Journal of Dental Sciences

1-4

Authors: Sneha S Shah

Oral ketorolac tromethamine(KT) in 10 and 20mg postoperative doses in an oral surgery pain model have proven to be equally analgesic as 400mg ibuprofen, and significantly better than acetaminophen and acetaminophen-codeine combinations. It prevents pain by blocking arachidonic-acidpathway. To evaluate the analgesic effect of preoperative KT-10mg, on pain during and after open flap debridement(OFD) surgery. 42-patients were randomized(21-controls, 21-tests). Oral KT-10mg was given to test-group 10 minutes before administration of the local-anesthesia(L.A), prior to OFD. Visual analogue scale(VAS) was used to assess pain, immediately after OFD, and every hour after that until, first onset of pain, & time of onset of pain. The mean values of time of onset of pain in test-group was 3.57 hours, while it was 2.33 hours in the control-group(p=0.005). KT-10mg pre-medication was effective in pain reduction during surgery. However, it neither affected delayed pain levels, nor postoperative analgesic consumption

1-7

Authors: Ashwith Hegde

The concept of using rubber dam to isolate the tooth dates back to almost 150 years. Rubber dam application is considered mandatory in root canal treatment. The Quality Assurance Guidelines of the American Associations of Endodontists says that cleaning, shaping, disinfection and obturation of all canals are accomplished using an aseptic technique with dental dam isolation “whenever possible”. Root canal treatment without rubber dam has a negative impact on the treatment outcome, influences decision of the choice of root canal irrigant and also patient’s safety. This paper emphasizes the application of rubber dam in various difficult clinical situations.

1-9

Authors: Samar Khan

The intra-operative histological assessment of fresh tissue can provide valuable diagnostic information and guide surgical management. Artifacts in histopathology, could create serious errors and cause misdiagnosis. In some cases, the degree of artifactural damage is so large that may involve the entire specimen, rendering it suboptimal or useless for diagnostic purposes. Biopsy specimens of oral cavity are of small size and fine texture resulting into higher effectiveness of artifacts on them. Some artefacts are easily distinguished from normal or pathological tissue components, and some are difficult to distinguish from such entities.Artefacts may encounter at various stages which include during routine collection of tissues, fixation, processing, cutting and staining of tissues. This review encorporates all artifacts occurs during each stage of histopathological processing of tissues, in an attempt to identify the artifacts, their causative factors and appearance histopathologically so to differentiate them from that of pathological entitiy.

1-7

Authors: Sashi Bhushan Ekka

Seizure disorders are the most common serious chronic neurological condition. This review is intended to update the orthodontist regarding seizure disorders including etiology, medical and surgical management, impact on dental health, potential for altering orthodontic treatment planning and delivery, and guidelines for management of seizures in the orthodontic office. It is estimated that there are 55,00,000 persons with epilepsy in India, 20,00,000 in USA and 3,00,000 in UK. The majority of patients can be managed medically so that they remain free of seizures. Contemporary management may include medications, surgery, an implanted nerve-stimulation device, and/or a ketogenic diet. Considerations for the orthodontist planning treatment for a patient with a seizure disorder are specific details about seizure onset, frequency, and type, behavior during seizures, duration, triggers, recovery period, medical management, and compliance. Patients with epilepsy and a malocclusion should have a comprehensive orthodontic evaluation. Adverse side effects of Anti-EpilepticDrugs (AEDs) and past dental trauma should be researched by the orthodontist and reviewed as part of patient informed consent. The practitioner and staff should be prepared to recognize and respond appropriately when a patient has a seizure in the orthodontic office

1-15

Authors: Hemant K S Yadav

Oral drug delivery system has been area of interest for researcher and scientistto explore it tothe extreme potential in drug delivery system in past few years. The researchers are focusing on this drug delivery because of ease of administration and comfort offered by this route to patient. Hence drug delivery can be achieved by incorporating medicament in Chewing gum (CG)base because oral mucosa is highly vascular in nature resulting in rapid absorption of the drug into the systemic circulation. Chewing gum is a combination of a water-immiscible phase, known as gum base (insoluble gum base resin), emulsifiers, elastomers, fillers, antioxidants, softeners, sweeteners, food colourings, flavouring agents, waxes and in case of medicated chewing gum there is an incorporation of active substances in the formulation for getting the desired therapeutic effect.Due to sweet and refreshing taste of chewing gum it can be used as drug delivery system(DDS). CG can be used in prevention of dental caries, prevent the dryness of mouth and help in maintaining oral hygiene. Therefore it can be concluded that oral drug delivery can maketreatment more patient friendly, can be taken without water and reduce the cost of manufacturing compared to convention DDS

1-7

Authors: Jency Samuel Johnson

Child visit to the dentist’s office can elicit fear and anxiety which can cause chaos to both the dentist and the child patient and, which in turn subvert the delivery of quality dental care, thus posing a challenge to oral health care practitioners worldwide. As pedodontists, our motto is to strive to relieve pain and suffering, and pledge to do no harm. Anxiety if not handledwith tender love and care can be very devastating which has led to exploring new frontiers in behavior management. Behavior management with aversive methods using forced restraints, is no longer acceptable and may compound the hospital—and needle—phobia throughout life. Non pharmacological behavior management procedures like effective communication, distraction techniques, play therapy, modeling and adequate analgesia coupled with TLC may be sufficient to produce a cooperative, relaxed child. Assuming that the aforementioned non pharmacological behavior management techniques have failed, alternative pharmacological dental sedation methods is usually sought, in spite of moderate sedation with nitrous oxide being the safest mode of sedation, sedation with IV or IM ketamine remains one of the most used sedation technique popularly knownas angel dust because of the unique magical experience of both the patient and the anesthesiologist using it. Bearing in mind that the perks of ketamine dissociative sedation are not free off its risks, the purpose of this article is to give the readers, an in depth knowledge of this agent. To deliberate; is ketamine sedation the answer for the inconsolable anxious child requiring a painful procedure in the pediatric dental department

1-5

Authors: Nalini MS

Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity.This tumor-like lesion appears in response to various stimuli such as chronic low-grade local irritation and traumatic injury,as well as in pregnant women and in women taking oral contraceptives.Pyogenic granuloma usually present as smooth or lobulated red-to-purple mass that may be either pedunculated or sessile. Granuloma varies in size from a few millimetres to several centimetres. Here, we report a case of Pyogenic granuloma in the palate of a 35 years old woman which is very rare location for this lesion.

1-5

Authors: Pishipati Vinayak Kalyan Chakravarthy

The outcome of root canal treatment depend not only on the efficiency of every endodontic procedure but also on subsequent coronal restoration which should be in harmonious relationship with contiguous hard and soft tissues. Teeth having large defective coronal restorations requiring root canal treatment pose difficulties not only during rubber dam application but also during subsequent restorative procedures. In this article, one such case of endodontically involved maxillary lateral incisor having extensive restoration is presented in which a multidisciplinary treatment approach was carried out in a sequential manner for functional and esthetic rehabilitation of the tooth.

1-2

Authors: Sajani Ramachandran

Orofacial pain has been associated with many systemic diseases including some cardiac problems. Here we have discussed a case where the patient’s tooth ache was the only presenting complaint for an undetected atrial septal defect. This is to focus attention to the fact that any unexplained orofacial pain could be an indication for some undiagnosed condition and also highlight the critical role of a dentist in patient education and recognition of tooth ache as a possible cause of undetected congenital cardiac problem s.

1-6

Authors: Narmatha VJ

Dentin hypersensitivity is an oft encountered dental complaint, the management of which has evolved incredibly but remains an enigma. Nano - hydroxyapatite (n - HAp) is considered one of the most biocompatible and bioactive materials, and has gained wide accept ance in medicine and dentistry in recent years. An increasing number of reports have shown that nano - hydroxyapatite has the potential to remineralize artificial carious lesions following addition to toothpastes, mouthwashes, etc. Recently, occlusion of expo sed dentinal tubules by nano - hydroxyapatite, helping to reduce hypersensitivity, has been reported. Propolis , a natural, non - toxic resin produced by honey bees has also been reported to partially obliterate dentinal tubules and can be a good modality of treatment for hypersensitivity. Hence, the aim of this clinical trial is to compare the efficacy of propolis a nd nanohydroxyapatite dentifrice with benchmark potassium nitrate in controlling dentin hypersensitivity. Forty five patients with a complain of dentin hypersensitivity were recruited. Baseline examination was conducted using tactile and cold stimuli. Pati ents were randomly divided into three groups.(n=15) Grp I: Potassium nitrate desensitizing agent Grp II: Nanohydroxyapatite desensitizing agent G rp III: Propolis containing agent A visual analog scale was used to evaluate participants’ pain at baseline, one week, and four weeks after the usage of the dentifrices. According to paired t test, all the three desensitizing agents had a significant reduction in the dentin hypersensitivity (p<0.01). According to one way ANOVA, the sensitivity scores were signifi cantly lower in the group II in comparison with group I (p=0.03). However the difference between group I and group III, as well as group II and group III were not significant i.e. p=0.63 , p=0.21 respectively. Within the limitations of the study, it can be concluded that nanohydroxyapatite and propolis are a potential treatment modality for dentin hypersensitivity. Clinical significance: Nano - hydroxyapatite and propolis have proved to be a biocompatible and natural alternative for the treatment of dentin hy persensitivity, respectively.

1-5

Authors: Anand S Tegginamani

Radicular cysts (RCs) show distinct histopathological findings may be lined wholly or in part by non-stratified squamous epithelium, the scar fibrous connective tissue, few unexpected neoplasms have been reported and this an important insight into the knowledge of the histological variations of RCs.A total of 115 cases of RCs fromthe archives of Department of Oral Pathology evaluated for different varieties of epithelium among them 20%werenon-stratified squamous epithelium, 27.82% with arcading pattern 7.82% cysts with sheets of epithelial cells with cleft formation 44.34% cysts without epithelial lining. The presence of only inflammatory connective tissue, which had modest to moderate intensity of the inflammatory infiltrate, 4.35% foamy macrophages/hyaline bodies and 6.96% cholesterol crystals.Most clinicians discard periapical tissue after surgical procedure rather than submitting those for histopathologic evaluation, and then losing potentially valuable illuminating information.The apical soft tissue lesion should be evaluated histopathologically, not to distinguish cyst versus granuloma, butto rule out unexpected neoplasms or more aggressive cysts