The Journal of Contemporary Dental Practice

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2020 | July | Volume 21 | Issue 7

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Umarevathi Gopalakrishnan, Lodd Mahendra

Is the Stability of a Standard Stable Reference Stable Enough?

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:2] [Pages No:711 - 712]

   DOI: 10.5005/jp-journals-10024-2795  |  Open Access |  How to cite  | 



Kibrom Mehari, Allan S Parke, Francisco F Gallardo

Assessing the Effects of Air Abrasion with Aluminum Oxide or Glass Beads to Zirconia on the Bond Strength of Cement

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:713 - 717]

   DOI: 10.5005/jp-journals-10024-2879  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate the effects of air abrasion with aluminum oxide or glass beads to three types of zirconia containing various levels of cubic crystalline phases (3Y-TZP, Katana ML; 4Y-PSZ, Katana STML; and 5Y-PSZ, Katana UTML, Noritake) on the shear bond strength of resin cement. Materials and methods: Thirty block specimens (8 × 8 × 3.5 mm) were milled out of each zirconia material and mounted in plastic pipe. Ten specimens of each of the zirconia materials were air-abraded using 50 μm aluminum oxide particles, ten specimens were abraded using 80 μm glass beads, and ten specimens served as a control and received no surface treatment. A zirconia primer was applied to the surface of the zirconia specimens. Composite disks were bonded using a resin cement and light-cured. The specimens were stored in 37°C distilled water for 24 hours and thermocycled for 2,500 cycles. The specimens were loaded in shear on a universal testing machine. Data were analyzed with one-way and two-way ANOVAs and Tukey's post hoc tests (α = 0.05). Results: A significant difference in shear bond strength was found based on the surface treatment (p < 0.001), but not on the type of zirconia (p = 0.132). Conclusion: Air abrasion with glass beads or no surface treatment resulted in significantly lower bond strength of the resin cement to all three zirconia types compared to air abrasion with aluminum oxide. Clinical significance: Although air abrasion with aluminum oxide may reportedly be more likely to weaken cubic-containing zirconia compared to air abrasion with glass beads, the use of aluminum oxide results in greater bond strength of the resin cement.



Massimo Giovarruscio

A Survey on Perceived COVID-19 Risk in Dentistry and the Possible Use of Rapid Tests

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:718 - 722]

   DOI: 10.5005/jp-journals-10024-2851  |  Open Access |  How to cite  | 


Aim: The present study was conducted to assess the perceived risk of COVID-19 transmission in dental professionals (DPs), that include dentists and dental auxiliary staffs, and whether rapid tests should be a recommended tool to constrain the transmission of the COVID-19, and who should be bearing their cost (governments, dentists, or patients) through an online survey. Materials and methods: A sample size of n = 700 was recruited in the study. The study included DPs from all over the world. A randomized selection of samples was done through dental groups present on social networks. An online survey was conducted in April 2020, using the Google Form software to provide questions and collect and elaborate answers. Data were analyzed using the statistical software STATA and presented in terms of percentages. Results: About 78% of the study participants perceived a very high risk of COVID-19 contamination in dental settings. Nearly 80% of the study participants were willing to be subjected to rapid tests and the same could be performed on patients visiting their dental clinics, which could prevent the spread of the disease. About 55% of the participants had reported that additional costs for the rapid tests should be borne by the governments. Conclusion: The results of the present survey report that DPs do not feel safe and perceive a high risk of COVID-19 contagion and prevention of the disease could be done by performing rapid tests on dentists, dental staff, and patients visiting the dental clinics irrespective of age and gender of the participants. Significance: Since all the dentists and allied staff have perceived increased risk for COVID-19 transmission, it is important that preventive measures are implemented through rapid test kits at the earliest.



Amal I Linjawi

Comparison between Characteristics of Maxillary Right and Left Central Incisors: A Cone-beam Computed Tomography Study

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:723 - 727]

   DOI: 10.5005/jp-journals-10024-2874  |  Open Access |  How to cite  | 


Aim: To compare the angulation of maxillary left (UL) and right (UR) incisors and the width of alveolar bone. Materials and methods: This study was conducted using archived cone-beam computed tomography (CBCT) images of 50 male and 50 female patients. The UL and UR incisors were compared in terms of incisor/palatal plane angle, collum angle, labiopalatal crown-root position, and alveolar bone width (ABW). The comparison, with reference to gender and age, was analyzed using one-way analysis of variance and independent sample t test. Results: There is no substantial variance in the average differences of the assessed variables for UR and UL central incisors (p > 0.05). No significant association was found between crown labial to root and root labial to crown positions for both central incisors (p > 0.05). Statistical analyses revealed that tooth type has no significant association with the central incisors-related variables. Alveolar bone width, at various areas assessed, showed significant relation to gender. On the other hand, incisor/palatal plane angle and ABW at the cementoenamel junction and at level of Point A (subnasale) were significantly affected by age. Conclusion: Gender can significantly affect the development of ABW. Also, incisor/palatal plane angle and ABW at certain areas are correlated with age. Clinical significance: Understanding the similarities or differences between right and left maxillary central incisors may give better indication if cephalometric images are accurate in attaining such measurements. This in turn will also help orthodontist to choose the proper tool for treatment decision-making related to incisor tooth movement.



Andrea Del Giudice, Alessandro Mazzoni

Fatigue Resistance of Two Nickel–Titanium Rotary Instruments before and after Ex Vivo Root Canal Treatment

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:728 - 732]

   DOI: 10.5005/jp-journals-10024-2875  |  Open Access |  How to cite  | 


Aim: The aim of the present study is twofold: to evaluate cyclic fatigue resistance differences of two different nickel–titanium rotary instruments, brand new and after an ex vivo instrumentation of single root extracted teeth. Materials and methods: Twenty new S One 20.06 were randomly divided into two groups. The first group (n = 10) was immediately subjected to a cyclic fatigue test (S One Group I). The second group (n = 10) (S one Group II) performed a cyclic fatigue test after three ex vivo root canal treatment with a single-file technique. The same process has been carried out for 20 M-Two 20.06 instruments. Results: Mean time to fracture (TtF) for Group I was 51.14 ± 1.28 for S One and 32.62 ± 0.17 for M-Two 20.06 and for Group II was 46.00 ± 0.99 for S One and 27.75 ± 1.58 for M-Two 20.06. The reduction in TtF values from Group I to Group II was 11% for S One and 15% for M-Two. Statistical analysis found significant differences in all the groups examined (p value < 0.05). Mean fragment length (FL) for Group I was 3.07 ± 0.17 for S One and 3.05 ± 0.14 for M-Two 20.06 and for Group II was 3.05 ± 0.07 for S One and 3.05 ± 0.14 for M-Two 20.06. Statistical analysis was pursued, and no significant difference was found (p value > 0.05). Conclusion: The S-One showed significantly more resistance to cyclic fatigue stress than M-Two for both new and used instruments. This validates the hypothesis that the AF H wire enables the S One files to endure more the cyclic fatigue stresses. Clinical significance: This study demonstrates the cyclic fatigue resistance of a new endodontic instrument after repetitive usage.



Pablo A Millones-Gómez, Dora Maurtua-Torres, Reyma Bacilio-Amaranto, Roger D Calla-Poma, Margarita F Requena-Mendizabal, Ana C Valderrama-Negron, Marco A Calderon-Miranda, Rubén A Calla-Poma, María E Huauya_Leuyacc

Antimicrobial Activity and Antiadherent Effect of Peruvian Psidium guajava (Guava) Leaves on a Cariogenic Biofilm Model

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:8] [Pages No:733 - 740]

   DOI: 10.5005/jp-journals-10024-2893  |  Open Access |  How to cite  | 


Aim: Phytomedicine has been commonly practiced as a form of traditional medicine in various cultures for the treatment of oral diseases. Recently, it has gained importance as an alternative to conventional treatment. Several extracts of plants and fruits have been recently evaluated for their potential activity against microorganisms involved in the development of dental caries. The purpose of this study was to evaluate the antimicrobial activity and antiadherent effect of the crude organic extract (COE) and three partitions (aqueous, butanolic, and chloroformic) of Psidium guajava (guava) leaves on a cariogenic biofilm model. Materials and methods: Guava leaves were obtained from the mountains of northern Peru, where they grow wild and free of pesticides. The antimicrobial activity of the COEs and partitions against Streptococcus mutans and Streptococcus gordonii was determined by measuring the inhibition halos, while the effect on biofilm adhesion was determined by measuring the optical density using spectrophotometry. Results: An antibacterial effect of the COE and chloroformic partition against S. gordonii (p < 0.05) was found, as was a significant effect on biofilm adherence, with a minimum inhibitory concentration (MIC) of 0.78 mg/mL, which was maintained throughout the 7 days of evaluation. Conclusion: We conclude that the COEs and their chloroformic partition have antimicrobial and antibiotic effects against this strain of S. gordonii, making them of particular interest for evaluation as a promising alternative for the prevention of dental caries. Clinical significance: By knowing the antimicrobial effect of Psidium guajava, this substance can be effectively used in products aimed to prevent dental caries and periodontal disease.



Aniket Chavan, Pawan Darak, Saritha Vallabhaneni, Suresh Shenvi, Thimmanagowda N Patil

Comparative Evaluation of Efficacy of Four Different Materials in the Repair of Amalgam Restorations: An In Vitro Study

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:7] [Pages No:741 - 747]

   DOI: 10.5005/jp-journals-10024-2872  |  Open Access |  How to cite  | 


Aim: This study was aimed to compare the microleakage of amalgam restorations repaired with bonded amalgam, composite resin, ormocer, and glass ionomer restorative material. Materials and methods: Sixty extracted maxillary human premolars were prepared and restored with class I amalgam. A simulated defect was prepared that included the cavosurface margin on restorations, and the premolars were assigned to four treatment groups (n = 15): In group I, premolars were treated by bonded amalgam; in group II, premolars were repaired with composite resin; in group III, premolars were repaired by ormocer; and in group IV, premolars were repaired with glass ionomer restorative material. The teeth were immersed in 50% silver nitrate solution, thermocycled, sectioned longitudinally, and then blindly observed under a stereomicroscope by three trained examiners. Microleakage was evaluated using a 0–4 scale for dye penetration, and data were analyzed by Kruskal–Wallis test and Mann–Whitney U-test. Results: The microleakage values were more in the group repaired with glass ionomer restorative material and the Chi-squared test showed no significant difference in between the groups repaired with bonded amalgam, composite resin, and ormocer, but showed significant difference between the groups repaired with ormocer and glass ionomer restorative materials and between composite resin and glass ionomer restorative materials. Conclusion: None of the restorative techniques evaluated were able to completely eliminate marginal microleakage. Clinical significance: The results seem to be favorable within the limits of the in vitro conditions of the present study; however, the in vivo conditions are the best for clinically relevant findings.



Khalil I Assiri, Nuchilakath C Sandeepa, Rawan SM Asiri, Sara AM Mulawi, Shaden MH Najmi, Kumar C Srivastava

Assessment of Oral–Systemic Disease Association amongst Dental Patients: A Retrospective Panoramic Radiographic Study

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:8] [Pages No:748 - 755]

   DOI: 10.5005/jp-journals-10024-2838  |  Open Access |  How to cite  | 


Aim: The association between oral health and overall health has been broadly documented in the past few years and is supported by a rapidly growing body of evidence. Interventional studies were able to establish a linkage between dental intervention and its influence on medical situations. This study tried to determine whether the overall health of a subject may be correlated to radiographically noticeable dental pathology. There was a need to test a null theory of whether subjects having good oral health state had fewer systemic illnesses. Materials and methods: This was a retrospective panoramic radiographic study of 400 radiographs of 200 women and 200 men. Subjects were divided into a control group of subjects with no medical history, and a second group with patients who had presented with a medical history. A panoramic radiograph was observed for periapical radiolucency, caries, remaining teeth, remaining root, horizontal, and vertical bone loss. The oral index (OI) was calculated and correlated with the medical status of the patient. Results: Men demonstrated a higher incidence of horizontal bone loss and missing teeth. On the contrary, women showed higher incidences of vertical bone loss, compromised periapical index, and a greater number of root canal treated teeth. Patients having a medical history had a significant percentage of the increased number of periapical lesions, tooth loss, poor quality root canal treatment, and periapical index. Patients with both diabetes mellitus (DM) and hypertension [HTN (61.3%)], anemia (75%), prostate disease (100%), and disabilities such as hearing impairment and mental retardation (100%) had significantly higher percentages of the bad OI. Conclusion: Most patients with medical history demonstrated a significantly poor OI than those with no medical history. The present research contributes to scientific works by probing the relationship between oral health and the overall well-being. Increasing the sample size and interventional studies are needed as an extension of the current research. Clinical significance: Panoramic radiograph is commonly practiced as a screening radiograph in a dental setup. By calculating an OI of each patient based on certain dental conditions, it can help in revealing the burden of medical diseases on oral health and vice versa.



Scherene Basheer, Suma Thimmaiah

Assessment of Cervical Vertebral Bone Mineral Density in Adolescents Undergoing Functional Appliance Treatment

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:4] [Pages No:756 - 759]

   DOI: 10.5005/jp-journals-10024-2880  |  Open Access |  How to cite  | 


Aim: The cervical vertebral maturation (CVM) method has proved to be effective to assess the adolescent growth peak in both body height and mandibular size. The aim of this study was to evaluate whether cone-beam computed tomography (CBCT) images can be used to detect the changes of cervical vertebral bone mineral density (BMD) distribution and whether these changes are associated with CVM changes and mandibular length. Materials and methods: Samples were collected from the patients of age group between 9 years and 15 years of both sexes, who reported to the Department of Orthodontics and Dentofacial Orthopedics, RajaRajeswari Dental College and Hospital, Bengaluru. All the measurements were done on constructed CBCT three-dimensional images. Gray levels, which are equivalent to the BMD, were obtained for C2 and C3 vertebrae at pretreatment (T1) and six months after starting the treatment (T2). The vertebral variables [mean, standard deviation (SD)], CVM stages, and mandibular length between T1 and T2 were compared. Results: Significant changes in the examined variables were detected during the observation period. The BMD values showed a positive correlation with mandibular length increments. Conclusion: The CBCT is an effective tool to analyze the volumetric parameter of BMD in routine dentofacial orthopedics and the BMD distribution changed because of active bone remodeling during the maturation. Clinical significance: This study proves that CBCT imaging can provide additional information about the growth status of a patient above and beyond that obtained from two-dimensional cephalometric radiographs. CBCT is an effective tool to analyze the volumetric parameter of BMD in routine dentofacial orthopedics with better accuracy and minimum distortion.



Fariborz Moazami, Ahmad Gholami, Vahid Mehrabi, Yasamin Ghahramani

Evaluation of the Antibacterial and Antifungal Effects of ProRoot MTA and Nano-fast Cement: An In Vitro Study

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:760 - 764]

   DOI: 10.5005/jp-journals-10024-2877  |  Open Access |  How to cite  | 


Aim: One of the most vital characteristics of an ideal root filling material is the capability to inhibit the growth of the microorganisms. Mineral trioxide aggregate (MTA) is one of the most used root repair materials, with approved antibacterial effect. A newly introduced root repair material is nano-fast cement (NFC) which should be investigated. The antibacterial and antifungal activities of NFC were evaluated in the present study. Materials and methods: Enterococcus faecalis (PTCC 1394), Escherichia coli (ATTC 15224), and Candida albicans (PTCC 5027) were employed for the antimicrobial assessment. The following were the steps used to conduct the agar diffusion test (ADT): six agar plates were used. 0.5 McFarland concentration of each strain was cultured on two plates by a sterile cotton-tipped swab. Three holes with 5mm diameter were created on each plate. Freshly mixed cement was placed in the holes of the related plate. After two hours, the plates were incubated at 37°C for 24 hours. Then, the diameter of the growth inhibition zones were measured, and the mean values were used for the analysis. Direct contact test (DCT) was done by using the following steps: Freshly mixed materials were placed in the 96-well microtiter plate. 10 μL of each bacterial suspension was added to the tested cement. After one-hour incubation at 37°C, 245 μL of BHI broth was added to each well, and the plate was vortexed for 2 minutes. About 15 μL of this bacterial suspension was added to a new well which contained 215 μL of fresh medium. The kinetics of the bacterial outgrowth were measured by the microplate spectrophotometer hourly for 12 hours. Results: No significant differences were observed between the diameters of the growth inhibition zones of MTA and NFC groups in ADT. In DCT, the MTA inhibits E. coli more effectively than NFC (p value < 0.001). Both cements had the same inhibitory effect on E. faecalis and C. albicans. Conclusion: The MTA and NFC are almost equally effective against the tested microorganisms. Clinical significance: The antibacterial characteristic of any dental material is an important matter. As well, the antibacterial efficacy of the NFC should be evaluated.



Ashok Khandelwal, Shweta Raghav, Kamalshikha Baheti, Anurag Jindal, Shubhanjali Bansod, Amit Singh Choudhary

Assessment of Reliability of Cone-beam Computed Tomography in Skeletal and Dental Discrepancy

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:4] [Pages No:765 - 768]

   DOI: 10.5005/jp-journals-10024-2844  |  Open Access |  How to cite  | 


Aim: The present study was conducted to evaluate the reliability of cone-beam computed tomography (CBCT) in dental asymmetry with skeletal midline deviation. Materials and methods: This study was conducted on 124 patients (males 52, females 72) who underwent orthodontic treatment. The CBCT scan was obtained with the Planmica machine. Three maxillofacial radiologists evaluated 10 landmarks and 12 distances on maxillary and mandibular arches on CBCT images in all patients. Results: Interobserver mean difference at point 1 was 0.33; point 2, 0.34; point 3, 0.32; point 4, 0.58; point 5, 0.56; point 6, 0.44; point 7, 0.28; point 8, 0.22; point 9, 0.54; point 10, 0.21; point 11, 0.34; and point 12, 0.36. The discrepancy between intra- and interobserver was not considerable (p > 0.05). Conclusion: Cone-beam computed tomography is useful for diagnosis of skeletal asymmetry. Clinical significance: Cone-beam computed tomography is a reliable and reproducible tool for diagnosis of skeletal asymmetry for successful orthodontic treatment.



Samia M AL-shaer

Role of CT Scan in Early Diagnosis of Temporomandibular Joint Injury in Patients with Rheumatoid Arthritis

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:7] [Pages No:769 - 775]

   DOI: 10.5005/jp-journals-10024-2868  |  Open Access |  How to cite  | 


Aims and objectives: Early detection of rheumatoid injury in the temporomandibular joint using CT, which accurately detects bone changes before the clinical symptoms start appearing to protect the joint from irreversible damage, and the correlation of those radiological changes with the duration of rheumatoid arthritis disease. Materials and methods: It included 45 people aged 27–74 years who reviewed the internal medicine and rheumatology clinics at Al-Mouwasat Hospital during 2016–2018 and are affected with rheumatoid arthritis according to the criteria American College of Arthritis (ACR) European League against Rheumatism (EULAR) 2010 criteria. The informed consent of the patient and the approval of the Scientific Research Council were obtained to conduct the research. Results: Computed tomography revealed the radiological changes in the left and right side, respectively, in terms of p value <0.05: (1) Erosion of condyle (42.22–53.34%). (2) Decreased in the joint space (53.33–60.00%). (3) Mandibular subchondral cysts in both sides (77.14%). (4) Erosion of the articular fossa (48.89–57.78%). (5) Flattening of condyle (46.67–55.55%). (6) Effusion (2.22–4.44%). (7) Bone marrow edema (26.67–40.00%). (8) Subchondral sclerosis (60.00–73.33%). Conclusion and clinical significance: The occurrence of bone damage in the condyle and articular fossa of the temporomandibular joint despite the fact that the sample members have no clinical complaint indicates the ability of CT scan of early and accurate disclosure of rheumatoid injury in the temporomandibular joint.



Areej H Mukhtar, Montaser N Alqutub

Osteogenic Potential of Periodontal Ligament Stem Cells Cultured in Osteogenic and Regular Growth Media: Confocal and Scanning Electron Microscope Study

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:776 - 780]

   DOI: 10.5005/jp-journals-10024-2822  |  Open Access |  How to cite  | 


Aim: To evaluate the ability of osteogenic culture media in comparison with regular growth culture media in enhancing the osteoblastic cell differentiation of human periodontal ligament stem cells (hPDLSCs). Materials and methods: In vitro cultures of commercially obtained hPDLSCs were seeded onto xenograft bone blocks in both regular and osteogenic media. Confocal laser microscope images were obtained for cellular differentiation and adhesion, and scanning electron microscopy (SEM) images were obtained to validate the osteogenic differentiation by showing the morphological characteristics of the newly formed cells. Results: Confocal laser microscope analysis showed positive staining for new bone cells with an increased signal intensity when samples were cultured in osteogenic culture media compared with regular culture media. These findings indicate the effect of the active ingredients of the osteogenic culture media in enhancing the osteogenic differentiation hPDLSC. Scanning electron microscopy images validated the osteogenic differentiation showing a flattened, polygonal morphology with multiple extending cytoplasmic processes of new cells. Conclusion: Xenograft bone blocks are biocompatible scaffold for the osteogenic differentiation of seeded hPDLSCs. Osteogenic culture media enhances and increases the osteogenic differentiation of hPDLSCs into new bone cells more than regular growth culture media. Periodontal ligament stem cells are a predictable biological input as a cell-based tissue-engineered construct and biologically acceptable when it is cultured in a suitable growth media that mimics the intended environment. Clinical significance: Consideration of the clinical use of equine bone blocks and periodontal ligament stem cells in a suitable biological environment as a potential new option for bone regeneration techniques.



Sara Valizadeh, S Fatemeh Hashemi, Sedighe S Hashemikamangar, Mohammad J Kharazifard

Microleakage of a Self-adhesive Composite of Class V Cavities: Effect of Surface Treatment and Thermocycling

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:6] [Pages No:781 - 786]

   DOI: 10.5005/jp-journals-10024-2878  |  Open Access |  How to cite  | 


Aim: This study aimed to assess the microleakage of a self-adhesive composite compared to conventional composites in class V cavities. Materials and methods: In this in vitro experimental study, standard class V cavities were prepared in the buccal surface of 204 extracted teeth and randomly divided into six groups for restoration with (A) Vertiseflow (Kerr) self-adhesive composite, (B) acid etching (Kerr) + Vertiseflow, (C) acid etching + Optibond FL (Kerr) + Vertiseflow, (D) Er,Cr:YSGG laser + Vertiseflow, (E) acid etching + Optibond FL + Premise Flowable (Kerr), and (F) acid etching + Optibond FL + Z250 (3M). The teeth in each group were then randomly divided into two subgroups of with and without thermocycling (10,000 cycles between 5°C and 55°C). The microleakage was then determined at the enamel and dentin margins under a stereomicroscope using the dye penetration method. Data were analyzed using the Kruskal–Wallis test (α = 0.05). Results: No significant difference was noted in occlusal margin microleakage of no thermocycling groups, but acid etching + Vertiseflow showed the highest microleakage. At the gingival margin, the difference between acid etching + bonding agent + Z250 and laser + Vertiseflow was significant (p = 0.004). In thermocycling groups, the difference in the microleakage at the occlusal margin of Vertiseflow with that of acid etching + bonding agent + Premise (p = 0.002), acid etching + bonding agent + Vertiseflow (p = 0.009), and acid etching + bonding agent + Z250 (p = 0.037) groups was significant. The difference in the microleakage at the dentin margin was also significant among the groups (p < 0.05). The highest and the lowest microleakages were noted in laser + Vertiseflow and acid etching + bonding agent + Vertiseflow groups, respectively. Conclusion: Surface preparation with etching and adhesive application results in lower microleakage in class V cavities. But laser irradiation and the use of self-adhesive composite increase the microleakage. Clinical significance: It seems that self-adhesive composites cannot provide acceptable marginal integrity without any surface treatment.



Sumita Kumari, Supriya Singh, Jitendra P Singh

Impact of Oral Health Literacy on Periodontal Health among Low-income-group Workers of Dental Institutes in Patna, Bihar, India

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:787 - 791]

   DOI: 10.5005/jp-journals-10024-2835  |  Open Access |  How to cite  | 


Aim: To evaluate the impact of oral health literacy (OHL) on the periodontal health among low-income-group workers of dental institutes. Materials and methods: A cross-sectional study was conducted on 137 class III and IV workers of dental college. Data collection was done by using a customized pro forma including demographics, REALD-30 for calculating OHL, and items on oral hygiene habits like toothpaste use, brushing frequency, and any other oral hygiene aid. Following which periodontal health status was determined, which was categorized into severe, moderate, and mild periodontitis (health). The analysis was done using the SPSS 11.5. Periodontal health status was associated with OHL scores, oral hygiene habits, and demographics using the chi-square test. The statistical significance level was set at 5% level. Results: Among the 137 subjects, 25 participants reported health/mild periodontitis, 53 had moderate periodontitis, and 59 had severe periodontitis. Low OHL was observed in 52.5% and only 13.8% had high OHL. The participants who had low OHL, 56.94% (n = 41), were having severe disease, while the subjects who had better OHL, only 21.05% (n = 4) were found to have severe disease. Conclusion: The people with low socioeconomic classes can be reached effectively if the community involvement concept is used through the workers of dental institutions. But first efforts should be made to improve the OHL of these workers. Clinical significance: Improving OHL can be of great help to the clinicians and the community health workers because it helps them to make patient adherent to the treatment and the medications prescribed to them. Periodontitis affects people with low socioeconomic status and in the present study it was class III and IV workers. Improving OHL of this population will decrease the oral disease burden of India.



Kingston Chellapandian, Tripuravaram VK Reddy, Dhanasekaran Sihivahanan, Ashwin Ravichandran, Sujana Praveen

Comparative Efficacy of Resin Infiltrant and Two Remineralizing Agents on Demineralized Enamel: An In Vitro Study

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:6] [Pages No:792 - 797]

   DOI: 10.5005/jp-journals-10024-2824  |  Open Access |  How to cite  | 


Aim: To compare and evaluate the caries preventive effectiveness of resin infiltrant (ICON), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (GC Tooth Mousse), and nanohydroxyapatite (Aclaim) on incipient enamel lesions. Materials and methods: A total of 60 human maxillary incisors extracted for periodontal reasons were included in this study. The sectioning was done at the middle third region of the crown for the 60 samples with approximate dimensions of 5 × 5 × 5 mm). In order to create the artificial enamel lesions, the samples were demineralized by placing in a beaker containing the prepared demineralizing solution for 14 days. The study samples were then divided into four groups that are resin infiltrant (group I), CPP-ACP (group II), nanohydroxyapatite (group III), and control (group IV) with 15 enamel samples in each group. The caries preventive efficacy of each group was evaluated using a confocal laser scanning microscope. Results: The mean values after demineralization of enamel samples in demineralizing solution are 245 μm for resin infiltrant (group I), 246 μm for CPP-ACP (group II), 250 μm for nanohydroxyapatite (group III), and 247 μm for control (group IV). After remineralizing the enamel samples for a period of 30 days, the results are group I (resin infiltrant) 158 μm > group II (CPP-ACP) 28.8μm ≥ group III (nanohydroxyapatite) 26.3 μm. After subjecting it to demineralizing solution again for 14 days, the amount of material that was resistant to acid attack was group I (resin infiltrant) 114 μm (72%) > group III (CPP-ACP) 16.4 μm (57%) ≥ group III (nanohydroxyapatite) 13.8 μm (50%). The untreated control group showed increased progression of lesion and least resistance to acid challenge. Conclusion: Based on the results from this in vitro study, it can be concluded that when compared to the two remineralizing agents the resin infiltrant showed better caries preventive effectiveness. Clinical significance: Resin infiltrants have a favorable penetration potential in subsurface or incipient enamel lesions.



Pierre Kuoch, Eric Bonte

Endoperiodontal Lesions and Chicago's New Classification of Periodontal and Peri-implant Diseases and Conditions

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:798 - 802]

   DOI: 10.5005/jp-journals-10024-2876  |  Open Access |  How to cite  | 


Aim: To illustrate, with two clinical cases of endoperiodontal lesions, the clinical application of the new classification of periodontal and peri-implant diseases and conditions. Background: The endodont and the periodont are two entities that communicate with each other through physiological communication channels (apical foramen, lateral and secondary canals, and dentinal tubules) resulting in close anatomical and functional interaction. An endoperiodontal lesion is defined by pathological communication between the endodontic and periodontal tissues in a given tooth, according to the definition given by the new classification of periodontal and peri-implant diseases and conditions from the work of the Chicago Consensus Conference in 2017. This new classification differentiates the lesions with and without root damage. Diagnosis and therapeutic strategy will be analyzed through two clinical cases. Review results: The clinical cases we presented show that the treatment of these lesions must involve endodontic and periodontal management due to the intimate relationship between the tooth and periodontium. Conclusion: The classification of periodontal and peri-implant diseases and conditions provides a clinical focus on endoperiodontal lesions, based on signs and symptoms that have a direct effect on the prognosis and the treatment of the tooth. The pathological communication between the endodont and the periodontium complicates the management of the involved tooth. Clinical significance: Chicago's new classification of periodontal and peri-implant diseases and conditions offers an up-to-date vision of periodontal lesions management and highlights the intimate links between endodontic and periodontal tissues.



Ayman M Abulhamael, Stefan Zweig, Abrar S Kutbi, Rayan S Alrehili, Ziyad T Alzamzami, Yousef M Alharbi

Combination of Revascularization and Apexification in the Treatment of an Avulsed Tooth: A Case Report

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:5] [Pages No:803 - 807]

   DOI: 10.5005/jp-journals-10024-2830  |  Open Access |  How to cite  | 


Aim: To demonstrate an exceptional result in the treatment of an avulsed tooth that had been stored in a dry environment for over 2 hours before being replanted. Background: Sixteen percent of all traumatic injuries to the permanent dentition are avulsions. Maxillary central and lateral incisors are most commonly affected. Case description: In this report, a 7-year-old girl sustained trauma to the upper right maxillary incisor during a bicycle accident. The tooth was avulsed and remained outside the oral cavity for more than 2 hours in a dry napkin before eventual reimplantation in the emergency room. Upon presentation to the endodontic clinic at the University of Southern California, the case was assessed, and the available treatment options discussed with the patient's parents. Revascularization using BC putty was the chosen mode of treatment. At a 6-month recall appointment, the patient presented with a sinus tract. A decision was then made to perform apexification using the mineral trioxide aggregate (MTA) as an apical filling material. To date, the tooth remains intact and functional. Conclusion: Although both of the described treatment modalities are acceptable and commonly used in modern endodontics, apexification of a tooth following a failed attempt of a regenerative procedure has not been described. In this case, a chronic abscess formed and the ultimate goal of revascularization was not achieved. However, the performance of the revascularization procedure was not without benefit since it allowed the tooth to develop in both length, dentinal volume, and aided in the partial closure of the apical foramen. Additional studies are needed regarding the treatment of avulsed teeth. This case study may provide a viable treatment alternative in a number of clinical situations. Clinical significance: The procedures described in this case report may be of clinical significance in the treatment and retention of teeth, which may otherwise be considered to have a poor prognosis and extracted.



Amal I Linjawi

Sealants and White Spot Lesions in Orthodontics: A Review

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:7] [Pages No:808 - 814]

   DOI: 10.5005/jp-journals-10024-2882  |  Open Access |  How to cite  | 


Aim: This literature review aims to update the evidence for prevention of white spot lesion (WSL) using orthodontic sealants among patients with fixed orthodontic appliances. Background: As a major issue among orthodontists, prolonged treatment duration increases the risk of plaque development around orthodontic brackets and bands. In consequence, this can lead to heightened risk for caries development and higher possibility of WSL development around fixed orthodontic brackets. Results: Increased prevalence of WSLs generally occurs during orthodontic treatment. This review explored various products of orthodontic sealants used to prevent WSL. Orthodontic sealants do not require patient compliance and thus will further lessen the burden among orthodontists as well as support enamel surface for a long period of time during treatment. Certain factors, however, are considered important in the efficacy of these sealants, such as antibacterial activity, color stability, resistance to acid and brush abrasion, and their effect on shear bond strength (SBS). Conclusion: The review showed that the use of orthodontic sealants in preventing WSLs during and after fixed orthodontic treatment is significantly effective. However, the bioactive glass is deemed more effective against WSL development due to its ability to immediately repair enamel surface, low cytotoxicity, and high biocompatibility. Moreover, clinical studies on bioactive glass are still needed to determine its acceptability among patients with fixed orthodontic appliance. Clinical significance: Development of WSL around the orthodontic brackets during treatment is a difficult task among orthodontists. As such, this review explored various strategies to effectively combat WSL development for good oral health and esthetics during orthodontic treatment.



Vikram M Belkhode, Sharayu Nimonkar, Sudesh C Chaudhary, Anuja Hakkepatil, Pranali Nimonkar, Jyoti Prajapat

An Innovative Method for Iris Positioning in a Prosthetic Eye

[Year:2020] [Month:July] [Volume:21] [Number:7] [Pages:4] [Pages No:815 - 818]

   DOI: 10.5005/jp-journals-10024-2873  |  Open Access |  How to cite  | 


Aim: An apparatus named “laser pointer apparatus” is proposed for accurate iris positioning in a prosthetic eye. Background: Loss of an eye leads to significant psychological stress due to functional disability and societal response to the facial disablement. Custom-made eye prosthesis is a good option to rehabilitate such defects. Inaccurately positioned iris in a prosthetic eye results in squint eye appearance leading to poor esthetics and poor psychological impact among such unfortunate patients. Technique: A new apparatus called a laser pointer apparatus, which is an assembly of an occlusal plane analyzer, web camera, laser pointer, and software, has been introduced for iris positioning in a prosthetic eye. Conclusion: Iris positioning is one of the key steps in fabricating an eye prosthesis. Laser pointer apparatus is a reliable method for iris positioning in a prosthetic eye. Clinical significance: Positioning the iris to the ideal symmetrical position is a cardinal step in the fabrication of an ocular prosthesis. This article aims to introduce a “laser pointer apparatus” to orient iris in a prosthetic eye objectively to overcome the subjective errors.


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