Prajapati D, Nayak R. Rashmdeep's Method: A Novel Method to Confirm Nasal Breathing. J Contemp Dent Pract 2013;14(2):ii-iv.

To evaluate the effects of a preflaring method on the determination of working length in the curved mesial canals of mandibular molars.

Ninety mandibular molars with apical curvature of 30 to 40° were selected and randomly divided into two groups; each containing 45 teeth. In the first group, the initial instrumentation was performed with preflaring on the mesiobuccal canal (preflared group), and in the second group; the instrumentation was performed without preflaring on the mesiobuccal canal (nonpreflared group). A size 15 K-file was inserted in the mesiobuccal canals until the apical constriction could be felt by tactile sensation and a radiograph was taken to identify the distance between the file tip and radiographic apex. The location of the tip was classified as (a) within 1 mm of the radiographic apex, (b) more than 1 mm of the radiographic apex, or (c) overextended beyond the radiographic apex. The collected data was statistically analyzed and probability value was set to be ≤ 0.05.

The file tip was significantly closer to the true working length in the canals with early preflaring compared to the canals without early preflaring (p < 0.005). In the preflared group; 75.5% of the cases had the file tip in location ‘a’, 13.3% in location ‘b’, and 11.1% in location ‘c’. In the nonpreflared group; 33.3% of the cases had the file tip in location ‘a’, 53.3% in location ‘b’ and 13.3% in location ‘c’.

Preflaring the coronal portion of curved canals greatly improved the access to the apical constriction, and thus enhanced correct working length determination. If the coronal portion of the curved canals is not preflared, the clinician cannot discern the accuracy of what they feel apically. Thus, preflaring is a highly recommended procedure especially in curved canals for better determination of correct working length.

Iqbal A, Akbar I, AL-Omiri MK. An in vivo Study to determine the Effects of Early Preflaring on the Working Length in Curved Mesial Canals of Mandibular Molars. J Contemp Dent Pract 2013;14(2):163-167.

Chronic periodontitis is multifactorial and numerous risk factors have been identified to contribute in the disease progression. Current study aimed to conduct a cross-sectional study in a population of patients with cardiovascular diseases in order to correlate the association between obesity [body mass index (BMI) and waist circumference (WC)] and periodontal disease parameters.

The study was of a cross-sectional design and a total of 201 patients were examined after obtaining their informed consent. Subjects who had a history of cardiovascular diseases and under treatment were included in the study. Two indicators of obesity were used: BMI and WC. The following periodontal parameters were assessed: Probing depth, clinical attachment level. The oral hygiene status of the subjects was assessed by the oral hygiene index (OHI, simplified) given by John C Greene and Jack R Vermillion. The influence of the BMI and other confounding variables on periodontitis severity was assessed by multivariate logistic regression analysis. Data were analyzed using SPSS.

Significant association was seen with low density lipoproteins (LDL) and severity of periodontitis (p < 0.005), triglyceride levels (TGL) and severity of periodontitis (p < 0.005), cholesterol and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). Significant association was seen with smoking and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), WC and severity of periodontitis (p < 0.001), cholesterol and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001).

Obesity has been implicated as a risk factor for several conditions including cardiovascular disease, diabetes, etc. In our study the relation between measures of overall and abdominal obesity (BMI and WC) and periodontal disease showed significant association in the multivariate logistic regression analysis independent of other confounding factors.

Obesity can act as a significant risk factor in progression of periodontitis.

Palle AR, Reddy CMSK, Shankar BS, Gelli V, Sudhakar J, Reddy KKM. Association between Obesity and Chronic Periodontitis: A Cross-sectional Study. J Contemp Dent Pract 2013;14(2):168-173.

Oral mucosal lesions are frequently observed in institutionalized elderly patients more than other age groups. The aim of this study was to determine the prevalence of epulis fissuratum and denture stomatitis and their associated causes in dependent elderly complete denture wearers.

This study was conducted in dependent elderly complete denture's wearers living in four randomly selected nursing homes located in Tehran. Associated factors such as gender, age, use of medication, site of nursing home, denture quality and denture-wearing habit were studied.

Overall, 674 patients were examined; 201 had complete denture. The prevalence of denture stomatitis was 36%. There was significant relationship among the prevalence of denture stomatitis with gender and denture wearing period (p < 0.05). The prevalence of epulis fissuratum was 16.4%. There was significant relationship among the prevalence of epulis fissuratum with gender, denture quality and denture wearing habit (p < 0.05).

In this particular dependent age group, the prevalence of oral mucosal lesions is high and the mentioned associated factors should be noticed.

Dependent elderly complete denture wearers need more support and motivation for reducing the prevalence of these particular denture-associated oral mucosal lesions.

Atashrazm P, Sadri D. Prevalence of Oral Mucosal Lesions in a Group of Iranian Dependent Elderly Complete Denture Wearers. J Contemp Dent Pract 2013;14(2):174-178.

Bacterial infections are common complicating findings in course of liver cirrhosis, most of them being Gram-negative. Similarly periodontal pathogens are also mostly Gram-negative bacteria hence the objective was to evaluate the periodontal status in alcoholic liver cirrhosis patients and to compare the periodontal status of alcoholic liver cirrhosis patients in: a. Smokers with periodontitis and b. Nonsmokers with periodontitis.

A total of 150 patients made up the sample of this study. The sample size was divided into four groups. The first two groups comprised of 50 patients each comprising of patients with periodontitis who were nonsmokers and patients with periodontitis who were smokers respectively and the next two groups comprised of 25 patients each, which included patients diagnosed as suffering from alcoholic liver cirrhosis who are nonsmokers and patients diagnosed as suffering from alcoholic liver cirrhosis who are smokers. Screening examination included a proper medical history, dental history and Russell's periodontal index was done to evaluate and compare the periodontal status among the selected groups.

The data obtained was subjected to statistical analysis using the ANOVA Fisher's F-test. Multiple group comparisons were made using the Tukey's HSD test.

Conclusions that can be drawn from this study are: 1. Alcoholic liver cirrhosis patients demonstrated greater alveolar bone loss and increased periodontal destruction. 2. There is very high statistically significant difference on periodontal destruction in alcoholic liver cirrhosis patients (with or without smokers) when compared to the control group.

Periodontal diseases are bacterial infections associated with a bacterial load or insult to the host that elicits a strong inflammatory response cumulating to produce significant pathologic alterations in the systemic status of the host. Alcoholic liver cirrhosis patients as a consequence of liver dysfunction have elevated levels of serum cytokines. These are involved in the destructive process of periodontal disease probably through enhancement of collagenase and metalloproteinase activity. Hence, a study has been planned to evaluate periodontal status in patients with alcoholic liver cirrhosis.

Raghava KV, Shivananda H, Mundinamane D, Boloor V, Thomas B. Evaluation of Periodontal Status in Alcoholic Liver Cirrhosis Patients: A Comparative Study. J Contemp Dent Pract 2013;14(2):179-182.

Smear layer is a negative factor which prevents adhesion of the filling material to the dentinal walls. Recent advances in dental research have incorporated lasers as a potential adjunct in root canal treatment by removing the smear layer before filling the root canal system, enhancing the adhesion of sealers to dentin and improving the sealing ability.

To evaluate the microtensile bond strength of AH-Plus resin-based sealer to dentin after treatment with 980 nm diode and 1,064 nm neodymium-doped:yttrium aluminum garnet (Nd:YAG) laser in vitro.

Thirty specimens prepared for three groups namely group I (control), group II (980 nm diode–lased specimens) and group III (Nd:YAG–lased specimens). One tooth from each group was observed under scanning electron microscope for evaluation of intracanal root dentin morphology. Remaining specimens were used for making microsections by hard tissue microtome. Specimens for groups II and III were lased with 980 nm diode and 1,064 nm Nd:YAG laser. AH Plus sealer was applied onto specimens and mounted onto Instron universal testing machine for microtensile bond strength testing. Results were subjected to statistical analysis using one-way analysis of variance (ANOVA) and Tukey's test.

Group III Nd:YAG had maximum mean microtensile bond strength values (11.558 ± 0.869), followed by group II diode (9.073 ± 0.468) and group I control (6.05 ± 0.036). Statistically significant differences were seen among all the groups. SEM analysis shows removal of smear layer in both groups II and III.

Both Nd:YAG and diode laser were more effective than control group in improving the microtensile bond strength of AH Plus sealer to dentin.

Lasers have the potential to increase the adhesiveness of root canal sealer to dentin surface, thereby improving the quality of root canal obturation.

Maneesha D, Anil KG, Sindhu R, Surendranath G, Deepak S. An in vitro Evaluation of Microtensile Bond Strength of Resin-based Sealer with Dentin Treated with Diode and Nd:YAG Laser. J Contemp Dent Pract 2013;14(2): 183-187.

Compare the efficiency in removing two calcium hydroxide [Ca(OH)₂] preparations from root canal and apical third using single use syringe, ultrasonics and RinsEndo® with saline solution.

One hundred and eighty human singlerooted teeth were instrumented using ProTaper® rotary system, divided into two groups according to Ca(OH)₂ filling. A: Powder mixed with water, B: Pulpdent®. Each group was divided into three subgroups for the irrigation: A1, B1: Single use syringe; A2, B2: Ultrasonics; A3, B3: RinsEndo®.

Teeth were split longitudinally, photographed and imported into Adobe Photoshop. The percentage ratios of Ca(OH)₂ remaining in the canal and in the apical third were calculated. Data were statistically analyzed using ‘ANOVA two-way’ and ‘univariate tests’.

(a) Remnants of medicament were found in all teeth, (b) no statistically significant difference in the elimination of both Ca(OH)₂ from the entire canal (p = 0.436), however, mixed powder was better eliminated from the apical third (p = 0.005), (c) no statistically significant difference among the irrigation techniques in the whole canal (p = 0.608), though, RinsEndo® and ultrasonics were the most effective in cleaning the apical third (p = 0.032) when mixed powder was used.

None of the techniques removed completely Ca(OH)₂ from the canal. In the apical third, RinsEndo® and ultrasonics were the most effective when mixed powder was used.

Ca(OH)₂, the most commonly used intracanal dressing, should be completely eliminated before the obturation to assure a good endodontic sealing. Based on the results of this study, RinsEndo® and ultrasonics were the most effective in removal of Ca(OH)₂ especially the powder mixed with water presentation.

Maalouf L, Zogheib C, Naaman A. Removal Efficiency of Calcium Hydroxide Dressing from the Root Canal without Chemically Active Adjuvant. J Contemp Dent Pract 2013;14(2):188-192.

To compare clinically and radiographically, the regenerative potential of a β-tricalcium phosphate bone graft, Cerasorb^® with and without a bioresorbable type I collagen membrane, BioMend Extend^TM, in treating periodontal infrabony osseous defects.

A total of 20 sites from 10 patients showing bilateral infrabony defects were selected and selected sites were randomly divided into experimental site A (Cerasorb®) and experimental site B (Cerasorb^® and BioMend ExtendTM) by using split mouth design. The clinical parameters like plaque index, gingival index, probing pocket depth, clinical attachment level and gingival recession were recorded at baseline, 6 weeks, 3, 6 and 9 months. Radiographic evaluation (Linear CADIA) at 6 and 9 months; and intrasurgical measurements at baseline and 9 months were carried out to evaluate the defect fill, change in alveolar crest height and defect resolution.

Significant reduction in all clinical parameters was observed in both the groups. On comparison no statistical significance was observed between the two groups. Radiographically, in site A there was significant defect fill of 78.4 and 97.2% at 6 and 9 months respectively. Whereas in site B reduction was 78.4 and 97.2% at 6 and 9 months respectively. After surgical re-entry, there was significant defect fill of 89.2 and 74% in both groups.

Individually both the graft and membrane have shown promising results in the management of periodontal intrabony defects. But the added benefit by combining Cerasorb® with BioMend ExtendTM was not observed statistically in both clinical radiographic findings.

Kishore DT, Bandiwadekar T, Padma R, Debunath S, Profulla, Reddy A. Evaluation of Relative Efficacy of β-Tricalcium Phosphate with and without Type I Resorbable Collagen Membrane in Periodontal Infrabony Defects: A Clinical and Radiographic Study. J Contemp Dent Pract 2013;14(2): 193-201.

The patient's head can be slightly rotated sagittally vertically or transversely with the head holding device. Because of such improper positions due to head rotation, an error can occur in cephalometric measurements. The purpose of this study was to identify the projection errors of lateral cephalometric radiograph due to head rotation in the vertical Z-axis toward the focal spot.

Ten human dry skulls with permanent dentition were collected. Each dry skull was rotated from 0° to +20° at 5° intervals. A vertical axis, the Z-axis, was used as a rotational axis to have 50 lateral cephalometric radiographs exposed. Four linear (S-N, Go-Me, N-Me, S-Go) and six angular measurements (SNA, SNB, N-S-Ar, S-Ar-Go, Ar-Go-Me, ABmandibular plane angle) were calculated manually.

The findings were that: (1) Angular measurements have fewer projection errors than linear measurements. (2) The greater the number of landmarks on the midsagittal plane that are included in angular measurements, the fewer the projection errors occurring. (3) Horizontal linear measurements have more projection errors than vertical linear measurements.

The angular measurements of lateral cephalometric radiographs are more useful than linear measurements in minimizing the projection errors associated with head rotation on a vertical axis toward the focal spot.

Naresh V, Lokesh NK, Pratapvarma KVV, Srikrishna C, Chakravarthy VG, Shamnur N. Cephalometric Assessment of Effect of Head Rotation toward Focal Spot on Lateral Cephalometric Radiographs. J Contemp Dent Pract 2013;14(2):202-207.

The aim of the study was to evaluate esthetic improvement with the use of 35% hydrogen peroxide clinical bleaching as related to the different grades of enamel fluorosis in vivo and to study adverse effect of clinical bleaching with 35% hydrogen peroxide on teeth and gingiva.

A total of 60 children of different grades of fluorosis were included in the study. With 35% hydrogen peroxide-based dual activated bleaching system, in-office vital teeth bleaching was carried out for each subject. Clinical evaluation for improvement in esthetics, effect on teeth and gingiva were performed for each child during preoperative, immediate postoperative and later 6 months postoperative period. For evaluation and comparison, all the collected data were subjected to statistical analysis.

Although in all the subjects, partial shade relapse was seen over a period of time, good homogeneous and esthetic results were seen in very mild and mild cases. A total of 35% hydrogen peroxide in-office bleaching has no adverse effect on teeth and gingiva.

Comparing all the three groups who participated in the study, 35% hydrogen peroxide in-office bleaching seems to be very effective in very mild and mild forms of fluorosis.

In very mild and mild forms of fluorosis, in-office vital tooth bleaching with 35% hydrogen peroxide is the most conservative and effective approach in esthetic improvement.

Shanbhag R, Veena R, Nanjannawar G, Patil J, Hugar S, Vagrali H. Use of Clinical Bleaching with 35% Hydrogen Peroxide in Esthetic Improvement of Fluorotic Human Incisors in vivo. J Contemp Dent Pract 2013;14(2): 208-216.

The purpose of the present in vivo study was to measure the efficacy of different gingival displacement materials in achieving gingival tissue displacement and to compare the efficacy of Expasyl displacement paste (Pierre Rolland, France) and gingival displacement cord for gingival displacement.

Sixteen subjects were included in the study. Premolars were prepared to receive full veneer crown, gingival displacement was carried using gingival retraction cord and gingival displacement paste. Impression of the gingival sulcus was made. Sulcus width after displacement was measured under magnification.

The mean displacement value of sulcus width was 0.21 ± 0.01 mm for the gingival retraction cord and 0.26 ± 0.02 mm for the gingival displacement paste. ‘F’ test was used for statistical analysis. Difference among the two test agents was statistically significant (p < 0.01).

Gingival displacement paste showed better response in achieving horizontal displacement of the gingival sulcus than gingival retraction cord.

Gingival displacement helps in recording the unprepared tooth surface adjacent to the finish line in the impression being made, thereby helping a better marginal adaptation and emergence profile in the extracoronal restoration.

Prasanna GSR, Reddy K, Kumar RKN, Shivaprakash S. Evaluation of Efficacy of Different Gingival Displacement Materials on Gingival Sulcus Width. J Contemp Dent Pract 2013;14(2):217-221.

The purpose of this study was to determine the efficiency of locking plates and screw system in the treatment of mandibular fracture surgery, by comparing them with the conventional system.

A protocol for selection of patients with mandibular fractures was developed. One hundred patients were treated by locking plates and screw system and another 100 patients were treated with the conventional system. The patients were prospectively evaluated for the duration of surgery, difficulties encountered during surgery, neurologic changes, postsurgical occlusal relationship, adequacy of reduction and postsurgical complications. Data were compared for statistical significance with Chi-square test and Z-test.

There was statistically significant difference in postoperative infection, postoperative occlusal discrepancy, postoperative plate fracture and postoperative screw loosening and mobility of the fractured fragments and also the working time between the two systems.

The results of the present study are comparable with other published data and support the notion that the locking miniplate system is a valid alternative to conventional miniplates with several advantages, the only drawback being the additional working time required during adaptation of this hardware.

Nayak SS, Pushpalatha C, Tammanavar PS, Naduwinmani SL, Mohan M. Efficacy of Locking Plates/ Screw System in Mandibular Fracture Surgery. J Contemp Dent Pract 2013;14(2):222-226.

The aim is to radiographically quantify the bone density and relate the same with observer strategy in the bone healing.

To assess pattern of bone regeneration following grafting of defects with hydroxyapatite after apicoectomy/cystic enucleation.

An observer strategy involving trained and experienced examiners used in large series of cases, evaluated radiographically over a period of 1 year with intervals. The cases were grouped into different categories depending on (1) surgical site outline merging with material margin, (2) internal portion of surgical site (i.e. bone formation characteristics) and (3) density of surgical site. The radiographs examined by blind process and the findings were tabulated. Operating surgeon (oral surgeon) has done the interpretation of data to create observer strategy of grafting cases.

The outline of the defect was changed, partly reduced and completely absent along with remodeling, which showed ground glass, specular or trabecular pattern of bone over a time with increasing density correlating bone regeneration within a short duration. The applied strategy and classification are recommended for follow-up studies. In this study the characteristics of the new bone formation were also delineated. This strategy is helpful for follow-up studies; implant procedures and so; to know quality and condition of bone after treatment.

Kattimani VS, Bajantai NV, Sriram SK, Sriram RR, Rao VKP, Desai PD. Observer Strategy and Radiographic Classification of Healing after Grafting of Cystic Defects in Maxilla: A Radiological Appraisal. J Contemp Dent Pract 2013;14(2):227-232.

The aim of the present study was to evaluate the effect of periodontal therapy on serum C-reactive protein (CRP) levels in patients with gingivitis and chronic periodontitis.

A total of 60 subjects (30 males and 30 females) were included in the study with 20 subjects in each of the groups classified based on community periodontal index (CPI) scores: I: Healthy, II: Gingivitis, III: Mild periodontitis. Periodontal therapy was performed on groups II and III patients. Venous blood was collected from each subject at baseline and 3 months after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using immunoturbidimetric method.

The present study demonstrated that the periodontitis group had a higher mean CRP levels (2.49 ± 0.47 ng/ml) as compared to the gingivitis group (1.40 ± 0.32 ng/ml) and healthy group (0.56 ± 0.20 ng/ml). The mean CRP values after periodontal therapy were found to be reduced to 0.44 ± 0.23 ng/ml in group II and 1.30 ± 0.36 ng/ml in group III patients.

Within the limitations of this study, it can be concluded that CRP level progressively increases from periodontal health to disease. A decrease in CRP levels with periodontal treatment was also observed.

Due to its opsonizing abilities CRP plays an important role in the innate host defence. It can be hypothesized that CRP is a potential biomarker of periodontal disease. A number of studies have reported elevated serum CRP levels in periodontitis subjects. Long standing periodontal disease and raised CRP levels enhance the risk of cardiovascular disease, cerebrovascular accidents and preterm low birth weight infants. There is also evidence that effective periodontal therapy can lower serum CRP levels. However, the data of interventional studies on CRP in gingivitis and periodontitis is scarce.

Patil VA, Desai MH. Effect of Periodontal Therapy on Serum C-Reactive Protein Levels in Patients with Gingivitis and Chronic Periodontitis: A Clinicobiochemical Study. J Contemp Dent Pract 2013;14(2):233-237.

Few cephalometric analyses have been put forward to assess the treatment outcome after orthodontic treatment. However, these analyses are somewhat complicated and time consuming. The Tetragon analysis is introduced with measurement of treatment outcome as one of its objectives.

The study was undertaken to evaluate the treatment outcome by checking the skeletal and dental changes using pretreatment and post-treatment radiographs and to evaluate the efficiency of treatment in the Department of Orthodontics, College of Dental Sciences, Davangere, using the Tetragon analysis.

Records of 35 finished patients with fixed orthodontic therapy using preadjusted edgewise appliance were selected. The samples were analyzed separately for the skeletal parameters consisting of skeletal class I, II and III using Tetragon analysis.

The post-treatment reduction of upper incisor palatal plane angle was found to be statistically significant in skeletal class I (p < 0.01) and skeletal class II patients (p < 0.05). The post-treatment increase in interincisal angle was found to be statistically significant in skeletal class I (p < 0.01) class II patients (p < 0.05).

Fixed appliance therapy reduced the proclination of upper incisors and increased the interincisal angle in skeletal class I and II cases but not in skeletal class III cases. The lower incisal angulation and the maxilla-mandibular plane angle did change significantly and so were the angles of the Trigon. The Tetragon analysis proved easy to measure the treatment outcome.

Bhasin VS, Tammannavar P, Pushpalatha C, Nayak SS, Viswanathan V. A Cephalometric Evaluation of Pretreatment and Post-treatment Outcome using Tetragon Analysis: A Retrospective Study. J Contemp Dent Pract 2013;14(2):238-243.

Calixto LR, Tonetto MR, Pinto SCS, Barros ED, Borges AH, Lima FVP, de Andrade MF, Bandéca MC. Degree of Conversion and Hardness of Two Different Systems of the Vitrebond^TM Glass Ionomer Cement Light Cured with Blue LED. J Contemp Dent Pract 2013;14(2): 244-249.

To search if the shear bond strengths of brackets would change after two different base-cleaning procedures such as sandblasting or carbide bur cleaning, and to determine if a previously bonded tooth surface had any effect on bond strength.

A total of 120 new brackets were first bonded to 120 extracted premolars and then debonded and bond strength was recorded. The debonded brackets were divided into two groups and recycled either by sandblasting or tungsten-carbide bur cleaning. Sixty recycled brackets were divided into two subgroups: In each group; 30 recycled brackets were bonded to unused 30 extracted premolars. The remaining brackets were bonded to 30 previously used premolars. The brackets were debonded again and their bond strengths were remeasured.

Bond strength of rebonded brackets after sandblasting was not significantly different from that of new brackets while the bond strength of rebonded brackets after carbide bur cleaning group significantly decreased. The previously bonded tooth surface did not affect the bond strength significantly.

This study showed that rebonding the brackets after sandblasting supplies sufficient bond strength. Previously bonded tooth surface did not cause a decreasing effect on bond strength. However, when carbide bur cleaning procedure is chosen, the clinician should proceed cautiously.

Aksu M, Kocadereli I. Influence of Two Different Bracket Base Cleaning Procedures on Shear Bond Strength Reliability. J Contemp Dent Pract 2013;14(2):250-254.

Base metals have a wide use in casting methods. Sometimes they are reused in laboratories which may have an adverse effect on the restoration marginal integrity. This study aimed to investigate the effect of recasting of alloys on marginal integrity of restorations.

Models with two types of finishing lines shoulder bevel 45° and shoulder 135° were produced and 15 wax copings were formed on each one of them. Each group containing 15 copings was divided into three subgroups A, B and C. Group A was casted with 100% new alloy, group B with 50% new and 50% recasted alloy and group C with 100% recasted alloy. Obtained metal copings were placed on dies and marginal gap size between restoration margin and the dies finishing line was measured using metric microscope and Moticam camera in four points, buccal, lingual, mesial and distal.

A significant difference in mean marginal gap size exists among three types of alloys used (p-value = 0.036). A significant difference is observed between mean marginal gap size of two types of finishing lines for different alloys (p-value = 0.001).

Using 100% recasted alloy is not recommended for any of the two types of finishing lines.

Bajoghli F, Nosouhian S, Badrian H, Goroohi H, Saberian A, Gadesi L. Effect of Base Metal Alloys Recasting on Marginal Integrity of Castable Crowns. J Contemp Dent Pract 2013;14(2):255-258.

The aim of this study was to quantify and compare the amount of methyl methacrylate (MMA) monomer released from three different denture base acrylic material processed by different polymerization methods and storage conditions.

Microwave-cured, conventional heat and injection-technique acrylic polymerized materials were stored in neutral (pH = 7) and acidic (pH = 4.5) artificial saliva for 24 hours at the room temperature, separately. The residual MMA content was determined by high performance liquid chromatography (HPLC).

The MMA leaching from resins showed that microwave-cured material has lower residual MMA leach compared both conventional and injection-technique on neutral saliva storage conditions.

The all data's exhibited higher MMA release into an acidic saliva environment than neutral artificial saliva and there were no significant differences between the materials groups on acidic saliva storage conditions.

Microwave polymerization method might has some advantages on reducing release of MMA concentration and may contributory effect upon polymerization reaction on neutral pH storage condition, therefore methods of polymerization should be considered as amount of monomer release.

Tuna EB, Rohlig BG, Sancakli E, Evlioglu G, Gencay K. Influence of Acrylic Resin Polymerization Methods on Residual Monomer Release. J Contemp Dent Pract 2013;14(2):259-264.

Aim of the present study was to comparatively evaluate dimensional accuracy of newely introduced elastomeric impression material after repeated pours at different time intervals.

In the present study a total of 20 (10 + 10) impressions of master model were made from vinyl polyether silicone and vinyl polysiloxane impression material. Each impression was repeatedly poured at 1, 24 hours and 14 days. Therefore, a total of 60 casts were obtained. Casts obtained were scanned with three-dimensional (3D) laser scanner and measurements were done.

Vinyl polyether silicone produced overall undersized dies, with greatest change being 0.14% only after 14 days. Vinyl polysiloxane produced smaller dies after 1 and 24 hours and larger dies after 14 days, differing from master model by only 0.07% for the smallest die and to 0.02% for the largest die.

All the deviations measured from the master model with both the impression materials were within a clinically acceptable range.

In a typical fixed prosthodontic treatment accuracy of prosthesis is critical as it determines the success, failure and the prognosis of treatment including abutments. This is mainly dependent upon fit of prosthesis which in turn is dependent on dimensional accuracy of dies, poured from elastomeric impressions.

Pandita A, Jain T, Yadav NS, Feroz SMA, Pradeep, Diwedi A. Evaluation and Comparison of Dimensional Accuracy of Newly Introduced Elastomeric Impression Material using 3D Laser Scanners: An in vitro Study. J Contemp Dent Pract 2013;14(2):265-268.

In recent years some new solvent-free dental adhesives have been marketed. This study evaluated bonding effectiveness of a new one-step solvent-free self-etch adhesive in comparison with a common two-step self-etch adhesive used as gold standard.

Flat enamel and dentin surfaces were prepared on 60 incisors using silicon carbide papers. Clearfil SE Bond (CSEB) and Bond 1SF (B1SF) adhesives were applied on enamel/dentin surfaces in four groups (n = 15): (1) Enamel surface and CSEB, (2) dentin surface and CSEB, (3) enamel surface and B1SF, (4) dentin surface and B1SF. Composite resin buildups were carried out using Z100 composite resin. All the specimens were stored for 24 hours at 37¢XC and 100% relative humidity. After 500 rounds of thermocycling, shear bond strength (SBS) test was performed using a universal testing machine at 1 mm/min crosshead speed. Data were analyzed with one-way ANOVA and a post hoc Tukey test (α = 0.05). In each experimental group, two additional specimens were prepared for scanning electron microscopy evaluation.

Significant differences were observed between the study groups (p < 0.001). The highest enamel/dentin bond strengths were recorded in group 1 (CSEB) (p < 0.001). The SBS of the two-step self-etch adhesive to enamel and dentin was significantly higher than that of the one-step self-etch adhesive (p < 0.001). There was no significant difference between enamel and dentin SBS with B1SF (p = 0.559).

Within the limitations of the present study, when bonded to enamel and dentin the solvent-free adhesive B1SF underperforms as compared to CSEB as the control gold standard.

Shirban F, Khoroushi M, Shirban M. A New Solvent-free One-Step Self-Etch Adhesive: Bond Strength to Tooth Structures. J Contemp Dent Pract 2013;14(2):269-274.

To evaluate the effect of 2% chlorhexidine, 2% sodium hypochlorite, 3% hydrogen peroxide on shear bond strength of composite resin to dentin using two-step and onestep self-etch bonding systems and to study the mode of failure of specimens under stereomicroscope.

Eighty extracted sound human posterior teeth were used. The occlusal surfaces were ground to expose the dentin and were then randomly divided into 4 main groups. In group I, no cavity disinfectant was used and served as control. In groups II, III, IV, 2% chlorhexidine, 2% sodium hypochlorite and 3% hydrogen peroxide were used as cavity disinfectants respectively. Each group was then divided into two subgroups of 10 teeth each according to the bonding agent used, two-step self-etch (Adper SE Plus) and one-step self-etch (Adper Easy One) respectively. A transparent cylindrical plastic tube was loaded with microhybrid composite and placed over the dentin and light cured for 40 seconds. The specimens were subjected to shear stress in the universal testing machine.

Pretreatment with 2% chlorhexidine, 2% sodium hypochlorite and 3% hydrogen peroxide, had a negative effect on the shear bond strength of self-etching bonding systems.

The highest bond strength was found in 2% chlorhexidine group followed by 2% sodium hypochlorite group and the lowest bond strength was found in 3% hydrogen peroxide group.

All three cavity disinfectants used in this study reduced the shear bond strength and hence should be used with caution.

Reddy MSC, Mahesh MC, Bhandary S, Pramod J, Shetty A. Evaluation of Effect of Different Cavity Disinfectants on Shear Bond Strength of Composite Resin to Dentin using Two-Step Self-Etch and One-Step Self-Etch Bonding Systems: A Comparative in vitro Study. J Contemp Dent Pract 2013;14(2):275-280.

In routine histopathology, xylene has been used in tissue processing and staining. Presently health hazards of xylene are well documented and a safer substitute is an absolute necessity.

The present study was conducted to evaluate the efficacy of mineral oil as a deparaffinizing agent when compared to that of xylene by using hematoxylin and eosin (H&E) staining.

Thirty paraffin-embedded tissue blocks were randomly selected and two sections were taken from each block. Thirty sections were stained with conventional H&E method (group A) using xylene as deparaffinizing agent and 30 were stained with xylene free method using refined mineral oil (group B). Sections were blinded and analyzed by two pathologists using the parameters of uniformity, clarity and intensity of nuclear and cytoplasmic staining respectively (satisfactory = score 1, unsatisfactory = score 0). Score „d 4 was considered to be adequate for diagnosis.

100% of sections in group A and 93.3% of sections in group B were adequate for diagnosis (p-value 0.150).

The study recommends refined mineral oil as a biofriendly and effective xylene substitute in deparaffinization of tissue sections.

Premalatha BR, Patil S, Rao RS, Indu M. Mineral Oil—A Biofriendly Substitute for Xylene in Deparaffinization: A Novel Method. J Contemp Dent Pract 2013;14(2):281-286.

When two canine abutment teeth are used to support an overdenture prosthesis, optimal stress distribution to minimize forces to abutments is desired.

This study used photoelastic stress analysis to compare the stress patterns generated around canine abutments using two different overdenture retainer designs.

Two canine abutments were anchored in the photoelastic mandible and overdentures were fabricated using two different overdenture attachments. The fitting surface of dentures were lined with resilient layer of light bodied silicon rubberbase impression material to simulate oral mucosa. The attachments used were Bar-Clip and Short coping type. Verticalload of 5 to 50 lb was applied by jaw simulator. Resultant stress fringes were photographed and evaluated quantitatively.

Bar-Clip type of attachment transmitted more amount of stress than short coping type transmitted. There was gross difference in magnitude of stresses between two types of retainers.

As the retentivity of the attachment increased there was more stress concentration around the abutments.

Dwivedi A, Vyas R, Gupta A. Quantitative Evaluation and Comparison of Stress Transmission Characteristics of Bar-Clip and Short Coping Overdenture Attachments Under Dynamic Loading: A Photoelastic Stress Analysis. J Contemp Dent Pract 2013;14(2):287-292.

To investigate the pattern of routine endodontic practices among Nigerian dentists.

This study was a questionnaire-based survey of samples of dentists in the Nigerian cities of Enugu and Benin. The self-administered questionnaire contained 25 close-ended questions with multiple choice options. The data collected included demographic details of respondents, root canal preparation techniques, irrigants and intracanal medicaments used, the number of appointments, method of working length determination, root filling techniques, cements used, and the scope of treatment performed.

Most respondents used sodium hypochlorite as the irrigant, the step back technique for canal preparation, and lateral condensation with a zinc oxide-eugenol-based sealer for obturation. Most respondents did root canal treatment on all types of teeth and used radiographs to determine the working length 70% of the time. Most respondents followed up their patients for less than 12 months and most treated teeth with periapical areas larger than 10 mm by root canal therapy combined with apical surgery.

Most Nigerian dentists use step back technique for canal preparation and lateral condensation for obturation.

Endodontic practice by Nigerian dentists differs from some established practice quality guidelines in many other countries, particularly in nonperfusion of modern techniques into practice, popularity of antibiotic use for endodontic emergencies and a high rate of perforations.

Udoye CI, Sede MA, Jafarzadeh H, Abbott PV. A Survey of Endodontic Practices among Dentists in Nigeria. J Contemp Dent Pract 2013;14(2):293-298.

Musculoskeletal disorders (MSDs) are commonly experienced in dentistry. The objective of this study is to determine the prevalence of ergonomics and MSDs among dental professionals.

A cross-sectional survey was conducted among 170 dentists of different specialties. The questionnaire gathered information regarding demographic details, MSDs, work duration, working status, awareness of ergonomics, etc. Data was analyzed using SPSS version 15.0. Student's t-test and analysis of variance (ANOVA) test was used for comparison in mean scores. Stepwise multiple linear regression analysis was used to assess the independent variables that significantly influenced the variance in the dependent variable (pain).

It was found that 73.9% of the participants reported musculoskeletal pain and most common painful sites were neck and back. More than half of the participants, i.e. 232 (59.3%) were aware of correct ergonomic posture regarding dental. Almost percentage of pain increased significantly with increase in age and working time. Among all specialties, prosthodontics were found to have more prevalence of MSDs.

The appearance of musculoskeletal symptoms among dental professionals was quite common. It suggested that ergonomics should be covered in the educational system to reduce risks to dental practitioners.

Gopinadh A, Devi KNN, Chiramana S, Manne P, Sampath A, Babu MS. Ergonomics and Musculoskeletal Disorder: As an Occupational Hazard in Dentistry. J Contemp Dent Pract 2013;14(2):299-303.

Sreedevi G, Srinivas B, Reddy TPK, Prasad CMSK, Kumar BS, Satish R. Heritability of Thirty Cephalometric Parameters on Monozygotic and Dizygotic Twins: Twin Study Method. J Contemp Dent Pract 2013; 14(2):304-311.

To compare pretreatment and post-treatment dental arches in relation to intercanine and intermolar width changes in extraction and nonextraction treatment in class I patients.

In this retrospective study pretreatment and post-treatment dental casts of 60 patients (30 extractions of first premolars and 30 nonextractions) were selected.

Anterior and posterior arch widths in the canine and molar regions from the most labial aspect of buccal surfaces, the canines and the molars were measured with the help of digital caliper on the study models and compared statistically to determine whether the dental arches were narrower after extraction treatment.

At the start of the treatment there were no statistically significant differences in maxillary and mandibular intercanine widths in both groups. At the end of treatment in both the groups anterior and posterior arch width changes were not significant except for the intercanine dimension which was 0.82 mm larger (p < 0.05) in the extraction group.

The extraction treatment does not result in narrower dental arches than nonextraction treatment in intercanine and intermolar region.

It is documented that the arch widths determine smile esthetics and treatment stability. According to the findings of the present study the arch widths in extraction treatments are not narrower than nonextraction so there will not be any compromising effects on esthetics and treatment stability.

Golwalkar SA, Shetty V. Arch Widths after Extraction and Nonextraction Treatment in Class I Patients. J Contemp Dent Pract 2013;14(2):312-315.

Tonetto MR, Bandéca MC, de Oliveira Barud HG, Pinto SCS, Lima DM, Borges AH, de Campos EA, de Andrade MF. Influence of Artificial Aging in Marginal Adaptation of Mixed Class V Cavities. J Contemp Dent Pract 2013;14(2):316-319.

To present a case of multidisciplinary management and fixed rehabilitation of a young girl with amelogenesis imperfecta (AI), a severe open bite and occlusal instability.

AI is a genetic disorder characterized by enamel malformations, disturbances in tooth eruption and significant attrition. Early diagnosis is essential, since rapid breakdown of tooth structure may occur, giving rise to acute symptoms and complicated treatment. As AI is frequently accompanied by unesthetic appearance, open bite deformity and malocclusion, a multidisciplinary approach is often required.

This clinical report describes the condition and presents the case of a 10-year-old girl with hypocalcified form of AI. Orthodontic treatment and orthognathic surgery were performed as part of the prosthetic treatment plan to achieve acceptable and durable results. They consisted of correcting class II, posterior crossbite and anterior open bite with a fixed orthodontic appliance, Lefort I osteotomy, bilateral mandibular ramus osteotomy and genioplasty. Prosthodontics treatment consisted of metal-ceramic crowns with low-fusing ceramic for good long-term results. No deterioration in the rehabilitation was found after 5 years of follow-up.

Complete restoration of severe AI is a long and complex process generally extending over several years.

This article shows the important role of interdisciplinary approach to treating a patient with AI over a period of 8 years.

Millet C, Duprez JP. Multidisciplinary Management of a Child with Severe Open Bite and Amelogenesis Imperfecta. J Contemp Dent Pract 2013;14(2): 320-326.

This study aimed to describe certain common oral manifestations during early childhood that should be known by the pediatric dental surgeon.

The correct diagnosis and treatment of oral manifestations during early childhood is important for children's development. The pediatric dentist is responsible for maintaining oral health in children, since they change constantly during their development and growth.

Four cases of oral lesions are described, in which the diagnosis and related approach for each one is reported. The first was an acute primary herpetic gingivostomatitis, the second, pseudomembranous candidiasis, the third, chickenpox and the last was molluscum.

Professionals who treat children in this age group must be able to diagnose and treat common oral manifestations when necessary and should refer the child to a pediatrician for effective treatment if the presence of any systemic alteration is suspected.

Pathognomonic signs of the most common oral manifestations in early childhood should be known by dentists to improve early diagnosis and proper management.

Padovani MCRL, Barbosa PS, Baeder F, de Sant'Anna GR, Santos MTBR, Guaré RO. Oral Manifestations of Systemic Alterations in Early Childhood. J Contemp Dent Pract 2013;14(2):327-331.

The present case report describes the importance of interdisciplinary approach and gives an understanding on management of an adolescent with unilateral cleft lip and palate.

Failure of fusion between medial nasal process and maxillary process or between the palatal process leads to the formation of clefts. Clefts are result of genetic or environmental factors or a combination of both. Common dental problems associated with clefts includes anterior and posterior crossbites, hypodontia, malformation and abnormal eruption pattern.

A girl, aged 15 years reported with a chief complaint of unesthetic appearance of her maxillary anterior teeth. She had unilateral cleft lip and palate and had received cheiloplasty and palatoplasty when she was in young age and rhinoplasty when she was 14 years of age. At pretreatment evaluation, she had concave profile with maxillary arch constriction and oroantral fistula and mesially tipped maxillary left canine.

This patient's treatment was unconventional, but it was successful in significantly improving her masticatory function and smile, along with favorable dental and facial results. Generalized esthetics and function were significantly improved in this patient without orthognathic surgery, and treatment results were stable 3 years after the appliance removal.

Clinical considerations, sequencing of treatment phases as shown in this case report can be utilized while treating an adolescent with cleft lip and palate.

If the skeletal discrepancy is mild and esthetic concerns are minimal, dental compensation by orthodontic treatment alone might be recommended. The cephalometric analysis and prediction tracings provide further information for deciding whether a patient can be treated by orthodontics alone, or by orthodontics and an orthognathic surgical procedure.

A change in axial inclination of the teeth can camouflage the skeletal relationship adequately. However, one should be cautious in a growing patient, because he or she might outgrow the dental correction so that ultimately skeletal surgery would be indicated.

Adusumilli SP, Sudhakar P, Mummidi B, Reddy KVB, Rao CHH, Raju BHVRK. Interdisciplinary Treatment of an Adolescent with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2013;14(2):332-338.

To describe the options of treatment to remove a sialolith associated with the submandibular gland duct in a patient with epidermolysis bullosa (EB).

Treatment of patients with EB is very complex and involves a multidisciplinary team. This condition is characterized by a spectrum of blistering and mechanical fragility of the skin. One main feature of this disease is the esophageal constriction and possible constriction to the submandibular duct. This alteration may induce the formation of calculi in this duct, which is called sialolith. Once the sialolith obliterates the trajectory of the duct this will lead to a sialolithiasis. The calculi have to be removed.

Seventeen years old female patient with dystrophic EB developed a sialolith at the submandibular duct. She has a limited mouth opening and her tongue was collapsed with mouth floor. The first choice of treatment was the lithotripsy, once this procedure is less invasive and a surgical remove could worse the collapsed tongue. She was with acute pain and with a great augmentation in the submandibular area. Once the patient was debilitated and has difficult to swallow she invariably needed to be hospitalized in order to receive intravenous medication. During the hospitalization the sialolith could be seen through the opening of the duct and the calculi was removed with local anesthesia.

The treatment of sialolithiasis usually does not present major challenges, nevertheless if the sialolithiasis is associated with EB, the treatment became an extremely challenge. In this particular case the option of treatment was the less invasive.

This case report has an enormous clinical relevance once there is no protocol to treat patients with EB and buccal diseases.

Primo BT, da Costa DJ, Stringhini DJ, Rebellato NLB, de Moraes RS, Müller PR, Carneiro VL. Sialolithiasis in the Duct of Submandibular Gland: A Case Report in Patient with Epidermolysis Bullosa. J Contemp Dent Pract 2013;14(2):339-344.

This clinical report presents a rare case of maxillary central incisor with two separate roots.

Unusual morphology of the roots and root canals may exist in any tooth. Recognition of the dental anatomy and its variations is necessary for successful endodontic therapy. It is well known that maxillary incisors are usually single-rooted teeth.

The root canals were instrumented with conventional hand files and Gates Glidden and obturated by using the lateral technique. Recall radiograph after 1 year shows the healing process of the preoperative apical periodontitis.

Clinicians should be aware of unexpected root canal morphology when performing root canal therapy. The present case demonstrated the importance of accurate preoperative radiograph and adequate access preparation.

Maghsoudlou A, Jafarzadeh H, Forghani M. Endodontic Treatment of a Maxillary Central Incisor with Two Roots. J Contemp Dent Pract 2013;14(2):345-347.

Mummidi B, Rao CHH, Prasanna AL, Vijay M, Reddy KVB, Raju MAKV. Esthetic Dentistry in Patients with Bilaterally Missing Maxillary Lateral Incisors: A Multidisciplinary Case Report. J Contemp Dent Pract 2013;14(2):348-354.

An odontogenic keratocyst (OKC) or keratocystic odontogenic tumor (KCOT) and giant cell granuloma (GCG) in the jaws are common lesions which have been studied extensively in detail over the years. However, a lesion showing features of both is exceptionally rare and is reported only twice in the literature till date.

A rare case of OKC in mandible showing foci of GCG like areas is reported in a 29 years old male patient.

It seems to be a collision lesion, though the possibility of KCOT showing a reactive response to form giant cells or it being a rare variant cannot be totally ruled out.

This entity requires aggressive treatment since biological behavior of this unique lesion is difficult to predict unless more of such lesions are reported and followed up in future.

Ravi SB, Prashanthi C, Karun V, Melkundi M, Nyamati S, Annapoorna HB. Collision Lesion of Mandible: Coexistence of Keratocystic Odontogenic Tumor with Central Giant Cell Granuloma: A Rare Case Report. J Contemp Dent Pract 2013;14(2):355-359.

Venkataraghavan K, Patil S, Guvva S, Karthik S, Bhandi S. Abnormal Odontogenesis following Management of Childhood Cancer (Retinoblastoma): Review and a New Variant. J Contemp Dent Pract 2013;14(2):360-364.

Taneja N, Raju S, Mehta R, Kaur N. Review and Update: Advanced Investigation Methods for Diagnosis of Tongue Lesions. J Contemp Dent Pract 2013;14(2):365-369.