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Table of Contents
September-October 2019
Volume 11 | Issue 5
Page Nos. 235-328
Online since Tuesday, September 24, 2019
Accessed 93,212 times.
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REVIEW ARTICLES
Clinical performance of mineral trioxide aggregate versus calcium hydroxide as indirect pulp-capping agents in permanent teeth: A systematic review and meta-analysis
p. 235
Govula Kiranmayi, Nazia Hussainy, Anumala Lavanya, Sannapureddy Swapna
DOI
:10.4103/jioh.jioh_122_19
Aims and Objectives:
The aim of this study was to compare the clinical performance of mineral trioxide aggregate (MTA) and calcium hydroxide as indirect pulp-capping agents in permanent teeth.
Materials and Methods:
Search strategy includes randomized control trials and clinical trials from the databases of PubMed Central, Cochrane, EBSCO, and MEDLINE from January 1998 to May 2018. A total of six clinical trials that met all inclusion criteria were included in this systematic review. Meta-analysis was performed for three among the included studies. The primary clinical outcome of the included studies was to evaluate the pulp vitality with a normal response to thermal, electrical, and tactile tests without signs of spontaneous pain. The radiological outcome was to evaluate the absence of periapical radiolucency, periodontal ligament space widening, and the dentin bridge formation. The primary and predominant results were assessed based on the success or failure of pulp capping. The restorations were considered failure when there are clinical symptoms such as pain and tenderness and radiographic evidence of radiolucency in periapical region or widening of periodontal ligament.
Results:
In the six trials that are included, two studies are judged as low risk and four as medium risk of bias. With the help of meta-analysis, the evidence produced concluded that after six-month and one-year follow-up there was no statistically significant difference between MTA and calcium hydroxide as an indirect pulp-capping material.
Conclusion:
This systematic review of the available evidence reveals that MTA and calcium hydroxide demonstrated good consistent endurance in clinical studies and indistinguishable performance.
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Shrinkage in composites: An enigma
p. 244
Dhakshinamoorthy Malarvizhi, Arumugam Karthick, NewBegin Selvakumar Gold Pearlin Mary, Alagarsamy Venkatesh
DOI
:10.4103/jioh.jioh_36_19
In recent years, increased demand for perfectly aesthetic restoration coupled with improved performance of composite resin made clinicians to select composite resins over amalgam restoration. Patients prefer composite restoration not only for restoring anteriors but also to replace their unaesthetic amalgam restoration of their posteriors. The greatest limitation of composite resin as posterior restoration is its polymerization shrinkage leading to marginal leakage, tooth or restoration fracture, postoperative sensitivity, ultimately leading to the reduction of the long-term success of the restoration. There are several factors associated with the polymerization process that have its impact on the integrity of the tooth restoration complex. So the astute clinician should have thorough knowledge regarding the mechanism involved in polymerization shrinkage and the techniques of overcoming it. The objective of this article was to make the clinician understand the factors and the problems related to the polymerization shrinkage with the methods to overcome the same for the clinical longevity of the restoration.
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ORIGINAL RESEARCH
Effects of Toothpaste Containing Granular Calcium Carbonate on Oral Health
p. 249
Mami Endoh, Atsushi Takayanagi, Masatsugu Fujiseki, Yukio Eda, Morihide Itano, Yoshitaka Yano
DOI
:10.4103/jioh.jioh_37_18
Aims and Objectives:
To investigate the oral health effects of using toothpaste containing granular calcium carbonate (CaG).
Materials and Methods:
The subjects were adult volunteers. Two kinds of toothpaste, Paste P and Q were used. Paste P contained 13% CaG, which had a mean diameter of 250 µm and a breaking strength of 20 gf. Paste Q had the same formulation without CaG. Study 1 was to evaluate the ability to remove dental plaque by toothpaste with a single use, and it was a crossover study. The subjects were 50 adults. Plaque levels were assessed using the Quigley–Hein Index (QHI). Study 2 was to investigate the effects of CaG in toothpaste on gingival health. The subjects were 60 adults. The subjects used Paste P for 3 days before the baseline assessment. On the baseline assessment, the subjects whose gingival sulci were found to contain CaG were asked to continue using the Paste P for 6 months. The pocket depth, the gingival index (GI), the QHI, and the presence of CaG in the gingival sulci at 1, 3, and 6 months from the baseline were examined.
Results:
In study 1, the CaG-containing toothpaste produced a significantly lower mean QHI than the control. In study 2, the QHI and GI of the gingival sulci in which CaG was detected were significantly lower than those of the gingival sulci in which CaG was not detected.
Conclusion:
Toothpaste containing CaG removed greater amounts of plaque and did not have adverse effects on periodontal tissue.
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Radiographic detecting for the presence of extra chin foramen for the chosen Ramadi City Community Iraq
p. 256
Mohanad Aftan Hammad
DOI
:10.4103/jioh.jioh_291_18
Aims and Objectives:
The extra chin foramen (ECF) is a scarce structure in the anatomy of human lower jaw. When it is present, the dental surgeon should take care during anesthesia and surgical procedures for anterior teeth. To investigate the existence of the ECF and the direction in relation to chin foramen in chosen Ramadi City community persons, Al-Anbar Governorate, Iraq, digital panoramic and conventional intraoral (bisecting line angle technique) X-ray was used.
Materials and Methods:
A total of 100 patients (200 sides of mandible), 54 males and 46 females were selected. Each one was subjected to digital panoramic and conventional intraoral technique. The obtained images were evaluated for the existence of ECF in both male and female patients on each direction of lower jaw (left and right). Age relation to ECF existence was reported. Position of ECF to chin foramen (anterior or posterior) was calculated. The collected data were treated by the Statistical Package for the Social Sciences (SPSS) software, version 22.
Results:
ECFs were seen within 3.5% of the chosen population. Nonsignificant variations were observed between the existence of ECFs regarding gender, side of mandible, age coterie, and position of ECF to chin foramen (
P
> 0.05).
Conclusion:
A total of 7 (3.5%) ECFs were detected from 200 sides of mandible. ECFs were observed more in males (5 ECFs, 2.5%), at left side of mandible (4 ECFs, 2%), young patients (4 ECFs, 2%), and anterior to chin foramen (5 ECFs, 2.5%), so they were subjected to complications of damage to nerves and vessels during interventional dental surgery and anesthesia.
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Antibacterial activity of Algerian chewing sticks extracts on oral denture biofilm
p. 260
Wafae Didi, Hafida Hassaine, Sarah Gaouar
DOI
:10.4103/jioh.jioh_252_18
Aims and Objectives:
To evaluate potent antibiofilm activity of two Algerian chewing sticks,
Salvadora persica
and
Juglans regia
, on oral species adhered to elderly dentures.
Materials and Methods:
The antibacterial activity of the plant extracts and the effect on the biofilm formation were evaluated
in vitro
by the broth micro-dilution assay. The antibiofilm effect was tested
in vitro
on artificial oral biofilms, adhered to resin composite, and visualized by environmental scanning electron microscope.
Results:
Data revealed that bacteria of artificial biofilms were less sensitive than the planktonic strains. However, all tested bacteria, planktonic or biofilms, were more susceptible in the presence of extracts, with
J. regia
extract showing greater activity than
S. persica
.
Conclusion:
All tested oral bacteria, planktonic or biofilm, were more susceptible to
J. regia
and
S. persica
, respectively. Considering their antibacterial activity, these extracts may be of great interest for future studies about natural antiplaque agents in daily oral-care products, especially for elderly denture wearers.
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Oral hygiene status and practices among health-care workers: A cross-sectional study
p. 268
Moaz M Almoteb, Saud S Alalyani, Inderjit M Gowdar, Narendra V Penumatsa, Mohammed A M Siddiqui, Rajashekhara B Sharanesha
DOI
:10.4103/jioh.jioh_315_18
Aims and Objectives:
Health-care professionals have an important role in health education for their patients, families, and friends also at the community levels. However, understanding their own behavior toward their oral health is more important for the oral health educators who are also health-care professionals. Assessment and practice of oral hygiene status among health-care professionals working in King Khalid Hospital, Al-Kharj, Riyadh, Kingdom of Saudi Arabia was the aim of the study.
Materials and Methods:
A study was carried out with the aid of specially designed questionnaire consisting of details regarding demographic variables and oral hygiene practice among the health-care workers (HCWs). Convenience samples were selected and preformed questionnaire was given and oral examination was conducted on 267 male HCWs and 164 female HCWs. Data were analyzed using the Statistical Package of the Social Sciences (SPSS) software, version 20, to perform chi-square test and analysis of variance.
Results:
Among 431 HCWs, 267 males and 164 females participated. A total of 302 people told they brush once daily and it was significant among age group. Mean calculus (0.82) was more among the participants aged >50 years. Mean oral hygiene index-simplified (2.23) was more among those aged >50 years. Mean debris (1.40) was more among >50 years and was statistically significant.
Conclusion:
HCWs showed that their oral hygiene status was fair. Awareness programs must be conducted frequently to boost up the oral self-hygiene practices among them for many good reasons.
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An update on the relative vulnerability of the first and second permanent molars to caries in urban Nigerians
p. 274
Odogun A Loto, Afolabi Oyapero, Adenike O Awotile, Olugbenga A Adenuga-Taiwo, Lillian L Enone, Ifeoma N Menakaya
DOI
:10.4103/jioh.jioh_9_19
Aims and Objectives:
Caries is a dynamic disease from an interaction between environmental, behavioral, and genetic elements. We aimed to determine if the changing dietary patterns of urban Nigerians have any effect on the relative susceptibility of the first and second permanent molars to caries.
Materials and Methods:
The case files of 7977 patients, who attended the Restorative Clinic at the Lagos State University Teaching Hospital Dental Centre, from 2012 to 2015, were reviewed for the occurrence of caries. Differences in the levels of occurrence of caries between the first and second permanent molars, with regard to age, gender, and the mandible and maxilla, were established by means of chi-square test, and the level of significance was determined at
P
≤ 0.05.
Results:
The second permanent molars were more susceptible to caries at 4013 (58.8%) compared to first permanent molars at 3448 (46.2%). A higher proportion of second permanent molars were decayed or filled (3146, 42.2%) compared to that of the first molar (2348, 31.5%) (
P
< 0.001). However, a greater number of first molars (1100, 14.7%) were extracted due to caries compared to second molars (887, 11.6%). Males had more carious lesions (4422, 59.3%) compared to females (3039, 40.7%) (
P
> 0.05). The number of carious first and second molars was higher in the lower jaw (4498, 60.3%) compared to the upper jaw (2963, 39.7%) and the difference was statistically significant (
P
< 0.001).
Conclusion:
The second permanent molars were more vulnerable to caries indicating apparent changing dietary patterns of urban Nigerians. Further prospective studies, covering a wider age range, should be carried out to validate or refute the claim of this study.
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Association between chronic periodontitis and oral health–related quality of life in Indian adults
p. 280
Tarun Yadav, Priyanka Chopra, Shalini Kapoor
DOI
:10.4103/jioh.jioh_50_19
Aims and Objectives:
To assess the marked effect of periodontal conditions on oral health–related quality of life in the population of India.
Materials and Methods:
This cross-sectional study was carried out among 450 participants, with specific age group 30–60 years, residing in the Gurugram District, Haryana, through various camps conducted by the Faculty of Dental Sciences, SGT University, Gurugram, both in rural and urban areas. The data collection included a combination of clinical examination for the assessment of oral health status and questionnaire administration. Two pretested questionnaires and significant oral findings were the sources of data collection. Age and gender were calculated with correlation quality of life as
P
> 0.05. Prevalence of oral impacts with severity of periodontitis was analyzed using chi-square test and analysis of variance.
Results:
The severity of periodontal disease has a direct effect on oral health–related quality of life. Oral impact prevalence was found to be 59% and 81% in participants with moderate periodontitis and/or severe periodontitis, respectively. The extent and severity were also found to be proportional to the severity of periodontitis.
Conclusion:
Oral health–related quality of life worsens with the extension in severity of chronic periodontitis.
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Knowledge, attitude, and awareness of mothers toward emergency management of dental trauma in high literacy population
p. 287
Nair Resmy, Kumaran Parvathy, Xavier Mammachan Arun, Varma Balagopal
DOI
:10.4103/jioh.jioh_59_19
Aims and Objectives:
Most important oral health problem observed in childhood is dental trauma. This frequently occurs at home or during outdoor activities so emergency care is essential for good prognosis of the injury. For the better prognosis, parents have important role. Before planning educational promotion, it is essential to consider the understanding level of parents, where mothers play an important role. Evaluation of the knowledge, attitude as well as awareness in mothers toward immediate management in traumatic dental injuries.
Materials and Methods:
A 3-month survey was conducted among 120 mothers who visited the Department of Pedodontics and Preventive Dentistry for treatment. Fifteen closed-ended questions based on knowledge, attitude, and awareness were provided to the mothers, who were between 20 and 60 years of age. Results were statistically evaluated by using chi-square test, and the level of significance was set as
P
˂ 0.05. The Statistical Package for the Social Sciences (SPSS) was used for the statistical analysis. Independent two sample
t
-test was applied for comparing the mean difference of numerical variables between groups.
Results:
Results indicated the low knowledge level of mothers about immediate management of traumatic dental injuries. Residential status as well as education of mothers did not affect their awareness toward dental trauma, mother’s experience also had no effect in the preservation of avulsed tooth. No statistical significance was observed in either of the cases.
Conclusion:
The assessment showed a want of awareness and knowledge in mothers toward emergency management of traumatic dental injuries. Knowledge of parents in this area needs to be improved by educational programs.
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Comparison and evaluation of color stability and flexural strength of various provisional restorative materials after bleaching: An
in vitro
study
p. 293
Prashanth Kothari, Veena Hegde
DOI
:10.4103/jioh.jioh_83_19
Aims:
The purpose of this
in vitro
study was to evaluate and compare the effect of bleaching (16% carbamide peroxide) on color stability and flexural strength of DPI Self-Cure Tooth Moulding Powder, Protemp 4, and Revotek LC.
Materials and Methods:
Disc-shaped 10 samples were prepared for each of the materials DPI Tooth Moulding Powder, Protemp 4, and Revotek LC with a dimension of 10-mm diameter and 4-mm height. Similarly for flexural strength, 30 rectangular samples with a dimension of 25mm × 2mm × 2mm were made for each material. All the disc-shaped samples were dipped in bleaching agent and ΔE values were recorded before bleaching after 7 and 14 days of bleaching using spectrophotometer. For flexural strength, 10 rectangular samples of each material were kept in bleaching agent for 7 days and 10 samples were kept for 14 days. Remaining 10 without bleaching acted a control group. The data were subjected to repeated measures analysis of variance test.
Result:
No statistically significant difference was observed between the mean values of color change before bleaching and after 14 days of bleaching for all three materials. But statistically significant difference was observed in mean values of color change among the three materials (
P
< 0.001). For flexural strength, statistically significant difference was observed between the mean values of flexural strength before bleaching and after 14 days of bleaching for DPI (
P
= 0.007) and Revotek LC (
P
= 0.026).
Conclusion:
All the three materials showed noticeable color change after 7 and 14 days of bleaching when compared with color of specimen before bleaching. Maximum color change was observed in Protemp 4 and least color change was observed in Revotek LC. Flexural strength was significantly different among the material as well as there were significant changes in flexural strength of each material after bleaching.
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Referral pattern and treatment needs of patients managed at a Malaysian special care dentistry clinic
p. 299
Mas S Ahmad, Nur ES Shafie, Thahirah M Redhuan, Ilham W Mokhtar
DOI
:10.4103/jioh.jioh_84_19
Aims and Objectives:
This study was undertaken to investigate the referral patterns and treatment needs of patients managed by the special care dentistry (SCD) clinic specialists at a Malaysian teaching dental hospital, in preparation for improved oral health services for this patient population.
Materials and Methods:
The dental records of patients who attended the SCD clinic between January and December 2017, were reviewed for information, including sociodemographic characteristics, sources and reasons for referral, dental treatment needs, and medical profile. Quantitative data were analyzed via the Statistical Package for the Social Sciences version (chi-squared test,
P
< 0.01).
Results:
A total of 182 patients were managed in 2017, consisting mostly of Malays (89.6%) and with a majority being males (63.2%) in the 0–20 years age group (69.8%). A slight prevalence of adolescent/adult patients (52.2%) was reported as compared with that of pediatric patients (47.8%), with no significant difference between the genders. Many of the patients were encountered within the mobile dental service program (53.8%) and mostly first presented for routine checkups (66.5%). Treatment needs included periodontal therapy (76.9%), restoration (47.3%), exodontia (28.0%), and dentures (12.1%). The patient study sample additionally boasted physical impairments (58.8%), complex medical conditions (32.4%), psychiatric disorders (8.8%), and intellectual disabilities (8.2%). Systemic health issues included cardiovascular (18.7%), respiratory (9.9%), and endocrine (7.7%) disorders. Significant differences in the numbers of patients with physical disabilities and complex medical conditions were observed across age groups.
Conclusion:
This study provides important information for the future development of SCD services at the institutional and national levels.
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Reasons for permanent teeth extraction in the United Arab Emirates
p. 304
Raghad Hashim, Afraa Salah, Areej Hamid, Alaa Hamad, Kinda Slieby
DOI
:10.4103/jioh.jioh_95_19
Aims and Objectives:
The aims of this study were to investigate the primary reasons for extraction of permanent teeth and to assess its correlation with gender, age, and tooth type among patients treated in the two main dental colleges in United Arab Emirates (UAE).
Materials and Methods:
The study was conducted over 3 months; it consisted of 618 patients, aged 12–70 years, who underwent tooth extraction. There were 473 (70.7%) male and 181 (29.3%) female patients. Data retrieved were entered into excel database and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 21.
Results:
A total of 979 teeth were extracted from 618 patients. Caries was the main reason for tooth loss (81.5%), whereas periodontal diseases and orthodontics reasons were responsible for 10% and 4.7% of extractions, respectively. The highest rates (94.5%) of extraction occur among those aged 31–40 years. A significant association was present between gender and the number of teeth extracted.
Conclusion:
The findings of this study identified dental caries as the main reason for tooth extraction among the studied population in UAE.
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Prevalence and distribution of dental anomalies among a sample of orthodontic and non-orthodontic patients: A retrospective study
p. 309
Khalid A Aldhorae, Zainab M Altawili, Ali Assiry, Basema Alqadasi, Khalid A Al-Jawfi, Hisham Hwaiti
DOI
:10.4103/jioh.jioh_199_19
Aims and Objectives:
Dental anomalies are clinically evident abnormalities, which can lead to functional, aesthetic, and occlusal problems, which may complicate orthodontic treatment planning. The purpose of the study was to address the prevalence and distribution of dental anomalies in a group of Yemeni dental patients and to compare the presence of dental anomalies in patients seeking dental and orthodontic treatment.
Materials and Methods:
This retrospective study was conducted on 1675 digital panoramic radiographs for dental patients aged between 9 and 52 years, who visited orthodontic specialty centers in Sana’a, Yemen, from January 2018 to February 2019. The digital panoramic radiographs were evaluated for the prevalence and distribution of dental anomalies, such as supernumerary, hypodontia, microdontia, macrodontia, taurodontism, dens evaginatus, dens invaginatus, impaction, and dilacerations.
Results:
The distribution of anomalies was 30.61% among the orthodontic patients and 22.96% through non-orthodontic patients. The most frequent anomaly among the subjects was impaction (14%–47%), macrodontia (11.8%), microdontia (9.23%), hypodontia (7.48%), dilaceration (5.07%), dens evaginatus (1.91%), dens invaginatus (1.58%), hyperdontia (0.99%), and taurodontism (0.91%). Among the individuals who had dental anomalies, 57.9% of subjects showed one type of anomaly, 30.5% had two types of anomalies, whereas 11,49% had more than two types of anomalies. The selected dental anomalies in this study showed high prevalence rate among the orthodontic patients.
Conclusion:
Variations in data and results among different studies suggest the impact of racial, genetic, and environmental factors. The high frequency of dental anomalies emphasizes the need of early detection and diagnosis, which can be achieved through radiographic imaging, this would avoid potential orthodontic, functional, and aesthetic problems, and further emphasizes awareness to minimize any means of complexity of orthodontic and other dental problems.
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CASE REPORTS
Management of a traumatized and luxated maxillary incisor with customized computed-aided design and computer-aided manufacturing zirconia post–core and crown
p. 318
Vijetha Vishwanath, Hanumanth Murali Rao
DOI
:10.4103/jioh.jioh_35_19
The incidence of maxillary anteriors being injured during any assault to the facial region is nearly 37% owing to its position in the arch. Treatment planning always depends on the clinical scenario. Coronal fracture of teeth involving the pulp may need conventional endodontic treatment and aesthetic reconstruction. When there is not enough tooth structure to retain a crown, it may often need post–core to retain final post endodontic restoration. Various types and advancements of post-and-core systems have been documented in the literature over the years, with an excellent long-term prognosis. Although the traditional custom cast post-and-core system has been considered to be cumbersome and time-consuming, it has an added advantage of allowing modification in the angle of insertion and the position of the core to obtain optimal aesthetics. This case report presents the successful management with aesthetic rehabilitation of a fractured maxillary central incisor with customized computer-aided design–computer-aided manufacturing zirconia post–core and crown
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Glossitis mimicking median rhomboid glossitis induced by throat lozenges and refreshment candies
p. 323
Meircurius Dwi Condro Surboyo, Diah Savitri Ernawati, Adiastuti Endah Parmadiati
DOI
:10.4103/jioh.jioh_76_19
Acute sore throat is a condition of inflammation, characterized by pain, swelling, and burning sensation, which result from inflammation of the upper respiratory tract. Throat lozenges and refreshment candy containing the antiseptics and local anesthetics are commonly used to relieve the symptoms of sore throat. Side effects of using throat lozenges and refreshment candy have not been reported. This case report presents the case of glossitis mimicking median rhomboid glossitis induced by throat lozenges and refreshment candy, which is used to relieve the symptoms of sore throat. Management includes anamnesis, clinical examination, and instructions for stopping throat lozenges and refreshment candy consumption.
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