Routine staining procedures often pose a problem in differentiating a mitotic cell from an apoptotic cell, deteriorating the reliability of histology grading. Although various new methods have been recommended for identifying mitotic figures (MFs) in tissues, the time factor and cost makes them less feasible. Thus, an attempt was made to evaluate the efficacy of crystal violet and Feulgen reaction in identifying MFs and also to see for any variation in the number of MFs in various grades of Epithelial dysplasia.

Objectives:

1. Using crystal violet and Feulgen stain in the identification and counting of MFs on diagnosed cases of epithelial dysplasia and thereby to evaluate their efficacy.

2. To evaluate the variation in the number of MFs in various grades of epithelial dysplasia.

The study sample includes retrieval of 30 formalin fixed paraffin embedded tissue sections diagnosed for different grades of epithelial dysplasia (WHO grading system, 2005) from the archives, Department of Oral Pathology, MSRDC, Bengaluru. Ten tissue sections each of mild, moderate and severe epithelial dysplasia were stained with H&E, Feulgen and 1% crystal violet stains and the number of MFs were counted. Five cases of cervical carcinoma were taken as control. Stained sections were compared, and data obtained was statistically analyzed using the Kruskal-Wallis test.

A significant increase in the number of MFs (p = 0.02) was observed in Feulgen stained sections as compared to H&E stain.

Feulgen stain can be considered as a simple, reliable, cost-effective and reproducible method of staining MFs.

Rao RS, Patil S, Agarwal A. Comparison and Evaluation of Mitotic Figures in Oral Epithelial Dysplasia using Crystal Violet and Feulgen Stain. J Contemp Dent Pract 2014;15(3):273-277.

Many weapons are available in the arsenal of a dental professional to combat dental caries, which is almost ubiquitously present. From a public health perspective, most of these weapons are far from being an ideal drug. Hence, there is a demand for better and effective antibacterial agents. This factor stimulated the process of the present study. The aim of the study was to determine the effect of ethanol extract of Terminalia chebula on Streptococcus mutans.

Dried ripe fruits of Terminalia chebula were procured and powdered. Physical tests were done to estimate purity of the fruit powder. Hydroethanolic and aqueous extracts were prepared according to standard procedures. Minimum inhibitory concentration of the extracts was determined by tube dilution method and confirmed by agar dilution method. The effect of the hydroethanolic extract on sucrose induced adhesion, glucan-induced aggregation and on glycolysis of Streptococcus mutans was also assessed. Preservative, gelling agent and sweetener were added in suitable quantities to the ethanol extract, and mouthrinse was formulated. Minimum inhibitory concentration of the formulation was also determined.

Yield was better in case of aqueous extract. The Minimum inhibitory concentration of hydroethanolic extract was determined to be 2.5%. Minimum inhibitory concentration of the aqueous extract was determined to be 10%. Hydroethanolic extract of Terminalia chebula (2.5%) inhibited sucrose induced adherence and aggregation of Streptococcus mutans in vitro.

The mouthrinse formulated from ethanol extract of Terminalia chebula demonstrated substantial antibacterial activity and could be used as an effective anticaries agent.

Terminalia chebula mouthrinse can be effectively used in clinical practice as an anticaries mouthrinse with additional benefit being that it is safe and economical.

Nayak SS, Ankola AV, Metgud SC, Bolmal UK. An in vitro Study to determine the Effect of Terminalia chebula Extract and Its Formulation on Streptococcus mutans. J Contemp Dent Pract 2014;15(3):278-282.

Differences in the action of infrared Erbium laser system in regard to the nature of the ablation process and variations on the morphological aspects observed in the superficial structure of the target tissue irradiated, may be correlated to the structural optical modifications of the substrate produced by an interaction of the energy propagated by laser systems.

Lima DM, Tonetto MR, de Mendonça AAM, Elossais AA, Saad JRC, de Andrade MF, Pinto SCS, Bandéca MC. Human Dental Enamel and Dentin Structural Effects after Er:yag Laser Irradiation. J Contemp Dent Pract 2014;15(3):283-287.

To evaluate the association of the polymorphisms in the TGFB3 gene (rs2268626), and the BMP4 gene (rs17563) with dental caries in two different groups (noncleft group and oral cleft group) from a cleft center located at Rio de Janeiro, Brazil.

A total of 486 unrelated children and adolescents with or without caries were evaluated using a cohort design. Data on oral health habits was obtained through a questionnaire and caries data was collected by clinical examination. Genotyping of the selected polymorphisms for TGFB3 and BMP4 were carried out by real-time PCR using the TaqMan assay method from a genomic DNA isolated from buccal epithelial cells of all children and adolescents.

No association was found between BMP4 polymorphism and caries among individuals from both groups. For TGFB3 polymorphism, significant differences were observed for allele and genotype frequencies between caries free and caries affected individuals in oral cleft group (p = 0.013 and 0.006 for allele and genotype frequencies respectively).

Our findings provide evidence suggesting that TGFB3 may be involved in caries susceptibility in oral cleft group.

In the future, the possibility of identifying genes related to caries susceptibility can lead to counseling of the individual that carries gene alterations, with the aim of working on preventive measures for caries as well as bioengineering treatments.

Antunes LS, Tannure PN, Antunes LAA, Reis MF, Costa MC, Gouvêa CVD, Olej B, Granjeiro JM, Küchler EC. Genetic Association for Caries Susceptibility among Cleft Lip and/or Palate Individuals. J Contemp Dent Pract 2014;15(3):288-293.

Oral cancer is the 8th most common cancer worldwide. Squamous cell carcinomas constitute 94% of all oral malignancies and are often preceded by leukoplakia. Despite many adjunctive techniques to monitor transformation of leukoplakia to oral squamous cell carcinoma (OSCC), the mortality rate is on the rise.

Incidentally, patients diagnosed with oral potentially malignant disorders (OPMDs) and oral cancers manifest with low choles-terol levels. Given a thought, hypolipidemia may be a useful adjunctive tool as it reflects the initial changes within the neo-plastic cells, thus giving a red alert in malignant transformation of leukoplakia at the earlier stage.

To evaluate the feasibility of serum lipid profile as an adjunct early marker for malignant transformation of leukoplakia to OSCC.

To estimate the serum cholesterol, triglycerides and lipoprotein (HDL, LDL, VLDL) levels in patients with leukoplakia, OSCC and age matched healthy control group.

To compare the serum cholesterol, triglycerides and lipoprotein levels between patients of leukoplakia, OSCC and age matched healthy control group.

The study group comprised of selected 30 individuals which included 10 each of histopathologically confirmed OSCC, leukoplakia and healthy controls. A written consent was taken from all of them, and a thorough case history was recorded and then venous blood was collected 12 hours post fasting and centrifuged. The serum cholesterol, triglycerides and HDL were estimated by enzymatic and colorimetric methods using commercially available kits — Roche/ Hitachi cobas systems. Chemistry assay QC procured from Bio-Rad was used as control. VLDL and LDL were derived from these values. Results were statistically analyzed using ANOVA and post hoc Tukey Test.

Oral squamous cell carcinoma patients demonstrated significantly lower mean serum cholesterol level (151.60 mg/dl) than the control group (183.70 mg/dl). The mean cholesterol level in leukoplakia patients (173.90 mg/dl) was lower than that of control group (183.70 mg/dl) but higher than that of the OSCC group (151.60 mg/dl) with no statistical significance.

Convenience, universal availability, patient compatibility and simplicity being the merits of serum lipid profile make it a feasible adjunctive prognosticator in leukoplakic patients.

Ganavi BS, Patil S, Rao RS. Evaluation of Serum Lipids and Lipoproteins as Prognosticators in Leukoplakia. J Contemp Dent Pract 2014;15(3):294-299.

The aim of the study was to quantify the presence of mast cells in various inflammatory lesions like periapical granuloma, periapical cyst, inflammatory gingival hyperplasia and pyogenic granuloma. Mast cell degranulation and association with lymphocytes were also recorded in an attempt to understand the role of mast cells in the pathogenesis of these inflammatory lesions.

The quantification of mast cells was done on toluidine blue stained sections of all the four groups of lesions, using the image analyzer software, Image-Pro-Express (Media Cybernetics, USA).

An increased number of mast cells in various inflammatory lesions with a significant difference between the four groups were noted. Mast cell number tended to be greater in the lesions present in the anterior region of the mouth than in the posterior region of the oral cavity. The mean mast cell number decreased with the increasing age which was directly correlated with the age of the patients. Mast cell site, distribution, degranulation and its association with fibroblasts, lymphocytes and blood vessels were noted.

The location of mast cells in different areas, their association with lymphocytes, fibroblasts, endothelial cells, and the phenomenon of degranulation helps to appreciate the release of various mediators and multiple interactions among these cells, leading to increased vascular permeability, angiogenic response, collagen synthesis, regulation of inflammation, bone resorption, and extracellular matrix destruction, thus contributing to the pathogenesis of these inflammatory lesions.

Sheethal HS, Uma K, Rao K, Priya NS, Umadevi HS, Smitha T. A Quantitative Analysis of Mast Cells in Inflammatory Periapical and Gingival Lesions. J Contemp Dent Pract 2014;15(3):300-305.

The purpose of this study was to analyze the cervicoocclusal dimensions of brackets used in lingual orthodontics for maxillary and mandibular central and lateral incisors, to compare them with the numbers informed by the manufacturer.

The brackets were placed in a template and analyzed by scanning electron microscopy (SEM), evaluating the images with the aid of a software that allowed determination of reference points, tracing of lines on the bracket images and measurement of the distances.

Brackets manufactured by Dm Ceosa Hiro, Tecnident PSWb and Dentaurum Magic did not present statistically significant differences between the mean values of slot heights and the values informed by manufacturers. Conversely, the brands Ormco 7th generation, Ormco STb, GAC Innovation L, ORJORG, Tecnident, Ormco STb LSW and Adenta evolution STL exhibited statistically significant differences.

In general, there was a deficiency in the standardization of cervico-occlusal measurements of slots of the brackets analyzed.

Manufacturers should be attentive to the quality control of their materials. Future studies will analyze the actual clinical influence of these findings on the orthodontic mechanics.

Cotrim-Ferreira A, Cotrim-Ferreira F, Vellini-Ferreira F, Peron DF, Carvalho C, Torres FC. Evaluation of Cervico-occlusal Dimensions of Maxillary and Mandibular Incisor Brackets for Lingual Orthodontics. J Contemp Dent Pract 2014;15(3):306-311.

da Silva TM, Alves FRF. Ex vivo Accuracy of Root Zx Ii, Root ZX Mini and RomiApex A-15 Apex Locators in Extracted Vital Pulp Teeth. J Contemp Dent Pract 2014;15(3):312-314.

Hashem M, Binmgren MA, Alsaleem SO, Vellappally S, Assery MK, Sukumaran A. The Impact of Polymerization Method on Tensile Bond Strength between Denture Base and Acrylic Teeth. J Contemp Dent Pract 2014; 15(3):315-318.

To investigate the influence of different staining beverages on color stability, surface roughness and microhardness of silorane and methacrylate-based composite resins.

Three different composite resins (Filtek Silorane, Filtek P60, Filtek Supreme XT) were tested. Thirty cylindrical specimens (10 × 2 mm) per material were prepared and polished with a series of aluminum-oxide polishing disks. Each group was then randomly subdivided into three groups according to the test beverages: distilled water (control), cola and coffee. The samples were immersed into different beverages for 15 days. Color, surface roughness and microhardness values were measured by a spectrophotometer, prophylometer and Vickers hardness device respectively, at baseline and after 15 days. The data were subjected to statistical analysis.

Immersion in coffee resulted in a significant discoloration for all the composites tested, although the color change was lower in Filtek Silorane than that of MBCs (p < 0.05). All the composites tested showed similar surface roughness changes after immersion in different beverages (p > 0.05). Besides coffee caused more roughness change than others. Immersion in coffee caused highest microhardness change in Filtek Supreme XT (p < 0.05).

Cola and coffee altered, to some degree, the color, surface roughness and/or microhardness of the tested resin composites, depending on the characteristics of the materials.

Karaman E, Tuncer D, Firat E, Ozdemir OS, Karahan S. Influence of Different Staining Beverages on Color Stability, Surface Roughness and Microhardness of Silorane and Methacrylate-based Composite Resins. J Contemp Dent Pract 2014;15(3):319-325.

Pressing esthetic demands of good looking make people undergo bleaching procedures. However, the effect of bleaching agents on esthetic restorative materials with different surface preparations has been poorly studied.

The aim of this study was to examine the effect of a homebleaching agent (carbamide peroxide: CP 38%) on the surface roughness of the polished fiber reinforced composite (FRC), overglazed, autoglazed, or polished ceramic samples.

Twenty standardized cylindrical specimens were made of each of the following groups: overglazed, autoglazed, polished porcelain and also FRC. The test specimens exposed to the CP 38%, 15 minutes, twice a day for 2 weeks according to the manufacturer's recommendation. Six samples from each group were selected randomly to form negative controls. Surface roughness measurements (Ra, micrometer) for baseline, test and control specimens were performed by use of a profilometer. Paired t-test, Mann-Whitney test, and Kruskal-Wallis test were used for statistical analyses.

The data showed that bleaching with CP 38% significantly increased the surface roughness of all the test samples (p < 0.05). The type of surface preparation caused significant differences between the susceptibility of porcelain subgroups to bleaching (p < 0.05). The polished porcelain specimens showed the highest changes after bleaching.

CP 38% significantly increases the surface roughness of the porcelains and FRC. The type of surface condition affects the amenability of the porcelain surface to the bleaching agent. Glazed porcelains were more resistant to roughness than the polished porcelains and also the composite.

Roughening of porcelain and FRC occur following bleaching procedure. No special surface preparation of indirect esthetic restorative materials can completely preserve these materials from adverse effects of bleaching agents.

Torabi K, Rasaeipour S, Khaledi AA, Vojdani M, Ghodsi S. Evaluation of the Effect of a Homebleaching Agent on the Surface Characteristics of Indirect Esthetic Restorative Materials: Part I—Roughness. J Contemp Dent Pract 2014;15(3):326-330.

Cavalheiro JP, Tonetto MR, Borges ÁH, Bandéca MC, dos Santos RSS, de Campos EA, Saad JRC, Dantas AAR, de Andrade MF. Marginal Adaptation of Class V Restorations with Current-Generation Dentin-Bonding Agents: Effect of Different Dentin Surface Treatments. J Contemp Dent Pract 2014;15(3):331-335.

To evaluate the push-out bond strength of Biodentine (BD) in comparison with two available calcium silicate based materials, bioaggregate (BA) and ProRoot MTA (WMTA).

One hundred and twenty-three root dentin slices of freshly extracted single rooted human teeth were randomly divided into three groups (n = 41) according to the used test material: WMTA, BA, BD. After canal space preparation, the filling materials were placed inside the lumen of the slices. After 72 hours, the maximum force applied to materials at the time of dislodgement was recorded and slices were then examined under a stereomicroscope at ×40 magnification to determine the nature of bond failure. Analysis of variance (ANOVA) test was used to compare means of push-out bond strength. Post-hoc test was then accomplished for multiple comparisons. Chi-square test was used to determine if there is significant association between the type of material and type of failure.

The mean push-out bond strength ± standard deviation in MPa values of WMTA, BA and BD were 23.26 ± 5.49, 9.57 ± 3.45, 21.86 ± 6.9, respectively. There was no significant difference between the means of WMTA and BD (p = 0.566), but the mean of BA was significantly lower than those of WMTA and BD (p = 0.000). Under stereomicroscope, WMTA and BA showed a majority of mixed type of failure than cohesive failure, while BD showed the opposite. No adhesive failure was observed in any specimen.

The findings of the present study imply that the force needed for BD displacement is similar to WMTA and significantly higher than the force required to displace BA.

Alsubait SA, Hashem Q, AlHargan N, AlMohimeed K, Alkahtani A. Comparative Evaluation of Push-out Bond Strength of ProRoot MTA, Bioaggregate and Biodentine. J Contemp Dent Pract 2014;15(3):336-340.

Ramadan is a great opportunity for scientific research due to its peculiar nature. This study was designed to investigate whether morning saliva cortisol pick can change during and after Ramadan compared to before it.

A total of 30 healthy volunteer men (aged between 30 and 76 years) were asked to participate in a cross-sectional study between August 12 and September 10, 2010. Saliva was collected 2 weeks before the beginning of Ramadan (BR), during the first week (R1), middle (R2), the last week (R3) of Ramadan and 3 weeks after Ramadan (AR). Cortisol concentration was analyzed by ELISA. Statistical analysis of one-way repeated measures analysis of variance (ANOVA) was used.

The mean unstimulated saliva cortisol concentration and its output were significantly higher in the BR than during and after Ramadan.

Mean saliva cortisol concentration and its output tended to be lower during and 3 weeks after Ramadan.

Cortisol as a stress hormone seems to be low during Ramadan.

Vasaghi-Gharamaleki B, Mirzaii-Dizgah I. Unstimulated Whole Saliva Cortisol Levels during Ramadan in Iranian Muslims. J Contemp Dent Pract 2014;15(3):341-344.

The aim of this study was to evaluate women's oral hygiene knowledge, practice, and use of dental services during pregnancy in the north of Jordan.

Voluntary sample of 154 pregnant women of 18 to 40 years old were invited to participate in the study. They were asked to read a self-designated questionnaire and a cover letter which explained the purpose of the study. The questionnaire addressed self-reported demographics, knowledge, practice and use of dental services during pregnancy. Data were statistically analyzed using Chi-square test to determine statistically significant differences across knowledge, practice and use of dental services during pregnancy.

The sample included 29.3% aged 20 to 24 years old; 33.1% having bachelor degree; and 66.9% were housewives. The majority of study sample 68.2% knew they need dental consultation during pregnancy; however, 39.5% received dental consultation during pregnancy. Majority 62.4% brushed their teeth regularly; however, 73.2% does not use auxiliary dental hygiene devices. Majority 44.5% visited dentist, when they feel pain. Statistically significant association were found between educational level and knowledge about need to dental consultation during pregnancy (p = 0.012); educational level and knowledge about link between pregnancy and periodontal diseases (p = 0.01); and economic status and use of auxiliary dental hygiene devices during pregnancy (p = 0.040).

Pregnant women brushed their teeth regularly and visited dentist occasionally. Income was significantly associated with increase use of auxiliary dental hygiene devices. Educational level was significantly associated with mothers’ knowledge about the need for consultation and possible link between pregnancy and periodontal diseases.

Malkawi ZA, Tubaishat RS. Knowledge, Practice and Utilization of Dental Services among Pregnant Women in the North of Jordan. J Contemp Dent Pract 2014;15(3):345-351.

Eighty-six men requiring seminal fluid analysis as part of an on-going investigation for infertility in their spouses were serially recruited into the study. Basic dental and periodontal examination were performed. Each participant was also screened for periodontitis using a lateral flow immunoassay kit which detected levels of active membrane metalloproteinase-8. Results were read-off as a color change. Due to some incomplete entries, only 76 participants were involved in the final data analysis.

There were 55 subjects with subnormal counts (of which ten were found to be azoospermic, 41 oligospermic) and 25 normospermic controls. A positive association was found between periodontitis and subnormal sperm count in only one age group but statistically significant association was found between poor oral hygiene and subnormal sperm count across all age groups.

For the first time, there appears to be a significant association between poor oral and subnormal sperm count. There also appears to an association between chronic periodontitis and subnormal sperm count. These relationships warrant further investigation.

There appears to be a link between poor oral hygiene and low sperm count.

Nwhator SO, Umeizudike KA, Ayanbadejo PO, Opeodu OI, Olamijulo JA, Sorsa T. Another Reason for Impeccable Oral Hygiene: Oral Hygiene-Sperm Count Link. J Contemp Dent Pract 2014;15(3):352-358.

Jain S, Khaiser IM, Thakur S, Jain S. Restoflex—A Revolutionary Change in Preclinical Practice for Restorative Dentistry and Endodontics. J Contemp Dent Pract 2014;15(3):359-362.

A case of unusual root morphology is presented to demonstrate anatomic variations in mandibular third molar.

The most common configuration of mandibular third molar is two roots and three canals; however they may have many different combinations. Endodontic treatment was performed in mandibular third molar having aberrant anatomy.

Four root canal orifices were located with the aid of dental operating microscope (DOM) and three separate roots were diagnosed with radiographs. Spiral computed tomography (SCT) showed the presence of an extra canal and extra root, indicating a rare anatomic configuration. Looking for additional canals and roots are important part of successful endodontics, as the knowledge of their existence enable clinicians to treat a case successfully that otherwise might end in failure.

The use of DOM and SCT in this case greatly contributed toward making a confirmatory diagnosis and successful endodontic treatment of four-rooted and five-canalled mandibular third molar.

Variation in root canal anatomy is very common. Knowledge of these variations is very essential for successful root canal outcome, inability to do so can lead to missed canals and failures. Hence, thorough knowledge of root canal anatomy and advances in diagnostic aids are essential.

Garg AK, Bhardwaj A, Mantri VR, Agrawal N. Endodontic Management of Mesiobuccal-2 Canal in Four-Rooted and Five-Canalled Mandibular Third Molar. J Contemp Dent Pract 2014;15(3):363-366.

The aim of this clinical article is to describe the unusual anatomy that was detected in a maxillary first molar during routine endodontic treatment.

Variation in root and root canal morphology especially in multirooted teeth presents a constant challenge for a clinician in their detection and management. The literature is replete with cases that have extra canal or root but cases with fused root and fewer numbers of canals are sparse.

This case report describes the endodontic management of one such unusual case of maxillary first molar presenting with a single fused buccal and a palatal root. The confirmatory diagnosis of this morphologic aberration was done with the help of spiral computerized tomography, which revealed that the contralateral tooth also had a similar morphology.

Dental practitioners should always be aware of the fact that abnormalities need not be in form of extra roots or root canals; anomalies can also be in form of fewer number of roots or root canals.

A thorough knowledge of the complexities and variations of the root canal system would help in avoiding some of the common iatrogenic access opening errors like perforations and excessive tooth removal caused during the search for the missing or extracanal.

Nayak G, Dahiya S, Singh I, Mohammad FH. Endodontic Management of an Unusual Maxillary First Molar with a Single Buccal Root. J Contemp Dent Pract 2014;15(3):367-371.

Periodontitis is characterized by the formation of true pockets, bone loss and attachment loss. Various techniques have been attempted in the past to truly regenerate the lost periodontal structures, albeit with variable outcome. In this evolution, the technique being tried out widely is the use of platelet rich concentrates, namely platelet-rich fibrin (PRF).

In this report, we present a case of surgical treatment of osseous bone defects namely two walled crater and dehiscence treated in posterior teeth with autologously prepared platelet rich fibrin mixed with hydroxy apatite bone graft and PRF in the form of a membrane.

Our results showed clinical improvements in all the clinical parameters postoperatively namely the pocket depth reduction and gain in attachment level and hence, PRF can be used alone or in combination with the bone graft to yield successful clinical results in treating periodontal osseous defects.

Platelet-rich fibrin is an effective alternative to platelet-rich plasma (PRP) in reconstructing bone defects.

Ranganathan AT, Chandran CR. Platelet-Rich Fibrin in the Treatment of Periodontal Bone Defects. J Contemp Dent Pract 2014;15(3):372-375.

Frizzera F, Beccalli I, Maia RMLC, Tonetto MR, da Silva Zanetti LS, de Barros LPA. Conservative Treatment of Intraosseous Hemangiomas in the Mandible: Case Report with a 17-Year Follow-up Period. J Contemp Dent Pract 2014;15(3):376-380.

Turkyilmaz I. Management of a Malpositioned Implant using Custom Abutment and Screw-Retained Fixed Dental Prosthesis. J Contemp Dent Pract 2014;15(3): 381-384.