Open Access Case Report

A Conservative Approach to Prosthodontic Rehabilitation of a Patient with Mandibular Ameloblastoma- A Case Report

Prithika Eswaramurthy, Aniket U. Vaidya, Meena Aras

International Journal of Research and Reports in Dentistry, Page 7-11

Surgical resection to treat jaw pathologies results in loss of alveolar bone and teeth at the affected side. Prosthodontic rehabilitation helps the patient to cope up with masticatory difficulties and esthetic disfigurement, which arise as a consequence of morbid surgeries. The successful rehabilitation of such cases depends on strategic treatment planning. We report a case of a patient with mandibular Ameloblastoma who underwent marginal mandibular resection which resulted in many limiting factors like obliterated buccal and lingual sulci. Masticatory and speech inefficiency were chief concerns. Impression making and fabrication of a retentive prosthesis were the main challenges. Post-surgical radiographic examination revealed poor bone support. Therefore, a hollow cast partial denture using lost salt technique was fabricated and delivered to the patient.

Open Access Case Study

Pulpotomy in the Adult Patient: Does It Work? A Case Report

Noryagandi Abu Bakar

International Journal of Research and Reports in Dentistry, Page 1-6

Pulp exposure due to caries is exceedingly common. Generally, a tooth diagnosed with irreversible pulpitis can be treated and maintained successfully with conventional root canal treatment. However, emerging scientific evidence has shown that such teeth treated with pulpotomy as a first line of treatment provides increasingly predictable results. In this case report, the author describes a step-by step treatment procedure for pulpotomy in an adult tooth. Proper case selection and adhering to a rigid clinical protocol contributes to a successful outcome of pulpotomy treatment. In this case, Mineral Trioxide Aggregate (MTA) was placed as a capping material; haemostasis was achieved within 4 minutes and the tooth was restored with an excellent margin.

Open Access Case Study

Giant Mandibular Epulis: A Case Report

Rachid Aloua, R. El Bouihi, Faiçal Slimani

International Journal of Research and Reports in Dentistry, Page 29-32

We report the case of a giant mandibular epulis, observed at a fifty-year-old patient.

The tumor was taking root in the alveolar bone from the retro-molar to the symphyseal regions; the patient arrived late to the hospital. This great tumor encumbered the whole mouth and induced functional and aesthetic discomfort. The intervention has been done under general anesthesia. It started by total resection of the epulis, denudation, and a revision of the alveoli, then a multiple tooth extraction with a restoration of the gum.

The postoperation period was simple and allowed the patient to find his manducatory function.

The pathology analysis of the surgical material concluded that it was an inflammatory epulis, with no signs of malignant transformation.

Open Access Case Study

Clinico-Radiographical Findings in Mesenchymal Chondrosarcoma of Maxilla – A Rare Case Report

Akshay Sujith, R. Guruprasad, Neeta Sharma, Shruti S. Sambyal

International Journal of Research and Reports in Dentistry, Page 42-51

Chondrosarcoma is classified as a malignant tumor formed by the abnormal differentiation of hyaline cartilage. A painless, slow growing swelling with a lobulated appearance is the most common clinical feature of Chondrosarcoma. Mesenchymal Chondrosarcoma is a rare high grade histological variant of chondrosarcoma. There is skeletal and extra skelatal manifestation of this tumor and has a relatively poor prognosis. In this article we are discussing a case report on mesenchymal chondrosarcoma involving maxilla and the pterygopalatine space. A brief review on radiological features and differential diagnosis is also included in this article.

Open Access Original Research Article

Clinical Evaluation and Comparison of Obturation Quality Using Pediatric Rotary File, Rotary Endodontic File and H File in Root Canal of Primary Molars: A Double Blinded Randomized Controlled Trial

Sanjana Ghadge, Farhin Katge, Manohar Poojari, Khushboo Jain, Devendra Patil

International Journal of Research and Reports in Dentistry, Page 12-19

Aim: This study was conducted to evaluate and compare extent and quality of obturation in root canal of primary molars with Pediatric rotary file (Prime PedoTM), rotary endodontic file (Protaper UniversalTM) and conventional H files using photo stimulated phosphor plates.

Study Design: Randomized controlled trial.

Place and Duration of Study: The study was conducted in the Department of Pediatric and Preventive Dentistry at Terna Dental College, Navi Mumbai between February 2019 to June 2019.

Methodology: A total of 45 primary mandibular molars were randomly divided into 3 groups. Instrumentation was done in Group 1 with Pediatric rotary file (Prime PedoTM), Group 2 with rotary endodontic file (Protaper UniversalTM) and in Group 3 with H files. Irrigation was done with 10 ml sodium hypochlorite and 20 ml saline followed by drying with paper points and obturation using endoflas with a motor driven lentulospiral. Post-operative radiographs taken using photo stimulated phosphor plates were assessed by a blinded examiner and scored as underfilling, optimal or overfilling. Voids were assessed as present or absent. Scores obtained were analysed statistically using Chi square test.

Results: On comparison of the extent of obturation, maximum number of mesial canals instrumented with pediatric rotary files (96.7%) were optimally filled, followed by rotary endodontic file (83.3%) and H files (63.3%). The difference between three groups was statistically significant (P=0.026). 96.2% of distal canals instrumented with pediatric rotary files were optimally filled followed by 92.3% with rotary endodontic files and 84.6% with H files. However, no statistical difference was found (P=0.331). Minimal number of voids were observed with both pediatric rotary file and rotary endodontic files as compared to H files (P=0.012).

Conclusion: Pediatric rotary files resulted in better extent and quality of obturation as compared to Protaper UniversalTM and conventional H files.

Open Access Original Research Article

Predicting Odontogenic Jaw Lesions and Initial Surgical Treatment Based on Size of Lesion and Distance from Inferior Alveolar Nerve on Panoramic Radiographs

Sonal S. Shah, Shahabeddin Sassanpour, Robert S. Glickman

International Journal of Research and Reports in Dentistry, Page 33-41

Aims: The purpose of this small pilot study was to determine the type and initial management of relatively common radiolucent lesions that occur at the mandibular angle based on size of the lesion and its relation to the inferior alveolar nerve on panoramic radiograph. We also wanted to determine if useful information could be gained from the pattern of lesion expansion.

Methods: A retrospective review of the panoramic images of patients from New York University College of Dentistry from 2005 to 2018 with mandibular angle radiolucent lesions was performed. The lesions included were dentigerous cysts (DC), ameloblastomas, and odontogenic keratocysts (OKCs). A total of 63 patients met the inclusion criteria. The size of each lesion along with its distance from the superior border of the inferior alveolar nerve canal, both horizontally and vertically, was measured from the panoramic images. Formal statistical analysis was deemed unnecessary for this small pilot study.

Results: Our data suggest that mandibular angle lesions which were smaller in size and further from the inferior alveolar nerve were more likely to be dentigerous cysts. Those mandibular angle lesions with larger size and less distance from the nerve canal were more likely to be OKCs or ameloblastomas. Furthermore, based on our data, ameloblastomas had the largest average lesion size, both horizontally and vertically. Our data also showed that dentigerous cysts appear to grow relatively symmetrically, while ameloblastomas and OKCs have an asymmetrical growth pattern.

Conclusion: This study demonstrates how a surgeon can effectively utilize the panoramic radiograph to classify the lesion and thus guide initial surgical management of whether an immediate excisional biopsy can be definitive treatment or if the patient can benefit from immediate decompression therapy, thereby decreasing the necessity of further surgery.

Open Access Original Research Article

Reliability of Facial Measurements in Determination of Occlusal Vertical Dimension: A Cross-sectional Study on Indian Population

Tarun Dabra, M. B. Chowdhuri, Babita Dabra

International Journal of Research and Reports in Dentistry, Page 52-59

Background: Over a period of years, the dental profession has come to accept the idea that the facial measurements have an important role to play for the determination of the Vertical Dimension of Occlusion and for the arrangement of the teeth. However, there has been no study which has effectively verified the data. So this study was carried out to establish the reliability of facial measurements and their role in the determination of the vertical dimension for edentulous patients.

Methods: 2000 patients were selected and four groups were made. Three digital photographs for each person’s face were taken keeping the similar distance, light background to maintain standardization in the study. The photographs were transferred to the computer and opened into professional graphic software and enlarged to the standard life size. Measurements were recorded on both the left and right side of the face. Statistical analysis was carried out to determine the relation between facial measurements and the chin –nose distance.

Results: Chin-nose distance = 4.14 + 0.343 eye-ear distance left side predicts the vertical dimension for Maratha males, Chin-nose distance = 2.04 + 0.581 eye-ear distance right side predicts the vertical dimension for Maratha females, Chin-nose distance = 2.48 + 0.541 eye-ear distances right side predicts the vertical dimension for rest of India males, None of the distance seems to predict chin-nose distance with reasonable accuracy in rest of India females.

Conclusions: Eye-ear distance left side proved to be the best predictor for chin-nose distance in Maratha males. Eye-ear distance right side proved to be the best predictor for chin-nose distance in Maratha females. Eye-ear distance right side proved to be the best predictor for chin-nose distance in rest of India males. None of the distance seems to predict chin-nose distance with reasonable accuracy in rest of India females.

Open Access Original Research Article

Gingival Retraction Procedure is Associated with Increased Gene Expression of TNF-α and TNF-α Receptors: A Pilot Study

Gang Hu, Andrew Sullivan, Zaoling Hu, Saul Weiner

International Journal of Research and Reports in Dentistry, Page 60-67

Background: Gingival retraction procedure (GRP), a regularly practiced clinical procedure, displaces the gingiva from around the tooth, temporarily. It has been reported that increased tumor necrosis factor-alpha (TNF-α) levels in gingival crevicular fluid (GCF) were observed even after 30 days following GRP. TNF-α is a pro-inflammatory cytokine found in periodontally-diseased tissues and is associated with loss of connective tissue and bone. The effects of (TNF-α) are tightly regulated by TNF receptor-1 (TNFR1) and 2 (TNFR2). The object of these experiments was to test the hypothesis that up-regulation of TNF-α expression is associated with increased gene expression of its receptors, (i.e., TNFR1 and TNFR2).

Methods: In a GRP rat model, the gingival Index (GI) was recorded, the expressions of TNF-α, and associated genes TNFR1, and TNFR2 in gingival tissue were measured and hematoxylin and eosin (H&E) histological examination was performed.

Results: Expression of TNF-α and TNFR2-related genes demonstrated similar profiles. Both paralleled the profile of the GI. They peaked at day 1 after GRP, and were reduced but still remained at a higher level as compared to sham control at day 3 after GRP, and then returned close to normal at day 7. On the other hand, TNFR1 gene expression peaked at day 3 and remained elevated at day 7 after GRP.

Conclusions: The results indicate gene expressions of TNF-α and TNHR2 are closely associated with the time course of the gingival injury from the retraction procedure, while TNFR1 gene expression may have further long-term effects.

Open Access Review Article

Association between Periodontitis and Heart Disease: A Literature Review

Noha Algallai

International Journal of Research and Reports in Dentistry, Page 20-28

Background: Heart disease is a multi factorial disease that arises from both; genetic and environmental factors. Genetic factors include hypertension, diabetes, platelet aggregations, and cholesterol. Environmental factors include imbalanced diet, a sedentary lifestyle, stress life, smoking, infections, and the intake of non-steroid anti-inflammatory medications. Heart disease death rates are approximately 30% of total deaths. Periodontal disease, a progressive inflammation; leads to damage dental tissue that surrounds teeth due to bacterial infections that release toxins and cause inflammatory reaction. Poor oral hygiene is the main cause of periodontitis. Therefore, oral infections due to poor oral hygiene might increase systemic inflammation. Scientists have hypothesized that the connection between two diseases is due to the same bacteria. Bacteria which founded in infected periodontal tissue around teeth are causing inflammation, so during normal chewing or brushing, bacteria can enter the bloodstream and move to other parts of the circulatory system, contributing to the formation of heart disease. This literature review was conducted to examine the research evidence for an association between periodontal disease and risk of heart disease.

Method and Results: A literature review of Pub Med abstracts was undertaken. Identified studies were reported in the period (1993- 2017) determining the evidence for periodontitis and its association with increasing risk of heart disease and some pathologic pathways.

Conclusion: Many studies focused on the role of oral infections and periodontal infection in incidence of atherosclerotic. In addition, these studies determined that periodontal disease is a risk factor for heart disease. Though, it requires more considerable future studies to prove the cause-and-effect relationship between periodontal disease and heart disease.

Open Access Review Article

The Influence of Vitamin D and Calcium Supplements on Tooth Stability in Elderly: Systematic Review

Noha Algallai

International Journal of Research and Reports in Dentistry, Page 68-74

Background: Vitamin D is a fat-soluble vitamin that is available hardly ever in food, and can be available as a supplement. Furthermore, it is formed endogenously when rays from the sun strike the skin and prompt vitamin D synthesis. Vitamin D motivates the absorption of calcium in the intestine and maintains adequate serum calcium and phosphate concentrations to allow bone mineralization and to prevent hypocalcemia. Periodontitis is an inflammatory disease, described by losing in alveolar bone prompted by the immune response to bacterial invasion. Since vitamin D is associated with some inflammatory disorders and has a significant role in bone homeostasis, its insufficiency could affect the periodontium in a negative way and increase tooth loss that will assume vitamin D has an important role in decreasing the risk of periodontitis. The purpose of this study is to determine the effectiveness results of vitamin D and Calcium supplements in reducing tooth loss and improving the tooth retention.

Methods and Materials: This research is a systematic review that includes varies studies design of randomized controlled trials, cohort studies, cross-sectional studies and case-control studies that conducted in period (2000-2016).  Among 25 studies, 8 studies have included in this systematic review 

Results: The findings  were got by varies statistical methods including logistic regression, and t-tests, and most of them showed the statically significant between Vitamin D supplements and reduce tooth loss.

Conclusion: In conclusion, the studies presented the robust relation between vitamin D insufficiency intake and tooth loss. Intake both of vitamin D and calcium can associate inversely with periodontitis