Displaying publications 1 - 20 of 21 in total

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  1. Ramachandra SS
    J. Periodontol., 2018 Mar 23.
    PMID: 29572836 DOI: 10.1002/JPER.17-0482
    This letter is in regard to the article "Risk of periodontal disease in patients with asthma: a nationwide population-based retrospective cohort study" authored by Shen and collaborators in the August 2017 issue of the Journal of Periodontology. We found the authors' results interesting and believe that addition of the following points may have enhanced the potential implications of their observations. The role of mast cells in asthma is well-established, and mast cells also appear to have a role in the initiation of the inflammatory cascade that leads to periodontal destruction. This article is protected by copyright. All rights reserved.
  2. Gupta VV, Ramachandra SS
    J Indian Soc Periodontol, 2019 8 2;23(4):371-376.
    PMID: 31367137 DOI: 10.4103/jisp.jisp_654_18
    This report presents a 29-year-old aggressive periodontitis patient from Morocco with a history of orthodontic treatment. Despite all the first molars showing advanced bone loss, the maxillary anterior teeth did not show any periodontal destruction. The scientific literature rarely reports cases of aggressive periodontitis without involving maxillary anterior teeth. The treatment provided includes extraction of hopeless tooth, removal of overhanging restoration, scaling, root debridement, and regenerative periodontal therapy. The discussion highlights the dilemma during diagnosis of the case as either "iatrogenic periodontitis due to orthodontic treatment" or "localized aggressive periodontitis." The age group of 15-35 years is the common age group for patients' seeking orthodontic treatment and the occurrence of aggressive periodontitis. Sound knowledge of periodontitis and identification of early signs of aggressive periodontitis through meticulous periodontal examination may help in earlier identification and minimalistic treatment. Education regarding periodontitis, especially aggressive periodontitis, is essential among orthodontists and general dentists. This case report aims to discuss the dilemma involved during diagnosis of localized aggressive periodontitis.
  3. Ramachandra SS, Dicksit DD, Gundavarapu KC
    Br Dent J, 2014 Jul 11;217(1):3.
    PMID: 25012309 DOI: 10.1038/sj.bdj.2014.557
  4. Wong D, Ramachandra SS, Singh AK
    Contemp Clin Dent, 2015 9 1;6(3):418-20.
    PMID: 26321847 DOI: 10.4103/0976-237X.161908
    Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26-28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed.
  5. Ramachandra SS, Gupta VV, Muttalib KA
    J Oral Biol Craniofac Res, 2020 11 10;11(1):1-4.
    PMID: 33344152 DOI: 10.1016/j.jobcr.2020.11.001
    Introduction/Problem: Clinical experience in cases of advanced complexity/rare cases is limited among undergraduate dental students. This commentary narrates a module termed "case sharing", wherein a small group of undergraduate dental students treat/assist, document and present advanced or rare cases to their entire cohort in eight weeks.

    Approach: Undergraduate students perform procedures of straightforward and moderate complexity, and later assisted the clinical specialists during procedures of advanced complexity. students document these cases with clinical photographs and case notes to make presentations that were uploaded in the faculty's online management system to be reviewed by the entire cohort. student groups presented their cases with their entire cohort. an independent assessor assessed the groups for their organization of the case, information collected on the topic, critical analysis of the case, defending the diagnosis and treatment plan, teamwork and presentation skills.

    Evaluation: Students reported improvement in the depth of knowledge on particular diseases/procedures, a better understanding of holistic management of advanced cases, improved rapport, team spirit and communication among group members. they also reported difficulties in recruiting and completing the procedures within eight weeks.

    Discussion: Apart from improving the clinical experience of undergraduate students, the module provides an opportunity for the development of teamwork, communication skills, and ethical presentations among students, which are invaluable to the faculty to meet its programme learning outcomes. case sharing provides a platform for holistic learning and serves as an alternative learning method aside from didactic lectures and routine clinical supervision.

  6. Singh R, Ramachandra SS, Dayakara JK
    Cutis, 2016 Dec;98(6):E1-E2.
    PMID: 28099544
  7. Ramachandra SS, Western J S, Muttalib KA
    J Oral Biol Craniofac Res, 2020 02 03;10(2):54-58.
    PMID: 32095425 DOI: 10.1016/j.jobcr.2020.01.009
    Introduction: Integrated curricula are being increasingly adopted in health professions, owing to their advantages including patient-centred training and development of critical thinking. Similarly, the majority of dental Universities have either moved away from discipline-specific towards integrated curricula or have incorporated elements of integration. Despite several advantages offered by the integrated curriculum, one disadvantage is failure to assess depth of knowledge. Assessing the depth of knowledge is a characteristic of discipline-specific curriculum. This commentary describes the inclusion of both discipline-based and integrated assessments at Faculty of Dentistry, SEGi University, Malaysia.

    Material and methods: Module tests (discipline-based assessments) comprising of discipline specific questions are conducted at the end of every term, mimicking the traditional discipline-specific assessment. Questions in the module tests are intended to assess the depth of knowledge of students. Mid semester examinations are conducted at the end of the semester, mimicking the integrated assessment. Integrated questions are intended to test the breadth of knowledge of students.

    Results: Lecturers and students felt introduction of module tests, helped them to prepare for topics in a phased manner and better answer questions posed by lecturers during case discussions and clinical presentations. The 'borderline distinction' students felt that studying for module tests provided them with the depth of knowledge essential to answer questions during viva voce.

    Discussion: Including both the traditional and integrated methods of assessments would engage students in a learning experience developing their breadth and depth of knowledge. Further prospective research is essential to assess the impact of this assessment strategy.

  8. Western JS, Gupta VV, Ramachandra SS
    Compend Contin Educ Dent, 2019 Mar;40(3):172-177.
    PMID: 30829499
    This case report describes the management of a mandibular first molar with an additional distolingual root (radix entomolaris) and grade III cervical enamel projection through a multidisciplinary approach. Diagnosis for the case was endodontic-periodontal lesion due to non-vitality and associated advanced periodontal destruction. The patient was treated with drainage of the periodontal abscess with adjunct antibiotics, phase I periodontal therapy, endodontic therapy, radiculoplasty, regenerative periodontal therapy, replacement of the missing right mandibular second molar, and long-term maintenance. Follow-up of the patient up to 9 months has been uneventful. Cases of advanced periodontal destruction typically show some degree of tooth mobility, which was absent in this case. The article discusses the tripod effect as well as the increased surface area for periodontal attachment provided by the additional root contributing to the non-mobility of the involved tooth.
  9. Arora S, Ramachandra SS, Squier C
    J Oral Biol Craniofac Res, 2017 12 05;8(1):35-39.
    PMID: 29556461 DOI: 10.1016/j.jobcr.2017.12.002
    Introduction: Scientific literature suggests that human papillomavirus (HPV) infection may be associated with oral squamous cell carcinoma (OSCC). However, knowledge regarding HPV-OSCC link among oral health professionals (OHP) has been insufficient. So, the aim of this study was to assess the knowledge about HPV associated OSCC among OHP working in dental faculties in Malaysia.

    Methodology: Ethical committee of the University approved this study. A validated, pre-tested questionnaire was sent electronically to 224 OHP. Questionnaire collected information regarding demography, knowledge about HPV-OSCC link, HPV vaccine, and willingness to educate patients about HPV OSCC link among the participants of this cross-sectional study. Data collected was analysed using "Stata/IC-13" and was summarised using descriptive statistics like frequency, percentage, mean and standard deviation.

    Results: Out of 179 participants, around 39% of the participant's opined virus was not a causative factor for OSCC. Around, 44% replied posterior portion of the tongue/oro-pharynx was the commonest site for HPV related OSCC, whereas 29% replied that lateral border of the tongue was the common site for HPV related OSCC. Forty one percent educated patients regarding HPV infection being a causative factor for OSCC. HPV vaccine can prevent OSCC was stated by 70% OHP. Only 12% were aware of the availability of HPV vaccine in Malaysia. Majority (99%), agreed that there is a need to offer continuing education programmes to dentists highlighting advances and preventive strategies in the fight against OSCC.

    Conclusion: Substantial increase in awareness is required among OHP regarding HPV-OSCC link.

  10. Simon SS, Ramachandra SS, Abdullah DF, Islam MN
    Br Dent J, 2014 Aug;217(3):106.
    PMID: 25104668 DOI: 10.1038/sj.bdj.2014.654
  11. Rana R, Ramachandra SS, Lahori M, Singhal R, Jithendra KD
    Contemp Clin Dent, 2013 Oct;4(4):556-8.
    PMID: 24403810 DOI: 10.4103/0976-237X.123090
    Ideal alveolar ridge width and height allows placement of a natural appearing pontic, which provides maintenance of a plaque-free environment. The contour of a partially edentulous ridge should be thoroughly evaluated before a fixed partial denture is undertaken. Localized alveolar ridge defect refers to a volumetric deficit of the limited extent of bone and soft-tissue within the alveolar process. These ridge defects can be corrected by hard tissue and/or soft-tissue augmentation. A 30-year-old male patient was referred to the Department of Periodontology for correction of Seibert's Class III ridge defect in the lower anterior region. Granulation tissue/connective tissue present at the base of the defect was removed after elevation of full thickness flap. MucoMatrixX, an animal derived, collagen based soft-tissue graft was sutured to the labial flap and bone graft was placed into the defect. If a soft-tissue graft material could be used to replace the palatal grafts, then all the possible complications associated with donor site would be eliminated and above all periodontal plastic surgery and ridge augmentation would be better accepted by patients.
  12. Ramachandra SS, Rana R, Reetika S, Jithendra KD
    Cell Tissue Bank, 2014 Sep;15(3):297-305.
    PMID: 24002077 DOI: 10.1007/s10561-013-9395-8
    As esthetics gain importance, periodontal plastic surgical procedures involving soft tissue grafts are becoming commoner both around natural teeth as well as around implants. Periodontal soft tissue grafts are primarily used for the purpose of root coverage and in pre-prosthetic surgery to thicken a gingival site or to improve the crestal volume. Soft tissue grafts are usually harvested from the palate. Periodontal plastic surgical procedures involving soft tissue grafts harvested from the palate have two surgical sites; a recipient site and another donor site. Many patients are apprehensive about the soft tissue graft procedures, especially the creation of the second/donor surgical site in the palate. In the past decade, newer techniques and products have emerged which provide an option for the periodontist/patient to avoid the second surgical site. MucoMatrixX, Alloderm(®), Platelet rich fibrin, Puros(®) Dermis and Mucograft(®) are the various options available to the practicing periodontist to avoid the second surgical site. Use of these soft tissue allografts in an apprehensive patient would decrease patient morbidity and increase patient's acceptance towards periodontal plastic surgical procedures.
  13. 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
  14. 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.
  15. 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.
  16. Rana R, Ramachandra SS, Prasad UC, Aggarwal P, Dayakara JK
    Cutis, 2015 Aug;96(2):E27-30.
    PMID: 26367761
    Pyogenic granuloma (PG) is a tumorlike growth of the oral mucosa or skin that is considered to be an exaggerated conditioned response to minor trauma. It usually is painless, bleeds easily, and is considered to be nonneoplastic in nature. Pyogenic granuloma predominantly occurs in the second decade of life, mostly among young adult females. Clinically, it is a smooth or lobulated exophytic lesion manifesting as small, red, erythematous papules on a pedunculated or sometimes sessile base that usually is hemorrhagic. We report the case of 30-year-old woman who presented with a PG in the anterior palatal region during pregnancy that recurred with a satellite lesion 1 year following surgical excision.
  17. Simon SS, Ramachandra SS, Abdullah DD, Islam MN, Kalyan CG
    Educ Health (Abingdon), 2016 May-Aug;29(2):124-7.
    PMID: 27549650 DOI: 10.4103/1357-6283.188753
    BACKGROUND: Political crisis and worsening security situation in Egypt in late 2013 resulted in Malaysian students who were pursuing their dental education in Egypt being recalled home to Malaysia. The Ministry of Higher Education in Malaysia took steps to integrate these students into public and private universities in Malaysia.

    METHODS: We used a questionnaire and informal interviews to learn from students returning from Egypt about their experiences transitioning from dental schools in Egypt to Malaysia.

    RESULTS: We discuss the challenges students faced with regards to credit transfer, pastoral care, the differences in the curriculum between the dental faculties of the two nations, and the financial implications of this disruption of their training.

    DISCUSSION: We live in a fragile world where similar political situations will surely arise again. The approaches used by the Malaysian government and the lessons learned from these students may help others. The perspectives of these students may help educators reintegrate expatriate students who are displaced by political instability back into the education system of their own countries.
  18. Veerabhdrappa SK, Yadav S, Ramachandra SS, Dicksit DD, Muttalib KBA, Zamzuri ATB
    PMID: 35058568 DOI: 10.1057/s41271-021-00329-3
    Shisha is a centuries-old traditional smoking habit rapidly gaining popularity among the students and young adults in Malaysia. The present study evaluated secondhand smoke exposure (SHS) and characteristics of 25 indoor and 25 outdoor shisha centers (SC) operating around the educational institutes such as universities in Petaling Jaya, Malaysia. We observed a significantly higher particulate matter (PM)2.5 concentration in indoor than outdoor SC (3595.28 μg/m3 and 65.12 μg/m3, p 
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