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Table of Contents
May-August 2016
Volume 6 | Issue 2
Page Nos. 65-110
Online since Monday, September 12, 2016
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EDITORIAL
Change: The New Constant of Life
p. 65
Rohan Bhatt
DOI
:10.4103/2321-8568.190314
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RESEARCH ARTICLES
New Treatment Approaches of Oral Mucositis: A Review of Literature
p. 66
Narges Gholizadeh, Nafiseh Sheykhbahaei, Maryam-Sadat Sadrzadeh-Afshar
DOI
:10.4103/2321-8568.190319
Oral mucositis (OM) is described as inflammation of the mucosa in the oral cavity which is caused by destruction of the oral mucosal epithelial cells and growth suppression secondary to cancer treatment in the form of radiotherapy or chemotherapeutic drug substances. It is the most debilitating condition and the most common complication in cancer patients. It appears first by thinning of oral tissues which leads to erythema. As these tissues become thinner, ulceration eventually occurs. Potential complications include pain, increased risk of local and systemic infections, bleeding and insufficient food intake and may lead to breaks in treatment sessions. It is usually associated with pain, increased risk of infection and dysphasia and may lead to inadequate hydration and impaired nutritional status. Traditional management of OM has involved patient compliance and education, hydration, nutritional support, use of saline rinses, topical and systemic pain relief and infection surveillance and treatment. The PubMed, Medline, Ovid, Science Direct and Google were searched from 1998 to 2015. The search terms used for medical subject heading were 'oral mucositis' and 'new treatments of mucositis'. Unfortunately, there is not a single method which is capable of preventing or eliminating OM in an efficient way. In this article, we reviewed new therapeutic methods of OM including cryotherapy, honey and coffee, propolis, low-level laser therapy, growth factors, stem cell therapy, hyaluronic acid-based substances and matrix metalloprotease blockers.
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Harvesting Mesenchymal Stem Cells for Dental Tissue Regeneration
p. 73
Dinta Kathiriya, R Murali, Madhusudan Krishna, Krupali Kakkad, Parthkumar A Thakkar
DOI
:10.4103/2321-8568.190318
In the present day, stem cell (SC) research has grown exponentially due to the identification that SC-based therapies have the aptitude to improve the life of patients who are suffering from Alzheimer's disease to cardiac ischaemia and in regenerative medicine i.e. bone or tooth loss. Based on the potential to rescue and/or repair traumatised tissue and restore organ function, various varieties of SCs are being investigated. Different human dental SCs are rich with mesenchymal SCs appropriate for tissue engineering. These SCs can be isolated and grown under distinct tissue culture conditions and are useful in tissue engineering. Summarising the high proliferation rates and the multipotency and accessibility makes the dental SC an excellent resource for tissue regeneration. The present review explains findings in the field of dental SC research and on their potential application in the tissue regeneration.
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ORIGINAL ARTICLES
Prevalence of Coronary Artery Disease in Rheumatic Heart Disease and Comparison of Demographic and Coronary Artery Disease Profile with Atherosclerotic Coronary Artery Disease
p. 76
Dinesh Choudhary, Amit K Chaurasia, VA Rohan, Ajeet Arulkumar, S Mahesh Kumar, S Harikrishnan, G Sanjay, VK Ajithkumar, T Titus, JA Tharakan
DOI
:10.4103/2321-8568.190322
Aim:
In India, coronary angiography (CAG) is usually performed in rheumatic heart disease (RHD) patients before valve replacement surgery if there is any suspicion of coronary artery disease (CAD) or the patient is aged >40 years. The aims of the present study were (1) to find the prevalence of CAD, CAD patterns and its association with various CAD risk factors in RHD patients and (2) to study the association of inflammation seen in RHD with prevalence of CAD.
Materials and Methods:
The records of 1204 RHD patients who underwent CAG before surgery from 2001 to 2010 were evaluated. Patients of RHD with significant CAD (≥50% stenosis) were compared with age- and sex-matched patients of RHD with no CAD and atherosclerotic CAD patients. All RHD patients with embolic acute coronary artery syndrome were excluded from the study.
Results:
One-hundred and nine (9.05%) RHD patients had significant CAD (males 65.1% and females 34.9%). The mean age was 52.8 ± 8.6 years (52.3 ± 8.9 years for males and 53.6 ± 8 years for females). Involvement of mitral valve was seen in 66.1%, aortic valve in 7.3% and both valves in 26.6% in these patients. Single-vessel disease, double-vessel disease or triple-vessel disease was present in 58.7%, 27.5% and 13.8%, respectively. Left main coronary artery was involved in 4.6% of the cases. Left anterior descending (LAD) was the most common vessel involved (68.9%), followed by right coronary artery (44.1%) and left circumflex artery (42.3%). Univariate analysis showed that polymorphonuclear leucocyte count was significantly higher (
P
= 0.037; odds ratio: 1.03 with 95% confidence interval: 1.001–1.056) in RHD CAD patients than the atherosclerotic CAD patients.
Conclusion:
The prevalence of CAD in patients with RHD is similar to other Indian studies but lower than the Western countries. Single-vessel involvement, mostly LAD, is more common among these patients. CAD risk factor is less common than the atherosclerotic patients. CAD in these patients may be attributed to the inflammatory state seen with RHD.
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Comparison of Spaced and Non-spaced Dentitions among the Children of Vadodara City
p. 84
Anuradha Karri, Seema Bargale, Bhavna Dave, Anshula Deshpande, Swara Shah, Akash Ardeshana
DOI
:10.4103/2321-8568.190317
Aim:
To compare dental arch size, mesiodistal (MD) and buccolingual crown widths between spaced and non-spaced dental arches.
Materials and Methods:
A total of 80 children were included in the study, of which 40 children had spaced dentition and 40 had non-spaced dentition. The selection was done on the basis of selection criteria. Alginate impressions were taken, and models were prepared. The tooth measurements for MD, buccolingual and clinical crown height along with arch dimensions were measured with the help of digital Vernier callipers. The measurements were entered into the prepared pro forma sheets and analysed. Statistical tests applied were independent sample
t
-test and Pearson's correlation test.
Results:
The MD dimension of the teeth was more in the spaced dentition than the non-spaced dentition. The buccolingual dimensions of the teeth were more in the non-spaced dentition than the spaced dentition. However, the difference was not statistically significant (
P
≥ 0.05). There was no statistically significant difference in the crown size ratio between spaced and non-spaced dentition, except for mandibular left second molar (
P
≤ 0.05). The arch dimensions were also more both in the maxilla and mandible in spaced dentition when compared to non-spaced dentition. The correlation was statistically significant.
Conclusion:
The tooth and arch dimensions of spaced and non-spaced dentitions among the Gujarati children were evaluated. The crowding of primary dentition has a definite correlation to the dental crowns' MD width.
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Comparative Evaluation of Flexural Strength of Heat Polymerised Denture Base Resins after Reinforcement with Glass Fibres and Nylon Fibres: An
In vitro
Study
p. 91
Kusum Singh, Sumit Kumar Sharma, Pooja Negi, Manish Kumar, Divya Rajpurohit, Priyanka Khobre
DOI
:10.4103/2321-8568.190315
Aim:
This study was an
in vitro
study done to evaluate and compare the flexural strength (FS) of heat polymerised polymethyl methacrylate (PMMA) denture base resins after reinforcement with nylon fibres and different concentration of glass fibres (GFs).
Materials and Methods:
Fifty heat-cured PMMA resin samples were fabricated using a die and divided into five groups, having ten samples in each group. All the samples were tested on universal testing machine and three point bending test was done. Then, FS of each sample was calculated. Mean value of FS of each group was used for statistical analysis. One-way analysis of variance test was used for statistical analysis.
Results:
Results showed that the fibres significantly affected the FS of PMMA. FS increases to the maximum with 5% GFs as compared to 2% glass, 2% nylon and 10% GFs.
Conclusion:
Polymers used in denture base fabrication, reinforced with GFs have shown to have a positive effect on the fracture resistance of dentures as compared to unreinforced PMMA.
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Effect of Non-surgical Periodontal Therapy on Glycosylated Haemoglobin Levels in Diabetics and Non-diabetic Healthy Controls with Periodontitis
p. 95
Harnil Vaghani, Rupal Mehta, Khushboo Desai, Shilpa Duseja, Tanvi Mehta
DOI
:10.4103/2321-8568.190313
Aim:
The aim of this study was to compare the glycosylated haemoglobin (HbA1c) levels in healthy patients and patients with periodontitis, before and after non-surgical periodontal therapy.
Materials and Methods:
A total of sixty patients were selected and divided into two groups. Group A included thirty patients without periodontitis and Group B included thirty patients with periodontitis. Body mass index and clinical parameters, including oral hygiene index-simplified (OHI-S), gingival index (GI), probing pocket depth (PPD), clinical attachment level and HbA1c levels, of all patients were recorded at baseline. Both group patients received non-surgical, periodontal therapy (scaling and root planing). After 3 months, all the patients were re-examined for clinical parameters, and HbA1c levels were evaluated and compared with the baseline values.
Results:
There were no significant differences in clinical parameters after 3 months when compared to baseline levels of OHI-S, GI, PPD and HbA1c in Group A. There was no clinical attachment loss in Group A, either at the baseline or after 3 months. At the end of 3 months, Group B showed improvement in all the clinical parameters, and their HbA1c levels also significantly decreased although the values never reached those of the healthy controls.
Conclusion:
The HbA1c levels of patients with periodontitis (Group B) were significantly reduced after 3 months of non-surgical periodontal therapy, although they never reached the same level as that of the patients without periodontitis (Group A).
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Comparative Evaluation of Antimicrobial Efficacy of Coffee Extract and 0.2% Chlorhexidine Mouthwash on the Periodontal Pathogens
Porphyromonas Gingivalis
,
Prevotella Intermedia
,
Fusobacterium Nucleatum
and
Aggregatibacter Actinomycetemcomitans
: An
In Vitro
Study
p. 99
Tien Lung Yi, Monali Shah, Divyaraj Raulji, Deepak Dave
DOI
:10.4103/2321-8568.190316
Aim:
Coffee extract has demonstrated significant antimicrobial properties against various Gram-positive and Gram-negative bacteria. 0.2% chlorhexidine, a potent allopathic reagent, in the mouthwash form is considered the gold standard of chemical plaque control. The aim of this study was to evaluate the antimicrobial efficacy of different concentrations of coffee extract with 0.2% chlorhexidine mouthwash on the following Gram-negative periodontal pathogens:
Porphyromonas gingivalis
,
Prevotella intermedia
,
Fusobacterium nucleatum
and
Aggregatibacter actinomycetemcomitans
under
in vitro
conditions.
Materials and Methods:
Bacterial suspensions of
P. gingivalis
,
P. intermedia
,
F. nucleatum
and
A. actinomycetemcomitans
were inoculated in agar plates with four, 5 mm diameter wells. Various concentrations of coffee extract and chlorhexidine mouthwash were added into wells in different plates and then incubated at 37°C for 48 h. The diameter of zones of inhibition was measured, and statistical analysis was done.
Results:
0.2% chlorhexidine mouthwash showed greatest zone of inhibition against all periodontal pathogens. Coffee at a concentration of 20% and 15% showed activity against
P. gingivalis
,
P. intermedia
and
A. actinomycetemcomitans
.
F. nucleatum
was resistant to all concentrations of coffee extract.
Conclusion:
Coffee extract possesses antimicrobial activity against the various periodontal pathogens though not as efficacious as the standard chlorhexidine.
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CASE REPORTS
Hemisection-saving by Slicing
p. 104
Kunjan Joshi, Vatsala Singh, Preeti Kambalyal
DOI
:10.4103/2321-8568.190320
The progressing inflammatory periodontal disease, if untreated, ultimately results in tooth loss. This inflammatory process can also affect the bifurcation or trifurcation of multi-rooted teeth. A mandibular molar with Grade III furcation and an endodontic involvement has always been a challenge for treatment, management and long-term prognosis. Hemisection refers to the removal or separation of root with its accompanying crown portion of two-rooted teeth, most likely mandibular molars. It is one of the treatment options for preserving the remaining part of the molar having sound periodontium. The present case report demonstrates the successful management of Grade III furcation involvement by hemisection procedure in mandibular molar using a vertical cut method and rehabilitation with fixed prosthesis.
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Ocular Prosthesis in Phthisis Bulbi: Patient Rehabilitation
p. 108
Sumit Kumar Chattopadhyay, Pratheek Shetty, Sachin Sinha
DOI
:10.4103/2321-8568.190321
Normal facial appearance is one of the inherent human traits, which if altered or lost, challenges the patient's physical, psychological and mental well-being as well as maxillofacial prosthodontics' ingenuity. Maxillofacial prostheses, which restore and replace stomatognathic and associated facial structure with artificial substitute, aim to improve the quality of life along with the mental satisfaction. This article describes a technique by which the state-of-the-art custom ocular prostheses has been fabricated in a case of 'Phthisis Bulbi' by making an accurate functional impression with the fine details of the eye socket and following all the steps of fabrication meticulously.
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