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   2021| November  | Volume 13 | Issue 6  
    Online since November 10, 2021

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The impact of COVID-19-induced factors on “Work from Home” of employees
Santosh Kumar Verma, Barun Dev Kumar, Neha Singh, Priyanka Kumari, Madhu Ranjan, Abhishek Verma
November 2021, 13(6):1000-1002
Background: COVID-19 pandemic resulted in lockdown affecting all businesses globally. Everyone was forced to work from home (WFH) leading to challenges in productivity and motivation. Methodology: One thousand working professionals who worked from home participated in the online survey with semi-structured questionnaire using nonprobability Snowball sampling technique. Descriptive statistics was used to analyze the findings and to collect data method. Results: Participants were asked about their biggest worries during lockdown COVID-19 situation and their biggest worry was infection to COVID-19/death. Professionals were asked whether they were affected or not affected due to “WFH” in COVID situation. The questionnaire items were clubbed into six major categories of job role overload, lifestyle choices, family distraction, occupational discomfort, job performance, and distress, and majority categories were affected. Conclusion: Thus, it is observed that the increase in work commitments leads to distress among employees while distractions from family members disrupt the quality of work. While good job performance contributes to life satisfaction, distress significantly diminished it. This paves the way for more studies to be done on work–life balance under WFH arrangements for as long as the pandemic of COVID-19 is prevalent.
  1,046 197 -
Complementary and alternative medicines in oral health care: An integrative review
Basem Mohammed Abuzenada, Fawaz Pullishery, Mohamed Samir Abdelmagid Elnawawy, Samaher Abdullah Alshehri, Rowayda Mohammed Basheer Alostath, Batool Mabrook Bakhubira, Walaa Farhan Amerdash
November 2021, 13(6):892-897
Complementary and alternative medicine (CAM) uses a holistic approach that finds natural solutions that help the immune system to fight off infection and diseases. In conventional medicine, the diseases are treated as a series of symptoms developed and not its actual cause or etiology, but CAM commonly targets the exact cause of the disorder thereby stimulating the body's healing process. This is based on an integrative literature review of methods and techniques used as complementary and alternative approaches for oral health care. A comprehensive electronic database search was conducted in PubMed, CINAHL, MEDLINE, EMBASE, Google, Google Scholar, and SCOPUS. Medicinal plants such as Medicago Sativa, Aloe Barbadensis Miller (Aloe Vera), and Trifolium Pratense (Red Clover) have excellent applications in treating gum disorders, prevent tooth decay, and have demonstrated good antifungal activity in the oral cavity. Homeopathic medicines such as Belladonna, Antimonium crudum, and Chamomilla have useful applications in relieving toothache. In Chinese medicine, various acupressure points (Acupuncture) have been used to relieve pain related to tooth, head-and-neck region, sinusitis, etc. Dental professionals can utilize these treatment modalities in their practice along with other conventional procedures as an integrative treatment approach to achieve better outcomes.
  701 140 -
Cannabis associated mental health effects: A review
Neeraj Kancherla, Keerthana Mani Jeyanthi, Ramsha Abbas, Thanmay Sai Charaan Reddy Sathi, Amrita Upadhyay, Sameer Krishna Prasad Garlapati
November 2021, 13(6):943-976
According to the latest drift in Western countries, many lawmakers are trying to formulate policy to legalize the usage of Cannabis in the case of mentally vulnerable populations such as those suffering from depression, paranoia, and excessive anxiety. This particular trend has been due to short term success in the case of mood upliftment. Cannabis derivatives produce effects on both mood and cognitive function, which can be a double-edged sword if not followed with proper dosage. Beneficial effects, however, are limited and studies documenting those and even more meagre. Detrimental effects, especially those suffering from various hallucinating and delusional states, have been reported extensively in the literature. Here in the review article, we have tried to study and summarize various effects of Cannabis as well as Cannabis -derived products in the case of people who have various mental conditions. We have also tried to consider addiction to these substances and hence develop a framework for proper utilization of Cannabis in mentally ill people. Many clinicians are also in a dilemma when prescribing a Cannabis -based product to treat psychotic and mood-based disorders. Hence, a better understanding of the process of Cannabis -based treatment for the vulnerable population is necessary.
  714 87 -
Artificial saliva for therapeutic management of xerostomia: A narrative review
Hajer Ayed Alhejoury, Lina Fouad Mogharbel, Mohammed Ahmed Al-Qadhi, Suzan Sulaiman Shamlan, Amal Fuad Alturki, Wafaa Mohammed Babatin, Renad Abdualrahman Mohammed Alaishan, Fawaz Pullishery
November 2021, 13(6):903-907
In clinical practice, xerostomia or oral dryness is a chronic disease condition encountered by most dentists and dental hygienists, which often causes a negative impact on the oral health-related quality of life of the affected individual. Xerostomia is caused due to salivary gland dysfunction. It is related to reduced salivary secretion or the absence of saliva flow, more frequently, exhibits qualitative changes in saliva proteins and immunoglobulin concentrations that arise due to salivary gland dysfunction. This condition causes discomfort and interferes with normal oral activities, and affected individuals are at high caries risk. There are several options for treatment and symptom management: salivary stimulants, topical agents, saliva substitutes, and systemic sialogogues. This review explores the current status of therapeutic management of patients affected by xerostomia and hyposalivation using artificial saliva.
  688 85 -
Maternal periodontal Disease: A possible risk factor for adverse pregnancy outcomes in the Qassim Region of Saudi Arabia
Abdulwahab Alrumayh, Fahad Alfuhaid, Arshad Jamal Sayed, Sabahat Ullah Khan Tareen, Ibtehal Alrumayh, Mohammed Ali Habibullah
November 2021, 13(6):1723-1727
Background and Aims: In periodontal disease, pathogenic inflammatory factors hold a vital part in adverse pregnancy outcomes. In recent years, there has been a large amount of literature concerning the association between periodontal disease and adverse pregnancy outcomes such as preterm birth (PTB) and low-birth-weight baby (LBWB). In the Middle-east region, reports indicate a higher rate of adverse pregnancy outcomes, and periodontitis is believed to be one of several risk factors for adverse pregnancy outcomes. This cross-sectional, epidemiological study aimed to investigate the prevalence of periodontal diseases among pregnant women in the Qassim region and its association as a possible risk factor for adverse pregnancy outcomes. Materials and Methodology: This was a cross-sectional, epidemiological study of 380 pregnant women from the 8th week postconception to parturition who were attending to Maternal and Children's Hospital in Buraidah, Qassim, KSA. The data were collected through questionnaire and oral examination. Plaque scores (Silness and Loe) and gingival disease scores (Ramfjord Periodontal Disease Index [PDI]) were used to assess oral hygiene status. The questionnaire data collected included gestational age, plaque control habits, previous incidences of premature birth, and awareness of expectant mothers about periodontal disease. Results: Data were collected for 380 participants. Our results based on the plaque index and PDI showed that all (100%) of these 380 pregnant women suffered periodontal diseases (gingivitis 78.9% and periodontitis 21.1%). The distribution of gingivitis was the highest among 3rd trimester patients and lowest among 1st trimester patients. Mild-to-moderate types of periodontitis (4 mm–5 mm) were more prevalent among the participants compared with severe (more than 6 mm) forms of periodontitis with a higher prevalence in the 3rd trimester (7–9 months) of gestational age. Conclusions: A very strong significant association of pregnancy and periodontal disease in the Saudi population (Qassim Region) and periodontal disease is risk factor for PTB and LBWB for these patients.
  722 49 -
Evaluation of antioxidant property of amla on bond strength and color stability of power bleached teeth: An In vitro study
Shweta Gupta, Parinitha Mysore Shankar, Gurupadayya Bannimath, Vidya G Doddawad, BM Annapoorna
November 2021, 13(6):1244-1250
Introduction: Objective: To assess the antioxidant property of 10% amla extract in reversing the compromised bond strength and to assess the antioxidant property of 10% amla extract and Elsenz on the color stability of power bleached teeth. Materials and Methods: Ninty extracted single-rooted maxillary anterior were collected and divided as follows: The labial surfaces of 30 samples were subjected to power bleaching after which the samples were divided into three groups– Group I (control), Group II (antioxidant amla), and Group III (Elsenz) with n = 10 in each which were then stained with a coffee solution for 10 mins. The color difference was recorded with a colorimeter at baseline, after bleaching, after 7, and after 15 days of staining. sixty specimens were randomly divided into six groups (n = 10) as following: Group I (immediate bonding); Group II (bleaching + immediate bonding); Group III (bleaching + antioxidant and immediate bonding); Group IV (bleaching + 1 week storage + antioxidant + bonding); Group V (bleaching + 2 week storage + antioxidant + bonding); Group VI (bleaching + 2 week storage + bonding). All the specimens were tested for shear bond strength in universal testing machine. Statistical analysis was performed using ANOVA and Scheffe's post hoc test. Results:
  • Significantly higher staining was observed in Group II (amla) and least with Elsenz paste
  • The highest mean shear bond strength was found in Group I followed by Group V.
Conclusion: Elsenz showed the least staining followed by artificial saliva. 10% Amla extract neither was effective in preventing staining of power bleached enamel nor in restoring the poor bond strength of power bleached enamel.
  643 72 -
Considerations and implications in shade selection for dental restorations: A review
Malik Abdulaziz Alayed, Abdulaziz Sulaiman Alnasyan, Ali Abdullah Aljutayli, Mohammed Mansour Alzaben, Waleed Mohammed Alrusayni, Ali Abdulmohsen Al Hujaylan
November 2021, 13(6):898-902
Newer trends in shade matching have been driven by the market need for superior grade esthetic restorations. Modernized shade guides, obtainability of shade-taking devices, and research in the field of human color vision have ameliorated the capability of dentists to attain outstanding color-matched restorations. A detailed knowledge of natural teeth' appearance features is needed along with these new devices to increase shade-matching results.
  568 91 -
Skills, knowledge, and implementation of techniques for behavioral guidance in adults with a fear of dentistry
Wagisha Barbi, Vaibhav Raj, Mehdi Askari, Toshi Toshi, Dipti Gopalakrishnan, Khushboo Kumari, Priyadarshini Rangari
November 2021, 13(6):1462-1465
Background: Dental fear and anxiety (DFA) is considered the main reason of dental negligence which can lead to detrimental oral health as well as overall health including psychological well-being and quality of life in an individual. Aims: The present trial was aimed to assess the skill and knowledge of dentists in managing DFA in adult subjects, to evaluate the available strategies used in treating such subjects, and to find the need for further education. Materials and Methods: The present study was an original survey and questionnaire trial, which was distributed to the 82 dentists. The collected data were subjected to statistical evaluation and the results were formulated. Results: Educating and motivating subjects was found to be effective by 62.19% (n = 51) of dentists followed by successive approximation, and muscle relaxation was considered highly ineffective by one responder (1.21%). Music and reduced waiting time in the clinic appeared to be the most effective strategy as responded by 56.09% (n = 46) of dentists. Attempting treatment in various visits than a single seems to be a highly ineffective technique by 4 dentists (4.87%). Conclusion: Within its limitation, the study showed that the application of various behavior modification techniques can be effective in alleviating DFA in adult patients.
  583 12 -
Nanoparticles in prosthetic materials: A literature review
B Devi Parameswari, S Dhevishri, R Ranjith, H Annapoorni
November 2021, 13(6):917-920
The commonly used prosthodontic materials are resins, ceramics, metals and silicones. A comprehensive review of literature was completed about the incorporation of nanomaterials in prosthetic dentistry using PubMed and Google Scholar databases. This was supplemented with a manual search of selected journals. English language articles in peer- reviewed journals were selected. Current literature reveals that incorporation of nanomaterials has significantly improved the properties of the prosthetic materials within the clinically acceptable ranges. There appears to be a need for a standardization for these in vitro studies carried out to evaluate their physical, mechanical and antimicrobial properties
  476 86 -
The potential combination of noni (Morinda citrifolia) fruit extract and pandan (Pandanus amaryllifolius Roxb.) leaves extract as an anti-dandruff shampoo
Ambarwati Ambarwati, Tanti Azizah Sujono, Retno Sintowati
November 2021, 13(6):1369-1374
Aims: The study aimed to determine the inhibition activity of a combination of Noni fruit extract and Pandan leaves extract toward bacterial isolates that cause dandruff and to determine the potential of extract combination as an anti-dandruff shampoo. Subjects and Methods: The test bacteria were isolated from dandruff. The inhibition test of the extract combination was done by paper disc and well diffusion method. The identification of bacterial isolates was done in Balai Laboratorium Kesehatan Yogyakarta. Results: The study showed that the density of bacteria isolated from dandruff was 3.4 × 107 CFU/g. There were 28 pure bacteria isolates from purification process. The combination of Noni and Pandan extracts (1:1 v/v) could inhibit the growth of 92.9% bacterial isolates. There were seven species of bacteria from a total of 28 pure isolates, namely: Bacillus licheniformis, Bacillus megaterium, Bacillus alvei, Bacillus subtilis, Micrococcus sp, Stomatococcus sp, and Pseudomonas sp. Conclusions: Based on the research, it can be concluded that a combination of Noni fruit extract and Pandan leaves extract inhibited the growth of bacteria isolated from dandruff, so the combination of the extracts has potential as an anti-dandruff shampoo.
  478 73 -
From the editorial desk
Gobichettipalayam Jegatheeswaran Anbuselvan, Thuckanickenpalayam Ragunathan Yoithapprabhunath, Thangavelu Arthiie
November 2021, 13(6):891-891
  458 92 -
Perceived impact of the COVID-19 pandemic on orthodontic practice in the Middle East
Raghuveer Nallamothu, Dareen Dhaifullah Aljohani, Maryam Ali Al-Ramadhan, Abdullah Mohammed Eshag, Ghufran Abdullah Bakulka, Raghad Zaki Hasanian, Aeshah Hassan Abduljabar, Fawaz Pullishery
November 2021, 13(6):975-979
Background: With COVID-19 announced as a global pandemic, a countrywide lockdown was executed in many countries, including the Middle East. With no foregoing warning or expectation, orthodontic treatments were temporarily canceled as dental clinics and colleges were indefinitely closed. To the best of our knowledge, no study addresses the orthodontist perspective in such testing times, where they are entirely restricted to the confines of their homes. The study aims to assess the impact of the COVID-19-related lockdown on orthodontists and orthodontic postgraduate students' treatment and psychology. Materials and Methods: The survey participants consist of 315 orthodontists and orthodontic postgraduate residents from different Middle East countries. A pretested self-administered questionnaire was sent to the consenting participants through an online data collection platform (Google forms), covering participants' sociodemographics and participants' perceived impact of the COVID-19 pandemic. Results: A majority of the participants (87.61%) stated that the pandemic would permanently change their way of practicing orthodontics and also will lead to the reduction in the number of orthodontic patients in the future (78.73%), and a significant number of orthodontists (67.61%) has an opinion that the pandemic will not affect the viability of their profession. The majority of the respondents (88.57%) commented about the negative economic impact of COVID-19 on their income, and regarding the effect of COVID-19 on psychosocial well-being, 73.01% had experienced anxiety and depression, 88.25% were excited about the future of the profession, and 68.57% enjoyed the life with their family due to lockdown, and when asked about their social life with the family and friends, majority of the participants (66.34%) had an opinion that it has improved due to the increased free time. Conclusions: Most of the respondents reported perceived economic, psychosocial, and social impacts due to the pandemic.
  492 48 -
Evaluation of knowledge, attitude, awareness, fear, and anxiety levels in pateints visisting the routine dental outpatient department during COVID 19 pandemic - A cross-sectional hospital-based observational research
Puneeta Vohra, Rajnish Kumar Verma, Jeswin Singh Mongia, Pratiksha Kumar, Hemani Sukhija, Richa Singh, Heena Tiwari
November 2021, 13(6):1650-1654
Background: Since the COVID 19 pandemic has hit worldwide wide being one of the biggest psychological menace that had an impact on all socioeconomic strata as well age group of society. Looking at the present scenario of confusion and anxiety a cross-sectional research was planned to see the level of fear and anxiety among a patient who is already having concern about his oral health and when he comes to a dental outpatient department (OPD) what are his main areas of concern and anxiety. Methodology: Cross-sectional study was planned in faculty of dental sciences, all the patients coming to dental OPD over a period of 3 months from November 2020 to March 2021 were asked to self-fill or fill with assistance a google form compromising of 10 multiple response questionnaire validated according to previous studies and surveys. Later on, the data was compiled and evaluated. Results: Out of 511 Patients enrolled in the study after taking their online consent. 28.2% of population did not know about COVID 19. 67.4% were aware about the pandemic whereas 4.4% were confused and did not know about the complete scenario. 36.9% of population were not in stress and 62.4% were in stress and had anxiety regarding their visit for dental check up and treatment. 30.4% had no fear of catching the infection from dental procedure, 62.4% had fear and 7.2% of population was ignorant regarding the same. About 70.7% had quarantined themselves before coming for dental treatment. 62.4% were willing for dental treatment post-vaccination and 26% were not willing for treatment 11.6% were not sure. After applying statistical analysis, it was found that P < 0.05 and people coming to dental OPD were in lot of stress and anxiety regarding the dental procedures during the COVID pandemic. Conclusion: Since the global pandemic has caused major worry among the populations but still there are many who are not so anxious. Knowledge and awareness regarding the disease and vaccination have led to a wave of calmness in some, but still many people have been impacted and are in major dilemma whether they should get a dental treatment or should delay it ??
  476 62 -
Autorotation of the mandible as sequelae to maxillary intrusion: A systematic review
S Ganesh Kumar Reddy, Hisham M Ibrahim, Shweta Bhardwaj, Suraj Potdar, Akshay Kumar, Ashish Uppal, Heena Tiwari
November 2021, 13(6):947-951
Background: Autorotation of the mandible is a normally anticipated phenomenon following a surgical superior repositioning of the maxilla in clinical situations where patients have an excessive gummy smile. Prediction of the surgical treatment outcome following a presurgical orthodontic treatment is a critical element in the surgical treatment planning. Materials and Methods: The relevant articles were selected by hand search and electronic media (Google Scholar, PubMed, Science Direct, Medline, Embase, and Cochrane) from 1982 to 2020. All the relevant articles were properly screened, and findings were extracted from the articles. Results: It was observed that, following maxillary intrusion, mandible would eventually autorotate to take a new occlusion. Mandibular autorotation as a result of maxillary intrusion would lead to minimal shortening of the lower lip in the vertical plane. It was observed that the amount of mandibular autorotation correlates with the extent of maxillary impaction. Studies have shown that there is a passive soft-tissue response which may be attributed to the fact that no muscular detachment had been affected in the lower lip and soft-tissue chin region during the maxillary surgery. Conclusion: It is observed that there is a definite influence on the mandibular and chin positions as a result of maxillary intrusion and autorotation of the mandible. Every 1 mm of maxillary superior impaction, the chin moved 0.6 mm vertically and 0.2 mm horizontally. There is an appreciable shortening of the lower lip length.
  434 77 -
Evaluation of Class II restoration microleakage with various restorative materials: A comparative In vitro study
Madhura Pawar, Muhammad Atif Saleem Agwan, Bushra Ghani, Megha Khatri, Pooja Bopache, Mian Salman Aziz
November 2021, 13(6):1210-1214
Background and Objectives: The quest for a suitable esthetic material for tooth restoration has resulted in significant advancements in both material properties and application technique. Composites and acid-etch procedures are two significant advancements in esthetic restorative dentistry. Further research has strengthened composites' overall wear resistance and strength, but the problem of polymerization shrinkage has persisted. To reduce polymerization shrinkage and microleakage, a variety of techniques and material modifications have been suggested. The marginal leakage of amalgam, packable composite, flowable composite with packable composite, and high-viscosity traditional glass ionomer cement (GIC) was compared in this analysis to test the mentioned hypothesis. Materials and Methods: We chose 60 freshly extracted teeth and divided them into four classes of 15 teeth each. Class II cavities were prepared in a standardized manner. Group I was treated with amalgam, Group II with packable composite (GC G-aenial Posterior), Group III with flowable composite (G-aenial Universal Flo) as a liner and then restored with packable composite (GC G-aenial Posterior), and Group IV with high-viscosity traditional GIC (EQUI FORTE FILL). After that, the restorations were put through a thermocycling process. The specimens were soaked in 0.5% methylene blue dye before being cut into mesiodistal sections to assess microleakage at the gingival margin. After that, the parts were examined under a stereomicroscope. The degree of dye penetration was used to determine the score. Results: There was no microleakage in the control group, and the gap between the control and experimental groups was statistically significant (P = 0.017). Conclusion: The glass hybrid restorative device had less gingival microleakage than the resin-based restorative material, indicating that it has a better sealing capacity. Clinical acceptability of glass hybrid restorative systems, on the other hand, must be confirmed with a larger sample size and in vivo trials.
  430 72 -
Functional role of inorganic trace elements on enamel and dentin formation: A review
Izaz Shaik, Bhargavi Dasari, Asma Shaik, Mina Doos, Hemanadh Kolli, Devyani Rana, Rahul V C Tiwari
November 2021, 13(6):952-956
Calcium and phosphate are the major components of hydroxyapatite crystals that form the inorganic portion of the teeth. Apart from these, certain elements are present in little amounts in enamel and dentin of the human teeth. Although they are required in minute quantities, their absence may alter healthy development of enamel and dentin and may result in developmental tooth defects as well as dental caries. Furthermore, excessive intake of some trace elements may inversely affect tooth development and health. The exact of effects that trace elements have on teeth and oral health is still an unexplored territory. The present paper reviews the presence of trace elements in teeth and their role in tooth health and development.
  426 65 -
Knowledge, attitude and practice about radiation safety among the undergraduates in Eastern province dental college
M Nazargi Mahabob, Mahmoud Alabdulsalam, Abdulrahman Alabduladhem, Sulaiman Alfayz, Abdullah Alzuriq, Ali Mohammed Almomin
November 2021, 13(6):1442-1447
Background: Despite the fact that X-rays have a direct or indirect effect on tissues, imaging techniques have become an important part of modern dentistry, and dentists rely on them for diagnosis, treatment, and follow-up. This necessitates that dentists have adequate expertise and attitude in order to defend themselves and their patients. Aim: The present study was conducted to assess the knowledge, attitude, and practice of clinical side dental students and General Dental Practitioners (GDPs) regarding dental radiation protection safety protocol. Study Design: It is a prospective cross-section study among dental undergraduates and GDPs. Materials and Methods: One hundred and sixteen participants took part in this study and comprised 116 clinical side dental students and GDPs. Participants' data were gathered through a questionnaire that asked about their knowledge and practice of radiation biology, danger, and protection. Collected data subjected to statistical analysis using the SPSS 21. Pearson Chi-square test was done to evaluate the statistical significance. The P value fixed at ≤ 0.05 for significant. Results: From 116 participants, around 89.7%% of the participants believed that dental X-rays are harmful and 81% are having knowledge about annual radiation dose limit for a dentist, and overall, 56% of the participants were aware about the harmful effects of radiation exposure. Conclusion: There is a need to expand the curriculum to provide better exposure to radiation protection and its practice so that these students on graduation will be well-grounded with the principle governing dental radiography.
  425 52 -
Assessment of nickel and chromium level in gingival crevicular fluid in patients undergoing orthodontic treatment with or without fluoridated tooth paste
Amrita Pritam, Arya Priyadarshini, Kashif Hussain, Abhijit Kumar, Nikhil Kumar, Aniruddha Malakar
November 2021, 13(6):1588-1590
Background: Release of metallic ions, especially nickel and chromium, present in orthodontic fixed appliance attachments such as brackets and archwires has been a basis of concern in current years. The present study was conducted to assess nickel and chromium level in gingival crevicular fluid in patients undergoing orthodontic treatment. Materials and Methods: Forty patients undergoing fixed orthodontic treatment were divided into 2 groups of 20 each. Group I was fixed orthodontic treatment group and was given nonfluoridated toothpaste and Group II was fixed orthodontic treatment group and was given fluoridated toothpaste. The assessment of salivary nickel and chromium levels was done using inductively coupled plasma mass spectrometry. Results: In group I, there were 6 male and 14 female and in group II 7 males and 13 females. The mean nickel level (ng/ml) before treatment in group I was 0.49 and in group II was 0.52, on 7th day was 0.52 and 0.54, on 30th day was 13.4 and 100.2, and on 6th month was 0.54 and 0.52 in Group I and II, respectively. The mean chromium level (ng/ml) before treatment in Group I was 0.48 and in Group II was 0.52, on 7th day was 0.52 and 0.53, on 30th day was 40.6 and 62.4 and on 6th month was 4.9 and 0.52 in Group I and II, respectively. The difference was significant (P < 0.05). Conclusion: The release of metal ions such as nickel and chromium was more with fluoridated toothpaste as compared to nonfluoridated toothpaste in patients undergoing fixed orthodontics.
  434 41 -
Awareness and knowledge of different types of face masks amid the COVID-19 pandemic among health-care professionals across Kingdom of Saudi Arabia an original research
Khadijah Ali Almomen, Hanan Ahmed Alghamdi, Hend Abdrahman Ahmad, Leena Faisal AlJaafar, Marwa Salman Alawad, Mayar Saad Alharbi, Nouf Abaalkhail
November 2021, 13(6):1664-1667
Introduction: With the attack of the COVID-19 pandemic on the world, many countries have opted for the lockdown for preventing the spread of the virus. There have been many proposals for the prevention at individual level. These include repeated washing of hands, the sanitization, and the usage of the mouth masks. There have been many studies that suggested various types of the mouth masks for the prevention of the infection. Hence, in the present study, we intend to evaluate the knowledge and awareness of the health-care personnel of the different types of the face masks. Materials and Methods: We conducted the present review by the cross sectional survey method. The study is questionnaire based that was done for a period of 6 months. The survey was done by online only. The participation was voluntary and done in the state wide hospitals in the kingdom of the Saudi Arabia. The survey compromised twenty questions that assessed the knowledge and awareness of the health-care personnel of the different types of the face masks. Results: The total number of the participants was 1000. All were aware of the proper usage of the masks. There was noted enough awareness of the types of the masks among the participants. However, the awareness can further be enhanced. Conclusion: At the present condition of the infection rate, there may be a third wave of the pandemic around the world. As it has been shown in many studies that these barriers have prevented the infection rate, the wisdom points toward the prevention of the disease. The awareness has increased among the health care and also the personnel are conscious of the types of the masks. The same can be evaluated for the general public and the method of the mask wear can be appraised.
  412 47 -
Bone regenerative biomaterials in periapical surgery: A systemic review and meta-analysis
Ananad Sumangali, Amruta C Naik, Nimisha Mohan, Nivedita Gautam, Surbhi Abrol, Mohammed Mustafa, Heena Tiwari
November 2021, 13(6):933-937
Introduction: Successful treatment in the endodontics and periodontics depends on the periapical status. Hence, in the present meta-analysis, we evaluate the various bone regenerative materials in the periapical surgeries. Materials and Methods: Online data were collected from the search engines of EBSCO, PubMed, Google Scholar, and Scopus. The searched terms were bone regenerative, bone grafts, bio materials, periapical surgery, and endodontic surgery. Based on the PRISMA guidelines, the meta-analysis was performed. The studies for the past 10 years were considered that included at least 10 patients. The translatable articles were included that had the human studies that were clinical studies and/or trials and also had the bone regenerative materials used in the procedure. Results: A total of 475 articles were selected, of which 30 were selected based on the criteria. Of these, after the removal of the 21 duplicate articles, 9 articles were finalized. The meta-analysis showed that when the bone graft materials are used along with the barriers for the regeneration, there were observed higher success rates. Conclusions: The bone regenerative materials can be used for the successful outcome for the periapical surgeries. The guided tissue regeneration along with the bone regenerative materials may aid in the good prognosis of the endodontic and periodontal cases.
  378 77 -
Evaluation of In vivo antimalarial property of Nyctanthes arbor-tristis (night jasmine) leaves
Lopamudra Das, Ashok Kumar Panigrahi, Sashi Bhusan Biswal, Debasis Bisoi
November 2021, 13(6):1088-1092
Background: Nyctanthes arbor-tristis (NAT) is an ornamental garden plant traditionally used for treating many diseases such as helminthiasis, arthritis, and malaria. Aims: The aim of this study was to validate the ethnobotanical uses of the antimalarial activity of leaves of NAT by in vivo tests. Materials and Methods: Leaves of NAT were identified and authenticated and phytoconstituents of NAT were identified. The antimalarial activity of NAT was studied in in vivo for its schizonticidal activity, repository activity, and curative tests in Swiss albino mice by using Plasmodium berghei (ANKA). Statistical Analysis Used: One-way ANOVA was done for comparison of different groups followed by post hoc analysis (Tukey-Kramer multiple comparison tests). Level of significance was at P < 0.05. Results: The mean schizonticidal activity of NAT increased from 14.21 to 46.15 (P < 0.01) with doses ranging from 100 to 200 mg/kg compared to 67.29 with that of chloroquine (CQ). The repository activity with NAT doses 100–200 mg/kg increased from 12.91 to 42.85 (P < 0.01) compared to 78.79 in pyrimethamine 1.2 mg/kg/day. In Rane's test, there was chemosuppression in range of 55.50–65.02 (P < 0.01) with NAT in doses of 100–200 mg/kg compared to 74.15 with that of CQ 5 mg/kg. Conclusions: The antiplasmodial activity of NAT might be like that of artemisinin by producing oxidative stress mostly due to the iridoid glycosides. The active phytoconstituent(s) responsible may be tested individually or in combination both by in vitro and in vivo studies to identify the active chemical ingredient.
  380 74 -
Hydrogels and their role in bone tissue engineering: An overview
Jaisanghar Nallusamy, Raunak Kumar Das
November 2021, 13(6):908-912
An increasing incidence of the bone damage either due to trauma or a wide range of diseases related to bone necessitates the advent of new technologies or modification of the existing pattern of treatment to deliver utmost care to an individual thereby helping them to lead a normal and healthy life. Revolutionary changes in the field of tissue engineering (TE) pave a way from repair to regeneration of human tissues and restoring the health of an individual. Among the numerous biomaterials available, hydrogel emerges as a promising source of scaffold material in the field of bone TE (BTE). This article presents an overview on hydrogels and their role in BTE.
  372 74 -
The prevalence of root resorption after orthodontic treatment in patients attending a university hospital dental clinic
Basmah Mustafa Ageel, Elaf Abdulrahman Siraj, Khalid Hashim Zawawi, Ahmed Rami Afify
November 2021, 13(6):965-968
Introduction: After orthodontic treatment, some teeth undergo external root resorption due to different factors, such as the root shape, oral habits, biological and genetic factor, gender, and age. Furthermore, extraction cases, long treatment duration, and the amount of force applied during the treatment might be related to root resorption. Materials and Methods: Panoramic radiographs for 226 patients treated in the orthodontic department were screened. The lower first permanent molars, lower second premolars, and lower first premolars were measured in centimeters on a ruler using ImageJ System. Teeth were measured from the cusp tip to the cementoenamel junction (CEJ) and from the CEJ to the root apex, and then, the tooth was measured as a whole before and after the treatment. Results: Multiple analysis of variance showed that there were no interactions between the root lengths of all teeth tested and either gender, treatment type, or treatment duration (P > 0.05). Conclusion: Based on the results of this study, no statistically significance relationship between external apical root resorption and gender, type of treatment, and treatment duration was found.
  374 63 -
Assessment of awareness regarding health hazards of plastic chemicals and their warning label among a sample population of Varanasi City: A cross-sectional study
Parul Sharma, Priyanka Bhagat, MB Mandal, TB Singh
November 2021, 13(6):1428-1433
Background: Plastic containers are widely used to store and serve edibles. In the production of some types of plastic, chemicals such as bisphenol A (BPA) and bisphenol S (BPS) are used. These chemicals leach from the plastic containers into the edibles, get access into the biological systems, and cause a toxic impact on health. Aim: This cross-sectional survey was planned to assess the usage of food contact plastic and awareness regarding the health hazards of plastic chemicals and warning labels on plastic items among a sample population of Varanasi city. Materials and Methods: Data were collected by interviewing the 556 adult participants, using a prevalidated structured questionnaire. Chi-square test was used to test the association and P < 0.05 was considered as significant. Results: Most of the participants were found to be following routine practices during cooking and storage of edibles which may expose them to BPA and BPS through the gut. Although many participants were aware that plastic may contain some type of chemicals which may enter the human body and harm human health in some way, they lacked precise knowledge regarding warning label like “BPA free plastic” “plastic containing BPA” and “food grade plastic.” Furthermore, none of the participants could recognize the “resin identification codes” correctly. Conclusion: Most of the participants had only elementary awareness of health risk of plastic usage. A significant number of participants lacked crucial information that can help them to make healthy choices as a consumer and use safe alternatives of plastic.
  384 50 -
Knowledge, attitude, and awareness of orthognathic surgery among orthodontic patient-prospective study
Bhuvaneswari Mani, Muralimani Mani, Selvakumar Ramar, S Srinidhi, SR Bharathi, Tamilselvi Sengodan
November 2021, 13(6):1029-1032
Aim: The aim of the current survey was conducted to assess the knowledge, attitude, and awareness regarding orthognathic surgery among orthodontic patients. Materials and Methods: This is cross-sectional web-based questionnaire survey conducted among orthodontic patients in Tamil Nadu. The self-administered questions related to awareness of orthognathic surgery were collected from 500 subjects. The statistical analysis was done using the Statistical Package for the Social Sciences (V 22.0). The frequency distribution was computed. Results: This survey revealed that 466 (93.2%) respondents had awareness about the role of orthognathic surgery. 332 (66.4%) had given the correct responses related to differentiating skeletal and dental malocclusion, 454 (90.6%) had the awareness of risk factors associated with orthognathic surgery and 40 (7.0%) were experienced regarding the procedure. Conclusion: The result of the current study showed that it clearly implies that the population was aware of orthognathic surgery as a treatment modality for correcting skeletal deformities.
  372 57 -
Neuroscience of peripheral nerve regeneration
Sunil Paramel Mohan, Murugan Ramalingam
November 2021, 13(6):913-916
Peripheral nerve injury involves complex molecular, cellular, and genetic events that help in ultimate regeneration of nerve. Some key factors are upregulated and some downregulated in the process of regeneration of nerve to attain almost perfect architecture. This review renders short overview about how the injured neurons and supporting cells like Schwann cells help in creating ample microenvironment for regeneration of peripheral nerve and their maturation.
  370 59 -
The pandemic impact of COVID 19 on orthodontic practice: A cross sectional study
Muralidharan Dhanasekaran, I Bevin Shaga, Harish Ponniah, Padmasree Sankaranarayanan, Nagappan Nagappan, TM Parameswaran
November 2021, 13(6):1024-1028
Aim: The objective of this study was to determine the problem encountered by an orthodontist due to suspended treatment during and after lockdown COVID 19 and to assess the pandemic impact on orthodontic practices. Materials and Methods: This was a cross-sectional web-based questionnaire survey conducted among orthodontist in India. The pilot study was conducted to estimate the sample size and final sample size is 263 participants. The predesigned and validated, self-administered, structured 10 questions related to the impact of an orthodontist and their orthodontic practices during and after COVID 19 are used. The statistical analysis was done using Statistical Package for Social Sciences SPSS (V 22.0) the frequency distribution was computed. Results: The result showed that 81% orthodontist were reported that routine orthodontic treatment was disturbed due to this COVID 19 lockdown, about 79.1% reported hospital/clinic was closed due to lockdown with a duration of more than 1 month. Still, 64.6% orthodontist handling their orthodontic emergencies through telecommunication and 47.9% of orthodontist received a complaint about fixed appliance among all other appliances. Due to the current situation, 41.4% orthodontist suggested 3–6 months' period required to normalize the current situation and 66.9% agreed that there will be decline in orthodontic treatment need after COVID 19. Conclusion: Owing to the high virulence activity, elective procedures have been postponed and can manage a patient through virtual teleconsultation. Reassurance of the patient is needed regarding prolonged treatment duration due to this COVID 19 pandemic.
  364 64 -
Evaluation of gingival crevicular fluid and serum tartrate-resistant acid phosphatase levels in subjects with clinically healthy periodontium and chronic periodontitis – A clinico-biochemical study
Harshitha Baddam, Gopinath Vivekanandan, Kameswari Kondreddy, Swapna Peddi, Pranjal Praveen Chitnis, Yash Pal Singh, Rahul V C Tiwar
November 2021, 13(6):1275-1279
Background: Periodontitis is a chronic inflammatory disease with conglomerate etiology making it difficult to diagnose at the early stages. Potential biomarkers in gingival crevicular fluid (GCF) would determine the presence of the current disease activity, predict sites vulnerable for future breakdown, and assess the response to periodontal interventions. Merely elevated levels of inflammatory soft-tissue markers do not indicate bone destruction. Since there is no single ideal biomarker established, bone-related biomarkers such as telopeptide of type I collagen, osteocalcin, calprotectin, osteopontin, and tartrate-resistant acid phosphatase (TRAP) seem to hold great promise as predictive markers to determine bone destruction and active phases in the disease progression. The present study is intended to explore the biologic plausibility of the levels of TRAP in health and chronic periodontitis. Materials and Methods: The present cross-sectional clinico-biochemical study comprised 30 systemically healthy subjects with 15 periodontally healthy and 15 chronic periodontitis subjects who were age and gender matched. GCF and blood samples were collected from all the patients. TRAP estimation was done in both the samples using an enzyme-linked immunosorbent assay kit. The data were analyzed using independent t-test and Pearson correlation test. Results: Serum and GCF TRAP levels in chronic periodontitis subjects were significantly higher when compared to the periodontally healthy group. There were no significant correlations found among serum and GCF TRAP levels with increasing age and gender in both the groups. An increase in disease severity, i.e., increase in probing pocket depth and clinical attachment level, did not show correlation with the GCF and serum TRAP levels in the chronic periodontitis group. Conclusion: Based on the findings of the present study, increased GCF TRAP levels in chronic periodontitis seem to be a potential marker for identifying ongoing periodontal destruction.
  380 48 -
Survey of stress in COVID patient post treatment: A qualitative research
Neeraj Kancherla, Sameer Krishna Prasad Garlapati, Yeswanth Kumar Raparla, Maria Jamil, Javairia Jamil, Sai Mahitha Mannava
November 2021, 13(6):1646-1649
Aim: The purpose of our study was to examine the mental health status of patients with coronavirus disease-19 (COVID-19) who were hospitalized. Methodology: In this cross-sectional study, 106 inpatients with COVID-19 who had stable clinical conditions were evaluated psychologically by questionnaire: Depression, anxiety, and stress scales-21 (DASS-21). Results: About one-third of patients had comorbidities. In totality, 97.2% of patients with COVID-19 had some grade of depression. Extent of depression, assessed with the help of the DASS questionnaire, was 85.8%. All patients (100%) had serious (0.9%) and grave level of (99.1%) anxiety. Regarding to stress levels, 97.1% of patients had some degree of stress. In the worsening of stress category, 84.9% of patients had high-stress levels. Conclusion: The presence of such increased prevalence and seriousness of psychiatric disorders among hospitalized patients with COVID-19 underlines the necessity for serious consideration to the mental health standing of these patients.
  386 42 -
A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of gutta percha from the root canal
Shweta V Sagare, Padma Chandra, Tawanpreet Kaur, Onkar Ganorkar, Abhijeet Khade, Sachin Dev Mehta
November 2021, 13(6):1682-1685
Background: Teeth with apical periodontitis that either persisted or developed after initial root canal treatment is most often indicated for retreatment procedure. The present study was conducted to compare the WaveOne and NeoEndo retreatment file system for the removal of gutta-percha from the root canal. Materials and Methods: Fifty extracted mandibular first premolars with single straight roots were divided into two groups, Group I-WaveOne and Group II-NeoEndo. All samples were scanned with cone-beam computed tomography after the root filling and retreatment procedures. The decrease in the volume of filling material after each retreatment protocol was measured. Results: The mean volume of gutta-percha in Group I before retreatment was 5.6 and in Group II was 5.3, after retreatment in Group I was 2.7, and in Group II was 4.2. The mean percentage reduction in Group I was 45.2% and in Group II was 23.8%. The difference was significant (P < 0.05). Conclusion: Both systems failed to completely remove gutta-percha. WaveOne was significantly more effective than the NeoEndo retreatment system.
  371 52 -
Evaluation of macular thickness, retinal nerve fiber layer and ganglion cell layer thickness in patients among type 2 diabetes mellitus using optical coherence tomography
Kalaimamani Ezhilvendhan, Arjun Shenoy, R Rajeshkannan, SaravanaBhava Balachandrachari, Anitha Sathiyamoorthy
November 2021, 13(6):1055-1061
Background: Vascular abnormalities and microvasculopathy are one of the widely accepted factors of diabetic retinopathy (DR). Retinal Neuronal dysfunction and neurodegeneration are also important components in the pathogenesis of DR. However recent investigations show neurodegenerative alterations before the appearance of microvascular changes in patients having DR. Aims and Objectives: (1) To measure the macular thickness, retinal nerve fiber layer thickness, and ganglion cell complex thickness among patients with type 2 diabetes mellitus using optical coherence tomography. (2) To compare the macular thickness, retinal nerve fiber layer thickness and ganglion cell complex thickness in type 2 diabetic patients with and without DR with normal controls using optical coherence tomography. Materials and Methods: Thirty Patients with type 2 diabetes mellitus without DR, 30 having mild and moderate DR and 30 healthy normals are taken considering the inclusion and exclusion criteria. Macular thickness, retinal nerve fiber layer (RNFL) thickness, ganglion cell layer-inner plexiform layer (GCL-IPL) thickness was measured in each individual and it was compared using one way ANOVA test, post hoc test and Pearson correlation was performed to evaluate the linear correlation between variables and calculated P < 0.05 was regarded as its significance. Results: The average RNFL thickness was 90.27 ± 5.57 and 107.7 ± 5.32 um in diabetic patients and controls respectively (P < 0.001). Furthermore, for two different groups of diabetic patients, the average RNFL thickness was 89.92 ± 6.62 um in the no DR group and 78.6 ± 3.93 in the DR group (P = 0.339). The average GCL-IPL thickness was 82.65 ± 2.25 um and 92.10 ± 2.41 um in diabetic patients and controls, respectively (P < 0.001). Furthermore, for two different groups of diabetic patients, the average GCL-IPL thickness was 82.22 ± 2.11 um in the no DR group and 71.55 ± 2.34 in the DR group (P = 0.535). The average macular thickness was 238.03 ± 4.42 and 277.9 ± 5.85 um in diabetic patients and controls, respectively (P < 0.001). Furthermore, for two different groups of diabetic patients, the average macular thickness was 236.56 ± 4.10 um in the no DR group and 242.8 ± 4.95 um in the DR group (P = 0.585). Conclusion: There was a statistically significant reduction of mean RNFL, GCL-IPL and macular thickness in type 2 diabetic patients with no DR compared with a homogenous control group indicating neuroretinal changes occur before vascular changes of DR.
  368 51 -
The sealer penetration into the dentinal tubules: An appraisal of different irrigation systems: Original research
Thouseef Ch, Izaz Shaik, Mohammed Muzammil Khan, Prashik Parvekar, Mubashir Baig Mirza, Mohammed Mustafa, Heena Tiwari
November 2021, 13(6):1280-1285
Introduction: A good endodontic sealer aids in a successful root canal treatment. Sealer in turn depends on the thorough irrigation technique and debris removal. Hence, in the present study, we intend to compare the sealer's dispersion into dentinal tubules of the different irrigation systems by confocal laser scanning microscopy (CLSM). Methodology: Seventy-six single-rooted, freshly removed human mandibular premolars were taken. They were separated into equal groups as conventional endodontic needle irrigation system, Endovacirrigation, Endoactivator irrigation, and manual dynamic agitation groups. Protaper rotary system was used and obturation was done with gutta-percha. The sealer used was AH Plus labeled with fluorescent dye (0.1% Rhodamine B isothcyanate). Transverse sections from the root apex at the levels of 1 mm, 3 mm, and 5 mm were scanned using CLSM. The sealer's penetration for the depth and the percentage were measured. Results: We observed that endovac irrigation system showed maximum percentage and depth of sealer's penetration compared to endoactivator, manual dynamic agitation, and conventional methods at 1, 3, and 5 mm levels from the apex. Conclusion: The irrigation systems significantly influence the penetration of the Sealer into root dentinal tubules. When penetration of sealer at different levels, compared to endoactivator, manual dynamic agitation, and conventional method, significant greater levels were attained with the EndoVac system.
  362 52 -
Comparative evaluation of antimicrobial efficacy of calcium hydroxide, triple antibiotic paste, and 2% chlorhexidine combined with 0.5% cetrimide against Enterococcus faecalis biofilm-infected dentin model: An In vitro study
Shreya, Gaurav Jain, Srinkhala, Priyansha Singh, Kishan Agarwal
November 2021, 13(6):1538-1543
Background: Enterococcus faecalis is the most common and important microorganism found in infected root canals associated with persistent periapical periodontitis and failing endodontically treated tooth. Intracanal medicaments used after chemomechanical preparation of an infected root canal play a vital in eradication of this microorganism and pave the way for long-term success of endodontic therapy. Hence, the present in vitro study was conducted to assess the antimicrobial efficacy of calcium hydroxide (Ca(OH)2), triple antibiotic paste (metronidazole 400 mg + minocycline 100 mg + ciprofloxacin 500 mg), and 2% chlorhexidine (CHX) combined with 0.5% cetrimide on eradication of E. faecalis biofilm. Materials and Methods: Eighty dentin specimens were taken and infected extraorally with E. faecalis to induce microbial colonization. The specimens were then divided into four groups of twenty each based on medicaments used and further subdivided into two subgroups based on assessment of live cells done either immediately after the elimination of the medicament or after 24-h incubation in brain–heart infusion (BHI) medium: Group I specimens were treated with Ca(OH)2, Group II with triple antibiotic paste, Group III with 2% CHX combined with 0.5% cetrimide, and Group IV with saline (control) for 7 days at 37°C. Assessment of live cells was done using confocal microscope. Results: 2% CHX combined with 0.5% cetrimide (Group III) and triple antibiotic paste (Group II) showed a statistically significant result with high antimicrobial efficacy and lower percentage of live cells as compared to Ca(OH)2 (Group I). The mean percentage of live cells in Group I immediately after elimination of medicaments was 64.7%, in Group II was 1.52%, in Group III was 1.49%, and in Group IV was 83.4%. After 24 h of incubation in BHI medium, 2% CHX combined with 0.5% cetrimide (Group III) showed a statistically significant (p < 0.05) result of 1.27% mean live cells as compared to 84.2% in Ca(OH)2 (Group I), 1.82% in triple antibiotic paste (Group II), and 94.2% in saline (Group IV control). Conclusion: 2% CHX combined with 0.5% cetrimide exhibited maximum antimicrobial efficacy with least number of mean live cells followed by triple antibiotic paste as compared to Ca(OH)2. Based on these findings, 2% CHX combined with 0.5% cetrimide was most effective in eradicating E. faecalis from the extraorally infected dentine biofilm.
  342 63 -
Dundee ready education environment measure of dentistry: Analysis of dental students' perception about educational environment in college of dentistry, Mustaqbal University
Gurleen Arora, Shazia Nawabi, Mudit Uppal, Muhammad Qasim Javed, Shaikh Shoeb Yakub, Muhammad Umar Shah
November 2021, 13(6):1544-1550
Introduction: Evaluation of the educational environment is an important element which can be used to improve our curriculum. The aims and objectives of this cross-sectional study were to identify the student's perception about educational environment in College of Dentistry, Mustaqbal University. As the educational environment has a significant impact on the learning and academic performance of the students, the present study will help us identify areas of improvement and refining the dental curriculum. Materials and Methods: A total of 120 students of year 4, 5, 6, and interns, both male and female, responded to the Dundee Ready Education Environment Measure (DREEM) in the 1st month of the second semester, 2021. This scale measures the student's perceptions of the educational environment overall and for five domains: learning, teaching, academic self-perception, atmosphere, and social self-perception. Results: A total of 92 students responded and were generally positive about their learning environment, with a total DREEM score of 130.87 ± 32.73/200. The lowest score for Domain 5 (social self-perception) and the highest score for Domain 1 (student's perception of learning.) were noted. Conclusion: Students' perception of educational environment of College of Dentistry, Mustaqbal University, was more positive than negative. This study provided a valuable insight of how students perceive their course and identified several weak areas that need to be worked upon, hence helping in improvement of the curriculum.
  360 45 -
Denture hygiene awareness, attitude and practice among complete denture wearers during COVID-19 lockdown pandemic: A questionnaire based survey
Hemlata Dwivedi, Nirupam Paul, Kankana Lahiri Banerjee, Shivani Singh, Reeta Jain, Surender Kumar
November 2021, 13(6):1119-1123
Objective: To determine the denture hygiene habits in complete denture wearers during Covid-19 lockdown in Assam state. Materials and Methods: In this study, a self-administered structured questionnaire was developed to know the attitude of the patients regarding denture hygiene. The study sample consisted of 150 subjects, which included 63 (42%) males and 87 (58%) females. Results: 50.7% of individuals said that they have knowledge about denture cleansing methods, while only 40% individuals clean their dentures once daily. After education through an online survey, most individuals started practicing three times or at least two times. After educating two members in the same family, all subjects were cleaning either twice or thrice. All subjects were either using brushing or combination methods. Conclusion: Poor condition of complete dentures seen in the population is mainly due to lack of knowledge and irregular cleansing habits. Dentists must give proper instructions and do regular follow-up regarding maintenance of denture hygiene.
  342 61 -
Awareness, views, and expectations about COVID-19 vaccinations: A cross-sectional study of dental clinic patients in India
P J Swathy Anand, Kiran S Shankar, Teena Haneef, Lekshmy S R Nair, KM Seniya, RA Soorya
November 2021, 13(6):980-984
Introduction: Several vaccines against coronavirus disease 2019 (COVID-19) have been licensed and are being administered worldwide in various countries. However, the awareness, behaviors, and expectations of COVID-19 vaccines among dental clinic patients are poorly understood. Methods: An e-survey was carried out among 1800 patients who visited dental clinics in India. The survey was carried out using a questionnaire of four parts and informed consent (i.e. sociodemographics, knowledge, attitudes, and perceptions). The investigators used Internet methods for data collection during the pandemic. Results: The mean awareness score was significantly higher among participants who reported having a university/higher level of schooling, being in the upper socioeconomic status community, living in cities, and having previously received all required vaccines. The mean attitude score was slightly higher for participants who reported being female and had a history of getting all required vaccinations. Just over half (52%) of participants felt everyone should be vaccinated. This interpretation was slightly higher among females than males (56.9% vs. 47.9%, P = 0.004). Conclusions: The results indicate that patients attending dental clinics in India have insufficient awareness but more optimistic attitudes about the COVID-19 vaccine. Immediate health promotion campaigns must be implemented before vaccine schedules in order to increase awareness.
  346 57 -
COVID 19 scoping: A systemic review and meta-analysis
Harisha Dewan, Mohammed Nishan, Shan Sainudeen, Sanskriti, Kunal Jha, Ashish Mahobia, Rahul V C Tiwari
November 2021, 13(6):938-942
Introduction: The world has faced the pandemic of COVID-19 in the march of 2020 and still it continues to effect in 2021. Hence, in the present study we aim to evaluate the gulps in the research so that certain recommendations can be made for the future research. We conducted a scoping review of the COVID meta-analysis. Materials and Methods: Online data was collected from the search engines of EBSCO, PubMed, Google Scholar, and Scopus. The searched terms were COVID-19, CORONA, SARS-CoV-2, clinical features, Wuhan, etc. The study articles were collected that from January 2020 to February 2021. Based on the PRISMA guidelines, the meta-analysis was performed. Results: In the present study, we finalized 316 articles. On February 2020, the first article was published. We observed a spike in the meta-analysis later on. Most of the meta-analysis were issued in the virology and infection magazines. As expected, the majority studies were from Wuhan. The other countries that published the meta-analysis were the USA, the UK, and Italy. The studies included in each meta-analysis were nearly 25 and the subjects were approximately 16 thousand. However, we noticed a poor quality in majority of these meta-analysis and <10% of all the meta-analysis showed higher confidence. Conclusion: A poor quality of the meta-analysis has predominated the data and very few are of high quality. All the journal editors and the reviewing team should verify and thoroughly organize the protocol so that only high quality meta-analysis are encouraged.
  336 64 -
Assessment of serum selenium and ceruloplasmin in potentially malignant disorders and oral cancer
Mathew O Mampilly, Nidhi Ravindran, Mohamed Shajith Parambil, Kumar Nilesh, Parvathi Jayagopalan, Debjit Dhamali
November 2021, 13(6):989-992
Introduction: Despite extensive research and development, potentially malignant disorders (PMDs) of the oral cavity and oral cancer remain a serious concern. Diet and immunity have been identified as important modifiable factors in such diseases. Materials and Methods: A total of 20 patients and 10 healthy individuals, aged 30–60 years, were chosen from the outpatient Department of Oral and Maxillofacial Surgery, Yenepoya Dental College and hospital, Karnataka. The participants were grouped into three: Group 1: (10 healthy individuals), Group 2: (10 oral leukoplakia patients) and Group 3: (10 squamous cell carcinoma patients). Blood was chosen as the investigative medium. Ceruloplasmin was estimated by the diamine oxidase method. The technique of atomic absorption developed by Sir Alan Walsh in 1950 has become the preferred method of elemental analysis of selenium (atomic absorption spectrometer). Statistical analysis of the data obtained was done using one-way ANOVA test and the Turkey multiple comparisons test. Results: The intergroup comparison of ceruloplasmin shows that the mean value of Group I (Control) was 31.746 mg/dl, the mean value of Group II (leukoplakia) was 81.411 mg/dl, and the mean value of Group III (squamous cell carcinoma) was 90.7120 mg/dl. The intergroup comparison of selenium levels shows that the mean value of Group I (Control) was 119.937 (ng/ml), the mean value of Group II (leukoplakia) was 109.17 (ng/ml), and the mean value of Group III (squamous cell carcinoma) was 99.6230 (ng/ml). Conclusion: Antioxidants are an important defense system against free radical damage to cells. Ceruloplasmin and selenium levels in serum could be used as disease markers in leukoplakia and squamous cell carcinoma.
  336 63 -
Association of dyslipidemia with diabetic retinopathy in type 2 diabetes mellitus patients: A hospital-based study
Kalaimamani Ezhilvendhan, Anitha Sathiyamoorthy, B Jey Prakash, B Saravana Bhava, Arjun Shenoy
November 2021, 13(6):1062-1067
Background: Dyslipidemia is an important risk factor that can lead to the progression of retinopathy (DR). Diabetic dyslipidemia with low high-density lipoprotein (HDL) and increased triglycerides (TGs) are seen frequently among Type 2 diabetic mellitus. Aims and Objectives: (1) To assess the level of serum lipids (total cholesterol, TGs, HDL, and low-density lipoprotein [LDL]) among type 2 diabetes patients. (2) To determine the association between serum lipid levels and DR. Materials and Methods: This was a hospital-based cross-sectional study conducted in a tertiary care hospital in Salem from September 2018 to March 2020 with a sample size of 200. Details of their diabetic history were obtained. Patients were evaluated for their HbA1C levels, hypertension, and lipid profile status. Early treatment DR Study system was used to classify DR. Low density lipoprotein cholesterol was calculated by Freidewald's equation. Results: This study showed a significant association among DR and LDL cholesterol. DR with raised LDL, TGs levels, and lowered HDL on adjusted analysis. There was strong association between DR and serum cholesterol in unadjusted analysis; however, there was no association when adjusted for factors such as age, gender, duration of diabetes, and glycemic control. Majority of participants were males (57.5%) with a male: female = 1.35:1. The mean age of the patients in our study was 57.8 (5.8) years and 54.4 (6.6) years in patients with DR and patients without retinopathy, and it was found to be statistically significant. There was a significant difference in the duration of diabetes with the presence of DR and the patients with DR were having longer duration of diabetes (7.9 vs. 6.2 years; P < 0.001). Moderate nonproliferative diabetic retinopathy (NPDR) was found to be present in 41.0% of eyes followed by mild NPDR (20.5% eyes). Proliferative diabetic retinopathy was present only in 9.5%, and the severity of retinopathy was associated only with the HDL level, and there was no association found with total cholesterol, TG, and LDL cholesterol. Conclusion: A statistically significant correlation was found between dyslipidemia and the severity of DR among Type 2 diabetic patients.
  344 55 -
Knowledge, attitude, and practice towards digital imaging and cone beam computed tomography among dental practitioners in North Karnataka, India
Sudarshan Kumar Chinna, Nannuri Pranavi Reddy, Yekula Thapaswini, Akhila Muppidi, Sai Vinith Pattepu, Priyadarshini Sharma
November 2021, 13(6):1047-1049
Introduction: Cone beam computed tomography (CBCT) has one of the most important roles for diagnosis in dentistry. Aim and Objectives: The aim of this study is to assess the level of knowledge and awareness toward the scope of digital imaging and CBCT, among dental practitioners in North Karnataka regions such as Bidar and Raichur city. Materials and Methods: A questionnaire study was carried out among 200 dental practitioners of North Karnataka (Bidar and Raichur). A specially designed structured questionnaire (13 in number) was administered to assess the knowledge of digital imaging and CBCT. Data were analyzed using Pearson's correlation coefficient test, and any P ≤ 0.05 was considered to be statistically significant. Results: A total of 200 dentists were selected for the study, among which 93.5% were reported that digital imaging is the most useful method compared to conventional method. About 91.0% of the dentists were aware of CBCT. Of 91.5% of the dentists preferred CBCT for three-dimensional imaging in the head and neck region. Among all, majority of dentists reported that all types of radiography will be used in digital imaging (45.0%). Conclusion: The current study showed that knowledge of dentist regarding digital imaging and CBCT was not satisfactory; therefore, participants require an understanding of the concepts behind CBCT and related technologies, making appropriate training essential for every member of the dental team.
  346 52 -
Comparative evaluation of the effectiveness of rotary instrumentation over manual instrumentation with ultrasonic irrigation on incidence, duration, and intensity of postendodontic pain: An In vivo study
Ashutosh Shandilya, Subasish Behera, Gourav Kumar Sahu, Rashmi Rekha Mallick, Zakir Husain, Riddhima Chauhan
November 2021, 13(6):1149-1154
Aim: The aim of this study was to compare the effectiveness of rotary instrumentation over manual instrumentation with ultrasonic irrigation on incidence, duration, and intensity of postendodontic pain (PEP). Subjects and Methods: Eighty patients, with asymptomatic irreversible pulpitis in maxillary anterior teeth, were selected and treated with single-visit endodontic treatment. Patients were randomly divided into 2 groups (40 each), Group A (K files using step-back technique) and Group B (ProTaper Next using crown-down technique) along with passive ultrasonic irrigation. Patients were recalled, examined, and asked to fill up questionnaire after 24 h, 48 h, and 7 days. On the basis of response given in the feedback forms, incidence, duration, and intensity of PEP were evaluated. Results: Statistical analysis of the data was carried out using Chi-square test, and level of significance (P < 0.05) was evaluated. More incidence of pain was noticed in Group A when compared with Group B. Significant difference found between two groups (χ2 = 22.759; P = 0.001). There was also statistically significant difference between two groups at different time intervals. Conclusion: Both instrumentation techniques under investigation cause PEP. The incidence of pain was more in manual technique than rotary technique. The duration of pain was higher in manual group than rotary group at different time intervals.
  348 49 -
Effectiveness of platelet-rich fibrin in the treatment of intrabony defects with or without bone graft: A clinical comparative study
Mohammed Ahsan Razi, Shandar Siddiqui, Ankit Mahajan, Seema Qamar, Puja Kumari, Soni Kumari
November 2021, 13(6):1350-1353
Background: Periodontal diseases are a group of inflammatory diseases causing alveolar bone loss and eventually leading to loss of teeth. The present study was evaluated the effectiveness of platelet-rich fibrin (PRF) in the treatment of intrabony defects with or without bone graft. Materials and Methods: Thirty subjects with the presence of intrabony defects were enrolled. All subjects were included irrespective of age and gender. A questionnaire was prepared for extracting demographic and personal details of all the patients. William probe and moth mirror-tweezers set was used for carrying out clinical examination of all subjects. Random and unbiased division of all the subjects was done with ten patients in each group as follows: Group I: Subjects in which treatment was carried out using PRF with demineralized bone matrix, Group II: Subjects in which treatment was carried out using PRF alone, and Group III: Subjects in which treatment was carried in the form of open flap debridement (OFD). Pretreatment and posttreatment clinical variables were assessed which included plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively were calculated. Results: Mean PI among Group 1, Group 2, and Group 3 at baseline was 0.78, 0.8, and 0.84, respectively. Mean PI among Group 1, Group 2, and Group 3 at 9 months follow-up was 0.56, 0.55, and 0.72, respectively. Significant results were obtained while comparing the PI among the three study groups at follow-up. Mean GI among Group 1, Group 2, and Group 3 at baseline was 0.78, 0.8, and 0.84, respectively. Mean GI among Group 1, Group 2, and Group 3 at 9 months follow-up was 0.56, 0.55, and 0.72, respectively. Significant results were obtained while comparing the GI among the three study groups at follow-up. Significant difference was seen in PD, RAL, and GR from baseline to 9 months in all groups (P < 0.05). Conclusion: PRF leads to significantly better improvement in the clinical parameters on follow-up in comparison to OFD alone in patients with the presence of intrabony defects.
  348 49 -
Comparison of marginal fit and internal adaptation of copings fabricated with polyetheretherketone and zirconia – An In vitro study
V Amalorpavam, T Sreelal, Giri Chandramohan, GN Jithin, Ponjayanthi, Kamalashankar
November 2021, 13(6):1199-1205
Context: Purpose: The aim of this in vitro study was to evaluate and compare the Marginal fit and Internal adaptation of copings fabricated with polyetheretherketone (PEEK) and Zirconia luted with resin cements. Materials and Methods: Maxillary first premolar was prepared to receive all ceramic restoration. It was duplicated using addition silicon impression material for fabricating Cobalt–Chromium metal die, which is used as a master die. Using the master die, 30 heat cure acrylic samples were fabricated for the heat cure acrylic tooth models on which 15 PEEK and 15 zirconia copings were made. Self-adhesive resin cement is used for luting and 30 copings were luted. After 24 h, luted copings were having a disc of thickness 0.01 mm cutting at high speed using a Tooth cutting lathe for all the 30 samples. Field Scanning Electron Microscopic study analysis for evaluating marginal fit and internal adaptation of two groups were observed. The values were then analyzed using one-way ANOVA (post hoc) followed by Dunnet t-test. Results: Among those two groups, PEEK copings group materials showed the lowest mean value of (30.3 ± 5.1) for marginal gap, (29.1 ± 5.8) for internal gap whereas the zirconia copings group showed a mean value of (50.26 ± 16.02) and (32.8 ± 5.2) respectively. Conclusion: Among these two groups, comparatively less marginal fit and internal adaptation is seen in zirconia copings when compared to the PEEK copings. While the marginal fit and internal adaptation of both PEEK and zirconia copings were in the acceptable clinical range.
  348 47 -
Assessment of postoperative pain after single-visit root canal treatment using Wave One® and One Shape® single file system: A clinical study
Pooja Jain, Mulay Sanjyot, Swapnil Bhosale
November 2021, 13(6):1506-1512
Background: Wave One® (WO) and One Shape® (OS) are among the common endodontic file systems having rotary and reciprocating movement of instrument, respectively. The study evaluated the postoperative pain after single-visit root canal treatment using single file rotary and reciprocating system. Materials and Methods: The present study was conducted in the department of conservative dentistry and endodontics on 68 teeth of patients aged between 20 and 45 years. Sixty-eight teeth were divided into two study groups. In Group A, instrumentation with OS file systems (n = 34) was done with subgroup A1 having patients without periapical lesion (n = 17) and subgroup A2 having patients with periapical lesion (n = 17). In Group B, instrumentation with WO file systems (n = 34) was done with subgroup B1 having patients without periapical lesion (n = 17) and subgroup B2 having patients with periapical lesion (n = 17). The root canal shaping procedures were performed according to the manufacturer's instructions for each instrument system. Presence of postobturation pain was accessed by visual analog scale (VAS) scale (0–10), where 0 showed no pain, 1–3 mild pain, 4–6 moderate pain, 7–9 severe pain, and 10 worst possible pain. Results: The intensity of pain was measured with VAS score in patients without periapical lesions and with periapical lesions using WO and OS file system on the 1st, 2nd, 3rd, and 7th day. VAS score was found to be nonsignificant on the 1st, 2nd, 3rd, and 7th day in both groups (P > 0.05). Intergroup comparison of VAS score was found to be nonsignificant (P > 0.05). Conclusion: Both systems were found to have similar effect with respect to postoperative pain. However, WO single file system presented less pain as compared to OS system in cases with periapical lesion. Large sample studies are required to substantiate the result obtained in this study.
  346 48 -
COVID-2019–2020–2021: Systematic review and meta-analysis
S Ganesh Kumar Reddy, Maanini Mantena, Sameer Krishna Prasad Garlapati, B Prasanth Manohar, Harpreet Singh, Karan Singh Bajwa, Heena Tiwari
November 2021, 13(6):921-926
Introduction: The world has faced the pandemic of COVID-19 in March 2020 and still it continues to affect in 2021. There is a great variation about the course of the disease and its features. Hence, in the present systemic review, we intend to determine the pooled estimations in the clinical features and prognosis along with the subgroups based on the severity of the disease in various regions of the world. Materials and Methods: Online data were collected from the search engines of EBSCO, PubMed, Google Scholar, and Scopus. The searched terms were COVID 19, CORONA, SARS-CoV-2, clinical features, Wuhan, etc. The study articles were collected that from January 2020 to February 2021. Based on the PRISMA guidelines, a meta-analysis was performed. Results: A total of 5067 articles were selected, of which 176 were finalized for the study. There were a total of 11 countries that were included, with a total of 2½ lakh participants. Mean age was 47.5 years. Around 22.5% had comorbidities. The mortality was 5.5%. We observed a strong association between the medical condition of the patient and the severity of the infection. In severe cases, the most common symptoms were respiratory and gastrointestinal. The mortality was registered in those with pneumonia and end-organ failure. Conclusion: It can be concluded from this meta-analysis that in a fourth of the positive patients, the disease was severe. In nearly 6% of the COVID-19 patients, mortality was seen. Patients with comorbidities and the severe form of the disease should be closely monitored.
  322 68 -
Assessment of periodontal status in pre- and postmenopausal women with chronic periodontitis: A cross-sectional study
Richa Agrawal, Hina Ahmed, Neeharika Soorgani, Laxman Naik, Shyamsunder Reddy, Madhuchander Medabalmi
November 2021, 13(6):997-999
Introduction: Periodontitis is inflammation of periodontium. Periodontal disease is associated with various risk factors among which female hormonal alterations such as menopause have been found to be connected with periodontal breakdown and osteoporosis in women. The aim of this study was to determine the periodontal status in pre- and postmenopausal females. Materials and Methods: In this study, 60 female patients were analyzed aged between 40 and 60 years. Group 1 (test) comprised 30 premenopausal women with/without chronic periodontitis and Group II (control) comprised 30 postmenopausal women with/without chronic periodontitis. After recording clinical parameters, the scores were provided using Orthopantomograph for each patient. Paired t-test was applied for intragroup comparison and independent sample t-test was applied for intergroup comparison. The value of P < 0.05 was considered statistically significant. Results: The mean plaque index, gingival index, calculus index, pocket probing depth, and clinical attachment loss scores in the premenopausal group were less as compared to postmenopausal group. Both the groups showed statistically significant differences with T=15.28 and P = 0.01. Conclusion: Postmenopausal women are more susceptible to periodontitis. Hence, precaution and initial management of oral diseases should be the utmost priority in women's health. The effect of sex hormones can be reduced with regular dental examination, maintaining good oral hygiene, and hormonal replacement therapies.
  338 49 -
The association between chronic heroin smoking and chronic obstructive pulmonary disease
Ahmad Naoras Bitar, Amer Hayat Khan, Syed Azhar Syed Sulaiman, Irfhan Ali Bin Hyder Ali, Irfanullah Khan
November 2021, 13(6):1215-1223
Introduction: Little is known about the correlation between chronic obstructive pulmonary disease (COPD) and heroin smoking. Heroin smoking is a recent underinvestigated problem. The goal of this study is to study the impact of heroin smoking among COPD patients. Methods: This is a descriptive clinical study. A combination of self-reporting questionnaires and data extraction tools were used to collect information during baseline tests, interviews, and follow-ups. Patients' medical, clinical, and socioeconomic history were recorded. Participants were recruited using random sampling from multiple centers. Results: Out of 1034 COPD patients, heroin smokers represented the vast majority of addiction cases (n = 133). Heroin smokers were leaner than non-addicts (19.78 ± 4.07 and 24.01 ± 5.6, respectively). The most common type of comorbidities among heroin smokers was emphysema (27%). Both the forced expiratory volume (FEV1)/forced vital capacity ratio and FEV1% predicted were lower among heroin smokers than non-addicts (52.79 ± 12.71 and 48.54 ± 14.38, respectively). The majority of heroin smokers (55%) had advanced COPD, and at least 15% of heroin smokers suffered from frequent respiratory failure. The mean ± SD for COPD onset age among heroin smokers was 44.23 ± 5.72, and it showed a statistically significant correlation (P < 0.001). Conclusion: Heroin smoking might be linked to the onset of COPD. Heroin smokers showed a significantrespiratory impairment compared to tobacco smokers of the same age group.
  338 49 -
Can healthy eating index be a predictor for early childhood caries in Indian children
H V N Sai Krishna, C H Sravan Kumar, Appam Sai Krishna, Sri Rama Chandra Murthy Bandarii, Laxman Garine, Sai Kiran Yellavula
November 2021, 13(6):1033-1036
Objective: To assess whether Healthy Eating Index (HEI) can predict Error correction code (ECC) in children of 3–6 year old. Materials and Methods: Our sample included 350 3–6 year old children attending outpatient department of Pedodontia. Caries score was assessed using decayed, missing, and filled teeth index and HEI was used to evaluate the diet quality. Results: About 65.9% of the children who were breast feeding and bottle feeding at night had higher S-ECC and it was statistically significant (P = 0.001). Conclusion: HEI scores were inversely related to caries severity, i.e. HEI score was significantly higher in simple ECC (57.4) and lesser in S-ECC (53.2).
  326 60 -
A comprehensive cross-tabulation analysis of oral carcinoma patients: A retrospective study of recent 7 years
Wan Muhamad Amir W Ahmad, Farah Muna Mohamad Ghazali, Muhammad Azeem Yaqoob, Ghazi Hamad Alawthah, Kumar Chandan Srivastava, Deepti Shrivastava, Mohammad Khursheed Alam
November 2021, 13(6):1074-1078
Background and Objectives: According to the global cancer situation, which is very alarming, with over 10 million new diagnoses and more than 6 million deaths each year globally, cancer is one of the most prominent causes of morbidity and mortality today. One of the cancers is oral cancer. Oral cancer is the irregular development of malignant cells in the oral cavity. The study's objective was to decide the mortality of cross-tabulation among patients treated for oral carcinoma from Hospital Universiti Sains Malaysia (USM), Kelantan, Malaysia. Materials and Methods: This chapter summarizes the medical history for 7 years from January 2011 to December 2018 of patients who have been treated for oral carcinoma in the Hospital USM, Oral and Maxillofacial Surgery (OMFS) Unit. Each patient's complete medical record was checked, and data gathered were based on age, gender, site lesion, clinical diagnosis, and mortality. Version 26.0 of the SPSS software was used to evaluate the correlation and distribution of patient survival. Results: This was a retrospective cross-sectional review of the medical evidence of 117 patients infected for oral carcinoma at OMFS (Hospital USM). Sixty-seven (57.26%) of the patients were male and fifty (42.74%) were female. Patient age ranged from 25 to 93 years. Malay has the highest prevalence (85.5%) in oral carcinoma, followed by a second ethnic group, Chinese (7.7%). The result indicates that the majority of oral carcinoma patients were over 60 years old.Cases of oral squamous cell carcinoma have proved to be the most prevalent malignant tumour in the mouth cavity. The largest number of cases collected is 91% of the data collected. Mucoepidermoid carcinoma (10%) is the second most common small salivary gland tumor. Conclusion: OSCC is the most prevalent kind of oral cancer. According to the data review, the most popular site for oral cancer is the tongue.
  334 49 -
Drug repurposing for tooth regeneration: The promising premises
TC Divya, Sapna Chandira Muddappa, Prabath Singh, Rakesh R Rajan, M Remya, Deepthy Sreehari
November 2021, 13(6):957-959
Drug repurposing which identifies new therapeutic use(s) for drugs currently in use is a brand-new avenue of research interest worldwide. It circumvents the high-end monetary and time investment usually associated with contemporary drug discoveries. In the field of dentistry, recent studies in drug repurposing focuses in attaining dentin repair or reduction of bone resorption associated with apical periodontitis. Metformin, an anti-diabetic drug has shown pro-osteogenic properties. Aspirin a known anti-inflammatory agent with anticoagulant action is found to modulate the differentiation of dental pulp cells. The significant role of glycogen synthase kinase-3 inhibitors in activating the Wnt/-beta cat signaling pathway of mesenchymal pulp stem cells may pave the way to the pharmacological treatment of dental caries in near future. It is to be noted here that further preclinical and clinical studies are warranted for the regular therapeutic use of these potential drugs in clinical dentistry.
  336 47 -
To evaluate and compare the clinical and radiographic outcomes of formocresol, mineral trioxide aggregate, electrocautery, and bioactive glass when used for pulpotomy in human primary teeth
Safia Haideri, Monika Koul, Rachna Raj, Sharib Abdus Salam, Md Shadab kalim, Vivek Gupta
November 2021, 13(6):1251-1258
Aims: The aim of the present study is to evaluate and compare the clinical and radiographic outcomes of formocresol (FC), mineral trioxide aggregate (MTA), electrocautery, and bioactive glass (BAG) when used for pulpotomy in human primary teeth. Settings and Design: The present study comprised of total four Groups A, B, C, and D; the selected children for the procedure were randomly divided into four groups according to the type of agent used as Group A, Group B, Group C, and Group D, respectively, having 20 teeth. Methodology: In this study, pulpotomies were performed on the respective teeth. The teeth were treated using either FC, MTA, electrocautery, and BAG. Following the pulpotomy procedure, the teeth were evaluated for the clinical and radiographic success for 3, 6, and 12 months. The teeth were evaluated for the presence of pain, swelling, internal and external resorption, and radiolucency. Statistical Analysis Used: Fisher's exact test and Yates corrected Chi-square test is used. Results: After 12 months of follow-up, the clinical and radiographic success rates were high. Comparing the frequency (%) of overall clinical success rate of four groups at 12 months, the Chi-square test revealed significantly different and higher overall clinical success rate in MTA as compared to other groups, especially FC and EC at 12 months. Comparing the frequency (%) of overall radiographic success rate of four groups at 12 months, the Chi-square test revealed significantly different and higher overall radiographic success rate in MTA as compared to other groups, especially FC and EC at 12 months. Conclusions: In this study, the success rates of MTA, BAG, and FC are matching their physical and chemical properties which have been detailed and explained earlier.
  326 56 -
The effect of joint surface preparations and chemical surface treatment on the transverse strength of repaired denture base resin
Madhu Ranjan, Ujjal Chatterjee, Reshu Singh, Saumya Sharma, Harsh Mahajan, Rohit Anand
November 2021, 13(6):1007-1010
Aim: The aim of the study is to investigate the effect of joint surface preparations and chemical surface treatment given to prepared surface on the transverse strength of repaired denture base resin. Methodology: Two hundred and twenty specimens (DPI India) were randomly allocated into eight groups (n = 10), according to the combination of joint surface preparation (Butt joint, 45° bevel, and rounded joint) and chemical surface treatment (methylene chloride, ethyl acetate, and methyl methacrylate) for 30 and 60 s each. Specimens, after surface treatment, were repaired with self-cured resin (DPI India) and then subjected to 3-point bending test to measure transverse strength. Fractured surfaces were viewed under stereomicroscope and subjected to AutoCAD analysis to determine type of failure (adhesive or cohesive) and measure their area. Measurement data were analyzed by one-way analysis of variance, paired t-test, Dunnett's D test, and multiple comparison Bonferroni t-test, with a 5% significance level. Results: Most of the comparisons between the test specimens were statistically significant. Specimens (methylene chloride for 60 s and rounded joint) show 60%–70% gain of strength. Conclusions: For providing better bond strength to a repaired specimen, the segment of fractured specimens to be provided “Rounded joint” preparation with etching by methylene chloride for 60 s.
  334 47 -
Effect of novel cycloaliphatic comonomer incorporation on the color stability of thermo-polymerized denture base resin
Ranganathan Ajay, Mohan Navinbharathy, Ranganathan Krishnaraj, Venkatraman Shanmugam Rajaganeshan, Muthupettai Varadharajan Srikanth, Karthigeyan Suma
November 2021, 13(6):1131-1135
Background: Denture during its in vivo service encounters myriad food pigments and numerous physico-mechanical dynamic changes. Denture discoloration is one of the unresolved problems that should be unraveled to satisfy the esthetic demands of the patients. Aim: This study aims to evaluate the color stability of a novel denture base copolymer with 10% and 20% (vol/vol) concentration of cycloaliphatic comonomer. Materials and Methods: Control group (G0) comprises specimens made without cycloaliphatic comonomer. The specimens of trial groups G10 and G20 were fabricated with 10% and 20% cycloaliphatic comonomer, respectively. For each group, thirty specimens (n = 30) were made. The specimens (n = 10) were immersed in three food colorant solutions (erythrosine, tartrazine, sunset yellow) for 56 days after artificial thermal aging. Ultraviolet-visible spectrophotometer was employed to measure the tristimulus values and calculate the color change (ΔE) of the specimens prior to and following rapid thermal aging or immersion of the specimens in the food colorants. Results: G0 showed the highest ΔE and G20 exhibited the least with each colorant. G10 had an intermediate imperceptible ΔE with each colorant. Also, significant differences (P = .000) existed between the food colorants within each group. The highest ΔE value was observed with sunset yellow and the lowest ΔE with tartrazine with each group. Conclusion: The addition of cycloaliphatic comonomer in denture base acrylic resins improved the color stability. The new copolymer with 20 Vol.% comonomer exhibited the highest color stability with all the food colorants.
  342 35 -
Evaluation of reduction protocols in managing aerosol generation in caries management in COVID 19 in Riyadh: An original research
Abeer Ayiad Alamri, Ayad Bulayd Almutairi, Abeer Mohammed Hawsah, Atheer Hussain Aljarullah, Yara Waleed Almeerabdullah, Maha Abdullah Alenezi, Suhael Ahmed
November 2021, 13(6):1655-1658
Introduction: External high-volume extraction (HVE) devices may offer a way to reduce any aerosol particulate generated. The aim of this study was to measure the particle count during dental aerosol-generating procedures and compare the results with when a HVE device is used. Materials and Methods: Design A comparative clinical study measuring the amount of PM1, PM2.5, and PM10 aerosol particulate with and without the use of an external HVE device was undertaken. Materials and methods in total, ten restorative procedures were monitored with an industrial Trotec PC220 particle counter. The intervention was an external HVE device. Main outcome methods the air sampler was placed at the average working distance of the clinicians involved in the study − 420 mm. Results: In the present study, aerosol particulate was recorded at statistically significantly increased levels during dental procedures without an external HVE device versus with the device. Discussion The null hypothesis was rejected, in that significant differences were found between the results of the amount of aerosol particle count with and without a HVE device. Conclusion: If the results of the present study are repeated in an in vivo setting, an external high-volume suction device may potentially show a lower risk of transmission of viral particulate.
  332 41 -
Prevalence of titanium hypersensitivity in patients with titanium implants: A systematic review and meta-analysis
Rajsandeep Singh, Gurvanit Lehl, Arshad Bin Hussain, Tejal Nivrutti Abhang, Manisha Mangesh Kulkarni, Mohamed Fadul A Elagib, Rahul V C Tiwari
November 2021, 13(6):1345-1349
Background: With increase in exposure to titanium in daily life and its use in medical procedures, there is a greater chance for developing titanium hypersensitivity. Our aim and objective is to examine whether patient patients with titanium implants had a greater incidence of titanium hypersensitivity or not. Titanium is widely considered to have good biocompatibility. A passivating surface layer of TiO2 is formed when exposed to air which gives it good corrosion resistance. These properties along with its high strength, lightweight, and improvements in smelting technologies have led to its widespread use as an intraosseous and periosteal implant in dentistry and orthopedics. Materials and Methods: Only case–control studies were used for the meta-analysis. Studies with a sample size of <5 were excluded. Cutaneous and epicutaneous tests were used in the study. Results: Three studies met the inclusion criteria. Titanium hypersensitivity is more prevalent in patients with titanium implants. Conclusions: It is also used in a variety of medical devices such as pacemakers and insulin pumps. Moreover, our external exposure to titanium is increasing. It is used in aerospace, chemical, and automobile industries. It is also used in jewelry, home furnishings, and in making sports and marine equipment. Titanium implants increase the possibility of developing titanium hypersensitivity, and thus, it should be considered as a major factor in unexplained implant failure where other causes have been excluded.
  324 47 -
Effect of intra-articular injection of corticosteroid in the patients with osteoarthritis of the knee – A hospital-based cross-sectional study
Rajeev Reddy Kikkuri, Viveksheel Kashyap, Alka Upadhay, Vaibhav Kumar, Karri Sandeep Reddy, Richa Singhal
November 2021, 13(6):1162-1167
Background: Osteoarthritis (OA) of the peripheral joints is frequently related with physical disability and decline in health-related quality of life, deciphering into a significant burden on people and humankind. Although IA corticosteroid injections are being in clinical use, their long-term effects on knee OA are least studied and documented. Hence, the study was done with the aim of assessing the effect of intra-articular (IA) injection of corticosteroid in patients with OA of the knee. Methods: This prospective observational study was conducted over a period of 6 months between 40 years and 75 years with Grade I and II OA of the knee admitted under the Department of Orthopaedics, Tertiary Care Hospital, Belgaum. Patients' affected knee was injected with 80 mg of triamcinolone after the examination, and follow-ups had done at 2 weeks, 6 weeks, 3 months, and 6 months. The standard pro forma used were Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: The mean age of the participants was 58.96 ± 9.58, ranging from 40 to 75 years, with a slightly higher proportion of females. The proportion of Grade 1 and Grade II OA was 24% and 76%, respectively, and 54.7% had right-sided involvement. The difference between pre Rx: Pre intervention VAS score VAS score and follow-up periods at 2 weeks, 6 weeks, 3 months, and 6 months was statistically significant with respect to VAS scale, KOOS scale, and WOMAC scale (P < 0.001). Conclusion: there was no major adverse effect of corticosteroid injections, and it showed significant improvement in patients. There is a need to conduct large-scale well-controlled clinical trials with an appropriate control group, to be able to document the relative efficacy and safety of IA steroid injection.
  323 48 -
Association of human papilloma virus in oral squamous cell carcinoma: An alarming need for human papillomavirus 16 screening in cancer patients
Arvind Venkatesh, S Elengkumaran, C Ravindran, N Malathi
November 2021, 13(6):1224-1227
Background: The percentage of cancers of the tongue and palatine tonsils has continued to increase by 2%–4% among younger men. This increased prevalence of a subsection of oropharyngeal carcinoma can be associated with human papillomavirus (HPV). Among the head-and-neck cancers, a strong association with HPV infection is evident with oropharyngeal cancers, particularly tonsillar and basal tongue cancers. Objectives: Oral carcinoma, with an overall incidence of 16.1 adults per 100,000, is one of the leading malignancies worldwide, presenting a noticeable geographic variation in its distribution. Squamous cell carcinoma (SCC) being the most common of all oral malignancies, the objective of the study is to detect the HPV antigen p16 over-expression in patients with oral SCC using immunohistochemistry (IHC). Materials and Methods: Oral SCC (OSCC) diagnosed formalin-fixed-paraffin embedded blocks were processed for IHC. Results: Out of 50 cases, 3 were deferred due to insufficient tumor sample and 2/47 cases were p16 positive and the site was the lateral border of the tongue. Conclusion: The HPV antigen overexpression in patients with OSCC was investigated to detect the incidence of HPV in SCC of oral cavity. P16 was used as a marker for the detection of OSCC using IHC in HPV-induced OSCC. Positives were detected thus concluding the significance of studying HPV expression during diagnosis.
  324 47 -
Comparative evaluation of genotoxicity in tobacco users versus nontobacco users
Arun Jacob Thomas, Bindu J Nair, Sajna Oommen, V Syamkumar, Resmi K Raman
November 2021, 13(6):960-964
Background: Many of the contents of cigarette smoke are genotoxic in nature, and consequently, cytogenetic injury seems to be a trustworthy biomarker for deciding the influence of exposure to chromosome damaging agents in smoke. The cytokinesis-block micronucleus assay (CBMN assay) has been proven to be an effectual tool for the study of micronuclei (MN) that will help in estimating the genotoxicity in tobacco users alone which will further help in early cancer detection. Objective: The objective is to find out whether there is pronounced contrast in genotoxicity between tobacco users and nonusers by determining MN number in peripheral blood lymphocytes using CBMN assay. Methodology: MN frequency in peripheral blood lymphocytes was estimated in 5 ml of fresh blood obtained from sixty individuals using tobacco either smoking, chewing, or combination of both and also from thirty individuals with no habit of tobacco use. All were in the age group of 20–40 years. Results: There was a significant increase in genotoxicity in tobacco users when compared to that of nontobacco users. A positive correlation was also obtained between smoking index and MN frequency in the study. Conclusion: Approximation of frequency of MN by CBMN assay can be used to evaluate the genotoxicity present in blood and helps in identifying tobacco users who are at a high risk for the presence of cancer even before the appearance of clinical changes.
  300 68 -
Study of patterns of maxillofacial injuries: An institution-based observational study
Leslie Sara Mathew Kalathil, Ummar Mangalath, A Roshni, Sachin Aslam, Tom Thomas, Rakesh B Nair
November 2021, 13(6):1019-1023
Maxillofacial fractures are one of the common presentations in an emergency department. They are considered to be one of the significant and dominant conditions that requires treatment as the fractures can result in morbidity, mortality, psychological, functional disability, and facial mutilation. The incidence, patterns, and etiology of maxillofacial fractures vary from one country to another due to the geographical, cultural, social, and economic differences. The present study included 176 patients from January 2019 to September 2020 that aimed to evaluate the pattern of maxillofacial fractures and to learn the etiology for the same.
  320 46 -
Awareness of general practitioners toward hypertension management
Ramakant Rawat, Vidya Sagar Ram, Granth Kumar, Amit Varshney, Manoj Kumar, Pankaj Kumar, Navneet Agrawal
November 2021, 13(6):1513-1516
Introduction: The silent killer, hypertension (HTN), is a significant risk factor for cardiovascular disease. In India, HTN has a major public health effect on cardiovascular health and health-care systems. Aim: The present study was aimed to evaluate the awareness of general practitioners (GPs) toward HTN management and also their approach toward management. Materials and Methods: The present study was a questionnaire-based assessment study. A total of 100 GPs were included in the study as our study sample. All the participants were well informed about the study and after that those who were willing to participate were enrolled after obtaining a written informed consent. Results: The common presenting symptoms of hypertensive patients were predominantly morning headache (71%), dizziness (41%), palpitation (39%), and fatigability (29%). Majority (84%) practiced cuff placement method covering about 2/3rd of the arm at heart level. The preferred position while blood pressure (BP) examination of patient by majority of practitioners was while sitting (53%). The number of readings usually taken for measuring BP for each patient was as follows: one (3%), two (42%), and three (55)%. Conclusion: Although GPs in our study are well informed and up to date on certain aspects of HTN diagnosis and treatment, they may still lack an appropriate approach to HTN history taking, diagnosis, and treatment.
  318 47 -
Various assisted bone regeneration in apicectomy defects systematic review and meta analysis
Ananad Sumangali, Rahul V C Tiwari, Jeevana Kollipara, Mubashir Baig Mirza, Rajwinder Singh Brar, Akshay M Dhewale
November 2021, 13(6):927-932
Introduction: In the endodontic surgery, the common applications are the procedures that apply regenerative methods. There are various methods that help in the regeneration after the endodontic root end cutting or apicectomy. The outcome of the apicectomy depends on the procedure and the material. Hence in the present study, we intend to conduct the systemic review and meta-analysis of the various assisted bone regeneration in apicectomy defects. Materials and Methods: The study was conducted by the online search of the data that included the studies for the regenerative procedure in the endodontic surgery in patients with various periapical pathologies. The data search engines were Scopus, Web of Science, Google Scholar, and PubMed. The risk of the bias was calculated. The study participants were divided into case and control groups. Case group had undergone the regenerative surgery for the persistent periapical lesions, while the control group had not undergone the regenerative surgery for the persistent periapical l. The clinical and the radiograph outcomes were compared between the control and the case groups. Meta-analysis was done and the subgroups were evaluated. Results: From a total of 1561 articles, only 11 were finalized for the study to conduct the meta-analysis. The bias was noted for majority of the studies most of which were clinical trials. It was observed that the regenerative methods used in the endodontic surgery have significantly improved the outcome. The application of the expanded polytetrafluoroethylene only has no significant effect; however, application of the autologous platelet concentrates or collagen membranes only had good outcomes. The combination of the materials showed a significant outcome than when applied alone. Conclusions: From this meta-analysis, it is evident that regenerative procedures are beneficial in the endodontic apicectomy procedures. The materials used in these procedures will augment the outcome. A better prognosis is expected if the combination of the materials is used.
  306 59 -
Assessment of oral health status of patients undergoing fixed orthodontics: A clinical study
Amit Kumar, Jaideep Singh, Milind Wasnik, Jai Prakash Mongia, Tanusha Mahobia, Vishwas Bansal, Ali Hussain Mohammed Almansour
November 2021, 13(6):1259-1262
Background: The incidence of dental caries and gingival disease is at higher level in orthodontic patients. The present study demonstrated oral health status of patients undergoing fixed orthodontics. Methodology: A total of 168 patients age ranged 12–17 years who were undergoing orthodontic treatment for 2 years of both genders were recruited. The assessment of dental caries as Decayed, Missing, and Filled Teeth (DMFT) score and plaque index was determined at first, second, and last visits. Results: Age 12 years had 22 males and 28 females, 13 years had 14 males and 22 females, 14 years had 8 males and 18 females, 15 years had 7 males and 15 females, 16 years had 6 males and 14 females, and 17 years had 9 males and 5 females. The mean DMFT score in age group 12 years was 1.74 and 2.24 at first and third visits, respectively, at 13 years was 1.60 and 2.04 at first and third visits, respectively, at 14 years was 2.38 and 2.72 at first and third visits, respectively, at 15 years was 1.74 and 2.08, at 16 years was 3.32 and 3.56 and at 17 years was 3.40, and 3.64 at first and third visits, respectively. Conclusion: There was significant higher dental caries and plaque index in age group 12 years.
  308 56 -
Impact of tooth loss position on oral health-related quality of life in adults treated in the community
Ahmad Yahya Imam
November 2021, 13(6):969-974
Background: Tooth loss is known to have negative effects on both functional and psychological oral health-related quality of life (OHRQoL), but the impact of the position of the tooth loss (i.e. anterior or posterior) on the different psychosocial dimensions of OHRQoL has yet to be examined. Here, we examined how the position of lost teeth impacts the different dimensions of OHRQoL. Methods: This was a cross-sectional epidemiological study of adults aged 18 years and older attending routine examinations at primary care dental centers in Jeddah, Kingdom of Saudi Arabia. Demographic information was collected, and OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14) (Arabic form). Differences in total and subdomain OHIP-14 scores between individuals without tooth loss and those with ≥1 anterior or posterior missing teeth were assessed using Student's t-test, and analysis of covariance was used to assess the association between the presence and absence of missing teeth in each compartment and total and subdomain OHIP-14 scores after controlling for age, gender, and income. Results: The overall prevalence of tooth loss was 76%. In multivariate analysis controlling for age, gender, and income as covariates, anterior missing teeth were significantly associated with higher OHIP-14 total, physical pain, physical disability, psychological disability, and social disability scores, accounting for 6%–12% of the score variance. However, posterior missing teeth were only associated with total OHIP-14 and functional limitations domain scores, accounting for 6% and 7% of the variance, respectively. Conclusions: Here, we show for the first time the impact of the location of missing teeth on different OHRQoL dimensions. Anterior tooth loss has a wide-ranging impact on both physical and psychosocial functioning compared to posterior tooth loss, suggesting that anterior tooth restoration should be prioritized when treatment planning. The position of lost teeth must be considered in addition to the number of losses when examining the impact of tooth loss and its treatment on OHRQoL.
  312 51 -
Histocompatibility of dental restorative composite resin photopolymerized with a novel multifunctional comonomer: A histopathological analysis in rats
Jambai Sampathkumar Sivakumar, Ranganathan Ajay, Karuppiah Gokulapriyan, Natesan Thangaraj Deepa, Subramaniam Kalaiyarasu Vigneshwari, Shafie Ahamed
November 2021, 13(6):1124-1130
Background: Restorative dentistry is impossible without composite resins. Toxicity of these resins is common though possessing favorable properties. Modifications of the resin matrix are being executed to improve the properties of the material. Dipentaerythritol penta-/hexa-acrylate (DPEPHA) monomer has been recently identified as a cross-linking comonomer with the conventional resin matrix. Purpose: This study aimed to investigate the histocompatibility of DPEPHA comonomer in photopolymerized resin at 20 and 40 wt.% concentrations in rats. Materials and Methods: Eighteen male Wister rats were subjected to subcutaneous implantation of conventional resin specimens without DPEPHA (G0) and with DPEPHA at 20 wt.% (G20) and 40 wt.% (G40) concentrations. Then, the rats were subdivided according to the time of resection of the implantation sites at 1, 2, and 4 weeks (n = 6 rats). Tissue specimens were submitted to histopathological analysis. Results: Except for 4 weeks' time interval, there were significant differences (P < 0.05) in the inflammation among the groups at each time interval. The order of inflammation was NC <G40 ≤G20 <G0. Concerning the fibrous capsule thickness, significant difference existed among the groups at each time interval and within the groups at all 3 time intervals (P < 0.05). Conclusion: Composite resin specimens with DPEPHA comonomer exhibited good histocompatibility in rats at 40 wt.% concentration.
  302 60 -
Phenotypic expression of oral fibroblasts derived from oral submucous fibrosis: An assay through cell culture
Abhishek Banerjee, Mathew O Mampilly, VV Kamath, Vijayaraghavan Athreya, Vijayalakshmi Kotrashetti, Kumar Chandan Srivastava, Deepti Shrivastava
November 2021, 13(6):1234-1239
Objective: The present study aimed to establish cell lines of fibroblast from human OSF tissues and their response to varying concentrations of arecoline. The various morphological forms of fibroblasts were identified to establish phenotypic change. Materials and Method: Fibroblast cell lines were obtained from control samples as well as from OSF cases. The cell lines were treated with 50/100/150/300/500 ug/ml of arecoline and morphology were determined. Results: Three morphological forms were detected; F1 spindle, F2 epitheloid and the F3 stellate. The F3 to F1 ratio was higher in OSF. Arecoline at 50ug/ml was stimulatory and at 150ug/ml cytotoxic to the cell lines. Conclusion: Arecoline seems to enhance proliferation of the fibroblast at lower concentrations but cytotoxic at higher levels. This is probably due to the generation of new cell lines and response of the arecoline receptors indicating phenotypic change.
  324 36 -
Mucormycosis during Coronavirus Disease pandemic: A diagnosis we cannot afford to miss
Kaneesh Karthik Arthanari, Sivakumar Annamalai, Arthiie Thangavelu, Chandrika Palanivelu, Gowtham Suresh, Sambavi Anbuselvan
November 2021, 13(6):1769-1771
Mucormycosis is a very aggressive, devastating opportunistic fungal infection commonly involving nasal, maxillary,orbital, and cerebral regions. In the second wave of the coronavirus disease 2019 (COVID-19) pandemic, a high frequency of mucormycosis infections has been seen because of the triad of COVID-19, systemic steroids, and preexisting diabetes mellitus. A patient might present with a simple mobile tooth/teeth with multiple gingival abscesses Necrotic bone could be seen in the palate. Blackish discoloration might be present in the oral mucosa. There might be extraoral swelling . If rhino-oculo cerebral mucormycosis is diagnosed, then there are two immediate treatment modalities to be followed. Both surgical and medical treatment are necessary. Surgical is thorough debridement of the necrotic tissue. To prevent the occurrence of mucormycosis, meticulous glycemic control and rational use of steroids and antibiotics for the shortest possible time with adequate attention toward the ventilators and tubing are necessary.
  314 44 -
Platelet-rich plasma and platelet-rich fibrin as a regenerative tool
Athiban Inbarajan, Padmanabhan Thallam Veeravalli, Madhan Kumar Seenivasan, Shanmuganathan Natarajan, Anusha Sathiamurthy, R Shakir Ahmed, Anand Kumar Vaidyanathan
November 2021, 13(6):1266-1267
Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are used as a valuable adjunct in the treatment of maxillofacial rehabilitation. PRP used along with growth hormone helps in bone healing and tissue regeneration in the areas affected by bone and soft tissue-related defects. It aids not only in faster and better healing of the surgically debrided area but also in regeneration of the bone at a faster rate. This review comprises the applications of PRP and PRF and their uses in various procedures.
  292 60 -
Evaluation of effect of aluminum oxide on flexural strength and surface roughness of conventional heat-cure denture base resin
Madhu Ranjan, Ujjal Chatterjee, Arya Gupta, Souvir Pandey, Rohit Anand, Mritunjay Keshri
November 2021, 13(6):1003-1006
Purpose: Acrylic denture base tends to fracture frequently during their service due to poor strength. The surface roughness of denture base is a critical property because denture base with rough surface will cause accumulation of food particles ,thereby leading plaque retention . Microbes such as candida albicans are seen inhabitating the surface. Materials and Methods: Conventional heat cure denture base reins(DPI) and heat cure denture base resin with incorporation of 15wt% aluminium oxide was studied in two groups with 20 samples each. A mold of size 65 mm × 10 mm × 3 mm (ISO Standard) was obtained by investing brass rectangles. About forty specimens were prepared. Specimens were divided into two groups (n = 20) coded A and B. Group A was the control group (n = 20) without addition of aluminum oxide. Group B was the experimental group (n = 20) with addition of 15 wt % aluminum oxide. All the specimens were stored in distilled water for 14 days. The flexural strength was measured using a three-point bending test in a universal testing machine, and the surface roughness was measured using contact-type profilometer. Results: Incorporation of 15wt% aluminum oxide leads to a significant increase in flexural strength and surface roughness of conventional heat-cure denture base resin.
  296 53 -
Evaluation of frictional forces generated between three different ligation methods with four different sizes of orthodontic archwires: An In vitro study
Ranganathan Rathinasamy, Venkataramana Vannala, Nazargi Mahabob, S Bhuvaneshwari, George Sam, Aarthi Ganapathy
November 2021, 13(6):1434-1441
Aim: This in vitro study was done to evaluate and compare the frictional forces produced by a passive self-ligating bracket (SLB) and two types of elastomeric ligatures (unconventional elastomeric ligatures [UELs] and conventional elastomeric ligatures [CELs]) on a conventional bracket used with four types of wires. Materials: In this in vitro study, 8 numbers of conventional preadjusted edgewise appliance stainless steel brackets and 4 numbers of passive SLBs were tested. Four types of archwires and two types of ligatures were tested. Brackets were divided into three groups – Group I, Group II, and Group III. All the three groups were further divided into four subgroups based on different archwires. Methods: Custom-made mounting jig was specially constructed for this study – upper member and lower member. After the samples were mounted, traction test was conducted using universal testing machine and readings were tabulated for all specimens. The variables in each group were subjected to one-way analysis of variance. Results: All the three groups were tested for its total friction, static friction, and kinetic friction. SLBs showed a static mean little lower and had kinetic mean little greater than conventional bracket with unconventional module. Conclusion: UELs on conventional brackets and SLBs are able to produce lower frictional force when compared with CELs on conventional brackets.
  304 43 -
Evaluation of root dentinal damage associated with protaper gold, waveone gold, and protaper next during cleaning and shaping procedures: An In vitro analysis
Sarin Koroth, KC Ponnappa, Elsy P Simon, Subin Bharath, VJ Vivek, Chandini Raveendran
November 2021, 13(6):1098-1101
Aim: The purpose of this study is to evaluate and compare the incidence of dentinal defects after root canal shaping using rotary nickel-titanium (Ni-Ti) instruments (ProTaper Gold [PTG] and ProTaper Next [PTN]) and reciprocating instrument (WaveOne Gold [WOG]). Materials and Methods: One hundred human mandibular premolars with single root and single canal with canal curvature <10° were randomly divided into five groups (n = 20 teeth per group). The root canals were instrumented using hand K-files (positive control), full sequence rotary files PTG and PTN, and reciprocating single-file system WOG. One group was left unprepared and served as negative control. Roots were sectioned horizontally at 3, 6, and 9 mm from the apex and evaluated under a stereomicroscope. Results: PTG, WOG, and PTN showed dentinal defects in 40%, 53.3%and 30% of the samples, respectively. Conclusion: Irrespective of motion kinematics, dentinal defects are observed in all the Ni-Ti file groups. Within the limitations of the present study and the available literature, incidence of dentinal defects is less with instruments working in continuous rotation rather than instruments with reciprocating motion.
  290 56 -
Comparison of bone healing in immediate implant placement versus delayed implant placement
Gagandeep Singh, Rajat Pareek, Gaurav Singh Rajawat, Aljeeta Kadam, Mahmoud Al Abdulsalam, Abdulrahman Al Abdulathim
November 2021, 13(6):1309-1314
Introduction: Today, modern surgical and regenerative techniques with implant immediately placed into the prepared socket, predictable gap repair with bone substitutes and soft tissue grafts, have helped to eliminate concerns about bone deficiencies and allowed implant placement according to prosthodontic needs. Materials and Methods: The present in vivo study was designed to evaluate and compare the implant healing after immediate implant placement with or without bone graft and implant healing after delayed implant placement with or without bone graft. Crestal bone levels were compared in both the groups at preoperatively and postoperatively on immediate postoperatively, at 3rd month, and at 6th month. Results: Immediate implant group has more crestal bone level reduction at 3rd and 6th months as compared to the delayed implant group. Immediate implant with bone graft group has insignificant crestal bone level reduction at 3rd and 6th months as compared to immediate implant without bone graft group. Delayed implant with bone graft group has insignificant crestal bone level reduction at 3rd and 6th months as compared to delayed implant without bone graft group. Conclusion: It was concluded from this study that clinical and radiographical bone healing in the delayed implant group with or without bone graft (Group Y) appears to be better than the immediate dental implant group with or without bone graft (Group X).
  290 56 -
Evaluation of adiponectin and resistin levels in gingival crevicular fluid in patients with chronic periodontitis before and after treatment: A clinico-biochemical study
P Fairlin, S A Jacob Raja, Johnson Raja James, Tamil Selvan Kumar, Ravi Shankar, S Divya
November 2021, 13(6):1178-1183
Aim: The aim of this study was to find out the association of adiponectin and resistin levels in gingival crevicular fluid (GCF) with the clinical parameters before and after scaling and root planing in periodontitis patients. Methods: A total of 50 patients were recruited from the Outpatient Department of Periodontics, JKK Nattraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India. The protocol was reviewed and approved by the institutional ethical board. Informed consent was obtained from the patients and the study-related procedures were explained. Patients were divided into two groups. Group I (25 patients) consisted of healthy patients. Group II (25 patients) consisted of periodontitis patients. The periodontitis patients after treatment were considered as Group III. GCF samples were collected before treatment and 21 days after treatment. The levels of adiponectin and resistin were evaluated using Immunotag™ Human RETN enzyme-linked immunosorbent assay (ELISA) kit (ITEH0269) and Immunotag™ Human ADP (adiponectin) ELISA kit (ITEH2593). The levels were correlated with the clinical parameters. Results: There were an increase in the mean adiponectin level and a decrease in the mean resistin level at the end of periodontal therapy. Conclusions: Adiponectin which is an anti-inflammatory component was found to increase after periodontal therapy, and resistin which is an inflammatory component has been decreased after periodontal therapy.
  296 50 -
Aluminium induced neurodegeneration in rat cerebellum in the presence of ethanol coexposure
Buddhadeb Ghosh, Ravi Kant Sharma, Suman Yadav
November 2021, 13(6):1228-1233
Introduction: Both aluminium and ethanol are pro-oxidants and neurotoxic. Moderately intake of alcohol may favor the body in coronary heart disease and diabetes mellitus etc. Being cheaper aluminium and increasing consumption of alcohol in India mixed with each other and may induce neurotoxicity. The present study was planned to identify the level of aluminium induced neurodegeneration in presence of ethanol coexposure in the cerebellum. Materials and Methods: An experimental study was carried out at Dr. RP Government Medical College, Kangra, and Government Medical College, Amritsar, India after due approval from the Institute Animal Ethics Committee. Thirty-two Wistar rats were divided into one vehicle control and three experimental groups. Group I received the normal saline water as the vehicle control group. Group II received aluminium chloride 4.2 mg/kg body weight as the experimental group. Group III received ethanol 1 g/kg body weight as the experimental group. Group IV received both aluminium chloride 4.2 mg/kg body weight and ethanol 1 g/kg body weight as the experimental group. After 3 months of treatment, cerebellum was processed for histopathological observation under the microscope. Results: Experimental group treated with aluminium and ethanol separately showed reduction in the number of Purkinje cells, without a prominent nucleolus and well-defined nuclear membrane. Eosinophilic swelling adjacent to Purkinje cell bodies observed. The effects of combined administration of aluminium ethanol treated groups showed with acute neurodegeneration of Purkinje cell layer and granular layer. Pyknosis and neurofibrillary tangle seen in Purkinje cells. Conclusions: It has been suggested that the ethanol-induced the effects of aluminium on the cerebellum and plays a significant role in neurotoxicity.
  304 39 -
Analysis of stress distribution on the bone around an implant placed in the anterior maxilla using three different abutment angulations by means of finite element analysis
Snehal Shende, Amit Jadhav, Dhairaysheel N Edake, Amit Hemraj Patil, Hansraj Patil, Nitu Agrawal
November 2021, 13(6):1591-1596
Aim: the aim of the study was to study the effect of stress distribution on the bone around an implant using angled abutments by means of finite element analysis in the anterior maxillary region. Materials and Methods: A three-dimensional (3D) model of the of patient's maxilla of right central incisor: tooth, bone, crown, implant, and abutment system were used in this study. The models were designed for three situations with straight abutment, i.e. 0°, 15°, and 20° angled abutment. The load of 178N was applied on the cingulum area of the prosthesis at an angle of 130° in relationship with the long axis of the implant. After applying the static loads on each model, the stress generated in the bone and the implant was recorded. The results will be analyzed by analysis of variance test. Results: The cortical and cancellous on Mises stresses in 20° abutment model were found to be maximum as compared to 15° abutment followed by 0° abutment. The stress was concentrated in the implant-abutment joint area. The overall stresses in 20° abutment model were found to more than 15° abutment followed by 0° abutment. The magnitude of stresses increased as the angulations increased. Conclusion: From the conclusions of this study, the stress is more multiplied in angled abutments, hence care needs to be taken when restoring implants using angled abutments, especially in patients with heavy masticatory load or when planning for cantilevering of restorations in these angled implant restoration.
  302 41 -
Antimicrobial efficacy of green synthesis of silver nanoparticles against cariogenic pathogens – An In vitro study
M Chittrarasu, A Shafie Ahamed, Vaiyapuri Ravi
November 2021, 13(6):1188-1192
Background: Nowadays, emergence of drug resistance might happen in the world. Hence, invention of new dental material had started by researchers for the same. The present study evaluated the antimicrobial property of green synthesized nanosilver particles against dental cariogenic microorganisms such as Streptococcus mutans and Lactobacillus acidophilus. Materials and Methods: An in vitro study had been designed to meet the objectives. Galla Chinensis ellagic acid powder synthesized nanosilver particles (GCAgNPs) synthesized nanosilver particles were used in this study. The cariogenic bacteria S. mutans (ATCC 25175) and L. acidophilus (ATCC 4356) were used in this study. The antimicrobial activity was detected at different concentrations (1000 μg/ml, 500 μg/ml, 250 μg/ml, 125 μg/ml, and 62.5 μg/ml) by means of qualitative and quantitative methods. Results: The results show a statistically significant difference between all the concentration (1000 μg/ml, 500 μg/ml, 250 μg/ml, 125 μg/ml, 62.5 μg/ml) in Galla Chinensis synthesized silver nanoparticles (GCAgNPs) in S. mutans and L. acdiophilus. Intergroup comparison of GCAgNPs shows a statistically significant difference among all the concentrations against S. mutans and L. acidophilus. Conclusion: GCAgNPs show antimicrobial and antibiofilm activity against S. mutans and L. acidophilus microorganisms.
  304 38 -
Assessment of effect of menopause on saliva and oral health status
Richa Mishra, Khushtar Haider, Ramsha Rizwan, Shamim Monga, Amrita Pritam, Padam Singh
November 2021, 13(6):1535-1537
Background: Women at menopausal period may frequently develop several oral mucosal disorders. Xerostomia is also a common finding among postmenopausal women. The present study was conducted to assess effect of menopause on saliva and dental health. Materials and Methods: Forty postmenopausal women (Group I) and 40 control (Group II) underwent Oral Hygiene Index Simplified (OHIS), Decayed, Missing and Filled Teeth (DMFT index), Community periodontal index (CPI), and Loss of attachment (LOA), salivary pH and flow measurement. Results: Oral symptoms were normal in 22 and 40, xerostomia in 18 and 0 in Group I and II respectively, salivary pH was normal in 20 and 40, below acidic in 20 and 0, salivary flow was normal in 21 and 40, hyposalivation in 19 and 0 in group I and II, respectively. The difference was significant (P < 0.05). OHI-S was good in 4 and 25, fair in 6 and 10, poor in 30 and 5, DMFT index was decayed was 1.42 and 0.65, missing was 2.84 and 0.26 and filled was 1.06 and 0.52 seen in Group I and II respectively. CPI index mean value was 3.26 in Group I and 1.02 in Group II and mean LOA was 1.42 and 0.46 in Group I and II respectively. The difference was significant (P < 0.05). Conclusion: There was decrease in the salivary pH and flow rate in postmenopausal women which in turn leads to increased OHI-S, DMFT, CPI, and LOA.
  292 49 -
Efficacy of spironolactone in adult acne in polycystic ovary syndrome patients an original research
Neha Rani, Prashant Kumar, Anup Kumar Mishra, Bala Yadu Vamsi Sankuratri, Sanjana Sethi, Kalyani Gelada, Heena Tiwari
November 2021, 13(6):1659-1663
Introduction: This prospective clinical trial was designed to assess the effects of a long-term therapy with spironolactone, with and without dietary-induced weight-loss, on clinical features, lipid profile, and insulin levels in women with polycystic ovary syndrome (PCOS). Materials and Methods: Twenty-five patients (range of age 16–32 year; 13 lean and 12 overweight) fulfilling formal diagnostic criteria for PCOS (oligomenorrhea and/or amenorrhea, biochemical and/or clinical evidence of hyperadrogenism) were studied at baseline and then received oral spironolactone (100 mg/die) for 12 months; association with lifestyle modifications was recommended to all overweight patients. Clinical, endocrine, and metabolic parameters (oral glucose tolerance test [OGTT], lipid profile) were measured at baseline and at the end of the antiandrogen treatment. Results: The therapy was associated with a significant average decline of triglycerides in overweight subjects and with increased high-density lipoprotein-cholesterol levels in lean patients. The insulin levels at 60 min during OGTT, homeostasis model assessment-insulin resistance and area under curve of insulin were significantly lowered in overweight women after 12 months of spironolactone and weight loss and no negative changes in insulin secretion and sensitivity were observed in PCOS women after pharmacological treatment alone. Conclusion: The efficacy of spironolactone on the androgenic clinical aspects of PCOS has been confirmed in this study. Furthermore, our data show that long-term treatment with spironolactone exerts no negative effects on lipoprotein profile and glucose metabolism; more relevant beneficial effects on glucose and lipid metabolism were observed when the antiandrogen was associated with weight loss in overweight PCOS women.
  288 52 -
Assessment of the survival of a single implant-supported cantilever prosthesis in the anterior mandible
Soni Kumari, Gagan Preet Singh, Kishor B Bagalkot, Angel Subramanium, Tarun Koshy Isaac, Chandni
November 2021, 13(6):1668-1671
Background: Implant dentistry has seen rapid and remarkable progress in recent years. The present study assessed the survival of a single implant-supported cantilever prosthesis (ISCP) in the anterior mandible. Materials and Methods: Sixty-four patients with missing mandibular anterior teeth of both genders were provided with a single implant and restored with cantilever screw-retained prosthesis. All were followed for 2.5 years for the implant and prosthetic success. Results: Age group of 20–30 years comprised 14 males and 10 females, 30–40 years had 10 males and eight females, 40–50 years had six males and seven females, and 50–60 years had four males and five females. The difference was nonsignificant (P > 0.05). A screw loosening was seen in total of 15 cases, in 1 at 12 months, 5 at 18 months, 2 at 24 months, and 7 at 30 months, and porcelain fracture was seen in total of eight cases, in 4 at 18 months, 1 at 24 months, and 3 at 30 months. The difference was statistically significant (P < 0.05). Conclusion: Screw-retained ISCP developed complications such as screw loosening and porcelain fracture.
  290 49 -
Acceptance of COVID-19 vaccine among dental professionals: A cross-sectional study among practitioners, residents, and students
Rethi Gopakumar, J Mahesh, Bijo Alexander, KS Arya, Sunil John, Shruthi Kumbla
November 2021, 13(6):985-988
Introduction: The COVID-19 pandemic spread rapidly across the world, prompting governments to impose lengthy restrictions on both movement and trade. While lockdowns reduce the prevalence of COVID-19 disease, they may have a negative impact on the economy and job levels. Dental medicine has been one of the most severely impacted industries during this crisis. Dental professionals are exposed to environments with high levels of occupational hazards, additional risks of viral exposure, and transmission. Methods: We analyzed 705 anonymous questionnaires filled out by dentists, dental students, and postgraduate students about their willingness to consider a new SARS-CoV-2 vaccine. Results: Our findings show a statistically significant relationship between an individual's unemployment rate and their ability to be immunized with a SARS-CoV-2 vaccine. Conclusion: As part of the global vaccination program's alertness, these data may be used to forecast patterns in vaccine adoption or denial depending on economic burden during the COVID-19 pandemic by various industries.
  284 54 -
Practice of occlusal splint therapy for treating temporomandibular disorders by general dentists of Jabalpur – A cross-sectional survey
Anubhuti Sabhlok, Shreya Gupta, Muktha Girish, K V Rahul Ramesh, Harshit Shrivastava, Sadananda Hota
November 2021, 13(6):1079-1083
Aim: The aim of this study was to conduct a cross-sectional questionnaire-based survey concerning the practice of occlusal splint for treating temporomandibular disorders (TMDs) by the dental practitioners of Jabalpur. Materials and Methods: A questionnaire containing questions on diagnosis, treatment, and management of TMD was given to a total of 157 general dental practitioners in Jabalpur. The responses were collected; data analysis was done by Chi-square test. Results: Of the General Dental Practitioner's, nearly 78% of participants did not attend any continuing dental education on TMD per year. More than 10 years of experience (82%) was associated with increase in positive response for treatment of TMD patient. Both the diagnosis and treatment of TMD patient were done using combination methods. The duration of splint use was considered patient dependent (42.27%) irrespective of the years of practice. Soft splint was most commonly employed for treatment, and fabrication of splint was done on hinge and mean value articulator. Conclusion: The knowledge of occlusal splint by general practitioners was found to be insufficient for treating TMDs.
  290 45 -
Evaluation of root dentin thickness and smear layer removal efficacy of two novel nickel titanium rotary instruments – An In Vitro cone-beam computed tomography and scanning electron microscopy study
Gangili Sparsha Reddy, Rajeswari Kalaiselvam, Arasappan Rajakumaran, Manigandan Kuzhanchinathan, Ram Sabarish, Arathi Ganesh
November 2021, 13(6):1628-1632
Objective: This study aimed to compare the two nickel–titanium (NiTi) instruments on root dentin thickness using cone-beam computed tomography (CBCT) and ability to remove the smear layer using scanning electron microscope (SEM). Materials and Methods: The effect of two NiTi rotary instruments such as XP Endo shaper and ProTaper Gold (PTG) in retaining adequate dentin thickness and debridement (i.e., removal of smear layer) was evaluated in vitro using CBCT and SEM. After cleaning and shaping of the root canal with adequate irrigation, the effect of two NiTi instrument systems at 3 mm (apical), 6 mm (middle), and 9 mm (coronal) levels on buccal, lingual, mesial, and distal aspects in terms of amount of dentin removal and smear layer removal was evaluated. The data were analyzed using student's unpaired t-test with a significance of P ≤ 0.05. Results: Both NiTi instrument systems had no statistically significant difference in amount of dentin removal at all three levels and on all four aspects. In smear layer removal, PTG had significantly better efficacy compared to XP Endo shaper at the coronal third of root canal. Conclusion: Instrumentation with XP Endo Shaper and PTG showed a similar amount of dentin removal. PTG has a significant effect on smear layer removal compared to XP Endo Shaper only at the coronal third of root canal.
  280 54 -
Traumatic ulcerations frequencies and postinsertion adjustment appointments in complete denture patients
Sony Saraswati, Priyanka Razdan, Smita, Monika Aggarwal, Devleena Bhowmick, Priyanka Priyadarshni
November 2021, 13(6):1375-1380
Background and Aim: The patient who is wearing a denture after missing teeth faces traumatic ulceration very frequently. This ulceration creates difficulties in denture wearing. Hence, this study aimed to evaluate the most common locations of traumatic injuries in form of ulcerations, their frequency, and also the duration and number of adjustment visits required to achieve patient comfort following placement of complete removable dentures. Materials and Methods: Eighty edentulous patients were selected from a private clinic. Complete removable dentures were fabricated for all patients. All patients were evaluated for their complaints after denture insertion. Patients were followed up till the problem persisted. Descriptive analysis was done. Chi-squared test was used to differentiate the associations between lesions, postinsertion visits, and gender. Results: About 85.62% of patients need denture adjustment because of mucosal injuries during their first visit following. Approximately four appointments are needed for maxillary and six appointments needed for mandibular denture. Male and female have no difference in the number of mucosal injuries in the anatomical area evaluated in the maxilla and mandible using Fisher's exact test (P > 0.05). Mandibular dentures need more appointments than maxillary dentures after post insertion (P < 0.001). Conclusion: The vestibule was the most common site for mucosal injuries which can be corrected by proper extension of denture flanges during border molding. Pressure indicator ink (arti spot) and paste is used to correct the overextended denture flanges.
  289 45 -
Evaluation of the orofacial features in the victims of abuse and neglect of 5–16-year-old age children
Wagisha Barbi, Ravindra S Sonawane, Pinky Singh, Saurav Kumar, Boddupally Ravi Kumar, Aafreen Arora
November 2021, 13(6):1705-1708
Background: Oral cavity may be considered a pivotal focal point in physical assault or abuse because of its implication in communication and nutrition. Dentists trained in a child abuse curriculum can provide valuable information and assistance to physicians about oral and dental aspects of child abuse and neglect. The present study was conducted to evaluate the orofacial features of children between the age group of 5–16 years suspected to be victims of child abuse/neglect. Materials and Methods: This study was conducted on 250 children ranging between 5 and 16 years were enrolled in the study. All the participants were suspected to be victims of child abuse/neglect. The orofacial features were carefully examined by a well-trained dentist. Results: Two hundred and fifty children were enrolled in the study. Seventy-two children (30%) presented with laceration of various sites including lip (n = 13), frenum (n = 8), buccal mucosa (n = 26), palate (n = 16), and floor of the mouth (n = 9). Twenty-nine participants exhibited the features of avulsion (11.6%). Eighteen children revealed dento-alveolar fractures, 104 presented with dental caries (41.6%), 19 presented with missing teeth (7.6%), all the candidates presented with deposits (100%). Conclusion: Careful intraoral and perioral examination of the participants victimized to abuse and/neglect is necessary as the oral cavity is a central focus for physical abuse, which may be allied to its importance in communication and nutrition. Physicians and dentists should work together to increase the prevention, detection, and treatment of these conditions.
  284 50 -
Role of facial index and odontometric parameters in the establishment of stature and gender of individuals
Tarunikaa Gopinath, Suryaprakash Ganesh, Vijaya Nirmala Subramani
November 2021, 13(6):1068-1073
Background: Dental anthropology is an important aspect of bioarchaeology and forensic anthropology. In forensic anthropological studies, identifying an unknown individual from a mangled and decomposing body is a challenging task. Cranial remains are the only critical clues available for personal identification. Age, sex, and stature are significant parameters in establishing the identity of an unrecognized individual. Stature is the natural height of the individual in an upright position. Stature can be estimated from various parts of the body such as long bones, short bones, and skull. Few studies conducted in specific population have established a correlation for predicting stature from cephalometric and odontometric parameters. Thus, the present study was conducted to determine stature and gender based on cephalometric and odontometric parameters in the population of Tamil Nadu. Aims: The aim of this study was to investigate the possibility of predicting the stature and gender of an individual based on odontometric measurements, facial height, and bizygomatic width. Materials and methods: A total of seventy individuals in the age group of 18–24 years were selected for the study. The facial height, bizygomatic width and length ,mesiodistal and labiolingual diameter of clinical crown of maxillary central,lateral and canine teeth of both the right and left quadrants were measured. The values were analyzed statistically. Through this analysis, regression equations for estimation of stature from odontometric and facial index were derived. Results: Pearson correlation test was carried out to establish a correlation between the stature and the measured parameters. Regression analysis was carried out to establish stature from the odontometric and facial index of the individual. The regression equations were used to get estimated stature in the same sample of volunteers from which regression equations were obtained. Tabulated results showed a probable correlation between various parameters. Conclusion: In our study, a positive correlation between cephalometric measurements, gender, crown length of permanent left central incisor, and combined mesiodistal diameter of permanent maxillary anteriors with stature was found. This can be used as a supplementary method for estimating the stature of unknown human bodies.
  290 43 -
Comparative evaluation of shear bond strength of brackets bonded with self etch primer/adhesive and conventional etch/primer and adhesive system
Debarshi Bhattacharjee, Kanchan Sharma, Rajalaxmi Sahu, Komal Neha, Archana Kumari, Anurag Rai
November 2021, 13(6):1168-1173
Introduction: The shear bond strength obtained with an acid primer might not be clinically reliable. The present study evaluated the use of a new self-etch primer as compared with the conventional bonding procedure. The findings indicated that the use of a self-etch primer to bond orthodontic brackets to the namel surface provided lower, but clinically accept-able, shear bond forces (mean, 7.1 ± 4.4 MPa). Hence, this study has been designed to evaluate the shear bond strength of orthodontic brackets bonded with a self-etching primer system, and compare it with the conventional acid etching priming system. Materials and Methods: This study was designed to compare the shear bond strength of orthodontic brackets bonded with conventional acid etching- priming and a self-etching primer. For this purpose, one hundred and twenty noncarious, not subjected to any pretreatment chemical agents (e.g. hydrogen peroxide), no cracks caused by the presence of the extraction forceps, no caries and unrestored human maxillary 1st and 2nd premolars, freshly extracted for orthodontic treatment were collected and stored in distilled water before bonding. Separate molds of cold-cure acrylic were prepared and the extracted premolar teeth were embedded in the cold cure acrylic up to the cement enamel junction. Results: For the control group, the mean shear bond strength was 9.38 ± 6.02 MPa and for the experimental group, it is 6.91 ± 3.58 MPa. Group comparison using Chi-square test for the self-etching primer group adhesive remnant index (ARI) scores shows that more than half of the adhesive left over the tooth surface (score 3 and 4). For the conventional group, ARI scores show that there was no or slight amount of adhesive left over the tooth surface (score 5). The proportion of ARI score is significantly (P < 0.001) more in conventional (68.33%) as compared to self-etch primer (SEP) (28.33%). The proportion of ARI scores 4 and less is significantly more in SEP (71.67%) as compared to Conventional (6.67%) with P = 0.004 as per the Chi-square test. Conclusion: The bond strength of SEP is comparatively lesser than the conventional acid etching technique, but is definitely more or less to the required bond strength to resist masticatory forces. Majority of the studies conducted on self-etching primer are in vitro studies. Results of these cannot be extrapolated to the intraoral environment. Hence, further long-term clinical studies need to be carried out before actually recommending the use of self-etching primer in routine orthodontic bonding.
  282 49 -
Genotoxic effect of various forms of tobacco on oral buccal mucosa and nuclear changes as a biomarker
Sowmiya Devadoss, Murali Chinnakonda Raveendranath, T Shanmugam Kathiresan, Kesavan Ganesan
November 2021, 13(6):1141-1148
Aim: The present study aims to assess the genotoxic effect of various forms of tobacco users on buccal mucosa and nuclear changes as biomarkers. Materials and Methods: The study involves 150 cases, they were divided into three groups (two study groups and one control group). The buccal cytological smears were taken from three groups: Group I – 50 smokers, Group II – 50 nonsmokers (smokeless tobacco), and Group III – 50 control group. The buccal cells were transferred into a test tube containing Tris-ethylenediaminetetraacetic acid buffer (pH = 7) and was centrifuged (Remi® 1500 revolution/min [rpm]). Cell suspensions were transferred to the slides and fixed. The slides were stained using PAP and Feulgen stain. The MN and other nuclear abnormalities were studied and compared. Results: Nonsmokers (smokeless tobacco) had significantly increased frequency of all nuclear anomalies compared to smokers and healthy controls. Binucleation, karyorrhexis, micronuclei (MN), karyolysis, broken egg nuclei, and prominent nucleoli in nonsmokers (smokeless tobacco) and condensed chromatin in smokers were the most frequent anomalies. Binucleation and karyorrhexis were significantly more frequent in nonsmokers (smokeless tobacco) compared to smokers. The other nuclear abnormalities were not statistically significant in smokers and nonsmokers (smokeless tobacco). Conclusion: Numerous studies have stated that MN and other nuclear anomalies were present in higher frequency in smokers and nonsmokers. In our study, we found binucleation and karyorrhexis were statistically significant in nonsmokers (smokeless tobacco) compared to smokers. The other nuclear anomalies showed insignificant results. In order to further validate the significance of this study, a larger sample size has to be studied. On comparing the staining efficacy of smokers and nonsmokers using PAP and Feulgen stain, both the stains showed positive results. In the present study, DNA-specific Feulgen stain shows better staining of nuclear anomalies compared to DNA nonspecific PAP stain, which was found to be statistically significant.
  288 42 -
Effect of acidic beverages on color stability and microhardness of various esthetic restorative materials: A comparative study
Aradhana Rathod, Suneel V Vadavadagi, Tanya Verma, Pawan Kumar, Potluri Venkataratna Deepak, Saikat Deb, Azhar Iqbal
November 2021, 13(6):1084-1087
Aim: The aim of this study was to assess the effect of acidic beverages on color stability and microhardness of various esthetic restorative materials. Materials and Methods: A total of 60 samples were included in the present study. Group I: Microhybrid composite resin, Group II: Nanoceramic, Group III: ORMOCER (Organically Modified Ceramics). 10 mm internal diameter and 5 mm depth of cylindrical aluminum mold of were utilized to prepare the samples. All the esthetic restorative samples were submerged for 10 min in 25 ml of acidic drink (Coca-Cola) each day up to 15 days. Vickers diamond intender was used to measure the microhardness of each sample. These values were calculated with baseline, 7th, and 15th days for final microhardness values. Results: The mean surface microhardness of 63.20 ± 0.46 was shown by Group III which was slightly more than that in Group II (60.08 ± 0.34) and Group I (58.10 ± 1.76). Analysis of covariance did not show any statistically significant difference between the groups. The samples in Group I showed the highest reduction in surface microhardness value after immersion into acidic drink, followed by Group II and Group III on 7th day and 15th day. A statistically significant difference (P < 0.001) was found on the 7th day. Conclusion: The present study concludes that the Organically Modified Ceramics esthetic restorative material showed the finest behavior after being dipped in the acidic drink followed next by Nanoceramic and Microhybrid composite resin.
  278 52 -
Geometry of implant abutment surface improving cement effectiveness: An In vitro study
Aradhana Rathod, Mohammad Jalaluddin, Shrinivas, Trupti Jagannath Devadiga, Shruti Jha, Khaled M Alzahrani
November 2021, 13(6):1093-1097
Aim: The aim of the study was to investigate whether the surface geometry or topography of implant abutments affects the retentive strength of prosthesis cemented with zinc phosphate on standard machined, sandblasted, and grooved implant abutments and to compare the results between them. Materials and Methods: Fifteen similarly shaped implant abutments (MDcpk61; MIS Implant Technologies Ltd.,) (height 6.0 mm and 6-degree taper) were divided into three groups (n = 05): Group I – standard machined abutments without grooves, Group II – sandblasted abutments (same as Group I but sandblasted with 50 μ aluminum oxide), and Group III – abutment with prefabricated circumferential grooves. Further in these groups of 15 abutments, 5 abutments each are to be taken to check the retentive force of zinc phosphate cement. Fifteen identical cast copings was prepared to fit all 15 abutments. The castings will be cemented to each group of abutments with an above-mentioned luting agent. After thermal cycling and storage for 6 days in a water bath, a retention test is to be done with a tensile testing machine (Instron) (5 mm/min) and retentive forces will be recorded. Data will be subjected to one-way ANOVA test and Student's t-test. Results: For zinc phosphate cement, F = 30.53 (>3.59 for P = 0.05) shows a statistically significant difference between all the three groups. Conclusion: Circumferential grooves on implant abutments give better retention when compared with standard machined (plain) and sandblasted abutments despite marked difference. Clinical Significance: Retention of restoration depends on the surface of the abutment as well as the luting agents used. Incorporation of retentive grooves can enhance retention of prosthesis, especially in situation of short abutments.
  280 49 -
Prevalence and distribution of selected dental anomalies in the patients reporting to dental institute, RIMS, Ranchi
Sumit Mohan, Butta Viswanath, Jyoti Thakur, Shweta Tekriwal, Anubhuti Singh, Rima Jaiswal
November 2021, 13(6):993-996
Aim: The purpose of this study was to determine the prevalence of developmental dental anomalies in the East Indian subpopulation. Materials and Methods: The study was based on clinical examination, evaluation of dental casts, and radiographs of 2385 Indian patients (1169 males and 1216 females), who visited Dental Institute, Rajendra Institute of Medical Sciences, Ranchi. These patients were examined for shape anomalies, number anomalies, structural anomalies, and positional anomalies. Results: It was observed that 5.83% of patients reported with a dental anomaly. Males reported with higher incidence with a male-to-female ratio of 1: 0.96. Microdontia was the most common anomaly. Unilateral microdontia was more common than bilateral and was more prominent in males (9.05%). It was observed that peg laterals were frequently encountered developmental anomaly at 1.34%, while the incidence of amelogenesis imperfecta and dentinogenesis imperfecta was 0.29% and 0.33%, respectively. The present demography reported a very low incidence of dens, fusion, hyperdontia, hypodontia, and macrodontia at <0.01%, whereas anomalies such as transportation, transmigration, and hypodontia of the maxillary molar reported no prevalence. Conclusion: The percentage of dental anomalies although low should be treated as soon as possible to avoid further complications. The results of our study can serve as an indicator to ascertain the pattern of dental anomalies in Jharkhand. This might help to plan the dental treatment of the community.
  278 51 -
A comparative evaluation of transbuccal versus transoral approach for the management of mandibular angle fractures: A prospective, clinical, and radiographic study
Kritika Sehrawat, Bhavna Malik, HV Vallabha, Amrutham Bhavya Vaishnavi, Siva Kumar Pendyala, Mohammed Ibrahim, Fatima Abdullah Binyahya
November 2021, 13(6):1295-1299
Introduction: In the facial bones, the angle of the mandible is the common site of fractures. Furthermore, it is the site with the highest number of complications after fracture and hence needs an efficient fixation. The right approach is still debatable for the angle fractures. In the light of these factors, we evaluated the transoral and the transbuccal approaches for the treatment of fractures at the angle of the mandible. Materials and Methods: Twenty patients were equally divided into two groups of transoral and transbuccal methods. The parameters such as ease of access, surgical time, occlusion, postsurgical infection, fracture gaps, scarring, and complications were noted, and the values that were compared were statistically analyzed. P < 0.05 was considered statistically significant. Results: No significant variations were seen in the variables such as ease of access, occlusion, postsurgical infection, and fracture gaps. Surgical time was significantly less for the transoral method. Negligible scarring was noted in the transbuccal method. Conclusion: Although both the methods were comparable, the transbuccal approach was more efficient for the mandibular angular fracture treatment.
  278 48 -
A radiological evaluation of bone healing in postextraction sockets following bone grafting using beta-tricalcium phosphate and calcium phosphosilicate: A controlled comparative study
Alangkar Saha, R Sathish, Suhas Setty, Abhijit Maji, Jayanta Saha, Abhishek Chatterjee
November 2021, 13(6):1240-1243
Background: Healing unbinds a well choreographed array of cellular, physiologic, biochemical, and molecular processes directed toward restoring the integrity and functional capacity of the damaged structures. The rate and degree of healing vary among individuals but is greatest during the first few months or years after tooth loss. Evidence suggests that alveolar bone ridge resorption may be prevented, initially by reconstructive surgical techniques using several materials which are employed at the time of extraction. This droves to the development of bone substitutes materials such as hydroxyapatite, beta tricalcium phosphate (β TCP), and bioactive glasses. These regenerative materials not only act as an osteoconductive scaffold but also interact with the surrounding tissues and impart an osseostimulatory effect. Methods: Twenty adult patients who required bilateral removal of homologous tooth, were informed and described regarding post extraction socket grafting using β TCP and CPS followed by covering with Collagen Membrane. Radiographic densitometry evaluation of postoperative visits of immediate; 1st month; 3rd month; and 6th month using orthopantomograph was done. Results: The Karl Pearson's Correlation coefficient was used to determine the degree of bone density with adjacent bone preoperatively and postoperatively. The statistical evaluation, CPS was more superior to β TCP, with a difference of 58.75 and P value showed more significance (<0.0001). Conclusion: This article evaluates radiographically quality and quantity of bone formation in the socket, following extraction and bone grafting using Calcium Phosphosilicate (CPS) and β TCP, it is concluded that the two modalities of treatment were efficient in improving the clinical outcome parameters as well as showed comparable regenerative effects when used in the treatment of “socket grafting” while between them CPS more superior to β TCP biomaterials by Osteogenic properties.
  286 38 -
A comparative evaluation of the effectiveness of added auxiliary features, occlusal surface modifications, and reduction of total occlusal convergence on the resistance of full veneer metal crowns on a molar tooth with inadequate resistance form: An in vitro study
Nitu Agrawal, Rahul Kishore Chaudhari, Anjali Gaurishankar Gheware, Azeem Ul Yaqin Syed, Tabish Rashidi, Hadeer Bhutta
November 2021, 13(6):1015-1018
Introduction: Single crowns or fixed partial dentures retainers usually get dislodged due to inadequate resistance form. Hence, it is prudent to evaluate features of a tooth preparation, which can prevent these failures. Aim: To evaluate the effect of auxiliary features, occlusal surface modifications, and total occlusal convergence (TOC) on the resistance of a full veneer crown. Materials and Methods: An ivorine mandibular molar tooth was prepared with features of inadequate resistance form, i.e., 2.5 mm axial wall height and TOC of 20°. Seven auxiliary preparation features were subsequently added one by one to it. They were mesiodistal grooves, buccolingual and mesiodistal grooves, buccolingual grooves, mesiodistal boxes, occlusal inclined planes, 8° reduced TOC in the cervical aspect, and mesiodistal grooves added to 8° reduced TOC in the cervical aspect. Ten dies with their respective crowns were prepared for each group. Resistance testing of all the samples was performed on the INSTRON testing machine. Results: Modification of the overtapered die preparation by reducing the TOC to 8° in the cervical 1.5 mm of the axial wall and then subsequently adding mesiodistal grooves to the reduced TOC cervically offered the greatest resistance to dislodgment statistically. Conclusion: For an overtapered preparation, reducing the TOC to 8° in the cervical aspect and subsequently adding proximal grooves can provide maximum resistance form.
  280 44 -
Knowledge and experience of women about dental services utilization during pregnancy: A cross-sectional questionnaire study
Kapu Swathi, Ramesh Kumar Koothati, Rashmitha Roy Motor, Priyadarshini, CH RajaShekar, Sunayana Vallakonda
November 2021, 13(6):1042-1046
Aim of the Study: The present study was aimed to assess the knowledge and experience of women about dental services utilization during pregnancy. Methodology: A hospital-based, cross-sectional questionnaire-based study was conducted among 300 women of age between 18 and 45 years who attended Malla Reddy Dental Hospital during 3 months period from October 2019 to December 2019. A questionnaire was distributed to all the participants who had given consent to participate in the study. Results: Only 30.7% of the participants attended for dental checkup during their pregnancy. Among them, most of the people (52%) had visited dentist for toothache, followed by gum care (29.34%) and regular checkup (18.47%). Most of the subjects (69.3%) did not use dental services as they were unaware of dental checkup during pregnancy. A significant difference was found between the urban and rural participants regarding the visit to the dentist during pregnancy (P = 0.000, Chi-square value = 19.157). Conclusion: Most of the women unaware of dental checkup during pregnancy. They were also not sure aware of dental treatments which can be done during pregnancy and consequences of poor oral hygiene on pregnancy outcome.
  270 51 -
Comparative evaluation of salivary biomarker levels in e-Cigarette smokers and conventional smokers
Abhishek Verma, Kumar Anand, Manish Bhargava, Amulya Kolluri, Madhuresh Kumar, Devendra H Palve
November 2021, 13(6):1642-1645
Background: The cigarette smoking and its effect on the inflammatory cytokine levels in the smoker's saliva depicted the influence of electronic cigarettes on oral cytokine levels in oral fluids are scarce in the literature. Objectives: The present trial was conducted to compare and determine the proinflammatory and anti-inflammatory cytokines in whole stimulated saliva samples of electronic cigarette smokers, conventional smokers, and participants with no smoke exposure. Materials and Methods: Sixty adult participants were divided into the following four groups of nonsmokers, current smokers, smokers smoking both conventional and e-cigarettes, and e-cigarette smokers. The saliva samples were assessed for Interleukins (IL-1B, 6, 8, 10, and IL-1RA), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) using enzyme-linked immunosorbent assay. Plaque scores and Gingival Index, and body mass index were also calculated. Results: Statistically significant (P < 0.05) and remarkable relationship was seen in plaque scores and IL 1RA, 1 β, and 10 with the respective values as-0.285, 0.268, and 0.267. Regarding anti-inflammatory cytokines, CRP, IL-10, and IL-RA had the P-value of 0.073, 0.945, and 0.834 respectively. When these values were evaluated for proinflammatory cytokines, the P values were 0.0001, 0.019, 0.991, and 903 for TNF-α, IL-1 β, IL-6, and IL-8, respectively. These results were statistically significant for TNF-α (P = 0.001). Conclusion: Within its limitations, the present study concludes that smoking e-cigarettes whether solely or in combination with conventional smoking increases the levels of proinflammatory cytokines such as TNF-α and IL-1 β with decreased counter IL-1RA levels.
  270 49 -
Evaluating the effect of ormeloxifene on multiple fibroadenomas and mastalgia
Swagata Brahmachari, Vaishali Bhagat, Pooja Patil, Vikram Vasuniya
November 2021, 13(6):1386-1389
Introduction: Most common benign breast conditions presenting in the breast clinics include fibroadenomas and mastalgia, both these conditions cause considerable anxiety in the patients. Among other treatment modalities, the hormonal drug treatments are gaining popularity. Ormeloxifene (centchroman) is an antiestrogenic drug which is shown to have effect in reducing the pain in mastalgia patients and the size of fibroadenoma. Objectives: Ormeloxifene is selective antiestrogen and a nonsteroidal drug. It has a discerning antiestrogen action and hence is useful for the treatment of mastalgia and multiple small fibroadenomas. Hence, the objective of our study was to assess the effect of Ormeloxifene (centchroman) on multiple fibroadenoma and mastalgia. Materials and Methods: Patients with benign breast disease attending our surgery outpatient department from June 2016 to July 2017. Patients were started on Ormeloxifene 30 mg on alternate days for a period of 3 months. Patients were followed up to 6 months after the inception of the study. Parameters recorded include the Visual Analog Scale (VAS) for pain and ultrasonography for breast lump size. Results: Thirty patients were included in the study. We found very good response in the mastalgia; the VAS scores in these patients dropped from 10 to 3 in 90% in the 1st week of introduction of the drug, and at the end of 1 month, almost all of the patients were painless. Overall final response was noted in terms of complete dissolution and change in the size was noted in 34% partial response in 46 %, no changes in 17 % and increase in size of fibroadenoma was noted in only one case. Conclusion: Novex is proved to be safe drug for the treatment of mastalgia and fibroadenoma. Its results were great in mastalgia group. At the end of 6 months, the number of surgeries (if needed) decrease and there is considerable improvement in the patient satisfaction rate.
  270 47 -
Comparative evaluation of classical inferior alveolar nerve block and gow-gates nerve block for surgical removal of mandibular third molar: A prospective study
Abhilash Mathews Thomas, Ummar Mangalath, Roshni Abida, Sachin Aslam, Sooraj Soman, Rakesh B Nair
November 2021, 13(6):1011-1014
Background: The most commonly used nerve block procedure to anesthetize the mandibular arch is the classical inferior alveolar nerve block (IANB). In 1973, Gow-Gates developed a new procedure known as the Gow Gates nerve block, to achieve anesthesia in the same area with fewer complications. Methodology: The study comprised 80 patients who reported for the surgical removal of impacted third molar. The patients were randomly assigned into two groups– Group I received Gow-gates nerve block and Group II were administered classical IANB. Positive aspiration, meantime for the onset of anesthesia, mouth opening before and after each block and pain during the surgical procedure were compared. Results: Group 1 yielded positive aspiration in 2.5% of the cases (one patient) and 15% had positive aspiration in Group 2 (six patient). The mean time taken for onset of anesthesia was 6.16 min in Group 1 as compared to 2.78 min in Group 2. While comparing the quality of anesthesia between the blocks, 87.5% of the patients in Group 1 and Group 2 had successful anesthesia equally i.e., 35 of the 40 patients fell into category 1 and 2 of the eight-point category rating scale in both the groups and the remaining five patients (12.5%) in both the groups had unsuccessful anesthesia. Conclusion: Both approaches offer quality anesthesia in the posterior mandibular area when meticulously followed. The percentage of unsuccessful anesthesia in the Gow-Gates group could be attributed to the inexperience of the operator. Postoperative comfort and patient satisfaction were greater in the other group.
  278 39 -
Evaluation of the effect of different types of fluoride on tensile properties and surface roughness of different titanium-based archwires: An In vivo study
Rajkumar Balakrishnan, Sumaya Yousuf Jeri, VR Rekha, Gangesh Bahadur Singh, PR Deepak, Achuthan Nair
November 2021, 13(6):1193-1198
Objectives: The purpose of the study was to evaluate the effect of different types of fluoride on tensile properties and surface roughness of titanium based archwires clinically. Materials and methods: Three groups of archwires, namely nickel–titanium (NiTi), heat activated NiTi, and TMA was evaluated clinically. Each group comprised four subgroups, namely as received group, nonfluoride control group, APF gel group (received one application of 1.23% APF gel), and sodium fluoride mouthwash group (patients rinsed twice daily with 0.2% sodium fluoride mouthwash). All the archwires were removed after 3 weeks of clinical use and evaluated for surface roughness with three dimensional optical profiler. Tensile strength and elongation rate was determined with Instron universal testing machine. Results: NiTi, heat activated NiTi, and TMA archwires with APF gel application showed the highest reduction in tensile strength and elongation rate and highest value for surface roughness, followed by sodium fluoride mouthwash group and finally wires without fluoride application. NiTi wires had the highest reduction in tensile strength with APF gel followed by heat activated NiTi and TMA. Conclusion: APF gel with highest concentration of fluoride caused most degradation in the tensile properties and surface roughness of titanium based arch wires.
  274 42 -
Clinicopathological correlation of pulp stones and its association with hypertension and hyperlipidemia: An hospital-based prevalence study
Gowthami Jawahar, Gururaj Narayana Rao, A Alagu Vennila, S Deenul Fathima, M K Keerthik Lawanya, Daffney Mano Doss, I Anand Sherwood, A Annie Antinisha, B Bhuvana
November 2021, 13(6):1268-1274
Introduction: Pulp stones are the discrete calcification, located in pulp tissue or attached to or embedded in dentin. It occurs in physiological and pathological conditions. The exact etiopathogenesis of various types of pulp calcifications is unknown and the prevalence varies from 8% to 90%. The histopathological identification of pulp stones is higher than the radiological identification. Objective: The aim of the study is to evaluate and correlate the clinical parameters and histopathological analysis of pulp stone with systemic hypertension and hyperlipidemia. Materials and Methods: Seventy patients were selected for the study and a detailed case history was recorded. The radiological investigations were noted down and extirpated pulp tissues were sent for processing. The results were analyzed statistically using Chi-square test. Results: Out of 70 patients studied, pulp stones were observed radiologically in 14 patients and histopathologically in 30 patients. The presence of irregular and nonlaminated type of pulp stones histopathologically was significantly correlated with hypertension and hyperlipidemia. Conclusion: The patients with the histopathological presence of nonlaminated and irregular-shaped pulp should be evaluated for lipid profile and hypertension.
  270 46 -
Comparison of the efficiency and treatment outcome of patients treated with corticotomy-assisted En masse orthodontic retraction with the en masse retraction without corticotomy
Shubham Kumar, Saurav Kumar, Nadira Hassan, Sabika Mazhar, Ravi Anjan, Bharti Anand
November 2021, 13(6):1320-1323
Background: Corticotomy in fixed orthodontic treatment gives a potential approach to reduce the treatment duration. Typically, this duration of rapid tooth movement lasts 4–6 months. Aim: The aim of this study was to compare the treatment outcome and effectiveness in en masse retraction with and without corticotomy. Materials and Methods: Thirty-two patients (male 16 and female 16) who opted to undergo surgery to reduce the orthodontic treatment time were chosen for the research, and the group consisted of 26 patients (male 13 and female 13) who did not opt for the corticotomy procedure were selected as the control. There was no blindness of the party distribution. It was focused on the patient's ability to opt for an additional minor surgical procedure that may affect orthodontic treatment length. The operation was conducted under local anesthesia (Lignox 2%). The same maxillofacial surgeon performed all the surgical operations. Results: The space present in the maxillary and mandibular arch at the time of retraction had no statistically significant difference in both the control and study groups (P > 0.05). In comparison, the mean amount of retraction space in the maxillary arch and maxillary arch was significant in the control and study groups at 1 month, 2 months, 3 months, and 4 months of the time interval. Conclusion: It can be concluded that corticotomy-assisted retraction significantly decreases the total length of orthodontic care. Effectively stationary anchorage segment was made, thereby removing the need for other anchorage boosters, instrumental in maximum anchorage cases using corticotomy technique.
  269 47 -
Quadruple score: A novel scoring system for diagnosing breast lump – A retrospective pilot study
Swagata Brahmachari, Vikram Vasuniya, Soma Mukherjee, Aditi Chaurasia
November 2021, 13(6):1381-1385
Background: Triple test was a breakthrough in the initial screening of breast cancer due to its high sensitivity, but it has few limitations. To overcome those limitations, we developed a novel quadruple score which included physical examination, ultrasound, mammography, and fine-needle aspiration cytology (FNAC). Aim: The aim of this study was to test the sensitivity, specificity, negative predictive value (NPV), and positive predictive value of a novel quadruple score for the initial screening of breast cancer. Methodology: This retrospective study was conducted on 320 patients having breast lump to the Breast Cancer Outpatient Department of AIIMS, Bhopal. The physical examination findings, breast sonography findings, mammography, and FNAC findings were recorded in the set pro forma, these were later analyzed, and a cumulative scoring was done categorizing patients in the benign, dubious, and malignant category according to the QTS score. These findings were then validated and compared by histopathology. Results: Statistical results show a positive covariance σ suggesting the positive relation between them; also, the correlation coefficient was 0.9996 suggesting a strong linear correlation. On comparing the accuracy of all four variables as physical examination, USG, mammography and FNAC individually and QTS, the accuracy of QTS was highest i.e 99.44%. Conclusion: QTS is accurate and reliable diagnostic approach for evaluation of breast lumps. By using the quadruple scoring system, management of palpable breast lump will become more streamlined, providing a platform for managing discordant results, which can be followed universally.
  281 35 -
Analyzing effects of sickle cell disease on morphometric and cranial growth in Indian population
Kumari Menka, Kumar Anand, Mrigank Shekhar Jha, Abhinav Goel, Saba Nasreen, Devendra H Palve
November 2021, 13(6):1402-1405
Background: Sickle cell disease is the most pervasive autosomal recessive hereditary blood diseases and is characterized by the presence of sickle hemoglobin (HbS), which in turn gives rise to pathophysiological consequences. This HbS reduces the agility of erythrocytes plummeting their ability to pass through small vascular channels, which in turn results in increased blood viscosity and congestion of vascular beds, causing ischemia, local infarction, and hemolysis. Objectives: The current study was conducted to carry out the morphometric analysis in patients with sickle cell disease. Materials and Methods: This study was conducted on 75 subjects detected with sickle cell disease aged between 8 and 16.5 years. The study involved 38 males and 37 females. All the subjects were subjected to lateral cephalogram for the calculation of various angular and linear dimensions of the craniofacial structures. The linear measurements made were nasion-menton height, anterior nasal spine (ANS)-menton height, and nasion-ANS height, whereas the angular measurements made were Frankfurt mandibular plane angle, Frankfort mandibular incisor angle, and incisor mandibular plane angle. Results: Major chunk of the subjects had retruded mandible and vertical growth pattern. Few subjects exhibited with maxillary protrusion. Conclusion: It is concluded that early diagnosis and management of dental malocclusion in patients with sickle cell disease plays a pivotal role in an attempt to endow with a better quality of life to these individuals.
  276 40 -
Compound and complex odontomes: Case series with surgical management and brief review of literature
S Sajesh, Effie Edsor, S Nandagopan, S Sindhuja Devi, Venkatesh Praveen, Swaminathan Chidambareswaran
November 2021, 13(6):1772-1777
Odontomas are the most commonly occurring odontogenic tumor, and earlier they were considered developmental anomaly as the morphodifferentiation of ameloblast does not occur in odontomas. Odontomas are considered hamartoma rather than true neoplasms as histologically they contain odontogenic tissues which are native to the oral cavity. These odontomas are usually asymptomatic and are revealed in radiographic examination but can also present with over-retained deciduous teeth and malocclusion and with other local complications such as infection. Etiology of odontomas is considered to be from genetic, local environmental, and systemic factors. Broadly based on their radiologic and clinical features, they are classified into two types: compound composite odontomas and complex composite odontomas. The odontomas which resemble teeth are called compound composite odontomas and which do not resemble teeth are called complex composite odontomas. Odontomas are called composite odontomas as they contain both epithelial and mesenchymal derivatives. Here, we report two cases of compound composite odontoma, and a case of complex composite odontoma with relevant review of literature.
  266 47 -
Prevalence of periodontal disease and oral hygiene practices in Kancheepuram District population: An epidemiological study
Maharshi Malakar, PL Ravishankar, AV Saravanan, K Sunanda Rao, R Balaji
November 2021, 13(6):1517-1522
Background and Objectives: The purpose of the study was to evaluate the prevalence of periodontal disease status and oral hygiene practices in urban and rural population of Kancheepuram District, Tamil Nadu, India. Methods: This epidemiological survey was carried out on 1650 participants taken from both urban and rural areas of Kancheepuram District. The study groups will belong to rural and urban areas in the ratio of 1:2, respectively. Every individual was assessed with the oral hygiene index-simplified, community periodontal index of treatment needs and periodontal disease index. In addition, the oral hygiene practices were also studied and recorded in a specially designed pro forma. Data were subjected to statistical analysis using SPSS 19.0 software. Results: The study showed that 50% and 36% of the study participants have gingivitis and periodontitis, respectively, while only 14% of the study participants did not present with any form of periodontal disease. The study also showed that 16.63% of the study subjects among urban and 7.63% of them among rural do not have any type of periodontal disease. About 57.09% of the study participants among urban and 36.54% of the study participants among rural areas have gingivitis. The remaining 26.3% of the study participants in urban areas and 55.8% of the study participants in rural areas have periodontitis. It was observed that majority of participants brush once a day using Medium bristle tooth brush and toothpaste as dentifrice. Conclusion: Periodontal disease is widely spread among population of Kancheepuram District, with greater prevalence in rural population than in urban population. This could be mainly due to the lack of awareness and limited availability of resources. These estimates are vital for the future planning of dental services in Kancheepuram District, Tamil Nadu, India.
  274 39 -
Effect of the use of die lubricant on the marginal fit of wax patterns
Ajinkya Wagh, Mahesh Gandhewar, Pankaj Pawar, Ashada Chavan, Snehal Kharwade, Anjali Mendhe, Devina Singh
November 2021, 13(6):1115-1118
The aim of this study was to evaluate the effect of die lubricant on the fit of wax patterns. An ivorine tooth was prepared to receive full-coverage metal-ceramic restoration with 360° shoulder finish line. The tooth was duplicated 40 times using additional silicone. The impression was poured with Type IV dental stone. These 40 dies were divided into 2 groups 20 each. Group A: The patterns were fabricated with the use of die lubricant. Group B: The patterns were fabricated without the use of die lubricant. Later, these patterns were sequentially checked for the marginal fit on the stereomicroscope. The readings from the stereomicroscope were tabulated; independent Student's t-test was used to compare the marginal fit between Group A and Group B. The mean gap on all four tooth surfaces in Group A (with use of die lubricant) was more compared to Group B (without use of die lubricant). Conclusion: Die lubricant definitely has their effect on fit of the wax pattern which later might be duplicated in the casting.
  268 44 -
Antibiotic prescribing knowledge, awareness, and attitude of dental surgeons practicing in the urban Indian population
Rathi Rela, Aarti Vidyasindhu Sejao, Ankita Singh, Prabhat Kumar Singh, Mukesh Kumar, Shweta Kirti Gupta, Priyadarshini Rangari
November 2021, 13(6):1637-1641
Background: Studies have reported that dental procedures may serve as a portal of entry for bacteria into the blood circulation, commonly termed as bacteremia which may inhabitate the heart and joints subjected to repair and replacement by prosthesis and may lead to complications in immunocompromised patients. Dental procedure may play a pivotal role in the development of infective endocarditis and infection around the prosthetic joint. Antibiotic use is suggested for all dental procedures requiring gingival manipulation or of the periapical region of teeth or mucosal incision in these patients. Objective: The present study has been conducted to inspect the antibiotic prescribing practices of general dentists among 250 dental practitioners. Methods: The study was conducted on 250 dental surgeons practicing in the urban Indian population of various parts of the country. A validated questionnaire was developed by a multidisciplinary dental and medical team and was circulated on the subject of the basic knowledge and awareness about antibiotic prophylaxis in susceptible patients. The data from the participants were collected, collated, and statistically analyzed. Results: The present study comprised 250 dental surgeons; 178 out of 250 were male, whereas 72 were female. Antibiotic prophylaxis guidelines were followed by 169 practitioners (67.60%), whereas 81 (32.40%) dentists did not follow any guidelines. Out of 169, 67 followed the American Academy of Orthopaedic Surgeons (AAOS) guidelines (39.64%), 58 followed American Heart Association (AHA) guidelines (34.30%), whereas 44 followed general physician's guidelines (26.03%). On screening the underlying conditions for which antibiotic cover was prescribed, it was shown that majority of the dental surgeons did the same for patients with cardiac valve repair or replacement (230; 92%), followed by infective endocarditis (212; 84.80%); organ transplant (212; 84.405); diabetes (189; 75.60%); prosthetic joint replacement (150; 60%); and congenital heart defect (110; 44%). Conclusion: Patients should then be trained to perform meticulous oral hygiene and advised to schedule regular dental checkups to maintain optimal dental health. Dentists should use antibiotic prophylaxis in only conditions associated with a valid scientific basis and should follow the standard protocols recommended by the American Dental Association, AHA, or AAOS.
  266 45 -
Intraoperative management of recurrent leukoplakia at red zone
S Elengkumaran, C Deepak, A Emmanuel Dhiravia Sargunam, C Ravindran, Sharada T Rajan
November 2021, 13(6):1744-1746
Oral leukoplakia (OL) is a potentially malignant oral disorder (PMOD) that sometimes trans-form into oral squamous cell carcinoma (OSCC). OL is one of the most frequent PMODs seen in the oral cavity. The global prevalence of OL is approximately 2.6%, with its worst prognosis of undergoing a malignant transformation. Leukoplakia is clinically divided into red zones (tongue and floor of mouth) and nonred zones (buccal mucosa, palate, and soft palate) areas. The red zone areas have more potency of transforming into malignancy. Hence, patients with red zone areas need to be followed up more frequently and treated appropriately. This case report signifies the importance of treating one such case of leukoplakia at red zone area.
  268 42 -
Investigation of candidal species among people who suffer from oral potentially malignant disorders and oral squamous cell carcinoma
Mohammed Abidullah, Sunitha Bhosle, Bruhathi Komire, Priyadarshini Sharma, K Swathi, L Karthik
November 2021, 13(6):1050-1054
Aim and Objective: The aim of the present study was to evaluate the candidal species among masses with oral potentially malignant disorders and oral squamous cell carcinoma. Materials and Methods: This prospective and observational study was conducted by the Department of Oral Pathology and Microbiology, S. B. Patil Dental College, Bidar, Karnataka, India, from February 2018 to January 2019. The study composed of total of 150 individuals, of which 50 individuals did not had any visible manifestations, 50 were analyzed with potentially malignant disorders (PMDs) in particular oral leukoplakia, oral lichen planus, and oral submucous fibrosis and last group of 50 individuals were suffering from oral squamous cell carcinoma (OSCC). First, the swab samples were elicited from culture technique after that incisional biopsy of the discernible investigated lesion was done for the purpose of justopathological verification. The swab samples were streak on Sabouraud dextrose agar (SDA) and HiCrome Candida Differential HiVeg agar/CHROMagar medium and incubation at 37°C for 24–48 h. Biopsy was done for all the samples. Results: The proportion of candidates as men and women in control was 45 (90%) and 5 (10%), in PMD was 30 (60%) and 20 (40%), and in OSCC was 45 (90%) and 5 (10%), correspondingly. On evaluation on SDA medium in controls, PMD and OSCC groups, Candida was founded in 14 (28%), 20 (40%), and 42 (84%) and not founded in 36 (72%), 30 (60%), and 8 (16%) folks, subsequently. Intragroup contrast illustrated exceedingly necessary distinction with P = 0.000 between both controls versus OSCC and PMD in comparison to OSCC. Nevertheless, controls versus PMD manifested insignificant, P = 0.119. Investigation on CHROM AGAR media among controls, PMD and OSCC groups, Candida species was seen in 11 (22%), 19 (38%), and 40 (80%) and absent in 39 (78%), 31 (62%), and 10 (20%) individuals, respectively. On statistical inspection, the variations noted were enormous, (P = 0.000). On speciation of Candida in CHROM agar among the controls, PMD and OSCC groups, Candida albicans species was present in 9 (18%), 16 (32%), and 6 (12%), Candida krusei in 3 (6%), 6 (12%), and 13 (26%), Candida glabrata in 0, 0, and 8 (16%), and Candida tropicalis in 0, 0, and 3 (6%) cases, respectively. Nonetheless, only OSCC group reveal amalgamation of species such as C. glabrata and C. krusei was present in 2 (4%) case, C. tropicalis and C. krusei in was present 3 (6%) cases, C. tropicalis and C. glabrata was present in 2 (4%) case, C. albicans and C. tropicalis was present in 2 (4%) cases, and C. krusei, C. glabrata with C. albicans was present in 1 (2%) case, respectively. All other types of fungi were regarded as infectious excluding Candida, on analysis on SDA medium, infestation in the form of fungal molds was seen in 18 (36%) in controls, 12 (24%) in PMD and 8 (16%) in OSCC groups. Conclusion: We interpreted that the chief carrier of candidal species in PMDs and OSCC, yet more light is to be thrown on the topic that Candida has particular establishment in PMDs or in malignancy.
  268 41 -
Evaluation of change in surface enamel microhardness in patients undergoing fixed orthodontic appliance therapy – A randomized control trial
Ramya Rajendran, V Sudhakar, R Sumanth Rangarajan, Anandadevi Chinnasamy, G Vasupradha, J Sathiya Jeeva
November 2021, 13(6):1106-1110
Aim: This study aims at determining the amount of enamel decalcification in terms of microhardness. Materials and Methods: Twenty patients requiring treatment by extraction method for Class I malocclusion with bimaxillary protrusion were selected for the study. Twenty patients were randomly divided into control group and experimental group. In the control group (n = 40), extraction of permanent first premolars was done on day 1 of bonding to assess the Vickers hardness number (VHN) of enamel surface, and in the experimental group (n = 40), extraction of the contralateral premolars was done on the 28th day after bonding to assess the VHN of enamel surface. The values are tabulated and analyzed by SPSS software. Results: There is significant surface enamel dissolution of enamel crystals in the experimental group compared to the control group, and a statistically significant difference in VHN is evident between the control and experimental groups. The surface enamel dissolution (VHN) is not significant difference noted between mandibular and maxillary premolars of the control and experimental groups. Conclusion: The present study has demonstrated a higher level of surface enamel dissolution in the experimental group. There is a marked difference in the VHN between the control and experimental groups, which is statistically significant. The scanning electron microscopy study also confirms the presence of surface enamel demineralization following orthodontic bonding.
  266 42 -
Comparative evaluation of antibacterial property of bioactive glass alone and its combination with chlorhexidine against Enterococcus faecalis – An In vitro study
S Soumya, M A Faisal Gaffoor, Anoop Samuel, Rethi Gopakumar, C Sabari Girish, NC Sajeena
November 2021, 13(6):1448-1451
Context: One of the most common organisms responsible for root canal failure even after the usage of intracanal medicament is Enterococcus faecalis. Newer medicaments with higher antibacterial efficacy against E. faecalis need to be analyzed. Aim: The aim of this study was to compare the antibacterial property of bioactive glass (BAG) alone and its combination with chlorhexidine (CHX) against E. faecalis. Materials and Methods: Eighty permanent maxillary single-rooted teeth were included in the study. These teeth were randomly divided into three groups of ten teeth each. Dentin blocks were prepared. After debris and smear layer removal, dentin blocks were inoculated with E. faecalis and incubated for 7 days for biofilm formation. Medications including BAG alone and combination of CHX with BAG were placed into the dentin blocks and incubated at 37°C for 72 h. Dentinal shavings were collected, and the mean bacterial count was recorded. Statistical Analysis: The comparison of colony-forming unit (CFU) counts was done using one-way analysis of variance, Tukey's post hoc test, and unpaired t-test. The analysis was done using the Statistical Package for the Social Sciences version 20.0 for Windows. Results: Based on the CFU count obtained after 72 h, compared to the control group, both Group 1 and Group 2 reduced the bacterial load effectively. In comparison with Group 1, Group 2 (combination) was found to be more effective against E. faecalis. Conclusion: It can be concluded that although BAG was effective against E. faecalis, its efficacy increased significantly in combination with CHX.
  260 47 -
Quantitative evaluation of apically extruded debris in root canals prepared by single-file reciprocating and single file rotary instrumentation systems: A comparative In vitro study
Sonal Sinha, Konark Singh, Anju Singh, Swati Priya, Avanindra Kumar, Sahil Kawle
November 2021, 13(6):1398-1401
Background: Prevention of the debris from extruding to the periapical region is an important aspect to be taken care of as its extrusion can result in pain, periapical inflammation, and delayed healing owing to the presence of highly infective components in the debris. Aim: The present trial was aimed to compare and assess the amount of debris extruded apically using the single-file reciprocating system - WaveOne GOLD and single file rotary system - OneShape in root canal preparations in vitro. Materials and Methods: Thirty mandibular premolars were divided into two groups (15 samples each) prepared with a single-file reciprocating system - WaveOne GOLD and single-file rotary system - OneShape. Debris extruded was collected and then stored in an incubator. The final weight was calculated after obtaining the mean of three consecutive weights obtained for each tooth. The data were compared using the ANOVA and Turkey's post hoc analysis. Results: Debris extrusions were recorded in both groups and analysis revealed statistical differences in weight before and after the instrumentation procedures in both groups. When compared, reciprocating single file – WaveOne GOLD extruded more debris than rotary single file system – OneShape with a P < 0.001. Conclusions: The rotary instrumentation systems extrude lesser debris apically than the reciprocating instrumentation system. The difference found was statistically significant.
  262 44 -
Assessment of growth factors with three different platelet preparations, namely platelet-rich fibrin, platelet-rich plasma, and lyophilized platelet: An In vitro study
R Hariprasad, TL Suganya, Serin Sarah John, P Rajesh Raj, Feby kuriakose, VN Anoop
November 2021, 13(6):1696-1699
Assessment of growth factors with three different platelet preparations namely platelet rich fibrin, platelet rich plasma and lyophilized platelet-An invitro study Abstract Enhancing wound healing with patients own blood, particularly the platelet preparations have gained more popularity recently. These platelets excrete large amount of growth factors and cytokines that are associated with the healing process and regeneration. Even though these platelet concentrates are widely used in various forms, the mechanism behind that remains unclear. Therefore, this study aims at investigating the levels of growth factors in three different platelet preparations namely platelet rich plasma (PRP), platelet rich fibrin (PRF) and lyophilized platelets. Materials and Methods Autologous blood for preparing the platelet preparations was obtained from healthy donors aged between 25 to 35 years. The samples were then divided into three experimental groups. The preparation of PRP was done with the addition of anticoagulant and the PRF is prepared without adding it. The platelet counts in the blood were analyzed and the growth factors were quantitatively measured using ELISA reader. The statistical analysis was performed by using the Chi square test. Results In the quantitative analysis of growth factors LPL showed significant increase of the liberation of growth factors compared to PRP and PRF. Conclusions With the various recent advances in technologies for preparing these platelet concentrates this can be widely used in clinical practice more accurate in the future.
  256 50 -
The experience of organizing blood donation camp through student initiative
Akanksha Sharma, Jagga Sankalp Harish, Dinesh Kumar, Richa Ghay Thaman
November 2021, 13(6):1488-1495
Introduction: A blood donation camp was organized in the institute which was a student initiative and a street play on blood donation awareness was carried out at different parts of the institute. For this reason, the study aimed at assessing the knowledge, attitude, and practises among the voluntary donors was carried out to bring out further awareness programs. Materials and Methods: The study is a Cross-sectional analysis to know about the knowledge, attitude, and practises among the donors as well as collect information regarding the rare blood groups. The idea to conduct a blood donation camp at a tertiary care hospital in Amritsar was initiated by the students of the 2nd, 3rd, and 4th professional year and was implemented on February 8, 2018. On this day, two awareness street plays were carried out, first at the outpatient department area and then near the college entrance to spread the message about the benefits and necessity of blood donation. The activity of blood donation was executed by a group of 15 team members and the staff posted in the blood bank of the institute. Each donor was taken care of by looking after any postdonation weakness or nausea plus were also provided with refreshments. At the end, feedback forms were handed over and 50 such filled forms were collected. Results: Out of the 50 donors, there were 21 male (42%) and 29 females (58%), with a mean age of 21.45 ± 1.35 years. It was recognized that, among 50 donors, 52% of the donors have not donated in the last 2 years while 58% of the donors would voluntarily like to donate blood again. It was seen that 52% of the donors had fear of needles acting as a hindrance for the blood donation. Conclusion: My experience during the whole journey of the initiative was quite enlightening. Looking at the enthusiasm of the donors and the organizing team, it also encouraged the patients' relatives and professors to come forward for the donation. The success of the event has further encouraged me to carry out such more awareness projects in the future.
  274 31 -
Analysis of an herbal ayurdantham medicated tooth liquid on dentinal tubule occlusion using scanning electron microscopy
Ashwini Tumkur Shivkumar, Sowmya Halasabalu Kalgeri, Bhagyalakshmi Avinash, Harsha Raj Bassapa Shashidar, Ramya Sheshadri
November 2021, 13(6):1184-1187
Background: Dentin hypersensitivity is described as “short sharp pain arising from exposed dentin in response to various stimuli typically thermal, evaporative, tactile, osmotic or chemical and cannot be ascribed to any other form of dental defect or disease.” Dentine hypersensitivity can be treated with various desensitizing agents ,where oral rinse has a promising effect in delivering the therapeutic effect all over the tooth surface including interproximal areas, as they can flow and reach areas where toothpastes are not much effective, hence the occlusion of dentinal tubules using Ayurdhantam medicated an herbal mouthwash was evaluated. Methodology: Twenty such dentinal blocks were obtained; the surfaces of each dentin block were polished using a silicon carbide disc for 30 s to create a basic smear layer. The smear layer is finally detached by applying 17% EDTA solution onto the dentin blocks for 5 min to ensure the patency of the dentinal tubules, following which they were rinsed with distilled water. The specimens were placed into the Ayurdhantam solution (medicated) for 2 min every day for 7 days. The specimens were stored in artificial saliva during the study. The specimens were analyzed under scanning electron microscope (SEM) for the occlusion of dentinal tubules. Results: SEM images showed the partial occlusion of the tubules and a large amount of smear layer. Conclusions: Based on this in vitro experiment carried out, it is shown that Ayurdhantam-medicated mouthwash can be used for treating dentine hypersensitivity effectively.
  262 40 -
Caries risk assessment among school going young adolescents in Sullia Taluk-Dakshina Kannada
P Jagan, Radhakrishnan Karthikeyan, Rajendran Bharathan, NC Srihari, Arumugasamy Niranjana, Minu Suresh
November 2021, 13(6):1155-1161
Background: Dental caries continue to be one among the major problems related to oral health in developing countries, that affects 60%–90% of school-aged children and adults. According to the WHO Global oral data bank in 2009 the point prevalence was 54% among 12 years old. Studies on prevalence conducted in Dakshina Kannada district reported a caries prevalence ranging from 32.8% to 82.6%. This study was undertaken to assess the risk of among school-going young adolescents using the Cariogram model. Subject and Methods: A cross-sectional descriptive epidemiological study was conducted among school-going young adolescents of Sullia taluk Dakshina Kannada for a period of 3 months (August–October) 2019. From a total of 20 schools, 3 schools were randomly selected and children satisfying inclusion/exclusion criteria were randomly drawn from these schools. Data on parameters of Cariogram model were collected on a specially designed pro forma consisting of four parts, namely Questionnaire, along with a clinical examination, the collection of saliva and microbiological analysis. Descriptive data were recorded and Fischer's Exact test was used to test the significance of the findings. P ≤ 0.05. Results: An analysis of the relative contribution of each cariogram parameter in relation to the caries experience revealed that diet content, frequency of diet, mutans count were statistically significant factors in determining caries risk (P < 0.05). Conclusion: In conclusion, the present study performed with cariogram in young adolescent school-going children revealed that diet content, frequency of diet, mutans count were statistically significant factors in determining caries risk and susceptibility factors were mainly responsible for the aforementioned experience of the school children.
  254 47 -
A qualitative study of the impact of COVID 19, on health care providers for cancer patients: An original research
Rohit Kumar Jha, K Dilber Pareed, Sujit Ranjan Sahoo, Anudeep Kapalavayi, Pranoti Hiralkar, Sonali Perti, Amerah Al Salem
November 2021, 13(6):1341-1344
Introduction: In the challenging times of the COVID-19, the care of individuals with the debilitating diseases such as cancers has been an additional burden to the medical team. We aim to find out about the obstacles for the clinical care of the patients in the COVID, the questions frequently asked by cancer patients, and the medical care and support teams' general experience in taking care of cancer patients during the times of the pandemic. Materials and Methods: We conducted a Qualtrics survey that was developed by Cancer and Aging Research Group among 275 health care providers to cancer patients during. There were twenty questions in the survey. Of these 20, three open-ended questions were included that inquired about the barriers to the clinical care of cancer patients during COVID-19; the questions asked to the health care team by cancer patients or the attendants; health care teams general experience in the situations of the COVID-19. Two different reviewers performed the quality analysis for the open-ended questions after they were assigned a code. SPSS ver-23 was used for the descriptive statistics. Results: Medical services organizational difficulties and addressing necessities and support were generally reported. Hindrances to the medical health teams included the included administrative difficulties, access of the patient to the support and basic resources, uncertainties for patients' psychological and physical well-being, and teleconsultation challenges. The most common concern of the patients was the safety and the need for the treatment. Medical health care teams were seen to worry for the mental and the physical health of cancer patient. There was also reported concern for the medical team's own safety, obstruction in multi-level establishments; also the health team was seen feeling positive leadership and communications. Conclusion: The medical health provider teams felt a need for thorough support at the organizational level for cancer patients. Medical teams were expected to comprehend the short-term and long-term impact of the COVID-19 on cancer patients. It was accepted that there has been an increased workload and mental stress among the providers. Appreciating the experiences of the medical teams during the pandemic may help in the future guidance in the care of cancer patients.
  258 43 -
Efficacy of glycolic acid on debris and smear removal as a final rinse solution in curved canals: A scanning electron microscope study
Karunakaran Jeyaraman Venkataraman, Suresh Krishna Boominathan, Ragavendran Nagappan, Chris Susan Abraham, Anbarasi Kaliyaperumal, Jayaprakash Nachimuthu, Modachur Muruganathan Premkumar
November 2021, 13(6):1603-1608
Aim: This study aims to compare intraradicular smear layer removal efficacy of different concentrations of glycolic acid (GA), 17% ethylenediaminetetraacetic acid (EDTA), and 10% citric acid (CA) as final rinses in the canals of curved mesial root of mandibular first molars using the specific irrigant protocols. Materials and Methods: Fifty-eight mandibular first permanent molars with 15°–30° of curvature of the mesial roots were selected, standardized, mesiobuccal canal prepared using the rotary instrumentation. Sodium hypochlorite was used as initial rinse solution (8 ml). The samples were divided into control (n = 5) (I – Normal saline and II – 17% EDTA) and experimental groups (n = 8) (Groups III, IV, V, VI, VII, and VIII) based on the type of final rinse solution (5 ml) used, i.e. 2.5% GA, 5% GA, 10% GA, 17% GA, 37% GA, and 10% CA. Samples were split buccolingually, dehydrated, splutter coated, and examined under a scanning electron microscope. Results: Group IV presented the least amounts of smear among the GA experimental groups at the apical, middle, and coronal one-thirds of the root canal with a mean value of 2.6 ± 1.012, and on comparison with Group II, the results were comparable, and no significant difference found statistically (P > 0.05). Conclusion: The use of GA as final rinse solution for biomechanical preparation during endodontic therapy seems promising. Further evaluation in a clinical setting is recommended.
  252 48 -
Olfactory neuroblastoma managed with endoscopic sinus surgery
Saleh Mayoof Al-Osaimi, Althumali Abdulaziz Hameed, Atheer Abdulraheem Alsufyani, Rahaf Ghazi Altwairqi, Abrar Fahad Alotaibi
November 2021, 13(6):1728-1732
Olfactory neuroblastoma (ONB) or esthesioneuroblastoma is a rare malignancy of the nose and paranasal sinuses that originates from the upper nasal vault. We report a rare case of ONB in a 27-year-old female patient with a 2-year history of nasal obstruction, sneezing, nasal discharge, and left eye protrusion. The patient was successfully treated with endoscopic sinus surgery and adjuvant radiotherapy (RT) with 5-year follow-up duration. Studying ONB cases is of great importance due to its rare occurrence, and the lack of literature regarding its management often creates a dilemma leading to nonstandardized treatment methods. Prolonged surveillance is essential due to its late recurrence and endoscopic resection followed by adjuvant RT, which may be a feasible and effective treatment. There is no single case of ONB published yet in Saudi Arabia, and to our knowledge, this is the first case report.
  262 35 -
Bond strength of acrylic denture tooth to a novel thermo-polymerized denture base copolymer containing cycloaliphatic comonomer after mechanical and thermal aging
Ranganathan Ajay, Kanagesan Praveena, Krishnan Rajkumar, Ranganathan Krishnaraj, Selvakumar Preethisuganya, Karthigeyan Suma
November 2021, 13(6):1136-1140
Background: There are numerous artificial denture tooth materials available of which acrylic resin teeth were used widely. The resin teeth bond chemically to the denture base resin, and this bonding is affected by numerous intrinsic and extrinsic factors. The type of cross-linker in the denture base monomer is one such factor which has a questionable influence on the bond strength. Recently, cycloaliphatic comonomer was added in the methyl methacrylate monomer and the resultant novel copolymer possessed good physico-mechanical and biological properties. Purpose: The purpose of this study was to evaluate the shear bond strength (SBS) between acrylic denture tooth and resultant novel copolymer after cyclic loading and thermal aging. Materials and Methods: Sixty central incisor denture teeth were bonded to three types of acrylic denture base resin groups (n = 20 per group) categorized based on the presence of the cycloaliphatic comonomer – Control group (G0): denture bases without cycloaliphatic comonomer and trial groups G10 and G20 contain 10 vol.% and 20 vol.% comonomer, respectively, substituted in the denture base monomer component. The specimens were processed and subjected to cyclic loading and thermal aging which was then followed by SBS testing. Results: G20 possessed the highest SBS followed by G10. G0 had the least SBS. All the specimens of the control and trial groups exhibited adhesive–cohesive mixed failure at the resin tooth–base resin interface. Conclusion: The addition of cycloaliphatic comonomer increased the SBS between the resultant novel copolymer and the resin teeth after cyclic loading and thermal aging.
  254 43 -
An intraosseous giant cell granuloma: An uncommon presentation
V Ravi Pavan, Vijayanirmala Subramani, S Senthoor Pandian, G V V Giri
November 2021, 13(6):1741-1743
The giant cell granuloma is an identical reactive lesion which is mostly progressive in nature. The clinical behavior of these lesions varies from indolent to aggressive variant. The central form of giant cell granuloma involves the craniofacial bone, followed by long bones of hands and feet. These lesions are usually asymptomatic lesions and are discovered incidentally during routine radiographic examination. Radiograph features reveal multilocular jaw lesions, generally anterior to the first molar regions. Histologically, the lesion shows proliferating spindle-shaped stromal cells in a fibrovascular connective tissue stroma, which characteristically contains multiple multinucleated giant cells. Hemorrhage and hemosiderin pigmentations are often seen in tumor. Central giant cell granuloma is often confused with giant cell tumor of bone histologically. Here, we report a young male who was found to have large central giant cell granuloma in the anterior part of the mandible. The surgical treatment approach of central giant cell granuloma is discussed in this article.
  253 40 -
Comparative evaluation of the effectiveness of denture cleansers on surface hardness of permanent silicone denture liners – An In vitro study
M Abdul Sameeh, MK Jyothsna, R Nidhin, Prasanth Manohar, S Sreedevi, TP Sasikumar
November 2021, 13(6):1102-1105
Aim: This study aimed to determine the effect of three commercially available denture cleansers on surface hardness of two different silicone denture liners at various time intervals. Materials and Methods: A total of 120 cylindrical specimens of permanent silicone-based soft liners were prepared from a custom made metal mold with dimensions of 15 mm × 10 mm, of which 60 specimens were fabricated using Voco™ and the remaining 60 specimens with Molossil™ permanent denture liners. All specimens were divided into four major groups based on cleansing treatments, comprising 30 specimens each. And then, all cleansers dissolved in 250 mL water as recommended by the manufacturer. Specimens of the first group were cleansed daily by rinsing with water and second group with Periogard™ denture cleansing solution and third group with Secure™ denture cleansing solution and the fourth group with Polident™ denture cleansing solution. Specimens of all groups were tested on 1st week, 1st month, and 6th month time interval using a Shore A Durometer. Three readings were noted for each sample and the mean of those readings was taken. Results: Surface hardness of all the samples was significantly higher after a period of 6 months irrespective of the cleansing treatment. Statistically significant changes were observed between Polident™, Secure™, and Periogard™ denture cleanser groups over control with time. Minor changes were observed in surface hardness of Voco™ denture liners as compared to Molossil™ soft liners for all groups, as time progressed. Conclusion: Voco™ soft denture lining material can be performed significantly better than Mollosil™ soft denture lining material in all cleansing treatments and Polident™ denture cleanser has the least effect on surface hardness of soft liners than Periogard™ and Secure™ denture cleansing agents.
  250 43 -
Miniscrew implant supported maxillary canine retraction with and without Corticotomy Facilitated Orthodontics (CFO)
Saurav Kumar, Gaurav Verma, Nadira Hassan, Sana Shaikh, Bharti Anand, Ravi Anjan
November 2021, 13(6):1286-1290
Introduction: The purpose of the study was to scientifically test maxillary canine retraction assisted by miniscrew implant with corticotomy-facilitated orthodontics. Materials and Methods: Fifteen patients (six males, nine females) who had Class II division malocclusion with enhanced overjet were included in the study. Maxillary first premolars were surgical displaced along with retraction of maxillary. In the canine-premolar region, corticotomy was performed on one side of the maxillary arch; the other side served as the control region. Over a 4-month follow-up span, the following variables were examined: plaque index, tooth movement intensity, attachment degree, gingival regression, molar anchorage failure, gingival index, and scope of testing. Results: After 2 months, the canine retraction rate on the corticotomy side was more significant than on the control side by twice. The tooth movement rate steadily decreased to 1.6 times faster at the end of the 3rd month and to 1.06 times faster at the end of the 4th month. No failure of molar anchorage occurred on either the controlled or nonoperated hand during canine retraction. Conclusions: For people requiring orthodontic care with shortened treatment periods, corticotomy-facilitated orthodontics may be a viable treatment modality.
  252 41 -
Evaluation of long-term stability of secondary alveolar bone grafts in cleft palate patients using multislice computed tomography and three-dimensional printed models: A prospective study
Venkatesh Palankar, Atul Sattur, Aditi Palankar, S Raja Rajeswari, Srinath Thakur, Anil Kumar Desai
November 2021, 13(6):1496-1500
Aim: Three-dimensional (3D) printed models are contemporary volumetric bone graft assessment technique for secondary alveolar bone grafting (SABG) in cleft lip and palate (CLP) patients. The study aimed at evaluation of long-term stability of iliac autograft in SABG using multislice computed tomography (CT) and 3D-printed model-based volumetric analysis. Materials and Methods: Twenty-eight patients were included in this prospective clinical study. CT image (T1) was taken after orthodontic maxillary expansion, correlating with the presurgical image. Furthermore, 3D-printed model was prepared, and volumetric assessment of graft needed was ascertained with water displacement technique. SABG was carried on with the anterior iliac crest autografting procedure. After 1-year follow-up, postoperative CT analysis (T2) was followed upon. Results: The stability of bone graft at the 1-year postoperative was found to be 43.74% with mean bone loss of 56.26% (95% confidence interval; P < 0.005). The moderate scale of CLP cases has shown statistically significant bone stability compared to that of severe and mild cases. Furthermore, the 3D-printed model has shown a significant difference to that of T1 CT imaging (P < 0.005). Conclusion: Within the limitations of the study, it seems appropriate to conclude that 3D-printed models serves as better reference than CT imaging in the context of planning and execution of precise bone grafting in SABG.
  250 43 -
Assessment of effect of periodontal and prosthodontic therapy on glycemic control in patients with diabetes
Suman Bala, Ranjna Kumari
November 2021, 13(6):1561-1563
Background: Periodontitis is a chronic inflammatory disease of multifactorial etiology. The present study was conducted to assess the effect of periodontal and prosthodontic therapy on glycemic control in patients with diabetes. Materials and Methods: 80 type II diabetics patients of both genders were divided into Group I (periodontal and prosthodontic therapy) and Group II (Healthy). In control group, only oral hygiene instruction and mouth wash were prescribed. Results: Group I had 22 males and 18 females and Group II had 17 males and 23 females. The mean glycated hemoglobin level in Group I was 7.8% before and 6.7% after treatment and in Group II was 6.4% before and 6.2% after treatment. The difference was significant (P < 0.05). Conclusion: There was improvement in glycemic status in diabetic patients undergoing periodontal and prosthodontic therapy as compared to those not undergoing treatment.
  254 36 -
Root resorption of endodontically treated teeth following orthodontic treatment: A cross-sectional study
Rehan Ahmad Khan, Saurav Kumar, Nadira Hassan, Bharti Anand, Sabika Mazhar, Ravi Anjan
November 2021, 13(6):1306-1308
Background: Root resorption is an unwanted phenomenon occurring in a substantial population proportion these days. Hence, the current study was conducted to evaluate root resorption in endodontically treated teeth following fixed orthodontic treatment. Materials and Methods: A total of 100 patients were enrolled. Only those patients were enrolled that were scheduled to undergo fixed orthodontic therapy. Pretreatment examination was done in all the patients, and their radiographs were obtained. Both orthopantomograms and peri-apical radiographs were taken. All the patients were recalled on follow-up, and radiographic examination was again carried out. Pretreatment radiographs and follow-up radiographs were compared. The incidence of root resorption was documented. The data were entered in an Excel sheet (Microsoft office version 2007) and analyzed using IBM SPSS software version 20. Results: Root resorption was present in 30 patients. Among these 30 patients, 20 were male, whereas 10 were female. In 19 patients, root resorption was present in the maxillary arch, whereas in 11 patients, it was seen in the mandibular arch. The most common tooth involved with root resorption was premolars, followed by anteriors and molars. Conclusion: The risk of root resorption is higher in endodontically treated teeth under the influence of orthodontic forces.
  244 46 -
Comparison of efficacy of various intracanal irrigants with ultrasonic bypass system
Sonal Sinha, Akash Narayan Dutta Barua, Kuldeep Singh Rana, Karn Singh, Santosh Kumar, Roseka Saini
November 2021, 13(6):1390-1393
Background: The long-term success of root canal therapy depends on the effective debridement and removal of smear layer and debris from the canal. Root canals with difficult anatomy and complex systems pose great challenge to achieve this. Mechanical therapy alone cannot achieve this goal, various intracanal chemicals also have their own limitations along with the difficulty in reaching the farfetched and difficult areas, and hence, introduction of ultrasonic bypass system has been a boon for the endodontic therapy. Objectives: The aim of this study is to compare the various root canal medicaments along with ultrasonic bypass system in effectively cleaning the debris and smear layer from the various parts of the root canal system. Materials and Methods: Forty single-rooted anterior maxillary and mandibular human teeth were collected for this study, after disinfection, they were sectioned into three equal parts coronal, middle, and apical and these parts were later studies under SEM (Scanning Electron Microscope) and scoring as per the scoring criteria set before the study was done and results were then compared statistically. Results: Group with both ethylenediaminetetraacetic acid (EDTA) and NaOCl with ultrasonic bypass system was the most effective one, when compared with sterile water, NaOCl + ultrasonic bypass system, EDTA + ultrasonic bypass system. NaOCl + ultrasonic bypass system was more effective as compared with the EDTA + ultrasonic bypass system. Conclusion: Ultrasonic bypass system is a useful tool for debris and smear layer removal from a root canal system, but its effectiveness increases when both EDTA and NaOCl are used along with it.
  252 37 -
Dental diseases and factors defining utilization of dental care services among rural children aged 12 years in Nellore District, Andhra Pradesh: A community-based study
Chandrasekhara Reddy Vuyyuru, Rajeshree Narayan Rangari, Gowri Sankar Singaraju, Nagarjuna Pottem
November 2021, 13(6):1422-1427
Background: Rural children are predisposed to variety of dental problems, which may influence their overall health and well-being. Despite relentless efforts and achievements in oral health promotion by authorities, its impact seems limited in rural areas of developing countries. Aim: To generate data on the prevalence of dental caries and gingivitis, among 12-year-old rural children of Nellore district, Andhra Pradesh and factors facilitating or impeding uptake of dental care services. Methods: A cross-sectional, house-to-house survey was conducted in Kavali revenue division of Nellore district by random selection. A cluster sampling methodology was followed, and a total of 169 adolescents were involved in the study. Dental caries detection was performed according to the World Health Organization dentition status criteria and gingivitis according to modified Community Periodontal Index as gingivitis present or absent. Descriptive statistics were calculated. Results: Overall prevalence of dental caries and gingivitis was 39% and 35%, respectively, with <15% utilization of oral health care services. The main hurdle for this notably low utilization of oral health care services was that dental issues were not fatal or life-threatening. Conclusion: The prevalence of dental caries and gingivitis was high and poor utilization of oral health services was an importunate finding in this study. Understanding the trends of common oral diseases and hurdles in uptake of oral health care services could provide a basis for further research and improvement in accessibility to oral health care services in rural areas of developing nations.
  252 37 -
Assessment of anxiety associated with the dental treatments on the quality of life: An original research
Sneha Thakur, Harshawardhan Kadam, Soumya Jha, Anooja Lall, Kameswari Kondreddy, Arundhati Singh
November 2021, 13(6):1713-1716
Background: Patients around the world when attending the dental clinic are prone to undergo the feelings of fear and anxiety. This may impact the dental follow-up and prognosis. Aim: The aim of the study is to evaluate the dental anxiety in the patients attending for the dental treatment in a college, in India. Materials and Methods: A sample of 500 adults with ages 15–60 years was considered for the study. Modified dental anxiety questionnaire was used in the present study to assess the anxiety faced by the patients attending for the dental treatment. ANOVA and Chi-square test were used to test for the significance between the variables, and the correlation between these variables was assessed using the Spearman's correlation. Likert scale was used to know the cutoff for the severity of the dental anxiety. Results: Only in the 4% of the participants in the present study had dental anxiety. Gender, age, financial status, education impacted the dental anxiety and the regularity toward the appointments. Conclusion: It can be concluded from our study that there was a low anxiety in the dental patients toward the dental treatment and also anxiety decreased with the age. However, regular dental visits are advised to prevent the overall impact of the oral health on the general health.
  244 41 -
Root caries experience and its association with risk indicators among middle-aged adults
Lingaladinne Swetha Reddy, Satti Venkata Lakshmi, Yenugandula Vijaya Lakshmi, K Priya Deepa Lakshmi, Yadlapalli Sravanthi, Manupreet Kaur
November 2021, 13(6):1523-1529
Introduction: With an increasing number of retained teeth, there is an enhanced susceptibility to periodontal problems with gingival recession, which led root surface exposure to the oral environment and develops the root caries later stages among adults. Aim: Evaluate the root caries experience and its association with risk indicators among middle-aged South Indian adult dental patients using root caries index (RCI; Katz RV - 1979). Materials and Methods: The study was conducted among middle-aged (35 to 44 year) adults in the Outpatient Department of Private Dental Institute. Root caries experience was evaluated using the Katz RCI on a full mouth basis. Statistical analysis was done by using SPSS software. Results: The prevalence of root caries among study population was 8.9% with a mean RCI score of 1.04 ± 5.10. As age increased mean number of teeth with gingival recession (45.25 ± 27.09), decayed root surfaces (0.34 ± 1.11), filled root surfaces (0.39 ± 2.99), mean number of teeth missing (3.78 ± 6.42), and RCI (1.68 ± 6.93) also increased. Conclusion: Age, gender and higher number of retained teeth were concluded as a significant risk indicators for root caries.
  240 43 -
Determination of role of type 16 human papillomavirus and risk factors in assessing oropharyngeal cancer survival
Meenakshi Bhasin, Harkanwal Preet Singh, Padam Singh, Rachna Dhingra, Saniya Arora Kohli, Anurag Azad
November 2021, 13(6):1300-1302
Background: It is ascertained that the survival rate of patients infected with type 16 human papillomavirus (HPV16) positive is better as compared to those infected with HPV16 negative. The present study was conducted to determine rgw role of HPV16 and risk factors in assessing oropharyngeal cancer (OPC) death. Methodology: A total of 102 clinically and histologically proven cases of oral pharyngeal cancer were included. Seropositivity for HPV16 E6 as a marker of HPV16-positive cancer was estimated. Results: Out of 102 patients, there were 70 males and 32 females. Significant risk factors associated with OPC survival overall in the univariate analysis was female sex (hazard ratio [HR] 0.54, 95% confidence level [CL]: 0.36–80), alcohol use >2 drinks/day (HR 1.54, 95% CL: 1.12–2.08), smoking >10 pack-years (HR 2.20, 95% CL: 1.42–3.58), moderate dental (HR 1.54, 95% CL: 1.02–2.32), underweight (HR 2.24, 95% CL: 1.34–3.60), and Stage IV cancer (HR 2.82, 95% CL: 1.76–4.40). There was significant low risk for death among HPV16 positive (HR 0.48, 95% CL: 0.32–0.70). Conclusion: HPV16 status is an independent prognostic factor for OPC deaths. The common risk factors were female gender, moderate oral care, underweight body mass index, excessive alcohol, and smoking tobacco.
  242 40 -
Correlation of pharyngeal airway dimensions with maxillomandibular skeletal relation and mandibular morphology in subjects with skeletal Class I and Class II malocclusions and different growth patterns: A cephalometric study in selected local population
Pallavi Jeetesh Jadhav, Shivprasad Vasant Sonawane, Nikhil Mahajan, Bhushan Gorakh Chavan, Swapnil J Korde, Naufil Mushtaque Momin, Priyanka R Mahale
November 2021, 13(6):1111-1114
Objectives: To test the hypothesis that there is no positive correlation between skeletal Class II and mandibular morphology with pharyngeal dimensions in subjects with different growth patterns. Materials and Methods: Lateral cephalograms of 60 patients were collected and divided into 2 groups, comprising of 30 in each group. Group 1 consisted of cephalograms of patients having Class I malocclusion, and was further divided into subgroups. 1a) Class I with normal growth 1b) Class I with vertical growth. Group 2 consisted of cephalograms of patients having class II malocclusion and was further divided into subgroups 2a) Class II with normal growth, 2b) Class II with vertical growth. Results: The results showed that the estimated marginal mean for upper pharyngeal width in class I malocclusion group was 8.56 mm, for class II malocclusion group was 7.80 mm, for normal growth individuals was 9.73 mm and that for vertical growth individuals was 6.63 mm. The estimated marginal mean for lower pharyngeal width in class I malocclusion group was 9.62 mm, in class II malocclusion group was 9.10 mm, in normal growth individuals was 8.95 mm and that in vertical growth individuals was 9.77 mm. The estimated marginal mean for pharyngeal area in class I malocclusion group is 330.13, in class II malocclusion group is 308.17, in normal growth individuals is and that in vertical growth individuals is 309.83 Conclusions: The null hypothesis for this study, as per the statistical analysis, has been rejected.
  238 43 -
Fertility awareness and perceptions among procreant age group in Western India: An exploration with mixed methodology
Sonali Banerjee, N Mary Mathews
November 2021, 13(6):1551-1557
Background: In India, fertility rate demonstrates a descending trend whereas there is upsurge in infertility rate. In addition, a knowledge gap concerning fertility has been identified among the current generation. Aim: To quantify the fertility awareness and in-depth exploration of perceptions about fertility among procreant age group. Materials and Methods: Explanatory mixed method design with sequential data collection, nested sampling technique was assumed. Purposive sampling was incorporated to recruit 1000 participants into the prospective cohort study. Awareness was measured using fertility knowledge questionnaire, while qualitative data were collected by in-depth interview of 28 participants until data saturation. The study was intact in terms of ethical compliance. Results: Sociodemographic data revealed that the mean age of the respondents was 31.33 ± 6.4 years, 59.6% were female, 78.3% were married, 61.5% completed their university education, 76.0% were working. The mean of overall fertility awareness score was 50.2 ± 13.5. There was no statistical difference in responses of the subgroups (P > 0.05) and only educational status was significantly associated (P = 0.001*) with awareness scores. Perceptions pertinent to fertility were evidently varying amongst the general group and couples accessing fertility treatment, which subsequently was elucidated with the qualitative thematic analysis. Conclusion: Procreant age group of western India demonstrated low to average fertility awareness. Assertive recommendations were proposed for fertility awareness initiatives across both genders, irrespective of educational status.
  234 41 -
Evaluation of the effect of preoperative amoxicillin on bacteremia associated with exodontia in periodontal and periapical pathology
Effie Edsor, G Agnes Golda Priyadarshini, P Gowri Shankar, V Ramesh Srinivasan, T Vigneswaran, S Pradheep Raja
November 2021, 13(6):1577-1582
Aim: The aim of this study was to evaluate the efficacy of preoperative prophylactic antibiotics of 2 g of oral amoxicillin on bacteremia following extraction of teeth with periodontal and periapical pathology. Materials and Methods: This study was carried out on 160 patients. The patients were divided into four groups of forty patients each: two antibiotic groups, with periodontal and periapical pathology, receiving 2 g of oral amoxicillin preoperatively and two control groups, with periodontal and periapical pathology, receiving no amoxicillin preoperatively. Blood samples were collected before the start of the procedure, intraoperatively, and immediately following extraction of teeth. The collected blood samples were cultured and studied for bacterial growth. Results: In the control group patients with periodontal pathology, 17 out of 40 blood samples showed growth of Streptococcus viridans along with Staphylococcus epidermidis. In the control group patients with periapical pathology, 14 out of 40 blood samples showed growth of S. viridans and Staphylococcus aureus. No growth was observed in both the groups on prophylactic antibiotics with 2 g of oral amoxicillin. Conclusion: Bacteremia was found in 40% of the control group patients, while there was no bacteremia present in patients with preoperative administration of 2 g of oral amoxicillin.
  232 43 -
Esthetic and palliative management of congenitally missing anterior teeth using all ceramic fixed prosthesis: A clinical case report
Karthik Kannaiyan, Veerendra Prasad, V Bhanu Chander, Ramavarapu Avinash, Afreen Kouser
November 2021, 13(6):1737-1740
Congenitally missing anterior teeth alters the patient's physiognomy and diction in a big way. Maxillary incisor agenesis, prominently the lateral incisor is the most common congenitally missing permanent tooth, in the anterior maxillary region, which is the esthetic zone, representing approximately 20% of all dental anomalies. Treatment planning is inclusive of; smile design, preparation, perception of the patients, and their expectations in relation to esthetics, interdisciplinary alliance that meets the functional, health, and esthetic needs. A critical factor for the overall success is that of choosing a suitable restorative recourse. The case report describes the esthetic rehabilitation for congenitally missing maxillary lateral incisor and early traumatic loss of central incisor using an all ceramic-fixed prosthesis.
  240 34 -
Fracture resistance of endodontically treated mandibular permanent first molars reinforced with diagonal horizontal postdesign: A In vitro study
Karunakaran Jeyaraman Venkataraman, Aravindhan Venkatapathi, Sathyanarayanan Balasubramanian, Chandrika Ramanathan Palanivelu, Senthil Kumar Swaminathan, Leo Sujith Samuel, Sathya Thanapathi
November 2021, 13(6):1597-1602
Aim: This study aims to compare fracture resistance of mandibular first molars reinforced with diagonally placed horizontal posts after endodontic therapy. Materials and Methods: Thirty-two mandibular first molar teeth were selected, standardized, divided into four groups (GP) – GP I (endodontically treated-no post)), GP II (horizontal post-buccolingual), GP III (horizontal postdiagonal), and GP IV (natural teeth). The individual teeth were mounted on bases, coded, and suitably prepared for the facture testing procedure. Results: Buccolingual type of fracture was the most common among the experimental groups with a percentage of incidence of 37.50%. The cuspal type of fracture was the next most common with a percentage of incidence of 25.0%. The incidence of mesiodistal, comminuted, and proximal type of fractures was also observed and had a percentage of incidence of 9.38%, 9.38%, and 9.38%, respectively. Group IV had the highest fracture resistance with a mean value of 1279.82 (N). Group I, Group II, and Group III had mean values of 684.16(N), 756.84(N), and 758.17(N), respectively. There was a statistically significant difference between Gp IV and Gp (I–III) in load values of root fracture (P < 0.05). Conclusion: Within the limitations of this study, it can be concluded that diagonally placed horizontal postdesign has a higher resistance to facture when compared to buccolingually place horizontal postdesign and root canal treated non postgroup. These designs have the potential to be a conservative postendodontic management option. Further evaluation of different horizontal postdesigns and assessment in a clinical setting is recommended.
  234 40 -
Evaluating CagA and VacA oncoproteins of Helicobacter pylori in oral potentially malignant disorders
Ramya Sekar, Prabhu Shankar Dhayashankar, Abirami Mathivanan, Nazargi Mahabob, Jingade Krishnojirao Dayashankara Rao, Syed Fareed Mohsin
November 2021, 13(6):1564-1568
Oral Potentially Malignant Disorders such as leukoplakia, lichenplanus, Oral Submucous Fibrosis are most commonly encountered precancerous lesions in India. Although, usage of smoking tobacco has been decreased yet incidence of oral cancer seems to be in increasing trend. Apart from tobacco many non-tobacco causes are associated with the disease. Helicobacter pylori is a curved, flagellated bacterium that has been declared as group I carcinogen by WHO. They are proven causative agent for gastric carcinoma. They have been shown to harbour oral cavity by many authours. They produce onco-protein that causes DNA damage. CagA and VacA are such proteins that modulate certain oncogenes and tumour suppressor genes. In this study we have identified the organism from sub gingival plaque by PCR and those who harboured the organism were further subjected for identification of oncoproteins CagA and VacA by ELISA. This study shows that presence of organism in Oral leucoplakia, oral lichenplanus and Oral Submucous Fibrosis are statistically significant in comparison to control group (p>0.05). The presence of oncoproteins was also statistically significant in comparison to control group. These proteins are shown to accelerate inflammatory pathway thereby hasten the process of tumorigenesis. H.pylori infection as well the virulent strains can be diagnosed from oral cavity in the most non-invasive way at the earliest
  232 40 -
Facemask therapy in unilateral cleft lip and palate patients
Saurav Kumar, Gaurav Verma, Nadira Hassan, Ravi Anjan, Rehan Ahmad Khan, Sana Shaikh
November 2021, 13(6):1303-1305
Background: Midfacial hypoplasia is a common feature in patients with combined cleft lip and palate. The current study was done to assess the effect of facemask (FM) therapy in patients with unilateral cleft palate. Materials and Methods: A total of 16 patients with unilateral complete cleft lip and palate were treated with maxillary transversal discrepancy with rapid maxillary expansion (RME) followed by FM therapy. After the completion of the RME treatment, the same appliance was used for protraction. Radiographs were taken after removing the RME appliance (T1) and at the end of the FM treatment after removing the appliance (T2). Results: There were 5 males and 11 females. SNA was 73.1° and 79.4°, SNB was 75.2° and 72.4°, ANB was −3.21° and 2.90°, SN-PP was 11.2° and 10.4°, Co-A was 84.3 mm and 87.5 mm, A-HR was 55.2 mm and 57.8 mm, A-VR was 62.4 mm and 64.7 mm, and SN-MP was 38.2 mm and 41.5 mm before and after treatment, respectively. Conclusion: FM proved to be beneficial in causing significant improvement in patients having combined cleft lip and palate.
  226 46 -
To compare the accuracy of 0.022 inch slot of stainless steel and ceramic orthodontic brackets marketed by different manufacturers
Perumallapalli Divya, Santosh Reddy Banswada, Shilpa Reddy Kukunuru, Keerthi B Kavya, R Ravi Rathod, Keerthi Chowdary Polavarapu
November 2021, 13(6):1037-1041
Aim of the Study: The aim of the present study was to analyze the accuracy of 0.022 inch slot of stainless steel and ceramic orthodontic brackets marketed by different manufacturers. Materials and Methods: An in vitro study was done on upper left central incisor bracket of MBT 0.022 slot of American orthodontics (AO), 3M Unitek, Ormco with each 20 of stainless steel and ceramic brackets divided into six groups, and the total sample was 120. The brackets were scanned with stereo microscope of Magnus Company and Image Pro plus analysis software was used to evaluate the mesial face and base, distal face and base. Results: Comparison in between the groups of stainless steel showed that 3M Unitek brackets showed higher slot widths as compared to AO and Ormco which was statistically significant (P < 0.05). Comparison in between the groups of ceramic brackets of AO brackets showed higher slot widths as compared to Ormco and 3M Unitek ceramic brackets which was statistically significant (P < 0.05). Conclusion: By this study, there was a difference between stated values and measured values of brackets displaying inaccuracies in dimension. A clear impreciseness about the appliance could be needed during the finishing and detailing stage to avoid loss of torque control due to slot oversize and the divergence of slot walls.
  228 43 -
Oral health knowledge, attitude, and practices among the health-care professionals: A questionnaire-based survey
Anmol Mehrotra, Ankita Mehrotra, Ashish K Babu, Prachi Ji, Sagar Arjun Mapare, Ranjit Omprakash Pawar
November 2021, 13(6):1452-1457
Objective: The objective of the study is to determine the oral health knowledge, attitude, and practices among the health-care workers (HCWs). Materials and Methods: The present questionnaire-based survey among 473 HCW comprising of doctors, nurses, pharmacists, technicians, and interns was carried out to know the oral health knowledge, attitude, and practices among different HCW. Responses were recorded and data were assessed through descriptive statistics and by applying analysis of variance, Chi-square, and z-tests. Results: Maximum of doctors (98.7%), nurses (80.4%), interns (73.3%), pharmacists (70.8%), and technicians (67.1%) responded correctly that oral health is related to systemic health followed by treating a decayed tooth is equally important as treating other body ailments. Doctors revealed higher mean knowledge scores in comparison with other HCW. A significant difference is noted with regard to frequency of dental visit (P = 0.000), reason behind dental visit (P = 0.001), and barrier for not visiting the dentist (P = 0.013) among males and females. Similarly, a significant difference is noted with regard to frequency of dental visit (P = 0.001), dentist familiarizing about the treatment (P = 0.001), and his concern about the patients (P = 0.001) among between different HCW. Conclusion: From the results of the present study, a variation in oral health knowledge was observed among different HCW. All the participants showed a positive attitude toward professional dental care.
  230 41 -
Assessment of perceived competency of interns toward dental practice
Ravi Shankar Yadav, Rohit Sharma, Neha Singh, Meeta, Chintu Kumar Singh, Srinivas Ganti
November 2021, 13(6):1338-1340
Background: Many academic institutions have been cheering lecturers to execute flipped learning methodologies. The present study determined perceived competency of dental interns toward dental practice among various dental colleges. Materials and Methods: A total of 138 interns of dental college were provided with self-administered questionnaire with close-ended questions. All were instructed to read it and submit it. Results: Out of 138 subjects, there were 78 males and 60 females. The mean value for general patient management was 3.12 and 3.0 in males and females, periodontology and dental public health was 2.54 and 2.65, conservative dentistry was 2.70 and 2.82, oral rehabilitation was 2.32 and 2.30, orthodontics was 2.10 and 2.28, management of children and special needs patients was 2.52 and 2.64, oral and maxillofacial surgery was 2.49 and 2.42, and drug and emergency management was 2.62 and 2.60, respectively. Conclusion: Dental interns were well prepared toward dental practice.
  236 34 -
To evaluate the role of positron emission tomography-computerized tomography in initial staging of carcinoma breast
Anju Kansal, Gaurav Jaswal, Shreya Garg, Manraj Singh Kang, Hanuman Prasad Yadav, Raja Paramjeet Singh Banipal, Pardeep Garg, Taranjeet Kaur
November 2021, 13(6):1354-1359
Background: Breast cancer is the most common cancer in urban and second common in rural Indian women. In India, in spite of the best treatment available being given to the patients they lose their lives because of paucity of diagnostic aids and lack of an organized breast cancer screening program. Early detection, accurate staging, and initiation of appropriate therapy are the key factors for improving the treatment outcome and prognosis of the disease for the patients. Traditional staging methods include clinical examination, blood tests, chest X-ray, ultrasound of the abdomen, and/or skeletal survey. As these tests lack sensitivity and specificity, these are being scaled down. The hybrid positron emission tomography-computerized tomography (PET-CT) is a unique tool in the field of imaging modalities that combines the effectiveness of PET and CT. This study was undertaken to assess the efficacy and accuracy of PET-CT as a single-session staging modality in the very initial stage itself and if it can replace the conventional means of staging. Methods: This was a cross-sectional study conducted in the Radiotherapy department at GGS Medical College and Hospital Faridkot from March 2014 to October 2015. 52 patients with newly diagnosed and histopathologically proven carcinoma breast were staged by conventional modalities (clinical examination, blood tests, X-ray chest, mammography, ultrasonography abdomen, skeletal survey) and by 18F-fluorodeoxyglucose (18F FDG) PET/CT. PET-CT images were used for the detection, localization, staging of tumors and detection, evaluation, and diagnosis of metastatic lesions, disease burden and organ function along with treatment planning and planning therapeutic procedures. Following the completion of initial study, the results of 18F FDG PET-CT staging in comparison with conventional staging method were assessed. Along with this, the accuracy, changes in staging of cases of carcinoma breast and cost-effectiveness of 18F-FDG PET-CT were also studied. Results: All the pathologic entities identified by conventional imaging were also perceived with 18F-FDG PET/CT. Therefore, we recommend the use of PET/CT as an important imaging modality for initial diagnosis of carcinoma breast.
  236 33 -
Distally edentulous maxillary left-sided arch with pneumatized sinus area restored with corticobasal implants - A case report
Senthilnathan Radhakrishnan, KA Biju, Gobichettipalayam Jegatheeswaran Anbuselvan, Marudhamani Chinnannan, Kowsalya Devi Sivakumar
November 2021, 13(6):1759-1762
Restoration of severely atrophied ridges with conventional implants requires extensive surgical procedures which are totally expensive, and it also involves a great deal of postoperative discomfort to a patient. In such situations, basal implants come to rescue for rehabilitation where it utilizes the cortical bone for anchorage. The availability of several designs of these implants that exist today has made basal implantology flexible enough to accommodate any situation. This article is a case report of the patient whose maxillary arch was fully rehabilitated with endodontically treated teeth and fixed partial denture. The remaining edentulous region in the maxillary left side was treated with corticobasal implants and was rehabilitated with a fixed PFM prosthesis. The above-mentioned case has a follow-up of 3 years, and still, the implant-supported prosthesis provides better function for the patient.
  226 42 -
Assessment of cytokine and herpesvirus level in peri-implantitis and healthy patients
Sanjay Kumar Sahoo, Mohammad Jalaluddin, Lipsa Bhuyan, Kailash Chandra Dash, Silpiranjan Mishra, Pallavi Mishra
November 2021, 13(6):1418-1421
Background: The present study was conducted to assess level of cytokine and herpesvirus in peri-implantitis and healthy patients. Methodology: Fifty patients with healthy dental implant (Group I) and dental implant with peri-implantitis (Group II) were enrolled. The level of interleukin (IL)-1 β, IL-2, IL-4, IL-6, MCP-1 and tumor necrosis factor-α (TNF-α), and herpesvirus was estimated. Results: The mean IL-1 β level was 1.54 in Group I and 5.12 in Group II, IL-2 was 0.05 in Group I and 0.02 in Group II, IL-4 was 0.018 in Group I and 0.0021 in Group II, IL-6 was 0.83 in Group I and 0.92 in Group II, MCP-1 was 64.5 in Group I and 23.1 in Group II, and TNF-alpha was 1.54 in Group I and 1.05 in Group II. There was a significant higher level of TNF-alpha in virus + patients (P < 0.05). Conclusion: The cytokine level was increased in patients with peri-implantitis as compared to patients with healthy dental implants. Virus-positive patients exhibited higher cytokine levels than virus-negative patients.
  232 36 -
A comparative assessment of the effect of professional oral hygiene measures on the periodontal health of patients undergoing fixed orthodontic appliance therapy
Saurav Kumar, Shubham Kumar, Nadira Hassan, Ravi Anjan, Sana Shaikh, Devleena Bhowmick
November 2021, 13(6):1324-1326
Background: Fixed orthodontic treatment provides good alignment and improves the maxilla-mandibular and dentoalveolar function. The present study was conducted to evaluate fixed orthodontic patients' periodontal condition with professional oral hygiene measures. Materials and Methods: One-hundred and twenty patients undergoing fixed orthodontics were included in the study, divided with 60 patients in the control group (Group I) and the other 60 in the experimental group (Group II). Periodontal indices were compared. Results: In Group I, there were 40 females and 20 males, and in Group II, there were 35 females and 25 males. The mean gingival index was 0.62 and 1.14, plaque index was 0.94 and 1.38, and pocket depth was 1.50 and 1.68 at T0 and T1 in Group I, respectively. The mean gingival index was 0.80 and 1.14, plaque index was 1.2 and 0.81, and pocket depth was 1.31 and 1.57 at T0 and T1 in Group II, respectively. Conclusion: For patients undertaking orthodontic fixed appliance therapy, professional oral hygiene measures can significantly improve periodontal health.
  224 42 -
Morphometric analysis of mandibular foramen in Saudi children using cone-beam computed tomography
Guna Shekhar Madiraju, Nazargi Mahabob, Sanusi Mohammad Bello
November 2021, 13(6):1717-1722
Objectives: This study evaluated the position of the mandibular foramen (MF) with regard to the occlusal plane (OP) and the anterior border (AB) of the mandibular ramus (AB) in a sample of 7–12-year-old Saudi children using cone-beam computed tomography (CBCT) images. Materials and Methods: In this descriptive, observational study, 155 CBCT scans were selected and analyzed for positional changes in the MF. Reconstructed panoramic and axial sections were used to measure the MF-OP and MF-AB distances, respectively, on both the right and left sides of the mandible. Data were analyzed using paired t-test, independent t-test, one-way analysis of variance, and Tukey's honest significant difference post hoc tests where applicable, at a significance level of P < 0.05. Results: The mean distance of MF from the AB of the ramus was 14.68 mm, with no significant differences between the genders (P > 0.05). The MF moved upward from a position below the OP to above it, according to age in both males and females, and the difference between the age groups was significant (P < 0.05). No significant differences (P < 0.05) in the mean values of distances between the right and left sides of the mandible were seen. Conclusions: The location of the MF varies with respect to age and should be considered while administering inferior alveolar nerve block in children to achieve a more effective anesthesia.
  232 33 -
Diabetic retinopathy and its effect on quality of life: An original research
Ashish Mahobia, Sujit Ranjan Sahoo, Niladri Maiti, R Sathyanarayanan, R Aravinth, Roopa Reddy Pandraveti, Heena Tiwari
November 2021, 13(6):1365-1368
Introduction: Diabetes is associated with the vascular and the neuronal damage of the eye leading to diabetic retinopathy (DR). The circadian rhythms and also the quality of life (QoL) are known to be impacted by the photosensitive retinal ganglion cells, which are seen to be affected in the DR. Hence, we aim to find a relation between the DR and its impact on the life quality. Materials and Methods: Thousand participants were equally divided into two groups of case and controls (DR). The control group was further divided into three subgroups based on the severity of the disease as proliferative and nonproliferative (mild, moderate, and severe). The impact on the QoL was assessed using the Short Form Health Survey-36. The collected data were analyzed for the various grades of the severity of DR on the quality of the life. Results: There was a notable change between the case and the controls and the QoL deteriorated with the severity of the disease. However, these findings were insignificant statistically. Conclusion: DR impacts the QoL of the patients, and the severity of the disease is proportional to the worsening of the disease. Further, research is warranted for the association.
  212 52 -
An environmental scanning electron microscopy evaluation on comparison of three different bleaching agents using the laser activated in-office bleaching at different wavelengths
Shachi Goenka, Sushil Kumar Cirigiri, Kanika Poplai, Baig Mirza Aslam, Shalini Singh, Shweta Gangavane
November 2021, 13(6):1478-1482
Background: Shade of the teeth is of specific significance to the patient because of social and psychological concern and hence plays vital role as primary care. Bleaching is a noninvasive, relatively inexpensive, conservative, and low-maintenance method to change a smile dramatically. Aim: To study the effect of application of three bleaching agents at different wavelengths of laser on the enamel surface of teeth using an environmental scanning electron microscopy (ESEM). Materials and Methods: One hundred and twenty freshly extracted, noncarious intact maxillary central incisors were collected and stored in moist conditions in plastic containers. Using a randomized stratified design, the samples were divided into 12 groups (n = 10). The bleaching agent was mixed according to the manufacturer's instructions and applied on the enamel surface of the teeth followed by laser activation. The ultrastructural effects of the bleaching agent on the enamel were determined with an ESEM. Samples were assessed both before and after bleaching on the basis of the degree of surface damage. Because the observation by ESEM was designed to be qualitative, no statistical analysis was performed. Results: JW power bleaching agent and Opalescence Xtra boost showed minimum surface alteration when compared to Polaoffice. Furthermore, the groups treated with diode 810 nm showed less surface damage while neodymium-doped yttrium aluminum garnet 1064 nm more surface alterations than the groups treated with diodes. Conclusion: From this current study, it can be concluded that the diode laser of 810 nm with JW power bleaching showed minimum surface alterations.
  226 38 -
A comparative evaluation of silk suture and cyanoacrylate adhesive in the stabilization of free gingival graft harvested with erbium: Yttrium-aluminum-garnet laser: A clinical study
Asim Goel, Deepika Ghai, Anchal Sood, Gagan Preet Singh, Puneet Kamal Nagi, Padam Singh
November 2021, 13(6):1672-1678
Background: The most common technique for gingival augmentation is free gingival graft (FGG). The aim of this study is to clinically compare the efficacy of FGG harvested with erbium: yttrium-aluminum-garnet (Er: YAG) laser stabilized with 5-0 silk suture in comparison to N-butyl-2-cyanoacrylate tissue adhesive in increasing the width of keratinized gingiva (WK) for the management of Miller's Class I and II gingival recession. Methodology: Forty-eight gingival recession defects were divided into two Groups I and II. Group I sites were treated with FGG harvested using Er: YAG laser stabilized with 5-0 silk suture and Group II sites were treated with FGG harvested using Er: YAG laser stabilized with N-butyl-2-cyanoacrylate tissue adhesive. Clinical parameters such as gingival recession depth, clinical attachment level (CAL), gain in gingival tissue thickness, and WK were recorded at baseline and 3 and 6 months postoperatively. Results: A significant reduction in gingival recession defects, gain in CAL, increase in WK, and gain in gingival tissue thickness were observed in both the groups. Intergroup comparison of gingival recession defects, CAL, WK, and gingival tissue thickness yielded nonsignificant differences. Conclusion: Within the limits of this study, it can be concluded that both 5-0 silk suture and n-butyl-2-cyanoacrylate were equally efficacious in the stabilization of FGG. N-butyl-2-cyanoacrylate was easy to apply, consumed less operating time, and had no adverse effect. Hence, cyanoacrylate can be used as an alternative to suture in stabilization of FGG.
  222 40 -
Knowledge and awareness of jaw relation among dental interns: A questionnaire survey
Marciano John Vialli Paul, P Manimaran, C Dhinesh Kumar, Eucharist Paul Simon, Vindha Paul
November 2021, 13(6):1263-1265
Aims: This study aims to explore the awareness among the interns regarding the jaw relation procedures. Jaw relation is one of the most important criteria for the fabrication of complete dentures to provide a satisfactory oral function for the aging population. Settings and Design: The study design was a descriptive survey. Materials and Methods: A self-administered questionnaire was designed and distributed among 202 interns in three different colleges in Salem and Namakkal in Tamil Nadu using Stratified Proportionate Random Sampling Technique. The survey included a questionnaire with ten questions to assess the knowledge and awareness of jaw relation procedures among the interns. Statistical Analysis Used: The statistical tools used to analyze the levels of awareness among the interns were frequencies and percentage analysis. Chi-square tests and logistic regression were used to investigate the relationship between awareness among interns, with respect to gender, age, and complete dentures done, with the level of significance at P < 0.05 using Microsoft Excel and SPSS software version 23. Results: The awareness prevalent regarding jaw relation and its procedures among the respondents was 83%. There was a statistically significant relationship between maximum complete dentures done and awareness among interns (P < 0.001). Complete dentures made a significant contribution to the prediction of awareness (P < 0.0001). Conclusion: To improve the awareness among the interns increased educational programs, clinical training and greater patient exposure to the clinical application of jaw relation procedures to construct complete dentures are needed during their undergraduate education.
  224 38 -
Leptin levels in gingival crevicular fluid during orthodontic tooth movement
Joseph Alaguselvaraj, Kandanraj Selvaraj, Porselvi Bhaskaran, Sainath Muthiah Chidambaram, Thanigainathan Rajasekaran, Muralimani Mani
November 2021, 13(6):1174-1177
Aim: To evaluate the levels of leptin in gingival crevicular fluid (GCF) during orthodontic tooth movement and to find the role of leptin as a mediator for tooth movement. Materials and Methods: GCF was collected from 25 subjects and the levels of leptin in it were measured. Sample (A) pretreatment, (B) 6 h after applying retractive orthodontic force from right side canine, (C) without retractive force from left side canine, and after 21 days from right canine (D), and left canine (E). Results: GCF Leptin concentration in pretreatment, 6 h control and 21st day control were all similar. GCF leptin concentration at 6 h test tooth site was increased which was statistically significant. GCF leptin concentration in 21st day test tooth was decreased only a little than the control tooth which shows statistically no difference. Conclusion: Leptin is one of the mediators of orthodontic tooth movement.
  230 32 -
A comprehensive assessment of bone losses in the postoperative phase of single implant placed in mandibular first molar regions: A cone-beam computed tomography-based clinical study
Shruti Vishal Dev, Sonali Perti, Kalinga Keshari Sahoo, Arun Mohanty, Sourav Kumar Pati, A Nivya Sri
November 2021, 13(6):1530-1534
Background and Aim: Bone loss surrounding dental implant is an unavoidable phenomenon that occasionally leads to implant failure. Implant-related bone loss exhibits different patterns and rate as per oral milieu and hygiene habits. This study was aimed to clinically assess the crestal bone losses in the postoperative phase of single implant placed in mandibular first molar regions. Materials and Methods: The present in vivo study was planned and completed on the patients selected from the Department of Prosthodontics of the institute. A total of twenty patients were selected randomly in which right mandibular first molar was rehabilitated by dental implants. All radiographic analysis was attempted by cone-beam computed tomography (CBCT). All twenty implants were placed by standard clinical protocols. CBCT analysis was attempted to measure existing bone levels on all four surfaces of implant. These measurements were completed at three different postoperative phases. Informed consent was obtained from all participating patients. Statistical Analysis and Results: Statistical analysis was completed by statistical software Statistical Package for the Social Sciences. P <0.05 was taken as statistically significant. Among all 20 patients, males were 14 and females were 6 in the age range of 25–45 years. Mean bone losses were in the range of 0.226–0.737 for Group I. Intergroup comparison by two-sample t-test showed a significant difference (0.01) for mesial surfaces. All mean values were maximum for mesial surfaces and minimum for lingual surfaces. Conclusion: The mean crestal bone loss at four implant surfaces evaluated at different postoperative phases was nonsignificant. However, there were significant differences in mean crestal bone loss at four surfaces of all studied implants in a particular group.
  224 36 -
A comparative study evaluating implant success and bone loss in diabetes and nondiabetes
Rafat Sultana, Amit Raj, Wagisha Barbi, Shakeb Khan Afridi, Bibhu Prasad Mishra, Rajvir Malik
November 2021, 13(6):1410-1413
Background: Diabetes is seen to be associated with increased rate of failure of implants. The implant failure can be categorized as ailing, failing, and failed implants. The review of literature did not form any consensus on the effect of diabetes on the implant success rates. The reason we found was many confounding factors and nonconsideration of glycemic status of diabetic patients. Hence, in our study, we eliminated the confounding factors and took glycemic index in consideration. Materials and Methods: Forty-six participants were included in this study, out of which 26 were nondiabetic and 20 diabetic. Diabetics were further divided into two groups based on the HBA1C values, as controlled and uncontrolled diabetics. Results: We found that the uncontrolled diabetics had highest rate of implant failure as compared to other two groups. Furthermore, the controlled diabetics and nondiabetics had similar implant successes and failure rates. Conclusion: This suggests that controlled diabetics are comparable to nondiabetics in terms of implant success rates.
  220 38 -
Efficiency of laser versus bur in impacted mandibular third molar surgery: An original research
Niladri Maiti, Piyush Sharma, Samiksha Singh Jadon, Fida Qadri, V R Chandra Babu Pamidi, Sagar Ramesh Ganvir, Rahul V C Tiwari
November 2021, 13(6):1501-1505
Introduction: In oral and maxillofacial surgery, their clinical application has largely been restricted to soft tissue. Hence, the aim of this study was to assess the feasibility of erbium-yttrium aluminum garnet (Er: YAG) laser in bone cutting for removal of impacted lower third molar teeth and to compare its outcomes with that of surgical bur. Materials and Methods: The study comprised forty subjects requiring removal of impacted mandibular third molar, randomly categorized into two equal groups of 20 each, who had their impacted third molar removed either using Er: YAG laser or surgical bur as per their group, using standard methodology of extraction of impacted teeth. Clinical parameters such as pain, bleeding, time taken for bone cutting, postoperative swelling, trismus, wound healing, and complications were compared for both groups. Results: Clinical parameters such as pain, bleeding, and swelling were lower in laser group than bur group, although the difference was statistically not significant. However, postoperative swelling showed a significant difference in the two groups. Laser group required almost double the time taken for bone cutting with bur. Trismus persisted for a longer period in laser group. Wound healing and complications were assessed clinically and there was no significant difference in both the groups. Conclusion: Based on the results of our study, the possibility of bone cutting using lasers is pursued, the osteotomy is easily performed, and the technique is better suited to minimally invasive surgical procedures. The use of Er: YAG laser may be considered an alternative tool to surgical bur, especially in anxious patients.
  218 39 -
Extracorporeal plating of high-level condyle fracture through retromandibular approach – A technical note
R Murugan, S Thiruneelakandan, Meera Manojprabhakar, V Srivatson
November 2021, 13(6):1733-1736
The complex anatomy of the mandibular condyle makes its fracture management challenging and debatable. Apart from this, the approaches to condyle are also challenging as most of them depend on the surgical expertise. The retromandibular approach which was initially proposed for the vertical sub condylar osteotomies was later popularized for condyle fracture management. It is considered to be a gold standard approach in the management of low condylar fractures. Although it has its own demerits in managing high condylar fracture due to its poor access and visibility, the major complications of temporary facial nerve paresis and sialocele are very less compared to other approaches. However, modified extracorporeal plating combined with retromandibular approach proves to be effective in managing high condylar fracture. In this article, we discuss about a case of bilateral neck of condyle fracture that has been managed with the combined modified extracorporeal plating with retromandibular approach and has been followed with no complications for about 1 year.
  224 32 -
Retention of various luting agents used with implant-supported crowns
Santhosh Sathyanarayan, Tamizhesai Balavadivel, Rakshit C Guru, Abhijeet Rajendra Sande, Venkateswaran Rajendran, Arul Kumar Sengottaiyan
November 2021, 13(6):1206-1209
Background: Implant supported crowns can either be screw retained or cement retained. Recent advances in implant dentistry has improved the longevity of the implant restoration and has placed importance on esthetics and function. Cement retained restoration has added advantage of superior esthetics and is preferred by the clinician. However, selecting the ideal type of cement for luting implant supported crown has been a topic of debate. Methodology: A study was conducted at ESIC Dental College & Hospital, Kalaburagi to determine the retentive ability of three different luting agents. 30 samples were divided into three groups and luted with Zinc phosphate, Zinc Polycarboxylate and Glass ionomer cement. The retentive strength was evaluated using universal testing machine. Results: Results proved that zinc poly carboxylate cement had the highest retentive value followed by glass ionomer and zinc phosphate.
  224 32 -
Sturge–Weber syndrome and glaucoma
Sambavi Anbuselvan, Paneerselvam Venkatachalam
November 2021, 13(6):1765-1768
Sturge–Weber syndrome (SWS) is a neurocutaneous syndrome characterized by capillary venous malformations in the skin, eye, and brain with the occurrence of angiomas of the face, choroid, and leptomeninges. The characteristics signs include facial port-wine birth mark, glaucoma, choroidal hemangioma with brain malformations, and cognitive abnormalities. In this article, we have documented the case report of a 24-year-old male with SWS presenting with glaucoma.
  220 34 -
Cephalometric evaluation based on Steiner's analysis on adults of Bihar
Mrigank Shekhar Jha
November 2021, 13(6):1360-1364
Aim: To evaluate the mean cephalometric values for Steiner Analysis in bihar population. Objectives: To evaluate the cephalometric features of a bihar population and to present_an organized, comprehensive cephalometric norms for Steiner cephalometric analysis..To introduce mean values to assess skeletal, dental and soft tissue relationship using Steiner analysis for orthodontic diagnosis..To compare standards that will be derived with the earlier established norms for other population. Materials and Methods: The study was conducted in the Department of orthodontics and dentofacial orthopedics,Buddha Institute of Dental Sciences And Hospital,Patna(Bihar). The sample was collected from the out patient department of the same college. Source of the Data: The present analysis was made on lateral cephalograms of 60 subjects with well balanced and acceptable facial profile of Bihar population. The subjects were informed about the purpose of the study. Methods of Collection of Data: Subjects with age group of 18-26 years with dento-alveolar class I malocclusion and acceptable facial profile were selected by trained orthodontists, who belonged to the department of orthodontics and dentofacial orthopedics,Buddha Institute of Dental Sciences And Hospital. Results and Conclusion: There was increase in SNA angle, SNB angle, SND angle,in Bihar population than Caucasians. Bihar population has proclined and forwardly placed upper and lower incisors, which was indicative of bimaxillary protrusion as compared to Caucasians. Bihar population had protrusive upper and lower lips as compared to Caucasians. Bihar population males had tendency towards horizontal growth pattern of the mandible than females. Bihar females had more proclined lower incisors than males
  212 42 -
Clinical significance of talon cusp in a mixed dentition patient
Bhuvaneshwari Srinivasan, Anbuselvan Gobichettipalayam Jegatheeswaran, Senthilnathan Radhakrishnan, Faisal Mansour Bin Hayyan, Arthiie Thangavelu
November 2021, 13(6):1763-1764
Talon cusp is a developmental dental anomaly with supernumerary structure projecting from the dento-enamel junction towards the incisal edge of an anterior tooth. The etiology is usually unknown but studies states that talons cusp can occur due to the hyperactivity of the enamel organ during morph differentiation. The incidence is 0.04-10% and the prevalence is more in maxillary incisors than mandibular incisors and more in palatal aspect of the teeth. The most common complications are esthetics, increased risk for caries and occlusal accommodation. This article reports a case of talon cusp on the palatal surface of the permanent maxillary lateral incisor. Due to its clinical significance the dentist should be able to diagnose the supernumerary tooth and definitive treatment should be done.
  220 32 -
The effectiveness of the bilobed pectoralis major myocutaneous flap at a tertiary care hospital: A retrospective analytical study
Rohit Kumar Jha, Sreeja Jami, Rahul V C Tiwari, Jayendra Purohit, AP Vipindas, Mohammed Ibrahim, Fatima Abdullah Binyahya
November 2021, 13(6):1291-1294
Background: Cosmetic defects after the major orofacial disease corrections may have an effect on the overall well-being of the patient. Head-and-neck cosmetic surgeries after a major episode of oral cancer impact the functional ability of the individual in several ways. In general, two types of flap are used in reconstructive surgery: microvascular free flaps and regional pedicle flaps. In socioeconomically poor countries like India, bilobed pectoralis major myocutaneous (PMMC) flap has been seen as a mainstay in facial reconstructive surgeries. Materials and Methods: The present study was conducted on 100 individuals with oral neoplasm who underwent resective surgery had a soft-tissue defect. All the complications that arose after reconstructive surgery were noted. Simple proportions were recorded. Results: Majority of the individuals had the buccal mucosa as the common site of oral neoplasm, and the tumor nodes and metastases staging was I + II. One individual sustained total flap necrosis. Wound infection and dehiscence were the most common complications. Conclusions: PMMC is best proven for flap reconstruction in oral neoplasm cases. It is established to be effective with good acceptability and very few complications. Due to these reasons, in spite of the known advances in facial reconstructive surgeries, this technique is widely followed in developing countries.
  208 42 -
Is open reduction and internal fixation sacrosanct in the management of subcondylar fractures: A comparative study
Nandini Dayalan, Bhawna Kumari, Shilpa Sunil Khanna, Faisal Mohiuddin Ansari, Ramandeep Grewal, Sanket Kumar, Rahul V C Tiwari
November 2021, 13(6):1633-1636
Purpose: This paper is intended to compare and evaluate the better treatment option in the management of subcondylar fractures of the mandible. Materials and Methods: This study included 20 patients who were diagnosed clinically and radiologically to have sustained an isolated subcondylar fracture of the mandible. They were divided into two groups randomly. Group I included 10 patients who underwent treatment by intermaxillary fixation alone followed by active physiotherapy in the form of conservative management. Group II included 10 patients who underwent treatment by surgical intervention for open reduction and internal fixation under general anesthesia following elastic guidance. Factors such as maximal mouth opening, pain scores, and deviation of mandible on mouth opening were taken into consideration and evaluated. Results: It is observed that the patients in Group I had weight loss and restrictions in their social well-being in the early recovery phase, in addition to delay in return to function. In spite of the early return to function, patients in Group II were subjected to all kinds of surgical complications such as transient facial nerve injury, infection, and unesthetic scar. The maximal mouth opening and deviation of the mandible on mouth opening remained almost the same in both groups. Conclusion: A regular follow up of operated patients post trauma is essential to obtain morphological and functional recovery. When the respective advantages and disadvantages of both treatment options were compared and evaluated, it was observed that patients treated by closed reduction had a better clinical and psychological outcome.
  214 33 -
Microleakage at implant abutment and prosthesis interface in cemented implant-supported prosthesis
Soni Kumari, Manish Shivaji Jadhav, Vishal Gupta, Tarun Koshy Isaac, Angel Subramanium, Vinit Kumar
November 2021, 13(6):1679-1681
Background: Dental implants have an important role in mainstream dental practice today to restore esthetics. The present study was conducted to evaluate the microleakage at implant abutment and prosthesis interface in cemented implant-supported prosthesis. Materials and Methods: The present study comprised sixty replicas of abutment analog with length 5 mm, width of platform 4.8 mm, and taper 6° which were milled and divided into three groups. In Group I, nickel–chromium copings were fabricated; marginal gap was evaluated with optical microscope and luted with zinc oxide noneugenol cement, Group II with zinc polycarboxylate cement, and Group III with zinc phosphate cement. Microleakage was scored by the method used by Tjan et al. Results: The mean microleakage score in Group I was 2.5, in Group II was 1.9, and in Group III was 1.05. The difference was significant (P < 0.05). Conclusion: All cements showed microleakage. Minimum microleakage was seen with zinc phosphate cement than zinc oxide noneugenol cement and zinc polycarboxylate cement.
  208 38 -
Assessment of anatomical variations of mandibular canal depicted in panoramic radiography
Nidhi Thakur, Amish Kumar, Pinky Singh, Dipti Gopalakrishnan, Bibhu Prasad Mishra, Mrigank Shekhar Jha
November 2021, 13(6):1394-1397
Background: Anatomical variations of the mandibular canal play a vital role while performing surgical procedures affecting an area with mandibular canal course in the mandible. The neurovascular bundle may be severed during surgical procedures carried out mandible. Aims and Objectives: The present retrospective study was aimed to assess and evaluate the mandibular canal and its variations on the panoramic radiography. Materials and Methods: The study included 88 randomly selected panoramic radiographs with complete mandible and associated bone. On a panoramic radiograph, the following parameters were assessed including bifid mandibular canal and location of bifurcation, the diameter of the mandibular canal as recorded in the first molar region, trabeculation in submandibular gland fossa, anterior loop measurement, direction and diameter of the bifid mandibular canal were all evaluated. Statistical analysis was done. Results: In 51 hemimandibles, the mandibular canal was found to be corticalized, whereas in 21.59% (n = 19), the mandibular canal was visible. In the remaining 20.45% (n = 18) of the study participants, the mandibular canal was not visualized. In the submandibular gland fossa region, diminished trabeculation was seen in 55.68% of the evaluated radiographs, whereas trabeculation was not seen at all in the remaining 23.86% of the subjects. A significant correlation was seen in decreased trabeculation of submandibular gland fossa and absence of the mandibular canal (P value < 0.001). The bifid mandibular canal was seen in 19.31% of the study participants (n = 17) with a mean width of 3.12 ± 1.1 mm. Extension of the anterior loop of the mental nerve was seen as up to 2 mm in majority participants in 67.04% individuals (n = 59). Conclusion: The present study suggests that panoramic radiographs are a reliable tool for assessment of the mandibular canal and associated anatomical variations associated with it.
  206 40 -
Impact of Covid pandemic and working strategies on private practitioners
Ravi Shankar Yadav, Pinky Singh, Mehdi Askari, Sonal Sinha, Saurav Kumar, Vini Mehta
November 2021, 13(6):1414-1417
Background: The COVID-19 pandemic is badly affecting more than 2 million population of 213 countries and has caused 1,952,976 deaths till January 12, 2020. India has also suffered a great loss in terms of economy and people. Furthermore, owing to the complete lockdown enforced in India, restricting humanitarian movement also affected day-to-day life of Indians with a huge impact. Objectives: The present clinical trial was carried out to evaluate the impact of the COVID-19 pandemic on private practitioners. Furthermore, changes in their practice pattern were evaluated along with the perspective of their health, role, and response to the pandemic. Materials and Methods: The study includes a total of 120 health-care professionals of either gender. The stress and mental health of the participants was assessed using Depression Anxiety Stress Scale-21 in English format, also included the questions related to the demographic characteristics, use of technologies for providing virtual health care, changes in the working during the pandemic, and an opinion of their experiences during that period. The data collected were subjected to the analysis and were kept confidential and anonymous. Results: 16.6% of participants preferred virtual consultation before the pandemic in contrast to 83.3% during the pandemic. The most preferred method remained the phone call by 15.8% (n = 19) patients. Depression was seen severely in 35% of study participants (n = 42) and 13.3% of participants extremely severe depression was seen (n = 16). Severe and extremely severe anxiety was noticed in 31.66% (=38) and 15% (18) study participants respectively, whereas severe and extremely severe stress was found in 30% (n = 36), and 12.5% (n = 15) private practitioners. The most common factor that can be considered responsible for compromised mental health in private practitioners was the possibility of infecting the society seen in 59.1% (n = 71) participants. Conclusion: During the pandemic breakout, private practitioners suffered a great challenge both financially and mentally, especially during the lockdown. Furthermore, a significant increase was seen in the virtual consultation methods during the pandemic breakout.
  209 37 -
Analysis of risk factors associated with squamous cell carcinoma in the Indian population
Annasaheb J Dhumale, Sachin Mohite, Rathi Rela, Shahla khan, Wagisha Barbi, K A Ahamed Irfan, Priyadarshini Rangari
November 2021, 13(6):1406-1409
Background: Squamous cell carcinoma (SCC) describes the carcinomatous growth in the oral cavity. Recently, various authors have described increased SCC incidence in the young population. The distribution of SCC shows varied geographic spread, with the highest distribution in Asian countries. Aims: The present trial was carried out to assess the associated factors that could lead to increased risk of developing oral cancer. Materials and Methods: Oral examination was carried out for 21 participants by a dentist and any significant oral lesion or deleterious habit if present, was recorded. The data collected were analyzed. Results: Areca nut was chewed by 47.61% participants (n = 10), smoking tobacco by 76.19% (n = 16), chewing tobacco by 38.09% (n = 8), and consuming alcohol in 9 participants (42.85%). No significant difference was seen concerning age for any factor except alcohol which showed higher intake in the older group where six participants depicted alcohol intake as compared to three participants in the younger group. In participants who chewed areca nuts, 6 participants also smoked tobacco and 1 consumed alcohol. For tobacco chewing, 5 consumed alcohol and 6 also took tobacco as smoke. Conclusion: The present study showed that areca nut and tobacco chewing along with alcohol consumption and tobacco smoking increase the risk of developing SCC in the Indian population.
  206 38 -
Immediate psychological impact of dental students on COVID-19 epidemic in India – A cross sectional study
Saravanan Kandasamy, Reena Rachel John, Arunkumar Jayaraman, Suresh Chinnakutti, Manoj Chandrasekar, DY Mallikarjunan
November 2021, 13(6):1686-1695
Introduction: The 2019 coronavirus disease (COVID-19) epidemic is a global health threat and is by far the largest outbreak of atypical pneumonia since after SARS over the past few decades. Within weeks of the initial outbreak the total number of cases and deaths exceeded those of SARS. Such mass Casualties often trigger waves of heightened fear and anxiety in many population. Aim: To assess the psychological impact and mental health status among the dental students studying in the Vinayaka Mission's Sankarachariyar Dental College, Salem, India. Materials and Method: A total of 21 psychological state questionnaires along with demographic aspects were distributed to 460 under graduate dental students from Vinayaka Mission's Sankarachariyar Dental College, Salem, Tamilnadu. The Psychological state was assessed using the Depression, Anxiety and Stress Scale (DASS). Results: 404 questionnaires were taken for our study as they responded all questions. The results were calculated based on the responses obtained year wise, gender, Place of residence, Living with family, Steady family income and Acquaintance affected with covid and compared among the three psychological assessments Depression, Anxiety and stress. The results of the study were done using SPSS (V21.0IBM, Chicago) Software. Conclusion: We attempted to correlate the socio demographic datas with psychological status of the dental students' in our university using the DAS scale. This study focused on the need for treating the psychological impact of the society at this outbreak as the mental health is the most important to deal with.
  208 36 -
Oral health related quality of life changes in standard cleft and surgery patients- A clinical study
Jaideep Singh, Amit Kumar, Vasudha Sodani, Amit Kumar, Moazzam Jawaid, Milind Wasnik
November 2021, 13(6):1327-1332
Background: Malocclusions are expected to affect subjective attraction, social recognition, and intellect. For dentofacial deformities, functional concerns can also arise. The previous research has established a gradient on oral health-related quality of life (OHRQoL) scores through malocclusion intensity, particularly in the social and emotional realms. This study is used to assess the quality of oral health. Materials and Methods: A total of sixty patients began orthodontic therapy at a tertiary-care facility. Treatment in the orthodontic clinic is restricted to serious malocclusions. The study was selected from patients who meet the qualifying requirements of extreme malocclusion and orofacial clefting. The research removed patients with diagnosed hereditary syndromes. Patients got either single-arch or double-arch fixed equipment during their orthodontic procedure. Subjects were categorized as orthodontic patients with extreme malocclusions, needing orthodontic therapy, and severe spinal discrepancies, requiring both orthodontic treatment and orthognatic surgery. The overall score of one subject was 0–56, while the domain score was 0–8. Higher ratings for oral health profiles reflect a stronger effect on the relative quality of life of oral health. Results: For the 14 objects, the mean baseline Oral Health Impact Profile-14 (OHIP-14) score for all three categories was not statistically different for about half of the items. For surgery participants, the OHIP-14 baseline scores were nearly twice as large as the scores of the other two categories for each of these things (P = 0.05). There were a lot of statistically important variations involving the categories, and the three most significant ones are revealing pattern here. The multiple comparison power of nonsignificant predictive variables was extremely weak for the area of physical pain is 5.2%; 41.2% of remaining tests, and 84% for the functional limitation and mental deficiency domain. Conclusion: Patients receiving a mixture of orthognathic surgery and orthodontic therapy have comparatively low OHRQoL baseline; however in contrast with normal and cleft patients, they still gain the most from care.
  204 39 -
Clinical profile and comorbidities associated with rheumatoid arthritis patients in Sudair, Saudi Arabia
Fehaid Alanazi
November 2021, 13(6):1583-1587
Background: Rheumatoid arthritis (RA) is a chronic, debilitating condition that has a significant effect on the lives of patients, their families, and society at large. Aims: The aim is to determine the clinical profile and any comorbidities associated with RA patients in the Sudair region of Saudi Arabia. Subjects and Methods: Sixty patients were included in this cross-sectional observational study, both newly or already diagnosed with RA, fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for RA. They were followed up in the rheumatology clinic in King Khalid Majmaah Hospital in the Majmaah province from January 2017 to December 2020. Results: The subjects' mean age was 47.87 ± 11.55 years, 52 female and 8 male (female-to-male ratio 6.5:1). About 23.3% of patients with RA had positive family history. The main comorbidities and associated diseases were hypertension (18.3%) and hypothyroidism (15%). The most frequently involved joints were the wrist, metacarpophalangeal, proximal interphalangeal, elbow, and knee joints. Subjects were positive in 66.7% for rheumatoid factor and 78.3% for anti-cyclic citrullinated peptide. Both markers were positive in 60% of the patients. Conclusion: Approximately one-quarter of the studied group had a family history of RA. Hypertension followed by hypothyroidism was the most common comorbidities reported in our study.
  212 30 -
Assessment of cases of complete denture fracture
Ranjna Kumari, Suman Bala
November 2021, 13(6):1558-1560
Background: There are many causes and reasons associated with fractures of complete dentures. The present study assessed case of complete denture fracture. Materials and Methods: One hundred and fifty complete denture wearers reported to the department of prosthodontics for correction of complete denture fracture were examined carefully. The factors such as retention, stability, and occlusal errors were recorded. Cause of denture fracture was recorded too. Results: Out of 150 patients, males were 80 and females were 70. The site of fracture was incisor area in 25, canine area in 30, midline in 50, molar area in 10, and maxillary tuberosity/retromolar pad area in 35 cases. The etiology of denture fracture was accidental fall in 42, poor fit in 28, poor occlusion in 40, material breakage in 25, and acrylic base defect in 15 cases. The difference was statistically significant (P < 0.05). Conclusion: Most common cause of denture fracture was accidental fall, poor fit, poor occlusion, and material breakage.
  208 34 -
Novel approach to the clinical management of completely edentulous Hepatitis B carrier patient
J Dhivya Priya, A Angeline Daisy, M Karthika Devi, C Raahini
November 2021, 13(6):1755-1758
Incidence of infections is more common in the dental practice. In this article, we describe a novel approach to the clinical management of a completely edentulous patient who is in hepatitis B carrier state including infection control protocol for all clinical and laboratory steps. Furthermore, a novel method of incorporating patient's medical history in the form of a QR code in the processed denture is also described.
  210 29 -
Evaluation of remineralization seen in dentin related to ceramic restorations
Sonal Sinha, Gangishetti Sairam, Gaurav L Aidasani, Pallavi Madanshetty, Swati Priya, Sahil Kawle
November 2021, 13(6):1466-1469
Background: Recently, the caries management had shifted from extension for prevention to early detection and remineralization of remaining tooth structure using noninvasive techniques. Aim: The present trial was carried out to assess the effect of adding mono-n-Dodecyl phosphate as a surfactant to ceramic on remineralization of dentin. Materials and Methods: The 32 teeth were divided into the following four groups randomly (n = 8 each group) – Group I: cavities not restored, Group II: Restored with ceramic, Group III: restored with ceramic and 2% mono-n-Dodecyl phosphate, and Group IV: restored with ceramic and 5% mono-n-Dodecyl phosphate. Knoop indenter microhardness tests were done at 10, 20, and 40 days. The surface was evaluated under scanning electron microscope. The collected data were subjected to statistical evaluation, and the results were formulated. Results: In ceramic restored (Group II), an increase in Knoop microhardness (KHN) values was seen at 10-, 20-, and 40-day assessment with the respective values of 102.2 ± 20.3, 118.7 ± 19.4, and 127 ± 15.1. Similarly, a constant increase at different assessments was observed for Groups III and IV with 2% and 5% of mono-n-Dodecyl phosphate with ceramic with a 40-day KHN value of 128.2 ± 21.4 for Group III and 113.5 ± 17.3 for Group IV. A statistically significant difference was seen between ceramic and 5% mono-n-Dodecyl phosphate (Group IV) with hardness values of 30.31%, 29.8%, and 21.78% for Groups II, III, and IV, respectively, at 20 days. Conclusion: The present study concludes that ceramic restorations are effective in promoting dentin remineralization. However, the addition of only 2% mono-n-Dodecyl phosphate was beneficial, whereas 5% mono-n-Dodecyl phosphate reduced the efficacy of ceramic on dentin remineralization.
  188 50 -
Assessment of oral health status with visually impaired children in Patna City, Bihar
Santosh Anand, Kumari Kavita, Amresh Pandey, Shilpi Verma, Revati Singh, Rohit Singh
November 2021, 13(6):1709-1712
Aim: Children with a visually impairment often face various challenges in their day-to-day skills. Oral hygiene maintenance is one major task for them. Such child has difficulty to live current normal life and demands of permission or healthy life. The present study aims to assess the oral health in children with visually impaired using oral health status assessment tool in Patna city. Methodology: A cross-sectional institutional survey was implicated among visually impaired children who attend special school in Patna city. A total of 180 visually impaired children were selected as per the inclusion criteria. Participant's parents gave written consent for the study. The oral hygiene practices of visually impaired children were recorded by teachers. Oral health assessment tool (OHAT) findings were recorded by the principal investigator. Results: Sixty-seven percent of children had gingival inflammation and 59.8% had normal tongue. 55.2% of children had 1–3 decayed or broken teeth and 16.1% had unhealthy natural teeth. 78.7% of children had change in oral hygiene. Conclusion: Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool(OHAT). The sentence should be chaged as Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool (OHAT).
  202 34 -
Pleomorphic sarcoma of the oral cavity: A rare case entity
Sharada T Rajan, S Elengkumaran, Malathi Narasimhan, C Ravindran
November 2021, 13(6):1747-1749
Pleomorphic sarcomas are extremely rare in the oral cavity, representing only 5% of all soft tissue sarcomas in the extremities of adults. They form a group of highly undifferentiated pleomorphic malignant tumors. A 36-year-old male reported to the OP with a chief complaint of a tooth ache in the right lower quadrant for the past 6 months. The patient gave a history of extraction of a mobile tooth in that region. A radiograph of the region was advised. An incisional biopsy was also done and sent for histopathological examination. The microscopy revealed the presence of spindle-shaped cells showing dysplastic features. A panel of immunohistochemical markers were performed to identify the tissue of origin of the lesion. The article details the clinical, radiographic, and microscopic features of a pleomorphic soft tissue lesion along with the array of immunohistochemical markers, leading to the final diagnosis of such enigmatic lesions.
  200 34 -
Evaluation of crack propagation after root canal preparation with continuous and reciprocating files and final finishing with XP Endo Finisher – An In vitro study
R Hariprasad, VN Anoop, P Rajesh Raj, Vishnu Teja Obulareddy, Renju M Kunjumon, Kiran Kumar Sadula
November 2021, 13(6):1700-1704
Introduction: One of the disadvantages of stainless steel instruments used for root canal preparation is the lack of flexibility and shape memory. The invention of rotary instruments has been successful in overcoming these problems to a greater extent; however, some drawbacks still remain, one of which is vertical root fracture and the cause for it is microcracks formation in dentin, which in turn causes vertical root fracture. There are enough studies for microcracks using different rotary systems and this study compared microcracks with single as well as reciprocating files followed by final finishing with XP endo finisher. Apart from other studies, we used conefocal laser scanning microscope to assess microcrack propagation before and after instrumentation with each rotary system. Aim: To evaluate microcrack propagation in mandibular molars after root canal preparation with continuous and reciprocating file systems followed by final finishing with XP Endo finisher. Materials and Methods: Thirty mandibular molars indicated for the extraction due to periodontal causes were selected for this study. They were divided into three groups based on rotary systems used: Group A: ProTaper universal; Group B: ProTaper gold; and Group C: Waveone gold. All specimens were subjected to scanning before instrumentation to assess the presence of any existing cracks. Cone focal laser microscopic scanning is again repeated for each specimen after instrumentation with each rotary system and also after final finishing with XP Endo finisher. Statistical Analysis: One-way ANOVA is used. Results: Crack propagation is the highest with ProTaper universal and least with waveone gold. After final finishing of canals with XP Endo finisher, crack propagation observed was negligible. Conclusion: The success of root canal treatment depends on effective disinfection of root canal system. XP Endo finisher can be used as a final finishing file by considering its advantageous properties, moreover crack propagation with XP Endo finisher in an previously instrumented canal is negligible.
  194 39 -
To evaluate the prevalence of edentulousness, the present prosthetic status, and the need for prosthetic treatment in the population of Garhwa, Jharkhand
Amit Kumar Mishra, Manoj Kumar Thakur, Anand Uday Madihalli, Ankita Piplani, Roseneel Atreya, Arvind Jain
November 2021, 13(6):1609-1612
Aim: This study aimed to evaluate the prevalence of edentulousness, the present prosthetic status, and the need for prosthetic treatment in the population of Garhwa, Jharkhand. Materials and Methods: A descriptive cross-sectional study was conducted among the population of Garhwa, Jharkhand. The sample size included 460 subjects belonging to an age group of 25 years and above. Detailed case history and thorough dental examination was done and all the findings were recorded and compiled. Each subject was interrogated with the help of a predesigned closed ended questionnaire. Results: A total of six patients were completely edentulous, while 55.04% of males and 42.80% of females were partially edentulous. All patients who were completely edentulous were denture wearer, while among partially edentulous patients, 6.31% of males and 3.15% of females had RPD and 13.68% and 6.31% of males and females, respectively, had FPD as prosthesis. Prosthetic status of females was better than males In a comparison of prosthetic status between male and female, out of 460 subjects, 195 subjects opted for prosthesis, in which 117 were male and 78 were female. Conclusion: Community-based oral health education programs should be conducted to improve patients' oral health knowledge. Educating patients regarding the limitations of prosthesis as mechanical substitutes for natural teeth must be a continuing process from the initial patient contact until adjustments are completed.
  196 37 -
To evaluate the marginal adaptation of porcelain fused to metal crown with different base metal alloys
Manoj Kumar Thakur, Amit Kumar Mishra, Tanya Verma, Lenin Babu Thota, Sandeep Saurabh, Deepak Kumar
November 2021, 13(6):1315-1319
Introduction: The success of any restoration depends on the marginal seal. The adaptation of castings, luting cement, and the surface structures of the margins are all important factors in achieving marginal seal. Aim: The aim of this study was to evaluate the vertical marginal discrepancy of cast copings obtained by employing conventional casting technique with two different base metal alloys with two different finish lines before and after porcelain firing. Material and Methods: A total of forty wax copings were fabricated with stainless steel die assembly and divided into four groups with ten specimens for each metal and each finish line. Measurements were recorded from coping margin to the stainless steel die margin for vertical marginal gap recordings. Each metal coping was finished, and porcelain application was completed. Copings with porcelain were placed on their respective dies, again subjected to the same measuring microscope for checking the vertical marginal discrepancy by the same operator and results. Results: The results of the present study showed that the mean vertical marginal gaps of all the cast copings obtained in each group (G1–G8) were within clinically acceptable limits. The mean vertical marginal gap of G1 was 135.36 ± 2.30 μm, G2 was 67.22 ± 4.25 μm, G3: 39.47 ± 2.98 μm, G4: 71.00 ± 3.97 μm, G5: 109.57 ± 2.98 μm, G6: 109.57 ± 2.98 μm, and G8: 114.58 ± 2.40 μm. Conclusion: The difference in the vertical marginal gap of cast copings obtained in different groups was statistically highly significant at 0.005 level, while the difference in the vertical marginal gap of cast copings obtained at different points was statistically nonsignificant.
  202 31 -
A cross-sectional study to assess factors that determine tobacco habit initialization and cessation and oral cancer awareness among general population of Vikarabad District, Telangana
Hariprasad Gone, Nishath Sayed Abdul, Manish Pisarla, Karuparty Pavan Kumar, Ganesh Kulkarni, Rithesh Kumar Audurthi
November 2021, 13(6):1613-1619
Aims: The aim of the study was to assess factors that determine tobacco habit initialization and cessation and oral cancer awareness among the general population of Vikarabad district, Telangana. Materials and Methods: The current study was a cross-sectional study conducted among the general population of the Vikarabad district. All tobacco users satisfying inclusion criteria of age 18–40 years and at least 1 year of tobacco usage were included in the study. Multistage random sampling was followed to select tobacco users and structured, pretested questionnaires were distributed. The populations mean age was 30 years with majority being rural residents and men contributing the majority of the study population. Results: The mean age at which a person begins to smoke was 20.4 ± 5.7 years among the general population. Peer influence (77%) was reported as one of the major reasons, and habit formation was found to be the major factor (55.6%) for continuing tobacco and also work stress (17%) and relaxation (17%). The primary reason for quitting was fear or awareness of the adverse effects of tobacco. Self-abstinence was reported as a predominant method that they followed to quit tobacco habit during the past year, while 16.3% reported that they did not give it a try. About 58.6% of participants were advised by a health-care provider to quit tobacco, respectively. A major proportion of tobacco users (71%) knew that tobacco causes oral cancer. Half of the study population is unaware of oral cancer's early symptoms, noncontagious progression, lifestyle modification, and early treatment have a good prognosis. Conclusion: Findings of the study highlight the factors to be considered in framing effective antitobacco policies applicable to the rural population.
  197 34 -
Assessment of oral health and prevalence of oral conditions in human immunodeficiency virus-infected subjects visiting antiretroviral therapy centers
Wagisha Barbi, Kumari Shalini, Anjali Kumari, Vaibhava Raaj, Hitesh Gupta, Preeti Gauniyal, Priyadarshini Rangari
November 2021, 13(6):1470-1473
Background: Weakened immune system from acquired immunodeficiency syndrome (AIDS) makes the individual prone to various opportunistic infections which are life-threatening including various carcinomas and disorders affecting the neurological system. Aims: The present trial was done to assess the prevalence of oral presentations and treatment needs in AIDS/human immunodeficiency virus (HIV)-infected subjects visiting antiretroviral therapy centers. Materials and Methods: The study included 126 subjects. Oral cavity was assessed and dentition, periodontal condition, and lesions and conditions affecting the oral mucosa were identified along with their treatment needs. The collected data were subjected to statistical evaluation and the results were formulated. Results: Candidiasis was seen in 25.39% (n = 32) of total subjects. Concerning the periodontal status of HIV-infected study population, it was seen that maximum attachment loss both in males and females was within the range of 0–3 mm. Regarding decayed, missing, and filled teeth scores, these were statistically significantly higher in males (P = 0.001). Conclusion: The present study concluded that the majority of subjects infected with HIV present one or more oral presentation and lesion, with candidiasis being the most common condition.
  188 36 -
Functional and radiological outcome in distal third humerus fracture treated with extra-articular locking plate: A multicentric retrospective study
Ashis Kumar Gupta, Barada Prasanna Samal, Tushar Ranjan Dalei
November 2021, 13(6):1483-1487
Introduction: The optimal method for fixation of extra-articular distal humerus fractures poses a management dilemma. Although various plate configurations have been proposed, anatomic shaped extra-articular distal humerus locking plates (EADHPs) have emerged as a viable solution for these complex injuries. We assessed functional and radiologic outcomes in our retrospective case series of extra-articular distal humerus fractures managed with these plates at different centers in Cuttack, Odisha. Materials and Methods: One hundred and ten patients of extra-articular distal humerus fractures, who were operated at various trauma centers between January 2012 and December 2020, were identified. After exclusion, 100 patients were available for the final assessment. All patients were operated with the triceps-reflecting modified posterior approach. Regular functional–radiologic follow-up was done evaluating elbow functionality, fracture union, secondary displacement, nonunion, implant failure, and any complications; Mayo Elbow Performance Score (MEPS) was used for the final functional assessment. Results: Sixty-seven percent of male and 33% of female patients constituted the study group, who had an average follow-up of 18 months. Preoperatively three patients and postoperatively one patient had radial nerve palsy; all had neurapraxia and recovered completely. Overall, 95% of patients were adjudged to have complete radiological union within 3 months; 6% of patients developed nonunion. The mean flexion achieved was 123 + 22, and the mean extension was 4.031 + 6.50; five patients with head injury developed flexion deformity of 45. The average MEPS at the final follow-up was 91 + 9.8. Conclusion: Stable reconstruction and early initiation of physiotherapy are utilitarian to envision optimal outcome; the use of precontoured EADHPs has yielded satisfactory results with minimal complications in our hands.
  188 36 -
Assessment of correlation of serum high-sensitive C-reactive protein, urinary albumin-to-creatinine ratio, and lipid profile in diabetics
Shweta Kumari, Beena Singh
November 2021, 13(6):1569-1572
Background: This study aimed to measure the level of serum high-sensitive C-reactive protein (hs CRP), urinary albumin-to-creatinine ratio (ACR), lipid profile, and their association in diabetics. Methodology: One hundred and fifty diabetic patients were classified into three groups of 50 each. Group I were newly diagnosed with <5 years of diabetes, Group II were those having 5–10 years of diabetes, and Group III were diabetics with more than 10 years of diabetes. Lipid profile, hs-CRP level, and ACR were measured. Results: There was a correlation between hS CRP and ACR and triglyceride in Group I, hS CRP with ACR and triglyceride in Group I. In group II hS CRP showed significant correlation with ACR whereas in Group III significant correlation was observed with ACR, low density lipoprotein (LDL) and cholesterol. Conclusion: The level of hS CRP and ACR was found to be higher in patients with a longer duration of diabetes.
  188 33 -
Nonextraction correction of Class II malocclusion by pendulum appliance
Pallavi Jeetesh Jadhav, Shivprasad Vasant Sonawane, Nikhil Mahajan, Bhushan Gorakh Chavan, Priyanka R Mahale, Rakesh Ashok Pawar
November 2021, 13(6):1750-1754
A 13-year-old female patient, presented with the chief complaint of forwardly placed upper front teeth. On examination and analysis of relevant records, she was diagnosed as an Angle's Class II malocclusion on a skeletal Class I base. It was decided to treat the patient with a nonextraction treatment approach with the help of maxillary molar distalization followed by fixed mechanotherapy.
  188 31 -
Alterations in integumental facial dimensions after orthodontic treatment
Toshi Toshi, Madhukar Vashishtha, Amit Chaddha, Shakeel Ahmed Galagali, Dipti Gopalakrishnan, Ruchi Saini, Priyadarshini Rangari
November 2021, 13(6):1474-1477
Background: It is documented that the facial profile changes, morphology changes, and continued facial growth in early adults and late adolescents. Aims: The present trial was aimed to quantitatively assess the changes in facial growth from adolescents to adults. Materials and Methods: In the present study, 16 facial distances (transverse) and craniocaudal facial distances were measured, and growth changes were assessed. The collected data were subjected to statistical evaluation, and the results were formulated. Results: Upper face width was statistically significantly increased in males than females from posttreatment to recall with the P < 0.0001. The decrease in outer canthus was seen in females as compared to males, which was statistically significant with the P < 0.0001. An increase in mouth width was seen in both males and females with higher in females. Conclusion: The present study showed an increase in facial dimensions in both genders with age where transverse changes were higher than the craniocaudal alterations.
  184 30 -
Reliability of C-reactive protein as a biomarker for cardiovascular and oral diseases in young and old subjects
Wagisha Barbi, Saurav Kumar, Sonal Sinha, Mehdi Askari, Swati Priya, Shubham J Kumar
November 2021, 13(6):1458-1461
Background: Increased C-reactive protein (CRP) levels are associated with various diseases such as cardiovascular diseases (CVDs), periodontal diseases, and other inflammatory diseases and can be an effective biomarker for predicting future risks of periodontal diseases. Aims: The present trial was carried out to evaluate if CRP levels are lower in healthy and young individuals as compared to individuals with high body mass index (BMI), gingival index, and CVDs by assessing CRP levels in young and old individuals (more than 45 years). Materials and Methods: A total of 174 participants were recruited for the study and were divided into three following groups: Less than 45 years healthy participants (n = 124), more than 45 years healthy participants, and more 45-year-old participants with CVDs (n = 25). The collected data were subjected to the statistical analysis. Results: In Group I, females had a CRP level of 8476 ± 6.86 pg, females of Group II had a CRP value of 13,262 ± 3.76, and in females of Group III CRP value was 22,761 ± 6.24 pg. These values, respectively, for males were 8494 ± 7.68, 13,840 ± 4.82, and 13,839 ± 3.8. In smokers, the CRP values for Group I, II, and III were 29,012 ± 14.66, 12,568 ± 4.16, and 16,826 ± 3.42, respectively. Conclusion: CRP levels were higher in males as compared to females. Higher BMI was associated with higher values of CRP. The participants with higher BMI presented higher CRP values irrespective of age.
  184 30 -
Cardiovascular complications and its impact on outcomes in COVID-19: An original research
Prashant Kumar, Kaousthubh Tiwari, Siva Kumar Pendyala, Ratnesh Kumar Jaiswal, Neelathil Lisa Chacko, Ekta Srivastava, Rahul V C Tiwari
November 2021, 13(6):1333-1337
Introduction: The viral infection COVID-19 is highly infectious and has claimed many lives till date and is still continuing to consume lives. In the COVID-19, along with pulmonary symptoms, cardiovascular (CV) events were also recorded that have known to significantly contribute to the mortality. In our study, we designed and validated a new risk score that can predict CV events, and also evaluated the effect of these complications on the prognosis in COVID-19 patients. Materials and Methods: A retrospective, multicenter, observational study was done among 1000 laboratory-confirmed COVID-19 patients between June 2020 and December 2020. All the data of the clinical and laboratory parameters were collected. Patients were randomly divided into two groups for testing and validating the hypothesis. The identification of the independent risk factors was done by the logistic regression analysis method. Results: Of all the types of the clinical and laboratory parameters, ten “independent risk factors” were identified associated with CV events in Group A: male gender, older age, chronic heart disease, cough, lymphocyte count <1.1 × 109/L at admission, blood urea nitrogen >7 mmol/L at admission, estimated glomerular filtration rate <90 ml/min/1.73 m2 at admission, activated partial thromboplastin time >37 S, D-dimer, and procalcitonin >0.5 mg/L. In our study, we found that CV events were significantly related with inferior prognosis (P < 0.001). Conclusions: A new risk scoring system was designed in our study, which may be used as a predictive tool for CV complications among the patients with COVID-19 infection.
  174 38 -
Assessment of correlation of oxidative stress and insulin resistance with glucose-6-phosphate dehydrogenase activity in Type II diabetes mellitus patients
Beena Singh, Shweta Kumari
November 2021, 13(6):1573-1576
Background: The present study aimed to assess the correlation of oxidative stress glucose-6-phosphate dehydrogenase (G6PD) activity in type II diabetes mellitus (DM) patients. Methodology: Forty-eight type II DM patients and healthy subjects were recruited. In all, G6PD activity, protein carbonyl, and total thiol levels were measured. Results: The mean glycated hemoglobin (HbA1c) was 9.4% in Group I and 5.2% in Group II, G6PD activity was 6.5 U/gHb in Group I and 8.2 U/gHb in Group II, protein carbonyl was 14.2 nmol/mg protein in Group I and 3.5 nmol/mg protein in Group II, and total thiol level was 204.7 μmol/mL in Group I and 318.2 μmol/mL in Group II. In Group I, G6PD activity positively correlated with total thiol (r = 0.62) and negatively correlated with protein carbonyl (r = −0.73) and HbA1C (r = −0.67), protein carbonyl positively correlated with HbA1C (r =0.45) and negatively correlated with total thiol (r = −0.84), and total thiol negatively correlated with HbA1c (r = −0.30). Conclusion: G6PD may be considered a biomarker of oxidative stress and poor glycemic control in diabetic patients.
  170 36 -
Assessment of effect of different sterilization agents on dimensional accuracy of different impression materials in implant prosthesis – An In vitro study
Kumari Kavita, K R Parameshwar Reddy, K R Maheshwar Reddy, Swatantra Kumar, Gyanendra Pandey, Revati Singh
November 2021, 13(6):1620-1623
Aim: Sterilization of impression materials is of paramount importance. The present study was conducted to compare the effect of different disinfectants on dimensional accuracy of elastomeric impression materials used for implant prosthesis and other routine treatments. Materials and Methods: The present study was conducted with polyvinyl siloxane (PVS) (regular body), PVS (medium body), PVS (heavy body), and polyether (medium body) impression materials. Glutaraldehyde (2%) and sodium hypochlorite (NaOCl, 0.525%) were the disinfectant solutions employed in the study. After 16 h, the specimens were measured under Leica WILD stereomicroscope and dimensions were compared with master die. Results: The dimensional change in the Controls, 2% glutaraldehyde (Group I), and 0.525% NaOCl (Group II) was non significant where as Group III and Group IV showed statistically significant difference (P < 0.05). Results also showed significantly higher tear strength (newton/millimeter) in Control group followed by Group I and Group II. Conclusion: PVS (heavy body) was found to be most stable, and polyether was seen to be stable of all the impression materials.
  172 28 -
Frictional forces produced by three different ligation methods in two different types of brackets in 0.016 nickel-titanium wire: An in vitro study
B Kanagasabapathy, MM Varadharaja, R Saravanan, V Vignesh Kumar, R Mahalakshmi, Reshmi Leila Ninan, A Srivel Vigneswari, S Dwaragesh
November 2021, 13(6):1624-1627
Introduction: The aim of this in vitro study was to compare the frictional forces produced by three types of ligatures (conventional elastic ligatures, unconventional elastic ligatures, and tooth-colored ligature wire) on ceramic bracket and stainless steel brackets with 0.016 nickeltitanium (NiTi) archwire in the dry state. Materials and Methods: Twenty each stainless steel brackets and ceramic brackets (0.022 slot central incisor brackets) were mounted on the acrylic block. This assembly was mounted on the Instron machine with the crossheads moving upward at a speed of 10 mm/min in the upper jaw of the Instron machine, one acrylic block with hook and a straight length of 0.016 NiTi wire was attached to it. This wire was ligated to brackets with three different ligation methods. In each test, the brackets were moved a distance of 4 mm, 8 mm, and 12 mm across the central space, and the load cell readings were recorded on the digital display. The difference between the readings is noted. Results: Stainless steel brackets with 0.016 NiTi archwire ligated with conventional, unconventional, and tooth-colored ligation with the movement of 4 mm, 8 mm, and 12 mm shows that the tooth-colored ligation indicating least frictional force decay. Comparison of frictional forces (in newtons) between ceramic brackets and stainless steel brackets using 0.016 NiTi wire for a movement of 12 mm shows that stainless steel bracket with tooth-colored ligation produced least frictional force compared with ceramic bracket. Conclusion: Based on this study results, we can conclude that stainless steel brackets produce less frictional force compared to ceramic brackets. Similarly, tooth-colored ligatures can be preferred to reduce friction during leveling stage.
  170 29 -