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   2014| July  | Volume 6 | Issue 5  
    Online since July 25, 2014

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A newer technique to program a semi adjustable articulator
R Venkateshwaran, Suma Karthigeyan, PS Manoharan, Jagadish Konchada, Manikandan Ramaswamy, Bhuminathan
July 2014, 6(5):135-139
DOI:10.4103/0975-7406.137421  PMID:25210356
Introduction: The difficulty in reproducing accurate angle of condylar guidance in semi-adjustable articulators. Purpose: The purpose of this study was to determine the correlation between the angle of horizontal condylar inclination obtained on a semi-adjustable articulator and the corresponding angle traced on a temporomandibular joint (TMJ) radiograph in completely edentulous subject. Materials and Methods: The horizontal condylar inclination angle was obtained in a semi-adjustable articulator by means of height tracer (extra oral tracing device) and interocclusal records to program the articulator in 21 subjects. TMJ radiograph were recorded by the same operator with same orthopantomogram (OPG) machine (planmeca). Tracings of inclines of articular eminence on the radiograph were compared with the angle obtained on a semi-adjustable articulator. Each measurement was made using manual methods of measuring angle. The results were subjected to the Pearson correlation statistical analysis (α =0.01). Results: The outline of the articular eminence in a TMJ tomogram radiographic image was identified and traced. A significant correlation was found between the horizontal condylar inclination on a semi-adjustable and the corresponding TMJ tomogram radiographic image for both right (R = 0.789; P = 0.001) and left (i = 0.747; P = 0.004) sides. Conclusion: The articular eminence traced on a TMJ tomogram image represents the horizontal condylar inclination with a mean difference of 5° in 21 subjects evaluated.
  8,549 767 4
Gustatory dysfunction
T Maheswaran, P Abikshyeet, G Sitra, S Gokulanathan, V Vaithiyanadane, S Jeelani
July 2014, 6(5):30-33
DOI:10.4103/0975-7406.137257  PMID:25210380
Tastes in humans provide a vital tool for screening soluble chemicals for food evaluation, selection, and avoidance of potentially toxic substances. Taste or gustatory dysfunctions are implicated in loss of appetite, unintended weight loss, malnutrition, and reduced quality of life. Dental practitioners are often the first clinicians to be presented with complaints about taste dysfunction. This brief review provides a summary of the common causes of taste disorders, problems associated with assessing taste function in a clinical setting and management options available to the dental practitioner.
  8,349 241 25
Burning mouth syndrome: A review on its diagnostic and therapeutic approach
R Aravindhan, Santhanam Vidyalakshmi, Muniapillai Siva Kumar, C Satheesh, A Murali Balasubramanium, V Srinivas Prasad
July 2014, 6(5):21-25
DOI:10.4103/0975-7406.137255  PMID:25210377
Burning mouth syndrome (BMS), a chronic and intractable orofacial pain syndrome is characterized by the presence of burning sensation of the oral mucosa in the absence of specific oral lesion. This condition affects chiefly of middle aged and elderly woman with hormonal changes or psychological disorders. In addition to burning sensation, patient with BMS also complains of oral mucosal pain, altered taste sensation, and dry mouth. This condition is probably of multifactorial origin, often idiopathic and its exact etiopathogenesis remains unclear. So far, there is no definitive cure for this condition and most of the treatment approaches, medications remains unsatisfactory. An interdisciplinary and systematic approach is required for better patient management. The purpose of this article is to present a review of epidemiology, clinical presentation, classification, etiopathogenesis, diagnosis and management of BMS.
  6,431 343 19
Theranostics: A treasured tailor for tomorrow
S Jeelani, RC Jagat Reddy, Thangadurai Maheswaran, GS Asokan, A Dany, B Anand
July 2014, 6(5):6-8
DOI:10.4103/0975-7406.137249  PMID:25210387
Emerging as a targeted, safe, and efficient pharmacotherapy is the approach of theranostics, which focuses on patient-centered care. It is a combination of diagnosis and therapeutics. It provides a transition from conventional medicine to personalized medicine. It deals with the custom made treatment plan based on uniqueness of every individual thus resulting in right drug for the right patient at the right time. Genetics plays a significant role in theranostics. Theranostics provides a cost-effective specific successful treatment protocol. Pharmacogenetics, proteomics and biomarker profiling forms the backbone of theranostics. The role of theranostics is interestingly appreciated at multi levels with special consideration in oncology wherein nano formulations in the form of liposomes, dendrimers, polymeric nanoparticles, metallic nanoparticles, quantum dots and carbon nanotubes play a very important role. Thus, theranostics is a holistic transition from trial and error medicine to predictive, preventive and personalized medicine leading to improved quality care of pharmacotherapy.
  6,108 580 55
Periodontally accelerated osteogenic orthodontics: An interdisciplinary approach for faster orthodontic therapy
Srikanth Adusumilli, Lohith Yalamanchi, Pallavi Samatha Yalamanchili
July 2014, 6(5):2-5
DOI:10.4103/0975-7406.137244  PMID:25210373
Periodontally accelerated osteogenic orthodontics is a relatively new procedure designed to minimize the time taken for orthodontic treatment. The orthodontist avails of the aid of a periodontist to perform decortication of the bone and places bone graft for rapid orthodontic correction of malocclusion. A PubMed search was carried out to identify papers describing the procedure, and the data were organized in the current format.
  6,035 312 2
Janardhanam Dineshshankar, Muniapillai Sivakumar, A Murali Balasubramanium, G Kesavan, M Karthikeyan, V Srinivas Prasad
July 2014, 6(5):13-15
DOI:10.4103/0975-7406.137252  PMID:25210354
Taurodontism can be defined as a change in tooth shape caused by the failure of Hertwig's epithelial sheath diaphragm to invaginate at the proper horizontal level. An enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cemento-enamel junction are the characteristic features. Although permanent molar teeth are most commonly affected, this change can also be seen in both the permanent and deciduous dentition, unilaterally or bilaterally, and in any combination of teeth or quadrants. Whilst it appears most frequently as an isolated anomaly, its association with several syndromes and abnormalities has also been reported. Despite the clinical challenges, taurodontism has received little attention from clinicians. Due to the prevalence of taurodontism in modern dentitions and the critical need for its true diagnosis and management, this review addresses the etiology, clinical and radiographic features of taurodontism, its association with various syndromes and anomalies, as well as important considerations in various areas of expertise dental treatments of such teeth.
  4,963 316 8
A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages
Gautham Hegde, Nanditha Hegde, Anil Kumar, Keshavaraj
July 2014, 6(5):58-63
DOI:10.4103/0975-7406.137389  PMID:25210386
Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.
  4,009 148 5
Comparison of the frictional resistance between archwire and different bracket system: An in vitro study
Ajith R Pillai, Anil Gangadharan, Satheesh Kumar, Anwar Shah
July 2014, 6(5):150-155
DOI:10.4103/0975-7406.137429  PMID:25210359
Background and Objectives: The purpose of this study is to evaluate the frictional resistance generated by conventional stainless steel, radiance ceramic bracket, self-ligating and composite brackets using a 0.019 × 0.025 stainless steel straight length wires in a 022 slot and to select brackets based on their frictional characteristic. Methodology: In order to conduct this study, four different types of bracket system were selected of the mclaughlin-bennet-trevesi (MBT) discipline. They are Group 1 - stainless steel, Group 2 - composite bracket Group 3 - (American Orthodontics) radiance ceramic bracket Group 4 - self-ligating bracket (SLB) (Empower). In this study, five maxillary brackets of an arch of each type were used. All brackets are 0.022 × 0.028" in preadjusted edgewise appliance which simulates the dental arch. Five brackets were bonded to a stainless steel bar of dimension 150 mm × 25 mm × 3 mm. The bracket-arch wire units were submitted to mechanical test with an Instron universal testing machine 3365. A testing apparatus or holding jig was designed to hold the bracket during the mechanical test. Each sample was pulled at a speed of 6 mm for 1 min. Descriptive statistical information including mean and standard deviation of maximum friction force was calculated for each bracket wire combination. Interpretation and Conclusion: The SLB has the least friction among the four groups. The ceramic bracket showed the highest friction followed by stainless steel bracket, composite bracket, and SLB.
  3,661 191 4
Flavonoids - Clinical effects and applications in dentistry: A review
S Leena Sankari, N Aravindha Babu, Vidya Rani, C Priyadharsini, K M K Masthan
July 2014, 6(5):26-29
DOI:10.4103/0975-7406.137256  PMID:25210379
Flavonoids include a huge group of naturally occurring organic compounds. It is found in a large variety of plants including fruits, seeds, grains, tea vegetables, nuts, and wine. Many studies have shown that there is a strong association between flavonoid intake and the long-term effects on mortality. It is widely used in dentistry and it has many clinical effects. This article summarizes the effects of flavonoids to humankind and its clinical applications in dentistry.
  3,500 148 13
Immunology of oral candidiasis
Janardhanam Dineshshankar, Muniapillai Sivakumar, M Karthikeyan, P Udayakumar, KT Shanmugam, G Kesavan
July 2014, 6(5):9-12
DOI:10.4103/0975-7406.137251  PMID:25210393
A successful pathogen is one that is able to effectively survive and evade detection by the host immune defense. Oral candidiasis has adopted strategies, which evade host defense and eventually cause disease in at-risk patients. Host defense against infections with Candida spp. depends on rapid activation of an acute inflammatory response by innate immunity, followed by an incremental stimulation of specific immune responses mediated by T-cells (cellular immunity) or B-cells (humoral immunity). Understanding these complex pathways of immune evasion can potentially contribute to the development of novel therapeutic strategies against oral candidiasis.
  3,368 187 5
Lymphoepithelial cyst of the submandibular gland
A Saneem Ahamed, V Sadesh Kannan, K Velaven, GR Sathyanarayanan, J Roshni, E Elavarasi
July 2014, 6(5):185-187
DOI:10.4103/0975-7406.137464  PMID:25210369
Lymphoepithelial cysts are benign, slowly growing unilocular or multilocular lesions that appear in the head and neck. They are also called Branchial cyst. The head and neck sites are the salivary glands(more commonly parotid and rarely submandibular gland) and the oral cavity (usually the floor of the mouth). there are various methods of investigation available today, of which Fine needle aspiration cytology (FNAC) can be used to provide an immediate diagnosis of a lymphoepithelial cyst. The other investigations include, Ultrasonogram,and Computed tomography.It usually occurs due to the process of lymphocyte-induced cystic ductular dilatation and the confirmatory diagnosis is always made postoperatively by histopathological examination. The mainstay in the treatment of a lymphoepithelial cyst remains the surgical approach, which includes complete enucleation of the cyst along with total excision of the involved salivary gland. This is a report of a lymphoepithelial cyst involving the submandibular salivary gland and its management.
  3,250 186 7
The efficacy of different pre- and post-operative analgesics in the management of pain after orthodontic separator placement: A randomized clinical trial
V Sudhakar, TS Vinodhini, A Mathan Mohan, B Srinivasan, BK Rajkumar
July 2014, 6(5):80-84
DOI:10.4103/0975-7406.137393  PMID:25210391
Introduction: Pain-free treatment to the patients is considered as an important treatment objective for orthodontic health care providers. However, many orthodontists underestimate the degree of pain experienced by the patients. Hence, this study was conducted as a randomized, double-blinded clinical trial with the following objectives. Objective: To study the pain characteristics after separator placement; to compare the efficacy of various commonly used analgesics in pain management and to determine the efficacy of pre- and post-operative analgesics in pain management. Subjects and Methods: Data were collected from 154 patients (77 males and 77 females, age group of 14-21 years, with mean age of 18.8 years) who reported to Department of Orthodontics. Patients were randomly divided in to four groups. Group 1: Paracetamol 650 mg, Group 2: Ibuprofen 400 mg, Group 3: Aspirin 300 mg, Group 4: Placebo and the study were conducted as a randomized, double-blinded clinical trial. The patients were instructed to take two tablets, one tablet 1 h before separator placement, and the other one after 6 h. The pain evaluations were made by the patients, when teeth not touching (TNT), biting back teeth together, chewing food (CF) using a 100-mm visual analogue scale for 7 days after separator placement. Patients were advised to record the severity of pain. Results: Group 3 (Aspirin 300 mg) showed lowest pain values, followed by Group 2 (ibuprofen 400 mg), and Group 1 (paracetamol 650 mg). All NSAID's achieved good pain control compared to Group 4 (placebo), where the intensity pain was maximum. Conclusion: Pre- and post-operative analgesics were found to be more effective in controlling orthodontic pain, after separator placement at all-time intervals.
  3,137 123 10
How and why of orthodontic bond failures: An in vivo study
RK Vijayakumar, Raju Jagadeep, Fayyaz Ahamed, Aprose Kanna, K Suresh
July 2014, 6(5):85-89
DOI:10.4103/0975-7406.137394  PMID:25210392
Introduction: The bonding of orthodontic brackets and their failure rates by both direct and in-direct procedures are well-documented in orthodontic literature. Over the years different adhesive materials and various indirect bonding transfer procedures have been compared and evaluated for bond failure rates. The aim of our study is to highlight the use of a simple, inexpensive and ease of manipulation of a single thermo-plastic transfer tray and the use the of a single light cure adhesive to evaluate the bond failure rates in clinical situations. Materials and Methods: A total of 30 patients were randomly divided into two groups (Group A and Group B). A split-mouth study design was used, for, both the groups so that they were distributed equally with-out bias. After initial prophylaxis, both the procedures were done as per manufactures instructions. All patients were initially motivated and reviewed for bond failures rates for 6 months. Results: Bond failure rates were assessed for over-all direct and indirect procedures, anterior and posterior arches, and for individual tooth. Z-test was used for statistically analyzing, the normal distribution of the sample in a spilt mouth study. The results of the two groups were compared and P value was calculated using Z-proportion test to assess the significance of the bond failure. Conclusion: Over-all bond failure was more for direct bonding. Anterior bracket failure was more in-direct bonding than indirect procedure, which showed more posterior bracket failures. In individual tooth bond failure, mandibular incisor, and premolar brackets showed more failure, followed by maxillary premolars and canines.
  3,072 132 1
A hard tissue cephalometric comparative study between hand tracing and computerized tracing
Ramachandra Prabhakar, P Rajakumar, MK Karthikeyan, R Saravanan, N Raj Vikram, Adarsh Reddy
July 2014, 6(5):101-106
DOI:10.4103/0975-7406.137401  PMID:25210347
Aims: To analyze and compare the angular and linear hard tissue cephalometric measurements using hand-tracing and computerized tracings with Nemoceph and Dolphin software systems. Subjects and Methods: A total of 30 cephalograms were randomly chosen for study with the following criteria, cephalograms of patients with good contrast, no distortion, and minimal radiographic artifacts were considered using the digital method (Kodak 8000 C) with 12 angular and nine linear parameters selected for the study. Comparisons were determined by post-hoc test using Tukey HSD method. The N-Par tests were performed using Kruskal-Walli's method. Statistical Analysis Used: ANOVA and post-hoc. Results: The results of this study show that there is no significant difference in the angular and linear measurements recorded. The P values were significant at 0.05 levels for two parameters, Co-A and Co-Gn with the hand-tracing method. This was significant in ANOVA and post-hoc test by Tukey HSD method. Conclusions: This study of comparison provides support for transition from digital hand to computerized tracing methodology. In fact, digital computerized tracings were easier and less time consuming, with the same reliability irrespective of each method of tracing.
  2,985 152 9
Prevalence of dental caries among school-going children in Namakkal district: A cross-sectional study
Ramachandran Karunakaran, Sujatha Somasundaram, Murugesan Gawthaman, Selvaraj Vinodh, Sundaram Manikandan, Subramanian Gokulnathan
July 2014, 6(5):160-161
DOI:10.4103/0975-7406.137432  PMID:25210362
Aim: The aim of this study is to determine the prevalence of dental caries in primary teeth among 4-6 years old school going children in the Namakkal District. Materials and Methods: The study covered a total of 850 school going children in a total of 26 schools in the Namakkal district of Tamil Nadu. The age group selected for this study ranged from 4 to 6 years of age. Each child was examined in their respective schools by one of the four calibrated examiners and decay, missing and filled teeth (dmft) index was recorded along with demographic details. This study was done in September-October 2013 in a span of 1 month duration. Results: Of 850 children examined, 560 (65.88%) children had dental caries. Mean dmft score was 2.86. Prevalence of dental caries was higher in boys (69.6%) than in girls (61.5%). The untreated decay teeth accounted for 92.4%. Conclusion: The prevalence of dental caries among 4-6 years old children is high in the Namakkal district. The need for the creation of dental awareness among children and their primary caregivers is crucial and the need for developing immediate oral health promotion strategies including an increase in school dental health programs is recommended.
  2,917 200 6
Morphological alterations in the dentition of type I diabetes mellitus patients
Andamuthu Yamunadevi, Praveen S Basandi, GS Madhushankari, Mandana Donoghue, Alur Manjunath, Manickam Selvamani, HK Puneeth
July 2014, 6(5):122-126
DOI:10.4103/0975-7406.137415  PMID:25210352
Introduction: Type 1 diabetes mellitus (DM) is an endocrine disorder that occurs commonly in an age group, where the development of primary and permanent dentition takes place. As altered endocrine functions may affect the shape and size of teeth leading to dental anomalies, this study was conducted to look for the occurrence of any dental anomalies in type I DM patients. Materials and Methods: A diabetic camp was conducted at Alur Chandrashekharappa Memorial Hospital, Davangere, where 30 diabetic patients were examined and the impressions of their maxillary and mandibular arches were recorded. Age and sex matched controls were selected randomly, and similar recordings were done. Results: Type I diabetic patients showed statistically significant (P < 0.001) morphological alterations of total number of cusps, including presence of 6 th cusp in mandibular molars and extra cusps in mandibular premolars. Other alterations such as microdontia, flower shaped mandibular molars, prominent cusp of carabelli, and oblique ridge in maxillary molars were also noted. Severe attrition was found in 11 (36.6%) of the diabetic patients, whereas the control group showed attrition only in 2 (6.8%) patients. Conclusion: Remarkable morphological alterations do occur in the dentition of type I DM patients.
  2,918 117 3
Comparative clinical evaluation of transcutaneous electrical nerve stimulator over conventional local anesthesia in children seeking dental procedures: A clinical study
M Varadharaja, J Udhya, Ila Srinivasan, Jambai Sampath Kumar Sivakumar, Ramasamy Sundararajan Karthik, M Manivanan
July 2014, 6(5):113-117
DOI:10.4103/0975-7406.137407  PMID:25210350
Aim: The aim of this study to evaluate the effectiveness of pain control by employing transcutaneous electrical nerve stimulator (TENS) over conventional injectable local anesthesia for children requiring restorative procedures under rubber dam. Materials and Methods: The study design considered was the split mouth design, in experiment (right) side, dental procedures under rubber dam was performed under TENS and in control (left) side, dental procedures under rubber dam was performed under conventional injectable local anesthetic (LA). The level of comfort and discomfort experienced during TENS and conventional LA was determined using visual analog scale (VAS) and heart rate. Result: Increase in mean heart rate associated with TENS (0.78%) was significantly less compared to increase in heart rate with administration of conventional local anesthesia (11.78%). In VAS, the mean values for pain indicate that minimum pain was felt with TENS, which was closely followed by LA. Conclusion: TENS can offer many safer and psychological advantages and is a valuable alternative to conventional LA for children.
  2,910 123 1
Antibacterial activity of aqueous extracts of Indian chewing sticks on dental plaque: An in vitro study
Dola Srinivasa Rao, Tanuja Penmatsa, Alapati Kranthi Kumar, M Narendra Reddy, Nalam Sai Gautam, Nalam Radhika Gautam
July 2014, 6(5):140-145
DOI:10.4103/0975-7406.137426  PMID:25210357
The anti-microbial efficacy of aqueous extracts of Indian chewing sticks against different kinds of plaque bacteria in vitro was investigated. Supra-gingival plaque is cultured and subjected to the antibacterial activity of the aqueous extracts of chewing sticks (Neem, Acacia, Pongamia glabra, Achyranthes aspera, Streblus asper) separately. The results of the study demonstrate that all the five chewing sticks under study possess inhibitory potential against bacteria present in dental plaque mainly on aerobes. The antibacterial efficacy of aqueous extracts has antibacterial effects and could be used as a therapeutic agent and therefore, it appears to be potent anti-microbial agents that could be considered as a medicinal plant. Results of this study showed chewing sticks contained antibacterial agents, but the concentration and composition of the active substances differed among the plants.
  2,861 148 7
Comparative evaluation of dental age, bone age, and chronological age in the human immunodeficiency virus positive children
Vinod Kumar, Kavitha Patil, Karishma B Munoli
July 2014, 6(5):90-96
DOI:10.4103/0975-7406.137395  PMID:25210394
Background and Objective: The knowledge of bone age and dental age is of great importance for pediatrician and pediatric dentist. It is essential for pediatric dentist to formulate treatment plan and it is a source of complementary information for pediatrician. There are few studies in literature, which showed the relationship between dental age, bone age and chronological age in HIV-positive children. Therefore, objective of this study was to determine and compare dental age, bone age and chronological age in HIV-positive children. Materials and Methods: A total of 60 HIV-positive children between the age group of 18-14 years were selected. Chronological age was determined by recording date of birth. Dental age assessment was performed using orthopantamogram following the method described by Demirjian. Bone age estimation was carried out using hand-wrist radiograph following Bjork, Grave, and Brown's method. Results: Chronological age was advanced compared with dental age and bone age in both sexes. The correlation between chronological age, dental age and bone age were all positive in both sexes. Interpretation and Conclusion: The data supports the concept that dental age and bone age delay is a significant feature in HIV-positive children. It is important to consider dental age and bone age as variables for diagnosing growth retardation in HIV-positive children. To support our findings, further a well-designed, controlled as well as longitudinal study with a larger sample size is required.
  2,882 101 1
Ameloblastic carcinoma: A case series
P Satish Kumaran, V Anuradha, S Gokkulakrishnan, Lalita Thambiah, Ajay Kumar Jagadish, G Satheesh
July 2014, 6(5):208-211
DOI:10.4103/0975-7406.137473  PMID:25210376
Ameloblastic carcinoma is a rare odontogenic tumor exhibiting not only features of ameloblastoma, but also features of carcinoma. Clinical dissemination of this lesion is more aggressive and rapid than that of ameloblastoma and it can metastasize to the lung or regional lymph node. Histologically, there are features of both ameloblastoma and carcinoma. <50 cases have been reported until 2011. We report a series of six cases with our treatment modalities.
  2,789 143 2
Evaluation of nonsurgical periodontal therapy in chronic periodontitis patients with anemia by estimating hematological parameters and high-sensitivity C-reactive protein levels
S V V S Musalaiah, M Anupama, M Nagasree, Ch Murali Krishna, Aravind Kumar, P Mohan Kumar
July 2014, 6(5):64-69
DOI:10.4103/0975-7406.137390  PMID:25210388
Background: Periodontal tissues mount an immune inflammatory response to bacteria and their products. Certain inflammatory cytokines produced during periodontal inflammation increase the production of acute phase proteins like high-sensitivity C-reactive protein (hs-CRP) and can depress erythropoietin production leading to the development of anemia. Aim: The aim of this study is to investigate the efficacy of nonsurgical periodontal therapy on red blood cell (RBC) parameters and hs-CRP in chronic periodontitis patients with anemia. Materials and Methods: This is a longitudinal, interventional study with 6-month follow-up. A total of 30 subjects with anemia and chronic periodontitis with age group of 33-55 years were selected by screening hemoglobin (Hb) levels and examining periodontal findings. The clinical parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline. Laboratory blood investigations were performed to evaluate RBC count, Hb, packed cell volume (PCV), erythrocyte sedimentation rate (ESR) and red cell indices, hs-CRP at baseline. Nonsurgical periodontal therapy was performed for all patients. Patients were recalled after 6 months. The clinical and hematological parameters were re-evaluated to analyze the changes after nonsurgical periodontal therapy. Results: The results showed that there was a significant increase in Hb levels, RBC count and PCV from baseline to 6 months after nonsurgical periodontal therapy. There is significant decrease in levels of ESR and hs-CRP levels after nonsurgical periodontal therapy indicating resolution of periodontal inflammation. There is a significant decrease in PPD, scores of PI and GI and significant increase in CAL gain. Minimal changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH) and MCH concentration indicated that the lower values of red cell parameters are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes associated with chronic periodontal disease. Conclusion: The present study strengthens the hypothesis that chronic periodontitis may lead to anemia and provides evidence that nonsurgical periodontal therapy can improve the anemic status and reduce levels of hs-CRP in patients with chronic periodontitis.
  2,753 169 7
Patient compliance and supportive periodontal therapy: Study among young adults of Namakkal district
Subramanium Gokulanathan, Natarajan Balan, Ramaraj Jayabalan Aravind, Kavin Thangavelu
July 2014, 6(5):171-173
DOI:10.4103/0975-7406.137443  PMID:25210365
Aims: The aim of this study is to assess the patient compliance to supportive and maintenance periodontal therapy and to determine the reason for noncompliance among young adult patients of Namakkal district, India. Materials and Methods: This was a cross-sectional study conducted on 400 patients who underwent periodontal therapy and subsequently recalled for supportive and maintenance periodontal treatment in the Department of Periodontics, Vivekanandha Dental College for Women, Namakkal. Patients age group 25-35 years and of both gender were equally selected and grouped by occupation and socioeconomic status. According to their compliance with appointments, they are categorized as complete compliance, partially compliance and insufficient or noncompliance. Noncompliance and partially compliance patients were contacted and asked to rate their experience and reason for noncompliance. Results: In this study, 80% of patients showed complete compliance and were regular for supportive periodontal therapy appointments. Women were more regular in maintaining recall appointments than men. Salaried employers showed 84.3% complete compliance, while self-employed personals showed 77% complete compliance and 75% of nonworking personals were regular to the appointment schedule. Noncompliance person has quoted lack of time and forgetting the appointment date as a major reason for missed appointments. Conclusions: This study recommends the need for improvement in communication skills of practitioners and weekend appointment for patient undergoing periodontal maintenance therapy.
  2,690 152 6
Temperomandibular joint ankylosis in children
Perumal Jayavelu, SP Shrutha, GB Vinit
July 2014, 6(5):178-181
DOI:10.4103/0975-7406.137450  PMID:25210367
Temperomandibular joint (TMJ) ankylosis or hypo mobility involves fusion of the mandibular condyle to the base of the skull. Impairment of speech, difficulty in mastication, poor oral hygiene, rampant caries, and acute compromise of the airway pose a severe psychological burden on the tender minds of children. The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. This report describes a case of 7-year-old with inability to open mouth, diagnosed with unilateral right bony TMJ ankylosis. The surgical approach consisted of inter-positional arthroplasty followed by physiotherapy. A detailed history, clinical and functional examination, and radiographic examination facilitating correct diagnosis followed by immediate surgical intervention and physiotherapy can help us to restore physical, psychological and emotional health of the child patient.
  2,710 125 2
Perforated schneiderian membrane repair during sinus augmentation in conjunction with immediate implant placement
K Hameed Fathima, VS Harish, Perumal Jayavely, P Harinath
July 2014, 6(5):174-177
DOI:10.4103/0975-7406.137446  PMID:25210366
Dental implant associated rehabilitation of the posterior maxilla poses unique challenge owing to the presence of pneumatized sinuses and atrophied alveolar bone. Sinus augmentation procedure to manage expanded sinuses frequently results in membrane tear resulting in unfavorable stabilization of the graft and associated bone regeneration. Simultaneous implant placement during sinus augmentation procedures frequently requires a minimal alveolar bone height, which when not present forces clinician to defer implant placement resulting in extended treatment duration and multiple surgical appointments. The present case report is about a piezosurgery assisted lateral wall osteotomy approach for sinus augmentation associated with membrane repair with simultaneous implant placement in the posterior maxilla.
  2,728 105 1
Granularity in granular cell ameloblastoma
Andamuthu Yamunadevi, GS Madhushankari, Manickam Selvamani, Praveen S Basandi, Thukanayyakanpalayam Ragunathan Yoithapprabhunath, N Ganapathy
July 2014, 6(5):16-20
DOI:10.4103/0975-7406.137253  PMID:25210361
Granular cell ameloblastoma (GCA) is one of the rare histological variants of ameloblastoma (1.5-3.5%), identified by Krompechner in 1918 and is diagnosed by the characteristic presence of granular cells. These granular cells are seen in several physiological and pathological conditions and the granularity in GCA is due to lysosomal aggregates. This review is about the clinical features, histopathological features and differential diagnosis of GCA and also adds the theories for occurrence of granularity, electron microscopic findings, cell signaling pathways and immunohistochemistry findings related to these granular cells in GCA.
  2,665 160 3
Oral lymphangioma of the buccal mucosa a rare case report
Saligrama Seema Yoganna, Rame Gowda Gowda Rajendra Prasad, B Sekar
July 2014, 6(5):188-191
DOI:10.4103/0975-7406.137465  PMID:25210370
The lymphangioma are benign hamartomatous tumors of lymphatic vessels that arises from the sequestration of lymphatic that fails to communicate with the lymphatic system. Most common intra oral site being the anterior two-thirds of tongue, usually superficial in location and demonstrates a pebbly surface that resembles a cluster of translucent vesicles, they are typically soft and fluctuant masses. Secondary hemorrhage into the lymphatic spaces may cause some of these vesicles to become purple. They have been known to grow to large size causing difficulties in mastication and speech. A variant of lymphangioma is cystic hygroma grows as lymphatic anomaly found in the neck commonly present with significant airway obstruction. We present a rare case of lymphangioma affecting the buccal mucosa of a 14-year-old male.
  2,639 108 2
Anterior maxillary osteotomy: A technical note for superior repositioning: A bird wing segment
V Sadesh Kannan, A Saneem Ahamed, GR Sathyanarayanan, K Velaven, E Elavarasi, C Danavel
July 2014, 6(5):107-109
DOI:10.4103/0975-7406.137403  PMID:25210348
Aim: The aim of this study is to evaluate the efficacy of a single piece bird wing osteotectomy segment during anterior maxillary osteotomy (AMO) markedly reduces the duration of the surgery by nearly one-half of the time during bone removal with the conventional method thereby reducing the kinking effect to the palatal pedicle and gives good perfusion to the anterior segment. Materials and Methods: This study was conducted at Karpaga Vinayaga Institute of Dental Sciences composing of 20 patients in which male: female ratio was 8:12, with a mean age of 25-30 years. This bird wing segment technique is performed following presurgical orthodontics under the guidance of clinical assessment of the gummy smile with an incisal show when the lip is at repose (vertical maxillary excess), especially for the calculated amount of superior repositioning. It is calculated by subtracting 2 mm from the total amount of an incisor show when the lip is at repose. The normal incisal show when the lip is at repose is 2 mm. After conventional primary AMO cut was performed, the precise calculated. Results: All our cases were tested positive for pulp vitality, no relapse, and minimal edema and with no changes in the bite or dentoalveolar relation followed until 1 year postoperatively indicating a good perfusion to the anterior segment and all the patients were satisfied esthetically and free of complaints. Conclusion: This simple technique allows the precise amount of calculated bone removal in a single piece from the nasal floor markedly reduces the duration of the surgery by nearly one-half of the time during bone removal with the conventional method there by reducing the kinking effect to the palatal pedicle and maintains good perfusion.
  2,525 138 2
Evaluation of tensile strength and surface topography of orthodontic wires after infection control procedures: An in vitro study
M Brindha, N Kurunji Kumaran, K Rajasigamani
July 2014, 6(5):44-48
DOI:10.4103/0975-7406.137386  PMID:25210383
Aim: The aim of this study is to evaluate, the influence of four types of sterilization/disinfection procedures (autoclave, hot air oven, glutaraldehyde, and ultraviolet [UV] light) on the tensile strength and surface topography of three orthodontic wires (stainless steel (SS), titanium - molybdenum alloy [TMA], and cobalt chromium (CoCr)). Materials and Methods: Sample comprised of three types of 8 inches straight length segments of orthodontic wires. They were divided into three groups according to wire composition comprising of 50 samples each. Totally 50 samples of each group were then equally divided into five subgroups according to sterilization method. After sterilization and disinfection of the experimental group, surface topography was examined with scanning electron microscope (SEM) and tensile strength was tested using universal testing machine. Result: The results of this study show that the mean ultimate tensile strength (UTS) of SS wire after four sterilization procedures were similar to the control group (1845.815 ± 142.29 MPa).The mean UTS of TMA wire increases after four sterilization procedures when compared with the control group (874.107 ± 275.939 MPa). The mean UTS of CoCr wire remains same after UV light disinfection, but increases after other three sterilization procedures when compared with the control group (1449.759 ± 156.586 MPa). SEM photographs of the present study shows gross increase in pitting roughness of the surface topography of all the three types of wires after four types of sterilization. Conclusion: Orthodontists who want to offer maximum safety for their patients can sterilize orthodontic wires before placement, as it does not deteriorate the tensile strength and surface roughness of the alloys.
  2,488 106 7
Prognosis of teeth in the line of mandibular fractures
P Prasanna Kumar, BS Sridhar, Ramaiah Palle, Nishanth Singh, Vijay Kumar Singamaneni, Panchineni Rajesh
July 2014, 6(5):97-100
DOI:10.4103/0975-7406.137397  PMID:25210395
Introduction: The purpose of this study was to evaluate teeth involved in the line of fracture, clinically and radiographically, and their associated complications so as to indicate if they should be managed conservatively or extracted. Materials and Methods: Data were collected from patients records treated of mandibular fractures. It was included pre and postoperative panoramic radiographs, information such as demographic data, age, and sex, fracture location, mobility, and vitality of teeth in the line of fracture, teeth stabilizing the fracture segment. Results: The sample presented 25 patients with teeth in the line of mandibular fractures. A total of 16 patients teeth in the line of fracture were vital during the 6 th week postoperative follow-up and 9 patients with their teeth in the line of fracture were nonvital of which 4 were endodontically treated and the rest 5 patients teeth in the line of fracture were extracted as they showed signs of infection. Conclusion: This study demonstrated that the presence of teeth in the line of fracture is not a limiting factor for the treatment. Despite the risk of complications, tooth in the fracture line should be preserved for its merits. A regular clinical and radiological follow-up should be mandatory for at least a period of 1 year.
  2,458 96 3
Prevalence and clinicopathological comparison of kerotocystic odontogenic tumor and orthokeratinized odontogenic cyst in South Indian sample population: A retrospective study over 13 years
Manickam Selvamani, Andamuthu Yamuna Devi, Praveen S Basandi, GS Madhushankari
July 2014, 6(5):127-130
DOI:10.4103/0975-7406.137418  PMID:25210353
Aim and Methodology: The purpose of this study is to determine the prevalence of keratocystic odontogenic tumor (KCOT) and orthokeratinized odontogenic cyst (OOC), to identify their clinicopathological features among the patients by studying the biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India during the period of 2001-2013. Data for this study is retrieved from the case records of the patients fitting the histological classification of the World Health Organization (2005). The following clinical variables, namely age, gender, anatomical location, and histological features are analyzed. Results: Of the 3026 biopsy reports (100%) present in the archives, we had 31 cases (1.02%) of KCOT, 11 cases (0.36%) of OOC and a combination of para and orthokeratinized lining epithelium made 1 case (0.033%). The most frequent clinical manifestation was asymptomatic followed by the combination of pain and swelling. The male: female ratio was 1.4:1 with a mean age of 30 years in KCOT, while 2.7:1 with a mean age of 29.1 years in OOC. Posterior molar-ramus region was most commonly involved in both KCOT and OOC. Conclusion: Due to aggressiveness and high recurrence rate of KCOT, differentiation between KCOT and OOC is important, with respect to their treatment modalities. Such epidemiological pools are also essential for the analysis of geographical distribution of odontogenic tumours
  2,422 127 7
A comparative evaluation of mandibular incisor decrowding with coaxial and optiflex arch wires and their load-deflection rates
S Nagalakshmi, G Sriram, K Balachandar, D Dhayanithi
July 2014, 6(5):118-121
DOI:10.4103/0975-7406.137412  PMID:25210351
Aim: The aim of this study is to determine and compare the load-deflection rate of optiflex arch wire with that of coaxial arch wire and to determine and compare the decrowding efficiency of optiflex arch wire with coaxial arch wire within a period of 45 days. Materials and Methods: Load-deflection rates of optiflex and coaxial wires were found using the INSTRON (4300) machine. A steady load was given to the wire to make it deflect, and the load required to deflect the wire for every 1 mm up to 5 mm, were noted and tabulated. A total of 10 patients, 10-25 years of age (seven males and three females) were selected. All patients had angles Class I malocclusion with a crowding discrepancy of 3-9 mm (according to little's index). All patients required first premolar extraction. Pre (0 day) and post (45 th day) treatment study models and lateral cephalograms were taken for all patients and evaluated. Results: Optiflex had a low load-deflection when compared to coaxial wire. Clinically, optiflex and coaxial wire had similar decrowding efficiency. In both, study model and cephalometric analysis, there was no statistically significant value when comparing their mean variables. Conclusion: Optiflex is an appropriate wire for patients seeking esthetics during fixed appliance therapy as it combines esthetics and efficiency by delivering light continuous forces.
  2,459 89 1
Scanning electron microscopic study of teeth restored with fiber posts and composite resin: An in vitro study
KS Sridhara, Sunil Mankar, CM Jayshankar, K Vinaya
July 2014, 6(5):74-79
DOI:10.4103/0975-7406.137392  PMID:25210390
Aims and Objectives: The aim of this study is to compare and evaluate the thickness of resin dentin interface zones (RDIZ) obtained by luting carbon fiber post to intra-radicular dentin, either with All-Bond 2 bonding agent and C and B composite cement or Panavia F dentin-bonding system and Panavia F resin cement. Materials and Methods: Twenty single rooted mandibular premolars of similar sizes were prepared for the carbon fiber post after biomechanical preparation and obturation. They were divided into two groups, Group 1 and 2 of 10 samples each. Carbon fiber posts used for Group 1 samples were luted using All-Bond 2 and C and B cement. For Group 2 carbon fiber posts were luted using Panavia F dentin-bonding system and Panavia F resin cement. All the 20 samples were sectioned longitudinally and marked at three points on the length of the tooth from the dentin-core interface to the apex at 2 mm, 5 mm, and 8 mm to get coronal, middle, and apical areas, respectively. The formation and thickness (width) of the RDIZ at the marked areas was evaluated by scanning electron microscope using ×1000 magnification. The results were statistical analyzed. Results: Irrespective of the adhesive systems used all specimens showed a RDIZ formation. Microscopic examination of Group 1 showed significantly higher percentage of RDIZ (P < 0.05) than Group 2. RDIZ morphology was easily detectable at coronal and middle areas of all specimens. Conclusion: All-Bond 2 showed denser and wider RDIZ compared with the Panavia F.
  2,473 72 2
Administration of bisphosphonate (ibandronate) impedes molar tooth movement in rabbits: A radiographic assessment
V Venkataramana, S Sathesh Kumar, B Vishnuvardhan Reddy, A Sreekanth Cherukuri, K Raja Sigamani, G Chandrasekhar
July 2014, 6(5):165-170
DOI:10.4103/0975-7406.137440  PMID:25210364
Introduction: Bisphosphonate (Bp)-ibandronate is a pharmacological agent, exhibits antiosteoclastic or antiresorptive activity and used to treat osteolytic or osteopenic disorders. BP-ibandronate may also interfere during orthodontic tooth movement. The aim of this study was to examine the influence of locally administered Bp-ibandronate on experimental tooth movement in rabbits. Materials and Methods: Twenty rabbits were divided into two groups- "10" served as Group-1 (control) and other "10" as Group-2 (experimental). Both groups received nickel-titanium closed coil springs with 100 g force between mandibular molar and incisors. Group-1 animals received 1 ml normal saline and Group-2 animals received ibandronate solution (0.3 mg/kg body weight) locally, mesial to the mandibular molar on the 1 st , 7 th , and 14 th day of the experiment. A total of "40" lateral cephalograms were taken from both groups on the 1 st and 21 st day using a digital X-ray unit (Siemens X-ray systems, 300 mA Pleomophos analog, 2008, Germany). Individually, each animal's radiograph was traced manually and superimposed. The molar tooth movement was measured with the help of a standard metric scale. Results: The Student's t-test has been done to compare the mean values of Group-1 (4.650 ± 0.363) and Group-2 (2.030 ± 0.291) and the difference was statistically significant (P < 0.001). Conclusion: The retarded molar tooth movement was noticed in local drug administered rabbits, which could be beneficial in orthodontics to control the undesired tooth movement.
  2,443 91 1
Changes in quality of life during orthodontic correction of midline diastema
S Nagalakshmi, R Sathish, K Priya, D Dhayanithi
July 2014, 6(5):162-164
DOI:10.4103/0975-7406.137435  PMID:25210363
Aim: The aim of our study is to evaluate the changes in quality of life among patients treated for maxillary midline diastema by fixed orthodontic appliances. Materials and Methods: This prospective longitudinal study consists of 40 patients of age group 20-30 years who underwent orthodontic correction of midline diastema. The patient's quality of life is evaluated using 22-item orthognathic quality of life questionnaire. They were evaluated prior to appliance therapy, 1 month after appliance fixation, 4 th and 8 th month during treatment and 1 month after treatment. Results: Our results showed moderate improvement in quality of life as early as at the start of orthodontic therapy. The response was equal among both sexes. The quality of life experience improved only mildly during the orthodontic treatment. However, the condition specific quality of life at the end of appliance therapy improved by nearly 50% when compared with prior to treatment. Conclusion: Our study has concluded that the correction of midline diastema has improved the quality of life among young people by nearly 50%. The acceptance to orthodontic therapy and patient perception toward fixed appliance has demonstrated remarkable improvement in quality of life during the treatment. Our study calls for additional patient counseling and motivation during the course of fixed appliance therapy.
  2,386 109 4
A new atraumatic method of removing fractured palatal root using endodontic H-files luted with resin modified glass ionomercement: A pilot study
V Sadesh Kannan, A Saneem Ahamed, GR Sathya Narayanan, K Velavan, E Elavarasi, C Danavel
July 2014, 6(5):156-159
DOI:10.4103/0975-7406.137431  PMID:25210360
Purpose: The purpose of this study is to evaluate the efficacy of using endodontic H-files luted with Resin modified glass ionomer cement (RMGIC) in removing fractured palatal root. Materials and Methods: This study consists of 30 patients, of which 16 were males and 14 were females with a mean age of 36 years. In which, 19 were maxillary first molar and 11 were maxillary second molar. In that, 18 were fractured at the level of apical 1/3 rd and 12 were at the level of apical 2/3 rd . All cases were first tried with endodontic H-files, within few attempts, it was wedged tightly in the remaining pulp chamber with one or two clockwise direction and using sudden jerk with a downward pull the remnant part was removed. The cases, which fail to deliver after several attempts were taken up for study. After sufficient isolation with a rubber dam and the socket was dried using sterile gauze, under good lighting and vision again the same file was introduced, which was now luted with RMGIC, after 5 min of setting time, the same attempt using sudden jerk with a downward pull was given. Results: In those 30 cases, 20 cases were removed in the first few attempts using endodontic H-files. The 10 cases (7 cases were apical 2/3 rd and 3 cases were of apical 1/3 rd ), which fails to come out were tried using endodontic H-files luted with RMGIC, in which 9 cases were successfully removed (90%) and 1 case of apical 1/3 rd was again failed to come out. Conclusion: Even though, the number of cases were too small to come to a definitive conclusion, the encouraging result (90%) and technically easy, this is a novel method of removing fractured palatal root atraumatically and devoid of any complication.
  2,410 84 1
Adenomatoid odontogenic tumor in the maxillary antrum: A rare case entity
Kavitha Krishnamurthy, Ranjith Singh Balaji, Sumana Devadiga, Rame Gowda Rajendra Prasad
July 2014, 6(5):196-199
DOI:10.4103/0975-7406.137468  PMID:25210372
Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin. It occurs in the second decade of life. Females are more commonly affected than males. AOT has a striking tendency to occur in the anterior maxilla; however, very few cases have been reported to occur in the maxillary antrum. This is a case report of a 17-year-old male presented with a large radiolucent lesion associated with the crown of an unerupted canine located in the right maxillary antrum, which was clinically diagnosed as dentigerous cyst. The histopathological examination revealed the presence of AOT.
  2,375 98 2
Langerhans cells in lichen planus and lichenoid mucositis an immunohistochemical study
M Devi, TR Saraswathi, K Ranganathan, D Vijayalakshmi, C Sreeja, S Shabana Fathima
July 2014, 6(5):146-149
DOI:10.4103/0975-7406.137427  PMID:25210358
Aim: The aim of this study is to identify and evaluate Langerhans cell (LC) in lichen planus (LP), lichenoid mucositis (LM) and normal mucosa (NM) using CD1a monoclonal antibody immunohistochemically. Materials and Methods: A total of 15 cases of oral lichen planus and 15 cases of LM were selected based on clinical examination and confirmed by histopathological analysis. The biopsies from the 10 patients were taken from normal buccal mucosa as control. Paraffin blocks of tissue were made, which are used for routine hematoxylin and eosin staining and immunohistochemical staining using biotin streptavidin methods (CD1a monoclonal antibody). Analysis of CD1a expression was performed by evaluating the labeling index (LI) for each slide. Results: The mean CD1a LI for LP was significantly higher than that of LM and NM in the basal and supra basal layer. The mean CD1a positive cells in the connective tissues for LP were higher than that of LM and NM. Conclusion: This study clearly demonstrates a statistically significant increase in number of LC in LP than in LM, indicating the possible different immunopathogenic mechanisms.
  2,374 92 2
Nonsyndromic oligodontia in siblings: A rare case report
Veerabadhran Mahesh Mathian, Murugesan Gawthaman, Ramachandran Karunakaran, Selvaraj Vinodh, Sundaram Manikandan, Alagappan Meenakshi Sundaram
July 2014, 6(5):200-203
DOI:10.4103/0975-7406.137469  PMID:25210374
A syndrome is a medical condition that is characterized by a particular group of signs and symptoms, involving several organ systems. Oligodontia is defined as the developmental absence of six teeth or more, excluding third molars. Oligodontia can be classified as syndromic or nonsyndromic. Nonsyndrome oligodontia is a developmental dental anomaly without involvement of other organs. The consequences of missing teeth include abnormal occlusion or altered facial appearance, which can cause psychological distress in some patients. The management of oligodontia usually requires a multidisciplinary approach. The present article reports a case of oligodontia in siblings of the same family with no apparent systemic abnormalities.
  2,380 74 1
Interdisciplinary approach for improved esthetic results
G Sriram, S Nagalakshmi, K Balachandar, K Madhusudan
July 2014, 6(5):192-195
DOI:10.4103/0975-7406.137466  PMID:25210371
This clinical report describes an interdisciplinary (orthodontic, prosthodontics and operative dentist) approach for the coordinated treatment of an adult patient diagnosed with severely mutilated dentition secondary to caries lesion warranting restorative procedures that was facilitated with orthodontic treatment. The patient's specific esthetic expectation for the anterior teeth and improved smile were successfully met through planned treatment, including orthodontic tooth movement, restoration and porcelain conversion crowns. Such coordinated interdisciplinary evaluations and treatment are necessary for improved esthetics.
  2,369 82 1
Estimation of soft- and hard-tissue thickness at implant sites
Anil Kumar, Rohan Mascarenhas, Akhter Husain
July 2014, 6(5):34-38
DOI:10.4103/0975-7406.137384  PMID:25210381
Introduction: Anchorage control is a critical consideration when planning treatment for patients with dental and skeletal malocclusions. To obtain sufficient stability of implants, the thickness of the soft tissue and the cortical-bone in the placement site must be considered; so as to provide an anatomical map in order to assist the clinician in the placement of the implants. Objective: The aim of this study is to evaluate the thickness of soft- and hard-tissue. Materials and Methods: To measure soft tissue and cortical-bone thicknesses, 12 maxillary cross-sectional specimens were obtained from the cadavers, which were made at three maxillary mid-palatal suture areas: The interdental area between the first and second premolars (Group 1), the second premolar and the first molar (Group 2), and the first and second molars (Group 3). Sectioned samples along with reference rulers were digitally scanned. Scanned images were calibrated and measurements were made with image-analysis software. We measured the thickness of soft and hard-tissues at five sectional areas parallel to the buccopalatal cementoenamel junction (CEJ) line at 2-mm intervals and also thickness of soft tissue at the six landmarks including the incisive papilla (IP) on the palate. The line perpendicular to the occlusal plane was made and measurement was taken at 4-mm intervals from the closest five points to IP. Results: (1) Group 1:6 mm from CEJ in buccal side and 2 mm from CEJ in palatal side. (2) Group 2:8 mm from CEJ in buccal side and 4 mm from CEJ in palatal side. (3) Group 3:8 mm from CEJ in buccal side and 8 mm from CEJ in palatal side. Conclusions: The best site for placement of implant is with thinnest soft tissue and thickest hard tissue, which is in the middle from CEJ in buccal side and closest from CEJ in palatal side in Group 1 and faraway from CEJ in buccal side and closest from CEJ in palatal side in Group 2 and faraway from CEJ in buccal side and faraway from CEJ in palatal side in Group 3.
  2,336 96 2
Immunohistochemical study of p53 and proliferating cell nuclear antigen expression in odontogenic keratocyst and periapical cyst
Thara Purath Sajeevan, Tillai Rajasekaran Saraswathi, Kannan Ranganathan, Elizabeth Joshua, Uma Devi K Rao
July 2014, 6(5):52-57
DOI:10.4103/0975-7406.137388  PMID:25210385
Introduction: p53 protein is a product of p53 gene, which is now classified as a tumor suppressor gene. The gene is a frequent target for mutation, being seen as a common step in the pathogenesis of many human cancers. Proliferating cell nuclear antigen (PCNA) is an auxiliary protein of DNA polymerase delta and plays a critical role in initiation of cell proliferation. Aim: The aim of this study is to assess and compare the expression of p53 and PCNA in lining epithelium of odontogenic keratocyst (OKC) and periapical cyst (PA). Materials and Methods: A total of 20 cases comprising 10 OKC and 10 PA were included in retrospective study. Three paraffin section of 4 μm were cut, one was used for routine hematoxylin and eosin stain, while the other two were used for immunohistochemistry. Statistical analysis was performed using Chi-square test. Results: The level of staining and intensity were assessed in all these cases. OKC showed PCNA expression in all cases (100%), whereas in perapical cyst only 60% of cases exhibited PCNA staining. (1) OKC showed p53 expression in 6 cases (60%) whereas in PA only 10% of the cases exhibited p53 staining. Chi-square test showed PCNA staining intensity was more significant than p53 in OKC. (2) The staining intensity of PA using p53, PCNA revealed that PCNA stating intensity was more significant than p53. Conclusion: OKC shows significant proliferative activity than PA using PCNA and p53. PCNA staining was more intense when compared with p53 in both OKC and PA.
  2,325 106 2
A study on evaluation of center of resistance of maxillary four incisors during simultaneous intrusion and retraction: A finite element study
J Aruna
July 2014, 6(5):49-51
DOI:10.4103/0975-7406.137387  PMID:25210384
Aim: The aim of this study is to evaluate the center of resistance of maxillary incisors during simultaneous intrusion and retraction. Subjects and Methods: In this study, the following steps were employed namely, (1) Preprocessing - the creation of geometric model, mesh generation and boundary conditions. (2) Postprocessing - the tooth movement and determination of center of resistance. Results: The center of the mid-sagittal plane approximately 6 mm apical and 4 mm posterior to a line perpendicular to the occlusal plane from the labial alveolar crest of the central incisor resistance for the maxillary four incisors was located within the. Conclusion: Finite element is a sound mechanical method of analysis as it was sufficient enough to provide insight into interactions between orthodontic forces, and dental tissues and reliability of this study. Further by using this study clinically, the center of resistance can be precisely located in single rooted tooth during orthodontic treatment.
  2,282 105 -
Analysis of prevalence and clinical features of multicystic ameloblastoma and its histological subtypes in South Indian sample population: A retrospective study over 13 years
Manickam Selvamani, Andamuthu Yamunadevi, Praveen S Basandi, GS Madhushankari
July 2014, 6(5):131-134
DOI:10.4103/0975-7406.137419  PMID:25210355
Objective: The study was designed to analyze the frequency and clinical features of multicystic ameloblastoma and its histological variants in South Indian sample population, as there is minute information available in the English literature. Methodology: The study source was the biopsy specimens retrieved from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 13 years, from 2001 to 2013. Clinical data for the study were obtained from the case records of patients and the analyzed clinical variables were age, gender and anatomical location. Histologically, hematoxylin and eosin stained sections fitting the World Health Organization (2005) criteria for diagnosis of multicystic ameloblastoma were selectively included. Results: Of the 3026 biopsy reports analyzed, 103 cases were odontogenic tumors (3.4%) and 58 cases were ameloblastoma. 31 cases of multicystic ameloblastoma, including follicular ameloblastoma (54.8%), acanthomatous ameloblastoma (29%), plexiform ameloblastoma (6.5%), granular cell ameloblastoma (6.5%) and desmoplastic ameloblastoma (3.2%) were recorded. The age of the patients during the presentation of the lesion was ranging from 21 to 73 years, with a mean of 39.5 years. The most frequent clinical manifestation was swelling, followed by a combination of pain and swelling. In our study, ameloblastoma showed distinct anatomic predilections for occurrence in mandible (96.8%) rather than maxilla (3.2%). This study result also indicated that there is geographical variation in the frequency and distribution of ameloblastoma.
  2,274 103 6
Audit on titanium reconstruction of mandibular defects for jaw lesions
S Arun Paul, A Kaneesh Karthik, Rabin Chacko, Whinny Karunya
July 2014, 6(5):39-43
DOI:10.4103/0975-7406.137385  PMID:25210382
Aims: The aim of the study is to audit the titanium reconstruction of jaw defects in benign conditions in Christian Medical College and Hospital , Vellore. Methods and Material: A retrospective study of titanium reconstruction of mandibular defects due to jaw lesions at Christian Medical College and Hospital, Vellore, India, between May 2008 and May 2011. Results: Mouth opening, facial symmetry, occlusion, chewing ability, plate exposure and patient satisfaction were used as outcome measures. Conclusions: The three-dimensional titanium plate is a reasonable material for immediate mandible reconstruction after surgical resection of benign jaw pathologies.
  2,296 80 -
Relationship between gingival bleeding and anaerobic periodontal infection assessed by BANA (N-Benzoyl-DL-Arginine-β-Napthylamide) assay
S Muthukumar, M Vijay Anand, Seenivasan Madhankumar
July 2014, 6(5):70-73
DOI:10.4103/0975-7406.137391  PMID:25210389
Background: Since periodontal diseases are primarily inflammatory in nature, the ability to detect inflammatory lesions in gingival tissue is essential for the diagnosis and monitoring of changes in gingival status. Gingival bleeding has been used as a reliable and objective clinical parameter not only for the evaluation of inflammatory conditions of periodontium, but also in the detection of its activity and progression. The gingival bleeding index (Loe) is based on the presence or absence of gingival bleeding, thereby provides a means of converting observed clinical data into statistical analysis. Periodontitis is widely regarded as a bacterial infection mainly mediated by subgingival plaque. N-benzoyl-DL-arginine β-naphthylamide (BANA) test is a simple chair side test used to detect, the specific enzymatic activity of microorganisms involved in periodontal disease. Objective: The objective of this study is to compare the clinical evaluation of the gingival index (GI) with the enzymatic BANA test. Materials and Methods: A total of 320 sites were selected from 20 patients with generalized chronic periodontitis, based on the presence are absence of gingival bleeding according to GI of Loe. Sub-gingival plaque samples were collected using a sterile curette and the BANA test was performed. Results: The distribution of GI and the intensity of the BANA test for the 320 sites analyzed during the initial examination of patients, with significance determined by the Chi-square test. The results were statistically significant at P ≤ 0.000. Conclusion: There was a direct relationship between positive BANA test results and GI scores, clearly demonstrating the validity of gingival bleeding as a significant diagnostic parameter. Clinical Significance: The validity of gingival bleeding as a clinical tool not only for the diagnosis of periodontal disease, but also in the detection of its activity and progression could be established by correlating the GI scores (which is based on the presence or absence of bleeding) with the primary etiologic factors (putative periodontal pathogens) assessed by BANA assay.
  2,256 104 1
Mandibular second molar with 3 mesial canals and a radix paramolaris
N Ragavendran, Ganesh T Bhat, Mithra N Hegde
July 2014, 6(5):182-184
DOI:10.4103/0975-7406.137461  PMID:25210368
Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP), which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP.
  2,229 122 -
Recurrent peripheral odontogenic fibroma associated with basal cell budding
C Sreeja, N Vezhavendan, F Shabana, D Vijayalakshmi, M Devi, N Arunakiry
July 2014, 6(5):204-207
DOI:10.4103/0975-7406.137470  PMID:25210375
Peripheral odontogenic fibroma (POdF) is a rare benign odontogenic neoplasm. It represents the soft tissue counterpart of central odontogenic fibroma. The embryonic source of POdF has been suggested by many as arising from the rest of dental lamina that has persisted in the gingiva following its disintegration. It presents clinically as a firm, slow growing and sessile gingival mass, which is difficult to distinguish with more common inflammatory lesions. Very few cases of recurrence have been documented. It has been stated that histological budding of basal cell layer of the surface squamous epithelium is associated with higher recurrence and the presence of calcification in direct apposition to the epithelial rest is associated with lower recurrence. Hereby, we present a case which histologically exhibited budding of the basal cell layer, which could have been the reason for its recurrence.
  2,273 74 2
Keratin metaplasia in the epithelial lining of odontogenic cysts
Thangadurai Maheswaran, Venkatapathy Ramesh, Nirima Oza, Abikshyeet Panda, PD Balamurali
July 2014, 6(5):110-112
DOI:10.4103/0975-7406.137405  PMID:25210349
Objective: To find the prevalence of keratin metaplasia and its relation with clinico-pathological profile of the odontogenic cyst. Materials and Methods: Odontogenic cysts were studied histologically with special stains to identify the presence of keratin and compared with various parameters such as underlying connective tissue inflammation, average epithelial thickness, and site of the cyst, type of the cyst, age and the sex of the patient. Results: Of 71 cases of various odontogenic cysts, 26 (36.6%) cases exhibited keratinization in the epithelial lining. In cysts with severe inflammation there is absence of keratinization. Conclusions: This study reveals higher prevalence of keratin metaplasia in the odontogenic cysts. Furthermore, inflammation is found to be one of factor influencing keratin metaplasia.
  2,194 137 5
Extrusion of impacted mandibular second molar using removable appliance
MK Karthikeyan, Ramachandran Prabhakar, R Saravanan, N Raj Vikram, R Vinoth Kumar, R Eshwara Prasath
July 2014, 6(5):212-214
DOI:10.4103/0975-7406.137475  PMID:25210378
The purpose of this article is to review the principles of case management of impacted mandibular molars and to illustrate their potential to respond well to treatment. Although the scope of treatment may be influenced by the patient's age, past dental history, severity of impaction, dentoalveolar development, and root form, the case reports demonstrate the inherent potential for good treatment outcome even in the most unfavorable circumstances.
  2,159 75 -
Dental supplement 2014
GJ Anbuselvan
July 2014, 6(5):1-1
DOI:10.4103/0975-7406.137242  PMID:25210346
  1,959 112 -