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   Table of Contents - Current issue
September-December 2022
Volume 6 | Issue 3
Page Nos. 111-160

Online since Tuesday, November 15, 2022

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Medical emergencies during exodontia in a referral dental center in Saudi Arabia: A cross-sectional study p. 111
Ramat Oyebunmi Braimah, Dawood Ali-Alsuliman, Abdurrazaq Olanrewaju Taiwo, Bandar Alyami, Adebayo Aremu Ibikunle, Abdullah S Alwalah, Hammad Faries Almunajjim, Abdulrahman Saeed Alalharith
Background: Medical emergencies such as vasovagal attack, hypoglycemia, and asthmatic attacks that are not related to dentoalveolar procedures, such as bleeding and airway obstruction, etc., do occur in dental clinics; among these emergencies, about 90% are mild, while 8% are severe. Objectives: In this study, the prevalence and management of medical emergencies that occurred during simple and complex exodontia were reported. Methods: Herein, a 2-year prospective cross-sectional study was conducted on patients who were referred to an oral and maxillofacial surgery clinic for dental extractions between January 2019 and December 2020. Patient data including socio-demographic information, pre-existing medical conditions, modality of tooth extraction, types of emergencies encountered, and management protocols were collected. Results: Of 3706 patients, 105 patients had medical emergencies with a prevalence rate of 2.8%. In all, 44 (41.9%) male and 61 (58.1%) female patients aged between 18 and 69 years with a mean (±SD) of 36.9 (11.7) were identified. The reported medical emergencies included vasovagal syncope (38 (36.1%)), hypoglycemia (27 (25.7%)), orthostatic hypotension (26 (24.8%)), asthmatic attacks (5 (4.8%)), hyperventilation syndrome (5 (4.8%)), and seizures (4 (3.8%)). The reported pre-existing medical conditions in these patients included Type II diabetes (DM) + hypertension (HTN) + coronary artery surgery (CAS) (4 (3.8%)), asthma (5 (4.8%)), and seizure disorders (4 (3.8%)). The majority of patients did not exhibit any medical conditions (92 (87.6%)), and most of them recovered spontaneously (47 (44.7%) patients). Conclusion: The majority of patients did not have medical conditions. Vasovagal syncope was the most common medical emergency, followed by hypoglycemia. Asthmatic attacks, hyperventilation syndrome, and seizures were the least reported medical emergencies. Cardiac emergency cases were not reported.
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Smoking effect on the interleukin-1β expression and periodontal status of periodontitis patients p. 118
Muhammad Ihsan Rizal, Redha Putri Wiranda, Ria Aryani Hayuningtyas, Fatimah Maria Tadjoedin, Ferry Sandra, Melanie Sadono Djamil
Background: The smoking habit is a risk factor for periodontitis. Periodontitis is a multifactorial inflammatory disease associated with biofilm plaque dysbiosis and is characterized by the progressive deterioration of the periodontal tissue. Pro-inflammatory cytokines, such as interleukin-1β (IL-1β), can trigger inflammation of the tissue and become a stimulator to destroy it. Moreover, IL-1β will increase in response to inflammation. Objective: The aim of this study was to evaluate the differences in periodontal status and IL-1β gene expression between smoking and nonsmoking periodontitis subjects. Methods: This research was an analytic observational study with a cross-sectional design. The anthropometric demographic data included name, address, gender, age, plaque index examination, papillary bleeding index (PBI), calculus index, smoking status, and clinical photos to diagnose periodontitis. The collection of gingival crevicular fluid and the analysis of the IL-1β gene expression were conducted using real-time polymerase chain reaction. Results: There were significant differences in periodontal status for plaque index, calculus index, debris index, oral hygiene index, and PBI between smoking and nonsmoking subjects. The IL-1β gene expression was significantly higher (P = 0.047) in smoking subjects than in nonsmoking subjects, with mean ± standard deviation (11.34 ± 9.11) and (0.24 ± 0.42), respectively. Conclusion: This study revealed differences in periodontal status and the IL-1β gene expression between smok ing and nonsmoking periodontitis subjects. The periodontal rate was higher in periodontitis smokers compared to nonsmokers periodontitis. In this study, it was also found that the expression of the IL-1β gene was significantly higher in subjects with smoking periodontitis.
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Dental pain behavior of children with autism spectrum disorder at the Biruku Foundation, Bandung City p. 122
Hanna Asshabirina Wanazizah, Sri Susilawati, Inne Suherna Sasmita
Background: Dental pain is one of the most common symptoms of dental and oral problems that are generally identified by verbal self-reports; however, it is difficult for children with autism spectrum disorder (ASD) who have social communication deficits. Dental pain in children with ASD can be detected by specific behavioral changes. Objective: In this study, the aim was to determine the dental pain behavior of children with ASD at the Biruku Foundation, Bandung City. Methods: The descriptive method used a cross-sectional design approach. The study sample consisted of children with ASD who were diagnosed by pediatricians as high-functioning autism (HFA) or low-functioning autism (LFA) and who were experiencing dental caries as a factor causing dental pain, which was observed by the examination of 12 children by a total sampling technique. Data collection was conducted in the form of a Dental Discomfort Questionnaire (DDQ). Results: High DDQ scores were obtained for three children (25%), a moderate DDQ score for seven children (58.3%), and a low DDQ score for two children (16.7%). The most frequent dental pain behavior displayed by children with ASD at the Biruku Foundation was increased saliva production (8.8%). Conclusion: Dental pain in children with ASD at the Biruku Foundation, Bandung City fell into the moderate category.
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Modified learning of basic life support courses enhance attitude among professional healthcare students in Indonesia p. 129
Wiwiek Poedjiastoeti, Aryadi Subrata, Indrayadi Gunardi, Aristya Julianto Sidharta, Siriwan Suebnukarn
Background: Cardiovascular disease is one of the main causes of death worldwide. Basic life support (BLS) actions such as adequate cardiopulmonary resuscitation (CPR) and the provision of an automated external defibrillator (AED) may handle such a medical emergency. BLS is included in the curriculum for students in healthcare-related areas; hence, healthcare practitioners are required to execute BLS competently. Objectives: The aim of this study was to determine the most effective learning methods implemented in Indonesian higher education institutions. Methods: This cross-sectional study was conducted with health science, medical, and dental students from 22 Indonesian universities. In this investigation, a validated questionnaire with 33 items was provided (20 knowledge- and 13 attitude-related items). Data were analyzed using the Kruskal–Wallis’s test. Result: Among the participants, 98.2% (982 subjects) had BLS learning in their curricula. Types of BLS learning included the combination of theory, demonstration, and mannequins; combination of theory and demonstration; and theory (72.9%, 14.9%, and 12.2%, respectively). Most participants were categorized as having high knowledge (92.6%) and high attitude (98.7%). A significant correlation between knowledge and attitude toward BLS among health science students in Indonesia was observed (P < 0.05). The BLS learning type with the combination of theory, demonstration, and mannequins exhibited the highest rank (P = 0.000). Conclusion: An effective BLS learning method includes the provision of theory followed by demonstrations and hands-on trials on mannequins by students in the health sector according to the curriculum.
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Oral health-related quality of life of preschool children with a cleft lip or palate and their families p. 135
Divya Karikalan, Iyapparaja P, Madankumar PD
Background: Cleft lip and cleft palate are the most common congenital developmental deformities found worldwide. Children with oral clefts have a range of functional and esthetic complications. Hence, the successful management of children born with oral clefts requires coordinated care provided by several specialties. Knowledge of oral health-related quality of life improves treatment quality as children with oral clefts require multidisciplinary care aiming at a satisfactory quality of life. Objectives: In this study, the aim was to evaluate the oral health-related quality of life of children with oral clefts aged two to six years who had undergone surgical treatment using the Early Childhood Oral Health Impact Scale (Tamil version). Methods: This cross-sectional study was conducted for parents with children born with cleft lip and cleft palate, who had undergone treatment at a Tertiary Care Centre, Thanjavur, Tamil Nadu, India. A sample of 60 parents was selected, and the oral health-related quality of life of their children was assessed by applying the Early Childhood Oral Health Impact Scale questionnaire in Tamil language. Results: Comparison of the three groups i.e., cleft lip, cleft palate, and cleft lip and cleft palate, respectively, revealed no significant difference (P = 0.290) regarding the mean scores. Conclusion: Oral clefts and their treatment can negatively impact the quality of life of young children and their families, irrespective of the type of clefts. Therefore, the assessment of these influences can help clinicians and researchers improve the overall oral health outcomes of young children.
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Effect of tamarillo (Cyphomandra betacea Sendtn.) seed ethanol extract on HSC-3 tongue cancer cells p. 141
Saqila Salfabila, Janti Sudiono
Background: Cancer is characterized by abnormal cell growth. Squamous cell carcinoma is the most common type oral cancer. Tamarillo fruit extract shows antiproliferative and antioxidant activity against breast cancer (MDA-MB-231) and liver cancer (HepG2) cells in rat models. Tamarillo seed extract consists of phenolics, flavonoids, triterpenoids, tannins, and alkaloids, which have antioxidant, antiproliferative, anti-inflammatory, and anticancer activity. Objectives: The aim of this study was to determine the effect of tamarillo seed ethanol extract at different concentrations on the viability of a tongue cancer cell (human oral squamous carcinoma cell line HSC-3). Methods: This experimental in vitro laboratory study comprised a treatment group comprising HSC-3 cells treated with eight concentrations of tamarillo seed extract (8, 4, 2, 1, 0.5, 0.25, 0.125, and 0.0625 μg/µL) and a positive control group treated with 3% H2O2. Shapiro–Wilk test showed that the data were distributed normally with P > 0.05. One-way analysis of variance (ANOVA) test showed that there were significant differences among concentrations group of the extract on HSC-3 viability cells with P ≤ 0.05. Results: At a concentration of 2 μg/µL, tamarillo seed ethanol extract showed the highest cytotoxicity against HSC-3 cells. Post hoc test revealed a significant difference (P < 0.05) in cell viability of concentration 2 μg/µL compared with that of the lower concentrations (0.25, 0.125, and 0.0625 μg/µL) and the positive control but there was no significant difference with those of higher concentration (4 and 8 μg/µL). Conclusions: A low concentration of tamarillo seed ethanol extract (2 µg/µL) had the highest cytotoxicity against HSC-3 cells significantly reducing cell viability. However, this concentration was not able to surpass the inhibition ability of the positive control (3% H2O2).
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Custom splint: A conservative approach to pediatric mandibular dentoalveolar trauma p. 146
Priyanka Venugopal, Reshma Raj VP, Parvathy Kumaran, Arun Mamachan Xavier
Background: Traumatic dental injury is highly variable in children, commonly involving the anterior segments of the maxilla and mandible. The management of such injuries is challenging owing to the anatomical differences and stages of development. The aim of treatment (usually non-invasive) should always be to achieve a stable occlusion with minimal functional impairment. Case Report: This case report describes the conservative management of a mandibular dentoalveolar fracture in a 5-year-old child. On extra-oral examination, abrasions were noticed in the chin region with moderate facial edema in the lower part of the face. Intra-oral examination revealed labial ecchymosis in the mandibular anterior region and a step deformity between the distal aspect of #72 and #82. The displaced dentoalveolar segment was repositioned with finger pressure, and a modified closed cap splint was cemented to the reduced fractured jaw. Follow-up visits at 3 weeks and 1 year showed satisfactory healing. Conclusion: The goal in treating pediatric fractures is to restore the underlying bony structure to its preinjury position as soon as possible. The treatment of choice should be minimally invasive and should restore occlusion with minimal residual esthetic and functional impairment.
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Cheek plumper: An instant, noninvasive face-lifting prosthesis—A case report p. 152
Vidyalakshmi Chandrasekar, Ahila Singaravel Chidembaranathan, Balasubramanium Muthukumar
Background: Restoring lost form and function in edentulous patients is a challenge when the edentulous state has remained in a long term. Most patients with chronic edentulism suffer from a range of problems, such as reduction in facial height, cheek muscle wastage, and tongue spreading. These problems lead to an esthetic imbalance in the facial appearance. Many patients remain unsatisfied after fitting complete dentures, as these do not resolve the issue of sunken cheek appearance. Case Report: A 70-year-old male patient presented with the chief complaint of missing dentition. He also complained of the sunken cheeks. After restoration with conventional dentures, the patient still complained of sunken cheeks. This complaint was addressed by fabricating cheek plumper, and the cheek plumper was attached with the buccal flange of the maxillary denture utilizing intraoral neodymium magnets. Conclusion: Treating cases of the complete edentulism requires not only denture but also restoring the facial esthetic appearance by addressing muscle wastage. Cheek plumper is a simple, yet effective way to restore the facial contour.
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Preserving the tissue profile with immediate implant placement and immediate provisionalization technique p. 156
Adityo Widaryono, Sunny Indriani Kurnia, Fatimah Maria Tadjoedin
Background: Single-tooth replacement in the esthetic zone with a dental implant remains a challenge for clinicians. One challenge is the difficulty of creating a natural tissue profile in the cervical of the implant restoration. In a healed edentulous ridge, multiple surgeries along with hard- and soft-tissue augmentation will be required to gain sufficient tissue volume, thus significantly increasing the patient morbidity. Immediate implant placement, combined with a customized healing abutment, can potentially overcome these difficulties. Case Report: This case report describes the treatment of a patient with a subgingival fracture of the upper central incisor with an implant placement immediately after tooth extraction, xenograft gap filling, and nonfunctional provisional restoration to seal the extraction socket. The incisor had previously undergone root canal treatment and had been restored using a fiber post and ceramic crown. Conclusions: The use of the immediate implant placement with a nonfunctional provisional restoration (immediate implant placement and immediate provisionalization) technique preserves the tissue profile and volume during the implant healing period. This provides the clinician with a natural soft-tissue profile for implant restoration, without the need for an additional surgery.
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