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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 19 | Issue 3
Page Nos. 201-280

Online since Wednesday, July 31, 2019

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EDITORIAL  

Beyond statistical significance p. 201
N Gopi Chander
DOI:10.4103/jips.jips_207_19  
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ORIGINAL ARTICLES Top

Effect of intravenous administration of zoledronic acid on jaw bone density in cases having skeletal metastasis: A prospective clinical study p. 203
Veena Jain, Ashu Seith, Smita Manchanda, Rajath Pillai, DN Sharma, Vijay Prakash Mathur
DOI:10.4103/jips.jips_368_18  
Aim: The objective is to evaluate the effect of intravenous (i.v.) administration of bisphosphonate (zoledronic acid) therapy on the jaw bone density and incidence of any other bony patholog. Settings and Design: Observational – prospective study. Materials and Methods: A total of 57 patients having a history of bony metastasis (excluding the jaw bone) were enrolled following the inclusion/exclusion criteria. Each patient received six doses of 4 mg i.v. bisphosphonate once a month. Multidetector computed tomography (MDCT) of jawbones for each patient was performed before the start of therapy (baseline) and subsequently at 6 and 12 months. Bone density was assessed at 24 predetermined sites (8 sites in maxilla and 16 sites in mandible) and any pathological change in either of the jaw bones was noted. Statistical Analysis Used: Shapiro–Wilk test ,Pearson's Chisquare test and repeated measures analysis of variance. Results: The result showed no statistically significant increase in mean bone density over a period of 1 year in maxilla and mandible. However, a significant increase in bone density was observed from 6 months to 1 year in mandibular anterior cancellous bone. The detailed observation of each MDCT scan showed no pathological change in either of the jaw bones during the study period. Conclusion: The administration (i.v.) of six doses of 4 mg bisphosphonate did not lead to a significant change in bone density over a period of 1 year.
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One-year follow-up study to evaluate the marginal bone resorption and attachment loss with customized post with stud attachment and prefabricated access post for mandibular overdenture p. 210
Sachin Haribhau Chaware, Vibhuti Rohit Sachdev
DOI:10.4103/jips.jips_91_19  
Aim: This study aims to analyze the marginal bone resorption and attachment loss of the overdenture attachment for the mandibular overdenture. Settings and Design: Observational study done at MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India. Materials and Methods: A total of 30 subjects were selected of either sex between the age group of 50-70 years by designate of randomized parallel controlled sampling technique. The Cone beam computed tomography (CBCT) radiographic quantification determines the caliber of bone resorption and University of North Carolina (UNC) probe checked the depth of attachment loss of the abutment teeth that receive the cast coping (nonattachment control group), customized post and stud attachment, and prefabricated access post. Statistical Analysis Used: Oneway ANOVA test and post hoc Bonferroni multiple test. Results: statistical analysis reveals the comparison of distinction between groups is significant at P < 0.05. The control group records least bone resorption and attachment loss than Group II and Group I. However, Group II records marginally higher bone resorption and attachment loss than Group III. Conclusion: The result of the study within the physiologic limit analyze that, cast coping records least bone resorption and attachment loss followed by Customized post with stud attachment and prefabricated access posts. The prefabricated access post records higher bone resorption and attachment loss.
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Oral rehabilitation following fasciocutaneous free-flap reconstruction: A retrospective study p. 221
Zain Uddin Ahmed, Joseph M Huryn, Ivana Petrovic, Evan B Rosen
DOI:10.4103/jips.jips_97_19  
Aim: The aim of this study is to retrospectively, observe a consecutive series of patients with segmental mandibulectomy defects reconstructed with fasciocutaneous free flaps and mandibular resection prostheses, and to review treatment concepts for the management of such patients. Settings and Design: Observational study done at Memorial Sloan Kettering Cancer Center, New York, NY, USA. Materials and Methods: Records were reviewed of all patients who had fasciocutaneous free-flap reconstruction and fabrication of mandibular resection prostheses following segmental mandibulectomy between 2000 and 2017 at a tertiary cancer center. Mandibular resection prosthesis fabrication interval data, as well as follow-up interval data, were recorded. Statistical Analysis Used: Descriptive statistics. Results: Twenty-one consecutive patients had mandibular resection prostheses fabricated following segmental mandibulectomy and fasciocutaneous free-flap reconstruction during the study. The median time for mandibular resection prosthesis delivery following surgery was 9 months (range 4–41 months). There was a median of two-follow-up visits (range 0–4) within the first 90 days of mandibular resection prosthesis delivery. Conclusions: Oral rehabilitation with mandibular resection prosthesis following segmental mandibulectomy and fasciocutaneous free-flap reconstruction is an attainable treatment goal for the oncologic patient. Reviewing the proposed course of care is helpful for patient management.
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To study the effect of Cocos nucifera oil when incorporated into tissue conditioner on its tensile strength and antifungal activity: An in vitro study p. 225
Gayathri Krishnamoorthy, Aparna I Narayana, Prakash Yegneswaran Peralam, Dhanasekar Balkrishanan
DOI:10.4103/jips.jips_387_18  
Aim: This study aims to test the tensile strength and growth of Candida albicans on Viscogel tissue conditioner when incorporated with coconut oil (CCO) and to compare its efficacy with other antifungal agents. Settings and Design: Evaluative - In-vitro study design. Materials and Methods: Fifty dumbbell-shaped samples (n = 10) of Viscogel tissue conditioner were fabricated according to ASTM standard and were classified into 5 groups (10% CCO, 30% w/w tea tree oil, 5% w/w fluconazole, 0.03% w/w silver nanoparticles, and plain tissue conditioner). These samples were compared and evaluated for their tensile strength. Further to test the antifungal activity, a total of 60 samples (n = 15) were fabricated, each group (n = 15) was further divided into three subgroups (n = 5), namely 24-h, 3-day, and 5-day period, which were inoculated in sabouraud dextrose agar plate to test for the growth of C. albicans. Statistical Analysis Used: Oneway ANOVA and post hoc Tukey honestly significant difference test. Results: 10% w/w CCO yielded a mean tensile strength of 20.06 as compared to the plain tissue conditioner which showed a mean tensile strength of 17.81. Similarly, 10% w/w CCO incorporated into Viscogel tissue conditioner showed a significant reduction in the colonization of C. albicans on the 5th day. Conclusions: 10% w/w of CCO when mixed with Viscogel tissue conditioner showed a significant reduction in the growth of C. albicans, and addition of the same increased the tensile strength of the tissue conditioner.
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Microcomputed tomography a noninvasive method to evaluate the fit of a restoration as compared to conventional replica technique p. 233
Sabita M Ram, Nishita Narendra Ranadive, Jyoti B Nadgere
DOI:10.4103/jips.jips_71_19  
Aim: The aim of the study was to compare the assessment methods used to evaluate the fit of Ni-Cr metal copings. Settings and Design: Comparative- Invitro study design. Materials and Methods: A stainless steel die simulating a prepared first maxillary premolar was used as a master die. Wax pattern copings were fabricated by the conventional dipping wax technique (n = 20) on the master die and were cast in Ni-Cr alloy. The finished copings were fitted on the master die and scanned by the micro-computed tomography (CT) scanner. Multiple projections of the sample were reconstructed to evaluate the marginal and internal fit at 5 predetermined locations. The same copings were used for the replica technique and were evaluated under a stereomicroscope in the same locations. Statistical Analysis Used: Shapiro–Wilk's test and Unpaired t-test Results: The marginal fit values observed were 127.71 and 95.06 μm, chamfer area fit values were 151.97 and 132.7 μm, axial area fit values were 62.36 and 46.14 μm, axio-occlusal area fit values were 139.52 and 123.6 μm, occlusal area fit values were slightly higher with 217.91 and 193.1 μm, respectively, in replica and micro-CT technique. There was no statistically significant difference observed in the fit between the two assessment methods (α > 0.05). Conclusions: There was no difference observed in the marginal and internal fit of Ni-Cr metal copings with the two methods of assessment. However, the micro-CT technique proved to be simpler, noninvasive, and time-saving assessment method.
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Comparative analysis of shear bond strength of lithium disilicate samples cemented using different resin cement systems: An in vitro study p. 240
Viram Upadhyaya, Aman Arora, Jagriti Singhal, Smriti Kapur, Monika Sehgal
DOI:10.4103/jips.jips_161_19  
Aim: This study aims to evaluate and compare the shear bond strength (SBS) of three different resin cements - total etch and rinse, self-etch and self-adhesive resin cements, used to bond the lithium disilicate restorations to human dentin. Settings and Design: Comparative -Invitro study design. Materials and Methods: Forty-five lithium disilicate (IPS E.max) discs (4 mm in diameter and 3 mm thick) were fabricated and randomly divided into three groups (n = 15). The occlusal surfaces of 45 extracted human maxillary premolars were ground flat. Fifteen specimens were luted, under a constant load, with each of the following resin cement: Variolink N (Group VN), Multilink N (Group MN), and Multilink Speed (Group MS). All cemented specimens were stored in distilled water for 1-week following which, they were tested under shear loading at a constant crosshead speed of 1 mm/min until fracture on a universal testing machine; the load at fracture was reported in megapascals (MPa) as the bond strength. Fractured specimens were also inspected by the scanning electron microscopy. Statistical analysis of the collected data was performed using one-way ANOVA test, post hoc Bonferroni test, and Chi-square test (α =0.05). Statistical Analysis Used: Oneway ANOVA test and post hoc Bonferroni test. Results: Mean SBS data of the groups in MPa were: Variolink N (Group VN): 14.19 ± 0.76; Multilink N (Group MN): 10.702 ± 0.75; and Multilink Speed (Group MS): 5.462 ± 0.66. Significant differences in SBS (P < 0.001) of the three resin cement were found. Intergroup comparison revealed statistically significant differences in SBS between Groups VN and MN (P < 0.001), Groups B and C (P < 0.001), and Groups VN and MS (P < 0.001). Chi-square test used to compare the distribution of mode of bond failure among the three groups delineated that the cohesive failure was significantly more among Group VN, whereas adhesive failure was significantly more among Group MN and MS. Conclusion: Total etch and rinse resin cement, i.e., Variolink N (Group VN) produced significantly higher bond strength of all-ceramics to dentin surfaces than did the self-etch and self-adhesive resin cements, i.e., Multilink N and Multilink Speed, respectively.
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Comparative evaluation of diametral tensile strength of phosphate-bonded investment (ringless) material by using air-drying method, conventional hot air oven, microwave oven, and combination of microwave and conventional oven: An in vitro study p. 248
Akhil Rathi, Neelam Pande, Usha Radke, Saee Deshpande, Anuj Chandak
DOI:10.4103/jips.jips_45_19  
Aim: This study evaluated and compared the diametral tensile strength (DTS) of phosphate-bonded investment (PBI) material (ringless) used in removable cast partial denture fabrication. Settings and Design: Comparative - Invitro study. Materials and Methods: The PBI material, Wirovest used in this study was subjected to four different drying methods. A total of 80 specimens were prepared in a cylindrical form; 20 specimens were air dried for 2 h, 20 specimens were dried in a conventional oven at 230°C for 1 h, 20 specimens were dried in microwave oven at 600 W for 10 min, and remaining 20 specimens were dried first in microwave oven and then in conventional oven. The dried specimens were tested at 2-h interval for diametral compression at a crosshead speed of 0.5 cm/min. Statistical Analysis Used: Pairwise analysis. Results: The microwave drying technique and drying by combination method resulted in greater DTS, respectively. Conclusion: Within the limitation of this study, PBI specimens dried in microwave oven at 600W for 10 min increased the diametral strength and are also a time-saving procedure.
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Comparative evaluation of the shear bond strength of adhesive and self-adhesive resin luting agents to three commercially available composite core build-up materials: An in vitro study p. 255
Prachiti M Terni, Jyoti B Nadgere, Sabita M Ram, Naisargi P Shah, Janani Mahadevan
DOI:10.4103/jips.jips_84_19  
Aim: The aim of the study was to evaluate the shear bond strength of adhesive and self-adhesive resin luting agents (RLAs) to three commercially available composite core build-up materials (CBMs). Settings and Design: Comparative -invitro study. Materials and Methods: Sixty samples, 20 each of self-cure (Incore, Medicept: Group I), light cure (Light-Core, Bisco: Group II), and dual cure (LuxaCore Z-Dual, DMG America: Group III) composite CBMs were made in the lower mold space of a customized stainless steel jig. They were further subdivided into subgroups A and B for bonding with the adhesive (RelyX Ultimate, 3M ESPE) and self-adhesive (RelyX Unicem, 3M ESPE) RLAs respectively. For specimens in subgroup A, the bonding agent (Scotchbond Universal Adhesive, 3M ESPE) was rubbed onto the surface for 20 s prior to bonding with the adhesive RLA. For specimens in subgroup B, no pretreatment of the surface was carried out. The CBM-luting agent sample was tested for the shear bond strength in a universal testing machine. Statistical Analysis Used: ANOVA, Tukey's multiple comparison, and independent t-test. Results: Adhesive RLA showed the highest shear bond strength to light cured composite CBM. Self-adhesive RLA showed the highest shear bond strength to dual-cured composite CBM. Adhesive RLA showed higher shear bond strength to all three composite CBMs as compared to the self-adhesive luting agent. This difference was statistically significant for the self-cure and light cure composite CBMs. Conclusion: Adhesive RLA showed greater shear bond strengths to all the three groups of composite CBMs as compared to self-adhesive RLA.
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Comparative evaluation of the effect of plant extract, Thymus vulgaris and commercially available denture cleanser on the flexural strength and surface roughness of denture base resin p. 261
Bose Babu Namala, Veena Hegde
DOI:10.4103/jips.jips_141_19  
Aim: This study aims to evaluate and compare the effect of plant extract (thyme essential oil solution) and commercially available denture cleanser on the flexural strength and surface roughness of denture base resin. Settings and Design: Comparative In-vitro study. Chemical denture cleansers play a vital role in maintaining the hygiene and serviceability of the dentures. Bacterial resistance to these chemical agents paved way to plant-extracts as novel denture cleansing agents. However, the effect of these plant-extract denture cleansers on the physical and surface characteristics of denture base resins has not been evaluated. Material and Methods: A total of 90 heat polymerizing denture base material (Trevalon, Dentsply) samples were fabricated and divided into 3 groups with 30 samples each. Samples from each group were immersed in their respective denture cleanser solution (Group A- Distilled water(control); Group B- Fittydent denture cleanser; Group C- Thyme essential oil solution denture cleanser) for a simulated overnight 8hr immersion for 180 days. The samples were evaluated for increase in surface roughness and flexural strength using Tally-surf Surface Profiler and Instron Universal Testing Machine respectively. Results obtained were statistically analyzed using one-way ANOVA. Statistical Analysis Used: Oneway ANOVA , Post hoc Tukey's test. Results: Thyme essential oil solution group showed minimal increase in surface roughness (ΔRa) with values comparable to that of the control group which had the least increase in surface roughness and Fittydent group showed significant increase (P < 0.05) in surface roughness. For flexural strength, statistically significant difference (P < 0.05) was observed among the three groups with Fittydent group showing the highest flexural strength followed by control group and Thyme essential oil solution group. However, the decrease in the flexural strength was not of clinical significance. Conclusion: Plant extract - thyme essential oil denture cleanser was superior in preserving the surface roughness of denture base resins compared to commercially available denture cleanser. Clinically significant difference in flexural strength was not observed between the denture cleanser groups.
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CASE REPORTS Top

Rehabilitation of an ocular defect with intraorbital implant and custom-made prosthesis using digital photography and gridded spectacle p. 266
Dolanchanpa Dasgupta, Kaustubh Das, Rajwinder Singh
DOI:10.4103/jips.jips_226_18  
Accidental trauma involving the eye may necessitate surgical removal of the eye ball. Immediate management should consider future prosthetic rehabilitation. Insertion of eye ball implant after enucleation or evisceration preserves socket anatomy, maintains sulcus and fornix which ensures proper retention of ocular prosthesis in future. Placement of intraorbital ball implant also reduces the weight as well as enhances motility of the prosthesis, thus imparting life-like appearance. Custom-made acrylic prosthesis has been shown to deliver superior functional and esthetic result. Exact positioning of the iris disc on a custom-made scleral blank is critical from esthetic point of view. This clinical report describes prosthetic rehabilitation of an anophthalmic socket where intraorbital ball implant was inserted during evisceration. Custom-made acrylic ocular prosthesis with a prefabricated iris button was used. Here, digital photography and a specially fabricated spectacle gridded with mm scale were used for positioning iris button on the ocular prosthesis. These two methods of centration of iris button may be used to reduce chairside time and increase patient cooperation with a positive clinical outcome.
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Measuring the retention of removable mandibular prostheses by a standardized model: A technical report p. 272
Khaing Myat Thu, Haruki Shimizu, Manabu Kanazawa, Shunsuke Minakuchi
DOI:10.4103/jips.jips_173_19  
Three cases of mandibular implant overdentures (IODs) were measured for retention by a developed model. A nylon thread was tied through a hole at the midline of the IOD and seated it in the patient's mouth properly. Briefly, a facebow was set on the patient, with its arms firmly held by an assistant. The other end of the thread was tied into a loop, and the thread was inserted through a hole at the Camper's line of the facebow and hooked onto a portable force gauge. The thread was then pulled in parallel with the arms of the facebow by the force gauge until the prosthesis dislodged while the patient opened his mouth. Denture retention was measured five times, and the mean was calculated. Appropriate analysis for validity and reliability of the model was performed, and statistical results showed that it was valid and reliable for measuring the retention of removable mandibular prostheses.
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Rehabilitation of missing digit using customized attachment supported prosthesis p. 276
Siddharth Mehta, Rasalika Agrawal, Shashank Chitikeshi, DB Nandeeshwar
DOI:10.4103/jips.jips_372_18  
Traumatic amputation of a finger leads to psychological instability, functional loss, and poor esthetics. When surgical reconstruction in patients is not possible, prosthesis provides psychological, functional, rehabilitative, and esthetic restoration. Despite the availability of advanced skills, the best of materials and laboratory support, sometimes the anatomy of the defect, may be a hindrance in furnishing a better prosthesis. In the present case report, a defect with complete loss of stump was restored using customized ring-stump assembly, which helped to enhance the fit and retention of the prosthesis along with fulfilling the functional demands of the patient.
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