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   2016| May-June  | Volume 13 | Issue 3  
    Online since May 10, 2016

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Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy
Deepankar Misra, Sapna Panjwani, Shalu Rai, Akansha Misra, Mukul Prabhat, Prashant Gupta, Subrata K Talukder
2016, 13:217 (10 May 2016)
DOI:10.4103/1735-3327.182180  PMID:27274341
Background: To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns. Materials and Methods: In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS. Results: Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes. Conclusion: Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.
  11,163 496 3
A finite element study of teeth restored with post and core: Effect of design, material, and ferrule
Viram Upadhyaya, Akshay Bhargava, Hari Parkash, B Chittaranjan, Vivek Kumar
2016, 13:233 (10 May 2016)
DOI:10.4103/1735-3327.182182  PMID:27274343
Background: Different postdesigns and materials are available; however, no consensus exists regarding superiority for stress distribution. The aim of this study was to evaluate the effect of design and material of post with or without ferrule on stress distribution using finite element analysis. Materials and Methods: A total of 12 three-dimensional (3D) axisymmetric models of postretained central incisors were made: Six with ferrule design and six without it. Three of these six models had tapered posts, and three had parallel posts. The materials tested were titanium post with a composite resin core, nickel chromium cast post and core, and fiber reinforced composite (FRC) post with a composite resin core. The stress analysis was done using ANSYS software. The load of 100 N at an angle of 45΀ was applied 2 mm cervical to incisal edge on the palatal surface and results were analyzed using 3D von Mises criteria. Results: The highest amount of stress was in the cervical region. Overall, the stress in the tapered postsystem was more than the parallel one. FRC post and composite resin core recorded minimal stresses within the post but the stresses transmitted to cervical dentin were more as compared to other systems. Minimal stresses in cervical dentine were observed where the remaining coronal dentin was strengthen by ferrule. Conclusion: A rigid material with high modulus of elasticity for post and core system creates most uniform stress distribution pattern. Ferrule provides uniform distribution of stresses and decreases the cervical stresses.
  4,175 662 6
Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study
SG Damle, Hiteshwar Bhattal, Dhanashree Damle, Abhishek Dhindsa, Ashish Loomba, Sumit Singla
2016, 13:284 (10 May 2016)
DOI:10.4103/1735-3327.182191  PMID:27274351
Background: To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH) 2 ) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. Materials and Methods: The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH) 2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH) 2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). Results: In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH) 2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH) 2 group. Conclusion: MTA and Ca(OH) 2 , as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.
  3,639 597 5
Definitive guiding flange prosthesis: A definitive approach in segmental mandibulectomy defect
Sumanth Babu, Shaurya Manjunath, Mayuri Vajawat
2016, 13:292 (10 May 2016)
DOI:10.4103/1735-3327.182192  PMID:27274352
Mandibular discontinuity defects following a segmental mandibulectomy defects present a major challenge to the rehabilitation team. With no immediate intervention to rehabilitate the patient, definitive mandibular guidance prostheses with a metal guiding flange and acrylic teeth on the resected side can be used successfully to stabilize the occlusion and correct the deviation. The present case report describes the prosthodontic rehabilitation of a patient with a segmental mandibulectomy using a mandibular prosthesis with a metal guide flange and a maxillary stabilizing metal framework.
  3,266 366 2
Effect of cyclic loading on microleakage of silorane based composite compared with low shrinkage methacrylate-based composites
Hamid Kermanshah, Esmail Yasini, Razieh Hoseinifar
2016, 13:264 (10 May 2016)
DOI:10.4103/1735-3327.182188  PMID:27274348
Background: There are many concerns regarding the marginal seal of composite restorations, especially when composite restorations are subjected to cyclic loading. The aim of this study was to evaluate the effect of cyclic loading on the microleakage of silorane based composite compared with low shrinkage methacrylate-based composites in class V cavities. Materials and Methods: In this in vitro study, class V cavities were prepared on the facial and lingual surfaces of 48 human premolars (96 cavities). The teeth were randomly divided into four groups of 12 teeth (24 cavities) each and restored as follows: Group 1 (Siloran System Adhesive + Filtek P90), Group 2 (All Bond SE + Aelite LS Posterior), Group 3 (Futurabond NR + Grandio), and Group 4 (G-Bond + Kalore-GC). All the specimens were thermocycled for 2000 cycles (5-55°C) and then half of the specimens from each group, were Load cycled. All teeth were immersed in 0.5% basic fuchsine dye, sectioned, and observed under a stereomicroscope. Data were analyzed using Wilcoxon test, Kruskal-Wallis, and Mann-Whitney U-tests. P < 0.05 was considered as significant. Results: In both unloaded and loaded groups, no statistically significant differences were observed among four composites at the occlusal margin, but a significant difference in gingival microleakage was found between Aelite and silorane. Occlusal and gingival microleakage was not affected by cyclic loading in none of the four restorative materials. Conclusion: Silorane did not provide better marginal seal than the low shrinkage methacrylate-based composites (except Aelite). In addition, cyclic loading did not affect the marginal microleakage of evaluated composite restorations .
  3,163 181 2
Epithelial expression of keratinocytes growth factor in oral precancer lesions
Sudha Jimson, S Murali, Susan L Zunt, Lawrence I Goldblatt, Mythily Srinivasan
1900, 13:199 (1 January 1900)
DOI:10.4103/1735-3327.182148  PMID:27274338
Background: Keratinocyte growth factor (KGF) is a potent epithelial mitogen that acts by binding the KGF receptors (KGFRs) expressed on epithelial cells and regulates proliferation and differentiation. The objective of this study was to investigate the expression of KGF in the epithelium in oral precancer. Materials and Methods: Archival tissues of oral submucous fibrosis (SMF) and leukoplakia were assessed for epithelial KGF expression by immunohistochemistry and real-time quantitative polymerase chain reaction. Results: KGF was predominantly expressed in the basal and parabasal cells in the epithelium of SMF tissues. KGF transcript in the epithelial cells increased with increasing severity of epithelial dysplasia in oral leukoplakia. Conclusion: Although widely reported as a product secreted by the mesenchymal cells, our data suggest that the KGF is also expressed in oral epithelial cells much like the expression in ovarian epithelial cells. Based on the localization of KGF in cells at the epithelial mesenchymal junction and that of the reported presence of KGFR in oral keratinocytes, a potential mechanism involving paracrine and autocrine interactions of KGF and KGFR in early stages of oral precancer is postulated.
  2,991 282 3
Children's behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial
Ali Bagherian, Mahmood Sheikhfathollahi
2016, 13:272 (10 May 2016)
DOI:10.4103/1735-3327.182189  PMID:27274349
Background: Topical anesthesia has been widely advocated as an important component of atraumatic administration of intraoral local anesthesia. The aim of this study was to use direct observation of children's behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia. Materials and Methods: Forty-eight children participated in this randomized controlled clinical trial. They received two separate inferior alveolar nerve block or primary maxillary molar infiltration injections on contralateral sides of the jaws by both cotton-roll vibration (a combination of topical anesthesia gel, cotton roll, and vibration for physical distraction) and control (routine topical anesthesia) methods. Behavioral pain reactions of children were measured according to the author-developed face, head, foot, hand, trunk, and cry (FHFHTC) scale, resulting in total scores between 0 and 18. Results: The total scores on the FHFHTC scale ranged between 0-5 and 0-10 in the cotton-roll vibration and control methods, respectively. The mean ± standard deviation values of total scores on FHFHTC scale were lower in the cotton-roll vibration method (1.21 ± 1.38) than in control method (2.44 ± 2.18), and this was statistically significant (P < 0.001). Conclusion: It may be concluded that the cotton-roll vibration method can be more helpful than the routine topical anesthesia in reducing behavioral pain reactions in children during local anesthesia administration.
  2,842 392 7
Effect of local administration of platelet-derived growth factor B on functional recovery of peripheral nerve regeneration: A sciatic nerve transection model
Atefeh Golzadeh, Rahim Mohammadi
2016, 13:225 (10 May 2016)
DOI:10.4103/1735-3327.182181  PMID:27274342
Background: Effects of platelet-derived growth factor B (PDGF-B) on peripheral nerve regeneration was studied using a rat sciatic nerve transection model. Materials and Methods: Forty-five male, white Wistar rats were divided into three experimental groups (n = 15), randomly: Normal control group (NC), silicon group (SIL), and PDGF-B treated group (SIL/PDGF). In NC group, left sciatic nerve was exposed through a gluteal muscle incision and after homeostasis muscle was sutured. In the SIL group, the left sciatic nerve was exposed in the same way and transected proximal to tibio-peroneal bifurcation leaving a 10-mm gap. Proximal and distal stumps were each inserted into a silicone conduit and filled with 10 μL phosphate buffered solution. In SIL/PDGF group, the silicon conduit was filled with 10 μL PDGF-B (0.5 ng/mL). Each group was subdivided into three subgroups of five and were studied in 4, 8, 12 weeks after surgery. Results: Behavioral testing, sciatic nerve functional study, gastrocnemius muscle mass, and histomorphometric studies showed earlier regeneration of axons in SIL/PDGF than in SIL group (P < 0.05). Conclusion: Local administration of PDGF-B combined with silicon grafting could accelerate functional recovery and may have clinical implications for the surgical management of patients after facial nerve transection.
  2,794 279 8
Marginal adaptation of Spinell InCeram and feldspathic porcelain laminate veneers
Tahereh Ghaffari, Fahimeh Hamedi-Rad, Vahid Fakhrzadeh
2016, 13:239 (10 May 2016)
DOI:10.4103/1735-3327.182183  PMID:27274344
Background: This in vitro study investigated the marginal fit of two porcelain laminate veneers to help the selection of more accurate veneers in discolored teeth. Materials and Methods: Thirty impressions of metal master die created from the prepared labial surface of an acrylic maxillary central incisor were made and poured with Type IV stone. The dies were distributed into test groups (n = 15) for the construction of DuCeram and InCeram laminate veneers. An image-analysis program was used to measure the gap between the veneers and the master die at the labial, lingual, and proximal margins. Statistical analysis was performed with repeated measures ANOVA. Independent t-test was used to compare the mean values between the two groups. Values of P < 0.05 were judged to be significant. Results: Differences between marginal fit of two groups were significant (P < 0.001). The overall mean marginal gap values (μm) for InCeram and DuCeram were, respectively, 114.4 ± 40.81 and 282.3 ± 82.82. Independent t-test revealed significant differences between the marginal gaps of two materials at different predetermined points. Conclusion: Within the limitations of this study, the marginal gap in InCeram laminate veneer was within the clinically acceptable standard set at 120 μm.
  2,678 362 1
Masticatory ability with depression, anxiety, and stress: Does there exist any association?
Hamidreza Roohafza, Hamid Afshar, Ammar Hassanzadeh Keshteli, Mohamad Javad Shirani, Parastu Afghari, Amrita Vali, Peyman Adibi
2016, 13:211 (10 May 2016)
DOI:10.4103/1735-3327.182179  PMID:27274340
Background: Masticatory ability as a subjective response to masticatory function indicates patients' perception of their mastication. To the best of our knowledge, there has been no study on association between masticatory ability and psychological status. This study investigated the association between self-assessed masticatory ability (SAMA) and psychological status among a large sample of Iranian adults. Materials and Methods: In this cross-sectional study, data were extracted from 4135 adults who had been completed information in 20 counties across Isfahan province regarding masticatory ability and psychological statuses (depression, anxiety, and stress). An SAMA questionnaire, the Hospital Anxiety and Depression Scale and General Health Questionnaire were used to measure masticatory ability, depression and anxiety, and stress of study population. To analyze the data, ANOVA, χ2 test, and multinomial regression were applied at 0.05 for the significance level. Results: Masticatory ability was significantly correlated with depression (P < 0.001), anxiety (P < 0.001), and stress (P < 0.001). The participants in high masticatory ability group reported lower scores for presence of these psychological variables. Furthermore, males reported significantly higher level for masticatory ability than females (P = 0.025). In addition, there were significant association between low and moderate masticatory ability with anxiety (1.09, 1.08), depression (1.15, 1.13), and stress (1.11, 1.09), respectively. The association was still significant after adjusting for age, sex, educational level, and marital status. Conclusion: Despite study limitations, the results of this study provide evidence that participants with higher score of depression, anxiety, and stress suffer lower masticatory ability.
  2,717 291 4
The association between periodontal disease parameters and severity of atherosclerosis
Mohammad Ketabi, Fatemeh Rashidi Meybodi, Mohammad Reza Asgari
2016, 13:250 (10 May 2016)
DOI:10.4103/1735-3327.182185  PMID:27274346
Background: Atherosclerosis is the most common cause for heart attack and stroke. In the last decade, several epidemiological studies have found an association between periodontal infection and atherosclerosis. The aim of this research was to determine the possible association between chronic periodontal disease and severity of atherosclerosis. Materials and Methods: Eighty-two subjects that were referred to Chamran Heart Hospital in Isfahan for angiography were involved in this study. Fifty-nine subjects had coronary artery obstruction (CAO) and 23 showed no obstruction after angiography. The severity of CAO was assessed. Periodontal parameters including pocket depth (PD), gingival recession (R), clinical attachment level (CAL), and bleeding on probing (BOP) of all subjects were recorded. The decayed-missing-filled (DMF) index of all subjects was also measured. For statistical analysis, Pearson correlation test, Chi-square, and independent t-test were used. Results: There were significant positive correlation between variables R, PD, CAL, decayed (D), missing (M), DMF, BOP, and degree of CAO. However, there were no significant differences between filling variable degree of CAO (left anterior descending, left circumflex, and right coronary artery). Independent t-test showed that the mean of variables R, PD, AL, D, M, and DMF in patients with obstructed arteries were significantly higher than subjects without CAO. But there were no significant differences between variable F in two groups. Conclusion: The results of this cross-section analytical study showed an association between periodontal disease and dental parameters with the severity of CAO measured by angiography. However, this association must not interpret as a cause and effect relationship.
  2,689 304 7
Evaluation of threshold response and appropriate electrode placement site for electric pulp testing in fluorosed anterior teeth: An in vivo study
Harikumar Vemisetty, Amulya Vanapatla, Polavarapu Venkata Ravichandra, Surakanti Jayaprada Reddy, Rajani Punna, Srujana Chandragiri
2016, 13:245 (10 May 2016)
DOI:10.4103/1735-3327.182184  PMID:27274345
Background: Accurate diagnosis is key to success. Diagnosing the pulpal status in varied clinical situations poses a challenge to the clinician. Electric pulp test (EPT) is one of the valuable attempts in evaluating the sensibility of pulp tissue. The aim of this study was to find out and compare the threshold levels and optimal electrode placement site for EPT in fluorosed and nonfluorosed anterior teeth. Materials and Methodology: Eighty volunteers recruited for this study were divided into two groups based on the incidence of dental fluorosis. Electric pulp testing was done on either of the central incisors in fluorosed and nonfluorosed group. Four sites on each crown were tested 4 times with digitest electric pulp tester, and the mean of the threshold responses was recorded. The data were analyzed with SPSS, version 11. Means of variables from each location were compared using one-way ANOVA and Tukey's post-hoc test while the critical level of significance was set at P < 0.05. Results: The mean and standard deviation of threshold levels in fluorosed teeth were greater when compared to that of nonfluorosed teeth at all sites with incisal edge showing the least mean threshold levels for both the groups (P > 0.05). Conclusion: Within the limitations of this study, it can be concluded that fluorosed teeth respond to higher threshold levels than the non-fluorosed teeth, and incisal edge was the optimal electrode placement site.
  2,265 200 2
Association between serotonin transporter gene polymorphism and recurrent aphthous stomatitis
Aastha Manchanda, Asha R Iyengar, Seema Patil
2016, 13:206 (10 May 2016)
DOI:10.4103/1735-3327.182149  PMID:27274339
Background: Anxiety-related traits have been attributed to sequence variability in the genes coding for serotonin transmission in  the brain. Two alleles, termed long (L) and short (S) differing by 44 base pairs, are found in a polymorphism identified in the promoter region of serotonin transporter gene. The presence of the short allele  and SS and LS genotypes is found to be associated with the reduced expression of this gene decreasing the uptake of serotonin in the brain leading to various anxiety-related traits. Recurrent aphthous stomatitis (RAS) is an oral mucosal disease with varied etiology including the presence of stress, anxiety, and genetic influences. The present study aimed to determine this serotonin transporter gene polymorphism in patients with RAS and compare it with normal individuals. Materials and Methods: This study included 20 subjects with various forms of RAS and 20 normal healthy age- and gender-matched individuals. Desquamated oral mucosal cells were collected for DNA extraction and subjected to polymerase chain reaction for studying insertion/deletion in the 5-HTT gene-linked polymorphic region. Cross tabulations followed by Chi-square tests were performed to compare the significance of findings, P < 0.05 was considered statistically significant. Results: The LS genotype was the most common genotype found in the subjects with aphthous stomatitis (60%) and controls (40%). The total percentage of LS and SS genotypes and the frequency of S allele were found to be higher in the subjects with aphthous stomatitis as compared to the control group although a statistically significant correlation could not be established, P = 0.144 and 0.371, respectively. Conclusion: Within the limitations of this study, occurrence of RAS was not found to be associated with polymorphic promoter region in serotonin transporter gene.
  2,198 249 4
The role of vascular endothelial growth factor in proliferation of odontogenic cysts and tumors: An immunohistochemical study
Bhavana Gupta, Shaleen Chandra, Anil Singh, Kunal Sah, Vineet Raj, Vivek Gupta
2016, 13:256 (10 May 2016)
DOI:10.4103/1735-3327.182187  PMID:27274347
Background: Vascular endothelial growth factor (VEGF) is capable of initiating angiogenesis in blood vessels and may act as mitogenic agent for epithelium of odontogenic cysts and tumors. This study was conducted to evaluate the role of epithelial VEGF expression in odontogenic cysts and ameloblastoma and its correlation with argyrophilic nucleolar organizer region counts to assess its role in their biological behavior. Materials and Methods: In this retrospective cross-sectional study, 45 histologically confirmed cases, 15 cases of each of keratocystic odontogenic tumors (KCOTs), dentigerous cysts, and ameloblastomas were examined for immunohistochemical expression for epithelial VEGF, and argyrophilic nucleolar organizer regions (AgNORs) (used as secondary marker in this study) staining was done for comparing the proliferative capacity with VEGF. Results: KCOT shows mild expression within the basal layers and strong expression in the suprabasal layer whereas, in dentigerous cysts, a majority showed no VEGF expression whereas ameloblastomas showed strong expression in all cases by stellate reticulum-like cells at the center of the follicles and suprabasal layers of epithelium. The results of AgNOR counts were higher in KCOTs as compared to ameloblastoma and least in dentigerous cysts. Conclusion: VEGF expression by the epithelium of odontogenic cysts and tumors may play a role in epithelial proliferation via autocrine mechanism as reflected by increased AgNOR counts. The angiogenic activity via paracrine pathway may be responsible for the difference in growth rate and neoplastic behavior of the lesions.
  2,214 232 2
Comparison of patients' age receiving therapeutic services in a cleft care team in Isfahan
Saeed Soheilipour, Fatemeh Soheilipour, Fatemeh Derakhshandeh, Hedieh Hashemi, Mehrdad Memarzadeh, Hamid Salehiniya, Fahimeh Soheilipour
2016, 13:278 (10 May 2016)
DOI:10.4103/1735-3327.182190  PMID:27274350
Background: Due to numerous difficulties in patients suffering from varieties of cleft lip and palate, their therapeutic management involves interdisciplinary teamwork. This study was conducted to compare the age of commencing treatments such as speech therapy, secondary palate and alveolar bone grafting and orthodontics between those who sought treatment early and late. Materials and Methods: In this retrospective study, 260 files of patients with cleft lip and palate based on their age at the time of admission to a cleft care team were divided into two groups: The early admission and late admission. Both groups compared based on four variables including the mean age of beginning speech therapy, palatal secondary surgery, alveolar bone grafting, and receiving orthodontics using t-test. Results : Based on the results, among 134 patients admitted for speech therapy, the mean age of initiating speech therapy in early clients was 3.3 years, and in the late ones was 9 years. Among 47 patients with secondary surgery, the mean age in early clients was 3.88 years, and in the late clients was 15.7 years. Among 17 patients with alveolar bone grafting, the mean age in the first group was 9 years, and in the other was 16.69 years. Among 24 patients receiving orthodontic services, the mean age in early clients was 7.66 years, and in the second group was 17.05 years. Conclusion: There was a significant difference between the age of performing secondary surgery and alveolar bone grafting and the age of beginning speech therapy and receiving orthodontic services in early references and late references to the team.
  1,872 166 -