J Interdiscip Dentistry
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Platelet rich fibrin: A promising approach for root coverage
Aravind P Kumar, Bennete Fernandes, C Surya
July-December 2011, 1(2):115-118
Platelet rich fibrin is a novel treatment option available for various mucogingival defects with varied outcome. Although it is as its infancy, the best part of platelet-rich fibrin is acquirement of optimal esthetic results with excellent soft tissue contour and texture. This case reports highlights the usage of platelet rich fibrin membrane for the treatment of mucogingival defects such as gingival recession.
  4 5,714 1,086
Combined endodontic - Periodontal lesion: A clinical dilemma
Pushpendra Kumar Verma, Ruchi Srivastava, KK Gupta, Amitabh Srivastava
July-December 2011, 1(2):119-124
Endodontic-periodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. Periradicular bone loss secondary to endodontic pathosis is typically seen in teeth with necrotic pulps. The ultimate goal of periodontal therapy is not only to maintain the natural dentition, but also to restore lost periodontium. Combined periodontal and endodontic diseases involve the periodontal attachment apparatus. The treatment of endodontic-periodontal combined lesions requires both endodontic therapy and periodontal regenerative procedures. With advancements in new techniques and materials different treatment choices are available, providing a superior prognosis. This article includes case reports of combined endo-perio lesions which were first treated with conventional endodontic therapy and then followed by periodontal surgery. This combined treatment resulted in a radiographical evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the combined treatment modalities will restore health and function to the teeth with severe attachment loss caused by an endo-perio lesion.
  2 14,202 1,829
Periodontal considerations determining the design and location of margins in restorative dentistry
Arvind Shenoy, Nina Shenoy, Roopa Babannavar
January-April 2012, 2(1):3-10
The first and most basic objective of restorative dentistry is preservation of the tooth structure. However, for the long-term survival of restoration the periodontium must also remain healthy or vice versa. The connective tissue of the attachment apparatus consists of three-dimensionally oriented fibers connecting firmly the tooth structures to the surrounding gingiva. Both the epithelial as well as connective tissue attachment contribute to a 'protection mechanism' in a most challenging area where the natural tooth penetrates the ectodermal integrity of the body. The attainment of this objective would be far less complex if it could be considered independent of restoration of function, comfort and esthetics, but such is not the case. The latter objectives usually require sophisticated restorative dentistry as often such esthetic restorations require placement of intra-crevicular margins without compromising on the periodontal health.
  2 41,685 4,696
Single tooth implants: Pretreatment considerations and pretreatment evaluation
Vidya Kamalaksh Shenoy
September-December 2012, 2(3):149-157
Today, implants are considered as a first treatment option to replace missing teeth due to the considerable advantages over the other available options. The ultimate goal of implant treatment is to restore natural esthetics, function, long term health, and patient comfort. Hence, case selection and treatment planning are very crucial to achieve longevity and predictability of the restoration. This article presents a step-by-step protocol for gathering and analyzing the various factors at the pretreatment evaluation stage to set the groundwork for a dentist to consider implant as a restorative option. Clinical Relevance to Interdisciplinary Dentistry
  • To help the restorative dentist to identify the ideal implant receptor site.
  • Sound periodontal and restorative status is prerequisite to consider implant treatment as an option.
  • Restorative driven implant placement is paramount for overall integrity of the dentition.
  2 74,831 7,226
Clinical evaluation of the efficacy of bioactive glass and strontium chloride for treatment of dentinal hypersensitivity
Suryaprakash Ananthakrishna, Tumkur Naryanappa Raghu, Sunil Koshy, Naveen Kumar
May-August 2012, 2(2):92-97
Objective: Bioactive glass is a calcium sodium phosphosilicate material (24.5% CaO, 24.5% Na 2 O, 6.0% P 2 O 5 , and 45% SiO 2 ) that was originally developed as an implant material to regenerate bone and recently adapted for use in oral care products (NovaMin® , NovaMin Technology Inc.). NovaMin reacts rapidly with saliva to release sodium, which increases the salivary pH, as well as calcium and phosphate, creating the ideal conditions for tooth remineralization. NovaMin has been shown to occlude dentinal tubules and remineralize dentin; therefore, it could be used in the treatment of dentinal hypersensitivity. Thus, the aim of this study was to compare in vivo the effect of NovaMin and 10% strontium chloride containing dentifrices on dentinal hypersensitivity in a 6-week clinical study. Materials and Methods: Forty subjects were evaluated clinically for dentinal hypersensitivity using air blast method (dental air syringe) and cold water method, along with subjective perception of pain (0-10 scale) at baseline and at 2, 4, and 6 weeks. The subjects were then randomly divided into two groups and each group was treated with one of the two test dentifrices. Results: There was a general decrease in dentinal hypersensitivity levels in both the groups over 6 weeks, but there was a statistically greater difference in hypersensitivity at 2, 4, and 6 weeks in the group treated with DenShield (NovaMin containing dentifrice) when compared with the Senolin® (strontium chloride containing dentifrice) group. Clinical Relevance to Interdisciplinary Dentistry
  1. Dentin hypersensitivity is common problem experienced in clinical dental practice.
  2. It can occur due to changes in the crown, which involve removal of enamel as a result of attrition, abrasion, or erosion. Alternative causes of pain include chipped or fractured teeth, cracked cusps, carious lesions, leaky restorations, and developmental grooves.
  3. It can also occur due to exposure of root dentin as seen in gingival recession which is caused by chronic trauma from tooth brushing, acute and chronic inflammatory gingival and periodontal diseases, and acute trauma, as with periodontal surgery.
  4. The problem of dentin hypersensitivity is of concern to the general dental practitioner, the endodontist, and the periodontist, as the treatment requires a multidisciplinary approach very often. Correction could involve desensitizing dentifrices, restoration, crowns, and root coverage.
  2 5,359 798
Continuing antiplatelet therapy throughout dental procedures: A clinical dilemma
Sheeraz Badal, Syed Ahmed, Rohit Shrikanthan, Afreen Badal
January-April 2012, 2(1):15-19
Antiplatelet therapy is commonly recommended for the prevention of the thromboembolic events, including the myocardial infarction and stroke. It has reduced the mortality and morbidity of cardiovascular diseases remarkably. A considerable number of patients presenting before a dentist give a history of antiplatelet therapy. A clinical dilemma exists whether to discontinue the antiplatelet therapy or to continue during the routine and invasive dental procedures. Continuing antiplatelet therapy during surgery minimizes the risk of thromboembolic complications but theoretically increases the risk of hemorrhage. Discontinuing antiplatelet therapy may expose patients to life-threatening thromboembolic events, while presumably reducing the risk of hemorrhagic complications. Diverse opinions exist regarding the management of such patients. Some advice continuation of the antiplatelet therapy rather than inviting possible thromboembolic event, while others encourages its discontinuation.
  2 8,214 879
Ozone therapy in dentistry: A literature review
Bikash Pattanaik, Dinesh Jetwa, Seema Pattanaik, Sachin Manglekar, Dinesh N Naitam, Anurag Dani
July-December 2011, 1(2):87-92
This review of literature is an attempt to summarize different modalities of ozone application in dentistry. Ozone gas has a high oxidation potential and is effective against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation, platelets, and immune response. Ozone is used in dentistry in gaseous, ozonated water and as ozonated oils. Ozone was shown to be biocompatible and is used in all aspects of dentistry. It has been shown to stimulate remineralization of recent caries-affected teeth and is used as a preventive therapy in caries, root caries, and intracanal irrigants in endodontic treatment. It has been used in treatment of alveolitis, avascular osteonecrosis of the jaw, and herpes virus infection. It also inhibits plaque formation and can be used as an adjuvant in periodontal surgical and maintenance phase. Ozone has also been used in dental unit water line to disinfect water. Advantage of ozone therapy is it is an atraumatic, biologically based treatment. While laboratory studies suggest a promising potential of ozone in dentistry, less number of clinical studies were documented. More number of randomized, controlled trials need to be conducted to determine the precise indications and guidelines to treat various dental pathologies with this promising medical agent.
  2 17,622 2,883
Nanotechnology: The future
T.S.V Satyanarayana, Rathika Rai
July-December 2011, 1(2):93-100
The challenge to our profession today is to improve the quality of oral health while overcoming both extrinsic and intrinsic factors which may adversely affect our progress toward achieving this goal. Nanotechnology which is fast developing, its name reverberating in almost every field, is also making and is set to transform dentistry in a huge way. This article tries to give an insight of the application of nanotechnology in dentistry using both top down and bottom up approach, recent development of nano products with superior quality, helical rosette nanotubes as a bone substitute, surface treatment of implant, dentifrobot, improved diagnostic instruments, (biomarkers, stem cell imaging in MRI) precise drug delivery system, controlled radiation therapy and bio nano sensors for cancer treatment, the near to achieve future ground breaking realities of development of bionic mandible, nanorobots, respirocytes, microbiovore, cytorobots, karyorobots, their effect on dentistry and medicine, and the possible risk factors and the ethical concerns to be looked into for application of nanotechnology in dentistry.
  2 12,738 2,000
Pulse oximetry and laser doppler flowmetry for diagnosis of pulpal vitality
Dakshita Joy Vaghela, Ashish Amit Sinha
January-June 2011, 1(1):14-21
The usual pulpal diagnostic instruments have been shown to be unreliable in diagnosing the pulpal status of the teeth following a traumatic injury, especially for teeth with immature root formation and open apex. Compounding the problem with these testing methods is that they all are very subjective, dependant on cooperation and understanding of the situation by the patient, which can lead to a further difficulty in cases involving young children. It is important to note that the usual pulp vitality tests provide information only about the presence or absence of nerve receptors in the pulp and not about the pulpal blood supply. Recent efforts for assessing pulpal circulation have involved the use of laser Doppler flowmetry and pulse oximetry. Though both methods are in their infancy and are not yet ready for general clinical applications, but hopefully before long, these technologies will become part of dentists' diagnostic armamentaria. The PubMed database search revealed that the reference list for Pulse Oximetry featured 2196 articles; in dentistry-121 articles and for Laser Doppler Flowmetry-932 articles and in dentistry-18 articles. A forward search was undertaken on selected articles, author names, and contemporary endodontic texts. A review is presented on the key developments in the arena of these pulp-tests to familiarize the modern dentists with the new advances in endodontic diagnosis.
  2 26,604 2,933
Light weight maxillary complete denture: A case report using a simplified technique with thermocol
Vibha Shetty, Sivaranjani Gali, Smitha Ravindran
January-June 2011, 1(1):45-48
The success of a complete denture relies on the principles of retention, stability and support. The prosthodontist's skill lies in applying these principles efficiently in critical situations. Severely resorbed maxillary edentulous ridges that are narrow and constricted with increased inter ridge space provide decreased support, retention and stability. The consequent weight of the processed denture only compromises them further. This article describes a case report of an edentulous patient with resorbed ridges where a simplified technique of fabricating a light weight maxillary complete denture was used for preservation of denture bearing areas.
  1 13,036 1,478
Surgical esthetic correction for gingival pigmentation: Case series
Shilpi S Shah
September-December 2012, 2(3):195-200
Gingival pigmentation is a major concern for a large number of patients visiting the dentist. The patients with excessive gingival display and pigmentation are more concerned esthetically. Most pigmentation is caused by five primary pigments out of which melanin shows the maximum incidence rate. Melanin hyper pigmentation usually does not present as a medical problem, but patients may complain about their unesthetic black gums. The gingiva is the most frequently pigmented intraoral tissue, with the highest rate observed in the area of the incisors Esthetic periodontal plastic surgery is a boon in patients having "dark gums" and "gummy smile." This article offers a retrospective case series of gingival depigmentation by epithelial excision using scalpel. Out of the several techniques employed for depigmentation, the surgical technique using scalpel is still the first and most popular technique. Experience of 4 years is put forward with critical analysis of the surgical technique including the various advantages and disadvantages. This is a case report representing a simple surgical technique of de-epithelization which has been successfully used to treat gingival hyperpigmentation caused by excessive melanin deposition and highlights the relevance of an esthetically pleasing smile especially in smile conscious individuals. Clinical Relevance to Interdisciplinary Dentistry
  • Gingival hyper pigmentation is a very common esthetic complaint reported by patients in various fields of dentistry. Through this case series the dentists can ascertain the various types of techniques mentioned in the following article for treating pigmented gums with pleasing esthetics &acceptable patients satisfaction
  1 16,110 1,201
Magnet retained mandibular overdenture: A multidisciplinary approach
Suma Janya, Priyanka Gubrellay, Anupam Purwar, Shally Khanna
January-April 2013, 3(1):43-46
Magnets have been used widely in the field of dentistry for many years with some success, as they can be manufactured in small dimensions as retentive devices in overdenture technique, maxillofacial prosthesis, and obturators. These magnets are attached with remaining root structure or osseointegrated implants which transfer the occlusal load to the bone through the periodontal ligament of the retained roots, thereby prevent resorption of remaining alveolar bone proper and inter-radicular bone present around the roots. In this article, the use of magnetic assembly in fabrication of mandibular overdenture on retained roots and a conventional maxillary removable partial denture is discussed. Magnetic assembly consists of magnet and coping with a keeper on the remaining tooth structure since magnetic attachments can provide support, stability, and retention. Clinical Relevance to Interdisciplinary Dentistry
  • The present article demonstrates the rehabilitation of partially edentulous patient with the help of magnetic assembly mandibular overdenture and maxillary conventional removable partial denture. Clinical presentation showed few remaining teeth in relation to the mandibular ridge. A multidisciplinary approach was adopted to retain the remaining teeth in the mandibular arch with the help of endodontic treatment (root canal treatment) followed by prosthetic rehabilitation.
  1 9,411 1,186
Antimicrobial activity of various irrigants against E. faecalis biofilm: An in vitro study
A Afzal, V Rajesh Gopal, Rajesh Pillai, Asha Sarah Jacob, S U-Nu, S Shan
May-August 2013, 3(2):103-108
Aim: This study evaluated the antimicrobial efficacy of irrigants during the cleaning and shaping of the canal system. This in vitro study evaluated quantitatively and qualitatively, the antimicrobial activity of 2% chlorhexidine gluconate, 5.25% sodium hypochlorite and MTAD against E. faecalis. Materials and Methods: Eighty freshly extracted human single-rooted mandibular premolars were selected and sectioned below the cement-enamel junction at 15 mm length. E. faecalis ATCC 29212 strain and clinical strains were subcultured from nutrient agar plates in the laboratory. Single colonies of both strains were inoculated from nutrient agar cultures into 100 mL Tryptone Soya Broth (TSB) and incubated at 37°C and 150 rpm for 2 h. After 2 h, when the culture entered the logarithmic phase, the prepared teeth specimens were added and incubated at 37° C and 60 rpm for 7 days. Every 48 h, 75 mL of the culture was replaced with fresh TSB. The 80 samples were divided into two sets of 40 each: the first set of 40 specimens for ATCC 29212 and the second set of 40 specimens for clinical isolates. Each set was further subdivided into four groups of 10 teeth according to the selected irrigants. For quantitative assessment, six teeth from each group were used for viable count, and, for qualitative analysis, four teeth from each group sectioned vertically were used for fluorescent microscopy . Results: In the agar disc diffusion method, both Chlorhexidine and MTAD exhibited good antibacterial properties. Distilled water had no antimicrobial property. The colony counts in the clinical isolates and ATCC specimens when used with different irrigants were compared using one-way ANOVA. Conclusions: Sodium hypochlorite showed the most effective antimicrobial property among the three irrigants against E. faecalis biofilm. Clinical relevance to interdisciplinary dentistry
  • Microorganisms remaining in the root canal space after treatment or recolonizing the filled canal system are the main cause of endodontic failures.
  • Failure in Root canal therapy will lead reinfection which may become a problem which has to be handled with multidisciplinary approach such as endodontic surgery or therapy.
  1 4,055 489
Profilometric study to compare the effectiveness of various finishing and polishing techniques on different restorative glass ionomer cements
Puttur Laxmish Mallya, Shashirashmi Acharya, Vasudev Ballal, Kishore Ginjupalli, M Kundabala, Manuel Thomas
May-August 2013, 3(2):86-90
Objective: The aim of the present study was to evaluate the effect of various finishing and polishing techniques on the surface roughness of different types of glass ionomer (GI) restorative cements. Materials and Methods: Surface roughness of conventional, resin modified and nano-ionomer cements was evaluated after different polishing regimens. Totally 20 specimens of 12 mm thick and 10 mm diameter were prepared using Teflon mold. Prepared specimens were subjected to polishing (n = 5) by Sof-Lex discs, diamond finishing points and 30-fluted carbide burs. Control specimens did not receive any polishing treatment, but mylar trip was used as matrix. Average surface roughness (Ra) in micrometers was measured using Surtronic 3 + profilometer. Results were analyzed using Kruskal-Wallis and Mann-Whitney test. Results: Control specimens (mylar strip) showed least Ra values followed by Sof-Lex disc, carbide finishing burs and diamond finishing points with all types of glass ionomer cements used in the study. Among the GIs tested, Nano-ionomer showed least Ra followed by resin-modified GI and conventional GI. Conclusion: Mylar strip produced the smoothest surface on all the GIs tested. Nano-Ionomer showed the best polish ability with least Ra values. Clinical Relevance to Interdisciplinary Dentistry
  • Glass ionomer cements (GIC) is one of the most commonly used direct restorative material used in non-stress bearing areas especially to restore cervical lesion at tooth gingival interface
  • Polished GIC surface reduces plaque accumulation and thus decreases the incidence of gingival inflammation and thereby prevents periodontal problems
  • Finishing and polishing of the GIC enhances the longevity and color stability of the restoration.
  1 3,162 396
Self reported knowledge and practice of inter dental aids among group of dental students, Tumkur, India
Darshana Bennadi, Mythri Halappa, Nandita Kshetrimayum
September-December 2013, 3(3):159-162
Objectives : To evaluate knowledge and practice of inter dental aids among a group of dental students in Tumkur, India. Materials and Methods: A cross sectional descriptive study was conducted among dental students using questionnaire. Results: 84.6% dental students brushed their teeth twice daily. 74% students had knowledge regarding inter dental aids where as only 18% of the students practiced it. Significant differences (P < 0.05) were observed among students of different years in the knowledge and practice of inter dental aids. Conclusions: Among dental students, the overall knowledge of inter dental aids was good, even though there were deficits in knowledge in a few areas. The knowledge and practice of inter dental aids improved with increasing levels of education. Clinical Relevance to Interdisciplinary Dentistry
  1. Dental health is highly an individualized concept and dental student become a role model for oral health.
  2. Most of the studies have shown the oral health behavior of dental students giving importance to routine brushing aids and knowledge.
  3. The present study deals with knowledge and practice of interdental aids by dental students and recommends change in dental curriculum mainly subject of Preventive dentistry.
  4. Students have to be informed how to use that knowledge in the real life.
  1 2,457 443
Evaluation of bioactive glass and autogenous bone in the treatment of Grade II furcation involvement: A randomized controlled trial
Sally Abd El-Meniem El-Haddad, Mona Yehia Abd-El Razzak, Hussein Ibrahem Saudi, Nada Mohammad El Ghorab
January-April 2014, 4(1):13-23
Introduction: Furcation involvement is an inflammatory process that results in a breakdown of the supporting connective tissue and bone as a result of extension of periodontal destruction between the roots of multi-rooted teeth. Class II furcation lesions are a challenging scenario for periodontal therapy and a serious threat for tooth prognosis where the teeth mortality has been reported to occur more frequently in furcated teeth than in similar teeth without furcation defects. Aims and Objectives: The aim of this study was to compare the efficacy of bioactive glass (BG) grafting material versus autogenous bone grafting in the treatment of Grade II furcation involvement clinically and radiographically. Materials and Methods: A total of 30 patients with buccal mandibular Grade II furcation involvement were divided- by a split-mouth design- into three groups; group (Gp) I involved 30 sites grafted with BG; Gp II involved 30 sites grafted with autogenous bone and Gp III involved 10 sites treated with scaling and root planing only after flap reflection. Results: The postoperative healing periods were, generally uneventful with no postoperative complications. At the last follow-up period, the previous furcation sites were covered with healthy gingiva and there was a great reduction in the surface area of the furcation defects with a marked increase in the gray level in both Gp I and II with no significant difference, while there was a statistically significant difference between Gp I and Gp III and between Gp II and Gp III at 3 months and at 6 months of follow-up periods. Conclusion: The use of BG and autogenous bone grafts has better outcomes in the treatment of Grade II furcation involvement when compared with open debridement alone. The use of bony glass has nearly the same successful outcomes of the autogenous bone graft; however, it is less traumatic to the patient. Clinical Relevance to Interdisciplinary Dentistry
  • Periodontal regenerative procedure using bioactive glass material can be performed to enhance bone formation
  • Class II furcation lesions are a challenging scenario for periodontal therapy and a serious threat for tooth prognosis.
  1 4,559 517
Comparative evaluation of microleakage in Class V cavities using various glass ionomer cements: An in vitro study
Sunil Kumar Gupta, Jaya Gupta, Vidya Saraswathi, Vasudev Ballal, Shashi Rashmi Acharya
September-December 2012, 2(3):164-169
Aim: The study aimed to evaluate the microleakage of nano-filled resin-modified glass ionomer restorative (nano-filled RMGI) in comparison with that of conventional glass ionomer cement (CGIC), and resin-modified glass ionomer cement (RMGIC). Materials and Methods: Forty-five standardized Class V cavity preparations were prepared on sound extracted human molar teeth. Teeth were randomly assigned to three experimental groups of 15 teeth each and restored as follows: Group 1, CGIC; Group 2, RMGIC; and Group 3, nano-filled RMGI. The specimens were placed in a solution of 2% Rhodamine-B dye for 24 h at room temperature under vacuum. Staining along the tooth restoration interface was recorded. Results were analyzed using Kruskal-Wallis and Wilcoxon tests. Results: There were no statistically significant differences in dye leakage between all the three restorative materials for occlusal margins (P = 0.464). Group 3 showed significantly less microleakage compared to Group 1 (P = 0.007) and Group 2 (P = 0.040) at the gingival margins. The degree of microleakage in the gingival margins of each group was more than that found in occlusal margins. Conclusions: No material was able to completely eliminate microleakage at enamel, dentin, or cementum margin. Nano-filled RMGI showed least microleakage compared to other two cements at gingival margins. Clinical Relevance to Interdisciplinary Dentistry
  • Cervical lesions have been a restorative challenge for dentists for many years.
  • An interdisciplinary treatment approach is the appropriate choice in cases where there is gingival recession and cervical lesions.
  • Glass ionomer cements have been commonly used for restoration of cervical lesions.
  • Nano-filled resin-modified glass ionomer cement can be used for the restoration of cervical lesions, as it has a better marginal sealing ability compared to conventional glass ionomer and resin-modified glass ionomer cements.
  1 7,523 1,170
An assessment of prosthodontists' attitudes to the shortened dental arch concept
Pradeep C Kumar, Seema George
May-August 2012, 2(2):104-107
Aim: To assess the attitudes and experiences on the Shortened Dental Arch (SDA) concept from an exclusive sample of specialist prosthodontists. Materials and Methods: A questionnaire containing different statements with regard to the SDA concept was designed for this study. This was prefaced by a short explanation of the SDA concept. It was sent to a random sample of 51 specialist prosthodontists. Results: The response rate was 64%. Most of the respondents indicated experience with the SDA concept ranging from recent to ten years. Patients' reactions on the proposal of shortening their dental arch were quite varied, from either clear objections to no objections, or, initial objections that were withdrawn on explanation. Chewing ability, appearance, and oral comfort consequent to an SDA were rated as sufficient or satisfactory by the respondents. Conclusion: Overall, the specialist prosthodontists had a positive attitude toward the SDA concept. However, they had reservations about the management outcome of SDA. Clinical Relevance to Interdisciplinary Dentistry
  1. Prosthodontists had an overall positive attitude toward the SDA concept. In patients with caries and periodontal disease confined mainly to molar regions, active shortening of the dental arch should be considered.
  2. The SDA concept could be considered as a strategy to reduce the need for complex restorative treatment in the posterior regions of the mouth.
  3. Periodontally healthy and intact or restored anterior and premolar regions are a prerequisite to the success of SDA concept application.
  1 5,122 626
Questionable abutments: General considerations, changing trends in treatment planning and available options
D Krishna Prasad, Chethan Hegde, Anshul Bardia, D Anupama Prasad
January-April 2013, 3(1):12-17
Abutment teeth are called upon to withstand the forces normally directed to the missing teeth, in addition to those usually applied to the abutments. Whenever possible, an abutment should be a vital tooth. Normally, teeth with active periodontal problem should not be used as abutment teeth. The use of multiple splinted abutment teeth, non-rigid connectors or intermediate abutments makes the procedure much more difficult and often the result compromises the long-term prognosis. In cases where tooth preparation cannot solve the problem, the use of various attachments and a telescopic retainer must be considered. Understanding the basic concepts of how to retain various restorative components and how to protect the remaining tooth structure, will enable us to answer the numerous questionable situations that arise during the restorative process will be facilitated. Thus, this will result in final restorations that are based on sound design principles. Clinical Relevance to Interdisciplinary Dentistry
  • Fixed prosthetic treatments are always dependent upon the support they receive from abutment teeth. Abutment teeth should have sufficient coronal structure to provide retention to the prosthesis. It might sometimes be necessary to expose or increase the clinical crown by periodontal surgery for support and esthetics. It is also seen that many a times the teeth are supra erupted as a result of absence of opposing dentition which calls for the need of intentional endodontic treatment. By a combination of treatments with interdisciplinary dentistry, we will succeed in providing a functional prosthesis which fulfils esthetic and restorative needs.
  1 36,144 3,796
Research design hierarchy: Strength of evidence in evidence-based dentistry
BH Mithun Pai, G Rajesh, Ramya Shenoy
September-December 2012, 2(3):158-163
As practitioners, thinking critically about how we make clinical decisions is important. As educators, we should evaluate how to teach students to make clinical decisions. To make clinical decisions, and to practice modern dentistry and to educate the dental care professionals, the evidence-based dentistry forms an important asset. The cornerstone of evidence-based healthcare and health technology assessment is critical appraisal of the evidence underpinning a finding. The hierarchy of evidence includes several types of studies used to evaluate treatment effects, starting from case reports, observational studies, and randomized controlled trials (RCTs), the tip of which are systematic reviews, which constitute the highest level of evidence because they attempt to collect, combine, and report the best available evidence using systematic, transparent, and reproducible methodology. Clinicians are interested in the highest quality research report available to determine the "best therapy" for their patients. This article will assist in framing the questions and categorizing the best available evidence. A search was initiated to locate original research articles, review articles, and case reports pertaining to the key words: Evidence-based dentistry, hierarchy of evidence, ladder of evidence, research design hierarchy, strength of evidence. Electronic database was retrieved from PubMed , Google and Google Scholar to search and select keywords related to evidence-based medicine and dentistry. The keywords used were evidence based dentistry, research design hierarchy, evidence based practice, and strength of evidence. This article is the result of a literature study on evidence-based research design hierarchy. Clinical Relevance to Interdisciplinary Dentistry
  • Evidence-based practice (EBP) is an interdisciplinary approach gaining ground after 1992; hence, its usefulness in any discipline is worth the attention.
  • This article explores links between the state of academic and clinical training regarding interdisciplinary EBP and describes strategies to accelerate the translation of evidence across disciplines.
  • This paper examines the concept of hierarchy of research design, barriers and challenges and applying evidence based dentistry in practice.
  1 9,243 918
Significance and clinical relevance of biologic width to implant dentistry
Sangeeta Dhir
May-August 2012, 2(2):84-91
The concept of biologic width forms the basis for a successful peri-implant soft tissue integration around titanium implants. The purpose of this review is to evaluate the present knowledge about this important zone that forms the basis for a successful implant. Methodology: Electronic search of the Medline/PubMed was done using the search words and MeSH Headings including, biologic width, peri-implant soft tissue, crestal bone loss, platform switch, biologic width and dental implant, implant abutment junction. Hand search of the prosthetic,implantology, and the periodontology journals was also undertaken for the collection of the data. Clinical Relevance to Interdisciplinary Dentistry
  1. Implant dentistry involves an interdisciplinary treatment approach of prosthodontics, periodontics, and surgical aspects.
  2. A profound knowledge of the biologic response and the underlying anatomical/histologic aspects of the bone and the overlying soft tissues is critical for the success of the implant.
  3. Biologic width is a healthy self-limiting zone around implant. It acts as a mirror for the underlying health of the supporting tissues.
  4. Violation of the biologic width generates a revoking response from the tissues, which then tries to accommodate at the stake of the crestal bone.
  5. This review article tries to demystify the conveniently overlooked biologic zone and the affecting factors/variables responsible for the viability of this zone.
  1 22,232 2,635
Acetal resin as an esthetic clasp material
K Lekha, NP Savitha, Meshramkar Roseline, Ramesh K Nadiger
January-April 2012, 2(1):11-14
Removable partial dentures (RPDs) are an effective and affordable treatment option for partial edentulism. Restoration of esthetics is an important function of RPD and it determines the success of the treatment. The goal of achieving optimal esthetics - while maintaining retentive integrity, stability, and protecting the health of the tooth - is the most difficult task. The traditional use of the metal clasp like cobalt chromium (Co-Cr), gold, stainless steel, and titanium hampers esthetics, since its obvious display conflicts with patient's prosthetic confidentiality. Acetal resin (polyoxymethylene or POM), a thermoplastic resin, may be used as an alternative denture clasp material. This material was promoted primarily on the basis of superior esthetics, which allowed the clasps to better match the color of abutment tooth. PubMed and Google Scholar were used to search original research articles, case reports, and other reviews about acetal resin. The keywords used were acetal resin, esthetic, clasp, removable partial denture, thermoplastic, metal free framework. This article is the result of a literature study on acetal resin clasp material for conventional RPD.
  1 11,898 1,702
Gingival displacement in prosthodontics: A critical review of existing methods
Krishna D Prasad, Chethan Hegde, Gaurav Agrawal, Manoj Shetty
July-December 2011, 1(2):80-86
Tremendous progress has been made in procedures for making fixed prosthodontic impressions over the past few decades. A common objective for impressions and interim crowns or fixed dental prostheses is to register the prepared abutments and finish lines accurately. For all impression procedures, the gingival tissue must be displaced to allow the subgingival finish lines to be registered. Retraction is the temporary displacement of the gingival tissue away from the prepared teeth. This article discusses the current methods that are applied for displacement of gingival tissues so that adequate amount of unprepared tooth structure can be recorded with least distortion of impression material as well as minimal damage to attachment apparatus of the tooth. In addition to this, gingival displacement techniques around implants and for computer aided design/computer added manufacturing (CAD/CAM) based restorations have been discussed. PubMed and Google Scholar were used to search any studies involving gingival retraction techniques. The keywords used were gingival retraction, gingival displacement, gingival retraction in implants and retraction cord. Gingival retraction holds an indispensable place during soft tissue management before an impression is made. Swift increase in research work in the recent past leaves no option for a clinician, but to be updated and to possess optimum knowledge to rationalize the use of materials and techniques that are employed for gingival displacement in proximity to both teeth as well as implants.
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Biominerals in restorative dentistry
Neeta Shetty, M Kundabala
May-August 2013, 3(2):64-70
Restorative treatment strategies are being developed to repair and replace lost tooth structures and surrounding bone. The teeth under goes a constant cycle of demineralization and remineralization, but this natural remineralization process is inadequate to prevent progression of dental caries. Hence there is a need to supplement the tooth with a biomaterial which is bio inert or bioactive to remineralize, repair or regenerate the tissues of tooth. Calcium hydroxide is considered the gold standard material for repair of dentin, which is presently being replaced by materials with superior properties such as mineral trioxide aggregate. Biomaterials such as calcium phosphate cements are been advocated as bone substitute material because of properties such as biocompatibility, osteoconductivity and moldability. This review deals with the physiochemical properties of some of the biomineral based biomaterials which are currently used for repair, replacement or regeneration of hard tissues of teeth and bone. Clinical Relevance to Interdisciplinary Dentistry
  • Synthetic biomaterials containing biominerals are used in dentistry to repair and regenerate hard tissues of the teeth and bone.
  • Biomaterials containing biominerals are routinely used by specialist from various fields of dentistry such as restorative dentistry, periodontics and oral surgery.
  • Biomineral based biomaterials are used for direct and indirect pulp capping procedures, as an intracanal medicament in root canals, root perforation repair, periapical surgeries, repair of bony defects.
  1 4,543 852
An innovative approach for treating vertically fractured mandibular molar - hemisection with socket preservation
Vineet S Agrawal, Sonali Kapoor, Nimisha C Shah
May-August 2012, 2(2):141-143
Vertical root fracture has been described as longitudinally oriented fracture of the root extending from the root canal to the periodontium. The most predictable treatment option for vertical root fractures would be extraction in case of anterior teeth, and hemisection or root amputation of the involved root in the multi-rooted teeth. Following extraction, socket preservation procedure helps to retain the available bone and soft tissue for better function and aesthetics. This case report describes the treatment of a vertically fractured mandibular molar by hemisection with socket preservation surgery followed by restoration with a fixed prosthesis. Clinical Relevance to Interdisciplinary Dentistry
  1. Combined periodontics, endodontics, prosthetic and restorative innovative approach for management of vertically fractured teeth.
  2. Interdisciplinary approach combining surgical technique with endodontic and prosthetic rehabilitation.
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* Source: CrossRef