Journal of Dental Specialities

90-91

Authors: Vinod Sachdev*

Clinical dental practice frequently witnesses many anxious and skeptical patients specially children. Number of non pharmacological and pharmacological ways to control anxiety have been advocated in such patients. For patients who don’t advantage from nonpharmacological behavior modification, Conscious sedation has been the alternative modality. It was kept dormant due to taboos associated with its use in the past but is being used now increasingly in routine dental practice specially for pediatric patients. 1 Various drugs have been used with different administration routes for conscious sedation, but each one has their own risk index.1

100-108

Authors: Datla Durga Devi*,R Himabindu

Purpose: To evaluate the microbial load on impressions and the efficacy of various disinfectants on reducing microorganisms from the impression surface after disinfection. Materials and Methods: A total of 50 dentulous impressions were made for dentate patients each of age 20 to 50 years using Alginate and Polyvinyl siloxane. Impression compound and zinc oxide eugenol were used for edentulous patients each of age 50 to 70 years, total of 50 edentulous impressions were made. Samples were collected with the help of an 8mm diameter sterile cork borer from each individual impression. Alginate, ZOE and impression compound had 100 samples each. Polyvinyl siloxane had 125 samples. Out of 100 samples the first group of the sample was assigned as control (n=25), the second group of samples (n=25) were immersed in 2% Glutaraldehyde, the third group of samples (n=25) were sprayed with Dimenol, the fourth group of samples (n=25) were placed in the ultraviolet light chamber. For polyvinyl siloxane, an additional fifth sample group (n=25) was subjected to microwave radiation of 650W. The viability of microorganisms that can persist after rinsing and disinfecting the impression surface was tested by inoculating in nutrient media. The colony forming units were counted and compared with the control group. The data were documented and statistically analyzed. Results: There was a significant difference in the count among the control group and the disinfectant groups. Microbial load found on control groups was taken as 100%. Alginate samples which were disinfected with 2% Glutaraldehyde, Dimenol spray and UV light showed microbial load 31%, 46%, 44% respectively, Polyvinylsiloxane samples showed microbial load 35%, 53%, 48% and 0% with microwave radiation respectively. Impression compound samples showed 32%, 49%, 49% respectively & Zinc oxide eugenol samples with 2% Gluteraldehyde, dimenol and UV showed a load of 39%, 51%, 51% respectively. Conclusion: 2% Glutaraldehyde showed higher efficacy in reducing the microflora compared to Dimenol spray and UV radiation. There was complete removal of microorganisms with Microwave radiation.

115-120

Authors: Meltem Bakkal*,Mustafa Sarp Kaya

Introduction: The aim of this retrospective study was to evaluate the long term success of using a ready to use metronidazole paste in the pulpal treatment of non-vital deciduous teeth. The assessment was performed by clinical and radiographic records obtained from follow-ups at 6-30 months. Materials and Methods: Data of 166 children, who had pulpal treatment on their deciduous teeth between April 2013 through June 2016 by a single pediatric dentist, were reviewed for the present study. A pre-treatment history of fistula or swelling, tenderness to percussion, presence of abscess, excessive tooth mobility, radiolucency in the bifurcation and/or periradicular and/or periapical area cases were eligible for inclusion. Finally a total of 42 children with 47 deciduous molars treated with metronidazole paste participated in the study. To determine the success at 6-30 months after treatment, the clinical/radiographic data were evaluated by the principal investigator and a co-investigator. Categorical data association was tested with Chi square test with significance levels at p<0> Result: Success rate of non-vital deciduous teeth was determined as 83% at 6- 30 months after treatment and it was neither associated with gender (p=0.445), first/ second molar (p=0.692) nor maxillary/mandibular molar (p=0.853). Conclusion: Keeping a deciduous tooth in the arch is important to improve oral health of children. Metronidazole paste can be suggested to use for the local treatment of pulpal infections following a dental pulp necrosis and their complications in deciduous teeth, instead of performing extractions for them.

126-130

Authors: Nisheeth Sharma,Shalaj Bhatnagar,Payal Sharma,Piush Kumar,Rishibha Bhardwaj*

Aim: The purpose of this study is to compare the survival rate of orthodontic brackets using two different bonding techniques. Materials and Methods: Twenty patients requiring fixed orthodontic treatment were selected according to the inclusion and exclusion criteria after obtaining informed consent. Result: Twenty patients were selected with the mean age group of 17.5 ±5 years. A total of 360 brackets were bonded (180 brackets in each bonding technique) and were evaluated for survival rate for six months. The direct bonded bracket failure was only 6 out of 180 sample size and for the indirect bonded group was 8 out of 180. The total breakages were 14 including both the groups. The direct bonding group had 95.6% of survival rate which was lower when compared to 96.7% that of direct bonding group. The two bonding groups did not significantly differ in the survival rate. In the posterior region, most of the breakages were observed (12 nos.). ARI score 1 and 2 was found to be more prevalent in the direct bonding technique whereas in the indirect bonding brackets ARI score was found to be equally distributed amongst the group. However there was no significant difference in the ARI scores between the two bonding groups. Conclusion: The overall bond failure rate was minimal, irrespective of the type of technique used to bond the brackets. Bond failure occurred at the bracket-adhesive interface. There was no statistical difference in the ARI scores between the two groups.

136-139

Authors: Preeti Bhagia*,Ipseeta Menon,Ricky Pal Singh,Anubhav Sharma,Jyoti Goyal

Aim: To study effect of educational status of Anganwadi Workers on oral health education program and its impact on improving oral health of preschool children in Muradnagar block, Ghaziabad. Materials and Methods: Study was done amongst 30 Anganwadi Centres of Muradnagar selected by simple random sampling. Sample size was calculated to be 503. Anganwadi Workers were divided into four groups depending on their educational status. Pre tested questionnaire was used to assess baseline knowledge of Anganwadi workers on oral health. Oral health education was imparted to them. Clinical examination of preschool children attending Anganwadi centres was done at baseline and after oral health education program. Data was analysed using descriptive statistics and Statistical Package for Social Sciences software version 18. Results: Mean values of knowledge scores were found to be higher in Anganwadi workers (36.7) with high educational status leading to higher improvement (76%) in oral health status of preschool children. Conclusion: Educational Status of Anganwadi Workers has a significant impact on their oral health knowledge and efficiency of improving oral health status of preschool children.

145-150

Authors: Lakita Gulati*,Prerna Mohan,Rahul Chopra,Nikhil Sharma,Trishu Chowdhery

Introduction: Cosmetic expectations have increased with time and pigmentation of gingiva is a negative factor in an otherwise acceptable “smile window”. Amongst the various treatment modalities for depigmentation like scalpel technique, cryosurgery, laser, abrasion etc, there seems to be a need to compare efficacy of cryosurgery with TFE and Diode laser. Objective: The objective was to compare the efficacy of cryosurgery with 1,1,1,2 tetrafluroethane and Diode Laser for the treatment of gingival pigmentation. Materials and Methods: A randomized controlled split mouth study was conducted for 10 patients with gingival pigmentation, wherein one quadrant was treated with the TFE cooled swab( Group A) and the other quadrant was treated using diode laser (980nm at 1W) (Group B). Pre and post treatment photographs, VAS pain scores, were evaluated by the clinician at 4 days, 1 week, 1month and also number of analgesics required to be taken by the patient following treatment with both the techniques. Results: Clinically significant results were seen in both the groups. Mild erythema was seen immediately after the application of cryogen following which a whitish slough could be separated from the underlying connective tissue at fourth day. In group B, a white fibrin slough was seen 24hrs after the procedure. The healing was uneventful and complete epithelialization takes place in 3-4 weeks in both the groups. Though, the patient acceptance was good for both the procedures, mild pain and discomfort was experienced by the patient in group B. Conclusion: Depigmentation of gingival melanin hyperpigmentation by cryosurgery using TFE and diode laser were found to be an effective procedures, however the patient compliance and acceptance was greater in Tetrafluoroethane cryosurgery when compared to the Diode laser.

156-159

Authors: Ishani Chawla*,Ipseeta Menon,Ricky Pal Singh,Anubhav Sharma

Aim: To evaluate the knowledge of dental postgraduate students regarding publication of research papers. Materials and Methods: This was a questionnaire based comparative study in which after ethical approval the 2 groups compromising 30 post graduates students each( Group 1 = exam going final year Post Graduates, Group 2 = Post Graduates who just entered final year) were selected from a dental institution by simple random sampling. Then their knowledge regarding research publication was assessed using a self administered questionnaire. Results: The post graduates appearing for the exam has higher knowledge scores (mean score=5.87± 2.44) regarding research publication as compared to those who just entered the final year as their mean knowledge score (mean score=7.10±2.46). Conclusion: This study pinpoints the deficiencies in knowledge among Post graduates about research publication. To benefit the latter workshops and lectures on research publication should be made, part of post graduate curriculum so that they would be in ease during conducting and publishing their work without getting involved in fraudulent affairs.

166-168

Authors: Philip Mathew,Manoj Kumar Bhaskaran,Varun Menon P,Rahul VC Tiwari*,Kritika Sehrawat

Introduction: Palatal fistulas can be managed conservatively or surgically depending on the size of defect. Giant fistula is usually treated with local flaps or local flaps combined with regional flaps. Tongue flaps are an excellent alternative to close wide or recurrent palatal fistulae. Here we report a case of a giant palatal fistula postcleft palate surgery which had been operated thrice and failed in different centers. This fistula has been successfully repaired in our center with posteriorly based tongue flap.

172-173

Authors: Amita Poswal*,Harsha Jain,Balram Garg,Pradeep Sharma

Introduction: We present a case of chemical burn due to use of aspirin for pain control as self-medication. A patient placed Aspirin tablet in the right posterior lingual vestibule. A diagnosis of chemical burn was made based on history and clinical examination. Patient was advised to discontinue the habit and self- medication and was treated symptomatically.

177-181

Authors: Resham Narula*,Saru Dhir,Saurabh Gupta,Bharat Gupta,Neha Patil

With the growth of cosmetic dental procedures, the practise of dentistry has become increasingly centred on fulfilling patient desires. Porcelain veneers are increasing in popularity among today’s patients and dental practitioners for conservative restoration of unaesthetic anterior teeth. The ability to place restorations without significant removal of structure is becoming more critical than ever. Besides being painless and conservative, it is a durable material and doesn’t stain like composite making it attractive for a much longer period of time thus making contemporary dentistry, increasingly oriented toward elective and cosmetic procedures.

2-7

Authors: Rabinder Kaur, Piush Kumar, Shalaj Bhatnagar, Payal Sharma

Objective: To compare the clinical characteristics of conventional and Nickel-free metal brackets before and after recycling. Materials and Method: Total of 25 Nickel-free (Co-Cr alloy) premolar brackets MBT 0.022? slot and equal number of 17-4 Stainless Steel premolar brackets MBT 0.022? slot were used in the study. For evaluation of slot dimension, brackets were viewed at 40X magnification under Stereomicroscope. Acrylic jig was made by stabilising 0.019X0.025? Stainless Steel on which test bracket was placed and evaluated for frictional resistance by Universal Testing Machine (UTM). An occluso-gingival load via UTM was applied on bracket-adhesive interface for testing shear bond strength. Results: Paired t- test values for slot dimension showed significant differences between the groups before recycling on both Face and Base. When comparison was made within the groups, there was significant difference in 17-4 Stainless Steel brackets before and after recycling on both Face and Base. For frictional resistance, paired t test showed significant difference within Nickel-free brackets before and after recycling. For shear bond strength, paired t- test showed significant difference within the 17-4 Stainless Steel brackets before and after recycling. Conclusion: Shear bond strength of recycled brackets was greater than as-received brackets for both 17-4 Stainless Steel and Nickel-free brackets. The slot dimensions of as-received brackets exhibited a wider dimension at face than at the base. On recycling, Nickel-free brackets showed a significant increase in frictional values.

13-17

Authors: Chandan Pal, Rahul Chopra, Nikhil Sharma, Siddharth Tevatia, Joohi Chandra, Swapnil Singh

Introduction: Dentinal Hypersensitivity (DH) is characterized by short, sharp pain arising from exposed dentin in response to stimuli typically thermal, evaporative, tactile, osmotic or chemical. Most common modality for treatment of DH is desensitizing dentifrices through combined use of Diode laser along with desensitizing tooth paste which has shown encouraging results. The present study evaluated and compared the efficacy of toothpaste containing 10% Strontium Chloride (SrCl2) with or without Diode laser in the treatment of DH in the teeth with Miller’s Class I or II gingival recession. Materials and Method: The study included patients (aged 18 to 50 years) with chief complaint of dentinal hypersensitivity having Miller’s Class I or Class II gingival recession. A total of 20 sites equally and randomly divided into two groups; Test group (Diode+ Sensoform®-SrCl2 Toothpaste) and Control group (Sensoform®-SrCl2 Toothpaste). Pre and Post treatment VAS for DH was recorded at baseline, 7, 15 & 30 day using air blast test for both the groups. Result:Patients in both the groups reported reduced dentinal hypersensitivity. However, DH was significantly reduced in test group as compared to control group at all the intervals as measured using Visual analogue scale (VAS). Also, the test group showed statistically significant decrease in VAS, post treatment at baseline itself. Conclusion:Within the limitations of the present study, it can be concluded that combined use of desensitizing toothpaste (SrCl2) and diode laser therapy can be effective in providing immediate relief from DH in patients with Miller’s Class I or Class II recession.

18-23

Authors: Eiti Agrawal, Preeti Sharma, Rahul Chopra, Nikhil Sharma, Rajat Singla, Neelam Raghav

Introduction: Periodontitis is the destructive inflammatory disease of the supporting tissue of the teeth resulting in formation of periodontal pocket, gingival recession or both. Ozone (O3) is a triatomic molecule having disinfectant, antimicrobial and healing properties and has shown promising results in the treatment of periodontitis. The present study evaluated the usefulness of ozone water as an adjunct in non-surgical periodontal treatment. Materials and Method: In this split mouth study, 21 sites each of periodontal pockets (? 4mm) in patients with chronic periodontitis were randomly divided into two groups; SRP followed by irrigation with ozonated water test site and SRP followed by irrigation with distilled water (control site).The clinical parameters including plaque index, gingival index, periodontal probing depth and clinical attachment level (CAL) were recorded at baseline and 4 weeks recall. Result: Both the groups (test & control) showed improvement in all the recorded parameters (PI, GI, CAL, PPD) while the test group showed statistically significant reduction in all the clinical parameters compared to control group (p < 0> Conclusion:A single subgingival irrigation with ozonated water can be effectively used as an adjunct to SRP in non-surgical management of chronic periodontitis.

31-33

Authors: Rohit Kochhar, Ruchika Dewan, Manju Kumari, Ramsa Khan, Danish Khan

Introduction: Root microcracks may occur as a result of use of rotary cleaning and shaping instruments. It may be affected by the type and design of the rotary file system used to shape the root canal system. Aim: The aim of this study was to compare the incidence of root microcracks observed within the canal wall after canal preparation using different rotary and reciprocating instruments. Materials and Method: Fifty extracted single rooted anterior teeth were randomly assigned to 5 groups (N=10 teeth per group). The root canal preparation was done using TF Adaptive systems in Group 2, ProTaper Next in Group 3, WaveOne in Group 4 and Reciproc in Group 5. No instrumentation was done in Group 1. All the roots were horizontally sectioned 3, 6, and 9 mm from the apex and then viewed through a stereomicroscope at x25 magnification. Results: The control group had no cracks, and the difference between the control group and the experimental groups was statistically significant (p <0>significantly lower number of cracks than Group 2. Conclusion:All tested groups caused significantly more dentinal defect compared to the unprepared groups.

38-42

Authors: Amandeep Chopra

Introduction: Zika virus is prompting worldwide concern because of an alarming connection to a neurological birth disorder and the rapid spread of the virus across the globe. Health care professionals who come in contact with patients should be aware of this disease. The purpose of this study was to assess the knowledge of Healthcare professionals towards Zika Virus in Tricity, India. Materials and Method: A total of 510 healthcare practitioners were randomly approached to participate in this cross-sectional survey. A self-structured, closed ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding Zika virus. Multivariable linear regression analysis was carried out to assess the association of participant’s demographic and professional characteristics with the knowledge scores. Result: The mean knowledge score of the respondents was 12.57 ± 0.42. Multivariate regression analysis revealed that age, location, profession and years of clinical practice had a significant impact on knowledge score. Conclusion: Healthcare professionals from urban areas, medical profession and with higher clinical practice had better knowledge yet there were notable deficiencies regarding the virus characteristics, diagnostics, elimination and treatment.

46-49

Authors: K. Sayed Akber Pasha, Sandeep Bhatia, Rajdeep Singh

Introduction: It is a well known fact that the life of patient after the removal or exfoliation of all teeth becomes miserable as patient usually has common complaints of inappropriate chewing function along with some pain with the conventional dentures. The aim of this present study was to evaluate the difference in amount of bone resorption in the edentulous patients who were rehabilitated with telescopic implant denture versus those who were given screw retained prosthesis in the posterior area. Materials and Method:The present study comprised of a total of 20 male edentulous patients from the outpatient so as to place four implants in each arch with the use of cone beam computed tomography (CBCT) and surgical technique without raising the flap. After the insertion of prosthesis, panoramic radiograph was done immediately, another after six months and one more after twelve months of using the prosthesis. Results:The results of this present study depicted that even if the bone loss in Group I was slightly higher than Group II, but still the difference in the bone resorption in both the groups remained insignificant (p value>0.05). Discussion:As it is a well known fact that resorption of alveolar ridge occurs throughout life as it is a continuous process, so there was expected reduction in the height of alveolar ridges in the two study groups. The most probable reason for this reduction in bone height is that the transmitted forces to the alveolar bone exceed the normal level of bone tolerance. Conclusion:This study concludes that no single treatment option is better or worse than the other and both can be used to rehabilitate the edentulous patients based upon the factors of cost of treatment, invasiveness and patient preferences.

56-59

Authors: Anjali Malik, Karan Sharma, Vinod Sachdev, Shivani Mathur

Introduction: Antibiotics form an important constituent of therapeutic clinical care in dentistry. However recent reports highlight a growing injudicious use and rise of antibiotic resistance, with 7%-11% of all common antibiotics prescribed by dentist alone. The American Academy and pediatric dentistry has regarding antibiotic usage laid down guidelines catering specifically to the needs of children. Thus, the objective of this study was to compare the antibiotic prescription pattern among dental practitioners and the awareness of antibiotic resistance in Delhi – NCR region. Objective:To compare the antibiotic prescription pattern and the awareness of antibiotic resistance across various strata of dentists. Materials and Method:A total of 120 dentists participated in the study. Inclusion criteria was willingness to participate and mentally competent to answer in written format, for a self-designed questionnaire containing open and closed ended questions. Chi- Square Test was applied. Results: When comparisons were made between Interns and MDS it was found that there was a significant increase in the prescription of antibiotics among the MDS rather than Interns for most of the oral conditions except for a few conditions such as trauma (Interns =6.7% MDS = 11.7%).When asked about the exact dosage of medication to be provided to children only 3.3% did not know about it. Rest 41.7% Interns and 46.7% MDS prescribed it according to weight and age both 26.7% Interns and 35% MDS prescribed it according to weight alone, 13.3% Interns and 16.7% MDS according to age, 10% Interns and 6.7% MDS according to height only. For the management of oral conditions, it was found that the majority of dentists prescribed amoxicillin (73.3% Interns and 85 % MDS) as their first choice followed by alone or in combination metronidazole (6.7% Interns and 16.7% MDS), cephalosporin (5.0% Interns and 6.7% MDS), azithromycin, ciprofloxacin and erythromycin. Conclusion:The results of the study highlight prevailing attitudes among dentists prescribing antibiotics to children. There exists ambiguity over correct antibiotic usage which should be dealt with appropriate understanding of disease, immune system & comprehensive knowledge of antibiotic medications.

66-68

Authors: Krishnaveni Marella

Introduction: Bio Medical Waste (BMW) management is an integral part of any health care system. Proper handling, storage, transportation and safe disposal will prevent the chances of nosocomial infections not only among healthcare personnel but also in patients and their relatives visiting the centre. Objective:To assess the knowledge, attitude and practices about BMW handling among dental practitioners in an urban area of Andhra Pradesh. Materials and Method:A hospital based cross sectional study was conducted in Kurnool urban area from September 2017 to January 2018. A total of 360 dental practitioners were present in the study area, out of which 320 agreed and gave consent for participation in the study. A pre validated questionnaire was used for the study. Details regarding sociodemographic factors, and on knowledge attitude and practices about biomedical waste management practice were incorporated. Results:As per the knowledge about the biomedical waste management, 43.4% had excellent knowledge, 33.8% good, 19.4% moderate knowledge regarding the BMW management. Conclusion:Continuing training programs which emphasize on BMW management practices would assist in improving the present situation of safe handling and disposal of health care waste.

71-74

Authors: Swati Sharma, Nivedita, Monica Mehendiratta, Mohit Sharma

Ameloblastoma is the second most common benign neoplasm of odontogenic origin. It occurs commonly in third to fifth decade of life with no sex predilection. The clinical presentation of tumor includes swelling and facial disfigurement. Here we present a case report of 48 year old male patient reported with a chief complaint of pain and swelling in lower left front tooth region of the jaw since one month. Various investigation modalities were performed which assured the diagnosis of Follicular-acanthomatous ameloblastoma.

79-81

Authors: Amit Gupta, Sanjeev Kumar, Rajeev Pandey, Rajkumar Chakraborty

We present 2 cases of Trigeminal neuralgia (TN) refractory to medicinal therapy. The patients had pain that was unilateral along distribution of the trigeminal nerve trunk, particularly the second and third trunk. Peripheral glycerol injection is a “minimally invasive therapy” that can be considered for patients refractory to medicinal treatment. Ease of administration and repeatability favors its use in a clinical setup. Both the patients responded very well to the treatment and 6 month follow up showed no recurrence of TN.

85-86

Authors: Saurabh Gupta, Nabhika Mittal, Saru Dhir, Neha Patil, Manjushree Juneja, Saurabh Juneja

An awareness and understanding of the presence of an additional root and unusual root canal morphology is essential as it determines the successful outcome of endodontic treatment. Aberrations in root canal anatomy are commonly occurring phenomena. The endodontic treatment of mandibular premolar with aberrant root and root canal configuration can be diagnostically and clinically challenging. This article presents a rare anatomic configuration and points to importance of expecting and searching for additional canals because knowledge of their existence would enable clinician to treat a case successfully that otherwise might end in failure.