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   Table of Contents - Current issue
Coverpage
July-December 2021
Volume 13 | Issue 2
Page Nos. 81-173

Online since Tuesday, June 22, 2021

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ORIGINAL ARTICLES  

Hemodynamic changes in pediatric dental patients using 2% lignocaine, buffered lignocaine, and 4% articaine in pediatric dental procedures p. 81
Amit Khatri, MM Afsal, Namita Kalra, Rishi Tyagi, M Khadeeja Kulood
DOI:10.4103/jorr.jorr_19_20  
Background: The purpose of this study was to compare the hemodynamic changes (blood pressure, heart rate and oxygen saturation) when using three different local anesthetic agents such 2% Lignocaine with 1:200,000 epinephrine, Buffered Lignocaine and 4% Articaine with 1:200,000 epinephrine with inferior alveolar nerve block in pediatric dental patients. Methods: A double blind crossover study was designed where in 48; 5-10 year old patients received three sections of inferior alveolar nerve block injections in three appointments which scheduled one week apart. Blood pressure, heart rate and oxygen saturation was measured before and after administration. Results: When applying three factors ANOVA, no statistically significant difference was found between Lignocaine and Buffered Lignocaine, Buffered Lignocaine and Articaine in all the three parameters(P > 0.05 ). Conclusion: This findings in hemodynamic changes from this study reveals that all the three anesthetic agents are safe in children aged 5-10 years.
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Effect of thermocycling on shear bond strength of cemented zirconia-reinforced lithium silicate (Celtra Duo) p. 86
Kamilia Faisal Abdulkader, Lamia Sayed Kheiralla, Gihan Abd Elhady Elnaggar
DOI:10.4103/jorr.jorr_20_20  
Purpose: The aim of the present in vitro study is to evaluate the effect of thermocycling on the shear bond strength (SBS) of cemented zirconia-reinforced lithium silicate (ZLS) discs (Celtra Duo). Materials and Methods: Thirty-six Celtra Duo ceramic discs cemented (n = 36) to composites discs background (Master dent) by adhesive resin cement (Biscem). The baseline group (n = 12) did not subject to thermocycling, the second group (n = 12) was subject to 2500 thermal cycle, and the third group was subject to 5000 thermal cycles, then SBS and the failure mode were evaluated. Results: There was a statistically significant difference between the groups (P = 0.001) where the value of SBS (Mpa) was significantly decreased in both 2500 thermocycling group (P = 0.021) and 5000 thermocycling group (P = 0.001) when compared with their corresponding level measured at baseline group. In addition, there was a significant decrease in bond strength of 5000 thermocycling group when compared with its corresponding value in the 2500 thermocycling group (P = 0.001). Conclusion: Based on the results of the present study and within the limitations of this in vitro study, it can be concluded that the SBS of cemented ZLS restorations will be decreased when samples are subjected to thermocycling to simulate the clinical situation.
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Knowledge, attitude, and awareness among dentists regarding COVID-19 pandemic in West Bengal p. 94
Khooshbu Gayen, Sauvik Galui, Lopamoodra Das, Subrata Saha, Subir Sarkar
DOI:10.4103/jorr.jorr_39_20  
Background: Coronavirus disease-2019 (COVID-19) has been declared a global public health emergency, the rapid and extensive spread of COVID-19 pandemic. Objective: The aim of this study is to assess the knowledge, attitude, and awareness among the dentists of West Bengal regarding coronavirus disease (COVID-19). Materials and Methods: The study population for this survey are the dentists of West Bengal who work in government sector or in any private clinics. An online questionnaire comprising 28 questions was sent to the sample size. The questionnaire was composed of series of questions about the knowledge of dentists regarding the incubation period, symptoms, mode of transmission of coronavirus disease, their awareness about the infection control measures, and the attitude toward treating the patients with COVID-19. Results: A total of 107 dentists responded to this survey. Of them, 7.5% have completed their postgraduation in any specific subject, 30.2% are under postgraduate training, and 62.3% are practicing after completion of their graduation. Eighty percent of the dentists involved in the study have correctly reported the incubation period which is 7–14 days. Majority of the dentists were aware of the symptoms of COVID-19, which would help them in identifying the patients at risk of getting COVID-19 infection. Sixty-seven percent of them found it necessary to make the sitting arrangement at significant distances in the waiting area as a preventive measure. Majority of them considered that dentists should play an important role in spreading awareness regarding COVID-19. Conclusion: The dentists were found to have a good knowledge about the symptoms, mode of transmission, and the preventive measures. They were advised to follow the guidelines issued by the Centers for Disease Control and Prevention and the World Health Organization and remain well informed about the recommended disease management protocols so that no stone is left unturned in defeating this pandemic.
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In vivo comparison of postoperative pain using two different techniques for local anesthesia in single-sitting root canal treatment p. 100
Sumita A Bhagwat, Anchal Mehta, Leena V Padhye
DOI:10.4103/jorr.jorr_38_20  
Aim: This in vivo split-mouth randomized control trial was carried out to study and compare the incidence of postoperative pain associated with single-sitting endodontic treatment using inferior alveolar nerve block and intraligamentary injection as primary anesthetic technique. Methods: A total of 30 patients with bilateral symptomatic irreversible pulpitis in mandibular molars were selected to be included in the study. In each subject, molar in one quadrant was randomly assigned to Group 1 (intraligamentary injection), and the molar in the opposite quadrant was assigned to Group 2 (inferior alveolar nerve block). The root canal procedures for the patients were carried out in single sittings under rubber dam using hand ProtaperTM system, 2.5% sodium hypochlorite as irrigant alternating with normal saline and obturation by the lateral condensation technique. A questionnaire employing Visual Analog Scale (VAS) for pain assessment was given to the patient and instructions on how to fill the form were given. VAS scores for every tooth treated in every patient were recorded before beginning treatment and after completion of treatment for each tooth. The patients were recalled after 2 days, and the scores were analyzed. The results were tabulated and statistically analyzed for incidence and degree of pain. Results: Group 1 and Group 2 showed a steady reduction in postoperative pain from 4 h to 48 h as seen in the mean VAS scores. Comparison between the two groups at each time interval showed a difference which was statistically insignificant (P > 0.05). Conclusion: There is no difference in the incidence of postoperative pain when either inferior alveolar nerve block or intraligamentary injection is employed as the primary technique for achieving anesthesia during single-sitting root canal treatment.
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Knowledge, practice, and awareness of dental undergraduate and postgraduate students toward postexposure prophylaxis and needlestick injuries: A descriptive cross-sectional institutional dental hospital study p. 106
Asmat Fatima, Sharique Alam, Huma Iftekhar, Rajendra Kumar Tewari, Syed Mukhtar-Un Nisar Andrabi, Amber Ali Faraz
DOI:10.4103/jorr.jorr_4_20  
Background: The aim of the present study was to assess the knowledge, awareness, and practice of dental undergraduate, interns, and postgraduate students toward postexposure prophylaxis (PEP) and needlestick injuries. Materials and Methods: A cross-sectional, questionnaire-based survey was carried out among undergraduate, interns and postgraduate dental students in an institutional dental hospital in India. The students were required to fill a self-administered questionnaire with close ended questions with responses indicated by a simple tick box format. The questionnaire was divided into three sections intended to collect information on (1) sociodemographic characteristics, (2) knowledge, and (3) practice habits toward needlestick injury (NSI) and PEP of the respondents. Results: An adequate score (>70% correct response) to knowledge about NSI and PEP was obtained by 60.2% (50/83) of the respondents, while 47% (39/83) of the student participants obtained an adequate score (>70% score) to appropriate practice habits toward NSI and PEP. A high proportion (84.3%) of the student were vaccinated against Hepatitis B virus, but only 6% were aware of their serum antibody to HBsAg. 61.5% of the student reported experiencing NSI during clinical practice with 3.6% of the students taking PEP. The most common reason for not taking PEP was ignorance of PEP protocol (27.7%) and lack of support to report the incidence (18.1%). The postgraduate students scored better than the undergraduate students in both the knowledge and practice parameters, but the results were not statistically significant (P > 0.05). Conclusion: This study shows that dental students' knowledge, practice, and awareness toward NSI and PEP is inadequate. The current classroom education must be supplemented with additional interventions to ingrain appropriate practice habits.
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Temporomandibular joint ankylosis pattern, causes, and management among pediatric patient attending a tertiary hospital in Bangladesh p. 115
A F. M Shakilur Rahman, Ismat Ara Haider
DOI:10.4103/jorr.jorr_3_21  
Background: Temporomandibular joint (TMJ) ankylosis is a pathological condition where mandibular condyle fused the glenoid fossa of the temporal bone. It causes distressing and disabling conditions to the patient. The purpose of our study is to determine the frequency of pediatric TMJ ankylosis attending at Oral and Maxillofacial Surgery Department, Dhaka Dental College and Hospital, Bangladesh. Methodology: This was a retrospective, cross-sectional study for 18 patients (9 male and 9 female) aged up to 18 years old. Data assembled from the patient's surgical records reviewed from January 2016 to December 2018. Results: Females and males were affected equally, the most affected age group was 7–12 as well as 13–18 years old (n = 7, 38.89%), bilateral ankylosis (n = 11, 61.11%) was more common than unilateral (n = 7, 38.89). Type III (34.48%) ankylosis (Sawhney's classification) was found to be the most frequent type. Trauma (n = 11, 61.10%) was the major etiologic factor for pediatric TMJ ankylosis. All patients were managed by surgical intervention. Gap arthroplasty (n = 9; 50.0%) was the most preferable treatment method followed by interpositional arthroplasty (n = 7, 38.89%) and condylectomy (n = 2, 11.11%). Conclusion: The majority of the patient was affected by trauma. Most of the patients came with Type III ankylosis with having facial deformities. Absolute and proper management regarding mandibular condylar fracture and infection (middle ear) must be required to prevent TMJ ankylosis. Surgical intervention is the only treatment option for managing TMJ ankylosis. Aggressive physiotherapy is mandatory to prevent reankylosis, thus ensuring the patient's quality of life.
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CASE REPORTS Top

Solitary median maxillary central incisor: Gateway to diagnosis of systemic diseases p. 121
Brijinder Singh Talwar, MM Dempsy Chengappa, Atul Bali, Rahul Kaul
DOI:10.4103/jorr.jorr_49_20  
A Solitary median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with other systemic conditions. Most common association is with holoprosencephaly. It can easily be misdiagnosed as a simple case of hypodontia due to either traumatic dental injury or fusion of two central incisors or a mesiodens developing to the one side of midline or any other condition that may lead to growth termination of central incisor at the cellular level. Every dentist needs to be aware of oral manifestations of this anomaly, thereby facilitating an early diagnosis of SMMCI, as it may be a sign of other severe congenital or developmental anomalies. Proper follow-up and close monitoring of the growth and development of SMMCI patients are of critical importance. The aim of this paper was to report a case of a 12-year-old female child with an SMMCI and describe important symptoms of this syndrome.
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Photobiomodulation therapy in the treatment of a palatal ulcer p. 125
Nivedita Chinam, Aniket Vaidya, Thilak Thomas John
DOI:10.4103/jorr.jorr_43_20  
Oral mucosa is the most common site for ulcers, and severely painful ulcers of traumatic origin prompt the patient to visit an oral physician to seek necessary treatment. Currently, numerous topical analgesics and anti-inflammatory medications are prescribed to reduce pain and accelerate healing. An alternative to this is low-level laser therapy which is a drug-free and noninvasive therapy and has shown potential results in treatment of oral ulcers. In this paper, we report a case of a patient with palatal ulcer which was successfully treated using a 660-nm (red) laser.
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A case of ankyloglossia p. 129
Dipali Chaudhari, Swapna Mahale, Arunkumar Mahale
DOI:10.4103/jorr.jorr_40_19  
Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation due to limitation in tongue movement. In this article, we have reported a 22-year-old male with tongue-tie who complained of difficulty in speech following which he underwent frenectomy procedure under local anesthesia without any complications. Finally, he was given speech therapy sessions.
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REVIEW ARTICLES Top

The war between amalgam and composite: A critical review p. 133
Bhumika Kapoor, Lateef Ahmed
DOI:10.4103/jorr.jorr_32_20  
Amalgam and composite are the two most famous dental restorative materials till date and the choice between them is still debatable. Amalgam restorations have served the profession well and will continue to do so in the years to come. In terms of longevity, amalgam is superior to composite resins, especially when used for large restorations. In case of small restorations, composite is the restoration of choice as minimum removal of the sound structure is required. Where esthetics is a major concern, composite has a way far than amalgam. Amalgam has served as a better core material and has superior mechanical properties than composite. Composite has an advantage of adhesion over amalgam. This review article compares amalgam and composite as a restorative material.
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Congenital midline labial sinus of the upper lip – A review of literature p. 139
Anka Sharma, Amit R Parate, Vikrant O Kasat, Anirudh Upmanyu
DOI:10.4103/jorr.jorr_10_20  
Congenital midline labial sinus is a rare condition known to affect both the upper and the lower lip. This anomaly has been reported in both genders, but with a slightly increased predilection in females. It can occur either in isolation or in association with a wide array of congenital malformations such as cleft lip, cleft palate, Van der Woude syndrome, median lip pit, and brachydactylia. Usually, the patient presents with swelling of the upper lip with or without associated discharge. A history of recurrent cellulitis of the lip is almost always present. In this manuscript, a review of the literature (spanning across almost six decades) has been attempted for this rare condition. Search engines such as PubMed, Medscape, and Google Scholar were searched for keywords such as “recurrent cellulitis of the upper lip,” “sinus of the upper lip,” “fistula of the upper lip,” and “congenital midline labial sinus.” All the available full text in the English language was compiled and thoroughly scrutinized. The observations such as age, sex, clinical feature, associated anomaly, and other relevant information were noted and tabulated in the chronological order.
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Autologous platelet concentrates in periodontal regenerative therapy: A brief overview p. 143
Dhiraj B Dufare
DOI:10.4103/jorr.jorr_29_20  
Autologous platelet concentrates (platelet-rich plasma and platelet-rich fibrin) enriched with various growth factors play an important role in periodontal regeneration. This review includes biological principle, efficacy, and effectiveness of autologous platelet concentrates. Based on the result obtained from the systematic review and meta-analysis it can be concluded that complimentary effects of autologous platelet concentrates may be used as lucrative adjunct to regenerative periodontal therapy. However, postoperative plaque control is one of the key factors influencing periodontal healing following regenerative periodontal therapy.
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A clinical review of nanotechnology in maxillofacial practice p. 149
Naveen Nandagopal, M Usha, S Sreejith, Sandler Rajan
DOI:10.4103/jorr.jorr_16_20  
Nanotechnology is an emerging boon to change the health care in a fundamental way. Currently nanomedicine is in the transition stage from the world of fiction to a revolutionizing world of healthcare. Nanotechnology is the manipulation of matter at the molecular and atomic levels. The wide range of its clinical applications makes it to offer a promising future in the field of medicine as well as dentistry. Nanorobotics will expand enormously the effectiveness, comfort, and speed of treatments and significantly reducing their risk, cost and invasiveness. Although this rapidly advancing field of medicine offers a promising future, it may also pose a risk for misuse and abuse. Further extensive researches should be needed to pave a way for these breath-taking devices to revolutionize the future of healthcare.
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Association between rheumatoid arthritis and periodontal disease: A meta-analysis p. 161
Alberto Rodriguez-Archilla, Annalisa Vacca-Moreno
DOI:10.4103/jorr.jorr_10_21  
Rheumatoid arthritis (RA) is related to periodontal disease (PD) because both diseases share similar inflammatory pathogenic mechanisms that produce bone resorption. To assess the possible bidirectional link between RA and PD. A search for articles on RA and PD was conducted in the following electronic databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Google Scholar. Twenty-two studies with a low-moderate risk of bias according to the Newcastle-Ottawa Methodological Quality Scale were considered in this meta-analysis. The data were analyzed using the Statistical Software RevMan 5.4 (The Cochrane Collaboration, Oxford, UK). For continuous outcomes, the estimates of effects of the intervention were expressed as mean differences (MDs) using the inverse variance method, and for dichotomous outcomes, the estimates of effects of the intervention were expressed as odds ratios (OR) using the Mantel-Haenszel method, both with 95% confidence intervals. Patients with RA showed higher levels of: Plaque index (MD: 0.10; P < 0.001), gingival index (MD: 0.31; P < 0.001), probing depth (MD: 0.45; P < 0.001), clinical attachment loss (MD: 0.59; P < 0.001), and bleeding on probing (MD: 8.06; P < 0.001). They also had a lower number of remaining teeth (MD:-0.80; P = 0.27) and a greater number of missing teeth (MD: 2.70; P < 0.001). These same patients had a higher risk of both moderate (OR: 2.90; P = 0.008) and severe periodontitis (OR: 2.78; P = 0.01). Patients with RA have a higher risk of moderate-severe PD and a worsening of all periodontal parameters.
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SYSTEMATIC REVIEW Top

Impact of mobile phone radiation on salivary gland: A systematic review p. 168
MP Revanth, S Aparna, Parangimalai Diwakar Madankumar
DOI:10.4103/jorr.jorr_11_21  
In the recent decades, the use of mobile phone has increased drastically. This has raised many concerns about the potential health risk to the individuals who are exposed to mobile phone emitted radiation. The aim of this systematic review is to find out the impact of mobile phone emitted radiations on salivary gland. An electronic database search was performed to identify the suitable literature using Cochrane, EBSCO host, PubMed, Google Scholar, and Trip database. The literary search was focused on the impact of mobile phone emitted radiation on the salivary gland. Based on inclusion and exclusion criteria, the studies were selected. A total of 31 relevant studies were identified, and 11 articles were taken for the systematic review. The studies concluded that the radiations emitted by the mobile phones have detrimental effects on salivary gland.
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