International Poster Journal of Dentistry and Oral Medicine, 02/2023

An unfortunate traumatic amputation that results in the loss of all or part of a finger has a detrimental effect on a person's physical and psychological health. Consequently, an aesthetic finger prosthesis can have psychological, practical, and therapeutic benefits. Inadequate retention of the prosthesis is one of the main issues with the prosthetic replacement of a partially severe amputated finger. Adhesives, adhesive tape, magnets, and implants are the most often utilized as a retentive aid. The poster describes the prosthetic rehabilitation of partially amputated little finger using room temperature vulcanizing silicone (RTV) and retained by prefabricated rings. Keywords: Amputated finger, finger prosthesis, prefabricated finger rings, room temperature vulcanizing silicone (RTV)

Monozygotic (MZ) twins, known as identical twins, originate from the same fertilized ovum, and by the virtue of which share the same DNA, placenta, amniotic fluid, and physical features. Dizygotic (DZ) twins are formed when two sperms fertilize two eggs separately, and they do not share the same DNA. Palatal rugae have been considered equivalent to fingerprints, as they are unique to each individual. Exploring the degree of resemblance in tooth morphometry and the pattern of rugae and various mandibular measurements on orthopantograph (OPG) among twins shall aid in forensic identification. Keywords: Forensic sciences, twin studies, monozygotic, diazygotic

Questions: Craniomandibular dysfunctions (CMD) are dysregulations of the chewing organ and adjoining structures, which can lead to destruction of hard and soft dental tissues, joint cartilage, decreased chewing function, and pain, thereby massively reducing wellbeing and quality of life. The treatment of CMD requires accurate and objective diagnostics to enable a successful interdisciplinary treatment. Conventional diagnostics cannot completely detect the temporomandibular joint in its own complexity by technical restriction. In addition, due to a high proportion of "manual labour", human errors and diagnostic variances cannot be excluded (1). The aim of the present study was to evaluate a full digital workflow for craniomandibular dysfunction (CMD) diagnostics, including intraoral scans, digital volume tomography, digital motion tracking, and treatment with a 3D-shaped bite splint. Methods: This prospective study included n=19 adult patients (8 men, 11 women) suffering from CMD, who met the inclusion criteria and consented to the therapy and the use of their data. Inclusion criteria were as follows: - presence of a craniomandibular dysfunction requiring treatment - no previous splint therapy - no primary temporomandibular joint disease or general underlying disease that could be the cause of the pain or could influence the therapy outcome (e.g. rickets, Parkinson's disease, osteoporosis, psychosomatic diseases, neuralgias, and neuropathies). Prior to treatment, ethical approval was obtained by legal agency (EK 213062018). 3D diagnostics and data matching were performed, on the basis of which a 3D bite splint was designed and produced (SICAT, Bonn, Germany; Polymethylmethacrylat astron^® Clearsplint^® CAD/CAM, Schütz Dental GmbH, Rosbach, Germany). Patients were evaluated pre- and post-treatment and every 6 weeks up to 6 months by clinical analysis, splint adjustment, and questionnaire. Descriptive analysis and statistics were performed using MS Excel (Version 16.0, Microsoft Corporation, Redmond, USA). Results: Splint therapy led to a significant reduction in subjective complaints in 89% (n=17) of patients, whereas only 11% (n=2) reported unchanged complaints. 74% (n=14) of patients preferred digital impressions and milled bite splints; the other 26% (n=5) did not indicate a special preference. The majority of digital designed bite splints showed a satisfactory initial fit (58%//n=11) and 32% (n=6) could be fitted after minor adjustments. Conclusions: The digital workflow for CMD treatment, analysed in this study, showed a significant reduction in working time by a high proportion of digitization and automation combined with a high level of patient satisfaction and accuracy of splint fit. Nevertheless, the use of digital volume tomography did not improve diagnostics (2) and should be viewed critically in this context. Keywords: CMD treatment, 3D-shaped bite splints, digital workflow, economic efficiency

Introduction: KAP surveys in healthcare are focused evaluations that measure changes in human knowledge, attitudes, and practices in response to a specific intervention. It is a representative study of a specific population to collect information on what is known, believed, and done in relation to a particular topic. It quantifies and measures a phenomenon using reliable and valid questionnaires along with statistical processing of the information collected. This helps in assessing the need, planning, and implementing public health programs to ensure good research quality. Paediatric dentists and other health professionals have incorporated the use of the KAP survey as a means of research, but there is still a gap that needs to be bridged between what is known and what is to be done to carry out a KAP survey. Aim: The aim of this study is to compare the knowledge, attitude, and practice (KAP) regarding KAP surveys between paediatric dentists and other healthcare professionals. Methodology: A customized questionnaire survey is being formed and the question items are validated by six panel experts using two content validity indices: I-CVI = 0.8 and S-CVI = 0.9. This validated questionnaire is shared through electronic means utilizing snowball sampling technique. A detailed survey-based analysis will be carried out later for data evaluation and for concluding the inference after results are obtained. Results:  Only 26.7% of paediatric dentists and 8% of other dental specialties were aware about the level of evidence of a KAP survey. 20% of paediatric dentists and 13% of other dental specialties think that social and cultural factors govern the results of a KAP survey questionnaire. 20% of paediatric dentists and 21% of other dental specialties would consider only unique visitors of your survey in the statistical analysis. 10% of paediatric dentists and 7% of other dental specialties believes that a KAP survey should last 16-18 weeks ideally. 22% of paediatric dentists and 11% of other dental specialties are likely to implement the recommendations from a KAP survey in their clinical practice. Discussion: Mallah, N. et al (2020) strongly reported: • Inconsistent reporting of validation methodologies • Abuse of the term validation • Substantial risk of falsely generating the opinions and attitudes Most of the participants had knowledge regarding the KAP model & expressed a positive attitude. However, there was a significant difference in attitude & practice because of insufficient research skills, lack of familiarity with research studies, and a lack of access to resources. Conclusion: Thus, conducting a KAP survey is challenging for a variety of reasons for both paediatric dentists and other dental professionals. This is because data can be hard to interpret accurately, a lack of a standardized approach to validate findings, and analyst biases in KAP surveys. A main criticism of KAP surveys is that their findings generally lead to prescriptions for mass behaviour modification instead of targeting interventions toward individuals. In order to gain a thorough grasp, researchers recommend using participant observations, focus group discussions, and in-depth interviews. Keywords: KAP survey, cross sectional study, questionnaire

Oral–Facial–Digital Syndrome Type I (OFD1) is an X-linked dominant disorder. Nearly all carriers are female, and 75% of cases are sporadic. We report on a 19-year-old girl with OFD1. This case demonstrated unimaxillary disturbance of tooth development. The clinical observations included enamel hypoplasias, atypical pulp and root morphology, and periapical radiolucencies. Over time marginal periodontitis developed with vertical pockets, tooth loosening, gingival abscesses, and pain. As the conditions were refractory to preventive and restorative approaches, a more radical treatment was performed including extraction of maxillary teeth and full upper prosthesis. Diagnostic examination of teeth was performed on histologic sections made by cutting-grinding technique for hard tissues. The examination revealed disordered amelogenesis with extended enamel coverage of the root and enamel inclusions in the dentin. The chaotic morphology of the root surfaces explained the persistent periodontal complications in the maxilla and the patient discomfort. It is suggested that the transition of the enamel organ to Hertwig’s epithelial root sheet has been disturbed regionally by genetic mutations, leading to prolonged enamel formation and disturbance of both cementogenesis and dentinogenesis. The oral status and patient comfort improved significantly following prosthetic treatment. Keywords: Oral facial digital syndrome type I (OFD1), genetics, amelogenesis, cementogenesis, dentinogenesis, disturbed tooth development and morphology, periodontitis, dentures

Introduction: The fundamental idea of guided bone regeneration (GBR) is the use of a membrane to prevent non-osteogenic tissues from interfering with bone regeneration. The primary types of bone graft material are autogenous grafts, allografts, xenografts and alloplasts, in which the mechanism of regeneration can be accomplished through three different mechanisms, including osteogenesis, osteoinduction, and osteoconduction. Case Presentation: A 24-year-old male patient reported with the complaint of missing teeth in the anterior region and was willing to have an implant supported prosthesis. CBCT revealed a bone width of 2.8 mm. To achieve the desired results, a ridge augmentation procedure was carried out using guided bone regeneration through a combination of autograft and alloplast material. A 6-month follow-up revealed a 4.2 mm gain in the bone width, following which an implant was placed and immediate loading of the implant was carried out. Discussion: Guided bone regeneration in the present case was performed using a combination of autogenous and allograft material. Successful bone regeneration depends on multiple variables including the case selection, type of graft, adequate healing period, and operator skills. Guided bone regeneration using the staged approach provided the benefit to augment the alveolar ridge and improve the ridge morphology. Conclusion: In the present case, GBR with a mixture of autogenous graft , allograft graft, and PRF was effective for bone augmentation to allow future implant placement. Keywords: Allograft, guided bone regeneration, implant supported prosthesis, osseous defect

Three-dimensional (3D) printing technologies are advanced manufacturing technologies based on computer-aided design digital models to create 3D objects. In 3D printing, objects are fabricated by adding material(s) layer-after-layer, to form a 3D volumetric structure. It comprises data acquisition through various scanning technologies followed by data processing and designing the model with computer-aided design (CAD) software. The resulting STL file is imported into the printer software and the variables and parameters are specified to generate the information needed to run the 3D printer. Finally, the processed data is used to manufacture structures with the chosen material through the CAM step. This digital approach has various advantages including recording anatomic details with better accuracy and precision, decreased manual errors, convenience, less laborious work, and reduced wastage of dental materials. This presentation discusses the various applications of 3D printing in maxillofacial prosthodontics, implant retained prosthesis, and removable prosthesis. Keywords: 3D Printing, Andrew’s Bridge, feeding plate, immediate loading, orbital conformer, surgical stent

Introduction: Traumatic dental injury is a neglected oral condition despite its relatively high prevalence and significant impact on individuals as well as society. There is a consensus that the maxillary anterior teeth are most commonly traumatized. Consequently, traumatic injuries to these teeth pose a tremendous challenge to the treating dentist, both in terms of dealing with the sequelae of injuries and preventing their occurrence. Although treatment of fractured anterior teeth has received considerable attention, little importance has been given to the study of correlation between the pattern of traumatic dental injuries and its associated factors. Case series: A total of ten cases sought to establish and assess the relationship between the pattern of traumatic dental injuries in maxillary anterior teeth and its associated factors such as lip competence, malocclusion, and overjet as well as variables such as type of injury, vitality of the tooth, amount of tooth structure lost, and effect of velocity on trauma. Discussion: This case series showed that increased overjet, incompetent lips, Class II malocclusion, fall injuries, and higher force of impact has an association with the pattern of traumatic dental injuries. Ellis Class III fracture was the most common type of fracture observed involving the mesial incisal edges of central maxillary incisors. Conclusion: The present case series concludes that factors such as gender, cause of injury, and anatomy of tooth effect the pattern of maxillary anterior traumatic dental injuries. However, more clinical studies are required to highlight the prevalence of TDIs. Keywords: Traumatic dental injuries, fracture pattern, management

Background: COVID-19 is an ongoing global pandemic situation. Governments have ordered everyone to remain at home as an emergency measure and implemented school closures to prevent further spread of the infection. Under such situation children’s behaviour, particularly oral health behaviour and sedentary behaviour may have been drastically impacted and are of significant concern. So, this study was aimed to investigate the impact of lockdown and inter-related factors on the behavioural profile of children aged 4-12 years. Methods: The current study is the first nationwide representative study to investigate the impact of the COVID-19 pandemic on oral health behaviour and sedentary behaviour of children in India from the perspective of parent. A representative online survey was conducted among 250 families with 4- to 12-year- old children between May 2nd to May 9. Results: Children with low socioeconomic status, rural background, and very limited living space were affected significantly more. In oral health attitudes, respondents who had increased attention to oral health was more than those with decreased. Most of the children showed constant irritability and variable mood swings. Moreover, the children seemed to increase their use of screens, used to sleep more, and were less active physically. Concerning adaptation, most of the parents reported that their child was somehow able to adapt to restrictions of the COVID-19 outbreak. Conclusions: The present study concluded that the COVID-19 pandemic has strongly impacted the behavioural profile and oral health care of children in various regions and there is a need to reduce the psychological burden of this pandemic and the necessity of immediate intervention. Keywords: Impact, behaviour, oral health. pandemic, children dental team

Introduction: Pregnancy tumour is a non-neoplastic, reactive conditioned gingival enlargement which can interfere with mastication, speech, and maintenance of oral hygiene. Its management includes phase 1 therapy followed by complete surgical excision. Diode laser is reported as a suitable alternative to conventional surgical techniques, specifically in intra-oral areas, with the added advantage of decreased chairside time and a bloodless procedure. Objective: Reduce and eliminate pregnancy tumour using diode laser. Methods: A 27-year-old 34 weeks pregnant patient reported with gingival overgrowth on the palatal side of the upper anteriors. Three months back, the patient noticed the growth, which increased gradually in size and was associated with bleeding on chewing food and brushing and interfered with speech. Complete surgical excision was done under topical anaesthetic spray using diode laser. Results: There were no adverse events reported post operatively. Follow up after 15 days revealed adequately healed gingiva with normal probing depth and absence of bleeding on probing. Conclusion: Diode laser excision of a large and persistent pregnancy tumour is a good alternative to conventional surgical techniques in pregnancy and results in decrease chairside time, less stress, and better wound healing with minimal post-operative morbidity. Keywords: Diode laser, pyogenic granuloma, biopsy