The Journal of Contemporary Dental Practice

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2019 | August | Volume 20 | Issue 8

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Amol R Gadbail, Shailesh Gondivkar

A Critical Appraisal on the “Level-of-evidence” Classification Systems

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:1] [Pages No:879 - 879]

   DOI: 10.5005/jp-journals-10024-2674  |  Open Access |  How to cite  | 



Natália C Gutierrez, Sabrina E Moecke, Taciana MF Caneppele, Letícia CCC Perote, Graziela R Batista, Maria FRL Huhtalla, Carlos RG Torres

Bond Strength of Composite Resin Restoration Repair: Influence of Silane and Adhesive Systems

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:7] [Pages No:880 - 886]

Keywords: Adhesive system, Composite resin repair, Laboratory research, Tensile bond strength

   DOI: 10.5005/jp-journals-10024-2632  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the effect of silane (Si) application and different adhesive systems on the bond strength of composite resin repair. Materials and methods: One hundred composite truncated cone-shaped specimens were prepared and submitted to 5,000 thermal cycles to simulate existing restorations. Their top surfaces were airborne particle abraded with aluminum oxide, etched with phosphoric acid, and divided into two groups (n = 50) with or without Si application. Each group was divided into five subgroups (n = 10) according to the adhesive system applied: Solobond Plus Primer and Adhesive (SPA)—two-bottle, Solobond Plus adhesive (SA), Admira Bond (A)—one bottle, Futurabond DC (FDC)—self-etch, and Futurabond M (FM)—self-etch. New composite resin was applied over the bonded area. A control group was prepared to evaluate the cohesive strength of the composite resin. Specimens were submitted to tensile stress. Data were analyzed with two-way analysis of variance (ANOVA), and the Tukey and Dunnett tests. Results: Si application reduced the bond strength of all adhesives (p = 0.001). Groups SA and SPA showed higher bond strengths in relation to other groups (p = 0.01). Groups FDC + Si, FM, FM + Si, and A + Si showed smaller mean bond strength values than that of the control group (p < 0.05). Conclusion: Previous Si application reduced bond strength values. The two-bottle adhesive showed better results than one-bottle or self-etching systems for composite resin repairs. Clinical significance: The kind of adhesive system applied for composite resin repairs has a great influence on bond strength values. The use of Si in this situation is not recommended.



Pankaj Shelke, Ghevaram Prajapati

Expression of Yes-associated Protein in Oral Squamous Cell Carcinoma

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:6] [Pages No:887 - 892]

Keywords: Oral cancer, Oral squamous cell carcinoma, Prognostic marker, Yes-associated protein

   DOI: 10.5005/jp-journals-10024-2633  |  Open Access |  How to cite  | 


Aim: Though the exact mechanism of yes-associated protein (YAP) in tumorigenesis is not well understood, studies have shown that YAP plays an imperative role in cancer advancement via the Hippo signaling pathway. The purpose of the present study was to appraise the clinicopathological correlation of YAP expression in various grades and stages along with different parameters like tumor size and nodal metastasis in oral squamous cell carcinoma (OSCC). Materials and methods: Twenty-seven surgically excised specimens from patients with OSCC were selected for the study. Grading of the OSCC specimens was done according to Broder's grading system and staging had been done using tumor-node-metastasis (TNM) system by American Joint Committee on Cancer (AJCC). Comparative analysis of YAP expression and various aforementioned parameters of OSCC was performed and statistically analyzed. Results: Differences in the expression of YAP was observed among well differentiated and moderately differentiated OSCC, with increased YAP expression with successive grades but was statistically insignificant. On evaluating YAP expression among various stages of OSCC, we observed that stages I, II, and IV demonstrated a weak expression of YAP, while stage III showed a strong expression but the differences were insignificant. Insignificant differences were also noted in YAP expression between different tumor sizes, while significant differences were observed between different nodal statuses. Conclusion: Our results suggest that YAP could be responsible for extensive proliferation and invasiveness of OSCC.



Khalid Al-Johani

Prevalence of Recurrent Aphthous Stomatitis among Dental Students: A Cross Sectional Study

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:3] [Pages No:893 - 895]

Keywords: Aphthous ulcers, Dental students, Recurrent aphthous stomatitis, Stress

   DOI: 10.5005/jp-journals-10024-2630  |  Open Access |  How to cite  | 


Aim: This study aims to determine the prevalence of recurrent aphthous stomatitis (RAS) among dental students. Materials and methods: Dental students were asked to complete a questionnaire to investigate different aspects of RAS including prevalence, frequency of recurrence, and management modalities. Results: Of the 382 study participants (230 women, 152 men; 21–28 years old), 83 had a history of RAS (45 women, 38 men). A positive family history of RAS was more common in participants with RAS (48.2%) than in those without RAS (9.0%). Stress was reported as the most common trigger for an attack (53%), and the most commonly affected sites were the labial and the buccal mucosa. Reported treatment modalities included topical anesthetic, honey, and/or warm salt water rinsing; however, most participants reported no benefit from treatment apart from a temporary relief. Conclusion: RAS is common among dental students in Kingdom of Saudi Arabia. Despite ongoing research, the etiology of RAS is still unknown, and only symptomatic treatment is available. Clinical significance: RAS is a common painful oral ulcerative condition affecting young adults. RAS interferes with eating and speaking, affecting the quality of life.



MB Vinay Kumar, Vandana Narayanan, Sultan A Almalki, Suneethi M Dey, Saurabh Sathe

Assessment of Clinical Efficacy of Different Periodontal Dressing Materials on Wound Healing: A Comparative Study

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:5] [Pages No:896 - 900]

Keywords: Chronic periodontitis, Pain, Periodontal dressings, Surgical flaps

   DOI: 10.5005/jp-journals-10024-2631  |  Open Access |  How to cite  | 


Aim: The present study aims to assess the efficacy of different periodontal dressing materials on wound healing clinically. Materials and methods: A total of 45 patients between the age group of 30–45 years, with chronic generalized periodontitis with loss of attachment of 3–6 mm, who require periodontal flap surgery, were screened to include in the study. Out of 45 subjects, 24 were males and 21 were females. The subjects were randomized into 3 groups as 15 in each. Group I: a collagen dressing, group II: light-cure dressing, and group III: non-eugenol-based dressing. The clinical parameters such as plaque index, vertical probing depth, pain, gingival index, and patient satisfaction were documented for all the three groups on the 7th and the 14th day. Visual analog scale (VAS) was used to score the pain severity. The SPSS 20 software was used to analyze the data. The significance level was set at 5%. Results: The mean gingival index score reduced from 1.40 ± 0.14 to 1.10 ± 0.30 in group I, from 1.48 ± 0.01 to 1.26 ± 0.22 in group II, and from 1.58 ± 0.16 to 1.33 ± 0.10 in group III. The mean plaque index score reduced from 1.48 ± 0.56 to 1.18 ± 0.40 in group I, from 1.46 ± 0.01 to 1.24 ± 0.48 in group II, and from 1.42 ± 0.12 to 1.20 ± 0.20 in group III. There was a statistical difference found in all the three groups and between the groups from the plaque and gingival index scores. The probing depth comparison shows a significant difference in group I. Patient satisfaction was almost similar in all the groups. The pain index showed the reduction in the pain severity from the 7th day to the 14th day in all the subjects from all the three groups. Conclusion: It can be concluded that the periodontal wound covered with a collagen dressing material showed significant evidence to provide symptomatic relief and better healing to the patients compared to that of light-cure and non-eugenol periodontal dressing material.



Inas A Elghandour

Influence of Resin Solvent on Color and Surface Roughness of Aesthetic Restorative Materials

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:6] [Pages No:901 - 906]

Keywords: Color change, Detection of resin composites, Laboratory research, Resin composite, Resin remover, Resin solvent, Surface roughness

   DOI: 10.5005/jp-journals-10024-2628  |  Open Access |  How to cite  | 


Aim: The aim of the study was to ascertain the influence of a resin remover on color and surface roughness of two resin composites. Materials and methods: Disc-shaped specimens were fabricated from either a Te-Econom plus microhybrid or a Tetric EvoCeram nanocomposite. The color and surface roughness of the specimens were measured before and after treatment, with a resin remover for 3, 5, and 8 minutes. The color was measured using a reflective spectrophotometer according to the CIE L*a*b* color space measurements. Surface roughness was evaluated using optical profilometry. Results were statistically analyzed using Student's t test, ANOVA, Tukey's post hoc, and Pearson's correlation tests. Results: The resin remover induced a statistically significant color change of both resin composites, which increased with increasing the time of immersion to 8 minutes. The color change of Tetric EvoCeram was higher than that of the Te-Econom Plus. Surface roughness change was more pronounced with Tetric EvoCeram. No correlation was found between changes in color and surface roughness. Conclusion: Resin solvent changed the color of microhybrid and nanocomposite. Increasing the immersion time to 8 minutes increased the color change. The type of composite influenced the changes in color and surface roughness. Clinical significance: Resin solvent had potentials to stain resin composites, which could be helpful in its identification from tooth structure during removal of failed resin composite restorations.



Sameep Singh

Assessing the Accuracy of Low-cost Surgical Guides Generated Using Ridge Mapping by Means of Cone Beam Computerized Tomography

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:8] [Pages No:907 - 914]

Keywords: Cone beam computerized tomography, Flapless surgery, Guided surgery, Ridge mapping, Surgical guide

   DOI: 10.5005/jp-journals-10024-2627  |  Open Access |  How to cite  | 


Aim: Assessing the accuracy of surgical guides generated with the help of a simple chair side ridge mapping technique by comparing the planned implant position with the achieved implant position on post-op computerized tomography scans. Materials and methods: In this study, 20 implant sites in patients were selected. Ridge mapping was done through a vacuum press template at three buccal (B1, B2, B3), three lingual (L1, L2, L3), and one crestal (C) points for each implant site. Readings were transferred onto the cast, and surgical guides were fabricated for implant placement. Postoperative cone beam computerized tomography (CBCT) was done to assess planned and achieved implant position. Comparison was done between soft tissue depths and implant distance from the crest of alveolar bone determined by the ridge mapping technique with measurements done on CBCT. The points used for ridge mapping were used as the reference for measurements. The data were analyzed using paired t test. p < 0.05 was considered to be statistically significant. Results: On comparing the mean values of soft tissue depths from the ridge mapping and CBCT data, insignificant differences were found at B1, B2, L1, L2, L3, and C, but significant differences were found at B3. On comparing the implant distances from alveolar bone from both the data, insignificant differences were found at B, B2, B3, L1, L2, and L3 and significant difference was found at the crest in the mean values. Conclusion: Under the limitations of the above study, it can be concluded that a simple chairside procedure like ridge mapping can be used as an effective way for guided implant placement in sufficient available alveolar bone.



Asâd Naji-Amrani, Ammar Eid, Joseph Hemmerle

Effectiveness of Etching by Three Acids on the Morphological and Chemical Features of Dentin Tissue

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:5] [Pages No:915 - 919]

Keywords: Dentin demineralization, Phosphoric acid, Polyacrylic acid

   DOI: 10.5005/jp-journals-10024-2626  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate the microscopic and chemical effects of phosphoric acid gel, phosphoric acid liquid, and polyacrylic acid application for 15 seconds (s) on coronal dentin. Materials and methods: Twelve extracted teeth were selected. Three etching acids were used to prepare the dentin surfaces. Scanning electron microscopy (SEM) and X-ray energy dispersive spectroscopy (EDX) were used to analyze the chemical and morphological changes of the dentinal surfaces, including the depth of demineralization. Collected data were statistically analyzed by the one-way analysis of variance test. Results: Dentin etched with phosphoric acid gel or liquid showed greater peritubular dentin dissolution, including complete removal of the smear layer. In addition, there were many silica particles on the dentin etched by phosphoric acid gel 37%. The dentin that was etched with 25% polyacrylic acid for 15 seconds showed no smear layer removal. Chemical analysis (EDX) showed that dental surfaces etched with phosphoric acid liquid 37% for 15 seconds showed the strongest mineral dissolution at the calcium surface, with a calcium content of 5.25%. On the other hand, EDX analysis of the dental surface etched with 25% polyacrylic acid showed more surface enrichment in calcium (17.19%). Conclusion: Although phosphoric acid (gel or liquid) 37% cleans the dental surface, phosphoric acid gel precipitates silica particles on the etched dentin surface. These particles cannot be removed by rinsing off this acid. The application of polyacrylic acid for 15 seconds does not noticeably demineralized dentin, nor remove the smear layer. Clinical significance: The clinician should use phosphoric acid (gel or liquid) to clean dental surfaces to prepare them for the bonding process. The low demineralizing effects of the polyacrylic acid permits its use near the pulp.



Pooja Mishra, Neha Agarwal, Yogita Chaturvedi

Comparison of Punica granatum, Terminalia chebula, and Vitis vinifera Seed Extracts used as Mouthrinse on Salivary Streptococcus mutans Levels in Children

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:8] [Pages No:920 - 927]

Keywords: Buffering capacity, Mouthrinse, Nutraceutical, pH, Saliva, Streptococcus mutans

   DOI: 10.5005/jp-journals-10024-2617  |  Open Access |  How to cite  | 


Aim: The present study was conducted to compare the efficacy of all Punica granatum, Terminalia chebula, and Vitis vinifera on salivary Streptococcus mutans levels in children and also to evaluate their substantivity at an interval of 15 days that is at day 1, days 16, and 31. Materials and methods: This study was designed for a randomized clinical double-blinded study where 80 children of 8–15 years of age were living in a residential premise. Subjects were randomly divided into 4 groups of 20 each to whom mouthrinses were given. The criteria for assessing the efficacy was done by collecting the saliva sample for pH, buffering capacity, plaque index, and Streptococcus mutans microbiologic assay. These values were assessed at the baseline, days 16, and 31. Children were asked to discontinue mouthrinse from days 16 to 31. The supervisor was trained to administer the mouthrinses properly. Results: The data were coded and analysis was done using the SPSS version 20. The level of significance was set at p < 0.05. The pH and buffering capacity showed that values were almost the same among all four groups at various time intervals which showed statistically nonsignificant results. Punica granatum showed a maximum reduction in S. mutans count followed by T. chebula and V. vinifera, although they were statistically nonsignificant. The Vitis vinifera group had successfully reduced more plaque score at day 16 (0.04) followed by T. chebula (0.09) and P. granatum (0.12). Conclusion: This in vivo study implied that V. vinifera had shown the lowest plaque reduction owing to its antioxidant and phytochemical properties. And P. granatum showed the maximum substantivity. Clinical significance: Mouthrinses helped in reducing plaque deposition, caries activity, and helped in oral hygiene maintenance. Hereby, we can conclude that nutraceutical mouthrinses are safe in children and produced superior results than the chemical mouthrinses.



Sakshi Garg, Shashikala Jain, Rajnish Aggarwal, Sunita Choudhary, Nandalur K Reddy

Comparison of Dimensional Accuracy of Stone Models Fabricated by Three Different Impression Techniques Using Two Brands of Polyvinyl Siloxane Impression Materials

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:7] [Pages No:928 - 934]

Keywords: Dimensional accuracy, Monophase, One step putty wash, Polyvinyl siloxane, Two step putty wash

   DOI: 10.5005/jp-journals-10024-2629  |  Open Access |  How to cite  | 


Aim: The aim of this study is to check the dimensional precision of stone models made by two different brands of polyvinyl siloxane impression materials using the monophase, one-step, and two-step putty/light-body impression techniques. Materials and methods: A metal model, having two crown preparations, was fabricated. With each technique, 40 impressions were made using two types of polyvinyl siloxane impression materials (Aquasil and Virtual). A total of 240 impressions were made with both the polyvinyl siloxane impression materials. Monophase impressions were made with a medium body using an acrylic custom tray. By simultaneous usage of putty and light-body, one-step impressions were made with a perforated metal stock tray. For two-step impressions, a 25–40 microns thick cellophane sheet spacer was used. The stone casts were obtained from the impressions of the stainless steel model. Three different dimensions (height, diameter, and inter-abutment distance) on these resultant stone casts were compared with the standard die. The accuracy of two different brands of impression materials was also compared. The results were then statistically analyzed. Results: The resultant casts obtained from the different impression techniques had significantly larger dimensions in height and diameter, but smaller dimensions were observed for the inter-abutment distance. Larger deviation in resultant casts was observed in the monophase than one-step impression technique and the least deviation was observed in the two-step impression technique. Conclusion: The two-step impression technique produced the most accurate results in terms of the resultant casts. Out of the two different brands, Aquasil produced more fare results. Clinical significance: Adequate marginal adaptation, proper fit and least distortion of the castings, and the final prosthesis can be achieved by using the adequate impression technique and impression material.



John Jacob, Midhun Paul, Bilu Sara, Paul Steaphen, Neethu Philip, Jain Mathew

Comparative Analysis of Dentinal Crack Formation Following Root Canal Instrumentation with Hand K-Flex Files, ProTaper Next, and Self-adjusting Files

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:5] [Pages No:935 - 939]

Keywords: Dentinal cracks, NiTi instruments, ProTaper Next, Root canal preparation, Self-adjusting file, Stereomicroscope

   DOI: 10.5005/jp-journals-10024-2625  |  Open Access |  How to cite  | 


Aim: To evaluate and compare in vitro the dentinal crack formation in root canal dentin after root canal instrumentation with hand K-Flex files, ProTaper Next, and self-adjusting engine-driven files. Materials and methods: Ninety-two human mandibular first molar teeth were randomly divided into four groups (n = 23) as per the instrumentation protocol: group I—unprepared teeth (control); group II—hand K-Flex files (Sybron Endo); group III—ProTaper Next X1 and X2 (Dentsply Maillefer); group IV—self-adjusting file (ReDent Nova, Israel). All the roots were sectioned perpendicular to the long axis of the tooth at 9 mm, 6 mm, and 3 mm from the apex and thereby obtaining sixty-nine samples, which were then subjected to a stereomicroscopic examination for detection of dentinal cracks. Statistical analyses were done using the Chi-square test with SPSS (version 19), and p value was set at p < 0.05. Results: Statistically significant differences were seen between the instrumented groups. No dentinal cracks were found in the unprepared roots and those prepared with hand K-Flex files (0/23). Self-adjusting-file-instrumented group showed significantly less incidence of crack formation when compared to the ProTaper Next group with p = 0.001. Conclusion: Self-adjusting file is an efficient engine-driven NiTi instrument for root canal instrumentation with the least occurrence of crack formation in the root canal dentin compared to the ProTaper Next system. Clinical significance: The introduction of NiTi rotary file systems has metamorphosed the endodontic treatment by their better cutting efficiency and cleaning potentiality. Yet, evidenced-based clinical studies are to be conducted on the incidence of microfractures that can lead to vertical root fractures, which will be produced irrespective of the motion kinematics and design feature and thereby compromising the clinical maintenance of the endodontically treated teeth.



Gunaseelaraj Rajkumar, Sengottaiyan Arul Kumar, Radhakrishnan Geethakumari

Chemical Characterization of Denture Base Resin with a Novel Cycloaliphatic Monomer

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:7] [Pages No:940 - 946]

Keywords: Copolymer, Cycloaliphatic compound, Monomer, Modified monomer

   DOI: 10.5005/jp-journals-10024-2634  |  Open Access |  How to cite  | 


Aim: The aim of this study is to identify and characterize newly formed copolymers by modifying methyl methacrylate (MMA) monomer by substituting cycloaliphatic monomer using Fourier transform infra-red (FTIR) spectroscopy. Materials and methods: Heat-cure polymethyl methacrylate (HC-PMMA) experimental specimens were made by dissolving tricyclodecane dimethanol diacrylate (TCDDMDA) at 10% and 20% concentrations in commercially available MMA monomer. Specimens made without TCDDMDA served as the control. The specimen was then scrapped and mixed with dried potassium bromide (KBr) to form pellet. Each pellet was placed in a FTIR spectrometer and 10 scans were recorded with a spectral resolution of 4 cm1. A mean of scans was automatically processed and deduced by the system software and a final transmittance spectral graph was obtained for one specimen. Results: Three significant spectral differences exist between control and experimental groups. The first difference was the disappearance of weak peak at 1637.34 cm1 (alkenyl C=C stretch) in both experimental groups. The second difference was the appearance of new moderate broad peaks at 1482.25 cm1 and 1449.56 cm1 in both experimental groups which are attributed to the ring –CH2 asymmetric bending (C–H deformation) vibrations. The third difference was the appearance of another new weak peak at 1386.57 cm1 in both experimental groups. This new peak confirms the formation of a new structure of copolymer. Conclusion: TCDDMDA copolymerizes with MMA, thereby decreasing the uncured residual monomer in the polymerized specimens. Clinical significance: Copolymerization of TCDDMDA with MMA would lead to the development of new monomeric composition for the fabrication of dentures possessing better mechanical properties and biocompatibility.



Priyanka Gubrellay, Milap Karia, Kunal Talesara, Chetan Sharma, Shubhra Raghav, Paranna Sujatha

Effect of Dentin Bonding Agent on Intrapulpal Temperature during Fabrication of Provisional Restorations by a Direct Method: An In Vitro Study

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:5] [Pages No:947 - 951]

Keywords: Dentin bonding agent, Dentinal tubules, Desensitizing agents, Provisional restoration

   DOI: 10.5005/jp-journals-10024-2624  |  Open Access |  How to cite  | 


Aim: To determine the effect of three different provisional restorative materials (PRMs) and application of dentin bonding agent (DBA) on intrapulpal temperature rise during fabrication of provisional crowns using a direct method. Materials and methods: Three PRMs—polymethyl methacrylate resin (PMMA), bis-acrylic resin, and dimethyl methacrylate resin (DMMA)—were used in the study. Dentin bonding agent (Single Bond 2, 3M ESPE, Germany) was applied in a single layer or double layer as an insulating material. A total of 45 molars were prepared for complete coverage restoration with chamfer finish line and 1.5 mm axial and 2 mm occlusal reduction. After application of a single or double layer of DBA, provisional materials were polymerized according to the manufacturer's instructions. The temperature increase inside the pulp chamber was measured with a T-type thermocouple wire. The readings were averaged for each group to determine the mean value of temperature rise. Results: Statistical analysis was performed with analysis of variance (ANOVA) followed by post hoc Tukey test (a = 0.05). The temperature rise varied according to the provisional restoration material used (PMMA > DMMA > bis-acrylic resin) (p < 0.001) and the single or double layer of DBA (p < 0.001). Polymethyl methacrylate resin produced a higher intrapulpal temperature. Conclusion: Application of a double layer of DBA resulted in a significantly lower intrapulpal temperature.



Rajeev Arunachalam, Vini Rajeev, Ramesh Kumaresan, Sarath B Kurra

Clinical and Biochemical Valuation of Enzymatic and Nonenzymatic Stress Markers Following Full-mouth Disinfection in Aggressive Periodontitis

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:5] [Pages No:952 - 956]

Keywords: Aggressive periodontitis, Antioxidants, Biomarkers, Full-mouth disinfection

   DOI: 10.5005/jp-journals-10024-2622  |  Open Access |  How to cite  | 


Introduction: Assessment of host response to inflammation will throw light on the critical role of antioxidants (AOs) and free radicle damage in the etiology of periodontal disease. The purpose of the study was to assess the level of plasma oxidative stress in those having aggressive periodontal disease before and after full-mouth disinfection. Objectives were to find the influence of full-mouth disinfection analyzing the level of thiobarbituric acid reactive substances (TBARSs), thereby quantifying the lipid peroxidation (LPO) and also the activities of reduced glutathione (GSH), glutathione peroxidase (GPX), and catalase (CAT), valuing the AO defense systems in health and disease. Materials and methods: The valuation composed of 30 subjects with aggressive periodontal disease and 30 healthy controls. Clinical assessment included following periodontal parameters: plaque index (PI), papillary bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level (CAL). Levels of bone loss were assessed by taking full-mouth periapical radiographs. Initial periodontal therapy comprises of full-mouth disinfection which includes subgingival scaling and root planing within 24 hours combined with adjunctive chlorhexidine chemotherapy for aggressive periodontitis subject's at sites indicated. The parameters (clinical) were evaluated at the baseline and 8 weeks after initial periodontal therapy at six sites of teeth indicated. Plasma samples were taken and evaluated by standard procedures as defined in the literature. All the values were weighed and related. Results: Strong positive associations were detected among periodontal parameters and TBARS, enzymatic/nonenzymatic AO levels (p < 0.05), and pre- and postperiodontal management. The plasma levels of patients with aggressive periodontitis had high levels of TBARS and displayed a substantial escalation in the activities of GSH and GPX levels in the plasma matched to the healthy individuals (p < 0.05). Conclusion: This paper evaluated ROS activity and AO defense before and after treatment to stimulate added periodontal investigation in this part which will give an insight into the therapeutic options with foreseeable results.



Sana Bekri, Amel Labidi, Yosra Mabrouk, Hiba Triki, Lamia Mansour, Kamel B Salem

Evaluation of the Treatment Complexity with Single Complete Removable Denture: A Cross-sectional Study in Tunisia

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:6] [Pages No:957 - 962]

Keywords: Complaints, Patient satisfaction, Quality assessment, Single complete removable denture

   DOI: 10.5005/jp-journals-10024-2621  |  Open Access |  How to cite  | 


Aim: The aim of this study is to determine the complaints of patients wearing single complete removable dentures (SCRDs), to evaluate their satisfaction degree, and to identify the main construction faults committed. Materials and methods: One hundred patients with SCRDs were included. A questionnaire was prepared to investigate the patients’ complaints and satisfaction. This questionnaire was supplemented by a professional examination of dentures. Results: Loss of retention and chewing difficulties were the most common complaints of the patients. Examination of the complete dentures by a professional in removable prosthodontics has shown prosthetic instability, lack of retention, and poor adaptation of the prosthetic bases in 49%, 42%, and 38% of the cases, respectively. Occlusal errors related to balanced occlusion, occlusal plane orientation, and occlusal vertical dimension were found successively in 41%, 37%, and 27% of the examined dentures, respectively. Sixty-three percent of the patients were overall dissatisfied with their dentures. This dissatisfaction was correlated to the quality of the denture (p < 103). Conclusion: The complaints expressed by the patients with their dentures are mostly justified. The design of a single removable denture does not seem to be mastered by many practitioners.



Arjumand Farooqui, Vineet V Kini, Ashvini M Padhye

Comparative Evaluation of Two Different One-stage Full-mouth Disinfection Protocols using BANA Assay: A Randomized Clinical Study

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:7] [Pages No:963 - 969]

Keywords: n-Benzoyl-DL-arginine-2-naphthylamide, Dental plaque, One-stage full-mouth disinfection, Red complex, Tongue coat

   DOI: 10.5005/jp-journals-10024-2623  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate and compare two different one-stage full-mouth disinfection protocols in the treatment of chronic periodontitis by assessing dental plaque and tongue coat using BANA assay. Materials and methods: The present study was a prospective randomized clinical parallel arm study design including 40 healthy subjects randomly allocated into two groups, i.e., group A (Quirynen's protocol of one-stage full-mouth disinfection) and group B (Bollen's protocol of one-stage full-mouth disinfection). Subjects were assessed at baseline and six weeks using plaque index, gingival index, and sulcus bleeding index. Probing depth and relative clinical attachment level were also recorded at six weeks. Winkel tongue coat index and BANA were recorded at 8 weeks using subgingival plaque and tongue coat sample. Results: Both group A and group B demonstrated statistically significant reduction in plaque index, gingival index, sulcus bleeding index, Winkel tongue coat index, reduction in probing depth, and gain in relative clinical attachment level on intragroup comparison. There was no significant difference in BANA assay score of subgingival plaque and tongue coat samples in between group A and group B. Conclusion: From the findings of this study, both Quirynen's protocol and Bollen's protocol of one-stage full-mouth disinfection are effective in plaque reduction and tongue coat reduction and achieve comparable clinical healing outcomes. Clinical significance: The difference in duration and mode of use of chlorhexidine as a chemical plaque control agent in the two treatment interventions of Quirynen's and Bollen's protocol of one-stage full-mouth disinfection did not demonstrate statistical significance in reducing sulcus bleeding index scores, reducing probing depths, and gain in relative clinical attachment levels.



Tejashree Mantri, Vijayalaxmi Male, Renu Yadav, Girija R Adsure

Study of the Role of Salivary Lactate Dehydrogenase in Habitual Tobacco Chewers, Oral Submucous Fibrosis and Oral Cancer as a Biomarker

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:4] [Pages No:970 - 973]

Keywords: Lactate dehydrogenase, Oral cancer, Oral submucous fibrosis, Saliva, Tobacco pouch keratosis

   DOI: 10.5005/jp-journals-10024-2619  |  Open Access |  How to cite  | 


Aim: To evaluate the salivary lactate dehydrogenase (LDH) levels in clinico-pathologically confirmed oral submucous fibrosis (OSMF), oral cancer and clinically diagnosed tobacco pouch keratosis patients. Materials and methods: A prospective, comparative study was carried out in a tertiary healthcare centre located in Loni from October 2013 to January 2014. A total of 120 patients were separated into 4 groups depending upon the clinical diagnosis as follows. Group I: healthy control (with no addictions and diseases). Group II: oral cancer. Group III: oral submucous fibrosis. Group IV: habitual tobacco chewers (tobacco addiction without any disease). Substantiation was done using biopsy. The samples were inspected for salivary LDH levels by the technique in line with the recommendations of the International Federation of Clinical Chemistry with the help of Erba Chem semi auto analyser. Results: The mean salivary LDH levels in the control, oral cancer OSMF and habitual tobacco chewer group were 86.12 ± 7.05 IU/L, 592.09 ± 28.57 IU/L, 350.43 ± 5.90 IU/L and 125.19 ± 13.42 IU/L, respectively. Out of 4 groups, LDH activity was increased in saliva of patients with tobacco pouch keratosis, OSMF, and oral cancer consistently. Notable difference was found in the mean salivary levels of the above groups. Results were subjected to appropriate statistical analysis: one-way ANOVA, Student's unpaired t test for group-wise comparison followed by post hoc Tukey's test. Conclusion: We observed congruous higher levels of salivary LDH in oral precancer and cancer, and hence it could be a future marker.



Regenerative Endodontics for Upper Permanent Central Incisors after Traumatic Injury: Case Report with a 3-year Follow-up

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:4] [Pages No:974 - 977]

Keywords: Apical papilla stem cells, Dental pulp stem cells, Immature pulp, Regenerative endodontics

   DOI: 10.5005/jp-journals-10024-2618  |  Open Access |  How to cite  | 


Aim: The aim of this article is to describe a one-visit approach to attempt revascularization in the upper right and left central incisors after traumatic injury. Background: A single-visit conservative revascularization approach can be used to promote root growth and maturation following traumatic dental injury and loss of pulpal tissues. Case description: An eight-year-old female patient presented in Dentalia Clinics, Jeddah, Kingdom of Saudi Arabia, in 2016 with traumatic dental injury. Upon clinical and radiographic examination, it was found that the trauma resulted in loss of pulp vitality in two upper central incisors. Local anesthesia was administered, and a rubber dam was placed. Access cavity was done for each tooth separately. 2% chlorhexidine followed by sterile saline was used for irrigation with no instrumentation. Mineral trioxide aggregate (MTA) was used as the sealing material after blood clot formation. Follow-up showed continuous root maturation in the right central incisor, at 6 months, one year, two years, and three years. Root canal treatment was done in 2019 due to the development of periapical lesion. The 6-month follow-up radiograph also showed loss of the crown of the left central incisor due to a second trauma with retained apical root fragment. The fragment was embedded inside the bone and showed continuous maturation during the three years. Conclusion: A single-visit regenerative endodontic approach showed successful results in revascularizing the upper permanent central incisor after loss of pulpal tissue. Clinical significance: Immature permanent teeth can be treated by a single-visit revascularization procedure to promote root maturation and increase in radicular dentin length and width.



Aikaterini Mitroulia, Marianna Gavriiloglou, Poluxeni Athanasiadou, Athina Bakopoulou, Athanasios Poulopoulos, Dimitrios Andreadis

Salivary Gland Stem Cells and Tissue Regeneration: An Update on Possible Therapeutic Application

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:9] [Pages No:978 - 986]

Keywords: Salivary gland stem cells, Stem cell therapy, Tissue regeneration

   DOI: 10.5005/jp-journals-10024-2620  |  Open Access |  How to cite  | 


The aim of this review is to combine literature and experimental data concerning the impact of salivary gland (SG) stem cells (SCs) and their therapeutic prospects in tissue regeneration. So far, SCs were isolated from human and rodent major and minor SGs that enabled their regeneration. Several scaffolds were also combined with “SCs” and different “proteins” to achieve guided differentiation, although none have been proven as ideal. A new aspect of SC therapy aims to establish a vice versa relationship between SG and other ecto- or endodermal organs such as the pancreas, liver, kidneys, and thyroid. SC therapy could be a cheap and simple, non-traumatic, and individualized therapy for medically challenging cases like xerostomia and major organ failures. Functional improvement has been achieved in these organs, but till date, the whole organ in vivo regeneration was not achieved. Concerns about malignant formations and possible failures are yet to be resolved. In this review article, we highlight the basic embryology of SGs, existence of SG SCs with a detailed exploration of various cellular markers, scaffolds for tissue engineering, and, in the later part, cover potential therapeutic applications with a special focus on the pancreas and liver.



Mohasin A Khader, Karthika Rajeev, Anas A Khader

Role of Synthetic Hydroxyapatite—In Socket Preservation: A Systematic Review and Meta-analysis

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:7] [Pages No:987 - 993]

Keywords: Bone, Extraction, Healing, Implant, Regeneration, Restoration

   DOI: 10.5005/jp-journals-10024-2616  |  Open Access |  How to cite  | 


Since a long time, the preservation of the socket is emphasized for various reasons. Many studies have suggested the ridge preservation through socket grafting using various bone graft substitute materials (GSMs). But none of the studies suggested the material of choice for the grafting. So, the systematic review was planned to analyze the outcomes of synthetic hydroxyapatite (SHA) graft material for socket preservation. The review was aimed to determine the existing evidence for the use of SHA GSM for grafting and its usefulness. Materials and methods: The literature search was performed for the studies published in the English language independently by all four authors (search team) in the Medline database through the PubMed search engine for the past 5 years. The study involved predetermined inclusion and exclusion criteria for the search. The final lists of clinical trials were analyzed to determine the existing evidence and suggested the mechanism of action. Review results: The search resulted in 117 titles. After application of inclusion and exclusion criteria, a total of seven studies were found eligible for this systematic review. Out of seven, two studies were found eligible for meta-analysis whereas remaining included for the systematic review. Conclusion: The meta-analysis favors socket grafting compared to control in terms of preservation of existing bone height and width. The SHA grafting showed successful bone regeneration with less connective tissue component. The histomorphometric evaluation showed a good bone regeneration associated with SHA than xenograft. Within the limitations of this meta-analysis, the synthetic GSM can be used for socket grafting. Clinical significance: In the wake of increasing graft materials in the market and different origin raw material sources for the preparation of graft materials, clinicians are in dilemma for selection and its use. The success of grafting depends on the selection of appropriate material with a suitable calcium/phosphate (Ca/P) ratio. The review provided available evidence for the use of SHA.



Mehjabeen A Jabri, Song Wu, Yaoyuan Zhang, Junqing Ma, Lin Wang

A Review on Comparison of Tooth Size Discrepancies among Angle's Class I, II, and III Malocclusion: Is There a Significance?

[Year:2019] [Month:August] [Volume:20] [Number:8] [Pages:6] [Pages No:994 - 999]

Keywords: Angle class I, Angle class II, Angle class III, Malocclusion, Mandible, Maxilla, Orthodontics

   DOI: 10.5005/jp-journals-10024-2615  |  Open Access |  How to cite  | 


Aim: The contemporary article aims to review and compare various literatures concerning different conclusions regarding the correlation between tooth size discrepancy (TSD) and Angle's malocclusion groups. Background: Acquiring the ideal occlusion plays one of the major roles while designing the treatment plan for an orthodontic patient, any alterations in the individual tooth sizes are called TSD and will hinder this prime requirement. By determining the correct tooth size ratio, it further helps in acquiring the accurate interdigitation, balanced occlusion, and also predicting the orthodontic treatment results. Various investigations were carried out to know the correlation between tooth size discrepancies and different malocclusion groups, of which, a few reported a statistically significant difference whereas others reported no significant difference. Review results: A computerized database quest was operated utilizing the Medline database (Pubmed/Medline) for original research and review articles. Publications between 1946 and 2018 were included. Four hundred twenty-one articles were recovered from database search and, among them, 66 articles were selected to review the full-article. Conclusion: Although a comparison was done between the tooth-size ratios and malocclusion groups (classes I, II, and III), many investigators noted no significant difference but there is an inadequacy in the data particularly related to subgroups of Angle's classification of malocclusion among these investigations; therefore, further studies are required to interpret this correlation. Clinical significance: As there is high incidence of tooth size discrepancies noted in the previous literature orthodontist, Bolton's analysis regardless of malocclusion group, sex, and ethnicity is highly recommended.


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