Evaluation of Effectiveness of Intracanal Medicaments on Viability of Stem Cells of Apical Papilla.

INTRODUCTION: Regeneration, in the field of endodontics, is the process of restoring and maintaining both architectural form and biological functions of damaged tooth. Presently, regenerative endodontics is not hypothetical and is an alternative to conventional apexification procedures. There is a deficient knowledge concerning the role of intracanal medicaments and their effect on dental stem cells. AIM: The aim of this study was to evaluate the effectiveness of commonly used intracanal medicaments on the viability of dental stem cells of the apical papilla (SCAPs). MATERIALS AND METHODS: SCAPs were cultured and subjected to various concentrations including triple antibiotic paste, double antibiotic paste, Augmentin, and calcium hydroxide (Ca(OH)2). Viable percentage of stem cell counts was obtained 3 days after treatment. RESULTS: All three antibiotics used hereby significantly decreased SCAP cell survival at particular concentrations, whereas Ca(OH)2 showed stimulating effect on SCAP survival. CONCLUSION: As per results obtained within limitations of this study, use of Ca(OH)2 in regenerative endodontics in comparison to different commonly used antimicrobial combinations is recommended. Hereby, for clinical use, we suggest adequate concentrations of antimicrobials with adequate antibacterial efficacy should be used.

Comparison of Immediate Implant Placement Following Extraction with and Without Socket-Shield Technique in Esthetic Region.

INTRODUCTION: Immediate implant with socket shield and immediate implant without socket shield are the two techniques which can be used to preserve the already thin labial bone in the esthetic region, thus eliminating the need for graft materials. AIM: To compare the efficacy of immediate implant placement after extraction without socket-shield technique and with socket-shield technique in the esthetic region. MATERIALS AND METHODS: Sixteen patients who reported with unsalvageable maxillary anterior teeth with labial bone thickness of less than 2 mm, depicted on preoperative CBCT, were chosen for the study and randomly assigned one of the two groups: Group A comprising socket-shield technique patients and Group B comprising immediate implant placement without socket shield. The labial bone thickness was analyzed along its entire length through CBCT scan at definite follow-up intervals up to a period of 12 months after the procedure. RESULTS: Follow-up of 1 year demonstrated a statistically significant reduction in the labial bone thickness at the crest in Group B after 8th and 12th months of implant placement. CONCLUSION: The two techniques need further comparison though our study results demonstrated better preservation of bone through the socket-shield technique, thus eliminating the need for any bony substitutes.

Study of Normal Anatomy of Mandibular Canal and its Variations in Indian Population Using CBCT.

INTRODUCTION: Identification of detailed anatomy of mandibular canal (MC) with its contents including the position, course, and morphology is extremely important for the management of various surgical procedures including dental implant placement, third molar surgery, dental anesthesia, mandibular osteotomy, bone-harvesting procedure from the ramus and body of mandible, bone plating in angle and body region of mandible, or any other surgical procedure involving the mandible. METHODS: This prospective randomized study was carried out in the Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, on 100 randomly selected cone-beam computed tomography (CBCT) mandibular views displaying the entire mandible. RESULTS: Various parameters of the canal were studied in detail and subjected to statistical analysis using SPSS 20 software. For all the observations, paired t test was applied to compare right and left sides and independent t test for the comparison of gender. CONCLUSION: For centuries MC has been a paramount topic of discussion, and with the contraption of CBCT, we can finally decipher the canal in great detail. CBCT acts as a guide to prevent damage to the neurovascular bundle as the canal traverses its course and sometimes with certain variations.

Eagle's syndrome mimicking dental pain: A case report with a novel surgical approach.

PAIN in the craniofacial and neck region can be both intriguing and equally frustrating for the surgeon. This is principally because there is a multitude of related pain syndromes in this region, many of which are lacking in physical signs. Diagnosis then becomes even more dependent on an accurate description of the pain in terms of character, localization, duration, radiation, relieving and exacerbating factors. Familiarity and identification of a more obscure causative factor in a particular case lends itself not only to liberate the patient but also an increased awareness of the practitioner for the need to consider the coinciding minute diagnostic points of otolaryngology, ophthalmology and rhinology besides dentistry and oral surgery. The characteristic elongation of a styloid process may explain some occasions of pharyngeal, ear pain and sometimes headache, which have defied exhaustive diagnostic studies. A large spectrum of signs and symptoms has been mentioned in various reports of Eagle's syndrome. Diagnosis can be made with careful clinical evaluation and confirmed with radiographs showing an elongated styloid process or calcification of the stylohyoid complex. Styloidectomy is the procedural choice for Eagle's syndrome having high success rate. In our case, the intraoral approach for styloidectomy was not the routine one, for which the post-operative outcome was exceptionally good without any complications.

To Evaluate the Efficiency of Dexmedetomidine in Atomized Intranasal form for Sedation in Minor Oral Surgical Procedures.

AIM: This study aims to evaluate the efficiency of dexmedetomidine in atomized intranasal form for sedation in minor oral surgical procedures. MATERIALS AND METHODS: A total 25 patients fitting the inclusion and exclusion criteria were selected from the outpatient Department of Oral and Maxillofacial Surgery, Saraswati Dental College and Hospital, Lucknow. The drug was administered intranasally half an hour before the surgical procedure. The volume of drug used was recorded. The readings of all the parameters of sedation began 30 min after the drug had been administered. Intranasal sedation status was assessed by Ramsay sedation score and observer's assessment of alertness/sedation scales, every 15 min throughout the procedure. RESULTS: The primary outcome variable in this study is depth of sedation produced by intranasally administered dexmedetomidine. Secondary variables included respiratory rate, blood pressure (BP), heart rate (HR), and oxygen saturation (SpO2). The statistical software used was SPSS 20.0 for Windows (SPSS, Chicago, IL, USA). Data were expressed as mean and standard deviation or number (percentages). Sedation and behavior scores were analyzed by proportions. Hemodynamic variables including HR, SpO2, and BP and respiratory rate were analyzed by repeated measures ANOVA. When a significant result was obtained, the Tukey test was applied for post hoc pairwise comparisons. P < 0.05 was considered as statistically significant. All the parameters were recorded at a set interval of time. CONCLUSION: In conclusion, intranasal administration of 1.5 mg/kg atomized dexmedetomidine was clinically effective, convenient, and safe for the sedation of patients undergoing minor oral surgical procedures.

Use of T.M.J. Disc as a Soft Tissue Interpositional Graft Material for Functional Rehabilitation of Ankylosed T.M. Joint.

INTRODUCTION: Many surgical techniques have been described for the treatment of TMJ ankylosis, but no strategy has been uniformly agreed upon underscoring the difficulty of the problem. Despite new guidelines and updated methods, treating patients with TMJ Ankylosis remains a challenge as the incidence of recurrence after treatment is soaring. This study exemplifies our experience in using an unsullied method to treat TMJ Ankylosis to restore the structure of TMJ in conjunction with convalescing secondary maxillofacial deformity. MATERIALS AND METHODS: A total of 56 cases of unilateral bony TMJ ankylosis were included in the study, and postoperative results of T.M.J disc as a soft tissue interposition graft was evaluated. The operative protocol comprised of (1) resection of ankylotic mass, (2) intraoral ipsilateral coronoidectomy or contralateral coronoidectomy when needed, (4) interpositioning disc as soft tissue graft, (5) interposing and fixing sternoclavicular or costocondral graft with lag screws and (6) early mobilization, aggressive physiotherapy. RESULTS: The study assessed patients with regular follow-up checks for a period of 3 years. The average preoperative mouth opening was found to be 5.46 mm (range 2-10 mm). Mean post-operative mouth opening was 33.05 mm (range 24-43 mm), while 3 years post operative mouth opening (mean) was 39.75 mm. No cases of reankylosis were reported during this period suggesting it as a viable and satisfactory approach. CONCLUSION: The use of TMJ disc as a soft tissue interpositional graft material is an effectual method for functional rehabilitation of ankylosis cases and serves as an effective means of preventing recurrence.

Keratoameloblastoma: Report of a rare variant with review of literature.

Ameloblastoma has intrigued clinicians as well as pathologists due to its diverse clinical behavior and histomorphologic presentations. Keratoameloblastoma is a rare histologic sub type, characterized by extensive keratin formation within ameloblastic epithelium, with only a handful number of cases described in the literature. Here, we report a case of this uncommon sub type of ameloblastoma in a young female patient presenting as an extensive lesion in mandibular ramus area. The radiological and fine needle aspiration findings suggested of a keratinizing cystic lesion and incisional biopsy showed features of ameloblastoma. Patient underwent segmental mandibulectomy and histological examination of excisional specimen revealed features of ameloblastoma with abundant keratinization leading to a diagnosis of keratoameloblastoma. The diagnostic pitfalls related with the lesion have been discussed along with a short review of the literature.