Customization of attachments in tooth supported overdentures: Three clinical reports

In elderly patients with few remaining teeth, overdenture is a good treatment option. Roots beneath the denture protect the alveolar ridge, offer proprioception and improve retention, stability and masticatory efficiency of dentures. Customization of attachments available is a viable alternative for some patients in which prefabricated attachments cannot be placed or in which cost is a factor; to improve the final outcome of the treatment. Due to competitive commercialization, implant treatment has become the norm in current dentistry and the concept of tooth supported overdentures has eclipsed, but with proper case selection, thorough treatment planning and modifications in the denture such as customization of attachments, amalgam stops, cross-linked teeth, and metallic mesh can be applied to prolong the longevity and success of the attachment overdenture prosthesis.

Telescopic overdenture for oral rehabilitation of partially edentulous patient

A case report describing the rehabilitation of a patient presenting with partially edentulous arches and compromised abutment teeth has been described. The aim of this study was to restore function and esthetics and uplift the psychological status of the patient by fabrication of a fixed removable prosthesis using the existing abutment teeth as telescopic overdenture.

Profiling of Pro-Inflammatory Cytokines in Radiation Induced Oral Mucositis (RIOM) among Indian patients

Radiation-induced oral mucositis (RIOM) is aimed at evaluating the expression of NF-κß, IL-1α, IL-6, IL-8 and TNF-α in patients with RIOM so as to validate their role in the pathobiology of the disease. Blood samples were collected and serum of 45 patients isolated with clinical signs and symptoms of mucositis and 10 healthy controls were also included in the study. The expression level of NF-κß, IL-1α, IL-6, IL-8, TNF-α was investigated using ELISA. Mann Whitney U test was applied to find the significance of the expression of these markers in RIOM patients as compared to normal healthy controls and significant expression (P< 0.05) for NF-κß, IL-6, TNF-α and non-significant expression (P > 0.05) IL-1α and IL-8 was found. No significant change in the expression level of the cytokines was observed for patients undergoing chemotherapy and radiation therapy as well as those receiving only the radiation therapy as a part of their treatment. We have also found less expression in grade 1 of mucositis as compared to grade 4. Pro- inflammatory cytokines indeed play a vital role in the pathogenesis as well as progression of RIOM (AU)

Validation of ICMR index for identification of dental fluorosis in epidemiological studies.

Background & objectives: The Indian Council of Medical Research (ICMR) formulated a Task Force on dental fluorosis and recommended the subgroup to develop a simplified index for identification and grading of dental fluorosis to be used by the health workers. This study was conducted to pre-test the ‘ICMR Index for Dental Fluorosis’ in the field to check its reliability and reproducibility. Methods: A total of 600 photographs were taken, 150 in each grade of fluorosis by screening 14-17 yr school children from eight schools of Hisar (Haryana) and South west Delhi. Eighty photographs were finalized (20 in each grade) before calibration to be used for training of field workers. Calibration exercise was conducted involving the five member survey team on 100 diagnosed cases of dental fluorosis. The members again screened 74 children with dental fluorosis in the field to categorize in to different grades of fluorosis for assessment of inter-examiner reliability. Results: The ICMR criteria showed more difference in agreement in very mild and mild categories during calibration. The inter-examiner reliability (κ) ranged from 0.59-1. The criteria was further modified and inter- examiner reliability (κ) found to be 0.83-0.98 which was almost perfect agreement. Interpretation & conclusions: The tool developed by the ICMR to assess dental fluorosis can be used in a field set up by non-dental personnel reliably with high degree of reproducibility.

In‑office technique to fabricate triple tray.

Dual arch impressions have been in use for many years. Five in‑office techniques for fabrication of the tray have been suggested, in case the manufactured (stock) tray is not available to the clinician. The design consists of two parts of the tray (the plastic frame and lattice). Five types of materials for the lattice have been described. The indications, advantages, and disadvantages of the techniques together with an appraisal of the five different lattice materials have been described. Overall the techniques are simple and require materials that are easily available. It does not take much time and can be used to attain efficient results in case the stock tray is not available in the operatory.

Fracture management of an edentulous mandible in a geriatric osteoporotic patient.

Fracture of an edentulous mandible is a difficult task primarily due to the absence of teeth. The management becomes even more difficult if the patient is geriatric and osteoporotic. A simple technique of using bite block splint, maxillomandibular fixation screws, and intermaxillary fixation has been presented to enable healing of fracture of mandible in such cases. The technique, which crosses the boundaries of conventional fracture management provides, promising results with minimum morbidity thus imparting optimum quality of life ahead for the patient.

Endodontic management of open apex using Biodentine as a novel apical matrix.

Aim: Endodontic management of open apex using Biodentine as an apical matrix. Summary: An immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontist. Endodontic treatment options for such teeth consist of conventional apexification procedure with and without apical barriers. Biodentine™ is new calcium silicate based cement that exhibits physical and chemical properties similar to those described for certain Portland cement derivatives. This article demonstrates the use of the newer material, Biodentine as an apical matrix barrier in root end apexification procedure. This case reports present apexification and successful healing with the use of Biodentine as an apical barrier matrix. Conclusion: Apexification in one step using an apical plug of Biodentine can be considered a predictable treatment and may be an alternative to mineral trioxide aggregate apexification.

An alternative adhesive based technique of raising the occlusal vertical dimension.

Purpose: Decimated dentitions may require raising the vertical dimension in some conditions while performing a full mouth rehabilitation treatment. Increase in a vertical dimension should be diagnosed by reversible methods prior to performing any irreversible methods for a minimum time period. Reversible methods like splints and overlay dentures are often used for this purpose. These methods however cannot be used in some conditions like in cases of brittle teeth. Method: An alternative technique based on adhesive technology has been described which is reversible and yet minimally traumatic to teeth. Conclusions: The technique has two basic aims. The first is to accurately implement the occlusal scheme as planned in the diagnostic wax‑up in the reversible method of altering the vertical dimension. The second aim is to increase the vertical dimension with minimal damage to the teeth.

Prevalence of dental caries and treatment needs amongst the school children of three educational zones of urban Delhi, India.

Context : Dental caries is the most common oral disease that affects significant number of Indian population. The prevalence of caries in India is reported 31.5% to 89%. Aims : T0 his study was aimed to estimate the prevalence of dental caries and treatment needs in school going children of Delhi. Materials and Methods : A0 school based cross-sectional study was conducted in various educational zones of Delhi. A total of 520 school children in age range of 9-12 years were examined using WHO (1997) criteria. Statistical Analysis Used : C0 hi-square test. Results : T0 he prevalence of dental caries was found to be 52.3% with mean deft and DMFT of 0.5038 ± 1.0859 and 0.8250 ± 1.3437, respectively. Besides various treatment needs 49.7% required restorative treatment. Conclusion : T0 he prevalence of dental caries in Delhi school children is high with D+d components comprising of more than 95%. This indicates lack of awareness and affordability to the dental facilities available. Therefore, there is a need to develop preventive and promotional oral health strategies to combat this infectious disease.

Treatment of oral submucous fibrosis with ErCr: YSGG laser.

Oral submucous fibrosis (OSMF) is one of the most poorly understood and unsatisfactorily treated diseases. Various medical and surgical treatments have been used but with limited benefits. However, with advent of lasers, oral surgeons are provided with new modality for treating OSMF. This case report highlights the pioneering effort in treating a moderate case of bilateral OSMF with Erbium Chromium Yttrium Scandium Gallium Garnet (ErCr:YSGG) laser showing promising result during follow-up.

A Clinical Study To Evaluate Tooth Contact Patterns And Correlation With Masticatory Efficiency in Dentulous Subjects.

A variety of functional tooth contact patterns exist in population of young adult patients.The purpose of the present study is to find the relationship between different lateral tooth contact patterns and dental morphology and their effect on masticatory efficiency. Forty young dentulous subjects were selected and their impression with irreversible hydrocolloid was made. Polyvinyl silicone bite registration paste was used to record lateral tooth contact patterns in functional range of mandibular movement. Overjet and overbite including mesiodistal relation of tooth recoded with cast secured in the intercuspal position and masticatory efficiency was determined by calorimetric method by using raw carrot. Among all subjects 15% having canine protection, 55% group function, and 30% balance occlusion. There is positive correlation between age and masticatory efficiency [r=+0.656, p<.01] and negative correlation between overjet and masticatory efficiency [r=-0.409, p<0.01]. In the present study Canine protection occlusion had significantly lower mean masticatory efficiency than group function and balanced occlusion group. This signifies that the masticatory efficiency is dependent on lateral tooth contact patterns.

Oral healthcare for elderly: identifying the needs and feasible strategies for service provision.

The aim of the present study was to assess the oral health practices, status and treatment needs of the rural elderly in national capital territory of Delhi. An effort was also made to identify patterns of utilization of dental services and test alternate strategies for service provision. A total of 96 elderly subjects (47 males and 49 females) in 5 rural areas were interviewed and clinically examined using Basic Oral Health Survey criteria of W.H.O. This was followed by a community trial in which the 5 villages were divided into control and test groups. Results of the survey found that both traditional as well as modern oral health practices co-exist in the rural community. Dental services were available to a majority (mostly through private sector), and edentulousness was a condition of primary concern among the elderly as a result of unmet treatment needs for dental caries and periodontal diseases. Age was a variable that was statistically significantly associated with edentulousness (p=0.005). Results of the community trial showed that higher utilization of care can be achieved by providing on-site dental care as compared to referring cases to tertiary care centers. Nevertheless provision of treatment alone is not a suitable policy recommendation since many elderly did not avail care even at on-site community dental health programmes that were operated free of cost. This emphasizes the need of health education over treatment in order to empower the elderly, especially the non-ambulatory patients, to practice prevention and develop favourable attitudes towards accepting prompt treatment at primary health care level.