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   Table of Contents - Current issue
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January-June 2022
Volume 14 | Issue 1
Page Nos. 1-99

Online since Tuesday, January 4, 2022

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ORIGINAL ARTICLES  

Evaluation of chin morphology after two-jaw orthognathic surgery: A retrospective study using stereophotogrammetry p. 1
João Lisboa de Sousa Filho, Ana Maria Bettoni Rodrigues da Silva, Alexandre Elias Trivellato, Marco Antônio Rodrigues da Silva, Cássio Edvard Sverzut
DOI:10.4103/jorr.jorr_42_21  
Background: The mandibular advancement or setback achieved by bilateral sagittal osteotomy can generate significant changes in the soft tissues of the mandible and chin. This was a retrospective study of patients who underwent bimaxillary orthognathic surgery in the Oral and Maxillofacial Surgery Residency Training Program, School of Dentistry of Ribeirão Preto, University of São Paulo. Objective: The aim of this study was to retrospectively evaluate changes in chin morphology in patients with orthognathic surgery of two jaws using Three-dimensional (3D) photography. Based on inclusion and non inclusion criteria, 11 records including 9 women (81.1%) and 2 men (18.9%), with a mean age of 33.5 years, were incorporated in the study. 3D images were analyzed with Vectra M3® software (Canfield Scientific, Fairfield, NJ, USA), after marking reference points on the face, determining linear measurements, and performing area and angle calculations. We analyzed 3D photographs obtained preoperatively (T0), 6 months (T1), and 1 year (T2) after surgery. Results: Chin height (Li-Me) and surface (Li-Me) demonstrated an average increase of 9.2 mm and 8.8 mm, respectively, after 6 months. In addition, chin prominence (Go-Pg), chin-to-neck distance (C-Gn), and lower jaw area increased on average by 12.1 mm, 15.0 mm, and 34.6 mm2, respectively, after 6 months. However, the mentolabial angle (Li-Si-Pg) decreased on average by 18.8° after 6 months. All results remained stable after 12 months. Conclusion: In conclusion, 3D photography was very useful for the evaluation of facial soft-tissue changes after orthognathic surgery. Our study demonstrated a decrease in mentolabial angle and increases in chin prominence, chin height and surface, chin-to-neck distance, and lower jaw area.
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In vitro evaluation of cyclic loading on retention strength of Retention.sil and O/ring attachments for tooth supported overdenture Highly accessed article p. 7
Raadhikka Karthhik, Bharath Raj, GP Surendra Kumar
DOI:10.4103/jorr.jorr_40_21  
Statement of Problem: Numerous different attachments are used to retain overdentures. Hence, there is a need to assess new chairside attachment system based on polyvinylsiloxane (Retention.sil [R.S]) to know its in vitro behavior to be used clinically. Purpose: To assess and compare the retentive force of two female matrix retention system (R.S with a conventional O-ring [OR] attachment system) in tooth-supported overdenture. Materials and Methods: Completely edentulous mandibular model with two canine root-anchored ball attachments for overdentures were fabricated. A total of 30 mandibular dentures were made and divided to form two groups, each with a different attachment design. One group (test) received 5 pairs of R.S attachments while the other group (control) received 15 pairs of ORs. Retention force was measured by subjecting them to 540 cycles of insertion and de-insertion cycles (representing 6 months functional life) in axial direction before and after thermocycling. Results: Statistical analysis comprised Kolmogorov–Smirnov test, Friedman test, and Wilcoxon signed-rank test (α = 0.05). The initial retention of R.S attachments was 5.90 ± 0.77 N and of ball/OR 17.36 ± 3.81 N. The final retention of R.S attachments was 5.41 ± 0.72 N and of ball/OR 12.91 ± 3.18 N. The OR developed higher retentive force as compared to the R.S attachments (P < 0.05). However, no significant changes in retention force were observed for R.S groups after repeated dislodging and thermal undulation. Conclusion: Both systems presented acceptable retention capacities after 540 cycles. The newly developed R.S attachments can provide an alternative to OR attachments for short-term retention. Clinical studies are however required to elucidate the long-term performance of these materials.
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Suitability of virtual reality for simulating smoking among current mild cigarette smokers in Chennai city p. 16
Monica Gurupriya Mohanram, PD Madankumar
DOI:10.4103/jorr.jorr_37_21  
Background: Multi-component psychological interventions have proven broadly to be effective for smoking cessation. Cue-induced craving is considered responsible for relapse after smoking cessation. Cue Exposure Therapy (CET) consists of controlled and repeated exposure to stimuli associated with substance use to extinguish craving responses. A recent mode of cue presentation that has received increasing attention in the literature is the use of virtual reality (VR). VR uses computer-based technology to generate three-dimensional environment that allows people to move through their surroundings and interact with the created environment. The aim of our study was to determine the suitability of VR for simulating smoking among current cigarette smokers in Chennai city. Materials and Methods: A cross-sectional study was conducted with a purposive sample of 40 truck drivers above 18 years of age. Sense of satisfaction experienced by participants after completion of one VR session was assessed at the end of the experiment using suitability evaluation questionnaire (SEQ). Results: The mean age of the participants was 47.23 ± 12.43 ranging from 19 to 74 years. The suitability of VR for simulating smoking among current mild cigarette smokers according to the SEQ scale showed intermediate suitability. Conclusions: The result of the present study showed that VR environments that simulate real situations are suitable to elicit craving and thus assist in smoking cessation.
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Comparative evaluation of antiplaque and antigingivitis effect of 3% Murraya koenigii mouthwash versus 0.2% chlorhexidine mouthwash: A randomized double-blinded controlled trial p. 22
Vartika Verma, Shivani Sharma, Sanjeev Kumar Salaria, Sumit Malhotra, Mohd Nazar Rana, Pooja Mishra
DOI:10.4103/jorr.jorr_35_21  
Introduction: Control of supragingival plaque has been the mainstay in the primary and secondary prevention of periodontal diseases. Due to the difficulty in achieving adequate plaque control by mechanical means, there is a great interest in the use of antimicrobial agents to replace or to be used as adjuncts to mechanical approaches. Herbal products are considered as an interesting alternative to synthetic antimicrobials due to their distinctive advantages. Murraya koenigii is one such herb which not only adds aroma to our food but also has a huge panorama of antimicrobial, antioxidative, and cytotoxic properties. Aim: The aim of the study is to comparatively evaluate the effectiveness of 3% M. koenigii and 0.2% chlorhexidine gluconate (CHX) mouthwash in the reduction of plaque and gingivitis in patients suffering from mild to moderate gingivitis. Materials and Methods: Forty-five participants participating in this study were divided into three groups and underwent Phase I therapy on the first visit. Patients were recalled after 7 days; Group M, Group C, and Group P participants were instructed to use 3% M. koenigii, 0.2% CHX, and placebo mouthwash respectively, twice a day, for a minute for 2 weeks as an adjunct to mechanical plaque control. Turesky–Glickman–Gilmore modification of Quigley Hein plaque index (PI) and modified gingival index (GI) were recorded at baseline (7th day) and at the end of the study (22nd day). Student's paired t-test and one-way analysis of variance test, post hoc analysis were used for intra and intergroup comparison of parameters, respectively. Results: The results of the study showed that all the Groups M, C, P showed a statistically significant difference in gingival scores with a mean difference of 0.438 ± 0.234, 0.408 ± 0.388, 0.425 ± 0.237, respectively, when compared with baseline. Plaque scores for Group M and Group C were statistically significant with mean difference of 0.878 ± 0.433 and 1.090 ± 0.613, respectively. However, the mean change in PI and GI scores between the Groups M, P, and K was statistically nonsignificant. Conclusion: M. koenigii mouthwash is equally effective as CHX, in the reduction of plaque and gingivitis.
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Eruption chronology of 1st permanent tooth and evaluation of several factors among the children of Kolkata − An original research p. 28
Trisha Das Sarma, Gautam Kumar Kundu, Taniya Thakur, Poulam Guha
DOI:10.4103/jorr.jorr_34_21  
Objective: Eruption is an orderly, sequential, age-specific event and an important milestone during child's development. Along with the study of prenatal and postnatal growth, diagnosis and treatment planning and maintaining birth records also need idea about proper eruption sequence. The purposes of this study are as follows: To determine which permanent tooth first erupts and at which age, identify if any difference exists with the existing eruption sequence and to note factors if any related to specific eruption chronology among the 5–7 years' old children of North Kolkata. Materials and Methods: Socioeconomic statuses were noted as per the Modified Kuppuswamy Scale. Body mass index (BMI) was calculated with Centers for Disease Control and Prevention child and teen BMI calculator. Tooth notation was recorded using the foreign direct investment system. Children in whom no permanent tooth was erupted, intraoral periapical radiograph was taken with the help of dental mesh gauge in mandibular (mand.) anterior and posterior region. Variables which may influence eruption time were recorded in prevalidated questionnaire. Statistical analysis was performed using IBM SPSS 20.0 software. Results: Mand. central incisor (CI) was the 1st erupted permanent tooth in 31.8% children and Mand. 1st Molar (M1) in 67.9% of total study population. The mean age of eruption of 1st erupted permanent tooth was 5.981 ± 0.547 years. More no of samples (3.80%) from upper socioeconomic status have shown Mand. CI as 1st erupted permanent tooth. Percentage of preterm children (20%) and infants with any systemic diseases (9.50%) were also more in this group. Conclusion: In many children, Mand. CI is the 1st erupted permanent tooth; this is definitely a Milestone Data and did not match with Kronfild and Schour's permanent teeth eruption time table which we are blindly following for years. Parental education and further periodic revaluation are needed for future purpose.
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CASE REPORTS Top

Hypertelorism-microtia-clefting syndrome in a 9-month-old child: A rare case report p. 38
Supreet Shirolkar, Rajib Sikdar, Khooshbu Gayen, Anisha Bag, Santanu Mukhopadhyay, Subir Sarkar
DOI:10.4103/jorr.jorr_23_21  
Hypertelorism-microtia-clefting (HMC) syndrome is a very rare autosomal recessive disorder. HMC syndrome is malformation of orofacial region characterized by hypertelorism, microtia, and cleft lip and palate. Additional features such as microcephaly, congenital heart disease, and kidney abnormalities can also be present in HMC syndrome. Only few case reports of this syndrome have been documented in dental literature. In the article, we report a case of 9-month-old girl child presenting with typical features of this syndrome. The rarity of the syndrome prompted us to report the case.
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Bohns' nodules: A lesser reported clinical entity p. 42
Rahul Kaul, Atul Bali, Vijay Lal, Rishu Koul
DOI:10.4103/jorr.jorr_19_21  
Bohns' nodules is a transient oral mucosal condition found mainly in Caucasian infants which are usually asymptomatic and do not interfere with feeding. This is a case report of a 4-month-old female was brought by her mother to a dental clinic with the chief complaint of swelling present on the gum of the upper jaw. The parents of the child were counseled and reassured and no treatment of any kind was performed.
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Adenomatoid odontogenic tumor in association with dentigerous cyst: An enigma p. 44
Sonam Sharma, Amita Sharma
DOI:10.4103/jorr.jorr_16_21  
The odontogenic tissue surrounding an impacted tooth is a harbinger of a wide variety of odontogenic cysts and tumors. As these hamartomatous and neoplastic aberrations can occur at any stage of odontogenesis, therefore combined features of odontogenic tumors with epithelial and mesenchymal components can develop within the odontogenic cysts. One of the odontogenic cysts is the dentigerous cyst (DC) which is not only the most common developmental odontogenic cyst arising from the pericoronal tissue but is of great clinical significance owing to its neoplastic potential and association with other rare odontogenic tumors. We herein describe an unusual case of adenomatoid odontogenic tumor which developed secondary to a DC in a 22-year-old female and created a diagnostic conundrum. The approach to such a case, differential diagnosis, and review of the literature is also presented.
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REVIEW ARTICLES Top

Pediatric dentistry post coronavirus disease 2019: Changing treatment paradigms in the pandemic setting p. 50
MM Dempsy Chengappa, Atul Bali, Rahul Kaul, Rishu Koul
DOI:10.4103/jorr.jorr_55_20  
Coronavirus disease 2019 (COVID-19) pandemic has had a great impact on the practice of dentistry. Dental setups are potential focal points for cross-infection, and utmost care must be taken to reduce the risk of infection to, from, or among dentists, paradental staff, and patients. A specific concern for children is the uncertainty of their infection status; a clinical history may not be as suggestive of the infection as it is in adults. This makes pediatric dentists more prone to getting infected by the disease. The present review is aimed to provide an overview of potential dental emergencies in pediatric dental practice and a summary of the available treatment strategies that can be utilized by pediatric dentists with an aim to minimize aerosol generation to reduce chances of transmission during and after COVID-19 pandemic.
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Coronavirus disease 2019 pandemic: An insight into an urgent oral health care and future challenges based on current evidence p. 56
Sagar S Bhat, Ameet V Revankar, Shrinivas M Basavaraddi
DOI:10.4103/jorr.jorr_52_20  
A sequence of unexplained pneumonia cases was reported in December 2019 in Wuhan, China. After several analyses, in January 2020, the World Health Organization temporarily named this new virus as the 2019 novel coronavirus (2019-nCoV). It is found that 2019-nCoV is abundantly present in nasopharyngeal and salivary secretions of affected patients and it is found to be transmitted through the saliva and the feco–oral routes since its spread is through potential person-to-person transmission route which is predominantly thought to be respiratory droplet/contact in nature. Dental surgeons are at tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to aerosols, saliva, blood, and other body fluids and the handling of sharp instruments and also may encounter patients with suspected or confirmed severe acute respiratory syndrome coronavirus 2 infection and will have to act diligently not only to provide care but also at the same time prevent nosocomial spread of infection. The significance of this review is that oral health providers must be aware and be prepared to tackle any imminent infectious diseases like the present coronavirus disease 2019 outbreak, which can be life threatening to susceptible patients. This review provides a brief outline of the epidemiology, symptoms, mode of transmission, specific recommendations for dental practice that are suggested for patient screening, infection control strategies to block the person-to-person transmission routes in dental clinics and hospitals, and patient management protocol since there are certain chances of encountering oral emergencies such as acute pulpitis, periapical periodontitis, abscess, dental trauma, children's oral emergencies, and oro-maxillofacial infections during this period.
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Role of stem cells in periodontology: A review p. 66
Shruti Singh, Deepa Dhruvakumar
DOI:10.4103/jorr.jorr_15_21  
Periodontal regeneration is thought theoretically possible but clinically unpredictable. In periodontitis, inflammation clinically manifests as the deterioration of periodontal tissue support, and the regeneration of weakened tissue is the primary objective of therapy. For years, periodontists have attempted to remedy the damage through a combination of surgical techniques, the use of growth factors with grafting materials, and barrier membranes. Reports also appeared indicating the populations of adult stem cells (SCs) exist in periodontal ligaments of humans as well as animals. This paves the wave in modern cell treatment for periodontal regeneration. This review offers a description of adult human SCs and their potential for periodontal regeneration.
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Nonfluoride remineralizing agent for caries prevention in children: A systematic review and meta-analysis p. 71
Sowndarya Gunasekaran, Soundarya Sakthivel, Pazhayidath Isaac Nainan, BM Shanthala
DOI:10.4103/jorr.jorr_41_20  
Background: The recent outburst of nonfluoride remineralizing agents suggests that it may serve as alternative and as an adjunct for fluoride in preventing, arresting, or even reversing dental caries. Aim: This study aims to assess the caries prevention potential of a variety of nonfluoride agents in children, with an efficient and extended literature database search. Materials and Methods: Electronic (MEDLINE, PubMed, and The Cochrane Library) and manual searches were conducted for relevant studies published till March 2020. Randomized control trials (RCTs) that investigated the effect of nonfluoride remineralizing agents such as casein phosphopeptide-amorphous calcium phosphate (ACP), ACP, arginine, probiotic, xylitol, chlorhexidine, and nanoparticles in remineralization and prevention of dental caries were assessed. Results: Twelve studies met the criteria. There were 2653 patients in the test group and 2596 in the control group. Participants using nonfluoride agents were more likely to experience a reduction in dental caries compared to control ([standardized mean difference {SMD}] −0.55 [−1.06, 0.04], 95% confidence interval [CI], I2 = 98%), but there was substantial heterogeneity (98%) across studies. Moreover, an overall statistically insignificant benefit of Non-fluoride agent was detected (SMD −0.55 [−1.06, 0.04], 95% CI, I2 = 98% P < 0.00001). Conclusion: High-quality RCTs on the preventive effect of nonfluoride agents in children are still important to make a conclusive recommendation.
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Silver as an antimicrobial coating on titanium implants p. 80
Anukrati Katariya, Gouri Bhatia
DOI:10.4103/jorr.jorr_33_21  
Silver and its compounds have been used for centuries for their medicinal properties and for more than a century in dentistry. Biofilm formation and microbial colonization on the surface of implant devices may cause peri-implantitis, resistance to aggressive pharmacological agents as well as host defenses. Therefore, different surface treatments to improve the antibacterial activity of titanium implants have been created. Silver can be used to reduce bacterial adhesion to implant surfaces. The objective of this review is to depict the evidence supporting the medicinal use of silver in implant dentistry and their findings in clinical research.
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Ozone therapy in dentistry: A literature review p. 84
Vrinda Vats, Sonam Dhall, Akshat Sachdeva
DOI:10.4103/jorr.jorr_39_21  
Ozone is a form of oxygen which has shown to be fruitful in the management of various diseases for many years now. Ozone therapy is slowly emerging as an alternative treatment modality for many dental pathologies catering to all age groups. It has proven to be beneficial than conventional strategies with applications to dental treatment. The present article aims to discuss the role of ozone in the management of certain conditions in the oral cavity and its possible clinical applications in the future.
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Evidence of oral health intervention during pregnancy for spontaneous preterm birth reduction: An integrative review p. 88
Cristina Dutra Vieira, Andreza Nayla de Assis Aguiar, Camilla Aparecida Silva de Oliveira Lima, Zilma Silveira Nogueira Reis
DOI:10.4103/jorr.jorr_5_21  
Oral health care is critical for overall well-being, which is associated with better obstetric outcomes. The aim of the present integrative review was to assess scientific reports to support the planning of effective oral health interventions to prevent preterm birth (PTB) and low birth weight (LBW), as a secondary target. Seven bibliographic bases were searched from 2013 to 2018. Studies including oral health interventions during antenatal care with measurable impact on PTB or LBW reduction were searched. Sixteen studies were included. The heterogeneity in the population of pregnant women, and the types of oral intervention as well as the lack of accurate gestational ages, made it difficult to summarize the evidence. Despite the early intervention in high-risk groups, there was not enough evidence to support a significant reduction in PTB rates. There was some evidence that untreated periodontal disease in pregnancy was associated with LBW. This review did not provide strong evidence that preventive oral interventions during pregnancy had a measurable impact on spontaneous PTB reduction. However, further research is needed to clarify the impact of oral health interventions on the general pregnant women population or on those with a high risk of PTB and LBW.
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