Singapore Dental Journal

Background: This narrative review provides an evidence-based overview of the comparison between mini-dental implants (MDI) and conventional dental implants for definitive prosthesis retention. In addition, recommendations are made on whether the use of reduced diameter dental implants is more appropriate.

Method: A literature review was conducted via electronic search addressing the following topics: (1) osseointegration, (2) peri-implant soft tissue characteristics, (3) biomechanics, (4) implant survival and (5) implant success.

Conclusion: The procedure for dental implant prosthetic rehabilitation should preferentially include conventional dental implants (i.e. $>3$mm fixture diameter). Small (3–3.25mm) and narrow (3.3–3.5mm) dental implants should primarily be used in non-load-bearing regions. MDI ($<3$mm) should be considered to retain definitive prosthesis, only for reasons of anatomy or patient-centred preferences and as a last resort. If MDI are to be used, patients should be made aware of the lack of long-term, high-quality evidence as a part of the informed consent process and that most of the prospective data available pertain to MDI retaining complete dentures.

Nitrous oxide in oxygen (N₂O/O₂) inhalation sedation is used less commonly by Singapore dentists than their counterparts in the United Kingdom and the United States. Using this technique, trained dentists often perform the dual roles of a sedationist and an operating dentist. This paper describes the mechanism of action of N₂O and highlights the modern gas delivery system commonly used in dentistry. The built-in safety features of this unique system helps to ensure that patient-specific therapeutic dosages are effectively and safely administered by dentists. Existing evidence for adverse events and the safety profile of the N₂O/O₂ inhalation sedation is discussed. Finally, recommendations of equipment, training and techniques for safe N₂O/O₂ inhalation sedation are provided.

Background and Objective: There is a pressing need for developing innovative strategies to prevent allergic diseases among children. As house-dust mite (HDM) allergy is often seen in children with gingivitis, strategies should be derived from a conceptual framework of allergen elimination and pathogen eradication; one such strategy is dental scaling and root planing (SRP) to remove dental plaque and periodontal pathogens. The study aimed to evaluate the beneficial effects of comprehensive 6-months dental SRP to reduce the level of immunoglobulin E (IgE) and immunoglobulin G₄ (IgG₄) in children with gingivitis and HDM allergy. IgE and IgG₄, whose production is controlled mainly by Th-2 cells and B cells, are proven biomarkers for atopic inflammatory responses.

Methods: The present study conducted a non-blinded randomised controlled trial with superiority design. A total of 10 subjects (age range 6–16 years) with gingivitis and positive skin-prick test to HDM from Pediatric Allergy Outpatient Clinic, Dr. Soetomo General Hospital were enrolled in the present study. Of the 10 subjects, only five received dental SRP. We further evaluated total serum IgE and IgG₄ level before and 6 months after treatment.

Results and Discussion: Subjects in the standard treatment group showed a slight decrease in the IgE level ($p=0.019$) but no change in the IgG₄ level ($p=0.839$), while subjects in the intervention group showed a significant decrease in IgE ($p<0.001$) and IgG₄ levels ($p=0.001$).

Conclusion: The study results suggest that 6-month comprehensive dental scaling combined with root planing may help to reduce IgE and IgG₄ levels in children with gingivitis and HDM allergy. Furthermore, untreated or undertreated gingivitis is often associated with worsening allergic manifestation and thus should be avoided.

Trial Registration: ISRCTN31416107, retrospectively registered on 17 April 2018.

Background: Treatment of furcation involvement of molars with periodontal disease remains challenging and unpredictable. Platelet-rich fibrin (PRF) has received the attention of researchers due to its pleiotropic properties essential for periodontal wound healing. The osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully used in periodontal regeneration.

Aim: The present study aimed to explore the effectiveness of PRF alone and with DFDBA in the treatment of mandibular degree II furcation defects in subjects with chronic periodontitis.

Material and Methods: Patients treated were from the Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly. A total of 60 mandibular molars were treated with either open flap debridement (OFD) alone, $\mathrm{\text{PRF}}+\mathrm{\text{OFD}}$ combination or $\mathrm{\text{OFD}}+\mathrm{\text{PRF}}+\mathrm{\text{DFDBA}}$ combination. The soft and hard tissue parameters such as vertical probing depth (VPD), vertical clinical attachment level (VCAL), gingival marginal level (GML), horizontal probing depth (HPD), vertical bone fill (VBF), horizontal bone fill (HBF) and furcation width (FW) were determined at baseline and 9 months postoperatively. A paired $t$-test was conducted to assess the statistical significance between time period within each group for clinical and radiographic parameters. ANOVA and post-hoc Tukey’s tests were also conducted for intergroup comparison of soft and hard tissue parameters. Statistical significance was set at $p<0.05$.

Results and Discussion: After 9 months, all treatment groups showed significant ($p<0.001$) improvement in soft and hard tissue parameters, except GML in all the three groups and HBF and FW in the OFD group as compared to baseline. The mean VBF change was highest in the $\mathrm{\text{OFD}}+\mathrm{\text{PRF}}+\mathrm{\text{DFDBA}}$ group ($1.90+0.45$) mm, followed by that in the $\mathrm{\text{PRF}}+\mathrm{\text{OFD}}$ and OFD groups ($1.60+0.88$ and $0.45+0.51$mm, respectively).

Conclusions: It was shown that both $\mathrm{\text{PRF}}+\mathrm{\text{OFD}}$ and $\mathrm{\text{PRF}}+\mathrm{\text{DFDBA}}+\mathrm{\text{OFD}}$ combinations were significantly advantageous for the management of mandibular degree II furcation defects. However, the $\mathrm{\text{PRF}}+\mathrm{\text{DFDBA}}+\mathrm{\text{OFD}}$ combination has significantly greater benefits than $\mathrm{\text{PRF}}+\mathrm{\text{OFD}}$ combination in terms of VBF.

Aim: This study evaluates perception toward facial appearance in dentofacial deformity and the need for orthognathic surgery among the public with and without dental backgrounds.

Materials and Methods: A questionnaire consisting of 12 facial photographs of cases with dentofacial deformity or malocclusion in varying severity was used. A hundred individuals were selected to answer the questionnaire. The perception of facial appearance (FAS), treatment need score (TNS), and knowledge regarding dentofacial deformity were used for the evaluation.

Results: Significant differences were found between dental and non-dental when the respondents’ knowledge in all the questionnaire items ($p<0$.05) was assessed. However, no significant difference was found in the mean of FAS and TNS in all the presented cases (normal, borderline, severe). Pearson correlation between perceived FAS and TNS was statistically negative for severe and normal cases, whereby a decrease in FAS for severe cases showed an increase in TNS, and an increase in FAS for normal cases showed a decrease in TNS.

Conclusion: Respondents with dental background had sound knowledge of dentofacial deformity. A poorly attractive respondent with dentofacial deformity showed a greater need for orthognathic surgery.

Auricular reconstruction is a challenging issue. It can either be performed surgically or by the use of prosthesis. Definitive auricular prosthesis can be retained by craniofacial implants. Temporary (interim) prosthesis can be retained using adhesives, engaging anatomical undercuts and using mechanical means of retention-like spectacles. This case report proposes a new mechanical means of retention for a temporary auricular prosthesis, which can be suitable for non-eyeglass wearing females or for female patients who refuse to wear eyeglass for retaining their prosthesis.

The superficial temporal artery (STA) is a structure that is particularly vulnerable to injury, given its prominent location in the head and neck region. Pseudoaneurysms of this artery may be encountered during the management of maxillofacial trauma. This article presents a review of the relevant literature on this topic. One of the common surgical interventions includes ligation of the entire feeding artery, which compromises the corresponding blood supply. Preservation of the main trunk of the STA can be achieved in certain cases; one such case is detailed in this report.

Oncocytosis is a rare, benign, non-neoplastic lesion that can be further classified into diffuse oncocytosis or multifocal adenomatous oncocytic hyperplasia. This tumour has been estimated to account for 0.1% of all parotid gland tumours. Here, we report a rare case of a patient who presented to the Oral and Maxillofacial Surgery Department with a 3-cm swelling of his left parotid gland. Histopathological results from a superficial parotidectomy revealed the lesion to be a multifocal adenomatous oncocytic hyperplasia of the parotid gland. A description of this rare disease and its management are included in this article.