A Journal of Clinical Dentistry-Heal Talk

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Authors: Dr. Charushila Sardar Professor & P.G Guide Dr.Gaurang Mistry Professor & H.O.D Dr.Omkaar Shetty Professor & Dean Dr. Sahil Singh P.G Student Department of Prosthodontics D. Y. Patil School of Dentistry, Navi Mumbai

LASER is an acronym for LIGHT AMPLIFICATION BY STIMULATED EMISSION OF RADIATION. Early pioneering teams as Fisher and Frame in the United Kingdom began using CO2 lasers for soft tissue surgery. Melcer also initiated hard tissue applications with CO2 laser. Shortly thereafter, pioneering teams began exploring Nd:YAG lasers for soft tissue procedures and hard tissue applications.(1)

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Authors: Dr. Ankita Tripathi P G student Dr. Rahul Rao Professor Dr. Ashish Jain Professor& HOD Dr.MeenakshiVerma Professor

Adolescents and adults want to have a perfect body, a perfect smile and a perfect face. Smiles are important to young and old. Peg lateral is a kind of anomaly which affects the esthetic of an individual. Restoration in the esthetic zone is a demanding and technique sensitive procedure. In this article a case of a bilateral peg-shaped maxillary lateral incisor is described along with the minimally invasive treatment approach.The esthetic approach is reported step by step and also discussed

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Authors: Dr. Devinder Preet Singh Senior Lecturer Dr. Deepak K Gupta Professor & HOD Dr. Kanish Aggarwal P.G. Student

The comprehensive fixed orthodontic treatment is usually associated with a very prolonged treatment time, which remains one of the major concerns in the orthodontic treatment. The long treatment duration has been a constant deterrent for the patients seeking orthodontic care. The prolonged duration of the orthodontic treatment many times, prompts the patients to either avoid treatment or seek shorter alternative solutions, which may provide with suboptimal results.

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Authors: Dr Rohan Gupta Assistant professor Department of Periodontology and Oral Implantology, Rajasthan Dental College & Hospital, Jaipur Dr Nidha Madan PG student Department of Conservative Dentistry & Endodontics Mahatama Gandhi Dental College & Hospital, Jaipur Dr Pradeep Kumar Reader Department of Periodontology and Oral Implantology Rajasthan Dental College & Hospital, Jaipur Dr Hotilal Gupta Professor & HOD Department of Periodontology and Oral Implantology Rajasthan Dental College & Hospital, Jaipur

Intentional replantation is a treatment option when more conventional forms of treatment either fail or are impossible. This article presents an uncommon case of intentional replantation of periodontally involved hopeless adjacent maxillary incisors with 6 months of post operative results. Teeth were replanted after Tetracycline-HCI conditioning & stabilised by splinting. At the end of 6 months both teeth were asymptomatic and still in function with no radiographic signs of pathosis. Periodontal health was in normal limits with no bleeding on probing and no pathological pocket formation. The results obtained with these teeth may indicate a viable mode of treatment in certain situations to preserve the natural dentition with intentional replantation for periodontally involved hopeless teeth

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Authors: Dr. Derek Mahony BDS, MScOrth, DOrth RCS, MDOrth RCPS, MOrth RCS, FRCD, MOrth RCS/CDS, FICD, IBO

Snoring and/or sleep apnea affects million Australians. A CPAP device is the gold standard for treating this condition. CPAP stands for continuous airway pressure and this is facilitated by a machine that increases air pressure in the throat. The air is forced through with a mask that covers the nose, the nose and mouth or prongs that fit into the nose.

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Authors: Dr Nisha Yadav Senior lecturer Public Health Dentistry Department Manav Rachna Dental College, Faridabad Dr Roma Yadav Senior Lecturer Public Health Dentistry Department NIIMS Dental College, Jaipur Dr Meetika Pahuja Senior Lecturer Public Health Dentistry Department Subharti Dental College, Meerut Dr Sanchit Pradhan Senior Lecturer Public Health Dentistry Department Subharti Dental College, Meerut Dr Sahiba Miglani Lecturer Public Health Dentistry Department Manav Rachna Dental College, Faridabad Dr Tamanna Malik Private practitioner, Ludhaina, Punjab

Context: -Oral health status of the elderly represents an important means not only to identify oral problems but, also to determine social interventions for promotion, prevention and recovery of oral health. So, the present study was conducted to assess the dentition status of elderly residing in old age homes of Delhi. Aims: - To assess the dentition status of 65-74 year old elderly residing in old age homes of Delhi, India. Settings and design: - A cross-sectional study was conducted among a total 464 residents of 20 old age homes of Delhi, India. Subject and methods: - Residents with age group of 64-75 were included in the study. The dentition status was recorded using WHO oral health assessment form (1997). Statistical analysis used: - Chi square test and t test were used to find significance of variables. P value <0.05 was considered significant. Results: - Mean number of decayed teeth in 65-69 years and 70-74 years was 6, 5 respectively. Mean number of missing teeth in the present study was 16. Statistically significant difference was seen among both the age groups for missing and filled teeth Conclusion: - The present study underlines a considerable need for dental treatment in elderly as there were more number of decayed and missing teeth and less number of filled teeth in the study subjects which reflects less utilization of oral health care services by these elders residing in old age home

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Authors: Dr. Geet Vijay Assistant Professor Dental department, Medical college Kota Dr. Sumeet Agarwal bAssistant Professor Department of Prosthodontics and Crown & Bridge Bharati Vidyapeeth Dental College & Hospital Navi Mumbai Dr. Kriti Mehrotra PG student Babuji Dental College & Hospital Dr. Himmat Jaiswal Assistant Professor Department of Endodontics Bharati Vidyapeeth Dental College & Hospital Navi Mumbai Dr. Shiv Sonavane Assistant Professor Department of orthodontics Bharati Vidyapeeth Dental College & Hospital Navi Mumbai

The loose and unstable complete denture is one of the most common problems faced by denture patients. The problem increases, many folds in cases of highly resorbed mandibular ridges. This case report present various steps of conventional denture which has been modified for treating and providing a successful complete denture to a patient with highly resorbed mandibular ridge.

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Authors: Dr. Utpal Kumar Das Professor & H.O.D Dr. Sana Shaheen P.G.Student Dr. Sayantan Mukherjee Reader

Internal bleaching technique is a common treatment option for discolored non-vital anterior teeth, but it is not advisable for cases with internal cervical resorption. Therefore, other conservative bleaching techniques, such as external bleaching, may be proper treatment options in this situation.Among bleaching techniques, The walking bleach technique with sodium perborate and distilled water stands out because of its superior esthetic results with no side effects. Remaining discoloration should be covered by restorative options. The best choice for conservative restorations is ceramic laminate because of color stability, biocompatibility and durable esthetics. This clinical report presents the treatment of two discolored non-vital maxillary central incisors in a 18-year-old girl. A step-by-step practice is proposed for bleaching and restorative treatments of these discolored teeth are described.

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Authors: Dr Sahil Mustafa Kidwai P.G.Student Department of Oral Medicine & Radiology Subharti dental college and Hospital, Meerut, Uttar Pradesh Dr. Sumit Goel Reader Department of Oral Medicine & Radiology Subharti dental college and Hospital, Meerut, Uttar Pradesh Dr. Swati Gupta Reader Department of Oral Medicine & Radiology Subharti dental college and Hospital, Meerut, Uttar Pradesh Dr Riyaz Ahmad Professor Department of pedodontics LLRM Medical College, Meerut Dr Maneet Kukreja P.G.Student Department of prosthodontics Subharti dental college and Hospital, Meerut, Uttar Pradesh Dr Mallika Garg P.G.Student Department of Oral Medicine & Radiology Subharti dental college and Hospital, Meerut, Uttar Pradesh

Mandibular condylar hyperplasia (CH) is a rare disease ? rst described in 1836 as an overgrowth of the mandibular condyle, unilaterally or bilaterally, leading to facial asymmetry, mandibular deviation, malocclusion and articular dysfunction. A through clinical and radiographic examination of the changes in mandible with the help of photographs, cephalograms, and 3D CT aids in optimal results in restoring the functional integrity of the joints and esthetics of the face. Here we report an interesting and illustrative case of facial asymmetry with unilateral condylar hyperplasia

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Authors: Dr. Derek Mahony BDS, MScOrth, DOrth RCS, MDOrth RCPS, MOrth RCS, FRCD, MOrth RCS/CDS, FICD, IBO Dr. Edmund A. Lipskis DDS, MS, DABCP, FAACP, FAAFO, FIAO

I would like to thank Dr Ken Lipworth for giving me the idea to write this article. After attending my recent OSA symposium, Ken told me that he, and many other course participants, were confused about the role of TENS, in establishing the “correct bite” for a snoring appliance. “My understanding is that the TENSing will fatigue the muscle sufficiently to get to a point where the condyles will be in a neutral position (analogous to the effect of a deprogrammer) and will also give us a neutral vertical dimension. If this is correct, I don’t understand the next step - how to establish the protrusive position from the silicone bite.”

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Authors: Dr Anuj Satija Dept. of Orthodontics SBB Dental College , Ghaziabad. Dr Vismaiya Datta PG Student Dept. of Periodontics PDM Dental College, Bhadurgarh Senior lecturer

There are many etiological factors in the development of a median diastema and most have been investigated to some degree. Midline diastemata (or diastemas) occur in approximately 98% of 6 year olds, 49% of 11 year olds and 7% of 12–18 year olds.

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Authors: Dr. SachinGupta PG Student Dr. Anamika Sharma Professor & HOD Department of periodontology

Talon cusp is a relatively rare dental developmental anomaly characterized by the presence of an accessory cusp like structure projecting from the cingulum area or cementoenamel junction.It occurs in both primary and permanent dentition and is more common on the palatal surface of the permanent maxillary incisors.

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Authors: Dr. Himanshu Gupta P.G Student Dr. Vineeta Gupta Professor & Head Dr. Nutan Tyagi Reader Dr. Akansha Misra Senior Lecturer

Skin cancer is an uncontrolled growth of abnormal skin cells. It occurs due to DNA damage which leads to mutation of skin cells and results in the formation of malignant tumors. This may be caused by sun light or UV rays and commonly occurs on the skin which is more exposed to sunlight such as the head and neck region. A brief inspection of the head and neck region for suspicious lesion could easily be done during routine examination of patient 1.

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Authors: Dr. Roma Yadav Dept. of Public Health Dentistry NIMS Dental College, Jaipur, India. Dr. Abhishek Yadav Assistant Professor Dept. of Public Health Dentistry NIMS Dental College, Jaipur, India. Dr. Savita Solanki Assistant Professor Dept. of Public Health Dentistry PDM Dental College, Bahadurgarh, India. Dr. Meetika Pahuja Assistant Professor Dept. of Public Health Dentistry Subharti Dental College, Meerut, India. Assistant Professor Introduction Q Case Reports Case 1 Case 2 and mastication leads to release of residual maxillary anterior teeth that were replaced by uacks exist in the dental profession monomer in the oral cavity. This residual placing cold cure acrylic prosthesis intraorally especially in areas where there is monomer is often associated with and allowing it to cure in the mouth directly, by poor access to oral healthcare inflammatory, allergic reactions and even a road side dentist in her locality. One anterior either through

Quackery in dentistry has been practiced over decades. Autopolymerized acrylic resin is the most commonly used dental material by the quacks to fill the cavities and to fix the prosthesis directly in the oral cavity. This article presents the case reports to highlight cytotoxic effects of the autopolymerized acrylic resin used by dental quacks for fabrication of prosthesis which is directly allowed to polymerize in contact with adjacent teeth and gingiva in the oral cavity.

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Authors: 1) Dr. Akanksha Gupta 2) Dr. Swati Gupta 3) Dr. Sumit Goel 4) Dr. Sangeeta S. Malik 5) Dr. Nagaraju K. 6) Dr. Ravi Prakash S.M.

Crouzon's syndrome [CS], an autosomal dominant disorder with complete penetrance and variable expressivity is caused by mutation in the fibroblast growth factor receptor 2 (FGFR2) gene. Normally, the sutures in the human skull fuse after the complete growth of the brain, but if any of these sutures close early then it may interfere with the growth of the brain. The disease is characterized by premature synostosis of coronal and sagittal sutures which begins in the first year of life. Case report of an 8 year old boy is presented with characteristic features of Crouzon's syndrome. The patient presented with exophthalmos, hypertelorism, beaked nose, deviated nasal septum,high vault palate, crowding in maxillary premolar region, copper-beaten appearance of skull and diffuse indentation of inner table of skull. In addition to the classical features an interesting finding was the presence of prominent commissural lip pits.

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Authors: Dr Varsha Sharma PG Student Dr Ashish Kumar Professor Dr Komal Puri Assitant Professor Dr Manish Khatri Professor & HOD Dr Mansi Bansal Reader Dr Geeti Gupta Reader

Periodontitis is a multifactorial disease where bacteria and host both plays an important role. Non-Steroidal Anti-inflammatory Drugs have shown to be potent anti-inflammatory and host modulating agents (in low doses). This article is an attempt to review the role of NSAIDs in treatment of periodontal diseases.

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Authors: Dr. Charushila S.Sardar Professor D Y Patil University, School of Dentistry,Navi Mumbai. Ms. Siddhi S. Sardar B.D.S.(Final Year) Sinhgad Dental College,Pune.

We read in newspapers and also come across hoardings about saving water,saving trees,saving electricity. Even on our Colgate Tooth paste message is for saving water.Every one is trying to do their best to save our Earth from GLOBAL WARMING.Medical and Dental professionals play a vital role for following Green approach to prevent hazards to the environment.So let us know about Eco-friendly or Green Dentistry.

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Authors: Dr. Roma Yadav Assistant Professor Dept. of Public Health Dentistry NIMS Dental College, Jaipur (Rajasthan) Dr. Abhishek Yadav Assistant Professor Dept. of Public Health Dentistry NIMS Dental College, Jaipur (Rajasthan) Dr. Nishtha Kathuria Juneja MPH State Maternal Health Consultant

Diabetes mellitus is a major public health problem. A number of oral diseases have been associated with diabetes mellitus including xerostomia, candidal infections and periodontitis. The risk of periodontitis is increased by approximately threefold in diabetic individuals compared with non-diabetic individuals. Lifestyle changes, oral health education, dental care and self-monitoring need to be strengthened for diabetic patients

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Authors: Dr Salil Pawah Professor & HOD Dr Aditi Ghaii P.G Student Dr Chetan Pathak Sr. Lecturer Dr Meenu Garg Reader

Sensory organs play significant roles in our daily lives. One of the most commonly occurring loss of one of these organs is that of an eye.The loss of eye requires early replacement so that itrestores self-confidence in patients and prevents social embarrassment.The primary objective is to construct a prosthesis that will restore the defect, improve esthetics, and thereby benefit the morale of the patient.An ocular prosthesis is a simulation of human anatomy using prosthetic materials to create the illusion of a perfectly normal healthy eye and surrounding tissue.

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Authors: Dr. Iram Jan P.G Student Dept. of Oral & Maxillofacial Pathology & Microbiology Shree Bankey Bihari Dental College & Research Centre, Ghaziabad. Dr. Firdous Wani P.G Student Dept. of Oral Medicine & Radiology Shree Bankey Bihari Dental College & Research Centre, Ghaziabad. Dr. Ankita Khare P.G Student Dept. of Oral & Maxillofacial Pathology & Microbiology Shree Bankey Bihari Dental College and Research Centre, Ghaziabad. Dr. Mohammad Ehtisham P.G Student Dept. of Oral & Maxillofacial Pathology & Microbiology Institute of Dental Studies & Technologies, Modinagar.

Gingival growths are one of the most frequently encountered lesions in the oral cavity. Most of these lesions are innocuous, but some do have malignant potential. Different lesions with similar clinical presentations make it difficult to arrive at a correct diagnosis. One of the infrequently occurring gingival lesions is Peripheral Ossifying Fibroma (POF). Lesions with histological features similar to POF have been given various names, adding to the confusion. POF is a common solitary gingival overgrowth thought to arise from the gingival corium, periosteum and periodontal ligament(PDL).This article presents a case of Peripheral Ossifying Fibroma in a 19 year old female patient.

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Authors: Dr. Muralee Mohan Professor Dr. Rajendra Prasad Professor Dr. Mirant Patel P.G. Student Dr. Jitesh Sharma P.G. Student

A spinal fluid leak from the intracranial space to the nasal respiratory tract is potentially very serious because of the risk of an ascending infection which could produce fulminant meningitis. A cerebrospinal fluid (CSF) rhinorrhoea occurs when there is a fistula between the dura and the skull base and discharge of CSF from the nose. CSF rhinorrhea commonly occurs as a result of fronto-basal skull fractures, extensive intracranial surgery or destructive lesion. Concomitant peri-orbital hematoma is very significant hence, patients with head injuries and features of periorbital haematoma are at greater risk of unobserved dural tear and delayed CSF leakage.The beta-2 transferrin assay is the confirmatory test of choice because of its high sensitivity and specificity. The presence of skull base fractures with clinical csf leak only computed tomography will suffice. Most of CSF rhinorrhea resolve spontaneously, but if persists for more than 7 days than will lead to bacterial meningitis as a consequence. Treatment regime should be planned keeping in mind the neurological status of the patient along with clinical and radiological findings.

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Authors: Dr Salil Pawah Professor & HOD Dr Pushpanjali P.G Student Dr Chetan Pathak Sr. Lecturer Dr Meenu Garg Reader

The diagnostic wax-up should probably be labeled a diagnostic work-up because it is the most foolproof way to work up a treatment plan that will result in a three-dimensional visualization of the end result of a “best choice” of treatment. The diagnostic wax-up is the process by which programmed treatment planning is utilized step-by-step to determine the best choice of treatment. It is how we plan the sequence that must be followed to achieve a visualized end result.

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Authors: Dr. Nidhi Bhatia P.G Student Dept. of Periodontics & Oral Implantology Santosh dental college, Ghaziabad Dr. Adarsh Tripathi Private Practioner Dr. Sanjula Sirohi Sr.Lecturer Dept. of Conservative Dentistry & Endodontics KD Dental College & hospital , Mathura Dr. Jainendra Kumar P.G Student Dept. of Periodontics & Oral Implantology Santosh dental college, Ghaziabad Dr Meenu Bhasin Reader Santosh Dental College Dr Prashant Bhasin Reader Santosh Dental College

The era of nanotechnology is fast approaching. Virtually unheard of two decades, all disciplines will be impacted by advances in nanotechnology in near future. Growing interest in the future medical applications of nanotechnology is leading to the emergence of a new field called nanomedicine – the science and technology of diagnosing, treating, and preventing disease and traumatic injury, of relieving pain, and of preserving and improving human health, using nanoscale-structured materials, biotechnology and genetic engineering, and eventually complex molecular machine systems and nanorobots. Similarly, development of “nanodentistry” will make possible the maintenance of near-perfect oral health through the use of nanomaterials.The present article is a review, which describes about the potential use of nanotechhnology in the field of periodontics.

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Authors: Dr.Trupti Naykodi P.G Student Dr. Ranjeet Bapat Associate Professor & Guide Dr. Arvind Shetty Professor & HOD Dr. Pooja Wadkar Lecturer

Esthetics is important in today's age and people don't want to remain without teeth even for a day.Final restorations can vary between removableprosthesis, tooth-supported prosthesis or implant-supported prosthesis. Irrespective of the final treatment, the firstline of treatment would be to provisionally restore the patient's esthetic appearance while functionally stabilizingthe compromised arch.Teeth extracted can be used as natural tooth pontic for immediate temporization. It not only maintains the edentulous space but also relieves the patient's esthetic concern. This article discusses a case where extraction of a mobile tooth was done, followed by immediate implant placement and temporization with a natural tooth pontic.Following loss of a tooth, it is important that an immediate replacement is provided in order to avoid esthetic, masticatory, and phonetic difficulties, and to maintain the edentulous space.

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Authors: Dr. Ravnitya Pal Singh P.G Student Dr. Nutan Tyagi Reader Dr. Sonia Gupta P.G Student Dr. Nishita Anthwal P.G Student

Ebola is considered as a fast spreading virus that has been in the news for its recent severe outbreak in Africa. It has become a concern for WHO to cure and treat this menace before a more severe pandemic episode threatens the world. The fatality ratio is about 69%. Ebola has been found to spread through body fluids, which can make saliva a vital specimen for the detection and also as a mode of spread of Ebola. It is a major concern for dentists as we are in constant contact with body fluids like blood and saliva. No medicine or vaccination has still been approved for its cure. There are various ongoing research projects to find a vaccine against this virus.

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Authors: Dr. Neha Srivastava P.G Student Dr. Geeta Sharma Reader Dr. Seema Sharma Professor & HOD Dr. Manu Gupta Reader Dept. of Oral & Maxillofacial Pathology

Context: Aim: Materials and method: Results: Conclusion: Key words: Periodontal disease is one of the common inflammatory diseases with complex etiology and is multifactorial in origin. Several enzymes have been evaluated for the early diagnosis of periodontal disease. The enzyme Alkaline Phosphatase (ALP) plays a role in bone metabolism. In the periodontium, ALP is a very important enzyme as it is a part of normal turnover of periodontal ligament, root cementum, and bone homeostasis. Saliva is an easily collected fluid that contains locally and systemically derived markers of periodontal Disease. The purpose of this study was to evaluate the level of alkaline phosphatase activity in salivary sample from healthy subjects & patients with gingivitis & periodontitis. The study included 60 patients referred to Department of Oral & Maxillofacial Pathology and Microbiology, Santosh Dental College, Santosh University, Ghaziabad, U.P. They were divided into three groups, 20 healthy subjects, 20 subjects with gingivitis and 20 subjects with periodontitis. The clinical parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL) were recorded and salivary samples were collected for analysis of alkaline phosphatase (ALP) levels. Alkaline Phosphatase levels was analysed by autoanalyzer. A highly significant increase in mean value of clinical parameters was found in patients with periodontal disease (gingivitis and periodontitis) compared to healthy subjects. Also a highly significant increase in the mean value of alkaline phosphatase activity was illustrated as the severity of periodontal disease increased. Salivary alkaline phosphatase could be used as a useful marker for monitoring periodontal disease.

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Authors: Dr. Rahul Rao Professor & Guide Dr. Ashish Jain HOD Professor & Guide Dr. Haroon Deshmukh P.G Student Dr. Nehal Shetty P.G Student

Coronal fractures of the permanent dentition are one of the most frequent type of dental injury. Reattachment of a fractured fragment to the remaining tooth is often challenging but one of the best treatment protocols in regards to aesthetics, function as well as patient acceptance. Reattachment should always be considered for young patients if the original tooth fragment is retained following fracture even though long term prognosis is uncertain. This clinical case series describes fragment reattachment of three different complicated fractured anterior teeth.12 months clinical and radiographic examination showed a stable re-attachment, good aesthetics and healthy periodontium

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Authors: Dr. Shweta Saini Senior Lecturer Dept of Prosthodontics Guru Gobind Singh Dental College, Burhanpur, M.P. Dr. Mahinder Singh Chauhan Senior Lecturer Dept of Prosthodontics ITS Dental College, Muradnagar, U. P Dr. Pawanjeet Singh Chawla Reader Dept of Prosthodontics Rama Dental College Hospital & Research Centre Kanpur, U.P.

In the high tech era, we are fortunate to have many technological innovations to enhance treatment, including intraoral video cameras, CAD-CAM units, RVGs and air-abrasive units. However, no instrument is more representative of the term high-tech than, the laser. In clinical dentistry lasers were introduced with the hope of overcoming some of the drawbacks posed by the conventional methods of dental procedures. The speciality of Prosthodontics takes all concepts of dentistry and integrates effective comprehensive treatment planning. The practice will necessarily include a wide variety of patients seeking a diverse range of care. This article puts forward the state of the art of laser in prosthetic dentistry. Used in conjunction with or as a replacement for traditional methods, it is observed that specific laser technologies are becoming an essential component of contemporary dental practice over a decade.