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   2021| June  | Volume 13 | Issue 5  
    Online since June 5, 2021

 
 
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REVIEW ARTICLES
Nano-hydroxyapatite: A driving force for bone tissue engineering
M Prem Blaisie Rajula, Vivek Narayanan, G Devanand Venkatasubbu, Rekha Chandra Mani, A Sujana
June 2021, 13(5):11-14
DOI:10.4103/jpbs.JPBS_683_20  
Bone is an amazing nanocomposite tissue made of both organic (primarily collagen) and inorganic (primarily nano-hydroxyapatite [n-HA]) elements. Bone grafting is a widely used surgical technique in dental and orthopedic surgeries to enhance bone regeneration. In view of the significant drawbacks of traditional treatments, nanomaterials offer new strategies for bone regeneration. The HA with the chemical formula of Ca10(OH)2(PO4)6 is very identical to the inorganic portion of bone. Due to its high stability and minimal solubility, it is often used in orthopedic and dental procedures. Currently, n-HA, which facilitates the growth of new bone, has garnered considerable attention because of better bioactivity and bone integration ability when compared to porous HA. This review gives comprehensive insights related to n-HA structure, chemical composition, surface modification techniques, and their application in bone tissue engineering.
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Extraction or nonextraction in orthodontic cases: A review
Sagar Mapare, Ram Mundada, Arjun Karra, Shivam Agrawal, Sushil Bhagwan Mahajan, Ashutosh Tadawalkar
June 2021, 13(5):2-5
DOI:10.4103/jpbs.JPBS_549_20  
Orthodontic treatment helps bring teeth in alignment. There is always debate whether tooth should be extracted or not for treating crowding. The present article highlights various advantages and disadvantages of extraction.
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ORIGINAL ARTICLES
Comparison of sealing ability of bioceramic sealer, AH plus, and guttaflow in conservatively prepared curved root canals obturated with single-cone technique: An In vitro study
Shalan Kaul, Ajay Kumar, Bhumika Kamal Badiyani, Laxmi Sukhtankar, M Madhumitha, Amit Kumar
June 2021, 13(5):857-860
DOI:10.4103/jpbs.jpbs_52_21  
Background: Inadequate obturation techniques of the root canal system have been found to be the most frequent reason of failure post root canal treatment. An ideal endodontic sealer should fulfill all ideal requisites. The present study aimed to compare apical sealing ability between bioceramic (BC) sealer, GuttaFlow, and AH Plus. Methodology: One hundred and twenty-five curved roots of maxillary and mandibular third molar teeth with fully formed apex were collected for this study. The root canals were cleaned and shaped using a standard single-cone preparation to file at the established working length and divided into five groups of 25 each. Dye leakage was carried out. Group A: with GP, using EndoSequence BC sealer with conventional with 4% gutta-percha (Brasseler USA, Savannah, Georgia, USA); Group B: with ceramic coated with 4% gutta-percha (Brasseler USA, Savannah, Georgia, USA); Group C: with GP, using AH Plus sealer (Dentsply, De-Trey Konstanz, Germany) with 4% gutta-percha; Group D: with GuttaFlow bioseal (Roeko-Coltène/Whaledent, Langenau, Germany) with 4% Gutta-percha; and Group E is a negative control group. Statistical analysis was done using the Statistical Package for the Social Sciences software and Student's unpaired t-test. Results: The group AH Plus showed more leakage values than the GuttaFlow group and of two groups of BC sealer and negative control. Student's unpaired t-test disclosed no significant difference (P < 0.05) between the groups. Conclusion: None of the sealers used in the study could completely seal the apical foramen to have a fluid-tight seal.
  500 48 -
REVIEW ARTICLES
An overview of chitosan and its role in periodontics
Arthiie Thangavelu, K Sahaya Stelin, Venkataramana Vannala, Nazargi Mahabob, Faisal Mansour Bin Hayyan, Rajasekar Sundaram
June 2021, 13(5):15-18
DOI:10.4103/jpbs.JPBS_701_20  
Chitosan is a biopolymer with numerous biological properties such as antibacterial, anti-inflammatory, and wound healing. Chitosan also stimulates cell proliferation and osteogenesis and thus used as a scaffold material in tissue engineering. The physical proprieties of chitosan such as biocompatibility and biodegradability give promising results in periodontal therapies. This review gives an updated explanation of the applications of chitosan in dentistry and periodontics. Furthermore, the review demonstrates the actions of chitosan in detail and its role in the regeneration of periodontal structures.
  427 22 -
An update on newer pulpotomy agents in primary teeth: A literature review
Shruti Jha, Nancy Goel, Bhagabati Prasad Dash, Heena Sarangal, Ishika Garg, Ritu Namdev
June 2021, 13(5):57-61
DOI:10.4103/jpbs.JPBS_799_20  
Primary molars with asymptomatic reversible pulpitis are commonly treated by pulpotomy procedure. Different pulpotomy materials used so far for pulpotomy that have been mentioned in the literature have been included in this article. This literature review includes all medicaments including natural alternatives. Many significant medicaments with their success rates have been mentioned in this paper. To increase the therapeutic success of pulpotomy procedure, it is necessary to identify a novel effective and preferably natural pulpotomy medicament.
  404 17 -
Salivaomics for oral cancer detection: An insight
V Naga Sirisha Chundru, Ramadas Madhavan Nirmal, B Srikanth, Manasa Bojji, Namburi Midhun, B Jaya Lakshmi
June 2021, 13(5):52-56
DOI:10.4103/jpbs.JPBS_529_20  
Early detection is very crucial for successful management of oral cancer or any disease as such. Oral squamous cell carcinoma (OSCC) accounts for nearly 90% of malignancy of oral cavity. In the field of cancer research, there is always an ongoing quest for newer methods to lower the morbidity and mortality associated with OSCC. Saliva, a readily available noninvasive biofluid with constant contact with oral cancer lesion, offers an appealing alternative to serum and tissue testing. This review throws light on incorporation of newer technologies for harnessing the saliva to its fullest potential with increased specificity and sensitivity toward identification of cancer-specific molecular signatures for the development of point-of-care applications that could be used at the clinical setting.
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ORIGINAL ARTICLES
Clinical efficacy of resin infiltration technique alone or in combination with micro abrasion and in-office bleaching in adults with mild-to-moderate fluorosis stains
Poorvi Saxena, Mandeep S Grewal, Pamita Agarwal, Gagandeep Kaur, Jayant Verma, Vandana Chhikara
June 2021, 13(5):301-305
DOI:10.4103/jpbs.JPBS_795_20  
Background: The present study was conducted to evaluate the clinical efficacy of resin infiltration technique alone or in combination with microabrasion and in-office bleaching in adults with mild-to-moderate fluorosis stains on permanent maxillary anterior teeth at the end of 1 month. Materials and Methods: A total of 30 patients with nonpitted fluorosis stains on maxillary anterior were classified as mild (n = 15) and moderate (n = 15). Each grade is subdivided into three groups as Group A, Group B, and Group C. Group 1: Mild (score 2), Subgroup A: Resin infiltration (n = 5 patients), Subgroup B: Microabrasion followed by resin infiltration (n = 5 patients), Subgroup C: Microabrasion and bleaching followed by resin infiltration after 2 weeks (n = 5 patients). Group 2: Moderate (score 3), Subgroup A: Resin infiltration (n = 5 patients), Subgroup B: Microabrasion followed by resin infiltration (n = 5 patients), and Subgroup C: Microabrasion and bleaching followed by resin infiltration after 2 weeks (n = 5 patients). Microabrasion was performed with the opalustre kit from Ultradent according to the manufacturer's instructions. Pola office bleaching from SDI and Icon infiltrant was performed. Stain score, improvement in appearance score, need for further treatment, patient satisfaction score, tooth sensitivity immediately after treatment, 24 h and 72 h were recorded. Results: The mean appearance score in Group 1A was 73.60, in Group 1B was 72.87, in Group 1C was 65.27, in Group 2A was 68.00, in Group 2B was 72.93 and in Group 2C was 84.73. The mean need for further treatment score in Group 1A was 72.80, in Group 1B was 78.40, in Group 1C was 68.73, in Group 2A was 71.20, in Group 2B was 79.53 and in Group 2C was 88.73. The mean patient satisfaction score in Group 1A was 91.40, in Group 1B was 95.20, in Group 1C was 98.00, in Group 2A was 90.20, in Group 2B was 99.40 and in Group 2C was 100.00. There was a significant difference in mean tooth sensitivity immediately after treatment between Groups 1A, 1B, 1C, 2A, 2B, and 2C. There was a significant difference in mean tooth sensitivity after 24 h between Groups 1A, 1B, 1C, 2A, 2B, and 2C. Conclusion: Resin infiltration technique in combination with bleaching and microabrasion technique found to be effective in the management of dental fluorosis.
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EDITORIAL
From the editorial desk
Gobichettipalayam Jegatheeswaran Anbuselvan, Thuckanickenpalayam Ragunathan Yoithapprabhunath, Thangavelu Arthiie
June 2021, 13(5):1-1
DOI:10.4103/0975-7406.317716  
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REVIEW ARTICLES
COVID and animal trials: A systematic review
Muhamood Moothedath, Muhaseena Muhamood, Yadnit S Bhosale, Aseem Bhatia, Pranav Gupta, Medapati Rama Haranadha Reddy, Rahul V C Tiwari
June 2021, 13(5):31-35
DOI:10.4103/jpbs.JPBS_749_20  
Extensive work is being done to form targeted drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, it is imperative to have a safe and effective vaccine against the same to win the war against this pandemic. For creating an efficacious vaccine, a proper animal model needs to be selected which can have an acceptable similarity of response as well as effects when administered to humans. For the present research, extensive search was conducted in MEDLINE and bioRxiv and medRxiv servers which were published in the English language from January 1, 2020, to August 20, 2020. Search terms included animal models, SARS-CoV-2, COVID-19, immune response against coronavirus, nonhuman primates, mice, ferrets, and macaques. In our study, creating an adequate immune response mimicking the response as in humans, as the endpoint, was considered as inclusion criterion while assessment of any additional therapies like safety as well as minimal tolerable dose using animal models as well as formation of adequate sample size of these models against COVID-19 was not considered. In our search, 163 articles were shortlisted, of them only 20 articles were finally included in our study which addressed to our inclusion and exclusion criterion. Our research articles focused on nonhuman primates, mice, hamsters, ferrets, cats, and dogs, with the main goal to investigate the role of animal models in the pathogenesis of COVID-19. It was evident in our research that animal models only mimic limited signs and symptoms experienced in COVID infection as compared to infections in humans. However, they are still essential to understand the pathogenesis, transmissibility of viral particles, and vaccine testing.
  374 17 -
Fibroblastic growth factor as a diagnostic and prognostic marker in odontogenic cysts and tumors: A systematic review
Gururaj Narayana Rao, Adlin Saroja Rosaian, Gowthami Jawahar, P Hari Nivas Raj, J Beryl Rachel, P Blessing Emmanuel
June 2021, 13(5):6-10
DOI:10.4103/jpbs.JPBS_563_20  
Cellular signaling proteins maintain the basic activities of cell and communication, between the cells for normal growth and development and pathological situation as well. Fibroblast growth factor (FGF) and fibroblast growth factor receptors (FGFRs) have a comparatively huge part to play in the cellular communication processes. Human FGF has 22 members, 18 ligands, and 4 tyrosine kinase receptors for binding and is expressed in a wide range of cells. Any alteration in these factors would disrupt their normal function, leading to various abnormalities. The aim of this systematic analysis, is to understand the FGFs, the physiological and pathological role of FGF in oral diseases, and to predict the use of FGF in the predilection toward odontogenic cyst and tumors. This review helps confer the role of FGF in various physiological and pathological aspects in systemic diseases and analyzes its role in diagnosis and prognosis of odontogenic cysts and tumors.
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ORIGINAL ARTICLES
Knowledge, attitude, and psychological effect on undergraduate/postgraduate students in Lockdown COVID-19 situation
Santosh Kumar Verma, Barun Dev Kumar, Subhash Chandra, Neha Singh, Priyanka Kumari, Abhishek Verma
June 2021, 13(5):696-698
DOI:10.4103/jpbs.JPBS_829_20  
Background: Student psychological health has been an increasing concern. The COVID-19 pandemic situation has brought this vulnerable population into renewed focus. Objective: Our study aims to conduct a timely assessment of the effects of the COVID-19 pandemic on the mental health of college graduates and postgraduates. Methodology: We conducted online survey with 550 students to understand the effects of the pandemic on their psychology and well-being. The data were analyzed through quantitative and qualitative methods. Results: Of the 550 students, 138 (71%) indicated increased stress and anxiety due to the COVID-19 outbreak. When asked about how the lockdown in COVID-19 situation affecting them, 97% said that it is severely affecting them. When asked about what the problems do you faced during online class, 5% said the Internet, 83.8% said noninteractive, and 11.2% said lack of explanatory mediums. When asked about number of hours spent on the Internet, 100% said more than 10 h. When asked about the activities to keep yourself busy during lockdown in COVID-19 situation, 37% said social media followed by 23% who mentioned cooking. Conclusion: Due to the long-lasting pandemic situation and onerous measures such as lockdown and stay-at-home orders, the COVID-19 pandemic brings negative impacts on education. The findings of our study highlight the urgent need to develop interventions and preventive strategies to address the psychological health of college students.
  336 16 -
Prevalence and risk of obstructive sleep apnea and association with orofacial symptoms in patients attending the dental clinics
Yagoub D Alyami, Abrar M Sabeh, Abdulrahman Abdullah Bin Afif, Yara Musa Yousef Roblah, D Ibraheem Abdul Rahman, Mawwadah Khaled S. Alfarsi, Fadi Salem H. Alzahrani
June 2021, 13(5):571-574
DOI:10.4103/jpbs.JPBS_537_20  
Background: Dentists have a vital role in detection of the signs and symptoms of obstructive sleep apnea (OSA) as it modifies in anatomy of orofacial structures. Aims and Objectives: This study aims to assess the prevalence of OSA risk in patients attending dental department and explore the factors related with high-risk OSA. Materials and Methods: The study was carried in the Al-Farabi Dental College, Jeddah, Saudi Arabia, on 200 consecutive dental patients from June 1, 2018, to July 31, 2019. Demographic details and the OSA risk were evaluated based on the Berlin questionnaire (Arabic version). Two qualified investigators independently did anthropometric measurements, medical and dental examination. Results: About 3.7% of males and 13.8% of females were found to be at high risk of OSA. Obese individuals almost had twice more likely chance to have OSA symptoms. Conclusion: Our findings confirm that dentists have an important role in recognizing the OSA signs and symptoms.
  316 9 -
COVID-19-related anxiety among dental students in two dental schools in Saudi Arabia
Mahmoud El Homossany, Ghada Sultan Alrowaily, Wysal Abdullah Allugmani, Waleed Khalid Abo-Atwan, Rafat Ayman Al-Sulaiman, Obayy Mohammed Al-Mofareh, Aseel Salem Alharbi, Abdulrahman Daher Almuqrin
June 2021, 13(5):826-830
DOI:10.4103/jpbs.JPBS_828_20  
Background: Dentistry can be an overstressed career. Dentists come across countless routes of stress in dental schools. Onset foot in clinical training, they can find that the number and type of stressors often grow. Dental students encounter high levels of academic stress, which can adversely influence them from their study years working with phantom teeth through their preclinical and clinical practice years. The COVID-19 pandemic has revealed the world population to a high risk of infection that comprises a major stress factor, especially for vulnerable groups such as dental students. Objective: The objective of this study was to assess the levels of COVID-19-related stress and anxiety, changes in hygienic and social habits, as well as subjective worries regarding the dental profession among dental students. Materials and Methods: A self-structured questionnaire was sent to dental students of two dental schools in the city of Jeddah. It included demographic data, questions about the level of change in personal hygiene and social habits, students' perception about the sufficiency of information received during the outbreak and its source, subjective worries regarding the dental profession, and the Generalized Anxiety Disorder 7-item Scale. Three hundred and eight responses were received. Results: Moderate and severe anxieties were reported in 41% and 7% of students, respectively. About 57% of respondents agreed to continue e-learning in the theoretical part only, 1% for the clinical part only, 32% in both, and 10% were not interested in continuing e-learning. Most of the students reported that they received excellent information about COVID-19 during the outbreak, with social media as the main source of information for the majority, followed by the Health Department. A significant number of dentists (66%) wanted to temporarily shut their dental practices until the number of COVID-19 case rates reduces considerably. Conclusion: A considerable percentage of dental students are anxious and changed their hygienic and social habits due to COVID-19. This anxiety reflects worries about the dental profession in one-third of participants that necessitate counseling services and psychological support.
  306 11 -
Antimicrobial efficacy of irreversible hydrocolloid impression impregnated with silver nanoparticles compared to surface disinfected impressions - An In vivo study
Vaishnavi Rajendran, Karthigeyan Suma, Seyed Asharaf Ali, R Karthigeyan, G Kalarani
June 2021, 13(5):532-536
DOI:10.4103/jpbs.JPBS_565_20  
Background: Routine disinfection procedures have shown to cause incomplete disinfection and detrimental effects on dimensional properties of the impression. Hence, self-disinfecting impression materials impregnated with antimicrobial agents were developed. Purpose: The purpose is to evaluate the antimicrobial efficacy of silver nanoparticles (AgNPs) impregnated in irreversible hydrocolloid (IH) impression material in in vivo conditions. Materials and Methods: This study comprised of four groups-IH impressions disinfected by immersion in 2% glutaraldehyde, IH impregnated with AgNPs of sizes 80–100 nm and 20–30 nm, nondisinfected impressions as control. Five impressions were made for each group and a total of 20 impression samples were made. The antimicrobial action of each sample was assessed by counting the number of colony forming units and by disc diffusion method. Results: The results were obtained and the data were statistically analyzed by Kruskal–Wallis test and tabulated. The results revealed that AgNPs of size 80–100 nm when impregnated in irreversible impression material showed effective antimicrobial action. Conclusion: The anti-microbial action of 80–100 nm AgNP impregnated IH impressions is comparable to that of impressions disinfected by immersion in 2% glutaraldehyde for 10 min.
  306 10 -
Parental attitude and awareness toward preventive dentistry in Riyadh, Saudi Arabia: A cross-sectional study
Sultan A Almalki, Majed S Almutairi, Abdulmajeed Mohammed Alotaibi, Ahmed Saleh Almutairi, Lafi Muqbil ALbudayri, Ramzi Zayed Almutairi
June 2021, 13(5):257-262
DOI:10.4103/jpbs.JPBS_708_20  
Introduction: Preventive oral health of a child is dependent on the parental knowledge toward caries control, care of deciduous tooth, use of space maintainers for malocclusion, and utilization of various procedures available for preventing oral diseases by oral health professionals. This study was aimed to assess the attitude and awareness of preventive dentistry among parents residing in Riyadh city, Kingdom of Saudi Arabia. Methodology: A cross-sectional, questionnaire study was conducted among 300 male parents. Questionnaire was sent through the use of social media, and responses were collected. Results: Seventy-four percent of male Saudi parents were aware of prevention of oral diseases. 38.45% of male parents were aware of preventive dentistry procedure, but preventive dentistry utilization rate was seen among 6% population only. Attitude toward the prevention of oral disease was statistically not significant according to the age group and income but statistically significant according to education. The utilization of preventive procedures was significant according to education and income (P < 0.05). Conclusion: Awareness about preventive dentistry was more among Saudi parents but utilization rate was directly correlated to their education and income. After The utilization of preventive procedures was significant according to education and income (P < 0.05).
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Prevalence of bruxism among the students of gulf medical university: A cross-sectional questionnaire study
Anam Hussain, Marsha Rizvi, Umika Vohra, Kavleen Kohli, Sundus Asim, Manahil Fikree, Zainab Ovais, Sura Ali Ahmed
June 2021, 13(5):501-505
DOI:10.4103/jpbs.JPBS_644_20  
Introduction: Bruxism is a multifactorial phenomenon that involves grinding or clenching of teeth. The parafunctional habit includes abnormal tooth wear, tooth fracture, pain, and tooth mobility, along with headaches and facial muscle hypertrophy. It is imperative for students to be conscious of teeth grinding along with its possible causes. The student will be alert to visit the dentist if required and contribute to the recognition of etiological factors, to eliminate them. Objective: This study aims to find the prevalence and understanding of bruxism among Gulf Medical University (GMU) students. Materials and Methods: A cross-sectional, questionnaire-based study was conducted among 451 GMU students. The parameters for data collection were age, gender, prevalence, associated signs and symptoms, causes, genetic predisposition, time of day, and effect on the appearance of teeth. Results: While 35.9% were unaware, 41.7% of our samples reported bruxism. The majority recognized temporomandibular joint and facial pain as causative, and 24.8% reported symptoms. Headache (26.4%) was prime and 7.5% were associated with fracture and abnormal tooth wear to bruxism (38.1%) experienced night bruxism. A significant number of students (32.4%) identified abnormal anterior teeth relationship as the cause and (64.3%) associated bruxism and esthetics. Conclusion: Nearly 41.7% of the students reported bruxism. Around 35.9% of the samples were uninformed. Nearly 20.8% believed that bruxism had genetic relevance. Nearly 51.9% of the participants were asymptomatic. Around 38.1% had night bruxism and 32.4% identified abnormal anterior teeth relationship as the cause. The majority of the sample (64.3%) connected bruxism to negative effects on teeth and esthetics.
  302 8 -
Evaluating the need of continuing the antiplatelet drug therapy in patients undergoing minor oral surgical procedures
Abhinav Kumar, Amit Rao, Amit Nimkar, Monica Mahajani, Rama Krishna Suvvari, Rishabh Bhanot
June 2021, 13(5):80-83
DOI:10.4103/jpbs.JPBS_554_20  
Background: Dental treatment in patients on antiplatelet drug therapy is a long standing debate. Discontinuation of medication increases the risk of thrombotic complications, whereas continuation leads to increased postoperative bleeding. Aim: We conducted this prospective cross-sectional study to assess risk of bleeding in patients continuing antiplatelet medication while performing minor oral surgical procedures such as single or multiple teeth extraction, transalveolar extraction of third molar, biopsy, and alveoloplasty. Materials and Methods: We calibrated the steps taken to achieve hemostasis, time taken to arrest bleeding, and correlated time taken to achieve hemostasis in patients under antiplatelet drug therapy (Group A [n = 64] - aspirin, Group B [n = 36] - aspirin and clopidogrel) and in patients without any drug therapy (Group C [n = 100] healthy patients). Results: Out of 200 patients, Level 1 hemostatic measures were required for 129 (64.5%) patients, Level 2 hemostatic measures were taken for 68 (34.0%) patients, and Level 3 hemostatic measures were taken for 3 (1.5%) patients. Chi-square test conducted to compare the local hemostatic measures taken for minor oral surgical procedure for all groups was statistically significant (P ≤ 0.001). Conclusion: Overall, there was no postoperative bleeding within 24 h of extraction in any patient group. In conclusion, surgical procedures can be safely accomplished in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken.
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REVIEW ARTICLES
Comparison of the success rate of mineral trioxide aggregate, endosequence bioceramic root repair material, and calcium hydroxide for apexification of immature permanent teeth: Systematic review and meta-analysis
Izaz Shaik, Bhargavi Dasari, Rashmi Kolichala, Mina Doos, Fida Qadri, Jenefer Loveline Arokiyasamy, Rahul Vinay Chandra Tiwari
June 2021, 13(5):43-47
DOI:10.4103/jpbs.JPBS_810_20  
This systematic review aims to compare the success rate of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. Indexed Journals such as Google Scholar, PubMed, Scopus, Cochrane, Research Gate, Wiley Online Library, and other related journals were hand searched from inception till November 2020 and articles were selected for review based on PRISMA guidelines. Of the 410 studies that were identified, 150 articles were selected after title/abstract reading. After full-text reading and based on inclusion and exclusion criteria, 9 studies were finalized for systematic review. Clinical, radiographic success, and the time taken for apical barrier formation were reviewed. All the three materials had almost similar success rate in terms of clinical symptoms, but the time taken for apical barrier formation and also single visit treatment makes MTA and Endosequence BCRRM superior to calcium hydroxide. Studies comparing EndoSequence Root Repair Material and MTA are very limited and need further evaluation in the future.
  284 21 -
Regenerative endodontic therapy in the management of nonvital immature permanent teeth: A systematic review and meta-analysis
Izaz Shaik, Malti Tulli, Priyanka Unnam, Sangeetha Karunakaran, Durga Susmitha Vaddi, Rafiya Jabeen, Rahul Vinay Chandra Tiwari
June 2021, 13(5):36-42
DOI:10.4103/jpbs.JPBS_807_20  
This meta-analysis is intended to evaluate the reliability of evidences published in current regenerative endodontic publications in a critical way. This meta-analysis is used to summarize and analyze the various clinical and radiographic findings associated with nonvital immature permanent teeth which have been treated with regenerative endodontic techniques. We also intend to significantly evaluate the worth of facts provided in the previous published literature. A structured electronic search by authors was undertaken in August 2020 using MEDLINE and PubMed search engine. The chosen parameters studied in this systematic review were presented in flowcharts and were summarized. We observed a good accomplishment rates in terms of survival of the treated tooth and also in resolution of any associated pathology in the apical areas; on contrary, our results in relation to apex closure along with constant root development, our findings from various studies were quiet variable. Regenerative endodontic procedures are constantly being restructured and enhanced to benefit present-day dentistry in all likely ways. Still, many factors that are important for the success of regenerative endodontic treatment outcomes still remain unexplained. There are still numerous gaps in our expertise at the present stage of this study.
  274 16 -
ORIGINAL ARTICLES
Assessment of knowledge and awareness among dentists about COVID-19 infection: A qualitative study
Priyadeep Banerjee, Shilpi K Pandey, Balaji Sugriv Munde, Godavari Deepak Nagargoje, Sana Mohani, Mitra Ashok Shinde
June 2021, 13(5):162-166
DOI:10.4103/jpbs.JPBS_626_20  
Background: This study was an attempt to evaluate the knowledge and awareness among dentists about COVID-19 infection. Methodology: This study was conducted among 580 dental professionals that comprised graduates (BDS), masters (MDS), postgraduates, and PhD fellows. A questionnaire containing information about knowledge, attitude, and awareness about COVID-19 infection was administered and recorded. Results: A total of 493 (85%) respondents replied correct answer that SARS-CoV-2 causes COVID-19. A total of 464 (80%) respondents replied that SARS-CoV-2 is the highest infectious virus among all. A total of 510 (88%) respondents replied the correct answer that 2–14 days is the incubation period of COVID-19 virus. Only 116 (20%) respondents replied the correct answer that MERS has high mortality. Only 87 (15%) respondents were aware of the appropriate mortality rate of COVID-19 disease. A total of 455 (78.4%) respondents had knowledge of the method of detecting COVID-19 infection (real-time reverse transcription-polymerase chain reaction). Knowledge level was good as seen in 81%, fair in 9.5%, and poor in 10.5% of the respondents. Conclusion: The authors found that dental professionals had fair knowledge and awareness regarding COVID-19 infection.
  274 14 -
Antibacterial activity of various intracanal medicament against Enterococcus faecalis, Streptococcus mutans and Staphylococcus aureus: An In vitro study
Lokhasudhan Govindaraju, Sowjanyaa Jenarthanan, Divya Subramanyam, P Ajitha
June 2021, 13(5):157-161
DOI:10.4103/jpbs.JPBS_623_20  
Aim: The aim of this study was to evaluate and compare the antimicrobial efficacy of triple antibiotic paste (TAP), calcium hydroxide, and Odontopaste which are used as intracanal medicaments against Enterococcus faecalis, Streptococcus mutants, and Staphylococcus aureus. Materials and Methods: Antibiotic sensitivity testing was done using agar well diffusion method of the following intracanal medicaments: Group 1: TAP (Ciprofloxacin, metronidazole, and doxycycline mixed in a ratio of 1:1:1; Group 2: Calcium hydroxide paste; Group 3: Odontopaste; Group 4: Sterile saline (0.9%) as a negative control. Each medicament was tested against E. faecalis, S. mutants, and S. aureus. The maximum zone of inhibition was noted by diameter size (mm) and analyzed with one-way ANOVA. Results: TAP showed the highest zone of inhibition. There is no significant difference between Odontopaste and calcium hydroxide against E. faecalis and S. aureus. There is a significant difference between TAP, Odontopaste, and calcium hydroxide against S. mutants. The order of the highest zone of inhibition is TAP > Odontopaste>Calciumhydroxide. Conclusion: With in the limitations of the study, TAP had better antibacterial activity against E. faecalis, S. mutants, and S. aureus followed by odontopaste and calcium hydroxide, Hence, Odontopaste can be used as an alternative for calcium hydroxide in the infected root canal.
  268 19 -
Managing anticoagulant patients undergoing dental extraction by using hemostatic agent: Tranexamic acid mouthrinse
Pragya Jaiswal, Raghav Agrawal, Aniruddh Gandhi, Arvind Jain, Abhishek Kumar, Rathi Rela
June 2021, 13(5):469-472
DOI:10.4103/jpbs.JPBS_639_20  
Background: Patient who is on antiplatelet therapy had an impaired fibrin formation which leads to fibrinolysis which is the main reason behind postextraction bleeding. Objectives: The aim of the study is to manage anticoagulated patient who has to undergo dental extraction by using hemostatic agent and the objective is to rule out potential risk factor which may trigger bleeding. Methods: One hundred patients with anticoagulant and antiplatelet therapy and having International Normalized Ratio (INR) in-between 1.9 and 3.5 were selected. Postextraction instruction use 5 ml of 10% tranexamic acid mouthrinse four times a day for next 7 days was suggested. All demographic data, history of anticoagulant and antiplatelet therapy, details of bleeding, and treatment requirement were recorded to identify potential risk factor. Results: Of 100 subjects, 16 were reported postextraction bleeding on days 1 and 2 which was controlled by tranexamic acid pressure pack. Bleeding from extraction socket of 10 patients was stopped by gelatin foam. No life-threatening risk was observed. In patients with age group of 41–60 years whose INR value was ≥2.5, the number of teeth undergoing extraction, whose bleeding time was increased, and were on long duration of antiplatelet and anticoagulation therapy might increase the risk of bleeding. Conclusion: Use of tranexamic acid mouthrinse after extraction is an effective way to control bleeding on patients who are under antiplatelet therapy with at therapeutic INR level is a secure and allowable method of minimizing postextraction oozing.
  266 21 -
Three-dimensional evaluation of the tongue volume in different dentoskeletal patterns – A cone beam computed tomographic study
Seema Grover, Maninder Singh Sidhu, Gowri Sankar Singaraju, Ashish Dabas, Namrata Dogra, Munish Midha
June 2021, 13(5):137-142
DOI:10.4103/jpbs.JPBS_614_20  
Aim: The aim of this study is to evaluate tongue volume using cone-beam computed tomographic (CBCT) and its correlation to different growth patterns in patients. Materials and Methods: Sixty preorthodontic records of CBCT scans of subjects ranging from 14 to 25 age group from retrospective data of department were selected for the study. Patients were classified into three groups based on angle FMA; Group I (n = 20) with average growth pattern (FMA 22°–28°); Group II (n = 20) vertical growth pattern (FMA >28°); Group III (n = 25) horizontal growth pattern (FMA <20°). Tongue volume evaluation was done using Myrian® Software. Dentoskeletal features and parameters related to archform such as palatal vault depth, interpremolar, and intermolar distance were evaluated in all the subjects. ANOVA test was used for intergroup comparison of tongue volume and dentoskeletal parameters in all three groups. Correlation of the tongue volume to dentoskeletal parameters was done using Pearson's correlation test. Results: Mean tongue volume in Group I was 66.10 cm3, Group II, 66.04 cm3 and Group III was 66.72 cm3. There was a statistically significant correlation (P < 0.5) of tongue volume with palatal vault width, maxillary length, and mandibular interpremolar and intermolar distance among dentoskeletal parameters. Conclusion: Tongue volume was found equal in all groups despite the variation in growth patterns. Skeletal differences leading to different growth patterns were found to be related to mandibular morphology. The results indicate the indirect role of the tongue in causing malocclusion in orthodontic patients.
  272 12 -
Analyzing the role of malnourishment in malocclusion: A cross-sectional study
Kumar Anand, Kumari Menka, Saritha Maloth, Subhash Chandra Nayak, Tina Chowdhary, Manish Bhargava
June 2021, 13(5):452-455
DOI:10.4103/jpbs.JPBS_602_20  
Background: Malocclusion is defined as an occlusion in which there is malrelationship between the arches in any of the three planes or anomalies in tooth position beyond normal limits, the etiology being multifactorial. Malnutrition may also be allied to malocclusion, predominantly crowding, due to insufficient space for the teeth to erupt in the correct place. Objectives: The present study was conducted to investigate the role of diet as an etiological factor in the occurrence of malocclusion. Materials and Methods: Two hundred and twenty malnourished subjects were examined by a single experienced dental professional and the occlusal relationships were evaluated at a centric occlusion position by instructing the subject to swallow and then bite on the teeth together. Results: Ninety-eight subjects (44.54%) had Angle's Class I malocclusion with crowding: 18 (8.1%) presented with spacing. Angle's Class II division 1 malocclusion was evident in 52 subjects (23.63%), while Class II division 2 in 38 subjects (17.27%). Only 14 subjects (6.3%) presented with Angle's class III malocclusion. Conclusion: Dietary factors and dentition measures from a subset 220 malnourished subjects found that malnourished subjects with basal metabolic index <18.5 had statistically significant relationships with the crowding variables.
  266 14 -
Oral health myths among general population at Riyadh Region, Saudi Arabia
Inderjit Murugendrappa Gowdar, Ali Mesfer Alqahtani, Ali Mohammed Asiri, Shaya Farhan Aldossary, Ibrahim Abdullah Alkhurayef, Dhafer Ibrahim Alheneshi
June 2021, 13(5):241-245
DOI:10.4103/jpbs.JPBS_700_20  
Background: Taboos or myths have got a connection from the history where there was no scientific understanding about the concepts of health they are part of culture and information shared or communicated by a number of people. Understanding myths and misbelieves are important to provide good oral care with health education to the people. Aim: The aim of this study is to assess the prevalence of oral health myths and to find its association between the demographic factors of general public in the Riyadh region of Saudi Arabia. Methodology: Questionnaire consisting of demographic details and myths about oral health problems was sent through Google forms. The link of questionnaire was sent through social media and requested to send the link to their friends and relatives. Results: About 50.71% of the study participants were against to myths and 23.48% of study participants were toward myths. The response in terms of agreement, disagreement or do not know was statistically not significant according to age, gender, or education. Conclusion: The prevalence of myths about dental treatment is almost 50%. This population needs to be educated to know the fact and to take action to rectify them about dental treatments.
  270 8 -
Comparative evaluation of the effect of 0.2% chlorhexidine, 2% lemongrass oil, and 2% tea tree oil mouth rinse on salivary pH: An In vivo study
Saranya Manikandan, Annette M Bhambal, KS Ratchambiga, M Nithiela, JK Swatheka, B Sridarshini
June 2021, 13(5):757-760
DOI:10.4103/jpbs.JPBS_667_20  
Background: Mouthwashes containing essential oils are used in the prevention and treatment of periodontal diseases. Lemongrass oil (LGO) belongs to a section of andropogen called cymbogam of the family germineae and from it, the LGO is extracted. Tea tree oil (TTO) is extracted from Melaleuca alternifolia leaves (Myrtaceae family). Aim and Objective: The aim of the study is to evaluate the pH of saliva before and after using LGO and TTO mouth rinse and to determine its relevance to the oral health status. Materials and Methods: A purposive sample of 90 participants aged between 26 and 38 years were included in the study. The PH before and after the use of the chlorhexidine, LGO, and TTO mouthwashes are noted using the GC PH strips and a comparative study was made. Statistical analysis was performed using paired t-test. P < 0.05 was considered statistically significant. Results: Comparative analysis was made with Wilcoxon signed-ranks test and found that the TTO gives a greater increase in salivary pH with a P = 0.001** (P < 0.05) which is found to be statistically significant. Conclusion: The study conducted shows beneficial effects of TTO and LGO mouth rinse. Further studies with larger samples may produce more reliable values.
  268 10 -
Oral health-related quality of life and severity of periodontal disease
Neetha Bhargava, Atul Jadhav, Pratiksha Kumar, Aliza Kapoor, Durga Prasad Mudrakola, Sandeep Singh
June 2021, 13(5):387-390
DOI:10.4103/jpbs.JPBS_588_20  
Background: Oral diseases are among the most common diseases which could not dissociate from general conditions with regards to impacts on quality of life (QoL). The present study is aimed to assess the impact of the severity of periodontal disease on oral health QoL using oral health-related quality of life (OHQoL)-UK questionnaire. Materials and Methods: The OHQoL-UK questionnaire consists of 16 variables within four domains made up of symptoms, psychological, social dimensions, and physical dimensions. Summing up the responses produce overall OHQoL-UK scores ranging from 16 to 80. Internal consistency was assessed using Cronbach's reliability coefficient. Each patient underwent a periodontal examination including periodontal attachment levels with Williams' periodontal probe as part of his or her routine assessment by one clinician collaborating on the study. Results: Within 200 patients participating in this study, 51% were < diploma, 32% were < bachelor's degree, and 17% were bachelor's degree and higher. Patients with higher educational level have a higher mean QoL score (P = 0.0001) which was statistically significant in regard to all aspects. Conclusion: The mean QoL score was significantly lower in patients with severe periodontitis when compared to patients with mild periodontitis, patients with better academic qualification have higher mean QoL score. According to the effect of severity of periodontal condition and educational level on QoL, required intervention should be done for treatment to improve QoL as a result.
  264 12 -
REVIEW ARTICLES
Role of human papilloma virus in malignant transformation of oral lichen planus: A systematic review
Aswathy K Vijayan, Arvind Muthukrishnan, Mathew Vidyadharan, Aparna M Nair
June 2021, 13(5):62-67
DOI:10.4103/jpbs.JPBS_836_20  
Lichen planus (LP) is a chronic inflammatory mucocutaneous disease. The disease has a cell-mediated immune reaction which is precipitated by a specific trigger which turns the self-peptides antigenic. The role of human papillomavirus (HPV) in the malignant transformation of oral LP (OLP) has always been debated. Establishing a definitive part played by HPV in the malignant transformation of OLP, would possibly provide screening for the viruses, HPV vaccination, and antiviral therapy along with conventional treatment in LP which could improve prognosis. This systematic review is to assess the role of HPV in the malignant transformation of OLP. We performed a systematic search of PubMed, MEDLINE, and Google. The information was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All full-text papers that assessed the association of HPV in malignant transformation of OLP were considered eligible. The outcome parameter included the malignant transformation of OLP. We found a total of 19 studies from which five were found suitable for the review. Results from this systematic review showed HPV is associated with OLP. There is an increased prevalence of HPV in the erosive-atrophic (EA) variant of OLP compared to non-EA variant. There seems to be no strong evidence to prove the association between HPV and malignant transformation of OLP. Taking up the oncogenic potential of high-risk types and OLP as a potentially malignant disorder, more number of studies need to be performed on the dysplastic subtype of OLP and in those OLP lesions that progress to oral squamous cell carcinomas.
  250 26 -
ORIGINAL ARTICLES
Cone-Beam computed tomography assessment of canal-centering ability for traditionally used nickel titanium and nickel titanium files with reciprocating hand piece and wave-one files
Rubeena Tabasum Shaik, Satyanarayana V V Uppalapati, Lavanya Neelima Uppu, Sriramarao Sudhamsetty, D Praneeth Kumar, Maheswari Kumpatla
June 2021, 13(5):88-91
DOI:10.4103/jpbs.JPBS_568_20  
Aim of the Study: Need for our study was to evaluate a comparison between canal preparation ability of nickel–titanium (NiTi) hand files with step-back manual technique, of NiTi files installed on a reciprocating hand piece and of Wave-One files utilizing noninvasive cone-beam computed tomography (CBCT) technique. Materials and Methods: Thirty extracted intact single-rooted human mandibular premolars were used in the study, segregated in three sets of 10 specimens each, where canal instrumentation was done by different methods using NiTi in step-back technique, using reciprocating hand piece with NiTi files and using primary file with the use of Wave-One reciprocating system. Later, evaluation of centering ability was conducted using the references through CBCT images. Results: Hand NiTi files showed even less canal centering ability as compared to other two sets. Mesiodistal diameter at 9 mm length of the prepared canal was 1.06 and later was 0.98, which shows excessive preparation in case of Set I versus Set II. In case of comparison between Set III and Set I, mesiodistal diameter at 9 mm length of the prepared canal was 0.99, and later was 1.06, depicting better canal shaping ability with Wave-One file. Conclusion: The use of hand NiTi files installed on a reciprocating hand piece would be economically beneficial producing the similar results as that of wave one without any deviation from the original canal anatomy.
  256 18 -
A randomized controlled trial on a minimally invasive microsurgical versus conventional procedure for the management of localized gingival recession in esthetic zone using alloderm
Robin Srivastava, Ranjana Mohan, MD Saravana Balaji, VK Vijay, S Srinivasan, M Navarasu
June 2021, 13(5):476-483
DOI:10.4103/jpbs.JPBS_756_20  
Background: Microsurgical technique is a recent advancement in periodontal plastic surgery, which improves the predictability of periodontal procedures, providing better esthetic results with minimal postoperative discomfort. Alloderm is an alternate to connective tissue grafts, which has been successfully used for root coverage. The present study aims at Comparative assessment of Micro and Conventional surgical techniques for root coverage using coronally positioned flap (CPF) with Alloderm. Materials and Methods: Twenty sites with Miller's Class I or II gingival recession defects were selected; sites were randomly divided into control and test groups. Test sites were treated with CPF and acellular dermal matrix (ADM) using Microsurgery and control sites were treated with CPF and ADM using conventional method. Results: Conventional and Microsurgical procedures for root coverage showed a statistically significant difference in all clinical parameters from baseline to 3 and 6 months (P < 0.01). The microsurgical technique demonstrated a significant difference in ultrasonographic thickness of gingiva (P < 0.003) and patient satisfaction score (P < 0.005). Conclusion: Microsurgical procedure for root coverage was found to be superior to the conventional macrosurgical approach under magnification. Microsurgical sites healed faster with neovascularization demonstrated on ultrasonographic evaluation with improved gingival thickness and patient satisfaction scores.
  258 15 -
Cognizance and use of minimally invasive dentistry approach by general dentists: An overlooked companion
Santosh Kumar, Nutan Mala, Kuldeep Singh Rana, Nasim Namazi, Rathi Rela, Kunal Kumar
June 2021, 13(5):199-202
DOI:10.4103/jpbs.JPBS_674_20  
Background: Dental caries begins with the decalcification of the first nonorganic part, followed by the decay of the organic tooth matrix. Minimally invasive dentistry (MID) focuses on using the adhesive technique for restoration as these techniques allow minimum removal of healthy tooth structure. Objective: This study aimed to assess the attitude, knowledge, and behavior of the general dentists toward the use of MID and to evaluate if MID is considered as standard care measure among general dentists. Materials and Methods: This was a cross-section observational survey and included 285 practicing dentists. The survey questions were divided into two parts. The question related to the use of sharp explorer utilized response categories (1–5), with options of always, most of the time, often, sometimes, and never or rarely. The independent variables collected were age, gender, years of practice, clinical hours, type of practice, postgraduate education, and clinic environment. The data collected were tabulated and were statistically analyzed. Results: The results of the present study showed that MID meets the standard of care for the treatment of both primary teeth 85.96% (n = 245) as well as permanent teeth 78.24% (n = 223). ART, sandwich technique, in-office, and at-home topical fluoride application were considered active for treating dental caries. The use of sharp explorers, nonsharp explorers, radiographs, and magnification were considered common for caries detection. Conclusion: The more dentists who listened to about MID in the past responded that the MID concept is the standard of care for the treatment of primary and permanent teeth than dentists who have heard little or nothing about MID.
  258 12 -
Knowledge, awareness, and attitude among practicing orthodontist on teledentistry during COVID pandemic in Kerala: A cross-sectional survey
Pradeep Philip George, Terry Thomas Edathotty, S Gopikrishnan, PS Prasanth, Sandeep Mathew, AA Mohammed Ameen
June 2021, 13(5):846-850
DOI:10.4103/jpbs.JPBS_826_20  
Background: Considering the gravity of coronavirus disease 2019 (COVID-19) and its potential to unfold within the dental workplace or institutions, a shift from traditional dental practice to a newer method is needed. Teledentistry is widely being practiced in this pandemic era for the diagnosis and to give instructions to the patients. Hence, an attempt has been made to explore the knowledge, attitude, and awareness of practicing orthodontists regarding the usage of teledentistry during COVID lockdown, in Kerala. Materials and Methods: A cross-sectional, descriptive study was done on about 150 orthodontic professionals. A pretested, self-organized, close-ended survey was managed through online stages that comprised of 15 questions. The information gathered was assembled in a systematic way and investigated regarding recurrence and Chi-square test was utilized for the examination of frequencies. Results: It was observed that 93.3% orthodontic practitioners had knowledge regarding teledentistry and a positive attitude toward teledentistry was shown by younger age group practitioners and those who were working in institutions (P < 0.05). 77.3% believed that teledentistry can save dentist's time and 71.3% responded that the new technology can be helpful in reducing the cost of treatment for patients. Conclusion: The knowledge, awareness, and attitudes were discovered to be acceptable among the orthodontic practitioners. Younger practitioners had more positive attitude toward teledentistry, and there was an overall positive attitude for using teledentistry as a temporary alternate for direct patient contact in COVID-19 pandemic time.
  256 12 -
A comparative evaluation of microleakage between resin-modified glass ionomer, flowable composite, and cention-N in Class V restorations: A confocal laser scanning microscope study
Krishnan Venugopal, L Krishnaprasad, V P Prabath Singh, Arjun B Ravi, Kaushik Haridas, Drisya Soman
June 2021, 13(5):132-136
DOI:10.4103/jpbs.JPBS_609_20  
Background: Microleakage is a concern while restoring cervical lesions. Many products have attempted to minimize the interfacial gap between the tooth and restoration, the main pathway of microleakage. Aims and Objective: To compare and evaluate the microleakage in Class V cavity restored with nanohybrid flowable composite, Resin modified Glass Ionomer and Cention N. Method: Class V cavities were prepared on mandibular premolars on buccal surface with their occlusal margin placed in enamel and the gingival margin in dentin. The teeth were randomly assigned to three groups of 20 teeth each and restored with Flowable composite , Resin Modified GIC and Cention N. Samples were immersed in 0.5% Rhodamine dye, sectioned and microleakage measured using Confocal Laser Scanning Microscopy. Statistical analysis was done using Oneway ANOVA Bonferroni's test and Kruskal Waliis test. Results: The average depth of penetration of dye and scoring of depth were noted. On comparing dye penetration values between groups, RMGIC is compared with Flowable composite and Cention N, statistically significant result was obtained suggesting lesser dye penetration in RMGIC group (P < 0.001) where other comparison did not. Conclusion: RMGIC showed significantly less microleakage compared to the other two restorative materials used in the study and enamel margin of all restorations showed lesser microleakage than dentin margin.
  250 17 -
Evaluation of oral hygiene status in patients with hemorrhagic and ischemic stroke
Raman Kant Sinha, Anupama Singh, Amit Kishor, Shree Richa, Rajiva Kumar, Abhishek Kumar
June 2021, 13(5):233-236
DOI:10.4103/jpbs.JPBS_698_20  
Background: Stroke can broadly be categorized into ischemic or hemorrhagic. Ischemic stroke accounts for 85% of cerebrovascular accidents (CVAs), whereas hemorrhagic stroke accounts for 15% of CVAs. Stroke is broadly associated with loss of sensation or unilateral paralysis of orofacial structures. Objectives: The present study was conducted to evaluate the prevalence of various oral features in patients with ischemic and hemorrhagic stroke. Materials and Methods: One hundred patients diagnosed with stroke admitted in the intensive care unit were included in the study. The evaluation of oral manifestations and their prevalence was done by a well-experienced oral medicine expert deputed in the dental department of the hospital. A single examiner performed all oral evaluations. Results: The mean and median for the age were 60.8 and 59. Sixty of 100 patients were male, whereas 38 were female. Forty patients had hemorrhagic stroke, whereas 60 had ischemic stroke. Senenty-eight patients of 100 had features of periodontitis, 90 of 100 patients presented with halitosis, 79 presented with caries, 83 patients had positive signs of tongue hypermobility, and 75 patients had dysphagia. Conclusion: Oral hygiene is the most neglected aspect during rehabilitation in stroke patients. It is critical for stroke patients to receive thorough oral care, as it can prevent other systemic ailments and potentially life-threatening complications like aspiration pneumonia.
  253 12 -
Osseointegration of dental implants in ridges with insufficient bones using different membranes for guided bone regeneration
Vikas Vaibhav, Abhishek Sinha, Deepika Bolisetty, Abhishek Verma, Kunal Kumar, Sanjeev Singh
June 2021, 13(5):225-228
DOI:10.4103/jpbs.JPBS_696_20  
Background: The use of membrane with the guided bone regeneration (GBR) has been a controversial aspect of the implant placement, which helps achieve the primary graft stabilization and inhibit early graft loss. Objectives: The present clinical trial was aimed to determine the results of GBR with nonresorbable (expanded polytetrafluoroethylene [e-PTFE]) and resorbable (collagen) membrane both clinically and radiographically for 2 years with dental implant placement. Materials and Methods: 16 subjects having 32 sites for implant placement in a split-mouth pattern were included in the study. The sites for implant was prepared and grafted with the autogenous graft procured from the mandibular ramus area followed by graft coverage with either e-PTFE or collagen membrane. Various radiographic and clinical parameters were assessed for 2 years at an interval of 6 months each. The collected data were recorded for each study subject for all the implant sites and were statistically analyzed. Results: The mean values for periodontal probing depth at 6 months, 12 months, 18 months, and 24 months were 2.25 ± 0.17, 2.67 ± 1.84, 2.64 ± 1.21, and 3.01 ± 0.52, respectively, for the e-PTFE group. For the collagen group, the probing depth mean values at 6 months, 12 months, 18 months, and 24 months were 2.30 ± 0.14, 2.59 ± 1.76, 2.62 ± 1.30, and 2.98 ± 0.81, respectively. The corresponding clinical and radiographic parameters at all time intervals were nonsignificant on the intergroup comparison. Conclusion: Dental implants placed with simultaneous GBR have an acceptable survival rate at the end of 2 years irrespective of the resorbable or non-resorbable membrane used.
  252 12 -
Attitude of dental students towards the rubber dam use in operative dentistry
Basem Mohammed Abuzenada
June 2021, 13(5):637-641
DOI:10.4103/jpbs.JPBS_764_20  
Aim: Operative dentistry and endodontics are the two major areas where rubber dam is used extensively with special emphasis to train students on its application during dental curriculum. The purpose of the present study was to evaluate the attitude of dental students toward the use of rubber dam in operative dentistry clinics along with emphasis on evaluation of its prospective application after graduation. Materials and Methods: A structured questionnaire-based analysis was performed among internship students of a dentistry program, Batterjee Medical College, Jeddah, Saudi Arabia. The questions were based on training, latex allergy, and selection of jaws for application of rubber dam and prospective use of rubber dam during practice. Results: A completed questionnaire by all participants (n = 110) was analyzed and subjected to statistical analysis. Around 80.9% of the students agreed that adequate and satisfactory training for rubber dam placement was imparted while 59.1% agreed that they enquire about latex allergy before placement of rubber dam. Further, 85.5% of the students planned to use rubber dam for all procedures after graduation. Conclusion: A promising response was exhibited by this group of future dentists toward the application of rubber dam during restorative procedures.
  248 13 -
Knowledge and attitude regarding COVID-19 among students from multiple professional background in Riyadh Region, Saudi Arabia: A cross-sectional study
Rajashekhara Bhari Sharanesha, Bader Khalid Aljuai, Tariq Ahmed Alfaifi, Abdulelah M Shukr, Mohammed Abdullah Bamuqadm, Abdulmalik Abdullah Alhoti
June 2021, 13(5):251-256
DOI:10.4103/jpbs.JPBS_703_20  
Introduction: Coronavirus disease 2019 is abbreviated as “COVID-19” caused by the severe acute respiratory syndrome-corona virus 2 first emerged in Wuhan, China, on December 2019. On 15th of March, this disease has been classified by the World Health Organization as a pandemic and a global public health emergency. Objective: The study's aim was to evaluate the knowledge and behavior toward the virus among professional students of Riyadh, Saudi Arabia. Methodology: A cross-sectional study done on 753 students which were invited to complete a Google document using a 20-item electronic questionnaire that was design to gauge knowledge and attitude toward COVID-19. The study was conducted from February 20 to March 18, 2020 in Alkharj and Riyadh region. Results: The predominant sex is male (73%), the common age is <25 years old, more medical students were involved in the study than any other specialty and the predominant educational degree of the participants was bachelors. The awareness of mode of transmission of novel coronavirus infection is less in business administration participants compare to others and is highly significant (P ˂ 0.001). Most of the participants (588 [98%]) were aware of coronavirus but only 302 (50%) of respondents are aware of COVID-19 which is highly significant (P ˂ 0.001). Conclusion: The results are mostly uniform among different professional students with the exception of some knowledge-related questions. The Internet was the main source of information, so there is a need to create more awareness about COVID-19 through social media.
  252 8 -
Basics of epigenetics and role of epigenetics in diabetic complications
Andamuthu Yamunadevi, Ramani Pratibha, Muthusamy Rajmohan, Sengottaiyan Mahendraperumal, Nalliappan Ganapathy
June 2021, 13(5):336-343
DOI:10.4103/jpbs.JPBS_771_20  
The term “Epigenetics” includes mechanisms by which genetic expression is altered without a change in the underlying DNA sequence. The changes caused by epigenetic mechanisms are inheritable and are one way in direction (irreversible) and also explains why there is differences in genetic expressions of monozygotic twins. The epigenetic mechanisms alter the genetic expressions through DNA methylation, posttranslational modifications (PTMs) of histone, and noncoding RNAs. DNA methylation and histone PTMs cause relaxation or condensation of chromatin units. The epigenetic actions of noncoding RNAs such as microRNAs, small nucleolar RNAs, small interfering RNAs, and long noncoding RNAs act by modifying transcription factors or by degrading target messenger RNAs and their translation factors. Various pathologies and environmental factors cause changes in the cellular epigenetic mechanisms and the epigenetic alterations occurring in diabetes mellitus (DM) are reviewed. DM causes hemodynamic changes and metabolic changes like hyperglycemia and dyslipidemia. These changes induce oxidative stress and activate intracellular signaling and kinases in the target cells. Epigenetic alterations cause chromatin remodeling and altered gene expression leading to inflammation, proliferation, atrophy, hypertrophy, etc.; thereby, diabetic complications such as neuropathy, nephropathy, vasculitis result in the corresponding target organ. When these epigenetic alterations persist for a longer period without intervention, the target cells attain “metabolic memory” meaning that these epigenetic mutations cannot be reversed even after attaining normal blood glucose levels. Thus, epigenetics, an insightful and efficient tool in genomic research, has started crawling into the research arena and needs to reach leaps and bounds for the better understanding of health and diseases.
  242 15 -
REVIEW ARTICLES
First molars in permanent dentition and their malformations in various pathologies: A review
Andamuthu Yamunadevi, Ramani Pratibha, Muthusamy Rajmohan, Sengottaiyan Mahendraperumal, Nalliappan Ganapathy, Rajamani Srivandhana
June 2021, 13(5):23-30
DOI:10.4103/jpbs.JPBS_744_20  
Permanent maxillary and mandibular first molars are the first permanent teeth to erupt into the oral cavity along with the mandibular incisors. It serves as an excellent record of maternal and fetal health, reflecting the prenatal, perinatal, and postnatal health and diseases. This review focuses on the molar morphogenesis, molar malformations, their etiopathogenesis, and pathologies causing specific pattern of molar malformations.
  238 18 -
ORIGINAL ARTICLES
Application of willems method as an age estimator in early adolescents of Bangalore Population
Boraiah Shivakumar, Rashmi Bankur, Sudarshan Kumar Chinna, Boraiah Niveditha, Vipin Jain, Deepa Sundar
June 2021, 13(5):595-597
DOI:10.4103/jpbs.JPBS_693_20  
Introduction: Dental age (DA) assessment is a reliable method for chronological age (CA) estimation used for criminal, forensic, and anthropologic purposes. Age estimation also provides valuable information when the birth date is unavailable, as in case of migrants. Furthermore, the CA of living people is important for employment and marriage purpose. Objectives: The aim of the present study is to check the reliability of the Willems method in the population of Bangalore. Materials and Methods: The study was conducted on 205 (109 boys and 96 girls) participants by their radiographic records in the department of forensic odontology using modified Demirjian's method by Willem et al. Results: A total of 205 subjects were selected for the study, among which 109 (53.2%) were boys and 96 (46.8%) were girls. The mean CA was 12.23 ± 1.75 and the mean DA was 12.20 ± 1.99. Willems method seems to be reliable in estimating DA in Bangalore populations. Conclusion: This study showed that the Willems method gave near precise estimation of the CA.
  244 11 -
Cariostatic efficacy of cinnamon water extract on Streptococcus mutans: An In vitro study
Nutan Mala, Sinha Sonal, Amit Kumar, Harsh Vardhan Choudhary, Prafulla Songara, Kumar Ramesh
June 2021, 13(5):212-216
DOI:10.4103/jpbs.JPBS_677_20  
Background: Dental caries is a chronic, widespread, and infectious disease affecting the large population. Anticariogenic effects of different herbs and natural products are observed, cinnamon among these, showed the ability to inhibit Streptococcus mutans biofilm. Objectives: The aim of this study was to assess the cinnamon water extract use on nicotine exposed S. mutans biolfilms. Materials and Methods: Microtiter plates having S. mutans culture were treated using varying nicotine concentration range (0–32 mg/ml). These were then either subjected to cinnamon water (2.5 mg/ml) extract or no treatment and analyzed using a spectrophotometer to see planktonic growth, total growth absorbance, and biofilm formation. Results: About 2.5 mg/ml of cinnamon water inhibits the S. mutans biofilm (nicotine-induced) considerably at various nicotine levels (0–32 mg/ml). Conclusion: Cinnamon water extract has a powerful inhibitory effect for S. mutans growth. Nicotine-induced S. mutans growth is markedly reduced by treating with cinnamon water extract.
  240 14 -
A comparative evaluation between the use of buccal pad of fat and bovine collagen membrane in the management of oral submucous fibrosis
Sonal Kothari, Sahil Mittal, Izaz Shaik, Khalid Gufran, Rimmi Daharwal, Hemanadh Kolli
June 2021, 13(5):190-193
DOI:10.4103/jpbs.JPBS_654_20  
Purpose: This study is intended to assess and compare the effectiveness of BFP and BCM as reconstruction materials in treating oral submucous fibrosis (OSMF). Materials and Methods: This study comprised twenty patients of 20 and 60 years who were clinically diagnosed with OSMF. All patients were subjected to fibrotomy with reconstruction under general anesthesia. In all the patients, following fibrotomy reconstruction was done using the buccal pad of fat on the left and with the collagen membrane on the right. The temporal muscle insertions were released, and coronoidectomy was performed as and when required. Any third molars if present were removed. All patients were feeded for 7 days by Ryle's tube and were on intravenous antibiotics for 5 days. Clinical evaluation was done at periodic intervals of 7, 30, 90, and 180 days postoperatively for mouth opening, burning, pain on mouth opening, and recurrence. Results: The mean age of patients was 27.3 years. A 12 mm was mean preoperative mouth opening. Intraoperative mouth opening was 37 mm in all the patients and maintained at 36 mm at the 6th-month postoperative period. No significant difference was observed between both sides pertaining to pain on maximal mouth opening, burning sensation, or postoperative infection. However, there was a significant difference in the time taken for epithelization on both sides. Conclusion: The results of this study reveal that both Buccal Pad of Fat (BPF) and BCM are viable reconstruction options, but BFP as a reconstruction material exhibited prompt epithelization with the lowest wound contracture.
  238 13 -
Oral health and rheumatoid arthritis: A case control study
Suhael Ahmed, Shubham Kumar, Rana Ali Alsaadi, Faisal Mohiuddin Ansari, Surbhi Abrol, Devleena Bhowmick, Nafeesa Tabassum
June 2021, 13(5):315-318
DOI:10.4103/jpbs.JPBS_704_20  
Introduction: Association between oral health and rheumatoid arthritis is well established. Oral health-related quality of life was determined in patients diagnosed with rheumatoid arthritis (RA). Materials and Methods: This study was conducted among 45 patients (males 25 and female 20) (Group I) of RA and 45 healthy participants as control (Group II). Disease activity score 28 test, health assessment questionnaire (HAQ), and general oral health assessment index (GOHAI) questionnaire were applied. Results: The mean HAQ score in Group I was 1.14 and in Group II was 0.36. The mean GOHAI score in Group I was 36.4 and in Group II was 52.8. The mean HAQ in males was 0.94 and in females was 34.6. The mean GOHAI in males was 12.6 and in females was 38.2. In Group I, there were 15 patients with HAQ level 1 and 30 with HAQ level 2 and in Group II was 40 with HAQ levels 1 and 5 with HAQ level 2. In Group I, 42 had Dt GOHAI = 0 and 3 had Dt GOHAI = 1 and in Group II, 10 had Dt GOHAI = 0 and 35 had Dt GOHAI = 1. The difference was statistically significant (P < 0.05). There was a statistically significant difference in the mean value of HAQ and GOHAI in degree of disease activity (P < 0.05). There was an increase in HAQ and decreases GOHAI scores with the deterioration of disease. There was a correlation between age and involved joints with HAQ and inverse relationship between age and involved joints with GOHAI. Conclusion: Authors found that RA patients had poor oral health quality of life. It was found that aging and with the deterioration of disease, GOHAI, and the oral health quality of life of patients decreased.
  238 12 -
Knowledge and attitude towards dental clinical practice related to COVID-19 pandemic among dental interns in Saudi Arabia
Suhail Shariff, Muath Muhammad Benten, Mohammed Khaled Ahmed Al-Zabidi, Ghaida Mohammed Alshehri, Ahad Abdulaziz Almehmadi, Shahad T F Alhazmi, Elaf Waleed AlDara
June 2021, 13(5):831-835
DOI:10.4103/jpbs.JPBS_827_20  
Background: The newly emerged pandemic has created many dilemmas in dental clinical practice all over the world. Most of the practicing dentists and dental students are at higher risk of getting infected and transmitted the disease. The study aimed to explore the knowledge and attitudes among dental interns in Saudi Arabia related to the COVID-19 pandemic. Materials and Methods: An online questionnaire survey was carried out among dental students pursuing their internship at different universities in Saudi Arabia. A combination of convenience and snowball sampling was used to identify interns from each province of the Kingdom. The questionnaire was validated and pretested, which recorded the knowledge, attitude, and concerns related to dental practice and COVID-19. Results: The knowledge related to COVID-19 and its importance in clinical dental practice was below average among dental interns, and only 22.2% gave a correct response to all questions. About 80.8% and 85% of the dental students were worried about contracting the infection during dental practice and transmitting it to family and friends, respectively. Conclusion: Dental students showed satisfactory knowledge, attitude, and practices related to COVID-19, and most of them were aware and adhering to the preventive guidelines set by the ministry of health.
  242 8 -
Assessment of implant stability in immediate implant placement using different bone grafting materials: A clinical study
Mohammad Jalaluddin, Saurabh Sathe, Joyce Thomas, Shaista Haleem, Sachin Naik, Madhuniranjanswamy Mahalakshmamma Shivanna
June 2021, 13(5):612-615
DOI:10.4103/jpbs.JPBS_627_20  
Aim: The aim of the present study was to assess the implant stability in immediate implant placement using different bone grafting materials. Materials and Methods: Twelve patients (5 males, 7 females, range of 40–58 years) were included in the study. All patients were divided into two groups based on the graft material used. For Group 1, Xenograft bone grafting material was used, and for Group 2, Freeze-dried bone allograft was used. The patients were suggested to rinse with 0.2% chlorhexidine mouth wash for 1 min. Periotome was used for atraumatic tooth extraction, and necessary care was taken to avoid fracture of socket wall. The implant was placed with respective bone grafting materials. An Orthopantomogram (OPG) radiograph is taken at the day of the operation to serve as baseline data for the marginal bone level. Clinical and radiological parameters were evaluated at baseline, 3 months, 6 months, and 12 months to assess the mean marginal bone level changes. Periotest was used for the measurement of implant stability. Results: The mean marginal bone level in Group 1 at baseline (13.58 ± 1.09), 3 months (12.64 ± 0.88), 6 months (12.02 ± 1.42), and 12 months (11.20 ± 1.26), respectively. In Group 2, the marginal bone level was at baseline (14.22 ± 0.26), 3 months (13.52 ± 1.28), 6 months (13.10 ± 0.32), and 12 months (12.12 ± 1.26), respectively. There was a statistically significant difference found in both the groups. Moreover, there was no statistically significant differences found between the groups at all the duration on intergroup comparison of the mean marginal bone level. The mean difference of implant stability in Group 1 the implant stability was 188.6 ± 22.5 and in Group 2 was 191.5 ± 18.2, and there was no statistically significant difference found between the groups. Conclusion: Both bone grafting materials used in the study showed improvement in implant stability and marginal bone levels after immediate placement of implant.
  230 19 -
Comparative evaluation of primary stability of two different types of orthodontic mini-implants
Jyotirmay Singh, Sanjay Kumar Singh, Abhinav Raj Gupta, Subhash Chandra Nayak, Ritesh Vatsa, Priyanka Priyadarshni
June 2021, 13(5):128-131
DOI:10.4103/jpbs.JPBS_604_20  
Background: The mini-implants introduced new possibilities of adequate anchorage in orthodontics. Furthermore, due to its small size, it can even be placed at relatively difficult sites with ease. Removal torque should be high to prevent implant unscrewing. Objective: This prospective clinical trial was aimed to evaluate the insertion torque and removal torque of single-threaded and double-threaded cylindrical orthodontic mini-implants. Materials and Methods: A total of 36 cases were randomly divided into two groups, with an equal number of patients in each group (n = 18). In Group 1 single-threaded cylindrical mini-implant was placed, and in the other group, cylindrical implants with double-threaded were placed. Maximum insertion torque (MIT) and maximum removal torques (MRTs) were recorded for both groups. Data collected were subjected to statistical analysis. Results: MIT was found to be significantly higher than MRT for both the groups and between the groups. Intergroup comparison in the present study showed significantly higher values for MIT than MRT. Intergroup comparison of MIT showed more values for Group 2 as compared to Group 1. Similar statistically significant values were seen in terms with MRT, where double-threaded cylindrical mini-implants had more torque value than the other group. Conclusions: Orthodontic mini screws represent effective temporary anchorage devices. Double-threaded cylindrical mini-implants have significantly higher insertion and removal torque than single-threaded mini-implants and hence better stability.
  234 13 -
Reliability of photogrammetric landmarks to the conventional cephalogram for analyzing soft-tissue landmarks in orthodontics
Pragya Jaiswal, Aniruddha Gandhi, Abhinav Raj Gupta, Nidhi Malik, Sanjay Kumar Singh, Kumar Ramesh
June 2021, 13(5):171-175
DOI:10.4103/jpbs.JPBS_634_20  
Background: Graber introduced facial photographs as an internal diagnostic aid. Facial photographs could serve as an important alternative assessment tool in the absence of equipment for cephalometric analysis. Objectives: The present study was aimed at assessing whether analyzing the photographs could have precision for assessing the landmarks appropriate for facial analysis. In addition, the relationship between frontal cephalogram and measurements on photographs was assessed. Materials and Methods: Twenty individuals including both males and females within the age range of 18 years to 28 years were enrolled in the study. Frontal facial photographs, as well as frontal cephalograms, were obtained for all the included study participants. Various soft-tissue vertical and horizontal landmarks were marked on both radiographs and photographs. The data were collected and subjected to statistical analysis. Results: The results showed a statistically insignificant difference between all the vertical and horizontal parameters on photographs and cephalograms. The reliability of the digital photographs was comparable to that of the cephalograms with nonsignificant differences in the recorded mean values using the one-way ANOVA test where the statistical significance level was kept at P ≤ 0.05. Conclusion: The present study concluded that photography is a cost-effective and reliable method for soft-tissue landmark identification, and allows recording the images of sufficient quantity for analysis. Low-cost and easily captured photographic images can replace costly radiographic procedures without causing any discomfort to the patients.
  234 12 -
Potential antibacterial efficacy of garlic extract on Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae: An In vitro study
Mohammed Abidullah, Pradnya Jadhav, S Sri Sujan, Ayyapa Gandhi Shrimanikandan, Chukka Rakesh Reddy, Raj Kumar Wasan
June 2021, 13(5):590-594
DOI:10.4103/jpbs.JPBS_681_20  
Background: Garlic has been recommended by many ancient medicines such as the Chinese and the Indian medicine to cure respiratory and digestive issues along with treating microbial infestation and leprosy. The therapeutic effects encompass many advantages in the field of cardiovascular system, antibiotics, anticancer, anti-inflammatory, and hormone-like effects. Aims and Objective: The present study was carried out to evaluate the garlic antibacterial effect against clinical isolates of Staphylococcus aureus, Escherichia coli, and Pneumoniae from patients attending referral hospital. Materials and Methods: The isolation of bacteria was done from pus sample collected from referral hospital, Bedar, Karnataka, with sterile swabs. The study samples were inoculated under aseptic conditions on culture media such as nutrient agar, blood agar, and MacConkey agar plates and isolated the pathogen bacteria such as E. coli, Klebsiella pneumoniae, and S. aureus. The garlic bulbs were peeled off and then ligated using pestle simultaneously with addition of minor quantity of H2O for preparation of plant extract and study the antimicrobial effect of garlic on these bacteria. Results: The result showed that garlic extracts have a high range of antibacterial effect against both Gram-negative (E. coli and K. pneumoniae) and Gram-positive bacteria Staphylococcus. Conclusion: The present study observations revealed that garlic makes large clear zones in comparison to the currently available antibiotics used in the study. The potentiality of the garlic can be utilized in the field of antibacterial agents. It can be prepared in the form of tablets in the best concentrations and affordable dosages so that it can be used as medicine against these pathogenic organisms.
  232 12 -
Assessment of levels of C-reactive proteins and interleukin 6 in patients with peri-implantitis: A Case–Control study
Aditya Khichy, Ruhani Khichy, Ravpreet Singh, Yashika Bali, Supreet Kaur, Tarunpreet Kaur Gill
June 2021, 13(5):444-447
DOI:10.4103/jpbs.JPBS_540_20  
Aim: The present study was undertaken for assessing the C-reactive proteins (CRP) levels and IL-6 levels in patients with peri-implantitis. Materials and Methods: A total of 20 patients with confirmed clinical and radiographic diagnosis of peri-implantitis were included in the present study. Another set of 20 subjects who reported for routine health check-up were included as healthy controls. All the subjects were recalled in the morning and fasting (minimum of 12 h) venous blood samples were obtained. Plain vials were used for collecting the venous blood which was sent to the laboratory for biochemical analysis. In the laboratory, levels of CRP were assessed by means of latex enhanced nephelometric method, and interleukin 6 (IL-6) was assessed by means of Elisa kit. Results: Mean levels of CRPs in patients of the peri-implantitis group and the control group was found to be 0.795 mg/dL and 0.294 mg/dL respectively. Mean IL-6 levels among the patients of the peri-implantitis group and the control group was found to be 12.178 pg/ml and 6.458 pg/ml respectively. While analyzing statistically, significant results were obtained. Conclusion: Enhanced periodontal inflammation in peri-implantitis patients is accompanied by a considerable increase in the concentration of CRPs and IL-6.
  234 10 -
Efficacy of transdermal diclofenac patch and ketoprofen patch as postoperative analgesia after extraction of first premolars bilaterally in both arches for orthodontic purpose: A comparative study
Daya Shankar, Abhishek Sinha, Santosh Anand, Neeraj Verma, Shivendra Choudhary
June 2021, 13(5):101-104
DOI:10.4103/jpbs.JPBS_571_20  
Aim: The aim of the study was to compare the efficacy of transdermal diclofenac patch with ketoprofen patch as postoperative analgesia after extraction of first premolars bilaterally in both arches for orthodontic purpose. Materials and Methods: A split-mouth technique was used in 52 patients with the age group of 15–25 years for extracting maxillary and mandibular first premolars bilaterally for orthodontic reason. A single ketoprofen patch was used after the extraction of premolars from first and fourth quadrant, whereas for the extraction of second and third quadrant premolars, diclofenac patch was used. All the extractions were performed under local anesthesia. The data were compiled and statistically analyzed using the student's t-test. Results: Mean visual analog scale score for diclofenac and ketoprofen patch was 2.05 (0.75) and 1.09 (0.3), respectively. Thirteen patients required additional medication (25%) and 1 (1.9%) patient with diclofenac and ketoprofen patch, respectively. No major complication or adverse effects were observed in any of the groups. Conclusion: Both diclofenac and ketoprofen transdermal patches are helpful in relieving pain after orthodontic extraction. Patients with diclofenac patch required more additional analgesia within 24 h compared to that with ketoprofen patch. None of the drugs showed any significant adverse effects and were well tolerated by the patients.
  230 12 -
Efficacy of routinely used analgesics in management of pulpal pain postoperatively a clinical study
Lavanya Thota, Rahul Bansal, Gunaranjan Thota, Meena Kumari Chikkanna, Hanan Shanab, Vinutha V Kumari
June 2021, 13(5):684-687
DOI:10.4103/jpbs.JPBS_782_20  
Aim: The aim of this study was to evaluate the efficacy of various routinely used analgesics in the management of pulpal pain preoperatively. Materials and Methods: A total of 150 patients were randomly selected and divided into five groups each. At initial visit, a self-administered questionnaire was given, and patients were asked to mark on the Visual Analog Scale (VAS) indicating severity of pain at that moment which is taken as a pretreatment VAS score. Group I patients received aceclofenac + paracetamol, Group II: ketorolac tromethamine, Group III: lornoxicam + paracetamol, Group IV: tramadol + paracetamol, and Group V: paracetamol. All the patients are requested to record their pain levels at 4 h, 6 h, 8 h, 24 h, and 48 h by means of VAS scores before and after treatment. Results: There was no significant decrease in frequency of pain when compared in the first three groups, whereas in Group III and Group IV, the patients experienced an effective reduction in pain because of sustained releasing ability of these drugs. Overall, there was no statistically significant differences among all the groups. Conclusion: This study suggests that there was no significant difference in reduction of pain preoperatively. However, lornoxicam + paracetamol and tramadol + paracetamol were effective because of their sustained releasing ability. Ketorolac was effective to reduce the pain for shorter duration. Paracetamol can be advised in compromised patients where safety is concerned.
  226 16 -
Perception of dental students on gender preferences in career choice, plans, and expectations in dentistry in the Kingdom of Saudi Arabia
Fawaz Pullishery, Hajer Ayed Alhejoury, Turki Hamza Ahmed, Wysal Abdullah Allugmani, Ghada Sultan Alrowaily, Dareen Dhaifullah Aljohani, Bassam Abdullah Alshehab
June 2021, 13(5):821-825
DOI:10.4103/jpbs.JPBS_803_20  
Introduction: Gender-based preferences are common in dental practice and maybe even more prevalent in academic dentistry. A large number of females have been entering the practice of general dentistry for the past two decades. The present study was done to assess dental students' perception of gender preferences in dentistry using a questionnaire in Saudi Arabia. Materials and Methods: A survey was conducted using a pretested questionnaire among dental interns pursuing their internship at different dental schools in Saudi Arabia. The questionnaires were distributed to 482 interns who were willing to participate in the survey. All the responses were collected, tabulated, and analyzed accordingly using appropriate statistical methods. Results: Four hundred and eighty-two dental interns (180 males and 302 females) responded to the survey. Most female interns (68%) prefer female patients for their treatments to the opposite gender. Seventy-five percent of the male interns felt more capable than females to handle stress and workload associated with branches such as prosthodontics, surgery, and implantology. 52.1% felt that female students fared well in academics. Conclusion: The present study shows that more females are taking up this profession in the current situation. It also shows that females are as competitive as males in dentistry and that most of the dental interns want to take up postgraduation after completion of the course. Both males and females are given equal working space and respect in this field of dentistry.
  230 10 -
Analysis of clinical, radiographic, and treatment profile of 10 cases of neurogenic tumors and tumor-like lesions of the oral and maxillofacial region: An observational study
Mohit Mohindra, Sumit Verma, Manraj Singh Kang, Bhavneesh Goel, Anjali Pawan Kumar, Gunjan Virendra Manchanda
June 2021, 13(5):68-71
DOI:10.4103/jpbs.JPBS_539_20  
Background: Soft tissues of the head and neck areas are a very frequent site of occurrence of certain benign tumors of the peripheral nerve sheath, especially the neurofibromas. Hence, the present study was conducted for assessing clinical, radiographic, and treatment profile of 10 cases of neurogenic tumors and tumor-like lesions of the oral and maxillofacial region. Materials and Methods: Data records of a total of 10 patients who were diagnosed with tumors of neurogenic origin were enrolled in the present study. Data files were analyzed over a time period of 2 years, and complete clinical and radiographic details were evaluated. All the patients in which incomplete information was present in the record files were excluded from the present study. The assessment of the histopathologic reports was done, and final diagnosis was recorded separately in the master chart. Results: Neurofibroma was the diagnosis in two cases. In another set of two cases, final diagnosis of traumatic neuroma was achieved. A single case Schwannoma of mandible depicting multilocular radiolucency was present. Granular cell tumor was present in three cases. It was present clinically in the form of swelling, ulcerative nodule, and nodular growth in the three respective cases. Surgical excision was carried out in all the cases, and follow-up records did not depict any case of recurrence of complication posttreatment. Conclusion: Neurogenic tumors of oral and maxillafacial region are a rare phenomenon and mainly present in the form of benign neoplasm. However, careful recognition and diagnosis of these lesions are necessary to rule any possible malignant changes.
  216 22 -
Skeletal and soft-tissue stability following advancement genioplasty: A comparative analysis between wire and miniplate osteosynthesis
Ramandeep Singh Brar, Ritesh Gupta, Shuchi Gupta, Kuldeep Chaudhary, Preeti Singh, Mandeep Kaur
June 2021, 13(5):72-75
DOI:10.4103/jpbs.JPBS_547_20  
Background: Genioplasty has nowadays become a routine procedure in the correction of dentofacial deformities. The present study aimed to evaluate and compare the osseous and soft-tissue stability after advancement genioplasties, stabilized using wire and plate osteosynthesis. Methodology: The study was conducted on ten patients who underwent advanced genioplasty. The patients were divided equally into two groups. In the Group I patients, plates and in Group II, wires were used for stabilization. Lateral cephalograms preoperative and 6 months postoperative were analyzed using Park et al. method of cephalometric analysis. Results: All the ten patients experienced a reliable improvement in esthetics. Although statistically not significant, Group II wire patients have slightly more relapse in the horizontal direction than Group I. The mean ratio of sagittal changes of osseous soft tissue for Group I was 1:0.88 and for Group II wires was 1:0.80. Conclusion: The choice of method of fixation following genioplasty would entirely be based on the merits of the individual cases. The marginal edge of advantage seen in miniplate osteosynthesis when compared to wire osteosynthesis is seen in cases that require larger chin advancements.
  222 14 -
Comparative evaluation of marginal bone loss and implant failure rate in smokers and nonsmokers
Abhishek Kumar, Saba Nasreen, Subhash Bandgar, Devleena Bhowmick, Ritesh Vatsa, Priyanka Priyadarshni
June 2021, 13(5):203-206
DOI:10.4103/jpbs.JPBS_676_20  
Background: Smoking impose various ill-effects on the alveolar bone concerning dental implants including reduced bone height, delayed healing of bone, poor peri-implant bone formation, increased bone loss, and peri-implantitis. Aims: The present clinical trial was aimed to analyze the smoking effect on dental implant survival rate as well as marginal bone loss in dental implants. Materials and Methods: Out of 86 patients, Group I had 43 patients who were smokers and Group II had nonsmokers. Following the implant placement, marginal bone loss radiographically and mobility were assessed clinically at 3, 6, and 12 months after implant loading. Results: The mean marginal loss seen in smokers at 3 months was 2.13 ± 0.21, 2.46 ± 0.09, 2.60 ± 0.0.92, and 2.74 ± 0.11 for maxillary anterior, maxillary posterior, mandibular anterior, and mandibular posterior regions, respectively. The 12-month recall visit showed a higher proportion of smokers having implant mobility. In smokers, 13.95% (n = 6) of the study participants had implant mobility, whereas 6.97% (n = 3) of the nonsmokers had mobility. Conclusion: Smoking is associated with long-term implant failure which is directly proportional to the duration ad frequency of smoking. Furthermore, smoking has a detrimental effect on dental implants and its surrounding bone.
  224 11 -
Assessment of knowledge about ergonomics and determining musculoskeletal disorders in dentists: An original research
Mukesh Kumar, Gaurav Mishra, Ramasubramoniam Vaibhav, Sunayana Priyadarshini, . Simran, Neeraja Turagam
June 2021, 13(5):391-394
DOI:10.4103/jpbs.JPBS_591_20  
Background: Musculoskeletal disorders (MSDs) are commonly occurring disorders nowadays. The present study was conducted with the aim of determining MSDs in dentists and to assess knowledge about ergonomics. Materials and Methods: This questionnaire study was conducted among 460 dental professionals of different age groups. Parameters such as posture of dentists, working alone or with an assistant, and number of breaks were recorded. Type of MSDs and the type and effectiveness were recorded. Results: BDS students were seventy, interns were 112, general dentists were 186, and specialists were 92. Year of practice was <5 years in 215, 5–10 years in 70, 10–20 years in 35, and >20 years in 140 students. Fourteen percent of students, 18% interns, 45% general practitioners, and 32% of specialists had a prevalence of MSD. Most common MSDs in students were upper back pain seen in 6%, in interns were upper back pain seen in 8%, in general practitioners were shoulder pain seen in 21%, and in specialists were hand/wrist pain seen in 10%. Forty-five percent of students, 67% interns, 72% general dentists, and 80% of specialists had idea about ergonomics. Seventy-four percent of students, 80% of interns, 83% of general dentists, and 87% of specialists think that ergonomics may improve performance. Sitting position was preferred seen in 53% of students, 58% of interns, 65% general dentists, and 60% of specialists. Forty-five percent of students, 47% of interns, 56% of general dentists, and 52% of specialists perform physical activity during work. The difference was found to be statistically significant (P < 0.05). Seventy-nine percent of students, 83% of interns, 86% of general dentists, and 88% of specialists show prolong sitting or standing. Conclusion: Authors found that all prefer to apply ergonomic in clinical practice. There is a lack of knowledge among BDS students and interns about ergonomics.
  222 12 -
Awareness regarding impact of tobacco on oral health: An original study
Sneh Agrawal, Rashmi Jawade, Leena Sharma, Monica Mahajani, Vino Tito V. Kurien, MC Mahitha
June 2021, 13(5):395-397
DOI:10.4103/jpbs.JPBS_616_20  
Introduction: The use of tobacco in all forms is increasing day by day globally causing its ill effects on oral as well as overall health of the people and affecting their sense of well-being and quality of life. Aim and Objectives: The present study was done to investigate among patients the awareness of tobacco use and its ill effects on oral health. Materials and Methods: This descriptive, cross-sectional study was conducted at Dr. RRK Dental College and Hospital, Akola. A total of 297 patients were asked using a self-structured questionnaire. Results: Out of a total of 297 patients participating in the study, 48 (16.2%) were female and 248 (83.8%) were male. About 81.7% of the patients were aware that heart problems can be one of the ill effects of tobacco chewing, while 3.7% were still not sure about it. Conclusions: We found that patients had a knowledge about the impact of tobacco on oral health.
  220 14 -
Knowledge and practice about self-medication for oral health problems among population in Riyadh Region, Saudi Arabia
Inderjit Murugendrappa Gowdar, Meshal Mohammed Alhaqbani, Ahmad Mohammed Almughirah, Saeed Abdullah Basalem, Fahad Ibrahim Alsultan, Mohammed Rashed Alkhathlan
June 2021, 13(5):246-250
DOI:10.4103/jpbs.JPBS_702_20  
Aim: The aim of this study was to know self-medication practices among the population of Riyadh region for oral health issues. Methodology: A questionnaire consisting of demographic self-practice of medication for oral health problems and knowledge about self-medication practices was sent through Google forms and it was in Arabic and English languages. The link of the questionnaire was sent through social and requested to send the link to their friends and relatives. Results: About 50.4% of study participants were having self-practice of medication for oral health problems. Self-practice of medication for oral health issues was statistically significant according to age gender and education (P < 0.05). Toothache (62.4%) is the main problem triggering self-medication and lack of time (44.6%) is the main reason for self-medication. Pain killer (68.8%) was the main medication and antibiotics were used by 2.2% of subjects. Conclusion: Self-medication practice is prevalent in the world and hence, education regarding its consequences and adverse effects for the general public is mandatory.
  222 9 -
Remineralization of artificial dentin lesion In vitro using dental nano-materials
Roshni U Rai, Ravi Ranjan, Mukesh Kumar, Uzma Mukri, Nutan Mala, Kunal Kumar
June 2021, 13(5):229-232
DOI:10.4103/jpbs.JPBS_697_20  
Background: Teeth in the human body are the most mineralized tissue, which contain both organic and inorganic components. Demineralization and remineralization of teeth occur continuously, but demineralization causes structural loss of a tooth. Aim: This study was done to find the effect of ceramic by adding mono-n-Dodecyl phosphate to ceramic in dentin remineralization. Materials and Methods: A total of sixty permanent intact tooth specimens were randomly divided into four equal groups: Group 1: control group, Group 2: dentin was etched and restored with plain ceramic restoration, Group 3: etched dentin restored with ceramic containing 2% mono-n-Dodecyl phosphate, and Group 4: etched dentin restored with ceramic containing 5% mono-n-Dodecyl phosphate. Each sample was immersed completely in simulated body fluid and was kept in an incubator at 37°C to simulate the human body environment. Knoop microhardness measurements were recorded at 10, 20, and 38 days. Results: Knoop microhardness of dentin (KHN) reduced to 32.6% after dentin was etched. No significant difference was found between group 2, 3 and 4 after 10 days. KHN value was increased and showed significant changes restored with group 2 and 3, group 3 showed nonsignificant changes. Conclusion: Through this study, we found that Ceramic can be used as a remineralizing agent to restore marginal dentine around of the cavity and root lesions from secondary caries.
  220 10 -
REVIEW ARTICLES
COVID-19 antibody tests: An overview
Arjun B Ravi, V P Prabath Singh, Roshni Chandran, Krishnan Venugopal, Kaushik Haridas, R Kavitha
June 2021, 13(5):48-51
DOI:10.4103/jpbs.JPBS_786_20  
Novel coronavirus (nCoV) first emerged in Hubei province of China in December 2019. The virus initially known as 2019-nCoV was renamed to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses. The associated disease is known as coronavirus disease 2019 (COVID-19). As the COVID-19 pandemic has unfolded, interest has grown in antibody testing as a way to measure how far the infection has spread and to identify individuals who may be immune. Molecular diagnostic tests like polymerase chain reaction are developed rapidly, however they are not able to fulfill all the requirements of an epidemic reaction. Hence, to complement molecular diagnostic tests, serology tests emerged as a vital aspect of the overall response by confirming the presence of antibodies during the early stage of the infection. Antibody tests help in assessing herd immunity, data about the ongoing phase of infection, identifying potential donors for convalescent plasma therapy, etc. This review currently focuses on giving an overview about the antibody tests in SARS-CoV-2 infections.
  216 14 -
ORIGINAL ARTICLES
New insights for consummate diagnosis and management of oral submucous fibrosis using reactive and reparative fibrotic parameter derived algorithm
Ramya Ramadoss, Rajkumar Krishnan, V Vasanthi, Divya Bose, R Vijayalakshmi, Rajashree Padmanabhan, Balakumar Subramanian
June 2021, 13(5):323-332
DOI:10.4103/jpbs.JPBS_822_20  
Objective: Reproducibility of qualitative changes in histopathological diagnosis involving narrow variation is often challenging. This study aims to characterize the histological fibrotic events in detail so as to derive an in-depth multiparametric algorithm with individually quantified histological parameters for effective monitoring of the. disease process in oral submucous fibrosis and for potential therapeutic targets for early intervention. Methods: Formalin fixed paraffin embedded (FFPE) blocks of oral submucous fibrosis (OSMF), were taken and sections were stained with Hematoxylin & Eosin stain and Masson Trichrome stain. Photomicrographs were assessed for various morphometric parameters with Image J software version 1.8. Linear Regression was used to model the relationship using Inflammatory Cell Count, Extent of Inflammation collagen stained area, Epithelial thickness integrated density of collagen, MVPA, Area, Perimeter, were taken as variables. Result: Inflammatory cell count and the extent of inflammation also decreased with increasing grades of OSMF. Collagen proportionate area, integrated collagen density and epithelial thickness were compared among different grades of OSMF. Grade IV OSMF had greatest mean collagen proportionate area , highest integrated collagen density and lowest epithelial thickness when compared to other grades of OSMF. Linear regression model revealed smaller variation between Grade I to Grade II. Whereas Grade II to Grade IV exhibited larger variation suggestive of increased growth rate and all the coefficients were found to lie within 95% confidence limits Conclusion: Diagnostic algorithm with multiparametric regression model were derived and combinatorial therapeutic approaches have been suggested for more effective management of oral submucous fibrosis
  210 14 -
Assessment of age-related changes of salivary immunoglobulin a levels among healthy individuals
Manishkumar Dinkar Shete, Dipak Baliram Patil, Priyatam Karade, Rutuja Chopade, Neha Gandhi, Uddhav Alane
June 2021, 13(5):461-464
DOI:10.4103/jpbs.JPBS_605_20  
Background: Secretory immunoglobulin A (IgA) is the first line of defense against pathogens that invade mucosal surfaces. It has been reported that the immune system exhibits profound age-related changes. The aim of this study was to investigate the age-dependent changes of salivary IgA among healthy individuals. Materials and Methods: Saliva samples were collected from 120 healthy individuals (aged 11–70 years). The salivary IgA concentrations were measured by the use of a single radial immunodiffusion technique and analyzed using the Mann–Whitney U, Kruskal–Wallis, and Chi-square tests. Results: The mean salivary IgA levels were 81.11 ± 4.50 mg/dl at age 11–20 years, 92.71 ± 13.76 mg/dl at age 21–30 years, 96.50 ± 4.04 mg/dl at age 31–40 years, 104.96 ± 10.15 mg/dl at age 41–50 years, 113.22 ± 7.85 mg/dl at age 51–60 years, and 91.38 ± 4.77 mg/dl at age 61–70 years. There was a significant difference among the mean salivary IgA levels of different age groups (P < 0.001). Conclusion: These results showed that the salivary IgA levels exhibit age-related changes. Oral immunization may be considered to improve oral immunity when the salivary concentrations of IgA begin to decrease during lifetime.
  210 12 -
A comparative assessment of three different irrigating systems in root canal treatment: An In vitro study
Prabhat Mandhotra, Kulwant Rai, Gurkirat Singh Grewal, Kanwarpreet Singh, Vineet Galhotra, Neel Gagan
June 2021, 13(5):429-431
DOI:10.4103/jpbs.JPBS_587_20  
Background: Exact diagnosis, efficient cleaning, shaping as well as disinfection of the root canals lead to successful root canal treatment. The present study compared three different irrigating systems in root canal treatment. Methodology: Sixty recently extracted permanent mandibular molars were classified into four groups: Group I, II, III, and IV with 15 teeth each. Group I comprised Endo-Irrigator Plus system. Group II comprised EndoActivator, Group III utilized passive ultrasonic irrigation (PUI), and Group IV was control, in which no activation of the irrigant was done. Stereomicroscope (X20) magnification was used for checking isthmus cleanliness. The scoring criteria were divided into score 1–5 depending on the amount of debris in root canal walls. Results: The mean ± standard deviation debris removal score in Group I was 2.6 ± 0.80, in Group II was 3.8 ± 0.72, in Group III was 3.9 ± 1.06, and in Group IV was 4.2 ± 0.82. The difference was significant (P < 0.05). Conclusion: Authors found that Endo-Irrigator Plus exhibited better cleaning efficacy followed by EndoActivator and PUI.
  208 14 -
Clinico-microbiological efficacy of indocyanine green as a novel photosensitizer for photodynamic therapy among patients with chronic periodontitis: A split-mouth randomized controlled clinical trial
Shaswata Karmakar, Shobha Prakash, Mahesh Jagadeson, Arunkumar Namachivayam, Dipanjan Das, Sabourni Sarkar
June 2021, 13(5):143-148
DOI:10.4103/jpbs.JPBS_613_20  
Objective: Conventional nonsurgical periodontal therapy, i.e., scaling and root planing (SRP), is not sufficient to completely eradicate the microorganisms present in dental plaque biofilm due to the incapability of instruments to reach the inaccessible areas of a tooth with anatomical variations. Hence, to increase the effectiveness of SRP, many adjunctive treatment strategies are proposed, including photodynamic therapy (PDT). Therefore, the purpose of this study was to determine the clinical and microbiological efficacy of PDT using Indocyanine green (ICG) as a novel photosensitizer for the treatment of chronic periodontitis. Materials and Methods: Twenty individuals who fulfilled the eligibility criteria were enrolled for this randomized controlled clinical trial using split-mouth design. Treatment sites from each individual were randomly allocated into two groups: SRP was done for the sites of the control group and an additional session of PDT using ICG was performed for the sites of the test group. Subgingival plaque samples were collected from both the sites and sent for quantitative analysis of Treponema denticola, Porphyromonas gingivalis, and Tannerella forsythia using real-time polymerase chain reaction (RT-PCR) technique. Probing pocket depth (PD), clinical attachment loss (CAL), and count of all the three microorganisms were assessed at baseline and after 3 months. Results: After 3 months, PD and CAL showed statistically significant improvement in the test sites (P < 0.001) compared to the control sites. However, the differences in the microbiological parameters were statistically nonsignificant between the groups. Conclusion: ICG as a photosensitizer may enhance the outcomes of SRP and can be used for PDT for the nonsurgical management of periodontal diseases.
  208 13 -
Influence of dental prostheses on cognitive functioning in elderly population: A systematic review
Syed Ershad Ahmed, Jayashree Mohan, Parithimar Kalaignan, Saravanan Kandasamy, Ramesh Raju, Bharath Champakesan
June 2021, 13(5):788-794
DOI:10.4103/jpbs.JPBS_773_20  
Aim: The aim of the systematic review was to assess the influence of dental prostheses on cognitive functioning in elderly population. Materials and Methods: This systematic review was conducted according to the PRISMA guidelines. The initial electronic search was conducted using the following search databases: MEDLINE (PubMed), Cochrane Library, Google Scholar, and EMBASE. The search was limited to English language using the search items/keywords: “dental prostheses and cognitive functioning,” “dental prostheses and brain function,” “Tooth loss and cognitive loss,” “mastication and prefrontal activity,” and “prostheses on mental state.” The search strategy was followed using the PICOS framework. Results: A total of 19 studies were selected according to the selection criteria. Out of 19 studies, 15 studies were included and 4 studies were excluded from the review. Conclusion: With the available evidence in the literature, it can be concluded that dental prostheses have a very significant role in preventing the cognitive impairment and act as a protective factor in enhancing the cognitive function in patients with dementia-related diseases and neurodegenerative diseases.
  206 14 -
Evaluation of oral hygiene status among 12–14-year-old school children
Deepesh Jaiswal, Preeti Kalia, Shilpa Hiremath, Abhay Kumar Singh, Pooja Pani, Nishant Kumar
June 2021, 13(5):112-115
DOI:10.4103/jpbs.JPBS_590_20  
Background: Oral diseases such as dental caries, gingivitis, and periodontitis are common among population. The present study was conducted to assess dental caries status and oral hygiene practice among school children. Materials and Methods: This school-based study was conducted on 520 children of age group of 12–14 years of both genders. Location, education, and employment status of parents, use of toothbrush, frequency of brushing, dental floss, total number of meals in a day, number of snacks between meals and sugar consumption, and decayed, missing, filled teeth were recorded. Results: There were 266 males and 254 females. Age group 12 years had 80 males and 90 females, 13 years had 70 males and 60 females, and 14 years had 116 males and 104 females. Ninety-six males and 110 females were from urban and 170 males and 144 females were from rural. The mean plaque score in 12-year male children was 0.61 ± 0.32, in 13-year children was 0.68 ± 0.45, and in 14 years was 0.74 ± 0.48. In males, the mean plaque score was 0.70 ± 0.38 and in females was 0.66 ± 0.42. In children from urban area, the mean plaque score was 0.62 ± 0.34 and from rural area was 0.74 ± 0.40. Four hundred and eighteen children were using toothpaste and they had plaque score of 0.76 and 102 children were using floss and they had plaque score of 0.89. Three hundred and twenty children were brushing once, 90 twice, and 110 irregular and there mean plaque score was 0.70, 0.61, and 0.76, respectively. The difference was significant (P < 0.05). Conclusion: Authors found that oral health status of children consuming high sugar, more snacks per day, and brushing occasionally was poor.
  202 16 -
Effectiveness of a structured instructional module regarding the prevention of oral cancer among adolescents in urban colleges
Vimal Vibhakar, Ankur Jethlia, Nidhi Thakur, Milind Wasnik, Ram Prasad Sah, Subhash Bandgar
June 2021, 13(5):167-170
DOI:10.4103/jpbs.JPBS_633_20  
Background: Oral cancer is a preventable disease that can be controlled by tobacco cessation and health education. For development of a healthy nation, a healthy society is desirable that is dependent on physically and mentally strong adolescents and adults. Objectives: The present study was conducted to assess the effectiveness and utilization of a structured instructional module on knowledge, attitude, and practice regarding the prevention of oral cancer among adolescents. Materials and Methods: The study was conducted on 500 preuniversity urban college students, divided into two groups: experimental and control groups (n = 250 each). A structured instructional module was developed and knowledge, attitude, and practice of students were analyzed. Pre and post values for all parameters were taken and subjected to statistical analysis using SPSS software version 20.0. Results: The data were collected and compared for sociodemographic variables and knowledge, attitude, and practice of students for prevention of oral cancers. A statistically significant correlation was observed between all the parameters for both the groups. In the experimental group, a significant correlation (P ≤ 0.05) was observed between pre- and posttest values for knowledge, attitude, and practices for prevention of oral cancers. Conclusion: It has been observed that there are several implications of the structured instructional module in the field of education, practice, administration, and research.
  198 19 -
A comparative evaluation of lateral condylar guidance by clinical and radiographic methods – Hanau's formula revisited
Kanagesan Praveena, Ranganathan Ajay, Veeramalai Devaki, Kandasamy Balu, Selvakumar Preethisuganya, Venkatachalam Menaga
June 2021, 13(5):537-541
DOI:10.4103/jpbs.JPBS_640_20  
Background: Various clinical methods for recording the condylar guidance (CG) are the intraoral check bite method, graphic tracings, and functional recordings. Accuracy of graphic tracings is affected by patient-related factors such as neuromuscular control of the individual, stability of record bases as well as stability of recording media. The current recommended average settings using Hanau's formula questionable, and thus reassessment is needed. Purpose: The purpose of this study is to use radiographic technique to determine the lateral CG and compare these values with those obtained using Hanau's formula and to evaluate whether there are differences between the right and left paths of the condyles. Materials and Methods: Twenty completely edentulous patients were selected. Articulator was modified with sectioned protractor for obtaining per degree interval calibration. With the protrusive records, the horizontal CG (H) was adjusted and the Bennett's angle (LCG-C) was calculated using the formula. With the tracing device in the mouth, sub-mento vertex projection radiographs were obtained. Each radiograph was traced and superimposed for Bennett angle determination (LCG-M). Results: The median (interquartile range [IQR]) of right and left LCG-C were 15.45 (0.8) and 15.50 (0.7), respectively. The median (IQR) of right and left LCG-M were 37.00 (6.0) and 36.50 (6.8), respectively. A statistically significant difference exists between LCG-C and LCG-M. Both LCG-C and-M values exhibited no variations on both sides. Conclusions: Radiographic technique yielded an amplified LCG when compared to the value obtained by Hanau's formula.
  208 9 -
REVIEW ARTICLES
Lasers in maxillofacial surgery – Review of literature
Khadar Vali Shaik, Mohammed Ibrahim Nazal Alanazi, Rakan Menwer Albilasi, Bader Falah Arqoub Albalawi, Faris Alturqi Alruwaili
June 2021, 13(5):19-22
DOI:10.4103/jpbs.JPBS_710_20  
The availability of different wavelengths of lasers has created a surgical panacea in the last decade and laser technology has become the standard of care for many oral and maxillofacial surgical procedures. In this article, based on literature search, we have reviewed the usage of laser in maxillofacial surgery based on the current evidence available on laser-assisted maxillofacial surgery, in PubMed database.
  192 25 -
ORIGINAL ARTICLES
Molar incisor hypomineralization: clinical characteristics with special emphasis on etiological criteria
Nancy Goel, Shruti Jha, Subhasmita Bhol, Bhagabati Prasad Dash, Heena Sarangal, Ritu Namdev
June 2021, 13(5):651-655
DOI:10.4103/jpbs.JPBS_801_20  
Molar incisor hypomineralization (MIH) is an entity to describe the enamel defects of the first permanent molars with the involvement of one or more incisors due to an underlying systemic cause. It is a frequently encountered challenge by dentists in a dental clinic and dental complications affecting patient's quality of life. Early diagnosis is the key to protect and prevent the deterioration of the condition. This article aims to highlight different aspects of etiology to treatment options in young patients related to MIH.
  204 11 -
Comparison of the efficacy of K-File, canal brush technique, and sonic irrigation technique in the retrievability of calcium hydroxide and metapex intracanal medicaments from root canals: An In vitro cone-beam computed tomography analysis
Arunima Chandran, Faisal M A Gaffoor, Rethi Gopakumar, Sabari Girish, S Soumya, Maya R Nair
June 2021, 13(5):496-500
DOI:10.4103/jpbs.JPBS_664_20  
Background and Objectives: At present, none of the routinely used irrigating agents and activation techniques were able to completely remove the Ca(OH)2 intracanal medicament placed inside the root canal system during endodontic therapy. With this as the background, the aim of this study was to achieve complete removal of Ca(OH)2 when mixed with two different vehicles, using various irrigant activation techniques such as K-file, canal brush technique, and sonic irrigation technique, from the root canals of extracted human teeth. Materials and Methods: Seventy-two mandibular premolar teeth with straight single root canal were selected and filled either with oil-based Metapex or calcium hydroxide powder mixed with distilled water and were activated using different activation techniques such as K-file, canal brush, and sonic MM1500 and NaOCl alone. Volumetric analysis was performed utilizing cone-beam computed tomography. Results: None of the irrigants used were able to completely remove Ca(OH)2 from root canal. Sonic MM1500 showed significant removal efficacy than K-file, canal brush technique, and NaOCl for both aqueous-based and oil-based calcium hydroxide. Conclusion: Sonic MM1500 performed better than K-file, canal brush technique, and NaOCl in removing both Metapex and Ca(OH)2 powder. Regardless of the vehicles and agitation technique used, the remnants of Ca(OH)2 were present on all thirds of the canal walls.
  204 11 -
Role of selective serotonin reuptake inhibitors in prognosis dental implants: A retrospective study
Praveen Chandra, Sonali Roy, Archana Kumari, Ritika Agarwal, Aartika Singh, Suprabha Sharan
June 2021, 13(5):92-96
DOI:10.4103/jpbs.JPBS_569_20  
Background: Many recent research shows that antidepressants interfere with the osseointegration of implants. The main purpose of this study was to determine the association between selective serotonin reuptake inhibitors (SSRI) and dental implant failure. Materials and Methodology: A retrospective study consisted of 410 patients (720 dental implants). Patients' records were used to retrieve the history of SSRI use and medication. The study consists of two groups. Group I (SSRI users) consisted of 128 patients (245 dental implants) patients, whereas Group II (non-SSRI users) was formed by 282 patients (475 dental implants). The implant failure rate was evaluated and statistically examined using the Chi-square test. Results: Group I had 30 implant failures with 13 (12%) males and 14 (11.8%) females, whereas Group II had 28 implant failures with 12 (6.3%) males and 16 (5.6%) females. In Group I, 26% of the implants failed in the age group >50 years, whereas it was 10.4% in Group II. However, in the age group <50 years, it was 6% and 4.2% Groups I and II, respectively. Group I shows that out of 40 implants in diabetic patients, 12 had failure, whereas in Group II, out of 32 implants placed in diabetics, 7 had failure. In smokers, 48% of the implants failed in Group I, and 29% in group II. In non-smokers the failure was seen in 7.7% cases in Group I and 2.1% cases in Group II. The difference was statistically significant (P < 0.05). Conclusion: The usage of SSRIs is associated with an increased rate of implant failure. It has a deleterious effect on bone remodeling and leads to excessive osteoporosis.
  202 13 -
CASE REPORTS
Management of shrunken cheeks by hollow buccal cheek plumper prosthesis
Parthasarathy Natarajan, Seenivasan Madhan Kumar, Shanmuganathan Natarajan, Fathima Banu Raza
June 2021, 13(5):875-877
DOI:10.4103/jpbs.JPBS_688_20  
Aging and a long period of edentulousness causes resorption of the maxillary residual ridge, resulting in narrowing of the arch and loss of facial muscle support that leads to the sunken appearance of cheeks. In completely edentulous patients, though the conventional complete denture does offer provision to the muscles encircling the mouth, yet the cheek plumber prosthesis is required to improve the muscle tone. This case report highlights the advantages and the sequential steps required in the indigenous method of fabricating a hollow cheek plumper appliance for a completely edentulous patient with a sunken appearance.
  196 17 -
ORIGINAL ARTICLES
The effects of double antibiotic paste and amoxicillin-clavulanate paste used in endodontic regeneration on microhardness of radicular dentine: An In vitro study
Meenu Madhukumar, Praveena Geetha, K Radhakrishnan Nair, Manu Unnikrishnan
June 2021, 13(5):510-515
DOI:10.4103/jpbs.JPBS_531_20  
Objective: Double antibiotic paste is a root canal medicament used in regenerative endodontics and its long-term exposure to dental hard tissues was shown to reduce its mechanical properties. The amoxicillin-clavulanate paste is a medicament effective against endodontic pathogens and is effective in endodontic regeneration. Its effect on radicular dentine is yet to be investigated. The purpose of this study is to investigate and compare the effects of double antibiotic paste and amoxicillin-clavulanate paste on the microhardness of radicular dentine. Materials and Methods: The root canal of 45 premolars was mechanically prepared and divided into three groups for the placement of intracanal medicament: Group 1 (n = 15) double antibiotic paste, Group 2 (n = 15) amoxicillin-clavulanate paste, and Group 3 control group (n = 15). All the specimens were subject to microhardness testing at 500 and 1000 microns depth for 1 week, 1 month, and 3 months and analyzed. Results: There is no significant reduction in microhardness of radicular dentin at 1 week on all the three groups. At 1 month and 3 month period, the amoxicillin-clavulanate paste is found to have no significant effect on dentin microhardness when compared to double antibiotic paste. Conclusion: The use of amoxicillin-clavulanate paste as an intracanal medicament does not cause significant weakening of dentin even after its long-term use.
  202 11 -
Efficiency of different endodontic irrigation and activation systems, self-adjusting file instrumentation/irrigation system, and XP-endo finisher in removal of the intracanal smear layer: An Ex vivo scanning electron microscope study
Priyatam Karade, Deepak Sharma, Upendra A Hoshing, Ashish H Medha, Anil R Bhagat, Rutuja V Chopade
June 2021, 13(5):402-407
DOI:10.4103/jpbs.JPBS_775_20  
Aim: This ex vivo study was designed to evaluate and compare different endodontic irrigation and activation systems, the self-adjusting file (SAF) instrumentation/irrigation system, and XP-endo finisher for removal of intracanal smear layer. Materials and Methods: Fifty recently extracted, noncarious human intact single-rooted premolars were selected and divided into five groups (n = 10) according to the root canal irrigation systems; syringe and needle irrigation, passive ultrasonic irrigation (PUI), EndoVac irrigation system, SAF system, and XP-endo finisher. All groups were prepared to apical size F4 file except for the SAF group which was prepared to apical size 20 K-file and then instrumented with the SAF file. Each sample was subjected to final irrigation using different irrigation/activation systems. After splitting the samples, one half of each root was selected for examination under scanning electron microscope. The irrigation systems were compared using the Fisher's exact test with significance set at P < 0.05. Results: In the coronal part, there was no difference among the groups. In the mid-root section, the results of the PUI, EndoVac, SAF, and XP-endo finisher groups tended to be better than syringe and needle irrigation, but the difference was not significant. The apical part of the canal, the SAF system, and XP-endo finisher group seemed to be cleaner than those of the EndoVac group, but this difference was not significant. Conclusions: Within the limitations of the present study, SAF system and XP-endo finisher group cleaned the apical part of the canal more efficiently than EndoVac, PUI, and syringe and needle irrigation.
  200 12 -
Influence of titania nanotubes diameter on its antibacterial efficacy against periodontal pathogens: An In vitro analysis
S Raja Rajeswari, Vidyashree Nandini, Agilan Perumal, Rajendran , Triveni Gowda
June 2021, 13(5):284-288
DOI:10.4103/jpbs.JPBS_743_20  
Background: Peri implant infection in dental implantology is a frequently encountered clinical problem. Titania nanotubes (TNTs) are recent improvement in surface characterization, showing promising results. Aim: The nanosurface parameter tweaking has been implicated with profound change in the microbiological and biological response. Hence, it was proposed that alteration in the nanotube diameter could have positive influence in its antibacterial activity against salient periodontal pathogens. Materials and Methods: Commercially, pure titanium discs of 8-mm diameter and 1.5-mm thickness were prepared. Polished titanium discs were used as control (Group A). Vertically oriented, structured TNTs were fabricated by anodization technique and grouped as B and C, having nanotube diameter, 40 and 80 nm subsequently. The surface characterizations of the samples were done by scanning electron microscope analysis. The antibacterial activity was evaluated with the bacterial colony counting method, at 24 h, 72 h, and 1-week intervals. Statistical Analysis: The one-way analysis of variance and Tukey's honest significance post hoc test were employed to assess the statistical significance. Results: The 80 nm nanotubes showed better antibacterial activity comparatively, at all three-time intervals investigated. Conclusion: The optimal TNT diameter of 80 nm was the most effective from an antimicrobial stand point of view.
  196 15 -
Disinfection of impression materials with glutaraldehyde, ultraviolet radiation, and autoclave: A comparative study
Monica Kotwal, Vishal Partap Singh, Humaira Mushtaq, Rimsha Ahmed, Gaurav Rai, Amit Kumar
June 2021, 13(5):289-292
DOI:10.4103/jpbs.JPBS_755_20  
Background: The present study was conducted to compare various methods of disinfection of impression materials such as glutaraldehyde, ultraviolet (UV) radiation, and autoclave. Materials and Methods: The present study was conducted on eighty alginate impression materials which were disinfectant with 2.2% glutaraldehyde, UV radiation, and autoclave. The pre- and postbacterial count was assessed. Results: The mean premicrobial contamination in Group I was 362.2 106 colony-forming unit (CFU)/ml, in Group II was 306.4 106 CFU/ml, and in Group III was 336.2 106 CFU/ml. The mean postmicrobial contamination in Group I was 65.2 106 CFU/ml, in Group II was 76.7 106 CFU/ml, and in Group III was 28.4 106 CFU/ml. Conclusion: The authors found that autoclave proved to be better in terms of reduction in bacterial colonies as compared to glutaraldehyde and UV radiation.
  194 16 -
Antimicrobial efficacy of different pulp-capping materials against Enterococcus faecalis: An In vitro study
Jenny Atom, Ningthoukhongjam Rati Devi, Ronel Lairenlakpam, Mohammed Hussain Dafer Al Wadei, Abdulrahim R Hakami, Abdulkarim S BinShaya
June 2021, 13(5):608-611
DOI:10.4103/jpbs.JPBS_586_20  
Aim: The present study aims to assess the antimicrobial action of three different pulp-capping agents against Enterococcus faecalis. Materials and Methods: Three pulp-capping agents were chosen for this study: Calcicur, mineral trioxide aggregate (MTA)-Angelus, and Dycal. The zone of inhibition produced by these three pulp-capping agents was measured at 24 h and 72 h to assess their antimicrobial efficacy against E. faecalis. The agar diffusion method was used to examine the antimicrobial effect of pulp-capping agents. Mueller-Hinton agar plates were used to inoculate the microorganisms. Analysis of variance (ANOVA) and Tukey's post hoc tests were done to compare the different groups. P < 0.05 was considered as statistically significant. Results: At 24 h, the highest zone of inhibition was found in MTA-Angelus (3.32 ± 0.11 mm), followed by Dycal (2.02 ± 0.46 mm) and Calcicur (1.84 ± 0.92 mm). After 72 h, MTA-Angelus demonstrated a zone of inhibition of 4.60 ± 0.22 mm, followed by Dycal (3.48 ± 0.74 mm) and Calcicur (2.90 ± 0.18 mm). ANOVA test showed a highly statistical significance. A statistically significant difference (P < 0.001) was shown between MTA-Angelus and Dycal. Calcicur did not show any significant difference. Conclusion: This trial found that the freshly mixed MTA-Angelus has a significantly superior antimicrobial effect against E. faecalis than Dycal and Calcicur.
  200 10 -
Preservation of alveolar ridge using graft material after tooth extraction: A clinical trial
Kunal Kumar, Revati Singh, Vishal Mugal, Nikhil Dhingra, Priyanka Priyadarshni, Subhash Bandgar
June 2021, 13(5):456-460
DOI:10.4103/jpbs.JPBS_603_20  
Background: The alveolar process is a tooth-dependent structure, and hence, removal of teeth results in the alteration of alveolar process. To alter bone remodeling after dental extraction, various techniques have been put forward for ridge preservation. Aim: The aim of this study is to evaluate and compare the changes of hard and soft tissues in postextraction socket after the application of bone graft material. Materials and Methods: Healthy patients of sample size of 40 were selected who underwent the extraction of anterior tooth irrespective of the arch, from premolar of one side to another, with the exception of incisors in mandible. Twenty patients were randomly selected as the control group and other 20 as the experimental group using an allograft bone material, i.e., beta-tricalcium phosphate to fill the socket. Cone-beam computed tomography (CBCT) was done as baseline preoperative and postoperative at 14 weeks after the extraction. CBCTs data help in recording linear and volumetric measurements which was performed by calibrated examiners to record all the measurements. After measurements, digital planning of dental implants was performed. Results: Forty participants were selected, in which 20 patients each were as the experimental and control groups. No significant difference was found at basal line at any of the cases. At follow-up of 14 weeks, statistical significance was seen in buccal and lingual plate height in the experimental group, and no significant difference was seen in the control group.(P = 0.023). Conclusions: This study clearly points out that an alveolar ridge preservation technique provides therapeutic benefit by limiting bone resorption in comparison to extraction alone.
  198 11 -
Antibacterial effect of silver nanoparticle gel as an intracanal medicament in combination with other medicaments against Enterococcus faecalis: An In vitro study
Pranav Nayyar, Achla Sethi, Divyangana Thakur, Sanjana Khullar, Sunya Gayati, Kumar Adarsh
June 2021, 13(5):408-411
DOI:10.4103/jpbs.JPBS_600_20  
Background: Bacteria and their by-products are responsible for various pulpal and periapical infections which can be classified as biofilm-mediated infections. Recently, nanoparticles have been introduced to decrease the bacterial load in endodontic infections. Aim and Objectives: The aim of the study was to compare and evaluate the antibacterial effect of silver nanoparticles alone and combination of silver nanoparticles with calcium hydroxide and chlorhexidine against Enterococcus faecalis. Materials and Methods: A pure culture of E. faecalis was used as the test microorganism. After 24 h of incubation the bacterial colonies were isolated and suspended in 5 ml of infusion broth followed by incubation at 37°C for 4 h. 0.5 McFarland of the bacterial suspension was prepared and then cultured on Mueller–Hinton agar culture medium with the help of a sterile swab. In each culture plate, five wells were created with a sterile pipette for placement of the samples. Results: Statistically significant difference in the antibacterial effect of the combination of silver nanocure gel with various medicaments was observed when compared to the effect of silver nanocure gel alone. Silver nanocure gel in combination with calcium hydroxide (Group B) was more efficacious as compared to silver nanocure gel alone (Group A) (P < 0.001). Antibacterial activity of silver nanocure gel in combination with chlorhexidine (Group C) was also significantly higher than silver nanocure gel alone (P < 0.001). Conclusion: The present study is an in vitro study, in which we concluded that the combination of all the intracanal medicaments is the best among for elimination of E. faecalis biofilm from the root canal. The above findings need to be tested in vivo also.
  194 14 -
The knowledge and awareness of medical emergencies and management among dental students
Khadijah Mohideen, Balakrishnan Thayumanavan, C Krithika, Rafique Nazia, Balasubramaniam Murali, C Pravda, Maimoon Arshadha
June 2021, 13(5):741-747
DOI:10.4103/jpbs.JPBS_559_20  
Background: Every dentist should anticipate being confronted with a medical emergency (ME), and one should always be ready to treat the most catastrophic ones. Aim: This study aimed to assess the knowledge of dental clinical students of Tamil Nadu in the ME understanding and management to create awareness toward patient care. Methodology: A total of 768 dental students, including final-year students and residents from different colleges, took part in the questionnaire-based cross-sectional study. The selection of study participants was by the convenience sampling method. The questionnaire contained thirty closed multiple-choice questions to assess their knowledge of MEs. Microsoft Office Excel software was used for compiling the answers. The descriptive analysis of the data is exhibited in graphs. Results: The majority of participants were mindful of the vital signs; only 55% of the participants know the importance of checking their respiration rate. The knowledge of identifying MEs such as anaphylaxis was 91%, and only 27%–37% of the respondents knew to identify angina, transient ischemia, and lidocaine toxicity. Approximately 15%–40% of the respondents only knew the management of angina, cardiac arrest, hyperventilation, respiratory obstruction, and seizure. Only 10% agreed that the best office emergency kit should be prepared by themselves. Roughly 78% of the respondents were conscious of the patient's referral whenever necessary and aware of state dental acts. Conclusion: This study reflects a significant need for training in executing ME among dental students who are to transmute into future dental professionals.
  198 10 -
Assessment of habits of tobacco use among dental and nondental students of Indian Population: A cross-sectional study
Iqbal Singh, Jogjatin Khurana, Lalit Patil, Manish Shivaji Jadhav, Roshani Chawla, Punam S Patil
June 2021, 13(5):417-420
DOI:10.4103/jpbs.JPBS_611_20  
Background: Tobacco usage can be equated to an unending progressive pandemic which continues to spread globally at an alarming unhindered pace. Dental surgeons have a key role in initiating reduction and even cessation of tobacco habits. Hence, the present study was undertaken for analyzing the habits of tobacco use among dental and nondental students of Indian population. Materials and Methods: A total of 500 dental students and 500 nondental students were enrolled in the present study. Among dental students, only interns were enrolled across different dental colleges of India. A questionnaire was framed and was sent to all the students in the form of Google Forms. The questionnaire contained questions pertaining to the assessment of prevalence of tobacco use and type of tobacco use habit. All the results were recorded and analyzed. Results: Five hundred dental students and 500 nondental students were enrolled. Among the dental group, tobacco use habits were present in 23.8% of the students, whereas in the nondental group, tobacco use habits were present in 43.6% of the students. While comparing the prevalence of tobacco use habits among the dental and nondental groups, significant results were obtained. In the dental group, smoking habit and chewing habit were present in 44.54% and 32.77% of the students, respectively. In the nondental group, smoking habit and chewing habit were present in 52.29% and 29.82% of the students, respectively. While comparing the pattern of tobacco use among students of the two study groups, nonsignificant results were obtained. Conclusion: There is an urgent need of tobacco cessation programs in the community to decrease the morbidity and mortality associated with it.
  194 11 -
Assessment of periodontal status and treatment needs among beedi factory workers
Anupama Singh, Raman Kant Sinha, Shree Richa, Rajiva Kumar, Amit Kishor, Abhishek Kumar
June 2021, 13(5):237-240
DOI:10.4103/jpbs.JPBS_699_20  
Introduction: Periodontal disease is considered to be one of the most common oral conditions in human population sharing an equal prevalence rate in both developed and developing countries. It is observed that in India, more than 800 million beedis are sold every year; hence, beedi making is a big industry involving approximately 4.4 million workers, and 76% of these workers are women. Objectives: The objectives of this study were to assess the frequency of gingival and periodontal disease and to evaluate the treatment needs in labors working in a beedi factory. Materials and Methods: A cross-sectional study was conducted on 1000 daily wage labors working in a beedi factory resided at Patna, Bihar. Subjects aged between 19 and 60 years were randomly selected for the study. The community periodontal index of treatment needs (CPITN) index with CPTIN probe along with the demographic data was recorded in daylight. Results: None of the study subjects was found to fall in category community periodontal index-1 (CPI-1), 67.2% of the study population was found to be in CPI-2, 12.3% were found to be in CPI-3, and 9.7% of the study subjects scored CPI-4. For the treatment needs, majority of the subjects were in TN2 category; however, with advancing age, there was increase in the percentage of population requiring TN3 treatment needs. Conclusion: CPITN index along with the demographic data was recorded in daylight. The high prevalence rate of periodontal disease in these beedi factory workers was found, which increased with advancing age. The treatment need index also showed rise in the requirement of complex procedures with advancing age, suggesting the role of dental education and regular checkups in these population groups.
  190 13 -
Knowledge, perception, and attitude on conservative and endodontic practice on COVID pandemic situation: A qualitative research
Sumit Khatore, Sakshi Kathuria, Manoj Kumar Rawat, Amar Ashok Thakare, Surbhi Abrol, Sai Prashanth Pinnamaneni, Rahul VinayChandra Tiwari
June 2021, 13(5):353-358
DOI:10.4103/jpbs.JPBS_740_20  
Aim: The purpose of our study was to analyze the knowledge and attitude of conservative as well as endodontic practice among dental professionals during coronavirus pandemic situation. Methodology: A cross-sectional study was conducted over a period of 3 months among 1256 dental surgeons, which included 400 MDS and 856 BDS dentists. Questionnaire assessed knowledge of the participants about COVID-19, risk assessment about the pandemic, preparedness of the participants, as well as specific precautions in cases which require conservative and endodontic treatment strategies against COVID-19. Results: It was observed that around 83% of the study participants felt that rubber dams are a useful tool to prevent cross-infections, even COVID-19. However, COVID-19 prevention techniques such as use of low-speed handpiece and chemicomechanical techniques were preferred by a smaller number of participants: 25% of participants by former, only 12% for the latter. To prevent aerosol splatter, use of high-volume suction was preferred by 49% of dental surgeons. Conclusion: In our study, we concluded that dental surgeons, who come under high risk category; had good basic knowledge about COVID-19 disease process as well as transmission. However, it is imperative that these clinicians need to be extra cautious in handling cases during this pandemic time and limit the disease spread as well.
  190 12 -
Immunohistochemical Expression of the Epithelial to Mesenchymal Transition Proteins E-cadherin and β-catenin in Grades of Oral Squamous Cell Carcinoma
Vijay Kumar, Abikshyeet Panda, Kailash Chandra Dash, Lipsa Bhuyan, Niva Mahapatra, Pallavi Mishra
June 2021, 13(5):555-560
DOI:10.4103/jpbs.JPBS_562_20  
Background: E-Cadherin/β-Catenin protein complexes play a major role in epithelial to mesenchymal transition (EMT) and vice versa. Such types of EMT are implicated physiologically during embryonic development and pathologically in tissue fibrosis and tumorigenesis. Aims: The aim was the evaluation of E-Cadherin and β-Catenin immunoreactivity in various grades of oral squamous cell carcinoma (OSCC) and to correlate their pattern of expression. Materials and Methods: Immunohistochemical expression of E-Cadherin/β-Catenin was evaluated in a total n = 30 tissue samples comprising of n = 10 well-differentiated squamous cell carcinoma (WDSCC), n = 10 moderately differentiated squamous cell carcinoma (MDSCC), and n = 10 poorly differentiated squamous cell carcinoma (PDSCC). Based on the intensity of staining, an immunoreactivity scoring was calculated. Statistical Analysis: The scorings obtained were subjected to independent t-test, paired t-test, Chi-square test, and ANOVA test using SPSS version 20.0 statistical analysis software. P < 0.05 was considered statistically significant. Results: A significant difference was observed in the expression of β-Catenin between normal mucosa and WDSCC; normal mucosa and MDSCC. A gradual decrease in the immunoreactivity score of E-Cadherin is seen in WDSCC, MDSCC, and PDSCC. Conclusion: Therefore, dysregulation of these proteins can lead to tumor progression, invasion, and metastasis. Further studies are warranted to specify the role of these EMT proteins as prognostic/therapeutic markers in patients suffering from OSCC.
  192 10 -
Comparative evaluation of anti-inflammatory efficacy of turmeric and chlorhexidine gel as an adjunct to scaling and root planing in the treatment of gingivitis
Swati Singh, Barun Dev Kumar, Santosh Kumar Verma, Priyanka Kumari, Neha Singh
June 2021, 13(5):679-683
DOI:10.4103/jpbs.JPBS_713_20  
Background: Dental plaque is a complex ecosystem which consists of densely packed microbial colonies, microbial by-products, salivary glycoproteins and desquamated epithelial cells. Clinical studies have proved the relationship between plaque and periodontal disease. Aim: This study compares the anti-plaque efficacy and anti-inflammatory potential of turmeric gel with 0.2% chlorhexidine gel along with scaling and root planing (SRP). Materials and Methods: One hundred and fifty individuals were selected and divided into three groups for the study. Group A was instructed to use 0.2% chlorhexidine gel, whereas Group B used turmeric gel along with SRP. Participants were assessed for plaque and gingivitis on the 14th and 21st days. Subjective and objective criteria were assessed. The clinical data were recorded and used for statistical analysis to obtain results. Results: The percentage reduction of plaque index (PI) between the chlorhexidine and turmeric gel on 21st day were 74.85 and 65.91 respectively. similarly, the percentage reduction of gingival index (GI) between the chlorhexidine and turmeric gel on 21st day were 58.49 and 62.46 respectively. Conclusion: Turmeric gel shows a slightly lower anti-plaque property in comparison to chlorhexidine gel. Their effect on a reduction of gingival inflammation was equal. It was also noted that turmeric gel showed better acceptability and biocompatibility by the participants.
  190 12 -
Assessment of salivary cortisol concentrations as a level of stress indicator among individuals undergoing dental extraction procedure
Balakrishnan Thayumanavan, C Krithika, Khadijah Mohideen, AV R. Ranjalitha, CM Sacred Twinkle, C Pravda, Swetha Prabhu
June 2021, 13(5):735-740
DOI:10.4103/jpbs.JPBS_557_20  
Background: Anxious patients tend to exaggerate the aversive events before the actual dental therapy. The anxiety and fear are the major factors that regulate cortisol levels. Aim: Our study aims to estimate the salivary cortisol among patients subjected to dental extraction and correlate any existence between pre- and post-extraction cortisol levels and vital parameters compared to the control group. Methodology: The study sample included sixty individuals, thirty patients indicated for a dental extraction, and thirty healthy patients between the ages of 18 and 60 years. We collected saliva samples from the control group and pre- and post-extraction samples from the study group participants and vital parameters. We used quantitative ELISA Kit, Diagnostics Biochem Canada Inc. (DBC), to estimate the salivary cortisol level. We evaluated the values using the Chi-square test, Pearson correlation test, and paired t-test using the JMP 15; JMP Pro, Version 15 (SAS) Microsoft® Windows® for × 64. Results: The mean value of cortisol concentration of saliva was significantly greater in the preextraction group (6.13 ± 0.53 μg/dl) than after extraction group (3.17 ± 0.14 μg/dl) (P < 0.001). There were no significant associations between hemodynamic parameters and salivary cortisol concentration except for the postextraction systolic blood pressure (BP). A comparison of hemodynamic parameters between the study and control group revealed substantial differences in systolic BP. Conclusion: The patient's anticipation and anxiety toward dental therapy elevate the cortisol level. Dental surgeons should treat the patients more conveniently and effectively without any strains and provide a comfortable atmosphere to avoid stress-related consequences.
  192 9 -
Clinical photography knowledge and skills among dental students in Saudi Arabia: A cross-sectional survey
Rozan Khaled Albugami, Nadin Naji Binmahfod, Manar Abdulkareem Muhsin, Rafal Ahmad Bamane, Abdulrahman Dhaher Almuqrin, Ohoud Abdullah Aldahri, Fawaz Pullishery
June 2021, 13(5):801-806
DOI:10.4103/jpbs.JPBS_770_20  
Background and Aim: Clinical photographs have become an important entity in contemporary dental education in Saudi Arabia. The study assessed the knowledge and skills related to clinical photography among final-year undergraduate dental students in different dental schools in the Western province of Saudi Arabia. Materials and Methods: A face-to-face interview was conducted using a pretested and validated questionnaire after obtaining relevant consent from the college administration and the students. Trained and calibrated data collectors interviewed the dental students between November 2019 and February 2020. Results: The knowledge related to clinical photography was “good” only in 17.2% of the participants, and most of the students demonstrated “poor” knowledge (58.9%). Digital single lens-reflex (DSLR) camera was used by only 43.9% of the students for taking clinical photographs. The practice of taking informed consent from patients for taking and using clinical photographs was reported in 77.6% of the dental students. Conclusion: The knowledge related to dental clinical photography was not satisfactory, and students need to improve the understanding of the proper functioning of digital cameras and also the medicolegal issues related to clinical photography.
  192 9 -
Scanning electron microscopic and dye penetration evaluation of hand instrumentation techniques on formation of smear layer in root canal preparation: An In vitro study
Vineet Galhotra, Ankur Chauhan, Sagar H Mohkar, Amit Heda, Govind Nandkumar Agrawal, Aniket Chavan
June 2021, 13(5):412-416
DOI:10.4103/jpbs.JPBS_578_20  
Aims and Objectives: The present study was undertaken for evaluating various hand instrumentation techniques with different instruments in the formation of smear layer. Materials and Methods: One hundred and seventy-five extracted mandibular molars were collected and were cut at cementoenamel junction. Afterward, the distal roots were separated. Working length was determined, and roots were divided into five equal groups with 35 roots in each group as follows: Group A: K-type files with conventional step-back technique, Group B: Canal Master U instrument with clockwise–counterclockwise rotation, Group C: Flex-R® files with clockwise–counterclockwise rotation, Group D: FlexoFiles® with conventional step-back technique, and Group E: Nickel titanium files with conventional step-back technique. Biomechanical preparation was done according to their respective groups. The teeth in various groups were scanned under scanning electron microscope and scoring was done. All the results were analyzed by SPSS software version 17.0. Results: Scanning electron microscopic results indicated that apparently there seems to be a significant difference in the scoring of the smear layer between each group at all the three levels, but the difference was statistically nonsignificant. Microleakage was present in all the samples. Nonsignificant results were obtained while comparing the microleakage in between different the groups. However, microleakage was highest in Group D. Conclusion: The amount of smear layer is maximum at the apical third and lesser in the middle third followed by the coronal third in all the groups. All the samples showed microleakage to a varying extent.
  184 16 -
A new zinc reinforced glass ionomer cement: A boon in dentistry
Amit Kumar, Anil Raj, Dharmendra Kumar Singh, Shashank Donthagani, Manoj Kumar, Kumar Ramesh
June 2021, 13(5):272-275
DOI:10.4103/jpbs.JPBS_730_20  
Background: Conventional glass ionomer cement (CGIC) has many beneficial properties, but it has poor physical and mechanical properties. Therefore, new glass ionomer cement (GIC) is manufactured by adding zinc to improve the mechanical properties of GIC ChemFil Rock. This material possesses better flexural tensile strength and compressive strength in comparison to conventional to CGIC. Objectives: The aim of this study was to compare four properties of ZRGI like fracture toughness, surface micro-hardness, abrasive wear, and roughness to other GIC material, which are commercially available as: resin-coated glass ionomer (EQUIA FIL). Materials and Methods: The study was done in dual phase. In phase-1, micro-hardness surface roughness, abrasion of four GIC and a composite resin as control was analyzed and in phase-2, fracture toughness of four GIC was done at 24 h interval so that all cement achieve its peak strength. Results: Micro-hardness value of ChemFil Rock was lowest among different GIC groups. All four GIC group exhibit similar abrasion capacities, while composite were more wear-resistant significantly. Roughness change was highest on ChemFil Rock compared to other GIC. EQUIA FIL has the highest fracture toughness, followed by ChemFil Rock. Conclusion: We can conclude that incorporating zinc in the matrix of chemfil rock increases fracture toughness and good abrasive wear, but it does not improve micro-hardness or surface roughness.
  186 14 -
Assessment of titanium level in submucosal plaque around healthy implants and implants with peri-implantitis: A clinical study
Juzer Rasul, Manoj Kumar Thakur, Barkha Maheshwari, Nausheen Aga, Harsh Kumar, Monica Mahajani
June 2021, 13(5):383-386
DOI:10.4103/jpbs.JPBS_815_20  
Background: The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. Methodology: Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. Results: The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 μg and in Group II was 0.91 ± 0.04 μg. A highly significant difference between both groups was found (P < 0.05). Conclusion: There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.
  190 9 -
A study of creatinine level among patients with dyslipidemia and type 2 diabetes mellitus using multilayer perceptron and multiple linear regression
Farah Muna Mohamad Ghazali, Wan Muhamad Amir W Ahmad, Kumar Chandan Srivastava, Deepti Shrivastava, Nor Farid Mohd Noor, Nurul Asyikin Nizam Akbar, Nor Azlida Aleng, Mohammad Khursheed Alam
June 2021, 13(5):795-800
DOI:10.4103/jpbs.JPBS_778_20  
Background and Objective: Dyslipidemia is one of the most important risk factors for coronary heart disease with diabetes mellitus. Diabetic dyslipidemia is correlated with reduced concentrations of high-density lipoprotein cholesterol, elevated concentrations of plasma triglycerides, and increased concentrations of dense small particles of low-density lipoprotein cholesterol. Furthermore, dyslipidemia is one of the factors that accelerate renal failure in patients with nephropathy that is observed to be higher in these patients. This paper aims to propose the variable selection using the multilayer perceptron (MLP) neural network methodology before performing the multiple linear regression (MLR) modeling. Dataset consists of patient with Dyslipidemia, and Type 2 Diabetes Mellitus was selected to illustrate the design-build methodology. According to clinical expert's opinion and based on their assessment, these variables were chosen, which comprises the level of creatinine, urea, total cholesterol, uric acid, sodium, and HbA1c. Materials and Methods: At the first stage, all the selected variables will be a screen for their clinical important point of view, and it was found that creatinine has a significant relationship to the level of urea reading, a total of cholesterol reading, and the level of uric acid reading. By considering the level of significance, α = 0.05, these three variables are being selected and used for the input of the MLP model. Then, the MLR is being applied according to the best variable obtained through MLP process. Results: Through the testing/out-sample mean squared error (MSE), the performance of MLP was assessed. MSE is an indication of the distance from the actual findings from our estimates. The smallest MSE of the MLP shows the best variable selection combination in the model. Conclusion: In this research paper, we also provide the R syntax for MLP better illustration. The key factors associated with creatinine were urea, total cholesterol, and uric acid in patients with dyslipidemia and type 2 diabetes mellitus.
  184 15 -
Evaluation of relationship between quality and performance measures concepts of pediatric oral health: A cross-sectional study
Saba Nasreen, Ravi Ranjan, J Manju, Mutum Sangeeta Devi, Nutan Mala, Vini Mehta
June 2021, 13(5):217-220
DOI:10.4103/jpbs.JPBS_678_20  
Background: The dental quality alliance of the American Dental Association developed quality and performance measure concepts (QMCs) for pediatric dentistry to identify variations in care and to improve quality of care. Objectives: This study evaluated the relationship between the proposed QMCs and oral health, measured as caries status. Methodology: Parents/guardians of new patients presenting to the Nationwide Children's Hospital Dental Clinic for a nonurgent hygiene appointment were asked to complete a 10-question survey that reflected the QMCs. An oral examination was completed on each patient to determine his/her caries status. Results: For the majority of the QMCs evaluated in the study, there was no statistically significant difference in caries status between patients who had attended care according to the QMCs and those who had not. Conclusions: From the findings, attending care as outlined by the QMCs may be no better than counting procedures as a measure of quality oral health-care outcomes.
  180 18 -
CASE REPORTS
Apexification and repair of root fracture with mineral trioxide aggregate – A case report with 5-year follow-up
Sankar Annamalai, VP Hariharavel, Kavitha Ramar, Victor Samuel
June 2021, 13(5):881-885
DOI:10.4103/jpbs.JPBS_789_20  
Young patients are most susceptible to trauma which involves teeth and their supporting structures. Severity can vary from simple enamel fracture to complete tooth avulsion. The treatment modality ranges from a noninvasive procedure to surgical intervention. The present case report describes the unique management, 5-year follow-up, and prognosis of a 10-year-old child diagnosed with lateral luxation and horizontal apical root fracture of maxillary central incisor with open apex.
  183 14 -
ORIGINAL ARTICLES
In vitro assessment of apical microleakage of teeth sealed with three different root canal sealers: A comparative study
Kulwant Rai, Prabhat Mandhotra, Neeraj Sharma, Lalit Patil, Akshey Sharma, Simreet Singh
June 2021, 13(5):375-378
DOI:10.4103/jpbs.JPBS_610_20  
Background: For the success of an endodontic treatment, a hermetic seal is of utmost importance. The event of entry of cariogenic bacteria through the interface between the tooth and the restoration of a proliferation of these microbes and subsequent adverse effects on the pulpal tissue or recurrent caries can be expected. Hence, the present study was undertaken for evaluating the apical microleakage of teeth sealed with four different root canal sealers. Materials and Methods: Collection of a total of ninety freshly extracted mandibular first premolars was done for the present study. Establishment of working length was done by measuring the root canal length and subtracting 1 mm from it. All the specimens were divided into three study groups as follows: Group A: Endofill sealer group, Group B: EndoREZ sealer group, and Group C: AH Plus group. The resin points were supplied with the sealer (according to their respective study groups), and obturation was done. Application of four layers of nail polish was done on the entire tooth surface leaving the apical 2 mm portion. This was followed by immersion of the specimens in the India ink followed by storage for 1 week at room temperature. Afterward, thorough washing of the specimens was done in running water. Removal of the nail polish was done. All the specimens were observed under microscope for assessing the extent of dye penetration. Results: The mean apical dye penetration among specimens of Group A, Group B, and Group C was found to be 0.86 mm, 0.39 mm, and 0.03 mm, respectively. While comparing statistically, significant results were obtained. The mean apical dye penetration was highest for Group A and was lowest for Group C. Conclusion: Minimal microleakage is exhibited by a resin-based sealer. Hence, they provide a better apical seal in patients undergoing root canal therapy.
  184 13 -
Bone graft and intraosseous anchorage of dental implants for reconstruction of the residual alveolar ridge
Yashika Bali, Ravpreet Singh, Tarunpreet Kaur Gill, Rathi Rela, Ritesh Vatsa, Priyanka Priyadarshni
June 2021, 13(5):465-468
DOI:10.4103/jpbs.JPBS_638_20  
Background: Bone grafting aims at better dental implant osseointegration and preserves the remaining alveolar bone in the socket. The success of various bone grafting materials plays a vital role in assessing future implant function. Aims and Objectives: The present clinical trial was aimed at evaluating the results of guided bone regeneration (GBR) with and without the bioresorbable membrane in the dental implant placement. Materials and Methods: The 20 patients were divided into two groups (n = 10). First was Group I- GBR with bioresorbable collagen membrane (BioGide™) and second was Group II- GBR without membrane. Bone gain and bone levels were analyzed for both groups. All the collected data were analyzed statistically. Results: For Group I, bone levels at baseline were nonsignificant (P = 0.2188) Similarly, nonsignificant values were seen in both groups at 3 months with bone level values of 0.25 ± 0.17 and 0.38 ± 0.24 for Group I and Group II, respectively. Changes in the bone levels were found to be 2.45 ± 0.349 and 2.58 ± 0.304 from Group I and II, respectively, inferring the nonsignificant difference with P value of 0.3723. The percentage of bone gain for intergroup at the end of 3 months was 89.15% ±0.678 for Group I and 88.68% ± 0.503%; these values were statistically nonsignificant (P = 0.982). Conclusion: Nonsignificant difference was observed between the two groups with and without membrane in terms of changes in bone level, percentage of bone gain, and bone defect reduction. This study concludes that the use of bone grafts significantly improves residual alveolar ridge irrespective of membrane used.
  186 11 -
Stress distribution in cortical bone around the basal implant – A finite element analysis
Anip Kumar Roy, Nivedita Dixit, Prashant Punde, Koshika Tondon Sinha, Mohammad Jalaluddin, Ashish Kumar
June 2021, 13(5):633-636
DOI:10.4103/jpbs.JPBS_679_20  
Aim: The aim of the study was to develop a model that represents a basal implant with stress distribution in the cortical bone on application of loads emulating masticatory forces. Materials and Methods: In this study, the stress distribution in the bone and the implant is evaluated by applying various loads that emulate the masticatory forces. The geometric models of cortical bone representing the premolar area and a basal implant model of the following specifications, longitudinal oval threaded pin (1.95 mm × 2.1/2.3 mm ø), height of the implant head (7.2 mm), and width of the implant head (3.5 mm) (BOI BS, IDHEDENTAL), were generated with Ansys software, and both the implant model and the bone model are superimposed to mimic the bone implant system as a unit. Results: Overall comparison of stress distribution on both implant shaft and implant neck showed that maximum stresses are located at implant neck irrespective of forces applied and minimum stresses are located at implant shaft. On overall comparison of stresses seen within the bone and the implant, it was observed that the maximum stresses were seen in the implant neck followed by the implant shaft followed by the bone interface. Conclusion: The present study concluded that the stress transmission is greatest during application of oblique load (70 N) followed by horizontal load (10 N) and the least by vertical load (35 N).
  186 11 -
Knowledge and awareness of postextraction complications among dental seniors and interns in Riyadh Province
Adel Alenazi, Abdulbari Aleidan, Mohammed Alotheem, Rakan Alqahtani
June 2021, 13(5):602-607
DOI:10.4103/jpbs.JPBS_721_20  
Background: Postextraction complications are multifactorial. Taking proper medical and dental history, thorough planning, and a skillful dentist can help the prediction and reduction of these complications. Objective: This study aims to assess and compare the knowledge of senior students and interns regarding postextraction complications in government and private colleges in Riyadh Province. Materials and Methods: A random sampling technique was used to select a minimum of 250 participants for this study. A self-designed, close-ended questionnaire was disseminated through an online platform in a manner. Sixth-year (senior) dental students and interns were included in the study. Data were coded and entered into spreadsheet software and analyzed using Chi-square tests. Results: More than half were dental interns (54.04%), and the rest were senior students (45.96%). Male participants comprised 52.57% of the total participants, whereas females were 47.43%. Most participants were from government colleges (53.31%), whereas 46.69% belonged to private colleges. Male interns from government colleges demonstrated the best knowledge among all the participants. In private colleges, females demonstrated better knowledge than males in both the senior and intern groups, and the difference was statistically significant. The difference in knowledge between participants from government and private colleges was found to be statistically significant (P = 0.001). Government colleges were found to demonstrate more complications than private colleges, and the difference was statistically significant (P = 0.003). Conclusion: Male interns from government colleges had the best knowledge about the postextraction complications among the candidates.
  186 10 -
Comparative evaluation of internal margin adaptation and integrity of class I preparations using two composites: An In Vitro study
Subhasmita Bhol, Neha Patwa, Suprabha Sharan, Shemil Mohamed Sha, Muqthadir Siddiqui Mohammed Abdul, Alen Pius, Shalini Singh
June 2021, 13(5):348-352
DOI:10.4103/jpbs.JPBS_739_20  
Aim and Objectives: The aim of this study is to evaluate the internal margin adaptation and integrity of Class 1 preparations using two composites types (bulk fill/conventional) with two placement methods (4/2 mm increments). Materials and Methods: Class 1 preparations of 4 mm × 4 mm dimensions were made on 30 extracted human mandibular molars. They were randomly divided into three groups; among them, in Group 1 (n = 10), cavities were filled with SureFil SDR Bulk Fill, Group 2 (n = 10) cavities were filled with Filtek Bulk Fill of 4 mm increments in both groups, and in Group 3 (n = 10), cavities were filled with conventional composite Filtek Z350 with 2 mm increments. Samples were sectioned occlusogingivally. Then, dye was on internal margins, and images of each specimen were recorded using a digital camera to evaluate the marginal integrity and adaptation of restorative material to the tooth surface with image analysis software. Then, collected data were put under the statistical analysis with analysis of variance test and post hoc Tukey's test. Results: There was no significant difference in overall dye penetration in bulk fill and conventional (incremental fill) composite resins; however, when dye penetration was evaluated at different locations, within enamel and mid-dentin, significantly more gap-free margins were found than at the pulpal interface. Filtek Bulk Fill and conventional composite (Filtek Z350) showed comparatively more dye penetration toward the pulpal interface compared to SDR Bulk Fill. Conclusion: There were no significant differences in percentage of gap-free margins between fill types for any of the composite materials. The proportions of gap-free margin were less at the pulpal interface and mid-dentin portions and enamel when filled with 4 and 2 mm increments.
  178 17 -
Clinico-histological evaluation of dentino-pulpal complex of direct pulp capping agents: A clinical study
Muqthadir Siddiqui Mohammed Abdul, Nikhil Murali, Priyank Rai, Mubashir Baig Mirza, Shazia Salim, M Aparna, Shalini Singh
June 2021, 13(5):194-198
DOI:10.4103/jpbs.JPBS_665_20  
Introduction: Direct pulp capping treatment (DPC) maintains pulp vitality by promoting healing or repair in dentistry, which can be attributed to the advent of bioceramic materials. Aim: This examination looked to evaluate the clinical and histological effectuality of Biodentine with Dycal for DPC. Materials and Methodology: In this study, 30 intact human orthodontic teeth undergoing therapeutic extraction were chosen to perform DPC. They were arbitrarily divided into two groups (n = 15) and DPC with Biodentine and Dycal was performed. Composite resin was used as permanent restoration. After a period of 1 and 6 weeks, clinical as well as electric pulp tests were carried out. Asymptomatic patients were re-called after 6 weeks; follow-up radiograph was taken. Electric pulp testing and thermal testing was done to check the pulpal status of the teeth. This was followed by atraumatic extraction, and the teeth were sent for histological examination. SPSS Version 21.0. Armonk, NY: IBM Corp.was used for data analysis. Results: There was no pain and sensitivity in using Biodentine. Whereas, sensitivity and pain was noted when Dycal was used. The dentinal bridge was better with Biodentine when compared with Dycal. Conclusion: In accordance with the obtained results, it was concluded that on clinical and histological evaluation, Biodentine performed better as DPC agent. Subsequently, Biodentine is more dependable for the long-haul protection of dental pulp than Dycal.
  178 17 -
Influence of implant angulation and implant number on the accuracy of definitive casts
Abhay Kiran Narayane, Suhana Shamsuddeen, Swati Kharat, Tabish Rashidi, Aachut Pandav, Manoj Kumar Thakur
June 2021, 13(5):367-369
DOI:10.4103/jpbs.JPBS_792_20  
Background: The present study determined the effect of implant angulation and implant number on the dimensional precision of implant definitive casts. Materials and Methods: Three definitive casts with implant analogs placed in a triangular pattern were made from dental stone. Group I was control group, Group II in which implant numbers 1 and 3 were at 5° convergence to the implant number 2. Group III in which implant numbers 1 and 3 are at 5° divergence to the implant number 2. Group IV in which implant numbers 1 and 3 are at 10° convergence to the implant number 2. Implant analogs were secured in all the definitive casts with cyanoacrylate. Three open tray impressions of the definitive cast were obtained and poured in Type IV dental stone. Coordinates in the three planes were measured at implant analog top surface and base of the cast using a fine tip measuring stylus. The data were aligned and angular differences between implant analog vectors from definitive and duplicate casts were measured. Results: There was a significant correlation between dental implant number and dental implant angulation (P < 0.05). There was a significant result when comparing the effect of the parallel group from 5° divergence and 10° convergence groups. A significant results while comparing the parallel group with 5° divergence and 10° convergence was obtained whereas while comparing 5° divergence, 5° divergence, and 10° convergence a nonsignificant difference was obtained (P > 0.05). Conclusion: Close proximity of implant angulation toward right-angled direction results in higher precision of implant.
  178 14 -
Inter maxillary fixation versus open reduction for the treatment of mandibular condyle fractures: A comparative evaluation
Saba Nasreen, Anupam Bansal, Rathi Rela, Gaurav Rai, Ram Prasad Sah, Abhinav Raj Gupta
June 2021, 13(5):268-271
DOI:10.4103/jpbs.JPBS_729_20  
Background: The treatment for fractured mandibular condyles aims at restoring the masticatory ability, occlusion, symmetry, and function as the bit were before the trauma. The treatment of the mandibular condylar fracture can be done based on the two protocols. Aims: The present clinical trial was conducted to collate aftertreatment upshot of closed treatment and open surgical treatment for mandibular condyle fractures. Materials and Methods: Forty-two patients were divided into two groups (n = 12) which were treated with either the closed reduction using intermaxillary fixation or open reduction and internal fixation. The following clinical parameters were assessed at 1st and 3rd day and at 1, 3, and 6 weeks: lateral excursion and protrusion, occlusion; interincisal opening, mandibular ramus height, deviation/deflection during jaw opening, and pain assessment using visual analog score. The collected data were subjected to statistical evaluation. Results: Interincisal opening was found to be 8.125 ± 0.3467 mm and 6.016 ± 0.1528 mm, respectively, for Group I and Group II which was statistically significant (P < 0.00001). At the 3 months and 6th week postoperatively, it was increased in the surgical groups to 17.433 ± 0.3822 mm and 19.175 ± 0.3696 mm, respectively. Conclusion: The present trial suggests surgical open reduction and internal fixation treatment of the mandibular condylar fracture is better than the nonsurgical closed reduction in terms of interincisal opening, lateral excursion, and protrusive mandibular movement range.
  180 11 -
Oral and esophageal cancer: Incidence, prevalence and correlation in general Indian Population: A retrospective study
Manish Khare, Yatindra Dewangan, Tarun Nayak, Dharmendra Kumar Singh, Vimal Vibhakar, Kumar Ramesh
June 2021, 13(5):221-224
DOI:10.4103/jpbs.JPBS_695_20  
Background: Squamous cell carcinoma is the most frequent head-and-neck malignancy and chiefly encompasses malignancies of the upper aerodigestive tract, including the oral cavity, nasal cavity, paranasal sinuses, nasopharynx, oropharynx, hypopharynx, pharynx, and larynx. Objectives: The current study was conducted to evaluate the incidence, prevalence, and correlation of oral and esophageal cancer in the Indian population. Materials and Methods: The present study was conducted on the basis of data collected from various government cancer hospitals in India. A total of 1000 patients of either sex admitted to the oncology ward with head-and-neck cancer from June 2018 to June 2020 were included in the study. Information regarding family history, deleterious habits, and immunity status was also collected from their medical records. The readings were recorded in a master chart, and data analysis was carried out statistically. Results: A total of 1000 patients (617 males and 383 females) between the age range of 38 and 86 years were selected for the study. A total of 425 out of 1000 patients had esophageal cancer, whereas, 575 patients had oral cancer. A total of 347 males and 228 females had oral cancer, whereas 270 males and 155 females had esophageal cancer. Among the patients with oral cancer, 44 presented with a history of cigarette smoking, 49 with bidi smoking, 140 with tobacco chewing, 142 with gutkha chewing, and 159 with betel quid chewing. Majority of the patients had a habit of consuming tobacco in smokeless form. Among the patients with esophageal cancer, 175 presented with a history of cigarette smoking, 136 with bidi smoking, 12 with tobacco chewing, 13 with gutkha chewing, and nine with betel quid chewing. Conclusion: The incidence of both types of cancer was high in older age group, particularly in those aged above 50 years. Males had a higher predilection rate than females for both cancer types. The incidence of oral cancer was higher than that of esophageal cancer. Majority of the patients with oral cancer had a history of tobacco consumption in smokeless form, whereas the ones with esophageal cancer reported with a history of tobacco consumption in smoked form.
  182 9 -
Management of internal disc derangement using normal saline and sodium hyaluronate: A comparative study
Neha Singh, Shailendra Kumar Dubey, Nilesh Bhanawat, Gaurav Rai, Abhishek Kumar, Ritesh Vatsa
June 2021, 13(5):207-211
DOI:10.4103/jpbs.JPBS_675_20  
Background: Arthrocentesis of the temporomandibular joint (TMJ) is the unadorned form of surgical therapy which comprises of lavage of inflammatory enzymes and mediators and improve joint mobility and eliminate pain by pressure of the lavage solution in the upper compartment of TMJ. Objectives: The current study was conducted to assess and compare the effectiveness of arthrocentesis with normal saline alone and in conjunction with sodium hyaluronate (SH) injection in the treatment of internal derangement of the TMJ. Methodology: Sixty patients with internal derangement of the TMJ were randomly divided into two equal groups; Group 1 was performed with normal saline and Group 2 with normal saline followed by 1 ml of SH. The patients were followed up after 1 week to check for any postoperative complications and 1, 2, and 3 months for subsequent sessions and changes in subjective and objective variables. Results: The increase in mouth opening from preoperative to 3 months' postoperatively was 4.9 mm for Group 1 and 6.43 mm for Group 2. The change in the pain score (visual analogue scale scale) in Group 1 from the preoperative session to 3 months' follow-up was 7.23–4.1 and in Group 2 was 7.36–3.7. The difference in clicking/popping in Group 1 from preoperative session to 3 months' follow-up was 2.43–1 and in Group 2 was 2.4–0.53. Conclusion: Patients refractory to conservative treatment showed promising results with arthrocentesis with SH than arthrocentesis alone in treatment of TMJ internal derangement.
  176 15 -
A survey of retention practices and protocols followed among orthodontists in India
SR Radha, Gowri Sankar Singaraju, Prasad Mandava, Vivek Reddy Ganugapanta, Hema Bapireddy, Lakshmi Narayana Pilli
June 2021, 13(5):149-156
DOI:10.4103/jpbs.JPBS_615_20  
Background: There are different types of retention protocols and retainers prescribed by the orthodontists across the globe. Aim: The study was conducted with the aim of evaluating the retention practices followed by the orthodontists in India. Materials and Methods: A questionnaire link with a set of 29 questions was generated using the Google Forms App. The questions related to the basic demographic details followed by retention procedures in maxilla and mandible as related to the type of retainer, duration of wear, retention check-ups, and adjunctive procedures being followed. The Google forms were mailed to 1147 registered life members of the Indian Orthodontic Society. Results: The overall response rate was 20.1%. On receiving of the completed questionnaires, the data were statistically analyzed. Dual mode of retention, fixed retainers with removable thermoplastic resin (TR)/vacuum formed retainers (VFR) (24%) were the common type of retention in maxilla whereas the fixed bonded retainer (44.5%) was more commonly used in mandible. Full time wear of maxillary retainer was recommended by 85.2% of the respondents. The recommended duration of the fixed retainer is for 2–5 years (41.9%). Conclusion: A trend towards more dual retention instead of solitary removable or solitary fixed retention, more VFR instead of Hawley-type retainers has been demonstrated in the survey.
  178 13 -
Evaluation of preoperative salivary cortisol level in patients undergoing major maxillofacial surgery
Archana Kumari, Praveen Chandra, Sonali Roy, Ritika Agarwal, Aartika Singh, Suprabha Sharan
June 2021, 13(5):120-123
DOI:10.4103/jpbs.JPBS_598_20  
Aim: The main purpose of the study was to compare the preoperative salivary cortisol levels 3 days before the major surgery under general anesthesia and to compare it with the patients undergoing extraction under local anesthesia. Materials and Methods: Forty-two patients were undergoing major surgery and 42 age- and sex-matched patients undergoing dental extraction were included and their salivary cortisol levels were analyzed before and after the dental procedure. Results: Results showed that there is a significant increase in the mean salivary cortisol concentration after extraction (23.7 ± 9.2) than before extraction (18.9 ± 23.7) in the study group (P = 0.015) as well as in the control group. The comparison between salivary cortisol in the study group before (18.9 ± 23.7) and after (23.7 ± 9.2) surgery was significantly higher than the control group (15.2 ± 5.5) (P = 0.013 and 0.005), respectively. Conclusion: We have concluded from this study that the salivary cortisol level shows a significant increase on the day of surgery.
  178 13 -
Assessment of the relationship between dental anxiety and oral health-related quality of life
Siraj D. A . A. Khan, Naif Mahdi Alqannass, Mohannad Mesfer Alwadei, Mazen Dhafer Alnajrani, Ziyad Mohammed Alshahrani, Ali Yahya Al Alhareth, Khalid Mohammed Alqahtani
June 2021, 13(5):359-362
DOI:10.4103/jpbs.JPBS_742_20  
Background: Dental anxiety and fear are the frequently encountered entities among most of the patients. The present study was conducted to assess the relationship between dental anxiety and quality of life (QoL). Materials and Methods: This study comprised of 118 patients. Dental trait anxiety (dental anxiety scale [DAS] and short version of the dental anxiety inventory [S-DAI]), Oral Health Impact Profile (OHIP-14), Decayed, Missing, and Filled Teeth (DMFT) score, and global assessment of functioning were recorded before and after treatment. Results: Out of 118 patients, males were 52 and females were 56. There was a correlation between both oral health ratings and DMFT (P < 0.001). OHIP-14 total score was significantly associated with both dental anxiety measures. DMFT shows significant association with dental anxiety and oral health-related QoL (OH-QoL) (P < 0.05). The mean DAS score before treatment was 17.3 and after treatment was 12.60, S-DAI score was 40.1 and 31.5 before and after treatment respectively, oral health status (patient rating) was 38.4 and 74.20 before and after treatment respectively, oral health status (dentist rating) was 38.7 and 73.1 before and after treatment respectively and aesthetics (dentist rating) was 35.6 and 72.4 before and after treatment respectively. There was improvement of OH-QoL with dental anxiety reduction which was significantly significant (P < 0.05). Conclusion: Authors found that there is correlation between dental anxiety and fear with the poor oral health-related oral hygiene.
  182 8 -
Assessment of prevalence of recurrent aphthous stomatitis in the North Indian population: A cross-sectional study
Ramneet Kaur, Ashima Bali Behl, Ramandeep Singh Punia, Kumar Nirav, Khundongbam Bikramjit Singh, Sukhpreet Kaur
June 2021, 13(5):363-366
DOI:10.4103/jpbs.JPBS_581_20  
Aim and Objective: The present study was undertaken for assessing the prevalence of recurrent aphthous stomatitis (RAS) in the North Indian population. Materials and Methods: Assessment of a total of 4255 patients was done over a period of 2 years, who came for a routine dental checkup. Recording of the complete demographic and clinical details of all the patients was done. The prevalence of RAS was assessed. Profile of patients with RAS was assessed separately. A pro forma was made and the type of treatment protocol followed by patients with RAS was also recorded. All the results were recorded in a Microsoft Excel sheet and were analyzed using SPSS software. Results: Analysis of a total of 4255 patients was done. RAS was found to be present in 800 patients. The overall prevalence of RAS was found to be 18.93%. Significant results were obtained when analyzing age, gender, and occupation as risk factors for RAS. Labial/buccal mucosa involvement occurred in 51.875% of the cases. In 44% of the cases, the size of the RAS was between 1 cm and 3 cm. Home remedy was followed in 17.875% of the cases. Conclusion: A significant proportion of patients in the North Indian population is affected by RAS. In comparison to males, females are more commonly affected.
  178 11 -
Assessment of the effect of complete dentures on respiratory performance: A spirometric analysis
Jawaz Ahmad Shah Bukhari, Sidhant Sudan, Bhushan Bangar, Neeraj Kumar, Prateek Bhatia, Rohit Duggal
June 2021, 13(5):440-443
DOI:10.4103/jpbs.JPBS_585_20  
Background: Among the vital functions, respiration can be claimed to be one of the most important. A thorough understanding of the patient should be an important aspect a prosthodontist should dwell into so as to predispose patients to acknowledge the kind of prosthesis they require. Hence, the present study was conducted for assessing the effect of complete dentures on respiratory performance. Materials and Methods: Fifty patients with the presence of complete edentulous arch and who had a history of complete denture usage for at least 5 years were enrolled. All the spirometric procedures were performed by trained technicians. A diagnostic spirometer was employed for performing the spirometric test. Testing was carried out in the following steps: Stage 1: testing in the absence of denture, Stage 2: testing in the presence of both dentures, Stage 3: testing in the presence of maxillary denture only, and Stage 4: testing in the presence of mandibular dentures only. Forced vital capacity (FVC) value, peak expiratory flow (PEF) value, forced expiratory volume in 1 s (FEV1) value, and forced expiratory flow 25%–75% (FEF25–75) value were recorded with the spirometric test. Analysis of all the results was done by SPSS software. Results: The spirometric value of FVC, PEF, FEV1, and FEF25–75 in the absence of both maxillary and mandibular dentures (Stage 1) was found to be 3.18, 5.83, 2.44, and 2.80, respectively. The spirometric value of FVC, PEF, FEV1, and FEF25–75 in the presence of both maxillary and mandibular dentures (Stage 2) was found to be 3.09, 5.67, 2.41, and 2.67, respectively. While analyzing statistically, it was seen that there was a significant decrease in the value of spirometric variables in the presence of dentures. Conclusion: Chronic denture wearer edentulous patients are subjected to the risk of development of spirometric alterations. Hence, these patients should be given timely instructions about the various respiratory exercise protocols.
  172 17 -
Mandibular ramus as a strong expressor of sex determinations: A digital radiographic study
Ramneet Kaur, Shambulingappa Pallagatti, Amit Aggarwal, Preeti Garg Mittal, MandeepSingh , Mili Lalitkumar Patel
June 2021, 13(5):421-424
DOI:10.4103/jpbs.JPBS_574_20  
Background: This study aimed to assess the effectiveness of mandibular ramus in gender identification in Haryana population. Materials and Methods: One hundred patients were assessed. Panoramic radiological examination was done. Following parameters were recorded: MAX. RM. WDTH (Maximum ramus breadth), MIN. RM. WDTH (Minimum ramus breadth), CND. HGT. RM (Condylar height), PRJ. HGT. RM (Projective height of the ramus), and CRND. HGT. RM (Coronoid height). All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software version 16.0. Results: There is significant difference found in males and females in maximum ramus width, minimum ramus width, condylar height, and coronoid height and between male and females in condylar height and coronoid height. Furthermore, there was statistical significant difference between male and females in coronoid height. Conclusion: Mandibular ramus can be used for gender assessment as a part of forensic investigation.
  176 12 -
Perception, knowledge, and attitude of individuals from different Regions of Saudi Arabia toward dental implants and bone grafts
Malak Sultan Alkhaldi, Abrar Ali Alshuaibi, Shamoukh Safar Alshahran, Pradeep Koppolu, Rawa Kamal Abdelrahim, Lingam Amara Swapna
June 2021, 13(5):575-579
DOI:10.4103/jpbs.JPBS_533_20  
Aim: The aim of this study was to assess the perception, knowledge, and attitude of individuals from different regions of Saudi Arabia toward dental implants and bone grafts. Material and Methods: An online, self-oriented, and cross-sectional-based questionnaire with 21 items was given to 1622 individuals from different regions of Saudi Arabia. The questionnaire recorded the perception, knowledge, and attitude of participants and their agreement or rejection of dental implants and various kinds of bone grafts. The responses were compared with age, sex, and educational level. Descriptive statistical analysis was performed for the collected data and P < 0.05 was considered statistically significant. Results: Most of the males (35.8%) and females (39.8%) reported that the major source of data regarding dental implants is friends and families. Majority of the participants (approximately 75% males and 73% females) support the idea that dental implants last for lifetime, whereas majority of the participants (approximately 49% males and 56% females) displayed their unawareness regarding materials used for dental implants. The overall acceptance rates of participants for autografts, alloplasts, xenografts from the cow, xenografts from the horse, and allografts were 40%, 15.9%, 2.5%, 2.2%, and 1.6%, respectively. Conclusion: The expense of dental implants was considered the foremost reason for avoiding the procedure. Most of the participants think that fixed dental prostheses last longer than removable prosthesis. Autograft was the most accepted bone graft, whereas allograft was the least accepted bone graft over the responded participants.
  174 13 -
Assessment of the effect of bone density on implant stability: A clinical study
Raghunadh Sreerama, Krishna Chaitanya Kolluru, Vineela Gottumukkala, Chaitanya Kumar Innampudi, Jagga Rao Konathala, G Krishnaveni
June 2021, 13(5):297-300
DOI:10.4103/jpbs.JPBS_794_20  
Background: In this study, we determined the effect of bone density on implant stability. Methodology: Two hundred and sixty dental implant sites in 128 patients were assessed for resonance frequency analysis (RFA) following implant insertion, at 6 months and 12 months. The implant stability quotient (ISQ) was determined. Results: The mean ± standard deviation bone density in anterior mandible was 862.8 ± 203.4 Hounsfield units (HU), in posterior mandible was 528.4 ± 115.6 HU, in anterior maxilla was 594.2 ± 95.2 HU, and in posterior maxilla was 438.1 ± 110.2 HU. The mean insertion torque in successful implants was 38.2 ± 7.1 Ncm and in failed implants was 22.4 ± 4.2 Ncm. The mean RFA value in successful implants was 65.4 ± 5.8 and in failed implants was 45.8 ± 4.1 ISQ. A statistically significant (P < 0.05) difference was obtained. Conclusion: Within the limitation of the study, we observed that successful implants exhibited higher RFA and insertion torque and were higher into failed implants suggesting a correlation of bone quality and implant stability parameters.
  176 10 -
Assessment of oral health-care needs for patients under palliative care
Atul Kumar Singh, Rahul Mishra, Harsh Kumar, Leena Priya, Harsha Vardhan Choudhary, Kunal Kumar
June 2021, 13(5):180-183
DOI:10.4103/jpbs.JPBS_636_20  
Background: Patients under palliative care and their caregivers often ignore the dental treatment and oral hygiene needs as a result of which they face many day to day problems, which include difficulty in chewing, halitosis, and dry mouth eventually deteriorating the quality of life. Objective: The aim of this study is to understand the oral needs and oral health-related concerns of the patients under palliative care. Methodology: A total of eight patients agreed to enroll in the study. A detailed interview with oral examination, including Sillness and Loe Plaque Index and Decayed Missing and Filled Teeth (dmft) Index, was recorded. Patients were also given the treatment needed if willing for the same. Results: In our study, we observed that the mean dmft scores of dentulous patients were 7.96 ± 3.35, and mean plaque score was 1.75 ± 2.12, which was significantly higher and further highlights the need for dental treatment. Conclusion: The patients under palliative care have many oral problems such as dry mouth, difficulty in eating, halitosis which needs to be addressed; hence, dental health plays an important role in improving the quality of life of these patients.
  176 10 -
Titanium mesh versus medpor implant in orbital floor reconstructions: A comparative study
Vishnu Gowtham Marella, Rohit , Prateek Khetrapal, Alankrutha Gangasani, Rishabh Bhanot, Ashish Uppal
June 2021, 13(5):76-79
DOI:10.4103/jpbs.JPBS_553_20  
Background: Treating orbital injuries is interesting and difficult in the facial trauma. The balance in facial proportions and also the facial esthetics are required to achieve an anatomical harmony. Objective: To compare the functional results of individual reconstruction of orbital floor using either titanium mesh or Medpor in terms of various factors. Materials and Methods: There were two study groups including eight subjects with orbital floor fracture, namely A (Medpor) and B (titanium mesh). Various parameters were analyzed postoperatively at intervals of 1 week, 3 week, 6th week, and 3 months after the surgery. Statistical Analysis: Comparison of the different time points with respect to pain scores in the two study groups by Wilcoxon matched pairs test was done. P value was significant in the study Group A with P = 0.0431* and was insignificant in the study Group B with P = 0.1088. Results: All three cases of titanium mesh in orbital floor reconstruction had signs of infection, tenderness, and radiographic proof after 1 week in two subjects and 3 weeks in one patient. Pain was seen in all eight patients 1 week postoperatively. Conclusion: Although orbital reconstruction is a technique sensitive procedure both Medpore and Titanium mesh functions.
  170 16 -
Effect of chlorhexidine and probiotics on halitosis
Sunith Sudhakaran, Jibin Jose Tom, Arun Shyam, Sreerag Mohan, Shabeer Ali, Mahesh Raj
June 2021, 13(5):807-811
DOI:10.4103/jpbs.JPBS_768_20  
Objective: The purpose of this study was to analyze the effect of chemical method of oral hygiene practice, chlorhexidine (CHX) disinfection, and the followed consumption of probiotics on oral malodor in children. The effects of chemical and mechanical oral hygiene practice methods on the intensity of oral malodor were also evaluated. Materials and Methods: Organoleptic test (OLT) scores of 2 or more of 196 children were randomly allocated to four groups: 1: Conventional oral hygiene practices (COH) including flossing and tooth brushing, 2: COH + tongue scraping (TS), 3: COH + TS + CHX, and 4: COH + TS + CHX + probiotics. OLT was performed at 1-week and 3-month follow-ups. Results: A stable and significant number of individuals showed crucial and average levels of improvement in Group 4 OLT scores. The improvement of Group 3 OLT scores was also remarkable but not steady over the follow-ups. Neither remarkable nor steady improvements in the OLT scores was detected in Groups 1 and 2 through follow-ups. Conclusion: Oral disinfection followed by probiotic therapy with CHX may decrease the severity of oral malodor over a long period of time.
  174 11 -
Evaluation of the efficacy of regional anesthesia and intramuscular diclofenac in the management of postoperative pain: A comparative study
Ankita Raj, Priyanka Unnam, Richa Kumari, Shraddha Joshi, Bhushan Thoke, Shilpa Sunil Khanna
June 2021, 13(5):473-475
DOI:10.4103/jpbs.JPBS_666_20  
Aim: Managing postoperative pain following maxillofacial surgery is an important task. Our study aims to compare this with regional anesthesia or IM diclofenac. Materials and Methods: This study included 30 patients who underwent bi-jaw orthognathic surgery between April 2016 and January 2020. Two groups were formed. Group A was administered inferior alveolar nerve block at the surgical site bilaterally using 0.5% ropivacaine and Group B were administered 75 mg intramuscular diclofenac just before extubation. Tramadol HCl 2 mg/kg body wt is used as a rescue analgesic. The pain was evaluated periodically at 2nd, 4th, 6th, and 12 h postoperatively. Results: The mean Visual Analog Scale score was 2 in Group A and 5 in Group B. The mean duration of analgesia was 6 h 42 min, whereas in Group B, it was 8 h and 5 min. In 2 patients (13.3%) belonging to Group A and 3 patients (20%) belonging to Group B. There were no local complications in any group. Conclusion: It was observed that regional anesthesia in the form of intraoral nerve blocks was efficient than diclofenac (75 mg) administered intramuscularly for the management of immediate postoperative pain.
  174 11 -
Influence of inter-radicular septal bone quantity in primary stability of immediate molar implants with different length and diameter placed in mandibular region. A cone-beam computed tomography-based simulated implant study
Arshad Jamal Sayed, Safia Shoeb Shaikh, Shoeb Yakub Shaikh, Mohammed Abid Hussain, Sabahat Ullah Khan Tareen, Vaibhav Awinashe
June 2021, 13(5):484-491
DOI:10.4103/jpbs.JPBS_818_20  
Aim: The purpose of this in vitro study was to investigate the influence of length and width of implant on primary stability in immediate implants in mandibular first molar. Materials and Methods: The study was carried out on 40 cone-beam computed tomography scans selected with defined inclusion and exclusion criteria. According to the diameter and length of implants, they were divided into nine groups (G1 to G9). The virtual implants of different diameters and length were placed in mandibular first molar and measurements were done for peri-implant horizontal and vertical gap defect, peri-implant interradicular bone support and apical bone support for all the groups. Results: The study groups Diameter, (D-7 mm) showed least horizontal gap defect (Buccal-1.30 ± 0.56 mm, lingual-1.30 ± 0.56 mm, mesial-1.20 ± 0.51 mm, and distal-1.05 ± 0.59 mm) as compared to regular implant diameter (D-4.7) groups (Buccal-2.35 ± 0.483 mm, lingual-2.10 mm ± 0.44 mm, mesial-2.30 ± 0.64 mm, and distal-2.25 ± 0.43 mm). The unsupported Vertical implant gap defect at the coronal part of the socket was 2.80 mm ± 0.83 mm for all groups in both horizontal and vertical direction. The vertical peri-implant interradicular bone support showed increased bone support with increase in implant length (L). The buccal and lingual inter-radicular bone-support was least for Length (L-8.5 mm), moderate for L-11.5 mm, and highest for L-13.5 mm groups, respectively. The mesial inter-radicular bone support was least for G4G7, moderate for G1G2G5G8, and maximum for G3G6G9 groups. Similarly, the distal inter-radicular bone support was least for G4G7, moderate for G1G5G8, and maximum for G2G3G6G9 groups, respectively. There was no apical bone support in L-8.5 mm group as the tip of implant was 3.5–4 mm within the socket tip. Whereas, L-11.5 mm had decent (0.9–1 mm) and L-13.5 mm had Good (1.35–1.95 mm) apical bone support as the implant tip was beyond the socket tip. Conclusion: All the groups showed good interradicular bone support on buccal and lingual surfaces. Regular width implants with longer length showed satisfactory interradicular bone support on mesial and distal surfaces. Longer implants showed good apical bone support in all the four surfaces and hence good apical primary stability expected.
  176 9 -
Knowledge, practices, and perceptions about tooth whitening among female population in Saudi Arabia – A cross-sectional study
Hani Sabri Jaha, Hajer Ayed Alhejoury, Amal Abdelrahman Fayad, Ayoob Mutleb Alnafisah, Ibrahim Alhosain Bahshan, Saud Ismail Assiri, Ahmed Salem Alsubhi
June 2021, 13(5):817-820
DOI:10.4103/jpbs.JPBS_769_20  
Background: Tooth-whitening procedures have gained wide popularity among the Saudi population. The present study aimed to assess the knowledge, attitude, and perception about tooth-whitening procedures among Jeddah's general population. Materials and Methods: A face-to-face interview was conducted on randomly selected female patients attending dental clinics. A pretested and structured questionnaire was used to record the response by calibrated interviewers. The responses regarding knowledge, attitude, and perceptions were recorded and subjected to statistical analysis. Results: The findings showed that the prevalence of tooth whitening among the participants was 43.7%, and about 8.7% reported that they did it once every year. In-office bleaching was the most preferred method (31.4%), followed by whitening toothpaste (8.7%). An increased frequency of bleaching was reported by participants belonging to younger age group (P < 0.001). Conclusion: The knowledge related to the mechanism of action and adverse effects was average among the participants. Younger age groups were more concerned about tooth-whitening procedures compared to the older ones.
  176 8 -
Attention to COVID-19 pandemic among dental experts of Kerala State, India: A knowledge, attitude, and practice study
A Aravind, Samyukta Nair, TK Aparna, Arun Jacob Thomas, Sajna Oommen, Aravind Vijayan
June 2021, 13(5):836-840
DOI:10.4103/jpbs.JPBS_831_20  
Background: Dentists are the common preys for the transmission of pandemic disease because of the airborne spread via routine dental checkups. This study which is a cross-sectional one gives the idea about awareness and alertness of dentists about COVID-19 in Kerala, India. Materials and Methods: The survey comprised 25 closed-ended questions. The survey was separated into two sections. The initial segment of the poll was identified with the socio-segment qualities that were researched, while the subsequent part was worried about dental practitioners' perspectives toward the management of COVID-19 and the apparent danger of defilement in dental facilities. Results: Coronavirus management in dental clinics differs regarding adherence to the rules. An aggregate of 750 respondents finished the form, out of which 686 (91.46%) complete reactions were incorporated. The majority of the respondents concurred on inquiries regarding the knowledge, practice, and mentality of dental specialists toward the COVID-19 pandemic. Conclusion: The feedback of most dental specialists with respect to the readiness and view of disease control measures against the COVID-19 pandemic was positive. Dental facilities need to adhere more to the central and state government suggestions in alertness of their facilities or by tutoring their dental specialists and staff.
  172 10 -
A comparative evaluation of abrasion resistance of three commercially available type IV dental stone, dried using three different drying techniques - An In vitro Study
Sayed M Killedar, Rajesh Shetty, J Rahul, Jittin James, Ranjith Karaththodiyil, Annie Edwin
June 2021, 13(5):580-585
DOI:10.4103/jpbs.JPBS_538_20  
Background: The microwave technique of drying dental stone to achieve improved hardness and strength has been suggested in recent years. However, its effect on the wear properties of dental stone has not been thoroughly examined. Aim: The present study was conducted in vitro to determine the abrasion resistance of three commercially available Type IV dental stones using three different drying techniques. Materials and Methods: A total of 180 samples were prepared from 3 Type IV dental stones; namely Eliterock, Zhermack (Italy), Kalrock, Kalabhai industries (India), and Gyprock (Rajkot, India). Samples were subjected to drying in open air for 2 h, hot air oven at a temp of 230°C for 1 h and microwave oven for 5 min at 900Watts. Abrasion resistance was determined using a customized metallic abrasion resistance tester. Results: Microwave oven drying produced samples with increased abrasion resistance values when compared to samples dried in hot air oven and air-dried specimens. Eliterock showed significantly higher mean abrasion resistance values followed by Kalrock and Gyprock. Conclusion: Drying type IV dental stone in a microwave oven at 900W for 5 min increased the abrasion resistance within short time.
  172 10 -
Efficacy of curcumin and topical steroids in the treatment for oral submucous fibrosis: A comparative study
TA Deepak, M Manjunath, Harshita Thakur
June 2021, 13(5):542-548
DOI:10.4103/jpbs.JPBS_687_20  
Context: Oral submucous fibrosis (OSMF) is a chronic debilitating disease of the oral cavity, characterized by inflammation and progressive fibrosis of the submucosal tissues. The main agent involved in the pathogenesis of OSMF is areca nut. A wide range of treatment, including drug management, surgical therapy, and physiotherapy, has been attempted till date, with varying degrees of benefit. Aims: The objective of this study was to assess efficacy of curcumin for the treatment of OSMF; to asses efficacy of topical steroids for the treatment of OSMF; and to compare the efficacy of curcumin and topical steroid for the treatment of OSMF. Setting and Design: Participants were assessed based subjective and objective feature of OSMF, i.e., burning sensation of the oral cavity and interincisal distance, respectively. Methodology: Thirty participants were categorized into two groups: Group A was administered curcumin and Group B was administered topical steroids for a period of 3 months and followed up after 6 months. The assessment was based on maximal incisal opening and burning sensation for spicy food on Visual Analog Scale score. Analysis: Independent t test was applied for comparison within the group, ANOVA Bonferroni post hoc test was applied for multiple comparison of mean and Mann–Whitney U test was applied to compare the groups. Results: The statistical analysis revealed curcumin to be more efficient than topical steroid. Conclusion: The present study demonstrates the efficiency of curcumin and topical steroid to alleviate the clinical findings of OSMF. However, curcumin is comparatively more efficient than steroids for the treatment of OSMF.
  174 8 -
Prevalence of oral health status and needs in institutionlized physically challenged children
Rahul Mishra, Atul Kumar Singh, Sanjana Tyagi, Harsha Vardhan Choudhary, Shweta Kirti Gupta, Kunal Kumar
June 2021, 13(5):184-186
DOI:10.4103/jpbs.JPBS_637_20  
Background: Oral hygiene has significant effect on the overall health of an individual as it has vital role in human life, so it is necessary to protect oral hygiene of all children since childhood. Objectives: The objectives were to evaluate and compare the prevalence of dental caries and oral hygiene status in institutionalized physically challenged children of Bihar. Materials and Methodology: A total of 700 (400 male and 300 female) children were included in the study that were physically handicapped and were institutionalized in various special schools. In this study, complete oral examination was done and was recorded by using Oral Hygiene Status-Simplified given by Greene and Vermillion, 1964, and all statistical analyses were done by using SPSS software. For statistical analysis, Chi-square test and ANOVA were used. Results: Out of 700 children, 48.8% (342) had dental caries with mean Decayed, Missing, and Filled Teeth (DMFT) index of 0.86 (standard deviation [SD] ±1.37) and mean dmft index of 0.36 (SD ± 0.98). In this study, orthopedic, blind, deaf and dumb, and compound students were examined. It was observed that the dental caries prevalence was high in the blind group (71%) compared to that of the deaf and dumb group (40.2%), while oral hygiene status was observed as good in 42.2%, fair in 46.9%, and poor in 10.9% of children. Conclusion: Every dental professional should be aware of his/her responsibilities and provide both comprehensive and incremental dental care to improve the overall oral hygiene condition of physically handicapped children.
  170 12 -
Antibacterial and antifungal efficacy of platelet-rich fibrin and platelet-rich fibrin matrix against root canal microflora
Pinky Singh, Subhra Dey, Vinisha Pandey, Arora Abhas, Suprabha Sharan, Neetu Kharat
June 2021, 13(5):124-127
DOI:10.4103/jpbs.JPBS_601_20  
Background: Binding of such proteins with a developing fibrin mesh or to the extracellular matrix has the ability to create chemotactic gradients aiding the recruitment of stem cells, thereby, stimulating cell migration and differentiation this may promotes repair and regeneration. There is a unique concept in platelet concentrates called platelet-rich fibrin matrix (PRFM) which is processed using higher attraction without the utilization of bovine thrombin. Aim and Objectives: The aim of this study is to evaluate the antibacterial and antifungal effects of platelet-rich fibrin (PRF) and PRFM against root canal microflora. Materials and Methods: Blood samples were taken from 20 adults, age ranging from 20 to 40 years who were systemically healthy, nonsmokers with no symptoms of infection, or on antibiotics at least 3 months before experiments. The procedures and the protocols involved in the study were accepted by the Institutional Ethical Committee. Written informed consent was obtained from the donors and patients. Approximately 10 ml of blood was collected from each donor. 5 ml of blood was used for the preparation of PRF and 5 ml for PRFM. Results: The antifungal scores among the groups. The highest antifungal scores were seen in metapex followed by PRF and PRFM group. Kruskal–Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups (P = 0.00). The antibacterial scores among the groups. The highest antibacterial scores were seen in Metapex followed by PRF group and PRFM group Kruskal–Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups. Conclusion: PRF demonstrated antibacterial activity against passage isolates but had no antifungal efficacy. This antibacterial property may be a valuable adjunct when using PRF for regenerative procedures in endodontics. Both PRF and PRFM have to be analyzed for antimicrobial properties for extended duration and various other clinical strains with larger sample size.
  168 14 -
Evaluation of quality of endodontic re-treatment and changes in periapical status
Nausheen Aga, Manoj Kumar Thakur, Muhammad Atif Saleem Agwan, Muna Eisa, Amel Yousif Habshi, Sarah Azeem
June 2021, 13(5):379-382
DOI:10.4103/jpbs.JPBS_814_20  
Background: The present study was conducted to assess quality of root canal (RC) filling before and after RC re-treatment. Materials and Methods: Two hundred and thirty-eight radiographs of failed endodontic treatment were assessed. The periapical status of the endodontic treatment was evaluated with periapical index (PAI) scoring system. PAI <3 showed absence and PAI >3 showed presence of periapical lesion. Results: There was a statistically significant increase in scores 1 and 3 and decrease in scores 2, 4, 5, and 6 after treatment (P < 0.05). PAI score >3 was seen in 37% before which decreased to 16% after endodontic retreatment. 34.6% obturation was homogenous and 65.4% was nonhomogenous before endodontic retreatment. After endodontic retreatment, 95.2% became homogenous and 4.8% nonhomogenous. The reason for endodontic failure was furcation in 2%, iatrogenic causes in 3%, loss of coronal seal in 16%, periapical pathology in 25%, and inadequate root filling in 54%. Conclusion: There was significant improvement and decrease in size of periapical lesions in re-endodontic cases as compared to primary RC treated teeth.
  172 9 -
Evaluation of horizontal distance between WALA-FA point in angle's Class I, Class II, and Class III malocclusion
R Mahalakshmi, MM Varadharaja, Reshmi Leila Ninan, V Vignesh Kumar, B Kanagasabapathy, M.D Saravana Balaji
June 2021, 13(5):506-509
DOI:10.4103/jpbs.JPBS_793_20  
Introduction: The objective of the study was to measure the horizontal distance between the FA-WALA (Facial Axis Point-William Andrews and Larry Andrews) of posterior teeth in Angle's Class I, Class II, and Class III malocclusions and to assess the depth of the Curve of Spee, to find the correlation between intercanine FA and intercanine WALA and its significance. Material and Methods: Sixty pretreatment mandibular casts of patients with an age range of 18–35 years were included. A sample size of 20 was evaluated in Angle's Class I, Class II, and Class III, respectively. The WALA ridge and FA points were marked in the model and calibrated using the digital Vernier caliper. Results: There was an incremental increase in the horizontal distance from the FA-WALA in the posterior teeth. The mandibular intercanine FA-FA and intercanine WALA-WALA distance were greater in Angle's Class III group when compared to Angle's Class II. The Curve of Spee measurement was increased in Angle's Class II group, while Angle's Class III had a flat curve. Conclusion: The horizontal distance between FA-WALA increased incrementally in the posterior teeth in Angle's Class I, Class II, and Class III malocclusions. In Angle's Class II malocclusion, the Curve of Spee measurement was increased and had a narrower mandibular arch.
  172 9 -
Oral sensations among individuals with illicit drug dependence in rehabilitation centers: A cross-sectional study
Lipsa Bhuyan, Roquaiya Nishat, Balasubramanya Goutham, Kailash Chandra Dash, Pallavi Mishra, Niva Mahapatra
June 2021, 13(5):561-565
DOI:10.4103/jpbs.JPBS_576_20  
Background: In developing countries like India, irrespective of the various government laws and actions, substance abuse is a growing problem. Individuals with illicit drug dependence face social and psychological stigma with considerable health problems. Negligence to oral hygiene and lack of oral health treatments intensifies the sensations experienced by the subjects. Aim: The aim is to determine the patterns of substance abuse and oral health sensations among individuals with illicit drug dependence. Materials and Methods: A cross-sectional study was conducted wherein 213 male individuals with illicit drug dependence history, admitted in rehabilitation centers of Bhubaneswar, formed the study population. Information pertaining to the type and duration of drug dependence along with oral sensations experienced by the individuals during a period of 3 months was obtained by interviewing by the subjects. Chi-square test was done to identify variations in oral sensations produced by different illicit drugs and its relationship with their usage pattern. Results: About 40.8% of dependents reported cannabis intake, thus making it the most commonly consumed drug. About 80.8% of all the subjects reported dryness of the mouth, 47.9% reported sensitivity of teeth and 28.2% suffered from the numbness of their mouth. About 19.7% of the individuals felt like chewing on something, 23% inclined toward grinding, whereas 11.7% experienced pain in the jaw muscles and joint. Sixty percent of substance dependents who smoked drugs had sensitive teeth (P ≤ 0.05). All the oral sensations experienced were significantly more among drug dependents with a history of illicit drug usage for >5years in comparison to others. Conclusion: Substance abuse results in a range of oral sensations. De-addiction programs in India lack oral health-care components. Studies on oral complications related to addiction stresses on the need of oral healthcare at various levels, including education, prevention, and treatment. All these components should be amalgamated into general care services for addicts.
  170 10 -
The efficacy of commercially available herbal dentifrices in comparison with conventional dentifrices against two common oral microbes: An In vitro study
Nikesh Thounaojam, Nelson Sanjenbam, Supriyo Pal, Dharmendra Kumar Singh, Kunal Kumar, Mayank Shah
June 2021, 13(5):176-179
DOI:10.4103/jpbs.JPBS_635_20  
Background: Mechanical plaque removal is considered the gold standard for controlling and prevention of plaque and gingivitis. The present study was conducted to evaluate the efficacy of commercially available herbal dentifrices in comparison with conventional dentifrices against two of the common oral microbes, namely Streptococcus mutans and Candida albicans. Materials and Methods: To determine the antimicrobial properties of individual dentifrices, the zone of inhibition on the blood agar plates was measured and also disc diffusion method was used for testing the antibacterial properties for which a thin paper disc containing the antimicrobial agent was applied on a culture of bacteria grown on agar media. Each dentifrice was tested in 50% concentration (1:1 dilution [50% w/w] using sterile deionized distilled water/half strength) and 100% concentration (full strength). The blood agar plates were then incubated aerobically at 37°C. The measurement of zone of inhibition was done after 24–48 and 72 h on the underside of the Petri dishes using Vernier calipers. Results: At 50% concentration, Regimen B2 showed the maximum zone of inhibition which was closely followed by Regimen A1 for S. mutans, whereas at 100% concentration, Regimen A1 showed better effects. For C. albicans, it was observed that Dabur red toothpaste showed the significantly higher zone of inhibition at 50% concentration when the concentration was made 100% and also Dabur red toothpaste showed the maximum zone of inhibition. Conclusion: This concluded that the herbal dentifrices are equally and sometimes better than the conventional ones.
  168 12 -
CASE REPORTS
A focal intrinsic physiologic pigmentation of tongue
Senthilnathan Radhakrishnan, Kalaiselvi Santhosh, Gobichetipalayam Jegatheeswaran Anbuselvan, Gandhimathi Kanthasamy
June 2021, 13(5):878-880
DOI:10.4103/jpbs.JPBS_745_20  
Pigmentation is defined as the process of deposition of pigments in the tissues. It can be endogenous or exogenous in origin and may be physiological or pathological. Pigmentation is a common intraoral finding; various diseases can lead to varied discolorations of the mucosa. Diagnosis of pigmented lesions of the oral cavity is a challenging task, therefore understanding of the causes of mucosal pigmentation and appropriate evaluation of the patient are essential in the diagnosis of the pigmented lesions.
  170 9 -
Idiopathic desquamative gingivitis
Zuhair M Alkahtani, Rajeev Arunachalam, Ranjeet Ajit Bapat, Arthiie Thangavelu, Anbuselvan Gobichettipalayam Jegatheeswaran
June 2021, 13(5):865-867
DOI:10.4103/jpbs.JPBS_622_20  
Desquamative gingivitis is described as an erythematous, desquamated gingival lesion. There are many etiologic factors for the appearance of such lesions. The aim of this case report is to diagnose the cause of the lesion by analyzing the complete medical, dental, and personal histories. An elaborated differential diagnosis is done, and the lesion is successfully treated accordingly. The gold standard treatment is usually provided by systemic or topical corticosteroids. Another treatment option is antioxidant therapy which provides rapid healing of the tissue
  168 11 -
ORIGINAL ARTICLES
A retrospective study to evaluate biopsies of oral and maxillofacial lesions
Harkanwal Preet Singh, SH Thippeswamy, Piyush Gandhi, Varun Salgotra, Shivendra Choudhary, Ritika Agarwal
June 2021, 13(5):116-119
DOI:10.4103/jpbs.JPBS_597_20  
Background: The clinical manifestations of these lesions comprises pain, paresthesia, swelling, drainage, tooth loss, root resorption, and facial deformity. Alteration in oral and maxillofacial (OMF) tissues of the lesions may cause esthetically and functionally unfavourable effects in patients. Aims and Objectives: To determine the frequency of odontogenic cysts, tumors, and other lesions. Materials and Methods: Patient's records of histopathological reports from the archives of the Department of Oral and Maxillofacial Pathology were obtained and reviewed over a period of 2 years, and therefore, the lesions were classified into four groups. In cases of recurrent lesions, only the primary diagnosis was considered. The research protocol was approved by the ethical committee of the institution. Results: About 56.4% of males had ameloblastoma, 54.9% of females had cementoma. 59.4% females had giant cell granuloma, 87.5% females had pyogenic granuloma, 77.2% females had osteoma, 65.1% of the female population were belongs to the benign fibro-osseous lesions and 50.2% of females were from fibrous dysplasia in group 3. About 58.8% females had squamous cell carcinoma in group 4. Conclusion: To adequately determine the prevalence and incidence rate of OMF lesions, biopsies performed by other specialists such as otolaryngologists and plastic surgeons in OMF regions should also be evaluated.
  164 15 -
Comparative evaluation of periodontal osseous defects using direct digital radiography and cone-beam computed tomography
Ruhi Mark, Ranjana Mohan, M Gundappa, M D Saravana Balaji, VK Vijay, M Umayal
June 2021, 13(5):306-311
DOI:10.4103/jpbs.JPBS_804_20  
Objectives: To evaluate and compare the accuracy of Direct Digital Radiography (DDR) and cone-beam computed tomography (CBCT) in determination and diagnosis of periodontal osseous defects. Methods: A nonrandomized in vivo study was conducted to compare the two imaging modalities, DDR and CBCT, for the diagnosis of periodontal osseous defects. Comparison was made between the linear measurements of DDR and CBCT images with the actual measurements of various osseous defects during surgical exposure (Gold standard). Results: The results of the present study demonstrated the difference in the mean values of the DDR and surgical exposure measurements of periodontal osseous defects, whereas comparable mean values were found between the CBCT and surgical exposure measurements, with no statistically significant difference (P > 0.05) being found between each modality. Conclusion: CBCT proved to be an indispensable imaging tool in detecting and quantifying periodontal defects and furcation involvement more precisely and could provide additional benefits over the traditional radiography for clinical and postsurgical evaluation.
  170 8 -
Copolymerization of ring-opening oxaspiro comonomer with denture base acrylic resin by free-radical/cationic hybrid polymerization
Ranganathan Ajay, Vikraman Rakshagan, Murugesan Sreevarun, Dharanividhya Bhuvaneshkumar, Sekaran SajidaBegum, Veerakumar Vignesh
June 2021, 13(5):527-531
DOI:10.4103/jpbs.JPBS_582_20  
Background: Polymerization shrinkage is an innate characteristic of thermo-polymerized denture base acrylic resin. Volumetric shrinkage is still a problem, although myriad material modifications. Ring-opening oxaspiro monomers have promising volumetric expansions of about 7%. These monomers have diminished the shrinkage in dental filling resins through copolymerization (CP). However, their CP with denture base resins is not reported yet. Purpose: The aim is to confirm the CP of an oxaspiro monomer with methyl methacrylate (MMA) by radical-cationic hybrid polymerization and to assess the degree of conversion (DC) of the formed copolymer. Materials and Methods: The oxaspiro monomer was synthesized by a transesterification reaction. The study groups were based on the composition and thermo-polymerization method. The control and E1 groups were thermo-polymerized in water-bath, whereas the E2 group in a laboratory autoclave. Both E1 and E2 groups contained the oxaspiro monomer and cationic initiator. E2 group had an additional radical initiator. The CP and DC were confirmed and assessed by infrared spectroscopy. Results: Accentuation of carbonyl peak, the disappearance of the spiro-carbon peak, and the appearance of ether linkages in experimental groups confirmed the ring-opening. E2 group had the highest DC. Conclusion: The oxaspiro monomer successfully copolymerized with MMA and had good DC.
  160 18 -
Effect of different bonding techniques on marginal adaptation of harmonize composite resin at different storage times
Ebaa Ibrahim Alagha
June 2021, 13(5):586-589
DOI:10.4103/jpbs.JPBS_564_20  
Aim: The aim of this study is to evaluate the outcome of diverse bonding methods on marginal adaptation of harmonize composite at altered times of storage. Materials and Methods: The study was done on 120 upper premolars with two adhesive systems (n = 60), self-etch, and total-etch type. Sixty teeth of each method were stored at three different times (n = 20) 1 day, 3, and 6 months. Class II cavities were made in all teeth restored with Harmonize composite incrementally. Then, each tooth was sectioned into two halves in buccolingual direction and observed with stereomicroscope for detecting any gaps and scanning electron microscope to assess resin-dentin junction. Results: Mean gap area was more in the self-etch group at the cervical and occlusal margins. Storage period of 6 months revealed significantly highest mean gap area. Conclusions: Total-etch system showed better marginal adaptation than the self-etch system and storage of resin in water has unfavorable marginal adaptation.
  166 9 -
Comparative evaluation of salivary visfatin levels in healthy and periodontally diseased patients before and after scaling and root planing
Greeshma Saseendran, Seba Abraham, Aparna M Nair, MK Reejamol
June 2021, 13(5):624-628
DOI:10.4103/jpbs.JPBS_546_20  
Aim: The aim of this study was to compare the levels of salivary visfatin in healthy controls, patients with gingivitis and patients with chronic periodontitis and also to assess the outcome of scaling and root planing (SRP) on the levels of salivary visfatin in patients with gingivitis and chronic periodontitis. Materials and Methods: A total of 48 patients, both males and females, in the age group of 25–50 years were enrolled into three groups, based on their clinical parameters: Group I (Healthy controls - 16), Group II (Patients with gingivitis - 16), and Group III (Patients with chronic periodontitis - 16). Groups II and III were examined 2 months after SRP. The clinical parameters that were recorded include plaque index, modified gingival index, gingival bleeding index, pocket depth, and clinical attachment level. The samples of saliva were collected from each patient and the levels of visfatin were evaluated using enzyme-linked immunosorbent assay kit. Results: The mean concentration of salivary visfatin at baseline was found to be highest in Group III and lowest in Group I. A statistically significant reduction (P < 0.01) in the mean concentration of salivary visfatin and the clinical parameters were observed after 2 months of SRP. Conclusion: The levels of salivary visfatin can thus be considered as an inflammatory biomarker for periodontal diseases. However, future longitudinal prospective studies are needed to support these findings.
  162 13 -
CASE REPORTS
Foreign body removal and revascularization of teeth with periapical radiolucency: 18 Months' follow-up
Kaarunya Ravikumar, Yadav Chakravarthy, A Kumar, Mothiraj Samynathan, R Jeya Varshini
June 2021, 13(5):886-889
DOI:10.4103/jpbs.JPBS_536_20  
Revascularization of the dental pulp is an emerging regenerative endodontic approach in which a new tissue is formed inside the root canal by induction of blood clot, allowing the continuation in the development of root. In this case report, the effective management of previously fractured immature tooth with the presence of foreign body (wire) inside the canal and radiographic periapical radiolucency had been described. A 17-year-old patient with immature fractured upper left lateral incisor with radiographic evidence of foreign body (wire) inside the canal was treated with removal of wire by H file followed by revascularization protocol that used working length determination, 5.25% sodium hypochlorite irrigation, intracanal medication with calcium hydroxide, final irrigation with 17% ethylenediaminetetraacetic acid and saline, induction of apical bleeding and blood clot formation, and coronal seal with mineral trioxide aggregate. Patient was recalled at every 3 months and response checked as the tooth remained asymptomatic. At 18 months' follow-up, intraoral periapical radiography radiograph was taken to evaluate the revascularization procedure. The periapical radiolucency was healed and root closure began to appear. Increased thickness of root width was also found. Although revascularization shows clinically acceptable results, care should be taken to achieve proper disinfection of canals and regular follow-up to improve long-term efficacy and new approaches.
  162 12 -
ORIGINAL ARTICLES
Assessment of c-reactive protein level in oral submucous fibrosis and oral squamous cell carcinoma patient
Geeta Sharma, Randhir Kumar, Sharib Abdus Salam, Prashant Bhasin, Nishant Kumar Tewari, Suman Yadav
June 2021, 13(5):748-750
DOI:10.4103/jpbs.JPBS_607_20  
Background: Potentially malignant disorders are highly prevalent in India. In this study, we assessed C-reactive protein (CRP) levels in patients with oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC). Methodology: Sixty-four patients (OSMF and OSCC) were undertaken and were classified into 3 groups, OSMF patients (Group I, 34), OSCC (Group II, 30), and healthy controls (Group III, 26). Immunoturbidimetry method was used for the estimation of CRP levels. Results: Maximum cases in Group I was seen in the age group 40–60 years (males-10, females-3), Group II in the age group 40–60 years (males-11, females-5) and Group III (males-5, females-6). The mean CRP level in Group I was 6.12 ± 4.5 mg/l, in Group II was 28.4 ± 21.5 mg/l, and in Group III was 3.15 ± 2.19 mg/l. The difference was significant (P < 0.05). Conclusion: Authors found that OSMF and oral cancer patients had increased CRP levels as compared to healthy subjects.
  164 10 -
Stature estimation of an individual using nasal, facial, and palatal height among Tamil Nadu population
J Dinakaran, P Hariganesgh, S Shamala, K Dhivya, V Saranya, M Saranya
June 2021, 13(5):751-756
DOI:10.4103/jpbs.JPBS_595_20  
Background: Stature estimation in human identification has a significant forensic importance. The stature correlates positively with bones or human body parts. Measurements of various body parts such as the arm, leg, feet, and finger can be used to estimate stature. This study is done to correlate the stature of person with facial, nasal, and palatal height among Tamil Nadu population. Aim and Objective: The aim and objective was to determine an individual's stature using facial, nasal, and palatal height and to find out the most reliable parameter to determine the stature of the person. Materials and Methods: Anthropometer, Vernier caliper, and palatometer were used for the analysis. The initial pilot study included 20 individuals. The representative study included 100 individuals of age 21–25 years. (Group 1 – males, Group 2 – females). Values of the three parameters (nasal, facial, and palatal) are calculated and related to that of the person's stature. Results: The quantitative data collected from the subjects are studied using (Pearson correlation) statistical analysis. The quantitative data availed from nasal height were found to be more reliable compared to the other two data in stature prediction. Correlation between stature and nasal height shows a significant positive correlation among the female group (2) with (P– value = 0.57). Conclusion: This study may play a significant role in case of human identification immediately after mass disasters and certain criminal investigations. Further studies with larger samples may produce more reliable values.
  166 8 -
Impact of noise in operating theater: A surgeon's and anesthesiologist's perspective
Pritika Srivastava, Premalatha Shetty, Sameep Shetty, Madhusudan Upadya, Aditya Nandan
June 2021, 13(5):711-715
DOI:10.4103/jpbs.JPBS_656_20  
Background and Aims: Noise is often considered as an undesirable sound. Excess noise is a health threat that deteriorates one's concentration and communication. Noise in the operating theater can be disturbing, impairs communication, and can lead to stress. The aim of this survey was to assimilate information about the perspective of surgeons and anesthesiologists regarding noise in the operating theater and whether it affects their work atmosphere. Methods: A questionnaire consisting of 15 closed-ended questions excluding one open-ended question was given to surgeons from various specialties and anesthesiologists. The subjective response were analyzed and documented. Data analysis was done using descriptive statistics. Association was found out using Chi-square test. Results: We collected a total of 290 responses, of which 87.6% (n = 254) considered noise to increase the stress level and deteriorates the quality of teamwork (83.8%, n = 243). Noise affects communication among the staff (86.2%, n = 250) and decreases their concentration level (85.5%, n = 248) which could be harmful in view of the patient's safety. 87.9% (n = 255) of the participants were in favor of limiting the number of people in the operating theater. Nonetheless, 73% (n = 211) considered music has a calming effect and were in favor of music in the operating theater. Conclusion: Noise in the operating theater can have distressing effects on surgeons, jeopardizing the patient's safety. However, a flip side to this is that music is considered to have a calming and soothing effect decreasing the anxiety and stress levels.
  166 8 -
Prevalence and risk factors for oral potentially malignant disorders in Indian population
Amit Kumar Singh, Rashi Chauhan, Kumar Anand, Manisha Singh, Somesh Ranjan Das, Amitabh Kumar Sinha
June 2021, 13(5):398-401
DOI:10.4103/jpbs.JPBS_751_20  
Background: The present study was conducted to assess risk factors and prevalence of potentially malignant disorders (PMDs) among Indian population. Materials and Methods: 1280 Indian population of both genders were enrolled. Habits such as smoking bidi, cigarette, consumption of tobacco such as in the form of zarda, chaini khaini, pan masala, arecanut, and alcohol were recorded. Risk factors and prevalence rate of disorders were recorded. Results: There were 750 (58.6%) males and 530 (41.4%) females. Speckled leukoplakia was seen among 470 (36.7%), oral lichen planus (OLP) in 246 (19.2%), oral submucous fibrosis (OSMF) in 274 (21.4%), erythroplakia in 120 (9.3%), and oral squamous cell carcinoma (OSCC) in 107 (8.3%) participants. Maximum cases of speckled leukoplakia (162) was seen in the age group of 31–40 years, OLP (99) in 41–50 years, OSMF (95) in 31–40 years, erythroplakia (48) in 21–30 years, OSCC (44) in 41–50 years. Conclusion: Risks factors associated with PMDs were found to be tobacco and arecanut. There was higher prevalence of leukoplakia. Age group of 31–40 years had higher cases and most common site was buccal mucosa and vestibule.
  162 11 -
Self-reported knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia – A cross-sectional study
Khalid Gufran, Khalid Muslih Alanazi, Abdulrhman Khalid Alanazi, Abdulmajeed Saeed Alqwiri, Faiz Mohammed Alsubaie, Nawaf Munawir Alotaibi
June 2021, 13(5):280-283
DOI:10.4103/jpbs.JPBS_737_20  
Background: Periodontal disease is a common pathological oral ailment which affects the supporting structures of the teeth. Dental plaque is one of the major causes for gingivitis and periodontitis. If left untreated, this will lead to tooth loss. Studies have shown that oral prophylaxis will reduce gingival and periodontal inflammation by removing the plaque in all the surfaces. The objective was to assess knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia. Methodology: A descriptive study was conducted among people using questionnaire. Results: 96% of the subjects brushed their teeth with brush and paste. 59% of the study subjects had knowledge regarding interdental aids, whereas only 15% of them practiced it. 72% of the people mentioned that dentists gave information regarding interdental aids. Conclusions: Among the study subjects, even though there were deficits in few areas, overall knowledge about interdental aids was good and it increased with increasing level of education.
  162 11 -
Comparative evaluation of surface detail reproduction and dimensional stability of poly ether, vinyl siloxane, and vinyl siloxane ether impression materials: An In vitro study
Shyma Rose, Shyammohan Aravindakshan, Jafar Abdulla Mohamed Usman, Raza Mohamed, Sheethel Menon, Rahmath Shameem Shafiullah, Mahmoud Gamal Salloum
June 2021, 13(5):851-856
DOI:10.4103/jpbs.JPBS_819_20  
Introduction: Impression making is an integral part of prosthetic dentistry. Development of material science has allowed integrating qualities of hydrophilic polyether and hydrophobic polyvinyl siloxane into a newer hybrid material, vinyl polysiloxane (VPS) ether. This study was aimed to compare the VPS ether with the polyether and polyvinyl siloxane in terms of accuracy and dimensional stability. Materials and Methods: Stainless steel dies with the American Dental Association specification 19 were made. Die has three horizontal and two vertical lines which are used for taking the impression. Two cross-points at the junction of the vertical lines with line 2 were marked as x and x' and served as beginning and end points of measurements for dimensional accuracy. Accuracy was evaluated 30 min after making each impression. If at least two of the three horizontal lines were reproduced continuously between cross-points, this impression was considered satisfactory. The specimens are poured with Type IV gypsum product and allowed to set completely for 24 h. Then, dimensional stability was measured in the model by measuring the distance between the two lines and comparing the distance with the measurement of line on metal die, which was used to make the impression. Results: The mean value obtained for light- and medium-bodied VPS ether was 0.05370 and 0.05330 and for light and medium-bodied polyvinyl siloxane was 0.06370 and 0.07150, respectively. The mean value for polyether monophase was 0.06430. Two-way ANOVA and post hoc test showed statistical significance. Conclusion: The newer VPS ether material showed good surface detail reproduction and dimensional stability when compared with polyvinyl siloxane and polyether.
  158 14 -
Clinico-cytological study of fungal elements in the buccal smears of prediabetic, diabetic, and nondiabetic individuals in association with burning sensation
C Divyadharshini, R Sathya, Gururaj Narayana Rao, J Beryl Rachel, BS Harishini, T Divyna Daniel
June 2021, 13(5):84-87
DOI:10.4103/jpbs.JPBS_558_20  
Introduction: Diabetes mellitus is a metabolic disorder that may have profound effects on oral mucosa being prone to infections, particularly candidiasis. In healthy individuals, the candida is a commensal, but in diabetic patients, it forms severe colonization, even in the absence of any clinically evident lesion and may cause a burning sensation of the mouth. This study aims to identify the presence or absence of fungal elements in buccal smears of nondiabetic, prediabetic, and diabetic individuals and to correlate the presence or absence of burning sensation in the oral cavity. Materials and Methods: A total of ninety individuals were selected for the study and divided into Group 1 – thirty cases of diabetics, Group 2 – thirty cases of prediabetic patients, and Group 3 – thirty cases of nondiabetic individuals. Detailed case history and thorough intra and extraoral examination were recorded. The buccal smears were cultured in Sabouraud dextrose agar, subcultured in HiCrome™ agar, observed for the colonies of fungal elements, and were analyzed for species differentiation. Results: There was a positive correlation between the presence of fungal elements and burning sensation in diabetic individuals, whereas it was not the case in the nondiabetic and prediabetic individuals. Conclusion: Candida colonization is one among a factor in diabetic individuals related with burning sensation of the mouth.
  162 9 -
Association of dental neglect scale and severity of dental caries among nursing students: A cross-sectional study
S Athira, Chitra Girija Vallabhan, Sujith Sivarajan, C Dithi, PJ Swathy Anand, Thara Chandran
June 2021, 13(5):812-816
DOI:10.4103/jpbs.JPBS_766_20  
Aims: The aim of this study is to assess the utilization of available dental services and home dental care practices in a sample of nursing students and to seek out the correlation if any, between the Dental Neglect Scale (DNS) scores and severity of dental caries. Subjects and Methods: The study was conducted among 630 nursing students aged 18–21 years from the area of South Bangalore. The study was cross-sectional in design and a convenience sampling method was adopted to get the desired sample size. A prestructured questionnaire was administered to the students in their classrooms. Following this, a brief oral examination was conducted using mouth mirror and light for the detection of any visible carious lesions. Results: The dental attendance variable was found to be significantly associated with the DNS scores (P < 0.001). The DNS scores were significantly higher (P < 0.001) among those who had visible caries than those who do not. A very good correlation was obtained between scores of DNS and the caries severity (P < 0.001, r = 0.773). Conclusions: The DNS can be a very good predictor of the dental attendance pattern as well as clinically assessed severity of carious lesions.
  158 13 -
Assessment of effect of fixed orthodontic treatment on gingival health: An observational study
Vasu Kumar, Purushottam Singh, Vishal Kumar Arora, Sukhpreet Kaur, Sahil Sarin, Harmeet Singh
June 2021, 13(5):425-428
DOI:10.4103/jpbs.JPBS_589_20  
Background: Prime components of fixed orthodontic treatments decrease the self-cleansing ability of the tongue and the cheeks leading to an increase in production of bacterial plaque. Hence, the present study was undertaken for assessing the effect of fixed orthodontic treatment on gingival health. Materials and Methods: A total of 120 patients who were scheduled orthodontic treatment were enrolled. Complete data records of all the patients were recorded. Intra- and extraoral radiographs were obtained and photographic records were noted in separate pro forma. Complete intraoral examination of all the patients was carried out for recording visible plaque, any inflammation (visible clinically), and gingival recession. Based on the assessment of gingival texture and capillary transparency, analysis of gingival biotype was done. Follow-up records were assessed. Results: The mean visible plaque value before treatment and after treatment was found to be 3.11 and 5.81, respectively. The mean visible inflammation value before treatment and after treatment was found to be 2.89 and 15.43, respectively. The mean gingival recession score value before treatment and after treatment was found to be 0.19 and 0.383, respectively. A significant increase in the visible plaque value, visible inflammation value, and gingival recession score was observed posttreatment. While comparing the gingival biotype, it was seen that in both the maxillary and mandibular arches, there was an increase in the thick gingival biotype while there was a decrease in thin maxillary biotype. Conclusion: There is a significant increase in plaque accumulation, inflammation, and gingival recession following fixed orthodontic treatment. Hence, during the course of orthodontic treatment, regular oral prophylaxis should be done.
  160 11 -
Assessment of separation impact and perception of discomfort on various orthodontic separators: A comparative clinical study
Shaheen Vilayil Shamsuddin, Sami Alshahrani, George Sam, Sumaya Yousuf Jeri, Sriram Kirti Ranjan Bhuyan, Deviprasad Mahanta
June 2021, 13(5):642-645
DOI:10.4103/jpbs.JPBS_765_20  
Aim: This study aimed to evaluate the extent of separation and perception of pain and discomfort with the use of three different orthodontic separators. Materials and Methods: A total of sixty participants (26 males and 34 females) aged between 18 and 25 years were enrolled in this study. Participants were divided into three experimental groups: Group I: elastomeric separator, Group II: Dumbbell separators, and Group III: Kesling Separators. All the participants were asked to revisit 24 h after separator placement, and the effect of separation obtained by three different types of separators was measured. The space generated between premolars and molars was recorded separately on days 1, 3, and 7. The visual analog scales were used to assess pain. Results: The mean age in Dumbbell separators group was slightly more (23.32 ± 2.28) compared to Kesling Separators and Elastomeric separator group (22.46 ± 1.20 and 21.10 ± 1.19 years, respectively). The extent of separation on days 1, 3, and 7 was more in Group II study participants (0.20 ± 0.02, 0.32 ± 0.05, and 0.48 ± 0.07 mm, respectively) compared to other groups. A statistically significant (P = 0.022) difference was noted on day 7 in terms of no pain being recorded more in Group II participants, followed next by Groups III and I. Conclusion: This study concluded that the Dumbbell separators produce acceptable separation with negligible pain and discomfort when compared to elastomeric separators and Kesling separators.
  162 9 -
Assessment of marginal integrity and color stability of provisional restoration fabricated from different autopolymerizing acrylic resins – A comparative study
Mohamed Usman Jafar Abdulla, Mohammed Hussain Dafer Al Wadei, Mohamed Abd-Ellatif El-Patal, George Sam, Yousef H Abokhlifa, Ashutosh Thorat
June 2021, 13(5):616-619
DOI:10.4103/jpbs.JPBS_617_20  
Aim: The present study is aimed to assess the marginal integrity and color stability of provisional restorations fabricated from different autopolymerizing acrylic resins. Materials and Methods: Totally, 60 provisional crowns were fabricated. A mandibular first molar artificial typodont was mounted on a base of dental stone. The mandibular first molar which was mounted was prepared for full cast crown, using the tooth preparation standard principles with shoulder finish line of 1 mm and taper 6°. There were 20 samples in each acrylic resin group: Group I: Polyvinyl-ethyl methacrylate resin, Group II: Autopolymerizing bis-acrylic material, and Group III: Polymethyl methacrylate (PMMA) autopolymerizing resin. Crowns were verified for marginal adaptation using stereomicroscope at a ×40. The color stability was measured using spectrophotometer poststaining period. Results: Autopolymerizing bis-acrylic material group showed minimum mean vertical marginal discrepancy (128.68 ± 18.036 μm) followed by PMMA autopolymerizing resin group (147.49 ± 20.128 μm) and polyvinyl-ethyl methacrylate resin group (172.89 ± 22.118 μm). Analysis of variance demonstrated a statistically significant difference between different autopolymerizing acrylic resins. The color change values did not show any significant difference between the groups on numerous comparisons between different autopolymerizing acrylic resin groups. A statistically significant difference was seen between Groups I and II, Groups I and III, and Groups II and III (P < 0.05). Conclusion: This study concluded that the autopolymerizing bis-acrylic material demonstrated significantly improved marginal integrity when compared to PMMA autopolymerizing resin and polyvinyl-ethyl methacrylate resin.
  160 10 -
Relation between childhood asthma and dental erosion in Al-Kharj Region of Saudi Arabia: A cross-sectional study
Abdulfatah Alazmah
June 2021, 13(5):293-296
DOI:10.4103/jpbs.JPBS_779_20  
Background: Asthma is a long-lasting disease that affects large number of the society and could impact on the oral health leading to increase in the needs of prevention and treatment. Currently, the prevalence of childhood asthma in Saudi Arabia is ranging from 9% to 33%. Objective: the objective was to evaluate dental erosion in control children and those with asthma. Materials and Methods: This was a cross-sectional study, with a sample of 100 children aged 3–12 years. Equally distribution of subjects was between the asthmatic and non-asthmatic group, at Prince Sattam Bin Abdulaziz University Dental Clinics, Alkharj, Saudi Arabia. The assessment consisted of an oral examination assessing erosive wear according to the American Academy of Pediatrics 2018 guidelines and a questionnaire to the parents/guardians addressing the background details and information about the child asthma. Results: Among 12 (24%) asthmatic children and 9 (18%) non-asthmatic children had dental erosion. In the adjusted analysis, no association was found between asthma and erosion. It has been shown that oral hygiene may have an effect occurrence or severity of erosion; brushing teeth once or more per day appeared to have less incidence of dental erosion compared with those not brushing their teeth regularly. Conclusions: This article provided no additional data than that given earlier, where no correlation was observed between asthma and dental erosion in children aged from 3 to 12 years.
  162 8 -
Relationship between body mass index and dental caries in 13–15-year-old school children of government and private schools in Bengaluru City
V Syamkumar, Arun Jacob Thomas, Sajna Oommen, S Aswin, PJ Swathy Anand, V Mathew
June 2021, 13(5):841-845
DOI:10.4103/jpbs.JPBS_824_20  
Aims: The aim of the study was to assess the correlation between body mass index (BMI) and dental caries of 13–15-years-old school children in urban Bangalore and to compare the correlation between BMI and dental decay amongst government and private school children of age group 13–15 years in Bangalore city. Subjects and Methods: A total of 660 students 13–15 years old were inducted in the study. According to these, 330 students from government schools and 330 students from private schools were examined. A specially designed structured questionnaire was used for compilation of data in the survey. BMI for age percentiles was deducted by weight in kilogram divided by height in meter square. Results: Overall a positive correlation was found between Decayed, Missing, and Filled Teeth DMFT and BMI. In government schools, Overweight children had more mean DMFT (1.43) than other BMI categories while in Private schools, At risk of overweight children had more mean DMFT (1.4) than other category of BMI children. Conclusions: A positive correlation was found between DMFT and BMI. In government schools, Overweight children had more mean DMFT than other BMI category while in Private schools, At risk of overweight children had more mean DMFT than other category children.
  158 12 -
Evaluation of healing of periapical tissue in permanent incisors with open apices after unintentional extrusion of mineral trioxide aggregate – A retrospective study
Sonali Roy, Archana Kumari, Praveen Chandra, Ritika Agarwal, Pinki Bankoti, Farah Ahmed
June 2021, 13(5):97-100
DOI:10.4103/jpbs.JPBS_570_20  
Aim: The aim of the present study was to retrospectively assess the healing of periapical lesions in permanent central incisors with open apices after unintentional extrusion of mineral trioxide aggregate (MTA). Materials and Methods: The clinical and radiographic records of 75 maxillary permanent central teeth treated by MTA apexification were evaluated. Teeth with unintentionally extruded MTA formed the study group (Group 1, n = 28), whereas the teeth with no MTA extrusion formed the control group (Group 2, n = 47). For both the groups, the records were analyzed for a follow-up period of 3 years. Results: Complete healing (CH) was observed in 25 teeth in the study group, whereas all the teeth in the control group showed CH (P > 0.05). Within the study group, 6 teeth (21%) showed CH in the 6th month in Group 1, whereas in the control group, 34 teeth (72.3%) showed CH (P < 0.001). At the 1-year follow-up appointment, 19 teeth (67.8%) showed CH in Group 1, whereas 9 teeth (19.1%) showed the same result in Group 2 (P < 0.001). At the end of the 3-year follow-up period, it was noticed that in 21 (84%) teeth, extruded MTA remained unchanged, whereas it was reduced in 4 (16%) of them (P < 0.001). Conclusion: Extrusion of MTA does not have a significant effect on the healing of the periapical lesion. However, it may lead to a delay in the healing of periapical healing. Patients should be informed about the complication and consequences of extruded MTA and should be kept on follow-up to observe periapical healing.
  160 10 -
Assessment of levels of plasma oxidative stress in patient having aggressive periodontitis before and after full mouth disinfection
Sachin Bhagat, Parthivi Singh, Anuj Singh Parihar, Gurpreet Kaur, Harsh Takkar, Rathi Rela
June 2021, 13(5):432-435
DOI:10.4103/jpbs.JPBS_599_20  
Aim: The primary purpose of the study was to evaluate the levels of oxidative stress in plasma in patients with aggressive periodontitis (AgP) before and after full-mouth disinfection. Materials and Methods: Twenty-five healthy controls and 25 participants with aggressive periodontal were assessed for plaque index, probing pocket depth, papillary bleeding index, and clinical attachment level. Periodontal bone support was assessed by taking full mouth periapical radiographs. Full-mouth disinfection of the patient was done within 24 h of clinical assessment of AgP. These parameters were assessed at the baseline and after 8 weeks of initial periodontal therapy. Plasma samples were taken and evaluated for various oxidative stress markers. Results: Strong positive correlation was observed among periodontal parameters and levels of enzymatic/nonenzymatic biomarkers for oxidative stress (thiobarbituric acid-reactive substances [TBARS], glutathione peroxidase [GPX], and catalase [CAT]) (P < 0.05), before and after periodontal management. The patients with AgP had high levels of TBARS, GPX, and CAT levels in the plasma matched to the healthy individuals (P < 0.05). Conclusion: Enzymatic and nonenzymatic oxidative stress may have a role in the pathogenesis AP. Initial periodontal treatment can lead to the reduction of these stresses.
  158 10 -
Influence of occlusal bite forces on teeth with altered periodontal support: A three-dimensional finite element stress analysis
Richa Agrawal, Sumit Narang, Hina Ahmed, Shyam Prasad, Shyamsunder Reddy, Shivaramakrishna Aila
June 2021, 13(5):688-691
DOI:10.4103/jpbs.JPBS_785_20  
Background: Masticatory forces generate various degrees of stress and strain in the periodontium of teeth which determine the clinical functions and load-bearing capacity of the teeth. There are few in vitro studies that have analyzed stress generated due to combined forces acting on the teeth. Thus, the objective of the present study was to do a comparative analysis of the influence of various stresses on the periodontal ligament and alveolar bone of maxillary central incisor with normal bone height and reduced bone height under simulated standard masticatory using finite element stress analysis. Methodology: A 3D model of the tooth was obtained with the help of ANSYS software. These models were subjected to various oblique forces, i.e., 100N and 235.9N, applied at 45° angle on the lingual surface of the maxillary central incisor and stress values were recorded in three dimensions. The results from FE analysis were analyzed using 3D Von Mises Criteria. Results: It was observed that in healthy periodontium; it was observed that among the periodontal structure studied, the maximum stress levels were exerted on root followed by cortical bone, cancellous bone, and PDL, irrespective of the force, as compared to the diseased periodontium, in which the bone height was reduced, the maximum stresses were on root followed by cortical bone, PDL, and cancellous bone. Conclusion: The main factor governing the success of any periodontal procedure depends on the height of the remaining bone and the amount of force exerted on to the tooth and the stress generated within the tooth. The finite element method could be of substantial importance in this respect as it can assess the stresses of various occlusal forces on the periodontal ligament, root, cortical bone, and cancellous bone of teeth in a periodontally healthy and diseased state.
  156 11 -
Knowledge and apprehension of dental health professionals pertaining to COVID in Southern India: A questionnaire study
Izna , Venkata Krishna Sasank Kuntamukkula, Shilpa Sunil Khanna, Onkar Salokhe, Rahul Vinay Chandra Tiwari, Heena Tiwari
June 2021, 13(5):448-451
DOI:10.4103/jpbs.JPBS_551_20  
Aim: This study was intended to evaluate the knowledge and apprehension of dental health professionals pertaining to COVID-19. Materials and Methods: In this cross-sectional survey, a self-administered questionnaire survey was used to validate the dental health professional's knowledge and apprehension pertaining to COVID-19. In this regard, a preliminary study with a convenience sample of 124 dentists working in various clinics in southern India was conducted so as to evaluate the knowledge and apprehension of dentists related to COVID-19 in India. This study, while limited in sample size, benefits the general practitioners as target readers to assess the awareness pertaining to COVID-19. Results: The results of this study reveal that there exists a good knowledge among dental health professionals pertaining to the COVID-19 virus and its oral manifestations in addition to the precautions to be taken for the prevention of COVID-19 in a clinical setup. However, there exists an apprehension as well as lack of awareness pertaining to the laboratory test to be carried out in a patient suspected with COVID-19 infections as well as the role of a mouthwash and the management of contaminated air in the dental clinic. Conclusion: The results elicited that there is a dearth of knowledge and relatively a fair apprehension among dental health professionals pertaining to COVID-19.
  152 14 -
CASE REPORTS
Esthetic root coverage by subepithelial connective tissue graft with management of repeated rupture of palatal arterial bleeding: A rare case report
Archana Agroya, Shilpa Sunil Khanna, Parul Chhabra, Ami Mayurkumar Sheth, Naresh Vattikunta, Navneet Kaur
June 2021, 13(5):861-864
DOI:10.4103/jpbs.JPBS_550_20  
Nowadays, patients are much concerned about esthetics of the oro-facial region. Gingival recession is considered as one of the major esthetic problems creating complex situations by compromising oral esthetics. This can be treated successfully by means of several mucogingival surgical procedures which can be used to accomplish satisfactory root coverage without any loss of interdental soft- and hard-tissue height. Grafts are also very useful in such scenarios. Our case reports the connective tissue graft technique used in the treatment of gingival recession. The objective of this case was to evaluate the efficacy of connective tissue graft (CTG) and also to mention the management of complications on the donor site.
  154 11 -
ORIGINAL ARTICLES
Microwave-based rapid tissue processing technique: A novel aid in histopathologic laboratory
Pallavi Mishra, Alokenath Bandyopadhyay, Harish Kumar, Kailash Chandra Dash, Lipsa Bhuyan, Abikshyeet Panda
June 2021, 13(5):566-570
DOI:10.4103/jpbs.JPBS_561_20  
Introduction: Conventional tissue processing takes a lot of time, but microwave processing method though rapid, its quality of tissue texture and staining properties is still questionable. Therefore, we conducted this study to find out the reliability of histological sections in the microwave method. Aim and Objectives: The aim is to assess whether microwave tissue processing, which is a rapid technique, is comparable to conventional tissue processing in terms of quality and reliability of histological sections. Materials and Methods: A total of 80 formalin-fixed tissue samples were taken and were divided into two pieces. One subjected to conventional tissue processing and the other subjected to microwave tissue processing. The slides were coded and evaluated by three independent observers using various parameters. All the data were subjected to Chi-square test. Results: Both the process did not differ in their efficiency in overall nuclear details, overall cytoplasmic detail, occurrence of artifact and tissue architecture, nuclear staining, cytoplasmic staining, and red blood cell staining. Although the other observers did not find any statistical significance, according to observer 3, conventional processing proved to have marginally significantly better epithelial connective tissue interface than microwave processing (P = 0.047). Conclusion: The microwave method of tissue processing is an economical procedure which reduces the obnoxious chemicals as well as the turnaround time.
  156 9 -
Evaluation of dental status in relation to excessive horizontal and vertical overlap in North Indian population
Anil Raj, Ravi Ranjan, Amit Kumar, Mukesh Kumar, Nutan Mala, Kumar Ramesh
June 2021, 13(5):276-279
DOI:10.4103/jpbs.JPBS_731_20  
Introduction: Tooth wear (attrition) is a multifactorial entity, the pathogenesis of which involves many factors but the role of malocclusion cannot be undermined. Overjet and overbite play an important role in defining occlusion, hence they should also play an important role in causing attrition. Objectives: This study aims to evaluate the relationship of dental health status between the vertical and horizontal overlap. Materials and Methods: This study was conducted on 600 patients selected randomly from rural population which were divided into three equal groups as per the predefined criteria, namely, horizontal overlap, vertical overlap, and control group. All patients were examined for the tooth attrition. Results: In Group 1 – 73 patients out of 200 showed one or more teeth attrition, in Group 2 – 38 patients out of 200 showed one or more teeth attrition, and in the control group, 22 patients out of 200 showed one or more teeth attrition. Conclusion: It was concluded that both vertical and horizontal abnormal relationships of teeth play an important role in the etiology of attrition, with abnormal horizontal overlap being the more detrimental as compared to the vertical one.
  152 12 -
Assessment of prevalence of dental caries among school-going children: A cross-sectional study
Iqbal Singh, Kanwalpreet Kaur, Samisha Narang, Saurabh Yadav, Sukhpreet Kaur, Neha Verma Singh
June 2021, 13(5):333-335
DOI:10.4103/jpbs.JPBS_575_20  
Background: The background of the study was to assess the prevalence of dental caries among school-going children. Materials and Methods: Six thousand eight hundred and ninety school-going children was enrolled. General clinical examination was carried out. Mouth mirror, probe, and explorer were used for carrying out the clinical examination. Over a time span of 6 months, the entire study was completed. All the examiners who performed clinical examination underwent a single-day training program for detecting dental caries. All the participants were seated on straight wooden chairs and were examined clinically. The prevalence of caries was recorded. Results: The prevalence was 26.02%. Among these children with dental caries, 50.25% of the children belonged to the age group of 13–15 years, while the remaining 49.75% of the children belonged to the age group of 9–12 years. Prevalence of dental caries was significantly higher in females (71.11%) in comparison to males. Furthermore, dental caries was significantly more prevalent among participants with toothbrushing frequency of less than once a day (51.20%). Conclusion: There is an imperative need for intimating health check-up camps among school-going children.
  150 14 -
Analysis of age and gender-related changes in gingival width in patients of known population: A scross-sectional study
Vaishali Gandhi, Purushottam Singh, Rimjhim Bakshi, Ravpreet Singh, Ritesh Sood, Arundeep S Brar
June 2021, 13(5):436-439
DOI:10.4103/jpbs.JPBS_584_20  
Aims: The present study was conducted for analyzing age and gender-related alterations in gingival width (GW) in patients of known population. Materials and Methods: Two hundred and ten healthy participants were enrolled in the present research. All the participants were divided into the following study groups with seventy participants in each group based on their age: adolescents, young adults, and older adults. All the participants were recalled and oral and periodontal examination was carried out using mouth mirror, probe, and explorer. Lidocaine spray was used for anesthetizing the anterior gingival region. A probe was used for assessing the width of the gingiva, in which and rubber stopper was fitted. In all the six maxillary anterior and mandibular anterior teeth, the width and thickness of the attached gingivae were assessed. All the measurements were recorded and analyzed. Results: Mean width of the attached gingiva in the maxillary arch in adolescents, young adults, and older adults were found to be 2.51 mm, 2.93 mm, and 3.92 mm, respectively. Mean width of the attached gingiva in the mandibular arch in adolescents, young adults, and older adults were found to be 1.76 mm, 2.39 mm, and 3.19 mm, respectively. Significant results were observed while comparing the GW among participants divided on the basis of age group. Nonsignificant results were observed while comparing the GW among participants divided on the basis of gender. Conclusion: There is a significant enhancement of GW with the advancement of age in both the maxillary arch and mandibular arch.
  154 9 -
Factors influencing clinical after effects of post orthognathic surgery - An observational clinical study
Saba Nasreen, Mohammed Saif Tagala, Sandeep Kumar Samal, Abhinav Raj Gupta, Ram Prasad Sah, Debarshi Bhattacharjee
June 2021, 13(5):492-495
DOI:10.4103/jpbs.JPBS_728_20  
Background: For maintaining the occlusion, screws to anchor bones are needed to be used in transalveolar manner to get the intermaxillary fixation in participants with no preoperative orthodontic treatment or participants with loose or broken appliances. Aims: The present clinical trial was hence aimed to assess the postoperative complications following orthognathic surgical repair of skeletal malocclusion. Materials and Methods: Forty-two participants were divided into two groups (n = 22). In Group I, predrill was done to create the holes in transalveolar position before screw insertion. For Group II, self-cutting screws were used without the drills. The radiographs were then taken to assess the associated root injuries. To evaluate the effect of different steroid doses on the pain, nerve healing, and swelling, the participants were divided into three groups (n = 14). Plate removal and associated factors were also evaluated. Collected data were statistically analyzed. Results: In Group where no predrill was done, no root injuries were seen. Considerably less facial edema was observed in Group II and III compared to control Group I. This difference was statistically significant with a P value of 0.2057. At 1 week, 3 months, and 6-month postoperatively in Group II and Group III, no significant difference was seen. No significant difference in the postoperative pain between the groups was seen (P = 0.85103). Neurosensory Visual Analog Score measurement revealed no significant difference between three groups at 6 months with the P value of 0.81821. Conclusion: The present study concludes that risk for the root injury is possessed by the screws that require predrill, whereas the self-drilling screws had no risk for root injury.
  152 10 -
Awareness and knowledge about sugar substitutes among population in Riyadh Region
Inderjit Murugendrappa Gowdar, Bader Khalid Aljuaid, Abdulilah Ibrahim Almasaad, Mohammed Abdullah Bamuqadm, Tariq Ahmed Alfaifi, Abdulmalik Abdullah Alhoti
June 2021, 13(5):263-267
DOI:10.4103/jpbs.JPBS_725_20  
Background: The food we consume will have sugar in one or the other form, which is not ideal for our teeth. This can be replaced by the use of sugar substitutes available in the market. Sugar substitutes have beneficial and adverse effects on health. In spite of their beneficial effects, long-term use of sugar substitutes is not recommended because of their health-related complications. Therefore, before consuming any sugar substitutes, everyone needs to know about both health benefits and their health hazards; hence, the present study was designed to assess the awareness, knowledge, and utilization of sugar substitutes among the general population in Riyadh Region, Kingdom of Saudi Arabia. Objectives: The aim is to assess the awareness and knowledge about sugar substitutes. Methodology: Questionnaire consisting of demographic details, awareness, and knowledge about sugar substitutes were sent through social media and it was in the Arabic and English Language. After completing the questionnaire, participants are requested to send the link to their friends and relatives. Results: About 60.20% of participants were aware of sugar substitutes. Statistically significant difference was observed for gender and awareness of sugar substitutes (P < 0.05). About 31.5% of the participants are of the view that sugar substitutes have got side effects. About 61.9% of participants are of the view that Sugar substitute reduces the chance of occurrence of dental caries. Conclusions: Overall, 60.2% of study participants were aware of sugar substitutes, but the controversy on most of the artificial sweeteners cannot be ignored. Hence, the safety of these sweeteners is of prime importance for scientists. Any usage of sugar substitutes should be weighed against the adverse effects.
  150 12 -
Comparative evaluation of changes in microflora in delayed and immediate implant placement: An In vivo study
Shivendra Choudhary, Neeraj Verma, Santosh Anand, Abhishek Sinha, Daya Shankar
June 2021, 13(5):105-108
DOI:10.4103/jpbs.JPBS_572_20  
Aim: This study is aimed to compare and evaluate the changes in the microflora in immediate and delayed placed implants. Materials and Methods: In this study, the implant site sample was taken and assessed during different phases of treatment for delayed and immediate implants. They were looked for Streptococcus, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, and Fusobacterium nucleatum. Results: The results showed that Streptococci were found in a higher number in all the phases of the treatment. The presence of pathogenic organisms such as P. gingivalis and Fusobacterium, in considerable amounts, was seen in both the groups. Conclusion: Thus, we conclude that implant mode of placement, delayed or immediate placement does not alter the flora of the oral cavity. Organisms present remains the same in all the phase of the treatment. To prevent the disease, one must continuously monitor the implant, with the increasing age changes, the microflora is continually changing in the oral cavity. The periodontal health should be assessed before the placement of the implant, followed by follow-ups after a set period for a better prognosis.
  152 10 -
Anaesthetic efficacy of lidocaine and articaine in inferior alveolar nerve block combined with buccal infiltration in patients with irreversible pulpitis
Shrimanikandan Ayappa Gandhi, Sambarta Das, Abhisek Das, Yoshaskam Agnihotri, Rajanna Venkatraman Mohan, Venkata Ramanan Dasu Subramanian
June 2021, 13(5):731-734
DOI:10.4103/jpbs.JPBS_747_20  
Purpose: This prospective, randomized, double-blinded study was conducted to compare the anesthetic efficacy of 2% lidocaine with 1:200,000 epinephrine and 4% articaine with 1:200,000 epinephrine in inferior alveolar nerve block (IANB) combined with buccal infiltration in patients with irreversible pulpitis. Methods: Group I: Thirty patients received IANB of 2% lidocaine without buccal infiltration. Group II: Thirty patients received IANB of 2% lidocaine followed by buccal infiltration with 2% lidocaine. Group III: Thirty patients received IANB with 4% articaine followed by buccal infiltration with 4% articaine. Pain during the procedures was recorded by using a Heft Parker visual analog scale. No pain or mild pain on endodontic access was recorded as success and analyzed using Chi-square analysis. Results: Group I obtained 30% success rate. Fifty percent successful anesthesia was obtained for Group II. The success rate was increased to 70% for Group III with statistically significant difference among all the groups (P < 0.05). Conclusion: The use of 4% articaine as both IANB and buccal infiltration recorded the highest success rate (70%) when compared to either 2% lidocaine as IANB with buccal infiltration (50%) or 2% lidocaine as IANB alone (30%) in patients with irreversible pulpitis.
  154 8 -
Comparative study of tooth size and arch dimensions in class I crowded, proclined malocclusion and class I normal occlusion
Dhayanithi Devakrishnan, Vimala Gnansambandam, Saravanan Kandasamy, Nagalakshmi Sengottuvel, Preethi Kumaragurubaran, Maivizhi Rajasekaran
June 2021, 13(5):783-787
DOI:10.4103/jpbs.JPBS_781_20  
Aim: The objectives are to compare the extent and to find whether it is arch dimension or tooth size that contributes to a greater extent to malocclusions such as dental crowding and proclination. Materials and Methods: A total of 90 pretreatment models were selected and divided into three groups, namely uncrowded (Group-A), crowded (Group B), and proclination (Group-C). Measurements obtained were: (1) The largest mesiodistal width of each tooth on each arch (except the second and third molars), (2) Buccal inter-canine and inter-molar widths, (3) Lingual inter-canine and inter-molar widths, (4) Arch perimeters, and (5) Arch length. Results: The mesiodistal teeth dimensions were higher in crowded and proclination group. Both inter canine width and inter molar width of maxilla were reduced in crowded group. Maxillary and mandibular arch perimeter and arch lengths were higher proclination group.
  150 11 -
Synthesis and characterization of a ring-opening oxaspiro comonomer by a novel catalytic method for denture base resins
Ranganathan Ajay, Vikraman Rakshagan, Rajamani Ganeshkumar, Elumalai Ambedkar, Shafiullah RahmathShameem, Kanagesan Praveena
June 2021, 13(5):521-526
DOI:10.4103/jpbs.JPBS_524_20  
Background: 3,9-Dimethylene-1,5,7,11-tetraoxaspiro[5,5]undecane (DMTOSU) is a double ring-opening monomer that exhibits expansion upon polymerization and may be used as a denture base resin's comonomer to offset or minimize polymerization shrinkage. It's synthesis by transesterification reaction (TE) catalyzed by distannoxane is not reported in the literature. The synthesis became the prime concern because this monomer is hardly available commercially. Purpose: The purpose is to confirm the DMTOSU synthesis and compare the synthesized monomers obtained by two different catalytic processes through Fourier transform infrared (FTIR) and nuclear magnetic resonance (NMR) spectroscopies. Materials and Methods: Scheme I synthesis was by TE catalyzed by dichlorotetrabutyl distannoxane (DCBS) yielding M1 monomer. Scheme II synthesis was catalyzed by dibutyltin oxide-carbon disulfide (DBTO-CS2) yielding M2 monomer. Results: The appearance of a characteristic peak at 1212 cm−1 in FTIR spectrum, a doublet at δ 4.95 in 1H-NMR spectrum and a peak at δ 117.12 in 13C-NMR spectrum confirmed the synthesis of DMTOSU-M1catalyzed by DCBS, which is not significantly different from DMTOSU-M2 catalyzed by DBTO-CS2. Conclusion: The catalytic action of DCBS is a successful alternative to the DBTO-CS2 catalysis in DMTOSU synthesis.
  148 13 -
Oral health status of Down's syndrome patients in Aseer, Saudi Arabia
NC Sandeepa, Sara Ali Al Hagbani, Fatmah Abdulrahman Alhammad, Amal Saeed Al Shahrani, Sara Eid Al Asmari
June 2021, 13(5):656-659
DOI:10.4103/jpbs.JPBS_593_20  
Introduction: It was observed that compared to the general population, mentally challenged subjects have higher rates of poor oral hygiene. Gingivitis is a common finding with moderate or severe variety reported most commonly. Periodontal disease is the most significant oral health problem, which can even lead to mobility of tooth and tooth loss. It is essential to generate oral health precautionary agendas and familiarize it with them. Materials and Methods: Four Centres of rehabilitation in the Aseer region of Saudi Arabia were included and subjects of 3–24 year age group was examined. Written informed consent was obtained from directors of Centres. Caries, oral hygiene status, soft-tissue and hard-tissue lesions were evaluated and statistically analyzed. Results: Higher Decayed, Missing and Filled Teeth score was observed in the present study in contrast to many other studies. Periodontal disease was seen in higher age group with higher percentages. Poor oral hygiene was seen in 27.3% of males and 66.7% of females. Tongue lesions comprised 85.7%, which accounted for the major part of soft-tissue abnormality. Various occlusal abnormalities (75%) and developmental tooth disturbances (53.6%) constitute the higher portion in hard-tissue abnormality. Conclusion: Dentists should be conscious of the range of oral anomalies that can manifest in this group of the patients. The microbial or serological investigation was not done which could have explained the etiology behind these lesions. In spite of these confines, the survey result have provided information regarding the oral health status of Down's syndrome subjects and the necessity of focusing on oral health need.
  152 8 -
To compare and analyze the potency of two topical anesthetic gels in reducing inferior alveolar injection pain in children of 8–12 years: A double-blinded clinical trial
Dharati Patel, Banibrata Lahiri, Mohamed Abd-Ellatif El-Patal, Abdulfatah Alazmah, Parth Patel, Yousef H Abokhlifa
June 2021, 13(5):646-650
DOI:10.4103/jpbs.JPBS_772_20  
Aim: To compare and analyze the clinical adequacy of two topical anesthetic gels, Precaine (8% lidocaine + 0.8% dibucaine) and Precaine B (20% benzocaine) in children before intraoral local anesthetic injections. Materials and Methods: This clinical study included thirty children who needed an inferior alveolar nerve block. They were divided into three groups: Group A: Precaine topical gel group, Group B: Precaine B topical gel Group, Group C: no anesthetic topical gel group (control group). These two effective topical gels were applied before giving intraoral local anesthesia, and afterward, the child's pain response was surveyed utilizing the Wong-Baker Faces Pain Rating Scale. The scores obtained were subjected to statistical analysis. Results: Intergroup comparison showed a significant mean difference between the control group and Precaine group (P > 0.05) as well as Precaine B group (P > 0.05). However, there is no significant difference obtained between Group A and Group B (P < 0.05). Conclusion: It is psychologically and clinically beneficial to apply a topical anesthetic agent before injecting any intraoral anesthesia. In this study, both anesthetic gels showed a nonsignificant difference in reducing inferior alveolar injection pain, but Precaine B shows more promising results than Precaine.
  150 9 -
Cementum malformations-diagnostic dilemma: Study in Western Maharashtra Population
Prashant Punde, Ashutosh Jaysing Thorat, Aditya Gopinath Jangam, Narne Raja Subhash, Shaista Haleem, Ashvini Kishor Vadane
June 2021, 13(5):620-623
DOI:10.4103/jpbs.JPBS_625_20  
Aim: The present study was study to observe incidence of cemental malformations related to mandibular molar roots. Materials and Methods: All cases requiring radiographs of mandibular molars reporting to author during 2011–2019 were included in this study. Mandibular molars had been observed for any radiographic malformations. Any such alterations were noted. Results: Author has screened about 522 intraoral periapical radiographs in this study. A total of 63 cases of root malformations reported with two cases of cementoma were observed in this study. Both these cases were diagnosed as benign cementoblastoma (BC) on excisional biopsy. Conclusion: In this study, we have observed that incidence of cemental malformations is 1.2% and of BC is 0.38% as compared to overall incidence of 1%–6% in Western Maharashtra.
  148 11 -
Evaluation of inhibitory effect of self-etch adhesives incorporated with proanthocyanidin on cysteine cathepsins present in dentin hybrid layer using gelatin zymography: An In vitro study
Arun Senthamilselvan, Kaarunya Ravikumar, DY Mallikarjunan, Thendral Annadurai, Mothiraj Samynathan, R Jeya Varshini
June 2021, 13(5):516-520
DOI:10.4103/jpbs.JPBS_535_20  
Aim: The aim of the study is to evaluate the inhibitory effect of single-bottle and two-bottle self-etch adhesive system after surface pretreatment with 6.5% proanthocyanidin (PA) on cysteine cathepsins (CCs) present in dentin hybrid layer using gelatin zymography. Materials and Methods: Thirty-five samples of dentin measuring 3 mm × 3 mm were obtained from 35 caries-free human third molars which were divided into seven groups. The bonded specimens were cut vertically into 1 mm thick adhesive/dentin interfaces with microtome and were pulverized into powder and subjected to zymography analysis for enzymatic activity. Results: Group VI and VII which were positive control groups had shown thicker clear bands of 50 kDa. Group IV and V which had the administration of chlorhexidine showed thicker clear bands of 50 kDa which indicated slight activity of CCs. Group II in which PA used along with single-bottle system also showed thicker clear band of 59 kDa. CCs could be active due to strong acidic nature of monomer in this group. Group III in which PA used along with two bottle system had no band formation where there is crosslinking of catalytic and allosteric domains of enzymes by PA. Conclusion: Under the limitations of this study, PA proved as a non-specific natural inhibitor of CCs. Two-bottle system showed inhibition of CCs and single bottle system failed to inhibit their activity. Future research have to be done on the bond strength and durability of self-etch adhesives after using PA and its effect on long term survival of the restorations.
  146 12 -
Effect of food colorants on color of denture base acrylic resins
Sunil Kumar Vaddamanu, Rajesh Vyas, Sourav Kumar Pati, Radhika Thakkar, Amit Kumar, Bhumika Kamal Badiyani
June 2021, 13(5):664-666
DOI:10.4103/jpbs.JPBS_759_20  
Background: Acrylic resin has been successfully used for complete denture fabrication for many years. Color stability is very crucial clinical properties for dental materials, and color change may be an indicator of aging or damaging of materials. Aim and Objectives: This study has been designed to determine the color stability of heat cure denture base acrylic resins in commonly consumed solutions causing stains. Methodology: Four hundred disc samples of four commercially used heat cure denture base resins (Trevalon®, DPI®, Veracril®, and Pyrax®) were fabricated (100 in each group). These were checked for any change in optical density by immersing them in four different staining solutions (tea, coffee, turmeric, and betel leaf, i.e., paan) and synthetic saliva for 1-month synthetic saliva was taken as control. The denture cleansers were also evaluated for their efficacy determined by their ability to remove the stains caused by the staining solutions. Results: It was observed that Trevalon® showed least change in optical density and coffee illustrated the maximum potential for staining the denture base resins and is the most difficult to be removed using a denture cleanser. Conclusion: It can be concluded that Trevalon® demonstrated maximum color stability. Among the staining solutions, coffee caused maximum stains.
  148 9 -
Evaluation of bone regeneration around implants with and without flap elevation
Sachin Sinha, Santosh Kumar, Priyanshu Ranjan Sonoo, Utkarsh Kumar, Rohit Siddhartha, Sanjay Kumar Singh
June 2021, 13(5):699-705
DOI:10.4103/jpbs.JPBS_691_20  
Background: The aim of this study is to clinically evaluate and compare the clinical success and the relative bone healing of the implants which are placed using a flapless procedure and compare it to those placed by the conventional flap technique. Materials and Methods: This study was conducted with ten patients that were randomly divided into two groups. Group A included patients with immediately placed implants after extraction with flap elevation. Group B included patients with immediately placed implants after extraction without any flap elevation. The clinical parameters recorded were Plaque index, Modified Gingival Index, Early Wound Healing Index, Buser's criteria, Distance between implant shoulder and the crestal bone (DIB), and Radiographic Examination in a standardized manner to evaluate changes for the DIB values. Results: There was an improvement in Plaque Score from baseline to 1 month and baseline to abutment placement (6 months), which was statistically significant, but the plaque score from 3 months to abutment placement (6 months) was statistically nonsignificant in both the group. There was an increase in modified gingival score from baseline to 3 months, baseline to abutment placement (6 months), and 3 months to abutment placement (6 months), which was statistically significant in both the groups. The DIB scores in Group A recorded at baseline to 6 months were 2.80 ± 0.57 and 1.90 ± 0.42, respectively, showing a mean difference of −0.90 and P = 0.001 in comparison. Whereas, the DIB scores in Group B at baseline to 6 months were 3.20 ± 0.57 and 2.50 ± 0.50, respectively, showing a mean difference of −0.70 and P = 0.001 in comparison. The DIC scores in Group A at baseline to 6 months were 1.60 ± 0.54 and 0.00 ± 0.00, respectively, showing a mean difference of −1.60 and P = 0.003 in comparison, Whereas the DIC scores in Group B at baseline to 6 months were 1.40 ± 0.54 and 0.00 ± 0.00, respectively, showing a mean difference of −1.40 and P = 0.005 in comparison. Conclusion: Implants placed in fresh extraction sockets with and without mucoperiosteal flap elevation can be successfully done with augmentation procedures. Short-term survival rates and clinical outcomes of both groups were similar and appeared to be predictable treatment modalities.
  146 10 -
CASE REPORTS
Cerebriform Tongue
Vini Rajeev, Sulphi Abdul Basheer, Mutassim Elnager, A Kaneesh Karthik, A Senthilnathan Radhakrishnan
June 2021, 13(5):868-870
DOI:10.4103/jpbs.JPBS_628_20  
Cerebriform tongue (CT) is diagnosed to be a benign clinical condition that is characterized by grooves on the dorsal surface of the tongue and referred with other terminologies such as the scrotal tongue, grooved tongue, lingua fissurata, and lingua plicata which can be chronic trauma, vitamin deficiencies, and probably not a developmental malformation. The incidence of this condition was predominant among males and found to be higher with increasing age. It is very rarely observed in children. It is usually painless and sometimes food debris accumulation can irritate. CT has been reported with the association of various systemic factors and syndromes. A case of a 62-year-old male with CT is presented along with the review of the literature.
  144 10 -
ORIGINAL ARTICLES
Effect of conventional periodontal treatment (Scaling and Root Planing) on Type-2 diabetic patient with moderate generalized chronic periodontitis: A clinical study
Sachin Sinha, Priyanshu Ranjan Sonoo, Rohit Siddhartha, Sanjay Kumar Singh, Anjali Singh
June 2021, 13(5):706-710
DOI:10.4103/jpbs.JPBS_692_20  
Background: The aim is to assess the effect of periodontal therapy and scaling and root planing (SRP) on the metabolic control in Type 2 diabetes mellitus (DM) patients with chronic periodontitis based on the estimation of glycated hemoglobin (HbA1c). Materials and Methods: A prospective, comparative, clinical study was performed on 50 patients suffering from Type 2 DM with moderate, generalized chronic periodontitis. Type 2 moderately controlled diabetic patients with HbA1c values within the range of 6%–8% were selected. The parameters recorded were gingival index, plaque index, sulcus bleeding index, probing pocket depth, clinical attachment level, and HbA1c. The recordings were done at baseline and 6 months after SRP procedures. Results: Reductions in all the clinical parameters were observed and were found to be statistically significant (P < 0.05). Conclusion: SRP resulted in a statistically significant reduction in the clinical parameters and HbA1c. Hence, periodontal treatment should be included in the management of diabetic patients.
  143 9 -
Reliability of modified hertels exophthalmometer as an intraoperative tool for assessment of relative globe position in orbital/zygomatic fracture
Abinaya Subramanian, K Santhosh Kumar, GV V. Giri, C Ravindran, Emmanuel Azariah, Madhumita Ramakrishnan
June 2021, 13(5):716-720
DOI:10.4103/jpbs.JPBS_594_20  
Introduction: Axial globe position assessment is commonly carried out with Hertels Exophthalmometer. Hertels requires an intact lateral orbital rim for its placement, which is often fractured in zygomatic fractures. Hence, to overcome this problem, we have modified the instrument for its application in zygomatic/orbital fractures. Reliability of this Modified Hertels Exopthalmometer has been already validated in normal healthy patients. Therefore, the aim of this study is to assess the efficacy of the Modified Hertels Exophthalmometer in pateints with zygomatic/orbital fracture. Materials and Methods: This is a prospective study carried out between April 2015 and October 2017, including 20 patients with a mean age of 34 years. Enophthalmos was measured using Modified Hertels in patients with unilateral orbital/zygomatic fracture indicated for surgical intervention by a single observer. The data was collected and statistically analyzed. Paired sample t-test was done to compare the preoperative exophthalmometer reading with readings at different time points. Results: A statistically significant difference was noted (P = 0.031) among the variables of Modified Hertels. We believe this instrument to be of practical use in the assessment of enophthalmos/exophthalmos in patients with lateral orbital trauma, surgery or disease and also precludes the use of rim-based exophthalmometry and other modifications of same.
  140 12 -
Evaluation of tensile bonding strength of permanent soft relining material to denture base acrylic resin after erbium:Yttrium–Aluminum–Garnet laser treatment – An in vitro study
Vinutha Varadharaju Kumari, Ramesh K Nadiger, Sami Aldhuwayhi, Saquib Ahmed Shaikh, Angel Mary Joseph, Mohammed Ziauddeen Mustafa
June 2021, 13(5):660-663
DOI:10.4103/jpbs.JPBS_583_20  
Purpose: The purpose of the study was to assess the effectiveness of erbium:yttrium–aluminum–garnet (Er:YAG) laser surface pretreatment at various pulse durations of exposure on increasing the tensile bonding strength of permanent soft relining material and acrylic resin. Materials and Methods: Polymethyl methacrylate resin samples were fabricated and grouped as comparison group (no laser surface pretreatment) and three test groups (received Er:YAG laser surface pretreatment at various pulse durations of 10 s, 20 s, and 30 s) for bonding with the permanent soft relining material, Molloplast B. Following the surface pretreatment, the samples were tested for tensile stress using a universal testing machine. Loads at the point of failure were noted and the tensile bond strength values were obtained. Parametric tests of one-way-ANOVA and Tukey's post hoc tests were done. Results: The highest tensile bonding strength was recorded in Group C, and the control group recorded the lowest bonding strength. Conclusion: Er:YAG laser surface pretreatment at 10 Hz, 3 W, and 300 mJ for 30 s improved the bonding strength of the permanent soft relining material to heat-processed acrylic resin material.
  144 8 -
Assessing the articular eminence asymmetry in dentate, partially edentulous and edentulous patients using cone-beam ct
Mushtaq Kose Hamza, Abhinethra Mariyappa Shantha, Deepak Timmasandra Ashwathappa, Shobha Rajanna, Arun Khondapura Puttegowda
June 2021, 13(5):667-671
DOI:10.4103/jpbs.JPBS_685_20  
Background and Objectives: The relationship between the articular eminence (AE) inclination and masticatory system in the biomechanics of temporomandibular joint (TMJ) is defined by the degree with normal values of 30°–60° obtained between the posterior wall of the AE and a horizontal reference plane. The purpose of this study was to assess the asymmetry of the AE in dentate, partially edentulous, and edentulous patients using cone-beam computed tomography (CBCT) imaging and to compare the determined asymmetry in the dentulous with partially and completely edentulous patients. Materials and Methods: CBCT images of 120 TMJ joints in sixty patients were evaluated. AE inclination and height values were traced on the central sagittal slice of right and left TMJ. The patients were grouped as dentate, partially edentulous, and edentulous with an age range of 20–80 years. Statistical analysis included student's paired and independent t-test, analysis of variance, and Tukey's post hoc test, and P < 0.05 was considered statistically significant. Results: AE inclination revealed highest value in dentate patients (60.98 ± 5.42) followed by partially edentulous (53.40 ± 7.91) and lowest in the edentulous patients (51.43 ± 3.63). P < 0.001 was statistically significant between these groups. Conclusion: The results obtained in the present study showed steep inclination of AE in dentate followed by partially edentulous and edentulous subjects. No significant differences among the age, gender, and sides were found.
  142 8 -
An In vitro study to assess the effectiveness of the shear bond strength of mineral trioxide aggregate with different adhesive systems
Abdulelah Sameer Sindi
June 2021, 13(5):672-675
DOI:10.4103/jpbs.JPBS_689_20  
Purpose of the Study: Mineral trioxide aggregate (MTA) is a biocompatible material and has excellent sealing ability. It is proved and claimed that it provides double seal due to its physical sealing ability as well as ability to induce cementogenesis that provides biological seal. Aim and Objectives: The aim of the study was to assess the shear bond strength of MTA with three different types of adhesive systems: (1) self-adhering flowable composite, (2) etch and rinse (ER) adhesive system, and (3) self-etch (SE) adhesive system. Materials and Methods: Ninety MTA specimens were prepared using cylindrical acrylic blocks, having a central cavity with 2 mm depth and 4 mm diameter. MTA was mixed and placed in the prepared cavity and was covered with moist cotton pellet and temporary filling material (Cavit). They were further divided into three groups which were further divided into two subgroups. After the bonding agents was applied, the composite resin was placed over the MTA surface. The specimens were then tested for shear bond strength; statically analysis was done. Result: After 24 h, the mean value of ER group was found to be significantly higher than SE and the self-adhering composite groups. Among the 45 min groups, there was no significant difference observed. Conclusion: In single visit, after 45 min, self-adhering flowable can be used successfully as a final restorative material in place of conventional flowable composite without using any alternative adhesive system over MTA.
  140 10 -
In vivo comparison of crestal bone heights following implant placement with “Flapless” and “Flap” techniques in the sites of early loaded implants
Suhani Kukreja Pahuja, Pooja Negi, Anjali Singh, Gangesh Bahadur Singh, Deepa Rayast, Manisha Minz
June 2021, 13(5):370-374
DOI:10.4103/jpbs.JPBS_580_20  
Purpose: The purpose was to evaluate the difference in crestal bone loss (CBL) around implants with flap and flapless methods followed by early loading. Materials and Methods: Twenty implants were placed in twenty patients – ten using flap and ten using flapless techniques. The difference in CBL was measured on standardized digital periapical radiograph taken at 0 week, 6 weeks, 12 weeks, and 6 months. Results: The present study showed the mean CBL on proximal surfaces when evaluated at intervals of 0 week, 6 weeks, 12 weeks, and 6 months for flapless method was significantly lower than with flap method the values of which were +0.07 mm against +0.26 mm on mesial side and +0.15 mm against +0.33 mm on distal side at 6 months. Conclusion: The flapless approach is a predictable procedure when patient selection and surgical technique are appropriate, and results in lesser CBL.
  140 10 -
Assessment of pattern of oral prosthetic treatment and prevalence of oral diseases in edentulous patients in North Indian Population: A cross-sectional study
Ashish Kumar, Ravinder S Saini, Vikas Sharma, Roshni U Rai, Prahlad Gupta, Preeti Sabharwal
June 2021, 13(5):187-189
DOI:10.4103/jpbs.JPBS_648_20  
Background: The present study was undertaken for assessing the pattern of oral prosthetic treatment and prevalence of dental diseases in edentulous patients in North Indian population. Materials and Methods: A survey was carried out in North Indian population, and screening of the edentulous patients was done. Five hundred edentulous patients were enrolled. Complete oral and general examination was carried out. Pro forma was framed, and clinical details were recorded. Using mouth mirror and explorer, complete oral examination was carried out. Demographic profile was also evaluated. Prosthetic rehabilitation pattern of all the participants was also recorded. Results: Complete removable denture and removable partial denture were method of rehabilitation in 28% and 31% of the participants. Dental implant-supported complete denture was used in 8% of the patients, whereas dental implant-supported overdenture was used in 33% of the participants. Ulcerative lesions were present in 5% of the patients, whereas oral leukoplakia was present in 4% of the patients. Oral lichen planus and torus were present in 2% and 1% of the patients. Conclusion: Majority of the geriatric patients prefer having removable denture. Furthermore, due to nutritional deficiency associated with geriatric age, oral leukoplakia and ulcerative lesions are more common in them.
  136 10 -
Examining the effect of gravity on different irrigation systems: An In vitro study
Mohammed Hussain Dafer Al Wadei, Mohammed Abdul Kader, Ahmed Babiker Mohamed Ali, Wafa Hassan Alaajam, Shan Sainudeen, Saeed M AlQahtani
June 2021, 13(5):692-695
DOI:10.4103/jpbs.JPBS_813_20  
Background: Periapical extrusion is frequently observed during endodontic therapy. It can lead to acute injury of periapical tissues, resulting in interappointment pain or swelling. The effect is pronounced in teeth with immature apex, which are more susceptible to the extrusion of irrigant. The aim of this study was to evaluate the effect of gravity on the apical extrusion of irrigating solution with different irrigation protocols in single-rooted premolars. Methodology: A total number of 80 permanent single-rooted teeth (premolars) with same working length (WL) were divided into two main groups: Group A: Penetration depth of irrigation syringe to 2 mm from the WL and Group B: Penetration depth of irrigation syringe to 4 mm from the WL. Each group was subdivided into four subgroups. (n = 10). The extruded debris and irrigants were weighed, and the data were statistically analyzed by the analysis of variance and the Tukey test. Results: Irrespective of the irrigation technique used, the amount of irrigant extruded from the apex showed a statistically significant difference related to the effect of gravity (P < 0.05). There was no statistically significant difference observed between irrigation methods (P > 0.05). Conclusion: The degree of apical extrusion of irrigant was dependent on the type of irrigation technique and gravity. Greater caution should be taken during irrigation to prevent postoperative pain.
  136 10 -
Analysis of surface roughness and three-dimensional scanning topography of zirconia implants before and after photofunctionalization by atomic force microscopy: An In Vitro study
R Arun Jaikumar, Suma Karthigeyan, TR Ramesh Bhat, Madhulika Naidu, GR Praveen Raj, Senthil Natarajan
June 2021, 13(5):766-771
DOI:10.4103/jpbs.JPBS_724_20  
Aim: To analyze surface roughness and three-dimensional (3D) scanning topography parameters of zirconia implants before and after photofunctionalization by atomic force microscopy (AFM). Materials and Methods: Ten commercially available zirconia implants five each in the study and control group were taken. The study group was subjected to ultraviolet (UV) radiation for 48 h using the shorter wavelength of 254 nm. After washing all the implants with 70% alcohol and drying, 3D surface topography and roughness parameters were analyzed using CSC 17 probe AFM at three different magnifications 25 μm, 50 μm, and 80 μm, respectively. Results: The surface topography and calculated mean amplitude, spatial, and hybrid parameters of the study group were higher than the control group (P < 0.05) in all three magnifications. Up to scale depth and peak value for the study and control group were (−0.4–0.4: −2-1) (−0.75 to 0.6:−1–1.3) (−0.75-−0.5: −1.5-1.3) for the study and control group at 25, 50, and 80 μm magnification, respectively. This indicates that photofunctionalization increased surface roughness of Zirconia implants to desirable extent. Conclusion: There is a definite difference in the quantitative topographic characteristics with zirconia implants being microroughned after photofunctionalization (UV treatment).
  136 10 -
CASE REPORTS
A case of keloid
Venkataramana Vannala, Nazargi Mahabob, Senthilnathan Radhakrishnan, Sambavi Anbuselvan
June 2021, 13(5):871-874
DOI:10.4103/jpbs.JPBS_673_20  
Keloids are unorganized proliferation of fibrous tissue, usually arising from a site of injury, due to an aberrant healing process. Clinically, it presents as an ugly scar tissue on the skin and shows genetic predilection. They cause esthetic, physical, and psychological disturbances in the affected individuals. Such patients require special precautions during the normal surgical procedures. Keloid treatment is prone to a high degree of resistance and recurrence. In this article, one such a case is reported along with a review of the literature discussing the nature of the lesion, treatment options, and the recommended precautions.
  136 8 -
ORIGINAL ARTICLES
Assessment of fracture resistances of endodontically treated teeth filled with different root canal filling systems
Padma Chandra, Vishal Singh, Shelly Singh, Govind Nandkumar Agrawal, Amit Heda, Nikita Sureshkumar Patel
June 2021, 13(5):109-111
DOI:10.4103/jpbs.JPBS_573_20  
Background: The motive of endodontic therapy is cleaning, shaping, and subsequently obturation. This study assessed different root canal filling systems in terms of fracture resistances of endodontically treated teeth. Methodology: This study was conducted on eighty single-rooted permanent mandibular incisor teeth which were divided into five groups: Group I was negative control; Group II was positive control; Group III comprised of gutta-percha/AH Plus; Group IV comprised of Thermafil/AH Plus; and Group V Resilon/Epiphany SE. Universal testing machine measured fracture resistance. Results: The mean fracture resistance in Group I was 458.6 ± 112.4 N, in Group II was 214.8 ± 104.6 N, in Group III was 428.6 ± 108.2 N, in Group IV was 388.2 ± 126.2 N, and in Group V was 334.8 ± 102.7 N. The difference found to be statistically significant (P < 0.05). Intergroup comparison showed a statistically significant difference (P < 0.05) between Groups I-II, I-V, II-III, and II-IV. Conclusion: The authors found that lateral condensation performed with AH Plus sealer and gutta-percha and the Thermafil technique were the highest among all other methods.
  132 12 -
Assessment of knowledge, attitude, and practice about oral health in patients with cardiovascular diseases - An original study
Sai Prashanth Pinnamaneni, Shubham Kumar, Surbhi Abrol, Rajwinder Singh Brar, Prasad Anand Khudare, Nivedita Gautam
June 2021, 13(5):344-347
DOI:10.4103/jpbs.JPBS_733_20  
Background: Lack of exercise and change in diet habits and urbanization had led to the rapid increase in the case of cardiovascular diseases (CVDs). Study was conducted to assess knowledge, attitude, and practice (KAP) about oral health in patients with CVDs. Materials and Methods: This study was conducted among 172 CVDs patients. Oral health indices (OHIs) such as OHI, decay-missing-filled, and periodontal disease index were recorded. KAP components were categorized into poor, moderate, and good. Results: Out of 172 patients, males were 102 and females were 70, age group 30–60 years had 46 and >60 years had 126 patients. Thirty-four were illiterate, 72 had up to primary and 46 had up to secondary and 20 had degree, 104 were married and 68 were unmarried. Resident was urban in 110 and rural in 62 and financial status was very good in 26, good in 50, and moderate in 96. Females had higher KAP score than males; however, the difference was nonsignificant (P > 0.05). As the age advanced, KAP score increased (P < 0.05), patients living in urban area had significantly higher KAP score than living in rural area, and the difference was statistically significant (P < 0.05). Patients with very good financial status had significantly higher KAP score than living in rural area (P < 0.05). As the education level increased, KAP score increased, the difference was statistically significant (P < 0.05). Conclusion: Authors found that patients with CVDs had moderate knowledge and attitude, but the practice was poor. There is need to educate the people about the importance of oral hygiene and their subsequent effect on general body.
  126 16 -
A prospective study to assess the efficacy of 4% articaine, 0.5% bupivacaine and 2% lignocaine using a single buccal supraperiosteal injection for maxillary tooth extraction
Deepak Chandrasekaran, Ravindran Chinnaswami, K Shanthi, A Emmanuel Dhiravia Sargunam, K Santhosh Kumar, Tharini Satheesh
June 2021, 13(5):721-724
DOI:10.4103/jpbs.JPBS_659_20  
Introduction: The aim of this study was to demonstrate if articaine hydrochloride administered alone as a single buccal infiltration in maxillary tooth extraction can provide adequate palatal anesthesia as compared to buccal and palatal injection using lidocaine and bupivacaine. Materials and Methods: A prospective double-blinded trial was conducted on 150 patients who required maxillary tooth extraction. The patients were divided into three different groups consisting of 50 patients each. Each group was administered with 4% articaine into buccal vestibular mucosa of the tooth to be extracted, 2% lignocaine and 0.5% bupivacaine was injected into buccal and palatal side of the tooth to be extracted, respectively. Following the tooth extraction, all patients were asked to complete a 10-score Visual Analog Scale (VAS) and 5-score facial pain scale (FPS) to assess the pain on extraction. Results: According to the VAS and FPS scores, the pain on extraction between buccal infiltration of articaine and the routine buccal and palatal infiltration of lignocaine was statistically significant. Conclusion: The routine use of a palatal injection for extraction of maxillary teeth may not be required when articaine is used as a local anesthetic solution.
  128 14 -
Utility of Chitra–HASi granules in cystic defects of the maxillofacial region: A pilot study
Manikandhan Ramanathan, Raj Kumar Tiwari, Sunil Paramel Mohan, Dayasankar Prabhu Shankar, Ritvi K Bagadia, PR Harikrishna Varma, Francis Boniface Fernandez, S Suresh Babu
June 2021, 13(5):772-777
DOI:10.4103/jpbs.JPBS_816_20  
Background: Cystic defects that are critical sized or larger require bone replacement strategies. However, due to inherent disadvantages of the various types of grafts, none of the available materials are best suited for these defects. Among the alloplastic materials, hydroxyapatite (HA)-based grafts are the most popular, due to their osteoconductive nature and resemblance to mineral bone. The aim of the study was to assess the utility of the novel material “Chitra-HASi” as a bone substitute in the maxillofacial region. Materials and Methods: In a single-arm, prospective study, patients with radicular and dentigerous cysts were included and the minimum defect size was standardized at 20 × 20 mm or above. The Chitra–HASi material was developed by a wet precipitation technique and adopted for use following multiple in vitro and in vivo studies, confirming its safety and biocompatibility profile. All cysts underwent enucleation, followed by peripheral ostectomy and apicectomy of the teeth involved. The HASi graft was packed inside the cystic defect in a granular form and covered with a mucoperiosteal flap. Panoramic radiographs were taken preoperatively and at 3, 6, and 12 months postoperatively. Results: Twenty-three patients were included in the study, of which only 10 patients could be followed up for 12 months after graft placement. The mean preoperative bone density was found to be 14.9% ± 4.97 (standard deviation), whereas the postoperative 3-month, 6-month, and 12-month densities had a mean difference of −11.3%, −22.9%, and −37.3%, respectively, and the differences were statistically significant. Minor complications such as sinus formation (n = 7) and extrusion of granules (n = 4) were noted, which were managed conservatively. Only two patients required graft removal secondary to infection, leading to a persistent sinus tract. Conclusion: The results of the study suggest that Chitra–HASi granules show potential as an alternative to other bone substitutes. The addition of silica to the porous HA material offers superior strength characteristics and needs long-term evaluation to assess its stability in large cystic defects.
  124 13 -
Assessment of white spots with quantitative light-induced fluorescence in patients undergoing fixed orthodontics
Harshal Kumar, Kanchan Sharma, Archana Kumari, Sonakshi Singh, Mrinal Kumar Nandi, Kankana Lahiri Banerjee
June 2021, 13(5):312-314
DOI:10.4103/jpbs.JPBS_812_20  
Background: The present study determined white spots with the help of quantitative light-induced fluorescence (QLF) in patients undergoing fixed orthodontics. Materials and Methods: Sixty-four patients undergoing fixed orthodontics above 12 years underwent debonding, and the presence of carious lesion was assessed at baseline and after 6 weeks, 6 months, and 2 years. QLF images were taken with intraoral fluorescence camera. QLF images were examined visually for signs of demineralization, and scoring system was used. Results: It is found that there was fluorescence loss over a period of time. The median sum of fluorescence loss per patient was 55.6% and 29.2% and 101.4% at quartiles at baseline which changed to 51.2% and 26.5% at the first quartile and 101.4% at the second quartile. At 2 years, it was 43.7% and at the first quartile was 22.1% and at the second quartile was 99.1%. There was significant improvement at T2 (P < 0.05), however, between baseline and F1 and between F1 and F2, there was nonsignificant improvement (P > 0.05). The median value for total lesion area per patient was 3.6 mm2 with quartiles 1.2 mm2 and 8.2 mm2 at baseline, 2.6 mm2 with quartiles 0.7 mm2 and 6.3 mm2 at 6 weeks, 2.3 mm2 with quartiles 0.7 mm2 and 6.3 mm2 at 6 months, and 1.8 mm2 with quartiles 0.5 mm2 and 5.8 mm2 at 2 years which was statistically significant (P < 0.05). Conclusion: The authors found that white spots during fixed orthodontic treatment and after debonding is a common phenomenon. Although there was improvement in disappearance of these lesions, complete removal cannot be ensured.
  128 9 -
In vitro results of scanning technique on assessing cement thickness and interfacial nanoleakage of luted CAD/CAM-fabricated fiber posts
Sunil Kumar Vaddamanu, Rajesh Vyas, Shashit Shetty Bavabeedu, Suraj Arora, Bhumika Kamal Badiyani, Amit Kumar
June 2021, 13(5):676-678
DOI:10.4103/jpbs.JPBS_761_20  
Background: Fiber posts are broadly used due to their good esthetics and elasticity close to that of dentin, which allows for uniform stress distribution within a root and lowers the possibility of nonrestorable root fractures. Aim and Objectives: The study assessed the layer of cement thickness and interfacial nanoleakage of luted fiber posts which were fabricated with CAD/CAM technology following direct scanning of the post space (DS) method, scanning of a polyether impression of the post space (IS), and scanning of a plaster model of the post space (MS). Methodology: Ninety premolars were chosen randomly and were assigned to three groups according to the scanning technique. Posts were computer designed and milled from experimental fiber-reinforced composite blocks. Results: The mean and standard deviation values of cement thickness, respectively, were: DS 172 ± 39 = m; IS 199 ± 55 = m, and MS MPa 272 ± 81 = m. The fiber posts fabricated following DS technique demonstrated superior performance compared to posts fabricated upon IS and MS, in terms of the post retention. The cement thickness did not differ between DS and IS, whereas in MS group, the cement layer was significantly thicker than in the remaining two groups. The scanning technique did not influence the sealing ability, as all groups showed comparable nanoleakage. Conclusion: Fiber posts fabricated following DS technique demonstrated superior performance. Furthermore, scanning technique did not influence the sealing ability, as all groups showed comparable nanoleakage.
  122 10 -
The effects of various final irrigants on the bond strength of root dentin exposed to chloroform: An In vitro study
Feby Kuriakose, Basil Joy, Joy Mathew, Ranjith Karathodiyil, R Hariprasad, Teenu Philip
June 2021, 13(5):629-632
DOI:10.4103/jpbs.JPBS_555_20  
Aim: The aim of the study was to assess the reaction of different final irrigants to the bond strength of root dentin exposed to chloroform. Materials and Methods: Fifty extracted maxillary central incisors were selected. Working length was determined, and canal was instrumented with ProTaper rotary system (Dentsply Maillefer) till F4 file. The specimens were then divided into five groups (n = 10). Group 1: not disclosed to any root canal solvent, Group 2: disclosed to chloroform for 5 min, Group 3: chloroform for 5 min followed by absolute alcohol, Group 4: chloroform for 5 min followed by chlorhexidine (CHX), And Group 5 – chloroform for 5 min followed by saline. The canals were obturated with F4 gutta-percha cones with AH Plus sealer. The samples will be sectioned horizontally into 1 ± 0.1 mm thick slices. The push-out bond strength was performed in a universal testing machine. Results were statistically analyzed by one-way analysis of variance. Results: There existed a significant difference between the mean push-out bond strength of different groups. Irrigation with chloroform negatively affected the bonding between root canal sealer and root dentine. Absolute alcohol significantly improved the bond strength values. Conclusion: Exposure with chloroform during the retreatment will decrease the bonding between sealer (AH Plus) and root dentine. The use of absolute alcohol as a final irrigant improved the bonding between sealer and dentin. CHX and saline showed no improvement in bond strength.
  120 10 -
Oral health status and treatment needs of psychiatric outpatients aged 18-64 years in District Civil Hospital, Raichur, Karnataka: A cross-sectional study
Venkatesh Goud, Karthik Kannaiyan, Boinapelli Vengal Rao, Mohammed Abidullah, Veena Dharani, Madhukar Nayak
June 2021, 13(5):598-601
DOI:10.4103/jpbs.JPBS_776_20  
Background: Psychiatric patients or mentally ill patients conform a substantial section of the community deserving special attention. This study aimed to assess the oral health status and treatment needs of psychiatric patients attending District Civil Hospital, Raichur, Karnataka. Materials and Methods: The study group comprised 150 outpatients aged 18–64 years, attending the Department of Psychiatry, District Civil Hospital, Raichur. A specific questionnaire was drawn up and was used to record the demographic and medical data and oral hygiene practices. Type III clinical examination was carried out. The WHO Assessment Form 1997 was used to assess the oral health status of the study population. Results: Of the 150 patients examined, 90 (60%) were male and 60 (40%) were female. The mean age of the patients was 33.79 ± 10.57 years. The majority (52%) were diagnosed with epilepsy and 18% had anxiety disorder. The prevalence of caries was 87.3%. Periodontal status, according to the Community Periodontal Index scores, was as follows: 54% of the patients had shallow pocket (4 mm–5 mm) and 32% of the patients had 6-mm or more deep pocket. Conclusion: This study highlights a substantial need for prevention and treatment of oral health needs among psychiatric patients, and to increase awareness toward oral health.
  116 13 -
Analysis of geometric proportions on maxillary anterior teeth for esthetic smile design: An In vivo study
Pinky Varghese, Babu Cherian, Binsu Sukumaran, Sreena Anu, Basil M Jacob, Vighnesh Varma Raja
June 2021, 13(5):778-782
DOI:10.4103/jpbs.JPBS_808_20  
Background and Objectives: The maxillary central incisor is the dominant element of anterior dental composition and hence should be restored or replaced with proper proportion of width and length for better aesthetic results. However, the literature is not clear regarding verifiable guidelines for the determination of proportions of the teeth. The aim of this study was to investigate the existence and suitability of Golden Rectangle, Recurring Aesthetic Dental Proportion, and Golden percentage between the widths of maxillary anterior teeth in individuals with natural dentition, with the aid of digital photographs and computer analysis. Material and Methods: Frontal full-face digital photographs of the subjects (in smile) were made under standardized conditions using a digital camera and a tripod stand was used to place and orient the camera in the standardized position (camera was positioned 1 meter away from the patient; and the lens of the camera was adjusted at the patients' lip level). Imaging software (Adobe Photoshop CS5; Adobe Systems, Inc, San Jose, Calif.) was used to mark the anatomic landmarks and to digitally analyze the photograph. The entire process of proportion analysis was done by a single observer. Results: The RED proportion was not found to exist between the six maxillary anterior teeth. The values suggested in the golden percentage were not applicable on the subjects of this study. However, a slight modification of these percentages can be adopted taking into consideration the ethnicity differences of the subjects in this study. The values obtained were 24%, 15%, 11% in males and 23%, 15%, and 11% in females. Golden rectangle concept can be used for choosing dimensions of maxillary central incisors which are esthetically pleasing. Conclusion: RED proportion is an unsuitable methods to relate the successive widths of the maxillary anterior teeth. The golden percentage theory seems to be applicable to relate the successive widths of the maxillary anterior teeth if percentages are adjusted taking into consideration the ethnicity of the population. Golden rectangle concept is suitable for choosing dimensions of maxillary central incisors which are esthetically pleasing.
  120 8 -
Analysis of surface morphology and elemental composition on zirconia implants before and after photofunctionalization by scanning electron microscopy and energy dispersive X ray spectroscopy – An In vitro study
R Arun Jaikumar, Suma Karthigeyan, Ramesh Bhat, Madhulika Naidu, Senthilnathan Natarajan, Vignesswary Angamuthu
June 2021, 13(5):761-765
DOI:10.4103/jpbs.JPBS_716_20  
Background: The purpose of this study is to analyze the surface morphology and elemental composition of zirconia implants before and after photofunctionalization. Materials and Methods: Ten zirconia implants (white sky implant system– Bredent Company) five each in the study group and control group was taken. Study group samples were treated with ultraviolet light for 48 h. Microstructured surface of the study and control group blanks at abutment and thread regions were documented by Scanning Electron Microscope The semi-quantitative element composition was analyzed using Energy-dispersive X-ray (EDX) spectrum. Results: SEM images of the study and control group divulged a varied array of topographical configuration of the abutment area and thread region at different magnifications. At low magnification, both study and control group revealed plain compact surface and wavy porous area, whereas higher magnification showed dense grainy regions of various sizes and intensities disrupted by pores. EDX spectrum analysis for elemental composition showed increased oxygen concentration in the study group (42.8%) than the control group (29.09%), whereas carbon concentration was lower in photofunctionalized group (34.34%) than in the control group (45.41%). Conclusion: In zirconia implants, photofunctionalization is a viable method to effectively enhance the surface topography and hydrophilicity of bone-implant interface.
  118 8 -
Evaluation of central obesity, increased body mass index, and its relation to oropharyngeal airway space using lateral cephalogram in risk prediction of obstructive sleep apnea
Nanitha Lakshmi KavithaGiri, M Sudhaa Mani, S Yasmeen Ahamed, G Sivaraman
June 2021, 13(5):549-554
DOI:10.4103/jpbs.JPBS_566_20  
Introduction: Maxillofacial radiologists play a significant role in detecting airway changes using radiographic tools. Clinical examination parameters and lateral cephalogram parameters play a vital role in diagnosing obstructive sleep apnea (OSA) and dreadful consequences. Aim and Objectives: This study aims to evaluate central obesity, increased body mass index (BMI), and its relation to oropharyngeal airway space using lateral cephalogram in risk prediction of OSA. Objectives are to measure central obesity and BMI. Methodology: BMI is measured using World Health Organization guidelines to measure oropharyngeal airway space and the tongue and soft palate area using lateral cephalogram to predict OSA's risk using Berlin's questionnaire. Age group between 18 and 60 years with 20 individuals in each group will be present in the study. Conclusion: Cephalometric upper airway space and soft-tissue variables in different BMI groups were compared, and it was found that there was a decrease in SPAS, MAS with an increase in BMI, and in patients with BMI <24, there was narrower nasopharynx and oropharynx.
  116 10 -
Incidence and severity of postoperative pain following root canal treatment in nonvital pulps with hand and rotary instrumentation techniques in Chhattisgarh Population
Mahesh Motlani, P Krishna Prasad, Ramanpal Singh Makkad, Rashmi Nair, Saara Khiyani, Sushmita Batra
June 2021, 13(5):319-322
DOI:10.4103/jpbs.JPBS_711_20  
Aim: To evaluate the incidence and severity of postoperative pain following root canal treatment in nonvital pulps with hand and rotary instrumentation techniques in Chhattisgarh population. Materials and Methods: Sixty asymptomatic single-canaled nonvital teeth were selected and were divided into two groups of 30 each. Group I: 30 single-canalled teeth were treated in a single visit and prepared with hand file system. Group II: 30 single-canaled teeth treated in a single visit and prepared with K3-rotary file system. Group I and II were divided into two subgroups of 15 each (Group IA, IB and Group IIA, IIB) which were irrigated with 2% chlorhexidine and 5.25% sodium hypochlorite, respectively. The patients were recalled at 24, 48, and 72 h and at 1 week to record the incidence and severity of postoperative pain by using visual analog scale. Results: Results showed low incidence and severity of postoperative pain following a single-visit treatment with rotary instrumentation when compared to hand instrumentation technique. No statistical significant difference was observed between the groups at different time intervals, i.e., at 24, 48, and 72 h and at 1 week. The use of recent endodontic techniques and devices reduces the postoperative pain. Conclusions: Postoperative pain after root canal treatment ranged from mild to severe and it can happen even after high-standard root canal treatment. There is low incidence and severity of postoperative pain following a single-visit treatment with rotary instrumentation when compared to hand instrumentation technique.
  98 10 -
A confocal microscopic study on percentage penetration of different sealers into dentin
Vivian Flourish D'Costa, Amadeus Leroy Rodrigues, Madhu Keshava Bangera, Purnima A Bhat, Raunak Umesh Rai
June 2021, 13(5):725-730
DOI:10.4103/jpbs.JPBS_646_20  
Context: Three-dimensional seal of the root canal space has always been challenging. The incorporation of gutta-percha and sealer prevents microleakage by bacteria, ensuring a shielded root canal space. However, the penetration of sealer to various depths within the root canal has always been looked with curiosity. Aims: Thus, the present in vitro study was undertaken to evaluate the percentage and average depth of penetration of Endoflas F. S., AH Plus, and Epiphany sealers into dentinal tubules among the coronal, middle, and apical thirds of the roots following obturation with a lateral compaction technique using Confocal Laser Scanning Microscopy. Settings and Design: The study is an in vitro randomized control trial. Subjects and Methods: Thirty sound central incisors were decoronated at the level of the cementoenamel junction. Working length determination was done followed by a meticulous cleaning, shaping, and under copious irrigation. The teeth were then randomly divided into three groups: Endoflas FS sealer, AH Plus sealer, and Epiphany sealer. On fluorescence treatment, the teeth were sectioned at the midpoint of coronal, middle, and apical third of each root and viewed under confocal laser scanning microscope. Statistical Analysis Used: The results were analyzed using one-way ANOVA, and the significant difference between groups was analyzed with post hoc Tukey test. Results: Epiphany sealer provided with better percentage and depth penetration in comparison to Endoflas FS and AH Plus sealers. Furthermore, the coronal third of the root had better percentage and sealer penetration than the middle and apical thirds. Conclusions: Sealers tend to provide a firm bond between the tooth and the gutta-percha. They bind, lubricate, and seal the gutta-percha cones to fill the accessory canals. Within the limitations of this study, the superior flow and enhanced setting time Epihany sealers provide better percentage and depth of penetration than AH Plus and Endoflas FS.
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