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   2013| July-August  | Volume 24 | Issue 4  
    Online since September 19, 2013

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Prevalence of work-related musculoskeletal complaints among dentists in India: A national cross-sectional survey
Vijaya K Kumar, Senthil P Kumar, Mohan R Baliga
July-August 2013, 24(4):428-438
DOI:10.4103/0970-9290.118387  PMID:24047834
Context: Work-related musculoskeletal disorders (WRMSD) had been previously reported to have a high prevalence among dentists in different parts of the world. Aims: The study aimed to assess the prevalence of self-reported WRMSD among dental professionals in India. Material and Methods: A cross-sectional survey of 646 dentists (response rate of 82.97%) was done using self-administered questionnaire which consisted of 27 items based on Nordic questionnaire for screening WRMSDs. Additional items of the questionnaire were added after preliminary content validation from six experienced dentists. Participant socio-demographic characteristics, work-related physical load characteristics, musculoskeletal symptom characteristics were evaluated. Statistical analysis used: All data were analyzed descriptively using percentiles and association between work-related physical load and WRMSD prevalence was done using Chi-square test. Results: All 536 dentists had at least one work-related musculoskeletal symptom in the previous year with an overall period prevalence rate of 100%. The type of symptoms present were pain (99.06%), stiffness (3.35%), fatigue (8.39%), discomfort (12.87%), clicks/sounds (4.1%), and other neurogenic (20.14%). The regions of symptoms were neck (75.74%), wrist/hand (73.13%), lower back (72.01%), shoulder (69.4%), hip (29.85%), upper back (18.65%), ankle (12.31%), and elbow (7.46%). Number of regions affected were two (82.83%), three (51.86%), four, or more (15.11%). Recurrent symptoms were present in 76.11%. Strong association was noted between sustained work postures and symptom regions for pain in WRMSD. Conclusion: The study found an overall one-year period prevalence rate of 100% for WRMSDs among Indian dentists. Measures for improving education and ergonomic evaluations are indicated on a large scale to prevent decline in work performance and incidence of WRMSDs among Indian dentists.
  31 10,706 561
Antimicrobial activity of plant extracts on Candida albicans: An in vitro study
Sunitha Jagalur Doddanna, Shilpa Patel, Madhusudan Astekar Sundarrao, Ravindra Setru Veerabhadrappa
July-August 2013, 24(4):401-405
DOI:10.4103/0970-9290.118358  PMID:24047829
Background and Objectives: Plants as sources of medicinal compounds have continued to play a predominant role in the maintenance of human health since ancient times. Even though several effective antifungal agents are available for oral candida infections, the failure is not uncommon because isolates of Candida albicans may exhibits resistance to the drug during therapy. The present study was conducted to evaluate the antimicrobial effects of few plant extracts on Candida albicans. An additional objective was to identify an alternative, inexpensive, simple, and effective method of preventing and controlling Candida albicans. Materials and Methods: Fine texture powder or paste form of leaves was soaked in sterile distilled water and 100% ethyl alcohol, which were kept in refrigerator at 4°C for 24 h. Then filtrates were prepared and kept in a hot air oven to get a black shining crystal powder/paste form. Stock solutions of plant extracts were inoculated on petri plates containing species of Candida albicans and incubated at 25 ± 2°C for 72 h. Results: Alcoholic curry leaves showed the maximum zone of inhibition on Candida albicans followed by aqueous tea leaves. The other plant extracts like alcoholic onion leaves, alcoholic tea leaves, alcoholic onion bulb, alcoholic aloe vera, and alcoholic mint leaves also inhibited the growth of Candida albicans but lesser extent. Conclusion: The present study renders few medicinal plants as an alternative medicines to the field of dentistry which can be used adjunct to conventional therapy of oral candidasis.
  24 12,262 666
Assessment of chemomechanical removal of carious lesions using Papacarie Duo ™: Randomized longitudinal clinical trial
Simone Ferreira Borges Matsumoto, Lara Jansiski Motta, Thays Almeida Alfaya, Carolina Cardoso Guedes, Kristianne Porta Santos Fernandes, Sandra Kalil Bussadori
July-August 2013, 24(4):488-492
DOI:10.4103/0970-9290.118393  PMID:24047844
Background: Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. Aim: The aim of the present study was to assess the effectiveness of Papacarie Duo ® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur). Settings and Design: A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. Materials and Methods: Two teeth were treated in each child (split-mouth design), with the randomization of two methods: Group 1 - chemomechanical caries removal with Papacarie Duo™; and Group 2 - removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale); rtention of the restorative material in the cavity; and the presence of secondary caries after 30 days. Statistical Analysis Used: Chi-squared test, Student's t-test, and Wilcoxon test. Results: No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13), the occurrence of pain (P = 0.585), or restoration status at the 30-day clinical evaluation (P = 0.713). Conclusion: The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.
  19 6,032 267
Oral health status of children with acute lymphoblastic leukemia undergoing chemotherapy
Umme Azher, Natasha Shiggaon
July-August 2013, 24(4):523-523
DOI:10.4103/0970-9290.118371  PMID:24047855
Objective: The aim of this study was to evaluate the oral health status of children with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. Study Design : A total of 94 patients of both sexes in the age group of 2-14 years who were diagnosed with acute lymphoblastic leukemia were selected for the study. The oral cavity was examined for dental caries using def-t and DMF-T indices, gingival status was evaluated by using the modified gingival index, and the WHO oral toxicity scale was used to record oral mucositis. Results: Statistical analysis was done by using Kruskal-Wallis and Mann-Whitney tests. Both DMF-T and def-t were highest in children during the maintenance phase of the chemotherapy followed by the induction therapy with radiotherapy (I 2 ) and induction therapy (I 1 ) phases. The prevalence of gingival inflammation was highest in the maintenance phase of the chemotherapy followed by the induction therapy with radiotherapy (I 2 ) and Induction therapy (I 1 ) phases. Signs and severity of oral mucositis were highest in children undergoing induction therapy with radiotherapy (I 2 ). Conclusion: Good oral care is essential to maintain healthy oral cavity in children with acute lymphoblastic leukemia, as improvement in oral conditions may diminish their sufferings and prevent the spread of serious infections from oral cavity.
  14 6,019 225
Assessment of antimicrobial potential of 10% ginger extract against Streptococcus mutans, Candida albicans, and Enterococcus faecalis: An in vitro study
Anjan Giriraju, GY Yunus
July-August 2013, 24(4):397-400
DOI:10.4103/0970-9290.118356  PMID:24047828
Background: Streptococcus mutans, Candida albicans, and Enterococcus faecalis are the three oral microorganisms most commonly implicated in the causation of oral infections. All these oral microorganisms have shown resistant to routinely used antimicrobials. There is a need for an antimicrobial agent which is effective, safe, and economical. Zingiber officinale, commonly known as ginger is one such plant product which has been used from ancient time. It has been shown to possess promising inhibitory effect on many of the oral microorganisms. On review of dental literature, there was scarcity of studies which had tried to assess antimicrobial potential of ginger extract against S. mutans, E. faecalis, and C. albicans; hence, the present study was designed. Aim: To evaluate the in vitro antimicrobial potential of 10% ginger extract against S. mutans, E. faecalis, and C. albicans. Settings and Design: Laboratory setting and experimental design. Materials and Methods: In the first part of the study, 10% ethanolic ginger extract was prepared in the laboratory of Pharmacy College. It was then subjected to microbiological assay to determine its zone of inhibition using Agar disk diffusion test and minimum inhibitory concentration (MIC) using serial broth dilution method against S. mutans, C. albicans, and E. faecalis. Results: 10% ethanolic ginger extract showed: (a) Maximum zone of inhibition of 8 mm, 14 mm, and 11 mm against S. mutans, C. albicans, and E. faecalis respectively. (b) MIC of 1.25%, 2.5%, and 2.5% against S. mutans, C. albicans, and E. faecalis respectively. Conclusion: 10% ethanolic ginger extract was found to possess antimicrobial potential against all the three pathogens used in the study.
  12 13,334 528
Evaluation of micronutrient (zinc, copper and iron) levels in periodontitis patients with and without diabetes mellitus type 2: A biochemical study
Biju Thomas, Anshuman Gautam, B Rajendra Prasad, Suchetha Kumari
July-August 2013, 24(4):468-473
DOI:10.4103/0970-9290.118400  PMID:24047840
Context: Periodontal tissue destruction is caused by an inappropriate host response to microorganisms. Diabetes is a metabolic disease and most of its complications are due to hyperglycemia. Periodontitis is considered as its sixth complication. Micronutrients such as zinc, copper and iron are essential for human health. There is accumulating evidence that the metabolism of several trace elements is altered in diabetes mellitus and that these nutrients might have specific roles in the pathogenesis and progress of this disease and its complication. An association between micronutrients and periodontitis has also been suggested by preliminary studies. However, till date there is a lack of relevant clinical data. Aim: This study was designed to estimate and compare the serum levels of zinc, copper and iron in diabetes mellitus type 2 patients and healthy individuals with and without periodontitis. Setting and Design: Single centre case-control study. Subjects and Materials: This study included 150 subjects, 50 in each group. Group 1 comprised of 50 subject with diabetes mellitus type 2 and periodontitis. Group 2 comprised of 50 subjects with chronic periodontitis and Group 3 comprised of 50 control subjects. Atomic absorption spectrophotometry method was used to measure clinical level of zinc and copper in serum. Estimation of serum iron levels was done by bathophenanthroline method. Statistical analysis: The results obtained were tabulated and subjected to statistical analysis by analysis of variance and Tukey multiple comparison tests using statistical software SPSS version 17. Results: The results showed that the serum levels of zinc decreased and serum levels of iron and copper increased in diabetes patients with periodontitis compared to healthy individuals with and without periodontitis. Conclusion: Imbalance of Zinc, copper and iron levels in the serum can predispose an individual to the risk of developing periodontitis.
  10 5,317 392
Effect of fluoride-free and fluoridated carbamide peroxide gels on the hardness and surface roughness of aesthetic restorative materials
Homayoon Alaghehmand, Behnaz Esmaeili, Sina Arab Sheibani
July-August 2013, 24(4):478-483
DOI:10.4103/0970-9290.118397  PMID:24047842
Background: Bleaching products may show some side effects on soft and hard tissues and restorative materials in the oral cavity. This study evaluated the effect of carbamide peroxide gel with and without fluoride ions on the microhardness and surface roughness of tooth-colored restorative materials. Materials and Methods: In this in-vitro study, 76 cubic specimens (4 mm 3 × 4 mm 3 × 3 mm 3 ) were fabricated from 4 aesthetic A3-shade restorative materials. These materials consisted of two composite resins and two glass ionomers. The specimens made from each material were treated with the following surface treatments: 1. Control group: The specimens were not bleached and were stored in normal saline. Group 2. Fluoridated 20% carbamide peroxide gel, treated 3 h a day for 4 weeks. Group 3. Treated 1 h a day with fluoride-less 22% carbamide peroxide for two weeks. From each group, three other specimens were selected to be evaluated in terms of changes in surface roughness, under scanning electron microscopy (SEM). Results: In this study, fluoridated 20% carbamide peroxide gel increased the microhardness of the four aesthetic restorative materials. The fluoride-free carbamide peroxide 22% reduced the microhardness of the four used materials, which this change was significant for Vitremer and Amelogen. SEM analyses showed changes in surface roughness of glass ionomer specimens. Conclusion: The effect of bleaching on the microhardness of restorative materials is material dependent. Before the application of bleaching systems on the glass ionomer materials, the application of a protective barrier should be considered.
  8 2,843 127
Reliability of the frontal sinus index as a maturity indicator
Ajinkya A Patil, Ameet V Revankar
July-August 2013, 24(4):523-523
DOI:10.4103/0970-9290.118372  PMID:24047856
Aim: The aim of this study was to compare the reliability of frontal sinus as a skeletal maturity indicator in males and females. Setting and Sample Population: Lateral cephalograms of 75 males and 75 females, both in pre- and post-pubertal stages of development as determined by Middle phalanx of the third finger (MP3) radiographs. Materials and Methods: Lateral cephalograms were analyzed for frontal sinus maturity. Maximum height, maximum width and height to width ratio of the sinus were calculated. The mean height to width ratio of the sinus at respective MP3 stages were tabulated and subjected to statistical analysis to determine the correlation. Correlation at different MP3 stages between males and females was also determined. Results: Statistically significant differences were observed between the mean values of F and FG along with F and I stage in males, significant difference between the values of FG stage among males and females were also observed. Conclusion: Based on statistical and direct comparison of raw data, study concludes that frontal sinus is not reliable as a sole criterion for prediction of skeletal maturity.
  7 4,395 401
Comparative evaluation of antibacterial property and substantivity of chlorhexidine containing dentifrices with sodium lauryl sulfate and Tween as surfactants: An in vivo study
V Venu, AR Prabhakar, N Basappa
July-August 2013, 24(4):521-522
DOI:10.4103/0970-9290.118367  PMID:24047853
Aim: The aim of the study was to determine the antibacterial property and substantivity of chlorhexidine containing dentifrices with sodium lauryl sulfate (SLS) and Tween as surfactants. Materials and Methods: It is a double-blind cross over the study, a total of 20 children within their mixed dentition period (7-13 year) having Streptococci mutans count more than 10 6 were selected for the main study. Three types of chlorhexidine containing dentifrices were used with a washout period of 1 week. Out of the three toothpastes, one was without surfactant and other two toothpastes contained SLS and Tween as surfactants respectively. 20 volunteers brushed for 1 min during the study day with their assigned toothpaste. Saliva samples were collected before brushing, immediately after brushing and 1, 3, 5, and 7 hand sent for microbial analysis. The culture carried out by inoculating saliva sample onto Mitis salivarius agar for selective isolation of S. mutans followed by counting of colony forming unit. Results: Group I and III (Chlorhexidine and CHX + Tween) had shown statistically significant reduction in bacterial count until 7 h when compared to their baseline values ( P < 0.001). Group II toothpaste (CHX + SLS) had shown significant reduction in bacterial count until 3 h only. On inter group comparison, Group III had shown good amount of percentage reduction in bacterial count when compared to other groups. Conclusion: CHX + Tween toothpaste had shown statistically significant reduction in antibacterial activity and substantivity than other groups. These findings show chlorhexidine containing toothpaste with non-ionic surfactant will be able to maintain the antibacterial property and substantivity of chlorhexidine.
  6 4,170 184
Comparing the sealing properties of mineral trioxide aggregate and an experimental ceramic based root end filling material in different environments
Seyed Mohsen Hasheminia, Sam Loriaei Nejad, Omid Dianat, Jalil Modaresi, Faranak Mahjour
July-August 2013, 24(4):474-477
DOI:10.4103/0970-9290.118399  PMID:24047841
Background: An apical seal is an important factor in achieving success in surgical endodontics. Aim: The purpose of this study was to compare the sealing properties of mineral trioxide aggregate (MTA) with a new ceramic based root end filling material (Cold Ceramic) in different environments. Materials and Methods: One hundred teeth were selected. The root canals were instrumented and obturated. Except for the apical 2 mm, the root surfaces were sealed. After root resection, 3 mm depth root-end cavities were prepared. For each material, roots were divided into 3 equal subgroups and the root-end filling was done in different environments (dry, saliva contaminated, blood contaminated). Five roots served as positive and 5 roots as negative controls. Samples were immersed in 2% methylene blue dye. Roots were sectioned longitudinally and examined under stereomicroscope to record the extension of dye penetration. Results: All experimental groups demonstrated dye penetration. The lowest linear leakage was seen in Cold Ceramic blood contaminated group while the highest leakage was observed in MTA blood contaminated group. The linear dye penetration of both MTA and Cold Ceramic (CC) groups did not show any significant differences among different environments. Also, the difference between MTA and CC was not significant in dry and saliva contaminated subgroups. Only the difference between dye penetration of MTA and CC in blood contaminated subgroups showed significant difference ( P = 0.008). Conclusion: The sealing property of this ceramic based root end filling material (Cold Ceramic) is better than MTA in blood contaminated condition and at least similar to MTA in other conditions.
  6 2,892 174
Prevalence of dentofacial abnormalities in children and adolescents with β-thalassaemia major
Arun Elangovan, Jayanthi Mungara, Elizabeth Joseph, Vignesh Guptha
July-August 2013, 24(4):406-410
DOI:10.4103/0970-9290.118360  PMID:24047830
Background: β-thalassaemia major is a hereditary hemolytic anemia and the patients often experience growth retardation, protrusive maxilla, and depressed nasal bride leading to various degrees of malocclusion. Aim: The purpose of this investigation is to find the prevalence of dentofacial abnormalities in β-thalassaemia major patients. Subjects and Methods: Seventy-two patients between 6 and 18 years of age diagnosed with β-thalassaemia major were examined for extraoral abnormalities, malocclusion, oral hygiene, and dental caries. Data obtained were tabulated and statistically analyzed using Chi-square and paired t-test. Results: Thirty-nine (54.2%) were males and 33 (45.8%) were females. Prominent extraoral abnormalities were found in 41 (56.9%) of the individuals. Study population predominantly had class I occlusion (59.7%) followed by class II occlusion (23.6%) and no class III occlusion. Mean oral hygiene index-simplified score was 2.43 ± 1.24, mean decayed missing filled teeth (DMFT) score was 7.10 ± 3.92, and deft was 5.68 ± 3.12. Conclusion: Despite starting regular blood transfusion at an early age, β-thalassaemia major patients showed marked facial abnormalities. When compared with individuals with no systemic disease, oral hygiene status was similar, but the caries experience was higher in β-thalassaemia major patients. Therefore, emphasis to educate these patients in the prevention and control of dental caries and maintenance of good oral hygiene should be considered.
  5 5,660 344
Comparative evaluation of stresses in tooth implant connected fixed partial denture by varying the implant design and position: A 3D finite element study
KV Pratheep, Abby Abraham, H Annapoorni, S Vigneshwaran
July-August 2013, 24(4):439-445
DOI:10.4103/0970-9290.118388  PMID:24047835
Aim: This study aims at evaluating stresses generated in a fixed tooth to implant connected fixed partial denture (FPD) by finite element method by varying implant design and position, in unilateral distal extension cases, i.e. for replacing mandibular 1 st and 2 nd molars. Materials and Methods: Four models were created, Model 1-A finite element model (FEA) model of a crestal implant-tooth connected metal ceramic FPD with pontic in 36 region. The 35 region simulated the second premolar. Model 2-A FEA model of a basal implant-tooth connected metal ceramic FPD. Model 3-A FEA model of a crestal implant in 36 region connected to tooth 35 and cantilevered posteriorly with pontic in 37 region, made of metal ceramic. Model 4-A FEA model of a basal implant in 36 region connected to tooth 35 and cantilevered posteriorly with pontic in 37 region, made of metal ceramic. A vertical force of 100N directed evenly on the nodes on the occlusal surface of each of the three crowns. The models displayed stress both numerically and by color coding. Results: On comparing models 1 and 2, the model 1 showed comparatively more stresses in crestal bone area of the implant. On comparing models 3 and 4, model 3 showed lesser von misses stress values. Conclusion: In case of tooth implant connected FPDs without any cantilevers, basal implants show better stress distribution when compared to crestal implants. In case of cantilever designs, crestal implant design showed lower stress values, but the difference in stresses were less.
  4 4,073 226
Restoration of an endodontically treated premolar with limited interocclusal clearance
Sandya K Kini, Vidya Saraswathi Muliya
July-August 2013, 24(4):518-520
DOI:10.4103/0970-9290.118383  PMID:24047851
Endodontically treated teeth with the loss of coronal tooth structure when left untreated for a long period may cause supraeruption, drifting, tipping, and rotation of adjacent and opposing teeth. This may be challenging to the clinician, when fabricating a crown because of inadequate interocclusal space. This case report describes a simple technique to restore an endodontically treated maxillary first premolar with the loss of coronal tooth structure and lack of interocclusal space. The maxillary first premolar had a single root canal and was endodontically treated. The lower premolar had supraerupted reducing the interocclusal space. A minimally invasive and esthetic technique was used to restore the tooth with limited interocclusal clearance. The tooth was restored with a Richmond crown, which had the morphology of a canine instead of a premolar. Thus, the tooth was salvaged by changing the morphology of the crown and the desired functional and esthetic results were obtained.
  4 3,718 210
Calcium phosphate cement as an alternative for formocresol in primary teeth pulpotomies
Bijimole Jose, N Ratnakumari, Mira Mohanty, HK Varma, Manoj Komath
July-August 2013, 24(4):522-522
DOI:10.4103/0970-9290.118370  PMID:24047854
Background: Formocresol remains to be the preferred medicament in pulpotomy, despite the concerns regarding tissue devitalization and systemic toxicity. Several materials were used as alternatives, but none proved significantly advantageous. Of recent, calcium phosphate cement (CPC) has been projected as an ideal pulpotomy material considering its tissue compatibility and dentinogenic properties. This study explores the suitability of a CPC formulation for pulpotomy, in comparison with formocresol. Materials and Methods: This comparative case study included 10 children (8-12 age group) having a pair of non-carious primary canines (both maxillary and mandibular) posted for extraction. Pulpotomy was performed with CPC in the right canines and formocresol in the left and sealed with IRM ® (Dentsply). The teeth were extracted at 70 ± 5 days and sectioned and stained for the histopathological evaluation. Parameters such as pulpal inflammation, tissue reaction to material, dentine bridge formation, location of dentine bridge, quality of dentine formation in bridge, and connective tissue in bridge etc. were evaluated. Results: The histological assessment after 70 days showed no statistically significant difference between the two groups in any of the parameters. However, CPC gave more favorable results in pulpal inflammation, with a lower score of 1.6 against 2.6 for formocresol. CPC samples showed better formation of dentine bridge in quantity and quality. The mean scores for CPC for the extent of dentine bridge formation, quality of dentine bridge and connective tissue in the bridge, were 2.0, 1.4, and 1.2 respectively, whereas the corresponding values for formocresol were 0.8, 0.2, and 1.0. Conclusion: CPC is more compatible to pulp tissues than formocresol and it shows good healing potential. CPC is capable of inducing dentine formation without an area of necrosis.
  2 7,456 320
Comparison of marginal accuracy of castings fabricated by conventional casting technique and accelerated casting technique: An in vitro study
S Srikanth Reddy, Kakkirala Revathi, S Kranthikumar Reddy
July-August 2013, 24(4):446-450
DOI:10.4103/0970-9290.118390  PMID:24047836
Background: Conventional casting technique is time consuming when compared to accelerated casting technique. In this study, marginal accuracy of castings fabricated using accelerated and conventional casting technique was compared. Materials and Methods: 20 wax patterns were fabricated and the marginal discrepancy between the die and patterns were measured using Optical stereomicroscope. Ten wax patterns were used for Conventional casting and the rest for Accelerated casting. A Nickel-Chromium alloy was used for the casting. The castings were measured for marginal discrepancies and compared. Results: Castings fabricated using Conventional casting technique showed less vertical marginal discrepancy than the castings fabricated by Accelerated casting technique. The values were statistically highly significant. Conclusion: Conventional casting technique produced better marginal accuracy when compared to Accelerated casting. The vertical marginal discrepancy produced by the Accelerated casting technique was well within the maximum clinical tolerance limits. Clinical Implication: Accelerated casting technique can be used to save lab time to fabricate clinical crowns with acceptable vertical marginal discrepancy.
  2 3,193 225
Effect of ion-implantation on surface characteristics of nickel titanium and titanium molybdenum alloy arch wires
Manu Krishnan, Seema Saraswathy, Kalathil Sukumaran, Kurian Mathew Abraham
July-August 2013, 24(4):411-417
DOI:10.4103/0970-9290.118375  PMID:24047831
Aim: To evaluate the changes in surface roughness and frictional features of 'ion-implanted nickel titanium (NiTi) and titanium molybdenum alloy (TMA) arch wires' from its conventional types in an in-vitro laboratory set up. Materials and Methods: 'Ion-implanted NiTi and low friction TMA arch wires' were assessed for surface roughness with scanning electron microscopy (SEM) and 3 dimensional (3D) optical profilometry. Frictional forces were studied in a universal testing machine. Surface roughness of arch wires were determined as Root Mean Square (RMS) values in nanometers and Frictional Forces (FF) in grams. Statistical Analysis Used: Mean values of RMS and FF were compared by Student's 't' test and one way analysis of variance (ANOVA). Results: SEM images showed a smooth topography for ion-implanted versions. 3D optical profilometry demonstrated reduction of RMS values by 58.43% for ion-implanted NiTi (795.95 to 330.87 nm) and 48.90% for TMA groups (463.28 to 236.35 nm) from controls. Nonetheless, the corresponding decrease in FF was only 29.18% for NiTi and 22.04% for TMA, suggesting partial correction of surface roughness and disproportionate reduction in frictional forces with ion-implantation. Though the reductions were highly significant at P < 0.001, relations between surface roughness and frictional forces remained non conclusive even after ion-implantation. Conclusion: The study proved that ion-implantation can significantly reduce the surface roughness of NiTi and TMA wires but could not make a similar reduction in frictional forces. This can be attributed to the inherent differences in stiffness and surface reactivity of NiTi and TMA wires when used in combination with stainless steel brackets, which needs further investigations.
  2 3,852 217
Evaluation of biological, physical and chemical properties of mineral trioxide aggregate mixed with 4-META/MMA-TBB
Rudra Kaul, Riyaz Farooq, Vibhuti Kaul, Altaf H Malik, Aamir Rashid Purra, Lateef Ahmad
July-August 2013, 24(4):418-422
DOI:10.4103/0970-9290.118381  PMID:24047832
Aim: To evaluate the change in physical, chemical and biological properties when mineral trioxide aggregate (MTA) is mixed with a resin 4-methacryloxyethyl trimellitate anhydride (4-META)/methyl methacrylate-tri-n-butyl-borane (MMA)-TBB. Materials and Methods: For biological evaluation MTA was inoculated in Wistar rat's subcutaneous tissue and peripheral tissue response was checked after 72 h, 7 days, 15 days and 30 days. Setting time was evaluated using Gillmore needle. The Ca++ release at the end of 24 h was checked using ethylenediaminetetraacetic acid titration method. For all the trials MTA mixed with water was kept as a control and the ratio of MTA with resin was 1:1 by weight. Results: The biological reaction was verified by two observers and their readings were matched using kappa test and there was an excellent relevance. There was no significant difference in the tissue reaction at the end of 30 days where both the groups seemed to show healing. Setting time of MTA with 4-META/MMA-TBB was coming to a mean of 26 min (approx.), which is almost 6 times lesser than that of MTA with water. After applying t test, the difference in Ca++ release was found significant (P = 0.00), with mean of 0.044 and 0.031 mol/L of MTA with water and MTA with 4-META/MMA-TBB respectively. Conclusion: Under the parameters of this study, this new experimental cement has better handling, physical and chemical properties. Even its subcutaneous tissue reaction is comparable to MTA mixed with water.
  2 2,931 161
Finite element stress analysis on the influence of cuspal angle and superstructure materials in an implant-supported prosthesis
G Lambodaran, N Gopi Chander, M Vasantakumar
July-August 2013, 24(4):423-427
DOI:10.4103/0970-9290.118384  PMID:24047833
Purpose: To investigate the effect of superstructure materials and cuspal angle in an implant-supported fixed partial denture. Materials and Methods: This finite element analysis study was carried out with varying cuspal angulations of 0°, 20° and 33° and superstructure materials. The simulated models were loaded with 300N forces under different axial and non-axial angulations. The graphical and numerical stresses were investigated. Results: The results demonstrated that the maximum stress occurred in the metal framework in all the materials except acrylic, for which it occurred in the coronal part of the implant. In the acrylic, the maximum stress recorded was 78 MPa with the 20° angulation. Ni Cr recorded a maximum stress of 111 MPa with the 33° angulation. Conclusion: The cuspal morphology and type of superstructure material plays a pivotal role in controlling the stress transferred to the implant and the supporting bone.
  2 2,508 137
Prediction of the size of unerupted canines and premolars in an Iranian population
Mashaallah Khanehmasjedi, Leila Bassir
July-August 2013, 24(4):493-497
DOI:10.4103/0970-9290.118389  PMID:24047845
Background and Aim: One of the important aspects of diagnosis and treatment planning in the mixed dentition is estimation of the size of unerupted permanent canines and premolars. One of the most commonly used the prediction methods are Tanaka and Johnston, which are based on data from a sample of Northern European descent children. The accuracy of this method when applied to a different ethnic population is questionable. The aim of this study was to determine the modified equations from Tanaka and Johnston for Iranian population. Materials and Methods: This study was an analytic and cross-sectional investigation with the randomized cluster sampling in Ahwaz. Fifty four students of 14-18 years age (32 girls, 22 boys) were selected between 320 students and plaster models of their maxillary and mandibular arches were prepared. Subjects had fully erupted teeth, class I canine and molar relationship and presented no proximal caries or fillings, morphological anomalies, missing teeth or occlusal abrasion, and bruxism. The mesiodistal crown diameters of the permanent teeth were measured with using the sharpened boley gauge (accuracy 0.01 mm). The data were analyzed by using the regression correlation analyses and t-test. Results: The size of permanent canines and premolars were larger in maxilla than mandible and males than females. These values in Iran were different from other countries. Conclusion: In this study to predict the space (in mm) required for alignment of unerupted canine and premolars in Iranian children, halve the sum of mesiodistal dimension of the four mandibular incisors and add the respective constants 10.5 for upper jaw and 10 for lower jaw.
  2 3,575 150
Evaluation of total soluble solids content (TSSC) and endogenous pH in antimicrobials of pediatric use
Alessandro Leite Cavalcanti, Klélia Forte de Oliveira, Alidianne F. C. Xavier, Daiane S. C. Pinto, Fernando Fernandes Vieira
July-August 2013, 24(4):498-501
DOI:10.4103/0970-9290.118386  PMID:24047846
Background: The use of liquid pharmaceutical preparations is a daily occurrence for some children. Evidences show a significant relation between the intake of oral sucrose based medicines and an increase incidence in dental caries. Aim: This in vitro experimental study evaluated the Total Soluble Solids Content (TSSC) by means of Brix scale refractometry and the endogenous pH of antimicrobials of pediatric use presented as oral suspensions. Materials and Methods: Nine medications (6 chemotherapics and 3 antibiotics) were evaluated by random experiment with 3 repetitions for each sample. The analysis of TSSC readings were performed by Brix refractometry using the Abbé refractometer, and the pH values were determined by potentiometry. Results: The mean TSS contents ranged from 11.73 (Keflaxina) to 63.83 (Azitromed). The minimum and maximum mean pH values were 4.12 (Keflaxina) and 10.97 (Zitroneo), respectively. Conclusions: The chemotherapic antimicrobials evaluated in this study presented the highest TSSC means, while the antibiotics showed pHs below the values considered as critical, which may contribute to the development of caries lesions in case of inadequate administration of these medications to children.
  2 11,372 144
Facial nerve injury following surgery for temporomandibular joint ankylosis: A prospective clinical study
S Gokkulakrishnan, Sanjay Singh, Ashish Sharma, Amit Kumar Singh, Rajshree Borah
July-August 2013, 24(4):521-521
DOI:10.4103/0970-9290.118365  PMID:24047852
Objective: The purpose of this prospective study was to evaluate the incidence and degree of facial nerve damage and time taken for its recovery following surgery for temporomandibular joint (TMJ) ankylosis. Materials and Methods: A total of 30 subjects with the TMJ ankylosis with or without history of previous surgery were included in this prospective study. House-Brackmann grading system was used to assess the function of the facial nerve post-operatively. Results: Most of the subjects were in the age range of 13-15 years. Eight subjects had bilateral ankylosis and remaining 22 had unilateral ankylosis. Out of 32 joints in which gap arthroplasty was performed, 4 had Grade 1 injury, 14 had Grade 2 injury, 12 had Grade 3, and 2 with the Grade 4 injury 24 h post-operatively. Whereas, out of 6 cases of interpositional arthroplasty 4 had Grade 1 injury and 2 had Grade 4 injury. According to House-Brackmann grading system, at 24 h, 78.9% patients had different grades of facial nerve injury, which gradually improved and came to normal limits within 1-3 months post-operatively. Comparison of change in the Grade of injury at 3 months follow-up as compared to baseline (24 h) showed full recovery in all the cases (100%) showing a statistically significant difference from baseline (P < 0.001). Conclusion: When proper care is taken during surgery for TMJ ankylosis, permanent facial nerve injury is rare. However, the incidence and degree of temporary nerve injury could be either due to the heavy retraction causing compression and or stretching of nerve fiber resulting in neuropraxia.
  1 5,135 188
Hereditary ectodermal dysplasia: Report of 11 patients from a family
Seema Vaidya, Mukund Risbud, Avinash Kshar, Praveenkumar Ramdurg
July-August 2013, 24(4):502-506
DOI:10.4103/0970-9290.118373  PMID:24047847
Hereditary Ectodermal Dysplasia is an inherited disorder commonly involving skin, teeth, hair, and nails. We have observed ectodermal dysplasia (EDs) in 11 individuals over two generations in one family. Smooth, dry, thin skin was seen in most affected individuals. All had fine, slow-growing scalp hair and body hair and some had sparse eyebrows and short eyelashes. Nearly all showed decrease in sweating. Severe teeth abnormalities were seen in all patients and fingernail abnormalities were not so severe but toenail abnormalities were seen in all patients. No other abnormalities were seen in affected individuals in this family. It is very rare to find such a large family having ectodermal dysplasia.
  - 4,131 221
Modified snap-on attachment with 'O-ring' for two piece hollow bulb obturator
C Gunasekar, KS Gamal Abdul Nasser, C Sabarigirinathan, K Ram Kumar
July-August 2013, 24(4):507-510
DOI:10.4103/0970-9290.118376  PMID:24047848
Restoration of near normal functions in patients who have been treated with hemimaxillectomy is generally difficult, in view of the restriction in mouth opening following healing of large surgical wound. Further, the extent and nature of the surgical defect differ from patient to patient. Thus, design of an obturator needs to be patient oriented. In this report, we describe a novel snap-on attachment with O-ring in a conventional two piece hollow bulb obturator for a 70-year-old male treated for carcinoma of the left maxilla and sinus.
  - 2,888 181
McGibbon Syndrome: A report of three siblings
J Maria Rajathi, Ravi D Austin, Philips Mathew
July-August 2013, 24(4):511-514
DOI:10.4103/0970-9290.118377  PMID:24047849
Amelogenesis Imperfecta (AI) is a collective term for a number of developmental conditions characterized by abnormal enamel formation. Only a few cases of AI have been reported to occur in association with syndromes and metabolic conditions. McGibbon Syndrome or AI and Nephrocalcinosis Syndrome are such disorders with defective enamel and renal calcifications. Early diagnosis of this condition is essential to prevent renal failure and death of the patient.
  - 3,103 164
Maxillary repositioning according to Frankfort horizontal plane during orthognathic surgery
Mehdi Ghoreishian, Dariush Hasheminia, Hadi Hashemzehi, Saber Khazaei
July-August 2013, 24(4):484-487
DOI:10.4103/0970-9290.118395  PMID:24047843
Context: There are a lot of disagreements among surgeons over controlling the maxillary position during orthognathic surgery. Aim: To investigate maxillary repositioning according to Frankfort horizontal plane in orthognathic surgery. Materials and Methods: Fourteen patients were selected who were submitted to maxillary or bimaxillary surgery. Maxillary model surgery was performed based on the treatment planning and an intermediate splint was made. The surgical technique in this study was based on maxillary osteotomy according to the findings of the model surgery, in a manner that the osteotomy line was parallel to the Frankfort horizontal plane. Intermediate splint was used for repositioning of the maxilla in the new position and the vertical position of that was determined according to external reference point and fixed on this position. The upper central incisor designed from prediction tracing and post-operative cephalometry on the first tracing. The new position of maxilla was evaluated horizontally and vertically. Statistical Analysis Used: A paired t-test was used to compare the predicted maxillary position and the actual position. Association between these two groups of variables was evaluated with Pearson correlation. Results: The mean difference between the maxillary planned position and post-operative cephalometric radiography varied between 0.3 mm and 0.9 mm vertically (P value = 0.315) and 0.0 mm and 0.9 mm horizontally (P value = 0.034). The averages of horizontally and vertically observed changes were 0.3 mm and 0.17 mm respectively (P < 0.001). Conclusion: Good surgical accuracy in repositioning of the maxilla can be achieved according to Frankfort horizontal plane during the surgery. By eliminating the ramping effect the accuracy of surgery increases.
  - 2,814 113
Assessment of precipitate formation on interaction of irrigants used in different combinations: An in vitro study
Amarnath Shenoy, Nagesh Bolla, Sayish , Raj K Sarath, CH Sunil Ram, Sumlatha
July-August 2013, 24(4):451-455
DOI:10.4103/0970-9290.118392  PMID:24047837
Introduction: Irrigants play an essential role in the successful debridement and disinfection of pulp space. Various combination of irrigants used during root canal treatment enhance their efficacy, but some form precipitates which affects the diffusion of intracanal medicaments and the seal of the obturated root canal. Aim: To evaluate the combination of various irrigants whether it forms the precipitate and also to quantify the amount of precipitate formed. Materials and Methods: Five different irrigants were taken in ten test tubes each having the combination of two irrigants and observed for 2 min for precipitate formation. Results: One-way-ANOVA test revealed more amounts of precipitate with 2% Chlorhexidine (CHX) 5% Tulsi followed by 2% CHX, 5% Neem and 3% Sodium hypochlorite 2% CHX. Conclusion: Precipitate formation is seen more with the 2% CHX-5% Neem followed by 2% CHX-5% Tulsi when compared with the control group. When these combinations of irrigants were used, intermediate flushes of saline or distilled water reduced the amount of precipitate.
  - 3,931 320
Determination of craniofacial relation among the subethnic Indian population: A modified approach (vertical evaluation)
A Sumathi Felicita, Shyamala Chandrasekar, KK Shanthasundari
July-August 2013, 24(4):456-463
DOI:10.4103/0970-9290.118396  PMID:24047838
Aim: To measure the vertical linear cephalometric dimensions of the anterior and posterior segments of the craniofacial complex and establish ratios between vertical linear dimensions 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: The vertical segments measured are anterior maxilla, posterior maxilla, and ramus-cranial floor vertical. The facial heights were measured in the anterior and posterior region of the craniofacial complex. Establish ratios and proportions between the vertical segments and different facial heights. Results: In both the sexes, the ratio between anterior maxilla, posterior maxilla, and ramus-cranial floor vertical is 1:1:1, PTFH:ATFH is 1:1, AUFH:ATFH is 2:5, ALFH:ATFH is 3:5, PUFH:PTFH is 1:2, PLFH:PTFH is 1:2, AUDH:ALDH is 2:3, and facial depth is 2:1. PUDH:PLDH is 7:9 in females and 3:4 in males. There was a statistically significant difference in posterior total facial height:anterior total facial height ratio between the two sexes with a "P" value of 95%. Conclusion: Thus, the anterior maxilla, posterior maxilla, and cranial floor-ramus vertical composite are in dimensional balance in subjects with normal occlusion and facial harmony. This analysis helps to identify skeletal deviations in size and position in the vertical dimension and allows the clinician to outline an appropriate treatment.
  - 4,947 224
Efficacy of crystallization test for screening of oral squamous cell carcinoma with clinico-pathological correlation
Sachin C Sarode, Gargi S Sarode, Suresh Barpande, Jagdish V Tupkari
July-August 2013, 24(4):464-467
DOI:10.4103/0970-9290.118398  PMID:24047839
Aim: To determine the efficacy of crystallization test for screening oral squamous cell carcinoma (OSCC) with clinico-pathologic correlation. Materials and Methods: Fifty patients of OSCC and 30 healthy individuals were selected. One drop of blood was collected into 1 cc of doubled distilled water at room temperature to give a final dilution of 6% hemolyzed blood. 0.1 to 0.2 cc of blood sample was then subjected to crystallization test using 10% cupric chloride solution. Results: In healthy control group, the typical pattern was an eccentrically placed center of gravity with needles arranged in radiating fashion, while in OSCC group, there was 'transverse form' (TF) formation. The sensitivity and specificity of this test was found to be 96% and 96.66%, respectively. The positive and negative predictive values were found to be 97.96% and 98.55%, respectively. The mean TF frequency was found to be increasing from grade I (3.20 ± 1.5%) to grade II (653 ± 2.23%) and difference was statistically significant (P = 0.0001). However, there was no correlation between mean TF frequency and TNM stages of OSCC. Conclusion: Crystallization test is a simple, reliable, economical, less time-consuming, and less invasive screening procedure, which can be used for early detection of OSCC.
  - 2,903 321
A new and simple infant assessment table
MS Muthu, JM Farzan, KM Prathibha
July-August 2013, 24(4):515-517
DOI:10.4103/0970-9290.118380  PMID:24047850
Oral examination of an infant forms an important first step toward a lifetime of excellent oral health. Examining an infant during the first visit and the subsequent preventive examination visits may be challenging to dentists and pediatric dentists. There are few concerns regarding the effective oral examination using the traditional "knee-to-knee" position. This paper presents a new, simple infant examination table (INFANTT) to facilitate this examination. This table has many advantages, which includes its stability and simplicity. It is non-threatening and resembles common household furniture. Various modifications of the basic design are also possible to suit the individual dentist's preferences and dental office needs. Additionally, it is possible to use this INFANTT for performing fluoride varnish applications, taking radiographs of the anterior teeth and extraction of natal, neonatal teeth and traumatized teeth.
  - 2,953 206
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