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   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 11 | Issue 2
Page Nos. 61-109

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ORIGINAL ARTICLES  

Comparative evaluation of smear layer removal efficacy of three herbal irrigants in the apical third of the root canal: An in vitro scanning electron microscopic study p. 61
GR Ranjitha, Shreya Rajesh Mutha, R Anithakumari, R Vikram, Naveen Kumar, AK Shivekshith
DOI:10.4103/srmjrds.srmjrds_2_20  
Background: Smear layer removal from the apical third of the root canal is critical and the widely used chemical irrigants have been associated with detrimental effects. Hence, the study aimed to evaluate the smear layer removal efficacy of three herbal extracts used as endodontic irrigants in the apical third of the root canal. Materials and Methods: Forty-eight single-rooted premolars were divided into three experimental groups and a control group and were irrigated with Neem extract (Group 1), Orange peel extract (Group 2), Tulasi extract (Group 3), 5.25% sodium hypochlorite (Group 4) and their effect on smear layer removal was examined under the field-emission scanning electron microscope. Statistical Analysis: Kruskal–Wallis test followed by Mann–Whitney post-hoc analysis was done to compare the mean smear layer scores between the four groups in the apical third of the root sections. Results: The lowest mean remaining smear layer scores was shown by Neem extract (0.83), followed by sodium hypochlorite (1.08), orange peel extract (1.67), and the highest for Tulasi extract (2.42). On intergroup comparison, Neem extract showed statistically significant less smear layer scores in comparison to Orange peel extract (P = 0.006) and Tulasi (P = 0.001). Neem showed no statistically significant difference with sodium hypochlorite (P = 0.37). Conclusions: Neem extract can be considered as an efficient smear layer removal irrigant in the apical third of the root canal.
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Prevalence of dental fluorosis in 6–14 year old children in Greater Noida city, Uttar Pradesh – An epidemiological study p. 66
Sukhdeep Singh, Dhirja Goel, Neha Awasthi, Deepak Khandelwal, Aakansha Sharma, Neha Singh
DOI:10.4103/srmjrds.srmjrds_76_19  
Background: Endemic fluorosis is one of the major health problems in India. About 96% of the fluoride found in the body is in bones and teeth. When ingested in adequate quantities, fluoride is beneficial for teeth by reducing the level of dental caries, whereas the ingestion of fluoride in higher concentrations may cause fluorosis. Objectives: The objective of the study was to find the prevalence of dental fluorosis in school-going children of 6–14 years in Greater Noida City, residing there since birth. The severity of fluorosis was determined after estimating the fluoride concentration in drinkable groundwater. The distribution of dental fluorosis was then compared according to various variables. Materials and Methods: A sample of 1516 school-going children, residing in the Greater Noida since childhood and consuming the groundwater, were taken across various schools from all five directions. These children were examined for dental fluorosis according to the Dean's criteria for assessment. Results: The prevalence of dental fluorosis in 6–14-year-old school-going children was 69.9%. A stepwise increase in prevalence was noted with a corresponding rise in the water fluoride content in different zones of the city. Conclusion: The prevalence of dental fluorosis was found to be 69.9% with the groundwater concentration gradient ranging from 1.6 to 2.4 ppm.
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Salivary levels of calcium and phosphorus in children with and without early childhood caries: A pilot study p. 72
S Aruna, B Meenakshi, KV Rama, S Valarmathi
DOI:10.4103/srmjrds.srmjrds_5_20  
Background: The role of saliva in the maintenance of oral health is unequivocal, and its composition influences the dynamics of dental caries by modifying the phases of demineralization and remineralization. Rationale: Dental caries is a dynamic disease characterized by phases of demineralization and remineralization. Remineralization is facilitated by saliva. In children-free from caries, remineralization is dominant, and in caries-active children, demineralization is predominant. Hence, this study has been planned to evaluate the levels of calcium and phosphorus in the saliva which play a significant role in the remineralization process. Objectives: This pilot study was carried out to evaluate the salivary calcium and phosphorus levels of children aged 3–6 years and their possible association with early childhood caries. Materials and Methods: Eighteen children aged 3–6 years were divided into two groups of nine children each – Group I is the caries-free group and children affected with early childhood caries comprising the Group II. Four milliliters of unstimulated whole saliva was collected. The salivary levels of calcium and phosphorus were evaluated using an emission spectrometer – inductively coupled plasma optical emission spectrometer ICP-OES available at Sophisticated Analytical Instrument Facility, Indian Institute of Technology Madras. Descriptive statistics were done. Results: The salivary levels of calcium and phosphorus in children-free from caries were found to be higher than in saliva of children with early childhood caries. Conclusion: More research is needed to elucidate the role of these elements in the prevention of caries.
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Geographic disproportions in dental workforce distribution and its impact on oral disease burden: An Indian perspective p. 76
Krishnan Padminee, R Anusha, Krishnan Lakshmi, Parangimalai Diwakar Madan Kumar
DOI:10.4103/srmjrds.srmjrds_79_19  
Introduction: Dental workforce planning depends on the consumers need or demand and availability or supply of dental care. Dental workforce planning is commonly based on three methods that include dentist population ratios, demand-based models and need based models. Although the production of dentists has exponentially risen in the last decade, the oral disease burden does not seem to be reduced. Materials and Methods: Data regarding population census, number of registered dentists under Dental Council of India, number of government dentists, and disability-adjusted life years (DALY) measures for overall oral disease burden, Dental caries in deciduous and permanent teeth, edentulousness, periodontal disease, and other dental diseases for each state in India were collected from different sources and subjected to descriptive statistics. Association between dental workforce and DALY of oral disease burden was assessed using Pearson's correlation coefficient with P set at 5%. Results: The dentist population ratio ranged from 1:1000 to 1:20,000 in different states of India. The DALY of oral disease burden ranged from 250 to 350. Pearson's correlation showed no association between dental workforce distribution and oral disease burden (P = 0.084). Conclusion: Dental workforce and the conspicuous geographical imbalance associated with it solely do not contribute to the oral disease burden in India. Need-based workforce planning along with optimal resource allocation in terms of material and funds might unlatch the barriers faced by the disadvantaged population with grave dental needs.
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Effectiveness of various intracanal medicaments on Candida albicans: An in vitro study p. 82
Prenu Paul, TP Chandru, Faizal C Peedikayil, Gufran Ahmed, Soni Kottayi, Najma Azhikodan
DOI:10.4103/srmjrds.srmjrds_20_20  
Background: Microbiological studies have shown that Candida albicans is the most commonly found fungi, ranging from 7% to 18% of the root canal infections of tooth. Various intracanal medicaments were analyzed to know the best among them. Objectives: The study objective was to evaluate and compare the antifungal efficacy of various intracanal medicaments, i.e., calcium hydroxide, Odontopaste®, Ledermix® paste, Pulpdent® paste, tri-antibiotic paste, and Coconut® oil cream on C. albicans Materials and Methods: Seventy freshly extracted human permanent maxillary and mandibular anterior teeth extracted for various therapeutic reasons were selected for the study. A standard strain of C. albicans (10,231) was selected and suspended in 20.0 ml of Sabouraud Dextrose broth, and the suspension was adjusted to match the turbidity equivalent to 0.5 McFarland standards. The dentinal blocks were inoculated with C. albicans strains. The seventy dentinal blocks were then divided into seven groups according to the intracanal medicaments used in the study. Each group comprised of ten specimens. Each group was further divided into two subgroups according to the experimental periods, i.e., day 1 and day 7. The data were tabulated and statistically analyzed using nonparametric Wilcoxon signed-rank test and Kruskal–Wallis test to compare the mean and median reduction of C. albicans between intracanal medicaments. P < 0.05 was considered statistically significant.Results: Among the tested medicaments, Odontopaste® and Ledermix® paste showed the maximum effectiveness throughout the experimental period followed by Pulpdent® paste. Conclusion: The medicaments used in this study showed antimicrobial activity even though complete elimination was not obtained with any of the medicaments. The present study also showed that Odontopaste® and Ledermix® paste were the most effective antimicrobial medicaments against C. albicans. More researches are necessary for improving the antifungal efficacy of the medication used nowadays as intracanal dressing.
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CASE REPORTS Top

A rare case report of dual mesiodens p. 87
Aditya Parampill, Reetika Rastogi, Rupinder Bhatia
DOI:10.4103/srmjrds.srmjrds_83_19  
Supernumerary teeth, a developmental anomaly when compared to the normal dentition, are characterized by the presence of an extra tooth or teeth. The most common supernumerary teeth are the mesiodens which is located in the middle region of the premaxilla, between the two central incisors. Its' prevalence differs between different racial groups, and in the population of India, it varies from 0.3% to 3.8%, with a ratio of 2:
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Autotransplantation: An alternative treatment for horizontally impacted permanent incisors: A case report with review of literature p. 91
Ritesh R Kalaskar, Priyanka Bhaje, Ashita Ritesh Kalaskar, Priyanka Sharma
DOI:10.4103/srmjrds.srmjrds_85_19  
Horizontally impacted permanent maxillary incisors are rarely treated by surgical extraction due to their unfavorable position and traumatic extraction. Fixed prostheses such as fixed partial dentures and implants are contraindicated in children because of their growing age, as they adversely affect bone growth. In this case report, we have presented 18-month follow-up study of a 13-year-old child with a horizontally impacted permanent maxillary lateral incisor which was autotransplanted into its original position. To avoid interference in periodontal healing, intentional endodontic treatment was carried out followed by placement of a jacket crown.
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An unusual presentation of oral lichen planus with desquamative gingivitis p. 95
Nisha Ashifa, S Rajasekar, Senthil Kumar, V Parvathi
DOI:10.4103/srmjrds.srmjrds_86_19  
Lichen planus (LP) is a chronic, autoimmune, mucocutaneous disease affecting the skin and mucosa. Oral LP (OLP) usually presents as a bilateral symmetrical lesion that affects approximately 1%–2% of the population. OLP exhibits a wide variety of clinical presentations. This case report deals with a 52-year-old female patient with OLP lesion isolated to the left buccal mucosa and desquamative gingivitis in relation to marginal gingiva of maxillary left premolars with white lacy striae extending from the left- to right-side central incisor region and a brownish-black-pigmented papule to the left angle of lip. Incisional biopsy was performed which revealed typical features of OLP. The patient was advised topical corticosteroids and antioxidants. She was subjected to oral prophylaxis to eliminate local irritating factors and was encouraged to follow meticulous oral hygiene measures to maintain periodontal health following which there was a resolution of the lesion and the symptoms.
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REVIEW ARTICLES Top

Lesion sterilization and tissue repair in primary teeth p. 99
Amarshree A Shetty, G Geethanjali, Amitha M Hegde
DOI:10.4103/srmjrds.srmjrds_87_19  
In primary teeth that are pulpally involved, pulp therapy is performed with the sole aim of maintaining the teeth until normal physiological exfoliation. This is to avoid any abnormalities in occlusion in the permanent dentition. However, conditions such as the presence of extensive root resorption and/or presence of furcal radiolucency may contradict pulpectomy, and in such cases, lesion sterilization and tissue repair seems to be a promising alternative to extraction followed by space maintenance.
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Glycyrrhiza glabra: Its role in dentistry p. 106
Chaitali Hambire, Umesh Hambire
DOI:10.4103/srmjrds.srmjrds_94_19  
Glycyrrhiza glabra has been used as medicine in Ayurveda and flavouring herb for more than 4000 years. It is reported to have antiviral, anticancer, anti-ulcer, anti-diabetic, anti-oxidant,anti-malarial, anti-fungal, anti-bacterial, immune-stimulant, antithrombotic, anticonvulsant, anti-allergenic and expectorant activities. The presence of alkaloids, tannins, essential oils and flavonoids prevent the adherence of bacteria to the tooth surfaces, inhibit glucan production and have inhibitory effect on amylases. This paper presents a review of role of Glycyrrhiza glabra in dentistry.
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