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   2017| November  | Volume 9 | Issue 5  
    Online since November 27, 2017

 
 
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REVIEW ARTICLES
Obstructive sleep apnea
Joseph Arnold, M Sunilkumar, V Krishna, SP Yoganand, M Sathish Kumar, D Shanmugapriyan
November 2017, 9(5):26-28
DOI:10.4103/jpbs.JPBS_155_17  PMID:29284930
Obstructive sleep apnea syndrome (OSAS) is a potentially serious disorder attacking millions of people around the world. Many of these individuals are undiagnosed, and even though diagnosed often exhibit a poor compliance with the use of continuous positive airway pressure at nights, a very effective nonsurgical treatment. A variety of surgical procedures have been proposed to manage and treat OSA. This article throws insights into assessing the sites of obstruction and a number of surgical procedures designed to address OSA. The scope of this article is to provide information to dentists which enables them to identify the patients who have OSAS and to guide these patients in making informed decisions regarding treatment options.
  13 5,557 278
ORIGINAL ARTICLES
Prevalence, characteristics, and complications of supernumerary teeth in nonsyndromic pediatric population of South India: A clinical and radiographic study
Gibi Syriac, Elizabeth Joseph, S Rupesh, John Philip, Sunu Alice Cherian, Josey Mathew
November 2017, 9(5):231-236
DOI:10.4103/jpbs.JPBS_154_17  PMID:29284970
Introduction: Supernumerary teeth are the presence of more number of teeth over the normal dental formula and may occur in permanent as well as early mixed dentition. This study determined the prevalence, characteristics, and complications caused by supernumerary teeth in nonsyndromic South Indian pediatric population. Materials and Methods: Characteristics of supernumerary teeth determined by clinical and radiographic examination were recorded. The age, sex, number of supernumerary teeth, eruption status, morphology, position, orientation, and complications (if any) associated with supernumerary teeth were recorded for each patient who had supernumerary teeth. The data collected were statistically analyzed. Results: Supernumerary teeth were detected in 45 subjects (1.1%), of which 34 (75.6%) were male and 11 (24.4%) were female. There was no association between the number of supernumerary teeth and the gender of the patient. The total number of supernumerary teeth among the affected 45 patients was 54. The average number of supernumerary teeth per person was 1.2. The number of supernumerary teeth was one in 35 cases, two in 8 cases, and 3 in 1 case. Of the 45 patients, 8 patients with supernumerary teeth were in deciduous dentition stage, 29 patients were in mixed dentition stage, and 8 patients were in permanent dentition stage. Most supernumerary teeth presented in the anterior maxilla. Morphologically, conical-shaped supernumerary teeth were the most common finding. 68.5% of supernumerary teeth presented with straight orientation and inverted orientation was seen in 24.1%. Complications seen in patients with supernumerary teeth were delayed or noneruption of adjacent tooth malposition or rotation of adjacent teeth, diastema formation, and formation of dentigerous cyst. Conclusions: Supernumerary teeth have an incidence of 1.1% in South Indian population and can cause many complications that can harm the developing occlusion. Knowledge about supernumerary teeth may help the dentist in early diagnosis and early intervention.
  10 3,142 156
CASE REPORTS
Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach
JV Karunakaran, Chris Susan Abraham, A Kaneesh Karthik, N Jayaprakash
November 2017, 9(5):246-251
DOI:10.4103/jpbs.JPBS_100_17  PMID:29284973
  7 8,352 480
Pterygoid implant for atrophic posterior maxilla
VR Balaji, R Lambodharan, D Manikandan, S Deenadayalan
November 2017, 9(5):261-263
DOI:10.4103/jpbs.JPBS_103_17  PMID:29284976
Replacement of missing teeth in the posterior maxilla is always a challenge for the treating implant surgeon as the posterior maxilla has several obstacles in the form of quality, quantity, the anatomy of the maxillary sinus, and inaccessibility. To overcome these deficiencies, several surgical procedures such as sinus lift, bone augmentation, tilted implants, short implants, and zygomatic implants were tried. Since these procedures have their own limitations, pterygomaxillary region provides us an excellent place for placement of implant and rehabilitation of posterior maxilla. This case report describes the usage of the pterygomaxillary region for placement of the implant to restore atrophic posterior maxilla, without any additional surgical procedures.
  7 4,894 376
REVIEW ARTICLES
Ancient seed for modern cure – pomegranate review of therapeutic applications in periodontics
Arthiie Thangavelu, Sugumari Elavarasu, Rajasekar Sundaram, Tamilselvan Kumar, Dhivya Rajendran, Fairlin Prem
November 2017, 9(5):11-14
DOI:10.4103/jpbs.JPBS_101_17  PMID:29284927
Punica granatum (pomegranate), the member of Punicaceae family, is used in the prevention and treatment of health disorders. P. granatum contains diverse range of phytochemicals including ellagic acid, punicalagin, pedunculagin, quercetin, rutin, tannic acid, polyphenol, anthocyanins, and catechins. This review aims at providing an overview of the chemical constituents, antibacterial, anti-inflammatory, and antioxidant properties of P. granatum, and its role in the prevention and treatment of gingival and periodontal diseases.
  7 5,346 233
ORIGINAL ARTICLES
Incidence of trismus in transalveolar extraction of lower third molar
Gowri Balakrishnan, Ramesh Narendar, Thangavelu Kavin, Sivasubramanian Venkataraman, Subramaniam Gokulanathan
November 2017, 9(5):222-227
DOI:10.4103/jpbs.JPBS_161_17  PMID:29284968
Background: Conventional mandibular third molar removal produces tissue trauma that induces an inflammatory reaction, leading to postoperative sequelae, the most common ones being trismus which influences the patient's quality of life in the postoperative period. Identifying the factors determining trismus after mandibular third molar extraction helps us to evaluate and correlate the incidence of trismus with morphological and surgical factors that are associated with its incidence in the postoperative period. Methodology: Patients referred to our institution for surgical removal of their impacted lower third molar between November 2014 and February 2015 were the participants of the study. Type of impaction, indication, and level of difficulty based on Pedersen criteria were obtained. Postoperative pain, swelling, and mouth opening (MO) limitations were evaluated at postoperative day (POD) 0, POD1, POD3, POD5, and POD7 and were analyzed. P < 0.05 was considered statistically significant. Result and Conclusion: In this study, out of fifty patients, only nine patients had experienced limited MO during postoperative period when the duration of procedure exceeded 30 min. However, it occurred as cumulative of pericoronitis and tooth sectioning done. The postoperative trismus was more significant in disto-angular impaction (P < 0.05) due to postoperative sequelae, swelling and pain.
  6 3,432 197
Assessment of regeneration of bone in the extracted third molar sockets augmented using xenograft (CollaPlugTN Zimmer) in comparison with the normal healing on the contralateral side
Murugan Ranganathan, M Balaji, R Krishnaraj, Vivek Narayanan, Annamalai Thangavelu
November 2017, 9(5):180-186
DOI:10.4103/jpbs.JPBS_176_17  PMID:29284960
Introduction: Alveolar bone resorption is a significant clinical problem. Bone loss in third molar region following extraction or surgical removal not only leads to periodontal problems in second molar region but also it may lead to some serious problems like increased incidence of angle fractures. In order to reduce the risks following third molar surgery, the socket should be augmented with bone grafts. In recent days guided tissue regeneration is the most accepted and successful technique followed many authors and its efficacy has been proved. Materials and Methods: Based upon our clinical experience, the use of bio absorbable collagen wound dressing such as CollaPlugTN has achieved quick healing and more primary wound coverage. Amongst the graft materials collagen is preferable due to its high biocompatibility and hemostatic ability. This study was done to assess the regeneration of bone in the extracted third molar sockets using xenograft (CollaPlugTN-Zimmer) which was compared with the normal healing on the contra lateral side. The assessment was done to analyze post-operative healing complications and to compare the bone density formed between control site and implant site radiologically. Conclusion: On this basis of this study, the use of collaplugTN appears to be beneficial to the patient in postoperative wound healing and also for better bone formation. The use of this material was advantageous because of its simplicity of application cost effectiveness and availability. There is enhanced wound healing and early bone formation.
  5 6,270 167
An In vitro comparison of coconut water, milk, and saline in maintaining periodontal ligament cell viability
Vivian Flourish D'Costa, Madhu Keshava Bangera, Shravan Kini, Shakkira Moosa Kutty, Mallikarjuna Ragher
November 2017, 9(5):107-111
DOI:10.4103/jpbs.JPBS_117_17  PMID:29284947
Background and Objectives: Two of the most critical factors affecting the prognosis of an avulsed tooth after replantation are extraoral dry time and the storage media in which the tooth is placed before treatment is rendered. The present study is undertaken to evaluate the periodontal ligament (PDL) cell viability after storage of teeth in different storage media, namely, coconut water, milk, and saline. Materials and Methods: Forty sound human premolars undergoing extraction for orthodontic purpose were selected. The teeth were allowed to lie dry on sand/mud for 30 min followed by which they were randomly divided and stored in three different media, i.e., coconut water, milk, and saline. After 45-min storage in their respective media, the root surface was then scraped for PDL tissue. Results: The ANOVA and Newman–Keuls post hoc procedure for statistical analysis of viable cell count under a light microscope using hemocytometer demonstrated that coconut water preserved significantly more PDL cells viable (P < 0.05) compared with milk and saline. Conclusion: Storage media help in preserving the viability of PDL cells when immediate replantation is not possible. This study evaluated the posttraumatic PDL cells' viability following storage in three different storage media. Within the parameters of this study, it was found that coconut water is the most effective media for maintaining the viability of PDL.
  5 3,332 40
Effect of surface modifications on the retention of cement-retained implant crowns under fatigue loads: An In vitro study
R Ajay, K Suma, Seyed Asharaf Ali, Jambai Sampath Kumar Sivakumar, V Rakshagan, V Devaki, K Divya
November 2017, 9(5):154-160
DOI:10.4103/jpbs.JPBS_146_17  PMID:29284956
Background: Masticatory forces cause fatigue to the dental luting agents, adversely affecting the retention of these cement-retained crowns. Sandblasting (SB) and diamond abrading the abutment surface improves the bond strength of luting agents. However, the effect of acid etching (AE) on the implant abutment surface and the effect of other surface modifications under masticatory load are yet to be documented. Purpose: The aim of the study was to evaluate the effect of abutment surface modifications on the retention of cement-retained restorations subjected to cyclic fatigue loads. Materials and Methods: Forty Ni-Cr copings were made on Cp-titanium laboratory analogs. The specimens were divided into two groups as Group I: Uniaxial tensile loading (UTL) and Group II: Offaxial cyclic loading followed by uniaxial tensile loading [CTL]. Further subgrouped as, subgroup I: Control (C), subgroup II: SB, subgroup III: AE, and subgroup IV: SB + AE. The copings were luted with Zn2(PO4)3and subjected to uniaxial tensile loading. Copings were recemented, and CTL was conducted. Two-way analysis of variance was used as the statistical test of significance. Results: In relation to the subgroups, the bond strength of Zn2(PO4)3was higher in Group I than in Group II. The bond strength in subgroup IV was superior in both Group I and Group II (547.170 N ± 5.752 and 531.975 N ± 6.221 respectively). Conclusions: For both UTL and CTL, abutment SB + AE elicited maximum coping retention followed by AE. Off-axial cyclic loading adversely affected the retention irrespective of the surface modifications.
  5 3,116 280
Comparative evaluation of dental and skeletal fluorosis in an endemic fluorosed district, Salem, Tamil Nadu
Maya Ramesh, N Malathi, K Ramesh, Rita Mary Aruna, Sarah Kuruvilla
November 2017, 9(5):88-91
DOI:10.4103/jpbs.JPBS_77_17  PMID:29284943
Background: High levels of fluoride in the drinking water, especially ground water, results in skeletal fluorosis which involves the bone and major joints. This study was conducted to assess the prevalence of skeletal fluorosis to compare with dental fluorosis in an endemically fluorosed population in the District of Salem, Tamil Nadu. Materials and Methods: Institutional ethical clearance was obtained. A total of 206 patients who reported to the Department of Hematology for blood investigations were the participants in this study. Age, sex, place, weight, height, dental fluorosis, and skeletal complaints were noted down. Body mass index was calculated, and statistical analysis was performed. Results: Dental fluorosis was present in 63.1% and absent in 36.9% of the samples reported. Skeletal fluorosis was present in 24.8% and was absent in 75.2%. A large number of the patients had knee pain and difficulty in bending. Chi-square test was used for statistical analysis. Skeletal fluorosis and age were compared and P value was 0.00 and was significant. Dental fluorosis and skeletal fluorosis were compared and P value was found to be 0.000 and significant. Discussion and Conclusion: There is a need to take measures to prevent dental and skeletal fluorosis among the residents of Salem district. Calcium balance should be maintained, and fluoride intake should be minimized to reduce the symptoms. The government should provide water with low fluoride level for drinking and cooking. Once the symptoms develop, treatment largely remains symptomatic, using analgesics and physiotherapy.
  5 2,597 131
REVIEW ARTICLES
Systemic and topical steroids in the management of oral mucosal lesions
M Shashi Kiran, S Vidya, Gunjan Singh Aswal, Vinod Kumar, Vineet Rai
November 2017, 9(5):1-3
DOI:10.4103/jpbs.JPBS_91_17  PMID:29284925
From the time of its introduction in the 1040s, glucocorticoids have provided a panacea for many diseases. The therapeutic benefit of corticosteroids lies in their anti-inflammatory and immunosuppressive properties which makes them highly effective in the management of oral mucosal lesions. This article aims to present to the clinician, the plethora of options available as steroid therapy and enables one to choose based on the underlying disease and the properties of the drug.
  5 4,989 417
ORIGINAL ARTICLES
Color stability assessment of two different composite resins with variable immersion time using various beverages: An In vitro study
M Senthil Kumar, R Ajay, SA Miskeen Sahib, M Chittrarasu, M Navarasu, N Ragavendran, Omar Farooq Burhanuddin Mohammed
November 2017, 9(5):161-165
DOI:10.4103/jpbs.JPBS_149_17  PMID:29284957
Purpose of the Study: The aim of the study was to evaluate the difference in the color of microhybrid (MH) and nanofilled (NF) composite resins after 24 and 48 h in beverages such as red wine (RW), Coca-Cola, and distilled water. The specific objective of this study was to investigate the cumulative effect of the colorant solutions on the dental composites. Materials and Methods: MH and NF composite resins (A2 shade) were used in this current study. Sixty disk-shaped material specimens (10 mm in diameter × 2 mm in thickness) were prepared using a fiber mold (ring), with the desired dimensions. The specimen surfaces were polished using super-snap polishing system. Sixty specimens were divided into two groups of 30 each (Group I: MH resin composite; Group II: NF resin composite). Both the groups divided into six subgroups (Subgroup I: RW for 24 h [RW-24]; Subgroup II: RW for 48 h; Subgroup III: Coca-Cola for 24 h [CC-24]; Subgroup IV: Coca-Cola for 48 h [CC-48]; Subgroup V: Distilled water for 24 h [DW-24]; Subgroup VI: Distilled water for 48 h [DW-48]). All the samples were immersed in respective drinks for a period of 24 h, and color differences were measured using ultraviolet spectrophotometer. Once again, all the samples were immersed for another 24 h in the same drinks. After 48 h, the color change of the samples was measured. Measurements were made according to the CIE L × a × b × color space relative to the CIE standard illuminant D65. The color changes of the specimens were evaluated using the following formula: [INSIDE:1]Statistical analysis was performed. The data were analyzed using the one-way ANOVA and t-test at a significance level of 0.05. Conclusion: Color stability of MH composite resin was found to be inferior than the NF resin composite irrespective of immersion medium and time. In RW, the color change observed was maximum for both composite resins followed by Coca-Cola. Immersing the resin composites in distilled water for 24 and 48 h had negligible color change. A 48-h immersion of both composite resins in all three immersion mediums showed greater color change than 24 h immersion.
  4 3,774 181
Incidence and pattern of dental erosion in gastroesophageal reflux disease patients
Anupama Ramachandran, Sulthan Ibrahim Raja Khan, Nandinee Vaitheeswaran
November 2017, 9(5):138-141
DOI:10.4103/jpbs.JPBS_125_17  PMID:29284953
Aim: Gastroesophageal reflux disease (GERD) is a very common condition whose consequences of are localized not only in the esophagus; extra-esophageal involvement has frequently been reported. The aim of the study is to examine the incidence and pattern of dental erosion in GERD patients. Methodology: A total of 50 patients were recruited in this study (control -25 and GERD -25). All participants diagnosed having GERD by the endoscopic examination by their gastroenterologist are included. The patients were examined for dental erosion and will be quantified using Basic erosive wear examination index. Results: The results showed that the incidence of dental erosion was 88% as compared to 32% in the control group which was found to be statistically significant.
  4 3,305 145
Effect of transcutaneous electrical nerve stimulation on parotid saliva flow in patients with hyposalivation
P Venkatalakshmi Aparna, S Leena Sankari, M Deivanayagi, A Priyadharshini, CK Vishnupriya, B Niveditha
November 2017, 9(5):142-146
DOI:10.4103/jpbs.JPBS_124_17  PMID:29284954
Context: In recent days, we have come across an increase incidence of dry mouth as a side effects of drugs and in order to bring an awareness about a simple non- invasive method to increase the salivary flow, we have used TENS which in many way is beneficial to patients with metabolic disorders. Aims and Objectives: The aim is to assess the effectiveness of transcutaneous electrical nerve stimulation on salivary gland function in patients with hyposalivation. Subjects and Methods: The present study included total of 25 subjects with complaint of hyposalivation. Written informed consent was obtained from all the participants. Subjects with pacemakers, autoimmune diseases, pregnancy, and history of salivary gland pathology were excluded from the study. Subjects were asked to refrain from eating, drinking, chewing gum, smoking, and oral hygiene procedures for at least 1 h before the appointment. Unstimulated saliva was collected using modified Carlson Crittenden cup placed over the Stenson's duct bilaterally for 5 min and measured. TENS pads were placed over the parotid region and were activated. The intensity control switch was adjusted for patient's comfort. The intensity was turned up 1 increment at a time at 5 s intervals until the optimal intensity level was reached and stimulated saliva was then collected for 5 min using the modified Carlson Crittenden cup and measured. Any increase in parotid salivary flow (SF) with electrostimulation was considered a positive finding. Statistical Analysis Used: A paired t-test, evaluating mean changes in stimulated versus unstimulated SF rates, was applied to look for statistically significant differences using PASW 18.0 for Windows. An independent sample t-test was performed to note difference between genders. Results: There was significant increase in parotid SF in 19 of 25 patients after transcutaneous electrical nerve stimulation. Males showed more salivary secretion when compared to females. Conclusions: From the results of the study and within limitations of the study, it can be concluded that TENS was effective in increasing the SF rate in hyposalivatory patients with residual saliva. TENS was less effective in patients who are under xerogenic drugs. Thus, TENS may be an ever-growing armamentarium in the management of salivary gland hypofunction when other therapies have failed or are contraindicated.
  4 2,804 129
Evaluation of push out bond strength of fiber post after treating the intra radicular post space with different post space treatment techniques: A randomized controlled In vitro trial
Sebeena Mathew, Iswarya R Raju, CP Sreedev, K Karthick, T Boopathi, NT Deepa
November 2017, 9(5):197-200
DOI:10.4103/jpbs.JPBS_156_17  PMID:29284963
Objective: The aim of this study was to evaluate the push out bond strength after treating the post space with different irrigation procedures. Study Design: The study sample comprised of 60 recently extracted premolars. These teeth were placed in 5.25% sodium hypochlorite solution for 5 min and then washed under tap water. De-coronated samples were biomechanically prepared until F3 ProTaper and obturated using AH-Plus and 30# (6%) gutta-percha. The specimens were allowed to set for 24 h and then post space was prepared. The teeth were randomly assigned into three experimental groups based on the treatment technique: Group A – control, Group B – sodium hypochlorite and ethylene diamine tetra acetic acid (EDTA) and Group C – diode laser and EDTA. The samples were sectioned horizontally and push out bond strength was evaluated. The stereomicroscopic examination was done for evaluating the failure mode. One-way ANOVA variance followed by Tukey's post-hoc test was used for statistical analysis using SPSS software. Results: Use of diode laser does not enhance the bond strength of fiber post. Conclusion: Diode laser at a very low pulse can be used as an irrigant adjuvant to vaporize the cement residues. Using diode laser does not enhance the bond strength. EDTA as final irrigant increases the bond strength of fiber post.
  4 2,283 122
REVIEW ARTICLES
Oral field cancerization and its clinical implications in the management in potentially malignant disorders
Anisha Cynthia Sathiasekar, Deepu George Mathew, MS Jaish Lal, AA Arul Prakash, KU Goma Kumar
November 2017, 9(5):23-25
DOI:10.4103/jpbs.JPBS_109_17  PMID:29284929
Oral cancer is one of the common malignancies reported in India. Most of these cancers are preceded by potentially malignant disorders. Despite improvements in the management strategies of these cancers the posttreatment prognosis has remained poor. The 5-year survival rates of oral cancers in most countries are still below 50%. The poor outcomes in oral cancer prevention and treatment can be due to nature of the spread of genetically altered cells as fields within the epithelial compartment. The conventional management protocols need to be modified taking into consideration the field spread of genetically altered cells.
  4 3,143 245
Are tooth prints a hard tissue equivalence of finger print in mass disaster: A rationalized review
Shaik Kamal Sha, B Vengal Rao, M Sirisha Rao, KV Halini Kumari, Sudarshan Kumar Chinna, Divya Sahu
November 2017, 9(5):29-33
DOI:10.4103/jpbs.JPBS_131_17  PMID:29284931
Personal identification methods may not be efficient when bodies are decomposed, burned, in cases of mass disasters when soft tissue cannot provide reliable information or has been lost. Various methods currently employed in forensic odontology for personal identification include comparing with antemortem dental charts, rugoscopy, denture labeling, DNA analysis from dental pulp, bite mark analysis, etc., Recently, there is growing interest in the study of enamel rod end patterns. These enamel rod end patterns are termed as “Tooth prints” and the study of these prints is known as “Ameloglyphics” (amelo: Enamel, Glyphics: Carvings). This review encompasses about the basis of using enamel rod end patterns, methods of obtaining the patterns and further suggests these tooth prints as an analogy to finger print in personal identification in mass disasters.
  4 3,803 203
A clinicopathological study of various oral cancer diagnostic techniques
G Ulaganathan, K Thanvir Mohamed Niazi, Soundarya Srinivasan, VR Balaji, D Manikandan, KA Shahul Hameed, A Banumathi
November 2017, 9(5):4-10
DOI:10.4103/jpbs.JPBS_110_17  PMID:29284926
Oral cancer is one of the most commonly occurring malignant tumors in the head and neck regions with high incident rate and mortality rate in the developed countries than in the developing countries. Generally, the survival rate of cancer patients may increase when diagnosed at early stage, followed by prompt treatment and therapy. Recently, cancer diagnosis and therapy design for a specific cancer patient have been performed with the advanced computer-aided techniques. The responses of the cancer therapy could be continuously monitored to ensure the effectiveness of the treatment process that hardly requires diagnostic result as quick as possible to improve the quality and patient care. This paper gives an overview of oral cancer occurrence, different types, and various diagnostic techniques. In addition, a brief introduction is given to various stages of immunoanalysis including tissue image preparation, whole slide imaging, and microscopic image analysis.
  4 2,841 194
CASE REPORTS
Management of tooth fractures using fiber post and fragment reattachment: Report of two cases
Rajesh Gopal, Lalkrishna Raveendran, Sonia P Pathrose, Benin Paulaian
November 2017, 9(5):295-298
DOI:10.4103/jpbs.JPBS_111_17  PMID:29284984
Reattachment of the tooth fragment is an ultraconservative technique for managing coronal tooth fractures when the tooth fragment is available, and there is minimal violation of the biological width. The advances in adhesive dentistry have allowed dentists to use the patient's own fragment to restore the fractured tooth which provides fast and esthetically pleasing results. This article reports fragment reattachment technique and presents two clinical cases of complicated crown fracture.
  3 2,374 148
ORIGINAL ARTICLES
Maternal risk factors and periodontal disease: A cross-sectional study among postpartum mothers in Tamil Nadu
Rohini Govindasamy, Manikandan Dhanasekaran, Sheeja S Varghese, VR Balaji, B Karthikeyan, Ananthi Christopher
November 2017, 9(5):50-54
DOI:10.4103/jpbs.JPBS_88_17  PMID:29284936
Background and Aim: It is inconclusive that periodontitis is an independent risk factor for adverse pregnancy outcomes. This study aims to investigate the association between maternal periodontitis and preterm and/or low birth weight babies. Settings and Design: This was a prospective cross-sectional study. After prior informed consent, 3500 postpartum mothers were selected from various hospitals in Tamil Nadu and categorized into the following groups: group-1 – Normal term normal birth weight (n = 1100); Group-2 – Preterm normal birth weight (n = 400); Group-3 – preterm low birth weight (PTLBW) (n = 1000); and Group-4 – Normal term low birth weight (n = 1000). Periodontal examination was done, and risk factors were ascertained by means of questionnaire and medical records. Statistical Analysis: Comparison between case groups and control groups were done, odds ratio (OR) was calculated, and statistical significance were assessed by Chi-square tests. To control for the possible confounders, all variables with P < 0.05 were selected and entered into multivariate regression model, and OR and 95% confidence limits were again estimated. SPSS-15 software was used. Results: Periodontitis was diagnosed in 54.8%, 52.3%, 53.8%, 59.4%, respectively. On comparison between the groups, none of periodontal parameters showed significant association except for the crude association observed in Group-4 for mild periodontitis (OR - 1.561; P = 0.000) and PTLBW. Conclusion: Periodontitis is not a significant independent risk factor, and obstetric factors contribute a major risk for preterm and/or low birth weight babies
  3 2,310 88
Musculoskeletal disorders and mental health-related issues as occupational hazards among dental practitioners in Salem city: A cross-sectional study
Vanita D Revankar, Yadav Chakravarthy, S Naveen, Arun Senthamil Selvan, Aarthi Ganapathy, AS Prasad
November 2017, 9(5):228-230
DOI:10.4103/jpbs.JPBS_145_17  PMID:29284969
Background: Like in any other profession, dental surgeons are also afflicted by many occupational health hazards such as Musculoskeletal disorders (MSD) and mental health related issues. Aims: To assess the distribution of MSD and mental health related issues amidst dentists in Salem City according to age, sex and number of working hours per week. Objectives: A survey was organized to check the rate of occurrence of these occupational health hazards among dental practitioners in Salem city. Materials and Methods: The study was conducted among one hundred and fifty dentists practicing in Salem City in the form of questionnaire. Dentists were asked about any occupational disease that they suffered related to a musculo–skeletal pain and its location whether in the back, upper limbs or lower limbs. In addition to this,dentists were asked about mental stress that they had experienced. Results: MSD showed higher rate of prevalence compared to mental health related issues. Conclusion: The application of preventive measures is necessary, in view of the high rate of these disorders in the society of dental practitioners.
  3 2,530 130
Knowledge and attitude of dental surgeons about ocular complications due to dental infection
Prahalad Hunsigi, Vinod Kumar, MR Pradeep, BC Arun Kumar
November 2017, 9(5):147-153
DOI:10.4103/jpbs.JPBS_108_17  PMID:29284955
Background: Ocular complications such as ophthalmia, defective vision, orbital cellulitis, and blindness (temporary or permanent) are rare complications due to dental infection. Currently, there is lack of guidelines in preventing and managing ocular problems. Hence, we assessed the dentist's knowledge and attitudes about ocular complications due to dental infection. Materials and Methods: A cross-sectional prospective survey selecting practicing dentists or academicians was carried out through e-mail using a standardized self-administered questionnaire. The data were statistically analyzed using descriptive statistics (percentage). Results: Only 25% participants knew about ocular complications due to dental infection. Journals and internet were the key sources of information among dentists. Majority of participants responded that ocular complications are underreported in the literature. Large proportion (90%) of the participants advocated research on ocular complications due to dental infection. Many participants indicated the prevention of ocular complications. Conclusion: In our observation, dentist's knowledge about ocular complications due to dental infection was poor, and the awareness and practice of taking preventive measures were satisfactory. There is need for providing adequate information about ocular problems in the curriculum of dentistry. Dentists should be trained about prevention and initial management of ocular complications due to dental infection through special educations such as continuing dental educations, workshops, and symposium.
  3 2,250 78
Evaluation of microhardness of residual dentin in primary molars following caries removal with conventional and chemomechanical techniques: An In vitro Study
A Shihab Anwar, R Krishna Kumar, V Arun Prasad Rao, N Venugopal Reddy, VJ Reshma
November 2017, 9(5):166-172
DOI:10.4103/jpbs.JPBS_148_17  PMID:29284958
Background: Many patients consider removal of caries to be a very unpleasant experience. Removal of caries with conventional drill is considered traumatic mainly due to fear and anxiety of children and their parents. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralization, and minimal intervention for the placement and replacement of restorations, thus reaching the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. Chemomechanical caries removal (CMCR) is a method for minimally invasive, gentle dentin caries removal based on biological principles which is an effective alternative to the traditional method. The present study was done to compare the microhardness of sound dentin before and after carious removal using a chemomechanical method and a conventional method. Materials and Methods: The present in vitro study was done on 28 proximal surfaces of fourteen extracted primary molars (with active caries on one proximal surface and sound side as control). The study was done to assess the Knoop microhardness of remaining dentinal surface after caries removal using a slow speed conventional bur and a chemomechanical method (Carie-Care). Results and Conclusion: The rotary instrument group showed a consistent microhardness value with not much difference according to depth. The chemomechanical group showed a lesser microhardness value closer to the cavity floor than away from it. The microhardness values at all depths were significantly different for each treatment group with an increased value seen in the rotary group. The mean microhardness values of residual dentin in treated side were found to be insignificant when compared among each interval in each group. The microhardness of sound dentin had high significant difference from that of residual dentin in both the rotary group and the chemomechanical group.
  3 3,546 188
CASE REPORTS
Successful surgical management of palatogingival groove using platelet-rich fibrin and guided tissue regeneration: A novel approach
JV Karunakaran, Susan Mathew Fenn, N Jayaprakash, N Ragavendran
November 2017, 9(5):268-273
DOI:10.4103/jpbs.JPBS_126_17  PMID:29284978
Palatogingival groove also known as radicularlingual groove is a developmental anomaly involving the lingual surface of the maxillary incisors. They are inconspicuous, funnel-shaped, extend for varying distances on root surface and occur due to infolding of the hertwigs epithelial root sheath. This encourages adherence of microorganisms and plaque to levels significant for pathological changes resulting in endodontic and periodontal lesions. The variations in anatomy of the tooth as a cause of pulp necrosis in teeth of anterior maxillary segment should be considered by the clinician when other etiological factors are ruled out. Recognition of palatogingival groove is critical, especially because of its diagnostic complexity and the problems that may arise if it is not properly interpreted and treated. Regeneration is a new emerging approach in endodontics. Choukroun et al. were among the pioneers for using platelet-rich fibrin (PRF) to improve bone healing. PRF is rich in platelet cytokines and growth factors. Numerous techniques have been used to eliminate or seal the groove and regenerate endodontic and periodontal tissues. In this case report of two cases, a novel combination therapy involving ultrasonics, blend of PRF with bone graft, guided tissue regeneration membrane was used in the treatment of a palatogingival groove with an endoperio lesion to ensure arrest of disease progression and promote regeneration. The groove was cleaned and prepared ultrasonically and sealed with a bioactive dentin substitute.
  2 4,789 226
Erosion infiltration technique': A novel alternative for masking enamel white spot lesion
Praveen Muthuvel, Aarthi Ganapathy, Mohan Kumar Subramaniam, Vanita D Revankar
November 2017, 9(5):289-291
DOI:10.4103/jpbs.JPBS_150_17  PMID:29284982
Enamel White spot lesions are early signs of demineralization under the intact enamel, which may or may not lead to the development of caries. An inactive white spot lesion might act as an arrested dental caries and impair the esthetic appearance by displaying a milky white color from its interior opacity. The first choice of treatment is remineralization with various remineralizing agents such as fluoride and ACP-CCP. Caries infiltration is a less invasive and effective method for arresting the white spot lesions. It also improves the esthetics by masking the chalky white appearance by the process of optical adaptation to the adjacent healthy enamel. This is achieved by the hydrophobic resin, which has a similar refractive index to that of the healthy enamel.
  2 3,061 136
ORIGINAL ARTICLES
Efficacy of denture cleansers on impact strength of heat polymerized acrylic resins
Mallikarjuna Ragher, Uma Mayoor Prabhu, Jaya Prakash Ittigi, Ravi Naik, CS Mahesh, MR Pradeep
November 2017, 9(5):241-245
DOI:10.4103/jpbs.JPBS_112_17  PMID:29284972
Purpose: The study was aimed to compare and evaluate the changes in the impact strength of heat cure denture base resins when treated using denture cleansers. Methodology: Study was conducted with sample size of 40 and dimesion 65 mm length, 10 mm width, and 3 mm thickness as per the ISO 1567. Distilled water has been used as control group, in which 10 samples were immersed of 40 samples. Of remaining 30 samples, 10 were treated with Clinsodent, 10 were treated with VI-Clean, and 10 were treated with Clanden denture cleansers. The impact strength of these specimens from each group was tested with the help of Charpy-type pendulum impact strength tester. The energy absorbed to fracture the specimens was recorded, and impact strength was calculated and was analyzed using Kruskal–Wallis ANOVA and Mann–Whitney test. Results: Impact strength of samples was significantly reduced after immersion in denture cleansers Clinsodent, VI-Clean, and Clanden solutions when compared to control group. Conclusion: Clinsodent, VI-Clean, and Clanden denture cleansers decrease the impact strength of heat cure denture base resin after immersion. Hence, the study concludes that denture cleansers should be used with caution and advised to follow manufacturer's instructions.
  2 2,254 106
Detection of adherence of Enterococcus faecalis in infected dentin of extracted human teeth using confocal laser scanning microscope: An In vitro Study
V Siddharth Nair, Moksha Nayak, MK Ramya, G Sivadas, C Ganesh, S Lakshmi Devi, Vaishnavi Vedam
November 2017, 9(5):41-44
DOI:10.4103/jpbs.JPBS_92_17  PMID:29284934
Aim: The aim of this study is to detect in vitro adherence of Enterococcus faecalis to the infected dentinal tubules of human extracted teeth using confocal laser scanning microscope. Subjects and Methods: Roots from human premolar teeth (n = 40) were infected with E. faecalis strain the American Type Culture Collection 29212 in brain heart infusion for 21 days. After the experimental period, specimens were divided into two groups, Group A (n = 20), Group B (n = 20), and Group A specimens were stained with fluorescein diacetate dye for the detection of viability and adherence Group B were stained with acridine orange dye for detection of metabolic activity and adherence. Samples were washed, thoroughly sectioned and examined by confocal laser scanning microscopy. Computer-assisted determinants of fluorescence, bacterial viability, metabolic activity, and adherence were compared statistically. Results: E. faecalis was able to invade the dentinal tubules to a depth of 1–400 μm and adhere to 1–200 μm depth. Adherence (90%) was significantly higher in 1–100 μm using fluorescein diacetate and acridine orange dye. Conclusion: Adherence of E. faecalis as evaluated by confocal laser scanning microscope was highest at the depth of 1–100 μm which may have an impact on the shaping and cleaning procedures on the root canal.
  2 2,197 102
An evaluation of occlusal relationship and primate space in deciduous dentition in Kancheepuram District, Tamil Nadu, India
Daya Srinivasan, Divya Loganathan, S Saravana Kumar, C Joe Louis, Senthil Eagappan, Divya Natarajan
November 2017, 9(5):45-49
DOI:10.4103/jpbs.JPBS_89_17  PMID:29284935
Aim: The objective of the study was to evaluate the occlusal characteristics of primary dentition in 3–5-year-old children in Kancheepuram district. Materials and Methods: A cross-sectional survey was carried out on children aged 3–5 year old in the Kancheepuram district. A total of 603 children were examined. Occlusal relationship was assessed separately on both right and left side and was classified as a flush terminal plane, mesial step, or distal step. Similarly, occlusal relationship of primary canine was examined and classified as Class I, II, or III. Primate space was measured in both the arches using digital Vernier caliper. Results: Pearson Chi-square test was used. Statistical significance was noted on both right and left side primary molar occlusion as well as in the canine occlusion across the three age groups. Primate spaces in both arches have been found to be significant across the three age groups. Mann–Whitney test between gender and occlusal relationship was found to be not significant. Conclusion: Flush terminal plane is the most common primary molar occlusion found in the present study which is statistically significant. Most of the children had primate space present in upper and lower teeth which is statistically significant.
  2 4,094 159
Prevalence of oral mucosal lesions among dental patients with mixed habits in Salem district - A study
R Karthik, N Mohan
November 2017, 9(5):55-67
DOI:10.4103/jpbs.JPBS_86_17  PMID:29284937
Background: The practice of betel nut chewing with or without tobacco is still practiced in south india, salem inspite of its harmful effects. Methodology: 200 Patients visiting the outpatient department, Oral medicine and radiology from Aug 2015 to Aug 2016. Result and Conclusion: In our study, 3 women were exclusively churut smokers. Thirty-eight percent of the dental patients were beedi smoker, 32% were tobacco chewers, 12% were both betel nut and tobacco chewers, 8% were exclusively betel nut chewers, 1% of the dental population were exclusively churut smokers. Mean age group of the study population is 50.2 (14.4). There are 28 females and 172 males in the study group. Chi-square test revealed a statistically significant difference (P = 0.001) between males and females based on soft-tissue findings and no statistically significant difference (P = 0.572) between males and females based on distribution of hard-tissue findings.
  2 4,934 147
A comparative evaluation of intraradicular smear removal efficacy of 2% chitosan (low molecular weight), 4% Chitosan Citrate, and 10% Citric Acid when Used as Final Rinse in Irrigation Protocols: A Field Emission Scanning Electron Microscopic Study
M Praveen, G Aarthi, PK Meenapriya, S Senthil Kumar, NS Mohan Kumar, JV Karunakaran
November 2017, 9(5):73-78
DOI:10.4103/jpbs.JPBS_158_17  PMID:29284939
Aim: This study aims to compare the smear layer removal efficacy of 2% chitosan (low molecular weight) (C-LMV), 4% chitosan citrate (CC), and 10% citric acid (CA) when used in specific irrigant protocols. Materials and Methods: A total of 60 single-rooted maxillary incisors and canines were decoronated, standardized to a root length of 15 mm, and prepared with rotary files up to protaper F3 size. Sodium hypochlorite was used as initial rinse [8 ml]. The samples were divided into experimental (Group III, IV, V, and VI) (n = 10) and control groups (I – 17% EDTA, II – normal saline) (n = 5) based on the type of final rinse solution (5 ml) used, that is, 2% C-LMV, 4% C-citrate, 10% CA, and 1% acetic acid. Samples were dehydrated, split buccolingually, gold sputter coated, and examined in field emission scanning electron microscope. Results: Overall, the Group IV, V, and III presented the least amounts of smear, debris, and erosion among the experimental groups at the apical, middle, and coronal one-thirds of the root canal with a mean value of 1.53 ± 0.42, 1.33 ± 0.42, and 1.60 ± 0.46, respectively, and there was no statistically significant difference (P > 0.05). Conclusion: The use of CC as final rinse solution during biomechanical preparation seems promising.
  2 2,709 145
Recovery of mercury from dental amalgam scrap-Indian perspective
Kadandale Sadasiva, Sreeram Rayar, Unnikrishnan Manu, Kumarappan Senthilkumar, Srinivasan Daya, Nagarajan Anushaa
November 2017, 9(5):79-81
DOI:10.4103/jpbs.JPBS_90_17  PMID:29284940
Aim: The aim is to recycle mercury from dental amalgam scrap using the vacuum distillation method. Materials and Methods: A total of 150 g of dental amalgam scrap was taken in a round bottom flask and was subjected to vacuum distillation at 398°C. The vapor of mercury was collected in another round bottom flask. Observation: The procedure is carried out for mercury recovery using vacuum distillation apparatus, and mercury vapor are collected in a round bottom flask, and the silver is recovered using sucrose as reducing agent. Using 150 g of dental amalgam scrap 50%–80% of silver are recovered, and silver has a purity of 70%–80%. However, the total time required in the reduction process ranged between 303 and 600 min. Conclusion: Mercury could be recycled from dental amalgam scrap through vacuum distillation method at 398°C and its implication of dental amalgam scrap in an Indian perspective.
  2 2,375 92
A comparative evaluation of bifidobacteria levels in early childhood caries and severe early childhood caries
Suraj Nair, V Suresh Kumar, Ramesh Krishnan, Pooja Rajan
November 2017, 9(5):82-84
DOI:10.4103/jpbs.JPBS_75_17  PMID:29284941
Background: Bifidobacteria levels in saliva were found to be significantly correlated in adults with dental caries but less information available in the literature regarding its role in children. Aim: The aim is to compare the salivary levels of Bifidobacteria in children who are caries free with that of early childhood caries (ECC) and severe ECC (S-ECC). Materials and Methods: Saliva was collected using the tongue-loop method from a total of 60 children between the age group of 3–5 years and they were further divided into 3 groups. In addition, the age and gender of the children, sugar amount in diet, sugar frequency in diet, were recorded. Results: Bifidobacteria was isolated from all the three groups, but more were from S-ECC, followed by ECC and very few cases of caries-free children and was found to statistically significant (P < 0.001). Salivary levels of Bifidobacteria were significantly correlated with amount of sugar in the diet and frequency of sugar consumption. Conclusions: Salivary levels of Bifidobacteria were significantly associated with S-ECC and ECC, followed by caries free group. In future, it can be used as a salivary marker for caries risk assesment.
  2 1,924 87
Evaluation of efficiency of different decontamination methods of dental burs: An In vivo study
Abirami Mathivanan, D Saisadan, P Manimaran, C Dhinesh Kumar, K Sasikala, Ajmalkhan Kattack
November 2017, 9(5):37-40
DOI:10.4103/jpbs.JPBS_81_17  PMID:29284933
Introduction: Infection control is very important in dentistry. Both dentist and patients are at risk of communicating diseases during treatment procedures. Dental burs have been identified as a source of cross-contamination between patient and dental personnel. Aim: The present study was done to quantitatively and qualitatively assess the pathogenic contamination of dental burs used for tooth preparation and to determine the effective method of sterilization(autoclave,glass bead sterilizer, hot air oven and surgical spirit immersion) of burs used for crown preparation. Methodology: Dental burs were assessed before and after tooth preparation,also after sterilization burs were evaluated. Conclusion: Findings of our study revealed that among the experimental groups used in the present study, Autoclave and Hot air oven was found to be the relatively best method to sterilize burs. Proper cleaning and sterilization of burs should be strictly employed to prevent cross contamination in clinical practice.
  2 5,410 128
Platelet-rich plasma and incidence of alveolar osteitis in high-risk patients undergoing extractions of mandibular molars: A case–control study
Nitin Prataap, PM Sunil, CB Sudeep, Vivek Suku Ninan, Arun Tom, MR Arjun
November 2017, 9(5):173-179
DOI:10.4103/jpbs.JPBS_151_17  PMID:29284959
Background: To evaluate the efficiency of platelet-rich plasma (PRP) on the incidence of alveolar osteitis (AO) in patients with potential risk factors for the development of AO. Materials and Methods: This study was conducted in 150 patients visiting the outpatient department of oral and maxillofacial surgery. Patients with potential risk factors for the development of AO which included smokers, alcoholics, postmenopausal women, patients on oral contraceptives, pericoronitis, and bruxism were included for the study. Patients were randomly divided into two groups. Group A consisted of 75 patients in which PRP was placed in the socket after extraction. Group B consisted of 75 patients in which sockets were left for normal healing without the placement of PRP. The patients were assessed for pain and dry socket on the 3rd and 5th postoperative day. Results: All the local signs and symptoms of inflammation were mild to moderate and subsided in normal course of time. Pain was less in Group A where the extraction sockets were treated with PRP. Soft-tissue healing was also statistically significant on the PRP treated site when compared to the other group where PRP was not placed into the socket after extraction. The incidence of AO among the patients who have the potential risk factor for the development of the same was significantly reduced in Group A. Conclusion: The study showed that autologous PRP is a biocompatible material and has significantly improved the process of soft-tissue healing, reduced pain, and decreased the incidence of AO in the extraction socket when treated with PRP.
  2 2,294 85
Smoking cessation advice: Knowledge, attitude, and practice among clinical dental students'
Allama Prabhu, Jayesh Kumar Jain, B Sakeenabhi, PG Naveen Kumar, Mohamed Imranulla, Mallikarjuna Ragher
November 2017, 9(5):117-120
DOI:10.4103/jpbs.JPBS_118_17  PMID:29284949
Background: Smoking is the single most important public health challenge facing the National Health Service. The detrimental effects on the general health of tobacco smoking are well documented. Smoking is a primary risk factor for oral cancer and many oral diseases. Dental professional scan plays an important role in preventing adverse health effects by promoting smoking cessation. Objective: To assess the knowledge, attitude, and practice among clinical dental students in giving smoking cessation advice and to explore the barriers to this activity. Materials and Methods: A total of 262 clinical dental trainee of two dental colleges (College of Dental Sciences and Bapuji Dental College) of Davangere city were included in the survey. A self-administered questionnaire was administered to assess the knowledge, attitude, and practice toward Tobacco Cessation Advise. Results: Among the 262 participants in the study, around 51% said they know about Nicotine Replacement Therapy, and among them, only 4.6% were aware of the options available in the market. When asked about 5A's of tobacco cessation, only 35.5% were aware of it. Similarly, when asked about 5R's of tobacco cessation, 48.5% were unaware of it. Conclusions: The respondents did not have sufficient knowledge regarding tobacco cessation advice. With patient's disinterest and lack of time being quoted as the important barriers in providing tobacco cessation advice, it is highly recommended that there is need to incorporate few chapters on tobacco, its effect and cessation of habit in the undergraduate dental curriculum with simultaneous application of the same in clinical practice.
  2 2,709 150
Effect of biomineralization ability on push-out strength of proroot mineral trioxide aggregate, mineral trioxide aggregate branco, and calcium phosphate cement on dentin: An In vitro evaluation
Vanita D Revankar, MS Prathap, K Harish Kumar Shetty, Azmin Shahul, K Sahana
November 2017, 9(5):121-126
DOI:10.4103/jpbs.JPBS_120_17  PMID:29284950
Context: Biomineralization is a process which leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface. It is due to interaction of mineral trioxide aggregate (MTA) and Portland cement with dentin in phosphate-buffered solution (PBS). This study is aimed to evaluate the effect of influence of biomineralization process on push-out bond strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK, USA), MTA Branco (Angelus Soluc¸o˜es Odontolo´gicas, Londrina, PR, Brazil) and calcium phosphate cement (BioGraft CPC). Aim: The aim of this study was to evaluate the effect of biomineralization process on the push-out strength of ProRoot MTA, MTA Branco, and CPC after mixing with 0.2% chlorhexidine gluconate solution (0.2% CHX) and 2% lidocaine solution (2% LA) on the bond strength of MTA-dentin. Materials and Methods: Dentin discs with uniform cavities were restored with ProRoot MTA, MTA Branco, and calcium phosphate cement after mixing with 0.2% CHX solution and 2% lidocaine solution. The samples were uniformly distributed into two groups. Experimental group being immersed in PBS solution and control group being immersed in saline for 2 months. Instron testing machine (Model 4444; Instron Corp., Canton, MA, USA) was used to determine the bond strength. Statistical Analysis Used: A two-way analysis of variance and post hoc analysis by Bonferroni test. Results: All samples immersed in experimental group displayed a significantly greater resistance to displacement than that observed for the samples in control group (P < 0.05). MTAs displayed a significantly greater resistance to displacement than calcium phosphate cements. Conclusion: The main conclusion of this study was that the push-out bond strength of the cements, mainly the MTA groups, was positively influenced by the biomineralization process.
  2 2,194 95
Evaluation of antibacterial activity of three selected fruit juices on clinical endodontic bacterial strains
Subasish Behera, Prashant Khetrapal, Sandhya Kapoor Punia, Deepak Agrawal, Minal Khandelwal, Jitendra Lohar
November 2017, 9(5):217-221
DOI:10.4103/jpbs.JPBS_164_17  PMID:29284967
Introduction: The increasing problem of antibiotic drug resistance by pathogenic microorganisms in the past few decades has recently led to the continuous exploration of natural plant products for new antibiotic agents. Many consumable food materials have good as well as their bad effects, good effect includes their antibacterial effects on different microorganisms present in the oral cavity. Recently, natural products have been evaluated as source of antimicrobial agent with efficacies against a variety of microorganisms. Methodology: The present study describes the antibacterial activity of three selected fruit juices (Apple, Pomegranate and Grape) on endodontic bacterial strains. Antimicrobial activity of fruit juices were tested by wel l diffusion assay by an inhibition zone surrounding the well. The aim of the study was to evaluate the antibacterial activity of three fruit juises on different endodontic strains. Result: Agar well diffusion method was adopted for determining antibacterial potency. Antibacterial activity present on the plates was indicated by an inhibition zone surrounding the well containing the fruit juice. The zone of inhibition was measured by measuring scale in millimeter. Comparision between antibacterial efficacy of all three fruit juices against Enterococcus feacalis and Streptococcus mutans was observed with significant value of P ≤ 0.05. Conclusion: The results obtained in this study clearly demonstrated a significant antimicrobial effect of apple fruit juice against Enterococcus fecalis and Streptococcus mutans. However, preclinical and clinical trials are needed to evaluate biocompatibility & safety before apple can conclusively be recommended in endodontic therapy, but in vitro observation of apple effectiveness appears promising.
  2 3,335 185
Comparative evaluation of serum lipid profile in patients with oral submucous fibrosis and oral squamous cell carcinoma with that of control subjects: A case control study
A Cicilia Subbulakshmi, N Mohan, R Thiruneervannan, S Naveen
November 2017, 9(5):191-196
DOI:10.4103/jpbs.JPBS_142_17  PMID:29284962
Aim: The aim of the study was to evaluate the serum lipid profile among untreated oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSMF) patients. Materials and Methods: This study was done in three groups of patients - OSMF, OSCC, and control. There are twenty participants in each group. Calorimetric method using semi-autoanalyzer was used for analyzing the lipid levels (cholesterol, triglycerides [TGL], and high-density lipids [HDL]) after collecting 2 ml of fasting blood from these patients. Low-density lipid [LDL] values were obtained by calculator method. Results: There was a significant decrease in serum lipid levels of patients with OSMF and OSCC. Conclusion: The decrease in lipid levels in OSMF and OSCC patients is due to its utilization by the cells during the cancer process.
  2 2,567 148
CASE REPORTS
Dental implants: A remote option in case of somatic delusion disorder
Thanvir Mohamed Niazi, G Ulaganathan, S Kalaiselvan, R Lambodharan, R Mahalakshmi, M Sophia, V Usha Giridhar
November 2017, 9(5):257-260
DOI:10.4103/jpbs.JPBS_105_17  PMID:29284975
A 29-year-old female was referred by a psychiatrist for dental implantation and prosthodontic rehabilitation, as she had all her healthy permanent teeth extracted within a span of 2–6 months, due to somatic delusional disorder. She presently refuses artificial dentures and implants with the fear of having worms in her teeth and the fear not yet allayed. The patient cannot be treated for her edentulous state until her psychiatric symptoms are treated. This is the limitation for the implant surgeon where service rendered is impaired in spite of advanced professional skills, ideal patient ridge, and other factors, just where the patient is not mentally prepared for the dental rehabilitation procedures.
  1 2,078 66
Rehabilitation of anterior maxilla with dental implants in periodontally compromised patient
D Manikandan, VR Balaji, R Lamobodharan, R Mahalakshmi
November 2017, 9(5):264-267
DOI:10.4103/jpbs.JPBS_159_17  PMID:29284977
Although implant is the treatment of choice for rehabilitation of patients with aggressive periodontitis, it is also challenging for the dentists. There are various views about success of implant therapy for these patients. Few authors have proposed that aggressive periodontitis patients have less success rate of implant survival, while many authors have shown successful management of aggressive periodontitis patients with implants. For implants to be successful in these patient, it is important to control the periodontal disease before placement of implants. Thus a multidisciplinary approach is essential for successful rehabilitation of these patients. This case report aims at discussing the periodontal management and implant rehabilitation in a patient with aggressive periodontitis.
  1 2,053 77
Neurilemmoma of maxillary alveolus: A rare case report and review of literature
Saravanan Kandasamy, R Senthil Nathan, Reena Rachel John
November 2017, 9(5):285-288
DOI:10.4103/jpbs.JPBS_114_17  PMID:29284981
Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannomas account for 1% of head and neck region and are commonly seen at the base of the tongue. Most of the literature, reports of schwannomas in the tongue region are common. In this article we report a rare occurrence of schwannoma in the maxillary alveolus region and its management. A 45 year old female patient reported to the department of oral and maxillofacial surgery with a complaint of swelling in the left maxillary alveolus in relation to molar teeth that had been present for more than 3 months. Apparently the swelling was small one initially, which gradually increased in size. Such a rare cas e of intraoral schwannoma should be followed up periodically to look for any malignant transformation and recurrences. An important conclusion that has evolved from the reviewed articles, is that the differential diagnosis of painless nodules in head and neck must include schwannomas.
  1 1,678 62
CASE SERIES
Management of tooth surface loss of varying etiology with full mouth all ceramic computer-aided design/computer-aided manufacture restorations
Nirmal Famila Bettie, Saravanan Kandasamy, Venkat Prasad
November 2017, 9(5):302-305
DOI:10.4103/jpbs.JPBS_130_17  PMID:29284986
The anatomical form of a tooth can undergo changes leading to loss of tooth form. The loss of tooth surface can be due to varying etiology. Dental caries, attrition, abrasion, erosion, involving any surface of the tooth can lead to loss of tooth structure. The rate of tooth destruction may proceed to such an extent that the esthetics, function and comfort may be lost. The role of a practioner lies in identification and screening of such case and motivate for oral rehabilitation that includes habit cessation. Computerized dentistry has raised the bar as far as esthetic restorations are concerned. Demanding esthetics has made zirconia crowns as the material of choice in full mouth rehabilitations. However, appropriate treatment planning with scientific evidence and a recommended treatment protocol with careful implementation results in successful restorations and satisfied patients.
  1 2,176 91
ORIGINAL ARTICLES
Partial edentulousness in a rural population based on Kennedy's classification: Epidemiological study
P Manimaran, C Dhinesh Kumar, D Saisadan, M Abirami, Nanda Kumar, Jeevitha Mani
November 2017, 9(5):34-36
DOI:10.4103/jpbs.JPBS_87_17  PMID:29284932
Introduction: Edentulousness falls in a special category among the various conditions of dental origin. A simple estimation of the partial edentulous condition is a rough indication of the prevalence of dental diseases and success or failure of dental care. Methodology: In this study a cross sectional survey was carried out among 1000 patients of rural population in JKK Nataraja Dental College, Komarapalayam, Namakkal District, Tamilnadu, India. The aim of this study was to evaluate the epidemiological features of partial edentulous condition in the age group of 30-60 years in a rural Population based on the Kennedy classification. A pre tested questionnaire was Used in this study. Result: Chi-square test was conducted and results were obtained and P value <0.05 was considered stastically significant. Conclusion: The study revealed Kennedy Class III partially edentulous condition was more common than other conditions. There is significant correlation between lack of awareness,education and socio-economic status in relation to loss of teeth among population.
  1 2,516 111
Knowledge and attitude about early childhood caries among pregnant mothers from low socioeconomic status: A questionnaire study
Pooja Rajan, Ramesh Krishnan, Suresh Kumar, Suraj Nair
November 2017, 9(5):85-87
DOI:10.4103/jpbs.JPBS_76_17  PMID:29284942
Background: For health and well-being, oral health is an integral component. Unfortunately, many children are afflicted with dental caries at an early age, even those as young as 12 months. By imparting knowledge, awareness among parents about this disease can bring about reduction of early childhood caries (ECC) at an early stage. Aim: The aim of this study was to evaluate knowledge and attitude of expectant mothers about ECC and to reassess the level of knowledge after giving anticipatory guidance. Materials and Methods: The questionnaire consisted of 10 questions which were distributed to 100 participants after which anticipatory guidance was given to them. After 15 days, the same questionnaire was distributed among the participants with order of the questions interchanged. Chi-square test was used for statistical analysis. Results: There was a significant improvement in the knowledge and attitude about the disease after giving the anticipatory guidance among the participants. P < 0.01 and the result were statistically significant. Conclusion: Knowledge and attitude of mothers were found to increase on provision of anticipatory guidance, which was retained even after 15 days.
  1 2,451 109
Root canal configuration of human permanent mandibular first molars of an indo-dravidian population based in Southern India: An In vitro study
JV Karunakaran, Leo Sujith Samuel, Yousef Rishal, M Derick Joseph, K Rahul Suresh, Sam T Varghese
November 2017, 9(5):68-72
DOI:10.4103/jpbs.JPBS_163_17  PMID:29284938
Aim: This study aims to analyze root canal configuration of human permanent mandibular first molars of an indo-Dravidian population based in southern India. Materials and Methods: A total of 1147 mandibular first permanent molars were collected, cleansed, and stored. The number of roots was recorded, access preparations made, pattern of orifices recorded after pulpal floor debridement, dye injected into the canals using apical negative pressure and subjected to a clearing technique. They were then analyzed using a stereo microscope and the canal configurations recorded (Vertucci). The number of roots, the pattern of orifices and canal configuration were recorded. Results: The pattern of orifices was triangular (87.9%), rectangular (8.5%), C-shaped (3.0%), and two orifice pattern (0.6%). About 95.6% of teeth had two roots, and 4.4% had three roots. The most common canal system configuration in mesial root was Vertucci type IV (52.3%), followed by type II (35%). Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5%) and IV (12.4%). The distolingual root had a type I configuration. Conclusion: Awareness of canal configuration, adequate clinical skills, use of specialized techniques of diagnosis, debridement and obturation will pave the way for successful treatment outcomes.
  1 2,758 82
Comparison of orthopantomogram and lateral cephalogram for mandibular measurements
S Saravana Kumar, V Thailavathy, Daya Srinivasan, Divya Loganathan, J Yamini
November 2017, 9(5):92-95
DOI:10.4103/jpbs.JPBS_98_17  PMID:29284944
Aim: The aim of the present study is to clarify the possible application of orthopantomogram (OPG) for evaluating craniofacial specifications such as angular and linear measurements of the mandible by comparing with lateral cephalogram. Materials and Methods: OPG and lateral cephalogram were taken from 100 patients of age group 16–35 years from Chettinad Dental College and Research Institute. Linear measurements (body length and ramus height) and angular measurement (gonial angle) were assessed both in lateral cephalogram and OPG. Independent t-test was performed for comparison of OPG and lateral cephalogram using SPSS with a probability level of P < 0.05 considered to be statistically significant. Results: The results of the present study show that there is no statistically significant difference in ramus height and gonial angle when compared between OPG and lateral cephalogram while statistically significant difference exists for body length between OPG and lateral cephalogram. Conclusion: It may be concluded that panoramic radiography can be used to determine the gonial angle and ramus height as accurately as a lateral cephalogram. However, clinicians should be vigilant when predicting horizontal measurement from OPGs.
  1 3,527 254
Comparison of efficacy of amoxicillin versus ciprofloxacin in postsurgical management of transalveolar extraction
Balan Natarajan, Gowri Balakrishnan, Kavin Thangavelu
November 2017, 9(5):187-190
DOI:10.4103/jpbs.JPBS_162_17  PMID:29284961
Background: The transalveolar extraction and the use of pharmacological antibiotic therapy following the surgical procedure in management of postoperative infection go hand in hand in minor oral surgery. Attention has often been focused on antibiotic therapy administered at different time schedules (before or after surgery or both). This investigation reveals how the use of different molecules and dosages is critical in the postoperative period and has always provided positive result. Methodology: A prospective randomized study was carried out in 100 healthy controls of age group 20–50 years undergoing transalveolar extraction in the Department of Oral and Maxillofacial Surgery, Vivekanandha Dental College for Women. A 5-day regimen of amoxicillin or ciprofloxacin group of antibiotics along with regular analgesics was administered to the patients following transalveolar extraction. The patients were evaluated for postoperative infection, inflammation and wound care on postoperative days: day zero, day 2, day 5, day 7, day 15, day 30, and analyzed. A P < 0.05 was considered statistically significant. Results and Conclusion: A total of 100 patients aged 23–50 years (24.6–4.43) met the inclusion criteria. Male accounted for 44, while female were 55, giving male:female ratio 1:1.4. Postoperative infection was minimum with ciprofloxacin group as compared to amoxicillin group and was more significant (P < 0.005) on evaluation. A complete review has also been taken into an account, various strategies used such as surgical flaps, no traumatic osteotomy, and primary or secondary closure.
  1 2,551 139
Assessment of total antioxidant capacity and antimicrobial activity of Glycyrrhiza glabra in saliva of HIV-infected patients
Eby Aluckal, Asif Ismail, Anoopa Paulose, Sanju Lakshmanan, MS Balakrishnan, Benoy Mathew, M Vikneshan, Abraham Kunnilathu
November 2017, 9(5):237-240
DOI:10.4103/jpbs.JPBS_141_17  PMID:29284971
Objectives: The objectives of this study were to evaluate the antimicrobial activity and total antioxidant capacity (TAC) of licorice in Saliva of HIV/AIDS patients. Materials and Methods: Saliva specimens were collected from 20 people living with HIV infection, with CD4 count <500 cells/mm3 from people infected with HIV/AIDS in Mangalore city, India. A combination of amoxicillin-clavulanic acid and nystatin was taken as the positive control and normal saline as negative control. Results were compared using one-way analysis of variance followed by Tukey's post hoc analysis in SPSS 19. Results: The TAC was evaluated spectrophotometrically at 695nm using the phosphomolybdenum method. Glycyrrhiza glabra showed a statistically significant reduction (P < 0.05) in total Candida count. The TAC of G. glabra was found to be 4.467 mM/L. Conclusions: G. glabra extracts showed good anticandidal activity and also high antioxidant property which reduces the oxidative stress of HIV-infected people.
  1 2,055 89
An In Vivo study to compare and evaluate the correlation of the facial measurements with the combined mesiodistal width of the maxillary anterior teeth between males and females
Reshma Banu, Savita Dandekeri, K Kamalkanth Shenoy, Sanath Shetty, Vidya Bhat, Mallikarjuna Ragher
November 2017, 9(5):127-131
DOI:10.4103/jpbs.JPBS_123_17  PMID:29284951
Aim: The aim of this study was to compare and evaluate the correlation of the facial measurements (interalar, intercommissural, intercanthal, and interpupillary distance) with the combined mesiodistal width of the maxillary anterior teeth between males and females. Objectives: The objectives of this study were: (a) To evaluate the correlation of the facial measurements (interalar, intercommissural, intercanthal, and interpupillary distance) and combined mesiodistal width of maxillary anterior teeth. (b) To compare the correlation of the facial measurements (interalar, intercommissural, intercanthal, and interpupillary distance) with the combined mesiodistal width of maxillary anterior teeth between males and females. Materials and Methods: This study was carried out on 120 dentate Subjects selected from Yenepoya Dental College, Mangalore. The vernier caliper was used to measure the interalar, intercommissural, intercanthal, and interpupillary distance. The mesiodistal width of maxillary anterior teeth was measured on the cast. For accuracy, every distance was measured three times and the mean taken. Results: Comparison of parameters between males and females was calculated using independent sample t-test. The values obtained for each variables are interalar distance: for males 38.89 ± 2.19 and for females 35.58 ± 2.33. Intercommissural distance: for males 50.96 ± 2.99 and for females 47.15 ± 2.97. Intercanthal distance: for males 31.92 ± 1.46 and for females 30.46 ± 2.07. Interpupillary distance: for males 65.15 ± 2.82 and for females 61.78 ± 3.18. Mesiodistal width of maxillary anterior teeth: for males 52.55 ± 1.82 and for females 51.33 ± 2.50. Conclusion: Within the limitations of this study, the study concluded there is a significant correlation between interalar, intercommissural, intercanthal, interpupillary distance, and mesiodistal width of maxillary anterior teeth in total subjects. In females, there is a significant correlation between interalar, intercanthal, interpupillary distance, and mesiodistal width of maxillary anterior teeth.
  1 2,474 102
An evaluation of the effect of various gloves on polymerization inhibition of elastomeric impression materials: An In vitro study
Vinuta Hiremath, G Vinayakumar, Mallikarjuna Ragher, Sounyala Rayannavar, Mahantesh Bembalagi, BL Ashwini
November 2017, 9(5):132-137
DOI:10.4103/jpbs.JPBS_122_17  PMID:29284952
Background: Latex protective barriers such as gloves and rubber dam material have been used widely in restorative procedures for crown and bridge. However, the chemical used during latex glove fabrication is thought to inhibit the polymerization of elastomeric impression materials used for impression making which has a detrimental effect on the dimensional accuracy and surface definition of resultant casts used for restorative procedures. The objectives of the study were to examine the surface of different elastomeric impressions on contact with various gloves. Materials and Methods: This clinical study included a total of eighty specimens of two types of the putty elastomeric impression material were hand manipulated by wearing three different gloves materials and is placed on a marked area of a clean and alcohol-treated glass slab at room temperature. The specimens examined for any signs of polymerization inhibition. The specimen will be rated as being “inhibited” if any residue remains on the glass slab and absence of the above will result as “no inhibition.” Results: The results showed no interference with the polymerization inhibition of the selected elastomers followed by the nitrile glove. The latex gloves showed inhibited set of the elastomeric impression material but set after sometime confirming time-dependent inhibition of the impression material. Conclusion: This study shows that the use of latex and sometime nitrile gloves during crown and bridge procedures should be contraindicated and the use of vinyl gloves should be stressed when working with elastomeric impression materials.
  1 3,291 143
To compare and evaluate the sorption and solubility of four luting cements after immersion in artificial saliva of different pH values
Kadambari Bharali, Manjula Das, Silpi Jalan, Rajdeep Paul, Adrija Deka
November 2017, 9(5):103-106
DOI:10.4103/jpbs.JPBS_153_17  PMID:29284946
Introduction: The word 'luting' is derived from a latin word 'Lutum' which means 'mud'. 'Luting' is a word that is often used to describe the use of a mouldable substance to seal a space or to cement two components together. Therefore in view of the clinical importance of dissolution of luting cements in the oral environment, an in vitro study was designed to compare the sorption and solubility of commercially available luting cements mainly zinc phosphate, Glass Ionomer cement, Resin Modified Glass Ionomer Cement and Resin Cement .after immersion in artificial saliva of different ph values of 5 and 7. Aim: To Compare and Evaluate the sorption and solubility of four luting cements after immersion in artificial saliva of different pH values. Materials and Method: A total of 120 test samples were prepared of which 30 samples of each luting cement were prepared for the purpose of assessing the water solubility and sorptionThese luting cements were grouped as: GROUP- A (Zinc Phosphate cement), GROUP- B (Glass Ionomer Cement), GROUP-C (Resin Modified Cement), GROUP- D (Resin Cement) In these groups, based on immersion of artificial saliva of acidic pH 5 and neutral pH7 , the luting cement specimens were subdivided into 2 groups of 15 samples each. The volume (V) of each specimen was calculated using mathematical formula. Conclusion: Resin cement had the highest resistance to solubility and sorption followed by resin modified GIC , Conventional GIC, and Zinc Phosphate which exhibited the least resistance to solubility in both artificial saliva of pH 5 and pH 7.
  1 3,240 132
Effect of fluoride varnish and dentifrices and its combination on deciduous enamel demineralization: An In vitro study
Allama Prabhu, BG Prasanna, B Sakeenabhi, GM Prashanth, R Subramaniam, Mallikarjuna Ragher
November 2017, 9(5):112-116
DOI:10.4103/jpbs.JPBS_121_17  PMID:29284948
Introduction: Dental caries remains the most important dental health problem in developing countries. Application of varnish on tooth surfaces is shown to promote the uptake of firmly bound fluoride by enamel, which is considered important. Along with the incorporation of fluoride into the crystalline lattice, there is formation of calcium fluoride compounds on enamel. Methodology: Seventy deciduous canines were covered with nail polish. A window measuring 4 mm × 4 mm was left on their buccal surface, These were randomly assigned to seven groups (n = 6): S: sound enamel not subjected to any regimen or treatment; N: negative control, subjected to the pH-cycling regimen without any treatment; D1 and D2: subjected to the pH-cycling regimen and treated two times daily with 1100 and 500 ppm F dentifrice, respectively; VF: fluoride varnish (subjected to F-varnish before and in the middle of the pH-cycling regimen); and VF + D1 and VF + D2. After a period of 10 days, sectioning of teeth was done, and enamel demineralization was measured. Results: The combination of dentifrice and varnish (groups VF + D1 and VF + D2) significantly reduced demineralization compared with the N group at all distances evaluated (P < 0.05), but the combination did not differ from the dentifrice groups at most distances from the surface (P > 0.05). Conclusion: The results of this study suggest that the combination of F-varnish with dentifrices containing 500 or 1100 ppm F is not more effective in reducing demineralization in primary teeth than the isolated effect of dentifrice containing 1100 ppm.
  1 2,436 81
REVIEW ARTICLES
Molecular pathogenesis and diagnostic imaging of metastatic jaw tumors
Kenniyan Kumar Srichinthu, Arjun Parameshwar Raveendran, Periyasamy Tamilthangam, Joseph Joe, Charanya Duraisamy, Thukanayakanpalayam Ragunathan Yoithapprabhunath, Chitturi Ravi Teja
November 2017, 9(5):15-22
DOI:10.4103/jpbs.JPBS_138_17  PMID:29284928
Metastasis is the spread of malignant cells from a primary tumor to distant sites through lymphatics or blood vessels. Malignant lesions metastasizing to the oral and perioral region are a rarity indeed. Malignant lesions could metastasize to both soft tissue of oral cavity and the hard tissues of the jaws and recent meta-analysis showed that metastasis is more common in the jaws than oral soft tissues because of rich vascular supply. The incidence is very low when compared to the incidence of primary oral cancers; nevertheless, one has to include in the diagnostic workup, metastatic malignant lesions, when an irregular ill-defined radiolucency or radiodensity with ragged edges in noted. It could be a challenging task for a diagnostician, in cases with the presence and location of the primary tumor is unknown. Advanced oral imaging technologies and biochemical markers play a vital role in diagnosing such lesions.
  1 2,739 119
CASE REPORTS
Case presentation of two maxillectomy patients restored with two-piece hollow bulb obturator retained using two different types of magnets
B Devi Parameswari, M Rajakumar, N Jagadesaan, H Annapoorni
November 2017, 9(5):252-256
DOI:10.4103/jpbs.JPBS_85_17  PMID:29284974
Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two partially edentulous patients, both with surgically induced palatal defect and explains how to achieve the goal for esthetics and phonetics. This also describes the fabrication of a hollow obturator by two piece method, which is simple and may be used as definitive obturator for maximum comfort of the patient. In both the above cases, since the mouth opening is restricted due to surgery, obturator prosthesis is given as two pieces retained with opposite poles of magnet, which facilitates the removal and insertion of the prosthesis.
  - 2,789 116
A conservative method of retaining an interim obturator for a total maxillectomy patient
Nirmal Famila Bettie
November 2017, 9(5):299-301
DOI:10.4103/jpbs.JPBS_127_17  PMID:29284985
Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.
  - 2,225 110
Biological rehabilitation of complex oblique crown-root fracture segment reattachment
Iswarya R Raju, CP Sreedev, Sebeena Mathew, NT Deepa, K Karthick, T Boopathi
November 2017, 9(5):292-294
DOI:10.4103/jpbs.JPBS_152_17  PMID:29284983
Dental trauma can predominantly affect the maxillary anteriors. Trauma can occur to any age group due to accidents, assaults, or leisure activities. The goal of the treatment for traumatically injured teeth is to return the teeth to acceptable function and form. In this case presentation, the endodontic and esthetic treatment approach of crown fracture is presented.
  - 1,975 68
Evaluation of the accuracy of cone beam computed tomography for immediate implant placement- A case report
B Saravanan, P Jayavelu, R Riaz, AR Tariqsalam
November 2017, 9(5):274-280
DOI:10.4103/jpbs.JPBS_94_17  PMID:29284979
Diagnostic imaging acts as a distinctive method in analyzing and drawing in the appropriate treatment protocol for any procedure. Pertaining to immediate implant placement, determining the bone width and height plays a vital role in the success of the implant therapy. This visualization of the measurements done preoperatively will enhance the treatment by reducing the overall time span of the procedure. Currently, cone beam computed tomography (CBCT) plays a significant role in the preoperative determination of the measurements of the tooth and the bone. This case report is regarding, a 27-year-old male patient reporting to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital, with a chief complaint of fractured crown in relation to the upper left front tooth region. On clinical examination, there was the presence of an endodontically failed and fractured crown in relation to 22. With the interpretation of clinical and radiographic examination, the tooth was categorized under unfavorable prognosis. The patient was given a detailed description of the various treatment procedures available pertaining to that present condition, along with immediate implant placement procedure. Since the patient was young and conscious about his esthetics and accuracy, he opted for placement of immediate implant followed by extraction of the tooth. To accurately determine the length and width, the tooth and socket measurements were preoperatively measured by CBCT. This article evaluates the accuracy of CBCT by comparing the clinical quantity of bone and dimensions of tooth to be extracted and alveolar socket.
  - 2,113 89
Esthetic management of compromised ridge in the anterior maxilla, a modified prosthetic approach
R Lambodharan, B Sivasaranya, VR Balaji, Divagar Chandrasekaran
November 2017, 9(5):281-284
DOI:10.4103/jpbs.JPBS_102_17  PMID:29284980
Replacing a missing tooth with an implant, especially in the esthetic zone has been increasing demand for the patient. Placing dental implants in the esthetic zone, especially in the compromised ridge with thin gingival thin biotype is considered to be the ultimate challenge for many dentists. This case report illustrates the implant placement in the traumatic anterior maxilla with thin gingival biotype (Class IV) and a modified approach in prosthetic placement.
  - 2,157 81
ORIGINAL ARTICLES
Comparison of marginal periosteal pedicle graft and bioactive glass with platelet-rich fibrin and bioactive glass in the treatment of intrabony defects – A clinicoradiographic study
MS Yasaswini, KV Prabhakara Rao, P Tanuja, Narendra Reddy Motakatla
November 2017, 9(5):96-102
DOI:10.4103/jpbs.JPBS_99_17  PMID:29284945
Introduction and Objectives: The objective of the study was to compare clinically and radiographically the regenerative potential of marginal periosteal pedicle graft (MPPG) or platelet-rich fibrin (PRF) with a bioactive glass in the treatment of two- and three-wall intrabony defects. Methods: A total of 28 sites (bilateral or contralateral infrabony defects) from 14 patient were treated with MPPG (Experimental site A) and the other site was treated with PRF (Experimental site B). The clinical parameters, such as full-mouth plaque index (PI) and site PI, were recorded at baseline, 3, 6, and 9 months' postsurgery while sulcus bleeding index (SBI), probing pocket depth (PD), clinical attachment level (CAL), and gingival recession were recorded at baseline, 6, and 9 months. Radiographic evaluation was carried out to evaluate the defect fill, change in alveolar crest height, and percent defect fill at 6 and 9 months. Results: Results showed that both the experimental groups showed clinically and statistically significant reduction in mean PI, SBI, PD, radiographic defect depth, and gain in CAL. The percentage of defect fill at 6 months (70.55 ± 15.99 vs. 55.30 ± 11.87) and 9 months (84.55 ± 11.74 vs. 72.2 ± 9.91) was significantly greater in Site A compared to Site B. Conclusions: Within the limitations of this study, it can be concluded that both the treatment modalities showed the potential of enhancing bone regeneration. However, the use of marginal periosteal pedicle flap showed better improvement in clinical and radiographic parameters.
  - 2,718 125
Incidence of risk and complications associated with orthodontic therapeutic extraction
Ramesh Narendar, Gowri Balakrishnan, Thangavelu Kavin, Sivasubramanian Venkataraman, Syed Khalid Altaf, Subramaniam Gokulanathan
November 2017, 9(5):201-204
DOI:10.4103/jpbs.JPBS_160_17  PMID:29284964
Background: Extraction in orthodontics are carried out in the cases where there is space deficiency to align the teeth. The elective extraction of first or second premolars has been discussed in the literature for more than 50 years. In the 1940s and 1950s Nance, Dewel and Carey reviewed this as a useful option, and in the 1970s Logan and other leading orthodontists favoured the extraction as choice. It is not always the elective extraction of premolar is a smooth drive for the surgeon as well as to patient. Sometimes the elective extraction of premolar result in complications, which might be due to both anatomical and surgical factors. Methodology: The study sample consisted of 100 patients referred for one or more orthodontic extractions to the department of oral and maxillofacial surgery were included in this retrospective study at the vivekanandha dental college for women tiruchengode between November 2014 and May 2016. All referrals were from the department of orthodontics. A survey was carried out to record the intraoperative risks and correlated with its morbidity as when occured. All intraoperative morbities were managed appropriately as required. Result and Conclusion: Between November 2014 and May 2016, 100 patients had one or more premolar teeth removed by the oral surgeons. The sample size was 100 patients who had a total of 334 premolars removed. The sample's mean age was 11.4+\- 8.4 years, and 57.0% were male. The average number of teeth extracted per patient was 2.34 +\- 1.46, and 73.8% had complete root development. More than 93.4% of subjects had normal root and bone morphology, whereas 35.65% had variations in root forms and bone texture. The intra-operative and post operative complication rates were 7.4% and 1.9%, respectively. Complications were generally minor (91.9%) and were managed nonoperatively on an outpatient basis. There were no case of oral antral communication.
  - 2,217 101
Immunohistochemical expression of ezrin in oral potentially malignant disorders-A descriptive study
Raghini Mohanraj, Pratibha Ramani, Priya Premkumar, Anuja Natesan, Herald J Sherlin, Gheena Sukumaran
November 2017, 9(5):205-210
DOI:10.4103/jpbs.JPBS_139_17  PMID:29284965
Introduction: Ezrin, also known as cytovillin, is a member of the ERM family of protein. Ezrin cross-links actin filament with the plasma membrane. They are involved in the formation of microvilli, cell–cell adhesion, maintenance of cell shape, cell motility, and membrane trafficking. Recent analysis reveals their involvement in signaling pathways. Ezrin is highly expressed in several types of human cancers, and correlation between its immunoreactivity and histopathological data as well as the patient outcome has previously been studied. Objective: The objective of the study was to analyze the immunohistochemical expression pattern of ezrin in oral potentially malignant disorders (OPMDs), namely, oral submucous fibrosis (OSMF) with different grades and clinically leucoplakia (hyperkeratosis with various degree of dysplasia) and its use as a predictive marker for malignant transformation. Subjects and Methods: Sample size n = 43, histopathologically confirmed cases of OPMDs (13 cases of OSMF with different grades and 30 cases of clinically leukoplakia) were retrieved from the Department of Oral and Maxillofacial Pathology. Immunohistochemistry was done using anti-ezrin antibody, and the expression was graded in terms of proportion and intensity. Results: There was a significant expression of ezrin in OPMDs, and its cytoplasmic shift can be used as a predictive marker for malignant transformation. Conclusion: The findings of the current study revealed that the expression of ezrin in OPMDs may be related to the progression of the disease.
  - 2,014 95
A study of diabetes associated oral manifestations
T Shanmugam Kathiresan, K. M. K Masthan, R Sarangarajan, N Aravindha Babu, Prashant Kumar
November 2017, 9(5):211-216
DOI:10.4103/jpbs.JPBS_157_17  PMID:29284966
Aim: The aim of this work was to determine the frequency of oral changes in diabetic patients and to study the relationship between periodontal disease and diabetes mellitus. Materials and Methods: The study sample consisted of 440 known diabetic patients between the age group of 20–80 years, of which 212 were males and 228 were females. One hundred and six patients were below 40 years, 138 patients between 41 and 50 years, 97 in 51–60 years, and 99 above 60 years of age. Data were statistically analyzed by Student's t-test. Results: Nearly 57% of the patients showed a Russell's Periodontal Index score of 2–4.9, which suggested an established periodontal disease. Risk factors for the people above the age of 40 years to develop diabetes were 76%. Conclusion: The frequency of oral manifestations in diabetic patients was significantly high, hence showing a relationship of gingival and periodontal diseases with diabetes mellitus.
  - 2,942 117
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