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   Table of Contents - Current issue
October-December 2022
Volume 14 | Issue 4
Page Nos. 165-217

Online since Tuesday, November 15, 2022

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Pattern of postoperative pain during endodontic treatment – A randomized control study p. 165
Anupama Kiran, Rashmi N Chidanadappa, Artinder Kaur
Background: The purpose of this study was to evaluate the effect of occlusal relief on the pattern of postoperative pain at different time intervals in patients diagnosed with irreversible pulpitis and apical periodontitis. The null hypothesis proposed was, there is no difference in the postoperative pain in the experimental and control groups. Materials and Methods: In this randomized study, sixty posterior teeth with irreversible pulpitis and slight tender to percussion were included. Root canal treatment was initiated and biomechanical preparation was done. Closed dressing was given after placing calcium hydroxide as an intracanal medicament. The patients were randomized using computer-generated randomization software into the experimental group where occlusal contacts were relieved (n = 30) and to the control group where occlusal contacts were left intact (n = 30). Postoperative pain at different intervals was recorded using the Heft-Parker Visual Analog Scale and analyzed. Results: There is no statistically significant difference in the incidence of postoperative pain between the two groups. There is a significant reduction in pain at 6 h within the groups compared to all other time intervals, and flare-ups were reported in the occlusal intact group. Conclusion: The pattern of postoperative pain did show a gradual reduction in the occlusion relieved group. Flare-ups were reported in the occlusion intact group. Within the limitations of the study, the occlusal reduction could play an important role in prevention of flare-ups during endodontic treatment.
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How much disinfected ground tooth do we need to fill an empty alveolus after extraction? Experimental in vitro study p. 171
José Luis Calvo-Guirado, Felix De Carlos-Villafranca, Miguel Angel Garcés-Villalá, Nuria García-Carrillo, Vidushi Jindal, Francisco Martinez-Martínez
Aim and Objectives: The main objective of this study was to evaluate how much crushed, extracted human teeth material can use to fill an empty alveolus of the mandibular anterior teeth. Material and Methods: Fifty-four human teeth were collected from 10 donors due to advanced periodontal disease. The patients were clinically selected, signed informed consent, and receive no financial compensation for participating in this study. Fifty-four teeth were mechanically cleaned, dried, sectioned, and grounded. All teeth are grounded using the Smart Dentin Grinder machine. Cone-beam computed tomography scanners of each patient were done and processed the standard tessellation language images by a three-dimensional (3D) printer, and 3D models were obtained. Results: The mean of each alveolus was 12.1 ± 0.34 mm for lower incisors and 17 ± 0.29 mm for lower canines. The mean values of root material we need for central and lateral incisors alveolus filling were 0.298 ± 0.14 cc, and for lower canines was 1.02 cc. Therefore, we need one root or one and half-crowns must be needed to fill a lower incisor alveolus. A lower canine needs at least one canine root or one canine crown and two lower incisors crown to fill the canine alveoli. Conclusions: Dentin is a helpful graft to fulfill an empty alveolus due to osteoinductive properties, and a ground crown is useful for buccal bone protection due to osteoconductive properties before and after implant placement.
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Comparative evaluation of the effect of degree of convergence and surface area on the retentive force of titanium crowns cemented with various adhesive luting agents on extracted human teeth – A laboratory study p. 178
Ashish Choudhary, Ekta Choudhary, Surabhi Duggal
Introduction: The retention of base metal crowns and noble metal crowns cemented with various luting agents is well documented. However, little emphasis was given to the degree of convergence and surface area of tooth preparation. Aim and Objective: A study was planned to analyze the effect of the degree of convergence and surface area of the tooth preparation on the retention of titanium crowns with various adhesive luting agents. Materials and Methods: Forty-five caries-free extracted human premolars were obtained. They were divided into three groups according to the degree of convergence and further subdivided based on the type of luting agents used. The teeth were prepared with an angle of convergence of 5°, 10°, and 15° with a flat occlusal surface using K9 crown finishing installation, complete. Light body copper band impressions were made to determine the surface area. Titanium crowns thus obtained were sandblasted, ultrasonically cleaned, and cemented using Panavia F, Calibra, and Glass Ionomer Cement. Results: Results showed that Panavia F was the best luting agent exhibiting maximum retentive force to dislodge the crown in a vertical direction using the universal tensile testing machine at a cross-head speed of 1 mm/min. Conclusion: The force required to dislodge the titanium crown from the prepared tooth was maximum for Panavia F on 5°, 10°, and 15° angle of convergence at 65.23 kgf, 48.52 kgf, and 40.14 kgf. Retentive force values drastically reduced as the degree of convergence increased. There was a reduction in the surface area due to an increase in the taper.
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Third-order effects and maxillary incisor control in lingual orthodontics – A finite element study of a ribbon arch and edgewise straight wire system p. 185
Siddhartha Kaustav Konwar, Manjusha Goswami, Anmol S Kalha, Vishal Singh
Introduction: The aim of the present study was to analyze the effects of retraction mechanics on torque control when retraction forces were applied on the maxillary anterior dentition in two distinct lingual appliance systems. Materials and Methods: A three-dimensional bilateral maxillary model was created where the first premolar extraction case was included. 150 g (1.47 N) of retraction force was applied on each side from canine (C) hook to molar for both edgewise straight wire system and ribbonarch appliances. Results: In the edgewise appliance, it was observed in the X-axis that there was less amount of tipping of the six anterior teeth of the canine and central incisor (CI) when compared with the lateral incisor (LI) at occlusal point. In the Y-axis, overall extrusion was observed. In the Z-axis, there was less lingual crown movement. In the ribbonarch appliance, it was observed in the X-axis that there was less tipping, prominently in the canine and CI than in the LI. In the Y-axis, overall extrusion was observed. In the Z-axis, there was less lingual crown movement, whereas the CI and canine showed less movement when compared with the LI. Conclusions: It was observed that there was greater torque loss and extrusion in the edgewise appliance along with greater maximum principal stress in the cervical half of the facial side in the periodontal ligament (PDL) and minimum principal stress on the cervical half of the palatal side in the PDL when compared with the ribbonarch appliance.
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Reinforcement of endodontically treated teeth by different intraorifice barrier materials p. 193
Divya Gupta, Sharad Kamat, Santosh Hugar, Girish Nanjannawar, Ruchika Gupta, Saquib Mulla
Background: Fracture incidences are more common in teeth with endodontic therapy and hence endodontic therapy should aim toward the reinforcement of such teeth by placing various restorative materials. Aims: Comparative evaluation of different intraorifice barrier material on strengthening the fracture resistance of teeth requiring endodontic therapy. Methods: Sixty extracted human mandibular premolars with one root were divided into four groups (n = 15); Group 1- Light cured Glass ionomer cement, Group 2 - Nanohybrid composite (NHC), Group 3 - High copper amalgam, Group 4-Control. Decoronation of specimens was done to a standardized length of 14 mm and was instrumented up to International Organization for Standardization (ISO) #30 size master apical file. Gutta percha was used to carry out the obturation by the cold lateral compaction technique. With the exception of the control group, elimination of 3 mm obturation from the coronal portion was done and intraorifice barrier materials were placed. Universal Testing Machine was used for testing fracture resistance. Statistical Analysis: Analysis of variance was applied to analyze the data obtained and pairwise comparison was done by post hoc tukey's test (P < 0.05). Results: Better resistance to fracture incidence was seen with NHCs. Control group presented the least values. Conclusion: On placement of intraorifice barrier materials in teeth with endodontic therapy, there was a reduction in fracture incidence.
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Comparison of dental occlusion in children with mouth breathing and different types of pharyngeal lymphoid tissue obstruction p. 198
Tanzeem Ahmed, Samsuddin Ahmed, Nikhil Kaushal
Background: The relationship between malocclusion and respiration has been debated for decades. Aim: The aim of this study is to assess dental occlusion in relation to mouth breathing and different types of pharyngeal lymphoid tissue obstruction in children. Settings and Design: This was a cross-sectional study of 200 children aged between 6 and 12 years who were clinically examined and divided into two groups: mouth breathers and nasal breathers. Materials and Methods: The children were subjected to otorhinolaryngologic examination to identify the type of pharyngeal obstruction. Dental interarch relationship and pharyngeal tissue obstruction were diagnosed and appropriate cross tabulations were done. Statistical Analysis Used: The data collected were statistically analyzed using the SPSS version 15.0 software. Results: Statistically significant association was found between type of breathing and pharyngeal lymphoid tissue obstruction (P = 0.001), dental occlusion and type of breathing (P = 0.001), and pharyngeal lymphoid tissue obstruction and dental occlusion (P = 0.001). Higher prevalence of crossbite, deep bite, and Class II malocclusion was seen in children with adenotonsillar hypertrophy as well as mouth breathing habit. Conclusion: Obstructive tonsils and adenoids are risk factors for the development of malocclusion. Early detection and correction of airway obstruction can help in proper growth of the dentofacial region.
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A case report on anesthesia management for a patient with deep neck space infection (retropharyngeal and parapharyngeal abscess) p. 202
Aastha Jindal, Amit Kumar, Kamlesh Kunwar Shekhawat, Parul Sharma
A 44-year-old woman complained of neck swelling, discomfort, and swallowing difficulties. She was admitted to the hospital on an emergency basis for incision and drainage. Deep neck space infection was diagnosed using a neck X-ray, ultrasonography, and contrast enhanced computed tomography. The successful anesthetic management of this patient at the Pacific Institute of Medical Sciences in Udaipur is presented here.
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A simplified intraoral appliance for protecting the flap in a patient with oral submucous fibrosis p. 205
Sonia Abraham, PS Manoharan, N Karthi Arivarasan, K Prabhu, VC Karthik, A Kirubakaran
Oral submucous fibrosis (OSMF) is a chronic, debilitating premalignant condition of the oral cavity predominantly caused by betel chewing. In this condition, the sub mucosal tissues (lamina propria and deeper connective tissue) show inflammation and progressive fibrosis that results in inability to open the mouth. Surgical excision of fibrous bands is usually the treatment of choice. Postsurgical trauma to the flap during occlusion is one of the common complications that may occur in those patients. Hence, an intraoral appliance which could protect the flap is necessary. This article explains about the fabrication of an intraoral appliance in a simplified manner to protect the flap from trauma during the occlusion of a patient diagnosed with OSMF who underwent surgical excision of fibrous tissue. The appliance helped in better healing of the surgical site, avoided the trauma to the flap, comfortable and cost effective.
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A review of photobiomodulation and its application in dentistry p. 209
Shruti Soni, Sahil Thakar
Photobiomodulation (PBM), which is further termed as low-level laser therapy is a noninvasive type of therapy. It uses a certain wavelength of red and infrared light and brings about many physiological effects in cells and tissues which establish the basis of PBM. This light therapy photochemically triggers the cells and results in the production of molecules for example, adenosine triphosphate, reactive oxygen species, calcium ions, etc., This further contributes to cell proliferation, differentiation, and migration. PBM contributes in alleviating pain, promotes tissue healing and also has an anti-inflammatory effect on targeted tissues. Research on PBM began back in the 1960s and various studies conducted in the past documented that this therapy has many applications in various specialties of dentistry. Till date, further studies are being conducted to discover more beneficial properties of this therapy. This therapy can be used for the treatment of multitudinous conditions of the oral cavity such as aphthous ulcers, herpes, pemphigus, burning mouth syndrome, and many more conditions, it can mitigate the pain following the orthodontic treatment, can be used to deal with the temporomandibular disorders (TMDs), alleviate dental pains, enhances the depth of anesthesia and many more uses in dentistry.
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The why and how of pulpal pain p. 213
Preeti Nair, Priyanka Deepak Deshmukh, Somya Bhavsar, Ganiga Channaiah Shivkumar
A proper understanding of pulpal pain has been an enigma to the scientific community. While neurons and transmitters are active participants, focus on neuropeptides has not been emphatic. A complex array of interaction of inflammatory substances, with assortment of nerve fibers in the presence of these molecules, has shed some light to this mysterious phenomenon of pulp pain. A literature search was made of the standard textbooks, Google Scholars, Pubmed and Scopus database for review, original research, case control studies using key words like “pulpal pain” and 'chemicals responsible for pain mechanism' . This paper is an attempt at highlighting not only the roles of these proteinaceous materials, so that they could be targeted to eliminate pain, but also the neuro anatomy and neurophysiology of the pulp.
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