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   2016| March-April  | Volume 6 | Issue 2  
    Online since March 15, 2016

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Medication-related osteonecrosis of the jaw: Clinical and practical guidelines
Daniele Rosella, Piero Papi, Rita Giardino, Emauele Cicalini, Luca Piccoli, Giorgio Pompa
March-April 2016, 6(2):97-104
Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction, consisting of progressive bone destruction in the maxillofacial region of patients. ONJ can be caused by two pharmacological agents: Antiresorptive (including bisphosphonates (BPs) and receptor activator of nuclear factor kappa-B ligand inhibitors) and antiangiogenic. MRONJ pathophysiology is not completely elucidated. There are several suggested hypothesis that could explain its unique localization to the jaws: Inflammation or infection, microtrauma, altered bone remodeling or over suppression of bone resorption, angiogenesis inhibition, soft tissue BPs toxicity, peculiar biofilm of the oral cavity, terminal vascularization of the mandible, suppression of immunity, or Vitamin D deficiency. Dental screening and adequate treatment are fundamental to reduce the risk of osteonecrosis in patients under antiresorptive or antiangiogenic therapy, or before initiating the administration. The treatment of MRONJ is generally difficult and the optimal therapy strategy is still to be established. For this reason, prevention is even more important. It is suggested that a multidisciplinary team approach including a dentist, an oncologist, and a maxillofacial surgeon to evaluate and decide the best therapy for the patient. The choice between a conservative treatment and surgery is not easy, and it should be made on a case by case basis. However, the initial approach should be as conservative as possible. The most important goals of treatment for patients with established MRONJ are primarily the control of infection, bone necrosis progression, and pain. The aim of this paper is to represent the current knowledge about MRONJ, its preventive measures and management strategies.
  36 5,582 486
Diabetes an inducing factor for dental caries: A case control analysis in Jammu
Iqbal Singh, Paramjeet Singh, Amarpreet Singh, Tara Singh, Robindera Kour
March-April 2016, 6(2):125-129
Objective: Diabetes mellitus (DM) is a common chronic disease and it has emerged as a major health-care problem. There are more chances of dentinal caries among diabetics than nondiabetics. DM is responsible for causing ascendancy in the proportion and activity of saliva that impacts the oral health. The objective of the present study is to evaluate the impact of various factors present in saliva on tooth decay amid type-II DM in Jammu.Materials and Methods: The subjects in our analysis comprises of 50 patients with type-II DM and 50 controls within the age group of 30–60 years. Diabetic status was assessed by estimating random blood glucose levels. Dental findings were recorded using modified World Health Organization (WHO) Oral health survey-basic method 2013. Salivary samples from all the subjects were collected and sent to the laboratory for interpretation of pH, flow rate, and salivary calcium. The analysis of salivary components decayed tooth was carried using analysis of variance (ANOVA) and Pearson's correlation test. All the parameters were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: The results have shown a significantly lower values of salivary pH, flow rate, and calcium levels in diabetics than in nondiabetics. Conclusion: Within the limits of the present study, the results indicated that patients with type-II DM have high rate of dental caries and are at high risk of caries development. The decline in the salivary components will reduce capability of supporting the mineral compartment of tooth structure to resist the demineralization process by cariogenic potentials thereby creating a favorable environment for caries progression.
  7 2,614 273
Revolution in Orthodontics: Finite element analysis
Johar Rajvinder Singh, Prabhuraj Kambalyal, Megha Jain, Piyush Khandelwal
March-April 2016, 6(2):110-114
Engineering has not only developed in the field of medicine but has also become quite established in the field of dentistry, especially Orthodontics. Finite element analysis (FEA) is a computational procedure to calculate the stress in an element, which performs a model solution. This structural analysis allows the determination of stress resulting from external force, pressure, thermal change, and other factors. This method is extremely useful for indicating mechanical aspects of biomaterials and human tissues that can hardly be measured in vivo. The results obtained can then be studied using visualization software within the finite element method (FEM) to view a variety of parameters, and to fully identify implications of the analysis. This is a review to show the applications of FEM in Orthodontics. It is extremely important to verify what the purpose of the study is in order to correctly apply FEM.
  5 4,197 321
Oral malignant melanoma: An aggressive clinical entity - Report of a rare case with review of literature
Shamimul Hasan, Sami Faisal Jamdar, Jogender Jangra, Sadun Mohammad Al Ageel Al Beaiji
March-April 2016, 6(2):176-181
Melanomais one of the most dreaded and aggressive neoplasms, being derived from epidermal melanocytes. The majority of melanomas are seen to involve the skin, and primary mucosal melanomas account for less than 1% of all melanomas. Oral malignant melanomas (OMM) are asymptomatic at the initial presentation, but later they become painful with growth and expansion. In the late stages, the patient may present with ulceration, bleeding, tooth mobility, paresthesia, ill-fitting prosthesis, and delayed healing of the extraction sockets. Diagnosis is often delayed due to asymptomatic clinical presentation, with silent progression of the lesion. OMM are associated with poor prognosis due to their invasive and metastasizing tendencies. The condition has poor survival rates, and metastatic melanomas show even worse prognosis. The 5-year survival rate for OMM ranges 4.5–29%, with 18.5 months being the mean survival rate. The tumor is best managed by wide surgical resection; however, consideration should also be made for adjunctive therapies such as chemotherapy, immunotherapy, and radiotherapy. Recurrences may be seen even 10–15 years after the primary therapy. This paper aims to present an interesting report of aggressive OMM in a 50-year-old male patient and emphasizes the role of dental professionals in maintaining a high degree of vigilance for the pigmented lesions of the oral cavity. Pigmented lesions of uncertain origin should be routinely biopsied to rule out malignancy. Early diagnosis of this dreadful entity entails thorough history taking, physical examination, and radiographic features coupled with histopathology.
  4 2,298 166
Epidemiology of periodontal diseases in Indian population since last decade
Anuja Chandra, Om Prakash Yadav, Sugandha Narula, Angel Dutta
March-April 2016, 6(2):91-96
Objective: India suffers lot of disparities in terms of oral health care and 95% of the Indian population suffers from periodontal disease. The aim of this review is to estimate the risk factors responsible for periodontal diseases as well as prevalence for the same in the last decade to make an attempt to develop a strategy to improve formulation of an effective oral health care policy in India. Materials and Methods: Keywords such as “prevalence of periodontal diseases,” “epidemiology,” “periodontitis in India,” and “oral hygiene status in India” were searched for appropriate studies to obtain a bibliographic database. The references of selected articles and relevant reviews were searched for any missed publications that included studies conducted in India estimating periodontal diseases with adequate sample size. Clinical parameters, sample size, and findings for each study were tabulated from 2006 to 2015 (till September 15, 2015) in chronological order to observe the prevalence as well as epidemiology of periodontal disease in India. Results: The projection of periodontal disease is disturbing. In addition, the majority of studies done have used the Community Periodontal Index of Treatment Needs (CPITN) as its epidemiological tool that can grossly underestimate the presence of deep pockets. Conclusion: Current knowledge has shown that periodontitis does not present a linear progression and is not age-dependent. Moreover, its distribution and severity are strongly influenced by host susceptibility and risk factors. A structured all-inclusive survey of all districts of the states is a prerequisite for the constitution of an apt and cogent health care policy in our country.
  4 3,534 266
Prognostic potential of AgNORs in oral submucous fibrosis
Sanjay Murgod, Girish Hemadal Channabasaviah, Dyamenahalli Malleshappa Shivamurthy, Lingappa Ashok, Savita Jangal Krishnappa
March-April 2016, 6(2):167-175
Aim and Objective: The role of prognosis cannot be stressed enough, especially when it comes to potentially malignant lesions. The argyrophilic nucleolar organizer regions (AgNORs), which is simple and cost-effective has been used in diagnostic and prognostic pathologies. This study seeks to identify the nucleolar organizer regions (NORs) in oral submucous fibrosis (OSMF), to correlate the AgNOR count with the histologic grade of OSMF, and to evaluate the prognostic potential of AgNOR. Materials and Methods: The sample size consisted of archival paraffin blocks of 35 cases of varying grades of OSMF and 10 cases of squamous cell carcinoma. Normal mucosa samples served as controls for the study. AgNOR staining in accordance with the method of Smith and Crocker was performed and Student's t-test was used for statistical analysis. Results: The results showed an increase in AgNOR counts with corresponding grades of OSMF, the count being least in normal mucosa and also an increase in AgNOR count with corresponding decrease in differentiation of oral squamous cell carcinoma. Conclusion: AgNOR staining is a rapid and inexpensive procedure representing cellular proliferation that can be used to assess the nature of the lesion and therefore, the prognosis.
  2 1,586 183
Impact of dental neglect score on oral health among patients receiving fixed orthodontic treatment: A cross-sectional study
Vijayendra Pandey, Subhash Chandra, HP Dilip Kumar, Ashish Gupta, Poonam Preet Bhandari, Pankaj Rathod
March-April 2016, 6(2):120-124
Objective: Maintenance of meticulous oral health practices is critical for patients who are under orthodontic treatment as failure to do so can result in deterioration of periodontal health. Thus, the present study was commenced to assess dental negligence and oral health status among patients undergoing orthodontic treatment using dental neglect scale (DNS) questionnaire. Materials and Methods: The present cross-sectional study was planned and carried out among the 40 patients undergoing fixed orthodontic treatment. The study comprised of two questionnaires, one was close-ended questionnaire which consisted of questions regarding patient practice in maintenance of oral health and other questionnaire comprised of DNS followed by examination of oral hygiene status using Oral Hygiene Index Simplified. Data so obtained were subjected to analysis using SPSS version 20 and Chi-square test was used to statistically analyze data with P < 0.05 regarded as a statistically significant value. Results: The present study revealed that 63% among the studied orthodontic patients brushed once daily, 26% brushed twice daily, and 11% brushed thrice. About one-fourth was using brush with soft bristles and only 9% among the respondents used interdental aids. Data revealed positive correlation between DNS and oral hygiene index-simplified score with P < 0.05. Conclusion: The present study found that less frequency of brushing, rinsing mouth, and eating sticky and hard food can be attributed to self-neglect of the orthodontic patients.
  2 2,014 152
Oral health knowledge, attitude, and self-care practices among pharmacists in Riyadh, Riyadh Province, Saudi Arabia
Mohammad Abdul Baseer, Mohammed Aleemullah Mehkari, Fahad AbdulMohsen Fahad Al-Marek, Omar Ahmad Bajahzar
March-April 2016, 6(2):134-141
Aim: Identifying and addressing gaps in the oral health knowledge, attitude, and practices of pharmacists is important before they can be considered as a member of the oral health promotion team. The aim of this study was to determine the prevailing oral health knowledge, attitude, and self-care practices among a sample of pharmacists from Riyadh, Riyadh Province, Saudi Arabia. Materials and Methods: A cross-sectional study involving 200 pharmacists working in community- and hospital-based pharmacies was conducted using a structured, self-administered, close-ended questionnaire. The responses were collected and descriptive statistics of the mean scores of knowledge, attitude, and self-care practices were calculated. Mann–Whitney U and Kruskal–Wallis tests were performed to compare the different groups. Spearman's rank correlation coefficient was used to assess the association among knowledge–attitude, knowledge–practice, and attitude–practice. Results: Overall, the mean scores of oral health knowledge, attitude, and self-care practices were found to be 5.27 ± 1.05, 3.89 ± 0.83, and 2.1 ± 0.61, respectively. Male non-Saudi pharmacists working in chain pharmacies, having 11–15 years of experience with a Master's degree qualification showed significantly higher mean knowledge and practices scores as compared to their counterparts. Spearman's correlation tests revealed a significant positive correlation of knowledge–practice (r = 0.262, P < 0.01), whereas knowledge–attitude (r = -0.149, P < 0.05) as well as attitudes–practices (r = -0.196, P < 0.01) were negatively correlated. Conclusion: Pharmacists exhibited an average knowledge, negative attitude, and inadequate self-care practices toward oral health. However, increasing oral health knowledge can have profound improvement in oral self-care practices.
  2 2,129 198
Herbal panacea: The need for today in dentistry
Mukut Seal, Rahul Rishi, G Satish, KT Divya, Pratim Talukdar, Radhika Maniyar
March-April 2016, 6(2):105-109
Among ancient civilizations, India has been known to be a rich repository of medicinal plants. Herbal extracts have been used in traditional medicine for several thousand years. Some plants contain phytochemicals that have effects on the body. The use of phytotherapy is staging a comeback and an era of herbal renaissance is being revolutionized all over the globe. Herbs are a class of plants that are devoid of the woody tissue characteristic of shrubs or trees and have been known for their aromatic, flavoring, and medicinal values over the past centuries. Since the birth of contemporary practices, many have turned away from herbal therapies in favor of synthetic drugs. But these synthetic medicines can alter microbiota and have several side effects. However, the blind dependence on synthetics is over and people are returning to the naturals with the hope of safety and security. Hence, the search for alternative natural products continue. This review includes a few herbs, which can be used in dentistry as alternatives to allopathic medicines.
  2 2,679 256
A cross-sectional study on oral health status of battery factory workers in Chennai city
J Babu Susai Raj, Sabitha Gokulraj, Konthoujam Sulochana, Vivek Tripathi, Susanthi Ronanki, Preeti Sharma
March-April 2016, 6(2):149-153
Aim and Objective: Some occupational exposures are associated with oral changes in both hard and soft tissues. Presence of oral lesions can interfere with speech, swallowing, and general health of a patient. The present cross-sectional study was conducted to evaluate the oral health status of battery factory workers in Chennai city. Materials and Methods: A total of 600 subjects were selected in battery factory out of 3500 workers using statistical sample selection formula 4pq/l2 and divided into study and control groups based on acid exposure. The data were recorded on a modified World Health Organization 1997 pro forma. The data were evaluated using Chi-square test and Mann–Whitney U-test. Results: Oral symptoms such as disturbed taste, dry mouth, oral ulcers, and foul breath were statistically significant between the groups (<0.001). Dental erosion was statistically significant with the duration of working years. Dental erosion was significant among study group compared to control (0.001). Conclusion: The present study showed that selected samples had various oral conditions due to exposure to acids from battery. It was observed that oral health problems were directly related to the duration of acid exposure in the study group. Implementing exhaust ventilation and monitoring the devices help in reducing the acid exposure. Implementation of oral hygiene education and nutritional supplementation helps in improving their oral health.
  1 1,694 154
The opinion and response of health professionals associated with academics about the research design and methods: A study
Syed Ahmed Raheel, Omar Bashar Kujan
March-April 2016, 6(2):154-160
Aim: The study aimed to survey the opinions and responses of health professionals in academics about their interest and experience in research, knowledge over study designs, and application of a common study design to find out the objectives behind any research study. Materials and Methods: A semi-structured questionnaire containing three variables with 15 questions were sent to 300 health professionals associated with academics in the category of Bachelor/Master/Doctorate working at Al-Farabi Colleges campuses located in Riyadh, Saudi Arabia. Data were collected manually, descriptive frequencies were generated and the variables were statistically analyzed using Chi-square test. The knowledge scores between the qualification and gender were carried out using ANOVA and t-test. The final response rate was in conjuction to the statistician to exclude the uncompleted responses from the statistical analysis. Results: The results showed a discrepancy in the participation; of 95 health professionals, (40) were females and (55) were males. Bachelor (16), Masters (61) and Doctorate holders (18) gave their opinion. For the first variable (research experience), all the surveyed categories showed the same response. However, for the second variable (study design and research criteria) bachelor holders showed poor, but equal performance was reported to the master and doctorate holders. In the third variable (objectives and common designs), bachelor holders showed a poor response in contrast to the master and doctorate holders whose have mixed opinions. For knowledge scores, no significance was present between the master and doctorate holders. Conclusion: There is a lack of understanding of the research objectives and common designs frequently used in research studies particularly among the bachelor holders. Additional postgraduate education on research methods is recommended to improve the knowledge and practices of research.
  1 1,592 172
Comparative evaluation of different mechanical modifications of denture teeth on bond strength between high-impact acrylic resin and denture teeth: An in vitro study
Sumit Singh Phukela, Siddesh Kumar Chintalapudi, Harleen Sachdeva, Rupinder Singh Dhall, Neeraj Sharma, Allama Prabhu
March-April 2016, 6(2):161-166
Aim and Objective: Acrylic teeth separates from the denture base and remains a major worry in day-to-day routine dental procedure. The present study was conducted to comparatively evaluate different mechanical modifications of acrylic teeth on bond strength between Lucitone 199 heat cure resin and cross-linked teeth. Materials and Methods: The test specimens, central incisors (21) were demarcated into four groups. Group 1 was the control group, whereas Group 2, Group 3, and Group 4 were experimental groups modified with round groove, vertical groove, and T-shaped groove, respectively. The preparation of masterpiece was done by aligning the long axis of the central incisor teeth at 45° to the base of a wax block (8 mm × 10 mm × 30 mm), with ridge lap surface contacting the base. These test specimen (21) was prepared by Lucitone 199 heat cure resin. Evaluation of bond strength of all the specimens was done using universal tester (materials testing machine). Shapiro–Wilk Test, one-way analysis of variance (ANOVA), and Bonferroni test were done to do statistical investigation. Results: Group 1 specimens prepared by Lucitone 199 heat cure resin showed the lowest bond strength and Group 4 specimens prepared with T-shaped groove packed with Lucitone 199 exhibited the highest bond strength. Conclusion: The bond strength between Lucitone 199 heat cure resin and cross-linked teeth was increased when mechanical modifications was done on denture teeth. The specimens prepared with T-shaped groove packed with Lucitone 199 heat cure resin showed the highest bond strength followed by Group 3, Group 2, and lastly Group 1 prepared by Lucitone 199 heat cure resin.
  1 2,147 183
A survey on oral hygiene methods practiced by patients attending Dentistry Department at a Tertiary Care Hospital from Central Gujarat
SN Goryawala, Paragkumar Chavda, Sneha Udhani, Naiya V Pathak, Shivang Pathak, Ritu Ojha
March-April 2016, 6(2):115-119
Objective: Oral hygiene is important not only for maintaining health of teeth and gingivae in an individual but also for good and uneventful regeneration and healing of tissues, when one has undergone one or other dental treatments. This makes it important to have an understanding of oral hygiene practices employed by the population. Materials and Methodology: This descriptive cross-sectional hospital-based survey was carried out to know oral hygiene methods practiced by patients who visited Department of Dentistry at a Tertiary Care Hospital attached to medical college from Central Gujarat. While examining and recording their history, their mode of oral hygiene practice was also noted. Recorded data were entered in Microsoft Excel and analyzed in SPSS Statistics Version 17.0. The study reports proportions of the variables under study in percentages. Results: The patients ranged from 4 to 80 years in age with equal numbers from both genders. The number of participants using modern and scientific material and instrument for oral hygiene was good. However, majority of them performed it only once a day, and none after every meal or at bed time. Conclusion: There is a need to improve the frequency of oral hygiene procedure among the studied population as well as use of dental floss needs to be increased.
  - 1,514 119
A comparative analysis of the accuracy of implant master casts fabricated from two different transfer impression techniques
Rupali Patil, Pankaj Kadam, Chetan Oswal, Seema Patil, Shweta Jajoo, Arati Gachake
March-April 2016, 6(2):142-148
Aim: This study evaluated and compared two impression techniques in terms of their dimensional accuracies to reproduce implant positions on working casts. Materials and Methods: A master model was designed to simulate a clinical situation. Impressions were made using four techniques: (1) Stock open tray (SOT) technique; (2) stock closed tray (SCT) technique; (3) custom open tray (COT) technique; and (3) custom closed tray (CCT) technique. Reference points on the hexagonal silhouette of the implant on master model and onto the analogs of the obtained master casts were compared after using the four impression techniques. Measurements were made using an optical microscope, capable of recording under 50x magnifications. The means and standard deviations of all the groups and subgroups were calculated and statically analyzed using analysis of variance (ANOVA) and Tukey's test. Results: The open tray impressions showed significantly less variation from the master model and all the techniques studied were comparable. Conclusion: All the techniques studied shown some distortion. COT showed the most accurate results of all the techniques.
  - 2,459 167
Comparative evaluation and effect of organic and inorganic fluoride dentifrices on enamel microhardness: An in vitro study
Krishna Prasad Shetty, SV Satish, Veerbhadra Gouda, Abhishek Rajpal Badade, Basavana Gouda, Snehalata Patil
March-April 2016, 6(2):130-133
Aim: To compare and evaluate the microhardness of enamel surface after the application of organic fluoride and inorganic fluoride dentifrices. Materials and Methods: Twenty freshly extracted premolars were collected and decoronation of all the teeth was done at cementoenamel junction. The crowns were sectioned mesiodistally into two halves with the help of diamond disc, and then the subsequent forty samples kept in 1% citric acid for the demineralization and divided into two groups by simple randomization, that is, Group A (inorganic sodium fluoride dentifrice) and Group B (organic amine fluoride dentifrice). They were treated using same protocol for 3 min, daily twice for 7 days. Those samples preserved in artificial saliva in between treatment. The enamel surface microhardness evaluated using Vickers hardness test at base level, after demineralization, as well as after remineralization. Statistical analysis of surface microhardness obtained at different stages done by Student's t-test and P < 0.05 was considered statistically significant. Results: The samples which were treated with sodium fluoride (Group A) could not restore the mean microhardness after treatment to that of preoperative level whereas amine fluoride (Group B) treated samples showed a statistically significant increase in mean surface microhardness from baseline. Conclusion: Organic fluoride (amine fluoride) remineralization was more effective in restoring enamel microhardness than inorganic fluoride (sodium fluoride) remineralization.
  - 1,738 220