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   Table of Contents - Current issue
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July-December 2021
Volume 13 | Issue 2
Page Nos. 83-159

Online since Friday, January 14, 2022

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EDITORIAL  

It is High Time that Journals Underscore the Indispensable Nature of Statistics in Scientific Research p. 83
Viswa Chaitanya Chandu
DOI:10.4103/jofs.jofs_259_21  
The role of biostatisticians in scientific research is poorly defined. Majority of manuscripts submitted to scientific journals do not receive statistical advice at as many stages as it requires and neither do they get subjected to a thorough statistical review as an integral part of the peer-review mechanism. This raises concerns about the validity of research findings, especially in light of the increasing reports on the incidence of statistical misuse in health-care research. It is high time that journals emphasize on statistical review of research submissions to ensure scientific validity.
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ORIGINAL ARTICLES Top

2D Evaluation of Condylar Vertical Positional Changes and Stability after Bilateral Sagittal Split Osteotomy p. 85
Syeda Fathimuz Zahara, Nandish Shetty, Pooja Harish
DOI:10.4103/jofs.jofs_28_21  
Introduction: The purpose of this study was to evaluate the condylar vertical positional changes and stability after the bilateral sagittal split osteotomy (BSSO) setback procedure for class III malocclusions. Materials and methods: This was a retrospective study comprising lateral cephalograms of 11 patients with 8 males and 3 females who had undergone BSSO, without additional surgery. Manual superimposition was performed with the Frankfurt horizontal plane as a reference. Condylar vertical, linear, and angular positional changes, and chin position were considered. To compare pre- and postsurgical statistics paired t test was used. Significance was set at P-value <0.05. Results: Two angular and three linear parameters showed statistically significant changes. The articular angle, gonial angle, the mandibular plane angle, and Ramal height decreased, Pogonion-Nasion parallel to Sella-Nasion increased postsurgically. Conclusion: There were significant condylar changes and the rigid fixation method provided maximum stability after the BSSO surgical procedure.
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Effect of Time, Temperature, and Storage on Fluoride Release and Recharge of Esthetic Restorative Materials p. 90
Madhura Sen, Prashanthi S Madhyastha, Madhu K Bangera, Srikant Natarajan, Ravindra Kotian
DOI:10.4103/jofs.jofs_236_20  
Introduction: The fluoride-containing restorative materials act as fluoride reservoir and release fluoride into the oral fluids gradually, thereby inhibiting secondary caries and restoration failure. The study can be utilized to develop improved regimes for topical fluoride delivery. The study evaluated and compared the influence of temperature, time, and storage conditions on the fluoride release and recharge of esthetic restorative materials. Materials and Methods: Silorane-based composite, methacrylate-based composite, compomer, and glass ionomer cement (GIC) were investigated for fluoride release and recharge with the fluoride selective ion electrode after immersion in distilled water and artificial saliva at 4°C, 37°C, and 55°C. Comparison between immersion media was performed with student t test, and comparison between materials and time interval (weeks and days) was performed with one-way ANOVA and Tukey post hoc test. The assessment of variation over time was assessed with repeated measures ANOVA. P-value was established to be significant at P < 0.05. Results: The highest rerelease was seen with GIC, followed by Dyract AP, Filtek P90, and Z100. Fluoride rerelease was greatest in GIC followed by Dyract AP in artificial saliva when compared to distilled water. Fluoride release was more significant at a higher temperature of 55°C. Also, fluoride recharge was highest at week 3 where the greatest rerelease was seen on day one. Conclusion: Fluoride release and recharge increase with temperature, time interval, and in artificial saliva.
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Histoscore and Discontinuity Score − A Novel Scoring System to Evaluate Immunohistochemical Expression of COX-2 and Type IV Collagen in Oral Potentially Malignant Disorders and Oral Squamous Cell Carcinoma p. 96
P. Sharada, Uma Swaminathan, B. R. Nagamalini, K. Vinod Kumar, B. K. Ashwini
DOI:10.4103/jofs.jofs_141_21  
Introduction: Cyclooxygenase 2 (COX-2) expression in oral potentially malignant disorders (OPMDs) such as oral submucous fibrosis (OSMF) and oral squamous cell carcinomas (OSCCs) has revealed inconclusive reports. Studies on loss of type IV collagen expression in oral epithelial dysplasias (OEDs) and OSCCs were subjective and lacked systemic approach. To evaluate the immunohistochemical (IHC) expression of COX-2 and type IV collagen in OED, OSMF, and OSCC. Materials and methods: IHC expression of COX-2 and type IV collagen on paraffin-embedded tissue section of 10 cases each in normal oral mucosa, mild OED, moderate OED, and severe OED, OSMF, and OSCC were evaluated using mean H score and discontinuity Score (DS) designed grades for every group, respectively. Mean H score of COX-2 was compared within and between the groups using analysis of variance (ANOVA), and DS designed specifically for type IV collagen expression was compared using Kruskal–Wallis ANOVA. Pairwise comparison between the groups were performed using Tukey multiple posthoc procedure and Mann–Whitney U test for COX-2 and type IV collagen, respectively. Results: Mean H scores of COX-2 expression increased significantly (P = 0.0001) as disease progressed from mild OED to severe OED. But COX-2 in OSCC was less than that observed in mild OED (P = 0.0001). Expression of COX-2 in OSMF was more than that observed in moderate OED. Type IV collagen expression decreased as disease progressed from OED to malignancy (P = 0.0001). OSMF indicated a variation in grades of loss of type IV collagen expression. Conclusion: Expression of COX-2 in OED, OSMF, and OSCC and DS for type IV collagen expression in our study could be effectively applied to assess the malignant potential of OPMDs. However, further studies need to be implemented on a larger sample size to conclude the above findings.
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Assessment of Position of Posterior Superior Alveolar Artery in Relation to Maxillary Sinus using Cone-Beam Computed Tomography p. 105
Manjushri Waingade, Someshwari Salunkhe, Raghavendra S Medikeri
DOI:10.4103/jofs.jofs_57_21  
Introduction: Posterior superior alveolar artery (PSAA) is branch of the maxillary artery which usually supplies the lateral wall of the sinus and overlying membrane. Evaluation and awareness of the anatomy of maxillary sinus before surgery is crucial to avoid surgical complications. The aim of this study was to examine the position and diameter of PSAA using cone-beam computed tomography (CBCT). Materials and methods: CBCT images of 201 healthy individuals were examined to evaluate the presence, position, and diameter of PSAA. The distances of lower border of the artery to the alveolar crest, bone height below the sinus floor to the ridge crest, distance of the artery to the medial sinus wall were measured; also presence of sinus septa were recorded. Results: The PSAA was detected in 90.04%, and it was located intraosseously and extraosseously in 65.74% and 32.25% of the sample population, respectively. The mean diameter of the PSAA was 0.94 ± 0.46 mm. The mean PSAA to the medial wall distance was 14.56 ± 3.05 mm, PSAA to alveolar crest distance (dentate patients) was 15.92 ± 3.84 mm, respectively. In the maxillary sinuses examined only 7.7% showed the presence of septa. There was no statistically significant difference when position of PSAA was compared with gender and diameter of PSAA was compared with age and gender. Conclusion: The likelihood of detecting the PSAA on CBCT is high; its location is intraosseous or beneath the sinus membrane in most patients. A thorough understanding of the PSAA regarding its location, diameter, and related structures can avoid complications during surgery.
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Pulp Tooth Ratio-Based Age Estimation of Adults Using CBCT Images p. 114
Nitin V Muralidhar, Priyanka Nitin, Swathi Kumareswar, Ajith Pillai
DOI:10.4103/jofs.jofs_232_21  
Introduction: The estimation of the age is of great significance in the various branches including the forensics dentistry. Various teeth have been considered for establishing the age using the pulp tooth ratio (PTR), using cone-beam computed tomography (CBCT) images. Hence, to standardize the protocol and the teeth to be considered for age prediction, we have selected and compared the maxillary and mandibular central incisors and canines, as these are the teeth having the least morphologic disturbances. Materials and methods: One hundred CBCT scans of patients visiting a private imaging center were collected, and the pulp volumes were assessed by the CBCT with sections axially and sagitally using “OnDemand3D Dental software.” The linear regression analysis was performed to know the relation of the variables. The correlation of the variables was estimated using the Pearson correlation coefficient. Results: Maxillary central incisors exhibited more reliability than the maxillary canines for age estimation and among the parameters used, the axial section was found to deliver better prediction percentage than the sagittal ones. Conclusion: Maxillary central incisor PTR can be reliably used to estimate the age of an individual when compared with the canines.
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Remineralizing Agents in the Prevention of Caries: A Systematic Review and Meta-analysis of Randomized Controlled Trials p. 121
Divya Bhavani Vasamsetti, Srinivas Pachava, Devaki Talluri
DOI:10.4103/jofs.jofs_235_21  
Introduction: The systematic review presented here aims to determine and find out the clinical efficacy of various remineralization agents for early enamel caries. Materials and methods: An aggregate of 240 articles has been retrieved from PubMed, Cochrane Library, Trip, and Google scholarly databases from 2010 to 2020, of which 18 randomized controlled trials (RCTs) have been integrated into this systematic review, and six of which were considered for meta-analysis. The risk of bias in each study was evaluated using the Cochrane collaboration’s tool. Results: Ten of the 18 studies suggest that carious lesions are successfully minimized by remineralization. Four studies showed superior efficacy of casein phosphopeptide and amorphous calcium phosphate (CPP-ACP) in the remineralization of white spot lesions. There was no statistically significant difference (standard mean difference = −0.18, 95% confidence interval: −0.48 to 0.12, P = 0.23) between the experimental and control groups. Conclusion: This review has demonstrated an absence of dependable proof supporting the clinical adequacy of remineralizing agents. Therefore, RCTs in well-designed forms are needed to enhance all sorts of evidence in this field.
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Efficacy of Curcumin and Piperine as Antioxidant Adjuvant to Intralesional Dexamethasone Injection for Management of Oral Submucous Fibrosis: A Clinical Trial p. 129
Nilima Sharma, Abhinav Jain, Sudhir Bahudar, Sukhvinder Singh Oberoi
DOI:10.4103/jofs.jofs_218_21  
Introduction: Oral submucous fibrosis (OSMF) is a well-recognized potentially malignant disorder of the oral mucosa with malignant potential estimated to be 7% to 13%. Both conservative and surgical treatment methodologies have been tried to bring relief from burning sensation, to decrease fibrous bands and to improve mouth opening. The role of curcumin as an anti-inflammatory, antioxidant has not been well established for the treatment of OSMF. Therefore, this study is undertaken. Materials and methods: The patients of OSMF attending the outpatient department of dentistry and otorhinolaryngology constituted the subjects for this study. Both groups were injected twice a week with dexamethasone sodium phosphate 4 mg/mL for 12 weeks. In addition, the test group was asked to take orally tablet TurmixR (curcumin 300 mg and piperine 5 mg) tablet 300 mg thrice daily orally for 3 months. The following outcome variables were measured 3 months posttreatment [burning sensation on visual analog scale, mouth opening (in millimeters) by vernier calipers, percentage relief in symptoms from pretreatment stage, and ultrasonographic evaluation of thickness of fibrotic bands]. Results: The mean change in burning sensation and mouth opening at weeks 3, 5, 7, 9, and 12 was significantly more among test group. The mean change in band length on ultrasonography on both right and left side from pre to mid and posttreatment was significantly more among test group. Conclusion: The commercially prepared avatar of Curcuma longa (turmeric) shows promise in reduction of signs and symptoms of patients with OSMF.
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Combination of Dental Pulp Stem-Cell Secretome and Robusta Coffee Bean Extract (Coffea canephora) in Enhancing Osteocalcin and Alkaline Phosphatase Expression in Periodontitis-Induced Wistar Rats p. 136
Millenieo Martin, Desi Sandra Sari, Roslian Ayu Mantika, Depi Praharani
DOI:10.4103/jofs.jofs_157_21  
Introduction: Indonesia riches with many beneficial herbal ingredients; one of them is coffee obtained from Jember which has antibacterial and anti-inflammatory properties for treating periodontitis. Meanwhile, dental pulp stem cells (DPSCs) during culture secrete various advantageous secretome for tissue regeneration. This investigation intended to examine the expression of osteocalcin (OCN) and alkaline phosphatase (ALP) after the administration of the combination between DPSC secretome and the Robusta coffee bean extract (RCBE) in periodontitis-induced animal model. Materials and methods: Thirty-five Wistar rats were randomly selected and divided into seven groups accordingly; group K0, group K1-7 (untreated periodontitis rats for 7 days), group K1-14 (untreated periodontitis rats for 14 days), group K2-7 (periodontitis rats administered with RCBE for 7 days), group K2-14 (periodontitis rats administered with RCBE for 14 days), group K3-7 [administered with both RCBE and stem-cell secretome (SCS) for 7 days], and group K3-14 (administered with both RCBE and SCS for 14 days). Periodontitis was induced by implementing wire installed in the rat’s first mandibular molar. The combination of RCBE and DPSC secretome was administered intrasulcus in the rat’s first mandibular molar gingiva. Moreover, least significant difference was performed after the analysis of variance test to investigate the significant difference between groups (P < 0.05). Results: The highest OCN and ALP were expressed in group K3-14, whereas the lowest OCN expression was found in K1-7 group and lowest ALP expression was displayed in K0 group. Additionally, there was significant difference in OCN and ALP between groups. Conclusion: The administration of the combination between dental pulp stem-cell secretome and RCBE (Coffea canephora) can enhance OCN and ALP expression as documented immunohistochemically.
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Association between Gingival Thickness and Recession in Nonperiodontitis Patients p. 142
Marjita Sarma, Nina Shenoy
DOI:10.4103/jofs.jofs_62_21  
Introduction: Gingival biotype defined as a genetically determined trait describes the thickness of gingiva faciopalatally. Gingival thickness plays an important role in the development and successful treatment of mucogingival defects. Gingival recession (GR) is an undesirable condition that creates root exposure, sensitivity, and unesthetic appearance. One of the main causes proposed for GR is an overzealous toothbrushing habit. Gingival tissues can be considered as “picture framework” for restorative and aesthetic procedures. The restorative dentist must take into account the response of gingival tissues to both inflammation and restorative margins to achieve maximum desirable outcomes. Hence, the aim of this study was to determine the association between gingival thickness (GT) and GR in nonperiodontitis patients. Materials and methods: The cross-sectional study was conducted in the Department of Periodontology, Mangalore. Eighty subjects with GR of both genders aged 18 to 35 years participated in the study. GT was assessed in the maxillary and mandibular teeth using the probe transparency method. A questionnaire was utilized to determine the toothbrushing habits of the subjects. Results: Thin gingiva was more commonly found in the maxillary arch (50%) and anterior sextant (52.50%). Maxillary posterior teeth were found to be frequently affected with GR (4.49%). Comparison of GT in the anterior and posterior sextants was not statistically significant (P = 0.43). A higher prevalence of thin biotype (73.8%) was found in sites with recession. Chi-squared test was used to determine the association between GT and GR. Statistical analysis was performed using the SPSS software version 22 (IBM). Conclusion: It can be concluded that there were variations in GT with respect to dental arch and sextants. Gingiva was thinner in the maxillary arch and anterior sextant. Receded surfaces were considerably higher on the buccal surfaces of posterior teeth. Higher prevalence of thin biotype was found at sites with recession. Subjects with splaying or flattening of their toothbrush bristles had a higher mean recession depth when compared with other subjects. However, the association between GT and GR was not statistically significant.
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Assessment of Inflammatory Domain on the Proliferative Activity of Odontogenic Keratocyst in Comparison with Dentigerous Cyst and Perapical Cyst p. 148
Reshma Amin, Ramya Shenoy
DOI:10.4103/jofs.jofs_257_21  
Introduction: Ki67 is a proven marker in assessing the aggressiveness of various neoplasms expressed in proliferating cells. The recognized role of p53 in a stress-induced cell represents gene mutation or disturbance of growth regulation. Therefore, a comparative analysis of p53 can give a better picture of proliferation in odontogenic keratocyst (OKC). In recent years, minichromosome maintenance (MCM) proteins are frequently in use for the application and evaluating cell proliferation. Our study plan was to compare the inter-relationship of p53, Ki67, minimicrosome (MCM2) markers in OKC, and other odontogenic cysts in inflammation, further checking the markers as a valuable tool in the prognosis and treatment of OKC. Materials and methods: Selected cases of 40 OKCs, 10 cases each of dentigerous cyst (DC) and periapical (PA) cyst showing mild to moderate inflammation were chosen from the department archives. Immunohistochemical procedure was carried out on all cases; interexaminer reliability was checked with Cronbach Alfa; and Chi-square was applied to check the association between the data. Results: Immunoexpression was significantly higher in OKC among p53, Ki67, and MCM2. The positivity of cells observed in OKC in the three markers did not show much difference (P = 0.666), though the intensity was statistically significant (P = 0.010). Comparative analysis among OKC, DC, and PA in all the three markers indicated statistical significance in the percentage of the positive cells and intensity. Conclusion: Considering the proportion of cycling cells relative to the expression of three markers, OKC imparts valuable information on proliferation. We speculate that the biological potential of OKC’s histopathogenesis lies within the lining epithelium, inflammatory cytokines contributing to the changes.
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Study of HPV16 L1 Capsid Seropositivity in Patients with Oral and Oropharyngeal Cancers p. 155
Shalini Kanaparti, Prasanthi Kolli, Pendyala Jyothi, Alapati Yedukondala Rao, Talapagala Lokeshu, Jahnavi Induluri
DOI:10.4103/jofs.jofs_258_21  
Introduction: Epidemiologic studies show that incidence of oral and oropharyngeal cancers (OPCs) is increasing worldwide over the last decades and the increase is more marked in men than in women. Several meta-analyses have suggested a rising prevalence of human papillomavirus (HPV) in the setting of OPC over time and have now reached epidemic proportions in many areas of the world. The aim of the study is to study the seroprevalence of HPV16-specific immunoglobulin (Ig) G and IgM antibodies and to determine whether the presence of these antibodies could be used as a potential biomarker in HPV16-related oral and OPCs. Materials and methods: Blood samples were collected from 70 patients with oral and OPCs. Samples were analyzed by indirect enzyme-linked immunosorbant assay (ELISA) to detect HPV16-specific IgG and IgM antibodies. Furthermore, the association of various other causal factors such as smoking, alcohol consumption, and betel nut chewing were also evaluated. Results: ELISA revealed that the HPV16-specific IgG antibodies were detected in 7 (10%) out of 70 patients analyzed and HPV16-specific IgM antibodies were not detected in all the cases (0%). High prevalence n = 4 (57.1%) of HPV16-related oral and OPCs was observed among males and in the 51 to 60 years age group who were smokers and alcohol abusers. Conclusion: Determining the HPV status in patients with OPC by serology might be an affordable option in the clinical settings to reduce the morbidity and mortality of patients with oral and OPCs by early intervention.
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