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   2008| October-December  | Volume 19 | Issue 4  
    Online since December 15, 2008

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Tobacco smoking and surgical healing of oral tissues: A review
SM Balaji
October-December 2008, 19(4):344-348
DOI:10.4103/0970-9290.44540  PMID:19075440
It is believed that the crew of Columbus had introduced tobacco from the 'American India' to the rest of the world, and tobacco was attributed as a medicinal plant. It was often used to avert hunger during long hours of work. But in reality, tobacco causes various ill effects including pre-malignant lesions and cancers. This article aims at reviewing the literature pertaining to the effect of tobacco smoking upon the outcome of various surgical procedures performed in the oral cavity. Tobacco affects postoperative wound healing following surgical and nonsurgical tooth extractions, routine maxillofacial surgeries, implants, and periodontal therapies. In an experimental study, bone regeneration after distraction osteogenesis was found to be negatively affected by smoking. Thus, tobacco, a peripheral vasoconstrictor, along with its products like nicotine increases platelet adhesiveness, raises the risk of microvascular occlusion, and causes tissue ischemia. Smoking tobacco is also associated with catecholamines release resulting in vasoconstriction and decreased tissue perfusion. Smoking is believed to suppress the innate and host immune responses, affecting the function of neutrophils - the prime line of defense against infection. Thus, the association between smoking and delayed healing of oral tissues following surgeries is evident. Dental surgeons should stress on the ill effects of tobacco upon the routine postoperative healing to smoker patients and should aid them to become tobacco-free.
  72 40,907 2,002
A five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated at two hospitals of Mysore city
BR Chandra Shekar, CVK Reddy
October-December 2008, 19(4):304-308
DOI:10.4103/0970-9290.44532  PMID:19075432
Objectives: This study aims to provide a five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated during 1 st January 1998 and 31 st December 2002 in two hospitals of Mysore city; to determine the age and sex distribution, etiology, type of injury, day and time of accident, and the influence of alcohol and other drugs; andto suggest measures to prevent such injuries. Materials and Methods: After obtaining permission from the concerned authorities, a pre-designed questionnaire was used to collect the necessary data from the two hospitals. The data was then computerized and statistical analysis was done using statistical package for the social sciences (SPSS) windows version 10. Results: Road traffic accident (RTA) was the common cause for maxillofacial injuries. Men sustained more injuries compared to women. The injuries were mostly sustained in the age group of 11-40 years, constituting about 78% of all the injuries. Two wheelers were the most commonly involved compared to other vehicle types. Influence of alcohol at the time of injury was found in about 58% of the patients with maxillofacial injuries. The most number of accidents occurred in the weekends. Mandibular fractures were the most common. Conclusion: RTAs are the most common cause for maxillofacial injuries. If RTAs are considered an epidemic of modern times, then prevention is its vaccine.
  67 13,207 701
Evaluation of salivary sialic acid, total protein, and total sugar in oral cancer: A preliminary report
PR Sanjay, Kaveri Hallikeri, AR Shivashankara
October-December 2008, 19(4):288-291
DOI:10.4103/0970-9290.44529  PMID:19075429
Aim: Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, noninvasive methods like analysis of saliva may provide a cost-effective approach for screening a large population. Thus, this study aimed to estimate salivary levels of sialic acid, total protein, and total sugar in the oral cancer patients and in healthy control group to evaluate their role in diagnosis and prognosis of oral cancer. Study Design: Unstimulated whole saliva samples were collected from 30 healthy controls (Group I) and 30 squamous cell carcinoma patients (group II). Estimations of salivary levels of sialic acid, total protein, and total sugar were performed. This was correlated histopathologically with the grades of carcinoma. Statistical Analysis and Results: The Student's ' t ' test and multivariate regression analysis were performed. The results showed that salivary levels of total protein, total sugar, protein-bound sialic acid, and free sialic acid were significantly higher in oral cancer patients compared to those of normal healthy controls ( P values in all the results were less than 0.001). The salivary free sialic acid levels were found to be significantly higher in well-differentiated squamous cell carcinoma than in moderately differentiated carcinoma ( P < 0.001). However, protein-bound sialic acid, total proteins, and total sugars did not show any statistical significance between well and moderately differentiated carcinomas. Conclusion: Biochemical analysis of saliva can be used in early detection of cancer and is best correlated with histopathological degree of squamous cell carcinoma.
  39 12,215 2,049
Evaluation of the Divine Proportion in the facial profile of young females
Arezoo Jahanbin, Mohammad Basafa, Yekta Alizadeh
October-December 2008, 19(4):292-296
DOI:10.4103/0970-9290.44530  PMID:19075430
Background: Beauty is the phenomenon of experiencing pleasure, through the perception of balance. According to some authors, attractive faces have ideal proportions that are related to the Divine Proportion (1.618:1). Aim: The purpose of this study was to evaluate the Divine Proportion in the human profile and investigate the effects of this ratio on the perception of the beauty of the profile. Study and Design: We conducted a cross-sectional study to determine the mentioned aims. Materials and Methods : In this cross-sectional study, fifty females in the age range of 20-25 years, with acceptable profiles were selected. Standardized profile silhouettes were each given a score by 20 judges (consisting of 10 men and 10 women) using the visual analog scale. Five landmarks were determined and five ratios were measured on the silhouettes by using the adobe photoshop program. Statistical Analysis: The Student's t test was used to compare profile proportions of the subjects. Results: Statistical analysis showed none of the proportions had the mean of 1.618, but in subjects having higher esthetic scores, trichion (Te)-soft tissue menton (Me):Tr-subnasale (Sn) and Tr-Me:soft tissue nasion (N)-Me, with the mean of 1.58 were closer to Divine Proportion. Conclusions : The results suggested the perception of beauty is influenced by the Divine Proportions and Tr-Me:Tr-Sn and Tr-Me:N-Me are the most influential ratios in the perception of the beauty of profile; however, if the Divine Proportion is to be used in treatment planning, it should be used along with other factors.
  38 16,225 1,718
Incremental lines in root cementum of human teeth: An approach to their role in age estimation using polarizing microscopy
Pooja Aggarwal, Susmita Saxena, Puja Bansal
October-December 2008, 19(4):326-330
DOI:10.4103/0970-9290.44536  PMID:19075436
Age estimation is an important factor in the identification of an individual in forensic science. The hard tissues of the human dentition are able to resist decay and degradation long after other tissues are lost. This resistance has made teeth useful indicators for age calculation. Recent research indicates that tooth cementum annulations (TCA) may be used more reliably than any other morphological or histological traits of the adult skeleton for age estimation. The purpose of this study was to examine the correlation between age and the number of incremental lines in human dental cementum and to ascertain the best method of studying cementum with respect to different forms of microscopy. Thirty nonrestorable teeth were extracted from 20 people, and longitudinal ground section of each tooth was prepared. Photomicrographs of the area at the junction of apical and middle third of the root under light and polarized microscope were taken. The cementum was composed of multiple light and dark bands that were counted on the photomicrograph with the help of image analysis software and added to the average eruption time of individual tooth. The predicted age of the individual was thus obtained. Results showed a significant correlation between the predicted age and actual chronological age of the individual. These data indicate that quantitation of cementum annuli is a moderately reliable means for age estimation in humans and polarizing microscopy is a better means of visualizing incremental lines of cementum compared to light microscopy.
  31 21,858 1,420
Prevalence of dental fluorosis and associated risk factors in 11-15 year old school children of Kanyakumari District, Tamilnadu, India: A cross sectional survey
Jagan Kumar Baskaradoss, Roger B Clement, Aswath Narayanan
October-December 2008, 19(4):297-303
DOI:10.4103/0970-9290.44531  PMID:19075431
Objectives: This study presents data on the prevalence and severity of dental fluorosis in 11-15-years-old school children of Kanyakumari district, TamilNadu, India, and also the relationships between prevalence of dental fluorosis and selected risk factors. Materials and Methods: A total of 1800 children, from all the nine blocks of Kanyakumari district, studying in classes 6-10 were examined using type III examination. The assessment form designed specifically for this study was used while examining each student. Results: Dental fluorosis was present in 15.8% (285 children) of the study population and the community fluorosis index was calculated to be 0.27. The prevalence of dental fluorosis varied from as low as 1.4% in some blocks to as high as 29.4% in some others. There was a significant difference in the level of dental fluorosis between rural and urban residents ( P < 0.001). The prevalence of dental fluorosis was higher in children who consumed pipe water as compared to children who consumed ground water. 65% of the children with dental fluorosis had no caries, indicating the positive effects of fluoride. Conclusions: The prevalence of dental fluorosis can be attributed to the level of fluoride in the drinking water as it exhibited a step-wise increase when the water fluoride levels increased from 1.5-1.7 ppm. Measures for defluoridation of drinking water before distribution has to be taken in the high prevalence blocks to lower the burden of dental fluorosis in this community.
  23 14,405 1,915
Reverse transcriptase polymerase chain reaction study to evaluate dissemination of cancer cells into circulation after incision biopsy in oral squamous cell carcinoma
Sunita Dyavanagoudar, Alka Kale, Kishore Bhat, Seema Hallikerimath
October-December 2008, 19(4):315-319
DOI:10.4103/0970-9290.44534  PMID:19075434
Background: Tissue manipulation by incisions, radiotherapy, and palpation may lead to dissemination of cancer cells into circulation. Circulating cancer cells in blood play a central role in metastatic process. Their numbers can be very small and for their detection,reverse transcriptase polymerase chain reaction (RT-PCR) has been successfully used in this study. Materials and Methods: To examine whether cancer cell dissemination results from incision biopsy, we tried to detect oral squamous cell carcinoma (OSCC) cells in the peripheral blood sample before and after incision biopsy by CK19 RT-PCR. The study group consisted of 25 OSCC patients and the control group consisted of five patients with oral submucos fibrosis and five with leukoplakia. Five ml of blood collected before and twice (15 and 30 min) after incision were used for CK19 RT-PCR. Results: Four (16%) of 25 cases of OSCC were positive for CK19 transcripts in their peripheral blood drained 15 min after incision. CK19 transcripts were not detected in the control group. Conclusion : Surgical invasion, in the form of incisional biopsy, causes dissemination of cancer cells into circulation, resulting in increased risk of metastasis.
  23 5,365 414
In vivo evaluation of crestal bone heights following implant placement with 'flapless' and 'with-flap' techniques in sites of immediately loaded implants
Shibu Job, Vinaya Bhat, E Munirathnam Naidu
October-December 2008, 19(4):320-325
DOI:10.4103/0970-9290.44535  PMID:19075435
Purpose: To evaluate and compare the changes in crestal bone height around implants placed with flapless surgery and with-flap surgery. Materials and Methods: Ten implants were placed in six patients - five using flapless and five using with-flap techniques. Single-piece root-form implants and a one-stage approach with immediate nonfunctional loading protocol were used. The change in heights of crestal bone was measured on standardized digital periapical radiographs taken at 0, 1, and 3 months. Results: On mesial side, the mean change from months 0-1, months 1-3, and months 0-3 for flapless method was significantly lower than with-flap method [0.01-0.06 mm for flapless and 0.13-0.40 mm for with-flap ( P = 0.01)]. On the distal side, the mean change from months 0-1, months 1-3, and months 0-3 for flapless method was significantly lower than with-flap method [0.02-0.05 mm for flapless and 0.09-0.30 mm for with-flap ( P = 0.01)]. Conclusions: During the three-month period, reduction of crestal bone height around the implants placed with flapless surgery (0.06 mm) was not statistically significant, while the reduction of crestal bone height around the implants placed using with-flap surgery (0.4 mm) was statistically significant. Comparitively, flapless approach showed lesser crestal bone height reduction, which was statistically significant.
  21 11,800 1,103
Utilizing dental colleges for the eradication of oral cancer in India
Jacob Kuruvilla
October-December 2008, 19(4):349-353
DOI:10.4103/0970-9290.44541  PMID:19075441
Dental education in India has grown in such a way that it ranks first in the world in having the highest number of dental schools. There are 240 dental schools all over the country. Paradoxically, even with this large number of dentists and dental institutions, India contributes to the highest number of incident cases of oral cancer. In India, oral cancer burden approximates to 20-30% of all cancers. The plausible reason for this high incidence of oral cancer could be expounded on the fact that there exists a high usage of tobacco within the country. The evidence for the high prevalence of using chewable tobacco products, especially in the youth, was recently reported in the Global Youth Tobacco Survey. This increasing usage of chewing tobacco and related products will further accrue to the mortality and morbidity figures in the near future. To effectuate a breakthrough in the existing situation, the work force of dental schools could be capitalized on. The aim of this article is to present the burden of oral cancer in the country and identify trends in the prevalence of tobacco usage, which if continues could alert an epidemic of oral cancer in the near future; and how dental schools in the country can be utilized for preventing this upcoming epidemic.
  18 8,196 763
Dental caries experience and treatment needs of green marble mine laborers in Udaipur district, Rajasthan, India
Prabu Duraiswamy, T Santhosh Kumar, Rushabh J Dagli, Chandrakant , Suhas Kulkarni
October-December 2008, 19(4):331-334
DOI:10.4103/0970-9290.44537  PMID:19075437
Background and Objectives: The study was undertaken at Kesariyaji, located in Udaipur district of Rajasthan. There are about 3 million workers who marble mine at Rajasthan. Living conditions of these workers are substandard and most of them are immigrant workers living in tiny shacks. Majority of them belong to lower socioeconomic status with poor educational background. The present study was carried out to estimate dental caries prevalence and treatment needs of laborers working in the green marble mines of Udaipur district. Basic Research Design: The data was collected using the methods and standards recommended by the WHO. Dentition status and treatment needs along with decayed, missing, and filled teeth (DMFT) index, and decayed, missing, and filled surfaces score were recorded. Standard error of mean was calculated for all the mean values of treatment needs. There were three examiners, who were trained before the survey for inter-examiner variability, and the reliability was tested by means of weighted kappa statistics, which was 90%. Participants: The study population comprised 513 men in four age groups of 18-25, 26-34, 35-44, and 45-54 years, respectively. Results: The mean DMFT for all age groups was 3.13 with highest mean of 4.0 for the age group of 45-54 years. Mean decayed teeth were 2.60, 3.33, 1.46, and 1.5 for the age groups 15-24, 25-34, 35-44, and 45-54 years, respectively. Filled component was nil for all age groups. Most of the subjects required one surface filling with a very less proportion needing pulp care. Conclusions: The missing component constituted the major part of DMFT index in the 45-54 years age group and the absence of filled component in the whole study population implies that the treatment needs of the study population are unmet. Thus, intervention in the form of oral health promotion and curative services are the need of the hour.
  11 6,837 533
Dentinogenesis imperfecta: A review and case report of a family over four generations
Sudhir Bhandari, Karneev Pannu
October-December 2008, 19(4):357-361
DOI:10.4103/0970-9290.44543  PMID:19075443
Dentinogenesis imperfecta (DGI) is one of the most common hereditary disorders of dentin formation. It follows an autosomal dominant pattern of transmission, affecting both the formation and mineralization of dentin. Either or both primary and permanent dentition is affected by it. This paper briefly reviews the manifestations of DGI Type II (DGI1) and presents a case report of a family affected with DGI1 over four generations.
  6 15,191 1,382
Immunology of root resorption: A literature review
Luciano B Silva, Carolina S Guimaraes, Roberto A Santos
October-December 2008, 19(4):340-343
DOI:10.4103/0970-9290.44539  PMID:19075439
Root resorption seems to be related to a complex combination of mechanical factors and biological activity, which comprehends the role of immunologic structures including specialized cells. The aim of this research was to explain the development of the process - from mineralization to the destruction of hard tissues - and the possible relationship between root resorption and immunology, along with discussing current concepts described in the literature.
  6 9,856 944
Extended osteoplastic maxillotomy for total excision of giant multicompartmental juvenile nasopharyngeal angiofibroma
Santosh Koshy, Mercy George, Ashish Gupta, Roy T Daniel
October-December 2008, 19(4):366-369
DOI:10.4103/0970-9290.44526  PMID:19075445
Juvenile nasopharyngeal angiofibroma (JNA) is a rare vascular neoplasm occurring almost exclusively in adolescent males. Although benign, it is often locally aggressive and can erode into surrounding tissues and structures resulting in significant morbidity and mortality. In 20% of cases, there is intracranial extension. In this paper, we report on the total excision of a large, recurrent JNA with intracranial extension into the middle cranial fossa encroaching into the cavernous sinus, by right temporal craniotomy and extended osteoplastic maxillotomy.
  5 5,079 295
Treatment of traumatized maxillary permanent lateral and central incisors horizontal root fractures
Mutan Hamdi Aras, Erdal Ozcan, Yahya Orcun Zorba, Muzaffer Aslan
October-December 2008, 19(4):354-356
DOI:10.4103/0970-9290.44542  PMID:19075442
Traumatic injuries of teeth are the main cause of emergency treatment in dental practice. Horizontal root fractures are more frequently observed in the maxillary anterior region and young male patients. The most common type of root fracture is in the middle third, followed by apical, and coronal part. This case report describes two horizontal root fractures of the maxillary right central and lateral incisors due to a sport injury. The lateral incisor was healed satisfactorily without treatment. The central incisor was endodontically treated.
  4 17,266 1,049
Crystal growth vs. conventional acid etching: A comparative evaluation of etch patterns, penetration depths, and bond strengths
Raghu Devanna, KM Keluskar
October-December 2008, 19(4):309-314
DOI:10.4103/0970-9290.44533  PMID:19075433
The present study was undertaken to investigate the effect on enamel surface, penetration depth, and bond strength produced by 37% phosphoric acid and 20% sulfated polyacrylic acid as etching agents for direct bonding. Eighty teeth were used to study the efficacy of the etching agents on the enamel surface, penetration depth, and tensile bond strength. It was determined from the present study that a 30 sec application of 20% sulfated polyacrylic acid produced comparable etching topography with that of 37% phosphoric acid applied for 30 sec. The 37% phosphoric acid dissolves enamel to a greater extent than does the 20% sulfated polyacrylic acid. Instron Universal testing machine was used to evaluate the bond strengths of the two etching agents. Twenty percent sulfated polyacrylic acid provided adequate tensile bond strength. It was ascertained that crystal growth can be an alternative to conventional phosphoric acid etching as it dissolves lesser enamel and provides adequate tensile bond strength.
  4 8,222 590
A study to determine whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion by unbiased observers: A pilot study
Vernie A Fernandes, Vidya Chitre, Meena Aras
October-December 2008, 19(4):335-339
DOI:10.4103/0970-9290.44538  PMID:19075438
Context: By convention, the posterior palatal seal area is located on the palate between the anterior and posterior vibrating lines. However, there are opposing views on whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion. Aims: The study was carried out to determine whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion by unbiased observers. A second part of the study was formulated to evaluate whether the palpatory method correlated with the nose-blowing method in locating the anterior line of flexion Materials and Methods: Twenty-three dental undergraduate clinical students were selected as observers. Twenty-three edentulous patients were randomly selected. The students were asked to record the anterior and posterior vibrating line on one patient each using two differently colored marking pencils. Also, the anterior vibrating line was marked by the palpatory method (using T burnisher) using a third colored marking pencil. The marked lines were then transferred onto the previously made impression of modeling plastic. Results: Of the 23 recorders used in the study, 19 could locate separate anterior and posterior lines of flexion. In 4 cases, the anterior and posterior lines of flexion coincided and were not distinct. In 20 cases, the palpatory method produced a line anterior to the line located by the Valsalva maneuver. Conclusions: The anterior and posterior vibrating lines could be located by the undergraduate students as two separate lines of flexion when the appropriate action was elicited for each of them; and the palpatory method produced a line slightly anterior to the anterior vibrating line located by the Valsalva maneuver.
  4 14,046 743
Ethics in presentation: Teach the teachers first
B Sivapathasundharam
October-December 2008, 19(4):283-283
DOI:10.4103/0970-9290.44525  PMID:19075427
  1 4,344 1,110
Correcting the frenal pull and increasing the width of keratinized mucosa around endosseous implants using denudation procedure
Jun-Beom Park
October-December 2008, 19(4):362-365
DOI:10.4103/0970-9290.44527  PMID:19075444
The frenum exerts a pull upon the tissue and can lead to the continuation of the lesion, and the keratinized tissue provides increased resistance to the periodontium. Various techniques have been used to deepen the vestibule and increase the keratinized mucosa. However, there is no case report on correcting the frenal pull and increasing the keratinized mucosa around dental implant using denudation procedure. This article presents a case of frenal pull that was corrected with denudation procedure with the incision line within the keratinized tissue.
  - 9,531 390
A novel simplified numbering system for dental burs
Senthil Kumar Hemamalathi, Mohan Abarajithan, Deivanayagam Kandaswamy
October-December 2008, 19(4):284-287
DOI:10.4103/0970-9290.44528  PMID:19075428
A universally accepted standardization is of great value for any material or equipment that is used globally. A single number or name should represent the particular material or instrument throughout the world. Since the dental burs are used worldwide, a single standard numbering system, which gives a unique specification for each bur in any part of the world, is mandatory. Though the existing systems have tried to attain this goal, they have their own advantages and limitations that are explained in detail in this article. So, the idea of proposing a novel system is to formulate a simple way of mentioning each bur with its dimension and composition without the need for memorizing the numbers.
  - 29,984 1,677
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