Browsing by Author "Zainab Akram"

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Comparative evaluation of pit & fissure sealant retention using cotton roll & rubber dam isolation techniques – a systematic review & meta-analysis
(Springer Nature, 2025) Neha Shukla; Zainab Akram; Pg G.Naveen Kumar; Mahesh R. Khairnar; Jadhav Sachin Kumar; Savitha S. Priyadarsini
Background: Isolation with cotton rolls does not always provide as complete isolation as rubber dam, especially in procedures where absolute moisture control is critical. Therefore, this review aims to summarize and analyze previous studies evaluating the retention and marginal integrity of pit & fissure sealant using rubber dam and cotton roll isolation techniques during dental treatment in children. Material and methods: In accordance with PRISMA guidelines, search yielded 1361 articles, with seven RCTs and one non-RCT design meeting the inclusion criteria. Data were extracted on study design, sample size, sealant type, follow-up duration, retention rates, and caries incidence. Results: The comparison of retention rate between rubber dam and cotton roll at six months difference was non-significant (OR:1.15; p = 0.64) while there was significant difference at 12 month (OR:2.23; p < 0.001). The difference for the marginal integrity was statistically significant at six months (OR:2.00; p = 0.03) while non-significant difference observed (OR:1.74; p = 0.10) at 12 months. Conclusion: The sealant placed using a rubber dam as an isolation technique showed higher retention than the cotton roll after 12 months. In terms of marginal integrity, the performance of the rubber dam and cotton roll was equivalent at the end of 12 months. © The Author(s), under exclusive licence to British Dental Association 2024.
Comparative evaluation of pit & fissure sealant retention using cotton roll & rubber dam isolation techniques – a systematic review & meta-analysis
(Springer Nature, 2024) Neha Shukla; Zainab Akram; P. G. Naveen Kumar; Mahesh R. Khairnar; Sachin Kumar Jadhav; Savitha Priyadarsini
Background: Isolation with cotton rolls does not always provide as complete isolation as rubber dam, especially in procedures where absolute moisture control is critical. Therefore, this review aims to summarize and analyze previous studies evaluating the retention and marginal integrity of pit & fissure sealant using rubber dam and cotton roll isolation techniques during dental treatment in children. Material and methods: In accordance with PRISMA guidelines, search yielded 1361 articles, with seven RCTs and one non-RCT design meeting the inclusion criteria. Data were extracted on study design, sample size, sealant type, follow-up duration, retention rates, and caries incidence. Results: The comparison of retention rate between rubber dam and cotton roll at six months difference was non-significant (OR:1.15; p = 0.64) while there was significant difference at 12 month (OR:2.23; p < 0.001). The difference for the marginal integrity was statistically significant at six months (OR:2.00; p = 0.03) while non-significant difference observed (OR:1.74; p = 0.10) at 12 months. Conclusion: The sealant placed using a rubber dam as an isolation technique showed higher retention than the cotton roll after 12 months. In terms of marginal integrity, the performance of the rubber dam and cotton roll was equivalent at the end of 12 months. © The Author(s), under exclusive licence to British Dental Association 2024.
COMPARATIVE EVALUATION OF RETENTION AND CARIES PREVENTIVE EFFECT OF HYDROPHILIC AND HYDROPHOBIC PIT AND FISSURE SEALANTS: A SYSTEMATIC REVIEW AND META ANALYSIS
(Elsevier Inc., 2025) Jadhav Sachin Kumar; Zainab Akram; Pg G.Naveen Kumar; Mahesh R. Khairnar; Neha Shukla
Background: Dental sealants are critical in preventing caries by protecting pits and fissures from food and microorganism accumulation. Sealants are categorized as hydrophobic and hydrophilic. Hydrophobic sealants exhibit higher retention but less effective in moist environments, hydrophilic sealants perform better under such conditions. Evaluating retention and caries prevention efficacy of these sealants is essential for optimizing dental care practices. This review evaluates retention and caries preventive efficacy of both sealants. Materials and Methods: Data on study design, sample size, sealant type, follow-up duration, retention rates, and secondary caries incidence were extracted. The risk of bias assessed using RevMan 5.4, and meta-analyses were conducted with both random-effects model and fixed-effects model based on heterogeneity and nature of included studies. Results: Adhering to PRISMA guidelines, 15 Randomized Controlled Trials (RCTs) and 3 Non-Randomized Controlled Trials (NRCTs) met with inclusion criteria. Hydrophilic sealants showed significantly higher retention rates at 3 months (OR: 3.00, 95 % CI: 1.46-6.16) and 12 months (OR: 2.00, 95 % CI: 1.35-2.96). However, no significant differences observed at 6, 9, and 18 months. Caries prevention efficacy was similar for both sealant types across all follow-up periods, with low heterogeneity indicating consistent results. Discussion: Hydrophilic sealants initially provide better retention due to moisture-resistant properties but do not sustain this advantage in long run. Both sealant types are equally effective in preventing caries. These findings align with prior studies, emphasizing importance of moisture control in sealant application. Conclusion: Hydrophilic sealants exhibit superior short-term retention and similar caries prevention efficacy compared to hydrophobic sealants. © 2024 Elsevier Inc.
Comparative Evaluation of the Effect of Laser Therapy and Behavioral Counseling in Tobacco Cessation: A Randomized Controlled Trial
(Kerman University of Medical Sciences, 2025) Zainab Akram; Puvvadi G. Naveen Kumar; Mahesh R. Khairnar; Jadhav Sachin Kumar; Jyotsna Kailashiya; S. Savitha Priyadarsini; Alka Singh
Background: Laser auricular acupuncture is a form of therapy that is non-invasive, aseptic, and painless, thus advantageous over the traditional form of acupuncture for tobacco cessation. The objective of the study is to evaluate and compare nicotine dependence, urinary cotinine level, physical effects, and quit rate among tobacco chewers before and one month after laser therapy and behavioral counseling, and to evaluate and compare extrinsic stains one month post-intervention. Methods: The present study was a randomized controlled trial, with laser therapy and behavioral counseling as the test and control interventions, respectively. The laser was focused on both ears once a week for four weeks. Counseling sessions were held once a week for four weeks. Nicotine dependence, urinary cotinine level, physical effects, as measured using the Visual Analog Scale, and quit rate were recorded before and after the intervention. Results: The results showed significant reductions in nicotine dependence in both laser and counseling groups post-intervention (P < 0.001). Urinary cotinine levels increased significantly in the counseling group post-intervention (P = 0.010). Inter-group comparison revealed significant differences in pre-and post-intervention cotinine levels (P < 0.05). Adjusted analysis confirmed significant post-intervention differences between the groups (P = 0.048). Conclusion: This study demonstrates that combining laser auricular acupuncture therapy with behavioral counseling yields superior outcomes for smokeless tobacco cessation compared to behavioral counseling alone. The combined approach results in greater reductions in nicotine dependence, lower urinary cotinine levels, slightly higher quit rates, and significant improvements in various physical effects associated with tobacco use. © 2025 The Author(s); Published by Kerman University of Medical Sciences.
COMPARING THE EFFICACY OF OSSEODENSIFICATION OVER CONVENTIONAL DRILLING TECHNIQUE ON IMPLANT STABILITY AND BONE DENSITY IN LOW BONE DENSITY SITES: A SYSTEMATIC REVIEW AND META-ANALYSIS
(Elsevier Inc., 2025) Shraddha Shilpi; Monika Bansal; Mahesh R. Khairnar; Gokila Vani Su; Zainab Akram; Rashika M; Sakshi Agarwal
Purpose of the research: To assess the efficacy of osseodensification (OD) over conventional drilling technique (CD) on implant stability and bone density in low bone density sites. Materials and methods: An electronic and manual search were conducted to analyze the effect of OD over CD technique on implant stability and bone density in human-based randomized controlled trials (RCTs) and nonrandomized controlled trials (NRCTs). The risk of bias was assessed using (RoB 2.0) and (ROBINS-I) tools for RCTs and NRCTs respectively. The meta-analysis was applied with RevMan 5.4, using the random-fixed effects model. Heterogeneity was assessed by a Q test and quantified with I2 statistics. Results: Our literature search identified 1454 publications, of which only 6 met all the inclusion criteria. The meta-analysis of the included studies showed that the implant stability quotient (ISQ) was greater in OD than in the CD group without being statistically significant both immediately and at the follow-up period after implant placement, with a standardized mean difference of 2.13 [95%CI = −0.08, 4.35] with P = .06 and 1.81 [95%CI = −0.41, 4.03] with P = .11 respectively. The difference in bone density in the OD compared to the CD group was statistically significant, immediately after implant placement with a standardized mean difference of 2.14 [95%CI = 0.68, 3.59] with P = .004 and nonsignificant at 3 to 7 months with a standardized mean difference of 1.54 [95%CI = −0.34, 3.43] with P = .11. Conclusion: The findings of the present review and meta-analysis show that dental implants placed using the OD technique reveal greater implant stability and improved bone density in areas with low bone density compared to the CD technique. However, more clinical studies are needed to validate the findings. © 2025 Elsevier Inc.
Effect of Kangen and reverse osmosis water on dental plaque, salivary pH and salivary Streptococcus mutans counts: a randomized-controlled trial (A preliminary study)
(IWA Publishing, 2023) Ananta Kusumakar; Zainab Akram; Mahesh Ravindra Khairnar; Sachin Kumar Jadhav; Harloveen Sabharwal; Savitha S. Priyadarsini; Naveen P.G. Kumar
Purpose: The present randomized-controlled trial was conducted to assess the effect of Kangen water and reverse osmosis (RO) water on dental plaque, salivary pH and salivary Streptococcus mutans count. Materials and methods: This randomized control trial was conducted for 14 days on 24 randomly selected participants from the pool of undergraduate dental students. Participants were randomly divided into two groups of 12 each: the Kangen water (pH 9) group and the RO water group. Participants in each group were asked to drink allocated water for 7 days. Dental plaque, salivary pH and microbial colony-forming units (CFUs) were assessed after 7 and 14 days. Results: Intragroup comparison showed that all three outcomes showed a significant improvement in the Kangen water group after 14 days, whereas no difference was seen in the RO water group. Intergroup comparison showed a significant difference in plaque score and CFU among the two groups after 7 and 14 days, whereas pH between the two groups did not show a significant difference. Conclusions: Regular drinking of alkaline Kangen water with pH 9 was found to be effective in reducing plaque and salivary Streptococcus mutans count when compared to RO water. © 2023 The Authors
Effect of Laser Auricular Acupuncture in Tobacco Smoking Cessation: A Systematic Review and Meta-Analysis
(Mary Ann Liebert Inc., 2024) Zainab Akram; Mahesh R. Khairnar; P.G. Naveen Kumar; Sachin Kumar Jadhav; Ananta Kusumakar; S. Savitha Priyadarsini
Introduction: This study explores laser auricular acupuncture as a potential solution for nicotine dependence, comparing it to conventional counseling. With a death every 6.5 s due to tobacco, the systematic review aims to assess the efficacy of laser acupuncture versus counseling or placebo, offering insights into innovative strategies for combating tobacco addiction. Methods: A systematic search across scientific databases yielded 2537 articles (2000–2021), reduced to 1294 after deduplication. Abstract screening narrowed it down to eight articles; after a full-text assessment based on inclusion/exclusion criteria, four were selected. Inter-rater reliability between coders (Z.A., M.R.K.) was strong at each screening stage, with perfect agreement at the full text (j = 1.0), abstract (j = 0.99), and title (j = 0.89) stages, all with a 95% confidence interval. Results: In the meta-analysis of two studies on post-intervention nicotine dependence using the Fagerstrom scale, the laser group showed significantly lower scores (p = 0.002, mean difference = -0.60). Examining subjects who failed to quit smoking immediately after therapy, the laser group had 53.8% continuation compared to 83.0% in the comparison group (non-significant difference). At the 3-month mark, the continuation rates were 60.8% for the laser group and 86.6% for the comparison group (non-significant difference). Conclusion: Potential superiority of laser auricular acupuncture over behavioral counseling in tobacco cessation, with reported safety. However, the limited trials and sample size warrant cautious interpretation. Laser therapy emerges as a promising modality, but further extensive trials, especially in combination with other interventions, are crucial to solidify its efficacy in facilitating successful tobacco cessation. © Mary Ann Liebert, Inc.
Evaluation of Randomised Controlled Trials Published in Indian Specialty Dental Journals for Statistical Testing of Baseline Differences: A Meta-Epidemiological Study
(Wolters Kluwer Medknow Publications, 2023) Mahesh R. Khairnar; Naveen Kumar; Ananta Kusumakar; Zainab Akram; Harloveen Sabharwal; Sachin Jadhav
Background: In randomised controlled trials (RCTs), the application of a test of significance to compare the baseline differences between the intervention groups is a common practice, though it has been condemned by many researchers. Objective: This study aimed to assess the proportion of RCTs on human participants comparing the baseline differences between intervention groups using the test of significance in nine dental specialty journals published in India and to estimate the proportion of studies reporting baseline demographic and clinical characteristics in a table. Materials and Methods: RCTs published in nine dental journals published by dental specialty associations of India were screened. A literature search was limited to the time duration of five years from 2017 to 2021. Results: The authors analysed 326 RCTs. Of 326 RCTs published, 237 RCTs (72.7%) did not report the baseline demographic and clinical characteristics table. Tests of significance were applied to compare baseline differences between the intervention arms in 148 (45.4%) RCTs published. Conclusions: Although criticised by the Consolidated Standards of Reporting Trials (CONSORT) statement, the majority of the trials published in dental specialty journals failed to avoid comparison of baseline differences with significance test and failed to report baseline characteristic table. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
Novel Tripartite Classification for Fractures of Coronoid Process of Mandible: A Retrospective Tertiary Center Study
(Springer, 2024) Arjun Mahajan; Akhilesh Kumar Singh; Naresh Kumar Sharma; Vyomika Bansal; Sudeep Kumar; Sharanya Mani; Zainab Akram
Introduction: Coronoid process of mandible is seldom fractured during maxillofacial trauma. Majority of the cases of coronoid fracture are treated conservatively, but some lead to complications which are often overlooked. At present, the literature on coronoid fractures is inadequate for meta-analysis. Also, there exists no standardized classification in the literature. Hence, the purpose of this study was to analyze the incidence and establish a novel ‘tripartite’ classification. Material and Methods: In this study carried out at level 1 trauma center, all patients with coronoid fracture with or without associated maxillofacial fractures were included. Relevant data were noted from Hospital records and CT scans (computer tomographic scans). These cases were classified according to ‘tripartite’ classification and treated. Data feed was given to IBM® SPSS® statistics (version 21) for analysis. Results: Among 33 coronoid fracture patients, majority (57.57% cases) were from age group of 21–40 years with 82.85% cases attributed to road traffic accidents. 11.43% cases were bilateral, and the rest unilateral cases revealed right-side predilection. Conclusion: Novel tripartite classification allows us to easily categorize and visualize the coronoid fractures. Horizontal types 1 to 3 and vertical types 4 to 6 are in increasing order of incidence, which makes it easy for communication, treatment approach and record maintenance. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Salivary alpha amylase as a diagnostic biomarker for dental caries – A systematic review and meta analysis
(Elsevier Ltd, 2025) S. Savitha Priyadarsini; Puvvadi G. Naveen Kumar; Mahesh R. Khairnar; Zainab Akram; Ridhi Ghodela; Jadhav Sachin Kumar; Neha Shukla
Objective: This systematic review and meta-analysis aimed to assess the association between the dental caries and the level of salivary alpha amylase activity among caries active and caries free individuals. Design: This review followed the PRISMA guidelines and registered in PROSPERO (CRD42024518973). A comprehensive search across various research databases until January 31, 2024 yielded 1031 articles, where multiple screening ultimately narrowed it to 13 articles. Appropriate cross sectional studies comparing caries active (CA), caries free (CF) group and evaluating their level of salivary alpha amylase activity were included. Results: The meta-analysis was performed on all 13 included studies utilizing a random effects model and two sub group analysis were performed where studies with salivary alpha amylase activity estimated using spectrophotometer and autoanalyzer were analyzed separately among caries active and caries free group. The pooled data reveals that the salivary alpha amylase activity was significantly higher (p = 0.005) in caries active group compared to caries free group with a standardized mean difference of 1.30. Conclusion: This review indicated the differences in the salivary alpha amylase activity among caries active and caries free individuals which could aid in identifying individuals susceptible to dental caries thereby offering new insights for preventive dentistry by assessing their caries risk, enabling tailored preventive strategies. © 2024 Elsevier Ltd
The Impact of Graphic Health Warning Labels on Smokeless Tobacco Packets on Motivation to Quit among Current Users: A Cross-Sectional Study
(Kerman University of Medical Sciences, 2025) Jadhav Sachin Kumar; Puvvadi Gopalakrishna Naveenkumar; Mahesh R. Khairnar; Zainab Akram; Neha Chauhan; Neha Shukla
Background: Smokeless tobacco (SLT) use constitutes a considerable public health concern, especially in India, where there are more than 300 million users. This study seeks to assess the influence of graphic health warning labels (GHWLs) on smokeless tobacco (SLT) packaging on encouraging cessation among users. Methods: A cross-sectional study was conducted at the Faculty of Dental Sciences, BHU, Varanasi outpatient department, from December 2023 to April 2024. The study involved 387 participants, selected via simple random sampling, who were current smokeless tobacco users. Data was collected through structured interviews using a validated questionnaire. Statistical analysis was performed using SPSS version 21.0, with a significance level set at P < 0.05. Findings: Awareness of GHWLs was high, with 91.7% of participants recognizing the labels. Among these, 66% considered quitting or reducing smokeless tobacco use due to the labels. Increased health awareness and serious consideration to quit were reported by 50.1% of participants, while 28.9% reported no impact. Awareness of tobacco cessation clinics was moderate at 48.1%, and 66.1% expressed willingness to seek help, primarily due to health concerns. Positive correlations were found between education level and awareness (r = 0.387) and education and attitude towards quitting (r = 0.227). Younger participants and those with shorter durations of smokeless tobacco use exhibited higher health awareness and a greater likelihood of considering cessation. Conclusion: GHWLs are a potent tool in tobacco control, significantly influencing smokeless tobacco users’ intentions to quit. A multifaceted approach involving GHWLs and comprehensive support systems can substantially reduce smokeless tobacco use and its associated health risks. © 2025 The Author(s); Published by Kerman University of Medical Sciences.