Lingual Aspect Of Tooth Research Articles

Fixed Lingual Retainer Positioner: A narrative review

Retention is one of the most critical phase of Orthodontic treatment . Angle stated that "the problem involved in retention are greater than the difficulties being encountered in the treatment, and tests the utmost skill of the operator. The various retention appliances available include Removable retainers and bonded retainers. Removable retainers have their own advantages and disadvantages, but they need patient’s compliance to wear them.Fixed retainers consist of a length of orthodontic wire that is bonded on the lingual aspect of tooth .The major advantages of bonded retainers includes invisibility, no patient compliance required and long term retention.
 
 Bonding of a lingual retainer is a challenging and technique sensitive procedure because it requires long working time and has a risk of contamination from saliva and moisture, leading to bond failure as it is difficult to adaptation of the retainer wire and further stabilization of contoured retainer wire in the oral cavity during bonding.
 If retainer wire can be effectively stabilized over the lingual surface of tooth prior to bonding, bonding becomes a simple process.
 Various methods used to stabilize lingual retainer before bonding involves use of separators (Kesling and elastomeric separators), materials like resin, memosil, glue etc or use of metal Stablizers in form of W,V or use of wires .
 
 The objectives of this article is to compile the different retention techniques used to stabilize the lingual retainer wire for bonding altogether at one place.
 
 Keywords: Retainers, lingual aspect, Bonding, Stablization

A rare co-occurrence of facial talon's cusp on fused maxillary permanent central and lateral incisor

Fusion is a developmental anomaly of dental hard tissues characterised by the union of two adjacent teeth. It can be complete or incomplete and commonly seen in deciduous than in the permanent dentition with higher frequency in anterior maxillary regions. Talon’s cusp is an unusual cuspal projection from the lingual aspect of the tooth with normal enamel and dentin and varying degree of pulp tissue. It commonly affects the permanent maxillary lateral incisors followed by central incisors and canines. Talon cusp is mostly found on the lingual aspect of teeth and rarely it projects from the facial aspect. We hereby report a case of fusion of permanent left central and lateral incisor with facial talon cusp which is rarely reported.

Endodontic-periodontal management of two rooted maxillary lateral incisor associated with complex radicular lingual groove by using spiral computed tomography as a diagnostic aid: a case report

To present the successful endodontic and periodontal management of a two rooted maxillary lateral incisor tooth with a complex radicular lingual groove and severe periodontal destruction using spiral computed tomography as a diagnostic aid. A 30-year-old male patient presented with a chief complaint of mobility and discharge of pus in an upper front tooth. Clinical examination revealed a sinus tract on the labial gingival surface and a 10-mm-deep periodontal pocket associated with maxillary left lateral incisor tooth. On the lingual side, a groove emerging from cingulum, continuing mesioapically down the lingual aspect of tooth was found. Intraoral periapical radiographs demonstrated a lateral periodontal defect around the mesial aspect and a diffuse radiolucency at the apex of maxillary left lateral incisor tooth. The sinus tract was traced with gutta-percha to the maxillary left lateral incisor that showed an accessory root surrounded by a large radiolucent area. A spiral computed tomographic scan for better understanding of the complicated root canal morphology of the tooth was performed. Based on the clinical, radiographic and spiral computed tomographic findings, a diagnosis of an endo-perio lesion in tooth 22 was made. Management consisted of conventional root canal treatment, radiculoplasty, root resection of accessory root and surgical curettage of the periodontal defect. Follow-up with radiographic examination at 3 months and 1 year was performed. At 1-year recall, the patient was asymptomatic, there was no evidence of the sinus tract and a 3-mm nonbleeding pocket was present in relation to tooth 22. Progression of hard tissue healing was observed in the periapical radiograph taken 1 year postoperatively. The key to achieving favourable results in this particular type of developmental anomaly is accurate diagnosis and treatment planning. The health of the periapical osseous tissues appears to be the provital factor for tooth retention. A favourable outcome can only be achieved with a comprehensive treatment approach that effectively manages all local factors that are contributing to the disease process.

Intravenous Bisphosphonate–Associated Osteonecrosis of the Jaw

Bisphosphonates have received attention in the dental and medical scientific literature because of spontaneous necrosis of the jaw subsequent to their use. As the population ages, the use of these medications is increasing; the medical benefits seem to outweigh the risk for osteonecrosis of the jaw (ONJ). A 71-year-old white male with a history of multiple myeloma, for which he was receiving intravenous (IV) zoledronic acid, presented for routine periodontal maintenance therapy. Intraoral observation revealed a 9x4-mm area of exposed bone on the lingual aspect of tooth #31. Initially, the site was treated conservatively with topical 0.12% chlorhexidine gluconate application. Over a 12-month period, the area of exposed bone increased in size to 20x9 mm and became symptomatic. The osseous necrosis progressed, ultimately resulting in a pathologic fracture of the right posterior mandible that was managed by reduction and stabilization. At 5 months post-surgery, bone exposure persisted in the region, and a new site of osteonecrosis developed on the contralateral side of the jaw. ONJ associated with IV bisphosphonate therapy is extremely difficult to manage. Dental treatment of ONJ should be conservative and provide relief to the patient. Patients with cancer who are candidates for IV bisphosphonate therapy should be informed of the potential risks and be referred for dental evaluation. Dentists should collaborate with physicians to minimize the risk for ONJ.