Controlled Type -II Diabetes Mellitus - No More Contra-Indication for Delayed Loading of Two Piece Dental Implants - A Case Report

With changing lifestyle and increasing obesity, prevalence of type -II Diabetes Mellitus is increasing in geriatric individuals, who are generally prone to tooth loss. As a result the demand for implants in these patients is also increasing and planning implants has been a challenge to present day dentists. Diabetes Mellitus causes impaired metabolism in general, especially bone metabolism resulting in impaired Osseointegration and poor wound healing. Growing demand of implants in Type II DM patients has initiated research towards implants survival rates. Extensive research till now states - poorly controlled diabetic patients have higher implant failure rates, where as Diabetic patients with controlled blood glucose levels respond to implants in similar way as healthy patients. The present article is one such trail to confirm that type II Diabetes Mellitus is no more contra-indication for Implants till Blood glucose levels are controlled to normal levels. Key words: Type-II Diabetes Mellitus; Two-piece implant; Delayed loading;

Surgical Treatment of A Premolar Case Retained In Inverted Position by Extra Buccal Access

Dental impaction is usually asymptomatic. In most cases it is recognized by chance by general dentists or orthodontists, when a patient arrives your office for a routine check-up. Mandibular third molars are the most commonly impacted teeth. Very few studies have been done to assess the prevalence of impacted premolars in inverted position. This study aims to approach the planning, diagnosis and surgical treatment of a case of premolar held in reverse position through extra oral access. Key words: Tooth impaction; impacted premolars; pathology; migration; surgical treatment;

Amlodipine Induced Gingival Overgrowth, Unusual Defect and The Impact of Oral Environment: A Case Report

Introduction: Calcium-channel blockers are known for their buccal side effect as Gingival Overgrowth (GO). Although Amlodipine is considered a safe drug, it may induce gingival overgrowth for some individuals, inducing then, an aesthetic prejudice for the patient and causing serious managerial problems for clinicians. This case reports unusual defects of Amlodipine-induced gingival overgrowth, with a large gingival mass that almost completely disappeared only after improving the buccal environment. Case Study: A 51-year old Moroccan woman was complaining of gingival bleeding swelling. The examination revealed a general GO on the labial side, from the 22 to 15. It involved the entire height of the keratinized gingiva, including papillae on the buccal side. The oral hygiene was really defective with abundant plaque and calculus. The patient had hypertension and daily treated by Amlodipine 5mg for one year. But she developed the GO just few months before her first visit. The mass, associated with a chronic periodontitis, almost disappeared after scaling and root planning. Such a minimal surgical treatment showed improvement with no drug substitution or reduction. She was regularly followed up for 10 months. Conclusion: Improvement of oral hygiene, associated to periodontal non-surgical treatment alone, can afford clinical satisfaction. Changing the patient’s medication should be the last solution when local measures fail.

CBCT Imaging Of A Giant Sialolith (Megalith)

Background: A 25-year-old man presented to the Department of Oral Medicine and Radiology with a painful and persistent discharge under the tongue on right side of the mouth. The patient complained of repeated episodes of pain before, during and after food intake with a recent episode of fever. Panoramic radiograph showed a radio-opaque mass superimposing over right mandibular angle region (Figure 1). Cone Beam Computed Tomography (CBCT) was obtained for the description and location of the radio-opaque mass. Multiple planar images were constructed which showed a round sialolith measuring around 22 mm x 18mm, in coronal section (Figure 2) and Three-Dimensional (3D) reconstruction (Figure 3). Key words: Sialolithiasis; sialography; cone beam computed tomography;

Orthodontic treatment enhanced using PRP: An alternative to Orthognathic surgery?

Background: The aim was to use an alternative technique to orthognathic surgery with similar functional and aesthetic outcome with the added advantages of being less invasive and comfortable to a patient. Here, we evaluate the efficacy of PRP in the acceleration of Orthodontic treatment using Invisalign to correct a malocclusion of Class III with functional reverse bite in a patient who declined surgery but requested the least visible and time consuming procedure. Methods: PRP was applied three times during the course of the therapy. The orthodontic treatment lasted 10 months. The patient was further provided with restorative care. Protrusion of teeth 11, 21, and 22 by bodily movement, shaping of the upper dental arch and rectification of lower incisors were achieved with no adverse effect to the patient’s dental health. Since we assumed that the pathophysiology of the effect of PRP is the same as for corticotomy, we must assume an effect lasting only three months. The great advantage of our method is the fact that it is a minimally invasive technique and hence we could repeat the procedure thrice. Results: Three applications of PRP significantly shortened the length of orthodontic therapy from 21 months to 10 months. Conclusions: We can conclude that although the technique is perhaps a bit lengthy in terms of time taken to achieve the desired results after surgery but it provides a safe alternative approach for patients who decline surgery or instances where surgery cannot be carried out. Keywords: PRP; corticotomy; orthodontic; aligner; Invisalign;

Assessment Of Schoolchildren’s Temporomandibular Joint Sounds Associated With Bruxism

Many studies have explained temporomandibular joint (TMJ) sounds in children are frequent with TMJ disorder. In addition to multiple divergent findings are designed to evaluate the relationship between bruxism and TMJ disorder in children. Aim: study was designed and conducted to assess the possible relationship between bruxism and joint sounds in schoolchildren. Subjects and Methods: The sample comprised 60 schoolchildren participants between 6 to 10 years of age, of whom 30 children with bruxism as study group G1 and another 30 without bruxism as a control group G2 who were scheduled and randomly selected for treatment at (Outpatient Dental Clinics, Zagazig University Hospital). Examiner performed assessment who was blinded allocation of the groups. Assessment involved of (manual palpation, lateral and dorsal extra-auricular auscultation of TMJ by stethoscope for detecting of joint sounds, differentiating between joint sounds as a click/pop or crepitation) Three readings were performed on each participant. Collected data were checked, entered and statistically analyzed to test different variables by chi-square test with the level of significance (p< 0.05). Results: There were statistically significant association between joint sounds with regarding to bruxism and age, which showed the higher prevalence rates of joint sounds were found in children aged eight to ten years in comparison to those aged sex and seven years. However, there were statistically insignificant association between joints sounds and type in relation to gender. Conclusion: The bruxism in children may be associated with the symptoms of joint sounds with significant association regarding to age. Keywords: Bruxism; Temporomandibular Joint; Child; bruxism; TMJ sound