Contemporary Clinical Dentistry最新文献

Squamous odontogenic tumor (SOT), first described by Pullon et al. in 1975, is an exceptionally rare, locally infiltrative, and benign odontogenic epithelial neoplasm. To the best of our knowledge, English literature has reported only 50 cases till date, with central SOTs being more frequent than peripheral subtypes. A 25-year-old female patient reported with a persistent, asymptomatic, gingival growth with respect to mandibular incisor-canine region recurring for the third time. Surgeries were performed previously but no histopathological evaluation was done. Provisionally, a diagnosis of reactive jaw lesion was made based on the clinical and radiographic features, but on histopathological evaluation, the scenario changed. This case underscores the features of peripheral variant of SOT and the importance of considering it in the differential diagnosis of anterior jaw lesions, especially in atypical demographics such as young females. Early recognition through histopathology and other advanced diagnostic techniques are crucial to avoid the misdiagnosis and ensure the optimal outcomes.

This case report describes the successful nonsurgical correction of a gummy smile in a 23-year-old female patient with vertical maxillary excess and hypermobile lips using miniscrew-assisted orthodontic mechanotherapy. Excessive gingival display was reduced by applying controlled forces to the upper front teeth and miniscrew-assisted intrusion. The treatment also improved the patient's facial profile by promoting counterclockwise jaw rotation, normalizing her skeletal imbalance. In addition, the hyperactive lip movements during smiling were minimized, likely due to neuromuscular adaptation and altered tooth position. This approach highlights how miniscrews can effectively correct gummy smiles without surgery, offering a sustainable and less invasive alternative.

The first clinical isolation of Eggerthia catenaformis, a rare novel bacteria from gingival crevicular fluid (GCF) and dental plaque samples of chronic periodontitis patients, is described in this article. This bacterium is a strict anaerobic nonspore-forming Gram-positive bacillus usually associated with brain abscess, intestinal, and pleural infections. Isolation of such bacteria from GCF and dental plaque samples of chronic periodontitis patients would be a rare novel case of its own, depicting possible oro-systemic relationship and possible evolution of oral dysbiosis.

Context: Oral submucous fibrosis (OSMF) is an oral potentially malignant disorder characterized by progressive scarring disorder affecting the submucosa of the panoral mucous membrane. It has a high risk of malignant transformation.

Aims: This study aims to identify the possible association of rs3819024 (A/G) of interleukin (IL) 17A gene and rs763780 (C/T) of IL17F gene polymorphisms with the increased risk for development of OSMF and oral squamous cell carcinoma (OSCC).

Settings and design: One hundred OSMF patients and 50 OSCC patients as cases and 100 healthy individuals as control subjects were selected based on inclusion and exclusion criteria from the outpatient department of the dental college and hospital in Kolkata.

Methods: Deoxyribonucleic acid (DNA) was extracted with the phenol-chloroform-isoamyl alcohol method. Genotyping was done by polymerase chain reaction (PCR). These PCR products were subjected to restriction fragment length polymorphism analysis following restriction enzyme digestion to determine the type of polymorphism. The digested DNA was then separated and analyzed using agarose gel electrophoresis. Quantitative genotypic data and the disease risk were evaluated by the odds ratio and confidence interval analysis.

Statistical analysis used: Chi-square association test.

Results: Single-nucleotide polymorphisms rs3819024 (A/G) polymorphism of the IL17A gene and rs763780 (C/T) polymorphism of the IL17F gene, respectively, were associated with the risk of development of OSCC and OSMF. CC genotype has shown statistically significant increased risk for developing OSCC and OSMF.

Conclusions: Mutated allele G of rs3819024 may act as a protective allele, while the mutated C allele of rs763780 may act as a risk allele for the development of OSMF and malignant conditions.

Periodontal plastic surgery is constantly seeking alternatives that can replace the use of connective tissue grafts, due to the need for a second surgical area and the possibility of reducing the morbidity of the procedure and providing better comfort to the patient. The use of leukocyte- and platelet-rich fibrin (L-PRF) in the treatment of gingival recessions (GRs) has been studied and its potential has been observed. We report a clinical case of a 49-year-old female patient, a non-smoker, with hypothyroidism and multiple gingival recessions (GRs) in the anterior teeth classified as Miller Class I or Cairo Type 1 (RT1-), which are not associated with a non-carious cervical lesion. The patient presented with aesthetic discomfort and dentin hypersensitivity. Root coverage of the recessions was performed with L-PRF membranes associated with a coronally advanced flap. After 8 months of follow-up, we observed complete coverage of the exposed roots, thickness keratinized gingiva gain, and patient satisfaction with gingival esthetics and dentin hypersensitivity.

A gummy smile is a condition, in which the gingival tissue is excessively displayed when smiling. Orthodontic treatment is often combined with other treatments such as crown lengthening and composite restorations to treat the gummy smile. Crown lengthening may be executed utilizing a three-dimensional (3D) printed surgical guide, which provides precise digital measurement of the patient's optimal gingival height and facilitates enhanced predictability in esthetic treatment results. This case reported postorthodontic treatment combined with a 3D-printed crown lengthening guide design to enhance the smile line and follow up with a composite restoration on lateral incisors. Patient exhibits a Class II skeletal malocclusion with gummy smile. The ultimate results of orthodontic treatment, as well as crown lengthening and composite restoration, are assessed through the use of a digital wax-up intraoral mock-up in 3D printing. Crown lengthening with a surgical guide offered precise results on a reference basis. The treatment was subsequently concluded with the placement of composite restorations on the lateral incisors. An examination of the complete smile showed 6.24 mm preoperative gingival display and 0.24 mm postoperative. Following 14 days, 1 month, and 3 months, the gingival appearance was steady. The patient expressed satisfaction with the final results of the interdisciplinary orthodontic treatment, which addressed their concerns while achieving the desired aesthetic outcomes. The utilization of 3D-printed technology helps to forecast treatment outcomes, which improves patient care in modern dentistry.

Background: Osteoporosis places a significant strain on the healthcare system and contributes significantly to morbidity and mortality. Digital panoramic radiographs, which are typically taken for routine dental examinations, are quite useful for spotting early low mineral density changes.

Aim: The aim of the study was to assess the diagnostic efficiency of gonial and antigonial radiographic indices in identifying low bone mineral density in aged women.

Materials and methods: A total of 800 panoramic radiographs were assessed from the archives, and 118 radiographic images among controls and study groups were included. Radiomorphometric indicators such as gonial angle (GA), gonial index (GI), antigonial angle (AA), antigonial depth (AD), and antigonial index (AI) were studied.

Results: A statistically significant higher GA, GI, AA, AD, and AI among control groups were evident compared to study groups.

Conclusion: In screening for early osteoporotic alterations, all indices evaluated in the present study can be used as radiographic screening methods to identify low bone mineral density among aged women.

Novelty: The study attempted to evaluate the GA, GI, AA, AD, and AI of the mandible in orthopantomography individually for normal and aged women. Hence, they can be used as an opportunistic screening tool.

The article summarizes the common bracket prescription maneuvers used in preadjusted edgewise appliances and their effects on the inbuilt prescription. The illustrations presented are designed as a ready reckoner for teaching and chairside use.

Background: Effective communication is a skill for oral healthcare professionals, particularly while delivering bad news to patients. Structured approaches such as the SPIKES protocol can reduce patient anxiety, improve satisfaction, and support patient-centered care. While the SPIKES protocol is well recognized and increasingly practiced worldwide, in India, its awareness, practice, and training remain limited.

Aim: To assess the awareness, application, and training needs related to the SPIKES protocol among oral healthcare professionals in Indore, India.

Materials and methods: A descriptive and cross-sectional survey was conducted between April and June 2024 at the Government College of Dentistry, Indore. A total of 200 oral healthcare professionals completed a validated, structured questionnaire with 18 items divided into three domains: professional background, awareness and use of the SPIKES protocol, and training needs.

Results: Overall, 72% of participants agreed that following a structured protocol is essential when delivering bad news. Awareness of the SPIKES protocol was reported by only 38%, and among them, <20% had applied it in practice. A significant majority (84%) expressed the need for formal training in communication skills and the SPIKES protocol, with postgraduate students showing the highest demand (P < 0.05).

Conclusion: Awareness of the SPIKES protocol among oral healthcare professionals in India remains low, and its practice is also limited. At the same time, the strong demand for formal training highlights the need for immediate action. Incorporating SPIKES training modules, simulation-based teaching, and structured communication skill workshops into both undergraduate and postgraduate curricula are essential to ensure patient-centered cancer care.

Context: Saliva is rich in antioxidants, a natural defense system. Vitamin D, a steroid hormone and an antioxidant, is required in optimal quantities to maintain normal mineralization of teeth. The enzyme, glutathione peroxidase (GPx) is an antioxidant having an essential role in neutralizing free radicals. An imbalance in such salivary antioxidants causes an increase in reactive oxygen species, leading to oxidative stress that affects intracellular signals and promotes the growth of cariogenic bacteria.

Aim: The aim of this study was to evaluate and compare the levels of salivary Vitamin 25(OH)D and GPx in children with and without caries.

Settings and design: A cross-sectional study was conducted with 120 children, between 3 and 10 years of age.

Subjects and methods: Salivary samples of children with and without caries were collected to assess the levels of Vitamin D and GPx through commercially available enzyme-linked immunosorbent assay kits.

Statistical analysis used: Descriptive mean, along with Mann-Whitney test.

Results: Salivary Vitamin 25(OH) D levels were significantly higher in caries-free children, showing a strong inverse correlation with caries risk. This suggests a protective role of Vitamin D. Although the mean GPx levels were higher in children with caries, the difference was not statistically significant, indicating a possible oxidative stress response but limited diagnostic value. Overall, Vitamin D showed a more consistent association with caries status than GPx.

Conclusions: This study focused on individual antioxidant biomarkers, thus allowing applications for tailor made preventive strategies for early intervention of caries progression in pediatric population.