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   Table of Contents - Current issue
July-December 2018
Volume 10 | Issue 2
Page Nos. 57-133

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Dentists as Vanguard of Oral Health p. 57
Rooban Thavarajah
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Clinical Complications in Procedures for Horizontal Bone Augmentation Through Autologous Onlay Grafts Obtained From the Mandibular Ramus: An Observational Study p. 59
Daniel R.B de Resende, Aline Siqueira, Eduardo Rosas, Eduardo Borie Echevarrķa
Aim and Objective : The aim of this study was to describe clinically the prevalence of postsurgical complications in a group of patients treated with autologous bone grafts obtained from the mandibular ramus. Materials and Methods: Data were obtained from a sample of 76 adults, who were subjected to a surgical procedure of horizontal bone augmentation through autologous onlay bone grafts obtained from the oblique line of mandible. A total of 113 onlay grafts were removed and placed in 152 recipients’ area, previously fitted to the receptor site and stabilized through two fixation screws. All complications were recorded in relation to the recipient and donor sites, and the follow-up time of the sample was of 2 years. Results: Of the entire sample studied, 69.7% did not show any type of postsurgical complication; however, 30.3% of them exhibited a type of complication, with temporary paresthesia being the most prevalent (7.9%). Conclusion: More than 30% of the patients that received horizontal bone augmentation through autologous onlay bone grafts obtained from the oblique line according to the conventional technique showed some type of postsurgical complication.
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Age Estimation by Modified Demirjian’s Method in Children and Adolescents of Hyderabad Population—A Panoramic Study p. 63
M. Priyanka, G. Kiran, R. Poornima, R. Shravani, K. C. Shobhita, P. Preethi
Introduction: Human identification is one of the most important tasks of forensic practitioner. Estimation of age is one of the essential factors which play a significant role in each aspect of life, including forensic medicine and dentistry, wherein race, age, and sex determination are used in person identification. Aims and Objectives: To correlate the relationship between chronological age (CA) with dental age (DA) using modified Demirjian’s method and to establish the applicability of modified Demirjian’s method in Hyderabad population. Materials and Methods: Our study samples consist of 113 randomly selected samples (39 males and 74 females) of age ranging from 8 to 20 years of Hyderabad population for children and adolescents. Panoramic radiographs of these patients were evaluated based on the modified Demirjian’s method. The obtained data were tabulated and analyzed using SPSS version 20.0. Results: The present study showed a significant correlation between CA and DA in both females (r = 0.84) and males (r = 0.882). The overall mean difference between the DA and CA for females and males was +1.14 and +0.86, respectively. In the whole sample, DA was found to be over estimated by +1.04 with CA. Conclusion: DA overestimated the CA by +1.04 years. According to the present study, there was a difference and overestimation of DA in comparison with CA in Hyderabad population and hence population specific formula for each area is necessary.
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Comparison of the Shear Bond Strength of Treated and Untreated Brackets on Treated and Untreated Enamel Surfaces in Rebonding p. 69
Delal Dara Kilinc, Gülşilay Sayar
Aim and Objective: This study aimed to compare the shear bond strength (SBS) of treated and untreated brackets on treated and untreated enamel surfaces in rebonding. The null hypothesis was that there was no difference between the SBS of the treated and untreated rebonded brackets on treated and untreated enamel surfaces. Materials and Methods: Fifty extracted premolars were bonded by the same conventional bonding method and then debonded, and the SBS of each tooth was recorded. The debonded brackets and teeth were divided into two equal groups. In the first group, the debonded brackets were recycled by direct flaming followed by alumina oxide sandblasting, and the teeth were treated with a tungsten carbide bur applied with a low-speed hand piece. In the second group, neither the teeth surfaces nor the bracket bases were treated. Rebonding was performed followed by debonding, and the SBS of each tooth was recorded again. Results: Both rebonded bracket groups showed lower SBS results than that of the first debonding tests. A statistically significant difference was found within the untreated bracket groups between the first and second debonding test (P < 0.001). Conclusion: The rebonding of treated enamel surfaces and treated bracket bases showed higher SBS values compared to the untreated ones. The null hypothesis was rejected.
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Association of Maternal and Child Dental Anxiety With Dental Caries Experience and Dental Attendance Pattern of the Child p. 75
Shruti Balasubramanian, Suprabha B Shrikrishna, Ramya Shenoy, Arathi Rao
Introduction: Children with early childhood caries may have dental anxiety. Maternal anxiety can influence the child dental anxiety. Aims and Objective: To explore the association of maternal and child dental anxiety with the dental caries experience and the dental attendance pattern of the child. Materials and Methods: This cross-sectional study involved 227 mother–child dyads with children aged between 3 and 6 years. Mothers answered a questionnaire on dental attendance pattern. Corah’s dental anxiety scale was used to assess maternal anxiety, and facial image scale was used to assess dental anxiety in children. The “dmft” index of the child was recorded by a calibrated dentist. Statistical tests (Chi-square and Student’s t-tests) were employed to analyze the data, and P < 0.05 was considered significant. Result: Maternal anxiety was significantly associated with the mean number of missing and filled teeth in children (P = 0.005; P < 0.001, respectively). Child anxiety was significantly associated with the mean number of missing teeth (P < 0.001), increased frequency of missed dental appointments (P = 0.003), and decreased the frequency of dental visits (P = 0.008). Conclusion: Both maternal and child dental anxiety can influence the dental caries experience of the child. The dental anxiety of the child can influence the dental attendance pattern.
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Assessment of Sagittal Skeletal Base Relationship of Maxilla and Mandible by Horizontal Appraisal Method—A Comparative and Reliability Study p. 80
Paoulomi Roy, Supriya Nambiar, B. Unnikrishnan, Asavari Desai, C. Suresh
Introduction: The evaluation of antero-posterior apical base relationship is crucial before orthodontic diagnosis and treatment planning. Aim and Objectives: The present study is aimed to compare the credibility of five cephalometric measurements in assessing the antero-posterior jaw relationship and to assess the correlation between various measurements used for antero-posterior discrepancy, including ANB, Yen angle, Beta angle, Wits appraisal, and horizontal appraisal. Materials and Methods: A total of 99 patients aged 16 years and above patients were subdivided into skeletal Classes I, II, and III groups of 33, each based upon the ANB angle derived from the pretreatment cephalogram. Results: The results showed that AH/BH and ANB had very high sensitivity and specificity to discriminate a Class II from Class I and Class III from Class I. Wits, YEN, and Beta showed lower specificity to differentiate Class II from Class I and Wits and Yen to differentiate Class III from Class I except Beta which had 100% sensitivity to differentiate Class III from Class I. Conclusion: The horizontal appraisal method enriches the current cephalometric tools available for the clinician to assess the antero-posterior jaw relationship accurately and reproducibly.
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A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient’s Awareness p. 86
Arunachalam M Anusa, Rooban Thavarajah, Dinesh Nayak, Elizabeth Joshua, Umadevi Krishnamohan Rao, Kannan Ranganathan
Aim and Objective: Schizophrenia is a psychiatric disorder that requires long-term treatment. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD), the severity of which is measured by Abnormal Involuntary Movement Scale (AIMS). This study examined the relationship among TD, orofacial musculature activity, and patient’s awareness of Abnormal Involuntary Movement (AIM). The knowledge would help dentists to deliver oral care for schizophrenics with TD. Materials and Methods: We identified 317 patients from a standard, data sharing initiative, of whom 38.3% exhibited AIM score of 2 to 15. The patient demographics, drug history, details of AIMS were subjected to descriptive and inferential statistical analysis using SPSS with P ≤ 0.05 as significance. Results: The mean of only orofacial features (n = 56) was 3.43 ± 2.68. Muscles of facial expression was involved in nine (7.9% of all TD), lip/perioral area in 27 (23.68%), jaw in 52 (45.61%), and tongue in 77 (67.54%). The patient’s perception of AIM precipitated stress when involving jaw, tongue, limbs, and trunk was statistically significant (P ≤ 0.05). The multiple regression model statistically significantly predicted TD for factors considered. Conclusion: Around 1% of global population is being diagnosed with schizophrenia, carry an inherent risk of developing TD. They might have orodental care requirements, including prosthodontic and restorative services. Primary physicians and dentists need to be aware of TD and its mechanism for appropriate patient management.
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Effect of Orthodontic Sealant Containing Antimicrobial Selenium on the Shear Bond Strength of Orthodontic Bracket p. 96
Pinandi S Pudyani, Fibriana Safitri, Ananto A Alhasyimi
Intoduction: Fixed orthodontic treatment has a high risk of enamel demineralization. Sealant containing selenium is a material that has been developed to prevent enamel demineralization and stated to be applicable as a primer bracket adhesion. Aim and Objective: This aim of this study was to investigate the shear bond strength (SBS) of an orthodontic bracket after application of sealant containing selenium as a primer. Materials and Methods: A total of 100 extracted human premolars were used in this study, which were randomly divided into two groups. Group I consisted of 50 teeth as the control group, to which a conventional primer (CP) was applied, whereas for group II comprising 50 teeth, a sealant containing selenium selenium primer (SP) was applied. SBS of the orthodontic brackets was measured using a universal testing machine. The adhesive remnant index (ARI) scores were calculated to determine the location of the bond failure using a stereomicroscope. A t test was used for analyzing the SBS data, whereas the Mann–Whitney test was used for analyzing the ARI scores. Results: There was no significant SBS difference (P > 0.05) between CP and SP groups. CP groups showed slightly higher SBS [9.05 ±3.10 megapascal (MPa)] than that in the SP groups (8.21 ± 3.78 MPa). The bond failures of both the groups occurred at the adhesive–adhesive interface. Conclusion: The results showed that sealant containing selenium can be used as a primer within orthodontic adhesive material, as the physical–mechanical properties remained unchanged.
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Does Darkening of Roots or Loss of White Line on Panoramic Radiographs Pose a Risk for Inferior Alveolar Nerve Damage? A CBCT Evaluation p. 101
Chintan M Savani, Kishan Panicker, B. Sarat Ravi Kiran, Uday Kiran Uppada
Introduction: Surgical removal of impacted mandibular third molars may cause dysesthesia due to damage to the inferior alveolar nerve (IAN), and the risk increases when there is direct contact between the nerve and the tooth root. An accurate preoperative radiographic examination using Cone beam computed tomography (CBCT) provides precise information pertaining the relationship between the third molar roots and the inferior alveolar canal. Aim & Objective: This study was intended to correlate the two panoramic radiographic findings in predicting the absence of corticalization between the mandibular canal and the third molar on cone beam computed tomography (CBCT) images and to evaluate the possibility of inferior alveolar nerve (IAN) injury. Materials and Methods: The study was conducted on 60 patients, who were divided into two groups of 30 each. Group I included 30 patients whose panoramic radiographic findings showed darkening of the root of impacted mandibular third molar. Group II included 30 patients whose panoramic radiographic findings showed interruption of white line of mandibular canal. The patients whose panoramic radiographic findings showed darkening of the root or interruption in the white line of the canal were subjected to CBCT examination. Surgical removal of impacted mandibular third molar in all the patients was performed under local anesthesia (LA). Evaluation for any nerve injury was performed and recorded as presence or absence of paresthesia at regular postoperatively. Results: The results of this study showed that 46.7% patients had absence of cortication in Group I (darkening of roots), whereas it was absent in 33.3% of patients in Group II (loss of white lines). Presence of cortication was seen in 53.3% of patients in Group I when compared to 66.7% in Group II. The difference between the groups was not found to be statistically significant. Conclusion: Darkening of roots and interruption of white line observed on panoramic radiographs, both as isolated findings and in association, were effective in determining the risk relationship between the tooth roots and the mandibular canal necessitating CBCT evaluation.
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Cytological Method of Barr Body Expression in Dental Pulp Tissue at Varying Temperature p. 108
Ambika Murugesan, Sekar Balakrishnan, Indra Priyadharshini Kumaresan, Arun Jayakumar, Jayashree Mohan, Bharath Champakesan
Introduction: Natural disasters in large population need major attention in person identification. It can be performed by means of simple techniques that are easier to use. Aim: To identify the Barr body in female dental pulp by cytological method, after exposing at varying temperature. Objective: The expression of Barr bodies was compared among different age groups, various temperature, and two types of stain. Materials and Methods: Teeth obtained from 60 female individuals were divided into two groups based on their age. In each group, 30 teeth were exposed at three different temperatures (200°C, 300°C, and 400°C), 10 teeth in each temperature. The pulp tissue obtained from teeth was centrifuged and stained with hematoxylin and eosin (H&E) and Papanicolaou stain (PAP). Presence of visible sex chromatin in the nuclear periphery was considered positive for Barr chromatin test. The results obtained were analyzed by both descriptive analysis and independent t-test. Result: The peripherally condensed Barr body in hyperchromatic nuclear outline was clearly visible in younger individuals at 200°C and is more accurately expressed in H&E stain. Conclusion: In our study, based on the results obtained from the smear of pulp tissue, expression of Barr bodies’ decreases as age and temperature increases. Further study with increase in sample size is mandatory to confirm the above conclusion.
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The Effect of Platelet-Rich Fibrin on Soft Tissue and Crestal Bone in One-Stage Implant Placement in Fresh Extraction Sockets: A Randomized Controlled Clinical Trial p. 112
Kishore K Avula, Uma D Rayavaram, Sravanthi Gujjula, Siva Sai Prasad R Dandu, Prasuna Egatela, Ravindra R Nagireddy
Introduction: The goal of modern dentistry is to prevent tooth loss and provide a healthy dentition with optimal functional efficiency, structural balance, and aesthetic harmony. The placement of an implant immediately after tooth extraction helps to maintain the bone crest and leads to ideal implant positioning from a prosthetic point of view and has the potential of decreasing the total treatment time for patients. Aim and Objective: To evaluate the platelet rich fibrin with or without bone ceramic on soft issue and crestal bone in one stage implant placement in fresh extraction socket. Materials and Methods: A total of 30 patients were randomly assigned into two groups—each group comprising 15 patients based on platelet-rich fibrin with and without bone ceramic and one-stage implant placement in fresh extraction socket. All patients were prospectively evaluated clinically and radiographically. All the data were analyzed using a software statistical package for social sciences (SPSS) version 11.5 (Chicago, Illinois, USA). Results: During the 6-month interval, no implant was lost; the mean bone level at the implants increased in platelet-rich fibrin (PRF) with bone ceramic group and decreased in PRF group and papillary index increased in both the groups, whereas modified sulcus bleeding index and probing pocket depth (PPD) decreased in both the groups. Conclusion: It can be concluded that mean crestal bone levels increased in PRF with bone ceramic group, whereas decrease in PRF group and both the groups are statistically significant. When the papillary levels are compared between the two groups, there was no statistical significance, but increased papillary levels were found in both the groups. The mean PPD was decreased in both the groups, but there was no statistical significance between the two groups.
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Two Different Methods for Collection of Gingival Crevicular Blood to Estimate Random Blood Glucose Levels—A Comparative Study p. 117
Aarthi Nisha Venkatesan, Julius Amaldas, Mohan Valiathan, Vidya Jayaram, Parthiban Jayaraman
Aim and Objective: The present study was done to validate a reliable method for collection of gingival crevicular blood (GCB) and to use it as an alternative to routinely collected venous blood (VB) to estimate random blood glucose (RBS) levels. Materials and Methods: The study group comprised of 50 type 2 diabetic patients (n = 50), aged between 21 and 80 years attending the outpatient department of Sree Balaji Dental College and Hospital, Chennai. The study was a cross-sectional observational study that comprised of thorough clinical evaluation and estimation of RBS levels from GCB by two different methods, namely, direct glucometric method and collection through capillary tube method. Results: Out of the 50 patients, 27 (54%) were females and 23 (46%) were males. All the patients were among 20 to 70 years of age. On comparing the RBS levels from gingival crevicular obtained by direct intraoral method and capillary tube method, a statistically significant correlation of P < 0.05 was obtained proving statistically significant results. Further on comparing the results with VB glucose levels, there was no statistically significant difference found among the methods. Conclusion: The above study concludes that GCB collected by both capillary tube and direct intraoral method yielded almost similar blood glucose results which conclude either of the methods can be used to collect the sample.
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Is the Intention Being Realized in Execution: Evaluation of Oral Health Promotion Program at a South Indian University p. 121
Viswa C Chandu, Srinivas Pachava, Viswanath Vadapalli, Suresh Sanikommu
Introduction: There are accessibility problems for rural Indian population with respect to oral health care. Dental Council of India envisioned that establishment of satellite clinics would be a beneficial strategy for rural population to have better access to oral health care, curtailing the accessibility problems and financial barriers for oral health care utilization to some extent. Aim and Objective: The aim of this study was to procure data on the functioning of these satellite clinics and evaluate an oral health promotion program in a satellite clinic located in a South Indian university. Materials and Methods: A total of 301 participants were selected through two-stage random sampling to evaluate the functioning of a dental satellite clinic located in a South Indian university. The data collected include demographics, utilization of services at the satellite clinics, and self-reported oral and general health status. Results: The utilization of services was only 9.3%, and a majority of the participants were not aware of the existence of the clinic. Promotion of available services and provision of oral health education were the major suggestions received from the study participants. Conclusion: Evaluation of satellite clinics both from the students’ perspective and with regard to oral health status of concerned populations must be seriously undertaken.
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Bone Cells and Mast Cells Express MMP-9 During Tooth Eruption In Vivo p. 127
Nayra S.C Lima, Isabela R Magalhães, Lívia F Lima-Pansini, Letícia N Gama-de-Souza, Marcos S Pacheco, Karla L.A Coburn
Context: Tooth development takes place inside a bony crypt in the alveolar bones. Tooth eruption requires, therefore, the removal of bone and lamina propria to establish the eruptive pathway. Matrix metalloproteinases (MMPs) belong to a family of enzymes responsible for the degradation of the extracellular matrix (ECM). MMP-9 is a member of this family and is secreted by a variety of cells, including mast cells. Both have been identified as possible collaborators for tissue remodeling during tooth eruption. Aims: The aim of this study is to analyze the bone remodeling, MMP-9 expression, and the prevalence of mast cells throughout the eruptive process of rat molars. Materials and Methods: Twenty-eight rats (4–17 days old) were used in this study. Histomorphometric analyses were performed to determine the bone area in the basal and coronal regions of the bony crypt and the prevalence of mast cells at the lamina propria along the eruptive process. Immunohistochemistry was performed to detect MMP-9 expression in the lamina propria and alveolar bone. Results: Increased bone apposition at the base of the bony crypt was observed at 14 days and increased resorption of the coronal bone was detected after 9 days. An elevated number of mast cells was observed in 9-day-old rats, and MMP-9 was strongly expressed in mast cells and osteoclasts. Conclusion: Taken together, we suggest that mast cells may contribute to the recruitment of osteoclast precursors during tooth eruption and that MMP-9 is possibly involved in the removal of the ECM during the eruptive process.
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