Dental Journal of Advance Studies

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Volume 12, Number 2, May-August 2024
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FROM THE EDITOR'S DESK

Tarun Kalra

From the Editor's Desk

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:1] [Pages No:iv - iv]

   DOI: 10.5005/djas-12-2-iv  |  Open Access | 

66

EDITORIAL

Arun Suresh Dodamani

Dental Education in India: Embracing Transformation for a Rapidly Evolving Future

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:1] [Pages No:v - v]

   DOI: 10.5005/djas-12-2-v  |  Open Access | 

262

ORIGINAL RESEARCH

Neha Menrai, Sameer Makkar, Sandeep Gupta, Ajay Aryan, Chetna Tarnach

To Compare the Efficacy of Preoperative Oral Medication of Ibuprofen and Ketorolac on Anesthetic Efficacy of Maxillary Buccal Infiltration Using Buffered 2% Lidocaine with 1:100,000 Adrenaline with Irreversible Symptomatic Pulpitis: A Prospective Clinical Study

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:4] [Pages No:73 - 76]

Keywords: Buffered lidocaine, Maxillary buccal infiltration, Sodium bicarbonate

   DOI: 10.5005/djas-11014-0031  |  Open Access |  How to cite  | 

Abstract

Aim: To assess the effects of ibuprofen and ketorolac, two preoperative oral medications on the effectiveness of anesthesia for maxillary buccal infiltration with buffered 2% lidocaine and 1:100,000 adrenaline in patients with irreversible symptomatic pulpitis. Materials and methods: In the endodontics and conservative dentistry department, a prospective clinical trial was conducted. About 45 participants participated in the trial and were divided into three groups. The patients were divided into three groups at random and given one of three drugs, including ibuprofen, ketorolac, and placebo, an hour before local anesthesia. All patients received a maximal buccal infiltration of buffered 2% lidocaine with 1:200,000 epinephrine. After 15 minutes of administration of maxillary buccal infiltration, endodontic access preparation was started. Pain felt during therapy was noted using a Heft Parker visual analogue scale. Success was deemed to be the absence of pain or only mild discomfort. Results: A nonparametric c2 test statistical analysis revealed that the placebo had a 30% success rate. Ibuprofen premedication had a success rate of 32.5%, while ketorolac premedication had a success rate of 37.5%. The three groups did not significantly differ from one another. Conclusion: Ibuprofen or ketorolac preoperative administration has no appreciable impact on the success rate of maxillary buccal infiltration in patients with irreversible pulpitis.

82

ORIGINAL RESEARCH

Anu A Ali, Byju P Kurian, Jimmy George, Jinsa P Devassy, Lithiya S John, Saranya Ravikumar

Comparison of Peri-implant Strain on Loading, between Splinted, Nonsplinted, Cement-retained and Screw-retained Implant-supported Prostheses: An In Vitro Study

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:7] [Pages No:77 - 83]

Keywords: Cement-retained prosthesis, Nonsplinted prosthesis, Peri-implant strains, Screw-retained prosthesis, Splinted prosthesis

   DOI: 10.5005/djas-11014-0043  |  Open Access |  How to cite  | 

Abstract

Background and objectives: The present in vitro study was done to measure and compare peri-implant strain generated by different types of prostheses, namely, cement-retained splinted, cement-retained nonsplinted, screw-retained splinted and screw-retained nonsplinted with the help of strain gauges in polyurethane mandibular model under loading. Materials and methods: Implants were placed in two polyurethane mandibular models in first and second molar regions. Four different types of prostheses were made. Cement-retained splinted and cement-retained nonsplinted prostheses were fabricated on one model. Screw-retained splinted and screw-retained nonsplinted are fabricated on another model. Strain gauges are attached on the buccal and lingual sides of each implant. Metal jigs were fabricated for simultaneous load application during vertical and oblique loading. A static load of 400 N was applied to the central fossae region of both molars using the universal testing machine to test vertical loading. The load was applied at 30° to the crown to test oblique loading. For every model, a load was applied 15 times, and the peri-implant strain was recorded. Results: On vertical loading, the mean peri-implant strain (±SD) generated was found to be highest in nonsplinted screw-retained (1211.50 ± 65.28 microstrains and 1009.1 ± 42.06 macrostrains) and least in splinted cement-retained (630.70 ± 31.98 microstrains and 519.60 ± 32.48 microstrains) in the first molar region and second molar region, respectively. On oblique loading, the mean peri-implant strain (±SD) generated was found to be highest in nonsplinted screw-retained (702.47 ± 31.47 microstrains and 565.00 ± 16.11 microstrains) and least in splinted cement-retained (396.33 ± 27.04 microstrains and 302.47 ± 36.19 microstrains) in both 1st and 2nd molars, respectively. Conclusion: Splinted crowns produce less peri-implant strain when compared with nonsplinted crowns. Cement-retained prosthesis produces less strain when compared with screw-retained prosthesis. The least peri-implant strain was observed in splinted cement-retained crowns.

77

ORIGINAL RESEARCH

Deepthy S Sivan, Byju P Kurian, Babu Cherian, Blessenty Joy, Minu Raju, Anju S Raju

Comparative Evaluation of Dimensional Stability of Elastomeric Impression Materials Subjected to Ultraviolet Irradiation and Spray Atomized Disinfection: An In Vitro Study

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:7] [Pages No:84 - 90]

Keywords: 2.5% chlorhexidine gluconate, Condensation silicone, Disinfection, Elastomeric impression materials, Polyether, Polyvinyl siloxane, Spray atomization, UV irradiation

   DOI: 10.5005/djas-11014-0045  |  Open Access |  How to cite  | 

Abstract

Aim and background: The study was done to compare and evaluate the linear dimensional stability of three elastomeric impression materials, namely polyether (PE), polyvinyl siloxane (PVS), and polydimethylsiloxane (PDS) after subjecting to ultraviolet (UV) irradiation and spray disinfection techniques. Methods and methodology: Three elastomeric impression materials namely PE (3M ESPE Impregum soft), PVS (Zhermack elite P And P), and PDS (Zhermack Oranwash L and its indurater) of light body consistency were used. Ultraviolet rays and 2.5% chlorhexidine (CHX) gluconate (spray disinfection) were used as disinfectants. A master die was used to create 40 samples from each material. Three parallel lines of equal length were given in the die. A sample was accepted if two or three lines were reproduced continuously and were well-defined. A total of 120 samples were made and subjected to disinfection. Out of the 40 samples from each material, 20 samples were irradiated with UV light of approximately 200–280 nm for 20 minutes and the next 20 from each material were treated with spray atomized disinfection. The sample was sprayed and sealed in a plastic bag for 30 minutes. Measurements of the samples were done. Each line in the sample was evaluated under a stereomicroscope at 10× magnification. The average length of lines in each sample was compared to that in the die. The values obtained in the UV irradiation and spray disinfection were also compared. Results: A statistically significant difference was shown in the dimensional stability of all three elastomeric impression materials subjected to UV irradiation and spray disinfection when compared with that of the die. Polyether demonstrated a statistically significant difference when compared with UV and spray atomized samples whereas PVS and PDS showed dimensional change when compared with the die, but no statistically significant difference was found when samples treated with both the disinfection techniques were compared. Conclusion: Elastomeric impression materials of light body consistency had dimensional change when treated with UV irradiation for 20 minutes and spray atomization with 2.5% CHX gluconate. Clinical significance: Prevention of cross-contamination when handling impression materials without hampering their dimensional stability is mandatory to obtain a successful treatment.

75

ORIGINAL RESEARCH

Unnati Agarwal, Abhishek Singh, Shitij Srivastava, Abhinav Shekhar, Love K Bhatia, Anshuman Chaturvedi

A Comparative Evaluation of Different Gingival Retraction Methods: A Double-blinded In Vivo Randomized Controlled Trial

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:6] [Pages No:91 - 96]

Keywords: Blinded study, Gingival retraction, In vivo study, Randomized controlled trial, Retraction cord, Retraction paste, Retraction gel, Sulcular width, Sulcular depth

   DOI: 10.5005/djas-11014-0046  |  Open Access |  How to cite  | 

Abstract

Aims and background: Successful treatment of a fixed prosthesis relies on the procedure's accuracy. An important step is to make an accurate impression. The impression at the margins should have substantial thickness to prevent tears and distortion. This study evaluates three different gingival retraction materials, namely retraction cord with epinephrine, retraction paste and retraction gel, using sulcular width and sulcular depth. Materials and methods: The efficacy of the gingival retraction of retraction cord with epinephrine, retraction paste and retraction gel was evaluated by measuring the sulcus depth and sulcus width recorded in a single stage putty light body impression made with additional to silicone impression material. Results: The mean change in sulcus width for the retraction cord with epinephrine was 0.310, that for the retraction paste was 0.264, and that for the retraction paste was 0.287. The mean change in sulcus depth produced by retraction cord with epinephrine was 0.337, followed by retraction gel 0.309 and then retraction paste 0.305. Conclusion: Retraction cord with epinephrine was the most effective method of gingival retraction in terms of both sulcus width and depth when compared to retraction paste and retraction gel. Clinical significance: Comparison of sulcus width and depth resulted in a statistically significant difference between the gingival retraction achieved by retraction cord with epinephrine (Group A) and retraction gel (Group C). Since this study is an in vivo, double-blinded and randomized controlled trial, the inferences drawn can be applied to clinical practice.

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ORIGINAL RESEARCH

Asusa C Loli, Tarun Kalra, Manjit Kumar, Ajay Bansal, Abhishek Avasthi

To Evaluate and Compare the Position of Frankfort Horizontal Plane and Camper's Plane to Occlusal Plane: An In Vivo Study

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:4] [Pages No:97 - 100]

Keywords: Ala-tragus line, Camper's plane, Frankfort horizontal plane, Natural head position, Occlusal plane

   DOI: 10.5005/djas-11014-0049  |  Open Access |  How to cite  | 

Abstract

Aim: This study was undertaken to evaluate and compare the position of Frankfort horizontal plane and Camper's plane to the occlusal plane. Materials and methods: In this study, 80 subjects aged between 19 and 25 years with normal occlusion were selected from undergraduate and postgraduate students of Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India. Measurement of the clinical parameters was done using computer software program Screen Protractor version 4.0 and the radiographic (lateral cephalograms) were traced using an X-ray viewer. Results: It was observed that neither the clinical nor the radiographic (lateral cephalogram) Camper's plane was parallel to the occlusal plane but on comparison it was found that clinical Camper's plane was almost parallel to the occlusal plane. Conclusion: The study showed that neither the Camper's plane nor the Frankfort horizontal plane was parallel to occlusal plane.

96

ORIGINAL RESEARCH

Yogender Kumar, Shweta Lodha

Adhesive Bond Strength of Glass Ionomer Cement Modified with Chitosan at Different Concentrations: An In Vitro Comparative Evaluation

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:5] [Pages No:101 - 105]

Keywords: Adhesive bond strength, Chitosan, Chitosan-modified GIC, Glass ionomer cement, Shear bond strength

   DOI: 10.5005/djas-11014-0053  |  Open Access |  How to cite  | 

Abstract

Aims and background: To assess and compare the adhesive bond strengths of conventional glass ionomer cement (GIC), 5% Chitosan-modified GIC and 10% Chitosan-modified GIC to human dentin. Materials and methods: About 45 molars of permanent human teeth were inspected for defects, cleaned, and embedded in acrylic resin. Glass ionomer cement was modified by adding chitosan at different concentrations, i.e., 5% volume/volume (v/v) and 10% v/v. Dentin surfaces were exposed by removing the enamel and then polished. The dentin surfaces were then conditioned. The samples were categorized randomly into three groups: Conventional GIC (Group A), 5% Chitosan-modified GIC (Group B), and 10% Chitosan-modified GIC (Group C). Standardized molds were applied to the exposed dentin, and GIC was bonded using these molds to form cylindrical specimens. After incubation and thermocycling, a universal testing machine was used to measure the adhesive bond strength. The readings were analyzed using one-way ANOVA and post hoc Tukey's test using SPSS software V.21. Results: The highest mean adhesive bond strength was observed in group C (10% Chitosan-modified GIC), followed by group B (5% Chitosan-modified GIC), and group A (Conventional GIC). There were statistically significant differences noted between Conventional GIC and 10% Chitosan-modified GIC, as well as between 5% Chitosan-modified GIC and 10% Chitosan-modified GIC. However, there was no statistically significant difference between Conventional GIC and 5% Chitosan-modified GIC. Conclusion: Incorporating Chitosan into GIC enhanced adhesive bond strength, with 10% Chitosan-modified GIC showing the most significant improvement. These modifications have the potential to enhance clinical outcomes in restorative dentistry. Clinical significance: Enhanced adhesive bond strength with 10% Chitosan-modified GIC suggests potential for more reliable and long-lasting dental restorations.

111

ORIGINAL RESEARCH

Divyanshu Choudhary, Yogender Kumar, Shreya Agarwal

Impact of Antioxidants on Bond Strength between Resin Composites and Bleached Enamel: An In Vitro Comparative Evaluation

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:5] [Pages No:106 - 110]

Keywords: 35% hydrogen peroxide, Aloe vera, Ascorbic acid, Green tea, Shear bond strength

   DOI: 10.5005/djas-11014-0055  |  Open Access |  How to cite  | 

Abstract

Aims and background: The purpose of the study was to assess and compare the impact of different antioxidants, namely Camellia sinensis (Green tea), Aloe Barbadensis Miller (Aloe vera), Ascorbic acid, and Phyllanthus emblica (Amla), on the bond strength of resin composites to bleached enamel in vitro. Methods: A total of 60 intact permanent incisors were collected and mounted in self-cure acrylic resin. The facial surface was flattened using sandpaper. Teeth were divided into two groups on the basis of the bleaching agent used. Group A: no bleaching, Group B: 35% hydrogen peroxide. After bleaching following the manufacturer's instructions the teeth were washed and dried. Group B was further subdivided based on the antioxidants used. B0/C0– No antioxidant, B1/C1 – 10% Green tea, B2/C2 – 10% Aloe vera, B3/C3 – 10% Sodium Ascorbate, B4/C4 – 10% Amla. The flattened and treated enamel surface was bonded to composite resin using plastic molds. Samples were subjected to shear bond strength (SBS) evaluation. The results were analyzed using one-way ANOVA and Post Hoc Tukey's Test to evaluate the differences in the SBS. Results: The highest SBS was presented by unbleached group A (51.520) followed by group B (34.288). 10% sodium ascorbate showed the most potent antioxidant action in reducing bleach effect while 10% Amla gave the worst results. Conclusion: Ascorbic acid enhanced the SBS to enamel bleached with hydrogen peroxide, outperforming Green tea, Aloe vera, and Amla. Clinical significance: Bleaching sometimes fails to completely resolve discoloration, necessitating composite restorations. In these cases, antioxidants can restore the weakened bond strength between bleached enamel and resin composite, which is essential for clinical practice.

95

CASE REPORT

Sugandha Malhotra, Anu Girdhar, Gagandeep K Chahal, Jaspinder S Gill, Neha Ahuja, Komalbir Kaur

Restoring Oral Function: A Case Report on Prosthodontic Rehabilitation with a Hollow Bulb Obturator for a Post-maxillectomy Patient Following COVID Mucormycosis

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:4] [Pages No:111 - 114]

Keywords: Case report, Coronavirus disease-2019, Hollow bulb obturator, Maxillary defects, Mucormycosis, Prosthetic rehabilitation

   DOI: 10.5005/djas-11014-0048  |  Open Access |  How to cite  | 

Abstract

Mucormycosis is a rarely seen but potentially fatal fungal infection attributed to coronavirus disease-2019 (COVID-19). It can result in severe tissue destruction and deformity in various anatomical regions, particularly the maxillofacial area. This article illustrates the case of a patient who underwent a left partial maxillectomy due to rhino-orbital-cerebral mucormycosis following the COVID-19 infection. A hollow-bulb definitive obturator, an economical and practical option for prosthodontics restoration of acquired maxillary defects, rehabilitated the patient. The article explores the clinical manifestations, diagnosis, management, and outcomes of the case, as well as the implications for clinical practice. It underscores the importance of multidisciplinary care and individualized intervention for patients with maxillofacial defects caused by mucormycosis.

90

CASE REPORT

Praveen K Pandey, Swatee Agarwal, Gaurav Chandra, Sujeet Singh, Amartya P Srivastava, Durga P Soni

Epidermoid Cyst of Floor of the Mouth: A Rare Entity

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:3] [Pages No:115 - 117]

Keywords: Case report, Dermoid cysts, Epidermoid cyst, Floor of the mouth, Non-odontogenic cysts

   DOI: 10.5005/djas-11014-0050  |  Open Access |  How to cite  | 

Abstract

Dermoid and epidermoid cysts, originating from ectodermal tissue, are benign, slowly growing developmental cysts that can appear anywhere in the body. Just 1.6% of these cysts occur in the oral cavity and less than 7% of them impact the head and neck area. Three histological variations of dermoid cysts that Meyer revised and described in 1955 are the teratoid variant, epidermoid cysts, and dermoid cysts. The ectodermal tissue of the first and second branchial arches which gets entrapped might fuse during the third and fourth weeks of pregnancy and may lead to the development of a midline epidermoid cyst in the floor of the mouth. The sublingual, submaxillary, and submandibular areas are the sites of development, the floor of the mouth being an uncommon location for this condition. A slow-growing intraoral dermoid cyst may increase and obstruct speech or deglutition, or it may represent a compromise to the airway and necessitate prompt surgical surgery. We document a case of a 23-year-old female with an epidermoid cyst clinically appreciable as a large sublingual swelling obstructing swallowing and speech. An intraoral approach was used to surgically incise the pathology.

80

CASE REPORT

Amrit Baweja, Narayana Prasad, Karan Mehta, Harkirat Singh

Uprighting Mandibular Third Molar Using NiTi Wire

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:3] [Pages No:118 - 120]

Keywords: Case report, Impacted tooth, Molar uprighting, NiTi, Orthodontics

   DOI: 10.5005/djas-11014-0051  |  Open Access |  How to cite  | 

Abstract

If impacted teeth can be brought into occlusion, they should be brought into occlusion, especially in young patients. When the second molar is missing, saving the third molar becomes all the more important. In this case, the patient presented with a missing mandibular second molar, and an impacted mandibular third molar. A 0.019 × 0.025 NiTi wire was used to upright the impacted molar and bring it into occlusion. This method is economical, effective and works well for bonded and banded teeth.

82

CASE REPORT

Sarika Kapila, Tejinder Kaur, Advaya Rath, Utkarsha Kapila

Langerhans Cell Histiocytosis of the Oral Cavity: A Rare Case Report and Diagnostic Dilemma

[Year:2024] [Month:May-August] [Volume:12] [Number:2] [Pages:4] [Pages No:121 - 124]

Keywords: Case report, Langerhans cell histiocytosis, Mobile teeth, Rare disease, Systemic involvement

   DOI: 10.5005/djas-11014-0052  |  Open Access |  How to cite  | 

Abstract

Langerhans cell histiocytosis (LCH) is a peculiar derangement regulated by cells of the reticuloendothelial system that may sometimes involve the oral cavity. The purpose of the present report is to suggest a case of LCH manifesting in the cavities of the mouth and how it may present as a diagnostic challenge. A female patient aged 33 reported having complaints of loose teeth, bleeding gums and foul smell from the mouth. Clinical and radiographic examination revealed multiple areas of gingival necrosis, ulcerations and aggressive bone loss. Initially diagnosed as aggressive periodontitis, when the lesions did not resolve, an incisional biopsy along with immunohistochemistry found Langerhans cells, affirmative reciprocation to langerin as well as CD1a, subsequently the female patient was clinically diagnosed as positive for LCH. The patient was given chemotherapy supplemented with Vinca alkaloids coupled with corticosteroids through a systemic route. The patient had multiorgan involvement, but successive retrogradation of lesions lying in the gingival area, along with a marked reduction in overall tooth mobility and harshness of pain perception, observed on the 6-month follow-up. Conclusion: Langerhans cell histiocytosis is a uniquely rare malady that may sometimes manifest in the oral cavity, so precise detection using appropriate clinical diagnostic methods, treatment and none-relapse follow-up are essential for adequate management. Awareness regarding oral manifestations of LCH is indispensable in clinical practice, as it not only aids in timely diagnosis but also encourages early intervention, thereby providing a better prognosis for the affected subject cases.

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