A Journal of Clinical Dentistry-Heal Talk

4-50

Authors: Dr. Namita Jaggi Dr. Deepak Girdhar

Invisalign is a series of clear, removable teeth aligners that orthodontists use as an alternative to traditional metal dental braces. Invisalign is designed, manufactured, and marketed by Santa Clara-based medical-device company Align Technology, Invisalign is an improved copy of a technique developed by orthodontists in the early 1900s. Orthodontists used a clear polymer aligner to move the teeth by setting the teeth into a different place in the plaster model and then making a new aligner. This article describes the Invisalign technique. The technology behind Invisalign and its development is reviewed. The Invisalign clinical technique is described, and the advantages and disadvantages of using Invisalign are highlighted.

10

Authors: Dr. Rakesh Agarwal, Dr. Chand Sawhney, Dr. Santosh Kumar Dr. Mohit Dhingra, Dr. Amit Agarwal

Begg technique is based on an unique approach to treat the orthodontic cases by using light forces with the objective of moving the teeth with optimal forces. The advantages of this technique includes-

11-13

Authors: Dr. Shilpa Khullar Dr. Anika Mittal Dr. Pankaj Datta

To understand how an implant can function within physiologic limits of health, one should consider information from many areas including physiology, biochemistry, biomaterials and biomechanics in relation to normal repair and regeneration mechanisms. Providing that the implant material is biocompatible and that correct insertion techniques are employed, healing after insertion of an implant can be described using known repair mechanisms. When an endosteal implant is inserted, epithelium, connective tissue and periosteum are incised and bone is removed in creating the osteotomy to receive the implant. This causes tissue injury and induces an expected slight inflammatory reaction. A cellular response is induced in which pluripotential cells undergo cell differentiation into a variety of cell types required for healing.1 Biochemical and bioelectric signals have been described to occur to influence the processes of angiogenesis and ostoegenesis.2 Although these responses occur naturally in response to tissue injury, factors within the clinical protocol directly affect them and therefore influence the healing.

11-12

Authors: Dr. J.T. Nainani Prof. (Dr.) Ghanta Sunil Prof. (Dr.) U.S. Krishna Nayak Dr. N. Robin Mathew Prof. (Dr.) K. Saidath

In recent years patient awareness & changed lifestyles have increased the demand for adult orthodontic treatment. Multidisciplinary dental therapy has allowed better management of the more complicated & unique requirements of adult patients, thereby greatly improving quality of care, as well as treatment prognosis. The orthodontist treating adult patients often encounters a dentition that was neglected after premature extractions of posterior teeth. This early loss of posterior teeth and a delay in replacing the missing teeth results in over eruption of antagonist teeth1. This situation can complicate the placement of prosthetic restoration and may lead to lateral occlusal interferences.

12-14

Authors: Dr. Kunal Mehta Dr. Omkar Shetty Dr. Sabita Ram

Aim: To evaluate and compare the stress distribution under Polymethyl Methacrylate Acrylic Resin and Acetyl Acrylate Resin dentures during simulated occlusal loading.Objectives: 1)To evaluate the amount of stress distribution on the edentulous ridge under Polymethyl Methacrylate Acrylic Resin Dentures subjected to simulated occlusal loading. 2) To evaluate the amount of stress distribution on edentulous ridge under Acetyl Acrylate Resin Dentures subjected to simulated occlusal loading.3) To compare the stress distribution on the edentulous ridge under Polymethyl Methacrylate Acrylic Resin and Acetyl Acrylate Resin Dentures subjected to simulated occlusal loading. Materials and Methods:The materials used were Polymethyl Methacrylate Resin ( Group I ) and Acetyl Acrylate Resin. They were evaluated for stress distribution under occlusal loading. Results: The observations obtained were statistically analyzed by Student’s t- test and Levene’s test. Group I showed equal distribution on all the surfaces where as Acetyl Acrylate showed more stress premolar and molar region. Conclusion: Polymethyl Methacrylate Acrylic Resin Dentures (Group I) showed better stress distribution than Acetyl Acrylate Resin Dentures(Group II).

13-17

Authors: Dr. Kotni Prem Sagar Dr. Mukesh Kumar Dr. B. V. Sreenivasa Murthy

Thirty four freshly extracted single canal teeth were cleaned, shaped, and obturated with gutta percha and Zinc Oxide Eugenol sealer. After removing 4 mm of coronal gutta percha from thirty teeth, they were randomely divided into three groups of ten teeth each. 4mm of either Mineral Trioxide Aggregate or Glass ionomer or bonding agent and flowable composite was placed in the chamber over gutta percha. A positive control group of two teeth received no barrier. A negative control of two teeth was covered on the coronal aspect with sticky wax. Teeth were thermocycled for 500 times(50and 550). All teeth were covered with two coats of nail varnish except the access openings. All teeth were immersed in Indian ink for 48 hours and then sectioned longitudinally and then the amount of dye penetration was measured under a stereomicroscope at 30X magnification to the nearest 0.5 mm. The mean penetration was for each group was compared using ANOVA and Multiple comparisons were carried out within the different groups. Results showed that glass ionomer group leaked significantly more than MTA and flowable composite. There was no significant difference between MTA and flowable composite. Positive control sections exhibited maximum leakage whereas negative controls had none. It was concluded from this study that the placement of intracoronal barrier potentially reduces the avenue for microleakage as compared to a barrier-less root canal. Mineral trioxide aggregate and flowable composite with dentin bonding agent when placed coronally in 4mm thickness over gutta percha, seals the canal content significantly better than glass ionomer cement. The gray or white MTA and flowable composites can be advantageous in case of retreatment or post preparation as its removal would be much easier. Mineral trioxide aggregate and flowable composite with dentin bonding agent may be preferred over glass ionomer as a coronal barrier placed immediately following root canal treatment to prevent reinfection of the canal system.

15-17

Authors: Dr. Priyanka Kant Dr. Neelkamal Sharda Dr. Natalia Desilva

Oral submucous fibrosis was first described in 600 B.C, by Sushruta a well-known expert on Indian Medicine. He described in his classification of mouth and throat maladies a condition called “Vidari” which is similar to oral submucous fibrosis.

17

Authors: Dr. Anuja Agarwal, Dr. Manoj Basal Dr. Nitin Sharma, Dr. Nishant Kumar

Basal cell carcinoma is the most common malignancies in Asians and usually present in patients between ages of 50 to 70 years. The ala of the nose and nasolabial fold is the most common site. Surgical excision of the tumours from the face may create an unsighted defect that is difficult to restore. Skin graft can cover only superficial defects and has a tendency to contract and may not take properly. Also because of colour mismatch, it is not cosmetically identical to the face. The nasolabial flaps are very useful and versatile local flaps, with robust vascularity. The flap can ne superiorly based to reconstruct defects on the cheek, side wall or dorsum of the nose, alae, columella and lower eye lid. Inferiorly based flaps can be used to reconstruct defects in the upper and lower lip.

18

Authors: Dr. Shashikala Jain Dr. Sanjay Jain Dr. Atul Bhardwaj Dr. Sandeep Kumar Dr. Rajnish Aggarwal

The Crown and Sleeve-coping removable telescopic partial denture utilizes the basic concept of an overdenture. While functioning as an overdenture it also serves the therapeutic role of a periodontal splint. It is the best treatment modality in patients with weakened periodontal situation where the main challenge of therapy is to salvage the remaining abutment teeth, the periodontal apparatus and the alveolar bone support. The Crown and Sleeve-coping prosthesis is used as a therapy rather than a mere replacement. CAD/CAM based zirconia ceramics are popular contemporary ceramics with excellent physical properties, biocompatibility and superior esthetics.

18 & 20

Authors: Dr. Khaidem Deba Dr. Nadeem Yunus Dr. Amit Kumar Tamrakar

Restoration of facial defects is a difficult challenge for both the surgeon and the prosthodontist. Both surgical reconstruc¬tion and prosthodontic restorations have distinct limitations. The prosthodontist is limited by inadequate materials available for facial restorations, mov¬able tissue beds, difficulty in retaining large prostheses, and the patient's capability to accept the final result. Patient acceptance and use of facial prostheses is not uni¬versal primarily due to unrealistic patient expectations. This article emphasize upon, the objective historical aspects of maxillofacial prosthetics.

18-19

Authors: Dr. Khaidem Deba Dr. Amit Kumar Tamrakar Dr. Nadeem Yunus Dr. Murali G.

Maxillofacial prosthetics is a branch of dentistry that deals with congenital and acquired defects of the head and neck. Maxillofacial prosthetics integrates parts of multiple disciplines including head and neck oncology, congenital malformation, plastic surgery, speech, and other related disciplines. A person’s personality can be affected to a great extent due to Facial disfigurement. Maxillofacial prosthesis helps in rehabilitating such cases and makes them socially acceptable. In the previous articles of this series we discussed about the objectives and historical aspects of oral and maxillofacial prosthetics and materials used to fabricate them. In the present article a case report of eye prosthesis is presented here.

20-23

Authors: Dr. Sonal Dalal Dr. Milan Dalal Dr. Rizwan Momin

The focus of periodontal surgery has shifted over time from a philosophy based on resection to one based on regeneration. This shift has particular significance in cases of advanced periodontitis in aesthetic zone. When severe attachment loss is present, cosmetic reconstruction can not take place until the periodontitis has been treated and the ongoing loss of attachment has been arrested. In the past, resective surgical techniques were used to treat such cases without aesthetic value. Recent advancement in regeneration techniques have potential to restore lost periodontal tissue and has aesthetic value.

20

Authors: Dr. Anubha Nirwal Dr. Anamika Sharma

An endodontic clinician may face unwanted situations during root canal treatment. We present here an unusual case of necrosis of periodontal tissues and supporting alveolar bone following the use of Caustinerf Forte in an iatrogenic perforated pulp chamber floor during endodontic treatment.

22-24 & 26

Authors: Dr. Meenu Garg Dr. K.N. Raghavendra Swamy Dr. Anil Kumar Gujjari Dr. Ramesh Gupta

Purpose: The aim of this study was to evaluate and compare the transverse strength of conventional heat cure denture base resin reinforced with glass and carbon fibers processed by heat and microwave energy. Materials and Methods: Total 48 specimens were fabricated. Out of these-24 specimens were processed by conventional heat & 24 specimens were processed by microwave energy. The specimens were divided into 6 groups (8 specimens in each group Group1: unreinforced, processed by heat. Group2: unreinforced, processed by microwave energy. Group3: Reinforced with glass fibers, processed by heat. Group4: Reinforced with carbon fibers, processed by heat.Group5: Reinforced with glass fibers, processed by microwave energy.Group6: Reinforced with carbon fibers processed by microwave energy. After processing, the specimens were subjected to transverse strength testing. Results: Microwave polymerized group has greater mean transverse strength as compared to heat polymerized group. Among all the groups, group-5 has the highest mean transverse strength value. Whereas, group-1 has the least mean transverse strength value. Conclusion: Within the limitations of this in-vitro study, glass fiber reinforced resin with microwave polymerization technique, significantly increases the transverse strength of heat cure denture base resin.

22

Authors: Dr. Anuja Agarwal Dr. Nishant Kumar Dr. Amit Tyagi Dr. Kriti Agarwal

Odontomes are hamartomas composed of various dental tissues, i.e., enamel, dentin, cementum and sometimes pulp. They are slow-growing, benign tumours showing nonaggressive behaviour1. They are classified as complex, when the calcified tissues are present simply as an irregular mass composed mainly of mature tubular dentin, or compound, if there is superficial anatomic similarity to even rudimentary teeth2. Complex odontome are less common than the compound variety in the ratio 1:23.We present a case of complex odontome, in a 42 year old male in the area of left angle of mandible region.

23-24

Authors: Dr. Malathi Buddhi Dr. Arpana Arora

Sleep apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing. A description of normal sleep physiology and causes and effects of sleep deprivation has been discussed. Types of apneas and diagnostic parameters for apneas have been elaborated.Sleep apnea in children and effects of not diagnosing and treating the same has been discussed in this part of the series on Sleep Apnea.

24

Authors: Dr. Rajesh J. Kamdar Dr. Amol J. Pharande Dr. Chetan D. Patil

Ideally, extraction of deciduous teeth should be avoided as far as possible. If, at all extraction is undertaken then after considering dental age of the patient, we should decide about space maintainence. The use of space maintainers after the premature loss of deciduous molars is important for maintaining integrity of the arch. In this case report we describe a procedure which should help Dental Surgeons to prepare fixed maintainers in their Dental office.

26-27

Authors: Prof. (Dr.) Muralee Miohan Dr. Smitha Bhat Dr. Arvind Karikal Dr. Akshaya Ashok Kulkarni

Fine needle aspiration cytology (FNAC) is a technique for obtaining cells from a lesion for cytological examination and evaluation1. Initially it was conceived as a means to confirm a clinical suspicion of local recurrence or metastasis of known cancer without subjecting the patient to further surgical intervention.3 Kun reported the use of aspiration cytology as early as 1847. Hirschfield published the first diagnosis of a solid tumor, a lymphoma, using aspiration cytology in the year 1919. Martin and Ellis were the ones to suggest aspiration cytology as a routine procedure for the diagnosis of solid tumors. Their use in the head and neck area was advanced in the 1950s and 1960s by Enroth et al.

26

Authors: Dr. Naresh Sharma Dr. Archana Sachdeva Dr. Sachin Dev Sachdeva

Head injuries are prevalent in collision sports. Concussions represent the relatively benign end of the spectrum of injuries. Severe closed head injuries include epidural hematomas, acute subdural hematomas, intracerebral hematomas, intraventricular hematomas, subarachnoid hemorrhages, and diffuse axonal injuries.

27-29

Authors: Dr. Gaurav Mittal Dr. Deepa Hatwal Dr. Prerna Mathur Dr. Rahul Paul

Central giant cell granuloma is a non neoplsatic lesion which exhibits a spectrum of clinical behavior ranging from non aggressive to aggressive variants. It is defined as an intraosseous lesion consisting of cellular fibrous tissue containing multiple foci of hemorrhage and aggregation of multi nucleated giant cells. These lesions may sometimes lead to a confusion in their diagnosis as many pathologists report them taking in to consideration one of the prominent histopathologic feature. These confusions may be because of the smaller number of cases reported in the literature with uncertain clinical radiographic and histopathologic features of these lesions. The case reported here resembled a wide variety of conditions that led to a misdiagnosis on clinical and radiographic examination but was histopathologically diagnosed as CGCG. This paper presents a case of CGCG involving the anterior mandible in a young male patient with clinical, radiological, histopathological and surgical aspect of the lesion. The striking feature of the present case is its aggressive nature and the presence of an impacted canine in the lesion which led to misdiagnosis of the pathology.

28-29

Authors: Dr. Varun Kumar, Dr. Ankit Gupta Dr. Puneet Kalra, Dr. Renu Chaturvedi

The main aim of maxillofacial prosthodontics is successful rehabilitation of function and esthetic of patients with gross anatomic defects and deformities of head and neck. The demand for maxillofacial prosthetic devices for the rehabilitation of such types of patients has intensified in recent years. This paper presents a case report of a female patient who has undergone hemimaxillectomy of right side.

28-29

Authors: Dr. Amarnath Shenoy Dr. Shruti D. Nayak Dr. Arjun Nayak

Ozone therapy is slowly capturing increasing attention in our country since recent developments have clarified biochemical mechanisms of action and the real possibility of taming ozone toxicity. The potential toxicological actions of ozone should not preclude its employment for dental and medical purposes.

32

Authors: Dr. Ajai Kumar Garg Dr. Poonam Agrawal

Dental treatment and procedures are most widely accepted as factors predisposing infective endocarditis. However most cases of infective endocarditis are not preceded by dental procedures within 3 months before endocarditis. Antibiotic prophylaxis, if 100% effective, likely prevents only a small number of cases of endocarditis. Frequency and magnitude of bacteremia associated with dental procures and routine daily activities like tooth brushing and flossing are similar. In view of this, American Heart Association has recommended antibiotic prophylaxis only patients with high risk cardiac lesions, in conjunction with dental procedures wherein there is manipulation of gingival tissue, periapical region of teeth or perforation of oral mucosa. Maintaining good dental hygiene is also advised.

32-33

Authors: Dr. Muralee Mohan Dr. Smitha Bhat Dr. Arvind Karikal Dr. Shyam S. Bhat

Sialolithiasis is the most common cause of salivary gland obstruction. Obstruction can be complete or partial and may cause recurrent symptoms. The retained saliva exerts retrograde pressure on the salivary gland, and may cause transient or total damage to the parenchyma and the ductal system.

33-34

Authors: Dr. Poonam Agrawal Dr. Ajay Kumar Gupta Dr. Ajai Kumar Garg

Clefts of lip and palate are common serious congenital anomalies affecting the orofacial region. A cleft lip or cleft palate is a defect in the lip or palate. These two entities can occur separately or simultaneously. The cleft lip can be unilateral or bilateral, it can be complete or incomplete. The cleft palate is divided into prepalatal clefts and postpalatal clefts, the incisive foramen being the dividing point. Prepalatal clefts involve the anterior palate , alveolus, lip, nostril floor, ala nasi. They can be complete or incomplete. Post postpalatal clefts are posterior to incisive foramen. They can be complete or incomplete depending on whether or not they extend all the way through the soft and hard palates to the incisive foramen.

34-36

Authors: Dr. Shilpa Khullar, Dr. S. Sood Dr. A. Mittal, Dr. K. Bhargave Dr. Pankaj Datta, Dr. S. Sharma

Tobacco use is one of the leading preventable causes of morbidity and mortality. The most powerful predictor of adult tobacco use is its initiation during adolescence, the most susceptible time for onset of this habit. Initiation of tobacco use is associated with peer pressure, parental use, school factors, cultural norms, lower self esteem, accessibility, moderate pricing, desire for experimentation and aggressive marketing by tobacco companies.

35-37

Authors: Dr. Shilpashree K.B. Dr. Naganandini S. Dr. Ramakrishna T.

Early Childhood Caries is a complex disease involving maxillary primary incisors within a month after eruption and spreads rapidly to involve other primary teeth1. It is a serious socio-behavioural and dental problem that afflicts infants and toddlers2. American Academy of Pediatric Dentistry (AAPD) in 2003 defined ECC as the presence of one or more decayed (non-cavitated or cavitated), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. The academy also specifies that, in children younger than 3 years of age, any sign of smooth surface caries is indicative of severe early childhood caries (S-ECC). From ages 3 through 5, 1 or more cavitated, missing (due to caries) or filled smooth surfaces in primary maxillary anterior teeth or a decayed, missing, or filled score of > or equal to 4 (age 3), > or equal to 5 (age 4), or > or equal to 6 (age 5) surfaces constitutes severe early childhood caries (S-ECC)

36

Authors: Dr. Udo Krase-Hohenstein

Prof. Dr. Georg Dietz (Munich) was already interested in bone regeneration and calcium hydroxide (CaOH) more than 20 years ago. Dietz published 1998 together with Prof.Dr. Peter Bartholmes and Dr.Wolfgang Röcher the book “Calcium Hydroxide and Bone Regeneration”, reporting at length about alcium hydroxide’s effect on bones. My generation learned extensively that calcium hydroxide in contact with bloody tissue generates a necrobiotical zone. A calcite membrane develops, which reduces a deep acid burning, preventing a deeper penetration. This is an aqueous CaOH solution, which has a necrobiotical effect. Dietz found out by chance that the “oily” CaOH suspension had a beneficial bone regeneration effect. What are the respective interrelational changes ccurring in aqueous and oily calcium hydroxide suspension? While the aqueous CaOH suspension builds a calcite membrane that prevents a deep acid burning of the tissue, the oil in the oily CaOH suspension prevents an acid burning of the bloody tissue. An oily protective cell layer develops, whereby calcium hydroxide in the oily suspension cannot react with the body water.

36-37

Authors: Dr. Poonam Agrawal Dr. Ajai Kumar Garg

Clinical applications of universal precautions should be familiar to every health care professionals providing dental, medical, or other patient care. Blood is the single most important source of HIV, HBV, HCV and other blood borne pathogens in the occupational setting. Infection control efforts for HIV, HBV, HCV, and other blood borne pathogens must focus on preventing exposures to blood as well as on delivery of HBV immunization and proper sterilization of instruments.

37-39

Authors: Dr. Ramakrishna T. Dr. Shilpashree K.B Dr. Shabana A.G.

Background and Objectives: Preschool oral health is an overlooked aspect of childhood health and well being, especially Early Childhood Caries. It is an infectious and multifactorial disease of the Childhood. Several factors play a role in the etiology of disease. The objectives of the present study was to 1) To determine prevalence of Early Childhood Caries in children aged 3 years attending the Anganwadi Centers of Bangalore South 2) To correlate the Early Childhood Caries in children aged 3 years with feeding practices. Methodology: A Cross-sectional study was conducted in children aged 3years attending Anganwadi centres of Bangalore South. Required and relevant information regarding feeding practices were obtained from parents. Dentition Status and Treatment Need (WHO 1997) was used to record caries. ANOVA and f-test was used for statistical analysis. Results: The prevalence of ECC was 31.4% with mean dmft of study population is 1.15±2.28 with the males having an average dmft of 1.31±2.48 and females having an average dmft of 1.01±2.07. The risk factors for caries in this study population were found to be the habit of bottle feeding in the night with a p value of <0.001, children who consumed more in between meal snacks had a higher ECC prevalence with a p value of <0.001. Conclusions: The present study provides an insight regarding the caries prevalence in children aged 3 years. This study indicates high caries levels in children with bottle feeding at night and snacking frequency of more than 3 times in a day.

38-39

Authors: Dr. Naresh Sharma Dr. Visuja Chaudhary

Effect of calcium hydroxide/Iodoform paste on necrosis of gingiva: a case report.

39-41

Authors: Dr. Neelkamal Sharda Dr. Priyanka Kant

Few advances in dentistry have been as remarkable as the use of dental implants to restore orofacial form and function. Dental implants are gaining immense popularity and wide acceptance because they not only replace lost teeth, but are also permanent restorations that do not interfere with oral function or speech or compromise the self-esteem of patients. It is important to be able to place the implants in the mandible and maxilla with a high degree of precision. No tool in dentistry plays a more vital role in diagnosis and treatment planning than radiography.

40

Authors: Dr. Prerna Kataria, Dr. Gurleen Kaur Dr. Mudit Uppal

Sudden loss of teeth, especially in the anterior region, can severely affect the psychology of the patient. This loss of the tooth can be due to trauma, periodontal disease or endodontic failure. Although an anterior tooth has mechanical functionality, it is the compromised facial esthetics associated with tooth loss that is the patient's primary concern. Immediate esthetic replacement of the missing tooth will be required1. This replacement can be temporary, semi-temporary or permanent in nature. Depending on many clinical and economic factors, a course of treatment is decided upon by the patient and dentist. Various options for prosthetic replacement of missing anterior teeth present the clinician with certain challenges. The ability of clinicians to restore these edentulous areas using commonly available materials, combined with a direct method of application, would eliminate or greatly reduce many of the obstacles. In the past there have been a number of different techniques described for splinting teeth and adding a natural tooth pontic, denture tooth, or composite resin tooth pontic. These pontics were connected to the adjacent teeth with adhesive composite resins, wire, metal mesh, nylon, mesh and cast metal frameworks bonded to the adjacent teeth2,3. But the advent of dental resins and resin adhesive techniques in the late 1950s allowed clinicians to achieve better, more esthetic stabilization technique.

40-42

Authors: Dr. Sajili Mittal, Dr. Prerna Kataria Dr. Vishal Arya, Dr. Lavina Taneja Arya

Increased tooth mobility has concerned dentists since the 19th century1. The stability of the dentition is dependent on the resistance of the supporting structures of the teeth and the magnitude, frequency, duration and the direction of forces acting upon them2. To evaluate the effectiveness of periodontal treatment, the examination of tooth mobility is significant & should therefore be accurate. Examination of tooth mobility is an important diagnostic aid in determining the severity of periodontal disease.

42-43

Authors: Dr. Vishweanath Patil Dr. Siddharth Sonwane

Although a small number of health care providers (including orthodontists) have decided to “go bare” and practice without professional liability insurance, the overwhelming majority are insured against loss from professional negligence by one of the dozen or so carriers. This review present possible Legal issue and its related suggestions.

42-43

Authors: Dr. Vivek Mehta Dr. Anupma Mehta

No other factor plays a more significant role in pediatric dentistry than the restoration of deciduous dentition till its normal time of exfoliation. Premature loss of deciduous tooth might lead to wide range of implications. The stainless steel crown is the best restorative material for the treatment of badly broken down primary teeth. In this review article we discuss the role of stainless steel crowns in pediatric dentistry.

43

Authors: Dr. Suprabha Hooda Dr. Niraj Rampal Dr. Salil Pawah Dr. Amit Gupta Dr. Bhanu Madan Dr. Prasoon Shukla Dr. Gautam Adhikari

Rehabilitation of patients with disabilities of head and neck region due to either acquired or congenital defects is a challenging task. These defects may range from minor cosmetic discrepancies to major functional limitations. The prosthodontic management of these patients aims at not only restoring the patients physical handicap but also ensures their psychological well being. The successful rehabilitation of such a patient requires the concerted and team effort of various disciplines of dentistry as well as other health professionals. The prosthodontist also has a major role to play in their rehabilitation of velopharyngeal defect. Common problems encountered in treating maxillofacial patients are psychological, cosmetic, loss of function, retention of prosthesis and recurrence of tumor. This case report describes the prosthetic management of a patient with velopharyngeal defect.

44-45

Authors: Dr. Shabeer Ahamed Dr. Sanara P.P.

Brief background: Healing is a matter of time, but it is sometimes also a matter of opportunity. The regeneration of new periodontal attachment apparatus, after the natural attachment has been destroyed is one of the most challenging problems in dentistry. The goal of regeneration is to reconstitute the components of periodontium on to a root surface which was devoid of periodontal attachment. If the goal of periodontal regeneration is to be realized, it has to be approached from a basic molecular and biological perspective. Materials and methods: This case series present two cases of osseous defects and their management with two different regenerative approaches, one case with the introduction of a filler material into the defect, and the other case was treated with bone graft and guided tissue regeneration. Discussion: The discussion includes the new attachment; the various bone grafts, their mechanisms, guided tissue regeneration, and the effects of combined techniques. Summary And Conclusion: Various regenerative techniques used alone or in combination to treat the periodontal defects seems to demonstrate favorable healing outcome. This paper highlights different regenerative techniques for managing periodontal bone defects.

45 & 47

Authors: Dr. Rahul P. Ganani Dr. Gaurang Mistry Dr. Omkar Shetty

Mere replacement of the tooth does not serve the purpose of high esthetic outcome. Advances in the field of restorative materials allow a lost tooth to be replaced by an artificial tooth structure that is virtually indiscernible from the original. However, in fixed partial dentures, the standards for the pontic area and the adjacent soft tissue have increased in particular. One of the most challenging issues in a dental treatment plan is to preserve interproximal tissue after the loss of tooth, which is most detrimental in the esthetic outcome of the case. The loss of an anterior tooth is a severe emotional trauma to the patient and if the replacement does not simulate the natural tooth, the effect is multifold. The ovate pontic is a technique used to create the illusion that the tooth is growing out of the gum, it can also help to create or maintain the presence of interdental papilla, plus an ovate pontic contour has an effective design for cleansibility. Unfortunately, an ovate pontic design is not usually utilized by clinicians, as it is a technique sensitive. In this paper i am going to throw light on various easy approaches for desirable ovate pontic.

46

Authors: Dr. Sudipto Podder Dr. Sunil Kar

properly planned and executed cases of full mouth rehabilitation is not often seen as,there are many dependant factors which impacts the prognosis of it.Condylar guidance, incisal guidance,vertical height and occlusion are some of it.A properly done full mouth rehabilitation will corelate all these factors and reestablish them as natural as possible for success.

46-47

Authors: Dr. Pooja Kabra

A case is reported documenting successful treatment of periapical lesion involving in a maxillary right lateral incisor with dens in dente. Conventional endodontic therapy was performed and partial resolution of the lesion was evident at periodic 1month interval,3 month interval, 6 month interval and complete resolution was observed at1year interval

48

Authors: Dr. Sonal Dalal

Many materials have been used to fabricate splints for periodontally involved teeth. Older materials relied mainly on wire or silk ligatures. But the advent of dental resins and resin adhesive techniques in the late 1950s allowed clinicians to achieve better, more aesthetic stabilization techniques. This paper reports a modality for lower anterior periodontal tooth stabilization using a fiber reinforced composite splint.

48-50

Authors: Dr. Gaurav Setya Dr. Jyoti Sachdeva Dr. Shveta Arora Setya

Many laser instruments are available for treating oral disease. Some treatments involve removalof hard and/or soft dental tissue. However, other beneficial therapeutic results can occur without a photothermal event, and these effects are known as photobiomodulating or low-level lasereffects. They can be produced by all lasers; however, specific photobiomodulating laser instruments are available that operate at levels below 500 mW and can be used to provide a wide range of benefits. This article describe the many uses for these devices used in the dental practice

49-50

Authors: Prof. (Dr.) Ghanta Sunil Prof. (Dr.) U.S. Krishna Nayak Dr. Bindu S. Dr. Soumi Samuel

Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual’s life with phases of symptoms affecting the quality of life. In an attempt to treat this complex group of disorders many treatment modalities have been identified some of which are also considered in other Cochrane reviews. This article mainly reviews some of the studies carried out to show the relation between orthodontic treatment and temperomandibular disorders also some of the treatment options in treating tmj disorders has been discussed

49-50

Authors: Dr. Gaurav Setya Dr. Shveta Arora Setya

“Great things come in small packages”. This holds true for the word ‘Nano’. It has conjured up speculation about a seismic shift in almost every aspect of science and engineering. Among the most prominent and rapidly emerging fields is nanotechnology, including nanomedicine. Nanotechnology is expected to pervade and further revolutionize the practice of medicine and dentistry and may well have important applications spanning all aspects of disease, diagnosis, prevention and treatment.