Phenotypic characteristics and differentiation potential of gingival mesenchymal stem cells in hyperglycemia ­ an ex vivo exploratory study / Características fenotípicas y potencial de diferenciación de las células madre mesenquimales gingivales en la hiperglucemia: un estudio exploratorio ex vivo

Background: The therapeutic use of gingival mesenchymal stem cells (GMSCs) as autologous cells may pose the challenge of alterations inflicted by the hyperglycemic environment. Objective: This study aims to assess the effects of hyperglycemia on the characteristics of GMSCs in diabetics. Materials and Methods: 10 patients who consented and fulfilled the criteria for inclusion and exclusion were recruited and categorized as test (HbA1c > 6.5) and control (HbA1c < 6.0). Gingival explants were obtained from gingival collar of teeth, washed, digested and cultured. The cells were subjected to microscopic observation to assess phenotype characteristics, and flow cytometry and qRT-PCR to assess differentiation potential. Stem cell markers CD90, CD73, CD105, CD34, CD45, HLA DR & HLA ABC, osteogenic differentiation markers RUNX2 & OCN, adipogenic differentiation markers PPARG2 & FABP4 and chondrogenic differentiation markers SOX9 & AGCN were evaluated. Results: Microscopic appearance of spindle shaped cells was found to be comparable in both groups. Flow cytometry results demonstrated comparable expressions with both groups, samples being positive for CD90, CD73, CD105, HLA ABC and negative for CD34, CD45 & HLA DR. There were variations in the expression of markers when assessed for differentiation potentials. Conclusions: The hyperglycemic environment did not manifest any changes in the phenotypic characteristics of GMSCs among diabetics. However, the expression of certain differentiation markers was significantly altered in the diabetic test population included. Further research is being conducted to understand the GMSCs in a hyperglycemic environment with an aim to develop strategies to optimize its clinical implications. Keywords: Gingiva; Mesenchymal stem cells; Diabetes mellitus; Cell Differentiation; Hyperglycemia; Flow cytometry.

Antededentes: El uso terapéutico de células madre mesenquimales gingivales(GMSC) como células autólogas puede plantear el desafío de las alteraciones infligidas por el entorno hiperglucémico. Objetivo: Este estudio tiene como objetivo evaluar los efectos de la hiperglucemia sobre las características de las GMSC en diabéticos. Materiales y Métodos: Se reclutaron y categorizaron 10 pacientes que dieron su consentimiento y cumplieron los criterios de inclusión y exclusión como prueba (HbA1c > 6,5) y control (HbA1c < 6,0). Los explantes gingivales se obtuvieron del cuello gingival de los dientes, se lavaron, digirieron y cultivaron. Las células se sometieron a observación microscópica para evaluar las características fenotípicas y a citometría de flujo y qRT-PCR para evaluar el potencial de diferenciación. Se evaluaron los marcadores de células madre CD90, CD73, CD105, CD34, CD45, HLA DR y HLA ABC, marcadores de diferenciación osteogénica RUNX2 y OCN, marcadores de diferenciación adipogénica PPARG2 y FABP4 y marcadores de diferenciación condrogénica SOX9 y AGCN. Resultados: Se encontró que la apariencia microscópica de las células fusiformes era comparable en ambos grupos. Los resultados de la citometría de flujo demostraron expresiones comparables en ambos grupos, siendo las muestras positivas para CD90, CD73, CD105, HLA ABC y negativas para CD34, CD45 y HLA DR. Hubo variaciones en la expresión de los marcadores cuando se evaluaron los potenciales de diferenciación. Conclusiones: El entorno hiperglucémico no manifestó ningún cambio en las características fenotípicas de las GMSC entre los diabéticos. Sin embargo, la expresión de ciertos marcadores de diferenciación se alteró significativamente en la población de prueba de diabetes incluida. Se están realizando más investigaciones para comprender las GMSC en un entorno hiperglucémico con el objetivo de desarrollar estrategias para optimizar sus implicaciones clínicas.

COVID-19 and Personal Protective Equipment-Related Challenges Faced by Pediatric Dentists during patient care: A Qualitative Study

Abstract Objective: To describe the challenges pediatric dentists face while caring for their patients during the pandemic. Material and Methods: A descriptive qualitative study was conducted with purposefully sampled pediatric dentists. Data were collected through in-depth, semi-structured interviews until the content of the collected data reached theoretical saturation. Data were transcribed verbatim, coded, and analyzed using content analyses. Results: Seven participants (four females and three males) between 29 and 50 years participated in the study. Three themes emerged from the analyses: Anxiety and fear; PPE (Personal Protective Equipment) and its impact on care delivery; and 3) Behavior management. Conclusion: Dental care delivery was challenging for pediatric dentists. They experienced high anxiety levels and modified their services according to the recommended guidelines while making accommodations to lessen patients' COVID-19-related anxiety. The additional mandated PPE use affected the communication between the dentists and their patients, affecting their dentist-patient bonding.

Association of Sleep Quality and Stress with Academic Performance among Undergraduate Dental Students of Bhubaneswar, India

ABSTRACT Objective: To assess sleep quality and stress level and to analyze their effect on the academic performance of undergraduate dental students. Material and Methods: A cross-sectional descriptive survey was conducted among 234 undergraduate dental students at Bhubaneswar. Pittsburgh Sleep Quality Index (PSQI), consisting of 18 items rated on a 4-point Likert scale, assessed sleep quality. Kessler Psychological Distress Scale (K10) evaluated the stress level. Google Forms collected demographic details and marks obtained in their previous examination. Chi-square, Mann-Whitney U, Kruskal-Wallis tests, and Spearman correlation coefficient were used for analysis (p≤0.05). Results: Mean PSQI and K10 scores were 4.87±4.5 and 17.60±8.5, respectively. 38% of students had poor sleep quality, and mean actual sleep hours were 8.01±1.7. One-fourth (24.8%) of subjects had moderate to severe stress. Sleep quality significantly differed among the various academic years (p=0.001). A post-hoc test showed a difference between 1st and 2nd-year students and 1st and 4th-year students. A statistically significant difference between genders regarding the components of the K10 scale was observed. A non-significant positive correlation between total marks and K10 score and a negative correlation between marks and global PSQI score was found. Conclusion: Sleep quality and stress harm the academic performance of dental students.

COVID-19 Related Knowledge, Attitude, Practice Evaluation among Indian Dental Patients: A Cross-Sectional Survey

ABSTRACT Objective: To assess the awareness about COVID-19 among dental patients and determine the association between COVID-19 awareness and perceived stress among dental patients. Material and Methods: A selfadministered knowledge, attitude and practices (KAP) questionnaire and perceived stress scale (PSS) were employed to assess the knowledge and attitude among dental patients visiting the outpatient department. A p-value of ≤ 0.05 was considered statistically significant. An independent t-test was used to compare the KAP and PSS scores based on age, gender, occupation and the responses to unscorable questions. Spearman's correlation was employed to assess the association between KAP and PSS scores. Results: The older participants (mean KAP score = 16±2.2), the participants who answered that the Coronavirus outbreak changed their daily routine (mean KAP score = 15.8±2.2) and the participants who answered that they changed their plans due to the Coronavirus outbreak (mean KAP score = 16±2.14) had significantly higher KAP scores when compared to their respective counterparts. The Spearman's correlation value of -0.45 suggested a moderate negative association between the KAP and PSS scores, but this correlation was not statistically significant. Conclusion: The participants had a moderate to good level of knowledge related to COVID-19 and were positive in their approach and outlook on overcoming the pandemic.

Impact of Internet Addiction on Academic Performance of Undergraduate Dental Students of Bhubaneswar, India

ABSTRACT Objective: To assess the level of internet addiction and its impact on the academic performance of undergraduate dental students of Bhubaneswar. Material and Methods: A cross-sectional descriptive survey was steered among 814 undergraduate dental students (representing first year through internship) in Bhubaneswar, India. Internet addiction was assessed with the Internet Addiction Test (IAT) developed by Young, which consisted of 20 items rated on a 5-point Likert scale. Google Forms were used to collect the data. Statistical tests like Chi-square, Kruskal-Wallis, and Spearman correlation coefficient were used to analyze the qualitative and quantitative variables, respectively, with the significance level set at p ≤ 0.05. Results: The prevalence of Internet Addiction was found to be 27.5%. Interns showed the highest mean Internet Addiction (57.91±10.71) score. The proportion of addicted students was higher in males, 74 (31.4%), than in females, 150 (26%). The mean scores for individual domains were overuse (16.31±3.64), non-restraints (7.77±2.66), inhibiting the flow of life (9.52±3.05), emotional state (11.25±2.86), and dependence (10.47±2.53). A correlation coefficient (Spearman's rho value of -.167) indicates a negative correlation between internet addiction and academic scores, which was statistically significant (p=0.001). Conclusion: This study revealed that internet use for varying purposes eventually leads to addiction and affects students' academic performance. The affected students need early intervention and control over internet usage.

Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

Evaluation of molar bite force in carious and non-carious primary dentition among 4 to 6 year old children / Evaluación de la fuerza de mordida molar en dentición temporal cariada y no cariada en niños de 4 a 6 años

Objetive: The aim of the study was to evaluate the maximum molar bite force in children aged 4 to 6 years with and without dental caries. Material and Methods: This cross sectional study was carried out from May 2018 to December 2018. A total of 288 children aged between 4 to 6 years were randomly selected from six different primary schools in Chennai city, India and divided into two groups of 144 children each, based on the presence and absence of caries: Group A children with non-carious dentition and Group B children with carious dentition. Bite force measurement was performed using standardized custom made occlusal force gauge. Statistical analysis used: Data were expressed as the mean ± SD. Student's t­test (two tailed, independent) and ANOVA were used to find the significance of study parameters between the groups. Results: Occlusal bite force of non-carious dentition (367.94 ±33.71N) was higher than the carious dentition (326.73±27.83N) and it was statistically significant (p≤0.01). Overall occlusal bite force of boys (350.44±35.84N) was significantly higher than that of girls (344.22±38.25N). Flush terminal plane molar relationship showed higher occlusal bite force (380.54±27.36N) followed by mesial step (350.82±22.25N) and distal step (310.63±20.82N) molar relationship. Conclusion: Non-carious dentition showed significantly higher bite force than carious dentition in children 4 to 6 years of age. Boys had higher bite force than the girls and flush terminal plane molar relationship showed higher bite force than mesial and distal step molar relationship.

Objetivo: El objetivo del estudio fue evaluar la fuerza de mordida molar máxima en niños y niñas de 4 a 6 años con y sin caries dental. Material y Métodos: Este estudio transversal se llevó a cabo entre mayo de 2018 y diciembre de 2018. Se seleccionó aleatoriamente un total de 288 niños y niñas de entre 4 y 6 años de seis escuelas primarias diferentes en la ciudad de Chennai, India, y se dividieron en dos grupos de 144 niños cada uno según la presencia y ausencia de caries: El grupo A incluye niños con dentición no-cariada y el grupo B incluye niños con dentición cariada. La medición de la fuerza de mordida se realizó utilizando un medidor de fuerza oclusal estandarizado hecho a medida.Análisis estadístico utilizado: Los datos se expresaron como la media ± SD. Se utilizó la prueba t de Student (dos colas, independiente) y ANOVA para encontrar la importancia de los parámetros de estudio entre los grupos. Resultados: La fuerza de mordida oclusal de la dentición no cariada (367,94 ±33,71N) fue mayor que la de la dentición cariada (326,73±27,83N) y fue estadísticamente significativa (p≤0,01). La fuerza de mordida oclusal global de los niños (350,44±35,84N) fue significativamente mayor que la de las niñas (344,22±38,25N). La relación molar en el plano terminal al ras mostró una mayor fuerza de mordida oclusal (380,54 ± 27,36 N), seguida de una relación molar de escalón mesial (350,82 ± 22,25 N) y escalón distal (310,63 ± 20,82N).Conclusión: La dentición no cariada mostró una fuerza de mordida significativamente mayor que la dentición cariada en niños de 4 a 6 años de edad. Los niños tenían una mayor fuerza de mordida que las niñas y la relación molar en el plano terminal mostró una mayor fuerza de mordida que la relación molar escalonada mesial y distal.

Evaluation of Lung Volume and Effect of Vital Staining as Motivation to Quit Tobacco among Nicotine Dependents of Kanpur, India

Abstract Objective: To quantify and compare respiratory functions and further screen the oral mucosa of tobacco and non-tobacco users. Material and Methods: First control group, non-tobacco users (n=55); Second group, smokers' group (n=168) who currently smoked cigarettes; Third group smokeless/chewing type, tobacco group (n=81); Fourth group, both smokeless and smoking type tobacco users (n=46). Fagerstrom Test for Nicotine Dependences (FTND) and Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) instruments were used to assess nicotine dependence. Subsequently, spirometry and Toluidine Blue (TB) vital staining were performed. Chi-squared and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: Fagerstrom test resulted in 48.8% of subjects with low dependency, followed by an increase in nicotine dependency from low to moderate (29.2%), moderate (15.6%), and highly dependent (6.4%) groups. All respiratory function tests and oral screening confirmed significant changes amongst tobacco and non-tobacco users. The forced vital capacity of non-smoker group was significantly different from other tobacco users' group (p<0.05). Conclusion: Early effects of tobacco use can lead to complications with the respiratory system and oral cavity. Such data can be used to delineate the harm of tobacco and should be used to urge individuals to evade the utilization of tobacco (AU).

Oral Health Literacy - Adult Questionnaire: Psychometric Properties and its Influence on Oral Health Status of School Teachers in Bhubaneswar, India

Abstract Objective: To translate Oral Health Literacy - Adult Questionnaire from English to Odia language and test its psychometric properties and assess its influence on oral health status of school teachers. Material and Methods: A cross-sectional survey was performed among 400; 116 (29%) males and 284 (71%) female school teachers of Bhubaneswar. OHL-AQ questionnaire subsequent to being translated to Odia language utilizing World Health Organization recommended translation back translation protocol was then tested for the establishment of its psychometric properties with assistance from the selected expert panel of academicians. The oral health status of participants was assessed using the WHO oral health assessment form-2013. Chi-square, t-tests, one-way ANOVA, and linear regression were used for statistical analysis. Results: Internal consistency of OHL-AQ-O was acceptable with an alpha value of 0.70. Test-retest reliability showed almost perfect agreement (ICC=0.90, CI=0.85-0.93) indicating highly reliable translated scale (p=0.001). Overall mean oral health literacy scores were 13.02±1.86, with about 80% belonging to the high oral health literacy level group. Caries prevalence was 78%, with a mean DMFT of 3.04±2.55. Shallow pockets were absent majorly in teachers belonging to the high oral health literacy group (p=0.01). The multiple linear regression model depicted that only the teaching experience variable added significantly to the prediction (p=0.008). Conclusion: OHL-AQ-O questionnaire was found valid and reliable to measure OHL. Further application of the instrument in other communities and populations will support establishing the external validity of the OHL-AQ-O.

Comparison of Oncostatin M in Patients with Chronic Periodontitis with and without Diabetes

Abstract Objective: To compare the Oncostatin M (OSM) concentrations in tissues of patients with chronic periodontitis with and without diabetes. Material and Methods: Sixty-four subjects visiting the dental outpatient department were categorized as "healthy" (Group 1), "periodontitis" (Group 2), and "diabetes with periodontitis" (Group 3) groups. The clinical oral examination included assessment of plaque, gingivitis, probing depth, clinical attachment level. Blood glucose was assessed for group 3 patients. OSM concentration in the tissues was assessed using ELISA in all groups. Results: The mean OSM was 0.02 ± 0.04 pg/mg in the healthy group, 0.12 ± 0.09 pg/mg in the chronic periodontitis group and 0.13 ± 0.10 pg/mg in the diabetes-periodontitis group. A significantly higher mean OSM was seen in Group 2 and Group 3 than Group 1. The amount of OSM positively correlated with probing depth and clinical attachment level. Conclusion: Periodontal disease causes a rise in Oncostatin M, independent of the diabetic status. Expression of OSM in the gingival tissues can serve as an inflammatory marker.

Performance Appraisal of Select Nations in Mitigation of COVID-19 Pandemic using Entropy based TOPSIS Method / Avaliação de desempenho de nações selecionadas na mitigação de pandemia de COVID-19 usando método TOPSIS baseado em entropia

Abstract The present study was an effort to assess the mitigation interventions carried out, so far, by the nations to fight the pandemic COVID-19. The novelty of the study was that it had considered the issue of pandemic mitigation strategy as a decision making problem. The performances of the twenty nations were to be ranked. The problem considered in the study was essentially a Multi-Criteria Decision Analysis (MCDA) problem. The available alternatives were the 20 countries and the 8 traits were the criteria. The Technique of Order Preference Similarity to the Ideal Solution (TOPSIS) was used in the present study. The study used Entropy method for assignment of weights to all the criteria. The performance score obtained in respect of the countries considered in the study and the corresponding ranks indicated the relative performances of the countries in their efforts to mitigate the COVID-19 pandemic. The results show that New Zealand is the best performing country and India is the worst one. Brazil ranked 17th, while the rank of UK was 15. The performance of the USA stood at 18th position.

Resumo O presente estudo foi um esforço para avaliar as intervenções de mitigação realizadas, até o momento, pelas nações para combater a pandemia COVID-19. A novidade do estudo é que considerou a questão da estratégia de mitigação da pandemia como um problema de tomada de decisão. As performances das vinte nações deveriam ser classificadas. O problema considerado no estudo era essencialmente um problema de Análise de Decisão Multi-Critério (MCDA). As alternativas disponíveis eram os 20 países e as 8 características eram os critérios. A Técnica de Similaridade de Preferência de Pedido com a Solução Ideal (TOPSIS) foi utilizada no presente estudo. O estudo utilizou o método da Entropia para atribuição de pesos a todos os critérios. A pontuação de desempenho obtida em relação aos países considerados no estudo e as classificações correspondentes indicaram os desempenhos relativos dos países em seus esforços para mitigar a pandemia COVID-19. Os resultados mostram que a Nova Zelândia é o país com melhor desempenho e a Índia o pior. O Brasil ficou em 17º, enquanto o Reino Unido ficou em 15. O desempenho dos EUA ficou na 18ª posição.

Effect of Oral and Maxillofacial Injuries on the Development of Post-Traumatic Stress Disorder: A Cross-Sectional Study

ABSTRACT Objective: To assess the influence of oral and maxillofacial trauma on the development of Post-Traumatic Stress Disorder (PTSD) and to determine the efficiency of the Impact of Event Scale-Revised (IES-R) as a diagnostic tool for detecting PTSD in patients with Oral and Maxillofacial injuries. Material and Methods: PTSD was assessed one month postoperatively by the diagnostic instrument, IES-R, to arrive at a provisional diagnosis. A structured clinician-administered PTSD Scale then assessed the patients for the Diagnostic and Statistical Manual of Mental Disorders-5th edition (CAPS-5) to establish a final diagnosis. The assessment of the severity of PTSD was done based on various types of oral and maxillofacial injuries. Results: The IES-R scale provisionally diagnosed 54 subjects with PTSD, out of which 42 were diagnosed to have PTSD by the CAPS-5 scale. Subjects with injuries involving the 'orbital complex,' those presenting with a perceptible scar in the maxillofacial region and with multiple avulsed/ luxated anterior teeth, showed a higher affinity to develop PTSD, and this was statistically significant. Conclusion: Higher levels of PTSD in patients with injuries to the maxillofacial region warrants correct diagnosis and detection, and hence the maxillofacial surgeon plays a vital role in this regard. The IES-R is a useful diagnostic tool to detect PTSD early.

Validation and Assessment of COVID-19 Peritraumatic Distress Index among Indian Dental Professionals

ABSTRACT Objective: To establish the validity of COVID-19 Peritraumatic Distress Index (CPDI) questionnaire and assess the stress with its associated factors during COVID-19 among dental professionals in Bhubaneswar, India. Material and Methods: An online survey through Google Forms was steered among 234 dentists. CPDI questionnaire was used for data collection post its validation assessment. Content validity was judged satisfactory by two psychiatrists, and excellent internal consistency was found (Cronbach's alpha = 0.92). For statistical analysis, chi-square and binomial logistic regression tests were used with a significance level of p=0.05. Results: 70 (29.9%) were males and 164 (70.1%) were females with a mean age of 30.58 ± 6.70 years. Around 50% had an MDS degree and were attached to an institution and nearly 80% were having experience of less than 10 years. The mean CPDI score was found to be 29.09 ± 15.47. A statistically significant association was observed between CPDI scores with age (p<0.003), gender (p<0.03), practice (p<0.06) and education (p<0.006). Binomial logistic regression revealed that odds of stress were 2 times higher among males than females (OR=2.01, p<0.04), which was statistically significant. Conclusion: Acceptable validation scores confirmed CPDI as an effective instrument for detecting stress. Importance of early interventions to combat the issue of stress among dental professionals as it is allied with negative consequences on health and furthermore affects daily activities is highlighted.

Perception of Indian Dental Students to Pursue Higher Education Abroad during COVID-19

ABSTRACT Objective: To evaluate Indian dental students' perception of seeking international dental higher education during COVID-19. Material and Methods: We conducted an online survey among the dental students. A self-administered questionnaire was prepared, which had information on country choice, reasons for the decision to study abroad, measures to be taken by the foreign universities because of COVID-19, the application's status, current plan, and opinions on exploring other possibilities. Results: Four hundred students constituted the final sample, out of which the majority were females (69.3%). Most of the students were not sure about their status in the application process (63%). The current plan to study abroad remained uncertain for almost half of the students (50.2%). Concerning the status of the application process, a significantly higher number of female students were "not sure" and are still "searching colleges" (p<0.001). Similarly, a higher number of females were "uncertain" or "postponed" or "canceled" when compared to the males concerning the current plan to study abroad (p=0.001). Also, a significantly higher proportion of female students cited the study budget as the main deterrent for pursuing a career abroad and opined that "flexible study options" will help them get admissions post-COVID-19 (p=0.001 and 0.035). Conclusion: A substantial impact was perceived by Indian dental students concerning higher education abroad, more among females.

Age Estimation by Modified Demirjian's Method in a Hospital-Based Population: A Radiographic Study

ABSTRACT Objective: To test the modified Demirjian's method of dental age estimation on the South Indian population and correlate it with the patient's chronological age. Material and Methods: This retrospective radiographic study was performed on digital panoramic radiographs taken during a one-year duration. Radiographs of patients in the age range from 8 to 18 years were included in the study. The radiographs were examined and according to the stage of the crown and root status of the left side mandibular teeth. The stage of calcification was observed for eight teeth in the mandibular arch and was recorded in a specially designed proforma. Each rated tooth with stage was converted into a score using a conversion table specified for girls and boys. Results: 224 digital panoramic radiographs were retrieved from the radiologic database. Out of total study sample, 49.5% (n=111) were boys and 50.5% (n=113). The mean chronological and estimated dental age using dental maturity scores resulted in an overestimation of 3 years and eight months. Also, it was noted that there was a strong positive association between chronological (real) and dental age. Conclusion: It was observed that there was a strong correlation between chronological and dental age. A new formula for determining the chronological age from the estimated dental age was derived. Further studies on a larger population may prove the reliability of this age estimation method.

Radiographic Assessment of Third Molars Agenesis Patterns in Young Adults

ABSTRACT Objective: To determine the prevalence of third molar agenesis and associated characteristics. Material and Methods: A total of 2374 panoramic radiographs were retrieved from the radiological archives and evaluated in a computer monitor under optimum viewing conditions. The basic demographic data (age and sex) and the primary findings regarding the presence or absence of third molars in the maxillary and mandibular arches were recorded systematically in a specially designed proforma. Categorical variables were compared using the Chi-square test. Results: A total of 2000 panoramic radiographs were included in the study, of which 1004 were females (50.2%), and 996 were of males (49.8%). The incidence of third molar agenesis was 486 patients (24.3%). Maxillary third molar showed a higher prevalence of agenesis (28.8%) than mandibular third molars (16.4%). A total of 1514 patients (75.7%) had third molars in all four quadrants, and the remaining 486 patients (24.3%) had agenesis of third molar tooth in at least one of the quadrants. Single tooth agenesis was observed in 219 (11%) patients, two teeth agenesis in 172 (8.6%) patients, three teeth agenesis in 39 (2%) patients, and four teeth agenesis in 56 (2.8%) patients. Conclusion: The present study exhibited a maximum number of single tooth agenesis. It was also observed that maxillary third molar agenesis is more than the mandibular third molar and the right side is more than the left side. Agenesis of the third molar is more prevalent in males as compared to females.

The Role of Online Teaching Among the Undergraduate Dental Students During the Current COVID-19 Pandemic in India: A Pilot Study

ABSTRACT Objective: To assess the usefulness of online teaching for undergraduate students during this Corona pandemic, to point the drawbacks of online teaching, and to learn the areas of improvement in online teaching for the future. Material and Methods: A descriptive cross-sectional study on 130 students was done in Bhubaneswar, Odisha, India. The questionnaire consisted of two parts, personal details and specific information. The first part of the questionnaire consisted of questions related to age, gender, etc. The second part had questions pertaining to online teaching. Pearson's Chi-square test was applied and the level of significance was set at 5%. Results: Most of the students (83.3%) were in the view that classroom lectures are the best mean of imparting knowledge, which was significant (p<0.001). A significant number of students (88.1%) agreed that online teaching is the best method of teaching apart from classroom teaching. Almost all the students (93%) agreed significantly that online teaching is the best way to learn in this present pandemic scenario. Most students (59.6%) agreed that connectivity/network issue is a major drawback in online teaching, which is again significant (p<0.001). Conclusion: Here in these testing times, the role of online teaching becomes important for medical/dental students, both undergraduates and postgraduates, to keep up with their studies.

Assessment on Oral Health Knowledge, Attitude, and Behaviour and its Association with Sociodemographic and Habitual Factors of South Indian Population

ABSTRACT Objective: To assess the oral health knowledge, attitude, behaviour, and its association with sociodemographic and habitual factors among South Indian Population. Material and Methods: A total of 288 adults living in a residential community situated in Chennai were selected by systematic random sampling method participated in this cross-sectional study. Data collection was carried out using a validated questionnaire. Results: About 97.9% of the participants in our study had good knowledge, 33.3% had a positive attitude and 48.2% had adequate oral health behaviour. Sociodemographic and habitual factors like diet (p=0.006), education (p=0.009), and employment (p=0.003) were significantly associated with knowledge. On the other hand, diet (p=0.012) was the only factor significantly associated with attitude. Ownership of house (p= 0.030) was significantly associated with behaviour and no factor was associated with all three KAB profiles. Absence of correlation were identified between Knowledge-Attitude (r=0.11, p=0.23), Knowledge-Behaviour (r= -0.037, p= 0.68) and Attitude-Behaviour (r =0.01, p=0.94). Conclusion: It has been found a massive number of participants possessed a high knowledge level towards oral health. On the other hand, less than half of the participants had a positive attitude and adequate behaviour towards oral health. No positive linear correlation was seen among knowledge, attitude, and behaviour towards oral health.

Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

ABSTRACT Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods: Thirty subjects with a history of xerostomia and subjects withunstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student's t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p<0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p<0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p<0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was notstatistically significant in both groups (p<0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.