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   Table of Contents - Current issue
July-September 2018
Volume 10 | Issue 3
Page Nos. 127-195

Online since Wednesday, September 12, 2018

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Comparative evaluation of the effect of a saliva substitute on the color stability of three different direct tooth-colored restorative materials: An in vitro spectrophotometric study Highly accessed article p. 127
Sumanthini V Margasahayam, Pranjal S Walzade, Vanitha U Shenoy
Context: An aesthetic restorative material that would be suitable to be used in patients who are prescribed saliva substitute (SS) for symptomatic relief from xerostomia. Aims: This study aimed to evaluate and compare the effect of SS on the color stability of three different direct tooth-colored restorative materials. Settings and Design: This is an in vitro spectrophotometric study where standard uniform disc-shaped specimens were immersed in a SS for 30 days. Materials and Methods: The materials investigated were resin-modified-glass ionomer cement (RM-GIC), light-cured (LC) resin composite restorative material (Filtek™ Z350 XT), and LC fluoride-releasing restorative material (Ketac™ N100). Sixteen disc-shaped samples of each test material were prepared using a polytetrafluoroethylene mold, making up a total of 48 samples and were assigned to three groups: Group I (RM-GIC), Group II (Filtek™ Z350 XT), and Group III (Ketac™ N100). They were further divided into two subgroups A and B with eight samples each based on the immersion solutions namely distilled water (DW) and SS, respectively. The samples were immersed for 30 days. Baseline and postimmersion color analysis was done with a spectrophotometer. The CIE L*a*b* values were measured and CIE ΔE values obtained were tabulated. Statistical Analysis Used: The data obtained were statistically analyzed using ANOVA and independent t-test, and the pair-wise significance between groups was obtained using least significant difference test. P < 0.05 was considered statistically significant. Results: All the samples immersed in SS showed greater discoloration (ΔE >3.3) than the samples immersed in DW and was found to be statistically significant (P < 0.05). Ketac™ N100 displayed relatively lesser discoloration when compared to RM-GIC and Filtek™ Z350 XT when immersed in a SS. Conclusions: Among the materials tested, Ketac™ N100 was found to be more color stable.
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A comparative evaluation of bite force as a parameter for the stability in conventional and three-dimensional mini plates p. 133
Gyan Chand Jain, Reeta Jain, Hemlata Dwivedi
Introduction: Maxillofacial skeleton fractures can be treated by open (surgical) and closed (non-surgical) techniques. Fracture sites are immobilized either with intermaxillary fixation or external or internal devices (i.e. plates and screws) to allow bone healing. Aim: The study was primarily aimed at investigating the comparison between three-dimensional (3D) mini plates versus conventional mini plates in mandibular fractures under functional load. Methodology: This study was carried out in twenty patients for treatment of mandibular fractures. Bite force readings were made using indigenous bite force recorder in kilograms. Bite forces were recorded at the operated site and contralateral site of the same region. Bite force recordings were done preoperatively before fixing Erich arch bar and postoperatively at each follow-up (7th, 14th, 21st, 28th, and 90th day). Observations: Data show postoperatively in operated sites of the molar that patients in Group A generate more biting force on day 28 and day 90 when compared to Group B. The difference in mean bite force over control group on fractured sites of molars and incisors when comparison was done between postoperative days interval was significant. Conclusion: It was concluded that the 3D mini plates in mandibular fractures are efficacious enough to bear masticatory loads during the osteosynthesis of fracture. It gives the advantage of reduced implant material and 3D stability with almost similar results as seen in two conventional mini plates osteosynthesis.
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Expression of desmosomal proteins and their implications during enamel organ morphogenesis p. 139
Background/Objective: The present article is between the fewest that describe the expression of desmosomal proteins in human tooth organ and to implicate desmosome and its components in tooth morphogenesis. Although present in all epithelia, desmosomes are particularly down regulated in undifferentiated, dedifferentiated and malignant cells. Methodology: In the present article, using immunohistochemical staining, we report the expression patterns of 6 desmosomal components; Desmoplakin, plakoglobin, desmoglein, plakophilin-1, plakophilin-2, and plakophilin-3. The dental, oral and ectodermal epithelia were investigated in 7 and 9 weeks' human embryos. Results: The expression of these components appeared to associate with cell differentiation, stage of development and epithelial type. The fundamental desmosomal proteins, desmoplakin, plakoglobin and desmoglein, produced almost identical profiles, suggesting that desmosomes are absent or under developed in negative and weak reacting areas respectively. Whilst the accessory component plakophilin-1 was always absent, plakophilin-2 and -3 were strongly labeled in the embryonic epidermis and moderately expressed in the oral epithelium. In the developing enamel organ, gradients of fundamental protein expressions were produced being strong towards the oral epithelium and weak/negative around the inner enamel epithelium. These gradients were also produced using antibodies to plakophilin-2 and -3 although the majority of enamel organ cells were unlabeled. Conclusion: Mirror image symmetry was foundwas found for the distribution patterns of these markers. Furthermore, the left-right asymmetry was found both for the maxillary and mandibular tooth germs, thus bringing further evidence implicating desmosome and its components in the mechanisms regulating tooth morphogenesis.
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Sustenance of salivary response in human population and suggestions for elderly denture wearer: An in vivo study p. 146
Devendra Chopra, Ravi Dwivedi
Aim: The purpose of this study was to confirm whether psychic stimulation of salivation occurs in human also and to formulate certain guidelines for complete denture wearers. Material and Methods: Armamentarium used for this study includes preweighed cotton packets, two glass beakers, stopwatch, electronic digital balance, cotton tweezers, and hot fresh snacks. After this, the mopping protocol for the participants was made, and each participant was told to follow the instructions for all the 6 days of observations. The collected data of salivary flow as per the protocol were tabulated in terms of increase in cotton weight for all the steps. Similar tables were prepared for all the forty participants. As the sample size was small, a nonparametric analytical plan was adopted. Wilcoxon signed-rank test (nonparametric variant of paired t-test) and Mann–Whitney U-test (nonparametric variant of Student's t-test) were used. Results: For baseline secretions (day 1 without thought of food) values for all steps were overall higher in males, mean value is 2.99 ± 1.14 g as compared to 2.08 ± 0.82 g for females for Step 1 (0 – 3)mts, in males as compared to in females for Step 5(12 – 15)mts. Overall, a significant difference between two genders was observed for baseline flow during all the steps except for Step 5 (P < 0.05) with males showing significantly higher flow as compared to females. It was observed that there was a significant difference between baseline and stimulated salivary flow in all the participants on all the days of observation, except for the Step 4 and 5 where it was near to baseline. Conclusions: The findings generally suggest that yes there is an enhancement of salivary flow with the thought of food, but it lasts for 6–9 min after which it turns to base level.
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Efficacy of digital volume tomography in the preoperative assessment of position of inferior alveolar canal with impacted mandibular third molars in a subset of Indian population p. 153
Biyas Bhowmik, Venkatesh G Naikmasur, Kruthika Satyabodh Guttal
Context: Choosing an imaging source, which provides minimum radiation exposure to the patient, to facilitate surgical removal of impacted mandibular third molars (MTMs), thereby avoiding unwanted neurological complications. Aim: The aim of the study was to assess the efficacy of digital volume tomography (DVT) in evaluating the position of inferior alveolar canal (IAC) in relation to impacted MTMs and comparing it with conventional radiography (CR) in a subset of the Indian population. Materials and Methods: Four experienced observers assessed two groups: 33 DVT and 33 CR images, for the position of root-tips of impacted MTM in the proximity to IAC, in both vertical and horizontal planes. The diagnostic information was compared in both the groups. Statistical Analysis: Chi-square test, Mann–Whitney U-test, and Kappa statistics were used. Results: Comparison between DVT and CR revealed no statistically significant variation in assessing relationship in the vertical plane. There was, however, a significant difference between the groups, while comparing the diagnostic information for the horizontal dimension, for both the mesial and the distal roots, with an advantage for DVT (P < 0.05 for both mesial and distal roots). Conclusion: DVT is highly accurate in predicting neurovascular bundle exposure. It is indispensable for preoperative evaluation of impacted MTM.
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Digital learning: WhatsApp as a teaching aid in oral pathology for undergraduates p. 160
M Indu, Shalu Kandhol, Latha Mary Cherian
Background: Influence of social media such as WhatsApp is tremendously increased among students. The query aroused was whether such a familiar platform could be used as a learning tool. Objectives: The purpose of the study was to assess the effectiveness of WhatsApp as an educational tool in a complex subject such as oral pathology among undergraduate students. Methods: Third-year students of Government Dental College, Alappuzha, were selected as the study population and were divided into Group A and Group B by a simple random sampling. Histopathology slides were discussed conventionally with both Group A and Group B. Furthermore, labeled histopathological images were discussed only for Group A students, in a WhatsApp group named “GDC ALLEPPEY OPATH.” To assess the effectiveness of a new method, a questionnaire was given to both groups and the results were statistically analyzed using Mann–Whitney U-test. An additional opinion poll was carried out with Group A to identify students' perspective toward the novel learning tool. Results: Pair-wise comparison of the mean scores of Group A and Group B showed a statistically significant higher mean score for Group A (P = 0.005). There was a significant improvement in the mean score of Group A in their ability to comprehend individual histopathologic features compared to that of Group B (P = 0.008). Conclusion: WhatsApp can prove to be highly advantageous and enhance learning in undergraduate students when used in supplementation to the conventional learning methods.
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Comparative evaluation of signs of temporomandibular joint dysfunction and occlusal discrepancies in asymptomatic men and women: A cross-sectional study p. 164
Mukesh Dhanda, Aaron F Gomes, S Meru, Rishi Ranjan, Ankita Devrani, Sumit Choudhary
Context: Temporomandibular joint (TMJ) disorders represent a multifactorial disease process manifesting with various combination of signs and symptoms. Several studies have shown that there is an increased prevalence of TMJ dysfunction among females; however, there has been no conclusive explanation for this increased occurrence. Occlusal discrepancies have been identified as a causative factor in several cases. Aims: The present study was designed to identify the presence of three signs of occlusal discrepancy, namely the presence of anterior and/or lateral slide from centric relation to centric occlusion, occlusal contact on the nonworking side, and disclusive contact distal to canine on working side on purposeful lateral movement of mandible, in among the population with no signs of TMJ dysfunction. Methods and Materials: A sample population of 620 patients consisting of 313 females and 307 males with no signs of TMJ dysfunction were included in this study. Individual patients were examined for maximum inter-incisal opening, deviation of mandible on opening and closing, presence of joint sounds, and the three abovementioned signs of occlusal discrepancies. Results and Conclusion: The results revealed that there was no statistically significant difference in the occurrence of signs of TMJ dysfunction and of occlusal discrepancies among symptom-free men and women.
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Management of alveolar defect with one-piece implant and index of gingival porcelain shade selection in a North Indian Youth p. 169
Devendra Chopra, Vipin Bhatnagar, Sudhanshu Srivastava
Esthetics is a prime demand for patients who seek anterior replacement of missing teeth. Resorption of the alveolar bone of the edentulous area occurs if left untreated for a long time. It further leads to thinning of the labial cortical plate in the maxillary arch. Few other reasons for narrowing of the alveolar crest are anatomic such as congenitally missing teeth and pathologic, that is dental trauma from tooth avulsion. Nowadays, patients always look for a fixed alternative for the restoration of missing teeth. Other than a conventional fixed partial denture, dental implants are the first choice of treatment. It is one of the difficult tasks for the clinician as well as the dental technician to meet the expectation of the patient when the ridge defect is present in the edentulous area. Extensively invasive procedures such as guided bone regeneration for correction of alveolar defects lead to prolong treatment time and induce psychological trauma to the patient.
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Successful management of three-wall periodontal intrabony defect using novabone dental putty® p. 172
Roshan Prabhakar Dhonge, Anukriti Vishwakarma
Chronic periodontitis can result in destructive changes in the soft and hard tissues of the periodontium, culminating in loss of periodontal attachment, formation of periodontal pocket, and loss of supporting alveolar bone. Suprabony pockets are typically associated with a horizontal pattern of alveolar bone loss that is not amenable to periodontal regeneration with available regenerative therapies, while intrabony pockets are associated with vertical or angular bony defects that are often responsive to periodontal regeneration. The purpose of this case report is to describe the regenerative potential of Novabone Dental Putty® in the human periodontal three-wall intrabony defect. The case has been evaluated clinically and radiographically at baseline and 6 months after the completion of osseous regenerative surgery. The successful healing of intrabony defect was found to be achieved after 6 months of follow up.
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Orthodontic treatment of bimaxillary protrusion - A case with extracted maxillary lateral incisor p. 176
Suruchi Satyajit Jatol-Tekade, Satyajit Ashok Tekade, Kush Pathak, Sachin Tikekar
This article is presented for reporting a case of an extracted maxillary lateral incisor before orthodontic treatment planning, and canine substitution was performed as best option remained. This procedure required special consideration for esthetics and functional issues. A 21-year-old female patient with missing upper right lateral incisor with Class I bimaxillary protrusion came to seek treatment for malaligned teeth. Previously, she tried getting them corrected by extracting most prominent tooth which was maxillary right lateral incisor most probably. As she must have strongly requested to the previous dental surgeon about extraction, she got the lateral incisor removed. But to patient's displease, extraction of upper right lateral incisor didn't solve the problem and came to Orthodontist for correction of malaligned teeth. This skeletal Class II patient was having lateral tongue thrust on the right side causing posterior open bite, and on the left side, premolar and molar were in crossbite. Over-retained and malpositioned 53 caused 13 impacted and might have caused 12 to erupt so much labially that it needed to be removed. At the end of treatment, the patient was having Class II molar relation on both sides. The upper right canine was reshaped to look like lateral incisor. Esthetic results were satisfactory to the patient.
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Comparison of biomechanical properties of different implant-abutment connections p. 180
Kalpana Devaraju, Sanjana J Rao, Joel Koshy Joseph, Sampath Raju Kumara Kurapati
Implant abutment connection has proven to have a significant impact on the success of the prosthetic rehabilitation for an implant-supported restoration. This connection not only provides the base on which the restoration is supported but also maintains the integrity of the hard and the soft tissues surrounding the implant. In this review, we describe the performances of different implant-abutment connections that are the external implant connections, internal implant connections, and the Morse taper connections in terms of their mechanical properties, biological properties, and its biomechanical effects.
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Enlightening the path of dentistry: Lasers – A brief review p. 184
Sudhanshu Srivastava, Sumit Kumar Misra, Devendra Chopra, Purnima Sharma
Lasers were brought into the field of clinical dentistry with the expectation of conquering a portion of the downsides postured by the customary strategies for dental practice. One of the primary objectives in dentistry is to give the treatment as agreeable as conceivable. The laser is being utilized as a part of various dental procedures including soft tissue surgeries, cavity preparation, caries removal, and caries detection. The utilization of current normal lasers in dentistry brought about less pressure and dread in patients amid dental techniques, likewise prompting more moderate nonobtrusive strategies for delicate and hard tissues with insignificant discomfort and bleeding. This article will briefly elaborate uses of laser in dentistry.
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Tumor markers in oral squamous cell carcinoma as an adjunct to diagnosis: An insight p. 190
Monika Negi, Sucheta Bansal, Abhiney Puri, Rajat Nangia
The topic of tumor markers is an immeasurable one, and there is an opulence of data collected till now. It has been deduced that tumor markers can suffice as an acceptable screening test for initiating definitive diagnostic procedures with a goal of making an “early diagnosis.” Through modern techniques of sensitive immunoassays such as radioimmunoassay and enzyme-linked immunosorbent assay, quantitative as well as qualitative evaluation of these markers is possible. Most tumor markers are substances produced by some types of nonneoplastic cells, although perhaps in much lower quantities than they are produced by tumor cells. The review article on tumor markers in oral squamous cell carcinoma (OSCC) as an adjunct to diagnosis is grounded totally on our analysis, consultation, experience, exploration, reviews, and original articles on the subject. Guidelines have been developed by various national skillful and international Oracle groups for the use of tumor markers for cancers, but none of these are currently formalized to maneuver in OSCC. It has been concluded that tumor markers cannot be maneuvered as fundamental modalities for the diagnosis of oral cancer. Tumor markers' main profitability in clinical medicine has been a laboratory test to support the diagnosis; further detailed studies are required to determine their practical usefulness in clinical workflow. It cannot be used as a sole diagnostic tool but can be used as an adjunct to routine histopathology using hematoxylin and eosin stain. Instead by combining various tumor markers, we can achieve a great specificity and sensitivity in the follow-up of one type of malignancy, for example, OSCC.
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