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   Table of Contents - Current issue
October-December 2020
Volume 12 | Issue 4
Page Nos. 187-262

Online since Thursday, October 15, 2020

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A comparative study to assess the independency of lipid profile and blood sugar levels as a diagnostic marker in oral cancer and precancerous disorders p. 187
Rohan Sachdev, Kriti Garg, Garima Singh, Vishal Mehrotra
Context: Lipids are the main cell membrane components important for different biological functions including cell growth and division of normal and malignant tissues. Low lipid values in cancer, precancer lesion, and condition may be due to of lipid peroxidation and also lipids play a key role in the higher utilization of lipids including total cholesterol (TC) and triglycerides (TG) for new membrane biogenesis. Aims: The present study was aimed to assess the independency and comparison of serum lipid profile and blood glucose level in patients with oral carcinoma and precancerous lesions and conditions. Settings and Design: The total sample sizes of 180 individuals were chosen in a 2-year duration: 60 were diagnosed with leukoplakia/oral submucous fibrosis, 60 with oral carcinoma, and 60 of the control group. Subjects and Methods: The serum triglycerides (TGs) were estimated by GPO-PAP End Point Assay method, total cholesterol (TC) by CHOD-PAP, and high-density lipoprotein (HDL) cholesterol by PEG-CHOD-PAP End Point Assay method with lipid clearing factors. The low-density lipoprotein (LDL) and very LDL (VLDL) levels were calculated using Friedewald's equation. Statistical Analysis Used: Collected data were statistically calculated by Student's t-test and by Chi-square test with SPSS version 17. All values were considered statistically significant for a value of P < 0.05. Results: This study showed that parameters TC, TG, and HDL of lipid profile were reduced in the oral precancerous study group as compared to the oral carcinoma study group, whereas in all the study groups, no statistically changes were found in LDL, VLDL, fasting blood sugar, and postprandial blood sugar levels. Conclusions: Low serum value of TC, TG, and HDL may be the indicator for the increased risk of developing precancer diseases and oral cancer in healthy individuals with tobacco habits. Low lipid profile parameters can be used as diagnostic markers in assessment of oral cancer and precancer along with other parameters of biochemical markers.
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A full coronal restoration using a contralateral maxillary primary first molar stainless steel crown on mandibular primary first molar: An In vivo study p. 192
Kinjal A Chavda, Megha C Patel, Rohan K Bhatt
Context: Stainless steel crowns (SSCs) are considered most successful and widely used full coronal restorations for primary molars. Choice of an appropriate SSC, with regard to size of the crown, proximal fit, and marginal adaptation has always been challenging for pedodontist. Contralateral crown is one such unique approach to restore the primary molars with anatomical variation as well as in cases of loss of arch length due to mesiodistal (MD) caries. Aims: This study aims to evaluate the clinical outcome of a contralateral SSC on primary first molars. Objectives: The objective is to assess the longevity of restoration, gingival health of the tooth, and tooth wear of opposing tooth in concern. Subjects and Methods: A total of 60 children between the age group of 3–8 years participated in the study. SSC was placed using MD width of maxillary primary first molar on mandibular primary first molar using Mink and Bennett technique. Regular follow-up was scheduled at 3, 6, and 12 months' interval. Statistical Analysis: Statistical analysis was performed in Excel format using SPSS version 18. The level of statistical significance was set at P < 0.05. Results: The success rate using contralateral SSC on primary first molar during 12 months was 93.3%. Gingival health at baseline, 3, 6, and 12 months' interval showed clinically significant difference (P = 0.1) whereas the tooth wear showed statistically significant difference at 12 months' interval (P < 0.001). Conclusions: The approach of placing contralateral SSC on primary first molar proved to be successful and has no harmful effect on gingiva provided that good oral hygiene was maintained.
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Association between periodontal disease and chronic obstructive pulmonary disease: A case–control study p. 198
Radhika Gupta, Shanta Shree, Mallapragada Siddharth, Hari M Kansal
Background: It has been recognized that oral infections, especially periodontal diseases, may affect the course and pathogenesis of a number of systemic diseases. The present study is done with an aim to determine the association between chronic obstructive pulmonary disease (COPD) and periodontal disease. Materials and Methods: The study included 130 individuals consisting of 65 patients (case group) having COPD and 65 individuals as controls. Individuals in the case group were well-functioning and ambulatory patients having COPD as determined by their history and by performing pulmonary function test, who were then graded into mild, moderate, severe, and very severe. Periodontal status was evaluated by the following indices: simplified oral hygiene index (OHI-S), plaque index (PI), gingival index (GI), pocket probing depth (PPD), and clinical attachment level (CAL). Results: Individuals in the case group had significantly higher OHI-S, PI, GI, PPD, and CAL (P < 0.0001) compared with the control group. A significant positive relationship was observed between COPD subgroup P values and PI, thus indicating a trend in which severity of lung obstruction increased as these periodontal indices worsened. Conclusion: The patients with COPD showed poor oral hygiene and higher prevalence of periodontal disease. The lack of awareness and negligence toward oral health care was noted, which increased as the severity of COPD increased. The dental community's awareness of poor health within this population should be elevated. Prevention and treatment of periodontal disease could be included in planned intervention campaigns designed to help patients with COPD.
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Comparative evaluation of gingival response following the placement of light-cured dressing and noneugenol dressing after periodontal flap surgery: A clinical study p. 204
Saransh Srivastava, Priyanka Tandon, Himani Sharma, Stuti Gupta
Aim: The aim of the study was to compare light-cured dressing with most widely used noneugenol pack in the perspective of esthetics, acceptance, and healing following periodontal flap surgery. Materials and Methods: Fifty-eight patients suffering from generalized chronic periodontitis, requiring periodontal flap surgery on contralateral sides of the arch, were selected and divided randomly into Group I (control) and Group II (test). In Group I, a noneugenol dressing and in Group II light-cured dressing were applied after flap surgery. Clinical parameters such as debris index, plaque index, and modified gingival index were recorded at baseline (day 0) and 10 days postoperatively (after removal of the dressing). The data were collected and statistically analyzed. Results: Group II showed better results than Group I when debris index, plaque index, and modified gingival index scores were compared though the differences were not statistically significant. Patients found no unpleasant taste/smell and perceived the light-cured dressing to be better. Conclusion: The noneugenol dressing retained more plaque on its undersurface than light-cure dressing. However, this did not have much influence on the healing outcome and clinical gingival parameters, which were optimal and comparable in both groups. The greater number of patients showed a preference for light-cure dressing, based on its superior esthetics and taste.
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Awareness related to COVID 19 among dental health-care students and professionals of national capital region: A cross sectional study p. 209
Monis Raza, Shubhangi Jain, Payal Sharma, Piush Kumar, Divya Shetty, Achint Juneja
Background and Objective: The Coronavirus 2 syndrome (SARS CoV 2) or COVID-19 pandemic's rapid and widespread reach has become a major cause of concern to the dental health-care profession. The goal of this study was to assess the knowledge among dental students and professionals about COVID-19 disease and related infection management practices in the region of Delhi-National Capital Region, India. Materials and Methods: An online questionnaire was created, and it was divided into six sections to assess the awareness with respect to the facts, diagnostic aspects of the disease, and its importance in dental treatment. Convenient sampling method was used for data collection. Comparison was done among the following four groups: Bachelor of Dental Surgery (BDS) students, Master of Dental Surgery (MDS) students, academicians (teaching in a dental college), and academicians + practitioners (teaching/not teaching but working in a private dental clinic) over a total of 500 responses for a period of 10 days. The data were coded, entered, and analyzed using SPSS 20.0 version. Descriptive statistics, frequencies, and percentages were used to summarize the data. ANOVA test was used to determine the association of study disciplines among BDS, MDS, practitioners, and academicians and practitioners. P < 0.05 was considered statistically significant. Results: The average correct responses among various sections among all groups came out to be 60.64%, with the highest score being 64.91% among academicians + practitioners and the lowest score being 57.45% among BDS students. Among the sections, 72.4% was highest (section 1: what is coronavirus) and 41.2% was lowest (section 5: diagnosis/tests). Comparison of the overall sections among various groups showed a nonsignificant result although some individual questions showed a statistically significant result. Conclusion: Dental health professionals need regular educational activities and training programs on infection prevention practices with respect to COVID-19 infection to serve not just their own practice but also to help the health-care sector in case the demand arises.
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Pathological signatures of identity in Ajnala skeletal remains: A forensic dentistry investigation p. 216
Jagmahender Singh Sehrawat, Sakshi Aggarwal
Background: Teeth can reveal important information about an individual's lifestyle, sex, occupation, ethnicity, pollutant exposures, dietary status and identity. The analysis of skeletal or dental remains can lay emphasis on the social, health and disease/illnesses status of individuals or the community health. Aims and Objectives: In this study, an attempt was made to estimate the pathological status and possible lifestyle of the individuals whose dental remains were excavated from an abandoned well in Ajnala, India. These individuals were subjected to a mass burial in the year 1857 and thereafter a religious structure was built on top of the disused well. Materials and Methods: The excavated teeth were segregated into different tooth types on the basis of their identifying anatomical features and they were further examined for the wear (according to the Smith and Knights wear criteria) as well as caries (into pit and fissure and deep caries) rates. The pathological status of 3533 (1853 maxillary and 1680 mandibular teeth) avulsed teeth of all types was analysed and results were presented in the textual, tabular and graphical forms. Results: Out of total 3533 teeth examined in this study, 97% had undergone wear of some sort; the majority of the teeth were having Grade '0' wear and the Grade III wear were minimal. It was also observed that the prevalence of pit and fissure caries was higher as compared to the deep caries. Discussion and Conclusions: The low frequency of caries in Ajnala teeth can be attributed to the consumption of a diet low in sugars. As the buried individuals were reportedly army recruits who might had sound health and good oral hygiene prior to being eligible for undergoing a rigorous recruitment process; the negligible percentages of wear and caries in Ajnala teeth may be self-explanatory about their military affiliations.
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Clinical and radiographical evaluation of single- versus multiple-visit pulpectomy treatment in primary teeth with apical periodontitis p. 225
Bhargavi S Patel, Shantanu R Choudhari, Swati Goyal, Chetana B Patel, Sweta A Waghela
Context: This study highlights success rate as well as advantages and disadvantages of single- versus multiple-visit pulpectomy in children. Aims: This study was aimed to compare the success rate of single- and multiple-visit pulpectomy in primary teeth with apical periodontitis. Settings and Design: It was a randomized, double-blind study. The study was conducted in children with one or more restorable sixty primary molars with deep carious lesions and requiring pulpectomy in the age group of 4–8 years. Subjects and Methods: Selected teeth were divided into two groups of thirty each and treated either in single visit or multiple visits. Follow-up was done at the period of 1 month, 3 months, and 6 months and evaluated using Gutmann criteria. Statistical Analysis Used: The normality of data was checked by Shapiro–Wilk test. Intragroup comparison was made by using Friedman test and post hoc-Wilcoxon test. Mann–Whitney U-test was used for inter group comparison. Results: Clinical and radiographical success for both group showed statistically significant (P < 0.001) improvement when the baseline score (preoperative) was compared with other time intervals. No statistically significant difference (P > 0.05) was obtained when clinical outcome was compared between two groups. Although radiographical success for multiple-visit group is slightly more than the single-visit group at all time intervals, statistically it was not significant (P > 0.05). Conclusions: Single-visit can be considered a viable alternative to multiple-visit pulpectomy considering its various advantages, especially in children.
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Prevalence of dental caries among 12-15 years old school children of government and private schools in Agra City p. 232
Ankita Bansal, Navpreet Kaur, Pramod Kumar Yadav, Vivek Kumar Sharma, Prateek Jain, Gaurav Agrawal
Background: Oral health is an important component of general health, with dental caries affecting a person's ability to eat, speak, or socialize. Dental caries is one of the most prevalent diseases affecting human beings and persists till date as a challenge to the medical and dental profession in particular and the society in general. Aim: The study aims to assess the prevalence of dental caries among 12–15-years-old school-going children of government and private schools in Agra city, Uttar Pradesh, India. Materials and Methods: A crosssectional study was conducted among 12–15–years-old school-going children of government and private schools in Agra city, Uttar Pradesh, India. A total of 1600 school children were through a multistage random sampling procedure. The children were examined according to the World Health Organization criteria, 2013. Information regarding a patient's demographic profile was recorded using a self–administered questionnaire. Chi-square test was used to find the significance of study parameters. The level of significance (P value) was fixed at 0.05. Results: The present study reveals a prevalence of dental caries was almost of the same magnitude in the 12 and 13 years of age group, and it was found to be 28.6% and 28.9%, respectively among government and private school children. It was found that among 14 and 15 years of age groups, dental caries affected 22.9% and 19.6% of the study participants, respectively from both government and private school children. The results were found to be highly statistically significant between government and private school children regarding the number of carious teeth. Conclusion: The prevalence of dental caries was found to be the major public health problem among both the government and private school children of Agra city, which need immediate attention. Therefore, there is a need to develop preventive and promotional oral health strategies to combat this disease.
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Management of orthodontically induced mucogingival fenestration: A rare case report p. 237
Vandana Aditya Pant, Nidhi Chaudhary, Pranav Kumar Singh
Gingival fenestrations are of uncertain etiotogy having rarely been reported in the dental literature. It seems to have multifactorial origin and is commonly associated with the anterior region of the arch especially the incisors. The etiology of such defects can be due to decreased thickness of the alveolar housing, contour of the root apex, orthodontic tooth movement and endodontic pathology. To established an accurate diagnosis and proper institution of multidisciplinary comprehensive treatment protocol for salvaging teeth with complex orthodontic –periodontal problem. A 24- year old female patient reported to the department of Periodontics with exposed root in relation to maxillary right central incisor. History revealed previous orthodontic treatment 2-3 years back. On intra oral examination tooth exhibited grade 1 mobility and midline diastema. Apical portion of the root was seen perforating the buccal cortical plate and the mucosa. An interdisciplinary treatment was instituted which included root canal treatment followed by root end resection and soft tissue management. This case report resulted in an uneventful healing with coverage of the complete root apex and diastema closure with complete patient satisfaction. Combined orthodontic-periodontal problems offer great challenges to a clinician, therefore, an accurate diagnosis and treatment planning should be made accordingly for optimum outcome.
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Cone-beam computed tomography and microscope-assisted endodontic management of maxillary first premolar with three roots p. 240
Sruthi Moonnamkoottu Sunildath, Josey Mathew, Liza George, RV Vineet
This study aims to report the endodontic management of the maxillary first premolar with three roots, using cone-beam computed tomography (CBCT) and an operating microscope. Most maxillary first premolars have two roots, buccal and palatal but it may rarely have three. The incidence of three separate roots in maxillary first premolars ranges between 0.5% and 6%. Variation in root anatomy makes root canal treatment challenging necessitating improved technology. CBCT imaging provides precise location and visualization of root morphology, and canal anatomy. Operating microscope provides better lighting, magnification, and visualization of the operative field that helps to recognize and locate additional roots canals. This article reports the endodontic management of a maxillary right first premolar with three separate roots.
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Infected dentigerous cyst in the maxilla: Report of two cases p. 244
Nanda Pai, Samar Salim Shemna, Prerana N Dubey, Pratha Poddar
Dentigerous cyst (tooth-bearing), is the second-most common odontogenic cyst in the Indian population. They remain asymptomatic, causing pain and swelling only when infected. Many a times they are diagnosed only on routine radiography. This article presents two cases of infected dentigerous cyst in the maxilla, one of them being a rare occurrence of the cyst involving the maxillary sinus around the maxillary third molar.
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A conservative approach in management of a molar incisor hypomineralization: Report of a case p. 248
Ramneet Kaur, Akhil Sharma, Vasundhara Pathania, Ruchika Kundra
Enamel hypomineralization is a developmental defect of enamel occurs due to disturbances in early calcification or maturation during amelogenesis. It can be seen in both the primary and permanent dentitions. These defects usually involves permanent molars and incisors presenting as well demarcated, asymmetrical opaque lesions varying from white to yellow or brown in color. Partial or complete loss of enamel in these soft, porous, and hypomineralized teeth leads to hypersensitivity, impaired masticatory functions, and esthetics. Difficulty in achieving local anesthesia and managing behavior of a young and fearful child makes it even more challenging to the clinicians that necessitate the use of a more conservative approach during the dental treatment. Therefore, we are presenting here a case of diagnosis, restorative, and esthetic correction of molar incisor hypomineralization in a 12-year-old child with least invasive clinical procedures.
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Eco-friendly dentistry: Preventing pollution to promoting sustainability p. 251
Reena Mittal, Rachna Maheshwari, Siddhi Tripathi, Sujata Pandey
In today's world, being eco-friendly is a part of every profession. Medical profession is concerned with maintaining general health and well-being of the individual. Dentistry is dedicated toward maintenance of oral health and enhancing function. However, it has a huge impact on environment due to generation of large amount of waste including metallic waste and excessive use of water and electricity. Practicing green dentistry involves judicious use of water and electricity, decreasing waste production, and decreasing pollution with the use of the latest technologies. Oral health workers should recognize the significance of contributing in the interests of sustainability. They share the moral responsibility toward the society to provide optimal oral health services, maintain patient safety as well as reduce their impact on natural resources. This study reviews some practical suggestions for making dental practice eco-friendly by enhancing the use of newer technologies and reducing the use of disposables and paper and eco-friendly waste management.
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Feasibility assessment for using telehealth technology among dentists and general population in Satara district, Maharashtra p. 258
Ankita N Mane, KM Shivakumar, Vidya Kadashetti
Background: In this era of modern medicine, teledentistry has been constantly changing with the advent of information and technology. Teledentistry is a part of telemedicine. Teledentistry has many branches such as telestomatology, teleradiology, telepathology, tele oral surgery, and teleorthodontics. Teledentistry uses information technologies and communication system to deliver health-care services to people. Materials and Methods: A cross-sectional analytical study was conducted among the all dental specialist and people related to dental health service of Satara district. Respondents were given a brief introduction to the purpose of survey in an electronic format (dentist) and physical format (general population). Bulk of questions were focused on two domains (1) need for telehealth technology (2) interest in using telehealth technology for dental care delivery. The Collected information is subjected to descriptive statistical analysis. The Chi-square test was used to test the association of variables for dentists and general population. Results: Results showed great need of telehealth technology to overcome the obstacle in providing sufficient oral health services to the rural and underserved population as well as positive response from the dentist toward teledentistry. Out of 196 general population and 60 dentists, it is not easy for 67% general population to visit dentist due to difficulty of basic transportation services. Moreover, 56% people have no access to dentist only. 80% of dentist is willing to participate in teledentistry program if it ever comes and 83.33% dentists think it can improve overall efficiency of dental health-care services. Conclusion: Unwillingness and attitude among local dental practitioners can be changed through increasing scope of education regarding teledentistry at the central government level through preparing legislation.
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