Interdisciplinary Dentistry

Webinars-boon or bane Mahalaxmi Sekar, Monisha P Khatri Journal of Interdisciplinary Dentistry 2020 10(3):95-96

Detection and comparison of spirochetes in periodontal health and disease by microscopy and polymerase chain reaction techniques: A microbiological study Reshma Naik, SP Pushpa, Kishore Bhat, Sanjeevini Hattarki Journal of Interdisciplinary Dentistry 2020 10(3):97-104 Background: Periodontitis is caused by specific microorganisms or group of specific microorganisms. Spirochetes have been implicated to play a role in the pathogenesis of the periodontal disease. Objectives: The aim is to detect the prevalence of total spirochetes in patients with healthy periodontium, gingivitis, and periodontitis using microscopy and polymerase chain reaction (PCR) techniques. And to compare microscopy (silver nitrate staining) technique and PCR technique in the detection of spirochetes. Subjects and Methods: A total of 150 patients were selected and divided into healthy, gingivitis, and periodontitis groups with 50 patients in each group. Subgingival plaque samples were collected using sterile Gracey curettes. The plaque samples were analyzed for the presence of spirochetes using microscopy and PCR techniques. Statistical analysis for the prevalence of spirochetes was performed using the Chi-square test. The sensitivity and specificity of the microscopy and PCR techniques were compared. Results: The prevalence of spirochetes increased from healthy to gingivitis to periodontitis patients. The prevalence of spirochetes was statistically significantly higher in the periodontitis group as compared to the healthy and gingivitis group. PCR was more sensitive in detecting spirochetes than microscopy, but that microscopy showed slightly greater specificity than PCR. Conclusion: There is a strong association between the presence of spirochetes with periodontal disease as well as its severity. The microscopic method by silver nitrate staining can be a very useful, simple, and rapid screening method for the evaluation of oral spirochetes, but PCR technique may serve as more sensitive indicator of subjects at risk for periodontal disease, thus allowing preventive measures.

Comparison of tensile and tear strength of three silicone materials for maxillofacial prosthesis in Indian climatic condition Vibha Shetty, Anoop Sharma, Sweekriti Mishra Journal of Interdisciplinary Dentistry 2020 10(3):105-110 Aims: The aim of the study was to evaluate and compare physical properties such as tensile strength and tear strength of three commonly used silicone maxillofacial materials in Indian climatic condition. Settings and Design: An in vitro study was conducted to compare the tensile and tear strength using a universal testing machine with 100 N load at a speed of 20 mm/min. Specimens were prepared from three commercially available silicones, i.e., medical grade silicone (control group), prosthetic grade silicone (test Group 1), and a locally available medical grade silicone (test Group 2). One-way analysis of variance was carried out to test any significant difference between the mean values of tensile and tear strength between the tested materials. Post hoc test of Tukey was used to find which of the two groups' means shows a significant difference. Results: Prosthetic grade silicone showed the highest tensile strength with a P< 0.001* among the two tested materials. Tear strength and mean elongation was highest in control showing statistically significant results (<0.001*). Locally available medical grade silicone showed the least favorable properties among all the tested materials, though tensile strength was within acceptable range. Conclusions: Tensile strength of prosthetic silicone was highest followed by medical grade, whereas tear strength and elongation were maximum in medical grade silicone. Locally available medical grade silicone showed the least favorable properties.

Effect of probiotics on Candida in diabetic and nondiabetic complete denture wearers – An In vivo study Bonda Rajasekhar, Anil Kumar Gujjari, Ranjitha Shankaregowda, Karteek Durbakula Journal of Interdisciplinary Dentistry 2020 10(3):111-116 Aim: To evaluate the effectiveness of probiotics on Candida albicans in diabetic and nondiabetic complete denture wearers. Study Design: Twenty complete denture wearers with dentures aging more than 6 months were selected randomly and divided into two groups (controlled diabetic and nondiabetic) based on their blood glucose levels and medical history. Materials and Methods: Probiotics were prescribed for all the subjects for the duration of 30 days. Microbial swab was collected from their dentures at 0, 15th, and 30th days and incubated in Sabouraud's dextrose agar broth. C. albicans colony-forming units (CFU/ml) were counted. Statistical Analysis: The candidial CFUs were compared using statistical analyses such as descriptive statistics, paired samples t-test, independent samples t-test, and repeated-measures ANOVA test and P < 0.05 was considered as statistically significant. Results: C. albicans count reduced in both the groups during the usage of probiotics, but the reduction was more in controlled diabetic subjects which showed statistically significant results. Conclusion: Probiotics can be used as an alternative therapy for the management of oral candidiasis in denture wearers particularly in controlled diabetic patients.

Management of a velopharyngeal defect with hollow speech bulb prosthesis Snehal Jaiswal, Mohit Kheur, Tabrez Lakha Journal of Interdisciplinary Dentistry 2020 10(3):117-121 Velopharyngeal (VP) insufficiency is an anatomic defect of the soft palate which renders the palatopharyngeal sphincter incomplete. In cases where a surgically repaired soft palate is too short to contact the pharyngeal walls during function, speech aid prosthesis or speech bulbs are optimum choices of treatment. This case report elaborates the correction of hypernasality of speech associated with VP insufficiency, by means of speech bulb prosthesis. This speech bulb is a combination of cast partial denture with extension into the defect area to hold heat cure acrylic material. This retentive component was embedded in heat cure acrylic resin material to aid in retention. This improved the hypernasality, speech, comfort, retention, and overall patient acceptance.

Rehabilitation of dentition affected by stage IV periodontitis through an interdisciplinary approach Abin Sam Abraham, Jimmy George, Deepak Thomas, Babu Cherian Journal of Interdisciplinary Dentistry 2020 10(3):122-125 Rehabilitation of periodontally compromised dentitions is always challenging in order to restore the masticatory function as well as to prevent future disease progression. This case report discusses an interdisciplinary approach for managing a case of Stage IV periodontitis in a female patient who presented with multiple mobile furcations involved posterior teeth. By a combined endo-perio-prosthetic effort, the retention and rehabilitation of majority of her teeth was achieved.

Rehabilitating a maxillectomy patient by interdisciplinary alveolar bone preservation technique using submergence of teeth roots C Femil Jilta, RS Sreeraj, R Ravichandran, K Harsha Kumar Journal of Interdisciplinary Dentistry 2020 10(3):126-131 Retention for edentulous maxillary obturator is always challenging. Although implants offer good retention in edentulous patients, lack of tissue beds, less predictable integration, economic constraints may preclude implantation. Therefore, the preservation of residual alveolar ridge is mandatory to enhance the retention, support, and stability of the removable obturator prosthesis. Retaining roots through “Root submergence technique” maintains the attachment apparatus and aids in decreasing the resorptive pattern, thereby preserving the residual ridge to some extent. Here, we report a case in which nonvital root submergence is carried out in a partial maxillectomy patient to prevent alveolar ridge resorption adhering to DeVan's dictum “Perpetual preservation” of what remains is more important than the meticulous replacement of what is missing.

Managing esthetics by immediately placed immediately loaded implants: A case report Amitabh Srivastava, Shivam Yadav, Anshdha Shah, Sajid Husain Journal of Interdisciplinary Dentistry 2020 10(3):132-136 \Immediate implants offer a suitable treatment modality as treatment time is reduced, and postextraction bone loss can be avoided. Temporization of implants in the anterior region is becoming much needed for esthetics as well as helps to avoid the second-stage surgical procedure. A 23-year-old female presented with mobility in lower anterior teeth and radiographic bone loss extending to the apical third. The patient was treated with postextraction immediate implants, and immediate nonfunctional prosthesis was given after evaluation of implant stability quotient by radiofrequency analysis using the Ostell® device. A 7-month follow-up presented successful temporization and osseointegration.

Management of a nonvital discolored tooth associated with radicular cyst: A multidisciplinary approach Richa Gupta, Nilav Bhagabati, Gaurav Jain, Jyoti Ahlawat Journal of Interdisciplinary Dentistry 2020 10(3):137-140 The radicular cyst arises from proliferated epithelial cell rests of malassez when they get stimulated by an inflammatory process originating from pulpal necrosis of a nonvital tooth. The associated tooth is usually asymptomatic and may result in swelling of the soft tissues and mobility of the teeth involved. The typical radiographic description of the lesion is a round or oval, well-circumscribed radiolucency involving the apex of the tooth. Radicular cysts can be managed either surgically or nonsurgically. The nonvital, discolored anterior tooth associated with the lesion is a common esthetic concern for patients. It can effect their self-confidence and employability. Discolored nonvital teeth are frequently compromised due to root canal treatment, previous trauma, or caries. Invasive treatment options like crowns or veneers further weaken the tooth structure. This case report presents the successful surgical management of a radicular cyst associated with a nonvital discolored anterior tooth. This will also include the technicalities involved in the inside/outside nonvital bleaching technique.

Salvaging a tooth with radisection: A case report with 3-year long-term follow-up Monisha P Khatri, Anupama Biradar, Shruti Paradkar, Sachin Shivanaikar Journal of Interdisciplinary Dentistry 2020 10(3):141-144 The successful management of endodontically involved teeth depends on adequate biomechanical preparation and obturation in adherence to a satisfactory coronal seal. However, challenges such as extensive carious involvement, periodontal attachment loss, and iatrogenic mishaps which include ledges, blocked canals, and instrument separation compromise the salvation of the teeth. Treatment options for such mishaps in multirooted teeth can range from endodontic treatment alone, combined endodontic-periodontic treatment, or extraction in cases with poor prognosis. One such treatment in case of file fracture or extensive periodontal involvement in maxillary molars could be root resection, also known as radisection. This procedure offers an economically viable treatment option for the patient to preserve the natural tooth. This article highlights a case report of root resection in maxillary molar with endodontic, periodontic, and prosthetic management with resultant successful oral rehabilitation along with a follow-up of 3 years.

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