J Interdiscip Dentistry
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   2015| September-December  | Volume 5 | Issue 3  
    Online since April 28, 2016

 
 
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CASE REPORTS
Comparison of mineral trioxide aggregate and biodentine for management of open apices
Deenadayalan Elumalai, Bhumika Kapoor, Rajendra Kumar Tewrai, Surendra Kumar Mishra
September-December 2015, 5(3):131-135
DOI:10.4103/2229-5194.181379  
Open apices are a constant challenge to an endodontist. This case report describes the management of open apices with periapical radiolucencies in maxillary central incisors. Mineral trioxide aggregate (MTA) and biodentine were used to form an apical barrier and further obturation was completed with the same. The rationale of this case report was to observe the effect of MTA and biodentine on periapical healing in the same patient. It was concluded that initial healing was better in the case of biodentine while long-term effect of MTA was better. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY The rationale of endodontic treatment is to prevent and treat apical periodontitis. In this case, root was not completely formed and hence periodontium was not continuous. With root end closure using MTA and Biodentine, biomimetic activity was initiated which further led to healing of periapical radioluceny and bone formation. Proper coronal seal is inevitable to prevent leakage and further success of endodontic treatment. Hence, crown fabrication is important not only for esthetic purposes but for further long term success.
  12,282 1,767 -
SHORT COMMUNICATION
Functionally generated pathways to develop occlusal scheme for removable partial denture
Pravinkumar G Patil, Smita P Nimbalkar-Patil, Rahul S Kulkarni
September-December 2015, 5(3):154-157
DOI:10.4103/2229-5194.181380  
The functionally generated pathway (FGP) technique consists of registering the occlusal pathways of the posterior teeth in the functional wax and has been classically described as the "three-dimensional static expression of dynamic tooth movement." This clinical report describes the treatment of a partially edentulous patient, with a cast removable partial denture, in which occlusion was developed using the FGP procedure. The FGP technique utilizes the patient's masticatory system to develop occlusion and has the advantages of being simple, accurate, and reliable. If the FGP technique is properly accomplished, only minor intraoral occlusal adjustments are necessary. This article described a technique of developing the FGP occlusion for a patient with cast partial denture with Kennedy's Class III edentulous mandibular arch. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY The FGP is highly versatile technique of developing the occlusion-pattern in the removable and fixed dental prostheses including implant restorations. It can be employed with equal efficacy in fabrication of relatively simple restorations such as a single crown, or more complex full mouth reconstructions.
  11,466 1,237 1
EDITORIAL
Increased life expectancy: Is dentistry in India ready?
Ashita Uppoor
September-December 2015, 5(3):113-113
DOI:10.4103/2229-5194.181381  
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CASE REPORTS
Gingival fenestration defect in the maxillary anterior region treated with coronally positioned flap using platelet-rich fibrin membrane
Dhruvakumar Deepa, Nalini Jain
September-December 2015, 5(3):140-144
DOI:10.4103/2229-5194.181378  
This report describes the management of gingival fenestration of maxillary right lateral incisor using platelet-rich fibrin (PRF) and coronally repositioned flap procedure. Earlier reports have been documented where fenestration defects around implants are treated with PRF. To the best of our knowledge, this is the first case reported with PRF and chronic renal failure in gingival fenestration around natural tooth. Initial oblique incisions were placed on either side of the defect at the level of the cementoenamel junction #12, followed by vertical incisions extending beyond the mucogingival junction into the alveolar mucosa. After flap elevation, recontouring of the irregular prominent bony margin was performed. Thorough root planing was done; freshly prepared PRF was placed over the root surface and sutured; overlying flap was coronally repositioned and sutured with 5-0 silk sutures. The results of the case demonstrated satisfactory healing of the gingival fenestration defect with excellent color, texture match with the surrounding area along with the keratinized tissue formation emphasizing the importance of using PRF as a membrane in esthetically demanding areas. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY PRF could be a good option in treating fenestration which provides good healing and color match especially in esthetically demanding areas.
  5,515 292 -
INVITED REVIEW
A conceptual framework (Cat-4) for estimating clinical relevance of evidence related to oral diagnosis
Rahul Nair, Amanda-Mae Nguee Ai-Min
September-December 2015, 5(3):114-118
DOI:10.4103/2229-5194.181372  
This article categorizes studies that assess diagnosis in oral health care into four categories (Cat-4) based on the extent of clinically relevant information in its reported analyses. Category 1 includes studies publishing results from in vitro research. Category 2 includes studies that compare the test results of a diagnostic test of interest versus those of a reference test. Category 3 includes studies that assess the overall effect of the diagnostic test on future health, function, or quality of life. Finally, Category 4 includes studies that report economic analyses. Each category also includes a hierarchy of evidence (based on study design) that can be used for further assessment of internal validity along with other published criteria for testing internal validity and applicability. Clinical application of Cat-4 should result in greater awareness of the uncertainties in diagnosis that can result in missed diagnosis and overdiagnosis. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY
  • Quantification of the ultimate effects of diagnosis on a patientss' lives is needed
  • Cat-4 presents a framework that can combine clinical relevance and assessment of internal validity to evidence related to diagnosis
  • An understanding of the aspects of the evidence that are missing may result in a more realistic planning of clinical procedures.
  3,800 2,006 1
ORIGINAL ARTICLES
Assessment of bone mineral density in pre- and post-menopausal women using densitometric software: A pilot study
Pallavi Taneja, Roseline Meshramkar, Kruthika Satyabodh Guttal
September-December 2015, 5(3):125-130
DOI:10.4103/2229-5194.181374  
Objectives: The density of available bone in the edentulous site of the patient is arguably the primary determining factors in predicting final prosthetic treatment outcome. The aim of the study was to compare and correlate the quality of mandibular bone with the help of densitometric software available in Kodak 9000C and to further substantiate the results, morphometric analysis using orthopantomograph (OPG) and quantitative ultrasound of calcaneus bone. Materials and Methods: Twenty premenopausal and twenty postmenopausal women were selected for the study with edentulous span in the mandibular second premolar and first molar region. Bone density of the edentulous span was calculated using the digital Kodak software 9000C for all the OPGs. Various radiomorphometric indices were measured on the OPG. Results were statistically analyzed. Results: The results proved that there was a statistically significant difference in the bone densitometric values for digital OPG readings, ultrasound values, mandibular cortical index, antegonial index, for pre- and post-menopausal women. Conclusion: Within the limitations of the study, the use of densitometric software yielded positive results. The results supported the fact that bone density reduces in postmenopausal women and can be used as an effective aid to quantify the bone mineral density which ultimately plays a significant role in prosthetic implant outcome. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY The use of densitometric software could be used independently to measure bone density in future. An integrated team approach between the implantologist, prosthodontist, and radiologist provides a customized treatment plan, thereby, optimal patient care.
  3,778 821 -
An in vitro study to evaluate the accuracy of dies obtained from dual-arch impression trays using addition silicone impression material and tray combinations
S George, Vidya K Shenoy, Shobha J Rodrigues, Thilak Shetty, Sharon Saldanha
September-December 2015, 5(3):119-124
DOI:10.4103/2229-5194.181373  
Objectives: This study aims to evaluate and compare the accuracy of dies obtained from dual-arch impression trays using vinyl polysiloxane impression material and tray combinations. Materials and Methods: Typodont teeth were embedded in the maxillary and mandibular Dentoform model bases and mounted in an articulator using maximum intercuspation. Impressions were made with vinyl polysiloxane materials (Reprosil Putty, Aquasil Ultra Heavy, Aquasil Ultra LV [Dentsply International]) using one-step simultaneous dual viscosity technique in dual-arch plastic trays and metal trays as well as in full arch acrylic resin custom trays. These were compared for the dimensional accuracy with the dies prepared from typodont tooth as a control. Results obtained were statistically analyzed. Results: The results indicated that dies obtained from all the impression combinations showed increased dimension (acrylic resin custom trays 9.4 ± 0.048 mm, dual-arch plastic trays 9.5 ± 0.035 mm, and dual-arch metal trays 9.41 ± 0.017 mm) as compared to the dimension of control (9.39 ± 0.007 mm). Conclusion: All the tray impression material combinations showed variable accuracies. Full arch acrylic resin trays exhibited the greatest accuracy whereas dual-arch plastic trays showed the least accuracy. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY In fixed prosthodontics, a lower incidence of errors can be obtained using a combination of PVS impression material with metal or custom tray, thereby improving the accuracy of the subsequent restoration. Interdisciplinary dentistry necessitates good prosthodontics and as such prosthodontics is an integral part of good interdisciplinary dentistry.
  3,261 1,203 -
REVIEW ARTICLE
Dental implant for the geriatric patient
Divya Prakash, UB Gajre, Prachi Bhowmick Bhatia
September-December 2015, 5(3):150-153
DOI:10.4103/2229-5194.181377  
Older adults are expected to account for an increasingly disproportionate number of individuals needing oral implant prostheses. However, unfavourable jawbone quantity and quality, particularly atrophy of the maxilla, impair implant success. Furthermore, placement of implants in sites that had been edentulous for shorter periods was associated with greater crestal bone loss, a finding that may have implications for younger adults undergoing such treatment. When treatment planning is done for tooth replacement, patients should be presented with all possible treatment options regardless of age. Dental implant therapy has proven to be a predictable method of permanent tooth replacement. Several studies demonstrate high implant survival rates, a relatively low need for recurrent care, and improved quality of patients lives. This modality is an accepted treatment option for all ages. Consequently, implant-.supported prosthodontic rehabilitation for function and esthetics is indicated more frequently. Authors have used MEDLINE and PUBMED search for locating, selecting, extracting and synthesising data. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY The rehabilitation of the geriatric patient is a herculean task for the prosthodontist. Prior to the use of dental implants for rehabilitation various factors are to be taken into account such as nutrition, lifestyle diseases etc. Which may need consultation and intervention from the medical fraternity. Management of medically compromised patients and psychological counselling plays a pivotal role in the success of prosthodontic rehabilitation. Thus an co-.ordinated inter-.disciplinary approach is the need of the hour.
  3,755 478 1
CASE REPORTS
Delayed obturator for irradiated maxillectomy patients: Case report of two patients
Sushil Kar, Arvind Tripathi
September-December 2015, 5(3):136-139
DOI:10.4103/2229-5194.181376  
Functional rehabilitation is the sequel to tumor ablation and consequent cancer-free status in most patients. Unfortunately, a plethora of reasons may play a stellar role in delayed rehabilitation. These may range from unsuitability of the remnant tissue bed for prosthesis, prolonged tissue inflammation, postirradiation unfavorable tissue changes, and secondary bacterial or fungal infection in the recipient tissue bed. In some situations, the economic status of the patient may grossly restrict the patient's effort to seek prosthetic service. These unwarranted and undesirable obstacles would lead to gross facial disfigurement and a progressive tissue shrinkage which might render the recipient site nonamenable to the seating of the prosthesis. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY
  • When prosthodontic therapy is not conjoint with surgery, the succeeding tissue contracture, and soft tissue collapse can lead to irreversible unesthetic, and contorted facial contours
  • Components of prosthesis function assessed were esthetics, speech, mastication, all of which were restored to satisfactory levels by the interim obturators. Thus, optimal restoration of esthetics and function is achievable despite a time lag in prosthodontic therapy after surgery.
  2,554 211 -
Restoring function and esthetics in an adolescent with idiopathic multiple unerupted permanent teeth: A clinical report
Mayur Hegde, Aditya Shetty, Vidya K Shenoy, DV Nagaratna, Bharath Prabhu, Mithun Upadhya
September-December 2015, 5(3):145-149
DOI:10.4103/2229-5194.181375  
Idiopathic multiple unerupted teeth have several debilitating oral and psychological manifestations, especially with young children and adolescents. The multiple unerupted permanent teeth can cause serious problems in terms of treatment time and outcome. This clinical report presents a multidisciplinary approach for the management of an adolescent girl with idiopathic multiple unerupted teeth. At the 2-year follow-up, there was a significant improvement in the oral function and psychosocial activities without any prosthetic complications. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY
  • Interdisciplinary team including Prosthodontist, Restorative Dentist, Periodontist and an Oral Surgeon will help in significantly improving the quality of life of the patient
  • Special emphasis is placed on early diagnosis, careful treatment planning, and co-.ordination and timing of different phases of the treatment
  • A system for integrating all the specialities will be a guarantee for a successful outcome.
  1,763 174 -
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