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Diagnostic Wax Up: January 2014
Diagnostic Wax Up: January 2014
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diagnostic wax up
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Dr. R. D. Das
Editor, Dental Section
Advisors
Dr. Sharad Kokate
Dr. Sanjeev Yadav
Dr. (Mrs.) P. P. Page
5 PHOTODYNAMIC THERAPY 16
Authors
Dr Gopal Sharma, Dr Deepa Das, Dr Bhagyashri Purandare, Dr Jaya Mukherjee
I am very happy to know that the Dental College is coming out with the
issue of “DENTO -MED” .
Since we started with our Post Graduate studies few years back the
college is buzzing with scientific activities & has grown to new heights .
To compile all these scientific activities by the staff and the students we
decided to print our own scientific magazine and is being published at regular
intervals.
I congratulate the staff, the students and specially the editorial team in
making this journal a great success & to sustain the same, getting it to greater
heights.
Dr. G. D. Pol
Chairman
I thank the editor of the journal prof. (Dr.) R. D. Das and his editorial team
for taking great efforts to comeout with this excellent issue.
Having this ‘writing strategy’ means you are making sure you have both external
motives, such as scoring points and internal motives, which mean working out why
writing for journal matters to you. This will help you to maintain the motivation you will
need to write and publish over a longer term.
Our commitment to come up with a journal and a platform for scientific writing of
excellence has been applauded; both for our consistency in bringing out the journal on
time and striving to maintain a high level of quality throughout. We, at the editorial
board, are proud to announce the first dental issue, we too hope we continue to achieve
greater heights in genius and quality here at the editorial desk and hope that you as
authors too help to maintain the standards of quality and scientific content contribution!
Dr. Shreyas.H.Gupte
Reader, Department Of Oral & Maxillofacial Surgery.
YMT's Dental College & Hospital, Navi Mumbai.
DISCUSSION:
Though we are professionally trained
dentists we are doctors first, hence we should
look at all possibilities causing a particular
complication may be local or systemic and if need
arises apt referrals should be done to attend to
the patients problem more rationally and prevent
any further complications either medical or
medico legal.
Abstract: INTRODUCTION
Objective: Dental caries can be traced to be as old as
1
To assess the prevalence of dental caries civilization with its evidence seen even in skeletal
and treatment needs among 10-12 year old remnants of prehistoric human. It is a
children of Jaffari school, Mumbai, India. multifactorial disease, caused by a web of factors
like micro-organisms, substrate, host factors
2
Methods: related to the teeth and time.
Study population comprised of children Dental caries is the most common chronic
aged 10-12 years who were attending the Jaffari disease of childhood that interferes with normal
school in Govandi. The children were examined nutrition intake, speech, self-esteem and daily
in their school seated on an ordinary chair, in routine activities, because the caries pain
broad day light using WHO (1997) criteria. All the adversely affects the normal food intake.
children requiring treatment were referred to the Hence, an attempt is made to provide baseline
Department of Pedodontics and Public Health data of dental caries prevalence and treatment
dentistry, Y.M.T. Dental College and Hospital, needs among 10-12 year old children of Jaffari
Kharghar. school, Mumbai, India.
Abstract: Introduction:
Purpose: One of the major concerns in orthodontics
1) This study was done to assess reliability of Beta is the accurate evaluation of sagittal jaw
Angle in sagittal skeletal discrepancy and effect relationship between maxilla and mandible.
of jaw rotations on the measurement of Beta Rotations of jaws during growth,vertical
Angle. relationships between jaws,lack of validity of
2)To compare the values of Beta Angle and ANB landmark location and inter-examiner variability
angle in sagittal skeletal discrepancy cases. makes diagnosis even more critical. (1-3)
Material and Method:
Since Wylie's first attempt to describe A- P
Total 60 patients cephalograms (aged 15 to 25
jaw relationship, various other cephalometric
years) were selected for the study. The mean and
parameters have been proposed.4 Downs(1948)
SD were calculated for ANB angle and Beta
introduced the A-B plane angle.5A few years later
Angle. After using Analysis of Variance, we
obtained results that showed stastically significant Riedel in 1952 introduced ANB angle. Although
difference between the values of ANB and Beta some authors have questioned the reliability of
angle in different sagittal skeletal growth ANB angle depending upon changing position of
patterns. nasion during growth, till date it is the most
commonly used measurement to assess the
Conclusion: sagittal discrepancy.6-8 Recently, few researchers
1) From the present study, it can be concluded have proposed new angular measurements to
that ANB angle remains more reliable as assess the anteroposterior jaw discrepancy
compared to Beta Angle in non-growing between maxilla and mandible.9
individuals. Alex Jacobson in 1975 introduced
2) Jaw rotations affect Beta Angle to a large Wits appraisal. It relates point A and Point B to the
extent and can often be misleading. functional occlusal plane. The distance between
Key words: Beta Angle, ANB angle, jaw rotations, the points of intersection AO and BO is measured
sagittal skeletal growth pattern. to describe antero-posterior relationship.In
females AO should coincide BO, whereas in
jaw discrepancy. Skeletal Class III : ANB angle less than or equal to
i) It uses point A and Point B, which can be 1
0
Discussion:
In orthodontics diagnosis and treatment
planning is an indispensible step and
anteroposterior relation of the jaws is generally
determined by cephalometric analysis.
9
Authors have mentioned that the Beta
Clinicians with increasing frequency are treating Angle remains relatively stable even when the
malocclusions in conjunction with orthognathic jaws are rotated. They suggest that as B-Point
surgery. A method of maxillomandibular rotated either backward or downward, then the
assessment that provides accurate data on this C-B line is also rotated in the same direction,
relation at an early age would be highly carrying the perpendicular from point A with it.
desirable.11To evaluate this relationship, various Because the A-B line is also rotating in the same
angular and linear measurements have been direction, the Beta Angle remains relatively
suggested, but these can be erroneous as
stable. But, on the contrary when actually, it is
angular measurements are affected by the
measured on cephalograms, there is substantial
inclinations of reference line.
variation in Beta Angle measurement .This factor
So, one must consider Bjorks opinion
of jaw rotations can often be misleading and
that the human body constitutes a functional
makes the interpretation of this angle much
entity, no part of which can be varied without
more complex. H o w e v e r, ANB angle
entailing some changes in other parts. Similarly,
the facial skeleton and the dentition are measurements did not show so much variation in
functional parts of the skull as a whole. It follows, measurements in the same cephalograms.
therefore, that variations in the bite will be This variability in measurements can
largely related to cranial and facial structures.
14
make this angle more unreliable during
Baik and Ververidou suggested that, consecutive comparisons, throughout
Beta angle enables better diagnosis and orthodontic treatment.
treatment planning for patients. But in the The present study is in contradiction to
present study it is observed that the complex previously done study by Sachdeva et al. who
geometry in the craniofacial region makes this showed that Beta Angle is significant to asses
FIG-4 & FIG-5 Surgical specimen showing soft tissue along with small rudimentary teeth like structures .
patient with an unaesthetic non-vital tooth. Over the years, a number of bleaching and
restorative techniques have been proposed for
Introduction managing discoloured non-vital incisors(Table
Permanent incisors may discolour 1)
following trauma, loss of vitality, endodontic All of them have their own advantages and
1
treatment and restorative procedures. The blood disadvantages.So proper case selection and
pigment haematin is responsible for enamel and techniques are to be customized for each
dentine staining following trauma-induced individual case.
Advantages Disadvantages
Conservative, safe and effective Requires compliant patient
Rapid bleaching result Risk of bacterial contamination if the patient
does not return for access closure
No sensitivity (non-vital tooth) Risk of food impaction in open access cavities
Bleach accesses internal aspect of the tooth. Risk of sensitivity of adjacent teeth
Lower concentration than walking bleach or Requires manual dexterity by the patient
power bleach technique.
Discolouration is easier to mask with Additional cost of tray fabrication
restoration if necessary
Figure no 5 Inserting the bleaching gel inside the tooth and on the tray
the kit. The male component of an attachment (1975) in a 5-year study found that retention of
(stud) was then cemented in the post space using mandibular canines for overdentures led to
type I glass ionomer cement [fig. 4]. preservation of alveolar bone. Further,
Roumanas et al. concluded that anterior
6
Peripheral molding was done and secondary mandible height resorbed four times faster than
impressions were made. While making maxillary arch with conventional dentures. He
mandibular secondary impression female also found that overdenture patients had a
components were placed on the stud intra-orally chewing efficiency which was one-third higher
so as to record space required. Face bow transfer than that of complete denture wearers.
was made and the cast mounted on a semi- The success of the overdentures depends upon
adjustable articulator (Hanau wide view). the proper attachment selection for the particular
Interocclusal records were made in bite case. Attachment selection is based on available
registration wax. The horizontal and lateral interarch space, amount of bone support
condylar guidances were set, maxillary and opposing dentition, clinical experience, personal
mandibular anterior teeth arranged and the preferences, maintenance of oral hygiene and
incisal guidance was adjusted. The posterior cost. Accessposts are stud attachments that work
7
teeth were set in a bilateral balanced occlusion. well with overdentures, as they are the simplest
The trial dentures were then tried in the mouth, of all. They occupy a small vertical space and the
vertical dimension verified, centric and eccentric male units on the different roots do not require
contacts were evaluated. The facial and parallelism. Resiliency of female component
functional harmony was studied and patient’s relieves stress being directly transferred to the
approval obtained. The dentures were then abutment. The nylon cap provides 3-5 pounds of
waxed and processed. After curing was retention. The technical work required is minimal
completed, laboratory remount and occlusal and can be carried out at chairside, thus making
adjustment was done. Finally, the dentures were it cost effective.
finished and polished.
The female component (nylon cap) of an CONCLUSION
attachment was then attached to the intaglio The concept of overdentures provides a
surface of the mandibular denture using positive means of delaying the process of
autopolymerizing acrylic resin. For this purpose, a resorption of alveolar bone. Although it is a
rubber band was used to cover the undercut area feasible alternative, it is not often used to its full
of stud (to avoid locking) and the nylon cap was potential. Careful case selections, abutment
placed on the ball of the post. Once the nylon preparation, maintainance of oral hygiene as
caps were picked up, rubber bands were well as periodic recall are keys to successful
removed and flash trimmed. The denture was overdenture rehabilitation.
adjusted and equilibrated [fig. 5 and 6]. Post
insertion instructions were given along with a
recall appointment. The following day, the mouth
was observed for sore areas and final occlusal