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   Table of Contents - Current issue
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January-March 2021
Volume 8 | Issue 1
Page Nos. 1-68

Online since Thursday, February 25, 2021

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ORIGINAL ARTICLES  

Effectiveness of a lecture-based educational module for parental knowledge regarding infant oral health care p. 1
Gauri Shailesh Lele, Dipti Gholap
DOI:10.4103/jdrr.jdrr_101_20  
Context: As parents are primarily responsible for their infant's oral health, it is dependent on their beliefs, attitude, and knowledge. Thus, educating parents by providing anticipatory guidance could help in improving the oral health of infants. Aim: To test the effectiveness of a lecture-based educational module in the improvement and retention of parental knowledge regarding infant oral health care. Setting and Design: This interventional study, with the inclusion of 110 parents of infants, was carried out in the Departments of Pediatric Dentistry, Pediatrics, and Gynaecology. Subjects and Methods: An educational module in the form of a brief lecture using a power-point presentation was prepared. This included the key features of anticipatory guidance such as the importance of healthy pregnancy, diet and nutrition, oral hygiene maintenance, feeding practices, development of teeth, causes and sequelae of early childhood caries, importance of early and regular dental visits, and treatment of carious primary teeth. Parental knowledge regarding infant oral health was assessed before and after the intervention, and later at a 3-month interval, based on their responses to a validated questionnaire. Statistical Analysis Used: Percentage analysis was used to observe the change in, and retention of parents' knowledge. Results: There is a lack of basic knowledge among parents regarding infant oral health care. The lecture-based educational module was found to be effective in improving parental knowledge and in its retention over a 3-month period. Conclusions: The lecture-based education module was found to be an effective tool in providing anticipatory guidance to parents regarding infant oral health.
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Awareness, attitudes, and practices related to oral potentially malignant disorders and oral cancer among indigenous medicine practitioners in the Western Province, Sri Lanka p. 7
Prasanna Jayasekara, Priyanga A Gamage, Pemith R Liyanage, Nilanthi T Kossinna
DOI:10.4103/jdrr.jdrr_95_20  
Introduction: Oral cancer is a major public health problem in Sri Lanka. Health-care professionals have an important responsibility in control of oral potentially malignant disorders (OPMDs) and oral cancer. Since a considerable number of patients in Sri Lanka seek treatment from indigenous medicine practitioners (IMPs) for common oral conditions, they can be utilized for oral cancer control program. Aims: The aim of this study was to assess awareness, attitudes, and practices related to OPMDs and oral cancers among IMPs of government Ayurveda health-care centers in the Western Province, Sri Lanka. Subjects and Methods: A descriptive cross-sectional study was conducted among 338 of IMPs working in government Ayurveda health-care centers in the Western Province, Sri Lanka, from July 2018 to October 2018. A self-administered questionnaire was used to assess the awareness, attitudes, and practices. Statistical Analysis Used: Chi-square test and Fisher's exact test were used to detect associations with 0.05 significance level. Results: The response rate was 89.6%. Most of IMPs (63.7%) possessed satisfactory awareness, while 64.4% of IMPs had positive attitudes regarding OPMDs and oral cancer. Majority (83.5%) believed that lime in betel quid contains carcinogens. Majority of them were willing to do opportunistic screening (90.7%) and they considered it as their responsibility (92.1%). Only 41.3% of the IMPs examine oral cavity routinely and 55.5% of them advice patients regarding risk factors of OPMDs and oral cancer. Conclusions: Majority of IMPs possessed satisfactory overall awareness and positive attitudes regarding OPMDs and oral cancer. However, practices of IMPs related to OPMDs and oral cancer need to improve.
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Self-medication practices and ignorance to seek treatment for oral health problems amongst adult dental patients: A cross-sectional survey Highly accessed article p. 12
Mouttoukichenin Surenthar, Jimsha Vannathan Kumaran, Subramanian Vasudevan Srinivasan, Mariappan Jonathan Daniel
DOI:10.4103/jdrr.jdrr_67_20  
Background: Self-medication is one of the major health concerns worldwide, and the World Health Organization has laid emphasis on correctly investigating and controlling it. Self-medication turns public and professional concern regarding imprudent practices, which has dramatically increased during the past few decades, especially in the developing countries. Aim and Objective: The aim of this study was to assess the self-medication practice for oral and dental health problems among adult dental patients in a teaching hospital, and the objective was to find the association between self-medication and ignorance in seeking dental treatment among those patients. Materials and Methods: This study was conducted among 100 participants with 50 males and 50 females from outpatient block, with various oral health problems. Results: The prevalence of practice of self-medication was 87% among dental patients irrespective of their oral health problem and was 70.1%, which was exclusively for oral health problems among those 87%. About 44.2% of the respondents answered that the professional operative procedures weaken the teeth, and about 24.5% of the respondents fear that dentists prescribed drugs would cause side effects, and this might be the reason behind these patients undertaking self-medication which was highlighted in this study. Conclusion: The increased prevalence of self-medication in this study was alarming with analgesics being the most commonly used drug without even considering the toxic effects of it. This study emphasized that there is a paramount need for educational programs on the public associated with indiscriminate usage of drugs in which all health-care providers including pharmacists should play a vital role, and the government should also emphasize on formulating new techniques on the sale of drugs which could reach both literate and illiterate individuals.
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Comparative evaluation of the cleaning efficacy of two commercially available buffered sodium hypochlorite solutions by measurement of lateral penetration of sealer into radicular dentin: A fluorescence microscopic study p. 16
Poorva Kurtarkar, Shalini D Aggarwal, Rhea Digholkar, Prasanna Dhatavkar
DOI:10.4103/jdrr.jdrr_71_20  
Aim: The aim of this study was to assess and compare the efficacy of two commercially available sodium hypochlorite (NaOCl) solutions by measurement of lateral penetration of sealer into radicular dentin using fluorescence microscopy – an in vitro study. Materials and Methods: Thirty-six roots were obtained and stored in 0.5% thymol solution. Roots were then randomly allocated to the respective groups – Group I (control group): roots irrigated with 3% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) solution (n = 12), Group II: roots irrigated with chloraxid extra (solution of 5.25% NaOCl with surfactants) with n = 12, and Group III: roots irrigated with ChlorOQuick (solution of 5% NaOCl with 9% etidronic acid solution) with n = 12. Root canal preparation was done, and samples were obturated using AH plus sealer mixed with rhodamine dye. Slices of 0.5 mm thickness were mounted on glass slides and examined with fluorescence microscope. Statistical Analysis Used: Student's unpaired t-test and one-way analysis of variance with Tukey-Kramer multiple comparison test were used for statistical analysis. Results: There was no significant difference between mean values of measurement of lateral penetration of sealer into radicular dentin when Group I, Group II and in Group III compared each other (P = 0.3598). Group I (control group – 3% NaOCl followed by 17% EDTA) permitted the maximum amount of sealer penetration laterally into the dentinal tubules from the root canal lumen followed by Group II (5.25% NaOCl modified with surfactants). Group III (5% NaOCl + 9% etidronic acid) showed the least sealer penetration in this study. Conclusions: Within the limitations of this study, we could conclude that the cleaning efficacy of modifications to NaOCl provided results similar to the conventional irrigation protocol and hence could be used as a stand-alone irrigant.
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Studies on cytokine production in gutkha and panmasala chewers p. 20
Meghmala Sheshrao Waghmode, Gaurav Kumalakar Gaikwad, Mayur Anil Ghule, Pravin Jaysingh Indalkar, Neha Nitin Patil
DOI:10.4103/jdrr.jdrr_108_20  
Panmasala is one of the products which have been favored by the people of all ages In Indian. It contains areca nut, lime, flavoring agents and catechu. It holds prominent place in Indian market. It has been reported to affect human health by causing oral cancer and dysfunctioning of vital organs. Current research was carried on testing the effect of saliva of panmasala eaters on cytokine production by peripheral blood mononuclear cells (PBMC's). Panmasala (Vimal) and Gutkha (RMD) were used for the study of cytokine modulation. MACSPlex Cytokine12 assay was used for the estimation of cytokine after treatment of PBMC's with the saliva of panmasala eater. Concentration of cytokines (IL 10, IL 12, L 17, IFN α, IFN γ, TNF α, GM CSF,IL 4,IL 6,IL 5,IL 2 and IL 9) was found to be increased in the sample containing PBMC's treated with the saliva of panmasala. Based on the findings supported with the statistical analysis, it can be concluded that panmasala and gutkha have negative impact on immune function. There is a strong need to generate social awareness about health hazards of pan masala and gutkha.
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Comparative evaluation of novel gel-containing curcumin, Aloe Vera, and honey with triamcinolone acetonide as an adjunct to oral physiotherapy in oral submucous fibrosis patients: A pilot study p. 25

DOI:10.4103/jdrr.jdrr_82_20  
Background and Objective: Oral submucous fibrosis (OSMF) is a juxtraepithelial inflammatory reaction followed by fibro elastic change of lamina propria. Hence, the inflammation is a definite component of OSMF. Combinations of turmeric, Aloe vera, and honey have antioxidant and anti-inflammatory effects which may act synergistically to serve as beneficiary for treating OSMF disease. Hence, the present study aims to compare the efficacy of topical application of novel gel containing curcumin, Aloe vera, honey, and physiotherapy with 0.1% triamcinolone acetonide and physiotherapy in the reduction of clinical signs and symptoms of OSMF patients. Materials and Methods: A total of 20 clinically diagnosed OSMF patients were divided into two groups containing 10 patients each. Participants including in Group A were treated with topical application of novel gel-containing curcumin, Aloe vera, and honey along with physiotherapy. Group B patients were treated with the topical application of 0.1% triamcinolone acetonide along with physiotherapy. Participants were evaluated at baseline and at the 7th day, 14th day, and 21st day. They were evaluated for mouth opening (maximum interincisal distance) and burning sensation (Visual Analogue Scale). Results: The reduction in burning sensation and increase in mouth opening is observed in both the groups. Both groups showed no statistically significant difference. Thus, both are statistically equally effective. Reduction burning sensation at the 21st day was more in Group A than in Group B, but difference is not statistically significant. Conclusion: Novel gel is as effective as topical steroid triamcinolone acetonide in reducing the signs and symptoms of OSMF.
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The interrelation among configuration of embrasure and recession of median papilla p. 31
Arti Jayman Raval
DOI:10.4103/jdrr.jdrr_122_20  
Background: The aim of this study was to find interrelation among embrasure configuration and recession of median papilla was. To assess impact of extent from the point of contact to bone crest (BC) on the existence of the interproximal papilla by radiographic method and to evaluate the extent between the papilla tip (PT) to the BC by comparing clinical and radiographic methods were the objectives. Methods: With the use of periapical radiographs (paralleling cone technique in RVG with grid) of the maxillary central incisors, the central papilla was evaluated in 100 adults. To evaluate and compare the extent between PT and BC, bone sounding was used. The vertical measurements were: papilla recession, contact point (CP) to BC, CP to proximal cement-enamel junction (pCEJ), and papilla height. The interdental width was the horizontal measurement. According to width interproximally and pCEJ to point of contact extent, total four study groups were divided: long narrow, short narrow, long wide, and short wide. Results: The comparison among radiographic method and clinical method revealed that there was statistically no significant difference between two methods among long-narrow and short-wide group. However, statistically significant difference was noted among short-narrow and long-wide group. Conclusion: Median papilla recession was associated with a wide-long type of embrasure configuration. Although many features such as periodontal phenotype and shape of teeth may influence the probability of the existence of the inter-proximal papilla, therefore the interconnections between these factors are not clear and require further research.
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A survey about knowledge, attitude, and practice of oral health among the students of Faculty of Medicine, Medical College, Vadodara – A comparative study p. 36
Arti Jayman Raval, Shoyeb K Shaikh
DOI:10.4103/jdrr.jdrr_123_20  
Background: Oral health is essential for maintenance of good mental and physical health. The relationship between knowledge and better oral health has been well recorded. The aim of this study was to evaluate, assess, and compare about knowledge, attitude, and practice of oral and periodontal health in the professionals of medical, physiotherapy, and nursing. Materials and Methods: A survey was carried out among the students of Faculty of Medicine, Medical College Vadodara. Three hundred students were chosen using a simple random sampling method, and a self-constructed 15-item questionnaire about oral and periodontal health awareness was allotted to all students. Descriptive statistics such as mean, one-way analysis of variance, and post hoc test was used to compare overall oral and periodontal health awareness and knowledge among the students. Results: A considerable lack of oral hygiene awareness and limited knowledge of oral hygiene practices even in health professionals were noted. Conclusions: Therefore, there is an immediate requirement for extensive educational programs to encourage good oral health and conduct various learning programs about the right oral hygiene practices even in health professionals.
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CASE REPORTS Top

Management of invasive cervical resorption in maxillary incisors with cone-beam computed tomography: A case series p. 40
Murugadoss Vaanjay, Ernest Prince, I Anand Sherwood, V Nivedha, J Evangelin
DOI:10.4103/jdrr.jdrr_83_20  
The purpose of this case report is to highlight the importance of cone-beam computed tomography, magnification, thermoplastic gutta-percha obturation, trichloroacetic acid, and bioactive endodontic cement usage in diagnosis and efficient management of invasive cervical resorption (ICR). Patients with predisposing factors associated with ICR, especially trauma of maxillary incisors, need close periodic monitoring to prevent the progression of the resorptive activity and initiate early management.
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A modified protocol for periodontally accelerated osteogenic orthodontics using piezocision and platelet.rich fibrin in accelerating extraction space closure p. 46
Jinsa N Joseph, A Shanaj Doulath, Aniruddh V Yashwant, Pratebha Balu
DOI:10.4103/jdrr.jdrr_91_20  
Periodontally accelerated osteogenic orthodontics, a newly evolved technique, involves a combination of corticotomy followed by placement of bone graft and orthodontic force application for the closure of extraction space. This interdisciplinary approach has solved the issue of increased treatment duration by accelerating extraction space closure. The index case describes corticotomy procedure done using piezocision technique along with platelet-rich fibrin placement that has enhanced tooth movement, improved wound healing, and reduced adverse effects including root resorption and damage to periodontium. It was concluded that the orthodontic tooth movement was increased postsurgery, thereby lessening treatment duration and patient discomfort.
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Gingival Depigmentation p. 51
Raju Y Anarthe, Amit M Mani, Vinay H Vadvadgi, Shriram Suresh Kendre, Snehal B Sinare, Shruti S Deshmukh
DOI:10.4103/jdrr.jdrr_105_20  
Gingival hyperpigmentation is the condition where melanin deposition occurs in the suprabasal cell layers of the gingival epithelium. Gingival hyperpigmentation is a multifactorial benign condition which causes esthetic concern to the person. Melanin is a nonhemoglobin-derived pigment formed by melanocytes, which are dendritic cells of neuroectodermal origin in the basal and spinous layers. Melanin is a brown-colored pigment, and it is the result of endogenous pigmentation. The deposition of melanin pigment darkens the color of the gingiva. Many individuals visit the dentist or periodontist to seek the treatment of hyperpigmentation of the gingiva. Gingival pigmentation is usually considered as a genetic factor and affects different races differently. Various treatment modalities are available to remove gingival hyperpigmentation which includes scalpel technique, abrasion using diamond bur, laser therapy, electrosurgery, cryotherapy, chemical cauterization, depigmentation followed by gingival autografts, or platelet-rich fibrin. The present case report describes the case of gingival hyperpigmentation managed by scalpel technique and abrasions by diamond bur which is a simple and a cost-effective technique with satisfactory results.
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REVIEW ARTICLES Top

Ramadan fasting and dental implications: A special review p. 55
Sanjeev Tyagi, Nitish Mathur
DOI:10.4103/jdrr.jdrr_86_20  
Fasting during the holy month of Ramadan is considered obligatory for all Muslims. It is regarded as one of the five pillars of Islam in which all the followers observe complete abstinence from food and fluid during daylight hours. Such a strict practice has built up hesitations among the followers to go for a dental treatment. This article aims to describe the modifications in the dental practice required for Muslims during this month alongside the oral health-care tips. A dentist should consider these alternatives and appreciate the religious custom so as to provide a compassionate service.
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COVID-19 outbreak: A renaissance in dentistry p. 59
Neha Singh, Vivek Gupta, Santosh Kumar Verma, Priyanka Kumari
DOI:10.4103/jdrr.jdrr_72_20  
The novel coronavirus which originated from the city of Wuhan, China, in late 2019 has put the entire human race at risk. The widespread destruction caused by novel coronavirus has led the World Health Organization to declare it a pandemic disease on March 11, 2020. Health workers, especially the dentist, are at great risk of getting infected due to the nature of dental procedure which requires close proximity to the patient's mouth. The risk of cross-infection from dental settings is high, so proper infection control measures are required to restrict the spread of infection. This article focuses on the effect of COVID-19 on dental fraternity, its management in dental setup to restrict cross-contamination, and information on various guidelines issued to render their services in COVID-19 situation.
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Biofeedback in oral cancer pain: A review p. 65
Roopa Yadahalli, Gargi S Sarode, Sachin C Sarode
DOI:10.4103/jdrr.jdrr_112_20  
Pain is one of the initial symptoms in oral cancer, and is a prevalent condition in patients who are waiting for the treatment and in those undergoing treatment. Literature reviews very little data on the management of oral cancer pain nonpharmacologically. Successful management of pain control needs to be tackled by a multimodal approach. There is no confirmation of the effectiveness of nonpharmacological ways as relaxation, imagery, hypnosis, distraction, and biofeedback for the treatment of oral cancer pain. Recently, biofeedback and relaxation therapy are known to be a potential treatment for an extensive range of conditions. This biofeedback therapy can be applied to oral cancer pain management through the muscle relaxation technique is being covered in the present review.
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