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Oral health: charcoal brushes

Ramachandra SS, Dicksit DD, Gundavarapu KC

Br Dent J, 2014 Jul 11;217(1):3.
PMID: 25012309 DOI: 10.1038/sj.bdj.2014.557
Importance-performance analysis of dental satisfaction among three ethnic groups in malaysia

Dewi FD, Gundavarapu KC, Cugati N

Oral Health Prev Dent, 2013;11(2):131-9.
PMID: 23757453 DOI: 10.3290/j.ohpd.a29735

PURPOSE: To find the differences in patient satisfaction related to dental services among three ethnic groups - Chinese, Indian and Malay - at AIMST University Dental Centre and analyse them with an importance-performance grid, identifying the weak and strong points, in order to provide better service.
MATERIALS AND METHODS: This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test.
RESULTS: Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians.
CONCLUSION: The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.
Fulltext Extraction protocols for orthodontic treatment: A retrospective study

Thirunavukkarasu VN, Ramachandra SS, Dicksit DD, Gundavarapu KC

Contemp Clin Dent, 2016 Jan-Mar;7(1):41-4.
PMID: 27041899 DOI: 10.4103/0976-237X.177092

BACKGROUND AND OBJECTIVES: Various extraction protocols have been followed for successful orthodontic treatment. The purpose of this study was to evaluate the extraction protocols in patients who had previously undergone orthodontic treatment and also who had reported for continuing orthodontic treatment from other clinics.
MATERIALS AND METHODS: One hundred thirty eight patients who registered for orthodontic treatment at the Faculty of Dentistry were divided into 10 extraction protocols based on the Orthodontic treatment protocol given by Janson et al. and were evaluated for statistical significance.
RESULTS: The descriptive statistics of the study revealed a total of 40 (29%) patients in protocol 1, 43 (31.2%) in protocol 2, 18 (13%) in protocol 3, 16 (11.6%) in protocol 5, and 12 (8.7%) in Type 3 category of protocol 9. The Type 3 category in protocol 9 was statistically significant compared to other studies. Midline shift and collapse of the arch form were noticed in these individuals.
CONCLUSION: Extraction of permanent teeth such as canine and lateral incisors without rational reasons could have devastating consequences on the entire occlusion. The percentage of cases wherein extraction of permanent teeth in the crowded region was adopted as a treatment option instead of orthodontic treatment is still prevalent in dental practice. The shortage of orthodontists in Malaysia, the long waiting period, and lack of subjective need for orthodontic treatment at an earlier age group were the reasons for the patient's to choose extraction of the mal-aligned teeth such as the maxillary canine or maxillary lateral incisors.
KEYWORDS: Extraction protocol; Malaysia; irrational extraction; orthodontic treatment
Fulltext Interleukin 1β (+3954; -511) Genotype Polymorphism and its Association with Severe Chronic Generalized Periodontitis in the Malaysian Population

Arora S, Ramachandra SS, Abdullah F, Gundavarapu KC

Contemp Clin Dent, 2017 Jan-Mar;8(1):102-105.
PMID: 28566859 DOI: 10.4103/ccd.ccd_1177_16

INTRODUCTION: Single-nucleotide polymorphisms (SNPs) in interleukin 1β (IL-1β) gene have been known to be associated with increased susceptibility to chronic periodontitis among various ethnic populations. SNPs are more commonly observed at loci + 3954 and - 511. The aim of this study was to evaluate the role of IL-1β gene polymorphism at loci +3954 and - 511, and its association with severe chronic generalized periodontitis among the ethnic Malay, Chinese, and Indians within the Malaysian population.

MATERIALS AND METHODS: Saliva samples from 120 subjects (60 cases and 60 controls) in the age group of 25-50 years were collected for isolation of genetic material using Norgen technique. Clinical attachment loss of ≥5 mm was considered as severe chronic generalized periodontitis. SNP's at loci +3954 and - 511 were identified and analyzed using Kompetitive Allele Specific Polymerase Chain Reaction Genotyping System (KASP™). Differences in the allele/genotype frequencies were assessed by Chi-square test (P < 0.05).

RESULTS: On the comparison between cases and controls of IL-1β genotype polymorphism (+3954 and - 511), the difference in the genotype frequencies was statistically insignificant in all the three ethnicities. The genotype frequency in both groups in all three ethnicities of the Malaysian population was similar.

CONCLUSION: IL-1β genotype polymorphism at +3954 and - 511 was found to be not associated with severe chronic generalized periodontitis among the three ethnicities in Malaysia. Studies with larger sample size should be done to confirm the findings of this study.
Influence of Grafting on Pocket Depth and Dentin Hypersensitivity Around Third Molar Extraction Sites: A Split-Mouth Randomized Controlled Trial

Majid H, Ramachandra SS, Kumar S, Wei M, Gundavarapu KC

Compend Contin Educ Dent, 2022 Jan;43(1):e5-e8.
PMID: 35019665

This study evaluated the effect of alloplastic bone grafts in osseous defects following surgical removal of horizontally impacted third molars by comparing the periodontal measures distal to the second molar in grafted and nongrafted third molar extraction sites. Materials and Methods: A double-blind, randomized, controlled clinical trial was designed on subjects with bilateral horizontally impacted mandibular third molars. Grafting consisting of alloplasts at the third molar extraction sites was compared with nongrafted sites. This study assessed 54 randomized sites in 27 patients who were selected using a split-mouth design. The predictor variable included the change in pocket depth distal to the mandibular second molar and associated dentin hypersensitivity around the second molar, assessed preoperatively and at 3 and 6 months after third molar surgery. The data regarding pocket depth reduction was statistically analyzed using paired t-test. The data concerning reduction in dentin hypersensitivity was statistically analyzed using chi-square test. Results: Six months after third molar surgery, mean pocket depth distal to mandibular second molar decreased significantly at the grafted sites compared to the nongrafted sites. The reduction in dentin hypersensitivity of mandibular second molar was statistically significant for the grafted sites at 6 months, compared to the nongrafted sites.
Fulltext Differential Diagnosis between Chronic versus Aggressive Periodontitis and Staging of Aggressive Periodontitis: A Cross-sectional Study

Ramachandra SS, Gupta VV, Mehta DS, Gundavarapu KC, Luigi N

Contemp Clin Dent, 2017 Oct-Dec;8(4):594-603.
PMID: 29326511 DOI: 10.4103/ccd.ccd_623_17

Background: Differentiating between chronic periodontitis (CP) and aggressive periodontitis (AgP) is challenging. The aim of this study was to assess the variations in diagnosis between CP versus AgP and the staging of AgP based on the disease-staging index for AgP among periodontists, specialists in oral medicine, and general dental practitioners (GDPs).

Materials and Methods: Fifteen cases diagnosed as either CP or AgP were included in a "case document" and sent electronically to 75 respondents. Case document included a detailed history with periodontal charting, clinical features, images, and radiographs for all the cases. Diagnosis and staging for the case (if diagnosed as AgP) were requested. A reordered case document (cases in a different sequence) was again sent to respondents after a gap of 1 month.

Statistical analysis: Descriptive statistics including frequency and percentage were calculated. Pearson's Chi-square test was used to analyze the data collected.

Results: For the "case document," 10.17% of the responses were different from those of the authors for diagnosis, whereas 4.48% of the responses were different from those of the authors for the staging of AgP. The agreement in the overall responses was in the range of 0.69-0.84, which was considered good. Comparison of the responses for diagnosis showed statistically significant (P = 0.009) difference between specialists in oral medicine and GDPs.

Conclusions: Variations exist among respondents regarding the diagnosis of CP versus AgP. Staging of AgP based on the listed criteria showed low variations.