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   Table of Contents - Current issue
Coverpage
April-June 2021
Volume 12 | Issue 2
Page Nos. 51-103

Online since Wednesday, July 28, 2021

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EDITORIAL  

Dental Articles Shared the Most in Twittersphere in 2020 p. 51
Jafar Kolahi, David G Dunning, Pedram Iranmanesh, Maryam Tofanghchiha
DOI:10.4103/denthyp.denthyp_80_21  
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SPECIAL COMMUNICATION Top

The Application of the Assembly Line to the Delivery of Oral Health Care p. 54
Edward F Rossomando
DOI:10.4103/denthyp.denthyp_107_20  
This paper examines the delivery of oral health care and compares the delivery in 2020 with that before 1900. While equipment and materials have changed, the design of the office, and the use of personnel within the office has remained remarkably similar. The doctor is responsible for diagnosis and treatment with some support services provided by hygienists and assistants. This piece work delivery model contrasts with an assembly line model. The assembly line model is explored here in a hypothetical visit to a dental office in 2025. The paper describes the layout of practice as well as the role of the doctor and auxiliary personnel in the office.
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ORIGINAL RESEARCHES Top

Comparison of Commercially Available 0.12% And 0.2% Chlorhexidine Mouthrinses on Plaque and Gingiva: A Randomized Controlled Trial p. 59
Swarnalatha C., Suresh Babu J., Nada Nasser Almansour, Saleh Ali Almalaq, Fahad Abdulrahman Alnasrallah, Tayf Naif Radhi Alshammari, Mohammad Saafaq Alshammari, Abhishek Singh Nayyar
DOI:10.4103/denthyp.denthyp_62_20  
Introduction: Regardless of potent anti-microbial and anti-plaque properties of Chlorhexidine (CHX), its widespread and comprehensive uses are restricted by local side effects which are mostly dose dependent. Thus, by understanding the properties and limitations of the CHX molecule, consideration has been given to CHX with lower concentrations, though, this, may produce an impact on its activity emphasizing the need for further clinical trials. The present study was, thus, designed to assess and compare the efficacy of commercially available 0.12% (Periogard) and 0.2% (Hexidine) of CHX mouthrinses on dental plaque and gingiva over a period of eight weeks. Materials and Methods: A randomized control, triple blind parallel clinical trial was designed among ninety-nine subjects. The study subjects were randomly distributed into three groups with random allocation of mouthrinses to each group. Plaque and gingival indices were recorded by using Plaque and Gingival indices were recorded by using Turesky, Gilmore and Glickman’s modification of Quigley Hein Plaque Index and Loe and Silness Gingival Index. Statistical analysis was done using IBM SPSS Statistics for Windows version 21 (IBM Corp, Armonk, USA). Wilcoxon matched pairs signed rank test was applied to compare reduction in mean plaque scores and mean gingival scores at different time intervals while pair-wise comparison in between the groups was done by using Mann-Whitney U test. P < 0.05 was considered as statistically significant. Results: Both the 0.2% and 0.12% CHX mouthrinses were effective in controlling plaque and gingivitis over a period of eight weeks. These mouthrinses exhibited significant decreases in mean plaque and gingival scores during baseline to 4th week examination, however, a significant rise in mean plaque and gingival score was noted again from 4th week to 8th week examination. Conclusion: The study concluded that lower concentrations of CHX (0.12%) are as effective as 0.2% of CHX, thereby, use of lower concentrations of CHX can be recommended.
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Oral Complications of Dental Prosthetic for Patients after Chemotherapy and Radiotherapy Treatment p. 67
Waseem Moshtaha
DOI:10.4103/denthyp.denthyp_57_20  
Introduction: Chemotherapy‐ and radiotherapy‐induced oral complication represents a therapeutic challenge frequently encountered in cancer patients. This side effect causes significant morbidity and may delay the treatment plan, as well as increase therapeutic expenses. The current study aimed to measure possible changes in oral microflora in cancer patients wearing dentures before starting and within 3 and 7 days of the first course of chemo/radiotherapy. The researcher seeks to investigate the association between these changes and the distressing oral problems compared with control patients. Material and Methods: The current study performed based on the case-control design in which 46 cancer patients who wear dentures and meet the inclusion criteria were selected from 80 patients as cases or tested group. Another 46 cancer patients who did not wear dentures were matched to be the control group. Based on the international safety standard, the oral microflora of the buccal mucosa was collected and cultured from two saliva samples at T0 (before chemotherapy), T1 (the day after chemotherapy), and T2 (7 days after chemotherapy). A series of descriptive and MacNemar analysis and other statistical tests included independent and paired t-tests, chi-square, were performed to determine significance at P < 0.05. Results: The current study revealed that that 25 patients (54.34%) who developed plaque that consisted predominantly of saprophytic Gram-positive cocci (Streptococcus spp., Leuconostoc spp., Granulicatella spp. and Gemella spp.). By investigation, 15 of these patients underwent chemotherapy/radiotherapy (60%). The other 21 patients (45.66%) developed periodontal pathogens (F. nucleatum, P. gingivalis, Actinobacillus spp. and Pep. micros). Regarding time variation (T0, T1, and T2), no significant differences were reported in bacterial changes. Furthermore, the control group swabs showed that the bacterial count did not change significantly during the observation period and both qualitative and quantitative bacterial growth was not significantly differed from the case group. Conclusion: The results of the current study indicate that there were no significant changes in the growth of microflora observed in the dental plaque and wearing dental of cancer patients within 7 days of the first course of chemo/radiotherapy. Furthermore, no correlation observed between oral mucositis and specific microorganisms.
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Expression of ALP and TGF-β in Osteoblast Cell Cultures after Administering Collagen Peptide Derived from Gouramy (Osphronemus goramy) Fish Scales p. 73
Melissa Tionardus, I Gusti Ngurah Agung Gede Dwija Putra, Noer Ulfah, Agung Krismariono, Ernie Maduratna Setiawatie, Chiquita Prahasanti
DOI:10.4103/denthyp.denthyp_153_20  
Introduction: Collagen peptide extracted from gouramy fish scale has noncytotoxic effects and good viability on osteoblast cells. Various characteristic tests also show that it could form as scaffold with the potential to be a biomaterial graft used in tissue engineering. Studies in this field are vital considering the fact that graft is highly essential for the development and success of regeneration therapy. The aim of the study was to examine the expression of alkaline phosphatase (ALP) and transforming growth factor-β (TGF-β) in osteoblast cell cultures after administering collagen peptide derived from gouramy fish scale. Material and Methods: Osteoblast cells were put into 60 well plates divided into two groups. The first group was to analyze the expression of ALP, while the second group was for TGF-β. Then, each of the group was divided into five other groups consisting of cell control and culture of osteoblast cell having collagen peptide derived from gouramy fish scale with four different concentrations. The collagen peptide was extracted through enzymatic method. Then, the immunocytochemistry assay was used to detect the expression of ALP and TGF-β in the osteoblast cell cultures derived from calvaria mice after administering collagen peptide from the fish scale. The statistical methods used include Multivariate Analysisof Variance (MANOVA) analysis with a significance value of 0.000 (P < 0.05) and Tukey Honest Significance Test (HSD). Results: The statistical results showed that the collagen peptide derived from gouramy fish scales with various concentrations produced significantly different expressions of ALP and TGF-β. Conclusion: The expression of ALP and TGF-β in osteoblast cell cultures increased after administering the collagen peptide derived from the gouramy fish scales.
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Patient Awareness of Oral Health and Periodontal Disease as a Potential Risk Factor of Breast Cancer p. 79
Ahmed Fouad, Fatimah Patel, Maha Al-Thagafi, Mawed Yahya, Mohamed Roshdy
DOI:10.4103/denthyp.denthyp_172_20  
Introduction: Breast cancer (BC) is a public health problem and the most frequent malignancy among women. Oral health is important and directly related to the overall general health of the body; it is dependent and related to oral health knowledge and oral hygiene behavior. Several studies have associated links between BC and periodontal disease (PD). The aim of the study was to assess oral health and periodontal disease awareness and potential risk factors of BC in a sample of Jeddah residents. Materials and Methods: A cross-sectional study was conducted on 106 adults with a self-answered questionnaire in the framework of a community service initiative sponsored by the Ministry of Health on the occasion of the world BC month, where the college students participated in. Results: In our study population, 68.68% of participants expressed proper oral hygiene awareness, while merely 42.72% identified the correct risk factors of BC. Only 12.3% had awareness of PD as a potential risk factor of BC, and their awareness was measured against their oral hygiene and periodontal health awareness, where 92.3% acknowledged the negative effect of oral hygiene neglect on the overall body health, 76.9% heard of dental plaque biofilm, and only 23.1% identified it as the causative of PD. Finally, 61.5% cleaned their teeth twice a day in accordance with the recommendations of the Saudi Dental Society. Conclusion: There is an urgent need for comprehensive educational programs to promote correct oral hygiene practice and educate on its positive impact on the overall body health. The knowledge and awareness on BC and PD can still rise by community services and awareness campaigns throughout the city of Jeddah.
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Saliva as a Diagnostic Aid in COVID-19: A Boon for Dentistry p. 87
Prashant Shetty, Barkha Udhani, Saleem D Makandar, Rabihah Alawi, Tahir Yusuf Noorani, Neetu Jha, Pradeep A Bapna
DOI:10.4103/denthyp.denthyp_180_20  
Introduction: Coronavirus disease 19 (COVID-19) is a highly contagious and virulent infection caused by severe acute respiratory syndrome coronavirus 2. The symptoms arise within 2 to 14 days after the infection. The specimens are collected from the upper respiratory tract through nasopharyngeal and oropharyngeal swab. This sampling requires close contact with COVID-19 patients and may directly cause transmission to health care professionals. Saliva specimens can be collected easily by asking patients to spit into a sterile container. Materials and Methods: In the current study, the selected patients (n = 20) were those who tested positive for COVID-19 and were admitted to the hospital. After getting approval from ethical committee of the hospital, both nasopharyngeal swab specimens and the salivary samples of each patient were collected and tested using standard procedure of real-time polymerase chain reaction. Results: The mean cycle threshold values obtained from both the sampling techniques were correlated. It was seen that there was no significant difference between them. The advantage of using saliva as a specimen is in the overall specimen collection procedure and its cost and time effectiveness. The diagnosis of COVID-19 through a rapid test procedure using salivary samples could be a boon to dentists. Conclusion: This would help in the detection of positive asymptomatic carriers of the virus among the patients who come to seek dental treatment and reduce the risk of infection in the dental office. The results of this study clearly show that the values obtained from the two sampling techniques are closely related, and hence saliva could definitely be considered as a diagnostic aid for COVID-19.
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In Vitro Osteogenic Potential of Freeze-Dried Homologous Platelet-Rich Plasma p. 91
Kwartarini Murdiastuti, Niken Olivia, Wiwin-winda Kusumadewi, Nandini Sumito
DOI:10.4103/denthyp.denthyp_183_20  
Introduction: Platelet-rich plasma (PRP) is paid attention for regenerative therapy because it clinically improves neoangiogenesis and periodontal regeneration. PRP can be made in form of homologous PRP (HPRP) from healthy, screened, and habitual blood donors and freeze-dried to increase stored time of HPRP and maintain growth factors. The purpose of this study is to evaluate freeze-dried homologous platelet-rich plasma (FD HPRP) on osteogenesis. Material and Methods: HPRP was taken from the blood bank and then a freeze-drying and γ-radiation process was carried out with doses of 20 and 25 KGy, respectively, for the sterilization. Blood was collected as much as 10 mL and then centrifuged at 700 rpm for 3 minutes to produce injectable platelet-rich fibrin (iPRF) as a positive control. Cell line MG63 were cultured to confluent, and then treated with FD HPRP 20 kGy, FD HPRP 25 kGy, iPRF, and one group non treated as a negative control. Osteocytes were determined based on morphology after hematoxylin staining to see the differentiation process. The data were analyzed using one-way analysis of variance (ANOVA). Results: There was a significant difference in the number of osteocytes between FD HPRP and negative control (P < 0.05). The number of osteocytes FD HPRP 25 was higher than FD HPRP 20. Conclusion: The present results indicate that FD HPRP could support the bone regeneration and used without any preparation like fresh PRP.
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ORIGINAL HYPOTHESIS Top

Topical Oral Melatonin Application Could Potentially Reduce the Risk of Orthodontic Appliance-Induced Periodontal Deterioration p. 96
Thodur Madapusi Balaji, Raghunathan Jagannathan, S. Murukesan, Swaminathan Rajendran, Lakshmi Priya Sridhar, Saranya Varadarajan, Deepika Rajendiran
DOI:10.4103/denthyp.denthyp_125_20  
Introduction: Although patients derive numerous aesthetic and functional benefits by wearing orthodontic appliances, they also undergo some adverse changes in the oral cavity such as chronic generalized marginal gingivitis and localized gingival enlargements that can be concerning. Salivary changes following placement of fixed orthodontic appliances have been documented by numerous research papers. The Hypothesis: Melatonin in the form of an orabase gel with 1% to 2% concentration applied daily topically on the gingival tissues throughout the orthodontic treatment phase could boost the salivary antioxidant levels, neutralize the nickel and chromium toxicity, potentially attenuating inflammation, and fibrotic enlargements of the periodontal tissue. Evaluation of the Hypothesis: Testing the abovementioned hypothesis will involve a randomized double-blinded clinical trial with a placebo and test orabase gel with 1% to 2% melatonin as an active drug agent. Testing and validating the proposed hypothesis will throw open a new vista in using melatonin as a topical adjuvant in orthodontic appliance wearers.
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Attention-Deficit/Hyperactivity Disorder Symptoms can be Reduced by Effectively Treating Obstructive Sleep Apnea with Oral Appliances: A Hypothesis p. 99
Lina Escobar, Héctor L Rodriguez, Jaime E Castellanos
DOI:10.4103/denthyp.denthyp_123_20  
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and can persist until adulthood. This disorder negatively affects almost all personal, academic, and work fields and often strains parent-child relationships. On the other hand, obstructive sleep apnea (OSA) is characterized by episodes of partial or complete obstruction of the upper airway during sleep. Some studies have suggested an association between OSA and ADHD in children and adults. The Hypothesis: It has been suggested that therapeutic intervention in OSA has a significant improvement in abnormal behaviors such as hyperactivity, inattention, and aggression, and in cognitive and school performance. OSA can lead to ADHD-like symptoms that disappear when OSA is sufficiently treated. The use of oral appliance therapy (OAT) is being studied as a method to control OSA. We hypothesize that the management of OSA with OAT could reduce ADHD symptoms. Evaluation of the Hypothesis: In patients who present with OSA and ADHD simultaneously, it should be evaluated whether the treatment of OSA with the use of OAT as rapid maxillary expansion devices or oral mandibular advancement devices reduces the symptoms of both OSA and ADHD, which would allow the establishment of an alternative method of treatment for both pathologies that is less invasive and less expensive.
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