Khushboo Rastogi

Phenytoin-induced gingival enlargement: a dental awakening for patients with epilepsy

Drug-induced gingival enlargement is the term now used to describe medication-related gingival hypertrophy or hyperplasia, a condition commonly induced by three main classes of drugs: anticonvulsants, antihypertensive calcium channel blockers and the immunosuppressant cyclosporine. The pathogenesis of drug-induced gingival enlargement is uncertain and there appears to be no unifying hypothesis that links together the three commonly implicated drugs. Phenytoin-induced gingival overgrowth is a well known and frequently reported gingival lesion, which was first detected in 1939. This case report consists of phenytoin usage, duration and poor oral hygiene.

Aesthetic management of a complicated crown fracture: a multidisciplinary approach

A predictable aesthetic restoration is not limited to the restored teeth; it has to include the gingival unit and its interface with the teeth involved. Orthodontic forced eruption may be a suitable approach without risking the aesthetic appearance in tooth fracture below the gingival attachment or alveolar bone crest. It is a well-documented clinical method for altering the relation between a non-restorable tooth and its attachment apparatus, elevating sound tooth material from within the alveolar socket to create a ferrule effect which is considered to be crucial for the optimal biomechanical behaviour of restored teeth. This report presents the reconstruction of a traumatised and fractured left maxillary lateral incisor by building a cast core with a cast post to perform orthodontic extrusion before placing porcelain fused to metal crown as the final restoration.

Surgical removal of mandibular tori and its use as an autogenous graft

While there is a hereditary component to tori, this does not explain all cases. Tori tend to appear more frequently during middle age of life. Certain ethnic groups are more prone to one torus or the other. Torus is mainly removed owing to prosthodontic reasons, as it may also be used as biomaterial, not only in periodontology, but also in implantology. This case report deals with the surgical removal of mandibular tori and is thereby improving clinical implications and serving as an adequate autogenous bone graft.

Fracture tooth fragment reattachment.

Coronal fractures of the anterior teeth are a common form of dental trauma and its sequelae may impair the establishment and accomplishment of an adequate treatment plan. Among the various treatment options, reattachment of a crown fragment is a conservative treatment that should be considered for crown fractures of anterior teeth. This clinical case reports the management of two coronal tooth fracture cases that were successfully treated using tooth fragment reattachment using glass-fibre-reinforced composite post.

Seeing the unseen: diagnosing acromegaly in a dental setup.

Acromegaly is a rare metabolic condition in adults caused due to over secretion of growth hormone mostly due to pituitary gland adenomas.Disproportionate skeletal, tissue and organ growth are characteristic of acromegaly but the changes may be so insidious that most of the times go unnoticed by the patient and family. Craniofacial soft tissue and skeletal changes including mandibular prognathism and disturbed occlusion are typical manifestations of the disease process. Dental professionals may be the first healthcare providers to be visited by these patients and thereby prove instrumental in early diagnosis. Here we report the diagnosis of a case of acromegaly in a dental setup.

A clinically hidden but severely destructive entity.

The diagnosis‘ Aggressive Periodontitis’ (AgP), defined by the International workshop for a classification of periodontal diseases and conditions in 1999, refers to the multifactorial, severe and rapidly progressive form of periodontitis, which primarily—but not exclusively—affects younger patients. Direct and indirect bacterial effects influencing the host immune response play a significant part in the aetiology of AgP comparable with chronic periodontitis. In addition to various virulence factors of specific periodontal pathogens, a genetic predisposition influences the outbreak and progression of the disease. This report describes the disciplinary treatment of AgP patient with progressing full-mouth bone resorption.

Molar distalisation by pendulum appliance.

The concept of ‘distal driving’ of maxillary posterior teeth has a long orthodontic history.1 Class II malocclusions, which are the most numerous among orthodontic cases, can be resolved by several procedures.1 One involves the distal movement of the maxillary molars to establish class I molar relationships. The premolars and canines are then sequentially moved posteriorly to class I positions, and finally the incisors are aligned and/or retracted.2 This version of the appliance is called as ‘Pend-X’. The pendulum springs are so efficient in expanding and …

Compound odontome: a tooth eruption disturbance.

Odontoma is perhaps more accurately defined as a hamartoma than a true neoplasm.1 The term odontoma was first coined by Broca in 1866, who defined it as a tumour formed by overgrowth of complete dental tissue.2 Odontoma has also been defined as ‘tumour’ that has developed and differentiated enough to produce enamel and dentin.3 Odontomas are usually composed of different dental tissues, including enamel, dentine, cementum and in some cases, pulp tissue.4 Although usually located pericoronally to an impacted tooth, odontoma may also arise from odontogenic progenitor cells within the periodontal ligaments and become located between …

An efficient method for correction of anterior crossbite without using bite plates.

In cases of anterior crossbite we need to disocclude the bite so as to initiate unrestricted pathway for the teeth to come into the arch. Various techniques have been advocated for this purpose but most of them are either costly, time consuming or not very effective. So, by the use of simple bondable Begg bracket and elastics we devised a method to disocclude the bite and help in correction of anterior crossbite. It is easy, economical, efficient and less time consuming.

Allogenous tooth fragment reattachment.

Coronal fractures of the anterior teeth are a common form of dental trauma and its sequelae may impair the establishment and accomplishment of an adequate treatment plan. Among the various treatment options, reattachment of a crown fragment obtained from a previously extracted tooth is a conservative treatment that should be considered for crown fractures of anterior teeth. This article reports reattachment of an allogenous tooth fragment in a fractured maxillary lateral incisor in a 38-year-old patient. It is suggested that allogenous reattachment in a fractured anterior tooth serves to be a better alternative and should be further researched. Aesthetic and functional rehabilitation of a fractured complicated anterior crown using allogenous tooth fragment is a better alternative to other more conventional treatment options.