Back Teeth Research Articles

Non-Neoformans Cryptococcal Infections in the Post-Coronavirus Disease-19 (COVID-19) Era: Are We Ready to Face the Emerging Challenge?

AbstractCoronaviruses are a large group of viruses that infect animals as well as humans, while it is also suggested that, rarely, coronaviruses that infect animals can evolve and infect humans. Current evidence suggests that severe acute respiratory syndrome (SARS) coronavirus-2 leads to coronavirus disease-19 (COVID-19), the respiratory illness responsible for COVID-19 pandemic, while it has a zoonotic origin, closely related to the bat-origin SARS-like coronavirus. Also, as per the current knowledge, the disease may induce significant and persistent lymphopenia which in turn may increase the risk for various opportunistic infections. Cryptococcus laurentii is one such rare, but serious fungal infection which has been reported in post-COVID-19 disease and is a rising cause of concern since it can turn out to be fatal. The infection is caused by a non-neoformans rare human pathogen. The present case report describes the case of a 45-years old male patient who reported to the Outpatient Department (OPD) for a routine dental complaint with a grossly destructed tooth in left lower back tooth region due to extensive carious involvement, while, simultaneously, presenting with fever since 5 days in the post-COVID-19 phase, and was later diagnosed as being positive for C. laurentii infection on urine culture sensitivity test.

Simple bone cyst of the mandible: A case report with review of literature

Simple bone cyst (SBC) was first described by Lucas in 1929. It is an asymptomatic, intraosseous cyst. It falls under pseudocyst category, as it is devoid of an epithelial lining and mostly discovered accidently on routine radiograph. It commonly affects metaphyses of long bones such as humerus and femur. Other terminologies used for this lesion include Solitary bone cyst, traumatic bone cyst and hemorrhagic bone cyst. The incidence of cyst affecting the jaws is only 1%. About 89% of the lesion occurs in mandible and 11% in maxilla. The purpose of this article is to present rare occurrence of SBC in the mandibular region with review of literature. An 18 year old male patient reported with pain in right lower back teeth region. Clinically 47 was tender. Panoramic radiograph showed a radiolucent unilocular lesion in ascending ramus and mandibular body distal to 47. Diagnosis of apical periodontitis in relation to 47 and simple bone cyst mandible was made by correlating clinical, radiographic and histopathological evaluation. Surgical curettage was performed and follow up after 4 months revealed no evidence of recurrence. Simple bone cyst is rare incidental lesion of the mandible. Thorough clinical, radiological and histopathologic evaluation is helpful for diagnosis and surgical management of the lesion. Conservative management should be approached to prevent noble structure, with follow up to confirm remission of the lesion.

Correlation between vertical dimension of occlusion and length of fingers in dentate subjects.

Objective: To determine whether there is a correlation between finger length and the vertical dimension of occlusion in dentate individuals attending the prosthodontics department at Muhammad Dental College, Mirpurkhas.Methodology: During this cross-sectional study 2023-2024, 218 patients with crown & bridge were included. Clinical an-thropometric measures were taken. The subjects received instructions to softly bite on their back teeth, keep their lips in passive contact, and keep their heads well-stabilized in order to retrieve the VDO. A Vernier caliper was then used to measure the distance. Each parameter was measured three times and average value was recorded.Results: Average age of the patients was 25.39±2.58 years. The parameters for index finger length (r=0.669; p=0.0005), little finger length (r=0.666; p=0.0005), and the length of the tip of the thumb and the index finger (r =0.663; p=0.0005) had the highest correlations with VDO.Conclusion: It is concluded that this procedure is simple, cost-effective, and non-invasive, therefore it might be used in routine practice to ascertain the vertical dimension of occlusion. Keywords: Dentistry practice, Vertical dimension of occlusion, Prosthodontic therapy

Overhauling dental implications in a child with rare craniofrontonasal syndrome: a case report

Craniofrontonasal syndrome is an extremely rare X-linked dominant genetic disorder characterized by features such as hypertelorism, craniosynostosis, ocular anomalies, a bifid nasal tip, and longitudinal ridging with splitting of the nails. Heterozygous females are more severely affected, presenting frontonasal dysplasia and coronal craniosynostosis (fusion of the coronal sutures), while males typically only exhibit hypertelorism. This case report describes the dental management of a 9-year-old female with craniofrontonasal syndrome who was referred to the department of paediatric and preventive dentistry for pain in the lower right and left back tooth region. The patient exhibited a clinical spectrum including microcephaly, short neck, axillary pterygium, clinodactyly of the toes, longitudinal ridging with split nails, pectus excavatum, and underdeveloped female genitalia. Extraoral examination revealed hypertelorism, flat nasal bridge, low-set ears, strabismus, antimongoloid slant, and an indistinct philtrum. Intraoral examination showed a high palatal vault, crowding of the upper and lower arches during the mixed dentition period, multiple dental caries, and poor oral hygiene. An orthopantomogram confirmed delayed dental development. Dental treatment was carried out on a dental chair system using adequate behaviour management techniques with short appointments, keeping in mind the reduced cooperative ability of the child. The importance of this report stems from the limited dental literature available on the syndrome. Preventive measures along with home care instructions were emphasized to support professional care.

A new multi-DOF envelope forming process for fabricating spiral bevel gears with back taper tooth

Spiral bevel gears are critical transmission components, and are widely used in the aerospace field. This paper proposes a new multi-DOF envelope forming process for fabricating spiral bevel gears. Firstly, the multi-DOF envelope forming principle of spiral bevel gears is proposed. Secondly, the design methods for the envelope tool geometry and movement are proposed based on the envelope geometry and movement relationships. Thirdly, the metal flow and tooth filling laws are revealed through 3D FE simulation of the multi-DOF envelope forming process of a typical spiral bevel gear. Fourthly, a new method for separating the envelope tool and the formed spiral bevel gear with back taper tooth is proposed to avoid their interference. Finally, experiments on multi-DOF envelope forming of this typical spiral bevel gear are conducted using new heavy load multi-DOF envelope forming equipment. The simulation and experimental results show the feasibility of the proposed multi-DOF envelope forming process for fabricating spiral bevel gears with back taper tooth and the corresponding process design methods.

Management of Ellis Class II Fracture in Young Permanent Maxillary Central Incisor

Background: Tooth fracture is a condition of missing or lost fragments of a complete tooth. Tooth fracture usually occurs simultaneously with another oral injury. Objective: This case report discussed the management of Ellis class II fractures on an immature permanent central incisor of a patient who reported to Jenderal Achmad Yani University (Unjani) Dental Hospital. Case: An 11-year-old girl revealed a broken upper left tooth, sensitive to cold drinks that interfered with her appearance one year ago. The patient had a good general condition, no abnormalities during an extraoral examination, and a history of pain on the lower back tooth since a year ago. Case Management: Management of Ellis class II fracture in young permanent central incisor was conducted by using a class IV composite resin restoration. Conclusion: The management of Ellis class II fracture should be conducted holistically and systematically with subjective, intraoral, extraoral, and adjunctive examinations which should be performed correctly and considering the child’s psychology.

Intraosseous schwannoma mimicking periapical radiolucency of mandible

Intraosseous schwannoma is a rare entity with less than 1% reported cases. Having predilection for posterior mandible, they are clinically slow growing and asymptomatic until they manifest as intra or extra oral swelling with or without nerve paraesthesia. 38-year-old female patient reported with chief complaint of swelling in lower left back teeth region gradually increasing to current size in last three months. With history of recent extraction, and well-defined, uniformly radiolucent lesion having sclerotic margins and buccal cortical breach, a provisional diagnosis of residual cyst of 36 was considered. However, incisional biopsy revealed it to be schwannoma, thereby changing the course of management. Absence of conclusive clinical signs and symptoms and non-specific radiographic features make intraosseous schwannoma a challenging diagnosis. It is therefore important that careful attention be paid to adjoining radiographic structures and possible nerve involvement.

Space management using Transpalatal arch in mixed dentition phase: A case report

Introduction: The early exfoliation of primary molars during the mixed dentition phase often results in disruptions to the normal development of occlusion. An alternative option for space management in the maxillary arch besides the commonly used Nance palatal holding appliance is the transpalatal arch which allows some amount of space regaining. Case report: A 9 year old female reported with a complaint of missing tooth in the upper right back tooth region since 2 years. On examination, there was premature loss of the right primary maxillary first molar causing space deficiency in the arch form. A treatment plan was made for space regaining and distalization with transpalatal arch custom made with 0.9mm stainless steel wires and soldered to the molar bands. The treatment spanned for 10 months with the eruption of the permanent successor in correct arch form. Conclusion: Although the use of transpalatal arch is limited in pediatric dentistry, it can be used for correcting minor space discrepancies of the maxillary arch. More number of cases need to be studied for extending the use of the appliance in interceptive orthodontics.

Extraction Management of Gangrene Radix with Radicular Cyst

Introduction: Radicular cysts are the most common type of cyst found in the teeth and mouth are associated with pulp necrosis and tooth root canal infections. Treatment that can be done for radicular cysts consists of surgical and non-surgical treatments, treatments such as tooth extraction. This case report describes the results of managing tooth root extraction with a radicular cyst. Case Report: A 22-year-old woman complained that her lower right back tooth had root residue. Objective examination revealed that her two roots remain, mesial and distal to tooth 46 Percussion (-) and palpation (+) revealed an asymptomatic, firm consistency, nodular lesion 1 cm in size. Radiographic examination showed a radiolucent area on tooth 46 with a clear and firm base in the shape of a semicircle measuring ± 1 cm. Case management: The tooth was extracted using a technique called infiltration anesthesia. Conclusion: Establishing a good and correct diagnosis in cases of radicular cysts can provide appropriate treatment for patients by knowing the characteristics of the lesion. Tooth extraction with optimal elimination of infected tissue is one of the treatments that can be carried out in radicular cysts

Pyogenic Granuloma of the Gingiva

Pyogenic granuloma is a benign vascular lesion that usually occurs in response to various stimuli caused by chronic irritation, trauma and hormonal factors. These lesions generally occur on the gingiva but can also occur on the lips, tongue and buccal mucosa. A 22 year old female patient came with complaints of a lump on the gingiva between teeth 35 and 36 and felt uncomfortable. I have had complaints since 7 months ago after a filling was made on the left back molar tooth, then 1 day later a lump appeared. Complaints are not accompanied by pain. The treatment plan in this case is to carry out information education communication, scaling, gingivectomy and a histopathological examination to confirm the diagnosis and carry out control and evaluation. Pyogenic granuloma is a benign, non-neoplastic lesion. The clinical picture of this lesion is generally a mass with a soft consistency, painless, and dark red to reddish purple in colour which usually appears as a solitary lesion with a diameter of 5-10 mm and is very fragile, so it bleeds easily due to minor trauma. Management of this lesion can be done with a surgical procedure to completely remove the lesion and then carry out an anatomical histopathological examination to confirm the diagnosis of this lesion. This lesion has no signs of malignancy

Mucormycosis of left maxilla: A case report and review

Mucormycosis is an angioinvasive infection caused by fungi of the Zygomycetes order. Rhizopus is the main pathogen responsible for 90% of cases of cerebral mucormycosis. The term rhinocerebral mucormycosis should be used only in the face, palatal, orbital, paranasal sinus, or brain area. Here, we present the case of a 42-year-old man who presented with complaints of pain and swelling in relation to the left upper back tooth region for the past 20 days. In this case, the patient was immunocompromised due to type II diabetes, as well as COVID hospitalization. This case enlightens the investigation, as well as the management protocol followed by post-operative rehabilitation. Early diagnosis and prompt treatment can significantly reduce the morbidity and mortality of these deadly fungal infections.

Comparative evaluation of hard and soft tissue parameters by using short implants and standard long implants with sinus lift for prosthetic rehabilitation of posterior maxilla.

The objective is to compare and evaluate the hard and soft tissue parameters by using short and standard long implants with sinus lifting in the posterior maxilla. Eleven patients with complaints of missing upper back teeth were enrolled in the study for implant-supported rehabilitation and were categorized into two groups: Group long (GL): longer implant (>8 mm) placement, preceded by Sinus Augmentation. Group short (GS): short implant (≤8 mm) placement, without sinus augmentation. The primary outcome measured was cumulative survival rate (CSR) in the compromised partial edentulous posterior maxilla. Secondary outcomes measured were implant stability (IS), marginal bone level alterations (MBL), pocket probing depth (PPD), crown-to-implant ratio, and any complications. The difference in CSR between the groups was not statistically significant (P = 0.317). High stability was achieved immediately after the placement of the implants, in both groups (GS: 64 ± 4.07, GL: 65.58 ± 9.75); this difference in the mean ISQ (IS quotients) values was not found to be statistically significant at implant placement (P = 0.7). The mean MBL reported in the study at the end of 12 months of prosthesis function was - 0.762 ± 0.48 mm and - 0.7 ± 0.34 mm for GS and GL, respectively. The mean PPD measurements in GS and GL groups were 1.917 ± 0.68 mm and 1.833 ± 0.38 mm, respectively, and it was not statistically significant (P = 0.8). Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading.

Presence of radix entomolaris in primary mandibular first molars: A review of rare entity

Numerous developmental anomalies with respect to crown and root are commonly seen in permanent dentition and while rarely in the primary dentition. Radix entomolaris (RE), an extra root seen on the distolingual aspect of mandibular molars, is one such aberration found. The presence of extra root in primary mandibular first molars is of extreme rarity and such two reports its significance had been discussed. Two children of 5- and 7 years old reported to the pediatric and preventive dentistry department with a chief complaint of pain in the right and left mandibular back teeth region, respectively. A diagnosis of chronic irreversible pulpitis was made in both cases with the accidental appraisal of RE in both the primary first molars on intraoral periapical radiographs. Standard pulpectomy was performed in both cases. Pediatric dentists as well as clinicians should update regarding the abnormal morphologies of primary molars and its diagnostic including treatment strategies.

Dental management of Goldenhar syndrome in a pediatric patient

Abstract: The purpose of the case report was to highlight the various features of Goldenhar syndrome to aid in the diagnosis of this syndrome which has classic clinical features such as microtia, preauricular skin tags, micrognathia, facial asymmetry, midface deficiency, malocclusion of teeth with poor oral hygiene, and carious teeth. A 12-year-old female child reported to the department with a chief complaint of pain in the lower left back tooth region. There was no significant prenatal, postnatal, and medical history. Herein, we report a case of Goldenhar syndrome with hemifacial micrognathia and microtia along with intraoral involvement which was clinically and radiographically assessed and described full-mouth rehabilitation procedures.

Pendekatan Klinis Perawatan Indirect Pulp Capping bagi Pelajar

Cavities or caries are diseases of the hard tissue of the teeth. The presence of caries must not be ignored and must be treated because carious lesions can spread and result in pain, tooth loss, and infection of the tissues supporting the teeth. This community service activity aims to increase public awareness of dental and oral health through curative efforts and evaluation of the clinical picture after indirect pulp capping treatment at the State Agricultural Development Vocational School, Ikurkoto Health Center Area, Padang City. The method used in this service begins with patient screening, pulp capping treatment, and evaluation in the form of subjective and objective examinations 1 week after treatment. Participants in the activity were 403 patients who came from around the Ikurkoto Community Health Center area. This activity found that cavities were more common in the back (posterior) teeth, especially the lower molars, as much as 80%, compared to the front (anterior) teeth, as much as 20%. The material used is a bioactive material, namely Glass Ionomer Cement (SIK) type 2 with different brands, namely Fuji II LC (type II aesthetic) 70% and Fuji IX (type II reinforced) 30%. The evaluation results after treatment showed that as many as 71% of dental patients were asymptomatic and responded well to pulp capping treatment.

Unlocking Biodentine\'s potential: A case report on successful furcation repair with a six-month follow-up

In this case report, we highlight the effectiveness of Biodentine in endodontic treatments, specifically in repairing furcation involvement. A 12-year-old patient had pain in the right lower back tooth, which indicated that a previous endodontic treatment had failed, and there was perforation in tooth 46. We successfully used Biodentine for nonsurgical repair, and a thorough follow-up showed that the radiolucency had resolved, and the patient was asymptomatic.

Granuloma Pyogenicum in an Extraction Site: An Unusual Case Report

Pyogenic granuloma also known as Granuloma pyogenicum is a typical, acquired, benign vascular lesion of the skin and mucous membranes. It can occasionally present intravascularly or subcutaneously. This report discusses the case of pyogenic granuloma in a 25-year-old male in extraction site in lower left back tooth region. Keywords: Pyogenic granuloma, lobular capillary hemangioma, benign neoplasm, hyperplastic lesion.

The Food-Crushing Reflex and Its Inhibition

Anterior tooth (ANT) contacts induce a short-latency reflex inhibition of the human jaw-closing muscles. The jaw is a rigid class 1 lever for pinpoint targeting muscle force into a single bite point, the pivoting food particle. Seesaw reflex movements around the food particle fulcrum multiply the food-crushing force. Unpredictable jolts of reaction force caused by food crushing are subjected to the rostral ANT and caudally to the two articulate ends of the jaw triangle. The compression/distraction strains of food crushing must be monitored and inhibited by withdrawal reflexes. The mesencephalic ganglion (Vmes), neural myelin sheath, and muscle stretch receptors evolved subsequently to the advent of jaws to improve the velocity of proprioceptive and withdrawal reflexes. In mammalians, the spindles of the taut motor units, stretched by the food fulcrum, send excitatory monosynaptic feedback for the efferent neurons of the respective ipsilateral muscle units via the Vmes. In the Vmes, the spindle-input-mediating afferent neurons are coupled with another source of afferent feedback, which is also excitatory, from the back tooth (BAT) mechanoreceptors. The two sources of excitatory pulses are summated and targeted for the efferent neurons to boost the stretched and taut motor units. Likewise, the afferent feedback from the ANT mechanoreceptors is also coupled in the Vmes with concomitant feedback from spindles. The ANT output, however, is inhibitory to negate the excitatory feedback from the stretched jaw muscle units. The inhibitory feed from the anterior teeth temporarily blocks the excitatory potential of the masticatory motor efferent neurons to protect the anterior teeth and jaw joints from inadvertent strains. The inhibitory inputs from the anterior teeth alternate with the excitatory inputs from the BAT to determine which jaw-closing muscle units are activated or inhibited at any given instant of food crushing. The Vmes exists in all jawed vertebrates, and its evolution was probably motivated by demands for the control of bite force. The monosynaptic unilateral food-crushing excitatory and inhibitory reflexes (UFCRs) override the coexisting bilaterally executed feed for the jaw muscles from the central nervous system. The hypothesis proposed in this study is that the Vmes-mediated UFCRs combine neural inputs from tooth contacts with concomitant feedback from the muscle stretch receptors for the control of the mammalian food-crushing bite force.

Dental management of a 3-year-old uncooperative child under general anaesthesia: a case report

Dental care is medically necessary for the purpose of eliminating and preventing orofacial disease, infection and pain, restoring the form and function of the dentition, and correcting facial disfiguration or dysfunction – American Academy of Pediatric Dentistry (AAPD). Lack of cooperation in young paediatric patients can be a confounding factor for dental rehabilitation procedures and even examination or radiographs. To complete necessary dental radiographs and/or treatment in young, uncooperative children general anaesthesia or deep sedation is often required. This article presents the case of a 3-year-old girl child with a complaint of sharp shooting pain in upper and lower left back tooth region and was extremely uncooperative. She was diagnosed with early childhood caries; full mouth rehabilitation was done under general anaesthesia. Clinical examination, classification and treatment plan are discussed based on the review of current literature available.

Management of Implant Screw Loosening - A Case Report

Dental implants have been a broadly recognised treatment modality to replace missing teeth and in order to restore the oral functions. The utilisation of root form endosseous implants have increased considerably and this option has become much more sophisticated with the introduction of latest designs and concepts. Long term post placement studies have revealed that prosthetic complications, including screw loosening, screw fracture, framework and implant fracture. Abutment screw loosening is the second most cause of failure of implant supported crowns, after loss of osseointegration. This condition is mostly witnessed in single implant supported restoration. Management of screw loosening is a challenging procedure and this clinical report describes the management of an implant abutment screw loosening of lower back teeth region with minimal damage to the existing restoration making it possible to be reused.