Prevalence of Oral Potentially Malignant Disorders among Fishermen Population in and around Pondicherry, South India - A Cross Sectional Study.

Context: In India fishing is a traditional occupation second only to agriculture. Fishermen are a marginalized group with high levels of occupational stress predisposing them to develop addictions to tobacco, alcohol, and areca nut chewing. These habits are well-established causes of developing oral potentially malignant disorders and oral cancer. Aims: To determine the prevalence of oral potentially malignant disorders among the fishermen population in and around Pondicherry. Settings and Design: Cross-sectional study. Methods and Material: A descriptive cross-sectional study was conducted using a pre-designed and pre-tested questionnaire to assess the prevalence of oral potentially malignant disorders among the fishermen population in and around Pondicherry. Statistical Analysis Used: Descriptive statistics were used with Pearson's correlation. Results: The study showed 24.8% of fishermen consumed tobacco, and 7.3% consumed both tobacco and alcohol. Oral potentially malignant disorders were seen in 16.79% of the population. Conclusions: The fishermen had a higher rate of addictions to tobacco, alcohol, and areca nut chewing and a higher prevalence of oral potentially malignant disorders.

Evaluation of dimensional stability, compressive resistance, and detail reproduction of thermoplastic resin (BDIMPRESS), elastomeric and composite bite registration material: An in vitro study.

Aim: The fabrication of an accurate prosthesis depends mainly on precise recording of the maxillo-mandibular relationship of the patient and transferring it to the articulator. BDIMPRESS is a new thermoplastic material that has been proposed as a potential material to be used as an inter-occlusal registration, but there has been no literature evidence regarding its application as a bite registration. The main purpose of this study is to evaluate and compare the dimensional stability, detail reproduction, and compressive resistance of new interocclusal recording material with other two commonly used materials. Settings and Design: In Vitro Comparative study. Materials and Methods: The study was conducted according to ADA Specification standards of testing for dimensional stability, detail reproduction and compressive resistance. Specimens were prepared for three different materials (Thermoplastic resin, Polyvinyl siloxane, and Bis- acrylic) with 12 samples each. Statistical Analysis Used: One way ANOVA was done for statistical analysis. Results: Polyvinyl siloxane material was dimensionally stable (mean at 1 hr: 24.928 mm; 24 hrs: 24.919 mm & 48 hrs: 24.912 mm) followed by Bis- acrylic material (mean at 1 hr: 24.851 mm; 24 hrs: 24.825 mm & 48 hrs: 24.815 mm). On one way ANOVA, strong significance was observed between groups (P = 0.00). Thermoplastic resin showed higher amount of detail reproduction with 10 (out of 12 samples) samples showing satisfactory results. While bis- acrylic material showed the least compressive resistance (Strain %: 0.484%; Displacement- 0.0990mm). One-way ANOVA showed presence of significance between the groups (P = 0.024). Conclusion: Polyvinyl siloxane showed superior dimensional stability, thermoplastic resin showed better detail reproduction and bis- acrylic showed high resistance to compression over other materials.

Effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing the post vital tooth preparation hypersensitivity: A randomized controlled trial.

Aim: Hypersensitivity is the most common clinical problem which is encountered by most of dental patients undergoing a vital tooth preparation for a fixed crown prosthesis. The aim of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing dentinal hypersensitivity following vital tooth preparation. Settings and Design: This study is a randomized control trial performed on 119 teeth of 68 patients who are in need of fixed prosthesis treatment. Materials and Methods: After a thorough clinical examination, patients were allocated into any of the randomly assigned four groups (Control, silver diamine fluoride, potassium nitrate, and glutaraldehyde) and the level of hypersensitivity was measured by blasting air on the surface of tooth at five different intervals (before preparation, after preparation, after application of desensitizers, before cementation and after a follow up period of about 30 days) and is graded using Schiff 's cumulative hypersensitivity index. Statistical Analysis Used: Kruskal wallis test is used to compare the rate of sensitivity between the 4 groups. Friedman and Wilcoxon test is used to compare the rate of sensitivity at 5 different intervals. Results: All the desensitizers used in this study reduced the level of hypersensitivity. Among which, silver diamine fluoride was found to be more effective after application, before cementation, and after a follow up period of about 30 days followed by GLUMA and potassium nitrate. Conclusion: The results of this study suggest that silver diamine fluoride was found to be more effective after application, before cementation of the definitive prosthesis and after a follow up period of 30 days.

Manual small incision cataract surgery: a viable option for cataract with pseudoexfoliation.

PURPOSE: The aim of the study was to assess the spectrum of clinical presentation, intraoperative challenges and immediate surgical outcome of cataract patients with pseudoexfoliation syndrome (PXF) following manual small incision cataract surgery (MSICS). METHODS: This prospective observational study which was conducted in a rural tertiary care hospital included adult patients with cataract and associated PXF. MSICS was performed for all after a complete ophthalmic and systemic examination. Clinical profile, intraoperative and post-operative complications were noted. Uncorrected visual acuity on first day post-surgery was used to assess the surgical outcome following MSICS. RESULTS: MSICS was performed in 80 eyes with varying grades of cataract and PXF. The mean age of the patients was 62.5 ± 8.9 years. PXF material on pupillary margin in 77(96%) patients was the most common finding noted. Majority of the patients had advanced cataract (72, 90%) and inadequate mydriasis (62, 77.5%). Posterior capsular rent (8, 10%) and zonular dehiscence (8, 10%) were the intraoperative difficulties faced. Uncorrected visual outcome on first post-operative day was moderate to good in 71 (88.8%) patients, limited by post-operative corneal oedema (21, 26.3%), iritis (31, 38.8%) and aphakia (9, 11.3%). CONCLUSION: Patients with pseudoexfoliation had poor pupillary dilatation, advanced cataracts and higher rate of posterior capsular rent. Our study showed good outcome of MSICS in PXF patients, even with advanced cataract suggesting that MSICS is a safe, effective and viable option for patients with PXF and cataract.

Effectiveness of Visual Distraction with and without Virtual Reality Glasses in Reducing Dental Anxiety among Children with Hearing and Speech Disability: A Pilot Study.

Aim and objective: To assess the effectiveness of visual distraction with and without virtual reality glasses in reducing dental anxiety among children with hearing and speech disabilities undergoing dental treatment. Materials and methods: Twenty-four children with hearing and speech disabilities aged 6-12 years were selected and were randomly divided into three groups (N = 8). Children in group A received no distraction, group B received visual distraction using virtual reality (VR) glasses and group C received visual distraction without VR glasses during dental treatment. The anxiety levels were measured using PJS- Pictorial Scale and physiological parameters - before, during, and after a dental procedure. Then intragroup and intergroup comparison was done. Results: Intragroup comparison showed that "During" and "Post" treatment anxiety scores were significantly (p < 0.05) lower than that of "baseline" in group B. Intergroup comparison of anxiety scores in the three groups, at all three intervals, showed a statistically significant difference in the "during treatment" anxiety score (p = 0.049) with least score in group B. Conclusion: Visual distraction using VR glasses can be recommended as an effective distraction technique in reducing dental anxiety among children with speech and hearing disabilities. How to cite this article: Kaur J, Shivashankarappa PG, A S, et al. Effectiveness of Visual Distraction with and without Virtual Reality Glasses in Reducing Dental Anxiety among Children with Hearing and Speech Disability: A Pilot Study. Int J Clin Pediatr Dent 2021;14(S-2):S162-S166.

Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial.

AIM: The aim of the study was to assess the remineralizing efficacy of fluoride and its combination varnishes on white spot lesion (WSL) in children with early childhood caries (ECC). MATERIALS AND METHODS: Sixty children with active WSL on primary maxillary anterior teeth were randomly selected. At baseline, the WSL activity was evaluated using ICDAS II [lesion activity assessment (LAA)] and its dimensions through photographic method. They were allocated to group I (GI) (5% NaF), group II (GII) [5% NaF with amorphous calcium phosphate (ACP)], and group III (GIII) [5% NaF with casein phosphopeptides - amorphous calcium phosphate (CPP -ACP)]. First, oral hygiene instructions and diet counseling were given followed by application of fluoride varnishes in their respective groups. The same parameters were recorded at follow-up of 2, 4, 12, and 24 weeks intervals. Data were collected and subjected to statistical analysis using Friedman Chi-square and Mann-Whitney tests. RESULTS: Overall, the active WSL changed to inactive over a period of 24 weeks in GI was 90%, GII was 95%, and 100% in GIII. There was a significant reduction in dimension of WSL in GI from 4.119 to 2.525 (p = 0.0001). Likewise, there was a significant reduction in dimension of WSL in GII and GIII from 4.586 to 3.258 and 4.696 to 1.2155, respectively (p = 0.0001, p = 0.0001). Comparatively, group III (MI varnish) showed statistically significant reduction in the dimension of WSL from baseline to 24 weeks (p = 0.002). But the results were statistically insignificant with change of active lesions to its inactivity (p = 0.349). CONCLUSION: Fluoride varnish with CPP-ACP was found to be an effective preventive strategy in reversing WSL in children with ECC. CLINICAL RELEVANCE: These combination varnishes could prove to be a promising preventive measure for pediatric dentists in reversing white spot lesions of ECC. CLINICAL TRIAL REGISTRY: NCT03360266. HOW TO CITE THIS ARTICLE: Radha S, Kayalvizhi G, Adimoulame S, et al. Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13(4):311-317.

Evaluation of Streptococcus mutans serotypes e, f, and k in saliva samples of 6-12-year-old school children before and after a short-term daily intake of the probiotic lozenge.

AIM: The aim of this study is to assess the variations in the levels of Streptococcus mutans in saliva before and after short-term daily intake of the probiotic lozenge. To estimate the prevalence of S. mutans serotypes e, f, and k and its variations in salivary levels before and after short-term daily intake of the probiotic lozenge. MATERIALS AND METHODS: This double-blind randomized controlled trial was conducted among 60 children of 6-12 years old, who were given lozenge twice daily containing probiotic bacteria twice daily, one in the morning and another in the evening after brushing for 1 month. The placebo lozenge group also followed the same protocol. A pre- and post-quantitative analysis of S. mutans and serotypes e, f, and k level were done in the saliva of both experiment and control groups. STATISTICAL ANALYSIS: The data thus collected were statistically evaluated using repeated measures of ANOVA, followed by post hoc test and independent t-test. RESULTS AND CONCLUSION: When compared with baseline, a significant reduction of S. mutans was seen after 1 month intervention and 6 months follow-up. The prevalence of serotype e was found to be 5% and serotype k was found to be 12%, whereas none of the samples carried serotype f. Future long-term research with a larger sample size is required to determine the prevalence of S. mutans serotype and longer evaluation period is required to assess the preventive role against caries development.

Microperimetry - A New Tool for Assessing Retinal Sensitivity in Macular Diseases.

INTRODUCTION: Macular disease is the leading cause of low vision in the Western world. Drusen and pigmentary irregularities are common among the rural Northern Indian population. The disease process leads to loss of central vision, metamorphopsia, macropsia or micropsia and colour vision defect. AIM: To study the retinal sensitivity changes in macular diseases using microperimetry. MATERIALS AND METHODS: It was an observational study, conducted in the Department of Ophthalmology at a rural tertiary care hospital. This study was started from December 2014 until June 2016, in all patients with macular disease above the age of 20 years attending the outpatient department. Microperimetry was done for 84 eyes of 52 patients with macular disease. Mean retinal Sensitivity (MS) and fixation stability was evaluated. The statistical analysis of mean retinal sensitivity, central 2° and 4° fixation was done by calculating the mean and standard deviation using 95% confidence interval. RESULTS: The range of age was between 20-81 years. Majority were 32 males (62%) and 20 females (38%). Out of the 84 eyes studied, majority of the macular disease were Age-Related Macular Degeneration (AMD) (50%). Rest 50% were other macular diseases. The mean retinal sensitivity (dB) shown by microperimetry was 10.83 in AMD, 9.12 in Cystoid Macular Oedema (CME), 10.34 in Epiretinal Membrane (ERM), 10.74 in Pigment Epithelial Detachment (PED), 8.96 in Central Serous Chorioretinopathy (CSCR), 6.43 in macular dystrophy, 7.15 in Lamellar Hole (LMH), 9.8 in Pseudomacular Hole (PMH), 3 in geographic atrophy, 11.1 in macular telangiectasia, 5.6 in Berlin oedema, 12.3 in macular scar and 15.2 in haemorrhage in macula. The study showed 64% of the eyes had stable 2° central fixation, 35% had relatively unstable fixation and 1% had unstable fixation. No significant correlation between retinal sensitivity and retinal thickness in AMD was found. CONCLUSION: This study shows that microperimetry can be a useful tool for objective evaluation of macular function and progression of the disease.

Comparative evaluation of applanation and indentation tonometers in a community ophthalmology setting in Southern India.

PURPOSE: Measurement of intraocular pressure (IOP) is one of the basic investigations in a general ophthalmic workup. In this study, we attempt to determine the agreement in the measurement of IOP obtained by Perkin's applanation tonometer, noncontact tonometer and Schiotz indentation tonometer in patients attending general ophthalmology OPD in a tertiary care centre in South India and its use in a community ophthalmology setting. METHODS: A cross-sectional analytical study in which IOP was measured in patients using the three tonometers. Central corneal thickness (CCT) was measured using Ultrasonic pachymetry. Bland Altman analysis was done to evaluate the agreement between instruments. RESULTS: 800 eyes of 400 patients were included in the study. By Bland Altman method, Schiotz indentation tonometer was found to have better correlation to IOP obtained by Perkin's applanation tonometer. Schiotz indentation tonometer was found to be most accurate when CCT was in the range of 501-550 µm and noncontact tonometer was found to be least accurate when CCT was greater than 600 microns. On comparing correlation at different age groups, both the methods had better correlation at <40 years age group. CONCLUSION: Both the tonometers showed a significant correlation with the gold standard technique (Perkin's applanation tonometer) over a range of IOP and CCT with the Schiotz tonometer better than the NCT. This study proves that Schiotz tonometer can be recommended as a reliable screening tool in community outreach ophthalmology services. The twin advantages of portability and availability make the Schiotz tonometer a popular choice among ophthalmology trainees and optometrists in a developing country like India.

Role of Optical Coherence Tomography in Assessing Anterior Chamber Angles.

INTRODUCTION: Gonioscopy is the gold standard in assessing anterior chamber angles. However, interobserver variations are common and there is a need for reliable objective method of assessment. AIM: To compare the anterior chamber angle by gonioscopy and Spectral Domain Optical Coherence Tomography (SD-OCT) in individuals with shallow anterior chamber. MATERIALS AND METHODS: This comparative observational study was conducted in a rural tertiary multi-speciality teaching hospital. A total of 101 eyes of 54 patients with shallow anterior chamber on slit lamp evaluation were included. Anterior chamber angle was graded by gonioscopy using the shaffer grading system. Angles were also assessed by SD-OCT with Trabecular Iris Angle (TIA) and Angle Opening Distance (AOD). Chi-square test, sensitivity, specificity, positive and negative predictive value to find correlation between OCT parameters and gonioscopy grading. RESULTS: Females represented 72.7%. The mean age was 53.93 ±8.24 years and mean anterior chamber depth was 2.47 ± 0.152 mm. Shaffer grade ≤ 2 were identified in 95(94%) superior, 42(41.5%) inferior, 65(64.3%) nasal and 57(56.4%) temporal quadrants. Cut-off values of TIA ≤ 22° and AOD ≤ 290 µm were taken as narrow angles on SD-OCT. TIA of ≤ 22° were found in 88(92.6%) nasal and 87(87%) temporal angles. AOD of ≤ 290 µm was found in 73(76.8%) nasal and 83(83%) temporal quadrants. Sensitivity in detecting narrow angles was 90.7% and 82.2% for TIA and AOD, while specificity was 11.7% and 23.4%, respectively. CONCLUSION: Individuals were found to have narrow angles more with SD-OCT. Sensitivity was high and specificity was low in detecting narrow angles compared to gonioscopy, making it an unreliable tool for screening.