Dental Management of Generalised Developmental Defect of Enamel in A Child with Global Developmental Delay

Development Defect of Enamel (DDE) although not common, can bring about serious sequelae and needs immediate action. If we leave the teeth untreated, many complications such as poor dental aesthetics, chipping of teeth and dental pain often set in. These complications are further aggravated if the patient has any coexisting medical issues, such as Global Developmental Delay (GDD). Children with GDD often exhibit poor oral health with an abundance of plaque that leads to caries and periodontal disease progression because of poor motor and cognitive development. Many of them also exhibit negative behaviour toward dental treatment. This case describes the dental care for a Global Developmental Delay (GDD) child with sporadic generalised Development Defect of Enamel (DDE). The case management touches on the appropriate behaviour guidance strategies used to aid the child’s unfavourable behaviour towards treatment and the restorative treatment performed to preserve the structural durability of the affected teeth in a general dental setting.

More Than a Deadly Virus: COVID-19 and Its Psychological Impact on American and Canadian Dental Practitioners

Objectives: The COVID-19 pandemic has significantly affected dental professionals, thus contributing to adverse psychological outcomes. The aim of this cross-sectional study was to investigate the psychosocial state of American and Canadian dental practitioners, with special emphasis on their affective well-being (both during lockdown and after re-opening), behavioral impact and cognitive responses. Methodology: Dental practitioners in Canada and USA were invited to participate in an online survey after the initial lockdown period. The questions evaluated the pandemic’s effect on affective, behavioral, and cognitive responses. Results: A total of 587 practitioners completed the online survey. The strongest emotions experienced during the lockdown were sadness followed by fear. Female practitioners, those in the 35-44 age group, and those with less work experience reported higher scores on fear. Following lockdown, participants reported higher anticipation. Males expressed higher feelings of disgust and anger during both phases. Canadians were trustful of the situation in both phases of the pandemic, whereas the emotions of Americans were more towards disgust. About 56.7% practitioners provided teledentistry during lockdown, mainly through video calling, with Canadians being significantly more involved than the American participants. The highest scores for participants’ experiences during lockdown were for a lack of social interaction, followed by concern for contracting infection, and stress from distressing media coverage. Most practitioners were very receptive of receiving the COVID-19 vaccine. Conclusions: The emotions and behaviors of dental practitioners varied significantly during and after the initial lockdown, highlighting their psychosocial state during the pandemic. The scarcity of literature focusing on these basic emotions during similar outbreaks calls attention for pursuing more research in these areas as they significantly contribute to the overall psychological health of professionals, especially in times of crises. Given the emotions reported by dental practitioners, it would be of value to develop standardized protocols and provide remote psychological support during such periods of uncertainty.

Hurdles in the Access of Regular Dental Care among the Medical & Dental Students of Lahore

Introduction: Despite the great leaps in oral health globally, many countries of the world still face a horde of dental problems. Especially poverty ridden populations of the developing nations. Distribution of oral disease varies among different communities and sometimes even in the same community due to various environmental factors, factors of personal hygiene and oral habits among different demographics. However, the condition of oral health in the patients of Lahore is abysmal as determined by various previous dental surveys. The prevalence of cavities in dental patients is 82.3% while the rest of 17.7% have swollen gums, abscess, infection, and pain. Thus, this study aims to test the barriers in the way of regular dental care by evaluating a major portion of medical and dental students by using a cross sectional, questionnaire-based study, and to make regular dental care more accessible to the students of this metropolis. Objective: To determine the factors that become a hurdle in the way of regular dental care among the medical and dental students of Lahore and to pave the way for further studies on this topic. Methodology: This survey, after approval from the Internal Review Board of de’Montmorency College of Dentistry, was carried out from July to October 2021. Sample size was calculated using OpenEpi, keeping the confidence level at 95% and the margin of error at 6%. The sampling population included 234 respondents who were randomly selected from 4 different medical and dental colleges of Lahore including both public and private sector colleges. Data was collected using a structured questionnaire titled; Questionnaire for Assessment of Perceived Oral Health Care Needs, Barriers to Accessing Oral Health Care Services and Its Utility8. Statistical analysis was performed using SPSS® version 22. Result: All of the participants were students of medical and dental colleges of Lahore. More than half of the participants agreed to have not visited a dentist regularly for regular checkups for maintenance of oral health. About 55% of the participants agreed to not visiting a dentist due to fear of infection transmission. We also found a significant association between the stream of education and regular dental visits (p=0.000). Conclusion: For medical and dental students, the biggest barrier in regular oral healthcare is fear of infection transmission, and unavailability of time. However, fear of dental procedures and high cost of service also play a role. Moreover, the high cost of service is not as strong of a factor as it is for the general population.

Ketoacidosis Secondary to Dento-Alveolar Infection in a Diabetic Pediatric Patient

Diabetic ketoacidosis (DKA) is a common complication of type I and occasionally type II diabetes mellitus. Patients with DKA require intensive multidisciplinary care involving dental surgeons and endocrine physicians in a hospital setting. The association between diabetes mellitus and oral infections is very common and infection is a well-recognized trigger of DKA. Yet very few cases of DKA secondary to dental infections have been reported in the literature. We, herein, report an interesting case of a pediatric patient presenting with ketoacidosis secondary to acute cervical adenophlegmon of dental origin.

A Dynamic Technique of Oral Rehabilization Using Fixed Prosthesis and CSC Telescopic Denture for Severe Advanced Periodontitis with Secondary Occlusal Traumatism – A Long-term Case Report

Clinical reports of many literatures had documented that meticulous non-surgical periodontal therapy (NSPT) and combined with periodontal prosthesis application might not only improve periodontal parameters, but also provide effective reduction of microbiological organisms associated with periodontal pathogen. A 54-year old female individual visited with chief complains of gingival bleeding and mobile teeth, and recurrent periodontal abscess over # 13, # 11, # 21, and # 22. Periapical radiographs disclosed moderate periodontal bone loss on the total remained teeth of maxilla and mandible arches. A diagnosis of generalized severe advanced periodontitis (SAP) with secondary occlusal traumatism (SOT) was established. This present case was to document the treatment of a 6 years longitudinally retrospective evaluation of case affected SAP with SOT using treatment of the combination of periodontal and perio-prosthetic design. Results showed that the remarkable improvement of periodontal tissues, reconstruction of posterior bite occlusion and recovery of esthetic appearance. It can be concluded that the Sandwich’s technique in treating patients affected SAP with SOT is an effective and valuable option.

Rehabilitation and Esthetic Enhancement of Edentulous Patient with Hollow Cheeks Using Innovative Detachable Cheek Plumper: Case Report

Complete edentulism for longer period of time and aging causes flaccid of facial musculature which leads to sunken cheeks and unpleasing appearance of face. In order to get a supplemental support for the drooping cheek muscles, fabrication of conventional complete denture with adjunct detachable cheek plumpers are simple, acceptable non-invasive and economical. Despite the discussion of various attachment used for cheek plumper in literature each have their own disadvantages. The present clinical report demonstrated the use of chairside available lingual sheath and stainless steel wire for the attachment of cheek plumpers to the maxillary complete denture.

Clinical Performance of Cast Metal and Fiber Post Retained Restorations in Endodontically Treated Teeth: A Systematic Review and Meta-Analysis

Purpose: The purpose of this systematic review was to assess the available literature to evaluate the clinical performance of different post systems for the rehabilitation of endodontically treated teeth (ETT). Clinical Significance: The loss of structural integrity of endodontically treated teeth usually requires the use of intra-radicular posts for the retention of the final restoration. The recent literature has reported controversial results regarding the clinical performance of different systems. Material and Methods: An electronic search restricted to the English language was performed up to May 31, 2020. Articles were selected if they met the following criteria: cohort studies and randomized clinical trials comparing the failure rate incidence between fiber and cast metal post, with a mean follow-up of 3 years. Results: 24 studies (14 cohort studies and 10 RCTs) published between 2000 and 2018 were included in this review. For cast metal posts, 210 cases were classified as failures (17.07%), and for fiber posts, 423 were classified as failures (10.6%). An unpaired t-test revealed that cast metal and fiber post values were not significantly different (p = 0.58) with the difference between means of 5.00 with 95% confidence of interval (-13.38 to 23.39). Four studies that presented cast metal and fiber posts groups were combined in the meta-analysis. There was no significant difference in the general failure analysis (risk ratio of 0.59 [95% CI: 0.30 to 1.18]; p = 0.13). Conclusions: Based on the present analysis results, the clinical performance of ETT restored with either cast metal- or fiber post-retained restorations presented similar results.

Periodontitis and Low Bone Mineral Density: A Bibliometric Study of the Top 100 cited Articles

Purpose: Science mapping is commonly known as Scientometrics; is used in combination with data visualization to analyze a considerable form of bibliographic resources to study and map the scientific field and thereby serving investigators to concentrate on under investigated areas of research. This scientometric study was aimed: 1) to evaluate the level of investigation in the field of periodontitis and osteoporosis, and 2) to recognize the journals, and countries in this field. Methods: The top hundred articles with most citations were selected by electronic searches in the MEDLINE database, and the citations were cross checked by Google Scholar database. The total number of publications per year along with their yearly growth was calculated. The following data regarding the journal, country of origin, and level of evidence were analysed. Results: 467 authors within 77 clusters contributed to these 100 articles. The annual rate of growth of publications in the period from 2011 to 2020 was 6.27%. The year range of these publications started from 1992 till 2019, the second decade of the new millennium showed the highest number of articles (39 out of 100 articles). Conclusion: Though the number of articles published on the present topic has risen in the last two decades, the proportion of studies with LOE1 is as low as 5%. Therefore, recommendations are made to the researchers to lay emphasis on producing more studies with LOE1 in future.

A Novel Method for Managing Flared Root Canal with Anatomic Post and Core: A Case Report

The compromised tooth structure after endodontic treatment necessitates the use of post and core for structural durability. Management of the flared root canal is still a tough obstacle for the clinicians. Reinforcing the root canal space with the customised anatomic post thus regains the lost structure within the canal and aids in establishing a great strength and stability to the tooth structure. The report of this case scenario aims on clinical technique of fabricating anatomic post with glass - fibre posts and composite resin on a central and lateral incisor.

Surgical and Nonsurgical Techniques in Orthodontics

Orthognathic surgery can be extremely useful in management of patients with complex malocclusions. It can benefit the patients by treating the esthetic and functional deformities. The collaboration between orthodontists and oral surgeons is crucial in obtaining optimal results for such complicated cases. The timing of the treatment and the age of the patient at the time of treatment play an important role in determining the type of treatment. This review discusses the different types of malocclusions in which the patient can be treated with conventional mechanics if presented during growing period and surgical management if presented after the growth is completed. Furthermore, the review describes the recent introduction of mini-screws and the non-surgical methods that can be used to treat complex malocclusions for adult patients.