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   2016| November-December  | Volume 13 | Issue 6  
    Online since December 29, 2016

 
 
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ORIGINAL ARTICLES
Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess
Lobna Abdel Aziz Aly, Nelly Ibrahim Hammouda
2016, 13:478 (29 December 2016)
DOI:10.4103/1735-3327.197039  PMID:28182056
Background: Excessive gingival display (GD) is a frequent finding that can occur because of various intraoral or extraoral etiologies. This work describes the use of a mucosal repositioned flap for the management of a gummy smile associated with vertical maxillary excess (VME) and hypermobility of the upper lip followed by injection of Botox. Materials and Methods: Seven female patients in the age range of 17–25 years presented with a gummy smile. At full smile, the average GD ranged from 6 to 8 mm. A clinical examination revealed hypermobility of the upper lip. A cephalometric analysis pointed to the presence of VME. The mucosal repositioned flap surgery was conducted followed by injection with botulinum toxin type A (Botox) 2 weeks postsurgically. Results: After 4 weeks, results were definitely observed with a decrease from 8 mm gingival exposure to 3 mm, which was considered as normal GD for an adult during smiling. Conclusion: For patients desiring a less invasive alternative to orthognathic surgery, the mucosal repositioned flap is a viable alternative. Moreover, Botox is a useful adjunct to enhance the esthetics and improve patient satisfaction where surgery alone may prove inadequately in moderate VME.
  4,261 625 5
Design, formulation, and physicochemical evaluation of periodontal propolis mucoadhesive gel
Abolfazl Aslani, Negar Malekpour
2016, 13:484 (29 December 2016)
DOI:10.4103/1735-3327.197037  PMID:28182054
Background: Periodontitis is a disease of tooth supporting tissues, and Gram-negative Bacteria are the main cause of this. Propolis has antibacterial, anti-inflammatory, and antioxidant effects due to its high polyphenol and flavonoids content. The aim of this study is the formulation of a mucoadhesive gel containing concentrated extract of propolis for treatment of periodontitis. Materials and Methods: Formulations containing carbopol 940, sodium carboxymethylcellulose (NaCMC), hydroxypropyl methylcellulose K4M, and propolis extract were prepared. Among ten prepared formulations, five formulations had acceptable and proper physical appearance and uniformity; thus, they were selected for physicochemical tests (centrifugal, thermal change, cooling and heating, freeze and thaw, thermal stress, and pH evaluation), quantification of flavonoids, viscosity, mucoadhesion, drug release, and syringeability tests. We investigated the antibacterial activity of F10 (carbopol 940 1%, NaCMC 3%) against Porphyromonas gingivalis using the disk diffusion method. Results: Phenolic content was measured 39.02 ± 3.24 mg/g of concentrated extract as gallic acid and flavonoid content was determined 743.28 ± 12.1 mg/g of concentrated extract as quercetin. Highest viscosity (3700 cps) and mucoadhesion (21 MPa) were seen in F10. Study of release profile in F10also revealed that propolis could release from this system in more than 7 days. All of the five selected formulations had ease of syringeability in 21-gauge needle for drug delivery into periodontal pocket. In the disk diffusion method, F10produced significant growth inhibition zones against P. gingivalis. Conclusion: Controlled release of drug into periodontal pocket helps effective treatment and recovery, higher persistence and reduces drug use frequency. Increase of carbopol 940 leads to viscosity and mucoadhesion elevation and accordingly decreases of release rate.F10was the best formulation because of highest viscosity and mucoadhesion and lowest release rate. It had efficient function in treatment of periodontitis, so we recommend it for clinical evaluation.
  3,343 435 4
CASE REPORT
Skin and mucosal ischemia as a complication after inferior alveolar nerve block
Pedro Christian Aravena, Camila Valeria, Nicolás Nuñez, Francisco Perez-Rojas, Cesar Coronado
2016, 13:560 (29 December 2016)
DOI:10.4103/1735-3327.197040  PMID:28182074
The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.
  2,840 223 1
ORIGINAL ARTICLES
Analysis of lipid profile in cancer patients, smokers, and nonsmokers
A Vikramsimha Reddy, Lakshmi Keerthana Killampalli, A Ravi Prakash, Sushma Naag, G Sreenath, Sunil Kumar Biraggari
2016, 13:494 (29 December 2016)
DOI:10.4103/1735-3327.197036  PMID:28182070
Background: Lipids play an important role in maintaining the cell membrane integrity. Lipid profile is a panel of blood tests that serve as an initial medical screening for abnormalities in lipids and approximate risk for cancer, cardiovascular diseases, pancreatitis, etc., The present study evaluates the alterations in lipid profile in cancer patients, smokers, and nonsmokers and aims to achieve a correlation between them. Materials and Methods: The study is an in vitro type of cross-sectional study with 25 oral cancer patients, 25 chronic smokers (habit persisting for 15 years or more), and 15 nonsmokers as control group. Blood samples had been collected, and triglycerides (TGs), total cholesterol (TC), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), and low-density lipoprotein (LDL) were analyzed using a lipid profile kit and an autoanalyzer. The results were analyzed using the unpaired t-test and ANOVA test (P < 0.05). Results: There was a significant increase in TC, TG, LDL, and VLDL and decrease in HDL in the smokers group when compared to the controls (P < 0.05). A significant increase in LDL, but a decrease in values of HDL, VLDL, TG, and TC was observed in the cancer patients group when compared to the controls (P < 0.05). Conclusion: There is an inverse relationship between serum lipid profile in smokers and cancer patients. The decrease in lipid profile in cancer patients might be due to their increased utilization of lipids by neoplastic cells in membrane biogenesis. Therefore, a decrease in lipid profile in smokers can be assumed that they might be more prone to develop cancerous conditions.
  2,348 257 9
Effects of alkaline treatment for fibroblastic adhesion on titanium
Miryam Cuellar-Flores, Laura Susana Acosta-Torres, Omar Martínez-Alvarez, Benjamin Sánchez-Trocino, Javier de la Fuente-Hernández, Rigoberto Garcia-Garduño, Rene Garcia-Contreras
1900, 13:473 (1 January 1900)
DOI:10.4103/1735-3327.197043  PMID:28182066
Background: The surface energy of titanium (Ti) implants is very important when determining hydrophilicity or hydrophobicity, which is vital in osseointegration. The purpose of this study was to determine how Ti plates with an alkaline treatment (NaOH) affect the adhesion and proliferation of human periodontal ligament fibroblasts (HPLF). Materials and Methods: In vitro experimental study was carried out. Type 1 commercially pure Ti plates were analyzed with atomic force microscopy to evaluate surface roughness. The plates were treated ultrasonically with NaOH at 5 M (pH 13.7) for 45 s. HPLF previously established from periodontal tissue was inoculated on the treated Ti plates. The adhered and proliferated viable cell numbers were determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method for 60 min and 24 h, respectively. The data were analyzed using Kruskal–Wallis tests and multiple comparisons of the Mann–Whitney U-test,P value was fixed at 0.05. Results: The mean roughness values equaled 0.04 μm with an almost flat surface and some grooves. The alkaline treatment of Ti plates caused significantly (P < 0.05) more pronounced HPLF adhesion and proliferation compared to untreated Ti plates. Conclusion: The treatment of Ti plates with NaOH enhances cell adhesion and the proliferation of HPLF cells. Clinically, the alkaline treatment of Ti-based implants could be an option to improve and accelerate osseointegration.
  2,018 402 4
Correlation between dental caries experience and mutans streptococci counts by microbial and molecular (polymerase chain reaction) assay using saliva as microbial risk indicator
SG Damle, Ashish Loomba, Abhishek Dhindsa, Ashu Loomba, Vikas Beniwal
2016, 13:552 (29 December 2016)
DOI:10.4103/1735-3327.197035  PMID:28182053
Background: The aim of this study was to assess the relationships of quantitative salivary levels of mutans streptococci (MS) in children, aged 3–6 years and 12–15 years, exhibiting variable patterns of caries activity, and to compare the association of MS in saliva using microbial and molecular (polymerase chain reaction [PCR]) assay. Materials and Methods: In this cross-sectional observational study, eighty children were included, forty children each in Group I (3–6 years) and Group II (12–15 years). Children were further divided into two subgroups (Group IC, INC and Group IIC, IINC) based on their dental caries status. Saliva samples were collected and plated onto Mitis Salivarius-Bacitracin agar plates. After detection of MS, DNA was isolated and purified, and MS were evaluated using the PCR and AP-PCR. Results: Of the selected 80 children, 42 were male and 38 were female. In Group IC, the mean colony count was 2.27 ± 0.54 × 105 CFU/ml, and in Group INC, the mean colony was found to be 1.61 ± 0.54 × 105 CFU/ml. In Group II, where mean colony count of 3.31 ± 0.85 × 105 CFU/ml and 2.44 ± 0.54 × 105 CFU/ml was observed in Group IIC and Group IINC, respectively. Conclusion: The mean colony count increased with increasing age and was also more in children with dental caries. Based on the matrices generated by the PCR analysis using coefficient slipped-strand mispairing, wide range of genetic diversity was seen in cases of children with and without clinically detectable caries.
  2,032 222 7
Comparative evaluation of canal cleaning ability of various rotary endodontic filesin apical third: A scanning electron microscopic study
Ganesh Ranganath Jadhav, Priya Mittal, Anish Kulkarni, Shibli Syed, Ravikiran Bagul, Saina Elahi, Dheeraj Kalra
2016, 13:508 (29 December 2016)
DOI:10.4103/1735-3327.197031  PMID:28182065
Background: The purpose of this study was to evaluate the canal cleaning ability of three novel endodontic rotary instruments and compare with ProTaper files as a control in apical third of root canals under scanning electron microscopy (SEM). Materials and Methods: Eighty freshly extracted mandibular premolars were selected according to inclusion criteria. Buccal cusp tips were ground to ensure having a flat coronal reference point with a total tooth length of 16 mm for all samples. Teeth were divided equally into four groups: Group I (ProTaper group), Group II (ProTaper next group), Group III (variable taper group), and Group IV (self-adjusting file [SAF] group). Using SEM, the dentinal surfaces were observed and rated at apical thirds with a magnification of ×1000 for the presence/absence of smear layer and debris. Descriptive analysis was performed, and analysis of variance with Bonferroni post hoc test was carried out for comparison between the groups, at a significance level of 0.05. Results: There was statistically significant difference between Group II and Group IV for debris (P = 0.047) and smear layer (P = 0.037). Conclusion: In apical third of root canal, SAF showed statistically significant canal cleaning ability due to combined effect of continuous streaming irrigation with effectively replacing the irrigant from the apical portion of the root canal, irrigants activation through the creation of turbulence, and its self-adapting design to root canal anatomy with a scrubbing motion on the canal walls.
  2,000 213 -
Attitude toward Public Health Dentistry as a career among dental students in Odisha: A Cross-sectional study
Nupur Sharma, Kittu Jain, Soumik Kabasi
2016, 13:532 (29 December 2016)
DOI:10.4103/1735-3327.197042  PMID:28182073
Background: Knowledge of dental students' expectations of their profession as well as their attitudes to study a particular specialty of dentistry is of great importance. These attitudes and expectations make studying dentistry meaningful to dental students and society and understanding these factors facilitate workforce planning in the dental sector The aim of the study was to assess the attitude of dental students towards considering Public Health Dentistry as their future career. Materials and Methods: A questionnaire-based, cross-sectional survey was conducted, which included the 3rd year, 4th fourth year and dental interns studying in the State of Odisha. It consisted of 27 questions that were graded on 5-point Likert scale. The responses for the attitude questions toward selecting Public Health Dentistry for postgraduation were categorized into three factors, which are a negative attitude (includes score 0–21), neutral attitude (score 22–44), and positive attitude (score 45–64). Differences between groups were examined using Chi-square test for proportions. The level of statistical significance was set atP< 0.05. Results: Among 886 respondents, 302 (34.08%) were males and 584 (65.91%) were females. One-third (33.52%) of them had a positive attitude toward selecting public health dentistry as their future career, and nearly two-third of them (58.23%) had neutral attitude, with very few students having a negative attitude (8.23%) toward the specialty for pursuing postgraduation. Conclusion: Respondents had a considerable amount of interest in pursuing postgraduation in this specialty. Efforts should be intensified, both by the dental council and by the dental colleges, to develop this specialty, keeping in mind the increasing attitude of dental undergraduates toward it.
  1,955 218 -
Evaluation of the effects of two different bone resorption inhibitors on osteoclast numbers and activity: An animal study
Narges Naghsh, Sayed Mohammad Razavi, Mohsen Minaiyan, Mohammad Shahabooei, Reza Birang, Parichehr Behfarnia, Samira Hajisadeghi
2016, 13:500 (29 December 2016)
DOI:10.4103/1735-3327.197034  PMID:28182072
Background: The aim of this study was to evaluate the effects of bone resorption inhibitors, doxycycline (DOX) and erythromycin (EM), on osseous wound healing in rat alveolar socket. Materials and Methods: In this randomized controlled trial, 45 8–10-week-old male Wistar rats had their maxillary right molar extracted. They were divided into three groups of 15. In Group 1 normal saline, Group 2 DOX, and Group 3 EM were administered at the doses of 5 ml/kg/day, 5 mg/kg/day, and 2 mg/kg/day, respectively, for 7 consecutive days. The rats were sacrificed 7, 14, and 21 days after surgery. Real-time polymerase chain reaction was employed to evaluate the mRNA expression of receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) and immunohistochemical staining for tartrate-resistant acid phosphatase (TRAP) to determine osteoclasts. The data were analyzed by one-way analysis of variance followed by Tukey's post hoc test using SPSS version 20. Significant level was set at 0.05. Results: The results showed that when drug-treated groups compared to control groups, RANKL gene expression significantly decreased, TRAP+ cells decreased on day 7. The RANKL/OPG ratios in the first two weeks in the test groups were significantly lower than the control group. There was no significant difference in the studied indices between DOX and EM groups. Conclusion: Following administration of DOX and EM, the number of osteoclasts and RANKL/OPG ratio decreased suggesting their anti-osteoclastogenesis activity. These two drugs have no advantage over each other in increasing the bone formation.
  1,937 157 2
Assessment of slice thickness effect on visibility of inferior alveolar canal in cone beam computed tomography images
Daryoush Goodarzi Pour, Banafsheh Arzi, Ahmad Reza Shamshiri
1900, 13:527 (1 January 1900)
DOI:10.4103/1735-3327.197041  PMID:28182059
Objective: The aim of this study is to evaluate the effect of slice thickness on the visibility of inferior alveolar canal (IAC) in cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images of thirty patients (15 male and 15 female) with an age range between 40–50 years old were used. Cross-sectional images were obtained with 0.5, 1, and 2 mm slice thickness and 2 mm interval. Two oral radiologists with at least 5 years' of experience observed all of the 90 images and rated the images based on the visibility of IAC in a 4-score classification (highly visible, visible, nearly visible, nearly invisible). Friedman test was used for the comparison of visibility of IAC in different slice thicknesses. To do the above test, the average of the scores of two examiners was calculated. A P. value below 0.05 was considered significant. Results: Visibility of IAC in different slice thicknesses of both raters showed no significant difference (P = 0.20). Conclusion: Within the limitations of this study the slice thickness has no effect on visibility of IAC in cross-sectional images. Future studies on other multiplanar images are recommended.
  1,922 165 7
The most painful site of maxillary anterior infiltrations
Roohollah Sharifi, Hesamedin Nazari, Peik Bolourchi, Saber Khazaei, Masoud Parirokh
2016, 13:539 (29 December 2016)
DOI:10.4103/1735-3327.197030  PMID:28182062
Background: The purpose of this study was to determine the most painful site of infiltration injection in the anterior part of maxilla. Materials and Methods: This single-blinded clinical trial was conducted on thirty healthy volunteers. The participants received three maxillary infiltrations injected at the region of central and lateral incisors as well as canines at three separated appointments with a 2-week interval. The outcome variable was pain that measured immediately after needle insertion (time = 0) and during injection of anesthetic solution in 5, 30, and 55 s by a visual analog scale. Data were analyzed by SPSS software version 16 using Friedman test. Results: There was no statistically significant difference in terms of needle insertion pain and during injection (time = 0, 5, 30, and 55 s) (P = 0.319,P= 0.849,P= 0.627, and P= 0.939, respectively) in the three injection sites. Conclusion: The pain intensity of infiltration was not associated with injection sites in the anterior maxilla.
  1,786 150 4
Physical activity among dental health professionals in Hyderabad City: A questionnaire survey
Adepu Srilatha, Dolar Doshi, M Padma Reddy, Suhas Kulkarni, B Srikanth Reddy, Sahithi Reddy
2016, 13:544 (29 December 2016)
DOI:10.4103/1735-3327.197038  PMID:28182058
Background: To assess and compare physical activity based on age, gender, marital status, education, and employment among dental health professionals in Hyderabad City, India. Materials and Methods: A cross-sectional questionnaire study was conducted among dentists and they were personally interviewed by a single trained interviewer. The frequency (in days) and time (in minutes) spent in doing vigorous- and moderate-intensity activity in a typical week in three domains and sedentary behavior were assessed using 16-item Global Physical Activity Questionnaire. Metabolic equivalents (METs) were used to express the intensity of physical activities. Results: Overall, 60.7% of the 313 respondents were physically active, with activity at work and commuting activity were the main contributors of physical activity. With increasing age, there was a decrease in physical activity with more sedentary behavior, professionals in age group of 21–30 years, who were single, those with Bachelor's Degree and those in teaching field performed activity at work, commuting, and recreational activity for more minutes with overall high MET minutes per week and least sedentary behavior. Conclusion: The prevalence of physical activity was high among dental health professionals.
  1,727 141 2
Ultrastructural analysis of oral exfoliated epithelial cells of tobacco smokers and betel nut chewers: A scanning electron microscopy study
Sameera Shamim Khan, Balasundari Shreedhar, Mala Kamboj
1900, 13:521 (1 January 1900)
DOI:10.4103/1735-3327.197033  PMID:28182055
Background: The study was undertaken to correlate epithelial surface pattern changes of oral exfoliated cells of tobacco smokers and betel nut chewers and also to compare them with patients of oral squamous cell carcinoma (OSCC) and healthy individuals. Materials and Methods: In this cross-sectional study, a total of fifty persons were included in the study, out of which thirty formed the study group (15 each tobacco smokers and betel nut chewers) and twenty formed the control group (ten each of OSCC patients – positive control and ten normal buccal mucosa – negative control). Their oral exfoliated cells were scraped, fixed, and studied under scanning electron microscope (SEM). The statistical analysis was determined using ANOVA, Tukey honestly significant difference, Chi-square test, and statistical SPASS software,P< 0.05. Results: OSCC, Individual cell modifications, intercellular relationships and surface characteristics observed by scanning electron microscopy between OSCC, tobacco smokers, betel nut chewers compared to normal oral mucosa have been tabulated. Conclusion: In normal oral mucosa, cell surface morphology depends on the state of keratinization of the tissue. Thus, it could prove helpful in detecting any carcinomatous change at its incipient stage and also give an insight into the ultra-structural details of cellular differentiations in epithelial tissues.
  1,699 146 2
The effect of acrylate-based dental adhesive solvent content on microleakage in composite restorations
Mahboubeh Mirzakhani, Sayed Mostafa Mousavinasab, Mohammad Atai
1900, 13:515 (1 January 1900)
DOI:10.4103/1735-3327.197032  PMID:28182040
Background: This study aimed to evaluate the effect of different percentages of ethanol solvent of an experimental methacrylate-based dentin bonding agent containing polyhedral oligomeric silsesquioxanes (POSS) on the microleakage of resin composite restorations. Materials and Methods: In this experimental study, 42 extracted human premolar teeth used and 84 standard Class V cavities were prepared on the buccal and lingual surfaces of the teeth. The teeth were divided into 6 groups of 7. Experimental bonding agents with different percentages of solvent were used in 5 groups and Single Bond® as a control. The teeth were restored with resin composite and subjected to thermal cycling test. Teeth were then immersed in a solution of 2% basic fuchsine dye for 24 h and sectioned buccolingually and scored using stereomicroscope with ×32 magnification. Microleakage data were analyzed using the Kruskal–Wallis, Mann–Whitney U, and Wilcoxon tests. Results: There were significant differences between the microleakage enamel margins (P = 0.036) and dentinal margins (P = 0.008) in all the groups. These significant differences were seen between the control group and groups containing 46 wt% solvent (P = 0.011), 46 wt% and 31 wt% solvent in dentinal (P = 0.027), 31 wt% and 0 wt% in enamel (P = 0.021), also 0 wt% and control in enamel (P = 0.039), and dentinal margins microleakage (P = 0.004). The microleakage in dentinal margins was higher than enamel margins (P < 0.001). In the groups with 46 wt% solvent (P = 0.103), 0 wt% (P = 0.122), and control group (P = 0.096), however, this difference was not significant. Conclusion: The adhesive containing 31 wt% solvent showed the least marginal microleakage, presence of POSS filler may also result in the reduction of microleakage.
  1,674 152 -