Sarode SC, Sarode G, Patil S. Sitespecific Oral Cancers are different Biological Entities. J Contemp Dent Pract 2017;18(6):421-422.

This study aimed to assess oral hygiene-related knowledge and practices among engineering students of Bhubaneswar city and also to evaluate the concepts about the side effects of tobacco usage among those students.

The study was conducted using a self-administered, close-ended questionnaire to assess the oral hygiene knowledge and practices and study the concepts on tobacco usage among 362 engineering students of Bhubaneswar city, Odisha, India. The obtained data were statistically analyzed using Statistical Package for the Social Sciences software version 20.0.

This survey found that 26.51% of the students had never visited a dentist. Nearly 43.64% of the participants were cognizant of the fact that improper brushing is the reason of tooth decay. About 47% of the participants consumed alcohol and 32.6% had the habit of chewing tobacco, though 80% were aware that use of smokeless tobacco can impair oral health and cause cancer and use of alcohol has detrimental effect on oral health.

Knowledge with respect to oral health among engineering students of Bhubaneswar city is adequate regarding using fluoridated toothpaste and flosses. However, an unhealthy snacking habit, overusage of toothbrushes, consumption of alcohol, and practicing tobacco habit show the lack of oral health knowledge in these students.

Our study provides an idea about the present scenario in terms of oral hygiene and tobacco usage in young individuals. This can form the basis for oral health education and tobacco cessation program. Moreover, as the habit of tobacco usage starts early during college life, adequate knowledge about its ill-effects would prevent deadly diseases, such as potentially malignant disorders and oral cancer.

Bandyopadhyay A, Bhuyan L, Panda A, Dash KC, Raghuvanshi M, Behura SS. Assessment of Oral Hygiene Knowledge, Practices, and Concepts of Tobacco Usage among Engineering Students in Bhubaneswar, Odisha, India. J Contemp Dent Pract 2017;18(6):423-428.

The effect of Khat and Shammah habits, with the parafunctional jaw activities that accompany them, on the structure and integrity of the natural dentition has not yet been investigated. The literature lacks studies that identify the patterns of tooth wear among Khat and Shammah users. Therefore, this study is the first attempt to address this concern in Jazan City population, Kingdom of Saudi Arabia.

A cross-sectional survey study was conducted among 300 recruits among dental clinics in Jazan City, Kingdom of Saudi Arabia from October 1, 2015, to April 30, 2016. Questionnaires were used for data collection on oral habits (Khat and Shammah use), age, gender, intake of acidic food or beverages, food habits (intake of fruits, grains, and vegetables), systemic diseases, oral hygiene habits (brushing frequency, technique, and type of toothbrush), parafunctional habits, stress, and acid reflux. Clinical examination was performed to assess the grade of tooth wear. Bivariate analysis was performed to determine the empirical relationship between the independent variables and outcomes. In addition, binary logistic regressions were used to measure the relationship between the independent variables and each of the dependent variables (presence of occlusal wear, tooth wear grade 0 through 4).

Khat and Shammah use was statistically significantly associated with tooth wear (p < 0.05). A significant association of tooth wear was observed with age, gender, intake of acidic food and beverages, oral hygiene habits, and stress.

Consumption of Khat and Shammah may be attributed as one of the major reasons associated with tooth wear among the Saudi population.

The habitual use of Khat and Shammah causes tooth wear of varying severity, which may negatively affect esthetics, phonetics, and function and necessitate a complex restorative treatment.

Sayed ME, Hamdi AD, Hakami BM, Mugri MH, Bhandi SH. Tooth Wear Patterns among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Crosssectional Survey. J Contemp Dent Pract 2017;18(6):429-436.

In cervical lesions, various restorative materials can be inserted, which can be affected by the application of periodontal scalers. This study evaluated and compared the marginal seal of class V glass ionomer, composite resin, and amalgam restorations after subjecting them to hand instrumentation and ultrasonic scaling.

In this experimental study, 30 sound human first premolars were selected. In each tooth, buccal and lingual cavities (4 mm mesiodistal width, 3 mm occlusogingival height, and 2 mm depth) were made. The teeth were randomly assigned to three groups of 10 teeth: (1) Glass ionomer group, (2) composite group, and (3) amalgam group. Teeth were subjected to thermocycling procedure for 1,000 cycles between 5 and 55°C water baths and a 1-minute dwell time. Then, each group was randomly subdivided: (1) Margins of 30 restorations were exposed to hand instrumentation procedures by applying 10 working strokes, (2) margins of 30 restorations were exposed to a periodontal tip mounted on a piezoelectric ultrasonic handpiece working at 25 kHz for 10 seconds. The specimens were serially sectioned mesiodistally. Each section was examined under a stereomicroscope. The extent of microleakage was ranked using a 0 to 4 scale at both occlusal and cervical margins of the restorations. Data were analyzed initially using the Kruskal–Wallis test, followed by multiple comparisons using the Mann–Whitney and Wilcoxon test.

The type of restorative material had a significant influence on dye penetration, whether in the enamel margin or in dentinal margin (p < 0.001). The microleakage of glass ionomer group was the highest. No statistical differences were found in dye penetration between scaling groups (hand instrumentation and ultrasonic scaling) (p > 0.05).

Type of restorative material had a significant influence on microleakage. No statistical differences were found in dye penetration between scaling groups.

The microleakage of glass ionomer restoration is greater than amalgam and composite restorations after subjecting them to hand instrumentation and ultrasonic scaling.

Rohani B, Barekatain M, Farhad SZ, Haghayegh N. Influence of Hand Instrumentation and Ultrasonic Scaling on the Microleakage of various Cervical Restorations: An in vitro Study. J Contemp Dent Pract 2017;18(6):437-442.

Surface treatment is necessarily required for bonding of zirconia to the veneering porcelain and luting cements. Sandblasting is the most common and probably the most efficient surface treatment method. Sandblasting roughens the surface and may affect the flexural strength of zirconia. Different sandblasting protocols may yield variable results. This study sought to assess the effect of sandblasting angle and distance on the biaxial flexural strength of zirconia-based ceramics.

This in vitro experimental study was conducted on 50 zirconia discs measuring 1.2 ± 0.2 mm in thickness and 15 ± 0.2 mm in diameter, which were randomly divided into five groups (n = 10) of one control and four experimental groups subjected to sandblasting with 110 µm aluminum oxide particles under 2 bar pressure for 10 seconds at 15 and 25 mm distances and 45 and 90° angles (between the nozzle head and zirconia surface). Surface roughness was measured by a roughness tester and samples were subjected to thermocycling followed by biaxial flexural strength testing according to ISO6872. The data were analyzed using one-way analysis of variance (p < 0.05).

No statistically significant difference was noted in the mean biaxial flexural strength of the five groups (p = 0.40). Different sandblasting protocols yielded significantly different surface roughness values (p < 0.001). The highest and the lowest mean surface roughness belonged to 15 mm/90° (0.51 µm) and control (0.001 µm) groups respectively.

Change in sandblasting angle and distance had no significant effect on the biaxial flexural strength of zirconiabased ceramic, but surface roughness was significantly different in the study groups.

Regardless of sandblasting angle, increasing distance to 25 mm significantly decreases surface roughness that may negatively affect zirconia bond strength.

Zeighami S, Gheidari A, Mahgoli H, Rohanian A, Ghodsi S. Effect of Sandblasting Angle and Distance on Biaxial Flexural Strength of Zirconia-based Ceramics. J Contemp Dent Pract 2017;18(6):443-447.

The aim of this study was to investigate the inclusion of silver nanoparticles (Ag NPs) in the mineral trioxide aggregate (MTA) composition to know which changes will result in the radiopacity of the material.

The experiment was performed according to the American National Standard Institute/American Dental Association specification no. 57/2000 and ISO 6876/2001. Five plates with five holes measuring 1 mm in depth and 5 mm in internal diameter were filled according to the different experimental groups as follows: white mineral trioxide aggregate (WMTA) + NP50 – W MTA with liquid Ag NP 50 ppm, WMTA + NP30 – W MTA with liquid Ag NP 30 ppm, WMTA + NP22 – W MTA with liquid Ag NP 22 ppm, WMTA + NPP – white MTA with liquid Ag NP and powder 1%, WMTA (control). After filling the plates, they were kept in an incubator at 37°C in relative humidity for setting. Each sample was positioned along an aluminum step-wedge placed above the Opteo digital sensor system. The image was divided into four quadrants, and three readings were made for each quadrant to render the average of each quadrant. The resulting data were submitted to Kruskal–Wallis and Dunn's tests.

The results showed statistically significant differences between WMTA + NP30, WMTA + NP22, and WMTA + NPP interactions compared with WMTA (control) (p < 0.05). The radiopacity was in descending order: WMTA + NPP, WMTA + NP22, WMTA + NP30, MTA + NP50, and WMTA.

Silver NPs changed the radiopacity of WMTA, being more evident in WMTA + NP powder at 1% weight.

The low radiopacity of MTA makes it difficult for any radiographic observation. The Ag NPs appear as an alternative, being an excellent radiopacifier as they have excellent antimicrobial property and relatively low toxicity.

Mendes MSS, Resende LD, Pinto CA, Raldi DP, Cardoso FGR, Habitante SM. Radiopacity of Mineral Trioxide Aggregate with and without Inclusion of Silver Nanoparticles. J Contemp Dent Pract 2017;18(6):448-451.

The fiber post type used in restoring endodontically treated teeth may affect the dental expert decision in the case of dental malpractice. The aim of this study was to evaluate the low-cost commercial fiber post in comparison with a higher cost or well-known documented fiber post system.

A total of 20 premolars were selected for the study; following endodontic treatment, specimens were randomly divided into two groups of 10 specimens each according to the type of fiber post used: (1) Low-cost commercial fiber post (OYAPost, Taper Lucent, OYARICOM) and (2) higher cost well-known fiber post (Rely X Fiber post, 3M ESPE). Both fiber posts were cemented using self-adhesive cement (Rely X Unicem). Samples were subjected to push-out bond strength and to failure analysis. One-way analysis of variance was used (p < 0.005).

There was no significant difference between the bond strength of the two tested groups (p > 0.05), while statistically significant difference (p < 0.05) was noted between the different post space regions (cervical, middle, and apical).

Based on the evidence from the study, it can be concluded that the type of fiber post should not affect the dental expert decision in the case of dental malpractice/lawsuit.

All types of low-cost fiber posts may behave similarly to other higher cost or well-documented fiber posts.

Ayoub F, Jassar H, El Husseini H, Salameh Z. Choice of Endodontic Fiber Posts and its Influence on Dental Malpractice: An in vitro Evaluation. J Contemp Dent Pract 2017;18(6):452-457.

The aim of the study is to analyze and compare the variation of lumen size and thickness of the elastomeric colored modules when immersed in four selected dietary media.

Sample size of 40 modules on each color – such as red, blue, green, and black – was taken and immersed in four dietary media (artificial saliva, coke mixed with artificial saliva, turmeric mixed with artificial saliva, and coffee mixed with artificial saliva). Beakers containing different dietary media and color modules are kept in the incubator at 37°C for 72 hours. After incubation period, all the segments of module strips removed from the dietary media were placed under the electric lamp and photographs were taken using Canon camera (SX400 IS). Photographs were transferred to GIMP software, and lumen size and thickness variation in the modules was measured.

Statistical analysis were performed using analysis of variance and t-test in Statistical Package for the Social Sciences software. It showed significant difference in thickness of black module in all dietary media. Significant difference existed between all the lumen sizes of four color modules in four dietary media.

This study was done to identify the material that has more changes in physical properties when exposed to various dietary media.

According to the results obtained, black color modules have increased in lumen size in all dietary media. In thickness, red color module showed less variation and black color module exhibited more variation.

Kanya SD, Babu KP, Venkatesan R, Kumar AN. Evaluation to prevent the Physical Changes in Colored Elastomeric Modules when exposed to various Dietary Media. J Contemp Dent Pract 2017;18(6):458-462.

The aim of this study was to compare canal transportation and centering ability of Twisted files (TF) and ProTaper (PT) files with conventional stainless steel (SS) K files.

Thirty mandibular premolar teeth with root curvature of 25 to 35° were selected. The samples were randomly divided into three groups of 10 each according to the type of files used for instrumentation. Group I was instrumented using TF, group II with PT files according to the manufacturer's recommendations, and group III with samples prepared with precurved SS K files using a step-back technique. After preparation, the samples were assessed using spiral computed tomography. Three sections were recorded at coronal, middle, and apical levels. Amount of transportation was assessed comparing with preinstrumentation images. Centering ability was calculated using Gambill's formula. The three groups were statistically compared using Student's t-test.

Twisted files showed the least canal transportation and the best centering ability followed by PT file system. Stainless steel K files showed the highest transportation and least centering ability.

Twisted files showed the least amount of transportation and better centering compared with the other file systems.

The study gives information of TF, a recently introduced rotary system (2008) with regard to its efficacy in preparing curved root canals. This study has shown that the centering ratio of rotary nickel titanium was better than that of SS files.

Rejula F, Christalin R, Ahmed W, Dinakaran S, Gopinathan AS, Babu A. Measure and compare the Degree of Root Canal Transportation and Canalcentering ability of Twisted, ProTaper, and Conventional Stainless Steel K Files using Spiral Computed Tomography: An in vitro Study. J Contemp Dent Pract 2017;18(6):463-469.

The present study's aim was to assess the pattern of palatine ridges/rugae to identify gender.

This study consists of a total of 50 participants (25 males and 25 females). Participants of the age range of 20 to 50 years were selected from the outpatient department. According to the shape and size of the patient's arches, maxillary impression trays were selected using alginate, and casts were poured subsequently. With the help of a sharp graphite pencil, the palatine ridges were delineated to make it prominent, and on either side of the midline, the number of rugae was counted and the length measured. Using these parameters, the pattern of rugae was determined. Data were analyzed using independent sample t-test. The level of significance was set at 5%.

Males had more number of palatal rugae (mean 5.96 ± 0.88) compared with females (5.24 ± 0.77), and there was a statistically significant association between them. The mean length of palatal rugae was more in males (6.25 ± 1.15 mm) than females (5.16 ± 1.40 mm), and it was found to be a statistically significant association. The straight pattern was more common in both males and females (2.56 ± 1.08, 2.32 ± 0.85 respectively) than other patterns.

This study concluded that straight rugae pattern has been found to be the most common pattern in both genders. However, the mean number of straight rugae pattern and length is slightly more in males than females.

The most challenging tasks in forensic medicine is human identification. Dental records, dactylogram, and comparing deoxyribonucleic acid are the widely used techniques in mass disasters, but these techniques have their own drawbacks and hence cannot be applied always. In such cases, less known techniques like rugoscopy will be helpful.

Gautam N, Patil SG, Krishna RG, Agastya H, Mushtaq L, Kumar KV. Association of Palatal Rugae Pattern in Gender Identification: An Exploratory Study. J Contemp Dent Pract 2017;18(6):470-473.

The aim was to evaluate the effect of botulinum toxin (Botox) injections as a conservative treatment for gummy smile.

An experimental in vivo study was conducted at a dermatology clinic in Riyadh in January 2016. The study included 23 female patients who ranged from 20 to 50 years and were treated with Botox injections due to excessive maxillary gingival display. The patients with short clinical crowns or long maxilla, those who were pregnant or breastfeeding, and patients with neuromuscular disorders were excluded. Patients received Botox type I, injected 3 mm lateral to the alar-fascial groove at the level of the nostril opening at the insertion of the levator labii superioris alaeque nasi muscle. Photos were taken of the patient's smile before and after the treatment and were then uploaded to the SketchUp program to calculate improvements in gingival display. The distance from the lower margin of the upper lip to the gingival margin was calculated pre- and posttreatment. The amount of improvement was calculated as (pre-Botox treatment – post-Botox treatment/pre-Botox treatment × 100). The mean percentage of the total improvement was analyzed.

A total of 23 female patients received treatment to improve their gummy smile. Improvement was clear 2 weeks after Botox injection. The mean percentage of improvement in the gingival display was 99.6%.

Botox type I is an effective conservative technique to improve gummy smile caused by muscular hyperfunction.

Patients’ retention highly indicated that they were satisfied with the provided treatment by Botox injections. Improving the quality of life with least painful experience and immediate results was the major advantage for Botox type I.

Al-Fouzan AF, Mokeem LS, Al-Saqat RT, Alfalah MA, Alharbi MA, Al-Samary AE. Botulinum Toxin for the Treatment of Gummy Smile. J Contemp Dent Pract 2017;18(6):474-478.

One of the common findings encountered by the clinician at the end of orthodontic treatment is the apical root resorption. Root resorption occurs to various degrees. A severe form of root resorption is characterized by shortening of root for more than 4 mm or more than one-third of the total tooth length. A low incidence rate of resorption is observed based on radiographic findings for the diagnosis of root resorption, panoramic radiography, and periapical radiography. Hence, we evaluated the accuracy of panoramic radiographic films for assessing the root resorption in comparison with the periapical films.

This study included the assessment of all the cases in which pre- and post-treatment radiographs were available for analysis of the assessment of the amount of root resorption. Complete records of 80 patients were analyzed. Examination of a total of 900 teeth was done. Mean age of the patients in this study was 21 years ranging from 11 to 38 years. The majority of the patients in the present study were females. All the treatments were carried out by registered orthodontists having minimum experience of more than 10 years. All the cases were divided into two study groups. Group I comprised panoramic radiographic findings, while group II consisted of periapical radiographic findings. For the measurement of crown portion, root portion, and the complete root length, magnification loops of over 100 powers with parallax correction with inbuilt grids were used. Assessment of the tooth length and the crown length was done by the same observers. All the results were analyzed by Statistical Package for the Social Sciences software version 6.0.

Maximum amount of root resorption was observed in case of maxillary central incisors and canines among group I and II cases respectively. However, nonsignificant difference was obtained while comparing the mean root resorption in relation to maxillary incisors and canines among the two study groups. While comparing the overall value of root resorption among the two study groups, a significant difference was obtained. The maximum value of tooth length in both the groups was observed in cases of maxillary canines. Significant differences were observed while comparing the tooth length of various teeth among the two study groups. Among the deviated forms of root shape, dilaceration was the most common form of root shape detected in both the study groups.

Periapical radiographs are more efficient in the assessment of the shape and resorption of the root.

Thorough evaluation of periapical radiographs is necessary for detection of even minute levels of root resorption.

Ahuja PD, Mhaske SP, Mishra G, Bhardwaj A, Dwivedi R, Mangalekar SB. Assessment of Root Resorption and Root Shape by Periapical and Panoramic Radiographs: A Comparative Study. J Contemp Dent Pract 2017;18(6):479-483.

The aim of the study is to compare the maximum stress distribution on the rotary retreatment instruments within the root canal at cervical, middle, and the apical one-third during retreatment of gutta-percha.

A human mandibular premolar was scanned, and three-dimensional geometry of the root was reconstructed using finite element analysis (FEA) software package (ANSYS). The basic model was kept unchanged; tooth models were created using the same dimensions and divided into two groups as follows: Group I: ProTaper Universal retreatment system and group II: Mtwo rotary retreatment system. The stress distribution on the surface and within the retreatment files was analyzed numerically in the FEA package (ANSYS).

The FEA analysis revealed that the retreatment instruments received the greatest stress in the cervical third, followed by the apical third and the middle third. The stress generated on the ProTaper Universal retreatment system was less when compared with the Mtwo retreatment files.

The study concludes that the retreatment instruments undergo higher stress in the cervical third region, and further in vivo and in vitro studies are necessary to evaluate the relationship between instrument designs, stress distribution, residual stresses after use, and the torsional fracture of the retreatment instrument.

The stress developed on the rotary retreatment instruments during retrieval of gutta-percha makes the instrument to get separated. There is no instrument system, i.e., suitable for all clinical situations and it is important to understand how the structural characteristics could influence the magnitude of stresses on the instrument to prevent its fracture in use.

Sihivahanan D, Reddy TVK, Thomas AR, Senthilnathan N, Sivakumar M, Shivanna S. Comparative Evaluation of Stress developed on Rotary Retreatment Instruments during Retrieval of Gutta-percha. J Contemp Dent Pract 2017;18(6):484-489.

Dermatoglyphics is an extremely useful tool as a preliminary investigation method for diagnosing suspected genetic disorders. Caries being a multifactorial disease with the influence of genetic pattern, early identification of caries risk children with dermatoglyphics can help in using effective and efficient caries preventive measures.

The study was undertaken to record and know the frequency of occurrence of fingerprint patterns among children with caries and in children without caries.

A total of 400 schoolchildren in the age group of 5 to 12 years were selected from a private school, Warangal, Telangana, India. Of 400 schoolchildren, 200 children were with caries group and 200 children were in caries-free group. Children with dental caries in five or more teeth based on the decayed, missing, filled teeth index performed were considered as study group, and the control group was normal healthy children without any dental caries. The fingerprints of each child were recorded using stamp pad method, and type of dermatoglyphic pattern of each digit was recorded based on Cummins and Midlo method. Data obtained were put for statistical analysis; p < 0.001 was considered statistically significant.

Although the frequency of whorl pattern was more prevalent in caries group, it was statistically significant on the left hand third digit of females and on the right hand third digit and the left hand fourth digit of males. Fingerprints of female caries-free group showed maximum of ulnar loop and males showed maximum of arches. There was a decrease in total ridge count in caries group, especially in males.

Dermatoglyphics could be an appropriate method to explore the possibility of a noninvasive and an early predictor for dental caries.

Dermatoglyphics has a future role in identifying people with or at increased risk for dental caries so that risk reduction measures or earlier therapy may be instituted.

Asif SM, Balaji Babu DBG, Naheeda S. Utility of Dermatoglyphic Pattern in Prediction of Caries in Children of Telangana Region, India. J Contemp Dent Pract 2017;18(6):490-496.

This study was conducted to evaluate the microleakage of class V cavities restored with composite resin and different adhesive systems.

In this experimental epidemiological investigation, a total of 75 freshly extracted human teeth were collected. The teeth were randomly divided into three groups (n = 25). Three different intermediate adhesive materials (Clearfil SE Bond, Single Bond, and Xeno III) were used for each group.

On testing without the application of occlusal load, the maximum microleakage was seen for group III (Xeno III) followed by group I (Clearfil SE) and then group II (Single Bond). On application of occlusal load, the maximum microleakage was seen for group III (Xeno III) followed by group II (Single Bond) and then group I (Clearfil SE Bond). The data were analyzed statistically using Kruskal–Wallis and Mann– Whitney U test.

Group III showed the maximum amount of microleakage both with and without occlusal load.

All adhesives under investigation exhibited a certain amount of microleakage in enamel and dentin.

Anjum S, Malik A, Sharma S. Evaluation of Microleakage in Class V Restorations with Three different Adhesive Systems. J Contemp Dent Pract 2017;18(6):497-500.

Organization of the findings associated with various diagnostic aids plays a key role in formulating the treatment plan of the patients undergoing dental and medical treatment. Enhanced consistency in diagnosing and classifying prosthodontic patients is the basic purpose of various classification systems. Hence, we planned this study to classify partially edentulous patients and completely dentate patients at the undergraduate clinics using the prosthodontic diagnostic index (PDI).

This study included classification of 13,599 edentulous patients who attended the clinics of undergraduate students of all the levels. Screening of all the patients was done radiographically with a digital orthopantomograph (OPG), and the data were saved in the computer system. The intraoral periapical radiographs (IOPA) taken for all the affected areas were also saved in the system. Based on the OPG and IOPA, the patients were classified into various classes. All the data of the patients were recorded and analyzed.

Total number of patients screened was 17,220, out of which 3,621 were under 18 years of age and were excluded from the study. Most of the patients belonged to the age group of 31 to 45 years: 5,360 (39.4%) patients (3,817 [43.0%] males and 1,543 [32.5%] females) were class I; 2,730 (20.0%) patients (1,729 [19.5%] males and 1,001 [21.1%] females) were class II; 4,576 (33.7%) patients (2,835 [32.0%] males and 1,741 [36.8%] females) were class III; and 933 (6.9%) patients (483 [5.5%] males and 450 [9.5%] females) were class IV.

There is a need to introduce PDI as a screening tool during the initial examination of the patient and to achieve a proper distribution of the patients among various levels of students, interns, and postgraduates.

Introduction of PDI will improve the treatment planning and prognosis of edentulous patients.

Shaik S, Alamodi E, Alshahrani G, Alfaifi KH. Radiographic Screening of Patients in a Dental School using the Prosthodontic Diagnostic Index. J Contemp Dent Pract 2017;18(6):501-505.

One of the potential sources for the occurrence of various systemic pathologies, such as cardiovascular diseases, cerebrovascular diseases, and respiratory diseases is periodontitis. Testing of glycosylated hemoglobin (HbA) is a highly standardized procedure and is becoming increasingly popular these days due to its cost-effectiveness and ease of use. Literature quotes numerous studies associating the periodontal diseases with various hemoglobin markers in diabetic and nondiabetic patients. Hence, we planned the present study to assess the levels of HbA in patients with periodontitis among nondiabetic patients.

For the present study, a total of 50 nondiabetic subjects who reported to the department with the chief complaint of periodontitis were included. Another set of 50 nondiabetic individuals were included in the present study of comparable age in whom no periodontitis was detected clinically. Clinical examination and radiographic evaluation was performed for the selection of the cases for the study group. The patients were sent to the laboratory after the clinical examination, for the testing of HbA. Testing of the hemoglobin A1c (HbA1c) levels of all the subjects and controls was performed and values were noted and evaluated.

Nonsignificant results were obtained while comparing the mean HbA1c concentrations among the study group and the control group. Nonsignificant results were obtained while comparing the mean HbA1c levels among males and females. While comparing the mean HbA1c levels between the study group and the control group divided on the basis of body mass index, nonsignificant results were obtained.

In nondiabetic subjects, no significant correlation could be observed between periodontitis and HbA1c levels.

The HbA1c cannot be used as a reliable maker for differentiation of patients with periodontal pathologies from patients free of periodontal pathologies.

Wahi S, Tripathi A, Wahi S, Mishra VD, Singh AP, Sinha N. Assessment of Levels of Glycosylated Hemoglobin in Patients with Periodontal Pathologies: A Comparative Study. J Contemp Dent Pract 2017;18(6):506-509.

Comparison of platform switched (PS), sloping shoulder, and regular implants on stress reduction in various bone densities with finite element analysis.

A total of 12 three-dimensional finite element models were built to analyze the stress distribution model. Nobel Biocare 4.3 × 8 mm regular platform replace select implant with matching diameter easy abutment, Nobel Biocare 4.3 × 8 mm replace select implant PS with 3.5 mm diameter easy abutment, Bicon 4 × 8 mm implant with 4 mm diameter sloping shoulder abutments were created virtually in compact bone density using software. The 130 N axial force and a 90 N oblique loading force were applied to the abutment to analyze the stress.

Under horizontal and vertical loading, the sloping shoulder implant had lesser stresses in cancellous bone when compared with PS and regular implants. Sloping shoulder implant showed more stress distribution at implant–abutment interface and at crestal area, whereas with regular implants, the stresses were distributed at cortical area.

Sloping shoulder implant in subcrestal position is much favorable for bone growth, stress distribution, and preservation of remaining bone.

Use of sloping shoulder implant design distributes the stress apically and creates lesser stresses when compared with PS implants.

Markose J, Suresh S, Eshwar S, Rekha K, Jain V, Manvi S. Comparison of Platform Switched and Sloping Shoulder Implants on Stress Reduction in various Bone Densities: Finite Element Analysis. J Contemp Dent Pract 2017;18(6):510-515.

Chronic apical periodontitis (CAP) manifests mostly as periapical radiolucency. Various inflammatory mediators play a significant role in the pathogenesis of apical periodontitis. In acute inflammatory conditions, C-reactive proteins (CRP) and fibrinogen show a rise in their concentrations. In chronic diseases with high inflammatory components, an increased prevalence of hypertension has been observed. Hence, we assessed the association of CAP and plasma levels of various inflammatory markers (CRP, interleukin 6 [IL-6], and fibrinogen) in severely hypertensive patients.

This study was conducted in the conservative wing of the institute and included assessment of 250 hypertensive patients with apical periodontitis. With the help of periapical radiographs and clinical examination, the assessment of following parameters was done: Amount of teeth present, visible plaque index, periodontal pocket probing depth, clinical attachment level, bleeding on probing, presence/absence of carious lesions, which included assessment of caries in crown portion, in the root portion, and residual tooth roots (RR), presence of CAP from each patient; 8 mm of venous blood was collected in the morning for the assessment of plasma levels of IL-6, CRP, and fibrinogen levels. Immediate collection and processing of the samples were done in the hospital laboratory. All the results were analyzed by Statistical Package for the Social Sciences software.

Out of 250, 155 patients were females. Mean plasma levels of CRP observed in our study were 0.8 mg/dL. Mean plasma levels of IL-6 and fibrinogen were found to be 3.3 and 337.1 mg/dL respectively. A significant correlation was observed while comparing mean body mass index (BMI), RR, and CAP in hypertensive patients. While comparing the mean plasma IL-6 levels, mean BMI, and CAP in the patients, significant results were obtained. Significant correlation was observed while comparing the mean BMI and CAP in hypertensive patients.

Systemic levels of CRP, IL-6, and fibrinogen levels are influenced by the presence of CAP in hypertensive patients.

In hypertensive patients, CAP alters the systemic levels of various inflammatory markers.

Rashmi N, Galhotra V, Goel P, Rajguru JP, Jha SK, Kulkarni K. Assessment of C-reactive Proteins, Cytokines, and Plasma Protein Levels in Hypertensive Patients with Apical Periodontitis. J Contemp Dent Pract 2017;18(6):516-521.

The purpose of this report is to present a case of endodontic management of a dilacerated maxillary central incisor fused to supernumerary tooth unusually appearing as a labial tubercle using cone beam computed tomography (CBCT) as a diagnostic aid.

Anterior teeth are commonly encountered with aberrant anatomical variations in the crown, number of roots, and root canals. Fusion is an infrequent developmental abnormality in shape of the tooth caused by the union of two adjacent tooth germs. A complete knowledge of such complex anatomies is mandatory for a successful root canal treatment. It highlights the endodontic and restorative approach in the functional and esthetic rehabilitation of the involved tooth.

Three-dimensional imaging using CBCT was used in this case to differentiate single labial canal and palatal C-shaped canal. The endodontic treatment was performed with the aid of dental operating microscope, and the root canals were obturated with a combination of single cone, carrier based, and cold flowable gutta-percha obturation system. The tooth remained asymptomatic without reinfection and symptoms of failure for 18 months.

Cone beam computed tomography is indispensable in treatment planning for cases where the radiographs cannot reveal useful information regarding the root canal shape. Postobturation CBCT has helped in avoiding further retreatment of the tooth, which otherwise is a challenging task.

The use of sophisticated equipment, such as dental operating microscope and CBCT has helped in accurate diagnosis and treatment planning of fused central incisor respectively.

Vinothkumar TS, Kandaswamy D, Arathi G, Ramkumar S, Felsypremila G. Endodontic Management of Dilacerated Maxillary Central Incisor fused to a Supernumerary Tooth using Cone Beam Computed Tomography: An Unusual Clinical Presentation. J Contemp Dent Pract 2017;18(6):522-526.

To systematically review high-quality randomized controlled trials (RCTs) and meta-analysis on the effectiveness of use of ibuprofen and low-level laser therapy (LLLT) for pain control during fixed orthodontic appliance therapy.

A web-based systematic search of PubMed and Medline database using relevant keywords was performed in August 2016 limited to the English language studies. Based on inclusion and exclusion criteria, RCTs utilizing blind approach were selected. The quality of studies was analyzed and only high-quality studies were included. Following data extraction, meta-analysis was performed by standardized mean difference Hedges’ (adjusted) g with 95% confidence interval.

A total number of six studies (four ibuprofen and two LLLT) comprising 315 patients were included. Heterogeneity among ibuprofen studies was small, while large heterogeneity was found among LLLT studies. The results showed that both ibuprofen and LLLT could reduce pain intensity during fixed orthodontic therapy and during 17 days follow-up period. However, this reduction was statistically significant only at 6 to 24 hours postoperatively for ibuprofen and 2 hours and 3 to 7 days for LLLT (p < 0.05).

Considering the limitations of the current metaanalysis, ibuprofen could alleviate orthodontic archwire activation pain during the 1st day with relatively high level of evidence. Low-level laser therapy could reduce this pain in the long term with limited evidence. Further well-designed RCTs are required to provide more evidence.

Eslamipour F, Motamedian SR, Bagheri F. Ibuprofen and Low-level Laser Therapy for Pain Control during Fixed Orthodontic Therapy: A Systematic Review of Randomized Controlled Trials and Meta-analysis. J Contemp Dent Pract 2017;18(6):527-533.

Photodynamic therapy has been advocated to increase the disinfection level of the root canal system.

Mohammadi Z, Jafarzadeh H, Shalavi S, Kinoshita JI. Photodynamic Therapy in Endodontics. J Contemp Dent Pract 2017;18(6):534-538.