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   Table of Contents - Current issue
October-December 2018
Volume 10 | Issue 4
Page Nos. 197-251

Online since Tuesday, December 4, 2018

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Comparative evaluation of physical and chemical properties of calcium silicate-based root-end filling materials (Mineral trioxide aggregate and biodentine): An in vitro study p. 197
Shilpa Kumari, Anika Mittal, Shifali Dadu, Aditi Dhaundiyal, Anju Abraham, Bidya Yendrembam
Aims: Evaluation and comparison of solubility, pH, and calcium ion release of calcium-silicate based root-end filling materials mineral trioxide aggregate (MTA) and biodentine. Methodology: The total sample size for the study was 120. Sixty samples were for solubility of MTA and biodentine and sixty for pH and calcium ion release of MTA and biodentine. MTA and biodentine were added to sixty stainless steel ring molds. The mass of 60 dried glass bottles was measured. Shifting of samples to bottles containing 5 mL of distilled water was done and was stored for 24 h. The bottles were dried at 105°C and weighed. This procedure was repeated for 3, 10, 30, and 60 days. Data obtained for solubility were analyzed with independent t-test. Sixty polyethylene tubes 1 mm long were filled with MTA and biodentine and placed in lidded flasks containing 10 mL distilled water and were preserved in an oven at 37°C. After 2 h, the flasks were removed from hot air oven, and the water was assessed for pH and calcium ion release. pH readings were performed with an pH Meter. Atomic absorption spectrophotometer was used for the detection of calcium ion release. Preservation of the tubes containing the cements was done in new flasks containing 10 mL of distilled water for further detection of pH and calcium ion release in the different time periods of 6, 24 h and 7, 28 days, respectively. Data were analyzed with independent t-test. Results: Significantly higher solubility was exhibited for biodentine for 30 and 60 days than MTA. Statistical difference was observed between the solubility, pH, and calcium ion release values of MTA and biodentine. Conclusions: Biodentine exhibited higher solubility, pH, and calcium ion release in comparison with MTA.
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Effect of occlusal contact of the loading rod tip on the fracture strength of ceramic crowns p. 203
Wilson B Mendes, Simonides Consani, Lourenço Correr-Sobrinho, Mario A C. Sinhoreti, Rafael L X. Consani
Aim: The aim of this study was to verify the effect of the occlusal contact of the rod tip on the fracture strength of crowns made with different ceramic systems. Materials and Methods: Conical preparation was performed on bovine teeth with diamond burs in mechanical lathe, and crowns were made for all-ceramic, metal-ceramic, In Ceram, and IPS Empress 2 ceramic systems according to manufacturers' instructions in prosthetic laboratory. The crowns were fixed with resin-modified glass ionomer cement or dual-curing composite resin under a static load of 4 kg for 1 min. To simulate the clinical contact between loading and ceramic crowns, the rod tip was made in accordance with the occlusal form of the ceramic crown. After storage in distilled water at 37°C for 24 h, the samples were submitted to 60,000 mechanical cycles at a load of 35 N/2 Hz immersed in distilled water. The fracture strength test was performed in an Instron with a cross-speed of 0.5 mm/min. Results: Data submitted to one-way ANOVA for randomized experiments followed by Tukey's test (α = 0.05) showed greater value for IPS Empress 2 (208.12 kgf) with significant difference in relation to all-ceramic (149.32 kgf) and In Ceram (142.25 kgf), whereas metal-ceramic showed intermediary value (182.83 kgf). Conclusion: The loading of the rod tip in occlusal contact with the crown did not promote premature failures during the mechanical fatigue test, and two-ceramic systems showed different values of fracture strength after mechanical fatigue test, with better performance for crowns manufactured with IPS Empress 2.
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Effect on indigenous die spacer thickness at varied evaporation times p. 209
V Swetha, Shalini Joshi, Chandrashekar Sajjan, Priyanka Konin, Aayesha Razzaque, Sangamma K Tippashetty
Aim: The present study was conducted to compare the effect of evaporation at different time intervals on film thickness at various applications of indigenous die spacer (S) Surana Enterprises, Mangalore Dental Corporation, India and TRUFIT GEO. TAUB PROD. & FUSION CO. INC. Jersey City, N.J Die spacer on ultrarock KALABHAI, Karsan, India die stone (DI) and Resin modified gypsum SynaRock XR, DFS GmbH, Germany die stone (DII). Materials and Methods: A total of 200 samples were prepared for study, and each sample was used for specific number of die spacer application (1, 2, 3, 4, or 5) after its evaporation at specific interval of time (0 h, 2 h, 4 h, 8 h, or 24 h). The specimens so obtained were then sectioned and die spacer thickness was measured using a stereo microscope. One-way analysis of variance was used for study parameters with 5% level of significance followed by Tukey's HSD post hoc test. Results: The highest mean value of die spacer thickness of 32.85 ± 0.28 μm was for SynaRrock die stone sample with 5 applications of TRU-FIT die spacer after 24 hours of evaporation and least of 13.80 ± 0.02 μm for ultrarock die stone sample with 1 application of Surana die spacer after 0 hour of evapouration. There is a significant difference in all subgroups at various evaporation time intervals. Conclusions: Evaporation of volatile substances at various time intervals varies the thickness of die spacer and thus affects the casting relief. The indigenous die spacer and die stone can also be used effectively.
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Considering vascular endothelial growth factor elevation in sera as marker for oral squamous cell carcinoma metastasis p. 216
PS Pradeep, R Randhya, B Ganesh Prasad
Background: Angiogenesis is the most important contributor for tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is thought to be one of the most contributing angiogenic factors and selective mitogen for vascular endothelial cells. This study was conducted to determine the circulating levels of VEGF in histopathologically proven well defined squamous cell carcinomas of the oral cavity with no metastasis and to compare with serum levels of patients with moderately and poorly differentiate squamous cell carcinomas with metastasis. Methodology: This study included 20 patients with no metastasis, 20 patients with metastatic squamous cell carcinoma, and 20 healthy individuals as control. The values of healthy volunteers and patients with oral squamous cell carcinoma were compared for VEGF levels only. Results: Statistical analysis showed that mean VEGF levels in the sera of oral squamous cell carcinoma patients with metastasis were significantly higher than that in patients with no metastasis. Moreover, serum VEGF level was understandably higher in both the groups than in controls. Conclusion: It may be safe to conclude that VEGF elevation in the serum can be a marker in case of metastatic oral squamous cell carcinomas.
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Occlusal vertical dimension: Effect on esthetic norms at smile p. 220
Aayesha Razzaque, Shalini Joshi, Sunil Dhaded, Chandrashekar Sajjan, Priyanka Konin, T Subashani
Background and Objectives: The restorative and esthetic needs for the complete mouth rehabilitation patient frequently require an increase in occlusal vertical dimension (OVD), in whom there would be tooth loss or attrition in existing teeth, decreased OVD, or opposing teeth supraeruption. The effect of increasing OVD for restorative purpose and esthetic norms while smiling is not well understood; hence, the purpose of this study is to evaluate the effect of those norms at smile. Methods: Eighty patients (40 males and 40 females) were selected from the student population of AME's Dental College, Raichur, between the age groups 21 and 30 years, and occlusal registrations of 2, 4, 6, and 8 mm in thickness for each individual were fabricated from the articulated casts. Posed smile images at OVD +0, +2, +4, +6, and +8 were taken with a digital single lens reflex (DSLR) camera and evaluated using AutoCAD software. Results: In this study, it was found that with an increase in OVD, the interlabial gap height, incisal edge to lower lip distance, and display zone area were increased statistically significantly (P < 0.05) in both male and female patients, whereas the smile index was decreased significantly (P < 0.05). No significant changes were observed in the intercommissural width and incisal edge to the upper lip distance in both male and female patients. Conclusion: There is obvious effect of aesthetic norms such as the vertical distance between the incisal edge to upper lip, vertical distance between incisal edge–lower lips, interlabialgap height, intercommissural width, internal display zone area, and smile index in both male and female patients. The obtained values can serve as guide for esthetic rehabilitation of patients.
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Ocular prosthesis using external plate technique p. 226
D Kalpana, Smitha Sharan, Joel Koshy Joseph, Sampath Kumara Raju Kurapati, Nadira Jabeen, Iti Badola
This case report describes fabrication of eye prosthesis for an unfortunate individual, using external plate technique. The treatment commenced with personal psychological counseling and reassuring him about the outcome after the treatment. Clinically, because of reduced eyelid opening and intraocular space, conventional small-sized conformers did not fit, and hence, impression was made with custom-made external plate technique. The outcome of the treatment was found satisfactory and was well accepted by the patient.
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Need of early dental intervention in vitamin D deficiency rickets p. 229
Aruna Ngangom, Mayank Jain, Simran Verma
Rickets is a disease that affects the growth of a child or individual because of defect in bone mineralization. There is utmost requirement of vitamin D for the proper bone formation and mineralization and any defect in its production and metabolism will lead to development of rickets. Though there is abundance of sunlight, vitamin D deficiency now emerges as a major health problem in the South East Asian population including India. A timely dental consultation and management is critical for prevention of significant oral findings in the affected individuals. Multiple dental abscesses in absence of caries or trauma is one of the most significant dental findings in Rickets. The goal of early intervention in the treatment of rickets is to minimize the late complications of rickets in affected children. The aim of this case report is to discuss about various oral findings of 17 years old boy suffering from rickets and to raise awareness on dental characteristics of this disorder.
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Management of hemifacial hypertrophy with extended corpus angle V-line mandibular ostectomy p. 233
Suresh Vyloppilli, Benny Joseph, KP Manojkumar, Shermil Sayd
Asymmetry is one of the most unusual and fascinating errors of human reproduction. A subtle asymmetric variation of the contralateral structures of the face occurs commonly in the general population, even in the absence of any local lesion or systemic conditions. Hemihypertrophy, congenital hemihypertrophy, hemimacrosomia, or partial gigantism are the terms used when the association of these changes with time or modifying circumstances such as trauma is missing. Meckel in 1822 gave the initial description, and the first report was by Wagner in 1839. This case report presents the case of a 20-year-old female with hemifacial hypertrophy, treated with “extended corpus angle V-line mandibular ostectomy” with modifications in armamentarium. Corrective procedure performed was in comparison to the contralateral side. Anterior half ostectomy, followed by posterior half ostectomy, was carried out with an oscillating saw, contra-angle handpiece, and curved chisel, respectively. Radiological assessment of the inferior alveolar nerve helped in planning the ostectomy and preservation of the nerve. Single-stage extended mandibular corpus-angle ostectomy has helped in accomplishing an esthetic correction.
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Management of lateral incisor fractured at crestal level: An interdisciplinary case report p. 237
K Saini Suresh, Saini Amita, Yadav Suman, S Sidhu Maninder
A successful restoration should not be limited to achieve esthetic and functional needs; it should also respect the dentogingival unit. A restoration, especially in a fractured tooth or short clinical crown, may violate biological width thus jeopardizing periodontal health, resulting in chronic inflammatory response and thereby inviting failure. Although crown lengthening can be achieved using surgical procedure, it is associated with removal of healthy bone and thus altering the crown length of the adjacent teeth. This article reports a case with 2½ years of clinical and radiographic follow-up success of maxillary left lateral incisor with crown-root fracture using orthodontic extrusion and fibrotomy.
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Pedicled forehead flap for the reconstruction of maxillary defect: A novel surgical case report p. 241
Sudipto Sahu, Subrat Padhiary, Rajarshi Banerjee, Sucharu Ghosh
“The tint of the forehead so exactly matches that of the face and nose that it must be the first choice” –Sir Harold Gillies and D. Ralph Millard Flaps from the frontal and temporal region have been used for mid-face, orbital, and peri-orbital reconstruction. The knowledge of the vascular anatomy of the region helps to dissect and harvest the muscle/fascia/skin/combined tissue flaps from that region depending on the requirement. Maxillectomy defects are usually covered with free flaps to fill the cavity. Here, we report an innovative technique in which a patient with a maxillectomy with external skin defect was covered with pedicled forehead flap based on the parietal and frontal branches of superficial temporal artery.
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Clinical comparison of placental membrane versus platelet-rich fibrin membrane for treatment of gingival recession: A 2-year follow-up case report p. 244
Mohd Rehan, Manish Khatri, Mansi Bansal, Komal Puri, Rashmi Shikha
An amnion membrane is a placenta-derived tissue that has been introduced recently as a guided tissue regeneration membrane in dentistry. Numerous growth factors, proteins, and stem cell reserves in amnion could help in accelerated wound healing and regeneration. In addition, growth factors released after activation from the platelets in platelet-rich fibrin (PRF) gets trapped within fibrin matrix and also been shown to stimulate the mitogenic response in the periosteum for bone repair during normal wound healing. In this case report, a healthy 22-year-old male patient with bilateral Miller's Class I recession defects affecting canine were treated surgically with coronally advanced flap (CAF) along with amniotic membrane (AM) or PRF in a split-mouth design for coverage of the recession. Follow-up was done at baseline, 3 months, 6 months, and 18 months to evaluate the effectiveness of CAF with either PRF membrane or bioresorbable AM in the treatment of localized Miller's Class I gingival recession defects. This case report demonstrated that CAF + PRF and CAF + AM are equally effective in providing clinically significant outcomes in respect to root coverage with AM showing the better percentage of root coverage as compared to PRF. Thus, both the treatment modalities can be used for the coverage of gingival recession depending on the choice of clinician.
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Dental age estimation in children and adolescents p. 248
Jyotsna Seth, Anubha Agarwal, Himanshu Aeran, Yogeshwari Krishnan
Age is estimated on basis of chronological age and bone age, dental age, mental age, and others. Dental age is considered to be vital as tooth development shows less variability than other developmental features and also low variability in relation to chronological age so, it is considered to be vital in establishing the age of an individual. Every person of all ages whether they are neonate, adults, or adolescent got right to be identified during death or when they are alive, and with the help of forensic odontology now it has become easier to estimate the age in very less time by various methods. However, different methods are associated with varying degrees of uncertainty and precision. From a statistical-methodological point of view, a combination of different measurement methods and a more conscious use of the relevant statistical methodology may provide more reliable estimates and better quantification. This review will deal with various aspects of age estimation such as morphological, biochemical, and radiographical methods and its scope and limitation.
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