Vol. 10 - 2019

July-December,Issue 2


Antimicrobial Efficacy of Different Commercially Available Herbal vs Chemical-based Dentifrices on Escherichia coli: An In Vitro Study

Saummya Singh, Ashok K Agarwal, Rashmi Bansal, Deepika Verma, Anuraag Gurtu, Aishwarya Roy

Introduction: Toothbrushing aids in control over cariogenic microorganisms. Various chemical and herbal ingredients are added to dentifrices
for antimicrobial efficacy. But sparse knowledge regarding the ingredients used in herbal dentifrices and their efficacy compared to chemical
dentifrices is present. So, various herbal dentifrices are evaluated and compared for their antimicrobial efficacy against Escherichia coli.
Materials and methods: Pure cultures of Escherichia coli (ATCC 25922) were subcultured on Müeller-Hinton broth at 37°C for 24 hours. The
nutrient agar plates were inoculated with 0.5 mL of 24-hour broth culture. Dilutions of the selected dentifrices were prepared and evaluated by
agar-well diffusion method. The agar plates were then incubated. The diameter of obtained zones of inhibition was measured. The antimicrobial
efficacy of the dentifrices was considered to be directly proportional with the size of obtained zone of inhibition.
Statistical analysis: The obtained results were tabulated and subjected to statistical analysis using one-way analysis of variance (ANOVA) and
independent t test.
Results: Amongst the herbal combinations, maximum zone of inhibition was observed with the dentifrices containing akarkara, neem, babool,
tomar, pudina, lavang, pippli, vajradanti, bakul, vidang, haldi, pilu, majuphal, and meswak. Amongst chemical-based dentifrices, triclosan and
sodium fluoride containing dentifrice depicted maximum zone of inhibition against E. coli. On comparing antimicrobial efficacy of herbal vs
chemical dentifrices, it was observed that there was no significant difference between them (p > 0.05).
Conclusion: Herbal dentifrices are more effective than chemical dentifrices and possess no side-effects. So, many lesions of oral cavity can be
treated by herbal dentifrices.
Keywords: Agar-well diffusion method, Antimicrobial efficacy, Chemical dentifrices, E. coli, Herbal dentifrices.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1216


Prevalence of Focal Fibrous Hyperplasia in Bareilly Region: A 10-year Institutional Retrospective Study

Shakir Alam, Madhusudan Astekar, Gaurav Sapra, Shamim Alam, Rajkumar R Choubey, Harshita Puthia

Background: Focal fibrous hyperplasia (FFH) is one of the most common benign soft tissue growths in the oral cavity. Chronic irritation or trauma
is frequently identified as the causative factor. It has a predilection for females, older than 30 years, few centimeters in diameter, pedunculated
or sessile and occurs frequently on the gingiva or buccal mucosa. Treatment involves surgical excision, and recurrences are very infrequent.
Aim: To evaluate the prevalence of FFH in any institutional setup for a period of 10 years.
Materials and methods: All the histologically diagnosed cases during the period of 10 years (2008–2017) were retrieved from the archives of
Department of Oral and Maxillofacial Pathology and evaluated for the prevalence of FFH. The details like age, sex, site, and anatomical side
were recorded.
Results: Out of the total 2,988 cases, 277 (9.27%) were found to be FFH of which 132 (48%) were male and 145 (52%) were female. Age ranged
between 10 years and 80 years and incidence was highest in 21–40 (46%) and 41–60 (21%) age groups. The most common site was left alveolar
mucosa (35.1%) followed by buccal mucosa (32.2%). The most commonly affected side was right side 188 (67.9%) and the least common was
midline 28 (10.1%).
Conclusion: This study indicates several differences in age and gender distribution as well as in site among the different lesions. The results of
this study vary from other studies and the data accessible here can be used as a guide for further multicenter studies.
Keywords: Focal fibrous hyperplasia, Low-grade irritation, Oral mucosa, Traumatic fibroma, Tumor’ reactive lesions.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1215


Detection of Anatomical Discrepancy in Mandible by Digital Panoramic Radiography: A Retrospective Study

Gyanendra Pandey, Sowmya G Vishnurao, Jyoti Bisht, Supriya Naren, Kratika Mohan, Swati Goley

Background: The imaging modality that has been converted to a seldom-used in dental practice and can be appreciated diagnostic tools
in the dentist’s exploitation is panoramic radiography. It is a two-dimensional (2D) image that is steadily used for innumerable investigative
tenacities as it provides broad coverage of the maxillofacial region in a single image. To dodge injury to several vital structures in the
maxillofacial region, the precise locality of the structures should be recognized prior to any invasive surgical procedures expending apposite
radiographic technique.
Aim and objectives: The aims and objectives of this study were to assess the radiographic discrepancy of anatomical landmarks in the mandible
on digital radiographs and to define how frequently different maxillofacial structures are perceived on digital panoramic radiography.
Materials and methods: A total of 200 panoramic radiographs were studied for normal anatomical disparities, such as mandibular canal,
mental foramen, the anterior loop of mental nerve, and incisive canal. Two autonomous observers assessed the scores recorded and further
was tabulated according to the desired criteria.
Results: In the present study, with a trial size of 200, the mandibular canal was evident in 92%. In 3% of the cases, with poor perceptibility
anterior looping of the mental nerve was visible. The mental foramen showed good visibility in 77%. In 32% of the cases, the incisive canal was
witnessed. The Chi-square test applied displayed the statistical variance considering p value <0.05 as statistically significant value.
Conclusion: According to the results of the present study, it could be established that panoramic radiographs provided sufficient information
for mental foramen and mandibular canal. They remain the most essential tools used for assessment of anatomical landmarks and appear to
have the best fiscal, edifying process.
Keywords: Anatomical landmarks, Anterior loop of mental nerve, Incisive foramen, Mandibular canal, Mental foramen, Panoramic radiography.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1223


Prevalence and Factors Associated with Missed Appointments in Pediatric Dental Office: A Retrospective Analysis

Anand Prabhu, Ramalingam Krishnakumar, Shashi Bhushan, Maruthamuthu Karthikeyan

Background: Missed appointments (MAs) tend to be common occurrences in dentistry and yet there are very few studies that have explored
their prevalence and associated factors.
Materials and methods: The present cross-sectional study was conducted over a period of 1 year to determine the prevalence of MAs and their
associated factors. The patient’s demographic data and treatment types associated with MAs were recorded and behavior was identified using
the Frankel’s behavior rating scale. Additionally, parents’ reason for missing the appointments and qualification of the treating doctor were
recorded. The statistical analysis was done using the Chi-square test where a p value of less than 0.05 was considered statistically significant.
Significant traits were further evaluated using the odds ratio.
Results: Endodontic treatments reported the most MAs followed by orthodontic treatments. The most common reason for MAs was that as the
symptoms and problems had resolved, it was deemed unnecessary to continue with treatment, despite the procedure being not complete.
Children treated by postgraduate students and children with a positive behavior were deemed to be less likely to miss appointments. Treatment
delay was determined to be the single most important predictor of MAs (p = 0.000).
Conclusion: Delay in treatment is a definite cause of inconvenience to both the children and their parents/supervisors and as such elimination
of the same could provide better appointment compliance in children.
Keywords: Frankel’s behavior rating scale, Missed dental appointments, Pediatric dentistry, Treatment delay.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1218


Correlation between Measured Parameters of Risk and Prognosis in Subjects with Chronic Periodontitis

Sripriya Nagarajan, Rampalli V Chandra, Gonela Tulasi, Aileni A Reddy, Anuup Kumar, Nagilla Jithender

Aims: In most of the cases, clinical parameters associated with poor prognosis are the same as the factors associated with increased risk, but
the relationship between risk and prognosis remains unclear. The objective of this study was to evaluate the correlation between measured
parameters of predictive risk and prognosis in subjects with chronic periodontitis.
Materials and methods: Three hundred subjects participated in the study. Modified periodontal risk assessment (MPRA) model was used to
assess the risk and prognosis was evaluated by using McGuire and Nunn prognostic criteria.
Results: Among the subjects, 57.3%, 38%, and 4.7% were categorized as having high, low, and medium risk, respectively. Assessment of prognosis
among study subjects showed that 38.0%, 24.0%, 17.7%, 17.0%, 2.0%, and 1.3% had good, fair, excellent, poor, hopeless, and questionable
prognosis, respectively. Though majority of the subjects had good prognosis (114 subjects; 38%), there was a substantial variability in the
distribution of the measured parameters as per the risk scores within this cohort. A strong positive correlation was seen between prognosis
and probing depth (PD) ≥5 mm. There was a weak, but statistically significant correlation between predictive risk from MPRA and various types
of prognosis (rs = 0.507; p < 0.001).
Conclusion: The measures used to assess risk and prognosis are almost similar, but the weak correlation between risk and prognosis seems to
suggest that an increased risk of developing periodontal disease need not necessarily indicate a bad prognosis.
Keywords: Chronic periodontitis, Periodontitis, Prognosis, Risk.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1219

Introduction: Artifacts in radiology refer to the unwanted structures or the discrepancies that appear in the diagnostic image, resulting in
obscuring the region of interest to be studied. This usually occurs when the gray scale values in the image do not display precisely the diminution
values of the content in the persons to be studied. Artifacts sometimes also appear as foreign structures that are not present in the region of
interest and are outside structures such as ear rings or other accessories. Since their presence deteriorates the image quality, the knowledge of
their presence alerts a radiologist, so that the findings should not get misinterpreted and diagnosis should become flawless.
Aim: The aim of this review is to ascertain the possible factors which give rise to the various artifacts in the radiographic image and lead to the
misinterpretation of the CBCT image.
Conclusion: The knowledge of various cone-beam artifacts is essential to limit a clinician in misdiagnosing a pathological condition and to help
an astute clinician in proper treatment planning.
Keywords: Artifacts, Cone beam, Resolution, Star effect, Streaking.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1222


Dentin Hypersensitivity after Cementation of Fixed Partial Denture: An Enigma

Rashmi Jawade, Siddharth Gosavi, Sulekha Gosavi, Snehal Taru

Dentin hypersensitivity is characterized by nonspontaneous short sharp pain due to the exposure of dentin in response to stimuli, which can
be because of thermal, evaporative, tactile, osmotic, or chemical effect and that cannot be ascribed to any other dental defect or disease. Postcementation, some of the patients receiving crowns or bridges on vital teeth have reported an incidence of sensitivity. Greater the diameter of
exposed tubules, the greater would be the sensitivity. To reduce the incidence of postoperative sensitivity, many methods are advocated which
concern with occlusion of dentinal tubules. This article reviews the mechanism and various treatment protocols followed in dentin hypersensitivity.
Keywords: Dentinal tubules, Desensitizers, Laser, Cementation.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1220


Bone Graft Banking: A Review

Himanshu P Singh, Archana Chaurasia, Jitendra K Diwakar, Ankita Bajaj

Nowadays there is an increased demand for replacement of human tissues which are lost due to variety of conditions like road traffic accident or
assault. Bone grafts have been employed for repair for more than hundred years. It is a dynamic process and is extensively used in reconstructive
surgery. During the last 20 years, it has undergone numerous advances, one of which is bone banking. Bone banks are necessary for providing
biological tissues. The growing need for musculoskeletal tissues has been due to the development of new surgical techniques. The large number
of reconstructive options brought about by advances in craniofacial surgery have created the need for large quantities of donor bone and for
techniques that can reliably transfer bone material to distant and sometimes hostile tissue bed. For a successful regeneration, bone graft when
applied should heal, become incorporated, revascularize, and eventually assume the desired form. To increase the safety of transplanted tissues,
standards for bone bank operation have been imposed by the government. This paper describes the technical considerations relating to how
a bone graft taken and how they are banked for long-term usage.
Keywords: Allograft, Autogenous, Bone banks, Bone grafts.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1214


Plasma Cell Gingivitis of Unknown Etiology: A Case Report

Maity Snigdha, Shashikumar Pratibha

Plasma cell gingivitis is a rare hypersensitive reaction of gingiva associated with various known and unknown allergens. Clinically, it is characterized
by marked erythematous enlarged gingiva confined to marginal and attached gingiva and extends to the mucogingival junction. It is often
confused with other gingival lesions such as pubertal- or pregnancy-induced gingivitis or plaque-associated gingivitis, lichen planus, cicatricial
pemphigoid, discoid lupus erythematosus, or leukemia. The exact diagnosis of plasma cell gingivitis is made, based on the histological picture
characterized by dense infiltration of plasma cells with atrophic stratified squamous epithelium. Most often the lesion presents with unknown
reasons that leads to unpredictable treatment outcome. Hence, we are documenting a case report of a 52-year-old female patient, who presented
with plasma cell gingivitis of unknown etiology with a focus on the treatment options.
Keywords: Gingivectomy, Glucocorticoid, Plasma cell gingivitis, Tetracycline.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1217


Management of Open Bite with Single Incisor Extraction: A Case Report

Farozan Jabeen, Sanjeev K Verma, Naaz Amrin, Mohammad Z Ansari

Maintenance of the primary dentition is important for the well-being of the child. The esthetic restoration of severely mutilated primary anterior
teeth has for a long time been a challenge for pediatric dentists. Nonpharmacological behavior-management techniques are primary techniques
for treating children in the dental chair. However, in very young children who are emotionally immature, these techniques cannot be applied.
Thus, to perform any dental treatment, pharmacological means are useful to obtain a quiescent cooperative patient. The purpose of this case
report is to highlight full mouth rehabilitation under general anesthesia in a pediatric patient.
Keywords: Early childhood caries, Esthetic rehabilitation, General anesthesia.
Journal of Dental Sciences and Oral Rehabilitation (2019): 10.5005/jp-journals-10086-1205

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