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   Table of Contents - Current issue
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July-December 2022
Volume 14 | Issue 2
Page Nos. 99-175

Online since Friday, July 1, 2022

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ORIGINAL ARTICLES  

Ultra fast papanicolaou stain versus conventional papanicolaou stain in oral cytology smears: A comparative study Highly accessed article p. 99
Korra Swetha Rani, Paremala Konda, ND V. N. Shyam, G Kiran Kumar, Vaishali Narayen, Y Reshma
DOI:10.4103/jorr.jorr_70_21  
Background: Exfoliative cytology is the technique of microscopic examination of shed or desquamated cells from the epithelial surface of mucous membrane. Papanicolaou stain (PAP) is the common stain used for these cytological smears. Conventional PAP (cPAP) stain has undergone many modifications, of these ultrafast PAP (UFPAP) is a popular stain used as it shortens the staining time and quality. UFPAP was discovered as a fusion of Romanowsky and PAP. Aim and Objectives: To evaluate and estimate the quality of UFPAP and c PAP stains in oral cytology smears of normal mucosa (NM), oral squamous cell carcinoma (OSCC), and oral potentially malignant disorders (OPMDs). Materials and Methods: 50 samples/smears were collected from outpatients from the Government Dental College and Hospital, Hyderabad. Samples include 10 cases of NM, 20 cases each of OPMDs (leukoplakia) and OSCC. Two cytological smears of representative areas were obtained and each smear is stained by the cPAP and UFPAP stains, respectively. Results and Observation: The quality index is obtained for the comparison of UFPAP and cPAP stains by using four parameters like - nuclear details, over all staining, background staining, and cell morphology. QI for all parameters of UFPAP staining was good compared to cPAP and percentage of UFPAP for NM, OPMDs and OSCC was 92.7%, 88.1%, 66.3% respectively. Conclusion: The study concludes that UFPAP staining is used for diagnosis in a regular oral cytology smears to offer immediate diagnosis of OPMDs and OSCCs.
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Copper nanoparticle-coated suture: A novel antimicrobial agent p. 104
Shraddha Rajendra Shimpi, Swapna Arunkumar Mahale, Dipali Dhanraj Chaudhari, Ankita A Katkurwar, Jui Vilas Bhandare
DOI:10.4103/jorr.jorr_47_21  
Introduction: As a new emerging nanotechnology approach, copper nanoparticles (CuNPs) coated on traditional silk suture were used. Its antimicrobial and anti-inflammatory properties, led to its increasing medical applications. Commercially available as wound dressings, surgical instruments and bone prostheses. Objectives: To compare physical parameters of nano-copper and silk suture. Methodology: Copper nanoparticles and deionized water were adopted for the preparation of the copper solution. The copper solution was obtained by dissolving 0.5 wt/v % of copper nanoparticles in a mixture of 5 v/v % of deionized water. The silk suture were dipped in the copper solution for 24 hr and then exposed to UV lamp in order to induce the synthesis of copper clusters on the surface of the suture. Inverted electron microscopy was performed in order to analyse the braided structure of the multifilament silk sutures and to verify the presence of copper on the surface. A quantitative spectrophotometry analysis was performed to quantify the percentage of copper deposited. Tensile strength was measured by Universal Testing Machine. Results: Nano-copper suture showed enhanced physical parameters as compared to silk suture. Conclusion: Copper nanoparticles due to their beneficial effects as antibacterial and wound healing accelerator in the periodontal surgeries could reduce inflammation and promote healing process.
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Adverse drug reactions and potential risk factors to Covishield vaccine: A cross-sectional study among dentists of different tertiary care centers p. 109
Kopal Sharma, Kanu Neemawat, Amit Sharma
DOI:10.4103/jorr.jorr_62_21  
Background: This study aims to study the predictors and the pattern of adverse drug reactions to Covishield vaccine which is being used in the mass vaccination program of the Government of India. Methods: This cross-sectional questionnaire-based study was conducted among the dentists working as faculty in four different tertiary care centers in Jaipur city. A prevalidated questionnaire was circulated through E-mail/social media groups to all the participants. Results: A total of 574 participants fulfilled the questionnaire platform; however, six had been excluded from the study due to incompletely filled questionnaires. The remaining 568 were enrolled for the final analysis. About 296 (52.11%) were male and 272 (47.89%) were female. About 52.8% were in the age group of 31–49 years. About 87.32% of the enrolled participants had received both doses of Covishield. Most common postvaccination symptoms were fever (n = 145), local pain at injection site (n = 123), tenderness at injection site (n = 117), and fatigue (n = 91). Female gender, presence of comorbid diseases, and past coronavirus disease-19 infection were statistically significant risk factors for having adverse reactions post vaccination, P = 0.02, 0.043, and 0.0002, respectively. Conclusions: The data suggest that Covishield is well tolerated in the Indian population. Fever, local pain, tenderness at injection site, and fatigue are few commonly reported side effects. All the side effects were mild to moderate in terms of severity.
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Role of scan body material and shape on the accuracy of complete arch implant digitalization p. 114
Raadhikka Karthhik, Bharath Raj, BV Karthikeyan
DOI:10.4103/jorr.jorr_63_21  
Purpose: The aim of the study was to evaluate how the intraoral scan body (SB) material and shape affects the scanning accuracy and scan time in completely edentulous situations since it is not well understood. Methodology: Two SB systems were evaluated: SB-1 group (Polyetheretherketone (PEEK)/Flag shaped, Biohorizon, USA), and SB-2 group (Titanium/cylindrical shape, Bioline, GmbH). On completely edentulous mandibular model with 4 dental implants (TMR 4.6, Biohorizon, USA) with scan bodies were positioned in the first molar and canine. The model was scanned using a calibrated laboratory scanner (D2000; 3Shape) to generate a master reference model (MRM). Ten consecutive digital impressions Standard Tessellation Language file were made of the model using an intraoral scanner (Trios, 3Shape A/S) for both the test groups. The test scans were superimposed over the MRM using a best-fit algorithm, and then, the distance deviation and angular deviation of the scan bodies were calculated. Scan time was also recorded. Mann–Whitney U-test was used to statistical analysis. P > 0.05 considered statistically significant. Results: Statistically significant differences were found between the SB material and shape on the linear measurement, angular deviation, and scan time (P < 0.05). The SB-1 group achieved higher accuracy overall and also exhibited noticeably lower scan time. Conclusion: The quality of digital intraoral impressions seems to be influenced by both the geometry and material of the SB. For clinical practice, the PEEK material seems clinically beneficial for decision-making.
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Clinical study evaluating the effectiveness and efficiency of Metrohex Plus Gel and diode laser therapy along with standard mechanical debridement for managing chronic periodontitis p. 121
Gaurav Singh, Shailendra S Chauhan, Aditya Sinha, Satendra Sharma
DOI:10.4103/jorr.jorr_69_21  
Aim: A study was carried out to determine how effective diode lasers and Metrohex Plus Gel are at managing chronic periodontitis when compared to standard periodontal therapy. Materials and Methods: A total of 90 sites having periodontal probing depth (PPD*) ≥5 mm were included with patients aged around 35–60 years. Each group contains 30 sites as follows: Group I – laser-assisted new attachment procedure*, Group II – Metrohex Plus Gel, Group III – scaling root planing (SRP)* alone. Results: Based on the average gingival index* value at baseline, 1 and 3 months, the values were 1.9 ± 0.67, 0.99 ± 0.26, and 0.89 ± 0.19, respectively. The mean plaque index* score decreased to 1.12 ± 0.31 at 1 month and 0.80 ± 0.31 at 3 months from 2.30 ± 0.58 at baseline. A PPD* reduction of 0.85 ± 0.03 mm was observed at 3 months for sites treated with laser, which was significantly higher than the reductions for sites treated with Metrohex plus (metronidazole 10 mg + chlorhexidine gluconate 0.25% w/w and hyaluronic acid) and SRP* alone. PPD* reductions were not significantly different between Groups I and II. Group II showed a 0.35 ± 0.11 mm improvement in clinical attachment levels compared to Group III. Conclusion: As opposed to simple SRP, diode laser therapy and Metrohex Plus Gel improve all clinical parameters in patients with periodontitis.
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Knowledge, attitude, and practice/awareness on the impact of mobile phone radiations on the oral cavity among mobile phone users: A cross-sectional study p. 126
MP Revanth, S Aparna, Parangimalai Diwakar Madankumar
DOI:10.4103/jorr.jorr_77_21  
Background: The usage of mobile phones has increased drastically in recent years. Their use without any knowledge of their adverse effects is quite unsafe. Studies on cancers due to electromagnetic radiation from mobile phones are available but there is a need to research on the harmful effects of mobile phones on general and oral health among the rampant mobile phone users. Aim: The aim of the study is to evaluate the knowledge, attitude, and practice or awareness regarding mobile phone radiation and its impact on the oral cavity among the individuals using mobile phones. Materials and Methods: The present study was a self-administered structured questionnaire study which was filled by 259 participants between the age group of 18–33 years through online forms. Results: The study resulted that 50% of the participants did not have knowledge on deleterious effects of mobile phone radiation on the oral cavity and have experienced oral problems such as dry mouth (39.4%) and hypersalivation (41.7%) after prolonged talk time and 54.1% of the participants were aware on the impact of mobile phone radiation on health status. Conclusion: The results showed that most of the participants were aware of the potential risks arising from the use of mobile phones on general health but lacking the knowledge on oral health.
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Estimation of the inflammatory burden and its impact after treatment in periodontally affected pre- and postmenopausal women p. 131
Jammula Surya Prasanna, Sumadhura Chinta
DOI:10.4103/jorr.jorr_19_22  
Context: Menopause, when menstruation ceases, is seen with an overall increase in body response to inflammation. Gingiva is no such exception. Gingival inflammation which leads to periodontitis is a condition, which is severe inflammatory in nature, affecting the tissues surrounding the teeth. If not treated in time apparently tooth loss might take place. Pre- and postmenopausal conditions, more or less are critical for inflammatory changes. Aims: In this study, among both conditions which one was oppressive and which reciprocated more to scaling was examined. Settings and Design: This study was a cross-sectional interventional study. Materials and Methods: Sixty female subjects aged between 40 and 50 years with periodontitis were recruited. These were meticulously examined by a gynecologist and equated into two groups of 30 patients each, Group I – premenopausal and Group II – postmenopausal women. Plaque index, periodontal index (PDI), and sulcular bleeding index were compared at baseline and 3 months after scaling. Statistical Analysis Used: IBM Statistical Package for the Social Sciences (SPSS) version 21 software was used. An independent sample t-test was applied for percentage decrement and intergroup comparison and paired t-test for intergroup comparisons. Results: Reduction was significant in all the above parameters in both the groups noted on intragroup comparison from baseline to 3 months (P < 0.001). However, the intergroup showed no significance except PDI at baseline. Conclusions: There was a remarkable effect of scaling on inflammatory conditions such as menopause and periodontitis. In the premenopausal stage only, if women undergo periodontal therapy, it can prevent future aggressive inflammatory changes in the postmenopausal stage.
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CASE REPORTS Top

Management of Type III palatogingival groove in permanent maxillary lateral incisor with intentional replantation p. 136
Aaliya Rehman, Huma Iftekhar, Rajendra Kumar Tewari, Surendra Kumar Mishra
DOI:10.4103/jorr.jorr_25_21  
A palatogingival groove (PGG) is a developmental deformity that may cause a severe periodontal breakdown or combined endodontic and periodontal defect. In the present case, a 24-year-old patient reported a complaint of pain in the upper left front tooth region for 3 months. Clinical and radiological examination revealed a PGG in the permanent maxillary left lateral incisor. Cone-beam computed tomography showed multiple shallow grooves on the root surface and a deep palatal groove extending to the apex. Interdisciplinary management comprising endodontic therapy and intentional replantation was formulated. After endodontic procedure, tooth #22 was gently extracted. The shallow grooves were removed by odontoplasty. A Class II cavity was made in the deep palatal groove and was connected with the root-end preparation. The cavity was sealed with biodentin up to the cementoenamel junction and the coronal portion was sealed with light-cured glass-ionomer cement. The tooth was replanted in socket and splinted for 7 days. Follow-up visits revealed the functional status of tooth and complete bony healing. Tooth discoloration was successfully managed with intracoronal bleaching with sodium perborate. A 12-month radiographic follow-up revealed no evidence of root resorption or ankylosis.
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Treatment-resistant gingivitis responding to photobiomodulation in pemphigus vulgaris p. 142
Nooshafarin Kazemikhoo, Dedee F Murrell
DOI:10.4103/jorr.jorr_29_21  
Gingivitis is a chronic inflammatory condition of the maxillary and mandibular gingiva due to poor hygiene of the gums. A 91-year-old woman with a prior diagnosis of pemphigus vulgaris and persistent gingivitis for 11 years was treated using photobiomodulation (PBM), red 650 nm laser light, 150 mW, 2 J/Cm2 in 16 sessions for 6 weeks. Redness and pain decreased significantly not long after photobiomodulation was commenced and healed completely in 16 sessions. In follow-up after 3 months, her situation was still stable. PBM can be used as an effective, noninvasive, safe, and cost–benefit treatment.
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Ravaged mandibular ramus: Two rare case presentations of unicystic ameloblastoma with a view on management p. 145
Justin Mathew, S Akhil, Jubin Thomas, Fousiya Ali
DOI:10.4103/jorr.jorr_43_21  
Unicystic ameloblastoma (UA) is a rare, slow-growing, persistent, locally invasive, and cystic variant of ameloblastoma. This article presents two different variants of UA. The first case was a rare presentation of UA in an 11-year-old patient involving the impacted second molar, which is otherwise usually associated with an impacted mandibular third molar. It was diagnosed with UA-luminal type and treated by a piezoelectric ultrasonic device with minimal trauma to soft tissue. The second one was associated with impacted mandibular third molar extending the entire ramus of mandible till the coronoid which was diagnosed with UA-mural type and treated by cystic enucleation with platelet-rich fibrin graft. Recurrence was not observed during a 6-month follow-up. The aim of this case presentation was to give an insight into the destructive nature of UA and its diagnosis and management to maxillofacial surgeons as well as dental practitioners.
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REVIEW ARTICLES Top

Role of dentist in diagnosis and management of mucormycosis in association with COVID-19 p. 150
Piyush Dongre, Tanya Bansal
DOI:10.4103/jorr.jorr_36_21  
The prevalence of fungal infection has skyrocketed in recent years. This is owing to the new corona virus's rapid spread. Mucormycosis is a deep fungal infection that has shown a rise in this worldwide pandemic period. Mucormycosis is a potentially fatal infection. To lower the rate of infection, it is critical to diagnose it as soon as possible and give appropriate treatment. The necessity of early diagnosis, prevention, and management of mucormycosis, as well as the role of the dentist in doing so, are discussed in this review article.
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Application of artificial intelligence in the diagnosis and survival prediction of patients with oral cancer: A systematic review p. 154
S Canty Sandra, Anusha Raghavan, PD Madan Kumar,
DOI:10.4103/jorr.jorr_65_21  
Oral cancer constitutes around 2.1% and it is the sixth-most common malignancy worldwide and the third-most common type of malignancy in India. The purpose of this systematic review is to find the prediction of survival rate among oral cancer patients using artificial intelligence (AI) and its forms like machine learning. Suitable articles were identified by searching PubMed, Trip database, Cochrane, and Google Scholar host databases. The search was done with the help of PIO analysis where the population stands for oral cancer patients, the intervention given here were AI and its subsets and the outcome were diagnosis and survival prediction of oral cancer. The screening of the titles and abstracts was done, and only those articles that fulfilled the eligibility criteria were selected. The search resulted in 451 articles, of which only six articles that fulfilled the criteria were included. The studies showed that AI models were able to predict the 5-year survival rate among oral cancer patients. The accuracy of the decision tree classifier, logistic regression, and boosted decision tree models were 76%, 60%, and 88.7%, respectively. Modern age diagnosed people tend to have a longer survival rate than those diagnosed in the past. The limitation was that these studies were created using retrospective cohorts, but for validation, they must be compared with prospective cohorts. These studies are important for identification and survival prediction, which will contribute to future advancements, change in the treatment plan, and reduce health-care problems.
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Mucormycosis: An emerging concern of orofacial complication in COVID-19 infection p. 161
Anam Mushtaq, Reshi Iram Shafi
DOI:10.4103/jorr.jorr_72_21  
Coronavirus disease (COVID-19) infection has been seen to be associated with secondary bacterial and fungal infections. Mucormycosis has been increasingly reported in patients with COVID-19 infection, especially those with underlying medical conditions such as diabetes mellitus and on steroid therapy. It is an acute invasive fungal infection primarily affecting individuals with suppressed immune system. This article presents the characteristics of mucormycosis infection and its etiological association with COVID-19. Its diagnosis and management based on the current guidelines have also been discussed in this literature review.
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Fabrication of hollow denture technique for highly resorbed ridges for geriatric cases-A literature review p. 165
Deepa Balu, Ahila Singaravel Chidembaranathan, Muthukumar Balasubramaniam
DOI:10.4103/jorr.jorr_3_22  
The purpose of the review was to validate the different methods used for the fabrication of hollow denture that gives the better retention and stability in highly resorbed conditions. This study includes various literatures that provide different techniques involved during for fabrication process of hollow denture and also incorporation of the various different materials such as salt, sugar crystals, chocolate syrup, soap, and latest advances including the three-dimensional (3D) resins that are used as the spacer material in the fabrication of these dentures. The results show that all these different techniques using the different spacer material possess the similar results of 25% reduction in weight of the dental prosthesis. There are increased retention, stability, and comfort in condition of highly resorbed conditions with increased interocclusal distance that also prevents the muscle atrophy and fatigue in elderly individuals.
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A review of various methods of tripodization in removable partial denture to introduce a simplified classification system p. 172
R Rohini, Aditi Mishra, Raghuwar Dayal Singh, Sunit Kumar Jurel, Pooran Chand
DOI:10.4103/jorr.jorr_8_22  
This article aims to present a newer and simplified classification of tripodization methods, which can help prosthodontists to choose a better method according to their ease and clinical expertise. This study was based on searching published scientific research. Data search was conducted via Medline via PubMed, Wiley Online library, Ebscohost, ScienceDirect, Research Gate as well as the Google Scholar till 2020 using the keywords – removable partial denture, method, tripodization. All the 21 selected articles were critically evaluated regarding the concepts and the techniques to introduce an innovative classification system for the various tripodization methods. The proposed classification system would help in appropriate selection of suitable tripodization method for every particular clinical situation in the process of removable partial denture fabrication.
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