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   Table of Contents - Current issue
July-December 2020
Volume 12 | Issue 2
Page Nos. 65-138

Online since Tuesday, February 16, 2021

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Update on SARS-CoV-2: Pathogenesis, Immunity, Treatment Protocol and Vaccines in Perspective p. 65
KM Vidya
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Effect of COVID-19 Home Confinement on Family Well-Being p. 69
Rooban Thavarajah, Anusa Arunachalam Mohandoss, Kannan Ranganathan
Introduction: Home confinement (HC) due to Corona Virus Disease-19 (COVID-19) creates changes in family dynamics. A survey tool was developed based on existing tools to measure the changes in family attachment, bonding, changeability, and interaction during HC. The aim was to capture the changes in family well-being in a defined cohort of dentists and observe the role of sociodemographic factors in such a change. Material and Methods: A new tool “home containment mediated family improvement index (HCMFII)” was developed, pretested, and used for measuring the changes in family well-being. The survey intended to capture the basic demographic details along with HCMFII. This was developed as a Google form and circulated among Indian dentists for 72 hours from 29 May to 1 June. Descriptive statistics, measures of association, and one-way analysis of variance (ANOVA) were used to identify the difference between the demographic factors and HCMFII scores. P ≤ 0.05 was taken as significant. Result: In the 72 hours, 213 Indian dentists completed the survey. Of them, 37 (17.4%) had negative HCMFII scores, 56 (26.3) in neutral, and 120 (56.3%) with a positive outlook during HC compared to pre-COVID-19 situation. The mean HCMFII score was 53.9 ± 14. Age (P = 0.02), marital status (P < 0.00), children (P < 0.001), and income (P = 0.01) were significant factors influencing the scores. Discussion and Conclusion: A new tool to capture familial well-being in chrono-environment in presented. One of the two dentists perceived better family well-being, whereas one of the four perceived no change. Cause of concern is that one of the eight dentists still continue to have more disagreement-discordance than before HC and lesser family well-being. Extension of this index study would help to gauge the family well-being during HC and institute better modes of familial engagement to change the course of the pandemic.
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Assessment of Oral Mucosal Lesions Among Tobacco Users – A Cross-Sectional Survey p. 80
Geeta Sharma, Sabitha Gokulraj, Atul Bharadwaj, Kyatsandra Narasimhaiah Jagadeesh, Anuj Singh Parihar, Shruthi S Hegde
Introduction: Increased consumption of tobacco can lead to various oral mucosal lesions. The study was done to assess the oral mucosal lesions among tobacco users. Materials & Methods: This cross-sectional study was conducted on 5240 subjects who found to have a history of tobacco usage. Subjects with presence of oral mucosal lesions were subjected to vital tissue staining with toluidine blue dye (TB). Factors such as socio-economic status, occupation, type of tobacco usage, education status and type of lesions were recorded. Results: Hyperkeratosis was seen in 562 patients followed by smoker’s melanosis in 360, leukoplakia in 252 patients, squamous cell carcinoma in 190 patients, smoker’s palate in 130 patients, erythroplakia in 96, lichen planus in 80 and OSMF in 70 patients. Cases were due to Cigarette/bidi, were due to gutkha usage, 252 (14.4%) due to hookah, hukli and 214 (12.2%) due to zarda/pan masala. Oral mucosal lesions were significantly higher in patients with the habit of smoking cigarette/beedi 974 (55.9%) compared to those patients that were chewing gutkha 300(17.2%) or panmasala 214 (12.2%) (P < 0.05). There was significantly maximum lesions seen in buccal mucosa (812) followed by the retromolar pad area in 302, floor of mouth in 199, palate in 176, gingiva in 128, tongue in 90 and lip in 33 cases (P < 0.05). Conclusion: Authors found that most common oral mucosal lesion was hyperkeratosis followed by leukoplakia and smokers melanosis. Most common type of tobacco use was cigarette/bidi and gutkha.
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Evaluation of Stressful Life Events and Psychiatric Disorders in Patients Presenting with Psychogenic or Organic Origin Complaints Referred to Mashhad Faculty of Dentistry p. 84
Zahra Delavarian, Abbas Javadzadeh Bolouri, Ala Ghazi, Zohreh Dalirsani, Peyman Hashemian, Tahereh Nosratzehi
Introduction: Diagnosis of stressful life events and psychiatric disorders plays an important role in the management of patients having somatic complaints of psychogenic origin. The aim of this study is to compare stressful events among patients presenting with complaints of psychogenic or organic origin referred to the Oral and Maxillofacial Pain Clinic of Mashhad Faculty of Dentistry. Materials and Methods: 132 patients with complaints of psychogenic or organic origin were enrolled in our study. Both control and case groups completed the Scl-90 questionnaire, and the case-group patients were further evaluated by interview with a psychiatrist using DSM-IV-TR criteria. Results: In the case group, changes in work responsibilities and in family member’s health were the most common events in females and males, respectively. In the control group, the most common event among females was change in financial status, while for males this was change in work responsibilities. The mean severity of stressful events in the case group was significantly higher than that in the control group. According to the Scl-90 questionnaire, most of the control group patients (69.9%) were lacking any psychiatric disorders while most of the case patients (53.8%) were classified as having a tendency towards psychogenic disorders. Conclusion: Dentists come across Patients with psychogenic origin disorders on a daily basis. Thus, diagnosis and efficient management of such disorders becomes critical in populations of both modern and developing countries having persistent worries and stressful lifestyles.
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Evaluation of the Genotoxic Effects of Orthodontic NiTi Wires on Oral Mucosal Cells: An In Vivo Study p. 91
Katheesa Parveen, Muraleedhara Bhat, Akhter Husain, Abubakkar M Kinchanakodi
Introduction: Orthodontic wires are one of the main components of fixed appliance treatment. Bio-degradation of the metals in these wires could be a source of genotoxicity in the oral cavity. Materials and Methods: After the ethical committee approval and obtaining patient consent, the oral buccal mucosal smears were collected from buccal mucosa using a metal spatula from 27 patients before bonding, during NiTi, and during SS wire stage. The MN assay test was performed using Papanicolaou staining procedure. The micronuclei were examined and counted using previously reported criteria under an electron microscope before bonding, during NiTi, and during SS wire stage. Result: The data collected were subjected to analysis of variance test with Greenhouse–Geisser correction for comparison. It determined that mean mucosa cells differed statistically significantly between time points. Post hoc tests using the Bonferroni correction showed that there was an increase in MN cells from before bonding brackets to the tooth (mean value 6.15 ± 2.769) to during NiTi wire stage (mean value 344.85 ± 64.73), and a reduced count from NiTi wire stage (mean value 344.85 ± 64.73) to SS wire stage (mean value 160.52 ± 47.52). Conclusion: The orthodontic wires were observed to be genotoxic. The NiTi wire is considered to have more potential to cause genotoxicity when compared to SS wires. This could be because of the Ni element present in a higher percentage in NiTi wire as compared to SS wire, hence, element Ni can be considered to be genotoxic. Whether the effect of these wires on oral buccal mucosal cells is reversible has to be evaluated further.
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Antibacterial Efficacy of the Extract of Sargassum Wightii Against Oral Pathogen − An In Vitro Study p. 96
KT Magesh, R Aravindhan, M Sathya Kumar, A Sivachandran
Introduction: Oral cavity contains a plethora of microorganisms. These microorganisms have shown both beneficence and maleficence. The most common disease affecting the oral cavity not only to the human being but also for the animals was dental caries that are proved to have multi-bacterial origin. Bacterial species such as Streptococcus mutans (S.mutans), S.sanguis and Lactobacillus fermentum plays a major role in the pathogenesis of this disease. In this study, the crude extract of sargassum wightii is tested for its antibacterial efficacy against the S.mutants. Materials and Methods: The brown seaweed S. wightii was collected from the Gulf of Mannar. The samples were cut into small pieces and shade dried for five days. After drying, the samples were grounded and stored. Stock solution was prepared using soxhlet apparatus. The organic extract of the seaweed S. wightii was assayed for the antimicrobial activity against S. mutans using agar diffusion method and the result was compared with the positive control sample (Ampicillin). Results: Stock solution of S.wightii used in this study was prepared in the following grades 500, 750, and 1000 μg. It was found that zone of inhibition increased steadily as the concentration of the extract increased. Highest inhibition zone of about 23 mm was found out at the concentration of 1000 μg, whereas the control showed 38 mm. Result showed the definite antibacterial activity of S.wightii even with the crude extract. Conclusion: Majority of the treatment and preventive approaches for dental caries are based on the use of synthetic antibiotics and chemicals. Their excessive use leads to alterations in the oral and intestinal microbiome, development of resistance and other undesirable side effects. The use of natural resources or products has proven to be copious source of biologically active compounds.
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Effect of Cocoa Administration on Osteoblast Counts and Alkaline Phosphatase Levels During Orthodontic Tooth Movement in Rats p. 101
Thalia Ayu Arianda, Putri Rezqita, Pinandi Sri Pudyani, Niswati Fathmah Rosyida, Ananto Ali Alhasyimi
Introduction: The cocoa effect on osteoblast activity during orthodontic tooth movement remains unknown. To analyze the effect of caffeine in cocoa on osteoblast counts and alkaline phosphatase (ALP) levels during orthodontic tooth movement. Materials and Methods: The subjects used in this study were 24 male Sprague–Dawley rats aged 2.5–3 months. They were divided into treatment and control groups (n =1 2). A three-spin stainless steel coil spring with a 35 cN orthodontic force was stabilized on the maxillary incisors. The rats in the treatment group were given 4.8 g of cocoa powder with 2.7 mg of caffeine. All the subjects were euthanized in four consequent time periods (0, 1, 7, and 14 days), and tissue specimens were stained with hematoxylin-eosin. Osteoblasts were observed and counted under a light microscope with an Optilab camera at 400× magnification. ALP levels were examined through ELISA. Data were analyzed through two-way ANOVA followed by LSD post-hoc test. Results: Significant differences were observed in the control and treatment groups and the time of observing osteoblast count and ALP levels (P < 0.05). Osteoblast counts and ALP levels in the treatment group were significantly lower than those in the control group. Conclusion: Caffeine in cocoa might inhibit osteoblast activities by decreasing ALP levels and osteoblast count.
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Serum Iron Indices in Patients with Oral Submucous Fibrosis- A Comparative Study p. 107
KA Jassim, BS Sreenivasan, Deepu George Mathew, Soma Susan Varghese, Mayeesh Radakrishna, T Radhika
Introduction: Oral submucous fibrosis (OSMF) is a potentially malignant disorder whose etiopathogenesis is still under investigation. Studies have reported altered serum iron levels in patients with OSMF. Hence, iron has been proposed to play an important role in the incidence and progression of the disease. This study was undertaken to understand the role of iron in the etiopathogenesis of OSMF by estimating haemoglobin and serum iron indices (serum iron, Total iron binding capacity [TIBC], percentage transferrin saturation and serum ferritin) in subjects with OSMF. Materials and Methods: Study group comprised of patients with histopathologically confirmed OSMF (n = 30). Age and sex matched subjects with clinically normal mucosa were selected as control group (n = 15). Hemoglobin, serum ferritin, serum iron, and TIBC were estimated (Siemens Dimension RXL Max Integrated chemistry system™). Statistical analysis used: SPSSv16 was used for statistical analysis. Independent sample t test was performed to compare the values between the study group and control group. ‘p’ value less than 0.05 was considered to be statistically significant. Results: There was a significant decrease in the haemoglobin, serum iron percentage transferrin saturation, serum ferritin levels and an increase in TIBC levels in the study (OSMF) group when compared to the control group (P < 0.001). TIBC levels showed a significant (P< 0.001) increase in the study group. Among the study group 44% were in an anemic state as per the hemoglobin values. Conclusion: The findings of the present study suggest that, iron deficiency state is prevalent among patients with OSMF. This deficiency of iron has an important role in the pathogenesis and progression of this disease.
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Evaluation of Salivary 8-Isoprostane in Oral Lichen Planus: Case Control Study p. 113
Asha Sicily Dinesan, Rathy Ravindran
Introduction: Lichen planus is a chronic inflammatory disease that affects the skin, nails, and the mucous membrane and oral mucosal involvement may frequently precedes skin manifestation. It is hypothesized that free radicals and reactive oxygen species has a strong relationship in the pathogenesis of oral lichen planus. F2-isoprostane are a group of bioactive prostaglandins and they are isomers of PGF2α is a most accurate approach to assess oxidant injury in vivo. The aim of the study was to evaluate the level of 8-isoprostane in saliva of patients with erosive and nonerosive oral lichen planus in comparison with healthy controls. Materials and Methods: The study participants were selected by convenience sampling from department of oral medicine and dermatology department of our institution. In this case control study, 36 patients with oral lichen planus and 36 control subjects were included. The lichen planus group is again subdivided into erosive and nonerosive lichen planus group. Unstimulated saliva was collected by passive drool method. The salivary 8–isoprostane level was measured by using 8-isoprostane ELISA kit. The statistical tests used were Chi square test, ANOVA and Pearson correlation. Results: The mean values of the salivary 8-isoprostane level an increase in the oral lichen planus group when compared with control group and is statistically significant (P ˂ 0.05). Conclusion: The present study showed that oxidative stress was increased in patients with oral lichen planus, reflected by higher concentration of salivary 8 isoprostane being higher in erosive lichen planus than nonerosive lichen planus.
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Scanning Electron Microscopic Evaluation of Erosive Potential of Pediatric Liquid Medicaments on Primary Teeth p. 119
Mantri Pushpanjali, Avula Jogendra Sai Sankar, Enuganti Sridevi, Kundeti Siva Sankar, Kattappagari Kiran Kumar, Kolasani Balaji
Introduction: Pediatric liquid medicaments (PLMs) are the most accepted form of medication prescribed for children to treat different infirmities, however, their harmful effects on a child’s dental health are unaware for most of us. The present in vitro study was aimed to evaluate the erosive potential of two commonly used PLM’S on primary teeth and the remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on these erosive lesions. Materials and Methods: Forty deciduous teeth were randomly assigned to five groups (n = 8) in which group I samples were treated with Meftagesic-P, group II with Kofarest-PD, group III with Meftagesic P + CPP-ACP paste, group IV with Kofarest-PD + CPP-ACP paste, and group V samples were immersed in artificial saliva (control). Photomicrographs were taken at 2000× and 5000× magnification using a scanning electron microscope (SEM). Results: SEM photomicrographs elicited erosive changes in the enamel surface of all the samples in both groups I and II, however, the erosive changes in group II samples were more pronounced. The enamel surface of group III and IV samples that were treated with CPP-ACP after exposure to medicaments showed remineralization of erosed areas. Conclusion: Both the PLMs used in the study showed an erosive effect on the primary enamel surface. The severity of erosion increased with the exposure time. However, the application of CPP-ACP paste following the exposure to PLMs showed noticeable remineralization.
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Versatility of Kinesio-Taping in Postoperative Swelling, Pain, and Trismus After Surgical Removal of Impacted Lower Third Molars p. 126
Dani Mihir Tusharbhai, Mohan Baliga, Aananya Mishra
Introduction: Although extraction of an impacted lower third molar is a routine procedure, postoperative morbidities typically include swelling, pain, and trismus that increase patient suffering postoperatively. The appliance of Kinesio tape (KT) improves the blood and lymph flow, removing congestions of lymphatic fluid and hemorrhages. The aim of the present study was to evaluate the efficacy of the application of KT on postoperative swelling, trismus, and pain thereby improving the patient condition and well-being. Materials and Methods: Thirty patients with surgical removal of third molars were enrolled and randomized into two treatment groups (with/without KT). The tape was applied immediately after surgery and removed on fifth postoperative day. Facial swelling was measured using a five-line measurement at six specific time points. Pain scores were assessed using a visual analog scale, and mouth opening ability was assessed by means of calipers. The data were analyzed and compared using an independent sample t test. Results: The application of KT significantly reduced postoperative swelling, pain, and trismus. Moreover, patients with KT showed a considerably lower morbidity rate. Conclusion: The application of KT is a self-effacing, less traumatic, economical approach, which is free from an adverse reaction and improves patients’ quality of life. Besides, it can be seen as an adjunct/alternative to steroids or supplementary medications.
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Assessment of Airway Dimensions and Hyoid Bone Position in Class II Patients Treated with Fixed Twin Block and Forsus Fatigue Resistant Device − A Retrospective Cephalometric Study p. 131
Neel Dedhiya, Tejashri Pradhan, Aarti Sethia
Introduction: Obstructive Sleep Apnea Syndrome (OSAS) regulate pharyngeal airway volume. Forward displacement of mandibular repositioning appliances has advantage over an improvement of pharyngeal airway space and a change in the hyoid bone position. This study aims to assess the changes in the pharyngeal airway dimensions and hyoid bone position in growing individuals with retrognathic mandible treated with Fixed Twin Block (FTB) and Forsus Fatigue Resistant Device (FRD) to correct the skeletal Class II pattern. Materials and Methods: 40 skeletal Class II pattern patients were included in the study, to assess the pharyngeal airway space at three levels, upper pharyngeal width (UPW), middle pharyngeal width (MPW), and lower pharyngeal width (LPW). Hyoid bone measurements were Vertical dimension H-HOR and Horizontal dimension was H- VER. The study patients were divided into three groups and in each group 20 patients. Group-A treated with FTB appliance and Group-B treated with Forsus FRD appliance and Group C served as control group. At pre and post functional treatment condition, lateral cephalograms were evaluated. Results: Cephalometric analysis revealed a significant increase in the mean change of MPW (P = 0.005) between the FTB and the control group. There was significant, mean change seen of pre, post UPW, mean change of MPW over groups (P<0.01). Statistical significant difference was noted in the mean change of mandibular corpus length over groups and also when compared with FTB-Control (P<0.01). A significant difference in the mean change of the mandibular unit length, premandibular corpus length over the groups was noted. Conclusion: The FTB appliance was more effective in correcting the skeletal class II malocclusion as compared to the Forsus FRD appliance and therefore, there was marked improvement in the oropharyngeal airway dimensions (UPW, MPW) and hyoid bone displacement (anterior and superior).
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