J Interdiscip Dentistry
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   2016| January-April  | Volume 6 | Issue 1  
    Online since August 10, 2016

 
 
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INVITED REVIEW
An overview of vital teeth bleaching
Sonal Bakul Joshi
January-April 2016, 6(1):3-13
DOI:10.4103/2229-5194.188155  
The virtue of "the perfect smile" is an easily achievable task with a better understanding of materials and diseases along with advances within the technology. Discolored teeth can often be corrected totally or partially by bleaching. Since bleaching is conservative, noninvasive, and inexpensive, it is the most opted treatment protocol by the masses. To achieve instant whitening with no risks and relapse, there have been developments of innovative technologies and promising products. This article aims to keep in pace with these newer trends and to provide an insight on the present day clinical challenges of vital tooth bleaching.
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CASE REPORTS
Platelet-rich fibrin-reinforced periosteal pedicle graft with vestibular incision subperiosteal tunnel access technique for the coverage of exposed root surface
Awadhesh Kumar Singh, Abhisek Gautam
January-April 2016, 6(1):33-38
DOI:10.4103/2229-5194.188167  
Platelet-rich fibrin (PRF) has been shown to promote soft tissue healing because it contains growth factors. Periosteal pedicle graft (PPG) provides not only good and predictable root coverage, but also reduces the need for the second surgical site. Access to the surgical site is obtained by minimally invasive technique known as vestibular incision subperiosteal tunnel access (VISTA) technique. Therefore, the purpose of this case report was to evaluate the PRF-reinforced PPG with VISTA technique for the coverage of exposed root surface. A patient with Miller Class II gingival recession of 6.5 mm was treated by PRF-reinforced PPG with VISTA technique. PRF was prepared from whole blood and applied to the root surface. After 6 months, 5.5 mm, that is, 84.6% of the root coverage was obtained. PRF-reinforced PPG with VISTA technique can be predictably used for the achievement of successful root coverage. The long-term follow-up with histologic studies will be required to obtained more information about PRF-reinforced PPG with VISTA technique for the coverage of exposed root surface. Clinical Relevance to Interdisciplinary Dentistry PRF is a fibrin matrix network in which platelets are trapped. Platelets in PRF release high amount of growth factors which take part in soft tissue and hard tissue repair and regeneration. As PRF-reinforced PPG and VISTA technique for coverage of exposed root surface showing good promising results, PRF can be used in various aspects/disciplines of the dentistry as well as in interdisciplinary dentistry to reinforced natural tissue regeneration (NTR) and natural bone regeneration (NBR).
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Occlusal rehabilitation of a geriatric patient with multiple failed fixed prostheses: A clinical report
Ravindra S Pawar, Rahul Shyamrao Kulkarni
January-April 2016, 6(1):39-43
DOI:10.4103/2229-5194.188170  
Commonly observed complications or clinical failures related to fixed dental prostheses (FDPs) include inferior esthetics, loss of retention, loss of tooth vitality due to secondary caries, periodontal disease, tooth fracture, and prosthesis fracture. While treatment of such complications is usually more demanding for the operator, psychological reassurance to the patient is an integral and often the foremost part of the retreatment procedure. This clinical report describes occlusal rehabilitation of a geriatric patient presented with multiple failed FDPs. Endodontic retreatment of abutments and meticulously designed ceramometal FDPs resulted in alleviation of dental pain, improvement in esthetics, gingival health, and enhanced masticatory efficiency while no complaints were reported during 1-year follow-up period. Clinical Relevance to Interdisciplinary Dentistry Complete mouth rehabilitation of a patient with previously failed prostheses often requires an interdisciplinary approach. In this patient, functional, esthetic, biological and restorative goals were defined before starting the treatment. Careful intraoral examination and radiographic analysis, occlusal analysis by mounting diagnostic casts on semi adjustable articulator, patient counselling to understand their expectations from treatment, and diagnostic wax up procedures, to determine approximate protocol of the treatment were performed. Satisfactory gingival health, esthetics, and function were reported at end of treatment and subsequent recall visits.
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Prosthodontic rehabilitation of a pediatric patient affected with anhidrotic ectodermal dysplasia: A rare case report
Vineet I.S. Khinda, Paramjit Khinda, Gurlal Singh Brar, Arun Yadav
January-April 2016, 6(1):25-28
DOI:10.4103/2229-5194.188162  
Ectodermal dysplasia (ED) is a hereditary disease characterized by congenital dysplasia of one or more ectodermal structures and other accessory appendages. The oral manifestations are anodontia and poor bony foundation which impairs both esthetic as well as masticatory function. The prosthodontic management of patients with such dysplastic condition necessitates a multidisciplinary approach. The strong, flexible nature of flexible denture material is perfectly suited to the variety of natural conditions in the mouth, simplifying design and enabling the flexible nylon resin to act as a built-in stress-breaker that provides superior function and stress distribution. Flexible partial dentures certainly offer advantages over conventional partials by way of superior esthetics, better function, durable material, and longevity of the prosthesis. This case report describes the prosthodontic oral rehabilitation of a 14-year-old female pediatric patient with anhidrotic ED using resin flexible prosthesis (Valplast). Clinical Relevance to Interdisciplinary Dentistry
  • A multidisciplinary approach comprising restorative, prosthetic, and periodontal treatment was done to achieve a satisfactory result. The treatment led to significant improvements in appearance, speech, and masticatory function
  • The focus is on the interdisciplinary management of a patient with complex restorative needs
  • An integrated approach that addresses both skeletal and dental issues can provide superior results. In this case, restorative goals guided the overall treatment plan, requiring the integration of restorative services at several stages of care, which involved a team of pedodontist, prosthodontist, and periodontist
  • Although implants are the ideal choice for partial anodontia, this case was treated in a conservative and minimally invasive method. Eventually the patient was satisfied with the prosthesis as function was re-established and esthetics was not compromised. Long-term success depends on regular recall appointments and meticulous maintenance of oral and prosthetic hygiene.
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The undesirable outcomes of late-referral traumatized immature permanent teeth and root-end-closure with mineral trioxide aggregate apical plug technique
Hacer Aksel
January-April 2016, 6(1):29-32
DOI:10.4103/2229-5194.188164  
Dental traumatic injuries mostly occur in children and affect the anterior dental region. The immediate management of the injuries prevents the loss of dental and alveolar structures. The lack of natural apical constriction in immature permanent teeth due to the pulp necrosis is problematic to treat. Frequently, the apical plug technique is used to attain apical closure that provides the obturation of the root canals without extrusion of the obturation material. In this case report, the endodontic treatment was achieved using apical plug technique with mineral trioxide aggregate (MTA) while prosthetic crown retained with fiber-reinforced post was used to restore the traumatized crown fracture of maxillary incisors. This case report suggests that MTA is influential apical barrier and successively induce periapical healing. Clinical Relevance to Interdisciplinary Dentistry
  • This article is the case report of a young 17-year-old boy with immature permanent teeth and crown fracture
  • The treatment of necrotic traumatized permanent teeth using mineral trioxide aggregate apical plug technique on a short-time scale is successful to achieve apical seal and healing of apical periodontitis while motivating the patient to attend the treatment
  • The crown fracture requires the use of fiber post that is suitable material for immature permanent root canals.
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EDITORIAL
"Antibiotic Apocalypse:" A wakeup call for dental professionals
Ashita Uppoor
January-April 2016, 6(1):1-1
DOI:10.4103/2229-5194.188152  
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ORIGINAL ARTICLES
Perception of gingival bleeding and oral health practices in dental anxious and nonanxious Nigerian teachers
Clement Chinedu Azodo, Agnes O Umoh
January-April 2016, 6(1):14-18
DOI:10.4103/2229-5194.188156  
Introduction: The objective of this study was to examine the perception of gingival bleeding and oral health practices in dental anxious and nonanxious Nigerian primary school teachers. Materials and Methods: This cross-sectional was conducted among public primary school teachers in Benin City, Edo State, Nigeria. Self-administered questionnaire which elicited information on demography, dental anxiety, gingival bleeding, teeth cleaning, and dental attendance was the data collection tool. Dental anxiety was assessed using Modified Dental Anxiety Scale and participants with scores ≥19 and <19 were considered as dental anxious and nonanxious, respectively. Results: A total of 151 teachers participated in the study giving 83.9% retrieval rate. Of the 151 teachers studied, 29 of them reported dental anxiety giving 19.2% prevalence. Dental anxious participants erroneously considered gingival bleeding during teeth cleaning as the manifestation of dental caries and gingival recession more than the nonanxious participants. Dental anxious participants reported lower gingival bleeding preventive measures awareness and took more actions other than visiting the dentist for gingival bleeding than the nonanxious participants. Dental anxious participants reported more daily teeth cleaning for reasonable duration using a combination of chewing stick, toothbrush, and toothpaste than the nonanxious participants. Dental anxious participants reported more irregular dental attendance and fair/poor gingival health status than nonanxious participants. Conclusion: Data from this study revealed that dental anxious participants generally had better oral self-care practices, poorer gingival health, more irregular dental attendance, lower gingival bleeding preventive measures awareness, more erroneous belief, and took more improper steps for gingival bleeding management than the nonanxious participants. Clinical Relevance to Interdisciplinary Dentistry Dentists and periodontologists must take into consideration the effect of dental anxiety on oral self-care, dental attendance practices, and periodontal health to ensure holistic dental healthcare awareness, utilization, and delivery.
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A comparative evaluation of the microleakage of blood-contaminated mineral trioxide aggregate and Biodentine as root-end filling materials: An in vitro study
Lisha Alphonsa Mathew, Sandya Kini, Shashi Rashmi Acharya, Shobha Kamath, Nympha Deena Menezes, Sheetal Rao
January-April 2016, 6(1):19-24
DOI:10.4103/2229-5194.188159  
Context: Success of a periradicular surgery depends on the attainment of a fluid tight apical seal with a well-adapted root-end restoration. Since achieving a dry field is not always possible, the study design was aimed at evaluating the sealing ability of test materials in blood-contaminated field which is usually the clinical scenario. Aims: To evaluate and compare the microleakage of blood-contaminated mineral trioxide aggregate (MTA) and Biodentine as root-end filling materials. Settings and Design: After decoronating, forty recently extracted single-rooted teeth were selected. The canal was enlarged to size #50 using hand files and the rest of the canal was prepared to #80 file at 1 mm increments. The canal was copiously irrigated with 2.5% sodium hypochlorite, ethylenediaminetetraacetic acid, and normal saline between instrument changes. After root-end resection, 3 mm of root-end preparation was done. Subjects and Methods: The root-end filling materials were placed in the following manner. Group 1: Root-end cavity was filled with MTA, Group 2: Root-end cavity was filled with Biodentine, Group 3: Root-end cavity was filled with MTA with blood contamination, and Group 4: Root-end cavity was filled with Biodentine with blood contamination. All samples were incubated for 24 h at 37°C and 100% humidity, and the microleakage was evaluated using a glucose filtration model. Statistical Analysis Used: Statistical analysis was done using an SPSS version 17 software. Data were analyzed with repeated-measures ANOVA and post hoc Bonferroni test. Results: Mean values of microleakage of the different groups in day 1, 4, and 7 were recorded. It was seen that the leakage was increasing with days irrespective of the material and no significant difference in the rate of increase was observed between the different materials. It was also seen that the blood-contaminated samples showed less leakage than the corresponding dry samples except the blood-contaminated Biodentine which showed more leakage on the day 1. However, overall, marginal means indicate no significant difference in the microleakage between materials. Conclusions: The sealing ability of Biodentine showed comparable results with that of MTA in dry and blood-contaminated environments and hence Biodentine can be used as an alternative to MTA for root-end filling procedures in a blood-contaminated environment. Clinical Relevance to Interdisciplinary Dentistry
  • With the movement toward evidence-based dental healthcare, interdisciplinary approach has been gaining ground quickly. Of which, endodontics forms an integral part of interdisciplinary dentistry
  • Integrating biochemical analysis with endodontics forms basis to research and is the foundation for a successful dental outcome
  • Biodentine shows to be bioactive, which helps to restore the tooth and periradicular structures back to normal form and function.
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PRESIDENTS MESSAGE
President's Message
Manoj Varma
January-April 2016, 6(1):2-2
DOI:10.4103/2229-5194.188153  
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REVIEW ARTICLES
Periodontal biotype: Basics and clinical considerations
Rucha Shah, NK Sowmya, Raison Thomas, Dhoom Singh Mehta
January-April 2016, 6(1):44-49
DOI:10.4103/2229-5194.188172  
Gingival/periodontal biotype is now known to influence the indications and outcomes of various therapies routinely performed in a dental clinic. The delicate thin biotype is more susceptible to injury and responds in a different way clinically as compared to the sturdier thick biotype. Assessment, identification, and indicated treatment considerations are now becoming the key to achieve predictable results, good esthetics, and stability of soft tissue margins. This review describes the various classifications, methods of assessment and clinical considerations for both the thick and thin tissue biotypes. Clinical Relevance to Interdisciplinary Dentistry In the era of evidence-based interdisciplinary dentistry, none of the dental disciplines are mutually exclusive. The treatment plan, treatment response, and prognosis of dental procedures vary greatly between teeth with different biotypes. Hence, the knowledge and assessment of gingival/periodontal biotype has become an important routine in clinical decision-making.
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SHORT COMMUNICATION
Modified technique to retrofit the crown on fractured core
Pravinkumar G Patil, Kangjie Tay
January-April 2016, 6(1):50-53
DOI:10.4103/2229-5194.188173  
Post and core followed by crown is a common treatment option to restore the form, function, and esthetics of an endodontically treated tooth. Although uncommon, it is possible that patients may present with fractured core during the crown cementation appointment due to various reasons, including trauma and composite debonding. Depending on the extent and severity of the fracture, retrofitting the crown on a fractured core can be a preferred option. This technique describes the fabrication of vacuum-formed thermoplastic template adapted on an elastomeric putty index obtained from the inner aspect of the crown to build back the composite resin core in original shape. This technique is simple to perform, and the additional time and cost of preparing new crown can be avoided. Clinical Relevance to Interdisciplinary Dentistry This technique demonstrated the preparation of a vacuum-formed thermoplastic template adapted to the polyvinyl siloxane putty index obtained from the inner aspect of the crown. The technique facilitated chairside repair of the fractured core, thus the additional time and cost of preparing a new crown can be avoided. The effect of the temperature onto the flexible putty during the adaptation of the thermoforming sheet needs to be carefully evaluated.
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