Radiographic assessment of impacted mandibular third molars

The surgical remedy of problems related to lower jaw 3 molars is related to common surgical risks like contamination, haemorrhage, pain and swelling. Certain unique risks are related with such surgery, specifically inferior alveolar and lingual nerve harm as these are adjacent vital structures. Risk assessment calls for an entire understanding of dental factors that can impact the care of these characteristic structures. Preoperative radiographic assessment warrants to provide data about the tooth itself, its encompassing bone, the neighbouring dentition, and related anatomical structural systems. Parameters that ought to be assessed are level of impaction, root formulations, angulation of the enamel, number of roots, root morphology, related pathology and, most importantly, the relation some of the crown/roots and the mandibular canal. An appropriate imaging method for 3 molars ought to display the complete 3rd molar and the mandibular canal below it. In this mini review, we elaborate on the generally used radiographic assessment methods of mandibular 3rd molars.

Amelogenesis imperfecta: A case series

Amelogenesis imperfecta (AI) refers to a group of rare genetic disorders that involve tooth development and that are passed down through families as a dominant trait. This condition is characterized by abnormal enamel formation caused by gene mutations that alter the quality and/or quantity of enamel. This dental problem can impact both primary and permanent dentition, varies among affected individuals, and results in esthetic and functional problems. The treatment planning for patients with AI is related to many factors, including the age of the patient, the type and severity of the disorder, intraoral conditions, and the socioeconomic status of the patient. It is crucial to plan a proper remedy, which requires collaboration among dental specialties to execute comprehensive dental treatment in order to provide a long-term solution with adequate esthetics. This clinical case study looks at three different types of amelogenesis imperfecta patients.

The elusive retromolar foramen and retromolar canal: A CBCT study

This study aims to evaluate the presence of retromolar foramen (RMF) and retromolar canal (RMC) in the mandible using cone beam computed tomography (CBCT) in Chhattishgarh population and to correlate its possible clinical impact. 175 CBCT images were collected from which 100 bilateral CBCT images of patients were retrospectively selected from the Department of Oral Medicine and Radiology of the Chhattishgarh Dental College and Research Institute and evaluated bilaterally which were taken for diagnostic purposes from maxillofacial radiology clinic and data were statistically analyzed. This was an observational descriptive study and all the images were processed and analyzed on CS3D imaging software. The data was analyzed using chi square test. The prevalence of RMF and RMC was observed in 8.5%, of which 10 were in females and 7 in males. The RMCs traversed in different directions – horizontal, vertical and angular. Based on the subjective assessment, each of these canals was further subclassified into straight and curved canal. In the present study in 12 of the cases angular curved type was found and in 3 cases, vertical straight was noticed. The bifurcation of the inferior alveolar nerve (IAN) canal was observed in 15% of the scans and remaining 85% had single mandibular canal. The proximity of RMF from buccal and lingual cortical plates was found buccally in 16 cases and in single case was found to be lingually. Position of RMF might change with the presence and absence of third molar. The absence of third molar results in anteriorly located RMF. In majority of cases it was found that RMF was located more buccal than lingual. The parameters considered in the current study will guide the oral and maxillofacial surgeons while giving incisions in 3molar impacted cases, other pathologies and ease to preserve the retromolar foramen.

Prevalence and pattern of oral and maxillofacial trauma in Chhattisgarh- A retrospective study

Maxillofacial trauma is any physical trauma to the facial region, commonly encountered by maxillofacial surgeons, and is often associated with high morbidity and so constitute quite a significant portion of the workload of the oral and maxillofacial surgeon. Maxillofacial injuries can occur as an isolated injury or may be associated with multiple injuries in other parts of the body. To assess the patterns, etiology, and treatment modalities of maxillofacial trauma in a teaching hospital in central India, over a 12-year period. Patients with maxillofacial trauma were identified using the department database and clinical records. 264 patients were identified with maxillofacial trauma in the department of oral and maxillofacial surgery between January 2006 and December 2018. The study showed that there was a male preponderance in all age groups over female. Of the 264 patients with maxillofacial injuries, 83,33% had isolated lower face (mandibular) fractures, followed by midface fractures (10.60%) and panfacial fractures (6.06%). Road traffic accidents (87.12%) were the most common form of etiology for trauma followed by assaults (10.98%). Most trauma were treated with open reduction internal fixation (89%) than closed reduction (11%). The etiology and pattern of maxillofacial injuries reflect the trauma patterns within the community and can thus provide a guide to help design programs toward prevention and treatment.

A boomy century of periodontal regeneration with biological mediators

With the advanced and improved knowledge of bone regeneration on the molecular level, some of key molecules that alter the complicated physiological method were identified, and are already in scientific use or beneath research to enhance bone restore. Of those molecules, BMPs were the maximum considerably studied, as they are robust osteoinductive elements. They result in the mitogenesis of mesenchymal stem cells (MSCs) and different osteoprogenitors, and their differentiation in the direction of osteoblasts. Other growth factors except BMPs which have been implicated through out the bone regeneration, with one-of-a-kind features with respect of cell proliferation, chemotaxis and angiogenesis, are also being investigated or are presently getting used to reinforce bone restore, which include platelet-derived growth factor, transforming growth factor- β, insulin-like growth factor-1, vascular endothelial growth factor and fibroblast growth factor, amongst others. One present day technique to enhance bone regeneration and soft-tissue recovery with the aid of using nearby application of growth factors is the use of platelet-rich plasma, an extent of the plasma fraction of autologous blood with platelet concentrations above baseline, that is wealthy in most of the aforementioned molecules. This overview focuses and target on the biological mediators that regulates key cellular events which have a capacity to induce the method of tissue repair and regeneration.

Comparative evaluation of biting force in 2mm locking plates with 2mm miniplates in the treatment of mandible fractures: A clinical study

1. To compare efficacy of 2mm locking plates with 2mm miniplates in the fixation of mandible fractures and 2. To evaluate and compare the biomechanical function by measuring the bite force at 1st week, 3rd week, 6th week and 3rd month postoperatively in 20 patients divided equally into two study groups.A prospective randomized study was carried out at Department of Oral and Maxillofacial Surgery, Meghna Institute of Dental Sciences, Nizamabad from 2019 to 2021 to treat consecutive mandibular fractures where patients were randomly divided into two groups each composed of 10 patients where Group A were treated with single 4 holed stainless-steel locking miniplates and Group B with two 4 holed stainless steel conventional mini plates both maintaining a gap of 2.0 mm system. Later assessment was done using bite force recording postoperatively at 1st week, 3rd week, 6th week and 3rd month and with the associated complications like Swelling, Infection, Paresthesia, Mobility between fracture fragments and Hardware failure.When the mean bite force values in right molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared to group B at 1st week and 3rd week (P<0.05). But no statistically significant differences were observed at 6th week and 3rd month (P>0.05).When the mean bite force values in the central incisor region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A compared to group B at 1st week and 3rd week (P<0.05). But no statistically significant differences were observed at 6th week and 3rd month (P>0.05).When the mean bite force values in left molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared group B at 3rd week (P<0.05). But no statistically significant differences were observed at 1st week, 6th week and 3rd month (P>0.05).The study signifies that both the fixation systems were able to provide stability to fracture segments, but locking plate system has provided better stability when compared to miniplates system, hence recommending for more elaborative studies to arrive at definitive conclusion.

Nuclear medicine imaging in oral diseases: A review

Nuclear medicine is the discipline of medicine that deals with the use of radionuclides in research, diagnosis, and treatment. It works on molecular & functional level and uses radiopharmaceuticals in its procedure helping in detection of lesions before morphologic change is evident. Radiopharmaceuticals also known as Radionuclides/ Radioisotopes are unstable atoms of a chemical element, actively emit radiation. These emitted radiations are absorbed by photomultiplier tube and reconstructed by a computer system followed by display of an image. The rationale of writing this article is to understand about Nuclear Medicine and its applications in oral diseases.

Prediction of nerve damage by comparing periapical radiographic signs of impacted mandibular third molars in close proximity to inferior alveolar nerve with their true tomographic relationship – An observational study

The purpose of the study was to correlate the accuracy of Roods and Shehab signs in an intraoral periapical radiograph (IOPAR) with Cone-beam computed tomography (CBCT) findings to indicate Cone-beam computed tomography only in high-risk conditions.70 impacted mandibular third molar teeth in 58 patients above 18 years with intraoral periapical radiographs presenting with one or more root and canal signs of Rood and Shehab criteria were included in the study. Winter's classification was recorded, and the patients were exposed to a Cone-beam computed tomographic scan. True canal – tooth relationship was assessed in the sectional images. Pearson Chi-square test was used to correlate periapical radiograph and tomographic findings, and an unpaired t-test was applied for descriptive analysis.Rood and Shehab canal criteria in the periapical radiographs were significantly correlated to direct contact of an impacted lower third molar with the canal (p< 0.05) and loss of cortication of Mandibular canal (p< 0.05) on the cone-beam computed tomography. Cone-beam computed tomography is recommended to assess the periapical radiographs with canal risk markers pre-operatively to help avoid iatrogenic complications.

Evaluation of zygomatic bone region for placement of quad zygomatic implants using CBCT in postmenopausal women

Insufficient height and width of the alveolar ridge at the implant site remains with inadequate bone volume following extraction in older age people especially in postmenopausal women. Postmenopausal women are susceptible to primary osteoporosis where more bone resorption than formation is seen resulting in decreased bone mass. Hence the present study aims to evaluate the zygomatic bone region for placement of quad zygomatic implants using CBCT.: A total of 120 CBCT images of female patients who were between the age group of 45 yrs to 65 yrs were taken. The zygomatic bone was evaluated for pneumatisation zones and thickness of zygomatic bone at three different regions i.e., superior, middle and inferior at nine points on zygoma bone along with bone to implant contact (BIC) region using virtual software. The largest thickness in the superior, middle and inferior regions were at Point A2(8.01+/-2.10 mm), Point B2 (7.01+/-1.62 mm), and Point C1 (6.65+/-1.64 mm), respectively. The virtually placed implants at Point A3 (15.92+/-4.16 mm) and Point B2 (12.02+/-3.62 mm) had the highest BICs. : To obtain the largest BICs, results suggested that the posterosuperior region (Point A3) and the centre of zygoma (Point B1) were the optimal places for the placement of quad zygomatic implants.

Variations in root canal morphology of the permanent mandibular first molar in Indian population- A CBCT study

The purpose of this study was to determine the variations in the number of canals and its morphology in permanent mandibular first molars using cone-beam computed tomography (CBCT) in a subset of Indian population. A total of 350 CBCT scans were collected and evaluated in all three orthogonal planes to determine the number of root canals and study their anatomic variations using Vertucci’s classification.: The total number of roots and root canals, the root canal configuration, the incidence, and the correlations between left- and right-side occurrences and between males and females were analysed. Statistically significant differences were evaluated using the chi-square test with SPSS 16.0 for Windows (SPSS, Chicago, IL), with significance set at p < 0.05.: The results of this study showed that predominantly, two thirds of the subjects had type VI mesial canal configuration and two-thirds had type I distal canal configuration. Also there was significant variance in the canal anatomy across gender and age of the subjects.: CBCT is a clinically useful tool in understanding the variations in root canal morphology, which guides in the assessment of the canal morphology aiding in successful root canal treatment.