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   Table of Contents - Current issue
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January-March 2022
Volume 9 | Issue 1
Page Nos. 1-84

Online since Thursday, April 7, 2022

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REVIEW ARTICLES  

The use of titanium platelet-rich fibrin to enhance the treatment outcome of intrabony defect in the chronic periodontitis patients – A systematic review and meta-analysis Highly accessed article p. 1
Swapna Arunkumar Mahale, Ankita Katkurwar, Jui Vilas Bhandare, Arunkumar Mahale
DOI:10.4103/jdrr.jdrr_141_21  
Aim and Objective: The aim and objective of the study are to ascertain the use of titanium platelet-rich fibrin (T-PRF) to enhance the treatment outcome of intrabony defect in the chronic periodontitis patients. Methodology: Data resources: Four databases MEDLINE (by PubMed), Cochrane database, EBSCO, and Google Scholar were explored to identify the studies in English from 2015 up to March 2021. An additional hand search of relevant journals was also done. All the reviewers screened the retrieved articles using the particular inclusion criteria. Randomized control trials evaluating the use of T-PRF to enhance the treatment outcome of intrabony defect in chronic periodontitis patients were included in the study. Outcome variables examined were probing pocket depth (PPD) reduction, relative attachment level (RAL) gain, change in gingival index (GI) and plaque index (PI), radiographic depth reduction. Statistical Analysis: Data were analyzed using Revman 5.3 software. The mean differences and 95% confidence interval were used to illustrate the estimate of effect size. Study Selection: five relevant articles were recognized for data procurement. A total of 138 patients had been appraised with confirmation of intrabony defects. In the included studies, age span of participants was between 20 and 59 years. Results: It displayed that the use of T-PRF induced a reduction in PPD, gain in RAL along with open flap debridement (OFD) in the management of intrabony defects. The use of T-PRF along with OFD and OFD only has equal effect on GI and PI. Conclusion: Thus, within the constraints of the study, it implies that T-PRF can be adapted contentedly in conjunction with OFD to deal with the intrabony defect.
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Are we ready for the pandemics: Analyzing indian dental institutions and their preparedness? Highly accessed article p. 9
Aditi Verma
DOI:10.4103/jdrr.jdrr_157_21  
The COVID-19 pandemic experienced by the Indian subcontinent has been lethal compared to the pandemics of the past. The only lesson learned so far is the need to update our health-care infrastructure. However, besides this, there is also an urgent need to make long-term changes to the continuance of our dental educational system, which is important for the foundations of our mainstream health-care services. This article evaluates the impact of the COVID-19 pandemic on Indian dental education, taking into due consideration the difficulties and available resources. It also intends to recommend strategies and prepare for such scenarios in future. Recent advances in pedagogical innovations involving technology have provided many prospects, especially in the field of online platform learning, but the students/staff requires proficient learning to utilize it effectively. Furthermore, the foremost need is to develop and evaluate the most appropriate technology-based learning for the preclinical and clinical settings. Thus, the current pandemic has undeniably brought countless challenges but also gave the prospect to revolutionize future of Indian dental education.
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ORIGINAL ARTICLES Top

Evaluation of mandibular canal and mental foramen variations on cone-beam computed tomography images Highly accessed article p. 14
Mehmet Zahit Adisen, Merve Aydogdu
DOI:10.4103/jdrr.jdrr_9_21  
Aim: The aim of the study was to evaluate the prevalence of mandibular canal (MC) and mental foramen (MF) variations using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images (n = 459) were retrospectively evaluated. The final sample consisted of 362 CBCT images of 152 men and 210 women between the ages of 10–87. MC and MF variations were evaluated according to presence and localizations. Data were analyzed using SPSS version 20. Results: Participants had a mean age of 38.79 ± 16.45 years. Fifty-seven images (15.7%) showed MC and MF variations. Forty-seven images (13%) showed bifid MCs (BMCs), 14 (3.9%) accessory mental foramen (AMF), and only five (1.4%) trifid MCs. MF was absent in one image (0.3%). The prevalence of AMF was statistically found to be higher among younger patients (7.9%). BMCs and AMF were more common in men than in women. Images with AMF presented unilateral placement, particularly on the right side. Conclusion: Variations were more common in men, and involvement was more frequent on the right side. Early identification of high-risk patients and variations can help prevent neurosensory complications such as bleeding, traumatic neuroma, paraesthesia, and paralysis.
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Descriptive study of dental diseases among patients visiting for dental care in a tertiary care center during COVID-19 pandemic p. 19
Hitesh Chander Mittal, Rajesh Kumar Singh, Ashish Pant, Pragati Singhal
DOI:10.4103/jdrr.jdrr_159_21  
Background: Recently, coronavirus disease 2019 (COVID-19) has affected all aspects of life globally. The COVID-19 pandemic is an extremely testing time for dental health professionals dealing with a high oral disease burden and being at higher risk of COVID-19. The aim of this study was to report the pattern of dental diseases among patients visiting the Department of Dentistry at a tertiary care center in Rajasthan, India. Methodology: A descriptive analysis of dental outpatient department (OPD) records of a tertiary care center during COVID-19 epidemic lockdown duration in India for demographics, diagnosis, the severity of pain, and triage for the urgency of treatment need was carried out. Data were analyzed using Epi info 7 software. Results: The majority of the patients (30%) were in the age group of 31–45 years and 14.47% of patients were >60 years. The triage of patients according to the need of procedures revealed the majority (77.76%) were in the urgent category, while 4.82% were in the emergency category. The majority of patients (67.22%) visited for endodontic treatment, with the main diagnosis of symptomatic apical periodontitis. The majority of diseases had moderate-to-severe pain at presentation. Conclusion: The majority of dental OPD patients reported moderate-to-severe pain of dental origin and required urgent care. The main endodontic diagnosis was symptomatic apical periodontitis.
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Cognizance of precision dental medicine among Indian dentists p. 24
Milanjeet Kaur Raizada, Ladu Singh Rajpurohit, Jasmine Bhogal
DOI:10.4103/jdrr.jdrr_166_21  
Background: Dental care providers play a pivotal role in administering precision dental medicine (PDM) to their patients. Nevertheless, the lack of acquaintance about pharmacogenomics, proteomics, metabolomics, etc., may restrict the ability of dentists to advise patients or employ test results. The objective of the study was to evaluate the cognizance of PDM among Indian dentists. Materials and Methods: A cross-sectional questionnaire-based survey was designed. The questionnaire was sent to 500 Indian dentists through e-mail and social media. The results were analyzed by SPSS software version 19. Chi-square test was used to find the association between their qualifications/experience and knowledge of PDM. P < 0.05 was considered statistically significant. Results: Out of 500, 358 dentists reverted back to the questionnaire. While 122 (32%) dentists knew about this term, only one (0.81%) out of these 122 dentists used a biomarker assay and only one answered both the genomics-based questions correctly. Knowledge of PDM among dentists was independent of their qualifications or experience as suggested by results of Chi-square test (P > 0.05). Conclusion: Results of the study highlighted that knowledge about PDM is meager among practicing dentists in India. Nevertheless, all who knew about PDM understand its importance. Incorporation of PDM at undergraduate level will not only familiarize them but also motivate them to pick up this topic for research.
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Do conventional and new-generation multiple ultrasonic applications change the shear bond strength of metal brackets? p. 29
Sirin Hatipoglu, Tugçe Paksoy
DOI:10.4103/jdrr.jdrr_175_21  
Background: The purpose of this study was to compare orthodontic braces' shear bond strength (SBS) before and after conventional and new-generation multiple ultrasonic instrumentations (UIs). Materials and Methods: One hundred and seventy-five extracted human premolars were bracketed and embedded in acrylic molds. Teeth were separated into 7 groups; each group consisted of 25 teeth. All samples were thermocycled 500 times and control group was randomly selected. To the rest of the teeth, UI and vector ultrasonic instrumentation (VUI) were performed, UI1 and VUI1 were separated. Following the second thermocycling, UI and VUI; UI2 and VUI2, and after the third thermocycling, UI and VUI the UI3 and VUI3 were separated. Results: The decreases in the mean SBS of the UI3 and VUI3 were found to be statistically significant compared to the control group's means. There were no statistically significant differences between neither the means of the control group and UI1, UI2, VUI1, VUI2; nor the means of the VUI1-UI1; VUI2-UI2; VUI3-UI3. There was no statistically significant difference among the means of the UI1-UI2-UI3. On the other hand, the VUI3 was found to have the least statistically significant SBS among VUI groups. Conclusions: Our results revealed that multiple UI and VUI applications both reduce the SBS of brackets. Although the reduction with VUI was found to be more than UI, there was no statistically significant difference between the two instrumentations. Both procedures can be used with caution as a multiple cleaning aid for patients undergoing fixed orthodontic treatment.
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Impact of the COVID-19 pandemic on the management of dental pain and odontogenic infections in pediatric patients p. 35
Nádia Carolina Teixeira Marques, Nelson Pereira Marques, Sarah Vitor Teixeira Rodrigues, Aluísio Eustáquio Freitas Miranda-Filho, Valdirene Miranda Esteves Orsi, Eduardo Araújo de Oliveira, Hercílio Martelli-Júnior
DOI:10.4103/jdrr.jdrr_172_21  
Objective: This study aimed to compare the number of procedures for dental pain relief and odontogenic infection control performed annually in pediatric patients before and during the pandemic to date. Methods: The longitudinal association between the number of procedures to treat pediatric urgent dental emergencies from the previous (2017–2019) to the pandemic (2020) period was evaluated by a negative binomial regression in the form of incidence rate ratio with 95% confidence interval. Results: This study showed a significant decrease in the number of pulp capping, pulpotomy, access to dental pulp and medication, endodontic medication with/without biomechanical root canal preparation, abscess drainage, and extraction of primary or permanent teeth, performed in patients up to 12 years old from the previous to the pandemic period. Conclusions: Therefore, the COVID-19 pandemic has adversely impacted on the number of procedures for dental pain relief and odontogenic infection control performed in pediatric patients.
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Dental Problems and Awareness of Patients for Oral Health in COVID-19 Pandemic during Lockdown and Postlockdown Period p. 39
Rashmi Deshpande Sathe, Annette M Bhambal, Shivakumar Ganiga Channaiah, Tarun Pratap Singh, Sameer V Sathe
DOI:10.4103/jdrr.jdrr_171_21  
Introduction: Due to the COVID-19 pandemic lockdown was imposed largely to control the rapid spread of this virus and get our health machinery ready to fight the disease. The dental services were restricted to urgent and emergency procedures. The aims and objectives of present study were assessment of dental problems faced by the patients during and after the lockdown, awareness of the patients regarding the oral health during this period and evaluation of current status of the dental problems. Materials and Methods: After taking informed consent of patients, cross sectional study was designed in form of online survey in month of February 2021. A link was shared to all the patients visiting dental outpatient department. There was no exclusion criterion for study. The responses were subjected to statistical analysis-using Chi-square test with significance value P < 0.05. Results: Total 506 responses (age range 5–68 years) of both the sexes were recorded. Out of them 269 (60.3%) did not have any dental problem whereas 177 (39.7%) had dental problem during the lockdown. Out of 177 responses, 62 patients faced multiple dental problems, highest being dentinal sensitivity/dental pain (50.2%).35.2% patients resorted to home remedies, 9.4% patients to teledentistry. Use of teledentistry was statistically significant for the dental problems of patients during lockdown (P < 0.05). Conclusion: Patients faced multiple problems Dental pain being the commonest. The current study has shown us the path for teledentistry and need for emergency dental services to tackle further such outbreaks.
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Assessment of dental caries and interrelationship with sugar exposure in rural population visiting a dental college p. 44
Avijit Avasthi
DOI:10.4103/jdrr.jdrr_170_21  
Objective: The observational study intended to estimate dental caries and check the interrelationship of sugar exposure with dental caries in people seeking dental treatment in a Dental College. Materials and Methods: Subjects were clinically assessed for dental caries and a semi-structured close-ended questionnaire was used in recording sugar consumption among the participants. Descriptive statistics was generated in frequency and percentage. Comparison of sugar consumption in relation to age, gender, and marital status was done using Unpaired T-test and Analysis of Variance (ANOVA). Correlation was explored between sugar consumption and dental caries by applying one-way ANOVA. Results: Total mean decay-missing-filled (DMF) was 3.82 ± 4.53 interquartile range (2–4). 76.6% had decayed teeth, followed by 38.1% having missing teeth and scantly quarter (21%) of subjects had undergone restorative treatment. Females had a high mean DMF score in comparison to males with nonsignificant difference. Tooth morbidity was more predominately confined to first molars and second molars. Married subjects fared poor in mean DMF with statistically significant (P < 0.002) effect in comparison to unmarried subjects. Edentulism advanced with age and the frequent intake of sugar in between meals worsened the total mean DMF.
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Comparison of effectiveness of novel vestibular incision for papilla reconstruction with semilunar flap technique. A randomized controlled study p. 49
Akhilesh Shewale, Sneha S Puri
DOI:10.4103/jdrr.jdrr_4_21  
Background: The presence or absence of the interdental papilla is a topic of great esthetic concern. Several surgical and nonsurgical techniques have been proposed to rebuild lost papilla. However, there is a paucity in the literature assessing comparative studies. Aims and Objective: The aim to evaluate and compare the effectiveness of novel vestibular incision for papilla reconstruction with semilunar flap technique. Objectives: To compare effectiveness of novel vestibular incision for papilla reconstruction with semilunar flap technique. Material and Methods: Fourteen patients with the age range of 20–40 years who were conscious for their esthetics with total or partial loss of the interdental papilla were selected for the study. The patients were randomly divided into two groups, namely Group A (vestibular incision subperiosteal tunnel access [VISTA] technique) and Group B (semilunar flap technique). Result: At 6-month postsurgery, there was a statistically significant reduction in vertical dimension, mesiodistal dimension, and area of the papilla defect in Group A as compared to Group B. At 6-month postsurgery, there was an increase in the height of the papilla in Group A, whereas there was a decrease in the height of the papilla in Group B. Both the techniques exhibited satisfactory results in terms of papillary defect fill over a 6-month period. Conclusion: The novel VISTA approach for papillary reconstruction could be a better alternative owing to less postoperative scarring and predictable results.
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Knowledge and practices related to oral potentially malignant disorder among the youth living in Urban slum areas in a commercial city in Sri Lanka p. 53
Halgamuwe Hewawasam Manori Dhanapriyanka, Raluwa Dona Fransisco Chandrika Kanthi
DOI:10.4103/jdrr.jdrr_154_21z  
Background: Oral potentially malignant disorder (OPMD) is an emerging problem among the youth due to the increase in use of different addictive substances. This study aims to assess the level of knowledge and selected practices related to OPMD among the youth between 15 and 24 years residing in urban slum areas in a commercial city in Sri Lanka. Methods: A descriptive cross-sectional study was conducted among a sample of 1435 youths. Cluster sampling technique combined with probability proportionate to size technique was used to select the sample. Data were collected using an interviewer-administered questionnaire. Results: The response rate was 99.7%. The mean age of the study sample was 17.53 years (95% confidence interval: 17.40–17.65). A higher percentage of youths had poor knowledge on OPMD (72%). The majority (around 85%) knew that smoked and smokeless forms of tobacco were risk factors for OPMD. However, the knowledge on areca nut packets, alcohol, and areca nut in betel quid as risk factors for OPMD was found to be relatively poor with proportions 31.9%, 21.6%, and 16.3%, respectively. In addition to that, study participants showed very poor Knowledge regarding the clinical presentations of OPMD. Around 10.9% and 2.3% knew that OPMD can present as a white patch and a red patch, respectively. Very few of the study sample (1.2%) were knowledgeable about the self-mouth examination for identification of OPMD. Conclusion: Poor knowledge on OPMD among the youth living in urban slum areas in a commercial city in Sri Lanka alarmed the need of implementing targeted interventions among these high-risk groups.
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Ameloblastoma of the jaws: A retrospective observational study of 131 cases at a tertiary level hospital in Bangladesh p. 59
A F. M Shakilur Rahman, Ismat Ara Haider
DOI:10.4103/jdrr.jdrr_181_21  
Aim: The purpose of this study is to evaluate the incidence, radiological features, histological variant, and different treatment options of patients with ameloblastoma of the jaws treated at a tertiary-level hospital in Bangladesh. Materials and Methods: Age, gender, tumor location, radiologic features, histological pattern, and treatment modalities were all evaluated in this retrospective observational study. The frequency and percentages of these study variables were analyzed using descriptive statistics. Results: A total of 131 patients were included in this study, 66 of them were female, with a male-to-female ratio of 1:1.01. The patients had a wide age range from 4 to 70 years, a mean age (±standard deviation) of 26.61 (±13.34) years, and a significant incidence in the third decade of life. The left side of the jaws was the most frequently involved site. The mandible (n = 125, 95.42%) was the most frequently affected site, with the body–angle–ramus (n = 73, 58.5%) area being the most frequently involved location. Multilocular radiolucency was seen in most cases (n = 73, 55.73%) on radiography. The most common histological pattern (n = 71, 54.2%) was follicular. The most preferred treatment was the dredging (n = 90, 68.70%) method. The recurrence rate of the dredging treatment method was 5.56%. Conclusions: Ameloblastoma was found to be more common in patients in their third decade of life, with a wide age range. The follicular ameloblastoma was the predominant histological type, with most of them occurring in the mandible's body–angle–ramus area. Most of the patients were treated by the dredging method.
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Evaluation of relationship between pharyngeal airway space and varying dimensions of maxilla and mandible p. 66
Prema Anbarasu, Sararvana Kumar Subramanian, Sagaya Mary Priya
DOI:10.4103/jdrr.jdrr_177_21  
Aim: Craniofacial abnormalities such as maxillary retrusion, mandibular retrognathism, short mandibular body, and downward and backward rotation of the mandible in hyperdivergent patients are considered to be the most important risk factor for upper airway obstruction. The aim of the study is to analyze the influence of maxillary and mandibular morphology on pharyngeal length. Materials and Methods: The study sample includes 146 pretreatment lateral cephalographs of both male and female patients aged between 18 and 30 years. The study sample was divided into three groups: Group I – Class I skeletal relationship, Group II – Class II, and Group III – Class III. Each group is further divided into three subgroups according to the growth pattern (A – horizontal, B – average, and C – vertical). The lateral cephalograms were traced both manually and digitally using FACAD imaging software. Results: Comparison of mean maxillary, mandibular, and airway dimensions done using one-way analysis of variance proclaims that the means of all the parameters of the study are statistically significant with P < 0.05 except the upper pharyngeal space. Pearson correlation test reveals a statistically significant positive correlation between the height of the ramus and the lower pharyngeal space. Conclusion: The upper pharyngeal space is reduced in Class III, and the lower pharyngeal space is reduced in Class II and Class III malocclusions. The airway dimension decreased in vertical growth pattern in all the skeletal malocclusion groups. Upper and lower pharyngeal space has a negative correlation with ANS-PNS (maxillary length) and length of the body of the mandible, respectively.
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Efficacy of 0.1% topical tacrolimus in the management of symptomatic geographic tongue: A placebo-controlled study p. 73
Rahul Srivastava, Devina Pradhan, Lokesh Sharma, Bhuvan Jyoti, Vishal Mehrotra
DOI:10.4103/jdrr.jdrr_127_20  
Background: Geographic tongue is characterized by erythematous patches with whitish margins across the surface of the tongue, with periods of exacerbation and remission that confer the typical migratory aspect of this entity. There is no definite treatment for geographic tongue as yet. The present study aims to evaluate the response of treatment with topical tacrolimus ointment 0.1% w/w (Protopic®) in geographic tongue. Materials and Methods: This was a prospective study involving a total of 14 patients who were randomly divided into two groups, namely Group A and Group B, with 7 patients in each group. Patients were requested to apply 0.1% topical tacrolimus ointment (Protopic®) in an oral base on their lesions and an identical placebo. At each visit, the burning sensation was tested through the Visual Analog Scale and the treatment responses were tested through Tel Aviv-San Francisco Scale. Data were assessed using IBM Statistical Package for Social Sciences (SPSS) Statistics version 21. Results: Patients in Group A (0.1% topical tacrolimus) depicted lower scores of burning sensation after the treatment as compared to Group B (placebo). The overall treatment response was significantly better in Group A than Group B. Conclusion: The results of the present study suggest that topical application of 0.1% tacrolimus is beneficial in the management of symptomatic geographic tongue.
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The possible link between cheilitis granulomatosa and oral health? p. 78
Tulika Wakhloo, Srinivas Gosla Reddy, Ashi Chug, Arvind Kumar
DOI:10.4103/jdrr.jdrr_188_21  
This article highlights cheilitis granulomatosa (CG) of the upper lip in a 6-year-old female child with neglected oral hygiene. CG is a rare, idiopathic, chronic inflammatory disorder presenting as a diagnostic dilemma due to a wide array of etiological factors. There is no standard treatment and often unpredictable therapeutic responses and spontaneous recurrences are reported. This article emphasizes on providing specialized dental treatment for active oral infections as the first line of therapy, especially in pediatric patients as it may turn out to be a major shot in the arm.
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Three-dimensional miniplate as a viable alternative fixation device for isolated maxillary sinus fracture management: A technical note p. 82
Uday Kiran Uppada
DOI:10.4103/jdrr.jdrr_187_21  
Isolated fractures of the anterior wall of the maxillary sinus are rare. Literature reveals that these fractures can be managed surgically through numerous ways but none have shown superior results over the other clinically. We put forth that three-dimensional miniplates can serve as a viable alternative fixation device for isolated maxillary sinus fracture management.
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