The Journal of Contemporary Dental Practice

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2018 | May | Volume 19 | Issue 5

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Laser Capture Microdissection in Oral Cancer

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:2] [Pages No:475 - 476]

   DOI: 10.5005/jp-journals-10024-2286  |  Open Access |  How to cite  | 



Naif A Bindayel

Occurrence of Malocclusion in Patients with Orofacial Pain and Temporomandibular Disorders

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:477 - 482]

Keywords: Disorders, Malocclusion, Orofacial, Prevalence, Temporomandibular

   DOI: 10.5005/jp-journals-10024-2287  |  Open Access |  How to cite  | 


Aim: This study aims to investigate the occurrence of malocclusion in patients with orofacial pain and temporomandibular disorders (TMDs). Materials and methods: A total of 437 standard orthodontic screening forms at a craniofacial pain TMD center were utilized to collect the data for this retrospective study. In addition to patient's demographics and Angle's molar classification, the following data were collected: Overjet (OJ), overbite (OB), mandibular range of motion, and whether or not there was a posterior crossbite or prior history of orthodontic therapy. Analysis of variance (ANOVA) and chi-square tests were then used to detect any statistical significant difference of the secondary variables’ distribution among the three malocclusion groups. Results: The majority of the studied population sample had a class I molar relationship (70.9%), followed by class II (21.1%) and class III molar relationship (8%). Overjet and OB were significantly increased for class II molar relationship group (p < 0.001), where no statistical differences could be identified for the mandibular range of motion between the groups. The prevalence of right and left posterior crossbite was about 12% for both, and most of the crossbites presented within class I molar group. Conclusion: Class I followed by class II molar relationships were found to be the most occurring relationship in the studied population. Posterior crossbite presented in 12% of cases and mostly affected subjects with class I molar relationship. Clinical significance: These findings would aid in recognizing the studied population's orthodontic presentation and support the assessment of their transverse interventional needs.



Giovanni D Alessandro, Tommaso Costi, Nadia Alkhamis, Simone Bagattoni, Agnese Sadotti, Gabriela Piana

Oral Health Status in Alzheimer's Disease Patients: A Descriptive Study in an Italian Population

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:7] [Pages No:483 - 489]

Keywords: Alzheimer's disease, Dementia, Descriptive study, Oral health, Professional

   DOI: 10.5005/jp-journals-10024-2288  |  Open Access |  How to cite  | 


Aim: To evaluate the oral health status in Alzheimer's disease (AD) patients. Materials and methods: A descriptive study was performed on 120 AD patients (60 institutionalized in a public institute and 60 attended a daytime center), from September 2013 to January 2014. About 103 subjects formed the control group. The following medical and dental data were collected: dementia severity, pharmacological therapy, physical status (American Society of Anesthesiologists [ASA]), decayed (D), filled (F), and remaining natural teeth (T), DF/T ratio, community periodontal index (CPI), and gingival index (GI). A t-test for independent samples and the Spearman's correlation test were used to evaluate all variables. The significance level was set at 0.05. Results: Statistically more AD patients (91.7%) were under pharmacological therapy and their physical status was more severe (ASA 2, ASA 3) compared with control subjects (p < 0.001). Moreover, they presented numbers of D, CPI, and GI significantly higher (p ≤ 0.005). In the institutionalized subgroup, statistically more moderate and severe AD cases were detected and more patients were edentulous (p < 0.001). Noninstitutionalized patients presented DF/T ratio, CPI, and GI significantly lower (p ≤ 0.024). A significant weak negative correlation (r = −0.121 to −0.372) between epidemiologic indices and AD severity was observed. Conclusion: Alzheimer's disease patients show a low oral health status that decreases progressively as the disease severity aggravates. Therefore, further studies are necessary to investigate oral health care interventions for AD patients. Clinical significance: It would be beneficial to introduce trained professional figures in specialized elderly institutions for regular follow-up visits and professional oral hygiene procedures. This task has to be coordinated with the treating physician, family members, and/or caregivers. Knowing that the severity of AD has a negative effect on the oral health status and the type of institutionalization exacerbates it.



Antoine Daraze

Cephalometric Evaluation of the Hyoid Bone Position in Lebanese Healthy Young Adults

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:12] [Pages No:490 - 501]

Keywords: Airway space, Anthropometry, Cephalometry, Crosssectional study, Hyoid bone position, Lebanon, Obstructive sleep apnea, Sex dimorphism, Tongue, Young adults

   DOI: 10.5005/jp-journals-10024-2289  |  Open Access |  How to cite  | 


Introduction: The objectives of this study are to assess hyoid sagittal and vertical position, and potential correlations with gender, skeletal class, and anthropometrics. Materials and methods: Twenty-seven cephalometric linear, angular, and ratio measurements for the hyoid were recorded on lateral cephalograms obtained from 117 healthy young Lebanese adults. Anthropometric parameters including height, weight, body mass index (BMI), and neck circumference (NC) were measured. Results: Statistically significant gender differences were demonstrated for 21 out of 27 parameters considered. All linear and two out of three angular measurements defining the vertical hyoid position were larger in males compared with females. Five linear, one angular, and two ratio measurements showed differences in the sagittal dimension. Skeletal classes did not influence the sagittal and vertical hyoid position. Anthropometric variables as height were strongly correlated to the vertical hyoid position, while weight correlated more sagittally. Conclusion: Cephalometric norms for hyoid position were established, sexual dimorphism and ethnic differences were demonstrated. Skeletal patterns did not influence the sagittal and vertical hyoid bone position. Anthropometric parameters, such as BMI correlated the least to both vertical and sagittal hyoid position measurements, while the impact of height and weight as separate entities made a paradigm shift providing accurate and strong correlation of the vertical hyoid position to the height, and the sagittal hyoid position to the weight of individuals. Clinical significance: The cephalometric norms for the hyoid bone position in the Lebanese population established in the present study are of paramount clinical importance and should be considered in planning combined orthodontic and breathing disorders treatments.



Md Jalaluddin, GB Goutham, Joseph Joy, Ipsita Jayanti, Anisha Avijeeta

Clinical Assessment of Gingival Sulcus Width using Various Gingival Displacement Materials

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:5] [Pages No:502 - 506]

Keywords: Aluminum chloride, Gingival displacement, Laser, Magic foam

   DOI: 10.5005/jp-journals-10024-2290  |  Open Access |  How to cite  | 


Aim: This study aims to compare the clinical efficacy of three different gingival retraction systems on gingival sulcus width. Materials and methods: Study was conducted on prepared right or left maxillary central incisor for 45 subjects. Totally, 15 patients were randomly allocated in three gingival displacement groups, i.e., group I (retraction cord impregnated with aluminum chloride), group II (magic foam), and group III (laser). The pre- and postdisplacement impressions were made with addition silicone material using two-stage double mix technique. Results: There was no difference between the groups at baseline. Group III produced more displacement (mean value 0.48 ± 0.101 mm) than group II (mean value 0.31 ± 0.09 mm) and group I (mean value 0.44 ± 0.11 mm), and this was statistically significant. Conclusion: Laser gingival displacement system was found to be effective among the three retraction systems. Choice of gingival displacement system is based on clinical situation and choice of operator. Clinical significance: The retraction groups in the study created greater amount of gingival retraction than the least sulcus width required for the elastomeric impression material and so are clinically useful.



Srinivasa Gowda, Dilip D Quadras, Shetty R Sesappa, GR Ramakrishna Maiya

Comparative Evaluation of Fracture Strength of Different Types of Composite Core Build-up Materials: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:8] [Pages No:507 - 514]

Keywords: Bonferroni's test, Hybrid composite, In vitro study, Nanocomposite, Ormocer

   DOI: 10.5005/jp-journals-10024-2291  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate the fracture strength of three types of composite core build-up materials. The objectives were to study and evaluate the fracture strength and type of fracture in composite core build-up in restoration of endodontically treated teeth with or without a prefabricated metallic post. Materials and methods: A total of 60 freshly extracted mandibular premolars free of caries, cracks, or fractures were endodontically treated and restored with composite core build-up with prefabricated metallic posts cemented with resin luting cement (group I) and without a post (group II). This was followed by a core build-up of 10 teeth each with three different types of composite materials: Hybrid composite, nanocomposite, and ormocer respectively. The samples were mounted on polyvinyl chloride block and then loaded in the universal load frame at 90° to the long axis of tooth. The fracture strength of the samples was directly obtained from the load indicator attached to the universal load frame. Results: Analysis of variance (ANOVA) test revealed that teeth restored with post exhibited highest fracture strength (1552.32 N) and teeth restored without post exhibited lowest fracture strength (232.20 N). Bonferroni's test revealed that values for hybrid composite (Z-100, 3M ESPE) with post, nanocomposite (Z-350, 3M ESPE) with post, ormocer composite (Admira- VOCO) with post, and nanocomposite (Z-350, 3M ESPE) without post were not significantly different from each other. Conclusion: Teeth restored with post and core using hybrid composite yielded the highest values for fracture strength. Teeth restored with ormocer core without post exhibited the lowest values. Teeth restored with nanocomposite core without post exhibited strength that was comparable with hybrid composite core but higher than that of ormocer. Clinical significance: Mutilated endodontically treated teeth can be prosthetically rehabilitated successfully by using adhesive composite core build-up along with post to meet anatomical, functional, and esthetic demands.



Waeil Batwa

Use of Interarch Width Ratio to measure Transverse Relationship: A New Method to measure and assess Interarch Discrepancy

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:515 - 520]

Keywords: Interarch ratio, Interarch width, Mandibular arch width, Maxillary arch width, Transverse discrepancy

   DOI: 10.5005/jp-journals-10024-2292  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to assess the arch width, transverse discrepancy, and transverse interarch ratio for class I malocclusion sample, with and without crossbite, in permanent dentition stage. Materials and methods: Records of class I malocclusion patients with minimal crowding and spacing with and without posterior crossbite were selected. Each group consisted of 40 pairs of dental casts (20 males and 20 females). Arch widths were measured for the canine, first, and second premolars, and first permanent molars using the buccal approach. Means and standard deviations (SDs) of dental arch widths were measured for the maxillary and mandibular arches, and the interarch width ratio was calculated. Results: There was a highly significant difference between the noncrossbite and crossbite groups regarding the maxillary width, p < 0.001. However, no differences were found between groups for the mandibular widths, p > 0.01. There were also significant differences between both groups for the intercanine, first and second premolars, and first molar ratios, p < 0.001. Conclusion: This new simple method showed that a transverse maxillary–mandibular ratio of 1:1.1 is ideal. A ratio less than 1:0.9 will indicate the presence of crossbite. Clinical significance: The interarch ratio significantly aids in orthodontic treatment planning in patients requiring maxillary expansion and/or surgical cases.



Rahul Garg, Pankaj Dixit, Taruna Khosla, Palak Gupta, Hiten Kalra

Enamel Surface Roughness after Debonding: A Comparative Study using Three Different Burs

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:521 - 526]

Keywords: Bracket debonding composite bur, Fiber glass bur, Orthodontic procedures, Tungsten carbide bur

   DOI: 10.5005/jp-journals-10024-2293  |  Open Access |  How to cite  | 


Aim: To compare effects of three different burs, i.e., tungsten carbide bur, composite bur, and fiber glass bur on the surface roughness of enamel after debonding evaluated by means of profilometry. Materials and methods: The present study was conducted in the Department of Orthodontics and Dentofacial Orthopedics, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India, from August 2011 to December 2012 on 36 extracted premolars. After mounting the samples in acrylic blocks with their buccal surfaces exposed, initial measurement of the surface roughness was made using profilometry. Teeth were then etched and brackets were bonded with light cure adhesive. After 3 days, the brackets were debonded using three different rotating burs at low speed, i.e., tungsten carbide bur, fiber glass bur, and composite bur. Enamel surface roughness values were obtained and assessed using paired t-test, one-way analysis of variance (ANOVA) test, and post hoc multiple tests. Results: Surface roughness of enamel increased significantly for tungsten carbide bur when compared with fiber glass bur and composite bur. But there was no significant difference in the surface roughness value when fiber glass bur was compared with the composite bur. Conclusion: Composite and fiber glass burs used for resin removal after orthodontic debonding produced a smoother enamel surface as compared with the tungsten carbide bur. Clinical significance: After an orthodontic treatment, restoring the enamel surface to its pretreatment condition without inducing any iatrogenic damage after debonding is a clinical challenge. Residual resin removal through proper means ensures a smooth surface, and, hence, a plaque-free environment. Finishing requires as much planning and execution as planned for the fixed therapy itself.



Nour M Al-Shammari, Sanaa M Shafshak, Mohamed S Ali

Effect of 0.8% Hyaluronic Acid in Conventional Treatment of Moderate to Severe Chronic Periodontitis

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:8] [Pages No:527 - 534]

Keywords: Adjunctive therapy, Chronic periodontitis, Hyaluronic acid, Inflammation, Scaling and root planing, Subgingival application

   DOI: 10.5005/jp-journals-10024-2294  |  Open Access |  How to cite  | 


Objective: The aim of this study is to evaluate the effect of the subgingival application of 0.8% hyaluronic acid (HA) gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) on clinical parameters and expression of human beta defensin-2 (hBD-2) in patients with moderate to severe chronic periodontitis. Materials and methods: In this randomized, split mouth design study, 24 participants with moderate to severe chronic periodontitis were evaluated after full mouth SRP. In the test sites 1 mL of 0.8% hyaluronan gel was applied subgingivally after SRP at baseline and 1 week post therapy. Plaque index (PI), gingival index (GI), papillary bleeding index (PBI), periodontal probing depth (PPD), and clinical attachment loss (CAL) were recorded and gingival crevicular fluid (GCF) samples were collected at baseline, after 6 and 12 weeks. Expression of human beta defensin-2 (hBD-2) was analyzed by enzyme-linked immunosorbent assay. Results: At baseline, there were no statistical differences between test and control sites in all clinical parameters and hBD-2 expression. An improvement of PI, GI, PBI, PPD, and CAL was observed at 6 and 12 weeks (p < 0.05) in both groups. Clinically, it was noticed that all indices except CAL had more statistically significant reduction in test sites than control sites at 6 and 12 weeks. The hBD-2 levels were significantly higher in the test sites than in the control sites at 6 and 12 weeks. Conclusion: The local application of 0.8% hyaluronan gel with SRP have a positive effect on periodontal health of moderate to severe chronic periodontitis patients after 6 and 12 weeks. Clinical significance: Subgingival application of 0.8% HA gel following SRP has shown anti-inflammatory effect and has a beneficial effect on clinical parameters in moderate to severe chronic periodontitis patients.



Deepti Raghav, Renu B Pachar, Ravishek K Singh, Sachin Kundra, Sankalp Arya, Lata K Mehta

Evaluation of Predictability of Suitable Implant Lengths as related to Accurate Treatment Planning using Recent Roentgenographic Measures: A Key to Success

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:535 - 540]

Keywords: Cephalogram, Cone beam computed tomography, Dental implants, Implant planning, Surgical guide

   DOI: 10.5005/jp-journals-10024-2295  |  Open Access |  How to cite  | 


Background and aim: Selection of suitable length of dental implants is very subjective and largely depends on clinical evidences and operator's expertise. The present study was aimed to assess the role of cone beam computed tomography (CBCT) and cephalograms as far as the selection of right implant length is concerned. Materials and methods: The study includes 220 patients for whom radiographic and follow-up records were obtained. There were 105 males and 115 females in the age range of 22 to 58 years. A total of 98 implant sites in different edentulous areas were studied. Length of implant was predicted at treatment planning and compared with finally placed implant at surgical stages. It also includes the in-depth exploration of (1) number of implants placed per patient, (2) implant per edentulous areas, (3) implant location, and (4) implant region. For prediction of implant lengths, CBCT results were obtained and compared with cephalometric findings. Accuracies of implant lengths as planned by CBCT and cephalometric images were also studied at treatment planning and surgical stages. Statistical analysis and results: Upon statistical comparisons, we found that larger implant lengths chosen at treatment planning stage did not change in 65.5% of patients. In addition, the smaller length implants were just about the same as that with larger dimensions. The CBCT results were satisfactory (up to 98.5%). Cephalometry was performed well in this prediction, especially in posterior mandible (87.9%). However, its performance in anterior maxillary region was not satisfactory (69.6%). Intergroup comparisons of CBCT and cephalometric results at different regions were significant (p < 0.001). Conclusion: Our study results show insignificant changes in the length of implants that was exactly planned using CBCT scans. Therefore, accurate prediction of implant lengths can be done using CBCT scans as they have superior and advanced tools that facilitate presurgical decision-making. Lateral cephalometric evaluation has been shown as an imperative radiographic tool for determining implant lengths as it confirmed the significance bone resorption on the selection of implant length at different sites. Clinical significance: The CBCT and lateral cephalogram offer excellent anatomical details that can be judiciously applied for treatment planning and other clinical decision-making, including selection of correct implant length. Our study advocates thorough cephalometric evaluations of mandible wherein implants are to be placed for implant-supported overdentures.



Clóvis L de Moraes Melo Neto, Guilherme T Costa, Tarso Lorga, Gabriela C Santin, José Mondelli, Sérgio Sábio

Effect of using the New Glass Fiber Pin in Resin Composite Restorations

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:5] [Pages No:541 - 545]

Keywords: Glass fiber pins, Laboratory research, Metal pin

   DOI: 10.5005/jp-journals-10024-2296  |  Open Access |  How to cite  | 


Aim: The purpose was to compare the fracture strength between restorations containing the metal pin (MP) and those containing the glass fiber pin (GFP). Materials and methods: Forty-five healthy bovine anterior teeth were used in this study. A preparation of 4 mm x 4 mm was created on the incisal surface of each tooth. All teeth were prepared in the same way. The teeth were randomly divided into three groups (n = 15): group I—control: teeth restored with resin composite (RC) only, without reinforcement; group II—Each tooth was restored with a MP and RC; group III—Each tooth was restored with a GFP and RC. The specimens were left in an oven at a temperature of 37°C for 24 hours before performing the fracture strength tests. The fracture strength test was performed in a universal test machine at an angle of 90°. Results: The Tukey test (p ≤ 0.05) showed that for the variable maximum force (kgf), there was no statistically significant difference among the groups (p = 0.272). The chi-square test showed that groups II and III presented over 70% of cohesiveadhesive type fractures when compared with group I (over 70% of adhesive fractures), and this difference was statistically significant (p < 0.05). Conclusion: The pins tested did not increase the fracture resistance of the restorations (RC) in comparison with group I (without reinforcement); however, with the use of the MP and GFP, there was a predominance of cohesive-adhesive fractures (groups II and III). Clinical significance: Evaluate if the new GFP can generate greater resistance to fracture of RC restorations.



Abhishek Jahagirdar, Praveen H Bhoopathi, Sreenivas Voruganti, Nukala S Suma, Tejaswini Samudrala, B Vinayak Kamath

Caries Assessment Spectrum and Treatment: Would It direct Future Epidemiological Surveys?

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:8] [Pages No:546 - 553]

Keywords: Caries Assessment Spectrum and Treatment, Caries epidemiology, Dental caries, Disease progression

   DOI: 10.5005/jp-journals-10024-2297  |  Open Access |  How to cite  | 


Aim: To evaluate caries spectrum among 12- and 15-year-old Indian children using the Caries Assessment Spectrum and Treatment (CAST) index. Materials and methods: An epidemiological survey of the schoolchildren was carried out in a district in India. A stratified cluster random sampling method was used to select the sample. The caries prevalence of the surveyed population was obtained by using this CAST tool. Chi-square test was used to verify the association between dental fluorosis, socioeconomic status, and age and caries experience. Mann–Whitney U-test was used to compare the caries experience between the two age groups Results: A total of 2,610 children were examined. The majority of the schoolchildren (12 years: 74.2%, 15 years: 75.5%) were healthy concerning their caries experience and the prevalence of the other codes was minimal. The prevalence of dentin carious lesions and the percent of restorable teeth was greater among the 15-year-olds. The mean decayed, missing, and filled teeth (DMFT) of 12- and 15-year-old subjects was calculated to be 0.22 and 0.29 respectively. Conclusion: The currently surveyed population showed a low caries prevalence and the use of the tool highlighted the caries spectrum in an impressive way. Clinical significance: A well-designed tool to assess the carious spectrum of an individual or a community, thus enabling the responsible stakeholders to plan an appropriate care that is necessary.



Mai E Khalaf, Qoot Alkhubaizi, Qasem D Alomari

Layered Base Plate Blocks and Operative Dentistry Skills

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:554 - 559]

Keywords: Cavity outline, Layered base plate blocks, Operative dentistry

   DOI: 10.5005/jp-journals-10024-2298  |  Open Access |  How to cite  | 


Aim: Preclinical dental training is essential for the development of psychomotor skills necessary for clinical practice. The study aimed to investigate the impact of teaching with a layered base plate blocks on cavity preparations and students’ self-perceived confidence, readiness, and ability. Materials and methods: A cross-sectional study recruited 52 dental students into two groups; one trained (test) with layered base plate and the other without (control). Students answered an eight-question survey to assess self-perceived confidence, readiness, and ability for performing cavity preparation at the start of their first preclinical operative dentistry course. Students prepared one molar tooth for a class I cavity and two for class II cavities. Preparations were assessed for different elements of depth and outline extension by two blinded examiners. Results: Statistically significant differences were found between the median scores with respect to the preparation of class II cavities among students exposed to layered base plate (Mann– Whitney U-test, p < 0.05). There were no significant differences between the median scores awarded with respect to the preparation of class I cavity. A statistically significant difference was reported in self-perceived confidence among students who trained with the layered base plate (χ2, p < 0.05). Conclusion: Training on the layered base plate blocks increased students’ initial confidence level in performing cavity preparations, and improved the preparation skills in class II cavity. Clinical significance: This study explores the methods of enhancing motor skills taught in preclinical operative dentistry courses, especially in short academic programs.



Hassan A Khiavi, Sareh Habibzadeh, Shima Safaeian, Mahsa Eftekhar

Fracture Strength of Endodontically treated Maxillary Central Incisors restored with Nickel Chromium and Nonprecious Gold Alloy Casting Post and Cores

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:8] [Pages No:560 - 567]

Keywords: Endodontically treated teeth, Fracture strength, Nonprecious gold alloy, Post and core

   DOI: 10.5005/jp-journals-10024-2299  |  Open Access |  How to cite  | 


Aim: Since fiber posts are not recommended for teeth under lateral loads, a new alloy containing >80% copper (nonprecious gold or NPG) was introduced with a modulus of elasticity closer to that of dentin and easier preparation. This study aimed to compare the fracture strength of endodontically treated maxillary central incisors restored with nickel chromium (Ni-Cr) and NPG alloys. Materials and methods: Casting post and cores were fabricated of Ni-Cr and NPG alloys for 24 maxillary central incisors (n = 12). Full-metal crowns were also fabricated and placed under cyclin loading in 30 N load and 45° angle, for 250,000 cycles with 2.6 Hz frequency. The fracture strength was measured at a crosshead speed of 0.5 mm/min and 135° angle in a universal testing machine. Data were analyzed using independent t-test. Results: The mean fracture strength was 731.179 ± 327.47 and 1411.89 ± 313.56 N in the Ni-Cr and NPG groups respectively; this difference was statistically significant (p < 0.001). The fracture was irreparable in all teeth since the fracture line was below the cementoenamel junction (CEJ). Conclusion: The fracture strength of teeth restored with cast NPG post and cores was significantly higher than that of teeth restored with cast Ni-Cr post and cores. Clinical significance: Due to proper mechanical properties, NPG post and cores seem to be a suitable choice for restoration of severely damaged anterior teeth, provided that other properties are proven to be acceptable.



Mojdeh Mehdizadeh, Shervin Bagherieh

Evaluation of Relationship between Exposure Parameters and Maxillofacial Bone Quality with Salivary Glands Absorbed Dose in Cone Beam Computed Tomography Imaging

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:568 - 573]

Keywords: Bone quality, Cone beam computed tomography, Dosimetry, Salivary glands

   DOI: 10.5005/jp-journals-10024-2300  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate the protective effect of jaw bone on the dose of salivary glands and its relationship with radiation conditions. Materials and methods: In this cross-sectional study, seven dried human skulls were used. In each mandible, six dosimeters were placed in six salivary gland regions numbered in visible light absorbent envelopes. Cone beam computed tomography (CBCT) images were taken from each mandible with a constant kV of 90 and mA varied from 6, 8, and 10. The absorbed dose was calculated using SOLAR 2A. The bone quality of each of the six areas was obtained using densitometry tool in On Demand software. Finally, the results were analyzed using Statistical Package for the Social Sciences (SPSS) software version 23 with covariance and Tukey tests (α = 0.05). Results: The results of covariance analysis and Tukey test indicated that the sublingual salivary gland had the highest absorption dose. Meanwhile, the results of the analysis showed that the absorption rate of the glands increased by increasing the radiation conditions from 6 to 8 and increasing from 8 to 10 mA (p < 0.001). The results of Pearson analysis showed an inverse relationship between absorbed dose and bone quality (r = –0.327) (p < 0.001). Conclusion: The results of this study showed that the absorption rate of salivary glands will increase with increasing radiation conditions, while increasing the quality of mandibular bone, the absorption dose will decrease. Clinical significance: The clinical significance is to reduce patient's absorbed dose in order to decrease the risk of mutation and cancer formation.



Jeevan Shetty, Rizwan Mokashi, Rashmita Nayak, Anand M Dharamsi, Sourav Malhotra

Crestal Bone Loss around Dental Implants: Platform Switching vs Platform Matching—A Retrospective Study

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:5] [Pages No:574 - 578]

Keywords: Crestal bone, Dental implants, Platform switching

   DOI: 10.5005/jp-journals-10024-2301  |  Open Access |  How to cite  | 


Aim: The objective of this study was to determine the vertical and horizontal marginal bone levels in platform-switched and platform-matched dental implants. Materials and methods: In the present study, 50 dental implants were placed in 50 patients over a 1-year period. Measurement was performed from the implant shoulder to the most apical and horizontal marginal defect by periapical radiographs to examine the changes of peri-implant alveolar bone before and 12 months after prosthodontic restoration delivery. Results: These marginal bone measurements showed a bone gain of 0.53 ± 0.98 mm in the vertical gap and 0.52 ± 0.93 mm in the horizontal gap of the platform matching, while in the platform switching, a bone gain of 1.33 ± 1 mm in the vertical gap (p < 0.05) and 1.60 ± 0.56 mm in the horizontal gap was found. Statistically significant difference was found for bone regeneration in the vertical gap between the two groups (p < 0.05) using t-test with Statistical Package for the Social Sciences (SPSS) statistical test version 17. Conclusion: The crestal bone around the implants can be preserved with platform-switching concept and it can be applied in clinical condition. Clinical significance: The crestal bone around the implants can be preserved with platform-switching concept.



S Ladke Vaibhav, P Lunawat Priya, C Kapse Sonam, Koshti Supriya, Yadav Garima, Shaikh Sabeer, Parag Juvale, Gitanjali Javir

Evaluation of Tumor-associated Tissue Eosinophilia in Different Stages of Oral Squamous Cell Carcinoma using Special Stains: An in vitro Histopathological Study

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:8] [Pages No:579 - 586]

Keywords: Eosinophilia, Oral squamous cell carcinoma, Prognosis, Stains, Tumor stroma, Tumor-associated tissue eosinophilia

   DOI: 10.5005/jp-journals-10024-2302  |  Open Access |  How to cite  | 


Aim: To evaluate the tissue eosinophilia in different stages and grades of oral squamous cell carcinoma (OSCC) and correlate its possible role as a prognosticator in primary OSCC using special stains like Congo red and carbol chromotrope. Materials and methods: Forty-five intraoral histopathologically proven cases of OSCC were selected (15 cases each of well-differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (MDSCC), and poorly differentiated squamous cell carcinoma (PDSCC)). Three sections of 4 μm were taken for each case. All slides were stained using routine stain, i.e., hematoxylin and eosin (H&E), and special stains, i.e., carbol chromotrope and Congo red respectively, for studying tissue eosinophils in all these groups. Histopathological evaluation was performed on paraffin sections for calculating the quantitative eosinophil distribution by two separate observers who were blinded to clinical and histopathological data. Tumor-associated tissue eosinophilia (TATE) was calculated using the density method. Results: An increase in the degree of TATE from stage I to stage IV suggested that elevated tissue eosinophilia was seen with an increasing size of primary tumor. Also an increase in TATE was observed with an increasing grade of OSCC. Chromotrope stain was found to be a much better and more specific stain for eosinophils, and gave more accurate eosinophil count compared with H&E and Congo red. Conclusion: The findings of the present study highlight the significance of eosinophil counting and that it can be used as an additional morphological parameter in the grading of OSCC which can also be included in the biopsy report.



Rizwan Mokashi, Punkit S Sudan, Anand M Dharamsi, Rinkee Mohanty, Archana L Misurya, Pradeepta Kaushal

Risk Assessment in Long-term Survival Rates of Dental Implants: A Prospective Clinical Study

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:4] [Pages No:587 - 590]

Keywords: Bruxism, Dental implant, Periodontitis, Smoking

   DOI: 10.5005/jp-journals-10024-2303  |  Open Access |  How to cite  | 


Aim: The present study was done to analyze the risk factors associated with dental implants in its survival rate. Materials and methods: The present study was conducted on 208 patients with 425 dental implants placed. Patients were divided into four groups: group I (diabetes), group II (periodontitis), group III (smoking), and group IV (bruxism). All patients were followed for 8 to 10 years for the survival rates. Results: Out of 425 dental implants, 145 were inserted in 72 males and 280 in 136 females. The difference was significant (p = 0.01). Group I had 16 males and 36 females, group II had 20 males and 32 females, group III had 28 males and 24 females, and group IV had 8 males and 44 females. The difference was statistically significant (p < 0.05). Out of 425 implants, 90 (21.17%) had failures: 24 dental implants (29%) in group I, 22 dental implants (15.2%) group II, 34 dental implants (27%) in group III, and 10 dental implants (13%) in group IV showed failure. The difference was significant (p < 0.05). Success rate was 70.7% in group I, 83.3% in group II, 80.9% in group III, and 86.3% in group IV. The difference was nonsignificant (p > 0.05). Conclusion: Diabetes, periodontitis, bruxism, and smoking are among various causative factors which affect the survival rate of dental implants. These are risk factors leading to implant failures. Clinical significance: Diabetes, periodontitis, bruxism, and smoking are among various causative factors which affect the survival rate of dental implants.



Michael G Botelho, Yali Lou, Brain W Darvell

Antibacterial Effect of Silver Diamine Fluoride on Cariogenic Organisms

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:8] [Pages No:591 - 598]

Keywords: Agar diffusion test, Ammonium fluoride, Antibacterial, Caries, Fluoride, Silver diamine fluoride, Silver nitrate

   DOI: 10.5005/jp-journals-10024-2304  |  Open Access |  How to cite  | 


Aim: To screen the possible antimicrobial activity of a range of clinically used, silver-based compounds on cariogenic organisms: silver diamine fluoride (SDF), silver fluoride, and silver nitrate. Materials and methods: Preliminary screening disk-diffusion susceptibility tests were conducted on Mueller–Hinton agar plates inoculated with Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces naeslundii, organisms known to be cariogenic. In order to identify which component of the silver compounds was responsible for any antibacterial (AB) effect, and to provide controls, the following were also investigated at high and low concentrations: sodium fluoride, ammonium fluoride, ammonium chloride, sodium fluoride, sodium chloride, and sodium nitrate, as well as deionized water as control. A volume of 10 μL of a test solution was dispensed onto a paper disk resting on the inoculated agar surface, and the plate incubated anaerobically at 37°C for 48 hours. The zones of inhibition were then measured. Results: Silver diamine fluoride, silver fluoride, silver nitrate, and ammonium fluoride had significant AB effect (p < 0.05) on all three test organisms, although ammonium fluoride had no effect at low concentration; the remaining other compounds had no effect. Conclusion: Silver ions appear to be the principal AB agent at both high and low concentration; fluoride ions only have an AB effect at high concentration, while ammonium, nitrate, chloride and sodium ions have none. The anticaries effect of topical silver solutions appears restricted to that of the silver ions. Clinical significance: Silver compounds, such as SDF, silver fluoride, and silver nitrate have AB effect against cariogenic organisms and these may have clinical impact in arresting or preventing dental decay. Sodium fluoride did not have AB effect under the conditions tested.



Michael G Botelho, Yanqi Yang, Vincent WS Leung, Bernard Low

Oral Rehabilitation of Young Adult with Amelogenesis Imperfecta

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:6] [Pages No:599 - 604]

Keywords: Amelogenesis imperfecta, Full ceramic crown, Orthodontic treatment, Porcelain veneers

   DOI: 10.5005/jp-journals-10024-2305  |  Open Access |  How to cite  | 


Background: Amelogenesis imperfecta is a heterogeneous group of hereditary disorders that affect the enamel formation of the primary and permanent dentitions while the remaining tooth structure is normal. Appropriate patient care is necessary to prevent adverse effects on dental oral health, dental disfigurement, and psychological well-being. Aim: This clinical report presents a 27-year-old Chinese male with amelogenesis imperfecta (AI) and his restorative management. Case report: This clinical report presents a 27-year-old Chinese male with AI and his restorative management. Extraoral examination showed a skeletal class III profile and increased lower facial proportion. Intraorally, all the permanent dentition was hypoplastic with noticeable tooth surface loss and a yellowbrown appearance. This was complicated with a mild malocclusion and food packing on his posterior teeth. The patient wanted to improve his appearance and masticatory efficiency. Orthodontic treatment was performed to treat the mild malocclusion and create physiological interproximal spacing to minimize tooth preparation and facilitate oral hygiene. Conclusion: This report demonstrates how a multidisciplinary approach for the management of AI can achieve a predictable, functional, and esthetic outcome. Orthodontic treatment facilitated a conservative prosthodontic treatment outcome by selectively increasing interproximal space, minimizing tooth preparation, correcting posterior bilateral cross-bite, as well as an anterior reverse overjet and derotation of the canines. Clinical significance: This case report demonstrates the effective restoration of AI using a multidisciplinary approach to overcome crowding using a relatively conservative approach.



Sultan Albeshri, Abdulaziz Alblaihess, Abdurahman A Niazy, Sundar Ramalingam, Chalini Sundar, Hamdan S Alghamdi

Biomarkers as Independent Predictors of Bone Regeneration around Biomaterials: A Systematic Review of Literature

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:14] [Pages No:605 - 618]

Keywords: Biomarkers, Biomaterials, Bone regeneration, Systematic review

   DOI: 10.5005/jp-journals-10024-2306  |  Open Access |  How to cite  | 


Background: Biomarkers are detected during bone formation and resorption associated with the dynamics of bone metabolism and are gaining importance as preferential indicators of bone healing in comparison with conventional methodologies. Current literature suggests that the usage of bone turnover markers for monitoring bone regeneration in association with biomaterials is limited. Aim: To systematically review literature and evaluate whether bone-biomarkers can independently predict bone regeneration following implantation of various bone biomaterials. Materials and methods: An electronic search was conducted in PubMed (MEDLINE) database from 1980 to January 2017. The articles for systematic review were selected based on formulated inclusion and exclusion criteria Results: Upon database searching, 443 articles were retrieved and thoroughly reviewed based on the inclusion and exclusion criteria. In all, 41 studies were finally included for evaluation out of which 4 were clinical studies and the remaining 37 studies utilized animal models. On further evaluation, 12 studies reported the presence of biomarkers in association with cellular response during bone regeneration around biomaterials. Moreover, biomarkers related to enzyme activity and matrix protein derivatives were enhanced during bone-matrix deposition as reported in 14 studies. Inorganic skeletal matrix biomarkers indicative of bone mineralization showed positive expression in eight studies. Conclusion: Several biomarkers appear to be useful for the assessment of bone regeneration around biomaterials. Although biomarkers are capable of independently predicting bone regeneration, lack of substantial evidence in the literature limits their true clinical utility. Clinical significance: Noninvasive and inexpensive methods of isolating and characterization of biomarkers from cellular and extracellular skeletal matrix during bone regeneration have proven value in evaluating success of bone biomaterials.



Mustafa Harith Al-Ani, Adil Osman Mageet

Extraction Planning in Orthodontics

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:5] [Pages No:619 - 623]

Keywords: Crowding, Extraction of teeth, Hypodontia, Longterm stability, Supernumerary

   DOI: 10.5005/jp-journals-10024-2307  |  Open Access |  How to cite  | 


Introduction: Planning extraction of teeth for orthodontic treatment is one of the challenging factors for successful functional and esthetic orthodontic results and for the longterm stability. Aim: The aim of this study is to document possible extraction guidelines for planning of orthodontic treatment for space deficiency cases related to excess tooth material. Results: The guidelines are written as patterns to facilitate the decision of extraction of teeth for class I, class II division 1, class II division 2, and class III malocclusions, for crowding, overjet reduction, or correcting the buccal segment relationship. The decision for extraction of teeth for orthodontic treatment is enforced by the oral hygiene, carious teeth, periodontal involvement, impacted teeth, supernumeraries, hypodontia, or for orthognathic purposes. Also, planning the decision for accurate extraction pattern is the main factor in the success of the orthodontic treatment and for the long-term stability of the results. Conclusion: Orthodontic tooth extraction should always be planned with consideration of the width and length of the face, the oral hygiene, carious activity, periodontal involvement, malformed crowns, length and health of the root of the teeth, prognosis of impacted teeth, supernumeraries, and hypodontia. Clinical significance: Accurate diagnosis and treatment planning following orthodontic extraction guidelines lead to a longterm stability of the corrected results.



S Sriram Balaji

A Comprehensive Review on the Errors That occur during Ideal Teeth Arrangement for Complete Denture Prosthesis

[Year:2018] [Month:] [Volume:19] [Number:5] [Pages:4] [Pages No:624 - 627]

Keywords: Artificial teeth arrangement, Complete denture prosthesis, Denture occlusion

   DOI: 10.5005/jp-journals-10024-2308  |  Open Access |  How to cite  | 


Aim: The aim of this article is to present a comprehensive review and a classification system on the various errors that occur during the ideal arrangement of artificial teeth for complete denture prosthesis. Materials and methods: Assessment of various classification systems presented for errors in artificial tooth arrangement and identifying the lacunae in each system. Results: A comprehensive review and a classification system on the various errors that occur during the ideal arrangement of artificial teeth for complete denture prosthesis have been presented. Conclusion: This classification system is aimed toward dental students and dental practitioners to aid in the arrangement of artificial teeth for complete denture prosthesis. Clinical significance: The proposed classification system helps the operator to identify the various errors which may occur during the arrangement of artificial teeth for complete denture prosthesis. It also aids in providing a detailed insight into the role played by artificial teeth in restoring the form and function of completely edentulous patients.


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