Periodontology

EDITORIAL
	Clinical Good Practice Guidelines (CGPR): A step in right direction...	p. 89
	Ashish Kumar DOI:10.4103/jisp.jisp_40_19
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PRESIDENT'S MESSAGE
	"Erevna" – Research, the lifeline of the present scientific era	p. 91
	Anil Melath DOI:10.4103/jisp.jisp_37_19
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SECRETARY'S MESSAGE
	Awards and rewards: Igniting talents in scientific, academic and clinical frontiers	p. 92
	Abhay Kolte DOI:10.4103/jisp.jisp_25_19
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REVIEW ARTICLE
	Efficacy of free gingival graft in the treatment of Miller Class I and Class II localized gingival recessions: A systematic review	p. 93
	Sukhada Dileep Deo, Sharath Kumara Shetty, Anita Kulloli, Ruchira Chavan, Poonam Dholakia, Shruti Ligade, Gopalakrishnan Dharmarajan DOI:10.4103/jisp.jisp_102_18   Background: Currently, the leading theme in mucogingival surgery is the correction of gingival recession defects. Free gingival graft (FGG) has been successfully in use in this category of reconstructive therapeutic modality. Objectives: The aim of this systematic review was to evaluate the literature with respect to efficacy of FGG in the management of Miller Class I and II localized gingival recessions. Data Sources: Search strategies were performed via electronic database which included Pubmed-Medline, Google scholar and manual search using University library resources. Two reviewers assessed the eligibility of the studies. Study Eligibility Criteria:Controlled clinical trials, randomized clinical trials and longitudinal studies evaluating recession areas treated by FGG with minimum of 6 months follow up were included. In-vitro and animal studies, studies mainly done on Miller Class III and IV gingival recession defect, studies on multiple gingival recessions and case series and case reports were excluded from the search. Results: The electronic and manual search identified a total of 557 articles. A final screen consisted of 39 articles out of which 17 articles were selected for full-text assessment. Finally, 7 articles were selected for detailed evaluation for this systematic review. FGG has shown significant results in all the studies except for one study. Conclusion: FGG produces substantial results, however, highly depends on the case selection and operator's skill and experience. FGG gives an impression of being the best alternative option in zones where gingival recession presents with inadequate width of attached gingiva and depth of vestibular fornix.
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ORIGINAL RESEARCH
	Evaluation and comparison of Vitamin D receptors in periodontal ligament tissue of Vitamin D-deficient chronic periodontitis patients before and after supplementation of Vitamin D3	p. 100
	Vishakha Sarang Patil, Rohini Salil Mali, Alpana Subodh Moghe DOI:10.4103/jisp.jisp_173_18   Background: Vitamin D, an important hormone required by the body, exerts its biological effects through Vitamin D receptors (VDRs) present on target cells. Vitamin D is ineffective in tissues which lack VDR. Various tissues show the presence of VDRs. However, evidence for the presence of VDRs in human periodontal ligament tissue in fully erupted teeth in adults is lacking. The present study intends to evaluate the presence of VDRs in periodontal ligament (PDL) tissue and assess their response to serum Vitamin D3 levels in chronic periodontic patients. Materials and Methods: A total of 19 chronic periodontitis patients were enrolled in the study and tested for serum 25(OH)D3 levels. Deficient patients were supplemented with Vitamin D3. PDL tissue of these patients was isolated after tooth extraction before and after supplementation of Vitamin D3 and analyzed for the presence of VDR in PDL tissue by using enzyme-linked immunosorbent assay. Results: All the chronic periodontitis patients were found to be deficient in Vitamin D3. The mean serum 25(OH)D3 level before supplementation was 13.96 ng/mL which significantly increased to 35.12 ng/mL after supplementation of Vitamin D3 for 6 weeks. VDR analysis determined mean VDR conc. in PDL tissue to be -1.443 ng/mL, which increased to 2.38 ng/mL after supplementation. A concentration dependent correlation was seen between serum 25(OH)D3 levels and VDR conc. in PDL tissue after supplementation. Conclusions: The study determined Vitamin D Receptors (VDR) in PDL tissue after supplementation of Vitamin D. Thus in addition to the standard treatment modalities, Vitamin D3 supplementation would be an important factor for generation of adequate immune response.
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	Estimation of Periostin and Tumour Necrosis Factor-α in Type II Diabetics with Chronic Periodontitis: A case–control study	p. 106
	Burra Naga Radhika, Deva Priya Appukuttan, Ponnudurai Samuel Gnana Prakash, Sangeetha Subramanian, Dhayanand John Victor, Aruna Balasundaram DOI:10.4103/jisp.jisp_397_18   Background: Periostin, a matricellular protein, is downregulated in chronic inflammatory periodontal disease and is negatively modulated by tumor necrosis factor-α (TNF-α) in human periodontal fibroblast cell culture. The study aimed to estimate the gingival crevicular fluid (GCF) levels of periostin and TNF-α and to discern their relationship in chronic periodontitis (CP) individuals with and without Type II diabetes mellitus (DM). Materials and Methods:A total of 60 participants were divided into three groups, with 20 in each group. Group I – systemically and periodontally healthy, Group II – generalized CP, and Group III – generalized CP with Type II DM. Plaque index, gingival index, sulcular bleeding index, probing depth, and clinical attachment level were recorded. GCF periostin and TNF-α were quantified using the enzyme-linked immunosorbent assay. Results: Intergroup comparison was performed using the one-way ANOVA and Kruskal–Wallis. The relationship between the variables was analyzed using the Pearson's and Kendall's Tau correlation. The GCF periostin levels in Groups I, II, and III was 27.52 ± 2.39 ng/mL, 20.18 ± 1.42 ng/mL, and 16.77 ± 3.29 ng/mL, respectively. The GCF TNF-α levels in Groups I, II, and III was 92.41 ± 19.30 ng/L, 118.53 ± 21.93 ng/L, and 147.67 ± 16.35 ng/L, respectively. Periostin decreased, and TNF-α increased in periodontal disease; moreover, periostin level correlated negatively with all the site-specific clinical parameters whereas TNF-α positively correlated (P < 0.001). Conclusions: TNF-α strongly and negatively downregulates periostin in a chronically inflamed locale leading to compromised integrity of the periodontium.
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	The effect of the chitosan-collagen membrane on wound healing process in rat mandibular defect	p. 113
	Agus Susanto, Susi Susanah, Bambang Pontjo Priosoeryanto, Mieke Hemiawati Satari, Ira Komara DOI:10.4103/jisp.jisp_232_18   Background: Collagen and chitosan are potential biomaterials for medical applications; chitosan-collagen membranes are used as a barrier membrane in guided tissue regeneration and guided bone regeneration. Aims:The purpose of this study was to analyze the effect of the chitosan-collagen membrane on wound healing in rat mandibular defect by counting the number of fibroblasts and new blood vessels. Materials and Methods: As much as 24 male Wistar rats were divided into two groups, the treatment and control group. Bone defects were made In the rat mandible with diamond bur with a diameter of 2 mm, then the defect was covered with a chitosan-collagen membrane, and the control group was covered without application of chitosan-collagen membrane. After the 3rd, 7th, 14th, and the 21st day, the defect site was analyzed histologically. The number of fibroblasts and blood vessels was counted under a light microscope, at five fields with ×1000 and ×400 microscope magnification. Statistical Analysis Used: This study was done by using analysis of variance and unpaired t-test. Results: The average number of fibroblasts and blood vessels in the treatment group was higher than the control group. There was a significant difference in the number of fibroblasts on the 3rd and 7th day (P = 0.001; P = 0.001) and the number of blood vessels on the 3rd day (P = 0.04). Conclusion: The chitosan-collagen membrane was able to increase the number of fibroblasts and new blood vessels in the wound healing process.
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	Hydrogen peroxide masks the bitterness of chlorhexidine mouthwash without affecting its antibacterial activity	p. 119
	Widhunya Mathurasai, Panida Thanyasrisung, Sireerat Sooampon, Benjar Issaranggun Na Ayuthaya DOI:10.4103/jisp.jisp_414_18   Background: Chlorhexidine (CHX) is an antiseptic mouthwash widely used as the gold standard for inhibiting plaque formation. However, the bitter taste of CHX limits patient compliance. We developed a 0.12% CHX and 1.5% hydrogen peroxide (H2O2) mouthwash that masked the bitter taste of CHX. This study evaluated the antibacterial activity and subject satisfaction of the developed mouthwash. Materials and Methods: Three mouthwashes were used as follows: (1) a commercial 0.12% CHX mouthwash, (2) a prepared 0.12% CHX mouthwash containing 1.5% H2O2, and (3) a prepared 0.12% CHX mouthwash. A disc diffusion assay was performed to determine the antibacterial activity of each mouthwash against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. To assess subject satisfaction with each mouthwash, a satisfaction questionnaire was completed immediately after rinsing with each mouthwash. Results: The antibacterial activities of the three mouthwashes were similar. Moreover, the questionnaire results revealed that the level of satisfaction was significantly higher for the 0.12% CHX/1.5% H2O2 mouthwash compared with the other mouthwashes. Conclusion: The 0.12% CHX/1.5% H2O2 mouthwash revealed a similar antibacterial activity as the CHX standard against periodontal disease pathogens. In addition, the subjects were more satisfied with the new formula compared with 0.12% CHX alone. These data suggest that the 0.12% CHX/1.5% H2O2 formulation is an alternative antibacterial mouthwash to avoid the unpleasant CHX side effects.
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	Effect of laser application in the healing of intrabony defects treated with bioactive glass	p. 124
	Rajesh Kumar Gupta, Baljeet Singh, Sachin Goyal, Nidhi Rani DOI:10.4103/jisp.jisp_546_18   Aims: Presence of bacteria within the environment of infrabony pockets affects healing during their treatment. Present investigation utilized a diode laser for pocket sanitization before the placement of bone biomaterial with the aim of enhancing the healing. Materials and Methods: Twelve patients with bilateral intrabony defects participated in a split-mouth study design. Control group received biomaterial application only after surgical debridement. Infrabony pockets in the test group were irradiated with 810-nm diode laser at 0.8 W, continuous wave for 20 s before surgical debridement and biomaterial application. Healing was assessed using clinical and radiologic parameters. Results: Control group showed mean probing depth (PD) reduction of 3.25 ± 0.62 at 3, 4.08 ± 0.90 mm at 6 months. 3.00 ± 0.73 at 3, 3.91 ± 0.66 mm at 6 months reduction in mean PD was seen in the test group (P < 0.001). No statistically significant differences between the groups were observed. A gain of 2.50 ± 0.67 at 3, 3.25 ± 0.62 mm at 6 months in relative clinical attachment level was seen in the control and of 2.33 ± 0.77 at 3, 3.16 ± 0.57 mm at 6 months in the test group (P < 0.001) without significant differences between groups. 1.33 ± 0.57 and 0.95 ± 0.68 mm hard-tissue fill (difference in the radiographic distance between cementoenamel junction and base of the intrabony defect pre- and post-operative) at 6 months was observed in the control and test groups, respectively (P < 0.001). Between groups differences (0.22 ± 0.24 mm) were not significant. Conclusions: Similar reduction in soft- and hard-tissue parameters in both groups indicates that adjunctive pocket sanitization with diode laser did not improve the healing of intrabony defects treated with bioactive glass.
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	Relevance of single-nucleotide polymorphism to the expression of resistin gene affecting serum and gingival crevicular fluid resistin levels in chronic periodontitis and type 2 diabetes mellitus: A randomized control clinical trial	p. 131
	Pranita Avinash Rode, Rajashri Abhay Kolte, Abhay Pandurang Kolte, Hemant Jyotiswarup Purohit, Charu Ram Ahuja DOI:10.4103/jisp.jisp_361_18   Aim: The present study is aimed to investigate whether single-nucleotide polymorphism (SNP) of resistin gene (RETN) at −420 and +299 sites, is associated with resistin levels in serum and gingival crevicular fluid (GCF) in periodontally healthy, chronic periodontitis (CP) with and without type 2 diabetes mellitus (T2DM) patients. Materials and Methods: Serum and GCF samples were procured from all the 60 patients (twenty in each group) of the three study groups i.e., periodontally healthy (Group I), CP (Group II) and CP with T2DM patients (Group III) to analyze resistin levels using enzyme-linked immunosorbent assay test and clinical parameters were assessed at baseline and at 3 months after scaling and root planing (SRP). RETN polymorphism at −420 and +299 was genotyped by polymerase chain reaction-restriction fragment length polymorphism technique. Results: Patients with SNP −420 and +299 were positively correlated with increased serum and GCF resistin levels in Group II and Group III patients. SRP led to substantial reduction in the serum and GCF resistin levels. Conclusion: These findings are suggestive of a biologic link between resistin, periodontal diseases, and periodontal diseases with T2DM and RETN SNP at −420 and +299 in imparting increased resistin levels in inflammatory and diabetic conditions.
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	Comparative evaluation of clinical efficacy of coronally advanced flap alone and in combination with placental membrane and demineralized freeze-dried bone allograft in the treatment of gingival recession	p. 137
	Priyanka Chopra, Jayashree Kassal, Sujata Surendra Masamatti, Harpreet Singh Grover DOI:10.4103/jisp.jisp_308_18   Background: Guided tissue regeneration is a very commonly employed technique for treating recession defects. However, achieving the required space beneath the membrane is often difficult. Aim and Objectives: The purpose of the present study was to compare and evaluate the clinical efficacy of coronally advanced flap (CAF) alone or in combination with amnion membrane (AM) or chorion membrane (CM) and demineralized freeze-dried bone allografts (DFDBAs) in the management of gingival recession (GR) defects. Materials and Methods: The sample size (Miller's Class I and Class II GR-type defects) consisted of thirty patients which were stratified into three groups randomly (ten for each group). Group A patients were treated with only CAF and Group B patients were treated by CAF in combination with CM and DFDBA. Similarly, Group C patients were treated by CAF in combination with AM and DFDBA. Clinical parameters such as gingival index, GR depth, GR width, relative attachment level, and width of keratinized tissue were assessed at baseline and 3 months postoperatively. Results: Inter- and intragroup data were analyzed by paired t-test. The percentage of root coverage obtained in the study groups was 60%, 78%, and 63%, respectively, for Groups A, B, and C. Statistically significant difference was obtained in the clinical parameters of Group B which was treated with CM and DFDBA. Conclusions:Combination of DFDBA and placental membrane (chorion/amnion) in CAF procedure provided an additional benefit over CAF alone in the treatment of Class I and II GR defects.
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	Effectiveness of naturally derived bovine hydroxyapatite (Cerabone™) combined with platelet-rich fibrin matrix in socket preservation: A randomized controlled clinical trial	p. 145
	Prathyusha Kollati, Suneetha Koneru, Chinni Doraswamy Dwarakanath, Sruthima Naga Venkata Satya Gottumukkala DOI:10.4103/jisp.jisp_400_18   Background and Objectives: Socket preservation is the procedure which is carried out at the time of extraction to enhance the esthetic predictability of prosthesis and to reduce the number of surgical interventions by minimizing the crestal bone loss. The aim of the present study was to compare the efficacy of natural bovine hydroxyapatite and platelet-rich fibrin (PRF) matrix along with collagen plug to unassisted natural healing in extraction sites. Materials and Methods: A sample of 25 patients of age 17–50 years who require extraction of at least two teeth which were not adjacent to each other were included in the study. One site in each patient was subjected to ridge preservation procedure using Cerabone™ PRF along with collagen plug and the other site was subjected to atraumatic extraction alone. Parameters such as loss of ridge width and loss of ridge height were measured clinically and radiographically at baseline and after 6 months. Results: The mean loss of width was found to be 2.75 mm (2.75 ± 1.49) at the control site compared to 1.47 mm (1.47 ± 1.44) at the test site. The test site showed 2.31 mm bone fill, (8.7%) compared to the control site. Conclusion: Within the limitations of the study, the results suggest that socket preservation procedure is a reliable method that minimizes the alveolar bone loss.
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	Comparative evaluation of human chorion membrane and platelet-rich fibrin membrane with coronally advanced flap in treatment of Miller's class I and II recession defects: A randomized controlled study	p. 152
	Shivani Ashwinikumar Dandekar, Neeraj Chandrahas Deshpande, Deepak Harishchandra Dave DOI:10.4103/jisp.jisp_408_18   Background: Root coverage procedures have gained much popularity in recent years, due to increasing esthetic demands of patients. Coronally advanced flap (CAF) is a predictable technique for treating gingival recessions. Platelet-rich fibrin (PRF), an autologous platelet concentrate, has properties to enhance soft-tissue wound healing. A current method in dentistry is the use of human chorion membrane, a placental derivative, having biologic properties that help in healing and regeneration. Thus, the aim of the study was evaluation and comparison of the efficacy of chorion membrane and PRF membrane in the treatment of Miller's Class I and Class II recession defects. Materials and Methods: This was a randomized controlled clinical study. Totally 30 sites with Miller's Class I and Class II recession were taken and randomly allocated to chorion membrane (test) PRF membrane (control) group. The clinical parameters recorded were clinical attachment level (CAL), recession height (REC-HT), recession width (REC-WD), width of keratinized gingiva (WKG) and gingival tissue thickness (GTH). Results:Significant differences were seen from baseline to 6 months in test group regarding gain in CAL (P < 0.001), reduction in REC-HT (P < 0.001), decrease in REC-WD (P = 0.02), increase in WKG (P < 0.001), and increase in GTH (P < 0.001). In the control group also, significant difference was noted at the end of 6 months i regarding gain in CAL (P < 0.001), reduction in REC-HT (P < 0.001), decrease in REC-WD (P = 0.029), increase in WKG (P < 0.001), and increase in GTH (P < 0.001). Intergroup analysis showed significant differences between test and control groups at the end of 6 months, with CAL, REC-HT, WKG, and GTH showing statistically significant differences with P = 0.002, 0.001, 0.001, and 0.026, respectively. No significant difference was seen regarding REC-WD (P = 0.39). Conclusions: Both are effective materials in root coverage, but chorion membrane showed better and more stable results at the end of 6 months as compared to PRF membrane in treating gingival recession.
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	Tooth loss and dementia: An oro-neural connection. A cross-sectional study	p. 158
	Rajeev Ranjan, Manisha Rout, Monalisa Mishra, Shobha Abhijeet Kore DOI:10.4103/jisp.jisp_430_18   Background: Recent cross-sectional studies have suggested that chronic inflammation resulting due to gingival and periodontal diseases may have potential reversible risk factors for dementia. Recently, cognition, memory deficit, and along with the behavioral defect have been considered as characteristics of dementia. Age is one of the main factors which is also known to be associated with dementia. The aim of the present study was to establish the correlation between tooth loss and diagnosis of cognitive impairment/dementia in elderly patients. Materials and Methods: A cross-sectional study, comprising of 300 patients (Age: 50–80 years), was conducted. For the assessment of cognitive impairment/dementia, Mini-Mental Status Examination (MMSE) was conducted. All the results were analyzed using the Chi-square and Kruskal–Wallis ANOVA test. Results: Number of teeth was found to be directly associated with MMSE. Less number of teeth was associated with lower MMSE score, irrespective of gender. The level of statistical significance was found to be P < 0.001. Factors, such as socioeconomic status, school education, and marital status, were found to have a statistically significant impact on the dementia scale. Conclusion: The current study found a significant association between tooth loss and cognitive impairment. Along with age factors such as socioeconomic status, education, and marital status were also found to have a direct or indirect impact on dementia. More prospective studies and clinical trials are required to be conducted to confirm the observations of this study.
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	Oral hygiene status, oral hygiene practices and periodontal health of brick kiln workers of Odisha	p. 163
	Banashree Baishya, Anurag Satpathy, Rashmita Nayak, Rinkee Mohanty DOI:10.4103/jisp.jisp_383_18   Aim and Objective: The aim of this study was to assess the oral hygiene status, oral hygiene practices, and periodontal health among brick kiln workers of Odisha. Materials and Methods: Four hundred and eight subjects (300 males and 108 females) between the ages of 22 and 65 years with mean age of 33.44 ± 2.34 years working in various brick kilns in the district of Khordha, Odisha, participated in the survey. Data were collected through personal interview and clinical examinations. Results: Overall prevalence of periodontal diseases among brick kiln workers was 86.27%. There was a statistically significant difference in the distribution of Community periodontal index (CPI) (P < 0.001) and loss of attachment score scores (P < 0.001). Periodontal disease was significantly associated with age, oral hygiene status, practices, and tissues abuse habits. Most of the workers were males (59%), in the age group of 30–40 years (40.69%), having only a primary level of education (75.98%) and were married (80.88%). Majority of the workers brushed their teeth once daily (78.9%) with toothbrush (51.5%) and used toothpaste (41.2%). Most of them were found to be consuming paan or gutkha as compared to cigarette or beedi smoking. Among the subjects with a CPI >2, higher prevalence of periodontal disease was seen in subjects older than 50 years of age (86.7%), those brushing once daily only (75.2%), brushing with finger (82.8%), with higher frequency and duration of consumption of tobacco and alcohol, and having a poor oral hygiene (85.5%). Conclusion: The survey among brick kiln workers revealed that the oral hygiene status was poor, they had ill-informed oral hygiene practices and most of them were suffering from periodontal disease.
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CASE REPORTS/CASE SERIES WITH DISCUSSIONS
	An infrequent clinical case of mucosal fenestration: Treated with an interdisciplinary approach and regenerative therapy	p. 168
	Zeba Jafri, Nishat Sultan, Nafis Ahmad, Anika Daing DOI:10.4103/jisp.jisp_325_18   Mucosal fenestration is a clinical finding in which a portion of the tooth root is denuded of the overlying alveolar bone and gingiva or oral mucosa, thus exposing the root to the oral cavity. If left untreated, they may be a source of infection by giving entry to oral pathogen, leading to further progression of periodontal disease. Depending on their site of presence, they may also be a reason of esthetic concern to some patients. This paper reports one such infrequent case of mucosal fenestration of lower incisor region that was well treated by an interdisciplinary approach and regenerative therapy.
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	Increasing the width of attached gingiva by using modified apically repositioned flap – A case series	p. 172
	Chakrapani Swarna, Surekha Govada, Karyamsetti Susmitha, Chintapalli Sowjanya DOI:10.4103/jisp.jisp_379_18   Attached gingiva plays a promising role in maintaining periodontal health. An adequate width of attached gingiva prevents plaque formation and soft-tissue recession. Among various techniques for augmenting width of attached gingiva, modified apically repositioned flap (MARF) is a simple and easy procedure that does not require a second surgical site. It is less time-consuming. It provides better operative and postoperative comfort for the patient. In this case series, MARF technique was used for augmenting the width of attached gingiva.
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	Management of massive peripheral ossifying fibroma using diode laser	p. 177
	Ruchi Gulati, Shaleen Khetarpal, Madhu Singh Ratre, Mishthu Solanki DOI:10.4103/jisp.jisp_431_18   Peripheral ossifying fibroma (POF) represents a non-neoplastic, reactive lesion of gingiva. The precise etiopathogenesis of POF is unclear; however, it is suggested to originate from the connective tissue of periodontal ligament. This lesion predominantly occurs in the maxillary anterior region. The standard treatment protocol involves surgical excision followed by the biopsy of lesion. The reactive nature and unpredictable course attribute to a high recurrence rate of the lesion; hence, proper postoperative monitoring and follow-up of the lesion are necessary. The present case was surgically managed using diode laser and did not show any sign of recurrence during the follow-up period of 6 months. Minimum intraoperative bleeding and postoperative pain, ease of operation, and patient's acceptance enable laser-assisted growth excision as a better treatment modality to other conventional surgical procedures, thus offering diode laser as a viable and effective treatment alternative in the management of massive overgrowth.
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ERRATUM
	Erratum: Pre-emptive 8 mg Dexamethasone and 120 mg Dtoricoxib for pain prevention after periodontal surgery: A randomised controlled clinical trial	p. 181
	DOI:10.4103/0972-124X.253313
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 Ahead of print articles

CASE REPORTS/CASE SERIES WITH DISCUSSIONS
Dental management of a patient with incidentally detected hemophilia: Report of a clinical case
Sreenivas Nagarakanti, Hasya Sappati, Sumanth Gunupati, Bhumanapalli Venkata Ramesh Reddy, Vijay Kumar Chava
DOI:10.4103/jisp.jisp_461_18
[ABSTRACT]    [PDF]
Esthetic lip repositioning: A cosmetic approach for correction of gummy smile – A case series
Asha Ramesh, Radha Vellayappan, Sheethalan Ravi, Kaarthikeyan Gurumoorthy
DOI:10.4103/jisp.jisp_548_18
[ABSTRACT]    [PDF]
Periodontal microsurgery for management of multiple marginal tissue recession using Zucchelli's modification of coronally advanced flap and pericardium membrane in an esthetic zone
Dinesh Yadav, Sangeeta Singh, Subrata Roy
DOI:10.4103/jisp.jisp_107_18
[ABSTRACT]    [PDF]
ORIGINAL ARTICLES
Knowledge on smoking and periodontal disease: A cross-sectional survey among targeted respondents
Shanthi Muniandy
DOI:10.4103/jisp.jisp_479_18
[ABSTRACT]    [PDF]
ORIGINAL RESEARCH
A 12-week, multicenter, normal-use evaluation of a manual toothbrush with angled bristle design
Ajay Madanlal Kakar, Smruti Krishnan Nair, Saurabh Saraf
DOI:10.4103/jisp.jisp_529_18
[ABSTRACT]    [PDF]
Periodontally accelerated osteogenic orthodontics combined with recombinant human bone morphogenetic protein-2: An outcome assessment
Rampalli Viswa Chandra, Madhukar Reddy Rachala, Koguru Madhavi, Prabhuraj Kambalyal, Aileni Amarender Reddy, Mir Hasan Ali
DOI:10.4103/jisp.jisp_612_18
[ABSTRACT]    [PDF]
Comparative evaluation of the chlorhexidine and cinnamon extract as ultrasonic coolant for reduction of bacterial load in dental aerosols
Kunal Sunder Sethi, Alefiya Mamajiwala, Swapna Mahale, Chetan Purushottam Raut, Prerna Karde
DOI:10.4103/jisp.jisp_517_18
[ABSTRACT]    [PDF]
Comparative evaluation of two antibacterial-coated resorbable sutures versus noncoated resorbable sutures in periodontal flap surgery: A clinico-microbiological study
Prerna Ashok Karde, Kunal Sunder Sethi, Swapna Arunkumar Mahale, Alefiya Shabbir Mamajiwala, Aishwarya Madhukar Kale, Chaitanya Pradeep Joshi
DOI:10.4103/jisp.jisp_524_18
[ABSTRACT]    [PDF]
Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis
Prathyusha Rampally, Rekha Rani Koduganti, Sastri Nadiminty Ganapathi, Veerendranath Reddy Panthula, Prasanna Jammula Surya
DOI:10.4103/jisp.jisp_528_18
[ABSTRACT]    [PDF]
To detect the minimum inhibitory concentration and time-kill curve of shiitake mushroom on periodontal pathogens: An in vitro study
Shikha Sharma, Shobha Prakash
DOI:10.4103/jisp.jisp_249_18
[ABSTRACT]    [PDF]
Evaluation and comparison of hydroxyapatite crystals with collagen fibrils bone graft alone and in combination with guided tissue regeneration membrane
Shalabh Mehrotra, Zoya Chowdhary, Tanushree Rastogi
DOI:10.4103/jisp.jisp_386_18
[ABSTRACT]    [PDF]
Prevalence of periodontitis in patients with pulmonary disease: A cross-sectional survey in the industrial district of India
Tanushree Rastogi, Zoya Chowdhary, Munagala Karthik Krishna, Shalabh Mehrotra, Ranjana Mohan
DOI:10.4103/jisp.jisp_435_18
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Cancer Research and Practice

REVIEW ARTICLE
	The roles of microRNA-331 Family in Cancers	p. 1
	Stefanie Mei En Shee, Rhun Yian Koh, Kenny Gah Leong Voon, Soi Moi Chye, Iekhsan Othman, Khuen Yen Ng DOI:10.4103/JCRP.JCRP_6_18   MicroRNAs (miRNAs) are single-stranded noncoding RNA strands that are involved in various pathological and physiological processes. Even though they do not code for any gene, they regulate gene expression by posttranscriptional modification through cleavage or translational repression of messenger RNA. Many miRNAs (for example, lethal-7 and miRNA-21) have been found to be involved in the pathogeneses of many diseases including cancers. The miRNA-331 family includes three miRNAs, namely, miRNA-331, miRNA-331-3p, and miRNA-331-5p. Recent studies have revealed that the miRNA-331 family is associated with the pathology of some cancers, including colorectal cancer, leukemia, hepatocellular carcinoma, prostate cancer, pancreatic cancer, breast cancer, melanoma, and lung cancer. Therefore, it is important to have a good understanding about how the miRNA-331 family regulates the pathogeneses of these cancers. In this review, we discuss the pathological and physiological roles of the miRNA-331 family. Understanding how these miRNAs regulate the gene expression levels of their targets and their involvement in cancers may lead to better therapeutic strategies to treat cancers.
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ORIGINAL ARTICLES
	Perceived benefits and barriers toward cervical cancer screening among women ≥15 years in Arsi Zone, Southeastern Ethiopia: Application of the health belief model in a community-based cross-sectional study	p. 7
	Gemechu Chemeda Feyisa, Haftom Temesgen DOI:10.4103/JCRP.JCRP_1_18   Introduction: The rate of cancer mortality is18.4/100,000 in Ethiopia, and cancer of the cervix is the second-most common cancer, with an incidence of 16.4/100,000. Cancer of the cervix is easily prevented through vaccinations against human papilloma virus, regular screening, and treatment. Assessing the perception of women with regard to the benefits and barriers of cervical cancer screening among women is important to decrease the barriers and increase the screening rate for early detection. The aim of this study was to describe women's perceived benefits and barriers to cervical cancer screening and their associated factors in Arsi zone, Southeastern Ethiopia. Materials and Methods: This community-based cross-sectional study design was conducted in Arsi zone, Southeastern Ethiopia among 906 women aged >15 years using a multi-stage sampling technique. After data had been coded and entered into Epi info, it was exported into SPSS for analysis. A binary logistic regression model was used to determine associations between sociodemographic characteristics and reproductive variables on the knowledge of cervical cancer and perception of screening at a value of P < 0.05. Results: Most of the participants had higher perceptions of the benefits and barriers to screening (567 [62.6%] and 487 [53.8%], respectively). The women who would like to undergo cervical cancer screening in the future when the service was available were 2.6 times more likely to believe in the benefits of undergoing screening than those who did not wish to undergo screening (adjusted odds ratio [AOR] = 2.3, 95% confidence interval [CI]: [1.2–4.6]). Women living in rural areas were four times more likely to perceive the benefits of cervical cancer screening than those living in semi-urban areas (AOR = 3.9, 95% CI: [1.9–7.7]). Women who started sexual intercourse at age <16 years were two times more likely to perceive barriers to cervical cancer screening than those who started sexual intercourse at age >16 years (AOR = 2.2, 95% CI: [1.5–3.3]). Moreover, the women who had >3 children were 1.5 times more likely to perceive barriers to cervical cancer screening than those who had <3 children (AOR = 1.5, 95% CI: [1.1–2.0]). Conclusion and Recommendation: There were high perceived benefits and barriers to screening in the community. We recommend decreasing the perceived barriers toward screening through education intervention and expanding screening services, as this can increase the uptake of screening in the community.
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	Perspectives of visual inspection of the cervix with acetic acid as an alternative to Pap smear test as a preventive measure of cervical cancer among female nurses in University College Hospital, Ibadan, Nigeria	p. 18
	Christene E Umukoro, Olufemi Y Makinde DOI:10.4103/JCRP.JCRP_10_18   Background: Visual inspection of the cervix with acetic acid (VIA) has been recommended by the World Health Organization as an alternative to the Pap smear test in preventing cervical cancer in low-resource healthcare settings. However, the level of awareness and uptake is still very low in Nigeria. In this study, the awareness and acceptance of VIA as a preventive measure against cervical cancer among female nurses at the University College Hospital (UCH), Ibadan was assessed. Materials and Methods: A pretested questionnaire on the knowledge of the risk factors of cervical cancer, uptake of the Pap smear test, and awareness and acceptance of VIA was administered to 301 female nurses at UCH, Ibadan. Results: The majority of the respondents (99%) knew about cervical cancer, but only 62.4% of them were aware that human papilloma virus is a causative agent. Early marriage (73.6%), high parity (64.0%), multiple sexual partners (91.1%), smoking (54.8%), and poor socioeconomic status (42.9%) were identified as risk factors for the disease. The proportion of those that had heard of VIA (43.6%) was low when compared with the Pap smear test (99%). However, 72.4% of them thought that female staff at the screening centers should promote VIA. Moreover, 61.5% believed that definitive treatment of cases could commence immediately after a VIA test. The age, duration of service, and educational qualification did not significantly (P > 0.05) influence the respondents' awareness of VIA as a cervical cancer screening technique. Conclusion: Adoption of VIA as part of routine checkups during postnatal visits and its integration into the nation l healthcare policy is recommended.
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SHORT COMMUNICATION
	Improving colorectal, oral, breast, and cervical cancer screening rates using an inreach approach	p. 26
	Lee-Kiat Ban, Ailun Heather Tseng, Hung-Chun Hsing, Henry Hsin-Chung Lee DOI:10.4103/JCRP.JCRP_5_18   The Taiwanese national cancer screening program was established in 1985 by providing Pap smear tests for women. At the same time, trial-based screening for colorectal, oral, and breast cancer screening was initiated. In 1999, outreach services for cancer screening were started and gradually scaled up to the national level. Our hospital is located in Hsinchu, Taiwan. Like many hospitals in Taiwan, we provide cancer screening services to the community. Our baseline screening rate was 96.6% in 2016. Aiming to increase the overall cancer (including colorectal, oral, breast, and cervical cancer) screening rates, we implemented two strategies. First, we modified the cancer screening workflow so that patients could receive screening counseling before the scheduled appointment. Second, we redesigned the clinic waiting room layout by moving check-in and cancer screening counters next to each other. By the end of 2017, the overall cancer screening rate increased from 96.6% to 105.4%. Our future efforts will be focused on collecting patient feedback, increasing coverage of hard-to-reach populations, and understanding barriers to cancer screening for specific groups of patients.
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CASE REPORTS
	Primary small-cell carcinoma of the glottic larynx: A case report from Northern Pakistan	p. 30
	Kanwal Awan, Humera Mahmood, Hadia Fatima, Sarosh Arif, Mohammad Faheem DOI:10.4103/JCRP.JCRP_2_18   Extrapulmonary neuroendocrine small-cell carcinoma is a rare tumor accounting for only 2.5%–4% of all small-cell carcinomas, and during the past 30 years, only 160 cases of primary small-cell carcinoma of the larynx have been reported worldwide. Most previously reported cases were metastatic small-cell carcinomas. Herein, we report the case of a 51-year-old male who was treated at the Atomic Energy Cancer Hospital, NORI, Islamabad, Pakistan for small-cell carcinoma of the larynx.
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	Brenner tumor of the ovary: Incidental finding with unusual combinations	p. 33
	Hema Udawat, Vandana Nunia, Natasha Agarwal, Arpita Jindal DOI:10.4103/JCRP.JCRP_3_18   The most common ovarian tumors are surface epithelial tumors, comprising 58% of all ovarian tumors. Among them, serous and mucinous cystadenomas are the most common (35%). A Brenner tumor is a rare, mostly benign type of ovarian epithelial neoplasm with an incidence of 1%–2%. Rarely, they occur in other locations, including the testis. The majority of Brenner tumors are benign; however, some can be malignant. These are most frequently found incidentally on pelvic examinations or during laparotomy. In the present case series, we report three cases of Brenner tumors diagnosed incidentally on histopathology. The first case was a rare combination of serous cystadenoma, with a focus showing a Brenner tumor in the wall of serous cystadenoma. The second case was a proliferating Brenner tumor in the wall of mucinous cystadenoma, and the third case had bilateral benign Brenner tumors.
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	Complete radiographic response of a rectal gastrointestinal stromal tumor to imatinib mesylate	p. 37
	Hsing-Yu Yang, Ming-Hung Lee DOI:10.4103/JCRP.JCRP_4_18   Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. These tumors occur rarely in the rectal region, with an incidence of <3%. In this case report, an 80-year-old man complained of abdominal fullness and difficulty in defecating during a visit to our outpatient department. A radiographic image survey showed an extraluminal lesion over the rectum, and the pathological diagnosis was GIST. Imatinib mesylate, a neoadjuvant agent, was administered. The patient then refused further surgical intervention and continued imatinib mesylate treatment. Subsequent magnetic resonance images revealed no obvious lesion occupying the pelvic cavity. In addition to this case, we also performed a literature review of rectal GIST treatment strategies.
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	Postmolar metastatic choriocarcinoma mimicking primary lung cancer	p. 41
	Chih-Chieh Yen, Hung-Wen Tsai, Chia-Jui Yen DOI:10.4103/JCRP.JCRP_7_18   Postmolar choriocarcinoma with delayed recurrence can be aggressive and has only been published in a few reports. We describe a postmenopausal woman with a molar pregnancy 10 years previously who presented with respiratory and neurological symptoms. Metastatic choriocarcinoma of the lungs with extensive metastases to various sites mimicking primary lung cancer was noted. She was successfully treated with systemic chemotherapy and had stable disease status 8 months after the diagnosis. Metastatic choriocarcinoma originating from an antecedent molar pregnancy can be overlooked given a prolonged latency. We review the published literature of postmolar choriocarcinoma and discuss the diagnosis and updates on treatment.
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	Paraneoplastic Systemic Sclerosis in a Patient with Metastatic Thymic Carcinoma	p. 45
	Hsing-Wu Chen, Ko-Jen Li, Hung-Yang Kuo DOI:10.4103/JCRP.JCRP_8_18   Thymic malignancies cause alterations in the immune system. Thymomas are known to be associated with paraneoplastic syndrome and autoimmunity, including myasthenia gravis, systemic lupus erythematosus, inappropriate antidiuretic hormone secretion, pure red cell aplasia, pernicious anemia, pemphigus, and autoimmune thyroid diseases. However, paraneoplastic syndrome has rarely been observed in patients with thymic carcinoma. The management of patients with paraneoplastic autoimmune disease is difficult, and treatment of the underlying malignancy is important. Herein, we present a case of thymic carcinoma who developed systemic sclerosis 3 years after the initial diagnosis during disease progression.
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	Hyperprogressive disease after nivolumab in a patient with microsatellite instability-high ampullary cancer	p. 50
	Yi-Hsuan Lai, Shih-Hung Yang DOI:10.4103/JCRP.JCRP_9_18   Ampullary cancer is a rare type of cancer with a limited choice of systemic therapy. Anti-programmed death-1 monoclonal antibodies have shown promising clinical benefits in multiple types of cancer, especially in tumors with microsatellite instability-high (MSI-H)/defective DNA mismatch repair and high tumor mutation burden. We report a case of a 61-year-old woman with MSI-H ampullary cancer who initially had slow progression without chemotherapy after recurrence. She experienced hyperprogressive disease with a dramatic deterioration of liver metastases following a short duration of nivolumab treatment.
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