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   Table of Contents - Current issue
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April-June 2021
Volume 8 | Issue 2
Page Nos. 69-141

Online since Friday, July 16, 2021

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ORIGINAL ARTICLES  

A pilot knowledge, attitude, and practice survey among pediatric dentists during COVID-19 pandemic Highly accessed article p. 69
Priyanka Kashyap
DOI:10.4103/jdrr.jdrr_156_20  
Introduction: COVID-19 pandemic has brought a drastic change in the way of practising dentistry. Adequate knowledge and training on prevention of this contagion will allow dental professionals to practise safely. The aim of the survey was to assess the knowledge, attitude, and practice of pediatric dentists during COVID-19 pandemic. Materials and Methods: This is a prospective pilot online survey among pediatric dentists in India. A self-explanatory, online questionnaire comprising 20 close-ended questions in English language was formulated via Google Forms. Results: We received a total of 55 responses. Overall knowledge was fair in 6/55 (10.9%) participants and majority (49/55; 89.1%) had good knowledge. Nearly all participants were changing gloves, performing temperature checks, and taking COVID-19-related history for each patient. However, only 75% (approx.) participants were sanitizing dental chair and surrounding surfaces after each patient visit. More than 90% of participants had received training for wearing personal protective equipment (PPE), but 27% (15/55) felt that they do not have adequate PPE. PPE most worn by respondents were gloves (52/55, 94.5%) and face shield or N95 mask (51/55; 92.7%), followed by surgical mask (46/55, 83.6%). Only 50% of respondents (approximately) were using goggles during routine dental practice. Nearly 96% of participants faced difficulties in communication and majority agreed that it interferes with patient management. About 98% of respondents felt that COVID-19 pandemic has reduced the frequency of patients. The most preferred mode of practice by pediatric dentists during COVID-19 pandemic was private practice as well as teledentistry. Conclusion: Majority of participants (89.1%) had a good level of knowledge about COVID-19 disease and were following adequate safety precautions to prevent its spread in their practice. We recommend all dental professionals to get proper training and follow guidelines by various agencies (CDC, WHO, and the American Dental Association) to prevent the spread of COVID-19 and ensure best dental practices.
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Cyclin D1 and nuclear factor kappa B expression in oral squamous cell carcinoma, oral submucous fibrosis, and oral squamous cell carcinoma associated with oral submucous fibrosis – An analytical cross-sectional study p. 75
Deepali Patekar, Sachin C Sarode, Gargi S Sarode, Pravin More
DOI:10.4103/jdrr.jdrr_153_20  
Background: According to statistics, oral squamous cell carcinoma (OSCC) is regarded as commonest cancer of the oral and maxillofacial region, having about 83% prevalence over the recent years. The prognostic accuracy of the cancer is determined by the stage of its detection and the onset of treatment. Expression of certain immunohistochemical markers such as cyclin Dl and nuclear factor kappa B (NF-κB) and their role in prognosis at an early stage would alter the treatment planning of such cases. Aim and Objectives: To assess and determine cyclin D1 and NF-κB expression using immunohistochemistry in OSCC, oral submucous fibrosis (OSMF) and OSCC associated with OSMF. Materials and Methods: An analytical cross-sectional study was conducted using 72 paraffin embedded and formalin fixed blocks of tissue retrieved from oral pathology department archives in a dental college. These bocks were categorized as cases equally divided into three groups. Group I consisted of 24 cases of OSCC; Group II consisted 24 cases of OSMF; and Group III consisted of 24 cases of OSCC-OSMF. Further, the cyclin D1 and NF-κB expression was evaluated and scoring criteria was followed by Soini et al. Statistical analysis was done using Pearson's correlation coefficient and Chi-square test, keeping 95% confidence intervals and having a P ≤ 0.05 statistically significant. Results: A moderate positive correlation was observed among cyclin D1 immune expression and NF-κB with the Dysplasia grades and Clinical stages in patient with OSMF, whereas a weak positive correlation was observed amongst cyclin D1 immune expression with Grades and TNM stages of OSCC patients. Conclusion: Our study concludes that there is significant expression of cyclin D1 and NF-κB amongst OSCC, OSMF, and OSCC-OSMF cases. Therefore, they could be considered important biomarkers, which act synergistically and can be used for the evaluation of the malignant potential of oral lesions.
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Investigation of the change in color caused by the contact of calcium silicate-based materials with endodontic irrigation solutions p. 82
Osman Atas, Ahmet Aras
DOI:10.4103/jdrr.jdrr_134_20  
Introduction: Although calcium silicate-based cements are very successful in healing, they cause esthetic problems and dissatisfaction, especially in anterior teeth because they cause discoloration in the teeth. This study aimed to detect the color changes that occur as a result of contact of BIOfactor mineral trioxide aggregate (MTA) and biodentin with three different irrigation agents. Methods: The materials to be tested (G1: BIOfactor MTA and G2: Biodentin) were prepared as per the manufacturer's directions. The prepared materials were placed in cylindrical molds of 8 mm diameter and 3 mm height and kept in a 37°C oven for 24 h to complete their hardening. Subsequently, the samples were immersed in one of three different irrigation solutions (5% sodium hypochlorite, 17% ethylenediaminetetraacetic acid [EDTA] or saline) for 24 h. After drying, spectrophotometer was utilized to quantify color under consistent laboratory light by the same administrator. Results: Significantly, more color changes were observed in the G1 group compared to the G2 group (P = 0.05). Although color changes were detected in all subgroups of G1 and G2 groups as a result of contact with different irrigation materials, it was determined that these changes were not statistically significant (P > 0.05). The irrigation agent that caused the most discoloration was saline (12.33 ± 6.87) in G1 group and EDTA (7.05 ± 3.48) in G2 group. Conclusion: As a result of this study, significantly more color changes were found in BIOfactor MTA than biodentin. It was found that different irrigation agents did not cause statistically significant color changes.
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Community-based preventive and oral health promotion programs in early diagnosis of oral disease: A cross-sectional study p. 86
Amanpreet Kaur Bhangu, Ramandeep Singh Gambhir, Latika Nirola
DOI:10.4103/jdrr.jdrr_169_20  
Background: It is very important to identify common oral health problems, particularly in rural areas, and counsel the patients screened for a particular oral disease for early treatment to prevent the progression of oral disease. The present study was conducted among the adult population and school students residing in rural areas to identify any oral disease at the earliest. Materials and Methods: A descriptive cross-sectional study was conducted among schoolchildren and adults residing in rural areas. Seventeen villages were selected on the basis of cluster sampling methodology. A total of 1892 individuals constituted the final sample size after making necessary exclusions. Statistical calculations were done using Chi-square test. Results: A number of school students were 1230 and 662 were adults. A number of male patients having pit and fissure caries were comparatively more as compared to females (45% and 36%, respectively). Periodontal disease and oral precancerous lesions were more prevalent in the 46–60-year age group. There was a statistically significant association between gender and pit and fissure caries in schoolchildren (P = 0.027). Conclusion: It is concluded from the present study that screening camps play a pivotal role in diagnosing a dental disease at the earliest and thus halting its progression.
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Does youtube™ offer reliable information about mini screws? p. 90
Sirin Hatipoglu, Firdevs Veziroglu Senel
DOI:10.4103/jdrr.jdrr_162_20  
Objective: The goal of the present study was to estimate the quality and accuracy of provided data of orthodontic mini-screws related YouTube™ videos. Materials and Methods: In this cross-sectional research, a systematic survey of YouTube™ videos about mini-screws was gathered by applying the term "mini screw." The first 200 videos were viewed and at the end, the study was based on 77 videos. Demographics of videos were recorded. The video content was scored using a 14-point score scale, which was used for the classification of low and high content video groups. The video information and quality index (VIQI) was used to evaluate the quality of videos. Descriptive statistic was used. Distribution of YouTube™ Video Demographics in Low and High content groups was done by using the Pearson Chi-squared test and Fisher exact test. The Mann–Whitney U-test was used to compare the quantitative data, which did not show normal distribution. Spearman's rho correlation analysis was used to investigate the relationships among the parameters. Significance was evaluated as P < 0.05. Results: We sorted 72 videos as low and 5 as high content. Healthcare providers uploaded most of the videos (58.4%). Educational videos were found to be the most (97.4%). Insertion of mini screw (65%), indication, and mechanics (45.5%) were the most; while, cost, oral hygiene (3.9%), and annoyance (5.2%) were the least mentioned topics. The mean "Duration of the videos" and "comments" in the high score group was statistically higher than the low content group. The VIQI Total Scores were found to be significantly higher in the high content group. Conclusion: Although a great variety of information, is available on YouTube™, content was found to be insufficient. Specialists must be aware that patients can use those videos as learning resources, and guide their patients to obtain correct/actual information.
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Self-perceived satisfaction with dental appearance and associated factors among secondary school students in Iringa, Tanzania p. 97
Protas Msungu, Matilda Mtaya-Mlangwa, Karpal Singh Sohal
DOI:10.4103/jdrr.jdrr_140_20  
Introduction: Oral health is not only the absence of oral ailments and dysfunctions but also includes other components that influence a person's social life like satisfaction with one's dental appearance and beauty. This study was done to determine the self-perceived satisfaction with dental appearance and associated factors among secondary school students in Iringa, Tanzania. Methods: This descriptive cross-sectional study was done in the Kilolo district of the Iringa region on the southern highlands of Tanzania. It involved students from four private and four government secondary schools. A self-administered structured questionnaire was used to collect information regarding students' perceptions of their teeth and satisfaction with their dental appearance. Data were entered in a computer program SPPS version 23.0 for analysis. Frequency distribution of different variables was generated, the association between variables was assessed by the Chi-square test, the P value was set at P < 0.05. Results: A total of 787 participants were included, of which 410 (52.9%) were female and the male/female ratio was 1:1.1. The age range was 15–21 years (mean 16.64 ± 1.35 years). Only 27% of the students perceived their dental appearance to be good. About 39% of the students were satisfied with their general dental appearance. There was a statistically significant association between students level of perception of their dental appearance and level of satisfaction with dental appearance Conclusion: The level of self-perceived satisfaction with dental appearance was low among the study participants. The students' self-perceived dental appearance influenced their satisfaction with their dental appearance, unlike factors such as age and sex. Self-satisfaction with dental appearance had a significant impact on the social life of the participants.
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Effects of tobacco chewing on periodontal health in Parsa, Nepal: A comparative study p. 102
Rajesh Shah, Snehashish Ghosh, Abanish Singh, Sartaj Singh Wazir, Harendra Mohan Singh, Rahul Gupta, Anirban Chaterjee
DOI:10.4103/jdrr.jdrr_164_20  
Background: Tobacco chewing in Nepal has been a part of cultural rituals in different since ages. The tobacco products and by-products are detrimental to oral as well as systemic health. Objectives: The objective of the study was to ascertain the causative effect of chewing tobacco in the periodontal health and to alert the society about the deleterious effects of the chewing tobacco. Methods: A comparative, cross-sectional study was conducted among 300 patients visiting the outpatient department of periodontology and oral implantology. The total study population was divided into two groups: tobacco user and nonuser. The study population was further re-categorized based on the duration of tobacco chewing into two groups. Periodontal health status of the participants was assessed using plaque index, gingival index, clinical attachment loss, and probing depth. Mann–Whitney test was used to compare the difference among the outcome variables. Results: Median score of PI was 1.32 (0.66–2.04), GI was 1.33 (0.70–2.06), CAL was 1.46 (0.98–2.10), and PD was 1.22 (0.59–1.86). The difference in PI, GI, CAL, and PD scores was statistically significant when compared among tobacco users and nonusers (P < 0.001) There was statistically significant difference in PI, GI, CAL, and PD when compared among the patients of age group ≤35 years and >35 years (P < 0.001) and the tobacco users consuming tobacco for ≤10 years and >10 years (P < 0.001). Conclusion: The present study revealed a direct impact of tobacco chewing on the periodontal health, with the severity of symptoms increased with the age and duration of the habit.
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Exploring dental anxiety among male and female across adolescents, young adults, and middle adults p. 107
Samina Bano, Syed Ansar Ahmad, Kriti Vyas
DOI:10.4103/jdrr.jdrr_142_20  
Introduction: Dental anxiety is a state of uneasiness and worry, making the patient feels that something terrible will happen to him regarding dental treatment and procedure. Research suggests that dental anxiety is a prominent factor in leading to avoidance of dental treatment by the patients. The intensity of dental anxiety varies individually and across gender. Research suggests that adopting healthy dental care habits encourages good oral health, contributing to the quality of life, whereas poor dental habits can lead to dental problems. Therefore, the present study attempts to explore the level of dental anxiety and dental care habits across age groups and gender. Methods: The sample consists of 150 patients from Delhi/National Capital Region. They were divided into three age groups – adolescence (n = 50), young adulthood (n = 50), and middle adulthood (n = 50). Modified Dental Anxiety Scale was used to assess dental anxiety and a semi-structured interview was taken to assess the level of dental hygiene among the patients. Results: there are statistically significant differences in dental anxiety scores between males and females. Our results also point that these gender differences persist across age groups – adolescence, young adulthood, and middle adulthood on dental anxiety. Conclusion: The findings reveal higher dental anxiety levels among adolescents, which gradually increase with age. Furthermore, females are more susceptible to have dental anxiety than males. Thus, dental professionals should provide age and gender-targeted counseling to avoid dental anxiety among their patients.
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Knowledge and attitude of dentists toward cone-beam computed tomography in and around salem district: A questionnaire survey p. 113
K Aswin Revanth, N Mohan, Sarrama Mathew, R Karthik, PT Ravikumar, Sabitha Gokulraj
DOI:10.4103/jdrr.jdrr_141_20  
Introduction: Cone-beam computed tomography (CBCT) is a revolutionary technique that was first created in 1982 for angiography and subsequently extended to maxillofacial imaging. It uses a divergent or "cone-" shaped ionizing radiation source and a two-dimensional (3D) region detector mounted on a rotating portal. During maxillofacial exposure, the radiation exposure dosage from CBCT is 10 times smaller than from conventional computed tomography scans. 3D perception of dental structures is growing quickly and it would not have been conceivable without the accessibility of advanced digital imaging. Materials and Methodology: A questionnaire study was done on 204 participants. The questions were self-designed, structured, and validated e questionnaire. Twenty-five multiple choice e questions were given to the participants. Results: Results were analyzed which shows that the vast majority of the members utilize advanced imaging in their daily schedule. Easy to store information and shorter time was the primary motivation to utilize CBCT than contrasted with less radiation dose. Advantages were data reconstruction and lower radiation dose followed shorter scan time, free from processing of radiograph. Discussion: Easy to store information and shorter time was the primary motivation to utilize CBCT. The most significant factor for preferring CBCT over digital imaging was the reduced radiation dose. The advantages were data reconstruction and lower radiation dose followed shorter scan time. Conclusion: In evaluating oral and maxillofacial pathologies with a reduction in radiation exposure, CBCT has a major role. Dental specialists should support CBCT imaging only as they expect that diagnostic performance can favor the still mind, improve persistent well-being, or significantly improve health outcomes. CBCT is one of the most notable recent developments in today's dentistry.
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REVIEW ARTICLES Top

Efficacy of natural tooth pontic in periodontally compromised patients: A systematic review p. 117
Prajakta Sugdeo Umarkar, Sharath K Shetty, Anita M Kulloli, Santosh Martande, Dharmarajan Gopalakrishnan
DOI:10.4103/jdrr.jdrr_148_20  
Periodontitis is a major concern for the dentist because the destruction of periodontal fibers causes mobility of teeth and eventually leads to tooth loss. Conventional techniques like removable temporary acrylic prosthesis, or resin-bonded bridges hold their own disadvantages and a fixed prosthesis may worsen the existing condition. Natural tooth pontic (NTP) in such cases may be advantageous in terms of esthetics and patient satisfaction along with cost effectiveness. Hence, the aim of this review was to evaluate the efficacy of NTP in periodontally compromised patients. Electronic search on data sources such as PubMed and Google scholar along with hand searching of the articles was done in institutional library. All case reports and case series were included in English language published till October 31, 2019, were included. After applying inclusion and exclusion criteria, ten articles were selected for the present review. The whole process was conducted by following the Preferred Reporting Items for Systematic Reviews guidelines. Our review noted that all the patients were satisfied with the appearance of the tooth and also comfortable in maintaining the oral hygiene as these pontics had a ridge lap design. Survival rate was 100% except for the case series which reported a survival rate of 75% while few others did not report anything since no follow-up was conducted. Overall NTP was well accepted by the patients. NTP can be of a great option as prosthesis in the patients with compromised periodontium. Patient's positive satisfaction, cost viability, and accomplishment of appearance in the esthetic zone of the oral cavity make this strategy as a valuable treatment option.
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Forensic odontology for general dentists p. 126
Rohan Ashok Gawali
DOI:10.4103/jdrr.jdrr_147_20  
Forensic odontology is the application of knowledge of dentistry for legal causes. Although Forensic odontology as a subject is new to the Indian scenario, its importance has been very well documented in global literature. Teeth are the hardest structures in the human body and they resist the challenges posed by nature very well. Furthermore, teeth are unique for each individual. Dr. Oscar Amoedo identified many victims of the Paris Charity Bazaar fire disaster with the help of dentition. Since then Dr. Oscar Amoedo is recognized as the 'Father of Forensic Odontology.' A general dental practitioner is central to many aspects of forensic odontology such as disaster victim identification, identification of recovered human remains, denture marking, and detecting abuse cases.
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Personal protective equipment: A solution to occupational hazard or an occupational hazard itself? p. 132
Neha Verma, Meenu G Singla
DOI:10.4103/jdrr.jdrr_152_20  
Personal protective equipment (PPE) has become an important and much talked about subject during the current coronavirus pandemic. Since the dental profession predominantly involves exposure of the dentist to various body fluids such as saliva and blood., the use of PPE is imperative for infection control in dental practice. However, even though protection is successfully achieved by PPE, such high level of protection is likely to entail additional workloads and occupational hazards on healthcare professionals including dentists. The present review aims to throw light on the occupational hazards that can occur and some tips to alleviate the discomfort following the use of PPE. These methods are relatively simple to follow while maintaining normal healthcare routine.
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SHORT COMMUNICATIONS Top

Green dentistry: A sustainable approach for rural india p. 136
Abhishek Kumbhalwar, Vini Mehta, Ankita Mathur
DOI:10.4103/jdrr.jdrr_144_20  
Oral health is a critical but overlooked component of overall health and well-being among children and adults. There is a need for comprehensive national educational programs to improve the rural population's oral health practice, knowledge, and attitudes.
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Innovative approach to upright anterior tooth p. 139
Harshil Naresh Joshi, Santosh Kumar Goje
DOI:10.4103/jdrr.jdrr_128_20  
Missing mandibular anterior tooth is one of the most commonly missing teeth in the arch. The replacement of the missing tooth can be done by various techniques. Removable partial denture, fixed partial prosthesis, or prosthetic implants is widely preferred. Angulations of the teeth adjacent to the edentulous area are critical because of various factors. In cases of the FPD abutment teeth is supporting tooth. Upright tooth is preferred for better prognosis. In implant placement, sufficient bone must be there to place implant. Uprigation of the adjacent teeth is required for better implant angulation. Here, we have used innovative approach to upright mandibular anterior tooth in minimum time possible.
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LETTER TO EDITOR Top

Probe design: Probing the untold story p. 141
Annuroopa Mahapatra, Kaushik Patnaik, Subash Chandra Raj
DOI:10.4103/jdrr.jdrr_149_20  
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