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  1. Venkiteswaran, Annapurny, Ha, Kien Onn
    Compendium of Oral Science, 2016;3(1):33-37.
    MyJurnal
    This case report describes the management of an impacted and dilacerated upper permanent incisor in an 11 year old girl who also presented with a congenitally missing lateral incisor in the same quadrant. The two treatment options commonly chosen for the management of an impacted incisor are surgical exposure followed by orthodontic traction and extraction of the tooth itself. This case posed an extra challenge as the adjacent lateral incisor was congenitally missing. Instead of resorting to the use of dentures, an alternative treatment involving the surgical repositioning of the impacted tooth was done. This method not only satisfied the patient’s aesthetic requirement but ensured preservation of alveolar bone height and thickness in the upper anterior segment. Surgical repositioning of an impacted and/or dilacerated tooth can be considered as an alternative treatment option when surgical exposure and traction of the tooth is not possible.
  2. Fathinah Hanem Azamzaki, Nurhanis Baharuddin, Tandon, Shobha, Venkiteswaran, Annapurny
    Compendium of Oral Science, 2018;5(1):18-25.
    MyJurnal
    Objectives:To determine the different occlusal characteristics in primary dentition of 3 to 6 year old Malay children and to create a preliminary database for future Malaysian studies as currently none of the studies has been conducted in Malaysian population regarding the occlusal features in primary dentition. Materials and method:The subjects were within the age ranging from 3 – 6 years old attending nurseries and kindergartens located within Sungai Buloh, Selangor. Sixty subjects were screened but only 47 fulfilled the criteria to be included in this study. Intra-oral examination was done to determine the terminal plane, canine relationship, overjet, overbite and primate space in the subjects. Results: Almost two thirds of the subjects (72.34%) presented with straight terminal plane. All but one subject were observed with Class I canine relationship. 61.7% subjects were with an ideal overjet and 53.19% of subjects had an ideal overbite. The mean value for primate space in the maxilla was 2.92mm and 1.60mm in the mandible. There was no significant difference between gender in all the parameters assessed. Conclusion: The results from the study shown that only few of the subjects had a tendency of malocclusion in their permanent dentition. However, a longitudinal study should be done to follow up their occlusal feature in the permanent dentition.
  3. Aimi Shafiqah Shukri, Muhammad Syazwan Hassan, Venkiteswaran, Annapurny
    Compendium of Oral Science, 2019;6(1):26-34.
    MyJurnal
    Objective: To assess if the recall appointments and the use of radiographs for paediatric dental patients at Faculty of Dentistry, UiTM comply with current guidelines. Materials and Method: A retrospective study was conducted using patients’ dental records that were registered at the Faculty of Dentistry UiTM. The sample consisted of 350 randomly chosen treatment records of paediatric patients aged between birth and 16 years of age at the time of data collection which was in the year 2016. Data collection included demographic details, whom the cases were treated by, caries risk assessment, radiographs taken and time taken for the patient’s review appointments. Results: An initial sample size of 350 records were assessed. The mean age of patients seen when they were first seen is 6.3 years old. Caries Risk Assessment was not reported in majority of the cases (58%,). Baseline radiographs were taken in 44.6% of the cases. For the assessment of recall attendance, only samples with data on CRA was analysed (n=145). The review appointments at 3 months interval was 70% whereas at 6 months was 6.2% and one year recall was 6.7%. A chi-square test showed significant difference (p=0.013) between the category of operators for the 1-year review whereby review was higher among students and specialists as compared to dental officers. Conclusion: This study shows poor adherence to the recommended recall protocol as suggested by NICE and AAPD guidelines. Further studies need to be done to assess the patients’ and clinicians awareness regarding the recall protocol and determine the problems causing poor recall attendance.
  4. Syazwani Hassan, Nur Nabila Zulkifly, Venkiteswaran, Annapurny, Rohaida Abdul Halim
    Scientific Research Journal, 2018;15(2):51-66.
    MyJurnal
    To ascertain the level of knowledge among primary school teachers towards the management of traumatic dental injuries (TDIs) in school and to determine the preference among teachers regarding the education tools that can be used to increase awareness and knowledge among them. A total of 150 teachers from primary schools in three different districts were included in the study and they were given self-administered questionnaires to be filled. The validated questionnaire was distributed randomly in the selected schools. The questionnaire included two scenarios comprising of tooth fracture and avulsion. Questions regarding awareness and management of these scenarios were asked. All 150 participants answered the questionnaire; of these 74% were females 26% were males. 64% of the participants had received tertiary education. Although 70% of teachers had obtained first aid training, only 9.3% of them had received training regrading dental injuries. About 53% of participants knew the correct answer for the appropriate response to fractured tooth and only 35.3% managed to correctly answer the question related to appropriate response to an avulsed tooth. Only 38.7% knew about appropriate rinsing solution and a mere 4.7% were familiar with proper storage media. Even though the teachers have poor knowledge regarding management of dental injuries, it is reassuring to know that 93% of them are keen on further training and awareness. More educational programmes need to be introduced to empower the teachers with the relevant knowledge required to deal with dental emergencies.
  5. Naili Hayati Binti Abdul Mukti, Noviaranny, Indah Yuri, Venkiteswaran, Annapurny, Sarah Haniza Binti Abdul Ghani
    MyJurnal
    In this paper, we discussed the characteristic of bimaxillary protrusion in different population. We also incorporated about aetiology and management of bimaxillary protrusion. It is importance to understand the characteristics of skeletal and dental of bimaxillary protrusions in a specific population, in order to decide whether to treat by orthodontic camouflage only, or combination with orthognathic surgery and orthodontics.
  6. Venkiteswaran A, Tandon S
    J Int Soc Prev Community Dent, 2021 04 15;11(2):115-124.
    PMID: 34036071 DOI: 10.4103/jispcd.JISPCD_320_20
    Aim: This narrative aims to outline the use of hypnosis in managing dental anxiety in during dental treatment. The PICO used to answer the objectives are (P) dental patients, (I) hypnosis, (C) conventional behaviour management techniques & (O) reduced pain/anxiety.

    Materials and Methods: An electronic search of three databases; PubMed, Scopus and EBSCOhost was conducted using the keywords "hypnosis or hypnotherapy" AND "dentistry or dental" between the year 2000 and 2020. A total of 19 studies were selected based on eligibility. Data extracted were study subject, design of study, parameters used to assess, type of hypnosis script used and the study outcome.

    Results: The studies show that hypnosis is effective in pain management and dental anxiety. It can also be used for improving compliance in patients who are wearing orthodontic appliances (Trakyali et al, 2008) and reducing salivary flow during dental treatment (Satlz et al, 2014).

    Conclusion: Hypnosis has the potential to be a useful tool in the management of children and adults.

  7. Sinniah SD, Venkiteswaran A, Zakaria NN
    Korean J Orthod, 2023 Mar 25;53(2):116-124.
    PMID: 36960722 DOI: 10.4041/kjod22.229
    OBJECTIVE: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity.

    METHODS: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics.

    RESULTS: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores.

    CONCLUSIONS: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

  8. Ibrahim DFA, Venkiteswaran A, Hasmun NN
    J Int Soc Prev Community Dent, 2023;13(4):273-286.
    PMID: 37876578 DOI: 10.4103/jispcd.JISPCD_29_23
    AIMS AND OBJECTIVES: The aim of this study was to systematically review the ability of resin infiltration to conceal demineralized enamel lesions to normal enamel translucency and to maintain color stability.

    MATERIALS AND METHODS: A literature search of PubMed, MEDLINE, Web of Science, and Scopus databases and a manual search of articles from 2009 to 2021 for randomized controlled trials (RCTs) and clinical efficacy trials (nonrandomized) were performed. Methodological quality and risk of bias (RoB) of included papers was assessed using Cochrane Collaboration Risk of Bias Tool 2.0 for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool for nonrandomized studies.

    RESULTS: A total of 352 titles and abstracts were reviewed. Eight RCTs and three clinical efficiency studies were included in this review. The masking effects of the demineralized enamel lesion were reported immediately after resin infiltration, and the color stability of this material was up to 24 months, with no adverse effects noted. For RCTs, four studies were classified as "some concerns" and four were as "low RoB." For nonrandomized studies, all of the studies presented an overall moderate RoB.

    CONCLUSION: Resin infiltration achieves the best esthetic outcomes compared with microabrasion and remineralization therapy. Color stability was achieved with this material for up to 24 months and no adverse effects were noted. Factors contributing to the esthetic outcomes of the resin include the elimination of the hypermineralized surface layer, the homogeneity of the resin itself, and polishing after resin infiltration. Longitudinal follow-up and improved control of confounding variables should characterize future high-quality systematic reviews.

  9. Ibrahim DFA, Venkiteswaran A, Hasmun NN
    J Int Soc Prev Community Dent, 2023;13(3):194-207.
    PMID: 37564169 DOI: 10.4103/jispcd.JISPCD_36_23
    AIMS AND OBJECTIVES: Studies on resin infiltration and its penetration capability are becoming the focus of emerging dentistry. The depth of resin penetration could be a key determining factor in creating a diffusion barrier and in the success of infiltration. The aim of this review article was to evaluate the penetration depth of commercially available resin infiltration in early caries lesions and to identify factors that influence the penetration capability of resin infiltration.

    MATERIALS AND METHODS: A literature search was performed in four databases (PubMed, Science Direct, Scopus, and Web of Science) and manual searching from 2009 to December 2022. Eligibility criteria included in vitro studies pertaining to factors affecting the penetration depth of resin infiltration into the enamel. The risk of bias assessment was done by using checklist for reporting in vitro studies (CRIS).

    RESULTS: The initial search resulted in a total of 297 studies. Twenty-nine were assessed for eligibility, and 23 were selected in the qualitative synthesis. According to the CRIS guidelines, all of the studies were classified as moderate risk of bias. The penetration of resin infiltration is influenced by the enamel surface treatment with hydrochloric acid, formulations containing triethylene glycol dimethacrylate (TEGDMA), the addition of ethanol, penetration time, duration of penetration time, saliva contamination, caries activity, and type of tooth. The hypermineralized surface layer needs to be removed for better resin perfusion.

    CONCLUSION: The key to optimal resin infiltration depends on the enamel surface treatment with hydrochloric acid and application technique, infiltration duration, formulation of TEGDMA and ethanol in the resin composition, as well as the type and caries activity of involved teeth. Resin infiltration has superior penetrability compared to fissure sealant, casein phosphopeptide-amorphous calcium phosphate nanocomplexes, flowable composite, adhesive and fluoride varnish. Resin penetration depth may be a critical factor in forming a diffusion barrier and the effectiveness of infiltration in halting the progression of caries.

  10. Tandon S, Venkiteswaran A, Baliga SM, Nayak UA
    J Indian Soc Pedod Prev Dent, 2017 5 12;35(2):102-105.
    PMID: 28492186 DOI: 10.4103/0970-4388.206038
    Research being an investigative process is employed to increase or revise the current knowledge. Scientific research involves the conduct of a methodical study to prove a hypothesis or give an answer to a specific question with the main aim of finding definitive answer. This paper aims to advance knowledge of research and develop interest in the postgraduate students. It also throws light on the existing and emerging research strengths within a "high-performance culture." The trends in dental research worldwide are looked at, in particular, a comparison between the publication status in two countries, namely India and Australia. The current themes in dental research are also discussed to facilitate future projects for the aspiring pediatric dentists. Stress is given to the importance of evidence-based dentistry as the current times call for high-quality and ethical papers which are devoid of plagiarism. The common reasons for failure of a research are explored and the strengthening factors are highlighted. Proper planning of a pertinent research project is beneficial to the researcher as well as the dental community.
  11. Brejawi MS, Venkiteswaran A, Ergieg SMO, Sabri BM
    J Int Soc Prev Community Dent, 2022;12(5):547-553.
    PMID: 36532319 DOI: 10.4103/jispcd.JISPCD_105_22
    AIM: This study aims to assess the relationship between stress, family functioning, and molar-incisor hypomineralization (MIH).

    MATERIALS AND METHODS: A total of 162 children between the ages of 7 and 9 years were included in this retrospective study, as were their respective parents; the children were examined for MIH while questionnaires centering on stress and family functioning were given to the parents. Statistical analysis was performed using the Mann-Whitney U test and independent samples T-test.

    RESULTS: A significant correlation between stress as a contributing factor and MIH was concluded; children with higher stress scores had higher occurrences of MIH. On the contrary, family functioning quality was not found to have a direct correlation with MIH.

    CONCLUSIONS: Stress is correlated to MIH and is potentially one of the main causal factors that contribute to the development of the defect.

  12. Ibrahim DFA, Hasmun NN, Liew YM, Venkiteswaran A
    Children (Basel), 2023 Jun 30;10(7).
    PMID: 37508644 DOI: 10.3390/children10071148
    Resin infiltration (RI) is used to mask enamel opacities. There are three recommended etching cycles. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles. This study aimed to evaluate the effects of repeated etching cycles during RI application on esthetic changes and surface roughness of demineralized enamel at multiple treatment stages. Artificial demineralization was prepared on the buccal surface of ninety sound extracted premolars. The teeth were divided into nine groups (n = 10); with each consecutive group having one additional etching cycle up to nine etching cycles. Resin infiltrant was performed twice, first for 3 min (Resin 1) and again for 1 min (Resin 2). Surface roughness and esthetic changes were assessed using a profilometer (Ambios XP-200) and Minolta spectrophotometer, respectively, at baseline (sound enamel), etching, resin 1, resin 2, 7 days, and 28 days post resin applications. Data were analyzed with two-way ANOVA (p < 0.05). There was a significant interaction between the different stages and various groups of etching cycles on surface roughness, F(48, 126) = 3.48, p < 0.001. There was a significant interaction between the different stages and various groups of etching cycles on color changes, F(4, 126) = 1.177, p = 0.045. The surface roughness of demineralized enamel infiltrated with RI was less than that of sound enamel (baseline). There is a significant difference in color changes between resin 1 and resin 2 (p < 0.05). After five etching cycles, RI improved the esthetic of the color of teeth similar to the baseline. Surface roughness and color changes remained constant for 28 days. RI can be considered an effective and predictable treatment option for the restoration of early enamel lesions owing to its better surface characteristics and reliable masking effects. The color stability and surface roughness stay unaltered for up to 28 days.
  13. Ibrahim DFA, Hasmun NN, Liew YM, Venkiteswaran A
    Photodiagnosis Photodyn Ther, 2024 Feb;45:103989.
    PMID: 38280674 DOI: 10.1016/j.pdpdt.2024.103989
    BACKGROUND: Resin infiltration is used to mask enamel opacities and the recommended etching cycles are three. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles.

    AIM: To determine the incremental and total enamel loss when enamel surfaces are exposed to multiple etching cycles and to assess the relative attenuation coefficient after multiple etching cycles and resin infiltration treatment.

    METHODS: Ninety extracted sound human premolars teeth were divided into 9 groups (n = 10); with each consecutive group having one additional etching cycle up to 9 cycles. The teeth were scanned with optical coherence tomography and enamel loss and attenuation coefficient were measured with MATLAB software. Enamel loss (one-way ANOVA, p ≤ 0.05) and attenuation coefficient (two-way ANOVA, p ≤ 0.05) were statistically analyzed.

    RESULTS: There was a significant total enamel loss of more than 33% found at the 7th etching cycle and more. There was no statistically significant difference in the incremental mean depth of penetration of resin between various etching cycles (F(8, 134) = [2.016], one-way ANOVA, p = 0.185).

    CONCLUSION: This study recommends that etching should not be repeated more than seven cycles to prevent excessive enamel loss. Following eight etching cycles, resin infiltration penetration appears approximately equal to that of healthy enamel.

  14. Sivakumar S, Venkiteswaran A, Roslan MA, Musa S
    J Clin Pediatr Dent, 2024 May;48(3):15-23.
    PMID: 38755977 DOI: 10.22514/jocpd.2024.054
    Postoperative pain is generally a novel experience among paediatric patients. Topical anaesthetics, distraction procedures, and buffering of anaesthetic solutions have been used in reducing the postoperative pain. In this review, the authors assessed various modalities used to alleviate postoperative pain in children's dental treatment under general anaesthesia. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol were strictly adhered to in this systematic review. Specific keywords including postoperative pain, general anaesthesia, children, and dental extraction were used in the search for relevant randomized control trial studies in Web of Science, Scopus and PubMed, and included articles published until June 2021. From a total of 191 abstracts, 21 were reviewed. From the six studies with the usage of non-steroidal anti-inflammatory drugs (NSAIDs) alone or in combination with paracetamol, four observed that the preoperative use of NSAIDs alone or in combination was better than paracetamol alone, one discovered preoperative intravenous paracetamol was better than postoperative intravenous paracetamol, and the remaining study found no difference among various groups. Of two studies comparing the usage of non-steroidal anti-inflammatory drugs with opioid analgesics, one stated intravenous fentanyl in combination was better, while the other study found no difference among groups. The results obtained in this review can be utilized by physicians to control postoperative pain in children undergoing dental treatment under general anaesthesia.
  15. Sivakumar S, Gupta AA, Nik Mohd Rosdy NMM, Venkiteswaran A, Raj AT, Awan KH
    Transl Cancer Res, 2020 Apr;9(4):3092-3100.
    PMID: 35117672 DOI: 10.21037/tcr.2020.01.09
    BACKGROUND: This study aims to qualitatively and quantitatively review the association between Epstein-Barr virus (EBV) and oral squamous cell carcinoma (OSCC).

    METHODS: PubMed, Scopus, and Web of Science databases were searched using the keywords "EBV or Epstein Barr virus and Oral cancer or Oral squamous cell carcinoma" for published case-control studies in the English language upto August 2019.

    RESULTS: The search yielded 985 articles out of which 966 articles were excluded by screening their titles and abstracts as they were irrelevant or duplicates. Based on the full-text assessment of the remaining 19 articles, only 7 satisfied the inclusion criteria and were included in the qualitative analysis, out of which only 4 were compatible to be included in the meta-analysis. The diagnostic modalities used included immunohistochemistry, in situ hybridization and polymerase chain reaction. The diagnostic targets included latent membrane protein (LMP)-1, EBV determined nuclear antigen-1, EBV-encoded small non-polyadenylated RNA-2. The meta-analysis showed that there is an association between the EBV and OSCC.

    CONCLUSIONS: Determining the association of EBV with OSCC is highly tedious due to the contrasting data obtained from individuals' studies which in turn is due to the wide variations in the sensitivity and specificity of the diagnostic modalities used and diagnostic targets selected. Although the meta-analysis revealed an association between EBV and OSCC, the number and the quality of the studies included in the meta-analysis are limited, thus the association requires further validation for any conclusive inference.

  16. Mohammed IE, Shariff N, Mohd Hanim MF, Mohd Yusof MYP, Md Sabri BA, Md Bohari NF, et al.
    Children (Basel), 2022 Dec 09;9(12).
    PMID: 36553379 DOI: 10.3390/children9121936
    Apart from the major drawback of black staining once lesion is arrested, few studies have indicated that dental personnel's perception and attitude towards silver diamine fluoride (SDF) influences its usage. This report aims to provide a systematic review presenting dental personnel's knowledge, attitudes, and perceptions, (KAPs) regarding SDF. A search of multiple electronic literature databases and a manual search were performed. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. A comprehensive search yielded 719 publications and 14 cross-sectional studies matching the inclusion criteria. Awareness of SDF among respondents ranged from 29.6% to 87.8%, whereas awareness of its use in dentistry ranged from 14.4% to 94.5%. Regarding attitude towards SDF, the mean score ranged from 3.39 to 14.35. An increase in knowledge of and attitude towards SDF is significantly associated with the usage of SDF and may increase the usage of SDF. This review provides vital information on dental personnel's KAPs regarding SDF. It is anticipated that the adaptation of SDF usage will be more widespread in the future, especially among children. Findings from the review may assist intervention programs to change misperceptions and to enhance awareness regarding SDF among dental personnel.
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