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   Table of Contents - Current issue
January-February 2021
Volume 13 | Issue 1
Page Nos. 1-100

Online since Friday, January 29, 2021

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Clinical and microbiological evaluation of calcium silicate versus calcium hydroxide in two-step indirect pulp treatment: A randomized clinical trial Highly accessed article p. 1
Ehsan Hossam El-Din Bayoumy, Mohsen Hussien Abi Elhassan, Ahmed Abdel Fattah Al-Zohairy, Basma Ahmed Al-Awady
Aim: To evaluate the clinical and microbiological performances of calcium silicate in comparison to calcium hydroxide in patients with deep carious lesions using two-step indirect pulp capping in 12 months follow-up. Materials and Methods: Fifty teeth with deep carious lesions received randomly either TheraCal (resin-modified calcium silicate pulp capping material) or Dycal (calcium hydroxide pulp capping material), application of both materials was done in accordance with the manufacturers’ instructions after the excavation of caries on the cavity walls and taking the caries sample from the central carious lesion for microbiological study then the cavities were sealed with conventional glass ionomer cement as a temporary restoration. After 6 months, pain assessment was performed, the cavities were reopened, temporary restorations and pulp capping material were removed, and another dentin sample was taken for microbiological study. In the same visit, caries was excavated to firm dentin and permanent resin composite restorations were applied. Then the patients were recalled after 6 months for pain assessment by a blinded assessor by the use of the visual analog scale system. Results: Pain score results showed a statistically significant difference between the two groups at 6 months and 12 months. Regarding bacterial reduction, there was a statistically significant difference between the two groups in all viable microorganisms except for lactobacilli and mutant streptococci. Conclusions: Resin-modified calcium silicate and calcium hydroxide can both be considered as effective pulp capping materials through relieving pain and possessing antibacterial properties.
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Clinical evaluation of sectional matrix versus circumferential matrix for reproduction of proximal contact by undergraduate students and postgraduate dentists: A randomized controlled trial Highly accessed article p. 10
Omar Osama Shaalan, Shereen Hafez Ibrahim
Aim: In clinical practice, obtaining physiologic proximal contact points is essential for protection of balance and harmony of the stomatognathic system. Consequently, challenges have emerged due to the technique sensitivity of the restorative procedures of posterior proximal resin composite restorations. This study aimed at assessing the influence of different matricing techniques; either sectional matrix or circumferential matrix and operator experience; either undergraduate students or postgraduate dentists on reproduction of optimum proximal contacts for posterior proximal resin composite restorations. Materials and Methods: A total of 60 patients were enrolled; after class II cavity preparation, matrix systems were applied by undergraduate students or postgraduate dentists, by using either sectional matrix or circumferential matrix systems. Cavity preparations were restored by using resin composite restorations according to manufacturers’ instructions. Tightness of proximal contacts was evaluated by using dental floss according to FDI recommendations to be either optimum, tight, or open contact. Chi-square test was used to compare between groups; P value ≤ 0.05 was considered statistically significant. Relative risk (RR) was used to determine the clinical significance. Results: There was a statistically significant difference between the sectional matricing technique and the circumferential matricing technique (P < 0.0001). There was less risk of poor proximal contact (tight or open) with the sectional matrix system, and the risk was 70% less than the circumferential matrix. Conclusions: Optimum contact points were highly associated with the sectional matrix system. Open and tight contacts were highly associated with the circumferential matrix system regardless of operator experience.
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Efficacy of 3% Psidium guajava local drug delivery in the treatment of chronic periodontitis: A randomized controlled trial p. 17
H Manohar Sharma, PC Deepika, MP Venkatesh, S Chandan, Pratibha Shashikumar
Aim: Herbal products are increasingly used as therapeutic agents in the prevention and management of periodontal diseases to preclude the side effects of antibiotics. A recent addition to the list is the leaves of P guajava, as they possess antimicrobial, anti-inflammatory, and antioxidant properties. This study evaluates the effects of the adjunctive use of 3% P. guajava local drug delivery in the management of chronic periodontitis. Materials and Methods: This was a split-mouth study involving contralateral sites in 15 patients (30 sites), who were randomly treated with either 3% P. guajava gel local drug delivery along with scaling and root planing (SRP) or SRP alone. The primary objective was to evaluate pocket probing depth (PPD), clinical attachment level (CAL), and colony counts of A.actenomycetemcomitans (Aa) and P.gingivalis (Pg); the secondary objective was to evaluate plaque, gingival, and bleeding scores. All parameters were assessed at baseline, one month and three months. The data were analyzed by using SPSS 18.5. Results: There was a significant overall improvement in clinical parameters over the study period. There was a statistically significant reduction in site-specific indices, PPD (2.74 ± 0.283), and gain in CAL (2.8 ± 0.152) in the test sites at three months. Microbiological analysis showed a significant reduction in the colony counts of Aa (17.4 ± 0.026) and Pg (22.7 ± 1.225) in the test sites at one and three months. (P < 0.001). Conclusion: Improvements in clinical and microbiological parameters showed that adjunctive use of locally delivered 3% P. guajava gel is effective in the management of chronic periodontitis.
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The comparison of maxillary and mandibular dental arch size in male and female Papuan in Surabaya: A cross-sectional study p. 24
I Gusti Aju Wahju Ardani, Ageng Wicaksono, Oyai Fredy Kromsian, Jusuf Sjamsudin
Aim: The aim of this study was to analyze the differences in the size of maxillary and mandibular dental arch between Papuan males and females. Materials and Methods: An analytical cross-sectional study design was carried out in 12 Papuan males and 12 Papuan females aged above 18–25 years in the Surabaya. Raberin method was used to measure the maxillary and mandibular dental arches width in the dental cast in transversal (L33, L66, L77) and sagittal direction (L31, L61, L71). The statistical analysis was used to analyze the data normality by Kolmogorov–Smirnov test (P > 0.05). In addition, the independent t test was done to determine the differences between groups (P < 0.01). Results: The average sizes of the maxillary dental arch width in the transversal direction in Papuan males, respectively, L33, L66, and L77 were 35.86, 56.58, and 65.61 mm. The average sizes of the maxillary dental arch in the sagittal direction in men L31, L61, and L71 were 4.04, 35.60, and 46.41 mm. The average widths of the maxillary dental arch in a transversal direction in Papuan female L33, L66, and L77 were 32.45, 53.54, and 63 mm. The average sizes of the maxillary dental arch in the sagittal direction in female L31, L61, and L71 were 3.55, 31.94, and 42.42 mm. There was a significant difference between men and female maxillary dental arch in sagittal and transversal measurement (P < 0.01). Conclusion: Male Papuan has a bigger maxillary and mandibular dental arch width as compared to female Papuan. Evaluation of Papuan dental arches may help the orthodontist to determine the diagnosis and treatment plan in this population.
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Evaluation of dental arch forms of Indo-Aryan and Mongoloid ethnicity using 3D models and its correlation with preformed archwires: A cross-sectional study p. 29
Atrayee Barman, Maninder Singh Sidhu, Seema Grover, Namrata Dogra, Ashish Dabas
Aim: The aim of this study was to compare two ethnic groups in India: Indo-Aryan and Mongoloid for variation in arch dimensions, and to determine best-fitting preformed archwire for each group using three-dimensional (3D) models. Materials and Methods: An observational cross-sectional study was conducted on 40 subjects from two ethnic groups. Sample subjects were divided into Group I (n = 20) Indo-Aryan and Group II (n = 20) Mongoloid population. Their maxillary and mandibular plaster models were aligned and laser scanned to obtain 3D virtual models. Linear measurements included intercanine width, intermolar width, canine depth, and molar depth, whereas proportional measurements included canine width/depth ratio, and molar width/depth ratio. Statistical analysis was performed using SPSS statistical software (version 22; IBM, Armonk, New York). Shapiro–Wilk test was done to find if data for both groups were normally distributed (P < 0.05) and Mann–Whitney test for nonnormal distribution groups. Statistical significance was determined at the P < 0.05 level. Results: Intercanine width was similar in both groups, whereas Group II (Mongoloid) showed highly statistically significant increased IMW and IMW/D ratio (P ≤ 0.001) as compared to Group I (Indo-Aryan). Conclusion: Mongoloid arches were broader than that of Indo-Aryan group. For Indo-Aryan group, ovoid and tapered preformed archwire could be used in maxillary arch, whereas only tapered archwire was appropriate in mandibular arch. For Mongoloid group, both ovoid and tapered preformed archwire could be used in both maxillary and mandibular arch.
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Development and comparison of the new index with DAI for evaluating orthodontic treatment need in high caries prevalence community: A diagnostic test study p. 38
Thearmontree Angkana, Thuput Sudarat, Suntornlohanakul Supanee
Aim: The aim of this study was to develop an index for evaluating orthodontic treatment need called “Community Orthodontic Treatment Need Index (COTN)” and to preliminarily compare its accuracy and reliability with Dental Aesthetic Index (DAI). Materials and Methods: This diagnostic test study includes three steps. First and second steps were related to develop the index (COTN) and assessing its accuracy and reliability in dental models. The 110 orthodontic dental models were randomly selected from the pooled dental models of 12–14-year-old children who came for orthodontic screening at the University Orthodontic Clinic. Seven experienced orthodontists assessed orthodontic treatment needs in all 110 dental models (gold standard). Eighty dental models were randomly selected from these 110 models to develop the index by creating algebraic equations using discriminant analysis. Another 30 dental models were evaluated for accuracy and intra-examiner reliability of the two indexes. The last step compared reliability and time consuming of indices in the community. Two examiners assessed 28 schoolchildren aged 12–14 years who were purposively selected using two indices at school. Kappa coefficient, sensitivity, specificity, and paired t test were calculated. Results: COTN contains both anterior and posterior teeth components. It was more likely to have better accuracy and intra-examiner reliability in evaluating orthodontic treatment needs in dental models than DAI (sensitivity + specificity = 1.67 vs. 1.56, kappa = 0.811 vs. 0.689, respectively). Nevertheless, COTN was comparable to DAI for reliability and time consuming when used in the community. Conclusion: This new index (COTN) could be an alternative index for evaluating orthodontic treatment need in high caries prevalence community.
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Eugenol and thymol as potential inhibitors for polymicrobial oral biofilms: An in vitro study p. 45
Diyah Tri Utami, Sylvia Utami Tunjung Pratiwi, Tetiana Haniastuti, Triana Hertiani
Aim: Dysbiosis of polymicrobial biofilms causes dental caries. In a search for a new effective anticaries agent from eugenol and thymol, this study aimed to investigate the efficacy of eugenol and thymol on polymicrobial (Streptococcus sanguinis, Lactobacillus acidophilus, Actinomyces viscosus, and S. mutans) biofilms. Materials and Methods: Antibacterial and antibiofilm activities were tested using the microdilution method. Antibiofilm activities consisted of inhibiting biofilm formation and degradation of polymicrobial biofilms. Tests were conducted using the microdilution method on 96-well microtiter plates. Tests were done at concentration of 1% v/v, 0.5% v/v, 0.25% v/v, and 0.125% v/v. The compound for biofilm staining was 1% v/v crystal violet, and this study used a microplate reader at a wavelength of 595 nm. The minimum biofilm inhibition concentration (MBIC50) and the value of minimum biofilm eradication concentration (MBEC50) were calculated to determine the effectiveness of antibiofilm test compounds against polymicrobial biofilms. The comparative compound used chloramphenicol and Listerine. Scanning electron microscope (SEM) was used to observe the morphological changes in the biofilm after the treatment. Results: Eugenol and thymol showed inhibitory activity against the formation of polymicrobial biofilms. In cells treated with eugenol on polymicrobial biofilms, the matrix of extracellular polymeric substance (EPS) became degraded. Thymol inhibited the biofilms’ growth and damaged the EPS which protect bacterial biofilms. Conclusion: Based on these results, it can be concluded that eugenol and thymol have an inhibiting effect on the formation of polymicrobial biofilms at 24 h and has a great potential in anticaries.
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Cytomorphometric analysis of exfoliated buccal mucosal cells in smokers and patients with hypertension: A quantitative analysis p. 53
Tumpuri Srilatha, Suvarna Manthapuri, Sanjeevareddygari Shylaja, Oruganti Venkata Ramanand, Eppalapalli Sharath Reddy, Vishwakarma Raghu Vamshi
Aim: To examine and estimate cytomorphometric changes by using parameters such as cell area (CA), nuclear area (NA), cell diameter (CD), nuclear diameter (ND), and nuclear-cytoplasmic ratio (N/C) in exfoliated buccal mucosal cells in smokers, patients with hypertension, and healthy individuals by using Papanicolaou stain. Materials and Methods: This quantitative analysis was performed on totally 120 individuals who were randomly selected and were divided into four groups. Group 1: 30 healthy individuals free of hypertension and without any smoking habit comprised the control group; Group 2: 30 individuals with smoking habit and without hypertension; Group 3: 30 individuals with smoking habit and with hypertension; and group 4: 30 individuals with hypertension and without smoking habit. Buccal smears were taken and stained by Papanicolaou stain. Image analysis of 50 cells was done at 40× magnification with a digital image capture analysis software system (ProgRes capture pro, version 2.8.8). The obtained parameters were statistically compared among the groups by one-way ANOVA test and Kruskal–Wallis test. Results: Statistically significant increase in NA, ND, and N/C ratio values were found in smokers and smokers with hypertension, and minimal change was observed in patients with hypertension alone when compared with normal mucosa. Conclusion: Smoking habit alone and patients with hypertension along with smoking habit show significant cytomorphometric changes. The combined use of exfoliative cytology and cytomorphometric analysis gives an added advantage in monitoring clinically suspect lesions and early detection of malignancy in high-risk individuals such as smokers.
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Hyposalivation is the main risk factor for poor oral health status in Indonesian elderly p. 60
Dewi Agustina, Bernadetta Esti Chrismawaty, Lisdrianto Hanindriyo
Aim: To analyze the effect of xerostomia and hyposalivation as risk factors for poor oral health status in Indonesian elderly. Materials and Methods: Oral health status of 158 elders in Yogyakarta, Indonesia was determined using Oral Hygiene Index-Simplified, Decayed, Missing, and Filled Teeth (DMFT) index, modified Community Periodontal Index, and number of natural occluding pairs (NOP). Xerostomia was determined by Xerostomia Inventory and hyposalivation was identified by measuring whole unstimulated saliva flow. Bivariate and multivariate analyses were done to analyze the possible correlation between the event of hyposalivation and xerostomia with each of the independent variables (oral health status) and to assess the simultaneous effect of hyposalivation and xerostomia for the event of poor oral hygiene (OH), respectively. Results: Periodontal pocket, high DMFT index, poor OH, ≤5 NOP, xerostomia, and hyposalivation were experienced by 41, 113, 44, 116, 94, and 40 of 158 participants, respectively. Based on the bivariate analysis between the event of xerostomia and oral health status indicators, it was found that there was a significantly different proportion of OH condition between the group of participants with and without xerostomia (P = 0.035). Conversely, the proportions of periodontal pocket and OH condition were significantly different between the group of participants with and without hyposalivation with P values of <0.001. The multivariate analysis demonstrated that the participants with hyposalivation and xerostomia have a 5.68 and 2.49 times higher risk of experiencing poor OH condition, respectively, accounted for 20% of the total model. Conclusion: Hyposalivation is the main risk factor for poor oral health status in Indonesian elderly.
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Variability of dimensional stability of different interocclusal recording materials according to time: A comparative in vitro study p. 65
Felipe Lozano, Francisco Sanchez, Patricia Agüero, Arnaldo Munive-Degregori, Enma Ambrocio, Frank Mayta-Tovalino
Aim: The aim of this study was to assess variability of dimensional stability of different interocclusal recording materials according to time in a comparative in vitro study. Materials and Methods: This was an experimental in vitro study. The sample was made up of n = 80 intermaxillary records. To record dimensional stability, it used a high-precision device manufactured according to specification No.19 of the American Dental Association. Measurement of discrepancies was recorded with a precision digital caliper (0.01 mm). The intermaxillary recording materials were placed inside the metal device as follows: The silicone by addition was injected using a system of cartridges and special mixing tips and Godiva was immersed in hot water (40–45°C) for 5 min to soften them. Inferential statistical analysis was performed with ANOVA and Bonferroni test, with a level of statistical significance of P < 0.05. Results: Aluwax and Godiva wax presented linear dimensional changes from the time the intermaxillary record was taken and increased with storage time. Occlufast silicone remained stable for up to 7 days (0.120 ± 0.015) mm, while Futar D silicone was stable for up to 22 days (–0.028 ± 0.009) mm. Conclusion: Silicones and polyvinyl siloxanes presented greater dimensional stability than the godiva and Aluwax (Futar D silicone being more stable than the Occlufast silicone). Finally, Godiva presented greater dimensional stability than the Aluwax because it presented the greatest dimensional variation over time with respect to the other materials.
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Comparison of friction coefficient and surface roughness on stainless steel nickel titanium, and nickel-titanium copper wires to standard edgewise brackets: An experimental in vitro study p. 71
Yuniar Elsa Dwinuria, Dimas Iman Nugroho, Jusuf Sjamsudin, Ida Bagus Narmada
Aim: The aim of this study was to investigate the friction and the difference in the roughness of the wire on the standard edgewise bracket. Materials and Methods: This was an experimental laboratory study with a posttest only control group design. The number of samples in this research was 21. The samples were divided into three groups (n = 7) consisting of 0.016′′ x 0.022′′ stainless steel archwire (SS group), 0.016′′ x 0.022′′ nickel-titanium archwire (NiTi group), and 0.016′′ x 0.022′′ nickel-titanium copper archwire (NiTiCu group). The bracket used in each group is standard edgewise slot 0.018. Friction coefficient test was conducted by creating an examination tool from acrylic to fixate the bracket with a size of 2cm x 5cm. The bracket was then attached using glue (polyvinyl acetate) and the archwire was fixated to the bracket using power O. After the friction test, three samples were taken from each group to be tested morphology and topography of each type using scanning electron microscope (SEM). Statistical analysis used in this research is using one-way analysis of variance (ANOVA) to find out the comparison of variables and Tukey’s honest significant difference (HSD) to find out the comparison between three groups (P < 0.05). Results: The lowest friction coefficient was found in SS archwire, which consecutively followed by NiTiCu and NiTi. The smoothest archwire surface observed by SEM was SS, followed by NiTiCu and NiTi. Conclusion: SS wire has the smoothest archwire surface and the lowest frictional force, so it is well used for the teeth movement in space closing on edgewise bracket.
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Knowledge, attitude, and experience of master degree dental students toward child physical abuse in Egypt: A cross-sectional study p. 76
Randa Youssef Abd Al Gawad, Sara Ahmed Mahmoud
Aim: Identification of child physical abuse (CPA) cases is a global worldwide concern nowadays due to its serious lifelong consequences. The aim of this study was to assess knowledge, attitude, and experience of pediatric dentistry master’s degree students and other master’s degree students toward CPA. Materials and Methods: A cross-sectional study with convenient consecutive sampling was conducted on 124 Master Degree dental students at Cairo University, during the academic year (2018–2019). The sample was divided into Group I: 53 Pediatric Dentistry Master Degree students and Group II: 71 Other Master Degree students, where data regarding their knowledge, attitude, and experiences toward CPA were collected using a structured, self-administered questionnaire. Collected data were tabulated and statistically analyzed. Comparisons between the two groups were performed using chi-square test (P < 0.05). Results: Only11.4% of Group I and 9.9% of Group II received previous training about CPA. Regarding knowledge, there was no statistically significant difference between both groups, except for Qs 12 and Q15 where Group I showed statistically significant higher positive responses (52.8% and 79.2%, respectively). When assessing attitude, there was no statistically significant difference between both groups, except for Q 21, where Group I showed a statistically significant higher positive response (92.5%). Regarding experience, Group I reported more suspicions toward physical abuse cases (56.6%); however, Group II reported more cases (76.7%). Conclusion: Both groups had nearly equivalent positive knowledge, attitude, and experience toward CPA; however, the number of suspected cases was far beyond the worldwide records. Training courses and data available at workplaces are still not sufficient.
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The assessment of aggressive periodontitis at Kuantan, Pahang: A retrospective study p. 83
Nurul Farahin binti Fazid, Siti Mahirah binti So’odi, Munirah Yaacob, Juzaily Hussain, Suhaila Muhammad Ali
Aim: Aggressive periodontitis (AgP) is a less common but rapidly destructive form of periodontitis. Literature is scarce regarding the prevalence and characteristics of the disease in Malaysia. This study was conducted to assess the prevalence of AgP and its correlation with sociodemographic, risk factors, and clinical presentations. Materials and Methods: This retrospective cross-sectional descriptive study of AgP includes patients who had attended the IIUM Dental Clinic from the year 2014 up to June 2017. The data regarding the characteristics of AgP were extracted from patients’ case records systematically using a standard data extraction form. Descriptive analysis, independent t-test, and χ2 test were conducted using IBM SPSS, version 24.0 software. Results: Of 262 periodontitis cases, 11 were confirmed to have AgP, giving a prevalence of 4.2%. Seven of them had the generalized form of AgP with a mean (±SE) age of 36.4 (±6.99) years. Eight of them were female, the majority were Malay, and four of them claimed of having familial aggregation. The localized form had significantly deeper pocket depth of at least 6 mm. However, the percentage of bleeding on probing and plaque scores were significantly higher in the generalized form of the disease (P < 0.05). First molars showed the highest frequency of tooth loss and clinical attachment loss. Conclusion: The prevalence rate of AgP in a specified population in Kuantan was found at 4.2%, affecting younger age group compared to chronic periodontitis. Age, the percentage of bleeding on probing, plaque score, and deep pockets were significantly associated with the types of AgP.
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Allelic sharing among madurese as a tool of madurese identification using 11 short tandem repeats and amelogenin gene: An observational analytical study p. 89
Ahmad Yudianto, Agung Sosiawan, Abdul Hadi Furqoni, Indah Nuraini Masjkur, Qurrota A’yunil Huda
Aim: To analyze the allelic sharing and a set of preferable short tandem repeats (STRs) loci among the Madurese full siblings. Materials and Methods: This was an observational analytical study. The research subjects were determined from 20 Madurese families that originated from Madura Island, Indonesia consisting of father, mother, and two biological children. The blood samples were collected, and kinship relationship was examined by using the PCR-STR technique by 11 loci of genotyped STR alleles and a sex-typing amelogenin locus. Calculations of combined sibship indices (CSIs) for each pair were done to determine the likelihood ratios. Results: Based on 220 observations (20 pairs of full sibling x 11 loci) of the STR allele genotype, 4 STR loci were found: D8S1179, F13, CSF1PO, and FES. A high-shared allelic frequency was found in two alleles that were shared among 11 STR loci by 57 times (25.9%), one allele shared among eleven STR loci by 130 times (59.1%), and zero alleles by 33 times (15.0%). Conclusion: This study indicated the power of one allele in the sibship among a Madurese establishment through the 11 STR loci.
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ABO blood group detection in extracted teeth: A forensic study p. 93
Mithilesh N Mishra, Vidyadevi Chandavarkar, Deepak Bhargava, Ritika Sharma, Radhika Gupta, Sahil Thakar
Aim: The aim of this study was to ascertain ABO blood group from extracted teeth using pulp and dentin tissues with the help of the absorption–elution (AE) technique. Materials and Methods: The study was conducted using an experimental study design and included 60 patients who underwent extraction due to periodontal and therapeutic purposes. Blood group antigens were ascertained for all the study participants using capillary blood by slide agglutination method (Controls). AE technique was used to check blood grouping using powdered dentine and dental pulp immediately after extraction and after 9 months. The study group was compared with the control group for blood group determination at different time intervals to find the sensitivity of dental pulp and a significant difference between those values at different time intervals. The statistical tests used were the Shapiro–Wilk test, chi-squared test, multivariate linear regression, and the Pearson correlation coefficient. Results: A total of 60 study subjects, 39 males and 21 females, were taken. In the estimation of blood group, 54 teeth, that is, 90% of total sample, were positive. We found an inverse relationship between the result for the blood grouping and time intervals, that is, 100% and 80% test results, done on the day of extraction and after 9 months. Conclusion: It could be inferred that the antigens from pulp are biologically stable for long time. This study brings a spotlight on the time duration for which teeth can remain as the prominent source for the detection of blood group.
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Reviewers List, 2020 p. 100

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