Indian Journal of Dental Research最新文献

Aim and objectives: Quantitative evaluation and comparison of Cyclin D1 expression in various histological grades of oral epithelial dysplasia.

Material and methods: A total of 66 instances of oral epithelial dysplasia were included, with a histological diagnosis, consisting of 22 cases for each of the three histopathological grades. These cases were evaluated for cyclin D1 expression using immunohistochemistry techniques. To compare the average number of positive cells among the three groups with epithelial dysplasia, the Tukey's multiple post hoc method and the one-way ANOVA test were utilized. A P value of 0.05 or less was considered statistically significant.

Results: The expression of Cyclin D1 protein has been shown to vary significantly across mild, moderate, and severe epithelial dysplasia, with the group exhibiting severe oral epithelial dysplasia (OED) showing the highest average levels of expression.

Conclusion: The overproduction of cyclin D1 in individuals with severe epithelial dysplasia suggests that it could serve as a precursor to the onset of oral cancer. Cyclin D1 may act as a potential predictive marker for malignant transformation.

Background: This study aimed to evaluate and compare the effects of low-level laser therapy (LLLT) and platelet-rich fibrin (PRF) on orthodontic tooth movement (OTM), focussing on canine retraction and levels of inflammatory cytokine interleukin-1 beta (IL-1β).

Methods: Forty sites requiring canine retraction were randomly assigned to two groups: LLLT and PRF. Laser treatment was performed at a wavelength of 940 nm with a power output of 200 mW, and PRF was prepared by centrifugation. Canine retraction rates were measured over an eight-week period, and gingival crevicular fluid (GCF) samples were collected to assess IL-1β levels.

Results: The mean canine retraction rate was 4.828 mm in the LLLT group and 4.013 mm in the PRF group, indicating that LLLT significantly accelerated tooth movement compared to PRF. Although IL-1β levels were higher in the LLLT group at T2 (P < 0.05), no significant differences were observed between the groups at other time points. This study found that both treatments were effective in promoting OTM without adversely affecting periodontal health.

Conclusions: Both LLLT and PRF can be used therapeutically to enhance OTM; LLLT demonstrates a superior rate of canine retraction. This study suggests that while IL-1β levels provide insights into inflammatory responses during tooth movement, the presence of additional growth factors in PRF may also influence outcomes.

Objectives: To determine the prevalence of a pattern of mandibular third molar impactions in the Malaysian population who visited a private university oral health centre.

Materials and method: A total of 170 cone beam computed tomography (CBCT) radiographs were selected from Malaysia's private university's oral health centre. The radiographic measurements were carried out using the ExamVisionQ CBCT software program. The impaction patterns were classified according to Winter's classification and Pell & Gregory classification. The angulation of impacted mandibular third molar was determined by the angle formed between the intersected longitudinal axis of the second and third molars. The third molar was to be considered impacted according to its relationship to the anterior border of the ramus (Class 1, 2, 3) and occlusal surface in relation to the adjacent molar (level A, B, C). The data were analysed using a Pearson Chi-squared (X 2 ) test on SPSS version 24.0.

Results: All selected radiographs showed the presence of impacted mandibular third molars. On overall comparison, the prevalence of mesioangular impaction was found to be the highest. The level A impactions were commonly seen in Chinese (74%), followed by Indians (11%) and Malays (8%). The class 1 impactions were commonly seen in Chinese (75%), followed by Indians (11.5%) and Malays (8.4%). Mesioangular were the most common impactions, followed by horizontal, vertical, and distoangular in all the races.

Conclusion: The mesioangular impactions were found to be the most frequent occurrence among all the races, whereas differences were seen in levels of impaction to some extent among ethnic groups.

Background: Oral submucous fibrosis (OSF) is a chronic, progressive disorder characterised by reduced mouth opening (MO) and a risk of malignant transformation. Despite numerous non-surgical interventions, sustained functional improvement remains elusive. This study introduces a cost-effectiveness analysis framework to compare various OSF treatments, addressing a critical knowledge gap.

Materials and methods: Data from a previously published network meta-analysis (NMA) comprising 72 studies ( N = 5268 patients) were analysed. Cost/millimeter of MO improvement (cost/mm) and cost/millimeter/week (cost/mm/week) were calculated. Incremental Cost-Effectiveness Ratio (ICER) was computed against placebo and multivitamins. P ≤0.05 considered significant.

Results: The median cost/mm was INR 1906.57, ranging from INR 403.35 (ultrasound + exercise) to INR 10,368.36 (steroids + exercise). Cost/mm/week ranged from INR 59.97 (topical steroids) to INR 2292.83 (steroids + exercise). Kruskal-Wallis tests showed significant differences in cost/mm ( P = 0.002) and cost/mm/week ( P = 0.004). ICER analysis identified steroid with or with spreading factor (SSF) + exercise as the most cost-effective (-4918.38 INR/placebo, -2365.78 INR/multivitamins), while SSF + placebo was least cost-effective (ICER: 8540.79 INR/placebo, 8382.25 INR/multivitamins).

Discussion and conclusion: This study presents the first cost-effectiveness analysis of non-surgical OSF treatments, revealing substantial economic variations across interventions. Ultrasound with exercise and SSF + exercise was the most cost-efficient, supporting the integration of multimodal non-pharmacological therapies into OSF management. Conversely, nutraceutical products (NPs) demonstrated inconsistent cost-effectiveness, with systemic NPs outperforming topical applications. Given the economic burden and limited efficacy of some treatments, these findings emphasise the need for evidence-based, cost-conscious decision-making. The cost/mm and cost/mm/week metrics provide a novel perspective, facilitating better resource allocation in OSF care.

Background: In the absence of pre-extraction records, it is indeed a challenge for the prosthodontist to select artificial teeth for the patient. This study proposes to generate a proportion by correlating lower facial height and maxillary central incisor height that can aid in the anterior aesthetic designing. The resultant formula(s) can be of use in the fields of restorative and prosthetic dentistry.

Materials and methods: The present study was carried out in sub-populations of two states of India, GROUP A-Tamil Nadu (n = 100) and GROUP B-Jammu and Kashmir (n = 100). The lower facial height and maxillary right central incisor height of all the subjects were measured. The two quantities between males and females; and between population of two states were analysed using an independent t-test. After deriving a positive correlation, linear regression was performed to generate an equation.

Results: The difference between mean values of lower facial height of populations in Tamil Nadu and Jammu and Kashmir was not statistically significant (P = 0.315); however, the difference between mean values of maxillary right central incisor of sub-populations in Tamil Nadu and Jammu and Kashmir was statistically significant (P = 0.011). Association of the two quantities assessed using Pearson's criteria was statistically significant (P = 0.000) with a positive r value. An equation for the calculation of upper right central incisor height using the data of lower facial height was formulated.

Conclusion: The resulting equation can be used to generate a guide for the anterior teeth selection process as well as aid in aesthetic restorations for anterior teeth for the two distinct Indian sub-populations.

Background: Digital dentistry has rapidly transformed dental practice and education worldwide, offering enhanced precision, efficiency, and patient engagement. Despite these advancements, the adoption and integration of digital technologies in India remain limited due to infrastructural and educational barriers. This has created a gap in understanding the true impact and readiness of dental professionals to embrace digital solutions, especially within prosthodontic education.

Objective: The present study aimed to assess the current state of digital dentistry within clinical and contemporary prosthodontic education, focusing on practitioners' knowledge, perceptions, and the economic viability of these technologies in Faridabad, Haryana.

Materials and methods: A cross-sectional, online questionnaire-based survey using a Likert scale was conducted among 314 practicing dentists and dental students in Faridabad. The instrument measured awareness, practical use, and opinions regarding digital dentistry, as well as perceived barriers to implementation.

Results: Of the 314 participants, 62.1% (n = 195) were first introduced to digital dentistry during their BDS/MDS course. Awareness of digital technologies was high, with 90.4% familiar with their various applications. A majority (63.7%) preferred using a combination of digital and conventional methods in their clinical practice. However, 74.5% cited the non-availability of advanced digital technologies in India as a critical barrier to broader adoption. Additionally, 53% strongly agreed that digitalisation is essential for the future of dentistry, while 51.3% noted that cost and inadequate training pose significant hindrances to practical uptake.

Conclusion: Digital technologies are poised to significantly broaden their impact on both dental practice and education. Addressing infrastructural deficits and enhancing training will be crucial for accelerating the adoption of digital dentistry in India and realising its benefits within prosthodontic practice.

Purpose: To evaluate and compare chairside clinical time and acceptance of prefabricated and conventional band and loop space maintainers in children with premature loss of primary molars.

Methods: Sixty children aged 4-8 years with premature loss of primary first or second molars requiring a space maintainer were randomized into two groups: group 1, conventional band and loop space maintainer (CBLSM), and group 2, prefabricated band and loop space maintainer (PBLSM). The clinical evaluation for patient acceptance was carried out at six months follow-up using a five-point Likert scale. Patient comfort during clinical procedure, chairside clinical time, space loss, gingival index and plaque index were also recorded and compared between the two groups.

Results: After six months, both space maintainers were well accepted by the children, showing no statistically significant difference between the groups ( P > 0.05). In group 1, 40% of children, and in group 2, 46.6% of them showed mild discomfort measured using the Sound, Eye, Motor (SEM) scale, while the others were comfortable during the clinical procedure. The mean chairside clinical time required was 14.12 ± 3.90 and 19.96 ± 5.55 min for group 1 and group 2, respectively, and there was a statistically significant difference between the two groups ( P < 0.001). The plaque index, the gingival index and space loss after six months had no statistically significant differences between groups.

Conclusion: The CBLSM and PBLSM were comparable in terms of patient acceptance, comfort during clinical procedure and space loss after six months. However, the mean chairside clinical time required was significantly higher in PBLSM group.

Background: Maximum mouth opening (MMO) is a significant clinical parameter in prosthodontics. Although most clinical and research evaluations are performed in the upright position, the procedures are frequently performed at reclined chair positions. Limited data exist on the influence of dental chair positions on MMO.

Aim: The study aims to evaluate and compare the differences in MMO between three standardised dental chair positions: upright (90°), semi-supine (120°), and full supine (180°).

Materials and methods: The study involved 60 dentulous participants aged 20-30 years, with definitive criteria. MMO was recorded using a digital vernier calliper across three calibrated positions (90°, 120°, and 180°). Measurements were made thrice in each position, and the mean value was documented. The data was statistically analysed with an established significance level ( P < 0.05).

Results: MMO values displayed a gradual increase with 52.38 ± 5.65 mm (90°), 53.82 ± 5.61 mm (120°), and 54.40 ± 5.69 mm (180°). ANOVA displayed insignificance. (F (2,177) =2.03, P = 0.13). Despite a non-significant ANOVA, the Bonferroni-adjusted post hoc tests revealed significant pairwise differences ( P < 0.05) between all positions. Conclusion : Chair positions influence MMO in dentulous individuals. Fixed patient positioning is essential to ensure accuracy and reproducibility in clinical procedures and research involving MMO assessment.

Abstract: Tooth-supported overdentures offer an effective and conservative option for patients with partial edentulism and systemic contraindications to implant therapy. Retaining natural roots under the denture base helps preserve alveolar bone, enhances proprioception, and improves prosthesis stability. This case report describes the rehabilitation of a 76-year-old man with osteoporosis on long-term bisphosphonate therapy, type 2 diabetes, and hypertension. Due to the high risk of medication-related osteonecrosis of the jaw (MRONJ), implant placement was contraindicated. A maxillary overdenture retained by custom O-ball attachments on multiple remaining roots was chosen as a minimally invasive and cost-effective treatment. The prosthesis provided excellent retention, stability, and patient satisfaction, successfully resolving issues experienced with previous conventional dentures. This case highlights the value of utilizing existing teeth with custom attachments to achieve functional and predictable overdenture outcomes in medically compromised patients.

Aim: The purpose of this study was to analyse the diagnostic features and clinical characteristics of cracked molar teeth.

Materials and methods: Patients diagnosed with cracked molar teeth were selected for this study. Clinical signs and symptoms, age, gender, and radiographic findings were recorded. Data collected included tooth number, presence/absence of restoration, direction and location of the crack, pulp vitality testing (cold test/electronic pulp testing), transillumination findings, methylene blue dye staining results, bite test response, percussion and palpation findings, presence of wear facets, presence or absence of periodontal pocket depth, and the final pulpal and periapical diagnoses.

Results: Out of 220 patients, 33 patients with cracked teeth were diagnosed. Cracked teeth were most frequently observed in patients aged between 30 and 40 years. A sensitive response to the bite test was observed in 98% of cases. Transillumination and methylene blue dye were effective in detecting cracks in 99% of cases. Mandibular first molar (55%) was most commonly affected, followed by mandibular second molar (36%) and maxillary first molar (9%). Most cracks (67%) were found in intact teeth, while 33% were associated with restored teeth, which was significant ( P = 0.021). Cracks were not significantly associated with deep periodontal pockets (18%) ( P = 0.026). The presence of wear facets was not significantly higher in cracked teeth. ( P = 0.602). Fifteen per cent of cracked teeth showed reversible pulpitis, 45% irreversible pulpitis, and 39% pulpal necrosis.

Conclusion: A combined approach using history, clinical signs and symptoms, and tests, such as bite test, transillumination, and staining with methylene blue dye, is recommended for detecting cracks in teeth. Most cracked teeth showed pulpal diagnosis of irreversible pulpitis and pulpal necrosis, for which root canal treatment is recommended.