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   Table of Contents - Current issue
Coverpage
October-December 2018
Volume 5 | Issue 4
Page Nos. 45-83

Online since Wednesday, May 29, 2019

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ORIGINAL ARTICLES  

Comparative study of remineralization potential of three different remineralizing agents on demineralized enamel using light fluorescence and confocal fluorescence microscope: An in vitro study p. 45
Trishagni Chaudhury, S Ananthakrishna, R Veena Kumari, Sukhbir Kour, Aswathi Syam
DOI:10.4103/INPC.INPC_6_19  
Aim and Objective: The main objective of this in vitro study was to evaluate the comparative analysis of remineralization potential of three different materials – casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF), calcium sucrose phosphate (CaSP), and bioactive glass on demineralized enamel using light fluorescence microscopy and confocal laser scanning fluorescence microscopy. Materials and Methods: A total of 40 single-rooted maxillary and mandibular premolars were selected; 4 mm × 4 mm window was prepared on the buccal surfaces of the teeth, which was then subjected to demineralization for 96 h at 37°C. Teeth were randomly selected and divided into four study groups of 10 teeth each: Group 1 (artificial saliva), Group 2 (CPP-ACPF), Group 3 (bioactive glass), and Group 4 (CaSP). Each group was treated with respective remineralizing agents and sectioned with Struers Minitom diamond saw. Each section obtained was visualized under light fluorescence microscope for detection of remineralized and demineralized zones and also was visualized under confocal laser scanning fluorescent microscope for the quantification of demineralized and remineralized zones. Statistical Analysis: Statistical analysis was done using paired t-test, followed by one-way ANOVA, where P ≤ 0.05. Results: All the groups showed better statistically significant remineralization potential when compared to the control group, but among them Group 4, that is, Toothmin group showed the highest mean remineralized value, followed by Groups 3, 2, and 1, though the values were not statistically significant (P ≤ 0.05). Light fluorescence microscopy was an efficient diagnostic aid in detecting remineralization and demineralization. Conclusion: CaSP (Toothmin) has got the best remineralization potential when compared to other groups.
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A clinical study of incidence, etiology, and pattern of mandibular fractures in K. R. Hospital, Mysore p. 50
S Sandeep Tejaswi, TS Subash
DOI:10.4103/INPC.INPC_14_19  
Introduction: The mandible is the second-most common fractured part of the maxillofacial region after the nasal bone. The incidences, etiology, and pattern of mandibular fractures vary considerably among the different population; there is a need to evaluate aspects of mandibular fracture in Mysore. The main causes of mandible fractures in this study are road traffic accident (RTA), assault, fall, sports-related injuries, and industrial trauma. Materials and Methods: A total of 50 patients records were taken from MLC books who sustained mandibular fracture presenting to the Department of Dentistry, K.R. Hospital from January 2016 to December 2016. A standardized maxillofacial trauma pro forma was used to record the data in relation to age, gender, etiology, and anatomical site. The mandibular fractures were classified based on the anatomical sites such as symphysis, parasymphysis, body, angle, ramus, condyle, coronoid, and dentoalveolar process. Patients were divided into the following age group of <10 years, 11–20 years, 21–30 years, 31–40 years, 41–50 years, and 50 years and above; data were obtained and analyzed using simple descriptive statistical analysis and Pearson's Chi-squared test. Results: A total of 50 patients with 70 fractures were analyzed for the study, in which 32 were male (64%) and 18 (36%) were female. The patients ranged from <10 years to 50 years. The highest prevalence of fracture occurred in the age group of 21–30 (33.3%) years followed by age group of 50 years and above (28.6%). Mandibular fractures are predominantly caused by RTA which consisted of (16/50, 32%). The second-most common was fall (13/50, 26%), followed by assault (10/50, 20%), sports (8/50, 16%), and industrial trauma (3/50, 6%). RTA was the main cause in the age group of 31–40 years. Fall was the second cause in the age group of 40–50 years and above. RTA remains the predominant cause of mandibular fracture in the age group of 31–40 years in this study. Conclusion: Among 70 fracture sites located in this study, sites which fracture were seen was parasymphysis 31.42%, followed by angle 20%, condyle 18.57%, symphysis and dentoalveolar 8.57%, body 7.14%, ramus 4.28%, and the least was coronoid 1.42%. The parasymphysis is the most common site of fracture in this study similar to the other previous studies. In cases with unilateral fractures, parasymphysis was the most common 33.33%, followed by the angle of 19.60%. The most common combination was parasymphysis and condyle.
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A comparative evaluation of plastic and metal impression trays on the accuracy of cast p. 53
Jiji M Edakkalathur, Kurien Varghese, Sony Sebastian, Bilaal Sidhique Abubacker
DOI:10.4103/INPC.INPC_10_19  
Background: Defects in making an impression could affect the accuracy and fit of the final prostheses. Aims and Objectives: The present study evaluates whether the rigidity of impression trays made out of two different materials affect the accuracy of cast poured out of same impression material. Materials and Methods: For the present study, metallic perforated rim-lock tray and disposable plastic tray were selected for making the impression. Alginate (Tropicalgin™) was used as the impression material of choice. A master model constructed with stainless steel abutments at 44 and 47 and 34 and 37 region was used for making impressions using metal and plastic impression trays respectively. The cast was poured with type III dental stone and the distance between the reference points were measured using CMM (Coordinate Measuring Machine). The results obtained were compared and statistical analysis done using one sample t – test. Results: The study came out with results showing statistically significant differences (P < 0.05) between casts made out of these two different impression tray materials. Conclusions: The study concluded that rigidity of perforated metal stock trays ensured better results than perforated plastic stock trays for impressions using alginate impression material.
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A comparative evaluation of maxillary canine retraction using flap and flapless corticotomy: A clinical study p. 57
Sarvesh P Agrawal, Shreya Iyengar, Udita A Thakkar, Reema Agrawal, Syed Mohammed Ali, Vinod Sargaiyan
DOI:10.4103/INPC.INPC_12_19  
Objective: The objective of this study is to compare and evaluate the effectiveness of maxillary canine retraction using flap and flapless corticotomy. Materials and Methods: A sample of 10 adult patients undergoing orthodontic treatment requiring therapeutic extraction of maxillary first premolars bilaterally were selected, compliant with the inclusion criteria. By random allocation, one site was selected for flap corticotomy-facilitated orthodontics (CFO) and opposite site for flapless CFO. After corticotomy procedure, maxillary canine retractions were done on both the sides using sliding mechanics. A paired t-test was used to determine the statistical significance of the difference in the amount of tooth movement between the flap and flapless sides. Results: There were statistically significant differences (P ≤ 0.01) in the rates of anteroposterior movement of the canines between the flap and flapless sides at all measurement times, and the rates of canine retraction were consistently higher in the flap side than in the flapless side. Conclusions: Flap corticotomy technique is more effective as compared to that of flapless corticotomy technique. Clinical Relevance: Flap corticotomy will be more effective clinically; however, the histologic correlation in regard to the changes in both the technique would be more beneficial.
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Prevalence of oral submucous fibrosis among habitual gutkha and areca nut chewers in Dhanbad district p. 60
Animesh Kumar Shivam, Farrukh Azam, Heena Sadiq
DOI:10.4103/INPC.INPC_5_19  
Objectives: To assess the incidence rate of oral submucous fibrosis (OSMF) and its etiology in patients attending outpatient department at Patliputra Medical College and Hospital (PMCH), Dhanbad. Methodology: The diagnosis of OSMF was based on clinical examination and evaluating patient's signs and symptoms. Results: The total number of patients affected by OSMF in this time duration was 270. Of these, 232 (86%) were male, while 38 were female (14%). The greatest proportion of OSMF patients (58.58%) had a habit of chewing areca nut alone or in the form of gutkha. Conclusion: This study reveals that the incidence rate of OSMF in patients visiting PMCH, Dhanbad was 1%. Males were more affected than females. It was seen that the major etiological factors in the development of OSMF was areca nut and gutkha usage by the patients.
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Knowledge, attitude, and practice of dentists toward patients with human immunodeficiency virus and hepatitis B virus infections in Bhubaneswar, Odisha, India p. 63
Rajeev Ranjan, Rudra Joshi, Saurabh Pramanik, Chhaya Jha, Anirban Kundu, Diplina Barman
DOI:10.4103/INPC.INPC_7_19  
Background: During routine dental work, dentists and dental students can be exposed to human immunodeficiency virus (HIV) and hepatitis B virus (HBV). The aim of the present study was to assess the knowledge, attitude, and practice of the dentists toward HIV- and HBV-infected patients in Bhubaneswar, Odisha, India. Materials and Methods: A cross-sectional study was conducted among dentists practicing in Bhubaneswar, Odisha, India, from December 2016 to April 2017. A total of 200 practitioners (89 males and 111 females) participated in the study. A pretested validated questionnaire related to the knowledge, attitude, and practices (knowledge – 17, attitude – 13, and practice – 17) of the dentists toward HIV- and HBV-infected patients was distributed among dental practitioners. Results: Almost 80% of the dental practitioners had existing fear and concern of the infection transmission from HIV and HBV patients, and this was the primary cause of refusal to treat these infected patients. Conclusion: The dentists did not have proper knowledge in the field of transmission of HIV and HBV infections. Fear and concern of being infected make them to refuse treating these patients. Therefore, training dentists to improve their attitudes toward the treatment of these patients is necessary.
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Appraisal of orthodontic brackets for Adhesive Remnant Index with and without primer: In vitro study Highly accessed article p. 68
Ayub Khan, Sri Sujan Suryadevaraya, B Vengal Rao, Sweta Kattimani, Shaik Kamal Sha, Bindu V Bhaskar
DOI:10.4103/INPC.INPC_9_18  
Introduction: The elementary function of the primer is to boost the efficiency of the final bond. The secondary function is to protect the enamel from the ensuing demineralization by the acid-etching and to reduce marginal leakage. Primer computing is a step in the bonding procedure which necessitates increased chair time risk of moisture contamination and an increased procedural cost. Hence, the present study is intended to evaluate the Adhesive Remnant Index (ARI) for the site of bond failure. Methodology: Eighty extracted premolars procured from the department of orthodontics and private clinics divided into two groups with and without primer, after debonding the enamel surfaces, were examined under stereomicroscope of ×20 magnification for ARI, using the 4-point scale described by Artun and Bergland. Results: The frequency distribution of ARI with primer application showed statistically significant results. There were significant differences in debonded locations, between enamel-adhesive with primer and without primer. Conclusions: A conventional adhesive system with primers showed low ARI scores in comparison to adhesive system without primer.
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Chitosan hydrogel: Its applications in medicine and dentistry p. 71
Guljot Singh, Umang Jamwal
DOI:10.4103/INPC.INPC_2_19  
Since times immemorial, there has been an interactive interdependence of man on nature. The world of technology has overpowered him, yet technology and nature go hand in hand to help mankind fulfill his day-to-day necessities. The developing civilization has once again led to a quest to turn to nature in search for materials that are ecofriendly and economical. Chitosan is one such polymer. The combination of properties of chitosan such as biocompatibility, biodegradability, nontoxicity, and antibacterial properties open many possibilities for its application in medicine and dentistry. This article overviews the applications of chitosan in the form of hydrogels that can be applied effectively and give promising results for target delivery of drugs, the reduction of toxicity, and its uses focused towards the advancement of dentistry.
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CASE REPORTS Top

Restoring biomechanics in immature young maxillary permanent central incisor p. 77
MR Amith, P Venugopal, CM Jayashankara, S Anil Kumar, P Sharath Kumar, SA Girish
DOI:10.4103/INPC.INPC_8_19  
Treatment of immature young permanent tooth is complex owing to the presence of open apex and thin fragile dentinal walls. To create an apical seal, the treatment of choice would be apexification. The present clinical case is a report of immature permanent young central incisor associated with the periapical lesion treated with single-visit Biodentine® apexification and restored with glass fiber post in the aid of dual-cured resin composite to achieve monobloc effect. The concept of accomplishing monobloc with root dentin is imperative for the durability of the foundation.
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Software-guided predictable endodontic management of three-rooted lower right second premolar p. 81
Purnil B Shah, Nili Shah, Pratik Kariya
DOI:10.4103/INPC.INPC_9_19  
It is essential in endodontics to understand the morphological anatomy of the roots and root canal systems of the teeth to increase the success rate of root canal therapy. Advanced diagnostic imaging modalities like cone-beam computed tomography (CBCT) and the assistive software like three-dimensional (3D) Endo Software (by Dentsply Sirona) are very helpful aids in understanding the anatomy of the teeth, especially the complicated premolars. Most commonly mandibular first and second premolars have a single root and root canal system. However, multiple roots and canals have also been reported in few cases which are considered as a challenging task for an endodontist. The present case report discusses the complete endodontic management of a three-rooted mandibular second premolar using CBCT imaging and assistive guidance by 3D Endo Software (by Dentsply Sirona).
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