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ORIGINAL ARTICLES |
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Pediatricians view about oral health care and treatment needs of children in Bhopal city: Bridging the gap between pediatricians and pedodontist |
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Babita Niranjan, Shashikiran Nandihalli Devendrappa, Shilpy Singla, Ruchi Thakur DOI:10.4103/0976-433X.129054 Objective: Repeated efforts in the form of educational programs and surveys have been made time and again to enhance the knowledge, attitude and behavior of pediatricians regarding pediatric dentistry. However, it is unfortunate to conceive that there is still a huge need to bridge the gap. This study is yet another effort to detect the loopholes so that henceforth in future a better rapport and a better consultation program can be established between pediatricians and pedodontists. Need of the hour is to improve the communication between the two fraternities. Aim and Objectives: The aim of the study of the following study is to evaluate the knowledge, attitude and behavior of pediatricians regarding pediatric dentistry in Bhopal city (Madhya Pradesh). Material and Methods: Pediatricians in Bhopal were requested to fill up an open ended questionnaire, which comprised of questions relating to the basic knowledge regarding the scope of pediatric dentistry and how according to them was this specialty beneficial to the young patients. Result: The present study shows that the pediatricians who were surveyed had poor knowledge regarding dental and oral health and treatment needs in children. Most of pediatricians were not aware of many aspects of child oral health care and areas of concerns were identified. Conclusion: Pediatricians have a fair knowledge about oral health and different treatment modalities such as pit and fissures sealants, restoration, root canal treatment, crowns, space maintainers and topical fluorides in children. |
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Sensory nerve paresthesia following third molar surgery: Effectiveness of an evidence based protocol |
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Mohanavalli Singaram, Venkesana Balakrishnaraja Krishnakumararaja, Sasikala Balasubramaniam, Elavenil Paneerselvam, Poornima Poornima, Gayathri Gopi DOI:10.4103/0976-433X.129055 Objective: To assess the incidence of inferior alveolar and lingual nerve paresthesia following third molar surgeries and to assess the effectiveness of a set departmental protocol for reducing the incidence of these paresthesia. Study Design: The study included 110 patients who underwent surgery for third molar removal. All cases followed a protocol which included using a standard Ward's incision, raising a lingual flap, use of minimal ostectomy and tooth sectioning in all cases. A standardized data form was used to record the patient's age, sex, Pederson's difficulty index, distance between the root apices and inferior alveolar canal, the length of the "redline" and operating time. Results: Postoperative inferior alveolar nerve paresthesia occurred in five cases (4.5%) and lingual nerve paresthesia occurred in one case (0.9%). Paresthesia was significantly related to the duration of the surgical procedure, but unrelated to the other variables recorded. Conclusion: The current protocol followed appears to be effective in reducing the incidence of inferior alveolar and lingual nerve paresthesia to an acceptable level even in the presence of high risk factors. |
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Prevalence of traumatic dental injuries in primary teeth: A retrospective study |
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Gali Nagarjuna Chowdary, Ramkumar Hemalatha, Rajendran Vijayakumar, Rajendran Ganesh, Haridoss Selvakumar, Subramanian Mangaiyarkarasi DOI:10.4103/0976-433X.129056 Introduction: Trauma to the oral region occurs frequently and comprises 5% of all injuries, which is more prevalent among preschoolers. Aim: The purpose of this retrospective study was to determine the prevalence of traumatic injuries to primary teeth reported to Department of Pedodontics and Preventive Dentistry, SRM Dental College, Chennai, during the years 2003-2013. Materials and Methods: The data was retrieved from records of patients according to sex, age, cause, number of injured teeth and type of tooth. A total number of 65,870 children reported, out of which 34,942 were boys and 30,928 were girls below the age of 6 years. All recorded data was analyzed with the SPSS software (15.0 version).The statistical analysis of the sample was performed using the Chi-square test. Results: The gender difference in the prevalence of traumatic dental injuries was statistically significant (males 66% vs. females 34% of which the maxillary central incisors are most affected (77.21%). Conclusion: Education to parents and caregivers regarding the epidemiology of traumatic injuries and emphasis on an early dental visit may play a major role in reducing the prevalence of dental injury and minimize their detrimental effects on children's quality of life. |
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Comparison of dental anxiety among patients visiting a dental college and private dental clinics in Thiruvallur district, India |
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R Ganesh, Chandasmita Goswami, Rumana Munshi DOI:10.4103/0976-433X.129060 Background: The objective of the study was to assess and compare the prevalence of dental anxiety based on age and gender distribution among the patients reporting at private dental clinics in Thiruvallur district and in private dental college, Thiruvallur. Materials and Methods: The sample comprised of 230 patients, out of which 115 patients randomly selected from the private dental clinics and other 115 patients from Priyadarshini Dental College and Hospital, Thiruvallur. Modified Dental Anxiety Scale (MDAS) was used to assess the anxiety level of the patients. Result: A total of 115 patients in dental college and 115 patients in dental clinics were questioned in the study. Out of these, 13% of patients in dental college and 20.90% of patients in dental clinics were severely anxious. A total of 4.30% of patients in dental college and 3.50% of patients in dental clinics were not anxious at all. The ratio of rate of anxiety of female patients was greater than males. Conclusion: The prevalence of dental anxiety among the patients in this study was high. This highlights the need for dentists to understand what patients feel about dental treatment procedures and aid dentist efforts to improve patients care. |
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Evaluation of gingival pigmentation in children exposed to and not exposed to environmental tobacco smoking |
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Shabeer Mohamed Madani, Biju Thomas DOI:10.4103/0976-433X.129066 Background and Aim: The exposure to environmental tobacco smoke (ETS) has been recognized as a strong contributor to respiratory disorders, lung cancer, peripheral vascular function and death. Increased gingival pigmentation in smokers is established. In children exposed to ETS, an increased incidence of caries and pigmentation of gingiva were documented. In a country like India where no stringent smoke-free policies exist and the presence of joint family systems in rural population, children are at a greater health risk when either one of the family member is a smoker. The potential accumulation in melanin-containing tissues of nicotine and tobacco-specific compounds may be a concern for any individual who is chronically exposed to tobacco smoke. Gingival pigmentation is easy to assess and could be of significant importance while educating parents in terms of their child's health. Thus primary objective of our study is to assess the effects of ETS on gingival pigmentation in children with ≥1 smoker parent or close relatives. Materials and Methods: A total of 228 students between the age group of 6-16 years were selected randomly. The cases included children exposed to ETS who were non-smokers and the controls were not exposed to ETS at home. Pigmentation was assessed using Dummet & Co's pigmentation index and smoking was assessed by interview. Results: The prevalence of pigmentation in subjects not exposed to ETS was found to be 132 (80.5%) subjects in comparison to 32 (19.5%) without any gingival pigmentation. It can also be noted that all the 64 (100%) subjects exposed to ETS had pigmented gingiva. Conclusion: Within the limitations of this cross-sectional observational study, we conclude that there may be a correlation between gingival melanin pigmentation of children exposed to ETS. |
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REVIEW ARTICLES |
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Statins: The paradigm shift in periodontal regeneration |
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Prerna Kataria, Jasmine Kaur, Eram Parvez, RP Maurya DOI:10.4103/0976-433X.129069 Statins, the lipid-lowering drugs, provide an important and effective approach for the treatment of hyperlipidemia and arteriosclerosis. They function by reducing the blood cholesterol levels which came as a marked discovery to intervene in cardiovascular and cerebrovascular diseases related to increased lipid levels. Their long-term systemic administration in humans has been shown to result in increased bone mineral density. In recent scenario, statins thus modulate bone metabolism exhibiting antibone resorbing properties by upregulating the bone morphogenic proteins and blocking the intermediate metabolites of the mevalonate pathway, made evident by various in vivo and in vitro studies thus providing a new direction in the field of periodontal regeneration. Statins also offered the added advantage of anti-inflammatory and antioxidant properties. Thus, the use of statins both systemically and locally gained wide acceptance by the periodontists as they have shown to increase the bone mineral density and may be effective for periodontal regeneration by stimulation of regenerative factors. This article reviews the beneficial effect of statins and examines their potential role in regenerative periodontal therapy. |
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Sjogren's syndrome: A review |
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Mallika Kishore, Sunil Ramchandra Panat, Ashish Aggarwal, Nupur Agarwal, Nitin Upadhyay, Ritika Garg DOI:10.4103/0976-433X.129070 Sjogren's syndrome (SS) is a chronic autoimmune disease characterized by the lymphocytic infiltration of salivary and lacrimal glands leading to xerostomia and keratoconjunctivitis sicca. Prevalence of primary SS in the general population has been estimated to be around 1-3%. SS is an under-recognized disease in which most of the significant progress has been made in the past 25 years. The herald of newer diagnostic tools could help clinicians and thereby provide significant relief to patients through earlier treatments. The treatment of SS is limited to symptomatic management, and involves the use of solutions to replace salivary secretion and afford a measure of hydration. The purpose of present paper is to highlight the difficulties and complexities that are inherent in the diagnosis of SS and the important role that dental practitioners can play in the management of its oral manifestations. |
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Transcutaneous electric nerve stimulation in trigeminal neuralgia: A review of literature |
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Varadarajan Usha DOI:10.4103/0976-433X.129071 Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of mostly older females around 35 years. A thorough investigation and proper diagnosis is a must prior to treatment for which investigations like computed tomography and magnetic resonance imaging should be done to rule out other systemic pathology. A proper history and multidisciplinary examination is a must for the same. The surgeon should have a thorough knowledge of both odontogenic and non odontogenic cause of pain to confirm the diagnosis and a diagnostic block has been enough in case of no other systemic pathology. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, alcohol injection, peripheral neurectomy, rhizotomy and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is a safer, cheaper and promising option for management of neuralgic patients as an adjunct with the drugs used like baclofen or carbamazepine thereby reducing the dose of the drugs taken and minimizing the side-effects of the drugs. The analgesic mechanism of TENS involves gate control theory, physiological block and endogenous pain inhibitory systems. It is a noninvasive and safer adjunct to medical treatment in chronic neuralgic pain, economical and easy for both the doctor and the patient. The reduction of pain can be assessed by patient's verbal response as comparatively objective scale like visual analog scale or McGill's questionnaire could not be clinically applied. TENS cannot be considered as a sole remedy in chronic pain conditions, but as an adjunct whose effectiveness needs a continuous follow-up. |
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A Review of fluoride and its diverse effects |
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Maya Ramesh, Rita Mary Aruna, Narasimhan Malathi, Ramesh Krishnan DOI:10.4103/0976-433X.129072 Increased intake of fluoride in water and diet results in dental and skeletal fluorosis. Many states in India are affected by fluorosis. The optimum level of fluoride in drinking water for anti-cariogenic effect was thought to be 1 ppm. Various effects of fluoride on plants, animals and humans are discussed here. Currently, it is identified that fluoride has significant role in gene polymorphisms and lowered intelligent quotient. |
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Prosthodontic treatment strategy for patients with ectodermal dysplasia: A literature review |
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Cecil Williams, Manish Kumar, Manas Bajpai, Deshant Agarwal, Anuj Lavania DOI:10.4103/0976-433X.129073 Ectodermal dysplasia (ED) is a congenital syndrome characterized by developmental failure of two or more ectodermal structures and their accessory appendages. ED is commonly a difficult condition to manage with prosthodontics because of the typical oral deficiencies and because the afflicted individuals are quite young when they are evaluated for treatment. It is important that these individuals receive dental treatment at an early age for physiologic and psychosocial reasons. Patient with this disease often need a multidisciplinary approach to treatment planning and dental treatment to regain appropriate function, esthetics, and comfort. The definitive treatment plan may include removable, fixed, or implant-supported prosthesis or a combination of these options. This article reviews the literature that pertains to the prosthodontic treatment of the ED and the review includes considerations in patient management and timing of treatment. |
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CASE REPORTS |
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Hollow maxillary denture: A new modified technique for improving retention in resorbed maxillary ridges |
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Laxman Singh Kaira, Esha Dabral DOI:10.4103/0976-433X.129074 The success of a complete denture relies on the principles of retention, stability, and support. The prosthodontist skill lies in applying these principles efficiently in critical situations. Severely resorbed maxillary edentulous ridges that are narrow and constricted with increased interridge space provide decreased support, retention, and stability. The consequent weight of the processed denture only compromises them further. This article describes a case report of an edentulous patient with resorbed ridges, where a simplified technique of fabricating a hollow maxillary complete denture was used for preservation of denture bearing areas. |
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Oral submucous fibrosis associated with malignancy |
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Gargi Chaudhuri, Rajdeep Das, Mousumi Pal, Sanchita Kundu DOI:10.4103/0976-433X.129075 Oral submucous fibrosis (OSF) is a chronic condition of the oral mucosa, first described among five East African women of Indian origin under the term "atrophia idiopathica (tropica) mucosae oris." It is characterized by a generalized submucous fibrosis. The pathogenesis of the disease is not well-established, but epidemiological evidences strongly indicate the association of betel quid habit. It is logical to hypothesize that the increased collagen production or reduced collagen degradation is the possible mechanism in the development of the disease. The malignant potentiality and also the origin of cancers in different intraoral locations in OSF patients is attributable to the generalized epithelial atrophy. Here, a clinical case of OSF in a 36-year-old male patient is being discussed, encompassing the pathogenesis and malignant potentiality of the disease. |
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Peripheral odontoma: A case report |
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Bhawarlal Chanaram, Ramkumar Hemalatha, Rajendran Vijayakumar, Haridoss Selvakumar DOI:10.4103/0976-433X.129076 Odontomas refers to any tumor of odontogenic origin. The well-differentiated epithelial and mesenchymal cell gives rise to ameloblast and odontoblast which lays down enamel, dentin and pulpal tissue of the odontoma. The enamel thus laid is in an abnormal pattern and is considered as a developmental anomaly rather than true neoplasm. Odontomas are hamartomatous developmental malformations of odontogenic origin which manifest as denticles, or amorphous masses comprising of the dental tissues. Although a majority of odontomas are intraosseous; there are case reports of odontomas that erupted into the oral cavity. Even less common are peripheral or soft-tissue odontomas, only a few of which have been reported to date. They commonly occur in the pre-maxillary region and associated complications include delayed or uneruption of permanent teeth, retention of the primary teeth and dentigerous cyst formation. Management usually requires surgical removal of the odontoma and the impacted tooth followed by subsequent orthodontic intervention to correct the malocclusion. The present case report describes a case of peripheral odontoma that was present in the alveolar mucosa of a 12-year-old female patient who reported with a chief complaint of unerupted left maxillary lateral incisor. The diagnosis, complications, treatment and prognosis of this entity will be discussed. |
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SHORT COMMUNICATIONS |
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Modified support phase appliance after twin block therapy |
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Gautham Sivamurthy, S Aravind Kumar, Christine Samantha DOI:10.4103/0976-433X.129077 Buccal segment occlusion is the cornerstone of stability after correction of Class II malocclusion using a twin block appliance. The following short communication is a modification of Clark's original support phase appliance, to achieve better retention after treatment. |
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Guiding jig for accurate placement of temporary anchorage implants |
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Vimala Gnanasambandam, Sainath Muthiah Chidambaram, Manonmani Arumugam DOI:10.4103/0976-433X.129078 Introduction: Temporary anchorage devices are becoming an integral component of fixed orthodontic armamentarium. Success of implants, to a large extent depends on selecting and placing them in an ideal bone space. Locating the exact spot is critical and error of even a millimeter may injure the adjacent root. It is therefore advisable that guidance to locate the spot be utilized especially by a novice to refrain from untoward injury to neighboring anatomical structures. This paper describes about an efficient guiding jig that can be easily fabricated within few minutes of chair side time. |
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