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   Table of Contents - Current issue
Coverpage
May-August 2016
Volume 7 | Issue 2
Page Nos. 69-120

Online since Wednesday, November 16, 2016

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EDITORIAL  

The challenges ahead p. 69
Vinay S Dua
DOI:10.4103/0976-6944.194196  
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REVIEW ARTICLES Top

Oral and dental management of leukemic children p. 70
Saurabh Ramesh Joshi, Gowri Swaminatham Pendyala, Vikrant O Kasat, Viddyasagar Mopagar, Shantanu Chaudhari
DOI:10.4103/0976-6944.194198  
Leukemia is the most common malignancy in children which constitutes approximately 30% of all childhood cancers. Leukemia is the malignancy of white blood cells precursors in which the normal marrow elements are replaced by the poorly formed blast cells. Bone marrow transplantation along with a high dose of chemotherapy and radiotherapy is the most accepted treatment for acute leukemias. Leukemic patients suffer from acute complications in the oral cavity and long-term complications in dental and craniofacial development secondary to antineoplastic therapy. This review aims to provide an insight into clinical research evidence available for the management of leukemic patients in the dental office. For review, a search of "PubMed" and "Google Scholar" was made with the keywords "acute leukemia AND dental management," "oral health considerations AND leukemic children," "chemotherapy AND acute leukemia," "radiotherapy AND acute leukemia." It was supplemented with hand search to identify related published articles in the dental journals.
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Association between periodontitis and Alzheimer's disease: Does the link exist? p. 74
Ravi Prakash Popat, Neeta V Bhavsar, Parita Ravi Popat
DOI:10.4103/0976-6944.194202  
The relationship between oral and systemic health has remained a matter of debate since the early 1900s. In recent years, concept of "focal infection," systemic effect from oral microorganism, gained much attention. Based on the theory of "focal infection," periodontitis is linked with various systemic conditions such as diabetes, cardiovascular disease, preterm birth/low-birth-weight infants, and aspiration pneumonia. In this review, we discuss the association between periodontitis and Alzheimer's disease.
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ORIGINAL ARTICLES Top

Salivary tumor necrosis factor alpha and interleukin 6 levels in oral lichen planus patients p. 79
Maryam Robati, Hojatollah Yousefimanesh, Reza Maleki, M Ghafourian Brujerdnia
DOI:10.4103/0976-6944.194206  
Background: Oral lichen planus (OLP) is an inflammatory disease, and its etiology remains unknown, but there is much evidence that implies the existence of an immunological background. Aims: The salivary levels of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) as representatives of T-helper 1, 2 cells in OLP are compared to healthy individuals. Methods: This case-control study contains 60 patients with OLP and 30 healthy individuals. Patients were selected from those referred to the Department of Oral Medicine of Ahvaz Dentistry. After explaining the study whole saliva was collected. The salivary levels of TNF-α and IL-6 were measured using ELISA test. Statistical Analysis: t-test and Kruskal-Wallis test were used for statistical analysis. Results: The salivary levels of TNF-α and IL-6 in the group with OLP were significantly higher than the healthy group. The average concentrations of TNF-α and IL-6 were in the erosive/atrophic group (0.23 ± 0.08, 0.46 ± 0.02 Pg/ml respectively). The salivary levels of TNF-α and IL-6 in the erosive/atrophic group were significantly higher than the healthy and the reticular groups. Conclusions: The salivary levels of TNF-α and IL-6 were significantly increased in the group with OLP.
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Comparative histological and morphometric analysis of the effectiveness of manual and different recently introduced rotary instruments: An in vitro study p. 83
Shalu Krishan, Saloni Gupta
DOI:10.4103/0976-6944.194208  
Aims: The aim of this study is to evaluate cleaning efficacy of K-file, ProTaper Next, and V-Taper file systems by histological and morphometric analysis. Subjects and Methods: Thirty extracted, single rooted human mandibular premolars were selected. The teeth were randomly divided into three groups with ten teeth each. In Group 1 teeth were prepared with K-file, in Group 2 with ProTaper Next rotary system, and Group 3 with V-Taper rotary system. Histological and morphometric analysis of specimen were done and observed under an optic microscope. Statistical Analysis Used: The data were statistically analyzed using nonparametric analysis of variance Kruskal-Wallis test and the level of significance was set at P < 0.05. SPSS version 12 software was used for statistical analysis. Results: Instrumentation with stainless steel K-files showed minimum amount of debris, followed by ProTaper Next files, and rotary V-Taper files were least effective with the maximum amount of debris; however, there were no significant differences between the three experimental groups. Conclusions: Both the manual and rotary instrumentation are relatively efficient in cleaning the apical third of the root canal system, and the choice between manual and rotary instrumentation should depend on case to case basis.
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Estimation of serum and salivary level of resistin in obese patients with periodontitis p. 87
Reema M Rao, Nina Shenoy, Biju Thomas
DOI:10.4103/0976-6944.194222  
Context: Obesity is considered as one of the risk indicators of periodontal diseases. Resistin could be one such marker that could provide a link among the periodontitis-obesity. Aims: The aim of this study was to corelate the serum and saliva resistin levels and its association in obese individuals with chronic periodontitis. Settings and Design: A cross-sectional study was done to co-relate the serum and saliva resistin levels and its association in obese individuals with chronic periodontitis. Subjects and Methods: Participants were divided into Group I comprising 15 obese individuals with healthy gingiva (control group) and Group II comprising 15 obese individuals with chronic moderate periodontitis (periodontitis group).Gingival index, clinical attachment level and body mass index were determined. Enzyme-linked immunosorbent assay test was used to determine the level of resistin in both serum and saliva. Statistical Analysis Used: To study the difference in the levels of resistin between two groups in terms of saliva and serum, independent sample t-test was used. Results: The highest resistin levels were seen in the serum and saliva of Group II. Correlation of serum resistin concentration with salivary resistin concentration was positive among both the groups. A positive corelation was observed between resistin and clinical parameters and was statistically significant. Conclusion: Thus, resistin can be considered as a potential mediator linking obesity and periodontal disease. Hence, it can be concluded that resistin probably may bear similar features of a proinflammatory cytokine and could play a role in inflammatory diseases like periodontitis.
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Genotoxic and cytotoxic effects following dental and panoramic radiography p. 92
N Mohan, PT Ravikumar, C Madhumitha
DOI:10.4103/0976-6944.194229  
Aim: To evaluate the effects of diagnostic radiation on the epithelial cells of oral mucosa. Objective: To evaluate and compare the possible cellular changes seen in oral epithelium after panoramic and periapical radiography. Materials and Methods: The patients who are advised for panoramic radiography and intraoral periapical radiography (IOPAR) were included in the study with 20 subjects in each group. Smear from the buccal mucosa was taken immediately before and 10 days after the radiation exposure. The cellular changes were studied under the compound microscope. Results: The mean value of micronuclei, condensed chromatin, karyorrhectic cells, pyknotic cells, karyolytic cells, and cells with nuclear bud was found to be increased after IOPAR and panoramic radiographic exposure. Conclusion: The genotoxic effect induced by periapical radiography exposure is more when compared to panoramic radiograph exposure. The cytotoxic effects caused by panoramic radiography on oral epithelial cells are more compared to that of IOPAR.
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Study of the relationship between taste sensation and dental caries experience among dental students p. 99
Sumith Gunawardane, Sajjiv Ariyasinghe, Sunethra Rajapakse
DOI:10.4103/0976-6944.194232  
Background and Aims: High sugar intake has been found to be related to high caries experience. High sugar intake is found to be prevalent among individuals who have a preference for sweet substances. Genetic sensitivity to taste has been implicated in the preference for or rejection of some foods. TAS2R38 gene appears to strongly mediate the bitter taste perception. It has also been shown that the genetic sensitivity to bitter compounds such as 6-n-propylthiouracil (PROP) is also mediated by this gene. The objective of this study was to determine the association of coronal dental caries among dental students with different genetic sensitivity levels of taste sensation as determined by the PROP. Materials and Methods: Coronal caries and restorations in permanent dentition were evaluated in 78 healthy 1 st year dental students aged 20-25 years. A filter paper containing PROP was used to determine the subjects' inherited ability to taste bitter and sweet taste sensation. Subjects were categorized into groups of supertasters, medium tasters, and nontasters according to the modified Green's scale. The data were analyzed using Shapiro-Wilk test and Kruskal-Wallis test. Results: The mean decayed, missing, and filled teeth for nontasters was 1.64 ± 2.04 while 2.38 ± 3.24 for medium tasters and 1.96 ± 2.31 for supertasters. Conclusion: Although the scientific literature suggested a significant difference in dental caries experience and inherited the ability to taste bitter taste sensation, differences in the presenting study were not statistically significant. Although this study gives negative results for the hypothesis we intended to test, the researchers expect to do the study with a large sample of Sri Lankan population in a different context.
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Dental caries status in human immunodeficiency virus-positive and acquired immunodeficiency syndrome patients p. 103
Amit Malhotra, Jyoti Ahlawat, Mithra N Hegde, Ananya Mahajan
DOI:10.4103/0976-6944.194235  
Purpose: There is a major population suffering from human immunodeficiency virus (HIV) infection in the world yet not many studies documenting dental caries disease status in HIV +ve and acquired immunodeficiency syndrome patients are published. The present research was aimed to assess dental caries in HIV infected population, through measurement of decayed, missing, and filled (DMF) index. Materials and Methods: The study is a randomized and cross-sectional in nature. A total of One hundred HIV +ve patients were analyzed. They were distributed into two test groups: Group I (test) - 50 patients evidently HIV +ve with CD4 count >200 and Group II (test) - 50 patients evidently HIV +ve with CD4 count more than 200, respectively, whereas Group III (control) included 50 HIV −ve patients. Information was collected and analyzed regarding age, gender, skin color, habits, general and oral diseases, highly active antiretroviral therapy. Results: The mean DMF teeth score for Group I, Group II, and Control Group were found to be 17.64, 17.30, and 11.462, respectively. The results were analyzed using ANOVA and Tukey HSD, the difference in caries status was found to be very highly significant between both Group I and control, Group II and control; but was not significant in between the test groups, Group I and Group II. Conclusion: An increase in dental caries was observed in HIV + ve individuals as compared to normal population but it did not increase markedly with a decrease in CD4 count.
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Microbial flora on the white coats of dental health care professionals p. 107
Tony Saj, PS Murali, Sumit Bohra, Shilpa Shenoy, US Krishnanayak
DOI:10.4103/0976-6944.194238  
Objective: To determine the types of microbial flora present on the white coats of dental healthcare professionals in a Dental Institution and Hospital. Materials and Methods: A total of 100 white coats of dental healthcare professionals were included in the study. An informed consent and questionnaire were taken. A cross-sectional survey was designed with bacterial contamination of white coats in three predetermined areas (chest, pocket, and sleeves). Sterile swabs were moistened with sterile saline. The growth on the plates was determined based on colony morphology, gram-staining, and standard biochemical tests. Chi-square test was used to assess the association among the study variables. Results: Of the total sample, five washed their white coats every day, 60 weekly once, and 35 weekly twice. About 12% of the doctors exchanged their white coats. About 33% of the doctors wore their white coats while eating. Staphylococcus aureus was the most predominant isolate found on the sleeves, and Escherichia coli was found on the pockets. Most of the organisms were seen Gram-positive staphylococci and Gram-negative E. coli. No statistically significant association between the overall presence of microbial flora was observed when compared with different gender, frequency of washings, and practice of exchanging. Conclusions: White coats are a potential source of cross-infection even in dental settings and surroundings. It is therefore recommended that guidelines be prepared for handling and cleaning procedures of white coats.
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CASE REPORTS Top

Mineral trioxide aggregate obturation in retreatment with regenerative adjuncts of bioceramic allograft in large periapical defects p. 110
Asma Zoya, Sajid Ali, Masood Hasan Khan, Fehmi Mian
DOI:10.4103/0976-6944.194239  
Endodontic overfills and incomplete obturation is usually associated with an array of local complications and results in persistent periapical infection and inflammation. In addition, imprecise management of immature roots also leads to treatment failure. Here, a case of open apices of maxillary central incisors with extrusion of Gutta-percha and associated large periapical lesion is presented. Mineral trioxide aggregate (MTA) was used to obturate the blunderbuss canals, and an alloplastic graft (biphasic calcium phosphate) was filled in the bony defect after surgical curettage. At the 6th month postoperatively, periapical osseous healing was satisfactory. The advantages and indications of MTA as obturation material and bone graft in periodontal regeneration are discussed. Clinically and radiographically, the case was followed for 5 years to assess the outcomes of MTA obturation.
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Immediate implant: An approach for better esthetics!!! p. 115
Deepak Grover, Gurpreet Kaur
DOI:10.4103/0976-6944.194240  
Dental implants can be placed in fresh sockets just after tooth extraction. These are called "immediate implants." The intention of placing immediate implants is to try to preserve tissue contour, dimension, and also decrease treatment time. The soft and hard tissue changes following tooth extraction are in close relationship to the timing of the implant placement. In spite of similar success rates reported for immediate, early, and delayed placement, it is very important to understand the risk factors related to each procedure, to have careful case selection, and to closely follow the surgical and prosthetic protocols. The paper describes a case of 29-year-old male with right maxillary lateral incisor root stump, treated with extraction of the root stump followed by immediate implant placement.
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