The objective of this study was to evaluate the histopathology effects of two medicaments Allium sativum oil and formocresol on the remaining pulp tissue of the permanent teething children.

A total of 18 premolars were included in this study. Two sound premolars were extracted and subjected to histological examination to show the normal pulp tissue. Pulpotomy procedure was performed in the rest of the remaining 16 premolars; half of them using Allium sativum oil and the rest of the tested premolars were medicated using formocresol and all were sealed with suitable restoration. Then, premolars extracted at variable intervals (48 hours, 2 weeks, 1 month, 2 months), stained using hemotoxylin and eosin etain (H&E) and prepared for histopathology examination.

Histological evaluation seemed far more promising for Allium sativum oil than formocresol. Histological evaluation revealed that teeth treated with Allium sativa oil showed inflammatory changes that had been resolved in the end of the study. On the contrary, the severe chronic inflammation of pulp tissue accompanied with formocresol eventually produced pulp necrosis with or without fibrosis. In addition, pulp calcification was evidenced in certain cases.

Allium sativum oil is a biocompatible material that is compatible with vital human pulp tissue. It offers a good healing potential, leaving the remaining pulp tissue healthy and functioning.

Mohammad SG, Raheel SA, Baroudi K. Histological Evaluation of Allium sativum Oil as a New Medicament for Pulp Treatment of Permanent Teeth. J Contemp Dent Pract 2015;16(2):85-90.

This study evaluated in vitro the mechanical changes of 0.018” (0.45 mm) and 0.016 × 0.022” (0.40 × 0.55 mm) thermoactivated nickel-titanium archwires subjected to heat treatment on their distal ends.

Ten archwires in diameters 0.018” and 0.016 × 0.022” by different manufacturers Ormco, Morelli, Orthometric and Unitek were tested. Each tested archwire had an experimental side, submitted to heat treatment, and an annealing-free control. Tests for load/deflection were performed using a universal testing machine, with temperature control in the austenitic transformation phase through temperaturecontrolled chamber. The variables showed normal distribution (Kolmogorov-Smirnov), the t-student test was applied in order to observe the difference between the experimental and control groups. Statistical significance was set at p < 0.05.

There were no statistically significant differences between the groups.

Heat treatment carried out in the region corresponding to the first molar distal region on thermoactivated nickel-titanium archwires did not influence the load/deflection values in adjacent portion.

Bramante FS, da Fonseca Junior FM, Pinzan-Vercelino CRM, de Araújo Gurgel J, de Jesus Tavarez RR, Filho EMM, Tonetto MR, Borges AH, Bandéca MC. Deflection Evaluation of Thermoactivated Nickel-Titanium Archwires after Heat Treatment on their Distal Ends. J Contemp Dent Pract 2015;16(2):91-95.

To evaluate the solubility of five different root canal sealers (AH Plus Jet, RealSeal SE, MTA Fillapex, Tubli-Seal, and Acroseal) in chloroform, eucalyptol and Endosolv-E solvents.

Ninety root canal sealer samples were prepared and then divided into three groups for immersion in a solvent for 2, 5 or 10 minutes. The mean values of the root canal sealers’ dissolution in the solvents were obtained by the difference between the preimmersion original weight and the post-immersion weight on a digital analytical scale. Data were statistically analyzed by a Kruskal-Wallis test with a Bonferroni correction.

Chloroform was a more effective solvent than eucalyptol or Endosolv E for all root canal sealers, except for RealSeal SE, at all time points (p < 0.003). RealSeal SE was the least soluble sealer in all solvents at all time points.

Chloroform demonstrated a superior ability over other solvents in dissolving canal sealing materials, and eucalyptol was found to be the least effective solvent in this study.

This study can help to the clinicians about which solvent should be preferred for solving the filling materials in retreatment cases.

Bayram E, Dalat D, Bayram M. Solubility Evaluation of Different Root Canal Sealing Materials. J Contemp Dent Pract 2015;16(2):96-100.

The characteristics of tissue conditioners support microorganism development that can threaten the health of the dentures user.

The object of this study was to evaluate the effect on antimicrobial activity, roughness and wettability surface of a tissue conditioners material combined with the antimicrobial polymer poly (2-tert-butilaminoethyl) methacrylate (PTBAEMA).

Specimens of tissue conditioner (Coe Soft^®) were divided into three groups, according to the concentration of PTBAEMA incorporated (0, 10 and 25%). Antimicrobial activity was assessed by adherence assay of one of the microorganisms, Staphylococcus aureus, Streptococcus mutans and Candida albicans. Roughness measurements were made using a Mitutoyo SJ-400, and the mean arithmetic roughness values (Ra) obtained were used for the comparisons. The wettability properties were determined by contact angle measurements.

The group containing 25% of PTBAEMA inhibited totally the S. aureus and S. mutans biofilm formation. A significant reduction in the S. aureus (Kruskal-Wallis, p = 0,001) and S. mutans (Kruscal-Wallis, p = 0,001) count for 10% PTBAEMA group compared with respective control group. No significant difference was found for C. albicans among PTBAEMA groups and control group (ANOVA, p > 0,05). Incorporating 10 and 25% PTBAEMA increased surface roughness and decreased contact angles (ANOVA and Tukey's post hoc tests, α = 5%).

Incorporating 10% PTBAEMA into tissue conditioner increases wettability and roughness of tissue conditioner surface; and decreases the adhesion of S. mutans and S. aureus on material surface, but did not exhibit antimicrobial effect against C. albicans.

The PTBAEMA incorporated into tissue conditioner could prevent biofilm formation on elderly patient.

Toda C, Marin DOM, Rodriguez LS, Paleari AG, Pero AC, Compagnoni MA. Antimicrobial Activity of a Tissue Conditioner Combined with a Biocide Polymer. J Contemp Dent Pract 2015;16(2):101-106.

Matrix metalloproteinase-3 (MMP-3) plays a key role in development of cancer. The purpose of this study was to assess MMP-3 in the serum and saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC).

Thirty patients with OLP (8 reticular and 22 erosive forms), and 20 patients with OSCC (6 in low stage and 14 in advanced stage), were enrolled in this study, conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The serum and saliva MMP-3 was assayed by ELISA method. Statistical analysis of the Student's t-test, ANOVA and Pearson correlation coefficient was performed. The mean saliva and serum levels of MMP-3 were significantly higher in patients with OSCC compared with OLP.

The serum and saliva MMP-3 concentrations increased from reticular form of OLP to erosive form of OLP, and increased further to low stage of OSCC and advanced stage of OSCC. Serum MMP-3 correlated significantly with unstimulated (r = 0.310, p = 0.038) and stimulated (r = 0.365, p < 0.026) saliva MMP-3.

Serum and saliva MMP-3 levels appear associated with OLP and OSCC.

Agha-Hosseini F, Mirzaii-Dizgah I, Mahboobi N, Shirazian S, Harirchi I. Serum and Saliva MMP-3 in Patients with OLP and Oral SCC. J Contemp Dent Pract 2015;16(2):107-111.

Recurrent aphtous ulcers (RAUs) are of the most painful and common oral mucosal diseases with uncertain etiology including trauma, genetics, stress, immune dysfunction, and vitamin deficiencies. The aim of this study was to investigate the relationship between oral health impacts, patients’ oral health-related quality of life and anxiety and depression in patients with recurrent aphtous ulcers.

Sixty patients were diagnosed RAU (30 men and 30 women, mean age: 29.5 ± 9.6 years) and sixty controls, who matched the patients with age and gender, participated in this study. Participants completed hospital anxiety and depression (HAD) scale, oral health impact profile (OHIP-14), and United Kingdom oral health related quality of life measure (OHQoL-UK). The statistically significance levels were set at p . 0.05.

Both patients and controls reported comparable depression and anxiety scores (p > 0.05). Ulcer patients reported worse oral health impacts and inferior quality of life in comparison to controls (p < 0.001). Among both groups, no relationships were detected between HAD scores on one hand and OHIP and/or OHQoL-UK on the other hand (p > 0.05).

Recurrent aphthous ulcers increase the negative oral health impacts on patients and consequently cause inferior quality of life. Stressful situations and conditions (including anxiety and depression) were not related to oral health impacts and quality of life in patients with RAUs.

Zwiri AMA. Anxiety, Depression and Quality of Life among Patients with Recurrent Aphthous Ulcers. J Contemp Dent Pract 2015;16(2):112-117.

The aim of the study was to identify the presence of post-traumatic stress disorder (PTSD) in patients who had sustained facial injuries, additionally, we aimed to identify other variables that may modify the psychological response to trauma that include gender, age and presence of disfigurement posttreatment and visible scars/orthopedic injuries.

Participants comprised of 460 patients from several multinodal trauma centers in Bengaluru City, Karnataka, who had sustained facial injuries that had healed either with or without significant disfigurement or scarring and with visible/orthopedic injuries. One hundred and eleven patients of the chosen 460 had sustained nondisfiguring facial injuries while 153 patients sustained disfiguring facial injuries, 64 patients who sustained facial injury (i.e. 19.5%) were lost to follow-up and were not included in the study. One hundred and thirty-two had sustained orthopedic/visible injuries; however, in this group, 18 (i.e. 13.6%) patients were lost to follow-up and were excluded from the study. The impact of events scale (IES) was used to check the presence of PTSD.

Statistically significant higher means of IES were present in patients with disfiguring facial injuries compared to nondisfiguring facial injuries, female patients compared to male patients, patients with disfiguring facial injuries compared to orthopedic/visible injuries and patients who were younger than 50 years of age compared to patients who were older than 50 years of age and the results observed were similar at all three study intervals (date of discharge (DOD), 1 month and 6 months postoperatively).

Patients with disfiguring facial injuries had significantly higher PTSD levels compared to patients with nondisfiguring facial injuries, patients with orthopedic/visible injuries had statistically significant lower IES scores which could not be strictly termed PTSD when compared to patients with disfiguring facial injuries who had high scores of IES corresponding to high levels of PTSD and these results were observed at all three study intervals (DOD, 1 and 6 months postoperatively). Female patients with disfiguring facial injuries had significantly higher PTSD levels compared to male patients (at all the study intervals) and patients younger than 50 years of age had significantly higher PTSD levels compared to older patients.

Prashanth NT, Raghuveer HP, Kumar RD, Shobha ES, Rangan V, Hullale B. Post-traumatic Stress Disorder in Facial Injuries: A Comparative Study. J Contemp Dent Pract 2015;16(2):118-125.

Tetracycline-stained tooth structure is difficult to bleach using nightguard tray methods. The possible benefits of in-office light-accelerated bleaching systems based on the photo-Fenton reaction are of interest as possible adjunctive treatments. This study was a proof of concept for possible benefits of this approach, using dentine slabs from human tooth roots stained in a reproducible manner with the tetracycline antibiotic demeclocycline hydrochloride.

Color changes overtime in tetracycline stained roots from single rooted teeth treated using gel (Zoom! WhiteSpeed^®) alone, blue LED light alone, or gel plus light in combination were tracked using standardized digital photography. Controls received no treatment. Changes in color channel data were tracked overtime, for each treatment group (N = 20 per group).

Dentin was lighter after bleaching, with significant improvements in the dentin color for the blue channel (yellow shade) followed by the green channel and luminosity. The greatest changes occurred with gel activated by light (p < 0.0001), which was superior to effects seen with gel alone. Use of the light alone did not significantly alter shade.

This proof of concept study demonstrates that bleaching using the photo-Fenton chemistry is capable of lightening tetracycline-stained dentine. Further investigation of the use of this method for treating tetracycline-stained teeth in clinical settings appears warranted.

Because tetracycline staining may respond to bleaching treatments based on the photo-Fenton reaction, systems, such as Zoom! WhiteSpeed, may have benefits as adjuncts to home bleaching for patients with tetracycline-staining.

Bennett ZY, Walsh LJ. Effect of Photo- Fenton Bleaching on Tetracycline-stained Dentin in vitro. J Contemp Dent Pract 2015;16(2):126-129.

Prompt-L-Pop is a sixth generation bonding system contains methacrylated phosphoric acid esters that combine an acidic component for etching the enamel and a primer, is an all-in-one adhesive. This study was undertaken to compare the bonding strength of brackets to enamel with traditional bonding technique and the new Prompt-L-Pop system using the same composite resin.

In this in vitro experimental study, 60 human premolar teeth extracted for orthodontic treatment were collected. The samples were randomly divided into three groups comprising of 20 teeth in each group. Shear bond strength and ARI scores for the specimens were measured. Comparison was done using one way ANOVA and Chi-square test.

Fourth generation bonding adhesive system depicted similar bond strength to fifth generation bonding adhesive system. Both fourth and fifth generation exhibited higher shear bond strength as compared to sixth generation bonding adhesive system.

Fourth and fifth generation exhibited higher shear bond strength as compared to sixth generation bonding adhesive system but the sixth generation has clinically acceptable shear bond strength. Also, it was found that sixth generation leaves less residual adhesive on the tooth after bracket removal.

Sreedhara S, Savakkanavar MB, Rajesh RNG, Ankireddy RKR, Sanjay N, Girish KS. Effect of Self-etch Primer-adhesive and Conventional Adhesive Systems on the Shear Bond Strength and Bond Failure of Orthodontic Brackets: A Comparative Study. J Contemp Dent Pract 2015;16(2):130-134.

This study assessed how changing the Zirconia (Zr) substructure affected the color samples after they have been overlaid by the same shade of veneering ceramic.

Three commercial Zr materials were tested in this study: Prettau^® Zirconia (ZirKonZahn, Italy), Cercon (Dentsply, Germany) and InCoris ZI (Sirona, Germany). For each system, 15 disk-shaped specimens (10 × 1 mm) were fabricated. Three shades of A1, A2 and A3.5 of porcelain (IPS e.MaxCeram, IvoclarVivadent, USA) were used for layering the specimens. Five specimens from each type of Zr were layered with same shade of ceramic. Color measurements were recorderd by a spectrophotometer Color-Eye^® 7000A (X-Rite, Grand Rapids, MI). Mean values of L, a, b color coordinates and ?E were recorded and comparisons were made.

Differences in the ΔE were recorded for the same porcelain shade with different Zr substructures and affected the color of the specimens (p < 0.01, ANOVA). The maximum difference between the ΔE values for the A1, A2 and A3.5 shades with three types of Zr substructures was found to be 1.59, 1.69 and 1.45 respectively. Multiple comparisons of the ΔE with PostHoc Tukey test revealed a statistically significant difference (p < 0.05) between the three types of Zr, except between Type 2 Zr and Type 3 Zr for the Shade A1. The mean values of L, a, b and ΔE for the Prettau^® Zirconia substructure were found to be the least among the three types.

The brand of Zr used influences the final color of the all ceramic Zr based restorations and this has clinical significance.

Habib SR, Al Shiddi IF. Comparison of Shade of Ceramic with Three Different Zirconia Substructures using Spectrophotometer. J Contemp Dent Pract 2015;16(2): 135-140.

This study aimed to evaluate the interactions between salivary proteins and titanium disks with different surface treatments.

Machined titanium disks (n = 48) were divided into four experimental groups (n = 12), according to their surface treatments: surface polishing (SP); acid etching (A); spot-blasting plus acid etching (SB-A); spot-blasting followed by acid etching and nano-functionalization (SB-A-NF). Titanium surfaces were characterized by surface roughness and scanning electron microscopy (SEM). Specimens were incubated with human saliva extracted from submandibular and sublingual glands. Total salivary protein adsorbed to titanium was quantified and samples were submitted to western blotting for mucin glycoprotein 2 (MG2) and lactoferrin identification.

Surface roughness was statistically higher for SB-A and SB-A-NF groups. Scanning electron microscopy images confirmed that titanium surface treatments increased surface roughness with higher number of porous and scratches for SB-A and SB-A-NF groups. Total protein adsorption was significantly higher for SB-A and SB-A-NF groups (p < 0.05), which also presented higher interactions with MG2 and lactoferrin proteins.

The roughing of titanium surface by spot-blasting plus acid etching treatments contribute to higher interaction with salivary proteins, such as MG2 and lactoferrin.

Titanium surface roughing increases the interactions of the substratum with salivary proteins, which can influence the integration of dental implants and their components to the oral environment. However, those treatments should be used carefully intraorally, avoiding increase biofilm formation.

Cavalcanti YW, Soares RV, Assis MAL, Zenóbio EG, da Silva Girundi FM. Titanium Surface Roughing Treatments contribute to Higher Interaction with Salivary Proteins MG2 and Lactoferrin. J Contemp Dent Pract 2015;16(2):141-146.

The purpose of this study was to evaluate the effect of self-adhesive and self-etching resin cements on the bond strength of nonmetallic posts in different root regions.

Sixty single-rooted human teeth were decoronated, endodontically treated, post-space prepared, and divided into six groups. Glass-fiber (GF) posts (Exacto, Angelus) and fiber-reinforced composite (FRC) posts (EverStick, StickTeck) were cemented with self-adhesive resin cement (Breeze) (SA) (Pentral Clinical) and self-etching resin cement (Panavia-F) (SE) (Kuraray). Six 1-mm-thick rods were obtained from the cervical (C), middle (M), and apical (A) regions of the roots. The specimens were then subjected to microtensile testing in a special machine (BISCO; Schaumburg, IL, USA) at a crosshead speed of 0.5 mm/min. Microtensile bond strength data were analyzed with two-way ANOVA and Tukey's tests.

Means (and SD) of the MPa were: GF/SA/C: 14.32 (2.84), GF/SA/M: 10.69 (2.72), GF/SA/A: 6.77 (2.17), GF/SE/C: 11.56 (4.13), GF/SE/M: 6.49 (2.54), GF/SE/A: 3.60 (1.29), FRC/SA/C: 16.89 (2.66), FRC/SA/M: 13.18 (2.19), FRC/SA/A: 8.45 (1.77), FRC/SE/C: 13.69 (3.26), FRC/SE/M: 9.58 (2.23), FRC/SE/A: 5.62 (2.12). The difference among the regions was statistically significant for all groups (p < 0.05). The selfadhesive resin cement showed better results than the selfetching resin cement when compared to each post (p < 0.05). No statistically significant differences in bond strengths of the resin cements when comparable to each post (p > 0.05).

The bond strength values were significantly affected by the resin cement and the highest values were found for self-adhesive resin cement.

da Silva MB, de Jesus Tavarez RR, de Assis FS, Tonetto MR, Porto TS, Bhandi SH, El-Mowafy O, de Toledo Porto Neto S, Bandeca MC. The Effect of Self-adhesive and Self-etching Resin Cements on the Bond Strength of Nonmetallic Posts in Different Root Thirds. J Contemp Dent Pract 2015;16(2):147-153.

The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans.

Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage.

The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagenpreserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months.

Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone.

Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice.

Di Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015;16(2):154-162.

Anitha S, Rao DSC. Hemisection: A Treatment Option for an Endodontically Treated Molar with Vertical Root Fracture. J Contemp Dent Pract 2015;16(2):163- 165.