Knowledge and awareness about temporomandibular disorder among dentists in India: Questionnaire study and review.

AIM: Temporomandibular disorders (TMD) comprise ailments involving the jaw joint (temporomandibular joint) and its associated anatomical structures. The complexity involved in TMD is primarily due to its broad spectrum of conditions, clinical signs and symptoms variability, and multifactorial etiology. Considering the above, the present study was performed to help understand the prevailing knowledge and awareness of TMD among Indian dentists in the context of the new specialty "orofacial pain". SETTINGS AND DESIGN: Questinnaire study and review. MATERIALS AND METHODS: The questionnaire was distributed using a web-based portal nationwide among Indian dentists. Dentists were invited to participate, clearly stating that the intent and purpose of the questionnaire was to record the existing knowledge and awareness concerning temporomandibular disorders among Indian dentists. The questionnaire was segregated into three sections: pathogenesis, diagnosis, and management of TMDs. The questions were recorded using a Likert three-point scale (1=agree; 2=disagree; 3=not aware). 310 dentists participated in the survey, among which 105 were general dentists (BDS [Bachelor of Dental Surgery] graduates), and 205 were dentists with specialist training (MDS [Masters of Dental Surgery] graduates). STATISTICAL ANALYSIS USED: The results obtained from the study participants was used to calculate the percentage and frequency, following which tabulations were made based on graduate type and clinical experience. The values obtained from all three sections were recorded, and the responses were analysed using Pearson's Chi-Square test with statistical significance kept at P < 0.05. RESULTS: Results of the study disclosed that only 58.1% of general dentists and 46.8% of specialists were confident in handling temporomandibular disorder patients. Splint therapy was the preferred treatment modality for general dentists, whereas dentists with specialist training preferred occlusal rehabilitation. CONCLUSION: The results of the current survey indicate that Indian dentists lack sufficient training in dental schools on all three sections and face difficulty diagnosing and treating TMDs.

Immediate and Delayed Effects of Diode Laser on Debonding of Ceramic Brackets: An in vitro Study.

AIM: The aim of the study is to evaluate the immediate and delayed effects of diode laser on debonding of ceramic brackets. MATERIALS AND METHODS: A total of 60 human extracted premolar teeth were randomly assigned to three different treatment groups. All teeth were bonded with adhesive precoated (APC) ceramic brackets (3M Unitek). A total of 20 teeth were debonded without lasing (group 1), 20 immediately after lasing (group 2), and 20 1 hour after lasing (group 3). For the lasing groups (groups 2 and 3), access cavity was prepared on the occlusal surface to a 2 mm diameter. A transbond plus self-etching primer (3M Unitek, Monrovia, CA, USA) and APC PLUS clarity advanced brackets (3M, Unitek, Monrovia, CA, USA) were used. The shear bond strength (SBS) and adhesive remnant index (ARI) were measured. The internal pulpal wall temperature was noted for the laser groups. RESULTS: The mean SBS was 15.4, 11.57, and 11.79 MPa for groups 1 to 3 respectively. Post hoc test showed significant difference (p < 0.001) between the control group and the lased groups. For groups 2 and 3, the rise in temperature was at an average of 1.4 and 1.3°C respectively. CONCLUSION: The SBS of APC brackets decreased by 33.3% on application of diode laser without increasing the internal pulp chamber wall temperature significantly. Shear bond strength remains more or less the same whether debonding is done immediately after lasing or 1 hour after lasing. Diode lasers increased the ARI scores and thus decreased the risk of enamel fracture.

An Accurate Methodology to detect Leaching of Nickel and Chromium Ions in the Initial Phase of Orthodontic Treatment: An in vivo Study.

AIM: The aim of this study was to evaluate the release of nickel and chromium ions in human saliva during fixed orthodontic therapy. MATERIALS AND METHODS: Ten patients with Angle's Class-I malocclusion with bimaxillary protrusion without any metal restorations or crowns and with all the permanent teeth were selected. Five male patients and five female patients in the age group range of 14 to 23 years were scheduled for orthodontic treatment with first premolar extraction. Saliva samples were collected in three stages: sample 1, before orthodontic treatment; sample 2, after 10 days of bonding sample; and sample 3, after 1 month of bonding. The samples were analyzed for the following metals nickel and chromium using inductively coupled plasma optical emission spectrometry (ICP-OES). RESULTS: The levels of nickel and chromium were statistically significant, while nickel showed a gradual increase in the first 10 days and a decline thereafter. Chromium showed a gradual increase and was statistically significant on the 30th day. CONCLUSION: There was greatest release of ions during the first 10 days and a gradual decline thereafter. Control group had traces of nickel and chromium. While comparing levels of nickel in saliva, there was a significant rise from baseline to 10th and 30th-day sample, which was statistically significant. While comparing 10th day to that of 30th day, there was no statistical significance. The levels of chromium ion in the saliva were more in 30th day, and when comparing 10th-day sample with 30th day, there was statistical significance. CLINICAL SIGNIFICANCE: Nickel and chromium levels were well within the permissible levels. However, some hypersensitive individuals may be allergic to this minimal permissible level.

Stabilising springs for fixed lingual retainer.

Most treated malocclusion needs fixed lingual retention. To stabilise fixed lingual retainer in the exact location needs proper stabilisation. Proper stabilization requires a holding spring. This Stabilising Spring should be easy to fabricate and help the clinician to stabilise the retainer quickly and save the chair side time. More over it should not irritate the mucosa and should be easy to insert and remove.