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  Citation statistics : Table of Contents
   2011| November-December  | Volume 22 | Issue 6  
    Online since April 5, 2012

 
 
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ORIGINAL RESEARCH
Evaluation of craniofacial morphology in patients with obstructive sleep apnea using lateral cephalometry and dynamic MRI
Rekha Bharadwaj, A Ravikumar, NR Krishnaswamy
November-December 2011, 22(6):739-748
DOI:10.4103/0970-9290.94566  
Context: Obstructive sleep apnea (OSA) is a potentially life-threatening disorder, characterized by repeated collapse of the upper airway during sleep with cessation of breathing. The altered mouth breathing produces morphological changes in craniofacial region. Aim: This study was designed to compare and validate the craniofacial morphological characteristics in patients with OSA using lateral cephalometry and to investigate the dentofacial characteristics of patients with OSA with respect to the obstructive sites determined by dynamic magnetic resonance imaging (MRI) to more accurately clarify the pathophysiological features. Materials and Methods: 10 patients with OSA were divided into two groups of five each according to their obstructive site determined by dynamic MRI. (1) Obstruction at the retropalatal and retroglossal region (Rp + Rg group) and (2) obstruction at the retropalatal region (Rp group). Lateral cephalogram both in upright and supine position was taken for all the subjects. In addition, dynamic MRI was performed to identify the sites of obstruction of the upper airway. Statistical analysis used: Independent t-test was performed to evaluate the significant difference in the upright cephalometric variables between the study and control group and between the two groups. The changes in skeletal and soft tissue parameters with change in posture was assessed within the study and control group by paired t test. P value of ≤0.05 was considered as statistically significant. Results: The study indicated that the first group of patients with both retropalatal and retroglossal obstruction showed signs of skeletal discrepancy that predisposed to obstruction at the retroglossal level and the soft tissue components like the soft palate and tongue that contributed to retropalatal obstruction. However, the second group of patients with only retropalatal obstruction had primarily soft tissue components associated with increased BMI that contributed to retropalatal obstruction. Conclusion: Evaluation of craniofacial morphology in OSA patients is bound to help the concerned specialist in recognizing the morphological changes induced by altered sleep pattern so as to provide the appropriate treatment.
  6 6,673 420
A correlative study of dental age and skeletal maturation
Kiran Sachan, Vijay Prakash Sharma, Pradeep Tandon
November-December 2011, 22(6):882-882
DOI:10.4103/0970-9290.94698  
Introduction: Skeletal age had been assessed by comparison between maturation of hand-wrist with stages of cervical vertebrae or canine calcification stages in past and this had been closely related to craniofacial growth. The importance of pubertal growth spurt in various types of orthodontic therapies is already established. Aims and Objectives: Hence, this study was aimed to evaluate the relationship of skeletal maturity by hand-wrist with cervical vertebral maturation indicators and canine calcification stages. Materials and Methods: The study consisted of randomly selected 90 children from Lucknow population with 45 males (age range 10-13 years) and 45 females (age range 9-12 years). Lateral Cephalogram, hand-wrist x-ray, and periapical x-rays of maxillary and mandibular right canines were taken. Statistical Analysis: Mean, standard deviation was calculated of different groups. Correlation was made among cervical vertebral maturation, hand wrist maturation, and canine calcification stages at various age groups. Results: There was strong correlation between skeletal maturation indicator and cervical vertebral maturation indicator for both male (0.849) and female (0.932), whereas correlation between skeletal maturation indicator and canine calcification was good for both male and female (0.635, 0.891). Conclusion: It was concluded that cervical vertebral maturation indicator and canine calcification stages can also be used for assessing skeletal maturity.
  3 7,570 493
REVIEW ARTICLES
Ergonomic applications to dental practice
Shipra Gupta
November-December 2011, 22(6):816-822
DOI:10.4103/0970-9290.94677  
The term "work-related musculoskeletal disorders (WMSDs)," refers to musculoskeletal disorders to which the work environment contributes significantly, or to musculoskeletal disorders that are made worse or longer lasting by work conditions or workplace risk factors. In recent years, there has been an increase in reporting WMSDs for dental persons. Risk factors of WMSDs with specific reference to dentistry include - stress, poor flexibility, improper positioning, infrequent breaks, repetitive movements, weak postural muscles, prolonged awkward postures and improper adjustment of equipment. Ergonomics is the science of designing jobs, equipment and workplaces to fit workers. Proper ergonomic design is necessary to prevent repetitive strain injuries, which can develop over time and can lead to long-term disability. In this article, 20 strategies to prevent WMSDs in the dental operatory are discussed.
  3 14,181 726
SHORT COMMUNICATIONS
Is the concept of ethics misplaced in the migration of Indian trained dentists to Australia? The need for better international co-operation in dentistry
Madhan Balasubramanian, Stephanie D Short
November-December 2011, 22(6):866-868
DOI:10.4103/0970-9290.94689  
The purpose of this article is to discuss the ethics involved in the migration of Indian trained dentists to Australia. It develops from interviews of senior oral health leaders in both the countries to provide evidence that ethics in migration is diluted in practice and to suggest that migratory procedures in both the countries should be reconsidered. There is also an urgent need for more organized bilateral communication and negotiation between the concerned organizations of both the countries (dental councils, immigration departments and research centers) in order to prevent the somewhat irreversible and intensive brain drain of top quality dentists from India to Australia. We would suggest as a starting point better monitoring of the migrants' academic and social background, the nature of the educational investment in India and the nature of the stay in Australia. This new information base could possibly lay the groundwork for more restrictive policies to be introduced both in Australia and India.
  3 2,069 97
CASE REPORTS
Darier disease with oral and esophageal involvement: A case report
Magesh Karuppur Thiagarajan, Malathi Narasimhan, Anandan Sankarasubramanian
November-December 2011, 22(6):843-846
DOI:10.4103/0970-9290.94682  
A 58-year-old man presented with itchy papular eruptions all over the body since 15 years. Intraoral examination revealed raised papular lesions on the labial mucosa, hard palate, and tongue. The histopathology of the oral and skin lesions was confirmative of Darier disease (DD). This patient also showed esophageal involvement, which was confirmed histopathologically. Such a presentation of DD, with oral and esophageal involvement, is rare.
  2 4,698 155
ORIGINAL RESEARCH
Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan
Happy Adeyinka Adedapo, Ahmed Oluwatoyin Lawal, Akinyele Olumuyiwa Adisa, Bukola Folasade Adeyemi
November-December 2011, 22(6):795-798
DOI:10.4103/0970-9290.94671  
Aim: The aim of this study was to determine the prevalence of self-medication practices among dental out patients presenting at a tertiary health care center in Ibadan, and to determine factors that are associated with these practices. Materials and Methods: All patients presenting over a 4-month period, who consented to participate in the study, had a semi-structured questionnaire, highlighting age, sex, income and educational qualification, history of past practice of self-medication, substances used and reasons for resorting to self-medication administered to them. Data obtained were analyzed with the SPSS 12.0.1 software. Frequency tables were generated and statistical relationship between the variables was analyzed using the Chi-square test. Statistical significance was set at P>0.05. Results: There were 108 (38.03%) males and 176 (61.97%) females. A total of 139 (48.9%) of the respondents claimed that they have been involved in self-medication. 54.7% of the people involved in self-medication were female, while 41.7% were male. There was a statistically significant difference in self-medication between males and females (P=0.001). 71.2% of the respondents had post-secondary education and only 28.8% had secondary education or less. Conclusion: Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority in the overall public health campaigns.
  2 3,563 165
Repair of amalgam restorations with composite resin and bonded amalgam: A microleakage study
Daniela Araújo Veloso Popoff, Fabiana Santos Gonçalves, Cláudia Silami Magalhães, Allyson Nogueira Moreira, Raquel Conceição Ferreira, Ivar A Mjör
November-December 2011, 22(6):799-803
DOI:10.4103/0970-9290.94672  
Background: Total replacement is the most common technique for defective amalgam restorations, and it represents a major part of restorative dental treatment. Repair is an alternative option for amalgam restorations with localized defects. Aims: This study compared microleakage of amalgam restorations repaired by bonded amalgam or composite resin. Materials and Methods: Thirty extracted human pre-molars were prepared and restored with class I amalgam. A simulated defect was prepared that included the cavosurface margin on restorations, and the pre-molars were assigned to two treatment groups (n=15): In group 1, premolars were treated by composite resin (34% Tooth Conditioner Gel + Adper Single Bond 2 + Z100) and in group 2, premolars were repaired by bonded amalgam (34% Tooth Conditioner Gel + Prime and Bond 2.1 + Permite C). The teeth were immersed in a 50% silver nitrate solution, thermocycled, sectioned longitudinally and then observed by three examiners using a stereomicroscope. Microleakage was evaluated using a 0-4 scale for dye penetration, and data was analyzed by Kruskal Wallis and Dunn tests. Results: Neither of the two methods eliminated microleakage completely. Composite resin was significantly the most effective for repair/tooth interface sealing (score 0 = 80.0%; P=0.0317). For the repair/restoration interface, composite resin was also statistically more effective as a sealant (score 0=66%; P=0.0005) when compared to the bonded amalgam technique (score 0=13%; P=0.0005). Conclusions: The use of adhesive systems significantly affected the ability to seal the repair/ tooth interface. However, at the level of the repair/restoration interface, the bonded amalgam technique may increase microleakage.
  2 13,581 255
CASE REPORTS
Primary tuberculosis of the oral cavity
R Kamala, Abhishek Sinha, Amitabh Srivastava, Sunita Srivastava
November-December 2011, 22(6):835-838
DOI:10.4103/0970-9290.94680  
There is a well-known phrase that states, "The more things change, the more they stay the same." This expression continues to apply to tuberculosis (TB), a widespread infectious disease traced back to the earliest of centuries. TB has claimed its victims throughout much of known human history. Mycobacterium tuberculosis may have killed more persons than any other microbial pathogen and is one of the major causes of ill health and death worldwide. Although the overall incidence of TB has decreased, recently, the incidence of this disease appears to be increasing. Oral lesions of TB though uncommon are seen in both the primary and secondary stages of the disease. In secondary TB, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes, or in any other part of the body and can be detected by a systemic examination. Most of the cases are secondary to pulmonary disease and the primary form is uncommon. Here, we present a case of primary oral TB, affecting the gingiva and hard palate in a 40-year-old Indian female patient.
  1 9,215 431
Accidental ingestion of a barbed wire broach and its endoscopic retrieval: Prevention better than cure
Rajashekar Mohan, Sreesha Rao, Mathew Benjamin, Radhakrishna K Bhagavan
November-December 2011, 22(6):839-842
DOI:10.4103/0970-9290.94681  
Ingestion of instruments is a potential complication that can occur during dental procedures. We report a case of accidental ingestion of an endodontic barbed wire broach during root canal treatment and its subsequent retrieval by endoscopic methods. Although prevention is the best approach, proper management of such an event is also crucial. The objective of this report is to draw attention to the potentially serious complications that can occur if preventive techniques are not practised, and to discuss the accepted guidelines for management of such an event.
  1 2,847 140
ORIGINAL RESEARCH
Eruption times and patterns of permanent teeth in school children of India
Ambika Lakshmappa, Mahima Veeranna Guledgud, Karthikeya Patil
November-December 2011, 22(6):755-763
DOI:10.4103/0970-9290.94568  
Aim: To study the eruption pattern of permanent teeth excluding third molars in school children of Mysore, South India. Objectives: To compare the eruption times determined with previous studies. To determine range of variation of the eruption time of each tooth and evaluate if any preponderance exists in the eruption timings of maxillary and mandibular teeth and between boys and girls. Materials and Methods: This was a descriptive cross sectional study. A random sample of 5007 school children in the age group of 5-14 years was selected. The mean age of eruption of individual permanent teeth was recorded and results were analyzed using Probit analysis. Results: The study population included 2371 boys constituting 47.26% and 2636 girls constituting 52.65% of the total sample. In the age group of 5 years, one of the permanent teeth was found to be erupted. In the age group of 14 years, all the permanent teeth except third molar had erupted. Girls showed early tooth eruption compared to boys. Mandibular teeth erupted earlier than maxillary teeth in both the sexes. Right and left sided teeth erupted at the same time in both the arches. Conclusion: The mean ages of eruption obtained from the present study are strikingly comparable with those of other investigators in different populations across the world. Since the current study involves a large sample of children, the data reported in this study could be used as standards when assessing permanent tooth eruption in Indian children.
  1 10,686 502
Efficacy of various spray disinfectants on irreversible hydrocolloid impression materials: An in vitro study
Santosh Doddamani, Raghunath A Patil, SA Gangadhar
November-December 2011, 22(6):764-769
DOI:10.4103/0970-9290.94662  
Background: Most of the materials (casts, impressions, etc.) that are sent to the dental laboratories show the presence of numerous pathogenic microorganisms. All the spray disinfectants are not equally effective against these microorganisms. Aims and Objectives: The aim was to compare the effectiveness of different spray disinfectants on irreversible hydrocolloid impressions and to find out the most effective dilution, contact time, and effect against each microorganism studied. Materials and Methods: The effects of four spray disinfectants, 5.25% sodium hypochlorite, 0.525% sodium hypochlorite, 1:213 (1 part in 213 parts of water) povidone iodine, and 2% glutaraldehyde along with control (distilled water) on irreversible hydrocolloid impressions contaminated with Staphylococcus aureus, Bacillus subtilis and Streptococcus viridans were studied. Results: Sodium hypochlorite, 5.25%, showed 1-min exposure time which was able to effect a 4log10 reduction in bacterial counts against S. aureus and S. viridans followed by 0.525% sodium hypochlorite and 2% glutaraldehyde for 10 min. None were able to effect a 4 log10 reduction against B. subtilis. Conclusion: Sodium hypochlorite with a concentration of 5.25% was the most effective disinfectant and required the shortest contact time (1 min). Not all ADA-approved concentrations of surface disinfectants work equally well on irreversible hydrocolloid impression materials.
  1 4,306 246
In vitro study on tooth enamel lesions related to whitening dentifrice
Danilo Barral de Araújo, Luciana Rodrigues Silva, Elisângela de Jesus Campos, Roberto Paulo Correia de Araújo
November-December 2011, 22(6):770-776
DOI:10.4103/0970-9290.94665  
Background: The tooth whitening substances for extrinsic use that are available in Brazil contain hydrogen peroxide or carbamide peroxide. Several studies have attributed the appearance of lesions in the enamel morphology, including hypersensitivity, to these substances. Such lesions justify fluoride therapy and application of infrared lasers, among other procedures. However, there is no consensus among researchers regarding the relevance of the severity of lesions detected on the tooth surface. Objectives: The present study was carried out with an aim of evaluating in vitro the effects of the hydrogen peroxide, carbamide peroxide and sodium bicarbonate contained in dentifrice formulations, on human tooth enamel. Materials and Methods: After darkening process in laboratory, human premolars were brushed using dentifrice containing the two whitening substances (Rembrandt - carbamide peroxide and Mentadent - hydrogen peroxide) and the abrasive product (Colgate - sodium bicarbonate). The degree of specimen staining before and after this procedure was determined using spectrophotometry. Scanning electron microscopy (SEM) was used to obtain images, which were analyzed to show the nature of the lesions that appeared on the enamel surface. Results: The effectiveness of the whitening caused by hydrogen peroxide and carbamide peroxide and the abrasion caused by bicarbonate were confirmed, given that the treated test pieces returned to their original coloration. Based on SEM, evaluation of the enamel surfaces subjected to the test products showed that different types of morphologic lesions of varying severity appeared. Conclusions: Whitening dentifrice containing hydrogen peroxide and carbamide peroxide produced lesions on the enamel surface such that the greatest sequelae were associated with exposure to hydrogen peroxide.
  1 6,607 208
Radiographic versus electronic root canal working length determination
Lumnije Kqiku, Peter Städtler
November-December 2011, 22(6):777-780
DOI:10.4103/0970-9290.94666  
Purpose: The aim of this ex vivo study was to compare the accuracy of radiographic and electronic root canal length determination methods, compared with actual root canal length obtained with stereomicroscope. Materials and Methods: Thirty extracted single-rooted permanent teeth were used for this study. After access preparation, actual length (AL) of the root canal were determined for each tooth by inserting a #15 file until the tip of the file was visible at the apical foramen under a stereomicroscope. The radiographic working length determination was determined with a digital radiographic system and for the electronic measurement all teeth were embedded in an alginate model to test apex locator in-vitro. Data was analyzed using the descriptive statistic and intraclass correlation coefficient. Results: No significant difference was found between the radiographic and electronic root canal working length determination (P>0.05). The percentage of electronic measurements within ±0.5 mm to the apical constriction was 93.34% and 90% for radiographic methods within ±0.5 mm of all cases compared with AL. Conclusions: The present ex vivo study showed that electronic root canal working length determination is not superior to radiographic methods. Both methods provided a good performance in determining the root canal working length.
  1 6,455 351
Oxidation heat treatment affecting metal-ceramic bonding
Shraddha Rathi, Hari Parkash, B Chittaranjan, Akshaya Bhargava
November-December 2011, 22(6):877-878
DOI:10.4103/0970-9290.94664  
Aim of the Study: There is dearth of literature regarding the effects of oxidation heat treatment (OHT) as surface pretreatments on bond strength of base metal alloys and porcelain. Materials and Methods: Forty-five bar specimens of each two commercially available base metal alloys Mealloy and Wirorn-99 (were fabricated. Dimensions of each specimen were 15.0 × 2.0 × 0.5 mm (according to the ISO 6872-1984). According to the surface pretreatments the samples of the two groups were categorized into three subgroups: With OHT only, with sandblasting only (with Al 2 O 3 of 110 μm) and with OHT and sandblasting. Application of commercially available Duceram porcelain in thickness of 2.00 mm was applied over the surface of metal with the pretreatments. Samples were then placed under SEM for EDX examination to evaluate ionic changes that occurred at the metal-ceramic interface. Flexural bond strength of each sample was calculated under Universal Testing Machine. Results: The one-way ANOVA indicated no significant influence of either metal type (P=0.811) or any surface pretreatment (P=0.757) on the metal-ceramic bond strength. Conclusion: OHT resulted in the increase in amount of oxides at the metal-ceramic interface. However, neither metal type nor surface pretreatments affected bond strength.
  1 3,255 150
Rigidity, retention, and resistance of titanium versus double taper light root canal posts: An in vitro evaluation
Ramneek Khatter, Ripu Daman Singh, Renu Sroa
November-December 2011, 22(6):879-879
DOI:10.4103/0970-9290.94694  
Aim: to evaluate and compare the physical properties of titanium posts and double taper (DT) light posts. Materials and Methods: Sixty posts (30 titanium post and 30 DT light post) were selected and divided into three groups. In Group I: Ten posts of each type were subjected to a three-point bending test. In Group II: 20 posts extracted maxillary central incisors were restored with ten posts of each type and subjected to tensile loading. In Group III: 20 posts extracted maxillary central incisors were restored with ten posts of each type and subjected to compressive loading at an angle of 135°. Results: The results showed that DT light posts were significantly less rigid (P <0.001), more retentive and significantly less resistant to fracture (P <0.001) as compared to titanium posts. Conclusion: It is suggested that although the DT light post system does not completely fulfill the requirements claimed by manufacturer but it would meet the requirements to combat the physiological forces operating in the oral cavity.
  1 2,691 98
A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: A clinical study
Mukesh Kumar Goyal, Shelly Goyal
November-December 2011, 22(6):880-880
DOI:10.4103/0970-9290.94695  
Aim: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. Materials and Methods: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study. Hanau H2 (non-arcon type) and Hanau Wide-Vue (arcon type) articulators were programmed for sagittal condylar guidance values using the same protrusive record made in polysiloxane bite registration material with edge to edge degree of protrusion. The resultant values for both the articulators on either side were compared with values obtained from tracing of digital lateral cephalogram using Kodak Dental imaging Window software 6.6.3.0-C program. The tabulated data were subjected to statistical analysis, ANOVA (Fishers 'F' test) for group comparison, Tukey's HSD test for inter-comparison, student's unpaired 't' test for intra-group comparison, and level of significance (P) was calculated using the same. Results: The mean sagittal condylar guidance values of the three different groups were found to be very highly significant (P=0.001) and highly significant (P=0.002) on the right and left sides respectively. There was a very highly significant difference (P=0.001) and highly significant difference (P=0.003) between the arcon and non-arcon group on the right and left side respectively. No significant difference was found between the arcon and cephalometric group (P=0.284 right, P=0.853 left) and a statistically significant difference was found between the non-arcon and cephalometric group (P=0.049 right, P=0.015 left). On intragroup comparison there was no statistically significant difference in sagittal condylar values on the right and left sides. Conclusion: The mean difference in the sagittal condylar guidance values obtained from non-arcon and arcon articulators shows a low level of reproducibility, and no significant difference found in mean sagittal condylar values obtained from arcon articulator and cephalometric tracings indicates replication of sagittal condylar guidance value from image of articular eminence.
  1 7,487 444
REVIEW ARTICLES
Role of colors in prosthodontics: Application of color science in restorative dentistry
Vinaya Bhat, D Krishna Prasad, Sonali Sood, Aruna Bhat
November-December 2011, 22(6):804-809
DOI:10.4103/0970-9290.94675  
Shade selection procedure depends on various factors including translucency, contour and surface texture. Tooth shade selection using a conventional means involves a high degree of subjectivity. Traditional shade guides are available that use several methods for quantifying shade. Technology-based systems provide with an advantage of natural looking restorations. They include RGB devices, colorimeters, spectrophotometers. The impact of the color science can be seen on various restorative materials ranging from ceramics to maxillofacial prosthetic materials.
  1 7,945 677
Colposcopy: A new ray in the diagnosis of oral lesions
Shambulingappa Pallagatti, Soheyl Sheikh, Nidhi Puri, Deepak Gupta, Balwinder Singh
November-December 2011, 22(6):810-815
DOI:10.4103/0970-9290.94676  
Oral squamous cell carcinoma is the most common cancer of the oral cavity. The survival rates for oral cancer patients will significantly be improved provided lesions are detected and treated at the infancy stage. Early diagnosis is therefore of paramount importance. Histopathological examination is considered as the gold standard in diagnosing oral lesions. Therefore, the selection for a biopsy site is highly significant. In this article, we present a current review of the colposcope and oral application of the colposcopy technique and its use as an adjunct in the early diagnosis of premalignant and malignant lesions of the oral mucosa. We stress upon the fact that colposcopy (direct oral microscopy) of oral mucosal lesions helps in selecting more representative sites for biopsy than routine clinical examination alone. Because of its precision, versatility, ease of use, and being a non-invasive technique, colposcopy might prove to be a useful step toward continuing to learn and improve the care for our patients.
  1 6,571 915
Perlecan (basement membrane heparan sulfate proteoglycan) and its role in oral malignancies: An overview
Mithilesh Mishra, Veena V Naik, Alka D Kale, Anil V Ankola, Ganga S Pilli
November-December 2011, 22(6):823-826
DOI:10.4103/0970-9290.94678  
Perlecan means pearl-like structures. Perlecan is a large proteoglycan (400-500 kDa) present in virtually all vascularized tissues with a distribution that is primarily confined to basement membranes including those of oral mucosa. It is a basement membrane-type heparan sulfate proteoglycan. Perlecan is synthesized by basal cells and fibroblasts adjacent to the basal lamina . Perlecan is also synthesized by vascular endothelial and smooth muscle cells present in the extracellular matrix. It has been demonstrated in recent years that perlecan is distributed in the stromal space of various pathophysiological conditions. The complex pleiotropy of perlecan suggests that this gene product is involved in several developmental processes, at both early and late stages of embryogenesis, as well as in cancer and diabetes. In the oral cavity, perlecan expression is reported to basal cells in normal mucosa and its expression increases in precancer and cancerous conditions. It is also expressed in various odontogenic tumors such as ameloblastoma, keratocyst odontogenic tumor, and also salivary gland tumors such as adenoid cystic carcinoma, mucoepidermoid carcinoma, etc.
  1 3,389 188
Oral lichenoid lesions: Clinico-pathological mimicry and its diagnostic implications
Santhosh Kumar S Hiremath, Alka D Kale, Seema Charantimath
November-December 2011, 22(6):827-834
DOI:10.4103/0970-9290.94679  
Oral cavity is commonly affected by number of lichenoid lesions, whose clinical and histopathologic features overlap due to the presence of inflammatory cells in connective tissue. Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. The literature discussed in the article is an attempt to segregate individual lichenoid lesions by defining clinical and histopathologic variations among each other, which avoids the diagnostic problem.
  1 25,882 966
SHORT COMMUNICATIONS
Oral lesions associated with hydroxyurea treatment
Regina Mendonça, Luiz Alcino Gueiros, Kátia Capellaro, Vitória Régia Pereira Pinheiro, Márcio Ajudarte Lopes
November-December 2011, 22(6):869-870
DOI:10.4103/0970-9290.94690  
Hydroxyurea (HU) is an antimetabolic agent commonly used in myeloproliferative disorders and hematological diseases as well as in severe psoriasis. Despite of usually be well tolerated, sometimes it can induce immunosuppression and mucocutaneous adverse effects associated with discomfort or pain. Nevertheless, oral mucosal adverse reactions are extremely uncommon and present as ulcers, tongue depapilation and dyschromia. Complete remission of adverse effects is usually observed after withdrawal of the medication. The aim of this paper is to report two patients with oral lesions related to HU treatment. T0 he patients were adequately managed by changing hydroxyurea with imatinib mesilate. Oral lesions are rare complications of long-term hydroxyurea treatment and may be an indication of stopping therapy and substitution with imatinib mesilate.
  1 5,926 69
Intermuscular lipoma of the submandibular space
Patrícia Adachi, Shajadi P Kaba, Ana Maria P Soubhia, Elio H Shinohara
November-December 2011, 22(6):871-872
DOI:10.4103/0970-9290.94691  
Deep lipomas, especially in the head and neck region, are uncommon. This report describes the case of a patient with a large intermuscular lipoma of the submandibular space, which had been present for 10 years and was diagnosed by computed tomography. The clinical, imaging, and histopathological features, as well as the management of the tumor, are described.
  1 2,602 108
Pleomorphic adenoma of the soft palate: Myoepithelial cell predominant
Deepak Daryani, R Gopakumar, Vidya Ajila
November-December 2011, 22(6):853-856
DOI:10.4103/0970-9290.94685  
The pleomorphic adenoma is the most common salivary gland tumor. A remarkable morphological diversity can exist from one tumor to the next. We present here a case of pleomorphic adenoma of minor salivary glands of the soft palate which had predominantly myoepithelial cells with minimal stroma, ductal cells, or tubular elements.
  1 7,352 241
Exostosis: A donor site for autograft
Rajiv N Puttaswamaiah, Sushama R Galgali, Vinayak S Gowda
November-December 2011, 22(6):860-862
DOI:10.4103/0970-9290.94687  
This article reports the utilization of exostosis as a source of autogenous bone for the treatment of osseous defects. A patient presented with an exostosis on the mandibular lingual region on the right side of the jaw. Exostosis was surgically removed using a chisel and mallet. The autograft thus obtained was used to treat a shallow osseous crater between 46 and 47. New bone formation was noticed at the grafted site 6 months after grafting. Bone formed in the grafted areas showed comparable clinical features to those of native bone.
  1 2,874 88
A modified technique for retention of orbital prosthesis
Sameera R Shaikh, Pravinkumar G Patil, Santosh Puri
November-December 2011, 22(6):863-865
DOI:10.4103/0970-9290.94688  
An orbital defect (congenital or acquired) causes severe facial asymmetry and disfigurement, which results in psychological and social disturbances to the patient. It becomes a challenging task for a maxillofacial prosthodontist to fabricate a prosthesis that replicates the healthy side of the face. Success of the prosthesis depends primarily on satisfactory retention of the same. This clinical report illustrates rehabilitation of a patient with an orbital defect by fabricating a hollow orbital prosthesis, utilizing anatomical undercuts for retention using an acrylic resin template relined by a resilient denture liner.
  1 3,547 248
ORIGINAL RESEARCH
A SEM evaluation of dentinal adaptation of root canal obturation with GuttaFlow and conventional obturating material
Vinod Upadhyay, Manoj Upadhyay, RK Panday, TP Chturvedi, Usha Bajpai
November-December 2011, 22(6):881-881
DOI:10.4103/0970-9290.94696  
Objective: The aim of this in-vitro study was to compare dentinal adaptation of conventional obturating material and GuttaFlow in young permanent teeth of child patients. Materials and Methods: Ten young permanent anterior teeth with closed foramen were selected for the study. Root canal preparations were carried out using a step back technique. The canal was alternately irrigated with 5.25% sodium hypochlorite solution and 17% EDTA and normal saline. After root canal preparation specimens were randomly divided into two groups (n=5). GROUP "A": Obturated with zinc-oxide eugenol sealer and gutta-percha cone using cold lateral obturation technique. GROUP "B": Obturated with GuttaFlow as per the manufacturer's instruction. The teeth were split into two halves. Five randomly chosen longitudinal split teeth samples each from Group "A" and Group "B" was observed under scanning electron microscope to access the interface between obturating material and dentin at the level of 2 mm from the apex. Results: On statistical analysis the dentinal adaptation (μm) of Group A was observed with a mean of 0.52 and standard deviation 0.15, while the value of mean and standard deviation were noted 0.12 and 0.02 for Group B. The "t" value on comparison of Group A and Group B is 5.79 with "P " value of <0.001, which is highly significant. Conclusion: From result of the study it can be concluded Group B samples showed significantly superior seal when compared with Group A. Complete seal was not observed in any of Group A samples.
  - 4,033 252
Dimensional accuracy and detail reproduction of two hydrophilic vinyl polysiloxane impression materials tested under different conditions
Preeti Agarwal Katyayan, Natarajan Kalavathy, Manish Katyayan
November-December 2011, 22(6):881-882
DOI:10.4103/0970-9290.94697  
Background and Objectives: A limitation of vinyl polysiloxane (VPS) impression materials is hydrophobicity, and manufacturers have added surfactants and labeled these new products as "hydrophilic." The purpose of this investigation was to evaluate and compare the dimensional accuracy and surface detail reproduction of two hydrophilic VPS impression materials under dry, moist, and wet conditions. Materials and Methods: Ten impressions were made under dry, moist, and wet conditions respectively, with monophase, and regular body VPS impression material using a stainless steel metal die similar to that described in American Dental Association (ADA) specification 19, with lines scribed on it. Dimensional accuracy was measured by comparing the average length of the middle horizontal line in each impression to the same line on the metal die, by using a measuring microscope. The surface detail was evaluated. A one-way analysis of variance and Student t-test were used to compare mean dimensional changes (α = 0.05). Results: Conditions (dry, moist, and wet) did not cause significant adverse effects on the dimensional accuracy of either material. The mean dimensional changes were 0.00084% (+0.00041%) for monophase and 0.00119% (+0.00033%) for regular body. Monophase material was satisfactory in detail reproduction 100% of the time in dry conditions, 90% in moist, and only 20% in wet conditions. The regular body showed 100% satisfactory impressions in dry, 80% in moist, and 10% in wet conditions. With the additional smooth surface evaluation, only under dry conditions impressions with clinically acceptable surface quality were produced. Conclusions: Dimensional changes for both materials were well within ADA standards of minimal shrinkage value of 0.5%.
  - 4,361 238
Alveolar bone mass in pre- and postmenopausal women with serum calcium as a marker: A comparative study
Amitha Ramesh, Karishma Mahajan, Biju Thomas, Nina Shenoy, Rahul Bhandary
November-December 2011, 22(6):878-878
DOI:10.4103/0970-9290.94667  
Context: In most women bone mass reaches its peak in the third decade of life and declines thereafter with the onset of menopause and might lead to osteoporosis. Osteoporosis may result in reduced jaw bone mass and alterations of the mandibular structure. Qualitative and quantitative indices have been used for panoramic radiographs to assess the alveolar bone quality. Aims: The purpose of this study was to compare the alveolar bone quality of premenopausal and postmenopausal women using the panoramic mandibular index (PMI). This study also aimed to estimate the levels of serum calcium in premenopausal and postmenopausal women. Settings and Design: Single centre case control study. Materials and Methods: A total of 30 patients were divided into three groups of ten each - the healthy group, control group, and study group. Alveolar bone mass was evaluated by the PMI. Serum calcium was also assessed for all the patients. Statistical analysis used: The results obtained were subjected to statistical analysis by one-way analysis of variance using Statistical Software SPSS version 17, Tukey test for comparision, Pearson's correlation coefficient was employed. Results: Premenopausal women had the highest values for alveolar cortical bone mass as recorded by the PMI, followed by postmenopausal women with a healthy periodontium. The lowest values were recorded in the group of postmenopausal women with chronic generalized periodontitis. Similar results were found for serum calcium values. Conclusion: Postmenopausal women exhibit a reduced alveolar bone mass and lowered levels of serum total calcium with the increasing age. These changes may be useful indicators for low skeletal bone mineral density or osteoporosis.
  - 3,057 267
Proliferative and morphologic characterization of buccal mucosal fibroblasts in areca nut chewers: A cell culture study
Deepu George Mathew, K Skariah Skariah, Kannan Ranganathan
November-December 2011, 22(6):879-879
DOI:10.4103/0970-9290.94693  
Objective: To isolate, culture and characterize fibroblasts from the buccal mucosa of areca nut chewers with and without oral submucous fibrosis (OSF). Materials and Methods: Primary fibroblast cultures were established by the collagenase disaggregation technique and the phenotypic and growth characteristics were studied. Results: Cells cultured from OSF showed a statistically significant increase in both the post-mitotic fibroblast subpopulation and the population doubling time when compared with controls. Conclusion: There was a significant increase in the pro-fibrotic, post-mitotic subpopulation of fibroblasts in areca nut chewers with OSF.
  - 3,836 317
Evaluation of resorbable membrane in treatment of human gingival isolated buccal recession
Sumit Narang, Ruby Gupta
November-December 2011, 22(6):749-754
DOI:10.4103/0970-9290.94567  
Background: Gingival recession in its localized or generalized form is an undesirable condition which results in root exposure. Several different techniques have been described in order to cover the exposed root surface, and increase the dimensions of the keratinized tissue in gingival recession defects. The aim of the present study is to evaluate the result using a bio resorbable membrane for the treatment of human isolated buccal gingival recession. Materials and Methods: Ten patients, i.e. 6 males and 4 females, mean age 34.5 years, with Miller's classification class I or II facial mucogingival defects were selected. A full thickness flap up to the mucogingival junction, followed by a split thickness flap was reflected. This was done so as to cover the membrane at the defect site, at the same time cover the denuded root surface. All parameters were recorded by a single investigator for each surgical site before surgery (baseline), after 3 weeks, 3 months, 6 months and 9 months. Results: The selected sites clinically presented with initial mean recession of 4.4 mm, mean area of recession of 10.5 mm and initial mean keratinized tissue width 4.2 mm. The results of this study had showed a mean coverage of the recession defects by 3.45 mm and a significant gain in keratinized tissue width of 0.8 mm post operatively at nine months. There was also a significant reduction in area of recession. The difference between the base line reading and post operative readings was both clinically and statistically significant. The mean percentage of root coverage was 79.75%. Conclusion: Resorbable membrane is a versatile treatment modality for coverage of isolated buccal gingival recession. Although membrane exposure occurred in four patients, it did not interfere with post operative healing.
  - 3,556 215
Variability in the proportion of components of iodoform-based Guedes-Pinto paste mixed by dental students and pediatric dentists
Anna Carolina Volpi Mello-Moura, Juliana Fanaro, Maria Aparecida Nicoletti, Fausto Medeiros Mendes, Marcia Turolla Wanderley, Antonio Carlos Guedes-Pinto
November-December 2011, 22(6):781-785
DOI:10.4103/0970-9290.94668  
Objective: Guedes-Pinto paste (GPP) is an iodoform paste used in most dental schools in Brazil. The paste is a composite of medicines (Rifocort® , camphorated paramonochlorophenol [PMCC], and iodoform) used for endodontic treatment of primary teeth. The aim of this study was to evaluate the proportion variability of GPP components when mixed by undergraduate dentistry students and pediatric dentists. Materials and Methods: The study was divided into 4 groups: G1 (15 undergraduate students), G2 (15 specialists in Pediatric Dentistry), G3 (15 professors with clinical activity), and G4 (7 professors-researchers). All volunteers prepared GPP according to the original specifications: the same visual proportion for each component. The components were weighed using an analytical balance and the percentage was calculated. Result: After normality (Kolmogorov-Smirnov) and homogeneity tests (Levene test), the data were submitted to analysis of variance and intraclass correlation coefficient tests (P<0.05). The percentage means of each respective group were as follows: Rifocort® 20.2%, 20.8%, 26.7%, 27.3%; camphorated PMCC 9.2%, 8.1%, 6.7%, 5.1%; and the iodoform 70.6%, 71.1%, 64.7%, 67.6%. There were no significant differences between groups for the component percentages. There was a high intraclass correlation coefficient (G1 0.945; G2 0.951; G3 0.921; and G4 0.870). Conclusion: The proportion of GPP was similar in all the groups, allowing us to conclude that ideal GPP proportion, based on the entire group mean, was 23.8% of Rifocort® ; 7.0% of camphorated PMCC; and 69.2% of iodoform.
  - 5,091 170
Osteotome sinus floor elevation without bone grafting and simultaneous implant placement in the atrophic maxilla: A pilot study
DP Senyilmaz, O Kasaboglu
November-December 2011, 22(6):786-789
DOI:10.4103/0970-9290.94669  
Aims: This study evaluated the clinical and radiographic outcome of implants placed in the posterior maxilla with the osteotome sinus floor elevation (OSFE) technique without graft material. Materials and Methods: Twenty-seven 4.1-mm-diameter dental implants (Straumann AG, Basel, Switzerland) were placed to 17 sinuses with residual bone height of ≤10 mm and ≥5 mm to rehabilitate 23 molar and 4 premolar sites. Implants were simultaneously placed with the OSFE procedure without graft material. Results: All implants were successfully integrated after 8-12 weeks healing time. At the 2-year follow-up, all the implants presented the survival criteria proposed by Buser et al. and Cochran et al. Conclusion: The OSFE technique without grafting material may be predictable because the success rate was 100% in this study. Implants gained endo-sinus bone despite the lack of graft material. More patients and longer follow-up are needed to validate the results of this pilot study.
  - 3,534 131
Influence of different light sources on the conversion of composite resins
Emerson H Silva, Rodrigo C Albuquerque, Lincoln D Lanza, Guilherme C Vieira, Rogéli TRC Peixoto, Hugo H Alvim, Maria I Yoshida
November-December 2011, 22(6):790-794
DOI:10.4103/0970-9290.94670  
Aims: The purpose of this paper was to evaluate the influence of different light curing units on the conversion of four composite resins with different compositions (Durafill VS® - Heraeus-Kulzer, Tetric Ceram® - Ivoclar/Vivadent, Filtek™ Supreme XT - 3M ESPE™ e Aelite™ LS Packable - Bisco), using differential scanning calorimetry. Materials and Methods: A stainless steel matrix was used to prepare 48 cylindrical composite test samples (n=6), measuring 3 mm in diameter and 1 mm in thickness. The samples were photoactivated using a halogen lamp (Optilux™ 500 - Demetron/Kerr) and three different generations of light-emitting diodes (LEDs) (LEC-470 I - MMOptics, Radii Plus - SDI and Ultra-Lume™ LED 5 - Ultradent). After removal of the matrix, each sample was weighed and hermetically sealed in an aluminum pan and analyzed. The amount of heat liberated by thermopolymerisation of residual monomers after photoactivation was measured in Joules/gram (J/g). The data were submitted to Analysis of Variance (ANOVA) test (P ≤ 0.002) and the Tukey test (P < 0.05). Results: The Ultra-Lume™ LED 5 was superior on degree of conversion for all resins. The Radii Plus was equal to the Ultra-Lume™ LED 5, except for the resin Tetric Ceram® , were the Optilux™ 500 was superior. The LEC-470 I was inferior for the conversion of all resins. Conclusion: The study proves the importance of the compatibility of the different photoinitiators in resin composites with the different light sources.
  - 3,122 111
Comparison of fracture resistance of teeth restored with ceramic inlay and resin composite: An in vitro study
Priti D Desai, Utapal Kumar Das
November-December 2011, 22(6):877-877
DOI:10.4103/0970-9290.94663  
Aim: The aim of this study was to evaluate the in vitro fracture resistance of teeth restored with bonded ceramic inlay and direct composite resin restoration in comparison to the normal tooth. Materials and Methods: This study evaluated the fracture strength of the teeth restored with bonded ceramic inlay and direct composite resin restoration in comparison to the normal teeth. Thirty intact human maxillary first premolars were assigned to three groups: Group 1 - comprising sound/unprepared teeth (control). Group 2 - comprising of Class-II direct composite resin restored teeth and Group 3 - comprising Class-II ceramic inlay restored teeth. Cavities were prepared with occlusal width of 1/3 intercuspal distance and 2 mm deep pulpally. Group 2 teeth were restored with hybrid composite resin (Z350 3M ESPE, USA) and group 3 teeth were restored with Vitadur Alpha alumina (Ivoclare Vivadent, Liechtenstein, Europe). Ceramic inlay was bonded with adhesive cement (rely X resin cement of 3MESPE, USA). The specimens were subjected to a compressive load until they fractured. Data were analyzed statistically by unpaired Student's t test. Results: The fracture resistant strength, expressed as kilonewton (KN), was group 1 - 1.51 KN, group 2 - 1.25 KN, and group 3 - 1.58 KN. Statistically, group III had highest fracture resistance followed by group I, while group II had the lowest average fracture resistance. Conclusion: The fracture resistant strength of teeth restored with ceramic inlay was comparable to that of the normal intact teeth or slightly higher, while teeth restored with direct composite resin restoration showed less fracture resistant strength than that of the normal teeth.
  - 8,038 289
SHORT COMMUNICATION
Salvation of a severely resorbed mandibular ridge with a neutral zone technique
Kanhaiya L Gupta, Suchi Agarwal
November-December 2011, 22(6):883-883
DOI:10.4103/0970-9290.94699  
The objective of any prosthodontic service is to restore the patient to normal function, contour, esthetics, speech, and health. An optimum denture stability is difficult to achieve in conventional complete dentures. This problem is more magnified in mandibular dentures. The design of prostheses to replace lost teeth and resorbed ridges is largely determined by the position and amount of morphological change in the denture-bearing area of the jaws. A neutral zone may be defined as the space where, during function, the forces of the lips and cheeks pressing inward neutralize the forces of the tongue pressing outward. The neutral zone concept implies acquired muscle control, especially by tongue, lips, and cheeks toward the denture stability. Advocates of the neutral zone concept agree that a lack of favorable leverage is observed when teeth are positioned directly over the ridge. By employing the neutral zone concept, the dislodging muscle energy can easily become a retentive and stabilizing force.
  - 6,734 535
SHORT COMMUNICATIONS
Restoration of blinking reflex and facial symmetry in a Bell's palsy patient
Priyanka Somani, Ajay Kumar Nayak
November-December 2011, 22(6):857-859
DOI:10.4103/0970-9290.94686  
Patients afflicted with Bell's palsy are faced with both functional and esthetic impairment. Prominent among these are the inability to close the eyelids and abnormal facial appearance, with concomitant difficulty in eating, drinking and speaking. Rehabilitation of such patients can be achieved by a multispecialty approach, with the prosthodontist functioning as an integral part of the treatment team. This article describes a simple and effective approach to restore the blinking reflex of the upper eyelid with custom gold implant and facial esthetics with cheek support prosthesis.
  - 3,751 167
A conservative approach to pediatric mandibular fracture management: Outcome and advantages
Amit Khatri, Namita Kalra
November-December 2011, 22(6):873-876
DOI:10.4103/0970-9290.94692  
Pediatric mandibular fractures are rare and their treatment remains controversial. Management is extremely complicated in mixed dentition as it is inherently dynamic and unstable. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. This case report describes and evaluates the conservative technique of acrylic splint in the treatment of pediatric mandible fracture in a 12-year-old female child. The patient with isolated mandibular fracture was treated with acrylic splint and interdental wiring followed by evaluation of clinical and radiographic healing as well as the somatosensory status. Patient demonstrated clinical union to her pre-injury occlusion by three to four weeks. Panoramic finding supported the finding of clinical examination throughout the study. High osteogenic potential of the pediatric mandible allowed conservative management to be successful in this case.
  - 5,501 304
Multiple glass pieces in paranasal sinuses
Syed Ahmed Mohiuddin, Shazia Rahiman, Shammeem Sultana
November-December 2011, 22(6):847-849
DOI:10.4103/0970-9290.94683  
Here, a case has been reported of a road traffic accident with multiple glass pieces arranged in an unusual pattern in the left maxillary sinus, ethmoid sinus, nasopharynx and medial side of the orbit, as seen in the radiographs. Combined surgical approach through the existing wound and endoscopic surgery was successfully used to remove nearly all the glass pieces.
  - 2,352 92
Report of rare palatal expression of Nevus of Ota with amendment of Tanino's classification
Mahima V Guledgud, Karthikeya Patil, Srikanth H Srivathsa, Suchetha N Malleshi
November-December 2011, 22(6):850-852
DOI:10.4103/0970-9290.94684  
Nevus of Ota, a benign melanocytic pigmentary disorder with rare malignant transformation potential, affects 0.014-0.034% of the Asian and Black population and has a strong predilection for females. It occurs in the area innervated by the first and second division of the trigeminal nerve. Oral manifestation is rarely noted with only 14 cases reported till date. This report documents a case of Nevus of Ota with the infrequently noted oral involvement, in an Indian lady. Since oral manifestation is not acknowledged in Tanino's classification, the authors propose a modification to the same.
  - 4,050 103
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