IDA Maharashtra State Branch Dental Dialogue July-September2012

JULY - SEPT.
2012
Vol. XXXVIII No.3
Deepika Padukone at WDS Mumbai 2012
51
D D
Dental Dialogue
Vol. XXXVIII No. 3 JULY - SEPT. 2012
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
INDIAN DENTAL ASSOCIATION

MAHARASHTRA STATE BRANCH
Website : www.idamsb.org Office : 57, 38 Rutu Dent, Pradhan Park, M. G. Road, Nashik 422 001 Tel. No. (O) 0253-2313512 (R) 0253-2577389 Mob. : 90110 27610, 94222 46871 E-mail : n sanjayvasantbhawsar@yahoo.com n sanjayvbhawsar@gmail.com
President : I st Vice President : II nd Vice President : III rd Vice President : President Elect : Imm. Past President : Hon. Editor :
Dr. Sanjay Bhawsar Dr. Manoj Joshi Dr. Suhas Merchant Dr. Aruna Bhandari Dr. Bajrang Shinde Dr. Arunkumar Chhajed Dr. Rajendra Bhasme
Dental Dialogue
Official Journal of IDA MSB
Editorial Office
1215 'A' Ground Floor, Opp. Daulatrao Bhosale School, Shivaji Peth, Kolhapur - 416 012. Tel. : 0231-2629331
Residence
249 / 79, JANAK, 1 / 101, Near Nagala Park Kaman, Nagala Park, Kolhapur - 416 003. Tel : 0231-2653473
Mobile : 9422419428
Telefax : P. P. 0231-2653906
E-mail : rajendrabhasme1959@gmail.com / yahoo.com
Happ
Indian Dental Association Maharashtra State Branch
Diwa
li
87
Dental Dialogue
Vol. XXXVIII No. 3
JULY - SEPT. 2012
88
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
WHAT IS IN....
What is in . . . 89 ............................................................................................................................................ Editorial 91 ........................................................................................................................................... Presidents Message 93 ............................................................................................................................................ Total Oral Rehabilitation Of Oligodontia Associated With Early 95 Childhood Caries : A Case Report With 18 Months Follow-up ............................................................................................................................................ Lipoma, A Rare Intraoral Tumor A Case Report 98 ............................................................................................................................................ 100 Importance Of Pre-anaesthetic Evaluation ............................................................................................................................................ Orthodontic Management Of Ectopically Erupted Maxillary 102 Central Incisor A Case Report ............................................................................................................................................ Root Canal Treatment Of Mandibular Iind Premolar Having Unusual 104 Anatomy A Case Report ............................................................................................................................................ 105 Feedback ............................................................................................................................................ Taurodontism Involving Deciduous And Permanent Teeth - A Case Report 106 ............................................................................................................................................ Digital Models : 3-d Evaluation Of Dental Arch And Its Implications In Orthodontics 108 ............................................................................................................................................ Association Between Abo Blood Groups And Chronic Periodontitis 110 ........................................................................................................................................... Probiotics - A Friendly Bacteria To The Host 112 ............................................................................................................................................ Primary Tuberculosis of the Gingiva : A Case Report 116 ............................................................................................................................................ Orthopaedic Facemask Therapy 118 ............................................................................................................................................ Dental Dialogue News 119 ............................................................................................................................................
Happ
Diwa
li
89
Dental Dialogue
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Happy Diwali & Happy New Year Vikram Samvat 2069
90
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dear Collegues, At the outset we would like to Wish Very Happy Diwali & A Happy New Year Vikram Samvat 2069 to all our members. This will be the last issue of my Second tenure as Editor, Dental Dialogue. Editor expresses hearty gratitude to HSG, Dr. Ashok Dhoble, Presidents IDA MSB & HSS of Maharashtra State branch for their unconditional support. Situation in IDA MSB in the year of Golden Jubillee was unhealthy. Due to this 50th MSDC was cancelled & all members felt very sad that the Dr. Rajendra Bhasme, BDS, MJC * Bachelor of Dental Surgery Golden Jubillee was not celebrated due to unavoidable circumstances. * Master of Journalism & Communication Science Editor would like to appeal to all members of IDA MSB that, this situation should not arise in future. Member should not strain their relations beyond the point of breaking. 51st MSDC will be held at Pune hosted by IDA MSB & 52nd MSDC will be held at Nashik. Please attend in large nos. From 2013 onwards CDE points will become mandatory for the renewal of registration of Dental Council. So all are requested to attend the State & National Conferences & get the necessary CDE points at earlist. We need to earn 100 CDE points in five years. Atleast 20 points per year. If all members attend the Conferences regularly, there will not be any difficulty in getting the points. So mark the dates for the national & state conferences. Also the organisers should arrange the dates well in advance & convey it in time to all members.
EDITORIAL
hr Xrnmdbr d ZyVZ df AmnUmbm d Amnbo gd Hw$Qw> {~`m Zm gwIg_ rMo, ââmQ>rMo d Amamo`_` Omdmom...
AmZ XmMo jU CYirV Xrnmdbr Ambr.. gVa Jm `m {X`m Zr A JUo gObr..
ZyVZ dfm {^Z XZ {dH $_ g dV 2069

Dental Dialogue
This Issue is released on 14th Nov. 2012 i.e. Diwali Padwa Kartik Shukla Pratipada, Vikram Samvat 2069, at Kolhapur
91
Dental Dialogue
Vol. XXXVIII No. 3
JULY - SEPT. 2012
hm{X H$ ewôN>m !
92
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
PRESIDENT'S MESSAGE..
Dear Friends, I feel great contentment in witnessing the tremendous strides made by IDA MSB from its inception to the present day and reach the remarkable status that it is known for today. As I come to the end of this fantastic year, I am extremely happy to inform you all that in these few months we have been successful in organizing various workshops and programmes in different zones of Maharashtra state. IDA has always been a very active body. In todays fast changing scenario, it has been a sincere effort from our side to bring out the art and science, of what is performed and to Dr. Sanjay Bhavsar reflect on the importance of update in dentistry. In this year 2012, 4 new IDA branches have been installed i.e. Vasai, Parbhani, Malegaon, and Sangamner by the committee. We have been conducting a State Students Conference every year to get the students together, share knowledge, exchange ideas and promote research. It gives them a platform to put forth their talent, update their knowledge and develop their personalities. However, there are around 32 dental colleges and 16,000 students in our state alone. And thus, I have come up with the novel idea of conducting the Students Conference at a zonal level so that each and every student can benefit from these events. My aim is and has always been to benefit one and all of our members from our activities. I am happy to inform you that IDA has been in the forefront in conducting various programmes of immense value to the students, academicians and research scholars and the practitioners in various zones of our state. It included CDE Programmes, workshops, student conferences, zonal conventions, sports and innumerable scientific and cultural events we will be memorable always. We have conducted 4 student conferences this year; Karad, Nasik, Mumbai and Parbani. Not to forget the 6th, 7th and 8th zonal conventions in Dombivali, Gadhinglaj and Kolhapur which have been a great success. st I am looking forward to the most awaited 51 IDA State Conference this December. It will include various cultural events, trade-fairs , lecture series, demonstrations, workshops, scientific presentations etc. We plan to make this a memorable one for one and all. I would like to like to extend my gratitude to all IDA members for their participation and encouragement, who make all our efforts worthwhile. I request you to continue the same and participate in large numbers and benefit from it. The association of the Government of Maharashtra, IDA Head Office and IDA MSB has encouraged us in planning a Dental Check up of Anganwadi Sevika & Children, where in check up of nearly one lakh people will be done. This will be held in the forthcoming year and a pilot project will be conducted next month. I request all the members to join hands with us to serve this huge number and make this project a success. Your participation is a motivation to the work we do and hence I appeal to all our members to contribute in numbers for all our programmes. Let us enjoy the festive spirit of the season; the season of warmth, joy and cheer. Best wishes to all the IDA members for this years auspicious Diwali. I wish all our members good health and success in this wonderful year ahead. The best insurance for tomorrow is a job well done today. I believe in this vision and look forward to taking IDA to soaring heights which we all have dream of.
Dr. Sanjay V. Bhawsar President, IDA MSB
Happ
Diwa
li
93
Dental Dialogue
Vol. XXXVIII No. 3
JULY - SEPT. 2012
hm{X H$ ewôN>m !
94
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Pedodontics
Total Oral Rehabilitation of Oligodontia Associated with Early Childhood Caries : A Case Report with 18 months follow-up
Dr Patil Anil T. M. D. S., Senior Lecturer, Pedodontics and Preventive Dentistry Dr Shipurkar Anita A., M. D. S. Prof, Dept. of Prosthodontics Dr Aparadh Aparna T., B. D. S. Lecturer, Dept. of Prosthodontics
Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli Abstract: Oligodontia is the agenesis of 6 or more teeth, excluding third molars. The etiology of congenital absence of teeth is believed to be rooted in heredity or developmental anomalies. The absence of teeth in children can cause aesthetic, functional, and psychological problems, particularly if the anterior region is involved. The purpose of this case report was to present a clinical case of oligodontia in a 3-year-girl associated with early childhood caries. Root pieces extracted, primary molar endodontically treated and dentures were placed to maintain a daily diet and to re-establish speech, facial aesthetics in the patient. The patient was followed for 18 months both clinically and radiographically. It is emphasized that conventional prosthetic treatment in children can lead to a satisfactory result. Keywords: Oligodontia, Hypodontia, Early Childhood Caries. Introduction: Tooth agenesis is a common developmental anomaly. Congenital tooth agenesis can be either hypodontia (agenesis of fewer than six teeth excluding third molars) or oligodontia (agenesis of more than six teeth excluding third molars). Oligodontia can occur either as an isolated condition or associated with genetic syndromes (syndromatic oligodontia)1. Graber reported that the overall frequency of congenitally missing teeth ranged from 1.6 to 9.6 per cent in studies from different countries. The prevalence of oligodontia has been reported as 0.3%1,3. It affects females more often than males, with a gender ratio of 3:24. Congenitally absent maxillary lateral incisors, maxillary second premolars, and mandibular central incisors are most often seen in oligodontia cases5, while agenesis of, canines, or first permanent molars, maxillary central incisors is rare1. Symptoms frequently found in individuals with oligodontia, are reduction in size and form of teeth and alveolar processes, delayed eruption, persistent deciduous
2
teeth, anomalies of the enamel, increased free-way space and cleft lip/palate, false diastema, and deep overbite1. Speech and masticatory functional disorders occur most frequently; however, aesthetic, physiological, and psychological problems may also arise. The etiology of congenital absence of teeth is believed to be heredity or developmental3. Although oligodontia is genetically conditioned, factors such as X-ray therapy, particular medications, infectious diseases, trauma, and endocrine and intrauterine disorders cannot be excluded. Studies have shown that MSX1 and PAX genes play a role in early tooth development6. Familial tooth agenesis can occur as an isolated anomaly or as part of a genetic syndrome3 and is transmitted as an autosomal dominant, recessive, or X-linked condition4. Early childhood caries (ECC) is defined as the presence of one or more decayed (noncavitated or cavitated), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. There is early carious involvement of the maxillary anterior teeth, the maxillary and mandibular first primary molars, and sometimes the mandibular canines. This case report describes oral rehabilitation for a young girl with non-syndromic oligodontia and ECC. Case A 3-year old girl was reported to Department of Pediatric Dentistry, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India with a chief complaint of missing and carious teeth, chewing and speech problems. The child was born to non-consanguineous parents. The mother stated that pregnancy was normal, in prenatal period she did'nt had any intake of medication. Feeding habits included history of breastfeeding upto 18 months of age and bottle-feeding at bedtime upto 30 months of age. Child had no siblings and the family history did not reveal any history regarding missing teeth. The patient had intelligence in the normal range. Partial absence of primary teeth associated with ECC resulted in dietary problems that resulted in dietary deficiencies with low self esteem.
95
Dental Dialogue
Dr. Anil Patil, et al Extra-oral examination revealed no abnormalities of the skin, hair, or nails. The patient showed mandibular retrognathism, a convex facial profile (Figure 1). Intraoral examination revealed the root pieces of 54, 52, 51, 61, 62, 64, 84 and caries Preoperative extra-oral involved enamel, dentin approaching view showing unaesthetic smile pulp of 74 and caries involving enamel, dentin of 55,53,65,75 and missing 83,82,81,71,72,73 with thin alveolar ridges, reduced vertical bone height (Figure 2 and 3). Routine investigations were normal.
Vol. XXXVIII No. 3
JULY - SEPT. 2012
were made on the master casts to establish maxillomandibular relations. Prosthesis was fabricated with heat cure resin. After the final insertion of dentures, routine oral hygiene instructions were given to child and her parents (Figure 7, 8). Initial lack of compliance by the child observed. At recall appointments, discomfort areas were relieved. Retention and stabilization of dentures were clinically Postoperative facial view with smile acceptable. Parents were happy with a significant improvement in terms of speech and mastication. Further followPostoperative 18 months Postoperative 18 months ups have taken follow-up panoramic follow-up extra-oral view radiograph place 3, 6 and 18 months (Figure 9,10). Future treatment will include relining, rebasing, or remaking the dentures to accommodate growth and development. Discussion: The oral rehabilitation of children presenting with ECC and oligodontia is challenging because of patient's age, stage of growth, soft tissue defects and psychological status. The main goals of dental treatment are improving sagittal and vertical skeletal relationship during craniofacial growth and development and enhancements in esthetics, speech, and masticatory efficiency. Patient age plays a significant role in selecting and planning treatment. Other factors include number and condition of teeth present, number of missing teeth, carious teeth, condition of supporting tissues, occlusion, and interocclusal rest space8. In a growing child, with the vertical development of the jaws, implant over-structures may not meet with the teeth of the opposite jaw, and may result in prosthetic infraocclusion8. Clinical reports have demonstrated importance of prosthetic treatment in patients with oligodontia for physiological and psychological reasons. Dental prostheses improve the tone of muscles of mastication and may compensate for the reduced vertical dimension. In this case, removable partial denture is recommended for easy care, acceptable cost, and easy adjustment during growth, restoration of vertical dimension and easy replacement of missing teeth. Oral rehabilitation at the age of 3 is thought to be beneficial in terms of emotional development. Although
Preoperative intraoral view of maxillary arch
Preoperative intraoral view of mandibular arch
A n o r t h o p a n t o m o g ra p h revealed missing six mandibular primary anteriors and six mandibular permanent anteriors. (Figure 4) Parents were educated about probable treatment options. The importance of preventive measures and regular follow up was stressed. Tell show do technique was used to achieve treatment. The carious 55,65,75 were restored with glass ionomer cement and 53 restored with composite resin restoration (Figure 5) . For 74, caries excavated and access cavity made and pulp extirpation, debridement Intraoral view of maxillary showing post-extraction a n d arch healing wounds and 53 composite restoration obturation done under local anesthesia and stainless steel crown cemented. Root pieces of 54, 52, 51, 61, 62, 64, 84 were extracted Intraoral view of mandibular arch showing post-extraction under local anesthesia ((Figure healing wound and pulpectomised 6)). 74 with stainless steel crown
Panoramic radiograph
Prosthetic treatment can play an important role in the dental management of patients whose dentition fails to develop normally. The principle and technique are same as used in adult therapy7. Routine procedures were followed for the construction of the removable partial dentures. Preliminary impressions were made and custom trays were prepared and functional impressions made and models prepared. Acrylic bases with wax rims
96
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Anil Patil, et al 1978;96:266275. 3. Schalk-van der Weide Y, Steen WH, Bosman F. Distribution of missing teeth and tooth morphology in patients with oligodontia. ASDC J Dent Child. 1992; 59: 133140. 4. Bailleul-Forestier I, Berdal A, Vinckier F, de Ravel T, Fryns JP, Verloes A. The genetic basis of inherited anomalies of the teeth. Part 2: syndromes with significant dental involvement. Eur J Med Genet. 2008; 51:383408. 5. Polder BJ, Van't Hof MA, Van der Linden FP, KuijpersJagtman AM. A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol. 2004;32:217226. 6. Mostowska A, Biedziak B, Trzeciak WH. A novel mutation in PAX9 causes familial form of molar oligodontia. Eur J Hum Genet. 2006;14:173179. 7. Bishop K, Addy L, Knox J. Modern restorative management of patients with congenitally missing teeth: 3. Conventional restorative options and considerations. Dent Update. 2007;34:3032. 34, 3738. 8. Imirzalioglu P, Uckan S, Haydar SG. Surgical and prosthodontic treatment alternatives for children and adolescents with ectodermal dysplasia: a clinical report. J Prosthet Dent 2002;88: 569-572. 9. Till MJ, Marques AP. Ectodermal dysplasia: treatment considerations and case reports. Northwest Dent. 1992; 71: 25 28.
the definite time to initialize treatment is controversial, Till and Marquez9 recommend that an initial prosthesis could be fitted when child starts school, so that child may enjoy a better appearance and will have time to adapt to the prosthesis. Thereby, a higher self-esteem and better social acceptance was promoted with the use of dentures. Facial profile and expression improved with dentures; in addition, mastication and dietary patterns improved. Conclusion: Oligodontia associated with ECC cause considerable social problems in children. When it is not possible to utilize implants for patients due to age or insufficient amount of alveolar bone, conventional prosthodontic rehabilitation is an effective approach to improve the appearance, mastication and speech. Thus, early diagnosis and treatment of such children is necessary. References: 1. Dhanrajani PJ. Hypodontia: etiology, clinical features, and management. Quintessence Int. 2002; 33: 294 302. 2. Graber LW. Congenital absence of teeth: a review with emphasis on inheritance patterns. J Am Dent Assoc.
REQUEST & GUIDELINES TO AUTHORS

1. The article should be sent to the editor both by post in three copies and CD / by Email & copyright letter should be send with the artical. 2. The text should be in MS Office 2007 only & in A4 Size & Illustrations in JPEG Format & restrict the references 10 only. 3. Decision of the editorial committee would be final & binding. 4. The accepted manuscript would be liable to editorial modifications & alterations. 5. Please spell-check and check your articles for any grammatical & technical mistakes/errors prior of sending them for publishing. 6. Kindly give the proper references to the photographs included & attached with the article & Mark the said CD with proper references. 7. IDA ID No. should be given by author & co-authors & should give preferenses of authors. 8. Clinical articles are also invited from our Hon. Members. 9. Beautiful photographs for cover page are also invited. Send your articles to : EDITOR,
51st Maharashtra State Dental Conference 15th & 16th December 2012
Attend in Large Numbers
PUNE
Dental Dialogue
249 / 79, JANAK, 1/101, Near Nagala Park Kaman, Nagala Park, Kolhapur - 416 003. Ph. : (0231) 2653473 Tel. Fax : P.P. 0231-2653906 Mob. : 9422419428 E-mail : rajendrabhasme1959@gmail.com / yahoo.com
KOLKATTA
22nd to 25th February 2013
97
66th Indian Dental Conference
Dental Dialogue
Medicine & Radiology
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Lipoma, A Rare Intraoral Tumor A Case Report

Dr. Rajeev M. Gadgil, MDS Prof. & Guide Dr. Ajay R. Bhoosreddy, HOD & Prof. Dr. Chetan J. Bhadage, MDS, Reader Dr. Shital S. Nikam, PG Student, Dr. Seema A. Bhoosreddy, MDS, Prof.
Dept. of Oral Medicine & Radiology, M.G.V., K.B.H. Dental College and Hospital, Panchavati, Nashik
Abstract Lipoma is a relatively rare intraoral tumor although it occurs with considerable frequency in other areas, particularly in the subcutaneous tissues of the neck. It constitutes about 1% to 2% of all benign neoplasms of the oral cavity. Lipomas are common benign soft tissue neoplasms of mature adipose tissue. They have been known to grow to large sizes causing mastication and speech difficulties. Commonly it presents as a well circumscribed, lobulated mass of variable size. We present a rare case of lipoma affecting the oral cavity of a 72 year old male patient. Key words lipoma, alveolar ridge, adipocytes. Introduction The first description of oral lipoma was given by Roux PI in 1848 where in a review of alveolar mass; he referred it as a yellow epulis.1 Described by Boyd as ''one of the most innocent of tumors''2, lipomas represent the most common soft-tissue mesenchymal tumor that can be found in almost every organ. Lipoma makes up 4% to 5% of all benign tumors in the body.1 Occurs predominantly on the posterior aspect of the neck, the extremities, the trunk and the axilla. Rarely do they present on the face, scalp or sternal region.2 Case report A 72 years male reported with a chief complaint of growth in left front region of lower jaw since 2 months. Patient was apparently asymptomatic 2 months back when he noticed a small swelling in the mandibular left canine region of jaw. The size gradually went on increasing till it reached present size. Swelling was not associated with pain, discharge. Patient also gives history of extraction of 33, 34, and35 two months back. Patient was physically healthy with no significant extra oral finding (fig. 1) Lymph nodes were not palpable. Intraoral examination revealed s o l i t a r y, 2 c m 2 c m , w e l l circumscribed, sessile, pale pink coloured swelling on alveolar ridge in
the mandibular left canine region. On palpation consistency of the lesion was soft, fluctuant, non-tender. It was mobile and slippery under palpating finger. A small bony protuberance was palpable at anterior end of s we l l i n g . ( f i g 2 ) C o m p l e te ly Intraoral Swelling On Alveolar Ridge In edentulous maxillary and Mandibular Left mandibular arches were seen with Canine Region healing socket of 13, 23, and 15. Radiographic examination revealed swelling was not from hard tissue but of soft tissue origin with healing socket of 33, 34, and 35.Diffuse radiopacity seen in 36 region indicative of retained root piece (fig Intraoral Periapical 3).A bony Radiograph Showing Healing Sockets And protuberan Retained Root Piece ce was seen on occlusal radiograph in canine region(fig 4). Lesion showed negative aspiration. Based on c l i n i c a l a n d ra d i o g ra p h i c Occlusal Radiograph presentation working diagnosis Showing Bony Protuberance of benign soft tissue cyst or tumor was given. Differential diagnosis included gingival cyst of soft tissue, lateral periodontal cyst, residual cyst, mucocele, salivary gland tumor, and lipoma. Routine blood examination was found to be normal. An excisional biopsy was performed under local anesthesia. The specimen was fixed in 10% formalin and submitted for microscopic evaluation. Microscopic evaluation of specimen showed tissue composed of mature adipocytes surrounded by Microscopic Examination delicate interlacing collagen Showing Overlying fibers with Mild chronic Parakeartinized Stratified Squamous Epithelium With inflammatory cell infiltrate, Mature Adipocyte Interlacing Collagen Fibers chiefly lymphocytes. Surface showed Overlying parakeartinized stratified squamous epithelium. (fig 5)
Extra Oral Presentation Of Patient
98
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Rajiv Gandhi, et al References
1. SekarB.,Augustine D.,Murali S. INTRAORAL LIPOMA, A RARE TUMOR - A CASE REPORT WITH REVIEW OF LITERATURE. Oral & maxillofacial pathology journal.2011 July- Dec; 2 (2): 174-77. 2. P. Scolozzia, T. Lombardib, G. Mairec, F. Pedeutourc, M. Richter. Infiltrating intramuscular lipoma of the temporal muscle.A case report with molecular cytogenetic analysis. Oral Oncology. 2003; 39: 316322. 3. Luiz Carlos Oliveira dos Santos1, Stela Maris Wanderley Rocha, CamilaNunesCarvalho, Ericka PorangabaAccioly de Oliveira, Davi Felipe Costa Neyes. Intraoral lipoma: an atypical case. Braz J Otorhinolaryngol.2011 ;77(5):676. 4. Rajendran R, Sivapathasundharam B. Shafer's Textbook of oral Pathology. 5th edition. Elsevier; 2006: 194-195. 5. F. DISPENZA, A. DE STEFANO,G. ROMAN, A. MAZZONI.Posttraumatic lipoma of the parotid gland: case report. ACTA OTORHINOLARYNGOLOGIC ITALICA 2008:28:87-88. 6. deVisscher JG. Lipornas and fibrolipomas of the oral Cavity. J Maxillofac Surg. 1982;10: 177-81. 7. F. DISPENZA, A. DE STEFANcY, G. ROMANO, A MAZZONI. Posttraumatic lipoma of the parotid gland: case report ACTA OTORI IINOLARYNGOLOCHCA ITALICA. 2008;28:87-88. De CathroAL,De Castro E V, Felipini RC, Ribeiro AC, Soubhia AM. Osteolipoma of the buccal ,mucosa. Med Oral Patol Oral Cir Bucal. 2010; 15:e347.9.
Final diagnosis was lipoma. Discussion A lipoma in the mouth is an asymptomatic slowly growing benign tumor of mesenchymal origin consisting of fat.' 3 It appears that the cells of the lipoma differ metabolically from normal fat cells even though they are histologically similar. Thus person on starvation diet will lose fat from normal fat deposit in the body, but not from the lipoma.4It can Arise in every location where fat is normally present. 13% of which occurring in the head and neck region.5 Can occur in various anatomic sites including the major salivary glands, buccal mucosa, lip, tongue, palate, vestibule, and floor of mouth. Although benign in nature, their progressive growth may cause interference with speech and mastication due to tumor's dimension.1It is usually found in adults. The female to male ratio for all lipomas is 2:1, but oral lipomas occur more in men than in women (1.5: 1). 6 It may present in various forms, as sessile or pediculate and single or lobulated tumor of variable sizes although mostly below 3 cm diameter, and generally surrounded by a fibrous capsule. These lesions are soft, and rarely develop in the mouth.3 Different causes of lipomasare mentioned in the literature as heredity, obesity, diabetes, radiation, endocrine disorders, insulin injection, corticosteroid therapy and trauma. In our case, trauma due to extraction of teeth may be considered as etiological agent for lipoma, as both are found to be correlated on clinical history. Trauma to soft tissue has been hypothesized to result in haematoma, with subsequent lymphatic effusion, fat necrosis and lipoma formation located in the subcutaneous plane. 7 The diagnosis is made by histopathological examination of an incisional or excisional specimen. An important feature is that the tumor tends to float when placed in a 10% formaldehyde solution.3 Histologically, lipomas can be classified into the following microscopic subtypes: simple lipomas, fibrolipomas, spindle cell lipomas, intramuscular or infiltrating lipomas, salivary gland lipomas, myxoidlipomas, and atypical lipomas. 8 Treatment consists of conservative surgical removal of the lipomaand recurrences are rare.3
APPEAL
To, All branch Secretaries & Members Copys for the news matter should be - Typewritten or well written with the spacing without spelling mistakes. - On one side of page only (keep back page empty) - Reach before the 10th of Every Quarter i.e. March, June, September & December month. Photographs should be - Colour photograph shall be sharp, Well contrast with full light effect. - Caption should be written on the back of photograph Names of the persons from Right to Left. - Photographs with action are most preferable (As lighting the lamp, / opening ceremony etc.) - News matter if published in the local news paper please send the photo copy of the page. - Photographs & Newsmatter will not be returned back (it would not be possible) - News matter which will be sent should be signed by office bearer of the branch. - Any special extra-curricular activity of member should be sent for DD. which all our members should know. - Poems, Dental Unfortgetable experience, jokes subject which should be discussed all over the state & practical tips to the treatment of patients should be sent. - Editorial board's decision will be final. - Address - 249/79 JANAK - 1 / 101, NAGALA PARK, KOLHAPUR. Ph. : 0231-2653473, Mobile 9422419428 email - rajendrabhasme1959@gmail.com / yahoo.com
51st Maharashtra State Dental Conference
15th & 16th December 2012

PUNE
99
Dental Dialogue
Oral Surgery
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Importance Of Pre-anaesthetic Evaluation

Dr. Archana S. Joshi
MDS, Oral & Maxillofacial Surgeon, Private Practitioner Dr. Shrirang G. Joshi, MDS, Orthodontist
ABSTRACT Before administrating any anaesthetic, either local or general, it is very important to make a pre-anaesthetic evaluation of the patient. The dental surgeon should keep in mind that all the pertinent information is secured to evaluate and determine how and to what extent the medical condition might affect any treatment plan rather than to diagnose and treat any systemic pathology. It's very important to observe, ask clear concise questions & listen attentively during history taking and evaluation. The pre-anaesthetic evaluation should be so well planned and organized that all necessary information can be secured effortlessly in a short period causing minimum concern to the patient. Hence , pre-anaesthetic evaluation & proper planning of a procedure is of utmost importance for administration of an anaesthetic agent. After all, a well planned preoperative preparation increases patient compliance, improves clinical outcome and subsequently helps to reduce adverse outcomes or events. INTRODUCTION Before administrating any anaesthetic, either local or general, it is very essential to make pre-anaesthetic evaluation1 of a patient. A dental surgeon bears the responsibility of not only rendering efficient and competent dental treatment, but understanding the patient's general physical condition and many a times, detecting medical conditions which the patients are unaware of. Also maintaining records of each and every patient will always help in the long run. The dentist should keep in mind that all the pertinent information is secured to evaluate & not to diagnose or treat any medical problem. Selection of an anaesthetic agent always depends on with preoperative evaluation of the patient and proper planning of the procedure. KEY WORDS Pre-operative evaluation, medical history, physical status, patient compliance. 1. To obtain medical history and determine the general physical and mental condition. 2. To determine the need for a medical consultation and investigations required. 3. History of any unpleasant anaesthetic experience or any specific drug sensitivity. 4. To educate the patient and relatives about the anaesthesia, procedure and post-operative care, thereby gaining their confidence, reducing their apprehension and facilitating recovery.
5. Need for any pre-medication or intraoperative sedation. To choose the plan considering the risk factors. 6. To obtain written informed consent from the patient and close relative. ROUTINE PRE-ANAESTHETIC EVALUATION HISTORY After securing the preliminary information such as the age, sex, height, weight and occupation, etc. the few minutes required to complete the pre-anaesthetic evaluation are very important2. It not only gives the dentist a chance to observe and understand the new patient better, but also gives the patient the added confidence of knowing that he/she is being given special treatment. So, practically one has to bear in mind that it is not time wasted, but time invested. The patient's pulse rate and blood pressure should be taken and recorded. A brief but adequate medical history should be taken which should inform the dentist of the following: 1. Patient's general physical and psychological condition 2. Current medical problems, medications for that, their dose, duration and side effects 3. H/O drug allergies. 4. H/O use of tobacco or alcohol consumption-frequency, quantity and duration. 5. Prior anaesthetic exposure: type & any adverse effects. 6. A brief but adequate medical history should be taken as an aid in determining the patient's general condition. General health and review of the various organ systems should be done which would inform the dentist of the following. 1. Cardiovascular system (Hypertension, Heart disease, Angina, Activity level) 2. Respiratory system (Cough, cold, sputum, Asthma, upper respiratory track infection) 3. Central Nervous system (Headache, Dizziness, visual disturbances, stroke, seizures-epilepsy) 4. Gastrointestinal system (Diarrhoea, nausea, acidity, etc.) 5. Renal system . 6. Hepatic system.(h/o jaundice, hepatitis) 7. Haemotologic system (Excessive bleeding, anaemia, any blood dyscrasias) 8. Musculoskeletal system (arthritis, joint pain, etc) 9. Reproductive system (Pregnancy, menstrual history)
100
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Archana Joshi, et al emergency . Practice in assigning a physical status will result in the procedure becoming second nature and ultimately result in a convenient and concise form of communication7. ASA PHYSICAL STATUS SCALE Class I A normal healthy individual Class II A patient with mild to moderate systemic disease Class III A patient with severe systemic disease that is not fully incapacitating, but with some functional limitations Class IV A patient with severe systemic disease, that is a constant threat to life Class V A moribund patient who is not expected to survive for 24 hours, irrespective of treatment Class VI A declared brain-dead patient whose organs are being removed for donor purpose CONCLUSION The pre-anaesthetic evaluation should be so well planned and organized that all necessary information can be secured effortlessly in a short period causing minimum concern to the patient. Maintaining the record sheets permanently of all patients will always help in the long run. The physical evaluation is done to determine how and to what extent the medical condition might affect any treatment plan rather than to diagnose and treat any systemic pathology. It's very important to observe, ask clear concise questions and listen attentively before coming to a conclusion. Listening is a great art and a good listener gets much more from observing and listening. There should be considerable cooperation between the dental surgeon and the physician and the dentist should present the case and the suggested procedure from the dental point of view as they are professionally, morally & legally responsible for the patient's well being. Importantly, all this reduces stress on both the doctor as well as the patient. After all, a well planned preoperative preparation improves clinical outcome, increases patient compliance and helps to reduce adverse outcomes or events subsequently. REFERENCES
1. Haberkern CM, Lecky J H. Preoperative assessment and the anesthesia clinic: Anesthesiology Clin North Am 1996; 14: 609-30. 2. Twersky RS, Lebovits AH, Lewis M, Frank D: Early anesthesia evaluation of the ambulatory surgical patient: does it really help? Jr. Clin Anesth 1992 ; 4:204-7. 3. American Society of Anesthesiologists task force on preanesthesia evaluation: Anesthesiology 2002; 96: 485-496. 4. Saklad Saklad et al. ;Grading of patients for surgical procedures: Anesthesiology 1941; 2 : 281-4. 5. Anon.: New classification of physical status: Anesthesiology 1963;24:111 6. Owens WD, Felts JA, Spitznagel EL: Jr. ASA Physical Status Classifications: A study of consistency of ratings: Anesthesiology 1978; 49: 239-43. 7. Barbeito A, Schultz J, Dwane P, Gan TJ, Reynolds JD, Spahn T: ASA Physical Status Classificationa pregnant pause: Anesthesiology 2002 ; 96:96.
6
The pre-anaesthetic evaluation should be a routine procedure completed in a short period causing minimum concern to the patient, but done thoroughly3. A record sheet should be printed with all necessary questionnaire and it should be attached with the patient's treatment chart so it becomes a permanent record. If any condition is diagnosed the patient can be informed & referred to the physician. The questions should not be confusing or frightening for the patients. Also, never unduly cut short the patient when they are answering. It's very important to ask clear concise questions, listen attentively, observe and integrate all the findings. PHYSICAL EXAMINATION It includes 1.Vital signs 2.Airway 3.Heart 5.Extremities 6.Neurological examination 4.Lungs
Pulse & Blood pressure should be checked & recorded. Hypertension needs proper evaluation. It can produce cardiac changes due to strain on the heart muscles & subsequent hypertrophy. Episodes of marked hypertension, Ischaemic ST changes on ECG are associated with an increased incidence of postoperative myocardial infarction. Underlying cardiac disease can be a cause of majority of fatalities that occur during anaesthesia in the dental office. Diseases of the lungs are of utmost importance because of their implications on gaseous exchange. Skin and mucous membrane should be examined for pallor to find out anaemia/jaundice and petechiae seen in blood dyscrasias, physical trauma and subacute bacterial endocarditis. The importance of examining the airway cannot be overemphasized. Inspection should be done for loose teeth, dentures, protruding upper incisors, extent of mouth opening, micrognathia, large tongue, limited TMJ movements as all these have to be considered if endotracheal intubation is required. Routine preoperative laboratory tests for all patients undergoing surgery or major dental procedures should be done. Patients above 40 years undergoing general anaesthesia have to get their ECG, chest X-ray, blood chemistry including blood sugar, serum electrolytes, creatinine, blood urea nitrogen done in addition to routine tests even if they are asymptomatic. Though the yield of these tests in terms of identification of an unsuspected disease may be very small, they serve as useful baseline values for comparison in intra and postoperative period. AMERICAN SOCIETY OF ANAESTHESIOLOGISTS The American Society of Anaesthesiologists (ASA) (4,5) (Table 1) have introduced a grading system as a simple description of the physical status of a patient requiring anaesthesia and surgery. It allows a quick summary of the physical status. If the procedure is an emergency, the physical status designation is followed by E for
101
Dental Dialogue
Orthodondotics
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Orthodontic Management Of Ectopically Erupted Maxillary Central Incisor A Case Report

Dr. Vikranth Shetty, MDS Reader Dept. Of Orthodontics, Tatyasaheb Kore Dental College and Research Centre, Kolhapur
ABSTRACT In many situations once when decidous teeth are lost the permanent teeth fail to erupt. The premature loss of decidous teeth could be another reason for delayed eruption. Also early loss of decidous teeth means early eruption of permanent teeth but occasionally a bony crypt forms in the line of eruption of permanent teeth and impairs the eruption. In addition disorders like hypothyroidism, hypopituitarism and hypoparathyroidism are commonly associated with delayed eruption. KEY WORDS: Delayed eruption, Decidous teeth, Permanent teeth INTRODUCTION Impaction of tooth is a retardation or impairment in the normal process of eruption. The frequency of maxillary incisor impaction ranges from 0.06% to 0.2%. The aetiology could be due to obstructive and traumatic. Obstructive causes includes supernumerary teeth, odontome and ectopic position of tooth bud. The traumatic includes obstruction due to soft tissue fibrosis , dilaceration, arrest of root development and acute trauma leading to intrusive luxation. The most common cause is a fibrous barrier and cause of impaction is a supernumerary teeth in the premaxillary region. CASE REPORT A 14 year old male patient reported to department with a chief complaint of gap in between teeth in the upper front region of jaw. On clinical examination following findings are noted Extraoral features: Mesocephalic type and straight profile with competent lips present. Intraoral Features: Class I molar relation on both right and left side. Missing 11. Spacing in the maxillary arch. Rotation with respect to 14,15,24,25.
Post-Treatment Pre-Treatment
Diagnosis: Angles Class I malocclusion on a class I skeletal base with spacing present in the maxillary arch. TREATMENT OBJECTIVES 1)Achieving a pleasant profile 2)Extrusion of 11 3)Achieving an ideal overjet and overbite TREATMENT SEQUENCES MAXILLARY ARCH STEPS (WIRE) 1)O.O175 Coax 2)0.016 niti 3)17x25 niti DURATION ( months) one three one
4)0.18 stainless steel wire with open coil spring and surgical exposure of central incisor done. 5)17x25 stainless steel 6)19x25 stainless steel 7)0.14 niti (settling) MANDIBULAR ARCH STEPS(WIRE) 1)O.O175 Coax 2)0.016 niti 3)17x25 niti 4)17x25 stainless steel DURATION(MONTHS) one three one . three three four three
102
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Vikrant Shetty
5)19x25 stainless steel 6)0.14 niti (settling) DISCUSSION
four three
REFERENCES:
1) Ericson S. kurol J. Resorption of maxillary lateral incisor caused by ectopic eruption of canines. A clinical and radiographic analysis of predisposing factors. AmJ Orthod Dentofacial Orthop 1988;94 (6): 503-13. 2) Bishara SE. Impacted maxillary canines. A review AmJ Orthod Dentofacial orthop 1992;101(2);159-71. 3) Baccetti T.A controlled study of associated dental anomalies. Angle Orthod 1998;68(3):267-74 4) Frank CA. Treatment options for impacted teeth. J Am Dent Assoc 2000;131:623-32. 5) Becker A. Early treatment for impacted maxillary incisors. AmJ orthod Dentofacial orthop 2002;121:586-87.
The case presented in this article is a class I malocclusion with impacted right central incisor. A thorough examination of IOPA with 11,21 and maxillary occlusal radiograph was done. The case was treated by preadjusted edgewise appliance of MBT 0.022 prescription. The extrusion of teeth was done in a span of 8 months. Achieving a proper torque with 11 was vital during final phase of treatment. However a proper contact point was established between 11, 21. CONCLUSION: Ectopic eruption of teeth leads to displacement of adjacent teeth. Extraction therapy is the treatment plan done . But with proper diagnosis and thorough clinical examination with proper treatment mechanics the impacted 11 could be brought into proper occlusion. This article highlights the importance of using efficient treatment approach to deal with impacted maxillary central incisors rather than outrightly presenting extraction modality as treatment approach.
KOLKATTA
22st to 25th February 2013
www.idc2013.org.in
103
Dental Dialogue
Conservative Dentistry
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Root Canal Treatment of Mandibular IInd Premolar Having Unusual Anatomy A Case Report
Dr. Hemant T. Vagarali, Reader, Dr. Sunil Saler, Prof. & HOD Dr. Jay Kumar Patil, Prof. Dr. Santosh Hugar, Reader Dr. Girish Nanjannavar, Lecturer Dr. Pranav Patil, Lecturer Dr. Ravindra Kole, Lecturer
Dept. of Conservative Dentistry, Bharati Vidyapeeth Deemed University, Dental College & Hospital, Sangli
Abstract Variations in dental anatomy and root canal morphology are found in all teeth .Knowledge of these variations particularly number of roots ,canals and their configurations are utmost important in successful root canal treatment. The present case highlights the successful root canal treatment of mandibular 2nd premolar which has three roots. Key words : premolar Introduction The variations of root canal morphology mainly in multirooted teeth are constant challenge for diagnosis and successful endodontic therapy. Complete knowledge of root canal morphology of each tooth is mandatory because non treatment of one canal can lead to endodontic failure. Apical ramifications, apical deltas, lateral canals or extra canals are some of the morphological variations which are commonly encountered. Most of the studies and clinical case reports are focused on multirooted teeth to highlight anatomic and morphologic variations. However such variations can also be seen in single roote teeth such as premolars. Mandibular premolar have single root and single canal in 70% of the cases. However 30% of the cases show variations such as one root twocanals,two roots with two canals.The present case shows the rare variation in the mandibular second premolar wiyh three roots and three canal. Case report A 33 year old male patient reported to the department of conservative dentistry with the chief complaint of severe pain in lower right side of the jaw. On clinical and radiographic examination it was found that mandibular second premolar was carious and case was diagnosed as acute periapical abscess. Immediately rootcanal Root canal, anatomy, mandibular IInd
treatment was started under local anesthesia. Two canals were located, cleaning and shaping was completed and patient was recalled after three days for obturation. However patient returned to the department very next day with intense pain. Though endodontic flareup was suspected, multiple radiographs were taken. Radiographs revealed three roots one of which was not cleaned. Cleaning and shaping of third was completed. Obturation was done in subsequent visit after the pain relief. Discussion Succussful root canal treatment depends upon through cleaning and shaping of the root canals. Morphologic variations of root canals offer major challenge in the treatment due to variation in number of roots and root canals. Vertucci's classification is standardized method for categorizing root canal anatomic variations. However many variations exist, and it is important to evaluate each case for variations. Anatomic characteristics of permanent mandibular second premolar is described as a tooth with one root and one canal. However literature describes variations in 33% of the cases ,such as one root two canals and two roots two canals. Because of such variations it becomes mandatory to surch for additional canals during the root canal treatment of premolars. It is impossible to determine the number of roots and canals based on clinical examination alone. Multiple radiographs with angulations definitely help in detecting multiple roots and canals.Carefull examination of the floor of the pulp chamber , endodontic microscopes also help in detecting additional canals. In the present case the patient experienced severe pain even after cleaning and shaping of both the canals, which led to suspect presence of additional canal in the tooth, which was detected with the help of multiple radiographs with different angulations.
104
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Hemant Vagarali, et al
4. Karsener P, Rankow HJ. Anatomy of the pulp chamber floor. J Endod 2003;30:5-16. 5. Sert S, Bayirili S.Evaluation of the root canal configuration of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod 2004;30:3918. 6. Slowey R. Radiographic aids in the detection of extra root canal. Oral Surg Oral med Oral Pathol 1974;28:419-25. 7. Lebfeld H, Rostein I. incidence of four rooted maxillary second molars :literature review and radiographic survey of 1200 teeth. J Endod 1989;15:129-31. 8. Slowey RR. Root canal anatomy ,road map to successful endodontics. Dent Clin North Am 1979;23:555-73. 9. Vertucci FJ. Root canal morphology and its relationship to endodontic procedure.Endod Topics 2005;10:3-29. 10. Karsener P, Rankow HJ. Anatomy of the pulp chamber floor. J Endod 2004;30:5-16. 11. Sabala CL,Benenati F, Neas BR. Bilateral root and root canal abreations in a dental school patient population. J Endod 1994;20:38-42.
Conclusion Variations in the root canal morphology is rule rather than exception. The clinician should be aware of all kinds of variations in different teeth ,and should make effective use of diagnostic tools for accurate diagnosis and treatment.
Root canal treatment of a premolar with three roots.
References
1. Holtzmzn I. Multiple canal morphology in maxillary first molar. Case reports. Q uintessence Int 1997;23:707-8. 2. Malagnio V,Gallotini I.Some unusal clinical cases on root canal anatomy of permamnant maxillaray molars.J Endod 1997; 23:127-8. 3. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral med Oral Pathol 1984;58:589-99.
Wish you all a very happy & prosperous diwali. The last issue of Dental Dialogue was very informative covering both scientific & association activities. You as Editor of it deserve heartiest congratulations. Dr. Subhash Sane, Nashik (12th Nov. 2012) Very good issue of Dental Dialogue dated April - June 2012. Good coverage given to various streams in dentistry. Keep up the good work. Dr. Rajeev Joshi, Dombivali (8th Nov. 2012)
We salute your enthusiasm and commitment towards Dental Dialogue and IDA MSB. Dr. Ashish Mahajan, Hon. Secretary, IDA Jalgaon Branch (8th Nov. 2012) Dear Dr. Bhasme, Hearty congratulations for crossing financial hurdels in publishing of Dental Dialogue successfully Hats off to you ! People who have created mess should learn from you and your sincearity & dedication for IDA MSB is really appericiated you have kept IDA MSB alive in real way ! Keep the same enthusiasm ! Dr. Ashish Khasbage, Buldana (8th Nov. 2012) Congratulations ! Dental Dialogue kept IDA MSB alive by coming with nice publication. Dr. C. C. Tambade, Kalyan-Ulhasnagar (8th Nov. 2012) Congratulations for excellent issue of Dental Dialogue. Dr. Harish Kulkarni, Kolhapur (19th Oct. 2012) Congratulations ! Dr. M. M. Mujumdar, Wai (15th Oct. 2012)
k c a b d e e
By Sms
Congratulations for informative issue of Dental Dialogue April - June 2012. We are habitual of looking DD with interesting coverpage photograph. So waiting for next issue with photographs. Thanks ! Dr. Sandeep Patil, Amaravati (22nd Nov. 2012) Congratulation for coming out with quality dental dialogue with good text and attractive photograph. Dr. Aruna Bhandari, Loni, Shrirampur (27th Nov. 2012)
By E-mail
Dental Dialogue in 'new avatar' is really fabulous. It's cover page is like a new sun is shining on dental horizon. After seeing photo of our Late classmate Dr. Pravin Patil I felt very sad. Memories of college days flash backed in my mind. He was really a nice fellow, a gentleman. Lastly the contents in the Dental Dialogue are really informative and readable. I am proud that my classmate Dr. Bhasme is running the tabauloid in such a good manner. Many Congratulation for it. I wish all the success and fame for the Dental Dialogue in future. Dr. Ahtesham Danish, Malegaon (Nashik)
105
Dental Dialogue
Pedodontics
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Taurodontism Involving Deciduous And Permanent Teeth - A Case Report

Dr Madhuri A Joshi
Reader, Dept of pediatric and preventive dentistry, Vasantdada Patil Dental College And Hospital, Kavalapur, Sangli ABSTRACT Taurodontism is a peculiar dental anomaly in which the body of the tooth is enlarged at the expense of roots. It is common in permanent dentition and rare in deciduous dentition. Endodontic treatment of taurodont teeth is a challenging task due to altered morphology of roots. This article presents a case with taurodontism involving both deciduous molars and multiple permanent molars. KEY WORDS: taurodontism, deciduous molars, permanent molars, pulp chamber, short roots. INTRODUCTION The term taurodontism was originally described by Sir Arthur Keith in 1913. He used the Latin word Tauro and Greek word Odonto to refer the condition i.e. bull tooth. (1) It is a peculiar anomaly in which the body of the tooth is enlarged at the expense of roots. The term taurodontism means 'bull-like' teeth and its usage is derived from the similarity of these teeth to those of cud chewing animals. (2) The taurodont teeth are identified by elongated pulp chambers and apical displacement of bifurcation or trifurcation of roots. Due to this, pulp chamber has greater apico-occlusal height and lacks constriction at the level of C.E.J., giving pulp chamber a rectangular shape. (3, 4) Taurodontism is of anthropologic interest as it has been found in fossils hominids especially in the Neanderthal man, with a very high prevalence during the Neolithic period. Previously it was thought to be confined to the early populations, but it is known to be widespread in many modern races. (2, 5, 6) Taurodontism can occur either as an isolated trait or may be associated with certain diseases such as X chromosome alterations (E.g. Klienfeilter's syndrome), D o w n' s s y n d r o m e , A m e l o g e n e s i s i m p e r f e c t , Hypothyroidism. (2) The condition affects permanent teeth more frequently than deciduous teeth. It may be unilateral or bilateral. The teeth involved are almost invariably molars either single or multiple. The involved teeth have no remarkable morphologic clinical characteristics. The condition is recognized accidently on radiographic examination. (2)
The exact etiology of taurodontism is not known. Morigan proposed following possible etiologic causes of taurodontism: - A specialized or retrograde characteristic. - A primitive pattern. - Medellin recessive trait. - An Atavistic feature. - A mutation resulting from odontoblastic deficiency during dentinogenesis of root. (7) Hammer proposed that failure of epithelial diaphragm to invaginate at proper horizontal level may be the cause of taurodontism. (8) Shaw has classified taurodont teeth into Hypertaurodont, Mesotaurodont, and Hypotaurodont depending upon the level of bifurcation or trifurcation of roots. (2) Because of alterations in the root morphology and enlarged pulp cavity, pulp therapy for taurodont teeth becomes a challenging task. Shorter roots of deciduous taurodont teeth make selection of obturating materials more important. Presented here with a case of taurodontism involving deciduous molars and multiple permanent molars. CASE REPORT 8yr old female child patient reported to dental clinic with complaint of pain in the upper right posterior region of jaw. Patient was conscious, co-operative and medical history was not significant. On clinical examination 54 was having deep caries involving mesial and distal proximal surfaces with clinical pulp exposure.74 was having disto-occlusal caries without pulp exposure. 75 was having mesioocclusal caries with apparent pulp exposure. I.O.P.A. radiograph of 54,74, 75 region were
106
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Madhuri Joshi component specific syndrome. In the present case patient has no systemic disease. The morphologic changes in taurodontism like wide variation in the size and shape of the pulp chamber with varying degrees of obliteration and canal configuration make root canal therapy a challenge. Voluminous pulp tissue lead to profuse bleeding and this may be confused with perforation. Hence while performing root canal treatment of taurodont tooth a proper radiographic examination, careful estimation of working length and careful selection of obturating materials particularly in case of deciduous teeth is necessary. REFERENCES 1) Tsesis I, Shifman A, Kaufman A Y : Taurodontism: An Endodontic Challenge: Report of a case, J Endod. 2003; 29: 353-5
taken, which revealed taurodontism of 54,55,74,75.(Figure 1,2 ). To assess the status of entire deciduous dentition along with developing permanent teeth O P G was advised. (Figure 3). O P G revealed that all deciduous molars and first permanent molars are taurodont. The status of permanent second molars and premolars could not be assessed as they were in developing stage.
The 54 was extracted as it was non-restorable. 74 was restored with resin modified glass ionomer cement. 75 was treated with pulpectomy as diagnosis of chronic irreversible pulpitis was made. On access opening there was profuse bleeding from coronal pulp may be due to increased volume of pulp tissue. The roots were short. Ca(OH)2 + iodoform combination was used as an obturating material. DISCUSSION Taurodontism is an anomaly of multi-rooted teeth. It is more common in permanent dentition and rare in deciduous dentition. In the given case both deciduous and multiple permanent molars are affected. Mandibular molars are found to be affected more often than maxillary molars. In the present case both the maxillary and mandibular molars are affected. Similar cases were reportlared by Rao A. Arathi R., in which both deciduous and permanent molars were affected (9). Similarly Bhat S. et al reported taurodontism of deciduous teeth (10), This condition can occur as an isolated trait or as a
2) Shafer's Textbook Of Oral Pathology, Elsevier publications, Ed 3) Llamas R, Jimenez-Planas A: Taurodontism in premolar; Oral surg Oral med Oral pathol; 1993, 75:501-5 4) Durr D P, Campos CA, Ayers CS: Clinical significance of taurodontism; JADA;1980;100;378 5) Guttal K.S. Naikmasur V.G., Bhargava P, Bhathi R.J. ;Frequency of developmental dental anomalies in the Indian population; Eur J Dent; Jul 4(3);263-9 6) Burkelin S., Brever D., Schafer E ; Prevalence of taurodont and pyramidal molars in a German population; J Endo; 2011 (Feb) 37(2); 158-62. 7) Mangion J J : Two cases of taurodontism in modern human jaws; Br Dent Jr ; 1962; 309-12.
8) Hammer J.E., Wilkop C.J.Jr, Metro P.S.; Taurodontism: Report of a case; 1964;16;409-18. 9) Rao A. Arathi R. : Taurodontism of deciduous and permanent molars: Report of two cases; J Ind Soc Pedod Prev Dent;2006,24:42-44 Bhat S., Sargod S., Mohammed S.V. : Taurodontism in deciduous molars-A case report ; J Ind Soc Pedod Prev Dent;2004: December 22(4),193-6.
KOLKATTA
www.idc2013.org.in

107
PUNE
Dental Dialogue
Orthodontics
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Digital Models : 3-D Evaluation of Dental Arch and Its Implications in Orthodontics
Dr. Chanamallappa Ganiger, MDS, Associate professor
Dr. Sandesh Phaphe, MDS Reader Department of Orthodontics and Dentofacial Orthopedics School of Dental Sciences, KIMSDU, Karad In 2003, The American Association of Orthodontists (AAO) published a list of recommended basic orthodontic records in their Clinical Practice Guidelines for Orthodontics and Dentofacial Orthopedics. According to the AAO, pretreatment and post-treatment records should include extraoral and intraoral photographs, dental models, intraoral and / or panoramic radiographs, and cephalometric radiographs, as well as any additional indicated tests or procedures. Thus, study models are an integral part of the orthodontist's armamentarium. OrthoCADTM recommends using specific disposable trays, alginate, and wax bites. When OrthoCADTM receives the impressions and bite registration, the models are poured and scanned through a proprietary process. The maxillary and mandibular digital casts are articulated by using the bite registration that was sent with the impressions. Although a wax bite is said to be acceptable, it is strongly recommended that a fast setting polyvinyl siloxane be used for bite registration since its accuracy is critical especially when making measurements of inter arch relationships, digital images are fabricated from the digital models using stereo lithography. Within 5 days of receiving the impressions, the electronic information is posted on the OrthoCADTM server as an electronic file. The file, which is typically 400 to 800 kilobytes for children and a little larger for adults, is then downloaded to a designated folder on the practitioner's PC or server, either automatically or manually. OrthoCADTM saves the file on their server for 10 years. OrthoCADs 3-D browser software allows the clinician five simultaneous views of the models. This enables the models to be viewed from multiple perspectives at the same time. These views of the models can be rotated or enlarged to evaluate tooth position and make measurements in any plane of space. Bolton analysis, Tanaka Johnson analysis, tooth width, curve-length, point-to-plane measurements, and any point-to-point measurements can be performed OrthoCADTM also features a cross-sectioning tool that can slice the digital models in any vertical or horizontal plane to check symmetry, overjet, overbite or to measure any location. The Jaws Alignment Tool can be used to move the lower jaw in different directions, thus enabling assessment of the occlusal contacts. The Occlusogram feature is a visual multicolor representation of these occlusal contacts that displays the distance between opposing teeth. OrthoCADs virtual set-up enables the clinician
Comparison of plaster and Digital models Digital models are also an excellent tool for patient education. The younger generations of patients currently in treatment are familiar with computers and are comfortable with computer-generated images. They can relate to digital models and probably expect to see this technology when they visit their orthodontists. Digital models improve communication between the clinician and the patient, enhancing informed consent. The two major computerized model systems creating digital models are OrthoCADTM (Cadent, Inc, Fairview, NJ) and E-modelsTM (GeoDigm, Corp, Chanhassen, MN). OrthoCADTM OrthoCADTM was the first company to introduce a digital model service to the orthodontic market in early 1999. The startup software for OthoCADTM is free of charge and is about 8 megabytes in size. There are no service contracts required to allow OrthoCADTM to generate digital models. A practitioner can get started with OrthoCADTM, log onto www.orthocad.com or call 800-577-8767.
108
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Chanamallappa Ganiger, et al The e-models software allows the models to be moved, rotated, or enlarged or evaluate tooth position and make measurements in any plane of space. Bolton analyses, tooth width, curve-length measurements, and any point-topoint or point-to-plane measurements can be performed. E-modelsTM also features a cross-sectioning tool that can slice the digital models in any vertical or horizontal plane to check symmetry, overjet, and overbite and to help measure any location. There is a Color Bite Mapping feature that is a visual representation of occlusal relationships. An articulation feature allows either a predetermined or custom center of rotation option. This allows the clinician to animate articulation and evaluate occlusal contacts during jaw closing. Probably the most useful feature of the e-modelsTM software is e-planTM. This feature enables the clinician to simulate any desired treatment option by using a virtual diagnostic setup. Once a desired setup is entered, there is an animation function that can be used to illustrate to the patient how the teeth will move to correct the malocclusion. There are two different options that the clinician has to utilize this virtual diagnostic setup technology. The first option is to have the teeth of the digital model sectioned so that the orthodontist can manipulate the position of each individual tooth, simulating various treatment outcomes. The second option is the e-planTM service. The orthodontist simply prescribes a treatment outcome and the tooth position is determined by GeoDigm. One of the newest innovations that are offered by GeoDigm is a system by which the orthodontist places brackets virtually on the teeth of the digital models. An indirect bonding tray is then fabricated and sent to the orthodontist. This innovation allows more accurate bracket placement. Conclusion: What we think we know today, shatters the errors and blunders of yesterday and is tomorrow discarded as worthless. So we go from larger mistakes to smaller mistakes, so long as we do not loose courage. This is true of all therapy; no method is final Frederic Jensen. References:
1. Warradine N. et al. Holograms as substitutes for orthodontic study casts. Am J Orthod Dentofacial Orthop. 1990;98:110-116. 2. Robert AW. Treatment prediction with 3-D computer tomographic skull model .Am J Orthod Dentofacial Orthop .1994;106:156-160. 3. Kuroda T. 3-D dental cast analyzing system using laser scanning. Am J Orthod Dentofacial Orthop .1996;110:365-369. 4. Okumuru H. et al.3-D computer aided design system applied to diagnosis and treatment planning .Eu J Orthod. 1999; 21:263-274. 5. Fiorelli G and Melsen B. The 3-D' occulograms software '. Am J Orthod Dentofacial Orthop .1999;116:363-368. 6. Tuncay OC. 3D imaging and motion animation.Semin Orthod . 2001;7:244-250. 7. Jawes M. and Axel.B. Technology to create the three dimentional patient record. Semin Orthod.2001;7:251-257. 8. Wenzel A. et al.Digital radiography for orthodontist. Am J Orthod Dentofacial Orthop Am J Orthod Dentofacial Orthop. 2002;121:231-235. 9. Hayashi K. et al .3D analysis of dental casts based on newly defined palatal reference plane .2003 ;73:539-544. Matthew JP. , Stuart DJ. , and Brian JI. Digital models. Semin Orthod. 2004;10:226-238.
TM
to simulate and visualize any desired treatment option including virtual extractions, interproximal reduction, expansion leveling, and to apply various fixed appliances. A new innovation introduced by OrthoCADTM is their Bracket Placement System. The clinician generates a digital model of the desired treatment objective by using the Virtual setup software. Based on this model, the clinician then places each bracket in the desired position virtually on the digital model. A bracket placement wand has a miniature video camera that transmits high resolution images of the intraoral environment and a removable sleeve that can be sterilized. The system determines the relative position of the wand versus the actual tooth and gives the practitioner a positioning target and signals when the virtual placement coincides with the actual placement. A bracket is then tacked in place by using the wand's internal curing light. Thus, bracket placement becomes more accurate and time efficient. The OrthoCADTM digital models may be retrieved within many practice management and imaging software programs. Currently Dolphin, Vistadent, Walrus, Sirona, Practice Works Imaging, Dr. View, Oasys, Ortho II, IMS, Orthohart, Televox, OrthoSesame are compatible with the OrthoCADTM software. One of the new innovations that OrthoCADTM is currently testing is a centric occlusioncentric relation (CO-CR) feature in their software. Emodels
TM
EmodelsTM by GeoDigm was founded in 1996 as Interactive Reflective imaging System. It has since changed its name and has grown considerably. To get started with emodelsTM, one could either log into www.geodigmcorp. com or call 866-436-6335. The software, which is about 12 megabytes, is downloaded over the net or will be sent on CD at no charge. GeoDigm will send postage-paid next-day shipping kits for the impressions and a bite registration. The orthodontist could either send disposable trays or metal trays. When the impression is received by GeoDigm, a plaster model is fabricated. That plaster model is then scanned by using a nondestructive laser scanning process that digitally maps the geometry of the cast's anatomy with an accuracy of 0.1 mm10. A laser strip is projected onto the cast and its distortion is read by multiple cameras while the cast is oriented on multiple axes to expose all surfaces for scanning. The maxillary and mandibular digital casts are articulated. Based on the wax bite sent with the impressions. Within 5 days, the electronic information, which is about 800 kilobytes, is noted on the GeoDigm Web server and is accessible 24 hours a day. The company maintains a copy of the electronic file on its server.
109
Dental Dialogue
Periodontics
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Association Between ABO blood Groups and Chronic Periodontitis

Dr. Surekha Rathod, Prof., Dept. of Periodontics Dr. Alka Dive, Prof. & Head Dept. of Oral Pathology Dr. Abhay Kolte, Head Dept. of Periodontics
VSPM Dental College & Research Centre, Nagpur Background: one possible mechanism by which individuals of a specific blood group have a lower frequency of periodontitis could be due to increased level of antibodies against more strains of periodontitis causing bacteria. The majority of researchers have claimed that different ABO blood groups constitute an increase risk of development of periodontal and oral diseases where as one study failed to find such an association. So aim of the study was to assess the relationship between ABO blood groups & chronic periodontitis. Materials & methods: Group A: 30 subjects diagnosed with gingivitis Group B: 30 subjects diagnosed with periodontitis. Group C: 30 subjects as healthy controls. Hematological investigations : (Erythrocyte count, Mean corpuscular volume of erythrocytes (MCV), Hemoglobin concentration (HB%), Mean corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin concentration(MCHC), ESR & ABO blood subgroups) of all the subjects were done. Results: Data was statistically analysed by Annova test. Hematocrit values (HB&MCV) were more in gingivitis group as compared to periodontitis & control group. MCHC & MCH values were more in periodontitis group as compared to gingivitis and healthy group. The gingivitis and periodontitis group showed a trend more towards blood group 'B'(53.3%) & 'O'(11%), 'B'(50%) & 'O'(26.7%) respectively as compared to blood group 'A' and 'AB'. Conclusion: Significant relationship between ABO blood type & severity of periodontitis were determined. Patients with blood group 'B' appear to be at greater risk of developing more severe form of periodontitis. Key words: ABO blood group, Periodontitis, Hematocrit. Introduction: Periodontitis is a chronic condition of the supporting tissues of the teeth. Bacteremia in periodontitis has been demonstrated & the extent is directly related to severity of inflammation of the periodontal tissues. It has been therefore speculated that periodontitis result in a low grade systemic inflammation. Anemia of chronic disease has been described in the literature & seems to be one of the most common forms of anemia observed in clinical medicine. It occurs in chronic infections, inflammatory conditions or a neoplastic dis-order despite presence of adequate iron stores & vitamins. ABO, Rh & MN are three important blood systems among which ABO & Rh systems have major clinical significance & they are determined by the nature of different proteins present on the surface of red cells(1). The ABO blood system comprises of four blood types O, A, B & AB. Blood group 'O' erythrocytes have no true antigen but blood serum of 'O' type individuals carries antibodies to both A&B antigens. Types A &B erythrocyte carry the A &B antigen respectively and make antibodies to the others. Type AB erythrocyte do not manufacture antibodies to the other blood types because they have both A & B antigens. Many diseases particularly digestive disorders, cancer and infections show preferences among the ABO blood types. The other important blood system is the Rhesus (Rh) system. This system determined by the nature of different proteins present on the surface of erythrocyte. Few studies have investigated the relationship between blood type and dental caries. Individuals of blood group A appear to have a lower incidence of caries & cavities compared to those with other blood groups, this difference is particularly marked if the group A individuals are secretors(2). The secretion of ABO antigens into saliva probably inhibits the ability of bacteria to attach to the tooth surface(3,4). This is because many of these bacteria have surface lectins which they use to attach body surface and are often ABO specific. Also non secretors tend to have lower levels of IgA antibodies in their saliva which may comprise their ability to keep bacterial counts low. It has been noted that many individuals with high rates of caries have low rate of periodontitis & viceversa(5). One possible mechanism by which individuals of a specific blood group have a lower frequency of periodontitis could be due to increased level of antibodies against more strains of periodontitis causing bacteria(6,7). Limited efforts have been made to investigate the relationship between ABO blood group & periodontitis. The majority of the researchers have claimed that different ABO blood groups constitute an increased risk of development of periodontal & oral diseases, where as one study failed to find such an association. A view of few research on the subject a clinical study was therefore, undertaken to study the association between various ABO blood groups, erythrocyte count & periodontal disease in the Department of periodontology, VSPM Dental College & Research Centre, Nagpur. Design & Methodology: Study design: This was a cross sectional double blind study. The examiners were not aware of the blood group of the patients and the laboratory technician were not were not aware of the periodontal status of the patients. The study design was reviewed and approved by the ethical committee of the faculty of dentistry, VSPM Dental college and Research Centre, Nagpur. A total of 90 subjects were included in the study. Group A: 30 subjects diagnosed with gingivitis. Group B: 30 subjects diagnosed with chronic periodontitis.
110
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Surekha Rathod, et al healthy periodontium. This compares unfavourably with the study carried out by Kaslick et al (1971) who reported 36% of individuals with blood group 'O' in subjects with healthy periodontium. On the basis of the study Kaslick et al (9) 1971 stated that genetic factors may play an important role in the etiology and pathogenesis of juvenile periodontitis. This may also be true for chronic gingivitis and destructive periodontitis. Studies involving larger sample size are recommended before any of the data used diagnostically. The current study indicates that periodontitis needs to be considered as a chronic disease which may cause lower hematocrit in substantial no. of patients and is in agreement with the study by Hutter et al (10). Conclusion: In conclusion present study provides evidence that periodontitis like other chronic conditions may tend towards anemia as the no. of erythrocytes and levels of hemoglobin are lower in affected patients. These findings may be related to evaluated levels of proinflammatory cytokines in plasma of periodontitis patients suppressing erythropoiesis. Significant relationship between ABO blood type and severity of periodontitis were determined. Patients with blood group 'B' appear to be at greater risk of developing more severe form of periodontitis. ABO blood group may constitute a risk factor in the development of periodontal disease. Further long term studies with greater sample size are needed to count. References:
1. Skripal IG: ABO system of blood groups in people and their resistance to certain infectious diseases. Microbiol 1996, 58(2): 102-108 2. Hakomori S: Antigen structure and genetic basis of histo-blood groups A, B and O: their changes associated with human cancer. Biochem , Biophysics Acta 1999, 1473(1) : 247-268. 3. Holbork WP, Blackwell CC: Secretor status and dental caries in Iceland: FEMS Microbiol Immunol 1989, 1 (6-7):397-399. 4. Means R.T. Dessypris EN and Krantz S.B: Inhibition of human erythroid colony forming units by interleukin-1 is mediated by gamma interferon. Journal of cellular physiology 1992, 150, 59-64 5. Suadicani P, Hein HO : Airborne occupational exposure, ABO phenotype and risk of ischaemic heart disease in the Coepenhagen male study: Journal of cardiovas. Risk 2002, 9 (4):191-198. 6. Arowojolu MO, Dosmu EB: The relationship between juvenile and nonjuvenile periodontitis, ABO blood groups and hemoglobin types: Afr J Med Med Science 2002, 31(3):249-252. 7. Demir T, Tazel A: The effect of ABO blood types on periodontal status: Eur J. Dent 2007, 1(3): 139-143. 8. Kaslick RS, West TL: Association between ABO blood group, HL-A antigen and periodontal diseases in young adults- A follow up study : J Periodontol 1980,51(6): 339-342. 9. Kaslick RS, Chaseus AL: Investigations of periodontosis with periodontitis. Literature survey and finding based on ABO blood groups: J Periodontol 1971,42, 420-427 10.Hutler et al: Lower no. of erythrocytes and lower levels of hemoglobin in periodontitis patients as compared to control subjects. J Clin Periodontol 2001, 28, 930-936.
Graph 1: comparision of hematocrit values among the study groups.
Group C: 30 subjects as healthy controls. Criteria for patient selection: Group A: -Moderate & severe gingivitis affecting more than 30% of sites. -No attachment loss -Non-smoker -No history of systemic diseases such as diabetes, leukemia, metabolic bone disease or epilepsy Group B: -Moderate & severe periodontitis affecting more than 30 % of sites. -Non smoker -With same socioeconomic status -No history of systemic diseases such as diabetes, leukemia, metabolic bone disease or epilepsy Group C: a.Inclusion criteria: -Good general health -Periodontally healthy individuals with probing sulcus depth less than 3 mm. b.Exclusion criteria: -Pregnant women are excluded from the study. -Patient who have been on any long term medications 3 months preceding the study. Hematological investigations: Venous samples were obtained from all the 3 groups and subjected to following investigations, 1.Erythocyte count 2.Mean corpuscular volume of erythrocytes(MCV) 3.Hemoglobin concentration(Hb%) 4.Mean corpuscular hemoglobin(MCH) 5.Mean corpuscular hemoglobin concentration(MCHC) 6.Erythrocyte sedimentation rate(ESR) 7.ABO blood subgroups were determined. Results: Statistical analysis of the data was obtained. It was done by using Annova test. Comparision of hematocrit value between gingivitis, periodontitis and control group showed a significantly more hematocrit (Hb & MCV) values in gingivitis group as compared to periodontitis and control group and MCHC & MCH values were more in case of periodontitis group as compared to gingivitis and healthy group. The observation of the study are shown in table II the statistical analysis showed that there was a significant difference between all 3 groups. The gingivitis and periodontitis group showed a trend more towards blood group 'B' (53.3%) & 'O' (36.7%), 'B' (50%) & 'O' (26.7%) respectively as compared to blood group 'A' and 'AB'. Discussion : In dentistry, Weber and Pastern 1927 were the first who study the association of various ABO blood group with periodontal diseases. Kaslick et al ( 8 ) (1971) documented that gingivitis is significantly different in ABO blood grouping than normal periodontium. In another study Kaslick et al in 1971 reported that juvenile periodontritis is associated more in patients with blood group B but significantly less with blood group 'O'. The finding of this study reveals 23.3% of subjects with blood group 'O' in
Graph 2: Proportion of study population according to blood groups
111
Dental Dialogue
Periodontics
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Probiotics - A Friendly Bacteria to the Host

Dr. Swapna Mahale, Prof. & PG Guide Dr. Pankaj Kantilal Kalasva, PG Student Dr. Amol Beldar, Senior lecturer
Department of Periodontology & Implantology, MGV's K.B.H.Dental College & Hospital, Panchavati, Nashik ABSTRACT Probiotics are live micro-organisms that when administered in adequate amounts confer health benefits upon the host although a lot of work has been done regarding the effects of probiotic applications on systemic health particularly gastrointestinal tract. The impact of probiotics on oral health is relatively new with lots of research going on. The area of probiotics and periodontal disease is still in its infancy. Keywords: Probiotics, Periodontal diseases. INTRODUCTION Microbial cultures have been used for thousands of years in food and alcoholic fermentations, and in the past century have undergone scientific scrutiny for their ability to prevent and cure a variety of diseases. This has led to the coining of the term Probiotics, or Pro-life. The first clinical trials in the 1930s focused on the effect of probiotics on constipation and research has steadily increased since then. Today probiotics are available in a variety of food products and supplements. In the United States, food products containing probiotics are almost exclusively dairy products, fluid milk and yogurt due to the historical association of lactic acid bacteria with fermented milk. The most frequently used bacteria in these products include the Lactobacillus and Bifidobacterium species. The concept of probiotics probably dates back to 1908, when Noble Prize winner Eli Metchnikoff suggested that the long life of Bulgarian peasants resulted from their consumption of fermented milk products. The term "probiotic" was first used in 1965, by Lilly and Stillwell for describing substances secreted by one organism which stimulate the growth of another. Marteau et al, in 2002 defined them as "microbial preparations or components of microbial cells that have a beneficial effect on health and well being". An expert panel commissioned by FAO (Food a n d A g r i c u l t u re Organization) and WHO defined probiotic as "live micro-organisms," which, when administered in adequate amounts confers a health benefit on the host. MECHANISM OF ACTION Several mechanisms have been postulated regarding action of Probiotics. Partial lactose digestion and stimulation of the intestinal mucosal lactase activity has been postulated as a possible mechanism against some types of diarrhoea. Lactobacilli used in the fermented milk industry have active beta-galactosidase to decrease the lactose concentration in dairy products, which may affect the severity of osmotic diarrhea due to organisms as rotavirus. Lactic acid bacteria produce several metabolites like fatty free acids, hydrogen peroxide, and bacteriocins etc. which prevent the growth of food borne pathogens in dairy products [Fig.1]. It can also use enzymatic mechanisms to modify toxin receptors and block toxin mediated pathology. Probiotic agents also prevent colonization of pathogens by competitive inhibition. The other suggested mechanisms for the effect on intestinal microflora are lowering the intestinal pH, release of gut protective metabolites, regulation of intestinal motility and mucus production (1, 2). Fig.1. The following are the commercially available probiotic species.
Lactobacillus species Bifidobacterium species Streptococeus species
L.acidophilus L.casei L.fermentum L.gasseri L.johnsonii L.lactis L.paracasei L.reuteri L.rhamnosus L.salivarius
B.bifidum B.breve B.lactis B.longum
S.thermophilus
USES OF PROBIOTICS Intestinal tract health A number of studies have found probiotic consumption
112
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Swapna Mahale, et al such as Lactobacillus GG may be helpful in alleviating some of the symptoms of food allergies such as those associated with milk protein (12). Its consumption may thus be a means for primary prevention of allergy in susceptible individuals. This could play a key role in minimizing allergy at a time when the prevalence of allergic disease in Western societies has increased dramatically over the past 40 years. Cancer Studies of the effect of probiotic consumption on cancer appear promising. Animal and in vitro studies indicate that probiotic bacteria may reduce colon cancer risk by reducing the incidence and number of tumors. A clinical study done by Aso Y et al 1992 showed an increased recurrence-free period in subjects with bladder cancer. However its result are too preliminary to develop specific recommendations on probiotic consumption for preventing cancer in humans (13). EVIDENCE BASED PROBIOTIC EFFECTIVENESS IN PERIODONTAL DISEASE Probiotics for periodontal therapy have not been extensively studied. Clinical studies where probiotic species have been investigated specifically from a periodontal disease perspective are sparse. Lactobacillus reuteri and Lactobacillus brevi are among the species able to affect gingivitis and plaque composition positively as well as being specific markers for periodontal disease (14). A significant decrease in gingival bleeding and a reduction in gingivitis were observed after a two week intake of probiotic species. The observed improvements in clinical status may be attributed to the effective colonization of the probiotic bacteria within the oral cavity. The oral administration of a tablet containing L. salivarius WB21 was able to decrease the plaque index significantly, and the pocket probing depth markedly, in subjects who were smokers (15). Another finding in this clinical trial was the ability of L. salivarius WB21 to successfully reduce the prevalence of periodontal pathogens. Shimauchi H et al 2008 in the study stressed that a probiotic intervention could be a useful tool for the treatment of inflammation and the clinical symptoms of periodontitis. L. acidophilus contained in a tablet named Acilact was first clinically tested by Pozharitskaia et al in 1994 and they found improved clinical parameters in periodontitis patients and shifts in local microflora towards gram positive cocci and lactobacilli (16). Later in the year 2002 Grudianov et al also carried out a clinical study where they obtained a probiotic mix in the tablet forms, viz Acilact and Bifidumbacterin and found normalization of micro flora and reduction of signs of gingivitis and periodontitis (17). Recently Shimazaki and colleagues 2008 used epidemiological data to assess the relationship between periodontal health and the consumption of dairy products such as cheese, milk, and yoghurt (18). They found that
to be useful in the treatment of many types of diarrhea, including antibiotic-associated diarrhea in adults, travellers' diarrhea, and diarrheal diseases in young children caused by rotaviruses (3, 4). The most commonly studied probiotic species have been Lactobacillus GG, L. casei, B. bifidum and S. thermophilus. As diarrhea is the major cause of infant death worldwide and can be incapacitating in adults, the widespread use of probiotics could be an important, non-invasive means to prevent and treat diseases, particularly in developing countries. Probiotic bacteria have also been shown to preserve intestinal integrity and mediate the effects of inflammatory bowel diseases, irritable bowel syndrome, colitis, and alcoholic liver disease (5, 6). In addition, lactic acid bacteria may improve intestinal mobility and relieve constipation, particularly in seniors (7). Nutrient synthesis and bioavailability Fermentation of food with lactic acid bacteria has been shown to increase folic acid content of yogurt, bifidus milk and kefir and niacin and riboflavin levels in yogurt, vitamin B12 in cottage cheese and vitamin B6 in Cheddar cheese (8, 9). In addition to nutrient synthesis, probiotics may improve the digestibility of some dietary nutrients such as protein and fat (10). Short-chain fatty acids such as lactic acid, propionic acid and butyric acid produced by lactic acid bacteria may help to maintain an appropriate pH and protect against pathological changes in the colonic mucosa. Immune system Evidence from in vitro systems, animal models and humans suggests that probiotics can enhance both the specific and nonspecific immune response, possibly by activating macrophages, increasing levels of cytokines, increasing natural killer cell activity, and/or increasing levels of immunoglobulins (11). In spite of limited testing in humans, these results may be particularly important to the elderly, who could benefit from an enhanced immune response. Lactose intolerance Several lines of evidence show that the appropriate strains of lactic acid bacteria, such as S. thermophilus, L. bulgaricus and other lactobacilli in fermented milk products, can alleviate symptoms of lactose intolerance by providing bacterial lactase to the intestine and stomach. Because lactose intolerance affects almost 70% of the population worldwide, consumption of these products may be a good way to incorporate dairy products and their accompanying nutrients into the diets of lactose intolerant individuals. Allergy Probiotics may exert a beneficial effect on allergic reaction by improving mucosal barrier function. In addition, probiotic consumption by young children may beneficially affect immune system development. Probiotics
113
Dental Dialogue
Dr. Swapna Mahale, et al individuals, particularly non-smokers, who regularly consumed yoghurt or beverages containing lactic acid exhibited lower probing depths and less loss of clinical attachment than individuals who consumed few of these dairy products. By controlling the growth of the pathogens responsible for periodontitis, the lactic acid bacteria present in yoghurt would be in part responsible for the beneficial effects observed. Longitudinal studies are required however to clarify the observed re l a t i o n s h i p b e t we e n regular consumption of products containing probiotics and periodontal health. A particular concern when evaluating probiotic effects on periodontal disease relates to the means of administration of these bacteria. Generally probiotics are delivered in dairy products (mainly fermented milks), as food supplements in tablet forms or in soft drinks. However these routes of administration cannot provide prolonged contact with oral tissues, facilitating probiotic adhesion to saliva coated surfaces. A lozenge form, chewing gum or tablet might better serve the needs for periodontal health prophylaxis. Controlled clinical trials and long term studies are required to investigate the concentration of probiotic bacteria in the specific means of administration.
Vol. XXXVIII No. 3
JULY - SEPT. 2012
which gave guidelines for all companies producing probiotic products. These guidelines include 1. Implementation of guidelines for use of probiotics; 2. Phase I, II and III clinical trials to prove health benefits that are as good as or better than standard prevention or treatments for a particular condition or disease; 3. Good manufacturing practice and production of high quality products; 4. studies to identify mechanism of action in-vivo; 5. Informative/precise labelling; 6. development of probiotic organism that can carry vaccines to hosts and /or antiviral probiotics; 7. Expansion of proven strains to benefit the oral cavity, nasopharynx, respiratory tract, stomach, vagina, bladder and skin as well as for cancer, allergies and recovery from surgery/injury. Conclusion Probiotics represent a new area of research in periodontal therapy. The existence of probiotics in the indigenous oral microflora of humans warrants exploration because these bacteria offer the advantage of being perfectly adapted to the human oral ecosystem. Based on current research data the effects of probiotics on periodontal health and its maintenance are not clear. Preliminary data obtained by various research workers have been encouraging but numerous properly controlled, randomized long term clinical trials will be required to clearly establish the potential of probiotics in preventing and treating periodontal diseases. Much more scientific developments are needed to have a better understanding of these tiny forms of lives in order to broaden their potential application s. T h e alleged h e a l t h benefits of consuming probiotics are (fig. 2). Fig.2.
SAFETY Probiotics are live micro-organisms and hence, it is possible that they may result in infection in the host. Different strains of probiotics have different safety profiles. Although probiotic therapy is generally considered safe, the concept of willingly ingesting live bacteria remains somewhat counter intuitive. However ,in order to establish safety guidelines for probiotic organisms, FAO and WHO recommends that probiotic strains be characterized at a minimum with a series of tests, like antibiotic resistance patterns, metabolic activities, toxin production, haemolytic activities, infectivity in immuno-compromised animal models, side effects in humans, and adverse outcome in consumers(1). FAO/WHO developed Operating Standards in 2002,
114
JULY - SEPT. 2012

REFERENCES.
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Swapna Mahale, et al
15. Shimauchi H, Mayanagi G, Nakaya S. Improvement of periodontal condition by probiotics with Lactobacillus salivarius WB21: a randomized double blind, placebo controlled study. J Clin Periodontol 2008; 35:897-905. 16. Pozharitskaia MM, Morozova LV, Melnichuk GM, Melnichuk SS. The use of the new bacterial biopreparation acilact in the combined treatment of periodontitis. Stomatologia 1994; 73:17-20. 17. Grudianov AI, Dimitrieva NA, Fomenko EV. Use of probiotics Bifidumbacterium and Acilact in tablets in therapy of periodontal inflammation. Stomatologia 2002; 81:39-43. 18. Shimazaki Y, Shirota T, Uchida K, Yonemoto K, et al. Intake of dairy products and periodontal disease: the Hisayama study. J Periodontal 2008; 79(1):131-137.
1. V Gupta, R Garg. Probiotics Indian Journal of Medical Microbiology, Vol. 27, No. 3, July-September, 2009, pp. 202-209 2. Siitonen S, Vapaatalo H, Salminen S, Gordin A, Saxelin M, Wikberg R, Kirkkola AL. Effect of Lactobacillus GG yoghurt in prevention of antibiotic associated diarrhoea. Ann Med 1990; 22:57-59. 3. S, Oksanen T, Porsti I, Salminen E. Prevention of traveller's diarrhea by Lactobacillus GG. Ann Med 1990; 22:53-56. 4. Isolauri E, Juntunen M, Rautanen T, Sillanaukee P, Koivula T. A human Lactobacillus strain (Lactobacillus casei sp. Strain GG) promotes recovery from acute diarrhea in children. Pediatrics 1991; 88:90-97. 5. Nanji AA, Khettry U, Sadrzadeh SMH. Lactobacillus feeding reduces endotoxemia and severity of experimental alcoholic liver (disease). Proc Soc Exp Biol Med 1994; 205:243-7. 6. Kruis W, Schutz E, Fric P, Fixa B, Judmaier G, Stolte M. Doubleblind comparison of an oral Escherichia coli preparation and mesalazine in maintaining remission of ulcerative colitis. Aliment Pharmacol Ther 1997; 11:853-8. 7. Gade J, Thorn P. Paraghurt for patients with irritable bowel syndrome. Scan J Prim Health Care 1989; 7:23- 26. 8. Seki M, Igarashi T, Fukuda Y, Simamura S, Kaswashima T, Ogasa K. The effect of Bifidobacterium cultured milk on the "regularity" among an aged group. Nutr Foodstuff 1978; 31: 379-87. 9. Shahani KM, Chandan RC. Nutritional and healthful aspects of cultured and culture-containing dairy foods. J Dairy Sci 1979; 62:1685-94. 10. Alm L. Effect of fermentation on B-vitamin content of milk in Sweden. J Dairy Sci 1982; 65:353-9. 11. Friend BA, Shahani KM. Nutritional and therapeutic aspects of lactobacilli. J Appl Nutr 1984; 36:125-53. 12. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immun 1997; 99: 179-85. 13. Aso Y, Akazan H. Prophylactic effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer. Urol Int 1992; 49:125-9. 14. Riccia DND, Bizzini F, Perili MG, Polimenni A, Trinceirri V. Antiinflammatory Effects of L. brevei on periodontal disease. Oral Dis 2007; 13:376-385.
Your product such as Medicines, Dental materials & equipments, books, magazines, local foreign tour programs will be infront of Dental Surgeon's table within reasonable rates in all over Maharashtra So promote your sale & services and product profile Through
Dental Dialogue is 1/4 Demy Size Colour Offset Printing Quarterly Magazine.
Contents : Research Articals, Research Papers & News
PUBLISHED FOUR TIMES A YEAR
In the Interest of Dental Surgeon to update their knowledge Circulation FREE to the Members of Indian Dental Association Maharashtra State Branch ......................... CONTACT .........................
EDITOR,
KOLKATTA
www.idc2013.org.in
Dental Dialogue
Official Journal of IDA MSB

Resi. : 249 / 79, JANAK, 1/101, Near Nagala Park Kaman, Nagala Park, Kolhapur - 416 003. Ph. : (0231) 2653473 Tel. Fax : P.P. 0231-2653906 Mob. : 9422419428 E-mail : rajendrabhasme1959@gmail.com / yahoo.com
115
Dental Dialogue
Oral Surgery
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Primary Tuberculosis of the Gingiva : A Case Report

Dr. Minal Gurjar, Reader Department of Periodontics, Dr. Vivek Gurjar, Porf. Dept. of Oral and Maxillofacial Surgery BVDU Dental College and Hospital, Sangli
ABSTRACT: TB is a chronic infectious disease and a major health problem, especially in India. Most of the tuberculous lesions of oral cavity are secondary to lung disease, usually seen in elderly patients. Primary tuberculosis of the oral cavity is rare and is most commonly found in children and adolescents rather than in adults. Here we report a case of tuberculosis of the gingiva in a 23-year-old female patient. Keywords: Primary Tuberculosis, gingiva INTRODUCTION: Tuberculosis is a chronic granulornatous disease that can affect various systems of the body. In humans the disease is caused by Mycobacterium tuberculosis, Mycobacterium bovis and atypical Mycobacteria. Pulmonary tuberculosis is the most common form of the disease. However, tuberculosis can also occur in the lymph nodes, meninges, kidneys, bone, skin and in the oral cavity (1) . Most people make their first contact with the disease by inhalation of the bacilli through dust or droplets. Primary infection can also affect the pharynx, cervical lymph nodes, intestine or oral mucosa. Both primary and secondary types of tuberculosis can cause lesions in the oral cavity. In secondary tuberculosis, lesions of the oral cavity may accompany lesions in the pharynx, lungs, lymph nodes or skin. When oral lesions of tuberculosis are the sole manifestations of the disease, the clinician may face a diagnostic challenge and a risk of cross-infection from the patient. CASE REPORT: A 23 year old female was referred to our unit with a chief complaint of localized gingival enlargement in relation to the upper right canine (fig.1) which was of two months duration, and had gradually increased in size. Her medical history revealed no systemic problems and she was not on any medication .She had regular menustral cycles, and was presently not pregnant. The patient had no history of dental trauma or any surgery. On examination, her general condition and vital signs were normal. The teeth and rest of the oral cavity was normal with good oral hygiene. Prior to surgical excision of the lesion, a complete hemogram was advised. Results of complete blood count were within normal limits, and HIV test was negative. There DISCUSSION: Tuberculosis is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have an active tubercular infection cough, sneeze, or otherwise transmit their saliva through the air. Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progress to active disease, which, if left untreated, may prove fatal. Although tuberculosis has a definite affinity for the lungs, it can affect any part of the body. Oral manifestations of tuberculosis are usually seen was an elevated erythrocyte sedimentation rate (ESR). An excisional biopsy of the lesion was carried out. Standard oral antibiotics and analgesics were prescribed. Histopathological report revealed well formed necrotizing granulomas with giant cells and inflammatory cells. A stain for acid-fast bacillus was positive. The diagnosis was further confirmed by polymerase chain reaction.EnzymeLinked Immunosorbent Assay test confirmed the presence of antibodies against mycobacterium tuberculosis. These features were consistent with those of a tuberculous granulomatous lesion. . However, the chest X- ray did not reveal any characteristic finding. Based on all the above observations, the patient was referred to a physician who initiated a WHO recommended category 1 antitubercular therapy with rifampicin (450 mg), isoniazid (600 mg), ethambutol (1200 mg) and pyrazinamide (1500 mg) for two months, with three times doses per week, followed with a continuation phase with isoniazid (300 mg) and thioacetazone (150 mg) for six months. The patient reported to us after 6 months with relatively normal gingival features.
116
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
Dr. Minal Gurjar, et al pulmonary disease. Self inoculation may take place from infected sputum or hematogenous seeding. CONCLUSION: In cases of ulceroinflammatory lesion of oral cavity, tuberculosis should be considered as a differential diagnosis and a biopsy should be done in order to reach an accurate diagnosis. X-ray chest should also be done in each case for decision on the issue of primary versus secondary tuberculosis of oral cavity. A major concern for dentists and other health care workers, in light of re-emergence of the disease, is the risk of transmission of tuberculosis in the dental setting. Dentists are involved in the effort to control tuberculosis through early detection and referral of patients to physicians for proper treatment and by developing and implementing appropriate infection control programs. References: 1. Topazian RG, Goldberg MH: Oral and Maxillofacial Infections, (2nd ed.), WB Saunders Co, pg. 413, 1987 2. Prabbu SR, Daftary DK, Dholakia HM: Tuberculous ulcer of the tongue oral Surg, 36: 384-6, 1978. 3. Shafer WG, Hine MK, Levy BM: A text book of Oral Pathology, 4th Ed, WB Saunders Company Philadelphia, 1993 4. Abbot JN, Briney AT and Denam SA: Recovery of Tubercle bacilli from mouth washings of tuberculous dental patients; I Am Dent Assoc, 50:49-52, 1955 5 . E. M. Iype, K. Ramdas, M. Pandey et al., Primary tuberculosis of the tongue: report of three cases, British Journal of Oral and Maxillofacial Surgery, vol. 39, no. 5, pp. 402403, 2001. 6. B. V. Karthikeyan, A. R. Pradeep, and C. G. D. Sharma, Primary tuberculous gingival enlargement: a rare entity, Journal of the Canadian Dental Association, vol. 72, no. 7, pp. 645648, 2006. 7. L. M. Junquera Gutirrez, D. Alonso Vaquero, J. M. Albertos Castro, J. J. Palacios Gutierrez, and J. C. Vicente Rodriguez, Primary tuberculosis of the oral cavity, Revue de Stomatologie et de Chirurgie Maxillo-Faciale, vol. 97, no. 1, pp. 36, 1996.
secondary to infection in some other part of the body. Occasionally the recognition of an oral tuberculous lesion precedes the detection of pulmonary tuberculosis (2). Compared with tuberculous involvement of other parts of the body, the primary occurrence of this disease in the oral cavity and jaw bones is relatively rare. Oral lesions of tuberculosis are non specific in their clinical presentation and are often overlooked by the clinician. Although the pathogenesis of oral involvement is not definitely established, it appears most likely that the organisms gain entry into the mucosal tissue through a break in the surface (3) The probable importance of an intact mucosal epithelium in providing protection against the infection has support from the observation of Abbot et al (4) who were able to isolate the tubercle bacilli from mouth washings of 44.9 % of the patients with active pulmonary lesions. When the primary lesions of tuberculosis occur in the mouth, the most frequent sites of involvement are gingiva, tooth extraction sockets and the buccal folds. The systemic factors that favor the chances of oral infection in tuberculosis include lowered host resistance and increased virulence of the organisms. The local predisposing factors may be poor oral hygiene, local trauma, the presence of existing lesions like leucoplakia, periapical granulomas, dental cysts, dental abscess, jaw fractures and periodontitis. The primary tuberculosis of oral cavity is unusual, and most references in medical literature are a few case reports (5) . The intact oral mucosa is relatively resistant to invasion of bacilli and this only happens in 0.050.1% of cases with tuberculosis (6). The resistance is caused by the cleansing action of saliva, the presence of salivary enzymes, tissue antibodies, oral saprophytes, and thickness of the protective epithelial covering. Micro-organism needs a disruption of oral mucosa to become pathogenic (7). Any break or loss of the natural barrier, which may result from trauma, inflammatory conditions, tooth extraction, or poor oral hygiene, may provide a route of entry for the mycobacterium. In primary oral tuberculosis the organisms are directly inoculated into the oral mucous membrane of a person. In the secondary type, oral tuberculosis usually coexists with
KOLKATTA
www.idc2013.org.in

117
PUNE
Dental Dialogue
Orthodontics
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Orthopaedic Facemask Therapy

Dr. S. V. Ashtekar, Prof. Dr. Jagdeesh G., Sr. Lecturer
V. P. Dental College and Hospital, Kawalapur, Sangli Introduction CL III malocclusions are always easy to identify difficult to diagnose and more difficult to treat. Wide variety of skeletal and dental configurations exist that can lead to clinical manifestation of CIII malocclusion. Guyerand coworkers (1985)1 among others have noted that in a sample of children age 5 to 15 years who had Class III malocclusions, about 25% had simple maxillary skeletal retrusion and about 25% had simple mandibular prognathism. An additional20% had combination of these two relationship. Early intervention and facemask therapy plays an important role in correction of Class III malocclusion associated with maxillary deficiency. Case report 9/M reported with chief complaint of unpleasant facial appearance. On examination extra orally patient was presented concave profile, protruded chin, mandibular excess ,increased lower facial height and unpleasant smile. Intraoral examination revealed mixed dentition with well aligned lower arch, missing right and left deciduous second molars, crowed upper arch with palatally placed upper lateral incisors and missing both deciduous second molars. In occlusion, there was a severe anterior cross bite (i.e. 100%) with negative overjet of 3mm.After cephalometric examination it was revealed that it was a case of skeletal Cl III malocclusion with maxillary deficiency. Treatment plane decided was Orthopaedic facemask therapy to correct maxillary retrusion. Initially rapid maxillary expansion was done for 8 days (1 turn per day) to mobilisecircum maxillary sutures which will facilitate the forward movement of maxilla. Then the facemask appliance was used. Approximately 1Kg (1000gm) force was applied to pull the entire maxilla in forward direction. The elastics engaged to the central rod of facemask in 20 degree angulation to pull the maxilla forward and downward. The orthopaedic facemask was continued for 4weeks(14 hrs./day).The entire maxilla was pulled forward,anterior cross bite got corrected and the profile became straight from concave (photographs). Discussion From theoretical perspective it would seem appropriate to select a treatment modality that would fit the need of an individual (eg. FR 3 in case of maxillary retrusion, achin cup in case of mandibular (prognathism)1. However, the nature of treatment response produced by facemask and the age at which this therapy is initiated indicate the use of this appliance in a wide range of Cl III problems in juveniles .In many of the mild to moderate and some rather severe Cl III cases this type of therapy produces a pronounced occlusal changes within a relatively short period of time. Further study is needed to determine the best timing for longterm stability. Delair5 has shown that the forward positioning of the skeletal maxilla can be achieved with reverse headgear (face mask) if the treatment is started at an early age. Proffitand Fields3 recommended that a child with maxillary deficiency have a complete evaluation as early as possible. Little is known about stability of face mask therapy and a few published studies are of short durations and present varying results Conclusion Rapid maxillary expansion and facemask therapy is an effective method to correct skeletal Cl III malocclusion associated with deficient maxilla. It gives improvement in maxilla mandibular relations. It also improves the soft tissue profile and gives better lip competence. References
1) Mcnamara JA,Brudon W Jr. Orthodontic and orthopaedictreatment in the mixed dentition. Needham press;1993.133138 2) Petrick k Turley. Managing the developing Class III malocclusion with palatal expansion and facemask therapy. Am J Orhod DentofacialOrthop 2002;122.349-352. 3) Proffit WR, Fields HW Jr, Editors. Contemporary orthodontics. Saint Louis Mosby;2000. P 241 4) Dr .Kalavani S.V. Correction of skeletal Class III malocclusion in pre adolescents. DentairesRsvista 2009;23-33.1 5) Jiuhui Jiang, JiuxiangLin, and ChangrongJi. Two stage treatment of skeletal Class III malocclusions during the early permanent dentition. Am j OrthodDentofacialOrthop 2005; 128:520-7
118
JULY - SEPT. 2012

Attend in Large Numbers
Vol. XXXVIII No. 3
KOLKATTA
22nd to 25th February 2013
Dental Dialogue
NEWS
Dental Dialogue Join Social Scheme Security IDA MSB

Contact Dr. Narendra Paralkar
Clinic : 022 27823658, 27823757
WORLD DENTAL CONGRESS AT MUMBAI

(Dr. Rajendra Bhasme)
Ms. Prabhu Parmeshwaran MD of Colgate at inaugural function
World Dental Congress 5-7 Oct. 2012
Mumbai : 5th Oct. 2012 fourth edition of spectacular WDS was inaugurated here at Mumbai. More than 10000 delegates attended three day show at the eleborately built pavilion at Bandra Kurla Complex, Mumbai. Exhibitors to the show new products from 210 exhibitors with new equipments from 23 countries. About 23773 visitors visited this grand Global Show was arrarranged by IDA for last four years continuously Dr. Arun Sharma, Dr. Danial Mendoza, Dr. David Rising, Dr. Rajeev Chitguppi, Dr. Shailesh Lele & Dr. Porus Turnur gave scientific delebrations.
Launch of National Oral Hearld Card National Oral Health Card of IDA with Wrigley Orbit was launched here at the hands of Ambassador of ORBIT Deepika Padukone
MUMBAI BR.
RELEASE OF DENTAL DIALOGUE
Dr. Hemant Dhusia the President of IDA Mumbai Branch Dr. Sharif Firoz (Hon. Sec. IDA Mum. Br.), Dr. Mansing Pawar (Jt.Dir.MER, Dean, GDC Mumbai, the moderator) the speakers Dr. Shishir Singh (Dean, Prof & HOD, Dept of Cons, Terna Dental College), Dr. Rajesh Podar (Prof, Dept of Cons. Terna Dental College) & Dr. Sharad Kokate (Dean, Prof & HOD, YMT Dental College, Vice-President MSDC & IDA Mum Br.)
The 4th CDE Programme of IDA Mumbai Branch Endodontic Extravaganza held on 23rd September 2012 at The Peninsula Hotel, conducted by IDA Mumbai Branch, turned out to be a resounding success with a huge number of participants. The lecturers were the eloquent Dr. Shishir Singh, Dean, Prof. & HOD, Dept of Conservative, Terna Dental College & Dr. Rajesh Podar, Prof, Dept of Endodontics dept, Terna Dental College. The lectures on Wave One & Rotary Protaper Systems were followed by a fantastic Hands-On program in which the participants were allowed to work on extracted teeth and Endo VU Blocks with the rotary systems. The program was moderated by the eminent Dr. Mansing Pawar, Dean of Government Dental College. There was also a lecture and demonstration on laser by Dr. Priyanka Karande. The 4th IDA MSB meeting was also conducted successfully on the same day at the same venue.
Dr. Ram Mahudkar, Dr. Pramod Gurav, Dr. Sanjay Bhawsar, Dr. Ashok Dhoble, Dr. Suhas Merchant, Dr. Hemant Dhusia & Dr. Sharif Firoz
Mumbai, 23 Sept. : Relaese of the new issue of Dental Dialogue e.g. Apr. - June 2012 at Mumbai by auspicious hands of Dr. Ashok Dhoble HSG IDA at 3rd executive committee meeting of Indian Dental Association Maharashtra State Branch . Dr. Ram Mahudkar, Dr. Pramod Gurav President Elect IDA Head Office, Dr. Sanjay Bhawsar President IDA MSB, Dr. Ashok Dhoble HSG IDA HO, Dr. Suhas Merchant Vice President IDA MSB, Dr. Hemant Dhusia President Mumbai Branch & Dr. Sharif Firoz Secretary Mumbai Branch were present.
Wild Maharashtra Photography Contest

Photograph of our member Dr. Matrishva B. Vyas gets a special mention at Wild Maharashtra Photography Contest !! The contest was organised by Sanctuary Asia, the leading wildlife and conservation journal of India; and Maharashtra Tourism Development Corporation. In an endeavour to shine a spotlight on Maharashtra's most diverse and beautiful ecosystems, the threats to them and to encourage wildlife lovers to visit these wonderful destinations, Sanctuary Asia and the Maharashtra Tourism Development Corporation (MTDC) have Prize Winning organised a photo exhibition showcasing some of the most stunning images ever taken. Photograph by Dr. Matrishva Vyas
119
Dental Dialogue
Vol. XXXVIII No. 3
JULY - SEPT. 2012
KRISHNA SANGAM 1ST ZONAL STUDENT CONFERNECE, KARAD

School of Dental Sciences, KIMSDU, Karad in association with IDA MSB Satara District Branch organized a Western Maharashtra Zone Student Convention on 12th, 13th &14th Oct 2012, which was named KRISHNASANGAM. The name, though inspired by the confluence of the rivers Krishna and Koyna, became a literal translation in every sense. It was not only a confluence of students and clinicians from Western Maharashtra, but also of cultural, sports and scientific activities. This mega event was a grand Success. Sports activities completed on 12th October 2012. About 659 delegates from various Dental colleges registered for this conference. On Sat 13 Oct 2012 KRISHNA- SANGAM was officially declared open. Welcome address was given by Dr. M.V Ghorpade, Registrar, KIMSDU. This was followed by felicitation of the dignitaries on the Dias and lamp lighting. The Guest of Honour for the occasion was Dr Pramod Gurav President Elect I.D.A. Head Office. He spoke on the necessity of students & teachers becoming members of professional bodies like IDA.Hon'ble Principal Advisor Dr. Suresh Bhosale, Dr. Bajarang Shinde President Elect IDA MSB & Dr. Rajendra Bhasme, Editor, Dental Dialogue were also present. The inaugural function was followed by the first oration delivered by Dr Neeraj Seth, who spoke on the different avenues & options available for the students after graduation. The second oration was about handling complications in minor oral surgery and was delivered by Dr Pushkar Waknis, skilled Maxillo-Facial Surgeon. Dr.Manish Agarwal, a renowned Prosthodontist gave the third oration on complete denture fabrication on Sunday.. Saturday cultural evening extravaganza was held at Hotel Pankaj Lawns. The students of various dental colleges participated in singing, dancing, skit & fashion show competition. The Prize distribution & valedictory ceremony was held on Sunday 14 Oct 2012. Dr Ashok Dhobale HSG, IDA HO and Dr Sanjay Bhawsar President IDA MSB were the Guest of Honour. Also presiding over the function were Dr Neelima Malik Principal SDS Dr Renuka Pawar Vice- principal, Dr Bajrang Shinde President elect IDA MSB.
Dr. Chandrshekhar Ghorpade

Organising Chairman, Krishna Sangam
Dr. Sharadchandra Jagtap

Secretary, Satara
KOLHAPUR BR.
LATUR BR.
IDA LATUR Branch conducted a full day [9am to 6pm] endo hands-on course' MASTERING ENDODONTICS' on rotary technique by DR. AJIT SHALIGRAM [mds endo] at Latur City. Total 46 (forty six) participants attended the course and did the hands-on over extracted tooth. Course was arranged in two batches so that every paticipent get sufficient time to do hands-on under the supervision of DR. AJIT SHALIGRAM. First batch was on 12th Aug. {Sunday} and second on 9th Sep.{Sunday}2012. For this hands-on, participants from latur as well as from Osmanabad and Beed branch also present.
H$mohmnya, Vm. 28 : nmobrg ho Zoh_rM S>mQ>am Mo {_ AmhoV d amhVrb Ago {VnmXZ {Ohm nmobrg AYrjH$ {dO`qgh OmYd `m Zr Ho$bo. VgoM d H$emmVrb ~moJ S>mQ>am {d H$madmB H$a`mg nmo{bgm Mo g KQ>Zog ghH$m` amhrb Ago AmdmgZhr `m Zr {Xbo. B {S>`Z S>|Q>b On 9th Sep. IDA Latur felicitated Dr. Padmakar Patil (Principal, Agmo{gEeZ`m _hmamQ> amèmIo`m 8>`m am`Var` n[afXoVrb MIDSR Dental College, Latur) as he has been elected as a SENET S>m. A{dZme {enyaH$a _ Vr `m`mZ_mboMo Mm Xmdo nwn hmQ>ob E{Q>`m òWo MEMBER of MUHS University, Nashik. Dr. Uttam Deshmane a{ddma Jw \$bo Jobo. JALGAON BR. `mdoir _wI nmhUo hUyZ Vo CnpWV hmoVo. H$mohmnya emIo`m A`jm S>m. gmYZm Am ~S>}H$a `m Zr mVm{dH$ Ho$bo. g{Md S>m. e boe Omoer `m Zr 6th CDE programme on 9th Am^ma _mZbo. S>m. amhb nmodma `m Zr gyg MmbZ Ho$bo. Sept.2012. H$m` H $_mgmR>r emIoMo am` A`j Zm{eH$Mo S>m. g O` ^mdgma, S>|Q>b Guest speakerS>m`bmJMo g nmXH$ S>m. amO| ^_o, am` emIoMo am` A`j S>m. ~Oa J Dr. UMA MAHAJAN.(MDS CONSERVATIVE qeXo CnpWV hmoVo. DENTISTRY) lr_Vr A{ZVm {enyaH$a `m Zr S>m. {enyaH$a `m `m {V_og nwnhma An U Ho$bm. `m H$m` H $_mV _w ~B Mo S>m. {Xbrn nmoi d S>m. gwXe Z aU{ngo `m Zr Topic- COMPO-ESTHETICS. 56 members attended the programme. `m` X Vd H$ em d X Vd H$mMr O~m~Xmar `mda {ddoMZ Ho$bo. DR. UMA MAHAJAN, VAIJAYANTI PADHYE, PARLESH BHADADA, DR. H$m` H $_mgmR>r H$mohmnya, BMbH$a Or, H$amS>, {ZnmUr, JS>qhbO, ASHISH MAHAJAN, UMA MAHAJAN, VAIJAYANTI PADHYE, PARLESH BHADADA, SUYOG SOMANI. Bbm_nya, gm Jbr òWrb gw_mao e â X Vd H$ CnpWV hmoVo.
S>m. eboe Omoer

120
Dr. Ashish Mahajan
JULY - SEPT. 2012
Vol. XXXVIII No. 3
Dental Dialogue
NASHIK BR.
LONI BR.
The 3 rd State Scientific convention of hosted by Loni Branch on Thursday 30th August 2012 at Rural Dental College, Loni. The theme for the convention w a s A p p l i c a t i o n o f Advanced Imaging Technology in Dentistry with special emphasis on the role of CBCT in different specialities of dentistry. Dr. Vivek Soni, Dean, Dr. S. D. Dalvi, Hon. Vice-Chancellor, Dr. Sanjay Bhawsar, Hon. President of IDA-MSB were the Guest of Honour. The Galaxy of speakers comprised of Dr. Vivek Soni, Dr. Sanjay Bhavsar, Dr. Freny Karjodkar, Dr. Milind Saudagar, Dr. Arun Nayak, Dr. Prashant Shirke, Dr. Amit Agrawal and Dr. Prashant Jaju, who all in a very elaborate manner enlightened on the details of Cone Beam Computed Tomography to the audience. The convention was a huge success with 400 plus registrations. Delegates included from Mumbai, Dhule, Nasik, Nagpur, Aurangabad, Malegaon, Sangamner, Ahmednagar etc. A poster competition was organized on the theme Technological Advances in Dentistry with a total of 44 posters being presented.
5th State Scientific Zonal Convention for Maharashtra State was successfully taken on the 1st and 2nd sept 2012. The program was hosted by Nashik Branch there were near about 225 dentist participated into the conference all over from Nashik, Loni, Sangamner, Dhule, Malegaon & Mumbai. Dr. Anand Godshoy president IDA HO ,Dr. Pramod Gurav president Elect IDA HO were present as the Chief Guest for the programe.
ARABHA 2ND ZONAL STUDENTS CONFERENCE
Dr. Rahul Baldwa
KHARGHAR BR.
A CDE program was organized at state level at Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai,on 6th and 7th Sept. 2012. The program was attended by almost 150 members from different parts of Maharashtra. The main purpose was to highlight the salient features in the Complete Denture Prosthesis with the current trends and the need of the patients for satisfactory treatment. The program was conducted by Dr. Suresh Meshram, Principal/ Professor and eminent senior Prosthodontist and Dr. Milind Karmarkar, Professor in Prosthodontics. Dr. Sudarshan Ranpise
2nd Zonal Student Conference hosted by IDA Nashik Branch with help of MGVKBH Dental College, Nashik on 21st & 22nd October 2012. This programme includes sports cultural & scientific activities. Table Tennis, E-posters, Paper by students were also read. Dr. Mansing Pawar, Jt. Director, DMER, Dr. Sanjay Bhawsar, President IDA MSB, Dr. Ashok Patil, Dr. Doddamani were the Guest of Honour. About 500 delegates from ACPM Dhule, SMDT Sangamner, PMT Loni, Yashwantrao Chavan Nagar & MGV Nashik have attended.
Dr. Sachin Kochar
14TH DENTCON OF DHULE BR.

Silver Jubilee Celebrations of Dhule Branch was organised on 17th to 19th August 2012 at Hotel Residency Park at Dhule. Dentcon a branch conference was organised for 14 consecutive years was well attended and galaxy of renowned speakers share their knowledge and skills conducting hands on courses on micro endodontics & lasers & implants. Founder member of the branch were felicitated at the hands of Chief Guest Dr. Sanjay Bhawsar, President IDA MSB. The journal of Dhule branch was released on this occasion.
Dr. Parag Targe
121
Dental Dialogue
Vol. XXXVIII No. 3
JULY - SEPT. 2012
Vaibhav Medical
and
General Stores
Vishnu Nagar, Vasmat Road, PARBHANI
Prop. Mr. Sunil Narayanrao Nandkhedkar

RNI No. 27841/75 MAHENGO : 8987
Editorial Committee
Editor : DR. RAJENDRA BHASME BDS MJC
Assistant Editor : Dr. Shailesh Yadav Contributory Editors : Dr. R. S. Sathwane Dr. Abhay Kolte Dr. Vivek Pakhmode Business Managers : Dr. Vikas N. Patil, Dr. Ashish Khasbage Dr. Arun Khalikar Public Relations : Dr. Bajrang Shinde Dr. Chandrashekhar Tambade Dr. Naveen Hantodkar Dr. Sujit Pardeshi Co-ordinators : Dr. Harish Kulkarni Dr. Deepak Matani, Dr. Shrinivas Ashtekar Advisors : Dr. Ashok Dhoble, HSG Dr. S. G. Damle Dr. Dilip Pol Dr. Suresh Meshram Dr. Vijay Pethe Dr. Abhay Kamra Dr. Sabita M. Ram
International Advisor : Dr. Chhad Gehani (U.S.A.)

CopyRight Readressal Committee :
Pre. : Dr. Sanjay Bhawsar Dr. Pramod Gurav, Dr. Nitin Dani Dr. Jayant P. Deshpande Dr. Vijay Baldawa Members :
Circulation free to all members of IDA Maharashtra State Branch
Non Members : Rs. 15/- Inland
Opnions expressed in the articles and advertisements are those of the authors and not necessarily those of the Editor or Publisher. The Editor and Publisher disclaim any responsibility or liability for such material, views, statements of claims. The material (text, illustrations, slides, tables, etc.) supplied for articles is the sole responsibility of the author and / or Advertiser. Dental Dialogue is not responsible for verifying or authenticating the source of such material.
Copy right : All the rights are assigned by the author (s) to the Dental Dialogue & are reserved. No part of the article (s) should be reproduced or copied in any form or by any means i.e. graphic, electronic, or mechanical without written permission of the Editor.
Printed & Published by Dr. Rajendra Bhasme on behalf of the Indian Dental Association, Maharashtra State Branch and Printed at Rajhuns Printing Press, Bhausingji Road, Nagala Park, Kolhapur 416 002. and published at 1215 'A', Ground Floor, Opp. Daulatrao Bhosale School, Shivaji Peth, Kolhapur 416 012. Editor Dr. Rajendra Bhasme
122
Dental Dialogue
RNI Reg. No. 27841 / 75
k a ro und p o or or w br u
g in sh
re m ing ov
e s ig ne
to
b ha
sh d u r b th
it s
to
e th
w ho le
p l a mo ut h cl -
qu
NEW COLGATE 360 SURROUND

The latest breakthrough in mechanical plaque removal for better oral health Removes up to 88% more plaque than an ordinary flat-trimmed toothbrush1 1 Provides superior cleaning, regardless of brushing technique
CLINICAL EVIDENCE Colgate 360 Surround removes significantly more plaque than an ordinary flat- trimmed toothbrush, regardless of brushing techniques*1
*p<0.05; patients were not given instructions for brushing technique during study
31% Greater
Removal
88% Greater
Removal
52% Greater
Removal
Whole-mouth plaque removal After 1 minute of brushing
Interproximal plaque removal After 1 minute of brushing
Gumline plaque removal After 1 minute of brushing
Refrence: 1. Mankodi S. Data on file. July 2010. Colgate e-Palmovie company
Dental Dialogue
MECHANICAL PLAQUE REMOVAL
fo
ra
It
an
w o r k o ore
ea

IDA Maharashtra State Branch Dental Dialogue July-September2012

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

IDA Maharashtra State Branch Dental Dialogue July-September2012

Diunggah oleh

Hak Cipta:

Format Tersedia

JULY - SEPT.

Vol. XXXVIII No.3

Deepika Padukone at WDS Mumbai 2012

Vol. XXXVIII No. 3 JULY - SEPT. 2012

JULY - SEPT. 2012

Vol. XXXVIII No. 3

INDIAN DENTAL ASSOCIATION

E-mail : rajendrabhasme1959@gmail.com / yahoo.com

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Happy Diwali & Happy New Year Vikram Samvat 2069

Happy Diwali & Happy New Year Vikram Samvat 2069

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

AmZ XmMo jU CYirV Xrnmdbr Ambr.. gVa Jm `m {X`m Zr A JUo gObr..

ZyVZ dfm {^Z XZ {dH $_ g dV 2069

Indian Dental Association Maharashtra State Branch

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

Dr. Sanjay V. Bhawsar President, IDA MSB

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

Indian Dental Association Maharashtra State Branch

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Preoperative intraoral view of maxillary arch

Preoperative intraoral view of mandibular arch

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

REQUEST & GUIDELINES TO AUTHORS

66th Indian Dental Conference

Indian Dental Association Maharashtra State Branch

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Lipoma, A Rare Intraoral Tumor A Case Report

Extra Oral Presentation Of Patient

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

51st Maharashtra State Dental Conference

15th & 16th December 2012

Vol. XXXVIII No. 3

JULY - SEPT. 2012

Importance Of Pre-anaesthetic Evaluation

Indian Dental Association Maharashtra State Branch

JULY - SEPT. 2012

Vol. XXXVIII No. 3

Indian Dental Association Maharashtra State Branch

Vol. XXXVIII No. 3

JULY - SEPT. 2012