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   2010| October-December  | Volume 21 | Issue 4  
    Online since December 24, 2010

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Endo-perio lesions: Diagnosis and clinical considerations
Nina Shenoy, Arvind Shenoy
October-December 2010, 21(4):579-585
DOI:10.4103/0970-9290.74238  PMID:21187629
The interrelationship between periodontal and endodontic disease has aroused confusion, queries and controversy. Differentiating between periodontal and endodontic problems can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may create periodontal involvement. In others, periodontal pathology may create pulpal pathology. This review article discusses the various clinical aspects to be considered for accurately diagnosing and treating endo-perio lesions.
  80,593 3,045 8
Hyaluronic acid: A promising mediator for periodontal regeneration
Jyoti Bansal, Suresh D Kedige, Samir Anand
October-December 2010, 21(4):575-578
DOI:10.4103/0970-9290.74232  PMID:21187628
Hyaluronic acid (HA) is a natural-non sulphated high molecular weight glycosaminoglycan that forms a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics, cell migration and proliferation. The use of HA in the treatment of inflammatory process is established in medical areas such as orthopedics, dermatology and ophthalmology. In the field of dentistry, hyaluronate has shown anti-inflammatory, antiedematous and anti-bacterial effects for the treatment of gingivitis and periodontitis. Due to its potential role in modulation of wound healing, its administration to periodontal wound sites could achieve comparable beneficial effects in periodontal tissue regeneration and periodontal disease treatment.
  18,530 727 24
Recurrent chronic suppurative osteomyelitis of the mandible
GC Rajkumar, M Hemalatha, R Shashikala, D Veerendra Kumar
October-December 2010, 21(4):606-608
DOI:10.4103/0970-9290.74229  PMID:21187635
Osteomyelitis of the maxillofacial skeleton is a rare condition in recent times. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis (CSO). This case report describes the successful surgical treatment of CSO of the mandible in an 18-year-old adult. Treatment included a pre-surgical course of antibiotics followed by sequestrectomy, resection of the coronoid process and removal of the pathologically fractured condylar process of the left side of the mandible. On post-operative clinical review at 1 week, the extra oral draining sinus healed with improved mouth opening.
  12,367 308 11
Restoration of posterior teeth using occlusal matrix technique
Josué Martos, Luiz Fernando M Silveira, Carmen M Ferrer-Luque, Santiago González-López
October-December 2010, 21(4):596-599
DOI:10.4103/0970-9290.74231  PMID:21187632
This article describes a technique for duplicating occlusal surface anatomy using the Biteperf device. Duplication requires an intact occlusal enamel surface and is only indicated when caries lesions are hidden. The occlusal matrix technique allows for preservation of all anatomic details. When the last layer of composite has been placed, the occlusal matrix is forced into the uncured composite to replicate the original occlusal surface, instead of performing manual curing and shaping as in the standard approach. It is technically possible to achieve this effect with any material that is able to copy anatomic details. The main benefits of the occlusal matrix technique, more precisely the Biteperf, are the technical ease of use due to its simplicity and its high accuracy in reconstructing occlusal morphology.
  10,246 232 1
Clinical investigation of mucosal thickness stability after soft tissue grafting around implants: A 3-year retrospective study
Stefano Speroni, Marco Cicciù, Paolo Maridati, Giovanni Battista Grossi, Carlo Maiorana
October-December 2010, 21(4):474-479
DOI:10.4103/0970-9290.74208  PMID:21187608
Purpose: To assess the long-term stability of gingival grafts placed around dental implants at the time of second surgery uncovering and to further investigate the association between mucosal thickness (MTh) by demographic variables and clinical investigation. Materials and Methods: Fourteen patients with submerged dental implants covered by inadequate keratinized mucosa were studied. The subjects underwent a periimplant plastic surgery (PPS) at the second-stage dental implant surgery and free gingival autograft orsubepithelial connective tissue graft were used according to the patients' clinical situation. Clinical measurement of MTh was assessed by bone sounding with a periodontal probe using customized acrylic stents andthe values were recorded at baseline (day of graft) and at 0.5, 1.5, 4, 12, 24 and 36 months after grafting. Results: At 12 months postoperatively, the mean MTh was 2.89 mm, with a mean additional increase of 1.75 mm when compared with baseline (P=0.0001). No statistically significant differences in MTh were found between the 12- and the 36-month observations (P=0.09). In addition, at 36 months, a thin mucosa was associated with a greater increase in the MTh compared with a thick mucosa (2.14 and 0.64 mm, respectively, P=0.006). Similarly, the mandibular sites were associated with a greater increase in the MTh in comparison with the maxillary sites (2.17 and 0.81 mm, respectively; P=0.02). Conclusions: Within the limitations of this investigation, the data suggest that PPS at the second-stage dental implant surgery could results in additional increases in MTh, especially when it is performed in areas where the mucosa is of a thin biotype.
  9,748 287 47
Genetic polymorphisms in periodontal diseases: An overview
R Vijayalakshmi, A Geetha, T Ramakrishnan, Pamela Emmadi
October-December 2010, 21(4):568-574
DOI:10.4103/0970-9290.74226  PMID:21187627
Periodontitis is a multi-factorial disease; several risk and susceptibility factors are proposed in its natural history. Genetics is considered a susceptibility factor in relation to periodontitis. This article is a nonsystematic review of literature and focuses on the role of genetic polymorphisms in periodontal diseases.
  8,735 1,185 16
Comparison of 2% chlorhexidine and 5.25% sodium hypochlorite irrigating solutions on postoperative pain: A randomized clinical trial
Kusum Bashetty, Jayshree Hegde
October-December 2010, 21(4):523-527
DOI:10.4103/0970-9290.74225  PMID:21187618
Aim: To compare the levels of postoperative pain after cleaning and shaping of root canals using two different root canal irrigants for debridement. Materials and Methods: Forty patients with irreversible pulpitis, pulp necrosis and non-vital teeth exhibiting acute apical periodontitis requiring root canal treatment were included. At random, canals were cleaned and shaped with the following protocols. 2% chlorhexidine solution in group I and 5.25% sodium hypochlorite solution in group II were used as an irrigants. Access cavities were closed with a sterile cotton pellet and cavit. The patients recorded degree of pain at various time intervals after cleaning and shaping on a visual analogue scale for 1 week. Results: The mean pain score for group I was between 0.65 and 3.35 and for group II was between 0.95 and 4.50. There was significant difference in the pain level between the two groups only at 6 th hour postoperatively (P<0.05) and the pain was more in sodium hypochlorite group. Conclusions: More pain was present in teeth irrigated using 5.25% sodium hypochlorite when compared to that in teeth irrigated using 2% chlorhexidine solution. Significant difference in pain level was present only at 6th hour postoperatively, and at all other periods (24 th hour, 4 th and 7 th days) there was no significant difference in pain level between the two groups.
  9,075 416 23
Estimation of salivary amylase and total proteins in leukemia patients and its correlation with clinical feature and radiographic finding
L Ashok, GP Sujatha, G Hema
October-December 2010, 21(4):486-490
DOI:10.4103/0970-9290.74212  PMID:21187610
Background: Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. Materials and Methods: In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. Results: In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (P<.05). On intraoral examination the study subjects showed pallor, gingivitis, gingival enlargement, petechiae, and ecchymosis. On the OPG, the radiographic features included generalized rarefaction of bone (20%), thinning of lamina dura (3.4%), generalized alveolar crest bone resorption (30%), thinning of walls of alveolar crypts (6.7%), besides others, e.g., periapical abscess (10%). Conclusions: The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.
  7,692 351 9
Alkaline phosphatase as a periodontal disease marker
Ranjan Malhotra, Vishakha Grover, Anoop Kapoor, Rupika Kapur
October-December 2010, 21(4):531-536
DOI:10.4103/0970-9290.74209  PMID:21187620
Background: The potential of alkaline phosphatase (ALP) as an important diagnostic marker of gingival crevicular fluid (GCF) has been the subject to investigation since 1970. ALP is stored in specific granules and secretory vesicles of the neutrophils and is mainly released during their migration to the site of infection. It is also present in bacteria within dental plaque, osteoblasts and fibroblasts. It has, thus, become important to elucidate whether GCF levels of ALP are potential measures of the inflammatory activity occurring in the adjacent periodontal tissues. Objective: The aim of this study was to assess the total activity of ALP in the GCF collected from healthy sites, sites with gingivitis and with chronic adult periodontitis. An attempt was also made to establish the correlation of ALP activity with plaque index, gingival index, bleeding index and probing depth. Materials and Methods: A total of 18 patients were divided into three groups: viz., healthy sites, Group I; gingivitis, Group II; chronic periodontitis, Group III. Clinical parameters like plaque index, bleeding index, gingival index and probing depth were recorded. The ALP level in GCF of all three groups was determined by spectrophotometric analysis. Results: Total enzyme activity of ALP was significantly higher in periodontitis as compared with that in healthy and gingivitis sites, and was significantly and positively correlated with probing depth. Conclusion: ALP can be considered as a periodontal disease marker as it can distinguish between healthy and inflamed sites. However, to better define its capacity for periodontal diagnosis, additional longitudinal studies are required.
  7,331 582 13
Comparative efficacy of two treatment modalities for dentinal hypersensitivity: A clinical trial
S Aparna, Swati Setty, Srinath Thakur
October-December 2010, 21(4):544-548
DOI:10.4103/0970-9290.74213  PMID:21187622
Background: Dentin hypersensitivity is a recurrent condition causing discomfort and sometimes pain to the patient, which also deters him from maintaining adequate oral hygiene. Home care and office measures are used for treatment of this malady. Aim: To evaluate and compare the efficacy of 2 treatment modalities for dentinal hypersensitivity, iontophoresis with acidulated phosphate gel (APF) gel, and dentin-bonding agent application. Materials and Methods: This split mouth randomized clinical study recruited subjects with a history of hypersensitivity with at least 2 teeth, verified by a light stroke with a dental explorer along the cervical third of the teeth. The patients were subjected to a 1-s air blast and cold water stimuli and their responses were recorded on a verbal rating scale. A total of 30 sites from 15 patients were divided into Group A-1.23% APF gel iontophoresis; and Group B-aqueous solution of hydroxyl-ethyl-methacrylate and glutaraldehyde. The teeth were evaluated immediately after the treatment and at the end of 2 weeks. In case of failure, the tooth was retreated with the same agent as before. Results: The results were statistically analyzed using Kruskal-Wallis analysis of variance and Mann-Whitney U tests. There was no statistically significant difference between the groups at the end of 2 weeks. However, Group A was more effective clinically, with fewer number of failures compared with Group B. Conclusion: Both the agents showed a statistically significant reduction in sensitivity compared with baseline; however, APF gel iontophoresis was more effective in reducing hypersensitivity over a longer time period.
  7,310 501 19
Ameloblastic fibro-odontoma of the anterior mandible in a 22-month-old boy
John Wewel, Nagamani Narayana
October-December 2010, 21(4):618-620
DOI:10.4103/0970-9290.74237  PMID:21187639
We report an ameloblastic fibro-odontoma (AFO) presenting in the anterior mandible as a "bump on his gums" in a 22-month-old boy. An occlusal radiograph revealed a well-circumscribed radiolucency with scattered radiopaque foci. The tumor was enucleated under general anesthesia. The histologic findings were characteristic of an AFO, a mixed odontogenic tumor most common in the posterior jaws, primarily affecting individuals with an average age of 10 years. The clinical presentation, microscopic findings, differential diagnoses, and treatment are discussed.
  7,344 189 7
Using zero inflated models to analyze dental caries with many zeroes
Shivalingappa B Javali, Parameshwar V Pandit
October-December 2010, 21(4):480-485
DOI:10.4103/0970-9290.74210  PMID:21187609
Aim: The study aimed to analyze and determine the factors associated with dental caries experience contains many zeros by zero inflated models. Design: A cross sectional design was employed using clinical examination and questionnaire with interview method. Materials and Methods: A study was conducted during March-August 2007 in Dharwad, Karnataka, India, involved a systematic random samples of 1760 individuals aged 18-40 years. The dental caries examination was carried out by using DMFT index (i.e. Decayed (D), Missing (M), Filled (F)). The DMFT index data contains many zeros were analyzed with Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. Results: The study findings indicated, the variables such as family size, frequency of brushing and duration of change of toothbrush were positively associated with dental caries. But the variable the frequency of sweet consumption is negatively associated with dental caries experience in Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. Conclusions: The ZIP model is a very good fit over the standard Poisson model and the ZINB is the better statistical fit compared to the Negative Binomial model. The Zero Inflated Negative Binomial model is better fit over the Zero Inflated Poisson model for modeling the DMF count data.
  7,026 159 10
Collarless metal ceramic restorations to obscure the umbrella effect
Shaista Afroz, Pooran Chand
October-December 2010, 21(4):600-602
DOI:10.4103/0970-9290.74228  PMID:21187633
Esthetics with porcelain fused to metal restoration in the anterior region can be adversely affected due to the inadequate teeth preparations and design of the prosthesis. We presented here a case report where esthetics was compromised due to darkening of the interdental papilla and marginal gingival and overcontoured restorations in relation to porcelain fused to metal restorations. Good esthetic results were obtained by using basic principles of tooth preparation and using collarless metal ceramic restorations.
  6,887 284 -
Autosomal-dominant osteopetrosis: An incidental finding
Maria Rajathi, Ravi David Austin, Philips Mathew, C Saravana Bharathi, Kumar Chandan Srivastava
October-December 2010, 21(4):611-614
DOI:10.4103/0970-9290.74234  PMID:21187637
Osteopetrosis is a descriptive term that refers to a group of rare, heritable disorders of the skeleton. Osteopetrotic conditions vary greatly in their presentation and severity, from just as an incidental finding on radiographs to causing life-threatening complications such as bone marrow suppression. It is caused by failure of osteoclast development and function. Osteopetrosis can be inherited as autosomal-recessive, autosomal-dominant or as X-linked traits, with the most severe forms being the autosomal-recessive ones. The severity of the disease is mild to moderate in the autosomal-dominant forms, with normal life expectancy. Diagnosis is largely based on clinical and radiographic evaluation. The present paper reports a case of autosomal-dominant osteopetrosis complicated by osteomyelitis with a short review of the condition.
  6,599 165 2
Fluoride content in bottled drinking waters, carbonated soft drinks and fruit juices in Davangere city, India
HM Thippeswamy, Nanditha Kumar, SR Anand, GM Prashant, GN Chandu
October-December 2010, 21(4):528-530
DOI:10.4103/0970-9290.74206  PMID:21187619
Background: The regular ingestion of fluoride lowers the prevalence of dental caries. The total daily intake of fluoride for optimal dental health should be 0.05-0.07 mg fluoride/kg body weight and to avoid the risk of dental fluorosis, the daily intake should not exceed a daily level of 0.10 mg fluoride/kg body weight. The main source of fluoride is from drinking water and other beverages. As in other countries, consumption of bottled water, juices and carbonated beverages has increased in our country. Objective: To analyze the fluoride content in bottled water, juices and carbonated soft drinks that were commonly available in Davangere city. Materials and Methods: Three samples of 10 commercially available brands of bottled drinking water, 12 fruit juices and 12 carbonated soft drinks were purchased. Bottled water and carbonated soft drinks were stored at a cold place until fluoride analysis was performed and a clear juice was prepared using different fruits without the addition of water. Then, the fluoride analysis was performed. Results: The mean and standard deviation of fluoride content of bottled water, fruit juices and carbonated soft drinks were measured, which were found to be 0.20 mg (±0.19) F/L, 0.29 mg (±0.06) F/L and 0.22 mg (±0.05) F/L, respectively. Conclusion: In viewing the results of the present study, it can be concluded that regulation of the optimal range of fluoride in bottled drinking water, carbonated soft drinks and fruit juices should be drawn for the Indian scenario.
  6,407 337 12
Central mucoepidermoid carcinoma of the mandible
Anita Munde, Ravindra Karle, Rashmi Metgud, BM Rudgi
October-December 2010, 21(4):609-610
DOI:10.4103/0970-9290.74230  PMID:21187636
Central mucoepidermoid carcinoma are extremely rare tumors, representing about 2 to 4% of all mucoepidermoid carcinomas. They are histologically low-grade cancers, usually affecting the mandible as uni- or multilocular radiographic lesions. Effective surgical treatment involving wide local excision or en bloc resection, allows patients to have a favorable prognosis after a long-term follow up. We report a case of central mucoepidermoid carcinoma affecting the mandible and discuss its clinical, radiographic, and histological findings, with a review of the literature.
  6,430 300 3
Evaluation of the antibacterial and physical properties of glass ionomer cements containing chlorhexidine and cetrimide: An in-vitro study
Mohanavelu Deepalakshmi, Saravanan Poorni, Revathi Miglani, Indira Rajamani, S Ramachandran
October-December 2010, 21(4):552-556
DOI:10.4103/0970-9290.74217  PMID:21187624
Background: Incorporation of antibacterial agents frequently results in changes in the physical properties of restorative materials. Materials and Methods: This in-vitro study investigated the antibacterial and physical properties of Glass ionomer cement (GIC) with chlorhexidine and cetrimide, to determine the optimal concentration, for incorporation of these agents to obtain antibacterial GICs for use with the Atraumatic restorative treatment approach. This was assessed using the agar diffusion test. Chlorhexidine diacetate and cetrimide were added to Glass ionomer cement type-IX (GIC-FUJI IX) at 1 and 2% W/W ratio. The experimental GIC specimens were placed on agar plates inoculated with Lactobacillus casei, and the area of inhibition was calculated after 48 hours. Results: All the experimental GICs exhibited inhibition of bacteria, but the sizes were dependent on the concentration of the antibacterial agent. Incorporation of chlorhexidine diacetate and cetrimide, at 2%, significantly decreased the compressive strength, and the setting time was extended a little by the addition of any concentration of chlorhexidine and cetrimide. Conclusions: The present study demonstrated that experimental GICs containing chlorhexidine diacetate and cetrimide were effective in inhibiting bacteria associated with caries, and incorporation of 1% cetrimide was optimal to give the appropriate antibacterial and physical properties.
  5,487 476 18
Three-dimensional finite element analysis of the stress distribution pattern in the design modifications of U-shaped palatal major connector
Hariharan Ramakrishnan, Raj G Singh
October-December 2010, 21(4):506-511
DOI:10.4103/0970-9290.74219  PMID:21187614
Background: The U-shaped maxillary major connector is considered to be the least-desirable design by many prosthodontists as it lacks rigidity, which is a primary requisite for a major connector. Aims and Objectives: Design modifications in the U-shaped palatal major connector are desired because it lacks rigidity. The study also aimed to determine the best design when a U-shaped palatal major connector is indicated for clinical use. Materials and Methods: The normal design and the design-modified models (modification 1, 2, 3, 4) were loaded at the functional cusps of the premolars and the molars with a magnitude of 200 N, 250 N and 300 N at angulations of 60 o and 90 o on both sides of the maxillary arch. Results for each loading were obtained as stress distribution colored images and numerical values were recorded. A three-dimensional finite element analysis study of the design-modified models was performed using two finite element softwares, namely PRO-E and IDEAS. Results: The least stress value of 7.86 Megapascals (MPa) at 200 N, 60 o was recorded for the double-thickness design, followed by design 1, which was 8.03 MPa. The least stress value for the palatal mucosa and ligament was provided by design modification 1 (0.5 mm-thick U-shaped connector, 9 mm anteroposteiorly, 14.6 mm laterally), which was 9.78 MPa and 2.98 MPa, respectively. Conclusion: The double-thickness group exhibited the least internal stress for the U-shaped major connector. However, it delivered the greatest stress to the palatal mucosa and the periodontal ligaments.
  5,768 157 1
Inner canthal distance and golden proportion as predictors of maxillary central incisor width in south Indian population
Shibu George, Vinaya Bhat
October-December 2010, 21(4):491-495
DOI:10.4103/0970-9290.74214  PMID:21187611
Objectives: Even though the constant relation of golden proportion and inner canthal distance (ICD) with the width of the maxillary central incisor (CIW) has been found in European population, it may not be applied to Indian population as we differ from Europeans racially and genetically. Hence, this study was carried out with the objectives of determining if these parameters are applicable to our population also. Materials and Methods: Three hundred south Indian subjects between 18 and 26 years of age, free from facial and dental deformities were examined. Inner canthus of each eye was used as soft tissue landmark. The maxillary central incisors were measured at the contact point area with the help of digital vernier caliper. The CIW was also calculated using golden proportion ratio to obtain the calculated central incisor width. A comparison was made with measured width. Statistical analyses were done to identify any significant difference using "Z" tests. Pearson's Correlation Coefficient test was used to evaluate the measured and the calculated width of the central incisor. Results: ICD and the width of two maxillary incisors were in golden proportion in south Indian population. Also, ICD when multiplied by a decreasing function value of the golden proportion and divided by 2 is a reliable predictor of determining CIW. Conclusion: As in the European population, the ICD and the golden proportion are reliable predictors for determining the width of the maxillary central incisors in the south Indian population also.
  5,525 382 5
Predicting the actual length of premolar teeth on the basis of panoramic radiology
S Yassaei, F Ezoddini-Ardakani, N Ostovar
October-December 2010, 21(4):468-473
DOI:10.4103/0970-9290.74207  PMID:21187607
Background: Panoramic radiography is one of the most common techniques for evaluating the jaw bones and associated structures. Aim: The aim of the study was to predict the actual length of the premolar teeth, based on measurements taken on a panoramic radiograph. Materials and Methods: This study was done in two stages. In the first stage, the actual and panoramic lengths of 102 teeth of orthodontic patients were measured and compared. In the next stage, the actual and radiographic vertical lengths of four metal balls placed in the molar and first premolar areas of 27 patients, referred to radiography clinic were also analyzed. Comparison of the mean magnification between the two methods was performed by one-sample T-test and P<0.05 was considered as statistically significant. Results: The total magnification of the premolar region in the vertical plane in the tooth length measurement method was 17.39%, while the same in the metal markers method was 27.39%. The upper teeth showed larger magnification than the lower teeth in the vertical plane. Similarly, the magnification and distortion of the metal markers in the horizontal plane were significantly more than this in the vertical plane and also their magnification and distortion in the molar region were more than this in the premolar region. The actual length of the premolar teeth can be estimated by using a suitable regression formula. Conclusion: Panoramic radiography can be used for calculating the actual length of premolar teeth.
  4,948 321 10
A simplified approach to fabrication of an ocular prosthesis: A case series
Amandeep Kaur, Arpan Pavaiya, Saumyendra Vikram Singh, Raghuvar Dayal Singh, Pooran Chand
October-December 2010, 21(4):615-617
DOI:10.4103/0970-9290.74236  PMID:21187638
The eye is a vital organ and an important component of facial expression. Loss of an eye has a crippling effect on the psychology of the patient. Enucleation of the eye is therefore normally followed by fabrication of an ocular prosthesis to improve esthetics. A less complex technique for fabrication of an ocular prosthesis is described in this report of two different cases.
  4,771 468 2
Morphology of collagen fibers and elastic system fibers in actinic cheilitis
Flávia C Sgarbi, Fernanda Bertini, Tábata de M Tera, Ana Sueli R Cavalcante
October-December 2010, 21(4):518-522
DOI:10.4103/0970-9290.74224  PMID:21187617
Background: Actinic cheilitis (AC) is a premalignant condition intimately related to exposure of the lips to sun rays. Aim: The objective of this study was to evaluate the elastic and collagen fibers in the lamina propria of AC. The degree of epithelial atypia was correlated with the quantity of elastic and collagen fibers. Materials and Methods: Fifty-one cases were investigated. One slide was stained with hematoxylin-eosin for the evaluation of atypia, the second was stained with Weigert's resorcin-fuchsin for the assessment of elastic fibers, and the third slide was stained with Mallory's trichrome for the analysis of collagen fibers. Results: Ordinal logistic regression analysis revealed a significant correlation between the presence of atypia and collagen fibers (P<0.05). Conclusions: It was concluded that there seems to be a reduction in the quantity of collagen fibers in cases of moderate and severe atypia. No correlation was observed between the degradation of elastic system fibers and the grade of dysplasia.
  4,993 157 6
An in vitro study of antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis
Swaty Jhamb, Vineeta Nikhil, Vijay Singh
October-December 2010, 21(4):512-514
DOI:10.4103/0970-9290.74222  PMID:21187615
Aim: To evaluate and compare the antibacterial effects of chlorhexidine and calcium hydroxide on Enterococcus faecalis. Materials and Methods: Root canal treatment involves a number of steps. In spite of all the steps done thoroughly, root canal treatment might fail due to the remnant microbes. Of all such bacteria, E. faecalis is found in failed root canals. The study tests the antibacterial activity of various intracanal medicaments. Agar diffusion test was used to evaluate the antibacterial effects of the following antibacterial agents: i. hexidine:0.2% chlorhexidine gluconate; ii. periogard:0.12% chlorhexidine gluconate; iii. calcium hydroxide powder plus sterile water; iv. metapaste plus sterile water; v. calcium hydroxide plus hexidine; vi. calcium hydroxide plus periogard; vii. metapaste plus hexidine; viii. metapaste plus periogard. The size of zones of inhibition was measured. Results: The average size of zones of inhibition after 72 hours were hexidine: 5 mm; periogard: 4.25 mm; calcium hydroxide plus sterile water: 0.5 mm; metapaste plus sterile water: 0.5 mm; calcium hydroxide plus hexidine: 4.7 mm; calcium hydroxide plus periogard: 4 mm; metapaste plus hexidine: 4.65 mm; metapaste plus periogard: 4 mm. Results were subjected to statistical analysis using one way analysis of variance and Tukey tests. Conclusion: Chlorhexidine and its preparations are more potent antibacterial agents againstE. faecalis in comparison to calcium hydroxide.
  4,613 326 13
Fluoride and bacterial content of bottled drinking water versus municipal tap water
H Mythri, GN Chandu, GM Prashant, VV Subba Reddy
October-December 2010, 21(4):515-517
DOI:10.4103/0970-9290.74223  PMID:21187616
Background: Water is a divine gift. People quench their thirst without questioning the source of water. But, apprehension about contaminants in municipal water supplies along with increased fear of fluorosis made bottled drinking water as one of the important tradable commodities. Objectives: The objectives of the study were to determine and compare the fluoride and bacterial contents of commercially available bottled drinking water and municipal tap water in Davangere city, Karnataka. Materials and Methods: Fifty samples of 10 categories of bottled drinking water with different batch numbers were purchased and municipal water from different sources were collected. Fluoride levels were determined by an ion-selective electrode. Water was cultured quantitatively and levels of bacteria were calculated as colony-forming units (CFUs) per milliliter. Results: Descriptive analysis of water samples for fluoride concentration was in the range of 0.07-0.33 for bottled drinking water, Bisleri showing the highest of 0.33. A comparison of the mean values of microbial count for bottled drinking water with that of municipal tap water showed no statistically significant difference, but was more than the standard levels along with the presence of fungus and maggots. Conclusion: The fluoride concentration was below the optimal level for both municipal tap water and bottled drinking water. CFUs were more than the recommended level in both municipal tap water and bottled drinking water.
  4,404 216 8
Effect of prepolymerized composite megafiller on the marginal adaptation of composite restorations in cavities with different C-factors: An SEM study
Sarita Bhushan, Ajay Logani, Naseem Shah
October-December 2010, 21(4):500-505
DOI:10.4103/0970-9290.74218  PMID:21187613
Aim: To evaluate the effect of prepolymerized custom-made composite megafiller and configuration factors (C-factor) on marginal adaptation of resin composite restorations. Materials and Methods: Forty extracted human mandibular molars were divided into four experimental groups consisting of 10 samples each. In groups I and III, class V (configuration factor 5) and in groups II and IV, class II box-shaped cavities (configuration factor 2) were prepared. Groups I and II were restored with a nanofilled composite (Filtek™ Z350 3M ESPE, St Paul, MN, USA) placed in horizontal increments. In groups III and IV, preformed composite megafiller was placed and cavities were restored with nanofilled composite Z-350. After curing, the samples were finished and prepared for examination under low vacuum scanning electron microscope. The data were analyzed with one-way analysis of variance. The significance between the individual groups was calculated by Post hoc test using the Holm-Sidak method ( P≤0.05). Results: The marginal gap values in groups III and IV were significantly lower than in groups I and II, respectively ( P≤0.05). Minimum gap values were seen in group IV. Conclusion: Use of prepolymerized composite megafiller and a lower C-factor decreased the marginal gaps between the tooth and composite restorations.
  4,352 172 -
Needs and demands of prosthetic treatment among two groups of individuals
Gadeer Nimri Mukatash, Medyan Al-Rousan, Basma Al-Sakarna
October-December 2010, 21(4):564-567
DOI:10.4103/0970-9290.74221  PMID:21187626
Objectives: The level of knowledge, awareness, and attitude about teeth-replacement options among a group of medical and paramedical subjects and to compare them with the general population. Materials and Methods: A self-administered questionnaires using simple Arabic language were distributed to two groups of subjects. Questions focused on the willingness to replace the missing teeth, the preferable methods of choice for replacement, and the reasons for these choices. The first group (G-I) was from the medical and paramedical staff who work in a military hospital at Jordan Royal medical services, the dental staff was excluded from the study. The other group (G-II) was from the general population who attended the dental department in the same hospital with comparable level of education. All the participants were partially edentulous excluding the third molars. Clinical examination was done by qualified prosthodontist to evaluate the possible prosthetic treatment options for replacement. A total of 612 questionnaires were distributed, of which 533 questionnaires were returned (response rate 87.09%). The results were analyzed and comparison was made between the two groups. Results: Responses to questions about awareness and attitude about prosthetic management of missing teeth revealed that G-I have more awareness than G-II to the probable causes for tooth/teeth replacement and limitation of the preferable method for replacement (P<0.05). More than 80% of the participants believed that replacement of anterior teeth is more important than the posterior teeth. Implants and fixed partial denture (FPD), respectively, were more preferable than removable prosthesis, although clinically was not indicated in cases (P<0.05). There was no clinical benefit from replacement of missing teeth in 33.4% while only 6% believe this. Conclusions: This study showed that the awareness and attitude between the medical and paramedical staff to prosthetic needs is better than between general populations. The demands for dental replacement by patients were significantly different when compared with the actual needs.
  4,132 231 8
Comparison of the regenerative potential of an allograft used alone and that in conjunction with an immunosuppressive drug in the treatment of human periodontal infrabony defects: A clinical and radiological study
Shivani Dhawan, Rajan Dhawan, Amarjit Singh Gill, Poonam Sikri
October-December 2010, 21(4):557-563
DOI:10.4103/0970-9290.74220  PMID:21187625
Background: Experimentation confirmed the conclusion that bone allografts, like other tissue and organ allografts, are immunogenic. These immune responses cause resorption of allograft, thus lowering the bone formation capacity of the graft. An attempt has been made in this study to prevent immune reactions and achieve enhanced regeneration of allograft-demineralized freeze-dried bone matrix by incorporating it with an immunosuppressive drug Cyclosporine-A (CsA) in the treatment of human periodontal infrabony defects. Materials and Methods: Fifteen patients showing clinical evidence of almost bilateral infrabony defects requiring bone grafting procedures were selected. In each patient, the infrabony defect of one side of the arch was designated as Group A (control site) and the infrabony defect of the contralateral side of the same arch was designated as Group B (test site). Results: On comparative evaluation of the two groups (by Student t-test), the mean values of reduction in probing depth (P=0.81 NS ) and gain in clinical attachment level (P=1.00 NS ) of Group B were found to be greater than that of Group-A, but the differences were statistically non-significant. The mean linear bone fill (P=0.010 ** ) of Group B was also detected to be higher than that of Group A, and the difference was found to be statistically significant. Conclusion: Increase in linear bone fill in Group B signifies the role of CsA in augmenting the regenerative potential of allograft by eliminating immune reactions.
  3,944 167 5
Comparison of manual and physiologically molded denture bases in complete denture wearers
Lakshmipathy P Reddy, Rajashekar Sangur
October-December 2010, 21(4):496-499
DOI:10.4103/0970-9290.74216  PMID:21187612
Background and Objectives: In complete denture wearers, the accumulation of food in the buccal vestibule is one of the factors causing discomfort to the patient. This study was conducted to evaluate the effect of mandibular denture buccal flange on food retention and to correlate between varying angulations of buccal flange of mandibular denture on food retention. Materials and Methods: Complete dentures were fabricated and the mandibular complete denture was duplicated. The existing (unduplicated) manually molded and physiologically molded dentures were tested for food retention. Twenty test particles having a diameter of 2±0.2 mm were placed on the middle part of the buccal flange and the subjects were instructed to expel the test particles by performing only functional movements of the buccal musculature. The numbers of residual test particles in the buccal vestibule were counted after 30s. The angulations of the denture buccal flange (duplicated) were measured with an optical bevel protractor and trimmed to 50° and the food retention test was performed. Similar tests were performed at 60°, 70° and 80° angulations. The data were evaluated using the Pearson correlation coefficient, One-way ANOVA test and Wilcoxon signed rank test. Results: The difference between the residual scores of manually molded and physiologically molded denture base was not significant. The difference between the residual scores at different angulations of the buccal flange of the denture was significant. Conclusion: Only the slope of the flange significantly affects the ability of subjects to expel the test particles.
  3,490 218 -
Prevalence of hypodontia in nine- to fourteen-year-old children who attended the Mashhad School of Dentistry
Behgat-al-molok Ajami, Mahboobeh Shabzendedar, Maryam Mehrjerdian
October-December 2010, 21(4):549-551
DOI:10.4103/0970-9290.74215  PMID:21187623
Context: Hypodontia is defined as the congenital absence of one or a few teeth, and is also the most common anomaly in dental development. This condition occurs either individually or as part of the symptoms of a syndrome, and it is more common in permanent teeth than in deciduous teeth, reporting a prevalence of between 1.6 and 9.6%. Aims: The objective of this study is to investigate the prevalence of hypodontia for permanent teeth in nine- to 14-year-old children who attended the Mashhad School of Dentistry in 2007. Setting and Design: We conducted this descriptive, analytical, cross-sectional study, to determine the mentioned aims. Materials and Methods: In this descriptive, cross-sectional study, panoramic radiographs belonging to 600 children (351 girls and 249 boys), aged nine to 14 years, were available for examination. All related findings were recorded in the respective forms. Statistical Analysis Used: The data were processed using Exact and Chi-square tests. Results: The prevalence of hypodontia in the girls was 9.2%, in the boys 8.8%, and in both sexes combined 9%. The most and the least frequent cases of absent teeth were the mandibular second premolars and the maxillary central incisor (only one child), respectively. The most commonly absent teeth were the mandibular second premolars, the maxillary lateral incisors, the mandibular central incisor, and the maxillary second premolars, in that order. Conclusions: This study showed a high frequency of hypodontia among the understudied population. Thus, due to the complicated treatment, accurate examination of children for on-time diagnosis of this developmental anomaly is crucial.
  3,311 141 12
Mongrelised genetics of H1N1 virus: A bird's eyeview
C Nagarathna, BS Shakuntala, HK Navin, Viral Pravin Maru
October-December 2010, 21(4):586-590
DOI:10.4103/0970-9290.74235  PMID:21187630
H1N1 influenza, also known as "novel H1N1 virus" has led to a "global outcry." This virus is more virulent when compared with other seasonal flu viruses. Virulence may change as the adaptive mutation gene increases within the virus. A study at the US Centre for Disease Control and Prevention published in May 2009 found that children had no preexisting immunity to the new strain as they showed no cross-reactive antibody reaction when compared with adults aged 18-64 years, who showed a cross-reactive antibody reaction of 6-9% and older adults with 33% immunity. This review article depicts H1N1 virus, its virulence with genetic evolution potential and preventive protocol for the dental professionals. This would allow us to comprehend the changes in the disease process and contribute in its prevention as "prevention is better than cure."
  2,901 115 1
Radiographic follow-up evaluation of sinus augmentation with deproteinized bovine bone and implant installation after loading
Jun-Beom Park
October-December 2010, 21(4):603-605
DOI:10.4103/0970-9290.74227  PMID:21187634
Computed tomography (CT) has been used in diagnosis and implant treatment, and CT can be used to assess the dimensional stability of graft materials after maxillary sinus augmentation. A 50-year-old male patient was treated for the simultaneous placement of implants with sinus augmentation and two post-operative CT scans were performed after the delivery of the prosthesis at 9 months and 15 months after the operation. There were no significant changes in alveolar bone height and the buccal window seemed to show remodeling over time. The continuity of the defect and the cortication were apparent in the 15-month post-operative CT scan. Implants installed simultaneously with sinus augmentation were well in function and the graft material seemed to be stable in maintaining tissue dimensions after the loading of the implants. The presented results need to be validated in further large case series or case-controlled studies.
  2,843 101 7
Arsenic content in Portland cement: A literature review
Talita Ribeiro Tenório de França, Raphaela Juvenal da Silva, Michellini Sedycias de Queiroz, Carlos Menezes Aguiar
October-December 2010, 21(4):591-595
DOI:10.4103/0970-9290.74233  PMID:21187631
Portland cement (PC) is a hydraulic binding material widely used in the building industry. The main interest in its use in dentistry is focused on a possible alternative to mineral trioxide aggregate (MTA) because PC is less expensive and is widely available. In dentistry, PC has been used in dental procedures such as pulpotomy, pulp capping, repair of root perforation and root-end filling. The purpose of this article is review the dental literature about the PC, its composition with special attention to arsenic content, properties, and application in dentistry. A bibliographic research was performed in Bireme, PubMed, LILACS and Scopus data bases looking for national and international studies about the PC composition, properties and clinical use. It was observed that PC has favorable biological properties very similar to those of MTA. The PC has shown good cell proliferation induction with formation of a monolayer cell, satisfactory inflammatory response, inhibitory effect of prostaglandin and antimicrobial effect. Studies have shown that PC is not cytotoxic, stimulates the apposition of reparative dentin and permits cellular attachment and growth. Regarding arsenic presence, its levels and release are low. PC has physical, chemical and biological properties similar to MTA. Arsenic levels and release are low, therefore, unable to cause toxic effects.
  2,687 123 9
Evaluation of biocompatibility of Targis Dentin and Artglass by using subcutaneous implantation test
Nalan Sule Sönmez, Erhan Sönmez, Cihan Akçaboy
October-December 2010, 21(4):537-543
DOI:10.4103/0970-9290.74211  PMID:21187621
Introduction: Biocompatibility of a crown-bridge material is as important as its physical and mechanical properties. It is also one of the most important factors for the long-lasting clinical success of that restoration. It directly contacts the vital prepared tooth and that is the reason it has to be nontoxic to the local tissues, such as the pulp, gingiva, or the rest of the body. Materials with different physical properties are used in the conventional fixed prosthodontic restorations. Recently, metal-free systems that are reinforced with fibers have been improved for crown and bridge restorations. These new composite systems have the advantages of both ceramic and polymer chemistry. Materials and Methods: In this research, biocompatibility of two ceramic-polymer-based prosthetic materials (Targis Dentin® and Artglass Dentin® ) was studied using a subcutaneous implantation test on rats. Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Results: Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90 th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Conclusion: At the end of the study, according to the FDI and ISO-7405 standards, Targis and Artglass indicated biocompatibility with the subcutaneous connective tissue of the rat.
  2,476 69 4
The intricacies of research work
V Ramesh
October-December 2010, 21(4):467-467
DOI:10.4103/0970-9290.74205  PMID:21187606
  2,140 344 -
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