The Journal of Contemporary Dental Practice

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2019 | November | Volume 20 | Issue 11

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Piyush Jain

Dietary Modification as a Part of Prescription in Inflammatory Lesions of Oral Cavity: A Need of the Hour

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:2] [Pages No:1239 - 1240]

   DOI: 10.5005/jp-journals-10024-2693  |  Open Access |  How to cite  | 



Ntombizodwa R Nkambule, Thomas K Madiba, Ahmed Bhayat

Dental Caries, Body Mass Index, and Diet among Learners at Selected Primary Schools in Pretoria, Gauteng Province, South Africa

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:8] [Pages No:1241 - 1248]

Keywords: Body mass index, Cross-sectional study, Dental caries, Diet, School children

   DOI: 10.5005/jp-journals-10024-2685  |  Open Access |  How to cite  | 


Aim: To assess whether the prevalence of dental caries (DC) was associated with the body mass index (BMI), socioeconomic status (SES), and diet of grade six learners in Pretoria, South Africa (SA). Materials and methods: A cross-sectional study was carried out. Learners underwent an oral and anthropometric examination, while the information on dietary intake and SES were collected using a standardized questionnaire. Results: Of a possible 529 learners, 440 (83%) participated of whom 53% were boys. The mean age was 11.8 years, and 50% fell into the “medium” SES category. The prevalence of DC was 43%. The mean decayed, missing and filled teeth (DMFT) score was 1.19 (SD = ±1.79), of which the decayed (D) component was the largest 1.07 (SD = ±1.59). Two-thirds (62%) of learners had a normal BMI, and 26% were underweight. Less than half (47%) reported brushing their teeth twice a day; 71% claimed to drink up to one and a half glasses of sugar-sweetened beverages (SSBs), and 67% reported eating one to three sweets a day. The prevalence of DC was not significantly associated with BMI, diet, or SES, although having no caries was associated with eating less than three sweets a day. Conclusion: The mean DMFT score was relatively low with much of the decayed teeth being untreated. Most learners were classified having a normal BMI, despite having bad eating habits. Oral health in this group of learners may be more influenced by healthcare-seeking behavior and access to healthcare services than by diet alone. Clinical significance: The decayed component was fairly high, which means that there is a huge need for dental treatment, and although prevention and oral health promotion is important, learners with decayed teeth should have access to curative services.



Enrica Giammarinaro, Saverio Cosola, Giacomo Oldoini, Francesco Gulia, David Peñarrocha-Oltra, Simone Marconcini, Anna Maria Genovesi

Local Formula with Mucoadhesive Property: A Randomized Clinical Trial of a Therapeutic Agent for the Treatment of Oral Aphthous Ulcers

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:5] [Pages No:1249 - 1253]

Keywords: Keywords: Adjuvant therapy, Laser therapy, Mucoadhesive gel, Oral aphthous ulcers, Recurrent aphthosis

   DOI: 10.5005/jp-journals-10024-2709  |  Open Access |  How to cite  | 


Background: Recurrent or occasional aphthous lesions represent a painful oral condition with high prevalence. Since the etiology is still unclear and most likely related to a dysfunction in the local immune system, several treatment strategies have been proposed, including systemic agents, local agents, and laser therapy, to reduce the pain and discomfort for the patient without acting on the causes. Materials and methods: The purpose of the present randomized study was to assess the clinical efficacy of a new topical gel with mucoadhesive property to reduce the pain and the dimension of the aphthosis lesions. Fifty patients presenting at least one minor ulcer were randomized to a control group (placebo prescription), a first test group (topical agent with laser), and a second test group (topical agent only). The healing rate, the visual analog scale (VAS) score for pain, and the diameter reduction were monitored for 10 days. Results: Both test groups showed better results than control group, significant clinical efficacy, and a median total reduction time of 4 days with no significant adjunctive benefit from the use of laser. Conclusion: The clinical results are encouraging; nevertheless other studies are needed to valid this kind of treatment. Clinical significance: The present randomized clinical study suggested that the use of topical mucoadhesive agents could represent a valid therapy for minor aphthous lesions.



Kevin Pirca, Gabriela Balbín-Sedano

Remineralizing Effect of Casein Phosphopeptide–Amorphous Calcium Phosphate and Sodium Fluoride on Artificial Tooth Enamel Erosion: An In Vitro Study

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:6] [Pages No:1254 - 1259]

Keywords: Keywords: Casein phosphopeptide–amorphous calcium phosphate, Dental erosion, Microroughness, Remineralization, Sodium fluoride

   DOI: 10.5005/jp-journals-10024-2710  |  Open Access |  How to cite  | 


Aim: To compare in vitro the remineralizing effect of toothpastes with casein phosphopeptide–amorphous calcium phosphate (FPC–FCA) and sodium fluoride on the artificial erosion of tooth enamel. Materials and methods: For the first phase of artificial erosion, group I was considered as the control group without treatment or erosion. For groups II and IV, the drink was used (Coca-Cola®), for groups III and V, the drink (Inca-Kola®), and the four groups were demineralized four times a day (every 3 hours for 2 minutes) for 5 days. In the treatment phase in groups II and III, brushing was performed with sodium fluoride paste (Colgate®), groups IV and V received brushing with FPC–FCA complex (MiPaste®), and for all groups, the same procedure was performed four times a day (every 3 hours for 5 minutes) for 90 days. At the end, the microroughness of the surfaces of all the groups was evaluated by means of a Rugosimeter (Mitutoyo). Results: It was evidenced that the group of sodium fluoride presented a microroughness of 2.79 μm being the group of least remineralization, but the FPC–FCA complex showed a microroughness of 1.96 μm; however, the control group presented a microroughness of 3.20 μm, and the groups sodium fluoride, FPC–FCA compared to the control group proved to be statistically significant with a p < 0.05. Conclusion: The remineralizing effect of FPC–FCA (MiPaste®) complex proved to be greater than sodium fluoride paste (Colgate®) under artificial enamel erosive conditions. Clinical importance: The results of this research serve as a basis for industries to generate products that have the potential for remineralization against various erosive beverages that are consumed daily.



FA Ageel, MQ Alqahtani

Effects of the Contents of Various Solvents in One-step Self-etch Adhesives on Shear Bond Strengths to Enamel and Dentin

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:9] [Pages No:1260 - 1268]

Keywords: Dentin, Enamel, Laboratory research, Self-etch adhesives, Shear bond strength, Solvents

   DOI: 10.5005/jp-journals-10024-2683  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the shear bond strengths (SBSs) of one-step self-etch adhesives containing different co-solvents to enamel and dentin and to determine the failure modes of tested specimens. Materials and methods: Two hundred and forty (n = 240) sound human molars were used. The buccal surfaces of each tooth were ground and polished to obtain flat enamel surfaces (n = 120) or to expose the underlying dentin (n = 120). The specimens with exposed enamel or dentin were randomly divided into four main groups (n = 30) according to the one-step self-etch adhesives used: Bond-1 SF, OptiBond All-In-One, G-aenial, and Single Bond Universal adhesive. All the main groups were then subdivided into two subgroups (control and thermocycling subgroups) (n = 15). After bonding procedures, a composite restoration (Filtek Z250) was applied in a vinyl tube and condensed against the cured adhesive bonding agent, to form a resin cylinder. The specimens were stored in distilled water at 37°C for 24 hours (control and thermocycling subgroups), followed by thermocycling (5–55°C/5,000 cycles + storage in artificial saliva for 2 weeks) (thermocycling subgroup). They were subjected to SBS testing in a universal testing machine at a crosshead speed of 0.5 mm/minute. After being shear-tested, all fractured samples were examined by means of a Hirox Digital Microscope at 50× magnification for failure analysis. The data were analyzed by one-way analysis of variance followed by Tukey's post hoc analysis at a p value of ≤0.05. Results: OptiBond All-In-One adhesive showed significantly higher mean SBS values on both types of tooth structures (enamel and dentin) and under different conditions (control and thermocycled) compared with the other three adhesives (p < 0.001), except in the enamel-thermocycled group, where the Single Bond Universal adhesive showed higher mean SBS but without a significant difference compared with the OptiBond All-In-One adhesive (p = 0.266), and there was no significant difference between OptiBond All-In-One and G-aenial Bond in the same group (p = 0.192). Conversely, Bond-1 SF showed significantly lower mean SBS values compared with those of the other three adhesives on different types of tooth structures and under different conditions (control and thermocycled) (p < 0.001). Conclusion: One-step self-etch adhesives containing ethanol as a solvent or co-solvent showed higher SBS compared with the other self-etching bonding agents. The bond strength values of these adhesives to dentin are significantly higher than those to enamel. Clinical relevance: The types of solvents of one-step self-etch adhesives had an effect on SBS, and the absence of solvent in those adhesives would adversely influence their performance.



Pratik Agrawal, Sujith Sivarajan, Adarsh Jayan, Kenchappanavar M Sangeetha

Evaluation of Efficacy of Different Instrumentation for Removal of Gutta-percha and Sealers in Endodontic Retreatment: An In Vitro Study

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:5] [Pages No:1269 - 1273]

Keywords: Endodontic retreatment, Gutta-percha, Sealers, Stereomicroscope

   DOI: 10.5005/jp-journals-10024-2670  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to evaluate the efficacy of different instrumentation for removal of gutta-percha and sealers in endodontic retreatment. Materials and methods: A total of single-rooted mandibular premolars were collected. Access opening was performed in all specimens. The working length was determined by reducing 1 mm from the length of instruments that were seen reaching the apex. All the canals were dried with paper points. Lateral condensation technique was used to obturate the canals with gutta-percha and zinc oxide eugenol was used as a sealer. The specimens were randomly segregated into three experimental groups. Group I: ultrasonic retreatment tip, group II: R-Endo retreatment files, group III: Mtwo retreatment files. Roots were grooved into two halves with a diamond disc in a longitudinal, buccolingual direction. A stereomicroscope with ×40 magnification was used to image the quantity of gutta-percha and sealer on canal walls. Results: With ultrasonic retreatment tip, least amount (1.96 ± 0.32) of gutta-percha and sealer remained, followed by Mtwo retreatment files (2.84 ± 0.24) and R-Endo retreatment files (3.18 ± 0.63). A statistically significant inter-group difference among different instrumentation groups was demonstrated by ANCOVA analysis. Conclusion: In the present study, ultrasonic retreatment tip file systems was found to be more effective in the removal of root canal filling material, followed subsequently by Mtwo retreatment file system and R-Endo retreatment file system. Clinical significance: Thorough removal of filling material from the root canals is essential during root canal retreatment for probable cleaning and shaping of canal morphology. Thus, clinicians should be aware of the suitable and better instrumentation system that provides a clean and sterile root canal system without any debris.



Linah M Ashy

Restoration-type Outcome of Freehand Implant Placement in Single Edentulous Gaps: An Observational Study

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:5] [Pages No:1274 - 1278]

Keywords: Freehand implant placement, Restoration outcome, Retrospective observational study

   DOI: 10.5005/jp-journals-10024-2706  |  Open Access |  How to cite  | 


Aim: To determine the restoration-type outcome of implants placed freehanded in single edentulous gaps. Materials and methods: Forty-nine implant analogs present in working models of 46 patients representing implants placed freehand with no surgical guides in single edentulous gaps were included in this study. Each model was scanned using an optical scanner and a cone beam-CT. Simplant Pro18 software was used to create a virtual tooth replacing the missing tooth in the scanned model. Two virtual implants were created; one superimposed on the implant analog of the model and a second in relation to the virtual crown with its long axis passing through the cingulum or perpendicular to the occlusal table of the virtual crown. Measurement of angular deviation in the position of the placed implant from that of the planned implant was calculated. Results: The average deviation in the position of placed implants was 9.78 ± 6.47 degrees angular deviation. There was no statistically significant difference in the extent of angular deviation between maxillary and mandibular implants. Whereas, there was a statistically significant difference between anterior and posterior implants. Clinically, 70.57% of the placed anterior implants, 29.41% of premolar implants, and 20% of molar implants need to be restored with cement-retained crowns. Conclusion: For single edentulous gaps, the potential for a cement-retained implant crown is significantly higher with freehand implant placement in the anterior than in the posterior regions. Clinical significance: With freehand implant placement in anterior single edentulous gaps, the potential for a cement-retained implant crown outcome is significantly higher than in posterior gaps. Maximum precision in implant treatment planning and placement is required in this region of the mouth to achieve optimum results.



Suma Karthigeyan, SreeVarun Murugesan, Balu Kandasamy, Devaki Veeramalai, Devi Natesan

Evaluation of In Vitro Cytotoxicity of Heat-cure Denture Base Resin Processed with a Dual-reactive Cycloaliphatic Monomer

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:7] [Pages No:1279 - 1285]

Keywords: Cell viability, Cycloaliphatic monomer, Cytotoxicity, Modified monomer

   DOI: 10.5005/jp-journals-10024-2688  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate cytotoxicity of tricyclodecane dimethanol diacrylate (TCDDMDA) when added to conventional heat-cure methyl methacrylate (MMA) monomer at 10% and 20% (v/v) concentrations. Materials and methods: Twenty seven disk-shaped processed specimens were divided into control group (n = 9; comprises specimens made without substituting TCDDMDA in MMA) and two experimental groups (n = 9 each; specimens prepared by substituting TCDDMDA in MMA at 10% and 20% (v/v) concentration). Eluates were prepared by placing three specimens of each group into 9 mL of culture medium and then incubated at 37°C for 24 hours. Continuous cells lines of L929 mouse fibroblast cells were used and MTT assay was employed to assess cytotoxicity. One-way analysis of variance (ANOVA) with post hoc Tukey's honestly significant difference (HSD) test was used to compare the mean optical density (OD) values and cell viability among the groups. Results: A statistically significant difference was obtained (p = 0.000) when the mean and standard deviation of OD and cell viability (%) of the groups were compared. Highest OD value and cell viability was obtained with E20 group followed by E10 group. Conclusion: Addition of TCDDMDA in MMA of heat-cure denture base resin has no cytotoxic effect on L929 mouse fibroblasts. Clinical significance: Dual-reactive TCDDMDA is a crosslinking monomer which has no cytotoxic effects on mammalian cell cultures. Hence, incorporation of TCDDMDA to MMA can be extrapolated and projected for fabricating dentures without compromising biocompatibility.



Manal A Al-Melh, Aly Nada, Hanan Badr, Lars Andersson

Effect of an Anesthetic Chewing Gum on the Initial Pain or Discomfort from Orthodontic Elastomeric Separator Placement

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:7] [Pages No:1286 - 1292]

Keywords: Anesthesia, Chewing gum, Discomfort, Pain, Separators

   DOI: 10.5005/jp-journals-10024-2708  |  Open Access |  How to cite  | 


Aim: The aim of this study was to investigate the effect of a formulated anesthetic chewing gum (ACG) on the initial pain/discomfort resulting from the placement of orthodontic separators. Materials and methods: The preparation of ACG formulation was investigated using food and drug administration (FDA)-certified ingredients. Sixty subjects were recruited and randomly allocated to three groups: (1) ACG, (2) chewing gum (CG) without anesthetics or (3) control (no CG) group. All subjects received an orthodontic elastomeric separator that was placed between the maxillary right or left first molar and second premolar. For all groups, the registration of pain/discomfort experienced immediately after separator placement (0 hour), then after 1, 4, and 8 hours was carried out using the visual analog scale. Results: Regarding the pain/discomfort perception, there was a statistically significant difference (p value <0.0001) between the three groups (ACG, CG, and controls) at each of the three-time points (1, 4 and 8 hours). There were no harms reported by both groups except for temporary mild muscle soreness from gum chewing that was reported by four subjects from the ACG group and two subjects from the CG group. Conclusion: The ACG can significantly decrease and eliminate the initial pain/discomfort resulting from the placement of the orthodontic elastomeric separators. Furthermore, the ACG may decrease the need for a systemic analgesic. Clinical significance: Orthodontic elastomeric separator placement can be uncomfortable. The ACG significantly decreased the initial pain/discomfort from orthodontic separators during the 8 hours. Therefore, the ACG can be used by the patients as needed whenever pain/discomfort is experienced from the placement of elastomeric separators. Consequently, this may reduce the need for systemic analgesics.



CH Archana, S Murali Krishna Raju, Sarjeev S Yadhav, Sita RK Manthena, Prathuri R Teja

Effect of Surface Pretreatment and Thermal Activation of Silane Coupling Agent on Bond Strength of Fiber Posts to Resin Cement

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:4] [Pages No:1293 - 1296]

Keywords: Fiber post, Sandblasting, Shear bond strength, Silanization, Thermal activation

   DOI: 10.5005/jp-journals-10024-2687  |  Open Access |  How to cite  | 


Introduction: For the restoration of grossly decayed root canal treated teeth, posts are used frequently to retain core for the definitive restoration. Therefore, it is necessary to create adequate adhesion at the post–root-cement interface for long-term performance of a post retained restoration. Aim: To establish the outcome of surface pretreatments such as silanization, sandblasting, and silanization followed by thermal activation of fiber posts on bonding with a dual-cured adhesive resin-based cement. Materials and methods: Eighty radiopaque, No #2 glass fiber-reinforced epoxy resin posts (Hi-Rem Posts, Overfibers, Switzerland), posts were wiped with alcohol (surgical spirit, 90% alcohol) for 5 seconds in a single stroke. A cylindrical plastic cap of diameter 10 mm and length of 15 mm, which is closed on one side, was selected. This was duplicated to form molds and fiber posts embedded perpendicularly in the polyester resin, and samples were made. Samples were randomly distributed into four groups based on the pretreatment done and each group contains 20 samples, group I—(control), group II—(silanization), group III—(sandblasting), and group IV—(thermal treatment of silane). After surface treatment, exposed post surface was uniformly coated with dual-cured resin cement. Cement was cured for 40 seconds with a halogen lamp. The samples are subjected to load in a universal testing machine (UTM) at a crosshead speed of 1.0 mm/minutes to evaluate the bonding failure at the interface. Results: Group IV resulted in the highest bond strength values followed by group III. Group II showed a comparatively higher value than group I but less than groups III and IV. Conclusion: Surface treatment procedure, on fiber post by silanization and sandblasting significantly improved adhesion between post and luting cement interface. Clinical significance: The surface pretreatment, such as sandblasting, silanization, thermal activation of silane coupling agents significantly improved, the retention of the post within in the root canal system.



Rajesh Vyas, Sunil K Vaddamanu, Vishwanath Gurumurthy, Mohamed S Kuruniyan, Syed A Quadri, Masroor A Kanji

Variations in the Compressive Strength of a Die Stone with Three Different Sulfates at Eight Different Concentrations: An In Vitro Study

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:10] [Pages No:1297 - 1306]

Keywords: Compressive strength, Die stone, Sulfate

   DOI: 10.5005/jp-journals-10024-2671  |  Open Access |  How to cite  | 


Aim: The present study aimed to evaluate the alteration in the compressive strength (CS) of the die stone with three different sulfate salt additives, each at eight various concentrations. Materials and methods: The specimens were prepared at specific dimensions (length: 2.5 cm and diameter: 2.5 cm) divided into three test groups based on the type of sulfate additives used [potassium sulfate (K2SO4), zinc sulfate (ZnSO4·H2O), and manganese sulfate (MnSO4·H2O)] and one control group, without any additives. Again, each group was divided into eight subgroups based on concentration of sulfates (ranging from 0.2% to 4%). A total of 375 specimens were tested. CS (in MPa) was evaluated after 72 hours of drying time, using an universal testing machine. Statistical analysis: A one-way analysis of variance (ANOVA) was used for intergroup comparisons. Individual comparisons were done using the post hoc Tukey HSD analysis. Results: All the three additives at all the concentrations have shown an inferior resistance to compressive forces when compared to the standard specimen. However, the least mean CS was observed at 0.8% of MnSO4 (10.95 MPa) and the highest was at 1% K2SO4 (25.28%). A highly significant difference (p < 0.001) was observed among the concentrations in all the three groups (K2SO4, MnSO4, and ZnSO4 groups) and F values were derived as 69.84, 24.29, and 130.52, respectively. At each concentration, comparisons between the groups have shown a significant difference (p < 0.05) at almost all concentrations. Conclusion: The CS of die stone is shown to be decreased with an increase in all three types of sulfate additives when compared to the control specimen. Clinical significance: Die stone is an often used gypsum material in the field of dentistry. Compressive strength of the die stone is crucial in prosthetic dentistry; chemical additives such as sulfate salts may increase the CS such that the die stone can withstand clinical and laboratory handling forces.



Leoney Andonissamy, Suma Karthigeyan, Seyed A Ali, John W Felix

Effect of Chemical Denture Disinfectants and Tree Extracts on Biofilm-forming Staphylococcus aureus and Viridans Streptococcus Species Isolated from Complete Denture

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:8] [Pages No:1307 - 1314]

Keywords: Biofilms, Denture disinfectants, Laboratory research, Plant-based disinfectants, Staphylococcus aureus, Viridans Streptococcus

   DOI: 10.5005/jp-journals-10024-2712  |  Open Access |  How to cite  | 


Aims: The present study aims at recording the antibacterial efficacy of various disinfectants used at different time periods against Staphylococcus aureus and viridans streptococcal species of bacteria isolated from complete dentures. Materials and methods: Fifty complete denture patients were selected for the study and swabs were collected from their complete denture surfaces. The isolated bacteria were subjected to six experimental groups which includes four groups of chemical denture disinfectants and two tree extracts groups. Isolation of the bacteria S. aureus and viridians streptococcal species was done by means of selective media and confirmed by means of biochemical tests. The bacteria were subjected to biofilm assays. The biofilm-forming bacteria with optical density (O.D.) values of more than 1.5 were selected for the study. About 150 acrylic specimens were fabricated and were contaminated by the 2 isolated bacteria mentioned above. The contaminated samples were disinfected by immersion for 10, 20, and 30 minutes in six disinfectants, namely: (1) 1% sodium hypochlorite, (2) 2% chlorhexidine, (3) 2% glutaraldehyde, (4) 3.8% sodium perborate, (5) 2% aalam extract, and (6) 2% neem extract. Results: ANOVA test was performed for both S. aureus and viridans streptococcal species with regard to various synthetic and tree extracts as well as time duration of disinfection. F values for disinfection vs S. aureus is 205.4 (p < 0.001) and the relevant Scheffe post hoc test values is in the following order: 3 < 1, 4 < 6, 2 < 5. F values for disinfection vs viridans streptococcal species is 364.7 (p < 0.001) and the relevant Scheffe post hoc test values is in the following order: 3 < 4 < 1, 6, 2 < 5. Conclusion: For biofilm-forming S. aureus, 2% glutaraldehyde showed best antibacterial efficacy which was followed by 1% sodium hypochlorite and 3.8% sodium perborate. When it comes to biofilm-forming viridans streptococcal species, 2% glutaraldehyde showed best antibacterial efficacy. Next to 2% glutaraldehyde, 3.8% sodium perborate exhibited good disinfection potential. Clinical significance: Complete denture patients have a plethora of microorganisms habitating their complete dentures. Some bacteria are capable of causing systemic illness such as aspiration pneumonia and endocarditis. Hence, constant removal and disinfection of biofilms from the denture surface is vital to the local and systemic wellness of the patient. The most common bacteria capable of causing pneumonia and endocarditis that are isolated from complete dentures include S. aureus and viridans streptococcal species. The present study evaluates antibacterial efficacy of different disinfection agents especially against these biofilm-forming bacteria for different time periods.



Arjun Kini, Shishir Shetty, Raksha Bhat, Preethesh Shetty

Microleakage Evaluation of an Alkasite Restorative Material: An In Vitro Dye Penetration Study

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:4] [Pages No:1315 - 1318]

Keywords: Adhesive, Class I cavity preparation, Dental restorations, Microleakage, Resin composites

   DOI: 10.5005/jp-journals-10024-2720  |  Open Access |  How to cite  | 


Aim: The aim of the present in vitro study was to comparatively evaluate the microleakage in three different esthetic restorative materials in class I cavities using the dye penetration technique. Materials and methods: Class I cavities were prepared on 24 human maxillary premolar teeth. The teeth were randomly divided into four groups of six samples each. Group I: Cention-N without adhesive (Ivoclar Vivadent, India), group II: Cention with adhesive (Ivoclar Vivadent, India), group III: type IX glass ionomer cement (Fuji), group IV: posterior composite (3M ESPE). The specimens were polished, subjected to thermocycling, and suspended in methylene blue dye for 24 hours. The teeth were sectioned longitudinally and the extent of microleakage was evaluated using the stereomicroscope. Results: The results were subjected to statistical analysis using the Pearson's Chi-square test and the interobserver variability was assessed by the Kappa test for interobserver variability. The analysis showed statistically significant results among the groups. Although, Cention N with adhesive showed the least microleakage followed by Cention N without adhesive. Conclusion: All the materials tested were unable to completely eliminate microleakage in class I cavities. However, the newer alkasite material Cention N proved to have the least microleakage among all groups. Clinical significance: According to the present study, Cention N, a newer alkasite restorative material, demonstrated promising results with the least microleakage in comparison with posterior resin composites and glass ionomer cements.



Bhagabati P Dash, Rami Reddy, Pritam Mohanty, Nivedita Sahoo, Sonika Dash, Suravi Chatterjee

A Cone-beam Computed Tomography Interpretation of Malar Bone Changes in Skeletal Malocclusion

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:4] [Pages No:1319 - 1322]

Keywords: Cone-beam computed tomography, Facial esthetics, Malar bone, Malocclusion

   DOI: 10.5005/jp-journals-10024-2680  |  Open Access |  How to cite  | 


Aim: The purpose of this cross-sectional study is to signify malar bone anatomy and to obtain linear correlation with varied skeletal pattern by utilizing cone beam computed tomographic views. Materials and methods: The experimental sample consisted of cone-beam computed tomography (CBCT) scans of 30 patients taken for the purpose of orthodontic treatment and peri implant planning (16 males and 14 females), 11–30 years of age (mean, 23.4 years). The sex and age were documented for all samples and nine landmarks were evaluated. The various CBCT were categorized into different malocclusions based on wits appraisal. Its prevalence was collated with age, sex and various malocclusion by Chi-square test. Results: Age and gender altogether influenced M1. The mean posterior zygomatic bone width (M1) for all sample was 63.7 mm. For M1 estimations, no huge contrast was observed among left and right side (p = 0.915). The mean anteriorzygomatic bone width (M2) was 51.8 mm. No noteworthy contrast amongst two sides (p = 0.995) or age (p = 0.067) was seen. Although sex altogether influenced M3 variety (p = 0.003), the mean greatest cortical thickness (max CT) (M4) was 9.36 mm, significant difference was observed between the minimum cortical thickness of skeletal class I and skeletal class III malocclusion design. Conclusion: Detailed evaluation of malar bone should be performed prior to any ortho-surgical procedure using CBCT. Clinical significance: Our study signifies the importance of consideration of zygoma during any pre-treatment evaluation of skeletal malocclusion. It also marks the pivotal role of zygoma while considering gross facial esthetics. Precise assurance of zygomatic bone size may likewise aid the choice of fitting surgeries and determination of zygomatic implant area.



Nida Ahmed, Vivek Gopalakrishna, Akshay Shetty, Vaibhav Nagraj, Mohammed Imran

Efficacy of PRF vs PRF + Biodegradable Collagen Plug in Post-extraction Preservation of Socket

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:6] [Pages No:1323 - 1328]

Keywords: Collagen plug, Platelet-rich fibrin, Socket preservation

   DOI: 10.5005/jp-journals-10024-2673  |  Open Access |  How to cite  | 


Aim: To compare the clinical sequelae of the efficacy of PRF vs PRF + collagen plug in soft tissue healing and preservation of the socket width, height, and bone density in patients reporting for extractions of maxillary or mandibular anterior or posterior teeth and patients who desired replacement of teeth with dental implants in future. Materials and methods: The study included 54 patients who were divided randomly into 3 groups consisting of 18 patients in each group: in group I, no preservation of extraction socket; in group II, PRF was used; and in group III, PRF + collagen plug was used for preservation of extraction socket. Assessment of the soft tissue healing, bone density, bone height, and width was done on 1st, 8th, 12th, and 16th weeks, postoperatively. Result: Both PRF and PRF + Collaplug are comparable to each other in preserving the bone height, bone density, and also similar soft tissue healing; however PRF + Collaplug is better than PRF alone in preserving the bone width 4th month postoperatively, indicating that the resorbable Collaplug® does play an additional role in preserving the socket width. Conclusion: PRF + Collaplug® has better clinical outcome in socket preservation in comparison to PRF alone. However, as results were not statistically significant, subjecting a larger sample size with PRF + Collaplug® for socket preservation may result in statistical critical values to substantiate our observations. Clinical significance: PRF and Collaplug® can help in ridge preservation after extraction and also avoid additional bone grafting procedures in future implant placement for the patients.



Shanthi Priya K, V Pridhvi Krishna, P Lakshmaiah, Manasa Chalapathi, Ganji Devi

Effect of Acidic Agents on Microhardness and Surface Morphology of Two Metal Ceramic Materials: An In Vitro Study

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:6] [Pages No:1329 - 1334]

Keywords: Acidic agents, Metal ceramics, Microhardness, Surface morphology

   DOI: 10.5005/jp-journals-10024-2690  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to evaluate the effect of acidic agents on microhardness and surface morphology of two metal ceramic materials at various intervals. Materials and methods: A total of 120 metal ceramic disks were prepared and divided into two categories with 60 each. Each category was divided into two groups, group I (Made of IPS d.SIGN) and group II (made of VITA VMK), containing 30 samples each, which was subdivided into three subgroups each containing 10 samples A(i) B(i) acting as control, A(ii) B(ii) immersed in 0.5% HCl, and A(iii) B(iii) immersed in soft cola drink. Group I was tested for microhardness with Vickers microhardness testing machine at an interval of 0 minute, 24 hours, and 168 hours after immersing in acidic agents. Group II was observed for surface morphology changes with scanning electron microscope before immersion, and at an interval of 24 hours and 168 hours after immersing in acidic agents. The results were analyzed statistically, tabulated, and compared. Results: Results revealed that there was a significant decrease in microhardness of IPS d.SIGN and VITA VMK when immersed in acidic agents at an interval of 0 minute, 24 hours, and 168 hours. There were significant surface morphological changes too of both the ceramics before and after immersing in acidic agents at 24 hours and 168 hours. Conclusion: Acidic agents evaluated in the present study affected microhardness and surface morphology of both the ceramics, and IPS d.SIGN is the most suitable and would be recommended in people who consume acidic beverages. Clinical significance: Durability of dental ceramics is very good, but degradation occurs when exposed to acidic agents. All the properties of ceramics are to be known in depth as they are widely used to construct various types of prostheses, and this has to be considered especially in people who consume acidic foods and drinks.



Kiran Murthy Dhananjaya, Suneel V Vadavadagi, Sultan A Almalki, Tanya Verma

In Vitro Analysis of Different Polishing Systems on the Color Stability and Surface Roughness of Nanocomposite Resins

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:4] [Pages No:1335 - 1338]

Keywords: Color stability, Nanocomposite, Polishing, Surface roughness

   DOI: 10.5005/jp-journals-10024-2691  |  Open Access |  How to cite  | 


Aim: To assess the different polishing systems on the color stability and surface roughness of nanocomposite resins. Materials and methods: A total of 60 composite resin samples were fabricated. The Tetric N Ceram composite was compacted into the custom-made cylindrical metallic mold of internal diameter 6 × 6 mm. Based on the polishing system used, sixty samples were divided into three groups. Group I: Sof-Lex, group II: Shofu super-snap polishing disks, and group III: Astropol. The samples in each group were immersed in beverage, that is tea. Spectrophotometer was used to measure the color of the samples after staining period. And surface profilometer was used to measure all surface roughness. Results: Of the three groups, Sof-Lex polishing group reported the least mean value of 0.458 ± 0.118 succeeded by Astropol polishing group (0.494 ± 0.121) and Shofu super-snap polishing group (0.540 ± 0.031) having the higher mean value. Statistically significant difference was found between the different polishing systems calculated by analysis of variance. And color change between the groups was not statistically significant. Conclusion: We conclude that a composite polished with Sof-Lex was a superior polish compared to Astropol polishing group and Shofu super-snap polishing group. There was only a minimal difference in the color stability of the composite between the groups. Clinical significance: Excellent finishing and polishing are the critical steps to enhance the esthetics and longevity of the composite restorations. High strength, fracture toughness, surface hardness, optimum polishability, and gloss are the functional properties which need assessment while a resin composite is used for restoration.



Amani Ahmad Al Tuwirqi, Ahmad Mohammad Alshammari, Osama Mahmood Felemban, Najat M Ali Farsi

Comparison of Penetration Depth and Microleakage of Resin Infiltrant and Conventional Sealant in Pits and Fissures of Permanent Teeth In Vitro

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:6] [Pages No:1339 - 1344]

Keywords: Fissure sealant, ICON, Microleakage, Penetration

   DOI: 10.5005/jp-journals-10024-2715  |  Open Access |  How to cite  | 


Aim: To assess the penetration and microleakage of a resin infiltrant for the prevention of noncavitated white lesion progression in the fissure system of permanent teeth and compare it to a conventional sealant. Materials and methods: Sixty extracted permanent teeth with artificially produced noncavitated white lesions were randomly distributed according to the restorative material into group I (experimental) which received ICON resin infiltration, and group II (control) which received Helioseal F fissure sealant. For the penetration test, restorative materials were mixed with a fluorescent dye (eosin H) before light curing; roots were then amputated, and three buccopalatal microscopic sections were obtained from each tooth. These were dipped in 0.001 mg of ethanolic sodium fluorescence solution. Material penetration depth was assessed through confocal microscopy. Thirty teeth (15 from each group) underwent a microleakage test. Teeth were thermocycled, and then immersed in 50% silver nitrate (AgNO3) solution for 3 hours. Microleakage was evaluated using X-ray microtomography (micro-CT); AgNO3 presence between the material and the tooth surface indicated microleakage. Results: The mean material penetration value in teeth treated with ICON (104.8571 ± 7.63360 μm) was significantly higher than that in teeth treated with Helioseal F (5.3158 ± 3.83825 μm) (p < 0.001). The mean microleakage value in demineralized enamel treated with Helioseal F (0.2238 ± 0.12561) was significantly greater than that in demineralized enamel treated with ICON (0.0119 ± 0.0097) (p < 0.001). Conclusion: ICON displayed more penetration and less microleakage than Helioseal F in pits and fissures of permanent teeth. Clinical significance: Resin infiltrant showed superior retention and can provide a good alternative for adhesives and fissure sealants.



Vamsi K Reddy, Swetha Reddy, Ramakrishna Ravi, Usha Purumadla

Bromelain vs Papain Gel for Caries Removal in Primary Teeth

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:5] [Pages No:1345 - 1349]

Keywords: Keywords: Bromelain, Chemomechanical caries removal, Demineralized dentin, Minimal invasive dentistry, Papain, Primary teeth

   DOI: 10.5005/jp-journals-10024-2711  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate and compare bromelain with papain as the chemomechanical caries removal agent in relation to their efficacy. Materials and methods: Thirty extracted primary molars with active carious lesion extending into dentin were selected. The samples were randomly divided into groups by sectioning the samples into two halves. Group I—cavity prepared using papain gel; group II—cavity prepared using bromelain gel. Time taken for caries removal in both the groups (I and II) was recorded with the help of a stopwatch. Following caries removal, the amount of remaining demineralized dentin was measured with the help of stereomicroscope and weld check (biological image analysis) software. Results: t test is used to evaluate the significance of study parameters on continuous scale between two groups on metric parameters. The mean of residual carious dentin thickness obtained from the group II (bromelain) was 36.74 μm, which was much lower than that obtained from group I (papain) with a mean of 73.84 μm. The mean time taken in the group II (bromelain) was 335.30 seconds which was nearly equal to the mean time of group I (papain) of 352.33 seconds. Conclusion: The amount of remaining demineralized dentin was found to be lower in bromelain group than the papain group and time taken for the carious dentin removal was almost found similar in both bromelain and papain groups. It may be concluded that bromelain was more effective in amount of caries removal than papain. Clinical significance: Chemomechanical caries removal with the organic gels pose a great benefit as they are less invasive and has low side effects and cost-effective.



Swati Srivastava, Noorah Alsalhi, Noura A Alrogaibah

Cone-beam Computed Tomographic Analysis of C-shaped Canals and Radicular Grooves in Mandibular Premolars: Prevalence and Related Factors

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:5] [Pages No:1350 - 1354]

Keywords: Cone-beam computed tomography, C-shaped canal, Mandibular premolars, Radicular groove

   DOI: 10.5005/jp-journals-10024-2692  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the prevalence of C-shaped canals and radicular grooves (RGs) in mandibular premolars using cone-beam computed tomography (CBCT) and correlating it with other factors like age, sex, unilateral, and bilateral prevalence. Materials and methods: CBCT images of 242 patients with an age group of 13–70 years were selected from pre-existing database. The prevalence of C-shaped canal and RG was recorded along with variables such as age, sex, and bilateral prevalence. Statistical analysis: Prevalence was compared using the Chi-square test (p < 0.05). Results: The prevalence of C-shaped configurations in the mandibular first premolars (17.4%) was significantly higher (p < 0.05) as compared with the mandibular second premolars (7.4%). CBCT analysis revealed that in cervical third, 88% of canals were found to be C4 type. A high prevalence of C2 type canal was found in middle (68.6%) and apical third (31.3%). The prevalence of RG in the mandibular first premolars (13%) was significantly higher (p < 0.05) as compared with the mandibular second premolars (4.3%). There was no statistically significant difference between sex and prevalence of C-shaped canals and RG but it was significantly higher in the age group of <50 years (p < 0.05). Conclusion: This study showed a high prevalence of C-shaped canals and RG in mandibular first premolars as compared with mandibular second premolars. The prevalence of the C-shaped canal and RG was significantly higher in the age group of <50 years. This knowledge may aid the clinicians for good endodontic prognosis. Clinical significance: This study result provides valuable insight into the prevalence of C-shaped canal and RG among the premolars which can help clinicians to prevent perforations or root fractures.



Sara A AIshammery

Evaluation of Light Activation on In-office Dental Bleaching: A Systematic Review

[Year:2019] [Month:November] [Volume:20] [Number:11] [Pages:6] [Pages No:1355 - 1360]

Keywords: Color change, Dental vital bleaching, Hydrogen peroxide, In-office dental bleaching, Sensitivity

   DOI: 10.5005/jp-journals-10024-2676  |  Open Access |  How to cite  | 


Aim: This review was undertaken to evaluate the efficacy of light activation on in-office dental bleaching in terms of color change and photosensitivity with available literature evidence. Materials and methods: The articles were searched from MEDLINE/Pubmed and Journal of Web, which were published from 2001 to 2019. Results: Out of the 124 references obtained, 13 articles in English language were read in full, which fulfilled the inclusion criteria. Conclusion: Light activation of hydrogen peroxide on in-office dental bleaching does not affect effectiveness of bleach. Clinical significance: Though claimed that in-office bleaching activated with light betters color change, the present review did not confirm this belief.


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