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Table of Contents
April-June 2021
Volume 13 | Issue 2
Page Nos. 61-149
Online since Monday, March 22, 2021
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ORIGINAL ARTICLES
Dental students' Perception on the impact of E-learning in continuing dental education during the current pandemic scenario
p. 61
Rupandeep Kaur Samra, Ashutosh Nirola, Anupama Verma, Archana Nagpal, Malvika Thakur
DOI
:10.4103/ijds.ijds_14_21
Background:
On account of the pandemic SARS-CoV-2 (COVID-19), education in higher institutes was strongly affected and they were shut down. The education shifted from “face-to-face” learning to online learning in the dental universities. The aim of this study was to assess the students' perspective on the implementation of online learning due to COVID-19, using a questionnaire-based survey in India.
Materials and Methods:
The authors sent out an electronic survey to the undergraduate dental students from October 17, 2020 to October 25, 2020. The online questionnaire had a combination of multiple-choice, Likert scale, and open-ended questions which gave insight into the demographics, access to technological sources, didactic benefit, study habits, perceived issues with e-learning, conduction of examinations during the pandemic period, and their mental health. Students were also asked for their views on the inclusion of online learning in the future curriculum. Qualitative data was expressed as number and percentage. A comparison was performed using Chi-square test. Kruskal-Wallis test was done for Likert scale questions and Bonferroni test was used for
post hoc
comparisons.
Results:
Among 2319 dental students, 63.9% exclusively used smartphones and 8.5% used laptops for classes. The rest of the students used both devices. To access online resources, about 2262 (97.5%) had Internet connection. Only 943 students (40.7%) did not encounter any difficulty while engaging in online learning. About 1466 students (63.2%) appeared for examinations. About 1261 students appeared offline for both theory and practical examinations. Fifty-five percent of the participants felt offline examinations to be a better alternative. About 69.6% of students preferred “face-to-face” learning instead of solely online learning. Nearly 19.4% of students wanted online education to be continued, while 28.5% wanted to keep both offline and online courses in the future curriculum. Most frequently encountered problems were difficulty in adjusting to new learning styles, having to perform responsibilities at home, and poor communication between educators and learners.
Conclusion:
Students showed a little reticent attitude towards on the implementation of online learning and were hopeful of engaging in online learning after improvisation in the future curriculum.
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Association of X-ray repair cross-complementing group 1 Arg399gln polymorphisms with the susceptibility to develop oral squamous cell carcinoma in tamol chewer's population in Assam, India
p. 73
Lhakit Lepcha, Manash Pratim Sarma, Amal Chandra Kataki, Bala Gopalan Unni
DOI
:10.4103/IJDS.IJDS_60_20
Background:
Various environmental factors have been reported to play key role in the development of oral squamous cell carcinoma (OSCC). A lesser known risk factor of oral cancer in India is the uncontrolled use of areca nut chewing. In North-East India, Areca nut, locally called as “Tamol” in Assam, is raw betel nut, lime and betel leaf without tobacco, which are more effective as compared to dried which can be the important contributing factor for OSCC.
Objectives:
The aim of the study was to detect the association between XRCC1 polymorphisms and increased risk of OSCC in tamol chewers population in Assam, India.
Methods:
50 OSCC patients, 50 tamol chewers and 50 controls were enrolled in the study. XRCC1 Arg399Gln polymorphisms were determined by using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP).
Results:
There was a significant association for XRCC1 codon 399 (Arg/Gln+Gln/Gln) (p<0.05; OR=1.909, CI= 0.8622- 4.227) with the wild type in cancer sample as compared with control sample. Similarly, the positive association for 399G/G (p<0.05; OR =2.842, CI = 0.919-8.79) genotypes with oral carcinoma and control sample. In case of tamol chewers, the AA genotype was found to be associated with 2-fold (OR- 2.25, CI= 0.709-7.14) increase risk of developing oral cancer while GA+AA genotype was associated with one and half fold (OR-1.62, CI=0.7354- 3.568) risk of developing oral cancer.
Conclusions:
Based on these results, the XRCC1399G>A genotype could be used as a useful molecular biomarker to predict genetic susceptibility in tamol chewers population and its susceptibility to develop OSCC.
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Differentiation of evaluation of reliability of cephalometric analysis of cephalometrically diagnosed skeletal class i malocclusion using readily available digital imaging software such as IMAGE J and ICY and traditional manual tracing
p. 80
Firoz A Khan, Purva Joneja, Deepak Singh Choudhary, Rizwan Ahmed, Sachin Tikekar
DOI
:10.4103/IJDS.IJDS_231_20
Background:
The skeletal and soft tissue analysis of the face in total is a very important parameter of diagnosis. Readily available and non expensive imaging software are available which can be used for cephalometric analysis for hard and soft tissues of the face to make an appropriate treatment plan.
Aims:
The purpose of this study was to compare the accuracy of linear and angular measurements between the digital software IMAGE J, ICY and manual tracing.
Objective:
The purpose of this study was to compare angular and linear measurements obtained through manual and digital cephalometric tracings using IMAGE J and ICY software with lateral cephalometric radiographs.
Material and Methods:
The sample consisted of 50 lateral cephalometric radiographs. One properly trained and calibrated examiner performed the 50 manual tracing and then the same radiograph was traced digitally on a digital software. Five angular measurements SNA (Sella, nasion, A point), SNB Sella, nasion, B point), ANB (A point, nasion, B point), W angle, ULA (Upper lip angle) and three linear measurements ULT (upper lip thickness), projection of upper lip to TVL (true vertical line) & WITS appraisal were traced the conventional lateral cephalogram of 50 participants were obtained. Manual tracing was done and hard tissue landmark including the above mentioned angular and linear variables were marked. In a similar way a soft copy of the above 50 radiograph was obtained and uploaded in the digital imaging software IMAGE J and ICY.
Results:
SNA, SNB, ANB, W angle, WITS appraisal, upper lip thickness (ULT) upper lip angle, (ULA), projection of labrale superioris to TVL showed statistically significant values when measured manually and by digital software methods. Values measured by software methods had less errors.
Conclusion:
The results show statistically significant values between manual and digital tracing. The actual variation lies in identification of landmarks and their measurements. landmarks are identified better in software methods than manual methods and also there was a difference in measurements of angular and linear values of soft and hard tissue landmarks.
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Evaluation of variation in implant stability quotient at different time intervals after immediate loading in the posterior mandible using penguin resonance frequency analysis system
p. 87
Akaljot Kaur, Harinder Kuckreja, Sameer Kaura, Naveen Oberoi, Jaswinder Kaur, Jasleen Arora
DOI
:10.4103/IJDS.IJDS_212_20
Purpose:
The aim of this
in vivo
study is to compare the variation in implant stability quotient (ISQ) values of implants using resonance frequency analysis (RFA) to access the immediately loaded (within 24 h) implants at different time intervals using Penguin RFA system.
Materials and Methods:
Ten Nobel Replace Tapered RP implants were placed in posterior mandible region of patients. Patients were included in the study after fulfilling the inclusion criteria. Prior to enrolling in the study, thorough information about the procedure was provided to the patients, and written consent was obtained for the same. Immediate loading was done within 24 h using tooth-colored self-cure acrylic resin. Penguin RFA System was used to measure the ISQ of dental implants. The ISQ values were recorded immediately after implant placement, after 4 weeks, after 8 weeks, and after 12 weeks.
Results:
The mean ISQ values of the immediately loaded implants at the time of placement were 82.60, after 4 weeks were 80.60, after 8 weeks were 83.70, and after 12 weeks were 87.10. There was a statistically significant difference between the ISQ values at the time of placement of implants and after 12 weeks.
Conclusion:
This study concluded that immediate loading in posterior mandible single tooth region is a safe and predictable option.
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Knowledge and practices of oral hygiene among undergraduate students of dayalbagh educational institute, Agra
p. 93
Suman Madan, Richa Verma, Gul Mathur
DOI
:10.4103/IJDS.IJDS_119_20
Background:
Healthy and well-functioning teeth in all phases of life is a necessity. Teeth help in proper mastication of food as well as in word pronunciation. It gives fullness to the face, thereby helping in the social appearance of a person. Oral health and systemic health are interconnected. Past studies indicate that oral diseases cause or increase the severity of noncommunicable diseases. The general public is unaware of this connection. Thus, the present research work was planned to assess the oral hygiene practices of students and their awareness for maintenance of oral health.
Research Methodology:
The present survey was conducted among 510 students (135 boys and 335 girls) in the age group of 17–30 years studying in Dayalbagh Educational Institute. Data were collected through a questionnaire adapted from the standard tool of oral health questionnaire by the WHO.
Results and Discussion:
The result of the present study showed that 93% of the students were using toothpaste and toothbrush for cleaning teeth, but only 31% and 2% of the students were using other measures such as mouthwash and floss. Data also showed that only 44% of the students brush twice a day and only 27% visit dentist for routine checkup.
Conclusion:
Majority of the students were aware of the linkage between oral health and systemic health. Thus, it is essential to organize oral health education program at mass level to create awareness in public so that not only their oral health but also their general health can be improved.
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Zinc oxide eugenol paste as a dressing material on surgical raw wounds after wide excision of oral potentially malignant disorders: A prospective controlled clinical trial
p. 98
Vishal , Tanya Khaitan, VK Prajapati
DOI
:10.4103/IJDS.IJDS_170_20
Introduction:
Oral potentially malignant disorders (PMDs) have a high risk to develop oral squamous cell carcinomas which are responsible for approximately 270,000 patients annually worldwide. When surgical excision of PMD is done, a raw denuded area is formed, which is required to be addressed. The present study was done to determine the effectiveness of zinc oxide (ZnO) eugenol paste as a dressing material of such surgical raw wounds and to assess its usefulness.
Materials and Methods:
A total of thirty patients with oral PMDs underwent wide surgical excision under local anesthesia. ZnO eugenol paste with preformed sterile gauge piece was applied in denuded area as dressing and sutured. Intraoperative evaluation was done on the following criteria: handling of ZnO eugenol paste and hemostasis achieved; postoperative evaluation included pain, adherence, granulation, epithelialization, reactivity to the ZnO eugenol. and overall usefulness as an intraoral dressing material.
Results:
Good hemostasis was obtained in 24 cases (80%). The mean score of pain was recorded as 3.5. Twenty-three cases (76%) showed granulation and epithelialization was rated as good. ZnO eugenol paste with the help of sutures showed good adherence in 29 cases (96.6%). No allergic reaction was noted. ZnO eugenol dressing was proved to be very effective in 28 cases (93.3%), effective in 2 cases (6.7%), and ineffective in 0 cases (0%).
Conclusion:
The chemical, physiological, and biological properties of ZnO eugenol have proved to be useful as a dressing material in cases of raw wound formed after excision of oral PMDs It is not a replacement for skin graft or collagen biodegradable membrane, but it can be one of the armamentaria for the oral surgeon in such cases.
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Efficacy and reliability of various grades of processed honey as a fixative: A comparative study
p. 103
Kunal Sah, BJ Janardhan, Raj Kumar Srivastava, Sanjay Nigam
DOI
:10.4103/IJDS.IJDS_173_20
Introduction:
Ethanol is a traditional cytofixative which is widely used for oral exfoliative cytology. Due to its limitations, a search of better, eco-friendly, and cost-effective fixative was explored. The present study was conducted to evaluate the efficacy and reliability of 10%, 20%, and 30% processed honey as a cytofixatives, and was compared with that of 95% ethanol.
Materials and Methods:
Four oral smears were obtained from each individual (
n
= 80) by gently scraping the buccal mucosa. One slide was fixed in ethanol (95%) and the other in various grades of processed honey (10%, 20%, and 30%), and stained with Papanicolaou stain. Two separate pathologists who were kept in blind for the fixative used evaluated the slides based on the five parameters (cell morphology, nuclear and cytoplasmic staining, clarity, and uniformity of staining).
Results:
In the present study, it was observed that 20% of processed honey showed overall good results, followed by (95% alcohol) and (10% honey). However, poor results were observed in (30% honey). When compared, no statistically significant difference was observed between the groups.
Conclusion:
The present study offers an innovative application using honey as a cytofixative. Honey in lower concentration is an excellent alternative to ethanol as a cytofixative.
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An
in vitro
study to assess the positional accuracy in multiple implants using different splinting materials in open-tray impression technique
p. 108
Nikhil Kumar Chaudhary, Manisha Gulati, Salil Pawah, Bhawana Tiwari, Chetan Pathak, Manisha Bhutani
DOI
:10.4103/IJDS.IJDS_202_20
Context:
Numerous implant techniques have been suggested in the literature to obtain an accurate master cast. One of those is to splint the impression copings; however, many controversies exist in type of splinting materials used.
Aim:
The aim of this study is to evaluate and compare the positional accuracy in multiple implants using different splinting materials in open-tray impression technique.
Settings and Design:
The study design involves an
in vitro
study.
Materials and Methods:
An acrylic resin model of a mandibular edentulous arch was used as a reference model in which four 3.75 mm × 10 mm implant analogs were placed and sequentially numbered as 1, 2, 3, and 4 from left to right. Open tray impression copings were attached to each of them and were then splinted by three different materials and divided into three Groups as Group I, Group II, and Group III splinted with pattern resin, composite resin, and titanium wire, respectively. Five implant level impressions were made from each group and poured in Type IV dental stone. The implant analogs were transferred to the casts and inter-implant distances were compared to the reference model using the Coordinate Measuring Machine.
Statistical Analysis Used:
One-way ANOVA test was used as a test of significance.
Results:
The present study revealed that all the three splinting materials can be used for the accurate reproduction of spatial relationship. There was no significant difference between the centroids of implant analogs 1 and 2, 1 and 3, 1 and 4, 2 and 3, 3 and 4, and 2 and 4 of reference model with the master models.
Conclusion:
Clinically acceptable accuracy in transferring the position of implants to the master cast could be obtained from all the three splinting materials used. However, splinting of impression copings with titanium wire showed greatest accuracy.
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CASE REPORTS
Obturator with saliva reservoir
p. 118
Dushyant Chauhan, Ashish Thakur, Rachana Chaudhary
DOI
:10.4103/IJDS.IJDS_122_20
Maxillectomy defects are usually due to surgical resection of carcinoma and results in a distinctive complication. In maxillectomy, there is a communication between the oral and nasal cavity which aggravates the problem and limits the treatment option. If the patient presents with additional xerostomia, then the level of difficulty increases many folds. This case report presents a patient with maxillectomy undergoing radiotherapy resulting in xerostomia. The patient wanted to have a definitive functional restoration. Due to the complexity of situation a conventional obturator was not enough as removable prosthesis in the dry mouth is not well tolerated. Initially, an interim obturator was fabricated and later definitive obturator using neutral zone technique with saliva reservoir was fabricated. Artificial saliva was used to maintain the moisture in the mouth and provided with adequate lubrication for the removable prosthesis to function. The prosthesis satisfactorily restored function and provided an adequate seal between the nasal and oral cavity. Shortcoming of this prosthesis was that the artificial saliva had to be replaced regularly. However, overall the patient was satisfied with the prosthesis.
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Mucocele in lower lip as a result of trauma
p. 122
Deepak Chauhan, Seema Thakur, Kalpana Verma, Ashish Justa
DOI
:10.4103/IJDS.IJDS_55_20
Mucocele is a common salivary gland disorder that can appear on the dorsal surface of the tongue, lacrimal sac, paranasal sinuses, and oral cavity. Mucocele results in alteration of the minor salivary glands due to a mucous accumulation causing limited swelling. Two histological types of mucoceles exist, namely extravasation and retention. Lower lip is the most common site of occurrence of these lesions in the oral cavity and the most probable cause is trauma or habits of lip biting. This report presented a 6½-year-old female child patient having mucocele on the inner side of her lower lip due to fall while playing, which resulted difficulty in mastication and speech. Treatment performed was conventional surgical excision followed by removal of the minor salivary glands.
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Fusion of multiple impacted supernumerary teeth with maxillary third molar - A rare case report
p. 125
DOI
:10.4103/IJDS.IJDS_224_20
Fused supernumerary teeth are an uncommon finding. Fusion is an abnormality of tooth development. It is common in the lower anterior but rare in maxilla. Supernumerary teeth are additional teeth in normal series, occurring with a frequency of 0.3%–3.8% in population. The frequency of fusion of a permanent tooth with a supernumerary is <1% of cases and usually involves maxillary anterior teeth. Panoramic radiograph revealed a radiopaque mass in periapical region associated with maxillary third molar. The findings were suggestive of impacted supernumerary teeth. This case is an example of a rare phenomenon of fused multiple impacted supernumerary teeth in maxillary third molar area.
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Effect of low-level laser therapy on wound healing after gingivectomy
p. 128
DOI
:10.4103/IJDS.IJDS_203_20
Low-level laser therapy (LLLT) is based on the principle of biostimulation or biomodulation effect. LLLT after gingivectomy has resulted in better wound healing because of its action on collagen synthesis, angiogenesis, and growth factor release. The authors here present a case report on the effect of LLLT, using a diode laser (InGaAsP), on wound healing and patient's response after scalpel gingivectomy.
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Excisional biopsy of verrucous carcinoma of tongue using diode laser
p. 134
Vikrant Sharma, DS Kalsi, Arushi Goyal, Sanjana Singh, Aditya Khichy, Anchal Sood
DOI
:10.4103/IJDS.IJDS_179_20
Oral verrucous carcinoma (OVC) is a subtle variant of oral squamous cell carcinoma with some peculiar features. It is locally invasive growth which rarely metastasizes. Verrucous carcinoma rarely affects the tongue. Herein, we report a case of excisional biopsy of a grayish-white lesion on the left lateral surface of the tongue performed with a 940-nm diode laser, which upon histopathological examination was diagnosed as OVC.
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A rare case of compound odontoma associated with unerupted mandibular primary canine
p. 138
Tanzeem Ahmed, Nikhil Kaushal
DOI
:10.4103/IJDS.IJDS_141_20
Odontomas are the most common odontogenic tumors. They are considered to be hamartomas rather than neoplasms and are composed of enamel, dentin, cementum, and pulp tissue. These lesions are considered benign; however, they often cause disturbances in eruption of the associated tooth. Early diagnosis and removal of an odontoma associated with a primary tooth are essential to prevent any further disturbance in the dental arch. Odontomas occur more frequently in the permanent dentition and are very rarely associated with the primary teeth. This report presents a rare case of compound odontoma associated with unerupted primary canine and its management. The adoption of a conservative surgical approach is advisable, in order to preserve the dental tissues and achieve optimal tissue healing.
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REVIEW ARTICLES
Axis of success: Primary and secondary stability of implant
p. 141
Nitin Sharma, Archana Nagpal, Anisha Kundal, Ayushi Singla, Vidushi Jindal
DOI
:10.4103/IJDS.IJDS_118_20
Primary and secondary stability mainly proceed along with mechanical phenomenon of implant engagement within the surrounding bone. Primary stability is an important element in attainment of secondary implant stability. Measuring stability of an implant helps dentist/operator about decision and timing of loading an implant. Primary and secondary implant stability is defined and discussed thoroughly. The factors affecting implant stability are classified and detailed in the simple manner in this review article. Till present time, no particular method has been established to evaluate the implant stability. Although resonance frequency analysis method evaluates stability of implants with the results outcome dependent on the sound theory, it surely cannot assure the success and failure or even long-term results of the dental implants.
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Ligaplants, the next-generation prosthodontic implants: A comprehensive review
p. 146
Natasha Bathla, Jenny Lalmalsawmi Sailo, Nisha Kapoor, Archana Nagpal, Rajeev Gupta, Ayushi Singla
DOI
:10.4103/IJDS.IJDS_140_20
The fields of tissue engineering and regenerative dentistry have undergone significant advancements, yet its application to the field of implant dentistry is lacking. The advent of periodontal tissue engineering has not only revolutionized field of periodontology but also prosthodontics implant dentistry. Currently, the development of a periodontal ligament (PDL) attachment around the dental implants has now become an important new therapeutic tool to replace the lost teeth. The PDL houses various vital cells that are important in the dynamic relationship between the tooth and bone. Thus, ligaplants are now an available option to improve the biological performance and to prolong the life of the dental prosthesis. The present article reveals the clinical benefits of such new generation periodontio-integrated implants and reviews the relevant scientific proofs.
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