The Journal of Contemporary Dental Practice

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2021 | March | Volume 22 | Issue 3

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Nilesh K Sharma, Gargi Sarode

Facial Masking and SAMPPs: Potential “Variolation” in COVID-19

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:2] [Pages No:205 - 206]

   DOI: 10.5005/jp-journals-10024-3008  |  Open Access |  How to cite  | 



Olesya Svystun, Lars Schropp, Ann Wenzel, Rubens Spin-Neto

Sella Turcica Area and Location of Point Sella in Cephalograms Acquired with Simulated Patient Head Movements

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:8] [Pages No:207 - 214]

Keywords: Cephalogram, Digital image, Distortion, Sella turcica

   DOI: 10.5005/jp-journals-10024-3056  |  Open Access |  How to cite  | 


Aim and objective: This study assesses changes in the sella turcica area (STA) and location of the cephalometric point sella (S) on lateral cephalograms acquired by charge-coupled device (CCD)-based cephalostats with and without simulated patient head movements. Materials and methods: A real skull was placed on a robot, able to simulate four head movements (anteroposterior translation/lifting/nodding/lateral rotation) at three distances (0.75/1.5/3 mm) and two patterns (returning to 0.5 mm away from the start position/staying at maximum movement excursion). Two ProMax-2D cephalostats (Dimax-3, D-3 or Dimax-4, D-4), and an Orthophos-SL cephalostat (ORT) acquired cephalograms during the predetermined movements (“cases,” 48 images/unit) and without movement (“controls,” 24 images/unit). Three observers manually traced the contour of sella turcica and marked point sella using a computer mouse. STA was calculated in pixels2 by dedicated software based on the tracing. S was defined by its x and y coordinates recorded by the same software in pixels. Ten percent of the images were assessed twice. The difference between cases and controls (case minus control) for the STA and S (namely Diff-STA and Diff-S) was calculated and assessed through descriptive statistics. Results: Inter- and intraobserver agreement ranged from moderate to good for STA and S. Diff-STA ranged from −42.5 to 12.9% (D-3), −15.3 to 9.6% (D-4), and −25.3 to 39.9% (ORT). Diff-S was represented up to 50% (D-3), 134% (D-4), and 103% (ORT) of the mean sella turcica diameter in control images. Conclusion: Simulated head movements caused significant distortion in lateral cephalograms acquired by CCD-based cephalostats, as seen from STA and S alterations, depending on the cephalostat. Clinical significance: Patient-related errors, including patient motion artifacts, are influential factors for the reliability of cephalometric tracing.



Gianluca Gambarini, Massimo Galli, Andrea Cicconetti, Marco Seracchiani, Federico Valenti Obino

Operative Torque Analysis to Evaluate Cutting Efficiency of Two Nickel-Titanium Rotary Instruments for Glide Path: An In Vitro Comparison

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:4] [Pages No:215 - 218]

Keywords: Cutting efficiency, Glide path, Nickel-titanium, Operative torque, Rotary instruments

   DOI: 10.5005/jp-journals-10024-3061  |  Open Access |  How to cite  | 


Aim and objective: The aim and objective of this study was to evaluate and compare the cutting efficacy of two different nickel titanium rotary instruments by a novel methodology: the operative torque (torque and time needed to progress toward the apex). Materials and methods: Ten fresh extracted upper first premolars with two canals were instrumented with a KaVo (Biberach, Germany) and a KaVo 1:1 handpiece at 300 rpm with maximum torque set at 2 N. One canal was instrumented with ProGlider NiTi rotary instruments (Dentsply Sirona Endodontics, Ballaigues, Switzerland), with tip size of 16.02, and the other one with EgdeGlidePath rotary instrument (EdgeEndo, Albuquerque, New Mexico). Mean instrumentation time, mean torque values, and maximum torque values were evaluated for each instrument. The significance level was set at p <0.05. Results: EdgeGlidePath instruments reached the working length in significantly less time with a significantly smaller amount of torque when compared to ProGlider (p >0.05). No instruments exhibited flute deformation or underwent intracanal failure. Conclusions: Operative torque is related to the capability to cut dentin and progress toward the apex: the smaller the torque values, the higher the cutting ability (and safety). Operative torque is also dependent on debris removal and irrigation techniques. Nevertheless, both operative torque and instrumentation time are clinically relevant parameters for evaluating instruments’ performance (i.e., cutting ability). Clinical significance: Operative torque during endodontic instrumentation helps understanding the overall performance in terms of both cutting efficiency and safety.



Patrícia MC Soares, Luis FSA Morgan, Stéphanie Q Tonelli, Francisco IR Limeira, Fábio FB Bruzinga, Paulo I Seraidarian, Rodrigo C Albuquerque, Frank F Silveira

Effect of Different Resin Cements on the Bond Strength of Custom-made Reinforced Glass Fiber Posts—A Push-out Study

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:5] [Pages No:219 - 223]

Keywords: Bond strength, Endodontically treated teeth, Glass fiber post, Push-out, Resin cements

   DOI: 10.5005/jp-journals-10024-3058  |  Open Access |  How to cite  | 


Aim and objective: This study aims to evaluate the effect of different resin cements on the bond strength (BS) of custom-made glass fiber posts (GFPs) using the push-out test. Materials and methods: Twenty-four uniradicular bovine teeth were selected. The crowns were sectioned at the cementoenamel junction, and the root canals were treated. The post spaces of the teeth were prepared to a length of 12 mm to receive a GFP. The specimens were randomly assigned to three experimental groups (n = 8), according to the resin cement used to fix the GFPs: RelyX U200 (U200), Allcem Core (ACC), and Allcem Dual (ACD). Each specimen was sectioned into six slices per root third (cervical, middle, and apical), which were subjected to the push-out test. BS values were calculated and compared using the Kruskal–Wallis and Friedman tests. Results: There were significant differences in the middle third, according to the resin cement type used (p < 0.05). ACD showed lower BS values (p < 0.05). Significant differences were observed for ACD among the thirds of the slices, with the lowest values also observed for the middle third (p < 0.05). Conclusion: The present study shows that ACC and U200 showed higher BS values compared with ACD, and were also less influenced by the depth of the root dentin. Clinical significance: The restoration of endodontically treated teeth is a challenge in dentistry, and, in most cases, will require installation of fiberglass pins. In this respect, several types of resin cements are indicated for cementation of these pins; for this reason, their adhesiveness must be adequately investigated. Conventional cements and self-adhesive cements have shown satisfactory performance in cementing the custom-made GFPs, thereby making these cements satisfactory clinical choices. The present study suggests that ACD had lower performance than the other two cements evaluated.



Suzzane Horani, Abdul Basir Barmak, Paul Emile Rossouw, Dimitrios Michelogiannakis

Changes in Airway Dimensions Following Non-extraction Clear Aligner Therapy in Adult Patients with Mild-to-moderate Crowding

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:7] [Pages No:224 - 230]

Keywords: Airway dimensions, Clear aligner therapy, Cone-beam computed tomography, Invisalign, Non-extraction therapy, Retrospective study

   DOI: 10.5005/jp-journals-10024-3037  |  Open Access |  How to cite  | 


Aim and objective: This retrospective study aimed to assess changes in airway dimensions with non-extraction clear-aligner-therapy (NE-CAT) in adult patients with mild-to-moderate crowding. Materials and methods: Cone-beam computed tomographic images were evaluated for 24 adults (16 females and 8 males) with mild-to-moderate crowding, and Class I or mild skeletal Class II malocclusion before and after NE-CAT. Cross-sectional and volumetric airway measurements were performed at the level of the nasal cavity, upper pharyngeal airway space (UAS), and lower pharyngeal airway space (LAS). The Frankfort-mandibular plane angle (FMA), point A-nasion-point B (ANB) angle, and intermolar width were measured. A paired t-test was used to assess changes in airway measurements. Linear regression analyses were performed to identify predictors of the pharyngeal airway volume change at the levels of the UAS and LAS. Results: There was a significant decrease (p = 0.004) in UAS mean volume (486.63 ± 752.73 mm3), LAS mean volume (p = 0.006), and cross-sectional airway area (p = 0.022) (1536.92 ± 2512.02 mm3 and 34.66 ± 69.35 mm2, respectively) with NE-CAT. The mean airway volume of the nasal cavity, mean cross-sectional airway areas of the nasal cavity and UAS, and mean minimum cross-sectional pharyngeal airway area did not change significantly with NE-CAT. Changes in pharyngeal airway volume were not significantly associated with patients’ age, gender, treatment duration, pretreatment ANB angle, and changes in FMA and maxillary first intermolar width with NE-CAT. Conclusion: Significant changes in the pharyngeal airway dimensions of the UAS and LAS with NE-CAT in adult patients with mild-to-moderate crowding were identified. Clinical significance: The results of the present study show that NE-CAT is not associated with an improvement in airway dimensions in adults with mild to moderate crowding.



Sara Alsubait, Yara Al-Shibani, Nouf Al-Shehri, Norah AlNowaiser, Tagreed Alojaymi, Nassr Almuflehi, Mazen Alkahtany

Efficacy of Different Endodontic Irrigant Activation Techniques on Debris Removal from the Mesial Root Canal System of Mandibular Molars

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:231 - 236]

Keywords: Debris removal, Isthmus, Root canal irrigation, Sonically activated irrigation, Ultrasonically activated irrigation, XP-endo Finisher

   DOI: 10.5005/jp-journals-10024-3054  |  Open Access |  How to cite  | 


Aim and objective: This study was conducted to compare debris removal from the mesial canal system with four different irrigation techniques: sonic activation with EDDY, passive ultrasonic irrigation (PUI), mechanical activation with the XP-endo Finisher (XPF), and manual dynamic irrigation (MDI) with gutta-percha. Materials and methods: Fifty-six extracted mandibular molars with isthmus in the apical 5 mm in mesial roots were sectioned horizontally at 3 mm and 5 mm from the apex. The sections were reassembled, and the mesial canals were prepared chemomecahanically. Specimens were allocated randomly into four groups according to the final irrigation technique. Standardized images of the coronal aspect of cross sections were obtained using a digital stereomicroscope before and after final irrigation protocols to calculate the percentage of debris elimination from the canal system after final irrigation. Results: The use of EDDY, PUI, and XPF exhibited significant reductions in debris compared with MDI at 5 mm (p <0.00) and at 3 mm (p <0.00). Furthermore, no significant difference was noted among EDDY, PUI, and XPF. For intragroup analysis, no statistically significant difference in the percentage of debris elimination was noted between 3 mm and 5 mm in all four groups. Conclusion: All groups showed a reduction in debris after the final irrigation protocol. However, the use of EDDY, PUI, and XPF after cleaning and shaping yielded a significant reduction in debris compared with MDI. Clinical significance: The use of PUI, XPF, and EDDY as an adjunctive irrigation step presented similar results in improving canal cleanliness, which is hypothesized to affect the treatment outcome.



Subhasmita Bhol, Nitin K Singh, Mayakkannan Senthil Kumar, Ateet Kakti, Mohanraj Madhumitha

Assessment of Remineralization Capacity of Various Remineralizing Agents on Artificial Enamel Lesions Using Confocal Laser Scanning Microscope: An In Vitro Study

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:5] [Pages No:237 - 241]

Keywords: Confocal laser scanning fluorescence microscopy, Demineralization, Remineralizing agents, Rhodamine B

   DOI: 10.5005/jp-journals-10024-3006  |  Open Access |  How to cite  | 


Aim and objective: The present study aimed at evaluating the effectiveness of diverse remineralizing agents on artificial enamel lesion using confocal laser scanning microscope (CLSM). Materials and methods: Totally 80 mandibular premolars which were single rooted were included. All teeth were suspended in a demineralizing solution to create artificial enamel lesions on the exposed enamel. The samples were separated randomly into four groups (20 each) depending on the application of the remineralizing agents as follows: group 1: control; group 2: calcium sucrose phosphate (CaSP); group 3: fluoride varnish; and group 4: casein phosphopeptides-amorphous calcium phosphate (CPP–ACP). The samples in individual group were treated with the corresponding remineralizing agent (except for the control group) two times a day for 14 days. The experimental and control groups were exposed to CLSM assessment to analyze the data of remineralization and demineralization. Results: The mean depth of remineralization of fluoride varnish group was slightly more compared to other groups. The highest mean depth of remineralization was found in the fluoride varnish group (122.26 ± 0.28) followed by CaSP (110.58 ± 1.34), CPP–ACP (107.08 ± 0.48), and control (157.78 ± 0.46) groups. The different comparisons among the remineralization material groups showed a statistically significant difference (p < 0.05) in almost all groups except group 2 vs group 4. Conclusion: This study concluded that improved remineralization of artificial enamel lesion could be achieved with the fluoride varnish group when compared to the CaSP and CPP–ACP groups. Clinical significance: Remineralization as a treatment technique has received a lot of consideration from clinicians. The process of remineralization and demineralization is considered an active process categorized by the movement of calcium and phosphate in and out of the enamel. Presently, the attention has changed toward increasing the resistance of the tooth by applying remineralizing agents topically, which has led to the notable fall in dental caries.



Ferena Sayar, Amirhossein Farahmand, Maryam Rezazadeh

Clinical Efficacy of Aloe Vera Toothpaste on Periodontal Parameters of Patients with Gingivitis—A Randomized, Controlled, Single-masked Clinical Trial

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:242 - 247]

Keywords: Aloe vera, Gingivitis, Oral hygiene, Toothpaste

   DOI: 10.5005/jp-journals-10024-3059  |  Open Access |  How to cite  | 


Aim and objective: This study aims to assess the effects of aloe vera toothpaste on dental plaques and gingivitis. Materials and methods: This single-center, single-blind, randomized, two-period crossover study was performed on 20 dental students with a mean age of 24.5 ± 4 years with gingivitis. Subjects were randomly assigned to two groups (n = 10). After 14 days of trial period, plaque index (PI) and gingival index (GI) were assessed for each group. The first group used aloe vera toothpaste for 30 days and then their PI and GI were recorded. A 2-week washout period was allowed and then the subjects used fluoride toothpaste for the next 30 days and underwent PI and GI assessment again. This order was reversed in group 2. Results: Toothpaste-containing aloe vera showed no significant improvement in the GI and PI scores as compared with a fluoride-containing dentifrice. PI was 2.14 ± 1.3 at baseline and 1.84 ± 1.02 in 30 days (p <0.098). GI was 0.62 ± 0.74 at baseline and 0.25 ± 0.46 at 30 days (p <0.068). During the trial, no side effects were seen due to the use of aloe vera or fluoride toothpaste. Conclusion: The effect of aloe vera toothpaste on PI and GI was similar to that of fluoride toothpaste and it seems that this toothpaste can be used as an alternative to a chemical toothpaste. Clinical significance: The use of an aloe vera toothpaste in improving the progression of gingivitis can be evaluated.



Kalpesh Sharma, Vijay N Yannawar, Ganesh R Kotalwar, Pallavi Madanshetty, Ishita Grover, Prashant S Lagali

Single Nucleotide Polymorphisms of BMP2 Gene Association with Skeletal Class I Crowding: A PCR Study

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:5] [Pages No:248 - 252]

Keywords: BMP2 gene, DNA sequencing, Genetic markers, Single nucleotide polymorphism, Skeletal class I

   DOI: 10.5005/jp-journals-10024-3088  |  Open Access |  How to cite  | 


Aim and objective: This study is conducted to find the association of BMP2 (bone morphogenic protein 2) gene variant rs1005464 and rs15705 with skeletal class I crowding cases. Materials and methods: Blood samples from 60 subjects who visited the Department of Orthodontics and Dentofacial Orthopaedics, D.A.P.M.R.V. Dental College, Bengaluru, were taken after written informed consent. These were divided into two groups: group A with 30 subjects having skeletal class I bases with crowding and group B with 30 subjects having skeletal class I bases without visible crowding or spacing (±2 mm). Around 2 mL of venous blood sample was procured from cases and controls after careful examination. All the samples were then subjected to polymerase chain reaction followed by DNA sequencing and capillary electrophoresis. BMP2 rs1005464 and rs15705 gene variants were assessed and Z-Test was used for statistical analysis. Result: GG (p = 0.001) and CC (p = 0.0024) genotype of BMP2 gene variant rs1005464 and rs15705, respectively, are significantly associated with skeletal class I crowding cases. Conclusion: This study concludes that BMP2 variants rs1005464 and rs15705 can be used as genetic markers for skeletal class I bases having crowding. Clinical significance: Predisposing genetic markers BMP2 can be identified prior and this would help in predicting the probability of potential crowding in the future and this would help in early prevention and intervention of crowding.



Raja AbdAlgadir Mustafa, Amal Hussein Abuaffan

Evaluation of Dental Crowding and Spacing in Relation to Tooth Size and Arch Dimensions in a Sample of Sudanese Adults

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:253 - 258]

Keywords: Arch dimension, Crowded, Spaced, Sudanese, Tooth size

   DOI: 10.5005/jp-journals-10024-3065  |  Open Access |  How to cite  | 


Aims and objectives: This study aimed to compare tooth size and arch dimensions between normal, crowded, and spaced groups in a Sudanese sample. Material and methods: A sample of 312 university students, were selected and divided into normal, crowded, and spaced groups. Each group included 104 students with equal males to females ratios. Age was ranged from 16 to 26 years. Mesiodistal (MD) tooth width of all teeth (except molars), arch perimeters, and dimension at the level of intercanine, interpremolar, and intermolar were measured for each group. ANOVA and student t-test were performed for the comparison between groups. Results: The MD dimensions of all teeth are greater in crowded arches as compared to the teeth in normal dental arches, except for the width of the maxillary, left second premolar in females, and mandibular left second premolar in male. Spaced arches were presented with significantly smaller MD width in all teeth when compared to normal arches, except for the width of maxillary right second premolar, maxillary left first premolar, mandibular right and left second premolars in female, and maxillary right second premolar in male. Crowded arches exhibit the largest total tooth material followed by normal and spaced dentition. Spaced arches show the widest arch dimension and perimeters followed by normal and crowded dentitions. Conclusions: Both tooth size and arch dimensions contribute to dental crowding and spacing. Clinical relevance: Since the size of the teeth and dental arches affect the space availability of the dentition. These factors should be considered in the initial stages of orthodontic treatment planning to avoid compromised treatment outcomes.



Rahhali Mohamed, Sakout Majid, Abdallaoui Faiza

Root Microcracks Formation during Root Canal Instrumentation Using Reciprocating and Rotary Files

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:5] [Pages No:259 - 263]

Keywords: Continuous rotation, Dentinal cracks, Nickel–titanium rotary files, Reciprocating motion

   DOI: 10.5005/jp-journals-10024-3055  |  Open Access |  How to cite  | 


Aim and objective: The aim of this study was to compare the formation of dentinal cracks with nickel–titanium (NiTi) instruments working in continuous rotation and reciprocating motion. Materials and methods: One hundred sixty extracted human mandibular first molars were selected for the study. The mesial roots were resected and mounted in resin blocks with simulated periodontal ligaments. Those teeth were randomly assigned to five groups (n = 32 teeth/group). The first one was treated with K-files and served as control group, and the remaining 128 teeth were divided into 4 groups depending on the root canal preparation technique. Group 2 samples were prepared by sequential ProTaper Universal (PTU), group 3 samples with rotary ProTaper Universal (RPTU), group 4 achieved by the One Shape (OS), and group 5 with the WaveOne (WO) primary files. Roots were then horizontally sectioned at 3, 6, and 9 mm from the apex, and the slices were then observed under a stereomicroscope at ×40 magnification to determine the presence of internal dentinal microcracks. The presence or absence of dentinal defaults was recorded and the statistical analysis was performed by Pearson Chi–square test. The significance level was set at p < 0.05. The study was made in the oral biology and biotechnology research laboratory of the faculty of medical dentistry of Rabat, Morocco. Results: No dentinal defect was seen with the stainless steel hand file (group 1). The manual PTU (group 2), the RPTU (group 3), the OS (group 4), and the WO (group 5) in reciprocating motion caused cracks in 15.6%, 12.4%, 21.9%, and 6.2% of samples, respectively. The highest percentage of dentinal defect was showed in group 4 but without significant difference with the other group (p > 0.05). Conclusions: Dentinal cracks are produced indifferently of motion kinematics. Within the limits of this study and the current literature, such incidence is less with instruments working in reciprocating motion compared with those working in continuous rotation. Manual and rotary NiTi sequential systems showed fewer microcracks than the single file system working by continuous rotation motion.



Swaroop Subramonia, Prasanna T Ramaiah, Suhas Setty, Mayank Khandelwal, Chethan K Dakshina, Cilpa Varghese

Prediction of Mandibular Growth Pattern Using Palatoscopy: A Retrospective Model Analysis

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:4] [Pages No:264 - 267]

Keywords: Craniofacial growth pattern, Mandibular growth pattern, Mandibular rotation, Palatoscopy

   DOI: 10.5005/jp-journals-10024-3060  |  Open Access |  How to cite  | 


Aim and objective: To predict and correlate mandibular growth pattern using palatoscopy (average, horizontal, and vertical). Materials and methods: This retrospective study includes 120 archived maxillary casts. One key person and two examiners performed the study; the key person was responsible for coding and collecting casts and radiographs, as well as calibration of the examiners. The key person divided the samples into three craniofacial growth pattern groups (average, horizontal, and vertical) based on Frankfort-mandibular plane angle (FMA), SN-GoGn, and facial axis angle and distributed them to the blinded examiners. Rugae were studied using a modified Thomas and Kotze classification system. After the analysis, the results were decoded and analyzed with the corresponding cephalometric radiographs. Results: Multinomial logistic regression was employed to predict the mandibular growth patterns with the following independent variables: Forwardly directed rugae, number of divergent rugae, predominant shape circular, predominant shape curved, primary rugae, predominant shape wavy, number of convergent rugae, and horizontally directed rugae. Conclusion: Palatal rugae patterns predict the growth pattern of the mandible. Clinical significance: Considering the significant parameters and their correlation with mandibular growth pattern, prediction of mandibular growth patterns can be done noninvasively.



Tiago HS Anastacio, Nathalia B de Moraes, Eduardo J de Moraes, Valquiria Quinelato, Jose A Calasans-Maia, Cintia CP Martins, Telma Aguiar, Aldir N Machado, Priscila L Casado

Analysis of Active Oral Tactile Sensitivity in Individuals with Complete Natural Dentition

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:5] [Pages No:268 - 272]

Keywords: Active tactile sensitivity, Dental occlusion, Mechanoreceptors, Oral proprioception, Periodontal ligaments, Permanent dentition

   DOI: 10.5005/jp-journals-10024-3069  |  Open Access |  How to cite  | 


Aim: To evaluate the active tactile sensitivity in individuals with complete natural dentition, determining the smallest thickness detected by the participants, and clarifying if there is a difference between the thicknesses analyzed. Materials and methods: Active tactile sensitivity was evaluated in 40 research participants. Inclusion criteria included participants with complete natural dentition, without active or history of periodontal disease, absence of temporomandibular disorders, bruxism, and restorations in the evaluated area. Exclusion criteria included age below 18 years. The active tactile perception threshold was evaluated by using carbon sheets of different thicknesses (0, 12, 24, 40, 80, 100, and 200 μm), which were inserted in the participants’ premolars, bilaterally. The carbon sheet was inserted so as not to come into contact with the oral soft tissues. Subsequently, the participant occluded and was asked about the perception of the intraocclusal object 20 times in each occlusal contact. The collected data were tabulated considering the amount of positive and negative responses for each carbon thickness. Values of p < 0.05 were considered significant. Results: The results showed that there was linearity in perception, on both sides, besides, the natural dentition was able to perceive difference in thickness from 12 μm. Conclusion: We conclude that the 12 μm thickness is noticeable in occlusion and can be differentiated from other thicknesses in natural dentition and that there is no difference between the tactile sensitivity of the right and left sides. Clinical significance: A better understanding of active oral tactile sensitivity will contribute to numerous clinical applications in dentistry, including occlusal adjustment in dental rehabilitation, dental implants prosthesis design, and survival of prosthetic rehabilitation.



Prasanti Kumari Pradhan, Kanhu C Sahoo, Khushboo Ghosh, S Lata, Gaurav Patri, Subhasmita Bhol

Does Cavity Disinfectant Affect Sealing Ability of Universal Self-etch Adhesive?

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:273 - 278]

Keywords: Caries, Cavity disinfectant, Chitosan, Chlorhexidine, Octenidine dihydrochloride

   DOI: 10.5005/jp-journals-10024-3052  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate 2% chlorhexidine disinfectant (CHX), chitosan, and octenidine dihydrochloride (as cavity disinfectants) on microleakage in cavities restored with universal self-etch adhesive. Materials and methods: Eighty extracted human permanent premolars were selected. Class V cavities were prepared on the facial surface of each tooth. The teeth were then divided into four groups of 20 teeth each. For the control group after cavity preparation, no disinfectant was applied. The other 3 groups were treated with 0.1% chitosan, 2% CHX, and 0.1% octenidine dihydrochloride (OCT). All the groups were restored with universal adhesive followed by composite resin. The teeth were then immersed in 1% methylene blue dye and were sectioned buccolingually. Microleakage was checked under a stereomicroscope on both occlusal and gingival margins. Result: Among all the groups chitosan-treated cavities showed the least microleakage. Chlorhexidine treated cavities showed less leakage as compared to control, OCT group at both the margins. Conclusion: Chitosan as a cavity disinfectant improves the sealing ability of the self-etch adhesive. Furthermore, in vivo studies need to be conducted to examine the interaction and long-term effect of chitosan with the other self-etch adhesive systems. Clinical significance: Chitosan a natural polysaccharide can be used as a cavity disinfectant as it improves the sealing ability of self-etch adhesive.



Rupali V Patil, Vasantha Vijayraghavan, Madhurakad Jadhav, Shweta Jajoo, Sneha Desai

Comparison of Tensile Bond Strength of Addition Silicone with Different Custom Tray Materials Using Different Retentive Methods

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:5] [Pages No:279 - 283]

Keywords: Acrylic resin, Addition silicone, Tensile bond strength, Tray adhesive, Tray repair material, Visible light cure resin

   DOI: 10.5005/jp-journals-10024-3009  |  Open Access |  How to cite  | 


Aim: To compare the bond strength of addition silicone with different commonly used custom tray materials by means of different retentive methods (mechanical, chemical, and a combination of chemical and mechanical methods). Materials and methods: Fabrications of 90 samples of different tray resin materials were done using an aluminum mold. They were divided into three main groups. Perforations, adhesive application, and a combination of both were done according to the grouping of samples. Polyvinyl siloxane material (medium body) was loaded over the samples. A universal testing machine with a crosshead speed of 5 mm/minute was used to determine the tensile bond strength of tray resin samples to medium body impression material. Based on these values, Student's-test, group statistics, and ANOVA test were used for statistical analysis. Results: Visible light cure (VLC) resin showed the highest bond strength in chemicomechanical methods. This was followed by repair resin material. Tray resin material showed poor bond strength in all three retentive methods. The mechanical method was the least retentive in all three resin materials. Clinical significance: VLC tray resin material can be used with chemical and mechanical retention in clinical situations to make predictably accurate elastomeric impressions. Conclusion: It was concluded that VLC tray resin shows good bond strength with polyvinyl siloxane impression material when both mechanical perforations and adhesive applications were done.



Mohammed Mashyakhy

Anatomical Evaluation of Maxillary Premolars in a Saudi Population: An In Vivo Cone-beam Computed Tomography Study

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:284 - 289]

Keywords: Anatomy, Cone-beam computed tomography, Maxillary premolars, Root canal morphology, Saudi population

   DOI: 10.5005/jp-journals-10024-3070  |  Open Access |  How to cite  | 


Aim and objectives: Evaluation of the root canal morphology of maxillary premolars was the primary objective of this study, on the criteria of the roots present, canals detected in the roots, and anatomical canal patterns according to Vertucci's classification observed in the Saudi population using cone-beam computed tomography (CBCT) radiographic analysis comparing them to previous reports in the same population. Materials and methods: A total of 710 maxillary 1st and 2nd premolars were considered in this research; of which 351 were 1st premolars and 359 were 2nd premolars. These premolars were investigated for their external and internal anatomy using CBCT. Teeth with apical closure and complete root development were included in the study. Endodontically treated teeth, teeth with calcified canals or resorbed roots, as well as unclear teeth on CBCT images were excluded. Results: Among the 351 maxillary 1st premolars, 40.7% of teeth had 1 root, 57.5% had 2 roots, and 1.7% had 3 roots. Around 93.2% of teeth had 2 canals, 3.7% had 1 canal, 2.6% had 3 canals, and 0.4% had 4 canals. According to Vertucci's classification, 63.8% of teeth had class IV configuration, 14.8% had class V configuration, 7.7% had class III configuration, and 6.8% had class II configuration. Likewise, among the maxillary second premolars, 88% of teeth had 1 root and 12% of teeth had 2 roots. Around 38.2% of teeth had a single canal while 61.0% of teeth had 2 canals, and 3 teeth were found with the extra canal (had 3 canals). More than one-third (38.2%) of teeth had Vertucci type I, 19.2% had Vertucci type IV, 15.3% had Vertucci type III, and 12.3% had Vertucci type V. Conclusion: Maxillary first premolars had a higher prevalence of 2 roots, whereas one root was predominant in second premolars. Most of the maxillary premolars had 2 canals with the majority having Vertucci type IV in the first premolars and type I in the second premolars. Clinical significance: Maxillary premolars present with external and internal anatomical variations, so clinician should be aware about these varieties by taking small field of view CBCT when needed which will be of great value.



Mustapha Houmani, Nabih Nader, Ziad Salameh, Antoine Berberi

Alveolar Ridge Preservation in the Esthetic Maxillary Zone: Tuberosity Punch Technique of Gingiva and Bone: A Pilot Study

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:8] [Pages No:290 - 297]

Keywords: Alveolar bone, Gingiva, Ridge preservation, Tuberosity

   DOI: 10.5005/jp-journals-10024-3049  |  Open Access |  How to cite  | 


Aim: This paper aims to present an alveolar ridge preservation technique, using an autologous punch formed of hard and soft tissues harvested from the tuberosity area. Materials and methods: Ten residual sockets in the anterior maxilla were filled with a punch of hard and soft tissues harvested from the tuberosity area. Clinical and radiographical data were collected at the surgical extraction time 0 (T0) and 5 months during implant placement (T1), from clinical and radiological measurements using cone-beam computed tomography scans and periapical radiographs. Core biopsy was harvested during implant placement for histological and histomorphometrical analysis. Results: Clinically, the alveolar ridge presented a mean width of 10.3 mm before extraction which decreased to 8.85 mm at T1, where the mean horizontal loss is 1.45 mm (standard deviation [SD] 1.03 mm). The initial ridge mean height was 11.25 mm and increased to 12.85 mm after 5 months, where the mean vertical gain is 1.6 mm (SD 0.65 mm). The radiological evaluation shows a reduction in the horizontal dimension with a mean of 1 mm; however, the sockets show stability in the vertical dimensions. Histology showed a new lamellar bone formation with some areas of woven bone. Histomorphometric analysis showed that the percentage of new bone formed was 42.44 ± 5.54% and 48.62 ± 8.66% of the connective tissue and 8.94 ± 5.28% of the residual autogenous bone. Conclusion: At T1, the extraction sockets showed significantly lower vertical and horizontal bone changes, compared to T0. The described preservation punch technique resulted in greater stability in the horizontal and vertical dimensions after 5 months. Clinical significance: Clinical and radiological results show that the punch of hard and soft tissue graft reduces hard and soft tissue dimensional alteration after tooth extraction. In addition, using autogenous bone showed histological new bone formation.



Mohammed Howait, Marwa Shaker, Haila Aljuhani, Manar AlMohnna

External Cervical Resorption: A Case Report and Brief Review of the Literature, and Treatment Algorithms

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:298 - 303]

Keywords: Apical periodontitis, External cervical resorption, Periapical lesion, Root resorption

   DOI: 10.5005/jp-journals-10024-3013  |  Open Access |  How to cite  | 


Aim: This report presents a case of external cervical resorption and illustrates the effects of a non-surgical approach in the amelioration of this condition and discusses the etiology, classifications, and treatment options. Background: One of the most common root resorption forms is external cervical resorption, which initiates in the cervical area of the tooth and spreads out in the thickness of the dentin in an irregular way. This resorptive process may spread across the dentin leading to significant loss of tooth structure, with or without pulp involvement. Case description: During a routine radiographic examination of a 25-year-old female patient, external cervical resorption in a maxillary right second premolar was discovered. Cone-beam computed tomography (CBCT) confirmed the extension of the lesion into the pulp and the need for root canal treatment. The defect was sealed with bioceramic putty. One year CBCT follow-up demonstrated the cessation of the resorption site with no clinical symptoms. Conclusion: CBCT examination and combining non-surgical root canal treatment with non-surgical repair using bioceramic putty was an effective treatment option. Clinical significance: Treatment selection of external cervical resorption depends on many factors, including the location and severity of the resorptive defect and the remaining tooth structure. If the resorptive defect has extended to the pulp, the management involves root canal treatment and subsequent placement of a direct restoration to restore the resorptive lesion.



Imran Shahid, Mukund Seshadri

Florid Cemento-osseous Dysplasia: A Report of Two Cases and Literature Review

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:304 - 309]

Keywords: Bone remodeling, Florid cemento-osseous dysplasia, Mandible, Orthodontic treatment, Osteomyelitis, Secondary infection

   DOI: 10.5005/jp-journals-10024-3029  |  Open Access |  How to cite  | 


Aim: This report aims to provide the clinical and radiographic features of two symptomatic Indian patients with florid cemento-osseous dysplasia (FCOD), along with a discussion of the differential diagnosis, potential challenges, and therapeutic implications. Background: FCOD is a rare, multifocal, periapical, and bilateral condition involving the premolar and molar region of the posterior mandible and sometimes the maxilla. Case description: The first patient is a 30-year-old female with a recent history of dental pain. The patient was otherwise healthy and the medical history was unremarkable. The second patient is a 50-year-old female with a history of orthodontic therapy. Radiographic evaluation using cone-beam computed tomography (CBCT) revealed bilateral involvement of the posterior mandible, sparing the entire maxilla in both patients Clinical significance: For a pathognomonic condition like FCOD, a radiology survey alone is often sufficient to arrive at the final diagnosis, and therefore surgical interventions should ideally be avoided.



Mohammad A Aldosari

Dental Magnification Loupes: An Update of the Evidence

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:6] [Pages No:310 - 315]

Keywords: Dental loupes, Dental professionals, Literature review, Loupe magnification, Musculoskeletal disorders

   DOI: 10.5005/jp-journals-10024-3057  |  Open Access |  How to cite  | 


Aim: To overview dental magnification loupes and to present the updated scientific evidence supporting its use. Background: The practice of dentistry places considerable stress on the operators’ visual acuity and musculoskeletal system. The use of magnification loupes has spanned many decades with claims of supporting visual and postural capacities of dental professionals and enhancing diagnostic and procedural accuracy. Review results: Galilean and prismatic loupes both provide lightweight and clinically appropriate magnifications between 2.5× and 5.0×, with beneficial features such as a fixed working distance and downward lens inclinations. Studies have found significantly increased detection and diagnostic abilities due to enhanced visibility and improved treatment outcomes for some investigated procedures. Postural studies have found improved positioning of the upper body when using loupes as compared to the positioning when using the naked eye, with practitioners experiencing reductions in musculoskeletal symptoms when using magnification loupes. Conclusion: The current evidence supports the presence of some visual advantages of loupe magnification in diagnosis and treatment delivery. However, more clinical trials are needed to investigate different procedure outcomes over the long term. Further, there is robust scientific evidence advocating the use of loupe magnification for postural and musculoskeletal support. Clinical significance: Dentistry is a visually and physically demanding profession with a high prevalence of musculoskeletal disorders among dental professionals. The use of loupe magnification potentially benefits both the dental healthcare provider and patients. Therefore, there is reason to consider the use of loupe magnification as an integral part of dental education and training, as well as a tool in the dental clinician's armamentarium.



Nujud A Sharawi, Ahmed Mohammed Hassan Somaili, Samar A Arishi, Raed MH Somaili, Latifah Y Ghazwani, Ali HA Sumayli, Mohammed AA Sumayli, Mona S Ghoussoub, Shankargouda Patil

Pharmacological Means of Pain Control during Separator Placement: A Systematic Review

[Year:2021] [Month:March] [Volume:22] [Number:3] [Pages:8] [Pages No:316 - 323]

Keywords: Analgesics, Pain management, Separator

   DOI: 10.5005/jp-journals-10024-3010  |  Open Access |  How to cite  | 


Aim: To assess the effectiveness of adjuvant analgesics/anesthetics in pain control after separator placement compared with no medication. Background: Separator placement to create space for cementing bands is the first clinical procedure done in orthodontics. Pain in this stage can negatively affect patient compliance and trust in the clinician. To date, there is no universally accepted regimen for pain control. Materials and methods: Electronic databases of PubMed, Scopus, and Web of Science were searched. One hundred and thirty-two potentially relevant studies were found. A total of eight randomized clinical trials including 642 subjects were selected. Data were extracted into customized forms, and selected studies were assessed for risk of bias using the Joanna Briggs Institute. Results: Results showed the use of analgesics led to lower reported pain scores at almost all time intervals. NSAIDs resulted in a statistically significant reduction in pain compared to a control group. Conclusion: According to the available literature, the use of analgesics is effective in controlling orthodontic pain due to separators. Acetaminophen and ibuprofen show a stable analgesic effect. Clinical implication: Acetaminophen 650 mg or ibuprofen 400 mg taken 1 hour prior to separator placement can reduce pain associated with the procedure.


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