Prognostic Impact of Poor Differentiation of Squamous Cell Carcinoma in Treatment Naïve Node-Negative Early Oral Cancers.

We have conducted this study to understand the impact of poor differentiation (PD), as a sole poor prognostic factor, in early oral cancers. This was a retrospective analysis of a prospectively maintained database of clinically node-negative early T stage OSCC patients operated between 2012 and 2014. Impact of PD on the survival and role of adjuvant therapy in these patients was noted. Out of 1172 patients screened, 280 patients were found to be eligible for the study. 11.4% patients had PDSCC. It was found to be associated with tongue cancers and peri-neural invasion. It had a significant impact on OS and DFS (48.7 months vs 81.4 months, p < 0.00 and 44.6 months vs 73.5 months, p < 0.00 respectively. Hazard ratio for DFS: 4.08. Although patients with PDSCC had better survival with radiotherapy, but this was not statistically significant. Poor differentiation as a stand-alone factor impacts survival in patients with early oral cancer. It may be seen more often in patients with tongue cancer and may have associated PNI. The role of adjuvant therapy in such patients is not clear.

Addressing the contralateral neck for ipsilateral disease recurrence in oral cavity cancers.

BACKGROUND: Evidence for performing contralateral neck dissection (CND) of recurrent oral cavity squamous cell cancers (OCSCC) is lacking. MATERIAL AND METHODS: This is a retrospective study of 78 consecutive OCSCC having ipsilateral recurrence recorded over five years. We screened 1658 OCSCC patients and selected those patients who underwent CND as part of treatment for ipsilateral recurrence. RESULTS: The median disease-free interval was 32 months. Incidence of contralateral nodal metastasis (CNM) in recurrent OCSCC was 23.1% and of which 14% were occult. The factor significantly influencing CNM was the depth of invasion (DOI) > 10 mm (p < 0.01). In our study, imaging had suboptimal PPV (33%) while it had high NPV (88%) in diagnosing nodal metastasis in recurrent OCSCC. CONCLUSION: DOI is the most important factor predicting CNM in case of ipsilateral primary recurrence. PET-CECT has a high NPV and contralateral neck should be addressed in case of tumours with higher DOI.

Intraoperative frozen section for detection of occult metastasis in clinically N0 neck does not improve outcome in oral cavity carcinomas.

OBJECTIVE: The objective of this study was to evaluate the utility of frozen section (FS) in detecting occult nodal metastasis in cN0 OSCC and its impact on regional failure and survival. MATERIALS AND METHODS: Clinical records of patients of OSCC operated from January 2013 to December 2014 were retrospectively reviewed. These patients were divided into two groups-Group A comprised of patients who underwent selective neck dissection (SND) (level III/IV) and FS based completion (level IV ± V); Group B included patients who underwent SND I-III/IV without FS. The sensitivity and specificity of FS in detecting occult metastasis was calculated. The regional failure rates and overall survival (OS) between the two groups were compared. RESULTS: The sensitivity, specificity, PPV (positive predictive value) and NPV (negative predictive value) of FS in detecting occult metastasis were 64.06%, 100%, 100%, and 92.15%, respectively. There was no significant difference in regional failure rates (p = 0.219) and OS (p = 0.08) between the two groups. CONCLUSION: FS has a poor sensitivity in detecting occult nodal metastasis. FS-guided neck dissection does not have a significant impact in reducing regional failure or improving OS in clinically node-negative neck in oral cavity carcinomas.

Role of Poor Oral Hygiene in Causation of Oral Cancer-a Review of Literature.

Oral squamous cell carcinomas (OSCC) are among the commonest cancers in South East Asia and more so in the Indian subcontinent. The role of tobacco and alcohol in the causation of these cancers is well-documented. Poor oral hygiene (POH) is often seen to co-exist in patients with OSCC. However, the role of poor oral hygiene in the etio-pathogenesis of these cancers is controversial. We decided to evaluate the available literature for evaluating the association of POH with OSCC. A thorough literature search of English-language articles in MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Web of Science databases was conducted, and 93 relevant articles were short-listed. We found that POH was strongly associated with oral cancers. It aids the carcinogenic potential of other known carcinogens like tobacco and alcohol. Even on adjusting for known confounding factors like tobacco, alcohol use, education, and socio-economic strata, presence of POH exhibits higher odds of developing oral cancer.

Volumetric analysis of root filling with cold lateral compaction, Obtura II, Thermafil, and Calamus using spiral computerized tomography: An In vitro Study.

AIM: The aim of the present study is volumetric analysis of root canal filling with cold lateral compaction, Obtura II, Thermafil, and Calamus using spiral computerized tomography (SCT). MATERIALS AND METHODS: Root canals of eighty mandibular premolars were instrumented using rotary ProTaper, and the volume of the canal space was measured using spiral computerized tomography (SCT). The teeth were divided into four groups of twenty teeth each, and root canals filled by lateral compaction technique, Thermafil carriers, Obtura II, and Calamus techniques, respectively. AH Plus was used as a sealer with all techniques. The filled volume in each canal was measured using SCT, and the percentage of obturated volume (POV) was calculated. The data were statistically analyzed using ANOVA, Kruskal-Wallis test, and Mann-Whitney U-test. RESULTS: The four groups were comparable in canal volume. The overall POV was 78.11%, 85.72%, 82.50%, and 87.89% for lateral compaction, Thermafil, Obtura II, and Calamus, respectively (P Conclusion: The greatest POV was obtained with Calamus and Thermafil. Voids were seen in all root fillings.

A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study.

The continuous development of esthetically acceptable adhesive restorative material has made a variety of tooth-colored materials available for clinical use. The advent of visible light polymerizing resin and the use of finer filler particles permit resin composites to be polished to higher degree. The effect of polishing systems on surface finish has been reported to be material-dependent, and the effectiveness of these systems was mostly product-dependent. Hence, the purpose of this study was to evaluate the efficiency of finishing and polishing systems on the surface roughness of nanofilled, microfilled, and hybrid composite restorative materials available in the market. HOW TO CITE THIS ARTICLE: Yadav RD, Raisingani D, Jindal D, Mathur R. A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study. Int J Clin Pediatr Dent 2016;9(3):201-208.

Information regarding use of rotary nickel- titanium endodontic instruments among general dental practitioners: a questionnaire survey

Aim: A cross-sectional questionnaire survey was conducted to obtain information on the use of rotary nickel ­titanium endodontic instruments was conducted among General Dental Practioner A two sectioned questionnaire was mailed to 200 randomly general practioners to obtain information on usage of Nickel ­Titanium endodontic instrument and data was collected. Results: Forty-six percent of the general practioners had used rotary NiTi instruments. 76% dentists use NiTi files for five or more times a week. Most of the dentist used NiTi file coronally &apically. General dentists experienced more file fracture at size 20 and 25 with 0.02 and 0.04 taper. Conclusions: Dentists are familiar with limitations of NiTi instruments and techniques. Current study showed the awareness of dentists about benefits of NiTi rotary instruments application comparing to traditional techniques and also the high percent usage of these instruments among general dentists.

Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files.

AIM: To evaluate the incidence of apical crack initiation during canal preparation with stainless steel K-files and hand protaper files (in vitro study). MATERIALS AND METHODS: Sixty extracted mandibular premo-lar teeth are randomly selected and embedded in an acrylic tube filled with autopolymerizing resin. A baseline image of the apical surface of each specimen was recorded under a digital microscope (80×). The cervical and middle thirds of all samples were flared with #2 and #1 Gates-Glidden (GG) drills, and a second image was recorded. The teeth were randomly divided into four groups of 15 teeth each according to the file type (hand K-file and hand-protaper) and working length (WL) (instrumented at WL and 1 mm less than WL). Final image after dye penetration and photomicrograph of the apical root surface were digitally recorded. RESULTS: Maximum numbers of cracks were observed with hand protaper files compared with hand K-file at the WL and 1 mm short of WL. Chi-square testing revealed a highly significant effect of WL on crack formation at WL and 1 mm short of WL (p = 0.000). CONCLUSION: Minimum numbers of cracks at WL and 1 mm short of WL were observed with hand K-file and maximum with hand protaper files. HOW TO CITE THIS ARTICLE: Soni D, Raisingani D, Mathur R, Madan N, Visnoi S. Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files. Int J Clin Pediatr Dent 2016;9(4):303-307.

Evaluation of Coronal Leakage Following Different Obturation Techniques and in-vitro Evalution Using Methylene Blue Dye Preparation.

INTRODUCTION: Coronal and apical leakage still remains one of the most important cause for endodontic failure in spite of the presence of advanced endodontic materials. The cause may attribute to different filling techniques, physical and chemical properties of sealers and presence or absence of smear layer assessment of coronal or apical leakage is used as a research method to compare the sealing ability of different techniques and endodontic materials. AIM: To compare the coronal bacterial leakage using methylene blue in four different obturation techniques after protaper hand instrumentation. MATERIALS AND METHODS: Ninety extracted single-rooted teeth were instrumented to an apical preparation size F3 Protaper hand files. Twenty teeth were randomly obturated with lateral compaction, 20 with vertical compaction, 20 with combination of vertical and lateral compaction and 20 with Thermafil. Ten teeth were used for positive and negative controls (five teeth in each group). Teeth were kept in 100% humidity for 90 days, and then subjected coronally to Proteus vulgaris for 21 days to assess bacterial leakage. After bacterial challenge, methylene blue was placed coronally for another 21 days, and then scoring was done according to depth of dye leakage. Chi-square test was done for statistical analysis. RESULTS: Leakage as observed with combination of vertical and lateral compaction was significantly less than vertical compaction, lateral compaction and thermafil carriers during bacterial challenge. However, when dye was used it also showed statistically significant results with thermafil carriers showing the least leakage in comparison to vertical condensation, lateral condensation and combined groups. CONCLUSION: The study concludes that two different methods i.e. bacterial and dye leakage revealed considerable variation on the same substrate Thus, due to the presence of variability among the results obtained by two different analytical methods used in the present study, the study emphasizes the need for standardization of methods as the lack of standardization hinders the comparison of different endodontic filling techniques.