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   Table of Contents - Current issue
April-June 2019
Volume 11 | Issue 2
Page Nos. 65-120

Online since Tuesday, April 30, 2019

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Comparison of changes in retentive force and wear pattern of two stud attachments for implant overdentures: An in vitro study Highly accessed article p. 65
Sajjy Upinder, Balvinder Singh Saluja, Gaurav Gupta, Bhupinder Kaur, Gurjot Singh
Context: Edentulous patients often complain about the instability of mandibular denture. To overcome that, implant-supported overdentures (IODs) have been applied as a good prosthetic option. Aims: The current study compared the changes in retentive force and patterns of surface wear of nylon rings of two stud attachments (ball and locator) upon cyclic loading. Subjects and Methods: Two implant analogs were fixed parallel to each other, 22 mm apart, in custom-made rectangular blocks for each attachment system. Ten nylon inserts of each attachment system were tested. Universal testing machine was used to measure the retentive force, and a low-value fatigue testing machine was used for cyclic loading of 2500 insertion–removal cycles. Surface changes of the components were evaluated by scanning electron microscope (SEM). Statistical Analysis Used: Paired Student's t-test was used to determine groups that were statistically significant. Results: The greatest retention loss rate, i.e., the difference between the initial retentive force and final retentive force was observed in the ball attachment (6.20 N) followed by locator attachment (3.70 N). The results were found to be statistically significant (d ≤ 0.001**). Upon SEM analysis, the nylon inserts of ball attachment revealed more surface wear compared to that of locator attachment. Conclusions: For greater retention and longer function, locator overdenture attachment should be preferred for implant overdentures over ball attachment.
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To compare the efficacy of plasma glucose level, finger capillary blood, and gingival crevicular blood to measure blood glucose level in chronic periodontitis patients p. 71
Shireen Singh, Amit Bhardwaj, Priyanka Chopra, Sujata Masamatti
Background: A high number of patients with Periodontitis may have undiagnosed diabetes mellitus (DM). Diabetes is an associated risk factor for chronic periodontitis and has several other oral symptoms including dry mouth and oral infection. Expanding the role of the dentist may prove to be an efficient method of early detection and management of diabetes. Aim: The purpose of the present study was to evaluate whether blood oozing from gingival crevice during routine periodontal examinztion can be used for determining glucose levels. Materials and Methods: A total of 120 male/female patients with Chronic Periodontitis in the age group of 30 years and above were selected and divided into three groups i.e. Control Group (Plasma glucose level), Test Group 1 (Finger capillary blood) and Test Group 2 (Gingival crevicular blood). Blood glucose measurements were made using gingival crevicular blood and finger capillary blood using glucose self monitoring device (Accu-Chek Active) and at the same time venous blood was collected for measurement of serum (plasma) glucose. Data obtained were statistically analyzed using Paired t-test (p), and Pearson's correlation test (r). Results: The results revealed a strong correlation between (a) gingival crevicular blood and finger capillary blood (r = 0.999; P < 0.133); and also (b) between GCB and Plasma glucose level (r =0.984; P < 0.230). Conclusion: The data from this study has shown that gingival crevicular blood collected during diagnostic periodontal examination can be an excellent source of blood for glucometric analysis. GCB can be used as a marker for blood glucose estimation using glucometer. The technique described is safe, easy to perform and helps to increase the frequency of diabetes screening in dental office.
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Evaluation of awareness toward various treatment modalities for replacement of teeth in local population of Sundar Nagar, District Mandi, Himachal Pradesh: A survey report p. 77
Amit Kumar, Rajeev Gupta, Archana Nagpal, Rupandeep Kaur Samra, Jasjit Kaur, Alisha Babbar
Background: The purpose of the study was to collect information from local population of Sundar Nagar, District Mandi, Himachal Pradesh, to assess their attitude toward replacement of teeth. Materials and Methods: An analytical, cross-sectional, epidemiological survey was conducted on 522 individuals randomly selected from a local population of Sundar Nagar, to determine attitude toward various treatment modalities for the replacement of teeth. A self-designed closed-ended questionnaire was prepared to assess the attitude of the patient, and collected data were analyzed statistically using the Chi-square test at the significance level of P < 0.05. Results: Around 87% of patients showed positive attitude for the replacement of missing teeth. Almost 78.2% of patients liked to replace missing teeth even although it is an expensive treatment. Around 47.1% of patients believed that they socialized less with a removable prosthesis because of poor stability and retention. Eighty-eight percent of patients of 40–59 years showed a positive attitude toward fixed prosthesis as compared to older age, who preferred removable prosthesis due to lack of interest in esthetics and low perceived need of prosthesis. Forty-seven percent of patients showed a positive attitude toward acceptance of implant. Conclusion: It is essential to evaluate attitude toward treatment as treatment expectations may influence treatment planning and perceived value by the patient and its outcome.
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Clinical and radiographic evaluation of autogenous dentin graft and demineralized freeze-dried bone allograft with chorion membrane in the treatment of Grade II and III furcation defects-: A randomized controlled trial p. 83
Guntakala Vikram Reddy, Atchuta Abhinav, Suryakanth Malgikar, Ch Bhagyashree, P Raja Babu, G Jagadish Reddy, S Vidya Sagar
Background: Periodontal Regeneration of any tissue type is a complex biological process in itself, requiring a triad of cells, locally acting growth factors, systemic hormones, and the extracellular matrix components in which these interact. Aims: The aim of this study was to compare the effectiveness of autogenous dentin graft (ADG) and demineralized freeze-dried bone allograft (DFDBA) with chorion membrane in the treatment of Grade II and III Furcation defects in patients with moderate-to-severe chronic periodontitis. Subjects and Methods: A total of 20 Grade II and III furcation defects in patients with moderate-to-severe chronic periodontitis were randomly assigned to either Group I (ADG + chorion membrane) or Group II (DFDBA + chorion membrane) and evaluated clinically for Gingival Index (GI), probing pocket depth (PPD), clinical attachment level (CAL), vertical bone depth (VBD), and horizontal bone depth (HBD) and radiographically for furcation bony defect (FBD). Results: Intragroup comparisons of clinical parameters GI, PPD, and CAL have shown a statistically significant reduction at the end of 3 months and 6 months, but intergroup comparison was not statistically significant. At the end of 6 months, there was a significant reduction in VBD in Group I (2.65 ± 0.71 mm) compared with Group II (4.00 ± 1.26 mm) and HBD (1.84 ± 0.59 mm) compared with Group II (3.95 ± 1.74 mm), respectively. At the end of 3 months and 6 months, FBD depth was significantly reduced in Group I (1.21 ± 1.10 and 0.43 ± 0.22 mm2, respectively) compared with the Group II (3.04 ± 2.45 and 2.68 ± 2.50 mm2, respectively). Conclusions: The results of the present study indicate that the use of ADG and chorion membrane improved all the clinical parameters. Individuals treated with ADG and chorion membrane showed significant reduction for VBD, HBD, and FBD in the treatment of Grade II and III furcation defects than in the individuals treated with DFDBA and chorion membrane.
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Information content of youtube videos on orthognathic surgery – Helpful? p. 90
Jasmine Grewal, Gayathri Marria, Saurabh Goel
Aim: The aim of this study is to investigate the accuracy of the information provided by YouTube videos regarding orthognathic surgery. Methods and Materials: YouTube was searched for four keywords such as orthognathic surgery, orthodontic surgery, jaw surgery, and jaw corrective surgery. While the videos having English language, primary content related to orthognathic surgery, and acceptable audio-visual quality were included in the study, the videos with non-English language, lacking audio or visuals, satirical videos, drama-based videos, and news stories were excluded for the study. YouTube advanced search option “sort by view count” was used. Videos were sorted into top 50 for each search term and overall into top 55 from the four searches. Video assessment was done based on the number of views, likes, dislikes, source, and primary intention. Every video was classified as “excellent,” “moderate,” or “poor” according to information content it provided. A predetermined list of orthognathic surgery-related information domains was also evaluated. Statistical Analysis Used: STATA version 8.2 was used. Results: The top 55 videos had a combined total of 7,663,296 views. Videos predominantly involved patients describing their personal experience (34.54%) and majority were positively biased (85.45%). While only 27.27% of videos were classified as having excellent general information, 61.81% of videos had moderate information and 10.90% videos provided poor information content. Conclusions: Information available on YouTube is of moderate quality, and patients should consult dentists regarding questions related to orthognathic surgery.
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Evaluation of knowledge and awareness among dental students and private dental practitioners about the emerging trend of travel medicine in and around Kanpur City p. 95
Kriti Garg, Rohan Sachdev, Devina Pradhan, Garima Singh
Context: For the evaluation of knowledge among dental students and practitioners. Aims: Travelers play a significant role in the spread of infections across various international borders, through their travel patterns. The aim of this study was to evaluate the knowledge and awareness among dental students and dental practitioners regarding the emerging trend of travel medicine in and around Kanpur city. Settings and Design: A descriptive, cross-sectional questionnaire study was performed. Subjects and Methods: The present study was performed at a private dental college in Kanpur from June to July 2018. A total of 450 dental students and dental practitioners of both genders were included in the study. Statistical Analysis Used: The collected data were analyzed by using appropriate statistical software. Results: A total of 190 males and 260 female respondents participated in the study, out of which 130 participants were married and 320 were single. Seventy respondents were aware of the concept of travel vaccines, whereas 30 respondents could give correct definition of travel medicine. Knowledge regarding travel medicine was found to be very poor, 310 of the total respondents were unaware of the uptake of travel vaccine. Conclusions: The present study suggests that, by increasing the knowledge regarding travel medicine uptake through various educational programs not only among dental students and dental practitioners but also among their families, the more uptake of travel medicine will be helpful in preventing various disease spread as these dental professionals may be helpful to educate their patients regarding vaccination during traveling.
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Comparison of various sealers on postoperative pain in single-visit endodontics: A randomized clinical study p. 99
Shahnaz Nabi, Riyaz Farooq, Aamir Purra, Fayaz Ahmed
Aim: The aim of this study is to evaluate the effect of bioceramic-based sealers on postendodontic pain following single-visit endodontics. Materials and Methods: Ninety patients requiring primary endodontic treatment were selected for the study. Patients were treated in single visit endodontically using three different bioceramic-based sealers: Group 1: obturation done using mineral trioxide aggregate plus sealer, Group 2: obturation done using EndoSequence BC sealer, and Group 3: iRoot SP sealer. Postendodontic pain was measured for 48 h postoperatively. Results: No significant difference was found in postendodontic pain scores between the sealers groups. Conclusion: Postendodontic pain was reduced in all treatment groups. Any of the three bioceramic sealers can be used for single-visit endodontics without fear of postoperative pain.
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A phase contrast cytomorphometric study of oral exfoliated cells in diabetes mellitus patients - An original study p. 103
RG Mridula, S Akhil, RB Vinod Kumar, Jubin Thomas, Ajish M Saji, Amal K Iype
Background of Study: Diabetes is the most common endocrine-metabolic disease affecting worldwide. Diagnosis of type 2 diabetes with the help of oral exfoliative cytology is a simple, noninvasive technique. Evaluation of cytomorphometric changes in exfoliated buccal cells in diabetes can help in the early detection and examination of diabetes. Aim: The aim is to study and compare the cytomorphometric features of buccal mucosal cells of normal individuals and type 2 diabetes patients and to evaluate the role of phase-contrast microscopy for visualizing cytomorphological changes in unstained smears. Materials and Methods: Fifty known type 2 diabetic patients and fifty healthy individuals were taken as study group and control group, respectively. Smears were prepared from the buccal mucosa of both study and control groups. Fixed, unstained smears were viewed under phase-contrast microscope, and cytomorphometric analysis was done using image analysis software for evaluating nuclear area (NA), cytoplasmic area (CyA), and nuclear/cytoplasmic ratio. Results: A statistically significant increase in NA(P = 0.000), CyA (P = 0.000), and N/Cy ratio (P = 0.000) was obtained from the smears of the study group when compared with the control group. Conclusions: Cytomorphometric analysis of exfoliated cells can aid in predicting systemic disease such as type 2 diabetes. With the use of phase-contrast microscope, the cellular details can be easily and quickly evaluated and it is a cost-effective method in cytomorphometric studies.
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Simple technique to fabricate a crown for abutment of an existing cast partial removable denture p. 108
Shefali Singla, Amarpreet Kaur, Manu Rathee
The requirement of full crown restoration for abutments of existing Cast partial removable denture is common. Retrofitting a crown to existing cast partial denture (CPD) clasps and guiding planes is a challenging task. Literature describes various direct, indirect, and direct-indirect techniques to overcome this dilemma. All these involve elaborate steps, necessitating refabrication of CPD or extended clinical adjustment time for ensuring a proper fit that is elusive in most cases and also patient has to do without CPD during laboratory procedure. The recent use of computer-aided design-computer-aided manufacture technology for this purpose is proving to be a promising but expensive option. A simple technique is presented here to generate a blueprint of required final contours to facilitate a fully contoured metal crown to fit under an existing CPD.
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Frenectomy with laterally displaced flap: A case series p. 112
S Janarthanan, RT Arun, S Srinivasan, S Senthil Kumar
The frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. The frena may jeopardize the gingival health when they are attached too closely to the gingival margin, either due to an interference in the plaque control or due to a muscle pull. In addition to this, the maxillary frenum may present esthetic problems or compromise the orthodontic result in the midline diastema cases, thus causing a recurrence after the treatment. Archer's “classical frenectomy” is an extensive procedure including the excision of fibers, interdental papilla, and exposure of the alveolar bone up to the palatine papilla. The resultant delayed healing, loss of the interdental papilla, and abnormal scar led toward the conservative approaches such as Edward's frenectomy, frenum relocation by Z-plasty, and free gingival graft, with their technical and esthetic limitations. A better approach in frenectomy to make a primary closure in the midline and to avoid an unesthetic scar by creating a zone of the attached gingiva is assisted with a lateral pedicle graft. A case series of this technique with its distinct advantages is presented.
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Pathologies of impacted teeth: A cone-beam computed tomography diagnosis p. 116
Komali Garlapati, Ancy V Ignatius, K Ajaykartik, Chintada Suvarna
An impacted tooth is the one which fails to erupt into its anatomic position due to various factors such as malposition, lack of space, or other impediments. The prevalence of impacted tooth varies with geographic locations and has been estimated to be between 8% and 38%. An impacted tooth can be a nidus for dental caries, infection, destruction of adjacent teeth, periodontal disease, and even oral and maxillofacial cysts or tumors. Therefore, careful evaluation of the history and the clinical and radiographic findings and knowledge about the various maxillofacial cysts and tumors help a clinician to arrive at early diagnosis and render proper treatment to a patient. The recent advancements made in the field of radiology, especially the cone-beam computed tomography (CBCT), is a boon to dentistry. The three-dimensional imaging has made CBCT the preferential imaging modality for the evaluation of unerupted/impacted or supernumerary teeth and also in the evaluation of odontogenic and nonodontogenic cysts/tumors of the jaws. The varied radiographic appearances of cysts/tumors in the maxillofacial region help in precise differentiation of the pathology and prompt the clinicians to arrive at an accurate early diagnosis. This article discusses three case reports of maxillofacial cysts/tumors associated with an impacted tooth where radiology plays an important role in the diagnosis of the lesions.
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