Danesh-Sani SA. Peri-implant Diseases: What do We know and What do We need to know?. J Contemp Dent Pract 2016;17(5):347-348.

The purpose of this research was to assess the antibacterial activity of a new bioceramic pulp capping material (endosequence root repair material [ERRM]) against the main cariogenic bacteria: Salivary mutans streptococci (MS) and lactobacilli and compare the results with mineral trioxide aggregate (MTA) and calcium hydroxide (Dycal).

The isolation of MS group bacteria and Lactobacillus (LB) spp. from stimulated saliva was performed with in-office caries risk test bacteria dip slide test. Endosequence root repair material, MTA (ProRoot MTA), and Dycal were used as pulp capping materials. Mutans Streptococci and LB were scattered on the agar dishes with a swab. The pulp capping materials under study were placed in the wells and prepared in the agar, immediately after mixing. The dishes were incubated for 24 hours at 37°C. The growth inhibition zones were recorded and compared for every material and bacterial strain. One-way analysis of variance test was done to compare the development of growth inhibition of selected bacteria against testing materials. Post hoc Tukey honest significant difference was conducted to compare each material group.

All the three selected pulp capping materials were found to inhibit the bacteria LB and MS. The antibacterial activity of ERRM and ProRoot MTA was significantly better than the Dycal. Against MS, ERRM and MTA showed no statistically significant difference. Mineral trioxide aggregate showed significantly better inhibitory activity against LB.

Endosequence root repair material and MTA had superior antibacterial properties against the main cariogenic bacteria: MS and LB compared with Dycal.

A pulp-capping agent having good antibacterial properties can have better success rate in maintaining the vitality of the tooth while treating deep carious lesions in patients.

Elshamy FMM, Singh G, Elraih H, Gupta I, AI Idris F. Antibacterial Effect of New Bioceramic Pulp Capping Material on the Main Cariogenic Bacteria. J Contemp Dent Pract 2016;17(5):349-353.

Surface characterization of dental implants allows us to better understand the effects of the implant on the host biological response. In this study, we analyzed and compared these characteristics among implants commercially available in South Africa.

Eight implants from different manufacturers were chosen for analysis (Touareg, ICE, (R)Evolutions, Uniti, AnyRidge, MIS, Ivory-QSI, Southern), using scanning electron microscopy (SEM), interferometry, and energy dispersive X-ray spectroscopy to study the surface chemical composition and morphology.

The results indicate that variations in manufacturer processes result in implant surfaces that are distinctly different from one another. Most implants presented a moderately rough surface with sandblasted-only implant surfaces having a lower mean value of S_a when compared with sandblasted and acidetched surfaces. Carbon contamination was detected on all the implants and that of aluminum on five implant surfaces. Ca and P were detected on the surface of Touareg implants, indicating the manufacturer's attempt to enhance osseointegration.

The surface of the implants showed a range of chemical, physical properties, and surface topographies.

The results indicate that implant surface treatment is not standardized. This may have clinical implications. Further clinical research is required.

Peck MT, Chrcanovic BR. Chemical and Topographic Analysis of Eight commercially Available Dental Implants. J Contemp Dent Pract 2016;17(5):354-360.

No randomized controlled trial has tried to compare early class III treatment outcomes between the removable mandibular retractor (RMR) and the bone-anchored intermaxillary traction (BAIMT). The objective of this study was to evaluate skeletal, dental, and soft-tissue changes following early class III treatment with these two treatment modalities.

A parallel group randomized controlled trial was conducted on patients with class III malocclusion, treated at the University of Al-Baath Dental School in Hamah, Syria. Ninetythree children with skeletal class III malocclusion were evaluated and 41 children fulfilled the inclusion criteria. Randomization was performed using computer-generated tables; allocation was concealed using sequentially numbered opaque and sealed envelopes. Thirty-eight participants were analyzed (mean age 11.46 ± 1.28 years). They were randomly distributed into two groups receiving either the RMR or the BAIMT technique with 19 children in each (1:1 allocation ratio). The primary outcome measure was the horizontal movement of points A, B, and Pogonion.

Point A showed greater anterior movement in the BAIMT group (x̄ = 1.69 mm) than in the RMR group (x̄ = 1.05 mm; p < 0.001). Points B and Pog showed posterior movement in the BAIMT group (x̄ = −3.01 and −2.51 mm respectively) and anterior movements in the RMR group (x̄ = 0.22 and 0.78 mm respectively).

The BAIMT appeared to be more effective than the RMR in the correction of mild to moderate class III malocclusion in growing patients.

Bone-anchored intermaxillary elastics appears to be a promising solution for class III growing patients with mild to moderate degrees of skeletal discrepancy.

Majanni AMR, Hajeer MY. The Removable Mandibular Retractor vs the Bone-anchored Intermaxillary Traction in the Correction of Skeletal Class III Malocclusion in Children: A Randomized Controlled Trial. J Contemp Dent Pract 2016;17(5):361-371.

Recent metallurgical research and advancement in material science has benefited orthodontists in the selection of an appropriate wire size and alloy type, which is necessary to provide an optimum and predictable treatment results. The purpose of the study was to clinically evaluate and compare the surface characteristics of 16 × 22 stainless steel, Titanium molybdenum alloy, timolium, and titanium-niobium before and after placing them in a patient's mouth for 3 months using a scanning electron microscope (SEM).

The total sample size was 40, which were divided into four groups (group 1 – stainless steel wires, 10 samples, group 2 – TMA wires, 10 samples, group 3 – timolium wires, 10 samples, and group 4 – titanium-niobium wires, 10 samples), and these were further subdivided into 5 each. The first subgroup of five samples was placed in the patient's mouth and was evaluated under SEM, and another subgroup of five samples was directly subjected to the SEM.

Scanning electron microscopic evaluation of surface characteristics of unused 16 × 22 rectangular stainless steel wire under 500 × magnification showed an overall smooth surface. Stainless steel wire samples placed in the patient's mouth showed black hazy patches, which may be interoperated as areas of stress. TMA unused wires showed multiple small voids of areas and small craters with fewer elevated regions. The TMA wire samples placed in the patient's mouth showed black hazy patches and prominent ridges, making the wire rougher. Timolium unused archwires showed heavy roughness and voids, whereas wires tested in the patient's mouth showed homogeneous distribution of deep cracks and craters. Unused titanium-niobium archwires showed uniform prominent striations and ridges with occasional voids, whereas wires used in the patient's mouth showed prominent huge voids that could be interpreted as maximum stress areas.

Stainless steel (group 1) used and unused wires showed smooth surface characteristics when compared with all the other three groups followed by timolium, which was superior to titanium-niobium wires and TMA wires.

Timolium wires are superior to titaniumniobium wires and TMA wires.

Babu KP, Keerthi VN, Madathody D, Prasanna AL, Gopinath V, Kumar MS, Kumar AN. Evaluating the Surface Characteristics of Stainless Steel, TMA, Timolium, and Titanium-niobium Wires: An in vivo Scanning Electron Microscope Study. J Contemp Dent Pract 2016;17(5):372-376.

Resin infiltration is an emerging technique for management of noncavitated lesions. This study evaluated the in vitro hydrolytic and color stability of the ICON® resin infiltration system (IC) in 42 extracted human teeth.

ICON^® resin infiltration system was compared with dental adhesive (DA) and dental sealant (DS). The products were applied according to manufacturer's instructions. The baseline weight and color of the samples were recorded. Color was recorded by spectoral colorimeter. The samples were subjected to four experimental conditions: (1) group 1: Stored in lactic acid solution (pH 4.9) for 24 hours; (2) group 2: Thermocycled for 100 cycles (temperatures: 5°C, 55°C, and dwell time of 15 seconds); (3) group 3: Stored in 0.1 N sodium hydroxide solution (pH 12.48) for 14 days at 60°C; (4) group 4: Stored in phosphate-buffered saline solution (pH 7.2) at 37°C for 4 months. The weight and color were recorded again after removal of the samples from the experimental conditions. Two-factor analysis of variance models and Tukey's Honestly Significant Difference were performed to assess statistical differences among the groups. Scanning electron microscopy imaging was performed for samples from groups 1, 3, and 4.

All the samples showed loss of material and change in color. In the demineralizing solution, IC showed significantly greater weight loss (p = 0.032) and color change (p = 0.038) compared with DA. Dental Sealant showed significantly greater weight loss than IC (p = 0.027) after thermocycling. Teeth in group 3 exhibited the greatest weight loss (p < 0.001). Teeth in group 2 exhibited the greatest color change (p < 0.001).

All tested materials showed loss of retention and color change in the experimental conditions. Infiltration system exhibited greatest weight loss and color change in demineralizing solution. Dental sealant exhibited greatest weight loss upon thermocycling.

Clinicians should be cautious about the limitations of retention and color stability when considering resin infiltration for incipient lesions.

Ritwik P, Jones CM, Fan Y, Sarkar NK. Hydrolytic and Color Stability of Resin Infiltration: A Preliminary in vitro Trial. J Contemp Dent Pract 2016;17(5):377-381.

Selecting and replacing missing teeth to natural proportions and esthetic preference of a patient in the absence of pre-extraction records is a very challenging task. Although facial analysis and proportions are well discussed in many populations, none exists for the Thrissur, Kerala, population. A prosthodontic rehabilitation for Kerala patients relying on other racial norms may result in dissonant facial proportions. Therefore, the purpose of this study was (1) to evaluate the validity of innercanthal distance as a guide in determining the mesiodistal dimension of six maxillary anterior teeth in a selected Malayalee population in the Thrissur Municipal Corporation area; (2) to check whether innercanthal distance undergoes dynamic changes over time as a result of aging; and (3) to evaluate whether there is a gender difference in the analyzed mean facial and dental proportions in this population.

The study was conducted on 1,200 subjects in the Thrissur Municipal Corporation area. From five wards, 240 subjects were selected, out of which 120 were from the 18 to 25 years age group and 120 from the 40 to 50 years age group. Sixty males and females were selected from each group. The innercanthal distance was measured using a Digital Vernier Caliper, and alginate impressions were made to evaluate the size of maxillary anteriors. The data was analyzed statistically.

The study showed that there is a high statistical significance between the innercanthal distance and the mesiodistal width of six maxillary anterior teeth in females (p < 0.01) and no significance in males. There was also dynamic changes in the innercanthal dimension and the mesiodistal width of maxillary anteriors with increase in age (p < 0.001). The difference in the mean of innercanthal distance between the genders was highly statistically significant, but no significance was found between the genders in the mesiodistal width of maxillary anteriors.

Within the population evaluated, there was a high statistical significance in females between the innercanthal distance and the mesiodistal width of six maxillary anterior teeth, but not for males. Innercanthal dimension was found to undergo dynamic changes as age increases in both males and females, and it was much higher in males than in females. There was no statistical significance in the comparative evaluation of mesiodistal width of maxillary anteriors of males and females in the study.

Teeth selection is a critical step in determining the outcome of successful prosthodontic treatment. No definite guidelines for the selection of maxillary anterior teeth pertaining to the Thrissur, Kerala, population exist. A prosthodontic rehabilitation of Thrissur, Kerala, patients relying on other racial norms will result in dissonant facial proportions. In selecting maxillary anterior teeth, the knowledge of racial norms will help specify certain esthetic and functional modifications in treatment plans, which might be specific to each group. Therefore, there remains an unquestionable need for a scientific and reliable method for maxillary anterior teeth selection, which can be applied on this group of Indian population.

Attokaran G, Shenoy K. Correlation between Innercanthal Distance and Mesiodistal Width of Maxillary Anterior Teeth in a Thrissur, Kerala, India, Population. J Contemp Dent Pract 2016;17(5):382-387.

Sense of coherence (SOC) is an important psychological factor that enables people to cope with stressors and successfully maintain and improve health. Oral health affects general health and impacts quality of life. The aim of the present study is to assess the association between SOC and oral health status among 16 to 17-year-old preuniversity students in Virajpet, Karnataka, India.

A total of 361 subjects were included in the study by stratified cluster random sampling method. Sense of coherence was measured using the Kannadatranslated 13-item scale proposed by Antonovsky. Oral health status was measured using oral hygiene index – simplified (OHI-S), Silness and Loe Plaque index, Community Periodontal Index (CPI) and Loss of Attachment (LA) as well as decayedmissing- filled teeth (DMFT) index. Chi-square test and analysis of variance were used to evaluate the association between SOC and oral health.

There was no statistically significant association of plaque index and caries experience with SOC, whereas the SOC scores were found to be significantly associated with loss of attachment and OHI-S among the subjects. The distribution of the mean number of sextants with loss of attachment was more among males.

Sense of coherence has a role to play in the maintenance of oral health. There is a need to closely examine the psychodynamic factors that affect oral health.

There is good evidence that SOC is a resource capable of promoting health, strengthening resilience, and developing a subjectively positive state of health.

Shilpa M, Naik SP, Potdar S, Reddy SG, Patwardhan PK, Shree SS. Sense of Coherence and Oral Health Status among 16 to 17-year-old Preuniversity Students of Virajpet Taluk: A Cross-sectional Study. J Contemp Dent Pract 2016;17(5):388-393.

The purpose of this in vitro study is to compare the compressive strength (CS) and diametral tensile strength (DTS) of the zirconia-reinforced restorative material (Zirconomer^®) with conventional glass ionomers (Fuji 1X) and amalgam.

Specimens (n = 120) were fabricated from silver amalgam, reinforced glass ionomer cement (GIC) (glass ionomer, Fuji 1X GC Corp.), and zirconia-reinforced glass ionomer (Zirconomer, Shofu Inc.) for testing the CS and DTS. The results were analyzed using analysis of variance, followed by a Tukey post hoc test.

Both CS and DTS were found to be significantly higher for the zirconia-reinforced GIC and silver amalgam compared with GIC (p < 0.001).

A newer class of restorative material like Zirconomer helps to overcome the potential hazard of mercury, but retains the strength and durability of amalgam as well as the sustained high-fluoride release of GICs. Furthermore, long-term studies are required to confirm its use as an alternative to the currently available posterior restorative material.

Chalissery VP, Marwah N, Almuhaiza M, AlZailai AM, Chalisserry EP, Bhandi SH, Anil S. Study of the Mechanical Properties of the Novel Zirconia-reinforced Glass Ionomer Cement. J Contemp Dent Pract 2016;17(5):394-398.

The purpose of this study was to compare the effect of enamel wetness on microshear bond strength using different adhesive systems.

To evaluate microshear bond strength of three bonding agents on dry enamel; to evaluate microshear bond strength of three bonding agents on wet enamel; and to compare microshear bond strength of three different bonding agents on dry and wet enamel.

Sixty extracted noncarious human premolars were selected for this study. Flat enamel surfaces of approximately 3 mm were obtained by grinding the buccal surfaces of premolars with water-cooled diamond disks. This study evaluated one etch-and-rinse adhesive system (Single Bond 2) and two self-etching adhesive systems (Clearfil SE Bond and Xeno-V). The specimens were divided into two groups (n = 30). Group I (dry) was air-dried for 30 seconds and in group II (wet) surfaces were blotted with absorbent paper to remove excess water. These groups were further divided into six subgroups (n = 10) according to the adhesives used. The resin composite, Filtek Z 250, was bonded to flat enamel surfaces that had been treated with one of the adhesives, following the manufacturer's instructions. After being stored in water at 37°C for 24 hours, bonded specimens were stressed in universal testing machine (Fig. 3) at a crosshead speed of 1 mm/min. The data were evaluated with one-way and two-way analysis of variance (ANOVA), t-test, and Tukey's Multiple Post hoc tests (α = 0.05).

The two-way ANOVA and Tukey's Multiple Post hoc tests showed significant differences among adhesive systems, but wetness did not influence microshear bond strength (p = 0.1762). The one-way ANOVA and t-test showed that the all-in-one adhesive (Xeno-V) was the only material influenced by the presence of water on the enamel surface. Xeno-V showed significantly higher microshear bond strength when the enamel was kept wet. Single Bond 2 adhesive showed significantly higher microshear bond strength as compared with Xeno-V adhesive but no significant difference when compared with Clearfil SE Bond adhesive in dry enamel. Single Bond 2 adhesive showed no significant difference in microshear bond strength as compared with self-etching adhesive systems (Clearfil SE Bond and Xeno-V), when the enamel was kept wet.

From the findings of the results, it was concluded that self-etching adhesives were not negatively affected by the presence of water on the enamel surface.

The all-in-one adhesive showed different behavior depending on whether the enamel surface was dry or wet. So the enamel surface should not be desiccated, when self-etching adhesives are used.

Kulkarni G, Mishra VK. Enamel Wetness Effects on Microshear Bond Strength of Different Bonding Agents (Adhesive Systems): An in vitro Comparative Evaluation Study. J Contemp Dent Pract 2016;17(5):399-407.

Some relation exists between oral and general health with progressive aging. Certain risk factors are common between oral and systemic diseases. Absence of teeth also affects the oral health by altering the quality of life. Hence, the nutritional changes occurring in elderly patients following prosthodontic rehabilitation are evaluated.

A total of 250 patients who underwent prosthodontic treatment for missing teeth were included for the study. Twice measurement of nutritional parameters was done: Initially at the time of diagnosis and then 5 months following commencement of the prosthodontic treatment. Dental analysis, evaluation of the diet, anthropometric assessment, and analysis of serum biochemical values were done in all the patients and tabulated records were maintained. Independent Student's t test and Tukey's test were done to assess the level of significance.

A total of 250 patients were included for the study. The complete denture (CD) group showed the highest alteration in the mean values of the nutritional parameters followed by the removable partial denture group. A significant change was seen in the body mass index, protein, carbohydrate, and iron levels among the different patients who were grouped based on the mode of treatment modality. The CD group showed significantly higher mean change in carbohydrates value compared with mean change in patients receiving fixed treatment.

Both nutrition and diet form an integral part of the prosthodontic treatment to maintain the health of elderly population.

With the advancement in the level of edentulism, rehabilitation by prosthetic treatment has become progressively important to restore and improve dietary parameters.

Aneja S, Jeergal VA, Patel A, Bhardwaj A, Patel N, Shah V. Assessment of Various Nutritional Parameters in Geriatric Patients Who underwent Different Prosthodontic Treatments. J Contemp Dent Pract 2016;17(5):408-413.

Osteonecrosis is one of the prevalent side effects of bisphosphonate (BP) therapy in oral cancer patients. In case of patients with various oncologic lesions, standard guidelines contraindicate the use of dental implants if the patients are on BP therapy. Literature also quotes studies that emphasize on the safety of dental implants in patients on BP therapy. Hence, this study aimed to retrospectively evaluate the clinical outcome of dental implants in patients on BP therapy.

In this retrospective analysis, a total of 140 dental implants in 112 patients were included. Inclusion criteria included only those patients who were on or had history of BP therapy. Calculation of implant failure and survival rate was done.

Ten cases of implant failure occurred, giving a success rate of above 92%, which was comparable to the results found in previous studies in patients who were not on BP therapy.

No significant risk of implant failure is seen in patients on BP therapy compared with other patients.

Suvarna S, Dutt P, Misra A, Usmani N, Singh A, Suvarna C. Intricate Assessment and Evaluation of Dental Implants in Patients on Bisphosphonate Therapy: A Retrospective Analysis. J Contemp Dent Pract 2016;17(5):414-417.

Alfawaz Y. Zirconia Crown as Single Unit Tooth Restoration: A Literature Review. J Contemp Dent Pract 2016;17(5):418-422.