Evaluation of hybrid implant in posterior edentulous maxilla with inadequate bone

Aim of this study is to investigate.Hybrid implant has got satisfactory results in our previous study in various edentulous areas with inadequate bone for endosseous implant placement .The credibility of the implant in the areas of posterior maxilla needed to be evaluated.Objectives• To evaluate the hybrid implant postoperatively 18 months for gingival status, pain, peri-implantitis and mobility, so that it can be applied in posterior maxillary edentulous spaces with inadequate bone as an alternative to conventional implant.Materials and methods15 patients were rehabilitated in the posterior edentulous areas with hybrid implant. we intended to study the rehabilitation of posterior maxillary edentulous space i.e. Maxillary- premolar, 1st molar and 2nd molar area with hybrid implant and evaluate the hybrid implant post operatively for 18months (1stmonth, 3rd month, 6th month ,12 th month,18thmonth).Results• During the study period the implant system presented with no gingivitis, peri-implantitis, and pain.• The periotest test values show the implant system to be very much stable.• Also proves to be safe, economical and clinician and patient friendly compared to other implant systems.Conclusion• Hybrid implant system proves to be very effective in rehabilitating the posterior maxillary regions with inadequate bone.• Also proves to be safe, economical and clinician and patient friendly compared to other implant systems.

Stress reduction intervention and the initial periodontal therapy outcome in chronic periodontitis patients. a randomized controlled pilot study

Background: Psychosocial stress, have been implicated as risk indicators for periodontal disease. Minimal evidence in literature exists to assess the effect of stress reduction therapy (SRT) in the outcome of non-surgical periodontal therapy (NSPT).Objective: Hence, we aimed to explore the possibility of employing SRT in stressed patients as an adjunctive intervention in the management NSPT.Materials and Methods: Sixty male patients divided into Group 1 comprised of 20 unstressed chronic periodontitis patients receiving non-surgical periodontal therapy alone, Group 2a (20 stressed chronic periodontitis patients) received intervention focused on SPT with NSPT and Group 2b (20 stressed chronic periodontitis patients) received only NSPT without SPT. Their stress level was evaluated using a standard questionnaire method and salivary cortisol levels, at baseline and 3 months along with periodontal parameters.Results: There was significant reduction in stress parameters for Group 2a patients. The reduction of total periodontitis affected sites was highest in Group I patients (55.4%), followed by Group 2a patients (53.2%) and Group 2b patients (38%).Conclusion: SRT may result in comparable treatment outcome to unstressed chronic periodontitis patients. This study opens new avenues to investigate the effects of stress management as an adjunctive to conventional NSPT, which should be explored further.

Crouzon’s syndrome: a new surgical approach

Crouzon’s syndrome is a rare genetic disorder characterized by distinctive malformations of the skull and facial region, premature cranial suture closure is the most common skull abnormality, optic disc edema and proptosis are among the most common ocular findings. It is a genetic disorder of gene FGFR-2 (Fibroblast Growth Factor Receptor-2) in 95% of cases, and in 5% of cases, FGFR-3 (Fibroblast Growth Factor Receptor-3) mutation occurs.Once a suture becomes fused, growth perpendicular to that suture becomes restricted and the fused bones act as a single body structure. Compensatory growth occurs at the remaining open sutures to allow continued brain growth, resulting in abnormal bone growth and producing facial deformities.In the new born child, some potential problems that may need to be addressed include respiratory difficulties, feeding problems, neurologic complications such as hydrocephalus and the potential risk of developmental delay.We represent a literature review and a rare case of Crouzon’s Syndrome, who wanted facial correction to be done at the age of 24years. We planned two stage surgical procedure, for correction of facial deformity.

Prevalence and knowledge of carpal tunnel syndrome among the dental practitioners; survey based study in Riyadh

Carpal Tunnel Syndrome (CTS) is a common medical condition that results in numbness, pain and tingling in the arm and constitutes about 90% of neuropathy entrapments. The condition arises when the median nerve in the arm is compressed. CTS can degenerate rapidly to cause nerve damage. The effects of CTS on medical practitioners can be serious given the speculation that the condition is work-related. Consequently, this study seeks to establish the prevalence and knowledge of CTS among dental practitioners in the city of Riyadh. In doing so, the research attempts to find relationships between CTS and workload and the experience of the dental practitioners. The study takes the model of sectional study that targets dental practitioners specifically in the city of Riyadh. The researchers recruited 190 dentists and used google forms to collect data from the respondents. The questions in the survey related to symptoms of the condition and the related demographics. The study found a significant comparison of the prevalence and knowledge of CTS among various subgroups. Daily patient exposure and work experience were some of the underlying features discovered in the study. Dentists with more work experience demonstrated significant knowledge on the condition and registered an equally high prevalence of pain associated with CST. The findings of the research show a direct correlation between workload, work experience, and CST.

Organoids: life in three dimensions- a review

Most of the diseases in humans are as a result of complex interactions occurring at cellular and molecular level. Research today has been focused in an attempt to reveal precisely the cellular evolution into pathogenesis. There are vast array of research fields, which include molecular biology, imaging techniques, etc. One of such field recently advancing worldwide is “Organotyping”. It is the successor of two dimensional cell cultures. Miniature organs and disease models can be produced from cells having the ability to proliferate and differentiate, by adopting definite protocols. Organoids are the potential tools to probe human biology and diseases; thereby they may change the approach to study diseases and provide treatment, in a more beneficiary way to the patient. Also organoids are used in vaccine production, cancer research, microbiology, tissue regeneration, drug testing, etc. Clinical trials are more devastating and may cost life of patients included in study. As such, organoids can be included in the protocols of clinical trials, through which the outcome of the study can be estimated. They open the doors for newer research methods and innovations, which are in peak requirement of present day scenario where new diseases are emerging and the diseases already existing are not yet cured.

Reliability of digital radiographs in measuring the vertical and horizontal dental implants’ dimensions a retrospective study

Introduction: Digital radiography can take accurate measurements. In implant dentistry, intraoral periapical (PA), bite-wing (BW) and panoramic (OPG) radiographs are being used, although it had limitations of distortion. This research aims to assess the accuracy of digital radiography in measuring dental implants and to evaluate the SIDEXIS software’s reliability in measuring their dimensions.Materials and Methods: Over 192 implants from 316 radiographs were selected. All radiographs were analyzed using SIDEXIS software. Statistical analysis was performed using SPSS.Results: Statistically significant differences (P < 0.5) between the actual heights and widths compared to the measured radiographic dimensions. Over all the distortion was greatest in OPGs. The magnifications were 2.48mm in height and 0.82mm in width for OPGS, 0.17mm in width for BWs while in PAs it was 1.37mm in height and 0.156mm in width. The magnification was more in maxilla for PAs and OPGs. Anteriorly the PAs had the greatest magnification (2.16mm), and OPGs had the greatest at (3.03mm) in height posteriorly.Conclusion: Digital OPG, PA and Bitewing radiographs are reliable for performing dimensions linear measurements for implants, and PAs have the highest precision. Additionally, SIDEXIS software provided accurate results and can be considered a reliable method for implants’ assessment.

Apexogenesis of traumatized maxillary right central incisor: Case report with 4years follow up

The main goal of vital pulp therapy is to preserve and maintain pulpal health in teeth that have been exposed to caries, trauma, and restorative procedures. This type of endodontic treatment is very important in young permanent teeth that have not reached their complete length and exhibit thin-walled roots and wide open apices. The developments in knowledge of pulpal physiology and immunology, beside to newly introduced dental materials, have changed the treatment approaches for teeth with involved pulps. This report describes a case of a young patient in whom maxillary right central incisor suffered crown fractures because of a traumatic accident. Pulpotomy with MTA were performed in order to achieve apexogenesis and the tooth was restored with a glass ionomer cement and composite resin. The patient was reviewed over 4years.

Assessment and comparison of the levels of N-nitrosonornicotine and 4-(n-methyl-n –nitrosamino) -1-(3-pyridyl)-1-butanone in the saliva of tobacco chewers and non- chewers -a hospital based study

Background: Studies estimating the Tobacco- specific nitrosamines, (TSNA’s) which are the strongest carcinogens in the saliva oftobacco users and tobacco quitters, are limited.Objectives: To assess and compare the levels of N- nitrosamines (NNN, NNK) in the saliva of tobacco chewers and non -chewers including those who have quit the habit of tobacco use.Methods: The study included 120 patients who were divided into three groups of 40 each: Group I- Smokeless tobacco chewersGroup II- Tobacco chewers who have completely stopped the habit at least 2 weeks prior to sample collection andGroup III- non-chewers. The salivary levels of two tobacco specific nitrosamines; NNN & NNK levels were estimated in the three study groups. Statistical analysis was done by Kruskal– Wallis, one-way analysis of variance (ANOVA) test, Mann-Whitney U test. (p-value < 0.05 was considered to be statistically significant)Results: In Group I, the mean level of NNN was 651.84 ± 359.78 and mean level of NNK was 168.32 ± 131.83. In Group II, the mean level of NNN was 119.52 ± 95.05 and mean level of NNK was 42.78 ± 43.19. In Group III, the mean level of NNN was 3.44 ±6.55 and mean level of NNK was 1.98 ± 3.68. There was a statistical difference in the 3 groups with respect to mean levels of NNN and NNK.Conclusion: The study indicated that salivary tobacco-specific nitrosamines are elevated in tobacco chewers. Saliva can be used to detect TSNA’s and screen for TSNA’s during each patient’s de-addiction process.

The effectiveness of platelet concentrations in periodontal surgeries

Platelets release several growth factors which stimulate tissue regeneration. Several techniques for platelet concentrates such as platelet rich plasma (PRP), plasma rich in growth factors (PRGF), platelet rich fibrin (PRF) and concentrated growth factors (CGF) have been introduced in dental surgeries for the prevention of hemorrhage and acceleration of tissue regeneration. However, a fabricating growth factors-enriched bone graft matrix which is called “sticky bone” has been demonstrated to provide stabilization in bony defects. In this article, we presented the method of preparing and utilizing CGF and sticky bone and evaluate the effect of CGF mixed with bone graft and CGF barrier membrane in periodontal surgeries.Methodology: We used websites such as PubMed, Scopus, and ISI Web of knowledge to get related articles about this subject. The research process involved specific key words " concentrated growth factor”- “Platelet rich fibrin”- growth factors-enriched bone graft” - “sticky bone” to find more articles which published from 2007 to March 2018.Results: We reviewed 48 articles, 43 articles were excluded. Only five articles have been conducted. Original human studies and case report were included.Conclusion: We concluded that the use of sticky bone and CGF is effective in bone grafting and implant.

Management of antero posterior discrepancy using expansion appliances- A case series

Antero-posterior deficiencies are one of the major concerns in adolescents especially when presented with class III malocclusion and anterior cross bite. These discrepancies are generally corrected by protraction of maxilla and expansion during growth period. A 16 year old boy and 12 year old girl presented with midface deficiency with anterior cross bite and Class III malocclusion. Antero-posterior expansion was planned with Hyrax and Jack screw appliances respectively. Anterior cross bite and Class III malocclusion was corrected. Majority of these antero posterior discrepancies can be corrected with antero-posterior expansion, hence are of prime importance.