Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. In recent past conservative and aesthetic reattachment of the fractured teeth has gained popularity. It also restores function, provides a positive psychological response, and is a relatively simple procedure. In this case presented below is a case of Ellis class III horizontal fracture in respect to 11. In order to do conservative treatment a combination of external enamel bevel and internal dentinal groove has been used to enhance the bonding between the fractured fragment and the remaining tooth. The treatment was found to be successful both functionally and aesthetically at the 12-month follow-up.
Introduction: Talon cusp is an uncommon developmental anomaly which is characterized by the presence of an extra cusp-like structure projecting from the cingulum area of maxillary or mandibular incisors. It consists of enamel, dentine with or without pulp tissue. Its aetiology is still unknown; however, its formation is attributed by the hyperactivity of the enamel organs during the morpho-differentiation stage.
Case Report: A healthy 15-year-old Malay female came to the paediatric dental clinic with the chief complaint of teeth sensitivity. An intra-oral examination revealed presence of a prominent cusp on the lingual surface as well as a deep fissure on the labial surface of mandibular right lateral incisor with a slight degree of mobility due to periapical abscess. An intraoral periapical radiograph revealed a radiopaque projection. The treatment was a root canal.
Conclusions: This case highlights the endodontic treatment of periapical lesions on the mandibular lateral incisor with talon cusp in an adolescent patient. Diagnosis and management of a rare anomaly are essential in the dental practice.
Aim: Langerhans cell histiocytosis or LCH is an atypical cancer originating form histocytes. Dental manifestation may mimic aggressive form of periodontitis with gingival overgrowth and bleeding, advance alveolar bone loss as well as generalized mobility of tooth. The ambiguity of its clinical features is one of the factors that makes identifying the disease a difficult task.
Presentation of Case: A 30 years old Malay man came with complain of gingival swelling and bleeding on the upper right quadrant associated with bad breath, scarce saliva, generalized tooth mobility, and whitish slough on the gingiva. The condition however does not present with pain or any systemic condition. The patient claimed to be systemically healthy. Intraoral examination displayed a diffused, erythematous swelling over attached gingiva on the maxillary posterior buccal region bilaterally along with sign of loss of pyramidal shape and ulceration with a punched-out profile covered by necrotic slough.
Discussion: Diagnosis of LCH is done with the aid of immunohisto chemical analysis of CD1a and S100. The clinical course of LCH is highly unpredictable and irregular, improvement noticeable with conventional periodontal treatments in controlling the oral manifestations of LCH on early course of the disease.
Conclusion: Proper multidisciplinary approach is essential in the management for the benefit of the patient in such rare entity.
Sialolithiasis is one of the common disease affecting salivary gland of head and neck region mainly submandibular gland. They are calcified deposits found in gland or its duct, composed of organic and inorganic substances. Rarely they enlarge in size above 10 mm and cause perforation of the floor of mouth. Such sialoliths are called as giant sialoliths. They manifest as a hard swelling in floor of mouth, associated with pain. Diagnosis is confirmed with the help of radiographs – occlusal radiograph, orthopantomogram or computed tomography scan in which the stone manifest as well defined radio-opacities. Various modalities of treatment were described in literature, which include intraoral/extraoral sialolithotomy, milking of gland, resection of gland etc. The choice of treatment should be based on size and location of the stone. Here we report a case of perforating sialolith in a 62 year old male patient treated by intraoral sialolithotomy.
Gorlin-Goltz syndrome, also known as basal cell nevomatosis (CBN), is a rare inherited disorder belonging to the family of neurocristopathies or diseases caused by abnormalities of the neural ridges. We report the case of 4 patients, suffering from this syndrome, followed up in the stomatology and maxillofacial surgery service in Casablanca, including a familial form in two cases: a mother and her son and 2 isolated cases, followed and treated in our service of maxillofacial surgery of the August 20 hospital in Casablanca. A clinical, biological and radiological assessment was made followed by surgical treatment for the 3 patients, an anatomo-pathological examination and the establishment of a strict monitoring plan.
Aims: The ligature-induced periodontitis model is one of the standard approaches through ligating the second maxillary molar tooth in rat models, however the procedure is technique sensitive, thus we proposed the technique of ligation of the lower incisor.
Place and Duration of Study: Animal Laboratory, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.
Methodology: 16 rats were used in the model to simulate periodontal tissue destruction by a two-week ligature placement around the mandibular incisor. The rats were analyzed for clinical attachment loss and radiographical finding to evaluate presence inflammatory bone loss, as well as changes in bone serum biomarkers.
Results: Two weeks after ligature placement gingival inflammation was significantly induced as well as increase depth of gingival sulcus accompanied by increased plaque level at local site. Mean probing depth increased from 0.41 ± 0.02 mm to 1.35 ± 0.04 mm as well radiographical changes increase from 6.41 ± 0.02 mm to 7.36 ± 0.04 mm after 14 days of ligature which are both statistically significant (P < 0.05). Bone serum biomarker assessment also shows significant difference for of OPG from 574.06 ± 30.76 to 508.70 ± 18.30, DKK1 at T0 was 1163.29 ± 56.87and 1154.86 ± 63.99, SOST from 1598.06 ± 172.77 to 1425.35 ± 225.75 and FGF23 from 590.27 ± 13.87 to 624.00 ± 18.34.
Conclusion: This proposed technique is likely to facilitate the use of the rat ligature-induced periodontitis model and thus add to a better understanding of the immunopathological mechanisms of periodontitis.
Superstitious beliefs have been present for thousands of years and vary around the world. Superstitions regarding health are common among some parts of the Nepalese population. These beliefs can range from harmless to dangerous, with potentially serious health implications. Many superstitions are related to dentistry. The rising Nepalese population in the UK means that practitioners may be faced with patients holding similar beliefs. Knowledge of the beliefs of this population and how they may affect their health-seeking behaviors can help practitioners overcome potential barriers to care.
Aims: The objective of this study is to assess current level of awareness and knowledge of oral cancer among undergraduate students in Brunei Darussalam
Study Design: Cross-sectional study using self-administered questionnaire
Methodology: The English language self-administered questionnaires were distributed to a random sample of undergraduates in the two universities. The respective university representatives distributed the questionnaires to students from random modules. 184 students from UBD and 198 students from UTB were included. The questionnaire has been pretested by 5 university students before the study began.
Results: A total of 392 students completed the questionnaires. Only 46.4% of the students were aware of the term ‘oral cancer’ and mere 1.5% were able to identify oral cancer diagnostic tests. Overall oral cancer knowledge level was low with a mean knowledge score of 37.3% only. However, 76.3% (95%CI: 71.9, 80.3) were able to identify tobacco smoking as a risk factor followed by poor oral hygiene 55.5% (95%CI: 61.6, 71.2) and 53.3% (95%CI: 48.2, 58.3) chewing tobacco or betel nut.
Conclusion: Oral cancer awareness and knowledge among undergraduates is poor. Effective oral cancer promotion and education by relevant agencies are highly suggested, particularly in tertiary education settings.
Title of Topic: “Ultrasound guided dextrose prolotherapy: a promising hope for temporomandibular joint dysfunction”.
Background & Objectives: Temporomandibular joint disorder (TMD) is a term used to describe a group of medical disorders causing temporomandibular joint (TMJ) pain and dysfunction. Prolotherapy also known as regenerative injection therapy is effective in stabilizing injured TMJ and relieving joint pain by injecting a non-pharmacological irritant solution into the region of the tendons or ligaments. Traditionally prolotherapy will do blindly. Image guided prolotherapy improves the accuracy of injections through direct visualisation of the needle into the target. Thus the present study aimed to evaluate the advantages of ultrasound guided prolotherapy with 25% dextrose for the cases with TMDS.
Methods: The present study included 15 patients with temporomandibular joint dysfunction reported to the department of oral and maxillofacial surgery. All patients were treated with two sessions of injections with 3 ml of proliferant solution (2 ml of 25% dextrose and 2% lignocaine with 1:2,00,000 adrenaline) one month apart. Follow up was done for 1 month, 3 months and 6 months. The patients were evaluated for pain, frequency of dislocation or subluxation, clicking sound, deviation of mouth and for maximum mouth opening both pre and post-operatively and scores were recorded and analysed with wilcoxon matched pairs test and dependent t test.
Results: Our study showed significant improvement in TMJ pain, clicking sound, deviation of mouth, number of locking episodes and mouth opening after the two sessions of injections.
Interpretation and Conclusion: Ultrasound guided prolotherapy with 25% dextrose appears promising for the treatment of symptomatic TMJ dysfunction, as evidenced by therapeutic benefits, simplicity, safety, patients; acceptance of the injection technique and lack of significant side effects.
The presented study was designed to show the pharmacological effect of Acacia Arabic gum as the Non-Surgical treatment of chronic periodontitis and it was estimated in A hospital based double blinded, randomized clinical trial using split mouth technique, conducted in the Khartoum Dental Teaching Hospital (KDTH). All patients diagnosed with chronic periodontitis according to American Academy Periodontology. As used split mouth technique, 88 sites (44 scaling and root planning and gum Arabic) had been enrolled randomly as intervention group, (44 sites scaling and root planning + distilled water) as a control group. Plaque Index (PI), Gingival Index (GI), Bleeding On Probing (BOP) , periodontal probing depth (PPD) , Clinical Attachment Loss (CAL) , measurements and scores in addition to Interleukin 1β (IL-1β) was done on day 0 and day 30. (47.7%) of the study were males and (52.3%) were females with the mean age was 40.7 years ±12.7. PI, GI, BOP, PPD, CAL and IL1β measurements showed a significant reduction in the AA group (P< 0.05). This study concludes that the adjunctive use of a pulsating jet containing Acacia Arabica (AA) as an irrigation solution was efficient in reducing plaque index, gingival index, and BOP, PPD, CAL, as well as IL 1β level in subjects with chronic periodontitis.
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the SARS-Cov2 virus. It emerged as a global pandemic early in 2020, affecting more than 200 countries and territories. The infection is highly contagious, spreads through person-to-person contact, via aerosol and droplets. The practice of social distancing - maintaining a distance of 1 - 2 meters or 6 feet -- between people has been widely recommended to slow or halt the spread. This places dentists at high risk of acquiring and transmitting the infection. The objective of this article is to reinforce infection control and prevent cross-transmission among orthodontic clinic and precautions to be taken for the treatment of orthodontic patients in a post-lockdown era, until at-home or in-office testing, vaccines, or successful treatments for COVID-19 shall be available.
Autoimmune bullous diseases is a heterogeneous group of disorders that is characterized by intraepithelial or sub epithelial blistering caused by formation of autoantibodies targeted against structures essential for integrity of skin and mucous membrane. One such type of autoimmune vesiculobullous disease is Pemphigus, which affects the skin and the mucous membrane. There are different types of pemphigus based on the clinical features, histopathological features and the specific antigens against which autoantibodies have been produced. This review gives an overview on thedifferent types of Pemphigus with its clinical, histopathological and immunopathological characteristics and its treatment.