Cementum Malformations-Diagnostic Dilemma: Study in Western Maharashtra Population.

AIM: The present study was study to observe incidence of cemental malformations related to mandibular molar roots. MATERIALS AND METHODS: All cases requiring radiographs of mandibular molars reporting to author during 2011-2019 were included in this study. Mandibular molars had been observed for any radiographic malformations. Any such alterations were noted. RESULTS: Author has screened about 522 intraoral periapical radiographs in this study. A total of 63 cases of root malformations reported with two cases of cementoma were observed in this study. Both these cases were diagnosed as benign cementoblastoma (BC) on excisional biopsy. CONCLUSION: In this study, we have observed that incidence of cemental malformations is 1.2% and of BC is 0.38% as compared to overall incidence of 1%-6% in Western Maharashtra.

Assessment of Marginal Integrity and Color Stability of Provisional Restoration Fabricated from Different Autopolymerizing Acrylic Resins - A Comparative Study.

AIM: The present study is aimed to assess the marginal integrity and color stability of provisional restorations fabricated from different autopolymerizing acrylic resins. MATERIALS AND METHODS: Totally, 60 provisional crowns were fabricated. A mandibular first molar artificial typodont was mounted on a base of dental stone. The mandibular first molar which was mounted was prepared for full cast crown, using the tooth preparation standard principles with shoulder finish line of 1 mm and taper 6°. There were 20 samples in each acrylic resin group: Group I: Polyvinyl-ethyl methacrylate resin, Group II: Autopolymerizing bis-acrylic material, and Group III: Polymethyl methacrylate (PMMA) autopolymerizing resin. Crowns were verified for marginal adaptation using stereomicroscope at a ×40. The color stability was measured using spectrophotometer poststaining period. RESULTS: Autopolymerizing bis-acrylic material group showed minimum mean vertical marginal discrepancy (128.68 ± 18.036 µm) followed by PMMA autopolymerizing resin group (147.49 ± 20.128 µm) and polyvinyl-ethyl methacrylate resin group (172.89 ± 22.118 µm). Analysis of variance demonstrated a statistically significant difference between different autopolymerizing acrylic resins. The color change values did not show any significant difference between the groups on numerous comparisons between different autopolymerizing acrylic resin groups. A statistically significant difference was seen between Groups I and II, Groups I and III, and Groups II and III (P < 0.05). CONCLUSION: This study concluded that the autopolymerizing bis-acrylic material demonstrated significantly improved marginal integrity when compared to PMMA autopolymerizing resin and polyvinyl-ethyl methacrylate resin.

Efficacy of Murva (Sansevieria roxburghiana Schult. and Schult.f.) as a suture material in closure of incisions in third molar surgeries: A prospective study.

INTRODUCTION: Adequate closure of the surgical wound is one of the most important aspects of surgery; improper suturing techniques or improper suturing materials sometimes compromise the success of surgery. Many synthetic materials have replaced the natural materials, which were once used for suturing in the ancient era, and Murva is one of them. There are references of Murva (Sansevieria roxburghiana Schult. and Schult.f.) at various contexts of "Sushruta Samhita" where it has been used as a suture material. It is a xerophytic herbaceous plant occurring abundantly in the eastern coastal region of India. The aim of this study is to evaluate the efficacy of Murva fibers as a suturing material in closure of intraoral incision in third molar surgeries. MATERIALS AND METHODS: Fifty incisions (Wards incision) placed for the surgical removal of mandibular third molar were sutured with Murva, and follow-up was carried out postoperatively on 1st, 2nd, 3rd, and 7th day. Patients were evaluated for pain, swelling, bleeding, infection, wound dehiscence, local tissue irritation, and bacterial colonization. RESULTS: On various follow-ups, progressively significant and predictable healing was observed without any uneventful evidence. CONCLUSION: The use of Murva as a suture material proved to be effective in closure of intraoral incisions.

Identifying the risk factors causing iatrogenic mandibular fractures associated with exodontia: a systemic meta-analysis of 200 cases from 1953 to 2015.

PURPOSE: Iatrogenic fracture of mandible (IFM) associated with exodontia though rare, they do occur with an incidence ranging from 0.0034 to 0.0075 %. Most of the data is in the form of case reports or a small case series. This is an attempt to amass the data available in literature since the last 62 years. The purpose of this meta-analysis is to identify the etiologies and risk factors leading to IFM associated with exodontia and also the measures to minimize the complication. METHODS: Articles published between 1953 and 2015 were searched in Medline database. Data was collected and analyzed based on age, gender, extracted tooth, status of dentition, pathological bone lesion adjacent to the tooth, type of impaction, angulation of the impacted third molar, site of fracture, side of fracture, time of fracture, and treatment of fracture. RESULTS: A review identified 200 documented cases of IFM associated with the removal of teeth. The reasons for its occurrence found to be multifactorial with a higher incidence in the fifth decade of life with male prevalence. Risk factors more commonly identified were removal of the third molar, fully dentate patient, associated pathology, impacted tooth, angle region, left quadrant, and time interval of 3 weeks postoperatively. CONCLUSIONS: IFM related to the removal of teeth is a rare complication. Identifying and addressing the risk factors will enable the surgeon to avoid the complication of IFM associated with exodontia.

Noninvasive Technique for Estimating Blood Glucose Levels among Diabetic Patients.

AIM: The present study was aimed to assess the fasting and postprandial gingival crevicular blood (GCB) glucose and finger stick blood glucose measurements using a glucometer. MATERIALS AND METHODS: A total of 30 subjects with periodontitis and positive bleeding on probing were considered. Subjects were instructed to report to the department after overnight fasting. Gingival crevicular blood samples were collected from anterior region showing bleeding on probing followed by finger stick blood sample collection. Then, the patients were instructed to take 75 gm of glucose and after 2 hours blood samples from two sites were collected similarly. Results were analyzed using unpaired t test and Pearson's correlation. RESULTS: Mean glucose levels form GCB and finger stick blood did not differ either during fasting or postprandial (p > 0.05). Significant correlation was found between GCB glucose levels and capillary finger stick blood (CFB) glucose levels during fasting (r = 0.946, p < 0.001) and postprandial (r=0.930, p < 0.001) blood estimation. CONCLUSION: Periodontal probing can be considered as an alternate noninvasive method of blood glucose estimation for screening of diabetes mellitus (DM). The technique described is safe, easy to perform, and helps to increase the frequency of diabetes screening in dental office. CLINICAL SIGNIFICANCE: The GCB from probing can be a good source of blood for estimating blood glucose levels and screening for diabetes using portable glucose monitors. Also, it will be a simple and relatively inexpensive in office screening procedure for any patient suspected to have diabetes.

Efficacy of buccal fat pad in the surgical management of oral submucous fibrosis: a prospective study.

PURPOSE: Various surgical treatment modalities have been advocated in the surgical management of oral submucous fibrosis with variable results. This prospective study evaluates the efficacy of buccal fat pad in the surgical treatment of oral submucous fibrosis. PATIENTS AND METHOD: In the present study, 20 patients were treated for oral submucous fibrosis with interincisal mouth opening less than 16 mm. Surgical procedure included fibrotomy, all third molar extractions, and coronoidotomy or coronoidectomy followed by reconstruction of fibrotomy defect with buccal pad of fat. Postoperatively, patients were prescribed nutritional and antioxidant supplements along with vigorous mouth opening exercise for 6 months. Regular follow-up was carried out for 2 years. RESULTS: Excellent increase in the interincisal mouth opening was noticed relieving trismus. Patient's ability of masticate and tolerance to regular food was increased significantly. Buccal fat pad underwent rapid epithelization within a period of 5-7 weeks. CONCLUSION: Buccal fat pad can be used effectively in the surgical management of oral submucous fibrosis with good functional and esthetic outcome, with only drawback of supple lobulated fat, which requires delicate handling and its limitation to reach anteriorly beyond the canine region.

Efficacy of nasolabial flap in reconstruction of fibrotomy defect in surgical management of oral submucous fibrosis: a prospective study.

PURPOSE: Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. This prospective study evaluates the efficacy of nasolabial flap in the reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis in terms of functional and esthetic outcomes. MATERIAL AND METHOD: In this prospective study, we treated 20 patients of oral submucous fibrosis surgically. The surgical protocol was consisting of bilateral fibrotomy, temporal myotomy, and coronoidotomy or coronoidectomy followed by reconstruction of fibrotomy defect with bilateral extended nasolabial flaps. All patients were prescribed with nutritional supplements and antioxidants. Vigorous mouth opening exercise was made compulsory for every patient. Preoperative and postoperative evaluation was done for interincisal mouth opening, function of mastication, and cosmetic results. Patient's regular follow-up was done for 2 years. RESULTS: Postoperatively, we noted excellent increase in the interincisal mouth opening relieving trismus. Patient's ability to chew solid food was increased significantly. Extraoral scar was minimal and well accepted by all the patients. There was no morbidity of the donor site. There was no injury to the facial nerve in all cases. The only drawback was intraoral hair growth which went on reducing with mucosalization of the graft tissue. CONCLUSION: Random pattern nasolabial flap is a very good option for intraoral reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis with excellent functional and cosmetic results with minimal complications.