of this condition in multimodality imaging and different strategies for the successful management in a short case series. Methods After obtaining the institutional ethics committee approval, retrospective review of the medical records of five patients of pancreatico-pleural fistulae who were diagnosed and successfully managed in our hospital in 2012 and 2013 was done. Follow up with out patient records of these patients was also included.Findings were compared with the current available literature on this entity. Results and discussion Pancreatico-pleural fistulae presents with massive pleural effusion.A high index of suspicion is essential for accurate diagnosis. Demonstration of the fistulous tracts requires cross sectional imaging with contrast enhanced CT being most commonly used and affords accurate diagnosis. MRI demonstrates the tracts and ductal disruptions with greater detail and are helpful in confirming the CT findings. Endoscopic ultrasound and ERCP also offer potential of diagnosis, although being technically demanding and invasive is reserved for interventions. Management of these conditions should be initially conservative with endoscopic stenting being offered in selected cases with favourable anatomy and not responding to conservative management. Surgery is reserved for cases not responding to conservative and endoscopic management. Conclusion In conclusion this case series highlights the clinical and imaging spectrum of pancreatico-pleural fistulae and provides insight into the different management strategies that can be adopted for this condition.Image: Expansion of the fistulous tract at CT