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   2016| Sep-Oct  | Volume 6 | Issue 5  
    Online since October 24, 2016

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Hyaluronic acid: Hope of light to black triangles
Jyotsana Tanwar, Shital A Hungund
Sep-Oct 2016, 6(5):497-500
DOI:10.4103/2231-0762.192948  PMID:27891319
Interdental papilla construction, especially in the esthetic area, is one of the most challenging tasks. Interdental papilla loss might occur due to several reasons as a consequence of periodontal surgery or trauma. The purpose of this study is to report the reconstruction of lost interdental papilla using hyaluronic acid gel. Hyaluronic acid is a glycosaminoglycan molecule with anti-inflammatory, anti-edematous properties on periodontal tissues invaded by submicrobial flora. It enhances wound healing and accelerates periodontal repair and regeneration. In addition to the field of dentistry, it has been used in other fields such as orthopedics, ophthalmology, and dermatology. It shows growth factor interaction, regulates osmotic pressure, and enhances tissue lubrication, which helps in maintaining the structural and homeostatic integrity of tissues, hence resulting in beneficial effect on lost interdental papilla. This study was aimed to reconstruct the lost interdental papilla by injecting 0.2% hyaluronic acid via nonsurgical approach. It is a noninvasive approach which reduces patient's postoperative discomfort with marked variations in the volume of interdental papilla before and after the procedure. As sufficient information is not available regarding the effectiveness of hyaluronic acid in interdental papilla construction, this study was conducted.
  6,332 406 1
Comparison of antibacterial efficacy of coconut oil and chlorhexidine on Streptococcus mutans: An : An in vivo study study
Faizal C Peedikayi, Vimal Remy, Seena John, TP Chandru, Prathima Sreenivasan, Gufran Ahmed Bijapur
Sep-Oct 2016, 6(5):447-452
DOI:10.4103/2231-0762.192934  PMID:27891311
Aims: Streptococcus mutans is the most common organism causing dental caries. Various chemotherapeutic agents are available that help in treating the bacteria, with each having their own merits and demerits. Recent research has shown that coconut oil has anti-inflammatory and antimicrobial action. Therefore, the present was conducted to determine the antibacterial efficacy of coconut oil and to compare it with chlorhexidine. Materials and Methods: A total of fifty female children aged 8–12 years were included in the study. Twenty five children were randomly distributed to each group, i.e., the study group (coconut oil) and the control group (chlorhexidine). The participants were asked to routinely perform oil swishing with coconut oil and chlorhexidine and rinse every day in the morning after brushing for 2–3 minutes. S. mutans in saliva and plaque were determined using a chairside method, i.e., the Dentocult SM Strip Mutans test. Patients were instructed to continue oil swishing for 30 days. S. mutans. counts in plaque and saliva on day 1, day 15, and day 30 were recorded and the results were compared using Wilcoxon matched pairs signed ranks test. Results: The results showed that there is a statistically significant decrease in S. mutans. count from coconut oil as well as chlorhexidine group from baseline to 30 days. The study also showed that in comparison of coconut oil and chlorhexidine there is no statistically significant change regarding the antibacterial efficacy. Conclusion: Coconut oil is as effective as chlorhexidine in the reduction of S. mutans.
  4,154 294 2
Complication of improper management of sodium hypochlorite accident during root canal treatment
Fatemah Faras, Fawaz Abo-Alhassan, Abdullah Sadeq, Hisham Burezq
Sep-Oct 2016, 6(5):493-496
DOI:10.4103/2231-0762.192939  PMID:27891318
Sodium Hypochlorite (NaOCl) is a common irrigation solution used in root canal treatment. It has strong antibacterial and tissue dissolving properties. Nevertheless, it has some serious complications, some of which are life-threatening. A young male presented with severe chemical burn of the right infraorbital area and partial necrosis of the hard palate resulting from extrusion of NaOCl during root canal treatment of the upper right 2nd molar tooth. The patient had a facial scar, and mucosal damage healed nearly completely. Several precautions must be taken during NaOCl use to prevent the spread of the solution into surrounding tissues. Early recognition of NaOCl accident and proper immediate management are important to achieve the best possible outcome.
  3,886 186 3
Evaluation of Moyer's mixed dentition space analysis in Indian children
Kamalshikha Baheti, Prashant Babaji, Meer J Ali, Ashish Surana, Samvit Mishra, Madhulika Srivastava
Sep-Oct 2016, 6(5):453-458
DOI:10.4103/2231-0762.184037  PMID:27891312
Aim and Objectives: Tooth size prediction values are not universal for all ethnic and racial groups. The present study evaluated the applicability of Moyer's mixed dentition space analysis in the Marwari community of Rajasthan, India. Materials and Methods: The mesiodistal dimension of permanent mandibular incisors, maxillary and mandibular canine, and premolars of both sides were measured and averaged in 200 adolescents (100 males and 100 females) of the Marwari population in Rajasthan using digital Vernier caliper. Data were statistically analyzed using Student's t–test. The data were then compared with Moyer's predicted values. The tooth measurements of male and female participants were compared with unpaired t-test. Results: Moyer's prediction chart was not comparable with the study population group. The coefficient of correlation and coefficient of determination in our study was 0.57 and 0.25, respectively. Mesiodistal width of measured teeth was lesser in females compared to males for both canine and premolars (P = 0.471 and P = 0.0001, respectively). Conclusion: There was significant statistical difference between values of the present study and Moyer's prediction values. Hence, new regression equation and prediction table can be used to predict mesiodistal dimensions of canine and premolars in Marwari children of Rajasthan.
  3,734 241 -
Single file reciprocating systems: A systematic review and meta-analysis of the literature: Comparison of reciproc and WaveOne
Rana Alsilani, Fatima Jadu, Dania F Bogari, Ahmed M Jan, Turki Y Alhazzazi
Sep-Oct 2016, 6(5):402-409
DOI:10.4103/2231-0762.192945  PMID:27891305
The introduction of single-file nickel-titanium (NiTi) reciprocating systems has been a major breakthrough in the field of endodontics. Thus, the aim of this study was to compare the available reciprocating systems, Reciproc and WaveOne, using a meta-analysis with different parameters. A comprehensive electronic literature search for Reciproc and WaveOne using PubMed and Google scholar was initially conducted in September 2014 and updated in September 2016. Inclusion and exclusion criteria were then established. Twenty-six studies were qualified for the systematic review, and only three studies were considered for the meta-analysis using cyclic fatigue resistance as the main parameter. The time to fracture for the Reciproc and WaveOne systems ranged from 119.7 sec to 156.4 sec and 74.8 sec to 99.6 sec, respectively. The pooled difference in mean time to fracture was longer for the Reciproc system by 45.6 sec. This difference was statistically significantly at P value < 0.001. In conclusion, our study supports the finding that Reciproc is more resistant to cyclic fatigue than WaveOne. However, with regard to other parameters, mixed results were obtained. Well-designed randomized clinical trials comparing both systems under the same experimental conditions should be done in future studies.
  3,373 335 -
Awareness about biomedical waste management and knowledge of effective recycling of dental materials among dental students
Rajeev Ranjan, Ruchi Pathak, Dhirendra K Singh, Md Jalaluddin, Shobha A Kore, Abhijeet R Kore
Sep-Oct 2016, 6(5):474-479
DOI:10.4103/2231-0762.192941  PMID:27891315
Aims and Objectives: Biomedical waste management has become a concern with increasing number of dental practitioners in India. Being health care professionals, dentists should be aware regarding safe disposal of biomedical waste and recycling of dental materials to minimize biohazards to the environment. The aim of the present study was to assess awareness regarding biomedical waste management as well as knowledge of effective recycling and reuse of dental materials among dental students. Materials and Methods: This cross-sectional study was conducted among dental students belonging from all dental colleges of Bhubaneswar, Odisha (India) from February 2016 to April 2016. A total of 500 students (208 males and 292 females) participated in the study, which was conducted in two phases. A questionnaire was distributed to assess the awareness of biomedical waste management and knowledge of effective recycling of dental materials, and collected data was examined on a 5-point unipolar scale in percentages to assess the relative awareness regarding these two different categorizes. The Statistical Package for Social Sciences was used to analyzed collected data. Results: Forty-four percent of the dental students were not at all aware about the management of biomedical waste, 22% were moderately aware, 21% slightly aware, 7% very aware, and 5% fell in extremely aware category. Similarly, a higher percentage of participants (61%) were completely unaware regarding recycling and reusing of biomedical waste. Conclusion: There is lack of sufficient knowledge among dental students regarding management of biomedical waste and recycling or reusing of dental materials. Considering its impact on the environment, biomedical waste management requires immediate academic assessment to increase the awareness during training courses.
  3,048 179 5
Metastasis to the oral soft tissues: A review of 412 cases
Soussan Irani
Sep-Oct 2016, 6(5):393-401
DOI:10.4103/2231-0762.192935  PMID:27891304
The present review article analyzes the characteristics of metastases to the oral soft tissues from 1937 to 2015. An extensive literature search was performed. All variables such as age, gender, and primary and secondary tumor sites were analyzed. Metastases to the major salivary glands were not included in this review. In general, there were 412 metastatic lesions developed in the oral soft tissues. The male-to-female ratio was approximately 1.8:1. The mean age of the patients at diagnosis was 58. The lung was the most common primary site and the gingiva was the most common metastatic site. The greater part of the histological examination yielded adenocarcinoma. The diagnosis of a metastatic lesion in the oral cavity is a challenge to the clinicians due to the lack of pathognomonic signs and symptoms. Oral metastases usually occur in the advanced stages of cancers, and the interval between appearance and death is usually short. The oral soft tissue metastasis can be easily recognized compared to the metastasis of jawbones. Early detection of oral lesions is important in the case of being the first sign of a malignancy in other parts of body.
  2,514 227 9
Comparative evaluation of the efficacy of fluoride varnish and casein phosphopeptide – Amorphous calcium phosphate in reducing Streptococcus mutans counts in dental plaque of children: An in vivo study
Shweta Chandak, Ashish Bhondey, Amit Bhardwaj, Jitesh Pimpale, Manisha Chandwani
Sep-Oct 2016, 6(5):423-429
DOI:10.4103/2231-0762.192936  PMID:27891308
Aim: To assess the comparative efficacy of fluoride varnish and casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) complex visa viz. Streptococcus mutans in plaque, and thereby the role that these two agents could play in the prevention of dental caries. Materials and Methods: A cluster sample of 120 caries inactive individuals belonging to moderate and high caries risk group were selected from 3–5-year-old age group based on the criteria given by Krassee and were randomized to four groups, namely, fluoride varnish – Group I, CPP–ACP complex – Group II, mixture of CPP–ACP complex –Gourp III, and fluoride and routine oral hygiene procedures as control – Group IV. The results thus obtained were analyzed using Statistical Package for the Social Sciences (SPSS) version 16. Results: A statistically significant difference in the pre and post-application scores of S. mutans (P < 0.01) count was observed in all the groups with CPP–ACP plus fluoride group being the most proficient. Conclusion: Materials such as fluoride varnish, CPP–ACP, and CPP–ACP plus fluoride protects the tooth structure, preserving the integrity of primary dentition, with the most encouraging results being with CPP–ACP plus fluoride.
  2,144 194 2
Forces in initial archwires during leveling and aligning: An in-vitro study
Rajesh Kumar Reddy, Pavan K Katari, Tarun T Bypureddy, Venkata Naga Sri Harsha Anumolu, Yenugupalli Kartheek, Nemala R.V Sairam
Sep-Oct 2016, 6(5):410-416
DOI:10.4103/2231-0762.192940  PMID:27891306
Aim: This in-vitro study measured the force deflection behavior of selected initial alignment archwires by conducting three-point bending tests under controlled tests. The study tested three wire designs, namely, co-axial multistranded stainless steel wires, nickel–titanium, and copper–nickel–titanium archwires. Materials and Methods: The archwires were ligated to a specially designed metal jig, simulating the arch. A testing machine (Instron) recorded activation and deactivation forces of different deflections at 37°C. Forces on activation and deactivation were compared by one-way analysis of variance (ANOVA). Results: Significant differences (P < 0.05) in activation and deactivation forces were observed among the tested wires. The co-axial multistranded wire had the lowest mean activation and deactivation forces, whereas conventional nickel–titanium wires had more mean activation and deactivation forces at different deflections. Conclusion: The activation and deactivation forces were higher for nickel–titanium followed by copper–nickel titanium and co-axial wires. The amount of percentage force loss was more for co-axial wire, indicating that these wires are not ideal for initial leveling and aligning.
  1,777 306 -
Effect of oral health education in the form of Braille and oral health talk on oral hygiene knowledge, practices, and status of 12–17 years old visually impaired school girls in Pune city: A comparative study
K Bhor, V Shetty, V Garcha, GC Nimbulkar
Sep-Oct 2016, 6(5):459-464
DOI:10.4103/2231-0762.192938  PMID:27891313
Aim: To assess the effect of oral health education (OHE) in the form of Braille and combination with Oral health talk (OHT) on oral hygiene knowledge, practices, and status of 12–17 years old visually impaired school girls in Pune city. Materials and Methods: A 6-week comparative study was conducted among 74 residential visually impaired school girls aged 12–17 years, who were trained to read Braille. The participants were divided into two groups, namely, Group A (n = 37) receiving OHE only in the form of Braille and Group B (n = 37) receiving OHE in form of Braille and OHT at baseline, 2, and 4-week interval. Oral health knowledge was assessed using a self-administered, pre-validated, pre-tested questionnaire typed in Marathi Braille. Assessment of oral hygiene practices and status was done using standardized proforma and simplified oral hygiene index (OHI-S), respectively, at baseline and at the end of 6 weeks. Data was analyzed using paired and unpaired Student's t-test. Results: The results showed a statistically significant increase in oral health knowledge levels in Group B (4.95 ± 1.66) as compared to Group A (2.97 ± 1.28). There was a significant increase in the frequency of mouth-rinsing in Group B (97.3%) as compared to Group A (86.5%) as well as in the tongue cleaning practice in Group B (100%) as compared to Group A (81.1%) at the end of 6 weeks. Conclusion: OHE in the form of Braille and OHT was more effective than OHE using only Braille.
  1,825 196 3
Morphological analysis of palatal rugae pattern in central Indian population
Neha Dwivedi, Anil Kumar Nagarajappa
Sep-Oct 2016, 6(5):417-422
DOI:10.4103/2231-0762.192947  PMID:27891307
Aim: The aim of this study was to analyze the morphological study of palatal rugae pattern in a central Indian population and to determine sex differentiation. Objectives: To investigate the distinctive rugae patterns of the study population and determine the contribution of rugae patterns in gender identification. Material and Methods: The present cross-sectional study was conducted among a Central Indian population with a sample size of 500 participants. The study involved 250 males and 250 females who were randomly selected from the outpatient department of Oral Medicine Diagnosis and Radiology, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh. After collection of impression, casts were made and analyzed to evaluate the palatal rugae pattern in a central Indian population by using Thomas and Kotze classification (1983) for number, shape, direction, and unification of palatal rugae pattern. The statistical analysis was carried out using Mann–Whitney test and Chi-square (χ2) tests for categorical variables. Result: Males showed more number of rugae than females [P = 0.00 (≤0.001)]. Males had more number of wavy rugae pattern whereas females showed more number of straight rugae patterns [P = 0.00 (≤0.001)]. Males showed more backwardly directed rugae whereas females showed more forwardly directed rugae [P = 0.00 (≤0.001)]. The unification did not show any significant difference. Conclusion: This study showed that there was a significant relationship between palatoscopy, human identification, and sex determination. Thus, palatoscopy can be considered as a cost effective, easy, unique, and stable method for human identification.
  1,780 149 -
Outcome of tobacco cessation in workplace and clinic settings: A comparative study
Ramdas S Ransing, Dipak B Patil, Maruti B Desai, Asawari Modak
Sep-Oct 2016, 6(5):487-492
DOI:10.4103/2231-0762.192946  PMID:27891317
Aims and Objectives: Several biological, social, and cultural factors contribute to the poor outcome of tobacco cessation interventions. Inability to engage large number of participants is one of the major identifiable factors. The objective of this study was to compare the outcome of tobacco cessation interventions in the clinical and workplace settings. Materials and Methods: In the present study, we recruited 100 participants in tobacco cessation clinic (TCC) group and workplace group (50 participants in each). Both the groups were regularly intervened and were followed up regularly at 2 weeks, 4 weeks, 3 months, and 6 months. Active interventions in the form of awareness lectures, focused group discussions, and if needed, pharmacotherapy (nicotine/non-nicotine replacement therapy) was carried out for all participants. The outcome was assessed as no change, harm reduction (>50% reduction), complete cessation, and drop out. Statistical analysis of the data was done using the Statistical Package for the Social Sciences version 21.0. Results: At the end of 1 month, there was higher tobacco cessation rate in the workplace group versus TCC group (n = 22, 44% vs n = 9, 18%; P < 0.0001). The tobacco cessation rate was maintained even after 6 months of intervention (n = 30, 60% vs n = 12, 24%; P = 0.002) and dropout rate was also lower among the workplace group than the TCC group (n = 14, 28% vs n = 27, 54%; P < 0.0001). Conclusions: Our study findings suggest that the workplace setting has superior outcome in tobacco cessation and harm reduction than clinical setting. In addition, it is associated with low dropout rate and the cessation effect is maintained over a period of 6 months.
  1,643 116 1
Histologic and histomorphometric evaluation of two grafting materials Cenobone and ITB-MBA in open sinus lift surgery
Babak Amoian, Maryam Seyedmajidi, Hamidreza Safipor, Sediqe Ebrahimipour
Sep-Oct 2016, 6(5):480-486
DOI:10.4103/2231-0762.192942  PMID:27891316
Aims and Objectives: Alveolar ridge reduction caused after tooth extraction can be minimized through ridge preservation and application of graft materials. The aim of this study was to compare the histologic and histomorphometric aspects of bone particulated allografts, Cenobone and ITB-MBA, in the reconstruction of vertical alveolar ridge after maxillary sinus augmentation. Materials and Methods: This clinical trial was performed among 20 patients. The participants were randomly divided into two groups of 10 participants. The first group received Cenobone and the second group received ITB-MBA. Tissue samples were prepared 6 months later at the time of implant installation and after successful maxillary sinus floor augmentation. Tissue sections were examined under a light microscope. The data were analyzed by Chi-square and t-test. Results: The mean trabecular thickness of the samples in the Cenobone group was 13.61 ± 7.47 μm compared to 13.73 ± 7.37 μm in the ITB-MBA group (P = 0.93). A mild inflammation process (Grade 1) was detected in both the groups. The amount of remaining biomaterial in the Cenobone group was estimated to be 8 ± 19% vs. 7 ± 12% in the ITB-MBA group (P = 0.30). Bone formation was reported 49.71% in the Cenobone group vs. 40.76% in the ITB-MBA group (P = 0.68). The mean newly formed vessel in the Cenobone group was 0.64 ± 0.7 vs. 1.5 ± 2.3 in the ITB-MBA group (P = 0.14). Conclusions: There was no significant difference between the two groups of patients regarding trabecular thickness, remaining biomaterial allograft, and the density of blood vessels after sinus floor elevation; hence, there was no difference between the two groups regarding implant outcome. More designed studies as randomized controlled trials and controlled clinical trials, which evaluate the long-term implant outcome; comparing the different bone graft materials is also required to improve evidence on survival and success rate.
  1,503 126 -
Assessment of oral health attitudes and behavior among students of Kuwait University Health Sciences Center
Dena A Ali
Sep-Oct 2016, 6(5):436-446
DOI:10.4103/2231-0762.192943  PMID:27891310
Aim: The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level. Materials and Methods: Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses. The data were analyzed for frequency distributions, and differences among the groups were assessed using the Mann–Whitney U test, Chi-square test, and Kruskal–Wallis test. P values less than 0.05 were considered to be statistically significant (P < 0.05). Results: The results of this study indicated that dental students achieved better oral health attitudes and behavior than that of their nondental professional fellow students (P < 0.05). Students in advanced academic levels and female students demonstrated better oral health attitudes and behavior. Conclusion: Dental students and students who were in advanced levels of their training along with female students demonstrated better oral health practices and perceptions than students in lower academic levels and male students, respectively. Additional studies for investigating the effectiveness and identifying areas requiring modification within the dental curriculum at KUHSC may be warranted.
  1,283 112 -
Comparison of views on the need for continuing education on oral cancer between general dentists and oral medicine experts: A Delphi survey
S Leuci, M Aria, M Nicolo, G Spagnuolo, K Warnakulasuriya, MD Mignogna
Sep-Oct 2016, 6(5):465-473
DOI:10.4103/2231-0762.192944  PMID:27891314
Objectives: The role of dental professionals in screening for oral cancer has been limited. The purpose of this study was to investigate and compare the educational priorities of oral medicine specialists, general dental practitioners, and doctors of dental surgery with regards to the diagnosis and management of oral cancers and potential malignant disorders. Study Design: This was a longitudinal survey. Materials and Methods: A Delphi survey was directed to a panel of 25 oral medicine specialists asking them to identify the major difficulties in diagnosing and managing patients with oral cancer or suspected malignancy. In a second phase, two groups of generalists were asked to express their ratings on the issues identified by experts. Results: The response rate of the experts to the survey was 84%, while only 44% of the generalists participated. Although the three groups agreed on most of the issues, there were significant differences of opinions on 10 of the items proposed by specialists (P < 0.05 from the Kruskal–Wallis test), which were observed mainly between experts and general dental practitioners (P < 0.017 from the Mann–Whitney U test). The opinion of the participants about future investments in the field of education resulted in similar results (P > 0.05 from the Chi-square test), with the specialists ranking highest on mandatory annual thematic courses, while the generalists prioritizing more interactive and extensive pre-graduation courses on oral cancer detection. Conclusion: This study confirms a clear need to improve the educational foundation on oral cancer by a didactic process starting with pre-graduation courses that should involve National Health Care Services, National Dental Associations, and academia.
  1,280 110 3
Evaluation of dental and bone age in iron-deficient anemic children of South India
Vinod Kumar, Harish Haridas, Prahlad Hunsigi, Umar Farooq, Sridhar R Erugula, Kranti K.R Ealla
Sep-Oct 2016, 6(5):430-435
DOI:10.4103/2231-0762.192937  PMID:27891309
Aims and Objectives: Dental and bone age is very essential for the dental practitioner in planning treatments and is an extra source of information for the pediatrician, orthopedician, and endocrinologist. There are few published data regarding collation between dental age, bone age, and chronological age in iron-deficiency anemic children. This study has been undertaken to evaluate and compare dental age, bone age, and chronological age in children with iron-deficiency anemia. Materials and Methods: One hundred iron-deficiency anemic children were selected in the age group of 8–14 years. Chronological age of the child was recorded by asking birth date from parents or checking school records. Dental age was calculated by Demirjians method and bone age was evaluated using Bjork, Grave, and Brown's method. Unpaired student's t-test and Pearson's correlation coefficient were the two statistical tests applied to compare dental, bone, and chronological age. Results: Dental and bone age was significantly lower (P < 0.001) compared to chronological age. The correlation between the three ages was positive in both sexes. Conclusion: Dental and bone age retardation was a significant feature in our sample of 100 iron-deficient anemic children. Bone age and dental age are valuable parameters in assessing the overall growth of the child. Further studies are required to corroborate our findings.
  1,251 92 2