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   Table of Contents - Current issue
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January-June 2018
Volume 10 | Issue 1
Page Nos. 1-46

Online since Friday, July 6, 2018

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EDITORIAL  

Indian dentistry: Today and tomorrow p. 1
Sonali Deshmukh
DOI:10.4103/jicdro.jicdro_7_18  
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REIVEW ARTICLE Top

Ascendancy of sex hormones on periodontium during reproductive life cycle of women p. 3
Ashutosh Nirola, Priyanka Batra, Jaspreet Kaur
DOI:10.4103/jicdro.jicdro_29_17  
Throughout the reproductive life cycle of women, fluctuating levels of sex hormones during puberty, menses, pregnancy, and menopause have direct and indirect effects on oral health and they also influence their susceptibility to periodontal disease. These physiological conditions are associated with an exaggerated inflammatory response without accompanying an increased plaque level. Changes in hormone levels also lead to alteration in the subgingival microflora, epithelial keratinization, decreased salivary flow, altered gingival crevicular fluid, effects on specific cells of periodontium and local immune system, burning sensation, halitosis, interproximal alveolar bone loss, and to a lesser extent, clinical attachment loss. The presence of maternal periodontitis has been associated with adverse pregnancy outcomes, such as preterm birth, preeclampsia, gestational diabetes, delivery of a small-for-gestational age infant, and fetal loss. The strength of these associations ranges from a 2–7-fold increase in risk. The increased risks suggested that periodontitis might be an independent risk factor for adverse pregnancy outcomes. Thus, the female body has a series of reaction to the hormonal changes seen within. Improper oral hygiene and hormonal imbalance seen during different life cycles of female patients exaggerate the oral tissue response to the plaque and other local factors, thus worsening the condition. Prevention is better than cure; hence, necessary precautions need to be taken at the earliest once the condition of the patient is known.
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ORIGINAL RESEARCH BASIC AND CLINICAL Top

Efficacy of oscillating – Rotating toothbrush (Oral –B) on periodontal health - A 4 week controlled clinical and microbiologic study p. 12
Sangeeta Dhir, Viveka Kumar
DOI:10.4103/jicdro.jicdro_32_17  
Aims: The aim of this study was to compare the efficacy of a powered toothbrush and manual toothbrush on the periodontal and microbial parameters. Settings and Design: This was a 4-week investigator-blinded, single-center, parallel group study. Subjects and Methods: A total of 120 participants were selected and assigned to one of the two toothbrush groups: study group (power toothbrush – Oral-B® CrissCross®) and control group (Oral-B® manual toothbrush). At baseline, gingival status, plaque, and bleeding on probing levels were recorded for the plaque index, gingival index, and bleeding index, respectively. Evaluation of the intraoral soft tissue for safety and clinical parameters was done for plaque, gingival status, and bleeding scores prior to the start of the study (i.e. baseline) and on the 28th day of the study. Statistical Analysis: Two-tailed statistical analyses were performed with a significance level set at P ≤ 0.05 and calculated using SPSS software. Changes in the clinical parameters (plaque index, gingival index, and bleeding index) were calculated using paired t-test. Comparisons between the powered and manual toothbrushes were performed using unpaired t-test. Analysis of categorized data (questionnaire) was done by Fisher's exact test. Results: Clinical parameters were recorded at baseline and on the 28th day. Reduction in plaque, gingival, and bleeding indexes for powered toothbrush was 89%, 85%, and 93% and for manual toothbrush it was 68%, 75%, 72% respectively. A significant reduction was observed in the plaque scores before and after brushing with both the manual and electric brushes. There was no clinically significant soft-tissue abrasion noticed in either of the groups. Preference analysis showed an increased preference for the electric toothbrush over the manual toothbrush. Conclusions: This study concluded that the oscillating-rotating technology as incorporated in the electric toothbrush had statistically significant results over the manual toothbrush and was found to be a safe and effective toothbrush for long-term use.
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Knowledge, attitude, and practice of professional indemnity insurance among dental practitioners in Maharashtra State, India p. 17
Vidhi Bhanushali, KM Shivakumar, Snehal Patil, Vidya Kadashetti
DOI:10.4103/jicdro.jicdro_27_17  
Aim: The aim of the study was to assess the knowledge, attitude, and practices among Indian dental practitioners regarding the professional indemnity insurance (PII) and to assess the perceived need among these practitioners regarding such insurance cover based on their demographic and professional characteristics. Materials and Methods: A cross-sectional survey was conducted in March 2015. A total of 610 dental practitioners were selected as the study population. List of registered dental practitioners was obtained from state dental councils and a few dental practitioners were selected randomly. These practitioners were then interviewed in person and also the questionnaire was put up on web for distant online interviews. The widely used questionnaire by “GLOBAL CHILD DENTAL FUND” for PII was obtained from its website (www.gcdfund.org) and was modified according to the results of a pilot study. Results: It was seen that knowledge and awareness among senior practitioners were higher and so were perceived need. More than 50% of the study population was not aware of dental indemnity insurance and did not know about the procedure to apply for it. Twenty percent of dentists felt that it was not mandatory for each and every dentist, whereas 9.5% felt that there was no need dental indemnity insurance. Conclusion: Most of the oral health practitioners do not have dental indemnity insurance. Hence, there is a need of spreading knowledge and awareness to dental practitioners about the uses and benefit of dental indemnity insurance. Provision of PII for dental practitioners is a welcome step on the part of insurance companies. Surely, it gives a sigh of relief to dental practitioners and establishments against the growing menace of compensation claims from patients.
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The prevalence of tooth wear and its associated risk factors in Indian South West coastal population: An epidemiological study p. 23
Mithra N Hegde, Mahalaxmi Yelapure, Manjiri N Honap, Darshana Devadiga
DOI:10.4103/jicdro.jicdro_22_17  
Background: The aim of the study was to estimate the prevalence of tooth wear in South West Coastal population of India and to investigate the risk factors associated with it. Materials and Methods: This study was conducted in the Department of Conservative Dentistry and Endodontics, A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, and the rural satellite centers during June 2016–August 2016. A total of 1000 patients were evaluated for the presence of attrition, abrasion, erosion, and abfraction followed by the questionnaire to evaluate risk factors associated with it. The data were statistically analyzed using SPSS version 22.0 software. Statistical analysis was carried out by applying Chi-square test for linear trend. Results: Total prevalence of tooth wear in the study population was 40.6% of which attrition (29%), abrasion (23.7%), erosion (4.6%), and abfraction (6.3%) were observed. The tooth wear was more prevalent in the age group of 40–60 years. Males and urban population showed higher tooth wear compared to females and rural population, respectively. Erosion lesions were higher in people consuming alcohol and soft drinks and with the gastric regurgitation compared to their counterparts. Attrition lesions were significantly higher among tobacco chewers and in patients with parafunctional habits such as bruxism compared to their counterparts. Conclusions: This study throws a light on the prevalence of tooth wear in South West Coastal population of India, and its associated risks, which can be utilized for patient education and increasing the awareness regarding tooth wear as timely intervention is vital for arresting irreversible disease process and the well-being of the patient.
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To compare the efficiency of maxillomandibular fixation screws over erich arch bar in achieving intermaxillary fixation in maxillofacial trauma: A clinical study p. 27
Lingraj Balihallimath, Rahul Jain, Ujjval Mehrotra, Ninad Rangnekar
DOI:10.4103/jicdro.jicdro_23_17  
Introduction: Intermaxillary fixation (IMF) is regarded as a significant step in the management of maxillofacial trauma. Various techniques have been mentioned in the literature for achieving maxillomandibular fixation (MMF). The conventional methods such as arch bars and eyelet wiring are the most commonly used, but these methods have their own shortcomings. With the introduction of self-tapping MMF screws in 1989, many of the drawbacks with the use of arch bars can be eliminated. Hence, the aim of this study was to compare the efficiency of MMF screws over arch bars in achieving IMF. Materials and Methods: Thirty patients that required IMF as a part of their treatment and reported to the Department of Oral and Maxillofacial Surgery KLE VKIDS and Dr. Prabhakar Kore charitable hospital, K LE, Belgaum, were included in the study. Patients were divided randomly into two groups: Group A: Patients treated using MMF screws and Group B: Patients treated using arch bars. Statistical analysis was performed using the Mann–Whitney U-test and unpaired t-test. Results: There was a significant difference in oral hygiene index between the two groups at the end of the 14th postoperative day. The time taken for the placement of MMF screws was significantly less (mean 18.7 min) as compared to arch bars (mean 41.2 min). Screw loosening was seen in 4 (26%) out of 15 patients and 3 screws (4.5%) out of 66 screws used showed partial mucosal coverage at the end of 2 weeks. There were no cases of penetration injury in Group A, while in Group B, penetration injury to the surgeon was noted in 5 (33.3%) cases. Conclusion: MMF screws provided good intraoperative MMF. Placement of screws consumes less time and reduces the intraoperative period and also the risk of penetration injury to the surgeon. We also observed better oral hygiene, better patient compliance, and no major complications with the use MMF screws. Hence MMF screws proved to be an efficient alternative to the conventional methods of achieving IMF.
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Application of fluorescent In situ hybridization for rapid detection of aggregatibacter actinomycetemcomitans in patients with chronic periodontitis p. 32
Kishore G Bhat, Aaradhana Chhatre, Vijay M Kumbar, Manohar S Kugaji, Sanjeevani Patil
DOI:10.4103/jicdro.jicdro_28_17  
Background: Aggregatibacter actinomycetemcomitans is a proven periodontal pathogen. In dentistry, there is a need to identify and quantitate the organisms from the diseased sites quickly and reliably. Since culture requires several days, molecular methods are being used frequently to detect A. actinomycetemcomitans. Among them, fluorescent in situ hybridization (FISH) is rapid, sensitive and quantitative. An attempt is made here to evaluate the applicability of this technique as a diagnostic tool in periodontology. Materials and Methods: A total of 77 healthy individuals and 77 patients with chronic periodontitis were enrolled for the study. Subgingival plaque was collected, fixed with paraformaldehyde and subjected to FISH. Oligonucleotide probe labelled with 6-carboxyfluorescein (FAM) was used for hybridization. After the procedure, the fluorescently stained A. actinomycetemcomitans were identified and counted from the smear and quantitated using a simple grading. Results: The data revealed that plaques from 84.5% of healthy individuals and 98.7% of chronic periodontitis showed the presence of A. actinomycetemcomitans. However, the number of these bacteria were very low in most positive samples from healthy subjects in contrast to patients with chronic periodontitis, who had higher number of organisms. Statistical analysis using Mann–Whitney test revealed a significant difference among the two groups with P ≤ 0.001 and Z = −5.833. Conclusions: The procedure used in the study is simple, rapid and can be easily adaptable. It also has a high sensitivity and has the ability to detect a single bacterial cell. The method can be directly applied to the clinical samples and can be used as a rapid diagnostic tool in periodontics.
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Determining the gingival biotype based on dentopapillary compound p. 37
Sheema Tasneem, K Venugopal, PL Ravishankar, Priyankar Chakraborty, V S P Gupta Kandukuri, AV Saravanan
DOI:10.4103/jicdro.jicdro_1_18  
Introduction: Knowledge of the gingival biotype or phenotype is of fundamental importance to an oral clinician. There is a direct correlation between gingival biotype and susceptibility to gingival recession following surgical and restorative procedures. The thick and slightly scalloped marginal gingiva with short and wide teeth on the one hand and the thin and highly scalloped marginal gingiva with slender teeth on the other may be the reason for different periodontal entities or so-called “gingival biotypes.” Aim: The present study is to analyze gingival biotype based on dentopapillary complex, taking transparency of the periodontal probe through the gingival margin as a method to differentiate thin from thick gingiva in different age groups. Materials and Methods: Sixty periodontally healthy individuals with all anterior teeth in both the jaws were participated in this study. Results: Thick biotype had area of anterior crowns as 490.17 mm2. Thin biotype had area of anterior crowns as 420.14 mm2 with P = 0.00 having high clinical significance. Conclusion: Teeth with large dentopapillary area had thick gingival biotype. Taking into consideration that the shape, size, form of the tooth and the surrounding gingiva is of paramount importance for the causation and progression of disease.
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CLINICAL SCIENCE AND TECHNIQUES/CASE REPORT WITH DISCUSSION Top

Management of iatrogenic errors: Furcal perforation p. 42
Gaurav Lal Aidasani, Sanjyot Mulay
DOI:10.4103/jicdro.jicdro_2_18  
Perforations as a possible complication during a root canal treatment may increase the risk of failure for the affected tooth. The influencing factors include the location and the size of the perforation, potential microbial colonization of the endodontic system, the time lapse between the occurrence of the perforation and repair, and the filling material. For the long-term success of the root canal system, it is essential to emphasize on disinfection and sterilization at the perforation site and in the remaining root canal system. Nonsurgical management is possible with predictable prognosis is possible if correct treatment is planned and executed.
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