Sarode GS, Sarode SC, Patil S. Onco- Golgi: The Missed Target. J Contemp Dent Pract 2016;17(6): 423-424.

General dentists issue approximately 10% of antibiotic prescriptions across the global medical community consummation. The use of antibiotics for the management of dentoalveolar infections should be considered only in the presence of an increased risk of a systemic involvement or to prevent metastatic infections. This study aimed to investigate the prophylactic and therapeutic antibiotic prescription patterns of Lebanese dentists for the management of dentoalveolar abscesses. The aim was to evaluate the influence of the patients’ medical condition and clinical signs data on the patterns of antibiotics prescription.

Only patients with a dentoalveolar abscess were included in the study. Age, medical history, reason for consultation, clinical signs and symptoms, diagnosis, type of local treatment, and type of antibiotherapy were collected for each patient attending dental clinics in Beirut. The data were analyzed with chi-square test and multivariate regression.

Out of the 563 initial patients, 127 were selected for the study and received a local treatment. The patient's medical condition and age did not affect the decision to prescribe antibiotics 36.2% patients with pain and 11.8% patients with swelling were prescribed antibiotics. Pain and swelling contributed to a higher level of antibiotic prescription compared to other signs and symptoms. Antibiotics were prescribed inappropriately to 51.76 and 38.10% among patients with an acute or chronic dentoalveolar abscess respectively. The main prescribed antibiotic was amoxicillin.

This study showed that dentists often did not follow the current prophylactic and therapeutic antibiotic prescription guidelines.

Antibiotics prescriptions in dentistry will be more pertinent, leading to a decrease in inadequacy of prescriptions, microbial resistance, and the development of multiresistant germs against antibiotics.

Asmar G, Cochelard D, Mokhbat J, Lemdani M, Haddadi A, Ayoub F. Prophylactic and Therapeutic Antibiotic Patterns of Lebanese Dentists for the Management of Dentoalveolar Abscesses. J Contemp Dent Pract 2016;17(6):425-433.

To evaluate changes in transverse dimensions of upper arch and thickness of the buccal bone plate in patients undergoing orthodontic treatment during the leveling phase.

Sixteen patients aged between 11 and 30 years, presenting with class I and II malocclusion, with minimum of 2 mm crowding treated without extraction, were divided into two groups: GI (n = 8), self-ligating brackets (Easyclip Aditek), and GII (n = 8), conventional preadjusted brackets (3M Unitek). The intercanines, interpremolar, and intermolar widths were measured in dental casts using a digital caliper, before (T1) and after 6 months of treatment (T2). Measurements of the thickness of the bone plate were performed by using cone-beam computed tomography (CBCT) scans and Dolphin three-dimensional program. Paired and nonpaired t tests were applied to analyze the results in and between the groups for the changes in the transversal arch dimensions and buccal bone thickness.

In all statistical tests, the significance level was set at 5%. A nonsignificant increase in transverse dimensions and a slight reduction on thickness of the buccal bone plate were observed in both groups.

The dimensional changes of transverse and thickness of the bone plate during the initial phase of treatment were similar, regardless of the bracket design.

It should be noted that the bracket design does not influence the treatment course regarding transversal dimensions and buccal bone thickness.

Ibiapina DJ, Oltramari-Navarro PV, Navarro RL, Almeida MR, Mendonça DL, Conti ACCF. Assessment of Dental Arch Changes and Buccal Bone Thickness in Patients treated with Self-ligating Brackets. J Contemp Dent Pract 2016;17(6):434-439.

Epidemiological data on gingivitis in children are important for understanding the natural course of the disease, identifying its risk factors, and predicting its time trends. The objective of this study was to evaluate the prevalence and severity of gingivitis among 6- and 12-year-old school children in Dhamar city, Yemen.

A total of 663 children (310 children of 6 years old and 353 children of 12 years old) were examined from 10 public primary schools. Gingival health status was assessed using the plaque index (PI), calculus index (CI), and gingival index (GI) on the six Ramfjord teeth. The latter index was used to categorize gingivitis severity at the subject level. Data were analyzed using independent t-test, chi-squared test, and Spearman's correlation. A p-value of < 0.05 was considered significant.

Both age groups had high mean of PI and GI with nonsignificant difference. The 12-year-old children had calculus deposits much higher than the 6-year-old group with significant difference. There was a significant correlation between age and gender of the whole sample with CI [(odds ratio, OR = 1.65, p = 0.003) and (OR = 0.74, p = 0.05) respectively]. Most of the participants presented with gingival inflammation, which was less in 12-year-old females.

Poor oral hygiene and mild gingivitis were highly prevalent among Yemeni school children.

The early assessment and intervention of gingivitis and periodontitis will minimize the chance of tooth loss. It has been reported that marginal gingivitis begins early in childhood, increases in prevalence and severity at puberty, and then subsides slightly to the remainder of the second decade of life.

Amran AG, Alhajj MN, Al-Rafik NA-HM. Evaluation of Gingival Health Status among 6- and 12-years-old Children in Dhamar City, Yemen: A Cross-sectional Study. J Contemp Dent Pract 2016;17(6):440-444.

Obturation of root canal with internal resorption represents a major challenge in Endodontics. In spite of that, usual obturation techniques are often employed without considering the best technique to solve this problem. The goal of this study was to investigate the ability of GuttaFlow2 in filling artificial internal resorption cavities.

The study sample included 36 human upper central incisors that were prepared using Protaper system (F4). Internal resorption cavities were prepared by cutting each tooth at 7 mm from the apex and preparing hemispherical cavities on both the sides and then re-attaching them. The sample was randomly separated into three groups (n = 12 in each group). In the first group, thermal injection technique (Obtura II) was employed and served as the control group. In the second group, injection of cold free-flow obturation technique with a master cone (GF2-C) was employed, whereas in the third group injection of cold free-flow obturation without a master cone (GF2) was followed. The teeth were re-cut at the same level as before and examined under a stereomicroscope. Subsequently, the captured images were transferred to AutoCAD program to measure the percentage of total filling “TF,” gutta-percha “G,” sealer “S,” and voids “V” out of the total surface of the cross sections.

All materials showed high filling properties in terms of “total filling,” ranging from 99.17% (for Obtura II) to 99.72% (for GF2-C). Regarding gutta-percha percentages of filling, they ranged from 83.15 to 83.93%, whereas those for the sealer ranged from 5.71 to 15.24%. GuttaFlow2 group with a master cone appeared to give the best results despite the insignificant differences among the three groups.

The GuttaFlow2 with a master cone technique seemed to be a promising filling material and gave results similar to those observed with Obtura II. It is recommended for use to obturate internal resorption cavities in clinical practice due to its good adaptability to root canal walls, ease of handling, and application.

Internal resorption defects can be successfully filled with GuttaFlow2 material when supplemented with a master cone, and the results are comparable with those obtained with the Obtura II technique.

Mohammad Y, Alafif H, Hajeer MY, Yassin O. An Evaluation of GuttaFlow2 in Filling Artificial Internal Resorption Cavities: An in vitro Study. J Contemp Dent Pract 2016;17(6):445-450.

The aim of this study is to assess the influence of eating, prior to application of professionally used gels, on the rate of fluoride absorption due to the ingestion of 1.23% acidulated phosphate fluoride (APF).

After fasting for 12 hours, 16 adult volunteers (> 65 kg) ingested two types of meal: Breakfast (n = 8) and Lunch (n = 8). Accidental ingestion of fluoride gel used in molding trays was simulated (12,300 ppm; 61.5 mg F; pH = 4.65) 15 minutes after eating. After ingestion of the fluoride solution, 3 mL of venous blood were collected at the following times: Zero (before ingestion) and 15, 30, 45 minutes, 1, 2, and 3 hours. Fluoride concentrations in blood plasma were determined using an ion selective electrode.

With the exception of time 0 (p > 0.05), the average blood plasma concentration of the breakfast group (BG) (0.34 ± 0.04 mg/L) was higher than that of the lunch group (LG) (0.24 ± 0.03 mg/L), with the moment of peak concentration being 2 hours after ingestion for both groups (BG = 0.4 mg/L; LG = 0.28 mg/L).

Results reinforce the idea that eating before undergoing professional application of fluoride is a factor of extreme importance regarding its safety, and that the time following a patient's heaviest meal should be the time of choice for planning clinical care.

Our results should be considered when planning collective action that involves the application of the gel on children in a school environment, thus ensuring the procedure's safety.

Cavalli AM, Rebouças AG, Zanin L, Flório FM. Assessment of the Influence of Meal Type on Fluoride Absorption due to Ingestion of professionally Applied Gels. J Contemp Dent Pract 2016;17(6):451-456.

The aim of this study is to evaluate the in vitro response of human gingival fibroblasts in primary cultures to two materials for temporary relining of dentures: Temporary Soft (TDV, Brazil) and Trusoft (Bosworth, USA) for 24 hours, 7 and 30 days by using a multi-parametric analysis.

Each material sample (TDV, TS, Polystyrene, Latex) was prepared and incubated in a culture medium for 1, 7, and 30 days at 37°C. Human gingival fibroblasts were exposed to the extracts and cell viability was evaluated by a multi-parametric assay, which allowed sequential analysis of mitochondrial activity (XTT), membrane integrity [neutral red (NR)], and cell density [crystal violet dye exclusion (CVDE)] in the same cells. Analysis of variance (ANOVA) was used to test the interactions of the three sources of variation (material, test method, and time) with the proportions of viable cells for each relining material.

Both evaluated materials (TDV and TS) had low cytotoxic effects during 1, 7, and 30 days after manipulation of the material, as assessed by all three methods used. A statistical difference was found when comparing the negative control group (latex fragments) with the other groups, which showed high toxicity and low percentage of cell viability in all tests used. There was no significant difference among other materials (p > 0.05).

Low cytotoxicity levels were detected by representatives of the major groups of temporary prosthetic relining materials, as evaluated by multiple cellular viability parameters in human fibroblasts.

There are various soft materials on the market for relining prostheses; however, the effects of these materials on tissues need to be clarified to avoid problems for patients.

Caldas IP, Scelza MZ, Gallito MA, Alves G, Silva L. In vitro Analysis of Cytotoxicity of Temporary Resilient Relining Materials. J Contemp Dent Pract 2016;17(6):457-462.

The purpose of this study is to functionally evaluate the behavior of the masticatory muscles (masseter and temporalis) following zygomaticomaxillary complex (ZMC) fractures by assessing bite force, electromyography (EMG), and mandibular movements.

Group I consisted of 20 patients with unilateral ZMC fractures who were treated surgically with one-, two-, or three-point fixations at the frontozygomatic, infraorbital, or zygomaticomaxillary buttress region as per clinical and radiological assessments. Group II control group included 20 normal patients. The muscle activity was functionally evaluated before and after the surgery for a period of 6 months. The evaluation consisted of bite force measurement, EMG analysis of masseter and temporalis muscles, and measurements of mandibular movements.

There was an increase in bite force and EMG activity throughout the evaluated postoperative period, but at the end of 6 months, the values were still below the control levels for majority of the patients. Maximum mouth opening increased considerably after the surgery.

According to bite force and EMG, the masticatory musculature returned to near normal levels by the 3rd month after the surgery.

Management of fractures of the zygoma by open reduction and fixation raises the question of the location of fixation points owing to the action of masseter and temporalis on the ZMC. This study supports the current clinical concept of minimized fixation in treating ZMC fractures.

Panchanathan S, Saranathan M, Kamalakaran AK, Duraisamy K. Functional Evaluation of the Behavior of Masticatory Muscles in Zygomaticomaxillary Complex Fracture: A Prospective Study. J Contemp Dent Pract 2016;17(6):463-469.

One of the most common and effective ways of replacing missing teeth is by dental implants. Both quality and quantity of bone along with the area of implant placement govern the prognosis of the implant procedure. Certain risk factors predispose the implant treatment to high failure rate. Hence, we assessed the implant patients who were referred from private practitioners to the specialty hospitals from 2010 to 2014.

All the patients being referred from private clinics to the specialty dental hospital for the purpose of prosthetic rehabilitation by dental implants from June 2010 to July 2014 were included in the present study. Skilled oral and maxillofacial surgeons were appointed for performing the implant surgical procedures. Prosthetic rehabilitation was done after 6 to 8 weeks and after 10 to 14 weeks in implant cases without and with bone augmentation procedures respectively. Distribution of dental implants based on the indications, location, dimension of augmentation procedure, and complication of implants was analyzed and assessed for the level of significance.

Of the patients, 712 were females, while the remaining were males. Most of the patients were in the age group of 50 to 59 years. As compared with completely edentulous patients, most of the patients required rehabilitation by a single implant. Maximum dental implants were placed in maxillary premolar region and mandibular first molar region. Over 1,000 cases in this study required rehabilitation by augmentation procedure.

Partially edentulous patients are most commonly referred to specialized dental hospitals for prosthetic rehabilitation by dental implants, mostly with the purpose of implant placement. Failure rate can be minimized by following strict patient selection protocols along with following a standard surgical criterion.

Following standard surgical protocols and strict treatment planning, prognosis of the dental implant procedures can be improved to a greater extent, thereby increasing its clinical success rate.

Thukral R, Kumar A, Prasant MC, Punjabi KM, Paliwal A, Patel K. Assessment of Patients Referred to Specialty Dental Hospitals for Dental Implant Procedure: A Retrospective Cohort Analysis. J Contemp Dent Pract 2016;17(6):470-475.

Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia. Therefore, we conducted this retrospective analysis of oral health status of CSHCN receiving various dental treatments in a given population.

A total of 200 CSHCN of age 14 years or less reporting in the pediatric wing of the general hospital from 2005 to 2014 that underwent comprehensive dental treatment under general anesthesia were included in the study. Patients with history of any additional systemic illness, any malignancy, any known drug allergy, or previous history of any dental treatment were excluded from the study. Complete mouth rehabilitation was done in these patients under general anesthesia following standard protocols. Data regarding the patient's disability, type, duration, and severity of disability was collected and analyzed. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Chi-square test, Student's t-test, and one-way analysis of variance were used to assess the level of significance.

Statistically significant results were obtained while analyzing the subject's decayed missing filled/decayed extracted filled teeth indices divided based on age. Significant difference was observed only in cases where patients underwent complete crown placement even when divided based on type of disability. While analyzing the prevalence, statistically significant results were observed in patients when divided based on their age.

In CSHCN, dental pathologies and caries indices are increased regardless of the type or extent of disability.

Children with special health care needs should be given special oral health care, and regular dental checkup should be conducted as they are more prone to have dental problems.

Solanki N, Kumar A, Awasthi N, Kundu A, Mathur S, Bidhumadhav S. Assessment of Oral Status in Pediatric Patients with Special Health Care Needs receiving Dental Rehabilitation Procedures under General Anesthesia: A Retrospective Analysis. J Contemp Dent Pract 2016;17(6):476-479.

Inflammation of tooth supporting structures is referred to as periodontitis. C-reactive proteins (CRP) levels are usually increased in case of chronic inflammatory process like periodontitis. Association of CRP with pregnancy has been observed in the past, which includes most commonly preterm delivery, preeclampsia, etc. Therefore, it can be hypothesized that CRP may act as a link between periodontitis and adverse pregnancy outcomes. Hence, we aim to evaluate the plasma CRP levels in pregnant women with and without periodontal pathologies.

The study included 210 pregnant women who reported to the hospital with periodontal problems and for routine checkups. All the patients were divided into three groups based on the presence and absence of periodontal pathologies. Russell's Periodontal Index Score was used for the evaluation of periodontal status of the subjects.

While comparing the mean CRP levels in all the three study groups, statistically significant results were obtained. Statistically significant results were obtained while comparing the mean CRP levels in group C patients before treatment and after treatment therapy. The CRP levels were estimated by taking blood samples. Paired t-test and one-way analysis of variance was used to assess the correlation between the two parameters.

Casual association might exist between the CRP levels and periodontal diseases in pregnant women and the CRP levels may also get elevated in pregnant women.

Mannava P, Gokhale S, Pujari S, Biswas KP, Kaliappan S, V Shashank. Comparative Evaluation of C-reactive Proteins in Pregnant Women with and without Periodontal Pathologies: A Prospective Cohort Analysis. J Contemp Dent Pract 2016;17(6):480-483.

Rheumatoid arthritis (RA) and periodontitis are common chronic inflammatory conditions. Several studies suggested a relationship between RA and periodontitis. Recent studies have shown a beneficial effect of periodontal treatment on the severity of active RA. So the aim of this study was to examine the effect of nonsurgical periodontal therapy on the clinical parameters of RA.

A total of 60 subjects with moderateto- severe chronic generalized periodontitis and active RA in the age range 18 to 65 were selected for the study. They were divided into two groups. Group A (control group) consisted of 30 subjects with chronic generalized periodontitis and RA, and group B of 30 subjects with chronic generalized periodontitis and RA and they received nonsurgical periodontal therapy (scaling, root planning, and oral hygiene instructions). Evaluation of clinical observations of Simplified Oral Hygiene Index (OHI-S), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), number of swollen joints (SJ), number of tender joints (TJ), values of erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) for patient's global assessment, 3 months disease activity score (DAS) index, and C-reactive protein (CRP) was done at baseline and 3 months. Statistical evaluation of clinical observations was carried out.

Group B subjects who received nonsurgical periodontal therapy showed statistically significant improvement in all periodontal and RA parameters at 3 months, compared with group A who did not receive periodontal therapy.

It can be concluded from the result that nonsurgical periodontal therapy may contribute to reduction in severity and symptoms of RA.

Rheumatoid arthritis patients should be evaluated for periodontitis and treated for the same in order to reduce its severity level.

Khare N, Vanza B, Sagar D, Saurav K, Chauhan R, Mishra S. Nonsurgical Periodontal Therapy decreases the Severity of Rheumatoid Arthritis: A Case–control Study. J Contemp Dent Pract 2016;17(6):484-488.

Spontaneous regeneration of bone is commonly seen in the small surgical defects caused by enucleation of cysts. However, in case of large surgical defects caused by the enucleation, spontaneous regeneration of bone is a rare phenomenon and it depends on factors, such as age of the patient, intact periosteum, and proper stabilization.

The study included 16 patients, who reported to the department of oral and maxillofacial surgery with the complaint of pain and swelling in the jaws diagnosed as cyst. The sample included equal numbers of male and female subjects aged between 15 and 40 years. Panoramic radiographs were taken pre- and postoperatively on day 2 of the enucleation.

The dimensions of the cyst were evaluated on the radiograph according to the proforma.

Subsequent radiographs were taken at regular intervals of 1.5, 3, and 6 months using standard parameters and were analyzed using MCID™ analysis software of imaging research.

Mean reduction was seen in up to 39 and 60% in the cystic cavity size and increase in the mean density up to 59 and 90.2% at 3 and 6 months intervals respectively.

Spontaneous bone regeneration was seen even after primary closure of the large cystic defect without the need for placement of foreign substances or grafts and it also eliminated the complications resulting from placement of foreign substance. Further studies are required in a larger sample with longer follow-up durations to confirm the outcome of the present work for the benefit of patients.

The present study depicted that spontaneous bone regeneration can occur with accepted results after simple enucleation of jaw cyst without the aid of any graft material. Hence, simple enucleation may be considered as a first line of treatment modality for cystic lesion of the jaws. This simplifies the surgical procedure, decreases the economic and biologic costs, and reduces the risk of postoperative complications. Follow-up is necessary along with patient's compliance for the success of treatment.

Wagdargi SS, Rai KK, Arunkumar KV, Katkol B, Arakeri G. Evaluation of Spontaneous Bone Regeneration after Enucleation of Large Cysts of the Jaws using Radiographic Computed Software. J Contemp Dent Pract 2016;17(6):489-495.

The results of previous studies about the efficacy of using self-ligating brackets (SLBs) in controlling canine movement during retraction are not in harmony. Therefore, the current study aimed to compare the effects of using new passive SLBs on maxillary canine retraction with sliding mechanics vs conventional ligating brackets (CLBs) tied with metal ligatures.

The sample comprised 15 adult patients (4 males, 11 females; 18–24 years) requiring bilateral extraction of maxillary first premolars. Units of randomization are the left or right maxillary canines within the same patient. The two maxillary canines in each patient were randomly assigned to one of the two groups in a simple split-mouth design. The canines in the SLBs group (n = 15) were bracketed with SLBs (Damon Q™), while the canines in the CLBs group (n = 15) were bracketed with conventional brackets (Mini Master Series). Transpalatal bars were used for anchorage. After leveling and alignment, 0.019 × 0.025ʺ stainless steel working archwires were placed. Canines were retracted using a nickel-titanium close-coil springs with a 150 gm force. The amount and rate of maxillary canine retraction, canine rotation, and loss of anchorage were measured on study models collected at the beginning of canine retraction (T0) and 12 weeks later (T1). Differences were analyzed using paired-samples t-tests.

The effect differences were statistically significant (p < 0.001). Using Damon Q™ SLBs, the amount and rate of canine retraction were greater, while canine rotation and anchorage loss were less.

From a clinical perspective, extraction space closure can be accomplished more effectively using SLBs.

Self-ligating brackets gave better results compared to the CLBs in terms of rate of movement, amount of canine rotation following extraction, and anchorage loss.

Hassan SE, Hajeer MY, Alali OH, Kaddah AS. The Effect of Using Self-ligating Brackets on Maxillary Canine Retraction: A Split-mouth Design Randomized Controlled Trial. J Contemp Dent Pract 2016;17(6):496-503.

Sarode GS, Batra A, Sarode SC, Yerawadekar S, Patil S. Oral Cancer-related Inherited Cancer Syndromes: A Comprehensive Review. J Contemp Dent Pract 2016;17(6):504-510.