The Journal of Contemporary Dental Practice

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2021 | February | Volume 22 | Issue 2


Urmi Ghone, Gargi S Sarode, Sachin Sarode, Shankargauda Patil

Revisiting Sports Dentistry with a Critical Appraisal

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:2] [Pages No:105 - 106]

Keywords: Dentistry, Injury, Sport, Trauma

PDF  |  DOI: 10.5005/jp-journals-10024-3007  |  Open Access |  How to cite  | 


Dental traumas caused due to sports and other athletic activities are the connecting bridge between sports and dentistry. Studies show that 13–39% of all dental injuries are accounted for sports, out of which 11–18% are maxillofacial injuries. This editorial broadly discusses the interconnection between sports and dentistry. It highlights the importance of Parents’, children\'s, sportspersons’, and even dental practitioners’ education on this topic of sports dentistry. The significant need for “team dentist” in schools and professional sports teams is also brought into the spotlight.


Rucha Shah, Raison Thomas, Triveni Mavinkote Gowda, Tarun Kumar Amanna Baron, Gayathri Gunjiganur Vemanaradhya, Shivani Bhagat

In Vitro Evaluation of Osteoblast Response to the Effect of Injectable Platelet-rich Fibrin Coating on Titanium Disks

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:4] [Pages No:107 - 110]

Keywords: Bone, Dental implants, Osseointegration, Osteoblasts, Platelet-rich fibrin

PDF  |  DOI: 10.5005/jp-journals-10024-3039  |  Open Access |  How to cite  | 


Aim: Biomimetic implant surface coatings can improve osteoblast response and enhance osseointegration. This study aimed to assess the response of osteoblast-like cell line (MG-63) coating of injectable platelet-rich fibrin on titanium discs. Materials and methods: Injectable-PRF (i-PRF) was prepared by centrifugation of blood at 700 rpm for 3 minutes without any anti-coagulant in i-PRF tubes. Ten commercially pure titanium discs were divided into control groups comprising plain discs, and test group, titanium discs were coated with i-PRF. These were then added to the cultured MG-63 cells. Cell proliferation, alkaline phosphatase production, and mineralization were assessed in both groups at day 1, 7, 14, and 21. Results: The cell proliferation, alkaline phosphatase production, and mineralization increased significantly from day 1 to day 21 in both test and control groups and was significantly higher in the test group than in control group at day 1, 7, 14, and 21 (p <0.001). Conclusions: Coating of titanium discs with i-PRF causes increased proliferation, alkaline phosphatase production, and increased mineralization at day 1, 7, 14, and 21 in MG-63 osteoblast-like cells. Clinical significance: Improved osteoblast proliferation and mineralization demonstrate enhanced activity on the surface of an implant, which in turn may lead to increased bone to implant contact and faster/ and/or enhanced osseointegration.


Abeer E ElEmbaby, Mouneir Slais, Ali Alawami, Mohammed Alabbad, Mishari Alsowyan, Neveen Hanna, Hala Bahgat

Spectrophotometric Analysis of Different Flowable Restorative Materials

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:111 - 116]

Keywords: Color change, Flowable composites, Staining solutions

PDF  |  DOI: 10.5005/jp-journals-10024-3031  |  Open Access |  How to cite  | 


Aim: To compare the color change of three flowable composites after exposure to staining solutions. Materials and methods: A total of 240 oval samples were constructed of conventional flowable resin composite, self-adhesive flowable resin composite, and nanohybrid flowable ormocer (n = 80). Each set was further subcategorized into three subsets as regards staining solution. The baseline color parameters were recorded using spectrophotometer after the immersion of the specimens in artificial saliva for 24 hours. Then, the measurements were taken again after exposure to staining solutions where the color change was measured as ∆E* = √ (∆L*2 + ∆a*2 + ∆b*2). Results: Conventional flowable resin composite had the best color stability in all staining solutions. The coffee was concluded to be the most staining solution. Compared to beverages, mouthwashes had a greater discoloration effect on nanohybrid flowable ormocer than on self-adhesive flowable composite. Conclusion: Conventional flowable composite had the highest color stability among the tested materials, followed by flowable nanohybrid ormocer, and the least was self-adhering flowable composite. Coffee had the greatest discoloration effect, followed by a sports drink and then the energy drink. However, mouthwashes did not have a significant discoloration effect. Clinical significance: Selection of flowable composite materials that are resistant to staining by coffee, beverages, or mouthwashes is an important factor that may influence the sustainability of the esthetic quality of the restoration.


Mukesh Kumar, Ajay Paliwal, Kumar Manish, Sai K Ganapathy, Neha Kumari, Ayush R Singh

Comparison of Canal Transportation in TruNatomy, ProTaper Gold, and Hyflex Electric Discharge Machining File Using Cone-beam Computed Tomography

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:5] [Pages No:117 - 121]

Keywords: Canal transportation, Cone-beam computed tomography, Hyflex EDM, ProTaper Gold, TruNatomy

PDF  |  DOI: 10.5005/jp-journals-10024-2970  |  Open Access |  How to cite  | 


Aim: This study was carried out to compare canal transportation in three new rotary file systems, namely TruNatomy, ProTaper Gold, and Hyflex Electric Discharge Machining file system, using cone-beam computed tomography. Materials and methods: The study was conducted on 105 extracted teeth consisting of 60 extracted mandibular first molars and 45 mandibular second premolars involving the mesiolingual canal of mandibular first molar and the root canal of second premolar. The teeth were randomly divided into three groups of 35 out of which each group consisted of 20 mandibular first molars and 15 mandibular second premolars. The TruNatomy rotary file was used in group I, ProTaper Gold was used in group II, and Hyflex Electric Discharge Machining was used in group III. Cone-beam computed tomography scan images were obtained both before and after instrumentation. Changes caused by preparation in the coronal, middle, and apical thirds were determined on cone-beam computed tomography scans and analyzed using the Kruskal–Wallis test at p ≤ 0.05 level of significance. Results: TruNatomy showed least amount of canal transportation as compared with other two file systems at all the three levels of canals. ProTaper Gold showed maximum amount of canal transportation as compared with other two file systems at all the three levels of canals. The Hyflex EDM rotary file system showed transportation, which was more than the TruNatomy file system while it was less than that of ProTaper Gold. The difference was statically significant at the middle one-third level (p = 0.03) and at the coronal level (p = 0.02). Conclusion: The TruNatomy system has least amount of canal transportation as compared with ProTaper Gold and Hyflex EDM system. With potential to preserve tooth structure, this file has an added advantage over other rotary file systems. Clinical significance: The TruNatomy file system has been recently introduced with good cyclic fatigue resistance. It is necessary to evaluate the root canal transportation caused by the TruNatomy file.


Jesuína L N Araújo, Cristiane de Melo Alencar, Gabriela M Barbosa, Cecy M Silva, Míriam L Turbino

Effect of LEDs with Different Wavelengths on the Microhardness and Nanohardness of Nanohybrid Composite Resins

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:122 - 127]

Keywords: Composite resin, Microhardness, Nanohardness, Photocuring

PDF  |  DOI: 10.5005/jp-journals-10024-3032  |  Open Access |  How to cite  | 


Aim: The aim of this study is to compare the effectiveness of polymerization of nanohybrid composite resins with different colors and thicknesses, photocured by units of different wavelengths through Knoop microhardness (KHN) and Berkovich nanohardness (DUH). Materials and methods: One hundred twenty specimens of Tetric N-Ceram (Ivoclar/Vivadent) were divided into groups (n = 5) according to the experimental test, the color of the composite resin (A2 and Bleach-M/BM), the light source: monowave (Elipar™ FreeLight DeepCure-3M/ESPE), dental products—1200 mW/cm²/15 seconds (FL); or polywave (Bluephase-Ivoclar/Vivadent 1200 mW/cm²/15 and 30 seconds (BP), and thickness (irradiated surface,1, 2, and 3 mm). The specimens were stored dry for 24 hours at 37°C and received five indentations on the top and button surfaces. Analysis of variance (ANOVA), Tukey, and Pearson correlation (p < 0.01%) tests were used. Results: A direct correlation was found between KHN and DUH. The higher values of KHN and DUH were observed with Elipar™ FreeLight DeepCure unit in irradiated surface and 1-mm-thick specimens at A2 color. Conclusion: That Elipar™ FreeLight DeepCure unit showed better effectiveness in curing nanohybrid composite resins, used in this work, in different colors and depths as compared to Bluephase in both experimental tests, and that DUH can substitute KHN test when comparing the effectiveness of polymerization. Clinical significance: The evaluation of the mechanical properties of composite resins is essential to verify their possible clinical performance.


Arunajatesan Subbiya, Kotishwaran Gayathri, Alagarsamy Venkatesh, Kesavaram Padmavathy, Krishnan Mahalakshmi, Suresh Mitthra

Evaluation of the Antibacterial Efficacy of Daptomycin, Gentamicin, and Calcium Hydroxide—Antibiotic Combinations on Enterococcus faecalis Dentinal Biofilm: An In Vitro Study

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:128 - 133]

Keywords: Calcium hydroxide, Daptomycin, Dentinal biofilm, E. faecalis, Gentamicin

PDF  |  DOI: 10.5005/jp-journals-10024-3048  |  Open Access |  How to cite  | 


Aim: To evaluate the antibacterial efficacy of calcium hydroxide (CH) with antibiotic combinations: daptomycin and gentamicin against Enterococcus faecalis (E. faecalis) dentinal biofilm. Materials and methods: Sixty freshly extracted single-rooted mandibular premolars were inoculated with E. faecalis (ATCC 29212) (n = 30) (group A) and clinical isolates (n = 30) (group B) for 3 weeks to form a biofilm. The tooth samples of groups A and B were randomly divided into three subgroups of 10 each, groups 1A and 1B (CH), groups 2A and 2B (CH+G), groups 3A and 3B (CH+D), depending on the medicaments to be placed for one week. The difference between initial and final CFU was calculated and statistically analyzed. Results: Among the clinical isolates, CH-antibiotic combinations were more effective than CH alone, which was statistically significant (p = 0.006). Conclusion: The dentinal biofilm of clinical isolates of E. faecalis strains exhibited more reduction in bacterial colonies with CH in combination with antibiotics (D and G). Clinical significance: Daptomycin and gentamicin when used as an intra-canal medicament in combination with CH are effective in eliminating E. faecalis.


Shwetha Balagopal, N. Sridhar, Kanwardeep Kaur

An In Vitro Evaluation of the Mechanical Properties and Fluoride-releasing Ability of a New Self-cure Filling Material

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:134 - 139]

Keywords: Flexural strength, Fluoride release, Glass ionomer cement, In vitro observational study, Restorative materials, Shear bond strength

PDF  |  DOI: 10.5005/jp-journals-10024-3050  |  Open Access |  How to cite  | 


Aim: The aim of this study was to examine and compare the flexural strength, shear bond strength, and fluoride-releasing ability of glass ionomer cement (GIC), Fuji IX GIC®, and a new alkasite filling material, Cention N®. Material and methods: The materials were divided into two groups, Fuji IX GIC® (n = 30) and Cention N® (n = 30) and further divided (n = 10) to test three parameters, the fluoride releasing ability, flexural strength, and shear bond strength. Fluoride release was checked using fluoride ion-selective electrode, and flexural strength and shear bond strength were tested using universal testing machine (Intron 3366, UK). Results: Fluoride release of Fuji IX GIC® was significantly higher compared to that of control Cention N® over a period of 21 days. Flexural strength of Cention N® was significantly higher compared to Fuji IX GIC® and there were no significant differences in shear bond strength of both the materials. Conclusion: From the results of the study, it can be concluded that Cention N® is an alkasite filling material for the complete and permanent replacement of tooth structure in posterior teeth and can be a good alternative when compared to GICs on the basis of their superior mechanical properties. Clinical significance: Cention N® is an innovative filling material for the complete and permanent replacement of tooth structure in posterior teeth and can be a good alternative when compared to GICs on the basis of their superior mechanical properties.


Salma Mahmoudd Fathy, Radwa Mohsen Kamal Emera, Reham Mohamed Abdallah

Surface Microhardness, Flexural Strength, and Clasp Retention and Deformation of Acetal vs Poly-ether-ether Ketone after Combined Thermal Cycling and pH Aging

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:140 - 145]

Keywords: Artificial saliva pH, Clasp retention, Deformation, Thermal cycling, Thermoplastic resins

PDF  |  DOI: 10.5005/jp-journals-10024-2937  |  Open Access |  How to cite  | 


Aim: To evaluate the effect of combined thermocycling and artificial saliva pH on flexural strength, surface microhardness, as well as clasp retention and deformation of two different thermoplastic polymers. Materials and methods: Three groups were created, heat-cured polymethyl methacrylate, acetal, and poly-ether-ether ketone (PEEK) resins. Specimens were wrapped in plastic bags containing artificial saliva with three pH values (acidic 5.8, neutral 7.2, and alkaline 8.3). Two Aker clasps materials (acetal and PEEK), for premolar and molar, were stored in neutral salivary pH. Specimens were subjected to 2,000 thermocycles (5–55°C). Surface microhardness, flexural strength, and clasp retention and deformation were evaluated before and after aging. Data were analyzed by ANOVA, Tukey\'s test, Student\'s t-test, and paired t-tests (p < 0.05). Results: Thermal cycling at acidic and alkaline pH significantly decreased flexural strength and surface microhardness of acetal. It had no significant effect on PEEK properties. Poly-ether-ether ketone showed statistically significant higher mechanical properties in all groups. Acetal clasps exhibited a statistically significant deformation and a corresponding decrease in retention after thermocycling at neutral pH. Conclusion: Mechanical properties of acetal, as well as its clasp retention and deformation, significantly decreased after combining thermal and pH aging and thermal cycling in neutral pH, respectively. Meanwhile, PEEK clasps were not significantly affected. Clinical significance: Different intraoral variables may significantly affect mechanical performance, retention, and deformation of TMs used for denture base and clasp construction. Some of these TMs may behave better than the other types with recommended improvement of the design like increasing clasp cross-section area.


Rahmath S Shafiullah, Ramasubramanian Hariharan, Chitra S Krishnan, Navarasampatti S Azhagarasan, Sampathkumar JayaKrishnaKumar, Mariappan Saravanakumar

Influence of Cortical Layer and Surgical Techniques on the Primary Implant Stability in Low-density Bone:An In Vitro Study

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:146 - 151]

Keywords: Insertion torque, Osteotomes, Primary stability, Resonance frequency analysis, Undersized preparation

PDF  |  DOI: 10.5005/jp-journals-10024-3003  |  Open Access |  How to cite  | 


Aim: This study aimed at evaluating the influence of cortical layer and surgical techniques on the primary stability of implants in low-density bone. Materials and methods: Two solid rigid polyurethane blocks with a density equivalent to 0.32 g/cm3 simulating cancellous bone were used. A short fiber-filled epoxy resin sheet of 2 mm was layered to one block to simulate cortico cancellous bone. A total of 40 implants were used in this study (n = 40). Twenty implants each (n = 20) were inserted in cancellous (Group 1) and cortico-cancellous bone (Group 2), of which 10 implants each (n = 10) were placed using undersized preparation technique with surgical drills—A and osteotomes—B, in both the groups. Insertion torque (IT) and implant stability quotient (ISQ) for each implant placed were assessed to determine the primary stability of each implant using a digital torque meter and resonance frequency analyzer, respectively. The values were statistically analyzed using an independent t-test (p < 0.05). Pearson\'s correlation analysis was performed to correlate between IT and ISQ. Results: Technique B resulted in significantly higher IT and ISQ values in Group 1 (27.69 ± 1.2 N cm; 52.5 ± 1.05 ISQ) and Group 2 (38.8 ± 0.87 N cm; 70.1 ± 1.04 ISQ) compared to those with technique A (22.40 ± 1.62 N cm; 41.75 ± 1.20 ISQ and 33.24 ± 0.67 N cm; 63.72 ± 1.33 ISQ), respectively. Group 2 exhibited significantly higher IT and ISQ values as compared to Group 1 irrespective of the surgical technique employed (p < 0.05). Conclusion: The presence of the cortical layer significantly influenced the primary stability and preparing low-density bone with an undersized preparation technique using osteotomes that significantly increased the IT and ISQ. Clinical significance: Undersizing the preparation site considerably will help achieve a significant increase in primary stability in the poor quality bone as in the posterior maxilla, thereby contributing to the success of the implant.


Nazargi Mahabob, Raouf Wahab Ali, Salma Alsalhi, Mostafa Alwabari, Anfal S Almarzooq, Sarah A Alnabi, Misba Fathima

Prevalence of TMJ Disorders among Patients Attending the King Faisal University Dental Clinics, KSA

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:4] [Pages No:152 - 155]

Keywords: Fonseca\'s questionnaire, Missing tooth, Pain, Parafunctional movements, Temporomandibular disorders

PDF  |  DOI: 10.5005/jp-journals-10024-3044  |  Open Access |  How to cite  | 


Aim: To assess the prevalence of signs and symptoms of temporomandibular disorders (TMDs) in a sample population of Al-Hasa by Fonseca\'s questionnaire. Materials and methods: A group of 240 patients was randomly selected from outpatients, attending the dental clinical complex of King Faisal University. The participants were grouped based on gender and age-groups: 14 to 20, 21 to 40, 41 to 60, and 61 ≤ years. Each participant was provided with a questionnaire and points were given accordingly for each question. The sum of points was used to classify the severity of TMD. The obtained data were analyzed with SPSS 21 and the significance level of p was fixed at ≤ 0.05. Results: Among all participants examined, 131 participants had no TMD (54.6%), 79 had mild TMD (32.9%), 19 had moderate TMD (7.9%), and 11 had severe TMD (4.6%). TMD problem increases with age and significance level (p = 0.007) and females had more TMD problems than males (p = 0.008). Conclusion: The Fonseca\'s questionnaire is an effective tool for screening the signs and symptoms of TMDs, in a short period, and classifies patients according to their severity. According to the study results, approximately 45.4% of the patients had some degree of TMD problems. The present study is cross-sectional with a limited number of participants and it should be followed by a longitudinal study in the near future to validate. Clinical significance: Early detection of TMD problems will help in treatment planning and prognosis.


Payal Kahar, Carol A Chapman, Sachi Brahmbhatt, Deepesh Khanna

Assessment of the Effects of Occluding Pairs of Teeth on Oral Health-related Quality of Life among Dialysis Patients

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:156 - 161]

Keywords: Dental health surveys, Dental prosthesis, Dialysis, Oral health, Quality of life, Tooth loss

PDF  |  DOI: 10.5005/jp-journals-10024-3046  |  Open Access |  How to cite  | 


Aim: To determine oral health-related quality of life (OHRQoL) in hemodialysis patients and assess if location and distribution of teeth had perceived oral impacts. Materials and methods: Face-to-face interviews and oral examinations were conducted among 96 patients in southwest Florida. Sociodemographic data in addition to self-reported medical conditions were collected. OHRQoL was determined using the Geriatric Oral Health Assessment Index (GOHAI-12). Presence of decayed teeth, missing teeth, anterior occluding pairs (AOPs) and posterior occluding pairs (POPs), and community periodontal index were ascertained through oral examinations. Results: Mean age was 64.81 ± 12.9 years. Mean number of teeth present was 20.12 ± 10.8. Nearly half (48%) of the participants had ≥1 decayed teeth. Among those examined for periodontal health, 86% had some form of periodontal disease. Mean AOP was 4.4 ± 2.3 and mean POP was 4.2 ± 3.1. Median GOHAI-12 score was 52. Limiting the kinds or amounts of food (p = 0.040), trouble biting or chewing (p = 0.010), feeling uncomfortable eating in front of people (p = 0.024), and pleased with looks (p = 0.038) were statistically significant for AOP groups. Only trouble biting or chewing (p = 0.044) and pleased with looks showed significant association with POP groups (p = 0.038). In adjusted regression analyses, participants with AOPs 0 to 2 had 86% lower odds of reporting GOHAI-12 scores above 40 (25th percentile) than the group with AOPs 3 to 6 (odds ratio = 0.14; 95% confidence interval = 0.04–0.58). Conclusion: The study highlights fewer AOP to have a larger effect than POP not only in the psychosocial dimension but also in the functional abilities. Lower GOHAI-12 scores were associated with AOP 2 or less than 2 in the study sample. Clinical significance: While treatment and management of oral health problems in dialysis patients are complicated by the presence of co-morbidities, age-related changes in the mouth, and issues of access to dental care, identification, repair, or replacement of strategically important teeth using the “shortened dental arch principle” to maintain oral function among hemodialysis patients are recommended.


Supraja Volety, Prajna P Shetty, Krishna Kumar, Gautam Shetty

Antifungal Effects of Herbal Extracts and Fluconazole on Heat-polymerized Acrylic Denture Base Resin as Denture Cleanser: An In Vitro Study

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:4] [Pages No:162 - 165]

Keywords: Antifungal efficacy, Denture cleanser, Essential oils, Fluconazole, Heat cure acrylic resin

PDF  |  DOI: 10.5005/jp-journals-10024-3042  |  Open Access |  How to cite  | 


Aim: The study aimed to investigate the antifungal effects of herbal extracts and fluconazole on heat-polymerized acrylic denture base resin as a denture cleanser. Materials and methods: Several essential oils, such as origanum oil and grape seed oil and commercially available antifungal agent fluconazole were used as denture cleansers and their antifungal efficacy was evaluated using a spectrophotometer. Overall, 68 samples were obtained and were divided into four groups, each containing 17 samples. These samples were immersed in Sabouraud dextrose broth consisting of Candida albicans for 16 hours and later in these antifungal solutions for 8 hours and their antifungal efficacy was measured. Data were subjected to an ANOVA test. Results: Among the study groups origanum oil showed the maximum antifungal activity with a mean optical density at 0.072 ± 0.014 followed by fluconazole (0.094 ± 0.155), and least by grape seed oil (0.190 ± 0.071). Conclusion: Results of this in vitro study showed that origanum oil was more effective than commercially available antifungal agents, and among the tested groups oregano oil was a potential agent in lowering the C. albicans colony. Clinical significance: Origanum oil, being a herbal product, can be considered as a denture cleanser and also be used as an effective alternative to commercially available antifungal agents without any side effects.


Hemlata Dwivedi, Bishnupati Singh, Prashant Gupta, Manjula Das, Reeta Jain, Surender Kumar

Correlation between Radiomorphometric Indices and Edentulous Mandibular Arches to Diagnose Osteoporosis Using Orthopantomogram in West Bengal State in India

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:166 - 171]

Keywords: Bone mineral density, Edentulous patient, Osteoporosis, Panoramic radiograph

PDF  |  DOI: 10.5005/jp-journals-10024-3030  |  Open Access |  How to cite  | 


Aim: To assess the influence of gender and age on different parameters of alveolar bone loss using orthopantomogram. Materials and methods: Eighty subjects were enrolled in the study (20 dentulous and 60 completely edentulous), fulfilling the inclusion and exclusion criteria. Completely edentulous subjects were divided into four groups (15 males and 15 females above 60 years) and (15 males and 15 females below 60 years). Dentulous group comprised 20 subjects (10 males and 10 females) between 41 and 75 years. After taking panoramic radiographs, vertical as well as horizontal reference lines were drawn. The parameters used for evaluation included mandibular cortical index (MCI), inferior mandibular cortical width (MCW), panoramic mandibular index (PMI), alveolar bone loss (ABL), and height of bone at first premolar (Hp) and first molar (Hm) of the mandible. Results: There was significant association between MCI and age for females with C2 and C3 categories being more common with advancing age. MCW was stable in all groups, except in females above 60 years of age. PMI and ABL were nonsignificant for age and gender. Although the average values of bone height (Hm and Hp) for males were higher than those of females, the results were statistically insignificant. Conclusion: Panoramic radiographic measurements could provide much valuable information and could help in evaluating patients with a low bone mineral density (BMD) with a few limitations. Clinical significance: Dental professionals could screen the patients through panoramic radiographs taken during routine clinical examination, which could help in identifying patients with a low BMD so that further treatment could be initiated early and thus to prevent a pathologic fracture.


Shabab A Khan, Sunita Singh, Nudrat Neyaz, Mishan Mohohar Jaiswal, Aditi S Tanwar, Amitu Singh

Comparison of Dimensional Accuracy of Three Different Impression Materials Using Three Different Techniques for Implant Impressions: An In Vitro Study

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:7] [Pages No:172 - 178]

Keywords: Dimensional accuracy, Impression materials, Impression techniques

PDF  |  DOI: 10.5005/jp-journals-10024-3014  |  Open Access |  How to cite  | 


Aim: To compare the dimensional accuracy of polyether, polyvinyl siloxane, and polyether polyvinyl siloxane hybrid impression materials using closed tray, open tray splinted, and open tray nonsplinted coping impression techniques and to find out the best suitable impression material and technique combination for implant impressions. Materials and methods: The sample size of the study was 45. The combinations of materials and techniques were divided into nine groups, namely polyvinyl siloxane with closed tray, polyvinyl siloxane with open tray nonsplinted copings, polyvinyl siloxane with open tray splinted copings, polyether with closed tray, polyether with open tray nonsplinted copings, polyether with open tray splinted copings, polyvinyl siloxane–polyether hybrid with closed tray, polyvinyl siloxane–polyether hybrid with open tray nonsplinted copings, and polyvinyl siloxane–polyether hybrid with open tray splinted copings. Five samples of each group were evaluated. A total of 45 impressions were taken. A stainless steel master metal framework with three internal hex implants was fabricated and used to generate the samples. A common condensation silicone putty spacer was applied over the impression copings attached to the implants, which was then duplicated. All trays were fabricated on this duplicated silicone die using light cure acrylic resin. Trays to be used for open tray techniques had their top removed for gaining access to screws of the impression copings. Splinting of coping for OS group was done using pattern resin. Impressions were poured, and master cast was generated. Interimplant distance was measured using stereomicroscope and an image analyzing software. Results: Open nonsplinted technique resulted in significantly better replication of implant positions compared to open splinted and closed techniques. Hybrid impression material depicted significantly better dimensional accuracy than polyether and polyvinyl siloxane. Hybrid open nonsplinted depicted least mean difference in interimplant distance, followed by hybrid open splinted and polyether open splinted groups. Polyvinyl siloxane closed tray showed maximum difference in interimplant distance in comparison with other groups. Conclusion: Polyvinyl siloxane–polyether hybrid impression material and open nonsplinted technique gave best replication of implant positions on the master cast. Clinical significance: Accuracy of impressions and casts is of great importance for the fabrication and long-term clinical success of precisely fitting implant-retained prostheses.


Spardha P Shrivastava, Rajani Dable, AP Nirmal Raj, Puneet Mutneja, Sparsh B Srivastava, Merazul Haque

Comparison of Mechanical Properties of PEEK and PMMA: An In Vitro Study

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:5] [Pages No:179 - 183]

Keywords: Flexural strength, Heat-activated PMMA, PEEK, Vickers microhardness test

PDF  |  DOI: 10.5005/jp-journals-10024-3077  |  Open Access |  How to cite  | 


Aim: Evaluation and comparison of flexural strength and hardness of heat-cured polymethylmethacrylate (PMMA) denture base with polyetheretherketone (PEEK). Material and methods: A total of 80 samples of PEEK and PMMA were prepared and divided into two groups: group A and group B, of 40 each. Both the groups were further divided into subgroups consisting of 20 samples of PMMA and PEEK. The group A specimens were tested for flexural strength by universal testing machine (UTM), and group B samples were subjected to hardness test using Vickers microhardness tester. The values obtained were subjected to statistical analysis. The readings were subjected to an unpaired t-test for comparison of flexural strength and hardness of PEEK and PMMA. Result: The flexural strength of PEEK was 183 MPa, while that of PMMA was 84 MPa. The hardness of PEEK and PMMA was 24 VHN and 19.4 VHN, respectively. Conclusion: It was observed that PEEK can be a potential denture base material with superior properties as compared to PMMA. Further researches are needed to be carried out. Clinical significance: PEEK as a denture base exhibits adequate flexural strength prolonging its clinical longevity and overcoming the most common reason for the failure of PMMA denture base that results in fracture.


Shafait U Khateeb, Sonia P Pathrose, Aparna S Kumar, Sengodan Haribaskar, Gunaranjan Thota

SEM Evaluation of Various Intracanal Irrigation Devices on Smear Layer Removal: A Comparative Study

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:5] [Pages No:184 - 188]

Keywords: Irrigation, Root canal, Scanning electron microscope, Smear Layer

PDF  |  DOI: 10.5005/jp-journals-10024-3002  |  Open Access |  How to cite  | 


Aim: The present study aimed at assessing the effectiveness of different intracanal irrigation devices on the removal of the smear layer. Materials and methods: The recently extracted 80 lower premolars having single canal were chosen for this in vitro study. A round diamond bur was used to gain endodontic access and the root canal was entered with a #15 K-file until the tip was just seen at the apical foramen. Manual instrumentation of root canals of all teeth was done using the step-back method. The samples were later divided randomly into four groups. Later, each sample was exposed to final irrigation by using four different irrigation systems, group 1: conventional needle irrigation, group 2: irrigation with ultrasonic activation, group 3: irrigation with EndoVac system activation, group 4: irrigation with EndoActivator. The samples were next mounted and visualized under scanning electron microscope (SEM) for the absence or presence of the smear layer. Results: Irrigation with EndoVac system activation showed the presence of least smear layer (2.40 ± 0.32), followed next by EndoActivator (3.24 ± 0.46) and ultrasonic activation (4.96 ± 0.54) and conventional needle irrigation (5.20 ± 0.10). No statistically significant difference was found in the apical and coronal thirds of the root canal in removal of the smear layer on an intragroup comparison. However, a statistically significant (p < 0.001) difference was seen between the groups at the apical and coronal thirds on an intergroup comparison. Conclusion: This study demonstrated the EndoVac system group to be efficient in removal of the smear layer when compared to the EndoActivator system, ultrasonic activation, and conventional needle irrigation group. Clinical significance: The definitive objective of endodontic therapy is to transform the affected teeth to a healthy and functional state. The irrigants can reach the working length when delivered by an effective irrigation delivery system. This type of delivery system should deliver adequate volume of irrigants all the way up to the working length and have sufficient flow and be efficient at debridement of complete canal system.

Original Article

Jyotirmay, Sanjay K Singh, Kumar Adarsh, Abhishak Sinha, Amit Kumar, Suprabha Sharan

Evaluation of Size of the Condyle in Vertical and Anteroposterior Skeletal Conditions with the Help of Cone-beam Computed Tomography

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:5] [Pages No:189 - 193]

Keywords: Anteroposterior skeletal pattern, Condyle size, Cone-beam computed tomography, Vertical skeletal pattern

PDF  |  DOI: 10.5005/jp-journals-10024-3001  |  Open Access |  How to cite  | 


Aim: Evaluation of size of the condyle in various vertical and anteroposterior skeletal conditions with the help of cone-beam computed tomography (CBCT). Methods and materials: In this study, 266 study participants were included consisting of 112 males and 144 females. The study participants were categorized as class I when −1° ≤ A point–nasion–B point angle (ANB) < 4°, class II when ANB ≥ 4°, and class III when ANB < −1°. The study participants were categorized as hypodivergent when the mandibular plane (MP) ≤ 23°, normodivergent when 23° < MP < 30°, and hyperdivergent when MP ≥ 30°. CBCT images were obtained for each subject and measurement of length, width, and height of the condyle was carried out. The data were collected and analysis of covariance test (ANCOVA) was used for statistical analysis. Statistical significance was adjusted at p ≤ 0.05. Results: The size of the condyle was smaller in females. The length of the condyle was similar in different anteroposterior and vertical positions with no significant difference. The width of the condyle and the height of the condyle were greatest in class III anteroposterior condition while they were lowest in class I condition. The width and height of the condyle were greatest in hypodivergent condition while they were lowest in hyperdivergent condition. Conclusion: It was concluded that the height and width of the condyle vary considerably in different vertical and anteroposterior skeletal patterns and the size of the condyle was smaller in women as compared with men. Clinical significance: The position of the condyle and its morphology are important features that constitute an important part of orthodontic treatment planning. The skeletal pattern of the patient has also an important effect on the diagnosis, planning of treatment, and prognosis in the orthodontic treatment.


Dan Henry Levy, Sarit Rozenfeld, Joe Ben Itzhak, Meital Abadi, Yoav Shapinko, Michael Solomonov

A Rare Case of Multiple Internal Root Resorption after the Delayed Treatment of a Traumatic Injury: A Case Report

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:5] [Pages No:194 - 198]

Keywords: Case report, Case-specific armamentarium, Delayed treatment, Dental trauma, Multiple internal root resorption

PDF  |  DOI: 10.5005/jp-journals-10024-3041  |  Open Access |  How to cite  | 


Aim: The objective of this case report was to present a rare case of simultaneous multiple internal root resorption (IRR) in four mandibular incisors and discuss the possible etiology and suitable armamentarium for its treatment based on different morphological considerations. Background: IRR in permanent dentition is a rare pathological condition and its etiology is not yet fully understood. Very few cases of multiple IRR were reported. This is the first reported case of multiple IRR due to traumatic injury. Case description: A 23-year-old man suffered trauma to his mandible after falling from a trampoline. His mandibular incisors suffered subluxation injuries and his orthodontic fixed retainer got detached. He delayed treatment and visited our clinic 4.5 months after the incident. Clinical and radiographic examination revealed four mandibular incisors with almost identical IRR defects at the apical third of the roots. The patient was then treated with four non-surgical root canal treatments using various endodontic instruments and techniques. Fifteen-month post-trauma, he showed no evidence of pathology at the follow-up examination. Conclusion: Delayed treatment of dental trauma might cause multiple IRR, and the presence of an orthodontic fixed retainer can distribute surface forces and result in uniform IRR defects. Clinical significance: The combination of the self-adjusting file (SAF) and the XP-endo finisher is recommended for chemomechanical preparation of IRR defects in oval canals, especially at the apical third.


Maria Kiatipi, Sotiria Davidopoulou, Konstantinos Arapostathis, Aristidis Arhakis

Dental Neglect in Children: A Comprehensive Review of the Literature

[Year:2021] [Month:February] [Volume:22] [Number:2] [Pages:6] [Pages No:199 - 204]

Keywords: Child neglect, Dental caries, Dental neglect

PDF  |  DOI: 10.5005/jp-journals-10024-3019  |  Open Access |  How to cite  | 


Aim: The purpose of this review is to present the most recent bibliography regarding the etiology, risk factor indicators, types of dental neglect, and the epidemiological studies, showing the relationship between neglect and dental caries indices. Moreover, the review will focus on the role of oral healthcare professionals in evaluating such conditions. Background: Untreated oral diseases, like dental caries, can lead to a variety of negative impacts on children including pain and infection. However, such complications can be prevented if a child\'s basic oral health needs are fulfilled. In addition, it is important to be aware that there are significant inequalities in accessing dental care and poverty, and such cases have to be distinguished from neglect. However, when there is adequate access to oral healthcare services and the parent or the guardian persistently fails to ensure appropriate medical care or treatment for his/her child, the possibility of dental neglect has to be seriously considered. Review results: Dental neglect can be apart of a child\'s general neglect with short-term complications, such as caries, as well as long-term consequences that extend to adulthood, such as poor growth and impaired quality of life. Conclusion: Early diagnosis of dental neglect plays an important role in avoiding adverse impacts on children. Signs and risk factors for dental neglect should alert the dental team in order to intervene in time and prevent suspected cases. Clinical significance: Diagnosis of dental neglect can be difficult. However, identifying dental neglect at an early stage and making a child protection referral may safeguard the child and prevent further harm. For this reason, dentists should be informed about dental neglect and they should know how to deal with these cases. Effective education is necessary to increase knowledge and awareness of all aspects of child neglect.

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