The Journal of Contemporary Dental Practice

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2021 | July | Volume 22 | Issue 7

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Sravya Reddy Dhopathi, Archana Andhavarapu

Yogic-humming: A Respiratory Defense Booster for COVID Times

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:3] [Pages No:721 - 723]

   DOI: 10.5005/jp-journals-10024-3134  |  Open Access |  How to cite  | 



Khaled Alqahtani

A Statistical Model to Determine the Relationship between Employee Supervisor Characteristics and Overall Satisfaction in Dental Departments in Saudi Arabia

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:724 - 729]

Keywords: Dental departments, Employee satisfaction, Exploratory study, Hospitals, Multiple linear regression, Statistical model, Survey analysis

   DOI: 10.5005/jp-journals-10024-3131  |  Open Access |  How to cite  | 


Aim and objective: An exploratory study was undertaken to determine the relationship between supervisor characteristics and overall satisfaction with supervisors as perceived by the employees of dental departments in hospitals in Saudi Arabia. Materials and methods: We conducted a survey that included six questions designed to measure the overall performance of a supervisor, as well as questions that were related to specific activities involving interactions between supervisors and employees indental departments of 30 hospitals that were randomly selected. At least 35 employees and one supervisor in each dental department were interviewed. Initially, six questionnaire items were chosen as possible explanatory variables. There are two broad types of variables included in this study. Variables X1 (handles employee complaints), X2 (does not allow for special treatment), and X5 (too critical of poor performance) relate to direct interpersonal relationships, i.e., direct connection between the employee and supervisor, whereas variables X3 (opportunity to learn new things) and X4 (raises based on performance) are of a less personal nature and relate to the job as a whole, i.e., indirect relationship between employees and their supervisor. Variable X6 (rate of advancing to better jobs) is not a direct evaluation of the supervisor, but serves more as a general measure of how the employee perceives his or her own progress in the hospital. Results: Using regression analysis, we observed that only X1 (handles employee complaints) and X3 (opportunity to learn new things) have an impact on response Y (overall rating of job being done by supervisor). There is a strong positive relationship between X1 and Y and also between X3 and Y. Conclusion: Therefore, when the supervisor listens and handles employee complaints and gives employees the opportunity to learn new things, the supervisor becomes favorable. Clinical significance: The relationship between supervisor characteristics and overall satisfaction with supervisors as perceived by the employees of dental departments has not been studied. An understanding of this relationship is valuable to improve employee–supervisor relations, which can improve the overall functioning of hospitals.



Eyad M Alduwayghiri, Nubesh Khan

Acceptance and Attitude toward COVID-19 Vaccination among the Public in Saudi Arabia: A Cross-sectional Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:5] [Pages No:730 - 734]

Keywords: Acceptance, Attitude, COVID-19, Saudi Arabia, Vaccination

   DOI: 10.5005/jp-journals-10024-3114  |  Open Access |  How to cite  | 


Aim and objective: This cross-sectional study aimed to investigate vaccine acceptance and attitude to novel coronavirus disease 2019 (COVID-19) vaccine among the general population in Saudi Arabia. Materials and methods: The present study was conducted among the general population in Saudi Arabia above 18 years of age. The data were collected online, by questionnaire containing 20 questions using Google form, in both Arabic and English, and were distributed to friends, families, and relatives through mail, WhatsApp groups, and Twitter. The questionnaire was randomly given out to the people living in five provinces of Saudi Arabia. Results: A sum of 1,713 participants responded to the online survey. The greatest number of participants were at the age between 31 years and 45 years (36.6%) and 56.4% were females. The results showed that 74.6% have not registered for the vaccination and 44.9% responded not to take the vaccine. About 60.80% were concerned about the side effects, and 48.2% were worried about the allergic reaction to COVID-19 vaccine. About 49.1% of participants agreed that preventive measures, such as wearing mask, social distance, and using sanitizers, keep the virus away, and 53.20% believes that being exposed to disease naturally is safer for the immune system. Around 23.90% believes that vaccination cannot reduce the possibility of getting COVID-19. Conclusion: In the present study, the negative attitudes and afraid of the side effects of the vaccine are the most reasons for indecision and rejection about COVID-19 vaccine. For the future COVID-19 vaccination campaign not to fail, the Ministry of Saudi Arabia should closely follow the vaccination development processes, inform the public transparently, and consider public's concerns. Clinical significance: The results of the current study will help the Ministry of Health in Saudi Arabia to attempt proactive missions by featuring the significance of immunization to the population and empowering vaccine take-up and acceptance.



Dennis Dennis, Sondang Pintauli, Shinta Debora

Microleakage Comparative Evaluation of RMGIC and Alkasite with and without Adhesive System in Class V Cavity: An In Vitro Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:4] [Pages No:735 - 738]

Keywords: Adhesive, Alkasite, Class V restoration, Microleakage, RMGIC

   DOI: 10.5005/jp-journals-10024-3130  |  Open Access |  How to cite  | 


Aim and objective: This study aimed to compare microleakage of resin-modified glass ionomer cement (RMGIC) and alkasite with and without adhesive system in class V cavity. Materials and methods: Thirty class V cavities were prepared on the buccal surface. All prepared samples were randomly divided into three groups. Group I was restored with RMGIC, group II was restored with Cention N after the application of adhesive system, and group III was restored with alkasite. Samples were subjected to 200 thermocycles between temperature baths at 5°C and 55°C. Samples were stained with 2% methylene blue. The teeth were sectioned longitudinally, and the sections were then observed under stereomicroscope at a magnification of 20×. Results: Statistical analysis showed that there was less microleakage in Cention N using adhesive system in both occlusal margin and gingival margin. Conclusion: There were significant differences between RMGIC, alkasite with adhesive system, and alkasite without adhesive system in class V cavity. Least microleakage at the occlusal margin and gingival margin was seen with Cention N using adhesive system and highest microleakage at the RMGIC. Clinical significance: Cention N using the adhesive system affects the microleakage in the class V restoration. The study theorizes that the material restorations showed less microleakage in the occlusal margin than in the gingival margin.



Henrry Torres

Histological Comparison of Post-extraction Alveolar Bone Repair Treated with Melatonin and Calcium Sulfate: An In Vivo Study in Cavia porcellus

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:739 - 744]

Keywords: Bone repair, Calcium sulfate, Cavia porcellus, Melatonin

   DOI: 10.5005/jp-journals-10024-3150  |  Open Access |  How to cite  | 


Aim and objective: To histologically compare alveolar bone repair after tooth extraction treated with melatonin and calcium sulfate in an in vivo experimental study in guinea pigs (Cavia porcellus). Materials and methods: The study was of longitudinal, prospective, and experimental design in an animal bio-model. A total of 24 male guinea pigs were included, weighing from 700 to 900 g and separated into two experimental groups (melatonin and calcium sulfate) for three periods (15, 30, and 45 days) at 15-day intervals after surgery. The guinea pigs were randomly included into groups for the time evaluated. Results: In relation to bone repair cells using calcium sulfate, the presence of osteoblasts at 15, 30, and 45 days was 39.0 ± 63, 55.3 ± 6.0, respectively, with 61.3 ± 10.0 cells per field. Regarding bone repair cells using melatonin, the presence of osteoblasts at 15, 30, and 45 days was 25.0 ± 3.7, 49.3 ± 1.5, respectively, with 53.6 ± 5.6 cells per field. Conclusion: Both melatonin and calcium sulfate were found to be useful in bone repair at a histological and clinical level, although they present certain nonsignificant, albeit marked advantages in the bone repair process when compared with the control socket at the histological level. Clinical significance: This research allows us to know the usefulness of these easily accessible chemicals for the generation of bone repair.



Tauane Vassoler, Letícia C Dogenski, Vanessa K Sartori, Julia S Presotto, Moisés Z Cardoso, Julia Zandoná, Micheline S Trentin, Maria SS Linden, Huriel S Palhano, Jose E Vargas, João P de Carli

Evaluation of the Genotoxicity of Tobacco and Alcohol in Oral Mucosa Cells: A Pilot Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:745 - 750]

Keywords: Alcoholism, Genotoxicity, Micronuclei, Oral cancer, Smoking

   DOI: 10.5005/jp-journals-10024-3145  |  Open Access |  How to cite  | 


Aim and objective: To define the genotoxic potential of tobacco and alcohol in the oral mucosa through a micronuclei (MN) test. Materials and methods: Samples of exfoliative cells from oral mucosa were collected using superficial scraping of the right- and left-cheek mucosa of 83 patients divided into four groups, namely: (G1) 24 individuals abstaining from tobacco and alcoholic beverages; (G2) 23 individuals who smoke and abstain from alcoholic beverages; (G3) 24 smokers and alcoholics; and (G4) 12 individuals who consume alcohol and abstain from tobacco. The samples were stained with Giemsa-Wright, and the frequencies of MN, binucleated cells, and metanuclear changes were recorded in the samples of each group (1,000 cells per patient). Results: Analysis of variance (ANOVA) showed a difference between groups for changes concerning karyorrhexis (p = 0), pycnosis (p = 0.002), karyolysis (p = 0.003), and binucleated cells (p = 0.046). As for the total number of changes, G3, G2, and G4, respectively, were significantly higher than G1. Conclusion: It is suggested that the influence of smoking and drinking on exfoliating cells of oral mucosa may cause metanuclear changes due to genetic changes that these products cause, and the MN test is effective in detecting and monitoring such changes. Clinical significance: MN test may work for constantly monitoring the oral mucosa of smokers and/or alcoholic patients, so that early cell changes may be diagnosed, preventing the genesis of oral cancer.



Rahul Srivastava, Atish Kundu, Devina Pradhan, Bhuvan Jyoti, Heeralal Chokotiya, Pranav Parashar

A Comparative Study to Evaluate the Efficacy of Curcumin Lozenges (TurmNova®) and Intralesional Corticosteroids with Hyaluronidase in Management of Oral Submucous Fibrosis

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:5] [Pages No:751 - 755]

Keywords: Corticosteroids, Curcumin lozenges, Oral submucous fibrosis, Turmeric

   DOI: 10.5005/jp-journals-10024-3144  |  Open Access |  How to cite  | 


Aim and objective: This study aims to compare the efficacy of TurmNova® lozenges and its active ingredient “curcumin” as a low-cost, safe, and noninvasive chemopreventive agent with intralesional corticosteroids (with hyaluronidase) in the management of oral submucous fibrosis (OSMF). Materials and methods: A total of 80 patients with group III OSMF (Khanna JN and Andrade NN classification) visiting the dental outpatient clinic of the Department of Oral Medicine and Radiology Rama Dental College Hospital and Research Center, Kanpur, were selected for the study. A total of 80 patients were randomly divided into two groups (40 participants each): group A to whom TurmNova® lozenges containing turmeric extract 100 mg along with clove oil 10 mg three times daily for 3 months were given and group B to whom intralesional infiltration of 2 mL dexamethasone (4 mg/mL) + hyaluronidase 1500 IU dissolved in 0.5 mL of 2% lignocaine twice a week for 3 months was given. Data were analyzed using the IBM SPSS Statistics, version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, version 21.0. Armonk, New York: IBM Corp.) Results: Statistical analysis revealed that there was significant clinical improvement in mouth opening and subjective symptoms, like burning sensation/pain associated with the lesion and tongue protrusion in the group A as compared to group B. Conclusion: Curcumin (100 mg) in an innovative delivery system of lozenge results in a higher level of plasma curcumin level. The aforementioned dosages prevent its biotransformation and inactivation by the liver enzymes. Because of these properties, curcumin lozenges are safer, low-cost, and effective alternative treatment in contrast to the present traditional treatment. Further long-term, prospective, large-scale studies need to be done. Clinical significance: Curcumin has a role in the treatment of oral premalignant conditions and acts as a very effective chemopreventive agent in the prevention of cancer.



Hesham H Abdulkarim, Rong Zeng, Vanessa K Pazdernik, Joan M Davis

Effect of Bone Graft on the Correlation between Clinical Bone Quality and CBCT-determined Bone Density: A Pilot Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:7] [Pages No:756 - 762]

Keywords: Allograft, Bone density, Bone quality, CBCT, Hounsfield unit, Xenograft

   DOI: 10.5005/jp-journals-10024-3133  |  Open Access |  How to cite  | 


Aim and objective: The aim of this pilot study is to explore the possible correlation between radiographic bone density and clinical bone quality in edentulous implant sites with and without a history of bone grafting. Materials and methods: A retrospective evaluation of 273 surgically placed dental implants with adequate preoperative cone-beam computed tomography (CBCT) between 2017 and 2019. Misch classification was used to assess the bone quality, and CBCT grayscale values, utilizing Hounsfield units (HU), were used for radiographic bone density assessment. Results: Sixty-six patients (mean age, 58 years; 43 [65%] female and 23 [35%] male) with 118 implant sites were included. A total of 38 sites with bone grafts were evaluated. Controlling for location, sites with previous bone graft had softer bone quality (p = 0.003) and greater bone density (p <0.001) compared to sites without previous bone grafts. A significant correlation existed between radiographic bone density and clinical bone quality (p ≤0.01). The magnitude of the relationship increased in the absence of bone graft (p <0.001) and became nonsignificant in sites with previous grafting. In sites with allograft, the relationship was not statistically different than those without bone graft (both p ≥0.07), while it was statistically different in sites with xenograft when sites assumed independent (p = 0.02). Conclusion: CBCT-determined radiographic bone density was correlated to clinical bone quality in the absence of previous bone grafting, while in the presence of previous bone graft, the radiographic bone density of the edentulous sites seemed to be not associated with the clinical bone density, especially in sites with history of xenograft bone grafting. Clinical significance: CBCT could be utilized to predict preoperative clinical bone quality in sites without previous bone grafting. When assessing sites with history of bone grafting, the CBCT should be interpreted with caution, especially if xenografts were used.



Jyotirmay , Abhinov R Gupta

Comparison of Apical Root Resorption in Patients Treated with Fixed Orthodontic Appliance and Clear Aligners: A Cone-beam Computed Tomography Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:763 - 768]

Keywords: Apical root resorption, Clear aligners, Cone-beam computed tomography, Fixed orthodontic appliances

   DOI: 10.5005/jp-journals-10024-3119  |  Open Access |  How to cite  | 


Aim and objective: To carry out comparison of apical root resorption (ARR) in the fixed orthodontic appliance and clear aligners with the help of cone-beam computed tomography (CBCT) imaging. Methods and materials: The study was conducted on 576 roots in 110 patients. These patients were divided into two groups such that each group consisted of 55 patients. A total of 288 roots were analyzed in each group. One group consisted of patients treated with the conventional fixed orthodontic appliance. Another group consisted of patients treated with clear aligners. Radiographic images were collected with the help of CBCT for each patient. One image was collected before treatment while another image was collected after treatment. The length of the root of the anterior tooth was measured with the help of CBCT images. The ARR was calculated for each tooth by obtaining the difference between the length of the root measured before orthodontic treatment and after orthodontic treatment. The data were recorded, and statistical analysis was carried out with the help of the paired t test and Chi-square test to compare ARR between the two groups. Results: The ARR was more in patients who were treated with fixed orthodontic treatment than in those patients who were treated with clear aligners. The mean value of ARR in fixed orthodontic appliances was 1.51 ± 1.34 mm, whereas the mean value of ARR in clear aligners was 1.12 ± 1.34 mm. The severity of ARR in the clear aligners group (on average) was significantly less than that in the fixed appliances group (on average). It was found that ARR in each individual's tooth included in the study was more in case of the fixed orthodontic appliance as compared with clear aligners (p <0.001). Conclusion: From the present study, it can be concluded that the amount of resorption at the root apex is less among patients who undergo treatment using clear aligners as compared with those treated with conventional fixed orthodontics appliances. Clinical significance: ARR found in the orthodontic treatment is a process that causes loss of hard dental tissues such as dentine and cementum at the root apex. Fixed orthodontic appliances are most common method of orthodontic treatment. However, clear aligners are also used commonly for orthodontic treatment.



Mannaa K Aldowsari, Fouad Salama, Mohamed H Al-Agamy, Sultan A Alquraishi, Faisal S Alsaif, Ibrahim B Aldossary

Clinical Efficacy of Single Use of Three Different Mouthrinses on the Level of Streptococcus mutans in Saliva

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:5] [Pages No:769 - 773]

Keywords: Antimicrobial agent, Caries, Chlorhexidine, Clinical study, Mouthrinse, Streptococcus mutans

   DOI: 10.5005/jp-journals-10024-3127  |  Open Access |  How to cite  | 


Aim and objective: The aim of this cross-sectional population-based clinical study was to assess the effect of single use of three different mouthrinses on the level of salivary Streptococcus mutans of 8 to 10-year-old Saudi children. Materials and methods: Convenient samples of 52 Saudi children aged 8–10 years were randomly allocated into four groups of 13 each. Saliva samples were collected to assess the level of S. mutans at baseline before rinsing with the assigned mouthrinse or control. Three mouthrinses, Avalon Avohex, Listerine Miswak, and Optima Aloe Dent Mouthrinse, were randomly distributed to the children. Each participant was instructed to rinse for 2 minutes using 10mL of the assigned mouthrinse. Saliva samples were collected after rinsing and colony forming unit (CFU) of S. mutans per mL of saliva was calculated. Statistical analysis was performed to compare S. mutans count at baselines and postintervention values of each experimental group and control using paired t-test and one-way ANOVA. All statistical analyses were set at a significance level of p < 0.05. Results: All test groups showed a reduction in salivary S. mutans compared to that at baseline. Statistically significant reduction (p > 0.05) in bacterial count was seen in Avalon Avohex group. Conclusion: A single-time rinse of chlorhexidine extract mouthrinse for 2 minutes effectively reduced the number of S. mutans of 8 to 10-year-old Saudi children. Clinical significance: Rinsing with chlorhexidine extract mouthrinse should be considered as a potential method in prevention of dental caries in children.



BS Kavya Rani, Arun K Joy, Archana A Thomas, Mathews Baby

Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:4] [Pages No:774 - 777]

Keywords: Demineralization, Enamel lesion, Fluoride varnish, Scanning electron microscope

   DOI: 10.5005/jp-journals-10024-3147  |  Open Access |  How to cite  | 


Aim: Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope. Materials and methods: Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM). Results: The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ± 0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ± 0.09), the control group (126.36 ± 0.10) and the Duraphat varnish (124.14 ± 0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ± 0.09), pursued by the Duraphat varnish use (106.68 ± 0.12), use of Clinpro White Varnish (112.36 ± 0.08), and then the control group (123.08 ± 0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p <0.001). Conclusion: The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups. Clinical significance: Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions.



Caroline Dillenburg, Letícia C Dogenski, Tainara E Kopper, André W Rosa, Dimas JR Neto, Moisés Z Cardoso, Julia Zandoná, Rejane EL Pedro, Micheline S Trentin, Maria SS Linden, João P de Carli

Evaluation of a Series of Overdentures Made in a Higher Education Dental Institution in Southern Brazil

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:778 - 783]

Keywords: Dental implants, Edentulous arcade, Implants, Overdenture, Prostheses

   DOI: 10.5005/jp-journals-10024-3149  |  Open Access |  How to cite  | 


Aim and objective: This study aimed to evaluate the epidemiological profile, oral health self-perception index, and level of satisfaction of users of complete implant-supported overdentures that had been used for at least 1 year and were made at the School of Dentistry of the University of Passo Fundo, Rio Grande do Sul, Brazil (FO/UPF), between 2014 and 2019. Materials and methods: The sample consisted of 30 patients with overdentures, who were selected from the dental records filed at the institution. Data on general health and the dental implants involved (brand, type of prosthetic connection, number of implants, and additional overdenture retention system) were collected from the medical records. The 30 patients were invited to answer the Oral Health Impact Profile-14 (OHIP-14) and visual analog scale (VAS) questionnaires, and due to the coronavirus disease 2019 pandemic, it was possible to contact 15 patients. Results: Most of the prostheses studied were mandibular overdentures, and 66.66% of the cases were retained by the O-ring system. As for the oral health self-perception of the individuals, it was concluded that male patients had a lower mean overall score (p = 0.047) and functional domain (p = 0.042) in the OHIP-14. The number of implants and the installation arch interfered with functional domain and psychological capacity (p <0.05). The VAS showed that women have greater esthetic satisfaction with prostheses (p = 0.048) and that the bar-clip retention system is more satisfactory than the O-ring (p = 0.017). Conclusion: Despite the limitations of overdentures, it was noted that, when properly indicated, they are a viable option for oral rehabilitation on implants. Clinical significance: Oral rehabilitation well-indicated with overdentures, especially those retained by the bar-clip system, results in an improvement in the patients’ quality of life.



Amit Porwal, Mohammed A Qahhar, Feras A Al Qatarneh, Seham A Areeshi, Mohammad BF Aldossary

Clinical and Radiographical Measurements of Supraeruption and Occlusal Interferences in Unopposed Posterior Teeth

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:9] [Pages No:784 - 792]

Keywords: Occlusal interferences, Overeruption, Panoramic radiograph, Study casts, Supraeruption

   DOI: 10.5005/jp-journals-10024-3143  |  Open Access |  How to cite  | 


Aims and objectives: This study compared the supraeruption of teeth for study casts (SCs) and panoramic radiographs (PRs) and its relation to tooth type, arch, facial sides, presence of occlusal interferences, and type of tooth movements. Materials and methods: A total of 65 patients with their SCs and PRs were recruited. Supraerupted tooth type, arches, sides involved, and the presence of occlusal interferences were recorded. The SCs for supraerupted teeth were photographed, and supraeruption from PRs was recorded from the patients’ files. The values were transferred to a software program and assessed. Results: The highest frequency was observed among the younger-age group and molars in both arches. Working side (WS) and retruded cuspal position (RCP) interferences were recorded the highest. Supraeruption values of 0.7–1.2 mm accounted for 47.5% (38) of the total. Tilting and tipping of teeth were the highest, followed by buccolingual displacement. Kappa tests showed good intraexaminer reliability and Bland–Altman plot showed 95% confidence interval band. Conclusions: No significant differences were observed in the supraeruption values between the type of tooth among different subgroups of SCs and PRs. Significant differences were recorded between the types and sites of teeth, with a higher ratio observed in molar teeth, mandibular arch, and young age group. RCP and WS were the most recorded occlusal interferences and buccolingual displacement, and tilting and tipping were the most noticeable occlusal tooth movements. Clinical significance: Diagnosis and measurements of supraeruption are essential, useful, and significant steps before treatments for replacement of missing tooth/teeth as well as corrections of occlusal interferences during different mandibular movements.



Md Asad Iqubal, Rohit Singh, Shilpi Verma, Naqoosh Haidry, Anuradha Pandey, Pallawee Choudhary

Quantitative and Mathematical Analysis of Mental Foramen along with Its Correlation with Sex and Age Using Cone-beam Computed Tomography

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:793 - 798]

Keywords: CBCT, Mental foramen, Quantitative measurements

   DOI: 10.5005/jp-journals-10024-3124  |  Open Access |  How to cite  | 


Aim and objective: The aim of the present study was to perform quantitative and mathematical analysis of mental foramen (MF) along with its correlation with study subject's sex and age using three-dimensional imaging like cone-beam computed tomography (CBCT). Materials and methods: The CBCT scan images stored in the database were used in this study. Two-hundred sixty-seven scans were selected. They were divided into four different age-groups. These age-groups were 16–23 years, 24–38 years, 39–55 years, and more than 56 years. Each age-group was further divided into two subgroups. One subgroup was of males, while the other subgroup was of females. Following this, there was evaluation of all CBCT-scanned images considering certain parameters like position of MF, size of MF, distance X, distance Y, and distance Z. Results: The MF was located generally apically to the premolar and molar. It was more commonly located between the first premolar and second premolar among females, while in males, it was mostly located along the long axis of the second premolar. In most of the age-groups, the MF was located between the long axis of the first premolar and second premolar. The average distance of MF from the apex of first premolar was 5.01 mm. Further, the average size of MF and its distance from the base of the mandible were greater in males as compared with females. When all these measurements were compared in different age-groups, the difference was not statistically significant. Conclusion: The average distance of MF from the apex of the first premolar was 5.01 mm. The average size of MF and its distance from the base of the mandible were greater in males as compared with females. When the measurements were compared in different age-groups, then the difference was not statistically significant. Clinical significance: MF is an important structure in the mandible because it acts as an important landmark in the anesthetic procedure; therefore, there was a need to carry out detailed quantitative and mathematical analysis for MF.



Anuradha Pandey, Naveen Kumar, Sachin Sinha, Kumari Kavita, Rachna Raj

Resistance against Fracture in Teeth Managed by Root Canal Treatment on Restoring with Onlays, Inlays, and Endocrowns: A Comparative Analysis

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:6] [Pages No:799 - 804]

Keywords: Cerasmart, Endocrown, Inlay, Onlay, Root canal treatment

   DOI: 10.5005/jp-journals-10024-3123  |  Open Access |  How to cite  | 


Aim and objective: To compare the fracture resistance in teeth managed by root canal treatment after restoring with different types of onlays, inlays, and endocrowns prepared with hybrid ceramics and pulp chambers restored with fiber-reinforced composite and resin composite that were radiopaque, light-cured, and flowable. Materials and methods: The present study was carried out on 252 extracted mandibular molars. All the specimens were divided into six groups randomly. Each group consisted of 42 specimens. Group 1 consisted of intact teeth without any access cavity. It was the control group. Group 2 consisted of teeth with endocrown and empty pulp chamber. Group 3 consisted of teeth with mesio-occlusal-distal (MOD) onlay prepared with hybrid ceramics and pulp chamber filled with flowable, light-cured, radiopaque resin composite. Group 4 consisted of teeth with MOD onlay and pulp chamber filled with fiber-reinforced composite. Group 5 consisted of teeth with MOD inlay and pulp chamber filled with flowable, light-cured, radiopaque resin composite. Group 6 consisted of teeth with MOD inlay and pulp chamber filled with fiber-reinforced composite. Inlay, onlay, and endocrowns were prepared with computer-aided design (CAD) and computer-aided machine (CAM) using hybrid ceramics. Universal testing machine was used for the measurement of the fracture resistance of each specimen. Inferential statistics were performed by applying Fisher's exact test and chi-square test. Results: Fracture strength was found to be maximum in the intact teeth group followed by the endocrown. The fracture strength was minimum in the inlay group. The fracture strength was intermediate in the onlay groups. Conclusion: Endocrown showed maximum fracture resistance as compared to the inlay and onlay restorations. Clinical significance: Proper management of root canal-treated teeth is one of the greatest challenges for endodontists. It has been observed that tooth preparation design and the material used for the restoration of root canal-treated teeth play a vital role in the resistance against fracture in the teeth.



Mosa A Shubayr, Estie Kruger, Marc Tennant

Factors Associated with Participation in Research Activities among Oral Health Providers in Jazan, Saudi Arabia: A Cross-sectional Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:7] [Pages No:805 - 811]

Keywords: Dental research, Online questionnaire, Oral health providers, Research and Development index

   DOI: 10.5005/jp-journals-10024-3125  |  Open Access |  How to cite  | 


Aims and objectives: This study aimed at quantifying participation in dental research–related activities reported by the Saudi Ministry of Health-associated oral healthcare providers in Jazan and to investigate its association with sociodemographic and professional characteristics, as well as practitioners’ perceptions of the Research and Development (R&D) index. Materials and methods: An online cross-sectional questionnaire was sent to oral health providers in Jazan using a convenience sampling technique. The questionnaire collected data on demographic characteristics and the 16 items of the R&D index. One-way ANOVA and t-tests were used to establish factors associated with R&D index scores. Multiple regression analyses with adjusted effects were conducted to identify the significant predictors for the factors associated with participation in dental research. Results: In total, 113 study participants completed the questionnaire with a response rate of 56.5%. Just over half (53.1%) of the participants were working in primary healthcare centers, and 46.9% were working in hospitals. Most of the study samples were dentists (92.0%), while a small percentage were dental hygienists (4.4%) and assistants (3.4%). The sample's participation in dental research was low with a mean of 3.57 (standard deviation = 3.69). The R&D support (p<0.001) and intentions (p = 0.050) significantly predicted the providers’ participation in dental research. Conclusion: The current study found that R&D support and intention significantly predicted the providers’ participation in dental research. Hence, it is recommended that comprehensive educational and training programs on dental research be developed that focus on the increase and implement it in their practice. Clinical significance: This study provides insights into factors and obstacles that influence dental research, which may be useful for future investigations.



Aamir M Nadeem, Bhaskar Nagaraj, Deepak A Jagadish, Dhruv Shetty, Surendra Lakshminarayana

A Histopathology-based Assessment of Biological Behavior in Oral Hyalinizing Extraosseous Lesions by Differential Stains

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:17] [Pages No:812 - 828]

Keywords: Alcian blue, Fibrosis, Hyaline, PAS, Picrosirius red, Polarizing microscopy, Safranin O, Salivary gland neoplasms

   DOI: 10.5005/jp-journals-10024-3122  |  Open Access |  How to cite  | 


Aim: The assessment of hyalinization to determine aggressive behavior in oral pathological lesions is a scarcely researched field that requires further exploration. The current study aims to predict the biological behavior of oral hyalinizing extraosseous lesions (OHEOL) by employing four differential stains with clinicopathologic correlation. Materials and methods: The study was performed on retrospectively diagnosed formalin-fixed paraffin-embedded cases of salivary gland tumors (SGTs) (n = 13), benign soft tissue (BST) lesions (n = 24), and oral submucous fibrosis (OSMF) (n = 53). The hematoxylin and eosin-stained sections were analyzed for the severity of hyalinization (SOH). Differential stains periodic acid Schiff (PAS), Alcian blue, safranin O, and picrosirius red with polarizing microscopy were used to assess the components of hyalinized tissue. The SOH was correlated with differential staining characteristics and clinicopathologic features to analyze possible correlation with aggressive potential in BST, advancement of disease in OSMF, and recurrence in SGT. Results: Intensity of picrosirius red stain significantly correlated with SOH of SGTs (p = 0.044). The intensity of PAS stain (p = 0.040), picrosirius red polarizing greenish-yellow color (p = 0.002), and pattern of distribution of picrosirius red (p = 0.023) significantly correlated with recurrence of SGTs. The intensity of differential stains increased with the SOH in BST lesions indicating their correlation with SOH. The intensity (p = 0.008) and pattern (p = 0.010) of Alcian blue staining and intensity of safranin O stain (p = 0.003) significantly correlated with SOH in OSMF. Picrosirius red polarizing color reddish and yellowish red (p = 0.002) significantly correlated with SOH distinguishing early and advanced OSMF. Conclusion: Picrosirius red and PAS stains are reliable indicators of SOH and recurrence potential in SGT. Alcian blue, safranin O, and picrosirius red polarizing colors enable detection of SOH and accurately distinguish early from advanced OSMF. Clinical significance: SOH can be considered as a histological predictor of aggressive biologic behavior in OHEOL. These findings will result in appropriate management protocols.



Anupama Ahirwar, Tarun Nanu, K Binu Nathan, Jeslee A Jose

Impact of Various Desensitizing Agents on Occlusion of Dentinal Tubules: A Scanning Electron Microscopic Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:4] [Pages No:829 - 832]

Keywords: Dentin hypersensitivity, Dentinal tubule, Desensitizing agents, Scanning electron microscope

   DOI: 10.5005/jp-journals-10024-3129  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to compare the capacity of three dissimilar commercially accessible desensitizing products for the occlusion of dentinal tubules using a scanning electron microscope (SEM). Materials and methods: The nondiseased human mandibular premolar teeth, ninety in number, were amassed for this study. The blocks subsequently made were subjected to polishing using abrasive paper to facilitate dentinal surface exposure. The samples were randomly allocated to one of the following three groups: Group I, samples to be treated with Admira Protect; Group II, samples to be treated with MI paste, Group III, samples to be treated with Remin Pro. Photomicrograph of every sample was taken to evaluate the occlusion of the dentin tubule under 2000× magnification of the SEM. Results: MI paste exhibited the greatest dentin tubular occlusion with a value of 2.746 ± 0.530 followed by Admira Protect (3.498 ± 0.202) and Remin Pro (4.594 ± 0.364) in that order. Amid the various desensitizing materials used, statistically significant differences (p <0.001) were noted. Conclusion: Within the confines of the limitations of the present research, following a comparative assessment of the three desensitizing materials used, it can be concluded that all of them were efficient in sealing off the dentin tubules in spite of differing chemical constitutions and techniques of application. When compared with the agents, Admira Protect and Remin Pro, MI paste exhibited the maximum occluding capacity of the dentinal tubules. Clinical significance: A short, sharp shooting pain characterizes the frequent problem of dentin hypersensitivity (DH). Sealing off the open dentin tubules, thereby reducing dentinal permeability, is a known method in the treatment of DH. As several agents exist to reduce DH, the best commercially marketed product for decreasing this condition by occluding the tubules should be identified by the clinicians.



Sonal Sahasrabudhe, M Sunil Kumar, Iram S Khan, Sindhu Naik, Ashok Kumar

Evaluation of Orthodontic Mini-implant-anchored en masse Retraction of Maxillary Anterior Teeth with Reduced Bone Support: A Prospective Finite Element Analysis Study

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:7] [Pages No:833 - 839]

Keywords: Alveolar bone loss, Anterior retraction hook, Finite element analysis, Orthodontic mini-implant

   DOI: 10.5005/jp-journals-10024-3126  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate force systems to bring about the en masse retraction of maxillary anterior teeth having reduced bone levels using finite element analysis. Materials and methods: This is a prospective study. Three-dimensional finite element models of maxillary dentition having normal alveolar bone level and 2, 4, and 6 mm bone loss with first premolar extraction were constructed from a spiral CT scan of a skull. Archwire and brackets were modeled on the facial surfaces of teeth. Retraction force of 175 gm was applied from an orthodontic mini-implant placed bilaterally between the second premolar and first molar and 12 mm above plane of the archwire to anterior retraction hook (ARH) fixed at two heights of 6 and 10 mm above the archwire. Results: Maximum displacement and periodontal ligament (PDL) stress were calculated for different combinations of bone levels and ARH. As the bone loss increased, the tipping tendency, amount of intrusion, and maximum von Mises stress in PDL also increased, showing a direct correlation. Conclusion: To minimize tipping and PDL stress, the height of ARH should be increased in alveolar bone loss conditions to allow retraction force to pass through or even above the center of resistance of anterior teeth. Even then, pure bodily retraction may not be achieved, but tipping tendency can be reduced. Nevertheless, it may not be suitable to increase ARH beyond a limit owing to chances of irritation to the vestibular mucosa. Alternative methods should be contemplated to reduce the tipping behavior. Clinical significance: The alternative is to apply a lighter retraction force to reduce lingual tipping. A higher counter-moment in the archwire or bracket can also be incorporated.



Casazza Estelle, Ré Jean-Philippe, Giraudeau Anne, Parfu Anne, Orthlieb Jean-Daniel

Dental Occlusion: Proposal for a Classification to Guide Occlusal Analysis and Optimize Research Protocols

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:10] [Pages No:840 - 849]

Keywords: Dysfunctions, Malocclusion, Occlusal functions, Occlusion

   DOI: 10.5005/jp-journals-10024-3113  |  Open Access |  How to cite  | 


Aim: Dental occlusion often rhymes with confusion, discrediting many research protocols. The profession seems to be in “major chaos about occlusion.” This may be due to the lack of a precise classification of occlusal dysfunctions. We suggest using a classification based on the separation of three occlusal functions, with the identification of precise, objective clinical diagnostic criteria. This article aims to define a precise classification of occlusal functions, in order to be able to establish a positive diagnosis of occlusal disorders. This occlusal analysis method could then be used in the daily practice of dentists and orthodontists, with a view to align epidemiological studies that focus on occlusion, in order to obtain results capable of comparison in different studies. Materials and methods: A analysis of the literature in PubMed database published between the early 1970s and the present day identified many confusing definitions of occlusal disorders. In this paper, we propose the separation of occlusal functions into three subcategories: Stabilizing, centering, and guiding functions, defining three different subcategories of occlusal disorder. Results: Occlusal function allows the definition of three kinds of malocclusion: Stabilizing dysfunction, centering dysfunction, and guiding dysfunction. The individualization of clear subcategories could allow the study of the more pertinent impacts of pathogenic malocclusion. Conclusion: This classification of occlusal functions or dysfunctions allows lines to be drawn between different occlusal situations that are frequently confused, such as a loss of posterior occlusal support and loss of occlusal vertical dimension, infra-occlusion and loss of posterior support, short or reduced dental arch, reversed and scissor occlusion, sagittally and transversely deflected mandible, posterior occlusal interference and balancing contact, as well as natural and iatrogenic malocclusion. Clinical significance: An occlusal analysis that makes use of the three occlusal functions, “stabilizing, centering, guiding,” could offer diagnostic standardization. It may also allow the avoidance of incorrect interpretations. Therefore, this occlusal function classification may be relevant to many fields, for instance, for epidemiological studies of occlusion and the periodontium, TMD and occlusion, or TMD and orthodontic treatment.



Maen Zreaqat, Rozita Hassan, AR Samsudin, Yasser Stas, Abdulfatah Hanoun

Tonsil Size and Mallampati Score as Clinical Predictive Factors for Obstructive Sleep Apnea Severity in Children

[Year:2021] [Month:July] [Volume:22] [Number:7] [Pages:4] [Pages No:850 - 853]

Keywords: Mallampati score, Obstructive sleep apnea, Tonsil size

   DOI: 10.5005/jp-journals-10024-3148  |  Open Access |  How to cite  | 


Aim and objective: The aim of this study was to determine the clinical utility of body mass index (BMI), tonsil size, and Mallampati scoring in predicting both the presence of and severity of pediatric obstructive sleep apnea (OSA). Materials and methods: This prospective cross-sectional study comprised 78 growing children in the age range of 11–14 years with polysomnography (PSG)-proven OSA and 86 non-OSA corresponding controls. BMI, tonsil size (Friedman grading scale), and Mallampati score were determined for both groups, and related differences were assessed with a t-test, while their independent association with OSA severity was tested with a regression analysis. Statistical significance was set at p < 0.05. Results: Male gender, BMI, tonsil size, and Mallampati score were significantly higher in the OSA group (p < 0.05). A significant correlation was recorded between the Mallampati score and OSA severity (p < 0.01), but not with BMI or tonsil size (p > 0.05). For every 1-point increase in the Mallampati scale, the apnea-hypopnea index (AHI) increased by more than five events per hour in the bivariate analysis and by more than three events per hour in the multivariate analysis. Conclusion: Male gender, increased BMI, high tonsil, and Mallampati scores were clinical indicators of the presence of OSA. However, only Mallampati scale had a significant association with OSA severity. Clinical diagnostic indicators should be established and encouraged especially in community-based studies. Clinical significance: Clinical diagnostic indicators are very useful in examining and screening children who are at risk of developing OSA as PSG is expensive and unsuitable for universal use in the pediatric population.


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