Comparative Evaluation of Different Alveolar Ridge Width Measurement Techniques in Dental Implant Treatment Planning: An in Vivo Observational Non-Interventional Study.

In todays era dental implant has become the dependable therapeutic treatment for the replacement of missing teeth. The success of dental implants depends not only on osteointegration of the implant but also on the surrounding hard and soft tissue. Presurgical evaluation of alveolar ridge width and height is of paramount important for implant placement. There are several methods to evaluate the alveolar ridge width and height such as ridge mapping and CBCT. This study included 30 sites from 8 patients in the age ranging from 30 to 65 years. A stent was prepared and the width of the alveolar ridge was estimated employing the following techniques: Group I: Measurement of alveolar ridge width on cone-beam computed tomography (CBCT) method, group II: Measurement of alveolar ridge width by ridge mapping technique, group III: Measurement of alveolar ridge width by surgical exposure. The minimum value for ridge mapping with caliper is 2 and maximum value is 9 with mean 4.5667 ± 1.63335 with standard error 0.29821. The minimum value for Cone beam computed tomography (CBCT) is 1.80 and maximum value is 9.30 with mean 4.6233 ± 1.67119 with standard error 0.30512. The minimum value for direct intrasurgical measurement with caliper is 2 and maximum value is 9 with mean 4.2000 ± 1.58441 with standard error 0.28927. Cone beam computed tomography could also be used to measure the ridge width accurately. Apart from measurement of alveolar ridge dimensions it had multiple other uses and thus can be advised as per requirement of the clinician.

Role of Prophylactic Dose of Oral Amoxicillin Trihydrate in Prevention of Bacteremia Post Surgical Removal of Impacted Mandibular Third Molar: A Clinical Study.

The current study is designed to evaluate the efficacy of pre-operative prophylactic antibiotic for prevention of bacteremia after surgical removal of impacted mandibular third molar SRIMTM. The study was carried out as an open clinical trial. Fifty patients who fulfilled the criteria were included. Twenty five randomly selected patients (study group) were administered two grams oral dose of amoxicillin trihydrate, one hour prior to the procedure. Twenty five patients (control group) were not administered any antibiotic prior to the procedure. All patients underwent surgical removal of impacted mandibular third molar through intraoral approach under local anesthesia. Blood culture for detection of aerobic and anaerobic micro-organisms was done for all 50 patients. Eleven out of the twenty five patients (44%) in the control group showed positive growth, including mixed growth (aerobic and anaerobic). Seven patients showed purely anaerobic, 2 patients purely aerobic and two mixed growth. In the study (antibiotic) group, 7 out of the 25 patients (28%) showed positive growth, including mixed growth. Three patients showed purely anaerobic, 2 patients purely aerobic and 2 mixed type of growth. The study suggests that the judicious use of antibiotic prophylaxis, in conjunction with optimal oral health care serves to minimize the adverse effects of antibiotic therapy; and at the same time reduce the significant morbidity and mortality associated with systemic infections that might occur due to bacteremia resulting from surgical procedures of the oral cavity.

A clinical tip for conservative retrieval of fractured abutment screw.

Fractures of the abutment screw are an extremely dreadful and taxing experience even for experienced clinicians. Retrieval of fractured screw segments due to excessive torque and improperly placed implants pose a great challenge to the clinician. The authors present a case wherein the fractured abutment screw was retrieved successfully with the help of an intraoral plastic mixing tip of light body putty material. The intraoral plastic mixing tips are a more readily available, cost-effective, and feasible alternative to other means of screw retrieval like ultrasonic scalers, endodontic files, and screw retrieval kits.

Distraction Osteogenesis as a reliable method in management of Obstructive Sleep Apnoea (OSA) secondary to TMJ Ankylosis: A Case Report.

Obstructive sleep apnoea (OSA) is identified as repetitive and intermittent upper airway collapse or narrowing during sleep. Skeletal advancement through maxillomandibular surgery remains the most effective surgical treatment for OSA but is radical with certain relapse rate. Distraction Osteogenesis of mandible is a single-jaw surgical treatment alternative to bi-jaw surgeries having lesser complications. This case report describes successful management of a 46-year-old patient who reported with a chief complain of obstruction in breathing while sleeping since one year. Obstructive Sleep Apnoea (OSA) secondary to a retrognathic mandible was the final diagnosis, which was successfully treated by Distraction Osteogenesis (DO) of the mandible. The case showed enhancement in airway by 13mm and marked forward movement of Point-B (SNB increased by 6 degrees). The Epworth Sleepiness Scale value decreased from 19mm to 8 mm indicating substantial increase in the airway with stable results after 18 months of follow-up (elimination of symptoms and subsequent sound sleep). Distraction osteogenesis is an effective and reliable method to treat obstructive sleep apnoea secondary to retrognathic mandible.

Mucormycosis and Aspergillosis Infection Following Maxillofacial Trauma: Case Report.

An invasive fungal infection caused by saprophytic and aerobic fungi Rhizopus, Rhizomucor, and Cunninghamella genera of the family Mucoraceae is known as Mucormycosis. Typically, Mucormycosis manifests in patients with conditions like uncontrolled diabetes, renal failure, patients receiving chemotherapy, long term steroid therapy or patients who are immunocompromised such as Acquired Immuno Deficiency Syndrome. The authors report a case of mixed opportunistic fungal infection of Mucormycosis and Aspergillosis following maxillofacial trauma that was treated by both medical and surgical line of management.

Liver Clot - The Catch Behind the Complication - A Case Report.

Rationale: Complications arising from the extraction of an over-retained deciduous tooth root are an extremely rare event in a dental office, just like liver clots post-extraction of teeth. Patient Concern: The patient reported to the department on the third post-operative day following extraction of a deciduous root stump, complaining of swelling with respect to the extraction site and inability to open his mouth completely. Diagnosis: An unusual presentation of a 'currant blood clot' also commonly known as 'liver clot' was noted in the extraction site. Treatment: An excisional biopsy of the mass was done under local anaesthesia and the sample was sent for histopathological analysis. Suspecting an underlying haematological condition, the patient was further referred to the Department of General Medicine at the institute for opinion and further investigations. Outcome: The blood investigations and subsequent peripheral blood smear analysis and bone marrow aspirate biopsy confirmed that the patient was a case of undiagnosed chronic myeloid leukaemia in the chronic phase. Take-away Lessons: Proper knowledge of possible complications and the reasons behind the same can prove beneficial for the overall health of the patient.

Patient-Specific Implants in Maxillofacial Reconstruction - A Case Report.

Rationale: The successful utilisation of three dimensional (3D) techniques in engineering a titanium patient specific implant (PSI) for a patient who underwent hemimaxillectomy following post COVID mucormycosis infection. Patient Concerns: Issues related to problems associated with resection following mucormycosis, such as occlusal function, aesthetics and facial asymmetry. Diagnosis: The patient affected by mucormycosis was left with Aramany class 1 and Cordeiro type II sub total maxillectomy defect. Treatment: The patient was operated for mucormycosis followed by reconstruction with patient specific implant. Outcome: Positive clinical outcomes, including improved facial symmetry, function and psychological well being with immediate replacement of the teeth, the benefits of which far outweigh the traditional approach. Take away Lessons: The advances in the use of PSI by integration of 3D printing and computer aided design computer aided manufacturing (CAD-CAM) technology for extensive and challenging defects in the maxillofacial region have been highlighted in this case report.

Effect of Local Anaesthesia with and without Adrenaline on Blood Glucose Concentration in Patients Undergoing Tooth Extractions - A Comparative Study.

Introduction: Local anaesthesia (LA) is the usual drug used in dentistry to reduce intraoperative pain. The efficacy of lignocaine is improved by adding adrenaline as a vasoconstrictor. Adrenaline decreases the systemic absorption of LA and reduces blood loss during the surgical procedure. The study was conducted to observe the effect of adrenaline on blood glucose concentration in patients undergoing tooth extraction. Materials and Methods: The study was conducted on 100 patients needing multiple teeth extraction. On the first appointment, extraction was done using lignocaine without adrenaline (plain), and for the second appointment, extraction was done using lignocaine with adrenaline (1:200,000). Serial blood glucose estimations were carried out at identical intervals on both occasions. Results: Significant difference in blood glucose level was noted when the patients received lignocaine with adrenaline before administration and after 10 min/20 min intervals (P < 0.05). Discussion: Constant vigilance and prudence are recommended while using lignocaine with adrenaline in patients suffering from diabetes mellitus.