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2018 | October | Volume 19 | Issue 10

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Charannya Seetharam, Nourah A Kader

Clinical Significance of the Floral Shift in Candidiasis

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:2] [Pages No:1161 - 1162]

Keywords: Antifungal agents, Azoles, Candida, Candidiasis, Drug resistance, Fungal

   DOI: 10.5005/jp-journals-10024-2399  |  Open Access |  How to cite  | 



Shaima R Al Naqbi, Harris Pratsinis, Dimitris Kletsas, Theodore Eliades, Athanasios E Athanasiou

In Vitro Assessment of Cytotoxicity and Estrogenicity of Vivera® Retainers

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:6] [Pages No:1163 - 1168]

Keywords: Cytotoxicity, Estrogenicity, Laboratory research Vivera® retainers

   DOI: 10.5005/jp-journals-10024-2400  |  Open Access |  How to cite  | 


Aim: To investigate the cytotoxicity and estrogenicity of Vivera® retainers by assessing their biological behavioral effects as-received from the manufacturer and after retrieved from patients. Materials and methods: In this, in vitro investigation six sets (maxillary and mandibular) of Vivera® retainers, three as received and three retrieved after four weeks of use by patients of an orthodontic postgraduate clinic, were immersed in the normal saline solution for 14 days following different modes of sterilization. The estrogenicity assays involved two cell lines, namely the estrogen-sensitive MCF-7 and the estrogeninsensitive MDA-MB-231. Following a 6 day incubation with the solutions to be tested, at concentrations varying from 5% to 20% v/v in medium supplemented with 2% fetal calf serum devoid of endogenous estrogens, estrogenicity was assessed by cell counting; β-Estradiol was used as positive control. The statistical analysis of data was performed with two-way analysis of variance (ANOVA) with appliance and concentration as predictors. Differences were further investigated with the Tukey multiple comparison tests at the 0.05 level of significance. Results: No significant MCF-7 proliferation was induced by the three samples compared either to the eluents from as-received retainers or to the negative control. As expected, β-estradiol induced a potent stimulation of MCF-7 cell proliferation, while no effect was observed on MDA-MB-231 cells. Conclusion: Under the conditions of this experiment eluents of as-received and retrieved Vivera® retainers did not seem to exhibit xenoestrogenic activity. Clinical significance: Vivera® retainers can be used as parttime removable oral appliances following the manufacturer's instructions.



Crawford Bain, Arwa Al Sayed, Eleftherios G Kaklamanos, Hizbullah AA Kazi

Toothbrushing–Should We Advise Mechanical or Power Brushes? Results of an International Delphi Conference

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:5] [Pages No:1169 - 1173]

Keywords: Delphi consensus conference, Manual brushes, Power brushes, Toothbrushing

   DOI: 10.5005/jp-journals-10024-2401  |  Open Access |  How to cite  | 


Background and aim: To develop evidence-based answers to a series of questions in relation to toothbrushing using a modified Delphi consensus approach. Oral hygiene and especially toothbrushing have been a fundamental part of the efforts to prevent caries and gingivitis. The questions discussed involved the frequency and duration of brushing, the effectiveness and safety of powered brushes and the recommendations for children and orthodontic patients. Review results: The Delphi panel agreed that twice daily brushing for 2 minutes and a systematic pattern is advised. Moreover, it was concluded that evidence suggests that power brushes are safe and more effective in the short and long-term compared to manual brushes in terms of plaque removal and gingivitis reduction. For children and orthodontic patients, the likelihood of enhancing compliance/convenience with use of a power brush was highlighted. Conclusion: Toothbrushing constitutes a fundamental part of the efforts to prevent caries and gingivitis. Clinical significance: Twice daily brushing for 2 minutes and a systematic pattern is advised. Power brushes are safe and could provide benefits, for adults, children and orthodontic patients.



Rakesh B Nair, T Ajay Das, A Sachin Aslam, Ummar Mangalath

Evaluation of Treatment Outcome Following Closed Reduction of Nasal Bone Fractures

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:7] [Pages No:1174 - 1180]

Keywords: Closed reduction, Efficacy of closed reduction, Esthetics, Maxillofacial trauma, Nasal fracture.

   DOI: 10.5005/jp-journals-10024-2402  |  Open Access |  How to cite  | 


Introduction: The closed reduction of a displaced nasal fracture is a preferred method in oral and maxillofacial surgery. This prospective study was conducted to evaluate the treatment outcome following closed reduction of nasal bone fractures. Materials and methods: A total of 20 patients with nasal bone fracture who underwent closed reduction were included in the study. The cases were operated under local or general anesthesia. The outcome of treatment was evaluated pre- and postoperatively through systematic follow-ups. Clinical assessment was done to evaluate functional (airway patency, nasal obstruction, crepitus) as well as esthetic parameters (facial symmetry, swelling, and nasal deviation). Functional and esthetic satisfaction of patients was assessed using visual analog scale (VAS) pre- and post-operatively. Results: It was observed that there was significant improvement in both functional and esthetic parameters following closed reduction of nasal fractures. Conclusion: The present study suggested that closed reduction of nasal bone fracture is very effective in the management of nasal bone fractures. However, further studies with larger sample size in different clinical situations should be considered to confirm the efficacy of the same. Clinical significance: Closed reduction can be a viable and more conservative alternative in management of nasal fractures.



Dalia AM Talaat, Ahmed AM Abdelrahman, Reham H Abdelaziz, Dina Nagy

Effect of Two Remineralizing Agents on Initial Caries-like Lesions in Young Permanent Teeth: An in Vitro Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:8] [Pages No:1181 - 1188]

Keywords: Casein phosphopeptide-amorphous calcium phosphate fluoride, Initial caries lesion, Nano-hydroxyapatite, Young permanent teeth.

   DOI: 10.5005/jp-journals-10024-2403  |  Open Access |  How to cite  | 


Aim: To compare the effect of nano-hydroxyapatite (9000 ppm F) and casein phosphopeptide-amorphous calcium phosphate fluoride (900 ppm F) pastes on initial enamel carious lesions of young permanent teeth. Materials and methods: Sixty extracted young premolars with a standardized window on enamel were immersed in a demineralizing solution for 48 hours to produce subsurface enamel lesions. They were divided into three groups according to remineralizing agents (n = 20) group I: nano-hydroxyapatite paste; group II: casein phosphopeptide-amorphous calcium phosphate fluoride paste; and group III: control (without an agent). The enamel surface microhardness (SMH) was measured at baseline, after the incipient enamel lesion, and after treatment. Additional twenty young premolars were selected and prepared as mentioned above for surface morphology evaluation by scanning electron microscope (SEM). Results: No significant difference was found in mean surface microhardness in teeth treated with nano-hydroxyapatite paste and those treated with casein phosphopeptide-amorphous calcium phosphate fluoride p = 0.26. SEM showed improvement in surface defects of demineralized enamel in the two test groups. Conclusion: Nano-hydroxyapatite and casein phosphopeptide- amorphous calcium phosphate fluoride pastes were effective in rehardening the initial enamel caries lesions in young permanent teeth. Clinical significance: The best strategy for caries management is to focus on the methods of improving the remineralization process with the aid of the remineralizing agents. The current study compared the remineralizing effect of two remineralizing agents. Within the limitations of the study, both remineralizing agents were effective for remineralization of early caries-like lesions.



Robert Garcia, Ghassan Sleilaty, Khaldoun Rifai

Effect of Rapid Maxillary Expansion on Condyle–fossa Relationship in Growing Patients

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:10] [Pages No:1189 - 1198]

Keywords: Condyle–fossa relationship, Cone-beam computer tomograph, Interglenoid fossa, Rapid maxillary expansion.

   DOI: 10.5005/jp-journals-10024-2404  |  Open Access |  How to cite  | 


Aim: This study tests whether rapid maxillary expansion (RME) exerts long term effects on interglenoid fossa distance and condyle fossa relationship. Materials and methods: Consecutive growing patients aged 8 to 13 years were allocated either to the RME group or control group. Cone-beam computed tomography was performed at baseline and at 6 months. Specific software was used to determine fixed landmarks. Multivariate Analysis of Covariance (MANCOVA) models were used, with time by group interaction, using age as a covariate. Results: Twenty-seven patients with a mean age of 11.4 ± 1.5 years were included. There was an overall significant group by time interaction (p = 0.012, effect size 0.59). Change in the lateral position of the glenoid fossa, the primary outcome, was reached (p = 0.008, effect size 0.258). Change in the laterolateral position of the center of the condyle, and the co-primary outcome was also significant (p = 0.011, effect size = 0.24). Nasal cavity width increased (p = 0.065, effect s ize = 0.14). There was aninitial a symmetry in the horizontal position of the condyles that was carried on with no effect of RME. Conclusion: Rapid maxillary expansion (RME) produces a significant increase in the interglenoid fossa distance and displacement of the mandibular condyles at 6 months in growing patients compared to a control group. Clinical significance: The current study shows that RME is effective during growth, widening the interglenoid fossa distance and the lateral positions of the condyles and eventually enlarging the nasal cavity, without causing asymmetry.



Rashmi Laddha, Monica Mahajania, Amruta Khadse, Rajat Bajaj, Rashmi Jawade, Shashwati Choube

Assessment of Sirtuin 3 and Sirtuin 4 Level in Patients with Diabetes Mellitus and Periodontitis: A Clinical Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:5] [Pages No:1199 - 1203]

Keywords: Diabetes mellitus, Periodontitis, Sirtuin.

   DOI: 10.5005/jp-journals-10024-2405  |  Open Access |  How to cite  | 


Aim: Periodontitis is considered as infection in periodontal supporting structure leading to tooth mobility and ulcerated periodontal pockets. The present study was conducted to assess Sirtuin 3 (SIRT 3) and SIRT 4 level in patients with diabetes mellitus (DM) and periodontitis. Materials and methods: The present study was conducted on 60 subjects. Subjects were divided into four groups, groups I to IV. Each group comprised of 15 subjects. In all subjects, fasting blood glucose level was assessed. Plaque index (PI), bleeding on probing (BOP), gingival index (GI), and clinical attachment level (CAL) were measured. The SIRT 3 and SIRT 4 were estimated by Western blot analysis. Results: In group I, mean age was 44.13 ± 1.35 years, in group II, it was 43.53 ± 1.45 years, in group III it was 43.93 ± 1.22 years, and in group IV, it was 44.47 ± 0.74 years. The mean BOP score was significantly higher in group IV (5.74 ± 0.30) compared with group I (1.92 ± 0.44), group II (2.25 ± 0.22), and group III (5.31 ± 0.54). A statistically significant (p < 0.001) difference was observed in mean PI score in group I (2.25 ± 0.23), group II (2.26 ± 0.13), group III (4.37 ± 0.60), and group IV (3.25 ± 0.16). Mean GI score was significantly higher in group IV (8.89 ± 0.89) as compared with group I (0.78 ± 0.23), group II (0.95 ± 0.18), and group III (8.69 ± 1.13). A statistically significant difference was seen in mean CAL in group III (5.66 ± 0.64) and group IV (6.37 ± 0.30). Mean fasting blood sugar (mg/dL) in group I was 80.40 ± 13.05, in group II, it was 160.40 ± 27.20, in group III, it was 77.00 ± 12.78, and in group IV, it was 264.20 ± 53.17. The nonsignificant mean expression of SIRT 3 was seen in group I (29.20 ± 3.14), group II (29.19 ± 2.18), group III (28.89 ± 2.77), and group IV (29.59 ± 5.82). In group I, the mean level of SIRT 4 was 28.93 ± 12.55, in group II, it was 28.82 ± 9.14, in group III, it was 28.88 ± 6.03, and in group IV, it was 29.05 ± 10.68. Conclusion: Association of DM and periodontitis is well known. The SIRT 3 and SIRT 4 are useful indicators of glycemic level in patients with DM. Clinical significance: The SIRT 3 and SIRT 4 in DM show variation in their level. Early assessment may be proved beneficial in patients who are not responding to other drugs.



Islam Saad, Suzan Salem

Evaluation of Serum Desmoglein 1 and Desmoglein 3 in Oral Erosive Lichen Planus before and after Topical Application of Tacrolimus

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:10] [Pages No:1204 - 1213]

Keywords: anti-Dsg1, anti-Dsg3, Oral erosive lichen planus, Topical tacrolimus.

   DOI: 10.5005/jp-journals-10024-2406  |  Open Access |  How to cite  | 


Aim: The current study will attempt to throw light on the role of desmoglein 1 and desmoglein 3 in the pathogenesis of erosive lichen planus and their response to topical application of tacrolimus. Materials and methods: Twenty patients with erosive oral lichen planus received tacrolimus ointment three times daily for eight weeks. Assessments using the clinical score and a visual analog scale were recorded at each visit. Serum concentrations of circulating autoantibodies to desmoglein 1 and desmoglein 3 will be determined by enzyme-linked immunosorbent assay (ELISA) at baseline, four weeks and eight weeks after treatment. Statistical software SPSS v.17.0 was used for statistical analysis. Results: All patients showed significant improvement in all outcomes within the follow-up periods when compared with the baseline (p < 0.05). The mean value of the visual analog scale were 8.30 ± 1.49, 4.15 ± 1.14, 2.10 ± 0.91, 0.90 ± 0.79, and 0.0 ± 0.0 starting from baseline to the end of follow up period. The mean value of the clinical score were 4.7 ± 0.48, 2.9 ± 1.29, 1.8 ± 1.32, 1.31 ± 0.69, and 0.69 ± 0.09 starting from baseline to the end of follow-up period. There was a significant decrease in the levels of anti-Dsg1 and anti-Dsg3, during the follow-up period (p ≤ 0.05). Conclusion: The concluded data suggest that antibodies against desmoglein 1 and desmoglein 3 seem to play a key role in the pathogenesis of oral lichen planus. Also, there is a significant decrease in the level of anti-Dsg1 and anti-Dsg3 autoantibodies with topical tacrolimus 0.1% ointment. Clinical significance: Monitoring the serum level of antibodies against keratinocyte cadherins Dsg 1 and Dsg 3 can be used to evaluate the effect of topical application of tacrolimus on Erosive Oral lichen planus.



AV Rajanikanth, Vinisha Pandey, Reshu Singh, Pawanjeet S Chawla, Eisha Shaw

Comparison of Flexural Strength and Surface Roughness of two Different Flexible and Heat Cure Denture Base Material: An in Vitro Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:7] [Pages No:1214 - 1220]

Keywords: Flexible denture base, Flexural strength, Surface roughness

   DOI: 10.5005/jp-journals-10024-2407  |  Open Access |  How to cite  | 


Aim: To Compare and Evaluate the Flexural Strength and Surface Roughness of Lucitone-FRS, Valplast (Flexible Denture Base Materials) and Trevalon (Heat Cure Denture Base Material). Materials and Methods: Three stainless steel master dies of dimension 65 x 20 x 3 mm were fabricated and were invested in standard metal denture flask. A total of 60 specimens were fabricated with 20 specimens of each type of denture base material. Fabrication of a Heat Cure Acrylic Denture Base Resin Specimen was Done Followed by Fabrication of Flexible Denture Base Resins Specimen. In the same manner, samples were fabricated for Lucitone–FRS, and Valplast. These specimens were further divided into two subsets; containing 10 specimens each from each group. In one subset, Flexural Strength was Measured while in the other subset, Surface Roughness was measured. The Surface Roughness values were measured using a surface testing machine Mitutoyo-SJSeries 201 (Japan). The flexural strength of specimens was measured using a 3-point bending test device on universal testing machine. All the results were compiled and Analyzed by SPSS software. Results: Flexural strength was found maximum in the VALPLAST and minimum in LUCITONE. Surface Roughness Test was done on total 10 samples of each material, i.e. Lucitone- FRS, Valplast and Trevalon. Results for Surface Roughness Test are Valplast has maximum Surface-Roughness followed by Trevalon and minimum in Lucitone-FRS on both polished and unpolished surface. Conclusion: Trevalon can be ideal in cross-arch stabilization cases and Valplast and Lucitone FRS can be successfully used in cases of small arch complete dentures and removable partial dentures. Clinical Significance: The selection of the right denture base material is imperative as it largely affects the overall clinical outcomes and comforts. Results of the present study would aid the dentist in the selection of ideal denture base materials for specific cases like those requiring Cross Arch Stabilization, Small Arch Complete Dentures, and Removable Partial D entures.



Seyed MR Hakimaneh, Shireen Shidfar, Hadi Teimoori, Sayed S Shayegh, Maryam A Zavaree, Farinaz Khodadad, Mohammad T Baghani

Effects of Excessive Implant Angulation on Retention of Two Types of Overdenture Attachments during Cyclic Loading

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:7] [Pages No:1221 - 1227]

Keywords: Dental implants, Dental prosthesis, Implant angulation, Implant-supported Overdenture, Retention.

   DOI: 10.5005/jp-journals-10024-2408  |  Open Access |  How to cite  | 


Aim: This study investigated the effects of implant angulation and cyclic dislodgment on retention of Locator and Dalbo Plus attachments. Materials and methods: Fifty pairs of acrylic blocks for five implant angulations (0, 10, 20, 30 and 40 degrees) and two attachment systems (locator and Dalbo Plus®; n = 5) were fabricated. In each pair, one block contained two implant analogs connected to their attachments, and the other block contained matrix parts of the attachments. 1440 cycles of insertion and removal were implicated on specimens after mounting the blocks in the universal testing machine. The retention was registered at cycle numbers 1, 120, 360, 720, and 1440. Data were analyzed using one-way analysis of variance (ANOVA) and Duncan's multiple range test (p ≤p 0.05). Results: Data analysis showed that implant angulation had significant effects on retention of both attachments at all different angles (p ≤ 0.05). Dalbo Plus showed no significant differences between 30 and 40 degrees (p ≥ 0.05), but between 0 and 30 degrees, differences were significant (p ≤ 0.05). Moreover, cyclic loading had significant effects on retention of both attachments at all different loading cycles (p ≤ 0.05). On evaluating combined effects of cyclic loading and implant angulation on retention, a significant decrease in retention was noted for both Locator and Dalbo Plus attachments at angulations of 0, 10, 20 degrees after 1440 cycles (1 year of clinical use; p ≤ 0.05). Conclusion: Both angulation and cyclic loading have negative effects on implant-supported overdentures and decrease retention over time. Furthermore, as the angle between implants increases, decrement of retention becomes more significant. Clinical significance:Inter-implant angulation could play a significant role in overdenture retention



Anup Shelke, Nitin Gadhiya, Sameer Narkhede, Rashmi Laddha, Monica Mahajania, Gaurav P Shetty

Effect of Subgingival Doxycycline Placement on Clinical and Microbiological Parameters in Inflammatory Periodontal Disease: Both in Vivo and in Vitro Studies

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:7] [Pages No:1228 - 1234]

Keywords: Doxycycline, Gingival index, Local drug delivery, Microbiology, Probing depth.

   DOI: 10.5005/jp-journals-10024-2409  |  Open Access |  How to cite  | 


Aim: To evaluate the effect of subgingival placement of doxycycline in the form of a resorbable membrane on the clinical and microbiological parameters in the treatment of inflammatory periodontal disease. Material and methods: We evaluated the effects of a controlled release system containing doxycycline both in vivo and in vitro conditions. Drug systems were prepared for both, and a total of 19 patients were included in the study with age range from 35 to 50 years. Clinical parameters like gingival index, probing depth, attachment loss, and gingival shrinkage were evaluated along with microbiological evaluation as well for a period of 10 weeks. Results: In vitro study showed that the doxycycline hydroxypropyl methylcellulose films are capable of releasing the drug in a sustained way with respect to time. It was observed that the gingival index score, periodontal probing depth, and gingival shrinkage showed low levels at the doxycycline-treated sites as compared to the placebo group. The microbial culture results also showed a marked reduction in the total anaerobic count post-treatment and till the end of the 10 week study period in the doxycycline-treated group. Thus, overall results showed that 30% doxycycline methylcellulose strips have significant effects and benefits on clinical and microbial parameters in more than 5 mm deep periodontal pockets. Conclusion: We conclude that 30% doxycycline both in vivo and vitro study has proven to be an effective antibiotic of choice both clinically and microbiologically. Clinical significance: Doxycycline has proven to have great promise as an antibiotic of choice. Thus, there is a significant advantage in the clinical use of doxycycline formulation for both the therapist and the patient. It can help dental professionals as an additional means to maintain an improved clinical health in periodontal problems of their patients. With this new therapeutic modality, we can augment the ability to treat periodontitis more effectively.



Hashim K Saeed, Adil O Mageet

Dental Arch Dimensions and Form in a Sudanese Sample

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:7] [Pages No:1235 - 1241]

Keywords: Arch form, Arch length, Arch width

   DOI: 10.5005/jp-journals-10024-2410  |  Open Access |  How to cite  | 


The aim of this study is to determine the dental arch dimensions (width and length) and form in a group of a Sudanese sample population. Background: The size and shape of dental arches have significant implication in orthodontic diagnosis and treatment planning as it affects the space available, dental esthetics and stability of the occlusion. Materials and methods: This study is a biometric analysis of dental casts of 50 adult Sudanese dental students (20 males, 30 females) aged between 19 to 22 years with normal occlusion. The study was conducted at the orthodontic clinics, Faculty of Dentistry, University of Khartoum. Each student was interviewed and written consent was given. The inclusion criteria were: complete permanent dentition fully erupted to the occlusal plane, no proximal caries or restorations, no attrition or dental anomalies, no extractions, no previous or ongoing orthodontic treatment and no fractures or jaw surgeries. Paired-test, ANOVA test, and Pearson's correlation were used for statistical analysis with a p-value set at 0.05. Results: The result showed normal occlusion is higher in males than in females. Upper arch dimensions (width and length) found to be higher in males than females, inter canine width (ICW), males 36, and females 34.45; interpremolar width (IPmW) males 48.08, females 47.58; inter-molar width (IMW) males 53.04, females 52.4; the length for males 37.98 and for females was 37.09. Comparison of Lower arch dimensions between males and females showed ICW (27.08 and 26.86); IPmW (40.97 and 39.67); IMW (45.61 and 45.69); depth was (33.91 and 33.91) consequently. The ovoid-shaped arch form was more common in both genders. Conclusion: Length dimension showed the highest value with square arch form. The width dimensions increase with little change in the inter-canine region but appreciably more in the distal part of the arch. Men have a more massive arch form than females. The ovoid arch form dominates in the Sudanese population. Clinical significance: Knowledge of arch dimensions that are associated with normal occlusion is helpful in determining treatment goals and proper diagnosis and treatment plan by choosing the right arch form for each race.



Satish S Bhosale, Bhoopendra S Rajput, Harsh Takkar, Sachin V Bhagat, Rajesh M Vagger, Mohd. Ibrahim K Shaikh

Establishment of Role of IL-2, IL-10 and IL-12 in Patients with Recurrent Aphthous Stomatitis—A Clinical Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:4] [Pages No:1242 - 1245]

Keywords: Interleukins, Recurrent aphthous stomatitis, Stress

   DOI: 10.5005/jp-journals-10024-2411  |  Open Access |  How to cite  | 


Background: Recurrent aphthous stomatitis is a vesiculobullous disease characterized by painful ulcers in the oral cavity. The role of interleukins such as IL-2, IL-10 and IL-12 in initiating disease demands careful assessment. The present study was conducted to determine the level of IL-2, IL-10 and IL-12 in patients with recurrent aphthous stomatitis. Materials and methods: The present study was conducted on 40 patients diagnosed with recurrent aphthous stomatitis. An equal number of age and gender-matched subjects (40) was included as a control. They were divided into 2 age groups from 20 to 40 years and 40 to 60 years. All were made to sit comfortably on a dental chair, and 1 ml of unstimulated saliva was collected in a sterile tube to assess the level of IL-2, IL-10 and IL-12 using ELISA. The level of IL-2, IL-10 and IL-12 was measured in pg/mL. Results: Each group had 10 males and 10 females. The difference was non-significant (P-1). Age group 20-40 years comprised of 14 patients in group I (eight males and six females) and 12 in group II (five males and seven females). Age group 40-60 years had six patients in group I (two males and four females) and 8 patients in group II (five males and three females). The difference was significant (p < 0.05). The most common form was minor (82%) followed by herpetiform (13%) and major (5%). In group I, the mean value of IL-2 level was 32.24 pg/mL, IL-10 was 1.24± 0.6 and IL-12 was 28.34± 4.04 and in group II, mean value of IL-2 level was 12.10 pg/mL, IL-10 was 2.56± 1.12 and IL-12 was 23.16± 4.16. The difference was significant (p < 0.05). Conclusion: Age group 20 to 40 years showed higher prevalence. The level of IL-2 and IL-12 is highly increased while IL-10 is decreased in patients. Clinical significance: Role of interleukins as a precipitating factor along with stress is well established. With the thorough knowledge of the disease process, the newer treatment modality specific against interleukins may be proven useful in controlling the disease.



Mahdi Akbarzadeh, Loghman R Sofi, Reza Fekrazad, Marjan Maleki

Effect of Er: YAG Laser, Sandblast and Several Types of Universal Bonding on Shear Bond Strength of Zirconia Ceramic to Composite Resin

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:8] [Pages No:1246 - 1253]

Keywords: Er: YAG Laser, Sandblasting, Shear bond strength, Universal bonding.

   DOI: 10.5005/jp-journals-10024-2412  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to investigate the effect of Erbium-doped yttrium aluminium garnet laser laser (Er: YAG laser), sandblast and several universal bonding on the shear bond strength of zirconia ceramic to composite resin. Materials and methods: In this experimental study, 96 Y-TZP disks were used. They were divided into six groups based on surface preparation: 1-Er: YAG laser + single bond universal/ 3M, 2-Er: YAG laser + all bond universal/bisco, 3-Er: YAG laser + G-premio bond/GC, 4-sandblast + single bond universal/3M, 5-sandblast + all bond universal/bisco, 6-sandblast + G-Premio bond/GC; in the next step, composite discs were cured on the surface of the zirconia discs and their shear bond strength was evaluated using a mechanical test machine (universal testing machine). Results: Two-way ANOVA showed that the surface preparation had a significant statistical effect on shear bond strength (p< 0.001). There was no association between these two variables with regards to the interaction of bonding and surface preparation (p = 0.064). Tukey's test showed that the shear bond strengths in the sandblast type group did not differ significantly between the groups according to the type of universal bonding, as well as in the Er: YAG laser treated group by type Universal bonding which was not significantly different between the groups of single bond universal and all bond universal, but there was a significant difference between the groups in terms of single bond universal and G-Premio, as well as all bond universal and G-Premio. Conclusion: Based on the results, the preparation of Er:YAG laser is a more appropriate method for increasing bond strength when compared with sandblasting, and among the universal bonding, G-Premio is also more suitable for this purpose. Clinical significance: The present data indicate that bond strength of laser preparation and G-Premio adhesive might be reliable for clinical application



Nallan C Chaitanya, Danam R Priyanka, Nithika Madireddy, Jampani N Priyanka, Madathanapalle Ramakrishna, Mujja Ajay, Ancy V Ignatius

Melasma Associated with Periodontitis, Anemia, and Vitamin D Abnormalities: A Chance Occurrence or a Syndrome

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:6] [Pages No:1254 - 1259]

Keywords: Hemoglobin percentage, Melasma, Periodontitis, Vitamin D.

   DOI: 10.5005/jp-journals-10024-2413  |  Open Access |  How to cite  | 


Aim: To correlate the possible association between melasma, periodontitis, vitamin D abnormalities, and anemia. Materials and methods: A total of 192 subjects, of either gender within the age group of 30 to 70 years were divided equally into two groups, group I (case group, patients with melasma) and group II (control group, patients without melasma). In all the subjects, anemia and periodontitis were checked clinically, along with biochemical evaluation of serum vitamin D levels and hemoglobin (Hb) percentage. Results: Student's t-test was performed with group statistics and chi-square for intervariable correlation was carried out. A significant correlation was found between patients having melasma and serum vitamin D levels with a p-value of 0.050. Between patients with melasma and periodontitis, there was a very significant correlation between the variables, with a p-value of 0.001. Conversely, the correlation between melasma and Hb percentage was found to be insignificant with the p-value 0.243, and all of the p-values remained at <0.05.The study thus demonstrated significant correlation between melasma, vitamin D abnormalities, and clinical periodontitis (p-value < 0.05), and no significant correlation between melasma and Hb. Conclusion: The cross-sectional study revealed that patients with melasma may have abnormal serum vitamin D and clinical periodontitis. This presence may be considered a syndromic occurrence. Clinical significance: The present study was done to correlate and also evaluate periodontitis, vitamin D abnormalities, and anemia in patients with melasma. It is primarily an observational study, attempting to evaluate the co-occurrence of the abovementioned variables. The findings may prompt us to further investigate melasma for the presence of periodontitis, anemia, and vitamin D abnormalities.



Rania Hadad, Dani A Samra

Skeletal Age-related Changes of Midpalatal Suture Densities in Skeletal Maxillary Constriction Patients: CBCT Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:7] [Pages No:1260 - 1266]

Keywords: Cervical vertebral maturation index, Cone-beam computed tomography, Midpalatal suture, Rapid maxillary expansion, Surgically assisted rapid maxillary expansion.

   DOI: 10.5005/jp-journals-10024-2414  |  Open Access |  How to cite  | 


Aim: To determine if density measurements of the midpalatal suture and cervical vertebral maturation index (CVMI) are related, and to investigate if CVMI could help in predicting of the developmental status of the midpalatal suture. Materials and methods: Cone-beam computed tomography (CBCT) images of 95 skeletal maxillary constriction patients (aged 8 to 18 years) were examined. The maturational stages of the cervical vertebrae were visually defined, and midpalatal suture density in the anterior region, the middle region, and the posterior region were measured. One-way ANOVA and Fisher's least significant difference (LSD) post-hoc test were used for statistical assessment. Results: Significant differences were found in MPDS: in anterior region between (c1, c2, c3, c4) and (c5, c6) stages, in middle region between (c1, c2, c3) and (c5, c6) stages, and in posterior region between (c1, c2, c3) and (c4, c5, c6) stages. Conclusion: Midpalatal suture densities in all regions increase with skeletal maturation advancement. The significant increase after puberty may have the key role in decreasing the skeletal effects of RME after that age. Clinical significances: It is important to assess the midpalatal suture density to choose between rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME). This study revealed a significant increase in the midpalatal suture density after puberty. Thus, it may better to perform RME before puberty.



Amol Gadbail, Shailesh Gondivkar, Trupti Gaikwad, Deepali Patekar

Usage Analysis of WhatsApp for Dentistry-related Purposes among General Dental Practitioners

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:6] [Pages No:1267 - 1272]

Keywords: Dentistry, General dental practice, Second Opinion, WhatsApp

   DOI: 10.5005/jp-journals-10024-2415  |  Open Access |  How to cite  | 


Introduction: To assess the knowledge and extent of WhatsApp usage for dentistry related purposes among general dental practitioners (GDPs). Materials and methods: A cross-sectional study was conducted among 105 randomly selected GDPs from Pune, Maharashtra, India. Data was collected in a personalized manner by means of validated questionnaire. Results and observations: A total of 105 dentists participated in the survey: 96.19% of dentists had WhatsApp installed in their phones; 67.32% of dentists sought second opinion on WhatsApp; 60.29% of dentists received prompt replies, while 38.23% received late replies; 98.52% of dentists sent clinical photographs and radiographs for second opinion. 88.11% of dentists were a part of various ‘dentistry related groups’ and 72.27% of dentists told that patients ask their queries on WhatsApp. 36.76% of GDPs obtained verbal consent from the patients for sending clinical materials for second opinion. Majority of population of GDPs 63.23% (43) did not obtain any form of consent from the patients. Conclusion: Majority of GDPs uses WhatsApp for ‘dentistry related purposes’ and it has become an integral part of their day-to-day practice. GDPs should obtain written consent before sending clinical materials for second opinion. Clinical significance: Till date, the extent of WhatsApp usage by general dental practitioners was not reported in the literature. It appears that, WhatsApp application has become an integral part of general dental practice in India. By virtue of this, obtaining second opinion, taking appointments and solving queries of patients are no longer a time consuming events. In future, instant messaging services might play major role in providing efficient services in health care industry.



Swapna Munaga, Abhisek Das, Ashfaq Yaqoob, Rizwan Mokashi, Prabhu MS Ismail

Comparative Clinical Evaluation of Composite Overcast Gold Post and Core Buildups in Endodontically Treated Teeth

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:5] [Pages No:1273 - 1277]

Keywords: Composite, Core, Gold, Post

   DOI: 10.5005/jp-journals-10024-2416  |  Open Access |  How to cite  | 


Background: The management of non-vital teeth includes endodontic treatment and restoration followed by post and core restoration in selected cases. The present study was conducted to compare the indirect cast post, and core buildup with direct composite post build up in patients. Materials and Methods: The present study was conducted on 128 teeth of 82 patients. The success rate over 3 years was evaluated clinically and radiographically by observing caries, tooth mobility, probing depth, periapical pathology, and root fractures. Results: Group I consisted of 16 incisors, 20 canines, 22 premolars, and six molars while group II had 17 incisors, 14 canines, 25 premolars, and eight molars. The difference was statistical non-significant (p–0.1). Forty-four teeth in group I and 42 teeth in group II utilized composite cement, whereas 18 teeth in group I and 16 teeth in group II used GIC and zinc phosphate was used in two teeth in group I and six teeth in group II. The difference was statistical ly significant (p< 0.05). Four teeth in group I and 8 in group II were lost. One tooth in group I and two teeth in group II showed root fracture and three teeth in group I and six teeth in group II showed periapical pathology. The difference was statistically significant (p–0.01). Most common type of complication was probing depth > 4 mm, caries, tooth mobility, and root fracture. The difference was non- significant (p–0.31). Conclusion: Both composite post buildup and cast gold post and core build-up exhibited similar properties. Clinical significance: Both composite post buildup and cast gold post and core build-up exhibited similar properties hence either of the methods can be used in post core build up.



Pratibha Sharma, Arihant Banthia, Srinivasa K Rao, Karthik Choudhary, Nitin Awasthi

A Study on the Evaluation of Pharyngeal Size in Different Skeletal Patterns: A Radiographic Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:6] [Pages No:1278 - 1283]

Keywords: ANB angle, Cephalometric, Pharyngeal airway and Sagittal.

   DOI: 10.5005/jp-journals-10024-2417  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the upper and lower pharyngeal airway dimensions were affected by different skeletal malocclusions. Materials and methods: Lateral cephalograms of 120 subjects were used to measure the pharyngeal airway and were divided into three groups (each group included 40 subjects) according to ANB angle: Class I (ANB angle 2o ≤ ANB ≤ 4o), Class II (ANB angle(ANB ≥ 6o), and Class III (ANB angle ≤ 0o). Various linear cephalometric airway measurements (14 measurements) were used to evaluate pharyngeal airway at various levels. Statistical analyses were performed Using the ANOVA and student t-test. Results: PNS-ppw1 (p < 0.001) and McNamara’ lower pharynx dimension (p < 0.05) showed a statistically significant difference between the groups. Two out of 14 variables ie Ba-PNS and t-ppw showed a statistically significant difference between male and female. In both measurements, the difference is significant only in the Class II group with the level of significance being (p < 0.001) in Ba-PNS measurement, and (p < 0.05) in t-ppw measurement. In both measurements males have statistically significant higher mean values than the females. Conclusion: The dimensions of pharyngeal structures were not affected by the changes of the ANB angle. The sagittal skeletal pattern does not seem to influence the variations in the upper airway dimension. There was no significant difference in the dimensions of pharyngeal structures among males and females. Clinical significance: The upper and lower pharyngeal airway dimensions are affected by different skeletal malocclusions can significantly aid in Orthodontic treatment planning.



Georges Aoun, Riad Bacho, Hicham A Diab, Ibrahim Nasseh

Palatine Tonsilloliths: A Retrospective Study on 500 Digital Panoramic Radiographs

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:4] [Pages No:1284 - 1287]

Keywords: Lebanese, panoramic, population, radiography, tonsillolith

   DOI: 10.5005/jp-journals-10024-2418  |  Open Access |  How to cite  | 


Aim: This study aimed to investigate palatine tonsilloliths in the Lebanese population via digital panoramic radiographs. Materials and methods: Digital panoramic radiographs of a sample of 500 Lebanese adult patients (281 females and 219 males) with an average age of 47.9 years were included in this study and assessed for tonsilloliths. The IBM® SPSS® (IBM, Armonk, NY, USA) version 20.0 for Windows was used to carry out statistical analysis of the data collected. Results: Tonsilloliths were found in 7.2% of cases (36 out of 500; belonging to 18 females and 18 males). Among these, 13 cases were on the right side, 12 on the left side and 11 were bilateral. Affected patients’ age ranged from 24 to 84 years (mean of 61 years). There was no statically significant relation between tonsilloliths presence and gender, while a low positive correlation was observed between tonsilloliths and age (r = 0.193). Conclusion: Palatine tonsilloliths may be discovered fortuitously on panoramic radiographs utilized regularly in dental offices; their incidence increases with age. Clinical significance: Panoramic radiographs may have a beneficial role in detecting palatine tonsilloliths sometimes connected to unpleasant symptoms such as non-specific chronic halitosis. Palatine Tonsilloliths: A retrospective study on 500 digital panoramic radiographs



Gopal Krishna Choudhury, Rajiv Mehngi, Pooja Bhagwat, Shruthi S Hegde, Divya Sah, Vikram S Rathod

Clinical and Histopathological Analysis of Odontogenic Tumors in Institution–A 10 Years Retrospective Study

[Year:2018] [Month:] [Volume:19] [Number:10] [Pages:5] [Pages No:1288 - 1292]

Keywords: Ameloblastoma, Keratocystic odontogenic tumor, Odontogenic tumor

   DOI: 10.5005/jp-journals-10024-2419  |  Open Access |  How to cite  | 


Aim: The present study was conducted to analyze the clinical and histopathological cases of odontogenic tumors (OTs). Materials and methods: The present 10-year retrospective study comprised of 104 OTs. Parameters such as name, age, gender, clinical features, location, extension, etc were noted. H and E stained slides were carefully assessed by an oral pathologist and were classified according to the latest WHO classification of head and neck tumors. Results: Out of 104 OTs, the most common was ameloblastoma constituting 45 cases, KCOT (28), odontoma (17), odontogenic myxoma (4), Calcifying epithelial odontogenic tumor (CEOT) (5), cementoblastoma (3) and calcifying cystic odontogenic tumor (2). The p value found to be 0.01 (significant). Common OTs was ameloblastoma (25 males and 20 males), KCOT (12 males and 16 females), odontoma (10 males and 7 females), odontogenic myxoma (3 males and 1 female), CEOT (3 males and 2 females), cementoblastoma (2 males and 1 female) and calcifying cystic odontogenic tumor (1 male and 1 female). Ameloblastoma, KCOT, and odontoma were predominantly seen in the age group 21-30 years, CEOT and cementoblastoma in age group 31-40 years. The difference was significant (P < 0.05). Common clinical features in OTs were facial disfigurement (65), swelling (78) and pain (55). The difference was non significant (P > 0.05). The average size of ameloblastoma was 6.8cm, KCOT was 4.2 cm, odontoma was 3.9 cm, odontogenic myxoma was 2.7 cm, CEOT was 5.5 cm, cementoblastoma was 3.8 cm and Calcifying cystic odontogenic tumour (COC) was 3.6 cm. The difference was non-significant (p > 0.05). Conclusion: Mandible exhibited more OTs as compared to the maxilla. The most common lesion was ameloblastoma, KCOT, and odontomas. We observed male predominance. Clinical significance: The study helps in assessing the occurrence of the odontogenic tumor. This is useful for identification and clinical management.


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