Open Access Case Study

Molar Hemisection in Teeth with Advanced Furcation Lesion: A Hope for the Hopeless

Mitali Bhosale, Purva Vijay Sinai Khandeparkar, Siddhi Shetye, Rakshit Vijay Sinai Khandeparker

Asian Journal of Dental Sciences, Page 9-13

Aim: The preservation of a functional dentition is very important in young individuals. Mandibular molar teeth, the first to erupt in the oral cavity are highly susceptible to caries. Pulpal involvement of these teeth along with furcation defects is a challenge to the maintain them in a functional occlusion. Advances in Restorative and Periodontal dentistry have made this possible.

Presentation of Case:  This is a case report of a 20 year old male patient with a chief complaint of pain and mobility in the mandibular left first molar. On examination, the tooth had a carious involvement, was sensitive to percussion and revealed grade 1 mobility with Glickman’s grade III furcation defect. A provisional diagnosis of a primary endo with secondary perio with tooth number 36 was given. On radiographic examination, bone loss was evident involving the furcation area. Root canal treatment was performed along with hemisection of tooth.

Discussion: In the Past cases exhibiting Glickman’s grade II or III furcation defects were considered untreatable. Root resection procedures help maintain a part or the entire tooth. These procedures are highly complex and their success depends upon a proper case selection.

Conclusion: The conservative management of teeth in young patients showing furcal defects can not only help maintain the tooth in functional dentition but it also reduces the financial burden, psychological stress and occlusal dysfunction.

Open Access Case Study

Frey’s Syndrome as an Unusual Consequence of Surgery for TMJ Ankylosis

Aritra Chatterjee, Subhasish Burman, Soumen Mandal, Abira Chattopadhyay, Md. Arif Hossain, Debabrata Gayen

Asian Journal of Dental Sciences, Page 14-19

Frey’s syndrome is a rare, unwanted complication of surgery/injury to the parotid gland, occasionally seen following surgery in the temporomandibular joint region, neck dissection and faces lift procedures. It is characterised by sweating, flushing and a sense of warmth over the distribution of the auriculotemporal nerve and/or greater auricular nerve while eating foods that produce a strong salivary stimulus. As a result this can be a source of great discomfort and embarrassment to the patient. Here, we present a case of Frey’s Syndrome which developed after an inter positional arthroplasty in the right TMJ region. In the follow up period he reported to us with complaints suggestive of gustatory sweating. A positive Minor’s Starch Iodine test confirmed the diagnosis. We reassured him and also mentioned the treatment options available. The symptoms being mild, he decided on no further interventions. The literature does not speak much of such a complication arising after surgery for TMJ ankylosis. This case should be an eye opener for many surgeons as to the possibilities of Frey’s syndrome developing after such surgeries and the means to manage them.

Open Access Case Study

Multidisciplinary Approach for the Management of Orthodontic Treatment Failure

Nissaf Daouahi, Donia Ouada, Dalenda Hadyaoui, Belhassen Harzallah, Mounir Cherif

Asian Journal of Dental Sciences, Page 20-30

This article describes a case of full mouth rehabilitation using ceramic veneers in combination with periodontal surgical approach for the management of orthodontic treament relapse.

A 38 -year-old female patient presented with a chief complain of poor esthetics after orthodontic treatment. She was bothered especially about her smile and was asking for its improvement. Unesthetic smile was caused by eroded maxillary incisors and old metal ceramic crowns with greyish shadow. Altered occlusal plan was also detected.

The treatment plan included endodontic re- treatment and crown lengthening followed by minimally invasive ceramic restorations including anterior and posterior Ceramic veneers.

Open Access Original Research Article

Symphyseal Injuries as Indices for Condylar Fractures Diagnosis

Arthur Nwashindi

Asian Journal of Dental Sciences, Page 1-8

Aims: The mechanism of condylar fractures and indices for diagnosis are complex hence the aim of this study was to investigate the influence of various injuries in the symphyseal region on condylar fracture patterns and correlating it with diagnosis.

Study Design:  Prospective study.

Place and Duration of Study: Oral and Maxillofacial clinic of University of Uyo Teaching hospital, Uyo Nigeria from February 2014 to January 2020.

Methodology: The study included 111 patients with condylar fractures associated with varying degrees of symphyseal injuries. Data on age, sex, soft tissue injuries, and symphyseal fractures were collated and analyzed using multivariate logistic regression.

Results: Age range 21-30 years had the highest occurrence of condylar fracture with males having more condylar fractures than females. Contusion has more association with condylar fractures followed by hard tissue fracture at the symphysis with a frequency of 38 (34.23%) while abrasion showed the injury with the least impact. Majority of the impact resulted in unilateral condylar fractures with a frequency of 62 (55.86%). Condylar fractures at the level of the condylar neck was more prevalent than at the level of the condylar head with the head showing only a frequency of 40 (36.04%)  as against 71 (69.96%) for condylar neck fractures

Conclusion: The occurrence of mandibular fractures is strongly correlated with age, sex, soft tissue injuries and hard tissue injuries at the symphysis. . Overall, contusion gave more of unilateral fractures while fracture at the symphysis resulted in more of bilateral condylar fractures.

Open Access Original Research Article

Orthodontic Treatment Eligibility among New Patients Referred to National Dental Centre, Brunei Darussalam

Taqtyuddin Tahir, Uday Kumar Umesan, Jagjit Singh Dhaliwal, Hanif Abdul Rahman

Asian Journal of Dental Sciences, Page 31-41

Aims: To evaluate orthodontic treatment eligibility and appropriateness of new orthodontic referrals made by the general dental practitioners (GDPs) to the Specialist Orthodontic Unit, National Dental Centre (NDC) for orthodontic assessment from government dental clinics in Brunei-Muara district using Index of Orthodontic Treatment Need (IOTN) as an objective measure.

Material and Methods: Patients’ data were collected from Brunei Health Information Management Systems (Bru-HIMS) for one-year period from 1st January 2018 to 31st December 2018. From this patient pool, a total of 147 patients who underwent orthodontic assessment were identified. The data collected were imported to RStudio to perform appropriate statistical analyses.

Results: Of 147 new patient referrals, 72.1% were female and 27.9% were male, with a mean age of 18.3 years (SD ± 5.8 years). Patients with age range of 9 to 39 years were evaluated. A total of 87.8% of new patient referrals were eligible under IOTN. The predominant incisor relationship referred was class II division 1 (33.3%) and the prevalence of class III was high at 30.6%. The most common malocclusion trait referred was a severe dental contact point displacements >4 mm, grade 4d (53.1%).

Conclusion: A total of 87.8% of new patient referrals were deemed eligible by specialist orthodontists utilizing IOTN. A total of 83.7% of new patient referrals were in a definite need for orthodontic treatment. It is highly recommended for general dental practitioners to have training in utilizing IOTN and necessitate establishment of proper referral guidelines.