The Journal of Contemporary Dental Practice

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2010 | October | Volume 11 | Issue 5

RESEARCH ARTICLE

Thikriat Al-Jewair, James L. Leake

The Prevalence and Risks of Early Childhood Caries (ECC) in Toronto, Canada

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:1 - 8]

PDF  |  DOI: 10.5005/jcdp-11-5-1  |  Open Access |  How to cite  | 

Abstract

Aim

To determine the prevalence and risks of early childhood caries (ECC) among children less than 71 months of age in Toronto, Canada, and to evaluate the association between parental/ caregiver depression and ECC.

Methods and Materials

A secondary analysis of data previously collected by the Toronto Public Health as part of the 2003 Toronto Perinatal and Child Health Survey was performed. The 90-item survey was conducted over the telephone to 1,000 families with children from zero years (birth) to six years of age. Parents/caregivers were asked about factors related to the development and health of their children. For this study, only children younger than six years of age (less than 71 months) were included (n=833). The primary outcome of interest was self-reported and measured by the response to the question of whether a physician/dentist had ever told the parent/caregiver his/her child had ECC.

Results

The prevalence of ECC was 4.7 percent (37 of 791 children). The child's age, his/her history of dental visits, teeth brushing, the use of fluoridated toothpaste, the parent's/caregiver's depressive tendencies, the language spoken at home, and the household annual income were all significant in the bivariate analysis. Multiple logistic regression identified four factors associated with ECC: the child's age (being three years of age or older), having at least one parent/ caregiver with depression, not speaking English at home, and having an annual household income less than $40,000 in Canadian dollars (CAD).

Conclusion

While a child's age, home language, and household income are known risks for ECC, the finding that parental/caregiver depression may be related to ECC is new.

Clinical Significance

Multiple risk factors are involved in the development of early childhood caries. Of particular importance are demographic (e.g., child's age), social (e.g., annual household income), and psychosocial factors (e.g., parental/ caregiver depression) that are indirectly linked to ECC. More attention needs to be placed on understanding the role and process by which these factors influence the development of ECC.

Citation

Al-Jewair TS, Leake JL. The Prevalence and Risks of Early Childhood Caries (ECC) in Toronto, Canada. J Contemp Dent Pract [Internet]. 2010 October; 11(5):001-008. Available from: http://www.thejcdp.com/journal/view/ volume11-issue5-al-jewair

RESEARCH ARTICLE

Horieh Moosavi, Farzaneh Ahrari, Mahsima Nojoomian

Clinical Evaluation of Bonded Amalgam Restorations in Endodontically Treated Premolar Teeth: A One-Year Evaluation

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:9 - 16]

PDF  |  DOI: 10.5005/jcdp-11-5-9  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this clinical study was to compare the fracture resistance, marginal adaptation, and rate of recurrent caries of bonded and nonbonded amalgam restorations in endodontically treated premolar teeth.

Methods and Materials

A total of 36 patients with endodontically treated maxillary first or second premolars were selected and divided into three groups. The treatments in all groups consisted of lingual cusp coverage and cementation of a prefabricated intracanal post (No. 2 long, Dentatus USA, New York, NY, USA). One type of cavity liner was used for each group as follows: copal varnish (Group A), Amalgambond Plus (Group B), and Scotchbond Multi-Purpose (Group C). The teeth were then restored with Cinalux high-copper spherical amalgam (Cinalux, Sh. Dr Faghihi Dental Co., Tehran, Iran). After one year, fracture resistance, marginal adaptation, and secondary caries were evaluated. Fischer's exact test was used for statistical analysis using a 0.05 percent significance level.

Results

There was no significant difference among groups with respect to fracture resistance (p=0.49). However, significant differences in marginal adaptation existed among the three groups (p=0.02) and no recurrent caries were found in any of the restored teeth.

Conclusion

Bonding amalgam restorations using Amalgambond Plus and Scotchbond Multi-Purpose Plus did not improve the fracture resistance or affect the resistance to secondary caries in endodontically treated premolar teeth. However, the teeth in both these bonded groups showed significant improvement in marginal adaptation compared with restorations placed with copal varnish (p=0.02).

Clinical Significance

Amalgambond Plus or Scotchbond Multi-Purpose adhesive resins significantly improved marginal adaptation of amalgam compared with copal varnish, but did not enhance fracture resistance or affect the prevention of secondary caries.

Citation

Ahrari F, Nojoomian M, Moosavi H. Clinical Evaluation of Bonded Amalgam Restorations in Endodontically Treated Premolar Teeth: A One-Year Evaluation. J Contemp Dent Pract [Internet]. 2010 October; 11(5):009-016. Available from: http://www.thejcdp.com/journal/ view/volume11-issue5-moosavi

RESEARCH ARTICLE

Christopher I. Udoye, Adeyemi O. Olusile, Elizabeth O. Oziegbe, Temitope A. Esan, Michael A. Ojo, Hector O. Olasoji

Tooth Loss Among Nigerians Treated in Teaching Hospitals: A National Pilot Study

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:17 - 24]

PDF  |  DOI: 10.5005/jcdp-11-5-17  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this study was to identify the causes and patterns of tooth loss among Nigerian adults.

Background

Tooth loss continues to be a major problem in clinical dentistry and has received significant attention in everyday dental practice. In Nigeria there is a discernible lack of current data that would explain the reasons and patterns of tooth loss from its different geopolitical zones.

Methods and Materials

The reasons for tooth extractions during a period of 12 months were obtained from the hospital records of teaching and specialist hospitals in Nigeria's six geopolitical zones and the Federal Capital Territory (FCT). Data were analyzed using Statistical Package for the Social Sciences for Windows (SPSS) version 9.0.

Results

A total of 4,204 teeth were extracted from 3,431 patients. Of these teeth 52.4 percent were lost due to dental caries while 30.2 percent were removed because of periodontal disease, 5.0 percent were missing as a result of trauma, and 3.9 percent were impacted and required extraction. The remaining 8.5 percent were extracted for a variety of reasons such as orthodontic treatment, overeruption, neoplasms, supernumerary teeth, attrition, a cystic lesion, and hypoplasia. Dental caries was the most common diagnosis given for tooth loss in the South-South (79 percent), South- East (68 percent), North-East (47 percent), North- West (69 percent), and North-Central (35 percent) zones followed by periodontal disease. In contrast, periodontal disease was the most common cause of tooth loss in the South-West zone (65 percent) and in the FCT (55 percent), followed by dental caries at 22 percent and 33 percent, respectively.

Conclusion

Although teeth were extracted based on a variety of diagnoses, dental caries was identified as the common reason cited for tooth loss in Nigeria and to a lesser extent periodontal disease. Also different reasons were given for tooth loss among the various geographical zones.

Clinical Significance

Tooth loss among Nigerians was attributed largely to dental caries and secondarily to periodontal disease. Both conditions can be prevented if diagnosed early enough and treatment is instituted in a timely manner.

Citation

Esan TA, Olusile AO, Ojo MA, Udoye CI, Oziegbe EO, Olasoji HO. Tooth loss among Nigerians treated in teaching hospitals: A National Pilot Study. J Contemp Dent Prac [Internet], 2010 October;11(5):017-024. Available from: http://www. thejcdp.com/journal/view/volume11-issue5-esan

RESEARCH ARTICLE

Hamideh Ameri, Marjaneh Ghavamnasiri, Ehsan Abdoli

Effects of Load Cycling on the Microleakage of Beveled and Nonbeveled Margins in Class V Resin-Based Composite Restorations

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:25 - 32]

PDF  |  DOI: 10.5005/jcdp-11-5-25  |  Open Access |  How to cite  | 

Abstract

Aim

This study evaluated the influence of mechanical loading and thermocycling on microleakage of class V resin-based composite restorations with and without enamel bevel.

Methods and Materials

Sixty class V cavity preparations measuring 3.0 mm wide (mesiogingivally) x 2.0 mm high (occluso-gingivally) x 1.5 mm deep with the occlusal margin in enamel and the gingival margin in cementum were prepared on the buccal surfaces of human premolars using a #12 diamond round bur (Drendel & Zweiling Diamant GmbH, Lemgo, Germany) in a high-speed, water-cooled handpiece. The specimens were then divided into two groups of 30 specimens each, based on the type of enamel cavosurface margin configuration as beveled or nonbeveled (butt joint). After restoring the preparations with a flowable resin-based composite (Tetric Flow, Ivoclar Vivadent-AG, Schaan, Liechtenstein) and finishing and polishing with sequential discs (Sof-Lex Pop-on, 3M-ESPE, St. Paul, MN, USA), the teeth were stored at 37°C and 100 percent humidity. Twenty-four hours later, half of the specimens in each group (nonbeveled “N” or beveled “B”) were exposed to a cycling loading for 250,000 cycles to simulate occlusal loading and assigned to two subgroups (NL+ or BL+), while the remainder of the specimens in each group were only maintained in a 100-percent-humidity environment, without any cyclical loading, until tested (NL– or BL–). The specimens were sealed with sticky wax (Kemdent, Associated Dental Products, Swindon, UK) and nail polish. The apical foramen of each tooth was sealed with sticky wax and the rest of the tooth was covered with nail varnish, except for an area within 1.0 mm around the composite restoration. To detect marginal leakage, all of the samples were stored in a 0.5 percent basic fuchsine solution for 24 hours. The specimens were then sectioned longitudinally using a low-speed diamond blade (IsoMet, Buehler Ltd., Lake Bluff, IL, USA), machined, and evaluated under 25X magnification using a stereomicroscope (M9, Wild Heerbrugg, Switzerland). The specimens were scored on a scale from 1 to 4 on the degree of dye penetration. The qualitative data were analyzed by the Mann- Whitney U test at a 5 percent significance level (p<0.05). The null hypothesis of this study was that there is no difference in microleakage between beveled and nonbeveled class V buccal preparations in premolar teeth restored with resinbased composite and subjected to simulated occlusal loading and thermocycling.

Results

In each group the gingival margin showed significantly more microleakage than the enamel margin (p<0.05). Load cycling did not result in an increase in microleakage in nonbeveled (p=0.259) or in beveled (p=0.053) occlusal margins. However, the gingival margins showed a statistically significant difference in microleakage after load cycling whether in cavities with enamel occlusal bevel (p=0.004) or in groups without a bevel. This means the enamel margin configuration of the enamel occlusal margin had no effect on decreasing microleakage in the gingival aspect of class V composite restorations. In general, the nonbeveled preparations in this study had significantly less microleakage than the bevel specimens whether they were loaded occlusally or not (p=0.001).

Clinical Significance

Within the limitations of this in vitro study, no benefit was derived from placing an enamel cavosurface bevel on the occlusal margin of a standardized class V composite restoration located at the cementoenamel junction. The most important consideration is to prevent microleakage along the gingival margin regardless of whether the occlusal enamel margin is beveled.

Citation

Ameri H, Ghavamnasiri M, Abdoli E. Effects of load cycling on the microleakage of beveled and nonbeveled occlusal margins in class V resin-based composite restorations. J Contemp Dent Pract [Internet]. 2010 October; 11(5):025- 032. Available from: http://www.thejcdp.com/ journal/view/volume11-issue5-ghavamnasiri

RESEARCH ARTICLE

Maryam Talebi, Iman Parisay, Ali Sarraf, Fateme Mazhari

Regression Equations for Predicting the Size of Unerupted Canines and Premolars in an Iranian Population: A Pilot Study

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:33 - 40]

PDF  |  DOI: 10.5005/jcdp-11-5-33  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this pilot study was to evaluate equations for predicting the size of unerupted canines and premolars during the mixed dentition period in an Iranian population.

Methods and Materials

This cross-sectional analysis was performed on 106 subjects (52 girls, 54 boys, aged 13–15 years). Data were obtained from dental cast by making direct measurements of the maximum mesiodistal widths of all mandibular and maxillary incisors, canines, premolars, and first molars with an electronic digital sliding caliper, with an accuracy of ±0.02 mm and repeatability of ±0.01 mm. The results were statistically analyzed using Student t tests, Pearson product-moment coefficients, and ANOVA tests. Correlation coefficients (r) and error variance of estimates were determined using a significance level of p<0.05.

Results

No significant differences were found between the mesiodistal tooth widths of males and females in this Iranian population. The highest correlation was between the sum of the mesiodistal width of canines and premolars in the maxilla with the mesiodistal width of the mandibular first molars and maxillary central incisors (r=0.742). A moderate correlation was obtained in the mandible (r=0.665). Approximations were developed to predict the size of the unerupted canines and premolars in both jaws (in the maxilla, Y = 0.740X + 14.271, or the simplified formula, Y = 3/4X + 14; for the mandibular arch, Y = 0.658X + 16.353, or the simplified formula, Y = 2/3 X + 16).

Conclusion

The strongest correlation was found for the sum of the mesiodistal width of canines and premolars in the maxilla with the mesiodistal width of the mandibular first molars and maxillary central incisors in the maxillary analysis (r=0.742). A moderate correlation was found in the mandible for the sum of the mesiodistal width of canines and premolars with the mesiodistal width of the mandibular first molars and maxillary central incisors (r=0.665).

Clinical Significance

The simplified equations proposed for the maxillary arch (Y = 3/4 X + 14) and for the mandibular arch (Y = 2/3 X + 16) offer an easy and practical way to predict the size of unerupted canines and premolars in the maxillary and mandibular arches of Iranian children.

Citation

Talebi M, Parisay I, Sarraf A, Mazhari F. Regression equations for predicting the size of unerupted canines and premolars in an Iranian population: A pilot study. J Contemp Dent Pract [Internet], 2010 October; 11(5):033-040. Available from http://www.thejcdp.com/journal/view/ volume11-issue5-talebi

RESEARCH ARTICLE

Vikas Deo, Ashok Bhati, Tony Kurien

The Pouch and Tunnel Technique for the Management of Adjacent Gingival Recession Defects: Surgical Correction and One-Year Follow-Up

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:41 - 48]

PDF  |  DOI: 10.5005/jcdp-11-5-41  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this report is to present a minimally invasive periodontal plastic surgical method for the treatment of gingival augmentation coronal to area of recession on the facial aspect of the mandibular central incisors.

Background

Gingival recession is a relatively common condition patients may discuss with their general dental practitioner. Several improvements in the available corrective surgical techniques have evolved, especially in flap design of periodontal cosmetic surgeries, which can produce a favorable final treatment outcome.

Case Description

A 21-year-old male patient diagnosed with Miller class II marginal tissue recession on the facial surface of the mandibular right and left central incisors was treated with a subepithelial connective tissue autograft underneath a supraperiosteal pouch and tunnel recipient site for multiple areas of gingival recession This flap design allowed intimate contact of donor tissue to the recipient site. One-year follow-up examination of the surgical site revealed excellent and stable root surface coverage.

Summary

The use of a technique that involves preservation of papilla height and ensures maximum blood supply to the graft helps to attain excellent esthetic and functional long-term results.

Clinical Significance

Given the increasing patient concerns about dental esthetics, the surgical treatment modality presented can be beneficial in efforts to meet the esthetic and functional demands of patients, thereby contributing positively to treatment acceptance and the overall outcome.

Citation

Kurien T, Deo V, Bhati A. The pouch and tunnel technique for the management of adjacent gingival recession defects: Surgical correction and one-year follow-up. J Contemp Dent Pract [Internet]. 2010 October; 11(5):041- 048. Available from: http://www.thejcdp.com/ journal/view/volume11-issue5-deo

RESEARCH ARTICLE

Ahmed Chkoura, Wafaa Elwady, Bouchra Taleb

Surgical Management of a Cutaneous Sinus Tract: A Case Report and Review of the Literature

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:7] [Pages No:49 - 55]

PDF  |  DOI: 10.5005/jcdp-11-5-49  |  Open Access |  How to cite  | 

Abstract

Aim

The purpose of this paper is to present a case involving the surgical management of a cutaneous sinus tract and a literature review.

Background

A cutaneous sinus tract of dental origin may easily be misdiagnosed. Exact diagnosis is necessary in the management of this pathological situation.

Case Description

A healthy 40-year-old man presented with a dimple in the skin of his right cheek. Upon further examination, the clinical crown of the mandibular right first molar was missing, leaving only the roots visible. Palpation of the affected area revealed a cord-like tract that was surgically excised.

Summary

A cutaneous sinus tract of dental origin is a canal that drains the infection from a dental source to the face or neck. A misdiagnosis of these lesions could lead to an ineffective and inappropriate treatment. We report a case of a cutaneous sinus tract of dental origin that we removed from the periapical zone of the causal teeth. The aim of this paper is to present a dental and medical literature review of cutaneous sinus tract that has a dental origin and to report a case where the sinus tract was surgically eliminated. Patients with a cutaneous facial sinus tract of dental origin often do not have obvious dental symptoms that can lead to misdiagnosing this pathological situation.

Clinical Significance

Elimination of the source of infection by endodontic treatment or tooth removal generally results in resolution of the sinus tract. But in the case of an older sinus tract, wound contraction and scar tissue formation may require surgical management to excise the cordlike tract.

Citation

Chkoura A, Elwady W, Taleb B. Surgical Management of a Cutaneous Sinus Tract: A Case Report and Review of the Literature. J Contemp Dent Pract [Internet]. 2010 October; 11(5):049-055. Available from: http://www.thejcdp. com/journal/view/volume11-issue5-chkoura

RESEARCH ARTICLE

Shital Hungund, Magesh Kumar

Palato-Radicular Groove and Localized Periodontitis: A Series of Case Reports

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:7] [Pages No:56 - 62]

PDF  |  DOI: 10.5005/jcdp-11-5-56  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this report is to present the management of three cases of different magnitude affecting the periodontal attachment apparatus due to the presence of a palato-radicular groove (PRG).

Background

The palato-radicular groove is a developmental anomaly often associated with localized periodontitis and pulpal necrosis.

Case description

The authors present three cases involving the management of teeth with a palato-radicular groove. In the first case, a 20-year-old woman presented with a 5 mm periodontal pocket associated with the maxillary right central incisor but no evidence of pulpal involvement. In the second case, there was extensive bone loss and pulpal necrosis of the maxillary right lateral incisor in a 35-year-old man. The third case involved severe localized periodontitis of the right and left maxillary lateral incisors of a 47-year-old man. This report describes the diagnosis and periodontal management of these three clinical situations.

Summary

Periodontal complications due to a palatal-radicular groove are relatively rare. However, when they do occur, the diagnosis of a pulpal or localized periodontal lesion can sometimes present a dilemma for the general dentist, particularly if a palato-radicular groove is the etiologic factor. This is because a radicular groove can act like a “funnel,” aiding microbial plaque accumulation, and lead to gingivitis, localized periodontitis, and even pulpal necrosis. But with a timely diagnosis and proper clinical management, the tooth or teeth involved can be treated and often retained.

Clinical Significance

Thorough examination of the morphological anomalies associated with the lateral and central incisors, in particular, aided by appropriate diagnostic aids, can lead to accurate diagnosis and management of a tooth or teeth with a palato-radicular groove.

Citation

Hungund S, Kumar M. Palato-Radicular Groove and Localized Periodontitis: A Series of Case Reports. J Contemp Dent Pract [Internet]. 2010 October; 11(5):056-062. Available from: http://www.thejcdp.com/journal/view/volume11- issue5-hungund

RESEARCH ARTICLE

Shobha Tandon, N. Sridhar

Continued Root-End Growth and Apexification Using a Calcium Hydroxide and Iodoform Paste (Metapex®): Three Case Reports

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:63 - 70]

PDF  |  DOI: 10.5005/jcdp-11-5-63  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of these case reports is to present a treatment to promote root-end growth and apexification in nonvital immature permanent teeth in children.

Methods and Materials

Three cases were presented where the calcium hydroxide and iodoform paste Metapex® was placed in the root canals of immature permanent teeth using disposable plastic tips. The teeth involved were evaluated radiographically at regular intervals for the first 12 months after placement of the paste. At the end of 12 months all the cases showed continued root growth and apical closure (apexification) with no evidence of periapical pathology. Conventional endodontic treatment was then performed.

Results

In all three of the clinical cases presented, a combination of calcium hydroxide and iodoform paste (Metapex®) was used and showed promising results in inducing root-end growth and closure after 12 months.

Conclusion

In these three clinical cases, the calcium hydroxide and iodoform paste Metapex® (Meta Biomed Co. Ltd., South Korea) was found to induce apical closure when assessed radiographically. Over a period of 12 months all the cases showed continued root growth.

Clinical Significance

The calcium hydroxide and iodoform paste Metapex® promoted continued root-end growth with apexification in the nonvital immature permanent teeth treated.

Citation

Sridhar N, Tandon S. Continued Root-Growth and Apexification Using a Calcium Hydroxide and Iodoform Paste (Metapex®): Three Case Reports. J Contemp Dent Pract [Internet]. 2010 October; 11(5):063-070. Available from: http://www.thejcdp.com/journal/view/volume11- issue5-sridhar

RESEARCH ARTICLE

Reynaldo Leite Martins-Junior, Antonio Jose Garcia Palma, Emilio Jose Marquardt, Thais Monteiro de Barros Gondin, Florence de Carvalho Kerber

Temporomandibular Disorders: A Report of 124 Patients

[Year:2010] [Month:October] [Volume:11] [Number:5] [Pages:8] [Pages No:71 - 78]

PDF  |  DOI: 10.5005/jcdp-11-5-71  |  Open Access |  How to cite  | 

Abstract

Aim

This study aims to present both the features of 124 consecutive patients with temporomandibular disorders (TMDs) and the results of a reversible, conservative, and low-tech treatment.

Methods and Materials

One hundred fifty-eight records of consecutive patients treated in School of Dentistry at the Univag-University Center in Varzea Grande-MT, Brazil, 124 of whom were considered TMD patients, were examined. The following data were obtained: gender, age, main complaint, diagnosis, co-morbidities, type of treatment performed, and treatment results. The patients who received a successful treatment were contacted for reevaluation four to six years after the conclusion of treatment.

Results

Pain was the main complaint for 92.7 percent of the patients. The majority of patients were female (female:male ratio of 4.1 :1), with a peak age range between 20 and 30 years. Roughly 59.7 percent of the patients were diagnosed as having a muscular TMD, 12.9 percent as an articular TMD, and 27.4 percent as a mixed TMD. The success rate for treatment was 91.7 percent, and there was a tendency toward the long-term maintenance of good results.

Conclusion

The features of the 124 TMD patients treated were similar to those reported in the literature with regard to gender, age, and diagnostic prevalence. Most of the disorders were of a muscular origin, and there was a predominance of women between 20 and 30 years of age. The conservative, reversible, and low-tech treatment success rate for TMD can reach values above 90 percent. Therefore, there is no need for invasive, irreversible, expensive, or high-tech treatments for the majority of patients.

Clinical Significance

The majority of TMD patients can benefit from reversible, conservative, and low-tech treatments such as parafunction control and therapeutic exercises that can be performed by any clinician once an accurate diagnosis has been made.

Citation

Martins-Junior RL, Palma AJG, Marquardt EJ, Gondin TMB, Kerber FC. Temporomandibular disorders: A report of 124 Patients. J Contemp Dent Pract [Internet]. 201 O October; 11 (5):071-078. Available from: http://www.thejcdp.com/journal/view/volume11- issue5-martins-junior

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