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   Table of Contents - Current issue
July-December 2020
Volume 4 | Issue 2
Page Nos. 75-129

Online since Thursday, January 28, 2021

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Requirements in the use of new types of esthetic restorative dental materials Highly accessed article p. 75
Anamaria Bechir
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Necessity of cone-beam computed tomography - An introduction and oral radiologist sketch p. 76
Ahmad Badruddin Ghazali
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Integration of teledentistry in oral health care during COVID-19 pandemic Highly accessed article p. 77
Neetika Singh, Amina Sultan, Akanksha Juneja, Isha Aggarwal, Tanzin Palkit, Tanvi Ohri
The COVID-19 pandemic has generated turmoil at all levels. The patients, in particular, are facing a tough time due to the non-availability of physical health care. As everyone is worried about their lives, oral health has taken a back seat. Patients who suffer from dental issues are in a dilemma over available options to address their oral health issues. This is where Teledentistry comes into the picture. Teledentistry is a mode to improve access to oral health services in areas with inadequate availability of general and specialty dental care and is emerging as a practical solution in emergency aid, initial consultation, and expert opinion. In India, several parts of the country lack a sufficient bandwidth or uninterrupted access to the internet facilities, which is also a huge barrier for practicing teledentistry during these pandemic times. Although teledentistry is yet to become an integral part of the oral health-care system in India, nonetheless, COVID times have at least pushed dental practitioners across the country into accepting and using it as an alternative method of dental care. This current pandemic can serve as an opportunity to develop teledentistry on a larger scale, making sure that no individual lacks oral health care, irrespective of the scenarios in the world.
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New insights in neutrophil extracellular traps: Its possible association in COVID-19 pathogenesis p. 82
Komal Fanda, Pallavi Sharma, Vikas Jindal, Ranjan Malhotra, Amit Goel, Malvika Thakur, Shivali Vashisht
Neutrophils discovered by Elie Metchnikoff are granulocytes that play a critical role as a first-line defense in innate immunity. They freely circulate in the blood vessels. Upon receiving the chemotactic gradient signal, neutrophils become the first white blood cells that get activated in various inflammatory sites, defending the human body from the microbial attack. The process of neutrophil extracellular traps (NETs) formation, through the neutrophil action mechanism, is a specific type of cell death, known as NETosis, distinct from necrosis and apoptosis. Oxidative burst mechanisms kill the pathogens trapped in NETs by two procedures – production of reactive oxygen species and chromatin unfolding. The mechanism of NETs draws an analog with the pathogenesis of periodontitis due to dysregulated neutrophilic response to specific bacterial species found in subgingival plaque. NETs are a fibrous structure that consists of a backbone of chromatin with attached globular domains. There are granular proteins and peptides in these domains as well as some cytoplasmic components. The core histones-A potent antimicrobials (H2A, H2B, H3, and H4) that together account for around 70% of the protein mass are the key component of the system. In this NETs-novel coronavirus disease-19 (nCOVID-19) intriguing centric overview, we have a mechanism for NET production; the ability of NETs to entrap and kill pathogens, including the potential immunogenicity of NETs in disease. We have also speculated a few comments on the possible role of NETs in the nCOVID-19.
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Psychosocial impact of novel COVID-19 on dental professionals – Current analysis and scoping review p. 88
Srinandan Pradhan, Prerna Upadhyay, Disha Gupta, Swapna Chavan, Parveen Kumar, Nirma Yadav
The human civilization of the world is probably going through the most important turning point of this millennium, in which the existence of humans is being challenged by the emergence of a severe respiratory syndrome novel coronavirus-19 (nCov-19), which can be seen in new areas around the world attempting to encroach and destroy. nCoV-19 pandemic has created a challenge for scientists and doctors from worldwide how to treat infected patients while protecting themselves from this infection, and the significant effect of this pandemic is on treating eye and dental diseases. The novel coronavirus disease 2019 (nCOVID-19) transmission through contact with droplets and aerosols generated during dental clinical procedures is expected. Hence, especially for dentists and health-care professionals that perform aerosol-generating procedures are restricted. As a result, severe financial implications being faced by dentists and health-care workers. Like other pandemics and emerging disease outbreaks, nCOVID-19 is creating immense psychosocial disturbances. The collective fear of nCOVID-19, which can be felt among working dental professionals in institutions, may be called “Dento-Coronophobia,” has led to an excess of psychotherapeutic manifestations at various levels of society. Therefore, this review has been done to define the psychological effect of nCOVID-19 on dental practitioners.
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Neutrophil equanimity: Function in health and diseases in periodontium p. 93
Pallavi Sharma, Komal Fanda, Vikas Jindal, Ranjan Malhotra, Amit Goel, Malvika Thakur, Shivali Vashisht
The oral cavity is a distinct space where the microbiota is continually changing from the mechanical effort of eating and the incursion of foreign microorganisms such as bacteria, fungi, and viruses. There is a balance between symbiotic bacteria and the innate immune system in healthy gingival tissues, which is mainly maintained by neutrophils. Neutrophils are the essential killers of the body and have been recognized for a long time. However, rather than accurate snipers, neutrophils are often seen as crude and unrefined legionnaires, whose successful missions are usually liable for significant collateral damage. The excess of microorganisms in the biofilm creates an inflammatory state that leads to the recruitment of more immune cells, in which mainly neutrophils can be detected. However, the microbial pathogens within the gingival crevice cannot be abolished or controlled by neutrophils. Sometimes, neutrophil accumulation, rather than protecting and favoring periodontal tissue, can lead to a chronic inflammatory disease that can destroy the tooth-supporting tissues or the periodontium. Thus, it is imperative to maintain homeostasis between neutrophil function and microbe challenge to ensure periodontal health. This critical review article aims to discuss and outline the morphology of neutrophil function in periodontal inflammation, including neutrophils' action on biofilm and neutrophil dysfunction to prevent various syndromes related to it and its myriad potential novel therapeutic measures.
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Detection of the frequency of microbial defilement “in-use” soap products at various dental departments: A microbiological research p. 100
Rohan Sachdev, Kriti Garg, Shubhra Saxena, Samiksha Shwetam, Vishal Mehrotra, Akash Srivastava
Context: Hand washing by a dental health professional before having contact with a patient's oral cavity is considered a fundamental dental clinic infection control measure. Aims: The aim of this study was to evaluate bar soap and liquid soap from dental departments for microbial contamination while it was in use. Settings and Design: This exploratory, cross-sectional study was carried out to identify microorganisms' presence in handwashing with liquid and bar soap at clinical and nonclinical departments in a dental college. Subjects and Methods: In the 2-month study period, all the dental students, dental faculty, and the other auxiliaries present were the participants, and a total of 35 handwashing place samples from 15 different dental departments were collected. The test tube samples of bar soap and liquid soap were all transferred to the microbiology laboratory for microbiological analysis of the samples. Statistical Analysis Used: Data were analyzed using a one-sample paired t-test and independent Student's t-test. Results: Nine different microbial species were identified. In both soaps, the abundance of Staphylococcus aureus was higher as compared to that of other microorganisms. Further, in both soaps, the mean number of microorganisms increased statistically significantly (P < 0.05 or P < 0.01 or P < 0.001) at post-use as compared to at pre-use except Aspergillus niger in liquid soap. However, the post-use mean abundance of microorganisms was found similar (P > 0.05) between the two groups (soaps). Conclusions: The microbial load of the in-use bar soap and liquid soap constituted a mixed flora of Gram-positive bacteria, Gram-negative bacteria, aerobes, anaerobes, and fungi. The results indicate that the bar soap under “in-use” condition harbors more of microorganisms as compared to that of liquid soap, and handwashing with such a soap may lead to the spread of infection.
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To correlate the anxiety, depression, and symptoms of stress levels among patients affected by oral lichen planus and lichenoid reaction p. 106
Tulika Sharma, Ishita Vaghela, Neha Raghuwanshi, Amit Kumar Dabas, Rudra Prasad Chatterjee, Heena Mehta
Introduction: Psychosomatic factor-like depression and depressive symptoms play an important role in the causation of different forms of mucosal changes among which one of them is oral lichen planus (OLP). Oral diseases may be a direct expression of emotions or conflicts. The research aimed to provide a precise estimate by assessing anxiety, depression, and stress in OLP patients and lichenoid reaction (LR) as compared to healthy controls using a self-report scale questionnaire. Materials and Methods: This methodological cross-sectional study comprised of 150 subjects, 50 normal healthy controls (control), 50 patients with OLP, and 50 patients with LR were recruited. The outcome measures of this study were done with pretested, prestructured 21 multiple-choice questions designed to evaluate depression, stress, anxiety levels were assessed using respectively Beck Anxiety Questionnaire, Beck Depression Questionnaire, and Holmes and Rahe Stress Inventory Scales depending on how the questions were answered at the time of presentation (enrolment). Results: The mean anxiety, depression, and stress scores were significantly (P <0.001) different and higher in both OLP and LR groups as compared to the control group. However, mean anxiety, depression, and stress scores were found similar (P >0.05) between the OLP and LR groups. Conclusion: The present study's findings may help direct future management strategies for the patient with OLP and LR. It also helps to understand the patient's behavior in respect of anxiety, depression, and stress. Ministry of health and family welfare – Dental Education should enhance dentistry and give training on how to screen anxiety and depression among Oral disease patients and should develop guidelines to screen and treat depression and anxiety among such patients.
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A comparative observational study based on two radiographic techniques in suspected unilateral mandibular condylar fracture p. 111
Shereen Fatima, Mohammad Ali R Patel, Aaisha Siddiqa, Neelakamal Hallur, Mohammed Arshad Hussain, Mohammed Haneef
Objective: This hypothetical comparative study aimed to compare two radiographic techniques based on the traditional radiograph (orthopantomography [OPG]) and computed tomography (CT) scans and find the best radiographic techniques to be used to confirm diagnostic accuracy and treatment planning in suspected unilateral condylar fractures. Materials and Methods: All patients with suspected unilateral condylar fractures were initially subjected to a radiologic assessment through a conventional radiographic technique of OPG to select the treatment modality, that is, open or closed. Subsequently, all patients were made to undergo a standard CT scan for the study of the temporomandibular joint, with the same objective, that is, (eighty radiographic imaging: forty OPG + forty CT scan) was done to determine which radiographic technique is more helpful in determining the final clinical diagnosis including treatment planning of suspected unilateral mandible condyle fracture. The findings were compared and cross-checked with those of conventional radiographic analysis. Results: It was found that out of the selected patients of confirmed forty unilateral condylar fractures, 33 patients were indicated for closed reduction by conventional radiography, were revealed to have a lateral extracapsular displacement on CT scan, and hence were treated by open reduction. Seven patients satisfied the criteria for closed reduction, both by conventional radiographs and CT scans. Conclusion: Through this theoretical research, it was found that both radiographic techniques are indispensable, specific, and standard in the detection of mandibular fractures. It was noted that CT scan radiographic information might help alter the approach and the treatment plan and prevent erroneous management in mandibular condylar fractures.
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Quantitative analysis of the efficacy of Papanicolaou, acridine orange, and AgNOR in oral exfoliative smears smokers for detecting micronuclei – A cross-sectional comparative study p. 116
D Anupriya, A. H. Harini Priya, R Sathish Muthukumar, C Sreeja, I Kannan, D Suresh
Context: Dentistry and its associated specialties play a crucial role in diagnosing and treating oral diseases due to deleterious oral habits. Oral health-care providers also conduct researches to identify the association between oral diseases resulting from these bad oral habits, such as oral squamous cell carcinoma. Aim: The purpose of this quantitative cross-sectional study was to compare the efficacy of exfoliative Papanicolaou staining (PAP) stains, acridine orange (AO), and AgNOR for detecting micronucleus (MN) count in smokers' (individuals with the habit of smoking) oral mucosa. Materials and Methods: Exfoliative cytology smears obtained from thirty smokers' oral mucosa were divided into three equal groups to evaluate the frequency of MN count after staining with PAP, AO, and AgNOR. Smears were collected from smokers' oral mucosa ranging in age from 30 to 70 years who visited the Department of Oral Medicine and Radiology and from the Department of Oral Pathology and Microbiology. Results and Stats: This research revealed the slightly different and higher MN count in PAP stain in the mean count among all the three stains after analysis and evaluation along with considerably higher in AO stain compare to AgNOR stain. Data were analyzed using Statistical Package for the Social Sciences SPSS software (windows Version 22.0 Chicago, IL, USA). Conclusion: In this quantitative, cross-sectional study, with limitations and pitfalls, the results showed higher proliferative activity in smokers' oral mucosa without any oral lesions and higher mean MN count in PAP stain followed by a mean range of AO stains.
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Management of impacted and dilacerated maxillary central incisor using tractional force p. 121
Nausheer Ahmed, Bhakthi Halapanavar, VN Aravinda, SJ Rajalakshmi
The prominent tooth location and root anomalies of impacted dilacerated incisors are a clinically challenging task for the orthodontist. The absence of anterior maxillary teeth has a significant impact on esthetics, speech, mastication, and psychosocial well-being in young patients. By nature of the vicinity, the impacted maxillary central incisors in children trigger a troubling condition for parents concerned with esthetics. The position, angulation, and direction of the patient's erupting tooth and crown and age are factors that hinder an impacted tooth's prognosis. Among these, the appropriate diagnosis of dilaceration is a crucial determinant of successful treatment. Decisions are made depending on the severity of dilacerations, whether the maxillary central incisor should be exposed and aligned or extracted and replaced by a prosthesis. The first treatment option always chosen to save the impacted maxillary central incisor is the exposure of the tooth surgically, followed by orthodontic traction forces. To prevent more complications, early intervention and detection of such cases are, therefore, most important. This case report elucidates the triumphant management in a 15-year-old female patient of a vertically impacted and dilacerated maxillary right central incisor positioned high in the vestibule, treated with a combined approach of surgical exposure and spontaneous orthodontic traction force.
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Ramsay Hunt syndrome management: A multimodal approach p. 126
P Sai Archana, S Samiunnisa Begum, S Sivan Sathish, A. H. Harini Priya, R Christeffi Mabel
Herpes zoster oticus or geniculate neuralgia or nervus intermediate neuralgia, also known as Ramsay Hunt syndrome (RHS), is a rare complication of herpes zoster, which is due to reactivation of latent varicella-zoster virus infection in the geniculate ganglion. RHS causes otalgia, auricular vesicles, and peripheral facial paralysis, rare in children but occurs with a female prediction in adults. Incidence and clinical severity increase with compromised immunity and progressing age. We often stare at a diagnostic challenge as these symptoms do not always present at the onset. Herpes zoster oticus accounts for about 12% of facial palsy cases, which is complete and typically unilateral, and full recovery occurs in only around 20% of untreated patients. With these features, we report the case of a 55-year-old male diagnosed with RHS, which was treated effectively with the combination therapy of antivirals and steroids along with physiotherapy. This article has described various etiopathogenesis, differential diagnosis, and various multimodal treatments available for RHS, including the medical management for immunocompromised patients and available vaccines pre- and postexposure to ensure the better prognosis and complete recovery.
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