The Journal of Contemporary Dental Practice

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2018 | September | Volume 19 | Issue 9

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Amol R Gadbail, Shailesh Gondivkar

Scope of Mathematical Biology in Cancer Research

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:2] [Pages No:1035 - 1036]

   DOI: 10.5005/jp-journals-10024-2376  |  Open Access |  How to cite  | 



Ana P Farina, Daniela C Miyagaki

Oral Lesions found in a Dental School in Southern Brazil

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1037 - 1041]

Keywords: Diagnosis, Epidemiology, Oral lesions, Stomatology, Treatment

   DOI: 10.5005/jp-journals-10024-2377  |  Open Access |  How to cite  | 


Objective: This study aimed to perform an epidemiological survey of the cases of oral lesions diagnosed in a Brazilian dental school. Materials and methods: An epidemiological survey was carried out at the Faculty of Dentistry of the University of Passo Fundo (FOUPF), Rio Grande do Sul, Brazil, between March 2015 and June 2017, characterizing the patients in terms of gender, age, and ethnicity. A total of 3,200 records were evaluated, from which 716 presented information on oral lesions diagnosed and treated at the clinics of the FOUPF. The data were evaluated by descriptive statistics of frequency. Results: The most frequent change was the coated tongue (13.83%). The majority of the patients were female (56%), white (31.57%), in the sixth decade of life (21.65%). Regarding the classification of lesions, the most frequent group was developmental changes (25%). Conclusion: It is considered that the sample studied presented a significant index of oral lesions and normality changes, considering that 716 (22.38%) patients studied showed some type of change in the oral cavity. Clinical significance: The sample studied presents peculiar characteristics regarding the number of oral lesions/conditions diagnosed. It is also considered that Schools of Dentistry are valuable environments for carrying out epidemiological surveys in stomatology, providing the diagnostic exercise, as long as the students are stimulated for this purpose.



Sanupa S Madhavan, Pochappallil V Sreedevi

Effectiveness of Mentha piperita Leaf Extracts against Oral Pathogens: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1042 - 1046]

Keywords: Antimicrobial activity, Mentha piperita, Oral pathogen, Zone of inhibition

   DOI: 10.5005/jp-journals-10024-2378  |  Open Access |  How to cite  | 


Aim: The study aims to assess the Mentha piperita leaf extract's effectiveness against oral pathogens. Materials and methods: The leaf extract of M. piperita was prepared using cold water method. The three microbial strains, i.e., Streptococcus mutans, Aggregatibacter actinomycetemcomitans, and Candida albicans were used as microbiological materials. Chlorhexidine 0.2% was used as positive control. The digital caliper was used to measure the zone of inhibition to know the antimicrobial activity at 24 and 48 hours. To compare the activity within and between the different microbial strains, one-way analysis of variance (ANOVA) was used. To analyze the data, Statistical Package for the Social Sciences (SPSS) software version of 21.0 was used. The p-value <0.05 was considered as statistically significant. Results: Maximum inhibition zone was seen in both M. piperita extracts and 0.2% chlorhexidine with S. mutans at 24 and 48 hours, followed by A. actinomycetemcomitans, and C. albicans respectively. The statistical analysis ANOVA reveals the statistically significant association of M. piperita extracts with p-value <0.001. The comparison with 0.2% chlorhexidine at 24 hours showed a p-value of <0.04 and at 48 hours, it showed a p-value <0.001, which was statistically significant. Conclusion: The present study concluded that M. piperita showed antimicrobial activity against the oral microorganisms which are causing major less or more severe oral diseases and it can be administered as an alternative medicine for the conventional treatment. Clinical significance: The study results serve as a guide in selecting and providing information about the efficacy of M. piperita extracts to the dental professionals. The discovery of a potential herbal medication would be a great development in the field of antimicrobial therapies.



Mukesh Gupta, Sumitha A David, A Nishad, Sudeep C Bhagvandas

In vitro Analysis of Shear Bond Strength and Adhesive Remnant Index of Stainless Steel Brackets with Different Adhesive Systems to Enamel

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1047 - 1051]

Keywords: Adhesive, Adhesive remnant index, Brackets, Shear bond strength

   DOI: 10.5005/jp-journals-10024-2379  |  Open Access |  How to cite  | 


Aim: This study aimed at evaluating and comparing the bond strength of stainless steel brackets bonded with multiple orthodontic adhesives. Materials and methods: About 60 premolars extracted to create space during orthodontic treatment were included in the present study. Premolar stainless steel brackets of size 0.022″ slot with the surface area of bracket base of 11.15 mm2 were used. The premolars were divided randomly into three groups of 20 in each. Group I: Conventional Acid Etching (Transbond XT); group II: Seventh-generation adhesive materials (Xeno V); and group III: Flowable composite (Filtek Z350 XT). Calculation of Adhesive Remnant Index (ARI) was done and shear bond strength was assessed. The probability level of 0.05 was considered as clinically significant. Results: The shear bond strength was highest in group II (17.46 ± 1.36), which was followed by group I (15.33 ± 2.78) and the least was shown by group III (13.96 ± 1.44). A statistically significant difference was found between group I vs II, group II vs III, and group III vs II. Utmost prevalence of about 35% was found in Transbond XT with an ARI score of 3 (followed by all adhesive left on the tooth), Filtek Z350 XT with 20%, and the least was found with Xeno V, about 5%. The probability was found to be p = 0.025 among different groups, which is statistically significant according to chi-square test. Conclusion: The study concluded that the adhesive materials of the seventh generation showed higher shear bond strength than that of the flowable composite and conventional acid etching. The ARI indicated that a minimum amount of the residual adhesive was found on the surface of the enamel after debonding. Clinical significance: This study helps orthodontists to select appropriate adhesive and orthodontic brackets for the benefit of the patient and to distinguish the distribution of stress homogeneously within the layer of cement while loading and subsequently minimizing the damage to the enamel during the debonding of orthodontic brackets.



Gabriela F da Fonseca, Amanda MO Dal Piva, João PM Tribst, Alexandre LS Borges

Influence of Restoration Height and Masticatory Load Orientation on Ceramic Endocrowns

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:6] [Pages No:1052 - 1057]

Keywords: Dental restoration failure, Dental stress analysis, Finite element analysis

   DOI: 10.5005/jp-journals-10024-2380  |  Open Access |  How to cite  | 


Aim: Endocrown restorations are an alternative to restore endodontically treated teeth. Due to the fact that in the literature it is recommended a remnant of 1.5 mm, different heights of endocrown were elaborated and analyzed, obtaining possible faults and their location. This study aimed to evaluate the mechanism of stress distribution in the tooth/restoration set, varying two factors: “restoration height”—three levels, and load application—two levels (oblique or axial), totaling six groups. Materials and methods: For finite element analysis (FEA), a maxillary premolar was modeled with an endodontic treatment. Then, this template was triplicated and each copy received an endocrown restoration of different heights: G6 (4.5 mm), G7 (5.5 mm), and G8 (6.5 mm). The models were exported in STEP format to analysis software (ANSYS 17.2, ANSYS Inc.). During preprocessing, the solids were considered isotropic, linearly elastic, and homogeneous. Initially, a load (300 N) was axially applied in the central fossa region. For a second evaluation, an oblique load (300 N) was applied on the grinding slope of functional cusp. System fixation occurred at the base of polyurethane cylinder. Results were evaluated through maximum principal stress (MPS). Results: For axial load, lower stress values were generated in all groups. For oblique load, G8 showed a higher stress concentration in the cement layer and root dentin. Conclusion: When an endocrown restoration is performed, there is a tendency of failure in the cement line and in the root directly proportional to its size. However, regardless of the size of the element to be reconstituted, the axial direction of the masticatory loads tends to decrease stress concentration. Clinical significance: When performing an endocrown restoration, care must be taken with its high regardless the tooth remnant high, altering even the anatomical angulations of the occlusal face, when necessary, to avoid stress concentration in thick areas.



Deepak Khandelwal

Control of Anxiety in Pediatric Patients using “Tell Show Do” Method and Audiovisual Distraction

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:7] [Pages No:1058 - 1064]

Keywords: Anxiety, Audiovisual distraction, First dental visit

   DOI: 10.5005/jp-journals-10024-2381  |  Open Access |  How to cite  | 


Introduction: Visiting a dentist can easily evoke strong fear reactions and acute anxiety in children. It is one of the most basic reasons for avoidance and neglect of dental care. It may obstruct delivery of dental care, as the child may be unwilling to accept the treatment being provided by the dentist. Aim: To evaluate and compare reduction in anxiety level in patients undergoing dental treatment at first dental visit. Technique: The study was conducted on 400 patients coming to the Department of Pedodontics and Preventive Dentistry, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, for their first dental visit. Anxiety was recorded using facial image scale (FIS), Venham's picture test (VPT), blood pressure, pulse rate (PR), and oxygen saturation (SpO2) at different stages of the visit. Patients coming for the first dental visit were subjected to restorative treatment under Tell show do (TSD) method and audiovisual distraction (AVD). The data collected were tabulated and subjected to statistical analysis. Conclusion: The AVD was found to be more capable in reducing anxiety than TSD. Combination of TSD and AVD had an additive effect in reduction of anxiety level and it proved to be more beneficiary. Clinical significance: If a child's behavior in the dental office cannot be managed, then it is difficult to hold out any dental treatment that is needed. Bringing positivity in the child's behavior would not only increase efficiency of work but would also make the experience for child undergoing treatment more pleasant.



Sabir Muliyar, Rekha P Thankachan, Abdul Shameem, Jacob T Kalliath, Ummer Mangalath, Sadiya Mangalath

Study to evaluate the Efficacy of Resin-modified Glass Ionomer Cement Liner as a Direct Pulp Capping Material

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:7] [Pages No:1065 - 1071]

Keywords: Direct pulp capping, Dycal, Glass ionomer cement, Iatrogenic exposure, Reparative dentin

   DOI: 10.5005/jp-journals-10024-2382  |  Open Access |  How to cite  | 


Aim: The aim of the present in vivo study was to compare efficacy of light-cured resin-modified glass ionomer liner, Vitrebond™ (3M ESPE) with Dycal® (Dentsply) on the healing of pulpal tissue in the event of a direct iatrogenic pulpal exposure. Materials and methods: Experimental group consisted of Vitrebond™ (3M ESPE) resin-modified glass ionomer liner, and Vitremer™ (3M ESPE) resin-modified glass ionomer cement (GIC) in comparison with the control group of Dycal® (Dentsply) as liner and Poly F® (Dentsply) dental cement. Class V cavities were prepared in 32 sound premolars that were scheduled for orthodontic extraction, and the exposures were capped according to groups. Five teeth from each group were extracted under local anesthesia after an interval of 24 hours, 35 and 60 days, and evaluated for inflammation, fibrotic changes, formation of reparative dentin and bacterial examination. Results: The present study did not show any statistically significant difference between two groups in terms of inflammation, fibrosis, reparative dentin formation, and bacterial examination Conclusion: This study shows that Vitrebond™ (3M ESPE) light-cured resin-modified glass ionomer liner can be used as an alternative to calcium hydroxide as a direct pulp capping material.



Matheus C Bandeca, Alvaro H Borges, Mateus R Tonetto, Suellen L Lima, Andreza MF Aranha, Fábio LM Pedro, Carlos L Antunes, Evanice MM Vieira, Carlo R De Musis

Eruption of Impacted Teeth in Cleft Lip and Palate Patients following Alveolar Bone Graft

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:4] [Pages No:1072 - 1075]

Keywords: Alveolar bone graft, Cleft lip, Cleft palate, Tooth eruption

   DOI: 10.5005/jp-journals-10024-2383  |  Open Access |  How to cite  | 


Introduction: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft. Materials and methods: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiabá, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed. Results: Forty-two patients treated at the institution from 2004 to 2011 had their charts retrospectively reviewed. They were 54.7% male and 45.2% female. The group aged 9 to 11 years was most affected, representing 59.5% of cases. A unilateral cleft was the most prevalent craniofacial anomaly (85.7%). A total of 57 impacted teeth were observed. Maxillary canines were the most commonly impacted teeth (97.6%) and the most frequently identified in patients with a transforamen incisor cleft (TIC) (76.3%). Orthodontic traction was required for both impacted maxillary canines and impacted lateral incisors (64.3 and 35.7% respectively). The orthodontic traction was required only in patients with a TIC (p = 0.0101). Conclusion: The canine teeth were the most commonly impacted teeth, found mainly in patients with a TIC. After placement of the alveolar bone graft in patients with a preforamen incisor cleft (PIC), all impacted teeth erupted spontaneously. Clinical significance: An impacted tooth can have negative consequences on a patient's quality of life. Thus, a survey evaluating the incidence and prognosis of impacted teeth after an alveolar bone graft for CLP was important.



Kailash C Dash, Roquaiya Nishat, Silpiranjan Mishra, Atul Bajoria

Comparative Study of Micronuclei Count in Patients with Different Tobacco-related Habits using Exfoliated Buccal Epithelial Cells: A Tool for Assessment of Genotoxicity

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:6] [Pages No:1076 - 1081]

Keywords: Genotoxicity, Giemsa stain, Micronuclei, Tobacco

   DOI: 10.5005/jp-journals-10024-2384  |  Open Access |  How to cite  | 


Aim: To study and compare the genotoxic effects of tobacco using micronuclei count in individuals with different tobaccorelated habits. Materials and methods: A cross-sectional study was done comprising 200 individuals, divided into four groups. Group I: 50 subjects with history of tobacco chewing, group II: 50 subjects with a history of smoking tobacco, group III: 50 subjects with a history of both tobacco chewing and smoking, and group IV: 50 subjects without any habits as controls (age-matched). The study groups were individually further divided into three subgroups which comprised of subjects with history of substance abuse for less than 5, 5 to 10, and greater than 10 years. Exfoliated cells from the buccal mucosa of the subjects were collected and stained using Giemsa stain. A total of 1,000 cells were examined for each case and micronuclei frequency was scored according to the guidelines given by Tolbert et al. Results: The mean number of micronuclei count was 18.28 ± 10.0 in group I (smokeless tobacco users), 11.38 ± 6.3 in group II (subjects with history of tobacco smoking), 22.44 ± 9.8 in group III (subjects with history of using both smokeless and smokable form of tobacco), and 4.86 ± 2.4 in the control group. The statistical difference was found to be highly significant (p < 0.001). Similarly, based on the duration, highly significant difference was notable in the mean number of micronuclei in subjects who had a history of substance abuse for more than 10 years Conclusion: A significantly higher micronucleus frequency was found in smokeless tobacco users than in smokers and controls. Micronuclei assay in the exfoliated buccal cells is a useful and minimally invasive method for monitoring early genotoxic damage. Clinical significance: Micronuclei assay can be used to detect genotoxic damage at the earliest and, if intervened at this point, may prevent frank malignancy, morbidity, and mortality.



Karthik Venkataraghavan, Karthik Venkataraghavan, Chirag R Panchal

Comparative Evaluation of Shear Bond Strength and Microleakage of Two Self-adhering Composite Resins: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1082 - 1086]

Keywords: Dental cement, Microleakage, Polymerization shrinkage, Resistance, Self-etch adhesive, Shear bond strength

   DOI: 10.5005/jp-journals-10024-2385  |  Open Access |  How to cite  | 


Introduction: A good dental cement used as repair material should possess chemical binding, easy handling characteristics, minimal marginal breakdown and minimal polymerization shrinkage, high resistance to wear, high cohesive strength, and good color stability. This study was undertaken to compare the in vitro microleakage and shear bond strength among the newly introduced Prime fill flow and Dyad flow. Aim: The aim of this study was to determine the effect on shear bond strength and microleakage of two self-adhesive composite resin. Materials and methods: Selected specimens were collected and stored in deionized water with an antibactericidal agent, 0.2% sodium azide, until ready to be used and were randomly divided into two groups: group I: Dyad flow and group II: Prime fill flow; specimens were sheared with a universal testing machine, and the results were calculated in megapascal, specimens were sectioned in a mesiodistal direction at four different locations, and analyzed for leakage (dye penetration) using a stereomicroscope. Results: The results of the present study showed that acceptable values for Prime fill flow seemed to have least microleakage and high bond strength as compared with Dyad flow. Conclusion: Here, it can be concluded that there was significant difference in the in vitro microleakage and shear bond strength among the Prime fill flow and Dyad flow. Clinical significance: Self-etch adhesives when compared with total-etch systems have the advantage of reducing the application time and the number of steps in pediatric dentistry. Patients’ age and cooperation are not always ideal; the treatment outcome is greatly influenced by the patients’ behavior. It is therefore imperative to recede the application time of some materials mostly in pediatric dentistry.



Ana CL Marques, Bernardo A Aguiar, Luciana MA Frota, Bruno M Guimarães, Nilton Vivacqua-Gomes, Rodrigo R Vivan, Marco AH Duarte, Bruno C de Vasconcelos

Evaluation of Influence of Widening Apical Preparation of Root Canals on Efficiency of Ethylenediaminetetraacetic Acid Agitation Protocols: Study by Scanning Electron Microscopy

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:8] [Pages No:1087 - 1094]

Keywords: Easy clean, Endodontics, Ethylenediaminetetraacetic acid, Laboratory research, Passive ultrasonic irrigation, Scanning electron microscopy evaluation

   DOI: 10.5005/jp-journals-10024-2386  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate the influence of widening the apical root canal preparation (RCP) on the efficiency of different ethylenediaminetetraacetic acid (EDTA) agitation protocols on smear layer removal: EDTA; EDTA + Easy Clean in rotary movement (ECROT); EDTA + Easy Clean in reciprocating movement (ECREC); and EDTA + Passive ultrasonic irrigation (PUI). Materials and methods: A total of 80 mandibular premolars had their crowns sectioned and then were divided into two groups according to widening: size 25 or 40, 0.08 taper. Sequentially they were once again allocated to subgroups according to the agitation protocol performing eight experimental groups (n = 10). Ten additional teeth were prepared for controls (C+/C-). The specimens were then submitted to the cleaning protocols and thereafter cleaved and microphotographed by variable pressure scanning electron microscopy (SEM) at previously determined points along their root thirds (750×). Scores were attributed to the images, and data were analyzed by the Kruskal–Wallis, Student–Newman–Keuls and Friedman tests. Results: A higher widening was observed to have a positive influence on cleaning efficiency offering significant differences in global and apical third evaluations (p < 0.05). Relative to the agitation, significant differences were observed mainly in the apical third, with PUI and ECROT providing the best results (p < 0.05); no difference for C+ was observed when higher widening was employed. Conclusion: A greater widening of the apical third provided a significant improvement in the action of the agitation/activation protocols. Moreover, the PUI and ECROT activation methods were shown to be superior to the use of EDTA solely, particularly in the apical third. Clinical significance: The findings of this study reinforce the need for clinical use of additional methods to complement cleaning. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.



Sandeep Singh, Zuber A Naqvi, Archana Lanje, Debkant Jena, Kandarpa Balakrishna

A Retrospective Analysis of Pulp Stones in Patients following Orthodontic Treatment

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1095 - 1099]

Keywords: Orthodontic tooth movement, Pulp stones, Pulpal calcifications

   DOI: 10.5005/jp-journals-10024-2387  |  Open Access |  How to cite  | 


Aim: The present study aimed to find prevalence of pulp stones in known South Indian orthodontic patients and to find correlation between pulp stones and patients who underwent orthodontic treatment as well as to reveal any differences due to gender, tooth type, and dental arches. Materials and methods: The present retrospective study was carried out among 200 patients who underwent nonextraction orthodontic treatment. Maxillary and mandibular first and second premolar and molar teeth were selected for the purpose of the study using panoramic radiographs. A total of 3200 teeth of 200 patients were studied for the presence of pulp stones. Statistical analysis of the obtained data was carried out using Statistical Package for Social the Sciences (SPSS) version 22.0. Chi-square test was applied to find the significant value and p ≤ 0.05 was considered as a significant value. Results: In all, 11.5% of cases reported pulp stones before the commencement of the orthodontic treatment and 15.5% cases after completion of orthodontic treatment. Overall, 4% increase in cases were found which was statistically significant (p < 0.05); 5.1% of total number of teeth were evaluated in both arches before orthodontic treatment and 6.3% of teeth after orthodontic treatment revealed the presence of pulp stones. Maxillary first molar was found to be teeth with maximum number of pulp stones before and after orthodontic treatment. Conclusion: The present study reported the prevalence of pulp stones to be increased by 4% in the pre- and posttreatment radiographs, which was statistically significant. The study found the presence of pulp stones more in maxillary first molar and it was found to be teeth with maximum number of pulp stones before and after orthodontic treatment. However, further researches with larger samples are advisable. Clinical significance: Dentists performing endodontic treatment among patients who have undergone orthodontic treatment should be aware about the increased chances of presence of pulp stones and thus to avoid hindrances encountered during extirpating the pulp, they should thoroughly study the radiographs beforehand.



Ajay K Gupta, Bibhu D Nanda, Munmun Moudgil

In vitro Evaluation and Comparison of Microleakage of Two Restorative Composite Resins in Class II Situations using Confocal Laser Scanning Microscopy

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1100 - 1104]

Keywords: Confocal laser scanning microscopy, Microleakage, Rhodamine B, SonicFill Bulk Fill composite, Tetric EvoCeram Bulk Fill composite

   DOI: 10.5005/jp-journals-10024-2388  |  Open Access |  How to cite  | 


Aim: The placement of composite in teeth is not an easy task and it poses many challenges. Microleakage is one of the factors that affects the success of any composite restoration. It influences the longevity of dental restorations. The present study was aimed to evaluate and compare microleakage of two restorative composites resins in class II cavities using confocal laser scanning microscopy (CLSM). Materials and methods: This was an in vitro study, which included 20 permanent mandibular first molar. On each tooth, 40 class II cavities were prepared with a carbide bur. The teeth were then randomly divided into two groups of 10 each. Group I included teeth in which SonicFill Bulk Fill composite was used. Group II included teeth in which Tetric EvoCeram Bulk Fill composite was used. The microleakage was measured using confocal microscopy at 10× magnification in the fluorescent mode by a scoring system Results: Estimation was done at cervical and occlusal levels, wherein group I included 10 teeth which were restored with SonicFill Bulk Fill composite and group II included 10 teeth which were restored with Tetric EvoCeram Bulk Fill composite. Microleakage was quantified on scoring basis, which was consecutively based on the dye penetration at different levels. Data thus obtained statistically revealed that microleakage was comparatively more in group II as compared with group I. In addition, it was somewhat similar on both cervical as well as occlusal regions. The difference was significant (p = 0.05). Comparison was also done at cervical and occlusal levels using Wilcoxon signedrank test, which showed significant levels of differences (p > 0.05). Conclusion: There is more microleakage in Tetric EvoCeram Bulk Fill composite as compared with SonicFill Bulk Fill composite. Clinical significance: No material seems to totally eliminate microleakage in class II situations with gingival margin ended in dentine. However, CLSM is a useful tool in microleakage evaluation that could be used successfully to estimate the severity of microbial penetrations and material of choice as well.



Awadhesh Gupta, Mohammed Abidullah, Swathi Bhuvinder, Padmavathi Katragadda

Role of E-cadherin in Progression of Oral Squamous Cell Carcinoma: A Retrospective Immunohistochemical Study

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:6] [Pages No:1105 - 1110]

Keywords: Cell adhesion molecules, Dysplastic epithelium, E-cadherin, Immunohistochemistry, Tumor markers

   DOI: 10.5005/jp-journals-10024-2389  |  Open Access |  How to cite  | 


Aim: The aim of present study was to assess the role of E-cadherin in oral carcinogenesis by comparing their expressions in normal oral mucosa, oral epithelial dysplasia (OED), and oral squamous cell carcinoma (OSCC). Materials and methods: To elucidate the pattern of E-cadherin expression in oral carcinogenesis, 21 archival cases of formalinfixed paraffin-embedded sections of OSCC, 21 OED, and 7 normal oral mucosa samples as control were used for the study. Results: We observed reduction/loss of E-cadherin in membranous expression pattern and staining intensity with progression from dysplasia to oral cancer. Conclusion: A decrease in staining intensity and loss of E-cadherin membranous expression were noted from dysplasia to carcinoma, suggesting its role as a tumor suppressor gene. Clinical significance: E-cadherin can be used as a biomarker to assess and evaluate the progression and prognosis of oral dysplastic lesions and OSCC.



Sachin V Shinde, Shivakshi Chansoria, Milind Limaye, Shokhi Bansal, Varsharani M Dhakne

Wound Healing in Dental Implant Surgery in Patients with or without Antibiotic Prophylaxis

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:6] [Pages No:1111 - 1116]

Keywords: Amoxicillin, Antibiotic prophylaxis, Cytokines, Dental implant

   DOI: 10.5005/jp-journals-10024-2390  |  Open Access |  How to cite  | 


Aim: To assess the association of various clinical parameters and proinflammatory cytokines in the wound-healing process of dental implants with the presence or absence of antibiotic prophylaxis. Materials and methods: The present study included evaluation of early wound-healing process in patients undergoing dental implant placement procedures with and without antibiotic prophylaxis. A total of 50 patients with partial edentulous arch were included in the present study. All the subjects were broadly divided into two study groups depending upon the presence or absence of prophylactic antibiotic therapy, with 25 patients in each group. One group consisted of subjects who were given prophylactic amoxicillin (2 gm), 1 hour before the starting of the surgery, followed by 500 mg 3 times a day for 1 week. Detection of interleukin (IL)-1β and -8 cytokine levels in the gingival crevicular fluid (GCF)/peri-implant crevicular fluid (PICF) was done immediately after the dental surgery. All the results were compiled and analyzed by Statistical Package for the Social Sciences (SPSS) software version 17.0. Results: A significant increase in the PICF IL-1β concentration at postoperative follow-up time was observed in the antibiotic group in comparison with the baseline values. A significant increase in the IL-8 concentration postoperatively in comparison with the baseline values in the antibiotic group was also observed. At the time of surgery, the IL-8 concentrations were statistically lower in the antibiotic group in comparison with the other study group. Concentration of amoxicillin, as observed by high-performance liquid chromatography (HPLC), was lower than the minimum detection levels. Conclusion: Detection of amoxicillin is not feasible within the GCF samples immediately after dental surgery procedure. Clinical significance: Clinical usefulness of prophylactic use of amoxicillin is still doubtful.



Mokshi Jain, Nabeel Nazar

Comparative Evaluation of the Efficacy of Intraligamentary and Supraperiosteal Injections in the Extraction of Maxillary Teeth: A Randomized Controlled Clinical Trial

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1117 - 1121]

Keywords: Anesthesia, Infiltration, Intraligamentary, Pain, Visual analog scale

   DOI: 10.5005/jp-journals-10024-2391  |  Open Access |  How to cite  | 


Aim: The aim of this clinical trial was to compare the efficiency of the intraligamentary (periodontal ligament) injection with supraperiosteal injections in extraction of maxillary teeth, using pain during injection and extraction as the parameters. Materials and methods: Thirty patients indicated for extraction of maxillary molars were randomly allocated into one of the following intervention groups (n = 15): intraligamentary injection and supraperiosteal injection. In both groups, anesthesia was given using a standard volume of 2% lignocaine with adrenaline 1:2,00,000 with a 27G needle. Patients indicated pain during injection and extraction and this was measured using the visual analog scale (VAS). Statistical analysis of the pain scores was done using chi-square test, Levene's test, and Mann–Whitney U test with the alpha error set at p = 0.05. Results: The mean VAS score for pain during injection was higher for the intraligamentary injection group (VAS = 18.67) than for the supraperiosteal infiltration group (VAS = 16), but this was not statistically significant (p > 0.05). The VAS score during extraction was significantly higher for the intraligamentary injection group (VAS = 34.67) than for the infiltration group (VAS = 20) (p < 0.05). Conclusion: Periodontal ligament injections may not be optimal, “stand-alone” alternatives to supraperiosteal injections in the exodontia of maxillary teeth. Clinical significance: Intraligamentary or periodontal injections are useful in extractions on patients with bleeding disorders, as they eliminate the risk of encountering blood vessels during injections as in the case of nerve blocks. The efficacy of intraligamentary injections in extraction of mandibular teeth has been widely studied. This study evaluates the efficacy of this alternate injection technique on maxillary teeth extraction and, if proved successful, can be useful in patients where supraperiosteal injections are contraindicated.



Radhika Chigurupati, Suchitra Bajaj, Sanjana Patrick, Moni A Kuriakose, N Praveen Birur, Shubhasini Raghavan, Amritha Suresh, Sumsum P Sunny, Petra Wilder-Smith, Keerthi Gurushanth, Shubha Gurudath, Pratima Rao

A Novel Mobile Health Approach to Early Diagnosis of Oral Cancer

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:7] [Pages No:1122 - 1128]

Keywords: Frontline health care providers, Mobile health, Oral cancer, Oral potentially malignant disorders, Remote diagnosis

   DOI: 10.5005/jp-journals-10024-2392  |  Open Access |  How to cite  | 


Aim: The incidence of oral cancer is high in India, which can be reduced by early detection. We aimed to empower frontline health care providers (FHP) for early detection and connect specialist to rural population through mHealth. Materials and methods: We provided training to FHPs in examination of oral cavity, use of mobile phone for image capture, and risk factor analysis. The FHPs were selected from different cohorts in resource-constrained settings. The workflow involved screening of high-risk individuals in door-to-door and workplace settings, and capture of images of suspected lesions. Uploaded data were interpreted and recommendation was sent by specialist from a remote location. Their recommendation was intimated to FHPs who arranged for further action. Two more initiatives, one for multiple dental schools and another for private practitioners, were undertaken. Results: During the period from 2010 to 2018, 42,754 subjects have been screened, and 5,406 subjects with potentially malignant disorders have been identified. The prevalence of potentially malignant disorders varied from 0.8 to 62% at different cohorts; 516 biopsies have been performed at remote locations. Conclusion: Connecting specialists to rural population was made possible through the use of mobile health. Trained FHP were able to reach out to the population. Electronic data capture facilitated efficient follow-up. The program was very cost-effective with screening completed under $1 per person. Clinical significance: In view of the high incidence of oral cancer in India, and the resource-constrained settings, mobile health paves the way for better access to specialist care for the rural population.



Ahmed Z Zidan, Sohaib A Mansouri

Effect of Water Sorption and Solubility on Color Stability of Bulk-Fill Resin Composite

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:6] [Pages No:1129 - 1134]

Keywords: Bulk-fill composite, Color stability, Solubility, Water sorption

   DOI: 10.5005/jp-journals-10024-2393  |  Open Access |  How to cite  | 


Aim: The objective of this study is to compare the bulk-fill resin composite to a conventional one, as regards; water sorption, solubility, and their effect on color stability. Materials and methods: This study was conducted using two types of composites: Bulk-fill composite (Filtek Bulk-Fill) and nanohybrid composite for control (Filtek Z250 XT). Specimens were prepared using a ring mold, 10 from each material. Specimens were desiccated, then weighed in a digital balance until a stable mass was acquired. For water sorption test, specimens were immersed in distilled water and placed in a lightproof incubator at 37 ± 1°C and the mass was measured weekly for 8 weeks. For solubility test, specimens were desiccated again in the desiccator until a stable mass was achieved. A spectrophotometer was used to record the baseline color measurements prior to water immersion and weekly for 8 weeks. Results: Bulk-fill composite showed higher water sorption value and lower water solubility values compared with that of the conventional one. No statistically significant difference was found for water sorption (p = 0.104) or water solubility (p = 0.098) between groups. The mean ÄE was lower in bulk-fill than conventional composite, and results showed a statistically significant difference (p = 0.009). Conclusion: Bulk-fill resin composite yielded better color stability and similar water sorption and solubility values. Clinical significance: Bulk-fill resin composite can be used in esthetically concerned patients.



Puja Khanna, Reena R Kumar, Sangeeta Sunda, Anil Miglani, Vikram Panghal, Nishtha Arora

Comparison of Frictional Resistance in Conventional Brackets with Different Stainless Steel Wires

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1135 - 1139]

Keywords: Bracket, Frictional resistance, Instron, Wires

   DOI: 10.5005/jp-journals-10024-2394  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate and compare static and kinetic friction of round (0.018”) and rectangular (0.019 × 0.025”) stainless steel (SS) wires of different brands with conventional preadjusted edgewise brackets. Materials and methods: Maxillary canine and two bicuspids of 0.022 × 0.028” slot sized MBT prescription (Gemini, 3M Unitek, Monrovia, California) brackets were chosen. The wires selected were 0.018” SS (3M Unitek); 0.018” Australian wire (AJ Wilcock, UK), and 0.019 × 0.025” SS (3M Unitek). The testing was done on Instron 3382. A total of 30 test combinations with three wires were repeated 10 times. The static and kinetic friction was recorded in Newton. The kinetic friction was also recorded in Newton at 3, 5, 7, and 9 mm of movement. One-way analysis of variance (ANOVA) and descriptive statistics were used for comparing the friction. To test the level of significance, multiple comparisons were used within wire in bracket by using post hoc test. Results: Static friction was found to be greater than kinetic in all wires; 0.018” SS (3M) wire exhibited minimum static and kinetic friction; while 0.019 × 0.025” SS (3M) exhibited maximum static friction. Kinetic friction was similar in both 0.018” AJ Wilcock and 0.019 × 0.025” SS but greater than 0.018” SS (3M). Conclusion: Least static and kinetic friction was exhibited by 0.018” SS (3M). Kinetic friction was similar in both 0.018” AJ Wilcock and 0.019 × 0.025” SS. Clinical significance: The study concluded that 0.018” SS (3M) is better for individual canine retraction than the other wires used in the study because it has the least frictional resistance; 0.019 × 0.025” SS (3M) is a better wire for canine retraction than 0.018” AJ Wilcock as we can have a three-dimensional control over tooth movement. When torque control is not a prime requisite, then 0.018” SS (3M) can be used for retraction of incisors instead of 0.018” AJ Wilcock in severely proclined incisor cases.



Tarun Vyas, Parul Rawat, Rahul P Goswami

Knowledge, Attitude, and Behavior toward Evidence-based Dentistry among Dental Professionals in Jodhpur, Rajasthan, India

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:7] [Pages No:1140 - 1146]

Keywords: Dentists, Evidence-based dentistry, Knowledge

   DOI: 10.5005/jp-journals-10024-2395  |  Open Access |  How to cite  | 


Introduction: Rendering quality care to the patient, dentists needs to update their skills and knowledge with latest diagnostics and treatment modalities. Evidence-based dentistry can provide best-known treatments. Aim: To assess knowledge, attitude, and practice of oral healthcare professionals toward evidence-based dentistry among dental professionals. Materials and methods: A cross-sectional study was conducted for a period of 3 months from April 2017 to June 2017 in Jodhpur city, Rajasthan, India. The data were collected by using closedended questionnaires. A total of 240 study subjects participated in the survey, which include dental practitioners and dentists attached to the two private dental colleges in the Jodhpur. Chisquare test was used to determine significant difference among the three groups. Results: Statistically significant difference among the three groups (academicians, practitioners, and academicians into dental practice) was found with regard to awareness of dentists about extracting journals, review publications, and databases relevant in carrying out evidence-based practice (EBP); 72.4% of academician felt lack of personal time was one of the major perceived barriers and about 50.7% of academician believe that learning skills of evidence-based dentistry helps them to utilize evidence-based dentistry in daily practice. Conclusion: Majority of the oral health practitioners were not aware about the concept of evidence-based dentistry. The regulatory body of dental sciences in India should make some necessary changes in the dental curriculum to include the concept of evidence-based dentistry in detail. Clinical significance: To improve the clinical expertise of the dental professional, to aid dental professional to reach best decision regarding dental treatment of the patient, to improve patient safety, and to improve the success rate of dental treatments, evidence-based dentistry should be the integral part of everyday dental practice.



Varsha A Jadhao, Pawankumar D Tekale, Amit Rao, Pratik Hande, Monica Mahajani, Prashant P Raktade, Ravidra Gedam, Vishwas Acharya

The Efficiency of Three Irrigating Solutions after Surgical Removal of Impacted Mandibular Third Molars: A Cross-sectional Study

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1147 - 1151]

Keywords: Chlorhexidine, Mandibular third molar, Normal saline, Povidone iodine

   DOI: 10.5005/jp-journals-10024-2396  |  Open Access |  How to cite  | 


Aim: The present study was conducted to assess the effect of irrigation with three different irrigants, namely normal saline, chlorhexidine, and povidone iodine on pain, alveolar osteitis, swelling, trismus, infection, and food impaction during surgical removal of impacted mandibular third molar. Materials and methods: Forty-eight patients, including 26 males and 22 females, fulfilling criteria for inclusion in this study were divided into three groups: group I where irrigant used was normal saline, group II as chlorhexidine, and group III as povidone iodine group. Results: The pain was significantly more in groups I and III in 24 hours and 7th day as well. Alveolar osteitis was noted in groups III and I, nil in group II. The facial swelling measured in millimeters on 24 hours and on 7th day was significantly higher in 24 hours in groups I and III than in group II. Trismus was significantly more in group I and group III than in group II (with p < 0.01) on 7th day. Conclusion: It is concluded that chlorhexidine is effective in reducing pain, alveolar osteitis, swelling, and trismus when used as an irrigant following surgical removal of impacted third molar. Clinical significance: Chlorhexidine as irrigating solution helps in reducing the postoperative consequences after third molar surgery. Further studies are required using large sample size.



Esam Halboub, Hemant R Chourasia, Rafael A Roges

Nonsurgical Management and 2-year Follow-up by means of Cone Beam Computed Tomography of an Invasive Cervical Resorption in a Molar

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:5] [Pages No:1152 - 1156]

Keywords: Cone beam computed tomography, Invasive cervical resorption, Mandibular first molar, Nonsurgical root canal treatment

   DOI: 10.5005/jp-journals-10024-2397  |  Open Access |  How to cite  | 


Background: Invasive cervical resorption (ICR) is a relatively uncommon form of external tooth resorption, characterized by an invasive nature. It is usually painless and detection of lesions is often made incidentally. Three-dimensional imaging techniques, such as cone beam computed tomography (CBCT), are useful in the diagnosis and management of ICR as the true extent of the defect cannot always be estimated using conventional radiographs. Aim: The aim of this article is to report on the successful treatment of ICR in mandibular first molar by nonsurgical approach and follow-up by means of CBCT. Case report: An 18-year-old patient was referred with a complaint of unusual radiolucency in the mesial cervical area of tooth #19 with unknown etiology. Cone beam computed tomography was performed to assess the extent of the lesion in three spatial levels and diagnosis of Heithersay class III ICR was made. This case presented with ICR (Heithersay class III) on tooth #19. Nonsurgical root canal treatment and removal of the lesion from the coronal access was performed; the resorptive defect was filled with dual-cure, self-adhesive, resin-modified glass ionomer cement (RMGIC); 6-month follow-up X-ray film showed no changes at the lesion site and tooth was asymptomatic; 1-year follow-up X-ray film showed slight mesial bone loss and a probing depth of 3 mm; finally, 2-year follow-up CBCT images showed no recurrence and no further bone destruction at the lesion site. Conclusion: The intraoral radiographs revealed the resorptive changes in two dimensions; therefore, the actual extent and location of the lesions are not fully understood. On the contrary, CBCT is a very useful tool to achieve a proper diagnosis; it detects the extent of the defect more accurately and hence, improves the treatment outcomes of ICR. Clinical significance: The ICR is usually seen as a late complication to traumatic injuries of the teeth; it is essential, therefore, that the patients who were exposed to situations that can damage the integrity of periodontal tissue need to have careful periodic recalls and X-ray examinations.



Rocco Franco, M Miranda, L Di Renzo, A Barlattani, A De Lorenzo, P Bollero

Oral Management of Steinert's Disease and Role of Anxiolysis

[Year:2018] [Month:] [Volume:19] [Number:9] [Pages:4] [Pages No:1157 - 1160]

Keywords: Anxiolysis, Myotonic dystrophy, Oral management

   DOI: 10.5005/jp-journals-10024-2398  |  Open Access |  How to cite  | 


Background: Myotonic dystrophy type I (DM1) is a genetic autosomal dominant disorder; malignant hyperthermia is a possible complication. It may occur following administration of some halogenated general anesthetics, muscle relaxants, or surgical stress Aim: The purpose of this case report is to evaluate the dental management of patients with Steinert's disease. Case report: The patient needed dental extraction. A locoregional paraperiosteal anesthesia was performed using bupivacaine without vasoconstrictor and sedation with nitrous oxide. The syndesmotomy of the elements 3.1, 4.1, and 4.2 was executed. The elements were dislocated through a straight lever and avulsed with an appropriate clamp. The socket was courted, washing with saline solution, inserting a fibrin sponge, and applying sutures (silk 3-0). Conclusion: Dental treatment of the patient with Steinert's dystrophy must be carried out under a hospital environment and the use of local anesthetic without vasoconstrictor and with use of nitrous oxide; anxiolysis is recommended. Clinical significance: This case report describes the precautions to perform oral surgery in patients with Steinert's disease and emphasizes the role of anxiolysis to avoid episodes of malignant hyperthermia.


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