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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 10 | Issue 3
Page Nos. 117-172

Online since Tuesday, October 15, 2019

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ORIGINAL ARTICLES  

Diagnostic performance of the visual caries classification of International Caries Detection and Assessment System II versus conventional radiography for the detection of occlusal carious lesions in primary molars p. 117
Jayachandra Reddy Bhumireddy, S V. S. G. Nirmala, Sreekanth Kumar Mallineni, Sivakumar Nuvvula
DOI:10.4103/srmjrds.srmjrds_11_19  
Objective: The aim of the present study was to evaluate the accuracy in the diagnosis of the occlusal caries lesion using the International Caries Detection and Assessment System II (ICDAS II) and conventional bitewing radiographs in primary molars. Materials and Methods: A total of 35 children was selected randomly and recruited for visual ICDAS II and conventional bitewing radiographic examination by two independent trained examiners. Two hundred and fifty-four teeth were examined at D1 (enamel caries lesions) and D3 (dentine caries lesions) thresholds. Results: Sensitivity and specificity at D1 for ICDAS II was 100%, whereas it was 2.97% and 100%, respectively, for bitewing radiographs. At D3 threshold, sensitivity and specificity of ICDAS II was 94.55% and 96.45%, whereas it was 60.0% and 98.99% respectively for bitewing radiographs. Conclusion: ICDAS II is better than conventional bitewing radiographs in detecting carious lesions that confined to enamel, and both are equally effective in the detection of dentinal carious lesions.
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Analysis of prognostic factors and patterns of failure in patients of oropharyngeal squamous cell carcinoma treated by definitive radiotherapy in a tertiary care cancer center of Northern India p. 122
Sankalp Singh, Nishant Lohia, Sharad Bhatnagar, Pankaj Kumar Sahu, Manoj Prashar, Sundaram Viswanath, Subramananiam Anand, S Harish, Gaurav Trivedi
DOI:10.4103/srmjrds.srmjrds_56_19  
Background: The incidence of oropharyngeal carcinoma is increasing despite decline in the incidence of head and neck cancers of other sites. Functional organ preservation with minimal toxicity and better survival is the management goal in oropharyngeal cancers (OPCs). Morbidity of surgery favors radiotherapy as primary modality in OPCs. Here, we have reviewed and analyzed various prognostic factors and results of conventional radiotherapy in patients treated at our institute with two-dimensional planning. Materials and Methods: The records of 70 patients who were treated radically with radiotherapy with or without concurrent chemotherapy from January 2014 to May 2018 were analyzed in our institute. Results: The median age was 61.5 years with male:female ratio of 6:1. History of tobacco use was present in 83%. Stage IVA comprised the bulk with 63% of cases. Eighty-one percent of the patients received concurrent cisplatin. Median disease-free survival at 1 and 5 years was 71.4% and 54.3%, respectively. Median overall survival at 1 and 5 years was 74.3% and 60%, respectively. Conclusion: Varied patient-related, tumor-related, and treatment-related factors determine the clinical severity and tumor stage and help in predicting survival in oropharyngeal carcinoma.
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Patterns of dental problems and time gap in utilization of dental services by patients visiting a dental college in North Kerala p. 130
Kuldeep Singh Shekhawat, Praveen Dinatius, T Vanishree, CB Thasneem
DOI:10.4103/srmjrds.srmjrds_42_19  
Introduction: Access to dental services is generally regarded as a necessary condition for achieving population-level oral health and well-being. Oral diseases are largely preventable by regular home oral care and preventive dental visits which help in the early detection and treatment of oral diseases. Aim: The objective was to assess the patterns of dental problems and time gap in utilizing dental services. Materials and Methods: A retrospective study was conducted on outpatients who visited Century Dental College, Kasaragod, Kerala, for duration of 6 months from July 2017 to December 2017. The data were collected from medical records from the outpatient department. Descriptive statistics were used to analyze the data. Results: A total of 2593 cases were analyzed. The mean age was 35.66 ± 13.2 years. The most common dental problem reported was decayed teeth (29.3%) followed by dental pain (23.5%) and deposits on teeth (14.4%). Only 3.98% of the patients visited immediately the next day as soon as they noticed black discoloration and/or informed about their decayed tooth. Males reportedly approached the college more than females for most of the chief complaints except for replacement of missing teeth. Conclusions: The most common dental problem reported was decayed teeth followed by dental pain and deposits on teeth. Only 3.77% of the patients reported for a routine dental checkup. Twelve percent of patients reported immediately the next day after experiencing dental pain. Most of the participants visit a dentist only if they had a problem.
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Simulation-based surgical skill training in internship program p. 135
Surekha Rathod, Dhanashree Ghoderao, Vrinda Kolte, Nilima Budhraja
DOI:10.4103/srmjrds.srmjrds_45_19  
Background: Objective structured assessment of technical skills (OSATS) are crucial in assessing operative skills. The education of basic surgical skill (BSS) depends on precise assessment of their surgical skill levels and competency level. Hence, this study aimed to determine the effectiveness of BSS module on intern's competency and confidence. Materials and Methods: Fifty-four interns were included in the module. Three faculty members were included in the module. The module has been prepared on: (1) Asepsis – surgical hand scrubbing, gloving, gowning. (2) Simple interrupted suturing. Intervention: Small group teaching was given to each batch, and hands-on training in dry skill laboratory on simulation was given. Interns were assessed by OSATS, and feedbacks were taken at the end of the assessment. Results: The score of global rating scale for each trainee increased within the 15 days of posting. The knowledge domain of posttest score also improved. Conclusion: BSS module was found to be effective, aiding for the interns to improve their knowledge and skills.
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Tongue morphometry: Evaluation of morphological variations in ethnic Tamil population p. 139
Lekshmy Jayan, R Bharanidharan, R Ramya, N Priyadharsini, A Ramesh Kumar
DOI:10.4103/srmjrds.srmjrds_39_19  
Introduction: Tongue is a vital organ well encased with in the oral cavity, morphological features of which are unique and differs from one individual to other. Visual inspection of the tongue is a noninvasive and inexpensive method to evaluate the morphological variations. Aim: This study aims to evaluate the morphological variations of tongue in male and female in ethnic Tamil population. Objective: The objective is to study the morphological features such as shape, length, and width of the tongue, presence and location of fissure pattern and its gender variations by visual examination method in ethnic Tamil population between age 21 and 30 years. Materials and Methods: The study sample included 250 male and 250 female (21–30 years). The participants were subjected to visual examination and by obtaining a digital photograph of the tongue on maximum protrusion to study the morphological variation like shape of the tongue, presence and location of fissure. Results: The mean for width of the tongue was 3.599. The length of the tongue had a mean value of 4.283. On analyzing the shape of the tongue, U shape was more common in both male (68%) and female (62%) and V shape is common in female (38%). In female, the most common is absent or no fissures whereas in male central fissure was most common. Conclusion: Tongue showed significant morphological variations in male and female. Visual examination of tongue is a simple and inexpensive way to collect data and can be saved along with other dental records. Tongue prints being unique can serve as both a biometric and forensic tool.
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Natural head posture changes after maxillomandibular procedures – A prospective study p. 145
Thenmozhi Thirumavalavan, T Selvakumar, M Shanmuga Sundaram, T Guru Prasad, V B Krishna Kumar Raja
DOI:10.4103/srmjrds.srmjrds_25_19  
Purpose of the Study: The aim of this study is to evaluate the natural head posture changes in the individuals after orthognathic surgery assessed using cone-beam computed tomography (CBCT) scan. Materials and Methods: The study was conducted in the age group above 18 years who underwent mandibular advancement for the correction of the skeletal deformity. The difference was evaluated in cases with the help of CBCT scan which was taken preoperatively and 3 months postoperatively. The inclusion criteria were patients undergoing mandibular advancement with or without maxillary procedures. The CBCT scan was taken in a natural head position with lips in a relaxed position and without any other tongue movements like swallowing. The exclusion criteria include patients with pharyngeal pathology, syndromic conditions, and history of orthognathic surgery. The head posture was determined by measuring the craniocervical angle (CCA) before and after surgery to evaluate the changes. The study was divided among bilateral sagittal split osteotomy (BSSO) advancement cases and maxillomandibular procedures. The statistical analysis was done using a paired t-test. Results: The head posture changes present in mandibular advancement cases show a decrease in the angulation of CCA in both types. The P value of head posture in BSSO advancement cases was 0.25, and for maxillomandibular cases, it was 0.007. Conclusion: The study was concluded by showing a decrease in the angulation of the CCA after orthognathic surgery. This shows improvement in the facial profile and structural positions.
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REVIEW ARTICLE Top

Role of collagen in oral and systemic diseases p. 149
Amol Jain, Kshama Chandurkar, Rohit Jaiswal
DOI:10.4103/srmjrds.srmjrds_43_19  
Collagen has been studied appreciably by a massive variety of researchers since 20th century. It is the most important fibrous glycoprotein among the ground substances and forms the core component within the connective tissue structures such as tendons, cartilage, the organic matrix of bone, and cornea, and they retain the muscularity and firmness of these elements. It has triple helices architecture. The collagen family so far has identified 20 different forms. All types of collagens play a role by synthesizing fibers and network of microfibers present in the ground substance, basal lamina also remaining constituents of the matrix. In this review we discuss about the organisation and role of different collagen forms in various tissues. It presents the fundamental structure, synthesis and the different disorders or syndromes which occur due to the defects in the collagen biosynthesis.
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CASE REPORTS Top

Herpes simplex virus: A seed or sequelae to pemphigus? p. 154
Sarita Yanduri, Anu Gokuldas, B Veerendra Kumar, S Suma, MG Madhura
DOI:10.4103/srmjrds.srmjrds_33_19  
Pemphigus vulgaris is a vesiculobullous lesion in which autoantibodies are produced against desmoglein-3 antigens. Despite having an autoimmune etiology, herpes simplex virus (HSV) is found to be an additional aggravating factor for this disease. Sometimes, there can be a coexistence between the two entities. Here, a unique case of a 65-year-old female patient who presented with the chief complaint of ulcers in the oral cavity for the past 2–3 months is discussed. Histopathologic and immunofluorescence investigations were suggestive of pemphigus, but the cytopathologic smears manifested characteristics indicative of HSV infection. The existence of a viral infection with the known case of pemphigus poses a potential difficulty in the classical treatment of the latter. This case report throws light on the interesting coexistence of these two disease processes, thus highlighting the pathogenesis and treatment plan which may have to be considered in such controversial cases.
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Adenoid cystic carcinoma of palate: A rare case report p. 158
Pratiksha Kumar, Sangeeta Wanjari, Hemani Sukhija, Anuradha Agarwal, Sukanta Sen, Sumanta Kumar Kolay
DOI:10.4103/srmjrds.srmjrds_29_19  
A 40-year-old female patient reported to the department with the complaint of a single growth and pain in the upper right back tooth region for 1 year. Intraoral examination revealed a single unilateral exophytic growth seen on the right upper pterygomandibular raphe region. Extraoral examination revealed no facial asymmetry and no evidence of lymphadenopathy. Histopathological examination revealed a hyperparakeratotic stratified squamous epithelium of variable thickness with broad and flattened rete ridges. Lesional tissue showed large sheets of cells surrounded by condensed collagen component. The lesional cells were basaloid in appearance with hyperchromatic nucleus predominately arranged in a cribriform pattern along with eosinophilic material. No evidence of perineural invasion was observed in serial sections. On the basis of these findings, the diagnosis of adenoid cystic carcinoma was established.
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Follicular ameloblastoma: A case report p. 161
Shivani Singh, Kamal Hasan, Abhijeet Alok
DOI:10.4103/srmjrds.srmjrds_28_19  
Ameloblastomas are slow-growing, locally invasive tumor affecting the maxillofacial region. There are various histologic variants of ameloblastoma. Most common being follicular ameloblastoma. Follicular ameloblastoma is commonly seen in elder people. Follicular ameloblastomas have got high recurrence rate. Radiographic finding shows a multilocular radiolucency with well-defined borders. This paper presents a case of follicular ameloblastoma in a 30-year-old female who had a swelling on the right mandible region.
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Accidental ingestion of segment of an Erich bar: An unusual case report p. 165
Mahashweta Nag, Rajeev Pandey, Varun Arya, Rahul Kashyap
DOI:10.4103/srmjrds.srmjrds_58_19  
Accidental aspiration or ingestion during dental procedure is a rarely occurring phenomenon. It is considered as a potential health problem worldwide. Aspiration of dental instruments is rare but require immediate management because it can compromise airway. Ingestion although considered less dangerous, it can also lead to complex gastroenterological procedures due to intestinal perforation and obstruction. Here, we present an unusual case of ingestion of a segment of the Erich arch bar measuring about 4 cm during arch bar wiring in a trauma patient having mandibular fracture.
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Esthetic rehabilitation for premature loss of primary anterior teeth p. 170
Paridhee Jalan, Aindrila Ghosh, Shabnam Zahir, Gautam Kumar Kundu
DOI:10.4103/srmjrds.srmjrds_51_19  
Over years primary anterior teeth have been prematurely lost due to Early Childhood Caries and trauma. While in the past once lost primary teeth could not be replaced, now due to increased aesthetic demands of the patient and their family, different fixed functional space maintainers have come to the forefront for aesthetically rehabilitating prematurely loss deciduous anterior teeth. This case report discusses how an avulsed deciduous maxillary anterior teeth was replaced in a three and a half year old male patient using a fixed functional space maintainer.
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