bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Caudal Epidural Steroid Injection in Chronic Low Back Pain due to Prolapse Intervertebral Disc
Authors: Sharma R , Kothari SY , Thukral BB , Chaudhary S
Published: July 2019

Background

Low back pain (LBP) due to disc herniation is a frequent cause of back pain. It is a debilitating condition having enormous medical and socio-economic effects. Epidural injection of steroids has been used to treat LBP for many decades. Despite widespread use and numerous publications there is significant controversy with regards to the medical necessity and indications for epidural injections, hence we planned this study.

Materials and methods

This was a prospective follow-up study. Forty-one patients of confirmed diagnosis of prolapse intervertebral disc (PIVD) were included. Caudal epidural steroid injection (CESI) of 80 mg methylprednisolone acetate diluted in 20 ml of 0.9% saline was given. Outcome was assessed by Numeric Pain Rating Scale (NRS), Oswestry Disability Index (ODI), Straight Leg Raise (SLR) and Modified Schober Test (MST) at baseline, one, three, six and twelve weeks follow-up.

Results

Thirty-seven patients completed the study. Significant improvement in patient's status was observed after CESI, as measured with MST, SLR, NRS and ODI at one and three weeks post injection and the improvement were maintained till 12th week. Eighty-three per cent of patients were satisfied at the end of the study and side-effects reported were mild.

Conclusion

CESI is a simple, safe and cost effective intervention procedure for the treatment of chronic LBP due to PIVD. It provides rapid pain relief and improvement of physical function starting within a week of injection.
Quality of Life in Postmenopausal Women and Its Correlation with Bone Mineral Density
Authors: Zonunsanga C , LNU Hmingthanmawii , Pertin Minggam , Chiru Chongreilen , Nongmaithem Romi Singh , Singh Yengkhom Jotin
Published: July 2019

Aim

To evaluate the quality of life in postmenopausal women and its correlation with bone mineral density.

Study design

Cross-sectional study.

Duration of the study

October 2012 to September 2014.

Settings

Physical Medicine and Rehabilitation Department, Regional Institute of Medical Sciences, Imphal.

Study population

Postmenopausal women who attended the department during the study period.

Materials and Methods

Quality of life was assessed using WHOQOL-BREF questionnaire, a validated brief version of the WHOQOL-100. Bone mineral density (BMD) in the lumbar spine, femoral neck and trochanter were measured using dual energy x-ray absorptiometry (DEXA) scan – GE Lunar model.

Results

A total of 125 patients were studied. The mean t-scores in lumbar spine, femoral neck and trochanter were -2.550 ± 1.209, -1.831 ± 0.921 and -1.621 ± 1.064 respectively. The mean BMD (g/cm2) in lumbar spine, femoral neck and trochanter were 0.867 ± 0.144, 0.789 ± 0.131 and 0.682 ± 0.139 respectively. The mean overall WHOQOL score was 57.68±10.07. There were statistically significant positive association of WHOQOL score with the BMDs in lumbar spine, femoral neck and trochanter (p < 0.05). Multivariate regression showed significant relation of overall WHOQOL score with BMD lumbar spine (b=0.229; R2=0.119), BMD femoral neck (b=0.285; R2=0.129), and BMD trochanter (b=0.245; R2=0.119).

Conclusion

BMDs in the lumbar spine, femoral neck and trochanter had a positive correlation with quality of life scores. BMD also had a good predictive value in determining the quality of life in postmenopausal women.
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) in Traumatic Spinal Cord Injury
Authors: Goyal Vinay , Laisram Nonica , Borah Diganta , Chethan. C
Published: July 2019

Hyponatraemia is a known complication associated with neurosurgical conditions including acute spinal injury. The prevalence of hyponatraemia in acute spinal cord injury has been known to be much higher than in the general population. Hyponatraemia is a marker of different underlying diseases and it can be a cause of morbidity itself; this implies the importance of a correct approach to the problem. The syndrome of inappropriate antidiuretic hormone (SIADH) is one of the most common causes of hyponatraemia; it is a disorder of sodium and water balance characterised by urinary dilution impairment and euvolaemic/hypotonic hyponatraemia, in the absence of renal disease or any identifiable nonosmotic stimulus able to induce antidiuretic hormone (ADH) release. It is a diagnosis of exclusion. We are reporting a case of hyponatraemia in a patient with lumbar spinal cord injury who was initially managed as any other hyponatraemia and was later diagnosed as suffering from SIADH.
Acquired Flat Foot due to Tibialis Posterior Rupture, a Known Yet Missed Cause
Authors: Mansoor S.N , Qureshi Ahmed Zaheer
Published: July 2019

Rupture of tibialis posterior tendon is a known cause of acquired flat foot but the diagnosis is missed or delayed in most of the cases. It may lead to significant morbidity. We present a case of 13 years old boy with history of blunt trauma to his left foot one year back and presented with pain medial aspect of right foot and difficulty in prolonged walking and running. Clinically he had a flat and hyperpronated foot. His x-rays were normal and MRI revealed partial tear of posterior tibial tendon. He was recommended medial arch support, shoe modification, NSAIDs and referred to orthopedic surgeon for repair. Posterior tibialis tendon dysfunction is one of the concealed injuries that require earliest diagnosis and immediate attention, failing which the outcomes can have debilitating effects on patient's quality of life. This is important to prevent foot deformities and long term disability.
Ultrasound: A Screening Tool for Carpal Tunnel Syndrome
Authors: Chandy Bobeena Rachel , Betty M. , Magimairaj Henry Prakash , Thomas Binu P. , Tharion George
Published: July 2019

Background

Electrodiagnostic test is considered as the gold standard for diagnosis of carpal tunnel syndrome (CTS). Ultrasonography provides a simple non-invasive means of visualising peripheral nerve pathology.

Objective

The objective of the study was to assess the role of ultrasonography in CTS and its correlation with the present day gold standard of nerve conduction studies (NCS).

Materials and Methods

A prospective cohort size of 100 subjects was calculated based on a hypothesized sensitivity of 90% and a confidence interval of 85-95%. All 100 subjects, 64 controls and 36 patients underwent nerve conduction studies and USG. Transverse images of the median nerve were obtained at three levels: proximal to the carpal tunnel inlet, at the carpal tunnel inlet and at the carpal tunnel outlet. The flattening ratio was also assessed at the tunnel inlet and outlet. Statistical analysis was done to corelate the ultrasound findings at each level with nerve conduction studies and calculation of the positive and negative predictive values. The cut offs of the cross-sectional areas of the median nerve at the three anatomical levels on ultrasonography were taken at the best sensitivity and specificity according to the ROC curve.

Results

We found that at any one anatomical level, the sensitivity of ultrasound to detect carpal tunnel syndrome by increase in the cross-sectional area of median nerve as compared to the nerve conduction studies is 90%.

Conclusions

At 45% specificity, ultrasonography could be used as a non-invasive and easily available screening tool in carpal tunnel syndrome. Also, the best level to look for nerve compression is at the level of the carpal tunnel inlet.
Prevalence of Upper Limb Neuropathy in Rehabilitated Spinal Cord Injured Patients in South India
Authors: Chatterjee Ahana , Bhide Rohit
Published: July 2019

Introduction

Paraplegics with spinal cord injury, independent in activities of daily living (ADL) are known to have upper limb neuropathy due to constant use for mobility and transfers. Additionally architectural barriers, disabled unfriendly public transport, diffi cult terrains and sociocultural barriers in a developing country like India, further adds strain on the upper limbs. Hence, it is important to know the effects of these increased demands in terms of prevalence of peripheral neuropathies in rehabilitated spinal cord injured population from developing countries. In this study we tried to find prevalence of upper limb neuropathy in SCI population in South India.

Methods

Patients with spinal cord injury with a neurological level T2 and below, not having any other associated complication of upper limb due to any other disease apart from SCI were recruited in the study. Total 51 patients (45 male and 6 female) out of 183 patients screened, met key inclusion criteria. All the subjects who were recruited in the study underwent electrodiagnostic studies for the median, ulnar and radial nerves (both sensory and motor). The baseline demographic parameters such as time since injury, age, sex, American Spinal Injury Association scale (AIS), vocation, comorbidities and current mode of indoor and outdoor mobility were recorded. The final diagnosis based on electrodiagnostic study of median/ulnar/radial nerve was graded in scale of 0-2 with 0 being normal, 1 being neuropathy of one hand and 2 being involvement of both the hands.

Results

The scores from demographic data and electrodiagnostic data were accessed and categorical comparison was made between different types of mobility aids and neuropathy (CTS/ulnar/radial). The study showed an overall prevalence of 80% for median neuropathy, 24% for ulnar neuropathy and 16% for radial neuropathy. However, no statistical correlation was found between the use of any particular mobility aid, time since injury, vocation and neuropathy.

Conclusions

We found high prevalence of upper limb compressive neuropathy in the spinal injured population studied, however, due to the small sample size, no statistical signifi cance could be found. We also found carpal tunnel syndrome to be the commonest neuropathy amongst the population especially in the groups that use wheelchair and elbow crutches for mobility.
Neuromuscular Electrical Stimulation for Early Recovery of Motor Control of Ankle along with Spasticity in Stroke Patients A Prospective Randomized Controlled Study
Authors: Joy AK , Mohes Annada Sankar , Bidyarani Th , Jongkey Aten , Singh L Darendtajit
Published: July 2019

Background and Purpose

Effect of neuromuscular electrical stimulation in acute stroke patients while stimulating only single muscle is not known. The purpose of the study is to find the influence of early neuromuscular electrical stimulation to the motor point of tibialis anterior muscle of the affected limb in achieving early motor control of the ankle with reduction in spasticity in poststroke patients.

Methods

One hundred and thirty-two subjects were selected between 45and 65 years of age and within 2 weeks of the first attack of stroke. They were randomly divided into study and control groups comprising 66 subjects in each group. Study group received neuromuscular electrical stimulation to tibialis anterior muscle of the affected limb, 15 minutes twice daily, 5 days a week up to 3 weeks along with conventional exercise therapy whereas control group received only exercise therapy for that period. Outcome measures include Modified Ashworth Scale for spasticity of ankle plantar flexors, motor power of ankle dorsiflexors and plantar flexors, motor control of ankle joint. They were recorded before starting treatment, after 3 weeks and at 7 weeks following starting the treatment.

Results

Significant improvement of spasticity was noticed after 7 weeks follow-up (p=0.014). Significant improvement also noticed in ankle dorsiflexor motor power (p<0.001), ankle motor control (p=0.007).

Conclusions

Neuromuscular electrical stimulation along with traditional exercise programme is superior to exercise alone for early recovery of ankle motor control, plantar-flexor spasticity and ankle dorsiflexor motor strength.
Contemporary Management of Patients on Warfarin, Aspirin And Clopidogrel Requiring Dentoalveolar Surgery
Authors: Galinde Jyotsna , Sidana Sunil
Published: July 2019

Patients with a variety of medical conditions often receive aspirin, warfarin or clopidogrel to prevent complications from atrial fibrillation, thromboembolisms or stroke. Although these medications can be lifesaving; it also can put patients at greater risk of experiencing haemorrhage after dental surgery. Therefore, a decision must be made whether to interrupt or continue anticoagulant treatment in patients undergoing various dental procedures. We have presented a review of this topic, including a brief description of the more commonly encountered anticoagulant and antiplatelet medications and the current recommendations for the surgical management of these patients.
Oral Lichen Planus : A Review
Authors: Gadda Rohit B , Salvi Rohini , Bhatia Varun Gul
Published: July 2019

Oral lichen planus (OLP) is a chronic mucosal condition commonly encountered in clinical dental practice. Lichen planus is believed to represent an abnormal immune response in which epithelial cells are recognized as foreign, secondary to changes in the antigenicity of the cell surface. It has various oral manifestations, the reticular form being the most common. The erosive and atrophic forms of OLP are less common, yet are most likely to cause symptoms. Topical corticosteroids constitute the mainstay of treatment for symptomatic lesions of OLP. Recalcitrant lesions can be treated with systemic steroids or other systemic medications. However, there is only weak evidence that these treatments are superior to placebo. Given reports of a slightly greater risk of squamous cell carcinoma developing in areas of erosive OLP, it is important for clinicians to maintain a high index of suspicion for all intraoral lichenoid lesions. Periodic follow-up of all patients with OLP is recommended.
Internet Resources for Dentistry: Utilization of the Internet to Support Professional Growth, Decision Making, and Patient Care
Authors: Guest Gary F.
Published: July 2019

The use of computers as an information resource in dentistry has grown dramatically over the past ten years. Fueled by the availability of more powerful computers, societal acceptance of computer-based resources, and the development of the Internet, millions of documents now provide a tremendously important repository of information for healthcare providers. Those involved in delivery of dental care need to know how to access and use this information for their professional development and to support clinically related activities. This paper presents issues related to the use of the Internet. It also provides information on the use of search engines to find resources (websites) on the Internet and descriptions of some available resources of interest to those involved in oral healthcare.
The Concept of “Risk” and the Emerging Discipline of Periodontal Medicine
Authors: Paquette David W. , Madianos Phoebus , Offenbacher Steven , Beck James D. , Williams Ray C.
Published: July 2019

Dental clinicians intuitively weigh patient risks for developing disease and use that information for making treatment decisions and recommendations. Periodontitis, for instance, is one oral disease with documented risk factors including smoking, specific plaque bacteria and diabetes mellitus. While this link between systemic disease and periodontitis was thought to be unidirectional, mounting evidence in the last decade suggests that the relationship may be bi-directional. Cross sectional and case control studies indicate that periodontitis may confer two and seven-fold elevations in risk for cardiovascular disease and premature low birth weight respectively. While these early studies indicate potential associations between oral and systemic health, they support the central hypothesis that periodontitis triggers both local and systemic host inflammatory responses. Consequently, a new discipline, periodontal medicine, has emerged in dentistry which seeks to further define these interrelationships through scientific inquiry. Ultimately, this new knowledge may prove useful in intervention strategies to reduce patient risks and prevent systemic disease outcomes. This manuscript clarifies the concept of risk, traces the emergence of periodontal medicine and serves as a resource for the oral health professional in assessing and utilizing the current evidence on periodontal-systemic disease connections.
Can the Method of Primer Application Influence Adhesion to Er:YAG-laser Irradiated Dentin?
Authors: Matos Adriana B. , Botta Sérgio B. , Vieira Samuel N. , Cordon Rosely , Marques Márcia M.
Published: July 2019

Aim

The aim of this study was to evaluate how cavity preparation and primer application methods influence the adhesion of composite resin to dentin using a self-etching system.

Methods and Materials

Forty-eight extracted, sound human molars were divided into six groups (n=8) according to the method used for the surface preparation of the teeth (#600-grit paper disc, diamond bur, and Er:YAG laser) and the primer application method utilized (active or passive). Following the adhesive procedure using a self-etching system, 5 mm high composite buildups were created with Z-250 composite resin. After storage in water at 37°C for 24 hours, the specimens were vertically sectioned into serial 1 mm2 sticks and tested for microtensile strength (μ-TBS). Nine additional molars were prepared for morphological analysis using scanning electron microscopy (SEM).

Results

Statistical analysis showed surface preparation technique (p<0.00) and primer application methods (p<0.001) do influence bond strength of the self-etching system tested. The best adhesion was achieved with specimens having the dentin ground with sandpaper followed by those ground with diamond burs. The worst bonding was obtained with Er:YAG laser ablated dentin. The active primer application method increased bonding performance compared to the passive method.

Conclusions

Within the limitations of the study, it can be stated surface treatment can influence the bond strength of the self-etching system tested and the active primer application method is more effective in achieving success in bonding to dentin compared with the passive application method.

Clinical Significance

Clinicians should use the active application method to apply a mild acidic self-etching primer along with an appropriate tooth surface preparation to facilitate the bond strength between dentin and composite resin.

Citation

Botta SB, Vieira SN, Cordon R, Marques MM, Matos AB. Can the Method of Primer Application Influence Adhesion to Er:YAG-laser Irradiated Dentin? J Contemp Dent Pract 2009 January; (10)1:049-057.
Evaluation of a New Furcation Stent as a Fixed Reference Point for Class II Furcation Measurements
Authors: Laxman Vandana K. , Khatri Manish , Devaraj C.G. , Reddy Kranti , Reddy Ramesh
Published: July 2019

Aim

To date probing of the furcation using sounding has been one of the reliable methods to assess horizontal component of furcation in multirooted teeth. A more precise and reliable measurement of this horizontal component of furcation involves using a fixed reference point providing stability and reproducibility of measurements. A custom stent is used to provide a fixed reference point and can be used pre- and postsurgically without re-entry. Therefore, the purposes of this study were to (1) assess the reliability of furcation measurements by direct probing (without stent) and with the use of a newly designed furcation stent and (2) to assess the furcation measurements in relation to gingival margin position pre- and post-operatively.

Methods and Materials

Forty-three chronic periodontitis patients with buccal grade II furcation involvement in maxillary or mandibular molars were included. The furcation involvement was measured by direct probing using a UNC-15 calibrated probe with and without using a custom stent. The furcation involvement and gingival margin position were measured pre- and post-surgically.

Results

There was a significant reduction in plaque (PI) and gingival inflammation (GI) during the study period. The reduction in plaque index and gingival index was observed from 1.75 ± 0.35 to 0.92 ± 0.30, 1.88 ± 0.35 to 0.98 ± 0.29, respectively. Complete agreement was found between the first and the second measurement for about 74% of sites without the custom stent, whereas 86% of the sites measured using the stent had complete agreement. The differences never exceeded 1 mm for any of the sites. There was significant (t = 2.49; p<0.05) difference observed at complete agreement level (‘0’ difference).

Conclusion

It may be concluded the clinical attachment level-H of the furcation involvement using a PCP UNC-15 probe and a custom designed stent provides reproducible information about the furcation depth in multirooted teeth.

Clinical Significance

Use of a simple modified furcation stent has shown greater reproducibility of furcal depth measurements than direct probing without the stent. The furcation stent definitely addresses the problems of existing methods of horizontal furcal depth measurements reported in the literature. The major advantages of the newly designed stent are the simple construction and non-invasive application which translates to wide practical applications.

Citation

Laxman VK, Khatri M, Devaraj CG, Reddy K, Reddy R. Evaluation of a New Furcation Stent as a Fixed Reference Point for Class II Furcation Measurements. J Contemp Dent Pract 2009 March; (10)2:018-025.
Fracture Resistance of Aluminium Oxide and Lithium Disilicate-based Crowns using Different Luting Cements: An in vitro Study
Authors: Al-Wahadni Ahed M. , Hussey David L. , Grey Nicholas , Hatamleh Muhanad M.
Published: July 2019

Aim

The aim of this study was to investigate the fracture resistance of two types of ceramic crowns cemented with two different cements.

Methods and Materials

Forty premolar crowns were fabricated using lithium-disilicate (IPS Empress-2) and glass-infiltrated aluminium-oxide (In-Ceram) ceramic systems. The crowns were divided into four groups (n=10) with Group 1 (IPS Empress-2) and Group 2 (In-Ceram) cemented with glass ionomer cement. Group 3 (IPS Empress-2) and Group 4 (In-Ceram) were cemented with resin cement. Crowns were tested in a universal testing machine at a compressive-load speed of 10 mm/min. Fracture modes were grouped into five categories. One way analysis of variance (ANOVA) and Bonferroni post-hoc tests were used to detect statistical significances (p<0.05).

Results

The mean (SD) fracture resistance (Newtons) for Groups 1 to 4 were: 245.35 (82.69), 390.48 (67.03), 269.69 (10.33), and 418.36 (26.24). The cement type had no statistical significant effect (p>0.05) on fracture resistance within each ceramic system tested. In-Ceram crowns cemented with either glass ionomer or resin cements exhibited a statistically significantly higher fracture-resistance than IPS Empress-2 crowns (p<0.05). Minimal fracture in the test crowns was the common mode exhibited.

Conclusion

Fracture resistance of IPS Empress-2 and In-Ceram crowns was not affected by the type of cement used for luting.

Clinical Significance

Both In-Ceram and IPS Empress-2 crowns can be successfully luted with the cements tested with In-Ceram exhibiting higher fracture resistance than IPS Empress-2.

Citation

Al-Wahadni AM, Hussey DL, Grey N, Hatamleh MM. Fracture Resistance of Aluminium Oxide and Lithium Disilicate-based Crowns using Different Luting Cements: An in vitro Study. J Contemp Dent Pract 2009 March; (10)2:051-058.
Effect of Labial Frenum Notch Size and Palatal Vault Depth on Stress Concentration in Maxillary Complete Dentures: A Finite Element Study
Authors: Savabi Omid , Nejatidanesh Farahnaz , Peimannia Elham
Published: July 2019

Aim

Fracture is a common cause of acrylic resin denture failure due to crack development in a site of excessive concentration of stress in the denture. The purpose of this study was to evaluate the effect of labial frenum notch size and palatal depth on stress concentration in maxillary complete dentures.

Methods and Materials

Three-dimensional finite element models of maxillary complete dentures with different palatal vault depths (shallow, medium, and deep) and different frenum notch sizes (small, medium, and large) were constructed. The stress concentration was analyzed using Nastran software and displayed in terms of von Mises stress generated under two conditions: dropping on a hard flat surface from a standard distance and applying vertical load to the occlusal surface.

Results

The greatest stress concentration was observed in the labial frenum notch. Stress increased with an increase in the size of the labial frenum notch and a decrease in the depth of the palatal vault. The stress concentration in maxillary denture bases was greater when a vertical load was applied compared with dropping the denture on a hard surface from a standard distance.

Conclusion

Using finite element analysis, the presence of a large labial frenum notch and a shallow palatal vault increased the concentration of stress in maxillary complete dentures. Stress concentration in a maxillary denture base is much greater during the application of a vertical load than when dropping the denture on a hard flat surface.

Clinical Significance

The concentration of stress at the tip of a large frenum notch and in a shallow palatal vault could have a weakening effect on the maxillary complete acrylic resin denture base making it more vulnerable to fracture. In this scenario alternative denture base strengthening strategies, such as using a metal framework, should be considered in the fabrication of maxillary complete dentures.

Citation

Nejatidanesh F, Peimannia E, Savabi O. Effect of Labial Frenum Notch Size and Palatal Vault Depth on Stress Concentration in Maxillary Complete Dentures: A Finite Element Study. J Contemp Dent Pract 2009 May; (10)3:059-066.
An In Vivo Evaluation of Two Types of Files used to Accurately Determine the Diameter of the Apical Constriction of a Root Canal: An In Vivo Study
Authors: Manwar Narendra , Darda Sumeet , Shori D.D.
Published: July 2019

Aim

The aim of this study was to compare sizes of the first instrument with or without a taper that binds at the apical constriction of a root canal after coronal flaring.

Methods and Materials

A total of 310 canals were evaluated in patients presenting for root canal therapy. Canals with intact apices were selected. After gaining straight line endodontic access, the coronal third was flared using Gates-Glidden drills. Working length was determined using an apex locator. ISO Standard K-files (tapered) were passively introduced into the canals starting with a No. 15 file. The first K-file size to bind against the canal walls without pushing and to reach the working length was recorded as the FKFB (First K File to Bind). Next, ISO Standard Lightspeed files (non-tapered instruments) starting with No. 20 were then gently introduced by hand to each canal in ascending order to the working length. The first size of a Lightspeed instrument to bind against the canal walls and reach the working length was recorded as FLSB (First Light Speed to Bind). In all instances a larger file was introduced to ensure it could not reach the same depth (i.e., working length). Statistical analysis was carried out using a univariate analysis of variance (ANOVA).

Results

The average size of the FLSB to bind against the canal walls first at the working length was approximately two ISO sizes larger than the FKFB (P<0.001).

Conclusion

The clinician should consider introducing a non-tapered instrument to working length after coronal flaring because determination of the initial narrow apical canal diameter plays a major factor in identifying the extent of final apical shaping. Because the first non-tapered instrument that binds the apical constriction is larger than the corresponding tapered instrument, it better reflects the actual narrow apical diameter of the canal.

Clinical Significance

The initiation of canal instrumentation with a K-file size three sizes beyond the mean values of the FLSB will result in greater final enlargement of the canal compared to starting with the FKFB. This increased canal enlargement facilitates improved mechanical and chemical cleansing of the root canal ensuring removal of more microorganisms and their substrates, thus, improving the outcome of the treatment.

Citation

Darda S, Manwar N, Chandak M, Shori DD. An In Vivo Evaluation of Two Types of Files used to Accurately Determine the Diameter of the Apical Constriction of a Root Canal: An In Vivo Study. J Contemp Dent Pract 2009 July; (10)4:043-050.
A Review of the Biological and Clinical Aspects of Radiation Caries
Authors: Aguiar Gabrielle P. , Jham Bruno C. , Magalhães Cláudia S. , Sensi Luis G. , Freire Addah R.
Published: July 2019

Aim

The aim of this article is to review the clinical and biological features underlying the development and progression of radiation caries.

Background

Although radiotherapy (RT) plays an important role in the management of patients with head and neck cancer (HNC), it is also associated with several undesired side effects such as radiation caries which is a common, yet serious, complication. To review the condition, the Pubmed database was searched using the keywords “radiotherapy,” “radiation,” “caries,” “hyposalivation,” “prevention” and “management”. Only studies published in the English language were selected. Cross-referencing identified additionally relevant studies.

Review Results

RT leads to alterations in the dentition, saliva, oral microflora, and diet of patients. Consequently, irradiated patients are at increased risk for the development of a rapid, rampant carious process known as radiation caries. Motivation of patients, adequate plaque control, stimulation of salivary flow, fluoride use, and nutritional orientation are essential to reduce the incidence of radiation caries and ultimately improve the quality of life for HNC patients.

Conclusion

Radiation caries is an aggressive side effect of RT. Dentists play an important role in the prevention of the condition via comprehensive oral healthcare before, during, and after the active cancer therapy.

Clinical Significance

Dentists should understand the clinical and biological aspects underlying radiation caries to prevent the development of lesions and provide optimal treatment when needed.

Citation

Aguiar GP, Jham BC, Magalhães CS, Sensi LG, Freire AR. A Review of the Biological and Clinical Aspects of Radiation Caries. J Contemp Dent Pract 2009 July; (10)4:083-089.
The Effect of the Surface Roughness of Porcelain on the Adhesion of Oral Streptococcus mutans
Authors: Al-Marzok Maan Ibrahim , Al-Azzawi Haitham J.
Published: July 2019

Aim

Dental plaque has a harmful influence on periodontal tissue. When a porcelain restoration is fabricated and refinishing of the glazed surface is inevitable, the increase in surface roughness facilitates the adhesion of plaque and its components. The aim of this in vitro study was to evaluate the effect of surface roughness of glazed or polished porcelain on the adhesion of oral Streptococcus mutans.

Methods and Materials

A total of 80 metalceramic specimens were prepared in the form of disks from two porcelain materials and divided into four groups according to the method of surface finishing. Surface roughness values (Ra-μm) for all specimens were recorded using a profilometer. S. mutans bacteria were isolated from saliva and all specimens were inoculated in test tubes containing a bacterial suspension allowing adhesion of the microorganisms to the specimens to occur. After incubation for 24 hours at 37°C, the specimens were transferred to a sterile saline solution and an inoculum of 0.1 ml from each selected dilution was spread on the selective medium, mitis salivarius bacitracin agar (MSB). Bacterial counts, expressed in colony forming unit (CFU) taking into consideration the dilution factor, were recorded.

Results

There was significant correlation (p<0.05) between surface roughness values (Ra-μm) and the amount of bacterial adhesion (CFU×103). The glazed surface was the smoothest and exhibited the least amount of bacterial adhesion.

Conclusions

A positive correlation between surface roughness and the amount of S. mutans adhesion was observed. The glazed porcelain surface was considered more biocompatible than other methods of porcelain surface finishing.

Clinical Significance

Chairside adjustments of the cervical contour or occlusal surface of porcelain restorations are sometimes necessary before or after cementation. Ideally, an uncemented restoration should be returned to the laboratory for reglazing after all adjustments have been completed.

It is important to evaluate various polishing procedures used for these adjusted surfaces to achieve a finished surface that as closely as possible approximates the quality of glazed porcelain.

Citation

Al-Marzok MI, Al-Azzawi HJ. The Effect of the Surface Roughness of Porcelain on the Adhesion of Oral Streptococcus mutans. J Contemp Dent Pract [Internet]. 2009 Nov; 10(6):017-024. Available from: http://www.thejcdp. com/journal/view/volume10-issue6-al-marzok.
The Restoration of Function and Esthetics of a Patient with Amelogenesis Imperfecta Using a Combination of Orthodontic and Prosthodontic Treatment: A Case Report
Authors: Gupta Seema , Kumar Sandeep
Published: July 2019

Aim

The purpose of this case report is to present the esthetic and functional rehabilitation of the teeth in a 20-year-old patient with amelogenesis imperfecta (AI), facial asymmetry due to functional mandibular shift, and unilateral posterior crossbite.

Background

AI is a group of hereditary defects of enamel unassociated with any other generalized defects. AI results in poor development or the complete absence of the enamel of the teeth caused by improper differentiation of ameloblasts.

Case Description

This report describes the diagnosis and treatment of a young female patient with AI and facial asymmetry using a combined orthodontic-prosthodontic approach. Initially, the posterior crossbite, mandibular shift, and facial asymmetry were treated orthodontically. Later, metal-ceramic crowns for posterior teeth and allceramic crowns for anterior teeth were fabricated for final restorations.

Coordinated orthodontic and prosthodontic treatment, with careful consideration of patient expectations and requests, were critical for a successful outcome and patient satisfaction.

Clinical Significance

The complexity of the management of patients with AI supports the suggestion that the dental profession should have appropriate methods for the rehabilitation of rare dental disorders.

Citation

Kumar S, Gupta S. The Restoration of Function and Esthetics of a Patient with Amelogenesis Imperfecta Using a Combination of Orthodontic and Prosthodontic Treatment: A Case Report. J Contemp Dent Pract [Internet]. 2009 Nov; 10(6):079-085. Available from: http://www. thejcdp.com/journal/view/volume10-issue6-kumar.
Fracture Resistance of Teeth Obturated with RealSeal™ Using Two Different Chelating Agents: An in vitro Study
Authors: Al-Kahtani Ahmed M. , Al-Fawaz Hussam , Al-Sarhan Mohammed , Al-Ali Khalil
Published: July 2019

Objectives

The aim of this study was to evaluate the fracture resistance of endodontically treated teeth filled with a resin-based obturation material using two different chelating agents.

Methods and Materials

Forty extracted singlecanal human teeth were prepared, instrumented, and randomly divided into three groups: Group 1 (n=15) received a final flush with 10 ml of neutralized 17% EDTA, followed by 10 ml of sodium hypochlorite (NaOCl), then obturated using lateral condensation with RealSeal. Group 2 (n=15) received a final flush of BioPure™ MTAD™, followed by 10 ml of NaOCl, then obturated using lateral condensation with RealSeal. Group 3, the control group (n=10), was instrumented but not obturated, then the root canal opening was sealed with a temporary filling material. The specimens were stored in 100% humidity for 10 days, mounted in polyester resin, and loaded to failure.

Results

The ANOVA revealed a significant difference between the control group and the experimental groups, although there was no statistically significant difference between Group 1 and Group 2 (p=0.05). The MTAD group displayed higher mean fracture load values than the EDTA group.

Conclusions

It can be concluded that filling the root canals with RealSeal™ increased the in vitro resistance to fracture of single-canal extracted human teeth when compared to instrumented and unobturated teeth. Teeth treated with MTAD demonstrated high fracture-resistance values when compared to teeth treated with 17% EDTA, but they were not statistically significant.

Citation

Al-Kahtani AM, Al-Fawaz H, Al-Sarhan
Incidence of Dry Socket, Alveolar Infection, and Postoperative Pain Following the Extraction of Erupted Teeth
Authors: Bortoluzzi Marcelo Carlos , Manfro Rafael , De Déa Bruna Eliza , Dutra Taísa Cristina
Published: July 2019

Aim

The aim of this study was to determine the incidence of dry socket, alveolar infection, and postoperative pain following the routine extraction of erupted teeth.

Methods and Materials

Using a questionnaire, this prospective cross-sectional study evaluated 357 consecutive surgeries in which 473 erupted teeth were extracted by dental students under rigorous control of microbiologic contaminants during a 22-month period. The subject sample consisted of 210 (58.8%) male patients ranging in age from 11 to 79 years (mean 41 ± 16.3). The most prevalent self-reported ethnicity was Caucasian (78.2%). The questionnaire consisted of 60 questions directed to the patient and to the dental student who performed the surgical procedure. The questionnaires were completed before and within seven days after the surgery to obtain outcomes data. Forty-five questionnaires were excluded due to lack of information, inconsistencies, or lack of contact with the patient; however, none had indications of alveolar infection or dry socket. The data were analyzed using descriptive statistics, chi-square tests (x2), and an odds ratio (OR) as appropriate at the critical level of significance, set at p<0.05 (x2) or p<0.01 (x2, with the Monte Carlo simulation).

Results

The observed incidence was 0.6% (two cases each) for both alveolar infection and dry socket. Higher pain levels and pain persisting longer than two days were observed with more traumatic surgeries, or associated with postoperative complications. Smoking was found to be statistically associated with the development of postoperative complications.

Conclusion

The incidence of alveolar infection, dry socket, and severe pain were very low for the routine extraction of erupted teeth. Severe pain that persists for more than two days can represent a sign of a postoperative complication such as dry socket.

Clinical Significance

Dental extraction is part of the dentists‵ daily work and intercurrences like dry socket, infection, and pain can occur. This manuscript reports the incidence of these occurrences and search for its predisposing factors.

Citation

Bortoluzzi MC, Manfro R, De Déa BE, Dutra TC. Incidence of Dry Socket, Alveolar Infection, and Postoperative Pain Following the Extraction of Erupted Teeth. J Contemp Dent Pract [Internet]. 2010 Jan; 11(1):033-040. Available from: http://www.thejcdp.com/journal/ view/volume11-issue1-bortoluzzi.
Oral Manifestations of “Meth Mouth”: A Case Report
Authors: Turkyilmaz Ilser
Published: July 2019

Aim

The aim of the documentation of this clinical case is to make clinicians aware of “meth mouth” and the medical risks associated with this serious condition.

Background

Methamphetamine is a very addictive, powerful stimulant that increases wakefulness and physical activity and can produce other effects such as cardiac dysrhythmias, hypertension, hallucinations, and violent behavior. Dental patients abusing methamphetamine can present with poor oral hygiene, xerostomia, rampant caries (“meth mouth”), and excessive tooth wear. Oral rehabilitation of patients using methamphetamine can be challenging.

Case Description

A 30-year-old Caucasian woman presented with dental pain, bad breath, and self-reported poor esthetics. A comprehensive examination including her medical history, panoramic radiograph, and intraoral examination revealed 19 carious lesions, which is not very common for a healthy adult. She reported her use of methamphetamine for five years and had not experienced any major carious episodes before she started using the drug.

The patient's medical and dental histories along with radiographic and clinical findings lead to a diagnosis of “meth mouth.” Although three different dental treatment modalities (either conventional or implantsupported) have been offered to the patient since August 2007, the patient has yet to initiate any treatment.

Clinical Significance

This clinical case showing oral manifestations of meth mouth was presented to help dental practitioners recognize and manage patients who may be abusing methamphetamines. Dental practitioners also may be skeptical about the reliability of appointment keeping by these patients, as they frequently miss their appointments without reasonable justification.

Citation

Turkyilmaz I. Oral Manifestations of “Meth Mouth”: A Case Report. J Contemp Dent Pract [Internet]. 2010 Jan; 11(1):073-080. Available from: http://www.thejcdp.com/journal/ view/volume11-issue1-turkyilmaz.
Effectiveness of Procedures for the Chemical-Mechanical Control of Dental Biofilm in Orthodontic Patients
Authors: Zenóbio Elton Gonçalves , Alves Karla Magalhães , Goursand Daniela , Cruz Roberval Almeida
Published: July 2019

Aim

Assess the effectiveness of chemicalmechanical control associated with orientation and motivation for the control of dental biofilm in orthodontic patients.

Methods and Materials

Thirty patients between 12 and 21 years of age wearing a fixed orthodontic appliance were divided into three groups. The control group (G1) received orientation regarding oral hygiene. The experimental groups (G2 and G3) received orientation regarding oral hygiene and diet as well as a hygiene kit and mouthwash; the mouthwash given to G2 was a placebo and that given to G3 contained essential oils (Listerine®).

Results

In the comparison between T0 and T60, vestibular gingivitis was worse in G1 (p<0.05), with no statistically significant differences regarding lingual gingivitis and biofilm. G2 and G3 exhibited a significant improvement in clinical conditions. In the comparison between groups, G3 had undergone a significantly greater improvement than the other groups.

Conclusion

The use of the commercial mouthwash, together with mechanical oral hygiene, orientation, and motivation, proved to be adequate conduct for the maintenance of oral health in orthodontic patients.

Clinical Significance

The present study contributes toward the maintenance of oral health in patients who wear a fixed orthodontic appliance through the prevention of dental biofilm buildup.

Citation

Alves KM, Goursand D, Zenobio EG, Cruz RA. Effectiveness of Procedures for the Chemical-Mechanical Control of Dental Biofilm in Orthodontic Patients. J Contemp Dent Pract [Internet]. 2010 March; 11(2):041-048. Available from: http://www.thejcdp.com/journal/view/ volume11-issue2-alves.
Gingival Enlargement in Neurofibromatosis Type 1: A Case Report and Literature Review
Authors: Bhardwaj Ashu , Mahajan Ajay
Published: July 2019

Aim

The purpose of this article is to describe a rare case of neurofibromatosis1 (NF1) of the gingiva and a review of the current literature.

Background

Neurofibromatosis1 (NF1) of the gingiva is an uncommon cause of gingival enlargement. The disease is clinically characterized by epidermal melanosis, nevi, and flabby skin or bone malformations; in addition, the lesions may undergo malignant transformation. Involvement of the gingiva with or without concurrent skin lesions has been reported only occasionally.

Case Description

A 40-year-old male patient with a history of NF1 came to us with a chief complaint of enlargement of the gums. Clinical examination revealed diffuse gingival enlargement with no signs of inflammation. The characteristic skin lesions associated with NF1 were also present. A gingival specimen was sent for biopsy.

Results

Based on the history, clinical, and histological findings, NF1 was established as the cause of the gingival enlargement.

NF1 may affect the gingival tissue; considering the neurological complications and malignant potential, NF1 must be diagnosed early and monitored regularly.

Clinical Significance

The clinician should be aware of clinical and histopathological findings of NF1 considering the fact that the condition has malignant potential.

Citation

Mahajan A, Dixit J, Bhardwaj A. Gingival Enlargement in Neurofibromatosis Type 1: A Case Report and Literature Review. J Contemp Dent Pract [Internet]. 2010 March; 11(2):057-063. Available from: http://www.thejcdp. com/journal/view/volume11-issue2-mahajan.
Non-syndromic Oligodontia in Permanent Dentition of Monozygotic Twins: Report of a Rare Case
Authors: Pai Keerthilatha M. , Sholapurkar Amar A. , Gadda Rohit B.
Published: July 2019

Aim

To report a case of non-syndromic oligodontia involving 26 permanent teeth in monozygotic twin sisters and to discuss the possible genetic etiology, inheritance pattern and associated dental anomalies of this condition.

Background

Hypodontia constitutes one of the most common developmental anomalies in humans and is defined as developmental absence of one or more teeth with reported prevalence of 1.6 to 9.6% in the permanent dentition. Oligodontia is defined as agenesis of six or more teeth excluding third molars.

Case Report

This article describes a case of non-syndromic oligodontia involving 26 permanent teeth in monozygotic twin sisters. The twins had positive family history of hypodontia in their paternal grandmother, parental consanguinity (first cousin) and similarity in pattern of oligodontia. Root formation of permanent maxillary first molars and central incisors was delayed in both the twins.

This article reports a case of nonsyndromic oligodontia in permanent dentition of monozygotic twins. Possible genetic etiology, inheritance pattern and associated dental anomalies are discussed.

Clinical Significance

Strong genetic link associated with oligodontia help the dentist to know the possibility of its occurrence in other family members and in future generations.

Citation

Gadda RB, Pai KM, Sholapurkar AA. Non-syndromic Oligodontia in Permanent Dentition of Monozygotic Twins: Report of a Rare Case. J Contemp Dent Pract [Internet]. 2010 March; 11(2):071-077. Available from: http://www.thejcdp. com/journal/view/volume11-issue2-gadda.