Kc Prabhat

A critical review of the implication of nanotechnology in modern dental practice

Curiosity has its own reason for existing. For thousands of years, mankind has been harnessing its curiosity into inquiry and the process of scientific methodology. If we consider technology as an engine, then science is its fuel. Science of miniaturization (nanotechnology) is manipulating matter at nanometer level and the application of the same to medicine is called nanomedicine. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. When we gain access to hold the nanorobots, we will be able to treat very rapidly a number of diseases that are a continuous threat for mankind today. The present article aims to provide an early glimpse on the impact and future implication of nanotechnology in dentistry, especially in oral surgery and orthodontics.

Drug addiction and periodontal diseases.

The prevalence of drug addiction is increasing globally. Drug abuse damages many parts of the body such as oral cavity, lungs, liver, brain, heart etc., Addicts suffer from physical, psychological, emotional and behavioral problems. Their nutrition is also compromised. There is certainly an impact of all these factors on the health of periodontium. Dentists should be aware of the effects of drugs while treating the drug addicts. This article correlates the studies done on the impact of abused drugs such as alcohol, tobacco, opiates, cannabis, amphetamines etc., on general and periodontal health.

Recent advances in the management of obstructive sleep apnea: The dental perspective.

Obstructive sleep apnea (OSA) is common in adult population. OSA shows detrimental effects on health, neuropsychological development, quality-of-life, and economic potential and now it is recognized as a public health problem. Despite the availability of expanded therapeutic options, polysomnography and nasal continuous positive airway pressure (CPAP) are the gold standards for the diagnosis and treatment for OSA. Recently, American Academy of Sleep Medicine has recommended oral appliances for OSA. Hence the therapeutic interventions that are directed at the site of airway obstruction in the maxillofacial region are within the scope of dentistry. Treatment of OSA can improve vitality, social and daytime functioning, family life and mental health of a person and hence the quality-of-life. Obesity is the main predisposing factor for OSA. Other than obesity, craniofacial abnormalities such as micrognathia and retrognathia, age, ethnic background and genetic predisposition, consumption of alcohol, smoking, and sedatives may also predispose to OSA. Treatment modalities for OSA are behavior modification, diet and medication, CPAP devices, surgical (maxillo-mandibular advancement surgery), and oral appliances. Treatment of a patient with OSA not only improves the physical health of the patients but also the mental and social well-being.

Role of oral health professional in pediatric obstructive sleep apnea.

Sleep disordered breathing (SDB) in children is common. The impact of SDB on the growth and development of child may have detrimental effects on health, neuropsychological development, quality of life, and economic potential; therefore, SDB in children should be recognized as a public health problem as in the adult population. The coexistence of obesity and obstructive sleep apnea (OSA) not only appears to yield increased morbidity rates and poorer responses to therapy, but also is altogether associated with a distinct and recognizable clinical phenotype. Therapeutic options have somewhat expanded since the initial treatment approaches were conducted, to include not only surgical extraction of hypertrophic adenoids and tonsils, but also nonsurgical alternatives such as continuous positive air pressure, anti-inflammatory agents and oral appliances (OAs). Now, American academy of sleep medicine (AAOSM) has recommended OAs for OSA, hence the therapeutic interventions that are directed at the site of airway obstruction in the maxillofacial region are within the scope of dentistry. Among the physicians treating the children, dentists are more likely to identify adenotonsillar hypertrophy. Hence, the dentist can play an important role in identifying and treating those cases with OAs, who refuse the surgery, or those with structural abnormality in which myofunctional appliances are beneficial.

Periodontal ligament distraction: A simplified approach for rapid canine retraction

Distraction osteogenesis is a method of inducing new bone formation by applying mechanical strains on preexisting bone. The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of “distracting the periodontal ligament” is proposed to elicit rapid canine retraction in two weeks. At the time of first premolar extraction, the interseptal bone distal to the canine was undermined with a bone bur, grooving vertically inside the extraction socket along the buccal and lingual sides and extending obliquely toward the socket base. Then, a tooth-borne, custom-made, intraoral distraction device was placed to distract the canine distally into the extraction space. It was activated 0.5 mm/day, immediately after the extraction. Canine was distracted 6.5 mm into the extraction space within two weeks.

Orthodontic care of medically compromised patients

Advances in the treatment of medical conditions have resulted in long-term disease-free survival. Consequently, many of these patients are now seeking orthodontic therapy. This article will discuss various systemic diseases, their effect on orthodontic treatment and the recommended methods to avoid the potential problems that may arise.

A cephalometric evaluation of tongue from the rest position to centric occlusion in the subjects with class II division 1 malocclusion and class I normal occlusion

Background: One of the common types of oro-dental morphopathologic relationship is the Class II Division 1 malocclusion. Therefore, the study of tongue position in Class II Division 1 may reveal a role of the tongue in the etiology or diagnosis of malocclusion. Aims: Present study was done with the aim to evaluate the tongue position radiographically in centric occlusion and rest position in the subjects with Angles Class 1 normal occlusion and subjects with Angles Class II Division 1 malocclusion and to find out any differences in tongue position between Angles Class 1 normal occlusion and Angles Class II Division 1 malocclusion group. Materials and Methods: The present study was conducted on lateral cephalogram of 40 subjects between the age ranges of 16 to 22 years. The samples were divided into the Angles Class 1 normal occlusion group (Group I) and the Angles Class II Division 1 malocclusion group (Group II) with the 20 in each groups. The study involved the evaluation of tongue position at rest position and centric occlusion on the lateral head cephalogram. Results: This study for the evaluation of the tongue position from the rest position to the centric occlusion showed no statistically significant changes in both groups. However, there were greater changes in various parameters (From the rest position to the centric occlusion) in the subjects with Angles Class II Division 1 malocclusion as compared to the subjects with the Angles Class I normal occlusion group. Conclusion: From the present study following conclusion can be drawn: with the closure of mandible from the rest position to centric occlusion the tongue moved antero-superiorly in the tip region, superiorly in the dorsum region, and antero-superiorly in the posterior region in normal occlusion and postero-superiorly in Class II Division 1 malocclusion.

A critical review of the management of deep overbite complicated by periodontal diseases

Traumatic deep overbite complicated with periodontal problems is a challenging problem for a periodontist as well as for an orthodontist. A thorough and systematic approach to periodontal and occlusal examination, etiological factors, diagnosis and treatment planning is essential for better treatment results. In such cases prevention of disease is better than its treatment therefore.

Biomechanics and orthodontic treatment protocol in maxillofacial distraction osteogenesis

As in the traditional combined surgical and orthodontic procedures, an Orthodontist can plays vital role in treatment planning and the orthodontic treatment of patient undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function, pre-distraction, and post-distraction orthodontic care. Based on clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and three-dimensional computed tomographic analysis, the Orthodontist, in collaboration with the Surgeon, plans distraction device placement and the predicted vectors of distraction. Finally, as in other forms of orthognathic surgery, the practice of distraction osteogenesis depends on the cooperation and planning between orthodontist and surgeon as a team. Purpose of this paper is to review biomechanics and orthodontic treatment protocol of distraction osteogenesis in the maxillofacial region.

Treatment of Angle Class I Malocclusion with Severe Bimaxillary Protrusion using Miniscrew Implants and Periodontal Ligament Distraction

Bimaxillary dentoalveolar protrusion is common in Asian population. In this patient with procumbent upper and lower lips, excessive lip strain, proclined and protruded maxillary and mandibular incisors with vertical growth pattern, an acceptable treatment result, was achieved with 4-first-premolar extractions. This case report is presented with the aim, to describe the treatment approach for bimaxillary dentoalveolar protrusion using miniscrew implants for anchorage in upper arch and periodontal ligament distraction for canine retraction in lower arch and then retraction of incisors into the newly formed bone distal to lateral incisor. Treatment was completed in 18 months. The patient profile was improved, with reduction in lip procumbency, decrease in lip eversion and protrusion, and decrease mentalis strain. Dentally, the interincisal angulation improved significantly because both the maxillary and mandibular incisors were uprighted after space closer.