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   Table of Contents - Current issue
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April-June 2018
Volume 10 | Issue 2
Page Nos. 61-125

Online since Friday, June 8, 2018

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ORIGINAL ARTICLES  

Comparing two cordless impression techniques for dimensional accuracy: An in vitro study p. 61
Nupur Dabas, Monika Malik Vigarniya, Shefali Phogat, Reshu Madan, Puja Malhotra, Ashish Dabas
DOI:10.4103/IJDS.IJDS_7_18  
Introduction: For a successful fixed partial prosthodontics, obtaining an accurate impression for making an accurate cast is of prime importance. Aim: The study emphasizes on using modified impression techniques for fixed prosthodontics without using retraction cord. Various mechanical and chemical methods have been used for achieving gingival retraction. Most of them are expensive, time consuming and uncomfortable for the patient. Cordless impression procedures using conventional impression materials are alternative to these methods. Methodology: In the present study, two cordless fixed prosthodontic impression procedures, matrix impression system and prefabricated crown shell technique; have been described and compared in terms of dimensional accuracy.An articulated acrylic resin typodont prepared with reference points was used as a master model. Addition silicon impression materials in various consistencies were used for making impressions. The coordinate measurement machine (Llyod,Germany) was used for three dimensional measurement of master model and stone casts with an accuracy of 0.0001mm. Observations: When comparing the accuracy of casts as per statistical analysis Group B (prefabricated crown shell technique) casts were less accurate in relation to inter abutment distance whereas all other distances produced statistically insignificant mean deviation from the master model. Conclusion: It can be concluded that prefabricated crown shell technique is not recommended for a long span bridge framework but is well indicated while making cordless impressions for fabrication of single crown.
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Comparison of stress, burnout and its association among postgraduate orthodontic and undergraduate students in India p. 66
VenkateshNettam , Prasad Mandava, Gowri SankarSingaraju, Vivek Reddy Ganugapanta, Harsha Yelchuri, RevathiPeddu
DOI:10.4103/IJDS.IJDS_127_17  
Aim and Objectives: Stress and burnout are the wave of the present decade and dentists and dental specialists are found repeatedly on top of the charts of the more stressed occupation; however, the prevalence among orthodontic postgraduates in India has not been well researched. The present study aimed to investigate the stress and burnout levels of postgraduate students of orthodontics in India. Materials and Methods: A descriptive, cross-sectional study was conducted to evaluate stress and burnout in postgraduate students of orthodontics in India. A stratified randomized sampling method, with stratification as North, East, West, South, and central population was employed. A questionnaire format formulated by the International Stress Management Association, including Maslach burnout inventory was filled by each of these individuals. Results: A total of 284 individuals showed significance for stress and personal accomplishment (PA) (P < 0.05) whereas statistically insignificant for genders. There is statistically significance for geographical distribution to depersonalization and PA. The Pearson's correlation is positive for stress and components of burnout in postgraduates and is negative for undergraduates. Conclusion: This study was the first of its kind to explore stress, burnout, and its association among orthodontic postgraduate students and undergraduates in the country. There are significant levels of stress and burnout in both undergraduates and postgraduates. There is a statistically significant positive correlation to the components of burnout found in postgraduates. These findings may help orthodontic community in planning, management, and prevention of stress and burnout.
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A comparative evaluation of porous hydroxyapatite bone graft with and without platelet-rich plasma in the treatment of periodontal intrabony osseous defects: A clinico-Radiographic study p. 72
Gouri Bhatia, Manish Khatri, Mansi Bansal, Sameer Saxena, Vipin Agarwal, Ashish Kumar
DOI:10.4103/IJDS.IJDS_5_18  
Background: Today, regenerative attempts for treatment of periodontal disease focus on the introduction of a filler material into the defect in hope of inducing bone regeneration. The purpose of this study was to clinically and radiographically evaluate the use of porous hydroxyapatite bone graft with and without platelet-rich plasma (PRP) in the treatment of intrabony defects. Materials and Methods: The study was carried out in ten patients between 18 and 60 years. Patients with pocket depth ≥5 mm and radiographic evidence of vertical bone loss in the affected site were randomly assigned to treatment with a combination of PRP + Hydroxyapatite (HA) (test sites) or HA alone (control sites). The parameters were compared at baseline and 6 months postoperatively. Results: There was a statistically significant reduction in probing depth and gain in clinical attachment in both the groups individually (more in experimental group); however, on comparing the two groups, the net reduction was not significant. Radiographic assessment showed a decrease in the defect size in both the groups. Conclusion: PRP in addition to a bone graft in the treatment of intrabony defects is safe and shows improved defect fill as compared to the use of bone graft alone.
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Association of nutritional status on salivary flow rate, dental caries status and eruption pattern in pediatric population in India p. 78
Neetika Singh, Kalpana Bansal, Radhika Chopra, Charan Kamal Kaur Dharmani
DOI:10.4103/IJDS.IJDS_69_17  
Aims: The purpose of the study was to assess the effect of nutrition on salivary flow rate (SFR) (unstimulated and stimulated), dental caries status, and eruption pattern in healthy and malnourished children. Materials and Methods: The study participants were categorized into healthy (Group I, n = 37) and malnourished groups (Group II: Malnourished height-for-age [n = 30] and Group III: Malnourished weight-for-age [n = 30]) as per classification of chronic malnutrition. SFR, dental caries status, and eruption pattern were noted for all groups. Statistical Analysis: Analysis of variance (ANOVA) was used to analyze the differences in unstimulated and stimulated SFR and dental caries among three groups. The lowest square difference was used for post hoc comparison and Pearson's correlation to investigate the association between SFR and dental caries. The statistical significance was set at P < 0.05. Results: The unstimulated SFR values were found to be 0.53 ± 0.15 ml/min (Group I), 0.14 ± 0.04 ml/min (Group II), and 0.21 ± 0.20 ml/min (Group III). For stimulated SFR, the values were 1.94 ± 0.44 ml/min (Group I), 1.17 ± 0.48 ml/min (Group II), and 1.07 ± 0.52 ml/min (Group III). Dental caries status was recorded to be 2.43 (Group I), 6.4 (Group II), and 4.66 (Group III). The participants with delayed eruption pattern were 8.10%, 23.30%, and 16.60% for Group I, Group II, and Group III, respectively. Conclusion: The values for unstimulated and stimulated SFR were significantly less, but dental caries status and delayed eruption were found to be more in malnourished groups as compared to the normal group.
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Denture disinfection by brushing and 6% hydrogen peroxide immersion on denture base resin after biofilm formation: An in vitro study p. 83
Manikya Shastri, Shalini Joshi, Chandrashekar Sajjan, Priyanka Konin
DOI:10.4103/IJDS.IJDS_6_18  
Background: Biofilm formation on acrylic dentures is often seen in denture wearers for which wide variety of denture cleansers are available. This study uses the commonly available 6% British Pharmacopoeia grade 20 volume hydrogen peroxide as denture cleanser. Aim: The aim of this study was to evaluate colonization and population dynamics of oral pathogenic microbial biofilm formation after assigning to one of the cleansing methods, manual brushing, or compound method (manual brushing with soft bristle wetted in distilled water and rinsed then immersion in 6% hydrogen peroxide solution) for the heat-cure acrylic denture base resin. Materials and Methods: Specimens of heat-cure acrylic resins discs were fabricated n = 120. Specimens n = 60 were placed in bacterial culture (Group I) and n = 60 were placed in fungal culture (Group II) until the formation of a biofilm which then was subjected to denture cleansing. They were then immersed in respective broth. The specimens were discarded, and Petri plate was incubated, and colony-forming units (CFUs) were counted. Values of microorganisms were grouped and analyzed according to the different hygiene methods by the Kruskal–Wallis test. Pairwise comparison was done by Mann–Whitney U-test. Results: The CFU in Group I and Group II after brushing was 60 CFU/ml and 50 CFU/ml, respectively. The CFU in Group I and Group II after subjecting to compound method was 1 CFU/ml. Conclusion: The compound method of this study was better when compared to only brushing method. Therefore, for the better maintenance of oral hygiene in denture wearers, the dentures need to be cleaned by manual brushing followed by immersion in hydrogen peroxide solution.
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The relationship of malocclusion with periodontal status, dental caries, and sociodemographic factors in school children of Ludhiana p. 87
Saurabh Goel, Amanpreet Singh, Girish Chaudhary, DS Kalsi, Anchal Sood, Gayathri Marria
DOI:10.4103/IJDS.IJDS_1_18  
Aim: The aim of this study was to find the relationship of orthodontic malocclusion with periodontal status, dental caries, and sociodemographic factors. Materials and Methods: The study population comprised 400 school-going children of age 11–14 years. The severity of malocclusion was determined by Treatment Priority Index. The sociodemographic factors were evaluated using a questionnaire that enquired about age, gender, parents' monthly income, and their educational status. Periodontal status was assessed using Community Periodontal Index of Treatment Need (CPITN) index. To know about dental caries, decayed, missing, filled teeth (DMFT) index was used in this study. Statistical Analysis Used: Spearman's rank correlation coefficients were used to find an association between variables. The effect of sociodemographic factors on treatment priority index (TPI) scores was examined using Chi-square test. Student's t-test (to compare TPI scores of different genders) and analysis of variance (to compare TPI scores among different age groups) were used in this study. Results: Out of a total of 400 children included in the study, 19.5% students had normal occlusion whereas a majority of them (80.5%) showed some sort of malocclusion. CPITN scores revealed that 3.1% pupils had no sign of the disease, 57.5% showed gingival bleeding after gentle probing, and 39.4% had supra or subgingival calculus. Conclusions: No statistically significant correlation was found between the orthodontic treatment need, periodontal status, and sociodemographic factors while a significant relation is observed of TPI with DMFT.
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Comparison of anesthetic efficacy of 4% articaine versus 2% lignocaine p. 92
Sumit Kumar Bansal, Sameer Kaura, Prineet Kaur Sangha, Paramjot Kaur, Rashi Bahl, Shokhi Bansal
DOI:10.4103/IJDS.IJDS_126_17  
Objective: Lignocaine is the most widely used local anesthetic agent in dentistry. It has been labeled as the “gold standard” to which all new local anesthetics are compared. Aim: The aim of this prospective, randomized study was to compare the anesthetic effi cacy of 4% articaine HCl with 1:100,000 adrenaline in comparison with 2% lignocaine HCl with 1:80,000 adrenaline in extraction of maxillary premolars for orthodontic considerations. Materials and Methods: A total of fi fty patients were included in this study. Drug volume, onset and duration of anesthesia, pain during injection and extraction, and postanesthetic complications were recorded for all patients. The values were compared and analyzed statistically using paired t-test. Results: In the present study, drug volume solution for articaine group was less than that of lignocaine group. The mean difference in pain rating (for palatal injection), onset, and also duration of anesthesia for articaine was highly signifi cant statistically on palatal aspect (P < 0.001). Conclusion: The present investigation asserts that articaine HCl has shorter onset time, longer duration of action, and similar effi cacy to lignocaine HCl and thus can also be used. Further controlled comparative clinical trials with similar local anesthetic agents in oral cavity with multicenter studies and a larger sample size are desirable to bring valuable attention to this research area and evaluate the safety and clinical efficacy of articaine HCl.
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Comparative evaluation of cleaning ability of reciproc and waveonegold reciprocating file systems – A scanning electron microscopic study p. 98
Jayaprada Reddy Surakanti, Rajani Punna, Amulya Vanapatla, Harikumar Vemisetty, Navya Poojitha Sajja, Tulasi Priya Nidumukkala
DOI:10.4103/IJDS.IJDS_112_17  
Objective: The aim of this study was to evaluate the canal cleaning ability of two reciprocating single file systems: Reciproc (VDW, Munich, Germany) and WaveOne gold (Dentsply Maillefer, Ballaigues, Switzerland) using scanning electron microscopy (SEM). Materials and Methods: Forty freshly extracted human mandibular premolar teeth with single root and canal were selected. The samples were randomly divided into two experimental groups (n = 15 each). Control group (n = 10) has non-instrumented teeth. Working length was determined using #10/15 K files. All the teeth were prepared to a # 25 final apical size following the manufacturer's instructions using crown-down technique. Teeth were sectioned buccolingually and examined under SEM at 20.0 kV and ×700 magnification. SEM images of the coronal, middle and apical third of the canal were taken and then analyzed using a five-score index. Results: The WaveOne Gold group presented a larger amount of debris than the Reciproc Group, however, without a statistically significant difference (P > 0.05). A larger amount of debris in the control group was observed, with the statistically significant difference between Reciproc and WaveOne Gold groups (P < 0.05). Conclusion: The two reciprocating single-file instrumentation systems presented similar effectiveness for root canal cleaning.
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CASE REPORTS Top

Periodontal plastic surgery: Made easy with acellular dermal matrix p. 102
M Thamilselvan, Prasanta Bandyopathyay, Somen Bagchi, Soma Mallick
DOI:10.4103/IJDS.IJDS_24_18  
Esthetics has become an important part in periodontal plastic surgery, and soft-tissue architecture plays an important role in achieving it. Among the various techniques, the use of autogenous connective tissue graft has been proved to be an effective and a successful approach in treating gingival recession. Recently, acellular dermal matrix (ADM) allograft has been used as a substitute for palatal connective tissue and it has shown to be a successful alternative for root coverage. This case report is an effort to evaluate the clinical effectiveness of ADM in coverage of denuded root with 6-month follow-up.
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Melanotic neuroectodermal tumor of infancy: A rare case report p. 105
Joyce Sequeira, Vinayakrishna Kolari, Sham Bhatt, Pallavi Sabarad, Shruti Gona Rao
DOI:10.4103/IJDS.IJDS_90_17  
Melanotic neuroectodermal tumor of infancy (MNTI) is a very rare neoplasm of infants seen in the oral cavity at or around birth. It shows rapid expansile growth which necessitates proper diagnosis and management. A 6.5-month-old female child reported with a swelling in the maxillary anterior alveolus, which was rapidly increasing in size and was asymptomatic. Radiographic examination showed a diffuse osteolytic radiolucent lesion in the anterior maxillary region and displacement of the developing primary tooth buds. Ultrasonography report revealed well-defined cystic lesion with calcifying foci within and with no internal vascularity. Wide surgical excision under general anesthesia was performed. Histopathological report revealed a nonencapsulated mass composed of a dual population of small round blue cells and larger melanin-containing epithelial cells in a dense cellular fibrous stroma. Tumor is seen to entrap mature bony trabeculae and soft tissue on the whole favoring a diagnosis of MNTI. Early recognition and regular follow-up is the key to successful treatment.
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Implant-supported maxillary incisor intrusion p. 109
Revathi Peddu, Kalyani Mallavarapu, Devikanth Lanka, Bhargavi Nuvusetty
DOI:10.4103/IJDS.IJDS_15_18  
Deep bite management and retention are cumbersome as the stability is questionable, especially when the correction is achieved by posterior extrusion in nongrowing patients. Hence, it is advisable to intrude the anteriors; however, as conventional methods of anterior intrusion tax the anchorage, choosing biomechanics which ensure stable anchorage is our goal. The use of mini-implants has revolutionized biomechanics in orthodontics with better results as far as anchorage is concerned. This case report supports the literature regarding the implant-supported anchorage for true intrusion.
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A saga of two aneurysmal bone cyst cases: An institutional case report p. 113
Rajarshi Banerji, Sandeep Pachisia, Subhransu Basu, Sudipto Sahu, Sucharu Ghosh
DOI:10.4103/IJDS.IJDS_21_18  
Aneurysmal bone cyst (ABC) is a benign osteolytic lesion mainly seen in the long bones and vertebrae but very rare in jaw. It is associated with rapid growth pattern, asymmetry of the face, and variable radiographic appearance which makes histopathologic evaluation a very important tool in its precise detection. Here, we present two cases of ABC are being described one of which occurred in a 46-year-old female, in the left side of mandible which was treated with curettage and extraction of involved and resorbed teeth. The other one occurred in a 44-year-old woman in both sides of the mandible, treated by curettage and extraction of involved tooth followed by platelet-rich fibrin bone graft.
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ORIGINAL ARTICLES Top

Prosthetic management of a hemi-Mandibulectomy patient p. 118
Shweta Choudhary, Supratim Ram, Ajit Kumar
DOI:10.4103/IJDS.IJDS_122_17  
This case report describes the prosthodontic management of a patient that has undergone hemimandibulectomy with a provisional training appliance followed by definitive flange prosthesis. The prosthodontic rehabilitation of a patient with acquired mandibular defects is important as the balance and symmetry of mandibular function is lost. There is an altered mandibular movement and deviation of the residual fragment toward the defective side. Besides, there is difficulty in swallowing and impaired speech. A corrective device named “Guide Flange Prosthesis” is indicated to limit that clinical manifestation. A 32-year-old female patient with segmental resection of the left mandible without reconstruction (Class III) reported our department. She had deviated mouth opening and disturbed profile with facial asymmetry. A training appliance with a palatal ramp followed by a definitive mandibular cast partial denture with a guiding flange-in was planned for this patient.
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REVIEW ARTICLE Top

Dental caries vaccine: An overview p. 121
Bhawna Arora, Vikas Setia, Amandeep Kaur, Mridul Mahajan, Harveen Kaur Sekhon, Harpreet Singh
DOI:10.4103/IJDS.IJDS_128_17  
Can infection with the dental caries pathogen, Streptococcus mutans, be intercepted or modified immunologically? Resolving this question requires answer to many questions: What are the pathways by which this cariogenic streptococcus enters and accumulates in the dental biofilm? Can bacterial components associated with virulence induce immune responses? What is the level of maturity of immune pathways in the oral cavity of the young child at the time of infection? Many such questions have been answered. For example, preclinical application of modern methods of mucosal vaccine design and delivery has routinely resulted in protection from dental caries caused by S. mutans infection, using antigens involved in the sucrose-independent or sucrose-dependent mechanisms of infection by these cariogenic streptococci. Passive administration of antibody to functional epitopes of S. mutans virulence antigens has also provided a degree of protection in preclinical studies and small-scale human investigations. The caries-protective capacity of active immunization with dental caries vaccines now awaits proof of principle in pediatric clinical trials.
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