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2019 | April | Volume 20 | Issue 4

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Krithika Gupta

Use of Tilapia Hepcidin in Oral Cancer Therapeutics: A Proposal

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:2] [Pages No:403 - 404]

   DOI: 10.5005/jp-journals-10024-2529  |  Open Access |  How to cite  | 



Flavia D Vivacqua, Marcella Canto, George T Candeiro, Bruno C de Vasconcelos, Nilton Vivacqua-Gomes

Durability of Two R-Phase Rotary Systems used in the Mechanical Instrumentation of Dilacerated Root Canals

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:4] [Pages No:405 - 408]

Keywords: Endodontics, Root canal preparation, Rotary endodontics

   DOI: 10.5005/jp-journals-10024-2530  |  Open Access |  How to cite  | 


Aim: This study was aimed to analyze, through an ex vivo test, the durability of two rotary systems used in curved root canals of extracted molars. Materials and methods: At first, 150 upper and lower molars were selected, presenting curvature at least in one of the root canals. They underwent access cavity and radiographed with a # 15 file into the canal to determine their maximum curvatures, classified as schneider. The teeth with one or more curved canals were included in this study. Finally, 120 curved root canals were statistically divided into six sets of 20 curved canals. Two rotatory systems, K3 XF (RCS sequence) and twisted file (Large Kit), both treatment R-Phase, were analyzed. Three kits were used for each system, each one instrumented one of the six sets of 20 curved canals. File deformations were noted, and the files were used until a fracture occurs or until completion of 20 canals preparation. Fractured files before the end of the instrumentation of the 20 canals were replaced, continuing the full instrumentation set. Statistical analysis was performed by analysis of variance (ANOVA) (p > 0.05), and a qualitative assessment was also made. Results: It was found that there was no statistical difference between the K3 XF and TF systems regarding fracture. Conclusion: There were no statistical differences between the K3 XF systems in the RCS sequence and the twisted file kit Large system, as to the number of instrumented conduits to the deformation or fracture. Clinical significance: The findings of this study reinforce that, it is necessary to choose files that support curved roots preventing accidents inside the root canal. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.



Aiman O Johar

Ridge Augmentation with Autogenous Bone Graft and Expanded Polytetrafluoroethylene Membrane using Tenting Screw: A Randomized Controlled Clinical Trial

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:8] [Pages No:409 - 416]

Keywords: Autogenous bone graft, Expanded polytetrafluoroethylene, Ridge augmentation, Tenting screw

   DOI: 10.5005/jp-journals-10024-2531  |  Open Access |  How to cite  | 


Background: The study aims to compare non-tenting screw and tenting with a reinforced expanded polytetrafluoroethylene (ePTFE) membrane in horizontal ridge augmentation using an autogenous bone graft. Material and methods: A randomized controlled clinical trial was conducted between 150 patients needing dental implants. The participants were randomly divided into three study groups; group 1: ridge augmentation using non-resorbable ePTFE membrane only, group2: ridge augmentation using an ePTFE and tenting screw with bone graft Bio-Oss mixed with autogenous bone particles and group 3 (control): ridge augmentation with a bone block. The initial measurement was done at the bone crest at the exact implant site and 10 mm apical to the bone crest. Repeat measurements were recorded after 6 months of healing. Statistical analysis was performed by paired sample t-test and two-way analysis of variance (ANOVA). Statistical significance was considered at p <0.05. Results: There was a significant gain in the bone in all the three groups postsurgery. Group 3 recorded higher reading at the crest and apical sites when compared to groups 1 and 2 at 6 months (late measurements). The difference in the percentage gain was statistically significant after adjusting for age as well as the initial measurement. The highest gain was seen in group 3 followed by groups 2 and 1. Conclusion: The membrane with tenting screw group and block bone groups had a significantly higher increase in measurement when compared to the membrane only group. Tenting screw with Bio-Oss can be used in patients with autogenous bone at the donor site. Clinical significance: Tenting screws in combination with membranes can be used to overcome the limitations posed by the use of membranes alone. It is also a useful method for a patient not consenting for block graft for any medical reason.



Karthika J, Rajeev Chandran K

Morphological Comparison of the Changes in the Gingiva of Albino Wistar Rats on Administering Tacrolimus and Sirolimus Separately: An Experimental Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:7] [Pages No:417 - 423]

Keywords: Gingival enlargement, Sirolimus, Tacrolimus

   DOI: 10.5005/jp-journals-10024-2532  |  Open Access |  How to cite  | 


Aim: To morphologically evaluate the effects and compare the magnitude of enlargement in the gingiva of male albino wistar rats, on the administration of tacrolimus and sirolimus. Materials and methods: The experiment was performed on 6-week-old, male Albino Wistar rats, weighing 150–220 g. The animals were housed in pairs, in plastic bottomed cages, with husk as a bedding; in well ventilated rooms subjected to normal atmospheric conditions at 21°C and the same regimen of lighting (12 hours of light/ dark cycle) at the central animal house and fed with a standard pellet diet and water ad libitum. The rats were divided into three groups with 10 rats each and administered 1.5 mg/kg tacrolimus, 2 mg/kg sirolimus and normal saline, respectively for 12 weeks. An impression was made of the rat mandibular incisal region at the end of every third week in polysiloxane impression material, using prefabricated impression trays. The vertical height, buccolingual width and mesiodistal width of the inter-dental papilla and the keratinized gingiva were measured on the study cast using a digital caliper. Statistical analysis was then carried out, and simultaneous comparisons, between the group and within the group were made by using the analysis of variance (ANOVA) repeated measures test. Results: The administration of both tacrolimus and sirolimus resulted in the enlargement of the gingiva, of the albino wistar rats in both the test groups (p <0.001). However, rats administered tacrolimus, showed a greater percentage increase in the gingival dimensions, compared to the sirolimus administered group and the control group, in all the measured dimensions, i.e., vertical height, mesiodistal width and buccolingual width at the end of every third week, in comparison to the baseline (p <0.001). Conclusion: Both drugs, tacrolimus and sirolimus, induced gingival enlargement in the male albino wistar rats. However, the tacrolimus administered group showed a two-fold greater increase in the gingival dimensions compared to the sirolimus administered group. Clinical significance: This study evaluates the effects of tacrolimus and sirolimus on the gingiva of albino wistar rats. Both the drugs are prime members of the immunosuppressive therapy given post-transplantation. Cyclosporine is substituted with tacrolimus to reduce the incidence and intensity of gingival enlargement in such subjects, even though both belong to the same class of drugs, namely calcineurin inhibitors. This study demonstrates that tacrolimus induces gingival enlargement whereas sirolimus does not. There is insufficient literature regarding the effects of sirolimus on gingival tissues. As per the results of this study, Sirolimus may be considered as a better substitute for cyclosporine, than tacrolimus, from a periodontal standpoint.



Márcia Rezende, Aline C Kapuchczinski, Laína Vochikovski, Ivo M Demiate, Alessandro D Loguercio, Stella Kossatz

Staining Power of Natural and Artificial Dyes after At-home Dental Bleaching

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:4] [Pages No:424 - 427]

Keywords: Coloring agents, Hydrogen peroxide, Laboratory research, Tooth bleaching

   DOI: 10.5005/jp-journals-10024-2533  |  Open Access |  How to cite  | 


Introduction: Bleached enamel surfaces may undergo changes and retain more dye, which is a reason to recommend the reduction/suspension of foods with dyes during dental bleaching. Aim: Evaluate the effects of the action of natural and artificial dyes on the bleached enamel of extracted human teeth. Materials and methods: Fifty human premolars were used, which were distributed in 5 groups (n = 10) according to the following staining solutions: GW (distilled water); GB (beet); Gca (caramel); GC (carmine); and GR (red 40). After the removal of the root and pulp section, the teeth were embedded in acrylic resin blocks, stored in artificial saliva, and kept at 37oC. At-home bleaching was performed using 16% carbamide peroxide (CP) for 3 hours daily for 3 weeks. After each daily session of bleaching, the specimens were exposed to the dye solution twice a day for 5 min; one of these exposures was performed immediately after bleaching. The color was recorded using a spectrophotometer according to the CIE Lab system (ƒ¢E) for the following periods: baseline, during bleaching (after 1st, 2nd, and 3rd week) and post-bleaching (after 1 week and 1 month). The color was evaluated by two-way analysis of variance and Tukey's test (ƒ¿=0.05). Results: There was effective dental bleaching for all groups: GW (18.5 ± 6.1), GB (19.9 ± 4.4), Gca (18.9 ± 6.1), GC (20.2 ± 4.6), and GR (19.3 ± 4.2), p <0.01. No color rebound was observed after 1 week and 1 month (p > 0.05). Conclusion: The exposure to beet, carmine, caramel, and red 40 dyes did not interfere with the effectiveness of dental bleaching using 16% CP. Clinical significance: Dyes consumption during bleaching did not affect the effectiveness of dental bleaching.



Nashwan A Noman, Adel A Aladimi, Baleegh A Alkadasi, Mohammed A Alraawi, Gassan M Al-Iryani, Fawzia I Shaabi, Asaad Khalid

Social Habits and Other Risk Factors that Cause Tooth Loss: An Associative Study Conducted in Taiz Governorate, Yemen

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:6] [Pages No:428 - 433]

Keywords: Dental caries, Khat, Meswake, Periodontal disease, Shammah, Smoking, Teeth extraction

   DOI: 10.5005/jp-journals-10024-2534  |  Open Access |  How to cite  | 


Aims: To investigate the relationship between tooth loss, age, gender, and its correlation with several local habits that affect oral health, especially the khat, and Shammah use. Materials and methods: The current study included 580 participants. They were divided into five age groups15–24, 25–34, 35–44, 45–54, and 55–64-years-old. Clinical and radiographic examinations were done for each subject. Reasons for teeth loss, age, gender, khat chewing, Shammah use, smoking, and use of oral hygiene aids were recorded. The data were statically analyzed using Chi-square tests of the statistical package for social sciences (SPSS) program. The p value < 0.05 were considered statistically significant. Results: Caries was the most cause of tooth loss in the young age groups 15–34 years-old and was significantly more common compared to the older groups (p < 0.001). The periodontal diseases increased with age and progressively became the main cause of tooth loss of 100% in the 55–64 years-old group. Orthodontic reasons for tooth extractions were limited to the young age group 15–24 years old. Third molars were the highest extracted teeth in the maxillary arch, while the first molars were the highest in the mandibular arch. Anterior teeth were the lowest extracted teeth ranging from 9; 1.6% in maxillary teeth and 9–29; 1.6–5% in the mandibular teeth. Conclusion: This study highlights the importance of local habitual use of khat 52.9% and Shammah 8.1% besides smoking in tooth loss. Caries was the main cause of tooth loss in the young age groups, followed by the periodontal disease in the older age. Molars were frequently extracted followed by maxillary first premolars. Clinical significance: Limited number of epidemiological surveys were carried out in Taiz Governorate to investigate the reasons of tooth loss and its relationship with social habits like Khat chewing, Shammah use, smoking, using of Miswake and toothbrush. The results of this study will guide us to develop a preventive program which may minimize tooth loss and its adverse effects.



Naren Sharma, Nitin Malik, Harpinder Singh, Anmol Bagaria

Comparative Evaluation of Effect of Lasers and Biodentine in Dentine Regeneration: A Clinical Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:10] [Pages No:434 - 443]

Keywords: Biodentine, Deep carious lesions, Dentine regeneration, Indirect pulp therapy, Laser biostimulation

   DOI: 10.5005/jp-journals-10024-2535  |  Open Access |  How to cite  | 


Aim: To compare and evaluate the effect of different liners separately and in combination with lasers that is resin modified glass-ionomer cement (RMGIC), Laser+RMGIC, Biodentine, Laser+Biodentinein the treatment of deep carious lesions. Materials and methods: Forty patients with deep caries indicated for pulp capping were selected. Curative procedure including the cavity preparation with maximal removal of softened dentine using spoon excavator, slow speed handpiece with round burs was performed. Patients were divided into four groups with 10 patients in each group In group A RMGIC liner, group B laser biostimulation followed by RMGIC liner, group C biodentine liner, group D laser biostimulation followed by Biodentine liner were placed in the cavity after caries removal. Cavities were temporarily restored with IRM for 8 weeks. After 8 weeks, liners in each group were removed, and cavities were permanently restored lower half of the cavity with a layer of flowable Z350 XT composite, and then the remaining half of the cavity with P60 filled composites (3 M ESPE, USA) in all the groups. The observation period was 12 months. Results: All the patients showed a positive response to cold test and electric pulp test at 3 months, 6 months, 12 months follow-up. In group A (RMGIC) two patients and in group B (Laser+Biodentine) three patients did not return back for the follow-up. To standardize the samples, seven patients were selected from each group with a total of 28 samples included in the study (n = 7) and statistical analysis was done using analysis of variance (ANOVA) test. The mean for the total amount of dentine deposited after 12 months was highest in: Group D–(Laser+Biodenitne) 0.32 mm > Group C–(Biodentine) 0.25 mm > Group B–(Laser+RMGIC) 0.10 > Group A–(RMGIC) 0.07 mm Conclusion: Within the limitation of the present study the following conclusion was drawn: • Lasers and biodentine are good indirect pulp capping agents • Laser has an additional effect on the tertiary dentine formation. Clinical significance: Lasers with antibacterial effect penetrate into dentinal tubules and accelerate the rate of dentin bridge formation in deep carious lesions.



Vartul Dwivedi, Torwane Nilesh Arjun, Sanjeev Tyagi

Effectiveness of Various Tongue Cleaning Aids in the Reduction of Tongue Coating and Bacterial Load: A Comparative Clinical Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:444 - 448]

Keywords: Biofilm, Brush scraper, Micro bacteria, Tongue, Tongue scraper

   DOI: 10.5005/jp-journals-10024-2536  |  Open Access |  How to cite  | 


Aim: To remove tongue biofilm and improve breath odor, specific instruments (tongue scrapers) or toothbrushes are used. Materials and methods: This study compared the effectiveness of a manual toothbrush that has a tongue scraper on the back of its head and two commercially available tongue scrapers in reducing the tongue coating and aerobic and anaerobic microbiota of the tongue dorsum. A randomized, negative controlled, double-blind, parallel design study for three different treatment interventions was conducted. Results: All tongue cleaners showed a significant reduction in Winkle's tongue coating scores with significant values of reduction (p <0.001) of the anaerobic bacterial count with plastic and metal tongue scraper when compared to brush scrapper. Conclusion: There was an effective reduction of bacterial load on tongue dorsum with the use of tongue cleaners, with maximum load reduction by using plastic tongue cleaners. Clinical significance: The results of the present study may be helpful for the dentists while prescribing tongue cleaners to their patients in their clinical practice.



Hamayun Zafar, Naif A Almosa

Prevalence of Work-related Musculoskeletal Disorders among Dental Students of King Saud University, Riyadh, Kingdom of Saudi Arabia

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:449 - 453]

Keywords: Dental students, Ergonomics, Saudi Arabia, Work-related musculoskeletal disorders

   DOI: 10.5005/jp-journals-10024-2537  |  Open Access |  How to cite  | 


Aim: To evaluate the presence of work-related musculoskeletal disorders (WRMSDs) among undergraduate dental students of the College of Dentistry, King Saud University (KSU), Riyadh, Saudi Arabia. Materials and methods: A questionnaire-based cross-sectional survey was conducted in 2017 and distributed to 150 undergraduate female, and male dental students of KSU who had started to work with patients in the clinic or with manikins. Data were collected related to WRMSDs. Results: Nearly, 142 (95%) students returned the completed questionnaire, 88 (62%) were females and 54 (38%) were males. The results of this study indicate that musculoskeletal symptoms among dental students of KSU are high. Females generally reported more WRMSDs. Seventy-two percent of females and 41% of males reported frequent headaches. Fourteen percent of females and 6% of males had some musculoskeletal pain disorders before joining the dental profession, whereas 68% of females and 43% of males reported pain attributed to their clinical dental work. In the majority of females (67%) and males (61%), the onset of pain was gradual. Commonly reported pain sites in both females and males were the neck, shoulder, upper and lower back. The most common pain sites, among females were shoulder and neck, and upper- and lower-back among males. Conclusion: The WRMSDs can affect the dental professionals from the early stages of their clinical carrier, even as dental students. Concrete steps are required to prevent the occurrence of WRMSDs among dental students by providing them the detailed knowledge about theoretical and practical aspects of dental ergonomics. Higher prevalence of WRMSDs among female dental students indicate that female dental professionals need to be extra vigilant to adhere to the principles of dental ergonomics from the very beginning of their clinical career.



Anu A George, Alex M Muruppel, Sudeep S, Dinesh N, Sandeep Lal

A Comparative Evaluation of the Effectiveness of Three Different Modalities in Occluding Dentinal Tubules: An In Vitro Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:6] [Pages No:454 - 459]

Keywords: Dentinal hypersensitivity, Desensitizing toothpaste, Diode laser, Tubule occlusion

   DOI: 10.5005/jp-journals-10024-2538  |  Open Access |  How to cite  | 


Aim: This in vitro study was designed to evaluate and compare the effectiveness of a dentifrice containing 8% arginine and calcium carbonate, diode laser (810 nm) and the combined use of diode laser (810 nm) and the same dentifrice in occluding dentinal tubules. Materials and methods: Forty sectioned dentine discs were observed in this study. The Samples were randomly divided into 4 groups. In group A, a dentifrice containing arginine and calcium carbonate was applied. In group B, the specimens were subjected to diode laser (810 nm) irradiation. In group C, the same dentifrice was applied and the specimens were subjected to diode laser (810 nm) treatment. Group D was left untreated and served as the control. The specimens were observed under the scanning electron microscope. Then the photomicrographs of each specimen were taken which were uploaded into Photoshop 7®, and the diameters of the dentinal tubules of each specimen were measured and the data were analyzed statistically. Results: The overall comparison between different treatment modalities using one-way analysis of variance (ANOVA) and multiple comparisons of two modalities assessed using post hoc Tukey method revealed that there is a highly significant difference (p value = 0.0001) in the dentinal tubule diameter and rate of occlusion in different treatment modalities. Conclusion: The study concluded that all three treatment modalities caused significant occlusion of dentinal tubules. The combined use of desensitizing toothpaste and diode laser (810 nm) is the most effective, then comes the diode laser (810 nm) alone and finally the desensitizing toothpaste alone. Clinical significance: This study suggests an effective treatment of dentinal hypersensitivity using diode laser and desensitizing toothpaste.



Vamshi Krishna G, Jayasree Komala, Abdul HB Mohsin, Mohd A Ahmed, Gangishetti Sairam, KV Sheethi

A Study to Evaluate the Effect of Hyperbaric Oxygen on Osseointegration of Root-form Endosseous Titanium Dental Implants: An In Vivo Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:6] [Pages No:460 - 465]

Keywords: Hyperbaric oxygen therapy, Hyperbaric oxygen therapy, Implant stability, Osseointegration, Resonance frequency analysis, Rabbit femur

   DOI: 10.5005/jp-journals-10024-2539  |  Open Access |  How to cite  | 


Aim: To evaluate the effect of hyperbaric oxygen (HBO) therapy on the osseointegration of dental implants by resonance frequency analysis. Materials and methods: Six rabbits of age 2 to 2 and 1/2 years, weight approximately 2 kg were selected and tagged 1–6. For all the animals’ right femur was selected as a control group (R) and left femur as test group (L). Initially, implants of dimensions 3.75x8mm (Adin Touareg) were placed in the right femur. Implant stability quotient (ISQ) values were recorded using OSSTELL ISQ at the time of surgery (R0), after one month (R1), and the end of the second month (R2). After two months of uneventful healing, implants were placed on the left femur of all the six rabbits and three were grouped as 2S (subjected to 2 HBO sessions at the weekly interval) and other three as 4S (subjected to 4 HBO sessions at weekly interval for a month). At the time of surgery (L0), end of one month (L1) and two months (L2), ISQ values were recorded and subjected to statistical analysis. The total duration of the study was 4 months from 3 March 2013 to 03 July 2013. Results: The data were statistically analyzed using t-test and analysis of variance (ANOVA) F. On the comparison between the control group (R) and test groups (2S and 4S) ISQ values for test groups were more which was highly statistically significant (p <0.001). Among the two test groups 4S group has more ISQ values compared to 2S (p <0.001). Conclusion: This study indicated that HBO therapy has a promotive effect on the rate of osseointegration of dental implants. Clinical significance: Study opens new scope for further in vivo research in utilizing hyperbaric oxygen therapy (HBOT) in implant surgeries, maxillofacial trauma cases and irradiated patients to hasten or improve osseointegration.



Leila Pishevar, Zohre Ashtijoo, Mahsa Khavvaji

The Effect of Ceramic Thickness on the Surface Microhardness of Dual-cured and Light-cured Resin Cements

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:466 - 470]

Keywords: Ceramic, Resin cement, Surface microhardness

   DOI: 10.5005/jp-journals-10024-2540  |  Open Access |  How to cite  | 


Aim: This study was conducted to evaluate the effect of ceramic thickness on the surface hardness of light-cured and dual-cured resin cements. Materials and methods: Forty disk-like specimens of the dual-cured resin cement and twenty-four specimens of the light-cured resin cement were prepared (with 6 mm diameter and 1mm thickness). The samples were light-cure d for 40 seconds through three different ceramic disks (2 mm, 3 mm and 4 mm). Control specimens from each group were directly polymerized under a Mylar strip. In the control group of the dual-cured resin cement, the cement setting was realized by chemical reaction alone. After storing dry in darkness (24 hours, 37°C), the surface hardness of the specimens was measured using the Vickers microhardness test. Data were statistically analyzed using a two-way analysis of variance (ANOVA) followed by the LSD's test (p <0.05). Results: BisCem resin cement which had been dual-cured under the 4 mm thickness ceramic with the 4.3 Vickers hardness, showed minimum surface microhardness, while the light-cured resin cement which had been directly activated in the control group with the 51.8 Vickers hardness value exhibited the maximum surface microhardness. So, BisCem dual polymerized control specimens had significantly higher hardness values in comparison to the chemically polymerized and indirectly activated ones (p <0.001). Conclusion: An increase in the thickness of ceramic could decrease the hardness of the resin cement. An overlying ceramic thickness of 3 mm and above was found to adversely affect the polymerization of the LC and DC resin cement and it was considered as the clinical threshold. In addition, using only the self-cured mode in the dual-cured resin cement was not sufficient for achieving the optimum surface microhardness. clinical significant: Adequate polymerization of resin cement is essential for the optimal mechanical properties and clinical performance. It affects by increasing the thickness of ceramic restorations.



Narayan Kulkarni

Correlation of Cervical Vertebral Bone Age and Demirjian's Stages of Dental Maturation for Lower Left Permanent Canine and Second Molar

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:471 - 475]

Keywords: Cervical vertebral bone age, Demirjian's method, Dental maturation

   DOI: 10.5005/jp-journals-10024-2541  |  Open Access |  How to cite  | 


Aim: To evaluate and correlate cervical vertebral bone age(CVBA) and Demirjian's stages of dental maturation for lower left permanent canine(CMS) and second molar (MMS). Materials and methods: A cross-sectional radiographic study was conducted on 264 participants with age group of 7–18 years who were further categorized into six subgroups having an interval of 2 years chronologic age. The CVBA, CMS, and MMS were assessed for the same patient. The assessment of CVBA of the participants involved in the study was derived from the equation given by Mito et al. The height and width of the 3rd and 4th cervical vertebra was measured with the help of IC measure software. The dental maturation was assessed as per the morphologic classification method given by Demirijian. Analysis of variance (ANOVA), Tukey's multiple comparisons and Spearman's correlation coefficient was utilized to determine the significance and correlation between the age groups, CVBA, CMS, and MMS. The multiple comparison levels were set at 0.05 level of significance. Results: Significantly different CVBA was observed among each individual stage of CMS and MMS. Significant changes in the dimensions of the cervical vertebra were observed when the dental maturation stage progressed from F to G and G to H stage. Conclusion: Chronologic age had a moderate correlation with CVBA. CVBA was significant for all the stages of maturation of CMS and MMS. Females revealed a higher level of maturation. A significant difference in the vertebral bone age was observed in the transition of stage F to G and G to H of dental maturation of canine and molar. Both CMS and MMS revealed a significant strong positive correlation with CVBA. Clinical significance: Cervical vertebral bone age can be utilized as an adjunct in identifying the stages of dental maturation of lower left permanent canine and second molar.



Salwa O Bajunaid, Bashaer Altwaim, Muneera Alhassan, Rawan Alammari

The Fit Accuracy of Removable Partial Denture Metal Frameworks Using Conventional and 3D Printed Techniques: An In Vitro Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:6] [Pages No:476 - 481]

Keywords: Fit accuracy, Laboratory research, Lost-wax technique, Removable partial denture framework, Selective laser melting laboratory research

   DOI: 10.5005/jp-journals-10024-2542  |  Open Access |  How to cite  | 


Aim: To evaluate the accuracy of removable partial denture (RPD) metal frameworks fabricated by the conventional lost-wax (CLW) technique and those made by the selective laser melting (SLM). Materials and methods: A dentoform of a mandibular Kennedy class III, modification 1 dental arch were surveyed, and rest seats were prepared on the abutment teeth. The dentoform was then duplicated into a metal die which was used as a reference model. Thirty RPD metal frameworks were fabricated by two techniques; fifteen for each technique. Polyvinyl siloxane (PVS) impression material was painted on the intaglio surface of the rests of each framework which is then seated on the reference die. PVS specimens that represent the gap under the rest were measured in four zones: buccal, lingual, marginal and central by a single examiner using a digital microscope at 50x in micrometers. Results: Comparison between the two techniques for each abutment tooth revealed that the CLW technique had better fit in one tooth, while the SLM technique showed a better fit in two teeth. Regarding the edentulous span length within the SLM technique, the long edentulous span had a significantly better fit. When comparing the four measured rest zones, it was found that in the CLW technique group, the marginal zone had the highest fit accuracy while the lingual zone showed the lowest fit accuracy. In the SLM group, the central zone had the best fit and the buccal zone had the worst fit. Conclusion: RPD frameworks fabricated using the SLM technique showed better fit accuracy than those made by the CLW technique, however, the difference was not statistically significant. Clinical significance: SLM is a promising technique for the fabrication of RPD frameworks in routine clinical practice.



Asok Mathew, Prabhu MN, PK Menon, Ahmed Radeideh, Sudhir Varma, Shibu Thomas, Nisha Varughese, Ghada MS Hamed

A Clinical Study on the Circadian Rhythm of Salivary Cortisol on Aggressive Periodontitis and Its Correlation with Clinical Parameters using Electrochemiluminescence Immunoassay Method

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:7] [Pages No:482 - 488]

Keywords: Aggressive periodontitis, Circadian rhythm, Electrochemiluminescence, Salivary cortisol

   DOI: 10.5005/jp-journals-10024-2543  |  Open Access |  How to cite  | 


Aim: Periodontal pathologies are gaining importance as there is a clear indication of bi-way control on general homeostasis of an individual. The study of HPA axis in various diseases has proved that there is evident vulnerability existing for any organism when the Cortisol diurnal rhythm is altered. The aim was to compare the diurnal rhythm of salivary cortisol in aggressive periodontitis with control patients. This study also compared various parameters like body mass index (BMI), waist circumference, Hamilton anxiety scale, OHI-S, clinical attachment loss in aggressive periodontitis. Materials and methods: 30 control patients were compared against 30 aggressive periodontitis patients in Salivary cortisol diurnal rhythm. It was estimated using the electrochemiluminescence (ECL) method on a 3 point analysis—Soon after waking up, 30 minutes after waking up, 1 hour before sleep to see the diurnal variation in aggressive periodontitis patients. The samples were transferred to CABRI labs to be frozen to –20°C. The analysis was done using Cobas e-411 autoanalyzer by Roche, USA. Results: The average cortisol in aggressive patients was found to be higher compared to control patients and was found to be statistically significant with a p value of 0.012. Control group is moderately skewed left (negative skewness graph) while the aggressive p periodontitis patients showed moderately skewed right (+ve skewness graph). Conclusion: The cortisol awakening response seen in control patients is not observed in aggressive periodontitis. Instead of giving a surge, the cortisol showed a dip in the first 30 minutes followed by a gradual increase in aggressive periodontitis instead of decline as observed in normal patients. Clinical significance: The study will focus on the importance of cortisol circadian rhythm on periodontal health allowing the microorganism to create an environment of dysbiosis.



Azadeh Abdollahi, Ezzatollah Jalalian

Effectiveness of Two Desensitizer Materials, Potassium Nitrate and Fluoride Varnish in Relieving Hypersensitivity After Crown Preparation

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:489 - 493]

Keywords: Fixed prosthodontics, Fluoride varnish, Hypersensitivity, Potassium nitrate, Vital tooth preparation

   DOI: 10.5005/jp-journals-10024-2544  |  Open Access |  How to cite  | 


Aim: The aim of this clinical investigation was to compare the efficacy of fluoride varnish and potassium nitrate on the reduction of hypersensitivity of prepared teeth both pre and post cementation. Materials and methods: In this randomized clinical trial, patients who needed at least three single crowns fixed partial prosthesis were included. Two desensitizing agents including fluoride varnish and potassium nitrate were used in this study and compared to the control group (sterile saline). In each patient, each prepared tooth was randomly assigned to one group. The desensitizing agent was applied on prepared teeth immediately after tooth preparation. The sensitivity of the teeth was measured by means of an air sensitivity test based on the visual analog scale at five different time points: baseline (2 hours after preparation), 7 days after preparation, before cementation, after cementation and one-week post cementation. Data were analyzed by Kruskal–Wallis and Friedman tests with a significant level of 0.05. Results: Overall 300 vital abutment teeth needed full crown coverage in 100 patients were included. Both desensitizers’ agents decreased the sensitivity of vital abutment teeth compared to the control group at every time intervals except at baseline (p = 0.089). There was no significant difference between fluoride varnish and potassium nitrate in the reduction of pre-cementation sensitivity while one week after cementation, sensitivity was more relieved by potassium nitrate compared to fluoride varnish (p = 0.023). Conclusion: The application of both desensitizers is effective in sensitivity reduction of vital abutment teeth. Potassium nitrate, however, is more eligible one week after cementation compared to fluoride varnish. Clinical significance: Both potassium nitrate and fluoride varnish are capable of desensitizing prepared tooth for the fixed partial denture.



Aparna Trivedi, Sajda K Gajdhar, Harshad Bhagwat, Gaurav K Khutwad, Prashant E Mall

Correlation of Blood Glucose Levels, Salivary Glucose Levels and Oral Colony Forming Units of Candida albicans in Type 2 Diabetes Mellitus Patients

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:494 - 498]

Keywords: Diabetics, Glucose oxidase kit, Oral candidal carriage, Salivary glucose, Sabouraud's dextrose agar

   DOI: 10.5005/jp-journals-10024-2545  |  Open Access |  How to cite  | 


Aim: The study aims to correlate salivary glucose, blood glucose levels and oral colony forming units of Candida albicans and to evaluate whether saliva can be used as noninvasive means to measure glycemic status in type II diabetics without the need for the invasive procedure. Materials and methods: The study included 100 type II diabetic patients (group I) of both genders with age 40 years and above and 100 healthy patients (group II), age and sex matched with the study group. Group I includes uncontrolled and controlled diabetics as groups IA and IB, respectively. Salivary glucose measurement was done using the enzymatic colorimetric method and blood glucose levels measured by doing venepuncture and centrifuged. The oral candidal carriage was calculated by incubation in Sabouraud's dextrose agar supplemented with chloramphenicol and incubated aerobically for 48 hours. To compare the mean values Z test was applied. To determine the relationship between two variables Pearson's correlation coefficient was used. Results: The salivary glucose levels showed a significant correlation with blood glucose levels. The salivary candida carriage was higher in uncontrolled as compared to controlled diabetics and healthy individuals. Conclusion: Positive correlation was obtained between salivary glucose and blood glucose in diabetics and candidal carriage has a positive correlation with blood glucose levels. This salivary glucose and blood glucose levels correlation confirms its use to find glycemic status in diabetic patients. Clinical significance: The positive correlation of salivary glucose with blood glucose shows that it can be utilized as a noninvasive tool for monitoring glycemic status in diabetic patients.



S Sriram Balaji

A Study to Determine the Accuracy of Various Clinical Techniques of Ridge Mapping before Implant Fixture Placement

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:499 - 503]

Keywords: Bone calliper, Bone width measurement, Dental implants, Ridge mapping

   DOI: 10.5005/jp-journals-10024-2546  |  Open Access |  How to cite  | 


Aim: The most important parameter to assess prior to implant fixture placement is the available bone width. Radiographic techniques have been found to be inadequate in providing this valuable information, unlike clinical techniques. The purpose of the present study was to determine the accuracy of various clinical techniques of ridge mapping before implant fixture placement. Materials and methods: Ten patients with at least two missing teeth adjacent to each other were selected for the study. Direct and indirect techniques of ridge mapping were carried out to assess the available bone width. Results: The data obtained were statistically analyzed using ANOVA and Tukey's Post Hoc analysis. The results indicate that there is no significant difference between direct and indirect technique of ridge mapping. Conclusion: Either direct or indirect technique of ridge mapping can be used to assess the width of available bone before implant fixture placement. Clinical significance: Clinical techniques of ridge mapping are handy and can be carried out chairside with ease and less cost and no radiation exposure. Indirect techniques of ridge mapping provide adequate and reliable data regarding bone width just like direct technique. In the absence of a bone mapping caliper, this technique can be used as a diagnostic procedure before implant placement. And during the indirect technique, any material can be utilized with equal efficacy for the fabrication of the guides.



Lanka Mahesh, Ashutosh Agarwal, Jose C Guirado, Praful Bali, Nitika Poonia

Survival of Implants after Indirect Maxillary Sinus Elevation Procedure: A Two Years Longitudinal Study

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:4] [Pages No:504 - 507]

Keywords: Bio-etch, Calcium phosphosilicate, Indirect maxillary sinus lift, Osseointegration, Osteotome

   DOI: 10.5005/jp-journals-10024-2547  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate the survival rate of two diverse implant systems with different implant surfaces with the same geometrical design. Materials and methods: One hundred fifty patients were included in the study in which 95 were males and 55 were females and 150 implants were placed using indirect sinus floor elevation technique and only one implant was placed in each subject and they were categorized into two groups of 100 in group A and 50 in group B as per two different implant systems. At review appointments, implants were tested clinically and radiographically and were examined for signs of infection. The patients were examined periodically after placement of the implants, and follow-up was conducted annually. Results: Results of the Chi-square analysis showed no significant association between the type of implant surface and rate of success or failure of the implant. There was no significant difference between the observed and expected frequency of successful implants in group A as well as group B, indicating that the surface type of implant had no significant association with the success of the implant in group A and B. Conclusion: To date, there is no consensus in the literature regarding the best surface and even on the macrotopography of the implants for better osseointegration. However, Surface treatments improve the result of osseointegration, especially in the early stages, benefiting bone affixation with qualitative and quantitative enhancements. In the present study, we achieved clinical success with both kinds of implant surfaces however Bioetched implant surface showed promising results comparable to Tiunite surface of Nobel BioCare Implants. In the future, more case-controlled studies with longer follow-up are needed to validate the results of the present findings.



Rohit K Menon, Mohammed MA Khan, Amol R Gadbail, Shailesh Gondivkar, Manpreet S Kakkar, Zeeshan H Ahmad

Prosthetic Rehabilitation of Microstomia Patients: A Systematic Review of Published Case Reports and Case Series

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:8] [Pages No:508 - 515]

Keywords: Dental implants, Microstomia, Rehabilitation, Scleroderma

   DOI: 10.5005/jp-journals-10024-2548  |  Open Access |  How to cite  | 


Statement of problem: Prosthetic techniques commonly employed for the rehabilitation of edentulous patients might not be adequate in the treatment of patients with microstomia. Purpose: The purpose of this paper is to systematically review all the prosthetic techniques that have been used in the oral rehabilitation of patients with microstomia. Materials and methods: Data sources, including PubMed, Google Scholar, SCOPUS and Web of Science, were searched for case reports and case series published through September 2017. Three investigators reviewed and verified the extracted data. Only case reports and case series on prosthetic rehabilitation in microstomia patients published in the English language were considered eligible. Results: A total of 212 records were identified from the database search. Forty duplicate records were removed. The remaining 172 articles were assessed for eligibility, and 139 articles were removed because they did not satisfy the inclusion criteria. A total of 34 cases (including 32 case reports and 1 case series) were finally included in the qualitative analysis. The review revealed the use of a modified impression technique with flexible and sectional trays to record impressions in patients with microstomia. Modified forms of oral prostheses ranging from sectional, flexible, collapsible and hinged dentures to implant-supported prosthesis were fabricated to overcome the limited mouth opening. The success of the prosthetic technique primarily depended on the extent of the microstomia and the nature of the cause of the microstomia. Conclusion: Even though the patient acceptance of the prosthetic techniques summarized in the systematic review were high, long-term success rates for each option could not be assessed because of the short follow-up time in most of the included case reports and series.



Elie Nasr, Elie Zebouni, Joseph Makzoume

All-ceramic Computer-aided Design and Computer-aided Manufacturing Restorations: Evolution of Structures and Criteria for Clinical Application

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:8] [Pages No:516 - 523]

Keywords: All-ceramic, Classification, Clinical indications, Computer-aided design and computer-aided manufacturing

   DOI: 10.5005/jp-journals-10024-2549  |  Open Access |  How to cite  | 


Background: At a time when esthetics is becoming increasingly important in society, the metal-ceramic system, although clinically reliable in the long term, no longer grants satisfaction in terms of mimicry and biocompatibility. Over the last two decades, the growth of computer-aided design and computer-aided manufacturing (CAD/CAM) systems has promoted the development of new all-ceramic materials. However, the abundance and diversity of the suggested materials involved in fixed prosthetic rehabilitation place the practitioner in a situation of conflict regarding the choice of selecting the type of restoration appropriate to the clinical situation presented to him/her. Aim: The aim of this article is to classify the different types of milled ceramics according to their microstructure, to review the clinical indications of each, and to indicate whether they should be cemented or bonded. Results: The diverse sorts of milled ceramics using the CAD/CAM procedures are classified into four categories according to their chemical nature. Therefore, the large constitutional and structural variety of the all-ceramic materials will define the esthetic and mechanical properties of each group. Conclusion: The all-ceramic CAD/CAM restorations are witnessing a well-deserved rise, knowing that none of those milled ceramics has a universal clinical application. Clinical significance: Given the abundance and diversity of the new machined ceramics materials, it is necessary to familiarize with their properties as well as with their mode of assembling to the dental structures to ensure the success and durability of the restoration.



Ilser Turkyilmaz, Sila C Isler, Ahu Uraz

A Technique for Restoring Severely Resorbed Edentulous Mandible with a Computer-aided Design and Computer-aided Manufacturing Surgical Guide and an Implant-supported Fixed Dental Prosthesis in Two Days

[Year:2019] [Month:April] [Volume:20] [Number:4] [Pages:5] [Pages No:524 - 528]

Keywords: Computer-aided design/computer-aided manufacturing, Cone beam computed tomography, Implant, Mandible, Surgical guide

   DOI: 10.5005/jp-journals-10024-2550  |  Open Access |  How to cite  | 


Aim: The aim of this report is to describe a technique, in which a severely resorbed edentulous mandible was restored with computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guide and an implant-supported fixed dental prosthesis in two days. Background: The quality of life of edentulous patients is generally restricted due to functional and psychosocial problems associated with complete dentures. These issues become worse over time due to ongoing bone resorption. Implant-supported prostheses have been utilized to overcome these problems. Case description: A 79-year-old patient with a severely resorbed edentulous maxilla and mandible presented to our clinic. After the cone beam computed tomography (CBCT) scans were performed, five implants were virtually placed via a 3-dimensional software. Then, a CAD/CAM surgical guide was fabricated with a stereolithographic method. Her mandible was restored with five implants by using the CAD/CAM surgical guide and the implant-supported prosthesis with CAD/CAM titanium framework in 2 days. Conclusion: The severely resorbed edentulous mandible was successfully restored with five dental implants, and the implant-supported fixed dental prosthesis via the CAD/CAM milled titanium framework. Clinical significance: The technique using software and hardware portrayed in this report may be a feasible option to restore similar patients if it is executed by trained restorative dentists adhering to strict guidelines.


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