Sarode GS, Sarode SC, Deshmukh R, Anand R, Patil S. Tumor Budding in Oral Squamous Cell Carcinoma. J Contemp Dent Pract 2017;18(9):743-744.

The aim of this study was to evaluate the accuracy of the results of cone beam computed tomography (CBCT) examinations, confirm the presence or absence of the second mesiobuccal (MB2) root canal in maxillary first and second molars, estimate the distance between the root canal orifices, observe the root types based on Vertucci classification system, and make comparisons between CBCT and periapical techniques in relation to the identification of the root canal form and the second root canal of the MB root.

The CBCT and periapical radiographic data from the Department of Maxillofacial Radiology were used to select 156 individuals (78 females and 78 males) for the evaluation of the anatomy of maxillary first and second molars.

The prevalence rate of the second root canal in the MB root in the maxillary first molars was 55.1%, with 44.1 and 63.3% in females and males respectively. The prevalence rate in maxillary second molars was 23.7%, with 15.7 and 30.2% in females and males respectively. In addition, the longest and shortest distances between the root canal orifices were 2.4 and 0.3 mm respectively, with a mean of 1.3 mm.

There was a significant difference between the results of periapical and CBCT radiographic techniques in relation to the presence or absence of the second root canal in the MB roots of maxillary first and second molars (p < 0.01), with better results being provided by the CBCT technique.

The results of CBCT images about the existence of the second root canal in the MB roots of maxillary first and second molars are more reliable, and we can use this technique in the finding of additional canals in the clinic.

Zand V, Mokhtari H, Zonouzi HRM, Shojaei SN. Root Canal Morphologies of Mesiobuccal Roots of Maxillary Molars using Cone beam Computed Tomography and Periapical Radiographic Techniques in an Iranian Population. J Contemp Dent Pract 2017;18(9):745-749.

The aim of this study is to describe the protocol used in the treatment of pulpally necrosed primary molars and to evaluate the effectiveness of ultrasonic instrumentation technique in primary dentition.

A total of 50 primary molars in 40 children, ranging from 8 to 10 years of age, were endodontically treated using standard protocols and ultrasonic instrumentation. The follow-up was done for each case ranging from 1 to 2½ years.

Clinical and radiographic controls showed a success rate of 97.5%, considering an evaluation time of 19 ± 9.02 months.

The use of ultrasonic instrumentation in primary molars with pulpal necrosis succeeded in reducing appointment time and showed a high success rate.

Ultrasonic instrumentation should be used as a standard protocol in instrumentation of endodontic treatment of primary molars so as to increase the success rate of primary teeth pulpectomies.

Singh R, Barua P, Kumar M, Safaya R, Monajemi H, Monajemi H. Effect of Ultrasonic Instrumentation in Treatment of Primary Molars. J Contemp Dent Pract 2017;18(9):750-753.

The purpose of this study was to determine the possible effects of genetic and environmental factors on dentofacial complex using monozygotic twins.

The study sample was made of 21 pairs of monozygotic twins (14 female pairs and seven male pairs) between 10 and 25 years. Pretreatment lateral cephalograms were used which were traced and digitized, and various landmarks to determine the anteroposterior and vertical proportions were marked. Samples were divided into two groups. The correlation between groups was found by calculating Pearson's product moment correlation coefficients.

The range of the correlation coefficient was from 0.705 to 0.952. Gonial angle showed the highest correlation coefficient (0.952), while saddle angle showed the lowest correlation coefficient (0.705).

The growth and development of craniofacial complex is under mutifactorial control. However, genetic influences do tend to play a dominant role.

By studying identical twins, we can study about the interaction of the environment with the genes and how it affects the growth and development of the body in general and dentofacial complex in particular. By utilizing twin studies, we can identify whether a particular trait, disease, or disorder is influenced more strongly by genetics or by the environment. Success of orthodontic treatment depends on a proper diagnosis of the problem including its etiological factors. Genetic studies let the orthodontists to understand the effects of genetic and environmental factors in the growth and development of dentofacial complex better and allows to prevent or treat malocclusions and skeletal anomalies in better ways.

Manjusha KK, Jyothindrakumar K, Nishad A, Manoj KM. Growth and Development of Dentofacial Complex influenced by Genetic and Environmental Factors using Monozygotic Twins. J Contemp Dent Pract 2017;18(9):754-758.

The aim of the study was (1) to explore the baseline beliefs and practices of accredited social health activist (ASHA) workers of Khurda district of Orissa with respect to tobacco cessation and (2) to assess whether a brief intervention will be effective in improving the beliefs and practices of ASHA workers. The results of this study could be utilized by policy makers for framing important strategies for tobacco cessation in rural areas utilizing ASHA workers.

A quasi-experimental study (before and after comparison) was performed in Khurda district of Orissa to find out whether a brief intervention could improve the beliefs and practices of ASHA workers related to antitobacco counseling in rural areas. A 14-item structured, interviewer-administered questionnaire, written in English (translated in Odiya), was used. The final sample size was estimated as 135. Data were entered into Statistical Package for the Social Sciences (version 21) for analysis.

All the mean belief items, practice items, degree of preparedness, and interest in training scores of study population increased significantly from baseline to postintervention. The study population showed a statistically significant improvement in postintervention composite belief and composite practices score.

The majority of ASHA workers had positive beliefs and favorable practices after attending a brief intervention toward smoking cessation in their community. After attending the intervention, nearly half of the respondents felt either somewhat or very well prepared for tobacco cessation. Most of them showed their interest toward getting further training in the field.

Training programs and regular tobacco cessation activities should be planned in the primary health-care delivery system of India.

Sudhakar KNV, Pathi J, Avinash J, Raju PVK, Sureshan V, Vidya KC. Readiness of Accredited Social Health Activist Workers for Tobacco Cessation Counseling after a Brief Intervention in Odisha, India: A Quasi-experimental Study. J Contemp Dent Pract 2017;18(9):759-764.

The aim of this study was to evaluate the stress and discrimination faced by human immunodeficiency virus (HIV)-affected adult patients on antiretroviral therapy (ART) for more than 1 year.

A cross-sectional study was carried out among 170 adults on ART, reporting to the ART center of the District Civil Hospital, for more than 1 year in Raichur Taluk, Karnataka, India. Convenience sampling technique was followed. Descriptive statistics was performed (Chi-square test) using Statistical Package for the Social Sciences version 16.0.

A total of 156 (91.8%) patients’ families had knowledge about their seropositive status. Seventeen (10.9%) HIV-positive patients reported of change in the attitude of their family members. The main reasons for not revealing the HIV status were the internalized stigma and fear of rejection. Women faced greater discrimination from family, friends, and neighbors than men.

It is necessary to not undermine the effect of rejection due to HIV. It is the only infection that has so many associated social and psychological norms which we need to tend at the earnest. Till date, there is an existence of condescendence toward treatment approach.

The presence of stigma and the fear of being discriminated could be a major hurdle in the rehabilitation of these patients into the mainstream society. Furthermore, it serves as an existing challenge to ascertain these individuals to achieve overall health.

Muralidharan S, Acharya AK, Margabandu S, Purushotaman S, Kannan R, Mahendrakar S, Kulkarni D. Stigma and Discrimination faced by HIV-infected Adults on Antiretroviral Therapy for more than 1 Year in Raichur Taluk, Karnataka, India. J Contemp Dent Pract 2017; 18(9):765-770.

Different biomaterials and techniques have been introduced in the field of prosthetic dentistry with the purpose of replacement and rehabilitation of the edentulous areas. Due to their shorter setting time, the light-activated restorative and prosthetic materials have the capability of releasing few amount of cytotoxic materials in the oral cavity. Polymer materials [urethane dimethacrylate (UDMA) and bis-acryl] are assumed to have high mechanical properties. Polymethyl methacrylate (PMMA) offers numerous advantages of being highly esthetic in nature and at the same time being cost-effective. Hence, this study aimed to assess and compare the water sorption and cytotoxicity of light-activated UDMA denture base resin and conventional heatactivated PMMA resin.

This study included assessment and comparison of water sorption and cytotoxicity of heat-activated PMMA resin and light-activated UDMA denture base system. Fabrication of heat-activated PMMA resin and UDMA specimens was done by investing the wax patterns in stone molds using manufacturer's instructions. Contraction of the specimens was done for assessment of cytotoxicity and water resorption of the UDMA and PMMA resin samples. All the results were analyzed by Statistical Package for the Social Sciences software version 18.0. Chi-square test and one-way analysis of variance tests were used for the assessment of the level of significance; p < 0.05 was taken as significant.

Mean lysis score observed in the PMMA and UDMA groups was 0.4 and 0.3 respectively. While observing at the 3 months time, the mean water resorption in the PMMA and UDMA groups was found to be 37.9 and 40.2 Significant difference in relation to water resorption was observed between the two study groups only at 3 months time.

Both materials used in this study are nontoxic. Furthermore, UDMA resin materials exhibited lower water resorption after more than 1 month of time of storage.

Water resorption is similar for different denture base resin systems till 1 months time.

Shetty P, Chhapdia L, Verma P, Sahu A, Kushwaha NS, Chaturvedi R, Manna S. Comparative Analysis of the Water Sorption and Cytotoxicity of Two different Denture Base Systems: An in vitro Study. J Contemp Dent Pract 2017;18(9):771-774.

To analyze factors that may affect recurrence, development of new lesions, and malignant transformation in patients with oral leukoplakia (OL) following surgical treatment with lasers.

A total of 40 patients were enrolled in this study, 17 females (mean age of 64.5 years; 33–88 years) and 23 males (mean age of 56.6 years; 28–84 years) with an overall mean age of 60.5 years. A total of 49 lesions were diagnosed and treated; 9 patients had more than one site affected. Mean time of follow-up was 22 months (6–71 months). Data were assessed by univariate Cox and multivariate Cox regression analyses.

Recurrence (OL at the same site of the initial lesion) was observed in 11 patients (27.5%) while 4 patients (10%) developed new lesions, and 2 patients (5%) experienced malignant transformation. Only two clinical factors were statistically associated with the outcome for the development of new lesions: patients . 60 years and female gender (p < 0.1). Neither of the outcomes of recurrences and malignant transformations was significantly correlated with any of the risk factors analyzed.

Surgical laser is not a deterrent for the outcomes evaluated; additionally, the design of this study did not allow us to determine whether the laser treatment had provided a great benefit by significantly reducing the rate of malignant transformation among the patients.

It is highly important to inform patients with OL that their condition can be treated, when possible, surgical laser, and that this treatment may be helpful in bringing down the odds of malignant transformation of their lesions. In addition, the patients should also be brought to the attention of the necessity of a continued clinical monitoring regardless of the outcome following a surgical intervention.

Galletta V, Azevedo L, Lodi G, Migliari D. Factors affecting Clinical Outcomes after Treatment of Oral Leukoplakia with CO₂ and Diode Laser. J Contemp Dent Pract 2017;18(9):775-780.

Rheumatoid arthritis (RA) is an autoimmune disorder that usually affects joints and making them warm, painful, and swollen. The chief purpose of this study was to evaluate movements of mandible in geriatric patients suffering from RA with or without temporomandibular joint dysfunction.

A total of 45 people were included in this study with age of 60 years and above. Partially or completely edentulous patients were divided into experimental and control group. Experimental group consists of 20 people suffering from arthritis and control group consists of 25 people without arthritis. Movements were recorded with or without prosthesis while mastication in both experimental and control group.

Statistical evaluation of two studied groups showed decrease opening angle (p < 0.05) during mastication; however, insertion of new prosthesis showd a significant increase in values in both groups, with an increase in opening and closing angles.

Positive correlation was found between arthritis and movements of the mandible in older people suffering from RA.

Patients suffering from RA are having restricted mandibular movements thus imposing an overall negative impact however; presence of prosthesis has been shown to enforce a positive effect on mandibular movement.

Dev S, Perti S, Garhnayak M, Sahoo KK, Dhal A, Garhnayak L. Intricate Estimation and Evaluation of Mandibular Movements in Geriatric Patients Suffering from Rheumatoid Arthritis. J Contemp Dent Pract 2017;18(9):781-784.

Dental implants have emerged as a new treatment modality for the majority of patients complaining of missing teeth. Bone quantity and bone quality are among various factors which ensure the longevity of dental implant in the patient's mouth. The assessment of cortical bone thickness of the outer layer and the cancellous bone density by cone beam computed tomography (CBCT) has proved beneficial for the patient. This study aimed at presurgical measurement of crestal bone thickness at various implant sites using CBCT images.

This study was conducted in the Department of Prosthodontics in the year 2015. It included 218 patients who wanted to replace missing teeth. Patients were subjected to CBCT scan using NewTom CBCT machine operating at 120 kVp and 5 mA with a resolution of 0.1 × 0.1 × 0.1 mm³. New Net Technologies (NNT) software with a slice thickness of 0.1 mm was used in this study. A total of 780 implant sites were identified on images of 218 patients. In all patients, the measurement of crestal bone thickness in the region of implant site was performed with NNT software. The buccolingual measurement of crestal bone was done in cross sections obtained after CBCT.

Out of 218 patients, males were 110 and females were 108. The difference between gender was nonsignificant (p > 0.05). Out of 780 implant sites, 370 were in the maxilla and 410 were in mandible. The difference was nonsignificant (p > 0.05). Out of 780 implant sites, 210 were in anterior maxilla and 160 were in the posterior maxilla. Totally, 235 sites were in anterior mandible and 175 were in the posterior mandible. The distribution was nonsignificant (p = 0.15). The mean crestal bone thickness in anterior maxilla was 0.82 mm, in posterior maxilla was 0.76 mm, in anterior mandible was 1.08 mm, and in posterior mandible was 1.18 mm. The difference among regions was significant (p = 0.01).

The highest thickness of cortical bone was observed in posterior mandible followed by anterior mandible, anterior maxilla, and posterior maxilla. Thus, considering the less cortical thickness in the posterior maxillary region, the implant placement should be done with proper attention.

Dental implant is the need of the hour. It is beneficial to patients in terms of longer survival rates. With CBCT, all measurements, such as bone quality and quantity have become easy because of three-dimensional nature. This has proved to be beneficial in the analysis of cortical bone thickness as well as measuring the distance from anatomical structures.

Gupta A, Rathee S, Agarwal J, Pachar RB. Measurement of Crestal Cortical Bone Thickness at Implant Site: A Cone Beam Computed Tomography Study. J Contemp Dent Pract 2017;18(9):785-789.

The aim of this study was (i) to evaluate the formation of air bubbles in the apical region of root canal (apical vapor lock) during syringe irrigation, using cone beam computed tomography (CBCT) and (ii) comparative evaluation of the elimination of an established vapor lock by EndoActivator, ultrasonics, and manual dynamic agitation (MDA), using CBCT.

A total of 60 extracted human singlerooted teeth were equally divided into three groups of 20 teeth each. The samples were decoronated 17 mm from the apex, cleaned, and shaped to size F4 Protaper using 3% sodium hypochlorite. Samples were irrigated with 3% sodium hypochlorite + cesium chloride radiopaque dye, and preoperative CBCT images were obtained. After formation of apical vapor lock in the scanned teeth, EndoActivator (group I), passive ultrasonic irrigation (group II), and MDA with K-file (group III) were performed and the teeth were again placed in CBCT scanner and results analyzed using the chi-square test.

The apical vapor lock was formed in all the samples. Out of the 20 teeth in each group, the apical vapor lock was eliminated in 18 samples of EndoActivator group (90%), 16 samples of ultrasonic group (80%), while it was eliminated in 10 samples by MDA (50%).

It is concluded that (1) apical vapor lock is consistently formed during endodontic irrigation in closed canal systems and (2) sonic activation performs better than the ultrasonics and MDA in eliminating the apical vapor lock, with statistically significant difference between all the three groups (p < 0.05).

The results suggest that the apical vapor lock (dead water zone) is consistently formed during endodontic irrigation which impedes irrigant penetration till the working length, thereby leading to inefficient debridement. Hence, to eliminate this vapor lock, techniques, such as sonics or ultrasonics should be used along with the irrigant after shaping and cleaning of the root canal.

Agarwal A, Deore RB, Rudagi K, Nanda Z, Baig MO, Fareez MA. Evaluation of Apical Vapor Lock Formation and comparative Evaluation of its Elimination using Three different Techniques: An in vitro Study. J Contemp Dent Pract 2017;18(9):790-794.

The aim of this study is to analyze and compare the immunohistochemical expression of cathepsin B in primary oral squamous cell carcinoma (OSCC) and recurrent OSCC.

A total of 50 cases were studied immunohistochemically for rabbit polyclonal antihuman cathepsin D expression. A total of 10 cases of breast carcinoma were taken as positive controls. Immunohistochemical staining was performed using labeled streptavidin–biotin technique.

All the 45 cases of OSCC, both primary and recurrent cases included, showed varying grades of cathepsin D immunoreactivity. Statistical significance at 5% level was observed in cathepsin D expression between the different grades of well, moderate, and poorly differentiated primary squamous cell carcinomas. In the comparison of cathepsin D staining intensity among primary squamous cell carcinomas with and without recurrence, a statistical significance between the groups was observed when the p-value was at 10%, but the same comparison was not significant when the p-value was at 5%.

Cathepsin D expression in primary squamous cell carcinomas with recurrences was very variable as compared with primary squamous cell carcinomas without recurrences. Comparison of cathepsin D expression in primary with their recurrent counterparts showed mostly similar intensity of expression in recurrent carcinomas, thus suggesting its limited usefulness in predicting recurrence.

Although cathepsin D might have shown limited usefulness in predicting cancer recurrence, it, however, is a proven valuable tool to detect the aggressiveness of other tumors, and if corroborated with a larger sample may hold the key to early, more effective, and more specific treatment modalities for cases of oral cancer also.

Satelur KP, Kumar GS. Immunohistochemical Expression of Cathepsin D in Primary and Recurrent Squamous Cell Carcinoma. J Contemp Dent Pract 2017;18(9): 795-801.

The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy.

Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime. Extraction sites were divided into two groups: Group I received Axiostat Hemostatic Dental Dressing (study site), and group II received conventional method; pressure pack with sterile gauze under biting pressure followed by suturing if required (control site) was used to attain hemostasis.

Extraction sites treated with Axiostat Hemostatic Dressing achieved hemostasis earlier (mean 1 minute 13 seconds) compared with control sites (mean = 14 minutes 1 second), which was also statistically significant (p < 0.001). Postoperative pain was considerably lower and significantly better healing was seen in the study group (p < 0.001) compared with the control.

Axiostat demonstrated to be an effective hemostatic agent that considerably lessens the bleeding time in patients on oral antiplatelet drugs postextraction. In addition, it even offered minimal postoperative pain and improved healing of the extraction wound. On comparing the results of this study with our study on HemCon Dental Dressing, Axiostat Dental Dressing (ADD) is found to be as effective and at par in achieving hemostasis in patients on oral antiplatelet therapy.

The past few decades have seen an upsurge in use of low-dose aspirin either alone or in combination with other drugs. When these patients require dental/maxillofacial treatment, earlier concept of stopping these medications is associated with increased risk of thromboembolic event. The present study highlights an alternative approach using ADD which aids in quick hemostasis, accentuates healing, and reduce postoperative pain.

Sharma S, Kale TP, Balihallimath LJ, Motimath A. Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs. J Contemp Dent Pract 2017;18(9):802-806.

The aim of this study is to compare triangular and envelope flap designs and the postoperative outcome in the surgical removal of impacted mandibular third molar.

A total of 50 participants were assessed clinically and were divided randomly into two groups. Group I (participants operated by triangular flap) and group II (participants operated by envelope flap), with 25 participants each between the age group of 20 and 30 years. Patient satisfaction was assessed subjectively using a graded scale from very satisfied to very unsatisfied. The degree of pain was recorded for 7 days with reference to predefined values on visual analog scale (VAS). Trismus was evaluated on the day 3, day 5, and day 7 of the postoperative period in millimeters. Quantitative data were analyzed by unpaired t-test and qualitative data were by Fischer's exact test.

The mean overall age is 25.5 years. There was no statistically significant difference between the study groups with respect to age. There was no significant association between the patient satisfaction and flap type (p = 0.684). A significant difference between the study groups on 4th, 5th, and 6th days with respect to pain was observed, wherein fewer subjects operated with triangular flap reported pain. A highly significant difference in mouth opening was observed, with triangular flap group participants having a higher mouth opening than envelope flap subjects on day 7.

The present study indicated that participants operated by triangular flap had a better mouth opening postoperatively compared with envelope flap participants, whereas there were no significant differences in patient satisfaction and pain scores at the end of the 7th day after third molar surgery.

Flap design is a significant factor in the surgical removal of impacted third molar, and it influences the severity of complications. Furthermore, it is important for allowing optimal visibility and access to the impacted tooth and also for subsequent healing of the surgically created defect.

Rabi A, Haris PMM, Panickal DM, Ahamed S, Pulikkottil VJ, Haris KTM. Comparative Evaluation of Two Different Flap Designs and Postoperative Outcome in the Surgical Removal of Impacted Mandibular Third Molar. J Contemp Dent Pract 2017;18(9):807-811.

The aim of this study was to test the effect of varying alcohol concentrations of various commercially available mouthwashes on force decay of elastomeric chains in prestretched and unstretched condition.

A total of five specimen groups were tested with a total sample size of 180 specimens. A specimen is described as a three-link, short module, clear elastomeric chain (3M Unitek, Ortho Plus, Ortho Organizer). The control and test groups were independently submerged in separate 37°C artificial saliva to simulate the oral conditions. Effects of different solution groups and time (initial, 1, 7, 14, 21, and 28 days) on three different elastomeric chains and force (cN) are analyzed with two-way analysis of variance; pair-wise comparisons are done by t-test.

Higher mean force was recorded initially followed by 24 hours >7 days >14 days >21 days and 28 days respectively. The difference in mean force decay among the different time intervals was found to be statistically significant (p < 0.001). Among the different solutions, higher mean force was recorded in 21.6% alcohol mixture > Listerine 8.38% > Wokadine > alcohol mixture 8.38% > artificial saliva.

In conclusion, alcohol-containing mouth rinses cause an increase in force decay of elastomeric chain over time.

These mouth rinses are commonly recommended during orthodontic treatment. The orthodontist can know better that the alcohol content of the mouth rinses and the structural and molecular modification results in the decay of elastomeric chain.

Ramachandraiah S, Sridharan K, Nishad A, Manjusha KK, Abraham EA, Ramees MM. Force Decay Characteristics of commonly used Elastomeric Chains on Exposure to various Mouth Rinses with different Alcohol Concentration: An in vitro Study. J Contemp Dent Pract 2017;18(9):812-820.

Obstructive sleep apnea (OSA) is one of the common prevalent conditions present worldwide. The process of abnormal habits related to clenching and grinding of teeth is referred to as bruxism and is characterized under the heading of parafunctional activity of the masticatory system. Osseointegrated dental implants represent advancements in the field of odontology. Despite its high success rate, failure and complications are often associated with dental implant treatment due to a number of factors. Hence, we aimed for the present study to assess the incidence of prosthetic complications in patients rehabilitated with implant-borne prosthesis in a sleep disorder unit.

The present study included the assessment of all the patients who underwent prosthetic rehabilitation by dental implants. An experienced registered prosthodontist was given duty for examination of all the cases from the record file data. Prosthetic complications in the patients were identified using photographs, radiographs, and all other relevant data of the patients obtained from the record files. All types of complications and other factors were recorded separately and analyzed.

While correlating the prosthetic complications in OSA patients grouped based on number of dental implants, nonsignificant results were obtained. Significant correlation was observed while comparing the prosthetic complications divided based on type of prosthesis. Fracture of the porcelain was observed in four and eight cases respectively, of screwed and cemented dental implant cases.

Some amount of significant correlation existed between the incidences of prosthetic complications and OSA.

Proper history of the patients undergoing dental implant procedures should be taken to avoid failure.

Suneel VB, Kotian S, Jujare RH, Shetty AK, Nidhi S, Grover S. Incidence of Prosthetic Complications associated with Implant-borne Prosthesis in a Sleep Disorder Center. J Contemp Dent Pract 2017;18(9):821-825.

Cleaning and shaping of the pulp canal is one of the most important steps of endodontic therapy. Serious complications occur by the apical extrusion of bacteria during the instrumentation procedures. Both crown-down (CD) and full-length linear motion (FM) techniques are routinely used as a component of taper rotary instrument procedures for achievement of thorough cleaning and shaping of the pulp canal space. Hence, we aimed for this study to assess the change in the amount of apically extruded bacteria using CD and FM instrumentation techniques produced by differences in taper between the instruments used during biomechanical preparation of root canals.

The present study included assessments of 132 extracted maxillary central incisor teeth. To achieve a uniform teeth length of 21 mm, the height of the tooth crown was reduced for preserving the coronal portion of teeth. A modified glass vial model was constructed for the estimation of amount of bacterial extrusion through the apical region. For filling of each pulp canal specimen, 20 mL of Enterococcus faecalis suspension was used followed by the use of a number 10 K-file for carrying the bacteria down the lengths of pulp canals. All the contaminated teeth specimens were divided into six study groups with groups I to III containing specimens prepared in the CD manner, while groups IV to VI contained specimens prepared in the FM manner. Six teeth were taken as negative control with three specimens with each technique, and another six specimens were taken as positive controls. Cultivable bacterial counts were determined by evaluating 100 mL saline solution from each vial followed by its inoculation on blood agar. All the colony-forming unit (CFU) values were log-transformed (base 10), and the results were analyzed by Statistical Package for the Social Sciences software.

A significantly lower quantity of CFU values was observed during CD instrumentation procedures with 0.02 files in comparison with all other study groups. However, while comparing both the instrumentation procedures when different taper files, other than 0.02 taper, were used for biomechanical preparation of root canal, nonsignificant results were obtained.

With 0.02 taper preparations, significantly less amount of extrusion of bacteria is associated when done with CD technique.

No change in the amount of apical extrusion of bacteria will be seen by changing the type of instrumentation procedures. Amount of bacteria extruded can be minimized using 0.02 taper.

Priyank H, Pandey V, Sethi A, Sharma VJ, Bali H, Punia RS. Quantitative Assessment of apically Extruded Bacteria using different Instrumentation Techniques and Preparation Taper. J Contemp Dent Pract 2017;18(9):826-830.

Considering the high success rate of osseointegration, there is ever-increasing use of dental implants. The mechanisms and biologic response of peri-implant tissues are different depending on the biocompatibility of the implant material. The aim of this study was to compare the proinflammatory cytokine levels in the gingival crevicular fluid (GCF) around dental implants with ceramic and titanium abutments.

All the patients with dental implants referring to two private offices of two prosthodontists from June to August 2016 were examined in relation to implant health, and eligible subjects, based on inclusion criteria, were included in this study with a slit-mouth design. In this context, on one side titanium implants and, on the other side, ceramic implants were used. Samples were collected from the peri-implant sulcus in each patient and sent to the immunology laboratory for determination of interleukin (IL)-6 and IL-1β proinflammatory cytokine levels using an enzyme-linked immunosorbent assay kit. Data were analyzed with Statistical Package for the Social Sciences version 16. Statistical significance was set at p < 0.05.

The results showed lower levels of IL-1β and IL-6 in the GCF around ceramic abutments compared with titanium implants. In addition, statistical comparison between IL-6 and IL-1β levels showed higher levels of IL-6 around titanium and ceramic abutments compared with IL-1β levels.

Based on the results of this study, the human body immune response to ceramic abutments is much better than that to titanium implants.

Considering that proinflammatory cytokine levels in GCF around ceramic abutments are lower than titanium ones, ceramic abutments are preferred for clinical usage.

Negahdari R, Rahbar M, Fakhrzadeh V, Eslami H, Akbari T, Bohluli S. Comparison of Proinflammatory Cytokine Levels in Gingival Crevicular Fluid around Dental Implants with Ceramic and Titanium Abutments. J Contemp Dent Pract 2017;18(9):831-836.

The aim of this study was to evaluate the effect of recasting base metal alloy on the metal–ceramic bond strength.

A total of 60 test samples were prepared from new and recast nickel–chromium alloy and divided into six groups. In group A0, test samples were prepared from 100% new alloy. Groups A1, A2, A3, A4, and A5 were prepared from 50% new alloy and 50% casting remnants (sprue and buttons) of the previous group by weight. All these samples were coated with ceramic (IPS d.SIGN and Ivoclar-Vivadent), and samples were then subjected to three-point bending test to evaluate metal–ceramic bond strength.

The values were analyzed using one-way analysis of variance and Tukey's post hoc test. The mean bond strength of group A0 was higher than that of groups A1, A2, A3, A4, and A5.

Metal–ceramic bond strength decreased significantly with multiple recastings.

Bond strength between metal and ceramic is a crucial factor for the clinical performance of metal–ceramic restorations. Recasting of alloys may affect the metal oxide layer composition and thickness of metal–ceramic interface, and thereby the metal–ceramic bond.

Meenakshi T, Bharathi M, Komala J. Evaluation of the Effect of recasting Nickel–chromium Base Metal Alloy on the Metal–ceramic Bond Strength: An in vitro Study. J Contemp Dent Pract 2017;18(9):837-841.

Immediate implant-loading protocol has progressed because of various clinical advantages offered by this treatment approach. However, available studies on edentulous patients are still few compared to those in which delayed implantloading protocol was applied.

This prospective study was to evaluate the implant survival rate and the peri-implant tissue response in a group of patients who received two unsplinted immediately loaded dental implants in the mandibular anterior region to retain a complete overdenture using locator attachments.

A total of 24 edentulous patients with a mean age of 63.4 years were involved in this study following certain inclusion criteria. All patients received a new set of complete dentures before implant positioning. Two Prima Connex tapered implants were put in the interforaminal area of the mandible with a flapless surgical procedure, and the prefabricated dentures were immediately retained with a zest locator attachment. Clinical and radiographic records of the patients were reviewed immediately after placement of the implant, at 3 months, and at 1, 2, and 3 years following fixture installation. The obtained data were analyzed using paired samples t-test and the Wilcoxon signed-rank test at 0.05 significance level.

At 3 years, all implants had osseointegrated with a 100% survival rate. In addition, the total mean marginal bone change was −0.89 ± 0.14 mm, and the mean periotest value was −7.631 ± 0.921.

Results of this study propose that immediate loading of mandibular implant overdentures that are retained with locator attachments was a feasible treatment alternative for this particular group of patients.

Immediate implant- loading of mandibular implant overdentures that are retained with locator attachments is a reliable treatment option

Al-Dharrab A. Three-year Prospective Evaluation of Immediately Loaded Mandibular Implant Overdentures retained with Locator Attachments. J Contemp Dent Pract 2017;18(9):842-850.

The aim of this scientific work is to illustrate the technique of shaping the root canal system using the multistep technique.

Over time, various endodontic instrumentation techniques have been put forward, from the “step-back” technique (apical–coronal) to the “crown-down” technique (coronal–apical), the “double-flared” technique, and the most recent “single-length” technique.

The multistep technique involves six steps, one of the main objectives of these being the safety of the use of mechanical instruments with a reduction in the risk that they fracture. This technique (“mixed”) provides for the use of both manual instruments in stainless steel and mechanical instruments in nickel titanium (Ni-Ti).

The multistep technique is based on a standardized, flexible, and clinical protocol, which can provide for a reduction in the number of endodontic passages and instruments used and, therefore, a simplification of the operating procedure depending on both the difficulty of the root canals and the competence of the operator.

This technique is a technique for shaping the endodontic space that allows the set objectives of endodontic therapy to be reached in a predictable way with a reduced risk of iatrogenic complications.

Gallottini L. Shaping of the Root Canal System: A Multistep Technique. J Contemp Dent Pract 2017;18(9):851-855.