A Journal of Clinical Dentistry-Heal Talk

1

Authors: Dr. Sujeet Singh

Mucoceles (Mouco-mucus and coele-cavity), are cavities filled with mucus1. These are one of the most common benign soft tissue masses that occur in the oral cavity. These are swelling in mouth which results from the accumulation of mucous secretion due to truma and lip biting habits or alteration of minor salivary glands. These are most commonly found on the lower lip, lateral to the midline2. These are rarely seen on the upper lip, retro molar pad or palate. These can affect the oral functions such as chewing and speaking and oral hygiene. Mucoceles can have very similar features with other oral lesions. Thus, a dentist must inform patients on their oral lesions advise them to seek further diagnosis and treatment in order to prevent any potential medical threats 3.

2

Authors: Dr. Shefali Singla1, Dr. Lalit Kumar2, Dr. Gaurav Varshney 3

Dental implant which is being widely used to restore edentulous space has great mechanics involved for long term success. Apart from good osseointegration, implant functioning also depends on the design and behaviour of abutment screw which holds the abutment to the implant body. Screw loosening is the second most common cause of implant abutment failure after poor osseointegration which if properly understood can add to a successful functioning implant. So, this article highlights the implant abutment screw geometry, the material used for its fabrication and the mechanics involved in the functioning of abutment screw implant interface and the factors which affect abutment screw loosening.

2

Authors: Dr. Amina Nisar1, Dr.Tanu Mahajan2

An adequate quality and quantity of bone is essential for successful placement of implants. Posterior maxilla presents many challenges to an implantologist because of its anatomical limitations. Alveolar bone resorption and pneumatization of the maxillary sinus reduces the available amount of bone both in height and width for the placement of dental implants. It is therefore, common to find the sinus floor close to the alveolar crest. This condition may be treated with an elevation of the maxillary sinus floor, which is usually accomplished by lateral or transcrestal approach to the antrum. As an alternative to these augmentation procedures, a more conservative treatment option would be to either place short implants or to bypass the sinus floor. This paper focuses on maxillary sinus by pass with tilted implants in close proximity to the sinus wall, thus, avoiding sinus floor elevation & bone grafting procedures.

2

Authors: Dr. Amit Thahriani1, Dr. Abhishek Khare2, Dr. Anupama Mahendra3, Dr. Amritaksha Bhattacharya4, Mr. Anoop Kumar Bajpai5

Various environmental factors play a significant role in the pathogenesis of head and neck cancer. Different forms of tobacco have been considered as major risk factors for head & neck cancer. Exposure to various end products of tobacco causes alteration in various cytological parameters such as nuclear size, cell size, nuclear to cytoplasmic ratio, nuclear shape etc. Of these parameters, the nuclear size, cytoplasmic size and their ratio have been shown to be significant. Aim: To assess the effect of tobacco on cytomorphology of exfoliative buccal mucosal cells. Objective: To confirm the cause effect relationship between tobacoo usage and quantitative cellular and nuclear alterations. Materials & Method: The study group consisted of 25 normal subjects (N), 25 subjects using some form of tobacco for more than 5 years but not having any oral lesion (H) and 25 patients having habit of using tobacco for more than 5 years and having a potentially malignant oral lesion (L). Since area is a better indicator of size as compared to diameter, comparison was made between cellular area, nuclear area and the ratio between nuclear and cytoplasmic area. Results: Revealed significantly increased n/c ratio among tobacco users caused principally by reduction in cytoplasmic area rather than an increased nuclear area. Patients with lesions showed both a significant decrease in cytoplasmic area along with increased nuclear area.

2

Authors: Dr. Poonam Singh1, Dr. Poonam Singh2, Dr. Braj Bhushan Mall3

A thorough knowledge of root canal anatomy is essential for the endodontic therapy. Aberrations in the root canal system, especially in multirooted teeth, can pose a considerable challenge to the endodontist during root canal treatment. The endodontist should be familiar with various root canal configurations and their variations for successful endodontic therapy. It is important to evaluate each individual case for variations. There are variations in number of root canals with altered configuration rarely existent in maxillary and mandibular molars can affect treatment outcome. The first case report presents the endodontic management of a maxillary first molar with a variant root canal anatomy, having five root canals, with mesiobuccal root having two canals (MB1, MB2) , distobuccal root having one canal (DB) and the palatal root having two canals (P1, P2) . The second case report presents the endodontic management of a mandibular first molar with a variant root canal anatomy, having five root canals, with mesial root having two canals (MB,ML) and distal root having three canals (DB, MD, DL) .

2

Authors: Dr. Manish Kumar1, Dr. M. Srinivasa Raju2

To a great extent oral tumors are preceded by potentially malignant lesions, which may appear as white or red patches on the oral mucosa. Leukoplakia is one of the most common epithelial precursors of oral squamous cell carcinoma. Speckled leukoplakia is an uncommon sort of leukoplakia with a very high risk of premalignant growth and mortality rate. Approximately 3 % of the worldwide population has suffered from leukoplakia, 5-25% of which tend to be malignant leukoplakia. Despite the fact that it is the common precancerous lesion, it represents a major diagnostic and therapeutic challenge. This case report was aimed to discuss early detection of speckled leukoplakia as one of the potentially malignant disorders.

3

Authors: Dr. Sreenita Chowdhury Pujari1, Dr. Binita Srivastava2

Odontoma is an odontogenic benign tumour composed of hard dental tissues, epithelial and mesenchymal cells. In most cases these lesions are usually asymptomatic and are often observed on routine radiographs. Morphologically, odontomas are classified as complex type when present as irregular masses containing different type of dental tissues or compound if there is anatomic similarity to teeth like denticles. An8-year old patient reported to the Department of Pedodontic and Preventive Dentistry, Santosh Dental College, Ghaziabad with doubt about the apparent delay in eruption of his left permanent maxillary incisor. Radiographic investigation showed the presence of a lesion formed by many small tooth-like structures that obstructed the respective permanent tooth eruption. The lesion was provisionally diagnosed as odontoma. Under local anesthesia, access to the lesion was achieved via intra-oral approach followed by surgical enucleation. The clinical presentation of the lesion confirmed the diagnosis of Compound Composite Odontoma. Routine follow-up was done for a year until the permanent tooth erupted and no recurrence was seen. Early diagnosis and treatment of Compound Odontoma ensures good prognosis and minimal psychological trauma to the patient.

3

Authors: Dr. William J. Clark & Dr. Derek Mahony

The author developed Twin Blocks in 1977 as removable functional appliances using inter-active occlusal inclined planes to guide the mandible forward for correction of a Class II malocclusion. Twin Block appliances are simple bite blocks that are designed for full-time wear. They achieve rapid functional correction of malocclusion by the transmission of favourable occlusal forces to occlusal inclined planes that cover the posterior teeth. The forces of occlusion are used as the functional mechanism to correct the malocclusion