Advances in Human Biology

1-6

Authors: Dishant Shah, Nimisha Desai, Rahul Dhanak.

Background: Lasers and optical technologies play a significant role in aesthetic and reconstructive surgery. The unique ability of optical technologies to target specific structures and layers in tissues to effect chemical, mechanical or thermal changes make them a powerful tool in cutaneous rejuvenation, hair removal, fat removal and treatment of vascular lesions such as port-wine stains, among many other procedures. With the development of adjunct techniques such as epidermal cooling, lasers and optical technologies have become more versatile and safe. The constant improvement of existing applications and the emergence of novel applications such as photodynamic therapy, nanoparticles, spectroscopy and noninvasive imaging continue to revolutionize aesthetic medicine by offering a minimally invasive alternative to traditional surgery. In the future, therapies will be based on individualized, maximum, safe radiant exposure to deliver optimal dosimetry. Lasers and optical technologies are headed toward safer, easier and more quantifiable individualized therapy.

10-20

Authors: Sujit Kumar, Killi V Prabhakara Rao, Dola Srinivasa Rao, Tanuja Penmatsa.

Aim: This study was conducted to evaluate the efficacy of the combination therapy i.e. inverted periosteal graft (IPG) with autogenous bone used alone and in conjunction with an osteoclast inhibitor - 1% alendronate (ALN) sodium gel, in the treatment of mandibular buccal degree II furcation defects. Materials and Method: A total of 28 buccal degree II furcation defects in 14 patients were selected and randomly divided into Group A and Group B. Experimental sites in Group A were treated using inverted periosteal graft and autogenous bone mixed with 1% alendronate gel and experimental sites in Group B were treated with inverted periosteal graft and autogenous bone only. Results: Both the experimental groups showed significant reduction in probing pocket depth, gain in clinical attachment level and mean percentage of horizontal defect fill (41.82% vs 49.09%) at 6 months. Experimental sites in group B showed a significant loss in mean vertical defect height compared to experimental group A (1.52% Vs -1.59%). Conclusion: It can be suggested that bisphosphonates such as alendronate sodium have the potential to inhibit the surgery induced bone loss.

26-30

Authors: Ravisankar Damineni, Abhilash, Mashalkar Shailendra, G Sharaschandra Reddy.

Aim: The purpose of this study was to evaluate the polymerization shrinkage of four different light cured composite resins used for restorative purposes by measuring shrinkage strain. Materials and Method: Thirty composite samples were divided into three groups of ten each. An experimental design was made to record the shrinkage strain while curing the composite sample. The readings were recorded and statistical analysis was done. Results: Results showed samples in group II (fiber reinforced composite) had least polymerization shrinkage whereas group III (Nano filled composite) had the highest shrinkage. Conclusion: Resin matrix composition, filler volume, type of filler and lot of other factors has to be considered before selecting a composite resin for a successful restoration.

37-43

Authors: Dipti S Shah, Kalpesh Vaishnav, Sareen Duseja, Ravi Joshi.

Aim: The purpose of this study was to evaluate the prevalence of causes of fixed dental prosthesis failures in Indian population. Materials and method: A total of 158 patients were selected for the study who reported to the OPD of the Department of prosthodontics, Karnavati School of Dentistry, with complaints related to fixed dental prosthesis (FDP). Site and condition of the prosthesis and its abutments were evaluated and the cause of failure was classified accordingly by John J. Manappallil’s classification. Results: Majority of failures (32.27%) were found to be class III failure followed by class VI failure (24.05 %). 13.29 % failures were Class IV, 12.65 % failures were identified as class II, 12.02 % failures as class V and 5.69 % failures were categorized in class I failure. Conclusion: Though earlier literature reported caries as the most common cause of fixed dental prosthesis failure, however present study reported class III failures, which include unserviceable restorations due to defective margins, technical failures or esthetic considerations as the most common cause. Therefore proper design of prosthesis is of utmost importance and should be kept in mind during fabrication of FDP.

48-53

Authors: Komali G

Aim: Ibuprofen400mg and Diclofenac Sodium 50mg marketed today inhibit Cox-1 and Cox-2 and have selectivity for Cox-1. Ibuprofen 400mg is an established analgesic in the management of acute dental pain. Diclofenac Sodium 50mg is also used in the management of acute pain, but there are very few studies comparing its analgesic efficacy with Ibuprofen. Materials and Method: A double blind randomized study was carried out to compare the analgesic efficacy, safety and potency of Ibuprofen and Diclofenac Sodium in acute pulpitis patients with moderate to severe pain. 60 patients with acute pulpitis were enrolled in the study and Ibuprofen 400mg and Diclofenac Sodium 50mg were randomly given to them. Self-administered questionnaire was given to the patients and they were asked to note the intensity of initial pain on Visual analogue scale. Results: Time of onset of action of drugs, Time to peak effect, Total analgesic effect and tolerability of the drugs were assessed. From the present study it was found that there were statistically significant differences in the onset of action of drug and Time to peak effect. Onset of action was early in Ibuprofen and Time to peak effect was early in Diclofenac sodium. Patients rated both drugs to be equally good on Global evaluation scales. Conclusion: It was found that Diclofenac Sodium is more potent compared to Ibuprofen.

60-63

Authors: Vipul V Solanki, Digish U Vaghela, Arunkumar Marekar, Shamji R Chauhan, Seema N Baxi.

Background: Clinically significant enlargement of the thyroid gland by amyloid deposition is rare. A case study of 22-year-old lady with gradual enlargement of the thyroid gland has been presented. Routine haemological, biochemical test including thyroid function tests were normal. Ultrasonographic findings were nonspecific. Amyloid goiter has to be differentiated from other types of goitre and malignancy. FNAC was found to be suspicious for the presence of amyloid. Special staining with thioflavin T confirmed amyloid deposition.

69-71

Authors: Geeta Mishra Tripathi, Shaji Thomas, NS Gautam, Ajay Pillai.

Background: Dentigerous cysts are common cysts of the jaws. They are associated with the crowns of permanent teeth, most frequently associated with impacted mandibular third molars. The other teeth that are commonly affected are, in order of frequency, the maxillary canines, the maxillary third molars and, rarely, the central incisor. Radiographically, the cyst appears as ovoid well-demarcated unilocular radiolucency with a sclerotic border. The present case reports describes the surgical enucleation of a 2 dentigerous cysts involving the lower permanent canine and upper premolar of maxilla in 12 years old nonsyndromic children.

77-81

Authors: Kartik Dholakia, Rahul Dhanak, Tushar Makwana.

Background: Osteoradionecrosis (ORN) is the death of bone due to radiation. The bone dies because of damage to its blood vessels caused by the radiation. Radiation provides high cure rates, but has also called increasing attention to its side effects. Osteoradionecrosis (ORN) is one of the most severe and serious complications of head and neck cancer treatment. A new theory for the pathogenesis of ORN has proposed that damage to bone is caused by radiation-induced fibrosis. Here there is a case which was operated conservatively and after 8 months of follow up no recurrence was observed.

1

Authors: Khushboo Desai

The first step in the evolution of ethics is a sense of solidarity with other human beings. Action indeed is the sole medium of expression for ethics. We as dental professionals have opted for a vocation where our knowledge and skill is to be used for the beneficence of others. Dental ethics comprises of all the moral values, duties and obligations towards our patients or in simple words morality is the attitude we adopt towards people. The "Hippocratic Oath" taken at the beginning of this noble professional career mandates us to be responsible and compassionate towards the society.

9-13

Authors: Heena Fuletra, Kamal Bagda, Suman Makam, Kruti Patel, Niket Kachhi

Aim: To evaluate the effect of cyclic loading on the tensile bond strength and retention of custom‑fabricated cast posts, prefabricated metal posts and glass fiber posts. Materials and Method: Thirty extracted human maxillary central incisors were decoronated at the cementoenamel junction (CEJ) and randomly divided into three groups (n=10). Specimens were instrumented and obturated. Twenty four hours after obturation, post space was prepared upto no. 5 Peeso Reamer. Groups A, B and C were restored using custom cast post and core, Para Post (Whale dent) and Reforpost (Angelus) respectively thereafter. Five specimens from each group were subjected to cyclic loading. Tensile bond strength (TBS) of teeth before and after cyclic loading was evaluated. Results: For both, with and without loading, Groups A and B were not significantly different from each other but Group C was significantly different from Groups A and B. The results indicated that cyclic loading reduces retention potential of all three types of post, but it was minimum in group C. Conclusions: Cyclic loading reduced the retention of all posts but was comparatively lesser for the glass fiber post. This system provides sufficient retention required for clinical success.

22-31

Authors: Anuradha Borse, Rubina Tabassum, Omkar Shetty

Aim: The purpose of the study was to evaluate and compare the stress distribution at the implant abutment interface in a platform switched Morse taper and pseudo platform switched internal hex connection implant system under simulated load using a 3D finite element analysis. Materials and Method: In the study ANKYLOS which is a Morse taper platform switching implant system (Group A) and XiVE having an internal hex connection which forms a pseudo platform switched implant system (Group B) were used. The geometric properties of implant systems were modeled using 3D finite element analysis. The masticatory forces of 200 N, 500 N and 1000 N were applied axially to both the implant systems with the abutment screw tightening torque of 110 Nm2, 320 Nm2 and 550 Nm2. Von Mises stress distribution pattern was analyzed considering the objectives of the study. In order to interpret the result, the data generated by finite element analysis (FEA) were statistically analyzed. Results: There was better stress distribution for Group B at the neck of implant as compared to Group A but on screw Group A showed more decrease in force concentration and therefore better stress distribution. Conclusion: Stress concentration on connecting screw of pseudo platform switch implant was more and may lead to fracture or loosing of screw than platform switched Morse taper implant.

40-44

Authors: S Venu M Reddy, T Hanumanth Rao, N S Gautam, N Radhika Gautam, Ravichandra Koganti

Aims: To compare the palatal rugae pattern for possible differences between North Indian, South Indian and Chinese students of Manipal University, Manipal. To determine the rugae length, shape, direction, unification and number of the primary rugae. Materials and Method: The study sample consisted of 50 diagnostic study models of 25 males and 25 females within the age group of 15-23 years that were available in the department and were free from palatal defects. These cases were further segregated into 10 cases of each of North Indian, South Indian and Chinese groups and their dental casts were analyzed. Results: There were no significant differences in any parameter when compared between the sexes in the three groups. The difference in length among 3 groups was not statistically significant. The most common rugae shapes observed were wavy and curved. The North Indian group had a predominantly curved rugae shape while the South Indian and Chinese groups had wavy rugae. The rugae direction observed was mostly forward. Most of North Indians and South Indians had forward rugae and Chinese group had both types. Conclusion: The present study indicated that the rugae patterns of the Chinese group are significantly different from the two Indian groups and can hence be used for group identity.

50-56

Authors: Khyati Shah, JR Patel, Tamanna Chhabra, Pathik Patel

Aim: The purpose of this study was to evaluate the reliability of programming the articulator using the radiographs and the interocclusal records made during Jaw relation (Arrow point tracing). Materials and Method: The study comprised of 15 edentulous subjects with well formed maxillary and mandibular ridges, with no signs and symptoms of temporomandibular joint disorders and neuromuscular disorders. Digital Orthopantomograph was taken for all the subjects. The condylar guidance angles were traced on Orthopantomograph for right and left sides and the values were recorded. The protrusive interocclusal records were made at jaw relation stage and at try-in stage using bite registration paste for all subjects. These interocclusal records were used to programme the Semi-adjustable articulator (Hanau Wide Vue) and the condylar guidance values on the right and left sides were recorded. The condylar guidance values so obtained were compared with the values obtained by Orthopantomograph. The condylar guidance values obtained by the various procedures were subjected to independent t-test and Pearson correlation test. Results: The results showed statistically significant difference between the condylar guidance values obtained from Orthopantomograph (Radiograph) and the condylar guidance values obtained at the stage of jaw relation. Conclusion: Within the limitations of the study, it can be concluded that the condylar guidance values obtained from the Radiographs were higher than those obtained at the stage of jaw relation recording stage.

65-68

Authors: Sumesh Choudhary, Vineet V Mishra

Background: Methotrexate (Mtx) is an accepted modality for conservative treatment of ectopic pregnancy. However, there is no consensus regarding its use in live ectopic pregnancy and high serum beta-human chorionic gonadotrophin (β-hCG) titres. Concurrent use of intra-sac hypertonic KCl, to produce cardiac asystole with systemic Mtx potentially improve outcome in live ectopic gestations with very high serum β-hCG titres. Here a successful management of live ectopic pregnancy in a 25-year-old nulliparous woman, with very high β-hCG titres (29502.04mIU/mL), using ultrasound-guided intra-cardiac potassium chloride (KCl) injection and systemic Mtx is reported. No treatment related complications were encountered. However, individualized treatment with a stringent follow-up regime is mandatory in such cases.

74-77

Authors: Rushit Patel, Jayanti Patel, Vandana Shah, Rakesh Shah, Vikas Bhakhar

Background: Teeth start to erupt during infancy and again when the primary teeth are replaced by the permanent teeth. If a tooth fails to erupt or emerges only partially, it is considered to be impacted. This most commonly happens with the wisdom teeth as they are the last teeth to erupt in the oral cavity between 17 to 21 years. An impacted tooth remains stuck in gum tissue or bone for various reasons as in overcrowded regions were there could be no room for them to emerge or if the jaw is too small to fit the wisdom teeth. Teeth may also become twisted, tilted or displaced as they try to emerge resulting in impaction.

81-84

Authors: Nalam Sai Gautam, N. Radhika Gautham

Background: Presence of Natal and neonatal teeth are a rare event in the oral cavity, which may interfere with breast feeding & may lead to numerous complications. The decision to keep or to extract these teeth should be evaluated in each case, keeping in mind the scientific knowledge, clinical common sense and parental opinion. A case of immature natal maxillary anterior teeth and a case of natal mandibular anterior tooth are reported.

1-6

Authors: MR Haranadha Reddy, Vimala Manne, Ranjit Manne, NVS Sekhar Reddy, John Koshy, Sri Harsha Konuru

Background: Patients seeking correction of dental or dentofacial deformities also present with concomitant soft tissue deformities like decreased lip length, increased or decreased lip thickness, inadequate vermillion show etc. Correction of skeletal or dental deformities alone may not achieve appreciable results unless a focus is made on the correction of soft tissue deformities during the treatment planning. Soft tissue deformities that exist with the skeletal or dental deformities may be self-corrected by Orthognathic surgery/Orthodontics or combination of both. But in many situations adjuvant procedures to the perioral structures may need to be performed to get the optimal overall results. This can be accomplished by dermal fillers, Botulinum Toxin A injections or by surgical soft tissues procedures.

13-19

Authors: Sthitaprajna Lenka, Nikil Jain, Rajat Mohanty, Dhirendra Kumar Singh, Minkle Gulati

Aim: Inferior dental anaesthesia via the direct intraoral approach, mandibular conduction anaesthesia via extraoral landmarks (Gow-Gates) and mandibular conduction anaesthesia via the tuberosity approach (Akinosi) were evaluated using pain during injection, aspiration test, pinprick, depth and frequency of anaesthesia, onset and duration of anaesthesia. Materials and Methods: 120 patients of both sexes, aged from 16 years to 50 years undergoing mandibular molar tooth extraction were included. They were randomly designated into 3 groups with regards to the applied technique of mandibular anaesthesia. Each patient was given injection of 2 ml of 2% lignocaine with adrenaline (1:80,000) using 2ml disposable syringes and a 25 gauge, 1.5 inch needle. Results: Classical inferior nerve block showed greater incidence of pain among the applied techniques. Positive aspiration was most frequently observed with classical inferior nerve block. The onset of anaesthesia was found to be slower with Gow-Gates technique while duration of anaesthesia was longer. Mandibular conduction anaesthesia via the tuberosity approach did not show any particular advantage over the other two techniques in this study. Conclusions: After using Gow-Gates method, it was found that the Gow-Gates technique is a highly successful alternative to the conventional inferior nerve block with regards to increased success rate, constancy of landmarks, decreased positive aspiration rate, decreased incidence of complications such as trismus, the advantage of one injection to anaesthetize a greater area supplied by the mandibular nerve, longer duration of anaesthesia and less amount of pain experienced during injection.

26-30

Authors: Shrudha Potdar, Nagesh Lakshminarayan, Siddana Goud R

Objective: Emblica officinalis fruit is used in Indian traditional medicine since ages as an antimicrobial agent. Review of literature yielded a paucity of studies related to the effect of Emblica officinalis fruit extract against Streptococcus mutans, Enterococcus faecalis and Candida albicans, so the present study was designed. Our aim was to determine the antimicrobial efficacy of ethanol, acetone and distilled water extracts of Emblica officinalis against Streptococcus mutans, Enterococcus faecalis and Candida albicans. Materials and Method: Extract of Emblica officinalis in ethanol, acetone and distilled water were obtained by cold maceration. The crude residue was obtained by evaporation at room temperature. The antimicrobial efficacy of Emblica officinalis in all extracts were assessed against oral microorganisms by finding out zone of inhibition and minimal inhibitory concentration. Results: Emblica officinalis in ethanol, acetone and distilled water were found to be effective against Streptococcus mutans, Enterococcus faecalis and Candida albicans by highest zone of inhibition being 38 mm for acetonic extract of emblica officinalis against Enterococcus faecalis. Minimum inhibitory concentration of ethanolic and acetonic emblica officinalis extracts for Candida albicans was established at 0.09% and distilled water extract at 1.56%. Minimum inhibitory concentration for ethanolic extract of emblica officinalis for Enterococcus faecalis was 3.12%, acetonic extract of Emblica officinalis was established at 0.39% and distilled water extract of emblica officinalis was established at 12.5%. Conclusion: Emblica officinalis could be considered as an effective antimicrobial agent. The antimicrobial activities can be enhanced if the phytoactive components are purified and adequate dosage determined for proper administration.

37-40

Authors: LR Surendra, Y NarendraNath Reddy, E Sivaprasad Reddy, D Ramaraju, T Yehoshuva Reddy

The Mandibular first molar is the tooth that requires root canal treatment most often. It usually has two roots with two canals mesially and one or two canals distally. A mandibular first molar with more than four canals represents a rare anatomical variation, especially when the three canals are found in distal root. With increasing reports of aberrant canal morphology, the clinician needs to be aware of this varied anatomy. This case report discusses endodontic management of 2 rooted mandibular molar with 3 distal canals (disto-buccal, middle- distal, disto-lingual) and 2 mesial canals.

44-50

Authors: Devanand Shetty, Suyog Dharmadhikari, Arvind Shetty, Ranjeet Bapat

Periodontal therapy has developed beyond the scope of the treatment of periodontal pathoses. Periodontal plastic surgery consists of the reconstructive procedures designed to enhance the both function and esthetics. Deficient ridges pose a severe problem to the restorative dentist in restoring the natural form, function and esthetics of the prosthesis replacing the natural dentition. Depending upon the severity, location of these defects and the prosthetic option chosen, hard and soft tissue ridge augmentation or non-surgical approach or a combination may help to address them. The present clinical report describes a soft tissue ridge augmentation of a localized ridge defect in maxillary aesthetic region using onlay interpositional graft followed by fixed partial denture.

56-59

Authors: Ramesh Pandey, Shefali Sharma, Mastan Mukarrab, Santosh Kumar

Background: A 13 year old boy presented with gradual poor grade in his school performance. Parents of the boy were worried because of his deteriorating academic performance and physical appearance. Patient was subjected to thorough clinical examination and Radiological examination and was found to be having features and findings consistent with Crouzon Syndrome. The patient was properly counselled and was lost to follow up after 6 months due to his social and economical constraints.