World Journal of Dentistry

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2022 | May-June | Volume 13 | Issue 3

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Maurilio D Angelo, Andrea Cicconetti, Federico Valenti Obino, Edit Khajanka, Alberto De Biase

An Update on the Analysis of the Mechanical Properties of New Generation Ni-Ti Rotary Instruments

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:1] [Pages No:181 - 181]

   DOI: 10.5005/jp-journals-10015-1920  |  Open Access |  How to cite  | 



Sineepat Talungchit, Waranun Buajeeb, Siribang-on Piboonniyom Khovidhunkit, Rudee Surarit, Kongthawat Chairatvit, Sittiruk Roytrakul, Hiroaki Kobayashi, Yuichi Izumi

Increased Salivary Periodontal Pathogens and IL-17A in Oral Lichen Planus Patients with or without Periodontitis

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:9] [Pages No:182 - 190]

Keywords: Oral lichen planus, Periodontal pathogens, Periodontitis, Salivary IL-17A

   DOI: 10.5005/jp-journals-10015-2049  |  Open Access |  How to cite  | 


Aim: Patients with oral lichen planus (OLP) who have gingival involvement are at increased risk for periodontal disease. This study aimed to investigate salivary levels of periodontopathic bacteria and inflammatory cytokines in OLP patients with or without periodontitis. Materials and methods: Seventeen OLP patients and 20 control subjects were evaluated for their Periodontal Screening and Recording (PSR) score to classify if they had periodontitis. Four groups were studied, OLP patients with periodontitis (OLP-P), without periodontitis (OLP), periodontitis patients (P) and normal subjects (N). Salivary levels of Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Treponema denticola (Td), and Tannerella forsythia (Tf) were determined by quantitative real-time polymerase chain reaction (qRT-PCR). Salivary levels of interleukin (IL)-1β, IL-6, and IL-17A were measured by enzyme-linked immunosorbent assay (ELISA). Results: OLP-P and P groups had higher plaque index, bleeding on probing, and PSR scores than other groups. OLP-P and OLP patients had increased salivary Aa, Fn, Pi, Td, Tf with significantly high levels of Pi as well as high salivary IL-1β, IL-6, and IL-17A. IL-17A levels were significantly highest in the OLP-P group. Salivary IL-1β was significantly correlated with the level of Pi. Conclusion: OLP patients with or without periodontitis had high levels of salivary periodontal pathogens and IL-17A. Clinical significance: These data supported that OLP patients were at high risk for periodontitis. Oral hygiene maintenance in OLP patients with gingival lesions is of importance and could help prevent periodontitis.



Fahad K Alwthinani, Pooja Arora

Effect of Zirconia Core Thickness, Firing Cycle and Veneering Technique on Biaxial Flexural Strength of Veneering Porcelain in Porcelain Veneered Zirconia Restorations

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:10] [Pages No:191 - 200]

Keywords: Core thickness, Firing cycle, Flexural strength, Porcelain veneer, Veneering technique, Zirconia

   DOI: 10.5005/jp-journals-10015-2051  |  Open Access |  How to cite  | 


Aim: Evaluate the effect of different core thicknesses, firing cycles and veneering techniques on the biaxial flexural strength of veneering porcelain. Materials and methods: One core material, Vita In-Ceram YZ, and one porcelain veneer material, VITA VM9, were used in this study. Vita YZ zirconia blocks were sectioned and sintered to provide slides of 1.65, 3.25, and 6.50 mm thickness. Two techniques were used to fabricate VITA VM9 porcelain veneer; Hand Layered (HL) and Pressed (PR). The assemblies were sintered as per three different firing cycles. Biaxial flexural strength was determined using a universal mechanical tester. Statistical analysis was conducted for all tests using ANOVA and Tukey post hoc test at p ≤ 0.05. Results: In pooling all flexural strength values, for VITA VM9 porcelain, the highest value resulted by using 1.65 mm YZ core thickness (146.10 ± 23.08 MPa) while the lowest value was obtained using 6.50 mm thickness (140.91 ± 27.501 MPa). However, the difference was not statistically significant. The highest value resulted by using Cycle 2 (Heat Rate 20 C/ Min, Hold Time 2 Minutes) (154.34 ± 22.11 MPa), while the lowest value was measured using Cycle 1 (Heat Rate 55 °C/ Min, Hold Time 1 Minute) (127.42 ± 26.62 MPa), and the difference was statistically significant. In pooling all values of (HL) VITA VM9, the result was (142.66 ± 25.87) MPa which was lower than (PR) VITA VM9 (145.87 ± 25.56), but not by a statistically significant amount. Conclusion: The effect of different YZ core thicknesses and veneering techniques on the biaxial flexural strength of VITA VM9 veneering porcelain was not statistically significant. Different firing cycles resulted in a significant effect on the biaxial flexural strength of porcelain veneer. Clinical significance: The use of an appropriate firing cycle can help to enhance the biaxial flexural strength of porcelain veneer in zirconia-based restorations.



Dhanasekaran Sihivahanan, Venugopal V Nandini, Tripuravaram VK Reddy

Biomineralized Limpet Radular Teeth as Functionalized Bio-fillers in Experimental Dental Composite Resin

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:201 - 206]

Keywords: Bio-filler, Composite resin, Limpet radula, Strength

   DOI: 10.5005/jp-journals-10015-2006  |  Open Access |  How to cite  | 


Aim and objective: To develop and analyze the mechanical properties of a silanized limpet radula as a bio-filler in an experimental composite resin. The objective is to compare the compressive, tensile, and flexural strength of the experimental composite resin with bio-filler and the Universal Hybrid Composite resin. Materials and methods: Littoraria scabra species have been selected and used in the study. The tongue-like radula was extracted from the buccal mass under an optical microscope. The radula was then subjected to SEM and EDX analysis. The experimental dental composite resin with 2.5% of radula as silanized bio-filler was prepared based on previous studies and SEM analysis was done to verify the filler morphology. The experimental composite resin was compared with the Universal Hybrid Composite resin. Based on ISO 4049, the samples were prepared and 15 samples from each group were then randomly subdivided into three subgroups to analyze the compressive, tensile, and flexural strength. Results: Statistical analysis were conducted using the Shapiro-Wilk and an independent t-test. Compared to universal hybrid composite resin, the experimental composite resin with the bio-filler had relatively high compressive, tensile, and flexural strength. Conclusion: Within the limitations of the analysis, it can be concluded that the addition of 2.5% of silanized limpet radula as bio-filler in experimental composite resin has improved mechanical properties than the Universal Hybrid Composite. Clinical significance: The extreme mechanical properties shown by limpet radula can be used as a bio-filler to improve the mechanical properties of composite resin.



Prasad Chitra, Govinakovi Shivamurthy Prashantha, Arun Rao

Effect of Fluoride Agents on Calcium Metabolism of Patients Undergoing Orthodontic Treatment: A Randomized Trial

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:7] [Pages No:207 - 213]

Keywords: Calcium metabolism, Fluoride, Tooth movement

   DOI: 10.5005/jp-journals-10015-2040  |  Open Access |  How to cite  | 


Aim: To avoid enamel demineralization, orthodontists generally prescribe fluoridated agents to their patients. The effects of fluorides on underlying biological tissues are not well-known. Previously published literature on animal studies provides evidence of fluorides modifying calcium metabolism. This study analyzes the effects of fluoridated mouthwashes and toothpastes on calcium metabolism in orthodontic patients. Materials and methods: A prospective randomized trial allocated 90 subjects to two treated groups (30 each), one group using non-fluoridated toothpaste and the other group using fluoridated toothpaste and mouthwashes and a control group with no intervention. All patients had uniform bracket prescriptions and were treated with similar archwire sequences. Blood samples at four specific time periods (before treatment,1 week, 30 days, and 6 months) were collected in a heparinized syringe and centrifuged to retrieve serum plasma. Serum thus collected was assessed for any alterations in calcium levels using a calcium test kit and comparisons of changes were made. Results: Maximum decrease in serum calcium levels were noted at 7 days in both fluoridated and non-fluoridated groups, although the results were not statistically significant at p < 0.001. Conclusion: The use of fluoride agents during fixed orthodontic therapy does not carry significant risk in alteration of calcium metabolism. However, known hypocalcemic patients can be given additional calcium supplements to avoid hypocalcemia. Additionally, this mild decrease in serum calcium could also favor the rate of orthodontic tooth movement. However, further studies are required in order to provide evidence for the same. Clinical significance: Fluoride containing oral hygiene agents should be used with caution in patients with decreased calcium levels.


Original Article

Palinee Hongpaitoon, Kiti Siriwatana, Nithimar Sermsuti-anuwat

Patient Satisfaction with Services in a University Oral and Maxillofacial Surgery Clinic during the First Wave of COVID-19 Pandemic

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:214 - 219]

Keywords: COVID-19, Maxillofacial surgery, Patient satisfaction, Telephone, University clinic

   DOI: 10.5005/jp-journals-10015-2050  |  Open Access |  How to cite  | 


Aim: This study aimed to assess patient satisfaction with the services provided by a University Oral and Maxillofacial Surgery Clinic in Bangkok, Thailand, during the first wave of the COVID-19 pandemic. Materials and methods: This cross-sectional study was conducted between 5th October and 15th December 2020. Data were collected using a validated patient satisfaction questionnaire through a telephone survey administered by a trained interviewer who had not previously interacted with the patients. Descriptive statistical analysis, Mann–Whitney U test, Pearson's Chi-squared test, and binary logistic regression were performed to analyze the data. Results: One hundred and sixty patients were recruited by means of consecutive sampling, of the 88 (54.82%) agreed to and completed a telephone interview. Mann–Whitney U test analysis revealed a statistically significant association between age and patient satisfaction, with patients aged >44 years having higher mean scores of satisfaction level than younger patients (p-value = 0.029). The bivariate regression model also indicated a statistically significant association between age and patient satisfaction, with older patients being 60.3% and 61.8% more likely to report a high level of satisfaction with the telephonic triage (p = 0.044) and postoperative instructions/recommendations, respectively (p = 0.043). However, the multivariate regression model revealed no significant associations. Conclusion: Overall, our findings warrant incessant development of patient management protocol interventions to ensure patient satisfaction and service quality amidst the pandemic. Clinical Significance: This study highlights the need for various triage and communication methods for different age groups of patients, that aim to increase their satisfaction level by maintaining the quality of services provided to them during the COVID-19 pandemic.



Kulashekar R Nandalur, Amit Porwal, Samaher M Masmali, Noha K Mokli, Hana Y Madkhli, Rishika R Nandalur, Priyanka Porwal

Screening of Partially Edentulous Patients using the Prosthodontic Diagnostic Index and Post-treatment Satisfaction of Fixed Partial Dentures: A Cross-sectional Survey

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:4] [Pages No:220 - 223]

Keywords: Fixed dental prosthesis, Patient satisfaction, Patient satisfaction questionnaire, Prosthodontic diagnostic index

   DOI: 10.5005/jp-journals-10015-2004  |  Open Access |  How to cite  | 


Aim: The present study was conducted to understand the correlation between the severity/complexity of the prosthodontic status of the patient before the start of the fixed prosthodontic treatment as classified by the prosthodontic diagnostic index for partially edentulous patients prescribed by the ACP and the patient satisfaction post-treatment using the patient satisfaction questionnaire. Materials and methods: An observational cross-sectional study was conducted among all the patients who underwent fixed prosthodontic treatment in the College of Dentistry, Jazan University. They were initially classified using the PDI for partially edentulous patients before treatment. A total of 128 patients were included into the study based on the inclusion criteria. The participants were interviewed post treatment using the Patient Satisfaction Questionnaire. Overall current satisfaction was calculated as the mean of current appearance, mastication, phonetics, cleansability, and cost satisfaction. The data was tabulated and subjected to statistical analysis using t-test and one way ANOVA. Results: The mean satisfaction values were high for all the PDI groups, for both the males and females. The males showed overall higher mean satisfaction for all the questions compared to the females (p > 0.05). The PDI group 4 showed overall less mean satisfaction compared to the other groups and statistically significant lesser satisfaction compared to group 1 (p < 0.05). Conclusion: Greater patient satisfaction was achieved for PDI class 1 which has less prosthodontic complexity of treatment when compared to a more complex PDI class 4. Student treatments should be limited to less complex PDI classes and clinicians with more experience are better suited to handle the more complex prosthodontic needs of the complex PDI patients. Clinical significance: PDI classification is a useful adjunct in assessing treatment need and expected future patient satisfaction. Hence, it should be applied as a screening tool in all the clinical situations needing fixed dental prosthesis.



Yosaphat B Rosanto, Cahya Y Hasan, Rahardjo , Antonius Surya

The Potential of Snail (Achatina Fulica) Mucus Gel as a Phythopharmaca to Accelerate the Inflammation Process during Wound Healing

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:4] [Pages No:224 - 227]

Keywords: Excision wound, Glycosaminoglycans, Heparan sulfate, Heparin sulfate, Hyaluronic acid

   DOI: 10.5005/jp-journals-10015-2056  |  Open Access |  How to cite  | 


Aim: To determine the potential of snail (Achatina fulica) mucus gel as a phytopharmaca material to accelerate the inflammatory process during wound healing Materials and methods: Snail mucus gel was mixed with 3% CMC-Na to concentrations of 0% (control), 24%, 48%, and 96% snail mucus. Four 5-mm diameter punch biopsy excision wounds were made on the back skin of Wistar rats (n = 6). The snail mucus gel was applied to the back wounds of the mice. The mice were euthanized on days 2, 4, and 7 and hematoxylin and eosin-stained sections of the skin wound area were prepared. The number of polymorphonuclear leukocytes in the dermis was observed during wound healing using a binocular microscope (400x). Results: A significant difference in the number of polymorphonuclear leukocytes (p = 0.000) was observed. The increase in the number of polymorphonuclear leukocytes peaked on day 4 in response to the 48% and 96% snail mucus gel concentrations. The 96% snail mucus gel had significantly more polymorphonuclear leukocytes than those in the other concentrations according to Tukey's test. Conclusion: Snail mucus accelerated the inflammatory process during wound healing. Clinical significance: Snail mucus is a potential material to be developed into a drug to accelerate wound healing. The toxicity, biocompatibility, and stability of the 96% snail mucus gel must be tested to produce a useful phytopharmaca product.



Keerti Kaushik, Maninder Singh Sidhu, Seema Grover, Ashish Dabas, Namrata Dogra, Jasmine Nindra, Akriti Bhargarva

Comparative Three Dimensional Evaluation of Dentoskeletal Parameters using AdvanSync & Herbst Appliance in Class II Malocclusion: “A Randomized Controlled Trial”

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:228 - 233]

Keywords: AdvanSync, CBCT, Class II malocclusion, Fixed functional appliance, Herbst

   DOI: 10.5005/jp-journals-10015-2048  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the dental and skeletal changes of AdvanSync and Herbst appliance using CBCT. Materials and methods: A single blinded clinical trial was conducted with a total of 39 Class II division 1 patients during their skeletal growth spurt and were randomly divided into three groups; AdvanSync group (n = 13), Herbst group (n = 13), and fixed mechanotherapy group (n = 13) who matched for skeletal age, sex, and craniofacial morphology. CBCT was taken at Pretreatment (T1) stage and Post-treatment stage (T2) after 8 months of appliance placement. Treatment changes were evaluated between these two time points using dentoskeletal variables. Statistical comparisons were done using one-way ANOVA with post hoc Tukey's test. Results: A significant mandibular growth increment with Herbst and significant headgear effect with AdvanSync appliance was observed as compared to fixed mechanotherapy group. Both appliances showed significant increase in total mandibular length, anterior, and posterior facial height. Conclusion: The AdvanSync and Herbst appliance resulted in correction of the Class II malocclusion. The AdvanSync showed more dentoalveolar effects but less mandibular length increment when compared to Herbst. Clinical significance: This study suggests that if the Class II malocclusion is due to retrognathic mandible mainly and the patient is in peak pubertal growth spurt, Herbst is the appliance of choice as this appliance supports more skeletal changes while in Class II malocclusion with a more dental and less skeletal contribution AdvanSync appliance works well. Also the age of the patient and compliance support the use of the AdvanSync appliance as for this appliance treatment duration is lesser and it is more patient friendly.



Shruti Shivakumar, Sandeep S Arora, Thilla S Vinothkumar

Clinical Assessment of the Effectiveness of Three Different Controlled-release Drugs in the Management of Chronic Periodontitis: An In vivo Study

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:5] [Pages No:234 - 238]

Keywords: Chronic periodontitis, Controlled release drugs, Nonsurgical therapy, Scaling and root planning

   DOI: 10.5005/jp-journals-10015-2005  |  Open Access |  How to cite  | 


Aim: The aim of the current research was to evaluate the efficiency of metronidazole gel, tetracycline fibers, and chlorhexidine chip agents in the treatment of chronic periodontitis. Materials and methods: A total of 60 healthy patients free from systemic diseases and having chronic generalized periodontitis were chosen for the purpose of this study. The subjects thus included were subjected to phase I therapy consisting of scaling and root planning performed over two visits by a single clinician, following which oral hygiene advice was rendered. A week after phase I management, the subjects were called again and re-evaluated to verify the chosen criteria. Subjects who were thus elected based on the inclusion criteria were assigned at random to one of the three investigational groups as (20 subjects in each group) Group A: Metronidazole, Group B: Tetracycline fibers, Group C: Chlorhexidine Chip. The follow-up after 1 week was regarded as the baseline appointment. Documentation of the gingival index, plaque index as well as the periodontal pocket depth (PPD) during the baseline appointment, plus after 1 month and 3 months after baseline was done and subjected to statistical analysis. Results: The highest reduction of the gingival index (GI) values was noted with the use of chlorhexidine chip (0.88 ± 0.07 and 0.82 ± 0.11) in pursuit by tetracycline fibers (0.96 ± 0.13 and 0.88 ± 0.10) plus the metronidazole investigational group (1.02 ± 0.04 and 0.98 ± 0.10), respectively. Highest reduction of the PI values was noted with the use of tetracycline fibers (0.82 ± 0.14 and 0.76 ± 0.02) in pursuit by chlorhexidine chip (0.88 ± 0.18 and 0.94 ± 0.06) as well as metronidazole investigational group (1.18 ± 1.08 and 1.06 ± 0.21), respectively. The greatest reduction in PPD from 5.78 ± 0.14 to 3.14 ± 0.10 was noted with use of tetracycline fibers. Conclusion: The current research, amid its limitations arrived at a conclusion that although a thorough scaling as well as root planning (SRP) is efficient in managing consistent periodontal pockets, superior results can be attained by employing topically delivered metronidazole gel, tetracycline fibers as well as chlorhexidine chips as adjuncts to the management strategy employed. Clinical significance: Multiple chemical substances may be utilized subgingivally as a management strategy to augment the efficiency of nonsurgical mechanical periodontal treatment. Topical drug delivery systems into the periodontal pocket show potential as a treatment strategy to attain superior clinical results when employed as an adjunctive form of therapy to the traditional nonsurgical periodontal management techniques. Rigorous research labors at this time, concentrate on evolution of novel techniques for efficient management.



Yaser A Alhazmi, Sameena Parveen, Wafa H Alfaifi, Naif M Najmi, Somayah A Namazi, Lamees H Abuzawah, Nasser M Mashhour

Assessment of Knowledge, Attitude and Practice of Diabetic Patients Towards Oral Health: A Cross-sectional Study

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:239 - 244]

Keywords: Dental caries, Diabetes, Oral hygiene, Periodontal infection

   DOI: 10.5005/jp-journals-10015-1922  |  Open Access |  How to cite  | 


Aim: The study's objective was to measure diabetic patients’ knowledge and awareness of the risks of oral illnesses viz. periodontal/gum disease or dental caries and to assess their attitudes and practices toward maintaining good oral health through proper oral hygiene and regular dental check-ups. Material and methods: The study was a descriptive observational survey performed on 210 patients with diabetes in the Jazan region, Saudi Arabia. Structured questionnaires were utilized to assess the respondents’ social background, medical history, dental services usage, knowledge, values, and attitude toward oral health. Results: Results showed that approximately 70% of the study participants were unaware that oral illnesses, viz. dental caries, and periodontal infection, occur more in people with diabetes. Diabetic patients had a low degree of responsiveness and knowledge of oral health, although most diabetic patients were known to the numerous medical problems associated with diabetes such as viz. delayed wound healing, cardiomyopathy, retinopathy, and nephropathy, etc. Conclusion: The study results indicated a lack of awareness regarding oral health problems associated with diabetes; however, these patients were well aware of the systemic complications. Clinical significance: This study suggests a need to educate diabetes patients about the oral manifestations associated with diabetes. Further, this awareness and early diagnosis of oral complications due to diabetes will improve overall oral health in these patients.



Purva Verma, Ravindra K Jain

Visual Assessment of Extent of White Spot Lesions in Subjects treated with Fixed Orthodontic Appliances: A Retrospective Study

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:5] [Pages No:245 - 249]

Keywords: Fixed orthodontic appliance, Orthodontic treatment, White spot lesion

   DOI: 10.5005/jp-journals-10015-2042  |  Open Access |  How to cite  | 


Aim: White spot lesions (WSLs) are invariably found in patients undergoing orthodontic treatment. The aim of this study was to assess the extent of WSLs in subjects treated with fixed orthodontic appliances for variable time duration. Materials and methods: In this retrospective evaluation, photographic records of 205 subjects were assessed for extent of WSL using a surface area analysis app. The subjects were splitted into three groups based on duration of orthodontic treatment: Group A (n = 62): Patients who completed their treatment in 10–12 months; Group B (n = 68): Patients in whom orthodontic treatment was completed in 13–24 months, and Group C (n = 75): Patient with total treatment duration of 25–36 months. The measurements were made at two time points: T0, that is, pretreatment and T1, that is, postdebonding. Total dental area of maxillary teeth was calculated and areas involved with WSLs were calculated for each tooth. Extent of area involved was calculated using the formula: Area of WSL (T1)–Area of WSL (T0). Intragroup comparison was done using paired t-test, intergroup comparison was performed using one-way ANOVA. Results: Intragroup comparison revealed significant difference in extent of WSL at T0 and T1 in all three groups (p-value < 0.05). Intergroup comparison at T1 revealed a significant difference amongst three groups for the extent of WSLs. Conclusion: The extent of WSLs depends on the duration of orthodontic treatment. Increased duration of orthodontic treatment was associated with increased extent of WSLs as assessed on digital photographs using an application. Clinical significance: Longer orthodontic treatment duration is associated with increase in progression of WSLs. Patients undergoing orthodontic treatment, especially for longer duration, must undergo regular oral prophylaxis and should be instructed and motivated to maintain good oral hygiene. Fluoridated mouthwash and remineralizing dentifrices must be incorporated in the daily oral hygiene regime of such patients.



Maged S Alhammadi, Esam Halboub, Abdullsalam A Al-Dumaini, Sultan MA Malhan, Faris Alfaife, Jabril Otudi

Perception of Dental, Smile and Gingival Esthetic Components by Dental Specialists, General Dental Practitioners, Dental Assistants and Laypersons: A Cross-sectional Study

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:11] [Pages No:250 - 260]

Keywords: Dental professionals, Esthetics, Gingival, Perception, Smile

   DOI: 10.5005/jp-journals-10015-1918  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate perception of dental, smile, and gingival esthetic components by dental specialists, general dental practitioners, dental assistants, and laypersons. Material and methods: Seven standard photographs representing dental, smile, and gingival components were manipulated digitally. The sample composed of 465 [74 dental specialists (DS), 152 general dental practitioners (GDP), 97 dental assistants (DA), and 142 laypersons (LP)] assessed the normal and the digitally manipulated images on a visual analog scale ranging from 1 to 5 where 1 is the less pleasant image and 5 is the standard normal image. The data was analyzed using Mann-Whitney and Kruskal-Wallis tests, and multiple linear regression analyses. Results: Out of 100, the overall rate was 81.42 ± 10.8% with no statistical gender differences. Regarding the individual components, females exhibited significant perception for “midline diastema,” while males showed significantly better perception for “gingival marginal height.” General dental practitioners (GDP) showed significantly higher perception score than DS, DA, and LP did. Out of the seven evaluated components, five were differently perceived in favor of the GDP followed by DS and the lowest were for LP. Linear regression analyses revealed that the “participant's category” (GDP vs others) was the only independent determinant of the overall esthetic perception in addition to six individual esthetic components. Conclusion: GDP showed more favorable perception of dental, gingival, and smile esthetics than laypersons and other dental professionals with considerable variations. Clinical significance: The patients’ perception toward esthetics is to be considered over that perceived by dental professionals during daily dental procedures and smile design.



Maria A Sruthi, Deepa Gurunathan

An Evidence-based Classification on the Location of White Spot Lesions in Primary Teeth: A Pilot Study

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:5] [Pages No:261 - 265]

Keywords: Classification, Early enamel lesions, Primary dentition, White spot lesions

   DOI: 10.5005/jp-journals-10015-2044  |  Open Access |  How to cite  | 


Aim: The aim of this study was to detect white spot lesions (WSL) on the surfaces of the teeth and devise a new classification system to classify WSL based on their location/site of occurrence pertaining to primary dentition. Materials and methods: A total of 300 children were assessed, out of which, 271 participants were detected with WSL. Each tooth detected with white spots was analyzed based on their occurrence on the surface of the tooth. Descriptive statistics was performed using SPSS software. Results: Based on their site of occurrence in the maxilla and mandible, WSL were greatest on the cervical region of incisors (60.5% and 43.8%), middle region of the canines (82.3% and 87%), and proximal regions of molars (88.5% and 98%). Conclusion: Based on the results, a new system of classification for WSL in primary dentition is devised. It combines ICDAS II criteria (code 1 and 2) along with the site of occurrence of the lesion. The knowledge of its location on the surface of tooth aids in registering the remineralizing effects of the prescribed remineralizing agents during follow-up. Clinical significance: The classification allows for easy identification of white spots between observers and the positive effects of various remineralising agents can be appreciated if the appropriate site was already known.



Anagha Chonat, A Vasanthakumari, Selvabalaji Arumugam, Parthiban Saket, S Preethi Archana, S Dhivya

Awareness and Attitude of Parents regarding Malocclusion and Early Interception of Oral Habits-associated Dentofacial Deformity in Children

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:5] [Pages No:266 - 270]

Keywords: Dentofacial deformity, Early interception, Malocclusion, Oral habits

   DOI: 10.5005/jp-journals-10015-2043  |  Open Access |  How to cite  | 


Aim: This questionnaire study was formulated to investigate the awareness and attitude of parents toward malocclusion and early orthodontic treatment, thereby determining whether there is an association between parental perceptions toward their child's orthodontic treatment. Materials and methods: This descriptive, cross-sectional study was aimed to investigate parents’ awareness and concerns toward the effects of malocclusion and early orthodontic treatment. Parents of 500 children aged between 5 and 14 years diagnosed with oral habits associated malocclusion were only considered. An interviewer-administered structured close-ended questionnaire consisting of 10 questions was presented to the parents. The first segment consisted of questions related to parent's awareness of habits and malocclusion. The second segment questions were aimed to assess the attitude and concerns regarding of malocclusion and orthodontic treatment. The data collected were tabulated on a Microsoft Excel computer program, and descriptive statistics using the Chi-square test were carried out. The statistical analysis was performed using SPSS software V.20.0. Result: A total of 500 parents whose children were identified with malocclusion associated with habits completed the questionnaire, of which most parents (64%) noticed their child's irregular teeth. While 18% did not know any kind of oral habit causing irregular teeth in children, 66% did not believe that irregularly arranged teeth due to oral habits have an ill effect on a child's growth. Conclusion: Overall, a lack of awareness regarding malocclusion and early orthodontic treatment in children was observed among the parents. Parents should be motivated, informed, and educated regarding the prevention of malocclusion. More efforts should be made to initiate guardian/parental awareness about malocclusion and treatment in children. Clinical significance: Early implementation of preventive and interceptive orthodontics can help prevent further dentofacial complications and expenses of orthodontic treatment. It becomes the primary responsibility of dental health care professionals to educate the patient, their parents and create a general awareness about preventive and interceptive orthodontics and its benefits.



Snehalata Narvekar, Shridhar D Baliga, Sulakshana S Baliga

Infection Control Measures practiced by Oral and Maxillofacial Surgeons during COVID-19 Pandemic: A Cross-sectional Study

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:271 - 276]

Keywords: Covid-19, Infection control measures practices, Oral and maxillofacial surgeons

   DOI: 10.5005/jp-journals-10015-2045  |  Open Access |  How to cite  | 


Aim: Since the source of the coronavirus disease 2019 (COVID-19), it has become global health emergency. It is life threatening condition and dentistry has been classified as the high-risk job let alone be the oral and maxillofacial surgeons, because of direct exposure to blood and saliva. The standard although are good are not sufficient during the pandemic like COVID-19. Adequate screening as well as the proper infection control measures are recommended. To know Infection control measures practiced by oral and maxillofacial surgeons during COVID-19 pandemic. Materials and methods: A cross sectional study was conducted on 353 oral maxillofacial surgeons to know the infection control measures practiced by them during COVID pandemic. Results: This study shows that majority of infection control measures were practiced more in government hospitals when compared to private hospitals Chi-square test and logistic regression analysis was used. Statistical significance was set at p <0.05. Conclusion This study highlights that oral and maxillofacial surgeon practicing infection control measures like use of prophylactic medication, high volume extra oral suction, negative pressure room, use of heap filters, fumigation system, and use of chemicals for disinfection were less likely to be affected by COVID-19. Clinical significance: The findings of this study will help us to provide practical advice to oral surgeons regarding appropriate use of infection control measures to protect themselves from the risk of COVID-19 infection during surgical procedures. Key message: Extensive Infection Control Measures in the field of Dentistry should be practiced on daily basis especially during pandemic like COVID-19, to contain spread of infection.



Bachar Reda, Luca Contardo, Abbass El-Outa

Disc Displacement with Intermittent Lock: A Case Series of a Rarely-addressed Disorder

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:277 - 282]

Keywords: Disc displacement, Intermittent locking, Orofacial pain, Temporomandibular disorders, Temporomandibular joint

   DOI: 10.5005/jp-journals-10015-1912  |  Open Access |  How to cite  | 


Aim: We describe a series of five cases presented with disc displacement with reduction and intermittent lock (DDwRIL), from presentation to follow-up. Background: Disc displacement with reduction with intermittent lock is a temporomandibular disorder in which the disc is displaced and reduced, along with temporary locking leading to limited opening. Due to the fact that it has only been recognized as a separate disease in 2013, there is no clear guideline on the management of these cases. Cases descriptions: We present five cases of clinically established DDwRIL in different age groups. We walk through clinical presentation and diagnostic workup. Several modalities were used in the management of described cases from noninterventional management with counselling only to physical and splint therapies. Conclusion: Disc displacement with reduction, with intermittent locking is a challenging temporomandibular disorder with risk to progress into disc displacement without reduction and hence necessitates a tailored approach and long-term follow-up. Clinical significance: To our knowledge, this is the first case series reported on DDwRIL which provides detailed clinical presentation, examination, management, and discussion for orofacial pain practitioners as well as for future studies on this disease.



Aravind S Kapali, Lizbeth Raju, Vanishri C Haragannavar, C Satish, Roopa S Rao, K Vineeth, Rajanikanth Rajaram, SV Sowmya

Need for Panel of Immunohistochemical Markers in Primary Intraosseous Squamous Cell Carcinoma Ex Odontogenic Keratocyst

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:283 - 288]

Keywords: Immunohistochemistry, Malignant transformation, Odontogenic cyst, Odontogenic keratocyst, Oral squamous cell carcinoma

   DOI: 10.5005/jp-journals-10015-2055  |  Open Access |  How to cite  | 


Aim: A unique case of Primary Intraosseous Squamous cell carcinoma (PIOSCC) arising from the lining of OKC in a 49-year-old female patient, quite aggressive in nature is presented here. Background: The occurrence of (PIOSCC) from an odontogenic cyst is rare with the incidence being 0.3–3%. Case description: In the present case histopathology was deceptive owing to the presence of spindle-shaped cells. This prompted us to use a panel of immunohistochemical markers such as CD34, Pancytokeratin, CK5/6, SMA, S100, and p63 to differentiate from sarcoma. Conclusion: The probable pathogenesis for such a transformation into malignancy could be attributed to the hypothesis of chronic inflammation. According to the English literature review, 34 cases have been reported until now, with the present case being the 35th case. Clinical significance: This report emphasizes the use of immunohistochemistry to arrive at a definitive diagnosis in scenarios of overlapping histological features.



Hussain Almubarak, Wafa M Alqahtani, Shaik M Shamsudeen, Shaik M Asif, Jagadish Hosmani, Usha Balan, Suraj Arora, Imran Khalid

Prevalence and Risk Factors of Oral Cancer Among Saudi Women: A Systematic Review

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:5] [Pages No:289 - 293]

Keywords: Alcohol, Oral cancer, Saudi Arabia, Smokeless tobacco, Tobacco, Women

   DOI: 10.5005/jp-journals-10015-1917  |  Open Access |  How to cite  | 


Background: Incidence of oral cancer among women has been increasing globally. Consumption of tobacco and alcohol are predominant cause while other factors such as genetics, dietary habits, nature of occupation, and oral hygiene barely determine prevalence of oral cancer among women. Aim of this study was to conduct a systematic review to assess the prevalence and the risk factors of oral cancer among women of Saudi Arabia. Methods: Search was done with combination of keywords in Google database using English language from 1990 till August 2020 with inclusion criteria includes original research, reviews, and studies focused on the prevalence and risk factors of oral cancer among Saudi Women. Case reports, investigative methods, treatment modalities for oral cancer, and articles that focused on other type of cancers were excluded from the study. Results: Out of 2,373 articles obtained, nine articles were under final selection after removing duplicates, irrelevant articles for the current topics and after application of inclusion and exclusion criteria.These articles reviewed to identify useful insights about oral cancer among women with special focus on Saudi Arabia. Conclusion: Observed geographical differentials of oral cancer subject to the development indexes of countries indicate that incidence rate of oral cancer among Saudi women is relatively lower compared to other regions, due to less exposure to cancer-causing risks. Tobacco consumptions particularly smokeless tobacco (Shammah) is the dominant cause among Saudi women, followed by genetic factors. However, a continuous vigilance for oral cancer among women in Saudi Arabia is critically needed for reducing common risks factors of the disease.



Gargi Sarode, Urmi Ghone, Pranali Dhirawani, Maithili Manohar, Sachin Sarode, Namrata Sengupta, Sourav Sudrania

Venoms and Oral Cancer: A Mini-review

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:6] [Pages No:294 - 299]

Keywords: Animal venoms, Bioactive compounds, Conventional cancer therapies, Natural derivatives, Oral cancer, OSCC

   DOI: 10.5005/jp-journals-10015-2041  |  Open Access |  How to cite  | 


Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in the world. The commonly employed treatment plan for OSCC is surgery followed by radiotherapy or chemotherapy or both. These conventional therapies are widely accepted but they have certain side effects and perilous consequences. The main drawback of these treatment regimes is nonspecific cell death. Recent advances in oral cancer therapies have shown that some natural compounds, especially animal venoms, offer potentially effective anticancer and cancer-preventive properties. To overcome the harmful effects of conventional therapies, these natural products can be considered as promising safe substitutes for the currently used regimes. This article discusses various potential bioactive animal venoms studied for OSCC therapy. Further extensive research in this field will open new gateways in OSCC therapeutic options.



Jagadish Hosmani, Abdullah Alqarni, Khalil Assiri

Plausible Mechanism in Prevention/Reversal of Oral Psychosomatic Disorders vis-à-vis Endogenous Secretion of N, N-Dimethyltryptamine

[Year:2022] [Month:May-June] [Volume:13] [Number:3] [Pages:4] [Pages No:300 - 303]

Keywords: COVID-19, N, N-Dimethyltryptamine, Oral psychosomatic disorders, Temporomandibular disorders, Sleep bruxism

   DOI: 10.5005/jp-journals-10015-2046  |  Open Access |  How to cite  | 


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