The immature root (open apex) with a necrotic pulp and apical pathosis presents multiple challenges to successful treatment and is difficult to treat with conventional root canal therapy. Mineral Trioxide Aggregate (MTA) has been successfully used in treatment of open apex. Extrusion of MTA through an open apex is not a commonly seen during the apexification procedure. Here we report the management of a case of a non-vital maxillary incisor with immature root. In this case despite of the use of an apical matrix, accidental extrusion of MTA occurred in the periapical region which did not show any negative effect on healing.
Immediate replacement of periodontally compromised tooth bears a challenging task due to poor abutment support. The use of natural tooth as pontic provides an excellent technique mainly as it helps the patient to cope up from the loss of the tooth. Various bonding agents have been used to bond pontic to the adjacent abutment teeth. In the present case report tri-n-butylborane initiated adhesive resin has been used (Super-bond C&B). Replacing missing teeth using either patient’s own tooth as pontic can be done by splinting adjacent teeth with adhesive resin.The splinting has an additional advantage of stabilizing adjacent mobile teeth.This case report details the case selection procedure with follow up of case selection, procedure with follow- up of case where natural tooth of the patient was used as pontic to replace a missing anterior tooth. We present a case reprt of 30 years old women with complaint of mobile right central incisor .On clinical examination the mandibular right central incisor showed showed grade III mobility. Both clinical and radiographic examinations indicated extraction of the mandibular right central incisors and because of high aesthetic demands of the patient the decision was made to utilize the crown of the extracted tooth as natural tooth pontic and bond it with adjacent teeth using 4-META/MMA-TBB resin marketed as Super-Bond C&B, (Sun-Medical, Co., Ltd). Natural tooth pontic has been shown to have a successful longevity but it does depend on the dexterity of the oral hygiene maintenance by the patient.
Background: Oral rehabilitation of periodontally compromised patient presents a challenge to clinicians. The periodontitis might have a negative influence on osseointegration leading to increased implant failure and management usually involve placing implants in healed sites after extraction of teeth with poor periodontal prognosis. However, patients who attain and maintain excellent plaque control, the technique of immediate implant placement can be utilised for oral rehabilitation.
Case Report: This case report describes comprehensive rehabilitation in a patient with history of periodontitis who underwent immediate implant placement following teeth extraction. With proper treatment planning, patient compliance and supportive periodontal therapy, good functional and aesthetic outcomes were achieved. There was no evidence of peri-implant mucositis or peri-implant bone loss after 30 months of follow-up.
Conclusion: The technique of immediate implant placement in periodontitis susceptible patient with proper management and carefully monitored supportive periodontal therapy can be a successful treatment modality with predictable outcome.
Background: Gingival crevicular fluid (GCF) is an important source of biomarkers. These properties is useful in monitoring the effectiveness of orthodontic treatment. Aspartate Aminotransferase (AST) is a soluble enzyme that is normally confined to the cytoplasm of cells, but is released to the extra cellular environment upon cell death. The activity levels of AST in the gingival crevicular fluid are considered to be important in regulating alveolar bone resorption during orthodontic tooth movement.
Aim: The aim of the study is to evaluate the activity of AST in GCF in the tissue response during orthodontic tooth movement in order to assess whether this enzyme has potential as possible diagnostic aid of the periodontal metabolic changes during orthodontic tooth movement.
Materials and Methods: Total 5 male and 5 female patients undergoing orthodontic treatment were included in study. The GCF was collected from mesial and distal gingival margins of canine at intervals 1st, 7th, 21th day after force application. Plaque index gingival index and probing depth scores for individual patients is obtained at different time interval. AST activity will be assessed for each subject during this interval.
Results: AST activity values in both mesial and distal sites increased significantly after 21 days compared to baseline. The increase of AST activity was greater at the distal sites (compression sites) than at the mesial sites (tension sites). Local host response toward the orthodontic forces might lead to an increase in AST activity levels.
Conclusion: Thus, it was concluded that within the limitations of the study, GCF AST activity can be considered as a biomarker of the periodontal metabolic changes during orthodontic tooth movement.
Aim: Eucleadivinorum Hern (Ebenaceae) is a treasured East African medicinal plant which has a long use in the management of dental caries. However, there are few reports on the antimicrobial activity of its different parts used in oral care. The aim of this study was to compare the antimicrobial activity of organic extracts of E. divinorum leaves, tender stems and root bark against some oral pathogens and formulate an herbal toothpaste from its most active extract.
Place and Duration of the Study: Leaves, tender stems and root bark of E. divinorum were collected from Elgueyo Marakwet Rift Valley located in the North Rift region of Kenya. The samples were analyzed at Moi University Chemistry Laboratory, Kenya between January 2020 and April 2020.
Methodology: Shade-dried samples were ground into powder and successively extracted with hexane, dichloromethane and ethanol. Antimicrobial activity of the extracts were determined by agar disc diffusion method. Minimum inhibitory concentration assay was performed for microorganisms that exhibited the highest sensitivity to ethanolic root bark extract (which had the highest recorded zone of inhibition diameters). The ethanolic root bark extract was used for the formulation of an herbal toothpaste.
Results: The ethanolic extract of E. divinorum root bark was found to be the most active with minimum inhibitory concentration of 25, 50, 25 and 25 µg/ml for Streptococcus pyogenes, Staphylococcus aureus, Escherichia coli and Candida albicans. Herbal toothpaste formulated with the ethanol extract of E. divinorum root bark had higher antimicrobial activity against the tested microorganisms compared to Colgate herbal toothpaste formulated with fluoride as the active ingredient.
Conclusion: The current study supports the use of this plant in traditional management of dental caries and as chewing sticks in Kenya.