Advances in Human Biology

8-13

Authors: Dipti S Shah, Kartik R. Morjaria, Kalpesh C Vaishnav, Pankaj R Patel, Aumkar R. Trivedi

Background: Ideal placement of bone integrated implants to retain a prosthesis is critical for a successful final prosthetic restoration. Several sources have described the importance and use of surgical templates for the optimal placement of extraoral implants. The literature is replete with information explaining the use of surgical templates for intraoral implant placement. Indeed, correct placement of implants facilitates creating a prosthesis that functions well and looks natural. To ensure proper implant placement, considerable effort should go into pre-surgical planning. It is clear that extraoral surgical templates aid in proper implant placement, yet the literature describing fabrication is limited. This article describes different methods for fabrication of surgical template for placement of implants for an auricular prosthesis.

20-27

Authors: Mira Thakkar, Rupal Mehta, Surabhi Joshi, Shefali Sharma

Background:The goal of modern dentistry is to restore the patient’s dentition to normal contour, function, comfort, esthetics, speech, health and implant dentistry has the ability to achieve this goal. Although implant is considered to be a safe technique to replace tooth or teeth, certain complications are bound to occur with implants like any other surgical procedures. Implant surgery complications are frequent occurrences in dental practice and knowledge in the management of these cases is essential. The article highlights the complications in implant surgery, which helps to prevent them by proper patient selection, devising proper treatment plan and treating the implant cases in a way to avoid complications and failures associated with implants.

34-42

Authors: Maruthi Devi K, MS Munisekhar, Charu Suri, Krishna A, G Kiran

Aim: Presence of Mast cells (MCs) near capillary sprouting sites suggests an association between MCs and anigogenesis. MCs are well recognized as being important in the generation of angiogenic response via the release of heparin and histamine and release and/or activation of extracellular matrix modified enzymes. Thus study was done to histologically evaluate and correlate the number of MCs and angiogenesis in different grades of Oral Squamous Cell Carcinoma (OSCC) and Verrucous Carcinoma (VC). Materials and Methods: A retrospective study was conducted to elaborate upon the correlation between MCs and tumor angiogenesis. Microvessel density (MVD) was detected by immune-histochemical staining using anti CD34 monoclonal antibody and Mast cell density (MCD) was detected by toluidine blue staining. Results: The results showed a significant correlation in the mean MVD and the mean MCD (r= 0.75, p<0.001) in Well Differentiated OSCC. However, in the other grades of carcinoma and normal tissue there was no significant correlation between the mean MVD and MCD. Conclusion: MC accumulation in tumors is probably a part of response to tumor derived chemoattractants. From our study and previous literature, there is an evidence that MCs in tumors are potentially angiogenic, but at the same time are pro-inflammatory and immunoamplifying in action.

52-55

Authors: Sandeep N, Aarti Saxena, G Siva Prasad Reddy, K Rekha Rani

Background: Placing implants in the posterior maxilla is challenging at times owing to poor quantity of bone and pneumatization of the maxillary sinus. In a patient desirous of implant related prosthesis, there arises a need to augment the bone height. The maxillary sinus lift technique using a lateral approach is frequently used for bone augmentation. This article reports one such treatment option for augmenting bone to place an implant.

60-64

Authors: Dipti S Shah, Amit M Nebhani, Kalpesh C Vaishnav, Pankaj R Patel, Dhaara M Rana

Background:The concept of conditioning oral mucosa has gained momentum over the last few years. Different tissue conditioning materials and soft liners have been used for this purpose. But the limitations of these materials has led to the introduction of liquid-supported dentures, which is a newer alternative to conventional complete denture prosthesis in cases with inflamed tissues, atrophic and severely resorbed edentulous ridges. Liquid supported Denture consists of a base which is covered with a preshaped close fitting flexible foil containing a thin film of high viscosity liquid which cushions the underlying tissues. This case report describes fabrication of liquid-supported dentures for patients with compromised tissues.

72-77

Authors: Dipti S Shah, Hirenkumar C Rana, Kalpesh C Vaishnav, Pankaj R Patel, Sareen Duseja

Background: Occlusal surface of the acrylic teeth of a single complete denture in opposition to natural dentition wears out with its use for a longer period of time, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, change in centric occlusion, denture instability, temporomandibular joint disturbances etc. Re-fabrication of new denture set over a period of time, inclusion of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. are some of the treatment options available to counteract that problem. Several articles have described methods to construct gold and metal occlusal surfaces, some of which are time-consuming, expensive and require many cumbersome steps. This clinical case describes the sequence of steps for construction of metal occlusal surfaces on single complete denture using the lost wax technique.

82-84

Authors: Rohan Bhatt, Applu Atrey, Ashish Kaur, Lipee Dave

Background:This article presents a case of accidental ingestion of dental bur by a patient during routine dental treatment. This article also points out the possible barrier techniques to prevent swallowing and ingestion of dental foreign objects by patient. An outline of the complications of swallowing/ingestion of foreign objects as well as the required diagnostic measures to be taken following the accidental swallowing and the different treatment options has been laid in brief.

6-10

Authors: Kuldeep Sharma

Background: Toothbrushes are an adjunct part of daily life being oldest and simplest method for maintaining oral hygiene. Explaining correct way of brushing and to keep a check on it, was a challenging task for the dentists in the past. This problem led to dental as well as periodontal problems. Now the new smart technology is used in toothbrushes that not only offer different brushing modes for polishing, massaging and cleaning but can also wirelessly connect to a mirror-mounted LCD display which monitors for regular brushing with timer and pressure measuring sensor. New Ionic toothbrushes have also been introduced which are helpful in removing plaque more effectively. The purpose of this paper is to discuss how the technological advancements have entered in dentistry and to show the future of oral hygiene maintenance in patients for keeping a record of every patient for better patient compliance and to prevent periodontal problem and hence delivering better treatment.

19-25

Authors: Shoba Fernandes, Siddana Goud. R, Shrudha Potdar, Sidhartha Ram Pujari

Background: Beliefs related to teething and practices regarding its management have varied cross culturally in various parts of the world. A paucity of specific studies related to teething in contemporary literature in India lead to this cross sectional study, to investigate the knowledge and practices about teething among the population in the central Indian region. Materials and Method: Cross sectional survey of 150 mothers with the youngest child of less than 24 months of age was performed. A structured questionnaire which consisted of 21 questions was utilized. The numerically coded data was entered using SPSS version 16 and chi square test applied to analyze variables. Results: The results showed that only 26.3% of interviewed mothers had good knowledge levels of teething problems. Majority of the mothers had good knowledge regarding irritability, biting fingers/objects and drooling. The remaining depicted inaccurate attribution to symptoms like fever (75%), diaper rash (77%) and diarrhoea (42%). 79% hesitated to consult dentists or health professionals. Conclusions: Poor knowledge levels among mothers shown in this study confirmed our belief that extensive parental education is necessary with regard to teething problems. The erroneous beliefs and practices demonstrated a need for further investigation.

31-36

Authors: Chintan Joshi, Hardik Mewada, Mahendra Patel, Pathik Patel

Single visit root canal treatment option is recently considered to be best for irreversible pulpitis and aymptomatic apical periodontitis cases. Also when gross coronal tooth structure has been destroyed by caries, post enodontically it is important to give a restoration which would reinforce the remaining tooth structure and resist fracture against heavy occlusal loading. So, in this particular case, single visit root canal treatment was opted and fibre reinforced nanohybrid composite system was used for reinforcing the coronal tooth portion. Follow up of 2 years showed no signs of any fracture of the crown portion without any symptom related to the root canal treatment.

7-14

Authors: Chirag Shah, Mayur Parmar, Khushboo Desai, Shilpa Budhiraja, Santosh Kumar.

Background: The periodontal flap is one of the most frequently employed procedures, particularly for moderate to deep pockets. Silk is the most commonly used suture material for approximating the flap margins together after periodontal flap surgery. There are some major disadvantages of silk sutures and to overcome some difficulties with sutures, a need for alternative of sutures is always felt. N-butyl cyanoacrylate is a tissue adhesive, which can be used for the closure of the incised wounds. Objective: The present study was carried out to evaluate and compare accumulation of dental plaque and response of gingival tissue during the healing period after periodontal flap surgery when closed with N butyl cyanoacrylate and silk sutures. Materials and Methods: The study was carried out on 30 patients and divided into three groups, 10 patients per group: Group A, Group B and Group C. In each patient, a split mouth design was employed. The flap surgical procedure was carried out for the pocket therapy and the selection of the site for suture and cyanoacrylate was done randomly. Antibiotics and analgesics were prescribed and the patients were recalled after 1 week, 3 weeks and 6 weeks. Results: It was found that healing with the cyanoacrylate is associated with less amount of inflammation during the first week when compared with silk. However, over a longer period the sites treated with both the materials showed similar healing patterns after 3 weeks and 6 weeks. Conclusion: It can be concluded that healing of periodontal flaps when closed with silk sutures and N butyl cyanoacrylate is normal, uneventful, healed by primary intention and aids in early initial healing compared to silk suture.

21-28

Authors: Chirag Shah, Darshan Modi, Surbhi Joshi, Khushboo Desai.

Objectives: The aim of the present study was to investigate the effect of improved periodontal health on metabolic control in type 2 diabetes mellitus (DM) patients. Material and Methods: Fifty (50) patients with type 2 DM were selected. Subjects were randomly assigned into two groups. Data collection: Plaque index (PI), gingival index (GI), probing pocket depth (PPD) and bleeding on probing (BOP) were recorded at baseline and after 3 months. Glycosylated haemoglobin (HbA1c), were analysed at baseline, 3 months following the periodontal therapy. The treatment group received full-mouth scaling and root planing whereas the control group received no periodontal treatment. Results: A statistically significant effect could be demonstrated for PI, GI, PPD, CAL and BOP for the treatment group. HbA1c levels in the treatment group decreased significantly whereas the control group showed a slight but insignificant decrease for this parameter. Conclusions: The results of this study showed that non-surgical periodontal treatment is associated with improved glycaemic control in type 2 patients and could be undertaken along with the standard measures for the diabetic patient care.

37-42

Authors: Chirag Shah, Bhavesh Modi, Shilpa Budhiraja, Khushboo Desai.

Objectives: This randomized split-mouth clinical trial was designed to evaluate the effect of gingival curettage with diode laser to gingival curettage with hand instruments. Materials and methods: A total of 34 chronic periodontitis subjects, of both genders, were selected. 5 mm or deep periodontal pockets (up to 7mm), indicated for curettage procedures were chosen from each subject. In all patients contralateral sides were randomly divided into experimental and control site. The patients had undergone scaling and root planing before curettage procedure. On the experimental site curettage was done with diode laser (980 nm) and on control site curettage was done with hand instruments (gracey curettes). Clinical data were collected at baseline, 1 week, 6 weeks and 3 months after therapy. Results: There was a significant improvement of all the clinical parameters - relative attachment level (RAL), probing pocket depth (PPD), plaque index (PI), modified gingival index (MGI) for both groups (P<0.001), when compared with the baseline value. However, there was no significant difference in PI and MGI between test and control groups. Significant improvement was noticed in PPD and RAL in experimental group when compared with control group. Conclusion: After 3 months of evaluation, the diode laser has shown little additional benefits in curettage procedure when compared to curettage procedure with hand instruments.

6-14

Authors: Neelampari Parikh, Zankhana Vyas, Gunjan Dave.

Among the types of adult stem cells, those derived from tooth structures have been receiving the attention of researchers over the past decade and inspiring hope for practical applications in the future. Dental stem cells are a valuable source of stem cells and are found in teeth with healthy pulp Till date five different human dental stem cells have been isolated and characterized: Dental Pulp Stem Cells (DPSCs), Stem Cells From Exfoliated Deciduous Teeth (SHED), Periodontal Ligament Stem Cells (PDLSCs), Stem Cells From Apical Papilla (SCAP) and Dental Follicle Progenitor Cells (DFPCs). The discovery of dental stem cells and recent advances in cellular and molecular biology have led to the development of novel therapeutic strategies that aim at the regeneration of oral tissues that were injured by disease or trauma. Dental Stem cells research has given newer conceptual approach to therapy of various diseases named “regenerative dentistry” and it will have its place in the clinical practice of dentistry in the future. This review, discusses the types of dental stem cells, their banking and their possible application in treatment of diseases in future.

23-29

Authors: Manish Shah, Pranav Kharod, Aesha Amin, Mahendra Patel.

Objective: To assess the influence of nanofilled, and nanoceramic, composite restorative systems on the fracture resistance of maxillary premolars with Class II mesio-occlusodistal (MOD) cavities. Materials and Method: 30 sound maxillary human premolars were divided into 3 groups of 10 teeth each. Teeth in the first group were left intact and tested as unprepared positive controls. Teeth in the remaining two groups were prepared with MOD cavities and were restored with a nanofilled composite (Ice, SDI), a nanoceramic composite (CeramX mono®). The specimens were loaded occlusally in a universal testing machine using a metal sphere that contacted only the teeth on the cuspal inclines until fracture occurred. The results were analysed by Kruskal-Wallis and Mann-Whitney U tests. The level of significance was set at 0.05. Results: No statistically significant difference in cuspal fracture resistance was found between the unprepared positive control teeth and those teeth restored with nano filled and nanoceramic composite (P > .05). Conclusion: Under compressive load testing, teeth with nanofilled and nanoceramic filled composite restorations had similar cuspal fracture resistance which was not statistically different form intact unprepared teeth.

35-38

Authors: Nilesh Raval, Hiren H Patadiya, Chintan Modi, Abhishek Nimavat, Suhani Khamar, Kanan Vachhrajani.

Pyogenic granuloma or granuloma pyogenicum or pregnancy tumor is a well-known oral lesion which is a fast growing reactive proliferation of endothelial cells mainly seen on the gingiva. It usually arises in response to various stimuli such as traumatic injury, local irritation, hormonal factors, or certain kinds of drugs. This article presents a detailed case history with complete investigation and thorough review of pregnancy tumor.

5-7

Authors: Nalam Sai Gautam, M Sridhar.

Background: Cleft lip and palate is associated constellation of problems that need to be solved for successful habilitation. Neonates with a cleft palate have difficulty in eating which may lead to failure to thrive. One of the immediate problems to be addressed in newborn is difficulty in feeding. Obturators are fabricated to overcome such problems in infants. The obturator prevents the tongue from entering the defect and interfering with the spontaneous growth of palatal shelves towards the midline. It also helps to position the tongue in correct position to perform its functional role in the development of jaws and contributes to speech development. A case of 1month old infant with cleft palate for whom obturator was made is presented here.

16-21

Authors: Jay C Shah, Navin S Shah, Parshwa N.Shah.

Background: Gardner’s syndrome, a hereditary dominant condition, comprises of multiple osteomas, cutaneous and soft tissue tumors and polyposis coli. In 1951, Gardner reported the association between surface tumors and colonic polyps that are prone to malignant degeneration. It follows dominant hereditary pattern of multiple osteoma associated with colonic polyposis. The most commonly affected bones are the mandible and maxilla, followed by the frontal, sphenoid and ethmoid bones. The most common cutaneous finding in patients with Gardner’s syndrome is epidermoid cysts, which tend to be numerous and are present in the multiple forms in 50 – 65% of the patients.