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   2018| January-February  | Volume 8 | Issue 1  
    Online since February 22, 2018

 
 
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CASE REPORT
Surgical management of double/triple mandibular fractures involving the condylar segment: Our perspective
Sunil S Nayak, Abhay Taranath Kamath
January-February 2018, 8(1):87-91
DOI:10.4103/jispcd.JISPCD_428_17  PMID:29629334
A series of surgical cases operated in our unit are considered to analyze and evaluate the different techniques and sequencing employed in the surgical management of double/triple mandibular fractures involving a condylar fracture. Deviating from the normal sequence of reducing and fixing the dentate segment first, we addressed the condylar segment first. A combination of different approaches for different cases such as a periangular with a vestibular, a preauricular and a retromandibular with a vestibular were used according to the type of fractures. The accessibility to one difficult case with a medially displaced condyle was facilitated by using Hegar's uterine dilators. In all cases, good anatomical reduction was achieved with stable occlusion and without any signs of facial nerve impairment. The 'Condyle first' approach in the surgical management of double/triple mandibular fractures, is a reliable and efficient technique.
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ORIGINAL ARTICLES
Immunohistochemical analysis of the role connective tissue growth factor in drug-induced gingival overgrowth in response to phenytoin, cyclosporine, and nifedipine
AJ Anand, Sivaram Gopalakrishnan, R Karthikeyan, Debasish Mishra, Shreeyam Mohapatra
January-February 2018, 8(1):12-20
DOI:10.4103/jispcd.JISPCD_403_17  PMID:29629324
Objective: To evaluate for the presence of connective tissue growth factor (CTGF) in drug (phenytoin, cyclosporine, and nifedipine)-induced gingival overgrowth (DIGO) and to compare it with healthy controls in the absence of overgrowth. Materials and Methods: Thirty-five patients were chosen for the study and segregated into study (25) and control groups (10). The study group consisted of phenytoin-induced (10), cyclosporine-induced (10), and nifedipine-induced (5) gingival overgrowth. After completing necessary medical evaluations, biopsy was done. The tissue samples were fixed in 10% formalin and then immunohistochemically evaluated for the presence of CTGF. The statistical analysis of the values was done using statistical package SPSS PC+ (Statistical Package for the Social Sciences, version 4.01). Results: The outcome of immunohistochemistry shows that DIGO samples express more CTGF than control group and phenytoin expresses more CTGF followed by nifedipine and cyclosporine. Conclusion: The study shows that there is an increase in the levels of CTGF in patients with DIGO in comparison to the control group without any gingival overgrowth. In the study, we compared the levels of CTGF in DIGO induced by three most commonly used drugs phenytoin, cyclosporine, and nifedipine. By comparing the levels of CTGF, we find that cyclosporine induces the production of least amount of CTGF. Therefore, it might be a more viable drug choice with reduced side effects.
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REVIEW ARTICLE
Oral pathology in forensic investigation
Thorakkal Shamim
January-February 2018, 8(1):1-5
DOI:10.4103/jispcd.JISPCD_435_17  PMID:29629322
Forensic odontology is the subdiscipline of dentistry which analyses dental evidence in the interest of justice. Oral pathology is the subdiscipline of dentistry that deals with the pathology affecting the oral and maxillofacial regions. This subdiscipline is utilized for identification through oral and maxillofacial pathologies with associated syndromes, enamel rod patterns, sex determination using exfoliative cytology, identification from occlusal morphology of teeth, and deoxyribonucleic acid profiling from teeth. This subdiscipline is also utilized for age estimation studies which include Gustafson's method, incremental lines of Retzius, perikymata, natal line formation in teeth, neonatal line, racemization of collagen in dentin, cemental incremental lines, thickness of the cementum, and translucency of dentin. Even though the expertise of an oral pathologist is not taken in forensic investigations, this paper aims to discuss the role of oral pathology in forensic investigation.
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ORIGINAL ARTICLES
The antiplaque efficacy of two herbal-based toothpastes: A clinical intervention
Sudhir Rama Varma, Husam Sherif, Ahmed Serafi, Salim Abu Fanas, Vijay Desai, Eiyas Abuhijleh, Ahmad Al Radaidah
January-February 2018, 8(1):21-27
DOI:10.4103/jispcd.JISPCD_411_17  PMID:29629325
Aims: This study is the first of its kind in the United Arab Emirates, where these herbal plant extracts are commonly incorporated into toothpaste. The present study compares two herbal toothpastes (Meswak extract and tea tree oil [TTO]) and analyses their efficiency in reducing plaque accumulation. Materials and Methods: A total of 25 patients were examined for plaque and assigned a plaque score. They were then randomly assigned to use either Meswak-based toothpaste or TTO-based toothpaste. After 24 h, a new plaque score was recorded, and the patients used their regular brand for 2 weeks. The patients were then instructed to use the second of the two study toothpastes for 24 h, and a third set of plaque scores was obtained. Statistical data were analyzed using the SPSS software with a significance of P < 0.05 and Kruskal–Wallis test. Results: Analysis of plaque scores showed a reduction in plaque index after using either of the two herbal-based toothpastes; however, when compared with TTO, Meswak-based toothpaste resulted in significantly less plaque. Conclusions: Brushing with Meswak-based toothpaste gave a significant drop in plaque score when compared with TTO-based paste.
  1,310 154 -
Extent of awareness regarding oral health and dental treatment needs among individuals with hearing and speech impairments in Saudi Arabia
Mohammed Mustafa, Faris Yahya I Asiri, Shahad AlGhannam, Ibrahim Ali Mohammed AlQarni, Mohammed Abdullah AlAteeg, Sukumaran Anil
January-February 2018, 8(1):70-76
DOI:10.4103/jispcd.JISPCD_194_17  PMID:29629332
Objective: This study aims to evaluate the awareness level of the individuals with hearing and speech impairments (deaf and dumb individuals), in relation to their oral health and dental treatment needs. Materials and Methods: The approach of stratified randomization method of sampling was used for the selection of participants. About 240 people with hearing and speech impairments (deaf and dumb) were selected from four cities of Saudi Arabia, which includes AlKharj, Riyadh, Dammam and Abha. A questionnaire of two sections was distributed among the participants for collecting data. A simple descriptive analysis was done, and the data were expressed in terms of frequencies and percentages. Microsoft Excel has been used for compilation of data and execution of graphs. Moreover, the questionnaire data were subject to SPSS data analysis (IBM SPSS Statistics for Windows, Version 22.0, Armonk, IBM Corp. NY). Results: Most of the participants were not aware of the importance of oral health. Majority of the participants described that they did not visit qualified dentists in the past and many of them did not know the right way of doing tooth brushing. Hence, deaf and dumb individuals lack basic knowledge about oral health and dental treatment needs. Conclusion: The study concluded that the awareness level of oral health and dental treatment needs is low among individuals with hearing and speech impairments (deaf and dumb) in Saudi Arabia.
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Anchorage in orthodontics: Three-dimensional scanner input
Fidele Nabbout, Pascal Baron
January-February 2018, 8(1):6-11
DOI:10.4103/jispcd.JISPCD_422_17  PMID:29629323
Aims and Objectives: The aim of this article is to re-evaluate anchorage coefficient values in orthodontics and their influence in the treatment decision through the usage of three-dimensional (3D) scanner. Materials and Methods: A sample of 80 patients was analyzed with the 3D scanner using the C2000 and Cepha 3DT softwares (CIRAD Montpellier, France). Tooth anatomy parameters (linear measurements, root, and crown volumes) were then calculated to determine new anchorage coefficients based on root volume. Data were collected and statistically evaluated with the StatView software (version 5.0). Results: The anchorage coefficient values found in this study are compared to those established in previous studies. These new values affect and modify our approach in orthodontic treatment from the standpoint of anchorage. Conclusion: The use of new anchorage coefficient values has significant clinical implications in conventional and in microimplants-assisted orthodontic mechanics through the selection and delivery of the optimal force system (magnitude and moment) for an adequate biological response.
  1,233 183 -
Relationship between physicochemical properties of saliva and dental caries and periodontal status among female teachers living in Central Iran
Amene Hosseini-Yekani, Azadeh Nadjarzadeh, Mehrdad Vossoughi, Javad Zavvar Reza, Ali Golkari
January-February 2018, 8(1):48-55
DOI:10.4103/jispcd.JISPCD_391_17  PMID:29629329
Objectives: There are inconsistent data about the association between saliva properties, dental caries, and periodontal status. In this study, we tried to examine the association between dental caries and periodontal status with salivary viscosity, flow rate, pH, and buffering capacity in adults. Methods: In the present cross-sectional study, 450 female teachers were randomly selected from schools located in Yazd, Iran. Oral examinations were conducted, and unstimulated saliva samples were collected. Salivary viscosity, flow rate, pH, and buffering capacity were assessed. The salivary physicochemical properties were compared among teachers with different types of oral health. Analyses were done using the Statistical Package for the Social Sciences version 16. Results: In total, 431 female teachers aged 40.45 ± 8.18 years were included in the study. Salivary flow rate, buffering capacity, pH, and viscosity, community periodontal index status were not significantly different in participants with and without tooth caries. There was a reverse linear association between salivary pH and flow rate with the decayed, missed, and filled teeth index (P < 0.05). The saliva buffering capacity was not significantly related to dental properties. Those with bleeding on probing had lower salivary pH, and buffering capacity compared to those with healthy gum. However, the salivary resting flow rate was not different in participants with bleeding on probing and healthy participants. Conclusion: Based on our results, saliva properties might be important predictors in oral health status. This means that any change in saliva combination might affect periodontal and dental diseases. Future prospective studies are recommended to confirm these results.
  1,077 98 -
Evaluation of the knowledge and attitudes of dental students toward occupational blood exposure accidents at the end of the dental training program
Abdelhadi Hbibi, Jalal Kasouati, Reda Charof, Souad Chaouir, Karima El Harti
January-February 2018, 8(1):77-86
DOI:10.4103/jispcd.JISPCD_282_17  PMID:29629333
Aims and Objectives: This study was conducted to assess knowledge, attitudes, and behavior regarding occupational blood exposure accidents (OBEA) among dental students at the end of the whole dental education program. Materials and Methods: The survey was performed using a student self-administered questionnaire during July 2015 in the dental teaching hospital in Rabat. It was conducted on 117 dental students registered in the 5th year. The results were analyzed by SPSS Software, Version 13.0. Univariate analysis was performed by descriptive statistics, and bivariate analysis was used to identify correlations between different variables. Results: Eighty-three students answered the questionnaire (participation rate: 70%). Most participants had incomplete knowledge about the management and the risks of OBEA. Thirty-five participants (42%) experienced at least one occupational exposure to patients' blood. Needle recapping has been the main cause of such injuries (41%). Most accidents occurred, respectively, in the oral surgery (51%) and the restorative dentistry (17%) departments. According to many participants, they had received insufficient education concerning this topic. Conclusions: More effective education on prevention and management of OBEA is highly recommended to reduce the prevalence of such injuries. Dental schools should set up a local management unit for following and supporting the exposed students.
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Knowledge, attitudes, and practices among health-care providers regarding Zika virus infection
Swati Sharma, Apurva Tyagi, Sujatha Ramachandra, Lipsa Bhuyan, Kailash Chandra Dash, Malvika Raghuvanshi
January-February 2018, 8(1):41-47
DOI:10.4103/jispcd.JISPCD_371_17  PMID:29629328
Aims and Objectives: Zika virus (ZIKV) is a mosquito-borne flavivirus that was first identified in Uganda in 1947 in monkeys. The study was designed to assess the knowledge, attitude, and practices regarding ZIKV infection among rural health-care providers in Aligarh district, Uttar Pradesh, India. Materials and Methods: A total of 600 health-care providers were selected through stratified random sampling in an interventional survey. A self-structured, closed-ended questionnaire was administered to each participant in two phases to record their demographic, professional characteristics, knowledge, attitude, and practices regarding ZIKV. Results: Out of 600 health-care workers contacted, 585 (97.5%) agreed to participate in the survey. Multivariable linear regression analysis was carried out to assess the association of participant's professional characteristics with their knowledge, attitude, and practices. Conclusion: It showed that there was a wide gap between the level of awareness, knowledge, and practice among the different categories of health-care providers about the ZIKV. This study revealed that there was a very high probability of the risk of transmission of ZIKAV through health-care settings and hence health-care personnel must strictly adhere to Universal Precautions to prevent it.
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A scanning electron microscope evaluation of smear layer removal and antimicrobial action of mixture of tetracycline, acid and detergent, sodium hypochlorite, ethylenediaminetetraacetic acid, and chlorhexidine gluconate: An in vitro study
KM Charlie, MA Kuttappa, Liza George, KV Manoj, Bobby Joseph, Nishin K John
January-February 2018, 8(1):62-69
DOI:10.4103/jispcd.JISPCD_379_17  PMID:29629331
Objectives: The main objective is to evaluate the efficiency in removal of smear layer of mixture of tetracycline, acid and detergent (MTAD), sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA) and chlorhexidine gluconate by scanning electron microscope (SEM) evaluation and also to evaluate the antimicrobial action of the same irrigants against standard culture strains of Enterococcus faecalis. Materials and Methods: This study included 60 extracted permanent teeth with single root canal. The sample was categorized into five groups with 12 teeth in each group. Root canals were enlarged till size 40 with K-files. One group was kept as control and irrigated only with saline. Other four groups used 5% NaOCl as irrigant during instrumentation and MTAD, 5% NaOCl, 17% EDTA, and 2% chlorhexidine gluconate as final rinse. Teeth were split and examined under SEM. To test the antibacterial action, the zone of inhibition method using agar plates was used. Obtained data were statistically analyzed by SPSS version 17 (SPSS Inc., Chicago, IL, USA). Results: MTAD and 17% EDTA removed smear layer from all regions of the root canals. About 5% NaOCl and 2% chlorhexidine gluconate were ineffective in removing the smear layer. The mean zone of inhibition formed by the irrigants was in the following order; MTAD (40.5 mm), 2% chlorhexidine gluconate (29.375 mm), 17% EDTA (24.125 mm), 5% NaOCl (22.125 mm), and saline (zero). Conclusion: MTAD showed high smear layer removal efficacy, but no significant difference was found to that of 17% EDTA. As the dimensions of the zones of inhibition showed, MTAD has got highest antibacterial action against E. faecalis, followed by 2% chlorhexidine gluconate, 17% EDTA, and 5% NaOCl. However, the exact correlation of in vitro study results to clinical conditions is impossible due to the variables involved.
  873 86 -
Association of anxiety with pain perception following periodontal flap surgery
Maryam Ahmadi, Amir Kiakojori, Sussan Moudi
January-February 2018, 8(1):28-33
DOI:10.4103/jispcd.JISPCD_385_17  PMID:29629326
Aims and Objectives: Dental pain and anxiety are important factors that prevent patients from seeking dental care. The aim of this study was to assess the relationship between trait anxiety and state anxiety and also to determine the effects of age and sex on pain perception after periodontal flap surgery. Materials and Methods: In this descriptive-analytical study, 50 patients who need periodontal flap surgery were assessed in a private periodontal specialty clinic in Babol city. The amount of anxiety was measured by the Spielberger State-Trait Anxiety Inventory test, and visual analog scale scores were used for postsurgical pain perceptions in 7 times (immediately after surgery and days 1–6 after surgery). Data were analyzed and evaluated by SPSS V22.0 software (IBM, United States). Results: In the trait anxiety study, there was a significant difference in pain perception between different anxiety classes at times immediately after surgery, 1st day, and 2nd day after surgery (P < 0.05), and in the state anxiety study, there was a significant difference in pain perception between different anxiety classes at times immediately after surgery until the 5th day after surgery (P < 0.05). Furthermore, the results indicate that the pain perception in female was significantly higher than male, at times immediately after surgery, 3rd day, and 5th day after surgery (P < 0.05). However, there was no association between age and pain perception in different times (P > 0.05). Conclusions: Anxiety is associated with pain perception following periodontal flap surgery, and female experience more pain after surgery, whereas the amount of pain perception is not related to age.
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Fracture resistance of ceramic crowns supported with indirect chair-side composite cores
Khalid M Abdelaziz, Cinderella K Keshk, Abdulkhaliq Alshadidi, Salman Mafraq, David F Murchison
January-February 2018, 8(1):34-40
DOI:10.4103/jispcd.JISPCD_381_17  PMID:29629327
Aims and Objectives: To evaluate the influence of indirect chair-side polymerization of resin composite cores on the fracture resistance of overlaying IPS e.max Press crowns. Materials and Methods: Root canals of 60 extracted premolars were prepared to receive #2 fiber posts after the crowns were sectioned 2 mm above the cervical line. In Groups 1–3 (n = 10 each), posts were luted to the prepared dowel spaces using self-adhesive resin cement. Resin composite cores were then bonded and incrementally built-up using Filtek Z250 XT, Filtek P60, and Filtek P90 resin composites. In Groups 4–6 (n = 10 each), the fabricated post-core systems were subjected to post-curing heat and pressure treatment before cementation to their respective teeth using self-adhesive resin cement. Another 10 sound premolars served as control. All teeth in the test and control groups were then subjected to standardized preparation to receive IPS e.max Press crowns before testing their fracture resistance and the mode of restorations' failure. The collected results were statistically analyzed using ANOVA, Kruskal–Wallis, and Tukey's tests on the past software used at α = 0.05 to stand on the significance of the detected differences. Results: Significant differences were detected between the fracture resistance of teeth in different groups (ANOVA, P = 2.857E-35). Crowns in Groups 4–6 provided higher fracture resistance than those in Groups 1–3 (Tukey's test, P < 0.05). Crowns in Groups 4 and 6 provided higher fracture resistance than the control, while those in Groups 2 and 3 provided lower fracture resistance than the control (Tukey's test, P < 0.05). Conclusion: Indirect composite cores improved the fracture resistance of IPS e.max Press crowns when compared to directly fabricated post and cores. The directly and indirectly polymerized nanohybrid, methacrylate-based composite (Filtek Z250 XT) cores yielded the highest fracture resistance for the utilized all-ceramic crowns.
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An evaluation of shear bond strength of admira (Ormocer) as an alternative material for bonding orthodontic brackets: An in vitro study
Altaf Hussian Thekiya, KR Aileni, Madhukar Reddy Rachala, Sathun Dharmender Reddy, K Sena Devi, Md. Yaser Ahmed Khan
January-February 2018, 8(1):56-61
DOI:10.4103/jispcd.JISPCD_375_17  PMID:29629330
Objective: To evaluate shear bond strength (SBS) of Ormocer-bonded orthodontic brackets with self-etching primer (SEP) and conventional adhesive system and also to assess the amount of adhesive remaining on the tooth surface after debonding using adhesive remnant index (ARI). Materials and Methods: The study was done on 90 extracted human upper first permanent maxillary premolars. The study sample was categorized into three groups of 30 each to assess the SBS using three adhesives, Ormocer, SEP, and conventional adhesive system. Following debonding, the surfaces of teeth were examined for residual adhesive remaining by means of the optical stereomicroscope at ×50 magnification. ARI (Artun and Bergland) was used to classify the amount of residual adhesive. Obtained data were expressed as mean ± standard deviation, and obtained data was expressed as mean ± standard deviation (SD) and statistical analysis was done using one way ANOVA and Mann-Whitney U-test [SPSS version 17 statistical package (SPSS Inc., Chicago, IL)]. Results: The mean SBS was maximum in Group I followed by Group II and Group III. The difference in the mean SBS among Group I (8.67 ± 1.84 Mpa), Group II (7.72 ± 1.82 MPa) and Group III (6.42 ± 1.55 MPa) was statistically significant. ARI was maximum in Group I followed by Group II and minimum Group III. Conclusion: Ormocer may be utilized as a substitute to generally used bisphenol A-glycidyl methacrylate-based adhesives; however, its effectiveness should be determined clinically by in vivo studies.
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ERRATUM
Erratum: Knowledge, attitude, and awareness among diabetic patients in Davangere about the association between diabetes and periodontal disease

January-February 2018, 8(1):92-0
DOI:10.4103/2231-0762.222774  PMID:29630068
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