The Journal of Contemporary Dental Practice

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2018 | June | Volume 19 | Issue 6

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Shailesh M Gondivkar, Amol R Gadbail

“Mind” in Betel-quid Use and Related Disorders

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:2] [Pages No:629 - 630]

   DOI: 10.5005/jp-journals-10024-2309  |  Open Access |  How to cite  | 



Abdulelah M BinMahfooz, Osama A Qutub

Effect of Surface Treatments and Adhesive Materials on the Shear Bond Strength of Artificial Denture Teeth to Denture Base Resins

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:631 - 636]

Keywords: Artificial tooth, Bonding, Denture base resin, Shear strength and surface treatment.

   DOI: 10.5005/jp-journals-10024-2310  |  Open Access |  How to cite  | 


Aim: The purpose of the current study was intended to evaluate the effect of different surface modifications and different adhesive materials on the shear bond strength of artificial teeth to heat-polymerized and thermoplastic denture base materials using different repair techniques. Materials and methods: Forty cross-linked artificial teeth used to construct different types of acrylic based denture prosthesis were selected to be bonded to two types of denture base materials, heat-polymerized acrylic resin denture base material, and thermoplastic acrylic resin denture base material. The specimens were divided into four subgroups according to the repair technique and adhesive material used. The base surfaces of all acrylic teeth then were moistened with monomer prior to bonding to the denture base specimens. Then, the specimens were tested using Universal Testing Machine for shear bond strength. The results were analyzed by using two-way analysis of variance (ANOVA) statistical analysis and multiple comparison tests, α≤0.05. Results: The effect of the types of denture base materials vs the surface conditioning methods displayed a statistically significant difference. Conclusion: This study concluded that monomer surface treatment of the bonded surface of artificial denture teeth and the use of cyanoacrylate adhesive followed by additional microwave polymerization displayed better shear bond strength when compared with other repair techniques. Clinical significance: Artificial teeth debonding from their denture bases is a common complication in dental practice. The current study evaluates different repairing techniques. Within the limitation of this study, the use of cyanoacrylate adhesive in combination with microwave polymerization is one of the best techniques of repairing denture teeth debonding.



Rasha AlSheikh, Abeer E El-Embaby

Spectrophotometric Comparison of Effectiveness of Two In-office Bleaching Agents with/without Light Activation: A Clinical Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:5] [Pages No:637 - 641]

Keywords: Bleaching systems, Clinical study, Spectrophotometer.

   DOI: 10.5005/jp-journals-10024-2311  |  Open Access |  How to cite  | 


Aim: The aim of the study is to evaluate the effectiveness of two different in-office bleaching agents, Zoom2 (Z) and Boost (B), regarding color stability 1-week, 2-week, 1-month and 2-month periods after treatment. Materials and methods: A total of 60 patients each of whom had anterior teeth of shade A3 or darker were randomly selected from the pool of patients attending the Dental Hospital at the University of Dammam. For the Z group (n = 30), a light activation unit was used to activate the bleaching agent. While for group B (n = 30), the whitening gel was used without light activation. The shades measurements were taken using spectrophotometer before the treatment, after 1-week, 2-week, 1-month, and 2-month periods. Results: Analysis of variance repeated-measures (ANOVA) test was applied to compare the mean effect of color change between the materials on various follow-up measurements. Wilcoxon signed rank test was applied to compare the mean effect of color change within the material on various follow-ups. A p-value ≤ 0.05 was considered statistically significant. At the termination of the study, the statistical analysis of the data indicated that both products efficiently lightened the color of the teeth but Z group is more efficient than B group in different follow-up intervals. Conclusion: Both tested whitening systems demonstrated efficient tooth whitening. Z system is more efficient and stable than B system at 2 months’ interval. Clinical significance: Zoom2 bleaching system is more efficient and stable than Boost bleaching system after 2 months’ follow-up.



BS Kavya Rani, Surya Viswambharapanicker, Shamil Mattumathody, Anagha Muralidharan, Abdul Rasheed Naseema Dinsha, Priyanka Saluja

Assessment of Shear Bond Strength and Marginal Sealing Ability of Pit and Fissure Sealants: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:5] [Pages No:642 - 646]

Keywords: Marginal sealing ability, Pit and fissures, Sealants, Shear bond strength.

   DOI: 10.5005/jp-journals-10024-2312  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to compare the shear bond strength and marginal sealing ability of self-adhering flowable composite and conventional fissure sealant. Materials and methods: The samples consisted of 30 healthy premolar teeth which were extracted due to orthodontic reasons and randomly divided into two groups of 15, i.e., group I (Fissurit F) and group II (Dyad Flow). Shear bond strength and marginal sealing ability of both the groups were evaluated in Statistical Package for the Social Sciences (SPSS) version 16. Results: The mean shear bond strength of Dyad Flow (group II) was found to be 1.4 ± 0.87 MPa and in Fissurit F (group I), it was 1.3 ± 1.4 MPa. Differences between the groups were statistically significant. In group II, 53.3% of specimens demonstrated score 0; 33.3% showed score 1; and 13.3% showed score 2. In group I, scores 0 and 1 showed 33.3% of dye penetration respectively. Scores 2 and 3 demonstrated 26.6 and 6.6% of dye penetration respectively. But there was no significant difference between both the sealant groups. Conclusion: The present study concluded that self-adhering flowable composite was found to have better shear bond strength and marginal sealing ability than conventional fissure sealant. Clinical significance: Self-adhering flowable composite can be effectively used in pediatric patients in whom isolation is difficult and exclusion of bonding agent leads to decrease in time consumption.



Effectiveness of the American Board of Orthodontics Discrepancy Index in predicting Treatment Time

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:4] [Pages No:647 - 650]

Keywords: American Board of Orthodontics, Discrepancy index, Orthodontic treatment time.

   DOI: 10.5005/jp-journals-10024-2313  |  Open Access |  How to cite  | 


Aim: This study was aimed to explore the effect of pretreatment severity of malocclusion on the duration of the treatment using The American Board of Orthodontics discrepancy index (ABO-DI). Materials and methods: This clinical retrospective study consisted of orthodontics records of 37 patients who were treated with comprehensive fixed orthodontic appliance from 2011 to 2013. The sample of the study was collected so as to exclude, to the maximum possible, the patient cooperation variability by reviewing all patient chart entries. The DI measurements were used to gather the information of the pretreatment and relate it to the time duration of the treatment. Statistical analyses were performed using the chi-square test and Pearson correlation coefficient. Results: The average treatment time was 24.5 months. The DI scores mean for class I and II was 14.30 and 20.15 respectively. Age and sex did not significantly influence the treatment duration (p > 0.05). Conclusion: The results of this study showed that the ABO-DI could be a useful tool to predict orthodontic treatment time. Clinical significance: The ABO-DI can significantly aid in orthodontic treatment time planning.



Ravi Nagpal, Sunil Pandey, Mahima Goel, Ankita Kar, Eliezer Rapsang, Priya Matani

Evaluation of Total Salivary Secretory Immunoglobulin A and Mutans-specific SIgA among Children having Dissimilar Caries Status

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:5] [Pages No:651 - 655]

Keywords: Bradford reagent, Dental caries, Enzyme linked immunosorbent assay, Immunoglobulin, Scanning electron microscopy.

   DOI: 10.5005/jp-journals-10024-2314  |  Open Access |  How to cite  | 


Introduction: The occurrence of dental caries has become quite a common phenomenon nowadays. The varying levels of salivary secretory immunoglobulin A (SIgA) usually determine the progression of caries. The present study was aimed to determine the correlation between SIgA and mutans-specific antigen SIgA in children having different caries status. Scanning electron microscopic analysis was also completed to correlate the results. Materials and methods: This study comprised 60 subjects, who were divided into three groups depending on caries status. In all, saliva was collected to determine the level of SIgA and mutans-specific antigen SIgA using enzyme linked immunosorbent assay (ELISA). The World Health Organization (WHO) criteria and method were used to evaluate dental caries. Bradford reagent was used to evaluate the levels of protein in the antigen. Furthermore, 20 sections of enamel were randomly obtained to estimate the severity of caries development among groups. Results: Categorical characteristics among all groups were compared by basic statistical analysis and Chi-squared test. Mean age (years) was found to be 9.214 ± 2.28, 9.5 ± 2.51, and 10.2 ± 2.35 in groups I, II, and III respectively. Mutans-specific IgA level (μg/mL) was 34.63 ± 7.46, 28.24 ± 4.52, and 23.56 ± 1.62 in groups I, II, and III respectively. Total SIgA (μg/mL) was 142.53 ± 22.4, 186.10 ± 24.70, and 214.8 ± 27.56 in groups I, II, and III respectively. Caries index was 6.74 ± 2.16, 2.32 ± 0.86, and 0 ± 0 in groups I, II, and III respectively. Conclusion: Immunoglobulin A is dominantly present in saliva and it plays a significant role in prevention of dental caries. Hence, dental caries is more likely to develop in subjects with low level of salivary IgA (high caries index). Clinical significance: A low level of IgA may be associated with a high risk of developing dental caries. This association may possibly be useful in predicting the future caries status. Accordingly, suitable caries-preventive measures can be selected and employed.



Moksha Nayak, CN Vijay Kumar, Veena Shetty, Anoop V Nair, L Krishna Prasada, Rakesh R Nair

Comparative Evaluation of Cytotoxicity and Genotoxicity of Two Bioceramic Sealers on Fibroblast Cell Line: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:656 - 661]

Keywords: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, Comet assay, Cytotoxicity, Endosequence BC, Fibroblasts, Genotoxicity, iRoot SP, L929, Zinc oxide eugenol.

   DOI: 10.5005/jp-journals-10024-2315  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate and compare the cytotoxicity and genotoxicity of two bioceramic root canal sealers: EndoSequence BC and iRoot SP with zinc oxide eugenol sealers on fibroblast cell line. Materials and methods: The sealers tested were zinc oxide eugenol, EndoSequence BC, and iRoot SP. Each material was mixed according to the manufacturer's instructions and mounted into sterile polyethylene color-coded rings, for cytotoxicity and genotoxicity evaluation. After 48 hours, the set materials were transferred to previously marked wells and cytotoxicity evaluation to L929 murine fibroblast cells was done by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. The percentages of viable cells were then calculated and values were statistically analyzed by Kruskal–Wallis test. The evaluation of genotoxicity of the materials to L929 murine fibroblast cells was carried out by Comet assay. To quantify deoxyribonucleic acid (DNA) damage, the following comet parameters were evaluated in the assay using Comet scoring software: tail length, tail moment, and Olive moment. The values were statistically analyzed using Kruskal–Wallis test with a significance value set to p < 0.05. Results: The results of the study showed that both cytotoxicity and genotoxicity evaluation by MTT assay and Comet assay can be done on L929 murine fibroblast cell line. Among the three tested materials, zinc oxide eugenol showed maximum cytotoxicity to the cells (30.64% viable cells), followed by EndoSequence BC (71.33% viable cells) and iRoot SP (75.11% viable cells). The evaluation of DNA damage by genotoxicity assessment showed iRoot SP to be least genotoxic followed closely by EndoSequence BC. Zinc oxide eugenol was genotoxic and induced more DNA damage on the fibroblast cell line studied. The statistical analyses for both the assays were nonsignificant. Conclusion: All the three tested sealers showed varying degrees of cytotoxicity and genotoxicity while using fibroblast cell line. Zinc oxide eugenol was most toxic in both the assays and iRoot SP showed least toxicity, followed closely by EndoSequence BC.



Ousama A Ayach, Rania Hadad

Correlation between Cervical Vertebrae Volume Parameter and the Skeletal Maturation Status

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:7] [Pages No:662 - 668]

Keywords: Cervical vertebrae, Growth, Middle phalanx maturation, Quantitative assessment, Skeletal age.

   DOI: 10.5005/jp-journals-10024-2316  |  Open Access |  How to cite  | 


Aim: Assessing skeletal maturity is a critical factor in orthopedic treatment and orthognathic surgery. Quantitative methods have been suggested to decide the skeletal age. This study aims to assess the correlation between the middle phalanx of the third finger (MP3) method and cervical vertebral volume parameters (CVVP) in skeletal age determination. Materials and methods: This cross-sectional study was conducted on 21 boys and 29 girls between the ages of 8 and 16 years, who were divided into five groups of skeletal maturation: 100 MP3 radiographs and cone beam computed tomography (CBCT) were obtained and analyzed. Middle phalanx of the third finger maturation stages were evaluated according to Perinetti method (stages F-FG-G-H-I). The CVVP was determined on CBCT using Mimics Medical software. Analysis of variance (ANOVA) and Bonferroni tests were utilized to investigate the differences in volumetric parameters between MP3 stages. Spearman correlation coefficient was employed to obtain the correlation between MP3 stages and the CVVP. Results: The differences in CVVP concentrated between MP3-I stage and the previous stages, with the highest values those for the 4th vertebra. Spearman test revealed a significant highest correlation between MP3 stages and the CVVP in the 4th vertebra; the lowest was in the 2nd, which was higher in the girls group. Conclusion: Strong level of agreement between the two methods was significant in the 4th vertebra. Clinical significance: Measurement of volumes of the 4th CVVP could be used as simple quantitative analysis in clinical practice to evaluate the maturity in orthodontic patients.



Srinivasa Gowda, Dilip D Quadras, Rajeet S Sesappa, Vidyachandra Katapadi

Evaluation of Effect of Connector Designs in Implant Tooth-supported Fixed Partial Denture: A Two-dimensional Finite Element Analysis

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:669 - 674]

Keywords: Connector, Geometric model, von Mises stress.

   DOI: 10.5005/jp-journals-10024-2317  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the effect of connector designs on scale and distribution pattern of the stress generated in the supporting bone of implant tooth-supported three-unit fixed partial denture in distal extension situation. Materials and methods: Three-unit fixed partial denture geometric models with implant abutment in second molar, pontic in first molar, and second premolar as mesial abutment in distal extension situations were evaluated using a two-dimensional (2D) finite element analysis. Three models were designed and constructed with mesial and distal rigid connectors, mesial nonrigid connector, and distal nonrigid connector respectively, using the software ANSYS, version 10.0 (University Intermediate). The models were analyzed to determine the maximum equivalent von Mises stress at five critical zones (maximum value) under static axial loading (240 N) after meshing and assigning the material properties. Results: The maximum stress concentration values at mesial and distal alveolar crest of the implant-supporting bone were 60.59 and 68.57 MPa, respectively, in Model No 1. The high equivalent von Mises stress concentration values at the mesial and distal alveolar crest of the implant-supporting bone were 1.65 and 0.747 MPa with 0.1 mm vertical movement and 7.88 and 9.34 MPa with 0.5 mm vertical movement of the connector respectively, in Model No 2. The high equivalent von Mises stress concentration values at mesial and distal alveolar crest of the implant-supporting bone were 10.45 and 3.43 MPa with 0.1 mm vertical movement and 4.50 and 5.71 MPa with 0.5 mm vertical movement of the connector respectively, in Model No 3. Conclusion: In the supporting bone around the implant in Model No 1, the maximum von Mises stress concentrations were displayed in the crestal zones. In the supporting bone around the implant abutment, the von Mises stress concentrations were minimal toward the apical third zone in all the models. The stress concentrations were minimal in the supporting bone around the implant and the natural tooth in the models with nonrigid connector. Clinical significance: When implant is used as distal abutment in three-unit implant tooth-supported fixed partial denture with pontic at first molar in distal extension situation, it is recommended to place the nonrigid connector in the mesial side of the distal implant abutment.



Nosratollah Eshghyar, Azadehzeinab Titidej, Maryam Jolehar

Prognostic New Marker (Bone Morphogenetic Protein 7) in Squamous Cell Carcinoma

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:5] [Pages No:675 - 679]

Keywords: Bone morphogenic protein 7, Lymphatic metastasis, Squamous cell carcinoma.

   DOI: 10.5005/jp-journals-10024-2318  |  Open Access |  How to cite  | 


Aim: Despite advances in the treatment of oral squamous cell carcinoma (OSCC), its prognosis is still poor. Therefore, it is important to identify the prognostic factors. The aim was to investigate the level of bone morphogenetic protein 7 (BMP7) in SCC of tongue and its relationship with some clinicopathologic parameters. Materials and methods: In this cross-sectional study, 128 patients with primary SCC of tongue were evaluated. Data were extracted and paraffin blocks were retrieved from the archives of Emam Khomeini Hospital, Tehran, and immunohistochemistry staining was done for the detection of marker. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16 and through chi-square and logistic regression tests. Results: The highest level of BMP7 expression was 54% in men (p = 0.044), 70% in the group aged under 45 years (p = 0.001), 68.2% in patients with lymph node metastasis (p < 0.001), and 100% in those with poorly differentiated tumors (p < 0.001). In multivariate analysis, the presence of lymph node metastasis and increased histopathological grade associated with 5.7 fold and 4.3 fold increase in the odds ratio (OR) of BMP7 expression respectively. Conclusion: Based on the results, there was a significant relationship between BMP7 expression and poor cellular differentiation and lymph node metastasis, so this marker could be a new prognostic marker in oral cancer. Clinical significance: This new marker could help clinicians to determine the prognosis of oral cancer, so it has an effect on optimal treatment.



Shugufta Mir, Ashesh Gautam, Renu Batra, Sarmeshta Soni, Kamini Lata

Evaluation of Antimicrobial Efficacy of Root Canal Sealers against Enterococcus faecalis: A Comparative Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:4] [Pages No:680 - 683]

Keywords: AH Plus, Antimicrobial agent, Endodontic infections, Endoflas FS, Enterococcus faecalis, Tubli-Seal.

   DOI: 10.5005/jp-journals-10024-2319  |  Open Access |  How to cite  | 


Aim: The study aimed to evaluate the efficacy of root canal sealer's antimicrobial activity against Enterococcus faecalis. Materials and methods: Root canal sealers with the brands Endoflas FS, AH Plus, and Tubli-Seal EWT were selected. Enterococcus faecalis organisms’ zone of inhibition was measured. Tukey post hoc tests and one-way analysis of variance (ANOVA) were used to compare the data among study groups and within its group. The data were said to be statistically significant with an established p-value less than 0.05. Results: The maximum zone of inhibition (23.20 ± 1.202 mm) was shown by Endoflas FS sealer; AH Plus and Tubli-Seal showed the inhibition zone of (18.42 ± 1.023) and (16.88 ± 0.962) respectively, following Endoflas FS. The ANOVA test showed p < 0.0001, which is highly statistically significant. AH Plus and Endoflas FS showed a statistically significant difference of 0.04 and 0.001 in between groups, and there was no statistically significant difference in the Tubli-Seal group from Tukey post hoc test. Conclusion: The study showed that Endoflas FS sealer has a significant antimicrobial effect against E. faecalis. Clinical significance: In clinical situation, despite perfect chemomechanical root canal preparation, persistence of microorganisms may reinfect the root canal. Therefore, endodontic root canal sealers play a major role in the eradication of bacteria. The polymicrobial nature of endodontic infection plays a main role during the usage of endodontic sealer with antimicrobial agents, which in turn reduces the failure of endodontic treatment.



Ebrahim Yarmohamadi, Pegah R Jahromi, Mahdi Akbarzadeh

Comparison of Cuspal Deflection and Microleakage of Premolar Teeth restored with Three Restorative Materials

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:684 - 689]

Keywords: Bulk fill composite, Cuspal deflection, Microleakage, Ormocer.

   DOI: 10.5005/jp-journals-10024-2320  |  Open Access |  How to cite  | 


Aim: This study aimed to assess cuspal deflection and microleakage of mesio-occluso-distal (MOD) cavities in premolar teeth restored with three different tooth-colored restorative materials to determine the effect of polymerization shrinkage stress over time. Materials and methods: The MOD cavities (4 mm depth) were prepared in 30 sound human maxillary premolars. The teeth were randomly divided into three groups (n = 10). The teeth were then restored with Filtek P60 (group I), X-tra fil (group II), and Admira Fusion x-tra (group III). Cuspal deflection was assessed after 5 minutes, 24 hours, 48 hours, and 7 days by measuring the intercuspal distance. After restoring the teeth, they were subjected to 1,000 thermal cycles and were then immersed in 2% methylene blue for 24 hours. After vertical section of teeth, they were observed under a stereomicroscope to assess microleakage. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) post hoc test. Friedman test was used to compare different time points in each group and nonparametric Mann–Whitney test was applied to assess microleakage (α 0.05). Results: The mean cuspal deflection was significantly different in the three groups (p < 0.001). The highest deflection was noted in Filtek P60 (14.8 ± 1.9) and the lowest was noted in Admira Fusion x-tra (7.4 ± 1.4 μm). Cuspal deflection significantly decreased after 7 days, but did not return to the baseline value. Admira Fusion x-tra showed significantly less deflection after 7 days (p < 0.001), but the other two groups were the same (p = 0.3). Microleakage was not significantly different among the three groups (p > 0.05). Conclusion: The lowest cuspal deflection was noted in Admira Fusion x-tra, although marginal microleakage was not significantly different among the groups. Clinical significance: As the lowest cusp deflection was noted in Admira Fusion x-tra, this restorative material can be suitable for esthetic restoration of extensive posterior cavities.



Sachin B Mangalekar, Hanumanth Reddy, Y Sunaina Shetty, Rajesh Shankarapillai, Gopinath Vivekanandan, Challa S Reddy

Evaluation of the Efficacy of Guava Extract as an Antimicrobial Agent on Periodontal Pathogens

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:8] [Pages No:690 - 697]

Keywords: Aggregatibacter actinomycetemcomitans, Antimicrobial, Guava, Porphyromonas gingivalis, Psidium guajava.

   DOI: 10.5005/jp-journals-10024-2321  |  Open Access |  How to cite  | 


Aim: The present study was undertaken to assess the inhibitory effect of guava extracts on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, to assess the time-kill curve of P. gingivalis and A. actinomycetemcomitans, and to determine the antiproteolytic activity of guava on P. gingivalis. Materials and methods: Kanamycin blood agar was used to isolate P. gingivalis and A. actinomycetemcomitans. Ethanolic guava extract (EGE) and aqueous guava extract (AGE) were prepared and the inhibitory effects of these extracts for two periodontal pathogens were tested by minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) procedures. Antibacterial activity of guava extracts was determined by well diffusion method. Antiproteolytic activity of guava on protease of P. gingivalis was determined by gelatin liquefaction test. Results: The MIC determined for AGE and EGE was at 75 μL/mL concentration for P. gingivalis, whereas EGE exhibited the activity at 75 μL/mL on P. gingivalis. The MIC determined for AGE was at 50 μL/mL for A. actinomycetemcomitans, whereas MIC determined for EGE was at 3.12 μL/mL for A. actinomycetemcomitans. Porphyromonas gingivalis was susceptible to EGE compared with AGE. Aggregatibacter actinomycetemcomitans was more susceptible to guava extracts compared with P. gingivalis. Conclusion: Guava extract may be a potential therapeutic agent for periodontitis as it shows significant activity against both P. gingivalis and A. actinomycetemcomitans. Clinical significance: Guava leaves extract can be used as economical and suitable adjuvant to synthetic drugs and can be a potential therapeutic agent for periodontitis.



Rajeev Lall, Anshu Sahu, Ankita Jaiswal, Sunder Kite, AR Sowmya, MC Sainath

Evaluation of Various Sterilization Processes of Orthodontic Instruments using Biological Indicators and Conventional Swab Test Method: A Comparative Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:698 - 703]

Keywords: Hot air oven, Steam autoclave, Sterilization.

   DOI: 10.5005/jp-journals-10024-2322  |  Open Access |  How to cite  | 


Aim: This study aimed to compare the efficiency of various sterilization procedures using conventional spore monitoring method, i.e., by using swab test and biological indicators and to determine the efficiency of cold sterilization by using Bioclenz-G (2% glutaraldehyde) solution. Materials and methods: Each group was divided into medium load (containing 15 sets of instruments) and heavy load (containing 30 sets of instruments). Each group was tested 15 times for medium and heavy loads. Two groups are swab tested control group and experimental group with three different methods of sterilization: hot air oven, cold sterilization, and ethylene dioxide sterilization. Results: Spores were present in all the groups tested for 10 minutes cycle, in comparison with no spore growth in any of the groups tested for a 10-hour cycle. Conclusion: All methods of sterilization showed complete sterilization of instruments when monitored with biological indicators. One group of heavy load in steam autoclave and one group each of medium load and heavy load in hot air oven sterilizer showed sterilization failure when monitored with the conventional swab test method. Clinical significance: This study proves the efficacy and durability of various sterilization procedures.



Dorothea C Dagassan-Berndt, Walter Clemens, Nicola U Zitzmann, Ralf K Schulze

Influence of Three-dimensional Imaging on Implant Treatment Planning: Implant Diameter and Length

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:8] [Pages No:704 - 711]

Keywords: Cone beam computed tomography, Dental implants, Implant treatment planning, Panoramic radiographs.

   DOI: 10.5005/jp-journals-10024-2323  |  Open Access |  How to cite  | 


Aim: To investigate the influence of the radiographic modalities panoramic radiography (PR) and cone beam computed tomography (CBCT) on selection of implant length and diameter. Materials and methods: Potential implant sites (59 sites, 40 patients) with available PRs and CBCTs were selected from the databases of two University dental schools. Six experienced clinicians were asked to select the appropriate implant length and diameter based on PR and CBCT. Results were compared with the actual surgical procedure and intra- /interrater agreement was calculated using Cohen's kappa. Results: On average, greater implant length was more often planned based on PR (24.2 vs 8.8% with CBCT), while wider implants were generally more frequently planned based on CBCTs (19.9 vs 29.7% with PR). Implant treatment planning based on PR and on CBCT images was equal in 50 to 67%. Compared with the actual surgery, CBCT revealed a higher agreement (46% for implant length), while for PR, 34.4% equal implant length was observed. Conclusion: The radiographic modality used for implant treatment planning affects implant selection. Clinical significance: The CBCT scans are advantageous for choosing the appropriate implant dimension. Caution should be exercised when selecting implant length planned from PR.



Rajeev Lall, Anshu Sahu, Sumaiya Nezam, Rajat Singh, Shashi B Kumar, Faizan B Ayub

Comparative Assessment of Facial Asymmetry in Malocclusion using Posteroanterior View

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:7] [Pages No:712 - 718]

Keywords: Craniofacial skeleton, Facial asymmetry, Posteroanterior cephalogram.

   DOI: 10.5005/jp-journals-10024-2324  |  Open Access |  How to cite  | 


Aim: The study was conducted to assess facial asymmetry in various dental malocclusions and to determine asymmetry in lower, mid, and upper face and jaws using posteroanterior cephalometric analysis. Materials and methods: Overall, 120 posteroanterior cephalograms were taken of individuals between 12 and 25 years of both sexes, and were divided into four groups: Angle's class I excellent occlusion, Angle's class I malocclusion, Angle's class II malocclusion, and Angle's class III malocclusion. These cephalograms were traced and Grummon's analysis was performed. Results: In Angle's class I occlusion and Angle's class II malocclusion, the results obtained showed asymmetry present in the upper face. Correlation was found between occlusion, malocclusion, and facial asymmetry. Conclusion: Facial asymmetry was found in all dental occlusions whether excellent or malocclusion group, with maximum asymmetry having upward trend toward upper face starting from lower. Clinical significance: For the success of the orthodontic treatments in various types of malocclusion and to determine the facial asymmetry, posteroanterior view can be very helpful, as it gives additional information which can be utilized to augment treatment planning and improve prognosis in terms of relapse prevention.



Saied Sadeghian, Amin Shirvani, Zeinab Azamian

Assessment of the Effect of Simulated Rhinoplasty and Genioplasty on the Facial Profile Attractiveness of Patients with a Convex Face

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:7] [Pages No:719 - 725]

Keywords: Convex profile, Facial attractiveness, Facial profile, Genioplasty, Rhinoplasty.

   DOI: 10.5005/jp-journals-10024-2325  |  Open Access |  How to cite  | 


ABSTRACT Aim: This study was performed to evaluate the effect of rhinoplasty and genioplasty on facial profile attractiveness assessed by orthodontists and laypersons. Materials and methods: In this study, posttreatment cephalograms of 30 class II patients with convex profile and nasal hump who had undergone camouflage treatment were traced. These profile outlines were modified by computer software to simulate rhinoplasty and genioplasty. Then, all these outlines were converted into silhouettes. There were four groups: no modification, rhinoplasty (R), genioplasty (G), and rhinoplasty plus genioplasty (RG). Esthetic assessment of all patients was done by two panels: six orthodontists and six laypersons. Data were analyzed using Friedman's and Wilcoxon's test with a significance level of 0.05. Results: The highest mean esthetics scores belonged to RG (3.9 ± 0.6), followed by R (3.5 ± 0.5), G (2.4 ± 0.5), and the initial image of the patients (2.13 ± 0.5). There was a significant improvement following all surgeries as determined by all evaluators (p < 0.001), except for orthodontists who did not find genioplasty more esthetic than no modification (p = 0.139). The mean score of esthetics by orthodontists was more than laypersons in all groups (p > 0.05). Conclusion: Both rhinoplasty and genioplasty improved the attractiveness of the patients’ facial profiles. The greatest improvement in the facial profile attractiveness in convex faces was observed after simultaneous nasal hump elimination and chin argumentation procedures. Clinical significance: Although both rhinoplasty and genioplasty could improve patients’ profile, the best result is achieved when combination of them is used for treatment of convex facial profile patients.



Krantikiran Reddy Ealla, PK Thaju Raj, Durga P Mudrakola, Deepak Baby, Rajeev K Govindankutty, Dilu Davis, Thenasseri P Sasikumar

Evaluation of Effectiveness of Two Different Endodontic Retreatment Systems in Removal of Gutta-percha: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:726 - 731]

Keywords: D-RaCe, Gutta-percha, H-files, ProTaper retreatment files, Scanning electron microscope.

   DOI: 10.5005/jp-journals-10024-2326  |  Open Access |  How to cite  | 


Aim: To determine the effectiveness of two different endodontic retreatment systems for the removal of laterally compacted gutta-percha (GP). Materials and methods: Sixty-three freshly extracted human maxillary central incisors were used for the study. The teeth were instrumented with K-flex files and obturated using lateral condensation technique with GP and AH Plus sealer. The teeth were divided into three retreatment groups, each group consisting of 21 teeth. Group I: D-RaCe desobturation files (D-RaCe); group II: ProTaper Universal retreatment files (PTUR); group III: Hedstrom files (H-file). After removal of GP, the teeth were split longitudinally and divided into three equal parts: Cervical, middle, and apical third. The middle and apical thirds of all root halves were examined using scanning electron microscope (SEM). The total surface area covered by the residual debris was evaluated using Motic Image plus 2.0 software. Statistical analysis was done by one-way analysis of variance (ANOVA) test with a p-value ≤0.05 used to determine significance and Tukey's multiple post hoc tests used for comparison between the groups, and ‘et’ test was done for comparison between the thirds within the same group. Results: The PTUR retreatment files showed overall better performance compared with D-RaCe files and H-files. The PTUR files performed better at middle third compared with others. The PTUR files and D-RaCe files performed equally at apical third better than H-files. Conclusion: ProTaper retreatment files are better compared with D-RaCe files and H-files for the retreatment of the previously endodontically treated teeth. Clinical significance: Highest efficacy for the removal of GP was shown by ProTaper Universal System followed by D-RaCe and H-file.



Amal Nawasrah, Mohammed M Gad, Mai El Zayat

Effect of Henna Addition on the Surface Roughness and Hardness of Polymethylmethacrylate Denture Base Material: An in vitro Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:7] [Pages No:732 - 738]

Keywords: Hardness, Henna, Physical properties, Polymethylmethacrylate, Surface roughness.

   DOI: 10.5005/jp-journals-10024-2327  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the effect of the addition of various henna—which can have antifungal properties—on the surface roughness and hardness of polymethylmethacrylate (PMMA) denture base material. Materials and methods: A total of 99 rectangular-shaped (10 × 20 × 3 mm3) specimens were prepared from heat-cured acrylic resin and divided into one control group without the addition of henna and five test groups, which were prepared by adding Yamani henna powder to polymer at concentrations of 1, 2.5, 5, 7.5, and 10 wt%. The polymer was added to the monomer, mixed, packed, and processed using the conventional water bath method. After processing, specimens were finished and polished, then kept in distilled water for 48 ± 2 hours. A profilometer and Vickers hardness tester were used to measure surface roughness and hardness respectively. Statistical data analysis was conducted via Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM, USA). The independent sample t-test was used and p ≤0.05 was considered statistically significant. Results: The addition of henna at varying concentrations significantly increased the surface roughness values (p ≤ 0.01) while decreasing hardness (p ≤ 0.0001). The most favorable addition value was 1% henna between all henna groups. Conclusion: The addition of henna to the acrylic resin may negatively affect the surface properties of PMMA acrylic denture base. Clinical significance: Antimicrobial denture with minimum deterioration effects on its physical properties could be achieved with henna addition to denture base material in low concentration. However, 1% henna showed the best results between the henna groups as regards roughness and hardness values.



Sanket S Agarkar, Atul Jajoo, Shaivi Sharma, Nitin Gadhiya, Sushma Sonawane, Sameer Narkhede

Comparison of Beta and ANB Angles for Evaluation of Sagittal Skeletal Discrepancy: A Cephalometric Study

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:4] [Pages No:739 - 742]

Keywords: ANB angle, Beta angle, Skeletal discrepancy.

   DOI: 10.5005/jp-journals-10024-2328  |  Open Access |  How to cite  | 


Aim: Diagnosis in orthodontic cases and treatment planning is a precise assessment of sagittal jaw relationship. A number of angular and linear measurements have been used to attain correct diagnosis. The present study is done to compare beta angle and A point–nasion–B point (ANB) angle for sagittal skeletal discrepancies. Materials and methods: A total of 105 subjects were included in between the age group of 18 and 24 years and were categorized based on the skeletal patterns as class I, class II, and class III having a sample of 35 in each group. Based on the ANB angle and patients’ profile, the sample was divided into different skeletal groups. Beta angle is the angle amid the perpendicular from C to B line through point A and the A-B line. Analysis of variance (ANOVA) and post hoc Scheffe's test were applied to analyze dependent variables. The level of significance was set at p-value 0.05. Results: The mean scores of ANB for class I skeletal pattern were 2.46 ± 0.460, for class II, 5.64 ± 1.258, and for class III, –1.03 ± 1.618. Similarly, significant differences were observed in beta angle for class I skeletal pattern as 31.71 ± 3.885, for class II, 24.97 ± 2.162, and for class III, 39.26 ± 3.649. Conclusion: Both ANB and beta angle showed significant differences with different skeletal patterns. Clinical significance: Both ANB and beta angle are awfully supportive diagnostic measurements to scrutinize sagittal jaw relationship.



Gurpreet Kaur, Jyoti Mittal, Harmunish S Mann, Samisha Narang, Mohit Kamra, Shekhar Kapoor, Madhu Sindhi, Ramneet Kataria

Comparative Study of the Efficacy of 4% Articaine vs 2% Lidocaine in Surgical Removal of Bilaterally Impacted Mandibular Third Molars

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:6] [Pages No:743 - 748]

Keywords: Articaine, Impacted mandibular third molar, Inferior alveolar nerve block, Lidocaine, Mandibular nerve block.

   DOI: 10.5005/jp-journals-10024-2329  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the safety and efficacy of 4% articaine with epinephrine (1:200,000) vs 2% lidocaine with epinephrine (1:200,000) during surgical removal of impacted mandibular third molars. Materials and methods: The present study was undertaken in 20 patients belonging to American Society of Anesthesiologists (ASA) class I, of the age group between 18 and 30 years with bilaterally impacted mandibular third molars. Each patient underwent similar surgical procedure. In the first appointment, the patient was randomly selected to receive either 4% articaine or 2% lidocaine (both with epinephrine 1:200,000). Intraoperative and postoperative evaluation was done for both the anesthetic solutions. Following parameters were evaluated: total volume of anesthetic solution used during the surgery, onset of action of the anesthetic agent, duration of anesthesia, duration of postoperative analgesia, incidence, type and severity of adverse reactions, any need to reanesthetize the surgical zone and quality of anesthesia provided by the local anesthetic. Subjective pain evaluation was done with the aid of 100 mm length visual analog scale (VAS) both intraoperatively and postoperatively. Results: In the present study, 4% articaine was found to have a significantly shorter onset of action than 2% lidocaine. Duration of anesthesia and postoperative analgesia of 4% articaine with epinephrine 1:200,000 was found to be significantly (1.44 and 1.28 times respectively) longer than 2% lidocaine with epinephrine 1:200,000. But no significant difference was found in other parameters. Conclusion: 4% articaine in comparison with 2% lidocaine (both with epinephrine 1:200,000) provided a shorter onset of action and longer duration of anesthesia. Clinical significance: No significant difference was recorded in the anesthetic efficacy between the two solutions.



Mohamed S Bamashmous

Veneer or Interproximal Enamel Reduction?

[Year:2018] [Month:] [Volume:19] [Number:6] [Pages:3] [Pages No:749 - 751]

Keywords: Esthetics, Interproximal reduction, Shape, Veneers.

   DOI: 10.5005/jp-journals-10024-2330  |  Open Access |  How to cite  | 


Background: Clinicians often ask, “Veneer or no to veneer?” Clinicians usually think of porcelain veneers for cases in which patients are dissatisfied with their teeth shape. Interproximal reduction can change teeth's shape and appearance within the enamel to improve gingival contour, eliminate black gingival triangles, and correct the Curve of Spee. Aim: Our aim is to present to clinicians the option of reshaping and interproximal reduction (IPR) as a valid alternative to porcelain veneers. Case report: A male patient with round bulbous-shaped anterior maxillary teeth sought a better masculine smile. Interproximal reduction with thin bur size was performed to reshape the anterior teeth in order to achieve a proportional teeth width to height and give a more rectangular rather than square shape. Finally, the orthodontist closed the multiple diastemas using round wires in order to reduce anterior teeth proclination. The patient received bleaching treatment and minor composite fillings. Conclusion: Not every cosmetic case should be treated with veneers and crowns. Conservative minimal intervention, such as IPR was more than sufficient in treating such cases. It is the right of the patients to be informed and educated about all possible treatment options. Clinical significance: Minor reshaping and IPR preserving teeth structures can be helpful in achieving esthetic results and patients’ confidence.


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