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   2018| March-April  | Volume 8 | Issue 2  
    Online since April 24, 2018

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A novel herbal formulation versus chlorhexidine mouthwash in efficacy against oral microflora
KS Vinod, KS Sunil, Priyanka Sethi, Ram Chand Bandla, Subhasini Singh, Deepak Patel
March-April 2018, 8(2):184-190
DOI:10.4103/jispcd.JISPCD_59_18  PMID:29780746
Aims and Objectives: The aim of the study was to compare and to analyze the antimicrobial efficacy of 0.12% chlorhexidine and new formulated herbal mouthwash after using for 14 days. The objective was to signify whether the noval herbal combination could be a better alternative mouthwash to Chlorhexidine (CHX). Materials and Methods: This is a double-blinded, random controlled research study conducted in the Department of Oral Pathology and Microbiology. A total of 200 dental students were selected randomly, comprising of two groups, 100 in each, aged between 18 and 22 years with gingival index of score II. The first group was advised to oral rinse with 0.12% chlorhexidine mouthwash and the second group with new formulated herbal mouthwash for 14 days. Saliva samples were collected on the day 0 (baseline), followed by day 7 and 14 and microbial colony count was performed. The data obtained was statistically analyzed using SPSS version 16. Student's t-test was applied for comparison of the mean microbial count between the two groups. Repeated measures analysis of variance followed by Tukey's post hoc test was applied to assess the changes from day 0 to day 7 to day 14. The statistical significance level was set at P < 0.05. Results: Microbial colonies were reduced better in chlorhexidine group on the day 7 whereas, on day 14, greater reduction was observed in the herbal group in both gender groups with high statistical significance (P < 0.001). Conclusions: Herbal mouthwash formulation performed effectively well on long-term usage, could be used as an alternative mouthwash to overcome the disadvantages of chlorhexidine.
  3 2,754 280
Antimicrobial efficacy of different endodontic sealers against Enterococcus faecalis: An In vitro study
Swati Dalmia, Abhidnya Gaikwad, Roshan Samuel, Gayatri Aher, Meenal Gulve, Swapnil Kolhe
March-April 2018, 8(2):104-109
DOI:10.4103/jispcd.JISPCD_29_18  PMID:29780734
Objective: The aim of this in vitro study is to compare the antimicrobial efficacy of four different endodontic sealers against Enterococcus faecalis. Material and Method: Four different endodontic sealers, namely, resin based (AH Plus), zinc oxide-eugenol based (Tubliseal), calcium hydroxide based (Sealapex), and mineral trioxide aggregate (MTA Fillapex) based were tested for their antimicrobial efficacy against E. faecalis using agar diffusion method. Four wells were made by the removal of agar at equidistant points and filled with freshly mixed respective root canal sealers and were inoculated with E. faecalis. All the three plates were incubated for a period of 72 h at 37°C under aerobic conditions. The diameter of inhibition zones was measured at 24, 48, and 72 h time intervals. Data obtained were statistically analyzed using one-way analysis of variance and unpaired t-test. Results: All the tested sealers showed some bacterial growth inhibition of E. faecalis. Their efficacy in descending order of antibacterial activity was as follows: Sealapex > AH Plus > Tubliseal > MTA Fillapex. The efficacy of the root canal sealers decreased marginally with increase in their duration of action. Conclusion: Antimicrobial efficacy of calcium hydroxide-based sealer was highest followed by resin-based sealer and was the least with MTA based sealer.
  2 2,628 249
Temporomandibular joint arthrocentesis: A prospective study and audit of 500 joints of central India
Shailesh Kumar, Kamini Kiran, Anurag Yadav
March-April 2018, 8(2):124-129
DOI:10.4103/jispcd.JISPCD_361_17  PMID:29780737
Aim and Objectives: Aim of this study was to compare prospective effectiveness of arthrocentesis of temporomandibular joint by single- and double-needle technique in central India population. Materials and Methods: Out of 230 patients, 500 joints were included in the study and were randomly selected into two groups: single needle and double needle. Follow-up of patients were done as 1 week, 1 and 3 months. (The statistical analysis was done using SPSS [Statistical Package for Social Sciences] Version 15.0 Statistical Analysis Software). Results: Both techniques were equally effective at reducing pain and increasing the maximal mouth opening. The single-needle technique was easier to perform and required a shorter operative time (P < 0.01). Conclusion: the results obtained indicate that single versus double arthrocentesis techniques were equally effective in reducing the pain and increasing the mouth opening and reducing the clicking sound. However, single-needle technique was easier to perform and required a shorter operative time.
  2 1,497 157
Effect of rapid maxillary expansion on glenoid fossa and condyle-fossa relationship in growing patients (MEGP): Study protocol for a controlled clinical trial
Mona Sayegh Ghoussoub, Khaldoun Rifai, Robert Garcia, Ghassan Sleilaty
March-April 2018, 8(2):130-136
DOI:10.4103/jispcd.JISPCD_458_17  PMID:29780738
Aims and Objectives: Rapid maxillary expansion (RME) is an orthodontic nonsurgical procedure aiming at increasing the width of the maxilla by opening mainly the intermaxillary suture in patients presenting a transverse maxillary skeletal deficiency. The objectives of the current prospective controlled clinical and radiographic study are to evaluate the hypothesis that RME in growing patients will result in radiographic changes at the level of interglenoid fossa distance, condyle-fossa relationship, and nasal cavity widths compared to the group who received no treatment initially and served as untreated control. Materials and Methods: In this prospective controlled clinical and radiographic study, forty healthy growing patients selected from a school-based population following a large screening campaign, ranging in age between 8 and 13 years, presenting a maxillary constriction with bilateral crossbite, and candidates for RME are being recruited. The first group will include participants willing to undergo treatment (n = 25) and the other group will include those inclined to postpone (n = 15). Results: The primary outcome is to compare radiologically the interglenoid fossa distance and the condyle-fossa relationship; nasal cavity width will be a secondary outcome. A multivariable analysis of Covariance model will be used, with the assessment of the time by group interaction, using age as covariate. The project protocol was reviewed and approved by the Ethics Committee of the Lebanese University, National Institute in Lebanon (CUEMB process number 31/04/2015). The study is funded by the Lebanese University and Centre National de Recherche Scientifique, Lebanon (Number: 652 on 14/04/2016). Conclusion: This prospective controlled clinical trial will give information about the effect of RME on the glenoid fossa and condyle-fossa relationship and its impact on the nasal cavity width. Trial Registration: Retrospectively registered in BioMed Central (DOI10.1186/ISRCTN77788053).
  2 1,307 146
Detection of ostecalcin in gingival crevicular fluid in a group of orthodontic patients
Najwa Adeeb Nassrawin
March-April 2018, 8(2):168-173
DOI:10.4103/jispcd.JISPCD_181_16  PMID:29780743
Aim: To detect osteocalcin (OC) in gingival crevicular fluid (GCF) and to monitor the concentration of OC at what stage inflammation and bone resorption reaches their maximum following orthodontic activation. Materials and Methods: GCF samples were collected from six adult orthodontic patients (mean age = 22.3, range 20–24 years) on 3, 7, 10, 14, 21, 28, and 35 days after activation of orthodontic appliance, from the tooth surface where bone resorption was expected to occur. A total of 330 GCF sample were collected using filter paper strip, the volume measured by weighing. OC was analyzed using Enzyme-Linked immunoassay technique. Data were analyzed using the Statistical Package for Social Sciences software, SPSS (SPSS Inc., Chicago, IL, USA) version 15. Results: An increase in GCF volume and flow rate was noted in the 10th day after activation of the orthodontic appliance activation; however, due to high-standard deviation, the result was not significant. OC was detected in all GCF samples. The amount and concentration were quite variable. Increase in the amount of OC was observed between days 7 and 14. Conclusion: OC was detected in all samples. The quantity of OC increased at day 10 in a number of samples. There was no obvious association between OC concentration and time of collection.
  2 1,111 101
Impact of sense of coherence on oral health among bus drivers: A cross-sectional study
Shaik Ijaz Ahmed, Kudlur Maheswarappa Sudhir, V Chandra Sekhara Reddy, R V. S. Krishna Kumar, G Srinivasulu, Athuluru Deepthi
March-April 2018, 8(2):145-152
DOI:10.4103/jispcd.JISPCD_1_18  PMID:29780740
Aim and Objectives: To assess the sense of coherence (SOC) and the impact of SOC on oral hygiene behaviors and oral health status among bus drivers in Nellore district, Andhra Pradesh. Materials and Methods: A descriptive cross-sectional study was conducted during August–September 2017. Cluster random sampling methodology was used for the selection of drivers. Five depots were randomly selected from the list of various Andhra Pradesh State Road Transport Corporation depots in Nellore district. The estimated sample size was proportionately divided among these five depots of Nellore district (n = 120). The SOC-related data were obtained using short version of Antonovsky's SOC scale. Every item was scored on a Likert scale ranging from 1 to 7. The sum of the scores for SOC was 13–91. A high score indicates a strong SOC. Clinical examination was done for recording oral health status using Oral Hygiene Index-simplified (OHI-S), dental caries, periodontal status, and oral mucosal lesions were recorded according to the WHO criteria 1997. Data were entered and analyzed using SPSS ver. 22 (SPSS Inc., Chicago, IL, USA). Results: Majority of the bus drivers who participated in the study had a low SOC (60%). A significant (P < 0.05) positive correlation was observed with age (r = 0.1420), socioeconomic status (r = 0.1467), and visit to dentist (r = 0.1912). A nonsignificant negative correlation was observed with habits (r = −0.0681), OHI-S (r = −0.0772), dental caries (r = −0.0874), Community Periodontal Index (r = −0.0642), loss of attachment (r = −0.0650), and oral mucosal lesions (r = −0.0542). Conclusion: Strong SOC was associated with increase in age, better socioeconomic status, good habits, increased frequency of dental visits, and a good oral health.
  1 1,178 137
The expression and functional significance of vascular endothelial-cadherin, CD44, and vimentin in oral squamous cell carcinoma
Soussan Irani, Arash Dehghan
March-April 2018, 8(2):110-117
DOI:10.4103/jispcd.JISPCD_408_17  PMID:29780735
Objectives: Ninety percent of head and neck cancers are squamous cell carcinoma which develops in the oral cavity. Metastasis is the main causative factor for death in 90% of all cancer-related deaths and begins with the invasion of tumor cells through the walls of small blood vessels or lymph vessels. A growing body of evidence has shown that vasculogenic mimicry (VM) facilitates tumor growth and cancer metastasis. The current study aimed to present the role of vascular endothelial (VE)-cadherin, CD44, and vimentin in inducing VM and epithelial-mesenchymal transition (EMT) and to identify the cancer stem cell (CSC) niche in different grades of oral squamous cell carcinoma (OSCC). Materials and Methods: A total of 63 OSCC samples (21 samples each grade) were collected from the archive of Pathology Department of Besat educational hospital, Hamadan, Iran, from 2000 to 2015. VE-cadherin, CD44, and vimentin/periodic acid–Schiff (PAS) double-staining were used to validate VM. VM was identified by the detection of PAS-positive loops surrounded by tumor cells. Chi-square test was used to examine the differences between the variables. Significant level was set at 0.05. Pearson's correlation was used to assess the co-localization of the markers. Results: There were statistically significant differences between tumor grade and the expression levels of VE-cadherin, CD44, and vimentin (P = 0.000). In addition, significant differences were found between tumor grade and microvessel density (P = 0.000) and between tumor grade and VM (P = 0.000). Conclusion: Our results may disclose a definite relationship between VE-cadherin, CD44 and vimentin expression levels, VM formation, EMT, CSCs, and microvessel count in OSCC samples. For this reason, it is suggested that VE-cadherin, CD44, and vimentin are related to angiogenesis and VM formation in OSCC, therefore, in tumor progression and metastasis. Recently, antitumor angiogenic therapies have been challenged. The presence of VM may explain the failure of antiangiogenic treatments.
  1 1,742 253
Correlation between interalar distance and mesiodistal width of maxillary anterior teeth in Thrissur, Kerala, Indian population
George Attokaran, Kamalakanth Shenoy
March-April 2018, 8(2):118-123
DOI:10.4103/jispcd.JISPCD_47_18  PMID:29780736
Aims and Objectives: The aim of this study was to assess the validity of interalar distance as an aid in maxillary anterior teeth selection in Thrissur, Kerala, Indian population. The study also evaluated whether interalar distance and maxillary anterior teeth undergo any changes as age increases in this population and whether there is a gender difference in these parameters in this population. Materials and Methods: A study was planned on 1200 participants in Thrissur Municipal Corporation area, Kerala, India, with the aim of checking the validity of interalar distance as a successful aid in maxillary anterior teeth selection. The collected data were analyzed using SPSS version 21.0. Mean standard deviation and 95% confidence intervals were estimated. Student's t-test was used for comparison between gender and two age groups such as 18–25 and 40–50 years. One-way ANOVA analysis was done for combined effects. Results: The study showed that there is a high statistical significance between the interalar distance and the mesiodistal width of six maxillary anterior teeth in females (P < 0.01) and no significance in males. Conclusion: The study concluded that, within the population evaluated, there was a high significant correlation between interalar distance and the mesiodistal width of six maxillary anterior teeth in both males and females. Both interalar distance and mesiodistal width of maxillary anterior teeth showed a significant increase in size as age increases. There was a significant increase in size difference for males compared to females in relation to interalar distance and not for mesiodistal width of maxillary anterior teeth.
  - 1,507 153
Knowledge and attitude of dental health professionals about middle east respiratory syndrome in Saudi Arabia
Sameer Abdullah Althomairy, Mohammad Abdul Baseer, Mansour Assery, Abdulrahman Dahham Alsaffan
March-April 2018, 8(2):137-144
DOI:10.4103/jispcd.JISPCD_9_18  PMID:29780739
Aim and Objective: This study aims to evaluate the knowledge and attitude of practicing dental health professionals (DHPs) (dentist and dental auxiliaries) toward Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Saudi Arabia. Materials and Methods: A cross-sectional descriptive study was undertaken among practicing DHPs in Saudi Arabia. A total of 202 DHPs participated in this study. Knowledge and attitude were assessed using self-administered and pretested questionnaire. The questionnaire was administered online through Survey Monkey® program by sending link to the registered E-mail. Descriptive statistics were performed on demographic data. Mean knowledge and mean attitude scores of DHPs were calculated. Mann–Whitney U-test and Kruskal–Wallis tests were used to disclose the differences between study variables. Chi-square tests and Spearman's correlation tests were applied to find the associations between the variables. Results: The study participants showed mean knowledge score of 12.26 ± 2.27 (based on 17 knowledge questions) and attitude score of 8.63 ± 1.68 (based on 10 attitude questions). The spearman's test showed the positive correlation between knowledge and attitude of DHPs about MERS (r = 0.093, P = 0.188). Knowledge gaps were reflected in questions related to the duration of infectivity (47.5%), treatment of MERS (39.6%), reservoir of MERS-CoV (38.1%), availability of vaccination against MERS-CoV (25.2%), the likelihood of infection (24.3%), and the type of MERS-CoV (23.3%). DHPs showed a positive attitude toward adherence to universal precautions given by CDC and WHO (0.94 ± 0.25), active participation infection control program (0.94 ± 0.24), and use of gowns, gloves, mask, and goggles while dealing with MERS-CoV patients (0.97 ± 0.17). Male DHPs showed significantly higher knowledge and positive attitude toward MERS-CoV infection compared to females. Conclusion: DHPs participated in this study showed good knowledge and positive attitude toward MERS. However, still few lacunae in the knowledge and attitudes toward MERS-CoV were found requiring extensive educational programs.
  - 1,964 240
Estimation of dental and bone age in obese children of south India
Shaji T Varghese, Vinod Kumar, Sam Paul, Lijo K Jose, Tom Mathew, Sabin Siddique
March-April 2018, 8(2):153-159
DOI:10.4103/jispcd.JISPCD_14_18  PMID:29780741
Aim: Determination of skeletal and dental age is very essential for Pediatric dentist and orthodontist to formulate a treatment plan, and it is a source of supplemental information for Pediatrics, Orthopedics, and Forensics. There are no available studies in the literature about the comparison of dental and bone age with chronological age in obese children of south India. Accordingly, the aim of this study was to evaluate and compare dental age, bone age, and chronological age in obese children of south India. Materials and Methods: Ethical approval was obtained from the ethical committee of college, and informed consent was obtained from parents of the study participants. A total of 100 obese study participants were selected between 8 to 14 years age group. Date of birth was considered to obtain chronological age. Demirjian's method was used to assess dental age. Bjork, Grave, and Brown's method was followed to detect bone age using hand-wrist radiograph. The comparison of three ages was done using the unpaired Student's t-test and Pearson's correlation coefficient. Results: Dental age and bone age were advanced in comparison to chronological age in both sexes and its statistically significant (P < 0.001). There was a positive correlationship between three ages in both sexes. Conclusion: As per our study, dental age and bone age were advanced in obese children, but dental age was more advanced. Dental age and bone age can be considered as variables for diagnosing the impact of growth in obese children. In the future, further studies are required to support our findings.
  - 1,369 131
Caries risk assessment of 12–13-year-old government and private school going children of Mysore city using cariogram: A comparative study
Sandhya P Naik, Shabna Moyin, Bhakti Patel, Lata Prabhu Warad, Sameer Punathil, CB Sudeep
March-April 2018, 8(2):160-167
DOI:10.4103/jispcd.JISPCD_437_17  PMID:29780742
Aim: The aim of this study is to assess the caries risk assessment of 12–13-year-old government and private school going children of Mysore city using Cariogram. Materials and Methods: A cross-sectional examination was carried out on a total of 104 government and private schoolchildren aged 12–13 years. Ten factors from the Cariogram software(D Bratthall, Computer software, Malmo, Sweden) were included from study participant's records to complete the Cariogram. The percentage of “chances of avoiding new lesions” (caries risk) among government and private school study participants were obtained from Cariogram, and the participants were classified into five risk groups. Statistical analysis was performed using the software program Statistical Package of Social Science (version 17.0, SPSS Inc., Chicago IL, USA). Results: Findings revealed that there is slight difference in caries risk among government and private schoolchildren, where 48% caries risk development and 52% chance to avoid dental caries were showed in government schoolchildren, and 51% caries risk development and 49% chance to avoid dental caries were showed in private schoolchildren, according to Cariogram. Decayed, missing, and filled teeth component, mutans streptococci, and Lactobacillus counts were slightly higher in private schoolchildren compared with government schoolchildren. Conclusion: The private schoolchildren had less favorable values than government schoolchildren for most of the caries-related factors. Cariogram can be the most modest and reliable tool for caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive strategies can be provided to overcome new carious lesion formation.
  - 1,803 188
Employing dimensional disparity of teeth to establish the gender in Odisha population: A dimorphic study
Kailash Chandra Dash, Abikshyeet Panda, Shyam Sundar Behura, Sujatha Ramachandra, Lipsa Bhuyan, Alokenath Bandopadhyay
March-April 2018, 8(2):174-178
DOI:10.4103/jispcd.JISPCD_42_18  PMID:29780744
Aims and Objectives: Determination of sex is one of the most important and crucial steps in forensic science. Sexual dimorphism using odontometric analysis is found to vary in different populations making it necessary to attain values of a specific population which helps the identification possible. This present study attempts to establish sexual dimorphism using odontometric analysis in Odisha population. Materials and Methods: A total of 200 subjects (100 male and 100 female) between ages 18 and 25 years were included in the study. Intraoral Mesiodistal (MD) and Buccolingual (BL) dimensions of 28 teeth (maxillary and mandibular) excluding third molar were taken using digital Vernier calipers. Data were charted and decrypted and statistical analysis was done using SPSS Software version 20. Results: Our study showed larger dimensions of tooth in males when compared to females (maxillary right and left central incisor, 1st and 2nd molar). Interestingly, reverse dimorphism was also observed in few teeth. Conclusion: The results of the present study showed that the linear (MD and BL) dimensions of teeth played a major role in the determination of gender in individuals. The variations or reverse dimorphism could be a result of geographic variations.
  - 1,344 120
Impact of minimal root canal taper on the fracture resistance of endodontically treated bicuspids
Carla Zogheib, Germain Sfeir, Gianluca Plotino, Gustavo De Deus, Maha Daou, Issam Khalil
March-April 2018, 8(2):179-183
DOI:10.4103/jispcd.JISPCD_88_18  PMID:29780745
Objective: Minimal invasive endodontics preserve coronal and radicular tooth structure to increase the fracture resistance of teeth. The aim of this study was to assess the influence of final preparation taper on the fracture resistance of maxillary premolars. Materials and Methods: Sixty maxillary premolars were selected and divided into 2 groups: 30 were shaped with a final apical diameter 30 and a 4% taper and 30 with 6% taper using iRaCe® instrument (FKG dentaire, Switzerland). All root canals were irrigated with sodium hypochlorite and final rinse with ethylenediaminetetraacetic acid. All canals were filled with gutta-percha single-cone filling technique and AHPlus® sealer (Dentsply- Maillefer, Baillagues, Switzerland) and access cavity restored with resin composite. Roots were wax coated, placed in an acrylic mold and loaded to compressive strength fracture in a mechanical material testing machine recording the maximum load at fracture and fracture pattern (favorable/restorable or unfavorable/unrestorable). Fracture loads were compared statistically, and data examined with Student t-test with a level of significance set at P ≤ 0.05. Results: No statistically significant difference was registered between the 4% taper of preparation (270.47 ± 90.9 N) and 6% taper of preparation (244.73 ± 120.3 N) regarding the fracture resistance of the endodontically treated premolars tested (P = 0.541), while more favorable restorable fractures were registered in the 4% taper group. Conclusions: Continuous 4% preparation taper did not enhance the fracture resistance of endodontically treated maxillary premolars when compared to a 6% taper root canal preparation. More fractures were registered in the 4% taper group.
  - 2,162 195
The effect of expiration date on mechanical properties of resin composites
Joseph Sabbagh, Fidele Nabbout, Edgard Jabbour, Gaetane Leloup
March-April 2018, 8(2):99-103
DOI:10.4103/jispcd.JISPCD_445_17  PMID:29780733
Objective: The aim of this in vitro study is to evaluate the effect of expiration date on some mechanical properties of resin composites after controlled storage of syringes and compules in a refrigerator at 4°C. Materials and Methods: Specimens were tested at 7 days after storage in distilled water at room temperature. The investigated properties are the static modulus of elasticity, the flexural strength, and the Vickers microhardness. Same batches of restorative materials were examined at baseline (at least 1 year before their expiration date) and 1 year after they expired. Results: Paired t-test is used to compare the results between the two groups using StatView software (version 5.0) SAS Campus Drive Cary, North Carolina, USA. Except for the flexural strength, no statistical differences were found between the mechanical properties of the expired and the unexpired group. Conclusion: The 1-year expiry date did not seem to affect the investigated mechanical properties.
  - 5,483 319
Effect of fixed metallic oral appliances on oral health
Ahmad Alnazzawi
March-April 2018, 8(2):93-98
DOI:10.4103/jispcd.JISPCD_416_17  PMID:29780732
There is a substantial proportion of the population using fixed metallic oral appliances, such as crowns and bridges, which are composed of various dental alloys. These restorations may be associated with a number of effects on oral health with variable degrees of severity, to review potential effects of using fixed metallic oral appliances, fabricated from various alloys. The MEDLINE/PubMed database was searched using certain combinations of keywords related to the topic. The search revealed that burning mouth syndrome, oral pigmentation, hypersensitivity and lichenoid reactions, and genotoxic and cytotoxic effects are the major potential oral health changes associated with fixed prosthodontic appliances. Certain oral disorders are associated with the use of fixed metallic oral appliances. Patch test is the most reliable method that can be applied for identifying metal allergy, and the simultaneous use of different alloys in the mouth is discouraged.
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