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   Table of Contents - Current issue
January-June 2017
Volume 7 | Issue 1
Page Nos. 1-61

Online since Friday, June 30, 2017

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Editorial message for volume 7 issue 1 of IJMD (January–June 2017) p. 1
KMK Masthan
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The prevalence of gingivitis and periodontal diseases in preschool children in Kolkata p. 3
Suchetana Goswami, Subrata Saha
Background: Gingivitis is common in children which if neglected may progress to periodontitis in the adults. Therefore, early diagnosis of gingivitis and appropriate therapeutic measures in children are of utmost importance to prevent or minimize progression of periodontitis in the adult population. Aims: The aim of this study was to determine the prevalence of gingivitis and periodontitis among preschool children in Kolkata. Materials and Methods: A cross-sectional survey of 200 children aged 2–5 years were performed from March 2015 to February 2016. The gingival index (GI) and pocket depth of fully erupted teeth were measured. Results: The comparison (t-test) of mean pocket depth was least (0.89 mm) between 3- and 4-year-old children and was highest (3.09 mm) between 2- and 4-year-old children. The mean GI among boys and girls differ significantly (P < 0.001). The boys had a higher GI and pocket depth than girls the mean GI in school going children was 0.67 ± 0.22 and in nonschool going children, it was 1.189 ± 0.12, and mean pocket depth was 2.05 ± 0.32 and 2.77 ± 0.55, respectively. The mean GI and pocket depth in children of upper and lower socioeconomic condition differ significantly. Conclusion: Preschool children in and around Kolkata suffer from varying degree of gingival diseases, and comprehensive preventive programs are needed to improve their oral health.
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Cleanliness drive: Straight wire appliance or Begg's appliance??? p. 8
Sanjeev Vasudev Jakati, Radhakrishna Gogineni, Mrunal S Aley, Harish K Atram, Achint D Chachada
Context: Plaque is a major etiological factor in causation of periodontal disease. Orthodontic appliances are known to accumulate plaque owing to their complex configuration. Aim: The aim of this study was to evaluate difference in plaque accumulation both quantitatively and qualitatively, and oral hygiene maintenance, between Begg's and Straight Wire appliances. Subjects and Methods: Eighty patients (40 of Begs and 40 of MBT) aged between 13 and 23 years were subjected to oral prophylaxis to bring the plaque score to zero before the start of study and were asked to report every 2 weeks to identify the microbial shift in plaque sample. The disclosing solution was applied on labial and lingual tooth surfaces and plaque was scored with the help of Quigly and Heins index. The plaque samples were collected in 2 ml of saline containing test tubes. Data were analyzed using IBM-SPSS software version 22. P<0.005 was considered statistically significant level. Results and Conclusion: Significant difference between Beggs group and MBT group for variables V1 (plaque index) and V2 (spirochetes count) at each time point existed. Furthermore, MBT group patients showed an increase in plaque index value at each point. In spite of maintaining same environment, plaque accumulation and spirochetes are more in Straight Wire appliance than Begg's.
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Oral cancer profile among patients who underwent oral biopsy in a tertiary referral center in Central Kerala p. 14
Sandhya Kandath, Bobby John, G Shobitha
Background: Oral cavity is one of the most common sites for cancer in our population due to a high prevalence of tobacco use in the country. Aim: The aim of this study was to retrospectively assess the oral cancer profile among patients who underwent biopsy in a tertiary center in Central Kerala and thereby implement the preventive measures for controlling it. Materials and Methods: This retrospective study was conducted by analyzing the histopathological records in the Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, from June 2008 to May 2014. Results: The study showed that among 1270 patients who underwent biopsy as a part of the diagnostic procedures during the study period, 570 (44.8%) patients were diagnosed as having dysplasia, premalignant and malignant lesions. Out of this, 361 patients were diagnosed with oral squamous cell carcinoma (SCC). There was an increased predilection of oral cancer among males and the predominant age group affected was between 61 and 70 years of age, followed by 30–40 years age group. Buccal mucosa was the most common site accounting for 42.6% of the total cases. The most prevalent histopathological pattern was moderately differentiated SCC. Statistically significant association was found between age group and histopathological grading, subsite, and histopathological grading with P< 0.005. Conclusion: The increased prevalence and younger age group involvement of oral SCC in the study suggest that preventive measures should be implemented in our society at the earliest. The data found in the study can be used to make public awareness of the harmful effects of tobacco and alcohol.
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Evaluation of clinical effificacy of Terminalia chebula inplaque-induced gingivitis: A randomized control trial p. 21
P S Viola Esther, S Elanchezhiyan, Rajkumar Daniel, TB Meenalochani, T Pavithra, D Surya
Introduction: Plaque control is fundamental to the prevention and management of periodontal diseases. However, most of the individuals do not practice plaque removal in an adequate manner. Hence, there is a need for an antiplaque agent that can be used on a daily basis without the side effects of antibacterial chemicals. The aim of the study is to evaluate the clinical efficacy of Terminalia chebula in patients with chronic gingivitis. Materials and Methods: Eighty patients, 18–40 years of age, diagnosed with chronic generalized gingivitis were selected and randomly divided into two groups. Group I underwent oral prophylaxis alone whereas Group II underwent oral prophylaxis and advised to do gingival massage by T. chebula powder. Clinical evaluation was done using plaque index (PI), gingival index (GI), and gingival bleeding index (GBI) at baseline and after 1 month. Results: Gingival massage with T. chebula powder showed a significant reduction in PI, GI, and GBI scores from baseline to 1 month. Conclusion: T. chebula powder is a useful herbal formulation for plaque control in patients with chronic gingivitis.
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Immunofluorescence as a diagnostic tool p. 25
Aarthi Ramachandran, T Radhika, Nadeem Jeddy, R Ananthalakshmi
Immunofluorescence (IF) is a molecular method for detection of antigen or antibody in a tissue section/serum sample. It is increasingly being used as an ancillary investigation that can add to the certainty of diagnosis, sometimes modify it and occasionally reveal a differential diagnosis. IF has also proved to be useful in assessing therapeutic response and predicting relapse. This review article discusses about the various techniques of IF and its diagnostic implication in mucocutaneous diseases.
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Hydrogels in maxillofacial prosthesis p. 29
Muthuvignesh Jayaram, N Sumankumar, S Egammai, S Rajkumar, N Nivethitha
Background: There is a growing need for prosthetic replacements in humans due to various reasons. Oro-facial deformities contribute more for these treatment modalities due to impairment in both function and esthetics. Biomaterials play an important role in replacing any form of defects. Selection of a good biomaterial is of prime importance as these materials determine the success of the treatment outcome. Acrylic resins and silicones are the most popular materials for replacing the lost tissues as far as the maxillofacial prosthesis is concerned. But these materials only help in covering the defect and give a very little therapeutic effect. Acrylic resins are very rigid materials and are less tolerated by the ailing patients. Silicones have very poor edge strength and colour retaining capacity. Purpose of Study: Hydrogels are hydrophilic gels which can be manipulated using polymeric network, are considered suitable maxilla facial materials. Hydro gels in dentistry can readily replace silicones as they have good physical, chemical and biological properties. They can also act as drug delivering devices which aids in healing of the defect and carriers for growth factors by which they stimulate the bone and tissue growth and they can be modified for their rigidity to have a good edge strength more recently. All these factors facilitate the hydrogels to serve as a good maxillofacial prosthesis material. Summary and Conclusion: Hydrogels are biocompatible materials which act as both therapeutic and replacement devices for the oro facial defects and can improve the patient's perception towards the positive outcome of the treatment.
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Furcation involvement: Still a dilemma p. 34
Zoya Chowdhary, Ranjana Mohan
Advances in dentistry, as well as the increased desire of patients to maintain their dentition, have led to treatment of teeth that once would have been thought to be removed; as furcally involved teeth present unique challenges to the success of periodontal therapy. The treatment, management, and long-term retention of molar teeth exhibiting furcation invasions, always have been a challenge to the discerning general dentist or dental specialist. Anatomically and morphologically complicating factors dictate modifications in treatment approaches used for managing these areas. This review evaluates the different aspects of furcation in terms of etiology, classification, diagnosis, and various treatment possibilities. This review evaluates the different aspects of furcation in terms of aetiology, classification, diagnosis and various treatment possibilities.
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Pulse therapy – A newer approach p. 41
Karuna Suran, Suran Pushpa
Pulse therapy is defined as discontinuous/intermittent intravenous infusion of very high doses of corticosteroids along with certain immunosuppressive agents over a short period. It has gained its popularity since last three decades due to the advantage of minimizing the adverse effects of conventional corticosteroid therapy, and their action is supposed to be mediated through nongenomic actions within the cell. The aim of pulse therapy is to achieve a faster response and stronger efficacy and to decrease the need for long-term use of systemic corticosteroids. This paper intends to review the various available pulse therapy regimens with dosages, indications, contraindications, and adverse effects.
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Prosthodontic management of a completely edentulous patient with Huntington's disease: A rare case report p. 45
Poojya Ramdev, Sapna Bhat, GS Amarnath, CS Shruthi
Dentists have a large role in geriatric health care for the ever increasing elderly population with associated physical and neurological disorders. According to the World Health Organization, between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%. Huntington's disease is a rare neurodegenerative, adult-onset familial disorder, which can affect both men and women. Poor oral hygiene and increased susceptibility to dental caries and periodontal diseases predispose them to early edentulism. Providing an effective dental prosthesis will alleviate functional, esthetic, and psychological disabilities of the patient. This case report explains the steps involved in the complete denture rehabilitation of a patient with Huntington's disease, with some modification of techniques and materials to suit the special situation.
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Biologic pre-extraction prosthesis (BPP): A provisional esthetic solution p. 49
Priyadarshini Rangarajan, Sankar Annamalai, J Selvakumar, M Anjana
The successful management of hopeless teeth in the anterior esthetic zone has become more challenging. Furthermore, extraction of anterior teeth has a far-reaching impact on an individual psyche. Immediate dentures and many other approaches have been described as a temporary replacement to give a feel good effect to the patient. This article presents a novel technique for provisionally replacing the anterior teeth with the use of unsalvageable natural teeth which are going to be extracted as biologic preextraction prosthesis. Furthermore, treatment with this technique led to overall improved esthetics, psychological wellbeing, and reduced treatment cost.
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Karyotype analysis for Turner syndrome p. 52
HS Vanishree, Shobha Bijjaraji, Anand S Tegginamani
The first karyotype investigation in a patient with Turner syndrome (TS) was performed in England, in 1959; prior to that, it was thought that humans possessed 48 chromosomes. Most individuals with down-syndrome possess 47 chromosomes, with an extra copy of chromosome 21. Most individuals with TS possess 45 chromosomes, with a missing X chromosome. Here, we present 45 XO karyotype analysis in a 12-year-old girl with TS; although it is common in females, it is still rare to encounter in dental institutions. Oral physicians and pediatric dentists need to be aware of the major clinical features for definitive diagnosis of TS for early recognition and timely investigation which will improve their quality of life and to guide for the oral care.
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Prosthetic management of a patient with an ocular defect p. 55
Ojasvi Nijhawan, Shreenivas Vasant Bhide, N Vasantha, Nikita Kandi
Prosthesis is an artificial substitute that is implanted into or integrated into a human body part to replace the missing natural organ, for the purpose of restoring a specific function or a group of related functions so that the patient may return to normal life as quickly as possible. An eye for an eye is what the old saying goes. The eye plays a vital role as one of the six senses. From vision to expression, it has varied functions. Loss of this organ severely impacts not only the vision but also self-confidence. A case report is presented where a simple technique is used to provide the subject with eye prosthesis as rapidly as possible.
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Traumatic optic neuropathy in zygomaticomaxillary complex fractures p. 58
Catherine Subha Chandran, Saravanan Chandran, P Priyadarshini, Vivek Narayanan
Traumatic optic neuropathy (TON) is uncommon, yet a serious sequela to a facial injury. The American Medical Association equates the total loss of vision in one eye to a 24% impairment of a whole man. Literature from the late 90s state, the occurrence of some 55 million eye injuries globally per day. Poor visual perception in 3% of maxillofacial trauma cases was evident in Indian studies carried out in 2011. This has been attributed in most cases to TON resulting from indirect injury to the optic nerve. Clinical diagnosis of TON is made on the basis of a specific constellation of history and physical examination findings. Magnetic resonance imaging with its inherent superior soft tissue contrast resolution has helped identify this problem early to a certain extent. However, the clinical situations characteristic of this type of injury makes a diagnosis and early surgical intervention difficult. Its management remains controversial, and data in literature does not indicate anyone to be superior to the other. Here, we present our experience with a case which fell into this much-disputed category.
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