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Friday, April 12, 2019

Preventive and Community Dentistry

Botulinum toxin application in facial esthetics and recent treatment indications (2013-2018)
Vivekanand Kattimani, Rahul Vinay Chandra Tiwari, Khalid Gufran, Bharti Wasan, PH Shilpa, Anas Abdul Khader

Journal of International Society of Preventive and Community Dentistry 2019 9(2):99-105

Background: Ever-changing perception of beauty from childhood to old age is changing with the revolution in cosmeceuticals science. Esthetics is an individual's perception since time immemorial. Standards of beauty have changed through centuries with increased awareness about esthetics. The face remains main source of information for identification and discrimination. It constitutes a structural ground for many nonverbal messages including the emotional state of a person, so the proverb “Face is an index of mind” holds good. The wrinkles and laxity are considered to be one of the factors for aging. Hence, escalating demand for cosmetic treatment to reduce facial wrinkles and laxity has stimulated us to search for published literature for nonsurgical techniques for enhancement of facial beauty. The review analyzed the published data to provide narrative basic review in a concise way to the beginners, clinicians, and students. Materials and Methods: We have adopted search criteria using keywords: Botox, Botulinum toxin, incobotulinumtoxinA, esthetics, face, uses of Botox, with various Boolean operators and or in title, and abstract using PubMed search engine. The database search limited to PubMed only from January 2013 to June 2018. Results: Various search results have been appended as annexures at the end of the article for further reference for the readers. Finally, 17 references were selected to write narrative review to meet our objectives. Conclusion: The advancing front in the use of toxins is an emerging science for the beautification of a face. Botox exploded in to market because of efficacy, tolerability, and minimally invasive nature. The present review gives brief about the history of Botulinum toxin, types, mechanism of action, clinical indications, preparations, storage, and technique for various uses with a brief note on patient selection, contraindications, and complications. 


The impact of sibling behavior on oral health: A narrative review
Sunaina Puri, Ramprasad Vasthare, Ravindra Munoli

Journal of International Society of Preventive and Community Dentistry 2019 9(2):106-111

Objective: The repetition of any behavior until it becomes a learned behavior begins in childhood. Oral health practices being no exception to this, are also acquired at this tender age, and have the potential of greatly affecting one in their lives. Oral health behaviors are learned through a multifactorial interplay, of which the family is a crucial and relatively unexplored area and will be highlighted in this review. This review discusses gender differences among siblings in relation to oral health, familial influence on acquisition and maintenance of oral hygiene habits, media influence on oral health attitudes and more. Methods: A thorough literature search between 1972 and 2017 was done using Scopus, PubMed, and Google Scholar databases, results reviewed, prioritized, and findings compiled. The keywords of the search strategy was as below: Siblings, sibling behavior, sibling oral health, siblings in dentistry, maternal oral health, family influence on oral health. 35 studies were evaluated for the review. The keywords were limited to activities of siblings and their behavior patterns in relation to dentistry and oral health. Results: Results showed that sibling dynamics have been involved in influencing the learning of oral health behaviors in children. Other factors include peer pressure and maternal influences. Conclusion: Sibling relationships play a vital role in shaping behavior characteristics including tooth brushing, oral hygiene, dental perceptions, and snacking behaviors which are pertinent to dentistry. 


Critical appraisal of bidirectional relationship between periodontitis and hyperlipidemia
Seba Abraham, Arya Premnath, PR Arunima, Reejamol Mohammed Kassim

Journal of International Society of Preventive and Community Dentistry 2019 9(2):112-118

Periodontal disease and hyperlipidemia are both multifactorial disease with a high prevalence Worldwide. Cross-sectional and longitudinal prospective clinical studies show some evidence for a bidirectional relationship. Periodontitis and hyperlipidemia share some common risk factors and there exist a mechanistic link between both. Studies have found a positive response to periodontal therapy among hyperlipidemic patients, and statin use by hyperlipidemic patients has shown to influence the periodontal health. However, in spite of the rising prevalence of both diseases, many people remain unaware of their association with each other. Hence, this article summarizes the cyclic relationship between periodontal disease and hyperlipidemia. 


The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial
Wahdan Mohammed Abdelghany Elkwatehy, Omair Mohammed Bukhari

Journal of International Society of Preventive and Community Dentistry 2019 9(2):119-128

Objectives: This clinical trial evaluates the efficacy of different pit and fissure sealant modalities as a caries prevention tool. Materials and Methods: Forty-four children aged 6–8 years with completely erupted first permanent molars participated in sealant placement randomized clinical trial. Split-mouth technique used and each child received four treatment modalities (ICON, Seal It, GCP glass seal, ICON/Seal It combination). Caries progression and sealant retention monitored over a period of 24 months. Results: Seal It and combination modalities had the highest efficacy in the prevention of pits and fissures caries, whereas the ICON had the lowest efficacy. Regarding retention, there were no significant differences among the four modalities during the 1, 3, and 6 months follow-up intervals. However, at 12, 18, and 24 months, the retention of Seal It and combination modalities were better than ICON and better than GCP, but the differences were not statistically significant. In addition, the retention of combination modality was better than Seal It, but the difference was not significant. At the end of the trial, the caries incidence was the highest in ICON group (20 lesions) followed by GCP group (13 lesions), Seal It group (3 lesions) and the lowest observed in combination group (2 lesions). Conclusions: Both Seal It and combination modalities are highly effective in the prevention of pits and fissures caries, GCP has acceptable effect while the use of ICON alone was not effective. The Seal It and ICON combination improves their clinical efficacy in caries prevention. 


A cephalometric evaluation of sexual dimorphism of the angle sella-nasion-frankfort horizontal plane in different sagittal classes of malocclusion in south Indian population
Sivareddy Rohit Reddy, Singaraju Gowri Sankar, Prasad Mandava, Vivek Reddy Ganugapanta, Surendra Gangavarapu, Swaroop Doddavarapu

Journal of International Society of Preventive and Community Dentistry 2019 9(2):129-136

Aims and Objectives: The present study aims to evaluate the gender dimorphism of the angle SN-FH between the sella-nasion (SN) plane and the Frankfort horizontal (FH) plane among the three types of skeletal malocclusion in South Indian population. The objectives included measurement of angle SN-FH, FH to the nasion (NFH), FH to the sella (SFH), and the difference of NFH and SFH (Δ). The null hypothesis was that there exists no variation of the angle SN-FH, NFH, SFH, and Δ between males and females and in the different skeletal relationship of jaws. Materials and Methods: Cephalometric data were retrieved from the archived records of 180 patients, comprising 90 males and 90 females, within three subgroups. Class I (60), Class II (20), and Class III (10) in each of the gender class were examined. Student's “t” test was used to analyze means of the gender differences and analysis of variance between subgroups, and significance was set at P < 0.05. Results: The average values obtained from this study for the overall population are 8.06 ± 3.34; for males, it is 7.42 ± 3.62, and for females, it is 8.7 ± 3.48. The gender difference is statistically significant only in Class I malocclusion (0.002). There is no statistical difference between different skeletal classes of malocclusion. Conclusion: The null hypothesis is partially rejected for as significant difference is established only for some of the parameters under the study. 


Oral behavior and dental status of orthodox christian priests and monks
Oksana Avdeenko, Irina Novikova, Anna Turkina, Irina Makeeva

Journal of International Society of Preventive and Community Dentistry 2019 9(2):137-143

Aims and Objectives: Common conditions of daily routine and diet may affect the dental status of individuals in organized groups and professional communities. The aim of this study was to reveal the specific aspects of dental status in orthodox priests and monks of the Yaroslavl region, Russia. Materials and Methods: Dental assessment of 311 participants (111 monks; 111 priests; and 90 local residents, not clergymen – as a control group) was performed, including Decayed, Missed, Filled Teeth, oral hygiene index (simplified), gingival, and Modified Papillary Bleeding Indices (MPBIs). The participants completed a questionnaire on food habits and awareness concerning dental health preservation. Statistical Analysis Used: Statistical analysis of the data was performed in SPSS software with the use of Shapiro–Wilk, Dunn's, Fisher tests, z-test as well as Spearman correlation, and ANOVA. Results: The median values of MPBI in monks were higher than in the groups of priests and local residents (P = 0.005). The differences in number of missing teeth were significantly higher in priests compared with local residents (P = 0.011), and the number of filled teeth was significantly higher in priests (P = 0.006) and local residents (P = 0.007) compared with monks. Wedge-shaped defects and erosions were more prevalent in the groups of priests (0.0018 and 0.001, respectively) and monks (0.004 and 0.001, respectively). ANOVA resulted in statistically significant influence of teeth brushing frequency and frequency of food intake on hygienic and periodontal indices values. Conclusions: The increased prevalence of some dental diseases among priests and monks could be attributed to the specific diet, lifestyle, and limited access to dental care. 


Comparison of the effect for fracture resistance of different coronally extended post length with two different post materials
Niharika Singh Chauhan, Nidhi Saraswat, Ankita Parashar, Kuldeep Singh Sandu, Kapil Jhajharia, Nirav Rabadiya

Journal of International Society of Preventive and Community Dentistry 2019 9(2):144-151

Aims and Objectives: To compare the effect for fracture resistance of different coronally extended post length with two different post materials. Materials and Methods: One hundred and sixty endodontically treated maxillary central incisors embedded in acrylic resin with decoronated root portion were taken for the study. The postspaces were prepared according to standard protocol. The samples were divided into two groups according to the post material: glass-fiber post and Quartz fiber post. These groups were further subdivided on the basis of coronal extension of 4 and 6 mm for glass fiber and Quartz fiber posts, respectively. The posts were then luted with dual-polymerizing resin cement followed by core buildup. Samples were subjected to increasing compressive oblique load until fracture occurred in a universal testing machine. Data were analyzed with one-way ANOVA and independent Student's t-test. Analysis was done using SPSS version 15 (SPSS Inc., Chicago, IL, USA) Windows software program. Results: Glass fiber post with coronal extension of 4 mm (182.8 N) showed better results than with 6-mm length (124.1 N). Similarly, in quartz fiber posts group, 4-mm postlength (314 N) was better when compared with 6 mm (160 N). The 4-mm coronal extension of quartz fiber post displayed superior fracture resistance. Conclusions: Glass fiber posts showed better fracture resistance than Quartz fiber posts. 4-mm coronal length showed more fracture resistance than 6 mm. 


Comparative evaluation of the effect of chemical disinfectants and ultraviolet disinfection on dimensional stability of the polyvinyl siloxane impressions
Sharayu Vinod Nimonkar, Vikram M Belkhode, SR Godbole, Pranali Vinod Nimonkar, Trupti Dahane, Seema Sathe

Journal of International Society of Preventive and Community Dentistry 2019 9(2):152-158

Context: Infection control is an important concept in the present day practice of dentistry. Disinfection of dental impressions is part of the daily routine in a dental clinics. After disinfection, it is important that impressions remain dimensionally stable. Aim: The purpose of this study was to compare the effect of chemical disinfectants and ultraviolet (UV) disinfection on the dimensional stability of the polyvinyl siloxane impressions. Objectives: The objective of the study is (1) To evaluate the effect of chemical disinfectant (2% glutaraldehyde and 1% sodium hypochlorite) and UV disinfectant on the dimensional stability of polyvinyl siloxane impression material. (2) Comparative evaluation of the dimensional discrepancy between the cast poured from the polyvinyl impressions material, that is subjected to chemical disinfectant and UV disinfectant to that of cast poured from impressions that were nondisinfected. Materials and Methods: A customized tray was fabricated to make impressions. Impressions were divided into four groups, 10 samples were disinfected with 2% glutaraldehyde for 20 min, 10 samples were disinfected with 1% sodium hypochlorite for 20 min, 10 samples were disinfected with UV light for 20 min, and 10 samples were not subjected to disinfection which served as control group. All the samples were poured after 30 min in die stone. Measurements were recorded using traveling microscope of 0.001 accuracy. Statistical analysis used in this study was the one-way ANOVA test. Results: The result showed significant dimensional changes in samples disinfected with 2% glutaraldehyde and 1% sodium hypochlorite, whereas samples disinfected with UV disinfectant unit showed no significant dimensional changes when compared with control group samples. Within the chemical groups, impressions disinfected with 1% sodium hypochlorite showed more discrepancy in the dimensions when compared to the 2% glutaraldehyde disinfected group. Conclusions: UV light disinfectant can be safely used to disinfect impressions as compared to chemical disinfectants in clinical prosthodontic procedures. 


The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy
Kondaveeti Satish Srinivas, M Arunan, E Venkatachalapathy, Christopher John, M Manickavasagam, CV Divyambika

Journal of International Society of Preventive and Community Dentistry 2019 9(2):159-165

Aims and Objectives: This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUVmax) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy. Materials and Methods: Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017–April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks' postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUVmax were recorded and correlated with immediate treatment response. Results: The mean pretherapy SUVMax of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUVMax of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUVMax was 3 months (range 2–5 months). The mean posttherapy SUVMax of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUVMax of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon–Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUVmax values for both primary tumor (P < 0.001) and regional node (P = 0.001). Majority of patients (n = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation. Conclusion: Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUVmax in comparison to the pretherapy SUVmax it failed to identify a cutoff value for pretherapy SUVmax which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity. 


Effect of weight reduction on the serum adiponectin and tumor necrosis factor-α levels and the clinical parameters of obese patients with and without periodontal disease
Lalith Vivekananda, Mohamed Faizuddin

Journal of International Society of Preventive and Community Dentistry 2019 9(2):166-171

Objective: The objective of the current study was to assess the impact of weight reduction on the attenuation of obesity-related periodontal inflammation. Methods: This study was conducted enrolling 60 obese subjects. They were divided into three groups of 20 each. Group 1-healthy group, Group 2-gingivitis group, and Group 3-periodontitis group. The body mass index and waist/hip ratio, periodontal parameters such as plaque index, bleeding index, full mouth periodontal probing depth (PPD) using the University of North Carolina 15 (UNC 15) probe and full mouth clinical attachment loss (CAL) with cementoenamel junction as the reference using UNC 15 probe was evaluated at baseline and after the attainment of ≥10% weight loss by the subjects. Adiponectin and tumor necrosis factor-alpha (TNF-α) levels were measured in the serum at baseline and after attainment of ≥10% reduction in weight in a period of 3–18 months. Results: Adherence to weight reduction program until the achievement of ≥10% reduction in body weight resulted in statistically significant (P < 0.0001) elevated serum adiponectin and reduced serum TNF-α levels in all three groups. Furthermore, elevations of adiponectin following weight reduction showed significant negative correlations with PPD in all the three groups and in patients with periodontitis, (Group 3) serum adiponectin levels showed significant negative correlations (P = 0.0001) with CAL in Group 3. Conclusions: Controlling obesity presents a good opportunity to alleviate the burden of periodontal disease. Simple weight reduction programs with diet and exercise-related lifestyle modifications may be an efficacious and barrier-free option. 


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