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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 11 | Issue 2
Page Nos. 53-99

Online since Monday, July 15, 2019

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ORIGINAL ARTICLES  

Comparative evaluation of multiple recession coverage procedures with mucogingival area as a prognostic factor: A randomized controlled clinical trial p. 53
Varsha Shivaji Ranmare, Triveni Kale, Merekhna Raghavan, Mitali Thamke
DOI:10.4103/2249-4987.262761  
Background: Denuded root surface may give rise to dentin hypersensitivity, deterioration in the esthetic appearance, and inability to perform proper oral hygiene procedure. Hence, various surgical procedures have been proposed to overcome the problem of gingival recession. Hence, the aim of the study was to perform recession coverage procedures and thereafter to compare the height, width, and thickness of the interdental papilla postoperatively. Materials and Methods: Thirty patients were selected with Miller's Class I/Class II localized gingival recession in the maxillary or mandibular anterior region (age 20–50 years) with the presence of buccal gingival recession (≥2 mm). The baseline measurements of height, width, and thickness of the interdental papilla were measured with a standardized vernier caliper, and width of keratinized gingiva, probing pocket depth, and clinical attachment level were measured with a UNC 15 probe. Mucogingival surgical procedures were performed and evaluated postoperatively up to 6 months. Results: The amount of root coverage was significantly correlated with the interdental papilla. Conclusion: This study indicates that the various recession coverage procedures did not affect the papilla dimension however, recession coverage was seen with lower height of the interdental papilla.
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A comparative clinicomicrobiological study to evaluate efficacy of superoxide solution with povidone-iodine irrigation in chronic periodontitis patients p. 58
Dipali Chaudhari, Swapna Mahale, Pooja Kadam, Shradha Shimpi, Lavanya Kalekar, Prasad Sonar
DOI:10.4103/2249-4987.262765  
Introduction: Oxum is a stable, nonflammable, and noncorrosive bactericidal, virucidal, fungicidal, and sporicidal solution that is ready to use with no further dilution or mixing. Superoxidized solutions have shown to be both safe and efficient as a wound care product that moistens, lubricates, debrides, and reduces the microbial load of various types of lesions. Superoxidized solutions are electrochemically processed aqueous solutions manufactured from pure solutions which are rich in reactive oxygen species with neutral pH and longer half-life (>12 months). Aim and Objective: The aim of the present study was to compare superoxide solution with povidone-iodine by means of clinical parameters and microbiologically by colony-forming units. Materials and Methods: A total of 20 sites with chronic periodontitis were selected for study and randomly divided into two groups (ten sites per group). In each patient, sites were selected having probing depth ≥5 mm. The patients were randomly allotted into one of the following groups prior to treatment. Group 1 (study group – irrigation with superoxidized solutions) Group 2 (study group – irrigation with povidone-iodine [Betadine]). The study period of 30 days was divided into baseline (0 day) and 30th day. Periodontal pockets were irrigated with superoxidized solution (oxum) and povidone-iodine (Betadine) from 10 ml syringe having blunt metallic cannula. A total time of 5–10 min was spent for irrigation of the sites. Samples of subgingival plaque from periodontal pockets were obtained with sterile curette at baseline and 1 month for colony-forming units. Results: Group A showed comparable improvement in all the clinical parameters (probing pocket depth and sulcus bleeding index) than Group B. Conclusion: Superoxidized water irrigation as an adjunct to scaling and root planing proved to be effective in the treatment of periodontitis. They allowed better retention and were biologically accepted without any side effects.
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Assessment of oral health knowledge, attitude, and behavior among school teachers of Karad city p. 63
KA Kamala, Akshata Pawaskar, S Sankethguddad, SR Ashwinirani, Abhijeet R Sande
DOI:10.4103/2249-4987.262782  
Aim: Teacher plays pivotal role in any educational system if they themselves are well educated; intellectually, this will add in the formation and modification of behavior of young children. Hence, the present study was undertaken with an aim to assess their knowledge, attitude, and behavior toward oral health in Karad City. Materials and Methods: A cross-sectional study was conducted on 300 school teachers of Karad City; both private and government school teachers were included in the study. Approval was obtained from the selected schools, and written informed consent was obtained before the start of the study. A self-structured questionnaire consisting of 14 questions regarding oral health knowledge, attitude, and behavior was distributed to the participants. The frequency and percentage of the data for all three sections were obtained during the analysis. Results: Response rate was 100 % with 300 school teachers from Government and privates schools. Among them 68% teachers were aware of what gum bleeding means, 70.67% had knowledge of how to prevent gum diseases by using tooth paste. Alost all of them (100%) agreed consuming sweets affect dental health. Nearly 83.33% of teachers agreed that intake soft drinks affect dental health and also has overall impact on the health of the body. About 88.67% teachers agreed to the necessary of regular visits to dentist and 3.67% teachers found toothache is the driving factor to the dentist. About 98.67% used tooth brush and tooth paste to clean their teeth and 73.67% of them brushed their teeth once daily. Conclusion: Overall oral health knowledge, attitude, and behavior of Karad school teachers was good.
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Relationship of fovea palatinae to vibrating line as a reliable guide in determining the posterior limit of maxillary denture p. 68
Indra Kumar Limbu, Bishal Babu Basnet
DOI:10.4103/2249-4987.262757  
Introduction: Determining the posterior extent of maxillary denture is an important factor for retention and patient comfort. Among the landmarks, fovea palatina are utilized to extend the posterior denture border as an indicator of posterior palatal seal. The spatial relationship of fovea palatina to the posterior vibrating line has variations and is related to the types of soft palate. Aim: The aim of this study is to investigate the relationship between clinically determined posterior vibrating line and fovea palatina in Nepalese population and also compare the variations among the different types of soft palate. Materials and Methods: In 140 edentulous patients (57.1% male, mean age = 65.78 years), fovea palatina and posterior vibrating line were marked, and the distance between them was recorded. The comparisons were made in palatal types and gender as independent variables. The level of significance was 0.05 (95% confidence interval). Results: The mean distance of posterior vibrating line from the fovea was found to be 3.43 mm posteriorly. Statistically significant difference (P < 0.05) was observed among Class I, II, and III soft palate types in the distances measured from the fovea palatina to the posterior vibrating line. The gender showed no statistically significant difference. Conclusions: The fovea palatina was located more posteriorly in the Nepalese population and can be used cautiously for locating the posterior extent of maxillary denture.
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Aloe vera on wound healing after periodontal flap surgery in chronic periodontitis patient: A randomized control trial p. 72
Anuja D Hudwekar, Amol Beldar, Supriya Murkute, Shruti Shankarrao Lendhey, Mitali Thamke
DOI:10.4103/jorr.jorr_14_19  
Introduction: Aloe vera is known for its wound healing and anti-inflammatory properties which may be used for periodontal healing. Early healing of the gingival and periodontal wounds promotes favorable treatment outcome. Aim: This study aimed to evaluate the efficacy of Aloe vera on wound healing after periodontal flap surgery. Materials and Methods: Ten patients with chronic periodontitis indicated for periodontal flap surgery were included in this single-blinded, split-mouth, randomized controlled clinical trial. The selected sites were allocated into test and control sites by using simple randomization. After flap surgery, only the test sites received an application of A loe vera extract (gel). Postoperative healing was assessed using the Early Healing Index (EHI) after the 1st week and the Healing Index (HI) after the 1st, 2nd, 3rd, and 4th weeks. Results: Better initial healing was observed in the test sites in comparison to the control sites in the 1st postoperative week as recorded by the EHI and HI, whereas no significant differences were observed at the 2nd, 3rd, and 4th weeks. Conclusion: Application of Aloe vera extract was effective in significantly improving healing scores in the 1st postoperative week.
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CASE REPORTS Top

Management of ankyloglossia p. 77
Aishwarya Madhukar Kale, Kunal S Sethi, Prerna Ashok Karde, Alefiya S Mamajiwala
DOI:10.4103/jorr.jorr_7_19  
Tongue tie which is also known as Ankyloglossia originated from Greek word “agkilos” which means curved and glossa which mean tongue. Ankyloglossia is usually associated with difficulty in speech articulation and breast feeding as it causes limited tongue movement. There are different modalities available to manage Ankylossia. A twenty-three year old male with ankyloglossia and a chief complaint of difficulty with speech underwent lingual frenectomy under local anaesthesia using a standard surgical technique using scalpel and blade that was followed with speech therapy. Two month follow up showed marked improvement in tongue movements with no signs of recurrence. Early diagnosis and proper surgical intervention is key to help the patient to avoid problem associated with Ankylossia and lead a better life.
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Ameloblastic carcinoma masquerading as dentigerous cyst of the mandible p. 81
Sruthi Selvam, Subramaniyan Damodaran, Venkatapathy Ramesh, Jonathan M Daniel
DOI:10.4103/jorr.jorr_11_19  
Ameloblastic carcinoma (AC) is a rare primary odontogenic tumor that has histological features of both ameloblastoma and carcinoma. The term AC was introduced by Elzay. In the last update of the World Health Organization classification, published in 2005, AC is defined as a rare odontogenic malignancy that combines the histological features of ameloblastoma with cytological atypia, even in the absence of metastases. It may develop de novo (primary type) or by malignant transformation of an ameloblastoma (secondary type) with a distinction between carcinoma ex intraosseous ameloblastoma and carcinoma ex peripheral ameloblastoma. Malignant ameloblastomas represent tumors that metastasize while both primary and metastatic lesions retain their benign histological appearance. We report a case of AC of the mandible in a 32-year-old male patient with clinical and radiological images and pathological features.
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Surgical excision of intraoral lipoma on buccal mucosa p. 85
Shreeprasad Vijay Wagle, Amit Arvind Agrawal, Rutuja Sankhe, Dinaz Bardoliwala
DOI:10.4103/jorr.jorr_10_19  
Lipomas are found rarely in the oral cavity. These tumors are of mesenchymal origin in the human body. Their etiology is still not clear. There are different theories to explain the pathogenesis of this adipose tissue tumor. Lipoma has different histological variants given in the literature. A case of intraoral lipoma occurring on the buccal mucosa in a 42-year-old male patient is reported in this article. Surgical excision was performed, and 1-month follow-up showed excellent healing without any recurrence. Lipomas are benign soft-tissue neoplasm of mature adipose tissue seen as a common entity in the head-and-neck region. Intraoral lipomas are rare tumors that may be noticed only during routine dental examinations. Rarely, they cause pain, resulting in delay to get the treatment done.
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REVIEW ARTICLES Top

Molecular mechanisms involved in making periodontitis – A painless disease entity p. 89
Shruti Maroo Rathi
DOI:10.4103/jorr.jorr_6_19  
Periodontitis is a chronic inflammatory disease that occurs in the tissues surrounding the tooth. It is due to the secretion of various inflammatory mediators from host as well as bacteria in response to microbial attack. Unlike any other inflammatory condition, even periodontitis is characterized by production of several inflammatory mediators such as leukotriene, cytokines, and arachidonic acid metabolites that are pro-algesic in nature, but still, patients with periodontitis do not present with “pain” as chief complaint nor do they self-medicate. Searches were carried out in the “Cochrane Library,” “MEDLINE,” “Web of Science,” “Scopus,” and “Google Scholar” databases, using the terms: “painless” and “periodontitis.” In this review, we discuss the role of various factors such as painless gene, calcitonin gene-related peptide and its receptors, endogenous opioids, butyric acid and CXC chemokine receptor 4 signaling by Porphyromonas gingivalis on hypoalgesia in periodontal disease. A detailed understanding of these mechanisms that are involved in making periodontitis, a unique painless inflammatory condition, is required as it can be used to develop new diagnostics and therapeutic modalities to treat severe chronic pain in other conditions.
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Intracanal medicaments – Their use in modern endodontics: A narrative review Highly accessed article p. 94
Ashok Kumar, Sadaf Tamanna, Huma Iftekhar
DOI:10.4103/jorr.jorr_3_19  
The main goal of an endodontic treatment is complete removal of bacteria, their byproducts, and pulpal remnants from infected root canals and the complete sealing of disinfected root canals. Intracanal medicaments have been thought as an important step in killing the bacteria in root canals; however, in modern endodontics, shaping and cleaning has been emphasized greater importance than intracanal medicaments as a means of disinfecting root canals. Furthermore, biocompatibility and stability are essential properties for intracanal medicaments. The more modern meaning of intracanal dressing is for a blockade against coronal leakage from the gap between filling materials and cavity wall. Calcium hydroxide has been determined as suitable for use as an intracanal medicament as it is stable for long periods, harmless to the body, and bactericidal in a limited area. Single-visit endodontics, where intracanal medicaments are not used, is nowadays indicated, and various reports have shown that the clinical outcomes between single- and multiple-visit endodontics are almost similar. There is no reason to counsel against single-visit endodontics. however, if multiple-visit endodontics is chosen, an intracanal medicament is strongly recommended. Therefore, the aim of this review is to critically appraise the need for an ideal intracanal medicament and to select cases requiring intracanal medicament instead of using it for each and every case.
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