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   2010| July-September  | Volume 21 | Issue 3  
    Online since September 29, 2010

 
 
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ORIGINAL RESEARCH
Effect of carbonated drink on excisional palatal wound healing: A study on Wistar rats
Girish Suragimath, KR Krishnaprasad, Srinivas Moogla, Sudheendra U Sridhara, Shashidara Raju
July-September 2010, 21(3):330-333
DOI:10.4103/0970-9290.70789  PMID:20930338
Background: Millions of people worldwide consume carbonated drinks every day. The effects of these drinks on hard tissues in the mouth have been proved beyond doubt. Only a little has been done so far to assess the effects of carbonated drinks on oral soft tissues. This study was an attempt to assess the effect of carbonated drinks on oral wound healing. Materials and Methods: Twenty female Wistar rats were considered for the study. A circular wound was created on the palate and the animals were divided into two groups (experimental and control group). The experimental group animals were fed with a commercially available carbonated drink instead of water, and two animals from each group were euthanized at 3, 7, 14 and 21 days. Wound site was assessed morphometrically and histologically. Results: There was a marked difference in the healing pattern between the experimental group and control group animals. Control group animals showed a normal healing pattern with formation of a fibrous connective tissue at the end of 21 days. In the experimental group, healing was delayed and disrupted. The wound site showed a definite palatal perforation in experimental group animals after 14 days, but osteoclasts were not noticed in the histological sections. Conclusion: Consumption of carbonated drinks can disrupt oral wound healing. Results suggest that the bone changes seen in experimental group samples are not mediated by osteoclasts, and acidity of the carbonated drinks could be one of the reasons for these changes.
  17,789 187 1
Evaluation of the antimicrobial activity of various concentrations of Tulsi (Ocimum sanctum) extract against Streptococcus mutans: An in vitro study
Pooja Agarwal, L Nagesh, Murlikrishnan
July-September 2010, 21(3):357-359
DOI:10.4103/0970-9290.70800  PMID:20930344
Aim: To determine if Tulsi (Ocimum sanctum) extract has an antimicrobial activity against Streptococcus mutans and to determine which concentration of Tulsi (Ocimum sanctum) extract among the 15 concentrations investigated has the maximum antimicrobial activity. Setting and Design: Experimental design, in vitro study, Lab setting. Materials and Methods: Ethanolic extract of Tulsi was prepared by the cold extraction method. The extract was then diluted with an inert solvent, dimethyl formamide, to obtain 15 different concentrations (0.5%, 1%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4%, 4.5%, 5%, 6%, 7% 8%, 9%, 10%) of the extract. 0.2% chlorhexidine was used as a positive control and dimethyl formamide was used as a negative control. The extract, along with the controls, was then subjected to microbiological investigation to determine which concentration among the 15 different concentrations of the extract gave a wider inhibition zone against Streptococcus mutans. The zones of inhibition were measured in millimeters using a vernier caliper. Results: At the 4% concentration of Tulsi extract, a zone of inhibition of 22 mm was obtained. This was the widest zone of inhibition observed among all the 15 different concentrations of Tulsi that were investigated. Conclusion: Tulsi extract demonstrated an antimicrobial property against Streptococcus mutans.
  15,609 1,652 25
The use of ozonated water and 0.2% chlorhexidine in the treatment of periodontitis patients: A clinical and microbiologic study
Durga Kshitish, Vandana K Laxman
July-September 2010, 21(3):341-348
DOI:10.4103/0970-9290.70796  PMID:20930341
Background: The development of periodontal disease has been thought to be associated with several restricted members of the oral anaerobic species, such as black-pigmented Porphyromonas species and Actinobacillus actinomycetemcomitans (Aa), in the subgingival environment. Apart from bacteria, certain viruses and fungi that are associated with periodontal disease are also present in the subgingival plaque . Materials and Methods: A randomized, double-blind, crossover split-mouth design was performed. A total of 16 patients suffering from generalized chronic periodontitis were selected for the study. The study period of 18 days was divided into two time-intervals, i.e. baseline (0 days) to 7 th day, with a washout period of 4 days followed by a second time interval of 7 days. The use of ozone and chlorhexidine gluconate (CHX) irrigation was randomized. Both the patient and the clinician evaluating the clinical parameters were blinded regarding the type of irrigation used. Results: The interpretation of clinical and microbial data is from baseline to 7 th day. A higher percentage of plaque index (12%), gingival index (29%) and bleeding index (26%) reduction was observed using ozone irrigation as compared to chlorhexidine. The percentile reduction of Aa (25%) using ozone was appreciable as compared to no change in Aa occurrence using chlorhexidine. By using O 3 and chlorhexidine, there was no antibacterial effect on Porphyromonas gingivalis (Pg) and Tannerella forsythensis. The antifungal effect of ozone from baseline (37%) to 7 th day (12.5%) was pronounced during the study period, unlike CHX, which did not demonstrate any antifungal effect. Conclusion: Ozone may be considered as an alternative management strategy due to its powerful ability to inactivate microorganisms. Also, there is growing evidence that ozone can be employed as a useful therapeutic agent in both dentistry and medicine.
  14,381 915 30
A radiographic correlation between systemic disorders and pulp stones
Moksha Nayak, Jitendra Kumar, L Krishna Prasad
July-September 2010, 21(3):369-373
DOI:10.4103/0970-9290.70806  PMID:20930347
Aim: The purpose of this study was to determine the correlation between pulp stones and cardiovascular disorders, Type II diabetes mellitus, autoimmune disorders and dental wear defects. This study also aims to evaluate the frequency of pulp stone in population of Dakshina Kannada district (Karnataka, India) and to determine association of pulp stones in different sexes, tooth type, dental arches and sides. Patients and Methods: A total of 1432 teeth of five groups were examined, comprising of patients with C.V.S. disorders; Type II diabetes mellitus, autoimmune disorders, dental wear defects and control group. Teeth were examined under 2Χ magnification on radio visiograph (RVG) and conventional intra-oral periapical radiograph. The presence or absence of pulp stones were recorded. Statistical Analysis Used: Chi-square analysis was used to compare the frequency of occurrence of pulp stones between sexes, tooth type, dental arches and sides. Results: Pulp stones were found in 134 (9.35%) of 1432 teeth detected. Significantly, higher numbers of pulp stones were recorded in patients with cardiovascular disorder (15.86%) than other groups. The occurrence of pulp stones were significantly higher in molars (18.29%) than premolars (6.6%) and in maxillary arch (12.36%) than in mandibular arch (5.95%). No significant difference was found between sexes and sides. Conclusion: Positive correlation was found between systemic disorder and pulp stones. Cardiovascular patients had maximum number of pulp stones followed by dental-wear defects and least number of pulp stones were evident in control group.
  12,947 742 13
Trends in the epidemiology of oral squamous cell carcinoma in Western UP: An institutional study
Preeti Sharma, Susmita Saxena, Pooja Aggarwal
July-September 2010, 21(3):316-319
DOI:10.4103/0970-9290.70782  PMID:20930335
Objective: The purpose of the study was to identify trends in incidence rates of oral squamous cell carcinoma (OSCC) at specific anatomic sites or within specific age or sex groups in the Western Uttar Pradesh population. Materials and Methods: The study covers the period from January 2004 through April 2009. OSCC cases were retrospectively analysed for site, age, gender and habits and the findings were formulated to chart the trends in Western U.P. Results: The study revealed a male to female ratio of 2.2:1 with the largest number of OSCCs developing in the fourth and fifth decades of life. Overall, the most common site was the buccal mucosa (63.75%), followed by retromolar area (15%), floor of the mouth (11.25%), lateral border of the tongue (3.75%), labial mucosa (3.75%), and palate (2.5%). Smokeless tobacco habit was more prevalent than smoking tobacco in both men as well as women. Karl - Pearson's correlation coefficient was calculated to find the degree of association between the two variables i.e. between gender to buccal mucosa and gender to smokeless and smoking tobacco habits, which were found to be positively correlated with respect to the age. Conclusion: Oral cancer is an important cause of morbidity and mortality worldwide with an incidence rate that varies widely by geographic location. Even within one geographic location, the incidence varies among groups categorized by age, sex, site or habit.
  12,550 1,066 57
Mucocele - A study of 36 cases
Dhaval R Jani, Jyoti Chawda, Sireesha Krishna Sundaragiri, Girish Parmar
July-September 2010, 21(3):337-340
DOI:10.4103/0970-9290.70793  PMID:20930340
Background: Mucocele is one of the most common benign soft tissue tumor present in the oral cavity. They are of two types - one is extravasation and second one is retention type but the majority are extravasation type. Aims: The objective is to determine various factors related to mucocele such as role of trauma due to nearby teeth, recurrence, duration, and to find out whether there is any role of psychological stress which initiates trauma like lip or cheek biting. Materials and Methods: 36 cases of mucocele diagnosed at the Department of the Oral Pathology, Govt. Dental College and Hospital, Ahmedabad, between 2004 and 2008 were reviewed. The clinical data were recorded and histopathologic diagnosis was made. Statistical Analysis Used: Data analysis tool, Microsoft Office Excel 2007. Results: A diagnosis of mucocele was established in 36 cases with male-to-female ratio of 1.77:1. Most common type was extravasation in 30 (83.33%) cases. The peak age of occurrence was between 1st and 3rd decade. Lateral side of the lower labial mucosa was the most affected site in 34 (94.44%) cases. The history of trauma appeared the major etiological factor seen in 28 (77.77%) cases. Conclusion: We conclude that there was male predominance and they were more affected in 2nd and 3rd decade. The lateral side of lower labial mucosa was the commonest site and the trauma due to teeth or lip biting was the major etiological factor for the occurrence of the mucocele. The article highlights role of psychological stress in occurrence of mucocele. The reader should understand the importance of histopathology examination and should try to control the psychological stress in such mucocele patients.
  12,796 392 7
Chitosan-based polyherbal toothpaste: As novel oral hygiene product
Nitin C Mohire, Adhikrao V Yadav
July-September 2010, 21(3):380-384
DOI:10.4103/0970-9290.70808  PMID:20930349
Objective: The objective of the present work was to develop chitosan-based polyherbal toothpaste and evaluate its plaque-reducing potential and efficacy in reduction of dental pathogens. Materials and Methods: Antimicrobial activity of herbal extracts against dental pathogens were performed by using disk diffusion method. The pharmaceutical evaluation of toothpaste was carried out as per the US Government Tooth Paste Specifications. A 4-week clinical study was conducted in patients with oro-dental problems to evaluate the plaque removing efficacy of chitosan-based polyherbal toothpaste with commercially available chlorhexidine gluconate (0.2% w/v) mouthwash as positive control. Total microbial count was carried out to determine the percentage decrease in the oral bacterial count over the period of treatment. Result: Herbal extracts were found to possess satisfactory antimicrobial activity against most of the dental pathogens. Chitosan-containing polyherbal toothpaste significantly reduces the plaque index by 70.47% and bacterial count by 85.29%, and thus fulfills the majority of esthetic and medicinal requirements of oral hygiene products. Conclusion: Chitosan-based polyherbal toothpaste proves itself as a promising novel oral hygiene product as compared with currently available oral hygiene products. A further study to confirm the exact mechanism and active constituents behind antiplaque and antimicrobial activity of chitosan-based polyherbal toothpaste and its efficacy in large number of patient population is on high demand.
  11,955 665 34
Antifungal efficacy of Punica granatum, Acacia nilotica, Cuminum cyminum and Foeniculum vulgare on Candida albicans: An in vitro study
Mithun B.H Pai, GM Prashant, KS Murlikrishna, KM Shivakumar, GN Chandu
July-September 2010, 21(3):334-336
DOI:10.4103/0970-9290.70792  PMID:20930339
Background: The establishment and maintenance of oral microbiota is related not only to interbacterial coaggregations but also to interactions of these bacteria with yeasts. Hence, it is important for agents used in the treatment of oral diseases to have antifungal properties for effective therapy. Objective: The main purpose of this study was to evaluate the in vitro antifungal efficacy of Punica granatum, Acacia nilotica, Cuminum cyminum and Foeniculum vulgare on Candida albicans. Materials and Methods: The pomegranate peel is separated, dried and powdered. Fennel, cumin and acacia bark obtained from the tree are powdered. Candida is inoculated at 37˚C and seeded on Sabourauds agar medium. Sterilized filter papers saturated with 30 μl of the extracts are placed on the seeded plates and inoculated at 24 and 48 h. Zones of inhibition on all four sides are measured around the filter paper with a vernier caliper. The experiments were repeated on four plates, with four samples of each extract on one plate for all of the extracts. Results: All the above-mentioned ingredients showed antifungal property, with Punica granatum showing the highest inhibition of Candida albicans with a mean zone of inhibition of 22 mm. P-values <0.05 were obtained for Punica granatum when compared with the other extracts. Conclusion: The results showed the potential use of these products as cheap and convenient adjuvants to pharmaceutical antifungal products.
  11,713 645 47
CASE REPORT
Cowden syndrome
SM Ravi Prakash, GN Suma, Sumit Goel
July-September 2010, 21(3):439-442
DOI:10.4103/0970-9290.70803  PMID:20930359
Cowden syndrome or multiple hamartoma syndrome is an autosomal dominant condition with variable expressions that result mainly from mutation in the PTEN gene on arm 10q. It is characterized by multiple hamartomatous neoplasms of the skin, oral mucosa, gastrointestinal tract, bones, CNS, eyes, and genitourinary tract. Mucocutaneous features include trichilemmomas, oral mucosal papillomatosis, acral keratosis, and palmoplantar keratosis. Here we present a case of Cowden syndrome in a 14-year-old female patient with the chief complaint of multiple oral papillomatous lesions.
  11,589 298 13
REVIEW ARTICLES
Infinite to finite: An overview of finite element analysis
A Srirekha, Kusum Bashetty
July-September 2010, 21(3):425-432
DOI:10.4103/0970-9290.70813  PMID:20930357
The method of finite elements was developed at perfectly right times; growing computer capacities, growing human skills and industry demands for ever faster and cost effective product development providing unlimited possibilities for the researching community. This paper reviews the basic concept, current status, advances, advantages, limitations and applications of finite element method (FEM) in restorative dentistry and endodontics. Finite element method is able to reveal the otherwise inaccessible stress distribution within the tooth-restoration complex and it has proven to be a useful tool in the thinking process for the understanding of tooth biomechanics and the biomimetic approach in restorative dentistry. Further improvement of the non-linear FEM solutions should be encouraged to widen the range of applications in dental and oral health science.
  9,704 674 31
Status of surface treatment in endosseous implant: A literary overview
Ankur Gupta, M Dhanraj, G Sivagami
July-September 2010, 21(3):433-438
DOI:10.4103/0970-9290.70805  PMID:20930358
The attachment of cells to titanium surfaces is an important phenomenon in the area of clinical implant dentistry. A major consideration in designing implants has been to produce surfaces that promote desirable responses in the cells and tissues. To achieve these requirements, the titanium implant surface can be modified in various ways. This review mainly focuses on the surface topography of dental implants currently in use, emphasizing the association of reported variables with biological outcome.
  8,925 480 40
ORIGINAL RESEARCH
ABO blood groups and Rhesus factor: An exploring link to periodontal diseases
Arati C Koregol, M Raghavendra, Sangamesh Nainegali, Nagaraj Kalburgi, Siddharth Varma
July-September 2010, 21(3):364-368
DOI:10.4103/0970-9290.70804  PMID:20930346
Background: The presence or absence of blood group antigens has been associated with various diseases, with antigens also acting as receptors for infectious agents. Scanty literature is available in assessing the relative liability of blood group phenotypes to periodontal diseases. This research was conducted to determine the association of the ABO blood group and Rhesus (Rh) factor to periodontal diseases to assess whether they could be the predictors of periodontal diseases. Materials and Methods: A total of 1,220 subjects aged between 20 and 55 years were selected on a random basis. The study populations were segregated into three groups according to Ramfjord's periodontal disease index: Healthy, Gingivitis and Periodontitis. Blood samples were collected to identify the ABO blood groups and the Rh factor by the slide method. Results: Blood group A showed a significantly higher percentage in the gingivitis group and blood group O showed a higher percentage in the periodontitis group. The blood group AB showed the least percentage of periodontal diseases. The distribution of Rh factor in all groups showed a significantly higher distribution of Rh-positive. Conclusion: The genetic factors may alter the oral ecology and the process of periodontal disease. These data are suggestive of a broad correlation between periodontal diseases and blood groups, which may act as risk predictors for periodontal diseases. This will make it possible to better-understand the risk factors of diseases of the periodontal tissues and to predict the effective methods of prevention and treatment of periodontal diseases.
  8,188 550 8
SHORT COMMUNICATIONS
Toothbrush injury in an adult
B Saravanan
July-September 2010, 21(3):446-448
DOI:10.4103/0970-9290.70797  PMID:20930361
Tooth brushing is an oral hygiene measure. Keeping the toothbrush in the mouth and doing other works with both arms may lead to injury of the oral tissues. We hereby report a case of severe injury to the oral mucosal tissues caused by the toothbrush, which was treated surgically.
  7,968 224 2
ORIGINAL RESEARCH
Histopathologic changes in soft tissue associated with radiographically normal impacted third molars
Vijayalakshmi S Kotrashetti, Alka D Kale, Sudhir S Bhalaerao, Seema R Hallikeremath
July-September 2010, 21(3):385-390
DOI:10.4103/0970-9290.70809  PMID:20930350
Background: The incidence of impacted or embedded third molars accounts for approximately 98%. Since 1948, there are studies reporting pathological changes in an asymptomatic dental follicle. Controversy still exists for removal of asmptomatic impacted teeth. Hence, this study was performed to histologically evaluate soft tissue pathosis in the pericoronal tissues of impacted third molars with pericoronal radiolucency measuring up to 2.5 mm on orthopantomographs. Materials and Methods: Forty-one asymptomatic impacted third molars with follicular space of up to 2.5 mm on radiographs were included. The disimpacted teeth and the follicular tissues were obtained for histological examination. Results: Age of the patients ranged from 14 to 25 years. Of 41 tissues evaluated, histopathological reports of 18 follicles were suggestive of dentigerous cyst, two follicles showed odontogenic keratocyst, one follicle each of calcifying epithelial odontogenic cyst, ameloblastoma-like proliferation, odontogenic myxoma and odontogenic fibroma. Conclusion: This study showed 58.5% of asymptomatic cases with definite pathological changes. Hence, thorough clinical and radiographic examination should be carried out for all impacted third molars and the dental follicular tissue should be submitted for histopathological evaluation.
  7,551 489 19
Evaluation of the C-reactive protein serum levels in periodontitis patients with or without atherosclerosis
Kaustubh S Thakare, Vikas Deo, Manohar L Bhongade
July-September 2010, 21(3):326-329
DOI:10.4103/0970-9290.70787  PMID:20930337
Background : Several studies suggested an association between periodontal disease and cardiovascular disease (CVD). C- reactive protein is elevated in periodontitis patients and has been found to be a predictor of increased risk for cardiovascular disease. Since, CRP is known to play a role in pathogenesis of atherosclerosis, the present study was undertaken to evaluate the serum levels of CRP in periodontitis patients with or without atherosclerosis. Materials and Methods : A total of 45 patients, 15 chronic periodontitis patients with atherosclerosis (Group A), 15 chronic periodontitis patients with no history of any systemic disease (Group B), and 15 clinically healthy individuals with no history of periodontal or systemic disease (Group C) within age range of 30 to 55 years were selected for the study. PI, PBI, PPD, CAL and radiographic marginal alveolar bone level were assessed in all the three groups. CRP levels were assessed with 'Turbi-latex' kit using turbidimetric analysis. Results : The mean CAL recorded was 4.9mm in group A, 4.6mm in group B and 1.9 mm in group C. The mean radiographic marginal bone level was 45 to 50% in group A, 45 to 50% in group B and 90 to 95% in group C. Mean serum C-reactive protein level was significantly higher in group A (8.9 mg/l), as compared to group B (4.9 mg/l) as well as group C (0.9 mg/l). Conclusion : Within the limits of this study it was concluded that periodontitis may add to the inflammatory burden of the individual and may result in increased risk of atherosclerosis based on serum C-reactive protein concentrations.
  7,238 448 14
SHORT COMMUNICATIONS
Schwannoma of the tongue: An unusual presentation in a child
Giridhar S Naidu, Samindra Mohan Sinha
July-September 2010, 21(3):457-459
DOI:10.4103/0970-9290.70790  PMID:20930365
Schwannomas are benign tumors of nerve sheath and quite uncommon in the oral cavity. In contrast to the earlier reports in the literature, a confounding case of a lingual schwannoma presenting as a symptomatic and exophytic growth on the ventral surface of the tongue in a 12-year-old boy is discussed here.
  7,366 216 14
ORIGINAL RESEARCH
Efficacy and acceptability of 0.074% diclofenac-containing mouthwash after periodontal surgery: A clinical study
Sangita Agarwal, Setu Mathur, Shaila Kothiwale, Amit Benjamin
July-September 2010, 21(3):408-412
DOI:10.4103/0970-9290.70814  PMID:20930354
Background: The systemic use of non-steroidal anti-inflammatory drugs are associated with various side-effects like hepatotoxicity, blood dyscrasias, nephrotoxicity and gastric irritability. Among these, gastric irritability is the most common and the most important one, which should be taken care of. Therefore, it may be preferable to use a local formulation such as a mouthwash to treat the inflammatory conditions of the oral cavity. Aim: To determine the efficacy and acceptability of 0.074% diclofenac mouthwash in relieving pain and inflammation of post-periodontal surgery patients. Materials and Methods: The study was designed as a double-blind, placebo-controlled clinical trial. Twenty chronic periodontitis patients who were scheduled for full-mouth periodontal flap surgery were randomized to receive either diclofenac mouthwash or placebo to rinse with 15 ml of solution daily for a period of 7 days. Modified gingival index (Lobene 1986) was used to verify gingival inflammation and visual analog scale was used to assess pain. After the baseline measurements for all the parameters were recorded, spontaneous pain and burning were evaluated daily while redness and edema were recorded on the 3 rd and 7 th day from the day of treatment. Results: Data obtained were analyzed statistically using paired " t" test for intragroup comparison and unpaired " t"-test for intergroup comparison. Spontaneous pain was significantly reduced by diclofenac mouthwash. Other parameters, i.e. gingival inflammation and swelling, had not shown significant reduction in scores in either group, although the reduction was higher in the test group. Conclusion: The new 0.074% diclofenac mouthwash is an effective and tolerable medicinal product for post-surgical symptomatic relief.
  6,698 404 4
An evaluation of the mechanical properties of Type III and Type IV gypsum mixed with two disinfectant solutions
Sunitha M Roy, J Sridevi, N Kalavathy
July-September 2010, 21(3):374-379
DOI:10.4103/0970-9290.70807  PMID:20930348
Background and Objectives: This in-vitro study was conducted to evaluate the strength and properties of Type III and Type IV gypsum mixed with disinfectant solutions. Materials and Methods: Type III and Type IV gypsum were used for the study. Three different mixing solutions namely waterqueous solutions of 0.525% sodium hypochlorite and 2% glutaraldehyde were used. Gypsum materials were subjected to further modification by adding a mixture of 1.0% gum arabic and 0.132% calcium hydroxide before mixing with the disinfectant solutions, at two different liquid/powder (L/P) ratios for each. Both, the unmodified and the modified gypsum were tested for compressive and tensile strength after one hour and one week from the start of the mix. The crystalline configuration of the fracture fragments of the unmodified and modified set gypsum were studied under the scanning electron microscope. Results: The disinfectant solutions reduced the strength of both Type III and Type IV gypsum. Water showed higher-strength, which was followed by 0.525% sodium hypochlorite and 2% glutaraldehyde. The modified Type III and Type IV gypsum with reduced L/P ratio also showed strength values less than that of the control groups. Interpretation and Conclusion: Chemical disinfectants reduced the strength of gypsum when used as water substitutes. Gum Arabic and calcium hydroxide additives permitted lower L/P ratio, however, there was still excess water retained in the set gypsum that lowered the strength values of Type III and Type IV gypsum. Hence, further reduction of L/P ratio may increase the properties of the modified Type III and Type IV gypsum.
  5,746 229 7
SHORT COMMUNICATIONS
Restoration of the maxillary anterior tooth using immediate implantation with simultaneous ridge augmentation
Jun-Beom Park
July-September 2010, 21(3):454-456
DOI:10.4103/0970-9290.70791  PMID:20930364
Atrophy is most severe during the first month of post-extraction in the anterior maxilla with the degree of horizontal bone resorption being nearly twice as high as that of vertical bone resorption. The loss of the buccal alveolar plate following tooth extraction may lead to palatal implant positioning of the implants. Thus, immediate or early implant placement in the extraction socket has been suggested, because it would reduce the time period and the number of surgical intervention and yield higher patient satisfaction compared with delayed placed implants. However, placement of an implant immediately after tooth extraction may result in a gap between the occlusal portion of the implant and the surrounding alveolar bone crest. In this case report, an implant-supported restoration which is in harmony with the surrounding hard and soft tissue was created by the immediate implant placement with ridge augmentation in anterior region with high satisfaction from the patient.
  5,783 187 4
ORIGINAL RESEARCH
Matrix metalloproteinase-1 expression in oral submucous fibrosis: An immunohistochemical study
Gauri Mishra, K Ranganathan
July-September 2010, 21(3):320-325
DOI:10.4103/0970-9290.70785  PMID:20930336
Context: Oral submucous fibrosis (OSF) is a form of pathological fibrosis affecting the oral mucosa. There is compelling evidence to implicate the habitual chewing of areca nut with the development of OSF. Because collagens are the major structural components of connective tissues, including oral submucosa, the composition of collagen within each tissue needs to be precisely regulated to maintain tissue integrity. Arecoline stimulates fibroblasts to increase the production of collagen by 150%. Aim: As the role of collagenase is implicated in cleaving the collagen under physical conditions, this study was carried out to evaluate the role of collagenase-1 (matrix metalloproteinase [MMP]-1) in a pathologic condition like OSF. Settings and Design: A total of 40 patients were included in the study, comprising of 30 OSF as Group 1 and 10 normal buccal mucosa tissue as Group 2. Materials and Methods: Both the groups were stained for MMP-1 by the immunohistochemical method using the streptavidin HRP-biotin labeling technique. MMP-1 expression intensity in the epithelium and connective tissue was decreased in Group 1 when compared to Group 2. Statistical Analysis Used: Chi-square test of association was used to determine the difference in the expression of MMP-1 between OSF and normal buccal mucosa and among different histological gradings of OSF. Results: The results were statistically significant. However, there was no statistically significant difference between the expression of MMP-1 among different histological grades of OSF in Group 1.
  5,381 564 5
A microbiological evaluation of the use of denture cleansers in combination with an oral rinse in complete denture patients
Murali Srinivasan, Manish Gulabani
July-September 2010, 21(3):353-356
DOI:10.4103/0970-9290.70799  PMID:20930343
Background and Aim : Patients with complete dentures more occasionally neglect their denture and oral health by improper maintenance of dentures, resulting in bad oral and denture hygiene. This may lead to a host of multiple local and systemic problems such as stomatitis, bacterial and fungal infections, reservoirs for distant infections, denture stains and bad breath. Most denture wearers maintain their dentures with simple manual cleansing methods, which are not adequate to effectively sanitize the reservoir of microorganisms inhabiting the denture surfaces. The aim of this study was to compare the efficacy of the use of a denture cleanser and compare it with an adjunct use of chlorhexidine mouth rinse along with the denture cleanser and possibly suggest it as a suitable protocol. Materials and Methods : Two groups of complete denture patients were selected for the study. The total number of patients in each group was 12 and the total period of the study was 21 days. Three sets of microbiological samples were collected from each patient: before the start of the study, on day 8 and on day 21 of the study. The first sample was collected after an initial washover period (7 days) with plain water before the start of the study and the second set after 1 week of study initiation, where group-1 followed protocol-I (denture cleanser only) and group-2 followed protocol-II (denture cleanser and mouth rinse). A second washout period of 7 days followed and a crossover of the protocol was performed for the groups and followed for 1 week. Then, a third set of samples were collected. The colony-forming units were calculated for each patient for each sample and statistically analyzed. Friedman test for non-parametric analysis was employed for the comparison within the groups and a Mann-Whitney test was used for the statistical comparison between the groups. Results : There was a definite reduction in the bacterial numbers and a significant statistical difference after administering the protocols in both the groups (P<0.001). However, there was little significance on comparing the samples between the groups (P=0.026) in the initial study period, and there was no statistical significance when comparing the groups after the crossover (P=0.140). Conclusion : The use of denture cleansers definitely reduced the microbial numbers as compared to plain manual cleansing methods in complete dentures. Although there was a substantial decrease in the bacterial colonies after the use of the mouthwash, it was not statistically significant.
  5,292 210 10
Influence of the processing technique on the flexural fatigue strength of denture base resins: An in vitro investigation
Rajlakshmi Banerjee, Sujoy Banerjee, PS Prabhudesai, SV Bhide
July-September 2010, 21(3):391-395
DOI:10.4103/0970-9290.70810  PMID:20930351
Background : Though acrylic resins possess many desirable properties, denture fracture due to flexural fatigue or impact failure is a common problem. One major factor influencing the flexural fatigue strength of denture base resins is the processing technique used. Aim: To measure the flexural fatigue strength of denture base resins polymerized using short and long curing cycles using water bath, pressure cooker, and microwave polymerization techniques. Materials and Methods: Flexural fatigue strength of 60 samples (n=10) were measured using a cyclic 3-point loading method on a dynamic universal testing machine. Data were analyzed using a Student 't' test. Results : Comparative evaluation using Student's 't' test of mean flexural fatigue strength of samples processed by water bath processing (660.6) and the microwave technique (893.6) showed statistically significant (P <0.01) result with microwave processing being higher. Comparison of water bath (660.6) and pressure cooker (740.6) processing and microwave (893.6) and pressure cooker (740.6) processing using Student's 't' test was not statistically significant (P >0.05). In the intra-group analysis, it was found that there was statistically significant difference in samples processed using the short and long curing cycle, the latter being better in all groups, P-values being <0.05, <0.001, and <0.001 for water bath, microwave, and pressure cooker polymerization techniques, respectively. Conclusion : The polymerization procedure plays an important role in influencing the flexural fatigue strength of denture base resins, and the microwave long curing processing technique produced denture bases with highest flexural fatigue strength.
  5,099 182 11
SHORT COMMUNICATIONS
Gingival plasma cell granuloma
Mangesh B Phadnaik, Nilofar Attar
July-September 2010, 21(3):460-462
DOI:10.4103/0970-9290.70788  PMID:20930366
Plasma cell granuloma is a rare reactive lesion composed of polyclonal plasma cells. It manifests primarily in the lungs, but may occur in various other anatomic locations like the oral cavity. Intraoral plasma cell granulomas involving the tongue, lip, oral mucosa and gingiva have been reported in the past. This case presents a 54-year-old female with chronic periodontitis and mandibular anterior gingival overgrowth treated by Phase I therapy (scaling and root planing) and excisional biopsy. Histological examination revealed inflammatory cell infiltrate containing sheets of plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma. This case highlights the need to biopsy for unusual lesions to rule out potential neoplasms.
  4,777 351 9
ORIGINAL RESEARCH
Folic acid in cleft lip, alveolus and palate prevention: Awareness among dental professionals
P Elavenil, C Murugavel, Kamal Kannadasan, VB Krishnakumar Raja, A Gnanam, G Kanimozhi, D Davis
July-September 2010, 21(3):360-363
DOI:10.4103/0970-9290.70802  PMID:20930345
Objectives : To determine the awareness amongst dental students, practitioners and maxillofacial surgeons the role of folic acid in the prevention of CLAP and its clinical use. Materials and Methods : Questionnaire based study involving a sample base of 1100, comprising of dental students, practitioners and specialist maxillofacial surgeons. Results : hundred percent of the sample population were aware of CLAP disorders, of which 9.5 % believed that CLAP could be prevented. 3.8 % of the population were able to correlate folic acid to CLAP while a negligible 0.03 % could provide the dosage. Conclusion : Educating healthcare providers and, in turn, the prospective parents on benefits folic acid would not only help in reducing the incidence of CLAP but also significantly influence the economics of the patients afflicted with CLAP disorders.
  4,732 204 -
Masseter muscle thickness in different skeletal morphology: An ultrasonographic study
Sushma Rani, MS Ravi
July-September 2010, 21(3):402-407
PMID:20930353
Background: The thickness of the masseter muscle during relaxation and contraction states was measured by ultrasonography. Subjects were classified according to their sagittal skeletal relationships. The association between muscle thickness and facial morphology was studied. Context: Masseter muscle thickness influences the skeletal patterns. Aim: To measure and compare the thickness of the masseter muscle in individuals with skeletal class I occlusion and skeletal class II malocclusions and to correlate its relationship with craniofacial morphology. Settings and Design: The study was conducted in a hospital setup and was designed to study the thickness of the masseter muscle in different skeletal morphologies. Materials and Methods: Seventy two individuals between the ages of 18 and 25 years were divided into Group I, Group IIA and Group IIB according to their skeletal relationships. Masseter muscle thickness was measured by ultrasonography. Eight linear and six angular cephalometric measurements were assessed. Statistical Analysis Used: Analysis of variance and Pearson's correlation analysis. Results: There was a statistically significant difference in muscle thickness between subjects of different skeletal patterns. Significant positive correlation between masseter muscle thickness and posterior total face height, jarabak ratio, ramus height, mandibular length and significant negative correlations with mandibular plane angle, gonial angle and PP-MP angle were observed. Conclusion: This study indicates the strong association between the masseter muscle and skeletal morphology.
  4,454 254 -
Transforming growth factor-β-1 polymorphisms are infrequent but exist at selected loci in oral submucous fibrosis
R Rajendran, RK Harish, Sukumaran Anil, Ravi Vidyadharan, Moinak Banerjee
July-September 2010, 21(3):413-419
DOI:10.4103/0970-9290.70815  PMID:20930355
Background : Oral submucous fibrosis (OSF) may be considered a collagen metabolic disorder resulting from areca-nut alkaloid exposure and individual variation in collagen metabolism. Due to the complexity of OSF pathogenesis, it is important to elucidate independent and interactive effects of polymorphisms of collagen-related genes on OSF risk. Materials and Methods : This study is focused on seven polymorphisms (SNPs) of transforming growth factor-beta-1 (TGF-beta-1) gene in patients with oral submucous fibrosis (OSF), belonging to south Indian ethnic extraction. The mean age at presentation was 43.9 years, range 23-72 years (n=50, M:F ratio, 2.6:1). DNA samples from 50 subjects of the same ethnic group and comparable demographic features who have had practiced the habit of areca-chewing of almost equal duration, but remained free of disease constituted the controls. All DNA samples were collected progressively and purified from peripheral blood employing standard protocols and tested for SNPs. They included two polymorphisms in the promoter region (C-509T and G-800A), three polymorphisms in exon-1 (Arg25Pro(G915C), Leu10Pro(T869C), Glu47Gly(A979G) and two in 5 ͲUTR regions (C→T(rs13306708) and G→A (rs9282871). The extracted DNA samples along with the primers underwent PCR amplification and the genotypic and allelic frequencies were calculated. All calculations were performed using the SPSS software. The PCR products were purified and subsequently sequenced using Flour S™ multi-imager system (Biorad). The sequenced data were analyzed using the BioEdit sequence analysis software. Results : Out of the seven polymorphisms analyzed, six such as two in the promoter region, three in exon-1 and one in 5¢UTR were found to have a " P" value above 0.05 and hence were not significant. The C→T transition (rs13306708) in the 5¢UTR region recorded a " P" value of 0.03 on comparison and hence was found to be significant. The allelic frequencies for this C→T transition in patients were 68.7% C and 31.2% T (27CC, 15CT, 8TT) and that in controls were 89.5% C and 10.4% T (42CC, 6CT, 2TT). Conclusions : The polymorphism in 5¢UTR C-T in TGF beta 1 gene has a significant association with OSF, being a prime determinant in the pro-angiogenic pathway which has got direct bearing with the pathophysiology of the disease. The proximity of this polymorphism to the transcription site and the associated risk involved is discussed.
  4,010 344 9
E-cadherin and CD1a expression in gingival epithelium in periodontal health, disease and post-treatment
Ramya Arun, R Hemalatha, KV Arun, TSS Kumar
July-September 2010, 21(3):396-401
DOI:10.4103/0970-9290.70811  PMID:20930352
Background: Epithelial integrity is important for maintenance of periodontal health. It is not fully known if non-surgical periodontal therapy is capable of recreating the epithelial barrier in its functional state. Patients and Methods: Sixty-five patients (31 males and 34 females) were included in the study. They were divided into group A (healthy gingiva 16 patients), group B (gingivitis 17 patients), group C (periodontitis 17 patients), and group D (post-treatment 15 patients). Gingival samples were collected and immunohistochemical study was done using E-cadherin and CD1a antibody. Statistical analysis was done using analysis of variance (ANOVA), followed by Tukey-Kramer multiple comparison test for CD1a and Tukey's highly significant difference (HSD) test for E-cadherin. Result: There was a statistically significant difference (P<0.001) in the expression of E-cadherin between healthy (1.846±0.555), gingivitis (1.100±0.994), and periodontitis group (0.700±0.483). Similarly, there was a statistically significant difference (P<0.001) in the expression of CD1a between healthy (75.70±3.09), gingivitis (42.53±3.09), and periodontitis group (29.07±3.08). However, the expression of E-cadherin (1.242±0.653) and CD1a in post-treatment samples (52.18±2.90) was lower with no statistically significant difference when compared to health. Discussion: The significant reduction in E-cadherin and CD1a levels in periodontal disease when compared to health could possibly be a result of invasion by the periodontopathogens and its subsequent sequel. Although, the post-treatment samples showed significant improvement when compared to disease, the reduction in E-cadherin and CD1a levels when compared to gingival health suggests that the epithelial barrier was not yet fully established in its functional state.
  4,023 172 11
Titanium implants: A removal torque study in osteopenic rabbits
Carine M Carvalho, Luiz F Carvalho, Lino J Costa, Marcelo J Sá, Cláudia R Figueiredo, Adílio S Azevedo
July-September 2010, 21(3):349-352
DOI:10.4103/0970-9290.70798  PMID:20930342
Context: Osteoporosis is a skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue. It may affect the craniomaxillofacial complex and result in less bone-implant contact. Aims: The objective of this study was to measure the endosseous integration of titanium implants using the removal torque test in low-mineral density experimental animal models. Materials and Methods: Thirty female New Zealand white rabbits were divided into two groups: control (n=14), sham-operated; and test (n=16), ovariectomized. All animals received 2.2 mm Χ 4.0 mm titanium implants in the right tibia, 120 days after ovariectomy or sham surgery. Animals were killed at 7 and 14 weeks of postimplant insertion, when implants were removed by reverse torque rotation using a digital torque meter. Statistical analysis used was Student's t-test. Results and Conclusion: At the 7-week period, the mean torque values for the control and test groups were 11.6 Ncm and 10.4 Ncm, respectively, with no statistical significance. Implant removal torque analysis showed statistically lower values (P<0.05) for the test group at the 14-week period (control=16.7 Ncm and test=9.7 Ncm). The results of this study indicate that hormonal privacy compromise implants biomechanical performance.
  4,033 123 16
Histological and radiographic evaluation of the muscle tissue of rats after implantation of bone morphogenic protein (rhBMP-2) in a scaffold of inorganic bone and after stimulation with low-power laser light
Antonio Lucindo Bengtson, Nadya Galvão Bengtson, Camilla Regina Galvão Bengtson, Fausto Medeiros Mendes, Sérgio Luiz Pinheiro
July-September 2010, 21(3):420-424
DOI:10.4103/0970-9290.70816  PMID:20930356
Objective: The present study histologically and radiologically evaluates the muscle tissue of rats after implantation of bone morphogenic protein (rhBMP-2) in a natural inorganic bone mineral scaffold from a bull calf femur and irradiation with low-power light laser. Materials and Methods: The right and left hind limbs of 16 rats were shaved and an incision was made in the muscle on the face corresponding to the median portion of the tibia, into which rhBMP-2 in a scaffold of inorganic bone was implanted. Two groups of limbs were formed: control (G1) and laser irradiation (G2). G2 received diode laser light applied in the direction of the implant, at a dose of 8 J/cm2 for three minutes. On the 7th, 21st, 40th and 112th days after implantation, hind limbs of 4 animals were radiographed and their implants removed together with the surrounding tissue for study under the microscope. The histological results were graded as 0=absence, 1=slight presence, 2=representative and 3=very representative, with regard to the following events: formation of osteoid structure, acute inflammation, chronic inflammation, fibrin deposition, neovascularization, foreign-body granuloma and fibrosis. Results: There were no statistically significant differences in these events at each evaluation times, between the two groups (P>0.05; Mann-Whitney test). Nevertheless, it could be concluded that the natural inorganic bone matrix with rhBMP-2, from the femur of a bull calf, is a biocompatible combination. Conclusions: Under these conditions, the inductive capacity of rhBMP-2 for cell differentiation was inhibited. There was a slight acceleration in tissue healing in the group that received irradiation with low-power laser light.
  3,898 82 7
LETTERS TO EDITOR
Why tooth carving?
Irulandy Ponniah
July-September 2010, 21(3):463-463
DOI:10.4103/0970-9290.70783  PMID:20930367
  3,329 365 1
SHORT COMMUNICATIONS
Spiral CT diagnosis and endodontic management of an anatomically variant palatal root with two canals in a maxillary first molar
Mohanavelu Deepalakshmi, Revathi Miglani, Rajamani Indira, S Ramachandran
July-September 2010, 21(3):443-445
DOI:10.4103/0970-9290.70801  PMID:20930360
This case report presents the endodontic management of an anatomically variant palatal root with 2 canals (Vertucci type II) in a maxillary first molar, which was confirmed with the help of spiral computed tomography (SCT). This serves to remind clinicians that such anatomic variations should be taken into account during the endodontic treatment of maxillary molars and highlights the invaluable aid of the SCT in accurate diagnosis and in negotiating the complex morphologic variations in root canals, thus enabling successful endodontic management.
  3,393 194 3
Modified measuring compass as an intraoral paralleling device
Pravinkumar G Patil
July-September 2010, 21(3):452-453
DOI:10.4103/0970-9290.70794  PMID:20930363
This article describes a simple technique of useful modification of measuring compass, procured from a school compass box, to make an intraoral paralleling device. This device is useful in examining parallelism of tooth or implant abutment preparations for a common path of placement in fixed dental prostheses. It can be used to examine the parallelism of guiding planes in removable partial denture patients as well.
  3,291 173 2
Metastatic lung malignancy to mandibular gingiva
Rohit B Moharil, Shubhangi Khandekar, Alka Dive
July-September 2010, 21(3):449-451
DOI:10.4103/0970-9290.70795  PMID:20930362
Metastatic tumors of oral cavity are uncommon and may occur in oral soft tissues or jaw bones. Because of their rarity, metastasis to oral cavity are challenging to diagnose and difficult to treat. They often have vague symptoms that mimic dental infections. These lesions generally show poorly differentiated histopathologic picture and have poor prognosis. We reported a case of a 40-year-old male patient of metastatic lesion to the oral cavity and brain with primary tumor, diagnosed as an undifferentiated epithelial malignancy of lung.
  3,230 193 3
GUEST EDITORIAL
Ethical guidelines deciding the authorship
Amar A Sholapurkar
July-September 2010, 21(3):315-315
DOI:10.4103/0970-9290.70781  PMID:20930334
  2,657 375 2
LETTERS TO EDITOR
Invited comment
K Ranganathan
July-September 2010, 21(3):464-465
DOI:10.4103/0970-9290.70786  PMID:20930368
  1,706 112 -
Author's reply
B Sivapathasundharam
July-September 2010, 21(3):463-464
  1,122 107 -
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