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   Table of Contents - Current issue
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July-September 2022
Volume 9 | Issue 3
Page Nos. 195-265

Online since Monday, November 14, 2022

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REVIEW ARTICLES  

Modern digital pediatric dentistry with the advent of intraoral sensors, computer-aided design/computer-aided manufacturing, and three-dimensional printing technologies: A comprehensive review Highly accessed article p. 195
Mohammad Kamran Khan
DOI:10.4103/jdrr.jdrr_83_22  
The conventional methods of fabrication of the dental prosthesis/appliances in pediatric dental patients pose many challenges such as prolonged and multiple appointments, discrepancy in the accuracy of the fit of prosthesis, and cumbersome dental laboratory procedures. The conventional impression-making procedures in young children are regarded as quite cumbersome and difficult due to several clinical factors in dentistry. In recent years, digital Intra-Oral Sensors (IOS), three-dimensional printing (3D-printing) technology and computer-aided design/computer-aided manufacturing (CAD-CAM) technology have been described in existing literature related to different aspects of pediatric dentistry. The aim of the current study was to review the literature related to recent innovative applications of IOS, CAD-CAM, and 3D-printing technology in modern pediatric dentistry. Pediatric dental procedures involving the modern digital technologies such as IOS, CAD-CAM, and 3D-printing in the applications for the digital impression procedure and the fabrication of various types of dental appliances have the good potential to deliver optimum oral-health care in children. Furthermore, it can help in motivating the children and also in instilling the positive attitude and behavior toward dentistry.
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Vitamin D Deficiency and Its Effects on Enamel, Dentin, and Pulp: A Literature Review p. 202
Tapasya Karemore, Mukta Motwani, Vaibhav Karemore
DOI:10.4103/jdrr.jdrr_69_22  
Vitamin D deficiency (VDD) is very common in the Indian subcontinent and many countries, in spite of plenty of sun exposure. Vitamin D has a definite influence on metabolism of bone and dental tissues. VDD causes a variety of bone deformities clinically represented as rickets and dental defects such as decreased enamel, dentin mineralization, and altered pulp morphology in children. Therefore, appropriate serum Vitamin D levels are required for the mineralization process of both teeth and bone. VDD may affect the teeth during intrauterine life and show changes in early childhood and may continue throughout life. Enamel, dentin, and pulp changes due to VDD can be diagnosed by clinical, microbiological, or histologic and radiologic examination. Knowledge of VDD-induced dental changes is necessary for early detection and in time corrections of defects produced. This review aims to collate the data available on the deficiency of Vitamin D observed among children and its manifestations affecting enamel, dentin, and pulp. To identify relevant articles, PubMed and Embase databases were searched for terms such as VDD (MesH terms), VDD (all fields), and dental enamel, dentin, and pulp (MesH and all fields). The related data searched includes peer-reviewed articles, randomized control trials, systematic reviews, and case reports for manuscript compilation.
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Prospect of Zirconium as a Dental Implant: A Comprehensive Review p. 206
Sarfaraj Ansary, Sajed Ali Molla, Ziyauddin Seikh, Shamim Haidar
DOI:0.4103/jdrr.jdrr_55_22  
Titanium and its alloys are satisfying the demand of dental implant industry for a long. Due to the problems of titanium implants, such as corrosion, ion radiation to the human body, cytotoxicity, and possible esthetic limitations, researchers are always looking for novel implant materials. Recently, zirconia implants as a substitute of titanium implants are becoming popular in the implant sector because of its improved biocompatibility, low plaque affinity, and desirable mechanical properties. However, there are very few clinical studies available for its long-term success rate. The purpose of the study is to summarize and analyze the current data accessible for zirconia implants with respect to its different mechanical properties and clinical survival rates. The available information suggests that a zirconia implant might be considered as a good alternative of titanium in the dentistry industry. It also shows good biocompatibility, better mechanical property, and esthetically a better choice of the implant compared to titanium implants.
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Influence of Helicobacter pylori infection on periodontitis: A meta-analysis p. 211
Alberto Rodriguez-Archilla, Rihab Amhaouache
DOI:10.4103/jdrr.jdrr_103_22  
Background: Helicobacter pylori detection in dental plaque, saliva, or oral mucosa would allow to include this bacteria as a member of the normal oral microbiota and have an etiological role in periodontitis. Objective: The objective of this study is to assess the possible relationship of H. pylori with periodontitis. Methods: A search for studies on H. pylori and periodontitis was conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science, and Scopus. The pooled prevalence was calculated according to DerSimonian and Laird method. For dichotomous outcomes, the estimates of effects of the intervention were expressed as odds ratios using Mantel–Haenszel method, and for continuous outcomes, the estimates of effects of the intervention were expressed as mean differences using the inverse-variance method, all with 95% confidence intervals. Results: Twenty-six studies with 4072 participants were included in this meta-analysis. Among periodontitis patients, the estimated prevalence of H. pylori detection was 47.93%. Periodontitis patients had 1.89 times more likely to be infected with H. pylori (P < 0.001) and also, an increase of 2.78 times the probability of H. pylori detection on dental plaque (P < 0.001). Similarly, H. pylori was 2.32 times more likely in the oral microbiota than in the gastric one (P < 0.001). Some periodontal parameters (plaque index, probing depth, and clinical attachment level) were significantly worse in positive H. pylori patients. Conclusions: H. pylori infection seems to aggravate periodontitis.
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ORIGINAL ARTICLES Top

Evaluation of surface roughness and color stability of fluorapatite/hydroxyapatite-containing glass carbomer filling material p. 217
Fatma Aytac Bal, Emine Sirin Karaarslan, Mehmet Buldur, Merve Agaccioglu, Osman Demir
DOI:10.4103/jdrr.jdrr_45_22  
Background: This study was designed to determine the effects of various finishing and polishing systems on the surface roughness and color stability of a glass carbomer filling material containing fluorapatite/hydroxyapatite particles. Materials and Methods: A glass carbomer filling material (with and without protecting coat [gloss] n = 100) and a microhybrid resin-based composite (n = 50) were tested in the study. No finishing and polishing was applied to ten samples for each material. The remaining samples were finished and polished with OneGloss, Enhance/PoGo, Identoflex, and Sof-Lex discs, and stored in a coffee solution. Surface roughness assessments were made with a profilometer. Color measures (L* a* b*) were calculated with a colorimeter on the periods of different staining procedures. For the data analysis, two-way analysis of variance was employed. For multiple comparisons, Bonferroni adjustment was used (P < 0.05). Results: The lowest and highest Ra values were found in the group of microhybrid resin-based composite with Mylar strip (0.17 ± 0.04, P < 0.05) and in the group of glass carbomer with gloss with Mylar strip (1.17 ± 0.30, P < 0.05), respectively. The ΔE* and ΔL* values of the glass carbomer with gloss were higher than the other groups. The microhybrid resin-based composite showed less change in all parameters. Conclusion: The results showed that the glass carbomer did not provide a high level of color stability and surface roughness like the microhybrid resin-based composite. On the other hand, the glass carbomer material was affected negatively by the gloss application.
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Effects of long-duration wearing of personal protective equipment with n95 masks on blood oxygen concentration and pulse rate among dental professionals p. 224
Alikunju Syed Khaja Hussain, K Mereesha, Divya Kallanchira Devaraj
DOI:10.4103/jdrr.jdrr_98_22  
Background: The importance of personal protective equipment (PPE) for health-care professionals working in an infective environment has been highlighted again in this COVID pandemic. CDC recommends the use of PPE with FFp2/N95 wear in dental health professionals. There are studies revealing the varied physiological as well as psychological impact of long-duration wear of PPE in health professionals. This study aims to evaluate the effects of wearing PPE with N95 mask before donning and after doffing (for 4 h) on the oxygen saturation levels and pulse rate. Materials and Methods: Forty dental surgeons of both sexes with informed consent working at a government dental college, in Kerala, were studied by a standard pulse oximetry test for oxygen saturation and pulse rate before donning and after doffing of PPE with FFP2/N95 respirator over 4 h duration. They were ensured to be hemodynamically stable, breathing room air under standard room temperature, and humidity. Data were entered and evaluated using a standard paired t-test using SPSS version 20. Results: The mean age group of the dental surgeons was 39 ± 9 years, and 60% were male. The mean values of oxygen saturation before donning and after doffing were 97.6 (1.1) and 96.7 (1.2), respectively, and the difference was significant (P < 0.01). The pulse rate before donning and after doffing was found to be 79.7 (6.7) and 81.2 (6.7), respectively, with significance (P < 0.01). However, the difference was not significant according to gender or age groups. Conclusion: The decrease in oxygen saturation and an increase in heart rate among dental surgeons were found to be significant after 4 h wear of PPE with FFP2 respirator. Nevertheless, these data of physiological impact of PPE cannot overshadow the risk-benefit ratio of PPE wear. The cautious use of PPE with improved technology can mitigate the risks involved in its use.
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Knowledge, attitude, and practice regarding nonrestorative cavity control among pediatric dentists: A questionnaire-based cross-sectional study p. 228
Bhavya Shah, KS Poonacha, Anshula Deshpande, Bhavna Dave, Vidhi Jaiswal, Saylee Deshmukh
DOI:10.4103/jdrr.jdrr_74_22  
Introduction: According to the worldwide burden of illnesses, unresolved dental decay is one of the most frequent oral diseases. One the significant barriers noticed during dental treatment of the children is fear and anxiety due to conventional treatment procedures. Hence, various dental caries removal and arrest techniques that are noninvasive and child friendly have to be incorporated by the pediatric dentists in their day-to-day practice. Aim: To evaluate knowledge, attitude, and practice regarding nonrestorative cavity control (NRCC) among pediatric dentists in India through the online survey. Materials and Methodology: An online questionnaire-based cross-sectional survey was carried out between January 2021 and May 2021 among the pediatric dentists in India. A structured questionnaire was used to assess the knowledge, attitude, and practice regarding NRCC technique. Self-administered questionnaire with 16 close-ended questions were formulated with multiple choice or Yes-No options. A total of 12 pediatric dentists working only as faculty, 47 only as practitioners, 39 as both faculty and practitioners, and 116 as postgraduate students participated in the study. Results: In the present study, 85% of pediatric dentists were aware about the concept of NRCC but not regarding the steps and the technique used in the concept. Most commonly chosen cariostatic agent was silver diamine fluoride (95.3%) followed by sodium fluoride varnish (86.9%) to use at concentrations 38% and 5%, respectively. 55.6% of the respondents stated that NRCC had various advantages which gave the technique an edge over other conventional techniques, whereas food impaction following slicing of the teeth (52.8%) was the most common disadvantage of this technique. Conclusion: The detailed knowledge related to NRCC is poor and misunderstood by most of the participants; hence, it warrants for the need to increase the awareness regarding this child friendly technique and motivate the pediatric dentists in using the same.
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Impact of endodontic treatment on the quality of life of individuals with cleft lip and palate p. 234
Márcia Mirolde Magno de Carvalho Santos, Sávio Brandelero Junior, Daniela Alejandra Cusicanqui Méndez, Gisele da Silva Dalben, Celso Kenji Nishiyama, Lidiane de Castro Pinto
DOI:10.4103/jdrr.jdrr_131_22  
Background: The root canal treatment can involve of teeth adjacent to the cleft area, either due to caries or for prosthetic purposes. Therefore, endodontic treatment could interfere with quality of life? Aims e Objectives: To assess the impact of endodontic treatment on the quality of life (QoL) and oral health of individuals with cleft lip and/or palate. Material and Methods: Sixty-five individuals meet the criteria, and this is a cross-sectional study. The Oral Health Impact Profile (OHIP-14) questionnaire was applied before endodontic treatment; 30–90 days after treatment. More questions were applied: “Was there any improvement in your QoL after endodontic treatment?” The options were “yes”/”no,” and mention the reason, in case the answer was negative. Results: OHIP-14 revealed weak impact for functional limitation, physical handicap, social impairment, and disabilities. The questionnaire showed medium impact physical pain and psychological discomfort/disability. The answer to question “Was there any improvement in your QoL after endodontic treatment?” was positive for 94% of respondents. Among the respondents, complete unilateral cleft lip and palate was observed in 28 individuals (43.1%), and 31.6% of teeth submitted to endodontic treatment were adjacent to the cleft area. Vital pulp therapy for prosthetic purposes was predominant (36.7%), and 25 out of the 79 endodontically treated teeth were premolars. Conclusion: The endodontic treatment improved the QoL and oral health of 94% of participants, and the OHIP-14 was effective in assessing the influence of medium impact factors.
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Evidence of oral mucosal manifestation in patients with COVID-19: A cross-sectional study in the Nagpur district of Maharashtra p. 239
Apeksha Dhole, Divya Dube, Mukta Motwani
DOI:10.4103/jdrr.jdrr_101_22  
Objective: The present study was directed to evaluate the occurrence, onset, and duration of oral manifestation in patients with COVID-19 in Nagpur (Maharashtra) and its periphery. Materials and Methods: The collection of data was by means of validated Google form questionnaire regarding the occurrence of oral mucosal manifestations in patients diagnosed with COVID-19 in the month of March to May 2021. Results: Oral manifestations experienced by the patient were loss of taste 60%, dry mouth 85%, oral ulcers 42.5%, burning mouth 40%, bleeding gums 7.9%, and jaw pain 2.5%. Conclusions: Oral symptoms are evident in patients suffering from COVID-19. Cause for many symptoms poses reasoning with the long-term use of antibiotics and also lies in the pathogenesis of the COVID-19 infection. Dentists are one of the primary health care providers who encounter such oral manifestation of systemic diseases. It is requisite for a dentist to identify such lesion and manage them accordingly to improve the quality of life for such patients.
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Assessment of velar morphological variants as gender determination tool in kanpur population: A digital cephalometric study p. 243
Rahul Srivastava, Sekhar Mukherjee, Devina Pradhan, Bhuvan Jyoti, Vishal Mehrotra, Prateek Singh
DOI:10.4103/jdrr.jdrr_89_22  
Background: The posterior fibromuscular part of the palate that attaches to the hard palate is what is often referred to as the soft palate. To distinguish between sexes, this research measured the velar for length, breadth, and morphological diversity. Materials and Methods: One hundred and fifty boys and girls, ages 15–25, had digital lateral cephalograms obtained. Using the taxonomy proposed by You et al., we categorized velar morphology into six different types and conducted an in-depth analysis of each. The resting length of the soft palate may be seen as a straight line stretching from the back of the nose to the tip of the uvula. It was also determined how wide the soft palate really is. IBM SPSS statistics 21 was used for the statistical analysis. The mean, the standard deviation, and the percentage distribution were used to describe the data. To ensure that the data were normally distributed, the Shapiro–Wilk test was run on them. Comparisons of clusters of discrete categories were made using the Chi-square test. To identify statistically significant differences between the sexes, we employed the independent Student's t-test. The mean length and width of different velar shapes of both genders were calculated using an analysis of variance test. Results: Type 2 was more common in males than in Types 1, 3, or 6. Form 6 was the rarest of the forms. Type 1 was more common among women than any of the other types, including Types 2, 3, and 6. The most frequent kind was Type 1. The veli of men are much longer and broader than those of females. Conclusion: In light of all the metric measurements from the current study, gender can be established from the length, width, and soft palate morphology.
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Bidirectional Relationship between Oral Health and Diabetes Mellitus: A Knowledge, Attitude, and Practice Survey p. 249
Priyanshu Kumar Shrivastava, Simran Uppal, Deepika Bablani Popli, Keya Sircar
DOI:10.4103/jdrr.jdrr_113_22  
Background: Diabetes mellitus is a chronic disease, known to be associated with several oral complications. A less well-known, but proven bidirectional relationship exists between diabetes and oral health, where one affects the other. Previous studies have shown a lack of awareness about this two-way relationship. This Knowledge, Attitude, and Practice (KAP) study was undertaken to identify the gaps in awareness about diabetes mellitus and its association with oral health. Objectives: The objective of this study was to evaluate and compare the KAPs of diabetics and nondiabetics (ND) regarding the bidirectional relationship between diabetes and oral health. Methodology: This study was conducted at a tertiary dental care institute wherein 75 diabetics, both Type I and II and 75 ND were enrolled. A questionnaire was administered by the investigators, in which responses to various questions regarding their demographics, KAPs in the context of oral health and diabetes were collected. The Chi-Square test was utilized for statistical analysis. Results: 27.3% of respondents had no knowledge about the bidirectional relationship between diabetes and oral health. Although the majority (69.3%) considered regular dental check-ups to be important for good oral health, they were found to be lacking in their practices, where 51.3% followed once a day brushing routine and 71.3% did not know about flossing or interdental cleaning. Conclusion: The study highlights the gaps in KAPs of people regarding the bidirectional relationship between diabetes and oral health and thus emphasizes the need for educational interventions at the community level.
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CASE REPORTS Top

Campagna technique: A boon for debilitated dentition patients p. 257
Akanksha Shinde, Nilesh Bulbule, Varun Bhatt, Akanksha Bhandari, Gayathri Balachandran, Amit Jagtap
DOI:10.4103/jdrr.jdrr_41_22  
Immediate complete denture insertion followed by removal of teeth provides a positive emotional response to the patient by saving the embarrassment of being edentulous and minimal alteration in general appearance, muscle tone, and speech. The patient gets adjusted to the change more quickly; the healing period is faster and less painful. However, the fabrication of immediate denture requires different impression techniques to follow than routine conventional complete denture procedure. This case report presents the fabrication of conventional immediate denture using Campagna impression technique which appears to be more precise among all the techniques as it ensures a similar degree of accuracy of the borders in the dentulous as well as edentulous region of the maxillary dental arch. To provide optimum benefit from the constructed denture, a lingualized balanced occlusal scheme was given.
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Craniofacial Manifestation and Orthosurgical Management of a Patient with Achondroplasia p. 261
Varun Govindraj, Sanjeev Datana, Mohit Sharma, Deepak Chauhan
DOI:10.4103/jdrr.jdrr_40_22  
Achondroplasia is a bone growth disorder results due to failure in endochondral ossification, conversion of cartilages into mature bones. It is the most common metaphyseal dysplastic condition of long bones. The incidence of achondroplasia is 1:25000–30,000 of live births. Our patient was a diagnosed case of achondroplasia, characterized by short stature, disproportionately short arms and legs, and short fingers. Craniofacial features include prominent forehead (frontal bossing), short cranial base, short nose, depressed nasal bridge, short upper lip leading to increased incisal show along with gingival visibility and hyperactive mentalis. Intraoral examination revealed constricted maxillary arch, multiple missing teeth, increased overjet of 12 mm, nonspecific molar, and canine relation bilaterally. Therapeutic intervention included orthosurgical management, i.e., Stage I (presurgical orthodontics)-leveling and alignment followed by closure of extraction spaces; Stage II (surgical management)–le fort-1 osteotomy and maxillary superior repositioning of 6 mm followed by 5 mm bilateral sagittal split ramus osteotomy with anticlockwise rotation of body of the mandible; and Stage III–settling of occlusion and fixed retention in maxillary and mandibular arch. Present case highlights the craniofacial manifestations of achondroplasia its effective management and the potential complications associated. Treating orthodontist should be aware of these features and their consequences in managing the patient to achieve a successful outcome.
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