BackgroundThe purpose of this descriptive study was to observe the distribution of four different classes of non-carious cervical root surface discrepancies in teeth with gingival recession. Additionally to explore the different treatment modalities in the literature for each of these defects.Material and MethodsA total of 150 subjects with at least one labial gingival recession were included in the study. 1400 teeth were evaluated using 2.5 X magnification loupes and UNC -15 probe for the presence of the cemento-enamel junction and step like defects according to Pini-Prato’s classification: A-, identifiable CEJ without defect; A+, identifiable CEJ with defect; B-, unidentifiable CEJ without defect, B+, unidentifiable CEJ with defect. Further a comprehensive electronic and hand search of pubmed indexed journals was performed to identify appropriate treatment modalities for these defects and their predictability following restorative/surgical or combination of both.ResultsA total of 1400 teeth with exposed root surfaces were examined (793 Maxillary; 607 mandibular). 499 teeth were A-, 405 were A+, 322 were B+ and 174 were B-. The distribution of these defects in different teeth was: 36% premolars, 32% molars, 21% incisors and 11% canines, collectively 68% in the aesthetic zone.ConclusionsMajority of these lesions are in the maxillary aesthetic zone. Hence the presence of the CEJ and the defect must be taken into account while managing these defects surgically. Key words:Cervical abrasion, gingival recession, magnification loupes, root coverage, step defects.
Aim: To assess the extent of self-awareness and knowledge of diabetes and its association with periodontal disease among patients seeking dental care. Materials and Methods: Data were collected in the form of a questionnaire from 150 consecutive adult patients from the outpatient department of Saveetha Dental College in Chennai, India. Complying patients were tested for diabetes mellitus by checking their random blood sugar and the results were correlated with the questionnaire and their periodontal findings. The findings were interpreted to examine the relationship between self-awareness and clinically diagnosed periodontitis. Results: One hundred fifty patients participated in the questionnaire and 70% were unaware of diabetes causing periodontal disease. A total of 47.3% of patients were also unwilling to get themselves tested for diabetes by their dentists as nearly 73.3% believed that they did not have diabetes. As a result, out of 150 patients, 41 consented to random blood sugar but only 23 patients followed up. Among these 23, 14 believed they were diabetic but only 12 of those 14 were proven to be so. Additionally, 20 patients were diagnosed with either localized or generalized chronic periodontitis while the remaining 3 patients had gingivitis. All 12 patients diagnosed with diabetes were affected by periodontitis as well. Conclusions: Patients are generally apprehensive and misinformed regarding the influence of periodontitis and diabetes between both diseases and must be educated by both the medical and dental practitioners regarding the implications of these chronic inflammatory diseases.
A 29-year-old female patient reported to the dental operatory with the chief complaint of pain in relation to the right lower back tooth region. The pain was sudden in onset and aggravated during mastication. The patient also gave a history of a metal allergy that presented as erythema on wearing artificial jewellery. Clinical examination in relation to teeth #46 and 47 revealed tenderness on percussion. Both teeth were endodontically treated one year prior to presentation and rehabilitated with Porcelain Fused Metal (PFM) crowns with no gingival recession [Table/ Fig-1,2]. Radiographic examination revealed recurrent caries beneath the crowns with mild root resorption and an associated periapical lesion in relation to tooth #46. There was also Grade III furcation involvement of tooth #47 [Table/ Fig-3] Adequate bone height and width were present as verified using CBCT [Table /Fig-4]. The poor prognosis of reendodontic treatment was explained and the patient wanted a more definitive treatment. The teeth were hence decided to be extracted and immediately replaced with one piece zirconia implants.
Knowledge of various anatomic landmarks is pivotal for important success. Bifid canals pose a challenge and can lead to difficulties while performing implant surgery in the mandible. Bifid canals can be diagnosed with panoramic radiography and more accurately with cone beam computerized tomography (CBCT). This case report details the placement of the implant in a patient with bilateral bifid canal and compromised interocclusal space, which was successfully treated using CBCT.
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