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   2016| July-December  | Volume 6 | Issue 2  
    Online since January 6, 2017

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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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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.
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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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Displacement of lower third molar to Submandibular fossa during extraction
Mohamed Said Hamed, Prathibha Prasad
July-December 2016, 6(2):107-110
Complications during the procedure of extraction can be immediate or postoperative. Some of the immediate complications are fracture of the tooth, fracture of alveolar plate, fracture of mandible, loss of tooth or root into either pharynx or soft tissues, damage to nerves or vessels, soft tissue damage, involvement of maxillary antrum, dislocation of temporomandibular joint, etc., whereas hemorrhage, dry socket, osteomyelitis, swelling, pain, ecchymosis, trismus, prolonged anesthesia, and infective endocarditis are the various postoperative complications of extraction. This report discusses a case of displaced mandibular third molar into submandibular space while attempting extraction of the same.
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Effectiveness of transcutaneous electrical nerve stimulation to relieve the tensed masticatory muscle: A retrospective study
Nisheeth Saawarn, Preeti P Nair, Sana Noor Siddiqui, Shiba K Neelakantan, Annette Bhambal, Pearl Helena Chand, Harshkant P Gharote
July-December 2016, 6(2):68-72
Introduction: Myositis, a painful inflammatory condition of masticatory muscles, characterized by protracted local muscle soreness or myofascial pain, is most commonly caused by a source of nociception found in the muscle tissues having origin in central nervous system. Various therapeutic modalities used are pharmacologic, physical, or psychological. Transcutaneous electrical nerve stimulation (TENS), a physical sensory stimulant therapy using high frequency and low-intensity electric current stimulates the nonnociceptive A-beta cutaneous afferents that activate the pain inhibitory mechanism. Its action is immediate with 50%-70% analgesic effect and induces few or no after effects. Purpose of Study: The objective of this retrospective analytical study was to assess the efficacy of TENS therapy in patients suffering from myositis. Materials and Methods: The clinical data of the patients of myositis treated with TENS during 2011-2012 in OPD of a dental school in India were retrieved from department archives and analyzed. In all these patients, severity of pain was assessed on visual analog scale at baseline and at every follow-up visit. The data were analyzed statistically using unpaired t-test. Results: Out of 22 patients treated, 18 showed significant improvement while three were unresponsive and in one patient the condition deteriorated. Conclusions: TENS may be an effective, economical, and easy to use therapy with minimal side effects in patients suffering from myositis.
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Extent of periodontal awareness and its treatment modalities among medical interns and postgraduates: A questionnaire study
Veena Kalburgi, Shefali Jain, Sandhya Raghuwanshi, Shailendra Dass
July-December 2016, 6(2):81-86
Aim: The aim of this study was to assess the awareness of oral hygiene, periodontal disease, and availability of treatment techniques among medical professionals. Materials and Methods: A cross-sectional study was conducted on 150 medical professionals randomly selected. Those interviewed included an equal number of medical interns and postgraduates. Each participant was given a self-administered, pretested, multiple choice questionnaire to solve on the spot. The questionnaire is based on information about different terminologies, periodontal diseases their cause, its systemic effects, different treatment techniques used, and newer treatment modalities. The questionnaire consists of 12 questions which are divided under headings such as (1) knowledge about periodontal diseases, (2) knowledge about its association and etiology, (3) awareness about treatment availability. Results: Positive attitude toward periodontal diseases was observed. The level of awareness was marginally higher with postgraduates. The difference was statistically significant among two groups except in case of treatment modality awareness. The obtained data were analyzed using SPSS version 15 for windows. Conclusion: Awareness about periodontal diseases, its etiology and association between systemic diseases were observed. However, awareness about periodontal therapy and newer treatment modalities was poor.
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Antifungal-prescribing pattern and attitude toward the treatment of oral candidiasis among dentists in and around Kothamangalam in Kerala: A survey
Asha S Anand, Majo Ambooken, Jayan Jacob Mathew, KS Harish Kumar, KC Vidya, Linu Sara Koshy
July-December 2016, 6(2):77-80
Context: Dentists come across various clinical entities of candidiasis and prescribe antifungals for its treatment. Aims: The aim of this study was to evaluate the attitude of dentists in and around Kothamangalam in Kerala toward the treatment of oral candidiasis and their current antifungal-prescribing pattern. Settings and Design: A questionnaire-based survey was conducted among the dental surgeons working in and around Kothamangalam, a small town in Ernakulam district, Kerala. Participants and Methods: The potential participants of the survey were identified from the faculty list of the three dental colleges as well as from the general practitioners list of Kothamangalam. A total of 150 questionnaires were distributed among dentist practitioners in Kerala. Of the 122 dentists responded, 22 were rejected due to insufficient data. The data from the remaining 100 questionnaires were entered for analysis. Statistical Analysis Used: The data were manually entered for analysis in the online portal - http://www.SurveyMonkey.com, and the analysis was performed. Results: Clotrimazole was the most common (71%) antifungal prescribed by the practitioners. Only 13% of the dentists prescribed antifungals systemically. Conclusions: Most dentists preferred topical treatment for the management of candidiasis. Clotrimazole is the most popular choice of antifungal employed followed by nystatin.
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Ectodermal dysplasia with total anodontia: Case report with review
Ankita Chugh, Neeraj Gupta, Vinay K Chugh
July-December 2016, 6(2):124-128
Ectodermal dysplasias (EDs) are rare hereditary disorders characterized by the abnormal development of certain tissues and structures of ectodermal origin. The condition is important for dentists as it affects teeth resulting in hypodontia or anodontia. Affected young children with anodontia face both functional and esthetic problems due to lack of teeth. Restoration of vertical height and teeth with prosthesis will improve appearance and thus boost their self-confidence. We report a case of hypohidrotic ED with total anodontia in a 5-year-old boy who was successfully rehabilitated with conventional complete dentures in both maxillary and mandibular arches. The aim of the treatment was to improve psychological development apart from promoting better functioning of the stomatognathic system.
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A rare case report of orthokeratinized odontogenic keratocyst associated erupting complex odontome with impacted mandibular molar
Kshitij O Bang, Ramakrishna S Shenoi, Rahul N Dahake, Nilima J Budhraja
July-December 2016, 6(2):119-123
Odontogenic keratocyst is a cyst of dental origin with an aggressive clinical behavior, having high recurrence rate. Odontomas are hamartomatous lesions composed of mature enamel, dentin, and pulp and may be compound or complex depending on the extent of morphodifferentiation or on their resemblance to normal teeth. They are the most common benign odontogenic tumors, constituting 22% of all odontogenic tumors of the jaw. We present a case report of a 19-year-old female with infected odontogenic keratocyst associated with the impacted mandibular second molar with the odontome and a submandibular space infection. However, there are very few case reports in the literature of the simultaneous occurrence of these two lesions, and hence this case is very rare. It is unclear whether the two lesions were just coincidental or were actually related to each other.
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Solitary neurofibroma of the gingiva: A rare case report
Priyanka Dalvi, KV Vandana, Shobha Prakash, KP Mohan
July-December 2016, 6(2):111-114
Solitary neurofibroma is a benign, slowly growing, relatively circumscribed, but nonencapsulated tumor of unknown etiology diagnosed by absence of other features of the associated systemic disease. A 70-year-old female patient reported to us with a localized gingival swelling in the upper right back tooth region. The lesion was an incidental finding at a routine dental checkup. Medical and family history was noncontributory. Apart from the oral cavity, no other similar swellings were found on the rest of the body and the regional lymph nodes were not palpable. Based on history, texture, appearance, and location a differential diagnosis of possible fibroma, peripheral ossifying fibroma, and peripheral giant cell granuloma was made. Excisional biopsy was planned as the lesion was small and solitary. Based on the history, clinical, radiographical, and histopathological findings diagnosis of neurofibroma was given. The patient has not reported with recurrence 6 months postoperatively. Even though it is a rare lesion in the oral cavity, solitary neurofibroma must be considered in the list for differential diagnosis in cases of intraoral swellings and intraosseous lesions of the jaws.
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Editorial message for volume 6 issue 2 of IJMD (July - December 2016)
KMK Masthan
July-December 2016, 6(2):59-60
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Osteoporosis: Current State and need for screening- Possible role of oral physicians
Abhishek Singh Nayyar, Ujjwala M Naphade, Milind V Naphade, Abdul Qahar Qureshi, Farooque Iqbal Siddiqui
July-December 2016, 6(2):93-98
Osteoporosis is characterized by low bone mineral density (BMD) and deterioration of bone structure resulting in an increased susceptibility to fractures of the hip, spine, and wrist. Osteoporosis contributes to a great deal of morbidity and mortality and is a large burden to the health service. In the past four decades, numerous research teams have reported oral radiographic findings associated with osteoporosis. Digital orthopantomographs (OPGs), taken for routine dental evaluations, have a significant role in screening for initial osteoporotic changes. A number of mandibular cortical indices have also been developed to allow quantification of mandibular bone mass and identification of osteoporosis. Klemetti index, mental index, panoramic mandibular index, antegonial index , and gonial index are all associated with a low BMD and of help in the initial screening of osteoporosis.
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Small tissue, big issue
Babita Yeshwante, Nazish Baig, Nikita Parasrampuria, Nikita Kale
July-December 2016, 6(2):115-118
One of the most important parts of an ideal smile is the presence of healthy gingiva. Gingival replacement is often a component of comprehensive prosthodontics. Gingival replacement prostheses have historically been used to replace lost tissue when other methods (e.g., surgery or regenerative procedures) were considered unpredictable or impossible. With this method, large tissue volumes are easily replaced. Gingival prostheses take several forms, and various authors have described their uses and methods of construction. Tissue replacement prostheses may be used to replace tissue lost through surgical gingival procedures, trauma, ridge resorption, or traumatic tooth extraction. From a prosthodontic point of view, restoration of these areas can be accomplished with either fixed or removable prostheses. Gingival prostheses may be made from acrylics, composite resins, silicones, or porcelain-based materials. Undercuts or dental attachments are used to secure removable prostheses, which are esthetically pleasing and easy to maintain. Healthy gingival tissues affect the esthetics, probably much more than teeth, a factor which is most often neglected in esthetic treatment planning. Periodontal flap surgeries often leave open embrasure spaces which are a huge esthetic deficit for the patient. This case report describes the use of a gingival prosthesis fabricated by valplast - a flexible nylon-based material to recreate the lost soft tissue esthetics.
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Cancer vaccine
J Saraswathy, J Sunitha, Nadeem Jeddy, T Radhika, R Ananthalakshmi
July-December 2016, 6(2):104-106
Cancer is a disease which has been causing tremendous morbidity and mortality in the current era. It still poses a big question for scientific community as no existing treatment has been able to solve the problem related to this disease. Research has progressed to a considerable extent but has failed to give a complete cure. The development in science and technology has made scientists to seek newer methods of treatment. One such milestone treatment for cancer is cancer vaccine. The aim of cancer vaccine is to stimulate the immune system to prevent the development of cancer cells.
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