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   Table of Contents - Current issue
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July-September 2021
Volume 12 | Issue 3
Page Nos. 117-180

Online since Friday, September 17, 2021

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ORIGINAL ARTICLES  

Comparative assessment of long-term bond strength between fiber post and root dentin with and without 6.5% cocoa seed extract pretreatment – An in vitro study Highly accessed article p. 117
Shilpi Tiwari, Chethana S Murthy, Meena Naganath, Anitha Kumari Rangappa
DOI:10.4103/srmjrds.srmjrds_25_21  
Background: Cocoa seed extract (CSE) is a natural cross-linker or biomodifier, which contains proanthocyanidin that increases the immediate resin-dentin bond strength as well as reduces the dentinal matrix degradation. There are very few studies which shows the long-term effects of the cross-linking agents on radicular dentin. Aim: The aim of this study was to assess and compare the effect of 6.5% cocoa seed extract (CSE) on long-term push out bond strength between fiber post and root dentin cemented by using two different adhesive systems – total etch adhesive system and self-etch adhesive system. Materials and Methods: Sixty extracted permanent maxillary central incisors were decoronated to standardize the root length. Root canal preparation followed by postspace preparation was done. Specimens were then randomly divided into four groups according to the adhesive technique and CSE pretreatment – Group 1: Total-etch adhesive + without 6.5% CSE treatment, Group 2: Total-etch adhesive + with 6.5% CSE treatment for 10 min, Group 3: Self-etch adhesive + without 6.5% CSE treatment, and Group 4: Self-etch adhesive + with 6.5% CSE treatment for 10 min. Fiber posts were cemented with resin cement, and then, specimens were stored in an incubator for 180 days. Specimens were then tested for pushout bond strength using the universal testing machine. Statistical analysis was performed using the one-way ANOVA followed by Tukey's post hoc analysis. Results: CSE-treated groups showed higher bond strength than nontreated group. Group 2 showed significantly higher bond strength among all groups. Conclusion: The pretreatment with Proanthocyanidines containing CSE can be a natural alternative to improve the long-term resin–dentin bond strength.
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A cone beam computed tomographic evaluation of root canal treatment quality using periapical and endodontic status scale p. 122
Sagar Jatish Shah, Gaurav Kulkarni, Naren Ramachandran, Padmini Chandrasekhar, Rajesh Satyanarain Podar, Shishir Singh
DOI:10.4103/srmjrds.srmjrds_31_21  
Background: Cone beam computed tomography (CBCT) is a three-dimensional digital imaging which provides an image that can be viewed in multiple planes thus providing a better understanding of the anatomy of the root canal. Aim: This study aimed to evaluate the endodontic treatment quality of root-filled teeth and to determine the relationship between endodontic technical errors and complications. Materials and Methods: One hundred and fifty-two root canals were evaluated by CBCT from December 2017 to January 2019. Three endodontists assessed the root canals for the presence of technical errors and treatment complications using the periapical and endodontic status scale. Chi-square test and descriptive analyses were performed. Results: Sixty-one (40.4%) root canals had periapical radiolucency followed by 45 (29.8%) root canals with short obturations. Sixty-nine root canals (45.7%) and 45 (29.8%) root canals had nonhomogenous root canal filling and coronal seal (CS), respectively. Statistically significant association was seen with the length of the root canal filling, homogeneity, CS, and complications (P < 0.05). Conclusions: There was high prevalence of apical radiolucency in root-filled teeth. The presence of short obturations, poor CS, and nonhomogenous obturation led to higher prevalence of endodontic complications.
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Change in sleep-wake cycle, use of digital media and emotional wellbeing amidst COVID-19 lockdown amongst dental students in India p. 128
Surekha Ramrao Rathod, Noopur Pradeep Gonde, Abhay Abhay Pandurang Kolte, Ashwini Narendra Jadhav
DOI:10.4103/srmjrds.srmjrds_51_21  
Background: Maharashtra is one of the major hotspots affected with COVID-19 infection in India. By imposing lockdown to implement preventive and control strategies, entire world is trying to contain the spread of this potentially fatal pandemic. Lockdown has compelled people to stay at home, refrain from their day-to-day activity and lead to drastic lifestyle changes. Aim: The aim of the study was to assess the impact of COVID-19 pandemic lockdown on sleep-wake pattern and emotional status among Bachelor of Dental Surgery undergraduate students. Materials and Methods: This observational online survey was carried out among the undergraduate students of our dental college. The question on individual sleep cycle, wake up pattern, eating habits, working hours, screen time on T.V., mobile, and laptop were addressed before and during the lockdown. The results were tabulated and analyzed using the SPSS software version 17.0. If P < 0.001, the results were reported to be statistically significant. Results: Statistical difference was observed in the usage of digital media, change in their sleep wake pattern, and eating habits among dental students during the lockdown period after applying paired test with P < 0.001. Furthermore, these unpredictable changes in their working hour, sleeping pattern, eating habits, and concern about spending time build stressful situation among students. Conclusion: It can be concluded that the dental students have increased level of stress and disturbance in sleep-wake cycle and emotional well-being during this COVID-19 lockdown.
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Parental knowledge, attitude and practice of oral hygiene of special children in Bangalore p. 132
Anagha Saseendran, Priya Nagar, KS Nameeda, K Fathimath Nihala
DOI:10.4103/srmjrds.srmjrds_126_20  
Background: Oral hygiene of special children is directly related to their disability, and parents play a key role in a child's oral hygiene maintenance which would influence their general health condition. Aim: The aim of this study was to evaluate the knowledge and attitude of parents of special children toward oral hygiene maintenance and to correlate the same with educational and socioeconomic status. Materials and Methods: A cross-sectional study was conducted among the mothers of children from special schools in Bangalore. The survey included questions related to knowledge and attitude of parents and practice of oral hygiene maintenance for their children. The results were tabulated and subjected to statistical analysis using Chi-square test. P < 0.05 was considered to be statistically significant. Results: The parents of the special children had sufficient knowledge on the maintenance of oral hygiene, and the educational status of the parent had a positive impact on the child's oral health. Conclusion: Oral hygiene maintenance of special children is extremely important as primary teeth serve as the milestone in orofacial growth and development.
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An exfoliative cytology study to assess oral mucosa of oral submucous fibrosis patients in Chennai, Tamil Nadu: A preliminary study p. 136
N Vaishnavi Dhanvantri, Raghavendhar Karthik, K Rajkumar
DOI:10.4103/srmjrds.srmjrds_139_20  
Background: Oral submucous fibrosis (OSMF) is a chronic, insidious disease that affects the oral mucosa. It is a progressive high risk potentially malignant disorder that leads to oral mucosa scarring. Aim: In this study, we aimed to study and compare the differences in the buccal cytological smear and the nuclear and cytoplasmic changes seen in the exfoliated cells of patients with OSMF and healthy controls, during preliminary screening. Materials and Methods: Patients with clinical OSMF (reduced mouth opening, blanched buccal mucosa, burning sensation in the buccal mucosa, palpable vertical bands) were included in the study. The cytological smears were stained with Papanicolaou stain and studied under light microscopy. The nuclear and cytoplasmic changes were recorded. The cytologic features that were assessed included the presence of keratinized squames, intermediate cells, inflammatory cells, cytoplasmic creasing, peri nuclear halo, and abnormal chromatin. In addition, the presence and absence of candidal organisms in the smear were assessed. Results: The cytological features which were seen to predominate in the OSMF patients were cells of intermediate and keratinized buccal epithelial cells, cytoplasmic creasing, and presence of inflammatory cells. Conclusion: We conclude that the results of our study indicate that there are cytological changes associated with OSMF that can be assessed with exfoliative cytology. The cellular pattern alterations recorded in our study adds on to the current knowledge pool and literature on OSMF. Further studies are necessary to validate the significance of such cellular alterations.
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REVIEW ARTICLES Top

Tantalum: A transmogrifying material in dental implant p. 141
Meenakshi Akshaya Lingam, Ishwarya Balasubramanian
DOI:10.4103/srmjrds.srmjrds_109_20  
Prosthodontic rehabilitation with implants aims at enhancing patient's quality of life and prolongation of survival of prosthesis. Porous tantalum trabecular metal (PTTM ) – incorporated titanium (Ti) is used extensively in orthopedics, but clinical researches and reports in the applications of oral cavity are limited. Therefore, prospective clinical trials of PTTM-incorporated Ti implants are essential for future use in dentistry. In this article, corrosion resistance and biocompatibility of tantalum is discussed elaborately and the usage of PTTM along with Ti in several studies is reported.
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Disinfection in regenerative endodontics and effect of commonly used antimicrobials on stem cell fate: A comprehensive review p. 146
Siddharth Rai, Anitha Kumari Rangappa
DOI:10.4103/srmjrds.srmjrds_76_20  
The endodontic management of necrotic immature permanent teeth is often challenging for the clinician. Regenerative endodontic treatment has emerged as an important alternative to the traditional apexification treatment in such cases. In regenerative endodontics, elimination of microbes from the root canal is important for the survival, proliferation, and differentiation of stem cells. Translational studies suggest that irrigants and medicaments used for root canal disinfection may adversely affect stem cells and ultimately, the regenerative outcome. Conventionally, irrigants and medicaments have been chosen for their maximum antimicrobial effect without considering their effects on stem cells and the dentinal microenvironment. In this review, advances in disinfection for regenerative endodontics are discussed.
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Clinical decision-making in the treatment of periodontitis with new classification system of periodontal diseases p. 152
Deepak Sharma, Shalu Chandna Bathla, Pravesh Kumar Jhingta, Ankit Mahajan
DOI:10.4103/srmjrds.srmjrds_8_21  
Clinical application of the new classification of periodontal diseases requires knowledge of case definitions, parameters, and criteria of different categories and subcategories to arrive at final diagnosis. Correct implementation of the new classification of periodontitis is possible by understanding of the basic rules and guidelines, clarification of complex issues, and use of evidence-based dental practices. Step-wise sequence should be adopted to diagnose a patient with periodontitis. The authors, based on the current scientific evidence and clinical experience, have described specific decision-making algorithms of the diagnostic process and treatment plans of various subcategories of periodontitis.
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“When virtuality merges with reality:” Application of virtual reality and augmented reality in dentistry - A literature review p. 161
Khushboo Rana, Bhavya Sharma, Subir Sarkar, Soumen Roy Choudhary
DOI:10.4103/srmjrds.srmjrds_9_21  
The term “virtuality” has been quoted as “real but not actual, ideal but not abstract” by Marcel Proust. Visual-based reality is gaining popularity in dentistry because of its use in dealing with image-guided and robot-assisted surgery. It has provided a new approach for improving the treatments and delivering education in dentistry. The major throwback was the use of images registration by endoscope camera devices in the form of a video which can be presented on a monitor where the operator is able to observe the site inside the patient. The technologies of modern science have amazed and also fascinate our vision regarding working with patients. This literature review provides only a glance at the future of intelligence science.
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CASE REPORTS Top

Gorlin–Goltz syndrome: Happenstance finding- A case report p. 168
Khooshbu Gayen, Sagar L Pabale, Paras Angrish, Supreet Shailesh Shirolkar, Subir Sarkar
DOI:10.4103/srmjrds.srmjrds_16_21  
Gorlin–Goltz syndrome (GGS), due to its sparse occurrence in various populations along with the variety of associated signs and symptoms, very often becomes a missed diagnosis. The most commonly associated triad with GGS is that of multiple odontogenic keratocysts in the jaws, skeletal abnormalities, and multiple basal cell nevus carcinomas. In many cases, each of these conditions is treated separately and the recognition of underlying syndrome is rare or happenstance. The case reported here is rare of its kind as it has been diagnosed in the first decade of life, thus avoiding the possibility of morbidity in later life in the form of neoplasia and hostile basal cell carcinomas. As per our knowledge, no case had yet been reported at this early age and it emphasizes the importance of pedodontist in early recognition of the syndrome.
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Ewing's sarcoma: A rare case report p. 172
J Faith Ratna Jerusha, Vandana Raghunath, B Ajay Reginald, B Siva Reddy, Firoz Kamal, Samatha Reddy
DOI:10.4103/srmjrds.srmjrds_37_21  
Ewing's sarcoma is an uncommon malignancy, constituting 4%–10% of the entire malignant osseous tumors involving children and young people. Rarely does it affect the facial bones, and added to its nonspecific presentation, its diagnosis remains challenging. Its occurrence is <3% in the head-and-neck region, with the mandible being frequently affected. It belongs to the ES family of tumors, shows rapid growth, and has a greater propensity for metastasis. ES of the jaws either presents as a primary or as a metastatic deposit. We report one such rare clinical and histological scenario of a primary ES of the mandible in a girl, of 8 years of age, whose clinical presentation mimicked that of an odontogenic tumor/cyst. Tumor cells were positive for CD99 and vimentin which confirmed the diagnosis. This report is to showcase the importance of early diagnosis in such rarely occurring aggressive tumors. It further facilitates appropriate therapy to achieve local control, prevent metastasis, and systemic eradication.
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Tooth-supported attachment retained overdenture: forgotten concept revisited - A case report p. 177
BT Pradeep Raja, PS Manoharan, E Rajkumar
DOI:10.4103/srmjrds.srmjrds_42_21  
Overdentures have been considered as a viable treatment alternative for complete dentures in preserving the alveolar ridge integrity. Overdentures remain the choice of the treatment for edentulous patients because of its associated advantages such as increased retention, stability, and support; decreased ridge resorption; and enhanced masticatory efficiency compared to the conventional dentures. Although implant-supported prosthesis provides a better survival, tooth-supported ball attachment retained prosthesis (TBSP) has its own advantages in terms of providing proprioception and economical alternative. Recent advancements with attachment-retained prosthesis enhanced the retention, stability, and support. With proper postoperative follow-up, it is possible for a practitioner to monitor the status of the abutments and provide the necessary care for longevity of the prosthesis. This case report postulates a technique for the fabrication of TBSP with stud attachments in the mandibular arch. Follow-up radiographs after 1 year revealed that alveolar bone of abutment teeth was considerably preserved.
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