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   Table of Contents - Current issue
May-June 2017
Volume 7 | Issue 3
Page Nos. 71-146

Online since Monday, May 22, 2017

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Nonthermal plasma in dentistry: An update p. 71
Rajeev Ranjan, PV Krishnamraju, Thatapudi Shankar, Snigdha Gowd
The recent enormous progress in understanding of plasma physics and development of plasma jet has attracted focus on the application of plasma in medicine and dentistry. Active plasma ions, electrons, and photons have the ability to activate and control various biochemical procedures. Nonthermal plasma (NTP) is widely used for various therapeutic applications in health care. Particularly in dentistry, NTP holds big potential such as for bacterial inactivation, efficient sterilization, and treatment of dental caries. This review intends to provide information on potential NTP applications in dentistry.
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Evaluation of periodontal status and treatment needs of institutionalized intellectually disabled individuals in Lebanon p. 76
Hicham A Diab, Ghassan N Hamadeh, Fouad Ayoub
Aims and Objectives: No reported data is available on the periodontal health and treatment needs of the intellectually disabled in Lebanon. To evaluate the periodontal condition and treatment needs of institutionalized intellectually disabled individuals in Lebanon. Materials and Methods: A total of 272 individuals (141 males and 131 females) aged 15 years and 35–44 years were examined. Periodontal health was recorded following the community periodontal index of treatment needs (CPITN), and treatment need was assigned accordingly. The IBM® SPSS® statistics 20.0 and Stata/SE 11.1 statistical packages were used to carry out all statistical analyses. Statistical analysis was performed using linear regression (P ≤ 0.05). Results: Healthy periodontium was recorded in 26.1%, bleeding on probing in 27.9%, supra-/sub-gingival calculus in 31.3%, pockets of 4–5 mm in 11% and ≥6 mm in 3.7%. The largest proportion of the sample was in need for oral hygiene instruction and calculus removal (42.3%). Age, geographical location, consumption of carbohydrate-rich meals and sweets between meals were significantly associated with CPITN score severity in multivariate analysis (P < 0.05). Gender, severity of disability, frequency of tooth brushing, and caretaker characteristics were not significant predictors of CPITN (P > 0.05). Conclusion: The predominantly poor periodontal health and social inequalities warrant nationwide preventive oral health programs in addition to planning the provision of treatment services to meet existing treatment needs.
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Cross-cultural validation of the scale of oral health-related outcomes for 5-year-old-children with a low-income sample from the dominican republic p. 84
Ninoska Abreu-Placeres, Luis Edgardo Garrido, Leandro Edgardo Féliz-Matos
Aims and Objectives: To conduct a thorough psychometric assessment and validation of a Spanish-adapted version of the Scale of Oral Health-Related Outcomes for 5-Year-Old-Children (SOHO-5). Materials and Methods: The sample consisted of 69 children aged 6 and 7 years attending a public school from a low-income community in the Dominican Republic. Outcomes consisted of SOHO-5 test scores and caries lesion severity scores, with the latter measured according to the International Caries Detection and Assessment System criteria. The IBM SPSS Statistics 20 and Mplus 7.4 programs were used for the statistical analyses. Results: A confirmatory factor analysis revealed an excellent fit for the theoretical one-factor structure of the SOHO-5, with all the items having high loadings on this latent factor. In addition, the SOHO-5 was able to significantly explain a large amount of variance (37%) in caries lesion severity (P < 0.001), while its scale scores had good internal consistency reliability (Cronbach's alpha [α] = 0.85, 95% confidence interval [CI] 0.79–0.90). Further, the SOHO-5 could identify children with moderate and extensive caries lesions (area under the receiver operating characteristic curve = 0.82, 95% CI 0.70–0.94, P < 0.001). Conclusions: The current findings highlight the good psychometric properties and criterion-related validity of the Spanish-adapted SOHO-5 for young children who come from impoverished backgrounds.
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Dental and skeletal age estimations in Lebanese children: A retrospective cross-sectional study p. 90
Antoine Saadé, Pascal Baron, Ziad Noujeim, Dany Azar
Aims and Objectives: Assessing dental and bone ages is frequently required in a wide range of fields such as odontology, forensic science, as well as orthopedics. The aim of this study was to evaluate applicability of two methods of bone age assessment and two methods of dental age (DA) assessment for Lebanese children. Materials and Methods: Skeletal age (SA) of 260 orthodontic patients (124 males, 136 females divided into four groups each) was consecutively assessed using Greulich and Pyle and Fishman's SMI methods. DA was evaluated using both Demirjian's and Willem's methods. Mean age was 11.89 ± 1.38 years for males and 11.75 ± 1.58 years for females. Data were collected and statistically analyzed using the SPSS software (IBM SPSS Statistics, version 21, USA). The differences between estimated DA, estimated SA, and chronological age (CA) were compared by gender and age group. Results: Greulich and Pyle method showed nonsignificant difference with CA in male sample, while in both assessment methods, the difference between skeletal and CAs is significant in female sample. Results of Willem's method in the whole sample suggested a statistically nonsignificant difference, when compared to CA. Demirjian's method delivered higher mean value than Willem's assessment in both genders. Conclusions: Greulich and Pyle method is accurate for SA assessment in males and only in one group of females, while it significantly overestimates age in all other female groups. Willem's method is more suitable to assess DA in both genders. A strong correlation exists between both dental and skeletal assessment methods and CA.
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Temporomandibular joint pain: Clinical presentations and response to conservative treatments in a nigerian tertiary hospital p. 98
Elijah Olufemi Oyetola, Olufunlola Motunrayo Adesina, Adeniyi Oluwadaisi, Adedotun Adewale, Opeyemi Adewole, E Anizoba
Aims and Objectives: The aims of this study are to determine the prevalence, pattern of presentation, and response to conservative (medical) interventions among patients who presented with temporomandibular joint (TMJ) pain in a Nigerian teaching hospital. Material and Methods: Consecutive patients who presented in Oral Medicine and Periodontology Clinic of Obafemi Awolowo University Teaching Hospitals' Complex on account of TMJ pain from January 2015 to December 2015 were recruited for the study. They were all interviewed and examined. The severity of pain was recorded using visual analog scale (VAS). Patients were treated with medications and physiotherapy. They were reviewed at 2, 4, and 6 weeks. Those who could not make the appointment were contacted through phone. The findings were recorded and analyzed using STATA version 11. Results: A total of 401 participants were seen, 55 presented on account of TMJ pain. The mean age of patients with TMJ pain was 54 ± 16.9 with 60% being female. Pain was present in all participants; other signs include clicking joint sound (85%), jaw deviation (64%), attrition (24%), and reduced mouth opening (23%). The left joint was more frequently affected (75%). Following 6 weeks of conservative treatments, none of the respondents had VAS score of more than 3. Conclusion: The prevalence of TMJ pain was 13%. TMJ was found to be more common in participants above 50 years with female predilection. Pain was most common symptom seen, and response to conservative treatments as assessed using VAS following 6-week of treatment showed complete remission of the pain.
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Evaluation of surface roughness of different direct resin-based composites p. 104
Nashaat Mohammed Magdy, Mohammed Zaheer Kola, Hamod Hussain Alqahtani, Mubarak Daghash Alqahtani, Abdullah Saud Alghmlas
Aims and Objective: To evaluate surface roughness of different resin-based composites. Materials and Methods: Three resin composites, one nanohybrid, one nanoceramic, and one bulk-fill resin-based composite, were used in this study. Cylindrical Teflon mold and 8 mm in diameter and 2 mm in thickness disc specimens were prepared. For each composite material, 15 discs were fabricated, with a total of sixty discs were obtained (n = 60). A glass slide 1–2 mm thick was placed over the strip before curing with the light-curing unit to flatten the surfaces. The specimens were then cured for 40 s through the Mylar strip and the glass slide. Five specimens per each material received no finishing treatment after being cured under Mylar strips; these specimens served as a control. Ten specimens from each composite material were finished/polished with Eve discs at coarse, medium, fine, and superfine grits for 30 s (using stopwatch) each on the specimens. After polishing, the composite surfaces were assessed quantitatively by profilometry and qualitatively by scanning electron microscopy. Data were analyzed using SPSS software. Results: Tetric Evo Ceram and Tetric Evo Ceram Bulk-Fill specimens polished with Eve revealed slightly the same surface appearance as the Mylar strip. Eve discs scratched and exposed fillers of Ceram-x. Eve discs for Z250 surfaces exposed and scratched the filler particles but less than occurred with Ceram-x. Conclusion: Bulk-Fill and nanohybrid resin composites exhibit smoothest surfaces compared with nanoceramic and microhybrid resin composites after polishing.
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Comparison of the effectiveness of a mobile phone-based education program in educating mothers as oral health providers in two regions of Saudi Arabia p. 110
Saleh Ali AlKlayb, Mansour K Assery, AlJohara AlQahtani, Madawy AlAnazi, Sharat Chandra Pani
Aims and Objectives: The penetration of mobile phone devices is widespread across the Kingdom of Saudi Arabia. Recently, there has been evidence of the success of phone-based applications in the provision of preventive oral health care to children and their parents. The aim of this study was to compare the effectiveness of a mobile phone-based application in educating mothers of children aged below 6 years of age in preventive dental care. Materials and Methods: A mobile phone-based application (iTeethey™) was developed for iPhone and Android and made freely available on Google Play and App Store. The application was then distributed to 3879 mothers of children below 6 years of age (1989 in Riyadh Region and 1890 in Najran region). The mothers were subjected to a standardized knowledge attitude and practice of oral hygiene questionnaire before being asked to download the application. A total of 1055 mothers who downloaded the application completed 3-month recall process. Results: Significant improvement in the knowledge of the mothers was reported after the use of the application from both regions. The mothers from Najran showed significantly greater improvement in knowledge when compared to the mothers from Riyadh region. The application was also more effective in mothers with more than one child when compared to first-time mothers. Conclusion: Within the limitations of this study, we can state that the mobile phone application used in this study significantly improves the knowledge of mothers toward their child's oral health.
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Clinicopathological profile and malignant transformation in oral lichen planus: A retrospective study p. 116
Alokenath Bandyopadhyay, Shyam Sundar Behura, Roquaiya Nishat, Kailash Chandra Dash, Lipsa Bhuyan, Sujatha Ramachandra
Objectives: The aim of this study was to analyze the histopathologically diagnosed cases of oral lichen planus (OLP) in terms of age, gender, clinical variant, site, hyperpigmentation, systemic illness, grade of dysplasia, and associated malignant transformation. This study also intended to do a review of reported cases of OLP with malignant transformation. Materials and Methods: One hundred and forty-three cases of histopathologically diagnosed OLP between 2010 and 2016 were retrospectively reviewed. Demographic and clinicopathological data including malignant transformation were obtained. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software for Windows version 20.0 (IBM SPSS, SPSS Inc., Chicago, IL, USA). A review of published literature on OLP with malignant transformation was also done from 1988 to 2017 and tabulated. Results: OLP in this study showed a male predilection with most of the patients in the third decade. The buccal mucosa (bilateral presentation) was the most common site (79.72%), and reticular type was the most common clinical type (79.02%) followed by erosive type (20.98%). The majority (92.31%) of cases were diagnosed with OLP without dysplasia. The rest (7.69%) of dysplastic cases were predominantly seen in the buccal mucosa of 58 years and above, female patients manifesting mainly as erosive type. Two patients (1.4%) previously diagnosed clinically and histopathologically as OLP developed oral squamous cell carcinoma. Conclusion: The present investigation revealed the predominance of OLP among middle-aged male population and the prevalence of bilateral involvement of buccal mucosa. Two of our cases showed malignant transformation over an average period of 3.5 years. The outcome of this study emphasizes the role of clinical follow-up of patients with OLP.
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Quantification and measurement of changes in anxiety level in preschool children and their mothers through multiple-visit dental treatment p. 125
Anandamoy Bagchi, Banibrata Lahiri, Md Jalaluddin, Gunjan Kumar, Sanjib Das, Kanika Singh Dhull
Aim: The aims of the present study were to quantify anxiety and find the level of anxiety in the very 1st day of dental treatment and the pattern of change in the following visits and to find possible impact of maternal anxiety during dental treatment of their wards. Materials and Methods: The study was conducted on 297 children aged 3–6 years visiting the Department of Pedodontics and Preventive Dentistry of Dr. R. Ahmed Dental College and Hospital for treatment. In addition, accompanying parents were also included in the study. The blood pressure and heart rate of the participants were recorded at three visits with a digital blood pressure and heart rate monitor with wrist cuff (Omron; Japan). The same instrument and the same procedure were employed for the mothers also. Blood pressures and pulse rates so recorded were tabulated according to age and were made ready for statistical analysis using the SPSS version 12 (Statistical Package for Social Sciences, SPSS Inc., Chicago, Illinosis, USA) software. Results: There was a significant difference in blood pressure and heart rate of children in the subsequent visits. Conclusion: The majority of the children suffered from anxiety on the 1st day of treatment which gradually diminished in the subsequent visits. Maternal anxiety was also highest in the initial visit which gradually came down in the subsequent visits.
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Association between nutritional status and early childhood caries in Indian children p. 131
H V. N Sai Krishna, E Manaswini, Vijay Y Kumar, Pavani Bellamkonda, A.S Kalyana Bhargava, Ramvilas Reddy Jaidupally
Aims and Objectives: To assess the body mass index (BMI) status and to correlate between nutritional status and early childhood caries among 3–6-year-old children in Vikarabad, Telangana, India. Materials and Methods: A cross-sectional study was conducted among 350 children attending the outpatient department of Pedodontia in Sri Sai College of Dental Surgery, Vikarabad. Caries experience was recorded using dmft index (WHO 1997); various anthropometric measures, such as weight, BMI, and height, were recorded as per the standard guidelines. Pearson correlation coefficient and chi square test were used to determine significant differences. Data were analyzed using the statistical analysis software (SPSS version 17.0 Chicago IL, USA) Results: Maximum number of participants (69%) were with normal BMI- for-age followed by underweight, overweight, and obese categories. The mean dmft values for each BMI category among the underweight, normal, overweight, and obese children were 4.9 ± 4.0, 4.6 ± 3.3, 2.7 ± 1.9, and 4.4 ± 3.0, respectively, which was statistically not significant. Conclusion: No significant association was found between dmft and BMI-for-age, rather a negative correlation existed between dmft and BMI-for-age (r = −0.023), which was not statistically significant (P = 0.66).
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Could salivary cyclosporine dosage replace the whole blood cyclosporine measurements in renal transplant patients? p. 136
Samia Aboujaoude, Marwan Masri, Sylvana Rizk, Souleima Chamat, Jad Farha, Zeina Majzoub
Background: Cyclosporin (CsA) has been extensively used as the immunosuppressant of choice in renal transplantation. Currently available approaches to assess CsA levels, both in serum and blood, fail to accurately reflect the concentration of the pharmacologically active drug fraction. Free CsA levels in biological fluids (blood or saliva) have been advocated to play an important role. Traditional salivary CsA monitoring tests are based on available archaic salivary techniques that are nonspecific and require large amounts of saliva. The aim of this study was to assess salivary CsA correlation using a novel and more accurate technique and to correlate with CsA levels in blood. Material and Methods: Patients provided blood samples of 2 ml and 2 ml of unstimulated saliva on the same day 2 h after the morning CsA dose (C2). Whole blood levels of CsA were determined using the monoclonal fluorescent polarization immunoassay (FPIA) kit. The FPIA kit was adapted to salivary testing by using a novel extraction method developed and patented under the name of Middle East Research Institute (MERI). Wilcoxon signed rank test compared the differences in blood and salivary CsA. Pearson's correlation coefficient assessed the linear association between blood and salivary CsA concentrations. All analyses were performed using IBM-SPSS version 23 (IBM Corp, Armonk, NY, USA). Results: No significant correlation was observed between blood and salivary CsA levels. Conclusion: Salivary CsA concentrations at C2cannot adequately replace C2blood levels as an indicator of CsA bioavailability despite improved performance of monoclonal FPIA and application of the MERI technique. More studies may be warranted to design more reliable and less invasive procedures for therapeutic drug monitoring.
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Cytomorphometric analysis on the effects of components of orthodontic appliances on the epithelial cells of the buccal mucosa p. 142
PG Francis, Mathai Thomas, Vincy Antony, Muhammed Shaloob, K Jubin Hassan, Gazanafer Roshan
Aim: The aim of the present study was to evaluate the effect of fixed orthodontic appliances on the epithelial cells of buccal mucosa in patients undergoing orthodontic treatment. Materials and Methods: The study group included 30 healthy patients who were advised orthodontic treatment. Applying sterile cement spatula, scrapping of exfoliated buccal epithelial cells was performed from the middle part of the inner cheeks before starting the orthodontic treatment and at 1st week, 2nd week, 1 month, and 45 days after the treatment, followed by smearing and staining with Papanicolaou stain. Light microscope was used to score micronuclei, and independent two-tailed t-test was used for statistical analysis. Results: Micronuclei were assessed during the various stages of treatment and were recorded accordingly. At 1 week, there was increase in micronuclei number compared to before starting the treatment (day 0) and at 15th day; 30th day showed decrease in number compared to 1 week but increase compared to day 0. The results of day 45 were almost equal to day 0 with a significant P value (P < 0.001). Conclusion: Fixed orthodontic appliances induce increased micronuclei frequency, especially in the first weeks of treatment, however, these genotoxic effects tend to approach baseline levels in later period.
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