A Journal of Clinical Dentistry-Heal Talk

3

Authors: Vipul Srivastava1, Shally Mahajan2

Gingival pigmentation is characterized by the presence of diffuse deep purplish discoloration or irregularly shaped brown and light brown or black patches, striae, or strands on gingiva. It has become a concern for many individuals seeking aesthetic improvement. This article explores the application of soft tissue diode laser in treating gingival depigmentation, comparing it with conventional methods. The advantages, disadvantages, indications, contraindications, and benefits to both dentists and patients are discussed. This case report documents the successful treatment of gingival depigmentation in a 36-year-old male using a soft tissue diode laser. The patient presented with a chief complaint of dark gums, expressing dissatisfaction with the aesthetics of his smile. Following a thorough clinical examination, the decision was made to employ a minimally invasive approach with the diode laser. The procedure demonstrated precision, minimal bleeding, and efficient removal of pigmented tissue. The patient exhibited a swift recovery with a significant improvement in gingival appearance. This abstract highlight the efficacy and aesthetic benefits of diode laser therapy in addressing melanin-induced gingival pigmentation.

3

Authors: Balavignesh S1, Manu Rathee2, Sarthak Singh Tomar3, Pritish Dixit4, Stalin M5, Kritika Diwan6

Currently, innovative techniques and materials are being developed in the field of dentistry. While each has its benefits and drawbacks, the primary challenge is selecting the most suitable materials based on their mechanical, physical, and biochemical properties. As there is a growing demand for esthetics, metal-free materials are needed to meet this demand. Recently, Polyetheretherketone (PEEK), a member of the Polyaryletherketone (PAEK) family, has emerged as a promising alternative material for fixed dental prostheses due to its impressive mechanical properties. Additionally, PEEK and PEEK-based compounds may offer viable alternatives to titanium in the field of dental implantology due to their biocompatibility and high-performance properties.

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Authors: Priyanka Raghav1, Abhiraj Raghav2

Background: Squamous cell carcinoma (SCC) accounts for approximately 94% of all oral malignancies, hence establishing oral squamous cell carcinoma (OSCC) as one of the top 10 most prevalent malignant tumors. Cells with several functions, such as macrophages and myofibroblasts, play a vital role in the biological behaviour of tumors. The aim of this study was to assess and evaluate the prevalence of myofibroblasts (MF) and macrophages in squamous cell carcinomas occurring in oral region. A total of 50 experimental subjects with well-differentiated oral squamous cell carcinoma (WDOSCC) ,moderately differentiated oral squamous cell carcinoma (MDOSCC), and poorly differentiated oral squamous cell carcinoma (PDOSCC) were taken .While 50 healthy subjects were taken as control group. The tissue samples were divided into sections that were 4 micrometers thick. These sections were subsequently subjected to both conventional staining using hematoxylin and eosin, as well as immunohistochemistry(IHC) staining using á- SMA. The comparative analysis of the expression levels of microRNAs was conducted across different stages of oral squamous cell carcinoma (OSCC). Statistical analysis was conducted on all of the outcomes. The findings revealed that the average final staining index score for patients with well-differentiated oral squamous cell carcinoma (WDOSCC) was 9.23, while it was 8.98 for those with moderately differentiated oral squamous cell carcinoma (MDOSCC), and 6.54 for individuals with poorly differentiated oral squamous cell carcinoma (PDOSCC). The control group, on the other hand, exhibited favourable cellular expressions. The present investigation's results indicate that MFs play a significant role in the pathogenesis of OSCCs, and their evaluation may serve as a valuable tool for predicting the invasive characteristics of these malignancies. Consequently, we advocate for the utilization of MFs as a stromal marker to facilitate the identification of invasion and progression in patients with oral squamous cell carcinoma (OSCC).

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Authors: Varun Kumar1, Jyotsna Seth2 , Shubham Talele3

Over the past two decades, the field of artificial intelligence (AI) has experienced notable growth and progress. In the fields of medicine and dentistry, AI shows significant potential for improving patient care and revolutionizing healthcare practices. In the dental field, ongoing research delves into various AI applications, including the recognition of normal and abnormal structures, disease diagnosis, and the prediction of treatment outcomes. This appraisal provides an overview of both current and potential utilizations of AI in the realm of dentistry.

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Authors: Lalit Kumar1, Charnpreet Singh2, Dr Puneet Sharma3, Dr Komalpreet Kaur4

Xerostomia, a prevalent condition impacting nutrition, dental health, and psychological well-being, often presents challenges such as glossitis, mucositis, and difficulty in oral functions. The poor retention and tolerance of removable dental prostheses in xerostomic patients exacerbate these issues. This paper introduces an innovative technique, incorporating a salivary reservoir into the maxillary complete denture which provides effective lubrication of oral tissues and is easily cleansed by the wearer. By addressing the fundamental issue of inadequate lubrication due to reduced salivary flow, this technique has the potential to revolutionize the management of xerostomia-related complications. This practical and accessible solution offers promise for prosthodontic practitioners seeking improved outcomes in the care of xerostomia-affected patients.

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Authors: Varun Kumar1, Kedar Deole2

Dealing with the intricate challenges involved in restoring anterior teeth to attain a natural appearance requires a thoughtful consideration of various factors such as inappropriate size, shape, gingival contour, and aesthetically displeasing shades. The growing desire for solutions that combine aesthetic appeal with the absence of metallic elements has driven the widespread adoption of dental zirconia, acknowledged for its outstanding aesthetic qualities and advantageous mechanical properties. This case report delves into clinical encounters related to customdesigned layered zirconia fixed dental prostheses specifically crafted for the restoration of anterior teeth. The report emphasizes the importance of prosthetic restoration for both endodontically treated and vital abutments, investigating the influence of zirconia composition, layering technique and the distinctive challenges associated with each condition. The specific characteristics of the abutments intricately influence the choices made regarding zirconia composition, framework design, and shade in layered zirconia prostheses. This interdependence underscores the significance of adopting a considerate and personalized approach to meet the distinctive requirements of each clinical scenario.

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Authors: Arpit Sikri1, Jyotsana Sikri2, Vritti Piplani3

Forensic odontology, a discipline with historical roots dating back to 66 AD, plays a crucial role in identifying victims within the legal system. The term "forensic" is derived from the Latin word 'forum,' meaning a court of law, while "odontology" refers to the study of teeth. This specialized field of dentistry contributes to justice by carefully examining dental evidence and presenting essential findings. Dental records and the expertise of forensic dental surgeons are particularly important in identifying deceased individuals, especially in cases where visual or fingerprint methods are insufficient due to postmortem changes or injuries. Prosthodontists, specialists in dental prosthetics, are becoming increasingly indispensable in maintaining comprehensive records. In situations where fingerprinting is impractical, dental identification becomes a critical tool. Forensic odontology focuses on scrutinizing dental evidence for legal purposes, highlighting the uniqueness of teeth influenced by various factors. Individually tailored dental prosthetics serve as primary identifiers in forensic cases involving unidentified bodies, filling crucial gaps where fingerprint databases fall short. During major disasters like aviation accidents or natural calamities such as earthquakes, swift and accurate victim identification is imperative. Victims with intact or most of their teeth provide vital characteristics for effective forensic identification. Prosthodontists, equipped with diverse identification techniques, play a pivotal role in such investigations, particularly when victims have dental prosthetics, offering essential clues for identification. Comparing postmortem dental remains with pre-death records, such as X-rays, is a common practice to confirm identities. Denture markings play a significant role in this process, providing a swift and reliable method of identification, especially when other methods fail. While standardized methods may be lacking, dental practitioners are urged to maintain comprehensive records, including denture markings, emphasizing the importance of readiness for disaster identification. Materials like all-acrylic dentures can be inscribed with a patient's name before fitting, contributing to rapid identification. Notably, in severe accidents where limbs are damaged, certain denture materials, particularly acrylic and metal-based types, often survive, enabling quick identification during calamities. Forensic odontology, an integral part of forensic science, has utilized dental findings for a century to aid the legal system.

3

Authors: Micky Kumari1, Rajdeep Beura2, Adrita Purkayastha3

Periodontitis is a chronic inflammatory disease caused by bacterial infection of the supporting tissues around the teeth. Serum albumin levels might be the practical marker of general health status. Albumin concentration is associated with nutrition and inflammation. The aim of the study is to evaluate the relationship between serum albumin and periodontal disease. A total number of 40 patients of both genders with age range of 35–70 years were included in the study. Patients were divided into two groups. Group I; clinically healthy subjects and Group II; patients with chronic periodontitis. The biochemical parameter serum albumin was correlated with periodontal status.

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Authors: Manisha Khanna1, Tarun Kumar2, Santosh Kumar3, Archana Jaglan4, Renu Yadav5

The aim os this review article is to obtain a basic insight on different types of skeletal anchorage used in orthodontics. The aim is to gain absolute anchorage and to avoid any unfavourable tooth movement in the name of anchorage loss. There are many devices available some of which are anchorage from the zygomatic bone, Miniplates Miniscrews and mid palatal implants. By eliminating the unpredictable reactions of periodontal anchorage, the potential of skeletal anchorage offers the practitioner complete control of anchorage and expands the current orthodontic treatment spectra, reducing unwanted side effects.

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Authors: Pratibha Yadav1, Tarun Kumar2, Geetika Tomer3, Shivani Kumari4, Pravriti Verma5

Impaction refers to a tooth's inability to emerge in the dental arch at the appropriate site. The most common reason for canine impaction is arch -length deficiency. In this overview, the reasons of impaction of the maxillary permanent canines are listed, along with hard tissue blockages, soft tissue diseases, and anomalies of nearby teeth, the classification and the treatment planning. The patient mostly notices when the impacted canine causes unesthetic appearance and a faulty occlusion. Various surgical interventions are also discussed in this review article.

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Authors: Diksha Tripathi1, Tarun Kumar2, Namrata Dogra3, Apurva Pathak4, Sakshi Tyagi5

Obstructive sleep apnoea (OSA) is becoming more and more common. The same is true of the effects on health, security, and the economy. The root causes of OSA and its effects can differ greatly from patient to patient1. This disorder is characterised by recurrent bouts of nocturnal breathing stoppage caused by upper airway collapse severe symptoms are strongly connected with cardiovascular morbidity and mortality2, such as excessive daytime drowsiness. There are now numerous therapeutic choices accessible for this disease management. This article contains basic information related to Obstructive sleep apnoea (OBS), along with the basic and recent treatment modalities which are being used for orthodontic considerations.

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Authors: Vipul Srivastava1, Shally Mahajan2

Tongue tie, a condition present at birth, occurs when the strip of skin beneath the tongue (lingual frenulum) is shorter than usual, limiting the range of motion. While traditionally associated with feeding difficulties in infants, recent studies suggest a surprising link between tongue tie and neck pain in both children and adults. This article aims at highlighting a multidisciplinary approach, where soft tissue diode lasers, offers a promising path to alleviating neck pain and improving overall well-being for those affected by this often-overlooked condition.

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Authors: Maddhesia D Taruna Puri Varun Kashyap Anita Bishnoi Mridul Khanduri

White spot lesions (WSLs) are a major side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The purpose of the article is to review the current evidence regarding diagnosis, risk assessment, prevention, intratreatment management, and post-orthodontic treatment of WSL, and to provide clinical recommendations useful for both the orthodontist and the general dental surgeons. Initial orthodontic patient evaluations should include a Caries risk assessment, and risk-specific prevention and management protocols can help reduce or eliminate this clinical problem. Depending on the severity of the lesions, a variety of treatment options are available for WSL, ranging from conservative to invasive techniques.

3

Authors: Preetika Yadav, Jyoti Sharma, Vivek Sharma, Chandrika Saini, Enna Madaan

One percent to sixteen percent of all acute dental injuries involve the avulsion of permanent teeth, which is considered a dental emergency. It often affects people in the 7 to 14 age range, and the maxillary central incisors are the most frequently affected teeth. Replanting an avulsed tooth can restore occlusal function and aesthetics. This article's goal is to detail the treatment of a 12-year-old male youngster who had his permanent maxillary central incisor avulsed and replanted seven days after receiving triple antibiotic root surface treatment.

3

Authors: Vipul Srivastava1, Shally Mahajan2

Laser technology has significantly transformed the landscape of dentistry, offering numerous benefits in terms of precision, reduced discomfort, and faster healing. However, it is not without its share of controversies. This article explores key controversies surrounding laser dentistry, including safety concerns, efficacy debates, cost considerations, regulatory challenges, and patient acceptance issues. By addressing these concerns, dental professionals can make informed decisions and create awareness about integrating laser technology into their practice, ensuring the best possible care for their patients.

3

Authors: Dr. Shrishti Bhardwaj, Dr. Lalit Kumar, Dr Komal Sehgal

A 40-year old male patient reported to the OPD with a chief complaint of difficulty in eating, drinking and speaking. He had undergone maxillectomy due to post covid mucormycosis 1 year back. Definitive hollow bulb obturator. It was made hollow to reduce the weight of the obturator. Primary and final impressions were taken and cast was formed. The hollow bulb was made with lost salt technique to reduce the weight.

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Authors: Manu Rathee1, Stalin M2, Maqbul Alam3, Sarthak Singh Tomar4, Kritika Diwan5

The structures of the hard and soft palates play an important role in speech and swallowing. When these structures are damaged or removed due to illness or injury, it can lead to disability or impairment. These defects can be present at birth or develop later in life. They often involve large openings in the palate and surrounding structures. To restore proper chewing, speech, and appearance, obturators are used to seal these defects. During the post-surgical phase, interim obturators may be recommended to promote healing and serve as a temporary prosthesis for patients with intraoral surgical defects. This article presents case reports describing the fabrication of an interim obturator using conventional techniques.

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Authors: Dr. Komalpreet Kaur, Dr. Lalit Kumar, Dr. Shefali Singla, Dr. Sunint Singh

A 55-year-old female patient came to the department with existing maxillary removable partial denture and Kennedy's class I modification I situation in lower arch.

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Authors: Novneet Kour1, Nausheen Fatima2, Avneet Kour3, Shweta Yadav4, Mohd Rehan5, Manish Khatri6

Piezosurgery is a novel technique that uses piezoelectric ultrasonic vibration to provide safe and precise osteotomy. Recently this technique has gained importance Fatimbecause of its ease of use and safety. Professor Vercelloti in 1988 invented this technique known as piezosurgery or piezoelectric bone surgery. The piezoelectric effect occurs when an electric current is passed around a stack of crystals and they start to vibrate at a modulated ultrasonic frequency of 24-29 Hz. and microvibration amplitude between 60 and 200 mm per second. This technique allows a clean precise and controlled cut of bony structures without causing destruction of soft tissue. This article focuses on the broad range of applications of this novel technique in Periodontology.

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Authors: Rajdeep Beura, Adrita Purkayastha, Micky Kumari, Samarjeet J. Pattanaik

Introduction/Background: Aims & Objectives: Results: Conclusion: Irrational use of drugs is a major problem for present day dental practice. Various medications are being prescribed for periodontal complaints. However, not many studies have been carried out on the type and distribution of medications prescribed for patients with periodontal concerns. Knowledge obtained from these may be beneficial for addressing issues such as injudicious use. To assess the pattern and trends of drug prescription for periodontal complaints in Bhubaneswar and Cuttack. Total 242 prescriptions were taken into account, and it was found that for various periodontal problems the main antibiotics prescribed are Ofloxacin and Ornidazole combination followed by Amoxicillin. Main analgesic prescribed are Diclofenac followed by a combination of Paracetamol and Aceclofenac. Main Proteolytic enzyme used are Seratiopeptidase. The above result indicates the need for more precise education of dentist on rational prescribing and to take measures for effective use of drugs in all types of periodontal complains.

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Authors: Seema Malhotra1, Nishita Kankane2, Vinay Kumar Gupta3

Abstract Background:Teething though a physiological process is shrouded by the myths. These myths have made parents believe teething as a pathological phenomenon. Aim:To evaluate differences in beliefs and related practices to alleviate teething symptoms by Non-health care professional parents, parents pursuing Allopathy, Homeopathy and Ayurveda.Material and methods: Two hundred and eight parents were randomly selected and cross-sectional survey was performed.The survey used a self-administered structured questionnaire containing 17 items divided into two sections.The first part contained twelve questions targeted to evaluate the parents’ beliefs about teething associated signs and symptoms. Second part composed of five questions that aimed at investigating the practices that the parents would do to manage teething problems.To summarize the sample and practices descriptive statistics were used.Results:>60% of Ayurveda and homeopathic professional parents attributed inflamed gingiva, increased salivation, fever, diarrhea, restlessness, reduced apatite and pain to teething. In each group highest percentage of response was that diarrhea is associated of teething.To relieve the health upsets for infant’s teething, 75% employed medications for symptomatic relief and this response was greatest in all groups.Conclusion: In every group most thought that infant’s suffer at least some symptoms hence prescribing medications for relief was a most common practice for management of teething related signs and symptoms.

2

Authors: Dr. Rohan Khare

A14 year old male patient reported to the dept with an impacted canine. On examination, canine exposure using LASER was decided. Soft tissue diode laser was set to gingivectomy mode (0.8 W setting) at continuous pulsation mode. The tissue was excised and COE Pak was given. Patient was recalled after 10 days. On examination, the healing was proper and further orthodontic treatment was initiated.

3

Authors: Manu Rathee1, Pritish Dixit2, Maqbul Alam3, Prachi Jain4, Sarthak Singh Tomar5, Kritika Diwan6

An intermediate abutment also known as a lone standing abutment or pier abutment is defined as a natural tooth or implant abutment that is located between terminal abutments that serve to support a fixed or removable dental prosthesis. If a rigid connector is used and occlusal load is applied on the abutment teeth at one end of fixed partial denture (FPD), it will tend to lift the other end like a Class I lever causing stress on the terminal abutments and ultimately failure of the FPD.Therefore, non-rigid connector is employed to diminish the forces instead of the usual rigid connector. This case report describes the prosthetic rehabilitation of missing maxillary first premolar and first molar using a five unit fixed dental prosthesis with a digitally designed and fabricated non-rigid connector

3

Authors: Dr. Yesh Sharma1, Dr. Kailash Asawa2, Dr. Mridula Tak3

A patient reported to the Department office Public Health Dentistry with a chief complaint of missing upper and lower teeth since 5 months. Patient gives history of exfoliation of teeth due to trauma 5 months ago. Patient undergone surgery of fracture of maxilla and mandible 5 months ago from Hospital, Udaipur.

3

Authors: 1Arjit Vihan, 2Rajendragouda Patil, 3Ambika Murari, 4Himani Singh

A 22-year-old female patient reported to the Department of Oral Medicine and Radiology of Kothiwal Dental College and Research Centre with a complain of swelling in right side of the face since 1 month. Swelling was associated with pain. Pain was gradual in onset, moderate in intensity, intermittent in nature. No aggravating and relieving factors. Eventually pain was associated with pus discharge which increased on chewing and subsides on itself.

4

Authors: Preeti Sangwan1, Tushti Upadhyayand2

Introduction: Case Report: Uniqueness of the Case: intentional replantation following endodontics may be an option when surgical access is very limited or presents unacceptable risks. It has been proposed as an alternative to retrograde endodontic procedure. The purpose of replantation is to prevent permanent loss of the tooth and to replace the landscape of the mouth. Any tooth that can be a traumatically removed can be a potential candidate for intentional replantation. A 14-year-old girl reported to our department with pain in lower right back tooth region with a history of failed endodontic procedure. Intraoral IOPA was taken, fractured instrument was seen at apical third of the canal. Tooth was intentionally removed a traumatically and treated endodontically, splinting was done. intentional replantation is considered as a last resort for preserving the tooth. It is a predictable method when tooth removed a traumatically.

4

Authors: Preetika Yadav, Riddhi Sidhmukh, Priti Deswal, Vivek Sharma, Chandrika Saini

Malocclusion are the most common conditions affecting the esthetics during the mixed dentition period of children. The objective of the treatment should be conservative, economical, and comfortable to the patient, with satisfaction being the major treatment outcome. The purpose of this case report is to describe the economical easy management technique in a boy aged 11 years, for correction of midline diastema and anterior single crossbite by a removable appliance incorporating a split labial bow and a z-spring, respectively and correcting both problems simultaneously with single appliance in 3 months with final alignment finishing with the help of sectional bracketing.

5

Authors: Dr Neha Gaur1 Dr Lalit Kumar2 Dr Shefali Singla3 Dr Manisha Khanna4

A 59 years old male patient reported to the Department of Prosthodontics with chief complaint of replacement of missing teeth. Pre-operative intra-oral assessment revealed #13 and #16 splinted together with a metallic bar and two implants with secured healing abutments wrt #23 and #25 region. The mandibular arch was already restored with splinted PFM crowns along with a cast partial denture with two precision attachments. A tooth-implant supported overdenture was planned. Faulty tooth supported bars were removed and new bars with precision attachments were fabricated based on established vertical dimension. The female housings were picked up in the denture base followed by teeth arrangement, wax-up and try-in. Insertion was done and patient was thoroughly examined in follow-up appointments after 24 hours, 1 week, 15 days and 1 month.

3

Authors: Ravnitya Pal Singh1, Supreet Singh2

A dermoid cyst is a teratoma of a cystic nature that contains an array of developmentally mature, solid tissues. It frequently consists of skin, hair follicles, and sweat glands, while other commonly found components include clumps of long hair,pocketsof sebum, blood, fat, bone, nail, teeth, eyes, cartilage, and thyroid tissue. As dermoid cysts grow slowly and contain mature tissue, this type of cystic teratoma is nearly always benign. In those rare cases wherein the dermoid cyst is malignant, a squamous cell carcinoma usually develops in adults, while infants and children are usually present with an endodermal sinus tumor.

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Authors: Vipul Srivastava1, Shally Mahajan2

The introduction of laser light as a source of amplified, stimulated emission of radiation, gave clinicians and researchers a chance and opportunity to obtain and use these high-powered light on biological tissues to create a new perspective for its application in healing and tissue regeneration. The use of laser light at power levels (specific wavelengths and power) have been documented to be capable of protein denaturation, water vaporisation and tissue ablation. The purpose of this article is to explain the mechanisms of action and to explore the uses of this group of lasers in general dental practice.

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Authors: Anurag Satpathy

Artificial intelligence (AI) is revolutionizing various fields, including business, medicine, education, and the arts. In the medical field, AI has made remarkable progress. AI algorithms designed for medical imaging can analyze images to detect abnormalities, leading to more precise and timely diagnose. In dentistry, it is used in diagnostic imaging, dental analytics, treatment planning, virtual and augmented reality training, natural language processing for medical records, patient experience through chatbots, and oral hygiene with smart devices. In periodontics, AI is being explored for tasks such as diagnosing and predicting periodontally compromised teeth, severity prediction of chronic periodontitis, correlation with systemic health outcomes, and detection of periodontal bone loss in radiographic images.While AI holds great potential, it also poses challenges. Privacy, security, transparency, accountability, and the impact on economic inequality and job markets are important considerations.