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   2017| March-April  | Volume 14 | Issue 2  
    Online since May 8, 2017

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Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant
VK Prajapati, Ruchi Mitra, KM Vinayak
March-April 2017, 14(2):137-142
DOI:10.4103/1735-3327.205792  PMID:28584538
Background: Caries in second molar is common and prophylactic removal of the impacted teeth may be considered appropriate. Caries detection and restoration can be difficult and a restored second molar can undergo recurrent caries if the third molar is not removed prophylactically. In this study, the clinical findings related to impaction and its association with angular position and depth of impacted third molar were evaluated. Materials and Methods: A retrospective descriptive study was carried out among the patients visiting the outpatient, department of Dentistry, RIMS, Ranchi. The clinical examination, periapical radiographs and Pre-op OPG were taken. Teeth positions were analyzed by Pell and Gregory and Winter classification. The angulation and depth of mandibular third molar impaction and caries in the second molar with the eruption status of the mandibular third molar was determined. Results: A total of 200 patients were included in the study between age group 17-45 years. Majority of the Patients reported to the hospital with complaints of decayed tooth (66%) and pain (59%). The most common third molar impaction was mesioangular followed by distoangular. A statistically highly significant difference (P = 0.001) was obtained with the presence of caries in second molar adjacent to mesioangular third molar in class I and level B. Conclusion: According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients about the possibility of caries in relation to third molar mandibular impaction.
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The use of the digital smile design concept as an auxiliary tool in periodontal plastic surgery
Felipe Rychuv Santos, Stephanie Felice Kamarowski, Camilo Andres Villabona Lopez, Carmen Lucia Mueller Storrer, Alexandre Teixeira Neto, Tatiana Miranda Deliberador
March-April 2017, 14(2):158-161
DOI:10.4103/1735-3327.205791  PMID:28584541
Periodontal surgery associated with prior waxing, mock-up, and the use of digital tools to design the smile is the current trend of reverse planning in periodontal plastic surgery. The objective of this study is to report a surgical resolution of the gummy smile using a prior esthetic design with the use of digital tools. A digital smile design and mock-up were used for performing gingival recontouring surgery. The relationship between the facial and dental measures and the incisal plane with the horizontal facial plane of reference were evaluated. The relative dental height x width was measured, and the dental contour drawing was inserted. Complementary lines are drawn such as the gingival zenith, joining lines of the gingival and incisal battlements. The periodontal esthetic was improved according to the established design digital smile pattern. These results demonstrate the importance of surgical techniques and are well accepted by patients and are easy to perform for the professional. When properly planned, they provide the desired expectations. Periodontal Surgical procedures associated with the design digital smile facilitate the communication between the patient and the professional. It is, therefore, essential to demonstrate the reverse planning of the smile and periodontal parameters with approval by the patient to solve the esthetic problem.
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Impact of virtual microscopy with conventional microscopy on student learning in dental histology
Alka Harish Hande, Vidya K Lohe, Minal S Chaudhary, Madhuri N Gawande, Swati K Patil, Prajakta R Zade
March-April 2017, 14(2):111-116
DOI:10.4103/1735-3327.205788  PMID:28584534
Background: In dental histology, the assimilation of histological features of different dental hard and soft tissues is done by conventional microscopy. This traditional method of learning prevents the students from screening the entire slide and change of magnification. To address these drawbacks, modification in conventional microscopy has evolved and become motivation for changing the learning tool. Virtual microscopy is the technique in which there is complete digitization of the microscopic glass slide, which can be analyzed on a computer. This research is designed to evaluate the effectiveness of virtual microscopy with conventional microscopy on student learning in dental histology. Materials and Methods: A cohort of 105 students were included and randomized into three groups: A, B, and C. Group A students studied the microscopic features of oral histologic lesions by conventional microscopy, Group B by virtual microscopy, and Group C by both conventional and virtual microscopy. The students' understanding of the subject was evaluated by a prepared questionnaire. Results: The effectiveness of the study designs on knowledge gains and satisfaction levels was assessed by statistical assessment of differences in mean test scores. The difference in score between Groups A, B, and C at pre- and post-test was highly significant. This enhanced understanding of the subject may be due to benefits of using virtual microscopy in teaching histology. Conclusion: The augmentation of conventional microscopy with virtual microscopy shows enhancement of the understanding of the subject as compared to the use of conventional microscopy and virtual microscopy alone.
  1,130 107 -
Intraoral ancient schwannoma: A systematic review of the case reports
Jahanshah Salehinejad, Zahra Sahebnasagh, Shadi Saghafi, Zoha Sahebnasagh, Nafise Amiri
March-April 2017, 14(2):87-96
DOI:10.4103/1735-3327.205796  PMID:28584531
Intraoral ancient schwannoma is a rare type of oral schwannoma, which is encapsulated and well demarcated from the surrounding tissues. Ancient schwannomas are associated with conventional features of neurilemmoma; however, they are distinguished from other types of schwannoma due to factors such as the long history, cellular architecture showing hypocellularity, and hyalinized matrices. This systematic review was performed through searching in databases such as PubMed and Google Scholar using related keywords (intraoral, oral, ancient, schwannoma, and neurilemmoma). Eventually, 26 case reports were systematically reviewed by the researchers. Required data were extracted by one researcher, and all the selected articles were reviewed in full text after screening. This systematic review aimed to determine the most significant influential factors in intraoral ancient schwannoma and evaluate the diagnostic and therapeutic methods in this regard.
  1,090 104 -
Evaluation and comparison of efficacy of three desensitizing dentifrices on dentinal hypersensitivity and salivary biochemical characteristics: A randomized controlled trial
Deepthi Athuluru, Chandrasekhara Reddy, KM Sudhir, Krishna Kumar, Sreenivasulu Gomasani, Sreenivas Nagarakanti
March-April 2017, 14(2):150-157
DOI:10.4103/1735-3327.205785  PMID:28584540
Background: This study aimed to evaluate and compare the efficacy of three desensitizing dentifrices on dentinal hypersensitivity (DH) and salivary biochemical characteristics. Materials and Methods: A randomized, parallel arm, triple-blinded, clinical trial was conducted over a period of 12 weeks, with a total of three visits: baseline, 6 weeks, and 12 weeks. Calcium sodium phosphosilicate, potassium nitrate and amine fluoride dentifrices were compared. A total of 68 subjects who satisfied the inclusion criteria were included and randomly divided into four groups. Visual analog scale scores for controlled air stimulus were used to assess dentinal sensitivity and salivary pH and buffering capacity were recorded at baseline, 6 and 12 weeks. Results: All groups showed a reduction in sensitivity scores at 6 and 12 weeks. The calcium sodium phosphosilicate group showed a higher degree of effectiveness in reducing DH than potassium nitrate, amine fluoride dentifrices, and placebo for sensitivity measures. Salivary pH of calcium sodium phosphosilicate group was more toward neutral, and the buffering capacity of the same group showed significant changes from baseline to 6 and 12 weeks compared to the other groups. Conclusion: The desensitizing toothpaste containing calcium sodium phosphosilicate was found to be more effective in reducing DH and showed improvement in salivary biochemical characteristics over a period of 12 weeks compared to others.
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Histological and histomorphometric evaluation of the synthetic biomaterial Natix®in horizontal reconstruction of alveolar ridge
Javad Mehrani Sabet, Babak Amoian, Maryam Seyedmajidi
March-April 2017, 14(2):97-103
Background: Following loss of teeth, atrophy of alveolar ridge of the jaws is a substantial problem and unintended outcome that compels clinicians to perform bone reconstruction ahead of implant placement. Although autogenous bone is recommended as the gold standard in bone reconstruction, aninvasive second surgery harvestinga limited volume of bone (from intraoral source) has led a significant approachingthe use of synthetic bone substitute materials. The aim of this study was to evaluate the histologic and histomorphometric properties of porous titanium granules (Natix®) used in horizontal reconstruction of alveolar ridge before implant placement. Materials and Methods: In the present quasi-experimental clinical trial, four patients (three females and one male) needed horizontal bone augmentation on ten areas of edentulous mandibular ridge before implant treatment. During surgery, the buccal aspect of edentulous ridge was augmented by Natix®, covered by resorbable membrane (Cytoplast®). After 8 months, 10 core biopsies were obtained. Results: In histological study, no foreign body reaction at the site of the newly formed bone or around the biomaterial residue was observed. Newly formed bone was fully vital with large lacunae containing osteocytes. In 60% of cases, connective tissue was observed at the biomaterial – new bone interface. In histomorphometric study, mean percentage of bone formation was 40.56% ± 19.83% and mean bone trabecular thickness was 39.98 ± 17.54 μ. Conclusion: Despite acceptable histological and histomorphometric bone formation findings, in clinical terms, no increase was created in the horizontal dimension. Thus, it seems that application of this biomaterial in horizontal reconstruction of alveolar ridges with noncontained defects is inappropriate.
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An overview on autologous fibrin glue in bone tissue engineering of maxillofacial surgery
Azizollah Khodakaram-Tafti, Davood Mehrabani, Hanieh Shaterzadeh-Yazdi
March-April 2017, 14(2):79-86
DOI:10.4103/1735-3327.205789  PMID:28584530
The purpose of this review is to have an overview on the applications on the autologous fibrin glue as a bone graft substitute in maxillofacial injuries and defects. A search was conducted using the databases such as Medline or PubMed and Google Scholar for articles from 1985 to 2016. The criteria were “Autograft,” “Fibrin tissue adhesive,” “Tissue engineering,” “Maxillofacial injury,” and “Regenerative medicine.” Bone tissue engineering is a new promising approach for bone defect reconstruction. In this technique, cells are combined with three-dimensional scaffolds to provide a tissue-like structure to replace lost parts of the tissue. Fibrin as a natural scaffold, because of its biocompatibility and biodegradability, and the initial stability of the grafted stem cells is introduced as an excellent scaffold for tissue engineering. It promotes cell migration, proliferation, and matrix making through acceleration in angiogenesis. Growth factors in fibrin glue can stimulate and promote tissue repair. Autologous fibrin scaffolds are excellent candidates for tissue engineering so that they can be produced faster, cheaper, and in larger quantities. In addition, they are easy to use and the probability of viral or prion transmission may be decreased. Therefore, autologous fibrin glue appears to be promising scaffold in regenerative maxillofacial surgery.
  1,059 117 -
Correlation between chronological age and third molar developmental stages in an Iranian population (Demirjian method)
Aria Khosronejad, Manijeh Navabi, Shirin Sakhdari, Vahid Rakhshan
March-April 2017, 14(2):143-149
DOI:10.4103/1735-3327.205787  PMID:28584539
Background: Third molar development is the only available tool for estimating the age of individuals after puberty. Since this tooth has very high interethnic variability, formulas calculated to estimate the age from its development stages cannot be generalized to other populations and should be adjusted for each region. Therefore, this study was conducted to evaluate this method in a sample of Tehran individuals for the first time, and also to compare the development of third molars across sexes and arches, and to estimate cutoff developmental stages for legal minor/major identification. Materials and Methods: A total of 150 dental patients aged between 15 and 25 years old were prospectively enrolled, and their Demirjian stages were recorded. The associations between chronological age and Demirjian stages were evaluated. Dental formation was compared between sexes and jaws. Cutoff stages were determined to identify legal minor/major cases (above or below 18 years old). Age estimation formula was found for this population. Results: Of the 150 included patients, 56 were males. The difference between the ages of males and females at each given developmental stage was nonsignificant (P > 0.05), except for the H stage. Age difference between same stage teeth of the maxilla and mandible was nonsignificant. Each of the G and H stages was significantly above 18 years old (P < 0.001). Furthermore, E and F stages were below 18 years old (P < 0.001). All the correlations between Demirjian stages and age were above 90% (all P< 0.001). Third molar development was positively affected by the chronological age (P = 0.000) and being maxillary (P = 0.000) but not sex (P = 0.113). Regression formula for age estimation was: age = 6.52+ (0.64 × sex) + (0.32 × arch) + (1.86 × Demirjian stage). Conclusion: Development of third molar might complete after the age 22. Iranian individuals with third molars at the G and H stages are likely above 18 while those at E and F are likely below 18. Pace of molar development differs for jaws, but intergender differences are open to further investigations.
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A comparison of the efficacy of mechanical, chemical, and microwave radiation methods in disinfecting complete dentures
Niloofar Mojarad, Zahra Khalili, Shima Aalaei
March-April 2017, 14(2):131-136
DOI:10.4103/1735-3327.205793  PMID:28584537
Background: Poor denture hygiene can be a potential source of pathogens. The aim of this study was to compare the efficacy of microwave radiation with that of chemical and mechanical techniques in disinfecting complete dentures contaminated with Staphylococcus aureus and Pseudomonas aeruginosa. Materials and Methods: Seventy-two sterilized mandibular dentures were separately contaminated with S. aureus (n = 32) and P. aeruginosa (n = 32) and then incubated at 37°C for 48 h. The contaminated dentures were disinfected as follows: chemical disinfection with Corega tablets; chemical disinfection with 2% glutaraldehyde; mechanical disinfection by brushing the denture; and physical disinfection by 650-W microwaves irradiation for 3 min with six samples in each subgroup. Six dentures served as negative control group, and six contaminated dentures with no disinfection served as the positive control group. 10-3–10-6 dilutions were cultured in the nutrient agar, and the colonies were counted after incubation at 37°C for 48 h. To evaluate the lasting time of disinfection, the containers with nutrient agar and dentures were stored for 7 days at 37°C to evaluate turbidity. Data were analyzed using Kruskal–Wallis and Mann–Whitney U-test (α = 0.05). Results: There was no evidence of bacterial growth in 48 h and turbidity after 7 days of incubation of dentures disinfected by microwaves, glutaraldehyde, and Corega tablets, which was statistically significant compared to the positive controls (P < 0.001). In mechanically disinfected dentures (brushing), bacterial growth was detected after 48 h which was statistically significant compared to the positive controls (P < 0.001) and turbidity was seen in all the nutrient agar plates. Conclusion: Microwave iradiation, 2% glutaraldehyde, and Corega tablets disinfected complete dentures contaminated with S. aureus and P. aeruginosa which lasted for a long and a short terms.
  1,045 81 -
Comparative assessment of salivary cotinine level and psychological dependence among tobacco users
Vrushali D Patel, Kiran B Jadhav, Vandana S Shah, Nidhi D Gupta
March-April 2017, 14(2):125-130
DOI:10.4103/1735-3327.205786  PMID:28584536
Background: The aim of the study was to assess the correlation between salivary cotinine level and psychological dependence measured through Fagerstrom test for nicotine dependence (FTND) questionnaire among tobacco users. Materials and Methods: This was a cross-sectional study, conducted on tobacco users. Participants with the present habit of tobacco chewing and smoking above the age of 16 years were included in the study. A standard questionnaire form of FTND revised version for smoking and smokeless form of tobacco were given to each participant. Each participant was asked to answer the questions as per their experience of tobacco consumption and calculate the total point score or FTND score. Salivary cotinine level assessment was done using commercial available NicAlert kit. Results: When salivary cotinine level was correlated with different variables of both groups, it was observed that weak correlation between salivary cotinine level and FTND scoring in smokers group (r = 0.083) and also in smokeless group (r = 0.081). When two groups were compared for salivary cotinine level, statistically significant difference (P = 0.021) was observed, with smokeless group showing high level of salivary cotinine level as compared to smokers group. Conclusion: Salivary cotinine and psychological dependence through FTND scoring are not strongly correlating with each other. This indicates that dependence over tobacco is a separate phenomenon and cannot be assessed by salivary cotinine level. It is well accepted that salivary cotinine level is influenced by age of individual, duration of habit, and type of tobacco consumption.
  1,051 65 -
Salivary oxidative stress in oral lichen planus treated with triamcinolone mouthrinse
Arash Mansourian, Farzaneh Agha-Hosseini, Hamed Hossein Kazemi, Nazanin Mortazavi, Mahdieh-Sadat Moosavi, Jalil Beytollahi, Iraj Mirzaii-Dizgah
March-April 2017, 14(2):104-110
DOI:10.4103/1735-3327.205794  PMID:28584533
Background: Total antioxidant capacity (TAC) and malondialdehyde (MDA) levels have not been reported in oral lichen planus (OLP) patients treated with a topical corticosteroid. This study evaluates TAC and MDA levels in unstimulated saliva of OLP patients. Such measurements may need to be supported by clinical observation. Materials and Methods: Twenty patients with OLP participated in a study conducted at the Department of Oral Medicine, Tehran University of Medical Sciences. Salivary TAC and MDA were determined by biochemical analyses before and after 5-week triamcinolone acetonide (0.2%) mouthrinse treatment. Subjective symptoms as well as lesion status pre- and post-treatment were measured using visual analog scale (VAS) and clinical scoring system, respectively. Wilcoxon signed rank test was used for the evaluation of MDA and TAC parameters, VASs, and rates of clinical scores. Spearman's rank correlation was used to determine the relationship between different variables. Results: A statistically significant increase in salivary TAC was found after treatment. There was no significant difference in the reduction of salivary MDA levels in OLP patients after treatment. Conclusion: Posttreatment analyses revealed a significant degree of recovery and pain relief of OLP lesions. Hence, triamcinolon mouthrinse by reducing oxidative stress is an appropriate treatment in OLP patients.
  985 99 -
Stress distribution in maxillary first molar periodontium using straight pull headgear with vertical and horizontal tubes: A finite element analysis
Masood Feizbakhsh, Mahmoud Kadkhodaei, Dana Zandian, Zahra Hosseinpour
March-April 2017, 14(2):117-124
DOI:10.4103/1735-3327.205795  PMID:28584535
Background: One of the most effective ways for distal movement of molars to treat Class II malocclusion is using extraoral force through a headgear device. The purpose of this study was the comparison of stress distribution in maxillary first molar periodontium using straight pull headgear in vertical and horizontal tubes through finite element method. Materials and Methods: Based on the real geometry model, a basic model of the first molar and maxillary bone was obtained using three-dimensional imaging of the skull. After the geometric modeling of periodontium components through CATIA software and the definition of mechanical properties and element classification, a force of 150 g for each headgear was defined in ABAQUS software. Consequently, Von Mises and Principal stresses were evaluated. The statistical analysis was performed using T-paired and Wilcoxon nonparametric tests. Results: Extension of areas with Von Mises and Principal stresses utilizing straight pull headgear with a vertical tube was not different from that of using a horizontal tube, but the numerical value of the Von Mises stress in the vertical tube was significantly reduced (P < 0/05). On the other hand, the difference of the principal stress between both tubes was not significant (P > 0/05). Conclusion: Based on the results, when force applied to the straight pull headgear with a vertical tube, Von Mises stress was reduced significantly in comparison with the horizontal tube. Therefore, to correct the mesiolingual movement of the maxillary first molar, vertical headgear tube is recommended.
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