Clinical procedures in stage II implant supported fixed dental prosthesis: A case report

Restoring a partially edentulous jaw with implant-supported prosthesis is a challenge. The clinical outcome will be satisfactory only when both the surgical phase as well as the prosthetic phase are planned in advance and executed while keeping in mind the aesthetic and functional necessities. In this case report we describe the steps in successfully restoring the edentulous space with implant supported FP1 prosthesis. The sequential steps that were followed in the prosthetic phase has been described in detail. From the satisfactory outcome of the case, it can be concluded that proper evaluation, prosthetically driven treatment planning and correct execution of the plan would ensure good predictability of the implant-supported prosthesis.

Piezosurgery – A novel tool in modern dentistry

Dentistry has undergone significant improvement with a lot of changing concepts involving novel surgical tools over the past two decades. Piezoelectric surgery, also popularly called as piezosurgery (PS), is a rapidly evolving technique of bone surgery which is gaining importance because of its ability to place osteotomy cuts with absolute precision and confidence, especially near the vital structures. Piezosurgical device functions with an ultrasonic frequency (25–29 KHz) resulting in microvibrations in the range of 60–200 µm/s enabling bone cutting that is secured and accurate preserving the underlying neurovascular elements along with improved visibility through bloodless surgical site and thorough debridement using internal irrigation system. Till date, PS has seen wide applications in various disciplines of medicine. In the field of dentistry, PS has emerged as a promising technical modality in bone graft harvesting, alveolar ridge expansion, sinus lift procedures, osteogenic distraction, and endodontic and periodontal surgeries. The present review addresses the efficiency of PS comparing it with the traditional dental surgical equipment. The advantages, limitations, and biological effects of PS as well its various applications in dentistry have also been discussed.

A case report of fordyce granules with leukoplakia: Ectopia with leukoplakia

Leukoplakia is a potentially malignant disorder that clinically presents as white lesion that cannot be scrapped off. It is associated with the habit of tobacco use, however, other factors have also to shown increase the risk of occurrence. Fordyce granules are not a disease per se but does appear as yellow spots in the oral cavity which can be easily identified clinically. The present article reports an interesting case of a patient with Leukoplakia and Fordyce granules underlying the white patch which was muffled in clinical examination and evident in histological diagnosis.

Oral appliances: An odds-on in obstructive sleep apnoea management

Breathing affiliated with sleep disorders usually lies between simple snoring without sleepiness, upper airway resistance syndrome, obstructive sleep apnoea (OSA) syndrome, and hypercapnic respiratory failure. Of all these, OSA is very often accompanied with morning symptoms and extension of comorbidities and mortalities with a high prevalence rate. General health implications and an altered quality of living are the major setbacks. Mostly patients with neurologic disorders are affected. There are many surgical and non-surgical approaches concerned with its management. This review article provides a description of oral appliances along with recent treatment modalities, clinical efficacy of alternative treatment modalities of OSA patients.

Mucormycosis and its association with coronavirus disease – 19

The pandemic coronavirus disease (COVID – 19) has been turning out to be an agonizing catastrophe among the human population all over the world. Among a perfect storm of the 2nd wave of COVID – 19, there is widespread and significant challenge due to the prevalence of the “MUCORMYCOSIS - the Black fungus infection.” It is a deadly but rare opportunistic fungal infection that mainly affects the immunocompromised people. It has been associated with COVID -19 as a Post – COVID manifestation among the recovered patients. The article provides information about Mucormycosis, its etiology, pathogenesis, predisposing factors, clinical manifestations, diagnosis, and management.

Lingual split bone technique – Revisited as a standard operating procedure for surgical removal of third molar during COVID pandemic

Objectives: The objective of the study is to revisit the forgotten art of Lingual split bone technique during the COVID pandemic as a Standard Operating Procedure (SOP) for the surgical removal of impacted mandibular third molars. It was originally introduced in early 90’s by Sir William Kelsey Fry and also we have compared its advantages over the bone guttering technique. Materials and Methods: Twenty seven cases were operated during COVID pandemic in our institution using Davi’s modified lingual split technique under strict COVID protocol. Results: All impacted mandibular third molars were successfully removed. With regards to post-operative complication; 3 patients had nerve injury (11%), 2 patients had lingual paraesthesia (7.6%), 1 patient had alveolar osteitis (3.8%), 2 patients had postoperative infection (7.6%), 3 patients had trismus (19%). The overall success rate was 100%. Also the results of a comparison between bone guttering and chisel-mallet technique were stated. Conclusion: The use of lingual split bone technique deserves consideration during this COVID time as an alternate for bone guttering in surgical removal of third molar as it ensures minimal cross infectivity rate among both dentists and patients. Thus, patient care can be delivered with confidence even during pandemic.

Apical reference point - A clinical perspective

The clinicians face various challenges in trying to find the optimum working length during root canal treatment. Unless proper biomechanical preparation up to the apical limit is done, reinfection of the canal occurs. Apical reference point must be measured with at most care as to avoid any damage to the surrounding periodontal tissues during the treatment.

Incidence of complications after the surgical removal of impacted mandibular third molars: A single center retrospective study

Objectives: The aim of the study was to study the incidence of complications associated with the surgical removal of impacted mandibular third molars in a single center. Material and Methods: A single center retrospective study was conducted in the Department of Oral and Maxillofacial Surgery at NSVK Sri Venkateshwara Dental College and Hospital located in Bannerughatta, Bengaluru. The study included patients between the ages of 15–60 years who had undergone surgical extraction of one or more mandibular third molar and had a difficulty score between 3 and 6 (Pederson’s difficulty index). During the course of study variables such as age, gender, impacted side, difficulty index, medical, and habit history along with complications and medications were recorded and accessed from the patient’s case history reports. In due course of the study, these variables were analyzed and correlated using descriptive analysis, Chi-square test, Contingency test, and regression analysis to understand whether or not these variables play an important role in aggravating post-extraction complications for mandibular third molars. Results: The study sample was composed of 250 patients with 52% female and 48% male with a mean age of 34 years. The complication rate observed was 7.6%, there was a statistically significant co-relation seen between gender (P = 0.016), age groups (p<0.05), spatial relationship (P = 0.019), and medical history (P = 0.016) when compared to the complications observed. The most common complications observed were trismus/muscle spasm followed by dry socket. However, the cases of neurosensory complications were extremely rare. Conclusion: There was a significant association to be found between the complication-rate and gender. Conditions such as muscle spasms/trismus and dry socket had a significant predilection toward the males while complications associated with neurosensory changes were commonly seen in females. There was also a significant association between habit history and rate of complication especially in conditions such as dry-socket where all the observed cases had positive history of tobacco/pan chewing habit. Interestingly all the males who complained of dry socket also had reported medical history of type (2) diabetes. Patients with complications such as neurosensory changes were few and could have been prevented with good surgical skills and precision; moreover, even if they were found they were temporary and treated with regular follow-ups.