Journal of Advanced Clinical and Research Insights


Critical values in patient care

K. R. Chatura

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:1] [No. of Hits: 795]


Lundberg coined the term critical (panic) values (CVs) for results, representing a pathophysiological state at such variance with normal as to be life-threatening unless something is done promptly, and for which some corrective action could be taken.[1]


Prevalence, perception and attitude of dental students towards academic dishonesty and ways to overcome cheating behaviors

Prabhakar A. Jeergal, R. Surekha, Priyadarshini Sharma, K. Anila, Vasanthi A. Jeergal, Tabitha Rani

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:2–6] [No. of Hits: 887] [No. of Citation: 9]


Background: The aim was to assess the attitude, perception and prevalence of cheating behavior by dental students and to determine various methods they used to commit the dishonest act and ways to create an environment to reduce the malpractice.

Materials and Methods: Closed-ended questionnaire was designed and distributed to 200 undergraduate students in various colleges of Dental Institution in India. The data were analyzed for percentage proportions.

Results: About 76% of students confessed to having participated in the act of cheating and 60% respondents strongly agreed to cheat owing to the pressure and workload that the dental college curriculum includes. Most common methods used to cheat were to directly peep into other people’s paper. Getting professional patients during clinical exams were not considered as a serious issue by many respondents. Majority of the students strongly agreed for raising the awareness of ethics and invigilators to be instructed to strictly monitor the examination hall.

Conclusion: Academic dishonesty is a serious concern among dental students because of the career they will embark on as health care professionals. Hence, it’s exceptionally crucial for us as mentors to consider the issue seriously and work on it by considering measures to reduce the pressure and workload of students and to undertake vital steps to reduce cheating behavior.

Keywords Academic dishonesty, cheating behavior, dental students


Dermatoglyphic patterns in subjects with potentially malignant disorders and oral carcinoma

Maria Priscilla David, Pooja Sinha

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:7–11] [No. of Hits: 5337] [No. of Citation: 9]


Background: The study of the epidermal ridges and the patterns formed by them is dermatoglyphics. The influence of genetic or environmental factors on early development is often reflected by the altered dermatoglyphics. Hence, this study is conducted to determine the dermatoglyphic dependence of potentially malignant disorders and oral carcinoma and hence that preventive measures can be instituted to high.risk groups and prevents the occurrence of disease.

Materials and Methods: Fingerprints were collected using ink method from 70 patients that includes 30 subjects with potentially malignant disorders, 10 subjects with oral cancer and 30 healthy controls. Data were subjected to statistical analysis (Student’s paired t.test).

Results: Mean number of loops and the mean number of total ridge count were found to be higher in case of subjects with potentially malignant disorders and oral carcinoma when compared with controls. Arches were seen predominantly in patients with oral cancer. Right ATD angle was lower in subjects without deleterious habit and potentially malignant disorders. These findings were highly significant statistically.

Conclusion: We, therefore, recommend dermatoglyphics to identify individuals who are more prone to develop potentially malignant disorders and oral squamous cell carcinoma. We suggest the use of the same as an education tool for genetic counseling.

Keywords Dermatoglyphics, oral carcinoma, potentially malignant disorders, ridge count


Epidemiology of orofacial pain: A retrospective study

Akshay Shetty, Leena James, Tejavathi Nagaraj, Marin Abraham

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:12–15] [No. of Hits: 6340] [No. of Citation: 9]


Background: The orofacial pain is a pervasive situation either of somatic or psychological etiology arising from the structures supplied by the trigeminal nerve. Identifying the cause of orofacial pain goes a long way in diagnosis and treatment.

Objectives: To evaluate the cause of pain among the subjects reporting to the dental college.

Materials and Methods: A retrospective study was conducted on a group of patients with persistent facial pain with an ebb to respond properly to previous treatments were assigned to specialists associated with Department of Oral Medicine and Radiology and Oral and Maxillofacial surgery in Sri Rajiv Gandhi College of Dental Sciences and Hospital from March 2010-April 2011.

Results: It was found that pulpitis was the most common cause of orofacial pain followed by periodontal pain. Neuralgias and TMJ disorders were the least likely cause.

Conclusion: Multidisciplinary approaches and a biopsychosocial model of pain management are an essential adjunct to established evidence-based medical and surgical management of these conditions

Keywords Epidemiology, orofacial pain, pulpitis, trigeminal system


Evaluation of sexual dimorphism by using permanent maxillary fi rst molar in Gujarati population

Rashmi Bhavasar, Falguni Patel, Nishit Soni, Pratik Patel, Vandana Shah, Priyank Shah

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:16–19] [No. of Hits: 2757] [No. of Citation: 6]


Background: Sexual dimorphism refers to those differences in size, stature and appearance between male and female that can be applied to dental identification of humans. Teeth are good sources of material for civil and identification. Tooth size standards based on odontometric investigation can be used in age and sex determination. The present study was planned to evaluate the existence of sexual dimorphism using both buccolingual (BL) and mesiodistal (MD) dimensions and prevalence of cusp of Carabelli in maxillary permanent first molars in Gujarati population.

Materials and Methods: Totally 60 students (30 males and 30 females) of Gujarati population with 10.35 years of age were selected by random sampling method. After oral examination, impressions of the maxillary arch were taken and the BL and MD dimensions of the maxillary first molars were measured using digital Vernier calipers on study casts and also checked for presence of cusp of Carebelli.

Results: The mean values of parameters (BL and MD dimensions) were greater in male when compared to female. There was a significant difference in mean values of MD dimensions of maxillary right first molar of males (10.39 ± 0.48) and females (10.11 ± 0.52) (P = 0.03). Moreover, presence of cusp of Carabelli was found to be more frequent in males (23.33%) when compared to females (11.67%).

Conclusion: The study results revealed that MD dimension can be used as a parameter to check the sexual dimorphism in Gujarati population.

Keywords Cusp of Carabelli, Gujarati population, maxillary first molar, sexual dimorphism


Evaluation of microvessel density in central and peripheral giant cell granulomas

Kaveri Hallikeri, Swetha Acharya, Anila Koneru, Dhiraj J. Trivedi

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:20–25] [No. of Hits: 4172] [No. of Citation: 6]


Background: Angiogenesis in the physiological status, balance is maintained between the pro- and anti-angiogenic factors and it is required for a tumor to grow beyond 1-2 mm in diameter. In central giant cell granuloma (CGCG) and peripheral giant cell granuloma (PGCG) the origin of giant cells, clinicopathological features overlap, but still there is a difference in the biological behavior. We aimed to assess the possible role of angiogenesis and presence of macrophages by the expression of CD34 and CD68 respectively.

Materials and Methods: Eighty cases each consisting of each forty CGCG and PGCG were evaluated clinically and immunohistochemically using CD34 and CD 68. Microvessel density (MVD) was expressed as the mean of blood vessels and macrophages in four high-power-fields. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-tests.

Results: The peak incidence of 21-30 years and 31-40 years was seen in CGCG’s and PGCG’s respectively with a statistical significant difference. Both groups showed female predominance with posterior mandible and maxilla being the common site. Number of mononuclear cells was more in the CGCG than PGCG with an ovoid morphology. CD34 positive microvessels and macrophages were more in CGCG compared to PGCG with statistically significant difference.

Conclusion: Clinicopathological features were similar to the previous studies. Statistically significant difference was evident in the MVD and macrophages in CGCG and PGCG. This new data about the microvessel count in the CGCG and PGCG adds to the literature. Importance of angiogenesis can add insight to the clinical behavior and also in understanding its histogenesis.

Keywords Angiogenesis, CD34, CD68, central giant cell granuloma, macrophage, microvessel, peripheral giant cell granuloma


Educational intervention on the plaque score among hearing impaired children

A. S. Seema Alse, Latha Anandkrishna, Prakash Chandra, M. Ramya, Punitha S. Kamath, Ashmitha K. Shetty

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:26–30] [No. of Hits: 1322] [No. of Citation: 19]


Background: Oral health is an integral part of overall health of all children. The maintenance of oral health of hearing impaired children is a challenging problem; due to lack of communicative skills and access to dental care. There is a need to improve oral health of children with hearing impairment (CHI). The aim is to evaluate the impact of oral health education (OHE) intervention on the plaque scores among hearing impaired children.

Materials and Methods: A total of 56 institutionalized CHI aged range 5-17 years were selected for this study. Oral hygiene status was assessed using Turesky-Gilmore-Glickman modification of the Quigley-Hein plaque index, dentition status along with decayed, missing, filled, surfaces were recorded. OHE along with the proper tooth brushing technique was demonstrated using a tooth model and a brush. Oral hygiene status was reassessed after 21 days and the data obtained were analyzed.

Results: A paired t-test and one-way analysis of variance was used to test the difference between the groups. In all the above tests, P < 0.05 was accepted as indicating statistical significance. A significant reduction in the plaque scores was seen in all the primary (0.323), mixed (0.231) and permanent dentition of children (0.200), with the plaque score reduction being more in the permanent dentition (P < 0.001).

Conclusion: OHE was effective in reducing the plaque scores in hearing impaired children. Different modalities for constant motivation and reinforcement in maintaining a good oral hygiene methods should be evaluated in children with special health care needs.

Keywords Hearing impairment, oral hygiene education, plaque scores, tooth brushing techniques


Parotid gland hemangioma with cytomegalovirus infection

K. R. Chatura, Mohammad Shahid Iqbal

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:31–32] [No. of Hits: 749] [No. of Citation: 3]


Salivary glands are a common site for hemangiomas in the head and neck region. Surgical pathologists are unfamiliar with hemangioma in salivary glands. We report a rare case of arteriovenous hemangioma of the parotid gland associated with cytomegalovirus.

Keywords Cytomegalovirus, hemangioma, parotid


Tubular basal cell adenoma of submandibular salivary gland: A rare case report with an unusual presentation

Dominic Augustine, S. Murali, B. Sekar, Maya Ramesh, Geroge Paul

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:33–35] [No. of Hits: 890] [No. of Citation: 1]


Basal cell adenoma is an uncommon salivary gland tumor. Its occurrence is mainly noted in the parotid gland and rarely in the submandibular gland. Owing to therapeutic and prognostic implications, differential diagnosis with adenoid cystic carcinoma is mandatory. The tubular variant is the least common histologic type and its occurrence in the submandibular salivary gland makes this case interesting to document.

Keywords Adenoid cystic carcinoma, basal cell adenoma, submandibular salivary gland


A dilemma in orthodontics: Extractions in borderline cases

Sushma Dhiman, Sandhya Maheshwari

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:36–39] [No. of Hits: 10086] [No. of Citation: 4]


Patient with good facial esthetics require extractions to reach a stable and functional occlusion can be categorized as a borderline case. It may also be defined as the case caught in between the conflict of extraction and nonextraction. Empirical evidence of uncertainty exists with these patients. Borderline cases may also have an absence of dental or craniofacial anomalies, permanent dentition, healthy periodontium and normal anteroposteriorly relationship between maxilla and mandible. Therefore, the aim of this paper is to describe criteria, which should be kept in mind before deciding to go for extraction or nonextraction treatment in borderline cases.

Keywords Borderline, extraction, non-extraction


Reliable molar distalizer: A review

P. Vasanthan, J. Sabarinathan, S. Sabitha, R. C. Sathishkumar

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:40–43] [No. of Hits: 4915] [No. of Citation: 3]


Current orthodontic philosophies have been oriented toward various conservative treatment methods to eliminate extractions and also try to avoid the demand for patient compliance. The distalization of molars creates additional space within the alveolar arch, and it is of important value for the cases with minimal arch length discrepancy and Angle’s Class-II molar relationship associated with normal mandible. Several appliances have been advocated to distalize molars in the upper arch. But, recent advances in molar distalization appliance design provide more precise control in bodily movement of teeth enabling better treatment options in orthodontics.

Keywords: Conventional pendulum appliances, modified pendulum appliances, molar distalization


Early detection of oral cancer: Duties of a dental surgeon

Nidhi Tripathi, Sanyog Pathak

[Year:2015] [Month:January-February] [Volume:2 ] [Number:1] [Pages No:44–45] [No. of Hits: 2381] [No. of Citation: 3]


Dental surgeons are the people who examine the oral cavity most frequently. Unfortunately, due to lack of knowledge and training, structures other than teeth are missed for proper examination. A large chunk of patients is still diagnosed in late stage of cancer when prognosis is poor. For provisional diagnosis and referral, visual examination by an expert dentist is sufficient. We, being stomatologists, can make a difference if little bit time is spent and responsibility is shown from our side. As we all know, expertise is acquired through imparting knowledge to budding dental graduates and training them to spot even the slightest changes in the epithelium. In this article, we would like to emphasize on the same.

Keywords Dental surgeon, early diagnosis, oral cancer