Journal of Dental Specialities

03

Authors: Prof. (Dr.) Hari Parkash

The Journal is aimed to provide a platform for scientific exchange of knowledge by publishing Original Research, Case Reports, Systematic Review and Clinical Tips and Communications for the benefit of Dental Fraternity. The journal is committed to enhance Scientific and Evidenced based Dentistry with clinical Outcomes.

5-15

Authors: Threesuttacheep R, Pothacharoen P, Kongtawelert P, Ongchai S, Jotikasthira D, Chatiketu P, Krisanpra

Purposes: The aims were to monitor remaining interrupted force magnitudes, and to compare chondroitin sulphate (CS) levels in gingival crevicular fluid (GCF) of moved mandibular canines, rates of space closure and patients’ pain and discomfort between interrupted and continuous orthodontic force patterns. Materials and method: Fifteen Class I malocclusion patients (5 males and 10 females; aged 17.00 + 3.18 years) who required orthodontic treatment with first premolar extractions, were recruited. Interrupted force pattern was generated by elastomeric chains, and continuous force pattern by Nickel-Titanium closed coil springs. Initial force magnitude was 120 g. Elastomeric chains were replaced by new ones at the end of fourth week during the loaded periods. During the unloaded and the loaded periods, remaining interrupted force magnitudes were measured, and those of continuous force pattern were calibrated and controlled. GCF samples were collected with Periopaper® strips. CS levels were measured by competitive ELISA with WF6 monoclonal antibody during the 8-week control, the unloaded and the 8-week loaded periods. Rates of space closure were measured, and amount of pain and discomfort was assessed by visual analog scale (VAS) scores. Results: Medians of interrupted force magnitudes were 120.0, 60.0, 50.0, 37.5 and 25.0 g, and after elastomeric chain replacement were 120.0, 62.5, 37.5, 25.0 and 25.0 g respectively. There were no significant differences in the median CS levels between the 8-week control and the unloaded periods, and between right and left mandibular canines. Medians of CS levels during the loaded periods, both interrupted and continuous force patterns, were significantly greater than those during the unloaded period (P=0.008 and P=0.027 respectively). Differences between medians of CS levels of interrupted and continuous force patterns during each 1-week loaded period were not significant. There was no significant difference in the rates of space closure, and the patients’ pain and discomfort between interrupted and continuous force patterns. Conclusion: Both interrupted and continuous force patterns, with 120 g initial force magnitude, cause no difference in biochemically-assessed bone remodeling activity, same rate of space closure and same patients’ pain and discomfort. Initial orthodontic force magnitude, of both interrupted and continuous force patterns, may play an important role for alveolar bone remodeling and clinical outcomes.

22-28

Authors: Prarthna B, Saurabh S, Batra P, Dhillon M

Objective: The aim of this study is to describe shape and measure the size of the sella turcica in subjects with class I and class II skeletal types and to check whether sella can be considered as diagnostic marker for skeletal class II malocclusion. Material and Methods: Lateral cephalometric radiographs of 44 individuals (age; 15–30 years) were taken and classified skeletally; 22 as Class I and 22 as Class II (11 males and 11 females in both groups). The linear dimensions (length, depth and diameter) of sella turcica were measured. Student’s t-test was used to calculate differences in linear dimensions. Results: Results show that the sella turcica presented with normal morphology in the majority of subjects (61 percent). No significant differences were found in linear dimensions between genders. Significant difference was found in the depth of sella between Class I and Class II subjects (p<0.05) with smaller depth measurements in skeletal Class II subjects. Conclusions: Significant difference was found in depth of sella between Class I and Class II subjects with smaller depth measurements in Class II subjects. It is concluded that size of sella turcica can be used to approximate the size of the pituitary gland in skeletal Class II malocclusion. Skeletal class II cases due to mandibular deficiency are associated with smaller depth of pituitary fossa.

36-39

Authors: Lone EA, Utreja AK, Singh SP, Jena AK

Objective: To evaluate the effect of comprehensive orthodontic treatment on frequency and severity of white spot lesions (WSLs). Methods: Total 92 (M=43, F=49) subjects in the age range of 12-35 years seeking comprehensive orthodontic treatment were screened for the study. Among 92 subjects, 46 subjects (M=18, F=28) who fulfilled the selection criteria were included in the study. In 46 subjects, a total of 1026 teeth were examined for the evaluation of WSLs. The frequency and severity of WSLs were recorded on a standard proforma at the beginning (T0) and after completion of orthodontic treatment (T1) by direct visual assessment and by DIAGNOdent. The pre-treatment (T0) and post-treatment (T1) visual and DIAGNOdent scores were compared by using Wilcoxon Signed Rank test. The P-value of 0.05 was considered as the level of significance. Results: The frequency of WSLs among subjects seeking comprehensive orthodontic treatment was increased significantly from the pre-treatment value of 65.2% to post-treatment value of 95.7% (P < 0.001). Of 1026 teeth examined, 107 (10.4%) teeth had white spot lesions at the beginning of orthodontic treatment and 272 (26.5%) teeth had white spot lesions at the end of orthodontic treatment (P<0.001). The mean DIAGNOdent score was comparable between the pre and post-treatment evaluation (P=0.282). Conclusion: Treatment of malocclusion by comprehensive orthodontic treatment had a significant effect on the development and severity of white spot lesions.

43-47

Authors: Sharma A, Shokeen S, Arora R, Dhaginakatti SA

Introduction: Forensic odontology involves application of dental sciences in the identification of deceased individuals through comparison of ante-mortem and post-mortem records. Aim: To study knowledge, attitude and practice of forensic odontology among private dental practitioners in Ghaziabad city. Material and Methods: A questionnaire based cross–sectional survey was conducted on 137 private dental practitioners in their dental clinic at Ghaziabad city. A 20 Item Structured questionnaire was used to assess knowledge of dentist about the significance of dental records, indicators of child abuse, dental age estimation, identification of an individual, bite marks and dentist as a witness in the court for forensic evidence. Questions regarding their attitude and practice about maintenance of dental records and source for update on recent advances in dental practice were assessed. Results In our study only 11% B.D.S and 23% M.D.S dental practitioners maintain dental records in their clinic. 98.4% of B.D.S and 90% of M.D.S dental practitioners said that their knowledge level/ awareness regarding forensic odontology were perceived to be inadequate. 77% of B.D.S and 66% of M.D.S dental practitioners did not know the relevance of maintaining dental records for identification of criminals and dead-bodies. 96.7% of B.D.S and 95.9% M.D.S dental practitioners were not confident in handling forensic dentistry related cases. Conclusion: Our study revealed prevalent inadequate knowledge, poor attitude and lack of practice pertaining to patient’s dental record maintenance and clinical knowledge of forensic odontology among dental practitioners in Ghaziabad.

54-59

Authors: Kumar P, Sharma R, Saroha K, Sharma P, Singh V

Aim and Objective: To assess and compare the shear bond strength of brackets bonded with two different self-adhesive systems with and without contamination (Water, Saliva and Blood) and to evaluate the effect of Salivatact on the shear bond strength obtained with Beauty Ortho Bond. Material and Method: 15 premolars each (a total of 180) were bonded with Transbond XT plus, Beauty Ortho Bond and Beauty Ortho Bond with salivatact under various conditions i.e. dry, water, saliva and blood contamination. The shear bond strength and the ARI values were obtained and evaluated statistically. Results: Transbond plus had the maximum bond strength in dry condition and when contaminated with water or saliva. The bond strength of Beauty Ortho Bond with and without salivatect was similar in dry condition and when contaminated with water or saliva. The shear bond strength was lowest after the blood contamination in all the groups and highest for dry condition. Contamination with water and saliva resulted in similar strengths for all the groups. The bond strength achieved with all the three contaminants (water, saliva, blood) was similar when Salivatact was used. Conclusion: Contamination decreases the bond strength for all the groups and this decrease is maximum in case of blood contamination. Bond strength of Transbond color change adhesive is higher than that of Beauty Ortho Bond under all conditions except when contaminated with blood using Salivatect. Beauty Ortho Bond using Salivatact had higher bond strength when contaminated with blood.

64-67

Authors: Yadav S, Agarwal A, Singh S, Kumar S, Anand KR, Chhabra V

Purpose: The aim of this follow up clinical study was to evaluate the effectiveness of 2mm, 3-dimentional locking titanium miniplates. Patients and Method: A prospective randomized clinical trial was carried out on 10 patients with mandibular fractures. The patients were evaluated for the operating time, clinical assessment of mobility after fixation, occlusion, adequacy of reduction on post-operative radiograph and any surgical complications. The statistical analysis was carried out in SPSS software. Results: In 10 patients, 9(90%) were males and 1(10%) were females with a mean age of 28.75 years. Road traffic accident (RTA) was the etiological factor in 7(70%), inter-personal violence in 2 (20%) and fall in 1(10%) patient. The average intra-operative time was 40.10 min locking plates. This was found to be statistically significant when compared to the intra-operative time of non-locking plates in the literature. Bite force was measured in kilogram/cm2 using indigenously designed bite force measurement device. All the measurements were compared to the control group who did not sustain mandible fracture. At third month it was found that there was no significant difference in the bite between locking plates and control group. On examination satisfactory postoperative functional occlusion was found to be 100% in locking plates. Conclusions: The results obtained suggest that 3-D locking plate/screw system fulfill the treatment goals of adequate reduction, fixation and stabilization of fracture of mandible. 3-D locking plating system adequately reduces the fracture without much need for adaptation and hence reduces the intra-operative time.

76-80

Authors: Choudhury R, Kukreja P, Kumar S, Bhatnagar A, Anand KR, Chhabra V

Purpose: The aim of this study was to investigate the effects of a new flap design, the pedicle flap used for the removal of mandibular third molars on postoperative morbidity. Materials and Method: 10 patients with partially erupted mandibular third molar were studied. Swelling, pain, trismus, dry socket and wound dehiscence measures were recorded on days 2 and 7. Data were analysed using the t-independent test and Fischer’s exact test. Results: Facial swelling, pain, restricted mouth opening was seen in the postoperative period. Wound dehiscence was seen in only 1 patient and no incidence of dry socket was noted. Conclusion: Pedicle flap design has led to better wound healing and lesser incidence of dry socket.

86-88

Authors: Nagda SJ

Current training in dental education in India is mostly traditional. The method followed all over is predominantly didactic i.e. lectures and laboratories for skills and clinical training. It is time to introspect and analyze the reasons our graduates are appearing for entrance examinations and repeating their graduation in various parts of the world. We need to assess our training program and see if it meets the needs of students and community; to see how it matches to the various dental training programs globally. Our fraternity has to be aware of the global changes that have occurred in the field of education. This will enable them to improve, innovate and strengthen their skills and the program. There are many challenges facing us. They range from teaching learning methods, curriculum innovations, assessment techniques and improving attitudes and communication skills. This article will be a preliminary article on dental education in India and a series of articles will follow to address some important and pressing issues.

92-95

Authors: Gupta S, Kumar K, Raviprakash SM, Arunkumar KV

Oral verrucous carcinoma was first recognized by Ackerman in 1948 as a distinct entity. Although it occurs at various anatomic sites, most intraoral cases involve buccal mucosa, alveolar mucosa and gingiva. The purpose of this article is to describe four cases of verrucous hyperplasia and carcinoma with special emphasis on various clinical presentation and the most predilection sites. Verrucous hyperplasia and verrucous carcinoma may not be distinguished clinically or may coexist, resulting in diagnostic difficulties. It should be born in mind that leukoplakic lesions may transform into verrucous carcinoma or squamous cell carcinoma, so all such pre-cancerous lesions should be scrutinized conscientiously. Thus, it is amenability of both the oral physicians and histopathologists to be scrupulous about warty and exophytic lesions.

102-108

Authors: Kumar S, Jayan B, Bansal AK

The interest in studying the upper airway has always been there in orthodontics. Acoustic Pharyngometry is a relatively new technique in this field which measures the upper airway precisely. The technique is based on acoustic reflection technology. Sound waves are projected down the airway and reflected back out in such a way that the Pharyngometry software can analyze and quantify changes in the airway cross sectional area. It is an easy and quick technique that measures patient’s pharyngeal airway size and patency from the oropharyngeal junction to the glottis. The technique is useful in screening of patients having higher risk for sleep disordered breathing, establishing candidacy for mandibular advancement device and accurate bite recording/ titration of the appliance and also for planning surgical intervention. The aim of this article is to sensitize orthodontic professionals about this technique and to discuss the basic procedural methodology along with its clinical usefulness.

112-116

Authors: Rathi P, Sood R, Dodwad V, Vaish S

Introduction: Enlarged Gingiva is one of the prime concerns for both dentists and patients causing esthetic and functional problems. The treatment is based on the understanding of cause and underlying pathologic changes, be it inflammatory, pharmacologically induced, associated with systemic diseases, neoplastic, iatrogenic or idiopathic. Objective: To provide minimally invasive periodontal therapy to patients presenting with gingival overgrowth of five different etiological backgrounds. Materials and Methods: Patients with gingival overgrowths reported to the Department of Periodontology and Oral Implantology, ITS-CDSR, Muradnagar, Ghaziabad. Based on the individual history, the patients were categorized under five sections. First was inflammatory due to local deposits, Second was drug induced (phenytoin and amlodipine), Third was iatrogenic in patient undergoing orthodontic treatment, Fourth idiopathic and Fifth Miscellaneous in which patient himself wanted gingival correction because of esthetic concerns. Different treatment strategies were advocated depending upon the history, clinical examination and medical consent. Results: All patients were successfully treated with full mouth scaling, root planing and surgical therapy. Full mouth gingivectomy and gingivoplasty was conducted one week apart, one quadrant each week with scalpel, electro cautery and LASER depending upon the patient’s requirement. Conclusion: This case series emphasizes on the different types of gingival enlargement based on the etiology and highlights different treatment modalities advocated to manage such cases.

120-122

Authors: Konwar SK, Saxena A, Singla A, Chandna AK

Anterior crossbite is an abnormal labiolingual relation in which maxillary anterior teeth are locked behind the mandibular anterior teeth. Many methods are used to raise the bite to correct anterior crossbite. Here, a new method is described which will retain the bite blocks in place for easier correction of anterior crossbite.