World Journal of Dentistry

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Volume 13, Number 6, November-December 2022


Rosemary Abbagnale, Shilpa Bhandi, Francesco Pagnoni, Dario Di Nardo

An Update on the Molecular Alterations and Inflammation Levels of Peri-implant Tissues

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:2] [Pages No:543 - 544]

   DOI: 10.5005/jp-journals-10015-2126  |  Open Access |  How to cite  | 


Pandi Sudarshan Shulamithi, Suhas Kulkarni, Dolar Doshi, Madepu Padma Reddy, Adepu Srilatha, Dantala Satyanarayana

Oral Health Illness Perception and Dental Caries: A Cross-sectional Study among Adult Dental Patients, Hyderabad, Telangana, India

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:545 - 550]

Keywords: Caries assessment spectrum and treatment index, Dental caries, Illness perception, Oral health, Revised illness perception questionnaire for oral health

   DOI: 10.5005/jp-journals-10015-2116  |  Open Access |  How to cite  | 


Aim: To evaluate and assess the relationship between oral health illness perception and caries status among adult dental patients according to variables (age, gender, and presence of dental problems other than dental caries). Materials and methods: A total of 311 adult dental patients with self-reported dental caries were recruited by systematic random sampling method. Oral health illness perception was assessed by using revised illness perception questionnaire for oral health (IPQ-R-OH) and caries status by caries assessment spectrum and treatment (CAST) index. Data were analyzed with Statistical Package for the Social Sciences (SPPS) version 24.0. Results: The overall illness perception towards oral health was higher among study participants. However, when individual dimensions were considered, study participants had higher illness perception for control, emotional representation, hopelessness, and illness coherence. Based on CAST severity, higher percentage of study participants (43.8%) had pulpitis and abscess or fistula (severe morbidity). There was no significant gender difference for illness perception and CAST severity. However, study participants in the age-group of <30 years of age and who had other dental problems had significant higher illness perception and CAST severity. Conclusion: Oral health illness perception was observed high among the study participants. Age and presence of dental problems other than dental caries were the significant predictors for illness perception. Clinical significance: The oral health illness perception among the study participants associates with number of important outcomes such as dental care utilization, treatment adherence, and functional recovery. Further, earlier perception of dental caries reduces the progression of the disease and can be prevented.


Abhishek A Talathi, Anil V Ankola, Apurva P Deshpande, Roopali Sankeshwari, Sagar Jalihal, Deepika V Bhat, Abhra R Choudhury

Comparative Evaluation of Different Mouthrinses on Plaque and Salivary Parameters among 12–15 Years Old Schoolchildren: A Randomized Field Trial

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:7] [Pages No:551 - 557]

Keywords: Mouthrinses, Plaque, Sodium fluoride, S. mutans, Xylitol

   DOI: 10.5005/jp-journals-10015-2128  |  Open Access |  How to cite  | 


Aim: To evaluate the effectiveness of xylitol, sodium fluoride, and xylitol–sodium fluoride mouthrinses on the plaque, salivary physicochemical parameters, and Streptococcus mutans counts. Materials and methods: A randomized controlled field trial was conducted on 60 children in the age group of 12–15 years who were randomized into three groups namely xylitol (group I), sodium fluoride (group II), and xylitol–sodium fluoride (group III). The S. mutans counts, plaque scores, and salivary parameters were measured before and after 21 days of mouthrinse usage. Caries experience was measured using the Decayed, Missing, and Filled Teeth (DMFT) index at baseline. Acceptability of mouthrinses was evaluated by a prevailed questionnaire. The Chi-square test, analysis of variance (ANOVA), and paired t-test were employed. Results: The mean DMFT of group I, group II, and group III were (4.20 + 1.196) (4.45 + 0.945) (4.15 + 1.040), respectively. There was statistically significant difference observed in plaque scores in all three groups from baseline to 21 days (p < 0.05). There was statistically significant increase in flow rate observed in group II and group III from baseline to 21 days. S. mutans count reduced significantly in group I and group II from baseline to 21 days. The order of overall acceptability of mouthrinse was group III>group II>group I (p < 0.05). Conclusion: There was a reduction in plaque scores, improvement in salivary parameters, and reduction in S. mutans counts observed between the xylitol, sodium fluoride, and combination (xylitol and sodium fluoride) mouthrinses. The combination of xylitol–sodium fluoride was the most acceptable mouthrinse. Clinical significance: In the current years, the use of chemical plaque control is one of the best ways of periodontal disease prevention. In the present study, the combination of xylitol and sodium fluoride mouthrinse was better accepted by the children. Also, a synergistic effect of fluoride and xylitol on inhibiting glycolytic activity has an added advantage to promote remineralization of teeth.


Balamanikandasrinivasan Chandrasekaran, Dikshita Kakati, Reena R John

Morphometric Analysis of Dry Human Mandibles to Assess the Position of Lingula, Course of the Inferior Alveolar Nerve: In Vitro Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:4] [Pages No:558 - 561]

Keywords: Inferior alveolar nerve, Mandibular canal, Sagittal split ramus osteotomy

   DOI: 10.5005/jp-journals-10015-2101  |  Open Access |  How to cite  | 


Aim: To assess the position of lingula and course of the inferior alveolar canal after sagittal split ramus osteotomy (SSRO) in dry human mandible. Methodology: Sagittal split ramus osteotomy was performed on both right and left sides of 20 adult dry mandibles. Position of lingula was assessed with a digital vernier caliper, course of the nerve in the canal was evaluated through radiographs, and location of canal was assessed on the right and left sides of mandibles. The results were tabulated and statistically analyzed using paired t-test and Chi-square test. Results: Position of lingula from anterior border of mandible varies between right and left sides of mandible which was statistically significant (p = 0.04). Curved course of canal was found in majority of the dry mandible—80% (right side) and 70% (left side). Location of canal after split was found to be on the distal segment—80% (right side) and 55% (left side). Conclusion: The significant finding of the study was that the position of lingula from the anterior border of ramus between right and left sides of mandible is not constant. Reference distances for surgery based on age and ethnicity can be formatted with future studies on similar guidelines. Clinical significance: The variations in position of lingula between right and left sides of the mandible and the ethnic variations have to be kept in mind as they can act as a reference point for performing the SSRO. Course and location of nerve in canal have to be taken into account during surgery as they are important factors in determining paresthesia.


Girish Madarahalli Shankarguru, Ranju Manjusha Bhaskaran, Nandlal Bhojraj, Indira Mysore Devraj

Evaluation of Antimicrobial Efficacy of Coconut Oil and Low-fluoride Mouthwashes against Streptococcus mutans in Children: A Comparative Clinicomicrobiological Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:562 - 567]

Keywords: Antimicrobial activity, Antiplaque activity, Low-fluoride mouthwash, Streptococcus mutans, Virgin coconut oil mouthwash

   DOI: 10.5005/jp-journals-10015-2115  |  Open Access |  How to cite  | 


Aims: To compare the antimicrobial properties of virgin coconut oil (VCO) mouthwash and a commercially available low-fluoride (0.05%) mouthwash against plaque Streptococcus mutans and to evaluate its efficacy on the supragingival plaque in the pediatric population of age group 6–9 years. Materials and methods: Saponification of VCO was done to obtain the free fatty acids. Minimum inhibition concentration was determined using the broth microdilution method, and VCO mouthwash was formulated. Sixty children were randomly allocated to two groups. VCO (0.02%) mouthwash and commercially available low-fluoride (0.05%) mouthwash were provided. Mouthrinsing was carried out twice daily using 5 mL of mouthwash for 1 minute. Plaque samples were collected at baseline after 30 days of intervention, and microbial analysis was done using mitis salivarius-bacitracin (MSB) agar. Results: Significant reduction in the S. mutans count and plaque scores were obtained in both the mouthwash groups at the end of 30 days. When combined with fluoride toothpaste, low-fluoride (0.05%) group exhibited a higher reduction of S. mutans count. Conclusion: VCO (0.02%) mouthwash can be recommended as a regular mouthwash for children with heavy plaque formation. Clinical significance: Herbal medicines of natural/botanical origin are being applied in clinical dentistry to inhibit microbial activity. Virgin coconut mouthwash which is rich in potassium salts of lauric acid, caprylic acid, capric acid, myristic acid, palmitic acid, stearic acid, oleic acid, and linoleic acid, has been found to be effective against S. mutans in the present study, which would open new vistas in promotion of natural products against oral microorganisms and dental caries in particular.


Ranganthan Ajay, Vikraman Rakshagan, Ramajayam Sasikala, Kandasamy Baburajan, Gnanasambandam Kalarani, Karthigeyan Suma

Evaluation of Linear Dimensional Stability of Monomethacrylate-based Dental Polymer Containing a Novel Tricyclic Diacrylate Cross-linker Using a Novel Surface-level Index Technique

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:568 - 573]

Keywords: Copolymer, Cycloaliphatic, Denture base, Dimensional stability, Linear shrinkage

   DOI: 10.5005/jp-journals-10015-2106  |  Open Access |  How to cite  | 


Aim and objectives: To evaluate and compare the linear dimensional stability of denture base copolymer containing a cycloaliphatic comonomer by employing conventional engraving technique (ET) and a novel surface-level index technique (SLIT). Materials and methods: Group I employed the SLIT and group II employed the ET. The subgroups were divided under both groups based on the: (1) Cycloaliphatic comonomer's concentrations (SG0, SG10, SG20, EG0, EG10, and EG20); (2) Corresponding mold spaces (SM0, SM10, SM20, EM0, EM10, and EM20). Rectangular mold spaces with four reference points were measured using the Euclidean norm. A total of 120 rectangular specimens (n = 20 for each subgroup) were fabricated and the distances between the reference points in the specimens were measured. The differences between the Euclidean norms of the molds and the resultant specimens were recorded. Results: A significant difference in the linear distortion between the techniques till 10% TCDDMDA comonomer concentration was observed beyond which there is no difference between the techniques. Within the techniques, a statistically significant difference in the linear distortion among and between the subgroups was evident. Conclusion: Employing the SLIT showed an amplified linear distortion of the denture base specimens when compared to ET. The novel copolymer P(MMA-Co-TCDDMDA) with 20% TCDDMDA demonstrated negligible linear dimensional distortion with either technique. Clinical significance: Employing P(MMA-Co-TCDDMDA) copolymer as denture base shall not only offset dimensional and occlusal inaccuracies but also improve the retention and stability of the denture base and eventually the life quality of the edentulous population.


Ban M Jassim, Rash Mehdi, Intisar J Ismail, Farah J Ibrahem

The Effect of Addition Nanoparticles Kraft Lignin to the Acrylic-based Provisional Restorations Crown and Bridge

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:8] [Pages No:574 - 581]

Keywords: Kraft lignin, Nanoparticles, Polymethyl methacrylate

   DOI: 10.5005/jp-journals-10015-2096  |  Open Access |  How to cite  | 


Aim and objective: To evaluate the effect of adding nanoform of biopolymer kraft lignin (KL) as reinforcement material as it had many functional groups to the acrylic-based provisional restorations crown and bridge for improving their properties. Materials and methods: The specimens were grouped according to the powder of nano KL which was added to the acrylic resin after sonication with the methyl methacrylate monomer in percentages of 0.5, 0.75, and 1.0% to be in four groups with the control without addition. In total, 112 specimens (28 per each test) were cured and fabricated to evaluate some mechanical properties, for transverse strength test, hardness test, surface roughness, and specimen for impact strength test, results were analyzed using Statistical Package for the Social Sciences. Results: Highly significant increase was obtained (p < 0.05) among the groups, in transverse strength (87.3243 N/mm2); impact strength (9.1071 kJ/m2) at 1.0 wt% group, which is the highest value; and hardness number concentration of KL 1.0% which had the highest mean value (84.0943); while the result indicates an increase in the surface roughness values than the control. Conclusion: Using such material KL in nanoform has a positive effect on the mechanical properties which are tested in acrylic used for crown and bridge, especially in the (1.0%) addition KL further study could be done for higher percentage. Clinical significance: According to this novel addition which indicated that lignin as a nanoparticle may have had interaction among the polymer matrix. So, it may anticipate in improving the mechanical properties by increasing the strength of the cold-cured acrylic resin.


Baskar Kavya, NJ Nagaraj, Manavalan Madhana Madhubala, Sekar Mahalaxmi

Antibiofilm Efficacy of Mimosa pudica against Clinical Isolates of Streptococcus mutans as a Mouthrinse

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:5] [Pages No:582 - 586]

Keywords: Biofilm, Chlorhexidine, Mimosa pudica L., Mouthrinse

   DOI: 10.5005/jp-journals-10015-2097  |  Open Access |  How to cite  | 


Aim: The aim of this study was to comparatively evaluate the antibiofilm efficacy of Mimosa pudica L. and chlorhexidine (CHX) against Streptococcus mutans (S. mutans) as a mouthrinse. Methods: S. mutans were cultured from saliva collected from high caries risk patients and inoculated in Mueller–Hinton agar plates. The mouthrinses were grouped as follows: group I—10% aqueous extract of M. pudica L. mouthrinse, group II—0.2% CHX mouthrinse, and group III—saline. The resazurin-based dye microbroth assay was used to check the effect of test rinses on the redox activity of salivary bacteria and optical density (OD) values were recorded. Biofilm was grown on the surface of enamel slabs for 7 days in an anaerobic work station using S. mutans and treated with respective mouthrinses for 2 minutes at room temperature. The slabs were stained using fluorescent dye propidium iodide and SYTO9 and visualized under confocal scanning laser microscopy (CLSM) and qualitatively analyzed for live/dead bacteria. The percentage of viability was determined and statistically analyzed using the one-way analysis of variance (ANOVA) test at the p-value of <0.05. Results: Based on OD values of resazurin-based dye assay and CLSM analysis, group II showed higher antibacterial efficacy with significant differences than groups I and III. Conclusion: The percentage of biofilm inhibition was found to be less for aqueous extract of M. pudica L. than CHX. However, it is evident that M. pudica L. can resist the oral cariogenic bacteria, thereby preventing the formation of dental caries.


Nusrin Thoniyottupurayil, H T Arvind Rao, Joyce Sequeira

Tissue Adhesive or Suture for Wound Closure Following Surgical Removal of an Impacted Mandibular Third Molar: A Randomized Comparative Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:7] [Pages No:587 - 593]

Keywords: Cyanoacrylate adhesive, Impacted third molar, Mervilyte, Mucoperiosteal flap

   DOI: 10.5005/jp-journals-10015-2091  |  Open Access |  How to cite  | 


Aim: To compare the efficacy of isoamyl 2-cyanoacrylat and 3–0 silk suture for the closure of wound after surgical removal of the impacted mandibular third molar. Materials and methods: This research was carried out on fourteen patients of both sexes, with a range of 18–35 years of age. Patients were randomly assigned to one of two groups (study or control) each with a submerged mesioangular impacted mandibular third molar (Class II Position B of Pell and Gregory's classification). After the surgical extraction of an impacted tooth, the flaps were closed using isoamyl 2-cyanoacrylate (Mervilyte) tissue adhesive in the study group and using 3–0 silk sutures in the control group. Recorded the time taken for placement of silk suture or cyanoacrylate tissue adhesive for the closure of the surgical wound. Both patient groups were given similar medication and postoperative instruction. Patients were recalled on postoperative day 1, day 3, and day 7 for evaluating postoperative pain, bleeding, and wound healing. Results: Fourteen subjects were enrolled in this study. In cyanoacrylate treated wounds, there was a considerable clinical and statistical improvement. The time it took to close a wound using isoamyl 2-cyanoacrylate was shorter (2.13 ± 0.61) whereas it was longer for the silk suture group (6.34 ± 1.86). Early hemostasis was achieved with isoamyl 2-cyanoacrylate. Postoperative discomfort and hemorrhage were reduced when compared to the silk suture group. In the isoamyl 2-cyanoacrylate group, wound healing was also improved. Conclusion: The use of cyanoacrylate tissue adhesive is a good method for the closure of mucoperiosteal flaps that is capable of overcoming most of the complications associated with traditional silk sutures, as well as providing ease of manipulation, time savings, and safety. Clinical significance: Cyanoacrylate tissue an adhesive is an alternative option for intraoral wound closure following surgical removal of impacted third molars because of its quick working time, ease of application, lower incidence of wound infection, and patient as well as surgeon comfort during the surgery.


Snega Thamilselvan, Abilasha Ramasubramanian, Pratibha Ramani, Gheena Sukumaran, Hannah Ravikumar

Analysis of Incidence of Clinically Diagnosed Oral Leukoplakia Patients Undergoing Incisional Biopsy Using Certainty Factor: An Institutional Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:594 - 599]

Keywords: Certainty factor, Incisional biopsy, Leukoplakia

   DOI: 10.5005/jp-journals-10015-2104  |  Open Access |  How to cite  | 


Aim: The aim of the study is to evaluate the frequency of clinically diagnosed oral leukoplakia patients undergoing biopsy or rather not in their early visit and correlate that with the certainty factor (C-factor) classification of oral leukoplakia. Materials and methods: This is a retrospective study performed at an institutional level that includes a total of n = 96 clinically diagnosed leukoplakia patients. The patients’ demographic data and clinical details were retrieved from the institutional database and tabulated. The data of clinicopathologically confirmed cases of oral leukoplakia patients were correlated with the diagnostic C-factor C1–C4 using van der Waal's classification. The study parameters, clinical diagnosis, and biopsy history were statistically analyzed using Pearson's Chi-square test and descriptive statistics were also performed for all study parameters using SPSS software. Results: The study results of n = 96 clinically diagnosed oral leukoplakia patients showed 90.6% had not undergone biopsy and 9.4% have done a biopsy. About 93.7% were males and 6.25% were females with 57.28% being >50 years of age and 33.28% being <50 years of age. About 66.5% of the population had at least one predisposing habit and 33.5% with no habit history. The histopathological evidence of 62.5% of patients showed grades of dysplasia. About 85.5% of the population had not reported for review after an initial provisional diagnosis. Statistical analysis revealed that incisional biopsy history and C-factor classification of oral leukoplakia have a correlation with a highly significant p-value = 0.000008 (p-value < 0.05). Conclusion: The correlation between clinically diagnosed leukoplakia with the C-factor classification of oral leukoplakia in our study showed 86.50% of patients were under the C1 category which is indicative of investigations not been done in their early visits. Conversely, this emphasizes a delay in the biopsy would mean overlooking the lesion and its severity. Clinical significance: Our study connotes the requirement of whether to biopsy the lesion or not which is imperative for determining further treatment plans in oral leukoplakia. The reason for early diagnosis and intervention in leukoplakia is an attempt to prevent malignant transformation.


Shweta Sonkusle, Jyoti I Pattanashetti, Nagaraj B Kalburgi, Varsha Singh, Kavita A Patil

Formulation and Evaluation of Antimicrobial Activity of Boswellia serrata Roxb. Gel against Periodontal Pathogens: An In Vitro Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:600 - 605]

Keywords: Disk diffusion test, Gingivitis, Local drug delivery, Minimum inhibitory concentration, Periopathogens

   DOI: 10.5005/jp-journals-10015-2125  |  Open Access |  How to cite  | 


Aim: To assess the antimicrobial activity of Boswellia serrata Roxb. in the form of gel against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Tannerella forsythia. Materials and methods: The bacterial strains of selected periopathogens were cultured in thioglycolate broth. The serial dilution method was used to evaluate Minimum Inhibitory Concentration (MIC). The tubes which were sensitive to MIC were plated and incubated for 24 hours. The colony count was done to determine the Minimum Bactericidal Concentration (MBC). Depending on the obtained concentrations, Boswellia serrata Roxb. gel was formulated in five concentrations and the physicochemical properties were evaluated. The periopathogens were cultured in brain–heart infusion agar plates. A disk diffusion test was performed to determine the zone of inhibition. Results: Boswellia serrata Roxb. impeded the growth of the selected periopathogens in a dose-dependent manner. F. nucleatum showed the maximum zone of inhibition at 3 μg/mL concentration. Conclusion: The physicochemical and antimicrobial properties of our study reveal that Boswellia serrata Roxb. gel can be used as an adjunct to non-surgical periodontal therapy (NSPT) as a topical gel or as a local drug delivery agent. Clinical significance: Periodontal diseases are primarily caused by plaque biofilm which commences with inflammation of the investing tissues of the tooth which, if left untreated, leads to progressive attachment loss. NSPT is the gold standard and indispensable phase of periodontal therapy. The insufficiency of NSPT in obliterating microbial growth in deep periodontal pockets and spurting microbial resistance to antibiotic drugs widened the array of research on botanical therapeutics. Boswellia serrata Roxb. is widely gaining popularity because of its antimicrobial properties and nary a side effect.


S Sowmithradevi, S KK Shantha, Ravindra K Jain

Correlation of Forehead Type with Maxillary Incisor Inclination in Dravidian South Indian Population: A Prospective Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:5] [Pages No:606 - 610]

Keywords: Buccolingual inclination, Photographic diagnosis, Smile esthetics

   DOI: 10.5005/jp-journals-10015-2090  |  Open Access |  How to cite  | 


Aim: To correlate maxillary central incisors labiolingual inclination (LI) with forehead inclination (FI) and assess the anteroposterior (AP) position of maxillary central incisor (CI) in Dravidian South Indian population with different forehead types using photographs. Materials and methods: This photograph-based study included 150 class I occlusion participants with good facial harmony equally divided into three groups (group A—angulated, group B—straight, and group C—rounded) based on forehead type. Reference points and lines were marked on the right profile full smile photographs of the participants taken in natural head position with CI and forehead in full view, and FI, II, and AP of CI in all groups were measured and tabulated. Descriptive statistics, Pearson's correlation test, and linear regression analysis were performed. Results: Incisor inclination was highest in group A (4.31 ± 2.50) and lowest in group B (1.01 ± 2.04). Pearson's correlation test revealed a statistically significant correlation between FI and II (p < 0.05). About 61.4% of the population had maxillary CI positioned anterior to forehead facial-axis point (FFA), 25.7% posterior to FFA, and 12.8% at FFA. Conclusion: The findings of the present study showed a moderate correlation (r = 0.696) between FI and II that shows inclination of FI can be used to determine the II. Majority of the study population (61.4%) had maxillary CI positioned anterior to FFA, which is considered the most esthetic position of incisors when finishing orthodontic treatment. Clinical significance: Forehead inclination assessed clinically can be used to determine the incisor inclination.


Megha Gugnani, Mamta Singla, Mandeep S Grewal, Anshul Arora, Gaurav Setya, Ayush Jain

Comparison of Four Different Light-curing Units and Evaluation of the Depth of Cure and Microhardness of Nanohybrid Composite Resin

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:611 - 616]

Keywords: Depth of cure, Hardness ratio, Light-emitting diode, Nanohybrid composite, Vickers hardness

   DOI: 10.5005/jp-journals-10015-2114  |  Open Access |  How to cite  | 


Aim: The current in vitro study compared four different light-curing units and evaluated the depth of cure and microhardness of nanohybrid composite resin. Materials and methods: Ninety-six composite specimens were obtained using polyurethane molds with 5 mm diameter and 2, 4, and 6 mm depth. Each specimen was light-cured using four different light-curing units (Bluephase N, iLED, SmartLite Focus, and Elipar DeepCure-L) for 20 seconds. The Vickers microhardness (VK) of the surface was determined by a microhardness indenter with a load of 200 gm applied for 15 seconds. The hardness ratio = VK of the bottom surface/VK of the top surface was calculated and compared. Depth of cure using a scraping method described in the International Organization for Standardization (ISO) standard for resin-based composites was performed, and mean was calculated and compared. Results: Data were analyzed using analysis of variance (ANOVA) test. Significant differences were found in hardness ratio and depth of cure (DOC) of samples cured by abovementioned light sources. Conclusion: Bluephase N reaches the minimum value indicated in literature (0.8) and depth of cure of 1.5 as compared to other light-curing units. Clinical significance: Clinicians need to follow the manufacturer's instructions for each light and to be cured accordingly to obtain a properly cured composite resin.


Pragati Nakra, Akhil Shetty, Sanjeevani Ratti

Skeletal Changes after Miniscrew-assisted Rapid Palatal Expansion in Young Adults: A Cone-beam Computed Tomography Technique Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:617 - 622]

Keywords: Buccal bone, Cone-beam computed tomography, Miniscrew-assisted rapid palatal expansion, Skeletal expansion

   DOI: 10.5005/jp-journals-10015-2124  |  Open Access |  How to cite  | 


Aim: To evaluate the skeletal changes in buccal bone thickness (BBT) and height in subjects treated with miniscrew-assisted rapid palatal expansion (MARPE) using Cone-beam Computed Tomography (CBCT). Materials and methods: CBCT records of 19 patients (age 18–30 years) were selected from the archives. The scans were taken before and immediately after the completion of expansion treatment using the MARPE appliance. These CBCT scans were calibrated and analyzed. The skeletal, dental, and airway parameters were evaluated for every patient at selected landmarks and a comparison was made before and after expansion. Skeletal measurements consisted of BBT, buccal bone height loss (BBHL), and midpalatal suture density ratio (MPSD). A paired t-test was employed to compare the means of the skeletal parameters pretreatment and posttreatment with the significance set at p < 0.05. Results: Statistically significant differences were noted in the skeletal parameters posttreatment. BBT decreased by 1.14 mm while buccal bone height reduced by 1.84 mm with a decrease in MPSD indicating successful expansion. Conclusion: MARPE treatment results in significant skeletal changes. The skeletal expansion opens up new avenues of treatment in contemporary orthodontics for mature patients. Clinical significance: MARPE is an effective technique for skeletal expansion to correct the transverse discrepancy in adults without the use of surgery.


Calvin Hilary, C Preeja, G Midhun Mohan, KS Mukunda

A Clinical Comparison of Pain Perception and Behavior in Children Using Conventional and Vibraject Injection Techniques

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:7] [Pages No:623 - 629]

Keywords: Conventional injection, Pain, Vibraject

   DOI: 10.5005/jp-journals-10015-2110  |  Open Access |  How to cite  | 


Aim: The study was aimed at evaluating the efficacy of vibraject in reducing pain and related disruptive behavior in children who underwent routine local anesthesia procedures in the dental setting. Materials and methods: A total of 60 healthy children who needed dental procedures on both sides of the oral cavity, which necessitates the administration of local anesthesia who visited the department, were selected for the study. The children were assigned into three groups based on their age. A split-mouth technique was used in the study. The children were given appointments for two consecutive days. In the first appointment, dental procedures were carried out with local anesthesia using a conventional injection technique, and on the next appointment, with the vibraject attachment. After the administration of local anesthesia, the evaluation of pain perception was recorded with the aid of Wong–Baker Faces Pain Rating Scale (WBFPS), followed by the assessment of the child's behavioral pattern based on Frankl Behaviour Rating Scale (FBRS). Results: The mean WBFPS score was higher with the conventional technique in comparison to the vibraject injection technique in all three age-groups of children. The overall standard deviation (SD) value was similar with both techniques, but the overall mean value was higher for the conventional technique compared to the vibraject injection technique, which was statistically significant. The mean value for FBRS scores was higher for the vibraject injection technique in children in the 6–9-year age-group, which was not statistically significant, but the mean value was higher for the conventional technique in children in the 9–12-year age-group which was also not statistically significant. However, statistical significance was observed in the 12–15 year age-group children who had a higher mean value with the vibraject technique in comparison to the conventional technique. Conclusion: The study gave promising results regarding the efficacy of vibraject in reducing pain and related disruptive behavior in children. Clinical significance: Vibraject can be used as the most cost-effective and easy painless technique to administer local anesthesia in pediatric clinical settings.


RV Sangeetha, TR Prasanna, KT Manjula, V Madhusudan

Comparison of Accuracy of Different Cephalometric Analyses Using NemoCeph Digital Software and Hand-traced Cephalometric Analyses: A Cephalometric Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:11] [Pages No:630 - 640]

Keywords: Cephalometrics, Manual tracing, NemoCeph software tracing

   DOI: 10.5005/jp-journals-10015-2098  |  Open Access |  How to cite  | 


Aim: The present study was done to assess the accuracy of various cephalometric analyses performed using NemoCeph cephalometric software (digital approach) with manual hand tracing. Materials and methods: This study was carried out by two examiners, 50 lateral cephalograms were selected, 11 angular and eight linear measurements were assessed using both manual and digital methods. Manual tracing is done by placing an acetate tracing sheet on the lateral cephalogram. For digital tracing, the lateral cephalogram is scanned and calibrated with a ruler which was incorporated in the cephalostat at the time of radiographic exposure and traced using NemoCeph software. Results: On intraclass correlation, NemoCeph measurements showed good agreement as hand measurements for majority of the values, suggesting good reliability. Pearson's correlation showed weak correlation with IMPA and AO-BO for examiner 1 and Pog-NB and lower lip-S line for examiner 2. Paired t-test showed significant difference (p < 0.05) for SNB, ANB, occlusal plane, FMA, IMPA, upper lip-S line, lower lip-S line, S-Go, N-Me, and AO-BO for both the examiners. Even though statistically significant differences were found for the majority of the values, all of which lie within two units, except for IMPA and S-Go. Conclusion: Digital cephalometrics has many advantages over manual tracing such as ease of use, instant image acquisition and storage, and time-saving. With further research using cephalometric software and proven clinical performance, digital cephalometric tracings can be preferred over manual methods. Clinical significance: In clinical settings, digital cephalometrics minimizes tracing errors, decreases manual work, and saves a significant amount of time. Moreover, it aids in immediate diagnosis and treatment planning.


Shweta Sonkusle, Jyoti I Pattanashetti, Nagaraj B Kalburgi, Kavita A Patil, Varsha Singh

Comparative Evaluation of Topical Application of Boswellia Serrata Gel with Chlorhexidine Gel in Management of Gingivitis: A Clinical Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:641 - 646]

Keywords: Frankincense, Gingivitis, Periodontal disease, Plaque, Sallaki

   DOI: 10.5005/jp-journals-10015-2113  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the efficacy of the topical application of Boswellia serrata gel and chlorhexidine gluconate gel in depletion of gingival inflammation and plaque in study participants diagnosed with plaque-induced gingivitis. Materials and methods: A total of 60 study participants diagnosed with chronic gingivitis in the age-group 18–40 years signed up for the research and were categorized into three equal groups. Group I: scaling + Boswellia serrata gel, group II: Scaling + Chlorhexidine gluconate gel, group III: scaling + placebo gel. A detailed case history including Gingival Index (Loe and Silness, 1963), Plaque Index (Silness and Loe, 1964), and Sulcus Bleeding Index (Muhlemann & Son, 1971) was recorded in their first visit which were reassessed after 14 days (second visit) and 21 days (third visit) and comparison was made with the baseline data. Results: The mean scores for Plaque Index, Gingival Index, and Sulcus Bleeding Index were significantly decreased during 2nd and 3rd visit after 14 and 21 days, respectively when compared with baseline scores. No significant difference was recorded between group I and group II (test groups) whereas there was significant difference between the test groups and group III (control group). Conclusion: Both Boswellia serrata gel and chlorhexidine gluconate gel were similar in action when used for topical application along with scaling and polishing in the management of chronic gingivitis study participants. Clinical significance: Boswellia serrata gel can be used as an adjunct to scaling and root planing as a long-term intervention due to its low cost availability and better tolerance when compared to the widespread side effects of chlorhexidine.


Karthik V Thomas, Prathap MS Nair, Vivian F D Costa, Jeslee A Jose, Nithin Suvarna

Comparative Evaluation of the Depth of Penetration and Persistence of Sealer Residues in Retreated Dentinal Tubules

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:5] [Pages No:647 - 651]

Keywords: AH Plus, BioRoot RCS, Confocal laser scanning microscopy, Depth of penetration, Sealapex

   DOI: 10.5005/jp-journals-10015-2099  |  Open Access |  How to cite  | 


Aim: To compare the depth of penetration and persistence of sealer residues in obturated canals with three commercially available root canal sealers using confocal laser scanning microscopy (CLSM). Methodology: Thirty single-rooted human premolars were selected and decoronated with diamond disks to standardize the root length at 14 mm. Access cavity and working length were determined; following which biomechanical preparation was carried out using rotary files in a crown-down manner. Copious irrigation was carried out during recapitulation so as to effectively debride the canal. Subsequently, the canals were dried and obturated using lateral condensation technique with gutta-percha (GP) sticks, coated with three categories of dye-incorporated sealers, that is, AH Plus, Sealapex, and BioRoot RCS. The teeth were coronally sealed and allowed to set for 2 weeks. All samples were reattended, sectioned 6 mm from the apex, and evaluated by confocal laser scanning microscope. Results: AH Plus sealer showed the highest depth of penetration followed by BioRoot RCS and Sealapex, respectively. Conclusion: The depth of penetration of sealers plays a pivotal role in the outcome of endodontic treatment. It is virtually impossible to remove the sealer residue of the contracted dentin tubules. However, complete removal is not an essential factor in follow-up treatment in endodontics. Clinical significance: The study provides insights into selection of appropriate sealer to achieve optimal penetration and retrievability clinically.


Vinay Suresan, Pritam Mohanty, Mohammad Jalaluddin, Sourav Sen, Nibedita Sethi, Kajol Priyadarshinee

Patients' Perception of Dental Students’ Consultation and Relational Empathy (CARE) in an Academic Dental Institution of Bhubaneswar City, India

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:6] [Pages No:652 - 657]

Keywords: Dental education, Dentist-patient relations, Dental students, Empathy, Patient-centered care

   DOI: 10.5005/jp-journals-10015-2070  |  Open Access |  How to cite  | 


Aim: The aim of this current study was to access the patients’ perception of dental students’ Consultation and relational empathy (CARE) in an Academic Dental Institution in Bhubaneswar City, India. Materials and methods: This cross-sectional, observational study was conducted among the patients attending an academic dental institution. A pretested, validated, and self-structured questionnaire was designed to assess their demographic information (gender, age, education, occupation, and annual income) and the CARE empathy assessment. The study was conducted over a period of 6 months. The Chi-squared test compared the differences between the patient demographics and CARE empathy scores. A linear regression analysis was used to assess the effects of demographic variables on the CARE empathy scores. Results: A total of 1,238 subjects participated in this study. The commonest age group was 28–37 years (n = 379, 30.4%). The male participants reported a higher mean empathy score (22.95 ± 5.1, n = 681, 54.6%) as compared to females. Subjects having college and higher educational qualifications reported higher empathy scores (23.38 ± 4.7, n = 509, 40.8%). Housewives had stated the least (CARE score = 21.91 ± 4.6, n = 416, 33.4%). The highest empathy scores were reported among subjects having an income between 5 and 10 lakh rupees per annum (CARE score = 23.26 ± 5.2, n = 85, 6.8%). The responses of the present study were skewed toward the “Good” and “Fair” categories of the CARE measure. A statistically significant correlation was noted for the education variable (p = 0.002) and the annual income (p = 0.012) variables. Conclusion: The CARE measure questionnaire was proven to be beneficial in recording the empathy scores. Overall reports show that there was fair empathy among the majority of the students as perceived by the patients. Clinical significance: Patient perceived empathy of the treating dentist plays a critical role in the establishment of interpersonal trust and partnership, willingness to share their concerns, and symptoms, encouraged positive behavioral change, and quick patient recovery.


Diana Prem, Balamanikandasrinivasan Chandrasekaran, Vinola Duraisamy, Baby John

Assessment of the Lifestyle Changes Experienced by Dental Professionals before and during COVID-19 Lockdown: A Comparative Pilot Study

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:8] [Pages No:658 - 665]

Keywords: COVID-19, Dentist, Lifestyle, Lockdown

   DOI: 10.5005/jp-journals-10015-2085  |  Open Access |  How to cite  | 


Aim: This pilot study was conducted to assess the impact caused to dental professionals of Tamil Nadu before and during the lockdown period toward lifestyle, psychological, and financial aspects. Materials and methods: An online cross-sectional survey among the dental practitioners of Tamil Nadu was done using Google Form for 2 weeks from 1st to 3rd week of June 2020. Totally 26 questionnaire comprising about routine activities, family time, work related, psychological, and financial aspect were asked and their responses in relation to before and during the lockdown period were obtained. Snowball sampling technique was used to collect the data. The obtained results were statistically analyzed using Chi-square and McNemar tests with a significance level of 95% (p < 0.05). Results: Prolonged lockdown has resulted in a delay in wake-up time (44.7%), more indoor activities (60%), and improved bonding with family (64.4%). Financially, most of them (62%) relied on previous savings during the lockdown period and 41.3% were confident about meeting their financial needs after lockdown. Majority of them (59.4%) did not expect support from government as they were self-confident about their practice. About 66.3% used this lockdown period to develop new hobbies such as cooking, painting, yoga, and meditation. Conclusion: COVID-19 has impacted dental professionals substantially. The effects caused by COVID-19 were not confined only to their professional life but also influenced them personally and psychologically. This pilot study gives an insight about how COVID-19 has changed the lifestyle of dentists in Tamil Nadu before and during lockdown. Clinical significance: The impacts caused due to lifestyle changes of dentists in Tamil Nadu have been discussed in this pilot study. The results of this study was useful to predict and propose the lifestyle changes experienced by dentists before and during the lockdown period. Majority of the dentists were ready to continue the positive habits developed during the lockdown. Hence, it is important to publish these results to understand the psychosocial well-being of the dentists in such situations.


Beegum Thaj, Asha Joseph, Venkitachalam Ramanarayanan, Prabath Singh, Arjun B Ravi, V Krishnan

Fracture Resistance of Two Preparation Designs on Anterior Laminate Veneers: A Systematic Review and Meta-analysis

[Year:2022] [Month:November-December] [Volume:13] [Number:6] [Pages:11] [Pages No:666 - 676]

Keywords: Butt joint preparation, Chamfer preparation, Fracture resistance, Laminate veneer, Tooth preparation designs, Veneers

   DOI: 10.5005/jp-journals-10015-2100  |  Open Access |  How to cite  | 


Aim: This systematic review aims to assess the fracture strength of two different types of tooth preparation designs for ceramic veneers and establish whether there is any association between the preparation performed and the type of failure observed. Background: This systematic review literature search was undertaken in the databases MEDLINE Ovid (from 1946), Scopus, and Google Scholar, as well as a hand search of the references of included publications. Ex vivo and in vitro studies were included. The risk of bias was assessed. Meta-analysis was performed comparing palatal chamfer and butt joint preparation using fracture resistance as an outcome. Review results: A total of 11 studies were included for systematic review and the meta-analysis included 10 studies of relatively high quality. Conclusions: Within the limitations of the current study, it can be concluded that the failure risk of the palatal chamfer and butt joint preparation veneers revealed no statistically significant difference, but further studies are required for validation. Clinical significance: Debonding is the most frequent complication and is found to be associated with lithium disilicate and zirconia restorations. The evidence seems to support the use of both butt joint and palatal chamfer incisal preparation design. In comparison with a specific type of material used for veneer (lithium disilicate and zirconia), the fracture strength of the tooth is unaffected by the palatal chamfer preparation made of, resulting in a lesser risk of failure in ceramic veneers compared to butt joint.

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