Intentional replantation with 180° rotation of a complicated crown-root fracture: A Case Report.

Complicated crown root fractures are mostly difficult to treat and have a poor prognosis. To restore the biological space, intentional replantation may be chosen when other immediate treatment options are not viable. Intentional replantation with tooth rotation consists of extraction, 180° rotation and replantation, thereby maintaining the biological width. This article presents management of a maxillary central incisor with complicated crown root fracture with open apex. The tooth was rotated and splinted for one week. The apex was closed with mineral trioxide aggregate (MTA) followed by obturation and post placement. The incompletely obturated adjacent tooth was non-surgically managed by retreatment. Finally, glass fibre post followed by crown with indirect composite built up was made. Patient was followed up every three months for the next two years without any complications.

Levels of Mercury in Fish-Eating Children, With and Without Amalgam Restoration.

BACKGROUND: Mercury is a naturally occurring metal that exists in three forms: elemental (metallic), inorganic, and organic mercury. Amalgam, which is an alloy of inorganic mercury, is used as a restorative material in dentistry. Organic mercury gets ingested in the body mainly by the consumption of seafood. Mercury is also stated to cause various adverse health effects such as gastrointestinal disturbances, dermatitis, muscle weakness, and neurological disorders. In recent years, the use of amalgam has become a controversy stating the various adverse effects of mercury. Hence, the study was conducted to determine and compare the variation in levels of organic and inorganic mercury in fish-eating children before and after placement of amalgam restoration. MATERIALS AND METHODS: Seventy-five subjects, 42 males (56%) and 35 females (44%) of age group ranging 7-13 years, living in South Canara district of Karnataka, India, were selected as a part of the study. Hair and urine samples were collected for estimation of organic and inorganic levels of mercury, respectively. Informed consent was collected from all the participating subjects. RESULTS: On comparison between organic and inorganic mercury levels during the study period, the concentration of organic mercury in hair samples was greater irrespective of amalgam restorations present (1.172 and 0.085, respectively; P < 0.001). CONCLUSION: Thus inorganic levels of mercury do not seem to pose a threat as much as the organic levels observed in hair, which remain fairly constant for a longer period of time. Hence in a coastal region where this study was undertaken and fish being a staple food, the risk could probably be attributed to more of an organic toxicity than an inorganic one. Thus amalgam is relatively safe to be practiced and the controversy against it should be reevaluated.

Comparative Evaluation of Erosive Potential of Various Frozen and Unfrozen Fruit Juices on Primary Teeth Enamel: An In Vitro Study.

BACKGROUND: Changing lifestyle pattern and food habits has a deteriorating effect on dental tissues. Dental erosion is a pathological wear of hard tissues of teeth with increased consumption of acidic and carbonated drinks. Susceptibility to erosion in primary dentition is more compared to permanent dentition due to softer and disordered crystal structure of enamel. OBJECTIVES: The main aim of the study was to determine and compare the erosive potential of different fruit juices in frozen/unfrozen forms on primary teeth by studying the calcium dissolution. MATERIALS AND METHODS: pH of four different juices (pure) - apple, orange, citrus limetta (musumbi) and grapes were determined using a digital pH meter. The titratable acidity of these in frozen and unfrozen forms were determined by adding 0.2 ml of 1M NaOH to these to raise to pH=5.5(critical pH) and pH =7(neutral pH). Forty eight caries free deciduous anterior teeth specimens were prepared to study the calcium dissolution by atomic absorption spectrophotometer. The results were analysed for statistical significance using One-way Repeated Measures ANOVA and pair wise multiple comparison with Bonferroni correction. RESULTS: Total titratable acidity and calcium dissolution were found to be significantly more in the initial thawed fruit juices. CONCLUSION: Frozen fruit juices had more buffering capacity and erosive potential than unfrozen forms. The study concluded that sucking on frozen fruit juices is more damaging to teeth than unfrozen forms because more of erosion is expected to occur in a frozen state.

Endodontic Management of a Severely Dilacerated Mandibular Third Molar: Case Report and Clinical Considerations.

This article aims at providing an insight to the clinical modifications required for the endodontic management of severely dilacerated mandibular third molar. A 35-year-old patient was referred for the root canal treatment of the mandibular left third molar. An intraoral periapical radiograph revealed a severe curvature in both the canals. A wide trapezoidal access was prepared following the use of intermediate-sized files for apical preparation. Owing to increased flexibility, Hero Shaper NITI files were used for the biomechanical preparation and single cone obturation was carried out. Third molars owing to their most posterior location-limited access coupled with a severe curvature pose utmost clinical challenges require meticulous skill, advanced technology, and patience to achieve success.

Detection of Adherence of Enterococcus faecalis in Infected Dentin of Extracted Human Teeth Using Confocal Laser Scanning Microscope: An In vitro Study.

AIM: The aim of this study is to detect in vitro adherence of Enterococcus faecalis to the infected dentinal tubules of human extracted teeth using confocal laser scanning microscope. SUBJECTS AND METHODS: Roots from human premolar teeth (n = 40) were infected with E. faecalis strain the American Type Culture Collection 29212 in brain heart infusion for 21 days. After the experimental period, specimens were divided into two groups, Group A (n = 20), Group B (n = 20), and Group A specimens were stained with fluorescein diacetate dye for the detection of viability and adherence Group B were stained with acridine orange dye for detection of metabolic activity and adherence. Samples were washed, thoroughly sectioned and examined by confocal laser scanning microscopy. Computer-assisted determinants of fluorescence, bacterial viability, metabolic activity, and adherence were compared statistically. RESULTS: E. faecalis was able to invade the dentinal tubules to a depth of 1-400 µm and adhere to 1-200 µm depth. Adherence (90%) was significantly higher in 1-100 µm using fluorescein diacetate and acridine orange dye. CONCLUSION: Adherence of E. faecalis as evaluated by confocal laser scanning microscope was highest at the depth of 1-100 µm which may have an impact on the shaping and cleaning procedures on the root canal.

Ameloblastic Fibroodontoma: Uncommon Case Presentation in a 6-Year-Old Child with Review of the Literature.

Ameloblastic fibroodontoma is a benign mixed odontogenic neoplasm considered in patients with asymptomatic swelling and unerupted teeth that exhibit histologic features between ameloblastic fibroma and complex odontoma. Radiographically, this lesion appears as radiolucency admixed with focal radio opaque masses of irregular shapes and sizes. This lesion is confirmed by the presence of proliferating odontogenic epithelium, ectomesenchyme, and dental hard tissue formation on pathological analysis supplementing clinical and radiographic findings. As this tumour is less commonly seen in routine clinical practice, ameloblastic fibroodontoma with detailed orofacial features and periodic approach to its diagnosis is discussed. This paper reports a case of ameloblastic fibroodontoma of the mandible in a 6-year-old male patient with an uncommon case presentation and review of the literature.

"Ormocer an innovative technology": A replacement for conventional cements and veneer? A comparative in vitro analysis.

OBJECTIVE: This in vitro study was designed to assess shear bond strength (SBS) of ormocer flowable (OF) resin as a luting agent, ormocer as an indirect veneer material with portrayal of modes of failures using scanning electron microscope (SEM). MATERIALS AND METHODS: Sixty maxillary central incisors were divided into Group I, II, and III with 20 samples each based on luting cement used. They were OF, self-adhesive (SA) cement, and total etch (TE) cement. These groups were subdivided into "a" and "b" of ten each based on the type of veneering materials used. Veneer discs were fabricated using Ormocer restorative (O) and pressable ceramic (C). Specimens were thermocycled and loaded under universal testing machine for SBS. The statistical analysis was done using one-way ANOVA post hoc Tukey honest significant difference method. RESULTS: A significant difference was observed between the Groups I and II (P < 0.05). The highest mean bond strength when using ormocer veneer was obtained with the Group Ia (19.11 ± 1.92 Mpa) and lowest by Group IIa (8.1 ± 1.04 Mpa), whereas the highest mean bond strength while using ceramic veneer was of similar range for Group Ib (18.04 ± 4.08 Mpa) and Group IIIb (18.07 ± 1.40 Mpa). SEM analysis revealed OF and TE presented mixed type of failure when compared with SA where failure mode was totally adhesive. CONCLUSION: OF was found equally efficient like TE. Bond strength of ormocer as a veneer was not inferior to ceramic making it one of the promising additions in the field of dentistry.

Unusual Presentation of Primary Squamous Cell Carcinoma of Mandible.

Carcinoma arising primarily from the jaw is a locally aggressive lesion with poor prognosis. Primary intraosseous carcinoma (PIOC) lesion develops either de novo remnants of odontogenic epithelium, odontogenic cyst/tumor, epithelium remnants, or/and salivary gland residues. We describe very interesting case of primary intraosseous carcinoma of mandible. This extensive lesion was sent for oncological opinion and further management. Due to the uncertainty of diagnostic criteria of PIOC, only few cases of this lesion with a typical presentation have been reported. This article presents a case of primary intraosseous carcinoma with a unique appearance and detailed review stating its clinicopathological correlation.