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   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 7 | Issue 2
Page Nos. 37-93

Online since Saturday, June 20, 2020

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ORIGINAL ARTICLES  

Effect of artificial saliva on the mechanical and tribological behavior of nano-/micro-filled biocomposite materials for biomedical applications p. 37
Efe Çetin Yilmaz
DOI:10.4103/jdrr.jdrr_19_20  
Aim: The purpose of this study is to investigate the effect of artificial saliva storage time of composite materials with different filler structure (micro/nanofiller) on the mechanical and tribological behavior. Material and Method: Mechanical and tribological behaviors of composite materials were investigated with storage in artificial saliva for the control group, 1 day, and 7 days. Composite materials were subjected to direct contact wear tests (80 N wear force, 100.000 wear cycles, 1.8 Hz wear frequency, and 37°C ambient temperature) with a computer-controlled dual-axis abrasion device. The surface hardness of composite materials after each artificial saliva test procedure was determined using the Vicker's Hardness method. Results: In this study, it was concluded that the waiting process in artificial saliva increases the tribological behavior of the composite material. Conclusion: However, for the composite test materials in this study considered, correlations between the contact-wear resistance and surface hardness were found to be statistically insignificant.
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Knowledge, attitude, and practices toward oral hygiene among students of medhanealem high school, addis ababa, Ethiopia p. 42
Bizuayehu Abate, Mahlet Ephrem, Miskir Gebremariam, Yodit Ayalew, Tariku Shimels
DOI:10.4103/jdrr.jdrr_6_20  
Introduction: Poor oral health can affect a person's day today as well as overall quality of life. Discomforts from experience of pain, problems with eating and chewing, embarrassment about the shape, and missing, discolored, or damaged teeth can adversely affect peoples' daily lives and well-being. The aim of this study was to assess the knowledge, attitude, and practice (KAP) of oral hygiene among preparatory students of Medhanealem High School in Addis Ababa, Ethiopia. Methods: A cross-sectional study design was conducted using a self-administered questionnaire from June to September 2019 in Medhanealem High School, Addis Ababa. Data were analyzed using SPSS v. 20, and a descriptive statistics was employed to present results on KAPs of high school students toward oral hygiene. Results: A total of 320 students have participated in the study, of whom 207 (64.7%) were female. The study revealed that 201 (62.8%) of the respondents had a poor knowledge with regard to oral hygiene, about half (52.1%) of the students had a negative attitude toward oral hygiene, and their oral hygiene practices were still low that 193 (60.4%) of the students reported inadequate practice. The chewed stick (Mefakiya) is the most common oral hygiene aid used for cleaning teeth, which was adopted by 134 (51%) students. Conclusions: The study showed that oral hygiene KAP among the secondary school students in Medhanealem Preparatory School were not satisfactory. The findings of this study suggest that awareness on the importance of oral hygiene needs to be enhanced along with regular education.
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Effects of stevia and xylitol chewing gums on salivary flow rate, pH, and taste acceptance p. 50
Mitali R Shinde, Jasmin Winnier
DOI:10.4103/jdrr.jdrr_20_20  
Context: Stevia is a natural sweetener which is used as a sugar substitute. There is limited research regarding the use of stevia chewing gum and its effect on salivary flow rate and pH. Aim: The aim of the study was to assess the effect of stevia and xylitol chewing gums on salivary flow rate, pH, and its taste acceptance. Setting and Design: A randomized, triple-blinded, clinical study with a crossover design was conducted. Subjects and Methods: Twenty children aged 8–13 years with decayed, missing, and filled teeth index score ≥3 were selected. Pretest unstimulated saliva was collected. The children were divided into two groups, and Stevia and Xylitol gums were provided to each group to chew for 15 min. Salivary samples were collected at 15 min and 1 h. Salivary flow rate and pH were measured at baseline, 15 min, and 1 h. Statistical Analysis: The collected data were subjected to statistical analysis using Wilcoxon signed-rank test, and P ≤ 0.05 was considered statistically significant. Results: There was an increase in the salivary flow rate from baseline to 15 min in children provided with stevia and Xylitol chewing gums with P = 0.003 and 0.001, respectively, in the trial. In the crossover trial, there was an increase in salivary flow rate from baseline to 15 min in children provided with stevia and Xylitol chewing gums with P = 0.020 and 0.001, respectively. There was a reduction in salivary pH from baseline to 15 min in children provided with Xylitol (P = 0.001) and 15 min to 1 h in stevia (P = 0.003) in the trial. In the crossover trial, there was a reduction in pH from baseline to 15 min (P = 0.020) and 15 min to 1 h (P = 0.003) in children provided with stevia and Xylitol chewing gums (P = 0.001). Conclusion: Stevia is equally effective to Xylitol chewing gum in increasing salivary flow rate and salivary pH. Stevia due to its bitter aftertaste is less accepted in children as compared to Xylitol.
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Retention in fixed orthodontic treatment: An important aspect affecting success of treatment outcome – A questionnaire study p. 56
Monika Mahajan
DOI:10.4103/jdrr.jdrr_17_20  
Context: Postorthodontic treatment, retention is an important phase which can be decisive in determining the stability of the achieved result of functional occlusion and esthetic appearance of the patient. There are different types of retainers and different retention protocols followed among the orthodontists. Aims: The purpose of this study was to determine different factors which affect compliance of the patient with removable retainers. Materials and Methods: Thirty-eight patients, who had finished fixed orthodontic treatment and were in retention phase wearing Hawley removable retainers, were included in the study. They were given a questionnaire which dealt with factors affecting patient compliance with removable retainers and different reasons for not wearing removable retainers. Statistical Analysis Used: Categorical variables were reported as counts and percentages. Gender comparisons were made with the Chi-square test/Fisher's exact test. Conclusion: The most common reason for not wearing retainer was reported as patients forgetting to wear the retainer. The common reason for relapse may be associated with patients who think that responsibility of retention is only of orthodontist and not themselves or of both. Gender wise: it was found that the factors of level of satisfaction during the present retention phase, forgetting to wear it, and responsibility of retention showed statistically significant differences.
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CASE REPORTS Top

Surgical management of class 3 invasive cervical resorption p. 64
Zehra Shavez, Shaikh Shahbaz, Sharique Alam
DOI:10.4103/jdrr.jdrr_10_20  
Invasive cervical resorption (ICR) is a pathologic loss of dental hard tissue at the cervical region of tooth beneath the epithelial attachment. ICR is multifactorial in origin and has various predisposing factors such as orthodontic treatment, trauma, and internal bleaching. Thus, a multidisciplinary approach comprising of surgical repair with root canal treatment is required for its successful treatment outcome.
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Cancellous osteoma of temporomandibular joint p. 67
Rajdeep Singh, Sagar Bhure, B Pramod Krishna, Heena Mazhar, Amy Thomas, Sushant Kumar Soni
DOI:10.4103/jdrr.jdrr_14_20  
Osteoma is a rare growth of bone, benign in nature, usually occurring in the craniofacial region. It usually results from the long-term deposition of compact and cancellous bone. The etiology of the tumor is not clear but can be linked with infections, inflammatory processes trauma, or/and abnormalities in growth. It manifests with symptoms of painful/painless swelling, dull pain in the preauricular region, clicking/popping and difficulty in mastication, trismus, gradual midline shift developing malocclusion, mandibular deviation of the contralateral side, and facial asymmetry. The diagnosis is mostly made by clinical and radiological imaging and is affirmed by histopathological examination. These condylar tumors have been usually treated by either resection through local excision or condylectomy with or without reconstruction. Therefore, we describe a rare case report of osteoma arising from the mandibular condylar neck of a 26-year-old female patient giving a chief complaint of difficulty in opening the mouth in the last 15 days along with pain. Radiographic images and computed tomography were suggestive of osteochondroma involving right condyle which, on excision and histopathological examination, was found to be cancellous osteoma.
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Conservative treatment of traumatic crown fracture extending into cementum by glass post aided adhesive bonding of autogenous tooth fragment: A report of two cases p. 70
Boris Saha, Sharique Alam, Surendra Kumar Mishra, Disha Mahore
DOI:10.4103/jdrr.jdrr_3_20  
Advancement in the adhesive system has made fragment reattachment a viable treatment option for treating tooth fractures. It offers a simple and conservative technique to restore esthetics and function. Reattachment of a completely disjointed crown may need additional fiber post retention due to the greater functional load borne by the fragment. This article reports two cases of complicated crown root fracture managed by utilizing fiber post to reattach the disjointed crown fragment. The reattached fragment has shown reliable retentivity and periodontal health at 1-year follow-up.
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REVIEW ARTICLES Top

Effect of additives to sodium hypochlorite on pulp tissue dissolution and physico-mechanical effects on root canal dentin: A systematic review p. 75
Poorva Kurtarkar, Shalini D Aggarwal, Ishan Ahmed, Swapnil Khadtare, Rhea Digholkar
DOI:10.4103/jdrr.jdrr_4_20  
Background: It is widely accepted now that; additives to sodium hypochlorite helps in better pulp tissue dissolution. However, due to proprietary concerns, the available literature is unable to clarify exactly how the modified NaOCl is better than unaltered NaOCl. This review evaluates the effect of additives on sodium hypochlorite on pulp tissue dissolution and physicomechanical effects on dentin. Methods: A systematic search was conducted using Medline PubMed, Ebscohost, Scopus, Google Scholar up to and including September 31, 2018, to identify relevant studies. All cross-reference lists of the selected studies were also screened. The inclusion criteria were articles in English or those having a detailed summary in English, published between January 2009 and September 2018. Articles were providing information about sodium hypochlorite, surfactants, and etidronic acid. Articles were providing information about in vitro studies, in which effect on root dentin was evaluated. Review, case reports, abstracts, letters to editors, and editorials were excluded. In vivo studies were excluded from this systematic review. Results: A total of 195 articles were examined, of which 11 articles were selected for the final synthesis. Most of the articles concluded that additives to sodium hypochlorite led to better pulp tissue dissolution and reduced the hardness of root canal dentin. Conclusion: This systematic review was able to garner adequate information stating that additives to sodium hypochlorite performed better pulp tissue dissolution. It was also able to evaluate successfully the physicomechanical effects of these solutions on root canal dentin.
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Combating respiratory hazards in dentistry: A comprehensive review p. 86
Shishir Singh, Sagar J Shah, Rajesh Podar, Roshan Shetty
DOI:10.4103/jdrr.jdrr_21_20  
Oral healthcare settings are known to produce aerosols during dental procedures. With the outbreak of novel coronavirus, which has a definite droplet and possible aerosol transmission, a review of reducing bioburden due to aerosol generation in oral healthcare settings is warranted. Literature reporting characterization of aerosols in dental and medical settings, and potential for cross-infection in oral healthcare settings, was thoroughly reviewed. This was followed by reviewing studies and guidelines issued by various health organizations on methods of reducing the burden of aerosols in dental setting. Oral healthcare settings can serve as a potential site for cross-infection of diseases such as tuberculosis and severe acute respiratory syndrome. COVID-19 spreads principally by respiratory droplets and may spread through aerosols. Many dental procedures are associated with the generation of a high number of aerosols. Airborne contamination can be kept to a minimum by following the hierarchy of controls which includes triage, engineering, and workplace controls followed by personal protection equipment. The use of high-volume suction is highly recommended to reduce aerosols in the dental office. Preprocedural rinse with 0.2% povidone iodine is effective in reducing viral load against COVID-19.
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SHORT COMMUNICATION Top

A modification of ward's incision for management of mandibular angle fracture p. 91
Uday Kiran Uppada
DOI:10.4103/jdrr.jdrr_18_20  
It is a well-known fact that mandibular angle fracture is one of the most frequently encountered fractures in the facial skeleton. Lot of emphasis is given to the kind of fixation devices as well as number of fixation devices used in the management of these fractures. However, it is noteworthy that some of the distinguished complications are associated with the flap design and soft-tissue handling. This short communication highlights the fact that the Ward's incision without the distal release is a very valuable surgical approach in the management of these fractures.
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