Search

Introduction: The dental clinic has for a long time been considered as a risky place for infection dissemination. Due to aerosol generating procedures, the risk of cross-transmission in dental clinics has recently risen. Open dental clinics should undergo present-time reassessment concerning infection control, in particular, to consider the implications of the SARS-CoV-2 pandemic for today’s advanced technological and medical practices. It might be necessary to make urgent and appropriate modifications to the design of air circulation systems in the dental environment to prevent microbial transmission. The Hypothesis: In order to minimise cross-transmission in multi-chair dental operatories, we have designed two model ventilation systems with 12 and 36 air change/hour capacities and with laminar airflow direction. The conditioned air directly blows into the dental treatment units, especially into the aerosol generating area, where the contamination is more concentrated. We hypothesise that these new designs could serve to isolate dental treatment units to function separately like closed dental operatories while keeping them open to each other. Evaluation of the Hypothesis: Thorough physical and biological investigations will be required to determine how these designs can be applied effectively in terms of the required spatial separation of dental treatment units in the open multi-chair dental operatories.

Diastema between the teeth negatively affects the patients' smile, psychology and daily activities by creating a disharmony in the patients' face. The development of diastema has been attributed to several factors such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Patients often present with complex problems that require a multidisciplinary treatment approach which includes determination of the aetiological factors, soft tissue morphology, occlusion, patient demands and aesthetic consideration to achieve satisfactory outcomes. Lack of current literature on classification of diastemas and multi-disciplinary approach of management led to the proposal of a new classification the ATAC (Anatomic and Therapeutic Classification) for management of the diastema. This case report highlights the use of the proposed classification for management of diastemas, requiring a perio-restorative intervention using a Chu's proportion gauge to achieve ideal aesthetics.

Background: Periodontal disease is a common pathological oral ailment which affects the supporting structures of the teeth. Dental plaque is one of the major causes for gingivitis and periodontitis. If left untreated, this will lead to tooth loss. Studies have shown that oral prophylaxis will reduce gingival and periodontal inflammation by removing the plaque in all the surfaces. The objective was to assess knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia. Methodology: A descriptive study was conducted among people using questionnaire. Results: 96% of the subjects brushed their teeth with brush and paste. 59% of the study subjects had knowledge regarding interdental aids, whereas only 15% of them practiced it. 72% of the people mentioned that dentists gave information regarding interdental aids. Conclusions: Among the study subjects, even though there were deficits in few areas, overall knowledge about interdental aids was good and it increased with increasing level of education.

Background: Interdental areas are more prone to plaque accumulation, thereby increasing the susceptibility for periodontal diseases. Proper method of interdental hygiene assessment and motivation to use interdental aids can potentially reduce the burden of periodontal diseases. Materials and Methods: Fifty consecutive volunteer participants who presented with gingival inflammation were recruited based on the set of inclusion criteria. Further, proposed interdental hygiene index (IDHI) and gingival index were recorded by the examiner. Patient-reported outcome measures (PROMs) were recorded on the baseline and 4-week follow-up visits. Descriptive statistics and correlation analysis were performed. Results: The study comprised 50 participants with 22 male and 23 female participants. At baseline, the mean/standard deviation of IDHI was 1.32 ± 0.10 and 0.62 ± 0.21 on follow–up, respectively. For Gingival Index (GI) at baseline, the mean/standard deviation was 1.61 ± 0.15 and 0.70 ± 0.24 on follow–up, respectively. Correlation analysis revealed a significant correlation between IDHI and GI at baseline and follow-up. Majority of the participants scored 0 on the Visual Analogue Scale (VAS) for pain, rated “Good” for acceptability of procedure and perceived efficacy of interdental brush. Participants reported to have acquired “High level of motivation” to use an interdental brush. Conclusion: IDHI is a simple and reliable tool to assess the interdental areas of the patient and motivate to use interdental brush for the maintenance of good oral hygiene. PROMs also revealed positive responses from participants.

Background: The aim of this study was to find interrelation among embrasure configuration and recession of median papilla was. To assess impact of extent from the point of contact to bone crest (BC) on the existence of the interproximal papilla by radiographic method and to evaluate the extent between the papilla tip (PT) to the BC by comparing clinical and radiographic methods were the objectives. Methods: With the use of periapical radiographs (paralleling cone technique in RVG with grid) of the maxillary central incisors, the central papilla was evaluated in 100 adults. To evaluate and compare the extent between PT and BC, bone sounding was used. The vertical measurements were: papilla recession, contact point (CP) to BC, CP to proximal cement-enamel junction (pCEJ), and papilla height. The interdental width was the horizontal measurement. According to width interproximally and pCEJ to point of contact extent, total four study groups were divided: long narrow, short narrow, long wide, and short wide. Results: The comparison among radiographic method and clinical method revealed that there was statistically no significant difference between two methods among long-narrow and short-wide group. However, statistically significant difference was noted among short-narrow and long-wide group. Conclusion: Median papilla recession was associated with a wide-long type of embrasure configuration. Although many features such as periodontal phenotype and shape of teeth may influence the probability of the existence of the inter-proximal papilla, therefore the interconnections between these factors are not clear and require further research.

Background: Alveolar bone loss at the crest and interdental osseous defects are the frequent outcomes of periodontal disease. Radiographs act as valuable adjunct as they provide essential information regarding the morphology of residual bone and help in determining the prognosis, formulating treatment plan, and establishing the outcome of various therapies. Aims: The aim of the study was to compare the measurements obtained by conventional (intraoral periapical [IOPA] radiographs) and digital radiographs (radiovisiography [RVG]) for the assessment of alveolar bone by utilizing intrasurgical (IS) measurements as the gold standard. Methods: Thirty systemically healthy periodontitis patients with 100 interproximal sites were selected to undergo periodontal flap surgery. IOPA radiographs and RVG were taken before surgery using paralleling cone technique with the help of extension cone paralleling technique (XCP)®. Measurements in case of horizontal and vertical bone loss were taken and compared to IS measurements. Statistical Analysis Used: Analysis of variance and post hoc test were used. Results: No statistically significant difference was found between conventional and digital radiographic method in comparison to IS (IS) method for the assessment of alveolar bone level. Conclusion: Both radiographic methods (conventional and digital) showed statistically nonsignificant results in comparison to IS measurements. Hence, either IOPA radiograph or RVG can be used to visualize the alveolar bone level in periodontal disease.

Background: Periodontitis presents itself in the form of gingivitis or periodontal pockets/periodontitis. Gingivitis always precedes the later, but the reverse may not be true. Dental plaque is the primary etiology for chronic gingivitis. Hence, a regular cleaning is necessary especially in the interdental areas for the removal of plaque and to prevent gingivitis and periodontitis by means apart from the regular brushing. The most common and affordable ways of achieving this are through the use of dental floss. Aim: The present study was carried out to evaluate the effect of flossing with a waxed dental floss apart from toothbrushing as an effective means to reduce gingival inflammation. Materials and Methods: The study was an open-labeled nonexperimental clinical study. A total of 60 adult patients between 20 and 50 years were selected and randomly assigned to 2 groups – one Group A with only manual toothbrushing (Oral B) and the Group B with manual toothbrushing (Oral B) and flossing with an unwaxed dental floss (Colgate). Both the groups were evaluated at baseline, after 14 days and after 28 days. Gingival index was recorded using the Loe and Sillness index while the gingival bleeding was scored using the Carter and Barnes Bleeding Index. The data collected were subjected to statistical analysis using SPSS 20.0 (Chicago, IL, USA). Student's “t”-test was carried out. All P < 0.05 were considered to be statistically significant. Results: There was a statistically significant reduction in the gingivitis, bleeding, and plaque accumulation in the Group B compared to Group A, at baseline and after 28 days of evaluation (P < 0.001). There was no significant reduction in the bleeding index for the lingual surfaces between the two groups. The results thus showed that there was a significant reduction in the plaque accumulation and gingival bleeding for Group B compared to Group A. Conclusion: Regular toothbrushing helped to improve the gingival health and reduce the amount of plaque accumulation. Toothbrushing and flossing served better in achieving interdental plaque control and in reducing gingival bleeding.

Background: Witnessing the alarming rise and pattern of distribution of dental caries worldwide, the need of the hour is to take initiative in preventing the spread further. Aim: This survey was conducted to determine the occurrence of dental caries and its associated risk factors in teenagers of Mumbai city who visited Nair Hospital Dental College. Materials and Methods: The objective of the study was to analyze the current dietary habits, oral hygiene status, and the number of sugar exposures in teenagers by a questionnaire followed by clinical examination which was carried out using International Caries Detection and Assessment System (ICDAS) II to detect the profile of dental caries. Statistical Analysis: The data obtained from the questionnaire and examination were analyzed using Chi-square test. Results: The survey showed that, out of the 300 teenagers examined, 67% visited the dentist only when they were symptomatic. Around 60% consumed sweets 2–3 times/day. A major percentage, 89%, consumed sweets irrespective of meal time and 52% consumed aerated drinks often. Only 16% used appropriate brushing techniques and 93% were not aware if their toothpaste was fluoridated. ICDAS II revealed that a total number of teeth requiring preventive treatment ranged from 8.3% to 14% and total number of teeth requiring definitive treatment ranged from 36% to 48%. It was found that tooth most commonly treated was 36 followed by tooth number 46 showing that the incidence of caries is higher in lower arch. Conclusion: Most of the teenagers had a high rate of sweet consumption in between meals and poor knowledge of brushing techniques, fluoridated toothpaste, interdental aids, and mouthrinses. ICDAS showed a high incidence of caries in teenagers, especially in the lower arch. ICDAS II showed good accuracy in differentiating between noncavitated and cavitated lesions which helps to provide an accurate treatment plan for teenagers so that it prevents the progression of the lesion.

The Whale's tail technique performed to obtain maximum interdental papilla fill in the anterior region after placement of bone grafts. This study aims to assess the clinical efficacy of this new technique. This report describes a series of three cases with a probing depth of 6-7 mm in the maxillary anterior teeth and their treatment with Whale's tail technique to obtain regeneration and maximum papilla preservation. The cases in this report showed a pocket depth reduction of 3-4mm and a clinical attachment gain of 3-4mm. The application of the "Whale's tail" flap leads to clinically significant improvement of hard and soft tissue conditions and allows regeneration of wide intrabony defects involving the maxillary anterior teeth with notable interdental diastemas, maintaining interproximal tissue to recreate a functional attachment with esthetic results.

Previous studies have reported the management of Class I and II papillary defects, but knowledge on Class III defects, estimated to have a poor periodontal prognosis, remains minimal. In this case report, a Class III papillary defect reconstruction was attempted mainly since the patient reported with difficulty in phonetics. In Stage I, autogenous bone graft from the maxillary tuberosity and subepithelial connective tissue graft was augmented to decrease the distance between the interdental bone crest and contact point, simultaneously achieving a switch in the periodontal biotype. In Stage II, subepithelial connective tissue graft was augmented to achieve papillary fill. To avoid manual errors associated with quantifying the posttreatment outcomes, image data processing ImageJ software was used to assess the length, perimeter, and surface area of papillary loss using the preoperative images.

Background: To evaluate the gingival margin position (GMP) before and after open flap debridement in different gingival thickness (GT). Materials and Methods: Twenty-seven healthy patients with moderate to advanced adult periodontitis were included in a randomized control clinical trial. A calibrated UNC-15 periodontal probe, an occlusal onlay stent was used for clinical measurements recorded at baseline, 3 month, 6 month, and 16 month. The changes in the GMP were studied at midbuccal (Mi-B), mesiobuccal (MB), and distobuccal sites. GT was measured presurgically, transgingivally at Mi-B and interdental sites, divided into 2 groups: Group 1 (thin) and Group 2 (thick). Results: In GT of ≤1 mm group, the statistically significant apical shift of GMP led to gingival recession at all study sites in the early postsurgical period of 1 and 3 months. During 6 and 16 months, the apical shift of GMP coincided with the Chernihiv Airport at Mi-B site (6 months), MB site (16 months). The gingival recession was obvious at Mi-B sites (16 months). In the GT of >1 mm, the statistically significant apical shift of GMP did not cause gingival recession at any sites throughout postsurgical (1, 3, 6, and 16 months) period. Conclusion: Thin gingiva showed apical shift of GMP leading to gingival recession as compared to thick gingiva postsurgically.

Context: The crown lengthening procedure (CLP) is routinely carried out to correct gingival levels and achieve esthetic contours and adequate crown lengths for restorative purposes. Though the short-term outcomes have been found to be stable, long-term results are not much reported. Aims: To evaluate the long-term stability of the marginal bone levels, gingival levels, and the status of the teeth, which underwent endodontic therapy, followed by CLP and final restorations. Settings and Design: Institutional setting, long-term case series. Materials and Methods: Case records of the patients who underwent CLP and endodontic therapy for corrections of the supra-erupted teeth to regain the lost interocclusal spaces were retrieved, and the cases with complete set of the clinical and radiographs were taken. All the cases were recalled and bone levels on the radiographs, bleeding on probing, probing pocket depths, and changes in the soft tissue margins were evaluated. Statistical Analysis Used: Descriptive analysis. Results: A total of 25 teeth had undergone CLP and endodontic therapy and final restorations for a minimum of 24 months. The mean post-restorative duration was 50.8 ± 22.48 months (range 24–96 months). All the teeth were functional and asymptomatic with 100% survival. Interdental bone loss of 1 mm, probing pockets of 5 mm, and 1 mm buccal recession were observed in 16% of the sites. The amount of interocclusal space regained was adequate to restore the missing teeth in the opposing arch. Conclusions: The CLP is a predictive procedure for correction of supra-erupted teeth. The survival of the teeth that underwent the procedure in the present study was 100% over 24–96 months.

Background: The association between interleukin-6 (IL-6) (-174G/C) gene polymorphisms and level of tissue breakdown and periodontal disease progression is unknown. The present study investigated quantitative parameters of interdental papilla in chronic periodontitis (CP) patients with IL-6 (-174G/C) gene polymorphisms. Materials and Methods: Sixty gingival samples were studied. After determination of IL-6 (-174G/C) gene polymorphisms using a tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) technique, 45 gingival tissue samples of CP patients (GG and GC+CC genotypes) were considered as case groups. Fifteen control samples were also collected from healthy individuals. After tissue processing, interdental gingival tissues were exhaustively sectioned into 4 μm-thick sections. Ten to thirteen sections were sampled by systematic uniform random sampling and stained with Masson trichrome, and the volume density (Vv) of the gingival components was estimated using Cavalier′s point counting method. Statistical analysis was performed by Student t-test to compare differences between groups. The significance level was set at P < 0.05. Results: There were statistically significant differences in the Vv of epithelium, connective tissue, collagenous and non-collagenous matrix, and blood vessels between the control and CP groups (P < 0.0001). There were no statistically significant differences in the Vv of epithelium, connective tissue of gingiva, collagenous and non-collagenous matrix, and blood vessels among GG, GC, and CC genotypes in CP patients (P > 0.05). Conclusion: Results of the current study showed that there was no association between IL-6 (-174G/C) gene polymorphisms and quantitative parameters of interdental papilla in CP patients.

The use of implant anchorage has simplified orthodontic treatment by sparing us the need for patient compliance and the complexity of treatment. One of the most important factors affecting the success of interdental implants is preventing the damage to adjacent roots and periodontal ligament. The most common causes of root damage from mini-implant insertion are improper site selection and an inaccurate angle of drill penetration. We thereby present a custom made modified grid help in more accurate placement of temporary anchorage devices and guide the angle of drill penetration. The grid can be placed anywhere in the oral cavity (buccally, palatally, anteriorly or posteriorly) and it can be attached to the main arch wire, bracket or even on unbounded teeth. The measuring reference grid with two vertical guide arms is connected with a horizontal arm that will later be secured to the adjacent bracket at both ends. The grid includes small squares, which effectively upgrade the efficiency during the orthodontic implant placement. The two vertical guide arms help in maintaining the desired angulation while drilling indicating the mesial and distal root surface of the adjacent teeth.

Objectives: The purpose of this study was to evaluate awareness regarding interdental aids in medical population. Materials and Methods: This study included 337 medical professionals living in Davangere district, Karnataka, India. A dental health questionnaire was distributed to all subjects consisting of 18questions. Results: Total 337 people with 187 females and 150 males who were of mean age 27.6±9.0 years participated in the study. The significant positive response (

Introduction: The thickness of cortical bone is an important factor in the stability of mini-implants. Knowledge of cortical bone thickness, in various areas, can guide clinicians in selecting the placement site for microimplants and the proper placement protocol. In this study, we investigated the cortical bone thickness of every interdental area on buccal and lingual sides as an aid in planning microimplant placement. Aims and objectives: The study was undertaken to evaluate the cortical bone thickness in 20 maxillae and 20 mandibles in 27 healthy Indian subjects of age ranging 18 to 35 years (mean age: 25.5 ± 5.3 years), using computed tomography (CT) scan images that were already made previously. Materials and methods: Cortical bone thickness was measured interdentally at 2, 4, 6, 8 and 10 mm from the alveolar crest toward the apical region on buccal and lingual sides in maxilla and mandible respectively, using computer software. Results: Cortical bone is thickest between 2nd premolar and 1st molar at 8 mm level from the alveolar crest. It is thickest in mandible on lingual aspect and greater in males than in females. Conclusion: Mini-implants have gained considerable popularity due to their low cost, effectiveness, clinical management and stability. Among the factors related to microimplant stability, bone density and cortical bone thickness appear to be critical for successful placement. This study will provide knowledge of cortical bone thickness in various areas which can guide the clinicians in selecting the placement site.

This bracket transfer tray is so designed in such a way that the excess composite flash during indirect bracket bonding is pushed in the incisal and occlusal direction only so that it can easily be removed by rotary instruments. In lingual orthodontics, where accessing the gingival and interdental areas with rotary instruments is very difficult, this transfer tray system is helpful for easy flash removal and simple clinical maneuver. Additional silicon putty material is used to make this tray that has a palatal strip, a labial/bucal strip with incisal and occlusal stops and interbracket connectors.

Background: In today's world, people are very much aware about their looks and personality. They are getting more concerned about the esthetics and thus are not ready to compromise the appearance of black holes, especially in the anterior region of the mouth. Various techniques like orthodontic correction, prosthetic veneers and various periodontal surgical methods have been used to cover these unaesthetic open embrasures. In the present study, a variant technique given by Beagle in 1992 was used to cover these open gingival embrasures. The technique uses a gingival flap from the labial aspect to close the open gingival embrasures thus solving the problem of black holes. Aims and Objectives: This clinical study was aimed to reconstruct the lost or blunted interdental papillae with gingival tissue for esthetic purpose and for maintaining oral health with the objective to determine the extent to which the procedure can revert the maxillary esthetics. Materials and Methods: The patients selected were those who were having a complaint of at least one black hole in the maxillary anterior region with grade '0' or '1' type of contour of interdental tissues. A total of 39 open embrasures were surgically closed using this technique. Various indices were taken pre-surgically and then again post surgically. Results: Plaque index and gingival index showed an initial increase in the scores at the end of 1 week. Later, there was a gradual fall till the end of the study. Bleeding index significantly increased at the end of 12 weeks ( P

Periodontal attachment loss in the maxillary anterior region can often lead to esthetic and functional clinical problems including disproportional and elongated clinical crowns and visible interdental embrasures. Gingival replacement prosthesis has historically been used to replace lost tissue. A gingival mask is an easily constructed and practical device to optimize the esthetic and functional outcome in these special situations while permitting cleansibility of the prosthesis and supporting tissues. This is a case report of a young female patient treated using silicon gingival veneer with a 2-year follow-up. The silicon gingival mask has enabled the patient to regain her lost smile and face people with newly found confidence also enhancing the esthetic appearance. Virtually, no problem was encountered during the 2 years of usage of the veneer and the patient continues to use it comfortably.

Woolly hair is a congenital abnormality of scalp hair manifesting as short, kinked hair, which may also involve the hair over the other parts of the body. Keratosis pilaris has been a well known association of woolly hair, and can also be a part of the Naxos or Carvajal syndromes. We herein present a case of woolly hair with associated keratosis pilaris, canaliform dystrophy of nails, increased interdental spaces and recurrent bullous impetigo. Although keratosis pilaris and teeth abnormalities have been reported as isolated associations with woolly hair, such a combination of findings as seen in our patient has not been reported before.