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   Table of Contents - Current issue
Coverpage
July-September 2018
Volume 5 | Issue 3
Page Nos. 69-101

Online since Monday, November 19, 2018

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EDITORIAL  

Editorial p. 69
D Gopalakrishnan
DOI:10.4103/jdrr.jdrr_60_18  
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GUEST EDITORIAL Top

Ethics committee in an academic institute p. 70
Ravindra B Ghooi
DOI:10.4103/jdrr.jdrr_58_18  
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MONOGRAPH Top

Various kinds of dental research studies and their requirements for ethical approvals p. 72
Pradnya Kakodkar, Ravindra Ghooi, Sanjyot Mulay
DOI:10.4103/jdrr.jdrr_57_18  
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Using Gagne's theory and Peyton's four-step approach to teach inferior alveolar nerve block injection p. 75
Abubaker Qutieshat
DOI:10.4103/jdrr.jdrr_42_18  
Developing skills in performing inferior alveolar nerve block injection is an essential element of the dentistry undergraduate curriculum. As a dental faculty staff member working in the conservative dentistry department, I provide preclinical and clinical teaching for dental students. This study presents a lesson plan for this injection technique using a combination of Gagne's nine events of instruction and Peyton's four-step approach. Gagne's nine events of instruction identified the mental conditions of learning that are necessary for effective learning when adult students are presented with various stimuli. This model is based on the nine instructional events used during a teaching session. These are gaining attention, defining learning objectives, stimulating recall of prerequisite learning, presenting the stimulus material, providing learning guidance, practice, providing feedback, assessing the performance, and enhancing retention and transfer. Peyton's four-step approach is a model for teaching practical skills. These are demonstration, deconstruction, explanation, and performance. Each step in this lesson plan is carefully arranged with relevant activities to suit learners with various learning styles using Gagne's theory, while Peyton's approach is incorporated to teach the actual skill. This lesson plan is particularly relevant for tutors designing injection techniques teaching for undergraduate dental and medical students and fresh graduates. In all, this lesson plan also serves as a template on which many other practical skill teachings can be subsequently modeled. The flexible adoption of Gagne's nine events of instruction in combination with other instructional models such as Peyton's approach facilitates the planning of effective clinical teaching sessions.
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ORIGINAL ARTICLES Top

Prevalence and distribution of tooth wear in an elderly cohort in Port Harcourt, Nigeria p. 80
Omoigberai Bashiru Braimoh, Grace Onyenashia Alade
DOI:10.4103/jdrr.jdrr_37_18  
Background: The retention of natural teeth and tooth wear is observed to be increasing among old people. Consequently, tooth wear may become a major dental problem among old people. Therefore, the purpose of this study was to determine the prevalence and distribution of tooth wear among the elderly in Port Harcourt, Rivers State, Nigeria. Subjects and Methods: The study was an observational research design among the elderly population in Port Harcourt, Rivers State. The subjects were selected by systematic random sampling and data collected using pilot-tested questionnaire. Tooth wear was recorded using tooth wear index, of Smith and Knight. Data were analyzed using Statistical Package for Social Sciences version 20. Chi-square analysis was used to test association between variables, and statistical significance inferred at P < 0.05 at 95% confidence interval. Results: The prevalence of tooth wear among the study participants was 83.2%. Approximately 40% had mild tooth wear and 177 had moderate tooth wear. Severe tooth wear was seen in 7.2% of the respondents. Attrition was observed in 10,362 (76.3%) teeth examined. Tooth wear significantly occurred in the mandible than the maxilla (P = 0.023). The prevalence of tooth wear was 38.0%, 28.4%, 19.9%, and 13.7% for the molar, premolar, incisors, and canine, respectively, in the maxilla and mandible combined. Conclusion: The results of this study compare with the findings of other Nigerian studies in a similar population. However, when compared to other studies in similar population from Western cultures and China, the observed pattern of tooth wear was different. Therefore, there is a need to develop appropriate local measures for the prevention of tooth wear lesions.
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Evaluation of clinical consequences postpartial edentulism in patients of Ranchi District: An epidemiological study p. 84
Surender Kumar, Prashant Gupta, Vivek Gupta, Bhavana Gupta
DOI:10.4103/jdrr.jdrr_46_18  
Aim: Partial edentulism is a state of missing one or more teeth in the dental arch and can arise due to multiple reasons including caries, periodontal disease, and trauma leading to deterioration of general health and lifestyle of the patient. Few studies have been documented regarding the behavior of the patients toward the consequences of partial edentulism and span of partial edentulism, but still, there is a paucity of information regarding the clinical findings among various age groups of partially edentulous patients of various regions in India. This study thereby aims to determine the various clinical consequences postpartial edentulism, among different age groups in Ranchi district of Jharkhand, India. Materials and Methods: About 1550 patients were screened and 120 partially edentulous cases were enrolled in this study. General information of the patient was entered in data sheet, and radiograph (orthopantomograph) was done. Information was gathered regarding various periodontal findings including proximal bone loss, drifting of adjacent teeth, supraeruption along with other clinical conditions such as difficulty in chewing, facial collapse, type of partial edentulism (Kennedy's class) to be correlated with age, and period of edentulousness. Results: Among 120 partially edentulous patients, 54.1% males and 45.8% females participated in the study. Among gender correlations, males predominated in Kennedy's Class I, II, and IV pattern of partially edentulousness whereas females showed greater Class III pattern which was statistically significant (P = 0.006). Maximum patients had difficulty in chewing (60%) whereas least presented with facial collapse (17.5%). Proximal bone loss was noted in elderly participants having >1 year of edentulousness (39.1%). Conclusions: Partial edentulousness results in multiple difficulties if not rehabilitated in the right time, thereby onus will be on the dental surgeon to motivate the patient regarding the importance of prosthetic rehabilitation.
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Are three-dimensional plates as effective as superior border plating in mandibular angle fractures? A comparative evaluation of effectiveness p. 88
E Santhosh Kumar, Ramen Sinha, Uday Kiran Uppada
DOI:10.4103/jdrr.jdrr_48_18  
Purpose: The purpose of this study is to evaluate the effectiveness of three-dimensional (3D) miniplates over standard miniplates in the management of mandibular angle fracture. Materials and Methods: This study included 40 individuals who were diagnosed clinically and radiographically to have sustained mandibular angle fracture and subsequently underwent open reduction and internal fixation (ORIF). All participants were divided randomly in to two groups. Group I included 20 patients who underwent ORIF for angle fracture with superior border plating using 2 mm 4 hole with gap miniplate while Group II included 20 patients who underwent ORIF with rectangular 3D miniplate placed through an intraoral incision in conjunction with the use of a trocar through percutaneous route for fixation of plate. Results: Patients who were treated using 3D plates had more pain on visual analog scale score and reduced mouth opening in the immediate postoperative phase. However, the stability at the facture site was superior to that of those treated by superior border plating. Conclusion: 3D plate was found to be standard in profile, strong yet malleable, facilitating reduction, and stabilization at both the superior and inferior borders, thereby giving a 3D stability at the fracture site and early return to normal function.
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An alternative approach to periapical radiography for gaggers p. 93
Sneha H Choudhary, Sheetal M Yamyar, Sunil S Mishra, Vishwas D Kadam, Narendra B Supe, Kuldeep S Patil
DOI:10.4103/jdrr.jdrr_40_18  
Context: Most difficult and common problem, while taking intraoral periapical radiographs in the posterior region of the jaw is gagging. Severe gag reflex at times does not allow periapical radiography causing an additional financial burden on the patient who is then sent for extraoral radiography. Aim: The aim of this study was to device a new technique with which the radiograph of maxillary and mandibular third molars can be obtained without causing much discomfort and additional financial burden to the patient. Settings and Design: The present technique was applied and tested for its validity on the routine patients visiting oral radiology department for radiograph of maxillary or mandibular third molars and who demonstrated severe gag reflex preventing periapical radiography. Subjects and Methods: The present technique required a dental chair, intraoral dental X-ray machine, regular size of two periapical films, and artery forceps. The film is placed parallel to the occlusal plane as in case of occlusal radiography with the embossed dot side facing toward the teeth to be radiographed, and exposures were made. Results: The resulting radiographs taken by the present technique showed a complete image of third molars without causing stimulation of gag reflex and without superimposition of the zygomatic process on roots of maxillary third molars. Conclusion: The present technique can be used satisfactorily for taking third molar radiographs in patients with severe gag reflex.
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Awareness, prevention and management of dental injuries among the kabbadi players of Madurai District p. 97
S Selva, R Karthi, S Aparna, PD Madan Kumar
DOI:10.4103/jdrr.jdrr_51_18  
Aim: The aim of this study is to evaluate the occurrence of dental injuries among kabaddi players, the level of knowledge of the participants about preventive measures and management of dental trauma. Materials and Methods: A cross-sectional study was carried out, among 100 players aged 16–25 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sports activities, the use of mouthguard and the athlete's awareness regarding the use of mouthguard. Results: The respondents consisted of males (84%) and females (16%) with a mean age of 18.5 years. Out of the total participants, 29% had chipping or fracture of teeth, 100% had soft-tissue laceration, 12% had avulsion of teeth, and 30% had suffered fracture of jaw/bones. Nearly 5% knew that it was possible to replant the teeth. 83% did not know what is the best time to put the teeth back in the mouth, 91% answered that they would carry avulsed tooth in water, 3% wrapped in cloth, and 6% answered others. Nearly 42% were aware that mouthguards prevent injury. Nearly 3% used mouthguards. Conclusion: Level of awareness and knowledge about sports-related orofacial injury are very poor among kabaddi players in Madurai. Education on the prevention of orofacial trauma should be given to the coaches and players. Wearing of mouthguards during sports activity should be compulsory during practice and competition events.
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