Open Access Case Report

Whale’s Tail Technique – A Novel Approach for Regeneration in Aesthetic Zone

Medha Sharma, B. S. Avinash, Rashmi Durga Kalyanam

Asian Journal of Dental Sciences, Page 24-28

The goal of present case report is to illustrate the success of a novel modified Whale’s tail technique for regeneration in aesthetic zone. A 49 years old male patient reported to the department of Periodontology having chief complaints as pain and increasing space between his upper front tooth region. Clinical examination revealed midline diastema and 8mm pocket depth with grade-I mobility for left maxillary central incisor. Radiograph revealed presence of  vertical bone loss. After phase-I therapy and frenectomy, modified Whale’s tail technique was employed to achieve regeneration. 9 months postoperative results showed reduction in pocket depth and improvement in bone level.

Open Access Case Report

Class II Malocclusion Treatment with the Distal Active Concept Technique

Mouna Ben Khalifa, Adel Ben Amor, Samir Tobji, Ines Dallel, Wiem Ben Amor

Asian Journal of Dental Sciences, Page 66-73

Aims: The aim of this case report is to evaluate the skeletal and dental effects of the Distal Active Concept (DAC) technique in an adolescent female patient.

Presentation of Case: The patient is a 14-year-old female who presented with a skeletal class II malocclusion, class II division 1 dental relationship, and protrusion of upper and lower incisors. She was treated using the DAC technique which relies mainly on the use of double class II elastics to correct the Class II malocclusion and is indicated for treating young patients presenting a skeletal class II division 1 malocclusion caused by a retrognathic mandible without extraction of premolars. During the distalization phase of the DAC technique, open coil springs are inserted in compression against the maxillary first molars and are associated with double class II elastics on each side to correct the molar et canine class II relationship. Bite turbos made of glass ionomer cement are placed on the occlusal surfaces of the lower first molars to facilitate the forward movement of the mandible.

Results: The upper lip protrusion was reduced after retraction of maxillary incisors so that the facial profile became more balanced. The patient’s occlusion was finished with a bilateral molar and canine class I relationship. No skeletal changes were obtained. The class II malocclusion was corrected mainly by dentoalveolar compensation. The maxillary incisors were retracted by 2 mm and the mandibular ones were protruded and intruded by 2 mm. Consequently, the overjet decreased from 6 to 2 mm, and the overbite from 4 to 2 mm. The upper first molar tipped slightly distally whereas the lower first molar moved mesially by 2 mm.

Conclusion: Orthopedic growth modification with the Distal Active Concept therapy can be attained, provided that the patient’s remaining pubertal growth is adequate. Otherwise, the skeletal discrepancy will remain the same, and the class II malocclusion will be corrected only by dental camouflage.

Open Access Case Report

Delayed and Non-Healing Wounds in Oral & Maxillofacial Surgery Practice- A Case Series

George Varghese, Akhilesh Prathap, R. S. Nidhin

Asian Journal of Dental Sciences, Page 119-127

Wound healing is a physiological response to an injury. It is a very complex biological process. The oral cavity is a remarkable environment where healing often occurs without scar formation, even though oral cavity harbors millions of microbes. But instances of delayed or non-healing of wounds are common in the practice of oral and maxillofacial surgery. A plethora of causes have been suggested by various authors to account for these phenomena.  Some of the common ones reported in the literature are the following [1]: old age, obesity, chronic diseases, vascular insufficiency, malnutrition, protein and vitamin deficiency, malignancy, anemia, stress, immune-deficiency, infection and deficient oxygen delivery to tissues. Underlying systemic conditions are often ignored or undetected by general practitioners and this influence wound healing significantly. This article presents a series of unusual cases of delayed/non healing wounds, which warrant the need of proper referral of such cases by general practitioners to tertiary care centres.


Open Access Case Study

Management of Tongue Tie Using Diode Laser: A Case Report

Keerti Rawat, Kabyik Goldar, Prakriti Chaudhary, Dileep Kishore

Asian Journal of Dental Sciences, Page 74-77

Background: Tongue tie, also known as ankyloglossia, is a congenital disorder that occurs when the inferior lingual frenulum is too short and shows attachment to the tip of the tongue, preventing normal tongue motions. Ankyloglossia can lead to a range of problems such as speech impediments, difficulties in breast feeding, malocclusion, poor oral hygiene, inability in deglutition, thus being an undesired problem in normal life activity.  Various techniques like scalpel, laser and electro-surgery have been performed in treating tongue tie. Though each technique has its own advantages and disadvantages, aim of all the treatment procedures is to relieve the high muscle attachment to improve the movement of the tongue.

Case presentation: A male patient aged ten came with a chief complaint of difficulty in speech to the department of periodontology. On examination presence of tongue tie was observed. For which complete blood profile got investigated, followed by treatment protocol which included oral hygiene instructions, oral prophylaxis and surgical relieving of the aberrant lingual frenum using laser. 

Result: Uneventful healing was observed with minimal pain experienced by the participating subject. Free movement of the tongue upto the normal range was observed after suture removal.

Conclusion: Speech difficulty and limitation of tongue movement makes it difficult for the patient’s having tongue tie. So, in order to remedy the condition, therapy should be administered on time and can be enhanced by surgical operations.

Open Access Case Study

Management of Instrument Separation: Retrieval and Bypass– Case Reports

R. Hemamalini, A. Vishalini, M. Kavitha

Asian Journal of Dental Sciences, Page 84-88

A thorough knowledge of the root canal morphology and unusual anatomy of the tooth is critical for successful endodontic treatment. Common configuration in mandibular molar is two roots and three root canals with different combinations or curvatures. Instrument separation is one of the most common iatrogenic error that occurs in an endodontic practice. The treatment option and success vary based on a number of factors. These case reports are on the retrieval of the separated instrument from the coronal third of the middle mesial canal of the mandibular first molar and bypassing the instrument in the apical curvature of distobuccal root of maxillary second molar.

Open Access Case Study

‘Better Late than Never’-A Case Report on Delayed Reimplantation of an Avulsed Tooth

Sudrisya Rajan, Prabhavathi Poornima, B. S. Keshava Prasad, Apoorva Prakash Karanam

Asian Journal of Dental Sciences, Page 132-136

Tooth avulsion is one of the most common dental injuries following trauma. Even though the golden period for reimplantation of an avulsed tooth ranges from 20-30 minutes after the trauma, it is not possible in all scenarios. In such cases, the option of delayed reimplantation can be considered. This paper highlights on the reimplantation of an avulsed tooth with 24 hours extraoral time with a follow up period of 6 months.

Open Access Minireview Article

Cryotherapy–A Glipmse of Hope in Endodontics

Prabhavathi Poornima, Atul U. R., B. S. Keshava Prasad

Asian Journal of Dental Sciences, Page 18-23

Intolerable pain is the most common reason a patient seeks endodontic therapy, hence pain management becomes a prerequisite during endodontic treatment. Premedication with prophylactic analgesics such as nonsteroidal anti-inflammatory drugs, paracetamol, or corticosteroids, use of longer-acting anesthetics, and occlusal reduction of the offending tooth are some of the strategies which have been endorsed for managing endodontic pain over the past decades. Constant evolutions in the field of endodontics require the practitioners and researchers to sort to emerging therapies that improve the patient’s comfort while being least invasive. Cryotherapy is one such evolution that is progressively becoming pervasive in the field of endodontics. Cryotherapy has already been showing promising results in other fields of dentistry. In this direction, the paper highlights a review of various scientific literature and research work done on the implementation of cryotherapy in managing post endodontic pain and its various applications in endodontics

Open Access Original Research Article

In vivo Comparison of Surface Changes between Two Nickel Titanium Rotary Single File Systems after Instrumentation in Moderately Curved Root Canals

Bushra Almas, H. Murali Rao, B. S. Keshava Prasad

Asian Journal of Dental Sciences, Page 29-42

Aim: To compare post instrumentation surface changes between Two Nickel-Titanium Single Rotary systems (FKG XP Endo Shaper, FKG Dentaire, La Chaux-de-Fonds, Switzerland and Micromega One Curve, Micro Mega, Besancon, France using Stereomicroscope.

Materials and Methods: 40 patients requiring endodontic treatment and satisfying the inclusion criteria for the study were included and randomly divided into 4 groups having 10 patients each. Group 1: Instrumentation of root canal in 10 patients was done using FKG Endo Shaper for 15 seconds. Group 2: Instrumentation of root canal in 10 patients using FKG Endo Shaper for 30 seconds Group 3: Instrumentation of root canal in 10 patients using Micromega One Curve for 15 seconds .Group 4: Instrumentation of root canal in 10 patients using Micromega One Curve for 30seconds. After instrumentation for specified time all the files were examined at the apical and middle third under the Stereomicroscope (Labomed, Inc, United States) at 40X magnification for the presence of any surface changes( defects/ deformity). Scoring of defects was assigned to each file according to the degree of damage. Results were statistically analysed using Kruskal Wallis test and Mann Whitney Post hoc test and were used to compare the median microscopic scores between different groups at Apical and Middle 3rd region. The level of significance was set at P<0.05.

Results: Comparison of microscopic scoring between both the file groups at apical and middle third region using Kruskal Wallis Test revealed that a statistically significant difference was observed in the apical region with p value <o.o2, No statistical significant difference was found in the middle third region, suggesting that the apical region showed more surface changes than the middle third region. Comparison of scores between groups at the apical region using Mann Whitney Post hoc test revealed that there was statistically significant difference in Group 1 compared with group 2, group 3 and group 4 whereas, there was no statistical significant difference between other groups. Comparison of microscopic scoring between Apical and Middle region in each group using Wilcoxon Signed Rank Test revealed that a statistically significant difference was found in the middle third region of Group 4 with P value P<0.03.

Conclusion: It was concluded that More surface changes were seen in FKG XP Endo Shaper file than Micromega One curve. Apical regions showed more changes compared to the middle third region and there was statistically significant difference between groups 1 ,2 and 3. None of the instruments fractured during instrumentation.

Open Access Original Research Article

Crestal Sinus Lift-Sinus Crestal Approach Kit and Simultaneous Implant Placement Using Platelet Rich Fibrin as an Exclusive Graft Material

Sarayu Gopal

Asian Journal of Dental Sciences, Page 89-100

Background: Sinus augmentation surgery has become a well accepted preprosthetic procedure for creating sufficient bone volume for the placement of endosseous implants in the atrophic posterior maxilla. All of the indirect sinus augmentation procedures to bring about sinus lift present the possibility of Schneiderian membrane perforation, the most common intraoperative complication with these techniques, with perforation rates of 21.4% on an average reported in the literature. This complication can occur either during osteotomy, which is performed with burs, or during the elevation of the membrane. Several other post operative complications reported are due to the malleting forces - benign paroxysmal vertigo, headache, excessive bleeding and other sinus complaints. During sinus-lift, the biomaterials are used as space maintainers and bone scaffold to promote bone formation in the sub sinus area. As evidenced by literature, when graft is not used, some authors have shown that true bone gain is in fact always limited and that implant apical ends might be enmeshed in the sinus connective tissue and, thus, not osseointegrated.

Methods: To evaluate the Efficacy of Sinus Crestal Approach (SCA) kit for Indirect sinus lift surgeries and further evaluate the bone regenerative property and over all utility of Platelet rich-fibrin when used as the exclusive graft material for sinus lift cases. Fifteen healthy patients seeking replacement of missing teeth in atrophic posterior maxilla or pneumatisation of sinus with all other situations ideal for placing implants were chosen. SCA kit was used for the surgical intervention. Endosseous implants of appropriate length and diameter with autologous graft material (PRF) was placed in the premolar-molar region.All patients were followed for clinical and radiological evaluation using IOPAR and digital OPG after 1 week, 3, 6 and 12 months period.

Results and Conclusion: SCA kit is an innovative tool to perform indirect sinus augmentation surgery in the atrophic posterior maxilla for prosthetic rehabilitation with limited complications. At the end of the study, the mean endosinus bone gain measured on the proximal sides of the implant was 1.2mm. Choukroun’s PRF used as sole filling material during the sinus lift and simultaneous implantation creates space and acts as a scaffold for predictable bone formation.

Open Access Original Research Article

Combined Effect of Acidic Beverages and Immersion Time on Bonding Strength of Composite to Enamel: An In-vitro Study

Mohd Haidil Akmal Mahdan, Nur Syahirah Abidin, Nur Aina Athirah Mohd Zaidi, Ahmad Syahrizan Sulaiman

Asian Journal of Dental Sciences, Page 101-110

Introduction: Carbonated beverages are widely consumed over the world. The effect of acidic liquids on dental enamel has a significant impact on composite resin adhering to the enamel substrate. The purpose of this study was to see how acidic beverages affected the bonding of composite resin to exposed enamel.

Methods and Materials: 128 premolars were taken and divided into four groups for both 24 hours immersion (n=40) and 15 days immersion (n=40). The samples were divided into the following categories: G1: 3x/15 mins immersion in Beverage A, G2: 3x/15 mins immersion in Beverage B, G3: 3x/15 mins immersion in Beverage C, G4: 3x/15 mins immersion in artificial saliva as control group. Prior to immersion, the buccal surfaces of the enamel were minimally ground at the layer of enamel solely using a Tungsten carbide bur, then flattened with #600 - #1200 silicon carbide paper (SiC) paper. Specimens were submerged in the media for 24 hours and 15 days, respectively. Following immersion, the specimens’ prepared surfaces were repaired using composite resin. The enamel pattern was morphological analyzed using a Scanning Electron Microscope (SEM) and the shear bond strength was determined.

Results: One-way ANOVA with multiple comparison tests was used to statistically evaluate the data. When compared to control media, all of the beverages tested significantly reduced shear strength. Following immersion in the test beverages, enamel's morphology changed noticeably, with Beverage A group displaying the most pronounced morphological changes.

Conclusion: All acidic beverages examined had a detrimental impact on shear strength. In different periods of time, varied degrees of enamel demineralization were detected.

Open Access Original Research Article

The Impact on Children’s Lifestyle and Behaviour Due to COVID-19 Pandemic- A Questionnaire Study

Mandar Todkar, Renuka Nagarale, Pratik Dhumavat, Shivani Bhukan, Ayesha Suse, Falak Butt

Asian Journal of Dental Sciences, Page 111-118

Introduction: The “COVID-19” pandemic has caused huge changes in people's lifestyle, health, and social relationships. This situation has had an intense impact on children, affecting their health, intellectual, physical, and emotional development. The aim of this study was to investigate the impact of “COVID-19” lockdown measures on the diet, behaviour and physical activities of children.

Study Design: A questionnaire study.

Place and Duration of Study: Department of Public Health Dentistry, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, between January 2022 and June 2022.

Methodology: A study was conducted among the pediatric population in Pune, a metropolitan city of Maharashtra. The participants were selected based on the age group ranging from 1 to 14 years. The structured, self-administered, and close-ended questionnaire comprised of 29 questions which included demographic data such as name, age, gender, and education. The statistical analysis was done using the descriptive statistics.

Results: In this study, there were total of 180 participants of age 1-14 years of age. About 87.3% of the participants were aware about balance diet and around 86.6% of the participants knew about the effects of excessive sugar on health. About 52.8% of the participants believed that “COVID-19” pandemic has reduced physical activities in children.

Conclusion: The level of knowledge of the participants in the study was adequate, while the attitude and practice relating to diet, lack of physical activities, excessive screen time and sedentary behaviors during “COVID-19” pandemic was average in the participants.

Open Access Review Article

Current Mucoadhesive Drug Delivery System for Recurrent Aphthous Stomatitis

Parastoo Namdar, Rezvan Yazdian-Robati, Pegah Mosannen Mozafari, Maryam Hashemi, Atena Shiva

Asian Journal of Dental Sciences, Page 1-17

Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease of the oral mucosa, RAS is characterized by extremely painful, recurring solitary, multiple ulcers in the upper throat and oral cavity, which may lead to difficulty in eating, speaking and swallowing and negatively affects the life standard of the patient’s. In patients undergoing fixed orthodontic treatment, the frequency of RAU Increases .The underlying etiology of RAS is noted clear and no curative treatment is available. Current treatment for RAS is often in the form of mouthwashes, creams, or ointments, but these are often ineffective, due to inadequate drug contact times with the lesions and poorly available use of drug. To overcome these problems, it has been proposed to incorporate drugs to mucoadhesive polymers or nanoparticulate systems containing mucoadhesive polymer(s) because of their propensity to interact with the mucosal surface. Mucoadhesions increased the residence time of drug carriers at the site of absorption, improved drug absorption, and controlled drug release from the devices used. Smaller size of particles has been supposed to diffuse much higher in the mucus layer and improve the bioavailability of drugs. In the present review, we focus on the mocuadhesive drug delivery system in the treatment of RAS.

Open Access Review Article

Effects of Nano-sized Particles on Mechanical Properties of Resin Dental Composites: A Review Article

Fathie Kundie, Nidal W. Elshereksi, Abdoulhdi A. Borhana Omran

Asian Journal of Dental Sciences, Page 43-55

Nanomaterials have unique physical and mechanical characteristics. The addition of nanoparticles advances the mechanical performance of polymers, because the ratio of surface area-to-volume is high. Nanoparticles are utilised to produce materials with different behaviour because of interfacial reactions. The current review compiles and discusses the available literature on the positive impact of nanoparticles on the mechanical behaviour of resin-based dental composites, in addition to the recent advancements. The effects of different types of fillers in nano-ranged size have been studied. It also presents appropriate filler quantity for the enhancement of some mechanical properties. Finally, the important role of energy dissipation mechanisms in dental composites has been emphasised. 

Open Access Review Article

Recent Advances in Biomimetic Materials Used in Restorative Dentistry: An Updated Review

Megha Rao, Vanamala Narayana, B. S. Keshava Prasad, Bushra Almas

Asian Journal of Dental Sciences, Page 56-65

The advances in biomimetic materials have seen a rapid rise in the last decade, with the introduction of several newer materials being launched into the market. These materials aim at preserving tooth structure, restoring the overall health of the tooth and making treatment outcomes more predictable. This review article aims at comprehensively describing biomimetic materials used in restorative dentistry.

Open Access Review Article

Importance of Dental Records in Post-mortem Identification: A Comprehensive Review

Mandar Todkar, Renuka Nagarale, Danish Suhaib, Sumayya Kazi, Nishigandha Waghmare, Sarim Khan

Asian Journal of Dental Sciences, Page 78-83

Forensic dentistry or forensic odontology involves handling, examination and evaluation of dental evidence in criminal justice cases. Forensic dentists are involved in assisting investigative agencies to identify recovered human remains in addition to the identification of whole or fragmented bodies. Forensic dentists have also been known to use their investigative techniques to identify burn victims by using the victims previous dental records. Forensic dentists may also be asked to assist in determining age, race, occupation, previous dental history and socioeconomic status of unidentified human beings.

Open Access Short Communication

Oral Prosthesis and Diabetes: Circumventing the Opportunistic Fungal Infections during SARS-CoV-2 Pandemic

H. S. Sreeshyla, Srinivas Iyer Meenakshi, Aradya Anupama

Asian Journal of Dental Sciences, Page 128-131

Diabetes is one of the most common systemic disease affecting the world and India accounts for the 2nd highest burden. Diabetes and oral health have a bidirectional relationship. Oral health issues are common among the diabetics, with higher incidence of xerostomia, dental caries, periodontal pathologies and tooth loss reported among them in comparison to the non-diabetics. The population wearing dentures and reported with denture associated stomatitis are also higher. The current SARS-CoV-2 pandemic has devastating effects on diabetic patients with post Covid complications including fungal infections such as mucormycosis being reported high among this group. Oral fungal infections are common among diabetes patients especially among the denture wearers. Palate is one of the common site of involvement by oral candidiasis and mucormycosis. It is time to educate denture wearing diabetic patients on the importance of oral and denture hygiene.