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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 7 | Issue 2
Page Nos. 33-67

Online since Tuesday, October 22, 2019

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EDITORIAL  

Systemic antibiotics in the treatment of periodontitis p. 33
Esra Guzeldemir-Akcakanat
DOI:10.4103/dmr.dmr_23_19  
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REVIEW ARTICLE Top

Relevance of hematological parameters in patients with recurrent aphthous stomatitis p. 35
Alberto Rodriguez-Archilla, Maria Brykova
DOI:10.4103/dmr.dmr_13_19  
Background: Recurrent aphthous stomatitis (RAS) continues to be a very common ulcerative disease of the oral mucosa, affecting approximately 20% of the general population. Hematinic deficiencies have been considered as a possible triggering factor, being iron, Vitamin B12, or folic acid deficiencies two times more frequent in patients with RAS. Objective: The objective was to assess the hematological parameters as possible etiological factors of RAS. Materials and Methods: A PubMed search of articles on hematological parameters in RAS was conducted. From 93 articles published between 1954 and 2018 (64 with full-text availability), 45 were excluded for several reasons: studies without a control group (17), studies with no clinical data (12), and studies with nonusable data (16). Data were processed using the statistical software RevMan 5.3 (The Cochrane Collaboration, Oxford, UK). For continuous outcomes, the estimates of effects of an intervention were expressed as mean differences using the inverse variance method, and for dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratio (OR) using Mantel-Haenszel method, both with 95% confidence intervals. Results: Nineteen studies of hematological parameters on RAS were included in this meta-analysis. RAS patients had a significantly higher risk of presenting low levels, together with lower concentrations, of hemoglobin (OR: 17.30), iron (OR: 6.67), folic acid (OR: 4.98), Vitamin B12(OR: 3.99), ferritin (OR: 2.86), and higher levels of homocysteine (OR: 7.22). Conclusion: Hematological disturbances may be an etiological factor of RAS.
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ORIGINAL ARTICLES Top

Molar incisor hypomineralization in North Malabar: An epidemiological study p. 40
Faizal C Peedikayil, Nitya C Tomy, TP Chandru, Mahmood Muthedath, Jerin Jose
DOI:10.4103/dmr.dmr_10_19  
Background and Objectives: Molar incisor hypomineralization (MIH) is an acquired developmental defect of unknown etiology. The acquired factors include perinatal events, exposure to fluoride, infantile exposure to biphenols and dioxins, childhood illness, specific chronic disease. A study was conducted in two districts, namely Kannur and Kasaragod district of Kerala to know the prevalence of molar incisal hypomineralization. Materials and Methods: A cross-sectional epidemiological study was conducted on a random sample of 2000 normal – healthy school children aged between 6 and 10 years of Kannur and Kasaragod district of Kerala. A full mouth inspection of wet teeth was performed for all the examined children using the 10-point scoring system which is in accordance with the European Academy of Paediatric Dentistry evaluation criteria. Data were collected, recorded, tabulated, and evaluated using the Statistical Package for the Social Sciences 17.0 for Windows. Percentage arithmetic mean value, standard deviation, independent sample t-test, Chi-square test, and Pearson correlations were used while a P< 0.05 was considered statistically significant. Results: The study result showed the prevalence of MIH as 19.8% in children of age group 6–10 years in northern Kerala. The prevalence in Kannur and Kasaragod districts were 16% and 23.6%, respectively. Interpretation and Conclusion: Prevalence of Molar Incisor Hypominerilization is more in Kasaragod district. Therefore, more studies should be done to confirm the effect of environmental factors in those areas.
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Location of mental foramen in a group of Libyan patients: An orthopantomographic study p. 45
Ahmed Taher Elhassan, Ahmed Ali Musrati, Nadiay Mohammed Ehtiwash, Syed Wali Peeran, Faisal Mohammed Alzahrani
DOI:10.4103/dmr.dmr_21_19  
Background and Objective: The mental foramen (MF) is a crucial landmark because the mental nerves and vessels exit through it. Therefore, marking its location is important when performing surgeries, placement of dental implants, or administering anesthesia and hence avoiding nerve damage. As the exact location and shape of the MF is not similar in different population groups, this study was the first one conducted to determine MF shape and position in a group of Libyan patients. Aim: The aim of this study was to determine the vertical and horizontal positions of the MF, in addition to its size and shape as seen in orthopantomogram (OPG) radiograph of Libyan patients. Age and gender differences in relation to the position and shape of MF were also evaluated. Materials and Methods: Out of 200 digital OPGs studied by two examiners, 123 fulfilled the inclusion criteria. Scanora Lite software (Palodex, Tuusula, Finland) program was used to measure the size of the MF as well as to determine its vertical and horizontal positions. The shape of the foramen was determined visually using the magnification tool of the software. Chi-square and t-test were applied. Results: The most common position of the MF was between first and second premolar, being closer to the second premolar for females and under the second premolar for males. The vertical location of the MF varied drastically with no statistical significant difference in both sides or between males and females. The difference in dimensions on the left and right sides was not statistically significant. The most common shape of MF was of the continuous type, and the tests showed significant difference with age and gender. Conclusion: The position and shape of MF is a crucial landmark for consideration of mental nerves and vessels when performing surgeries or administering anesthesia. The location of the MF on OPGs of Libyan patients regardless of gender is commonly below and between the mandibular premolar teeth closer to the second premolar, and the most common shape is a continuous type.
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Interrelationship between Porphyromonas gingivalis and complement C3 and factor B Levels in chronic periodontitis individuals p. 49
Srirangarajan Sridharan, Paruchuri M Sravani
DOI:10.4103/dmr.dmr_16_19  
Background: To evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) and serum levels of complement C3 and factor B and their correlation with Porphyromonas gingivalis levels in chronic periodontitis (CP) individuals. Materials and Methods: Thirty individuals were divided into three groups. Clinical parameters such as Plaque Index (PI), Gingival Index (GI), Probing depth (PD) and Clinical attachment level (CAL) were recorded and P. gingivalis levels were measured at baseline in Group I (periodontally healthy) and II( chronic periodontits) and 3 months post scaling and root planning (SRP) in Group III subjects. Serum and GCF samples were collected from all the individuals at baseline 3-month post-SRP to evaluate complement C3 and complement factor B levels by spectrophotometer and enzyme-linked immunosorbent assay, respectively. Levels of P. gingivalis were determined by anaerobic culture. Results: Complement C3 and factor B levels in serum and GCF along with P. gingivalis levels in plaque samples showed statistical significance between the groups (P < 0.001). SRP resulted in decrease in C3, factor B, and P. gingivalis levels after 3 months in CP group at P < 0001. Among the periodontal parameters, PD showed significant correlation with biochemical and microbiological parameters in both the groups before and after periodontal therapy. Conclusion: P. gingivalis correlated strongly with factor B values in CP and SRP resulted in reduction of these values suggesting a possible modulation of alternate complement pathway by P. gingivalis.
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Changes in salivary flow rate, pH, and viscosity among working men and women p. 56
Sethuraman Govindaraj, M Jonathan Daniel, Srinivasan Subramanian Vasudevan, Jimsha Vannathan Kumaran
DOI:10.4103/dmr.dmr_20_19  
Introduction: Salivary gland secretion is mainly under autonomic nervous control, but various hormones may also modulate the salivary composition. Psychological stress exerts its effect on salivary composition, increasing the value of saliva as a dynamic biological fluid determining the overall psychological health of an individual and also in maintaining adequate oral health. Aim and Objective: To determine the salivary flow rate, pH, and viscosity among working men and women. Materials and Methods: The present study consisted of 50 patients, of them 25 were working men and 25 working women. The levels of stress among them were assessed by job stress scale (Shukla and Srivastava, Cogent Business and Management, 2016). Results: The mean flow rate of saliva in working men and women was 0.36 ml/min and 0.25 ml/min and flow rate in men and women with stress was 0.2 ml/min and 0.15 ml/min, respectively. pH in working men and women was 7.1 and 6.7, respectively. pH in men and women with stress was 6.5 and 6.4, respectively. The viscosity of saliva in working men and women was 1.05 cP and 1.29 cP, respectively, whereas the viscosity of saliva in men and women with stress was 1.3 cP and 1.5 cP, respectively. Flow rate in working men and women with stress was found to be significant. Conclusion: To conclude, the stress job exerts its influence on salivary gland function, creating an impact on the quantity and quality of saliva in maintaining the oral health.
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Epidermal growth factor receptor as an early diagnostic marker of oral squamous cell carcinoma: Marking the line between severe dysplasia and oral squamous cell carcinoma p. 60
Sankeerti Mala
DOI:10.4103/dmr.dmr_38_18  
Context: Epidermal growth factor receptor (EGFR) and its ligands are involved in the cell growth of 70% cancer cells. EGFR overexpression or dysregulation may alter intracellular signaling pathways that affect tumor cell survival and apoptosis. It is hypothesized that only those potentially malignant lesions express high levels of EGFR progress to frank malignancies during tumorigenesis which suggests that increase in receptors might be the cause of malignancy rather than the effect of malignancy. Aims: The aim of the study was to assess and correlate the expression of EGFR in varying grades of oral epithelial dysplasia, oral squamous cell carcinoma (OSCC), and normal oral mucosa and to evaluate the early rate of malignant transformation in potentially malignant lesions. Settings and Design: It was a immunohistochemical study. Subjects and Methods: Twenty formalin-fixed, paraffin-embedded blocks of various grades of oral epithelial dysplasia, 10 formalin-fixed, paraffin-embedded blocks of OSCC, and 10 normal mucosae are stained with routine hematoxylin and eosin and immunostained with EGFR by avidin–biotin method. Statistical Analysis Used: Statistical analysis was performed by one-way ANOVA and multiple comparison tests using IBM SPSS Software 20.0 20. Results: Of 40 cases analyszd, 38 cases showed EGFR expression with varied extent and intensity of staining in the cytoplasm and cell membrane of keratinocytes in basal, parabasal, deep spinous, and superficial spinous layer. The results showed a statistically significant increase (P < 0.0001) in the staining extent and intensity of EGFR expression in severe dysplasia and OSCC. Conclusions: EGFRs may act as a marker since they reflect the early changes in dysplastic lesions – predicting the rate of malignant transformation in potentially malignant disorders and thereby aiding the oral pathologist in arresting the lesion before it enters malignancy.
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