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   Table of Contents - Current issue
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July-December 2017
Volume 7 | Issue 2
Page Nos. 63-154

Online since Thursday, December 28, 2017

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EDITORIAL  

Editorial message for IJMD volume 7 issue 2, July–December 2017 Highly accessed article p. 63
K M K Masthan
DOI:10.4103/ijmd.ijmd_59_17  
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ORIGINAL ARTICLES Top

Assessment of awareness regarding biomedical waste management among students and interns of dental institute p. 65
Anita Rama Kahar, Amishi Arora, Usha Radke, Jayashree Joshi
DOI:10.4103/ijmd.ijmd_14_17  
Introduction: In teaching institutes, most of the patients got treated by the students and the interns. They are the budding dentist of dental health-care profession. As these students and the interns work in direct contact with biomedical waste (BMW), they should have proper knowledge about its management to avoid the associated risk. Aims and Objectives: The aim of this study was to evaluate BMW education/awareness, awareness of BMW generation, hazard, and legislation and its management practices among the final BDS students and interns of VSPM Dental College and Research Centre, Nagpur, Maharashtra, India. Methodology: A cross-sectional questionnaire-based study was designed. The study was approved by the Institutional Ethical Committee. The questionnaire was consisted of 19 close-ended questions and one open-ended question. It was distributed anonymously among BDS final year students and interns. The solved questionnaire was collected back after 10 min and the data were analyzed. Results and Conclusion: The present study showed that awareness regarding the BMW was good and awareness about its generation; hazards, legislation, and awareness about BMW practices were moderate to poor.
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Validity and reliability of a questionnaire for measuring oral health-related quality of life in tobacco users p. 71
Sai HVN Krishna, Manaswini Eaturi
DOI:10.4103/ijmd.ijmd_20_17  
Background: The Oral Health Impact Profile (OHIP) is a well-known method for identifying dimensions in oral health-related quality of life. It measures the individuals' perception of the social impact of oral disorders on their well-being. Objective: To assess the validity and reliability of the oral health-related quality of life questionnaire in tobacco users. Materials and Methods: Data were collected from a sample of 210 patients using a modified (OHIP-21) questionnaire adopted from the OHIP-49 original questionnaire; responses were graded on a 5-point Likert scale. Results: The internal consistency reliability of the questionnaire, as estimated by Cronbach's alpha coefficient (α = 0.75), indicated that the components of the scale measured the same construct. Factor analysis provided a seven-factor model explaining 62.5% of the variance. Physical pain was loaded on the first factor. Conclusion: These preliminary results provided initial supportive evidence of the OHIP-21 reliability and validity in tobacco users. Further studies are needed to confirm this preliminary conclusion.
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Influence of music therapy to reduce anxiety during dental procedures in the Department of Prosthodontics p. 75
Neelam Abhay Pande, Jayashri Chahande, Usha Radke
DOI:10.4103/ijmd.ijmd_12_17  
Background: Music surrounds our lives. Music therapists assess emotional well-being, physical health, social functioning, and communication activities through musical responses. During all types of dental treatments, patients are very much apprehensive about the procedures. In prosthodontics, tooth preparation, patient's anxiety levels can be reduced, if his/her mind is diverted to listen to music, thus getting maximum cooperation. Aim: To reduce the anxiety levels in patients receiving fixed partial dentures (FPDs), by listening to passive music using earphones. This was a randomized control experimental study. Materials and Methods: A total of 100 patients requiring FPDs between the ages of 18 and 45 years were randomly selected. Patients dental anxiety scale (DAS) and their blood pressure (BP) as well as heart rate (HR) were recorded before starting the procedure. They were divided into two groups: Group I as control (without music) and Group II (with music, where patients listened to the passive music using earphones throughout the treatment). In both the groups, patient's BP and HR were also recorded at the end of impression making. The data were tabulated. Statistical analysis was performed using Chi-square test and Fisher's exact tests. Results: From DAS scale analysis, among patients with medium and high levels of anxiety, music had a significant influence on their fear and comfort. Findings of Group I and Group II in hemodynamic variables were also much comparable including dentist's rating and patient's behavior, treatability, and cooperation during the procedure. Conclusion: The influence of music showed reduced anxiety levels among patients receiving FPDs. It also helped lower the level of tension, better treatability, and better adjustment to the prosthodontic treatment.
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Association of recurrent aphthous stomatitis and psychological stress in school going teenagers of Bhopal city, Central India: A descriptive study p. 82
Pooja Khare, Vijayta Sharva, Hina Handa, Khare Amit, Manish Jain
DOI:10.4103/ijmd.ijmd_23_17  
Aims and Objectives: The present study was framed with the intention to find the prevalence of psychological stress and aphthous ulcer in school going teenagers of Bhopal district and to find a correlation between the two and also to find a gender predilection for psychological stress and aphthous ulcer. Materials and Methods: The present study is a questionnaire-based study, and the questionnaire was derived from Ministry of Social Security, National Solidarity and Reform Institutions. It is a twenty-item scale with eighteen positive and two negative questions. Eight private and eight government schools were chosen, and the students were asked to fill the questionnaire. Students were divided into four categories depending on the level of stress. Results: Among the study group, 32.4% (382) of males and 46.6% (437) of females suffered from the aphthous. Nearly 84.2% of females and 64.7% males were stressed which was significant. Conclusion: Stress and aphthous have a positive correlation, and therefore, most of them who had ulcers were found to be stressed. It is therefore need of the present academic curriculum to inculcate stress-free environment for a healthy mind in a healthy body.
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Are adults enough motivated for orthodontic treatment: A questionnaire study p. 87
Monika Mahajan
DOI:10.4103/ijmd.ijmd_24_17  
Context: Facial esthetics is an important determinant of self and social perceptions. Increased awareness toward orthodontic treatment has led to increase in number of adults seeking orthodontic treatment to improve their facial appearance. Understanding of different factors associated with adult orthodontic treatment allows better assessment of the requirements and priorities of adults during the treatment. Aims: The aim of this study was to assess different motivational factors which lead to adults seeking orthodontic treatment. Settings and Design: The adult patients coming to orthodontic outpatient department were given a questionnaire before the start of the treatment. Materials and Methods: A sample of 45 adult patients which included fifteen males and thirty females within the age group of 18–35 years was taken who had come for orthodontic treatment. These patients were asked to fill a questionnaire before the start of the treatment. Statistical Analysis Used: Differences in response of patients toward treatment were also evaluated gender wise using t-test. The t- test was also used to determine the influence of the scores combined in each of the four subgroups in the questionnaire. Results: On assessing different factors which motivated adults to seek orthodontic treatment, it was found that most of the patients realized the need for the orthodontic treatment in adult age only followed by the fact that adult patients were mostly unhappy about their dental appearance in perception of their smile before treatment which motivated them to seek treatment at this age.
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A quantitative study of comparing the routine decalcification and microwave decalcification methods by using different decalcifying agents p. 94
Vidya Kadashetti, KM Shivakumar, Rajendra Baad, Nupura Vibhute, Uzma Belgaumi, Sushma Bommanavar, Wasim Kamate, Sonali Sankapal
DOI:10.4103/ijmd.ijmd_37_17  
Background: Decalcification is a process of complete removal of calcium salts from mineralized tissues. Microwave decalcification is a novel technique that can accelerate the duration of decalcification compared to the manual method, by increasing the temperature to evaluate the fastest decalcifying agents and methods (routine with Microwave decalcification) in both bone and tooth. Materials and Methods: The study group consisted of 80 hard tissues, 40 teeth and 40 pieces of 1 cm × 1 cm cut bone specimens were decalcified by both routine and microwave method using four decalcifying solutions (five bone pieces and five teeth in each agents for both routine and microwave method). The four decalcifying solutions were 8% nitric acid, 8% formic acid, 8%formal nitric acid, and 14% of ethylenediaminetetraacetic acid (EDTA). Results: Duration of decalcifi cation of bone and tooth by both methods with 8% nitric acid took 10 days for CD and 2 days for MD respectively. Similarly for rest of the acids took more time to decalcify in CD method than MD method. Fourteen percent EDTA gave excellent results followed by 8% formal nitric acid, and 8% formic acid has good results than 8% nitric acid. Conclusion: Microwave processing proved to be an efficient and reliable procedure for the decalcification of bones and tooth. Microwave decalcification yielded quicker and better results compared to the routine methods. Therefore, microwave can serve as a quicker and reliable diagnostic method for a pathologist.
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Prevalence of orofacial pain in pregnant women: A cross-sectional study p. 101
KM Shivakumar, Snehal Patil, Vidya Kadashetti, KV Suresh, Vaishali Raje
DOI:10.4103/ijmd.ijmd_43_17  
Background: Pregnancy is a special time in woman's life, during this period, they are highly vulnerable for oral changes which would cause orofacial pain. Although the orofacial pain is invariably noticed, their basic data on prevalence and its characteristics has not been evaluated so far. The aim of this study was to assess the prevalence of orofacial pain and its characteristics in pregnancy. Materials and Methods: A descriptive cross-sectional study was conducted among 100 pregnant women to assess the prevalence orofacial pain and its characteristics. Questionnaire regarding sociodemographics, orofacial pain prevalence and severity were administered. Data were collected and analyzed. Results: Thirty-three percent reported to have orofacial pain. Most participants were aged 20–34 years. Majority (73%) of respondents were completed secondary School and 74% were homemakers. Large number of participants were belong to lower middle (28%), poor (26%), and below poverty line (21%). In regard to stages of pregnancy, 36% of participants were in second trimester, followed by third trimester (33%) and first trimester (31%). Majority (47%) of patient experienced tooth pain due to hot/cold liquids. Spontaneous burning sensation from tongue and oral mucosa was noticed in 8%. Most of the pregnant women suffered from acute pain (65%). With regard to frequency of pain, 31% of pregnant women get 4–5 episodes of pain weekly, which is followed by once a week (27%), and daily pain in (23%). Duration of pain lasts for <1 h in (38%) pregnant women. Conclusion: Results draws an insight into baseline data on the prevalence orofacial pain and its characteristics. During pregnancy pain was high and the presence of tooth pain was dominant.
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To determine the correlation between anthropometric variable of obesity and periodontitis among Mid-Western population of Nepal p. 106
Bhawana Neupane Pant, Rajesh Kumar Goit, Pushpa Bhargava, Ganesh Prasad Neupane
DOI:10.4103/ijmd.ijmd_38_17  
Purpose: Periodontitis qualifies as a major public health problem owing to its high prevalence and incidence in all regions of the world. Among many predisposing factors of periodontitis such as age, hygiene, gender, socioeconomic status, and tobacco consumption, obesity also has significant impact. Although a lot of progress has been achieved in past decade on accessibility and awareness about oral health, the obesity still remains impending and burgeoning health concern in Nepal. With this trend, we can foresee that the body mass index (BMI), one of the commonly used indirect measure of obesity, might potentially turn out to be one of the leading factors of periodontitis. Materials and Methodology: We screened 300 healthy controls and divided into two groups – Group I (BMI >30) and Group II (BMI <30) to study the correlation between BMI and periodontal status. Results: Our result showed that periodontitis is significantly correlated with BMI (P = 0.023) in Group I whereas no such correlation was seen in Group II (P = 0.22). The prevalence of periodontal disease was more in Group I (43.1%) as compared to Group II (5.3%) persons (Odds ratio = 11.826 and 95% confidence interval 5.415–21.828). Conclusion: Our data suggest that the BMI can be a good predictor of periodontitis.
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Effect of denture cleansers and accelerated aging on the color stability of maxillofacial silicone: An in vitro study p. 110
N Manjula
DOI:10.4103/ijmd.ijmd_39_17  
Aim: Evaluate the effect of denture cleansers and accelerated aging on the color stability of a commercially available maxillofacial silicone. Materials and Methods: A commercially available maxillofacial silicone cosmesil M511 was mixed according to manufacturer's instruction with the incorporation of three pigments, namely, Burnt sienna, Hansa Yellow, and Alizarin red and packed into the stone molds prepared using metal dies according to ASTM standards. After processing, initial color measurement was carried out 72 h following processing using a spectrophotometer. The samples were later subjected to disinfection and accelerated aging for 504 h and 1008 h following which color measurement was carried out. The results were analyzed using one-way ANOVA and Tukey's multiple comparison test (P < 0.001). Results: There was a statistically significant difference in the color stability of the silicone samples pigmented with Hansa Yellow than with Burnt Sienna and Alizarin Red after disinfection and 504 h of accelerated aging. Silicone samples disinfected with Fittydent denture cleanser showed better color stability than samples disinfected with neutral soap. There was a statistically significant difference in the color stability of the samples after 1008 h of accelerated aging irrespective of pigmentation and disinfection method. Conclusions: Silicone samples pigmented with Hansa Yellow had greater color stability than the samples pigmented with other two pigments after disinfection and 504 h of accelerated aging. After 1008 h of aging, all samples showed poor color stability irrespective of pigmentation and disinfection method.
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Dental caries experience and use of dental services among inmates of a district jail, Tumkur city p. 116
Mythri Halappa, B Surya, NM Aswathi
DOI:10.4103/ijmd.ijmd_41_17  
Introduction: The present survey was carried out to assess the dental caries status among the jail inmates, which would be helpful in planning suitable oral health-care services in a prison setting. Methodology: A cross-sectional survey was conducted in district jail. Demographic details along with caries status using DMFT index were assessed. Results: Two hundred and three inmates were included in the study, and 79.8% had decayed or missing or filled tooth and 20.2% were free from dental caries. Conclusion: A high proportion of prison inmates were affected by dental caries indicating the need for initiating oral health promotion activities among prison inmates.
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REVIEW ARTICLES Top

D-lightful therapy in prevention of periodontal disease p. 120
Ramaprabha Govindarajulu, S Lakshmi Sree Shankar, Senthilkumar Swaminathan, V Krishnan
DOI:10.4103/ijmd.ijmd_33_17  
Vitamin D has been shown to regulate musculoskeletal health by mediating calcium absorption and mineral homeostasis. Studies have shown an association between alveolar bone density, osteoporosis, and tooth loss suggesting that low bone mass may be a risk factor for periodontal disease. An emerging hypothesis is that Vitamin D may be beneficial for oral health, not only because of its direct effect on bone metabolism but also due to its ability to function as an anti-inflammatory agent stimulating the production of antimicrobial peptides, thereby protecting the periodontium. Several recent reports demonstrate a significant association between periodontal health and the intake of Vitamin D. This review discusses the pharmacology behind Vitamin D supplementation, current literature concerning Vitamin D supplementation, and various supplementation options in the treatment of periodontal disease.
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Maxillary canine impaction to treat or not p. 124
Swet Nisha, Pratibha Shashikumar, Sourav Chandra
DOI:10.4103/ijmd.ijmd_21_17  
Management of impacted canine teeth requires early diagnosis and interception of the clinical situation. Various treatment modalities are available in literature, and the clinical situation may demand interdisciplinary approach. The treatment options should be time- and cost-effective with promising result both functionally and esthetically. This review article is an overview of etiology, diagnosis, and treatment modalities for the management of impacted canine.
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Photobiomodulation and oral wound healing p. 129
E Vinesh, S Marytresa Jeyapriya, M Sathish Kumar, M Arunachalam
DOI:10.4103/ijmd.ijmd_60_17  
Wounds can be classified into different types based on the etiology, clinical presentation, degree of contamination, and the extent of involvement of overlying skin. Wound healing is a complex, dynamic, well-orchestrated biological process that plays a vital role in the survival of humans. Both wounding and wound healing may occur in any tissue or organ of the body. In adults, wound healing commences as a cascade and includes the following phases: 1. hemostasis, 2. inflammation, 3. proliferation, 4. angiogenesis, 5. re-epithelialization, and 6. cross linking of collagen. Photobiomodulation (PBM) or low level laser therapy employs light energy to produce biological cell response and to restore cell function. It uses nonionizing light sources such as light emitting diodes and lasers, in the visible and infrared spectrum, and it is found to elicit numerous therapeutic benefits such as immunomodulation, promotion of wound healing, and rapid regeneration of tissues. This review aims to explore the molecular mechanisms of PBM and its role in wound healing. Further studies on the molecular mechanisms of PBM and their pathways can preclude promising clinical interventions for wound care.
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CASE REPORTS Top

Unusual cystic lesion in mandibular midline: A diagnostic dilemma p. 135
Aravinda Konidena, Samridhi Shekhar, Avani Dixit, Deepa Jatti Patil
DOI:10.4103/ijmd.ijmd_6_17  
Odontogenic neoplasms present with characteristic clinicoradiological presentation giving clue to their diagnosis. However, unusual presentations may confuse the clinician and diagnosis may become elusive. We encountered one such atypical presentation when a 60-year-old female presented with an unusually large cystic lesion in the mandibular midline, creating a diagnostic dilemma. Unicystic ameloblastoma (UA) presents with clinical and radiographic features of a jaw cyst but show a typical ameloblastomatous transformation of lining epithelium, with or without luminal and/or mural tumor proliferation on histologic examination. This variant differs from solid ameloblastoma in being less aggressive and being seen commonly in young individuals. Another unique fact about UA is that recurrence may be long delayed, and a long-term postoperative follow-up is essential for proper management of these patients.
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Cemento-ossifying fibroma: Report of a case and emphasis on its diagnosis p. 140
Amita Rani, Namita Kalra, Rajni Poswal, Sonal Sharma
DOI:10.4103/ijmd.ijmd_7_17  
Cemento-ossifying fibroma (COF) is a benign neoplasm characterized by replacement of normal bone by fibrous tissue and varying amounts of newly formed bone or cementum-like material, or both. The COF has caused considerable controversy because of confusion regarding terminology and the criteria for its diagnosis. A case of COF in a 60-year-old female patient is reported. We are reporting the clinical presentation, diagnostic imaging, and surgical treatments of this lesion in this paper.
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Hollow denture: A boon in increased interridge space in edentulous ridges p. 144
Priti Rahul Jaiswal, Neelam Pande, Rajlakshmi Banerjee, Usha Radke
DOI:10.4103/ijmd.ijmd_30_17  
The success of complete denture relies on the principles of retention, stability, and support. Increased interridge space, long lip length, and resorbed ridges lead to a heavy-weighted prosthesis which transmits the leverage forces, hence affecting the retention, stability, and support. This article describes the case of a completely edentulous patient with increased interridge space, which was successfully rehabilitated with a hollow denture by simplified technique.
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A new innovative light-emitting diode habit-breaking appliance p. 149
Anurag Sahu, Tarulatha Revanappa Shyagali
DOI:10.4103/ijmd.ijmd_49_17  
The aim of the present case report is to introduce a modified and innovative design for effective habit breaking with minimal patient discomfort. Abnormal oral habits are one of the major etiological factors in malocclusion. The harmful, unbalanced pressure bears upon the immature, highly malleable alveolar ridges and brings about potential changes in the position of teeth and occlusion. These habits can also cause behavioral problems and are socially unacceptable. Various methods and appliances are used to break the abnormal oral habits, as a part of treatment of malocclusion. The traditional habit-breaking appliances used so far can cause irritation to the tongue, subsequently leading to ulceration and in addition can also cause mastication and speech problems. The appliance is a regular Hawley's appliance with the addition of the light-emitting diode bulb and the switch. When the child's tongue or the finger touches the appliance, the light bulb gets illuminated, thus reminding the child to quit the habit. The said appliance utilizes easily available electrical gadgets that will function by disturbing the subconsciously built vicious cycle. The reminders send by its activation will break the pleasure perception obtained during the habit. Habit breaking through this appliance is effective as it is superior to other appliances in the mode of action as well as the design itself is attractive to the children.
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Mandibular swelling: An uncommon site of presentation of metastatic disease p. 152
Anand Raja, Balasubramanian Venkitaraman
DOI:10.4103/ijmd.ijmd_46_17  
Metastatic tumors affecting the oral cavity are relatively uncommon. Isolated lesion of the mandible, especially those with soft tissue involvement, needs to be correctly differentiated from the benign lesion and primary malignant tumors of the oral cavity. Herein, we describe a patient who had presented with painful swelling of the jaw. On evaluation, she was diagnosed to have a metastatic tumor of the mandible with no other sites of metastasis. A high degree of suspicion is required to identify metastatic involvement of the mandible, especially in patients with a previous history of nonhead and neck malignancy.
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