The Journal of Contemporary Dental Practice

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2020 | June | Volume 21 | Issue 6


A Thirumal Raj, Shankargouda Patil

The SARS-CoV-2 Virus may Remain Viable on Oral Appliances for up to 3 Days?

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:1] [Pages No:597 - 597]

PDF  |  DOI: 10.5005/jp-journals-10024-2855  |  Open Access |  How to cite  | 


Gianluca Gambarini, Dario Di Nardo, Federico Valenti Obino, Gabriele Miccoli

Academic Dental Activities and COVID-19 Pandemic

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:1] [Pages No:598 - 598]

PDF  |  DOI: 10.5005/jp-journals-10024-2863  |  Open Access |  How to cite  | 


Gianluca Gambarini, Massimo Galli, Elisa Gambarini, Dario Di Nardo, Federico Valenti Obino, Gabriele Miccoli

Fine Aerosols and Perceived Risk of COVID-19 among Italian Dental Practitioners: An Experimental Survey

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:599 - 603]

Keywords: Dental practice,Airborne infections, Coronavirus, COVID-19

PDF  |  DOI: 10.5005/jp-journals-10024-2850  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to take a survey on Italian practitioners concerning the perceived risks of aerosol contamination in COVID-19 times and their attitude toward modifications of treatment protocols to reduce this risk. Materials and methods: Power analysis calculated a minimum sample size of 150 participants at 99% confidence level with a 5% margin of error. To homogenize responses elicited by different preventive measures by various national governments, only Italian dentists were included in the survey: overall 500 responses were collected. Results: Of the 500 analyzed respondents, there were 266 females and 234 males; 379 practitioners were allocated in the more experienced groups, and the remaining 121 in the less experienced group based on less or more than 5 years of practice. The 70% of the dentists consider the dental practice more dangerous for the diffusion of COVID-19 than other social activities. The 5% consider dental practice more dangerous only for the patients. Aerosol contamination was perceived as a risk from the most dentist (70%), but there was agreement on the most dangerous way of cross infection in dental settings. Most of the dentists (55%) believed implementations in their protocols were needed to reduce the risk of COVID-19 infections. No significant differences were found within the groups: both women and men, as well as practitioners with different experience levels (younger or older than 35 years) perceived very similarly the problems related to COVID-19 in dentistry (p > 0.05). Conclusion: The survey demonstrated that COVID-19 had a great impact on dental practitioners; it increased not only fear of aerosol contamination during dental treatments but also influenced the fear of close contacts. Significance: Airborne and waterborne infections are related with dental treatments and considered the preferred ways of diffusion for COVID-19. The risk of aerosol-related infections could interfere with the clinical practice of the dentist, during the COVID-19 pandemic; the limitations that provided changes to everyday behavior could affect the perception of the safety of the operators, staff, and patient and this could also affect economically the dental office.


Sunny P Tirupathi, Srinitya Rajasekhar, Pushpalatha Tummakomma, Aishwarya Arya Gangili, Abdul Rehman Ahmed Khan, Mohammed Khurramuddin, Usha Purumandla

Auto-controlled Syringe vs Insulin Syringe for Palatal Injections in Children: A Randomized Crossover Trial

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:604 - 608]

Keywords: Auto-controlled syringe, Children, Insulin syringe, Local anesthesia, Pain, Palate

PDF  |  DOI: 10.5005/jp-journals-10024-2864  |  Open Access |  How to cite  | 


Aim: This study aims to evaluate and compare the efficacy of auto-control syringe (ACS) and insulin syringe (IS) for palatal local anesthesia administration in children. Materials and methods: The study was a double-blind, randomized, and crossover trial, comprising 80 children requiring palatal anesthesia bilaterally (total 160 injections). Palatal anesthesia on one side was delivered with ACS in one appointment and contralaterally with IS in the second appointment. One-week washout period was given between first and second appointments. Each child acted as his own control. Each injection technique subjective and objective pain scores were measured twice (during needle prick and during actual deposition of local anesthesia). Subjective and objective evaluation of pain was measured with Wong-Baker FACES pain rating scale (WB-FPS) and the face, leg, activity, cry, and consolability scale (FLACC), respectively. After concluding second appointment, child was asked about their preference between both ACS and IS. Statistical evaluation was performed using Chi-square test. Results: Child reported less pain score for needle prick with IS as opposed to ACS (p value = 0.000416). There was no significant difference between dentist-reported pain scores between any group for both needle prick and local anesthesia administration. There is no significant difference between child reported pain score during administration of local anesthesia between two groups. Irrespective of pain scores, most of the children (96.5%) preferred IS. Conclusion: For palatal local anesthesia administration in children, both IS and auto-controlled syringe have similar efficacy. Clinical significance: Insulin syringe can serve as an economical alternative to the expensive auto-controlled syringe for palatal injections in children.


Fabiano V Vilhena, Mackeler R Polassi, Eloisa AC Paloco, Roberta CB Alonso, Ricardo D Guiraldo, Paulo HP D\'Alpino

Effectiveness of Toothpaste Containing REFIX Technology against Dentin Hypersensitivity: A Randomized Clinical Study

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:6] [Pages No:609 - 614]

Keywords: Dentin hypersensitivity, Desensitizing, Toothpaste,Clinical trial

PDF  |  DOI: 10.5005/jp-journals-10024-2847  |  Open Access |  How to cite  | 


Aim: This clinical study aimed to evaluate the efficacy of a toothpaste containing a proprietary REFIX technology (Regenerador + Sensitive DentalClean, Rabbit Corp) against dentin hypersensitivity. Materials and methods: Fifty-three volunteers who fulfilled the inclusion criteria and signed the consent form were included. They were examined for dentin hypersensitivity. The participants received a 1-second blast of air, and the tooth sensitivity, from 0 to 10, was immediately evaluated using a visual analog scale (VAS). Then, the participants brushed their teeth with the multifunctional toothpaste, and dentin hypersensitivity was tested a second time using the same scale. The participants continued to use the toothpaste three times a day for 1 week, after which dentin hypersensitivity was recorded for the third time. Data were statistically analyzed using analysis of variance (ANOVA) and Tukey\'s test (α = 0.05). Results: The mean patient age was 40 years, and 70% of the 53 subjects were female. There was a significant reduction in dentin hypersensitivity immediately after using the toothpaste and after 1 week. The baseline mean patient-reported pain score was severe (6.5 ± 2.4). Immediately after the first use of the toothpaste, the mean reported pain significantly decreased to mild pain (2.5 ± 2.5) (p < 0.05). After 1 week of consistent use of the toothpaste, the pain score reduced significantly (0.7 ± 1.2) (p < 0.05), and most participants reported no pain, demonstrating the effectiveness of the REFIX technology against dentin hypersensitivity. Conclusion: This clinical trial shows that the use of the phosphate-based desensitizing toothpaste containing REFIX technology significantly reduces dentin hypersensitivity after 1 week of consistent use. Clinical significance: The absence of pain, a desired clinical condition in patients with dentin hypersensitivity, was reached with the use of desensitizing toothpaste containing REFIX technology after 1 week of use. Such condition positively impacts quality of life, providing a healthier daily routine for patients.


Juliana S Siagian, Dennis Dennis, Tulus Ikhsan, Trimurni Abidin

Effect of Different LED Light-curing Units on Degree of Conversion and Microhardness of Bulk-fill Composite Resin

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:6] [Pages No:615 - 620]

Keywords: Bulk-fill composite resin, Degree of conversion, LED light-curing unit, Microhardness

PDF  |  DOI: 10.5005/jp-journals-10024-2848  |  Open Access |  How to cite  | 


Aim: The aim of this study is to compare the effect of the use of second-generation and third-generation LED light-curing units (LCUs) on the degree of conversion (DC) and microhardness (VHN) of bulk-fill resin composites. Materials and methods: Thirty cylindrical specimens (each n = 5) of Tetric N-Ceram Bulk-Fill, Filtek™ Bulk-Fill Posterior Restorative, and SDR flow were prepared in metal molds (5 mm in diameter and 4 mm in thickness) and cured with second-generation LED (SmartLite® Focus®, Dentsply Sirona) and third-generation LED (Bluephase® style, Ivoclar Vivadent) resulting in six groups. Degree of conversion was determined using Fourier transform infrared spectroscopy (FTIR), and microhardness with Vickers microhardness tester. Data were statistically analyzed using one-way ANOVA and least significance difference (LSD) test, and DC and microhardness were correlated using Pearson\'s correlation (α = 0.05). Results: There was a significant difference between DC and VHN between all groups of bulk-fill which were cured by second-generation LED curing light and third-generation LED curing light. Then there is no significant difference between DC of the three composite bulk-fill resins by (second-generation LED vs third-generation LED curing light). Conclusion: The second-generation LED curing light can still be used to cure bulk-fill resin composites by increasing the duration of irradiation. Clinical significance: In the microhardness test, there was a significant difference in the Filtek™ Bulk-Fill Posterior Restorative resin composites.


Dharmesh H Shivananda, Waseem Ansar, Abdul RN Dinsha, George Sam, Sajai Bharath, Ateet Kakti, Hosam Ali Baeshen

Effectiveness of Various Dental Varnishes in Prevention of Enamel Demineralization around Orthodontic Brackets: An In Vitro Study

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:621 - 625]

Keywords: Demineralization, Orthodontic treatment, Varnish,Brackets

PDF  |  DOI: 10.5005/jp-journals-10024-2820  |  Open Access |  How to cite  | 


Aim: The present study aimed to assess the efficacy of different dental varnishes in prevention of demineralization of enamel along the orthodontic brackets. Materials and methods: A total of 60 premolars that do not have caries and were extracted for orthodontic purposes were used in this study. Transbond™ Plus was used to bond premolar brackets onto the treated surface of enamel. The teeth were then divided into three groups. Group I: Profluorid varnish, group II: CPP-ACP varnish, and group III: Duraflor™ varnish. A Vickers diamond indenter was used to assess the microhardness of the surface of enamel at baseline, fourth day, and seventh day. Results: A slightly meaner surface microhardness (SMH; 334.20 ± 2.10) was seen in group III when compared with group I (332.16 ± 3.02) and group II (330.40 ± 2.02). The mean SMH was 342.02 ± 0.82 in group I on the fourth day which was slightly higher than that of the baseline values, followed by group III (339.48 ± 0.34) and group II (336.64 ± 1.14). No statistically significant differences were noted between the groups. A higher mean microhardness of 349.84 ± 0.66 was seen in group I on the seventh day, followed by group III (342.26 ± 1.08) and group II (338.18 ± 1.08). A statistically highly significant difference was seen between the groups. Conclusion: The present study concluded Profluorid varnish to have maximum potential to reduce demineralization of enamel followed by Duraflor and casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) group. Clinical significance: A most common clinical challenge encountered in orthodontic clinical practice is enamel demineralization or white spot lesion (WSL) development throughout the fixed appliance treatment. Thus, the information about several available varnishes is important to prevent demineralization in regular dental practice.


Isabelle Lins Macêdo de Oliveira, Oscar Felipe Fonseca de Brito, Laís Maciel Costa Gabriela Queiroz de Melo Monteiro, Marcos Antônio Japiassu Resende Montes

Microtensile Bond Strength of Bulk-fill Resin Composite Restorations in High C-factor Cavities

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:6] [Pages No:626 - 631]

Keywords: Composite resins, Dental bonding, Dentin, Laboratory research, Tensile strength

PDF  |  DOI: 10.5005/jp-journals-10024-2846  |  Open Access |  How to cite  | 


Aim: To evaluate the microtensile bond strength (μTBS) and the fracture modes of four bulk-fill resin composites (Tetric EvoCeram Bulk Fill/Ivoclar Vivadent, Filtek Bulk Fill/3M ESPE, Venus Bulk Fill/Heraus Kulzer, and Filtek Bulk Fill Flow/3M ESPE) and one conventional incrementally filled resin composite (Filtek Z250/3M ESPE) inserted in class I cavities, after 24 hours and 6 months of water storage. Materials and methods: In all, 30 sound human extracted molars were divided into five restorative groups. Standardized class I cavities were prepared and restored following the manufacturer\'s instructions. The restored teeth were then assigned into one of the storage times (24 hours or 6 months). The molars were then cut into 1 mm2 sticks and submitted to μTBS. All fractured specimens were analyzed under a stereomicroscope (40×). Data were submitted to analysis of variance (ANOVA) and the Tukey post hoc test was applied for comparison between groups; and paired t test for comparison within storage times (p = 0.05). Results: After 24 hours of storage, statistically significant differences were observed between Filtek Z250 and Filtek Bulk Fill Flow groups. However, after 6 months, no statistical differences were observed between groups. Additionally, no differences were observed for the μTBS between the storage times. Adhesive failures were the most frequent fracture mode after 24 hours (54%) and 6 months (43%), the resin cohesive fracture mode showed 16% for 24 hours and 14% for 6 months, the dentin cohesive fracture mode showed 14% for 24 hours and 26% for 6 months, and the mixed fracture mode showed 16% for 24 hours and 17% for 6 months. Conclusion: Bulk-fill resin composites obtained similar μTBS in high C-factor cavities as conventional incrementally filled resin composites. No bond strength reduction was observed after 6 months of storage. Clinical significance: Single increment restorations in high C-factor cavities with bulk-fill resin composites did not reduce μTBS after 24 hours or 6 months of storage. The comparable results to the conventional incrementally filled resin composites and the reduction in the operative time, make the bulk-fill resin composites a restorative option for posterior teeth restorations.


Vijay Parashar, Shabab A Khan, Puja Singh, Shishir Sharma, Kumar Anand

Effect of Intracanal Medicaments (Modified Triple Antibiotic Paste, Calcium Hydroxide, and Aloe Vera) on Microhardness of Root Dentine: An In Vitro Study

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:4] [Pages No:632 - 635]

Keywords: Aloe vera, Calcium hydroxide, Microhardness, Modified triple antibiotic paste, Root dentin

PDF  |  DOI: 10.5005/jp-journals-10024-2813  |  Open Access |  How to cite  | 


Aim: To compare the effect of three different intracanal medicaments, namely, modified triple antibiotic paste (MTAP), calcium hydroxide (Ca(OH)2), and aloe vera, on the root dentine microhardness. Materials and methods: A total of 50 extracted mandibular bicuspids were prepared using ProTaper Next rotary files. The roots of the bicuspids were alienated to three groups (n = 10 each) and one control group (untreated; n = 20). In three groups, the root canals were filled with MTAP, Ca(OH)2, and aloe vera medicaments. After 21 days, medicaments were removed by Endo activator. Mean Knoop hardness numbers were calculated after treatment and compared with the untreated control group. Data were evaluated using the Student\'s t test (paired), ANOVA (one-way) followed, and the post hoc test. Results: All treated groups except the aloe vera group had shown significant reduction (p < 0.05) in microhardness of the root dentin as compared with the untreated control group. The aloe vera group showed least reduction of microhardness and was statistically insignificant (p > 0.05). Conclusion: Aloe vera shows promising results in terms of fewer effects on microhardness of the root dentin compared to MTAP and Ca(OH)2. Clinical significance: Elimination of most of the bacterial infection from the root canal and very minimum to no effect on the microhardness of the dentin in the root part are the basics of success in any endodontic treatment. Further in vivo studies are required to compare the efficacy of these intracanal medicaments.


Apoorva Sahu, Veera Bhosale, Dhananjay Ghunawat, Girish Rathi, Mohammed YA Khan

An In Vivo Randomized Clinical Evaluation of the Surface Morphology of Nickel–Titanium, Beta-titanium, and Copper–Nickel–Titanium

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:4] [Pages No:636 - 639]

Keywords: Orthodontics, Surface roughness,Beta-titanium, Copper–titanium, Nickel–titanium

PDF  |  DOI: 10.5005/jp-journals-10024-2818  |  Open Access |  How to cite  | 


Aim: Variation in the surface roughness of archwires not only leads to more accumulation of plaque but also modifies the coefficient of friction. This necessitated for the present study to evaluate the surface characteristics of 0.016 × 0.022-inch nickel–titanium, beta-titanium, and copper–nickel–titanium archwires, before and after their use in the oral cavity using atomic force microscopy. Materials and methods: The control and experimental samples were measured at three different positions under atomic force microscopy. The surface roughness was measured using roughness average, root mean square, and maximum height before and after use in the oral cavity among 60 adult participants. Data were analyzed using a one-way analysis of variance and Student\'s t tests using the Statistical Package for Social Software (SPSS) v.20.0. Results: The surface roughness of archwires increased considerably after their clinical use compared to controls for nickel–titanium (p = 0.013) and beta-titanium (p = 0.002). A similar trend was noticed for root mean square where nickel–titanium (p = 0.014) and beta-titanium (p = 0.013) had increased root mean square. Maximum height was also noticed in nickel–titanium (p = 0.031) and beta-titanium (p = 0.016). Conclusion: Surface roughness and the level of friction of the orthodontic wires increase significantly for nickel–titanium and beta-titanium after the clinical use. There is a difference in increase of surface roughness of the archwire within and between the bracket slots. Clinical significance: Nickel–titanium and beta-titanium wires show more roughness and resultant higher friction levels after use in the oral cavity. Hence, care related to plaque accumulation is essential.


Ali Peimani, Tahereh Eslammanesh, Mostafa Sadeghi, Ramin Rahati

Effect of Diode Low-level Laser Irradiation Time on Socket Healing

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:640 - 644]

Keywords: Laser irradiation, Low-level laser therapy, Tooth socket, Wound healing

PDF  |  DOI: 10.5005/jp-journals-10024-2862  |  Open Access |  How to cite  | 


Aim: The purpose of this research was to survey the effect of low-level laser irradiation time on socket healing in rats. Materials and methods: This randomized nonblinded animal study was done on 24 male rats that were divided into four groups. First maxillary molars of rats were extracted through general anesthesia, and laser was used in all four groups: first group with zero radiation time, second group with 3 minutes, third group with 5 minutes, and fourth group with 10 minutes of radiation by the diode laser (power: 100 mW, wavelength: 980 nm). Half of the rats (three rats) were sacrificed on the 3rd day and another half of rats were sacrificed on the 7th day. Then, the presence of angiogenesis, bone trabeculae, fibroblasts, neutrophil cells, macrophage cells, and lymphocyte cells was assessed. Data were analyzed by SPSS (version 21) using parametric tests. Results: Among 24 rats, on the 3rd day, the percentage of macrophage and bone trabecula increased significantly in the 5 minute group (p = 0.041 and p < 0.01, respectively). Other changes in days 3 and 7 were not statistically significant (p > 0.05). Conclusion: Low-level laser radiation can accelerate the process of tooth socket healing, which was particularly noticeable in the 5 minute radiation over 3 days. Clinical significance: Using a low-level laser can be helpful in accelerating the healing of the tooth socket and reduce the complications after tooth extraction.


Mukesh Kumar, Sommya Kumari, Konark, Anju Singh, Pragyan Das

Orthodontic Inventory for Management of Nickel-sensitive Patients: An In Vitro Study

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:6] [Pages No:645 - 650]

Keywords: Titanium brackets,Friction, Nickel sensitivity

PDF  |  DOI: 10.5005/jp-journals-10024-2826  |  Open Access |  How to cite  | 


Aim: To compare the frictional resistance produced by titanium and stainless steel (SS) brackets with various orthodontic wires used in sliding mechanics. To evaluate surface texture of brackets and wires using scanning electron microscopy (SEM). Materials and methods: A total of 40 canine brackets of titanium and SS having 0.022” slot were tested for static and kinetic friction, with SS, low-friction titanium–molybdenum alloy (TMA), timolium and titanium–niobium (Ti–Nb) wires (0.019” × 0.025”), using a universal testing machine. To evaluate the surface roughness, the brackets and wires were subjected to SEM before and after testing. Results: Titanium brackets showed greater mean static and kinetic frictional forces compared to SS brackets with all the wires that were tested. It was lowest with timolium wire followed by SS wire, low-friction TMA and highest with Ti–Nb wire. The SEM indicated greater surface roughness of titanium bracket slot compared to the SS bracket slot, and titanium wires showed greater surface roughness compared to the SS wire. Conclusion: The SS bracket with SS wire would produce efficient results during retraction in sliding mechanics. However, in nickel-sensitive patients where titanium brackets are used as an alternative, the wire of choice would be timolium wire. Low-friction TMA and Ti–Nb wires would be the secondary wires of choice. Clinical significance: Nickel sensitivity and frictional resistance remain a matter of concern during orthodontic treatment for the patients and orthodontist, respectively. This study highlights the orthodontic wire of choice to reduce frictional resistance while using titanium brackets in nickel-sensitive patients.


Jéssica F de Camargo, Sara de F Ribeiro, Gisele Rovani, Carla Piardi, Valquíria de J Freitas, Diego J Gambin, Micheline S Trentin, Maria S Sandini Linden, João P de Carli

Histopathological Classifications of Oral Leukoplakia and its Relation to Cell Proliferative Activity: A Case Series

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:6] [Pages No:651 - 656]

Keywords: Argyrophilic nucleolar organizer regions, Diagnosis, Histological classification, Leukoplakia, Prognosis

PDF  |  DOI: 10.5005/jp-journals-10024-2840  |  Open Access |  How to cite  | 


Aim: This study relates the average number of nucleolar organizing regions (NORs) obtained in a series of cases of oral leukoplakia, with three methods of histopathological classification of such lesion. Materials and methods: This is a histopathological–histochemical laboratory cross-sectional study. The 18 cases of leukoplakia analyzed were filed at Pathology Service of the Biological Sciences Institute of the University of Passo Fundo, Rio Grande do Sul, Brazil (SDH/ICB/UPF) (2017 and 2018), from which epidemiological data were extracted. New histological sections were performed for impregnation by the argyrophilic nucleolar organizer regions (AgNOR) technique. The histopathological slides were analyzed by photon microscopy (1,000×), and the nuclei of 100 epithelial cells were photographed to count the number of NORs. Three methods were used for the lesions’ histopathological classification [World Health Organization (WHO), Brothwell, and binary system]. The means of NORs were compared with the three histopathological classifications by means of the t or analysis of variance (ANOVA) statistical tests, at a significance level of 5%. Results: According to the WHO classification method, most cases (11–61.1%) had a moderate classification. Evaluations by the Brothwell method showed moderate and mild classification in 50 and 38.9% of cases, respectively. According to the binary system, most cases (10–55.6%) had low risk. The average NORs found in 100 nuclei of each of the 18 lesions ranged from 2 to 4. When crossing the average NORs with the histopathological classification methods of the lesions by means of the t test or ANOVA, no significant relationship was noted. Conclusion: The average of NORs is not associated with the histological classifications of leukoplakias. Thus, the AgNOR method should be used with caution when differentiating different histological grades of leukoplakias. Clinical significance: The AgNOR method should be used with caution to determine the clinical treatment of oral leukoplakias, since no agreement was observed between this method and the histopathological classifications available for such lesion.


Juliana Y Nagata, Fernanda B Fagundes, Eliseu A Münchow, Maria TP Albuquerque

Single-session Endodontic Treatment is a Reality in Low-income Areas in Brazil?

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:9] [Pages No:657 - 665]

Keywords: Questionnaire, Single visit,Continuing education, Endodontics

PDF  |  DOI: 10.5005/jp-journals-10024-2861  |  Open Access |  How to cite  | 


Aim: The present study aimed to investigate the total number of visits required to conclude root canal treatments (RCTs) as well as the motivations associated to the choice of dentists practicing in low-income areas of Brazil. Materials and methods: A total of 3,103 questionnaires were electronically and individually delivered to professionals of Salvador, Sergipe, and Alagoas (Brazil). The questionnaire encompassed sociodemographic data and questions regarding the number of sessions required to conclude RCT. Also, postoperative pain, professional qualification, the use of technological resources, and time for one-visit treatment were evaluated. Data were analyzed using Chi-square and Poisson regression analyses (p < 0.05). Results: A total of 326 responses were obtained with higher prevalence of specialists in the field of endodontics (36.8%). Dentists reported greater preference for rotary instrumentation (Alagoas 54.6%, Aracaju 62.1%, and Salvador 83.5%), and most of the participants reported multiple visits to treat root canals with the necrotic pulp tissue associated or not to periapical radiolucency, excluding Salvador (53.8%). Dentists who graduated in public dental schools were less likely to perform RCT of necrotic teeth with periapical lesion in one clinical appointment (p = 0.034). The single-session therapy was positively associated to continuing education attendance (p = 0.004) and to the occurrence of clinical complications (p < 0.001). Dentists who graduated in lato sensu programs were more likely to conclude RCT in less than 60 minutes (p < 0.001), although the occurrence of postoperative pain was more likely observed upon this scenario (p < 0.001). Conclusion: Despite the social inequalities in the analyzed area, professionals have been seeking for knowledge by means of continuing education programs and the implementation of technological resources in their clinical routine, although this fact has poorly influenced the acceleration of RCT. Clinical significances: The total number of visits to conclude endodontic treatment may be influenced by both professional and biological parameters such as the attendance to postgraduation programs and the use of technology as well as to the biological condition of the pulp and the occurrence of postoperative complications.


Marina Cortese, Giada Pigato, Giulia Casiraghi, Maurizio Ferrari, Edoardo Bianco, Marcello Maddalone

Evaluation of the Oropharyngeal Airway Space in Class II Malocclusion Treated with Mandibular Activator: A Retrospective Study

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:7] [Pages No:666 - 672]

Keywords: Snoring, Temporomandibular joint,Class II malocclusion, Upper airway resistance syndrome, Mandibular activators, Occlusion, Oropharyngeal spaces, Obstructive sleep apnea syndrome, Sleep

PDF  |  DOI: 10.5005/jp-journals-10024-2856  |  Open Access |  How to cite  | 


Aim: The development of a class II malocclusion is usually related to a reduced oropharyngeal airway space. In order to prevent airway obstruction, functional appliances are commonly used for orthodontic therapy. The aim of the article is to verify if these appliances could positively influence oropharyngeal diameters preventing the onset of future respiratory disorders. Materials and methods: A group of 10 patients treated at the Dental Clinic of San Gerardo Hospital in Monza with mandibular activator was selected. Ten similar untreated class II subjects with retrognathic mandible were used as control group. The cephalometric tracings were made on lateral teleradiographs of the skull before and after the active therapy with functional devices for the treated group and before and after growth peak for the control one. Descriptive statistical analysis was calculated for all the cephalometric values in both study cases and control group using Excel worksheet. The data distribution was evaluated with Shapiro–Wilk test and the in-between group discrepancies were evaluated with Mann–Whitney U test. Results: At T1 period, both case and control groups showed a class II pattern. At T2 period, the study group shows an improvement in bones relationship with reduced ANB angles and OVJ measurements. The control group otherwise did not show any important changes in maxillo–mandibular discrepancies. The airway size increased in either group in most cases. No significant differences between the treated and control groups were detected for airway size neither in the upper, middle, nor lower level at the T1–T2 interval. Conclusion: The upper airway values did not show any significant discrepancies between the two groups during the observation period. Clinical significance: Functional devices were effective in solving class II relationships, but there is no evidence of successful breathing disorders prevention by using mandibular activators, probably due to the stability of airway tissues reached in pubertal age in both groups.


Maryam Firouzmandi, Maryam Firouzmandi, Mina Mohaghegh, Sonia Hessami

Effect of Simulated Pulpal Pressure on Knoop Hardness of Two Self-etch Adhesives with Different Aggressiveness

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:673 - 677]

Keywords: Knoop hardness, Polymerization, Pulpal pressure, Self-etch adhesives

PDF  |  DOI: 10.5005/jp-journals-10024-2845  |  Open Access |  How to cite  | 


Aim: Simulated pulpal pressure (PP) has been shown to affect the bond strength and nanoleakage of different adhesives at dentin interfaces but the effect of simulated PP on polymerization of adhesives has not been studied yet. Furthermore, it has been proposed that strong and mild self-etch adhesives have different polymerization behaviors. This study aimed to evaluate the effect of simulated PP on polymerization of two self-etch adhesives, Adper Prompt L-Pop (APLP) and Adper Easy Bond (AEB), by means of the Knoop hardness test. Materials and methods: Sixty caries-free human molars were used to prepare deep dentin specimens with a mean remaining dentin thickness of 0.9 mm. The specimens were bonded in the absence or presence of PP. The specimens were assigned to four equal groups (n = 15) as follows: AEB/-PP, APLP/-PP, AEB/+PP, and APLP/+PP. Bonding procedures were completed; then the specimens’ hardness was measured with the Knoop test. Data were analyzed with two-way ANOVA and the t test. Results: In the absence of PP, the hardness of AEB was significantly higher than that of APLP (p < 0.001). In contrast, when PP was simulated, the hardness of APLP was higher than that of AEB (p = 0.002). The hardness of AEB was not influenced by the presence of PP (p = 0.153). Simulation of PP resulted in a significant improvement in the hardness of APLP (p < 0.001). Conclusion: The polymerization degree of strong self-etch adhesive was lower compared to mild self-etch adhesive. In the presence of hydrostatic PP, the polymerization degree of strong self-etch adhesive was higher than mild self-etch adhesive. Clinical significance: Dentin moisture caused by positive PP might improve polymerization of strong self-etch adhesives.


Mohammed A Mousa

Influence of Weather on Hardness and Surface Roughness of Maxillofacial Elastomeric Materials

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:678 - 682]

Keywords: A-2186, Cosmesil M-511, Hardness, Maxillofacial elastomeric, Surface roughness, TechSil S-25,A-2000

PDF  |  DOI: 10.5005/jp-journals-10024-2853  |  Open Access |  How to cite  | 


Aims: The purpose of this study was to assess the influence of hot and dry weather on the hardness and surface roughness of four different maxillofacial silicone elastomeric materials (MFSEM) including two room-temperature vulcanized (RTV) and two high-temperature vulcanized (HTV) materials. Materials and methods: Eighty test specimens were fabricated according to the manufacturer\'s instructions into rectangular test specimens. The hardness and surface roughness were tested, after 6 months of exposure to natural hot and dry weather. The hardness was measured through the International Rubber Hardness Degree (IRHD) scale using an automated hardness tester. The surface roughness was measured using a novel 3D optical noncontact technique using a combination of a light sectioning microscope and a computer vision system. Statistical Package for Social Sciences software SPSS/version 24 was used for analysis and a comparison between two independent variables was done using an independent t test, while more than two variables were analyzed, F test (ANOVA) to be used followed by a post hoc test to determine the level of significance between every two groups. Results: The hot and dry weather statistically influenced the hardness and surface roughness of MFSEM. Cosmesil M-511 showed the least hardness in test groups while A-2000 showed the hardest material (p < 0.05). A-2000 showed significant changes from rough in case of nonweathered to become smoother in weather followed by A-2186 (p < 0.05). Cosmesil M-511 showed the roughest material. Conclusion: Cosmesil M-511 showed the least hard MFSEM after outdoor weathering while A-2000, the highest and least material showed hardness and surface roughness, respectively. Clinical implication: A-2000 had a high IRHD scale hardness. This makes this material more suitable for the replacement of ear and nose defects. Cosmesil M-511 is soft and easily adaptable material that makes the material more appropriate for the replacement of small facial defect with undercut area to be easily inserted and removed. Whilst A-2000 is smoother and finer in test specimens after weathering, Cosmesil M-511 became rougher after weathering.


Anuj Singh Parihar, Kyatsandra N Jagadeesh, Anuj Singh Parihar, Sami Alduwayhi, Sridhar Annapoorneshwari, Faiz Muslimveetil Khalid, Prashant Babaji

Evaluation of Microleakage and Microgap of Two Different Internal Implant–Abutment Connections: An In Vitro Study

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:3] [Pages No:683 - 685]

Keywords: Staphylococcus aureus,Bacteria, Dental implants

PDF  |  DOI: 10.5005/jp-journals-10024-2817  |  Open Access |  How to cite  | 


Aim: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant–abutment associations. Materials and methods: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram\'s stain and biochemical reactions were used for identification of colonies. Results: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 μm and was 10.4 μm in group II. The disparity among the two groups was found to be significant (p < 0.05). Conclusion: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection. Clinical significance: Microscopic space between implant and abutment may be the site of penetration of bacteria. This information will help to avoid microleakage to improve implant success rate.


Ahmed M Alassiry

Prevalence of Malocclusion Traits in Saudi Males Seeking Orthodontic Treatment in Najran in Saudi Arabia

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:686 - 690]

Keywords: Adolescents, Adults, Malocclusion, Prevalence, Saudi males

PDF  |  DOI: 10.5005/jp-journals-10024-2859  |  Open Access |  How to cite  | 


Aim: To study the prevalence of different malocclusion traits in Najran in Saudi adolescents and adults seeking orthodontic treatment in Najran in Saudi Arabia. Materials and methods: Two hundred and fifty male patients in the age group of 12–35 years who visited faculty of dentistry in Najran University for orthodontic treatment were examined and were divided into two age groups, adolescents and adults. The patients were examined and classified into Class I, Class II, and Class III malocclusions. They were also examined for overjet, overbite, open bite, crossbite, scissor\'s bite, crowding, and spacing. Results: The prevalence of Angle\'s malocclusion Classes I, II, and III was 52.8%, 31.6%, and 15.6%, respectively. The most common anomaly was moderate overbite followed by lateral open bite. Posterior crossbite was found to be more prevalent than anterior crossbite. Conclusion: Angle\'s Class I malocclusion was most prevalent type, followed by Class II, and then Class III. Clinical significance: The findings of this study can be used to formulate an appropriate preventive and orthodontic treatment measures pertaining to the population of adolescent and adult Saudi males.


Ramachandra Sujith, Tej G Yadav, Deepti Pitalia, Prashant Babaji, Kommula Apoorva, Ankita Sharma

Comparative Evaluation of Mechanical and Microleakage Properties of Cention-N, Composite, and Glass Ionomer Cement Restorative Materials

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:691 - 695]

Keywords: Hybrid composite, Properties,Cention-N, Glass ionomer cement

PDF  |  DOI: 10.5005/jp-journals-10024-2837  |  Open Access |  How to cite  | 


Aim: The longevity of restorative materials depends on the resistance to masticatory forces. The present study was undertaken to evaluate the mechanical and microleakage properties of Cention-N with glass ionomer cement (GIC) and composite restorative materials. Materials and methods: A total of 45 specimen blocks were prepared with 15 samples of each type of restorative material, namely Cention-N, GIC, and hybrid composite. Samples were subjected to load at crosshead speed of 0.75 ± 0.25 mm/min till the fracture of sample. Class V cavities were prepared on the buccal surface of orthodontically extracted premolars followed by restoration of each test material. All the surfaces of the tooth were coated with clear nail varnish except 1 mm around the margins of the restorations. These samples were immersed in 0.5% basic fuchsine dye and longitudinally sectioned and observed under stereomicroscope to check microleakage. The obtained data were statistically evaluated. Results: We found the highest mean compressive and flexural strength for hybrid composite followed by Cention-N and least for GIC which is statistically significant (p < 0.001). Conclusion: Mean microleakage was least for Cention-N. Cention-N is a newer restorative material having higher mechanical properties with lesser microleakage. Clinical significance: Cention-N is a newer restorative material having promising properties. This material can be used as an alternative restorative material.


Bruno da Silva Mesquita, Belmiro Cavalcanti do Egito Vasconcelos, Sandra Lucia Dantas de Moraes, Cleidiel Aparecido Araújo Lemos, Jéssica Marcela de Luna Gomes, Eduardo Piza Pellizzer, Emanuel Sávio de Souza Andrade

Pterygomaxillary Disjunction and its Influence on the Result of Surgically Assisted Maxillary Expansion: A Systematic Review and Meta-analysis

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:5] [Pages No:696 - 700]

Keywords: LeFort I osteotomy, Maxilla, Systematic review

PDF  |  DOI: 10.5005/jp-journals-10024-2857  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the available evidence to identify the influence of pterygomaxillary disjunction on the result of surgically assisted maxillary expansion. Background: LeFort I type osteotomy with disjunction of the pterygomaxillary suture is a procedure widely used in maxillofacial surgery. However, the need for its performance during surgically assisted maxillary expansions has been discussed in literature, since serious complications can be caused during this stage. Review results: Systematic review of articles was performed using three databases (PubMed, Web of Science, and Cochrane) published until May 2019. After applying the selection criteria, five articles were included in the systematic review, with a total of 141 patients. Meta-analysis showed the absence of significant difference between intervention and control groups in the preoperative period (standardized mean difference = −0.28; confidence interval, CI 95% = −0.81, 0.26; p = 0.31) and postoperative period (standardized mean difference = −0.12; 95% CI = −0.65, 0.42; p = 0.66). In general, the heterogeneity of statistical estimates was low (I2 = 0%). Conclusion: No statistically significant difference was observed between control group (without pterygomaxillary disjunction) and intervention group (with pterygomaxillary disjunction). Clinical significance: Based on the data analyzed in this systematic review, it could be concluded that pterygomaxillary disjunction is not a mandatory step to achieve satisfactory maxillary expansion. Thus, not performing pterygomaxillary disjunction can prevent complications and reduce surgical time.


Fadia Darwiche, Eyad Khodari, Dareen Aljehani, Anadha N Gujar, Hosam Baeshen

Comparison of Effectiveness of Corticotomy-assisted Accelerated Orthodontic Treatment and Conventional Orthodontic Treatment: A Systematic Review

[Year:2020] [Month:June] [Volume:21] [Number:6] [Pages:9] [Pages No:701 - 709]

Keywords: Fixed orthodontic treatment,Accelerated orthodontics, Corticotomy, Dentoalveolar distraction

PDF  |  DOI: 10.5005/jp-journals-10024-2886  |  Open Access |  How to cite  | 


Aim: To systematically review the comparative differences in the performance and timeliness of conventional orthodontic treatment with that of corticotomy-assisted accelerated orthodontic treatment. Data sources: The electronic databases PubMed and Google Scholar were searched from January 2007 to January 2018 in English, with manual searches of reference lists and gray literature. Thirty-six articles were included in the study with inclusion criteria as prospective clinical studies of patients treated with fixed conventional appliance and the intervention was the corticotomy-assisted accelerated orthodontic treatment method. Study selection: Two reviewers assessed independently the eligibility of the included articles. One investigator abstracted study design information, intervention details, and harms data from all included studies into a standardized evidence table. The accuracy of these data was checked by the second investigator. We resolved any disagreements through discussion with other authors. Results: Different aspects of the corticotomy-assisted accelerated orthodontics treatment method were investigated including risk factors, advantages, and disadvantages as compared to that of conventional orthodontic treatment. Conclusion: There is limited available evidence about effectiveness of corticotomy-assisted accelerated orthodontics. Although the current review indicates that the corticotomy-assisted accelerated orthodontic treatment method can fasten the treatment duration by 2.2–3 folds compared to conventional orthodontic treatment, furthermore, the level of evidence needs well-conducted prospective research with big sample size to draw valid conclusions. Clinical significance: Orthodontic treatment is a time-consuming process and due to noncompliance of patients, research has found different methods to accelerate the treatment, thus reducing the total treatment duration. Use of accelerated orthodontic techniques is expected to help clinicians in better treatment decisions for noncompliant patients.

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