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   2006| October-December  | Volume 17 | Issue 4  
 
 
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ORIGINAL RESEARCH
Pentoxifylline therapy : A new adjunct in the treatment of oral submucous fibrosis
R Rajendran, Vidya Rani, Saleem Shaikh
October-December 2006, 17(4):190-198
DOI:10.4103/0970-9290.29865  PMID:17217216
OBJECTIVE : This study was designed to determine the effect of pentoxifylline (Trental) on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN : This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy) in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets). The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls) were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS : Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test). Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000), tongue protrusion (t= 3.898, p = 0.002), and relief from perioral fibrotic bands (p = 0.0001554). Subjective symptoms of intolerance to spices (p = 0.0063218), burning sensation of mouth (p = 0.0005797), tinnitus (p=0.000042), difficulty in swallowing (p=0.0000714). and difficulty in speech (p=0.0000020) were also recorded significant improvement at the end of the trial period. CONCLUSION : This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.
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Evaluation of three topical anaesthetic agents against pain : A clinical study
R Nayak, P Sudha
October-December 2006, 17(4):155-160
DOI:10.4103/0970-9290.29871  PMID:17217210
AIM : To compare pain responses of children during local anaesthetic infiltration at bilateral buccal sites prepared with topical application of EMLA 5% cream, benzocaine 18% gel or lignocaine 5% ointment and also to find out the rapidity of onset of action of these agents. METHODS : 60 healthy children aged 6 to 12 years old, received bilateral buccal infiltration following application of topical anaesthetic agents applied in a double blind design. Pain responses were compared based on subject self report using visual analogue scale (VAS) and operator assessment using Sound -Eye -Motor (SEM) scale. RESULTS : Benzocaine gel had the rapidest onset of action. EMLA 5% cream proved to be superior in pain reduction compared to benzocaine and lignocaine. Taste acceptance was better with benzocaine gel. Further studies are required for EMLA cream with an improved formulation more suitable for mucosal application before its routine use in dentistry.
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Toothbrush selection : A dilemma?
Dhiraj Sasan, Betsy Thomas, Mahalinga K Bhat, KS Aithal, PR Ramesh
October-December 2006, 17(4):167-170
DOI:10.4103/0970-9290.29869  PMID:17217212
The toothbrush is a fundamental tool used for accomplishing plaque control. Various types of toothbrushes available in the market keep the buyer in a state of dilemma as to which one to choose, due to lack of information about the "quality" of it. This study has been designed to understand whether all the products available in the market adhere to the specifications laid down by the ADA, which is universally accepted in standardization of a tooth brush. 95% of the brushes surveyed contain less number of bristles per tuft than specified and a large percentage deviate from the standard prescribed value for their bristle diameter and other dimensions. Few brushes labeled as "Soft" were "Medium" and labeled "Medium" were "Hard". The study will bring to light the quality of toothbrushes available in India for a rationalised selection of appropriate toothbrush by the community at large.
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Dentinal hypersensitivity?-Can this agent be the solution?
Madhu SS Pretha, Swati Setty, S Ravindra
October-December 2006, 17(4):178-184
DOI:10.4103/0970-9290.29867  PMID:17217214
AIM : To test the efficacy of desensitizing tooth paste containing EMS salts in alleviating dentinal hypersensitivity, reducing plaque accumulation, and reducing gingivitis. METHODS : A randomised, single blind, parallel placebo controlled study was conducted in 40 cases. The cases were randomly assigned to test and control groups. The test group was instructed to use the test tooth paste (containing EMS salts) and control group a placebo tooth paste (without any therapeutic agents) for a period of 6 weeks. The hypersensitivity levels were measured with scratchometer and verbal rating scale. Student t test and wilcoxon's Mann-Whitney test were used to compare the test and control groups. RESULTS AND CONCLUSION : The results indicated that both the test as well as the control toothpastes were effective in alleviating dentinal hypersensitivity as well as reducing gingivitis. However, the test toothpaste was superior in alleviation of dentinal hypersensitivity.
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Oral health status and treatment needs in institutionalized psychiatric patients : One year descriptive cross sectional study
Manish Kumar, GN Chandu, MD Shafiulla
October-December 2006, 17(4):171-177
DOI:10.4103/0970-9290.29868  PMID:17217213
BACKGROUND AND OBJECTIVES : Psychiatric patients are one of the special groups requiring attention as they are often neglected. Oral health is an major determinant of general health for psychiatric patients and may have a low priority in the context of mental illness. The present study was conducted to assess the oral health status and treatment needs of institutionalized psychiatric patients of Davangere. METHODS : 220 psychiatric patients admitted in two general hospitals of Davangere during the period of one year were included in the study. The oral health status was evaluated with respect to caries, oral hygiene, and periodontal status. RESULTS : Of the 180 examined with the response rate of 81.8%. 58.3% were males, mean age was 36.7 years, 57.8% had < 1 year of mental illness with a mean of 2.2 years, and 90% were self-sufficient. The multiple logistic regression analysis showed that the mean DMFT (0.92) increased with age, duration of mental illness, and irregularity of oral hygiene habits (P<0.001). Mean OHI-S score was 3.3 and multiple logistic regression analysis showed that the mean OHI-S score increased with age (P<0.001). The multiple logistic regression analysis showed that the CPI score increased with age, duration of mental illness, and degree of helplessness (P<0.001). INTERPRETATION AND CONCLUSION : The findings of this study demonstrates low caries prevalence, poor oral hygiene, and extensive unmet needs for dental treatment.
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CASE REPORT
Extragingival pyogenic granuloma
Karthikeya Patil, VG Mahima, K Lahari
October-December 2006, 17(4):199-202
DOI:10.4103/0970-9290.29864  PMID:17217217
Pyogenic granuloma is a well-known localized granulation tissue overgrowth in reaction to mild irritation. Although it is known to show a striking predilection for the gingiva, it can be found extragingivally with varying clinical features that sometimes may mimic more serious lesions such as malignancies. The clinical diagnosis of such an uncommon extragingival pyogenic granulomra can be quite challenging. The purpose of this article is to report an unusual case of extragingival pyogenic granuloma occurring on the lower lip, which presented as a cutaneous horn.
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ORIGINAL RESEARCH
Dental arch dimensions in primary dentition of children aged three to five years in Chennai and Hyderabad
S Prabhakaran, CH Sriram, MS Muthu, Chandrasekhar R Rao, N Sivakumar
October-December 2006, 17(4):185-189
DOI:10.4103/0970-9290.29866  PMID:17217215
OBJECTIVE : The purpose of this study was to assess the arch dimensions in primary dentition of 3-5 years old children in Chennai and Hyderabad. As no primary to the mixed dentition and determining the existence of sexual dimorphism. METHODS : Children were selected fro various schools of both Chennai and Hyderabad, with complte set of primary dentition. Study casts were made and measurements of arch dimensions were made using digital sliding calipers. The data obtained was subjected to statistical analysis. RESULTS : The mean values and standard deviations of the various arch dimensions are given in the tables. CONCLUSION : Generally boys exhibited a greater arch dimensions than girls in both groups. Some of the dimensions showed a statistically significant mean values.
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Expression of matrix metalloproteinases (MMP-1, MMP-2 and MMP-9) and their inhibitors (TIMP-1 and TIMP-2) in oral submucous fibrosis
R Rajendran, PK Rajeesh Mohammed, Saleem Shaikh, Shanthi , MR Pillai
October-December 2006, 17(4):161-166
DOI:10.4103/0970-9290.29870  PMID:17217211
Immunohistochemical staining of formalin fixed, paraffin embedded tissue sections of OSF for MMPs-1,2,9 and their tissue inhibitors TIMP-1and 2 was performed using monospecific antibodies coupled with gelatin zymography (MMP-2 and 9) for measuring enzymatic activity quantitatively and for distinguishing the active from the inactive variants of enzymes. The present study, contrary to earlier reports, recorded statistically significant increase in the levels of stromal expression of MMP-1, MMP-2 and MMP-9 and TIMP-1 and TIMP-2 using monospecific antibodies reacting against tissue antigens.The simultaneous increase in reactivity of MMPs and TIMPs poise difficulty in interpretingthe results of this study. The possible reasons for this result, against the backdrop of existing knowledge, were attempted in this study.
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Immunoglobulin concentration in gingival tissue of type 2 diabetic patients with periodontitis
Sukumaran Anil
October-December 2006, 17(4):151-154
DOI:10.4103/0970-9290.29872  PMID:17217209
BACKGROUND: Diabetes mellitus is considered as a risk factor for the initiation and progression of periodontal disease. The diabetic patients often exhibit decreased immune response and increased susceptibility to infection. In the present study, a quantitative estimation of the gingival tissue immunoglobulin concentrations in diabetic and non diabetic subjects with periodontitis was assessed and compared with that of clinically healthy gingiva. METHOD: 40 gingival tissue samples obtained from 20 diabetic (Type 2) and 20 non-diabetic subjects were subjected to quantitative estimation of immunoglobulins G, A, and M. The data thus obtained were compared to the level of immunoglobulin found in clinically healthy gingiva. RESULTS: The IgG and IgA level in the tissues of both diabetic and non-diabetic subjects with periodontitis were found to be significantly higher than that of healthy subjects. The diabetic group also showed a significantly higher IgG and IgA levels compared to the non-diabetic group with periodontitis. CONCLUSION: These findings support the concept that the humoral immune response plays an important role in the pathogenesis of periodontal disease in diabetics. The significantly higher levels of immunoglobulin in the gingival tissues might be a protective mechanism against the increased bacterial challenge in diabetic subjects.
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EDITORIAL
Editorial
B Sivapathasundharam
October-December 2006, 17(4):150-150
DOI:10.4103/0970-9290.30413  
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