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Research & Reviews: A Journal of Dentistry ISSN: 2230-8008(online), ISSN: 2348-9561(print)

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It is my privilege to present the print version of the [Volume 7 Issue 3] of our Research & Reviews: Journal of Dentistry (RRJoD), 2016. The intension of RRJoD is to create an atmosphere that stimulates vision, research and growth in the area of Dentistry. Timely publication, honest communication, comprehensive editing and trust with authors and readers have been the hallmark of our journals. STM Journals provide a platform for scholarly research articles to be published in journals of international standards. STM journals strive to publish quality paper in record time, making it a leader in service and business offerings. The aim and scope of STM Journals is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high level learning, teaching and research in all the Science, Technology and Medical domains. Finally, I express my sincere gratitude to our Editorial/ Reviewer board, Authors and publication team for their continued support and invaluable contributions and suggestions in the form of authoring write-ups/reviewing and providing constructive comments for the advancement of the journals. With regards to their due continuous support and co-operation, we have been able to publish quality Research/Reviews findings for our customers base. I hope you will enjoy reading this issue and we welcome your feedback on any aspect of the Journal.

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Research & Reviews: A Journal of Dentistry

Contents

1. A Future Revolution in Medical/Dental Therapeutics: Medical Marijuana P. Flaer, J. Gallegos

2. Unicystic Ameloblastoma: Mural Variantâ&#x20AC;&#x201D;A Rare Case Report Tanvi Vijay, Abhishek Kumar Singh, Zibran Khan, Amar Singh Jadaun, Sandeep Dungarwal, Shivendra Kumar Singh

3. Minimal Invasive Approach in Periodontal Therapy: A Review Kunal Keshaw, Pushpa Pudalkatti, Anita Raikar, Gunjan Richa, Ancia Vas

4. Report of Two Cases with Supplemental Tooth in Primary Dentition Neelam Hasmukhbhai Joshi, Anshula Neeraj Deshpande, Rameshwari Raol, Urvashi Krunal Patel

5. Awareness Regarding Importance of Fluoridated Toothpaste among 12â&#x20AC;&#x201C;14 Years Old Children Poonacha K.S., Dimple Mehta, Anshula Deshpande, Seema Bargale, Neelam Joshi, Kishan Naik

Research & Reviews: A Journal of Dentistry ISSN: 2230-8008(online), ISSN: 2348-9561(print) Volume 7, Issue 3 www.stmjournals.com

A Future Revolution in Medical/Dental Therapeutics: Medical Marijuana P. Flaer1,*, J. Gallegos2 1

Department of Diagnosis, Florida Institute for Advanced Dental Education, Miami, Florida 33127, USA 2 Community Smiles, Miami, Florida 33127, USA

Abstract Dispensing and use of marijuana (Cannabis) and derivatives are restricted under federal statutory control in the United States as “SCHEDULE 1” substances (illegal drugs). However, at the state level (September 2016), “medical marijuana” is legal in 20 states plus “recreational marijuana” in four states and the districts of Columbia. Several other states have litigation for marijuana decriminalization on the November 2016 ballot. Pharmacotherapeutic use of marijuana and its derivatives may alter future prescribed use of opioid medications (most narcotic medicines) for pain control in medicine and dentistry— lowering the effective dose of the opioid when used in combination with marijuana. Although abuse of marijuana is still controversial, modern practitioners are beginning to incorporate “medical marijuana” into their clinical practice. Marijuana and its derivatives have been used for many indications in medicine and dentistry—some are supported by research evidence, however, many are not. Practitioners should take appropriate care that use of “medical marijuana” will benefit the patient and that such treatment is in the best interest of the patient. Keywords: Medical marijuana, pain control, marijuana research, opioids, chronic illnesses

INTRODUCTION Marijuana (Cannabis) and related drugs have potential therapeutic uses in medicine and dentistry. Therapeutic effects of marijuana that are supported by research evidence include the following [1–3]:  Activity in chronic and neuropathic pain.  Antiemetic properties in cancer chemotherapy.  Stimulated appetite (important for weight gain in HIV/AIDS).  Decreased spasticity in multiple sclerosis.  Lessened severity of “tics” in Tourette syndrome.  Increased uninterrupted sleep in chronic insomnia. Synthetic marijuana formulations are available as the prescription medicines Marinol (dronabinol) and Cesamet (nabilone)—both approved by the U.S. Food and Drug Administration as effective and safe [4]. These drugs are classified as SCHEDULES II and III, respectively by the Drug Enforcement Administration (DEA) and are available

according to laws in “medical marijuana” states. The synthetic marijuana formulations have been found to have therapeutic use in cancer chemotherapy and HIV/AIDS as antiemetics and for promoting appetite [4]. Another prescription medicine—the marijuana plant-derived drug Sativex—has similar activity as its natural source; although used in Europe, it is still undergoing clinical trials in the United States [5]. Marijuana in capsular form has a longer duration of action, decreased pain sensitivity, and less euphoric effects in analgesic activity [6, 7]. In addition, these marijuana-related drugs have a delayed onset of activity as compared to smoked marijuana—tending to lower the potential for abuse [8].

MEDICAL MARIJUANA On August 1, 2016, the U.S. Food and Drug Administration reaffirmed the status of marijuana and its derivatives as SCHEDULE I substances [9]. The classification of marijuana as a SCHEDULE I substance (i.e., an illegal

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Research & Reviews: A Journal of Dentistry ISSN: 2230-8008(online), ISSN: 2348-9561(print) Volume 7, Issue 3 www.stmjournals.com

Unicystic Ameloblastoma: Mural Variant—A Rare Case Report Tanvi Vijay1,*, Abhishek Kumar Singh2, Zibran Khan1, Amar Singh Jadaun3, Sandeep Dungarwal1, Shivendra Kumar Singh4 1

Department of Oral and Maxillofacial Surgery, Pacific Dental College and Hospital (PAHER) Udaipur, Rajasthan, India 2 Department of General Surgery, Dr. D.Y. Patil Hospital (Dr. D.Y. Patil University), Pune, Maharashtra, India 3 Oral and Maxillofacial Surgery, Ora Max Hospital, Bharuch, Gujarat, India 4 General Surgery, Public Health Centre, Muradnagar, Uttar Pradesh, India

Abstract According to the recent literatures, ameloblastoma is a benign tumour of jaw bones with locally invasive capacity. It is a true neoplasm of enamel-organ type of tissue which does not undergo differentiation to the point of enamel formation. It belongs to the group of tumors arising from odontogenic epithelium with mature fibrous stroma without odontogenic ectomesenchyme as per according to the World Health Organization (WHO) Classification of Odontogenic Tumors in 2005. This article describes a case of mural variant of unicystic ameloblastoma involving a 27-year-old male located in the lower vestibular/buccal gingiva. After the case presentation, clinical and microscopic findings are discussed. Keywords: Ameloblastoma, unicystic, mural, tumor

INTRODUCTION Ameloblastoma is the best-known odontogenic tumour, very often used as the norm by which other odontogenic tumours are judged. Its unique clinical and pathologic behaviour was described by Robinson (1937) as being “usually unicentric, non-functional, intermittent in growth, anatomically benign and clinically persistent”. It is classified clinically as unicystic ameloblastoma, multicystic or solid ameloblastoma, peripheral ameloblastoma, malignant ameloblastoma [1]. Though ‘unicystic ameloblastoma’ was instigated by Robinson and Martinez (1977), scepticism still exists regarding the nomenclature of ‘unicystic ameloblastoma’ with cystic (intracystic) ameloblastoma, ameloblastoma associated with dentigerous cyst, cystogenic ameloblastoma, extensive dentigerous cyst with intracystic ameloblastic papilloma, mural ameloblastoma, dentigerous cyst with ameloblastomatous proliferation, and ameloblastoma developing in a radicular cyst [2, 3]. The ‘unicystic’ term is gleaned from its macroscopic and microscopic nature. Unicystic ameloblastoma appears as a

unilocular as well as a multilocular bone defect [3]. They are seen around the fourth and the fifth decades of life, except the unicystic form, which is seen commonly in 2nd and 3rd decade. Published recurrence rates may overestimate or underestimate the actual recurrence for certain types of ameloblastoma. Ameloblastomas are benign aggressive slowgrowing neoplasms with a poorly understood potential for rare metastasis. They are capable of reaching large sizes with extensive local bone erosion and destruction [4]. However, it has been suggested that the cystic ameloblastoma, especially the unicystic type, is less aggressive, with a lower recurrence rate.

CASE REPORT A 27-year-old male non-smoker presented with a swelling on left posterior region of lower jaw since 2 months. Swelling gradually increased to 2 cm  2 cm with occasional pain. Clinical features revealed a lesion covered by normal mucosa with a smooth surface and firm

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Research & Reviews: A Journal of Dentistry ISSN: 2230-8008(online), ISSN: 2348-9561(print) Volume 7, Issue 3 www.stmjournals.com

Minimal Invasive Approach in Periodontal Therapy: A Review Kunal Keshaw*, Pushpa Pudalkatti, Anita Raikar, Gunjan Richa, Ancia Vas Department of Periodontology, Maratha Mandalâ&#x20AC;&#x2122;s Nathajirao G. Halgekar Institute of Dental Science and Research Centre, Belagavi, Karnataka, India Abstract Minimally invasive periodontal treatment procedures are mostly confined within the context of periodontal surgery and aim to perform less extensive surgical manipulation, leading to reduced level of pain and discomfort. It also prevents the delirious esthetic changes that could occur with the conventional surgical approaches. This review deals with the ground understanding of minimally invasive periodontal therapy inculcating the regenerative potential at the confined site, when performed. Many studies reveal that the microsurgical access flap, in terms of MIPS, has a high potential to seal the healing wound from the contaminated oral environment by achieving and maintaining primary closure. Soft tissues are preserved to avoid recession and this stands upon the aesthetic demands of both the patient and the clinician. However, larger studies are required to confirm and extend the reported positive preliminary outcomes. Keywords: MIPS, surgery, treatment procedures

INTRODUCTION The need of less invasive methods of interventional treatment, which can produce fewer complications have been evident since 25 years and has given rise to the idea of minimally invasive treatment (MI) with two interlaced paths of findings, one is newer regenerative materials and the other is developing novel surgical approaches. All of this aims at reducing the trauma of traditionally applied interventional procedures to achieve a harmonious therapeutic result. Minimally invasive procedures in medicine have been defined as those procedures that avoid use of open invasive surgery and favour more of closed or localized surgery. This in turn causes less pain, less scarring, speedy recovery and thus, reduces postsurgical complications. Minimally invasive dentistry is a concept that preserves dentition and supporting structures. The aim is to represent alternative approaches developed to allow less extensive manipulation of surrounding tissues than conventional procedures, while accomplishing the same objectives [1].

Healing that occurs in sound systemic and localized condition favors regeneration. Periodontal regeneration of intrabony defects has been achieved by employing different principles, using barrier membranes, demineralized freeze dried bone allografts, and wound healing modifiers as enamel matrix derivatives. With due course, development of surgical procedures was aimed at complete preservation of the soft tissues to achieve and maintain primary closure on top of the applied regenerative material/substance during the critical early stages of healing inculcating flap designs attempted to achieve passive primary closure of the flap combined with optimal wound stability. According to data obtained from controlled clinical trials and metaanalyses from various systematic reviews, minimal invasive periodontal therapy (MIPT) provided added benefits in terms of clinical attachment level (CAL) gain and probing pocket depth reduction when compared with access flap alone [2]. Flap dehiscence at regenerative sites is a frequent occurrence with barrier membranes, bone grafts, combination of barriers and grafts and, to a lesser extent, with EMD. Exposure

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Research & Reviews: A Journal of Dentistry ISSN: 2230-8008(online), ISSN: 2348-9561(print) Volume 7, Issue 3 www.stmjournals.com

Report of Two Cases with Supplemental Tooth in Primary Dentition Neelam Hasmukhbhai Joshi*, Anshula Neeraj Deshpande, Rameshwari Raol, Urvashi Krunal Patel Department of Paediatric and Preventive Dentistry, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India

Abstract Teeth that are seen in duplications are usually termed as supplemental teeth which may be present in both primary and permanent dentition. Supplemental teeth forms are actually the subset of supernumerary teeth which are commonly seen in permanent dentition as compared to primary dentition. The presence of these extra teeth may pose various clinical complications. Two cases with supplemental tooth in maxillary arch lateral incisor region are discussed and emphasis is laid on the importance of early diagnosis and treatment during early mixed dentition in present case report. Keywords: Supernumerary teeth, lateral incisor, malocclusion, maxillary arch, mixed dentition

INTRODUCTION A supplemental tooth is type of supernumerary teeth which is seen in addition to the normal sequence of teeth and can be located in any region of the dental arch. Usually, supernumerary teeth are missed by general dental practitioners and are found by chance on a radiographic procedure when it is associated with any of the impacted permanent tooth. They may also be found in the oral cavity following spontaneous eruption. There are various theories which explain the etiology of supernumerary teeth. One of them suggests that the supernumerary tooth is formed as an end result of division of the tooth bud [1]. Another well supported hypothesis in the literature is based on the hyperactivity theory, which advocates it as a result due to local, independent, conditioned hyperactivity of the dental lamina [1, 2]. Genetic predilection has also been mentioned to play a role, as similar anomalies are encountered in the relatives of children diagnosed with supplemental tooth. However, there is no specific genetic pattern or theory associated with supernumerary teeth; they have been commonly associated with various syndromes and defects such as cleft lip and palate, cleidocranial dysplasia, and Gardner

syndrome. Hence, the clinician should be aware of these systemic conditions and its association with supplemental teeth. In a survey carried out by Brook in 2,000 school children, 0.3–0.8% prevalence was found in primary dentitions and 1.7–2.1% prevalence was found in permanent dentitions [3]. The most common type of supernumerary teeth is single supernumeraries occurring in 76 to 86% of cases, followed with double supernumeraries in 12 to 23% of cases, and multiple being the most rarest found in less than 1% of cases [4]. According to Luten’s study, following teeth are listed in order of decreasing frequency: upper lateral incisors (50%), mesiodens (36%), upper central incisors (11%), followed by bicuspids (3%) [5]. Whereas according to Shapira and Kuftinec, the teeth in order of decreasing frequency are: upper central incisors, molars (especially upper molars), premolars, followed by lateral incisors and canines [6]. Considering the sex distribution, there is no significant difference in primary dentition but in permanent dentition male to female ratio is 2:1. The supernumerary according to their

teeth are classified position and form.

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Research & Reviews: A Journal of Dentistry ISSN: 2230-8008(online), ISSN: 2348-9561(print) Volume 7, Issue 3 www.stmjournals.com

Awareness Regarding Importance of Fluoridated Toothpaste among 12–14 Years Old Children Poonacha K.S., Dimple Mehta*, Anshula Deshpande, Seema Bargale, Neelam Joshi, Kishan Naik Department of Paedodontics and Preventive Dentistry, K.M. Shah dental College and Hospital; Sumandeep Vidyapeeth, Vadodara, Gujarat, India

Abstract Introduction: Brushing with fluoride dentifrice is a critical element of our defence against dental caries. Optimal caries protection from the fluoride in a dentifrice will only be provided if brushing delivers fluoride effectively and specifically to the teeth. Aim and Objectives: Aim was to assess the knowledge regarding use of fluoridated toothpaste in prevention of dental caries among 12–14 years old children. Objectives were to know whether the children in the age group of 12–14 years know the advantages of using fluoridated toothpaste over non-fluoridated toothpaste in prevention of dental caries and to create awareness about advantages of fluoridated toothpaste. Materials and Methods: 100 Children in the age group of 12–14 years were selected. The questionnaire proforma of multiple-choice questions regarding the knowledge and awareness of fluoridated toothpaste was given to the subjects to mark. The data was evaluated using chi square test and t-test. Result: Regarding the awareness of fluoride in toothpaste, only 26% children had the knowledge regarding fluoride content in toothpaste while only 12% children had knowledge regarding actual importance of fluoride in toothpaste. Conclusion: Based upon the findings of present study the awareness, knowledge and attitude of 12–14 years school going children regarding various oral hygiene measures and use of fluoridated toothpaste and its role in caries prevention was very poor. Keywords: Fluoridated toothpaste, fluoride, caries, oral hygiene practice, brushing

INTRODUCTION Brushing with fluoride dentifrice is a critical element of our defence against dental caries. It removes plaque, which can produce cariogenic acids and delivers fluoride to reduce demineralization and promote remineralization. Brushing frequency, brushing duration, rinsing and toothpaste quantity are all essential brushing behaviour factors to get optimal caries protection from the fluoride content of toothpaste [1]. Thorough rinsing with water after brushing has been shown in vivo to reduce the ability of fluoride dentifrices to protect against caries. Rinsing has been shown to reduce substantially the concentration of fluoride in saliva after brushing and also in plaque. However, brushing with fluoridated toothpaste causes increase in salivary fluoride levels,

which can reach up to 5 ppm immediately after brushing. Topical application of fluoride will lead to penetration of fluoride ions into enamel pores, which causes re-mineralization of demineralized enamel [2]. Of these studies on behavioural characteristics, only the effects of brushing frequency and rinsing have been well studied. Brushing twice a day improves caries protection than brushing once per day or less frequently. This benefit may result from improved plaque removal as well as increased fluoride exposure. This study was undertaken to evaluate awareness level in the most vulnerable age group of 12–14 years old children who have all permanent teeth erupted in oral cavity and to assess the knowledge acquired about the fluoride and its effects on teeth. Very few studies (Database search: PubMed, EBSCOhost, ScienceDirect) have also been

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