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   2013| April-June  | Volume 4 | Issue 2  
    Online since July 11, 2013

 
 
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CASE REPORTS
Management of anterior dental crossbite with removable appliances
Ayca Tuba Ulusoy, Ebru Hazar Bodrumlu
April-June 2013, 4(2):223-226
DOI:10.4103/0976-237X.114855  PMID:24015014
This case report describes the treatment of an 8-year-old girl with anterior dental crossbite using a series of removable appliances to bring the teeth into a normal position. Clinical presentation and intervention: A removable acrylic appliance with a bite plate incorporating a screw was used to correct the anterior dental crossbite and align the incisors. The subsequent eruption of the maxillary left lateral incisor on the palatinal side was treated with a second acrylic plate incorporating a labiolingual spring. After an 8-month period, the anterior crossbite involving multiple incisors was corrected.
  9,688 1,182 2
Oral proliferative verrucous leukoplakia: A case report with an update
Rakhi Issrani, Namdeo Prabhu, Vaishali Keluskar
April-June 2013, 4(2):258-262
DOI:10.4103/0976-237X.114887  PMID:24015023
White lesions both physiologic as well as pathologic are relatively frequent in the oral cavity, the most common pathology being oral leukoplakia (OL). There are many variants of OL, one of which is oral proliferative verrucous leukoplakia (OPVL). OPVL is a rare clinico-pathological entity, which is slow growing, long-term progressive lesion, but remains an enigmatic and difficult to define. The etiology of OPVL remains still unclear. Tobacco use does not seem to have a significant influence on the appearance of OPVL. These lesions may occur both in smokers and non-smokers. It is observed more frequently in women and elderly patients over 60 years at the time of diagnosis. The buccal mucosa and tongue are the most frequently involved sites. It develops initially as a white plaque of hyperkeratosis that eventually becomes a multifocal disease with confluent, exophytic and proliferative features. Various published case series have presented OPVL as a disease with aggressive biological behavior due to its high probability of recurrence and a high rate of malignant transformation. Prognosis is poor for this seemingly harmless-appearing white lesion of the oral mucosa. This article describes the clinical aspects and histologic features of an OPVL case that demonstrated the typical behavior pattern in a long-standing, persistent lesion and discusses this relatively rare entity in light of current information.
  5,204 572 5
Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement
Rafael Scaf de Molon, Érica Dorigatti de Avila, João Antonio Chaves de Souza, Andressa Vilas Boas Nogueira, Carolina Chan Cirelli, Rogerio Margonar, Joni Augusto Cirelli
April-June 2013, 4(2):243-247
DOI:10.4103/0976-237X.114876  PMID:24015019
Forced orthodontic eruption (FOE) is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.
  4,713 374 8
Paget disease of bone: A classic case report
Y Uday Shankar, Satya Ranjan Misra, Daniel Alex Vineet, Pavitra Baskaran
April-June 2013, 4(2):227-230
DOI:10.4103/0976-237X.114858  PMID:24015015
Paget disease of bone (PDB) is a chronic progressive disease of the bone of uncertain etiology, characterized initially by an increase in bone resorption, followed by a disorganized and excessive formation of bone, leading to pain, fractures, and deformities. It can manifest as a monostotic or polyostotic disease. The prevalence of PDB is common in the Anglo-Saxon population, but relatively rare in India. The disease is often asymptomatic and commonly seen in an aging population. The diagnosis of the disease is mostly based on radiological examination and on biochemical markers of bone turnover. Markedly elevated serum alkaline phosphatase (SAP) is a constant feature while calcium and phosphate levels are typically within normal limits. It is being successfully treated by biphosphonates, a group of anti-resorptive drugs, thereby decreasing the morbidity and mortality associated with the disease. We report a classic case of PDB with craniofacial involvement resulting in Leontiasis Ossea (lion like face), cotton wool appearance of the skull and elevated SAP.
  4,490 388 4
Filariasis of the buccal mucosa: A diagnostic dilemma
Seema Kurup, Ravi Veeraraghavan, Renju Jose, Ushass Puthalath
April-June 2013, 4(2):254-257
DOI:10.4103/0976-237X.114883  PMID:24015022
Filariasis is an endemic disease in tropical and subtropical countries. Filarial nematodes can infect humans through vectors, commonly mosquitoes. Human infection can manifest as lymphatic filariasis, subcutaneous or pulmonary nodules and with eye involvement. Intra-oral presentation is very rare and often poses a diagnostic dilemma to the dentist. We report a case of intra-oral Dirofilaria repens infection in a 54-year-old female patient, involving the buccal mucosa. History was unremarkable and on clinical examination, a diffuse swelling with no significant signs and symptoms was seen. Laboratory investigations and radiographs were non-contributory to diagnosis. Ultrasound findings revealed a hypo-echoic lesion in the muscular layer of the left cheek. Differential diagnoses considered were minor salivary gland tumor, parotid sialolith, and cysticercosis among others. The presence of a Dirofilaria worm in the excised nodule confirmed the diagnosis. Medical awareness of the risk of intra-oral nematode infection is essential. A detailed travel history, awareness of endemic status of certain diseases, proper diagnosis and management helps in better prognosis for the patient.
  4,652 181 4
ORIGINAL ARTICLES
Comparison of esthetic outcome after extraction or non-extraction orthodontic treatment in class II division 1 malocclusion patients
Sneh Lata Verma, VP Sharma, Pradeep Tandon, Gyan P Singh, Kiran Sachan
April-June 2013, 4(2):206-212
DOI:10.4103/0976-237X.114886  PMID:24015010
Introduction: The extraction of premolars as a practical form of orthodontic therapy has been accepted for many years, but there remains a controversy regarding the effect of premolar extraction to improve esthetics as well as dentoskeletal relationship. The esthetic impact of the soft-tissue profile might play a major role in deciding on premolar extraction or non-extraction treatment, particularly in borderline patients. This cephalometric study was undertaken to compare the post-treatment soft-tissue profiles of successfully managed Class II, Division 1 malocclusions treated with either all first premolar extractions or treatment with a non-extraction therapy. Materials and Methods: The sample consisted of 100 post-pubertal female patients of Class II Division I malocclusion. Group 1, treated with four first premolar extractions, consisted of 50 female patients with a mean age of 14 years 1 month. Group 2, treated without extractions, consisted of 50 patients with a mean age of 13 years 5 months. Pre-treatment and post-treatment lateral cephalometric radiographs were evaluated. The pre-treatment to post-treatment stage comparison and the intergroup comparison of the treatment changes were conducted between extraction and non-extraction groups of Class II malocclusion samples with t-tests. Results: The soft-tissue facial profiles of the extraction and non-extraction samples were the same following active treatment except for a more retruded lower lip and a more pronounced lower labial sulcus in those patients subjected to extraction. Conclusions: The extraction or non-extraction decision, if based on sound diagnostic criteria, seems to have no systematic detrimental effects on the facial profile.
  3,813 477 3
CASE REPORTS
Full mouth rehabilitation of a patient with mandibular implant screw retained Fp-3 prosthesis opposing maxillary acrylic removable over-denture
Ashish R Jain, Deepak Nallaswamy, Padma Ariga, Jacob Mathew Philip
April-June 2013, 4(2):231-235
DOI:10.4103/0976-237X.114862  PMID:24015016
A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses.
  3,720 367 1
Intraosseous adenoid cystic carcinoma of maxilla: A rare case report
Prasannasrinivas Suresh Deshpande, Raja Lakshmi Chintamaneni, Bhavana Sujanamulk, M.P.V. Prabhat, Sarat Gummadapu
April-June 2013, 4(2):239-242
DOI:10.4103/0976-237X.114872  PMID:24015018
Adenoid cystic carcinoma (ACC) accounts for approximately 6-10% of all salivary gland tumors. Palatal minor salivary glands, parotid, and sub-mandibular glands are usually affected. Rarely, these lesions arising intraosseously have been reported. Mandible is commonly involved than maxilla. The present case is a giant ACC involving the right maxilla. A thorough clinical and radiographic evaluation was performed to assess the involvement of surrounding vital structures along with a meticulous metastatic work-up. Computed tomography showed a giant lesion in maxilla encroaching the left nasal fossa, antrum, buccal space, and oral cavity. No metastasis was noted. Histological evaluation from multiple sites showed both cribriform and solid patterns. Radiotherapy was given as patient did not comply for surgery. Though central ACC is extremely rare, especially in maxilla, it should be included in the differentials for lesions in maxilla. A prompt diagnosis with treatment and long-term follow-up is advised in such cases.
  3,505 202 2
ORIGINAL ARTICLES
The effect of four sprue shapes on the quality of cobalt-chromium cast removable partial denture frame-works
M Viswambaran, SK Agarwal
April-June 2013, 4(2):132-139
DOI:10.4103/0976-237X.114839  PMID:24014998
Statement of Problem: Sprue design is a factor that controls the velocity and adequate supply of metal to the mould. Currently various manufacturers recommend different shapes of sprue, which have not been advocated in textbooks and literature is lacking for their routine applications. Purpose: This in vitro study was carried out to determine the efficacy of four sprue shapes in producing complete, void free cobalt-chrome removable partial denture frameworks. Materials and Methods: A brass metal die with a Kennedy class III, modification 1, partially edentulous arch was used and four sprue shapes (Group A-Ribbon, Group B-Square, Group C-Round and Group D- Round with reservoir) were evaluated. 40 refractory casts were made, 10 wax patterns for each sprue design were waxed up, invested with phosphate bonded investment material and castings done with induction casting machine by the same operator under standardized protocols. The cast frameworks were evaluated for 1.The defects observed visually before finishing and polishing procedures, 2. Fit on the master die as seen with naked eye and 3.Defects on radiographic evaluation. Data were tabulated and statistically analyzed with 1-way ANOVA followed by Student 't' test. Results: The results differed significantly (P < 0.0001) between the Groups with maximum defects in the castings of Group A followed in decreasing order by Group B, Group C and Group D. When comparing between the Groups (P < 0.05), the defects in Groups C and D was significantly lower than Group A and Group B. Conclusions: Round sprues with reservoir produced most satisfactory fit of castings with minimum number of internal and external defects.
  3,153 311 -
CASE REPORTS
Osteoradionecrosis of mandible: Case report with review of literature
Ravindran Rathy, S Sunil, M Nivia
April-June 2013, 4(2):251-253
DOI:10.4103/0976-237X.114882  PMID:24015021
Osteoradionecrosis (ORN) of the jaws, particularly of the mandible, is a long-term and serious complication of therapeutic radiotherapy for head and neck cancer. The mandible is affected more commonly than any other bones of the head and neck region. The incidence of ORN of mandible is reported to be between 2% and 22%. With the older radiation techniques, the rate of ORN was reported to be between 5% and 15%, whereas with newer techniques such as 3D conformal therapy and intensity modulated radiotherapy the rate of ORN has decreased to 6% or less. We here report a case of mandibular ORN and the literature review discusses the clinical features, pathogenesis, preventive measures, and management of ORN.
  3,080 315 -
ORIGINAL ARTICLES
Demographic and clinical profile of oral lichen planus: A retrospective study
Anita D Munde, Ravindra R Karle, Pranali K Wankhede, Safia S Shaikh, Meena Kulkurni
April-June 2013, 4(2):181-185
DOI:10.4103/0976-237X.114873  PMID:24015006
Introduction: Oral lichen planus (OLP) is a relatively common inflammatory mucocutaneous disorder that frequently involves the oral mucosa. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. An important complication of OLP is the development of oral squamous cell carcinoma, which led the World Health Organization (WHO) to classify OLP as a potentially malignant disorder. The demographic and clinical characteristics of OLP have been well-described in several relatively large series from developed countries, whereas such series from developing countries are rare. Objective: The objective of this retrospective study was to investigate the epidemiological and clinical characteristics of 128 OLP patients in rural population of India. Materials and Methods: In this study, the diagnostic criteria proposed by van der Meij et al. in 2003 based on the WHO definition of OLP were used to identify cases. Results: In 128 patients, M:F ratio was 1.61:1. The buccal mucosa was the most common site (88.20%). White lichen was seen in 83.59% and red lichen in 16.40% cases. Reticular type of OLP was the most common form (83.5%) followed by erosive (15.6%) and atrophic OLP (0.78%). The incidence of systemic diseases included hypertension (11%), diabetes mellitus (2.4%), and hypothyroidism (0.78%). Histopathologically epithelial dysplasia was present in 4 cases. Conclusion: Most of the characteristics are consistent with previous studies with differences in few. Lichen planus is a chronic disease where treatment is directed to control of symptoms. Long-term follow-up is essential to monitor for symptomatic flare ups and possible malignant transformation.
  3,012 336 7
A clinical study of the variation in horizontal condylar guidance obtained by using three anterior points of reference and two different articulator systems
Paranjay Prajapati, Rajesh Sethuraman, YG Naveen, Jayanti Patel
April-June 2013, 4(2):162-169
DOI:10.4103/0976-237X.114859  PMID:24015003
Background and Objectives: For mounting the maxillary cast to articulator, minimum three reference points not on single line, decide the plane to which maxillary cast is mounted. Variations exist in condylar guidance when different anterior reference points are used to mount the cast. Type of articulator may have influence on condylar guidance.A clinical study was planned to evaluate the effects of different anterior points of reference and two different articulator systems on condylar guidance. Materials and Methods: Total 15 subjects were selected. Six sets of maxillary casts were obtained. Face bow record was made using orbitale as anterior point of reference and the record was transferred to the Arcon and Non-Arcon articulator. The second and third mounting on Arcon and Non-Arcon articulator were done using Superior and inferior annular groove on incisal pin of articulator. Protrusive interocclusal records were made for all the subjects. Two lateral cephalograms one in maximum intercuspation and the other in protrusion for left and right side were taken. Anatomic condylar guidance of the subject were obtained from radiograph tracing. Arcon and Non-arcon articulator were programmed with Protrusive interocclusal record of the subjects and the condylar guidance was tabulated for right and left side. The procedure was repeated for all three mountings for both the articulators. Results: The orbitale is the best reference point which mounts maxillary cast closer to anatomic position. Inferior annular groove can also be used as anterior point of the reference. The superior annular groove is not recommended anterior point of reference.
  2,956 376 -
CASE REPORTS
Triple tooth in primary dentition: A proposed classification
Gaddam Shilpa, Sivakumar Nuvvula
April-June 2013, 4(2):263-267
DOI:10.4103/0976-237X.114890  PMID:24015024
Triple teeth may result from fusion, gemination or concrescence causing transient esthetic and functional problems in primary dentition and retardation or alteration of development and eruption of permanent successors. We report an unusual case of a boy aged five with fusion among maxillary left primary central incisor, lateral incisor and a supernumerary tooth concomitant with agenesis of permanent lateral incisor. A review of literature on triple tooth was done along with a proposed classification of the triple teeth.
  2,866 261 2
Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases
M.R. Ramesh Babu, C Ramesh, K Thirumurugan, G Arun Prasad
April-June 2013, 4(2):236-238
DOI:10.4103/0976-237X.114868  PMID:24015017
Deep vein thrombosis (DVT) is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.
  2,952 170 -
ORIGINAL ARTICLES
Comparative evaluation of surface porosities in conventional heat polymerized acrylic resin cured by water bath and microwave energy with microwavable acrylic resin cured by microwave energy
Sunint Singh, Jayant N Palaskar, Sanjeev Mittal
April-June 2013, 4(2):147-151
DOI:10.4103/0976-237X.114844  PMID:24015000
Background: Conventional heat cure poly methyl methacrylate (PMMA) is the most commonly used denture base resin despite having some short comings. Lengthy polymerization time being one of them and in order to overcome this fact microwave curing method was recommended. Unavailability of specially designed microwavable acrylic resin made it unpopular. Therefore, in this study, conventional heat cure PMMA was polymerized by microwave energy. Aim and Objectives: This study was designed to evaluate the surface porosities in PMMA cured by conventional water bath and microwave energy and compare it with microwavable acrylic resin cured by microwave energy. Materials and Methods: Wax samples were obtained by pouring molten wax into a metal mold of 25 mm × 12 mm × 3 mm dimensions. These samples were divided into three groups namely C, CM, and M. Group C denotes conventional heat cure PMMA cured by water bath method, CM denotes conventional heat cure PMMA cured by microwave energy, M denotes specially designed microwavable acrylic denture base resin cured by microwave energy. After polymerization, each sample was scanned in three pre-marked areas for surface porosities using the optical microscope. As per the literature available, this instrument is being used for the first time to measure the porosity in acrylic resin. It is a reliable method of measuring area of surface pores. Portion of the sample being scanned is displayed on the computer and with the help of software area of each pore was measured and data were analyzed. Results: Conventional heat cure PMMA samples cured by microwave energy showed maximum porosities than the samples cured by conventional water bath method and microwavable acrylic resin cured by microwave energy. Higher percentage of porosities was statistically significant, but well within the range to be clinically acceptable. Conclusion: Within the limitations of this in-vitro study, conventional heat cure PMMA can be cured by microwave energy without compromising on its property such as surface porosity.
  2,699 413 8
Effectiveness of sub gingival irrigation of an indigenous 1% curcumin solution on clinical and microbiological parameters in chronic periodontitis patients: A pilot randomized clinical trial
Sruthima N. V. S. Gottumukkala, Suneetha Koneru, Satheesh Mannem, Narendra Mandalapu
April-June 2013, 4(2):186-191
DOI:10.4103/0976-237X.114874  PMID:24015007
Aim: The aim of this study is to evaluate the efficacy of 1% curcumin (CU) solution and compare it with conventional irrigant i.e., 0.2% chlorhexidine (CHX) gluconate and a positive control (saline) as an adjunct to thorough scaling and root planing. Materials and Methods: A total of 23 patients with non-adjacent probing pocket depths (PPDs) ≥5mm were randomly assigned to CHX, CU and positive control irrigation groups and subjected to randomized single blinded clinical control trial. The clinical parameters bleeding on probing, redness, plaque index, PPD and microbiological parameter N-benzoyl-DL-arginine-2-naphthylamide (BANA) test were evaluated at baseline, 1, 3 and 6 months interval. Results: At 1 month evaluation, CU group showed better results compared with the other groups. However, by the end of the study period CHX group showed the best results with as light recurrence in the CU group. The results of BANA test showed similar results for both CU and CHX group throughout the study period. Conclusion: The results of this study show a mild to moderate beneficiary effect of CU irrigation when used as an adjunct to Scaling and root planing. Further studies may be required using varied concentrations of the drug to improve the substantivity of the drug and also to prevent early re-colonization of periodontal pathogens.
  2,627 301 7
A comparative scanning electron microscopy study between hand instrument, ultrasonic scaling and erbium doped:Yttirum aluminum garnet laser on root surface: A morphological and thermal analysis
Mitul Kumar Mishra, Shobha Prakash
April-June 2013, 4(2):198-205
DOI:10.4103/0976-237X.114881  PMID:24015009
Background and Objectives: Scaling and root planing is one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time consuming. In search of more efficient and less difficult instrumentation, investigators have proposed lasers as an alternative or as adjuncts to scaling and root planing. Hence, the purpose of the present study was to evaluate the effectiveness of erbium doped: Yttirum aluminum garnet (Er:YAG) laser scaling and root planing alone or as an adjunct to hand and ultrasonic instrumentation. Subjects and Methods: A total of 75 freshly extracted periodontally involved single rooted teeth were collected. Teeth were randomly divided into five treatment groups having 15 teeth each: Hand scaling only, ultrasonic scaling only, Er:YAG laser scaling only, hand scaling + Er:YAG laser scaling and ultrasonic scaling + Er:YAG laser scaling. Specimens were subjected to scanning electron microscopy and photographs were evaluated by three examiners who were blinded to the study. Parameters included were remaining calculus index, loss of tooth substance index, roughness loss of tooth substance index, presence or absence of smear layer, thermal damage and any other morphological damage. Results: Er:YAG laser treated specimens showed similar effectiveness in calculus removal to the other test groups whereas tooth substance loss and tooth surface roughness was more on comparison with other groups. Ultrasonic treated specimens showed better results as compared to other groups with different parameters. However, smear layer presence was seen more with hand and ultrasonic groups. Very few laser treated specimens showed thermal damage and morphological change. Interpretation and Conclusion: In our study, ultrasonic scaling specimen have shown root surface clean and practically unaltered. On the other hand, hand instrument have produced a plane surface, but removed more tooth structure. The laser treated specimens showed rough surfaces without much residual deposit or any other sign of morphological change.
  2,657 260 7
CASE REPORTS
Orthodontic movement of a maxillary central incisor with a horizontal root fracture treated using an intra-radicular fibre splint
Aditi Kapur, A Utreja, A Goyal, P Pankaj
April-June 2013, 4(2):271-273
DOI:10.4103/0976-237X.114889  PMID:24015026
This paper reports the case of a 15-year-old boy with a horizontal root fracture in the left maxillary central incisor along with class II division 1 malocclusion for whom a fixed orthodontic treatment was planned. The fracture was present at the junction of apical and middle-third as a result of trauma 2 years back. No splinting was carried out at that time and the tooth was found to be vital, asymptomatic and showed a type-1 repair pattern. An intentional root canal treatment was carried out for placement of an intra-radicular fiber splint, nearly 3 mm beyond the fracture line. Orthodontic treatment was initiated after a month; to which the fractured and splinted tooth responded successfully. This report highlights the successful use of an intra-radicular splint for horizontally fractured tooth requiring orthodontic treatment.
  2,446 216 -
ORIGINAL ARTICLES
A comparative evaluation of the retention of metallic brackets bonded with resin-modified glass ionomer cement under different enamel preparations: A pilot study
Padmaja Sharma, Ashima Valiathan, Ankit Arora, Sachin Agarwal
April-June 2013, 4(2):140-146
DOI:10.4103/0976-237X.114842  PMID:24014999
Introduction: For orthodontists, the ideal bonding material should be less moisture-sensitive and should release fluoride, thereby reducing unfavorable iatrogenic decalcification. Resin-Modified Glass Ionomer Cements (RMGICs), due to their ability to bond in the presence of saliva and blood can be a very good bonding agent for orthodontic attachments especially in the areas of mouth, which are difficult to access. Moreover, their fluoride releasing property makes them an ideal bonding agent for patients with poor oral hygiene. However, their immediate bond strength is said to be too low to immediately ligate the initial wire, which could increase the total number of appointments. The effect of sandblasting and the use of sodium hypochlorite (NaOCL) on the immediate bond failure of RMGIC clinically have not been reported in the literature until the date. This investigation intended to assess the effect of sandblasting (of the bracket base and enamel) and NaOCL on the rate of bond failure (with immediate ligation at 30 min) of Fuji Ortho LC and its comparison with that of conventional light cured composite resin over a period of 1 year. Materials and Methods: 400 sample teeth were further divided into 4 groups of 100 each and bonded as follows: (1) Group 1: Normal metallic brackets bonded with Fuji Ortho LC. (2) Group 2: Sandblasted bracket base and enamel surface, brackets bonded with Fuji Ortho LC. (3) Group 3: Deproteinized enamel surface using sodium hypochlorite and brackets bonded with Fuji Ortho LC. (4) Group 4: Normal metallic bracket bonded with Transbond XT after etching enamel with 37% phosphoric acid. This group served as control group. Results and Conclusion: Results showed that sandblasting the bracket base and enamel, can significantly reduce the bond failure rate of RMGIC.
  2,402 236 5
Comparison of the efficacy of chlorhexidine varnish and chip in the treatment of chronic periodontitis
BS Jagadish Pai, Smitha Anitha Rajan, M Srinivas, R Padma, Girish Suragimath, Amit Walvekar, Saakshi Goel, Vinesh Kamath
April-June 2013, 4(2):156-161
DOI:10.4103/0976-237X.114848  PMID:24015002
Background: The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone. Materials and Methods: Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3 rd site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively. Results: All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites. Interpretation and Conclusion: The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30 th day and 90 th day from baseline when compared to SRP alone. The results though were not statistically significant.
  2,345 234 2
Acquired acid resistance of human enamel treated with laser (Er:YAG laser and Co 2 laser) and acidulated phosphate fluoride treatment: An in vitro atomic emission spectrometry analysis
Anju Mathew, N Venugopal Reddy, DK Sugumaran, Joby Peter, M Shameer, Liju Marcely Dauravu
April-June 2013, 4(2):170-175
DOI:10.4103/0976-237X.114864  PMID:24015004
Background: Dental caries is essentially a process of diffusion and dissolution. If the aspect of dissolution can be curtailed some degree of prevention can be achieved. Aims: The present study was carried out to evaluate and compare the effect of Er:YAG laser and Co 2 laser irradiation combined with acidulated phosphate fluoride treatment on in vitro acid resistance of human enamel. Design: An in vitro study was carried out on 30 human premolars to evaluate the enamel's acid resistance using an atomic emission spectrometry analysis. Materials and Methods: A total of 60 enamel specimens were prepared from 30 human premolars and were randomly assigned to 6 groups: (1) Untreated (control); (2) 1.23% acidulated phosphate fluoride (APF) gel application alone for 4 min; (3) Er:YAG laser treatment alone; (4) Co 2 laser treatment alone; (5) Er:YAG laser + APF gel application; (6) Co 2 laser + APF gel application. The specimens were then individually immersed in 5 ml of acetate buffer solution (0.1 mol/L, pH 4.5) and incubated at 37°C for 24 h, and the acid resistance was evaluated by determining the calcium ion concentration using the atomic emission spectrometry. Statistical Analysis: An ANOVA model was constructed (P value of 0.05), followed by Tukey's test for multiple pair wise comparisons of mean values. Results: Significant differences were found between the control group and the test groups ( P < 0.001). Conclusions: Combining acidulated phosphate fluoride with either Er:YAG or Co 2 laser had a synergistic effect in decreasing the enamel demineralization more than either fluoride treatment or laser treatment alone.
  2,305 220 6
Resistin in serum and gingival crevicular fluid as a marker of periodontal inflammation and its correlation with single-nucleotide polymorphism in human resistin gene at −420
Swati Pradeep Patel, Pradeep Avani Raju
April-June 2013, 4(2):192-197
DOI:10.4103/0976-237X.114878  PMID:24015008
Aims: Resistin is an adipocytokine, which have been studied for its role in insulin resistance and recently in inflammation. The aim of the present study is to assess the concentration of resistin in serum and gingival crevicular fluid (GCF) and to compare the levels between subjects with and without periodontitis and type 2 diabetes mellitus (T2DM) and to further correlate the resistin levels with the single-nucleotide polymorphism (SNP) at −420. Setting and Designs: A total of 96 subjects (48 males and 48 females) were divided on the basis of gingival index (GI), probing pocket depth (PD), clinical attachment level (CAL) and hemoglobin A 1c levels into healthy (group 1, n = 24), uncontrolled-diabetes related periodontitis (group 2, n = 24), controlled-diabetes related periodontitis (group 3, n = 24) and chronic periodontitis without T2DM (group 4, n = 24). Materials and Methods: The GCF and serum levels of resistin were quantified using the enzyme-linked immunosorbent assay and compared among the study groups. Further, the association of the resistin levels with periodontal inflammation and SNP at −420 was studied. Results and Conclusion: The resistin levels in GCF and serum from patients with periodontitis or diabetes mellitus related periodontitis (controlled or uncontrolled) were higher than that of healthy subjects and correlated positively with GI. Further, subjects with GG genotype at −420 showed significantly higher GI, PD, CAL as compared with genotype group CC. Resistin was detected in all serum and GCF samples and was significantly higher in periodontitis. Further, GG genotype at −420 was associated significantly with periodontal inflammation and resistin levels.
  2,266 243 4
A comparative evaluation of antioxidant enzymes and selenium in the serum of periodontitis patients with diabetes mellitus type 2
Biju Thomas, Amitha Ramesh, Sneha Suresh, B Rajendra Prasad
April-June 2013, 4(2):176-180
DOI:10.4103/0976-237X.114867  PMID:24015005
Context: Chronic periodontitis is an inflammatory disease with an aberrant response characterized by exaggerated inflammation, involving the release of excess proteolytic enzymes and reactive oxygen species (ROS). Diabetes mellitus is a group of complex multisystem metabolic disorders characterized by a relative or absolute insufficiency of insulin secretion and or concomitant resistance to the metabolic action of insulin on target tissues. Increased production of ROS necessitates elevated requirements for the nutrients involved in antioxidant defenses: Selenium, zinc, and copper. Inflammatory states promote a decrease in the amount of systemic glutathione levels. Catalase is a central antioxidant enzyme constituting the primary defense against oxidative stress. Aims: This study has been designed to evaluate the comparison of glutathione, catalase, and selenium levels in the serum of diabetes mellitus type 2 patients and healthy individuals with and without periodontal disease. Settings and Design: This study is a case control study. Materials and Methods: The study was designed as a case - control study comprising of 150 subjects, inclusive of both sexes and were divided into three groups of 50 patients each. Group I: 50 subjects with type 2 diabetes mellitus and chronic periodontitis. Group II: 50 subjects who are systemically healthy with the chronic periodontitis. Group III: 50 subjects who are systemically healthy and not suffering from Periodontitis: Serum samples were taken for estimation of glutathione, catalase, and selenium from all groups, and Subjected to biochemical analysis after which atomic absorption spectrophotometry method was used to obtain their levels in serum. Statistical Analysis Used: ANOVA and Tukey HSD. Results: The serum levels of glutathione in diabetic patients with periodontitis were significantly lower with a mean of 61.36 + 8.054 when compared to healthy individuals with and without periodontitis with a mean of 56.93 + 6.874 and 90.36 + 6.564 respectively (P ≤ 0.005). The serum levels of catalase were significantly lower in diabetic patients with periodontitis with a mean of 19.30 + 7.355 when compared to healthy individuals with and without periodontitis with a mean of 20.71 + 6.472 and 36.09 + 5.108 respectively ( P ≤ 0.005). The serum levels of selenium were significantly lower in diabetic patients with periodontitis with a mean of 81.41 + 55.419 when compared to healthy individuals with and without periodontitis with a mean of 161.44 + 84.787 and 193.84 + 66.713 respectively (P ≤ 0.005). Conclusions: The findings from the study suggest that the levels of glutathione, catalase, and selenium are significantly lower in diabetic patients with periodontitis and also in healthy individuals with periodontitis, but are highest in healthy controls, showing that the serum levels are inversely proportional to inflammation and tissue destruction.
  2,226 211 9
CASE REPORTS
Abberantly placed impacted mandibular canine
Rashi Bahl, Jeetinder Singla, Mohita Gupta, Ankit Malhotra
April-June 2013, 4(2):217-219
DOI:10.4103/0976-237X.114850  PMID:24015012
Pre-eruptive migration of a tooth across the midline is termed as transmigration. It is believed that transmigration is rare and unique to the mandibular permanent canines, and even more rarely reported for others. Transmigration is a phenomenon of yet unknown etiology. It follows the direction of its long axis, with the crown leading the migration. The tendency of a canine to cross the barrier of mandibular midline suture is a more important consideration than the distance of migration after crossing the midline. Here we present one new case of aberrantly positioned right mandibular canine which has undergone migration and was accidently found on radiological examination before orthodontic treatment. Once diagnosed an aberrantly positioned impacted canine requires surgical removal.
  2,171 232 3
Maturogenesis of non-vital immature permanent teeth
Ritesh R Kalaskar, Ashita R Kalaskar
April-June 2013, 4(2):268-270
DOI:10.4103/0976-237X.114891  PMID:24015025
Pulpal necrosis in young permanent teeth often results in teeth with open apex, thin root walls and poor crown root ratio. Out of the available treatment options maturogenesis has been the most conservative option that exploits full potential of pulp for dentin deposition. Maturogenesis involves disinfecting the root canal system followed by stimulation of blood clot from the periapical tissue, which provides a matrix into which the cell could grow and sealing the coronal excess. In the present case report, tri antibacterial paste (3 Mix) was used as an intracanal medicament that proved successful in stimulating vital pulp cells of the periapical region for maturogenesis. Five months radiograph follow-up showed thickening of lateral dentinal walls, which progress until 15 months resulting in apical closure, thickening of lateral dentinal walls and increase root length.
  2,048 297 3
Facial pain due to elongated styloid process
Indu Bhusan Kar, Niranjan Mishra, Subhrajit Raut, Akhilesh Kumar Singh
April-June 2013, 4(2):248-250
DOI:10.4103/0976-237X.114879  PMID:24015020
Pain is the most frequent cause of suffering and disability. The etiology of orofacial pain is still elusive. However, the etiology has to be ascertained for definitive treatment. Only after a systematic and careful evaluation can a treating surgeon be aware of the underlying cause. Though dental causes predominate in the diagnosis of orofacial pain, the rare cause of facial pain have to be excluded, which would prevent unnecessary and fruitless dental treatment. The present case is an example of a rare condition that may be overlooked during examination. This paper will describe a case of vague unilateral orofacial pain, the diagnosis of which zeroed down to an elongated styloid process.
  2,070 172 3
Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma
Sagar S Vaishampayan, Deepa Nair, Asawari Patil, Pankaj Chaturvedi
April-June 2013, 4(2):220-222
DOI:10.4103/0976-237X.114852  PMID:24015013
Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be misleading. Clinical course and radiological features help immensely in these situations. Good communication between surgeon, radiologist, and pathologist is of paramount importance.
  2,068 133 2
ORIGINAL ARTICLES
Distance and protective barrier effects on the composite resin degree of conversion
Margareth Coutinho, Natália Carvalho Trevizam, Renata Nakase Takayassu, Ariene Arcas Leme, Giulliana Panfiglio Soares
April-June 2013, 4(2):152-155
DOI:10.4103/0976-237X.114845  PMID:24015001
Context: The food wrap films are used to cover the tip of curing light units in order to avoid contamination and prevent damage to the light guide. However, their effects on resin polymerization are not fully known. Aims: We investigated the effects on restoration efficiency of a food wrap protective barrier used on the tip of curing light units. Materials and Methods: For each treatment, five replications were performed, a total of 60 bovine incisor. The degree of conversion (%DC) of restorations with the composite resin Opallis EA2 was evaluated using 3 curing light devices (Optilux 501, Optilight and Ultra LED) and 2 curing distances (0 and 5 mm). The composite resin was tested for restoration of cavities in bovine crowns. %DC values were measured by the Fourier transform infrared spectroscopy-attenuated total reflectance technique. Statistical Analysis Used: The data were analyzed using 3-way ANOVA and Tukey's test. Results: Use of the protective film lowered %DC ( F = 4.13; P = 0.05), and the effects of curing distance were associated to the curing light device ( F = 3.61; P = 0.03). Conclusions: The distance from the light curing tip and use of a translucent protective barrier on the light-cure device can both impair composite resin %DC.
  1,872 208 3
EDITORIAL
Does raisins protect against cavities?
SG Damle
April-June 2013, 4(2):131-131
DOI:10.4103/0976-237X.114837  PMID:24014997
  1,470 154 -
ORIGINAL ARTICLES
The effect of using different rinsing angles on the micro-tensile bond strength of the sealant to the etched enamel
Hossein Afshar, Yahya Baradaran Nakhajavani, Rahil Ahmadi
April-June 2013, 4(2):213-216
DOI:10.4103/0976-237X.114888  PMID:24015011
Background and Objectives: Attempts to enhance bond strength of the sealant have been among the most important sides of dental research. The purpose of the present study was to evaluate the effect of using different rinsing angles on the micro-tensile bond strength of the sealant to the etched enamel. Materials and Methods: Sixty first-premolars were randomly assigned to six groups based on the rinsing angle applied (15°, 30°, 45°, 60°, 75° and 90°). Following etching and rinsing, a 4-mm height build-up of sealant material was created. Bonded specimens were sectioned into sticks (1 mm × 1 mm), which were subjected to micro-tensile bond strength, testing at a cross head speed of 0.5 mm/min. Statistical Analysis Used : The data were analyzed by Kolmogorov-Smirnov and post-hoc Tukey test. Results: The tensile bond strength in specimens rinsed at 90° were statistically higher compared to those rinsed at 15° and 30° (P < 0.05) and increasing the angle from 15° to 90° was correlated with a reduction in the number of specimens with adhesive failures. Conclusions: Rinsing the conditioned enamel surface at 90° may improve the bond strength and retention of the sealant.
  1,489 117 -
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