Journal of Dental Specialities

98-101

Authors: Upasana Tyagi, Ipseeta Menon, Deepa Tomar, Avnish Singh, Jyoti Goyal.

Aim: To assess the association between maternal oral health literacy and their preschoolers’ oral health outcomes in Muradnagar. Materials and Method: Among the preschool children of Muradnagar, a cross-sectional study was conducted to assess the association between maternal oral health literacy and their preschoolers’ oral health outcomes. The examiner for interviewing mothers and for the clinical examination of children was single trained calibrated. Rapid Estimate of Adult Literacy in Dentistry (REALD-30) was used to measure maternal oral health literacy. Mother`s socio-demographic variables, oral health related knowledge and behavior was recorded using a structured questionnaire. Clinical examination of the children was done by using Visible biofilm index, Modified gingival index and WHO dentition status 2013. SPSS software version 18 was used for statistical analysis. Results: 48% of the children were males, among the 197 Mother/Child Pairs examined. REALD-30 scores and clinical oral health status of the child (p<0.05) showed a significant relationship. Conclusion: Maternal oral health literacy significantly modifies oral health status of their preschoolers.

108-111

Authors: Arpit Shah, Romil Shah, Neha Vyas, Nitu Shah.

Introduction: Oral mucosal lesions are the most common lesions encountered by the dentist or physician during oral health screening. Oral submucous fibrosis is a common potentially malignant disorder associated with limited mouth opening due to fibrosis and muscle changes in the submucosa. The present study was carried out to compare the two surgical interventions for Oral submucous fibrosis using conventional scalpel technique and diode laser technique for the surgical excision of the fibrotic bands to improve the mouth opening for the patients and also to assess the post-operative pain and healing. Aims and Objectives: The present study was designed to analyze two treatment modalities of Oral submucous fibrosis using diode laser and scalpel surgery and to compare the outcome of both the interventions regarding postoperative pain and mouth opening. Materials and Method: A total of 20 patients (16 males and 4 females) were included in the study. The patients were divided equally and randomly into the treatment groups i.e., conventional scalpel technique and diode laser in a continuous mode after obtaining prior informed consent. Patients in Group A were treated with conventional scalpel technique while in group B were treated using Diode laser technique and followed up for a period of 3 months periodically. Results: The mean age of the study group was 32±15.38 years. The results of the present study showed significant changes in the mouth opening (pre-operative and post-operative comparison) for both the groups using One-way ANOVA and Bonferroni correction. Study groups also reflected highly significant difference for Post-operative pain assessed in VAS scale using Paired “t-test”.Conclusion: Fibrectomy with diode laser is an effective method with several advantages over the traditional methods and can safely be done in the patients with advanced stage of Oral submucous fibrosis. Diode lasers can be used as alternative instruments for excisional biopsies of oral soft tissue lesions. Intra- and postoperative complications are rare, with minor bleeding being the only complication observed during surgical procedures.

119-121

Authors: Sujeet Khiste, Bharat Gupta, Nikita Ramachandran, Nikita Ranade, Aalia Patrawala, Saniyah Shaikh, Bh

Introduction: Periodontal disease is a multi-factorial condition that has been predominantly seen in areas where dental health care facilities are limited. Rural areas in Maharashtra are currently deprived of adequate dental care facilities. Aim: The purpose of the present study was to evaluate the prevalence of periodontal disease in the rural population of Raigad district of Maharashtra state in India. Materials and Method: 400 subjects from Raigad district were randomly examined for prevalence of periodontal disease. Subjects were divided into following groups: 15-24 years, 25-44 years, 45-64 and 65-74 years. CPI score for the selected individuals were recorded and the data was analyzed. Results: It was observed that as the age increased, the CPI score also increased. While CPI score 2 (calculus) was most predominant in age groups 15-24 years, CPI score 3 (pathological pocket of 4-5 mm) was more common in the age groups 25-44 years &45-64 years. CPI score 4 (pathological pocket of >6 mm) was the highest in age groups 65-74 years. Conclusion: There is a high prevalence of periodontitis in the selected population. The severity of periodontitis was seen to increase with increase in age.

128-130

Authors: Nitin Malik, Ruchika Gupta Dewan, Sonal Soi Sharma, Rohit Kochhar.

Aim: The objective of this study was to compare the micro leakage in Class I cavity preparations restored with different tooth colored materials. Materials and Method: Standardized Class I cavity were made in 30 human premolar teeth. Specimens were randomly divided into four groups comprising of 10 samples each (n=10). Group I: Teeth were without any restorative material (Control). Group II: Restored with a nano ionomer, Group III: Restored with a silorane composite, Group IV: Restored with SDR. All specimens were immersed in 2% methylene blue dye. The specimens were sectioned and evaluated for microleakage under stereomicroscope. Results: Group IV (SDR) showed lesser microleakage than P90 followed by Ketac N100. Conclusion: It was concluded that SDR (Smart Dentin Replacement) had the lowest level of micro leakage amongst all the groups.

138-141

Authors: Mohit Mangla, Lily Rajput, Amit Kumar, Pradeep Sharma, Vidhi C. Rathi, Sanjeev Kumar.

Introduction: Mental foramen is a minute circular/oval shaped opening present bilaterally in the anterior surface of the body of the mandible. The mental foramen marks the termination of mandibular canal in the mandible, through which the inferior alveolar neurovascular bundle passes. Evaluation of the position of the mental foramen in various surgical procedures like fracture of body of mandible, nerve lateralization procedure, dental implant, orthognathic surgery etc. helps in preventing damage to neurovascular bundle thus preventing paresthesia of lower lip, gums and lower anterior teeth. The aim of this study was to determine the position of the mental foramen in the Muradnagar-Ghaziabad population using digital panoramic radiographs in order to keep a record of the variations of the morphologic features of the mental foramen in anethnic population of Muradnagar. Materials and Method: A total of 1000 digital orthopantomogram of 635 male and 365 female patients within the age group of 15 to 55years were collected and the position of mental foramen along the vertical and horizontal axis was analyzed. Results: The most common position of mental foramen was found to be in line with second premolar tooth (51%), in the horizontal axis and along the vertical axis, it was inferior to the apex of second premolar (68.1%). Conclusion: This Study supports the earlier literature regarding the position of mental foramen among north Indian population and suggests that variations are present between populations of different geographical areas.

148-151

Authors: Sandeep K. Bhullar, Viniti Goel, Amandeep Bhullar, Lakshay Goyal, Vijita Mehta, Tarun Nanda, Mallika.

The oral rehabilitation of patients after loss of teeth has made much progress in recent times. Whenever there is an inadequate vestibular depth present to maintain oral hygiene and to increase the retention and stability of the denture, deepening of the vestibule is considered. The vestibular depth depends on various factors such as age, physical status, amount and consistency of mucous membrane, amount of alveolar and basal bone, positon and tension of adjacent muscles, presence of bony projections and ridges and neurovascular foramina. One of the main objectives of periodontal therapy is to achieve an area which permits an optimal level of oral hygiene. A shallow labial vestibule hampers the proper placement of a tooth brush. As a result, a decreased depth of the vestibule is often associated with plaque accumulation and consequently marginal gingival inflammation. Vestibuloplasty is the surgical procedure whereby the oral vestibule is deepened by changing the soft tissue attachments. The most common procedures in vestibuloplasty are submucosal vestibuloplasty, secondary epithelial vestibuloplasty, soft tissue graft vestibuloplasty and Edlanplasty. Although vestibular depth extension procedure remains relatively painless under local anesthesia on the first day of surgery, there is a subtle increase in pain on the second day relative to the first. The present study was conducted to measure and compare pain by 3 different scales i.e., visual analogue scale, numerical rating scale, faces rating scale in vestibular extension procedure done by scalpel, laser and electrocautery. The pain was measured at baseline, 1 day post-operative, 1 week post-operative. Data thus collected was put to statistical analysis.

156-159

Authors: Richa, Neeraj Kumar.

Dental traumatic injuries in primary teeth are common in younger children. Root fractures in deciduous teeth are considered as a rare entity among all the dental traumatic injuries. These cases highlight the conservative management of intra alveolar root fracture in primary anterior teeth which were stabilized with multi-flex wire using composite resin. Patients were followed till the eruption of permanent successors. During follow ups, the patients were asymptomatic, roots of the deciduous teeth showed normal physiologic resorption and permanent teeth erupted in their normal position without any developmental defects related to the permanent teeth.

164-165

Authors: Nidhi Agarwal, Manpreet Kour, Ashish Anand.

Teeth present at the time of birth are termed as natal teeth and most of them represent the early eruption of normal primary teeth. Its occurrence is a rare condition and when present can be associated with numerous clinical complications. Due to this, majority of natal teeth are prematurely lost or extracted and the presence of retained natal teeth is uncommon. The purpose of this case report is to document a rare case of retained natal teeth in a 3 year old child and to highlight the importance of the periodic examination program in such cases.

169-171

Authors: Razeena Salam, Jagadish Pai, Anish Varkey, Amit Walvekar.

Peripheral ossifying fibroma (POF) is a type of non-neoplastic gingival enlargement which shows areas of calcification or ossification. It is reactive lesion which usually arises from interdental gingiva and mostly in the anterior maxillary region. It is most commonly seen in females of second decade. The etiology can be secondary to trauma or any other local irritating factors. Differential diagnosis of POF includes pyogenic granuloma and peripheral giant cell granuloma. Careful diagnosis of peripheral ossifying fibroma is important to avoid unnecessary aggressive therapy. The definitive diagnosis is done by using histopathological examination. A conservative surgical treatment which includes the excision of lesion provides an excellent prognosis. A rare case of a 21 year old female patient with peripheral ossifying fibroma in lower front tooth region of the mouth is presented here.

8-12

Authors: Jaishree Rijhwani, Vineet Kini, Ashvini M. Padhye, Priyanka Machale, Tushar Pathak, Bharat Gupta.

Objectives: To evaluate and compare the knowledge, attitude and practice among post-graduate staff and post-graduate students of dental colleges in Navi Mumbai for diagnosis, monitoring and management of patients with impaired glucose tolerance through a set of 18-item multiple- choice closed ended objective questions. Materials & Method: The cross-sectional questionnaire survey was conducted among post-graduate staff and post-graduate students of various dental specialties in dental colleges of Navi Mumbai during March – April 2015. The validated questionnaire consisted of 18-item closed ended questions based on recent literature and updated American Diabetic Association Guidelines (ADA) in 2014. Total of 605 individuals participated in the survey out of which 240 were post-graduate staff and 365 were post-graduate students. Results: After the questionnaire was collected out of 605 participants, 509 participants (84.13% response rate), met the inclusion criteria out of which 202 (39.69%) were PG Staff and 307 (60.31%) were PG Students. The results showed that PG Staff members were very much aware about the diagnosis, monitoring and management of patients with impaired glucose tolerance (IGT) as compared to PG students. The knowledge of PG staff was considerably higher, probably due to their clinical exposure. Conclusion: The study emphasizes the need for better instillation of diagnosis, monitoring and management protocols for impaired Glucose tolerance (IGT) and guidelines as standardized by ADA amongst both the post-graduate staff members and post-graduate students of dental colleges in Navi Mumbai in order to achieve prevention and better control of diabetes mellitus and its complications.

20-26

Authors: Mani Baweja, Namita Kalra, Rishi Tyagi, MMA Faridi, Amit Khatri.

Aim: To study and compare the prevalence and severity of dental caries in children from 3-5 years of age with different patterns of breastfeeding practices. Materials and Method: All the children, aged 3-5 years, attending Immunization Clinic/ Outpatient Department were recruited for the study. The detailed lactation history was inquired from the mothers to assign them into 3 different study groups: A. Group I: Children who were not breast-fed. B. Group II: Children with exclusive breastfeeding for 6 months and continued breastfeeding for ≤1 year. C. Group III: Children with exclusive breastfeeding for 6 months and continued breastfeeding for >1 year but ≤ 2 years. The detailed case history was taken after recording child’s basic information. A dental examination was carried out for each child and standardized indices were recorded for oral health assessment. Chi-square test was used for statistical significance of difference in prevalence of caries. Kruskal Wallis test and Mann Whitney test were used for inter group comparisons. Confounding variables were adjusted using negative binomial with log link function. Results: Children who were not breastfed (Group I) had 61% prevalence of caries and mean dmft index of 1.6. The prevalence of caries was 57% with mean dmft index of 1.0 in Group II and the prevalence of caries was 26% with mean dmft index of 0.6 in Group III. Negative binomial model proved highly significant relation of dental caries with breastfeeding up to 2 years. Conclusion: The prevalence and severity of dental caries was significantly less in breast fed children, especially in those children who were breast fed for 2 years.

31-35

Authors: Nikita Gupta, Anamika Sharma, Rohan Chaudhary.

Introduction: Bacteria in dental plaque are one of the main etiological factors causing periodontal disease. Gingivitis is common and non-specific inflammatory reaction to a complex indigenous micro-biota. Supra-gingival plaque control is an effective method of controlling gingivitis and the most widely practiced form of oral hygiene is tooth brushing with a dentifrice. Carbopol dentifrice has added properties like mucoadhesion and polymeric mineral surface active agents like carbomers making it superior to other dentifrices for controlling gingivitis. Purpose: To evaluate and compare the effectiveness of Herbal dentifrice and Carbopol formulated dentifrice in subjects with established gingivitis. Materials and Method: 30 subjects with chronic marginal gingivitis were selected and randomly divided into 2 groups. Group 1 received Carbopol formulated dentifrice. Group 2 received Herbal dentifrice. Subjects were asked to use the allocated dentifrice, two times a day, for 42 days. Values of Simplified oral hygiene index, Plaque index, Gingival index, and Sulcular bleeding index were assessed at baseline, after 21 and at 42 days. Data was analyzed by Student’s t-test (α = 0.05). Results: Oral hygiene (tooth brushing with dentifrices for 42 days) led to a significant decrease in plaque accumulation by 13% in group 1 and 8% in group 2. Simplified oral hygiene index showed improvement by 23% in group 1 and 10% in groups 2, Gingival sulcus bleeding showed reduction by 62% in group 1 and 24% in group 2 and gingival inflammation decreased by 14% in group 1 and 9% in group 2. Outcome of various indices in Carbopol formulated group (Gp1) showed a significant improvement in all the parameters (P < 0.05), except sulcular bleeding index from baseline to 42 days as compared to the Herbal test group (Gp2). Conclusion: Continuous use of Carbopol formulated dentifrice provided significant improvement of oral hygiene level in patients with established gingivitis.

40-45

Authors: Chitra Anandani, Madhusudan Astekar, Rashmi Metgud, Gayathri Ramesh, Khushboo Phull, Karanprakash Si.

Introduction: Odontogenic cysts are characterized by an expansile non–infiltrative growth through several mechanisms which include presence of mast cells in the capsule. The mast cells can be demonstrated histochemically as well as immunohistochemically. Aim and Objectives: The primary objective of the study was to analyze the presence and distribution of mast cells in radicular cyst, dentigerous cyst and keratocystic odontogenic tumor histochemically and immunohistochemically, to intercompare their expression and to correlate it with the degree of inflammation. Material and Methods: Tissue sections of 30 cases each of radicular cyst, dentigerous cyst and keratocystic odontogenic tumor were stained with toluidine blue and CD117. Quantitation and localization of mast cells was determined by dividing the section into subepithelial and deep zone. The mean number of mast cells was compared between toluidine blue and CD117 for each cyst, and also between two zones for each cyst, using ANOVA test. Correlation of mast cells with degree of inflammation was done using Pearson’s correlation coefficient. Results: The mean number of mast cells were maximum in keratocystic odontogenic tumor, both histochemically and immunohistochemically, with high localization in the subepithelial zone. Immunohistochemical staining detected higher number of mast cells than histochemistry (4.54 and 3.23 respectively). Statistically significant correlation of mast cells with degree of inflammation was observed. Conclusion: Mast cells may play a role in the pathogenesis of odontogenic cysts as an elevated number of mast cells were found in the connective tissue capsule of all three odontogenic cysts.

49-52

Authors: Vidya Goswami, Ipseeta Menon, Avnish Singh, Ricky Pal, Anubhav Sharma, Venkat R. Singh.

Background: The clinical appearance of sound gingiva differs from individual to individual and even at different sites in the oral cavity. Some characteristics are genetically influenced; others appear to be determined by external factors, and biological factors such as growth, gender and age. The present study was carried out to assess and compare knowledge, perception, awareness, extent, severity and factors affecting gingival pigmentation among 18-23 year old males and females studying in an institution in UP, India. Materials & Method: The study sample consisted of 300 degree college students aged between 18 to 23 years. A structured and self-administered questionnaire was used for obtaining information on knowledge, perception, awareness and clinical observations with regard to gingival pigmentation among the participating students. Results: It was observed that 87% males and 43% females in the 14-18 region, in 87% males and 54.7% females in 13-23 region, 93.5% males and 40.8% females in 24-28 region, 87% males and 45.3% females in the 44-48 region, 87% males and 59.2% females in the 33-43 region, 87% males and 40.8% females in the 34-38 region of the gingiva. Gingival pigmentation was found to be more of mild to moderate than severe, among the students. About half of the study population was still unaware of the treatment modalities available for reduction of gingival pigmentation. A little more than half of the population was not willing to undergo depigmentation procedures the most common reason was that they were fine with the appearance of their own gingiva. Conclusion: This study showed that females had higher prevalence of gingival pigmentation in the area of the smile line and were more concerned about the appearance of their gingiva than males.

58-61

Authors: Oshin Kanwar, Viniti Goel, Amandeep Chopra, Lakshay Goyal, Rajneesh Parimoo, Avleen Kaur.

Background and Objective: According to statistics provided by WHO, in 2014, over 600 million individuals were declared obese. India alone accounts for 20% of the world’s obese adults. It has been established that obesity is associated with various other systemic diseases. This study aimed to establish if there existed a similar association between Body Mass Index (BMI) and periodontal disease among the North Indian adult population. Materials and Method: A cross sectional study was conducted from October - December 2015, recruiting a total of 199 subjects who had been diagnosed with chronic periodontitis and gave no history of systemic illness. The personal details of the subjects including their age, sex, etc. were recorded along with their height (in cm) and weight (in Kg). Body mass index was calculated and subjects were categorized based on the same. Periodontal status was assessed using Russell’s Periodontal Index (PI). Results: A significant difference was seen in the values of BMI and PI, as well as in the BMI categories, among the study participants when categorized by gender. When the subjects were stratified according to 3 age groups: young (18–34), middle aged (35–60) and older adults (60+), a highly significant change was observed in the mean BMI and PI scores between the 3 categories. A weak and statistically insignificant association was found between the subjects’ BMI and their respective periodontal status. Conclusion: Though the literature supports a positive correlation between obesity and periodontal disease incidence and severity, the findings of our study implied the presence of an indistinct link between periodontal disease and body mass index among different variables in the North Indian adult demographic.

70-73

Authors: Mridula Goswami, Deepti Thakkar.

Von Willebrand disease is an autosomal inherited bleeding disorder caused due to the quantitative or qualitative defects of a multimeric glycoprotein, the Von Willebrand factor (VWF). VWF is a multi-adhesive protein that carries factor VIII in circulation and initiates aggregation of platelets to exposed sub endothelial collagen fibers. The deficiency or abnormality of VWF causes reduction in the levels of factor VIII, as seen in Hemophilia A patients. The common clinical manifestations of Von Willebrand disease include soft tissue and mucosal bleeding. The severity of the disease is determined by the extent of von Willebrand factor and factor VIII reduction in the circulation. Since symptoms are often mild, a significant majority of patients remain undiagnosed. This article presents the ongoing dental management of a seven-year old female diagnosed with Von Willebrand disease. The primary aim of the article is to focus on the diagnosis, management and dental considerations of this common yet overlooked disorder and distinguish it from Hemophilia.

78-81

Authors: Arushi Pandey, Anshu Choudhary, Amit Nandwana, Falak Ashraf, Manoj Singhal.

Adenomatoid odontogenic tumour(AOT) is a benign, non -neoplastic lesion with slow progressing growth. It occurs in two forms intraosseous and peripheral forms. This lesion is commonly found in the anterior maxilla and is mostly associated with the impacted canine tooth. Here we report a case of large cystic AOT associated with an impacted canine appearing to be a dentigerous cyst grossly and radiographically. Histopathologically varied spectrum of the lesion were noticed, which have been documented and will help us to better our knowledge of AOT.

86-89

Authors: Savy Arora, Sheena Anand, Sanjeev Mittal.

Use of attachments in providing better retention to removable prosthesis is not an outdated treatment modality. It is important for dentists to have more updated knowledge about its use and the success of such prosthesis is necessary to be able to benefit the patients. Proper diagnosis and treatment planning is necessary for selection of appropriate attachment type. This case report discusses use of an extracoronal attachment to enhance retention of a removable partial prosthesis.