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   2015| July-September  | Volume 6 | Issue 3  
    Online since August 4, 2015

 
 
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ORIGINAL ARTICLES
Correlation between prevalence of pulp stones and renal stones in Panchkula region of India
Tarun Kumar, Gagan Puri, Konidena Aravinda, Sanjeev Laller, Deepa Jatti, Rajesh Gupta
July-September 2015, 6(3):150-154
DOI:10.4103/0976-433X.162156  
Aim: Pulp stones are discrete calcified bodies found in the dental pulp. The aim of the present study was to determine the prevalence of pulp stones in patients with renal stones and to determine the relationship between the pulp stones and renal stones. Materials and Methods: A total of 240 patients participated in the study. Group A consisted of 120 patients who had renal calculi, and Group B had 120 randomly selected controls for the study. The periapical radiographs for all patients were evaluated for the presence or absence of the narrowing of dental pulp chambers and pulp canals. The radiographs were also evaluated to determine the presence or absence of pulp stones. The results were compared and analyzed using the Chi-square test (P < 0.001). Results: A total of 163 patients had pulp narrowing, and 112 patients had pulp stones, which included 55 controls and 57 renal calculi patients. There was no statistical correlation between pulp narrowing and renal stones (P > 0.001) and also between pulp stones and renal stones (P > 0.001). Conclusion: However, there was no significant correlation between the presence of pulp stones and renal stones, the incidental findings of pulp stones on periapical radiographs can provide useful information in the early diagnosis of the systemic calcifications.
  2 1,330 264
CASE REPORTS
Regenerative pulp therapy for immature nonvital teeth with plasma-rich fibrin
Amitava Bora, Shabnam Zahir, Gautam Kumar Kundu, Abhirup Goswami
July-September 2015, 6(3):198-202
DOI:10.4103/0976-433X.162184  
Regenerative endodontics is a biologically based procedure designed to replace damaged structures such as dentin, root structures, and cells of the pulp dentin complex. Regeneration of dental tissue is possible from a variety of pre existing dental stem cells in a properly disinfected root canal system in the presence of suitable growth factors and scaffold medium. Platelet-rich plasma or platelet-rich fibrin act as ideal three-dimensional scaffold medium and a rich source of growth factors that favors from stem cell multiplication and differentiation. The present case report presents a case of regenerative endodontic procedure in a 11-year-old male child with necrotized 31 and 41 with large periapical radiolucency and extra oral discharging sinus where plasma-rich fibrin has been used as scaffold and a source of growth factors.
  1 1,128 217
Fiber-reinforced composite: Post and core material in a pediatric patient: An alternative to usual
Sonu Acharya, Shobha Tandon
July-September 2015, 6(3):206-210
DOI:10.4103/0976-433X.162188  
Fractured teeth have always presented a challenge to the dentists. The predictability of root canal therapy, as it is today, can retain almost indefinitely, even very badly broken teeth. One of the widely accepted techniques involving restoration of extensively carious or badly fractured teeth is the fabrication of a post and core, utilizing the root canal space for anchorage. Thus far, the only materials that have been available to the dentists for this procedure have been a variety of metallic alloys. Hard and unyielding, these metals have to be cast in the precise shape of the prepared canals and cemented into place. Today, materials are available, which eliminate all the intermediate steps, and control is rendered in the hands of the dentists, to fabricate on the chair, a resilient, esthetic and bonded post and core. One such material is discussed here in pediatric permanent anterior tooth.
  1 2,096 348
Gingival vitiligo: A very rare clinical entity
Mundoor Manjunath Dayakar, Jitendra Kumar, Gurpur Prakash Pai, Sonal Srivastava
July-September 2015, 6(3):211-213
DOI:10.4103/0976-433X.162190  
Vitiligo affecting the skin is commonly reported although rare cases have been reported regarding depigmented lesions of the oral cavity. On reviewing the literature, only few cases of gingival vitiligo or similar lesions have been reported till date and these lesions cause an esthetic challenge. Vitiligo has been defined as an acquired, slowly progressive loss of cutaneous pigment that occurs as irregular, sharply defined patches that may or may not be surrounded by macroscopic hyperpigmentation. Here, we are presenting a very rare case of vitiligo affecting only gingiva in which the patient was otherwise absolutely asymptomatic, and patient does not have white patch anywhere in skin except on gingiva.
  - 1,529 178
Diagnostic dilemma: Radicular cyst or keratocystic odontogenic tumor?
Shubhankar Dasgupta, Shalu Rai, Deepankar Misra, Sapna Panjwani, Nivedita Singh
July-September 2015, 6(3):203-205
DOI:10.4103/0976-433X.162186  
Keratocystic odontogenic tumor was previously considered as a common cyst of developmental origin but now it is considered as a tumor of the oral cavity with high recurrence rate and it has an ability to mimic other jaw cysts. Present study is a case report of a 19 year old male presenting with apainful swelling in right lower face region. On clinical and radiographic examination, a provisional diagnosis of Radicular cyst was given. Histopathological examination revealed Keratocystic Odontogenic Tumor. KOT may look similar to endodontic lesion. The lesion was successfully treated by complete enucleation. The aim of the study is to report and distinguish a case of keratocystic odontogenic tumor simulating Radicular cyst because of its aggressive behavior and high recurrence rate.
  - 1,481 208
Walking bleach in primary teeth
Athimuthu Anantharaj, Prasannakumari Patil, Sudhir Ramakrishna, Ramya Jagadeesh
July-September 2015, 6(3):187-190
DOI:10.4103/0976-433X.162181  
Dental bleaching, also known as tooth whitening is a common procedure in dentistry. Dental bleaching in primary teeth has been reported with less frequency when compared to permanent teeth. Various methods are available for bleaching of both vital and nonvital teeth. The present article reports a clinical case of a 4-year-old girl who had discolored tooth 61 following pulpectomy procedure. Intra-coronal bleaching using sodium perborate with walking bleach technique was the treatment of choice. After a follow-up period of 3 weeks, an improvement in the discoloration was noticed.
  - 1,634 267
Allotransplant to replace avulsed mandibular central incisors using mesiodens
Parameswarappa Poornima, Suryakanth Motilal Pai, Mahesh Tirakappa Bajantri, Indavara Eregowda Neena
July-September 2015, 6(3):191-193
DOI:10.4103/0976-433X.156223  
Tooth transplantation has attracted great interests since ancient times. A successful case of tooth allotransplantation is presented in this article. Teeth from two different donors was implanted into the socket of the mandibular central incisors. Follow-up of 1-year indicated good periapical healing with no resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility. This article suggests tooth transplantation as an alternative to other restorative options in children.
  - 1,040 113
Immediate management of complicated crown fracture: A case series
Shilpy Singla, Nikita Agrawal, Nandihalli Devendrappa Shashikiran
July-September 2015, 6(3):194-197
DOI:10.4103/0976-433X.162183  
Trauma to anterior tooth is prevalent among adolescents. An immediate management of complicated crown fracture is reattachment of fragments or biologic tooth restoration. The present case series elucidate the fracture reattachment using conventional preparation design for resin restoration. The adhesive reattachment provides an original tooth color and contour that aids in rehabilitation of traumatized tooth. The present case series depicts that fracture reattachment is a viable, conservative and esthetic alternative for treatment of complicated crown fracture. The long-term prognosis is still obscure, but it is an immediate technique of esthetic rehabilitation.
  - 2,046 302
ORIGINAL ARTICLES
Assessment of periodontal status of Indian police personnel of Central India: A cross-sectional representative study
Aishwarya Singh, Ajay Bhambal, Sudhanshu Saxena, Vidhatri Tiwari, Utkarsh Tiwari, Anupriya Singh
July-September 2015, 6(3):155-160
DOI:10.4103/0976-433X.162162  
Background: Periodontal health is an integral part of oral and in turn general health. Police personnel form the pillars for safety and security of a community hence their health is of utmost importance. The present study aimed to assess the periodontal health status of district police personnel employed in police stations of Bhopal District of Central India. Materials and Methods: A cross-sectional study was conducted on all the available police personnel at various police stations. Final sample size comprised of 781 subjects. The data were recorded on modified World Health Organization format (1997) comprising Community Periodontal Index (CPI) and loss of attachment. Results: The mean age of subjects was 40.5 years, 95.6% were males and 4.4% were females. Regarding highest CPI score, 23.4% subjects had a healthy periodontium whereas maximum subjects (31.3) had a CPI score 2. The CPI scores showed a significant relationship with post, age and education. Conclusion: Overall periodontal status was poor with a high number of subjects requiring oral health education.
  - 899 167
Histomorphometric analysis of gingival tissue in smokers and nonsmokers
Mundoor Manjunath Dayakar, Jitendra Kumar, Gurpur Prakash Pai, Srikant Natarajan
July-September 2015, 6(3):161-165
DOI:10.4103/0976-433X.156214  
Background: Smoking has been recognized as a major risk factor for periodontal diseases. Periodontal diseases are known to cause inflammatory vascular and epithelial changes in the gingiva on its own even in the absence of smoking. Hence, the present study is conducted to compare the epithelial and vascular changes in the gingiva of smokers and nonsmokers suffering from chronic periodontitis. Aim of Study: The purpose of this study was to evaluate and compare the epithelial and microvasculature changes in the gingiva of smokers and nonsmokers with chronic periodontitis. Materials and Methods: The study population consisted of 15 smokers and 15 nonsmokers. Gingival tissue biopsies with diameter of 5 mm including both epithelium and connective tissue were harvested from periodontal surgical sites and sent for histopathological examination. The images of the histological section were interpreted using ImageJ analyzer system. Statistical Analysis: Student's t-test was used to compare the results. Results: Mean area of lumen and blood vessel density among smokers was lesser than nonsmokers, and thickness was found to be more in nonsmokers. Conclusion: The present study concludes that mean thickness of gingival epithelium, mean blood vessel density and lumen area were higher in nonsmokers compared to smokers. Percentage of small-sized and medium-sized blood vessels was higher in smokers.
  - 1,170 188
Knowledge, attitude, and practices about biomedical waste management among dental healthcare personnel in dental colleges in Himachal Pradesh: A cross-sectional study
Kavita Manchanda, Shailee Fotedar, Parveen Dahiya, Ankur Vats, Avishek De Sarkar, Anjali Shrivastava Vats
July-September 2015, 6(3):166-169
DOI:10.4103/0976-433X.156215  
Introduction: The waste created by the healthcare services while providing services which may be either curative, promotive, or preventive may be hazardous to health and environment if there is indiscriminate disposal of hospital waste. Objective: The objective was to assess knowledge, attitude, and practices of students (3 rd years, 4 th years), interns and teaching staff. Materials and Methods: A cross-sectional study was conducted using a close-ended questionnaire among the students, interns and teaching staff of three dental colleges in Himachal Pradesh. A total of 578 subjects were included in the study with their prior consent. Statistical Analysis: The data were tabulated, and interpretation was done in percentages by using SPSS version 13.0 (SPSS Inc., Chicago, IL, USA). Results: Many dentists have the knowledge about the waste management, but they lack in the attitude and practice. Conclusion: There is a need for education regarding hazards associated with improper waste disposal at all levels of dental personnel.
  - 2,969 398
Antibacterial efficacy of three root canal sealers against Enterococcus faecalis and Candida albicans: An in vitro study
Rahul Bhargava, K Shashikala, Rangoli Bhargava
July-September 2015, 6(3):170-174
DOI:10.4103/0976-433X.162177  
Aim: The aim of this in vitro study was to compare the antimicrobial efficacy of calcium hydroxide-based sealer (Apexit Plus), zinc oxide eugenol-based sealer (Endoflas FS) and resin-based sealer (EndoRez) root canal sealers against Enterococcus faecalis microbial type culture collection (MTCC) 439 and Candida albicans MTCC 239 using agar diffusion test. Materials and Methods: In the present study, 20 Mueller Hinton agar (MH agar) plates were employed. Three wells were made by removal of agar at equidistant points and filled with root canal sealers according to manufacturer's instructions. The strains of the bacteria and fungi used in this study were E. faecalis MTCC 439 and C. albicans MTCC 227. Both micro organisms were grown at 37°C for 24 h in MH Broth and seeded into MH agar to produce a turbidity of 0.5 on the McFarland scale, which corresponds to a concentration of 10 8 CFU/mL. This MH broth was used as a second layer. The seeded agar was then added over the plates immediately after the insertion of sealer cements. After incubation, the diameters of zones of inhibition around the plates were measured. Results: The results were statistically analyzed using two way ANOVA test. Against both the micro organisms used in this study, Endoflas FS showed the largest zones of inhibition followed by Apexit Plus and EndoRez. Conclusion: Within the limitations of this study, it can be concluded that: Root canal sealers showed different inhibitory effects depending on their types and microbial strains tested. Against Enterococcus faecalis and Candida albicans, zinc oxide based sealers showed the highest microbial zones of inhibition followed by the calcium hydroxide based sealer and resin based sealer respectively
  - 958 177
A comparative evaluation of ideal apical sealing material for open apex single rooted permanent tooth: An in vitro study
Chiranjit Ghosh, Gautam Kumar Kundu, Shabnam Zahir, Subrata Sarkar, Badruddin Ahmed Bazmi, Sudipta Kar
July-September 2015, 6(3):145-149
DOI:10.4103/0976-433X.162149  
Introduction: Traumatic injury and dental caries in developing tooth can cause irreversible damage to the pulpal tissue, which hinders the normal physiologic root development. Aims and Objectives: The aim was to find out the sealing efficacy of mineral trioxide aggregate (MTA) as an ideal apexification material of a permanent tooth with an open apex by comparative evaluation of grey and white MTA of different thickness and time interval in vitro. Materials and Methods: A total of 144 teeth were randomly distributed into 6 equal test groups containing 24 teeth each and then filled with white and gray MTA to thickness of 1, 2, and 4 mm. Microleakage of these samples was studied by bacterial leakage model at definite intervals (After 24 h,7 th day,15 th day, and 30 th day). Results: After 24 h, for 1 mm thickness, grey MTA showed less leakage than white MTA, but the difference is not statistically significant at 5% level (Z = 0.32, P = 0.75). After 7 days, in 1 and 2 mm thickness, White MTA showed 64.71% and 16.67% leakage, while Grey MTA revealed 50% and 8.33% leakage in the same category. No leakage was found among the samples of 4 mm in both MTA. After 15 days in 1 mm, 100% leakage was recorded in both MTA. In 2 mm, presence of leakage is 15% for White and 13.64% leakage were present in Grey MTA. However, this difference is not significant (Z = 0.126, P = 0.9). In 4 mm MTA, only 1 leakage was found in White and none for Grey. This difference is not significant (Z = 1.02, P = 0.31). After 30 days, in 2 mm, 9% more leakage was observed in White MTA samples (23.53%) than that of Grey MTA (14.29%). In the category of 4 mm, 0.37% more leakage was observed in White MTA samples (8.70%) than that of Grey MTA (8.33%). However, this difference was not statistically significant. Conclusion: The present study showed that apical barrier of 4 mm demonstrated less leakage than 1 and 2 mm barrier in both White and grey MTA after 30 days of study and grey MTA demonstrated significantly less leakage than white MTA.
  - 684 164
REVIEW ARTICLES
A new alternative cancer treatment modality: Immunotherapy
Vidhya Kalanjiam, GV Murali Gopika Manoharan
July-September 2015, 6(3):175-180
DOI:10.4103/0976-433X.162179  
In recent years, progress in understanding the natural immune system has led to research and development of an alternative therapeutic approach called immunotherapy that promises to provide a remarkable breakthrough in the future. Immunotherapy, also called as biological therapy, is a type of cancer treatment that uses the body's immune system to fight cancer. It exploits cells that often have different molecules on their surfaces called as antigens. Immunotherapy is used to provoke the immune system by attacking those antigens as targets. This review of literature is an attempt to summarize the various methods of immunotherapy - Toll like receptor targeting therapy, cell-based therapies through natural killer cells, dendritic cells, T-cells, vaccination (immune activation therapies), cytokine and chemokine therapies.
  - 1,934 268
Ayurveda and holistic approach in oro-dental care: An overview
Vinay Kumar Bhardwaj
July-September 2015, 6(3):181-186
DOI:10.4103/0976-433X.156218  
Dentistry was not a well recognized specialized branch of Ayurveda, literature shows it was included in its Shalakya Tantra. Before the inception and regular use of modern allopathic system, problems related to the oral cavity, plaques and infections were managed in ancient India. Traditional medicine can treat various infectious and chronic conditions. Various researchers have revealed that all kinds of chewing sticks described in ancient Ayurveda literature have medicinal and anti-cariogenic properties. Its oil pulling (Kabla Graham, Kabla Gardoosa) practice is claimed to cure about 30 systemic diseases. Use of safe, quality products and practices should be ensured based on available evidence if traditional medicine is to be acknowledged as part of primary health care. Traditional medicine is the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses. Traditional medicine that has been adopted by other populations (outside its indigenous culture) is often termed complementary or alternative medicine. Herbal medicines include herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other plant materials as active ingredients. Scientific validations of the Ayurveda dental health practices could justify their incorporation into modern oro dental care. Publicity of these techniques using appropriate media would benefit the general population by giving more confidence in the ancient practices, thus preventing various oro dental problems
  - 7,338 557
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