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   2012| May-June  | Volume 23 | Issue 3  
    Online since October 11, 2012

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Estimation of the level of tumor necrosis factor-α in gingival crevicular fluid and serum in periodontal health and disease: A biochemical study
Kalpana Gokul
May-June 2012, 23(3):348-352
DOI:10.4103/0970-9290.102221  PMID:23059571
Tumor Necrosis Factor-α(TNF-α), a "major inflammatory cytokine" not only plays an important role in periodontal destruction, but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF-α in GCF and serum and its relationship to periodontal disease. Aim: Hence, an attempt is made to estimate the level of TNF-α in GCF and serum, its relationship to periodontal disease, and to explore the possibility of using the level of TNF-α in GCF as a biochemical "marker" of periodontal disease. Materials and Methods: 60 subjects participated in the study and were grouped into control, gingivitis and periodonititis groups. The GCF and serum samples were assayed for TNF-α levels by Enzyme Linked Immunosorbent Assay (ELISA) method. Results: Showed elevated levels of TNF-α in group II and III subjects as compared to healthy controls in both GCF and serum, suggesting an association between periodontal disease and levels of TNF-α. Conclusion: It remains a possibility that the absence or low levels of TNF-α in GCF might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease "activity" and "inactivity" could suggest the possibility of using TNF-α in GCF as an "Indicator" of periodontal disease.
  27 3,399 215
Evaluation of the efficacy of a 5% calcium sodium phosphosilicate (Novamin®) containing dentifrice for the relief of dentinal hypersensitivity: A clinical study
KS Rajesh, Shashikanth Hedge, MS Arun Kumar, Deepa Gajendra Shetty
May-June 2012, 23(3):363-367
DOI:10.4103/0970-9290.102228  PMID:23059574
Context: Dentinal hypersensitivity (DH) is a commonly encountered problem. Several products are used in management of DH with varying results. Need is felt in dentistry for a material that chemically reacts, physically occludes and adheres intimately to dentinal tubules to reduce the possibility of its recurrence. One such material is calcium sodium phosphosilicate-Novamin ® . Aim: To evaluate an efficacy of a 5% calcium sodium phosphosilicate (Novamin ® SHY NM TM ) containing dentifrice compared to placebo for the relief of DH. Settings and Design: Outpatients visiting Dept of Periodontics, Yenepoya Dental College with DH were deemed eligible for this case-control clinical trial after an informed consent. Materials and Methods: 30 patients having at least 2 sensitive teeth with a VAS (Visual Analogue Scale) of >3 cm after air blast stimulation, qualified to participate in the study. Test (SHY NM TM toothpaste containing 5% calcium sodium phosphosilicate) and control (Pepsodent toothpaste without a desensitizing agent) groups, each containing 15 participants, were subjected to cold water and air blast stimulation for an assessment of DH at baseline, 6 th and 8 th week using VAS. Statistical analysis used: Unpaired t-test and repeated measures ANOVA. Results: 5% Novamin ® containing dentifrice significantly reduced DH within 6 th and 8 th week of usage when compared to a placebo dentifrice. Conclusions: A Novamin ® containing dentifrice significantly reduced DH when compared to a placebo dentifrice.
  24 7,060 403
Biocompatible implant surface treatments
Bikash Pattanaik, Sudhir Pawar, Seema Pattanaik
May-June 2012, 23(3):398-406
DOI:10.4103/0970-9290.102240  PMID:23059581
Surface plays a crucial role in biological interactions. Surface treatments have been applied to metallic biomaterials in order to improve their wear properties, corrosion resistance, and biocompatibility. A systematic review was performed on studies investigating the effects of implant surface treatments on biocompatibility. We searched the literature using PubMed, electronic databases from 1990 to 2009. Key words such as implant surface topography, surface roughness, surface treatment, surface characteristics, and surface coatings were used. The search was restricted to English language articles published from 1990 to December 2009. Additionally, a manual search in the major dental implant journals was performed. When considering studies, clinical studies were preferred followed by histological human studies, animal studies, and in vitro studies. A total of 115 articles were selected after elimination: clinical studies, 24; human histomorphometric studies, 11; animal histomorphometric studies, 46; in vitro studies, 34. The following observations were made in this review:
  • The focus has shifted from surface roughness to surface chemistry and a combination of chemical manipulations on the porous structure. More investigations are done regarding surface coatings.
  • Bone response to almost all the surface treatments was favorable.
  • Future trend is focused on the development of osteogenic implant surfaces.
Limitation of this study is that we tried to give a broader overview related to implant surface treatments. It does not give any conclusion regarding the best biocompatible implant surface treatment investigated till date. Unfortunately, the eventually selected studies were too heterogeneous for inference of data.
  17 7,042 369
Dental stem cells: Dentinogenic, osteogenic, and neurogenic differentiation and its clinical cell based therapies
Gurlal Singh Brar, Ravi Sher Singh Toor
May-June 2012, 23(3):393-397
DOI:10.4103/0970-9290.102239  PMID:23059580
Each year approximately $400 billion is spent treating Americans suffering some type of tissue loss or end-stage organ failure. This includes millions of dental and oral craniofacial procedure, ranging from tooth restorations to major reconstruction of facial soft and mineralized tissue. Recently, a population of putative post-natal stem cells in human dental pulp (DPSCs) has been identified within the "cell- rich zone" of dental pulp. The other type of stem cells from human exfoliated deciduous teeth (SHED) was identified to be a population of highly proliferative, clonogenic cells. Dental Pulp Stem Cells (DPSCs) can not only be derived from a very accessible tissue resource like SHED but are also capable of providing enough cells for potential cell-based therapies.
  16 5,004 401
Oro-mandibular manifestations of primary hyperparathyroidism
Sachin Rai, Sanjay K Bhadada, Vidya Rattan, Anil Bhansali, DS Rao, Viral Shah
May-June 2012, 23(3):384-387
DOI:10.4103/0970-9290.102236  PMID:23059578
Aims and Objective : To determine the effects of Primary Hyperparathyroidism on oral cavity in a symptomatic contemporary Indian population by taking note of the following parameters: (1) Radiological alteration of lamina dura, (2) mandibular cortical width, (3) prevalence of brown tumor, and (4) mandibular tori. Study Design : Twenty-six patients of Primary Hyperparathyroidism were examined clinically and radiologically for extra- and intraoral abnormalities. Loss of lamina dura, mandibular cortical width, presence of mandibular tori, and brown tumors were assessed and correlated with serum Calcium, Phosphate, Parathormone, and Alkaline phosphatase. The results were compared with twenty-six age- and gender-matched control subjects. The data was expressed as mean ± SD, and a probability (p) value of < 0.05 was considered significant. Pearson's statistical method was used to assess the significant correlation between radiological measurements and biochemical values. Results : Generalized absence of the lamina dura was the most consistent finding and there was a significant correlation between its loss and altered parathormone, alkaline phosphatase, and inorganic phosphate, but not with serum calcium or the duration of the disease. Mean values (in mm) for the cortical indices were significantly lower in the patients compared to the controls and correlated significantly with parathormone and alkaline phosphatase. None of the patients had mandibular tori and only one patient had a brown tumor. Conclusion : Loss of lamina dura, ground glass appearance, and mandibular cortical width reduction are common findings in primary hyperparathyroidism and these are significantly correlated with elevated parathormone and alkaline phosphatase. However, the presence of brown tumors and oral tori are less commonly encountered features.
  13 10,092 342
Marginal microleakage of resin-modified glass-ionomer and composite resin restorations: Effect of using etch-and-rinse and self-etch adhesives
Maryam Khoroushi, Tayebeh Mansouri Karvandi, Bentolhoda Kamali, Hamid Mazaheri
May-June 2012, 23(3):378-383
DOI:10.4103/0970-9290.102234  PMID:23059577
Objectives: Previous studies have shown that dental adhesives increase the bond strength of resin-modified glass-ionomer (RMGI) restorative materials to dentin. This in vitro study has evaluated the effect of etch-and-rinse and self-etch bonding systems v/s cavity conditioner, and in comparison to similar composite resin restorations on maintaining the marginal sealing of RMGI restorations. Materials and Methods: 98 rectangular cavities (2.5×3×1.5 mm) were prepared on buccal and palatal aspects of 49 human maxillary premolars, randomly divided into 7 groups (N=14). The cavities in groups 1, 2 and 3 were restored using a composite resin (APX). The cavities in groups 4, 5, 6 and 7 were restored using a resin-modified glass-ionomer (Fuji II LC). Before restoring, adhesive systems (Optibond FL = OFL, three-step etch-and-rinse; One Step Plus = OSP, two-step etch-and-rinse; Clearfil Protect Bond = CPB, two-step self-etch) were used as bonding agents in groups 1-6 as follow: OFL in groups 1 and 4, OSP in groups 2 and 5, and CPB in groups 3 and 6, respectively. The specimens in group 7 were restored with GC cavity conditioner and Fuji II LC. All the specimens were thermo-cycled for 1000 cycles. Microleakage scores were determined using dye penetration method. Statistical analyzes were carried out with Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: There were significant differences in microleakage scores at both enamel and dentinal margins between the study groups (P<0.05). The lowest microleakage scores at enamel and dentin margins of RMGI restorations were observed in group 6. Conclusion: Use of two-step self-etch adhesive, prior to restoring cervical cavities with RMGIC, seems to be more efficacious than the conventional cavity conditioner in decreasing marginal microleakage.
  11 6,215 248
Accessory neurovascular foramina on the lingual surface of mandible: Incidence, topography, and clinical implications
BV Murlimanju, KG Prakash, D Samiullah, Latha V Prabhu, Mangala M Pai, Rjanigandha Vadgaonkar, Rajalakshmi Rai
May-June 2012, 23(3):433-433
DOI:10.4103/0970-9290.102252  PMID:23059593
Context: It was suggested that the accessory neurovascular foramina of the mandible might be of significance in relation to the effectiveness of local anesthesia following the routine inferior alveolar nerve block. Aims: To investigate the incidence of neurovascular foramina over the lingual surface of the mandible in South Indian population. Settings and Design: The study was conducted at the department of anatomy. Materials and Methods: The study included 67 human adult dry mandibles, the exact ages and sexes of which were not known. The location and number of neurovascular foramina were topographically analyzed. Statistical Analysis Used: Descriptive statistics. Results: The foramina were observed in 64 mandibles (95.5%) and were often multiple in most of the cases. They were located between the two medial incisors in 8 mandibles (1.9%), between the medial and lateral incisor in 34 mandibles (50.7%; 25-bilateral; 7-right; 2-left), between the lateral incisor and canine in 7 mandibles (10.4%; 2-bilateral; 3-right; 2-left), between the canine and first premolar in 6 cases (8.9%; 3 on each side). Foramina were also present around the genial tubercle in 56 mandibles (83.6%). Among them, 52 mandibles showed a single foramen just above the genial tubercle, 34 mandibles had foramina below the tubercles, 13 mandibles had foramina on the right side of genial tubercle and 17 were having on the left side. Conclusion: Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.
  10 4,490 162
Effect of fluoride mouth rinses on various orthodontic archwire alloys tested by modified bending test: An in vitro study
Kamna Srivastava, Pavan Kumar Chandra, Nandini Kamat
May-June 2012, 23(3):433-434
DOI:10.4103/0970-9290.102253  PMID:23059594
Objective: Fluorides can cause corrosion and degradation in mechanical properties of commonly used archwires by forming hydrofluoric acid HF and causing disruption of protective titanium oxide layer. Hence, the aim of this study was to assess the change in load deflection characteristics of Ni-Ti, Cu Ni-Ti, S.S, and β-Ti wires on immersing in fluoride mouth rinses of two types- Phosflur and neutral NaF mouth rinse utilizing a modified bending test and comparing it to control. Materials and Methods: Round preformed wires were immersed in 10 ml of control and test solution (Phosflur and S-Flo mouth rinse) for 1.5 hours and incubated at 37°C. Modified bending test was carried out to evaluate load-deflection characteristics of different wires using Instron. Analysis of variance (ANOVA) was applied to determine if statistically significant difference exist among the mean load values obtained at various deflections in control and test solutions. Results: There was no statistically significant reduction in load deflection characteristics of Ni-Ti, copper Ni-Ti, β-Ti, and S.S wires on immersing in Phosflur mouth rinse and neutral sodium fluoride mouth rinses as compared to control at 2.5 and 1 mm of deflection in unloading phase. Conclusion: Phosflur and a neutral sodium fluoride mouth rinse did not affect the mechanical bending properties of Ni-Ti, copper Ni-Ti, B-Ti, and SS wires in in vitro conditions.
  8 3,165 174
Comparative evaluation of marginal integrity of glass ionomer and resin based fissure sealants using invasive and non-invasive techniques: An in vitro study
Shilpa Gunjal, L Nagesh, HG Raju
May-June 2012, 23(3):320-325
DOI:10.4103/0970-9290.102214  PMID:23059566
Background: Occlusal surfaces of the molars are highly susceptible to dental decay. Pit and fissure sealants are one of the best methods of preventing fissure caries. The main problem encountered is microleakage leading to deterioration of material and increased possibility of the development of secondary caries. Aims: To assess and compare the marginal integrity of glass ionomer (Fuji VII) and resin based (Clinpro) fissure sealants using invasive and non-invasive technique. Setting and Design: Experimental in-vitro study. Materials and Methods: An in-vitro study was conducted on 40 healthy, extracted premolars. The teeth were divided into 4 groups. Group I: Clinpro-invasive technique, group II: Clinpro-non-invasive technique, group III: Fuji VII-invasive technique, group IV: Fuji VII-non-invasive technique. Sealants were applied and subjected to an evaluation under SEM (scanning electron microscopy) for the width of the marginal gap. ANOVA (analysis of variance) and Duncan's multiple range tests were used for the statistical analysis. Results: The mean width of the marginal gap was 0.4089 μm in group I as compared to 3.0485 μm in group III; and the difference was statistically highly significant (P<0.001). In non-invasive technique, Clinpro and Fuji VII showed a mean marginal gap width of 0.4486 μm and 3.0485 μm, respectively. This difference was statistically highly significant at a P<0.001. There was no statistically significant difference in the mean widths between invasive and non-invasive techniques. Conclusion: Clinpro performed better in terms of marginal adaptation than did the Fuji VII sealant. The techniques (Invasive and non-invasive) does not influence the marginal integrity significantly.
  8 3,925 241
Perceived sources of stress amongst final year dental under graduate students in a dental teaching institution at Bangalore, India: A cross sectional study
AG Harikiran, J Srinagesh, KS Nagesh, N Sajudeen
May-June 2012, 23(3):331-336
DOI:10.4103/0970-9290.102218  PMID:23059568
Background: Dental schools are known to be highly demanding and stressful learning environments. Dentistry involves an acquisition of required academic, clinical and interpersonal skills during the course of learning. Practicing dentistry requires clinical skills and patient management skills, which also add to the stress perceived by the students. Identifying sources of stress represents the crucial first step towards advocating policy changes and strategies to alleviate the stressors and enhance students' stress coping skills. The aim of this study was to identify self-reported sources of the stress among the final year [4 th year] dental undergraduate students in a Dental Teaching Institution in Bangalore, India. Materials and Methods: A 38 items, 4-point Likert Scale item modified Dental Environmental Stress (DES) questionnaire, addressing 5 stressor domains (living accommodation, interpersonal relationships, academics, clinical skills and miscellaneous) was administered to all final year undergraduate dental students of the Institution. Items and domains were considered to be perceived as "stressful", when students classified them as 'slightly', 'moderately' or 'severely stressful'. Descriptive and bivariate analyzes based on chi square tests were performed. Results: Out of the 38 items, 19 items were reported to be "stressful" by >70% of the students. Of these, examinations, difficulty in managing difficult cases, lack of patient co-operation, difficulty and amount of course work and completing clinical requirements were reported to be "stressful" by >85% of the students. Personal physical health, difficulty in making friends, staying with roommates, narcotic substance dependencies were least commonly reported to be "stressful". Discussion and Conclusion: The stress provoking factors among >70% of the students are quite similar to those reported by the researchers' worldwide. Curricular changes, student support mechanisms at departmental/institutional level with appropriate policy changes need to be considered to assist the students in coping with identified stressors.
  8 6,574 328
Successful management of pulpo-periodontal lesion in maxillary lateral incisor with palatogingival groove using CBCT scan
Akhil Rajput, Sangeeta Talwar, Sarika Chaudhary, Ambica Khetarpal
May-June 2012, 23(3):415-418
DOI:10.4103/0970-9290.102243  PMID:23059584
Palatogingival groove is a rare developmental anomaly involving the lingual surface of the maxillary incisor and resulting in severe endodontic and periodontal lesions. This case report describes a multidisciplinary approach for the combined management of the endodontic and periodontal problems for successful rehabilitation of the involved tooth. Cone-beam computed tomography (CBCT) helped in correct diagnosis of the lesion and hence enabled effective treatment.
  7 6,058 307
Soft-tissue cephalometric norms for the Lambada population in Telangana Region of Andhra Pradesh
Mayuri Thomas, Val Deepti Reddy, Hanumantu Vidyadar Lakshmi
May-June 2012, 23(3):353-358
DOI:10.4103/0970-9290.102224  PMID:23059572
Introduction: Facial contours were traditionally considered to be the result of positioning of underlying hard tissue followed by the soft tissue. However, current trend shows a paradigm shift from the conventional hard tissue analysis to also include both hard- and soft-tissue analysis. The objective of our study was to determine the soft-tissue cephalometric norms for the Lambada population, to define gender differences and to correlate the variables, skeletal convexity (SC), and H angle (HA). Materials and Methods: Fifty subjects of Lambada ethnic group between 18 and 26 years old, grouped into 25 males and 25 females were taken. Their lateral cephalograms were obtained and analyzed using Holdaway's analysis. Descriptive statistics and the student's t-test were used. Results: Soft-tissue facial angle (SFA), superior sulcus depth (SSD), lower lip to H line (LL-H), and soft-tissue subnasale to H line (S-H) were well within the range given by Holdaway. The variable, lip strain showed that the upper denture is protrusive (P<0.001). Skeletal convexity and HA were significantly correlated in the female sample. HA revealed that a slightly more protrusive profile was acceptable for this ethnic group. Conclusion: Although established Caucasian norms are applicable to the Lambada ethnic tribe, few parameters like basic upper lip thickness (ULT) and upper lip strain (ULS), skeletal convexity, inferior sulcus to H line (LS-H) were significantly different. The male group exhibited straighter profile, thicker lips, prominent nose, deep mentolabial sulcus, and a prominent chin than females. The differences could be considered in diagnosis and treatment planning for orthodontic practice and for orthognathic surgery.
  7 3,698 200
Comparison of glycosylated hemoglobin levels in periodontitis patients and healthy controls: A pilot study in Indian population
Ruchika M Saxena, PC Deepika
May-June 2012, 23(3):368-372
DOI:10.4103/0970-9290.102231  PMID:23059575
Background: Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine if glycosylated hemoglobin is elevated in patients with periodontitis who are non-diabetic adults. Materials and Methods: A total of 36 patients were selected and were divided into test and control groups. Test group included 18 adults without diabetes, but with periodontitis (having at least five teeth with probing depth (PD) ≥5 mm, bleeding on probing (BOP), and clinical attachment loss (>1 mm) on >5 teeth or radiographic bone loss), and the control group included 18 healthy adults (PDs ≤4 mm and BOP ≤15% and no clinical attachment loss). Glycosylated hemoglobin (HbA1c) was assessed in laboratory for these patients. Groups were compared using the t test,kruskal-wallis test, pearsson correlation. Results: Both the groups showed similar HbA1c levels, but there was a marginal increase in levels in the test group (cases), which was not statistically significant (cases- 6.06%, controls-5.8%; P=0.101).There was no significant difference found in the mean HbA1c levels among males and females and among various age groups. Mean BMI among the cases and controls was found to be similar. When inter and intra group comparisons were done according to BMI categories among the cases and controls, we found similar mean HbA1c values. Conclusion: Indians are at a high risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in non-diabetic individuals. Periodontal disease may be a potential contributor to development of type 2 diabetes.
  5 5,385 259
The use of ultrasonography in diagnosis and management of superficial fascial space infections
Pravin U Mukhi, Uma R Mahindra
May-June 2012, 23(3):313-319
DOI:10.4103/0970-9290.102211  PMID:23059565
Aims and Objectives: To evaluate the role of ultrasonography as a diagnostic aid to differentiate cellulitis from abscess; and efficacy of ultrasound-guided surgical drainage of superficial abscesses in the maxillofacial region. Materials and Methods: a total of 26 patients with acute facial swellings were included in the study. Clinical examination confirmed the presence of space infection. Ultrasonographic examination of the swelling was then performed. If ultrasound images showed no collection and only thickness of subcutaneous tissue and muscle involved were increased, then the diagnosis was made as cellulitis. When collection was identified, diagnosis was made as abscess. Dimensions of abscess cavity, amount of pus collected, and depth of the center of the abscess cavity from the skin surface were recorded. Pus evacuation was then prime consideration either by needle aspiration or by incision and drainage. The amount of collection recorded on ultrasonography was compared with that drained at the time of surgery. Results: of 26 patients, 14 patients were diagnosed with cellulitis and the remaining 12 patients with abscesses in the maxillofacial region. Five of 12 cases of abscess were managed with ultrasound-guided needle aspiration; rest seven cases underwent the incision and drainage procedure. Clinical specificity (69.23%) was found to be poorer than ultrasound specificity (100 %), both clinical and ultrasound showed the same percentage of sensitivity (92.30%) Conclusions: from our experience we can conclude that ultrasonography is an inexpensive and non-invasive diagnostic technique that should be used to supplement clinical examination in patients with superficial fascial space infection.
  5 4,977 336
Concomitant occurrence of cemento-ossifying fibroma and adenomatoid odontogenic tumor with bilateral impacted permanent canines in the mandible
A Ravi Prakash, P Sreenivas Reddy, Rajanikanth , Radhika M Bavle
May-June 2012, 23(3):434-435
DOI:10.4103/0970-9290.102255  PMID:23059596
Adenomatoid odontogenic tumor (AOT) is an uncommon, benign and slow growing odontogenic tumor, which is usually located in an anterior region of the maxilla without pain. Cemento-ossifying fibroma (COF) is a relatively rare benign tumor of the jaw. Here we present 2 lesions presenting in unusual forms, follicular variant of AOT in the mandible and COF associated with impacted canine in the mandible, occurring concomitantly in the same patient. Both lesions presented classic histopathologic features.
  4 8,103 217
Aggressive fibromatosis of the oral cavity
Santhosh Rao, BS Dinesh
May-June 2012, 23(3):435-435
DOI:10.4103/0970-9290.102256  PMID:23059597
Fibromatosis are proliferations of highly differentiated fibrous tissue. The deep or musculoaponeurotic types of fibromatosis are known as desmoid tumors, aggressive fibromatosis, or desmoid-type fibrosarcoma. It is commonly seen as abdominal tumors; the occurrence of these tumors in maxillofacial region is a rare entity. We report a case of aggressive fibromatosis in a 50-year-old female, who presented with a swelling of the left side of the face. The tumor was extending in to the maxillary antrum which was confirmed as aggressive fibromatosis on histopathological examination. The detailed discussion of etiology, incidence, management and prognosis of the same in corelation with the literature is presented in the article.
  4 3,199 224
Influence of ultrasound and diamond burs treatments on microtensile bond strength
Alexandre Conde, Vivian Mainieri, Eduardo Gonçalves Mota, Hugo Mitsuo Oshima
May-June 2012, 23(3):373-377
DOI:10.4103/0970-9290.102232  PMID:23059576
Objective: To compare surface treatments with CVDentUS ® ultrasound tips (UT) and KGSorensen ® diamond burs (DB) on etched (e) and non-etched (n/e) dentin. The microtensile bond strength (μTBS) was measured and fractography was assessed by scanning electron microscope (SEM). Materials and Methods: Sixteen molars were divided into four groups of four teeth each according to treatment (DB-n/e; DB-e; UT-n/e; UT-e). The teeth were restored, sectioned into samples for μTBS (n=40) and tested on a EMIC DL-2000 universal machine (0.5 mm/min) and analyzed by SEM for fracture classification. Statistical Analysis: For analysis of the data on μTBS, the two-way ANOVA, using treatment and acid etching as fixed factor, and the Tukey test were used (α=0.05). To failures classification in cohesive in dentin (CD); cohesive in composite resin (CC); cohesive interfacial on base or top of hybrid layer (CBT); cohesive in adhesive (CA); mixed (M); interfacial on smear layer (S) the Fisher's exact test (α=0.05) was performed. Results: The mean values of μTBS (in MPa) in the different groups were as follows: UT-e: 45.31±8.16; DB-e: 34.04±9.29; UT-n/e: 15.17±3.71; and DB-n/e: 9.86±3.80. On analysis of the SEM micrographs, the DB-n/e group showed total obstruction of dentinal tubules; the UT-n/e group showed partial desobstruction of dentinal tubules and irregular surface; the DB-e group showed complete desobstruction of dentinal tubules; and the UT-e group showed complete desobstruction of dentinal tubules and irregular surface. Conclusion: The combination of ultrasound treatment and acid etching provides high values of μTBS. An association exists between CA/CC failures and the UT method, CBT failure and the DB method, CBT/CC failures and etching, S failure and non-etching.
  4 3,278 98
Potluri Venkatalakshmi Aparna, Ravi David Austin, Philips Mathew
May-June 2012, 23(3):426-427
DOI:10.4103/0970-9290.102246  PMID:23059587
"PICA" means perverted appetite for substances not fit as food or of no nutritional value such as, bricks, clay, soil, ice, laundry starch, etc. The word ''PICA'' is derived from Latin word for Magpie, a species of bird that feeds on whatever it encounters. ''PICA'' has been observed in ethnic groups worldwide in primitive and modern cultures, in both sexes and in all age groups. The case presented here reports a 30 year old female patient who had craving for ingestion of gravel and brick fragments since the age of 13 years. Iron deficiency anemia was found after complete blood count and iron studies. The diagnosis of "PICA" requires that the patient is persistently eating non-food substances for at least 1 month and such behavior is appropriate for the child's stage of development.
  4 3,794 166
Early eruption of permanent canines
S Madhu
May-June 2012, 23(3):428-430
DOI:10.4103/0970-9290.102247  PMID:23059588
Systemic and local factors can modify the eruption time of teeth. Generalized eruption time changes could be due to some systemic diseases like hyperthyroidism, hypophosphatasia, precocious puberty, Proteus syndrome, etc. Localized early eruption of permanent teeth could be due to early extraction of deciduous teeth. Presented here is an extremely rare case of early eruption of permanent canines in a 7-year old female child. Though the number of such cases is very limited, the clinician should poses adequate knowledge and keeps an open eye to identify such cases.
  4 7,562 206
An in vivo comparative evaluation to determine the accuracy of working length between radiographic and electronic apex locators
S Vijay Singh, Vineeta Nikhil, Aruna Vijay Singh, Suman Yadav
May-June 2012, 23(3):359-362
DOI:10.4103/0970-9290.102226  PMID:23059573
Background: An in vivo comparative evaluation to determine the accuracy of working length between radiographic and electronic apex locators. Aim: The study was aimed at evaluating the accuracy of electronic apex locator, to determine the working length of root canal, and to compare it with the radiographic method of working length determination. Materials and Methods: A total of 20 teeth selected for the study had to go for extraction because of periodontal or orthodontic reasons. Access cavity was prepared and the clinical estimated working length (CEWL) was determined with 10-25 no. K-file. A radiograph was then taken for determining the radiographic estimated working length (REWL). For electronic measurement of root canal, a 10 no. K-file was advanced toward the apex until it reached a 0.5 mm short of apex as shown by the apex locator. After fixing the file with a light cured composite, the tooth was extracted, the tooth surface was then longitudinally grounded using straight fissure diamond bur until the root canal and the tip of the file were visible. The distance of file from the minor constriction was measured with help of stereomicroscope. Statistical analysis : The chi-square test was used for statistical analysis for this study. Results: The chi-square test where χ2 = 21.034 with P = 0.000 indicated that a significant difference exists among the groups. The electronic method showed highest number of cases with the working length at the minor constrictor. Conclusion: The electronic method for determining the working length of root canal was found to be more accurate than the radiographic method.
  3 3,922 219
In vitro color stability of provisional restorative materials
Hamid Jalali, Hassan Dorriz, Farzaneh Hoseinkhezri, SF Emadian Razavi
May-June 2012, 23(3):388-392
DOI:10.4103/0970-9290.102238  PMID:23059579
Background: Discoloration of provisional restorations can result in esthetic problems which are critically important in, for example, anterior areas and may compromise the acceptability of the restoration. Aims: The purpose of this study was to investigate the effect of tea on provisional restorative materials. Setting and Design: This study was designed to measure the degree of color change of three acrylic resin provisional materials, before and after immersion in artificial saliva and artificial saliva-tea solution for 2 and 4 weeks. Materials and Methods : Three types of acrylic provisional materials (duralay, tempron, acropars TRP), were studied. Twenty disks (20±0.1 mm by 2±0.05 mm) were fabricated from each material. Specimens were polished with acrylic bur using pumice and diamond polishing paste. Base line color was measured using a spectrophotometer. Ten disks were stored in artificial saliva and 10 were stored in a solution of artificial saliva and tea at room temperature. Color measurements were made after 2 and 4 weeks of immersion. Statistical analysis used: Differences in color changes were compared by two way ANOVA, across the six groups, followed by a Turkey-Kramer's multiple comparison test. Results: For specimens immersed in artificial saliva, the color change of methyl methacrylate materials; duralay (ΔE=4.94) and tempron (ΔE=6.54), was significantly more than butyl methacrylate material; acropars (ΔE=4.10). After immersion in an artificial saliva- tea solution, tempron exhibited less color change (ΔE=8.50) compared to duralay (ΔE=10.93) and acropars (ΔE=15.64). Conclusion: Color stability of methyl methacrylate is higher than butyl methacrylates so if provisional materials are used for extended periods of time; tempron is preferred.
  3 4,419 276
Ultrasound-guided needle aspiration of parotid abscess
André Takahashi, Marcelo Zillo Martini, Juliana Seo, Humberto Gomes de Oliveira Neto, Elio Hitoshi Shinohara
May-June 2012, 23(3):423-425
DOI:10.4103/0970-9290.102245  PMID:23059586
Ultrasound (US) has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.
  3 10,176 112
Retention of fiber posts in different dentin regions: An in vitro study
Padmanabh Jha, Mesha Jha
May-June 2012, 23(3):337-340
DOI:10.4103/0970-9290.102219  PMID:23059569
Aim: The aim of this study was to evaluate the influence of different regions of dentin within the post space on the retention of fiber posts. Materials and Methods: Ten human incisors with straight roots were selected for this study. Endodontic treatment of the specimens was done. The post spaces were created immediately after obturation and the posts were luted with dual-cure resin cement. Approximately 2.5-mm-thick sections were made from the coronal, middle, and apical thirds of the post space and thus we had three groups: Group I: Cervical, Group II: Middle, Group III: Apical. The specimens were tested on a universal testing machine. Statistical analysis was done using the unpaired Student's t-test and one-way ANOVA test. Result: The best push-out strength was obtained with the apical sections (14.69±0.298 MPa), followed by the middle (10.66±0.34 MPa) and cervical sections (9.73±0.42 MPa). Conclusion: highest pust out strengths were obtained in apical sections followed by middle and coronal.
  2 3,000 141
The effect of remelting various combinations of new and used cobalt-chromium alloy on the mechanical properties and microstructure of the alloy
Sharad Gupta, Aruna S Mehta
May-June 2012, 23(3):341-347
DOI:10.4103/0970-9290.102220  PMID:23059570
Context: Remelting previously cast base metal alloy can adversely affect the mechanical properties of the alloy and necessitates addition of new alloy. Aims: To study the effect of remelting different combinations of new and used cobalt-chromium (Co-Cr) alloy on its mechanical properties and microstructure. Materials and Methods: Using induction casting, 24 tensile test specimens were prepared for eight different combinations of new and used Co-Cr alloy. The test specimens were assessed for yield strength and percentage elongation. Microhardness was evaluated using Vickers's hardness tester. The tensile testing was carried out on a 50 kN servo-hydraulic universal testing machine. Microstructure analysis was done using an optical photomicroscope on the fractured samples after acid etching. Statistical Analysis: The mean values (±standard deviation) and coefficient of variation were calculated. Student's 't' test was used for statistical analysis. Statistical significance was assumed at P=.05. Results: The mean yield strength of eight different combination groups were as follows: group A: 849 MPa, group B 1 : 834 MPa, group B 2 : 915 MPa, group B 3 : 897 MPa, group C 1 : 874 MPa, group C 2 : 859 MPa, group D 1 : 845 MPa, and group D 2 : 834 MPa. The mean percentage elongation for the different groups were as follows: group A: 7%, group B 1 : 7%, group B 2 : 8%, group B 3 : 7%, group C 1 : 8%, group C 2 : 7%, group D 1 : 7%, and group D 2 : 8%. The mean hardness values were as follows: group A: 373 VHN, group B 1 : 373 VHN, group B 2 : 346 VHN, group B 3 : 346 VHN, group C 1 : 364 VHN, group C 2 : 343 VHN, group D 1 : 376 VHN, and group D 2 : 373 VHN. Conclusion: Repeated remelting of base metal alloy for dental casting without addition of new alloy can affect the mechanical properties of the alloy. Microstructure analysis shows deterioration upon remelting. However, the addition of 25% and 50% (by weight) of new alloy to the remelted alloy can bring about improvement both in mechanical properties and in microstructure.
  2 2,813 92
Intraoral framework pick-up technique to improve fit of a metal-resin implant prosthesis
Mirza Rustum Baig, Rajan Gunaseelan
May-June 2012, 23(3):435-436
DOI:10.4103/0970-9290.102257  PMID:23059598
The achievement of passive fit is an important prerequisite for the prevention of complications in full-arch screw-retained implant prosthesis. With cemented prosthesis, the cementation compensates for the discrepancies in the cast framework, but the lack of retrievability seems undesirable. The aim of this paper is to propose a modified screw-retained prosthesis design for complete arch implant fixed rehabilitation. A technique for the fabrication of a full-arch metal-resin implant-supported screw-retained prosthesis is described. Cementation of the framework to the abutments intraorally improves the passivity of fit of the prosthesis on the implants. Maintenance of screw-access channels in the final prosthesis ensures retrievability. The metal-resin design allows for easy repair and maintenance. The prosthesis is cost-effective compared to conventional options and can be employed as a viable treatment alternative when considering metal-acrylic resin complete arch fixed prosthesis.
  2 4,649 131
Cysticercosis of the masseter
Prabhath Ramakrishnan, Shraddha Bahirwani, P Balaji
May-June 2012, 23(3):436-436
DOI:10.4103/0970-9290.102258  PMID:23059599
Cysticercosis of the oral cavity is a very rare soft tissue lesion and very few cases have been reported worldwide. Here we report a case of a cysticercous cellulosae within the masseter muscle which was diagnosed with the help of high resolution ultrasonography (USG) and ultrasound guided fine needle aspiration cytology (FNAC) and managed conservatively using oral antiparasitic medication. Cysticercosis is not commonly considered in the diagnosis of swellings of the head and neck and this is the reason why they are of utmost interest to the practitioner and have to be studied.
  2 4,334 230
Using a portable sulfide monitor as a motivational tool: A clinical study
Ranjit Singh Uppal, Ranjan Malhotra, Vishakha Grover, Deepak Grover
May-June 2012, 23(3):326-330
DOI:10.4103/0970-9290.102216  PMID:23059567
Aims and Objectives: Bad breath has a significant impact on daily life of those who suffer from it. Oral malodor may rank only behind dental caries and periodontal disease as the cause of patient's visit to dentist. An aim of this study was to use a portable sulfide monitor as a motivational tool for encouraging the patients towards the better oral hygiene by correlating the plaque scores with sulfide monitor scores, and comparing the sulfide monitor scores before and after complete prophylaxis and 3 months after patient motivation. Materials and Methods : 30 patients with chronic periodontitis, having chief complaint of oral malodor participated in this study. At first visit, the plaque scores (P1) and sulfide monitor scores before (BCR1) and after complete oral prophylaxis (BCR2) were taken. Then the patients were motivated towards the better oral hygiene. After 3 months, plaque scores (P2) and sulfide monitor scores (BCR3) were recorded again. Statistical Analysis: It was done using SPSS (student package software for statistical analysis). Paired sample test was performed. Results: Statistically significant reduction in sulfide monitor scores was reported after the complete oral prophylaxis and 3 months after patient motivation. Plaque scores were significantly reduced after a period of 3 months. Plaque scores and breathchecker scores were positively correlated. Conclusion : An intensity of the oral malodor was positively correlated with the plaque scores. The portable sulfide monitor was efficacious in motivating the patients towards the better oral hygiene.
  1 2,507 142
Determination of craniofacial relation among the subethnic Indian population: A modified approach - (Sagittal relation)
A Sumathi Felicita, Shyamala Chandrasekar, KK Shanthasundari
May-June 2012, 23(3):305-312
DOI:10.4103/0970-9290.102210  PMID:23059564
Aim : To measure the linear cephalometric dimensions of anterior and posterior segments of the craniofacial complex sagittally, to establish ratios between different linear dimensions of sagittal segments and check for dimensional balance among the various segments in subjects with normal occlusion, pleasing profile and facial harmony. Setting and Sample Population : Department of Orthodontics, Saveetha University. Lateral cephalograms of 120 subjects of both sexes in the age group of 17-28 years with normal occlusion belonging to Chennai, India Materials and Methods : Linear dimensions of anterior and posterior segments of the craniofacial complex were measured sagittally with the posterior maxillary plane as a key reference plane. Ratios were established between the various parameters in the anterior and posterior region. Results : A ratio of 1:1 was found to exist between the individual and aggregate sagittal segments of the craniofacial complex in both sexes. There was a statistically significant sexual dimorphism in the aggregate lengths(P=0.028,P=0.005).However, the ratio between the anterior cranial floor and effective maxillary length was 2:3 and 5:8 and that between anterior cranial floor to effective mandibular length was 5:8 and 3:5 in females and males respectively. The difference in the above values was not statistically significant. Conclusion : A dimensional balance was found to exist between the maxilla and mandible both at the dentoalveolar and skeletal level with a ratio of 1:1. There was also a dimensional balance between the posterior cranial floor and ramus width. However, there was no architectural balance between the anterior cranial floor and maxilla and mandible.
  1 3,482 256
Sublingual drug dispensing prosthesis
Dhanraj Ganapthy, Padma Ariga, Anand Selvaraj
May-June 2012, 23(3):434-434
DOI:10.4103/0970-9290.102254  PMID:23059595
Sublingual mode of drug administration is one of the fastest and predictable methods of drug delivery to the patient. Some patients, due to the pathological or psychological reasons, experience considerable difficulty in retaining the sub-lingual tablets. Therefore, often they either swallow or chew the sublingual tablets, thus reducing the efficacy of the medicines. Sublingual drug dispensing prosthesis is a special type of appliance that helps such patients to house the sublingual tablets in special slots in an intra-oral appliance, and thus enhances proposed drug delivery and improves the patient's health.
  - 3,021 126
"Liver clot"-A rare periodontal postsurgical complication
Dhara Pandya, Balaji Manohar, LK Mathur, Rajesh Shankarapillai
May-June 2012, 23(3):419-422
DOI:10.4103/0970-9290.102244  PMID:23059585
Bleeding is a common sequela of oral and periodontal surgery. Generally, bleeding is self-limiting. Following traumatic injury or surgical procedures, hemorrhage can range from a minor leakage or oozing at the site, to extensive bleeding leading to complete exsanguinations. Significant postsurgical hemorrhage following periodontal surgery is uncommon due to the primary closure of the soft tissues. This case report describes the unique formation of a "liver clot" or "currant jelly clot" following periodontal flap surgery. The likelihood of this may be attributed to many factors, like infection, intrinsic trauma, presence of foreign bodies like splinter of bone, a fleck of enamel, or a piece of dental restorative dressing material that may cause repeated, delayed organization of blood coagulum.
  - 87,191 499
Neutral zone and oral submucous fibrosis
Shaista Afroz, Sajjad Abdur Rahman, Indresh Rajawat, AK Verma
May-June 2012, 23(3):407-410
DOI:10.4103/0970-9290.102241  PMID:23059582
Oral submucous fibrosis is a premalignant condition in which rigidity of the lip, tongue, and palate results in reduced mouth opening and tongue movement. Limited mouth opening, mucosal rigidity, and reduced salivary flow makes prosthodontic procedures difficult in these patients and affects the stability, retention, and the support of removable prostheses. The burning sensation in the mouth that these patients experience reduces the tolerance to prostheses. We report a case of oral submucous fibrosis where the conventional neutral zone technique with certain modifications was utilized to rehabilitate a completely edentulous patient with this condition.
  - 4,837 439
Down's syndrome patient with multiple sialoliths in Stenson's duct
Jayant Palaskar, Sangeeta Palaskar, Nikhil Joshi
May-June 2012, 23(3):411-414
DOI:10.4103/0970-9290.102242  PMID:23059583
The presence of multiple sialoliths (calculi) in parotid duct is considered extremely rare. Parotid duct sialoliths are usually small and single. Multiple calculi formation, in any case, is an uncommon finding in the salivary glands. Salivary lithiasis is comparatively common in the Wharton's duct due to its tortuous ascending course and chemical composition of saliva of submandibular gland. The mechanism of sialolith formation in Down's syndrome patients is not completely known, and there are seldom cases reported in the literature available. The present case report is a very rare combination of a Down's syndrome with multiple sialoliths in Stenson's duct of left parotid gland in a 21year old male patient.
  - 2,934 130

May-June 2012, 23(3):430-430
  - 782 62
Recurrent chronic suppurative osteomyelitis of the mandible and human immunodeficiency virus infection
Syed Ahmed Zaki, Syed Ahmed Taqi, Angadi Rajasab Nilofer, Lateef Begum Sami, Syed Abdus Sami
May-June 2012, 23(3):431-431
DOI:10.4103/0970-9290.102249  PMID:23059590
  - 1,519 62
How many times the teeth must be brushed daily? Is it the same for all or not?
Ali M Tavana
May-June 2012, 23(3):431-432
DOI:10.4103/0970-9290.102250  PMID:23059591
  - 1,465 129
Bisphosphonate-associated osteonecrosis of the jaws
Rajiv S Desai, Subraj J Shetty
May-June 2012, 23(3):432-432
DOI:10.4103/0970-9290.102251  PMID:23059592
  - 1,591 90
25 years of Indian dental research and future directions
SM Balaji
May-June 2012, 23(3):299-300
DOI:10.4103/0970-9290.102208  PMID:23059562
  - 2,045 152
Effect of different curing temperatures on the distortion at the posterior peripheral seal: An in vitro study
Nirmala Pasam, RB Hallikerimath, Aman Arora, Shilpi Gilra
May-June 2012, 23(3):301-304
DOI:10.4103/0970-9290.102209  PMID:23059563
Context: Most of the maxillary complete dentures do not adapt accurately to the cast because of the changes in the resin during polymerization. The amount of heat associated with processing of polymethyl methacrylate has been correlated with the adaptation of the processed denture base to its supporting tissues. Aims: This study conducted to determine the effect of different curing temperatures on the accuracy of fit of a complete maxillary denture and to compare with that of fiber-reinforced acrylic resins. Materials and Methods : An ideal maxillary rubber mould used to make an edentulous cast. Forty-eight stone casts made from the ideal rubber mould. Out of 48 identical stone casts, 44 stone casts with wax adapted processed using simple acrylic resin. The remaining four stone casts were processed using fiber-reinforced acrylic resin. However, processing time for 12 hrs was maintained constant for all the samples. The variable to investigate was the temperature. Therefore, four denture bases processed at each temperature from 60°C to 80°C with two-degree increments for a total of 44 samples using simple acrylic resin. Remaining four samples processed at 70°C using fiber-reinforced acrylic resin. A traveling microscope used to measure the discrepancy between each cast and its denture base. Statistical analysis used: Analyzed with Student's unpaired t test. Results : Minimum distortion was observed at 70°C. Maximum distortion was observed for the denture bases processed at 80°C. Amount of distortion increases as the processing temperature increases which was highly significant. Distortion was significantly high from 60 to 68°C in the decreasing order. Conclusion: This study verified the observation that maxillary complete denture base show the greatest discrepancy at the central portion of the posterior palatal seal region as the processing temperature increases.
  - 4,219 247
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