The Journal of Contemporary Dental Practice

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2018 | December | Volume 19 | Issue 12

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Indian Higher Health Education Institutions and World University Ranking: A Viewpoint

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:2] [Pages No:1425 - 1426]

   DOI: 10.5005/jp-journals-10024-2443  |  Open Access |  How to cite  | 



Mehmet Yolagiden, Seyda Ersahan, Gokhan Suyun, Erturk Bilgec, Cumhur Aydin

Comparison of Four Electronic Apex Locators in Detecting Working Length: An Ex Vivo Study

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:7] [Pages No:1427 - 1433]

Keywords: Apex ID, Apex Pointer+, Apical constriction, Electronic apex locator, Raypex 5, Raypex 6, Working length determination

   DOI: 10.5005/jp-journals-10024-2444  |  Open Access |  How to cite  | 


Aim: To compare the accuracy of four different electronic apex locators (EALs) in detecting a position 0.5 mm short of the major foramen. Materials and methods: The actual working length of thirty-five extracted human teeth was determined visually as 0.5 mm short of the apical foramen. After actual working length measurements, electronic working length was measured with four different EALs (Apex Pointer+, Raypex 5, Apex ID, and Raypex 6). Measurements were repeated three times by different operators. The data were analyzed using the intraclass correlation coefficient (ICC), the repeated measure analysis of variance (rANOVA) and Bonferroni post hoc tests. The significance level was set at p. 0.05. Results: The mean differences between electronic and actual working length were.0.305 mm, 0.098 mm, 0.037, and 0.144 mm for the Apex Pointer+, the Raypex 5, the Apex ID, and the Raypex 6, respectively. Multiple paired comparisons (Bonferroni test) also showed the Apex Pointer+ is significantly different from the Raypex 5, Apex ID and Raypex 6 (p = 0.000, p = 0.001, and p = 0.001 respectively). Conclusion: All EALs showed an acceptable determination of the working length between the ranges of ± 0.5mm except for the Apex Pointer+ device, which had the lowest accuracy. Further studies may be beneficial especially to better evaluate the accuracy of the Apex Pointer+. Clinical significance: This article shows that Apex ID, which has only recently been introduced into the market, showed an acceptable determination of the working length. Its accuracy was similar to that of Raypex 5 and 6.



Abdullah Alsani, Abdulrahman A Balhaddad

Delayed Eruption of Maxillary Central Incisors Associated with the Presence of Supernumerary Teeth: A Case Report with 18 Months Follow-up

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:3] [Pages No:1434 - 1436]

Keywords: Delayed eruption, Diagnosis, Supernumerary teeth

   DOI: 10.5005/jp-journals-10024-2445  |  Open Access |  How to cite  | 


Aim: The aim of this study is to discuss a case of an 11-year-old pediatric patient, who was diagnosed with delayed eruption of the permanent maxillary central incisors because of palatally impacted supernumerary teeth. Background: The delayed eruption of permanent teeth can be a result of blocking by supernumerary teeth and over-retained primary teeth. Early diagnosis can help in avoiding the complications. The management of such cases depends on the stage of teeth development, teeth position, and space availability. Treatment may combine both surgical and orthodontic interventions. Case description: The case was managed by surgically removing the primary retained teeth and supernumerary teeth in two visits then allowing the impacted permanent incisors to erupt without any intervention. Conclusion: After 18 months follow-up, the two permanent incisors erupted spontaneously with no orthodontic intervention. Clinical significance: dentists should be aware of the importance of early diagnosis of supernumerary teeth. The management of such cases should be designed by a multidisciplinary team decision.



Menon P Rajagopal, Nidhin Ramabhadran, Rahul Nageshraj, Sheejith Madapathy, Pradeep Samuel, Jyothis Mathew

An In Vitro Comparative Evaluation of Shear Bond Strengths of Veneering Porcelain and Different Core Materials

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:7] [Pages No:1437 - 1443]

Keywords: Laser sintered metal, Metal ceramic interface, Shear bond strengths, Veneering porcelain, Zirconia liner

   DOI: 10.5005/jp-journals-10024-2446  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to evaluate and compare the bond strengths of different core structures to veneering porcelain. Materials and methods: Sixty specimens were divided into 4 groups of 15 each. Specimen fabrication was done according to the International Organization for Standardization (ISO) specifications 9693:1999. Group 1 comprised core structure made of cast alloy, group 2 from sintered metal, group 3 from milled zirconia and group 4 milled zirconia without liner at the interface. The shear bond strengths were recorded and the values obtained were statistically examined. Results: Highest values were recorded in group 3 and there were significant differences between groups 1 and 3 while groups 3 and 4 were not statistically different. This led us to imply that zirconia as a core structure provided maximum strengths and laser sintered metal came second. The results also pointed out that the role of the zirconia liner is not that crucial to attaining adequate strength. Conclusion: The present study concluded that zirconia and laser sintered metal are excellent core materials and feasible alternatives to cast alloy. We also concluded from our study that a zirconia liner did not affect the bond strength significantly and is not absolutely essential. Clinical significance: This study helps us to understand the role of materials used as core structures in enhancing the shear bond strength to veneer porcelains and also clarifies the role of a zirconia liner in the process.



Carlos AM Falcão, Elayne MO de Lima, José D de M Júnior, Sérgio AP Freitas, Eduardo S de L Veras, Luana KB Moura, Lucas F Falcão

Cement AH Plus Adhesiveness Assessment Associated with Mineral Trioxide Aggregate in Different Proportions (Push-out Test)

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:5] [Pages No:1444 - 1448]

Keywords: Adhesion, Dental cement, Dentistry

   DOI: 10.5005/jp-journals-10024-2447  |  Open Access |  How to cite  | 


Aim: The aim of the study is to evaluate the adhesiveness of the AH Plus plug cement, plus the mineral trioxide aggregate (MTA) in different proportions, through the push-out test. Materials and methods: The authors utilized fifty premolars with a single conduit, which were divided into five groups with 10 teeth. In group 1, the authors performed an obturation with AH Plus cement, group 2 was filled with AH Plus cement with 10% of MTA, group 3 was filled with AH Plus cement plus 20% MTA, group 4 was filled with AH Plus with 30% of MTA and group 5 filling was performed with the MTA Fillapex endodontic cement. The specimens were sectioned in 2 mm slices and submitted to the push-out test in a universal testing machine. The authors cataloged the data and follow through with statistical analysis based on T-test for independent samples, with a significance level of 5%. Results: There was no statistical difference in group 2. Groups 3 and 4 presented better adhesion than AH Plus cement and MTA Fillapex. There was no statistical difference between the AH Plus cement and the MTA Fillapex. Conclusion: The authors concluded that the addition of MTA in the proportion of 10% to the AH Plus does not alter its adhesive property. They also observed that when the MTA increased by 20% and 30% there was an increase in the adhesiveness of the material when submitted to the push-out test. Clinical significance: The relevance of this study refers to the MTA inducing the deposition of mineralized tissue. However, it is necessary to compare it to the AH Plus cement considered “Gold Standard” in physical-chemical properties tests.



Sujith Sivarajan, Arjun Rajan, Anjana S Nair, Shilpa Jayakumar, Arya S Pillai

An In Vitro Study to Evaluate and Compare the Hemocompatibility of Titanium and Zirconia Implant Materials after Sandblasted and Acid Etched Surface Treatment

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:7] [Pages No:1449 - 1455]

Keywords: Acid etching, Hemocompatibility, Sandblasting, titanium, Zirconia

   DOI: 10.5005/jp-journals-10024-2448  |  Open Access |  How to cite  | 


Aim: This study was aimed to investigate the hemocompatibility of zirconia and titanium implant materials after surface treatment with sandblasting and acid etching (SLA). Materials and methods: Sixty specimens were procured from manufacturers of dimension 10mm x 3mm, thirty of each were prefabricated medical grade titanium (Ti-6Al-4V) and thirty of sintered zirconia. Silicon carbide grit papers of 240 to 1200ìm, was used to polish the specimen surface. The surfaces were rinsed with water to remove any remnant particles after polishing. Later ultrasonic cleaning was done for 5 minutes using distilled water. The control specimens included 15 specimens each from titanium (groups A1) and zirconia (groups B1). The remaining 15 specimens (groups A2 and B2) were sandblasted using alumina particles of 150 microns particle size and using 20% hydrochloric acid, acid etching was done for 30 seconds. The specimens were scanned under electron microscope after surface treatment for analysis purpose and evaluated for surface characteristics. Before the exposure of specimens to blood, percentage hemolysis, prothrombin, platelet aggregation and activation, and thrombin time values were calculated. 1 ml of blood was added to each specimen for testing. The values before and after the exposure of specimens to blood were noted. Using a t-test, the values noted were statistically evaluated. Results: A1 (polished titanium) showed highest mean values after exposure, in platelet count (184.67 ± 1.29), Leucocyte count (7.27 ± 0.08), and Thrombin time (10.15 ± 0.34) while Prothrombin time's highest mean value after exposure were showed by A2 (SLA treated titanium) with a mean value of 10.04 ± 0.24. Conclusion: Surface treatment with sandblasting and acid etching (SLA) using 150 microns alumina particles and 20% hydrochloric acid increased the surface roughness of the titanium and zirconia implant materials and polished titanium showed maximum hemocompatibility. Clinical significance: The implant's success depends on its biocompatibility and its property of osseointegration. The adverse interaction between blood and the artificial surface is detected by the hemocompatibility test for medical materials, to know if the surface can activate or destruct the blood components. The success of implant placement also depends on the interaction between the blood and the specimen.



Mohammad K Soltani, Asieh Zohrei, Jalal Poorolajal

Comparison between Classic Twin-block and a Modified Clear Twin-block in Class II, Division 1 Malocclusions: A Randomized Clinical Trial

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:8] [Pages No:1456 - 1463]

Keywords: Appliance, Functional orthodontic, Twin-block

   DOI: 10.5005/jp-journals-10024-2449  |  Open Access |  How to cite  | 


Aim: The aim of this study was to compare dentoskeletal effects and patient's satisfaction with a modified twin-block (clear twinblock) and classic twin-block. Materials and methods: A total of 62 patients with skeletal class II malocclusion contributing to mandibular retrognathism with a minimum of 4 mm overjet, the FMA angle between 20 to 25 degree and being in stage 2 to 3 of cervical vertebral maturation participated in this study. Subjects were randomized in 1:1 ratio to classic and clear twin-block. Lateral cephalograms were taken at two stages—Pre- and post-treatment (when the overjet reduced to 1 to 0 mm). All the measurements were done with Dolphin software version 10.5. Four months after the start of the treatment the patients were asked to fill the questioners regarding their compliance from the appliances. Results: Both classic and clear twin-block groups showed mandibular advancement without statistically significant difference between them. However, SNB angle increased slightly more in clear group than the classic one. “Headgear effect” is not statistically noticeable in both groups. However, SNA angle decreased slightly more in Classic group. Increased in lower incisors proclination was happening in both groups, but in a clear group, this increase was significantly less. Overbite reduction could be seen in both groups with significantly more reduction in the classic group. Conclusion: Increase in lower incisors proclination was less in clear group than the classic one. Overbite reduction was more in the classic group than the classic one. Clinical significance: Clear twin-block is more beneficial in skeletal class II patients with proclined lower incisors and vertical growth pattern.



Sameer Punathil, Shabna Moyin, Shashit S Bavabeedu, Pratik Agrawal, Gaurav Garg

Evaluation of Intracanal Calcium Hydroxide Removal with Different Techniques: A Scanning Electron Microscope Study

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1464 - 1469]

Keywords: Calcium hydroxide, Different techniques, EndoVac system, Rotary Files, Ultrasonics

   DOI: 10.5005/jp-journals-10024-2450  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the efficacy of Intracanal calcium hydroxide removal with different techniques. Materials and methods: Seventy-five freshly extracted, non-carious, single canalled lower first premolars, having anatomic characteristics similar to each other, extracted for the orthodontic purpose were collected. After the root canal preparation, Calcium hydroxide was placed into the working length using lentulo spiral instrument till the medicament was visible at the apex. The specimens were segregated into three groups; Group 1: Rotary Files, Group 2: EndoVac system and Group 3: Ultrasonics. The evaluation was done with SEM in the coronal and apical third of the roots with a magnification of 1000x. The statistical analysis was done using statistical packages for social sciences (SPSS) software, version 20.0 for Windows (SPSS Inc., Chicago, IL). A p-value of less than 0.05 was considered significant statistically. Results: Maximum removal of Ca(OH)2 was analyzed in the EndoVac system (2.90 ± 0.12) followed by the rotary files (1.76 ± 0.26) and least was seen with Ultrasonics (1.32 ± 0.14). The p-value of 0.001 was seen between the coronal and apical third with the EndoVac system which is statistically significant. The significant difference statistically was observed between Rotary Files vs. Ultrasonics at apical third and with the EndoVac system vs. Ultrasonics at coronal third as well as at the apical third with p-value 0.001. Conclusion: It can be concluded that the EndoVac technique was effective in removing Ca(OH)2 medicament from the coronal and apical third of the root canal significantly. Clinical significance: Calcium hydroxide removal before the obturation was of priority as the Ca(OH)2 remnants have a negative impact of the ability for sealing the obturation material. Therefore, having a complete knowledge regarding the effective technique is much important.



Christopher I Udoye, Jun-Ichiro Kinoshita, Hamid Jafarzadeh, Atsufumi Manabe, Mikihiro Kobayashi

Prevalence and Reasons for Extraction of Endodontically Treated Teeth in Adult Nigerians

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:5] [Pages No:1470 - 1474]

Keywords: Endodontics, Retrospective study, Tooth extraction

   DOI: 10.5005/jp-journals-10024-2451  |  Open Access |  How to cite  | 


Aim: Teeth extraction is an important problem in elder patients. Although some of these teeth have been endodontically treated, many of them may be subjected to extraction. The reasons for extraction are important for prevention planning in further patients. The aim of this study was to assess the prevalence and important reasons for extraction of endodontically treated teeth in adult Nigerians. Materials and methods: This study involved a retrospective examination of 2,000 case files in the archives of the University of Nigeria Teaching Hospital. Out of the 2,000 case files, 650 concerned endodontically treated teeth. Results: The prevalence of extractions in the population was 21.5%. This was more often in the mandible (67.9%) than in the maxilla (32.1%). In both jaws, more molars were extracted (57.1%), followed by premolars (27.1%) and anterior teeth (15.7%). Extractions occurred 57.1% of times in females. However, the rate of extraction decreased with age but peaked in the 51-60 year age band. Conclusion: The association between age and extraction was proven. Caries, vertical root fracture and endodontic reasons accounted for the commonest cause of extraction in the mandible; while in the maxilla, endodontic reasons and cusp fracture caused extractions most often. Clinical significance: The reasons for extraction of endodontically treated teeth are different between maxilla and mandible.



Vinit Patil, Rajendra Baad, Nupura Vibhute, Uzma Belgaumi, Vidya Kadashetti, Anand Gudur

Evaluation of Radiation-induced Cytological Changes in Lesional Oral Cancer Cells and Adjacent Normal Mucosal Cells

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1475 - 1480]

Keywords: Cytology, Oral cancer, Radiosensitivity

   DOI: 10.5005/jp-journals-10024-2452  |  Open Access |  How to cite  | 


Aim: To assess various cytological changes for predicting radiosensitivity of oral squamous cell carcinoma by exfoliative cytology. Materials and methods: Histologically proven 30 cases of oral squamous cell carcinoma who underwent fractionated radiotherapy in a dose of 45-60 Gy in 5 fractions/week were enrolled in the study. The exfoliative cytology smear was evaluated on lesional and adjacent oral mucosa before radiotherapy, during radiotherapy (8 and 11th fraction) and post radiotherapy (4, 6 and 8 weeks). Various parameters like multinucleation, cellular enlargement, nuclear enlargement, cytoplasmic vacuolation, cytoplasmic granulation, leukocytic infiltration were evaluated. Results: Statistical significant values were seen in the intergroup comparison of all the parameters when compared adjacent mucosa and normal mucosa for leukocytic infiltration in pretreatment smear. Conclusion: The study showed that radiation-induced cytological changes in oral squamous cell carcinoma have a significant dose-related increase. This dose-response relationship and the high intratumoral variations suggest that serial assay of these changes has potential use for radiosensitivity prediction. Clinical significance: Radiosensitivity prediction can be evaluated by means of cytological smears in one stop crisis centre (OSCC) individuals subjected to fractionated radiotherapy by evaluating the cytological parameters.



Aiman O Johar

Clinical Performance of Implant Overdenture Versus Fixed Detachable Prosthesis

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:7] [Pages No:1481 - 1487]

Keywords: Number of implants, Overdenture, Patient satisfaction, Prosthesis design

   DOI: 10.5005/jp-journals-10024-2453  |  Open Access |  How to cite  | 


Aim: To evaluate the satisfaction of completely edentulous patients with a different number of implants to retain removable and support the fixed prosthesis. Materials and methods: Fifty patients with the single edentulous ridge (maxilla or mandible) were selected for this study and divided equally into five groups. Each group contained 10 patients. Group 1: conventional complete denture (negative control group), group 2: two implants retained overdenture, group 3: three implants retained overdenture, group 4: four implants retained overdenture, group 5: fixed detachable prosthesis with five implants placed between the mental foramen. After one year from completing the treatment, the patients were requested to fill a specially designed questionnaire to assess their overall quality of life and level of satisfaction, both aesthetically and functionally. Comparison of data between groups was performed using the Chi-square tests. The level of statistical significance was considered at p < 0.05. Results: Patients treated with conventional complete denture were all unsatisfied in their masticatory function, and 80% were also unsatisfied in phonetics, while only 50% of patients were satisfied aesthetically and mentally and 70% were satisfied in social life. The addition of two or more dental implants resulted in 100% satisfaction in the variables tested. There was no statistical difference between the number of implants and suprastructure design regarding patients’ satisfaction. Furthermore, implants retained overdenture and fixed detachable prosthesis design scored the same satisfactory level. Conclusion: The satisfaction level of the conventional complete denture in the treatment of an edentulous arch can be dramatically improved by adding dental implants and changing the design to an overdenture. Two implants with an overdenture design is a valid treatment option for the edentulous arch as well as three and four implants. Fixed detachable prosthesis did not add any further patient satisfaction when compared to implant retained overdenture. Clinical significance: Two implants with overdenture to treat edentulous jaw is effective as five implant fixed prosthesis.



Roopa K Thippanna, Jadhav M Shivaji, Pallavi Vaidya, Rohit Wadhwa, Anjali Wadhwa, Piyush Gandhi

An Innovative Method to Determine the Width of Maxillary Anterior Teeth with the Help of Measurements Obtained from the Master Cast

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1488 - 1493]

Keywords: Hamular notch, Incisive papilla, Tooth mold size

   DOI: 10.5005/jp-journals-10024-2454  |  Open Access |  How to cite  | 


Aim: Analyse the correlation between the measurements made from the landmarks on the cast and the width of the anterior teeth in dentulous study subjects and assessed whether a similar correlation exists in edentulous condition. Materials and methods: Measurements were made on the cast of dentulous and edentulous subjects. The measurements made were, from incisive papilla to the right hamular notch, from incisiv e papilla to left hamular notch and distance between two hamular notches. After measuring these distances, the predicted value was calculated by taking mean of these three distances. The actual value in both the groups was measured with a flexible ruler. The mean and standard deviation of both groups were calculated. Results were analyzed with correlation and regression analysis. Results: The analysis showed that there was a positive correlation between actual and predicted values in both dentulous and edentulous group of study subjects (p-value <0.01). As the actual value increased in both the groups, the predicted value also increased. So the actual value can be derived with the help of predicted value which will be useful in selecting the proper tooth mold size of the maxillary teeth for edentulous patients. Conclusion: A positive correlation exists between the width of the maxillary teeth (actual value) and mean of the distance (predicted value) between the right hamular notch and incisive papilla, left hamular notch and incisive papilla and interhamular distance in dentate subjects. Clinical significance: The results obtained from the present study will be helpful for selecting the proper teeth mold size along with other teeth selection methods. Further studies are required to derive a more scientific and reliable method for anterior teeth selection.



Antoine Saadé, Pascal Baron, Ziad EF Noujeim, Elie Arouk, Dany Azar

Predictability of Craniofacial Skeletal Age with Geometric Morphometrics

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:8] [Pages No:1494 - 1501]

Keywords: Centroid size, Cone beam computed tomography, Geometric morphometrics, Prospective cross-sectional study, Skeletal age

   DOI: 10.5005/jp-journals-10024-2455  |  Open Access |  How to cite  | 


Aim: This study aims to estimate skeletal age of craniofacial shape obtained from cone beam computed tomography (CBCT)-defined facial and basicranial landmarks using geometric morphometrics method in a random sample of growing patients, and explore the correlation between craniofacial shape and skeletal age as determined from hand and wrist radiograph. Materials and methods: Generalized Procrustes analysis (GPA) of craniofacial shape with estimation of centroid size was performed on CBCTs of 48 growing patients (mean age 11.7 ± 1.5 years). Greulich and Pyle method for skeletal age assessment were used for correlation with centroid size. Correlation among the variables relied on Pearson's coefficient and its 95% confidence interval was estimated. The model's R2 was calculated, (Cook's distances, Mahalanobis distances, leverage values, and studentized residuals) and multiple regression analysis performed using the Statistical Package for the Social Sciences (SPSS) version 22. Results: Mean skeletal age was 11.9 ± 2.4 years. Centroid size (151.5 ± 7.2) was significantly correlated with chronological age (R = 0.616, 95% CI 0.355–0.789, p < 0.01) and skeletal age (R = 0.605, 95 % CI 0.331–0.794, p < 0.01). Conclusion: A new equation for determining craniofacial skeletal age was developed, using the centroid size of the craniofacial frame, gender, and the known chronological age. Clinical significance: A CBCT may be used for skeletal age assessment without additional hand wrist radiograph.



Junaid MH Kapadia, Srinivas Ganti, Prashant Shriram, Arsalan SA Ansari, Anurag Azad, Abhinav Dubey

Evaluation of Effect of Glucosamine-Chondroitin Sulfate, Tramadol, and Sodium Hyaluronic Acid on Expression of Cytokine Levels in Internal Derangement of Temporomandibular Joint

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:5] [Pages No:1502 - 1506]

Keywords: Chondroitin sulfate, Glucosamine, TMJ, Tramadol

   DOI: 10.5005/jp-journals-10024-2456  |  Open Access |  How to cite  | 


Aim: Evaluation of the effect of glucosamine-chondroitin combination, tramadol, and sodium hyaluronic acid in temporomandibular joint (TMJ) disorders and its impact on the expression of various cytokines such as IL-6, IL-1s, TNF-ƒ¿, and PGE2. Materials and methods: The present study was conducted on 60 patients (males.30, females.30) suffering from internal derangement such as disc displacement with reduction of TMJ. The patients were divided into three groups of 20 each. Group I received a combination of 1.5g of glucosamine and 1.2 g of chondroitin sulfate per day and group II received 50 mg tramadol HCL peroral. Group III received sodium hyaluronate 10 mg/mL, 2 mL injection syringe on each joint. Pain (VAS) scale and maximum mouth opening (MMO) was measured. The level of IL-6, IL-1s, TNF-ƒ¿, and PGE2 levels were measured using Enzyme-linked immuno sorbent assay (ELISA). Results: There was an improvement in maximum mouth opening in all three groups (p < 0.05). There was a reduction in pain in all groups. IL- 1 s, TNF-ƒ¿, and PGE2 leve ls showed reduction while IL-6 showed an increase in value in group II and III. Conclusion: The efficacy of glucosamine chondroitin sulfate, tramadol and hyaluronic acid in TMJ disorders has been found to be effective. Clinical significance: IL-6, IL-1s, TNF-ƒ¿, and PGE2 levels indicate the risk of TMJ disorders. Thus earlier assessment of their levels helps in diagnosis, and better management may be done.



Mana Alqahtani, Mohammed Z Kola

Evaluation of Interactions of Surface Fluorides on Nickel–chromium and Casted Titanium Alloys: An In Vitro Study

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1507 - 1512]

Keywords: Fluorides, Scanning Electron Microscope, Surface roughness, Titanium

   DOI: 10.5005/jp-journals-10024-2457  |  Open Access |  How to cite  | 


Aim: The present study was conducted to assess the effects of topical fluoride on casted Titanium and nickel chromium using Scanning Electron Microscope. Materials and methods: This in vitro study comprised of 45 specimens of Titanium and 45 specimens of nickel-chromium of same dimensions. They were divided into three groups of 15 each. Group I specimens were immersed in 2% neutral sodium fluoride (NaF) solution for 16 minutes. Group II specimens were placed in 1.23% acidulated phosphate fluoride (APF) gel for eight minutes. Group III specimens were placed in distilled water for 8 minutes. All specimens were evaluated for surface roughness using a scanning electron microscope. Results: Data thus obtained were subjected to statistical analysis including post-hoc test and analysis variance (ANOVA). There was no significant increase in surface roughness of nickel- chromium specimens in group I, II and III (p > 0.05) whereas Titanium specimens in group II showed a substantial increase in surface roughness (p < 0.05). There was surface corrosion of Titanium specimens and slight pitting of nickelchromium specimens in group II. Conclusion: The studied preparation (1.23%) of acidulated phosphate fluoride has shown to affect the surface roughness of Titanium and nickel-chromium specimens whereas 2% neutral sodium fluoride and distilled water has no noticeable effect, therefore, providing some logical clinical correlations. Clinical significance: Clinicians must be well known about the logical usages of topical fluorides in dentistry. Different fluoride concentrations and preparations are capable of producing prosthesis's surface roughness of various degrees. Surface roughness is acting as potent areas of bacterial adhesion, plaque retention, calculus retention and microcrack formation with poor esthetics and therefore it significantly affect long-term prosthesis success. Thus, the operator must be very critically monitoring and managing the harmful effects of acidic fluoridated on prosthesis made up of casted Titanium and nickel-chromium.



Junaid MH Kapadia, Shweta Kajjari, Faizia Rahman, Deepak K Bansal

Fluoride, Thyroid Hormone Derangements and its Correlation with Tooth Eruption Pattern Among the Pediatric Population from Endemic and Non-endemic Fluorosis Areas

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:5] [Pages No:1513 - 1517]

Keywords: Fluorosis, Thyroid hormones, Tooth Eruption

   DOI: 10.5005/jp-journals-10024-2458  |  Open Access |  How to cite  | 


Aim: To comparatively evaluate the status of fluoride in the body with thyroid activity in the pediatric population of endemic fluorosis areas. The present study also attempted to elucidate whether any correlation exists between fluoride and thyroid hormone derangement with delayed tooth eruption. Materials and Methods: A total of 400 pediatric subjects were included in the present study. All the patients were divided into two broad groups; groups A and B. Group A included 200 subjects who belonged to the endemic fluorosis area while Group B included remaining 200 subjects, who belonged to the fluorosis non-endemic area. Group B subjects were taken as control. Group A subjects were further divided into two study groups as follows: Group A1: 100 Paediatric subjects with dental fluorosis, and Group A 2: A total of one hundred pediatric subjects without dental fluorosis. Dean's index of fluorosis was calculated in all the patients. Blood samples were collected and were sent to a laboratory for assessment of thyroid hormone levels. All the results were subjected to statistical analysis by Statistical Package for the Social Sciences (SPSS) software. Results: Mean thyroid stimulating hormone (TSH), water fluoride levels, urine fluoride levels and serum fluoride levels of subjects in group 1 were found to be significantly higher than that of subjects of group 2. Delayed tooth eruption was absent in subjects of group B while it was present in 100 subjects of group A. Thyroid hormone level derangement was seen in 54 percent subjects of group B, while it was seen in 67.5% subjects of group A. Conclusion: Positive correlation exists between fluorosis and thyroid functional activity. However; the tooth eruption pattern is independent up on the thyroid hormone derangement. Clinical significance: Delayed tooth eruption and alteration in thyroid hormone levels can occur in subjects of the endemic fluoride areas. Therefore, adequate measures should be taken for controlling such adverse effects.



Ammar A Siddiqui, Mohammed K Alsaleh, Sarah S Alajlan, Nasser F Alateeq, Naif S Alamer, Hazza A Alhobeira, Saif Khan

Alveolar Osteitis: Patient's Compliance with Post-extraction Instructions Following Permanent Teeth Extraction

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:8] [Pages No:1518 - 1525]

Keywords: Alveolar Osteitis, Dry socket, Patient's compliance, post-extraction

   DOI: 10.5005/jp-journals-10024-2459  |  Open Access |  How to cite  | 


Aim: The study aims to evaluate the patients’ compliance with post-extraction instructions to prevent the development of alveolar osteitis and keep the health of the socket. Alveolar osteitis “Dry socket” is considered one of the most common complications after extraction. Materials and methods: Study was based on an observational cross-sectional design involving 201 subjects (individuals). The subjects were evaluated via a survey questionnaire and clinical examination after obtaining their verbal and written consent. The study questionnaire was divided into the following sections; section one records the demographic data about the subject while the second section focuses on self-assessment mainly regarding compliance with post-extraction instructions and pain. Results: A total number of patients included in the study was 201, 122 (60.7%) male and 79 (39.3%) female with an age of more than 18 years. No statistically significant association was reported between a medical condition and dry socket. Out of 201 patients came for clinical examination, 89 felt pain at the site of extraction at different period started from the day of extraction till the day of examination with various pain intensity. Females were the most to feel pain after tooth extraction with 78%. Regarding prevalence, 14 (7%) patients reported having dry socket and poor socket status. A statistically significant association of non-complying patients with the incidence of the dry socket was observed for a wide range of age (18 to 40 years) Conclusion: The study showed a high degree of association between the incidence of dry socket cases for patients with poor compliance with post-extraction instruction. A strong relation was observed between the patients who felt pain and their gender (females) Clinical significance: Based on the findings of the present study, we recommend the need to properly educate patients on the effect of compliance and the various complications and factors affecting the socket status after tooth extraction due to non-compliance.



Vikram Singh, Neha Khare, Tony Varghese, MC Prashant, Kiran Dodani, Neelu Nagpal

Resistin and Plasma-reactive Oxygen Metabolite Levels in Obese and Nonobese Individuals with Chronic Periodontitis in Response to Nonsurgical Periodontal Therapy

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1526 - 1531]

Keywords: Nonsurgical periodontal therapy, Obesity, Resistin

   DOI: 10.5005/jp-journals-10024-2460  |  Open Access |  How to cite  | 


Aim: To assess and compare the impact of non-surgical periodontal therapy on plasma reactive oxygen metabolites and resistin values in chronic periodontitis obese and non-obese patients. Materials and methods: Total 200 subjects were included in the present study and were broadly divided into two study groups with 100 patients in each group as follows: group A: Obese patients with chronic periodontitis, group B: Non-obese, normal weight patients with chronic periodontitis. Various following periodontal parameter were calculated at the baseline time and two months after the nonsurgical periodontal therapy. Plasma reactive oxygen metabolite (RM) and serum and GCF resistin levelswere evaluated. Assessment of all the results was done by Statistical Package for Social Sciences (SPSS) software. Results: Significant results were obtained while doing an intergroup comparison of clinical attachment levels between two study groups. Significant results were obtained while comparing the clinical attachment levels in both the study groups at different time intervals. Significantmki 9 reduction in the RM was seen in Group B subjects in comparison to Group A subjects 2 months after nonsurgical periodontal therapy. Conclusion: In patients with chronic periodontitis, obesity can be considered as an important factor in the alteration of resistin levels. Clinical significance: Obese patients should be motivated for reducing weight so that periodontal therapy and other treatment modalities could be carried out more effectively.



Ghadeer I Basunbul

The Use of Magnifying Loupes among Dental Professionals

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:7] [Pages No:1532 - 1538]

Keywords: Dentists, Loups, Magnification, Magnifying loupes, Vision

   DOI: 10.5005/jp-journals-10024-2461  |  Open Access |  How to cite  | 


Aim: The study aims to determine the perspective of dental professionals towards magnifying loupes and the selection criteria used while purchasing them. Materials and methods: In this regard, a close-ended questionnaire was structured and distributed among 111 dental professionals. The questionnaire was designed to obtain information regarding the usage of magnifying loupes in dental practices and procedures, limiting factors, and selection criteria for purchasing. The results obtained from this study were statistically analyzed with the help of SPSS. Results: The findings illustrated that most respondents considered the use of magnifying loupes beneficial in dental practices. Also, 20.7% of them preferred “Through-the-Lens” magnifying loupes over “Flip-up” ones. Furthermore, many of the respondents considered that price, magnification, and resolution are the main factors in terms of selection criteria. Conclusion: Although, there is an immense growth seen in the usage of magnifying loupes in dentistry; still there is a need to increase the awareness of the dental professionals regarding the positive outcomes of magnification aids in dentistry. Clinical significance: The study will help enlightening clinicians regarding the selection criteria while purchasing magnifying loupes for dental practices.



Shagun Gulia, Vinaya Bhatt, Krishna Prasad D, Prateek Gupta

The Effect of Type II Diabetes Mellitus, Candida Albicans and Streptococcus Mutans on the Biofilm Formation on Prosthetic Materials

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:8] [Pages No:1539 - 1546]

Keywords: Artificial saliva, Biofim, Candida albicans, Natural saliva, Prosthetic materials, Streptococcus mutans, Type II diabetes mellitus

   DOI: 10.5005/jp-journals-10024-2462  |  Open Access |  How to cite  | 


Aim: To investigate the biofilm formation on Prosthetic materials as affected by type II diabetes mellitus, Candida albicans and Streptococcus mutans. Materials and methods: Two types of saliva, Natural saliva, and artificial saliva were collected and prepared respectively. The natural saliva was divided into diabetic and non-diabetic saliva. The Artificial saliva was further divided into two groups, one inoculated with Streptococcus mutans and the second with Candida albicans. The 150 samples of various prosthetic materials were prepared using nickel-chromium alloy, ceramic, soft liner, tooth molding powder; heat cured the acrylic resin. The samples were then immersed in natural saliva and artificial saliva and studied for biofilm formation. Results: D iabetic s aliva f ormed m ore b iofilm t han n ondiabetic saliva. Streptococcus mutans were able to form more biofilm than Candida albicans in artificial saliva on constitutive androstane receptor (hCAR) and spinal length (SL). In Diabetic saliva, there was a significant difference in the biofilm formation seen between MC and NCA (p < 0.05). No biofilm was formed on hCAR in Natural Saliva (Diabetic or non-diabetic). In Artificial saliva inoculated with Candida albicans and streptococcus mutans there is a significant difference in the biofilm formation in all the materials except NCA. Conclusion: Diabetic saliva has more potential to form biofilm than non-diabetic saliva. Also, Candida albicans and Streptococcus mutans both can form a biofilm on materials used with the maximum formation on hCAR. Smoother materials formed less biofilm than rougher surfaces like hCAR, PCM, SL. Clinical significance: It is desirable for dental restorative materials to have a low susceptibility for accumulation and formation of biofilm as it may lead to pathologies such as dental caries, periodontal disease, peri-implantitis, etc. which are plaquerelated. The most commonly used materials in prosthodontics have been used in the study to establish a direct relationship with the formation of biofilm, this, in turn, helps us to take the right call in choosing a material for a patient with an already compromised systemic condition.



Shailesh M Gondivkar, Amol R Gadbail, Palak Shroff, Subhash P Kumbhare

Analyses of the Erosive Potential of Various Soft Drinks and Packaged Fruit Juices on Teeth

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1547 - 1552]

Keywords: Carbonated drinks, critical pH, dental erosion, fruit juices, titratable acidity

   DOI: 10.5005/jp-journals-10024-2463  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the erosive potential of twenty beverages (8 carbonated drinks and 12 packaged fruit juices). Material and methods: Twenty-one sound permanent freshly extracted teeth were segmented into small enamel slices and stored in normal saline. The titratable acidity of each experimental drink was measured as the amount of 0.1 N sodium hydroxide (NaOH) required to raise pH to 5.5 and 7. The enamel specimens were incubated in freshly collected human saliva for 3 hours. One enamel slice was immersed in each beverage and percentage weight loss in the enamel slice was calculated after 6 and 24 hours intervals. Results: The titratable acidity values of the experimental drinks ranged from 0.2 to 5.6. The mean titratable acidity values of the packaged fruit juices were higher than carbonated drinks. A significant difference (p < 0.0 5) was found in the percentage weight loss of enamel specimens after 6 and 24 hours immersion in the carbonated drinks than packaged fruit juices. Apple juice followed by thumps up were found to be the most erosive drinks with the least effects of Miranda and Guava juice. Conclusion: Most of the beverages tested in this study showed erosive potential. The carbonated drinks caused significant dental erosion. Clinical significance: Individuals at risk for beverages-associated erosion, particularly those with high intakes or decreased salivary flow, should be provided preventive guidance regarding habits of beverages intake. Specific dietary recommendations for the prevention of dental erosion may now be developed based on the patient's history of beverage consumption.



Orlando Motohiro Tanaka, Armando Y Saga, Ivan P Taffarel, Leonardo L Locks, Gerson LU Ribeiro

Clinical Outcome of an Impacted Maxillary Canine: From Exposition to Occlusion

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:6] [Pages No:1553 - 1558]

Keywords: Impacted, Impaction, Maxillary canine, Orthodontics

   DOI: 10.5005/jp-journals-10024-2464  |  Open Access |  How to cite  | 


Aim: The aim is to report a case of impacted maxillary right canine successfully positioned into the occlusion line. Background: Although the treatment of choice for an impacted canine is a combined surgical-orthodontic approach, there are differences in technique. The preorthodontic uncovering and autonomous eruption technique is a safe and predictable option for the treatment of palatally impacted maxillary canines in adolescents and adults as is the orthodontic creation of a space before minimal surgical exposure, the bonding of a small attachment (an eyelet), full-flap closure, and immediate traction. Although the mechanical management of impacted teeth is a routine task for most orthodontists, certain types of impaction can be frustrating. Case description: An 18-year-old adult patient presented for clinical examination with a mobile maxillary right deciduous canine, the absence of a maxillary right permanent canine, Angle Class I malocclusion, an overjet of 2.0 mm, an overbite of 3.0 mm, and rotated canine and left maxillary central and lateral incisors. Cephalometric measurements revealed a skeletal Class I relationship as well as upright maxillary incisors (1. NA = 18°) and mandibular incisors (1. NB = 16°, IMPA = 80°). The facial profile was concave. Clinically, a constricted maxillary arch was observed, and the patient had a nail-biting habit. Conclusion: The canine was aligned, leveled and positioned in the occlusion line. The aesthetic, functional and periodontal results remained stable in the retention phase. Clinical significance: Various treatment strategies are available to treat impacted maxillary canines. The surgical, periodontal, and orthodontic considerations in the management of impacted canines must be clearly explained to the patient.



Arwa Aldeeri, Lulu Alhammad, Amjad Alduham, Waad Ghassan, Sanaa Shafshak, Eman Fatani

Association of Orthodontic Clear Aligners with Root Resorption Using Three-dimension Measurements: A Systematic Review

[Year:2018] [Month:December] [Volume:19] [Number:12] [Pages:7] [Pages No:1559 - 1565]

Keywords: Aligners, Orthodontic appliances, Removable, Root resorption, Systematic review

   DOI: 10.5005/jp-journals-10024-2465  |  Open Access |  How to cite  | 


Aim: This paper aims to assess the evidence in the literature reporting orthodontically induced inflammatory root resorption (OIIRR) in treatment with orthodontic clear aligners using 3D measurements. Materials and methods: Following preferred reporting Items for systematic reviews (PRISMA) statement, eight electronic databases were searched for relevant published and unpublished records. Data collected according to restricted inclusion and exclusion criteria. Results: A total of 236 articles were identified as relevant to our topic. Duplicates were excluded resulting in 226 papers, out of which 31 papers were relevant after screening titles and abstracts. Only 2 high-level evidence papers out of the 31 met the inclusion criteria for the qualitative synthesis. Conclusion: Based on the available studies with high level of evidence in the literature, we conclude that orthodontic clear aligners are non-inferior to light-force fixed orthodontic appliances, and superior to heavy-force fixed orthodontic appliances in terms of the risk for developing apical root resorption. Clinical significance: Orthodontists can be more assured about the low-risk of OIIRR associated with clear aligners compared to other orthodontic treatment modalities, and it remains up to the practitioner's assessment to select the appropriate treatment on a case by case basis.


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