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  Citation statistics : Table of Contents
   2015| January-March  | Volume 15 | Issue 1  
    Online since May 14, 2015

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Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management
Andrew L Young
January-March 2015, 15(1):2-7
DOI:10.4103/0972-4052.156998  PMID:26929478
Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care.
  22 7,700 968
Prevalence of Candida spp. among healthy denture and nondenture wearers with respect to hygiene and age
Bharathi Prakash, Malathi Shekar, Biswajit Maiti, Indrani Karunasagar, Sreeshma Padiyath
January-March 2015, 15(1):29-32
DOI:10.4103/0972-4052.155041  PMID:26929483
Dentures are inert and nonshading surfaces and therefore get easily colonized by Candida species. Subsequent biofilm produced by them lead to denture stomatitis and candidiasis. This study was aimed to understand the prevalence of Candida species among healthy denture and nondenture wearers with respect to their age and hygiene status. Swabs were collected from 50 complete dentures and 50 non-denture wearers and processed on Sabouraud's dextrose agar. Identification of Candida species was done by staining and a battery of biochemical tests. Data obtained was correlated with age & oral hygiene and statistical analysis was performed. Candida was isolated from both denture and nondenture wearers. Prevalence of different Candida species was significantly higher in denture wearers and found predominated by C. albicans, C. tropicalis, C. dubliensis and C. glabrata. Among nondenture wearers, C. albicans and C. tropicalis were isolated. Prevalence of Candida increased with increasing age among denture wearers. Men presented declining denture hygiene compared to women with increasing age. In comparison to nondenture wearers, multispecies of Candida colonized the dentures thus presenting higher risk of candidiasis especially with increasing age.
  4 3,293 258
Oral care needs, barriers and challenges among elderly in India
Ramesh Bharti, Anil Chandra, Aseem Prakash Tikku, Deeksha Arya, Richa Gupta
January-March 2015, 15(1):17-22
DOI:10.4103/0972-4052.155044  PMID:26929481
Objective: This paper presents an approach to the assessment of oral health needs of elderly and barriers to receive oral care in the life course. Background: The dental needs of the elderly are changing and growing day by day. The management of older patients requires not only an understanding of the medical and dental aspects of ageing but also provide them good oral health service. In the life course of elderly there are many hurdles to receive proper oral care. The use of an assessment of oral health need will be essential in the development of care pathways to the elderly. Methods: The proportion of older people is growing faster than that of any other age group. There is no sound database regarding the oral disease burden and treatment needs of the elderly in India. Physical and biological barriers with age can also affect oral health care either directly or indirectly. Conclusion: Oral care guidelines designed to assist elderly should consider not only prevention and treatment modalities but also the means of implementing such therapies in varying settings and utilizing the whole dental team.
  4 6,155 461
Fundamentals of cone beam computed tomography for a prosthodontist
George Puthenpurayil John, Tatu Elenjickal Joy, Justin Mathew, Vinod R. B. Kumar
January-March 2015, 15(1):8-13
DOI:10.4103/0972-4052.157001  PMID:26929479
Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone. [1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10-70 s) and radiation dosages reportedly up to 15-100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.
  4 4,243 419
Comparative evaluation of surface topography of tooth prepared using erbium, chromium: Yttrium, scandium, gallium, garnet laser and bur and its clinical implications
Mahesh Verma, Pooja Kumari, Rekha Gupta, Shubhra Gill, Ankur Gupta
January-March 2015, 15(1):23-28
DOI:10.4103/0972-4052.155042  PMID:26929482
Background: Erbium, chromium: Yttrium, scandium, gallium, garnet (Er, Cr: YSGG) laser has been successfully used in the ablation of dental hard and soft tissues. It has been reported that this system is also useful for preparing tooth surfaces and etching, but no consensus exist in the literature regarding the advantage of lasers over conventional tooth preparation technique. Materials and Methods: Labial surfaces of 25 extracted human maxillary central incisors were divided into two halves. Right half was prepared with diamond bur and left half with Er, Cr; YSGG laser and a reduction of 0.3-0.5 mm was carried out. Topography of prepared surfaces of five teeth were examined under scanning electron microscope (SEM). The remaining samples were divided into 4 groups of 10 specimens each based on the surface treatment received: One group was acid etched and other was nonetched. Composite resin cylinders were bonded on prepared surfaces and shear bond strength was assessed using a universal testing machine. Results: The SEM observation revealed that the laser prepared surfaces were clean, highly irregular and devoid of a smear layer. Bur prepared surfaces were relatively smooth but covered with smear layer. Highest bond strength was shown by laser prepared acid etched group, followed by bur prepared the acid etched group. The bur prepared nonacid etched group showed least bond strength. Conclusions: Er, Cr: YSGG laser can be used for preparing tooth and bond strength value achieved by laser preparation alone without surface treatment procedure lies in the range of clinical acceptability.
  3 3,059 179
Rehabilitation of a missing ear with an implant retained auricular prosthesis
Satyabodh Sheshraj Guttal, Shruti Shanbhag, Sudhindra S Kulkarni, Srinath L Thakur
January-March 2015, 15(1):70-75
DOI:10.4103/0972-4052.155046  PMID:26929490
Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient's physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis.
  2 4,236 339
Marginal accuracy of nickel chromium copings fabricated by conventional and accelerated casting procedures, produced with ringless and metal ring investment procedures: A comparative in vitro study
Deepa Alex, Y Bharath Shetty, Glynis Anita Miranda, M Bharath Prabhu, Reshma Karkera
January-March 2015, 15(1):58-64
DOI:10.4103/0972-4052.155043  PMID:26929488
Background: Conventional investing and casting techniques are time-consuming and usually requires 2-4 h for completion. Accelerated nonstandard, casting techniques have been reported to achieve similar quality results in significantly less time, namely, in 30-40 min. During casting, it is essential to achieve compensation for the shrinkage of solidifying alloy by investment expansion. The metal casting ring restricts the thermal expansion of investment because the thermal expansion of the ring is lesser than that of the investment. The use of casting ring was challenged with the introduction of the ringless technique. Materials and Methods: A total of 40 test samples of nickel chromium (Ni-Cr) cast copings were obtained from the patterns fabricated using inlay casting wax. The 20 wax patterns were invested using metal ring and 20 wax patterns were invested using the ringless investment system. Of both the groups, 10 samples underwent conventional casting, and the other 10 underwent accelerated casting. The patterns were casted using the induction casting technique. All the test samples of cast copings were evaluated for vertical marginal gaps at four points on the die employing a stereo optical microscope. Results: The vertical marginal discrepancy data obtained were tabulated. Mean and standard deviations were obtained. Vertical discrepancies were analyzed using analysis of variance and Tukey honestly significantly different. The data obtained were found to be very highly significant (P < 0.001). Mean vertical gap was the maximum for Group II (53.64 μm) followed by Group IV (47.62 μm), Group I (44.83 μm) and Group III (35.35 μm). Conclusion: The Ni-Cr cast copings fabricated with the conventional casting using ringless investment system showed significantly better marginal fit than that of cast copings fabricated from conventional and accelerated casting with metal ring investment and accelerated casting using ringless investment since those copings had shown the least vertical marginal discrepancies among the four methods evaluated in this study.
  2 3,783 301
Effect of oral prophylactic instrumentation on the surface texture of all metal restorative materials
CL Rajeswari, MV Sunil Kumar
January-March 2015, 15(1):39-45
DOI:10.4103/0972-4052.155039  PMID:26929485
Introduction: In the inaccessible areas on the crown the removal of calculus and stains by hand and ultrasonic instrumentation is the method for cleaning to preserve and increase the longevity of the restoration. However, when oral prophylaxis is performed on restorative crowns, it may produce some surface alterations and may favour plaque accumulation. Statement of Problem: Many patients may have restored their teeth with artificial crowns and would come to the dental office for oral prophylaxis. If a routine oral prophylaxis is followed, its effect on the restorative materials and the plaque accumulation can be studied. Materials and Methods: A total of 15 disc shaped wax patterns were invested and casted for cast titanium (Group A) and the remaining 15 disk shaped for nickel-chromium (Group B). The obtained castings were finished and polished. All the specimens were subjected to hand and ultrasonic scaling for 15 s. Profilometer and scanning electron microscopic was used to analyze and evaluate the surface roughness. Specimens of each group were embedded on the anterior lingual aspects of the removable lower retention plates. 5 volunteers were asked to wear it in the mouth for 24 h for 7 days. After 7 days, the specimens were stained with plaque disclosing solutions and the photomicrographs were taken by the optical stereomicroscope and the plaque accumulations were assessed in percentage. Results: The difference in average surface roughness (μm) of the polished test specimens was maximum for ultrasonic scaling than hand scaling and maximum for Group A than Group B. Plaque accumulation in percentage on the treated specimens was found to be nonsignificant but, mean plaque accumulation was maximum on ultrasonic scaling surface than hand scaling and maximum for Group A than Group B. Surface roughness was found to be statistically significant after hand scaling (F = 9.377, P = 0.000) and ultrasonic scaling (F = 5.373, P = 0.0000) by Student t-test. Conclusion: The Surface roughness and plaque accumulation on the specimens were more for Group A than Group B and maximum produced by ultrasonic scaling than hand scaling.
  2 2,676 157
Comparative evaluation of effects of bleaching on color stability and marginal adaptation of discolored direct and indirect composite laminate veneers under in vivo conditions
Veena Jain, Taposh K Das, Gunjan Pruthi, Naseem Shah, Suresh Rajendiran
January-March 2015, 15(1):46-52
DOI:10.4103/0972-4052.155038  PMID:26929486
Statement of Problem: Change in color and loss of marginal adaptation of tooth colored restorative materials is not acceptable. Bleaching is commonly used for treating discolored teeth. However, the literature is scanty regarding its effect on color and marginal adaptation of direct and indirect composite laminate veneers (CLVs) under in vivo conditions. Purpose: Purpose of the study was to determine the effect of bleaching on color change and marginal adaptation of direct and indirect CLVs over a period of time when exposed to the oral environment. Materials and Methods: For this purpose, a total of 14 subjects irrespective of age and sex indicated for CLV restorations on maxillary anterior teeth were selected following the inclusion and exclusion criteria. For each subject, indirect CLVs were fabricated and looted in the first quadrant (Group 1) and direct CLV's (Group 2), were given in the second quadrant. Color change was assessed clinically using intra-oral digital spectrophotometer and marginal adaptation was assessed on epoxy resin replica of the tooth-restoration interface under scanning electron microscope. After 6 months, the subjects underwent a home bleaching regimen for 14 days using 10% carbamide peroxide. The assessment of color change and marginal adaptation was done at 6 months after veneering (0-180 days), immediately after the bleaching regimen (0-194 days) and 3 months after the bleaching regimen (0-284 days). Results: The difference in median color change (ΔE) between the groups was tested using Wilcoxon rank sum test while the median color change with time within the groups was tested using Wilcoxon signed rank test. The difference in the rates of marginal adaptation was tested between the groups using Chi-square/Fisher's exact test. Bleaching led to statistically significant color change at cervical (CE), middle and incisal (IE) regions when direct and indirect composites were compared (P < 0.05). During intra-group comparison, direct CLV's showed significant color change at CE and IE regions when ΔE was compared at 180 days and 284 days (CE 10 vs. CE 30, P = 0.008, IE 10 vs. IE 30, P = 0.003). No significant differences were found when within group comparison was made for indirect laminates. Intergroup comparison between the groups showed significant difference in marginal adaptation at CE margin at all-time points (at baseline, P = 0.005; at 180 days, P = 0.007; 194 days, P = 0.025; at 284 days, P = 0.067). Conclusion: After bleaching, indirect CLVs performed better in terms of color stability whereas direct CLVs performed better in terms of marginal adaptation. Clinical Significance: Indirect composites should be preferred to direct composites as veneering materials as they have better color stability. Special attention should be given to their marginal adaptation especially in the CE region. Bleaching should be avoided in patients with composite restorations in the mouth.
  2 4,866 346
A comparative evaluation of bond strength of feldspathic porcelain to nickel-chromium alloy, when subjected to various surface treatments: An in vitro study
Kavan A Patel, Somil Mathur, Snehal Upadhyay
January-March 2015, 15(1):53-57
DOI:10.4103/0972-4052.155036  PMID:26929487
Purpose of the Study: The purpose was to evaluate the effect of various surface treatments and sandblasting with different particle size on the bond strength of feldspathic porcelain with predominantly base metal alloys, using a universal testing machine. Materials and Methods: Totally, 40 specimen of nickel-chromium alloy were prepared in an induction casting machine. The groups divided were as follows: Group I-sandblasted with 50 μ; Al 2 O 3 , Group II-sandblasted with 110 μ Al 2 O 3 , Group III-sandblasted with 250 μ Al 2 O 3 and Group IV-sandblasted with 250 μ Al 2 O 3, followed by oxidation and again sandblasted with 250 μ Al 2 O 3 . The dimensions of each specimen were adjusted so as to maintain the thickness of ceramic at 1 mm. The specimen were loaded on the assembly of the universal testing machine, and a cross head speed of 0.5 mm/min was used to apply a compressive force at the junction of metal and feldspathic porcelain. The force application continued until adhesive fracture occurred, and the readings of the load applied to that particular specimen were recorded. Results: The means for shear bond strength for Group I, II, III and IV were found to be (226.92 ± 1.67), (233.16 ± 3.85), (337.81 ± 16.97) and (237.08 ± 4.33), respectively. Means of shear bond strength among the groups were compared using one-way analysis of variance test. Comparison between individual groups were made with Tukey's Honestly Significant Difference post-hoc test. Conclusion: Different particle size and surface treatment have an important role on the bond strength of ceramic-metal interface. Greater particle size demonstrated higher bond strength.
  1 3,068 235
A comparative study to evaluate the osteoblastic cell behavior of two nano coated titanium surfaces with NAFION stabilized the membrane
Sanjna Nayar, Sanket Chakraverty
January-March 2015, 15(1):33-38
DOI:10.4103/0972-4052.155040  PMID:26929484
Aim: The aim of the study was to comparatively analyze the in vitro cell adhesion between nano coated titanium dioxide, and calcium hydroxyapatite (HA) coated titanium samples. Materials and Methods: Nano coated titanium dioxide, and calcium HA were coated onto the titanium samples by drop casting with NAFION membrane and cell culture was done by seeding human osteoblastic sarcoma cells on the coated samples. Results and conclusion: There was marked cell adhesion seen in the samples coated by titanium dioxide nano particles and more cells spreading as compared to calcium HA nano particles.
  1 2,900 154
A new and simple method of fabrication of tracheostomal prosthesis
N Vidya Sankari, Jayashree Mohan, Paul Simon, Indumathi Sivakumar, Yogesh Subamanium
January-March 2015, 15(1):76-82
DOI:10.4103/0972-4052.155047  PMID:26929491
Patients with a tracheostomy stoma experience compromised speech and function due to the associated changes in airflow patterns. Rehabilitation of a patient with tracheal stoma is a highly challenging task. The main objective is to design an inexpensive, easily fabricated stomal prosthesis for postlaryngectomy patients who require prolonged tracheotomy. This clinical case report describes a 29-year-old male patient who underwent for tracheotomy 3 months before for respiratory distress following a suicidal attempt. Hence tracheotomy was done, and the patient has been with the tracheostomal tube since surgery for the past 3 months. Laryngoscopy examination reported as restricted bilateral vocal cord movements, and the cords were in the adducted position with minimal glottic chink. No history of difficulty in swallowing. On examination, no scar or ulceration is seen around the stoma. The skin around the stoma is healthy. The patient was referred to the oral and maxillofacial Prosthodontics Department from the Department of ENT. The patient's old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. A tracheal button was made with 2 mm polyethylene urethane sheet to maintain the airway patency of the mature stoma. Width and length of the old tracheostomal tube were measured and customized with polyurethane sheet by directly flaming over heat. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis make more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications. An innovative approach for fabrication of tracheostomal prosthesis was discussed to increase its successful use in tracheostomal patients. The patient's old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis makes more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications.
  - 4,117 206
Shilpa Shetty
January-March 2015, 15(1):1-1
DOI:10.4103/0972-4052.156995  PMID:26929477
  - 1,777 148
Intervention for replacing missing teeth: Partially absent dentition-Evidence summary of Cochrane review
Srinivasan Jayaraman
January-March 2015, 15(1):65-69
DOI:10.4103/0972-4052.157055  PMID:26929489
Cochrane reviews are systematic reviews with meta analysis published by the Cochrane collaboration, in the Cochrane Database of Systematic Reviews (CDSR). These reviews provide the clinicians with the highest level of evidence as they use a highly structured and transparent systematic review model to address a specific research question. The management of partially absent dentition is routinely under taken by general dentist and Prosthodontist but clinical practice guidelines based on evidence to this common problem is yet to be summarized. This Cochrane systematic review aims to address the effect of different prosthesis for the treatment of partially absent dentition in the terms of, Long-term success, function, morbidity, and patient satisfaction. All randomized controlled trials were searched till March 18, 2011, based on the inclusion and exclusion criteria, 21 trials were included and 32 trials were excluded and, it was critically appraised using the Cochrane methodology for interventions. The summary of evidence from the study concludes that there is insufficient evidence to state the effectiveness of removable and fixed prosthesis in partially edentulous subjects in the following four outcomes. There were insufficient trials to perform a meta-analysis and sensitivity analysis. This evidence-based summary emphasizes and reinforces the need to reassess the quality of research currently pursued in our profession, to address the need to provide higher level of evidence for common conditions like partial edentulousness. The included studies are basically not from our population too, hence the urgency to address this critical issue.
  - 2,164 143
A novel technique using arti-spot coated on fleximeter strips to determine the clearance during tooth preparation in fixed partial denture
Soma Sundaram Prasadh
January-March 2015, 15(1):14-16
DOI:10.4103/0972-4052.155027  PMID:26929480
The amount of occlusal clearance during tooth preparation for fixed partial denture is more crucial and critical phase of fixed prosthodontics. Improper tooth reduction leads to compromise in structural durability and failure of the restoration. Over reduction affects the biological principles of tooth preparation. This article uses color coded fleximeter strips coated with arti-spot to determine the amount of clearance during tooth preparation in fixed partial denture.
  - 3,390 305