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   Table of Contents - Current issue
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January-March 2021
Volume 12 | Issue 1
Page Nos. 1-60

Online since Tuesday, March 30, 2021

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ORIGINAL ARTICLES  

Periodontium and restoration: A comparative study of restored and unrestored molars Highly accessed article p. 1
Adebola Oluyemisi Ehizele, Joan Emien Enabulele
DOI:10.4103/srmjrds.srmjrds_82_20  
Background: Restorations have been known to have a detrimental effect on the periodontium with certain teeth or groups of teeth prone to develop more severe periodontal destruction. This study compared the periodontal health of restored molars with that of unrestored molars and determined the correlation between the type, age, and status of the restorations on the molars and the health of the associated periodontium. Materials and Methods: Patients with at least one restored molar and its contralateral counterpart of one unrestored molar were recruited for the study. The type of restoration and material, age of restoration, and type of defects on the restoration were noted in the restored group, while the degree of tooth mobility, furcation involvement, gingival recession, gingival status, and periodontal pockets depth were measured in all teeth studied. Data were analyzed using IBM SPSS version 21.0. Results: A total of 160 molars (80 restored and 80 unrestored molars) were studied. There were more restored mandibular molars (53.7%) than restored maxillary molars (46.3%). More first molars (43) compared to second molars (37) were restored. The most prevalent type of restoration was amalgam restoration (67.5%), followed by glass ionomer cement restoration (10%). There was no statistically significant association between the type of restoration and the periodontal clinical parameters assessed (P > 0.05). Similarly, there was no statistically significant association between the class of the restoration whether Class I or II and the periodontal clinical parameters assessed. The restored molars had 3.2 (95% confidence interval [CI] 0.5–32.8) times the odds of bleeding on probing, 1.5 (95% CI 0.2–8.9) times the odds of having Grade 1 mobility, 2.1 (95% CI 0.5–10.0) times the odds of having Grade 1 gingival recession, and 1.5 (95% CI 0.3–9.2) times the odds of having Grade 1 furcation involvement than the unrestored. Conclusion: It can be concluded that there is no statistically significant difference in the health of the periodontium of restored and unrestored molars or correlation between the type, age, and status of the restorations on the molars and their periodontal health. The odds of having bleeding on probing, tooth mobility, gingival recession, and furcation involvement tends to be higher with the restoration of the molars.
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Assessment and comparison of toothpastes for pH and antibacterial effect against Streptococcus mutans: An in vitro study p. 8
Pooja J Shetty, RS Roshni, Leslie Gomes
DOI:10.4103/srmjrds.srmjrds_137_20  
Introduction: One of the universally practiced oral hygiene measures is tooth brushing with toothpaste. Each toothpaste is composed of different ingredients. The extent of the antimicrobial activity of toothpastes against cariogenic bacteria is still unclear. Toothpaste with the correct pH will help to neutralize the acidic activity of the oral cavity. However, there are lack of studies to determine pH of different toothpastes. Aim: The aim is to assess and compare the commercially available toothpastes for pH and antibacterial activity against Streptococcus mutans. Materials and Methods: Commercially available toothpastes composed of varying ingredients available in the local market were included in the study. The pH of the toothpastes was assessed using pH meter. The antimicrobial activity was assessed by making serial dilutions for each selected toothpastes in 1:1, 1:2, 1:4, and 1:8 ratio using distilled water. At different concentrations, the antimicrobial activity of the toothpastes against S. mutans was determined by the agar well diffusion method. The diameter of zones of inhibition (mm) was measured for assessing the antimicrobial activity. Results: The mean pH of toothpastes ranged from 7.262 ± 0.414 to 7.729 ± 0.534. All toothpastes showed antimicrobial activity against S. mutans in all four dilutions 1:1, 1:2, 1:4, 1:8. Data were analyzed using the Statistical Package for the Social Sciences version 22 software (IBM Corporation). - Analysis of Variance was used to analyze data. Conclusion: The present study showed that the pH of all the toothpastes are above that of critical pH. All the toothpastes had shown antimicrobial activity against S. mutans at varying dilutions.
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Relative position of mandibular foramen in 4–9-year-old children: A retrospective study p. 13
Sruthi Chandran, Faizal C Peedikayil, TP Chandru, Soni Kottayi, Seena John
DOI:10.4103/srmjrds.srmjrds_81_20  
Introduction: Most common nerve block used in children is the inferior alveolar nerve block (IANB) for anesthetizing mandibular teeth. Therefore, knowledge of the location of the mandibular foramen is necessary for a successful IANB anesthesia. Aim: The study aimed to correlate the position of mandibular foramen in relation to the mandibular occlusal plane and the deepest point of the coronoid notch as a clinical guide for IANB injection in 4–9-year-old children. Materials and Methods: One-hundred orthopantamographs were analyzed and divided into two groups; Group 1 (4–6 years) and Group 2 (7–9 years). The orthopantamographs were traced on the acetate paper using a radiograph viewer and measurements were taken from mandibular lingula (ML) to the occlusal plane and to the deepest point of the coronoid notch. Results: Statistical analysis of the data revealed that there was a significant difference in mean distance between the two groups on both sides by measuring the position of ML to the mandibular occlusal plane and to the deepest point of the coronoid notch. Intergroup comparison of the distance from ML to the deepest point of the coronoid notch on the right and left sides shows a statistically significant difference (P < 0.001). Conclusion: There is a significant difference in both the distance and position of mandibular foramen in the considered age groups.
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In-silico investigation of active component: Epicatechin in Acacia catechu on Salivary α- amylase p. 17
Preethi Arunachalam, Ramya Ramadoss, Amritha James, Lekshmy Jayan, Vasanthi Vinoth, Bose Divya
DOI:10.4103/srmjrds.srmjrds_128_20  
Background: Xerostomia is a common condition which affects majority of the people due to its multifarious etiologies. Although several treatment modalities are under practice, natural herbs show a great deal of beneficial effects recently. Saliva contains a considerable amount of proteins, among which the enzyme salivary α-amylase forms the major bulk. Acacia catechu is habitually known as Katha or Karangali, and the preparations are made from the heartwood or the leaves of this plant and have been used for decades and also as a thirst quencher. The relationship between the use of this decoction and saliva secretion has been a debate among researchers. Although there are no comprehensive validations behind the theory between amylase activity and A. catechu, virtual screening techniques such as docking could help to throw light on this theory. Aim: This study aimed to evaluate the binding efficacy of active ingredient of A. catechu on salivary α-amylase using molecular docking approach. Materials and Methods: The active ingredients of A. catechu were identified using an extensive literature search. The chemical structure of the identified ligand (epicatechin gallate) and the target protein (salivary alpha-amylase) was obtained using PubChem and molecular docking was analyzed using SYBYL2.0®. Results: Epicatechin gallate showed the highest binding affinity for human salivary amylase when compared to the other ligand molecules. Conclusion: The current study thus elucidates that A. catechu can possibly be effective as a stimulatory agent for patients suffering from xerostomia.
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Morphogenic correlation between facial form and intercanine width - an aid in forensic dentistry p. 22
S Sivaranjani, V Krishna Mohan, G Nimoshini, Bose Divya, V Vasanthi, Ramya Ramadoss
DOI:10.4103/srmjrds.srmjrds_105_20  
Background: Forensic odontology is a branch of forensic dentistry that utilizes dental remains for personal identification. When facial recognition is not possible, the facial form of the person can be reconstructed with the help of teeth present and dental structures available. The teeth in the maxillary intercanine region play a vital role for the same. The intercanine width varies considerably between different populations and races and its relation with other facial parameters can be used in personal identification and even facial reconstruction. Aim: The aim of the present study is to assess the correlation between the tooth form and face form by correlating the intercanine width with other facial parameters such as interpupillary distance, interalar distance, interzygomatic distance, and intercanthus distance in the Ethnic Tamil population. Materials and Methods: The study was conducted on a sample of 100 patients aged between 20 and 40 years. Five parameters, namely the intercanine width, interpupillary width, interalar distance, interzygomatic distance, and intercanthus distance was measured using a digital Vernier caliper. The data obtained were tabulated and analyzed using SPSS statistical analysis software. Unpaired t-test was used to compare the mean values of the parameters among males and females. Pearson's correlation was run to assess the relationship between the parameters and P < 0.05 was considered to be statistically significant. Results: Among 100 participants, 50 were male and 50 were female. The mean intercanine width of males (35.1 mm ± 3.8) and females (33.1 mm ± 3.1), mean interzygomatic distance of males (110.8 mm ± 12.3) and females (106.7 mm ± 8.1), and mean interalar distance of males (26.2 mm ± 5.8) and females (28.3 mm ± 4.5) were found to be statistically significant. There was a significant, moderate correlation (r = −0.3; P < 0.05) between the intercanine and intercanthus width in males but not in females. Conclusion: In the present study, a weak correlation existed between intercanine distance and other facial parameters. Several parameters determine the facial form and a combination of these parameters have to be considered thereby reconstruction of the face is possible for future prospectus in forensic dentistry.
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REVIEW ARTICLES Top

Giant cell lesions of the oral cavity Highly accessed article p. 27
Sreeja Chellaswamy, Pavithra Manohar, Beeula Rajakumari, Sathish Muthukumar Ramalingam, Vijayashree Ragavan, Nachiammai Nachiappan
DOI:10.4103/srmjrds.srmjrds_106_20  
Giant cells are formed by the union of several monocytes or macrophages which undergo a defined set of intercellular interactions that ultimately results in a multinucleated cell with a single cytoplasmic compartment. Giant cells are not only pathologic, there are even physiologic giant cells such as osteoclast, megakaryocytes, and trophoblast that helps in maintaining normal repair and remodeling process in the body. There are various classifications and theories for the formation of giant cells. Some of these giant cells act as a characteristic histopathologic feature in oral lesions and aid in diagnosis. In the field of challenging diagnosis, these characteristic features can provide a clue for diagnosing some oral lesions. On this background, the article was attempted to review various types of giant cells, their formation, and giant cell lesions of the oral cavity with basic information about their clinical, radiologic, histopathological features, and treatment planning.
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Compendium on safe dental instrumentation in COVID-19 p. 37
M Abdul Rawoof, Gopi Naveen Chander
DOI:10.4103/srmjrds.srmjrds_94_20  
Dentists are at higher risk due to COVID-19. The proximity during patient management, contacts with aerosols and saliva increases the chances to COVID-19 exposure. The patient management under prevailing COVID situation is done with greater preventive measures. Knowledge on virus, mode of transmission, advices on protection protocol to patient, dentist, and operatory units are essential to prevent the disease. Comprehensive protocol and many reports have been proposed on the preventive measures by the various organizations. In addition, it has been appraised periodically. In these situations, the basics are overlooked and can lead to confusion among the dentists. The review summarizes on the essential recommendations proposed by various organizations that can be followed by the dentists. Further it provides evidence on managing specific aspects on dental procedures, armamentarium, and clinical environment that were overlooked earlier.
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CASE REPORTS Top

Fibroepithelial polyp: A pediatric case report with clinicopathologic overview p. 41
Tharani Vijayakumar, P Krishna Vinoth, D Kiruthika, S Krishnaraj, M Kiruthika, V Vasanthi
DOI:10.4103/srmjrds.srmjrds_127_20  
Chronic irritation to the mucosa manifests as reactive lesions or mucocele in pediatric population. Reactive lesions may range from developmental, inflammatory to neoplastic. Adverse oral habits such as lip biting and cheek biting also contribute to these types of oral lesions. We present a case of a 9-year-old pediatric patient who reported with the complaint of swelling in the right side of the lower lip and history of chronic lip biting. After intraoral examination, clinical diagnosis of mucocele was made. Following excision, the histopathological features were suggestive of fibroepithelial polyp. To avoid misdiagnosis, proper history, clinical and histopathological correlation is advisable to evade misdiagnosis and disparity between clinical and histopathological diagnosis.
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Adenoid cystic carcinoma of the lower lip and buccal mucosa: A case report with review of literature p. 44
Amritha James, Nandhini Gunasekaran, SG Shalini, CS Sherwin Samuel, A Sheryl Dolly, NS Shree Abiraami
DOI:10.4103/srmjrds.srmjrds_122_20  
Adenoid cystic carcinoma (AdCC) is an aggressive neoplasm that often carries a poor prognosis due to its high recurrence rate. Due to its indolent growth, it is often overlooked by the patients and early diagnosis is often challenging due to its deceptively benign clinical course. We report a case of AdCC in the lower lip and buccal mucosa of a patient with a review of the literature and added emphasis on their diagnosis and prognosis.
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Mucocele showing both retention and extravasation phenomenon: An eccentric case report p. 48
Preethi Arunachalam, Dineshkumar Thayalan, Abdul Razak, K Abiramivarman, Abishek Gowtham, Abinaya Rajesh
DOI:10.4103/srmjrds.srmjrds_123_20  
An unusual report of mucocele presenting with both retention type and extravasation phenomenon has been presented. A 44-year-old male patient presented with a swelling in the commissure of the lip region for the past 2 months. A thorough clinical examination and history taking gave a diagnosis of a mucocele. This case highlights and discusses the histopathological features, differential diagnosis, and the theories behind the presentation of this rare case report.
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Cavernous hemangioma of the tongue p. 52
S Sivaranjani, Pregdeeswari Ulaganathan, Rachel Sarah Ruth Chacko, Madhu Narayan
DOI:10.4103/srmjrds.srmjrds_138_20  
Hemangiomas are benign tumors of the oral cavity. Some consider them as hamartomas or developmental anomaly. There are multiple ways of classification of hemangiomas. The most common being as capillary and cavernous ones. In this article, we present a case report of cavernous hemangioma of the tongue reported at our institution. Histopathological and immunohistochemical analyses were done to arrive at the diagnosis.
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Intraoral ductal papilloma of the lower lip in a 6-year-old patient p. 57
R Swaathi, Uma Sankari, IS Swetha, Tejasri Pokkali, Subitha Murali, AE Nagarathinam
DOI:10.4103/srmjrds.srmjrds_2_21  
Ductal papilloma is a type of rare salivary gland tumor of minor salivary glands and commonly seen in the lower lip and buccal vestibule. Ductal papilloma usually presents in the form of three histopathological variants, namely sialedenoma papilliferum, intraductal papilloma, and inverted ductal papilloma. The etiopathogenesis of a ductal papilloma remains unclear, but some authors suggest the association with human papilloma virus. Diagnosis of intraoral ductal papilloma predominantly depends on the histopathological features; however, clinical differential may include benign lesions such as mucocele, lipoma, and fibroma. Considering the benign and nonaggressive nature of such tumors, histopathology alone is suitable for the diagnosis. However, immunohistochemistry may be used in cases of aggressive growth or in malignant counterpart. In this case report, we report the rare case of intraoral ductal papilloma of the lower lip mimicking a mucocele in a 6-year-old female patient.
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