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   Table of Contents - Current issue
January-March 2023
Volume 14 | Issue 1
Page Nos. 1-55

Online since Saturday, March 18, 2023

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Clinical presentation and management of parotid gland tumors – A retrospective study in Northwestern Nigeria p. 1
Mujtaba Bala, Ramat Oyebunmi Braimah, Abdulrazaq Olanrewaju Taiwo, Sufiyanu Yabo Umar, Mukhtar Modibbo Ahmad
Background: Parotid gland tumors are the most common major salivary gland tumors occurring in humans. Aim: This study aimed to evaluate the pattern of clinical presentation and management of parotid gland tumors in Northwestern Nigeria. Materials and Methods: In this retrospective study sociodemographics, nature of the lesion, fine-needle aspiration cytology result, surgical procedure, and complications of patients with parotid gland tumors were recorded and analyzed using SPSS version 25. Results: There were 31 (45.6%) males and 37 (54.4%) females in the age range of 17–72 years with a mean ± standard deviation of 49.03 ± 15.61 years. Benign tumors constitute the majority 50 (73.5%), with pleomorphic adenoma being the most common 46 (67.6%), whereas malignant tumors were 18 (26.5%), with adenoid cystic carcinoma being the most common 6 (8.8%). Superficial parotidectomy was the highest surgical procedure performed in 42 (70.6%) patients. Selective neck dissection was done in 5 (27.8%) cases and soft tissue reconstruction with deltopectoral flaps in 3 (16.7%) of the malignant cases. Transient facial nerve paralysis was seen in 14 (29.2%) and 8 (47.1%) of patients who had superficial and total parotidectomies, respectively. Permanent facial nerve paralysis was seen in all 5 (27.8%) patients who had radical parotidectomy. Conclusion: Pleomorphic adenoma was the most common parotid gland tumor, and superficial parotidectomy was the major surgical procedure performed. Facial nerve paralysis is an inevitable complication but can be minimized with meticulous surgical maneuver.
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Assessing the relationship between the intercondylar distance and mandibular intercanine distance in orthopantomogram – A retrospective study p. 6
Praveena Prabhakar, RR Mahendra Raj, Thalaimalai Saravanan, Shakila Ramalingam
Background: In completely edentulous patients, it is necessary to replace the teeth with at most esthetics and comfort with less patient strain. Aim: The current retrospective study was done to find the relationship between the intercondylar distance and intercanine distance of the mandible by obtaining the ratio using an orthopantomogram (OPG) for lower anterior teeth selection in completely edentulous patients. Materials and Methods: The OPG of 500 subjects was selected randomly. The OPGs were taken using the Sirona Orthophos XG machine and exposed for 14.1 s at 64 kvp, 8 mA. Then, the intercondylar distance and mandibular intercanine distance were measured from the soft copy of the OPG using the software “Sidexis.” The required measurements were taken digitally from the OPG using the software “Sidexis” in millimeters (mm). The SPSS software version 22.0 was used for statistical analysis. Results: Pearson correlation coefficients (r) displayed a significant positive association between the intercondylar distance and intercanine distance of the mandible (r = 0.42; P = 0.0002). The correlation between intercondylar width and mandibular intercanine width was significant and positive for men (r = 0.26, P = 0.0003) but negative for women (r = −0.41, P = 0.0001). The ratio between the mean intercondylar width and the mean intercanine width was 1:4.90. Conclusion: The mandibular intercanine distance and the intercondylar distance have a positive and significant association. The ratio obtained in this study was 1:4.90 between the mandibular intercanine distance and the intercondylar distance that could be employed for the choice of mandibular anterior teeth.
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In vitro evaluation of apical leakage of three bioceramic materials using glucose leakage model in a simulated open apex p. 11
Sonal Sahu, Naren Ramachandran, Roshan Shetty, Avinash Salgar, Rajesh Podar, Shishir Singh
Background: Recently, new calcium silicate-based materials have been introduced as root-end filling material which offers improved color stability and handling characteristics, while exhibiting physical and chemical properties comparable with mineral trioxide aggregate (MTA). Aim: The purpose of this study was to compare the sealability of 3 calcium silicate-based materials - MTA Plus (Prevest Denpro, India), Biodentine (Septodont, St. Maurdes Fossés, France), and TotalFill BC RRM (FKG, Brasseler, Savannah, USA) in a simulated open apex model. Materials and Methods: Thirty-two recently extracted human maxillary anterior teeth with single, straight root canals were selected and after establishing the working length, canals were prepared by Protaper Gold system up to size F3. The apical end was resected at 3 mm to simulate an open apex. Prepared roots were divided into groups according to the root repair materials – MTA (Prevest Denpro, India), Totalfill Bioceramic Root Repair Material (FKG, Brasseler, Savannah, USA), and Biodentine (Septodont, St. Maurdes Fossés, France). The apical plug of the root filling material was placed in the orthograde direction and a glucose leakage model was used to study the sealability of the materials. Results: All three materials showed more leakage at 14 days than at 7 days, however, there was no statistically significant difference between them. Conclusion: All three bioceramic materials exhibited equal amounts of apical leakage at 7 and 14 days.
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Assessment of clinical and psychological parameters in pre- and post-menopausal women: A cross-sectional study p. 17
Surekha Ramrao Rathod, Ashwini Narendra Jadhav, Abhay Pandurang Kolte, Devdatt Laxman Pitale
Background: Literature evidence on periodontal disease-associated microorganism in pre-and postmenopausal women suggest a complicated relationship between steroid hormones, periodontal tissues, and microorganism. Aim: The objective of the study was to assess and contrast the periodontal health condition and quality of life (QoL) of pre-and postmenopausal women. Materials and Methods: 100 patients were divided into four groups, i.e., healthy pre-menopausal, periodontitis pre-menopausal, healthy post-menopausal, and periodontitis post-menopausal. Periodontal parameters such as Gingival Index (GI), Plaque Index (PI), Probing Pocket Depth, Clinical attachment levels, Simplified Oral hygiene index, and a Utian QoL questionnaire were filled by the patients. The differences between three groups were analyzed using a one-way ANOVA test at baseline and 3 months, followed by a post hoc Tukey test. Results: The PI, GI, and Simplified Oral Hygiene Index levels were significantly different between healthy premenopausal and postmenopausal subjects. QoL scores were compared between the healthy premenopausal and healthy postmenopausal subjects, among which no statistically significant difference was found with P = 0.705 when compared between the positive questions score and P = 0.730 when compared between the negative questions score of the two groups. Conclusion: This study shows that there is no relation between menopause and QoL in women with periodontitis before and after menopause.
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Effect of two different antifibrinolytic agents on platelet-rich fibrin: An in vitro comparative study p. 23
Vishnu Ponnusamy, H Esther Nalini, R Renuka Devi, Nivetha Raja
Background: Platelet-rich fibrin (PRF) is a potent autologous regenerative material used in periodontal regeneration. PRF collapses easily into the periodontal defect due to its faster resorption rate and lesser rigidity. The degradation time of PRF has a direct impact on the clinical outcome. Aim: This study aimed to compare and analyze the effect of two different antifibrinolytic agents on the degradability of PRF membranes. Materials and Methods: Twenty-one PRF membranes were randomly divided into three groups: Group 1 – Conventional PRF obtained by adding normal saline (Control), Group 2 – PRF obtained by adding 200 mg tranexamic acid (TXA), and Group 3 – PRF obtained by adding 250 mg epsilon aminocaproic acid (EACA). After storing at room temperature in normal saline, PRF membranes were retrieved at 1st, 2nd, and 3rd weeks and the percentage of remaining weight was calculated. ANOVA is used for the statistical comparison of the data between groups. Results: In comparison to the baseline, the mean PRF weight was decreased in all groups in the 1st, 2nd, and 3rd weeks. In the 1st, 2nd, and 3rd weeks, the mean percentage of the remaining weight of PRF membrane in Group 1, Group 2, and Group 3 were 69.53 ± 12.96, 36.23 ± 9.28, and 17.43 ± 4.75 respectively. The statistical significance with the percentage of the remaining weight of the PRF was obtained in 3rd week with a P = 0.029. Conclusion: TXA efficiently delayed the degradability of the PRF membrane compared to EACA under experimental conditions.
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Parental knowledge, attitude, and perception toward dental treatment during COVID-19 pandemic: A cross-sectional survey p. 28
C H Chandana Krishna Shree, Priya Nagar, HR Pooja, Andrea Natalia Mascarenhas
Background: Dental caries in pediatric dentistry is considered very alarming to parents considering its impact on the permanent dentition. Knowledge regarding caries in primary teeth and its impact on permanent dentition is limited. Aim: The aim was to evaluate the knowledge and perception of parents toward pediatric dental treatment during covid era and to check if there is a change in practices pertaining to the COVID-19 outbreak. Materials and Methodology: One hundred and twenty copies of the questionnaire were distributed through a Google Form to parents in the general Indian population. The questionnaire consisted of 16 questions. The first segment of the survey was about the knowledge of parents regarding caries and their consequences. The second segment was about the influence of COVID on the dental treatment of children. The third segment was about the influence of COVID on the preventive dental care of children. The results obtained were tabulated and analyzed using SPSS software. Results: Results suggest that 80%–95% of parents have good knowledge about tooth decay in the pediatric population and feel COVID is a barrier to visiting the dentist and feel the availability of the COVID vaccine to children would increase confidence to break this barrier. Conclusions: COVID pandemic has been a barricade for neglecting dental treatment. If adequate information about the etiology and consequences of tooth decay along with the availability of the COVID vaccine, no barrier can be seen between the dentist and the child's dental treatment.
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REMARK scoring of biomarkers predicting lymph node metastasis in oral squamous cell carcinoma – A systematic review p. 33
Riya Jain, Suchitra Gosavi, Deepak Sethia, Priya Jain
Background: A universal and systematic protocol is essential for accurate reporting of biomarker studies. For unity in reporting biomarker studies, many guidelines were introduced, Recommendations for Tumor Marker Prognostic Studies (REMARK) being one of them. Aim: The purpose of this review is to evaluate the quality of published articles of biomarkers that predict metastasis in lymph nodes in oral squamous cell carcinoma (OSCC) by the use of the reporting recommendations for tumor marker prognostic (REMARK) guidelines. Methods: Comprehensive search was done in MEDLINE via PubMed and Cochrane from January 2015 to December 2019 to identify manuscripts evaluating biomarkers predicting lymph node metastasis in OSCC. The significance of the univariate and multivariate analysis was assessed for each manuscript, and P < 0.05 was considered statistically significant. Results: Thirty-six results were included for the qualitative synthesis. The mean REMARK score was 11.13 (range: 5.01–17.15). Biomarkers with the highest REMARK score were phospholipase C, cyclin D, CD44+/CD133+, and matrix metalloproteinase-9 (MMP-9). While biomarkers such as LGALS1, NCOA7, and TMOD1 were associated with high risk of bias, hence its use as a biomarker predicting lymph node metastasis is questionable. Conclusions: In our review of 36 manuscripts, manuscripts examining biomarkers evaluating lymph node metastasis in OSCC need an improvement in their reporting. Biomarkers such as phospholipase C, cyclin D, CD44+/CD133+, and MMP-9 can be used as a predictor of lymph node metastasis in OSCC.
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Applications of corticosteroids in oral diseases – A narrative review p. 41
Aishwarya Umesh Lohokare, Shams Ul Nisa, Amit Mhapuskar, Kinjal Shankar Lakhani
Background: The anti-inflammatory and immunomodulatory properties of corticosteroids aids in the treatment of oral diseases both topically and systemically. Furthermore, its significance in medical emergencies like adrenal crisis and anaphylactic shock cannot be understated. Aim: The purpose of the current review article was to provide and simplify the application of steroids used in oral mucosal diseases. Methods: An online search was conducted using databases such as PubMed, Web of Science, Scopus, and Google Scholar to find articles with the terms “corticosteroids”, “oral medicine”, “recent advancements”, “dental applications”, “oral lichen planus”, “oral submucous fibrosis”, and “oral aphthous ulcers”. Results: A total of 34 articles were included and analyzed for this review. Conclusion: The overall effectiveness of medications depends on knowledge of the illness process, accurate diagnosis, and periodic follow-up.
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Enamel island technique and nonrigid connectors: A viable rehabilitation protocol p. 48
Maj Rahul Bahri, Poonam Prakash
Rationale: Fixed denture prosthodontics is a commonly practiced treatment option for rehabilitation of partially edentulous clinical conditions. Certain local and systemic factors contraindicate utilization of implant therapy. Long edentulous span, pier abutment, distal abutments, and intersegment prosthesis extending from one sextant to another are a few challenging situations due to altered biomechanics and require modification in treatment planning to achieve optimum outcome. Patient Concerns: A 37-year-old male patient reported with difficulty in mastication due to partially edentulous mandibular arch. Diagnosis: Based on clinical features, a diagnosis of Class II partially edentulous mandibular arch was made. Intervention: Rehabilitation of partially edentulous mandibular arch was done using customized semiprecision attachment. Outcomes: Recall appointments were scheduled at 48 h, 1 week, 1 month, and 3 months and the patient was found to be satisfied with the prosthesis. Lessons: Semiprecision attachment is a viable modality that is used in rehabilitation of pier abutment situations. It protects the abutment from unwanted leverage forces and ensures longevity of the restoration.
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Kindler syndrome and role of dental surgeon: Providing quality oral health care – A case report p. 52
CV Srinivedha, Adity Bansal, Ashi Chug
Introduction: Kindler syndrome is an autosomal recessive disorder with multisystem involvement such as cutaneous, oral, gastrointestinal, and urogenital manifestations. Rationale: Timely diagnosis and management of this syndrome are warranted. The dental surgeon has a prime role in diagnosing the same and halting the progression of gingivitis to periodontitis and referring the patient to appropriate specialists for effective and timely management of the same. Patient Concerns: In this case report, a 17-year-old patient had reported with the chief complaint of spontaneous bleeding from gums and swollen gums since birth, and blackish pigmentation of the skin. Diagnosis: On examination, the patient had poikiloderma, photosensitivity, gingival fragility, and skin atrophy suggesting a diagnosis of Kindler syndrome. Interventions: Oral prophylaxis was done for the patient on several sittings and the patient was on continuous follow-up for 2 years. Dermatology and urology opinions were sought and advice was followed. Outcomes: The patient had complete regression of spontaneous gingival bleeding and oral hygiene had also become satisfactory. Lesson: Prompt diagnosis of the disease with appropriate and early intervention by a dental surgeon could definitely stop the disease progression.
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