The aim of this study was investigate the effect of photodynamic therapy (PDT) using curcumin (C) as a photosensitizing agent irradiated with an LED (L) in the blue wavelength as a light source on a standard and clinical isolate of Streptococcus mutans (S. mutans) in a planktonic suspension model.

Suspensions of both strains were divided into 4 groups as follows: absence of C and L (control group: C–L–), with C and without L (C group: C+L–), absence of C with L (L group: C–L+) and presence of C and L (PDT group: C+L+). Three different concentrations of curcumin (0.75 mg/ml, 1.5 mg/ml and 3 mg/ml) and three light fluences of studied light source (24, 48 and 72 J cm^–2) were tested. Aliquots of each studied group was plated in BHI agar and submitted to colony forming units counting (CFU/ml) and the data transformed into logarithmical scale.

A high photoinactivation rate of more than 70% was verified to standard S. mutans strain submitted to PDT whereas the clinical isolate showed a lower sensitivity to all the associations of curcumin and LED. A slight bacterial reduction was verified to C+L– and C–L+, demonstrating no toxic effects to the isolated application of light and photosensitizer to both S. mutans strains tested.

Photodynamic therapy using a combination of curcumin and blue LED presented a substantial antimicrobial effect on S. mutans standard strain in a planktonic suspension model with a less pronounced effect on its clinical isolate counterparts due to resistance to this alternative approach.

Alternative antimicrobial approaches, as photodynamic therapy, should be encouraged due to optimal results against cariogenic bacteria aiming to prevent or treat dental caries.

Tonon CC, Paschoal MA, Correia M, Spolidório DMP, Bagnato VS, Giusti JSM, Santos-Pinto L. Comparative Effects of Photodynamic Therapy mediated by Curcumin on Standard and Clinical Isolate of Streptococcus mutans. J Contemp Dent Pract 2015;16(1):1-6.

To evaluate the effect of fiber post surface treatments on push-out bond strength between fiber post and root dentin.

Sixty bovine mandibular teeth (N = 60) were sectioned (16 mm), prepared (12 mm), embedded with acrylic resin and then allocated into six groups (n = 10): Gr1- Silane coupling agent (Sil) + Conventional resin cement AllCem (AlC); Gr2- Sil + Conventional resin cement RelyX ARC (ARC); Gr3- tribochemical silica coating (TBS) + AlC; Gr4– TBS + ARC; Gr5- No treatment (NT) + AlC; Gr6– NT+ ARC. Specimens were sectioned in four slices (2 mm) and submitted to push-out test. Fracture analyses were executed at x200. The values of the push-out bond strength were submitted to two-way ANOVA and Tukey test (á = 0.05).

Resin cement did not affect the bond strength values (p = 0.9674), fiber post surface treatment affected the push-out bond strength (p = 0.0353), interaction between factors did not affected the values (p = 0.338). Tukey test did not show differences between the groups. Adhesive failure between cement and dentin was predominantly.

The fiber post surface treatment appears have no influence on bond strength between fiber post and root dentin.

The tested fiber posts surface treatment appears do not influence the fiber post bond behavior.

Druck CC, Bergoli CD, Pereira GKR, Valandro LF. Effect of two Resin Cements and two Fiber Post Surface Treatments on Push-out Bond Strength between Fiber Post and Root Dentin. J Contemp Dent Pract 2015;16(1):7-12.

The aim of this study was to evaluate the main posttraumatic complications of severe luxation and replanted teeth using clinical and radiographic analyses.

Eighty-three patients aged between 7 and 55 years old presenting 180 traumatized teeth that suffered extrusive luxation (n = 67), lateral luxation (n = 69), intrusive luxation (n = 10) and tooth avulsion (n = 34) followed by replantation were evaluated. The follow-up period was 24 months. The complications examined were: pulp canal obliteration, pulp necrosis and root resorption (inflammatory and replacement). Furthermore, the relationship between time elapsed before receiving dental attendance and development of inflammatory resorption was observed.

Pulp necrosis was the main complication, occurring in 147 teeth (82.7%). All of the teeth that suffered intrusive luxation and tooth avulsion were diagnosed with pulp necrosis, with significant difference in comparison with another traumas (p < 0.001/Fisher's exact test). Inflammatory root resorption was observed in 20.5% of the cases and replacement resorption was more related to tooth replantation (94.1%), showing significant prevalence among tooth luxations (p < 0.001/Fisher's exact test). In addition, it was noted that patients who seek treatment 9 weeks after the trauma episode presented 10 times more chance of developing inflammatory resorption when compared with patients who seek treatment soon after dental trauma (Odds ratio test).

It may be concluded that pulp necrosis was the main post-traumatic complication observed in traumatized teeth and that delay in seeking treatment may damage the prognosis of severe luxation and replanted teeth.

Clinical studies describing the main complications that may affect traumatized teeth present great relevance to make the population aware of the importance of seeking immediate treatment and to alert the professional to the need for follow-up. When traumatic injuries are diagnosed and treated early, post-traumatic complications may be controlled, allowing conservation of the tooth in oral cavity.

Lima TFR, Nagata JY, de Souza- Filho FJ, de Jesus Soares A. Post-traumatic Complications of Severe Luxations and replanted Teeth. J Contemp Dent Pract 2015;16(1):13-19.

Giant cell lesions are characterised histologically by multinucleated giant cells in a background of ovoid to spindleshaped mesenchymal cells. There is a major debate whether these lesions are separate entities or variants of the same disease. Our aim was to study the nature of multinucleated and mononuclear cells from peripheral giant cell granuloma (PGCG), and central giant cell granuloma (CGCG) and giant cell tumor (GCT) of long bones using immunohistochemistry evaluation and to determine whether there is a correlation between recurrence and the markers used.

Ki-67, p53, Vimentin, smooth muscle specific actin, CD68 and alpha-1-antichymotrypsin were used to study 60 giant cell lesions. These included 26 CGCG, 28 PGCG, and 6 GCT cases using an avidin-biotin-complex immunohistochemistry standard method.

All studied cases showed the same results except the percentage of Ki-67 positive mononuclear cells in PGCG was significantly higher than that of both CGCG and GCT (p < 0.05). Interestingly, no statistical correlation between recurrence and the markers used was found.

Our results may suggest that these lesions have the same histogenesis. The mononuclear stromal cells, both histiocytic and myofibroblastic, are thought to be responsible for the behavior of these lesions whereas the multinucleated cells are considered as reactive. This might support the argument that PGCG, CGCG and GCT are different variants for the same disease. Further studies using molecular techniques are required to elucidate why some of these lesions behave aggressively than others.

Kujan O, Al-Shawaf AZ, Azzeghaiby S, AlManadille A, Aziz K, Raheel SA. Immunohistochemical Comparison of p53, Ki-67, CD68, Vimentin, α-smooth Muscle Actin and Alpha-1-Antichymotrypsin in Oral Peripheral and Central Giant Cell Granuloma. J Contemp Dent Pract 2015;16(1):20-24.

Three-dimensional Scaffold structure of synthetic biomaterials with their interconnected spaces seem to be a safe and effective option in supporting bone regeneration. The aim of this animal study was to compare the effectiveness of three different biocompatible scaffolds: bioglass (BG), demineralized bone matrix (DBM) and forstrite (FR).

Four healthy dogs were anesthetized and the first to fourth premolars were extracted atraumatically in each quadrant. After healing, linear incision was prepared from molar to anterior segment and 4 defects in each quadrant (16 defects in each dog) were prepared. Scaffold blocks of BG, DBM and FR were resized according to size of defects and placed in the 12 defects randomly, 4 defects remained as control group. The dogs were sacrificed in 4 time intervals (15, 30, 45 and 60 days after) and the percentage of different types of regenerated bones (lamellar and woven) and connective tissue were recorded in histological process. The data were analyzed by one-way ANOVA and post hoc using SPSS software Ver. 15 at significant level of 0.05.

In day 30th, although the amount of regenerated lamellar bone in control, DBM and BG Scaffold (22.37 ± 3.44; 21.46 ± 1.96; 21.21 ± 0.96) were near to each, the FR Scaffold provided the highest amount of lamellar (29.71 ± 7.94) and woven bone (18.28 ± 2.35). Also, FR Scaffold showed significant difference with BG (p = 0.026) and DBM Scaffolds (p = 0.032) in regenerated lamellar bone.

We recommend paying more attention to FR Scaffold as a biomaterial, but it is better to be compared with other nano biomaterials in future studies.

Rismanchian M, Nosouhian S, Razavi SM, Davoudi A, Sadeghiyan H. Comparing Three Different Threedimensional Scaffolds for Bone Tissue Engineering: An in vivo Study. J Contemp Dent Pract 2015;16(1):25-30.

To investigate the prevalence of the most common occupation-related health problems as well as factors associated with their incidence among dental practitioners.

A cross-sectional, questionnairebased survey of Libyan dental practitioners. Participants provided information regarding their experience of occupationally related problems they encountered over the past 12 months which included inquiries about musculoskeletal pain, percutaneous injuries, allergy, eye and sight problems, and hearing problems.

Musculoskeletal problems were the most frequently reported (48.2%), followed by percutaneous injuries (35%), eye problems (22%), allergy (11%) and hearing problems (7.6%). Musculoskeletal problems were significantly higher among dentists who work in private sector, full timer as well as those who prefer to work in a sitting position (p = 0.021, 0.027 and 0.008, respectively). Practitioners with less than 5 years in service reported significantly higher percentage of percutaneous injuries (p = 0.027) than their senior counterparts, whereas practitioners who spent more than 10 years in service were more likely to suffer from visual disturbances (p = 0.033).

The findings of this study indicate that musculoskeletal problems and percutaneous injuries are the most commonly reported occupational health problems among dentists, whereas allergic reactions and hearing problems are the least reported ones.

Dentists should use alternate working positions to minimise musculoskeletal problems and adopt more effective strategies to prevent percutaneous injuries particularly among novices.

Arheiam A, Ingafou M. Self-reported Occupational Health Problems among Libyan Dentists. J Contemp Dent Pract 2015;16(1):31-35.

To evaluate the influence of pH change and water storage up to 90 days on the sealing ability of two resin-based rootfilling materials.

Forty-four human mandibular single-rooted teeth were instrumented and filled with gutta-percha/ AH Plus or Resilon/Epiphany SE (n = 20 per group). Two teeth each were used as positive and negative controls. Specimens were set for 7 days under 100% humidity at 37°C. They were allocated into two subgroups (n = 10) according to whether they were tested immediately or stored for up to 90 days in water before testing. Sealing ability was evaluated by passive dye penetration. Absorbance at 630 nm (in μg/ml) was measured by spectrophotometry. The pH values were obtained in triplicate. Data were submitted to ANOVA by post-hoc Tukey's test (α = 0.05).

Specimens filled with Resilon/Epiphany SE exhibited more leakage than specimens filled with gutta-percha/AH Plus at the immediate time point (p < 0.001). No differences were detected between the groups after storage, or between the materials with pH changes after 30, 60 and 90 days (p > 0.05).

Gutta-percha/AH Plus provided superior sealing at the immediate time point. Water storage and pH changes did not influence the sealing ability of tested materials.

These results suggest that Resilon/ Epiphany SE sealer offered no apparent advantage over the more conventional gutta-percha/AH Plus sealer technique in terms of sealing ability.

de Fátima Carvalho Souza S, de Souza DN, de Fátima Vasconcelos Pereira A, Barroso LP, Bombana AC. Influence of pH Change and Water Storage on the Sealing Ability of Two Resin-based Root-filling Materials. J Contemp Dent Pract 2015;16(1):36-41.

The purpose of this study was to evaluate and to compare the cariogenic potential of different commonly consumed flavored milk on caries development in rat's molar teeth.

Sixty Sprague-Dawley rats infected with an active growing culture of Streptococcus mutans were offered chocolate flavored milk, strawberry flavored milk, banana flavored milk, plain milk, sweetened plain milk with 5% sucrose, and 10% sucrose ad libitum.

Rats consuming flavored milk developed significantly lower sulcal and smooth surface caries scores than rats consuming 10% sucrose. However, rats consuming plain milk developed significantly lower sulcal and smooth surface caries scores than animals consuming flavored or sweetened plain milk except for chocolate flavored milk.

It was concluded that flavored milk containing 5% sucrose showed a moderate cariogenic potential.

Although the overall results suggest that the cariogenic potential of flavored milk is moderate and despite their nutritional value, occasional consumption of flavored milk as a beverage might be accepted with caution. Parents, dental practitioners and other healthcare professionals should be aware of the cariogenicity of flavored milk. They should keenly encourage the use of plain milk and discourage the use of any cariogenic drink which has a deleterious effect on teeth.

Al-Jobair A, Khounganian R. Evaluating the Cariogenic Potential of Flavored Milk: An Experimental Study using Rat Model. J Contemp Dent Pract 2015;16(1):42-47.

This study compared the student's self-grades versus the examiners grades, inter examiner grades and grades of anterior with posterior teeth in a preclinical prosthodontic course.

75 students and 2 examiners participated in the study. The students prepared one anterior (upper central incisor) and one posterior (lower first molar) teeth for full veneer crowns in allocated time of 2 hours and 30 minutes. After the preparations, the students self-graded their preparations based on criteria-based evaluation forms. The examiners also completed the grading for the prepared teeth. All the grades were recorded, comparisons were made using SPSS version 21 and results tabulated.

The means of grades (8.32) by the students themselves were found to be higher compared to the examiners grades (7.3) for the anterior as well as posterior teeth. Comparison of the grades for the anterior/posterior teeth and the overall grades showed a statistically significant difference (p = 0.000). A moderate correlation (0.399) and a strong correlation (0.601) were found between the grades of the faculty and the students for the anterior and posterior teeth respectively. The overall grading for the anterior and posterior teeth by the two faculty members showed no statistically significant difference (p = 0.053) and a very strong correlation (0.784). The results of the test showed a significant difference (p = 0.001) between the overall grading for anterior and posterior teeth.

Students tended to grade their teeth preparations higher compared to the examiner grades, inter examiner variation in the grades existed and the grades of the anterior teeth were higher compared to the posterior teeth.

Habib SR, Sherfudhin H. Students’ Self-assessment: A Learning Tool and Its Comparison with the Faculty Assessments. J Contemp Dent Pract 2015;16(1):48-53.

To evaluate the effect of successive cycles of disinfection in different denture cleansers on the surface roughness and the Vickers hardness of two layers of acrylic resin (base-BL and enamel-EL) of two commercial cross-linked artificial teeth.

The occlusal surfaces of 60 acrylic resin denture posterior teeth (Trilux-TLX and SR Orthosit PE-SRO) embedded in autopolymerizing acrylic resin were ground flat with 1200-grit silicon carbide paper. Specimens were stored in distilled water at 37°C and then submitted to the microhardness (VHN) and roughness (ìm) tests. Specimens were stored in distilled water at 37°C for 90 days and submitted to 720 disinfection cycles in sodium hypochlorite at 0.5%, 30% vinegar solution or distilled water (control). Afterward, microhardness and roughness tests were again performed. Data were analyzed using two-way ANOVA and Tukey's test (α = 0.05).

Hypochlorite immersion decreased the hardness of BL and EL of SRO teeth, with an average reduction of 10.11% (p < 0.008). TLX teeth demonstrated a hardness reduction of 28.96% of both layers for all solutions including water (p < 0.0000). The roughness of both teeth was not affected by denture cleansers (p > 0.37).

Hypochlorite promoted deleterious effects on the hardness of both layers of the artificial teeth tested. Immersion in vinegar and water also resulted in reduction of hardness of TLX teeth.

The surface hardness of the different layers of cross-linked artificial teeth can be altered by daily disinfection in denture cleansers commonly indicated for removable dentures.

Neppelenbroek KH, Kurokawa LA, Procópio ALF, Pegoraro TA, Hotta J, Lima JFM, Urban VM. Hardness and Surface Roughness of Enamel and Base Layers of Resin Denture Teeth after Long-term repeated Chemical Disinfection. J Contemp Dent Pract 2015;16(1):54-60.

Guedes OA, Borges ÁH, Bandeca MC, Nakatani MK, de Araújo Estrela CR, de Alencar AHG, Estrela C. Chemical and Structural Characterization of Glass Ionomer Cements indicated for Atraumatic Restorative Treatment. J Contemp Dent Pract 2015;16(1):61-67.

The influence of the loss of teeth on the condylar position and on temporomandibular joint (TMJ) dysfunction syndrome remains a controversial issue. This study analyses the condylar position by means of a tomogram in partially dentate subjects which serves as a guide to predict which of the partially dentate statuses is prone to develop TMJ dysfunction syndrome in personnel without symptoms of the same.

Eighty personnel were enrolled in this study consisting of Kennedy's class I, II, III, IV and control to analyze the condylar position by means of a tomogram. In all the five groups TMJ sectional tomogram programmed in a panoramic radiographic machine (PLANMECA PM 2002 CC PROLINE) was taken with the subjects at maximal intercuspal position and rest position. Tomograms were evaluated using linear measurements of the anterior and posterior intra-articular joint spaces on the basis of drawings and tracings.

The results of the study revealed a predominance of reduced posterior condylar space in Kennedy's class I and II. A disparity was seen between the maximum intercuspal position and rest position, where the posterior joint space was reduced in the rest position.

Within the limitations of this study, it has been revealed that in Kennedy's classes I and II, for partially dentate personnel, a posterior displacement of the condyles was seen. This predisposition would suggest towards the necessity of restoring the missing dentition in order to maintain the harmony of the stomatognathic system.

Ammanna S, Rodrigues A, Shetty NS, Shetty K, Augustine D, Patil S. A Tomographic Study of the Mandibular Condyle Position in Partially Edentulous Population. J Contemp Dent Pract 2015;16(1):68-73.

The aim of this study is to report a clinical case of oral nevus.

Nevus is a congenital or acquired benign neoplasia that can be observed in the skin or mucous membranes. It is an uncommon condition in the oral mucosa. When it does occur, the preferred location is on the palate, followed by the cheek mucosa, lip and tongue.

In this case study, we relate the diagnosis and treatment of a 23-year-old female patient with an irregular, pigmented lesion of the oral mucosa that underwent excisional biopsy resulting in a diagnosis of intramucosal nevus.

Nevus can appear in the oral mucosa and should be removed.

It is important for dental professionals to adequately categorize and treat pigmented lesions in the mouth.

Freitas DA, Bonan PR, Sousa AA, Pereira MM, Oliveira SM, Jones KM. Intramucosal Nevus in the Oral Cavity. J Contemp Dent Pract 2015;16(1):74-76.

C-shaped canal system is a seldom-found root canal anatomy which displays a challenge in all stages of endodontic treatment. According to the literature, this type of canal morphology is not a common finding in the mandibular first molar teeth.

This case report presents endodontic management of a mandibular first molar with a C-shaped canal system.

Root canal system was cleaned and shaped by nickel-titanium (NiTi) rotary instruments combined with selfadjusting file (SAF). Obturation was performed using warm, vertical condensation combined with the injection of warm gutta-percha. Follow-up examination 12 months later showed that the tooth was asymptomatic. The radiological findings presented no signs of periapical pathology.

The clinician must be aware of the occurence and complexity of C-shaped canals in mandibular first molar teeth to perform a successful root canal treatment. The supplementary use of SAF after application of rotary instruments in C-shaped root canals might be a promising approach in endodontic treatment of this type of canal morphology.

Helvacioglu-Yigit D. Endodontic Management of C-shaped Root Canal System of Mandibular First Molar by using a modified Technique of Self-adjusting File System. J Contemp Dent Pract 2015;16(1):77-80.

Haddad EE, Lauritano D, Carinci F. Interradicular Septum as Guide for Pilot Drill in Postextractive Implantology: A Technical Note. J Contemp Dent Pract 2015;16(1):81-84.