Open Access Case Report

Tobacco Pouch Keratosis - A Common but of Ten Missed Oral Lesion

S. Annapoorani, A. Winnifred Christy, T. Jones Raja Devathambi

Asian Journal of Dental Sciences, Page 23-27

Aim: As a reference for cases related to smokeless tobacco use, its management and also states about the importance of proper and early diagnosis of tobacco pouch keratosis.

Presentation of Case: A 45 year old male complained of a rough surface with burning sensation occasionally in the mucosa of the lower front teeth region. The patient gave a positive history of using smokeless tobacco mixed with areca nuts, four times a day for the past seven years. A greyish white mucosal thickening was evident in the mandibular right and left buccal vestibule, labial vestibule with surface ulcerations from 35 to 45 region.  The lesions had ill-defined borders. It had a wrinkled, corrugated surface texture. On palpation the lesion had a rough and leathery consistency. 

Discussion: Smokeless tobacco usage is on an alarming rise in the Indian subcontinent. Some use it as an alternative for smoking and others use it along with smoking tobacco without realizing that smokeless tobacco also has equal potential to cause oral and systemic effects. One of the most common lesion which occurs due to use of smokeless tobacco is tobacco pouch keratosis. This paper presents a case report and a review about the prevalence, etiology, clinical features, pathogenesis, harmful effects, management and prevention of tobacco pouch keratosis.             

Conclusion: Based on the clinical examination the lesion was diagnosed as tobacco pouch keratosis. Non-invasive procedures like habit cessation, counselling, early diagnosis may prevent the prognosis of the lesion and also decrease financial burden of the patient.

Open Access Case Study

Guarding the Smile: A Case Report on Mouth-Guard Appliance

Aaheli Banerjee, Antik Bhattacharyya, Aindrila Ghosh, Shabnam Zahir

Asian Journal of Dental Sciences, Page 1-6

Orofacial injuries vary in complexities and affects people of all age group. Dental trauma in sports is the major linking channel between sports and dentistry. Sports dentistry is the prevention of oral/ facial athletic injuries and related oral diseases and manifestations. The preventive measures like usage of helmets, mouthguards and other protective gears have reduced the impact of these injuries in the athletes.

This report presents a case where a patient came for follow up appointment regarding a replanted avulsed tooth in the anterior region that was carried out 1 year back. Also, it was stated by the patient that he was involved in contact sports related activity.

The patient was motivated regarding the various protective mechanisms and the advantages of using them during sports activities and custom- made mouthguard was fabricated for this patient.

Open Access Case Study

Relining of Denture Bases with Temporary Soft Material in Denture Stomatitis Treatment: A Case Report

Carolina Yoshi Campos Sugio, Amanda Aparecida Maia Neves Garcia, Vinícius Carvalho Porto, Karin Hermana Neppelenbroek

Asian Journal of Dental Sciences, Page 28-32

The objective was to report a therapeutic method for denture stomatitis (DS) with the relining of the maxillary complete denture (CD). Patient JN, male, 70 years old, came to the clinic for rehabilitation treatment with new ones. On clinical examination, precarious condition of oral and prosthetic hygiene was observed, in addition to signs of DS in the supporting palatal mucosa. After oral hygiene guidelines, use and cleaning of the prostheses, the CD was relined with temporary soft material. After 14 days, clinical improvement of the signs of inflammation was observed and clinical procedures were started to obtain new prostheses. After installation, the patient was followed for 3 months, with the maintenance of the health of the palatal support tissues being observed. The suppression of contact between the contaminated acrylic base and the infected palatal mucosa after relining proved to be an alternative and efficient of the DS therapy for long-term.

Open Access Case Study

Tooth Fragmentation Reattachment using a Strip Crown with Resin Composite-A Case Report

Sushmita Roy, Madhumanti Karmakar, Pratik Lahiri, Shabnam Zahir

Asian Journal of Dental Sciences, Page 62-68

Coronal fracture of the anterior teeth is a common form of dental trauma. If the initial tooth fragment is maintained following fracture, reattachment of the broken fragment to the remaining tooth may offer higher and durable esthetics, a positive psychological response and could be a quicker and less complicated procedure. This report presents a case of a twelve-year-old boy, who came with a broken incisor due to an accident that occurred a month back. The patient also presented the fragment of the detached tooth. On radiographic examination it was revealed to be Elis class II fracture. The treatment plan was the reattachment of the fractured crown fragment using strip crown with resin composite on right central incisor.

Open Access Case Study

Esthetic Rehabilitation in Maxillary Anterior Zone in Patient with Fluorosis and Congenitally Missing Lateral Incisors with Space Closure Using Laminate Veneers-A Case Report

Manu Rathee, Sandeep Singh, Sanju Malik, S. Divakar, Sujata Chahal, Poonam Wakure

Asian Journal of Dental Sciences, Page 104-108

Cosmetic dentistry has broadened significantly in recent decades and restoring aesthetic appearance is a clinical challenge. Veneers is a minimally invasive method of restoring discoloured, fluorosed teeth and teeth with spacing.  One of the main reasons causing teeth discoloration is dental fluorosis, which is significant problem compromising dental aesthetics. Laminate veneers offer great assurance in this regard as they provide perfect aesthetic results in a very conservative way and simultaneously meet the structural, functional, biological and mechanical requirements necessary to ensure long term clinical performance. This case report describes the case of congenitally missing lateral incisors and severe dental fluorosis causing brownish patchy discoloration of the teeth which were contoured and restored with porcelain laminate veneers to achieve the desired aesthetic outcome.

Open Access Case Study

Maxillary Rehabilitation with Combined Fixed-Removable Prosthesis Using Extra Coronal Semi Precision Attachment: Case Report

Benkhalifa Sarra, Mabrouk Yosra, Mansour Lamia

Asian Journal of Dental Sciences, Page 134-141

Creating a hybrid prosthesis using attachments can be a challenging task for the dentist and for dental technician. The dentist should take into consideration the patient's preferences and requests as well as functional and esthetic demands.

Experience and knowledge on the part of the dentist and laboratory technician of difficulties and limitations of each clinical and laboratory step are essential components to successful fabrication and maintenance of these relatively complex restorations.

This article reports a full mouth rehabilitation utilizing fixed and cast removable partial prosthesis, combining them with extra coronal castable semi precision attachment (Ceka preci-clix 1271 extra coronal attachment).

Open Access Minireview Article

Luting Agents in Prosthodontics

Hee Li Chin, Sharon Han Shiou Shin

Asian Journal of Dental Sciences, Page 69-78

Aims: To discuss the properties, strengths and weaknesses of each luting agent for dental professionals to choose an appropriate luting agent for each unique clinical situation.

Background Information: One of the factors that determine the success of long-term fixed prostheses is the selection of a good dental luting agent that is ideal for the patient. However, as luting agents are continually being developed, a vast range of luting agents are now available for dental professionals. The selection of an appropriate luting agent may be difficult if they are inexperienced with the recent developments. 

Methods: Narrative literature review that uses literature results on luting agents that are assessed from searches on Google Scholars databases.

Conclusion: There is no available product that satisfies the requirements for an ideal luting agent and the existing agents may not be the best but they are safe to use with proven efficiency and reliability.

Open Access Original Research Article

Adherence of Periodontal Patients to Supportive Therapy at the University Clinics of Kinshasa, Democratic Republic of the Congo

M. N. Patrick Sekele, I. Jacques Bolenge, Nzudjom Foche Adelin Baudouin, S. Willy Lusasi, Koto-Te-Nyiwa Ngbolua, I. B. Jean-Paul Sekele

Asian Journal of Dental Sciences, Page 7-14

Aim of the Study: To determine the level of adherence of periodontal patients at the University Clinics of Kinshasa (CUK).

Methodology: A cross-sectional study on adherence of periodontal patients to supportive therapy was conducted at CUK from 2016 to 2019. Patients who have suffered from periodontitis during the study period and benefited from a non-surgical periodontal treatment, aged at least 18 years, answered at least to the three appointments recommended for a period of 6 months for the Supportive periodontal therapy (SPT) and who were available to undergo an interview on the basis of free consent were included. The convenience sampling technique was used. Univariate analyses were performed on socio-demographic, clinical, therapeutic and post-therapeutic variables in order to obtain descriptive statistics.

Results: Of 97 periodontal patients, 58.8% were female versus 41.2% male. The most representative age group was 18 to 30 years old (40.2%), 80.4% were incomplete adherents versus 19.6%, almost all periodontal patients were partial third party payers (85.6%); the preponderant reason for visit was pain (55.7%); most periodontal patients had benefited from motivation to oral hygiene, scaling and root planing (60.8%) The most common reason for non-return given by incompletely adherent periodontal patients was the disappearance of the main complaint. The Kolmogorov-Smirnov test for normality of the quantitative variable at the 0.05 probability level revealed that the distribution was not normal.

Conclusion and Suggestions: Incomplete adherence of periodontal patients to SPT at CUK was high. Special attention to the development of a therapeutic follow-up protocol deserves to be implemented.

Open Access Original Research Article

Frequency of Oral and Dental Diseases Presenting to Medical Professionals in Bayda City-Libya. Across-sectional Study

Maraai I. Orafi, Mansora Abd Alhamid

Asian Journal of Dental Sciences, Page 15-22

Objective: To find out the frequency of patients with oral diseases presented to medical professionals, type of oral symptoms/conditions and where were these patients referred?

Materials and Methods: A convenient sample size of 100 participants was decided. The questionnaire of the study was developed based on a previously validated survey with minor modifications. In particular, questions were raised regarding benign and malignant diseases and dental or denture-related problems. Also, medical practitioners were requested to identify the specialist to which the patient would be referred if a second opinion was required.

Results: The majority of the study participants were female (65%) and their ages ranged from 27 to 67 years with a mean of 38.38 years. Eighty- nine (89%) participants had seen patients with dental and or oral diseases. Majority of medical professionals (MPs) would refer patients to general dental practitioners (61%), while 10% would refer to oral surgeons, only 5% to oral medicine specialists, 6% to Ear, nose and throat surgeon(ENT) and 2% of MPs refer patients with oral soft tissue lesions to dermatologists.

Conclusion: The present study has shown that medical professionals commonly see patients presenting with oral diseases especially oral mucosal lesions and commonly refer patient to general dental practitioners rather than another dental specialty.

Open Access Original Research Article

Prosthetic Oral Rehabilitation Needs in Patients Of Patients Attending Dental Clinics in Ngaoundere- Cameroon

Salomon Zing, Ashu Michael Agbor, Tatiana Djomo Minsi, Jean Paul Sekele

Asian Journal of Dental Sciences, Page 33-41

Background: Tooth loss though preventable is still considered as a natural consequence of senility as it limits a person's esthetics, function and psychosocial well-being. In order to restore these deficits, dental prosthetics are needed. The objective of the current study was to describe oral prosthetic needs of patients attending dental clinics in the city of Ngaoundéré-Cameroon.

Methodology: This was a descriptive cross sectional carried out in the city of Ngaoundéré between January to June 2019 using structured questionnaires. A WHO questionnaire was used for evaluating the prosthetic needs.

Results: A total of 266 participants made up of 54.9% males and 45.1% females were recruited in the study. The 25 to 34 age range was more predominant with a frequency of 41%.The prevalence of partial edentulousness was 99.2 % while that of total tooth loss was 0.8%.  A third of the edentulous space  31.6% was in the maxilla and 44.4% in the mandible. The average number of tooth lost was 2 teeth and most of the teeth lost were molars. More than half 115 (43.2%) participants perceived the needed oral rehabilitation. From clinical examination, 4(2.6%) did not need oral rehabilitation, 37(24.9%)  needed one unit prosthesis like dental implants  in the mandible and 31(20.3 ) in the maxilla, 118 (77.2%)  needed multi unit prosthesis in the maxilla and 95(62.9) in the mandible, and 2 (1.3%) needed full prosthesis (replacement of all teeth) e.g.  implant retained full dentures. The relationship between the prevalence of edentulousness , marital status , and socio-cultural factors were statistically significant.

Conclusion: The average number of teeth lost was 2 teeth and the most lost types of teeth were molars. Partial edentulousness was higher than that of total. Kennedy class III was the most common. Financial difficulties were the main reason for the lack of prosthetic rehabilitation. Three quarter of the respondents needed prosthesis with Code 1 and code 2 WHO prosthetic needs.

Open Access Original Research Article

An Online Survey on the Effect of COVID-19 Pandemic on Psychological Health and Impact on Dissertation of Dental Postgraduate Students in India

Pinki Gupta, Ankita Singh, Atul Bhatnagar, Gargi Goel

Asian Journal of Dental Sciences, Page 42-50

Background: Corona virus disease 2019 (COVID-2019) is caused by a novel virus which belong to a family of corona virus. It is highly infectious and transmissible disease. First case of COVID-19 was reported in china on 31st December 2019 and on March 11, 2020 it was declared pandemic by WHO. In india the first case of COVID-19 was reported in Kerala, On January 27, 2020. COVID 19 has caused an immense pressure on the population, especially among doctors and health care workers. Post graduate dental students were also facing the high increasing risk, increase workloads as well as pressure to complete their thesis due to this COVID-19.

Aims and Objectives: The aim of this study is to assess the effect of COVID-19 pandemic on psychological health and impact on dissertation of post graduate students of dental field.

Materials and Methods: A web based cross- sectional study was conducted during July 2021 targeting dental postgraduate students. A self-developed questionnaire was circulated among the targeting population. Descriptive statistics was applied to calculate proportions and frequencies.

Results: Total of 223 participants completed the survey. Among the responses received 51.6% students had their dissertation in in vitro design and rest 48.4% had in vivo. More than 50% students were facing some kind of problems to complete their dissertation due to COVID-19. 36% students are planning to change their dissertation topic among them 75% planning to change their study design to in vitro. 100% of students were facing some kind of psychological problems and seeking help for the same.

Conclusion: This study suggests that COVID 19 has posed a negative impact on the academic works especially the dissertation work and the psychological state of the postgraduate dental students. Most of the students decided to change their area of dissertation towards in vitro study design.

Open Access Original Research Article

Quality of Oral Health and Satisfaction of Patients with Dental Prostheses in the City of Ngaoundere

Ashu Michael Agbor, Zing Salomon, Yasmine Mohamadou, Djoumou Francois

Asian Journal of Dental Sciences, Page 51-61

Introduction: Tooth loss affects speech, eating, social wellbeing as well as the quality of life of an individual. Determining the subjective effect of prosthetic treatments makes it possible to identify the needs of patients with dentures and also evaluate their prosthetic adaptability. The objective of our study was to evaluate the quality of life and the satisfaction of patients wearing dental prostheses in the city of Ngaoundéré.

Methodology: This was a cross-sectional descriptive study carried out in dental departments of some hospitals in the city of Ngaoundéré. The study population consisted of all consented patients who had been wearing dentures for at least one week. Data collection was carried out through a dental consultation using a pre-established consultation form to evaluate the oral health quality of life of participants the using OHIP 20 questionnaire and a secondly a questionnaire whichwas used to evaluate  their degree of satisfaction with the wearing of  dentures. This was followed by clinical evaluation to evaluate their treatment needs.

Results: A total of 100 patients with dentures made up of51% males were recruited in the study. The 41-50 and 51-60 years age groups were the most represented with a rate of 21%.A third 38(38%) of our population were workers in the formal sector, and 52(52%) were married. The DMFT index of our population was 8.9.Only 16(16%) of the patients had a fixed prosthesis with 42(42%) in the (esthetic zone) anterior section. More than half 53(53%) of the patients recorded a score higher than 95 on the OHIP scale, synonymous with a very good oral quality of life. More than two thirds 77(77%) of patients were generally satisfied with their prosthesis while 86% were dissatisfied with the cost.

Conclusion: Though the quality of oral life and satisfaction of edentulous patients with prostheses was good poverty and lack of insurance were factors affecting patients prosthetic rehabilitation. There was statically significant relationship between gender and quality of life but the type of prosthesis and duration of prosthesis did not have any statically significant relationship.

A re-evaluation of the cost of prosthetic treatments would improve their condition, by favoring their access to new prosthetic rehabilitation techniques such as implantology.

Open Access Original Research Article

Factors Influencing Choice of Root Canal Treatment by Patients Presenting With Non-vital Teeth in a Tertiary Health Facility in the South-South, Nigeria

R. Evbuomwan, H. A. Omokhua

Asian Journal of Dental Sciences, Page 92-103

Aim: To determine the factors that influenced treatment choices in patients presenting with non –vital teeth.

Methods: A descriptive cross- sectional study was carried out among patients presenting with a non-vital tooth at the Dental Centre, University of Benin Teaching Hospital. Respondents were selected using systemic sampling techniques. Data was obtained using a structured, interviewer-administered questionnaire. This was analyzed with IBM SPSS version 25.0  Frequency distribution and cross tabulation were computed for categorical variables. Oral health practices, knowledge and awareness of root canal treatment and factors influencing choice of treatment were obtained.

Results: The age range of participants was 20-60 years with majority of the respondents (53.7%) being female, with a female to male ratio of 1:0.9. Most respondents (55.2%) had poor oral health practices but good knowledge of root canal treatment was greater than half 56.5%. Most respondents had tertiary education (70.6%). Majority of respondents (74.3%) preferred to extract their teeth and cost was the major determinant of their choice.

Conclusion: The cost of root canal treatment was the ultimate factor in deciding the treatment choice amongst respondents. Younger age groups, female respondents, employed participants and respondents on health insurance were more likely to preserve their teeth. The role of attending dentists in influencing patient’s choice of treatment was relatively high, but was overshadowed by cost.  This Implies  that low income earners will continue to have their teeth removed except they can benefit from health insurance.

Open Access Original Research Article

Assessment of Serum Protein levels in Oral Submucous Fibrosis Patients

Sharique Ahmad, Tanish Baqar, Siddhartha Chandel

Asian Journal of Dental Sciences, Page 109-115

Background and Aim: Serum total protein, albumin and uric acid are plasma’s potent antioxidant defense; it can be used as a dependable marker of oxidative stress in the body and can untimely recognize oral submucous fibrosis (OSMF), beside the other intrusive and not so successful demonstrative aides. Hence the present study was aimed to compare the serum levels of total protein, albumin and uric acid in oral submucous fibrosis patients.

Material & Methods: Patients were allotted into three categories: Group I comprised 25 healthy individuals, Group II comprised of 25 individuals with chewing tobacco habit without OSMF, and Group III comprised of 25 patients with chewing tobacco habit with OSMF. The inclusive patients were asked to fast overnight. The very next day between 8-10a.m, 5 ml of blood was drawn from each subject intravenously, using a sterile disposable syringe. Assay of albumin & total protein were carried out using the bromocresol green method and that for uric acid was carried out by biuret method.

Results: The mean serum levels of Total protein fell from group I to group III; variation was not found to be statistically considerable. Serum levels of Albumin fell from group I to group III; dissimilarity was found to be statistically considerable (p < 0.05). Serum levels of Uric acid decreased from group I to group II; difference was found to be statistically significant (p < 0.05).

Conclusion: Our study proposes that the degree of oxidative damage in OSMF can be evaluated by estimating the levels of serum Total Protein, Albumin & Uric Acid in pretentious patients. The basic deficiency of antioxidants can be remedied by adding a diet of these antioxidants. This can help in successful management of OSMF and avoid the negative consequences.

Open Access Original Research Article

A Comparative Cephalometric Evaluation of Maxillary Central Incisor Crown Root Relationships in Various Malocclusions

Priya Raj, Ajith R. Pillai, Jayanth Jayarajan, Fawas Shaj, Sruthy Rajeev, Reyas Rasool

Asian Journal of Dental Sciences, Page 116-126

Background and Objectives: An attractive smile is a pleasant effect of Orthodontic treatment which has got a lot of emotional benefits.The variation in tooth morphology of anteriors and its angulations and Inclinations play an important role in Smile Esthetics.The angulations of the root to the crown of a single rooted anterior teeth is known as Collum angle.The Collum angle of a single- rooted teeth is of particular interest to an Orthodontist because any variation in root angulations can cause unpredictable axial force application in movements such as intrusion and extrusion.The aim of the study is to compare the Collum angle,Labial crown root angle and Torque angle of class I with that of class II and class III.

Materials and Methods: Lateral cephalometric radiographs of 15 patients with age 20-30yrs, each for Class I,class II div 2,Class II div 1,Class III. patients were collected from the Department of Orthodontics, Azeezia College of dental science. Lateral cephalometric radiographs are scanned, digitized, and loaded into Nemoceph software for landmark identification and measurement.These measurements were compared to find the changes in CA,LCRA and torque angle of maxillary central incisors of patients with class I ,class II and class III dental malocclusion.

Results and Discussion: CA, LCRA, Torque angle of Class II div 2 shows significant difference when comparing with other classes of malocclusion. Variations in the crown-root angle, or "collum angle" (CA), is an important factor in treatment planning because it helps to achieve greater predictability in root position, and to anticipate difficulties with intrusion, extrusion, tipping and torqueing mechanics.

Conclusions: CA, LCRA, Torque angle of Class II div 2 malocclusion showed significantly greater value, when comparing with other classes of malocclusion.

Open Access Original Research Article

Self Rating of Satisfaction with Dental Appearance of a Group of Nigerian Doctors and Nurses

Elfleda Angelina Aikins, Modupeoluwa Omotunde Soroye

Asian Journal of Dental Sciences, Page 127-133

Introduction: A pleasant dental appearance translates to a pleasant smile. The need for aesthetic dental changes is very often self-perceived and can have a large effect on individuals’ self-confidence and their overall quality of life. There is paucity of such data among  healthcare professionals particularly doctors and nurses thus the aim of this study is to assess the self-satisfaction of doctors and nurses with their dental aesthetics.

Materials and Methods: This was a self-administered questionnaire-based descriptive cross-sectional study carried out among medical doctors and nurses in University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State.

Results: A total of seventy-nine doctors and nurses participated in this study. Majority of the nurses were females (39,83.0%) whilst majority of doctors were males (21. 65.6%). More than half of the participants were single (45,57.0%). About half of the participants (44,55.7%) believed that their teeth were healthy and well-arranged. and were satisfied with the appearance of their teeth (47,59.5%).

Conclusion: Female participants expressed greater dissatisfaction with their dental aesthetics. Those aged 31–40-years were the most satisfied with their dental aesthetics.

Open Access Review Article

Endodontics and the Smear Layer: History, Effects and Approaches for Removal

Rajiv Narayan Purohit, Kanchan Purohit

Asian Journal of Dental Sciences, Page 79-91

The smear layer is the accumulation of mineralized and organic matter during endodontic therapy. The history of smear layer, its effect and approaches for removal are described in this review. The approaches for removal of smear layer include chemical removal, ultrasonic removal, laser removal and a combination of these approaches. In spite of diversity of opinions as to removal of the smear layer the general consensus stands in favor of removal of smear layer and the authors concur with the opinion that smear layer must be removed for better results in endodontic.