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   Table of Contents - Current issue
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January-June 2023
Volume 15 | Issue 1
Page Nos. 1-91

Online since Friday, December 30, 2022

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ORIGINAL ARTICLES  

Oral health status and treatment needs in primary school children of Kochi: A Mixed Indian urban population setting survey Highly accessed article p. 1
MM Dempsy Chengappa, Akshai Kannan, Rahul Koul
DOI:10.4103/jorr.jorr_61_21  
Background: Oral health has a multifaceted nature as it encompasses a person's ability to speak, smile, smell, taste, touch, chew, swallow, and convey a range of emotions through facial expressions with confidence and without pain, discomfort, and disease of the craniofacial complex. Oral health paves way for good general health and essential well-being. Aim: The present study was undertaken to determine the oral health status and treatment needs of school-going children aged 6–10 years of attending government schools in Kochi, Kerala, India. Materials and Methods: The present study was a cross-sectional study that included screening for dental caries, enamel fluorosis, dental trauma, malocclusion, and treatment needs of 533 primary government school-going children of Willingdon Island, Kochi. Children were assessed as per the World Health Organization Oral Health Assessment Form for Children given in the year 2013. A stratified random sampling method was followed. The means and percentages were calculated, and comparison was done using ANOVA, Chi-square test, and Student's t-test to find the difference in proportion. All values were considered statistically significant at P < 0.05. Results: The dentition status of the surveyed children revealed a prevalence of dental caries in the study was found to be 50.09% (267). A significant difference was observed between different class students concerning mean DMFT scores (F = 8.5660, P < 0.05). The survey also revealed that the prevalence of enamel fluorosis, traumatic dental injuries, and malocclusion was found to be 3.38%, 1.69%, and 2.63%, respectively. Treatment needs status among students revealed that 85 students needed a preventive or routine treatment and a minimum of two students needed immediate (urgent) treatment who were referred to a dental hospital and 9.76% of students needed Orthodontic intervention. Conclusion: The high prevalence rate shows that further follow-up and awareness among the teachers, parents, and students regarding dental caries, oral health, and dental hygiene is needed. Further, studies of similar nature on a larger sample are required to correlate the prevalence of dental caries in the target population with other socio-behavioral factors.
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Comparison of pre- and postsurgical periodontal therapeutic effects on serum sclerostin in confirmed periodontitis cases p. 8
Banda Madhavi, Jammula Surya Prasanna, Koduganti Rekha Rani
DOI:10.4103/jorr.jorr_12_22  
Context: Connective tissue and alveolar bone loss in the region of the teeth is very frequent in inflammatory conditions like periodontitis (PD). As things go, apical movement of junctional epithelium deepens the periodontal pocket, ultimately tooth loss. Periodontal research advancements in biomarker assay prop up the risk by prior identification. Sclerostin, a skeletal marker, has been assessed to explore the intensity of PD and its effect after periodontal therapy. Aims: This study aimed to estimate serum sclerostin in patients affected with PD at the reference point and after periodontal therapy. Settings and Design: This was an interventional prospective study. Materials and Methods: Age-matched 30 PD patients, both male and female, were chosen. Clinical considerations, probing pocket depth and clinical attachment level, were assessed. Serum sclerostin levels were estimated using ELISA at baseline, 4 weeks after nonsurgical periodontal therapy (NSPT), and after 6 weeks of Surgical Periodontal Therapy (SPT). Statistical Analysis Used: Data were scrutinized by the SPSS version 23. A descriptive, paired t-test was done for values obtained at various intervals. Results: A positive correlation of sclerostin was found with severity of PD and was declined from starting point to NSPT and further to SPT (P<0.001). Both clinical as well as biochemical parameters reduced to NSPT and more significant reduction to SPT (< 0.001). Conclusions: Sclerostin severity was reduced in NSPT stage compared with baseline values, and furthermore reduced in SPT stage. Concluding that periodontal therapy is effective on biochemical marks, intensity and periodontal disease initiation can prior be detected by markers such as sclerostin.
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Investigation of shear bond strength of different adhesive agents to demineralized enamel with or without resin ınfiltration p. 14
Rabia Bilgic, Merve Iscan Yapar, Neslihan Celik, Nilgun Akgul
DOI:10.4103/jorr.jorr_78_21  
Objectives: This study aimed to investigate the bond strength of adhesive agents to enamel surfaces with and without resin infiltration. Materials and Methods: The crowns and roots of 198 human incisors were separated from each other and placed in an acrylic mold. The teeth were ground until the guide grooves created with the slotted bur disappeared. Then, it was thrown into the demineralization solution and artificial caries lesions were created. Teeth were randomly divided into two main groups, and each main group was divided into five subgroups. And also the control group was determined. The materials and composite were applied to demineralized enamel. For the shear bond analysis, a universal testing machine was used. Statistical analysis of the data was evaluated by one-way ANOVA test and independent t-test. Results: The result showed that there was no statistical difference between no resin infiltrant adhesive bonding agent groups (P < 0.05) and no difference between resin-treated groups and untreated groups of each bonding agent (P < 0.05). Furthermore, there is no difference between resin infiltrant pretreated adhesive bonding agent groups (P < 0.05). Conclusion: The use of different adhesive systems during restorative procedures after resin infiltration did not affect the shear bond strength.
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A comparative evaluation of sagittal condylar guidance obtained by the protrusive interocclusal record and panoramic radiographic tracing in both dentulous and edentulous patients p. 21
Riju Das, Tapan Kumar Giri, Bishakha Kanrar, Sugato Mukherjee
DOI:10.4103/jorr.jorr_51_21  
Introduction: Successful prosthesis is made in harmony with the stomatognathic system. To fabricate a successful prosthesis the stomatognathic system must be simulated outside the patient's mouth in a mechanical device called articulator. For the aforesaid reason replication of sagittal condylar guidance outside the patients, the mouth is of utmost importance. Aim of Study: To compare sagittal condylar guidance obtained by conventional method and panoramic radiographic tracing in both dentulous and edentulous patients. (1) To determine the condylar guidance on panoramic radiographs in dentate and edentulous subjects. (2) To determine the condylar guidance by the conventional clinical method in both dentate and edentulous patients. (3) To compare the values obtained from panoramic radiographs with the values obtained by conventional techniques. (4) To compare the right side condylar guidance values to the left. Methodology: A total of 20 dentulous and 20 edentulous patients were selected and their sagittal condylar guidance is recorded firstly with conventional method and then with the tracing of orthopantomograph (OPG). Then, these values are compared with each other to find out any significant difference between these two methods. Results: There is no significant difference in sagittal condylar guidance obtained from OPG and protrusive interocclusal record (PIR) method in dentulous and edentulous patients. Conclusion: The radiographic method is a potential alternative to PIR method.
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The prevalence of pulp stones in a North Indian population: A retrospective panoramic radiograph study p. 28
Daiasharailang Lyngdoh, Sharique Alam, Huma Iftekhar, Aaliya Rehman, Syed Mukhtar Un Nisar Andrabi
DOI:10.4103/jorr.jorr_16_22  
Background: Pulp stones (PSs) are calcification within the pulp space formed as a physiologic or pathogenic response. Local and systemic factors are implicated in its occurrence. Objectives: The aim of this study was to estimate the prevalence of PSs in a sample of the North Indian population using dental panoramic radiographs, and to report its association with age, gender, tooth class, dental arch, and restorative status of the teeth (restored/unrestored). Materials and Methods: A total of 500 panoramic radiographs were randomly sampled from the archived dental records of patients treated in the dental hospital from 2015 to 2021. 450 panoramic radiographs containing 10,007 teeth met the inclusion criterion and were evaluated for the presence of PSs. The frequency of occurrence of PS between age, gender, tooth class, dental arch, and restorative status of the teeth was also calculated. Results: PSs were detected in 128 (28.44%) out of the 450 patients, and 369 (3.68%) of the 10,007 teeth examined. A χ2 test of independence did not reveal any statistically significant association of PS with gender, age, and dental arch. The presence of PS was greatest in molars, and the results were statistically significant compared to all the other tooth types. The frequencies of PS were higher in the first molars (18.21%) than in the second molars (9.01%) when consolidated data for both arches were analyzed (P < 0.05). Carious/restored teeth displayed a statistically significant higher prevalence of PS than unrestored and intact teeth (12.95% vs. 10.32% prevalence rate as a ratio of total teeth examined). Conclusions: The etiology of PSs is not completely validated. Further studies are needed to establish the factors involved in PS formation and evaluate its association with systemic diseases.
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The effect of prophylaxis paste and air-powder polishing on color stability and surface roughness of different composite resins p. 34
Turan Emre Kuzu, Ozcan Karatas
DOI:10.4103/jorr.jorr_14_22  
Aim: This study examined the impact of periodontal prophylaxis paste and air-powder treatment on nano- and microhybrid composite resin surface roughness and color change. Materials and Methods: Thirty specimens were prepared from a nanohybrid and a microhybrid composite resin. The specimens were distinct into three subgroups, and the first color measurements were done. Then, a periodontal prophylaxis paste was applied to one of the subgroups prepared from each composite, and air-powder polishing was applied to the second subgroups, and specimens in the third subgroup were kept in distilled water. Then, the specimens were washed and stored in distilled water for 24 h. After storing, the specimens' mean color change and surface roughness values were calculated. The data were recorded and statistically analyzed. Results: The highest mean color change was observed in the microhybrid composite air-powder group while the lowest in the nanohybrid composite control group. The surface roughness of the air-powder specimens was statistically significantly higher than in the other groups. Conclusions: Depending on the kind of composite resin, periodontal surface treatments may have an impact on color and surface roughness. After periodontal therapy, the dentist should assess the current composite resin restorations.
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Comparative cross-sectional study regarding the knowledge and attitude of dental students toward biomedical waste legislation, segregation, and management practice p. 40
Santosh Mahajan, Harsimran Singh Kapoor, Jagtar Singh
DOI:10.4103/jorr.jorr_42_22  
Introduction: Dental practices generate a huge amount of biomedical waste (BMW) and dental waste contaminated with body fluids and many toxic chemicals. Improper handling of these wastes affects the surroundings and health of all living beings of that area. It is, therefore, important for budding dentists to be well versed with the existing rules and regulations of BMW management and the harmful effects of these wastes. Materials and Methods: A cross-sectional questionnaire-based study was carried out among undergraduates, interns, and postgraduate students pursuing dentistry in a dental institute in Punjab. The responses of the student were recorded and analyzed statistically using Chi-square test and Student's t-test. Results: The mean knowledge score of the students about the segregation of BMW is significantly more than legislation (P = 0.003) and management (P = 0.03). The knowledge of preclinical students is found to be less than other students. More than 80% opined that and there should be a regular program on BMW management and it should be made a compulsory part of the college education. Conclusion: Although the knowledge of students attending patients is more than the preclinical students, their overall awareness is less than adequate. It is envisaged through this study that implementing BMW management to be a compulsory part of college education could help to fill the lacuna in the knowledge of the present scenario.
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CASE REPORTS Top

Rehabilitation of facial dermatologic lesion of dental origin in a pediatric patient p. 48
Mohammad Kamran Khan, Mahendra Kumar Jindal
DOI:10.4103/jorr.jorr_73_21  
Odontogenic cutaneous sinus tract (OCST) of the facial region is rarely found and mostly misdiagnosed because of its variable cutaneous manifestations with the absence of obvious dental symptoms. Usually, patients consider such lesions of dermatologic origin instead of dental origin, and hence, seek its treatment from medical specialists which results in recurrence due to inappropriate treatments without considering the dental etiology, dental history, intra-oral examination, and dental radiographs. The current article presents a case report about chronic OCST at mental region (chin) of the face in a 10-year-old male patient. The source of infection was completely eliminated by endodontic therapy using calcium hydroxide Ca(OH)2 and by conservative surgical debridement of periapical necrotic granulation tissue without excising the extra-oral sinus-tract orifice. The appropriate dental treatment resulted in the resolution of symptoms and rehabilitation of facial esthetics without any recurrence in follow-ups. Thus, the patient's quality of life was improved after successful dental treatment as evaluated by Child's Perception Questionnaire 8–10.
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A soft-tissue metastasis in neck: An unusual presentation of squamous cell carcinoma of the tongue in young adult p. 54
Shirish Sahebrao Chandanwale, Pubali Ghoshal, Shraddha Yadav, Mangesh Londhe
DOI:10.4103/jorr.jorr_6_22  
There is an alarming increase in the incidence of both oral and base of the tongue squamous cell carcinoma during the past decades, especially in women and younger patients without the traditional risk factors of alcohol or tobacco use. Locoregional spread of tumor via lymphatics to submandibular and jugulodigastric lymph nodes is common. Soft-tissue metastasis (STM) in the neck of oral tongue squamous cell carcinoma is very rare and represents nonnodal-based metastasis. It has a significant adverse impact on the survival of patients. STM in the neck as a presenting symptom of oral tongue carcinoma is very unusual and extremely rare.
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Regaining mandibular position after hemimandibulectomy using ancillary maxillofacial prosthesis p. 57
Ahila S Chidembaranathan, Culathur Thulasingam
DOI:10.4103/jorr.jorr_10_22  
Fracture of any part of the mandible leads to deviation of the remaining portion of the mandible toward the fracture site and alteration of the biting surface of the teeth. Surgical resection of the mandible more commonly affects physiological, psychological, and esthetic effects of an individual. In such kind of patient, a buccal-based guidance appliance had an effective role in reducing or correcting the deviation of the mandible. This case report describes the prosthetic rehabilitation of resected mandible on the right side, and the deviation was corrected using guide flange ancillary maxillofacial prosthesis with a novel design. The guide flange prosthesis along with regular exercise minimizes the deviation of the mandible which further improves the masticatory efficiency and quality of life.
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REVIEW ARTICLES Top

Psychological and social impact of malocclusion in children and young adults – A review p. 61
Aasini Maria Georgina, Jasmine S Sundar, G Srinivas
DOI:10.4103/jorr.jorr_68_21  
Malocclusion is a major oral health problem, which is prevalent among all age groups. Malocclusion affects speech and mastication and causes pain. In psychosocial health, it may impact an individual's self-esteem due to self-perceived appearance and peer's opinions. This article aims to assess the effect of malocclusion on psychological and social health (i.e., quality of life, [QoL]) in children and young adults by reviewing the literature. Studies found to be relevant were identified in PubMed, Cochrane, and Google Scholar. Studies with data on malocclusion, factors influencing the treatment, and QoL associated with oral health in children and adolescents were considered for this review. After carefully scrutinizing the study objective, a total of ten full-text articles were selected and reviewed. Researcher's found that dental problems such as anterior tooth trauma or missing malocclusion affect the esthetics and psychological behavior of adolescents. Malocclusion can be socially and psychologically stigmatizing for young adults.
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Application and trends in provisional dental restorative materials for fixed partial denture: An overview p. 65
Asmath Jehan, Ahila Singaravel Chidambaranathan, Muthukumar Balasubramanium
DOI:10.4103/jorr.jorr_28_22  
A provisional restoration must protect the prepared tooth, restore form and function which should be esthetically acceptable. Sometimes, they are made to assess the outcome of a specific therapy for definitive prosthesis. Hence, understanding the properties, manipulation methods, and uses of provisional restorative materials for fixed partial denture is essential for all dentists. The objective of the study was to assess the recent advancement in provisional restorative materials for dental prosthesis available now. Literature search on PubMed and Google Scholar was done from January 1965 to March 2022 using the keywords such as provisional and interim restorative materials. In addition, hand search was done through refereed dental journals for 2000 to 2022. Nanoparticle-reinforced provisional restorative materials for any fixed dental prosthesis had better mechanical properties compared to conventional provisional materials available in the market. Digitally fabricated provisional materials eliminate the impression and the laboratory fabrication procedures, so that it consumes less time for fabrication.
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Contemporary era of Three-dimensional printing in pediatric dentistry: An overview p. 72
Shaik Rabiya Shaheen, E Sridevi, AJ Sai Sankar, VS S Krishna, M Sridhar, K Siva Sankar
DOI:10.4103/jorr.jorr_35_22  
The technique of three-dimensional (3D) printing is used for generating 3D objects using Computer-Aided Design software or 3D scanners. The employment of 3D printing in medical and dental fields is one among the foremost recent emerging trends since it has numerous advantages over traditional techniques in terms of patient-specific personalized care. The database was thoroughly searched using PubMed, Google Scholar, and Ebscohost with keywords such as 3D printing, additive manufacturing, study model, treatment planning, clinical approach, fluoride application, space maintainer, occlusal splints, endodontic procedures, rehabilitation, nasoalveolar molding, and so on. There were no restrictions made on the year of publication, but the articles published in English were evaluated. With the continual advancements within the technology, this paper is aimed toward reviewing the present literature on various applications together with its specific applications regarding pediatric dental practice.
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Micro-computed tomography in endodontics p. 80
A Lavanya, Sajid Ali, Rajendra Kumar Tewari
DOI:10.4103/jorr.jorr_37_22  
In recent years, biomedical and dental researchers have started using micro-computed tomography (MCT) for research purposes. Due to a wide range of technological developments in various sources of X-ray and X-ray imaging techniques, the use of MCT in experimental studies has been improved. MCT systems allow researchers to analyze microstructures, differences in density, and morphological changes. This review article emphasizes on the recent advancements of MCT applied in endodontics. MCT applications in the analysis of root canal morphology, evaluation of biomechanical preparation, irrigation and intracanal medicament extrusion, restoration of root canal, and retreatment have been summarized.
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Relevance of ozone therapy in the field of conservative dentistry and endodontics p. 87
Rakesh Kumar Yadav, Rini Tiwari
DOI:10.4103/jorr.jorr_11_22  
Ozone is used as a therapy to treat many diseases/infections for many decades; one of its major roles is in dentistry. Ozone therapy in dentistry is an emerging noninvasive technology that can be an alternative to many invasive dental procedures. This review article focuses on the applications of ozone in endodontics.
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