Knowledge, attitude and practice of dental students and practitioners during the early days of COVID-19 pandemic in India: A cross-sectional study.

AIM: The novel coronavirus disease-2019 (COVID-19) is a major health problem and has affected innumerable people around the world. The current online-based study was conducted to assess the knowledge, attitude and practice (KAP) of dental students and professionals during the early days of lockdown in India from 2 April to 1 May 2020. METHODOLOGY: An online-based cross-sectional study was undertaken through WhatsApp messenger and e-mail groups among dental students and professionals. The KAP on COVID-19 was ascertained using an investigator designed and validated questionnaire. The results were stratified based on student vs professionals. The data were expressed as frequency and percentage analysed using the chi-square/Fishers exact test using IBM version 17. A probability value of <.05 was considered significant. RESULTS: A total of 287 complete responses from the dental students and professionals were received. The results indicated that the knowledge of both dental students and professionals were good and that the attitude and practice were in accordance with good clinical practice. No significant differences were found within the domains of KAP scores among the dental students and practitioners indicating that the study participants were abreast with the recent advances. CONCLUSION: The results of this study conducted during the early stage of the lockdown indicated that the dental students and professionals who had filled the questionnaire had very good knowledge of coronavirus and COVID-19. CLINICAL IMPLICATIONS: The results of the study indicate that the volunteers had good knowledge, attitude and self-care practice, which are necessary in preventing the spread of COVID-19. It is anticipated that detailed hands-on training in practical aspects of good clinical practice with protective gears will help students and professionals perform the necessary dental procedures in accordance with the guidelines set by Centers for Disease Control and Prevention and World Health Organization.

Apprehensions and Optimism among Dental Professionals during the COVID-19 Pandemic-A Nationwide Cross-Sectional Evaluation.

Globally, the pandemic of the coronavirus disease, which started in Wuhan, China, has become a major issue for public health. The COVID-19 epidemic notably causes health professionals to experience significantly more emotional stress than the general populace. The present study proposes to investigate the fear aspect in dentists in the initiation of clinical practice during these times. An online cross-sectional study was conducted among dental practitioners based on a pre-validated questionnaire. The data were expressed as frequency and percentage analyzed using the chi-square test using SPSS version 25. The data was obtained from 271 participants, where clinical practice after the first wave was mostly by freelancers (p-value = 0.01); most of whom were married (p-value = 0.065); 19.1% attached to institutes did not have changes in earnings; 28.1% of private practitioners had less than 10% reduction in cases. A total of 62% of private practitioners are concerned about the vaccine's preventative effects (p-value = 0.026), and 57% of private practitioners worry about being sued for the delay in treatment (p-value = 0.036). Only 33.1% of employees in institutions worry that becoming sick could endanger their family. As dentists continue to work their way through this pandemic, these pressures only occasionally have an impact on them. According to the researchers, this is the first study that has captured the anxiety and apprehensions that dental practitioners experienced during the height of the COVID-19 outbreak in India in April 2021. The study's findings demonstrate that the study population was generally upbeat and confident that they could quickly overcome their fear.

Nonsyndromic delayed eruption of multiple teeth: A rare case report.

Dental eruption is a very finely regulated process. A delay in tooth eruption may be due to a disturbance caused by local, systemic, or genetic abnormalities. Delayed eruption of multiple teeth in the absence of any etiology is very rare. Here, we report a case of delayed eruption in a 16-year-old female patient with multiple congenitally missing teeth and bilaterally ankylosed deciduous teeth with no underlying systemic or genetic disease.

Assessment of the number of root canals in the maxillary and mandibular molars: A radiographic study using cone beam computed tomography.

CONTEXT: The identification of root canals plays an important role in successful endodontic diagnosis and treatment. An inappropriate identification of canal resulting in incomplete removal of pulp tissue from the root canals is the main reason for the failure of endodontic treatment in molars. Radiographic imaging is an essential investigative tool in successful endodontics. Cone beam computed tomography (CBCT) the imaging is relatively a new method to visualize the roots in all the three planes. AIMS: This is a study to assess number of root canals in maxillary and mandibular first and second molars on both the right and left sides using CBCT imaging. SETTINGS AND DESIGN: A total of 100 CBCT images, which were available as soft copies on the hard drive of the computer in the Department of Oral Medicine and Radiology were considered for the study. SUBJECTS AND METHODS: The axial view sections of the maxillary and mandibular arch of 1 mm thickness were examined with a magnification of 250%. The Images were scrolled down from the cementoenamel junction till the apical foramen and the maximum number of canals in each root were recorded. STATISTICAL ANALYSIS USED: The collected data were tabulated (Microsoft Excel 2013) and analyzed by independent t-test using statistical analysis software SPSS. RESULTS: Among the maxillary first molars, 72.5% had 4 canals with 76.5% of mesiobuccal root having 2 canals. 49% of maxillary second molar had 3 canals with 53.5% of mesiobuccal root having 1 canal. 67.5% of mandibular first molar had 3 canals with 96.5% of mesial root having 2 canals. CONCLUSIONS: According to this study, the variations in the number of canals were more with respect to maxillary first molars when compared to the other molars. CBCT can provide the clinician with supplemental information about the different root canal configurations for successful root canal treatment.

Transcutaneous electrical nerve stimulation therapy: An adjuvant pain controlling modality in TMD patients - A clinical study.

BACKGROUND: The use of transcutaneous electrical nerve stimulation (TENS) in dentistry was first described in 1967, by Shane and Kessler, but it has yet to gain widespread acceptance in dentistry. A study was undertaken to evaluate the effectiveness of TENS therapy as an adjuvant modality and to compare it with the conventional medication in controlling pain in temporomandibular disorder (TMD) patients. MATERIALS AND METHODS: The study was carried out in the Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Mangalore. A total of 40 patients with the clinical symptom of pain associated with TMDs were randomly divided into two groups. Group A (control) patients were treated with medication (analgesics and muscle relaxants) alone, while group B patients were treated with TENS therapy in combination with medication. The intensity of the pain was assessed using the Visual Analog Scale (VAS). The results were analyzed with the student's 't' test. A P-value < 0.05 was considered as significant. RESULTS: A significant improvement was observed in both the TENS and the control group in terms of pain control. On comparative analysis, adjuvant TENS therapy was found to be more effective than medication alone, in controlling pain. (P value = 0.019). CONCLUSION: The observed data suggest that TENS therapy can be used as an adjuvant modality in the management of pain associated with TMDs. This study justifies the use of TENS therapy in the management of TMD.

Mandibular ameloblastic carcinoma.

Ameloblastic carcinoma is a rare aggressive odontogenic tumour that exhibits malignant histologic features in the primary site or in metastasis. This rare tumour needs immediate attention because of its aggressive and infiltrative nature. However, there are controversies regarding the definitive treatment because of the very few cases in the literature database. Here, we report a case of a 64-year-old male Asian patient who presented with a non-tender exophytic proliferative mass of 3 months duration. It was finally diagnosed as ameloblastic carcinoma and promptly treated surgically with a regular follow-up. Local long-term control and follow-up is imperative in such patient laying emphasis on potential pulmonary metastasis.

Efficacy of spirulina as an antioxidant adjuvant to corticosteroid injection in management of oral submucous fibrosis.

BACKGROUND AND OBJECTIVES: Oral submucous fibrosis (OSF) is a chronic condition of the oral cavity which results in permanent disability. A number of studies have proven that the management of premalignant diseases should include antioxidants. Therefore, a study was carried out to evaluate the efficacy of spirulina as an antioxidant adjuvant to corticosteroid injections in the management of 40 oral submucous fibrosis subjects of south Karnataka and north Kerala. MATERIALS AND METHODS: An intervention study was conducted on 40 oral submucous fibrosis cases, 40 patients were divided into two groups, group A (spirulina group) and group B (placebo group). Group A received spirulina 500 mg twice daily and biweekly intralesional steroid injection of Betamethasone 4 mg/ml for 3 months and group B was given placebo capsules twice daily and biweekly intralesional steroid injection of Betamethasone 4 mg/ml for 3 months. The results were analyzed with the paired "t" test and the unpaired "t" test. RESULTS: Clinical improvements in mouth opening was significant in the posttreatment period in both Spirulina and placebo groups. Both the groups showed statistically significant reduction in burning sensation. However, when both groups were compared, mouth opening and burning sensation was found to be statistically very highly significant in favor of the spirulina group. CONCLUSION: Spirulina can bring about clinical improvements in OSF patients. The observed effects suggest that spirulina can be used as an adjuvant therapy in the initial management of OSF patients. However, studies involving larger samples and longer period of treatment follow up are suggested in the future.

Oral biopsy: oral pathologist's perspective.

Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

Ectopic pleomorphic adenoma.

We describe a case of pleomorphic adenoma of minor salivary glands occurring in the retromolar area. A 58-year-old male patient reported with complaint of a small mass in the left lower retromolar region of the mouth. It has grown slowly to the present size. Based on the history and clinical findings, differential diagnosis of fibroma, minor salivary gland tumor, and mucocele were considered. The microscopic findings revealed the presence of minor salivary gland tissue and the lesions showed the presence of myoepithelial and epithelial cell proliferation. The cells were arranged in ductal pattern. There were areas where the epithelial cells showed proliferation in sheets, cords, and strands. The patient was followed up for a period of 6 months and there was no evidence of recurrence. The retromolar area being affected as in the case presented is rare for this condition. Surgical excision along with surrounding normal tissue is the treatment of choice.

Hand, foot and mouth disease: changing Indian scenario.

Hand, foot and mouth disease usually affect infants and children. Although seen worldwide, it is not common in India. It is moderately contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. It typically occurs in small epidemics, usually during the summer and autumn months. The incidence of hand, foot and mouth disease has recently been on the rise in India due to the probable mass immunization programs. This report describes a case of hand foot and mouth disease from Mangalore, South India. How to cite this article: Rao PK, Veena KM, Jagadishchandra H, Bhat SS, Shetty SR. Hand, Foot and Mouth Disease: Changing Indian Scenario. Int J Clin Pediatr Dent 2012;5(3):220-222.

Bilateral inflammatory cysts of the jaw: report of an unusual case.

Radicular cyst is the most common odontogenic cyst occurring in the jaws. The cyst is commonly found in relation to the maxillary anterior teeth in the third and fifth decade of life. Although multiple radicular cysts are not uncommon in the jaws, bilaterally symmetrical representation of these cysts is rare. Radiographs prior to extraction help in diagnosis of these cysts and thereby prevent further morbidities. We report a case of 16-year-old male patient who presented bilateral radicular cysts symmetrically in the mandible.

Facial talon in mandibular incisor: An unusual occurrence.

Talon cusp, also known as an eagle's talon, is a dental anomaly that occurs on the lingual aspect of teeth commonly, but occurrence on the facial aspect has rarely been reported. It is an extra cusp on an anterior tooth, which arises as a result of evagination on the surface of a crown before calcification has occurred. The incidence of talon cusp on lingual side is less than 6% and is even lesser on the facial aspect. Commonly involved teeth are maxillary incisors, usually unilateral but in some instances bilateral. The classical radiographical feature of talon cusp is double teeth appearance. The anomaly has been reported to be unusual in the mandibular dentition and extremely rare on the facial aspect. We report one such extremely rare case of facial talon cusp in mandibular central incisor.

Bone invasion in oral cancer patients: a comparison between Orthopantamograph, conventional computed tomography, and single positron emission computed tomography.

BACKGROUND AND OBJECTIVES: One of the important factors in the pretreatment evaluation of patients with squamous cell carcinoma is the detection of the presence and extent of bone invasion by the tumor, which is significant for planning the therapy and determining the prognosis. Therefore, a study was undertaken with an objective to compare the accuracy and predictability of an Orthopantamograph (OPG), conventional Computed Tomography (CT), and Single Positron Emission Computed Tomography (SPECT) in the detection of bone invasion in squamous cell carcinoma patients scheduled to undergo surgery. MATERIALS AND METHODS: A descriptive study was carried out on 15 patients with clinically and histopathologically diagnosed squamous cell carcinoma. OPG, conventional CT, and SPECT were carried out on all patients. Subsequently, the bone adjacent to the tumor was assessed histopathologically and served as a gold standard. The various imaging modalities were compared with the gold standard. RESULTS: The study revealed that the tumor infiltration into the bone was positive in eight out of fifteen cases and seven were negative for bone invasion. OPG and conventional CT showed the presence of bone invasion in six out of eight cases with a sensitivity of 75% and a specificity of 100%. The positive predictive value for OPG was 100% and the negative predictive value was 78%. SPECT showed the presence of bone invasion in eight out of eight cases with a sensitivity of 100% and a specificity of 14.3%. The positive predictive value for SPECT was 57% and the negative predictive value was 100%. CONCLUSION: The present study showed that SPECT was highly sensitive, but with a very low specificity due to an increase in false positive values. However, OPG and conventional CT showed an acceptable degree of sensitivity and specificity.

A case of a massive mandibular schwannoma.

Schwannoma, a benign nerve sheath tumor is relatively rare in occurrence and even rarer in sites, such as jaw bones. There are only 45 reported cases of intraosseous schwannoma of the jaws reported in the literature. We report a rare case of mandibular schwannoma in a 50-year-old Indian male. The clinical features resembled that of a residual cyst, fibro-osseous lesion or an odontogenic tumor/cyst. Radiological differential diagnoses of ameloblastoma or odontogenic keratocyst was made based on the findings of the orthopantomogram. The lesion was examined histopathologically and a final diagnosis of schwannoma arising from the inferior alveolar nerve was made. The aim of this report is to add information to the existing sparse literature on intraosseous schwannomas of the jaw.

Odontogenic keratocyst looks can be deceptive, causing endodontic misdiagnosis.

Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. When the cyst is multilocular and located at the molar ramus area, it may be confused to ameloblastoma. Lots of cases have been reported in the literature where OKC is associated with the nonvital tooth. So trauma could be one of the reasons in inducing this cyst. In our case, it was in the anterior region at the periapex of nonvital tooth having traumatic occlusion. Hence, the diagnosis of radicular cyst was made and endodontic treatment was done.

Ellis-van Creveld syndrome in an Indian child: a case report.

Ellis-van Creveld syndrome is a rare congenital genetic disorder having autosomal recessive inheritance. It is a syndrome affecting the Amish population of Pennsylvania in USA with prevalence rate of 1/5,000 live at birth. In non-Amish population, the birth prevalence is 7/1,000,000. The syndrome is characterized by bilateral postaxial polydactyly of the hands, chondrodysplasia of long bones resulting in acromesomelic dwarfism, ectodermal dysplasia affecting nails as well as teeth and congenital heart malformation. There were very rare reports of this syndrome in dentistry. The present case focuses on the striking and constant oral findings of these patients, which are the main diagnostic features of this syndrome. Since the oral manifestations affect the esthetic, speech, and jaw growth of the child, the dentists have an important role to play in proper management of such case.

Efficacy of alpha lipoic acid in adjunct with intralesional steroids and hyaluronidase in the management of oral submucous fibrosis.

BACKGROUND AND OBJECTIVES: Oral submucous fibrosis (OSF) is a chronic irreversible condition of the oral mucosa with proven malignant potential. However, till date, there has been a dearth of effective management strategies. This study used alpha lipoic acid, an antioxidant, in oral form to determine if it could be useful in managing OSF patients. MATERIALS AND METHODS: A case-control study was conducted on 18 patients of OSF (9 cases and 9 controls). The case group was treated using alpha lipoic acid in addition to the intralesional steroid and hyaluronidase injections used in the control group. RESULTS: The cases in the alpha lipoic acid group exhibited better relief of symptoms such as burning sensation of the mucosa and mouth opening, as compared to the controls. The use of alpha lipoic acid along with intralesional steroids and hyaluronidase caused reversal of higher clinical stages to lower ones. CONCLUSION: The use of an antioxidant, alpha lipoic acid, along with conventional therapy of intralesional steroid injections definitely seems to have a beneficial impact in the management of OSF.