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   Table of Contents - Current issue
July-December 2021
Volume 15 | Issue 2
Page Nos. 99-155

Online since Friday, September 17, 2021

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Post-COVID-19 mucormycosis – Are we through the storm as yet? p. 99
NK Sahoo, Vivek Saxena
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Development of apical root microcracks following different root canal preparation systems p. 102
Saleem Akhtar
Context: The most critical step in root canal therapy is cleaning and shaping of the root canal. A vast array of instruments both handheld and engine driven are available for root canal preparation. There are very few studies to compare the effect of different types of instruments on the development of apical root cracks. Hence, the aim of the study was to compare the development of apical root cracks following different root canal preparation techniques and instruments. Aims: The aim of this study is to compare the development of apical root cracks following different root canal preparation techniques and instruments. Settings and Design: This is an in vitro study. Subjects and Methods: Forty extracted mandibular premolar teeth were selected and mounted on resin blocks with simulated periodontal ligaments, after which the apex was exposed. All teeth were randomly divided into four groups; each group was earmarked for a specific technique and instrument used for root canal preparation. Digital images of external apical root surfaces of every tooth were taken before and after apical enlargement through optical microscope (×40). These images were compared, and the presence of cracks was evaluated. Statistical Analysis Used: Chi-square exact test was used to compare the four groups. Results: Overall P value was 0.167 which is not statistically significant and indicates that the proportion of teeth developing cracks was not statistically significant among the four groups. Conclusions: More cracks were developed with rotary system. However, the results were not statistically significant among the four groups.
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Comparative evaluation of contralateral pterygoid dysjunction versus nondysjunction in unilateral combined maxillomandibular distraction osteogenesis p. 106
Indranil Deb Roy, Serat Rahman, Pushpa Kumari
Aim: To prospectively evaluate efficacy of Unilateral Combined Maxillomandibular Distraction Osteogenesis in cases of facial asymmetry managed by Lefort I osteotomy with oblique ramal osteotomy with or without contralateral pterygoid dysjunction. Objective: To evaluate the post op result in terms of facial symmetry, amount of distraction achieved, occlusal cant changes and radiological findings. Patient and Methods - 9 cases of facial asymmetry were divided into two groups alternatively. Group I cases were managed with Lefort I osteotomy with bilateral pterygoid dysjunction with contralateral wire cinch on normal side along with oblique ramal osteotomy and fixation of distractor in osteotomized mandibular segments. Group II cases were managed without pterygoid dysjunction and cinch on contralateral normal side with all other procedures being same. Distraction of 9-16mm were carried out depending upon the requirement. Results: No significant difference was noted between the study groups at a follow up period of six months in terms of facial symmetry at maxillary and mandibular bases, and occlusal cant. Conclusion: Contralateral Pterygoid dysjunction on unaffected side is not necessary in Unilateral Combined Maxillomandibular Distraction Osteogenesis.
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Validation of mathematical relationship for anterior teeth in the Indian population p. 111
Pushkar Andhare, Sanjeev Datana, Shiv Shankar Agarwal, SK Bhandari
Introduction: Smile is an important part of facial esthetics. Various authors have established a mathematical correlation between maxillary and mandibular teeth dimensions and dwelled upon its importance in smile designing. The present study aims to validate one such mathematical relation in the Indian population with an objective to identify the tooth exhibiting maximum variation. Materials and Methods: The present study was conducted by using 225 study models. Mesiodistal dimensions of the maxillary and mandibular anterior teeth were recorded and applied to the mathematical relation for assessing the validation. Results: 37.8% of the study models showed complete validation of mathematical relation. Females showed significantly higher validation compared to males (P < 0.01). However, validation did not differ significantly in relation to malocclusion. 15.6% of the study models of the patients exhibited mandibular canine with increased mesiodistal dimension, 13.3% of the study models showed maxillary central incisor, while 8.9% of the study models sample showed maxillary lateral incisor with decreased mesiodistal dimension, responsible for invalidation. Conclusions: Mathematical relation under validation was found to be completely validated in 37.8% of the study sample of the Indian population. Validation was observed to be more in females than in males. Mandibular canine followed by maxillary central incisor was most commonly involved for the invalidation of mathematical relation.
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Social versus scientific-driven evidence-based orthodontics: Prediction of correlation among scientometric, altmetric, and level of evidence p. 117
Rajkumar Maurya, Sanjeev Datana, Sapna Verma, Sanjay Manohar Londhe, Sujit Kumar Bhandari
Aim: The present study was conducted to analyze the correlation between citations, altmetric score, and level of evidence of top prestigious orthodontic journals. Materials and Methods: Data mining of selected journals American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), European Journal of Orthodontics (EJO), and Angle Orthodontist (AO) was carried out using the Dimensions and the Webometric Analyst 4.1. The scores were correlated against the strength of study grades, which were interpreted from the GRADE criteria. Pearson's correlation test was used to assess the data statistically using the SPSS software version 21. Results: AJODO (3786) produced maximum publications followed by AO (1515) and EJO (1135). Most of the publications of AJODO (3654) were under “closed access,” whereas AO (194) provided the maximum of its publications under open access in comparison to EJO (151) and AJODO. It was also found that “Clinical Sciences” category had the maximum number of publications in all. The AO had maximum “mean” of field citation ratio (FCR) and relative citation ratio (RCR) (Mean FCR = 1.78/Mean RCR = 1.68) and AJODO received maximum total attention on social platform. The EJO showed the highest Pearson correlation value of 0.39 between citations and Altmetric, whereas AJODO showed the highest value of 0.16 for citations and grade of evidence. Conclusion: The present study found that the Altmetric score and level of evidence among all the three journals showed slight positive correlation by EJO and weak correlation by AJODO and AO in relation to citation and Altmetrics. However, weak positive correlation by AJODO and EJO in relation to citations and grade of evidence. It was found that only AO showed positive weak correlation between Altmetric score and grade of evidence.
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Correlating angular nasal parameters with skeletal malocclusion p. 125
Pushkar Andhare, Sanjeev Datana, Shiv Shankar Agarwal, SK Bhandari
Introduction: Human nose exhibits unique features and variations in response to various influencing factors. To establish the correlation between these nasal features and type of malocclusion, a study was formulated with aim to assess the nasofacial, nasolabial, and nasomental angles in various sagittal and vertical types of malocclusion. Materials and Methods: A study sample of 410 patients was selected from patients undergoing orthodontic treatment at the department to assess various nasal angular parameters. Data were divided into groups depending upon type of malocclusion and were subjected to suitable statistical analyses. Results: The mean nasofrontal angle was highest in Class I malocclusion (P < 0.05) and normodivergent patients. The mean nasolabial angle was highest in Class III malocclusion and hyperdivergent patients (P > 0.05). The mean nasomental angle was significantly higher in Class II malocclusion and hyperdivergent (P < 0.05). Columellar alar angle and nares axis angle showed significant positive correlation with each other but not with dorsum–base ratio. Conclusion: The nasal angular parameters show peculiar features in different types of malocclusion in sagittal and vertical planes. Hence, its clinical significance in orthodontic diagnosis and treatment planning needs to be deliberated to obtain a substantial esthetic outcome.
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Recent advances in materials for periodontal regeneration p. 130
Nitin Kumar Verma, Sangeeta Singh Ompal, Priyanka Prakash, Manish Mukherjee, AK Jha
Periodontal disease is a multifactorial disease resulting into pocket formation, recession, and bone loss. The ultimate goal of periodontal therapy is to halt the progression of periodontal disease and the regeneration of lost periodontal-supporting tissues. Periodontal regeneration by definition involves regeneration of cementum, alveolar bone, and periodontal ligament. Conventional surgical approaches such as open flap debridement have been found efficient in the establishment of improved periodontal form and architecture but have limited potential in restoring lost periodontal tissues. The ultimate aim of use of guided-tissue regeneration membranes and bone grafts is to achieve periodontal regeneration but instead of regeneration, bone fill is achieved in most of the cases. This has resulted in the development of different techniques, materials, and approaches for periodontal regeneration. These include modalities such as tissue engineering, use of stem cell, use of growth factors, scaffolds, gene therapy, and lasers. Many among these modalities have shown promising results in periodontal regeneration, but some are still under research and development.
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Interdisciplinary approach for replacement of missing tooth in esthetic zone p. 140
E Mahesh Gowda, NK Sahoo, TS Satisha
Dental implants play an important role in rehabilitation of the missing teeth with adequate esthetics with patient acceptance. Implant dentistry is multidisciplinary team approach involving disciplines for the diagnosis, treatment planning, and execution. This approach will help in establishing the appropriate esthetic objectives with the morphology and biology of tissues and thus provide the best level of care to the demanding clientele. All efforts should therefore be directed toward achieving this main goal of preserving the remaining tissues by utilizing the multidisciplinary approach. One such case report where a patient was rehabilitated for loss of anterior tooth with implants providing excellent esthetics is presented in the article.
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Transition of a Misch removable prosthesis-5 to a fixed prosthesis-3: From a removable to a fixed complete denture p. 144
Anup Gopi
An implant-supported denture is used when a person does not have any teeth in the jaw but has enough bone to support implants. Treatment options can be broadly divided into the fixed implant-supported prosthesis and removable implant-supported prosthesis (overdenture). However, when such completely edentulous patients who are already rehabilitated using removable implant-supported overdentures report for a fixed prosthesis, then it becomes a challenging situation. This article describes the challenges involved in the transition of one such patient rehabilitated previously using a RP-5 prosthesis to a fixed FP-3 prosthesis.
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Ultra-low frequency-transcutaneous electric nerve stimulation for functional border molding and cameo surface recording for enhanced complete denture success: A novel approach p. 148
Vijaya Kumar Rajamani, Kirandeep Singh, Parag Dua, Poonam Prakash
Ultra-low frequency transcutaneous electric nerve stimulation (ULF-TENS) is one of the therapeutic devices used for relaxation of orofacial musculature by the use of low frequency, low current stimulation of the certain branches of trigeminal and facial nerve. Complete denture fabrication is the most widely used modality for rehabilitation of completely edentulous maxillary and mandibular arches. Numerous efforts and techniques have been introduced to improve retention and stability of prosthesis, in order to improve form, function, esthetics, phonetics, and health of the patient. These include modifications in impression making and cameo surface recording to improve the adaptation of the prosthesis. Accurate tracing of functional borders during border molding and recording cameo surface of the prosthesis using ULF-TENS in patients with poor neuromuscular incoordination can play an important role in improving the stability and enhance the performance of the masticatory system. This clinical report describes recording of border molding and cameo surface using ULF-TENS in a completely edentulous patient, resulting in enhanced adaptation with adjacent stomatognathic system.
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Digital smile design and Computer-aided design/Computer-aided milling: Pivotal tools in esthetic dentistry p. 152
Harmanpreet Atwal, Tanuj Mendiratta, Dinesh Kumar, Amit Khattak
In the war of artisan versus automation, it is always the automation that is more efficient. Today's world of the digital revolution has made dental surgeon to go beyond the conventional boundaries to obtain results of perfect form and function. Digital smile design (DSD) plays a pivotal role in esthetic dentistry where problems of midline diastema, generalized spacing, discoloration, and stained teeth can easily be rectified. One can obtain postoperative results even before the patient is operated giving choice to both the patient and operator for correct diagnosis and treatment planning improving communication and predictability of the end result. This case report aims to highlight integrated planning for beautifying the smile of an esthetically conscious patient with a reverse smile line using DSD software which analyzed the facial harmony, dentogingival parameters, and teeth dimensions. The software allowed for correct diagnosis and patient's consent in treatment planning preoperatively and also severed as a guide for designing and fabricating all-ceramic restorations using Computer-aided design/Computer-aided milling.
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