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   Table of Contents - Current issue
March-April 2017
Volume 7 | Issue 2
Page Nos. 71-153

Online since Wednesday, March 29, 2017

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Metastasis to the Jawbones: A review of 453 cases p. 71
Soussan Irani
The purpose of the present article was to review the characteristics of the jawbone metastases to analyze all variables. A relevant English Literature search in PubMed, Scopus, and Google Scholar was performed. All variables such as age, gender, primary and secondary tumor sites were analyzed. There were 453 metastatic cases. The male-to-female ratio was 1.2:1, and the mean age of the patients was 53.4 years. The lung was the most common primary site in men, and breast in women. The most common metastatic site was the mandible, and adenocarcinoma was the most frequent histological diagnosis. Metastases to the jaw bones occur in the advanced stages of a malignancy hence; a careful examination of patients with jaw bone lesions is strongly suggested. Dentists, as well as general physicians, should take into consideration the possible presence of jaw metastases in cases which present atypical symptoms, especially in patients with known malignant disease.
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Evaluation of the effectiveness of a primary preventive dental health education programme implemented through school teachers for primary school children in Mysore city p. 82
Jaya Naidu, B Nandlal
Aims and Objectives: The present study was conducted with the aim of evaluating the effectiveness of a Primary Preventive Dental Health Education Programme conducted for 6-12-year-old primary school children in Mysore City. Materials and Methods: A total of 12 schools, one each in the category of Government, Aided, and Unaided, were randomly selected per zone viz., North, South, East, and West. These 12 schools constituted the study group where the Primary Preventive School Dental Health Education Programme (PPSDHEP) was implemented. Two additional schools were selected at random from the four zones to serve as the control. A total of 926 children participated in the study. The PPSDHEP involved the second-level transfer of preventive package wherein the oral health education was imparted to the school children by schoolteachers trained by the investigator. Among the parameters for evaluating the outcome of the programme were the pre and post-programme assessment (at the baseline and at follow-up, i.e., after 6 months) of knowledge, attitude, and practice (KAP), dental caries status, oral hygiene, and gingival health status. Results: The results suggest that the PPSDHEP resulted in bringing about an enhancement in the KAP towards oral health and also an improvement in dental caries, oral hygiene, and gingival health status of the school children in the study group. Conclusion: The present study supports the implementation of similar programmes in schools and the contention that schoolteachers are suitable personnel for imparting dental health education to school children on a regular basis.
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Assessment of effectiveness of fluconazole and clotrimazole in treating oral candidiasis patients: A comparative study p. 90
RC Jagat Reddy, S Jeelani, P Duraiselvi, M Kandasamy, G Suresh Kumar, R Azhal Vel Pandian
Aims: One of the most common fungal infections infecting humans is Candidiasis. Belonging to the group of opportunistic infections, it often affects individuals with various debilitating diseases. Fluconazole and clotrimazole are two of the commonly used anti-fungal agents for the treatment of oral candidiasis. Hence, we planned this study to evaluate the effectiveness of fluconazole and clotrimazole in the treatment of patients suffering from candidiasis. Materials and Methods: A total of 180 participants were enrolled in the present study. All the patients of candidiasis were divided broadly into two study groups. Group I included patients who were treated with fluconazole mouthrinse whereas group II included patients who were treated with clotrimazole mouth paint. Grading of patient discomfort was done as noted from readings given by the patients. Specimen was collection by a swab from the lesional area of the oral cavity from the patients and were incubated in Sabouraud's dextrose agar medium and assessed. All the patients were treated with medication as give to their respective groups. Patients were recalled as assessed. All the readings were recorded and analyzed. Results: For group I patients, the fungal eradication was 89.5%, whereas for group II patients, the fungal eradication was 86.7%. No significant results were obtained while comparing the mycological eradiation in patients of the two study groups. Conclusion: Approximately similar effectiveness in terms of treatment was noted with fluconazole and clotrimazole in treating patients with candidiasis.
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Infant and child oral health risk status correlated to behavioral habits of parents or caregivers: A survey in central Italy p. 95
Iole Vozza, Francesca Capasso, Elisa Marrese, Antonella Polimeni, Livia Ottolenghi
Aim: The aim of this survey was to evaluate the knowledge and awareness of parents and caregivers about potential oral health risk factors for their children in their first months of life (3-30 months). Materials and Methods: The participation to the survey was proposed to all parents or caregivers of children attending the public consulting service in Latina for mandatory vaccinations during the period of June to August 2014. A self-administered questionnaire was completed to obtain information regarding demographic variables, infant feeding practice, maternal oral health during and after pregnancy, children's oral hygiene habits and risk behaviors (e.g., sharing cutlery, tasting of baby food, nightly using of baby bottles with sugared beverages, or sugared pacifier), and knowledge about caries and its transmission. The analysis of the data was performed using SPSS 14.0 for Windows (SPSS Inc., Chicago, IL, USA). The variance analysis and chi-square test were used to investigate the relationship between the variables. Results: Overall, the parents of 304 children consented to fill the questionnaire. Data analysis showed that about 50% of respondents considered dental caries an infectious disease, however, 53.6% was not aware of the potential vertical transmissibility of cariogenic bacteria through contaminated saliva. It is a common trend in the early stages of weaning to taste the baby food (53%) and sharing cutlery (38.5%). With regard to children oral health care, parents reported no toothbrushing for 53.1% of the children in their first 3 years of life. The relationship between the two variables concerning caries transmissibility and tools sharing carried out on through Pearson chi-square test identified P = 0.32. Conclusions: From this survey, the need for parental oral health promoting program emerged to control children oral health risk status.
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Prevalence of dental anxiety among dental patients in Saudi Arabia p. 100
Mostafa I Fayad, Ahmed Elbieh, Mohammed N Baig, Selham Alhabib Alruwaili
Objective: Anxiety towards dental procedures are common difficulties that may be experienced by dental patients all over the world. This study focused on evaluating the dental anxiety frequency and its relationship with age, gender, educational level, and past dental visits among patients attending the outpatient clinics of College of Dentistry, Al Jouf University, Saudi Arabia. Material and Methods: A total of 221 patients, aged 21-50 years were selected for the study. A questionnaire comprising the Modified Dental Anxiety Scale (MDAS) was used to measure the level of dental anxiety. Data was analyzed using SPSS version 20. Results: The mean anxiety score of the 221 patients was 11.39 (SD ± 2.7). Independent t-test showed a significant variation between the age groups with regards to their mean overall anxiety score (P < 0.05), which reduced with increasing age. A significant difference was found by independent t-test in the mean total score between male and female groups and regarding previous dental visit (P < 0.05). Regarding education level, there was no significant difference between the groups (P > 0.05). Conclusion: Younger patients, female, and patients with previous unpleasant dental experience were associated with increased MDAS score. Clinical Significance: The present study was done for better patient management and proper treatment plan development for dentally anxious patients.
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Use of platelet rich plasma in the management of periodontal intra-osseous defects: A clinical study p. 105
Md. Jalaluddin , Dhirendra K Singh, Ipsita Jayanti, Prasad Kulkarni, Mohamed Faizuddin, Fouzia Tarannum
Background: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment, and alveolar bone around the affected tooth. Alveolar bone support and attachment apparatus regeneration has been achieved through various processes and have given elusive results. An expedient and cost-effective approach to obtain autologous platelet-derived growth factor (PDGF) and transforming growth factor (TGF)-β is the use of platelet-rich plasma (PRP). PRP is obtained by sequestrating and concentrating platelets by gradient density centrifugation. Aims: The current study was aimed at evaluating the regenerative potential of platelet-rich plasma in comparison with open flap debridement. Settings and Designs: This study was a randomized controlled clinical trial conducted in the Department of Periodontics and Oral Implantology, KIDS, Bhubaneswar, Odisha. Materials and Methods: Twenty periodontal infrabony defects in 10 patients; 6 males and 4 females of age between 25-45 years were included in this study and were followed up for a period of 6 months. Statistical Analysis: Both the groups showed a mean plaque index of 2.10 and 2.50 at baseline, 1.75 and 2.05 at 3 months, and 1.28 and 1.53 at the end of 6 months. The mean reduction of 0.35 and 0.45 at three months and 0.82 and 0.97 at six months was achieved, which was statistically significant. (P < 0.001). When comparison was done between the two groups it was not found to be statistically significant (P < 0.05). In each of the group there was definitive reduction in plaque score over a period of time. Results and Conclusion: There was no statistically significant difference in the treatment outcome between open flap debridement and PRP alone. Platelet-rich plasma application holds promise and needs further exploration.
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Prevalence of dentinogenesis imperfecta in a French population p. 116
Antoine Cassia, Georges Aoun, Abbass El-Outa, Gérard Pasquet, Robert Cavézian
Background: Dentinogenesis imperfecta is a genetic disorder of the dentin occurring during the tooth development. It leads to many structural changes that can be identified clinically (brownish colored teeth, cracked enamel) and radiologically (globular crown, cervical constriction, short roots, and obliterated pulp chamber and/or root canals). The aim of this study was to determine by panoramic radiographs assessment the incidence of dentinogenesis imperfecta in a group of patients attending a specialized maxillofacial imaging center in Paris, France. Material and Methods: A retrospective observational study was conducted using panoramic radiographs of 8830 patients (3723 males and 5107 females), which were used to search the radiological criteria of dentinogenesis imperfecta. Results: In our sample, the prevalence of dentinogenesis imperfecta was 0.057%. Out of the 8830 subjects, 0.080% of the males presented the radiological signs of the dentinogenesis imperfecta against 0.039% of the females. Conclusion: In our study, we found that dentinogenesis imperfecta is a relatively rare dental anomaly in France, with a rate different from the rates reported in other studies and with no disparity in prevalence among genders.
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Estimation of serum triglycerides, serum cholesterol, total protein, igg levels in chronic periodontitis affected elderly patients: A cross-sectional study p. 120
AV Saravanan, PL Ravishankar, Pradeep Kumar, K Rajapandian, V Kalaivani, M Prem Blaisie Rajula
Aim: The present study was conducted to evaluate the serum triglycerides, serum cholesterol, total protein, and IgG levels in elderly patients who were affected by periodontal disease. Materials and Methods: This study was conducted at the Rajah Muthiah Dental College and Hospital in the periodontics division. The study was conducted for a period of 3 months. This study is a prospective analytical study. Sixty individuals who were systemically healthy in the age group of 50 and above were included in this study. Control and experimental groups of 30 participants each were included. Plaque index, gingival index, probing pocket depth, and clinical attachment loss were recorded. Biochemical parameters such as serum cholesterol, serum triglycerides, total protein, and IgG levels were also evaluated and correlated with the periodontal parameters. Data was analyzed using SPSS version 16.0 (IBM Corp., Armonk, NY). The relationship between periodontal status and the biochemical parameters such as serum cholesterol, serum triglycerides, total protein, and IgG levels were evaluated by Student's t-test. Results: There was no significant difference in the plaque and gingival scores between the experimental and control group. It was observed that serum cholesterol level and total protein level was lower in participants suffering from chronic periodontitis. Triglycerides level was significantly elevated in the experimental group. IgG, a level which is not significant, concluded that there is no difference in control and experimental group. Conclusion: It was concluded from the results obtained from the study that there is an association between serum triglycerides, serum cholesterol, total protein, and periodontal disease. However, further longitudinal and well-controlled studies are required to evaluate the relationship between these biochemical parameters and periodontal disease.
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Evaluation of temporomandibular disorders before and after orthognathic surgery: Therapeutic considerations on a sample of 76 patients p. 125
Carlo di Paolo, Giorgio Pompa, Paolo Arangio, Anna di Nunno, Stefano Di Carlo, Daniele Rosella, Piero Papi, Piero Cascone
Objectives: Temporomandibular disorders may be associated with dental and facial malformations. The aim of this study is to record the prevalence of TMDs in patients scheduled for orthognathic surgery, reporting the development of TMDs and symptoms during the entire period of the treatment, and demonstrating the benefits of a team effort on this population. Materials and Methods: Assessment of temporomandibular status was performed using the RDC/TMD criteria at T0 (prior to orthodontic therapy), T1 (3 months after the surgery), and T2 post-therapeutic cycle (6 to 12 months postoperatively). A total of 76 participants were included in the study; all the patients underwent surgical treatment: 12 had bilateral sagittal split osteotomy, 6 with condylar position devices; 64 had Le Fort I + bilateral sagittal split osteotomy, and 15 with condylar position devices. Results were evaluated with a paired-sample t-test and segmentation analysis. Results: Forty-seven patients were affected by TMDs. At T0, 25 patients experienced TMJ pain, 27 had muscular pain, 31 suffered headaches, 42 had disc dislocation with reduction, and 5 were affected by disc dislocation without reduction. Thirty-five patients had occlusal signs of parafunctions, 8 reported tinnitus, and 7 dizziness. At T1, TMJ pain changed from 33.3% to 4.44%, muscular pain changed from 35.5% to 11.1%, headaches improved from 40% to 6.67%, and disc dislocation from 55.2% to 17.7%. Segmentation analysis highlighted improvement after therapy; 57 patients were considered recovered, 14 improved, none were considered stable, whereas 5 patients demonstrated some worsening, 3 of whom had not presented disc dislocation before surgery. At T2, 71 patients were considered completely recovered or improved. Conclusions: Our data indicates beyond any doubt that both functional status and pain levels related to TMDs can be significantly improved with a multi-disciplinary approach. We concluded that surgeon's intervention need to be modified in the presence of presurgical TMDs.
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Antibacterial efficacy of tender coconut water (Cocos nucifera L) on Streptococcus mutans: An in-vitro study p. 130
JN Rukmini, Sunkari Manasa, Chenna Rohini, Lavanya Putchla Sireesha, Sachan Ritu, GK Umashankar
Objective: The antibacterial property of coconut, the presence of lauric acid, and the ability to extract antimicrobial peptides Cn-AMP (1, 2, and 3) from tender coconut water has drawn attention on its effectiveness in normal consumption. An in-vitro experimental study was conducted to evaluate the antimicrobial efficacy of tender coconut water in its natural state on Streptococcus mutans. Materials and Methods: Fresh tender coconut water and pasteurized tender coconut water were taken as test samples, dimethyl formamide was used as the negative control, and 0.2% chlorhexidine was used as the positive control. Pure strain of S. mutans (MTCC 890) was used for determining the antibacterial effects. The test samples along with the controls were subjected to antimicrobial sensitivity test procedure and the zone of inhibition was examined. Kruskal-Wallis test was used to check for any significant differences in the antibacterial efficacy between the samples. Result: There was no zone of inhibition with the tender coconut water, fresh and pasteurised, and negative control (dimethyl formamide). Zone of inhibition was seen in positive control (0.2% Chlorhexidine). Conclusion: No antimicrobial activity was demonstrated with tender coconut water in its normal state (in vitro).
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The effects of economic crisis on the demand and supply of the dental services in Greece p. 135
Diamantopoulos Kostas, Niakas Dimitris
Objectives: This paper attempts to explore the impact of the economic crisis on the supply and demand of dental care services by listing the changes in costs for dental care as well as by the use of a questionnaire administered to dentists. Materials and Methods: The Health Accounts System, the Household Budget Surveys of the Greek Statistical Authority, and a questionnaire distributed to dentists working as self-employed were used as analysis tools. The survey involved a total of 361 dentists from all the regions of the country. Results: During the period of the economic crisis, the household expenses for dental care decreased by 57% according to the Health Accounts System and by 59.38% according to the Household Budget Surveys. Regarding public expenditures, the direct government expenses decreased (excluding social insurance) by 57.55% and social insurance by 91.04%. On the demand side, the majority of respondents indicate a reduction in quantity and prices of dental procedures. An increase is noted in the number of extractions and changes are not reflected in the number of fillings and surgical extractions. For root canal treatments, the percentage of dentists stating decrease in the number is almost equal to the percentage indicating increase. On the supply side, respondents notice an increase in professional costs due to an increase taxes and materials. Conclusions: Dental expenditures and private income for dentists collapsed during the Greek economic crisis, and demand for dental services remained stable only for emergency cases and pain management.
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A survey of oral health in institutionalized population with intellectual disabilities: Comparison with a national oral health survey of the normal population p. 141
Hicham A Diab, Ghassan N Hamadeh, Fouad Ayoub
Introduction: Compared to the general population, the intellectually-disabled (ID) experience poor health and inferior access to high quality health services. Aim: To compare the oral health of institutionalized ID Lebanese individuals to that of the normal Lebanese population (NLP). Materials and Methods: Caries and periodontal indices were recorded in 652 ID individuals (aged 6, 12, 15, and 35-44 years) residing in the 5 major Lebanese governorates. The comparison population was derived from the National Oral Health Survey conducted in 1994. Results: Six-year-old ID children had an average of 3.28 decayed primary teeth, 0.22 filled primary teeth, and an overall dft score of 3.50, whereas in the general population decayed, filled, and overall dft scores were 4.90, 0.10, and 5.4, respectively. The lowest number of permanent decayed teeth in the ID was recorded in the 35-44-year-old group (3.17) and the highest in 15-year-old group (4.01). In the NLP, the number of decayed permanent teeth gradually increased from age 12 (5.14) to age 35-44 years (7.20). Caries indices were generally better in the ID than that in the NLP, except for more missing teeth in ID adults (6.24 compared to 4.98). The ID population presented with more severe periodontal disease (pocketing) whereas the NLP presented with a greater proportion with calculus. Conclusion: This study highlighted important differences in oral health and treatment needs in the ID compared than that of the NLP. Policy changes are required if adequate services are to be provided for this group of the population.
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Knowledge, attitude, and practice towards HIV patients among dentists p. 148
RS Dhanya, Vijaya Hegde, S Anila, George Sam, Rajat R Khajuria, Rishav Singh
Aims and Objectives: Discrimination by some health care workers, including dentists, against human immunodeficiency virus (HIV) infected persons has been noted. The main aim of the present study was to assess the knowledge, attitude, and practice towards HIV patients among the dentists of Trichur district, Kerala. Materials and Methods: A cross-sectional survey was conducted among 206 dentists practicing in Trichur district of Kerala. Data was collected using a pretested, self-administered 26-item questionnaire and was statistically analyzed using SPSS software version 20. Results: Out of 206 participants, 39.3% were unwilling to treat HIV patients. A statistical significance was found between willingness to treat HIV infected patients and age groups (P = 0.0001) as well as between the willingness to treat HIV infected patients and ethical responsibility (P = 0.0001). Conclusion: Staff fears and increased personal risk are found to be the most frequently reported concerns in treating HIV patients among dentists of Trichur district, Kerala. Senior dentists showed more reluctance to treat HIV positive individuals.
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