Validity of the vertical tube-shift method in determining the relationship between the mandibular third molar roots and the inferior alveolar nerve canal.

OBJECTIVES: To assess the validity of the vertical tube-shift method using intraoral periapical radiography (IOPAR) for determining the relationship between the mandibular third molar roots and the inferior alveolar nerve (IAN) canal in comparison with cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Fifty impacted mandibular third molars were analyzed using the IOPAR vertical tube-shift method and CBCT. The relationship of the IAN canal to the impacted mandibular third molar was recorded as buccal, lingual or in line with the apex and was compared with CBCT findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the vertical tube-shift method in depicting the relationship (buccal/lingual/in line with the apex) of the IAN canal to the third molar root apex was calculated. RESULTS: The sensitivity and specificity PPV and NPV of the IOPAR vertical tube-shift technique was found to be highest for a lingual relationship (100%) followed by buccal (94.4%, 92.3%, 97.1%, and 85.7%) and in line with the apex relationship (88.9%, 95.0%, 80.0%, and 97.4%) of the IAN canal with the third molar root apex, respectively. A statistically significant association was observed between the IOPAR vertical tube-shift method and the CBCT with a P-value <0.01. CONCLUSION: The vertical tube-shift method can be used as an effective diagnostic tool in assessing the relationship of the IAN canal to the third molar root apex with high sensitivity, specificity, PPV, and NPV.

Rheumatoid arthritis affecting temporomandibular joint.

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

Aloe vera as cure for lichen planus.

Oral lichen planus is a difficult condition to treat because of its chronic nature. Various treatment modalities have resulted in partial regression of symptoms but not a complete cure. Aloe vera, a product with minimal adverse effects, can be tried to treat this disorder. A 38-year-old male patient diagnosed with lichen planus of the skin and the oral mucosa was suffering from severe pain and a burning sensation intraorally and pruritus of the skin lesions. Considering the extensive involvement, an herbal alternative was considered. The patient was prescribed aloe vera juice and gel application for two months. At the nine-month follow-up, the patient was symptom-free and totally cured of the intraoral and skin lesions.

Seating load parameters impact on dental ceramic reinforcement conferred by cementation with resin-cements.

OBJECTIVES: Cementation of all-ceramic restorations with resin-cements has been demonstrated to reduce the incidence of fracture in service. The aim was to investigate the influence of loading force and loading duration applied during cementation on the reinforcement conferred by a resin-cement on a leucite reinforced glass-ceramic. METHODS: 210 glass-ceramic discs (12 mm diameter, 0.8 mm thickness) were allocated to seven groups (n=30). The bi-axial flexure strength (BFS) was determined for 'as-fired' specimens (group A), following HF-acid etching (group B) and following etching and centrally loading on a semi-compliant substrate with 30 N for 300 s (group C). Further etched specimens were coated with Rely-X Unicem resin-cement under cementation loading of 5 or 30 N, for 60 or 300 s (groups D-F) prior to BFS determination using multilayered analytical solutions. BFS data was compared using factorial or one-way analyses of variance and the Weibull analysis. RESULTS: HF-acid etching of the 'as-fired' surface resulted in a significant reduction in mean BFS (P<0.001) whereas resin-cementation subsequently conferred significant strengthening (P<0.001) ranging from 24 to 38% and dependent on the loading parameters employed. A factorial significance (P=0.004) of seating load (5 or 30 N) and significant factorial interaction (P<0.001) of seating load and load duration (60 or 300 s) on the mean BFS were identified. SIGNIFICANCE: The magnitude of resin-reinforcement conferred was sensitive to the loading parameters investigated although the mechanisms underlying the variation appear complex. Similar patterns of variability can be expected clinically impacting on the clinical longevity of resin-cemented glass-ceramic restorations.