Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study

BACKGROUND

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation.

METHODS

This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance.

RESULTS

The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding.

CONCLUSION

The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Validation of Digital Impressions' Accuracy Obtained Using Intraoral and Extraoral Scanners: A Systematic Review

BACKGROUND

At present, the evidence regarding digital impressions' accuracy recorded by using digital scanners is lacking. This systematic review aimed to evaluate whether the type of scanning (intraoral/extraoral) affects the Accuracy of Digital Impressions.

METHOD

Two independent reviewers performed a systematic search in the database both electronically and manually (PubMed, Ebsco HOST, the Cochrane Library, and Google Scholar) for articles published from 1 January 2010 to 1 December 2022. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42020188765) and followed the PRISMA statement. The question in focus was as follows: Does the type of scanning (intraoral or extraoral) affect the accuracy of digital impression?

RESULTS

A total of 449 papers were obtained by searching electronically and manually. In total, 15 complete-text papers qualified for assessment based on eligibility criteria. After reading the full-text articles, five studies were excluded. Ten studies were selected for the qualitative analysis. The qualitative data reported that the accuracy of both types of scanners (intraoral and extraoral) lies within the range of clinical acceptability. Nevertheless, the intraoral scanners seem to be more accurate when compared to the extraoral scanners for a partial arch situation.

CONCLUSIONS

Scanning type affects the accuracy of the digital impression. Various factors influence the scanning ability. Intraoral scanners seem to be more accurate compared to extraoral scanners for a partial arch situation. More studies comparing the accuracy of the intraoral scanner and extraoral scanner for a complete arch scan and in an in vivo study setting are needed.

Assessment of Periodontal Health Among Removable and Fixed Partial Denture Wearers in Aseer Region of Saudi Arabia

BACKGROUND Prosthetic rehabilitation will have harmful effects on periodontal structure if the patient fails to maintain an oral hygiene protocol. This study aimed to evaluate oral hygiene in fixed and removable partial denture wearers in the Aseer Province of Saudi Arabia. MATERIAL AND METHODS This was a cross-sectional study done on 286 prosthesis wearers aged between 25 and 55 years; 142 were men and 144 women. Clinical examination was done using 3 periodontal parameters: plaque index, gingival index, and calculus surface index. RESULTS It was found that 72% and 25% of patients used fixed and removable partial prostheses, respectively. Most patients were in the 45-55 year age group (38.1%), were medically fit (78%), and used toothbrush and paste (70.6%). Most patients were instructed regarding the use of oral hygiene measures for their prostheses (71.3%). However, around half of the study group (52.8%) had odor from their prostheses. Most fixed prostheses were in the posterior teeth (73.2%) and had 3 units or more (58.7%). Removable partial dentures were mostly tooth-tissue supported (74%). A statistically significant difference was found for plaque index and gingival index between natural teeth and abutments in terms of various prosthetic parameters (P£0.001). The higher prevalence of gingival inflammation, plaque, and calculus accumulation in this study may be correlated to improper oral hygiene methods used by patients. CONCLUSIONS It can be concluded that there is a need to reinforce meticulous oral hygiene practices among patients using prosthodontic appliances.

Dental calculus - An emerging bio resource for past SARS CoV2 detection, studying its evolution and relationship with oral microflora

The most grievous threat to human health has been witnessed worldwide with the recent outbreak of Corona virus disease 2019 (COVID-19). There is mounting evidence available regarding theconnect of COVID -19 and oral cavity, particularly periodontal disease. The current review provides an update on the diagnostic potential of dental calculus and how this bio resource may help in providing us huge amount of diagnostic regarding the causative virus. Contemporary standard method of diagnosis via nasopharyngeal swabs (NPS) is tedious, may enhance the risk of aerosol contamination by inducing sneezing and detects the presence of active infection only.However,dental calculus being a mineralized deposit serves as a reservoir for biomoleculesand provides detection of past SARS CoV2 infection. Further, the abundance of information that can be obtained from this remarkable mineralized deposit on teeth regarding the viral genome, its evolution and interactions with the oral microflora shall enhance the understanding of the viral disease process and its connection with the periodontal disease. Additional diagnostic information, which may be obtained from this simple bio reservoir can complement the contemporary diagnostic strategies adopted in the management of COVID-19pandemic and enhance our existing knowledge for developing improvised novel approaches to mitigate the effects of mutated variants of the infectious agent.

Assessment and Correlation of Salivary Ca, Mg, and pH in Smokers and Non-Smokers with Generalized Chronic Periodontitis

Background and Objectives: Diagnostic evaluation with the aid of biomarkers has reached newer heights to assess disease activity. Salivary calcium, magnesium, and pH are one of the biochemical parameters which can be helpful in assessing the progression of periodontal disease. Smokers are at topnotch threat for having oral diseases, predominantly periodontal diseases. The aim of this study was to assess the salivary calcium, magnesium, and pH levels in smokers compared with non-smokers with chronic periodontitis. Materials and Methods: The current study was conducted on 210 individuals affected with generalized chronic periodontitis, with the age group between 25 and 55 years. Based on their smoking habit, an equal number of patients were categorized into two groups; namely, group I consisted of non-smokers and group II consisted of smokers. The clinical parameters that were measured included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Loss (CAL). The biochemical variables that were evaluated in the current study included salivary calcium, magnesium, and pH using an AVL9180 electrolyte analyzer (Roche, Germany). The gathered data were analyzed with an unpaired t test was using SPSS 20.0. Results: A statistically significant higher PPD (p < 0.01), CAL (p < 0.05), and salivary calcium levels (p < 0.001) were observed in the smokers' compared with their non-smoking counterparts. Among the biochemical parameters, calcium showed a significantly (p < 0.001) higher level in smokers (5.79 ± 1.76) in contrast to non-smokers (3.87 ± 1.03). Additionally, a significant negative correlation (p < 0.05) between calcium and PPD was observed in non-smokers, whereas a non-significant inverse relation (p > 0.05) was seen in smokers. Conclusions: The present study indicates that the salivary calcium level can be a potential biochemical parameter to assess the progression of periodontal disease in smokers and non-smokers. Within the limitations of the current study, the salivary biomarkers appear to have an essential role in the identification and indication of the status of periodontal diseases.

Effectiveness of a Single Chair Side Application of NovaMin® [Calcium Sodium Phosphosilicate] in the Treatment of Dentine Hypersensitivity following Ultrasonic Scaling-A Randomized Controlled Trial

Dentinal hypersensitivity or cervical dentinal sensitivity is one of the commonest clinical problems. The aim of this randomized controlled trial was to evaluate the effectiveness of a single chair side application of 100% pure calcium sodium phosphosilicate (NovaMin^®) in reducing dentin hypersensitivity following ultrasonic scaling as evaluated on a visual analogue scale (VAS). The study included 50 subjects who were selected based on an evaluation of dentinal hypersensitivity on a VAS carried out using a metered air blast from a three-way syringe and divided into two groups (n = 25/group); i.e., the test group (Group A) received the NovaMin^® paste and the control group (Group B) received a placebo paste made from pumice. All the 50 subjects included in the study were had VAS scores of 3 or more. The NovaMin^® powder mixed with distilled water was applied. Dentinal hypersensitivity was reassessed immediately and after 1, 2 and 4 weeks after the procedure. Results showed that the percentage reduction of dentinal hypersensitivity following a single application of NovaMin^® in powder form was about 76.38% immediately, 67.72% one week postoperatively, 52.76% two weeks postoperatively and 26.78% four weeks postoperatively. It can be concluded from the results of the current clinical study demonstrated that a single chair side application of NovaMin^® in powder form has a significant and immediate reduction in dentinal hypersensitivity, which lasted nearly for four weeks.

Dental implants in growing patients: A systematic review and meta-analysis

BACKGROUND: Dental implants provide a suitable and reliable treatment for the replacement of missing teeth. Very few studies have been reported in the literature regarding the application of dental implants in growing and developing patients. OBJECTIVE: This systematic review with meta-analysis aimed to systematically review the available literature regarding the application of dental implants in growing and developing patients. METHODS: A detailed search in the literature was performed with the help of keywords such as dental implants, treatment planning, children, adolescents, growing patients, and developing jaws. PubMed, Scopus, Web of Sciences, and Ovidsp databases were searched for papers published between 1980 and 2021. The papers focused on children, adolescents, developing jaws, and implants. In this systemic review, the dataset concerned with the type of study, aim, number of patients and specimens included, age of patients, total number of implants placed, total number of implants evaluated, medical history of developmental disorders of teeth such as ectodermal dysplasia, congenital absence of teeth, were evaluated. RESULTS: Out of the total literature searched, 33.45% of studies and case reports documented no complications in any implant treatment. In 47.21% of studies and case reports, there was both success and failure of implants while in 13.21% of studies and case reports there was a complete failure of implants. The most common cause for loss of permanent teeth in growing children and adolescent patients was dental trauma (73.13%) followed by congenital developmental disturbance of teeth (18.19%). CONCLUSION: It can be concluded from this systematic review that the use of implants in edentulous growing patients is determined by several parameters, including the patient’s overall health, the stage of jaw growth, the number of teeth to be replaced, and soft and hard tissue anatomic features. Still, the use of a conservative treatment strategy for missing teeth management in patients with developing jaws is common and recommended until the patient’s growth is completed, as there are chances of changes in the position of dental implants placed in the developing and growing jaws due to the continuous changes taking place in their body. However, placement of implants can be done in these patients successfully with proper treatment planning and taking into account the phase of growth with proper follow-up.

Non-surgical management of dens invaginatus type IIIB in maxillary lateral incisor with three root canals and 6-year follow-up: A case report and review of literature

BACKGROUND

The presence of dens invaginatus (DI) complicates treatment of any tooth, from diagnosis to access cavity and biomechanical preparation and obturation. Reports of successful non-surgical management of DI type IIIB in maxillary lateral incisor are rare. Here, we report such a case, with three root canals and a long follow-up.

CASE SUMMARY

A 13-year-old female patient presented with mild pain in the maxillary right lateral incisor (#7) for 10-15 d. On examination, the tooth was slightly rotated, with slight tenderness on percussion and grade I mobility but with no caries, pockets or restorations and non-vital pulp (via vitality tests). Radiographic examination revealed unusual configuration of the tooth’s root canals, with an enamel-lined invagination extending to the apex, suggesting the possibility of DI Oehler’s type IIIB and a periapical radiolucency. Widening the access cavity lingually revealed one distinct buccal orifice and two distinct palatal orifices; under higher magnification of a dental operating microscope (DOM), the mesio-palatal and disto-palatal orifices were observed as connected by a C-shaped groove. The root canals were prepared with hand K-files following a step-back technique, and obturated using a combination technique of lateral condensation and vertical compaction. At the 6-year follow-up, the patient was asymptomatic, and the periapical radiography displayed significant healing around the apical end of the root.

CONCLUSION

Proper knowledge of unusual root canal anatomy is required in treating DI. Conventional methods of root canal treatment can successfully resolve such complex cases, facilitated by DOM and cone-beam computed tomography.

Perception of Synchronized Online Teaching Using Blackboard Collaborate among Undergraduate Dental Students in Saudi Arabia

Blackboard is a collaborative virtual learning tool used for higher learning that has been found to be an effective and efficient means of interactions between teachers and students and offers effective educational information management. The aim of this research work is to assess the preclinical and clinical dental students' perception of Blackboard Collaborate as a quality teaching and learning tool as well as to find out areas that might appear as barriers to quality teaching and learning. This cross-sectional study was conducted online using survey monkey involving 245 dental students who had participated in the virtual classroom lectures during the pandemic with 18 students not completing the survey. The survey instrument was a nine-item questionnaire that included the age, sex, and year of study of the students as well as previous exposure to online lectures. The data collated was analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for windows version 22. Among 245 respondents that were enrolled in the study, 227 respondents completed the survey, of which 58.1% (n = 132) were male while 41.9% (n = 95) were females. Of the 227 respondents that completed this study, 74.8% (n = 170) of them experienced minimum to moderate technical problems regarding connectivity during the online sessions while 1.8% (n = 4) of the respondents experienced very severe technical problems. The majority of the respondents 54.2% (n = 123) support the continuation of online lectures even after the pandemic. In conclusion, we found a positive perception of our respondents to online lectures using Blackboard Collaborate. Internet connectivity as well as a decline in the comprehension of the lectures as compared to face-to-face learning were found as barriers to online learning.

Prevalence of Titanium Hypersensitivity in Patients with Titanium Implants: A Systematic Review and Meta-analysis

BACKGROUND

With increase in exposure to titanium in daily life and its use in medical procedures, there is a greater chance for developing titanium hypersensitivity. Our aim and objective is to examine whether patient patients with titanium implants had a greater incidence of titanium hypersensitivity or not. Titanium is widely considered to have good biocompatibility. A passivating surface layer of TiO₂ is formed when exposed to air which gives it good corrosion resistance. These properties along with its high strength, lightweight, and improvements in smelting technologies have led to its widespread use as an intraosseous and periosteal implant in dentistry and orthopedics.

MATERIALS AND METHODS

Only case-control studies were used for the meta-analysis. Studies with a sample size of <5 were excluded. Cutaneous and epicutaneous tests were used in the study.

RESULTS

Three studies met the inclusion criteria. Titanium hypersensitivity is more prevalent in patients with titanium implants.

CONCLUSIONS

It is also used in a variety of medical devices such as pacemakers and insulin pumps. Moreover, our external exposure to titanium is increasing. It is used in aerospace, chemical, and automobile industries. It is also used in jewelry, home furnishings, and in making sports and marine equipment. Titanium implants increase the possibility of developing titanium hypersensitivity, and thus, it should be considered as a major factor in unexplained implant failure where other causes have been excluded.

Evaluation of Antibacterial Activity of Pine Tar on Periodontal Pathogenic Bacteria: An In Vitro Study

Background

Periodontal pathogens play an important role in etiology and pathogenesis of periodontitis. Microbiological examination of sub gingival plaque is used at the present time in etiological research as well as in clinical treatment of periodontitis to select the appropriate antibiotic agent if indicated. Pine tar has been used for the treatment of various skin diseases. So the study was done to evaluate the effect of Pine Tar oil on bacteria isolated from periodontitis patients.

Methods

Plaque samples from volunteer patients were collected using sterile paper points. Robertson's Cooked Meat (RCM) medium was used for the transportation and cultivation of aerobic, microaerophilic, and anaerobic microorganisms.

Results

The result suggests the use of Pine tar oil for topical application in periodontal diseases. Disc diffusion analysis was sufficient enough to illustrate that 75 µl tar oil solution produced growth inhibition of microbial strains.

Conclusion

Pine tar oil has become one of the important areas of research both in pharmaceutical and periodontal research, hence in vivo studies has to be carried out with various form of pine tar.

Periodontal Treatment Practice and Referral Profile of General Dentists – A Cross-sectional Questionnaire Survey

BACKGROUND: Because of medical advancement, the mean age of the general population is increasing gradually. This increase in the mean age of patients has led to its implications on oral health. Hence, it is logical to assume an increase in the figure of referrals to specialists and the complexity of treatments provided. AIM: The aim of the survey was to assess the current status of periodontal treatment provided, awareness of referral profile, and criteria taken into consideration for the referral to the periodontist by general dentists. MATERIALS AND METHODS: This cross-sectional questionnaire study was conducted among 318 general dentists. The relevant work related to the status of periodontal procedures provided by dentists and their referral relationships were studied. The questionnaire consisting of six questions was designed. Descriptive statistics, including frequency distributions and measures of central tendency and Chi-square test, were used. RESULTS: The study showed that majority of the general dentists do non-surgical procedures by their own. However, around 85% of respondents did not provide surgical periodontal treatment by themselves. About 25% of the responding general dentists thought that they had inadequate education and experience in the field of periodontics which was a major reason for the referral to specialists. CONCLUSION: It was concluded that the general dentists are comfortable in carrying out the non-surgical procedures, but they had some reservations about the periodontal surgical procedures. Inadequate experience and facilities were the major reasons for the referral to periodontists. More of this type of study should be conducted to know the basic level of periodontal practices carried out among the general dentists and about the referral to the specialists.

Analysis of Tooth Extraction Causes and Patterns

PURPOSE: The purpose of this study was to investigate the causes and patterns of extraction of permanent teeth in the targeted population. METHODS: The study was conducted for a period of 11 months. An especially designed form was used to record the causes for extraction of a permanent tooth. Further, it was analyzed for age, gender, education, occupation, smoking, tooth position, endodontic treatment, chewing, esthetics, needs replacement, type of existing prosthesis, and causes for extraction. The various causes which were considered to determine association with the tooth extraction were dental caries, periodontal problems, trauma, orthodontics, prosthodontic failures, endodontic failures, and others. RESULTS: The percentage of extractions was almost the same in males and females aged. Maximum extractions were noticed in 36–45 years of age group (32.5%). The presence of caries was observed to be the main reason for extraction (68.1%), followed by periodontal problems (17.6%) and orthodontic problems (4.8%). The most frequently extracted posterior teeth were first mandibular molar (22.2%), followed by the third maxillary molar (15.2%). CONCLUSION: Dental caries was found to be the most common reason for the extraction of teeth. Molar teeth were found to be the most frequently extracted, with an increased number of extracted first premolars as a result of orthodontic treatment. Maxillary teeth are extracted more than mandibular, mainly due to caries and periodontal problems.

An Assessment of Dentist’s Attitudes to the Shortened Dental Arch Concept

AIM: The rehabilitation of a complete dental arch is a traditional concept to maintain proper functional occlusion, but it is neither compulsory nor always attainable in many patients. Nevertheless, it is always important to provide a minimum number of teeth for efficient function. This study aimed to assess the dentist’s attitude to a shortened dental arch (SDA) concept and to assess their perception and application of it in their clinical practice in the Aseer region, Saudi Arabia. DESIGN OF STUDY: A questionnaire with 17 questions was used to reveal the views of 204 dentists from the area of study about SDA. The questionnaire set basically consists of two parts. The first part included the dentists’ demographic data, and the second one consisted of the questions regarding the SDA concept. STATISTICAL ANALYSIS: Descriptive analysis and associations with the factors were tested for significance using Chi-square tests, and p < 0.05 was considered statistically significant. RESULTS: Among the respondents, 43.7% were aware of the SDA concept. Thus, the expected awareness about the SDA concept among the dentists was in the range of 36.31–51.05 with 95% confidence. A highly significant difference in awareness of SDA was observed between graduates and postgraduates. Among the respondents having more than 10 years of experience, the awareness level of SDA was 66.0%. CONCLUSIONS: The majority of participants alleged that the SDA concept is useful in clinical practice and is a useful treatment modality for older adults with limitations preventing complex restorative care. However, the application of the SDA varied significantly among dentists.