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Table of Contents
July-September 2021
Volume 32 | Issue 3
Page Nos. 275-414
Online since Wednesday, February 23, 2022
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EDITORIAL
Omicron! Alert for dental surgeons
p. 275
SM Balaji
DOI
:10.4103/ijdr.IJDR_5_22
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ORIGINAL RESEARCH: EVALUATIVE STUDY
Workplace violence among dental surgeons - A survey
p. 276
Reshma Poothakulath Krishnan, Pratibha Ramani, Gheena Sukumaran, Abilasha Ramasubramanian, Monica Karunagaran, R Hannah
DOI
:10.4103/ijdr.IJDR_880_19
Background:
Workplace violence is a multi-causal, multifaceted, public health, legal and social problem faced by all occupations worldwide. Recently, there has been an increase in the prevalence of workplace violence against doctors. Even though the government has attempted to address these problems in India, doctors are still experiencing violence in their workplaces.
Aim:
The aim of this survey was to determine the prevalence and awareness of workplace violence among dental surgeons.
Methodology:
This cross-sectional study was conducted among the dental surgeons. A self-administered questionnaire containing 15 questions was made and validated. A Web-based questionnaire was developed using Google forms and was circulated. A total of 112 responses were obtained. Questions were answered with “yes” “no” or by marking the correct responses. Frequency analysis and percentage analysis were done with the obtained results.
Results:
Our study showed that 74.1% of the participants heard about the workplace violence and 30.4% faced violence in their clinic. The nature of the violence was physical in 0.9%, verbal in 39.3%, and sexual in 0.9% among the participants who faced violence. A total of 92.9% of the participants reported that they require policies and guidelines against this workplace violence.
Conclusion:
Dental surgeons should have proper knowledge about the work-related violence and methods to control this violence. Policies, procedures, and intervention strategies should be undertaken to manage this alarming issues.
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Association of sleep disturbances and craniofacial characteristics in children with class ii malocclusion: An evaluative study
p. 280
Krishna Balraj, Vabitha Shetty, Amitha Hegde
DOI
:10.4103/ijdr.IJDR_226_19
Background:
Behaviour problems, poor academic performance and failure to thrive are some of the potential sequelae of sleep problems in children. Hence, there is a need to evaluate the prevalence of sleep problems and significant associations in children with skeletal class II malocclusion with mandibular retrognathism.
Aims:
This study aimed to determine associations if any between sleep practices and problems and craniofacial characteristics in children with skeletal class II malocclusion with mandibular deficiency.
Settings and Design:
A cross-sectional study was conducted among a group of children with skeletal class II malocclusion with mandibular retrognathism.
Materials and Methods:
Fifty children aged 8–14 years with skeletal class II with mandibular retrognathism and who required myofunctional therapy were selected. A validated sleep questionnaire assessed the sleep practices and problems. A detailed clinical examination including tonsils and evaluation for mouth breathing was performed. A lateral cephalogram recorded specific linear, angular variables as well as upper and lower pharyngeal airway space.
Statistical Analysis:
Descriptive statistics, frequency, and percentages were calculated, and the Chi-square test was used.
Results:
All children reported at least one sleep problem, with snoring reported by 76% of the children. Forty-two percent of the children showed a decreased upper airway, whereas 80% showed a decreased lower airway. Significant associations were seen between SN-MP and noisy breathing, upper airway, and snoring with a
P
value of 0.017. We also found significant associations between upper and lower airway and sleep positions with a
P
value of 0.021 and 0.005, respectively.
Conclusion:
All the children exhibited at least one sleep problem. There was a strong association of certain sleep practices and sleep problems with cephalometric variables.
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Using nitrous oxide inhalation sedation for classical conditioning - An evaluative study
p. 288
Vinita Goyel, Aman Jain, Shivani Mathur, Manvi Malik, Vinod Sachdev
DOI
:10.4103/ijdr.ijdr_146_21
Purpose:
This study was undertaken to evaluate conscious sedation as a means of classical conditioning for managing paediatric dental patients.
Methods:
A total of 20 healthy children
(American Society of Anesthesiologists I)
aged 5–9 years with positive and definitely positive Frankel behaviour rating scale were evaluated. In the first appointment (
A
1
) non-invasive treatment under nitrous oxide inhalation sedation was performed and oxygen saturation and pulse rate at 10%, 30% and 50% were recorded. In subsequent appointment (
A
2
) same treatment was executed under 100% oxygen and recordings were taken. Behaviour was assessed using comfort scale.
Results:
No significant difference was observed in pulse rate, oxygen saturation and visual analogue scale whereas scores of comfort scale showed significant results.
Conclusion:
Once behaviour modification to dental treatment is achieved, subsequent visit can be undertaken even without sedation, giving oxygen as a placebo where patient is sensitized to nasal hood resulting in positive dental behaviour.
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Prevalence of species-specific candidiasis and status of oral hygiene and dentition among diabetic patients: A hospital-based study
p. 292
Ritu Duggal, Ravinder Goswami, Immaculata Xess, Isha Duggal, Aditya Talwar, Vijay Prakash Mathur
DOI
:10.4103/ijdr.IJDR_827_20
Objective:
The study was undertaken to estimate the species-specific prevalence of oral candidiasis in diabetic individuals in India, and further find the relationship of oral carriage of Candida in diabetes with degree of diabetic control, duration of disease, type of diabetes and its effect on the status of oral hygiene status and decayed, missing and filled teeth (DMFT) score.
Methodology:
The prospective cross-sectional study involved 900 individuals (470 diabetic and 430 non-diabetic) visiting a tertiary care hospital. Informed consent was obtained from all the individuals participating in the study. The demographic details, medical history and oral cavity examination were recorded in a specially designed proforma. Swabs were taken for microbiological evaluation for specific prevalence of Candida.
Results:
The overall prevalence of Candida in diabetics was 22.1% as compared to 9.7% in non-diabetic individuals. However, among the type 1 and type 2 diabetics, the prevalence of Candida was equally distributed as 22.6% and 20.8%, respectively.
C. albicans
was the most common species (97.1%), while isolated cases of other species like
C. rugosa, C. tropicalis, C. glabrata
were also observed. The individuals with higher glycaemic score (HbA1c >7) showed higher prevalence of oral candidiasis. Oral hygiene status was observed to be lower among diabetics as compared to non-diabetic individuals.
Conclusion:
Oral candidiasis was more prevalent in diabetic patients, and
C. albicans
was the most common species. The diabetics also showed higher mean DMFT with lower oral hygiene status as compared to non-diabetic individuals.
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Evaluation of effect of low level laser therapy with intracanal medicament on periapical healing: A randomised control trial
p. 299
Deep Shah, Muckatira Cariappa Ponappa, Kongettira Chittiappa Ponnappa
DOI
:10.4103/ijdr.IJDR_896_20
Objective(s):
Photobiomodulation, also commonly referred to as low level laser therapy (LLLT), uses light energy to elicit biological responses from the cell and normalise cell function. Using LLLT on bone has been demonstrated to be effective in modulating inflammation, accelerating bone cell proliferation and enhancing the healing process. The objectives of this study were to evaluate postoperative pain and periapical healing in two different groups.
Materials and Methods:
40 subjects with periapical lesion were selected and were assigned randomly into two groups. Group I: Conventional root canal therapy along with LLLT. Group II: Conventional root canal therapy only. Radiographs were obtained and assessed at baseline, 3, 6 and 9 months postoperatively. The VAS pain scale was assessed post operatively at 0, 7
th
and 14
th
day respectively. The Independent
t
-test was used for evaluation of the data.
Results:
Significant differences were noted in reduction of periapicallesion at 3 and 9 months follow-up. The healing was better in Group I that received LLLT with the conventional Root Canal Treatment (RCT). Values for postoperative pain was lower in Group I than Group II, but were statistically non-significant.
Conclusion(s):
LLLT when used as an adjunct with conventional root canal treatment showed acceleration of the healing process of periapical lesions. LLLT has a positive effect on modulating the immune response for favourable healing.
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Occupational exposures to bloodborne pathogens and its underreporting in dental teaching environment in an Indian dental school
p. 305
Nilesh V Joshi, Mridula Joshi, Varsha Rathod, Deepak Langde
DOI
:10.4103/ijdr.IJDR_172_20
Introduction:
The aims of this study were 1) to find out the prevalence of occupational exposures to contaminated biological material among undergraduate students and interns; 2) to find out how many cases of occupational exposures to bloodborne pathogens are reported; and 3) to know the reasons for non-reporting of occupational exposures.
Materials and Methods:
The study was conducted in a Dental School in Navi-Mumbai, India. An anonymous self-administered questionnaire was formulated. 210 dental students were given a questionnaire out of which 150 students attending clinical postings in their third year, final year, and internship responded. Approval was obtained from the Institutional Ethical Committee.
Results:
The study revealed a very high prevalence (66.7%) of exposures among the students. Only 12% of the students reported the exposures to the staff. Students from III year and final year BDS (Bachelor of Dental Surgery) had mean exposure of 2.40 as compared to 1.94 among interns. 46% of the students stated that they did not report about the exposure because they thought that injury was of minor nature.
Conclusion:
There is a very high prevalence of occupational exposures among students which are not reported. There is a need for the development of a post exposure protocol which has to be strictly implemented. The principle of infection control has to be emphasised to the students periodically and they should be encouraged to report incidences of exposures to biological material.
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Diagnostic efficiency of methylene blue and lugol's iodine double staining method in oral leukoplakia in detecting dysplasia
p. 310
Dheeraj Sharma, Aravinda Konidena, Alpna Sharma
DOI
:10.4103/ijdr.IJDR_291_19
Objectives:
Early detection of dysplasia in oral potentially malignant disorders (PMD) might facilitate screening for possible subsequent malignant transformation. Vital staining is a non-invasive clinical adjunct used for determining the biopsy site, which facilitates early detection of dysplastic changes in PMD. Some authors suggested that double staining method has superior results over staining with a single dye.
Aim:
The aim of the study was to evaluate the accuracy of
in vivo
staining with methylene blue (MB) and Lugol's iodine (LI) double staining method in comparison with MB staining alone.
Materials and Methods:
Fifty patients of oral leukoplakia were recruited for the study. After obtaining written informed consent from the patients, the lesions were stained consecutively with 5% MB and 3% LI. The pattern of dye retention of MB alone, followed by MB and LI was noted. Incisional biopsy from the lesion was taken based on the retention of MB and the absence of staining of LI or by clinical judgement in case both stains were not retained. The clinical uptake of the stains was correlated with the degree of dysplasia on histopathological examination.
Results:
Out of 50 subjects, MB was retained in 47 cases (94%), while 3 cases (6%) failed to retain the dye. However, out of 47 cases, 20 cases had dark blue stain and were considered as MB positive, while the rest 27 cases had pale blue stain and were considered to be negative for MB staining. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) of MB staining were 57.82%, 100%, 100%, 26.53% and 46%, respectively. After applying both stains, i.e., double staining method, the outline of the lesion was better defined. Out of 50 PMD cases, 3 patients retained only LI and showed no dysplasia. Out of 47 cases which showed dysplasia, 27 cases showed pale blue retention of MB (-) and also were negative for LI. The rest 20 cases were positive for MB but negative for LI. The sensitivity, specificity, PPV and NPV with double staining technique were 100%.
Conclusion:
The accuracy and reliability of double staining method was superior to MB staining.
Clinical Relevance:
Increased accuracy of double staining method aids in better detection of dysplasia and is of great help to the clinician in deciding the nature of PMD in question.
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Oral health indicators of oral health related quality of life among Indian elderly: A cross-sectional study
p. 316
Charu Mohan Marya, Harpreet Singh Grover, Shourya Tandon, Anil Gupta, Ruchi Nagpal, Pratibha Taneja
DOI
:10.4103/ijdr.IJDR_81_19
Aim:
To assess the impact of tooth loss and periodontal status on oral health related quality of life among Indian elderly.
Methodology:
This study was a cross-sectional study conducted among 1200 elderly subjects of Faridabad district of Haryana. Study subjects were selected by a combination of systematic, cluster and multistage sampling techniques. The data were collected through a clinical oral examination for tooth loss and periodontal status assessment (WHO Oral Health Survey 2013) and a self-administered questionnaire to assess the OHRQoL. Dental behaviours such as dental visiting patterns, tobacco chewing habits and oral hygiene practices were also recorded.
Results:
In bivariate analysis significant associations were found among age, gender, education, tooth mobility and Oral health related quality of life (OHRQoL). Multivariate logistic regression showed significant impact of number of missing teeth and mobility on OHRQoL (
P
< 0.05).
Conclusion:
The conclusions derived from this study are of considerable importance for Indian policy makers in their work with planning and implementing public oral health strategies for geriatric population.
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Evaluation of accuracy of fit in cast metal post fabricated with direct and indirect techniques using micro-CT - An
in vitro
study
p. 323
Sujana Antony, Kondas Vijay Venkatesh, Dhanasekaran Sihi Vahanaan
DOI
:10.4103/ijdr.IJDR_399_19
Context:
Accuracy of fit of cast metal posts fabricated with direct and indirect techniques.
Aims:
To evaluate the accuracy of fit of cast metal posts fabricated with direct and indirect techniques using micro-CT.
Materials and Methods:
Sixty extracted human maxillary central incisors were used. The teeth were decoronated leaving 2 mm at the cementoenamel junction. Four patterns for each tooth were made including one direct and indirect wax pattern and one direct and indirect resin pattern. In total, 240 patterns and castings were made. Each tooth was scanned using microcomputed tomography (μCT) system with a resolution of 14.5 μm. μCT analyzer Sky scanner software was used to calculate the volume of space between the post and the canals. Statistical analysis used: The student paired
t
-test and unpaired
t
-test were used to determine the significant differences between groups.
Results:
The overall space between the canal walls and posts made with the direct wax and resin technique had an average mean value of 1.10 mm
3
, whereas with the indirect technique resin and wax pattern, the average mean was 1.30 mm
3
which was significant.
Conclusion:
Within the limitations of the study, it was found that the accuracy of fit is better in direct technique using wax pattern.
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Knowledge, attitude and practice of dental practitioners, interns and post-graduate trainees about COVID-19 pandemic in Chennai
p. 330
Chandrasekaran Krithika, Srithi Srinath, R Bharath Marlecha, Chitathoor Sridhar, J Sreedevi, Nadeem Jeddy, AC Vinod Kumar
DOI
:10.4103/ijdr.IJDR_436_20
Background:
Coronavirus disease-2019
(
COVID-19) pandemic has been sweeping around the globe and the cases have been reported in India since the second week of March, with Chennai being one of the most affected cities. Healthcare professionals, particularly the dental personnel have a higher risk of infection due to close face-to-face contact and the risk of inhalation of aerosolised particles.
Aim:
The aim of this study was to assess the knowledge, attitude and practice about COVID-19 among interns, post-graduate trainees and dental practitioners.
Material and Methods:
A cross-sectional survey was conducted using Google forms among three groups: interns, post-graduate trainees and dental practitioners. Data obtained was analysed by Chi-square test, Kruskal–Wallis and
post hoc
test using SPSS IBM software.
Results:
Of total score of 9 for knowledge-based questions, the score obtained by interns, post-graduate trainees and practitioners were 7.2, 7.2 and 7.5, respectively, with no statistically significant difference among the groups (
P
= 0.24). Of total score of 4 for attitude-based questions, the score obtained by interns, post-graduate trainees and practitioners were 1.6, 2.0, and 1.9, respectively, with statistically significant difference among the groups (0.009). Of total score of 7 for practice-based questions, the score obtained by interns, post-graduate trainees and practitioners were 3.2, 3.3, and 3.1, respectively, with no statistically significant difference among them (
P
= 0.63).
Conclusion:
Though the knowledge about COVID-19 appeared adequate, the attitude and practice component needs improvement. Continuing dental education programs and webinars can be conducted to update the dental professionals about the protocols to be followed during COVID-19 pandemic.
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Awareness and preparedness of dentists at handling medical emergencies in Delhi-National Capital Region – A cross-sectional survey
p. 336
Pooja Dudeja, Manisha Lakhanpal Sharma, Dhirendra Srivastava, Krishan Kumar Dudeja, Vinita Dahiya, Deepak Passi
DOI
:10.4103/ijdr.IJDR_347_19
Context:
A medical emergency (ME) may come as a surprise during our busy appointment schedules. Whether or not the office has prepared for this emergency generally decides how it will turn out.
Aim:
This cross-sectional survey aimed to evaluate the awareness and preparedness of dentists at handling MEs in a dental office.
Settings and Design:
The study was conducted over three months (December 2015 – February 2016) at two dental colleges of Delhi-National Capital Region (NCR). Materials and
Methods:
The total number of participants was 384, which were divided into four groups of ninety-six participants each,
i.e.,
Group 1 (Interns); Group 2 (Academicians); Group 3 (Postgraduate students (PG)) and Group 4 (Private practitioners (PP)).
Statistical Analysis:
The collected data was analysed on the Statistical Package for Social Sciences (SPSS) version 20 and subjected to ANOVA and Posthoc Bonferroni tests.
Results:
Academicians were found to have the maximum awareness about MEs occurring in the dental office, while, interns had the minimum preparedness for the same and their difference with the other groups was statistically significant (
P
< 0.05).
Conclusion:
A huge gap exists between the awareness and preparedness of dentists at managing MEs. Sound knowledge of essential drugs reinforced by regular practical training, mock drills and properly equipped dental offices is the need of the hour.
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ORIGINAL RESEARCH: PROSPECTIVE STUDY
Facio-odontometric analysis in mass disaster victim identification - A novel approach
p. 343
Rajkumari Sriraman, Monica Dev
DOI
:10.4103/ijdr.ijdr_266_21
Introduction:
Forensic dentistry is an evolving field in legal medicine. In mass disasters, the co-mingled body parts can be misplaced; however, the intervention by dental experts can efficiently sort out the dispute. Understanding the fact that, rule of phi applies to all that exists in nature, in the present study, we aimed to correlate the Total Maxillary Arch Perimeter with the Total Body Height of an individual in cases scenarios where only the skull along with maxilla is the only leftover remains of the unidentified.
Material and Methods:
An observational study was designed involving ninety subjects comprising 45 males and 45 females of age 25 to 30 years for the following parameters.
Total Body Height (TBH)
was measured in centimetres using anthropometric rod.
Total Facial Height (TFH)
was then measured from nasion to gnathion using digital vernier caliper.
Total Maxillary Arch Perimeter (TMAP)
was measured from the maxillary arch model cast using digital vernier caliper.
Results:
The Total Maxillary Arch perimeter has significant positive correlation with Total Body Height as well as Total Facial Height of an individual. The regression equation was positively established for the prediction of Total Body Height from the known Total Maxillary Arch Perimeter as Total Body Height = 80.91762 + 0.718777 (Total Maxillary Arch Perimeter).
Conclusion:
The Total Maxillary Arch Perimeter can be used as a predictive tool in estimating the Total Body Height of the individual where the skeletal remains of the skull along with maxilla is only present.
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ORIGINAL RESEARCH: COMPARATIVE STUDY
Comparing marginal microleakage in Class V cavities restored with flowable composite and Cention-N using confocal microscope-an
in-vitro
study
p. 348
Pratima R Shenoi, Vandana B Kokane, Himani V Thawale, Rajesh R Kubde, Mohit K Gunwal, Shriya P Shahu
DOI
:10.4103/ijdr.IJDR_90_20
Context:
Class V cavity presents a clinical challenge in the field of restorative dentistry as the margin placement is partially in enamel and partly in cementum, and the trouble associated with this design is the microleakage at the tooth restoration interface.
Aims:
To evaluate and compare marginal microleakage in Class V cavities when restored with flowable composite and Cention-N restorative material.
Methods and Material:
This
in-vitro
study was performed on 30 human maxillary premolars, which were extracted for orthodontic reasons. Class V cavities were prepared on the buccal surfaces of each tooth. After application of seventh-generation bonding agent (3M ESPE, Single Bond Universal Adhesive), the teeth were divided into two groups of 15 each and restored with flowable composite (3M ESPE Filtek Z350 XT) and Cention-N (Ivoclar Vivadent) and were subjected to thermocycling. The teeth were then immersed in 0.1% Rhodamine B dye for 48 h. They were sectioned longitudinally into mesial and distal parts with the help of an isomet diamond saw. The sections were observed under a confocal laser scanning microscope (CLSM).
Statistical Analysis Used:
The results were subjected to statistical analysis using the Mann–Whitney U test and Pearson's Chi-square test.
Results:
The analysis showed statistically significant results among the groups. Cention-N showed lesser microleakage, which was statistically significant when compared to flowable composite (
P
= 0.005).
Conclusions:
Cention-N showed significantly lesser leakage and better adaptation than flowable composite.
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Comparative evaluation of audio-visual and verbal education method on OHRQoL, dental anxiety, dental neglect of diabetes mellitus patients attending a teaching hospital in India
p. 354
Ankita Jain, Pradeep Tangade, Vikas Singh, Priyanka Yadav, Jagriti Yadav
DOI
:10.4103/ijdr.ijdr_822_21
Aim:
The aim of this study was to compare audio-visual and verbal education on oral health related quality of life, dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad.
Materials and Method:
The current longitudinal interventional study was conducted to check the efficiency of audio-visual and verbal education on OHRQoL, Dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad, U.P., India. A 14-item questionnaire, OHIP-14, with emphasis on seven proportions of impact was used to collect information on OHRQoL. Corah Dental Anxiety Scale (DAS) will be used to collect data on Dental Anxiety. A prevalidated revised proforma of Dental Neglect Scale (DNS) was used to gather information on Dental Neglect. The questionnaire was a six-question instrument related to dental problems. After collecting the initial baseline data, the sample was divided into two groups: verbal education group (
n =
1030) and audio-visual education group (
n =
1030). Then oral health education (OHE) was provided verbally to Group I patients and OHE with audio-visual aids was given to Group II patients visiting Teerthanker Mahaveer Hospital. OHE was repeated every 2 months. At every 6, 12 and 18 months, questionnaire was repeated to evaluate the effectiveness of OHE. Inspection will be conducted under natural daylight in hospital premises. To avoid the disruption while conducting the examination, adequate supply of instruments was taken. Instruments were sterilized by autoclaving in the college.
Results:
A total of 1926 patients attended all the follow-up and review examinations. Subject dropout for Group I was 2% with 1009 at 6
th
month; 3% with 978 at 12
th
month and 1% with 967 at 18
th
month. Subject dropout rate for Group II was 3% with 999 at 6
th
month; 0% with 999 at 12
th
month and 4% with 959 at 18
th
month. The difference of subject dropout among the groups was not statistically significant (
P =
0.23). Group mean total OHIP-14 score after 18 months was recorded as 15.36 ± 8.61, whereas in Audio-visual education group mean total OHIP-14 score after 18 months was recorded as 14.42 ± 7.59. At the end of study mean DAS score for DAS ≥15 (severe anxiety) was found to be 1.95 ± 2.18 in verbal education group, whereas in audio-visual education group mean DAS score for DAS ≥15 (severe anxiety) was found to be 2.24 ± 1.98. At the end of the study mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 3.54 ± 2.63 in verbal education group, whereas audiovisual education group mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 2.59 ± 2.75.
Conclusion:
The quality of life is a factor that can be considerably affected by oral health, which in turn reflects the general health of an individual. The main part of oral disease prevention is done by use of personal oral hygiene measures and maintaining oral hygiene. It is the duty of dental professionals to motivate, show and instruct patients to maintain appropriate oral health and oral hygiene. The study concludes that the program of this kind may be beneficial in improving many dimensions of dental health of an individual that includes physical health, emotional well-being, OHRQoL, inter-personal relationship and the fear related to dental treatment.
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Resin infiltration and remineralization interventions in management of moderate dental fluorosis: A quantitative light-induced fluorescence-based randomized controlled trial
p. 362
Shreepriya Singhania, B Nandlal, Raghavendra Shanbhog, Ragavee Veeramani
DOI
:10.4103/ijdr.IJDR_998_20
Context:
Aesthetic concerns due to dental fluorosis (DF) considerably impact pyschosocial health in young children and requires aesthetic microinvasive treatment.
Aims:
The aim of this study was to use quantitative light-induced fluorescence to evaluate two intervention protocols: microabrasion with resin infiltration and microabrasion with remineralization and assess which brings about more fluorescence gain; better colour masking and greater patient satisfaction among subjects with dental fluorosis.
Methods and Material:
120 maxillary central incisors with Grade 3 DF (Dean's Fluorosis Index) were randomly distributed into four groups:
I
-microabrasion + resin infiltration (fluorosis with stains);
II-
microabrasion + remineralization (fluorosis with stains);
III
-microabrasion + resin infiltration (fluorosis without stains);
IV-
microabrasion + remineralization (fluorosis without stains). At baseline, post-microabrasion and post-intervention Quantitative light-induced fluorescent images were captured. Fluorescence gain (ΔF) was analysed from the blue light images. The white light images were used to evaluate post intervention colour difference (ΔE = [(ΔL*) 2+(Δa*) 2+(Δb*) 2]1/2) and child satisfaction was evaluated.
Statistical Analysis Used:
Collected data was analysed using repeated measures ANOVA and Independent
t
-test.
Results:
Intra-group comparison of ΔF values showed statistically significant improvement in ΔF value in all the four groups (
P
< 0.001, 0.002). Inter-group comparison of ΔF values based on intervention showed statistically significant fluorescence gain (
P
< 0.004) indicating resin infiltration intervention being better than remineralization in unstained grade III fluorosis. The colour difference was statistically significantly better with resin infiltration in both stained and unstained Grade III DF (
P
< 0.001).
Conclusions:
Resin infiltration intervention showed better fluorescence gain and colour masking compared to remineralization intervention.
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Comparative efficacy of different varieties of toothbrushes in plaque control: A 12-week clinical trial
p. 372
Ajit K Prusty, Shivani Sharma, Sumit Malhotra
DOI
:10.4103/ijdr.IJDR_179_20
Aim:
The aim of this 12 week, single-blind clinical trial was to compare the efficacy of Manual (Oral-B Pro Health Gum care
®
), Powered (Oral-B Cross action Power Dual
®
) and Charcoal (Colgate slim Soft Charcoal
®
) toothbrushes in plaque control.
Materials and Methods:
60 systemically healthy students were selected at random among the students of a Dental College, living under similar environment and dietary conditions. Plaque and calculus were removed professionally and three varieties of toothbrush were distributed among them. Plaque index (PI), sulcus bleeding index (SBI) and gingival index (GI) were assessed at baseline, 3, 6 and 12 weeks. Assessment of colony forming units (CFU) was done at baseline and 12
th
week. The learning effect over a period of time was also assessed.
Results:
Over the 12-week period, PI reduced significantly (
P
< 0.001) with % reduction in plaque from 47% to 59%, 41% to 53% and 45% to 55% for manual, powered and charcoal brush. A significant reduction in GI and SBI was also seen with all the brushes. An insignificant difference in PI, GI and SBI was seen between the brushes. CFU count before and after brushing reduced gradually and statistically significantly (
P
< 0.001) for all the brushes; however, by end of 12
th
week period, there was no significant difference (
P
> 0.05). The learning effect increased from 35% to 60%, 24% to 56% and 31% to 58% for three brushes, respectively, but was more pronounced for powered brush.
Conclusion:
It can be concluded that all the three brushes (manual, powered and charcoal) are clinically effective in removing plaque, with learning effect more pronounced for powered brush and if proper technique is followed, no brush is superior to the other.
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ORIGINAL RESEARCH: IN VITRO STUDY
Estimation of IZOD impact strength between different concentrations of chitosan-reinforced denture base resins
p. 380
N Gopi Chander, Venkatraman Jayaraman
DOI
:10.4103/ijdr.ijdr_71_21
Background:
Poly-methyl methacrylate (PMMA) is an universally acceptable denture base material. Efforts are made to increase the applications with the addition of new constituents. Chitosan has established antifungal properties. The mechanical properties of Chitosan–denture base composite is less evaluated in the literature. This study estimates the differences in impact strength of material for different concentrations of chitosan-reinforced denture base resins.
Aim:
The study estimated the differences in IZOD impact strength of denture base resin reinforced with 0%, 5%, 10% and 15% of chitosan by weight.
Materials and Methods:
The acrylic samples were fabricated in according to ISO 180 regulations. The study had four test groups (n = 10). ACh0 was the control group with no reinforcements. ACh5, ACh10 and ACh15 had chitosan reinforcement of 5%, 10% and 15% by weight. The samples were processed by conventional heat polymerization cycle and tested in IZOD impact testing machine. The data were recorded and statistically analyzed with Kruskal–Wallis test.
Results:
The mean impact strength was high in ACh5 (4.25 ± 1.05 kJ/m
2
) compared to ACh0 (2.88 ± 0.60 kJ/m
2
), ACh10 (3.63 ± 0.40 kJ/m
2
), ACh15 (3.38±0.60 KJ/m
2
). Statistically significant differences between the test groups was determined by Kruskal–Wallis and
post hoc
Bonferroni test (Chi-square = 12.843,
P
= .005, df = 3).
Conclusion:
The impact strength of denture base resin increased with 5% chitosan compared with other percentage of chitosan. No statistical significant relationship was observed between the groups.
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Effect of nano-hydroxyapatite with biomimetic analogues on the characteristics of partially demineralised dentin: An
in-vitro
study
p. 385
Sharanya Nambiar, Mohini Kumari, Sylvia Mathew, Swaroop Hegde, Poornima Ramesh, Nithin Shetty
DOI
:10.4103/ijdr.IJDR_705_19
Background:
Research on dentin remineralisation protocols in particular 'biomimetic remineralisation' has gained huge momentum. Aim of this study was to evaluate if biomimetic analogs, incorporated in n-HAp, as an experimental formulation could aid in remineralization of artificial caries-like dentin and have anti-microbial effect on cariogenic bacteria, S mutans.
Materials and Methodology:
An experimental paste was formulated using nano-hydroxyapatite (nHAp) with Non-Collagenous Protein analogs- polyacrylic acid (PAA), sodium tri-poly phosphate (STPP) with Simulated Body Fluid. Partially demineralised dentin specimens were divided into three groups (
n
=10) based on the remineralisation treatment as, Group A- n-HAp paste, Group B- n-HAp and NCP analogues and Group C (Control) - no treatment. At the end of the experimental period, the specimens were assessed using SEM-EDS analysis and Vickers microhardness testing. Further, the antimicrobial efficacy of the paste was assessed.
Statistical Analysis:
The results were statistically analyzed using ANOVA with post-hoc Bonferroni test.
Results:
Dentin specimens treated with the experimental paste revealed greater tubular occlusion, with intra tubular deposits and increased mineral content. Specimens treated with n-HAp alone had higher microhardness values and inhibitory effect on the cariogenic bacteria.
Conclusion:
Non-Collagenous Protein analogs incorporated in n-HAp could remineralize the demineralised dentin and had antibacterial efficacy against S mutans.
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Efficacy of passive ultrasonic irrigation in the removal of three different intracanal medicaments - An
in-vitro
study
p. 390
Gangaraju Shakapuram, Mayuri Sailaja Pachalla, Anand Ramtheerth Karne, Sandeep Shiva, J Deepa, Supriya Kommineni
DOI
:10.4103/ijdr.IJDR_915_19
Background:
A successful root canal treatment involves the elimination of microorganisms, and prevents them from reinfecting the root and/or peri-radicular tissues. This can be mainly achieved by efficient cleaning and shaping of the root canal system. Due to the complexity of the root canal morphology, hand and rotary files cannot clean areas such as the isthmuses and lateral canals. In such cases, effective irrigation and the use of intracanal medicaments are essential. Medicaments that are applied should be removed before obturation.
Aim:
To evaluate the efficacy of passive ultrasonic irrigation in the removal of three different intracanal medicaments – Triple antibiotic paste (TAP), Odontopaste, and Metapex using a stereomicroscope.
Methodology:
A total of 45 single-rooted human teeth were selected and decoronated. The root canals were shaped with ProTaper rotary files. The specimens were fixed in modified Eppendorf vials with silicone material. The roots were split longitudinally, and a standardized groove was prepared in the apical part. The teeth were randomly divided into three groups each containing 15 samples based on the intracanal medicament used: TAP, Odontopaste, and Metapex
.
The root halves were reassembled with sticky wax and remounted in the Eppendorf vial. Each specimen was irrigated with 3% NaOCl and agitated using a passive ultrasonic device. The root segments were disassembled. Digital images were obtained using a stereomicroscope.
Results:
The data were evaluated statistically using Kruskal–Wallis and Mann–Whitney U tests. There was a statistically significant difference in the remaining intracanal medicament score (
P
< 0.05).
Conclusion:
Odontopaste showed the least remaining amount score, whereas TAP and Metapex showed greater retention within the dentin.
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Comparative evaluation of shear bond strength of two adhesive materials on demineralized dentin treated with silver diamine fluoride: An
in-vitro
study
p. 395
J Baby John, Pradeep D Gainneos, Basil M Mathew, C Bharath, Vinola Duraisamy
DOI
:10.4103/ijdr.ijdr_724_21
Context:
Early childhood caries (ECC) is one of the most common diseases in the children of developing countries, affecting their oral health-related quality of life. From an economic perspective, silver diamine fluoride (SDF) can limit the progression of active carious lesions.
Aims:
To estimate and compare the loss of shear bond strength among two adhesive materials on SDF-treated demineralized primary teeth dentin.
Settings and Design:
Laboratory setting and
in-vitro
study design.
Methods and Material:
For the
in-vitro
study, 40 primary teeth indicated for extraction were selected. The demineralization solution was 5% nitric acid. The samples were divided into four groups, Group 1 – GIC Type IX, Group 2 – Self-etch (SE) adhesive + G-Aenial Universal Flo, Group 3 – SDF + GIC Type IX, and Group 4 – SDF + SE adhesive + G-Aenial Universal Flo.
Statistical Analysis Used:
Descriptive analysis and analysis of variance with Tukey's Post hoc test.
Results:
The shear bond strength of GC G-Aenial Universal Flo (18.8165 ± 13.0448 MPa) found to be superior to GIC (5.7845 ± 1.8968 MPa). However, bond strength was significantly reduced with GC G-Aenial Universal Flo (34.0441 ± 14.1949/18.8165 ± 13.0448 MPa) compared to GIC (7.7956 ± 2.2804/5.7845 ± 1.8968 MPa) following the application of SDF.
Conclusions:
It was concluded that SE adhesive + GC G-Aenial Universal Flo is the material with better shear bond strength compared to GIC Type IX with and without SDF. Considering the severity and prevalence of ECC, socioeconomic strata of Indian population, the choice of material for masking the discoloration, and prevention of disease, GIC can be suggested as an alternative over GC G-Aenial Universal Flo.
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SYSTEMATIC REVIEW AND META-ANALYSIS
Systematic review on the genetic factors associated with skeletal Class II malocclusion
p. 399
Ashwin M George, A Sumathi Felicita, SD Milling Tania, J Vijayashree Priyadharsini
DOI
:10.4103/ijdr.IJDR_59_20
Aim:
The aim of this study is to review studies evaluating the role of genetics in skeletal class II malocclusion.
Objective:
To assess the scientific evidence associating the role of genes in skeletal class II malocclusion. Materials and Methods: A complete search across the electronic database through PubMed, Cochrane, LILACS, BMC and manual hand search of orthodontic journals were done till May 2019. The keywords for the search included: “Genetics”, “class II malocclusion”, “maxillary prognathism”, “mandibular retrognathism”.
Data Collection and Analysis:
Studies were selected based on PRISMA guidelines.
Results:
Articles were selected based on the inclusion and exclusion criteria. A total of 11 cross-sectional studies satisfied the inclusion criteria and were analyzed for the role of genes in skeletal class II malocclusion. Almost all the studies except for one revealed a positive correlation of genes with skeletal class II malocclusion.
Conclusions:
Out of the 11 studies included, a positive correlation of the genes with the skeletal II malocclusion was found in 10 studies. Genes FGFR2, MSX1, MATN1, MYOH1, ACTN3, GHR, KAT6B, HDAC4, AJUBA were found to be positively linked to skeletal class II malocclusion.
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CASE REPORTS
Basal cell carcinoma: Histopathological gamut
p. 407
Preeti Sharma, Vijay Wadhwan, Vishal Bansal
DOI
:10.4103/ijdr.IJDR_227_19
Introduction:
Basal cell carcinoma is the most common cutaneous malignancy which is exclusively observed on sun exposed and hair bearing areas of the face.
Diagnosis:
We report two rare cases of basal cell carcinoma, which presented as a diagnostic challenge because of rare histopathology.
Findings:
Both cases showed pigmentation, while one case resembled adenoid cystic carcinoma because of the glandular and ductal pattern of basaloid cells.
Result:
We present these cases because of rare histopathologic presentation.
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Recurrent ossifying fibroma of the orbit – A case report
p. 411
SM Balaji, Preetha Balaji
DOI
:10.4103/ijdr.ijdr_1008_21
Rationale:
Ossifying fibromas are mainly found in the jaws and are rare in other parts of the cranium. Orbital involvement is relatively rare.
Patient Details:
A case of an otherwise healthy 38-year-old overseas patient with gradual onset of a large growth in the right ocular area involving adjacent bone and operated twice over the last eight years is being presented. The lesion is involving the entire medial wall.
Treatment:
Considering the complex loco-regional anatomy as well as the restriction of overseas residence, preservation of a thin margin of bone was performed.
Take-Away Lessons:
The need for repeat radiological surveillance was stressed.
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© 2007 - Indian Journal of Dental Research | Published by Wolters Kluwer -
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Online since 25
th
January, 2007