World Journal of Dentistry

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2022 | September-October | Volume 13 | Issue 5

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Yaseer Arafat, Yenugula N Kumar, A. Thirumal Raj

Toothbrush, a Potential Source for SARS-CoV-2 RNA Detection

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:1] [Pages No:433 - 433]

   DOI: 10.5005/jp-journals-10015-2039  |  Open Access |  How to cite  | 



Claudia Ferdeghini, Luca Mirabelli, Edoardo Bianco, Subhalakshmi Hari, Marcello Maddalone

Oral Manifestations in Hospitalized COVID Patients

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:7] [Pages No:434 - 440]

Keywords: Ageusia, COVID-19, Oral manifestations, White tongue, Xerostomia

   DOI: 10.5005/jp-journals-10015-2082  |  Open Access |  How to cite  | 


Aim: Evaluation of oral lesions in COVID-hospitalized patients, analyzing the potential etiopathogenetic mechanisms. Materials and methods: We evaluated a total of 58 hospitalized COVID patients in the time span from April 2021 to May 2021. The group analyzed consists of 38 male patients (66%) and 20 female patients (34%), aged between 22 and 92, with a preponderance of 60–80 years. All patients underwent an oral evaluation in order to detect the various oral manifestations; moreover, the onset time of these lesions has been correlated with the time of manifestation of the general symptoms of COVID infection. Results: Xerostomia has been the most frequent oral manifestation detected (30 patients, 51.7% of the sample), followed by ageusia (16 patients, 27.6%), and white tongue (13 patients, 22.4%). Other oral manifestations observed were aphthous lesions, fissured tongue, metallic taste, tingling in the lip and chin, and burning mouth syndrome. Conclusion: Our findings show a significant correlation between the oral manifestations and the burst of viral replication phase in COVID patients. Clinical significance: Awareness of the possible oral manifestations of COVID infection is important to conduct a correct diagnosis in oral pathology.



Noha T Alloush, Nesrin A El-Mahrouky, Shereen M Kabeel, Ramez R Mostafa, Ahmed M Elwan, Adel T Alloush, Eman Hamid

Impact of Mandibular Implant-supported Overdenture on Changes of Electromyographic Activity, Brain Activity, and Cognitive Function: A Crossover Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:8] [Pages No:441 - 448]

Keywords: Conventional dentures, Edentulous patients, Electroencephalography, Electromyography, Implant-supported Overdentures, Mini-mental state examination

   DOI: 10.5005/jp-journals-10015-2111  |  Open Access |  How to cite  | 


Aim: The aim of this study was to assess and compare the impact of a complete mandibular denture and mandibular implant-supported overdenture on electromyographic activity, brain activity, and cognitive function among the same edentulous patients. Materials and methods: Ten completely edentulous nondenture wearers were selected. To assess the brain activity and cognitive function, electroencephalogram (EEG), mini-mental state examination (MMSE) questionnaire, and electromyographic examination of temporalis and masseter muscles were used. Data was collected before complete denture construction, 1 and 3 months after complete denture construction, and 1 and 3 months after implant-supported overdenture insertion. The results were statistically analyzed with the Statistical Package for the Social Sciences (SPSS) 17.0 version using the Wilcoxon signed-rank and Friedman test. Results: The results of this study revealed a statistically significant increase in the mean amplitude of the alpha wave, improvement in cognitive function (MMSE), and activity of the temporal and masseter muscles after implant insertion compared to complete denture insertion. Conclusion: Rehabilitation with implant-retained mandibular dentures may result in increased masticatory function with better chewing and increased brain activity after chewing, which may have a significant positive effect on cognitive functions and oral and general health in edentulous patients. Clinical significance: Implant-retained mandibular dentures are a beneficial treatment option for patients at risk of, or who wish to prevent, cognitive deterioration and impairment, and maintain their general health.



Radhakrishnan Prabhu, Ramachandra Prabhakar, Ramachandran Saravanan, Khalid Ghiaz, R Ganesh Kumar, Saravanan Muthiah, Vidya G Shankar

Influence of Cocos nucifera Oil Extract on the Caries Activity of Removable Partial Denture Wearers: Thirty-six Months Follow-up

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:5] [Pages No:449 - 453]

Keywords: Caries activity, Cocos nucifera oil, Oil pulling, Partial dentures, Removable dentures

   DOI: 10.5005/jp-journals-10015-2083  |  Open Access |  How to cite  | 


Objective: This study aimed to evaluate the intraoral caries activity of removable partial denture wearing patients with the use of Cocos nucifera oil as an adjuvant to routine oral hygiene measures. Materials and methods: Removable partial dentures were done for 63 patients and caries assessment was done for the remaining natural teeth which were used as the abutments for serving the purpose of retention and also for the non-abutment teeth. International Caries Detection and Assessment System (ICDAS) criteria of caries assessment was done following the regular use of C. nucifera oil. Standard protocols were followed, and revisits were carried out every 6 months duration for 36 months for assessment of the progression of caries activity. Qualified dental personnel examined the denture wearers for the entire study period. Results: Clinical evaluations were done after the restoration of the partially edentulous patients for an average of 6 months with the use of C. nucifera oil. About 82% of the teeth made had no noticeable difference in the caries activity status and 57% of the sample were without any signs of active caries activity. Results indicate that there was no loss of both the abutment and non-abutment teeth due to caries activity during the observation period, ensuring a 91% caries protection rate. Conclusion: C. nucifera oil exhibits caries protective activity and satisfactory survival rate without any loss of remaining natural teeth among removable partial denture wearing patients during the 36 months observation period.



Anuradha Patil, Shalini Aggarwal, Tejas Pol, Sanchita Bhor, Vanitha Shenoy, MV Sumanthini

Retreatment Efficacy of Hand vs Rotary Instrumentation in Oval-shaped Root Canals: An In Vitro Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:6] [Pages No:454 - 459]

Keywords: Endodontic Retreatment, Gutta-percha, Hedström files, Oval-shaped canal, ProTaper, R-Endo

   DOI: 10.5005/jp-journals-10015-2088  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the efficacy of the ProTaper Universal Retreatment system (PTUS) and R-Endo rotary instruments with Hedström files (H-files) for the removal of gutta-percha (GP) in Retreatment of oval-shaped root canals. Methods: Sixty mandibular premolars with one single straight canal were selected. These were instrumented with K-type files and filled using cold lateral compaction and sealer. Further, they were randomly divided into three groups of 20 each. Specimens were retreated with GP solvent and were split longitudinally. Root canal walls were examined using a stereomicroscope attached to Image Analyzer Software (MVIG 2005, Chroma Systems, India) to evaluate the cleanliness of root canal walls. Moreover, separated instruments during Retreatment and time required to remove obturating material were noted. Results: Residue percentage was lesser (Tukey's test, p < 0.01) when the PTUS was used than when the R-Endo and H-files were used. Most of the residue in all specimens was in the apical one-third [analysis of variance (ANOVA), p < 0.01]. However, the time for removal of the root canal filling was lower with rotary files as compared with H-files. There was one fractured instrument in the PTUS group. Conclusion: In this in vitro study, leftover residual filling material was found inside the root canal system, mainly in the apical third. The PTUS proved to be an efficient method of removing GP and sealer from mandibular premolars. More studies should be carried out using another endodontic Retreatment system to evaluate the efficacy in oval-shaped canals. Clinical significance: For the success of endodontic Retreatment complete removal of previous endodontic material is required for the elimination of endodontic microflora from the root canal system. Many techniques and instruments have been advocated in endodontic Retreatment to remove obturating materials. However, residues of filling materials and iatrogenic errors have been observed. Removal of GP is always challenging in oval-shaped root canals. The findings of this study will enable clinicians to select the endodontic file system to provide optimal patient care.



Sattyam Wankhade, Suryakant Deogade, Vinay Dutta

Impact of Oral Rehabilitation on Patients with Post-COVID-19 Mucormycosis Using Liverpool Oral Rehabilitation Questionnaire in Central India: Qualitative Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:5] [Pages No:460 - 464]

Keywords: Liverpool Oral Rehabilitation Questionnaire, Post-COVID-19 mucormycosis, Prosthetic rehabilitation, Quality of life

   DOI: 10.5005/jp-journals-10015-2093  |  Open Access |  How to cite  | 


Aim: This study aimed at qualitatively assessing post-COVID-19 mucormycosis prosthetically rehabilitated patients using Liverpool Oral Rehabilitation Questionnaire (LORQ) in Central India. Materials and methods: Forty-eight subjects were included in the study who were prosthetically treated post-COVID-19 mucormycosis and who were willing to participate in the study. The LORQ with certain modifications was given to the targeted population 1 week after the delivery of the prosthesis. Wilcoxon paired test was used to analyze the results and p-value ≤0.05 will be considered to be significant. Results: For all the individual questions, LORQ showed a significant decrease following the treatment (p < 0.05) except for Q3 (did you have mouth dryness?) where there was no significant difference between pre and postscores. Conclusion: On comparing the databases, it could be concluded that prosthetic rehabilitation of post-COVID-19 mucormycosis patients significantly improved the quality of life (QOL). Clinical significance: Since there is a lack of data regarding the impact of prosthodontic intervention on the life of people suffering from post-COVID-19 mucormycosis, this study was planned out. The result of this article will help clinicians to plan out future treatment strategies and modalities and have a better communication with the patient regarding the prosthetic outcome beforehand and endeavor the need of the patient.



Nisha Garg, Komalpreet Kaur, Sandeep Gupta, Virinder Goyal, Hyeon C Kim

An In Vitro Study of Shear Bond Strength of Various Dentin Bonding Agents in Class V Cavities

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:4] [Pages No:465 - 468]

Keywords: Bond strength, Bonding agents, Class V cavities, Micromechanical bonding, Molecular dispersion technology

   DOI: 10.5005/jp-journals-10015-2092  |  Open Access |  How to cite  | 


Aim: To compare and assess the shear bond strength of 4th, 5th, 6th, and 7th generation dentin bonding agents in class V cavities. Materials and methods: Freshly extracted 120 premolars were randomly divided into four different groups, that is, 4th generation (3M Multipurpose Scotchbond adhesive: Group 4G), 5th generation (Prime and Bond: Group 5G), 6th generation (Clearfil SE: Group 6G), and 7th generation (Tetric-N-Bond: Group 7G) dentin bonding agents. Class V cavities were prepared in all samples and dentin bonding agents were applied as per the manufacturer's instructions after placing a 26-gauge orthodontic wire at base of the cavity and cavities were then restored with composite resin. The cavities were then stored in distilled water for a period of 24 hours and the shear bond strength was evaluated after 24 hours using the Universal Instron strength testing machine. Statistical analysis was done using one-way analysis of variance (ANOVA) and post hoc Tukey's test to compare the bond strength among four groups. Results: Group 6G showed highest mean shear bond strength while the group 5G showed the lowest (p < 0.05). Scanning electron microscopic (SEM) results showed gap-free resin dentin interface and hybrid layer in group 6G while maximum gap was seen at the resin-dentin interface in group 5G. Conclusion: Based on the data revealed, it appears that contemporary self-etching dentin bonding agent (6th generation) represented the highest bond strength and has a significant difference than other groups. Clinical significance: Based on results of this study, we can select the bonding agent of high bond strength so as to improve the success of the restoration.



Uthman S Uthman

Impact of Fluoride Varnishes on Enamel Surface Microhardness of Primary Teeth: An In Vitro Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:4] [Pages No:469 - 472]

Keywords: Fluoride varnish, Primary teeth, Surface microhardness, white spot lesion

   DOI: 10.5005/jp-journals-10015-2059  |  Open Access |  How to cite  | 


Aim: Aim of the current research was performed to assess the outcome of three fluoride varnishes on enamel surface microhardness (SMH) of primary teeth. Materials and methods: A total of 60 primary teeth indicated for extraction were utilized in this research. The specimens were cleaned employing pumice slurry. The specimens were subjected to storage in distilled water having 0.2% thymol for prevention of bacterial growth through the period of the research. A 2 mm by 2 mm window was made on the enamel of the buccal surface, followed by embedding in acrylic with enamel surface exposed. The specimens were then randomly allocated to one of the three investigational groups as follows: group 1- Bifluorid 10® varnish, group 2- Clinpro white varnish, group 3- Fluorprotector varnish. The specimens underwent a pH cycle to replicate laboratory conditions similar to the mouth. And every cycle lasted for 24 hours. The SMH of enamel was gauged prior to treatment at baseline and following pH cycles employing the Vickers microhardness tester. Results: Bifluorid 10® group exhibited a mean SMH of 328.32 ± 0.11, 332.14 ± 0.08 by the Clinpro white, and 331.13 ± 0.06 by the Fluorprotector group at baseline, and there were no significant dissimilarities amid the various varnish groups. Clinpro white exhibited the lowest SMH at 284.02 ± 0.17 in pursuit by Fluorprotector varnish at 268.58 ± 0.10 as well as Bifluorid 10® varnish at 229.86 ± 0.21. There were statistically significant dissimilarities amid the various varnish groups with p < 0.001. Conclusion: The current research, amid its limitations, arrived at a conclusion that various fluoride-containing varnishes had a positive influence on preventing demineralization of primary teeth. However, Clinpro white varnish delineated maximum efficacy in enhancing the resistance of deciduous enamel to acid attacks vs Fluorprotector as well as the Bifluorid 10 fluoride varnish group. Clinical significance: Cycles of demineralization and remineralization occurring in an alternative manner on the surface of enamel lead to dental caries. Varnishes containing fluoride exhibit a dental caries preventive action on the dentition by exerting remineralizing effects. As a result, the enamel becomes unyielding to disintegration by acids. Fluoride varnish is a noninterventional, anticariogenic substance that can be used to manage early childhood caries (ECC).



Kirti Chawla, Arundeep K Lamba, Mahesh Verma

Antimicrobial Photodynamic Therapy and Er,Cr:YSGG Laser-assisted Periodontal Pocket Therapy for Treatment of Aggressive Periodontitis: A Randomized Controlled Clinical Trial

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:6] [Pages No:473 - 478]

Keywords: Aggressive periodontitis, Er, Cr:YSGG laser, Lasers, Photodynamic therapy

   DOI: 10.5005/jp-journals-10015-2081  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate and compare the clinical effects of Er,Cr:YSGG laser-assisted pocket therapy (ELAPT) and antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) on clinical outcomes of the treatment of aggressive periodontitis. Materials and methods: Twenty patients with age between 18 and 35 years who were clinically diagnosed with aggressive periodontitis were selected from the outpatient department of periodontics. On the basis of inclusion and exclusion criteria three different sites were selected in each patient and then assigned randomly to three groups of treatment modalities: aPDT (Group I), ELAPT (Group II), or SRP (Group III-control). PD reduction and CAL gain were compared to the baseline values—baseline, 3, 6, and 9 months. Results: Both the treatment modalities assessed, produced significant improvements in terms of the two outcome variables: PD reduction and CAL gain compared to the baseline values (p < 0 < 0.05) after 9 months, although no significant difference was seen between the two groups for PD reduction and CAL gain. Conclusion: Within the constraints, this study has shown promising results for the treatment of aggressive periodontitis using both the latest modalities photodynamic therapy (aPDT) and ELAPT. Future research with larger sample size shall be done to evaluate the effects of these modalities. Clinical significance: The treatment of aggressive periodontitis has always posed a challenge for clinicians, but there have been no established protocols and guidelines for the efficient control of the disease. Conventional adjunctive anti-infectious therapies like systemic antibiotics and local drug delivery are available as an adjunct to SRP but they have not proven to be effective. Antimicrobial photodynamic therapy or laser-assisted pocket therapy could be explored as new possibilities of antibacterial treatment and used as adjunct to SRP for the treatment of aggressive periodontitis.



Heer Kadhi, Jasmin Winnier, Ishani Ratnaparkhi

Assessment of Bond Strength Following Simultaneous Activation of Resin-modified Glass Ionomer and Self-etch Adhesive in Primary Molars: In Vitro Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:4] [Pages No:479 - 482]

Keywords: Bond strength, Resin-modified glass ionomer, Selective enamel etching, Simultaneous activation technique

   DOI: 10.5005/jp-journals-10015-2080  |  Open Access |  How to cite  | 


Aim: The aim of the study was to assess the bond strength following simultaneous activation of resin-modified glass ionomer (RMGI) base and self-etch adhesive in sandwich restoration compared to conventional sandwich restoration in primary molars. Materials and methods: Thirty non-carious primary molars were embedded in acrylic up to the cementoenamel junction. The coronal portion of the teeth were removed using a diamond disk to obtain flat dentin surfaces for standardization and allocated randomly to three different groups: group I—simultaneous activation of RMGI and self-etch adhesive (SAT); group II—simultaneous activation of RMGI and self-etch adhesive with enamel etching (SAT+EE); and group III—conventional sandwich technique (ST). All groups were then restored with bulk fill composite. The samples were stored in distilled water for 24 hours at room temperature and evaluated for shear bond strength under universal testing machine until failure. Results: The mean shear bond strength of group I was 1.40, group II was 3.10, and group III was 1.71. Analysis of variance (ANOVA) test results revealed statistically significant difference between the groups (p < 0.0001). Tukey's post-hoc analysis revealed a highly statistically significant difference between group I and group II (p < 0.0001). The difference between group II and group III was also significant (p < 0.001). Mean time taken was least for SAT group (70 seconds) followed by SAT+EE group (85 seconds) and the maximum time taken was for ST group (100 seconds). One-way ANOVA test suggested a statistically significant difference between the groups (p < 0.0001). Post-hoc analysis showed a statistically significant difference between group I and group II (p < 0.001) and group I and group III (p < 0.0001). Conclusion: Simultaneous activation technique with selective EE resulted in a greater bond strength as compared to that of without etching or the conventional technique. Clinical significance: This technique may provide better retention and longevity of the restoration. It involves less number of steps and is a time-saving procedure which can be beneficial for pediatric patients.



Anuva Bhandari, Eiti Agrawal, Neetika Gupta, Shradha, Anisha Koul, Swyeta J Gupta

Assessment of Knowledge, Attitude, and Practices Regarding Biomedical Waste Management among Dental Health Professionals in Tertiary Care Hospitals in Uttar Pradesh: A Cross-sectional Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:6] [Pages No:483 - 488]

Keywords: Biomedical waste management, COVID-19, Waste disposal

   DOI: 10.5005/jp-journals-10015-2095  |  Open Access |  How to cite  | 


Aim: To determine the level of attitude and awareness regarding biomedical waste management (BMWM) policy and practice among healthcare workers (HCWs) in tertiary level hospitals in Uttar Pradesh. Materials and methods: This is a questionnaire-based study which was done among 1,000 members of the hospital including undergraduate students, doctors (faculty members and postgraduate students), and class IV employees (cleaners and maintenance personnel). It consisted a total of 33 questions intended to obtain information about knowledge of BMWM practices grouped under three headings: (a) knowledge of biomedical waste (BMW) generation, segregation, and categorization; (b) knowledge of BMWM practice in hospitals on procedure and disposal; and (c) awareness regarding best management practices in dental office. Results: The mean scores were calculated and it was found that regarding knowledge of BMW generation, segregation, and categorization, the doctors had significantly more knowledge and dental students were having comparatively least knowledge among all groups, whereas mean value of attitude of BMWM practice in hospitals on procedure and disposal and practice regarding best waste management in dental office has shown statistically significant results with doctors. Conclusion: This study showed that there was a good, satisfactory, and poor level of knowledge, attitude, and practice about BMW generation hazards, legislation, and management among doctors (faculty members and postgraduate students), class IV employees, and dental students, respectively. Clinical significance: The awareness of these BMWM laws among the public, as well as development of policies and enforcement that respect those laws, is essential. Appropriate measures should be taken to minimize hazardous waste where possible or action should be taken to ensure that all generated waste is managed according to the correct norms and regulations.



Effect of Disinfectants on Dimensional Stability of Two Elastomeric Impression Materials: An In Vitro Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:4] [Pages No:489 - 492]

Keywords: Dimensional stability, Disinfectant, Elastomeric materials, Impression

   DOI: 10.5005/jp-journals-10015-2068  |  Open Access |  How to cite  | 


Aim: The aim of the current research was to evaluate the results of two different disinfectants on the dimensional stability of two elastomeric impression materials. Materials and methods: A total of 120 samples were prepared in the present study. In accordance with the American Dental Association (ADA) specification number 19, a uniform stainless steel master die was constructed. In the current research, Imprint™ impression materials such as vinyl polysiloxanes (VPS) as well as a polyethers (PE), Impregum™, were used and manipulated as per the manufacturer's recommendations. To accomplish disinfection, 60 samples of either material were procured and allocated at random to one of the three groups: control group, 2% glutaraldehyde (GA) group, and 5.25% sodium hypochlorite (NaOCl) group. A stereomicroscope with 20× magnifying power was employed in the evaluation of the dimensional stability along with the aid of image investigation software. Results: In VPS impression material, most dimension-related changes were noted with control group at 0.80 ± 0.02 in pursuit by 2% GA use at 0.43 ± 0.08. The lowest changes in the dimensions were noted with 5.25% NaOCl use at 0.36 ± 0.01. In PE impression material, most dimension-related changes were noted with control group at 0.84 ± 0.09 in pursuit by 2% GA use at 0.49 ± 0.05. The lowest changes in the dimensions were noted with the use of 5.25% NaOCl group at 0.43 ± 0.05. The differences amid the groups using ANOVA were found to be statistically significant with a p <0.001. Conclusion: The results of this research indicate that either of the two elastomeric impression supplies that is VPS and PE showed little dimensional changes when subjected to immersion in two different disinfectants. Prolonged storage of samples disinfected with 5.25% hypochlorite and 2% GA may be utilized in the clinical set-up as the ensuing dimensional changes that result are quite less. Clinical significance: Infection control has raised a significant alarm for the dental practitioner lately due to increasing communicable diseases. A route of possible infection could be through dental impressions that on being taken out of the mouth get laced with microbes present in the patient's saliva as well as blood. Therefore, it is necessary to identify an appropriate disinfectant that would have lowest unfavorable effect on the dimensional exactness of elastomeric impression materials.



Ayswarya V Vummidi, Paavai Ilango, T Vatsala, R Visali, T Abirami, Arul Pari, GD Gomathi

Comparison of Gingival Crevicular and Capillary Finger-prick Blood in the Blood Glucose Levels Assessment of Gingivitis and Periodontitis Patients

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:5] [Pages No:493 - 497]

Keywords: Diabetes, Finger-prick blood, Gingival crevicular blood, Glucose, Periodontitis

   DOI: 10.5005/jp-journals-10015-2094  |  Open Access |  How to cite  | 


Aim: The aim of this study is to determine the blood glucose levels from gingival crevicular bleeding during routine periodontal examination and to compare its accuracy with finger-prick blood (FPB) using a self-monitoring device during routine dental visits. Materials and methods: A total sample size of n = 80 with group I (gingivitis; n = 40) and group II (periodontitis; n = 40) subjects were included in this study. On periodontal examination, gingival crevicular blood (GCB) was collected and simultaneously FPB was collected from the same patient. A quantity of 2 µL blood from both were analyzed by self-monitoring glucometer (Accu-Chek Active). Results were obtained and statistically analyzed using SPSS software. Result: The mean GCB and FPB glucose levels were 50.98 ± 31.538 and 94.28 ± 41.464, respectively in gingivitis group whereas the mean GCB and FPB were 89.38 ± 46.022 and 160.80 ± 77.761, respectively in periodontitis group. Both the groups suggested a strong positive correlation, where r = 0.924 in gingivitis group and r = 0.808 in periodontitis group. Conclusion: The results from this current study show that GCB collected during diagnostic periodontal examination may also be a reliable source of blood for glucometeric analysis. The glucose levels of crevicular blood can also be a potential risk factor to alter the oral microflora favoring dysbiosis which may lead to the progression of periodontitis. Clinical significance: Diabetes and periodontitis being interlinked with each other influence the oral health and its related treatment. This emphasizes mandatory evaluation of blood glucose levels during regular dental screening. This study evaluates the GCB oozing during periodontal examination that can serve as an alternative source of blood for glucose evaluation, being less traumatic and noninvasive than FPB.



Nagashree Prabhu, Vabitha Shetty

Salivary C-reactive Protein as a Biomarker in Children with Sleep Disorders: An Evaluative Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:5] [Pages No:498 - 502]

Keywords: Biomarkers, Children, C-reactive protein, Saliva, Sleep disorders

   DOI: 10.5005/jp-journals-10015-2087  |  Open Access |  How to cite  | 


Aim: To evaluate salivary C-reactive protein (CRP) levels in children with skeletal class II malocclusion and with a positive history of sleep disorders. Materials and methods: Twenty-one children aged 8–12 years with skeletal class II malocclusion and at least one sleep disorder participated in the study (group I). Twenty-one age and gender-matched children with no skeletal malocclusion and no reported history of sleep disorders served as a comparison group (group II). All children were evaluated regarding their sleep history and clinically examined to determine craniofacial morphology. Children of group I were subjected to a radiographic assessment including evaluation of airway space. Unstimulated saliva was collected from all children. Salivary CRP was measured using CRP LEIT kit (Agappe) with calibrator, which is a latex-enhanced turbidimetric immunoassay. Statistical analysis for intergroup comparison (two groups) for normally distributed data was done using t-test. Results: There was a significantly higher level of salivary CRP, in children of group I when compared to that of group II children (p < 0.01). Conclusion: Salivary CRP may be a simple and noninvasive tool in the identification and screening of children at high risk for sleep disorders. Clinical significance: Routine salivary CRP monitoring could be a valuable biomarker in early recognition and treatment sleep disorders in children.



Uma Sudhakar, S Parthiban, Jagadish Ebenezer, Kumukcham Sophia, Nimisha Mithradas, Navina Ravindran

Collocation of Malondialdehyde and Superoxide Dismutase Levels in Chronic Periodontitis and Pruning them Post-scaling and Root Planing Coupled with Vitamin E Supplementation

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:5] [Pages No:503 - 507]

Keywords: Lipid peroxidation, Malondialdehyde, Oxidative stress, Superoxide dismutase, Vitamin E

   DOI: 10.5005/jp-journals-10015-2107  |  Open Access |  How to cite  | 


Aim: The purpose of this study is to determine the effect of vitamin E supplementation on malondialdehyde (MDA) and superoxide dismutase (SOD) status post-scaling and root planing (SRP) in patients with chronic periodontitis. Materials and methods: A total of 80 randomly selected chronic periodontitis patients were classified into two groups (40 each), group I and group II. Those in group I underwent SRP, whereas those in group II underwent SRP along with orally administered 400 mg of vitamin E every other day for 3 months. Gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded. A baseline examination and a 3-month recall were conducted for all the patients. Serum, saliva, and gingival crevicular fluid (GCF) were collected at baseline and 3 months posttreatment. Results: The results of the study showed that oxidative stress is more in chronic periodontitis patients. A reduction in CAL and PPD between group I and group II was observed after 3 months. However, it was not statistically significant. Post-periodontal therapy, along with vitamin E supplementation, showed that salivary and GCF MDA levels showed significant reduction at 3 months, whereas serum MDA levels did not. Salivary and serum SOD values showed significant p value after, whereas there was an increase in SOD levels in GCF, which was not statistically significant. Conclusion: Significant changes in MDA and SOD levels were noted after orally administered vitamin E supplementation. Larger sample sizes along with longitudinal studies were required in different reveries of chronic periodontitis. Clinical significance: The MDA levels were increased in chronic periodontitis, whereas SOD levels were lowered in chronic periodontitis. Conjugation of vitamin E supplementation improves periodontal healing as well as antioxidant defense.



Sumita Bhagwat, Namrata Vikmani, Leena Padhye

A Clinical Evaluation of Postoperative Pain with and without the Maintenance of Apical Patency in Single Sitting Root Canal Treatment

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:5] [Pages No:508 - 512]

Keywords: Apical patency, Postoperative pain, Single sitting root canal treatment

   DOI: 10.5005/jp-journals-10015-2108  |  Open Access |  How to cite  | 


Aims: The aim of the study was to assess whether maintenance of apical patency during instrumentation leads to altered postoperative pain in single-visit root canal treatment (RCT) as compared to non-maintenance of apical patency. Materials and methods: A total of 60 patients with symptomatic irreversible pulpitis in vital permanent mandibular molars were selected to be included in the study. The patients were randomly divided into two groups: group A, where apical patency was maintained and group B, where it was not maintained. The root canal procedures for the patients were carried out in single sitting under a rubber dam using E3 Azure (Endostar, Poland) rotary system, 2.5% sodium hypochlorite (NaOCl) as irrigant alternating with saline, and obturation by lateral compaction technique. A questionnaire employing visual analog scale (VAS) for pain assessment was given to the patient, and instructions on how to fill the form were given. The patients were recalled after 7 days, and the pain was analyzed. The result was tabulated and statistically analyzed. Results: There was no statistical difference in the postoperative pain between the groups where apical patency was maintained vs where apical patency was not maintained. Conclusion: Based on our findings and, in comparison with those of other studies, we conclude that there is no difference in postoperative pain when there is maintenance of apical patency vs non-maintenance of apical patency in permanent mandibular molars with vital pulps treated with single sitting root canals. Clinical significance: Achieving apical patency may not be mandatory for all cases of endodontics with respect to the goal of reduction in postoperative pain.



Raaja Raajalakshmi, Natesan Devi, Kandasamy Balu, Veeramalai Devaki, Paramasivam Arunkumar

Chemical Characterization and Degree of Conversion of a Novel Denture Base Polymer Processed by a Novel Photon-thermal Dual Polymerization Technique

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:7] [Pages No:513 - 519]

Keywords: Camphorquinone, Co-initiator, Copolymer, Denture base resin, Dual-cure

   DOI: 10.5005/jp-journals-10015-2109  |  Open Access |  How to cite  | 


Aims and objectives: The present research aimed to characterize the thermo-polymerized poly(methyl methacrylate) [TP-P(MMA)] with camphorquinone-2-(dimethylamino)ethyl methacrylate (CQ-DMAEMA) complex and to evaluate the degree of conversion (DC) of the formed novel copolymer P(MMA-co-DMAEMA). Materials and methods: The CQ was incorporated in the prepolymeric powder and the DMAEMA in the liquid monomer so that the CQ-DMAEMA ratio was 1:2. The CQ-DMAEMA complex concentration in the TP-P(MMA) was 5% (group B), 10% (group C), and 15% (group D). The TP-P(MMA) without the CQ-DMAEMA complex served as control (group A). Ten polymerized and unpolymerized specimens (n = 10 per group) were subjected to Fourier transform infrared spectroscopy (FTIR) using potassium bromide technique for assessing the copolymerization (CP) and DC. Results: New peaks ascribed to the methyl amino and tertiary amine groups were evident in all the trial groups which were absent in the control group. These peaks of the trial groups confirm the CP of the methacrylated amine with TP-P(MMA). Absence of the alkenyl C=C stretch peak in all the trial groups signifies higher DC than the control group. The TP-P(MMA) with 15% CQ-DMAEMA complex had the highest DC. Conclusion: The methacrylated amine successfully copolymerized with TP-P(MMA) which along with CQ formed a novel photon-thermal dual polymerized denture base copolymer P(MMA-co-DMAEMA) exhibiting higher DC than the conventional P(MMA). Clinical significance: The novel photon-thermal dual-polymerized denture base copolymer possessing good DC is expected to release meager or negligible amount of unreacted residual monomer and would possess palatable biocompatibility than the conventional P(MMA) without inducing denture-induced stomatitis in the edentulous geriatric population.



Vinay Suresan, Satyabrata Das, Rajnish K Verma, Bhagabati Dash, Aanchal Banka, Aiswarya Suresh

Antibiotic Prescribing Practices amongst the Dental Practitioners of Bhubaneswar City: A Cross-sectional Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:7] [Pages No:520 - 526]

Keywords: Antibacterial agents, Antibiotic prophylaxis, Dentists’, Drug resistance, Practice patterns

   DOI: 10.5005/jp-journals-10015-2069  |  Open Access |  How to cite  | 


Aim: To assess the antibiotic prescribing practices and knowledge of current antibiotic regimens amongst the dental practitioners of Bhubaneswar City, Odisha. Materials and methods: A descriptive, e-mail-based, cross-sectional study was conducted amongst 905 dental practitioners of Bhubaneswar city. A pretested, validated, a self-structured questionnaire was designed to assess the demographic data (age, gender, specialty, and years of experience) and 17 questions assessing the usual prescription patterns (type, dosage, and duration of antibiotics prescribed for selected diseases and prophylaxis). The knowledge-based questions were 10 in number and framed with a single correct response. The questionnaire was prepared in Google Forms and a link was generated. This link was e-mailed to the dental practitioners with a cover letter explaining the need for the survey. The study was conducted for a period of 6 months (December 2020 to May 2021). Results: A total of 826 subjects participated in this study. The commonest age group was 41–50 years (n = 363, 43.9%). A total of 367 (44.4%) BDS, 450 (54.5%) MDS, and nine (1.1%) PhD subjects formed the study sample. A combination of amoxicillin + clavulanic acid was their preferred first-line drug of choice. Similarly, the commonest second-line drug prescribed was cephalexin. Half of the study population (n = 413, 50%) prescribed antibiotics for their patients having endo-perio lesions. There were a mere 138 (38.8%) BDS, 170 (37.8%) MDS, and zero (0%) PhD subjects with adequate knowledge scores. Pedodontists (n = 104, 96.3%) prescribed the highest antibiotics as compared to other specialties. Endodontists (n = 33, 30.6%) prescribed the most adjunct medication in their practice. Conclusion: Inadequate knowledge was reported amongst the practicing dentists, therefore the study calls for the improvement of their knowledge through periodic dental education on the betterment of clinical practice and in turn reducing the occurrence of antimicrobial resistance (AMR). Clinical significance: AMR is a major concern for developing countries like India where there is an increased prevalence of self-medication and over-the-counter drug availability. Treating local odontogenic infections in regular dental practice with systemic antibiotics has received a red signal.



Divya Krishnamoorthi, Syed A Ali, Gunaseelaraj Rajkumar, Somasundaram Santhakumari, Soundararaj Ashna

Effect of Recycled Denture Base Polymeric Powder Incorporation on the Surface Properties of Heat-cured PMMA Denture Base Acrylic Resin: An In Vitro Study

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:7] [Pages No:527 - 533]

Keywords: Acrylic resins, Hardness test, Recycling, Reuse

   DOI: 10.5005/jp-journals-10015-2077  |  Open Access |  How to cite  | 


Aim: The present in vitro research aimed to assess the polishability (P), translucency (T), surface hardness (SH), and surface roughness (SR) of heat-cured PMMA-based denture base resin processed after modification with recycled denture base resin (r-PMMA) at 10, 20, 30, 40, and 50% (w/w) to commercially available resin (R10, R20, R30, R40, and R50) (w/w). Materials and methods: In total, 90 rectangular specimens (n = 15) were fabricated to test P and T and were analyzed through visual inspection accordingly to ISO standardization. 90 disk-shaped specimens (n = 15) were fabricated to test SR and SH. The mean arithmetic roughness (Ra) was recorded using a surface profilometer to assess the SR. Vicker's microhardness testing was done to obtain Vickers hardness number (VHN). Data were tabulated and compared using ANOVA (α = 0.05). Further post hoc Bonferroni tests were performed on each pair of groups. Results: All the specimens tested for P and T comply with the ISO 1567. The Ra of the control group- SR R0 was found to be 0.10 µm. The modification resulted in an increase in SR and was found to be ranging from 0.11 µm (SR R10) to 0.16 µm (SR R50). The VHN recorded for the control group (SH R0) was 20.35 kg/mm2. The experimental groups demonstrated a decrease in VHN, from 16.67 kg/mm2 (SH R10) to 13.85 kg/mm2 (SH R50). Conclusion: The polymeric modification does not affect the P and T of the cured specimens. The modification resulted in an increase of SR proportional to the w/w of r-PMMA added. The experimental groups demonstrated a decrease in VHN as a function of an increase in the addition of r-PMMA w/w. Clinical significance: The ability to reuse denture base resin would significantly reduce the nonbiodegradable type of biomedical waste that is produced and sent out of the dental institutes and practice.



Saeed M Alqahtani

Restoring Function and Enhancing Esthetics with Immediate Anterior Implant Placement and Full Mouth Rehabilitation: A Case Report

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:6] [Pages No:534 - 539]

Keywords: Early loaded, Immediate implant, SLActive Straumann implant

   DOI: 10.5005/jp-journals-10015-2076  |  Open Access |  How to cite  | 


Aim and objective: This case report represents the clinical treatment plan and radiographic outcome treated with early loaded SLActive surface Straumann implants in fresh extraction sockets in the maxillary and mandibular jaws. Background: Endosseous dental implants have revolutionized the way clinicians address edentulous or partially edentulous patients. Traditional implant procedures require a several-month healing interval following tooth extraction and an unloading healing period before restoration. Case description: A 68-year-old patient reported to our clinic with the complaint of replacing missing teeth. On examining the oral cavity and planning treatment protocol, immediate early loaded implants were initiated. The eight remaining anterior maxillary and mandibular teeth were extracted, an additional four maxillary and two mandibular implants were placed. A full mouth rehabilitation was planned with the patient. The treatment followed atraumatic extraction of anterior teeth and SLActive Straumann's immediate implant placement in the extraction socket. The prosthetic rehabilitation was done with a porcelain fused to metal crowns, and occlusion was checked. The patient was recalled for follow-up at week, month, 3 months, with no gingival tissue abnormalities were found. Conclusion: Immediate implant placement is a breakthrough in modern dentistry, which is beneficial to the patient as it reduces the treatment time and number of surgeries. The SLActive Straumann implant has accelerated bone healing and soft-tissue preservation. As a result, immediate implant treatment is one of the ideal procedures for preserving the patient's esthetic requirements. Clinical significance: The implant placement immediately after extraction has become a treatment of choice for patients as it preserves esthetics, reduces surgeries, and proven to be helpful in bone healing and soft-tissue preservation.



Namrata Sengupta, Urmi Ghone, Nidhi Kumari, Swapnagandha Mahindre, Renuka Gophane

Indigenous Causes of Human Papilloma Virus Negative Non-habit-associated Oral Squamous Cell Carcinoma: Perspectives and Prospects

[Year:2022] [Month:September-October] [Volume:13] [Number:5] [Pages:3] [Pages No:540 - 542]

   DOI: 10.5005/jp-journals-10015-2079  |  Open Access |  How to cite  | 


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