Journal of Dental Sciences

1-5

Authors: Spiti Datta

The acquired enamel pellicle (AEP) is a thin acellular film that forms on tooth surfaces upon exposure to the oral environment. A wide range of techniques have been used tocharacterize the morphology and ultrastructure of the AEP. The knowledge of the 3D structure and composition of the AEP, along with an understanding of its functions, could lead to the development of new therapeutic options for the treatment and prevention of numerous oraldiseases, such as periodontal disease

1-5

Authors: Lalit Kumar

There are several restorative alternatives for replacing a missing anterior tooth. The single implant-supported crown is among the best restorative options under certain biological and biomechanical condition like sufficient bone quantity, condition and morphology of the periodontium, integrity of natural and restored teeth. The long-term success of an implant supported crown depends upon the health and stability of the peri-implant hard and soft tissue. This case report we discuss the replacement of endondontically failed anterior teeth by extraction followed by immediate placement of implant along with bone graft and provisionalisation using zirconia abutment.

1-6

Authors: Kotyanaik Maloth

Proliferative verrucous leukoplakia (PVL) is a rareand specific variant of oral leukoplakia, different from oral verrucous leukoplakia, principally characterized by chronic proliferation, multiple occurrences, and refractoriness to treatment. Its rate of malignant transformation is extremely high. The aggressive and malignant behavior of Proliferative verrucous leukoplakia sometimes is masqueraded by atypical clinical presentation which can be eliminated by specific diagnostic criteria enlisted by the authors after extensive research. This paper report a case of Proliferative verrucous leukoplakia involving palate with a tendency of rapid transformation towards squamous cell carcinoma clinic-pathologically, emphasizing that all leukoplakia lesions should be closely monitored, even those that initially present nonaggressive behavior

1-10

Authors: Abu - Hussein Muhamad

Tooth avulsion in the permanent dentition constitutes a dental emergency. Replantation of the avulsed tooth restores aesthetics andocclusal function shortly after the injury. This article describes the management of a 12-year old male with four avulsed anterior maxillary permanent teeth. The avulsed teeth were replanted and root canal treatment carried out after a short fixation. Theresult obtained was very satisfactory and the teeth remain in good functional status one year after replantation. Early treatment and regular attendance to clinic following replantation is an important factor for good result.

1-9

Authors: Deepak Viswanath

Children suffer from dental caries and if left untreated, this leads to problems with eating, speaking, etc. In dentistry, the clinical practice is directed towards attitude that promotes oral health; and it ishere that Pediatricians occupy a privileged position, since they are the first people to check and monitor the child’s health at a very early age.To assess Knowledge, Attitude, and Awareness of Pediatricians regarding the use of various preventive dental aids in children. A cross sectional study was carried out involving 205 Pediatricians across Bangalore participated by filling out a specially designed questionnaire.All the Pediatricians, 100% responded positively regarding the use of tongue cleaners, 98.5%regarding the use of xylitol chewing gums, 91.2% regarding the use of dental floss, whereas only 69.8% were aware of the use of tooth gauze, 65.9% corresponded to the use of breath strips, 64.9%responded to the use of fluoride mouthwashes and only 57.1% were aware of the use of modified tooth brushes. It is important to develop oral health information programmes to Pediatricians as they are in a unique position to contribute to dental health of young patients since the children are brought to theiroffices at an early age as well as parents accept their recommendations easily. Therefore it is imperative that the Pediatricians need to update themselves on various dental aids for use in children

1-7

Authors: Shankar S

To study the effectiveness of a new dentifrice containing papain and bromelain extracts at whitening the tooth shade over a period of 3 weeks.A randomized, single center, pilotclinical study was designed to evaluate the effectiveness of a new dentifrice at whitening the tooth shade over a 3 week period .Thirty five subjects were included in the study.Each subject was assigned to the toothpaste. Subjects were instructed to brushtwice daily with the supplied toothpaste & tooth brush. The subjects were recalled after 1 week, 2 weeks and 3 weeks and the tooth shade was examined using a Vita shade guide.Thirty four subjects completed the study. One subject did not complete the studybecause of personal or medical reasons unrelated to use of study toothpaste. The below tables indicates that the test dentifrice resulted in whitening the tooth shade over a period of 3 weeks.The test dentifrice showed significant whitening of tooth shadewhich could be attributed to the role of proteolytic enzymes in the test dentifrice.

1-7

Authors: Shalini Gupta

Toinvestigate Developmental anomalies of teeth are clinically evident abnormalities. They may be the cause of various dental problems. Careful observation and appropriate investigations are required to diagnose the condition for appropriate treatment.Developmental dental anomalies are an important category of dental morphologic variations.All patients attending the outpatient department were screened for the presence of anomalies. A comprehensive clinical examination was carried out to identify the presence of microdontia, macrodontia, talon cusp, fusion, dens invaginatus, accessory cusp, transposition and supernumerary teeth. In the present study,A total of 130 patients were included in the group and the casts were prepared with informed content. Out of which totalof 93 casts were of maxillary and 37 of mandibular. This group consists of 78 male and 52 female patients. Developmental dental anomalies are marked deviations from the normal color, contour, size, number, and degree of development of teeth. Local as well as systemic factors may be responsible for these developmental disturbances. Such influences may begin before or after birth, hence deciduous or permanent teeth may be affected.

1-4

Authors: S omya G arg

Pyogenic granuloma(PG)is one of the inflammatory hyperplasias seen in the oral cavity. It is a tumorlike gingival enlargement that is considered an exaggerated conditioned response to minor trauma.It predominantly occurs in second decade of life in young females, possible because of the vascular effects of female hormones. Clinically itis a smooth or lobulated exophytic lesion,pedunculated or sometimes sessilebase, which is usually hemorrhagic. Treatment consists of removal of the lesions plus the elimination of irritating local factors. This article describes a case of 60 year old nonpregnant female with a large oral pyogenic granuloma

1-5

Authors: Anand Farias

Restoration of the posterior maxilla with reduced bone height and pneumatized sinus is a challenge to the implant surgeon. The surgeon has the option of a direct sinus-lift approach or an in-direct blind approach. Both of which have its own complications. Displacement of an implant into the maxillary sinus is rare occurrence and normally seen after the implant has been in service for a number of months. The displacement of an implant at the time of surgery is even rarer.This report presents a case of an implant displaced into the maxillary sinus during first stage surgery and discusses its possible cause, management and follow-up

1-12

Authors: Abu - Hussein Muhamad

The incorporation of miniscrews into orthodontic treatment planning has allowed for predictable anchorage control and has increased the ability to correct severe skeletal and dental discrepancies. Various minicsrews systems are now available for clinical use and abundant reports and studies are being published, dealing with different aspects of their applications (biology, surgical procedures, placement sites, complications, success rate). The aim of this article is to review the actual considerations regarding their mechanical properties, surgical considerations, risks and complications as well as their success rate and failure reasons.

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

1-4

Authors: Sura Ali Fuoad

Fissured tongue is a common benign condition of unknown etiology , Clinically it is seen as central groove could be associated with multiple fissures differs in numbers, depth and directions, usually are a symptomatic but could be associated with halitosis and burning pain. Fissured tongue is one of the nonspecific tongue lesions are frequently observed in psoriatic patients, on the other hand oral psoriasis is rare. Family history plays a role in both psoriasis and fissured tongue.

1-4

Authors: V M adhusudhan

Like any other branch of medicine or dentistry, orthodontic treatment is not without potential risks. Each year number of patients seek orthodontic treatment for correction of poor esthetic, abnormalfunctions and speech. An orthodontist always wants that treatment should be accurate for each patient without discomforts and pain. Even after certain risks are associated with orthodontic treatment which may be either iatrogenic or inherent. The purpose of this article is to enlights various risks and complications encountered inorthodontic practice and also describe their managements.

1-5

Authors: Steffi Jasbir Dhillon

Pregnancy is a unique state where an expecting mother undergoes profound physiological as well as psychological changes. The woman is more receptive so it is an opportune time for making healthy lifestyle and behavioral changes. The various professionals those are associated in providing health care to pregnant women are gynecologists, dentists and dieticians. Proper knowledge regarding oral care in pregnancy amongst them is obligatory

1-6

Authors: Mohammad Mukhit Kazi

Periodontal diseases are diagnosed traditionally by a radiographic and clinical examination. An important disadvantageof diagnosis by this method is that it is difficult to differentiate the stable patients and patients with active disease. The clinical parameters are not sufficient to predict active periodontal disease. Improved knowledge in understanding the pathogenesis of periodontal diseases has lead to the development of various newer diagnostic tests. These can accurately measure the sub-gingival microbial challenge and the host responses to these challenges. The concept of diagnosing the disease with laboratory tests is relatively new to the dental sciences. These tests are useful to predict patients with active sites and to predict which tooth or site will experience clinical attachment loss in near future. In addition diagnostic tests help to categorize patients into different disease categories; i.e. aggressive or chronic periodontitis, they will also help in differentiation of patients who respond or do not respond to treatment. They can also be used to determine the prognoses of either the entire patient or a specific tooth. This review article will help the dental practitioners to rethink about the role of the laboratory in the assessment of chronic periodontitis.

1-8

Authors: Priyanka Ghogre

An important consideration in endodontic treatment is the elimination of microorganisms, including fungi, from the complex three-dimensional root canal system. Yeasts can be detected in 7-17% of infected root canals. Candida albicans(CA) has a major role in endodontic treatment failure as the most important fungus isolated from the root canal system. C. albicans has been associated with root canal infections resistant to non-surgical therapy and a potentpathogen to infect periapical lesions. They are commonly associated with persistent cases of apical periodontitis, but yeasts can also be isolated in primary apical periodontitis. A variety of virulence factors enable C. albicans to adhere to and penetrate into dentine. Yeasts do not respond favourably to conservative root canal therapy, due to resistance against a commonly used medicament, calcium hydroxide. Thus, alternative therapeutic approaches and other intracanal medicaments are required to treat persistent cases of apical periodontitis

1-6

Authors: Sura Ali Fuoad

The explosion of knowledge coupled with a more diversified society, have led to a new set of demands on dentists. All the clinical dental specialties require a highlevel of training and talent.Postgraduate training in general dentistry is becoming more widespread and being employed to attempt to deal with these concerns. The Nature of the trend is quit variable among countries and nations, on the other hand most of them had almost the same determining factors for the trend; creating a postgraduate experience , lack of adequate training/experience,and improve students quality. As any trend ,post graduate clinical training in general dentistry has many advantages and disadvantages, on the otherhand in application ,pitfalls may be faced. For that reason ,there should be guides for implication of the trend

1-6

Authors: Prathibha Prasad

Central giant cell granuloma (CGCG) is a benign intraosseous lesion that occurs in long bones. It is an uncommon tumor in jaws, its etiology and pathogenesis is unknown. It affects females more often than males, in a 2:1 ratio and is seen most frequently under the age of 30 years. CGCGs can be aggressive or non-aggressive. The reported case is non-aggressive central giant cell granuloma of posterior mandible. The affected patient was a 25 year old Iraqi male who reported to us with recurrent pericoronitis in relation to lower left third molar.The low incidence of the lesion in Arab countries makes it a rare case report

1-5

Authors: Anita Dnyanoba Munde

Adenomatoid odontogenic tumour (AOT) is an uncommon benign lesion derived from the complex system of dental lamina or its remnants. It is categorized into 3 variants (follicular, extrafollicular and peripheral). It affects young individuals with female predominance, commonly located in anterior maxilla and is usually associated with impacted canine. A 20 year old female presnted with a large radiolucent lesion associated with impacted canine in mandibular anterior region which was clinically diagnosed as dentigerous cyst (DC). The microscopic examination revealed the presence of AOT in the fibrous capsule of the DC. This case represents an odontogenic cyst with neoplastic development, containing both epithelial and mesenchymal components. Very few cases of AOT associated with DC have been reported till date.

1-4

Authors: Rajiv Saini

Periodontitis is associated with elevated levels of systemic inflammatory biomarker C-reactive protein (CRP). This study is outlined to determine and correlate the C-reactive protein level in health, gingivitis and periodontitis and to assess the CRP values after complete scaling and root planning. Sixty systemically healthy subjects enrolled in the study. Twenty subjects each categorized under three group’s i.e. periodontally healthy, gingivitis and periodontitis. Clinical parameters and serum CRP is recorded at the baseline, 15th and 30th day. Patients with chronic periodontitis had statistically significant elevations in serum C- reactive protein levels as compared to gingivitis and absence of detection of serum CRP level in health group. Results showed a highly significant change in clinical parameters and serum CRP with regard to improvement in the gingival inflammation and reduced bleeding on probing and plaque accumulation from the baseline when compared to the 15th day and 30th day. A correlation exists between the periodontal disease and CRP, as the periodontal disease regresses the value of CRP lowers down significantly. Non-surgical periodontal treatment i.e. scaling and root planing was effective in reducing the levels of serum C - reactive protein