Journal of Advanced Clinical and Research Insights


Evaluation of condylar morphology using panoramic radiography

Vahanwala Sonal, Pagare Sandeep, Gavand Kapil, Roy Christine
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:5–8] [No. of Hits: 1024]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.94]


Background: Orthopantomograph (OPG) is a routine imaging modality utilized by most dental surgeons for obtaining general information about the teeth, mandible, and adjacent regions of the jaw. It also yields a favorable cost-benefit relationship and exposes patients to relatively low doses of radiation. Human mandibular condyle may be categorized into five basic types: Flattened, convex, angled, rounded, and concave. Morphologic changes of condyle occur due to developmental variations, remodeling, various diseases, trauma, endocrine disturbances, and radiation therapy. Among various imaging modalities used for temporomandibular joint (TMJ) imaging panoramic radiographs still remain the main screening modality for TMJ abnormalities.

Aims and Objectives: This study, aims at observing and recording the variation in the shapes of condyle on an OPG and thereby evaluates whether dentate or non-dentate oral cavity shows any peculiarities in Indian population and whether it could have a deterministic value in forensic science.

Materials and Methods: This study comprised radiographic evaluation of 400 condylar heads after visualizing 200 digitalised OPGs taken for routine investigation. The radiographs were evaluated by two oral radiologists for the formulation of operational definitions. Condylar morphology of four types was identified according to a particular classification. Trends occurring in the shapes were evaluated, and combinations of the condylar shapes present in population were identified.

Results: The present study is an attempt to scout the prevalent radiographic shapes of the condylar head on the OPG. Of the 200 pairs of condylar heads evaluated, 60% were oval in shape, followed by bird beak (29%), diamond (9%) and least being crooked finger (2%). This raised a curiosity whether the TMJ followed any typical feature of symmetry. Oval-oval was commonly occurring combination (67%), whereas crooked/crooked finger was a rarity.

Conclusion: Low exposure dose and ease of prescription makes OPG a common choice of imaging prescription. Evaluation of condyle on OPG seems to attract clinicians to make fine observations. Oval-oval being most common in both genders. More sample size and evaluation of other parameters may aid in giving more information about the population and thereby generating interest in forensics.

Keywords Condyle, orthopantomograms, temporomandibular joint

How to cite this article: Sonal V, Sandeep P, Kapil G, Christine R. Evaluation of condylar morphology using panoramic radiography. J Adv Clin Res Insights 2016;3:5-8.


Nuclear medicine in orofacial diagnosis: A review

Padmashree Shreenivasamurthy, Sridhar Lakshmana Shastry
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:28–32] [No. of Hits: 1941]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.99]


Radionuclide imaging is a form of noninvasive functional imaging technique, which provides information on pathophysiological and pathobiochemical processes. The other special imaging modalities, such as computed tomography (CT), magnetic resonance imaging, and diagnostic ultrasonography, are morphologic imaging techniques. Radionuclide imaging uses radioactive isotopes that emit γ (gamma) rays. Radionuclides allow measurement of tissue function in vivo and provide an early marker of disease, through measurement of biochemical change. After the radionuclides are administered, they get distributed in the body according to their clearance kinetics of that tracer. The gamma camera detects γ-rays and forms planar images showing the locations of the radionuclides in the body. The use of a scintillation crystal for an acquisition of data for image formation has led to the labeling of this technique as scintigraphy. Radionuclide imaging faces a parallel evolutionary shift from imaging function at the organ/tissue level to detecting changes at cellular and molecular levels. Single photon emission CT imaging and positron emission tomography imaging are advanced nuclear medicine techniques. This review provides an overview of the application of modern radionuclide imaging in the diagnosis and management of oral and maxillofacial diseases.

Keywords Nuclear medicine, positron emission tomography, radionuclide imaging, single photon emission computed tomography

How to cite this article: Shreenivasamurthy P, Shastry SL. Nuclear medicine in orofacial diagnosis: A review. J Adv Clin Res Insights 2016;3:28-32.


Antifungal effect of green tea extracts on oral Candida species: An in vitro study

M. G. Madhura, R. D. Shweta, B. Veerendra Kumar, D. Savithri, S. Gajalakshmi, B. V. Soumya
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:1–4] [No. of Hits: 747]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.93]


Background: Candida is one of the commensals housing the normal oral flora. Oral candidiasis is a common opportunistic infection caused by Candida species (Candida albicans being the most common one). Green tea is well-known for its various health benefits, and the literature reveals ongoing studies on the action mechanisms of green tea extract, in vitro and in vivo.

Aims and Objectives: The present study was undertaken to assess antifungal effect of green tea extracts; if proven, could it be used in future as an adjunctive treatment modality for treating candidiasis.

Materials and Methods: About 15 healthy volunteers with coated tongue were included for the study. Oral sample, from dorsum of the tongue was collected by commercially available pre-sterilized swabs. The material was inoculated into Sabouraud’s Dextrose Agar; confirmed for the presence of Candida species. The sensitivity test was carried out on a lawn culture with 25% and 50% green tea extracts at 24 h and 48 h intervals. The antifungal activity was assessed. Distilled water was used as a control. Student’s paired t-test was used to assess the difference in inhibition effect between 25% and 50% of green tea extract solution.

Results: Statistically significant increase in the zone of inhibition was noticed at both 25% and 50% concentration of green tea extracts when compared to control group, which did not show any zone of inhibition.

Conclusion: Having shown antifungal effects, the green tea extracts may be considered in future as a therapeutic adjunct.

Keywords Antifungal activity, epigallocatechin-gallate, green tea extracts, polyphenols

How to cite this article: Madhura MG, Shweta RD, Kumar BV, Savithri, Gajalakshmi S, Soumya BV. Antifungal effect of green tea extracts on oral Candida species: An in vitro study. J Adv Clin Res Insights 2016;3:1-4.


Laser: A revolutionary boon in dentistry

Shaveta Garg, M. K. Sunil, Ashwarya Trivedi, Raman Kumar, Radhika Sharma
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:9–12] [No. of Hits: 1330]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.95]


Introduction: Aphthous ulcers, commonly referred to as canker sores, are autoimmune and ulcerative lesions of the oral mucosa. Due to the indeterminate etiology of these lesions, it is often difficult to find a definitive cure and current treatment options are aimed toward ameliorating the symptoms.

Aim: The aim of this study is to assess the efficacy of low-level laser therapy (LLLT) in the treatment of aphthous ulcers.

Objective: To evaluate the efficacy of parameters such as reduction of pain, burning sensation, and healing time.

Materials and Methods: A total of 10 patients who presented with aphthous ulcers were included in the study. A single visit application of LLLT was given to each patient followed by recall visits. The first visit consisted of three sessions of low-level laser applications, lasting about 45 s, with a gap of about 30-60 s between each session, for a total laser application time of about 3 min. The pain scores and burning sensation were evaluated using visual analog scale (VAS) before and immediately post-operative laser applications, at third visit and at fifth visit.

Results: For evaluation of the reduction in pain and burning sensation, the mean of the reduction in VAS scores was evaluated for all the patients; P = 0.004 was highly significant in all the study groups.

Conclusion: LLLT is an effective modality for the treatment of aphthous ulcers. It provides immediate relief from pain, burning sensation and promotes healing time also.

Keywords Aphthous ulcer, diode laser, healing, low-level laser therapy, pain

How to cite this article: Garg S, Sunil MK, Trivedi A, Kumar R, Sharma R. Laser: A revolutionary boon in dentistry. J Adv Clin Res Insights 2016;3:9-12.


Correlation between reflux symptom index and reflux finding score in patients with laryngopharyngeal reflux: Our experience

Deepthi Satish, H. C. Badari Datta, B. V. Manjula, Brinda A. Poojari, Bhaskar Reddy Molluru
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:13–17] [No. of Hits: 1043]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.96]


Background: Laryngopharyngeal reflux (LPR) also known as extraesophageal reflux disease refers to retrograde flow of gastric contents to the upper aero-digestive tract. Belafsky, Postma, and Koufman have developed the reflux symptom index (RSI) and the reflux finding score (RFS) to diagnose LPR. Although both have been widely used, there is some controversy about their sensitivity and specificity in LPR diagnosis.

Materials and Methods: Patients who presented with symptoms of LPR were prospectively evaluated to study the correlation between scoring systems of RSI and RFS and also to assess the change in scores of RSI and RFS following 1 month of treatment with proton pump inhibitors (PPIs). Wilcoxon signed rank test and Student’s t-test (paired) have been used to find the significance of RSI and RFS components at baseline and follow-up. Pearson correlation of RSI and RFS scores are done at baseline and follow-up.

Results: In our study, we found no correlation between the RSI and RFS at baseline (P = 0.501) as well as on follow-up after treatment (P = 0.136). A significant improvement was noted in the RSI following treatment with PPIs for 1 month but no improvement was noted in the signs following treatment.

Conclusion: Based on our analysis, RSI scoring alone is fast and convenient to start treatment for patients with LPR medically along with lifestyle modifications.

Keywords Extraesophageal reflux disease, laryngopharyngeal reflux, reflux finding score, reflux symptom index

How to cite this article: Satish D, Datta HC, Manjula BV, Poojari BA, Molluru BR. Correlation between reflux symptom index and reflux finding score in patients with laryngopharyngeal reflux: Our experience. J Adv Clin Res Insights 2016;3:13-17.


Sexual dimorphism in Iranian population using diagonal distances on the facial and occlusal surfaces of mandibular first molar

S. Nonitha, Tejavathi Nagaraj, Sarvesh Dave, Nikita Sharma, Pinhaz Sherashiya, S. Hemavathy
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:18–22] [No. of Hits: 1382]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.97]


Background: Measurements of diagonal distances of teeth were one of the major tools in assessment of sexual dimorphism in various populations. Various research and studies were aimed at achieving the perfect results in forensic context.

Aims: The study was aimed to assess the degree of sexual dimorphism in permanent mandibular molar of Iranians using diagonal diameters.

Objectives: To evaluate the applicability of diagonal measurements in sex determination.

Materials and Methods: The study sample consisted of 30 Iranians students of age group between 15 to 25 years that included 15 male samples and 15 female samples ie of 1: 1 ratio. Diagonal distances on the occlusal surfaces and diagonal dimensions on the facial surface were considered. Calculations were done using manual Vernier calliper recorded dimensions were larger in males than in females.

Results: The mean values and standard deviation of all recorded dimensions were larger in males than in females.

Conclusion of Study: The results showed that occlusal and facial diagonal diameters of molars can be used for sex determination as they present a high degree of sexual dimorphism.

Keywords Sexual Dimorphism, Mandibular Molars, Odontometric Analysis

How to cite this article: Nonitha S, Nagaraj T, Dave S, Sharma N, Sherashiya P, Hemavathy S. Sexual dimorphism in Iranian population using diagonal distances on the facial and occlusal surfaces of mandibular first molar. J Adv Clin Res Insights 2016;3:18-22.


The renal resistive index is a non-invasive indicator of hepatorenal syndrome in cirrhotics

Mohsin Aslam, S. Ananth Ram, Ajoy Krishnamurthy
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:23–27] [No. of Hits: 2934]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.98]


Introduction: Hepatorenal syndrome (HRS) is defined as unexplained kidney failure in a patient with liver disease. The poor prognosis is due to both liver and renal failure, the latter being due to intrarenal vasoconstriction. The intrarenal arterial Doppler is a non-invasive tool used to study the extent of this vasoconstriction.

Aim: To determine if the intrarenal Doppler helps in indicating HRS in established cases of liver cirrhosis.

Materials and Methods: A total of 30 cirrhotics aged above 18 years with no prior or co-existing renal disorders were subjected to liver function tests, renal function test, complete blood count, urine examination, viral markers, ultrasonography abdomen, and the intrarenal artery Doppler for the resistive index (RI) calculation. RI was calculated using the formula: RI = (peak systolic flow - peak diastolic flow)/peak systolic flow and RI ≥0.77 was taken as diagnostic of HRS.

Results: Out of the 18 patients whose RI <0.77, 17 had normal creatinine. 12 patients who had raised RI, 6 had raised creatinine (2.68), while the other 6 had normal creatinine (0.88) implying that renal RI (RRI) is an early indicator of HRS even before creatinine could rise to fulfill the criteria for HRS.

Conclusion: RRI is a useful tool for indicating HRS in cirrhosis of the liver.

Keywords Cirrhosis, hepatorenal syndrome, renal artery Doppler, renal resistive index

How to cite this article: Aslam M, Ram SA, Krishnamurthy A. The renal resistive index is a non-invasive indicator of hepatorenal syndrome in cirrhotics. J Adv Clin Res Insights 2016;3:23-27.


Uses of lasers in endodontics

H. B. Swetha, Thokala Dhamodaran, Annapoorna Kini, N. Shubhashini
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:33–37] [No. of Hits: 1718]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.100]


LASER is light amplification by stimulated emission of radiation. Laser light is a man-made single-photon wavelength. The process occurs when an excited atom is stimulated to emit a photon. This is followed by subsequent release of another photon and so on. Stimulated emission generates, coherent (synchronous), monochromatic (single wave length), and collimated form of light LASER light when it reaches tissues gets reflected/absorbed/scattered/transmitted to surrounding tissues. This is due to the presence of water, proteins, and pigments in biological tissues. This absorption coefficient of biological tissue strongly depends on the wavelength of LASER.

Keywords Diagnosis, LASER, sterilization, root canal treatment

How to cite this article: Swetha HB, Dhamodaran T, Kini A, Shubhashini N. Uses of lasers in endodontics. J Adv Clin Res Insights 2016;3:33-37.


Point to ponder while prescribing phenytoin sodium infusion in septic shock patients: A case-based discussion

Habib Md Reazaul Karim, Ghazal Ahmed, Md Yunus, Prithwis Bhattacharyya
[Year:2016] [Month:January-February] [Volume:3 ] [Number:1] [Pages No:38–40] [No. of Hits: 772]
Full Text HTML |
  • [PDF]
  • [Abstract]
  • [DOI : 10.15713/ins.jcri.101]


Extravasations of many drugs can lead to phlebitis to soft tissue necrosis. Phenytoin sodium has also been implicated for such events in a few case reports with varying success of treatments. We present a case with due consent from the patient party where a single loading dose phenytoin sodium leads to phlebitis and rapidly progressed to gangrene of the hand in a critically ill patient ultimately requiring amputation despite providing possible treatments. The intention of presenting the case is to share our bad experience along with a point to ponder which probably would give an opportunity to critical care physicians to get rid of such avoidable traumatic problem while managing such patients in future.

Keywords Gangrene, phenytoin sodium extravasations, septic shock, vasopressor

How to cite this article: Karim HM, Ahmed G, Yunus M, Bhattacharyya P. Point to ponder while prescribing phenytoin sodium infusion in septic shock patients: A case-based discussion. J Adv Clin Res Insights 2016;3:38-40.