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Table of Contents
April-June 2015
Volume 6 | Issue 2
Page Nos. 37-74
Online since Wednesday, June 10, 2015
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EDITORIAL
Resources for practice management
p. 37
David G Dunning
DOI
:10.4103/2155-8213.158466
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SPECIAL COMMUNICATION
Dental science and technology parks: Rethinking university-industry connections
p. 40
Jafar Kolahi
DOI
:10.4103/2155-8213.158467
As the 21st century unfolds, the development of science-based technologies [such as nanodentistry, tissue engineering, three-dimensional (3D) printers, laser dentistry, and computer-aided design/computer-aided manufacturing (CAD/CAM)] should change clinical dental practice. Unfortunately, a persistent problem in dentistry is the slow acceptance of new technology by dental schools and some dentists. Most dental graduates, dental faculty, and dental researchers know little about the principles of entrepreneurship, e.g., the process of patenting and licensing, how to write a business plan, market analysis, sources of financing, and the establishment of small and medium-sized enterprises. Most dental graduates, dental faculty, and dental researchers know little about the topics mentioned above. They may know how to conduct a dental research project and publish a paper, but most have no idea of how to plan for the commercialization of research findings. University-industry research relationships are important in promoting innovation, and dental science and technology parks (STPs) can play a major role in this technological revolution.
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ORIGINAL HYPOTHESIS
Endodontic inter-appointment flare-ups: An example of chaos?
p. 44
Poorya Jalali, Gunnar Hasselgren
DOI
:10.4103/2155-8213.158471
Introduction:
Pain and/or swelling after instrumentation of a root canal constitute a significant complication during endodontic treatment. Despite a large number of articles discussing the causative factors behind endodontic flare-ups, the exact mechanism is still not understood.
The Hypothesis:
The seemingly irrational behavior of endodontic inter-appointment flare-ups may be due to sensitive dependence on initial conditions. A model based on Lorenz' chaos theory is presented as a possible explanation for the sudden emergence and unpredictability of flare-ups.
Evaluation of the Hypothesis:
All studies agree on some common traits regarding inter-appointment flare-ups: Careful instrumentation can still cause flare-up; the host inflammatory response behaves as a complex nonlinear network; and also the poly-etiologic nature of this phenomenon all illustrate the sensitive dependence on initial conditions of the system. Integrating more variables (e.g., different species of bacteria) into this already complex system will make it increasingly chaotic reflecting its unpredictable behavior.
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Possible neuroimmunomodulation therapy in T-cell-mediated oral diseases
p. 49
Tsuyoshi Sato, Michihiko Usui, Yuichiro Enoki, Shoichiro Kokabu, Tetsuya Yoda
DOI
:10.4103/2155-8213.158472
Introduction:
Recurrent aphthous stomatitis and oral lichen planus are local chronic inflammatory diseases which are implicated in T cell-mediated immunity. According to the systematic review, there is insufficient evidence to support any specific treatment for T-cell mediated oral diseases.
The hypothesis:
In this paper, we propose a hypothesis that recurrent aphthous stomatitis and oral lichen planus can be treated with selective α
7
subunit of nicotinic acetylcholine receptor (α
7
-nAChR) agonists. Our hypothesis is supported by the following two facts. First, the pathophysiological conditions, T
h
1/T
h
17 cell activation and autonomic nervous system dysfunction, are observed in T-cell mediated oral diseases as well as in T-cell mediated systemic diseases such as rheumatoid arthritis. Second, the cholinergic anti-inflammatory pathway is inhibited in systemic T-cell mediated chronic inflammatory diseases. On the other hand, treatment with α
7
-nAChR agonists which activate the cholinergic anti-inflammatory pathway suppresses neuroinflammation via inhibition of T
h
1/T
h
17 responses in animal model of systemic T-cell mediated chronic inflammatory diseases. We thus expect that selective α
7
-nAChR agonists will be effective for the treatment of T-cell mediated oral diseases.
Evaluation of the hypothesis:
To test our hypothesis, we need to develop in vivo mouse model of T-cell mediated oral diseases. To evaluate the therapeutic effect of a selective α
7
-nAChR agonist, we choose ABT-107 because of its safety and tolerability. We believe that the selective α
7
-nAChR agonist, especially ABT-107, may be a therapeutic drug to treat T-cell mediated oral diseases.
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ORIGINAL RESEARCH
Risk-averse purchasing behavior of female dentists and innovation in dental practice
p. 53
James J McGrath, Edward F Rossomando
DOI
:10.4103/2155-8213.158477
Introduction:
The aim of this study was to see if there was any correlation between the variables of age, gender, practice location and longevity, and type of practice on the risk-taking behavior of dentists in Connecticut. Risk-taking behavior was defined as the willingness to adopt new technologies. A questionnaire was used to gather data, and a series of questions were then posed to estimate the degree to which the responding dentists would be willing to implement the technology into their practices.
Materials and Methods:
Three hundred Connecticut dentists were randomly selected from a list of dentists that was provided by Benco Dental Supply Company. A questionnaire was written and mailed to all 300 dentists with a return envelope inside. One hundred twenty-nine dentists responded. The questionnaire contained questions to gather demographic information about the respondents. It posed a hypothetical situation that described a new imaging technology that was recently brought into the market. The only differences between this technology and current imaging machines were that it did not emit any radiation, and it was twice as expensive as comparable imaging technologies. A risk score was calculated based on the responses to the three main questions. Those who would adopt the technology quickly or immediately received higher risk scores, and those who would wait or would not buy the technology at all received low risk scores. The data were then analyzed with SPSS software to detect if there were statistically significant differences between different groups of dentists.
Results:
Male dentists were found to have higher risk scores than their female counterparts. Men in the 30-39-years age range had the highest risk scores, while women in this age range had the lowest. As age increased, the difference between the sexes decreased. Specialists were found to have higher risk scores compared to general dentists of the same gender; however, male general dentists still had higher risk scores than female specialists and general practitioners. Risk score also correlated with population density. As the population density of the practice location increased, so did the average risk score of the responding dentist.
Conclusions:
The results of this study provide evidence that there is a potential correlation of age, gender, practice location, and type of practice with the risk propensity of the responding dentist. There was less of a relationship found between practice longevity and risk score. Unfortunately, the sample size was too small to provide statistically significant correlations. Further research would be needed to explore these potential relationships, by surveying a larger population.
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Salivary IgA concentration in diabetic patients compared to healthy controls
p. 60
Farimah Sardari, Afshin Tahmasbi, Arash Ghanbarzadegan
DOI
:10.4103/2155-8213.158478
Introduction:
The alterations in salivary flow rate and its compositions could affect the development, symptoms, and severity of oral changes in diabetic patients. The aim of this study was to assess the concentration of salivary IgA in type I in comparison with type II diabetic patients and healthy controls.
Materials and Methods:
In this cross-sectional study, 25 patients with type I diabetes, 25 patients with type II diabetes, and 25 control subjects (12 subjects for the type I and 13 subjects for the type II) were enrolled. Unstimulated saliva samples were collected by spitting method and the concentration of salivary IgA was measured byenzyme-linked immunosorbent assay (ELISA) method.
Results:
The mean of salivary IgA in type I diabetic patients was 148.3 ± 38.7 μg/ml and in their controls was 65.8 ± 17.4 μg/ml (
P
< 0.001). In type II diabetic patients the mean of salivary IgA was 67.3 ± 20.6 μg/ml and in their controls was 63.3 ± 15.2 μg/ml. There was no significant difference between patients with type II diabetes and controls (
P
= 0.54). The mean of salivary IgA in patients with type I diabetes was significantly higher than in patients with type II diabetes (148.3 ± 38.7 versus 67.3 ± 20.6 μg/ml, respectively,
P
< 0.001).
Conclusions:
Level of salivary IgA in type II diabetic patients in comparison with their healthy control did not show any significant difference, but in type I diabetic patients was higher than that of healthy controls and type II diabetic patients.
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Efficacy of preprocedural mouth rinse containing chlorine dioxide in reduction of viable bacterial count in dental aerosols during ultrasonic scaling: A double-blind, placebo-controlled clinical trial
p. 65
Rajiv Saini
DOI
:10.4103/2155-8213.158479
Background:
The risk to dentists, dental assistants, and patients of infectious diseases through aerosols has long been recognized. The aim of this study was to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine (CHX) gluconate, chlorine dioxide (ClO
2
) mouthwash, and water in reducing the levels of viable bacteria in aerosols.
Materials and Methods:
This single-center, double-blind, placebo-controlled, three-group parallel-designed study was conducted over a period of 4 months. One hundred twenty patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of 40 patients each to receive the ClO
2
mouthwash, water, and 0.2% CHX gluconate respectively as preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at five standardized locations with respect to the reference point, i.e., the mouth of the patient. The blood agar plates were incubated at 37°C for 48 h, and the total number of colony-forming units (CFUs) was counted and statistically analyzed.
Results:
The results showed that CFUs in groups A and C were significantly reduced compared to group B, and
P
< 0.001 [analysis of variance (ANOVA)]. CFUs in group C underwent the highest reduction, but statistically there was no significant difference between the mean values of postprocedural CFUs in groups C and A (i.e.,
P
> 0.05). The numbers of CFUs were the highest at the patient's chest area and lowest at the patient's front i.e., the 6 o'clock position.
Conclusion:
This study proves that a regular preprocedural mouthrinse could significantly eliminate the majority of aerosols generated by the use of an ultrasonic unit, and that ClO
2
mouthrinse was found to be statistically equally effective in reducing the aerosol contamination to 0.2% CHX gluconate.
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LETTER TO THE EDITOR
Workplace bullying: Beware!
p. 72
Darshana Bennadi, Vinayak Konekeri
DOI
:10.4103/2155-8213.158480
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BOOK REVIEW
Dental instruments: A pocket guide, fifth edition
p. 74
Hakan Çolak
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