The Journal of Contemporary Dental Practice

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2019 | October | Volume 20 | Issue 10

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Shailesh M Gondivkar, Amol R Gadbail

Similarity Index Analysis of the Manuscript: A Viewpoint

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:1] [Pages No:1125 - 1125]

   DOI: 10.5005/jp-journals-10024-2686  |  Open Access |  How to cite  | 



Elodie Terrer, Amel Slimani, Nicolas Giraudeau, Bernard Levallois, Paul Tramini, Eric Bonte, Chau Hua, Marion Lucchini, Dominique Seux, Béatrice Thivichon, Anne Le Goff, Frédéric Cuisinier, Hervé Tassery

Performance of Fluorescence-based Systems in Early Caries Detection: A Public Health Issue

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:7] [Pages No:1126 - 1132]

Keywords: Advanced diagnostic methods, Cohort study, Dental caries, Dental health, Epidemiology, Prevention

   DOI: 10.5005/jp-journals-10024-2665  |  Open Access |  How to cite  | 


Aim: Modern clinical caries management involves early stage caries diagnosis and should fit with dental health policy. The objective of this study was to achieve early caries detection in enamel and dentine with a laser-based system (DIAGNOdent™ pen) first and secondary with a new fluorescence intra-oral camera (Soprolife®). A visual inspection with a loupe was used as control. Materials and methods: Following the consolidated standards of reporting trials recommendations, 628 occlusal fissures were included for analysis. Results: The sensitivity and specificity of both devices varied depending on the cutoff threshold of the caries score, and the ROC curve showed higher values for the Soprolife® than for DIAGNOdent™ pen. The values of the area under the curve decreased from 0.81 (Soprolife® in daylight) to 0.79 (Soprolife® in fluorescent mode) and 0.67 for DIAGNOdent™ pen. DIAGNOdent™ pen reproducibility (intra and inter-investigator) showed a wide dispersion, with many values scattered beyond the confidence limits (±2 SD), and the weighted kappa coefficient, which was quite low (0.58), confirmed this tendency. Conclusion: Caries prevalence in terms of public health policy is of interest and caries detection increased significantly when using an fluorescence-based intra-oral camera. Clinical significance: The clinical significance of these findings is that fluorescence could help improve caries diagnosis, reduce clinical misinterpretations, and finally benefit the patients.



Ziyad T Alzamzami, Ayman M Abulhamael, Darshita J Talim, Hala Khawaji, Sarah Barzanji, Rafael A Roges

Cone-beam Computed Tomographic Usage: Survey of American Endodontists

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1132 - 1137]

Keywords: Cone-beam computed tomography, Dentistry, Endodontics, Survey

   DOI: 10.5005/jp-journals-10024-2661  |  Open Access |  How to cite  | 


Aim: The aim of this study was to investigate the acceptance, accessibility, and usage of cone-beam computed tomographic (CBCT) imaging among American Association of Endodontists (AAE) members in the United States by means of an online survey. Materials and methods: An invitation to participate in a Web-based survey was sent to 3,000 members of the AAE. The survey consisted of 19 questions on demographics, access to CBCT machines, frequency of use for particular applications, and reasons in case CBCT was not used. Results: A total of 477 endodontists responded to the survey, representing a 15.9% response rate. Around 91.8% of endodontists used CBCT imaging in their practice. Around 86% of endodontists had access to CBCT in their office, while 14% referred their patients to an outside office. Cone-beam computed tomographic units used by endodontists were Carestream (59.6%), Morita (20.8%), and Sirona (5.7%). Around 81.1% of endodontists didn't think CBCT imaging has high risk of radiation exposure; however, 10% of their patients declined CBCT imaging due to both cost and radiation exposure. Around 92.7% requested the segmental view when asking for CBCT. Endodontists’ opinion was that CBCT enhances diagnosis of odontogenic pathosis, anatomical structures, treatment of iatrogenic errors, and diagnosis of nonodontogenic pathosis by 96.4%, 96.3%, 92.2%, and 88%, respectively. Around 93% of endodontists agreed that they would not consider doing CBCT for pregnant women. Majority of endodontists (74.6%) use CBCT in their practice for surgery, followed by 60.2% in nonsurgical retreatment. While 59.1% use CBCT in initial nonsurgical treatment, 44% reported that they use CBCT in endodontic recall and 9.2% use CBCT for pediatric patients. Conclusion: CBCT technology is becoming the imaging modality of choice for nonsurgical retreatments and presurgical treatment planning. Endodontists deal with complex cases and thus the CBCT is a necessary tool that helps save a lot of time and effort during treatment procedures, looking for canals or determining why a previous treatment failed, and in providing the most comprehensive care. Clinical significance: With the advancement in technology in the latest era, the three-dimensional CBCT imaging helped provide superior information over the two-dimensional periapical radiograph in making the correct diagnostic decision. This survey enlightened the usage of CBCT among endodontic practitioners in the United States.



Abdulwahab H Alamir, Yara A Hakami, Fatimah S Alabsi, Esam Halboub, Amal M Bajonaid

Potential Myogenous Temporomandibular Disorders Following Iatrogenic Occlusal Disturbance: A Pilot Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:3] [Pages No:1138 - 1140]

Keywords: Bite force, Iatrogenic, Myogenous, Occlusal interference, Temporomandibular disorders

   DOI: 10.5005/jp-journals-10024-2689  |  Open Access |  How to cite  | 


Aim: There is an inadvertent alteration of the occlusal surface after dental treatment. However, research concerning the effect of these iatrogenic disturbances on the temporomandibular joint (TMJ) is scarce. Hence, the present study aimed to investigate the relationship between sudden iatrogenic occlusal disturbance and its effect on the myogenous temporomandibular disorder (TMD). Materials and methods: A cross-sectional observational study was conducted among 30 female subjects aged 18 years to 38 years who received treatment (direct and indirect restorations altering the occlusal surfaces of teeth, and oral prophylaxis) in the students’ clinics at the College of Dentistry Jazan University. The preoperative assessment included a patient interview, a baseline occlusal record, and bite force analysis. All the assessments were repeated 2 weeks after the treatment. Descriptive statistics were calculated. Results: As there was no change observed in bite force as well as occlusal disturbances in the control group, no comparative tests could be applied. The treatment-induced occlusal disturbances were observed in 80% of the participants. The mean change in occlusal force on the treated teeth was found to be 5.6 ± 1.1 Newtons. None of the patients reported any symptoms related to pain or restriction in function in the TMJ. Conclusion: No relation was observed between the abrupt changes in the occlusal force due to dental treatment and the development of the myogenous TMD. Clinical significance: Iatrogenic occlusal interferences may cause/exacerbate TMDs; hence, extreme caution should be exercised by the clinicians to avoid causing harm to the patients.



Mazen Doumani, Ahmed N Alotaibi, Fadi Al Hussain, Ali A Alsweed, Ayman O Mandorah, Karim AH Qaddoura, Salman M Alanazi

Internal Bleaching of Endodontically Treated Teeth: A Dental Practitioner's Perspective from Kingdom of Saudi Arabia

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1141 - 1145]

Keywords: Carbamide peroxide, Discoloration, Hydrogen peroxide, Internal bleaching, Resorption, Sodium perborate

   DOI: 10.5005/jp-journals-10024-2675  |  Open Access |  How to cite  | 


Aim: To determine the knowledge and attitude of dental practitioners (DPs) for internal bleaching technique (IBT) in Kingdom of Saudi Arabia. Materials and methods: A cross-sectional study was developed based on a convenient sampling of dental practitioners and specialists working in Kingdom of Saudi Arabia. DPs responded to a structured, self-administered questionnaire for evaluation of their knowledge and attitude toward IBT. The questionnaire had two components: (i) the characteristics of the study participants; and (ii) the items related to the internal bleaching technique (IBT). Data analysis was conducted using SPSS (version 25.0), with descriptive statistics and a bivariate analysis. Results: A total of 532 dental practitioners (61.3% males and 38.7% females) participated in this study. The response rate of participation was estimated at 92.5%. Almost 37% participants considered the sodium perborate as the most commonly used dental material for internal bleaching. Almost 70% participants reported that superficial enamel discoloration was a contraindication for internal bleaching in endodontically treated teeth. Conclusion: DPs have good knowledge and attitude on use of IBT for discolored teeth. In general, there is a need to improve knowledge and attitude of dental professionals about the IBT by attending continuing dental educational programs. Clinical significance: Saving of the remaining tooth structure is a main principle of the different types of dental treatments. So the IBT should be known for all dental practitioners to use it before going to more aggressive dental treatment options such as full crowns.



Shahriar Eftekharian, Safoura Seifi, Farhad D Satari, Ali Akbar Moghaddamnia, Farideh Feizi, Sohrab Kazemi, Hemmat Gholinia

Curcumin Effect on the Prevention of Gingival Overgrowth Following Phenytoin Consumption in Rats: A Clinicohistological and Immunohistochemical Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1146 - 1150]

Keywords: α-SMA, Curcumin, Gingival overgrowth, Immunohistochemistry, Ki67, Morphometry, Phenytoin

   DOI: 10.5005/jp-journals-10024-2653  |  Open Access |  How to cite  | 


Aim: At the moment there is no clear evidence with clinico-histological and immunohistochemical studies in animals to show the curcumin effect on the gingival overgrowth following phenytoin consumption. The purpose of the present study was to identify this subject. Materials and methods: In this experimental study, 50 adult male Wistar rats were divided into three groups. The rats in groups I and II received 100 mg/kg of phenytoin per day. Group II also received 20 mg/kg intraperitoneal curcumin per day. The control group received the curcumin vehicle only. Gingival clinical dimensions were measured at the beginning and end of the study. The rats were then sacrificed, biopsy of gingiva was prepared, and the samples were stained with hematoxylin–eosin. Morphometry was performed to evaluate the degree of inflammation, epithelial thickness, number, and cross-sectional area of the blood vessels. Immunohistochemical staining was performed using Ki67 and α-SMA. Results: Compared to the control group, Phenytoin in group I increased gingival volume. There was significance difference in group II with group I and control after intervention in the clinical view (p = 0.002). The difference in the number of blood vessels between groups I and II was statistically significant (p = 0.001). Significant differences were observed in blood vessel cross-sectional area (p = 0.001), epithelial thickness (p = 0.002), Ki67, and α-SMA expression between groups I and II (p = 0.001). Conclusion: In rats, curcumin seems to exerts its effects in preventing an increase in gingival volume caused by Phenytoin through decreasing the inflammatory infiltration, decreasing the number of blood vessels and increasing their cross-sectional area, decreasing the thickness of the epithelium, and decreasing the expression of Ki67 and α-SMA. Clinical significance: It is suggested that curcumin may be effective in treatment of gingival enlargement following Phenytoin consumption in future. Larger sample size and clinical trials study are recommended.



Manjakandy Smitha, Tejavathi Nagaraj, Abdul R Khan, Kumaranachary Rinu

Comparison and Clinical Evaluation of Two Pit and Fissure Sealants on Permanent Mandibular First Molars: An In Vivo Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:8] [Pages No:1151 - 1158]

Keywords: Microfilled, Nanofilled, Pit and fissure sealant, Retention

   DOI: 10.5005/jp-journals-10024-2669  |  Open Access |  How to cite  | 


Aim: The aim of the study was to compare and evaluate the clinical efficacy of a microfilled pit and fissure sealant and a nanofilled pit and fissure sealant at 3, 6, and 12 months of interval. Materials and methods: Samples consisting of 55 healthy 8- to 12-year-old children with deep pits and fissures in mandibular first permanent molars were selected for the study. It was a split mouth design and randomized clinical trial. A total of 110 mandibular first molars were divided into two groups of 55 each: group I Fissurit FX sealant and group II Grandioseal nanofilled fissure sealant. The sealed teeth were clinically evaluated at 3, 6, and 12 months of interval to assess marginal adaptation, sealant retention, fissure caries development, roughness of sealant surface, and change of color around the sealant. Results: The results showed that both Fissurit FX and Grandioseal pit and fissure sealants were effective in preventing dental caries. Marginal adaptation was significantly better with Fissurit FX when compared to Grandioseal pit and fissure sealant. There was no difference in sealant retention between the two groups. The surface roughness of Fissurit FX was high when compared to that of Grandioseal. Statistical analysis was done using the Chi-squared test for intra-group comparison and Fisher's exact test for inter-group comparison. Results were considered statistically significant if p ≤ 0.05. Conclusion: Fissurit FX and Grandioseal pit and fissure sealants provided similar caries preventive effects and there was no difference in retention of sealants over a period of 1 year. However, surface roughness was better with Grandioseal fissure sealants. Clinical significance: This study is significant because there is limited evidence about the efficacy of nanofilled pit and fissure sealants in vivo. It will also provide dental practitioners an insight into the clinical efficacy of nanofilled pits and fissure sealant when compared to micro-filled sealant enabling them to make the right choice for the betterment of their dental practice.



Lucia Poma-Castillo, María Espinoza-Poma

Antifungal Activity of Ethanol-extracted Bixa orellana (L) (Achiote) on Candida albicans, at Six Different Concentrations

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1159 - 1163]

Keywords: Achiote, Antifungal activity, Bixa orellana (L), Candida albicans

   DOI: 10.5005/jp-journals-10024-2672  |  Open Access |  How to cite  | 


Aim: The aim of the study was to determine the antifungal activity of six different concentrations of the ethanol extract of Bixa orellana (L) (Achiote) on the strains of Candida albicans (ATCC 90028). Materials and methods: The ethanol extract of Bixa orellana (L) (BEE) was prepared in six different concentrations (5%, 10%, 20%, 40%, 60%, and 100%), which were confronted with the positive control group (Nystatin 100,000 UI/mL). The total sample consisted of n = 174 wells inoculated with each concentration evaluated in the Petri dishes. The cultivation procedure was carried out at a temperature of 37°C, and then the 6 mm diameter wells on which the sowing of the Candida albicans in suspension was carried out. Subsequently, the BEE (Achiote) was inoculated in all the concentrations mentioned in the same way for Nystatin; finally, the inhibition halos were evaluated by the Kirby–Bauer method at the scheduled times of 24, 48, and 72 hours. Results: The highest antifungal activity was found at 24 hours and this increased directly proportional to the concentration of BEE (5%, 10%, 20%, 40%, 60%, and 100%): 11 ± 0, 11 ± 0, 13.1 ± 1.3, 17.2 ± 0.8, 19.1 ± 1.0, and 21.4 ± 1.3 mm, respectively. However, there was no statistically significant difference when compared with Nystatin, at p > 0.05 Conclusion: It was shown that 5%, 10%, 20%, 40%, 60%, and 100% BEE had an antifungal effect against Candida albicans. However, there were no statistically significant differences against the effect of Nystatin at 100,000 IU/mL, who has an inhibitory effect greater than BEE, with a significance level of p < 0.05. Clinical significance: This article describes the antifungal activity and the possible impact on dentistry that the use of Bixa orellana (L) may have because according to our results it had an antifungal effect against strains of Candida albicans. This opens a great line of research to potentially use this natural resource in dentistry.



Talal M Zahid

Effect of Advanced Platelet-rich Fibrin on Wound Healing after Third Molar Extraction: A Split-mouth Randomized Double-blind Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:7] [Pages No:1164 - 1170]

Keywords: Healing, Impacted third molar surgery, Pain, Platelet-rich fibrin, Regeneration, Swelling, Wound healing

   DOI: 10.5005/jp-journals-10024-2666  |  Open Access |  How to cite  | 


Aim: To evaluate the potential of advanced platelet-rich fibrin (A-PRF) as a regenerative biomaterial for bone regeneration and postoperative sequelae after impacted third molar extractions. Materials and methods: This was a split-mouth, randomized, double-blind clinical trial. A total of 10 female patients in King Abdulaziz University Dental Hospital with bilateral impacted third molars were recruited into the study. Surgical extractions were performed on both sides of the mandible. Randomization was done by a coin toss; A-PRF was placed on the one side while the other side did not receive any intervention. Each patient acted as their own control. Both the patients and the investigators were blinded about the A-PRF side. The outcome on periodontal regeneration was made measuring pocket depth (PD), gum recession (GR), and clinical attachment level (CAL) before and at 1- and 3-months postoperatively. Pain, swelling, and healing were assessed on the 7th postoperative day. p value less than 0.05 was considered statistically significant. Results: An estimated 10 patients completed the study. There were no significant differences in PD, CAL, and GR between the two groups at any time point, although the data obtained were slightly favoring the A-PRF. However, a statistically significant reduction in pain and swelling was observed in the A-PRF group compared to the controls (p < 0.05). Conclusion: The findings of this study demonstrate A-PRF as a potential biomaterial for lessening the severity of pain and swelling after third molar surgery. Long-term trials with a larger sample size and more methodically sound assessment tools are needed to obtain more meaningful results on periodontal regeneration. Clinical significance: Placement of A-PRF clot in the extraction socket could lessen postoperative pain and increase patient comfort after third molar extraction. Trial registration: NCT03703479. Registered 8 October 2018



Amit Vanka, Sandeep Kumar Vishwakarma, Manohar K Bhat, Shanthi Vanka, Aleem A Khan

Osteo/odontogenic Differentiation of Human Mesenchymal Stem Cells with Platelet-rich Plasma and Mineral Trioxide Aggregate

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:8] [Pages No:1171 - 1178]

Keywords: Laboratory research, Mineral trioxide aggregate, Platelet-rich plasma, Stem cells

   DOI: 10.5005/jp-journals-10024-2677  |  Open Access |  How to cite  | 


Aim: Aim of the study was to investigate the effect of PRP and MTA individually and combined on in vitro human bone marrow mesenchymal stem cells’ (MSCs) proliferation and osteo/odontogenic differentiation potential. Materials and methods: MSCs were cultured in vitro with MTA, 5% PRP, 10% PRP, MTA with 5%PRP, and MTA with 10% PRP. Fetal calf serum (FCS) was used as control. Cell viability and proliferative efficiency were tested with cell adhesion and MTT assay. Osteo/odontogenic differentiation was assessed and quantified with alizarin red staining. Results: MTA alone, MTA with 5% PRP, and MTA with 10% PRP showed significantly high proliferation at day 7 and 14 when compared to the control group. Enhanced differentiation and the highest calcium deposition was observed in MTA with the 10% PRP group. Conclusion: Within limitations of the in vitro environment, results imply an increased proliferation and induction of MSCs into osteo/odontogenic differentiation by the combination rather than a mere sealing of PRP by MTA. Clinical significance: PRP and MTA have the potential for true regeneration of the pulp tissue. Moreover, the combination of PRP and MTA can be utilized to expand the MSCs to generate adequate numbers for clinical applications, without xenogenic contamination.



Mimoza Canga, Irene Malagnino, Giulia Malagnino, Vito Malagnino

Evaluating Therapy Treatments in Patients with Mental Disorders in Relation to Oral Health

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1179 - 1183]

Keywords: Dental caries, Longitudinal study, Mental health, Teeth extraction, Treatment duration

   DOI: 10.5005/jp-journals-10024-2678  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to find the correlation between dental caries and teeth loss in relation to gender, age, treatments with different therapies, time period being hospitalized, sugar consumption, smoking, and oral hygiene in mental disordered patients. Objective: Evaluating therapeutic treatments in patients with mental illnesses, focusing on the effects on oral health. Materials and methods: This is a longitudinal cohort study conducted on patients who have been hospitalized from 5 years to 30 years. Patients were observed for 7 months (January 2019–July 2019) in the psychiatric hospital “Ali Mihali”, in Vlora, Albania. In our study, 200 patients participated, of which 103 were females (51.5%) and 97 were males (48.5%). Results: In the present study, we analyzed the oral health of patients within the age class of 30–70 years. We divided them into four age groups: 30–40, 41–50, 51–60, and 61–70 years. According to the ANOVA test, a strongest influence on caries manifestation and missing teeth was noticed during the time the patient was being hospitalized, with p values = 0.000 in both cases. The treatments done with different therapies also had a strong influence on the teeth loss with a p value = 0.001, while in carious teeth the p value was 0.004. This study showed that there is a strong statistically significant correlation between sugar consumption and smoking, in relation to caries manifestation and teeth loss, with p values = 0.000, respectively. Conclusion: These patients are a vulnerable group, if we consider their oral health. The present study proved that the most important reasons for their poor dental health are: bad oral hygiene, smoking, sugar consumption, adverse effects of medications, and the time period that these patients have been hospitalized. Clinical significance: By knowing the factors that have worsened the oral health of mental disordered patients, we can try to raise the awareness about caries reduction and to avoid teeth loss.



Chippalapally Arun Kumar, C Ravi Kumar, Kanchiradasu Vamshikiran, G Naveen Kumar, M Akhilesh

Evaluation of Impact Strength of Dental Acrylic Resins by Incorporation of TiO2 Nanoparticles Using Two Different Processing Techniques

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1184 - 1189]

Keywords: Acrylic denture base, Impact strength, Microwave, TiO2 nanofillers

   DOI: 10.5005/jp-journals-10024-2655  |  Open Access |  How to cite  | 


Aim: The present study aims to evaluate the impact strength of PMMA incorporated with TiO2 nanoparticles by two different processing techniques i.e. water bath and microwave processing techniques. Materials and methods: A total of 80 samples made of PMMA were divided into four groups. Each group includes 20 samples with group I and II comprising of samples made of normal acrylic resin and acrylic resin reinforced with 1 wt% TiO2 nanoparticles processed with conventional water bath technique respectively, groups III and IV include normal acrylic resin and acrylic resin reinforced with 1 wt% TiO2 processed using microwave technique respectively. The specimens were tested for impact strength using IZOD pendulum impact tester. The impact energy values obtained were analyzed statistically. Results: The results through one-way ANOVA showed a high mean impact strength with group IV samples (23.13) and lowest with respect to group I (19.42) with highest statistical significance (p < 0.001). A post hoc Tukey test intergroup analysis showed a statistically significant difference between group I and other groups, whereas there was no statistical significance associated with other intergroup comparisons. Conclusion: PMMA with its current drawbacks in the physical and mechanical properties requires modifications to make it an ideal denture base material. The current investigation evaluates that a high mean impact strength with samples made of PMMA incorporated with TiO2 nanoparticles processed by microwave technique was obtained when compared with normal acrylic resins processed by water bath technique. Clinical significance: The methodology of current study can be used while processing of denture bases for patients to evaluate the effect of oral environment on inclusion of TiO2 nanoparticles with microwave processing in a clinical setup. This could help in reducing the amount of fractures associated with heavy load masticatory stresses and improving the mechanical properties in denture bases.



Maryam Hajiahmadi, Afsaneh Yegdaneh, Alireza Homayoni, Hossein Parishani, Hadi Moshkelgosha, Reza Salari-Moghaddam

Comparative Evaluation of Efficacy of “Green Tea” and “Green Tea with Xylitol” Mouthwashes on the Salivary Streptococcus mutans and Lactobacillus Colony Count in Children: A Randomized Clinical Trial

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1190 - 1194]

Keywords: Green tea, Lactobacillus, Mouthwash, Streptococcus mutans, Xylitol

   DOI: 10.5005/jp-journals-10024-2652  |  Open Access |  How to cite  | 


Aim: Green tea is an antimicrobial agent that has beneficial effects on oral and dental health. The aim of this study was to compare the effect of “green tea” and “green tea with xylitol” mouthwashes on the salivary Streptococcus mutans and Lactobacillus colony count in children. Materials and methods: In this double-blind randomized controlled clinical trial, 64 children aged 6–12 years were randomly divided into two groups. Subjects were instructed to wash their mouth with 5% “green tea” or 20% “green tea with xylitol” mouthwashes twice a day for a period of 2 weeks. Salivary counts of bacteria were determined at the baseline and after 2 weeks of intervention. Results: A significant difference was found between the average number of bacterial colonies between the two groups after intervention (p < 0.001). Conclusion: Findings of this study suggest that the effect of the “green tea with xylitol” mouthwash on reducing the number of salivary colonies of S. mutans and Lactobacillus is significantly higher than that of the “green tea” mouthwash. Clinical significance: The green tea mouthwash can be advised for dental and oral health of children.



Prerak Doshi, Aruna Kanaparthy, Rosaiah Kanaparthy, Disha S Parikh

A Comparative Analysis of Fracture Resistance and Mode of Failure of Endodontically Treated Teeth Restored Using Different Fiber Posts: An In Vitro Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1195 - 1199]

Keywords: Carbon fiber, Fracture resistance, Glass fiber post, Post and core, Static loading

   DOI: 10.5005/jp-journals-10024-2668  |  Open Access |  How to cite  | 


Aim: To evaluate the fracture resistance under static loading of endodontically treated teeth (maxillary central incisors) restored with carbon fiber posts, glass fiber posts, and everStick posts. The objectives of this study were to check the fracture resistance of the everStick post and compare it with glass fiber posts and carbon fiber posts and evaluated their modes of failure. Materials and methods: An estimated 80 freshly extracted human maxillary central incisors were collected for this study. The coronal portions of 60 teeth were sectioned 4 mm incisal to the cemento-enamel junction (CEJ) and 20 teeth were left intact to be used as controls. All the samples were embedded vertically in acrylic resin blocks and the groups were divided as follows. I—control group, II—carbon fiber group, III—glass fiber group, and IV—everStick (E-glass) group. Root canal treatment was completed in all the 80 teeth of 4 groups. Control group teeth were restored with a composite. In all other teeth, post and core placement was carried out. All specimens were mounted on a test block and subjected to static loading until fracture and the mode of fracture was recorded. Statistical analysis was carried out using ANOVA to calculate the mean values of all groups. An intergroup comparison was carried out using Tukey's post hoc test. Results: The study showed that group I showed the highest fracture resistance followed by group IV, which is everStick post group under static loading. There was a significant difference among test groups. The main mode of fracture was repairable as there was debonding of the core in all the fiber posts. Conclusion: Teeth of the control group showed highest fracture resistance and teeth restored with everStick posts showed higher fracture resistance than those restored with glass fiber or carbon fiber posts under static loading (p < 0.05). The principal mode of fracture was debonding of core and remaining root. Teeth restored without application of a post showed the highest fracture resistance than all other groups. Clinical significance: EverStick/E-glass fiber posts showed significantly higher fracture resistance than the other fiber posts and can be suggested for clinical use.



Virendra K Prajapati

Oral Health Behavior and Factors Influencing the Selection of Oral Hygiene Products among the Adolescent Tobacco Consumers in Jharkhand

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1200 - 1205]

Keywords: Adolescents, Interdental aids, Tobacco, Toothbrush, Toothpaste

   DOI: 10.5005/jp-journals-10024-2660  |  Open Access |  How to cite  | 


Aim: To identify the oral health behavior and factors influencing the selection of oral hygiene products by the adolescent tobacco consumers in Ranchi district, Jharkhand. This study will also attempt to identify the factors related to the selection of toothbrushes for oral hygiene maintenance. Materials and methods: A total of 800 adolescent tobacco consumers were selected from Ranchi district. A self-administered questionnaire collected information on the oral health behavior and factors influencing the selection of oral cleansing aids. Logistic regression analysis was performed. Results: Toothbrush (83.0%) and toothpaste (78.0%) were the most common oral cleansing aids. Media played an important role in the selection of toothbrushes and toothpaste. The dental visit (15.0%) for preventive dental care was reported to be less. The individuals belonging to upper class (OR = 2.8, p value < 0.001*), of nontribal origin (OR = 3.21, p value < 0.001*, and residing in urban areas (OR = 5.6, p value < 0.0001*) were more likely to use a toothbrush. Conclusion: The consumption of tobacco should be discouraged. Promotion of oral cleansing aids and interdental aids should be carried out using support from media. Clinical significance: The oral health behavior of adolescents needs to be improved. The adolescents should be promoted to quit tobacco, and education and counseling should be provided to them for the oral health promotion. Regular dental check-up for preventive care should be encouraged.


Original Research

Sonia Sacsaquispe-Contreras

Development of New Experimental Dentifrice of Peruvian Solanum tuberosum (Tocosh) Fermented by Water Stress: Antibacterial and Cytotoxic Activity

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1206 - 1211]

Keywords: Antibacterial, Cytotoxic, Dentifrice, Solanum tuberosum, Tocosh

   DOI: 10.5005/jp-journals-10024-2681  |  Open Access |  How to cite  | 


Aim:Tocosh” is a potato that has undergone a process of hydraulic oxidation that enhances its antimicrobial properties so that this natural resource can be used in medical sciences. The aim of this study was to develop and evaluate the antibacterial and cytotoxic activity of a new experimental tooth based on Solanum tuberosumTocosh” on the cell lines 3T3 and DU145. Materials and methods: To evaluate the cytotoxicity, cell cultures 3T3 and DU145 were used. Cell viability was determined by the MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) in a medium containing 10% calf serum where the cells were preincubated at a concentration of 1 × 106 cells/mL in culture medium for 3 hours at 37°C and 6.5% CO2. Then, the absorbance was measured using a microplate reader where the formazan crystals were diluted with acidic and cold isopropanol, and quantified in an ELISA reader. To evaluate the antibacterial effect, the Kirby Bauer inhibition halos method was used on strains of S. aureus (ATCC 25923), S. mutans (ATCC 25175), and S. mitis (ATCC 49456). Results: Solanum tuberosum (tocosh) was not cytotoxic because it only had one CC50 at the concentration of 0.26927 mg/mL and 0.26845 mg/mL for the cell lines 3T3 and DU145, respectively. Tocosh toothpaste (TD) has an antibacterial effect against S. aureus and S. mutans. Conclusion: The new ecological dentifrice was not cytotoxic since it did not alter cell viability because its CC50 was only 0.268 and 0.269 μg/mL for the 3T3 and DU145 cell lines, respectively; however, it presented an optimal antimicrobial activity against the oral strains evaluated. Clinical significance: This research has great potential for clinical use because this new dentifrice has antimicrobial activity against different oral germs.



Sunny Jain, Karan Kapoor, Karan Sethi, Divya R Dahiya, Bhupender Singh, Ritu Sangwan

Evaluation of Different Preosteotomy Determinants as Affecting the Success of Implant Therapy: A “CBCT”-based Clinical Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:5] [Pages No:1212 - 1216]

Keywords: Cone-beam computed tomography, Dental implant, Implant planning, Maxillary sinus, Prosthodontics

   DOI: 10.5005/jp-journals-10024-2662  |  Open Access |  How to cite  | 


Aim: The success of implant therapy is of greatest concern for clinicians because a minor negligence can lead to ultimate failure of treatment. However, comprehensive and precise treatment planning can ensure high success rate of implant therapy. Cone-beam computed tomography (CBCT) is an innovation that allows clinicians to explore all related factors in details. This study was conducted to evaluate different preosteotomy determinants as affecting the success of implant therapy in the maxillary anterior region using CBCT. Materials and methods: This study was conducted on 98 partially or complete denture patients willing for artificial replacement of their missing teeth by implant or implant over-denture. Demographic details of participating patients were collected. Furthermore, comprehensive local examination was also done to finalize the site of placement of implant. Cone-beam computed tomography was attempted in all patients for determining accurate implant location, status of bone, and other interrelated determinants of implant success. Cone-beam computed tomography was also prescribed for patients so as to have presurgical idea of implant dimensions as shown in virtual placement of implant. To rule out any interobserver bias, the interpretations of CBCT images were completed by two independent experienced observers. Results: In the 98 studied patients, 61 were males and 37 were females. The study was restricted to the maxillary anterior region only. The studied preosteotomy determinants were available bone height and width in the edentulous region from ridge crest up to the maxillary sinus floor or the nasal fossa floor. A total of 107 implants were placed virtually (on CBCT) in the maxillary anterior region and compared quantitatively in postosteotomy phases. Implant placement sites were the maxillary central incisor region (39), the lateral incisor region (31), and canine (37). Authors also noticed that the relative length and width of virtual implant remained unaffected in 97% of the cases. Conclusion: Cone-beam computed tomography showed accurate status of various presurgical determinants like trabeculae, peri-ridiculer pathology, and amount of horizontal and vertical bone losses. Hence, it was further concluded that all these presurgical determinants greatly affect the final success rate of implant therapy. It is therefore deemed necessary to judiciously consider and clinically manage such factors before attempting implant in the maxillary anterior region. Clinical significance: Presurgical evaluation of factors associated with implant dimensions significantly assists clinicians in deciding the finest treatment option. All additional information provided by CBCT genuinely led to a change in the treatment plan that provides enhanced clinical outcome with lesser postoperative complications.



Aparna Trivedi, Naveen R Banda, Nitu Mishra, Garima Singh, Ekta Srivastava

Evaluation of Eruption Pattern and Caries Occurrence among Children Affected with Fluorosis

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1217 - 1222]

Keywords: Dental caries, Eruption pattern of permanent teeth, Fluorosis

   DOI: 10.5005/jp-journals-10024-2663  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate eruption pattern and occurrence of caries in children affected with fluorosis. Materials and methods: One hundred and fifty subjects (75 each with/without fluorosis) with age group of 7–8 years were selected. Dental fluorosis assessed on the buccal surfaces of the permanent incisors and molars and scored using the Thylstrup and Fejerskov index. The tooth were scored as emerged when at least one cusp of the tooth was visible in the mouth. Caries attack rate in primary and permanent teeth were estimated using DMFS and defs index in fluorosis patient. The findings were subjected to statistical analysis. The data were analyzed using Student “t” test and ANOVA “F” test. Results: There was statistically highly significant difference found in the incidence of occlusal, mesioproximal, and distoproximal caries between fluorotic and nonfluorotic patients (p < 0.001). The result of present study showed a nonsignificant association between fluoride exposure parameter and median emergence ages of permanent incisors and molar teeth. On the other hand, caries occurrence shows a significant association with fluorosis. Conclusion: In this study, a significant positive correlation exists in the prevalence of caries and fluorosis. It is concluded that occlusal and proximal caries are less pronounced in fluorosis patients. Clinical significance: Dental caries is a public health problem. In this study, we study the fluoride effect since the predominant cariostatic effect of fluoride is beneficial in extensive caries reduction without a concomitant risk of dental fluorosis.



Sushilamma H Manjunath, Purushottam Rakhewar, Prashant Nahar, Varsha Tambe, Mahesh Gabhane, Anup Kharde

Evaluation of the Prevalence and Severity of Periodontal Diseases between Osteoporotic and Nonosteoporotic Subjects: A Cross-sectional Comparative Study

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1223 - 1228]

Keywords: Alveolar bone, Osteoporosis, Periodontal diseases

   DOI: 10.5005/jp-journals-10024-2717  |  Open Access |  How to cite  | 


Aim: To evaluate the prevalence and severity of periodontal diseases between osteoporotic and nonosteoporotic subjects. Materials and methods: The study population included 140 subjects (70 osteoporotic and 70 nonosteoporotic) age group of 35–70 years. Skeletal (calcaneal) bone mineral density (BMD) was measured by quantitative ultrasound technique (QUS) for T score values. Periodontal status was examined by plaque index (PI), bleeding index, probing depth (PD) and clinical attachment level. Digital panoramic and intraoral periapical radiographs (IOPA) were taken with fixed reference point for evaluation of bone interdental alveolar bone loss (ABL). The recorded data for T score, interdental ABL and periodontal status were subjected to statistical analysis for correlation and regression procedure. Results: The prevalence of the periodontal diseases, in osteoporotic group 120 (54.5%) were with periodontitis and in nonosteoporotic group 100 (50%) were with periodontitis. Correlation of T score with age, PI, gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), and ABL in nonosteoporotic group was found statistically not significant. The age was (r = −0.052) indicating positive association with weak correlation, The PI is (r 0.060) indicating positive association, the GI was (r = −0.053) indicating negative association with weak correlation, the PPD was (r = 0.070) indicating positive association with weak correlation, the CAL was (r = 0.133) indicating positive association with weak correlation, ABL was (r 0.027) indicating positive association with weak correlation. Conclusion: Calcaneal BMD was related to ABL and, to a less extent, to CAL, implicating osteoporotic subjects are at high risk indicator for periodontal diseases. Clinical significance: Even though the pathogenesis of periodontitis and osteoporosis differs; these diseases have several common risk factors. Both may have a additive impact on patients, which requires concomitant medical and dental management which mandates simultaneous diagnosis of both.



Danilo Alessio Di Stefano, Paolo Arosio, Lorenzo Cinci, Laura Pieri

Ridge Preservation Using an Innovative Enzyme-deantigenic Equine Bone Paste: A Case Report with 36-month Follow-up

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:6] [Pages No:1229 - 1234]

Keywords: Bone formation, Bone paste, Post-extractive sockets, Ridge preservation, Xenograft

   DOI: 10.5005/jp-journals-10024-2664  |  Open Access |  How to cite  | 


Aim: This study aimed to report a successful clinical, histological, and histomorphometric outcome of a novel equine-derived bone paste for a ridge preservation surgery involving a single post-extractive socket. Background: After tooth avulsion, unless the implant position is not carried out straightforwardly, the alveolar process undergoes resorption: to limit it, post-extractive sockets may be grafted according to the ridge preservation principles. Grafting materials should display proper biological properties and optimal handling characteristics. Bone pastes may facilitate grafting operations, avoid granules’ dispersion, and maximize the contact of the graft with the surrounding bone. An innovative equine-derived bone paste has been recently introduced on the market, but its use has never been documented in the medical literature. Case description: This report describes the treatment of a patient who received the equine-derived bone paste in a post-extractive socket to allow the preservation of the alveolar ridge and was later rehabilitated with a crown supported by a single implant. Conclusion: The handling properties of the equine-derived bone paste were excellent. At the 36-month follow-up, the peri-implant bone levels had been maintained, with the implant being successful according to the Albrektsson and Zarb criteria. Histologic outcome showed that the bone paste was fully biocompatible; histomorphometric analysis showed that a significant amount of newly formed bone could be observed in the grafted socket. Clinical significance: Alveolar ridge preservation using bone grafts is a well-known approach, yet there is still no agreement about which bone graft might be considered the most suitable for this indication. The novel equine-derived bone paste used in the present study appears a promising option for effective socket preservation and may promote secondary intention healing.



Mohammed S Al-Akhali

Successful Management of Khat Chewing-induced Gingival Recession by Using Tunnel Technique Utilizing Subepithelial Connective Tissue Graft: A Case Report

[Year:2019] [Month:October] [Volume:20] [Number:10] [Pages:4] [Pages No:1235 - 1238]

Keywords: Gingival recession, Khat chewing, Periodontics

   DOI: 10.5005/jp-journals-10024-2659  |  Open Access |  How to cite  | 


Aim: Treatment of an unusual gingival recession induced by khat chewing habit. Background: Gingival recession induced by khat chewing was confirmed by many authors. However, there is no proposal for treatment of gingival recession induced by chewing khat. Case description: A systemically healthy nonsmoking male khat chewer aged 38 years presented with class III gingival recession around the lower right incisor. The treatment approach involved a subepithelial connective tissue graft with a tunnel procedure. Conclusion: A full coverage of khat-induced recession was achieved by using tunnel technique utilizing subepithelial connective tissue graft at 1-year follow-up. Clinical significance: Treatment of gingival recession, including those induced by mechanical trauma such as chewing habits is considered as an esthetic demand and it is the responsibility of the clinician to determine the proper treatment plan for the correcting esthetic and functional defects of the periodontal tissues.


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