The Journal of Contemporary Dental Practice

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2019 | July | Volume 20 | Issue 7

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A Holistic Intervention for Oral Lichen Planus

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:3] [Pages No:765 - 767]

   DOI: 10.5005/jp-journals-10024-2635  |  Open Access |  How to cite  | 



German O Ramirez-Yanez, James E Scott

Architecture of the Mandibular Condylar Cartilage of Elderly Individuals: A Semiquantitative Light Microscopic Histological Study

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:768 - 772]

Keywords: Endochondral ossification, Fibrocartilage, Hyaline cartilage, Mandibular condyle

   DOI: 10.5005/jp-journals-10024-2594  |  Open Access |  How to cite  | 


Aim: This study aimed to categorize the constituent tissues of the mandibular condylar cartilage of elderly individuals. Materials and methods: Thirty-three mandibular condyles were collected from 20 human cadavers of individuals between 40 years and 103 years old. Samples were stained with Masson's trichrome and Herovici's stains and, examined under a light microscope. Results: All samples showed tissues that were categorized as fibrous and hyaline cartilage in the mandibular condylar cartilage. A thick fibrous cartilage layer was differentiated on the top of a thinner hyaline cartilage in all of the examined samples. Undifferentiated cells, as well as mature and hypertrophic chondroblasts, were observed in the layer identified as hyaline cartilage, even though they were not in an organized manner. Conclusion: The observations from this study confirm that both fibrocartilage and hyaline cartilage are still present in the mandibular condylar cartilage of elderly individuals. Clinical significance: The results from this study infer that the mandibular condylar cartilage could be still able to respond to stimulus in adults. In that context, the results of the present study set the basis for future studies aiming to elucidate the biological activity and the remodeling potential of the tissues at the mandibular condyle in adults.



Prevalence of a Second Root and Canal in Mandibular and Maxillary Canines in a Saudi Arabian Population: A Cone-beam Computed Tomography Study

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:773 - 777]

Keywords: Canines, CBCT, Root canal morphology, Saudi population

   DOI: 10.5005/jp-journals-10024-2595  |  Open Access |  How to cite  | 


Aim: This study evaluated the prevalence of a second root and canal, gender differences, and bilateral symmetry of mandibular and maxillary permanent canines in a Saudi Arabian population using a cone-beam computed tomography (CBCT). Materials and methods: The first step was to evaluate CBCT images of 208 patients with 794 canines (410 mandibular and 384 maxillary canines). The second step was to identify the number of roots, number of canals, and canal configurations based on Vertucci's classification to investigate the prevalence of a second root and a second canal, gender differences, and bilateral symmetry. A Z test evaluated differences in the independent proportions; a Chi-square test determined differences between genders and Cohen's Kappa test assessed bilateral symmetry. Results: The prevalence of two roots and two canals in mandibular canines was 2.7% and 9.3%, respectively, and Vertucci's type III appeared in 6.1%, and Vertucci's type V appeared in 3.2%. In maxillary canines, there were no two-rooted teeth, and only 1% of two canals were present with Vertucci's type III. There were no statistically significant differences between genders in both mandibular and maxillary canines. High bilateral symmetries of roots and canals appeared in mandibular canines (95.5% and 91.1%, respectively) and maxillary canines (100% and 98.9%, respectively). Conclusion: One root, one canal, and Vertucci's type I are the primary and typical characteristics of mandibular and maxillary canines. The presence of a second root in mandibular canines is small, although the presence of two canals is not unusual. Conversely, it is rare to find a second root and canal in maxillary canines. Clinical significance: Mandibular canines showed bilateral asymmetry (8.9%) in the number of canals between the right and left sides, which could be of clinical importance when planning root canal treatment (RCT) on contralateral canines.



Sameer Punathil, Sultan A Almalki, Inderjit M Gowdar, Vijay Amarnath MC, Krishnarao Chinnari

Assessment of Microleakage Using Dye Penetration Method in Primary Teeth Restored with Tooth-colored Materials: An In Vitro Study

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:778 - 782]

Keywords: Class II cavity preparation, Microleakage, Primary molars, Thermocycling

   DOI: 10.5005/jp-journals-10024-2596  |  Open Access |  How to cite  | 


Aim: The present study aimed to assess the microleakage in primary teeth restored with tooth-colored materials using the dye penetration method. Materials and methods: A total of 60 healthy primary molar teeth were included in this study and standardized class II mesio-occlusal cavities were prepared on the samples. Consequently, these teeth were randomly divided into three experimental groups (n = 20 each group) such as group I: nano-filled resin-modified glass-ionomer, group II: nanocomposite resin, and group III: Cention N. After completing all the restorations, the restored teeth were subjected to 100 cycles of thermocycling. Next, all the surfaces of the tooth, except the restoration and a 1-mm zone adjacent to the restoration's margins, were covered with two coats of nail varnish. The coated teeth were then submerged in a 0.5% basic fuchsin dye solution. The teeth were then sectioned along the center of each restoration mesiodistally. Each part was visualized under a stereomicroscope at ×40 magnifications to assess microleakage. Results: Out of all the included restorative materials, the least microleakage was demonstrated by teeth restored by the nano-filled resin-modified glass-ionomer (RMGI) group (1.05 ± 0.21) followed by the Cention N group (1.84 ± 0.14) and the nanocomposite resin group (3.10 ± 0.03). A statistical method involving the analysis of variance revealed a statistically significant difference among the different restorative materials. Multiple comparisons among the restorative materials showed a statistically significant difference between groups I and II and groups II and III restorative materials (p < 0.05). The dye penetration score 1 was more [11(55%)] for the nano-filled RMGI group, score 3 was more [12(60%)] for the nanocomposite resin group, and score 2 was more [9(45%)] for the Cention N group. Conclusion: The present study showed significantly less microleakage associated with the nano-filled resin-modified glass ionomer group than nanocomposite resin and Cention N groups. Clinical significance: Since many years, dentists have encountered a challenging problem with cervical lesions. Thus, an interdisciplinary treatment approach is the appropriate option in the management of carious teeth that involve gingival recession and cervical extension.



Amal I Linjawi, Amatulrehman M Bahaziq, Alaa H Qari, Ali H Hassan

Impact of Dental Visits on Oral Health Awareness in Saudi Arabia

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:783 - 788]

Keywords: Dental care, Dental visits, Oral health knowledge

   DOI: 10.5005/jp-journals-10024-2597  |  Open Access |  How to cite  | 


Aim: The aim of this study is to assess the impact of dental visits on oral health awareness among the Saudi population. Materials and methods: A cross-sectional survey was conducted in Saudi Arabia. An online self-administered questionnaire was distributed from January 2011 to June 2013. The questionnaire consisted of 21 multiple choice questions which was categorized into four: demographic data, dental care status, oral hygiene behavior, and oral health knowledge (OHK). Responses to the questions in the OHK category were grouped and scored according to their percentage of correct answers: 1 = very poor (0 to <25% correct), 2 = poor (25% to <50% correct), 3 = acceptable (50 to <75% correct), and 4 = good (75–100% correct). The sample was divided based on dental visit behavior into poor, average, and good dental visitors. Descriptive statistics, group comparisons, correlations, and linear regressions were conducted using SPSS (V16.0). A significance was set at p < 0.05. Results: A total of 845 participants were included: 73.4% were females, 85.1% were older than 19 years, 76.9% had a college-level education, and 75.3% were from western Saudi Arabia. A total of 14.1% were poor dental visitors, 67.5% were average dental visitors, and 18.5% were good dental visitors. The good dental visitor group showed significantly better results than the other two groups in terms of dental services received, brushing habits, interdental cleansing habits, use of miswak, and OHK (p < 0.05). The best predictors with significant but weak effects on dental visit habits were brushing habits, interdental cleansing habits, use of miswak, and OHK (F(8,836) = 7.212, R2 = 0.065, p < 0.0001). Conclusion: Dental visits were significantly correlated with OHK. However, the impact of dental visits on oral health awareness was found to be weak. Clinical significance: Well-designed preventive and educational dental visit programs need to be widely implemented as part of the governmental oral health plans.



Narmin M Helal, Osama A Basri

Significance of Cephalometric Radiograph in Orthodontic Treatment Plan Decision

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:789 - 793]

Keywords: Extraction, Lateral cephalograms, Orthodontics, Radiation exposure

   DOI: 10.5005/jp-journals-10024-2598  |  Open Access |  How to cite  | 


Aim: The lateral cephalometric radiograph is a standard component of clinical records taken for orthodontic diagnosis and treatment planning. The present study was conducted to assess the utility of cephalometric radiography and analysis in modern orthodontic diagnosis and treatment planning. Materials and methods: A research survey was conducted at Jacksonville University School of Orthodontics. Thirty-one residents and faculty were the participants. The survey sample was collected from the university patients’ pool. A survey was given to participants at two time points. At the first time point (T1), the participants were given full records without lateral cephalogram. At the second time point (T2), they were given full records with lateral cephalogram. Two measures were analyzed: (1) a change in orthodontic treatment decision and (2) a change in the orthodontic treatment plan. A traditional McNemar's test was used on paired binary data. We used the conditional logistic regression model with robust variance at a participant level to adjust for a participant-level clustering effect to test the difference in treatment decision before and after. A statistical significance was determined at p = 0.05. Results: It was found that 93.6% of the treatment decisions and 70% of the extraction decisions were consistent after the introduction of lateral cephalograms. There was no statistically significant association observed between two outcome measures and the use of cephalograms (p = 0.80). Conclusion: Sufficient evidence does not exist to warrant lateral cephalometric radiographs be taken as a part of standard diagnostic records on every individual seeking orthodontic treatment. Clinical significance: Evidenced-based selection criteria for prescribing lateral cephalometric radiographs should be developed to reduce the amount of radiation exposure to the general public.



Shikha Joshi, Sandeep Kumar, Shashikala Jain, Rajnish Aggarwal, Sunita Choudhary, Nandalur K Reddy

3D Finite Element Analysis to Assess the Stress Distribution Pattern in Mandibular Implant-supported Overdenture with Different Bar Heights

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:7] [Pages No:794 - 800]

Keywords: Bar heights, Dental implants, Finite element analysis, Overdenture, Stress analysis

   DOI: 10.5005/jp-journals-10024-2599  |  Open Access |  How to cite  | 


Aim: Proper stress distribution on dental implants is necessary in bar-retained implant overlay dentures. The purpose of the study is to comparatively assess the stress distribution pattern on the crestal bone at the bone–implant interface due to different bar heights using finite element models (FEMs). Materials and methods: Eight 3D FEMs were developed from mandibular overdentures with two implants in the canine region separated by a distance of 20 mm. In these models, four different bar heights from the mucosa (0.5, 1, 1.5, and 2 mm) with 12 mm occlusal plane height were analyzed. A unilateral and a bilateral vertical load of 150 N were applied to the central occlusal fossa of the first molar and the stress of bone around the implant was analyzed by finite element analysis (FEA). Results: By increasing the bar height, the maximum stress values around implants on the crestal bone were found to be increased in unilateral and bilateral loading models. In unilateral loading models, the maximum stress was found in a model with a 2 mm bar height (0.46 MPa) on the distal side of the ipsilateral implant, and in bilateral loading cases, the maximum stress was also found in a model with a 2 mm bar height (0.456 MPa). Conclusion: As the vertical cantilever increases (here the bar height), the maximum stress on the crestal bone increases. A minimum of 0.5 mm of space is sufficient between the mucosa and the inferior border of the bar to maintain oral hygiene. Clinical significance: From the present study, it can be concluded that an increase in bar height causes an increase in stress levels on the peri-implant crestal bone.



Faisal A Aljohani, Fahad S Alkhuwayr, Ammar A Siddiqui

Measurement of Parents’ Knowledge toward Oral Health of their Children: An Observational Study from Hail, Saudi Arabia

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:801 - 805]

Keywords: Attitude, Children, Knowledge, Oral health, Oral hygiene, Parents

   DOI: 10.5005/jp-journals-10024-2600  |  Open Access |  How to cite  | 


Aim: Parents’ knowledge of oral health maintenance is of crucial importance. Children are dependent on their parents for the maintenance of their oral health. Hence, the present study is aimed to measure parents’ knowledge toward the oral health of their children. Materials and methods: It was an observational study, having a cross-sectional design in which information from 223 participants were collected after obtaining written consent using a convenient sampling technique. Data obtained from the questionnaire were coded and analyzed using the Statistical Package for the Social Sciences (SPSS Version 20). Descriptive and inferential statistics were used. Data were displayed as number and percentage, and the Chi-square test was used to measure association. Ethical approval was obtained from the ethical approval committee of the University of Hail. Results: The total numbers of parents included in the study were 223, out of which, 91 (40.8%) were males and 132 (59.1%) were females. Around 58.3% of the respondents believed that they would go for a dental visit when the child had dental pain. A majority of the participants (60%) believed that concerns with primary dentition would lead to permanent dentition in the future. Almost 97% of parents knew that sugar and sticky food had a bad effect on oral health. Nearly 50% of parents reported correctly that prolonged bottle-feeding had a negative effect on their children's oral health. Conclusion: Most parents had satisfactory knowledge about the maintenance of oral hygiene of their children for most of the questions. However, the overall result of this study indicates that parents’ information and approach toward oral hygiene and dental care need to be improved. Clinical significance: Parents’ knowledge and positive attitude are central to children's oral health. The present study measured and recommends the need for oral health education and promotion for the parents.



Mônica S de Albuquerque, Armiliana S Nascimento, Ivan O Gialain, Eliane A de Lima, Jeysiellen AF Nery, Poliana R de Souza Araujo, Rebeca F de Menezes, Augusto S Kato, Rodivan Braz

Canal Transportation, Centering Ability, and Dentin Removal after Instrumentation: A Micro-CT Evaluation

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:806 - 811]

Keywords: Centering ability, Root canal treatment, Rotary instrumentation, Transportation

   DOI: 10.5005/jp-journals-10024-2601  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate and compare root canal transportation, centering ability, and amount of dentin removed after root instrumentation with different rotary and reciprocating systems, using micro-computed tomography (micro-CT). Materials and methods: Forty curved mesial canals of lower molars were selected and divided into four experimental groups (n = 10) according to the system used: protaper next (PTN), wave one gold (WOG), prodesign logic (LOG), and vortex blue (VTX). The roots were scanned before and after instrumentation using micro-CT, with a 16 μm isotropic resolution. Results: Data were statistically analyzed using the Bioestat and the significance level was set at 0.05. For canal transportation, no significant differences were verified between the groups at 6 mm or 9 mm from the apex. At the apical third, LOG had a smaller mesial deviation when compared with PTN. A significant difference was found at the apical and coronal thirds, though with LOG having the best centering ability at the apical third and the worst one at the coronal third. All systems caused a greater wear at the coronal third (9 mm), decreasing at the apical one (3 mm), with statistically significant differences. LOG removed less dentin from the apical third (3 mm) than did the other instruments. Conclusion: The systems evaluated presented different results for canal transportation, centering ability, and dentin removal at each third. Clinical significance: The systems were evaluated together to evaluate neither the marked dental deviations nor the long-term signifiers of the databases and they were evaluated within the limits of normality. Therefore, they can be used without risks of embrittlement of the dental roots.



Madhumitha Mohanraj, Rathna Prabhu, Eapen Thomas

Comparative Evaluation of Hydrophobic and Hydrophilic Resin-based Sealants: A Clinical Study

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:812 - 817]

Keywords: Caries evidence, Pit and fissure sealants, Retention

   DOI: 10.5005/jp-journals-10024-2602  |  Open Access |  How to cite  | 


Aim: The purpose of this study is to clinically evaluate and compare the retention and evidence of caries of three fissure sealants. Materials and methods: A total of 150 children, between 7 and 13 years of age, with fully erupted permanent molars, had sealants placed using a full-mouth design. Sealant retention was evaluated at 1, 3, 6, 9, and 12 months later. Teeth were evaluated for retention and evidence of caries using Simonsen's criteria and results were subjected to statistical analysis using the Chi-square test. Results: At 1-year examination, in teeth sealed with Clinpro: (a) 8% were completely retained, (b) 74.4% were partially lost, and (c) 8.5% were completely lost; with Embrace Wetbond: (a) none of the sealants were completely retained, (b) 13.1% were partially lost, and (c) 59.1% were completely lost; with Champ: (a) 1% were completely retained, (b) 71.4% were partially lost, and (c) 10.9% were completely lost. All the three sealants showed evidence of caries from 9 months. Conclusion: The retention of hydrophobic (Clinpro) sealant was superior to hydrophilic (Embrace Wetbond and Champ) sealants. The evidence of caries was less in the hydrophobic sealant group when compared with the hydrophilic sealant groups. There was no statistical difference in retention and evidence of caries between maxillary and mandibular teeth for all the three sealant groups. Clinical significance: Sealants prevent the occurrence of caries in the majority of children. Though hydrophobic sealants appear to be more successful, hydrophilic sealants too may provide promising results in the near future.



Arshad Hasan, Javeria A Khan, Muhamamd Taqi, Farah Naz, Saman Waqar, Noorulain Mehak, Haris Mehmood

Predictors for Proximal Caries in Permanent First Molars: A Multiple Regression Analysis

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:4] [Pages No:818 - 821]

Keywords: Caries risk, Dental Caries, Permanent first molar, Predictor, Proximal surface, Regression analysis

   DOI: 10.5005/jp-journals-10024-2603  |  Open Access |  How to cite  | 


Aim: The aim of this study was to determine the predictors of proximal decay in the permanent first molar. Materials and methods: A cross-sectional study was conducted at the Department of Oral Medicine, Dow Dental College, Dow University of Health Sciences. A total of 171 patients presenting with 227 first molars were included. Calibrated examiners performed a detailed history and examination using a specialized form. The form recorded caries predictors and assigned a caries risk category based on the presence of these predictors. The statistical analysis was performed using the SPSS for windows version 17. A descriptive analysis was used to calculate the mean and proportions. Backward regression was carried out to evaluate the predictor for caries on mesial and distal surfaces at p ≤ 0.05. Results: The included 171 patients presented with a total of 227 decayed first molars and 412 decayed proximal surfaces. The mesial surface was found to be more affected by decay (0.92 ± 0.85). The caries risk profile explains 60%, and caries on the adjacent surface explains 90% of caries occurrence on the mesial surface. In the case of distal surfaces, the predictor which can cause caries significantly was caries risk only. The caries risk profile explains the 3% of caries occurrence on distal surfaces. Conclusion: Our study identified caries on the adjacent tooth surface and the caries risk profile as significant predictors of future caries risk for the mesial surface of permanent molars. Clinical significance: Predictors for mesial and distal surfaces of the permanent first molar may differ. Overall caries risk and status of adjacent teeth must be taken into account to predict future caries occurrence.



Mohammed K Fahmi, Amal A Ashour, Vipin Arora

Effect of Multilayering Incremental Technique on the Microleakage of High-viscosity Bulk-fill Composite Restorations in Endodontically Treated Teeth

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:822 - 827]

Keywords: Bulk-fill composite restorations, Incremental, Technique, Microleakage

   DOI: 10.5005/jp-journals-10024-2604  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the effect of multilayering incremental technique on the microleakage of high-viscosity bulk-fill composite restorations in endodontically treated teeth. Materials and methods: A total of 60 human mandibular premolar teeth were divided into four groups after standardized access preparation with a protaper technique followed by single-cone obturation to receive the following restorations for the access preparations. Group I (n = 20): bulk-fill composite (Filtek™ Bulk fill) using a bulk technique, group II (n = 20): bulk-fill composite (Filtek™ Bulk fill) using an incremental layering technique, group III (negative control) (n = 10): gutta-percha was kept intact at the access orifice and covered with a nail polish, and group IV (positive control) (n = 10): gutta-percha was kept intact at the orifice. The samples were thermocycled at 5°C and 55°C for 500 cycles followed by dye penetration with 2% methylene blue and then the scoring was done under a stereomicroscope at 10× magnification. The data so obtained were compared for microleakage using a Chi-square test. There was a significant difference among all the groups except groups II and III. Results: Bulk-fill composites used with an incremental layering technique sealed significantly better than the other groups followed by bulk-fill composite in the bulk technique. Conclusion: Within the limitations of the present study, it can be concluded that the incremental layering technique with bulk-fill composites significantly decreases microleakage in the restored access preparations of endodontically treated teeth.



Fereshteh Shafiei, Zahra Jowkar, Neda Hosseini

Influence of Cavity Pretreatments on the Fracture Resistance of Premolars with Self-adhesive Cemented Composite Inlay

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:828 - 833]

Keywords: Acid-etching, Fracture resistance, Inlay, Self-adhesive cement, Universal adhesive

   DOI: 10.5005/jp-journals-10024-2605  |  Open Access |  How to cite  | 


Aim: The aim of this study is to investigate whether different cavity pretreatment approaches affect the strength of premolars restored with self-adhesive (SA) resin cemented-composite resin inlays after mechanical and water aging. Materials and methods: A total of 120 intact maxillary premolars were divided into 10 groups (n = 12). Mesio-occluso-distal (MOD) cavities were prepared in the teeth of nine groups, except group I in which the teeth remained intact. In group II, cavities were unrestored. Following fabrication of composite resin inlays for groups III–X, in group III, the inlays were cemented using the etch-and-rinse (E and R) adhesive/conventional resin cement. In other groups, cementation was performed using a SA cement with or without cavity pretreatments as follows: group IV: SA cement alone, group V: acid etching of enamel and dentin, group VI: acid etching of enamel, group VII: universal adhesive in the selective enamel-etching mode, group VIII: universal adhesive in the E and R mode, group IX: ethylenediaminetetraacetic acid (EDTA) conditioning, and group X: 20% polyacrylic acid conditioning. After aging processes, static fracture resistance was tested. Data were analyzed using one-way ANOVA and Dunn tests (α = 0.05). Results: Fracture resistance of the 10 groups yielded a significant difference (p < 0.001). The median fracture resistances in Newton were the following: Gr I = 1025A, Gr II = 311BC, Gr III = 785A, Gr IV = 500B, Gr V = 435B, Gr VI = 775A, Gr VII = 805A, Gr VIII = 411BC, Gr IX = 397BC, and Gr X = 312C. Conclusion: Unlike the conventional method, SA cementation could not restore the strength of inlay-cemented premolars. Selective enamel acid etching with or without universal adhesive significantly increased the fracture resistance. Clinical significance: Selective enamel acid etching is recommended for increasing the fracture resistance of the SA cemented composite inlay to the level of intact teeth.



Gaikwad Rahul N

Quantifying OHIP in the Context with Oral Health Literacy in Rural and Urban Population

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:4] [Pages No:834 - 837]

Keywords: Dental health literacy, OHIP, Oral health literacy, REALD-30

   DOI: 10.5005/jp-journals-10024-2606  |  Open Access |  How to cite  | 


Aim: The present study was undertaken to assess the knowledge and awareness of oral health literacy among rural and urban people and to correlate it with the oral health-related quality of life (OHRQoL). Materials and methods: The present study was conducted among the rural and urban population visiting the outpatient department. The study questionnaire was used to assess oral health literacy and these questions were framed based on the various aspects like general demographics, dental visit, and dentition status. A validated questionnaire to record the oral health impact profile (OHIP) was used to assess the quality of life. Further, the rapid estimate of adult literacy in dentistry-30 (REALD-30), the word recognition test, was used to assess oral health literacy. Results: Out of 1,000 participants, 500 were from the urban population and 500 from a rural area. The mean age of participants in the rural and urban population was 32.22 ± 10.66 and 30.43 ± 10.3, respectively. The mean score of OHIP in rural and urban participants was found to be 6.46 ± 6.815 and 6.34 ± 8.492, respectively. The mean score of REALD-30 in rural and urban participants was found to be 12.88 ± 7.214 and 20.9 ± 7.334, respectively. Conclusion: Results suggest that dental health literacy have an independent effect on dental health outcomes.



Patrícia de Almeida Rodrigues, Raquel de Souza Franco Nassar, Taiane S da Silva, Victor F Pedrinha, Larissa D Alexandrino

Effects of Different NaOCl Concentrations Followed by 17% EDTA on Dentin Permeability

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:4] [Pages No:838 - 841]

Keywords: Dentin permeability, Root canal irrigants, Sodium hypochlorite

   DOI: 10.5005/jp-journals-10024-2607  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the permeability of root dentin after immersion in sodium hypochlorite (NaOCl) at different concentrations for 30 minutes and a final wash with 17% ethylenediaminetetraacetic acid (EDTA) for 3 minutes. Materials and methods: Twenty 1 × 5 mm dentin fragments from the middle third of the root were prepared from 10 bovine teeth and divided into four groups; three of these groups were immersed in 1%, 2.5%, or 5.25% NaOCl for 30 minutes, while group IV was immersed in the saline solution. All dentin fragments were subjected to a final wash with 17% EDTA for 3 minutes. The fluid transport study model was used to measure the fluid conductance induced by hydrostatic pressure. The measurements were repeated twice to confirm the values, and in the case of a discrepancy, the procedure was performed again. Results: The control group (saline solution) presented lower hydraulic conductance mean values with (0.25 ± 0.12). The 5.25% NaOCl followed by 17% EDTA produced the highest mean conductance value (1.18 ± 0.18) followed by 2.5% NaOCl and 17% EDTA with (0.81 ± 0.09) and (0.48 ± 0.02), respectively. The results of the hydraulic conductance evaluation of dentin were different for each NaOCl concentration. After data analyses, there were significant differences from analysis of variance (ANOVA) between all the groups (p < 0.0001). Conclusion: The NaOCl solution concentration affects dentin permeability.



K Vijay Raghava, Kalyani P Sistla, Sarita J Narayan, Umesh Yadalam, Aditi Bose, Kiran Mitra

Efficacy of Curcumin as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients: A Randomized Controlled Clinical Trial

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:842 - 846]

Keywords: Curcumin, Local drug delivery, Periodontitis, Scaling and root planing

   DOI: 10.5005/jp-journals-10024-2608  |  Open Access |  How to cite  | 


Aim: The aim of the present study is to evaluate the efficacy of curcumin gel as local drug delivery post-scaling and root planing and its effect on clinical parameters like plaque, gingival scores, pocket depth, and clinical attachment level (CAL). Materials and methods: Ten patients with two sites in the contralateral quadrants having probing pocket depths (PPDs) of ≥5 mm were selected. Full-mouth scaling and root planing (SRP) was performed followed by the application of curcumin gel on a single side. Assessment of plaque index (PI), gingival index (GI), PPD, and CALs were done at the baseline and at the 4th week. Results: The results revealed that there was a statistically significant reduction in PI and probing depth in the test group when compared with the control group. CAL was improved but the results were not statically significant. Conclusion: The local application of curcumin gel when used in conjunction with SRP showed a significant improvement in periodontal parameters and has a beneficial effect in patients with chronic periodontitis. Clinical significance: Curcumin gel as an adjunct to SRP showed a marked improvement in restoring gingival health by an improvement in clinical parameters. It has proven properties like anti-inflammatory, antioxidant, antimicrobial, hepatoprotective, immunostimulant, antiseptic, antimutagenic, and it also accelerates wound healing. It may be a more acceptable and viable option for the common man. Curcumin can be used as an effective alternative local drug delivery agent.



Amar Sholapurkar, Maxim Philip Milosevic, Varun R Mallela, Keerthilatha M Pai

Solitary Large Intraoral Neurilemmoma of the Maxillary Vestibule: A Rare Case with Brief Literature Review

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:4] [Pages No:847 - 850]

Keywords: Antoni types A and B tissues, Buccal vestibule, Neurilemmoma, Schwannoma

   DOI: 10.5005/jp-journals-10024-2609  |  Open Access |  How to cite  | 


Aim: This current report aimed at presenting a rare case of a large solitary intraoral neurilemmoma of the buccal vestibule followed by a brief review of literature of neurilemmoma published between 1997 and 2017. Background: The diagnosis of slow-growing intraoral lesions requires a thorough patient history and clinical examination. Despite the best efforts of even the most experienced oral medicine expert, a definitive diagnosis may sometimes only be reached through excisional biopsy and histopathological evaluation. Case description: To the best of our knowledge, there have been only two cases of neurilemmoma of the buccal vestibule reported in the literature till date and, looking at the size of the lesion, our case is the largest among the ones reported. Conclusion: In the present case, a rare presentation of solitary buccal vestibular neurilemmoma establishes the need for the consideration of a wide range of pathologies in the differential diagnosis. Clinical significance: Clinicians should include neurilemmoma in their differential diagnosis for asymptomatic, slow-growing intraoral growths and ensure complete excision to prevent tumor recurrence. The reader should be able to recognize the clinical features of neurilemmoma and describe the histopathological features and management of the condition.



Violeta Malpartida-Carrillo, Pedro L Tinedo-Lôpez, Fernando Ortiz-Culca, Alejandro Cornejo-García, Maria E Guerrero, Silvia P Amaya-Pajares

Implant Rehabilitation Partial Maxillary Edentulism with Onlay Autogenous Chin Bone Grafting and Prosthetic Gingival Restoration: A Case Report

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:851 - 856]

Keywords: Alveolar bone grafting, Alveolar bone loss, Bone regeneration, Dental implants

   DOI: 10.5005/jp-journals-10024-2610  |  Open Access |  How to cite  | 


Background: Atrophic anterior maxilla rehabilitation can be a challenging procedure due to multiple factors that influence clinical decision making. After a prolonged loss of teeth, the residual bone often impedes the use of standard implant placement protocols and additional procedures are needed. Aim: The aim of this study is to describe the multidisciplinary approach for the diagnosis and treatment of a 50-year-old woman with prolonged use of a removable maxillary partial denture. Case Description: This article presents a full-mouth-phased rehabilitation of an atrophic anterior maxilla with three surgical stages. First, onlay autogenous chin bone grafting was used to return the lost tissue. After the consolidation, dental implants were placed in a second stage. A few months later, a connective tissue graft was used to improve the keratinized mucosa width. In the mentioned stages, leukocyte- and platelet-rich fibrin (L-PRF) was used to improve healing and promote tissue regeneration. Finally, prosthetic gingival restoration was used in the anterior region as an alternative to overcome the limitations of hard- and soft-tissue grafting. Conclusion: The use of autogenous grafts obtained from the chin in combination with xenograft and then covered with an absorbable collagen membrane represents a predictable procedure for the rehabilitation of the long-term partial maxillary edentulism. Prosthetic gingival restoration is an alternative technique to overcome the limitations of hard- and soft-tissue grafting. Clinical significance: The treatment of a patient with high and width alveolar bone loss needs a multidisciplinary approach. Autogenous grafts obtained from the chin in combination with xenograft and then covered with an absorbable collagen membrane represent an effective procedure. Also, prosthetic gingival restoration can be used as an alternative technique to overcome the limitations of hard- and soft-tissue grafting.



Orthodontic Retainers: A Contemporary Overview

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:857 - 862]

Keywords: Orthodontic retainers, Relapse, Removable retainers, Retention, Vacuum formed retainers

   DOI: 10.5005/jp-journals-10024-2611  |  Open Access |  How to cite  | 


Aim: The aim of this article is to provide an insight into the various modalities of retention and types of appliance used in achieving this objective. Background: Maintaining the orthodontically treated teeth in their corrected position is a challenging and ominous task since the inception of this specialty. Orthodontic retainers play a pivotal role in preventing posttreatment tooth movement, thereby maintaining the esthetic, function, and stability of the stomatognathic system. Results: An extensive study of literature suggests that there are significant variations in the results describing the effectiveness, cost factors, survival times, oral hygiene status, and regimen of various orthodontic retention appliances. In terms of patient's satisfaction and speech articulation, vacuum-formed retainers (VFRs) are better than Hawley retainers. Occlusal contacts are better achieved with Hawley retainers than VFRs. Conclusion: Currently, there is insufficient high-quality evidence in favor of a particular retention appliance/regime or protocol. There is a need for further evidence-based high-quality studies/randomize controlled trial studies (RCTs) to evaluate different orthodontic retention appliances and regime after the orthodontic treatment. Clinical significance: Irrespective of the appliance, the patients should be prepared for a long-term or indefinite retention phase following orthodontic treatment to prevent relapse.



Amol R Gadbail, Shailesh Gondivkar

Histomorphological Evidence of Cellular Cannibalism in Ameloblastoma

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:4] [Pages No:863 - 866]

Keywords: Ameloblastoma, CD68, Cellular cannibalism, Lysozyme

   DOI: 10.5005/jp-journals-10024-2612  |  Open Access |  How to cite  | 


Aim: To study the cellular cannibalism (CC) in the tumor cells of ameloblastoma. Materials and methods: Hematoxylin and eosin (HE)-stained sections of ameloblastoma cases (50) were retrieved from the archived specimens and screened for cellular cannibalism (CC) by stellate reticulum-like cells. Further characterization of CC was performed using CD68 and lysozyme antibodies. Results: CC was observed in 15 (30%) cases [follicular 10 (66.66%), unicystic 3 (20%), and acanthomatous 2 (13.33%)]. In acanthomatous ameloblastoma, the CC was observed in the central metaplastic squamous cells, while in 3 cases of unicystic ameloblastoma, CC was seen in stellate reticulum-like cells of intraluminal (2) and mural proliferations (1). All the 15 cases of ameloblastoma showed a negative expression of CD68 as well as lysozyme. Conclusion: CC is a new addition to the pathogenesis of ameloblastoma.



Zuhair S Natto, Ahmad Aljehani, Anfal Sarhan, Elaf Nawawi, Hanan Abdullatef, Lina Samarkandi, Maryam Nasser, Rawan Badri, Rufaida Quqandi, Sara Waheeb, Sarah Aljahdali, Yasser Merdad

A Descriptive Analysis of Clinical Articles Published in the Last 50 Years in the Dental Literature

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:6] [Pages No:867 - 872]

Keywords: Case controls, Case reports, Clinical trials, Cohort designs, Cross-sectional studies, Dental, Randomized clinical trials, RCTs, Type of articles

   DOI: 10.5005/jp-journals-10024-2613  |  Open Access |  How to cite  | 


Aims: This article describes the methodologies used in the dental literature and described how these approaches have changed over time. Materials and methods: Thirty-three ISI peer-reviewed journals were included in the analyses. Data were extracted independently by 11 investigators and in duplicate. Any differences in the results were resolved via discussion or by a third reviewer when necessary. Data were collected regarding the methodology used in the article, and dental specialty related to different study designs. In the case in which more than one study design or specialty was reported, reviewers were trained to identify the main methodology/specialty. Results: The majority (36.96%) used a case report (CR) as the primary methodology, followed by a clinical trial (CT) (18.21%) or randomized CT (15.11%). The least used methodologies included a cohort (COH) study (6.07%) or a systematic review (SA)/meta-analysis (MA) (6.73%). Periodontology published the highest number of case controls (CCs) (46.8%), randomized CTs (RCTs) (29.9%), cross-sectional (CS) studies (26.0%), SRs/MAs (19.8%), and CTs (17.1%). Oral and maxillofacial surgery published the highest number of CRs/case series (54.5%) and COH studies (30.5%), whereas operative dentistry published the lowest number of CRs/case series (0.7%), CCs (2.9%), and SRs/MAs (2.3%). CRs/case series retain the highest number of publications across all time points in the dental literature overall. Conclusion: Our results indicate an improvement in the types of research and the pyramid of evidence, which will help in applying evidence-based dentistry (EBD) in clinical decision-making. Clinical significance: Types of studies used in the dental field are not yet investigated. Thus, little is known about the common study design types in dental literature. This can affect the decision made regarding technique, risk factors, prevention, or treatment.



Hamid Jafarzadeh, Farzaneh Iusefipour, Mohammad-Ebrahim Zirouhi, Jun-Ichiro Kinoshita, Atsufumi Manabe, Mikihiro Kobayashi, Amir Azarpazhooh

A Consolidated Pulp Test System Including Flowmetry, Pulse Oximetry, and Thermometry

[Year:2019] [Month:July] [Volume:20] [Number:7] [Pages:5] [Pages No:873 - 877]

Keywords: Endodontics, Flowmetry, Pulp test, Pulp vitality, Pulse oximetry, Thermometry

   DOI: 10.5005/jp-journals-10024-2614  |  Open Access |  How to cite  | 


Aim: The aim of this study is to report manufacturing a consolidated pulp test system that includes thermometry, flowmetry, and pulse oximetry. Background: The ideal method for the evaluation of pulp vitality should be objective, noninvasive, easy to use, reliable, and painless. Currently, the most commonly used tests (such as electricity, heat, and cold tests) depend on patients’ sensibility and are highly subjective. They only measure a neural response and do not indicate the actual biologic status of the pulp. It has, therefore, been suggested that vitality tests such as flowmetry, pulse oximetry, thermometry, and photoplethysmography be used. Some research has been done on these systems; however, their high costs and space need to maintain all of them that have been obstacles to their use. Technique: This report describes designing and manufacturing a novel system for evaluating pulp vitality involving the use of three methods (flowmetry, pulse oximetry, and thermometry) combined in a single small system using only two probes. Conclusion: The consolidated pulp tests system may be accurate in determining the pulp vitality. However, after clinical use, some changes may be necessary for improvement of the system.


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