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   Table of Contents - Current issue
Coverpage
July-August 2018
Volume 10 | Issue 4
Page Nos. 157-209

Online since Tuesday, August 28, 2018

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REVIEW ARTICLES  

Chasing perfection: Body dysmorphic disorder and its significance in dentistry p. 157
Shruti S Kumar, Vishal Shrishail Kudagi, Gurvinder Kaur
DOI:10.4103/jioh.jioh_22_17  
Body dysmorphic disorder (BDD) is a type of mental illness, a somatoform disorder, wherein the affected person is concerned with body image, manifested as excessive concern about, and preoccupation with a perceived defect of their physical features. The individual may perceive a defect in either one feature or several features of their body, which causes psychological distress that impairs occupational or social functioning. Considerable numbers of these patients are obsessed with the appearance of their dentition and the shape of their jaws. Usually, the dentist can be the first to diagnose this condition which may otherwise pass unnoticed. This problem can sometimes interfere to a large extent in rendering appropriate dental treatment. BDD has remained an elusive topic for both researchers and clinicians likewise. This condition needs further research which can greatly help in intercepting and preventing its myriad lethal manifestations.
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Various recent reinforcement phase incorporations and modifications in glass ionomer powder compositions: A comprehensive review p. 161
Arbaz Sajjad, Wan Zaripah Wan Bakar, Dasmawati Mohamad, TP Kannan
DOI:10.4103/jioh.jioh_160_18  
Glass ionomer cements (GIC) were first introduced to dentistry in the late 1960s and since have proven to be useful in various areas of dental science, particularly restorative dentistry. As an aqueous polyelectrolyte system, GICs are known for their relative ease of use, chemical bond to the tooth, fluoride release and recharge, low coefficient of thermal expansion, and acceptable esthetic quality. However, clinical usage of GICs is still limited due to their relatively inferior mechanical properties and sensitivity to initial desiccation and moisture. Years of extensive research on enhancing the chemistry of the basic glasses have yielded improved formulations with enhanced mechanical properties and reduced moisture sensitivity. A comprehensive review of the available literature has revealed that not all modifications in glass powder have resulted in the desirable strengthening of GICs. There is a shift of focus toward studies on nanoscale particles and bioactive glass. Recent research has proven that incorporation of nanoceramics such as hydroxyapatite (HA), fluorapatite, silica, and zirconia (ZrO2) have resulted in improved mechanical properties of GICs due to their ability to release fluoride, high surface area, and better particle size distribution. More work should thus, be undertaken to optimize techniques for enhancing the physicomechanical properties of GICs by incorporation of nanophases of ZrO2, HA, and metallic nanofillers.
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Digital technology in the refining of protocols for the bonding of orthodontic brackets p. 168
Natalice Sousa de Oliveira, Henrique Pretti
DOI:10.4103/jioh.jioh_143_18  
Evaluating the quality of individual positions of the attachments will make it possible to foresee positions that may lead to undesirable orthodontic movements, thereby being of direct benefit to both the professional and patient. The purpose of this study was to list imprecision factors associated with traditional bonding methods, as well as present evidence about the software systems that incorporate digital technology to vestibular bonding. The electronic databases PubMed, MEDLINE, Cochrane, and Google Scholar were searched for available data. The following terms were used in the literature search: accuracy, orthodontic brackets, direct bonding, indirect bonding, and virtual orthodontic attachment bonding. Although the technological interface has optimized protocols, especially in planning and laboratory stage, digital systems did not demonstrate to guarantee accuracy. However, virtual orthodontics is now an irrevocable trend, for enabling more efficacy and therapeutic control. It is plausible that soon all orthodontic brackets will be placed digitally.
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ORIGINAL RESEARCH Top

Relationship of tooth loss, impaired chewing ability, and cognitive impairment among the elderly of western Maharashtra, India p. 172
Snehal Patil, Smruti Patel, KM Shivakumar, Siddhi Hathiwala
DOI:10.4103/jioh.jioh_89_18  
Aim: The aim of this study was to evaluate the association between the tooth loss impaired chewing ability and cognitive impairment among the elderly of western Maharashtra, India. Materials and Methods: It was a cross-sectional, community-based study conducted among 200 consenting elderly. Information regarding tooth loss, chewing ability and cognitive impairment (clock-drawing test), and sociodemographic variables were obtained and analyzed. Results: Participants with impaired chewing ability had 5.57 more odds of cognitive impairment. Similarly, those with multiple tooth loss had 2.4 times odds of cognitive impairment compared to normal counterparts. Conclusions: Multiple tooth loss and impaired chewing ability increase the odds of cognitive impairment.
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A comparative study of the effect of nanohydroxyapatite and eggshell on erosive lesions of the enamel of permanent teeth following soft drink exposure: A randomized clinical trial p. 176
Maede Yaberi, Roza Haghgoo
DOI:10.4103/jioh.jioh_84_18  
Aims: The purpose of this in situ study was to compare the effects of nanohydroxyapatite or eggshell (ES) extract on the microhardness of healthy third molar tooth enamel following soft drink exposure. Materials and Methods: This study was performed as a randomized clinical trial. This experimental study was conducted with ten participants and involved twenty extracted, healthy, permanent third molar teeth. The initial microhardness values of the teeth were measured. The teeth were then exposed to delestre for 10 min, and the microhardness was measured again. Samples were divided into two groups of 10. For each appliance, two teeth were placed, one from each group and one on either side of the appliance. For the in situ study, sections of two teeth, one from each group, were embedded in an appliance and placed in the mouth of the volunteer. Each volunteer used this appliance for 10 days. After 10 days, the microhardness of the teeth was measured again. Finally, data were analyzed using analysis of variance and paired t-tests. Results: The mean tooth enamel microhardness was significantly decreased following exposure to delestre and the mean microhardness of demineralized tooth enamel significantly increased after exposure to both nanohydroxyapatite and eggshell extract. Conclusion: Nanohydroxyapatite and ES have the potential to remineralization erosive lesions.
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Clinical and radiographic outcomes of three different loading protocols for single-implant-supported prostheses: A randomized controlled trial p. 180
Rami M Galal, Salah A Yousief, Waleed M.S. Alqahtani
DOI:10.4103/jioh.jioh_75_18  
Aims: The aim of this study is to assess the effects of early, immediate, and progressive loading of dental implants clinically and radiographically. Materials and Methods: Twenty implants were inserted in 20 patients. Five implants were used for each group (early, immediate, progressive, and conventional loading). In early loading, implant was loaded after 1 week. In immediate loading, loaded with temporary crown within 48 hours then definitive prosthesis after 4 months. In progressive loading loaded with temporary crowns out of occlusion after 3 months for the mandibular sites and 4 months for the maxillary ones for 1 month, and then loading on centric occlusion for 1 month, then full occlusion for 2 months, then definitive prostheses were used. Radiographic assessment for crestal bone loss was done. Clinical assessment of periodontal pocket depth was performed at 3, 6, and 9 months. Results: At 9 months, probing depths were 1.80 ± 0.37, 2.10 ± 0.34, 2.25 ± 0.18, and 1.83 ± 0.38, for immediate, early, progressive, and control groups, respectively. Immediate group showed statistically nonsignificant bone loss after 3 months in the mesial side but showed statistically significant bone loss after 6 and 9 months whereas statistically significant bone loss through all periods in the distal side. Early group showed statistically significant bone lose. Progressive group showed statistically nonsignificant bone loss after 3 months but significant loss after 6 and 9 months. Control group showed statistically nonsignificant bone loss. Conclusions: Immediate loading showed excellent soft-tissue reaction, and early loading responses are identical to conventional two-staged procedure. Progressive loading demonstrated significantly less crestal bone loss than conventional one.
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Prevalence of self-perceived halitosis, demographic factors and oral health care among defined groups of dental students in Iran p. 187
Mahin Bakhshi, Maryam Tofangchiha, Sedigheh Bakhtiari
DOI:10.4103/jioh.jioh_153_18  
Aim: This study was to determine the prevalence of self-perceived halitosis and the associated factors regarding health care among dental students. Materials and Methods: This study was conducted on 225 dental students. Information form which contained demographic factors and habits (cigarettes and alcohol), self-perceived halitosis and health cares was filled by them. Then, the organoleptic test was done. People whose organoleptic test score was ≥2 were considered with halitosis. Statistical tests such as Chi-square, Mann–Whitney, and logistic regression modeling were used to examine the relationship between variables and halitosis and their severity. Results: Out of 225 patients enrolled, 127 were female and 98 were male. Mean age of patients was 21.72 years. A total of 151 patients (67.1%) suffered from halitosis (66.9% of women and 67.3% of men), which showed no significant difference between them. Self-perceived halitosis was 76.9%. Among patients, 43 (19.1%) smoked. The odds for halitosis in people who did not use mouthwash regularly were 2.03 times higher than those who used mouthwash (P = 0.029). Moreover, people who brushed their teeth once a day were more likely to develop halitosis than those who brushed more than twice a day (odds ratio [OR] = 2.73, P = 0.038). The odds for halitosis was 1.86 times higher in people who did not use floss than those who used floss (P = 0.07); although this difference was not statistically significant at the 0.05 level. The use of tongue scrap was not significantly associated with the halitosis (OR = 1.13, P = 0.71). Conclusion: Self-perceived halitosis was high (76.9%) in dental students. In more than 75% of students who had genuine halitosis, halitosis had a negative effect on their social relations.
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Assessment of periodontal status among the outpatients attending private university dental clinics in Riyadh city, Saudi Arabia p. 192
Osamah Mohammed AI Mugeiren
DOI:10.4103/jioh.jioh_152_18  
Aim of the Study: The study aims to evaluate the prevalence of gingivitis and periodontitis among dental outpatients attending Munisiya Clinics of Riyadh Elm University using CPI criteria and also to compare the results with age, gender, systemic condition, smoking, and the use of oral hygiene measures. Materials and Methods: The periodontal status of 214 (90 male and 124 female) patients selected from outpatient's clinics in Munisiya Campus of Riyadh Elm University was evaluated according to the Community Periodontal Index (CPI) criteria. A close-ended, self-administered questionnaire recorded the patient's personal characteristics (age, gender, systemic condition, smoking, and the use of oral hygiene measures). The study population comprised three age groups – Group I: consisted of 148 patients aged 20–34 years old, Group II: consisted of 39 patients aged 35–49 years old, and Group III: consisted of 27 patients aged 50–64 years old. Data were collected tabulated and statistically analyzed to compare between all groups. Results: Our results showed that age and smoking status were considered significant factors associated with periodontitis. Furthermore, the highest prevalence of gingivitis was among younger age groups, while the highest prevalence of periodontitis was among older age groups. Furthermore, the highest prevalence of gingivitis and periodontitis was seen among males compared to female population. Conclusions: Smoking and diabetes mellitus were strongly associated with periodontitis. Moreover, irregular oral hygiene measures were considered among the risk factors of gingivitis and periodontitis.
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Oral-dental health knowledge, attitude and practice among dental and pharmacy students at Riyadh Elm University, KSA p. 198
Mohammed Mohsin Aljrais, Navin Ingle, Mansour K Assery
DOI:10.4103/jioh.jioh_133_18  
Aim: The aim of this study was to explore and assess oral health knowledge, attitude, and practice of dental students (DS) and pharmacy students (PS) at Riyadh Elm University. Materials and Methods: A cross-sectional study was conducted among 300 undergraduates including 150 DS and 150 PS from Riyadh Elm University using a self-administered structured questionnaire. Each group was further subdivided into equal portions of 75 males and 75 females. The mean percentage scores, standard deviation, and frequency distribution were calculated, while Student's t-test and Chi-square test were employed to test for the association between different variables. Results: DS showed the highest scores on 6 out of 8 of the knowledge questions compared to PS (P = 0.000), while their scores on the rest of the two questions were about similar with no significant difference between the two groups (P = 0.223 and 0.561). The unpaired t-test showed means of 114.375 ± 26.386 for the DS and 48.25 ± 30.046 for the PS who answered yes and the difference was significantly high (P = 0.000). On the other hand, the unpaired t-test showed a means of 101.75 ± 30.046 for the PS and 35.625 ± 26.386 for the DS who answered no (P = 0.000). The scores of the 4-point Likert Scale corresponding to the five attitude questions were comparable between the dental and pharmacy groups. There were no statistically significant differences in the attitude responses of the two groups as indicated by the Chi-square P values for every question (P = 0.155–0.767). Regarding oral care practice, a total of 113 (75.3%) of the DS and 127 (84.6%) of the PS showed to brush their teeth 2–3 times a day. A total of 107 (71.4%) and 111 (74.0%) of the respective DS and PS used to rinse their teeth from 2 to 3 times a daily. The responses of the DS and PS regarding teeth flossing, the use of dental fluorides, and the frequency of their dental checkup were very close. Chi-square P values were 0.215, 0.779, 0.985, 0.677, and 0.769, respectively, for the five practice questions with no significant difference. Conclusion: Oral health knowledge among DS was significantly higher than PS. The higher knowledge of DS could be attributed to their specialized courses on oral health which is lacking in the pharmacy program. PS had positive attitude and practice despite having poor knowledge regarding oral health. Both groups showed positive oral care attitude and practice with no significant statistic differences.
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Evaluation of light-curing units used in dental clinics at a University in Malaysia p. 206
Yi Ren Lee, Nik Rozainah Nik Abdul Ghani, Mohmed Isaqali Karobari, Tahir Yusuf Noorani, Mohamad Syahrizal Halim
DOI:10.4103/jioh.jioh_114_18  
Aim: The purpose of this study was to evaluate the efficiency of all light-curing units (LCUs) used in dental clinics of a university in Malaysia. Materials and Methods: Light intensity output (LIO) of each LCU was first determined using a light radiometer. A total of 88 LCUs were used in this study which were divided into three groups based on their LIO as follows: Group 1 (G1) ≥1000 mW/cm2, Group 2 (G2) 701–999 mW/cm2, and Group 3 (G3) ≤700 mW/cm2. Prepared composite resin specimens were then cured using these LCUs and were subjected to compressive strength test. Kruskal–Wallis test was used to compare the compressive strength of composite resin specimens cured by the three LCU groups. Independent t-test was used to compare LIO between corded and cordless light-emitting diode (LED) LCUs. The level of significance was set at P ≤ 0.05. Results: About 77.27% of LCUs had LIO ≥1000 mW/cm2 (G1), 14.77% had LIO ranging from 701 to 999 mW/cm2 (G2), and 7.95% ≤700 mW/cm2 (G3). There was no significant difference in the compressive strengths of composites cured by G1 and G2 (P > 0.05). However, compressive strength of composites cured by G1 was significantly higher than that of G3 (P < 0.05). Furthermore, compressive strengths of composite cured by G2 were also significantly higher than that of G3 (P < 0.05). The LIO of cordless LED LCU was significantly higher than that of the corded ones (P < 0.05). Conclusion: LCU with LIO above 700 mW/cm2 outperformed those with LIO < 700 mW/cm2. Cordless LED LCU demonstrated better performance than corded ones.
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