The Journal of Contemporary Dental Practice

Register      Login

Table of Content

2020 | November | Volume 21 | Issue 11

Total Views


Kiranam Chatti

Meditation and Yoga-assisted Alteration of Dietary Behavior as a Useful Strategy for Limiting Zoonotic Pandemics: A Novel Insight

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1197 - 1200]

   DOI: 10.5005/jp-journals-10024-2975  |  Open Access |  How to cite  | 


Vegetarian diets are known to have significant positive effects on personal and planetary health and are likely to curb zoonotic infection transmission. We propose that minimizing meat consumption should become an essential dietary shift in the post-COVID-19 era. To date, however, there is limited knowledge concerning suitable methods that could catalyze this change on a global scale. Meditation and Yoga are practical and easy to implement psychomodulatory strategies that can naturally trigger vegetarianism and related eating behaviors, lowering our reliance on animal meat. Decreasing dependence on animal meat reduces the need for animal markets and may substantially minimize the likelihood of spillover (passage of viruses from animal reservoirs into human populations). Global implementation of these strategies, in our opinion, can add to spiritual wisdom, compassion, and cooperative human behavior, thus reducing the encroachment of wild-life reserves and animal exploitation. The application of these ancient Indian approaches represents a novel and focused strategy toward curbing zoonotic pandemics.



Calvina Hartanto, Wandania Farahanny, Dennis Dennis

Comparative Evaluation of Short Fiber-reinforced Composite Resin Thickness on Fracture Resistance of Class II Composite Restoration: An In Vitro Study

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1201 - 1204]

   DOI: 10.5005/jp-journals-10024-2965  |  Open Access |  How to cite  | 


Aim: This study aims to evaluate the difference in fracture resistance of the short fiber-reinforced composite (SFRC) thickness as intermediate layer of class II composite restoration. Materials and methods: Thirty human maxillary premolars were selected and divided into three groups. In groups I, II, and III, class II cavities were prepared. Groups I and II were restored with 2 mm and 4 mm thickness of SRFC as intermediate layer. Group III as control group was restored with nanohybrid composite. Thermocycling procedure was performed manually 250 times. Fracture resistance was measured by using Universal Testing Machine. Data were analyzed statistically using One-way Analysis of Variance (ANOVA) and post hoc least significant difference (LSD) test. Results: The result showed that group II had the highest fracture resistance and group III had the lowest fracture resistance. The difference between groups was statistically significant (p value < 0.05). Conclusion: The conclusion showed that adding 4 mm of SFRC as an intermediate layer increased the fracture resistance. Clinical significance: The use of SFRC as intermediate layer enhanced the fracture resistance of class II composite restoration.



Priti Charde, Kaustubh S Thakare, Manohar Laxman Bhongade, Aleksa Markovic, Aniruddha M Deshpande

Reconstruction of Interimplant Papilla by Demineralized Freeze-dried Bone Allograft Block Fixed by Titanium Screw in Maxillary Esthetic Zone

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:5] [Pages No:1205 - 1209]

   DOI: 10.5005/jp-journals-10024-2960  |  Open Access |  How to cite  | 


Aim: To evaluate effectiveness of demineralized freeze-dried bone allograft (DFDBA) block fixed by titanium screw for reconstructing interimplant papilla in maxillary esthetic zone during one-stage early loading multiple implant procedure. Materials and methods: A total of 20 implants were placed in 10 systemically healthy patients (2 implants per patient) for replacement of multiple teeth by early loading one-stage implants along with interimplant papilla reconstruction using DFDBA block fixed by titanium screw. At the baseline, 6 months, and at 1 year, clinical measurements (interimplant papillary height measurement, papilla contour) and radiographic measurements were recorded. Results: At 1 year, mean gain in interimplant vertical crestal bone was 1.7 mm, and complete reconstruction of the papilla was observed in 90% cases. Conclusion: Demineralized freeze-dried bone allograft block fixed by titanium screw for reconstruction of interimplant papilla in maxillary esthetic zone during one-stage early loading multiple implant procedure is effective. Clinical significance: Presence of interimplant papilla is of utmost importance for esthetically successful implant-supported restoration in the anterior region. This technique leads to reconstruction of interimplant papilla, thus providing esthetic appearance.



Yemineni Bhavan Chand, Jaideep Mahendra, Nasina Jigeesh, Lakshmi Shivasubramanian, Shareen Babu Perika

Comparison of Stress Distribution and Deformation of Four Prosthetic Materials in Full-mouth Rehabilitation with Implants: A Three-dimensional Finite Element Study

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:8] [Pages No:1210 - 1217]

   DOI: 10.5005/jp-journals-10024-2959  |  Open Access |  How to cite  | 


Aim: This study aimed to compare the von Mises stress distribution and deformation on the implant, abutment, and abutment screw using metal-ceramic, zirconia, polyether ether ketone (PEEK), and Trinia as prosthetic materials for full-mouth cement-retained implant prosthesis using finite element analysis. Materials and methods: Four, 3-dimensional mandibular models were designed using Solidworks software. Six conical implants of 4.5 × 11.5 mm, with an internal hexagonal abutment, were fabricated and placed. The physical properties of the implant components, bone, and crowns were simulated to mesh the three-dimensional finite element models. The bite was recorded, and various contact points were marked, on which 50 N loads were applied. The von Mises stress distribution and resultant deformation were analyzed using the finite element method. Results: Higher stress distribution was recorded on the implants, abutments, and abutment screws when zirconia and PEEK prosthesis were used in comparison to metal-ceramic and Trinia. In consideration of deformation, zirconia and Trinia resulted in higher deformation of the implant assembly, abutment, and abutment screw when compared to metal-ceramic and PEEK prosthesis. Anterior implants showed a higher deformation and stress distribution when compared to posterior implants for all four prosthetic materials. Conclusion: Within the limitations of the study, metal-ceramic and Trinia showed less stress distribution, while metal-ceramic and PEEK exhibited less deformation on implant and its components. Hence in future, Trinia and PEEK along with metal-ceramic can be promising prosthetic materials of choice in full-mouth rehabilitation with implants. Clinical significance: Considering the deformation and stress distribution on the implant and its components, the selection of prosthetic material in full-mouth rehabilitation has always been a challenge. Findings of the abovementioned cross-sectional observational study could give an overall insight into materials such as metal-ceramic and Trinia as materials of choice, which can provide a basis for future clinical trials.



Afaf Y Al-Haddad, Kranthi R Kacharaju, Liew Y Haw, Teoh C Yee, Kirubagari Rajantheran, Chong See Mun, Muhamad F Ismail

Effect of Intracanal Medicaments on the Bond Strength of Bioceramic Root Filling Materials to Oval Canals

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1218 - 1221]

   DOI: 10.5005/jp-journals-10024-2958  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the effect of the prior application of intracanal medicaments on the bond strength of OrthoMTA (mineral trioxide aggregate) and iRoot SP to the root dentin. Materials and methods: Thirty single-rooted mandibular premolars were standardized and prepared using ProTaper rotary files. The specimens were divided into a control group and two experimental groups receiving Diapex and Odontopaste medicament, either filled with iRoot SP or OrthoMTA, for 1 week. Each root was sectioned transversally, and the push-out bond strength and failure modes were evaluated. The data were analyzed using Kruskal Wallis and Mann–Whitney U post hoc test. Results: There was no significant difference between the bond strength of iRoot SP and OrthoMTA without medicaments and with the prior placement of Diapex (p value > 0.05). However, iRoot SP showed significantly higher bond strength with the prior placement of Odontopaste (p value < 0.05). Also, there was no association between bond strength of OrthoMTA with or without intracanal medicament (p value > 0.05) and between failure mode and root filling materials (p value > 0.05). The prominent failure mode for all groups was cohesive. Conclusion: Prior application of Diapex has no effect on the bond strength of iRoot SP and OrthoMTA. However, Odontopaste improved the bond strength of iRoot SP. Clinical significance: Dislodgment resistance of root canal filling from root dentin could be an indicator of the durability and prognosis of endodontic treated teeth.



Suman Basavarajappa, Shahira

Do the Renal Function Parameters of Serum and Salivary Urea and Creatinine Alter in Smokeless Tobacco Chewers? A Case–Control Study

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:7] [Pages No:1222 - 1228]

   DOI: 10.5005/jp-journals-10024-2971  |  Open Access |  How to cite  | 


Aim: To evaluate and correlate the salivary urea and creatinine levels to the serum levels in smokeless tobacco (SLT) chewers. Materials and methods: The present study included 60 subjects, 30 SLT chewers, and 30 controls aged between 20 years and 60 years. Serum and salivary urea and creatinine levels were estimated using Berthelot-urease method enzymatic colorimetric method and modified Jaffe's method, respectively. Results: The mean salivary urea, mean serum, and salivary creatinine levels were higher in SLT chewers (33.77 ± 15.04, 0.76 ± 0.17, and 0.17 ± 0.07 mg/dL, respectively) than controls (32.3 ± 14.73, 0.67 ± 0.15, and 0.13 ± 0.05 mg/dL, respectively). Although serum and salivary urea showed a strongly positive correlation (r = 0.654, p < 0.001**) among SLT chewers and controls, no correlation was noted for serum and salivary creatinine (r = 0.098, p = 0.606). Receiver operating curve (ROC) analysis revealed better sensitivity and specificity of serum and salivary creatinine than for urea among both SLT chewers and controls. Conclusion: Salivary urea, serum, and salivary creatinine levels were higher among SLT chewers than controls showing that SLT can be nephrotoxic. Clinical significance: Smokeless tobacco chewers can be assessed for early renal damage caused by the tobacco products using salivary parameters of urea and creatinine so that they can be counseled for the risk of renal diseases and referred appropriately.



Mohammed S Bin-Shuwaish, Abdullah S AlJamhan

Bond Integrity of Resin-modified Glass Ionomer to Dentin Conditioned Using Photodynamic Therapy and Low-level Laser Therapy: An In Vitro Study

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1229 - 1232]

   DOI: 10.5005/jp-journals-10024-2948  |  Open Access |  How to cite  | 


Aim: The aim of the study was to assess the conditioning efficacy of photodynamic therapy (PDT) and Er,Cr:YSGG laser (ECYL) to dentin compared with conventional regime bonded to resin-modified glass ionomer (RMGIC). Materials and methods: Forty mandibular teeth were cleaned, disinfected, and mounted vertically within the segments of polyvinyl pipes up to cementoenamel junction. The occlusal surfaces were flattened, and samples were divided into four groups according to conditioning protocols. Samples in groups I and II underwent PDT, samples in group III were conditioned with low-level laser therapy (LLLT) using Er,Cr:YSGG laser (ECYL), and samples in group IV were conditioned using polyacrylic acid (PAA). Fuji II LC was applied incrementally and light cured for 20 seconds. All samples were placed in universal testing machine for shear bond strength (SBS) testing. The fracture surface was analyzed using stereomicroscope at 50× magnification to determine mode of failure. Among different investigational groups Tukey test was used as post hoc along with analysis of variance (ANOVA). Significance level was established at p <0.05. Results: Maximum SBS values were observed in group IV dentin conditioned with PAA (19.55 ± 1.84 MPa), whereas minimum SBS values were shown by group I (methylene blue photosensitizer, MBP) activated by PDT (13.52 ± 1.22 MPa). In group III, dentin conditioned with ECYL (18.22 ± 2.07 MPa) and group IV (19.55 ± 1.84 MPa) surface treated with PAA exhibited comparable SBS values (p > 0.05). Fracture analysis revealed that in PDT group adhesive failure type was in majority. However, admixed failure type was commonly presented in groups III and IV. Conclusion: PDT of dentin using photosensitizers MBP and CP deteriorates bond values when bonded to RMGIC. The use of LLLT to condition dentin has the potential to improve SBS. Clinical significance: Dentin conditioning with LLLT using ECYL may improve, is of utmost importance for better treatment outcome, predictable prognosis, and improved bond integrity to RMGIC.



Shalan Kaul, Feby Kuriakose, Jittin James, Basil Joy, Reema Malik

Evaluation of Radicular Dentin Microcracks Formation after Instrumentation with NiTi Hand and Rotary File System: A Stereomicroscopic Study

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:5] [Pages No:1233 - 1237]

   DOI: 10.5005/jp-journals-10024-2955  |  Open Access |  How to cite  | 


Aim and objective: The present study aimed to assess the formation of microcracks in root dentin post-instrumentation with nickel–titanium (NiTi) hand and rotary file system. Materials and methods: Totally, 80 freshly extracted mandibular premolar teeth with single roots were chosen for this study. Access opening was performed and #10 K-file was used to attain patency of canal. All specimens were divided into four groups (each group having 20 specimens), i.e., Group I: Unprepared, Group II: NiTi hand K-files, Group III: Self-adjusting file, and Group IV: XP-Shaper single file. Complete irrigation of all the canals was performed after instrumentation. All roots were cut horizontally at three levels [apical third (3 mm), middle third (6 mm), and cervical third (9 mm)] from the apex with diamond disc. A stereomicroscope was used to view the sections under 20× magnification. Results: Self-adjusting file showed least number of defects with a percentage of 75% followed by XP-Shaper and NiTi hand K-files with a values of 65 and 60%, respectively. Use of hand K-files resulted in greater number of incomplete cracks (30%) and use of XP-Shaper demonstrated greater number of craze lines (15%). A statistically significant difference was found between the experimental groups in the formation of dentinal defects of root at apical third (3 mm) (p < 0.031) and middle third (6 mm) (p < 0.001), whereas the sections at cervical third (9 mm) did not show any statistically significant difference (p > 0.312). Conclusion: The present study concluded that the self-adjusting file system gives promising better results in cleaning ability with minimal incidence of radicular dentin microcracks than XP-Shaper and NiTi hand K-files system. Clinical significance: The root dentin may unavoidably get damaged during instrumentation resulting in the formation of dentinal cracks and tiny complicated fractures, thus leading to endodontic failures. Various factors cause dentinal cracks, but the flexibility of file due to heat treatment, kinematics of the file, and the basic architecture of the file are the most significant ones. Self-adjusting file system represented satisfactory results with minimal microcracks defects.



Tamara Yuanita, Irma Drismayanti, Deavita Dinari, Lailatun Tedja

Effect of Calcium Hydroxide Combinations with Green Tea Extract and Cocoa Pod Husk Extract on p38 MAPK and Reparative Dentine

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:7] [Pages No:1238 - 1244]

   DOI: 10.5005/jp-journals-10024-2950  |  Open Access |  How to cite  | 


Aim and objective: The aim of this research is to analyze the effect of calcium hydroxide combinations with green tea extract and the combination of calcium hydroxide with cocoa pod husk extract on the activation of p38 MAPK and wide area of reparative dentin in mice dental. Materials and methods: This study used 36 rats that were randomly divided into three treatment groups: positive control group was applied calcium hydroxide and aquades (group I), the test group was applied calcium hydroxide combined with cocoa pod husk extract (group II), and the next test group was applied using calcium hydroxide combined with green tea extract (group III); all the cavities were restored with RMGIC. On day 7 and 28, experimental animals from each treatment group were killed by peritoneal injection to see the activation of p38 MAPK, while reparative dentin was only seen on day 28. Results: The result of data analysis using Multiple Comparison Tukey HSD test showed significant difference between the positive control group and the test groups for the average p38 MAPK activation value on day 7 and 28. But there was no significant difference between two test groups. The same thing was obtained in the calculation of the average area of reparative dentin, where group I had the lowest value compared to groups II and III on day 28 with a significant difference. There was no significant difference between groups II and III. Conclusion: The use of combination calcium hydroxide with green tea extract and combination calcium hydroxide with cocoa pod husk extract have significant effect on p38 MAPK activation and wide area of reparative dentin in mice dental. Clinical significance: The use of combination calcium hydroxide with green tea extract and combination calcium hydroxide with cocoa pod husk extract have been proven to activate more p38 and form a wider reparative dentin.



Kyatsandra N Jagadeesh, Sudhanshu Kumar, Anuj Singh Parihar, Randhir Kumar

Determination of Immediate-loaded Single Implants’ Stability with Periotest

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1245 - 1248]

   DOI: 10.5005/jp-journals-10024-2900  |  Open Access |  How to cite  | 


Aim and objective: The aim of this study was to determine the stability of immediate-loaded single implants with periotest. Materials and methods: In this in vivo study, dental implants with a length ranging from 10 to 13 mm and diameter of 3.0–4.2 mm were utilized. Stability of dental implant was evaluated using the Periotest® M handheld device before loading, at 1 month, 3 months, 6 months, and 1 year. Results: Implants 11.5 mm in length had the highest mean periotest value (0) after placement, whereas 10 mm-long implant had a value of −0.31 and 13 mm had a value of −0.48. After 1 month, 10 mm had a value of 1.23, 11.5 mm had a value of −0.32, and 13.0 mm had a value of −0.24. After 6 months, 10 mm had a value of 1.78, 11.5 mm had a value of −0.4, and 13.0 mm had a value of −0.41. After 1 year, 10 mm had a value of −0.54, 11.5 mm had a value of −0.51, and 13.0 mm had a value of −0.48. There was an unconstructive relationship between implant length and the average periotest score. There was also an unconstructive association between the implant diameter and the mean periotest value. Conclusion: The implant with long and greatest diameter had higher stability. Periotest can be used to determine dental implant stability. Clinical significance: Periotest is useful in determining dental implant stability. Large-scale studies may be helpful in obtaining useful results.



Srinivasan Bhuvaneshwari, Priyaranjan , Jyotirmay Singh, Baburajan Kandasamy, Sumit Dash, Mohammed A Razi

A Comparative Assessment of Peri-implant Soft and Hard Tissues with Immediate and Delayed Implants

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1249 - 1252]

   DOI: 10.5005/jp-journals-10024-2911  |  Open Access |  How to cite  | 


Aim and objective: This study was done to assess peri-implant soft tissues and hard tissues in immediate and delayed titanium implants cases. Materials and methods: This study was conducted on 84 patients who were randomly divided into two groups. Group I was immediate implant group (42 patients) and group II was delayed implant group (42 patients). Parameters such as peri-implant esthetic score, crestal bone defect, and densitometry of peri-implant were evaluated after 1 week, 1 month, 3 months, and 6 months. Results: The mean peri-implant esthetic score at first week in group I was 7.4 and in group II was 5.8, at first month in group I was 6.8 and in group II was 4.6, at third month in group I was 6.7 and in group II was 4.5 and at sixth month in group I was 6.4 and in group II was 4.4. The difference was significant (p value < 0.05). The mean peri-implant crestal bone loss (mm) after 1 week, 1 month, 3 months, and 6 months in group I was 0.24, 0.64, 0.86, and 1.04 and in group II was 0.28, 0.70, 0.94, and 1.14, respectively. The difference was nonsignificant (p value > 0.05). The mean peri-implant bone densitometry after 1 week, 1 month, 3 months, and 6 months in group I was 52.4, 45.6, 42.4, and 40.2 and in group II was 64.2, 60.5, 55.2, and 47.6, respectively. The difference was significant (p value < 0.05). Conclusion: Instantaneous implants exhibited enhanced esthetic and purposeful result such as healing of peri-implant bone and peri-implant soft tissues when compared to delayed implants. Clinical significance: Immediate implants can be used to improve esthetic and determined result in healing of peri-implant bone and peri-implant soft tissues.



Rashmi Issar, Shashi Ranjan, Shashank Saurav, Suman Kar, Swarupananda Bera, Pankaj Singh

Comparison of Fracture Resistance of Two Resin-based Sealers to Root Canal Walls: An In Vitro Study

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:5] [Pages No:1253 - 1257]

   DOI: 10.5005/jp-journals-10024-2963  |  Open Access |  How to cite  | 


Aim and objective: In the present study, the prepared roots obturated by gutta-percha/AH plus and Resilon/Epiphany were tested and compared for fracture resistance. The study also does a scanning electron microscope (SEM) evaluation of the adaptability of these obturating materials to root canal walls. Materials and methods: One hundred extracted mandibular premolars were decoronated and the dimensions of the roots were standardized. Each root was prepared to a size of #25 with 6% taper. Roots were gauged after preparation and those requiring more preparation were discarded. Seventy-seven prepared roots were finally selected for the study. The samples were then divided into three groups. Group I with 25 specimens was control group in which no obturation was performed, group II with 26 specimens was obturated by gutta-percha/AH plus sealer, and group III with 26 specimens was filled by Resilon/Epiphany. The method for obturation was cold lateral condensation. The samples were then stored at 100% humidity for 2 weeks. One random sample from groups II and III was subjected to SEM analysis. Groups I, II, and III were then subjected to vertical loading in Instron machine. One-way analysis of variance (ANOVA) test and Tukey's multiple comparison test were used for statistical analysis. Results: Group III exhibited the maximum fracture resistance as compared to groups I and II. The least mean fracture resistance of 370.05 N was seen in group II and the maximum mean fracture resistance of 481.05 kN was observed in group III. One-way ANOVA and Tukey's multiple comparison test between groups I, II, and III, group III showed a highly significant resistance to fracture as compared to groups I and II (p < 0.0001). Scanning electron microscope microphotographs showed a better adaptation of Resilon/Epiphany as compared to gutta-percha/AH plus to the root canal. Conclusion: The Resilon/Epiphany on obturation of root canals creates a monoblock by penetrating inside the dentinal irregularities, which strengthens the root and provides fracture resistance. This fracture resistance was significantly higher in the present study as compared to groups I and II. Clinical significance: In the present study, Resilon/Epiphany when used to obturate the prepared canals showed a promising result both in terms of fracture resistance and adaptability to root canal walls. This paves a way for the use of this combination of obturating material not only to strengthen the compromised root strength in clinical scenario but also providing an increased sealing ability which will contribute to the success of root canal treatment.



Kalaiselvi Santhosh, Sathick Manzoor, Anu Sushanth, Sakthidaran Seralathan, Vivekanandan Rajasekar, Anoop Jacob

A Cross-sectional Study to Evaluate Nuclear Changes in Buccal Mucosa Following Panoramic Radiography

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1258 - 1261]

   DOI: 10.5005/jp-journals-10024-2921  |  Open Access |  How to cite  | 


Aim and objective: To evaluate the possible genotoxic effect of X-rays on buccal mucosa while exposing to dental panoramic radiography using micronucleus test. Materials and methods: The study group comprised of 30 healthy subjects, 15 males and 15 females, aged between 24 years and 65 years. Samples were obtained from the exfoliated oral mucosa cells of buccal mucosa before and 12 days after exposing the patients to panoramic radiography. Results: The study reported that there was no significant increase in the number of micronuclei cells present before and after panoramic radiography. Positive correlation existed between age with pre- and postexposure micronuclei. Conclusion: Diagnostic dental panoramic radiograph does not induce micronuclei in the target buccal epithelium cells. A positive correlation between age and micronuclei frequency was established. Clinical significance: Panoramic radiographs does not induce cytotoxicity but increase frequency may be vulnerable to genotoxic effects in buccal mucosal cells. Hence, dental radiographs should be prescribed only when necessary.



Priyaranjan , Kunal Kumar, Vikas Vaibhav, Shruti Keerthi Thota, Ashfaq Yaqoob, Vaibhav Awinashe, Arshad Jamal Sayed

An In Vitro Assessment of Cytotoxicity of Polyvinyl Siloxane, Polyether, and Polyvinyl Ether Silicone on NIH/3T3 Cells

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1262 - 1265]

   DOI: 10.5005/jp-journals-10024-2927  |  Open Access |  How to cite  | 


Aim and objective: Cytotoxicity of polyvinyl siloxane (PVS), polyether (PE), and polyvinyl ether silicone (PVES) on NIH/3T3 cells. Materials and methods: This in vitro study used elastomeric impression materials which were divided into three groups, group I, II, and III with PVES (EXA\'lence light body), PVS (Flexceed light body), and PE impression material (Impregum), respectively. A total of 10 specimens were prepared. Dulbecco's modified Eagle's medium was used for growing mouse cell line NIH/3T3. Cytotoxicity level of all elastomers was measured with the test 3-(4,5-dimethylthiazol-2-yl)-2-5-diphenyltetrazolium bromide assay at regular intervals. Results: There was a decline in the survival rate with PVES as found on day 1, PVS and PE showed on 3rd and 7th day. Kruskal–Wallis test showed a significant difference in all groups at various days (p < 0.05). Conclusion: Authors found that PVES showed early cytotoxic signs as compared to PVS and PE. Cell viability for PVS was highest as compared to PVES and PE impression materials. Clinical implication: Cell viability for PVS was highest as compared to PVES and PE impression materials. This information is useful in the selection of impression materials.



Sumit Dash, Prabu MS Ismail, Jyotirmay Singh, Muhammad AS Agwan, Kaarunya Ravikumar, Thendral Annadurai

Assessment of Effectiveness of Erbium:Yttrium–Aluminum–Garnet Laser, GentleWave Irradiation, Photodynamic Therapy, and Sodium Hypochlorite in Smear Layer Removal

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1266 - 1269]

   DOI: 10.5005/jp-journals-10024-2976  |  Open Access |  How to cite  | 


Aim and objective: To compare the effectiveness of erbium:yttrium–aluminum–garnet laser, GentleWave irradiation, photodynamic therapy (PDT), and sodium hypochlorite in smear layer removal and dentin permeability with a scanning electron microscope (SEM). Materials and methods: Seventy-five recently extracted single-rooted teeth (maxillary second premolars) were randomly divided into 5 groups of 15 each. Group I teeth was the control group in which conventional root canal preparation (RCP) [17% ethylenediaminetetraacetic acid (EDTA)] was done without laser irradiation, group II teeth underwent RCP and GentleWave™ treatment, group III teeth were subjected to Er:YAG laser irradiation, group IV uses low-level 660 nm (PDT), and group V samples were irrigated with 5.25% NaOCl. All samples were viewed under the SEM. Images at the coronal, middle, and apical part of the root canal were obtained at ×1000. A scoring system for smear layer removal and debris removal scoring was used for analysis. Results: Smear layer removal was significantly higher at different points (coronal, middle, and apical area) in group I, followed by V, IV, II, and group III in declining order (p < 0.05). Intercomparison between the groups at different points indicates a significant difference in smear layer removal score between group I and group V at coronal, middle, and apical third. The result was not significant at coronal third and middle third, between group I and V, II and III, II and IV. The result was not significant at apical third between I and V, II and III, and II and IV (p < 0.05). Ethylenediaminetetraacetic acid and sodium hypochlorite are effective in smear layer removal followed by the Er-YAG laser technique. Conclusion: Ethylenediaminetetraacetic acid and NaOCl are effective in smear layer removal. Er:YAG laser-activated RCP was comparatively efficient in cleaning the smear layer and opening dentinal tubules. Clinical significance: Er:YAG laser-activated RCP was comparatively efficient in cleaning the smear layer and it can be used for effective removal of smear layer for clinical usage.



Allauddin Siddiqi, Sobia Zafar, Ajay Sharma, Alessandro Quaranta

Awareness of Diabetic Patients Regarding the Bidirectional Association between Periodontal Disease and Diabetes Mellitus: A Public Oral Health Concern

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:5] [Pages No:1270 - 1274]

   DOI: 10.5005/jp-journals-10024-2974  |  Open Access |  How to cite  | 


Aim and objective: The literature regarding the perception of the two-way relationship between diabetes mellitus and periodontal disease representing diabetic patients living in Australia is scarce. The study aimed to evaluate the knowledge and attitudes of diabetic patients regarding the bidirectional link and the role of medical healthcare professionals in providing oral health advice to their patients. Materials and methods: A convenience sample of diabetic patients attending general practice-based medical and dental centers was invited to complete a questionnaire-based survey. The survey was anonymous, and the responses of the participants were not identifiable. Results: A total of 241 participants completed the questionnaire; however, three survey responses were excluded as most of the critical questions were not answered. The majority (87.81%) of the participants reported with type 2 diabetes mellitus, while 11.76% had type 1 diabetes mellitus. Just over 61% of the participants reported brushing their teeth twice a day. The majority of participants (66.38%) said that their medical practitioner/diabetic educator never asked or examined their oral hygiene or any issues with the gums or teeth. The study noted that 54% of the participants never received any information regarding the bidirectional relationship between periodontal disease and diabetes mellitus and were unaware of the association. Conclusion: Patients with diabetes mellitus lack knowledge of the bidirectional association between periodontal disease and diabetes mellitus. In this regard, the study urged the need to implement European Federation of Periodontology and International Diabetes Federation guidelines effectively. Medical healthcare professionals and dentists should provide mutual care and should consider every patient as a shared responsibility. Clinical significance: Early detection of the disease, timely referrals, and a collaborative approach will enhance patient care and improve the quality of life of individuals living with periodontal disease.



Tugba Turk, Miccoli Gabriele, Simone Coppola

Nonsurgical Retreatment Using Regenerative Endodontic Protocols: A Case Report

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:4] [Pages No:1275 - 1278]

   DOI: 10.5005/jp-journals-10024-2909  |  Open Access |  How to cite  | 


Aim and objective: The aim of this case report was to describe regenerative endodontic procedures (REPs) of the previously treated mature teeth with long-term results. Background: Regenerative endodontic procedures are aimed to treat apical periodontitis and regenerate the pulp–dentin complex in necrotic teeth. However, there is no consensus in using REPs in the previously treated mature teeth. The aim of this case report was to describe REPs of the previously treated mature teeth with long-term results. Case description: A 25-year-old woman presented pain on chewing on 15 and swelling (WHO numbering system). The tooth had been endodontically treated and restored 4 years ago. After removing the old root canal filing, the roots were irrigated with 2.5% sodium hypochlorite and 17% EDTA using sonic activation. Calcium hydroxide (CH) was used as medicament for 3 weeks. At the second visit, CH was removed, and canals were irrigated as like as the first visit. Apical bleeding was induced, and concentrated growth factors (CGFs) were placed inside the root canal. The tooth has been followed up to 3 years. Conclusion: The tooth was functional and asymptomatic at the recall visits. Since the first-year follow-up, the tooth responded to the electric pulp test and the thermal test. Radiological examinations revealed healing of apical lesion and hard tissue deposition. Clinical significance: Regenerative endodontic procedures can offer an advantage over traditional endodontic procedures in terms of tertiary healing, with a predictable, user-friendly procedure also for retreatment cases.



Alessandro Nanussi, Margherita Varisco, Marina Cortese, Jessica Scali, Edoardo Bianco

Electromyographic Evaluation of Masticatory Muscles in a Young Patient with Crossbite Treated with Rapid Palatal Expander: A Case Report

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:5] [Pages No:1279 - 1283]

   DOI: 10.5005/jp-journals-10024-2782  |  Open Access |  How to cite  | 


Aim and objective: The purpose of this work is to investigate by electromyographic (EMG) surface analysis whether and how the variations in the occlusion due to the correction of the posterior crossbite using a rapid palatal expander (RPE) is accompanied by changes in the activity of the elevator muscles in the pediatric patients. Background: Posterior crossbite is a disgnathic jaw relationship common in patients undergoing growth. In the last 10 years, several studies demonstrated the effectiveness and reproducibility of surface EMG in the objective evaluation of temporal muscle and masseter activity and how this evidence can be an interesting aid in dental clinical practice. Case description: The case subject BF is an 11-year-old boy with a right I class relationship and a left II class relationship treated with a rapid palatal expansion protocol with a turn of the transversal screw twice a day (0.25 mm each turn) for a week. In this case report, EMG was used to evaluate the temporal muscle and masseter activity immediately before, immediately after, and 4 months after the RPE protocol. Conclusion: Four months after the treatment, a condition of well-being and neuromuscular equilibrium such as that of starting was preserved. Clinical significance: Electromyography is a noninvasive exam which evaluates the masticatory muscle activity by facial application of electrodes on masseter and temporal muscles. It can be an interesting aid in orthodontic clinical practice to evaluate preservation of a good muscular balance following orthodontic and orthognathic movements.



Luigi V Stefanelli, Alessio Franchina, Michele Pagliarulo, David Burgess, Stefano Di Carlo

Management of a Complex Case during COVID-19 Time Using One-day Digital Dentistry: A Case Report

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:9] [Pages No:1284 - 1292]

   DOI: 10.5005/jp-journals-10024-2913  |  Open Access |  How to cite  | 


Aim and objective: The aim of the present case report is to describe the digital management of an implant prosthetic rehabilitation performed by the use of different digital technologies, which allowed to successfully perform in 1 day both the surgical and the prosthetical stages with a minimally invasive approach and a high standard of care. Background: Coronavirus disease-2019 (COVID-19) pandemic is affecting dental everyday practice. Clinicians have to reduce the number of patients per day and the time they spend in the dental office. Minimally invasive and digital approaches, with less possible exposure and interaction, are suggested to reduce the risk of infection. Case description: The failure of a short-span implant prosthetic rehabilitation combined with pain and mobility of the involved teeth was the main complaint reported by a 78-year-old male patient, who asked an urgent appointment to solve the problem. An intraoral scanner allowed the clinician to immediately take a preliminary digital impression of the arch to be treated. The resulting 3D files were sent by e-mail to the dental technician who provided a digital wax-up for the computerized workflow. Computer-aided implantology (CAI) performed using an in-office cone-beam computed tomography (CBCT) allowed clinician to guide the surgical approach in a prosthetic manner. Such an integration inside a well-defined workflow was the key for a successful and rapid treatment. Conclusion: By using new innovative digital technology, the treatment was completed in 1 day, reducing the risk of COVID-19 by limiting the number of appointments and reducing contacts in confined environments like the dental office and public transportations. It also helped to reduce materials production and people movement in the treatment of dental emergency. Clinical significance: The possibility of performing an effective treatment saving time by using efficient technology and a minimally invasive procedure highlights the importance of digital planning in order to optimize every single step of the treatment. Digital workflow reduces also the movement of potentially infected materials from the office to the dental laboratory.



Nicholas G Fischer, Firas Mourad, Jose Villalobos-Tinoco

Conservative Ultrathin Veneer Restorations with Minimal Reduction: A 5-year Follow-up Report

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:5] [Pages No:1293 - 1297]

   DOI: 10.5005/jp-journals-10024-2946  |  Open Access |  How to cite  | 


Aim and objective: This case report shows how a feldspathic veneer with diagnostic wax-ups, subsequent mock-up, and reduction guides can lead to good patient esthetics and reports a 5-year follow-up. Background: Conservative tooth preparation is important for the long-term success of adhesive dentistry as it has been shown that bonding to enamel is more predictable in obtaining better long-term success than dentin. To preserve enamel for optimal bonding, diagnostic wax-ups and the subsequent mock-up are the first tools in a restorative dentist's arsenal to find and address differences between current and ideal tooth proportions and also help toward an overall conservative approach. Reduction guides are recommended in order to provide adequate tooth reduction and prevent over-reduction. Case description: This case report shows a 5-year follow-up of feldspathic veneer restorations for a patient with excessive space among teeth, defective composite restorations on facial and incisal surfaces, and worn teeth. Veneers were delivered with conservative tooth preparation combining different tooth reduction guides. Conclusion: This case report highlights the added benefits of tooth reduction guides and diagnostic wax-ups and the subsequent mock-up for long-term patient satisfaction. Clinical significance: Conservative tooth preparation, reduction guides, and wax-ups may increase the life span of veneer restorations and demonstrate good esthetics at 5 years.



Sanjeev B Khanagar, Ali Al-Ehaideb, Madhuniranjanswamy Mahalakshmamma Shivanna, Ikram Ul Haq, Abdulaziz Abdullah Al Kheraif, Sachin Naik, Prabhadevi Maganur

Age-related Oral Changes and Their Impact on Oral Health-related Quality of Life among Frail Elderly Population: A Review

[Year:2020] [Month:November] [Volume:21] [Number:11] [Pages:6] [Pages No:1298 - 1303]

   DOI: 10.5005/jp-journals-10024-2954  |  Open Access |  How to cite  | 


Background: In the present-day world, the aging elderly across the world are living longer. Most people are expected to live well into their sixties and even beyond. The increasing life expectancy of the aging population could be due to increased availability of healthcare facilities and improved quality care provided by them. Alongside increasing life expectancy, the individual's quality of life and also his/her oral health-related quality of life (OHR-QoL) are expected to improve so that they can enjoy their aging life. Aim and objective: The aim of this review article is to highlight aging-related oral health changes and their impact on the individual's quality of life. Review results: Age-related oral changes are seen in the tooth structure making the enamel more brittle resulting in severe attrition. Autoimmune diseases like Sjogren's syndrome are followed by decrease in the salivary gland function and the reason is unknown, and medications like antihypertensive and analgesics are associated with the decrease in salivary flow, which increases the patient's risk of developing dental caries, and also make the oral tissues more prone to mucosal infections. Edentulism has also been directly related to masticatory problems and nutritional problems. The studies reported on OHR-QoL of these frail elderly populations have shown lower scores. Conclusion: It is important for health professionals, especially those dealing with these frail elderly populations, to have a better understanding of their dental needs and also understand the physiologic changes undergone by them. The health professionals should understand and comprehend the oral health challenges these vulnerable people face. Clinical significance: Healthcare providers should conduct periodic oral examinations along with general examination and should avoid prescribing medications that have xerostomia as a side effect. The elderly individuals should be encouraged to keep their mouth moist using water or artificial saliva and maintain good oral and denture hygiene.


© Jaypee Brothers Medical Publishers (P) LTD.