World Journal of Dentistry

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2022 | July-August | Volume 13 | Issue 4

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Federico V Obino, Franco M Di Russo, Andrea Cicconetti, Alberto De Biase

Torsional Behavior of Nickel-titanium Rotary Instruments: What's New?

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:2] [Pages No:305 - 306]

   DOI: 10.5005/jp-journals-10015-1921  |  Open Access |  How to cite  | 



Mariana B da Cruz, Joana F Marques, Neusa Silva, Sara Madeira, Óscar Carvalho, Filipe S Silva, João MM Caramês, António DSP da Mata

Periodontal In Vitro Cells Response on Zirconia Implant Surfaces Textured with Milled Machining Micropores

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:9] [Pages No:307 - 315]

Keywords: Conventional milling, Human fetal osteoblasts, Human gingival fibroblast, Micro-pore, Zirconia

   DOI: 10.5005/jp-journals-10015-2058  |  Open Access |  How to cite  | 


Aim: The aim of this in vitro study was to investigate the influence of milled micropores created on zirconia implant surfaces with different widths, depths, and spacing on osteoblasts and fibroblasts cells response. Materials and methods: A total of 108 zirconia disks were produced using press-and-sintering techniques and randomly assigned in five groups textured with milled micropores with different dimensions of widths, depths, and spacings. All samples including control samples were sandblasted and acid-etched (SBAE). Fibroblasts and osteoblasts were cultured on disks for up to 14 days. Morphology and cellular adhesion were observed using scanning electron microscopy (SEM). Cell viability and proliferation were assessed using CellTiter-Blue® reagent and the alkaline phosphatase (ALP) activity was evaluated using a fluorometric enzyme assay. The levels of interleukin-1β, collagen type I, interleukin-8, and osteopontin were assessed using an appropriate enzyme-linked immunosorbent assay (ELISA) kit. The data was subject to statistical analysis performed using the IBM® SPSS® 24.0 software for Mac (SPSS, Chicago, USA). Group comparisons were tested using two-way ANOVA or Mann-Whitney U test with Tukey's multiple comparisons (Tukey's post hoc). Results were presented as mean ± standard deviation and the significance level was set at p < 0.05. Results: Cell viability and proliferation increase over time in all groups, in both cell lines, without significant differences between them. SEM images reveal adherent cells after 1 day of culture. The production of interleukin-1β, collagen type I, interleukin-8, and osteopontin did not show statistically significant differences, as well as the ALP activity when all groups were compared. Conclusion: Milled micro-pore dimensions between 10 μm and 100 μm on Zirconia implant surfaces with different widths, depths, and spacings did not improve periodontal cells behavior in SBAE surfaces. Clinical significance: The production of milled micro-pore modified Zirconia implant surfaces may help us to improve their clinical behavior.



Mazin Algahtani, Abdulhamid Al Ghwainem, Narendra V Penumatsa

Impact of Pediatric Drugs on Color Stability of Different Aesthetic Restorative Materials Used in Pediatric Dentistry: An In Vitro Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:4] [Pages No:316 - 319]

Keywords: Aesthetic restorative materials, Analgesics, Antibiotics, Spectrophotometer

   DOI: 10.5005/jp-journals-10015-2052  |  Open Access |  How to cite  | 


Aim: The current in vitro research aims to assess the effect of pediatric drug formulations on color steadiness of different aesthetic restorative materials employed in pedodontics. Materials and methods: This research studied three different aesthetic restorative agents based on which allocation was performed to three different investigational groups as under group 1: Composite resin, group 2: Giomer, group 3: Zirconia-reinforced GIC. Forty disk-like specimens were prepared for each of these materials, employing molds to attain a uniform size of 10 mm diameter by 2 mm thickness. For every specimen, the material was manipulated in accordance with the manufacturer's recommendations followed by adaptation to the mold. The specimen's from every material, that is, 20 for each medicinal liquid formulation, were subjected to immersion in two drugs in liquid form—Antibiotics (Amoxicillin and Clavulanic acid) and Analgesics (Ibuprofen and Paracetamol) thrice daily for 2 minutes at 37°C during the investigational tenure of 1 week. The shade/specimen color was evaluated employing a spectrophotometer in agreement with the CIELAB. Results: Following immersion in the antibiotic liquid, maximum resisting power toward color alteration was delineated by Giomer (2.62 ± 0.16–4.24 ± 0.06), pursued by Zirconia-strengthened GIC (2.40 ± 0.11–7.18 ± 0.10), then Composite resin (2.36 ± 0.03–9.02 ± 0.08) in that order. Following immersion in the analgesic liquid, maximum resisting power toward color alteration was delineated by Giomer (2.63 ± 0.14–4.88 ± 0.02), pursued by Zirconia-strengthened GIC (2.38 ± 0.10–8.48 ± 0.14), then Composite resin (2.42 ± 0.02–10.39 ± 0.12) in that order. Conclusion: According to the results of the current research, a conclusion may be derived that, although each of the aesthetic restorative materials depicted staining following exposure to two different medicinal liquid formulations, Giomer exhibited maximum resistance to color alteration than zirconia-strengthened GIC and composite resin. Clinical significance: The unceasing advice of pediatric medicines can display staining of both natural dentition as well as restorations. The esthetic appearance being a key apprehension for parents as well as their children these days, the enduring color steadiness of restorative materials is of the highest significance.



B K Sujani

Nonsurgical Periodontal Therapy Ameliorates Clinical Periodontal Parameters and Glycemic Levels in GDM Patients with Periodontitis

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:8] [Pages No:320 - 327]

Keywords: Clinical periodontal parameters, Gestational diabetes, Nonsurgical periodontal therapy, Periodontal disease

   DOI: 10.5005/jp-journals-10015-2065  |  Open Access |  How to cite  | 


Aim: To evaluate the effect of nonsurgical periodontal therapy on clinical periodontal parameters in pregnant periodontitis study participants with and without gestational diabetes mellitus (GDM) and to estimate the changes in glycemic level in GDM study participants with periodontitis, before and after periodontal therapy. Materials and methodology: The present study is an interventional, prospective trial. A total of 120 study participants were selected. Each subject was randomly assigned to one of the four groups comprising 30 study participants in each group, based on the diagnosis of the disease. Group 1 included pregnant study participants with GDM with periodontitis, group 2 included pregnant study participants with GDM with periodontitis, group 3 included pregnant study participants with periodontitis, and group 4 included pregnant study participants with periodontitis. Periodontal therapy comprising of scaling and root planing followed by oral hygiene instruction was performed in group 2 and group 4, whereas only oral hygiene instructions were given in group 1 and group 3 in the study participants at baseline. Periodontal parameters and glycemic levels were reassessed before parturition. The study data was analyzed using Statistical Package for Social Sciences (SPSS) software V.22, IBM, Corp. for Windows. Results: The study showed a significant reduction in all the clinical parameters in both the groups following nonsurgical periodontal therapy, along with a reduction in glycemic levels. However, the results were better in group 2 as compared to all other groups. Conclusion: Nonsurgical periodontal therapy (NSPT) in pregnant periodontitis study participants with or without GDM showed better clinical results and a reduction in glycemic levels. Clinical significance: Improvement in periodontal clinical parameters and reduction in glycemic levels following nonsurgical periodontal therapy in GDM with periodontitis study participants.



Sajid T Hussain, Jaideep Mahendra, Janani Muralidharan, Vivek Sharma

“Red-complex Bacteria in Patients with Plaque-induced Gingival Enlargement” Undergoing Fixed Orthodontic Therapy: A Cross-sectional Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:8] [Pages No:328 - 335]

Keywords: Bacteria, Orthodontic treatment, Periodontitis, Plaque

   DOI: 10.5005/jp-journals-10015-2062  |  Open Access |  How to cite  | 


Aim: The present study compares the quantitative analysis of the red-complex bacteria (RCB) in patients undergoing fixed orthodontic therapy with and without plaque-induced gingival enlargement. Materials and methods: Forty subjects undergoing orthodontic therapy were categorized into two groups: control group: 18 periodontally healthy subjects without plaque-induced gingival enlargement undergoing orthodontic treatment and study group: 22 subjects with plaque-induced gingival enlargement undergoing orthodontic treatment. Plaque index (PI), bleeding on probing (BOP %), simplified oral hygiene index (OHI-S), and probing pocket depth (PPD) were recorded. The type and frequency of tooth brushing were also assessed. Plaque samples were collected from the periodontal pockets and analyzed using real-time polymerase chain reaction (RT-PCR) for the detection of Treponema denticola (T.d), Tannerella forsythia (T.f), and Porphyromonas gingivalis (P.g), and statistical analysis was performed. Results: PPD, PI, OHI-S, BOP, type, and frequency of tooth brushing were higher in patients with plaque-induced gingival enlargement as compared to the controls. A significant increase in the levels of T.d, T.f, and P.g was found in both the groups, however it showed a statistical insignificance difference. Overall T.d was found to be more prevalent than T.f and P.g in both the groups. On correlating the RCB with the other variables. A positive correlation was seen with T.d and the oral hygiene index scores in the controls and the presence of T.d, T.f, and P.g with BOP and PPD in the study group. Conclusion: The expressions of RCB levels in the dental plaque of patients undergoing orthodontic treatment with and without the inflammatory enlargement were more or less the same however, T.d was found at higher levels than the other bacteria. Clinical significance: The study shows the association of the BOP and PPD and the presence of RCB in orthodontic patients with inflammatory enlargement putting these patients at a higher risk for periodontal attachment loss.



Mahali Sai Divya, Saraswati Srikanth Raju, Pallamala Gowtham

Correlation between Early Childhood Caries and Maternal Oral Hygiene Status: A Cross-sectional Study in Vijayawada, Andhra Pradesh, India

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:5] [Pages No:336 - 340]

Keywords: Children, Early childhood caries, Maternal oral hygiene

   DOI: 10.5005/jp-journals-10015-2054  |  Open Access |  How to cite  | 


Aim: This study was undertaken to evaluate the extent of influence maternal oral hygiene status exert on ECC below 6-year-old children. Materials and methods: The study was conducted in a random sample of 140 mother child pairs. A single calibrated examiner performed all clinical examinations under natural light using a mouth mirror and probe. Data such as the prevalence of caries in children, dental caries of the mothers was measured using DMFT index, plaque index (PI), and oral hygiene index (OHI) was obtained. The data was then tabulated and statistically analyzed. Results: Out of the 140 samples, 103 (73.57%) children had ECC of which 5–6 year children were more prevalent (84%). The association between ECC and mother's DMFT was significant (p = 0.0024). The correlation between ECC and mother's PI was significant (p = 0.0156). Conclusion: Maternal factors such as maternal dental caries and maternal oral hygiene status are important risk factors significantly associated with early childhood caries (ECC) in children. Clinicians should consider dental caries in the mother as a risk indicator for caries activity in children. Clinical significance: Mother needs to be counseled regarding their oral hygiene maintenance, which ultimately helps to prevent ECC at the primordial level.



Eldho Jijy Varghese, Tripuravaram VK Reddy, Kondas V Venkatesh

Comparative Evaluation of Mechanical Properties of Resin Luting Cement with Tooth-colored Nanoparticles: An In Vitro Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:7] [Pages No:341 - 347]

Keywords: Diametrical tensile strength, Hydroxyapatite nanoparticles, Shear bond strength, Titanium dioxide nanoparticles, Variolink N

   DOI: 10.5005/jp-journals-10015-2064  |  Open Access |  How to cite  | 


Aim: The aim of this study is to compare the shear bond strength and diametrical tensile strength of resin luting cement after the incorporation of titanium dioxide nanoparticles (TDNP) and hydroxyapatite nanoparticles (HANP). Materials and methods: Three main sample groups and three subgroups in the two experimental groups were made based on the weight percentage of nanoparticles. Forty-two samples were prepared by injecting the cement into a polytetrafluoroethylene (PTFE) mold positioned onto the occlusal surface of human maxillary second premolars embedded in acrylic blocks (prepared for bonding). Light curing was carried out following the manufacturer's instructions. The prepared samples were loaded at a crosshead speed of 1 mm/min on a universal-testing machine. The shear bond strength was evaluated by measuring the force (N) at which the bonding failed. Forty-two cylindrical samples were fabricated by injecting the cement into PTFE molds. The prepared samples were mounted on a universal-testing machine diametrically at a crosshead speed of 1 mm/min, and diametrical tensile strength was calculated by measuring the maximum force (N) at which the failure occurred. Results: Statistical analysis was carried out using one-way analysis of variance (ANOVA) and Tukey's honest significant difference tests. Maximum shear bond strength and diametrical tensile strength were achieved after 2 wt% of TDNP was incorporated into the resin luting cement (VARIOLINK N). Conclusion: TDNP can be considered a promising nanofiller for the manufacture of dental resin luting cement. Clinical significance: An ideal luting cement should have adequate bond strength and tensile strength properties to provide a durable bond for any indirect restorations. This study evaluates the shear bond strength and diametrical tensile strength after incorporating TiO2 and HANP into Variolink (Resin Luting Cement), which can be an eye-opener for manufacturing resin luting cement with potential nanoparticles as fillers.



Saransh Srivastava, Himani Sharma, Priyanka Tandon, Nikita Jain, Henna Singh, Sahitya Ambesh

Comparative Evaluation of the Outcome of Diode Laser 810 nm with 8% Arginine and Calcium Carbonate for the Management of Dentinal Hypersensitivity

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:5] [Pages No:348 - 352]

Keywords: Dentin hypersensitivity, Desensitizing toothpaste, Laser, Pro-arginine

   DOI: 10.5005/jp-journals-10015-2102  |  Open Access |  How to cite  | 


Aim: To compare and evaluate the adequacy of diode laser 810 nm, and 8% arginine with calcium carbonate (8% ACC) paste form (Pro-Argin™) for the management of dentinal hypersensitivity (DH). Materials and methods: Sixty-six patients contributing a total of 264 teeth severe hypersensitivity were randomly divided into three groups: group I: (n = 22) treated with 8% ACC paste form, group II: (n = 22) treated with diode laser 810 nm in contact mode, and group III: (n = 22) 8% ACC paste combination with diode laser 810 nm in contact mode. Tactile stimuli response was measured with visual analog scale (VAS) and air blast stimulation was measured by Schiff cold air sensitivity scale (SCASS) baseline, 15 minutes postapplication, 15 and 30 days post-therapy. Results: Significant reduction was noted in all groups in relation to VAS and SCASS scores (p-value < 0.001) on 15th day and 30th day. However, intergroup comparison revealed that the use of 8% ACC in combination with diode laser 810 nm in contact showed statistically significant decrease in sensitivity (p < 0.001) when compared to 8% ACC form and diode laser alone. Conclusion: The adjunctive utilization of diode laser 810 nm with 8% ACC shows a promising treatment alternative in alleviating DH. Clinical significance: Diode laser showed an immediate effect in combination with 8% ACC in the treatment of DH and the application or advising the same in people with DH will help in relieving their symptoms and will lead to better quality of life on a daily basis.



Arvina Rajasekar, Pratebha Balu, Dhanraj Ganapathy

Validation of True Perio: 14 Items Questionnaire for Assessing Patient-based Outcomes Following Periodontal Flap Surgery

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:5] [Pages No:353 - 357]

Keywords: Outcome, Periodontal flap surgery, QPBOPT, Quality of life, Questionnaire, Reliability, Validity

   DOI: 10.5005/jp-journals-10015-2063  |  Open Access |  How to cite  | 


Aim: This article aims to develop and validate a questionnaire to assess the patient-based outcomes following periodontal therapy (QPBOPT). Materials and methods: Questionnaire (QPBOPT) was formulated with 14 items, considering patient-based outcomes after periodontal therapy. Content validation was undertaken by seven experts in the field of periodontology and the questionnaire was pilot tested. Reliability was assessed using Cronbach's alpha and test–retest methods. The questionnaire was administered among 140 subjects, aged between 30 and 55 years who underwent periodontal flap surgery for periodontitis. Construct validity was done through principal component factor analysis. Results: Cronbach's alpha for the overall scale was 0.98 in this study, indicating a high correlation between the items, and the questionnaire was found to be reliable. Factor analysis explained a cumulative variance of 95.909%, which proved all the 14 items to be valid. Conclusion: Analysis of the data presented here shows that the questionnaire is valid and reliable for assessing the patient-based outcomes following periodontal therapy. Clinical significance: This questionnaire can be a very effective objective tool for the assessment of the treatment outcome following periodontal therapy.



Akhil Rajput, Umesh Kumar, Nikhil Sinha, Gulshan Kumar, Ruchi Vashisht, Krishan Gauba, Anup Kanase

Emergency Pain Management of Untreated Pulpitis during COVID-19 Lockdown by Telephonic Communication

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:4] [Pages No:358 - 361]

Keywords: Corticosteroids, COVID-19, Irreversible pulpitis, Teledentistry

   DOI: 10.5005/jp-journals-10015-2067  |  Open Access |  How to cite  | 


To evaluate the beneficial effects of orally administered corticosteroids in alleviating the pain of symptomatic pulpitis. Materials and Methods: Out of the 87 patients who contacted the expert panel telephonically during the period of COVID-19 lockdown, 55 patients complaining of moderate to severe dental pain were included in the study and thus advised to take oral tablets of paracetamol 650 mg postmeal thrice a day for 3–5 days along with a single oral dose of 4 mg of dexamethasone. The patients were asked to report their pain status after every 24 hours for at least 72 hours. In case of severe pain not controlled by these medicines even after 3 days, two tablets of dispersible ketorolac tromethamine (10 mg) were advised once on the fourth day, followed by a single tablet three times a day for another 3 days. In case the pain did not subside within 3 days of taking the second line of treatment, or there was a development of swelling/lymphadenopathy, the patient was advised to get the tooth extracted. Results: Out of 55 patients taking a single dose of dexamethasone, 47 (85.45%) patients reported a “significant” reduction of pain within 24–72 hours. The remaining eight patients (14.55%) in which severe pain was not controlled by paracetamol and dexamethasone even after 3 days, two tablets of ketorolac tromethamine (10 mg) were advised. Six patients (75%) reported a “significant” reduction in the pain, while two (25%) patients still in pain were advised tooth extraction and were referred to the emergency department of the tertiary care center. Conclusion: For the pain felt by patients diagnosed with symptomatic irreversible pulpitis, systemic corticosteroids administration is an adequate strategy in controlling pain for up to 48–72 hours, the time during which the pain is felt most.



Gaurav Patri, Surabhi Soumya, Prasanti Pradhan, Pratik Agrawal, S Lata

Radiographical Assessment of Periapical Lesion Resolution Following Nonsurgical Root Canal Treatment with Different Irrigation Protocols and Intracanal Medicaments

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:6] [Pages No:362 - 367]

Keywords: Calcium hydroxide, Modified triple antibiotic paste, Periapical diseases, Photoactivated disinfection

   DOI: 10.5005/jp-journals-10015-2060  |  Open Access |  How to cite  | 


Aim: To evaluate healing following nonsurgical treatment of periapical lesions using different intracanal medicaments and irrigation protocols. Materials and methods: Seventy-eight patients having periapical lesion were selected and randomly allocated into six equal groups based on the irrigation protocol followed and the intracanal medicament administered. The groups allocated were: positive pressure irrigation group (group I) and negative pressure irrigation group (group II). The subgroups were modified triple antibiotic paste (group Ia/IIa), photoactivated disinfection (group Ib/IIb), and calcium hydroxide (group Ic/IIc) subgroups. The patients were assessed radiographically based on the designated parameters at intervals of 3, 6, and 12 months. The data obtained were analyzed using one-way ANOVA with GPower software version 3.0. Kruskal Wallis test and Friedman test were used for intergroup comparison. An alpha level of 5% (p-value was <0.05) was considered significant. Results: Group II showed significantly better results than group I at 6 and 12 months (p = 0.042, 0.029). Group IIb showed the best healing at all time frames. Groups Ia and IIa showed better healing than group Ic and IIc at 6 and 12 months. Groups Ic & IIc showed the least amount of healing. Conclusion: The use of photoactivated disinfection (PAD) as an intracanal medicament and negative pressure irrigation for canal disinfection resulted in superior healing of periapical lesions. Clinical significance: Photoactivated disinfection resulted in superior canal disinfection followed by triple antibiotic paste and with negative pressure irrigation eventualized in better healing of periapical lesions. Calcium hydroxide was the least effective in canal disinfection and periapical lesion healing.



Muhamood Moothedath

Caries Risk Assessment in Young Adults of South Kerala with Multiple Dental Restorations Using the Cariogram with Salivary Tests

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:7] [Pages No:368 - 374]

Keywords: Caries risk assessment, Cariogram, Lactobacillus, Salivary test, Streptococcus

   DOI: 10.5005/jp-journals-10015-2071  |  Open Access |  How to cite  | 


Aim: The aim of this study was to determine the caries risk of young adults by using the Cariogram software and explore the interactions between the various caries-related factors and their associated caries risk determined by the Cariogram. Materials and methods: A cross-sectional comparative study was undertaken among 120 young adults (60 undergraduates and 60 postgraduates) aged 18–25 years. Clinical and radiographic examinations, salivary sampling, and a questionnaire on a diet were used to collect data from the study sample. The 10 distinct parameters of the Cariogram for each individual were obtained according to a preset scale of 0–2 or 0–3. The examiner gathered the data for each variable from the clinical examination or from laboratory tests, as well as from the completed questionnaire and dietary record. The favorable score was 0, while the unfavorable score was 3 or 2 in some circumstances. For each of the students studied, a caries risk profile was created, with the appropriate score assigned to each of the criteria to be considered by the software. The Cariogram model was then used to determine the caries risk profile of each individual in the study sample. Results: The study results depicted that most of the undergraduates (31.67%) and postgraduates (46.67%) had a good plaque index score. 36.67% had a Streptococcus count of 103,4 and 56.67% had a Lactobacillus count of less than 10.3 The salivary secretion rate of 41.67% of undergraduates and 38.33% of postgraduates was essentially normal at 0.9–1.1 ml/min. It was observed that 58.33% of the postgraduates had acceptable pH ≥6, and 3.33% of undergraduates had salivary pH between 4.5 and 5.5. Enumeration of salivary Streptococcus mutans and Lactobacillus, decayed missing filled teeth (DMFT), decayed missing filled surface (DMFS) score, salivary buffer capacity, plaque level, and use of fluoride supplementation were found to have a significant correlation with the caries risk determination. Conclusion: The Cariogram model can detect caries-related factors that may contribute to the anticipated caries risk. Streptococcus mutans count is the most important predictive factor in the model, followed by the DMFS, fluoride program, DMFT, Lactobacillus counts, buffer capacity, and plaque index. Preventive strategies can also be developed using these profile analyses to reduce or eliminate the risk of caries prevailing in the community.



Savita Abdulpur Mallikarjun, Sreedevi Das, Harsha Mysore Babu, Mahesh Ramanna Gowda, Archana Naik, Pallavi Nanaiah

Comparative Evaluation of Herpes Viruses in Chronic Periodontitis with and without Generalized Anxiety Disorder: A Clinico-microbial Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:7] [Pages No:375 - 381]

Keywords: Chronic periodontitis, Generalized anxiety disorder, Herpes viruses, Multiplex polymerase chain reaction, Stress

   DOI: 10.5005/jp-journals-10015-2053  |  Open Access |  How to cite  | 


Aim: The present study was aimed to detect, compare and correlate the presence of herpes simplex virus (HSV)—1, HSV-2, human cytomegalovirus (HCMV), and Epstein-Barr virus (EBV) in chronic periodontitis patients with and without generalized anxiety disorder (GAD). Materials and methods: A total of 45 patients, aged 30–55 years were divided into three groups of 15 study participants each into chronic periodontitis; chronic periodontitis with GAD and those without chronic periodontitis and without GAD groups based on the inclusion criteria. Subgingival plaque samples were collected using curettes from the deepest periodontal pockets and sent in transport media containing tris–ethylene diamine tetra acetic acid (EDTA) and analyzed using multiplex polymerase chain reaction (MPCR). Statistical analysis was done using Chi-square test and Spearman's correlation analysis. Results: The results of our study showed that there were elevated levels of HSV-1, HSV-2, EBV, and HCMV in the chronic periodontitis with GAD group as compared to the chronic periodontitis group with statistically significant difference observed only between the levels of EBV. The correlation analysis showed positive correlations between the herpes virus and the bleeding and plaque indices scores. On examining the correlation between herpes viruses, positive correlations were noticed between HSV-1 and EBV, HSV-1 and HCMV, and EBV and HCMV. Conclusion: Positive association of herpes viruses in GAD patients in this study suggests a possibility of viral role in the etiology of chronic periodontitis. Clinical significance: Treatment of GAD and chronic periodontitis simultaneously could reduce stress and viral load, thus contributing to down regulation of the progress of the chronic periodontitis.



Divya Gupta, Shalini Garg, Abhishek Dhindsa, Sarang Khajuria

Treatment of Deeply Carious Vital Primary Molars by Complete Caries Removal Using Three Different Bioactive Materials: A Pilot Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:7] [Pages No:382 - 388]

Keywords: Bioactive materials, Biodentine, Deep caries, Direct pulp capping, Indirect pulp capping

   DOI: 10.5005/jp-journals-10015-2061  |  Open Access |  How to cite  | 


Aim: Present prospective clinical study compared success following the treatment of deep carious primary molars by complete caries excavation (CCE) technique followed by indirect pulp capping (IPC) or direct pulp capping (DPC), as needed per case, with three different bioinductive materials over 12 months. Materials and methods: IPC or DPC was done on CCE in 45 molars of 31 children (mean age 5.74). Both the procedures were done with one of the materials randomly assigned to group I: White mineral trioxide aggregate (MTA) (n = 15, 33.3%), group II: Biodentine (n = 16, 35.5%), and group III: Dycal (n = 14, 31.2%). It was followed by restoration with resin-modified GIC and composite. Results: Tooth was used as a unit of analysis. Twenty-seven children with 41 teeth could complete 12 months’ follow-up. DPC was done in 20% of molars while IPC in 80% of molars. The success rate of CCE irrespective of the materials and in procedure pulpal exposure was 91.1%. MTA showed 100% success, followed by Biodentine with 94 and 75% in the Dycal group. Conclusion: CCE may be considered a definitive procedure in treating deeply carious primary molars when we use calcium silicate-based materials, MTA or Biodentine, compared to Dycal in IPC and DPC procedures. Clinical significance: Calcium silicate pulp capping may be a reliable option for treating deep carious primary molars, even in the cases of pulpal exposure during the procedure.



Santhosh Kumar Vellingiri, Shruti Shivakumar, Banibrata Lahiri, Aaquib Hashmi, Chaitra A Shivakumar, Niveditha Varmudy

In Vitro Assessment of the Wettability of Three Commercially Available Saliva Substitutes on Denture Base Material: A Comparative Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:5] [Pages No:389 - 393]

Keywords: Contact angle, Denture base material, Saliva substitute, Wettability

   DOI: 10.5005/jp-journals-10015-2057  |  Open Access |  How to cite  | 


Aim: To evaluate the wettability of three commercially obtainable saliva substitutes on denture base materials. Materials and methods: One hundred specimens of heat-cured acrylic resin were fabricated for the purpose of recording the contact angulations of the salivary substitute on its surface. A 100 specimens were randomly allocated into one of the following four groups comprising 25 specimens each: group A: Distilled water, group B: Aqwet, group C: Wet Mouth, group D: Moi-Stir. Using dental plaster the wax specimens were subjected to investment in dental flasks. The traditional method of acrylization was performed as per the recommendations of the manufacturer to procure 100 resin specimens. The specimens were subjected to drying and visualized under the SEM to evaluate the finish. The contact angulations that were advancing/receding were assessed with a goniometer employing the dynamic contact angle evaluation. Results: The Aqwet group (72.89 ± 1.24 and 64.30 ± 3.02) displayed the lowest mean advancing/receding contact angles, in pursuit by Moi-Stir (79.12 ± 2.04 and 70.67 ± 2.41), Wet Mouth (82.28 ± 2.46 and 76.16 ± 2.70) as well as Distilled water groups (85.31 ± 3.02 and 80.24 ± 2.49). A statistical significant difference with p < 0.001 was noted amid the experimental groups. Conclusion: Within the limitations of this research, a conclusion arrived at the Aqwet group having lower advancing and receding contact angle values compared to Moi-Stir, Wet Mouth as well as Distilled water groups upon heat-cured acrylic resin. On the basis of the measurements of contact angles, Aqwet salivary substitute exhibited superior wettability of the heat-cures acrylic resins. Clinical significance: A key characteristic affecting oral ease is the wettability of the denture tissue surface by saliva coupled with complete denture retention, especially in patients affected by xerostomia. Therefore, saliva substitutes consisting of thickening agents provide longer relief, increased moistening, and lubrication of the oral surfaces, hence exhibiting good wetting of the tissue surface of the denture.



Nutchaporn Sanguansin, Parin Chinwanitcharoen, Supakorn Asavarachan, Chatchawan Sasiwilasakorn, Vorapak Chaikornkij, Supanee Thanakun, Suchada Vuddhakanok

Emerged Medically Compromised Conditions in Thai Patients Visiting a Private Dental School

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:6] [Pages No:394 - 399]

Keywords: Cross-sectional study, Dental practice management, Dental records, Dental school, Thai

   DOI: 10.5005/jp-journals-10015-2075  |  Open Access |  How to cite  | 


Aim: To investigate medical conditions and medication use in dental patients visiting a private dental school and determine association among these factors. Materials and methods: Medical and personal profiles from systematically selected 712 dental chart records were reviewed and analyzed. Results: Females (457 patients; 64.2%) were more prevalent than males. Ages ranged between 12 and 84 years, with a median age of 27 (21, 49). The medical conditions and medication use were revealed in 217 (30.5%) and 136 (19.4%) patients with female preponderance. The most common medical conditions were hypertension (9.9%), allergy (9.1%), and diabetes mellitus (DM; 3.7%). The most prevalent drugs were drugs for hypertension and cardiovascular diseases (CVDs; 8.6%), followed by anti-diabetic drugs and drugs for thyroid disorders (4.1%). Antidyslipidemic drugs (2.7%) were usually observed. Significant associations of males with obesity, systolic blood pressure, smoking, and alcohol consumption were demonstrated (p < 0.001). Females were related with underweight (p < 0.001) and diastolic blood pressure (p = 0.009). Dental patients with overweight or obesity had a higher likelihood of having a history of hypertension or DM than normal or underweight patients [odds ratio (OR) = 15.62; 95% confidence interval (CI) 8.27,29.51; OR = 4.49; 95% CI 1.90,10.64; p = 0.001, respectively]. Drug allergy was frequent (7.3%), with the highest penicillin prevalence (35.3%). Filling, scaling, and oral surgery were the regular previous dental treatment. Medical consultation, significantly associated with high blood pressure levels and medical conditions, was stated in 32 (4.4%) participants. Conclusion: High number of medically compromised dental patients is demonstrated. Dentists should take a careful history of dental patients’ health status to render the most beneficial treatment. Clinical significance: High incidence of medical conditions and medication use in dental patients is revealed. Thorough history taking, careful clinical examinations, and knowledge about systemic diseases and medications taken by dental patients are fundamental requirements before any dental procedures.



Abhra R Choudhury, Anil V Ankola, Deepika Valakkunja, Apurva Deshpande, Atrey P Khot

Change in Knowledge, Awareness, and Perception of Dentists Regarding COVID-19 in Belagavi City, Karnataka: A Questionnaire Study

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:6] [Pages No:400 - 405]

Keywords: Awareness, COVID-19, Dentists, Knowledge, Perception, Questionnaire

   DOI: 10.5005/jp-journals-10015-2073  |  Open Access |  How to cite  | 


Aim: The study aims to assess the change in knowledge, awareness, and perception about COVID-19 among the dentists in Belagavi city, Karnataka. Materials and methods: A cross-sectional study was conducted among 212 dentists in Belagavi city, Karnataka. A self-designed questionnaire consisting of eight close-ended and five open-ended questions was used for the data collection in two phases, once in June 2020 and once in December 2020. All the data relating to demographic details followed by knowledge, awareness, and perception of dentists regarding COVID-19 were recorded. Descriptive statistics, Chi-square test, and McNemar test were used. Results: A total of 212 dentists participated in both phases of the study in June 2020 and December 2020. Most of them (39.6%) belonged to the age-group of 35–45 years, and 41.5% had more than 5 years of working experience in a private clinic. In phase 1 of the assessment of June 2020, almost 86.3% of the dentists agreed that dentists should use personal protective equipment kits for treatment, but only 35.8% knew what was included. There was a change in the knowledge, awareness, and perception in the second phase in December 2020 which was statistically significant. Conclusion: The knowledge, awareness, and perception of the dentists regarding COVID-19 in Belagavi city in December 2020 have increased when compared to June 2020. The ready availability of information and easy acquirement of knowledge, leading to better adaptability were the major reasons behind it. Clinical significance: The knowledge, awareness, and perception type of assessment regarding COVID-19 among the dentists in Belagavi city is important to analyze and evaluate their readiness to restart dental practices and how prepared they are in doing so.



Sanam Faheem, Rimsha Qasim, Syed JA Zaidi, Shahida Maqsood

Misconceptions and Cultural Practices toward Infant Teething among Mothers Visiting a Public Dental Hospital

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:6] [Pages No:406 - 411]

Keywords: Hospital, Infant, Mothers, Teething

   DOI: 10.5005/jp-journals-10015-2089  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to ascertain mothers’ awareness of the teething process in children, their associated symptoms, adopted cultural practices, and medicines given to relieve these symptoms. Materials and methods: A total of 115 mothers participated in this study that was conducted in the Dental Outpatient Department (OPD) of Dow University of Health Sciences from July 2021 to September 2021. The prevalidated adapted questionnaire consisting of 20 items which included mothers’ sociodemographic details, mothers’ awareness regarding the teething process, and cultural practices to relieve these symptoms was administered. Chi-square tests of significance (Fisher's exact test) were used with a 95% confidence interval while the p-value was set at less than 0.05 for statistical significance. Results: Out of 115, half of the mothers knew the completion dates of deciduous dentition, that is, approximately 3 years that was statistically significant with education. Fifty-two percent of the mothers expressed their concern when their children started teething which was correlated with education. Ninety percent of the mothers reported that teething was associated with different symptoms. Fever was the most reported symptom during teething followed by diarrhea and poor appetite. On worsening of teething symptoms, 61 (53%) mothers took their children to the hospital. Paracetamol was the most common medicament given by 59 (51.3%) mothers which was associated with their education and occupation. The majority of mothers did not associate teething symptoms with their older children and siblings and this was correlated with mothers’ education. Conclusion: In this study, awareness of teething symptoms was directly correlated with mothers’ educational levels. Misbeliefs of teething such as the association of diarrhea and fever with teething and the use of medicines for teething was prevalent in mothers having no professional education. Half of the mothers gave paracetamol during the teething period but some from the other half were dependent on harmful unregulated homeopathic drugs. Clinical significance: Mothers have wrongful beliefs regarding infant teething in Pakistan which endangers children's well-being. Harmful homeopathic drugs are being given for symptoms which have no relation to the teething process. Moreover, these misconceptions might delay accurate diagnosis of other ongoing diseases.



Wafa Khan, Vanishri Haragannavar, Anand Devaraj, BR Rajanikanth, Roopa S Rao, SV Sowmya

An Unusual Case of Intravascular Oral Nodular Fasciitis: A Case Report/Review

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:5] [Pages No:412 - 416]

Keywords: Muscle specific actin, Nodular fasciitis, Smooth muscle actin, Vimentin

   DOI: 10.5005/jp-journals-10015-2074  |  Open Access |  How to cite  | 


Aim: The term spindle cell lesion, or tumor, is a purely descriptive one. This manuscript aims to report a rare case of nodular fasciitis (NF). Background: Nodular fasciitis is a rapidly growing soft tissue myofibroblastic lesion that represents a tumor-like mass with low recurrence rate of 1–2%. Upto 20% of cases are reported to occur in the head and neck region but these lesions in the oral cavity are extremely rare and tend to affect children more. Case report: Overlapping clinico-radiographic and microscopic features make NF a diagnostic challenge not only for the clinicians but for the histopathologist as well. The case reported here is unique because of its occurrence in older age-group and its location. Conclusion: The deceptive clinical behavior coupled with nonspecific histologic features makes this lesion challenging to diagnose. Accurate diagnosis is important to avoid unnecessary and mutilating surgeries. Clinical significance: Immunohistochemistry (IHC) panel of markers vimentin, smooth muscle actin, muscle specific actin, desmin, CD34, S-100, and Ki-67 aided in solving the diagnostic dilemma.



Mathew T Maliael, Ravindra K Jain, M Srirengalakshmi

Effect of Nanoparticle Coatings on Frictional Resistance of Orthodontic Archwires: A Systematic Review and Meta-analysis

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:8] [Pages No:417 - 424]

Keywords: Friction, Nanoparticles, Orthodontic archwires, Orthodontics

   DOI: 10.5005/jp-journals-10015-2066  |  Open Access |  How to cite  | 


Aim: This review aims to perform a systematic evaluation of the literature and report on the effect of nanoparticle (NP) coating on frictional resistance (FR) of orthodontic archwires. Background: Frictional resistance offered by archwires and brackets during orthodontic treatment can be minimized by surface treatment, and NP coating of archwires and brackets has been reported to reduce FR. Review results: A total of ten in vitro studies were included in the qualitative analysis, and five studies were included in the quantitative analysis for this review; eight of the included articles identified a significant decrease in FR of the coated wires when compared to uncoated wires. The overall methodological quality of the included studies was moderate. There was a significant reduction in FR of NP coated SS wires (MD = −1.28N; 95% CI: −1.90, −0.67; p < 0.0001) and NiTi wires (MD = −0.19N; 95% CI: −0.28, −0.15; p < 0.00001) when compared with uncoated wires. Conclusion: Both qualitative and quantitative assessment of the available literature suggests a significant reduction in FR of orthodontic archwires subjected to NP coating. Clinical significance: Nanoparticle coating of archwires reduces FR; hence during orthodontic treatment coated archwires can be used to obtain better results.



Nabeeh A Al Qahtani

Role of Bone Marrow Mesenchymal Stromal Cells (BMMSCs) in Osseointegration among Diabetic Patients with Dental Implants

[Year:2022] [Month:July-August] [Volume:13] [Number:4] [Pages:7] [Pages No:425 - 431]

Keywords: Bone marrow mesenchymal stromal cells (BMMSCs), Dental implants, Diabetic patients, Osseointegration, Osteogenic potential

   DOI: 10.5005/jp-journals-10015-2072  |  Open Access |  How to cite  | 


Aim: This review aims to explore the literature regarding the potential of bone marrow mesenchymal stromal cells (BMMSCs) in enhancing the osseointegration of dental implants among diabetic patients. Background: Dental implants are a viable and popular option in oral rehabilitation. Various factors such as local, systemic, mechanical, and prosthetic factors play a crucial role in the successful osseointegration of dental implants. Diabetes mellitus (DM) is known to affect the survival of dental implants. Among the various methods developed to improve the survival rates in DM, bone marrow mesenchymal stem cells (BMMSCs) are gaining attention for their regenerative purposes. That could strengthen the osseointegration process in patients with DM. Review results: This review identified significant studies describing the effects of diabetes on stem cells and thereby affecting osseointegration. We identified studies that reported DM to have a negative impact on osseointegration of dental implants. We also found evidence that BMMSCs can improve the implant survival rate by enhancing osseointegration. Further, various methods of stem cell culture and scaffolds are discussed. Though the BMMSCs-coated implants improve implant survival rates, we could find only a few studies of stem cell-coated implants in diabetes. They show a positive result in diabetic subjects. Conclusion: Within the limitation of this comprehensive review, it can be concluded that BMMSCs enhance the osseointegration of dental implants among diabetic patients when their medical condition is wellcontrolled. Further double-blinded randomized controlled clinical trials are warranted to establish the clinical applicability of BMMSCs in dental implants in various systemic conditions. Clinical significance: Though literature supports implants in DM, many studies have proven the impaired osseointegration in DM. This review elaborates on the impactful role of BMMSCs in promoting the osseointegration of the implants placed in well-controlled diabetic patients.


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