A Journal of Clinical Dentistry-Heal Talk

02

Authors: Shakir Hussain Rather1, Humaira Mir2

Apexification is a method to induce a calcific barrier across an open apex or the sustained apical development of an incomplete root in teeth with necrotic pulp. Apical closure occurs approximately three years after eruption. Apexification is a treatment option that is done with the aim of apical repair by formation of hard tissue barrier through apex. Conventionally, a calcified barrier is inducted using a calcium hydroxide mixture. Various materials that can be used for apexification include Calcium hydroxide, MTA, Tricalcium phosphate, Dentin chips, Calcium phosphate ceramics and hydroxyapatite and bone morphogenetic proteins. Calcium hydroxide is the most common and traditional material employed for inducing apexification. Multi visit technique requiring 6-24months to complete by using calcium hydroxide paste with Iodoform.

02

Authors: Mohammad Imran Khan1, Awadhesh Kumar Gupta2

Mandibular anterior teeth often thought to have only single root canal in correspondence to the singular root morphology. In contrast many times two canal system exists in mandibular anterior teeth including premolars also. One should always be care full in finding the other canal in mandibular anterior teeth as missing one leads to the failure of the endodontic treatment. As mandibular incisors, are smaller in dimensions, two canals in a small space makes it challenging and technique sensitive to treat.

03

Authors: Vivek Bhaskar1, J. Sabarinathan2, Kamaraj Loganathan3

The incidence of impacted incisors is relatively low. However, due to their multifactorial etiology and varied clinical presentation, they pose a challenge to the orthodontist. Often, these cases would need to be treated using a multi disciplinary approach. Depending on the intra oral features, these cases can be treated by orthodontic extrusion of the impacted tooth, extraction of the impacted tooth followed by prosthetic rehabilitation etc. This article describes the management of an impacted mandibular lateral incisor whose eruption was impeded by complex odontomes, which was treated by surgical removal of the odontomes and exposure of the impacted incisor, followed by orthodontic extrusion.

04

Authors: Muhammad Mutiur Rahman

The rapid spread of SARS-CoV-2, responsible for the coronavirus disease (COVID-19), has become a worldwide emergency in the public health system. On 30th January 2020, the World Health Organization (WHO) recently announced a global pandemic disease after COVID-19 outbreak began last December from Wuhan, China. Notwithstanding global attempts to control the spread of the disease, the outbreak is still on the rise due to the trend of this virus spreading through the population. The virus has a predominantly respiratory transmission through aerosol and droplets. Dental care settings typically bear the risk of COVID-19 cross infection between patients and dental practitioners due to the complexity of its procedures. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This review provide dental practitioners with information on clinical symptoms, preventive measures and dental treatment protocols during and post COVID-19 outbreak.

04

Authors: Vinay Kumar Gupta1, Sumit Kumar2, Ayush Mehrotra3, Gaurav Mishra4

Background: Children in early ages, specially below the 4 years of age, spend their maximum time with parents especially mothers or guardians. Therefore, this study was conducted with the aim of assessing Mother's knowledge and beliefs about oral health of their preschool children. Materials &Methods: This was a cross sectional study which was conducted on mothers of preschool children of Lucknow city. A self-structured questionnaire in both Hindi and English language, was used to be filled by mothers as a tool to evaluate the knowledge and belief about their children's oral health. 'dmf' index in the oral cavity of children was recorded to know their dental caries status. Results: Out of those who were sent the survey form, total 324 mothers completed the survey. Children of only those mothers who completed the survey were examined. 87.7% children use toothbrush, 67.9% children brush their teeth once daily, 21% brush their teeth in night also. 18.5% children had experienced dental pain, 3.7% mother have gone to dentist for their child and only 9.9% of mother started brushing their child's teeth right after 1st tooth appeared in oral cavity. Approx. 67% mothers reported that their child had bottle at bed time, approximately 76% reported that they tasted food before feeding to the child with the same spoon, approx. 93% reported that they gave something like chocolate or toffee to calm the child, 51.9% of mother never clean child's teeth/gums after bottle feeding at night.34.5% children had<3 decayed teeth, 9.8% had 3-5 decayed teeth and 55.6 % children did not have any decay. Conclusion: The current study interprets that mother of preschool children have insufficient knowledge and attitude for oral health, the same is reflected in their oral health practices towards their children.

03

Authors: Dr. Saavi H Punia1, Dr. Himanshu Punia2

Dental amalgam is the silver colored material that is commonly used to fill teeth that have decay. Amalgam is a mixture of mercury and other metals in a stable form and makes strong, long-lasting fillings. Dental amalgam fillings have been used to restore decayed teeth for more than 150 years. Doctors and individuals request the removal of their amalgam (silver mercury) restorations due to the high mercury content. Prenatal exposure to high levels of mercury, radiation, and inflammation have been associated with adverse reproductive outcomes such as increases in preterm delivery, low birth weight, and delayed neurodevelopment. Few data are available to evaluate the potential effects of prenatal low-level exposure to these factors. A safe protocol to replace the silver mercury filling will ensure that there is minimal if any absorption of materials while being removed. Strong alternative white composite and lab-processed materials are available today to create a healthy and functioning mouth. Preparation of the patient prior to the procedure and after treatment is vital to establish the excretion of the mercury from the body

03

Authors: Dr. Vivek Chaudhary, Dr. Puneet Batra, Dr. Karan Sharma, Dr. Amit Srivastava, Dr. Mir Yasser Abdullah

Extended treatment time is a major concern for the patients who seek the orthodontic treatment. Several methods have been used by many clinicians for reducing overall treatment duration. Accelerated orthodontics enable in reduction of overall treatment time. Various drugs, devices and surgical intervention are used for obtaining final orthodontic treatment outcome in less time.

04

Authors: Dr.Shubhankar Kumar Singh1, Dr.Deepak Chopra 2

Pregnancy is a unique physiological state that affects almost all the organs, because of changes in the hormonal milieu meant to support the pregnancy. These changes generally reversible after delivery, are sometimes not without adverse effects. Recent upsurge in the interest in periodontal disease in pregnancy is attributed to association between periodontitis and adverse pregnancy outcome. Periodontal diseases are a group of infections and conditions that cause inflammation of the gingiva and the surrounding structures, which leads to destruction of the supporting tooth structures. Periodontal infections are predominantly caused by Gram-negative bacteriae that induce local and systemic elevations of proinflammatory cytokines. Transient bacteremia that occurs due to high vascularity of the periodontal tissue may lead to direct bacterial invasion of the fetoplacental unit. The release of toxic products incites host’s response and triggers an inflammatory response. As a source of subclinical and persistent infection along with the cascade of systemic inflammatory responses and immune-mediated injury, periodontitis puts the pregnancy at high risk. Evidence for and against association between oral diseases and adverse pregnancy outcome comes from cross-sectional studies and a few trials. Like any other association of obstetric outcome with systemic diseases, this one is also a subject of debate. We reviewed the studies providing evidence for and against effect of periodontal diseases on pregnancy. We found that different investigators have used different parameters to define periodontal disease, hence different results. Larger randomized controlled trials with uniform definitions of disease and outcome are needed to arrive at a definite conclusion.

06

Authors: DR. ASHIK MOHAN , DR. ASWATHI.R,

Background: Since late December 2019, COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2, has spread rapidly around the world, causing unprecedented changes in provided health care services. Patients diagnosed with sleep-disordered breathing (SDB) are subject to a higher risk of worse outcomes from COVID-19, due to the high prevalence of coexistent comorbidities such as obesity, hypertension and diabetes, features which are typically seen in patients with OSA. Additionally, treatment with positive airway treatment devices (PAP) can be challenging because of PAP-induced droplets and aerosols. In this context, sleep medicine practices are entering a new era and need to adapt rapidly to these circumstances, to provide the best care for patients with SDB.

02

Authors: Dr. Nahid Iftikhar1 , Dr.Binta Srivastava2 , Dr. Natasha Ghambir3

Currently, discovered coronavirus is a causative agent for infectious Coronavirus disease (COVID-19) which occurred in December 2019. Its approach of spread is primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. It is spreading quickly throughout the world. For COVID -19 there is no preventive vaccines at this time. Therefore, Dental health care professionals are at higher risk as they work in close proximity to patients. They are more prostrate to aerosol infections. Dentists should follow standard precautions to protect themselves from this virus. This article aims to provide all Protection and Preventive measures which can be taken by dental health care professionals while providing urgent dental care to the patients.

03

Authors: Dr. Shalini Dixit

A congenital condition, caused due to fusion between the tongue and floor of mouth is known as Ankyloglossia or tongue –tie.Wallace in 1960 defined tongue-tie as a condition in which tip of the tongue cannot be protruded beyond the lower incisor teeth because of a short frenulum linguae [1].It can vary from a thin elastic membrane to a thickened, white nonelastic tissue. Ankyloglossia is a Greek term made by combination of two Greek words agkilos (curved) and glossa (tongue).It is characterised by a short lingual frenulum resulting in restriction of tongue movement which may have strong impact on function.

03

Authors: Dr. Sanah Sayed

As I write this article during the covid times I think about a world where dentistry is much more than wearing face shields , PPE kits and providing pain relief however as we are forced to adapt to the new normal every day , we can only prepare ourselves to be better when smile makeovers can be a part of daily practice again! What helps me keep positive is that according to a recent AACD SURVEY when asked what is the most common thing that we notice about a person , most of them say their smile(45%) , speech(25%) , clothes (9% )and smell (8%) . This proves that we shall be back doing what we love most sooner than we realize that is transforming a smile and infact positively impacting our patient’s lives as well!

04

Authors: Dr. Shubhankar Kumar Singh1, Dr. Deepak Chopra 2

The beneficial effects of fluoride on human oral health are well studied. There are numerous studies demonstrating that a small amount of fluoride delivered to the oral cavity decreases the prevalence of dental decay and results in stronger teeth and bones. However, ingestion of fluoride more than the recommended limit leads to toxicity and adverse effects. In order to update our understanding of fluoride and its potential toxicity, we have described the mechanisms of fluoride metabolism, toxic effects, and management of fluoride toxicity. The main aim of this review is to highlight the potential adverse effects of fluoride overdose and poorly understood toxicity. In addition, the related clinical significance of fluoride overdose and toxicity has been discussed.

05

Authors: Dr. Shoborose Tantray1, Dr. Fahad wasey2

Novel corona virus (2019-nCoV) caused severe and even fatal pneumonia explored in a seafood market of Wuhan city, Hubei province, China, and rapidly spread to other provinces of China and other countries. The 2019-nCoV is different from SARS-CoV, but shared the same host receptor the human angiotensin-converting enzyme 2 (ACE2). The natural host of 2019-nCoV may be the bat Rhinolophus affinis as 2019-nCoV showed 96.2% of whole-genome identity to BatCoV RaTG13. The participants in dental practice expose to tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. Dental professionals play important roles in preventing the transmission of 2019-nCoV. Here are some of the recommendation in infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.

3

Authors: Dr Nitin Bhatnagar

Chorion membraneIt is a fetal membrane, composed of amniotic and chorion tissues. The chorion forms the outer limit of the sac that encloses the fetus and is composed of different type of collagen and cell adhesion bioactive factors. Thses are known to aid in the formation of granulation tissue by stimulating fibroblast growth and neovascularisation. Thses properties suggest that a chorion membrane may have considerable potential for regeneration

3

Authors: Dr. Shubhankar Kumar Singh1,Dr.Nilesh Ranjan2

The association between diabetes mellitus and periodontal disease has been studied in the last years, and several studies conclude that diabetes mellitus is a risk factor for the development of gingivitis and/or periodontitis in both diabetes type 1 and 2. In this review article we intend to demonstrate the possible association between diabetes mellitus and periodontal disease,assessing their main characteristics, the association with social status and the influence of periodontal disease control on Diabetes mellitus. Scientific research in recent years regarding this specific issue has allowed the establishment of a clear association between periodontal disease and diabetes mellitus among diabetics type 1 and 2. The main complications of diabetes mellitus are angiopathy, neuropathy, nephropathy and retinopathy.Several studies have demonstrated the oral manifestations of diabetes mellitus, assuming particular highlight the periodontal disease. There should be an interaction between general practitioners and dentists so that such patients have the appropriate preventive care and persistent periodontal therapy in specialized medical and dental clinics.

3

Authors: DR. FAHAD WASEY ,DR SHOBOROSE TANTRAY

Obstructive sleep apnea is potentially sleepdisorder with multiple of negative consequences on patients’ health and society .OSA Symptoms include loud snoring, daytime sleepiness, , and restless sleep. The ‘‘gold standard’’ of detection is by polysomnography, a detailed history and physical examination may help uncover previously undiagnosed cases. Under diagnosed obstructive sleep apnea can cause heart disease, hypertension, depression, and even death. Several othermodalities exist for treating obstructive sleep apnea, including continuous positive airway pressure (CPAP), oral appliances, and several surgical procedures. Conservative approaches like weight loss and alcohol and tobacco cessation, are also strongly encouraged in the patient with obstructive sleep apnea. With increased awareness, a multidisciplinary approach is necessary for an accurate management of the disease.

4

Authors: Dr.Aditi Garg1, Dr.M. Ganesh2, Dr.Vasudha Sodani3, Dr. D.N. Kamala4

Fluoridated toothpastes are one of the best sources of fluoride which effectively protects both deciduous and permanent teeth from caries. The different forms of fluoride available in toothpastes differ in the mechanisms by which they protect against caries. The fluoride concentrations in saliva and dental caries have been reported to be inversely related to the efficiency of caries prevention. With the help of newer fluoridated toothpastes effective caries prevention can be obtained by retention of fluoride in saliva for a longer duration of time. The aim of this study is to evaluate the fluoride retentivelevels in saliva following tooth brushing with two different types of fluoridated toothpastes namely Sodium fluoride (NaF) and fluoride containing bioactive glass and their efficacy in caries prevention.Thirty children in the age group of 3 to 6 years were randomly assigned into two groups as follows: Fifteen children using dentifrice containing 500 ppm of NaF (Colgate for kids) which is the control group and fifteen children using dentifrice fluoride containing bioactive glass (Elsenz) which is the test group. Salivary samples were collected prior to brushing, at an interval of 30 minutes and at an interval of 1 hour respectively and then the fluoride levels were determined. The results showed that there is a rise in the salivary fluoride levels at 30 minutes after brushing in both sodium fluoride and fluoride containing bioactive glass groups. However, in the fluoride containing bioactive glass toothpaste group,the salivary fluoride levels were highat the intervals of 30 minutes and at 1 hour individually from baseline, while with NaF group there is a rise of fluoride level at 30 minutes but decreases to the baseline at 1 hour. The study concluded that fluoride containing bioactive glass toothpaste (Elsenz)showed higher salivary fluoride retention at one hour in comparison to NaF containing toothpaste. Thus newer technology BioMinF, fluoride containing bioactive glass dentifrices with lower fluoride content and with long lasting performance should be adapted for pediatric age group.