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   2014| May-June  | Volume 25 | Issue 3  
    Online since August 7, 2014

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Cytokine gene polymorphism (interleukin-1β +3954, Interleukin-6 [−597/−174] and tumor necrosis factor-α −308) in chronic periodontitis with and without type 2 diabetes mellitus
Nitin Sharma, Rosamma Joseph, R Arun, R Chandni, K Lekshmy Srinivas, Moinak Banerjee
May-June 2014, 25(3):375-380
DOI:10.4103/0970-9290.138343  PMID:25098998
Background: Pro-inflammatory cytokine gene polymorphisms are potential candidates for susceptibility for both type 2 diabetes mellitus (DM) and chronic periodontitis (CHP). This study explored the association of interleukin-1 beta (IL-1 β) +3954, interleukin-6 (IL-6) −597/−174 and tumor necrosis factor-alpha (TNF-α) −308 single nucleotide polymorphisms in CHP with and without type 2 DM in Malayalam speaking subjects of Dravidian ethnicity. Materials and Methods: This case control study consisted of 51 chronic periodontitis with type 2 diabetes mellitus (CHPDM) and 51 CHP patients as cases and 51 healthy subjects as controls. Polymorphisms were identified by polymerase chain reaction amplification followed by restriction enzyme digestion and gel electrophoresis. Results: IL-1 β (+3954) TT genotype and T allele were significantly associated with CHPDM group when compared with CHP (P = 0.001), whereas CC genotype and allele C was higher in CHP subjects (P = 0.001). For IL-6 (−597) frequency of genotype GA/AA (P = 0.04) and allele A (P = 0.01) was lower in CHPDM group, and for TNF-α −308 the frequency of genotype GA (P = 0.01) and allele A (P = 0.01) was higher in CHP subjects when compared with controls. Conclusions: In Malayalam speaking Dravidian population, IL-6 (−597) genotype GA/AA and allele A appears to be protective for CHP with type 2 DM. Allele C of IL-1 β +3954 and allele A of TNF-α −308 appears to be risk factors for CHP individuals.
  13 2,968 144
Osteoporosis and periodontitis: Is there a possible link?
Shivanand S Aspalli, V Sudhir Shetty, Prachi G Parab, G Nagappa, Archana Devnoorkar, MV Devarathnamma
May-June 2014, 25(3):316-320
DOI:10.4103/0970-9290.138327  PMID:25098987
Background: Periodontitis and osteoporosis are two diseases found worldwide having the main characteristic of increasing intensity with age. Periodontitis is associated with resorption of the alveolar bone. Osteoporosis is characterized by bone loss leading to structural bone transformation. The association between periodontitis and osteoporosis is continually being examined. The aim of this study is to examine the condition of periodontal tissues in patients suffering from osteoporosis and establish a possible link. Materials and Methods: Cross-sectional study with 200 samples having test (n = 100) and control group (n = 100) were checked for periodontal condition. A total of 100 patients diagnosed as having osteoporosis based on bone mineral density at distal end of radius were regarded as test group and 100 subjects included in control group were healthy. Periodontal parameters measured were plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL). Statistical test performed were Student's paired t-test and unpaired t-test and Pearson's correlation coefficient. Results: Probing depth and CAL were significantly negatively co-related with T-score in test group when compared with control group. This meant an inverse relationship in between the T-score and the clinical parameters, PD and CAL. Furthermore, some difference was noted in test group in PI, GI and PD, CAL and T-score when compared with the controls. Conclusion: Thus, we conclude that there is a definite relationship between osteoporosis and periodontitis based on PD and CAL.
  12 4,108 198
Evaluation of circulatory and salivary levels of heat shock protein 60 in periodontal health and disease
R Ramya Nethravathy, Swarna Alamelu, KV Arun, TSS Kumar
May-June 2014, 25(3):300-304
DOI:10.4103/0970-9290.138317  PMID:25098984
Background: Self-antigens such as heat shock protein 60 (HSP 60) have recently been implicated in the periodontal disease pathogenesis. There is scant evidence regarding HSP 60 levels in circulation and saliva following periodontal disease and its possible relation to systemic inflammation. Aim of the Study: The aim was to evaluate the circulatory and salivary levels of HSP 60 in periodontal health and disease and to correlate it with high sensitivity C-reactive protein (hs-CRP). Materials and Methods: Forty-five peripheral blood samples were collected from two groups of patients (periodontally healthy - Group A [22 patients] and periodontal disease - Group B [23 patients]). Serum, cell lysates, and saliva samples were used to detect HSP 60 levels in both groups by enzyme linked immunosorbent assay technique. Measurement of hs-CRP was performed using an immunoturbidimetric assay. Statistical analysis was done using the student t-test and Pearson's correlation. Results: Circulatory HSP 60 was significantly increased in periodontal disease compared to health (P - 0.038). There was a significant correlation between the totals circulating HSP 60 and hs-CRP (P - 0.052), but there was no significant correlation between the salivary HSP 60 and hs-CRP levels in periodontal disease. Conclusion: Circulating HSP 60 levels may play a role in the systemic inflammatory state produced by periodontal disease. Salivary HSP 60 may not be used as a surrogate to determine systemic inflammation.
  10 2,071 140
Expression of podoplanin in oral premalignant and malignant lesions and its potential as a biomarker
J Logeswari, N Malathi, H Thamizhchelvan, N Sangeetha, S Vijaya Nirmala
May-June 2014, 25(3):305-310
DOI:10.4103/0970-9290.138321  PMID:25098985
Aim: To analyze and compare the expression of podoplanin in normal oral tissues, leukoplakia and oral squamous cell carcinoma (OSCC) and to predict its use as a biomarker. Materials and Methods: Ninety-two formalin fixed paraffin embedded tissue samples comprising of 32 cases of leukoplakia, 50 cases of OSCCs and ten normal gingival samples. The samples were retrieved from archives and immunohistochemically analyzed using podoplanin. Appendix tissue samples were used for control purposes. The results were tabulated and statistically analyzed using ANOVA/Kruskal-Wallis test with post-hoc tests, where demographic details are compared and analyzed using Pearson Chi-square test. Results: The study results showed, absence of podoplanin expression in the epithelium of all the gingival samples (Group I). Positive podoplanin expression noticed in 19 out of 32 (59.4%) cases of leukoplakia (Group II) and 41 out of 50 (82%) cases of OSCCs (Group III). The expression of podoplanin among different groups was highly significant (P = 0.000). Conclusion: The podoplanin may be considered as a predictor marker in assessing malignant transformation of premalignancies and prognosis of oral malignancy. Indeed it is believed that podoplanin might play a role in tumor progression though exact mechanism is not fully elucidated. Further research is required to understand its exact pathophysiology.
  8 2,571 317
Sweet's syndrome
Piyush G Limdiwala, Shilpa J Parikh, Jigna S Shah
May-June 2014, 25(3):401-405
DOI:10.4103/0970-9290.138358  PMID:25099003
Acute febrile neutrophilic dermatosis or Sweet's syndrome (SS) is characterized by painful, erythematous plaques of rapid onset accompanied by fever. The etiology of SS is unknown and it may be associated with antecedent infections, malignancies, autoimmune diseases, drugs and vaccines, upper respiratory or gastrointestinal infection, pregnancy, inflammatory bowel disease as well as chemotherapy or idiopathic. The standard therapy for SS is systemic corticosteroids. We report a rare case of 19-year-old young male patient with complaint of severe ill-defined type of pain in both jaws associated with plaques and papules on extensor surfaces of upper and lower extremities with bodyache and myalgia. Histopathological examination suggested perivascular neutrophilic infiltration with scattered eosinophils. Sweet syndrome has rare oral manifestations secondary to hematological changes. It can also present as a paraneoplastic syndrome (malignancy-associated form of condition, which is most commonly related to acute myelogenous leukemia), which leads to poor prognosis and thus it requires careful examination, early diagnosis and long-term follow-up.
  6 4,704 198
Cleaning and decompression of inferior alveolar canal to treat dysesthesia and paresthesia following endodontic treatment of a third molar
Rudy Scala, Alessandro Cucchi, Luca Cappellina, Paolo Ghensi
May-June 2014, 25(3):413-415
DOI:10.4103/0970-9290.138362  PMID:25099006
Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN). We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day.
  5 3,034 92
Facial talon cusp on mandibular incisor: A rare case report with review of literature
Suresh K Sachdeva, Pradhuman Verma, Sanjay Dutta, Kanika Gupta Verma
May-June 2014, 25(3):398-400
DOI:10.4103/0970-9290.138355  PMID:25099002
Talon cusp is a relatively rare developmental dental anomaly thought to arise as a result of evagination on the surface of a tooth crown before calcification has occurred. It is characterized by cusp-like projections from the cingulum area, or cemento-enamel junction of maxillary or mandibular anterior teeth, in both the primary and permanent dentition, usually observed on the lingual surface of the affected tooth. The cusp may or may not contain an extension of the pulp. The etiology remains unknown. The incidence is 0.04-8%. Any tooth may have a talon cusp but most of the cases involve maxillary lateral incisors. The anomaly has been reported to be rare especially when it occurs on mandibular teeth. This article reports a case of talon cusp on permanent mandibular central incisor that too on facial aspect which makes it a rare entity
  4 2,090 168
Stress analysis of two methods of ceramic inlay preparation by finite element
Leila Pishevar, Maryam Ghavam, Ahmadreza Pishevar
May-June 2014, 25(3):364-369
DOI:10.4103/0970-9290.138339  PMID:25098996
Objective: Ceramic inlays are bonded to tooth structure with resin cements. During the resin cement setting, shrinkage stress develops at the interfaces. During tooth preparation, the undercut areas formed due to the different patterns of caries progression can either be blocked out before taking impression with suitable cement such as glass ionomer cement, or before making the final restoration in the laboratory. Then, the relieved space will be filled with luting cement in clinic. The aim of this study was to compare these two methods of undercut filling in term of stress distribution in the ceramic inlay. Materials and Methods: An axisymmetric finite element analysis was performed to study the stress distribution during inlay cementing. The solid model was generated from a longitudinal section of maxillary premolar in which a class I cavity with 60 degree undercut at the preparation wall and 20 degree divergence of the vertical walls was prepared. A thermal model was used to simulate the polymerization shrinkage of the resin cement. Finite element analysis was carried out in ANSYS environment. Results: Filling the undercut by glass ionomer cement decreased the stress concentration at the ceramic/cement interface. The dominant normal stress at the tooth cement interface in absence of glass ionomer cement was tensile with maximum of 30 Mpa. Using glass ionomer, cement developed stresses with different compressive and tensile signs. With increasing the thickness of resin cement (100 µm, 150 µm, 200 µm), the stress increased. Conclusion: Cements with minimum shrinkage and as thin layer as possible should be used. Filling the undercut with glass ionomer cement decreases the stress. Other experimental and clinical studies must follow this research.
  4 2,509 81
Comparison of the apple vinegar with other chelating solutions on smear layer and calcium ions removal from the root canal
AL Kirchhoff, R Viapiana, CES Miranda, MD Sousa Neto, AM Cruz Filho
May-June 2014, 25(3):370-374
DOI:10.4103/0970-9290.138341  PMID:25098997
Background: The action of endodontic instruments during biomechanical preparation results in smear layer formation. Removing the smear layer enhances disinfection into dentinal tubules in addition to allowing tridimensional sealing of the root canal system. Aim: This study was designed to evaluate the smear layer removal and quantify the calcium ion release resulting from final irrigation with different chelating solutions. Materials and Methods: Fifty human canines were instrumented and the final irrigation was performed with apple vinegar, 5% malic acid, 5% acetic acid, 17% ethylenediamine tetra-acetic acid (EDTA), and distilled water (control), which were collected and analyzed by atomic absorption spectrometry to quantify the concentration of calcium ions released. Smear layer removal was assessed in the cervical, middle, and apical thirds by SEM. Results: There was statistically significant difference (P < 0.001) between 17% EDTA and the other solutions with regard to smear layer removal. Apple vinegar, 5% malic acid, and 5% acetic acid promoted similar root canal cleaning. There was no statistical difference among the root canal thirds. The highest concentrations of calcium ions were obtained with 17% EDTA (P<0.001) followed by malic acid, apple vinegar, and acetic acid. Apple vinegar and acetic acid removed the smallest quantity of calcium ions. Conclusion: It was concluded that 17% EDTA enabled greater smear layer removal and promoted release of the highest concentrations of calcium ions than the other solutions tested.
  4 3,670 216
Assessment of serum interleukin-8 as a sensitive serological marker in monitoring the therapeutic effect of levamisole in recurrent aphthous ulcers: A randomized control study
Prashant Gupta, L Ashok, Shantala R Naik
May-June 2014, 25(3):284-289
DOI:10.4103/0970-9290.138293  PMID:25098981
Aim: The study was designed to evaluate the serum interleukin-8 (IL-8) levels in patients with recurrent aphthous ulcer (RAU) and monitor the immunomodulation and altered IL-8 levels by levamisole before therapy and after levamisole therapy. Materials and Methods: This study was carried as a randomized case-control study involving a study group of 30 patients diagnosed as RAUs and given levamisole (vermisole 150 mg, od for 1 st 3 days of 3 weeks in a month and for 3 months with a gap of 1 week) and these patients were recalled after 3 months and were subjected for estimation of serum IL-8 levels. Control group had 20 age and sex matched individuals with no systemic illness and were not given any levamisole. Good compliance was reported at the end of the study. Results: Mild gastric irritation was reported and when severe it was managed by H1 blocker. Patients were reviewed after 3 months. The follow-up data at each visit with respect to each other and to base-line values was calibrated using a Students t-test. Highly significant comparisons were obtained in the serum IL-8 between study and control groups before the onset of levamisole (t = 6.53, P ≤ 0.001). IL-8 levels reduced by 72% after levamisole was instituted in RAU patients and comparison was highly significant for before and after levamisole onset (t = 5.54, P ≤ 0.001). Conclusion: This study points to the effectiveness of levamisole as an effective adjunct therapy in the routine management of RAU.
  4 2,478 184
Evaluation of the effect of different methods of microabrasion and polishing on surface roughness of dental enamel
Carlos Bertoldo, Debora Lima, Larissa Fragoso, Glaucia Ambrosano, Flavio Aguiar, Jose Lovadino
May-June 2014, 25(3):290-293
DOI:10.4103/0970-9290.138308  PMID:25098982
Description of the Technique: The microabrasion technique of enamel consists of selectively abrading the discolored areas or causing superficial structural changes in a selective way. Objective: In microabrasion technique, abrasive products associated with acids are used, and the evaluation of enamel roughness after this treatment, as well as surface polishing, is necessary. This in-vitro study evaluated the enamel roughness after microabrasion, followed by different polishing techniques. Settings and Design: Roughness analyses were performed before microabrasion (L1), after microabrasion (L2), and after polishing (L3).Thus, 60 bovine incisive teeth divided into two groups were selected (n=30): G1- 37% phosphoric acid (37%) (Dentsply) and pumice; G2- hydrochloric acid (6.6%) associated with silicon carbide (Opalustre - Ultradent). Thereafter, the groups were divided into three sub-groups (n=10), according to the system of polishing: A - Fine and superfine granulation aluminum oxide discs (SofLex 3M); B - Diamond Paste (FGM) associated with felt discs (FGM); C - Silicone tips (Enhance - Dentsply). A PROC MIXED procedure was applied after data exploratory analysis, as well as the Tukey-Kramer test (5%). Results: No statistical differences were found between G1 and G2 groups. L2 differed statistically from L1 and showed superior amounts of roughness. Differences in the amounts of post-polishing roughness for specific groups (1A, 2B, and 1C) arose, which demonstrated less roughness in L3 and differed statistically from L2 in the polishing system. Conclusion: All products increased enamel roughness, and the effectiveness of the polishing systems was dependent upon the abrasive used.
  4 4,989 189
Assessment of coronal leakage of a new temporary light-curing filling material in endodontically treated teeth
Aurilene S Cardoso, Nélida CS Silva, Juliana M Silva, Daniel R Herrera, Aline A Neves, Emmanuel João Nogueira Leal Silva
May-June 2014, 25(3):321-324
DOI:10.4103/0970-9290.138329  PMID:25098988
Introduction: The aim of this study was to evaluate the sealing ability of a new temporary filling material X-Temp LC (DFL, São Paulo, SP, Brazil) compared with that obtained for Coltosol (Vigodent, Rio de Janeiro, RJ, Brazil) and Vitro Fill (DFL, Rio de Janeiro, RJ, Brazil), using a dye penetration test. Methods: Standard endodontic access cavities were prepared in 75 human premolars. The teeth were divided into five groups (n = 15 for each group), including a positive (no sealing of access cavity) and a negative control (Filtek Z350 XT, 3M, São Paulo, SP, Brazil). In the experimental groups, the access cavities were sealed with one of the three tested materials. After that, the teeth were immersed in 10% Indian ink for 14 days. The teeth were then rinsed, dried, sectioned in bucco-lingual direction and evaluated under a stereomicroscope using scores for dye penetration. Data were analyzed using Kruskall-Wallis and Student-Newman-Keuls tests (α =0.05). Results: Positive control sections exhibited complete dye penetration and negative control had no specimen showing marginal leakage. X-Temp LC and Coltosol showed similar results, with no statistical difference between them. Vitro Fill exhibited the highest dye penetration among the experimental groups. Conclusion: The results of this in vitro study suggest that all temporary restorative materials exhibit some degree of marginal leakage. X-Temp LC and Coltosol, however seal better than Vitro Fill glass ionomer cement.
  4 2,951 149
A preliminary study to find out maximum occlusal bite force in Indian individuals
Veena Jain, Vijay Prakash Mathur, Rajath Sasidharan Pillai, Sandeep Kalra
May-June 2014, 25(3):325-330
DOI:10.4103/0970-9290.138330  PMID:25098989
Purpose: This preliminary hospital based study was designed to measure the mean maximum bite force (MMBF) in healthy Indian individuals. An attempt was made to correlate MMBF with body mass index (BMI) and some of the anthropometric features. Methodology: A total of 358 healthy subjects in the age range of 18-47 years (mean age = 26.66 ± 6.83) were selected following the selection criteria. Demographic details along with general physical and facial parameters such as height, weight, facial form, facial profile, arch form, and palatal contour were recorded in a predesigned proforma. The maximum bite force was recorded on both (right and left) sides using a specially designed piezoelectric transducer based device. Results: The MMBF in Indian individuals was found to be 372.39 ± 175.93 Newton (N). Males had significantly higher (P = 0.000) MMBF (448.47 ± 191.82 N) as compared to females (296.31 ± 116.79 N). Facial form (P = 0.001) and palatal contour (P = 0.000) showed a significant relationship with MMBF. Subjects having square facial form (421.34 ± 187.32 N) showed significantly higher MMBF as compared to other facial forms, that is, square tapered (358.86 ± 143.56 N; P = 0.038), ovoid (338.40 ± 163.02 N; P = 0.000) and tapered (349.22 ± 184.82 N; P = 0.028). Subjects with flat palatal contour showed significantly higher MMBF when compared to high (P = 0.002) and medium palatal (P = 0.002) contour. Though facial profile was not significantly related to MMBF, it was significantly higher in subjects having concave facial profile when compared to convex (P = 0.045) and straight (P = 0.039) facial profile. BMI and arch form showed no significant relationship with MMBF. Conclusion: The MMBF is found to be affected by gender and some of the anthropometric features like facial form and palatal contour.
  4 3,267 279
Determination of the biometric characteristics of palatine rugae patterns in Uttar Pradesh population: A cross-sectional study
Harjeet Kaur Sekhon, Keya Sircar, Sanjeet Singh, Deepti Jawa, Priyanka Sharma
May-June 2014, 25(3):331-335
DOI:10.4103/0970-9290.138331  PMID:25098990
Background: Identification is the establishment of identity of an individual. The basis of dental identification is based on the observation that no two individuals can have same dentition. Palatal rugae are irregular, asymmetric ridges of the mucous membrane extending laterally from the incisive papilla and the anterior part of the palatal raphe. The location of palatal rugae inside the oral cavity confers them with stability even when exposed to high temperatures or trauma. Their resistance to trauma and their apparent unique appearance has suggested their use as a tool for forensic identification. Aims: To record the biometric characteristics of shape, size, direction, number and position of palatal rugae and analyze whether palatal rugoscopy can be used as a tool for personal identification and for sex determination. Settings and Design: A cross-sectional study. Materials and Methods: The sample consisted of 100 subjects (50 males, 50 females) between 18 and 25 years. Maxillary impressions were made with elastomeric impression material and dental stone was used to make models. The palatal rugae patterns were traced and analyzed with a magnifying hand lens. The biometric characteristics of number, size, shape, and direction were analyzed using Thomaz and Kotz classification (1983). The casts were coded to blind the examiners about the identity of the subjects. Statistical Analysis Used: Unpaired t-test and one-way ANOVA using SPSS 19.0 statistical program for Windows. Results: The average number of rugae was slightly more in females. Wavy (44.9%) and curved (41.8%) shapes were more prevalent. Maximum number of rugae was found in E quadrant (40.73%). The average size was 9.221 mm. Most rugae were forwardly directed in both groups. Conclusion: This study concluded that rugae pattern are highly individualistic and can be used as a supplementary method for personal identification and sex determination. Further inter-observer and intra-observer variability were not found to be significant, which further validates the use of rugoscopy as a forensic tool.
  4 3,124 258
The application of finite element analysis in the skull biomechanics and dentistry
Felippe Bevilacqua Prado, Ana Cláudia Rossi, Alexandre Rodrigues Freire, Paulo Henrique Ferreira Caria
May-June 2014, 25(3):390-397
DOI:10.4103/0970-9290.138350  PMID:25099001
Empirical concepts describe the direction of the masticatory stress dissipation in the skull. The scientific evidence of the trajectories and the magnitude of stress dissipation can help in the diagnosis of the masticatory alterations and the planning of oral rehabilitation in the different areas of Dentistry. The Finite Element Analysis (FEA) is a tool that may reproduce complex structures with irregular geometries of natural and artificial tissues of the human body because it uses mathematical functions that enable the understanding of the craniofacial biomechanics. The aim of this study was to review the literature on the advantages and limitations of FEA in the skull biomechanics and Dentistry study. The keywords of the selected original research articles were: Finite element analysis, biomechanics, skull, Dentistry, teeth, and implant. The literature review was performed in the databases, PUBMED, MEDLINE and SCOPUS. The selected books and articles were between the years 1928 and 2010. The FEA is an assessment tool whose application in different areas of the Dentistry has gradually increased over the past 10 years, but its application in the analysis of the skull biomechanics is scarce. The main advantages of the FEA are the realistic mode of approach and the possibility of results being based on analysis of only one model. On the other hand, the main limitation of the FEA studies is the lack of anatomical details in the modeling phase of the craniofacial structures and the lack of information about the material properties.
  4 3,762 204
An ex vivo evaluation of the sealing ability of polydimethylsiloxane-based root canal sealers
Preeti Jain, Varun Pruthi, Vimal K Sikri
May-June 2014, 25(3):336-339
DOI:10.4103/0970-9290.138332  PMID:25098991
Aim: The aim was to study the sealing efficacy of polydimethylsiloxane-based root canal sealers. Materials and Methods: Polydimethylsiloxane-based root canal sealers were reviewed and subjected to an ex vivo study. A total of 60 extracted maxillary incisors were included in this study, which was conducted under two groups, Groups A and B, of 30 teeth each. In Group A, GuttaFlow and in Group B, RoekoSeal as sealers were used for obturation with Gutta-percha cones after preparing canal with a step back technique. The criterion for evaluating sealing efficacy of the sealers was light absorption by spectrophotometer. The collected data were analyzed statistically using one-way ANOVA test. Results: The findings of the study revealed that the mean leakage in Group B (0.1027) was significantly less than Group A (0.1649) (P < 0.001). RoekoSeal showed superior sealing ability. Conclusion: RoekoSeal had the better sealing ability than GuttaFlow and may be recommended for clinical use.
  3 2,429 169
Casting made simple using modified sprue design: An in vitro study
B Eswaran Baskaran, KR Geetha Prabhu, R Prabhu, G Phani Krishna, MA Eswaran, B Gajapathi
May-June 2014, 25(3):340-345
DOI:10.4103/0970-9290.138333  PMID:25098992
Background: Success in dental casting restorations for fixed partial dentures (FPDs) depends on the castability. Castability is described as the ability of an alloy to faithfully reproduce sharp detail and fine margins of a wax pattern. The goal of a prosthodontist is to provide the patient with restorations that fit precisely. Regardless of the alloy used for casting, the casting technique should yield a casted alloy, which should possess sufficient mass, surface hardness and minimal porosity after casting. Materials and Methods: Twenty patterns for casting were made from three-dimensional printed resin pattern simulating a 3 unit FPD and casted using modified sprue technique. Later test samples were cemented sequentially on stainless steel model using pressure indicating paste and evaluated for vertical marginal gap in eight predetermined reference areas. Marginal gap were measured in microns using Video Measuring System (VMS2010F-CIP Corporation, Korea). A portion of the axial wall of the cast abutments depicting premolar and molar were sectioned and embedded in acrylic resin and tested for micro hardness using Reichert Polyvar 2 Met Microhardness tester (Reichert, Austria) and porosity using Quantimet Image Analyzer (Quantimet Corporation London, England). Results: The results obtained for marginal gap, micro hardness, and porosity of all test samples were tabulated, descriptive statistics were calculated and the values were found to be within the clinically acceptable range. Conclusion: The new sprue technique can be an alternative and convenient method for casting which would minimize metal wasting and less time consuming. However, further studies with same technique on various parameters are to be conducted for its broad acceptance.
  2 3,796 244
Expression of maspin in benign and malignant salivary gland tumors: An immunohistochemical study
V Reshma, Kavita Rao, NS Priya, HS Umadevi, T Smitha, HS Sheethal
May-June 2014, 25(3):346-351
DOI:10.4103/0970-9290.138334  PMID:25098993
Context: Maspin is a novel serine protease inhibitor (serpin) with multifaceted tumor-suppressive activities. It was originally identified in normal human breast myoepithelial cells and shows variable expression in different types of cancer cells. Maspin displays anti-metastatic properties in mammary and prostate cancer. Its expression is maintained during ovarian, lung and pancreatic carcinogenesis, indicating that Maspin regulated metastatic potential is tissue specific. Thus, it is possible that Maspin participates in salivary gland tumor biology as well. In this study, expression pattern of maspin in benign and malignant salivary gland tumors is analyzed, to understand the biological behavior of salivary gland tumors with respect to maspin expression. Aims and Objectives: The aim of this study was to demonstrate, record, and correlate the expression pattern of maspin in benign and malignant salivary gland tumors. Settings and Design: A retrospective study of maspin expression in 30 diagnosed cases of benign and malignant salivary gland tumors retrieved from archives of our department. Materials and Methods: Anti-maspin antibody and horseradish peroxidase detection system. Statistical Analysis: Descriptive statistical analysis and Chi-square/Fisher Exact test. Results: Intense expression with P < 0.001 is associated with benign tumors, nuclear staining with P < 0.001 is significantly associated with benign tumors and cytoplasmic staining with P = 0.020 is associated with malignant tumors. Conclusion: Intensity of expression is more in benign tumors when compared with malignant tumors. The benign tumors showed both nuclear and cytoplasmic expression. Some malignant tumors did express maspin, but mainly in the cytoplasm.
  2 2,104 138
Steam sterilization effect on the accuracy of friction-style mechanical torque limiting devices
Seyed Jalil Sadr, Ali Fayyaz, Minoo Mahshid, Aboulfazl Saboury, Ghassem Ansari
May-June 2014, 25(3):352-356
DOI:10.4103/0970-9290.138335  PMID:25098994
Aim: This study was aimed to evaluate the effect of steam sterilization on the accuracy (within 10%) of friction-style mechanical torque limiting devices (F-S MTLDs) to achieve their target torque values. Materials and Methods: Fifteen new F-S MTLDs were selected from Astra Tech (25 Ncm, Hader SA, La Chaux-de-Fonds, Switzerland), BioHorizons (30 Ncm, Dynatorq ITL, Irvine, California, USA), Dr. Idhe (15-60 Ncm, Dr. Idhe Dental, Eching/Munich, Germany). Every peak torque measurement was tested ten times before steam sterilization using Tohnichi torque gauge (6Tohnichi-BTG (-S), Japan). Steam sterilization was performed using a 100 cycle autoclave. Preparation steps were carried out for the devices before each autoclave sterilization cycle. Peak torque measurements were repeated after every sterilization cycle. Mean difference between the measured and the targeted torque values were evaluated before and after aging. Repeated-measures of ANOVA were used to compare the differences of accuracy between subjects. Bonferroni post-hoc test was used for pairwise comparison. Results: Autoclaving resulted in an increase in the error values (the difference between peak torque and target torque values) in all the three groups studied (P < 0.05), with only Astra Tech devices showing >10% (maximum 12%) difference from their torque values in 5% of the measurements. Conclusion: Steam sterilization effect differs between target torque and measured peak values with an increase trend. The peak torque values showed a significant decrease for BioHorizons, while a significant increase was noted for Astra Tech and no significant change in Dr. Idhe group after sterilization. Clinical Implication: Within the limitation of this study the torque output of each individual device deviated in varying degrees from target torque values. However, the majority of the new frictional-style devices tested in this study, delivered fairly consistent torque output within 10% of their preset target values after sterilization. Astra Tech devices were the only one showing more than 10% difference from their torque values in 5% of the measurements. Combined effects of sterilization and aging still needs to be determined.
  2 2,406 83
Comparative study of various grading systems in oral squamous cell carcinoma and their value in predicting lymph node metastasis
Saleha Jamadar, TV Narayan, Balasundari Shreedhar, Leeky Mohanty, Sadhana Shenoy
May-June 2014, 25(3):357-363
DOI:10.4103/0970-9290.138336  PMID:25098995
Background: Regional lymph node (LN) metastasis is the single most prognostic factor for oral squamous cell carcinoma (OSCC). An analysis of the prognostic factors is important for predicting prognosis and reducing the mortality in these patients. Objectives: (1) To compare the value of various grading systems in predicting LN metastasis. (2) To evaluate histopathological parameters, which could help in predicting LN metastasis. Materials and Methods: A total of 20 excisional biopsies of OSCCs, were graded according to the four grading systems that is, Broder's, Jakobsson's, Anneroth and Hansen's, and Brynes. We also evaluated various histopathological parameters, which could help in predicting LN metastasis. Results: Grading at the invasive front was most prognostic of LN metastasis. Tumors with total malignancy score ≥8 showed higher incidence of metastases. Conclusion: The histopathological parameters that could help in predicting lymph node metastases (LNM) are keratinization, nuclear pleomorphism (NP), and the pattern of invasion (POI) when assessed at the invasive front. When the whole tumor was considered, histopathological parameters like NP and POI were significant in predicting LNM.
  2 6,075 611
Evaluating intrusive injuries in primary dentition from computed tomographic scans: A preliminary report
Makkada Yuvaraj Padmanabhan, Ramesh Kumar Pandey, Nitesh Tewari, Radhakrishnan Aparna
May-June 2014, 25(3):311-315
DOI:10.4103/0970-9290.138322  PMID:25098986
Context: Children sustaining maxillofacial trauma may undergo computed tomographic (CT) examination to exclude potential complications, which pave way for spread of infection into the meningeal region. Following treatment, these children report for management of their dental injuries as out-patients for which a separate conventional radiographic examination is usually done. The usefulness of the initial maxillofacial CT scan in evaluating dental injuries needs to be assessed so as to possibly avoid children from being subjected to a separate radiographic examination. Aims: The objective of this study was to evaluate the ability of pediatric dentists to assess intrusive injuries in primary dentition from preexisting maxillofacial CT scans of children. Settings and Design: Hospital based cross-sectional study. Subjects and Methods: Among 70 pediatric patients who were admitted following maxillofacial injuries, 10 children underwent CT examination. CT segments displaying the tooth bearing portions of the jaw were reformatted using the Dentascan software and three precalibrated pediatric dentists clinically examined the selected children and with the use of Dentascan based CT sections assessed the relative position of the intruded teeth in relation to the permanent successor and planned treatment for each individual intruded tooth. Statistical Analysis: Fleiss Kappa statistics. Results: There was perfect agreement between the interpretations of all participants (κ = 1.0000, 95% confidence interval = 0.6861-1.3139) and the interpretations of each participant with the "gold standard" evaluator (κ = 1.000). Conclusion: Maxillofacial CT scans made to assess maxillofacial injuries in children can also be reliably used for assessing intrusive injuries in primary dentition.
  2 1,762 110
Refinement influence in the cleaning efficacy of rotary nickel-titanium Mtwo ® instruments in oval-shaped canals by means of optical microscopy
Cibella Maymone Pontes, Luciana Moura Sassone, Cristiana Francescutti Murad, Rivail Antônio Sérgio Fidel, Fernando Sili Vilhena
May-June 2014, 25(3):279-283
DOI:10.4103/0970-9290.138286  PMID:25098980
Objective: This study evaluated the cleaning efficacy of the rotary nickel-titanium Mtwo ® by means of optical microscopy in oval-shaped root canals and compared refinement influence using ultrasonic files or Hedströem files. Materials and Methods: Twenty mandibular incisors were accessed, included in epoxy resin blocks, and cut transversely at 3, 6, and 9 mm from the apex. Teeth were instrumented using rotary nickel-titanium Mtwo. Digital images of the root cross sections were obtained before and after instrumentation with a digital camera attached to an optical microscope. Subsequently, samples were randomly divided into two groups for refinement. Group I was refined using ultrasonic files #30 and group II with Hedströem files #30. Final digital images of cross sections after refinement were captured and analyzed. The boundaries for the uninstrumented perimeter were measured by the software ImageTool 3.0. The data obtained were statistically analyzed by analysis of variance (ANOVA) and t-test. Results: Mtwo instrumentation produced 41.48% of the uninstrumented perimeter. The final refinement using Hedströem and ultrasonic files decreased the uninstrumented perimeter. Significant differences (t-test, P = 0.00) were found at the three thirds after the final refinement, except for the apical third that was enhanced by Hedströem file. However, there was no statistical difference between the two refinement techniques used (P > 0.05). Mtwo instrumentation was not capable of cleaning and shaping the entire perimeter of the root canals walls. Conclusions: The final refinement, either with ultrasonic files or with Hedströem files, resulted in significantly less uninstrumented perimeter.
  2 2,176 141
Abrasion resistance of direct and indirect resins as a function of a sealant veneer
Taciana Marco Ferraz Caneppele, Daniel Maranha Rocha, Maria Amelia Máximo Araujo, Márcia Carneiro Valera, Susana María Salazar Marocho
May-June 2014, 25(3):381-385
DOI:10.4103/0970-9290.138345  PMID:25098999
Background: Abrasive wear is one of the most common type of wear that not only affect teeth, as also dental restorations. Thus to investigate one of the etiological factors as tooth brushing procedure is clinical relevant in order to select the best material combination that may prevent damage of resin dental restoration's abrasion. Aims: This study evaluated the influence of tooth brushing on mass loss and surface roughness of direct Venus (Vs) and indirect Signum (Sg) resin composites, with and without a surface sealant, Fortify (F). Materials and Methods: Twenty-four specimens were prepared with each resin composite, using their proprietary curing units, according to manufacturer's instructions. All the specimens were polished and ultrasonically cleaned in distilled water for 5 minutes. Half of the specimens of each resin (n = 12) were covered with F (Vs F and Sg F ), except for the control (C) specimens (Vs C and Sg C ), which were not sealed. Mass loss (ML) as well as surface roughness (Ra ) was measured for all the specimens. Then, the specimens were subjected to toothbrush-dentifrice abrasion, using a testing machine for 67.000 brushing strokes, in an abrasive slurry. After brushing simulation, the specimens were removed from the holder, rinsed thoroughly and blot dried with soft absorbent paper. The abrasion of the material was quantitatively determined with final measurements of ML and surface roughness, using the method described above. Results: ML data were analyzed by two-way analysis of variance (ANOVA) and the analysis indicated that resin composites were not statistically different; however, the specimens sealed with F showed higher ML. Ra mean values of the groups Vs F and Sg F significantly increased. Conclusion: Tooth brushing affects mainly the roughness of the direct and indirect resin composites veneered with a sealant.
  2 2,502 90
The ECG made easy for the dental practitioner
UR Anoop, Ramesh , Kavita Verma, Narayanan
May-June 2014, 25(3):386-389
DOI:10.4103/0970-9290.138349  PMID:25099000
ECG is not taught to dental students formally in the dental curriculum. The general assumption is that dental surgeons do not handle any ECG related cases in clinical practice. But with an increase in medically compromised patients, the need for an interdisciplinary approach among dental and medical practitioners in the treatment of critically ill patients is becoming more relevant. Hence, we have to be aware of the basics of common medical investigations to be competent to assess and comprehend the medical conditions. So, this paper focuses on orienting the beginner to the basic concepts of ECG from the clinical perspective. The paper also discusses the ECG changes of myocardial infarction to familiarize the dental surgeon to read the ECG.
  2 4,302 274
Atypical histiocytic granuloma: A differential to nonhealing ulcers of the oral cavity
Shashi Ranjan, Sailesh K Mukul, Rashmi Issar
May-June 2014, 25(3):406-409
DOI:10.4103/0970-9290.138359  PMID:25099004
This is a case report of a rare clinical entity known as atypical histiocytic granuloma (AHG), which was previously grouped under a broad category known as pseudolymphoma or traumatic eosinophilic granuloma. Less than 15 cases of AHG have been reported until date. AHG poses diagnostic dilemma due to its clinical as well as histopathological appearance where it stimulates malignancy. A proper clinicopathological evaluation is necessary to establish the diagnosis and to avoid overtreatment. In this report, we review previously reported cases in literature and try to establish proper clinicopathological correlation, differential diagnosis and management. These will familiarize clinicians to include AHG in their differential diagnosis as well as for the pathologist to segregate pseudolymphomatous lesion in their proper categories. The role of immunohistochemistry (IHC) has been given prime importance to establish the exact diagnosis. Further in this report, we review different status on lymphoproliferative disorders and advocate the use of IHC in categorizing these lesions upon cell lineage and to establish proper nomenclature for these lesions.
  - 3,320 148
Improving by STAR network
SM Balaji
May-June 2014, 25(3):278-278
DOI:10.4103/0970-9290.138277  PMID:25098979
  - 1,418 89
Reducing waste in dental research
Oliver Hennedige
May-June 2014, 25(3):277-277
DOI:10.4103/0970-9290.138273  PMID:25098978
  - 1,896 121
An epidemiological study to determine the prevalence and risk assessment of gingivitis in 5-, 12- and 15-year-old children of rural and urban area of Panchkula (Haryana)
Avninder Kaur, Nidhi Gupta, Devinder Kaur Baweja, Mauli Simratvir
May-June 2014, 25(3):294-299
DOI:10.4103/0970-9290.138310  PMID:25098983
Objective: The aim and objective of the present study was to determine the prevalence and severity of gingivitis and evaluate the factors associated with gingivitis in children residing in rural and urban areas of Panchkula. Materials and Methods: The present study was carried out on a sample of 1269 school children, aged 5, 12 and 15 years, randomly selected from the rural and the urban schools of Panchkula and gingival index was recorded as devised by Loe and Silness (1963) to assess the severity of gingivitis. A standardized questionnaire was self prepared, which was filled by the examiner prior to the clinical examination. The data were subjected to SPSS, version 13, and statistically analyzed using Chi test, F test, ANOVA test. Results: In the age group of 5 years, the children affected with gingivitis in the rural and the urban areas were 67 and 33%, respectively, which was statistically highly significant (P = 0.0001). In the age group of 12 years, the children affected with gingivitis in the rural and the urban areas were 94 and 92%, respectively (P = 0.537), whereas in 15-year olds, the children affected with gingivitis in the rural and the urban areas were 98 and 64%, respectively (P = 0.0001). The children who brushed once a day had higher prevalence of gingivitis as compared to children who brushed more than once per day in all the age groups. Conclusion: The results showed that the percentage of children affected with gingivitis was significantly higher in the rural areas in 5- and 15-year-old children, but this trend was not seen in 12-year age group, reflecting the lack of awareness in rural areas.
  - 2,970 209
Augmentation of residual alveolar bone height with tissue engineering for dental implant placement
SM Balaji
May-June 2014, 25(3):410-412
DOI:10.4103/0970-9290.138360  PMID:25099005
The challenge of correcting deficient vertical alveolar height for dental implant placement has been there since dental implants came in to regular clinical placement. The ability of various methods to increase the residual alveolar height has met with varying results. The primary reason is that the techniques were not quite successful in maintaining the required residual alveolar height. Use of Bone Morphogentic Protein, especially rhBMP-2 has been met with high degree of success in deficient vertical alveolar height in a mandibular ridge. The demonstration of this using a case has been presented here.
  - 2,415 115
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