Malabar Dental College and Research Centre

Myofibroblasts after its discovery in 1971 as the principal cell for wound healing has come a long way as far as research is concerned. The primary focus of research has been regarding preventing certain unwanted effects of this cell such as wound contraction and scarring. As far as the oral and maxillofacial region is concerned, the primary concern of this untoward effect is during repair of cleft palate surgically which results impaired development of palate and the dentoalveolar structures. This review focuses on the basic aspects of myofibroblasts such as its origin, formation, function in wound healing, role in wound contraction and ways by which its unwanted effects can be overcome to improve the quality of the post surgical complications of cleft palate surgery.

BACKGROUND: To evaluate the efficacy of topical antiinflammatory agent (amlexanox 5%), along with topical antiseptic, analgesic, and anesthetic agent (benzalkonium chloride 0.01%, choline salicylate 8.7% and lidocaine hydrochloride 2%), in promoting ulcer healing, decreasing ulcer size, erythema, pain and recurrence in minor RAS. MATERIALS & METHODS: A randomized control trial was conducted on 100 patients of RAS who fulfilled the inclusion criteria. The number, size, erythema and pain with the ulcer were recorded. Visual analogue scale (VAS) and erythema scale were used to record pain and erythema. 50 patients comprising the study group received anti inflammatory paste (amlexanox 5%) applied four times daily and the control group of 50 patients received topical antiseptic, analgesic, and anesthetic agent (benzalkonium chloride 0.01%, choline salicylate 8.7% and lidocaine hydrochloride 2%) paste, patients were evaluated after 3rd, 6th, 9th and on 30th, 60th day for recurrence. RESULTS: The study group had reduction in ulcer number, size; erythema, pain and frequency of ulcers during follow up. The healing period and recurrence of ulceration reduced in both the groups but the study group had significant reduction in 30th and 60th day follow up for recurrence of ulcers. CONCLUSION: Amlexanox 5% can reduce the frequency, duration and symptoms associated with the aphthous ulcers with no sideeffects attributed to the drug. How to cite the article: Darshan DD, Kumar CN, Kumar AD, Manikantan NS, Balakrishnan D, Uthkal MP. Clinical study to know the efficacy of Amlexanox 5% with other topical Antiseptic, Analgesic and Anesthetic agents in treating minor RAS. J Int Oral Health 2014;6(1);5-11.

BACKGROUND: Dentists play very important role in the oral health education of the community. Thus it is important to know the status of knowledge, attitude, and behavior toward the maintenance of oral health at the student level. The aim of the present study was to evaluate the oral health knowledge, attitude, and behavior among preclinical and clinical dental students. MATERIALS AND METHODS: A cross-sectional study was conducted on 147 dental students from 1(st) to 4(th) year of Malabar Dental College, Kerala, in the year of March-June 2010 and was carried out with the help of 30 questionnaires. Age, gender and academic year data were recorded. Statistical analysis was performed with the help of SPSS version 20 using the Student's t-test and one-way ANOVA tests. RESULTS: The difference in scores of oral health knowledge, attitude and behavior between preclinical and clinical dental students was found statistically highly significant (Student's t-test, P < 0.001). The variation of scores of knowledge, attitude, and behavior also showed highly significant increase with the year of study (one-way ANOVA, P < 0.001). While the difference in scores between males and females showed that females have better oral health knowledge than males, but the difference was not statistically significant (Student's t-test, P > 0.01). The present study thus showed improvement of knowledge, attitude and behavior with the academic years and there was no bias of gender with reference to oral health. CONCLUSIONS: Although oral health knowledge, attitude and behavior showed improved results from 1(st) to 4(th) year dental students, it should be improved in order to serve better for the community in the future.

UNLABELLED: Identification of individuals is a challenging task in forensic odontology. In circumstances where identification of an individual by fingerprint or dental record comparison is difficult, the palatal rugae may be considered as an alternative source. Palatal rugae have been shown to be highly individualistic and it maintains consistency in shape throughout life. AIMS AND OBJECTIVES: The present study is conducted to test the efficiency of computerized software in the identification of individuals after obtaining digital photographic images of the rugae. MATERIALS AND METHODS: The intra oral photographs of 100 individuals were taken using a SLR digital camera. The custom made external attachment was attached to the camera to standardize all the photographs. A special software was designed called the Palatal Rugae Comparison Software (PRCS Version 2.0) to match the clinical photographs. Five evaluators including 3 dentists, 1 computer professional, and 1 general surgeon were asked to match the rugae pattern using the software. The results were recorded along with time taken by each operator to match all the photos using software. RESULTS: The software recorded an accuracy of 99% in identification of individuals. CONCLUSION: The present study supports the fact of individuality of the rugae. Computerized method has given very good results to support the individualization of rugae. Through our study, we feel that palatal rugae patterns will be of great use in the future of forensic odontology.

Oral cancer is one of the most common cancers worldwide. Despite of various advancements in the treatment modalities, oral cancer mortalities are more, particularly in developing countries like India. This is mainly due to the delay in diagnosis of oral cancer. Delay in diagnosis greatly reduces prognosis of the treatment and also cause increased morbidity and mortality rates. Early diagnosis plays a key role in effective management of oral cancer. A rapid diagnostic technique can greatly aid in the early diagnosis of oral cancer. Now a day's many adjunctive oral cancer screening techniques are available for the early diagnosis of cancer. Among these, autofluorescence based diagnostic techniques are rapidly emerging as a powerful tool. These techniques are broadly discussed in this review.

OBJECTIVE: (1) To evaluate the corrosion resistance of four different orthodontic archwires and to determine the effect of 0.5% NaF (simulating high fluoride-containing toothpaste of about 2250 ppm) on corrosion resistance of these archwires. (2) To assess whether surface roughness (Ra) is the primary factor influencing the corrosion resistance of these archwires. MATERIALS AND METHODS: Four different archwires (stainless steel [SS], nickel-titanium [NiTi], titanium molybdenum alloy [TMA], and ion-implanted TMA) were considered for this study. Surface characteristics were analyzed using scanning electron microscopy, atomic force microscopy (AFM), and energy dispersive spectroscopy. Linear polarization test, a fast electrochemical technique, was used to evaluate the corrosion resistance, in terms of polarization resistance of four different archwires in artificial saliva with NaF concentrations of 0% and 0.5%. Statistical analysis was performed by one-way analysis of variance. RESULTS: The potentiostatic study reveals that the corrosion resistance of low-friction TMA (L-TMA) > TMA > NiTi > SS. AFM analysis showed the surface Ra of TMA > NiTi > L-TMA > SS. This indicates that the chemical composition of the wire is the primary influential factor to have high corrosion resistance and surface Ra is only secondary. The corrosion resistance of all wires had reduced significantly in 0.5% acidic fluoride-containing artificial saliva due to formation of fluoride complex compound. CONCLUSION: The presence of 0.5% NaF in artificial saliva was detrimental to the corrosion resistance of the orthodontic archwires. Therefore, complete removal of residual high-fluorinated toothpastes from the crevice between archwire and bracket during tooth brushing is mandatory.

AIMS AND OBJECTIVES: Satisfactory composite restoration depends upon its smooth finish, quality of polishing agents, type of composite material used, and its composition. The present study evaluated the effect of different polishing systems on the surface roughness of composite resin. MATERIALS AND METHODS: Forty discs of composite were prepared and equally subjected to different finishing and polishing procedures; (i) unpolished control group, (ii) sof-lex discs, (iii) diamond tips, and (iv) Astrobrush groups. Later, the surface roughness for the entire specimen was evaluated using Profilomotor. Data were tabulated and statistically analyzed using analysis of variance and Tukey's test at significance level of 0.001. RESULTS: Composite surface roughness after polishing was statistically significant between the groups. Sof-lex group produced lesser surface roughness compared to control, Astrobrush, and diamond group. CONCLUSION: The present study indicated that diamond tips can be used to remove rough surface whereas sof-lex can be used for final finish and polish of the composite restoration.

AIM: The purpose of the present in vivo study was to measure the efficacy of different gingival displacement materials in achieving gingival tissue displacement and to compare the efficacy of Expasyl displacement paste (Pierre Rolland, France) and gingival displacement cord for gingival displacement. MATERIALS AND METHODS: Sixteen subjects were included in the study. Premolars were prepared to receive full veneer crown, gingival displacement was carried using gingival retraction cord and gingival displacement paste. Impression of the gingival sulcus was made. Sulcus width after displacement was measured under magnification. RESULTS: The mean displacement value of sulcus width was 0.21 ± 0.01 mm for the gingival retraction cord and 0.26 ± 0.02 mm for the gingival displacement paste. 'F' test was used for statistical analysis. Difference among the two test agents was statistically significant (p < 0.01). CONCLUSION: Gingival displacement paste showed better response in achieving horizontal displacement of the gingival sulcus than gingival retraction cord. CLINICAL SIGNIFICANCE: Gingival displacement helps in recording the unprepared tooth surface adjacent to the finish line in the impression being made, thereby helping a better marginal adaptation and emergence profile in the extracoronal restoration.

AIM: The present study was conducted to determine the prevalence rate of dental implants failure and risk factors affecting dental implant outcome. MATERIALS AND METHODS: The present retrospective study was conducted on 826 patients who received 1420 dental implants in both genders. Length of implant, diameter of implant, location of implant, and bone quality were recorded. Risk factors such as habit of smoking, history of diabetes, hypertension, etc., were recorded. RESULTS: < 0.05). Maximum dental implant failures were seen with smoking (37%) followed by hypertension (20.8%), diabetes (20.3%), and CVDs (18.7%). Healthy patients had the lowest failure rate (4.37%). CONCLUSION: Dental implant failure was high in type IV bone, dental implant with <3.75 mm diameter, dental implant with length <10.0 mm, and among smokers.

BACKGROUND: Host response to periodontal disease includes the release of different enzymes from stromal, epithelial or inflammatory cells. The enzymes which are produced from these cells are associated with cell injury and cell death like: Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP) and Blood urea nitrogen (BUN). Normal enzymatic activity of these enzymes is necessary for healthy functioning of gingiva and periodontium. The aim of the study is to estimate the levels of enzymes AST, ALT, ALP and BUN and to correlate the level of estimated enzymes with that of clinical parameters in the saliva of Healthy subjects, Gingivitis patients and patients with chronic periodontitis. METHODS: The study included a total of 40 male subjects within the age group of 21 to 50 years, and examined the activity of enzymes AST, ALT, ALP and BUN in saliva spectrophotometrically and compared their values between healthy subjects, gingivitis and chronic periodontitis patients. Clinical parameters like OHI - S (Oral hygiene index - Simplified, SBI (Sulcus Bleeding Index), PPD (Probing Pocket Depth), CAL (Clinical Attachment Level), and PI (Periodontal Index) were recorded. RESULTS: Obtained results showed statistically significant increases of activity of AST, ALT, ALP, and BUN in saliva from patients with periodontal disease (p<0.001) in relation to gingivitis and control groups. There was also an increase in periodontal parameters with an increase in salivary enzymes. CONCLUSION: The present study shows that the salivary enzyme activity can be used as biomarkers to determine periodontal tissue damage, which may be useful in diagnosis, prognosis and evaluation of post therapy effects in periodontal disease.

INTRODUCTION: is one among the major etiological agent in periodontal diseases and has been proved to cause gingival inflammation under orthodontic appliances. AIM: during orthodontic treatment, using real time-polymerase chain reaction (RT-PCR). MATERIALS AND METHODS: A randomised controlled trial was performed including 45 patients. There were three groups: Group A (control group), Group B (patients using Amflor mouthwash) and Group C (patients using probiotic mouthwash). During the treatment, all the 3 groups were advised to brush twice a day using Colgate tooth paste and Group B patients were advised to swish 15 ml fluoridated mouthwash (Amflor) and Group C advised to swish probiotic for 60 s before swallowing, once in the morning and once before sleep. After gently removing supragingival plaque, subgingival plaque samples were collected by inserting a sterile dental curette into the bottom of the gingival crevice around 31, 32, 41, and 42 at two different intervals: T1 at start and T2 after 6 months of fixed orthodontic treatment. Sub-gingival plaque samples collected were transferred to laboratory within 48 h for RT-PCR analysis in Tris-buffer solution, to maintain the integrity of bacterial DNA. RESULTS: were significantly decreased with probiotic mouth wash. CONCLUSIONS: Probiotic mouth wash can be used as an adjunctive measure along with regular brushing to improve periodontal status during fixed orthodontic treatment.

Treating partial edentulousness forms a major share of prosthodontic clinical practice. The purpose of this study was to find out the frequency of partial edentulism, its arch distribution status, awareness to restore, and the ratio of removable to fixed prosthesis among a student sample aged 18-25 years. The methodology selected was a questionnaire survey followed by clinical examination of the student community from Tirur taluk, Malappuram district, Kerala. The results showed that the frequency of partial edentulism among the surveyed group was significant with predominance in maxillary posterior edentulousness in men and mandibular posterior edentulousness in women. Though there was not any significant gender difference in the partial edentulism, women were more aware than men to restore it. All restored cases were with fixed bridges and no anterior edentulousness was found. The study also revealed a lack of awareness and need to educate the population.

AIM: This study aimed to correlate periodontal pathogens in endodontic periodontal diseases. METHODOLOGY: This study was conducted on 40 patients of both genders. All the participants were obtained from department of endodontics and periodontology with history of endo-perio lesion in same teeth. Polymerase chain reaction was performed and correlation was established. RESULTS: < 0.05). CONCLUSION: There was correlation between targeted bacterial species levels from concurrent endodontic-periodontal diseases. Thus, it can be suggested that dentinal tubules may be the pathway for spread of bacteria.

Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10-70 s) and radiation dosages reportedly up to 15-100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.

INTRODUCTION: Oral Leukoplakia (OL), the most common potentially malignant disorder, is diagnosed clinically on the basis of exclusion of other lesions. In a country like India, where prevalence of oral cancer is very high, the issue of carcinomatous foci within OL at the time of initial diagnosis of leukoplakia has never been addressed before. AIM: To estimate the prevalence and risk factors for epithelial dysplasia as well as carcinoma within OL lesions at the time of initial clinical presentation in an Indian population with high prevalence of tobacco use. MATERIALS AND METHODS: Clinical and pathologic data (age, sex, lesion location and histopathologic grading) of 546 cases of leukoplakia were analyzed. The prevalence rate of dysplasia and carcinoma in 546 oral leukoplakia cases was calculated. Univariate analysis was performed to examine risk factors associated with the presence of carcinoma and dysplasia within the lesions. RESULTS: The male to female ratio in this study was 2:1. Majority of the patients irrespective of sex had a history of tobacco use. Of the total 85% of non-homogeneous lesions and 70% for the homogeneous lesions were illustrating, features of epithelial dysplasia. The prevalence rate of carcinoma was 11.9%. In univariate analysis it was found that lesion site, clinical appearance, tobacco use were strongly correlated with the presence of carcinoma within OL. CONCLUSION: Our results demonstrate that majority of leukoplakia irrespective of its clinical appearance contain a dysplastic component and significant proportion contains carcinomatous foci. Lesions with certain features are more prone to have carcinomatous foci. However there is always a chance of finding foci of carcinoma in OL anywhere in the oral cavity. Therefore, excision biopsy is always mandatory before long term follow-up and treatment is planned.

Resorptive cells are responsible for the resorption of mineralized matrix of hard tissues. Bone-resorbing cells are called osteoclasts; however, they can resorb mineralized dental tissues or calcified cartilage and then they are called odontoclasts and chondroclasts, respectively. Resorptive cells form when mononuclear precursors derived from a monocyte-macrophage cell lineage are attracted to certain mineralized surfaces and subsequently fuse and adhere onto them for exerting their resorbing activity. These cells are responsible for degradation of calcified extracellular matrix composed of organic molecules and hydroxyapatite. The activity of these cells can be observed in both physiological and pathological processes throughout life and their activity is mainly required in bone turnover and growth, spontaneous and induced (orthodontic) tooth movement, tooth eruption, and bone fracture healing, as well as in pathological conditions such as osteoporosis, osteoarthritis, and bone metastasis. In addition, they are responsible for daily control of calcium homeostasis. Clastic cells also resorb the primary teeth for shedding before the permanent teeth erupt into the oral cavity.

BACKGROUND: Local delivery of antimicrobial agents provides higher concentration of the drug in the periodontal site for longer periods than systemically delivered methods. In the present study an attempt is made to know the efficacy of controlled local drug delivery of doxycycline as an adjunctive treatment in the management of chronic periodontitis. MATERIALS AND METHODS: A total of 12 patients, diagnosed as Chronic Periodontitis in the age of 25 to 55 years, were selected of both the sexes in this study. They were divided into Experimental group consisted of 30 sites who received complete scaling and root planing (SRP) followed by placement of Atridox gel and control group consisted of 30 sites who received only SRP. Clinical parameters were recorded at, baseline, days 30, 90 and 180. Parameters were plaque index, gingival index, gingival bleeding index and microbial analysis, probing pocket depth and Clinical attachment level (CAL). The microbiological analysis was done at baseline visit and at 90th day. Probing pocket depth and CAL were recorded only on day 0 and 180th day. RESULTS: In 180 days study, both the groups exhibited a significant improvement in periodontal status. Significant gain in attachment level was observed in both the group. Between both the groups the clinical parameters in the experimental groups exhibited better results as compared to the control group. Both the groups exhibited significant reduction in the number of spirochetes. CONCLUSION: Combination therapy of SRP and 10% DH gel demonstrated better results at all levels suggesting that this therapy can play a significant role as an adjunct to SRP in the management of chronic periodontitis.

Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice - from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors' clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.

Background: Oral health is an integral part of general health. It is an essential component of health throughout the life of an individual. Certain systemic diseases can manifest in the oral cavity. Majority of the population approach medical practitioners for their oral health problems at primary health center level. Hence, general practitioners should have adequate knowledge about oral health and also they should play an active role in oral health promotion. Aim: The aim was to assess oral health awareness among undergraduate medical students in Davangere city. Materials and Methods: A cross-sectional survey was conducted using a self-structured, pre-tested, closed-ended questionnaire consisting of 25 questions with options on Likert scale. All the undergraduate students of JJM Medical college and SS Medical colleges were included for the survey. Questions were related to oral health problems and their relation with general health. The data was collected, compiled, and analyzed using Chi-square test. Results: Only 25% of the undergraduate students were found to have good oral health awareness, 38% were found to have fair and 37% were found to have poor oral health awareness. Final year undergraduate medical students were found to have better oral health awareness (40%), when compared to second (13%) and third year students (23%) (P < 0.001). Conclusions: Oral health awareness among undergraduate medical students was found to be poor. Final year undergraduate students were found to have better oral health awareness.

INTRODUCTION: The purpose of this study was to evaluate and compare the fracture resistance of roots obturated with guttapercha using bonded amalgam, GC Light cure GIC (resin modified glass ionomer cement) and Tetric N Flow (flowable hybrid composite) as different intra orifice barriers. MATERIALS AND METHODS: Eighty freshly extracted mandibular premolars with straight roots were reduced to 14 mm from the coronal aspect. All canals were enlarged to size 30 and specimens were obturated with gutta percha cones, except for control group specimens the coronal 3 mm of root fillings of all other group specimens were removed with the aid of heated plugger. All samples were randomly divided into 4 groups of 20 specimens each. They were control, Fuji GC LC GIC, Tetric N Flow and Bonded Amalgam. After the placement of the intra orifice barrier materials, specimens stored at 37(o)C and 100% humidity for one week to allow the materials to set completely. After one week, all the groups were subjected to fracture resistance testing by using Universal testing machine. RESULTS: Data was analysed for significance by ANOVA (Analysis of variance) and further pair wise comparison was performed by Benferroni test. Level of significance was taken as 0.05. Tetric N Flow group showed better fracture resistance as compared to all other groups and Control group is least among the groups. Fracture resistance of Tetric N Flow compared with bonded amalgam was statistically significant. CONCLUSION: Tetric N Flow and Fuji GC LC GIC can be used as intra-orifice barriers with good fracture resistance in endodontically treated teeth.