Singapore Dental Journal最新文献

Aim

This in vitro study was conducted to evaluate the disinfection of dentinal tubules using 2% Chlorhexidine gel, Honey, Aloe vera gel, Curcuma longa, Propolis gel and Calcium hydroxide against Enterococcus faecalis.

Materials and method

Two hundred and ten human mandibular first premolars were infected with Enterococcus faecalis for 21 days. Samples were divided into 7 groups. Group I- Saline (negative control), Group II- 2% Chlorhexidine gel(CHX), Group III- honey, Group IV- Aloe vera gel, Group V- 20% Curcuma longa gel, Group VI- Propolis gel and Group VII -Calcium hydroxide (CH). At the end of 1, 3 and 5 days, the antimicrobial efficacy of medicaments against E.faecalis was assessed at the depths of 200 µm and 400 µm.

Results

2% Chlorhexidine gel was most effective followed by Propolis and Curcuma longa.

Conclusion

2% Chlorhexidine gel gave the best results. Among the herbal extracts Propolis and Curcuma longa hold a promising future but to implement their use as sole intracanal medicaments clinically, further in vivo and long term studies are warranted.

Infective endocarditis (IE) is associated with significant morbidity and mortality. The prevention of infective endocarditis, for many years, has involved the identification of at risk patients undergoing medical or dental procedures and the use of pre-procedural antibiotic prophylaxis. However, evidence regarding the effectiveness of such measures is lacking while evidence is mounting for the adverse effects of inappropriate antibiotic use. International guidelines for antibiotic prophylaxis were amended, radically in some cases to reflect this. Subsequent epidemiological observations of IE have shown mixed results, strengthening calls for well conducted randomised control trials, now that there is genuine clinical equipoise among clinicians about this question.

Background and objectives

Microbial biofilm and host susceptibility play an important role in the initiation and progression of periodontitis. Periodontitis is considered the sixth complication of diabetes mellitus and a bidirectional relationship exists between diabetes and periodontitis. This cross-sectional observational study was undertaken to evaluate the glycosylated haemoglobin (HbA1c) level in chronic periodontitis.

Methods

The study involved 100 subjects. The case group consisted of 50 subjects with chronic periodontitis and the control group consisted of 50 periodontally healthy subjects. Periodontal parameters including plaque index, oral hygiene index, modified gingival index, probing pocket depth, and clinical attachment level were measured and recorded. Systemic parameters like Body Mass Index (BMI), Waist Hip Ratio (WHR), C- Reactive Protein (CRP), Glycosylated haemoglobin (HbA1c), lipid profile, fasting blood sugar, post prandial blood sugar and serum albumin were assessed in all subjects.

Results

The mean HbA1C for the case group was 6.27±1.5 and for the control was 5.36±0.4 and the difference was statistically significant (p = 0.001). The mean FBS, PPBS, LDL, WHR, CRP was statistically significant between groups (p ≤0.05). Periodontal parameters like PI, OHI, MGI, PD and CAL were significantly higher in the case group than the control group (p value ≤ 0.05). The multivariate linear regression model with the dependent variable HbA1c showed chronic periodontitis was significantly associated with HbA1c level.

Conclusion

In chronic periodontitis patients (otherwise systemically healthy) the presence of periodontal inflammation affected the glycosylated haemoglobin level and they were in prediabetes stage. Therefore, it is plausible that the prediabetes stage might be reduced via appropriate periodontal therapy.

Background: The ideal goal of periodontal therapy is regeneration of the lost periodontium. However regeneration of the lost interdental papilla has been elusive. Therefore the ability of rebuilding lost papillae in the maxillary segment has become one of the major challenges in periodontal plastic surgery. Objectives of the study: To evaluate the success and predictability of surgical technique using a sub epithelial connective tissue graft interposed in a coronally displaced flap to reconstruct the lost interdental papillae. Methods: The purpose of this study is to evaluate the success and predictability of a surgical technique using a subepithelial connective tissue graft from the palate with coronally displaced flap to regenerate the lost interdental papilla in 11 systemically healthy patients.Results: Post treatment follow up show statistically significant results from baseline to 3months and 6 months. Conclusion: The present study attempted a single surgical procedure to reconstruct the lost interdental papilla using subepithelial connective tissue graft interposed in coronally displaced flap in 11 patients with Tarnow’s class-II papillary recessions. At the end of 6 months it was found that the sites demonstrated significantly superior results as determined by percentage of reduction in the area of the black triangle both clinically (60.26%) and on the model (54.29%). Clinical Implications: Although complete regeneration of interdental papilla was not achieved, the results of this study demonstrate that a predictable and an esthetically pleasing surgical outcome can be achieved in one attempt for class II papillary recessions.

Sinus augmentation is a predictable procedure that is often required when restoring the posterior maxilla with dental implants. Even with high success rates, careful pre-surgical planning is crucial. A 3D model is a valuable aid for the clinician as it allows for pre-operative simulation, which can reduce surgical time, reduce the risk of intra-operative complications and decrease the potential for error. The aim of this case report is to focus on how such a model is useful when undertaking a sinus augmentation procedure with simultaneous implant placement.

Prevalence of peri-implant complication is expected to be on the rise with the increased number of implants being placed. Depending on the degree of osseous involvement, the clinician needs to decide if the treatment goal is to arrest the disease progression, regeneration or explantation and replacement. Host's medical status, defect configuration, aesthetic outcome, ability to access for plaque control post-treatment, and the patient's wishes are key factors to consider. The purpose of this review is to provide a contemporary synopsis on the management of peri-implantitis with emphasis on explantation. Guidance on the identification of factors/situations where salvaging an implant may be less favourable is discussed and the various techniques to remove a fractured, or peri-implantitis-affected non-mobile implant are described.

The palatal injection of anaesthesia is more painful for the patient when compared to other sites of the oral cavity. Pre-cooling (cyro anaesthesia) is a well-known method practiced to reduce pain, with the use of ice or refrigerant spray on the affected site. The already known methods of ice application to the palatal site have few practical drawbacks. Therefore, this technical note highlights the use of an iced cotton bud as a novel way of providing effective pre-cooling for palatal anaesthesia. Commercially available cotton buds were dipped in clean water and then placed in the freezer. Next the frozen cotton bud was placed on the proposed anaesthetic site for one minute and anaesthesia less than 0.5CC local anaesthetic solution was delivered at a slow pace while maintaining pressure using the iced-cotton cotton bud. All patients tested showed a 0 pain response to a visual analogue scale of 0–10. This technique can be valuable to dental practitioners who are aiming for a pain free anaesthetic experience for their patients. There is potential for further research and evaluation of this technique.

Background

Mandibular neurovascular canal contents may be vulnerable to damage during mandibular surgical procedures. Greater knowledge of the location and configuration of the mandibular canal can help in the safe performance of these procedures in the dental clinic. Cross-sectional CBCT imaging is a good modality for studying the course, location, configuration and accessory branches of the mandibular canal. The aim of this study was to observe the branching of the mandibular canal at different segments of the mandible and mandibular tooth groups.

Methods

CBCT images of 116 mandibular halves were included in this study. The presence of secondary branching of the mandibular canal in the ramus, retromolar area, molar and premolar teeth as well as the length, diameter and angle of these branches were observed.

Results

sixty nine mandibular halves (59.5%), had a main canal with no branching, There were 36 IAC (31%) with one, 8 (6.9%) with two, 2 (1.7%) with three and 1(0.9%) with 5 accessory branches. Of these secondary branches, 16 (25.4%) were in the ramus, 16(25.4%) in the retromolar, and 31(49.2%) in the molar regions.

Conclusion

Advanced cross-sectional imaging modalities especially CBCT is a suitable tool for observing anatomic characteristics of mandibular canal to preserve this vital structure in surgical procedures.