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   Table of Contents - Current issue
July-December 2022
Volume 16 | Issue 2
Page Nos. 97-184

Online since Wednesday, December 21, 2022

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Post-COVID mucormycosis rehabilitation: Challenges and solutions p. 97
Satish R Iyer
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Evaluation of awareness about dental points among dentists and defense aspirants: A cross-sectional study p. 100
Preethi Subramanian, Roopa Jatti
Aim and Objective: The aim of the study is to evaluate the awareness about dental points among dentists and defense aspirants. Settings and Design: This was a cross-sectional questionnaire study. Materials and Methods: Two hundred and fifty dentists and 250 defense aspirants were included in the study. A self-assessed questionnaire was formulated separately for the dentists (nine items) and the defense aspirants (ten items) to assess the awareness about dental points, in which six questions were common for both the groups. Statistical Analysis Used: Chi-square goodness-of-fit test was used to compare the differences in the responses to the questions specific to the dentist and defense aspirant groups. Results: It shows that 56.9% of the defense aspirants and only 35.8% of the dentists were aware about scoring system which is necessary for defense selection. Nearly 59.9% of the dentists did not have adequate knowledge about the scoring system. Conclusion: Creating awareness is the first step of oral health education. Hence, dental health educational programs should be actively conducted in all health sectors of India to increase the awareness about dental points.
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Evaluation and comparison of periodontal and orthodontic parameters in patients managed with periodontally accelerated osteogenic orthodontics versus conventional orthodontic treatment p. 106
SK Rath, Dhruv Dubey, Karan Nehra
Introduction: Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a clinical procedure which is gaining popularity due to its claims to increase in alveolar bone width, shorter treatment time, increased post treatment stability, and decreased amount of apical root resorption. However, there is paucity of literature available on changes in periodontal and orthodontic parameters following (PAOO). Aims and Objective: The aims of the current study were to evaluate the efficacy of orthodontic treatment with PAOO and compare the treatment duration between the PAOO based fixed orthodontic treatment and the conventional fixed orthodontics in patients with bi-maxillary dentoalveolar protrusion. Materials and Methods: Group A consisted of 12 bimaxillary dentoalveolar protrusion patients who underwent PAOO during orthodontic treatment and Group B consisted of 12 Bimaxillary dentoalveolar protrusion patients who underwent conventional orthodontic treatment without PAOO. Statistical analysis was performed using the Wilcoxon test for a paired group comparison. Pre- and posttreatment measurements of each parameter were averaged (mean – SD), and all tests were performed at the 5% significance level. P values ≥0.05 were regarded as statistically significant. Results: No significant changes were seen in values probing depth, clinical attachment loss, width of keratinized attached gingiva, plaque index and gingival index between the two groups. However, statistically significant difference was seen in the orthodontic treatment duration between the two groups. Conclusion: It can be concluded that PAOO is a safe and reliable procedure which decreases the total orthodontic treatment duration significantly with stable periodontal results as achieved with conventional orthodontic treatment.
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Clinical outcome assessment of surgery first orthodontics after approach for skeletal malocclusions: A pilot study p. 112
Sanjeev Datana, Mohit Sharma, Shiv Shankar Agarwal, Sujit Kumar Bhandari
Background: To investigate treatment outcome of skeletal malocclusion managed employing SFOA. Material and Methods: The study sample (n=10) requiring mandibular orthognathic surgery was categorised as Group 1 (GP 1) – Skeletal Class II & Group 2 (GP 2) – Skeletal Class III. Pre (T0) and post (T1) treatment records were analyzed using the CCA Index to assess the clinical outcome of the treatment. Lateral cephalogram was analyzed using WITS Appraisal and McNamara analysis to quantify treatment changes. The total duration of treatment was recorded from the case records of patients. Pain perceived by the patients was assessed using Visual Analogue Scale (VAS) after 03 days of surgical procedure, 03 weeks and 03 months. Results: Mean change in SNB angle was significantly higher in Group 2 compared to Group 1 (P value<0.05). The mean change in ANB angle was significantly higher in Group 1 compared to Group 2 (P value<0.05). The mean change in facial aesthetics score and dental aesthetics score did not differ significantly between two study groups (P value>0.05). For both groups, mean pain response on 3rd day post-surgery was moderate to severe on the VAS which improved to mild to moderate by 3rd week and after 3 months majority of the patients had no pain. The mean total treatment duration from surgery to orthodontic finishing and detailing was 12.2 months, with a range of 8.4 months to 14.6 months. Conclusions: SFOA results in an immediate and marked improvement in skeletal component of the malocclusion along with significantly improved facial and dental aesthetics.
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Recovery of neurosensory deficit in zygomatic complex fracture: A prospective study p. 119
Serat Rahman, Indranil Deb Roy, Pushpa Kumari
Aim: This study is aimed to prospectively evaluate neurological alteration subsequent to zygomatic complex fracture. Objective: To evaluate recovery of neurosensory deficit in unilateral zygomatic complex fracture cases. Materials and Methods: 30 Cases with unilateral zygomatic complex fracture having neurosensory deficit were divided into three Groups based on their Management. Gp-I Cases were managed with indirect reduction without fixation. Gp-II cases were managed with open reduction and internal fixation and no surgical intervention in Gp-III cases. Neurosensory function was assessed with light touch, two point discrimination, brush directional stroke and response to thermal stimuli in the infraorbital nerve region. Results: Neurosensory changes were evaluated preoperatively, postmanagement after 1 week, 1 month, 3 months and 6 months. Recovery in Group II was better than in Group I, however, it was statistically insignificant. Recovery in Group I was better than in Group III, however, the comparative recovery was statistically insignificant. Recovery in Group II was statistically significant than in Group III. Conclusion: It was observed that in most of the cases, neurosensory deficit recovered within 6 months. Recovery was better in the cases where patients were managed with open reduction and internal fixation. On the basis of the current study, it is recommended that in such cases where there is significant displacement or rotation of fractured fragments, direct reduction and internal fixation should be performed to achieve early return to normal form, function, and decompression of the nerve.
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Clinicoradiographic comparison of sagittal condylar guidance angle determined by dynamic and radiographic methods p. 123
R Vijaya Kumar, Mahesh Eraiah Gowda, MP Shashidhar
Aim: This in vivo study was conducted to compare sagittal condylar guidance angle measured (SCGA) using cone-beam computed tomography (CBCT) panoramic-section and CBCT cross-section and extraoral Gothic arch tracing method (EGTM) in completely edentulous patients. Materials and Methods: Based on the inclusion and exclusion criteria, 30 completely edentulous individuals were evaluated. Radiologically, two modalities of CBCT imaging were used to record SCGA, i.e., CBCT panoramic section view and CBCT cross-sectional view. After recording, the CBCT of the patient SCGA was measured using the Frankfort horizontal reference line and mean curvature line. The most superior and most inferior points of the curvature were identified to determine the mean curvature line. SCGA was measured in the clinical method using EGTM with Hight tracers for the same patients. Data obtained using three methods were subjected to statistical analysis. Results: The mean right and left SCGA using CBCT panoramic view was 29.33 and 29.52, respectively. The mean right and left SCGA using CBCT cross-sectional view was 31.24 and 31.63, respectively. The mean right and left SCGA using extraoral Gothic arch method was 26.67 and 27, respectively. The SCGA differed significantly among the groups. Conclusion: There was a significant difference in values of SCGA when evaluated using the three techniques. The radiographic methods (CBCT panoramic section view and CBCT cross-sectional view) were comparable but varied significantly from extraoral Gothic arch tracing technique.
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A clinical and radiographic comparative evaluation of treatment outcome of different fiber post systems with conventional cast metal post and core system p. 130
Sourabh Sharma, Sonali Sharma, Balakrishnan Jayan, Anubhav Chakrabarty
Aim: To compare clinically and radiographically the treatment outcome of different post and core systems. Methodology: Patients with nonvital anterior teeth with middle or cervical third crown fracture and those fulfilling the inclusion and exclusion criteria were enrolled in the study. After clinical and radiological examination and confirmation of eligibility, the selected cases were randomly divided into three groups: Group A, cast metal post and core system (control group); Group B, glass fiber-reinforced resin post and core system (test group); and Group C, bundle glass fiber-reinforced resin post and core system (test group). Results: Group A (control group, cast metal post) provided the maximum number of failed cases with 1 sinus formation, 2 root fractures, 3 periapical pathology, 5 post adaptation failures, and 3 esthetic failures. In Group B (glass fiber post), there was 1 failed case due to debonding, 1 due to core fracture, and 3 were post adaptation failure. Minimum numbers of failures were seen in Group C (bundled glass fiber post) with only 1 post adaptation failure. Conclusion: The Bundle glass fiber reinforced resin post and core system can be a reliable alternative due to various advantages as - Can adapt any root canal morphology while preserving remaining dentine thickness - Provides homogenous reinforcement to the entire core buildup - Modulus of elasticity similar to that of dentin provides elevated shock resistance, shock absorption and prevents root fracture - Excellent esthetic property.
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Implant surface modification as a basis of osseointegration: A narrative review p. 139
Harshika Gautam, Gitanjali Yadav, Rajesh Bansal
This paper aims to review different surface modifications of dental implants, both commonly marketed and under experimental studies and their effect on osseointegration. The success of the implant–tissue interface depends on factors such as biocompatibility, chemical, mechanical, surface topography of dental implant, and local environmental factors in peri-implant area. The knowledge and understanding of bone healing physiology have driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, microdesign, and surface chemistry of dental implants to enhance osseointegration.
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Current trends in temporomandibular disorder management: A prosthodontist's perspective p. 146
Ranjoy Hazra, Ayush Srivastava, Dinesh Kumar, Amit Khattak
Temporomandibular disorders (TMDs) are a collective term that embraces a number of clinical conditions that involve the masticatory musculature and/or temporomandibular (TM) joints and associated musculoskeletal structures. TMDs are one of the most common causes of facial pain after odontogenic origin. The TMDs are of multifactorial etiology and characterized by multiplicity of clinical signs and symptoms, making its diagnosis and management very difficult for the clinician. Diagnostic criteria are used from a clinician standpoint to reach into an exact diagnoses based on a multiaxial diagnostic model. The stress is on a medical multidisciplinary model similar to ones used for other musculoskeletal disorders that involve the patient in the physical and behavioral management of his or her own problem. A majority of TMD patients achieve good relief of symptoms with noninvasive reversible treatment. Detailed knowledge of the disease and its etiopathology is mandatory to formulate an effective treatment plan. The primary objective for the prosthodontist as a member of a TMD team is to regain patient comfort and occlusal stability.
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Insight into contemporary molecular diagnostic techniques revolutionizing the specialty of oral maxillofacial pathology and microbiology p. 151
Sudip Indu, Vineet Singh Cheema
The specialty of oral maxillofacial pathology and microbiology is currently undergoing a paradigm shift as the present diagnostic protocols continue to upscale itself from the basics of H and E staining procedures, and immunohistochemistry to newer molecular diagnostic techniques such as polymerase chain reaction, comparative genomic hybridization, fluorescence in situ hybridization, and tissue microarray to name a few. In this era of growing numbers of pandemics like COVID-19 affecting the world population, it is imperative for all oral pathologists and microbiologists to keep abreast with these newer diagnostic facilities such that they can be valuable team members along with medical health care providers in the hour of need in encountering severe disease processes such as severe acute respiratory syndrome coronavirus 2, swine flu, and MERS.
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Frontal bone osteomyelitis following electrical burn injury p. 156
Nandakishore Sahoo, Ankur Thakral, N Mohan Rangan
Osteomyelitis of the frontal bone is an uncommon clinical presentation that usually occurs as a complication of trauma or sinusitis. An electrical burn injury of the scalp region leading to osteomyelitis of the skull bone is an extremely rare clinical presentation. An 8-year-old boy reported nonhealing forehead wounds for the last 6 months due to accidental contact with high-voltage power line. Clinical and radiological examination confirmed the diagnosis of osteomyelitis of the frontal bone. He underwent sequestrectomy of necrosed bone followed by soft-tissue reconstruction of the defect with local flap to achieve good wound healing and satisfactory cosmetic outcome. High-tension electrical burns resulting in severe injuries to the scalp, calvarium, meninges, and brain are among the most serious complications of burns. A proper diagnosis and early and aggressive surgical intervention is of utmost importance for management of skull osteomyelitis.
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Management of paediatric ameloblastoma p. 160
Ajay Premanand Desai, Sumeet Sehgal
Ameloblastoma is a benign odontogenic tumour of epithelial origin that is slowly growing, locally aggressive, has a high recurrence rate but is uncommon in children. It has a peak incidence in the third and fourth decades of life. Treatment of ameloblastoma in children is complicated by three factors: (1) physiologic factors such as the continued facial growth, different bone physiology and the presence of unerupted teeth; (2) difficulty in the initial diagnosis and (3) predominance of the unicystic type of ameloblastoma. To present the outcome and advantage of a conservative treatment approach in the management of unicystic ameloblastoma in a paediatric patient. An 11-year-old individual reported with osteolytic lesion right ramus of the mandible involving the body with impacted teeth mimicking dentigerous cyst. Incisional biopsy was suggestive of ameloblastoma without any known subtype. Considering the age and the subsequent reconstruction options, he was operated for peripheral ostectomy with chemical cauterisation. A satisfactory post-operative outcome was achieved. The case was followed up for 2 years with no sign of recurrence. Ameloblastomas in children differ from those in adults, with a higher percentage of unicystic tumours. Enucleation with peripheral ostectomy seems a viable option in paediatric patients considering the amount of post-operative morbidity associated with aggressive management which can always be taken up a later stage if warranted.
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A case of non-syndromic multiple odontogenic keratocyst with isolated dentigerous cyst: A diagnostic conundrum p. 165
Sudip Indu, Indranil Deb Roy, Kapil Tomar, Sabareesh Jakka, Anup Kumar Singh
Odontogenic keratocyst (OKC) is a common developmental odontogenic cyst affecting the maxillofacial region. They can occur in two different forms, either as solitary (non-syndromic OKCs) or as multiple OKCs (syndromic OKCs). Multiple OKCs are usually seen in association with Gorlin–Goltz syndrome or otherwise called nevoid basal cell carcinoma syndrome. However, approximately 5% of patients with OKC have multiple cysts without concomitant syndromic presentation. This article reports a case of multiple OKCs of orthokeratinised variant in a non-syndromic patient along with an isolated dentigerous cyst associated with impacted teeth in one of the quadrants. Simultaneous occurrence of dentigerous cyst along with multiple OKCs may be coincidental. Impacted teeth must be radiographed and evaluated histopathologically to rule out varied lesions and associated complications with them.
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Caldwell Luc in the era of endoscopic approach for maxillary sinus p. 171
Rajashekhar D Gadad, Vivek Saxena, H Rangarajan
Caldwell Luc is a historical procedure for the maxillary sinus, which is more than 100-year-old and is still a useful procedure of choice among surgeons in certain maxillary sinus pathologies. In the era of endoscopic sinus surgeries, the usefulness of Caldwell Luc is often questioned. We report two cases of chronic maxillary sinus disease one with an iatrogenic tooth root in the sinus for 2 years and the other with a mucosal polyp both of which were managed endoscopically earlier but with recurrence of symptoms. Both the cases were managed using a modified Caldwell-Luc approach. The patients were asymptomatic postoperatively with no recurrence.
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Modification of Twin-block appliance using an innovative approach p. 174
Harihara Naik, Raj Kumar Maurya
Successful correction of skeletal malocclusion using commonly used standard Twin-block design is a challenging task which can further become difficult to manage with noncompliant patients. Literatures have reported various modifications of commonly used Twin-block appliance to overcome the limitations of the design, to make it more patient-friendly with reproducible results. In the attempt of increasing comfort, retention, and acceptability to the existing design, the present article is reporting an innovative modification of Twin-block with a successful outcome and reproducible results.
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Collagen grafting in Godwin's vestibuloplasty p. 179
Swaminathan Chidambareswaran, Saroj Kumar Rath
Preprosthetic surgery is a part of maxillofacial surgery that restores oral function and facial form rendered deficient through loss or the absence of teeth and associated structures because of disease, trauma, or elective surgery for tumors and other conditions. This is concerned with the surgical modification of the alveolar process and its surrounding structure to enable the fabrication of a well-fitting, esthetic dental prosthesis. There are various techniques of vestibuloplasties, but the mostly used techniques are Kazanjian's and Clark's with split skin graft (SSG) or other grafting. With its better properties in all aspects, bovine collagen has become an alternative to SSG in intraoral grafting. Here, we have elaborated a successfully managed case of short lower anterior vestibule treated by Godwin's technique of vestibuloplasty followed by collagen grafting.
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Discerning observations opening pandoras box in orthopantomograms p. 183
Saugat Ray, Sanjeev Datana
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