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   Table of Contents - Current issue
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October-December 2018
Volume 9 | Issue 4
Page Nos. 153-204

Online since Tuesday, December 18, 2018

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ORIGINAL ARTICLES  

Micronuclei assay in oral exfoliated buccal cells of pesticides exposed agricultural labourers in Pondicherry population Highly accessed article p. 153
A Aroumougam, A Santha Devy, AN Uma, N Vezhavendhan, S Vidyalakshmi, KR Premlal
DOI:10.4103/srmjrds.srmjrds_74_17  
Background: Occupational exposure is caused by the chemical used in pesticides that are toxic to humans and accounts for significant morbidity and mortality, especially in the developing countries. The biologically active compound present in pesticides is with various degrees of toxicity that leads to DNA damage, which, when left unattended, could lead to the process of carcinogenesis. Therefore, it is important to focus on various biometric procedures in order to evaluate the risk associated with occupational health-related issues. One among the biomonitoring test employed, the micronuclei (Mn) assay on the buccal mucosal cells is used as a part of screening in order to assess the cytotoxic status. This assay has been substantiated in the literature for the last few decades. Aims: To assess the cytotoxic damage in agricultural laborers exposed to pesticides using Mn as a biomarker. Subjects and Methods: The study involved data and sample collections from agricultural laborers (Non exposed and exposed to pesticides) by buccal smears, Papanicolaou staining and comparison of number of Mn scores as per Tolbert's and Thomas criteria, respectively. The parameters before and after exposure were analyzed by paired t-tests and partial correlation. Results: The observation of the study revealed the frequency of Mn was high in exposed individuals irrespective of age and habits when compared to that of the control group. Conclusions: In this study, as the duration of exposure increased, there was an increase in the Mn count. This indicates that there was considerable cytotoxic damage.
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Effect of different chewing gums on dental plaque pH, salivary pH, and buffering capacity in children: A randomized controlled trial p. 158
Kameshwaran Muralikrishnan, Sharath Asokan, P R Geetha Priya
DOI:10.4103/srmjrds.srmjrds_45_18  
Aim: The aim of this study is to evaluate and compare the changes in dental plaque pH, salivary pH, and its buffering capacity after the use of three different chewing gums for 1 month in children aged 8–12 years. Methods: This randomized controlled clinical trial consisted of 90 children with Decayed, missing, Filled teeth (dmft/DMFT) <3. They were randomly divided into three groups to receive one of the following interventions: (a) chewing gum containing xylitol, (b) chewing gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and (c) chewing gum containing propolis. Oral prophylaxis was done, and saliva and plaque samples were collected after 48 h as preintervention data. Participants within the experimental groups chewed gums for 10 min, two times a day for a period of 1 month. Pre-and postintervention unstimulated saliva samples were analyzed to compare the changes in dental plaque pH, saliva pH, and buffer capacity. The data were then statistically analyzed using SPSS software. Paired t-test and Student's t-test were done for mean score analysis. Results: There was a statistically significant increase in plaque pH (P = 0.001) level in all three groups. Propolis chewing gum showed an increased salivary pH level (P = 0.036). When compared between genders, girls showed a significant increase in plaque pH level in all three groups and an increase in salivary pH level in xylitol group. Conclusion: Chewing gum containing xylitol can regulate the dental plaque pH, salivary pH, and buffer capacity in a significant way than CPP-ACP and propolis chewing gum.
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Feulgen stain as a special stain for mitotic figures and apoptotic bodies in oral squamous cell carcinoma p. 164
Sankari Radhakrishnan, Ramesh Venkatapathy, PD Balamurali, Karthik Shree V Prashad, B Premalatha, Saikat Chakraborty
DOI:10.4103/srmjrds.srmjrds_49_18  
Background: Oral cancer is one of the most prevalent cancers worldwide. The oral squamous cell carcinoma (OSCC) is graded for the proper treatment planning, and it has been a subjective phenomenon. This grading depends on several features, of which the presence of mitotic figures and apoptotic bodies is one of the important criteria. The routine hematoxylin and eosin (H and E) staining may help in identifying the mitotic figures and apoptotic bodies, but it is difficult to identify accurately. Thus, an attempt was made to evaluate the efficacy of crystal violet and Feulgen stain in identifying the mitotic figures and apoptotic bodies and to observe any variation in different grades of carcinoma. Aims: This study was aimed at using crystal violet and Feulgen stain in identifying mitotic figures and apoptotic bodies in different grades of OSCC. Materials and Methods: Fifteen diagnosed cases of OSCC were retrieved and stained with routine H and E, crystal violet stain, and Feulgen stain. All the sections were scanned for mitotic figures and apoptotic bodies. Apoptotic index (AI) and mitotic index (MI) were calculated. AI and MI were expressed as the average of a total number of apoptotic and mitotic cells counted in ten high-power fields. Results: A significant increase in MI and AI was found in Feulgen stain than crystal violet and H and E stain. Conclusion: Feulgen stain can be considered as the best, cost-effective, relatively cheap stain to visualize mitotic figures and apoptotic bodies.
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REVIEW ARTICLES Top

Regenerative periodontics in restoring oral functions: A power to regenerate what's lost p. 168
Hunny Sharma, Swati Verma
DOI:10.4103/srmjrds.srmjrds_24_18  
Although human oral cavity benefits from remarkable mechanical and functional properties, still it faces continuous insult and damage resulting from exposure to microbial attacks. In the past where conventional dentistry was only focused on evaluating, restoration, and replacement of the diseased oral structures. The recent era of advancement in the field of materials science, molecular biology, tissue engineering, and stem cell research's had let to the path of development of new era of periodontal engineering known as regenerative periodontics. The ultimate goal of regenerative periodontics is the regeneration of the lost periodontium due to advanced periodontal disease. Currently, scientists are working on a wide range of biomaterials and scaffolds, genes, stem cells, and growth factors in the hope of achieving more predictable outcomes in regenerative periodontics. Future research areas in regenerative periodontics include three-dimensional printing, tissue engineering, and gene therapy strategies which give more positive and predictable outcomes of regenerative periodontics. This review provides an overview of current on-going technique and researches in the field of regenerative periodontics and also will show a glimpse of what the future holds.
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Chemical burns of gingiva and its management p. 174
MM Dayakar, Prakash G Pai, Radhika Priyadarshini M Sooranagi, Vintu Vijayan, Abdul Waheed
DOI:10.4103/srmjrds.srmjrds_16_18  
Chemical burns on the gingiva can be caused by the use of certain pharmaceutical and nonpharmaceutical products by patients or by injudicious use of caustics by the dental clinician. These lesions in the oral cavity, however, are rarely reported. Hence, information about the product and needful instructions is necessary to be given to the patients for prevention of the same. These burns can be caused by the way of self-infliction, allergic tendency toward certain products, or it may be iatrogenic. A detailed history is the key to diagnosing and managing these cases. Chemical burns are usually treated by eliminating the etiology and managed by palliative therapy.
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Pulpotomy medicaments in primary teeth: A literature review of natural alternatives p. 181
Kanamarlapudi Venkata Saikiran, Rekhalakshmi Kamatham, Putta Sai Sahiti, Sivakumar Nuvvula
DOI:10.4103/srmjrds.srmjrds_14_18  
Pulpotomy is a procedure which involves complete amputation of the coronal pulp, followed by employment of an appropriate medicament that will stimulate healing and preserve the vitality of the tooth. This is the choice of treatment for cariously exposed vital primary molars, with formocresol considered as golden standard. However, controversies surrounding this medicament have generated inquisitiveness to exploration for natural alternatives. This narrative review is to focus on the use of natural products as alternative pulpotomy agents to formocresol so as to guide the clinicians in choosing proper medicament.
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Importance of cone-beam computed tomography in dentistry: An update p. 186
Shruthi Hegde, Vidya Ajila, Jasmine Shanti Kamath, Subhas Babu, Devika S Pillai, S Mithula Nair
DOI:10.4103/srmjrds.srmjrds_26_18  
In this era of advanced technology, cone-beam computed tomography (CBCT) has gained popularity in the field of oral radiology due to its advantages over conventional radiography. The use of CBCT is profoundly increasing for diagnosis and treatment planning in different specialties of dentistry. The incorporation of cone-beam technology into clinical practice is taking place because of the progress in image acquisition and three-dimensional (3D) imaging. The equipment design is easier to use, image distortion is minimal, and the images are compatible with other planning and simulation software. The 3D imaging has made the complex craniofacial structures more accessible for examination. Early and accurate diagnosis of deep-seated lesions is possible. CBCT provides a high-spatial resolution of bone and teeth which allows accurate understanding of the relationship of the adjacent structures. CBCT has helped in detecting a variety of cysts, tumors, infections, developmental anomalies, and traumatic injuries involving the maxillofacial structures. It has been used extensively for evaluating dental and osseous disease in the jaws. This paper reviews current advances in CBCT and their uses in dentistry.
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CASE REPORTS Top

Mucormycosis – Can the diagnosis be challenging at times?? p. 191
Vandana Raghunath, K Hanna Rose Priyanka, C Geetha Kiran, R Manasa Deepthi
DOI:10.4103/srmjrds.srmjrds_53_18  
Mucormycosis is an aggressive and often rapidly progressing fatal form of fungal infection mainly affecting the immunocompromised patients and characterized by destruction and necrosis. The paranasal sinuses get affected commonly in the rhinocerebral type with or without oral cavity involvement. At times, even in the setting of immunosuppression, it presents as a subtle clinical infection posing both as a diagnostic and therapeutic challenge to the clinicians. Further, in such immunocompromised cases, early diagnosis and prompt treatment become utmost demanding to prevent the ensuing morbidity and mortality. We present one such indolent case which presented as a sinus infection in a 50-year-old diabetic woman. Further, the granulomatous presentation on hematoxylin and eosin-stained sections led to an erroneous initial diagnosis, which later upon Grocott's methenamine silver staining was diagnosed as mucormycosis-rhinocerebral type. Thus, both clinical and histopathological presentations were defying.
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Salmon calcitonin - a boon in the management of central giant cell granuloma p. 197
D Nivethitha Gangai, G V. Murali Gopika Manoharan
DOI:10.4103/srmjrds.srmjrds_50_18  
Central giant cell granuloma is an uncommon, benign, proliferative lesion of unknown etiology, most commonly affecting anterior mandible of younger age group. Early diagnosis may be of benefit to the patient as conservative treatment modalities may be used as compared to radical surgical treatment. Calcitonin as a therapy for central giant cell granuloma of the jaws is a promising alternative to surgical curettage, particularly for larger lesions. We report a case of central giant cell granuloma of mandible in a 14-year-old female patient, who is being treated solely with intranasal spray of salmon calcitonin for 14 months showing greater results.
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Schwannoma of the base of the tongue mimicking fibroma p. 202
Sukhvinder Singh Rana, Neera Ohri
DOI:10.4103/srmjrds.srmjrds_35_18  
Schwannoma is a slow-growing benign tumor of the nerve sheath. It originates from the Schwann cell of the peripheral, autonomic, and cranial nerve. It is usually a single, circumscribed, firm, painless lesion of variable size. 25%–40% of all schwannomas are considered to affect the head and neck region, with the parapharyngeal space being the most common location. Only 1% of cases are intraoral. The treatment of choice is surgical excision of the tumor. Schwannomas do not show recurrence if completely excised. We report a case of schwannoma of the base of the tongue mimicking fibroma.
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