Swami Devi Dyal Hospital and Dental College

Abstract Tooth preparation represents a pivotal phase in fixed prosthodontics, as any inaccuracies at this stage are frequently irreversible and may compromise the overall success of the prosthesis. In complex or atypical cases, meticulous preoperative planning becomes imperative to ensure the optimal clinical outcomes even before intraoral procedures are initiated. Despite its potential to enhance precision and minimize the errors, the role of diagnostic tooth preparation (DTP) is often undervalued within the prosthodontic treatment sequence. DTP not only facilitates a more accurate assessment and modification of the proposed treatment plan but also contributes significantly to the success of procedures ranging from single-unit restorations to full-mouth rehabilitations. Therefore, the objective of this article is to emphasize the critical importance of incorporating DTP as an integral component of contemporary fixed prosthodontic practice.

Background:Titanium (Ti) implants are known to be bioinert, stress shielding, and poor osseointegration, due to modulus discrepancy with native bone. This research aims to design a porous Ti6Al4V implant with controllable oxidation to mimic the natural bone properties for better osseointegration.Materials and Methods:Porous Ti6Al4V foams were manufactured by coagulant-assisted metal foaming with egg white protein and citric acid as stabilizing matrix. The detailed characterization was conducted using X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, nanoindentation, and microcomputed tomography (micro-CT) to characterize microstructural, porosity, and mechanical properties. MTT assay and dual staining were used to study in vitro cytocompatibility using the human amniotic mesenchymal stem cells. In vivo biocompatibility and bone regeneration were evaluated through the rabbit femoral defect model at 4 and 12 weeks, using histology and micro-CT for bone ingrowth quantification.Results:The fabricated porous Ti6Al4V implants had 71%–75% porosity, facilitating nutrient transport and cellular ingrowth. Compressive modulus (284 MPa), measured via mechanical testing, was comparable to that of trabecular bone. In vitro studies demonstrated good cell viability and proliferation. In vivo, robust new bone formation was observed (~52% increase in bone volume), with over 90% tissue integration compared to control.Conclusions:Controlled oxidation of porous Ti6Al4V foam could provide a potential way to overcome the current limitations of dental implants. The improved biomechanical compatibility and osseointegration support its potential for clinical application in implantology.

Abstract Background: Orofacial manifestation and radiographic alterations of systemic sclerosis (SS) cases were limited and mainly reported on Caucasians, so far only case reports were reported the oral features of Indian people with SS. Thus, the purpose of this study was to assess the incidence of orofacial manifestation and radiographic alterations among North Indian people with SS. Materials and Methods: A total of 20 (18 female and two male) North Indian people with SS attending the Dental outpatient department were enrolled in the study from August 2015 to March 2017; all underwent orofacial clinical examination and further underwent panoramic radiography. Results: Among reported extraoral manifestations, thin atrophied and incompetent lips were most common (90.00%), followed by cutaneous hyperpigmentation and mask-like face (70.00%), cutaneous scar (65.00%), beak-shaped nose (55.00%), cutaneous hypopigmentaion (30.00%), and dysphagia (30.00%) in SS cases. Among reported intraoral manifestations, oral trismus, dental caries, and absence of bleeding on periodontal probing were the most common (85.00%), followed by depapillaion of tongue and burning sensation (75.00%), mucosal pigmentation (65.00%), xerostomia (60.00%), localized gingival recession (40.00%), and tooth mobility (25.00%) in SS cases. Among radiographic alterations, periodontal ligament widening was most common (65.00%), followed by mandibular angle resorption (45.00%), condylar and coronoid process resorption (35.00%), and ramus resorption (10.00%) in SS cases. Conclusion: The study results allow a rational understanding of orofacial manifestations and radiological alteration and their impact on oral health status in SS patients which enable the dentist for a better diagnosis and evolve a comprehensive treatment plan.

Odontometric measurements, are carried out for determination of space discrepancies in the dental arches. It is observed in orthodontic circles that a maximum number of cases of malocclusion appear during mixed dentition stage, which has long time period of time i.e from the 6 to 12 years. Space analysis in mixed dentition is an important aspect in orthodontic diagnosis and treatment planning. : The present study was done to assess and compare the applicability of Melgaco's linear regression equation for mixed dentition analysis in the population of Panchkula district of Haryana state in North India.Study was conducted on 200 patients who attended the OPD of department of Orthodontics & Dentofacial Orthopedics, Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula, Haryana, in order to evaluate applicability of Melgaco’s mixed dentition analysis. A digital vernier caliper (0-150mm) SL 1112 INSIZE CO. Ltd with resolution 0.01 was used.On comparing the values of our present study with the values derived from the Melgaco’s Brazilian population. The p value was ≤ 0.001 in males, females and overall sampled population which is considered to be statistically very highly significant when measurements of our study were compared with those for Melgaco’s Brazillian subjects.The regression equation given by Melgaco’s et. al. for sampled Brazilian population does not apply on our sampled population of Panchkula district. Hence, a new regression model was derived for this population.

To determine the amount of apical extrusion between various file systems during the retreatment procedure and to determine the effect of taper on the same. Seventy mandibular extracted premolars were taken, and preparation was performed using a Woodpecker file (Woodpecker Medical Instrument Co., Ltd., Guilin, China) (25/0.06). The gutta-percha (GP) was removed from each specimen with H file (#40/0.02) to simulate retreatment in seven groups (n = 10) using ProTaper Next (PTN;Dentsply, Maillefer, Ballaigues, Switzerland) (PTN) (30/0.07), Reciproc (25/0.08), Hyflex CM (30/0.06), Mtwo (30/0.05), Neoendo flex (30/0.04), Neoendo hybrid (30/0.04), and Flexicon file (30/0.06). The specimens were held with the help of a rubber stopper and put in the Eppendorf tube of volume 4 mL (pre-weighed before retreatment). The debris that was on the root surface of the specimen was washed with distilled water with 1 mL volume, kept in the oven, and then again weighed after 7 days. Apical extrusion was found in the following order: HYFLEX CM (LEAST) < FLEXICON < PROTAPER NEXT < RECIPROC < NEOENDO FLEX < NEOENDO HYBRID < MTWO (HIGHEST). W Hyflex CM and Flexicon files showed lesser extrusion of debris than others.

Periodontitis, a chronic inflammatory condition affecting the periodontal tissues and underlying bone, is now acknowledged as more than just a localized oral disease. With a global prevalence ranging from 20% to 50%, the implications of periodontitis extend beyond oral health, presenting significant concerns for public health. Research has demonstrated a strong association between periodontitis and cardiovascular disease, with shared risk factors encompassing age, smoking, socioeconomic status, and metabolic syndrome. Understanding the intricate relationship between periodontal disease and cardiovascular diseases, especially the development of arrhythmias like atrial fibrillation, is crucial. A comprehensive literature search using PubMed was conducted, employing keywords such as periodontitis, cardiovascular disease, cardiac arrhythmia, atrial fibrillation, and related terms. No exclusion criteria were used. This article reviews the current literature on the association between periodontitis and cardiovascular diseases, including atrial fibrillation. Atrial fibrillation, the most common cardiac arrhythmia, is influenced by various risk factors including alcohol consumption, advanced age, underlying heart and lung diseases, with poor oral hygiene emerging as a notable contributing factor. The direct invasion of endothelial cells by periodontal pathogens, the indirect pathway where periodontal disease triggers a systemic inflammatory response, and a shared genetic basis are three theories that explain this link. Patients with periodontal disease face an elevated risk of major cardiovascular events, especially arrhythmias, and recognizing this association is essential for healthcare practitioners to provide comprehensive care to patients with cardiac conditions.

Increased upper lip procumbency is associated with protrusive maxillary dentition in Angle’s class I malocclusion, creating unaesthetic facial profile, leading to the need of orthodontic treatment where Enmasse retraction will require maximum anchorage.The present study was conducted to compare Enmasse retraction of maxillary anteriors using mini implant and conventional anchorage in Angle’s Class I malocclusion with bimaxillary protrusion. A numeric approach was adopted. Finite element method was used to determine the stress and displacement of various components at a given time by dividing it into two groups namely, Implant arrangement and T- loop arrangement for enmasse retraction. Significant differences were observed when the stress values were compared between Implant arrangement and T-loop arrangement. In Implant arrangement highest stress values were seen around the lateral incisors and in T loop arrangement stresses were found around canine and premolar. Comparison of displacement in both arrangements gave results of greater displacement in anterior and posterior segments in T-loop arrangement. Mini implants were considered more effective for enmasse retraction but in this study, it was found that although the rate of retraction/ displacement was more in T-loop arrangement but Mini implants in implant arrangement served as an absolute anchorage.

Klippel-Feil syndrome (KFS) is a triad comprising cervical spine fusion, a low posterior hairline, and constrained neck movement. This triad is not universally present. The most frequent accompaniment is Sprengel's scapula deformity. According to the Feil classification, Class 1 (C1) is an immense fusion of many cervical vertebrae, Class 2 (C2) is a fusion of one or two vertebrae only, and Class 3 (C3) is coupled with thoracic and lumbar spinal vertebral fusion in addition to the fusion of the cervical vertebrae. Clarke's categorization of KFS includes other associated anomalies. The different classification systems for KFS have been made by the different specialists to whom patients may present, which include orthopedic surgeons, neurosurgeons, orthodontists, faciomaxillary surgeons, cardiologists, and pediatricians. This anomaly being rareand the lack of universally accepted classification may lead to confusion regarding the identification of the syndrome, especially the Clarke Type 3 with isolated facial dysmorphism may go undiagnosed. We report a case with KFS-Clarke Type 3 with isolated facial dysmorphism and Feil Type 2 with the fusion of C2-C3 cervical vertebrae, detected as an incidental radiologic finding, and initial impression of adenoid facies. Hence, this case also highlights the contrasting features between the facial dysmorphism of Clarke Type 3 KFS and adenoid facies.