Hussain QA, Awan KH. Role of Dental Profession in Oral Cancer Prevention and Diagnosis. J Contemp Dent Pract 2016;17(12):963-964.

Online learning media are increasingly being incorporated into medical and dental education. However, the coordination between obligatory and facultative teaching domains still remains unsatisfying. The Catalogue of Interactive Learning Objectives of the University Clinic of Mainz (ILKUM), aims to offer knowledge transfer for students while being mindful of their individual qualifications. Its hierarchical structure is designed according to the Association for Dental Education in Europe (ADEE) levels of competence.

The ILKUM was designed to establish a stronger interconnection between already existing and prospective learning strategies. All contents are linked to the current lectures as well as to e-learning modules, e.g., clinical case studies and OR videos. Students can conduct self-examinations regarding specific learning objectives. Since 2007, ILKUM has been developed and analyzed regarding its acceptance among dental students.

These improved e-learning techniques foster time and location-independent access to study materials and allow an estimation of the knowledge achieved by students. Surveys of our students clearly show a large demand for upgrading ILKUM content (89%; n = 172) with integrated self-testing (89%; n = 174). In parallel to the advancement of our e-learning offering, a portion of internet-based learning is constantly rising among students.

The broad acceptance and demand for the development of ILKUM show its potential. Moreover, ILKUM grants fast, topic-oriented querying of learning content without time and locale limitations as well as direct determination of the individually needed knowledge conditions.

The long-term goal of the ILKUM project is to be a sustainable, important additional modality of teaching and training for dental and medical students.

Mahmoodi B, Sagheb K, Sagheb K, Schulz P, Willershausen B, Al-Nawas B, Walter C. Catalogue of Interactive Learning Objectives to improve an Integrated Medical and Dental Curriculum. J Contemp Dent Pract 2016;17(12):965-968.

This study evaluated the cervical fit of cemented metal–ceramic and In-Ceram implant-supported crowns, before and after the cementing procedure.

Twenty crowns cemented on implant abutments are divided into two groups (n = 10): Group 1 – cemented metal–ceramic crowns and group 2 – cemented In-Ceram crowns. The marginal adaptations before and after cementation were evaluated in a comparison microscope with an error of 1 μm. All crowns were cemented with zinc phosphate cement.

The cervical misalignment of cemented crowns before cementation (52.65 ± 11.83 and 85.73 ± 14.06 μm) was lower than that after cementation (66.80 ± 15.86 and 89.36 ± 22.66 μm).

The cementing procedure interferes with the marginal fit of cemented crowns on implant abutments, with the prosthesis having better adaptation before cementation. Cemented metal–ceramic crowns exhibited better cervical adaptation than In-Ceram crowns cemented before and after the cementing procedure.

The maintenance of gum health and the longevity of prosthetic restorations are closely related to the restoration's marginal integrity.

Valente VS, Francischone CE, Vilarinho Soares de Moura CD, Francischone Júnior CE, Silva AM, Ribeiro IS, Maia Filho EM, Bandéca MC, Tonetto MR, de Jesus Tavarez RR. Marginal Fit Metal–Ceramic and In-Ceram Single Crown Cement retained in Implant-supported Abutments. J Contemp Dent Pract 2016;17(12):969-972.

This study aimed at evaluating and comparing the antibacterial activity of six types of dental luting cements on Streptococcus mutans and Lactobacillus acidophilus using the agar diffusion test (ADT) and the direct-contact test (DCT). The antibacterial activity in ADT was measured based on the diameter of the zone of inhibition formed, whereas in DCT the density of the bacterial suspension was measured. The lower the density of the suspension, the more antibacterial activity the cement possesses.

Agar diffusion test was carried out on the bacteria. After an incubation period of 24 hours, the plates were checked for the presence of zone of inhibition. In DCT the cement was mixed and applied. Once the cement was set, bacterial suspension and brain–heart infusion medium was poured and incubated for 24 hours. After 24 hours, the plate was placed in the enzyme-linked immunosorbent assay plate reader, which measured the optical density of the fluid. The first set of data was recorded approximately 1 hour after incubation. Overall, three sets of data were recorded. Additional experiments were performed on set test materials that were allowed to age for 24 hours, 1 week, 1, 3, and 6 months.

When using ADT only two cements zinc oxide eugenol (ZOE) and zinc polycarboxylate (ZPC) cement showed antibacterial activity against the test organisms. When using DCT, all cements showed some amount of antibacterial activity. Zinc oxide eugenol and ZPC cement showed highest amount of antibacterial activity against S. mutans and L. acidophilus respectively.

Within the limitations of study, ZOE cement and ZPC cement were most effective against the tested microorganisms followed by the newer resin cement. The glass ionomer cement was the weakest of all.

Patients with high caries index can be treated more effectively using the abovementioned cements.

Feroz SMA, Bhoyar A, Khan S. Comparative Evaluation of Antibacterial Effect of Dental Luting Cements on Streptococcus mutans and Lactobacillus acidophilus: An in vitro Study. J Contemp Dent Pract 2016;17(12):973-977.

To assess the impact of using preventive mouthwash agents on the surface hardness of various resins composites.

Hundred specimens were prepared from five types of composite resin material in a Teflon mold. Five specimens from each type of restorative materials (Herculite XRV Ultra, Estelite Σ Quick, Z Hermack, Versa Comp Sultan, and Empress Direct IPS) were evaluated posttreatment with immersion in four types of preventive mouthwashes gels and rinses – group 1: Flocare gel (0.4% stannous fluoride), group 2: Pascal gel (topical APF fluoride), group 3: Pro-relief mouthwash (Na fluoride), and group 4: Plax Soin mouthwash (Na fluoride) – at 37°C in a dark glass container at 24, 48, and 72 hours. Surface hardness measurement was made for each tested material. Statistically, we analyzed the mean values with one-way analysis of variance (ANOVA) and Tukey's test, with significance level of p < 0.05.

All composite resin materials showed decrease in their surface hardness with the time elapsed (24, 48, and 72 hours) postimmersion in the preventive mouthwashes and gels except the Herculite XRV Ultra and Versa Comp Sultan materials. Flocare gel group showed increase in the surface hardness after 48 hours of immersion than the other periods and in Estelite Σ Quick after 72 hours. There was significant differences in all materials tested with the immersion in the preventive mouthwashes and gels, such as Flocare gel (0.4% stannous fluoride), Pro-relief mouthwash (Na fluoride), and Plax Soin mouthwash (Na fluoride) except Pascal gel (topical APF fluoride) (p > 0.05), at time intervals mentioned earlier (p < 0.05).

The effect of preventive mouthwashes and gels on resin composite materials was decreased surface hardness with the time elapse of immersion for all materials except the Flocare gel group, which contains 0.4% stannous fluoride as a preventive ingredient increases the surface hardness after 48 h for Herculite XRV Ultra and Versa Comp Sultan and Estelite Σ Quick after 72 hours.

The preventive agents in the form of mouthwash and gel are used to prevent oral diseases that affect the surface hardness of composite resin, and this leads to occlusion, color stability, and surface roughness.

Al-Samadani KH, Surface Hardness of Dental Composite Resin Restorations in Response to Preventive Agents. J Contemp Dent Pract 2016;17(12):978-984

The decalcification protocol of dentin surface with sodium hypochlorite removes the exposed collagen fibrils and could improve the longevity of the bonding interface. This study evaluated the influence of collagen removal with 10% sodium hypochlorite (10% NaOCl) on the longitudinal shear bond strength (SBS) of adhesives to dentin.

Seventy-two extracted human molars were sectioned and the buccal and lingual surfaces were flattened and acid etched with 37% phosphoric acid for 15 seconds. The specimens were divided into six groups (n = 12 teeth – 24 sections), according to adhesive and collagen removal protocol: group 1: UNO Dentastic; group 2: Prime and Bond NT; group 3: Single Bond; group 4: 10% NaOCl + UNO Dentastic; group 5: 10% NaOCl + Prime and Bond NT; group 6: 10% NaOCl + Single Bond. Composite Z100 buildup was prepared, and the SBS test was assessed after 24 hours and 1 year. Data were submitted to three-way analysis of variance (ANOVA) and Tukey tests (p < 0.05).

The mean values (MPa) were for 24 hours: G1: 22.45^B; G2: 7.90^DE; G3: 12.56^CD; G4: 19.85^BC; G5: 33.73^A; G6: 20.77^B; and for 1 year: G1: 2.43^E; G2: 2.26^E; G3: 4.3^DE; G4: 18.79^BC; G5: 26.49^AB; G6: 22.73^B.

Dentin deproteinization treatment with 10% NaOCI influenced the SBS compared with conventional treatment. The negative influence on SBS detected for conventional groups at 1-year interval was not detected for deproteinized groups.

The longevity of hybrid layer is critical due to the hydrolysis process at the adhesive interface over time. The use of 10% NaOCl deproteinization protocol might improve the longevity of bonding in adhesive restorations.

Pucci CR, Barbosa NR, Bresciani E, Yui KCK, Huhtala MFRL, Barcellos DC, Torres CRG. Influence of Dentin Deproteinization on Bonding Degradation: 1-year Results. J Contemp Dent Pract 2016;17(12):985-989.

To evaluate the effect of intracanal cryotherapy with negative pressure irrigation (EndoVac) on postendodontic pain after vital single-visit root canal treatment (RCT).

A total of 75 single-rooted teeth with single root canal were treated endodontically. After root canal preparation with Protaper Universal rotary system and irrigation, teeth were divided randomly into three groups (n = 25) according to additional irrigation protocol as follows: Group I: No additional irrigation was applied (control); group II: A 20 mL of room temperature saline was irrigated during 5 minutes using EndoVac, and group III: A 20 mL of 2 to 4°C cold saline was irrigated during 5 minutes using EndoVac. Pain levels were assessed by visual analog scale (VAS) and verbal evaluation of pain questionnaire after 6, 12, 24, 48 hours, and 7 days of canal obturation. The data were then analyzed using Statistical Package for the Social Sciences (SPSS) 13.0 using Kruskal–Wallis and Mann–Whitney U tests at p-value of 0.05.

The results showed that pain levels were high in groups I and II after 6 hours that decreased with time to almost diminish after 1 week, and on the other hand, group III showed no pain among different monitoring periods. Also pain levels in groups II were lower compared with group I after only 6 hours, with significance p < 0.05.

Postendodontic pain presented with highest values after 6 hours of treatment and reduced to almost nil after 1 week. Intracanal cryotherapy eliminated postendodontic pain clinically. Negative pressure reduced postendodontic pain after 6 hours of treatment.

The outcome of this study indicates that the use of intracanal cryotherapy technique with negative pressure irrigation eliminates postendodontic pain after single-visit RCTs.

Al-Nahlawi T, Abo Hatab T, Abd Alrazak M, Al-Abdullah A. Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain. J Contemp Dent Pract 2016;17(12):990-996.

Various bulk-fill materials depending on their composition, viscosity, and flow ability have different physical and mechanical properties. The aim of this in vitro study was to determine and compare the shear bond strength and microleakage properties of activa restorative with other bulk-fill restorative materials surefil (SDR), Biodentine, ever X posterior.

Forty permanent premolars were selected for shear bond strength, and 20 permanent premolars were selected with class II cavities on mesial and distal side for microleakage. Universal testing device was used to assess the shear bond strength. Microleakage was checked using dye penetration method under a stereomicroscope. Mean and standard deviation values were calculated from the recorded values. Intergroup comparison was done by one-way analysis of variance (ANOVA) followed by pairwise comparison using Tukey honestly significant difference (HSD) post hoc test.

The mean shear bond strength was highest for SDR surefil followed by Ever X posterior, Bioactive restorative, and Biodentine respectively. In this study, SDR (surefil) showed better shear bond strength and better microleakage properties compared with the other test materials (F = 186.7157, p < 0.05).

The result of this study showed that flowable and fiber-reinforced composites have better shear bond strength and microleakage properties.

Flowable bulk-fill composite resins can be used as dentin substitutes because of its superior properties.

Alkhudhairy FI, Ahmad ZH. Comparison of Shear Bond Strength and Microleakage of Various Bulk-fill Bioactive Dentin substitutes: An in vitro study. J Contemp Dent Pract 2016;17(12):997-1002.

In restorative dentistry, the clinician commonly encounters the challenge of replicating the color of natural teeth due to the subjectivity of perceptual evaluation. Recent advances in photography and computing have resulted in the widespread use of the digital camera for color imaging. These instruments can be used effectively for shade matching and communication to yield predictable results.

The study sample consisted of 20 freshly extracted noncarious premolars. The Commission Internationale de l'Eclairage (CIE) L*a*b* values of the tooth were obtained through a spectrophotometer, digital camera, and digital camera with a polarizer. Shade selection was carried out using VITA 3D Master and calculating the Euclidian distance. The fabricated metal ceramic crowns were then evaluated to check the shade replication by comparing the CIE L*a*b* values of the crowns with the reference shade tab images.

The three-way analysis of variance (ANOVA) and comparative analysis using Bonferroni test reveals that the difference in the mean L*a* values between spectrophotometer and polarization dental imaging modality (PDIM) was insignificant. The difference in the mean L*a*b* of spectrophotometer and digital camera was statistically significant. The mean ΔE for metal ceramic crowns and shade tabs was 4.2 that was greater than the clinically acceptable level (3.2).

A statistically significant correlation was found to exist between the spectrophotometer and PDIM for all CIE L*, a*, and b* color coordinates.

The present study was undertaken to assess the shade-matching ability of three shade-matching devices, such as spectrophotometer, digital camera, and PDIM, in the accuracy of replication of metal ceramic restorations.

Lakhanpal S, Neelima MS. Accuracy of Three Shade-matching Devices in Replicating the Shade of Metal Ceramic Restorations: An in vitro Study. J Contemp Dent Pract 2016;17(12):1003-1008.

Oral submucous fibrosis (OSF) causes progressive debilitating symptoms, such as oral burning sensation (stomatopyrosis) and limited mouth opening. The standard of care (SOC) protocol includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. The objective of the study was to evaluate efficacy of rebamipide in alleviating burning sensation of the oral mucosa in OSF in comparison with SOC intralesional steroid injections.

Twenty OSF patients were divided into two groups [rebamipide (100 mg TID for 21 days) and betamethasone (4 mg/mL biweekly for 4 weeks)] of 10 each by random sampling. Burning sensation was assessed every week for 1 month. Burning sensation scores were analyzed using repeated measures analysis of variance (ANOVA) and paired t-test.

Change in burning sensation score was significant (p < 0.05) in the first four visits. However, score between the 4th and 5th visit was not statistically significant (p > 0.05).

Our study has shown that rebamipide can be considered as an effective modality to manage burning sensation in patients suffering from OSF.

Considering stomatopyrosis and trismus as a major cause for inability to eat in OSF, use of newer adjunctive modalities, such as rebamipide will ease patients suffering and also encourage them to consume food.

Baptist J, Shakya S, Ongole R. Rebamipide to Manage Stomatopyrosis in Oral Submucous Fibrosis. J Contemp Dent Pract 2016;17(12):1009-1012.

To evaluate the effect of audioanalgesia in 6- to 12-year-old children during dental treatment procedure.

A total of 40 children were selected and divided into two groups, study group – with audioanalgesia and control group – without audioanalgesia. The value of their pain was evaluated using Venham's pain rating scale. Data were compared using one-sample t-test using Statistical Package for the Social Sciences (SPSS) (Inc.; Chicago, IL, USA), version 17.0.

The difference in the control group and study group was statistically significant (p < 0.05).

The method of distraction using audioanalgesia instills better positive dental attitude in children and decreases their pain perception.

Playing or hearing music during dental procedure significantly alters the perception of pain in 6- to 12-year-old children.

Ramar K, Hariharavel VP, Sinnaduri G, Sambath G, Zohni F, Alagu PJ. Effect of Audioanalgesia in 6- to 12-year-old Children during Dental Treatment Procedure. J Contemp Dent Pract 2016;17(12):1013-1015.

This study was planned to find the solubility of the conventional luting cements in comparison with that of the polyacid-modified composite luting cement and recently introduced resin-modified glass ionomer cement (RMGIC) with exposure to water at early stages of mixing.

An in vitro study of the solubility of the following five commercially available luting cements, viz., glass ionomer cement (GIC) (Fuji I, GC), zinc phosphate (Elite 100, GC), polyacid-modified resin cement (PMCR) (Principle, Dentsply), polycarboxylate cement (PC) (Poly - F, Dentsply), RMGIC (Vitremer, 3M), was conducted. For each of these groups of cements, three resin holders were prepared containing two circular cavities of 5 mm diameter and 2 mm depth. All the cements to be studied were mixed in 30 seconds and then placed in the prepared cavities in the resin cement holder for 30 seconds.

From all of the observed luting cements, PMCR cement had shown the lowest mean loss of substance at all immersion times and RMGIC showed the highest mean loss of substance at all immersion times in water from 2 to 8 minutes. The solubility of cements decreased by 38% for GIC, 33% for ZnPO₄, 50% for PMCR, 29% for PC, and 17% for RMGIC.

The PMCR cement (Principle-Dentsply) had shown lowest solubility to water at the given time intervals of immersion. This was followed by PC, zinc phosphate, and GIC to various time intervals of immersion.

Karkera R, Nirmal Raj AP, Isaac L, Mustafa M, Reddy RN, Thomas M. Comparison of the Solubility of Conventional Luting Cements with that of the Polyacid Modified Composite Luting Cement and Resin-modified Glass Ionomer Cement. J Contemp Dent Pract 2016;17(12):1016-1021.

Beauty standards in today's modernized world scenario are formed by well-aligned and well-designed bright white teeth. One of the major reasons behind patients reporting to dental clinics is pain. Caries in the anterior primary teeth forms one of the major concerns from a restorative point of view. Very few studies are quoted in literature which stresses on the follow-up of anterior restorations in primary teeth. Hence, we evaluated and compared the efficacy of composite resin and resin-modified glass ionomer cement (RGIC) for class III restorations in primary anterior teeth.

The present study was conducted in the pediatric dental wing and included a total of 80 patients aged 3 to 5½ years who reported with the chief complaint of carious lesions in the primary anterior teeth. Patients having minimal of a pair of similar appearing small carious lesions on the same proximal surfaces of the deciduous maxillary incisors were included for the study. All the patients were randomly divided into two groups: One in which RGIC restoration was done and other in which composite restoration was done. Cavity preparation was done and filling of the cavity with the restorative materials was carried out. Assessment of the restorations was done at 4, 8, and 12 months time following criteria given by Ryge et al. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Mann–Whitney test and one-way analysis of variance (ANOVA) were used to evaluate the level of significance; p value less than 0.05 was considered as significant.

For composite and RGIC restorations, the mean score for anatomic shape was 1.21 and 1.10 respectively. While comparing the clinical parameters, nonsignificant results were obtained between composite and RGIC restorative materials at 4-, 8-, and 12-month interval. On comparing the clinical parameters for individual restorative materials at different time intervals, statistically significant results were obtained only for anatomical shape and form.

Both RGIC and composite resin restorative materials showed acceptable clinical outcomes after 12 months of follow-up in deciduous anterior teeth. In restoring class III restorations in primary anterior teeth, both the restorative materials showed similar outcome.

Priyank H, Verma A, Gupta K, Chaudhary E, Khandelwal D, Nihalani S. In vitro Comparative Evaluation of Various Restorative Materials used for restoring Class III Cavities in Deciduous Anterior Teeth: A Clinical Study. J Contemp Dent Pract 2016;17(12):1022-1026.

Chemomechanical caries removal (CMCR) is an effective method of caries removal especially for primary teeth as they cause less discomfort when compared with conventional caries removal. The most significant thing about caries removal is the elimination of cariogenic bacteria. This study compares the antibacterial activity of two CMCR gels.

A total of 40 primary molar teeth with carious dentin were split along the long axis in a laboratory. Total viable count (TVC) was taken for the teeth before splitting as a measure of colony-forming units per milliliter (CFU/mL). Each half was treated with either Carisolv or Carie-Care CMCR gels. Clean dentin samples were evaluated for Streptococcus mutans (SM) and Lactobacillus acidophilus (LB) after removal of carious tissue using the caries removal gels using serial dilutions and incubating on specific agar plates.

The results showed significant reduction in mean TVC after use of both the CMCR gels. Both gels reduced the CFU/mL of SM and LB to a significant level (p < 0.05). However, there was no significant difference between the antibacterial activities of the two CMCR gels.

The CMCR gels (Carisolv and Carie-Care) significantly reduced the residual TVC as well as SM and LB in carious primary dentin. Both CMCR gels had a similar antibacterial activity on the carious dentin of primary teeth.

The CMCR gels tested have a significant antibacterial activity and can be effectively used for elimination of caries-causing bacteria in primary teeth.

Gulzar S, Arora R, Shah AH, Bhardwaj B, Abusalim G, Khalil HS, Wyne AH. Antibacterial Activity of Two Chemomechanical Caries Removal Gels on Carious Dentin of Primary Teeth: An in vitro Study. J Contemp Dent Pract 2016;17(12):1027-1032.

This article presents a 6-month case report and an in vitro evaluation of the performance of the new self-etching glass-ceramic monobond etch and prime (MEP) when applied in a lithium disilicate (LD). The MEP contains in the same bottle, along with acid conditioner and silanes. This simplifies the bonding procedures by reducing not only the number of steps, but also the working time. A 42-year-old female patient sought for esthetic treatment, and the main complaint was the darkened appearance of the upper lateral incisor. The esthetic treatment includes dental bleaching and gingivectomy, all-ceramic zirconia crowns, and all-ceramic crown and laminate veneer LD. After 6 months of esthetic treatment, marginal staining, gap, or chip fracturing damaging margins after sharp explorer in the margins was not observed. Furthermore, the inferior etching pattern of MEP was compared with traditional hydrofluoric acid (HF) conditioning. The microshear bond strength to the intaglio surface of LD was statistically similar when HF was compared with MEP. This new self-etching glass-ceramic showed good in vitro and 6 months clinical results in this case report. Future long-term clinical studies with more clinical case need to be done to confirm the performance of the use of this new conditioner.

The use of a new self-etching glassceramic showed a good in vitro and 6 months clinical results. This new product can be an easy, simple, and alternative approach for esthetics bonding procedure.

Siqueira FSF, Alessi RS, Cardenas AFM, Kose C, Souza Pinto SC, Bandeca MC, Loguercio AD, Gomes JC. New Single-bottle Ceramic Primer: 6-month Case Report and Laboratory Performance. J Contemp Dent Pract 2016; 17(12):1033-1039.