Singapore Dental Journal最新文献

Background

This interventional controlled clinical trial with split mouth design compares the clinical effectiveness of autologous platelet rich fibrin with open flap debridement in the management of infrabony periodontal defects.

Methods

Fifteen patients with paired contralateral infrabony defects were treated with open flap debridement and autologous platelet rich fibrin (experimental group) or open flap debridement alone (control group). The changes in probing pocket depth, clinical attachment level, and radiographic defect depth were evaluated. Patient perception regarding pain and discomfort following the procedures and early soft tissue healing responses were assessed by visual analog scales, scored 7 days after the surgical procedures. Final reevaluation was done 1 year after surgery.

Results

Baseline clinical and radiographic measurements were comparable between the groups. Reevaluation at 1 year revealed that both treatment modalities resulted in a significant decrease in probing pocket depth, gain in clinical attachment and radiographic bone fill of the defects compared to baseline. Postoperative differences observed between the two groups were 2.27±0.29 mm (P<0.001) for probing pocket depth, 3.33±0.35 mm (P<0.001) for clinical attachment level and 1.29±0.32 mm (P<0.001) for radiographic infrabony defect depth reduction, all in favor of the experimental group. Patient preference was greater and early healing response better for the experimental group as assessed by the visual analog scores.

Conclusion

Within the limitations of this study it can be concluded that use of platelet rich fibrin is more effective than open flap debridement alone in the management of infrabony periodontal defects.

Prosthodontic rehabilitation of maxillary defects and early loading of endosseous implants has been widely published. The combination of the aforementioned treatment modalities are seldom reported in peer reviewed journals. This article describes the clinical presentation, management and prosthodontic rehabilitation of the maxillary defect of a patient. Clinical and scientific concerns are discussed.

The aim of this study was to compare the cytotoxicity of accelerated-set white MTA (AWMTA) and accelerated-set Malaysian white PC (AMWPC) on stem cells from human exfoliated deciduous teeth (SHED). The test materials were introduced into paraffin wax moulds after mixing with calcium chloride dihydrate and sterile distilled water. Subsequently, the set cement specimens were sterilized, incubated in a prepared Dulbecco's modified Eagle medium (DMEM) for seven days. The biomarker CD166 was used for characterization of SHED using flow cytometry. The material extracts were diluted at five different concentrations and incubated for 72 h with SHED. The cell viability was evaluated using Dimethylthiazol diphenyltetrazolium bromide (MTT) assay, and the data was analysed using Mann–Whitney test (P<0.05). The results showed that AWMTA revealed significantly greater cell viability at 25 and 12.5 mg/ml concentrations (P<0.05). Concomitantly, AMWPC exhibited greater cell viability at concentrations <12.5 mg/ml and the results were significant at 1.563 mg/ml (P<0.05). Both materials demonstrated moderate cytotoxicity at 25 mg/ml and slight cytotoxicity at 6.25 and 3.125 mg/ml. At 1.563 mg/ml, no cytotoxic activity was merely observed with AMWPC. In conclusion, AMWPC exhibited favourable and comparable cell viability to that of AWMTA, and has the potential to be used as an alternative and less costly material in dental applications.

Background

Maxillary sinus pathology is a common finding on routine CT scans of the head and neck. The purpose of this study was to assess the incidental findings in the maxillary sinus on CT scans in patients who presented for head and neck CT angiography.

Study design

Images of patients referred for head and neck CT angiography were reviewed over a 5-month period. All maxillary sinus incidental findings were recorded and categorised into mucosal thickening, polypoid mucosal thickening, partial and total opacification. The age and gender of the patients and the side of mucosal pathology was also recorded.

Results

A total of 262 CT scans were reviewed (524 maxillary sinuses). Seventy-two patients had pathological changes (27.5%), 44 (16.8%) had mucosal thickening, 20 (8.0%) had polypoid thickening, 6 (2.3%) had partial and another 7 (2.7%) had complete opacification.

Conclusions

There is a high rate of undiagnosed maxillary sinus pathology incidentally found on CT scans. Clinicians reviewing head and neck CT scans such as dentists, general medical practitioners, maxillofacial and ENT surgeons should be vigilant and aware of maxillary sinus disease when interpreting CT scans of the maxilla and patients should be followed up appropriately.

Functional rehabilitation of fully edentulous maxillary defects is always regarded as a prosthodontic challenge. Surgical augmentation does not always offer value addition in the functional treatment outcome. This article describes the maxillofacial prosthodontic treatment of an edentulous patient who received an abdominus microvascular free flap surgical augmentation of a large acquired maxillary defect.

In 2007, the Singapore Armed Forces deployed a Dental Project Team (DPT) to the capital city of the Bamiyan Province in Afghanistan. The team set up the province's first modern dental facility. Besides providing primary dental care to the 60,000 population there, the Singaporeans also trained and prepared a team of Afghan dentist and dental assistants. The Afghan dental team took over the dental clinic and continued to provide care when it was time for the DPT to depart for home. Braving challenging security and austere living conditions, the DPT completed its mission successfully.

There has been a lot of focus on osteonecrosis of the jaws associated with the usage of bisphosphonates both in dental and medical literature in recent years. However, the exact pathogenesis of bisphosphonate-related osteonecrosis of the jaws remains unclear. Against the background of emerging evidence of an evolving condition, it is not surprising that there is a lack of robust evidence-based recommendations on dental treatment of patients on bisphosphonates. This paper seeks to provide a rational approach to the dental management of patients on bisphosphonates based on current literature.

This study is aimed to evaluate the accuracy of Demirjian method in estimating the chronological age of male and female Kelantanese Malay children between 6 and 16 years of age and to establish a new dental age (DA) curve if the Demirjian method was not found to be accurate. About 905 panoramic radiographs of healthy Malay children between 6 and 16 years of age were collected from the radiographic unit in the Hospital Universiti Sains Malaysia (HUSM) and the orthodontic clinic in Hospital Kota Bharu (HKB). Children who had any disease affecting the dental development, or have agenesis in the lower arch and poor quality radiographic images were excluded. The results showed that Demirjian method overestimated the chronological age (CA) by 1.23 years for boys and 1.20 years for girls and it was less accurate for the Kelantanese Malay children. Thus new standard curve were produced and tested on external samples. Results showed that the mean difference between the chronological age and DA is about 0.17 years for boys and 0.11 years for girls. DA was more advanced in the Kelantanese Malay boys and girls as compared to French-Canadian children in all age groups. It is concluded that the Demirjian method tends to be less accurate in estimating the chronological age in Malay children. The new curve that was produced is more applicable to the Kelantanese Malay children.

In 1958, Singapore was the first country in Asia to implement a community water fluoridation program covering 100% of its population. There were no reports of anti-fluoridation activities or calls for referenda then; and at present, there is only mild opposition to water fluoridation. The water was initially fluoridated at 0.7 ppm but was gradually adjusted downwards to 0.6 ppm in January 1992, with a further reduction to 0.5 ppm in January 2008 where it has since remained unchanged. Fluoride varnishes and gels are also available for use by the professional for judicious application in individuals who are at high-risk of dental caries. In addition, fluoridated dentifrices and mouth rinses are also readily available over the counter for home use.

In addition to the use of fluorides, the following factors also contribute to the high level of oral health in Singapore: (i) a highly educated populace; (ii) public health education to increase awareness and literacy is routinely carried out by the Health Promotion Board; (iii) the School Dental Service provides ‘free’ dental care to school children up to 18 years of age; and (iv) primary dental care is also readily accessible by the general public by an extensive network of private and public sector dental clinics.

Facial anomalies in hemifacial microsomia patients may have significant psychosocial impact even from a very young age. The management and fabrication of an auricular prosthesis replacement supported by endosseous craniofacial implants for a young patient with Goldenhar-Gorlin Syndrome has been reported. It is beneficial for the defects of a hemifacial microsomia patient to be managed as early as possible, consistent with the patient's ability to manage the prosthesis.