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  Most popular articles (Since May 08, 2015)

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Pulse therapy – A newer approach
Karuna Suran, Suran Pushpa
January-June 2017, 7(1):41-44
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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Gingival veneer: A prosthetic solution for the esthetically challenging black triangles: A case series
Cholan Ramanujam, Surya Rengasamy, Russia Marimuthu
January-June 2015, 5(1):23-26
Anterior dental esthetics becomes crucial in patients with periodontal disease with open embrasures, increased crown height, black triangles. This article describes a technique for fabrication of gingival veneer for patients with black triangles and gingival recession. This is a conservative method of obtaining esthetics with the advantage of predictable esthetics.
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Resolvins: A novel theraputic approach in treating periodontal disease
H Nilofer Farjana, Nithya Anand, SC Chandrasekaran
January-June 2015, 5(1):10-14
Unresolved inflammation is associated with several widely occurring diseases such as arthritis, periodontal diseases, cancer, and atherosclerosis. Endogenous mechanisms are that which curtail excessive inflammation. A newly emerging chemical mediators derived from polyunsaturated fatty acids were identified that controls the acute inflammatory response by activating local resolution. They are specialized pro-resolving lipid mediators that includes lipoxins (LXs), resolvins (Rv), protectins, and maresins, because they are enzymatically biosynthesized during resolution of self-limited inflammation. They have anti-inflammatory and pro-resolution actions of Rv of the D1 with up regulation of arachidonic acid-derived endogenous resolution pathways (LXA4). A novel therapeutic host modulating are for resolution of inflammation.
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Perioceutics - Where do we stand?
Pavithra Rangarajan Seshadri, Krishnan Viswanathan
January-June 2015, 5(1):15-22
Periodontitis is a multifactorial infectious disease of the supporting structures of the teeth, characterized by destruction of the bone and connective tissue. Specific periodontopathic bacteria and their virulence factors are the primary etiologic agents. However, the interaction of host defense mechanisms and these etiological agents play an important role in the onset and progression of the disease. Research began to focus very closely on bacterial-host interaction, leading to host bacterial interrelationship era. The shift in concentration on host response has led to the development of host modulatory therapies which could improve therapeutic outcomes, slow the progression of disease, allow for more predictable management of patients, and possibly even work as preventive agents against the development of periodontitis. This paper reviews the host modulatory therapy, which is the effective means when used as an adjunct to mechanical periodontal therapy in treating periodontal diseases.
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Furcation involvement: Still a dilemma
Zoya Chowdhary, Ranjana Mohan
January-June 2017, 7(1):34-40
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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Correlation of dental caries and blood group in Western Punjab population in India
Smit Singla, Akhilesh Verma, Snehil Goyal, Itika Singla, Anjali Shetty
July-December 2015, 5(2):59-61
Background: Prevalence and treatment of the caries disease are interconnected concepts. Association between dental caries and ABO blood group is not studied in relation to a specific geographic location. Here a study conducted on a group of patients belonging to Western Punjab region. Objective: To determine the severity of dental caries in each type of blood group (ABO). Methods: The sample for the study consisted of 150 patients undergoing routine dental checkup in the dental center. Correlation between dental caries and blood groups were done using decayed, missing, and filled teeth index. Results: There is increased the prevalence of dental caries in nonsecretor as compared to secretors in Western Punjab population. Conclusion: Non secretors are more prone to dental caries as compared to secretors.
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Systemic management of recurrent aphthous stomatitis
A Winnifred Christy, J Leelavathy, T Jones Raja Devathambi, VM Roobitha
July-December 2015, 5(2):72-76
Recurrent aphthous stomatitis is the most common chronic disease of the oral cavity, affecting 5–25% of the population. The underlying etiology remains unclear, and no curative treatment is available. Local treatment will suffice for the majority of aphthous ulcers and only in the case of continuous outbreaks and symptoms systemic drug should be prescribed as pain is intense, and topical treatment is unable to afford symptoms relief. Systemic therapy is indicated in such situations with the triune action of providing symptom relief, promoting wound healing, and preventing recurrence. A PubMed search with the keywords of aphthous ulcers and systemic management was done, and all clinical trials and review articles in English literature from 1985 to 2014 were retrieved and compiled.
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Assessment of bone healing around immediately loading dental implants in posterior maxilla with two different osteotomy techniques
Mahmoud A Abdelkarim, Mohammed Said Hamed, Mohammed A Elsholkamy, Abdelbadia Abdallah Abdelmabood
January-June 2015, 5(1):31-39
The posterior region of the maxilla is characterized by thin cortical bone and trabecular bone of low-density. In addition, in many instances the height of the bone in this region is insufficient to achieve high primary stability because of the presence of the maxillary sinus. The aim of this study was to assess bone healing around immediately loaded dental implants in the posterior maxillary region with two different osteotomy techniques, conventional technique versus condensing technique. Twenty implants were inserted in 10 patients each patient received 2 implants. One implant was inserted by a conventional technique other implant was inserted by condensing technique one on each side of the maxilla. The follow-up was done at the following intervals, immediate postoperative, 6-, 12-, and 24-week. One implant from the group of condensing technique showed failure after 4 weeks. The results of this research demonstrate the success rate was 90% for condensing group and 100% for the conventional group.
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Karyotype analysis for Turner syndrome
HS Vanishree, Shobha Bijjaraji, Anand S Tegginamani
January-June 2017, 7(1):52-54
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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Immunity and periodontics: Connecting the dots
HS Grover, Rohit Saini, Pearl Bhardwaj, Amit Bhardwaj
July-December 2015, 5(2):62-67
Immunity is divided into two parts – the innate and adaptive responses. The innate immune system relies upon limited receptors to detect invading pathogens but compensates by targeting conserved microbial components that are shared by the large groups of pathogens. Various cells involved in innate immune responses include neutrophils, macrophages, dendritic cells, mast cell, neutrophils, natural killer cells, and eosinophils. The innate immune responses are the first line of defense against invading pathogens. They are also required to initiate specific adaptive immune responses. The second kind of protection is adaptive immunity which develops throughout our lives. It uses two basic strategies – Humoral immunity which works to eliminate antigens that are extracellular and cellular immunity which deals with antigen residing within a host cell. T- and B-lymphocytes are the main self-defense weapons of the adaptive immune system. Adaptive immunity relies upon a clonal system with each T-cell and B-cell expressing its own unique receptor.
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Identification of gingival pigmentation patterns and its correlation with skin color, gender and gingival phenotype in an Indian population
Purshottam S Rakhewar, Harshal Pradip Patil, Manojkumar Thorat
July-December 2016, 6(2):87-92
Objectives: Esthetics and smile-enhancing treatments have become an integral part of the dentistry; people always consult with periodontist for obtaining acceptable gingival esthetics. In smile designing esthetics, the color of gingiva has a major role. Although there is no any gold standard technique for managing melanin hyperpigmentation, esthetic concerns have lead increasing awareness about different depigmentation procedures. The aim of this study is to identify gingival melanin pigmentation patterns and to investigate its relationship based on clinical analysis with skin color, gender and gingival phenotype for various treatment modalities. Methods: In total, 200 subjects without any systemic disease (100 males and 100 females with mean age 26.5 years) screened by a single person and categorized them by skin color as fair, wheatish, brown, and dark to identify the different distribution patterns of gingival melanin pigmentation anatomically. Along with this severity of melanin pigmentation and gingival phenotypes were assessed. By using a Chi-square test correlations of variables were checked. Results: A positive statistical correlation was noticed between severity of gingival pigmentation and skin color. Dark-skinned subjects had heavy gingival pigmentation. The majority of population had pigmentation in attached gingiva and interdental papillae. Conclusion: Within the limits of the present study, the majority of population showed a positive correlation with their skin color and the severity of melanin pigmentation.
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Injuries to oral soft tissues by different factors: A clinical study
Smit Singla, Akhilesh Verma, Snehil Goyal, Itika Singla, Anjali Shetty
January-June 2016, 6(1):7-10
Background: Injuries to oral soft tissues are common. These can be caused by chemical, thermal, physical agents, self-mutilation, denture associated, etc., In this study, 110 patients were included from western Punjab population coming for routine checkup. Different causes for different types of injuries were noticed and tabulated to find the percentage of each cause, causing injuries to oral soft tissue. Objective: To determine the quantitative analysis of different causes which are a causative factor of oral injuries. Methods: The sample for the study consisted of 110 patients undergoing routine dental checkup in the dental center. Quantitative analysis of each causing factor was done by taking proper history from the patients and careful oral examination. Results: Females are more prone to soft tissue injuries as compared to males, and chemical burn is most common cause of soft tissue injury found in 44 patients followed by denture associated ulcers in 36 patients out of 110 patients.
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Influence of music therapy to reduce anxiety during dental procedures in the Department of Prosthodontics
Neelam Abhay Pande, Jayashri Chahande, Usha Radke
July-December 2017, 7(2):75-81
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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The prevalence of gingivitis and periodontal diseases in preschool children in Kolkata
Suchetana Goswami, Subrata Saha
January-June 2017, 7(1):3-7
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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Pro-Argin: A promising technology for dental hypersensitivity
Mythri Halappa, Prasun Roy, JV Bharateesh, KR Kashinath
July-December 2015, 5(2):68-71
Dentin hypersensitivity is a common occurrence and is often a chief concern among patients. The successful management of dentin hypersensitivity is often very challenging for the dental professional as the cause of the pain and the description of the discomfort varies. There are traditional methods that have been clinically evaluated and found to be effective, but a more effective, faster acting, and long-lasting treatment is required. Hence, Pro-Argin technology is considered to be a promising treatment for dentin hypersensitivity and stain removal.
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Histomorphometric and histological evaluations of the simvastatin effect on alveolar bone loss induced by cyclosporine A in rats
Samir Hagar, Shafik Sahar, Yahia Mona, Mamdouh Nancy
January-June 2015, 5(1):2-9
Background: Cyclosporin-A- has been used as an immunosuppressant to prevent the rejection of organ transplants. However, alveolar bone loss is an important negative side-effect of this drug. Simvastatin, a hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, is known to inhibit cholesterol biosynthesis. It has advanced effects on bone formation in vivo and in vitro. So,we evaluated the histological and histomorphometric analysis of osteoblast and osteoclast cells after administration of simvastatin in cyclosporin-A-associated alveolar bone loss in rats. Aim of the Study: To evaluate the effect of simvastatin and cyclosporin -A- on Alveolar bone by investigating the histological and histomorphometric results of osteoblast and osteoclast cells. Materials and Methods: 24 adult male rats will be divided into 3 groups: Group I: Control group; 4 rats, Group II: cyclosporine -A- group; 10 rats (10 mg/kg) subcutaneous injection, Group III: cyclosporine -A-/simvastatin group; 10 rats, simvastatin will be taken orally daily (20mg/kg/day). Two rats from the control group and 5 rats from each of the studied experimental groups (group II & III) were sacrificed on days 15 and 30 consecutively using Histological and Histomorphometric investigations. Results: Histological results revealed higher bone volume and osteoblast cells, and decreased number of osteoclast cells in Simvastatin group than in CsA group. The same results was statistically significant in Histomorphometric results of both osteoblast and osteoclast cells counts. In Histomorphometrical analysis showed a significant increase of osteoblast cells in Simvastatin group than CsA group, and significant decrease of osteoclast cells in Simvastatin group than CsA group. Conclusion: We can conclude that Simvastatin counteract the adverse effect of CsA induced alveolar bone loss that induced new bone formation.
  2,429 16 -
Triad treatment option to restore full mouth
Neelam Abhay Pande, Maithili Kolarkar
January-June 2015, 5(1):42-46
The primary consideration for continued denture success with a single conventional complete denture is the preservation of that which remains in the oral cavity. The single denture is a complex prosthesis that requires a complete understanding of the basics of denture occlusion. The problems involved in providing comfort, function, proper esthetics, and retention for the maxillary complete denture patient with natural opposing dentition may be challenging. The damage to the edentulous ridge and inability to wear the denture may be avoided by good prosthetic treatment which includes adequate denture base, correct jaw relation record, and proper occlusion. In this case report, a female patient reported with generalized attrition of the remaining maxillary dentition. After clinical evaluation, taking into consideration the patient's expectations, treatment plan was decided. Using fixed, removable, and complete denture prosthesis, patients functional and esthetic requirements were fulfilled, which gave her comfort and satisfaction.
  2,405 15 -
Cystic hygroma: Clinical, ultrasonographic, and cytological co-relation
Rakhi Chandak, Manoj Chandak, Shivlal Rawlani
January-June 2016, 6(1):52-54
Cystic hygromas are rare, congenital, benign lesions occurring early in life, mainly in the head, neck, and oral cavity. It is an aberrant proliferation of lymphatic vessels resulting from abnormal development of the lymphatic system. Lymphangiomas are classified as microcystic, macrocystic, and cystic hygromas according to the size of the lymphatic cavities incorporated. They are soft, vary in size and shape, and tend to grow extensively if not surgically excised. They are multilocular cysts filled with clear or yellow lymph fluid. Histopathologically, lymphangiomas are of three types: Lymphangioma simplex, cavernous lymphangioma, and cystic hygroma depending on the size of vascular spaces and thickness of the adventitia. The present report describes a case of cystic hygroma of the left posterior region of jaw in an 11-year-old male child and its clinical, ultrasonographic, and cytological correlation.
  2,357 25 -
Ortho-perio integration: An orthodontic review
Luv Agarwal, Ragni Tandon, Shrish Srivastava, Ankit Gupta
July-December 2016, 6(2):99-103
A multidisciplinary approach including an orthodontist and a periodontist is done in patients with periodontal disease. Both specialists should be involved in the treatment planning of such patients, and care should be taken in evaluation of progress of the treatment undertaken. Importance of multidisciplinary approach has increased as majority of patients seeking orthodontic treatment are adults. Orthodontic patients are highly susceptible to increased accumulation of plaque which makes integration of a periodontist very essential. Careful attention needs to be given to orthodontic patients as undesirable periodontal changes are seen. The purpose of this article is to highlight the importance of both specialties and in which conditions they are used as an adjunct and the mutual benefits shared by them.
  2,347 24 -
Unveiling the impacted incisor
Aniket Potnis, Chirag Panchasara, Ashutosh Shetty, US Krishna Nayak
January-June 2015, 5(1):27-30
Missing and unerupted maxillary incisors can have a major impact on dental and facial esthetics and were considered to be the most unattractive deviant occlusal trait. There are very few studies reporting any functional problems associated with the missing anterior teeth although some speech difficulties have been reported, particularly with the "s" sound. Although impaction of permanent tooth is rarely diagnosed during the mixed dentition period, an impacted central incisor is usually diagnosed accurately when there is delay in the eruption of tooth. As missing upper incisors are regarded as unattractive, this may have an effect on self-esteem and general social interaction and it is important to detect and manage the problem as early as possible. This case report describes the treatment of a patient with a horizontally impacted maxillary central incisor. Due to a midline shift and lack of space in the upper arch, a two stage treatment plan was developed. In the first stage, space was created by using a closed coil spring. The second stage involved surgical exposure and traction of the impacted central incisor. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches and an adequate width of attached gingiva.
  2,345 13 -
Knowledge, attitude, and practice toward oral health among pharmacy students in Chennai
M Youlanda Preethi, CS Suganya, R Ganesh
January-June 2016, 6(1):20-24
Aims: The aim of the study was to access the oral health knowledge, attitude, and practices among pharmacy students in Chennai. Settings and Design: This was a descriptive, cross-sectional study. Subjects and Methods: The descriptive, cross-sectional study was conducted among pharmacy students in Chennai. The questionnaire was to access the knowledge and practice toward oral health. Statistical Analysis Used: Statistical Package for the Social Science (SPSS). Results: 47.8% of the participants considered regular visit to the dentist is necessary. 64.8% of the participants have been professionally taught to brush. 31.9% of the participants prefer government hospitals for their treatment. Conclusions: There is a need for the comprehensive educational program among pharmacy students to promote oral hygiene and to impart education about oral hygiene practices.
  2,306 24 -
Autotransplantation of palatally impacted maxillary canine
Meena M Vora, Punam N Nagargoje
January-June 2016, 6(1):45-47
The occurrence of canine impaction is not a rare phenomenon. We report a case of horizontally placed palatally impacted maxillary canine in a 21-year-old male patient. The purpose of this report was to describe a patient undergoing autotransplantation of an impacted maxillary canine to its normal position in the dental arch.
  2,219 24 -
Gingival depigmentation to enhance esthetics by two different modalities
Abhishek Gautam, Vaibhava Raaj, Mamta Singh, Anusha
July-December 2015, 5(2):91-93
Gingival pigmentation is present in all races of the human community. The distribution and the intensity of color are different not only among different races but also in different area of the same oral cavity. The presence of pigmentation can be because of various reasons, but melanocyte deposition in basal layer of oral epithelium is one of the main factors for brown pigmentation. These pigmentation of melanin are been removed as cosmetic therapy. This case report presents two different treatment modalities of depigmentation in the same patient and hence giving us a better treatment modality between laser and electrocautery. The clinical results of these two methods have been compared by different criteria, which makes laser above the electrocautery in different ways.
  2,229 14 -
Shaping ability of different endodontic single-file systems using simulated resin blocks
Ahmed Abdulqader Rashid, Abdul Rahman Mohammed Saleh
July-December 2016, 6(2):61-67
Objectives: The aim of this study was to compare the shaping ability of four different single-file systems; WaveOne (Dentsply Maillefer, Ballaigues, Switzerland), Reciproc (VDW), OneShape (Micro Mega), and F360 (Komet Brasseler, Lemgo, Germany). Stainless steel K-file (KSS) (Dentsply Maillefer, Ballaigues, Switzerland) was used as a control during the preparation of simulated root canals. Materials and Methods: Eighty L-shaped canals in resin blocks were prepared to an apical size of 25 using one of the five groups (each group = 16). A series of pre- and post-operative images were taken by a digital camera (EOS 650D. Canon) and superimposed on two different layers. The amount of resin removed from both the inner and the outer sides of the canal were measured at five different points: orifice, half way of the orifice, beginning of the curvature, apex of the curve, and the apical end. The amount of resin removed by each system was measured using image analysis software. Canal aberrations and the preparation time were also recorded. The data were statistically analyzed by using analysis of variance, Tukey's post hoc, and Chi-square tests. Results: There are significant differences between all single files and KSS in time for preparation (P < 0.05) while there is no significant difference between all single nickel-titanium (NiTi) files. No instrument is fractured during canal preparation. More canal aberrations were reported with hand K-files in which there is a highly significant difference compared with other single-file systems. OneShape file reported fewer canal aberrations, but all OneShape files deformed after use. There are significant differences between single NiTi files and KSSs in preserving the canal curvature while there is no significant difference between all single NiTi files. Reciproc and WaveOne files removed significantly greater amounts of resin from the inner side at the beginning and apex of the curve (P < 0.05). Canals prepared with the F360 and OneShape systems were better centered compared with the Reciproc and WaveOne systems. Conclusion: Within the limitation of this study, NiTi instruments are superior to stainless steel K-files in their shaping ability. All single-file systems maintained root canal curvature well and were safe to use. Canals prepared with the F360 and OneShape systems were better centered compared with the Reciproc and WaveOne systems.
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Influence of the complete denture treatment on patients speech intelligibility
Surekha R Godbole, Pooja Rangilal Jaiswal, Shreyas S Gotoorkar, Kiran B Kulkarni, Apurva P Madhup
July-December 2016, 6(2):73-76
Context: An important aspect of oral rehabilitation that has been neglected all the while is speech efficiency which is also an important part of complete oral rehabilitation of edentulous patients apart from mastication and esthetics. Aim: Hence, the purpose of this study was to evaluate the influence of the complete denture treatment on patient's speech intelligibility using automatic speech recognition system. Settings and Design: Twenty completely edentulous patients were analyzed for speech intelligibility before and after denture insertion to check for improvement in phonetics after denture fabrication and insertion. Subjects and Methods: Speech was recorded in twenty edentulous patients 2 weeks before the fabrication of new complete maxillary and mandibular dentures and 1 week thereafter. Speech intelligibility was computed based on the word accuracy by means of an automated speech recognition system, and comparison was done between speech before and after denture insertion. Statistical Analysis Used: Statistical analysis was done using descriptive and inferential statistics using Student's paired t-test, and software used in the analysis was SPSS 17.0 version and P < 0.05 is considered as level of significance. Results: Improvement in the speech intelligibility of the patients was noted after fabrication of denture. Conclusions: It is possible to evaluate the mechanisms and the processes leading to speech difficulties and hence to make required adjustments within the denture which may produce the desired speech change as it is evident from the present study.
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