J Interdiscip Dentistry
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   2013| May-August  | Volume 3 | Issue 2  
    Online since February 11, 2014

 
 
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ORIGINAL ARTICLES
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
DOI:10.4103/2229-5194.126872  
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 5,572 564
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
DOI:10.4103/2229-5194.126867  
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 3,857 454
REVIEW ARTICLES
Biominerals in restorative dentistry
Neeta Shetty, M Kundabala
May-August 2013, 3(2):64-70
DOI:10.4103/2229-5194.126858  
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 5,593 937
CASE REPORTS
Syndesmocorono-radicular tooth: An endo-perio challenge
Rhythm Bains, Vivek Kumar Bains, Kapil Loomba, Kavita Verma, Anju Loomba
May-August 2013, 3(2):114-119
DOI:10.4103/2229-5194.126875  
Syndesmocorono-radicular tooth consist of palatoradicular groove that represents anomalous morphology and is the predisposing factor for developing localized chronic periodontitis and pulpal necrosis. This clinical report discusses diagnosis and endodontic-periodontal treatment of maxillary central incisor with palatoradicular groove that begins in the central fossa, crosses cingulum and extends a variable distance onto the root. Both endodontic and periodontal surgical therapy is required for treatment of pulpal pathosis, correction of osseous defect, pocket elimination and groove correction depending on the extent and depth of the radicular groove. Clinical Relevance to Interdisciplinary Dentistry
  • Endodontic failure may occur due to communication of palatal groove with pulp cavity. Such anomaly often predisposes to periodontal defects, severe bone destruction or combined endodontic-periodontal lesions.
  • Interdisciplinary treatment modalities used in the present case reports emphasizes on the team approach management consisting of both endodontist and periodontist.
  - 3,513 299
Management of an endo-perio lesion due to invasive cervical resorption: Literature review and a clinical report
Ahmed Kulsoom Siddiqui, Ramya Raghu, Ashish Shetty, Chinmaya Kumar Samantaroy
May-August 2013, 3(2):120-124
DOI:10.4103/2229-5194.126876  
Successful management of ICR relies on the location, size and accessibility of the lesion as well as the structural integrity of the tooth and periodontium after treatment is completed. The present case demonstrates that ICR can be arrested by the approach recommended by Heithersay. Here, a diode laser was used as an adjunct to aid in disinfecting the resorptive defect as well as the flap. Clinical Relevance to Interdisciplinary Dentistry
  • Invasive cervical resorption is a poorly understood and often misdiagnosed lesion.
  • Careful clinical, radiographic and periodontal examinations hold the key to successful management.
  • Teamwork by restorative dentists and periodontists is important for salvaging such damaged teeth.
  - 4,765 532
A simplified technique to make an immediate surgical obturator for a maxillectomy patient
Anand Farias, Chethan Hegde, D Krishnaprasad
May-August 2013, 3(2):125-128
DOI:10.4103/2229-5194.126877  
Patients with advanced carcinomas of the maxillary sinus are often treated with surgical resection by maxillectomy and face several complications including change and difficulty in speech, deglutition, mastication and esthetics, as well as psychological discomfort following the surgery. Most of difficulties can be overcome, to an extent, with the placement of an immediate surgical obturator. This clinical report describes the fabrication of a removable immediate surgical obturator for a patient with stage 4 carcinoma of the maxilla, which uses the patient's original occlusion and tooth position, made prior to the surgical resection and inserted at the time of surgery, to provide the patient with a means of masticatory efficiency, esthetics and psychological comfort during the healing period. Clinical Relevance to Interdisciplinary Dentistry
  • Highlights a team effort in the management of oral and facial carcinomas - Surgeon, Pathologist and Prosthodontist.
  • Provides a stable foundation for fabrication of future prosthesis.
  • Prosthetics to aid in the surgical management of scar tissues.
  • Esthetics and facial form maintained following surgery, minimizing post-surgical patient depression.
  - 5,552 447
EDITORIAL
To educate the educators
Kundabala Mala
May-August 2013, 3(2):51-51
DOI:10.4103/2229-5194.126848  
  - 1,736 217
INVITED ARTICLE
Implant dentistry: A multidisciplinary approach
Latha S Davda, Sanjay V Davda
May-August 2013, 3(2):52-56
DOI:10.4103/2229-5194.126850  
Dental implants are one of the options available to replace missing teeth. The long-term success of any dental implant treatment is influenced by several factors including patient factors, preventative measures used by the patient, esthetics, surgical factors, periodontal factors, restorative factors and mechanical factors of the implant system. Dental implants are placed and restored by specialists as well as general dental practitioners with differing levels of training in dental implantology. Therefore, it becomes very important for the main clinician in charge of the implant patient to be aware of the multidisciplinary approach that is required to ensure long-term implant success. The patient factors, assessment of patient for implants, esthetic factors and prevention influencing the treatment planning of a dental implant patient are discussed in this paper. This is the first in the series of three articles that will discuss the factors listed above with relevant case studies. Clinical relevance to interdisciplinary dentistry
  • Long term success of dental implants is dependent on good case selection,detailed patient assessment and implimentation of multidisciplinary approach.
  • It is in the best interest of the patient that all the specialties needed in that particular case work together under one lead clinician to achieve the best results.
  - 3,323 443
ORIGINAL ARTICLES
Evaluation of pattern of occlusal contacts in lateral excursion using articulating paper and shim stock: An in vivo study
Arshiya Gupta, Vidya Kamalaksh Shenoy, Thilak B Shetty, Shobha J Rodrigues
May-August 2013, 3(2):109-113
DOI:10.4103/2229-5194.126874  
Aim: This study was done to evaluate the pattern of occlusal contacts in lateral excursion and compared the relative accuracy of shim stock and articulating paper for determining occlusal contact patterns. Material and methods: The patterns of occlusal contacts of 70 young adults were examined in various lateral positions with shim stock and articulating paper in regulated lateral positions 0.5, 1, 2, and 3 mm from the maximum intercuspation. Results: Most contact patterns belonged to group function and a few to canine protection when only working side contacts were considered. When both working and nonworking side contacts were considered, nearly half the contact patterns were those other than canine protection and group function. Shim stock exhibited superior accuracy and reliability as compared to the articulating paper. Conclusion: In the lateral excursion other than canine protected and group function, there exists some other occlusal contact pattern. Shim stock exhibits superior accuracy and reliability as compared to the articulating paper. Clinical Relevance to Interdisciplinary Dentistry
  • It is important to understand how to evaluate the type of existing occlusion before any restorative procedure is undertaken
  • It helps to arrive at the best scheme of occlusion for any restorative procedure
  • It also provides a background on the various methods used to assess the occlusal contact in restorative dentistry.
  - 5,483 607
Role of probiotics on oral health: A randomized, double-blind, placebo-controlled study
Rajan Dhawan, Shivani Dhawan
May-August 2013, 3(2):71-78
DOI:10.4103/2229-5194.126862  
Aim: The aim of this study was to investigate commercially available combined probiotic formulation for its effect on plaque, gingivitis, and salivary Streptococcus mutans levels in subjects with chronic gingivitis. Materials and Methods: A total of 36 subjects were finally enrolled in a double-blind, placebo-controlled, randomized trial. Selected subjects were randomly divided into two groups: Group A (control group) with 17 subjects receiving placebo tablets twice daily and Group B (probiotic group) with 19 subjects receiving probiotic tablets twice daily. The study consisted of two 2-week periods: a 2-week intervention period (T1-T2) and a 2-week posttreatment period (T2-T3). Clinical parameters and bacterial counts of salivary Streptococcus. mutans were evaluated at baseline (T1), at the completion (T2) of medication, and 2 weeks after the medication (T3). Results: On comparative evaluation between the two groups, results indicated that Group B (probiotic group) exhibited statistically significant reduction in Plaque Index, Gingival Index, Calculus Index and Streptococcus. mutans level than Group A (control group) over the entire span of the study. Conclusion: Our results indicated that probiotic could be useful in the improvement/maintenance of oral health. Clinical Relevance to Interdisciplinary Dentistry
  • If left untreated, gingivitis can progress, increasing the risk of tooth loss. Oral administration of probiotics benefits oral health by preventing the growth of harmful microbiota or by modulating mucosal immunity in the oral cavity.
  • In this study, probiotics were given orally for 2 weeks to subjects suffering from gingivitis and results showed improvement in oral health.
  • Bacteriotherapy in the form of probiotics seems to be a natural way to maintain health and protect oral tissues from disease.
  • Efforts have been made in this article to increase the awareness with this aspect of oral disease therapy and encourage the implementation of the concept of "food rather than medicine".
  - 7,483 854
To assess knowledge and awareness of North Indian population towards periodontal therapy and oral-systemic disease link: A cross-sectional survey
Archana Bhatia, Sandeep Kumar Bains, Mohinder Pal Singh
May-August 2013, 3(2):79-85
DOI:10.4103/2229-5194.126865  
Aim of the Study: The aim of the present study was to explore and gain an understanding of patients' views on their periodontal conditions, their attitudes to oral health and expectations of treatment, as well as their knowledge toward oral-systemic disease link with the help of a questionnaire survey. Materials and Methods: The study subjects were patients with chronic periodontitis, who had been referred to Department of Periodontics. A total of 245 patients comprising of 125 males and 120 females were included in this study who attended department of Periodontics in Dasmesh Dental College and Hospital, Faridkot Punjab State during the study period from 10 th December 2010 to 10 th May 2011. Study was divided into two parts: First part consist of questions related to age, sex, demographic area along with oral hygiene measures and the second part consist of attitude toward periodontal therapy and oral-systemic disease link. Results: The results illustrated that females participate in this randomized study were more fearful about the periodontal therapy and only (13.8%) subjects were aware about the oral-systemic disease link while almost two-third population (68.9%) was unaware about this. Hence as a dentist, we should educate patients about this important relationship. Conclusion: The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care. Utilization of dental services in this country should, therefore, be improved not only by improving the availability and accessibility by manpower arrangements, but also to a great extent by increasing people awareness and knowledge of their own dental disorders and by attempting to change their attitudes and behavior in relation to oral health care. Clinical Relevance to Interdisciplinary Dentistry
  • The present article highlights the importance of an interdisciplinary approach for the purpose of providing knowledge and awareness to patients regarding periodontal therapy and oral systemic links.
  - 3,713 485
Concepts, aims, and drawbacks in interdisciplinary dentistry: Results of an international questionnaire
Gregor Slavicek, Alexandra Makarevich, Ivan Makarevich, Ksenia Bulatova
May-August 2013, 3(2):91-102
DOI:10.4103/2229-5194.126869  
Aim: This article describes the results of an opinion survey among dentists and dental technician regarding interdisciplinary dental teamwork. Materials and Methods: An electronic Internet-based version was available only in Russian. In all, 250 questionnaires were handed out in paper form and 100 access codes for the Web-based version were sent. The survey was conducted between February and May 2011. All questionnaires were filled anonymously. Conclusions: Authors concluded, that inter disciplinarity should not be regarded as the opposite of technological specialization. On the contrary, advancing technological developments in IDD will probably enforce a certain degree of specialization. Therefore, in the future it will become necessary not to lose contact with other specialties, keep open communication lines by means of a common language and common concepts, and also maintain communication with other medical specialties. There may well be a greater need to impart these competences in the course of training and post-graduate training. Clinical Relevance to Interdisciplinary Dentistry
  • IDD is based on proper and adequate communication within the interdisciplinary team, but frequently mentioned problems of communication and difficulties when assemble an interdisciplinary team with a high conflict potential.
  • More clear concepts of IDD are required and training concepts should be incorporated in undergraduate and postgraduate trainings.
  • The negative correlation between work experience and desired share of IDD in daily routine initially permits the conclusion that negative perception concerning IDD exist.
  • The negative correlation between work experience and the desired share of IDD in one's daily work is an alarming signal and should be considered in future studies.
  • Cooperation between specialties functions, mainly within closely related specialties. The need for interdisciplinary treatment concepts, however, is widely dispersed.
  - 4,597 447
REVIEW ARTICLES
Toll-like receptors: A double edge sword
Mishal Piyush Shah, Akash Prahlad Patel, Priteshkumar Sureshchand Ganna, Kinnari Mishal Shah
May-August 2013, 3(2):57-63
DOI:10.4103/2229-5194.126853  
Innate immunity is the first line of host defense and represents inherited resistance to infection. Innate immunity works through toll-like receptors (TLRs), which recognize the conserved molecular patterns on pathogenic bacteria known as pathogen-associated molecular patterns (PAMPs). The periodontium is a unique environment in which oral microorganisms are in constant contact with the host immune system. The TLRs present on gingival epithelial cells are continuously stimulated, resulting in production of cytokines and defensins that help to maintain oral health. If the epithelial barrier is breached, allowing invasion of bacteria into the underlying connective tissue, the TLRs on other resident and non-resident cells of the periodontium become activated. This leads to an exaggerated release of pro-inflammatory cytokines and other biological mediators, which may cause host tissue destruction. Clinical Relevance to Interdisciplinary Dentistry Protecting periodontium during and after the restoration is very important. since, periodontal tissues are in continuous contact with oral microorganisms and through that to the host immune system. The TLRs present on gingival epithelial cells are continuously stimulated, resulting in production of cytokines that help to maintain oral health. If the epithelial barrier is breached, during the restorative procedures or due to impinging restorations, allowing invasion of bacteria into the underlying connective tissue, which may cause host tissue destruction.
  - 7,192 1,191
SHORT COMMUNICATION
Fractured tooth rebonding: A ultra-conservative approach
Amit Yadav, Neeta Shetty
May-August 2013, 3(2):129-132
DOI:10.4103/2229-5194.126878  
Majority of the traumatic dental injuries involves the anterior teeth specially the maxillary incisors. Rebonding of the fractured fragment to the tooth retrieved in a fairly intact condition provides an ultra-conservative treatment option. Rebonding techniques provide good esthetics, restores immediate function and provides positive psychological support to the patient. With the introduction of resin based material and the mono block concept, rebonding is a feasible treatment procedure. These case reports discuss the techniques for rebonding fractured fragment to the tooth in a very conservative and cost-effective manner. Clinical Relevance to Interdisciplinary Dentistry
  • Management of traumatic injuries requires a multidisciplinary approach.
  • Fractured fragment rebonding where the fracture line violates the biological width will require periodontal procedures such as osteotomy, crown lengthening and gingivectomy to be carried out.
  • With the advancement in materials and techniques fractured fragment rebonding offers a viable restorative option for the clinician which restores immediate esthetics using an ultra-conservative approach.
  - 7,625 493
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