Contemporary Clinical Dentistry最新文献

Fibrous histiocytoma is a benign soft-tissue neoplasm that commonly involves the dermis. It is rare in the oral cavity. This lesion creates a diagnostic dilemma due to its nonspecific clinical appearance and microscopic similarities with other benign fibrous tissue lesions. Microscopically, it shows the proliferation of both spindle-shaped fibroblasts and histiocytes. Surgical excision is the treatment of choice with a good prognosis. The purpose of this paper is to report a rare case of gingival benign fibrous histiocytoma occurring in an 11-year-old female patient. The diagnosis of this lesion is based on combined clinical, histopathological, and immunohistochemical features.

Objectives: The present study evaluated hard- and soft-tissue changes in immediate implants using flapless approach with and without demineralized freeze-dried bone allograft (DFDBA) clinically and radiographically using cone-beam computed tomography (CBCT).

Materials and methods: Thirty-two sites in patients requiring immediate implants in the maxillary anterior region including the premolars were grouped according to the treatment provided with (test group) or without (control group) DFDBA. Plaque index, probing depth, soft-tissue assessment using Testori Esthetic Score (TS), and ridge width were recorded at baseline and postoperatively at 6 and 12 months, while crestal bone height (CBH), buccal bone thickness (BBT), jump space (JS), and gingival thickness were evaluated using CBCT at baseline and 12 months.

Results: Considerable differences among the different time lines and the groups in favor of the test group were prominently seen on the midfacial aspects at 12 months, with CBH values of -0.28 ± 0.17 mm in the test group as compared to -0.78 ± 0.34 in the control group (P < 0.0001). The JS was maximum on the buccal aspects being 1.42 ± 0.87 mm in the test group and 1.12 ± 0.81 mm in the control group which reduced at 12 months to 0.13 ± 0.35 mm and 0.73 ± 0.79 mm, respectively.

Conclusion: Immediate implants with DFDBA augmentation using a flapless protocol demonstrated reduced CBH with resolution of JS and increased BBT, especially at the coronal aspects which influence the tissue stability and overall esthetics.

Background: There is a high failure rate of endodontic treatment in the mandibular incisors due to insufficient knowledge of the morphology.

Aim: The aim of this study was to analyze the root canal morphology in mandibular incisor teeth in the North Indian subpopulation to improve the outcome of endodontic treatment.

Setting and design: A cross-sectional study was conducted at the OPD of a tertiary care institute.

Materials and methods: A total of 200 mandibular central incisors and 200 mandibular lateral incisors were selected from available cone-beam computed tomography examinations of 100 patients aged 18-79 years. They were evaluated for root canal system configuration and symmetry between right and left elements in the same individual.

Statistical analysis: Chi-square/Fisher's exact test was used to find the association between different study variables.

Results: For mandibular central incisors, type I Vertucci classification was present in 69% of cases, type II in 3.5%, type III in 18.5%, type IV in 2%, and type V in 7% of cases. For mandibular lateral incisors, type I was present in 70.5% of cases, type II in 4% of cases, type III in 19.5%, type IV in 2%, and type V in 4% of cases. There was no evidence of types VI, VII, and VIII. Symmetry of root canal morphology between left and right teeth was observed in 90% of central incisors and 93% of lateral incisors.

Conclusion: Type I Vertucci configuration was the most prevalent; however, the prevalence of other configurations is also evident. Therefore, endodontists should explore the morphology of these teeth carefully while performing root canal treatments.

Masson's tumor is a benign intravascular lesion of proliferating endothelial cells that accounts for 2% of vascular and subcutaneous lesions. It manifests clinically as a bluish swelling, resembling a mucocele or hemangioma. Intravascular papillary endothelial hyperplasia (IPEH) was coined by Clearkin and Enzinger in 1976 to describe reactive vascular expansion, following traumatic vascular stasis mimicking angiosarcoma. Clinically, this condition manifests as a bluish enlargement resembling a mucocele or hemangioma. We reported a rare case of IPEH located on the upper lip in an 18-year-old female. A diagnosis of IPEH was reported based on the histopathological findings of papillary proliferating endothelial cells with engorged red blood cells. There was no evidence of recurrence after 6 months of follow-up.

The objective is to minimize the inaccuracies in two-step impressions by homogenizing the polymerization shrinkage of elastomeric impression material in fixed prosthesis fabrication. The objective is accomplished by the technique of spacer adaptation and custom tray fabrication for two-step impressions. The technique makes the use of two vacuum-adapted spacers, selected based on the viscosity of elastomeric impression, and a vacuum-adapted custom tray. The procedure of using the specially fabricated custom tray for impression making is also presented. Consistent thickness of the two different viscosities of impression material is maintained due to vacuum adaptation of the spacers. This homogenizes the polymerization shrinkage of the elastomeric material in different regions of impression, as uniform space is occupied by the material in the space created by the spacer. The procedure of vacuum adaption of the tray material also limits the dimensional change of the tray. The technique minimizes the inaccuracies of impression by homogenizing the polymerization shrinkage of the elastomeric impression, thus promising a well-fitting prosthesis.

Background: Stainless steel (SS) orthodontic brackets may have varying corrosion resistance when used with mouthwashes during orthodontic treatment. Studying their effects on orthodontic brackets will be beneficial.

Aim: The study's objective was to analyze the surface characteristics of SS orthodontic brackets and their resistance to corrosion, exposed to chlorhexidine and povidone-iodine mouth rinses - an in vitro and in vivo study.

Materials and methods: The in vitro test: MBT 0.022" slot SS orthodontic brackets were immersed in three groups - Group A - Modified Meyer-Fusayama artificial saliva (AS), Group B - Chlorhexidine, and Group C - Povidone-iodine mouthwash. The in vivo test: Brackets were conventionally bonded on the patient's teeth and divided into Group I - control group, Group II - patients used chlorhexidine, and Group III used povidone-iodine mouth rinse. The corrosion resistance and surface characteristics of SS brackets were determined using scanning electron microscope (SEM), electrochemical impedance spectroscopy, and X-ray photoelectron spectroscopy.

Results: Higher corrosion resistance was obtained for brackets immersed in chlorhexidine mouth rinse. The polarization resistance value of the orthodontic SS bracket was 109 MΩ, 1383 MΩ, and 769 MΩ immersed in AS, chlorhexidine, and povidone-iodine mouth rinse, respectively. After surface chemical analysis, XPS data showed the largest intensity peak of metallic chromium (CrO) fresh sample and in the sample immersed in chlorhexidine mouthwash. According to SEM, brackets immersed in chlorhexidine showed a relatively smooth surface.

Conclusion: In this study, chlorhexidine was found to be less corrosive followed by povidone-iodine.

A health-care professional is expected to hone multiple skills that are not limited to possessing medical knowledge and clinical skills. Game-based assessments are an innovative type of assessment method that combines the features of gamification and simulation to revolutionize the delivery of medical education. These assessments have the potential to promote active engagement of students by ensuring sustained interest, which is not possible to accomplish with conventional assessments. Even though game-based assessments have immense scope in medical education delivery and have been linked with multiple merits, there are potential concerns with regard to their implementation in medical institutions. In conclusion, game-based assessments offer an immersive approach to assessing the performance of medical students, especially in the domain of critical thinking and decision-making. However, the process of planning and implementation of game-based assessment has its own share of challenges, and we must adopt a systematic approach to overcome the challenges and benefit students.

Background: The mucogingival conditions associated with the recession defects at the mandibular anterior region, not only make plaque control difficult to be performed by the patient but also pose a problem in passively advancing the tissues at the recipient site. This surgical technique is used to treat multiple recession defects in the mandibular anterior region.

Materials and methods: Twenty-five sites in 17 subjects (11 women and 6 men) underwent modified bridge flap and de-epithelized gingival unit graft (d-GUG) as a single-step treatment modality to cover the denuded root surface, as well as increase the width of keratinized gingiva in recession type 1 gingival recession defects in the mandibular anterior region.

Results: Nearly 60% of sites in our study showed complete root coverage, with a mean root coverage percentage of 88.08%. Furthermore, keratinized tissue width, keratinized tissue thickness as well as vestibular depth showed statistically significant increases as compared to baseline levels.

Conclusion: Thus, the modified bridge flap technique using d-GUG within the limitations of our study design, showed promising results in terms of recession coverage as well as management of the difficult mucogingival conditions at the mandibular anterior region.

Background: External apical root resorption (EARR) is an unfavorable side effect of orthodontic treatment. Orthodontic treatment of patients with increased crowding could lead to the proclination of incisors and proximity of roots to the cortical plates.

Aims: The aim of this study was to evaluate the effects of the proximity of the labial and lingual cortical plates and the inclination of incisors on EARR.

Settings and design: Twenty-six patients (age: 13.39 years) with nonextraction fixed orthodontic treatment were evaluated at pretreatment and posttreatment (52 cone-beam computed tomographies).

Materials and methods: The maxillary and mandibular incisors (416 teeth) were evaluated for the pretreatment predictors such as the labial and palatal (lingual) cortical plate thickness, width of the mandibular symphysis/maxillary alveolus and cancellous bone, position of the root apex in cancellous/cortical bone, and treatment factors such as distance of root to the labial and palatal (lingual) outer and inner cortical plate and incisor inclination.

Statistical analysis used: Statistical analyses were performed with R software at a 0.05 significance level. Each parameter was compared between pretreatment and posttreatment by a paired t-test, and the association to root resorption was performed using a regression model.

Results: Clinically significant (>1 mm) root resorption was observed in 35% of all mandibular incisors and 52% of all maxillary incisors. Width of cancellous bone, position of the root apex in cortical bone, proximity of the root apex to the labial and palatal (lingual) outer cortical plate, lingual inner cortical plate, and proclination of incisors were significant factors associated with EARR.

Conclusions: Proximity to the cortical plates and proclination of incisors are associated with increased EARR.

Background: The scientific literature has studies that assess the influence of erosive challenges with citric acidic drinks and substances on the adhesive bond strength to enamel and dentin, but does not contain information about the influence of regional components of an acidic diet on this process. Thus, this study evaluated the erosive influence of Amazonian tucupi on enamel and dentin microshear bond strength.

Materials and methods: One hundred and sixty-eight healthy bovine incisors teeth were used, divided into 12 groups (n = 14). For erosive cycling, distilled water (negative control), cola-based soft drink (positive control), or tucupi were used, followed by adhesive strategies of (1) etch-and-rinse (conventional) (Adper™ Single Bond 2) and (2) self-etching (Clearfil SE Bond). All specimens were subjected to erosive cycling for 5 days and, after 24 h, composite resin cylinders were built up for the microshear bond strength test. The data showed normal distribution and were analyzed by two-way ANOVA, followed by the Tukey post and test (P ≤ 0.05).

Results: There were no significant differences in enamel (P > 0.05). In dentin, only the groups exposed to cola-based soft drink showed significant differences (P < 0.01). The failure mode showed that Type II (mixed) was predominant (95%).

Conclusion: The erosive challenge with tucupi did not influence the bond strength to enamel and dentin, regardless of the adhesive strategy used.