The Journal of Contemporary Dental Practice

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2021 | June | Volume 22 | Issue 6

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Massimo Giovarruscio, Edit Khajanka, Almira Isufi, Maya Feghali, Luciano Pacifici, Orlando Donfrancesco, Andrea Pacifici

New Strategies and Instruments for Root Canal Shaping Procedure: An Overview

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:2] [Pages No:597 - 598]

   DOI: 10.5005/jp-journals-10024-3120  |  Open Access |  How to cite  | 



Nick Kelley, Grant C Vezina, Tarek El-Bialy

Cone-beam Computed Tomography Analysis of the Relationship between the Curve of Spee and the Collum Angle of Mandibular Anterior Teeth

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:6] [Pages No:599 - 604]

Keywords: Collum angle, Cone-beam computed tomography, Curve of Spee

   DOI: 10.5005/jp-journals-10024-3102  |  Open Access |  How to cite  | 


Aims and objectives: To evaluate the correlation between the curve of Spee (COS) of a patient and the Collum angle of mandibular anterior dentition using cone-beam computed tomography (CBCT). Materials and methods: This cross-sectional study was based on the analysis of 100 CBCTs of patients divided sagittally into two separate subjects. The Collum angles of the mandibular central incisor, mandibular lateral incisor, and the mandibular canine were measured along with the COS of that quadrant using Dolphin Imaging. A multivariate linear regression and Pearson correlation coefficients were conducted to measure the correlation between the COS and the Collum angle of mandibular anterior dentition. Results: The total number of participants in the cohort was 200 samples out of 100 patients as this was a split mouth study. The mean COS was 2.09 ± 1.239 mm. The mean Collum angle of the mandibular central incisor (L1) was found to be 6.50 ± 3.002 degrees. The mean Collum angle of the mandibular lateral incisor (L2) was 7.19 ± 2.554 degrees and the mean Collum angle of the mandibular canine (L3) was 7.03 ± 2.907 degrees. There was a statistically significant moderate correlation between L1, L2, and L3 and the COS with the Collum angle of the mandibular central incisor most highly correlated to the COS (0.42), followed by the mandibular lateral incisor (0.35) and then the mandibular canine (0.30). Conclusions: There is a statistically significant low to moderate correlation between the COS and the Collum angles of the mandibular anterior dentition.



Enrique E Zuñiga-Heredia, Takeshi Muguruma, Naohiko Kawamura

Frictional Forces of Three Types of Lingual Appliance with Self-ligating Mechanisms

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:5] [Pages No:605 - 609]

Keywords: Friction, Lingual orthodontics, Self-ligating bracket

   DOI: 10.5005/jp-journals-10024-3093  |  Open Access |  How to cite  | 


Aim and objective: The present study compared the frictional forces of three types of self-ligating lingual appliances. Materials and methods: The lingual appliances (2D, Forestadent; Alias, Ormco; and Clippy L, Tomy International) consisted of a self-ligating bracket (second premolar) and two self-ligating tubes (first and second molars) bonded to a stainless steel jig and attached to a “drawing-friction tester.” Full-size and non-full-size stainless steel archwires were tested, and the static and kinetic friction acting on six lingual appliance/wire combinations was estimated (n = 5). Three-dimensional micro-computed tomography (micro-CT) analysis of each premolar bracket was performed. The frictional forces were compared between the bracket/wire combinations using the Kruskal–Wallis and Mann–Whitney U tests. Results: The Alias and Clippy L bracket/wire combinations had greater contact between the wire surfaces and bracket slots compared to the 2D bracket/wire combination. For all lingual appliances, the static and kinetic frictional forces were significantly higher for the full-size than non-full-size archwire. The 2D bracket, which had a wider outer wing, had less frictional force than the other appliances. The Alias, which had a narrower outer wing, had a significantly lower frictional force than the Clippy L. Conclusions: Frictional force was significantly higher for heavier full-size bracket/archwire combinations than for non-full-size archwires. The 2D bracket had lower frictional force due to its archwire-holding mechanism. The outer wing width may influence the frictional resistance. Clinical significance: The frictional forces of self-ligating lingual appliances vary, and bracket design and archwire size may influence the frictional performance.



Marina L Bezerra, Luiz CCM Alves, Renan AA Tabosa, Sarah LO Dantas, Thalita JF da Rocha, Fávia MN Nigri, Jiovanne R Neri, Danilo LF Lima

Oral Conditions of Elders and Middle-aged Individuals with Multiple Myeloma

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:5] [Pages No:610 - 614]

Keywords: Multiple myeloma, Oral health, Periodontal diseases

   DOI: 10.5005/jp-journals-10024-3108  |  Open Access |  How to cite  | 


Aim and objective: The aim and objective of the present study was to assess the oral conditions of middle-aged and elderly individuals with multiple myeloma. Materials and methods: This cross-sectional, observational study was carried out in the city of Fortaleza, Ceará, in Northeastern Brazil. An oral examination was performed with 19 patients with multiple myeloma, and information on gender, age, diagnosis, diagnosis duration (months/years), and treatment duration (months/years) were collected. The gingival bleeding index (GBI) and probing depth (PD) were measured to check for periodontal disease, and the decayed, missing, and filled teeth (DMFT) index was used to assess dental conditions. Inferential statistics were also used, as well as the Mann–Whitney test to compare genders and continuous variables and the chi-square test for comparisons among the same groups with categorical variables. All statistical tests adopted a significance threshold of p ≤0.05. Results: Among the 19 patients analyzed, 10 (52.6%) were elderly, and 9 (47.4%), middle-aged. The mean age of the participants was 63.4 ± 11.7 years, ranging from 48 to 83 years old. Statistical significance was found regarding missing teeth in the elderly group (p = 0.037), restored teeth in the middle-aged group (p = 0.029), and gingival bleeding among women (p = 0.050). Hyposalivation was observed in 89.5% of the individuals, of which 68.4% were characterized as moderate to severe. Conclusion: Better dental conditions were observed in the middle-aged group when compared to the elderly. Men presented the lowest GBI values. The salivary flow of patients with multiple myeloma was reduced, and most of them showed moderate to severe hyposalivation. It can be assumed that such a situation is caused by the action of drugs, chemotherapy, or even age. Improvements in the oral health of these patients are needed in order to promote a better quality of life. Clinical significance: Knowledge of the oral manifestations of multiple myeloma patients is essential to assist in the early diagnosis of these alterations, as well as to propose an adequate treatment plan, aiming to improve these patients’ quality of life.



Amine el Zoghbi, Mohamad Halimi, Joseph Hobeiche, Camille Haddad

Effect of Occlusal Splints on Posture Balance in Patients with Temporomandibular Joint Disorder: A Prospective Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:5] [Pages No:615 - 619]

Keywords: Occlusal splint, Posture, Study type other, Temporomandibular disorders, Temporomandibular joints

   DOI: 10.5005/jp-journals-10024-3094  |  Open Access |  How to cite  | 


Aim and objective: Force platforms are widely used to evaluate the relationship between bodily posture and jaw positions. The aim and objective of this clinical prospective study was to evaluate the effect of occlusal splints on bodily posture using force platforms. Materials and methods: Forty-seven female patients with temporomandibular disorders (TMD) underwent a clinical and postural examination before and during an occlusal treatment with an upper splint. Six postural stabilometric examinations were performed under different visual conditions. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in static and dynamic conditions, with open and closed eyes, at baseline, at 1 week, and at 3 months. Changes in stabilometric parameters (sway area and sway length) were assessed and compared. Results: In static and dynamic positions, the sway surface area decreased significantly after the occlusal guard placement with closed eyes (p-value, 0.012). Likewise, the sway surface area decreased significantly in the dynamic lateral position with closed eyes (p-value, 0.018) and in anteroposterior dynamic position with open eyes (p-value, 0.031). The mean sway length decreased significantly after the placement of the occlusal guard when participants were in the lateral position with open eyes (p-value, 0.025) and in the anteroposterior position with open eyes (p-value, 0.014). On a 3-month assessment, the mean surface and mean length decreased significantly after the placement of the occlusal guard for practically all the static and dynamic positions. Conclusion: The sway surface area and sway length decreased significantly with the use of occlusal splints Clinical significance: In female patients with TMD, the use of an occlusal splint is associated with a postural improvement evaluated by posturo-stabilometric tests.



Sumaya Y Jeri, Sanjay Narayanamurthy, Sheethel Menon Vrinda, Crystal R Soans, Harshavardhan Reddy

Assessment of Microleakage under Stainless Steel Orthodontic Brackets Bonded with Various Adhesive Systems: An In Vitro Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:4] [Pages No:620 - 623]

Keywords: Adhesive, Brackets, Dye penetration, Microleakage

   DOI: 10.5005/jp-journals-10024-3089  |  Open Access |  How to cite  | 


Aim and objective: The aim of this study was to evaluate the extent of microleakage beneath stainless steel orthodontic brackets bonded with different adhesive systems. Materials and methods: Freshly extracted 60 human premolar teeth from mandibular arch were included in this study. After sterilizing all teeth, they were stored in thymol solution of 1% for further preparation. Acrylic blocks were used to mount the teeth in a way their roots were totally implanted up to the cement enamel junction in acrylic with crown being visible. A 0.022 slot, stainless steel preadjusted edgewise premolar brackets were taken. Sixty premolars were categorized randomly into three groups (20 premolars in each group) as follows: group I: flowable composite, group II: Fuji Ortho LC, group III: Transbond XT. Later, all the samples were subjected to thermocycling and tested immediately and 24 hours after water storage. The samples were submerged for 24 hours in methylene blue solution (2%) at room temperature. A ×20 magnification stereomicroscope was used to examine all samples. Results: The lowest microleakage (1.34 ± 0.20) was shown by Transbond XT restored teeth, followed by flowable composite group (1.79 ± 0.32) and Fuji Ortho LC group (2.98 ± 0.13). An analysis of variance showed statistically significant differences among various adhesive systems. A statistically significant difference (p <0.05) among groups I and II, and groups II and III adhesive materials was seen. Conclusion: This study demonstrated microleakage in all the examined adhesive groups but the lowest microleakage was found with Transbond XT group followed next by Filtek Z350 XT group and Fuji Ortho LC group. Clinical significance: Due to microleakage, the bacteria and fluids present intraorally penetrate through the gaps along the enamel-adhesive boundary. This penetration results in significant esthetic and clinical complications. Such problems related to microleakage can be addressed with the use of an appropriate adhesive agent.



Suasti Mendoza Diego, Del Valle Lovato Juan

Reliability of the Intraoral Records for programming the Condylar Inclination of the Semiadjustable Articulator

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:6] [Pages No:624 - 629]

Keywords: Condylar inclination, Intraoral records, Protrusion record, Semiadjustable articulator

   DOI: 10.5005/jp-journals-10024-3109  |  Open Access |  How to cite  | 


Aim and objective: The purpose of the investigation was to determine the reliability of intraoral records for the programming of the condylar inclination of the semiadjustable articulator (SAA), performed by dentistry students at the Central University of Ecuador (UCE). Materials and methods: The concordance study was of an observational type and was carried out in sixth- and seventh-semester students of the Faculty of Dentistry of the UCE in the period 2019 to 2020. It was applied to a sample made up of 60 students: divided into G1 (n = 30), sixth-semester students and G2 (n = 30), seventh-semester students. The students were given articulated plaster models in an SAA in order to program the condylar inclination based on intraoral records, comparing it with the condylar inclination obtained from a computed tomography (CT) scan by an expert, determining inter-rater reliability. A Fleiss’ Kappa test was performed for this study, with a 95% confidence level. Results: The average condylar inclination of the left side measured by the groups of students was 28.68° ± 10.16° and for the right side it was 27.85° ± 10.59°, while in CT, it was 45° on the left side and 35° on the right side. The range of discrepancy of the groups with the CT values is 4.30° to 19.11°, with a significant difference between the programmed condylar inclination of the SAA between the study groups (p <0.05), with greater amount of success in G1 (40% of students programmed the condylar inclination perfectly) compared to G2 (31.67% of students did it perfectly). Conclusion: When performing the Fleiss’ Kappa test, the concordance of the condylar inclination in an SAA programmed by the students gave a result with a negative sign, which suggests that there is no concordance of the articulator data compared to the CT, verifying that the students are not trained in this practice. Clinical significance: The clinical significance of this study lies in the fact that students must learn to better program the condylar inclination so that the treatments they carry out in the future are jointly and preserving all the normal anatomical factors related to the mouth and the TMJ, in order to do so. achieve more personalized treatments for each patient.



Jambai Sampathkumar Sivakumar, Venkatesan Sudhakar, Chandramohan Ravivarman, Sundaravadivel Vignesh, Shafie Ahamed

Chemical Characterization and Physical Properties of Dental Restorative Composite Resin with a Novel Multifunctional Cross-linking Comonomer

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:7] [Pages No:630 - 636]

Keywords: Copolymer, Cross-linker, Degree of conversion, Dipentaerythritol penta-/hexaacrylate, Glass transition temperature

   DOI: 10.5005/jp-journals-10024-3090  |  Open Access |  How to cite  | 


Aim and objective: To chemically characterize restorative composite resin polymerized with 20 wt.% and 40 wt.% dipentaerythritol penta-/hexaacrylate (DPEPHA) comonomer. Furthermore, this study aimed to evaluate the conversion degree (DC) and glass transition temperature (Tg) of the newly formed copolymer. Materials and methods: The trial groups were photo-polymerized with DPEPHA comonomer, whereas the control group was photo-polymerized only with the propriety resin monomers. Infrared (FTIR) and nuclear magnetic resonance (NMR) spectroscopies were used for establishing copolymerization. The characteristics and composition (mass %) of the surface were explained by field-emission scanning electron microscopy (FESEM) and energy-dispersive X-ray (EDX) spectroscopy, respectively. The DC and Tg of the resultant copolymers were evaluated through FTIR and differential scanning calorimetry, respectively. Appropriate statistical tests with corresponding post hoc tests were employed to compare the medians and means of DC and Tg, respectively. Results: The formation of a new copolymer P(GEU-Co-DPEPHA) was evident. The DC and Tg of the P(GEU-Co-DPEPHA) copolymer were greater than the control. DPEPHA in the copolymer at 40 wt.% concentration showed the highest DC and Tg. Conclusion: DPEPHA comonomer addition leads to the formation of a new P(GEU-Co-DPEPHA) copolymer with improved DC and Tg. Clinical significance: The novel P(GEU-Co-DPEPHA) copolymer may improve the physico-mechanical and biological properties of the restorative composite resin. This would improve the quality of restoration and its in vivo serviceability, thereby imparting a good living quality to the entailed population.



Manal A Al-Melh, Hanan Badr, Lars Andersson

Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:7] [Pages No:637 - 643]

Keywords: Injection anesthesia, Miniscrews, Needle stick, Pain, Topical anesthesia

   DOI: 10.5005/jp-journals-10024-3107  |  Open Access |  How to cite  | 


Aims and objectives: The aims of this study were to compare the anesthetic effect of a lidocaine/prilocaine (L/P) topical anesthetic with placebo on pain from needle sticks and to compare the anesthetic effect of the L/P topical anesthetic with an infiltrative anesthetic on pain from orthodontic miniscrew placement. Materials and methods: Pain elimination was analyzed from two interventions: (a) needle stick and (b) miniscrew insertion. When assessing pain from needle stick, one side of the mandible received 2.5% lidocaine/2.5% prilocaine topical anesthetic, and the other side received placebo. When evaluating pain from miniscrew placement, one side of the mandible received L/P topical anesthetic and the other side received infiltrative anesthetic. The findings were recorded on a Visual Analogue Scale after needle stick and after miniscrew placement. Subjective assessment was analyzed by a questionnaire. Results: The L/P topical anesthetic significantly eliminated the pain from needle stick (Mann–Whitney test of medians, 29.0 vs 0.0, respectively, p<0.001). However, the injection anesthetic eliminated the pain from the miniscrew placement better than the L/P topical anesthetic (Mann–Whitney test of medians, 0.0 vs 5.5, respectively, p<0.001). Eighty percent of the subjects felt more comfortable with L/P topical anesthetic than injection anesthetic. Pain from needle stick pain was reported to be the most uncomfortable part of the study. Conclusion: The L/P topical anesthetic efficiently eliminated pain from needle stick. The L/P topical anesthetic did not completely eliminate pain from miniscrew placement as the injection anesthesia, but it did reduce pain to tolerable levels. Clinical significance: L/P topical anesthetics can significantly eliminate pain from needle stick injections, and L/P topical anesthetics can reduce pain from orthodontic miniscrew placement to tolerable levels.



Aryen Kaushik, Rajeev R Singh, Pooja Rani, G Vinaya Kumar, Punit RS Khurana, Taranjeet Kaur

Effect of Three Different Cooling and Insulation Techniques on Pulp Chamber Temperature during Direct Temporization with Polymethyl methacrylate-based Resin

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:6] [Pages No:644 - 649]

Keywords: Cooling techniques, Intrapulpal temperature, Laboratory research, Polymethyl methacrylate, Provisionalization

   DOI: 10.5005/jp-journals-10024-3110  |  Open Access |  How to cite  | 


Aim and objective: This in vitro study evaluates and compares the changes in pulp chamber temperature during direct fabrication of provisional restorations in maxillary central incisors after using three different cooling techniques. Materials and methods: Total of 60 samples of maxillary central incisors along with their putty indices were divided into four groups (one control and three experimental) and were prepared using a surveyor cum milling machine. Teeth were sectioned 2 mm below cementoenamel junction and a K-type thermocouple wire was inserted in the tooth and secured at the pulpal roof using amalgam. Putty index filled with DPI tooth molding resin material [polymethyl methacrylate (PMMA)] was placed on the tooth and temperature changes per 5 seconds were recorded by temperature indicating device for the control, on–off, precooled putty, and dentin bonding agent (DBA) group. Results: The highest mean obtained was of the control (11.04°C), followed by DBA group (9.53°C), precooled putty group (6.67°C), and on–off group (1.94°C). Precooled putty index group took maximum time to reach the baseline temperature (847.5 seconds). Conclusion: On–off technique is the most effective method to reduce the intrapulpal temperature during polymerization, as compared to the other techniques used in the study. Retardation in the polymerization process was seen in precooled putty group, which may make this technique clinically inadvisable. Clinical significance: Thermal protection of pulp must always be considered during direct fabrication of provisional restoration when a PMMA-based resin is used. By using on–off technique, not only the thermal insult to the pulp can be effectively minimized but also the harmful effects of residual monomer (poor marginal fit and pulpal irritation) can be eliminated.



Uzma Mushtaq, Farheen Mushtaq, Divyangana Thakur, Kirti Rathee, Neelam Poonia, Sanjana Khullar

Comparative Evaluation of Postoperative Sensitivity Following Restoration of Class I Lesions with Different Restorative Materials: An In Vivo Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:5] [Pages No:650 - 654]

Keywords: Class I cavity, Postoperative sensitivity, Restorative material, Visual analog scale

   DOI: 10.5005/jp-journals-10024-3085  |  Open Access |  How to cite  | 


Aim and objective: This study was undertaken to compare postoperative sensitivity in posterior class I restorations using etch-and-rinse and self-etch composite resins, GC Fuji IX, and Cention-N. Materials and methods: The sample size consisted of 160 participants. After clinical and radiographic examination, the participants were randomly assigned to four groups consisting of 40 participants each according to the restorative materials used. Class I cavity was prepared and was restored on each patient and after restoration postoperative sensitivity was evaluated at 24 h, 48 h, and 7 days using the visual analog scale (VAS). The results were tabulated and statistically analyzed using analysis of variance (ANOVA) and post-hoc multiple comparison tests. Results: There were significant differences present between the groups at 24 h, 48 h, and 7 days. We found that the materials causing least postoperative sensitivity are ranked according to superiority as GC Fuji IX > nano-hybrid composite using self-etch adhesive > Cention-N > nano-hybrid composite using etch-and-rinse adhesive. Conclusion: Both GC Fuji IX and self-etch adhesive showed less postoperative sensitivity as compared to etch-and-rinse and Cention-N at 24 h. With GC Fuji IX and self-etch adhesive postoperative sensitivity was decreased while Cention-N also showed good results at 48 h and 7 days. Etch-and-rinse adhesive showed maximum postoperative sensitivity as compared to other groups at 24 h, 48 h, and 7 days. Clinical significance: Teeth restored with resin composites are susceptible to sensitivity. The restorative material used and their handling can influence postoperative sensitivity.



Shorouq K Hamid, AlAnood Hamad AlDubayan, Lujain A Alghamdi, Sultan Akhtar, Soban Q Khan, Ijlal S Ateeq, Mohammed M Gad

Mechanical, Surface, and Optical Properties of PMMA Denture Base Material Modified with Azadirachta indica as an Antifungal Agent

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:10] [Pages No:655 - 664]

Keywords: Azadirachta indica powder, Flexural strength, Hardness, Impact strength, Surface roughness, Translucency

   DOI: 10.5005/jp-journals-10024-3103  |  Open Access |  How to cite  | 


Aim and objective: The present study assessed the influence of Azadirachta indica (AI) powder on the mechanical, surface, and optical properties of heat-polymerized polymethyl methacrylate (PMMA) denture base material. Materials and methods: A total of 300 heat-polymerized PMMA acrylic resin specimens were fabricated with dimensions of 65 × 10 × 3.3 ± 0.01 mm for flexural strength, 50 × 6 × 4 ± 0.01 mm for impact strength testing, and 15 × 2 ± 0.01 mm for surface roughness, hardness, and translucency testing. The specimens were distributed into six groups (n = 10) based on AI powder concentration: An unmodified control group and AI powder–modified groups with 0.5, 1, 1.5, 2, and 2.5 wt% of acrylic resin powder. Universal testing machine was used to measure flexural strength and Charpy's impact tester for impact strength. Surface roughness, hardness, and translucency were assessed using a profilometer, Vicker hardness tester, and spectrophotometer, respectively. One-way analysis of variance (ANOVA) and posthoc Scheffe's test were utilized; p ≤ 0.05 was considered a statistically significant difference. Results: ANOVA showed no significant differences in terms of impact strength (p = 0.175) and surface roughness (p = 0.371), while significant differences were detected in terms of flexural strength, hardness, and translucency (p = 0.001). According to post hoc Scheffe's test, there was a significant decrease in flexural strength for AI groups (p < 0.001) except 0.5% AI group (p = 0.66), while impact strength had no significant difference between AI groups (p = 0.175). Hardness had an insignificant difference between control and modified groups (p>0.05), with exception of 2.5% AI group (p = 0.001). For translucency, a significant difference was found between control and all modified groups (p<0.05). Conclusion: Incorporating AI powder into heat-polymerized denture base material did not significantly alter impact strength, surface roughness, or hardness, except at 2.5% AI concentration, where hardness decreased. On the contrary, flexural strength and translucency were significantly affected. Clinical significance: This study contributes to establishing a new approach for denture stomatitis disease treatment and prevention with the lowest adverse effect on denture properties.



Syeda A Haseeb, Kamala Rajendra, Litto Manual, Anuraj S Kochhar, Deepa Dubey, Gagandeep S Dang

Comparative Evaluation of Implant Stability, Insertion Torque, and Implant Macrogeometry in Different Bone Densities Using Resonance Frequency Analysis

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:4] [Pages No:665 - 668]

Keywords: Bone density, Implant, Surface treating, Torque

   DOI: 10.5005/jp-journals-10024-3118  |  Open Access |  How to cite  | 


Aim and objective: Evaluation and comparison of insertion torque (IT) and the implant stability of two different implant macrogeometry in different bone densities using resonance frequency analysis. Materials and methods: A total of 48 implants (with two implant types having regular and novel macrogeometry) were classified into 4 groups with 12 samples in each group. Group A regular implant without surface treatment, group B regular implant with surface treating, group C novel implant deprived of surface treating, and group D was new dental implant with surface treatment were used. Implant stability quotient (ISQ), implant IT, removal torque (RT) percentage, and torque reduction percentage were calculated. Results: The mean ± SD ISQ value of bone 1 in group A was 56.7 ± 3.2, in group B was 58.6 ± 2.4, in group C was 57.1 ± 3.5, and in group D was 59.3 ± 2.9. In bone 2, the value was 57.8 ± 1.4, 59.5 ± 1.5, 58.2 ± 2.6, and 59.5 ± 2.4 among A, B, C, and D groups correspondingly. In bone 3, it was 59.4 ± 2.4, 60.3 ± 2.3, 60.4 ± 2.8, and 62.7 ± 2.5 among A, B, C, and D groups correspondingly. In bone 4, it was 67.2 ± 3.4, 69.5 ± 2.7, 68.7 ± 2.4, and 69.4 ± 2.3 among A, B, C, and D groups correspondingly. There was a substantial difference in IT and nonsignificant difference in RT in different groups. Conclusion: There was a low IT value with new implant macrogeometry as compared to regular implant macrogeometry. There was absence of association between IT and implant stability. Clinical significance: Calculation of torque insertion score helps in implant placement. Higher bone density scores produce a higher option of decreasing the initial torque. Low IT of new implant types is useful to reduce failure.



Nikhil Jambagi, Preeti Kore, Neha S Dhaded, Sneha A Patil, Malini Shankar

Comparison of Antimicrobial Efficacy of Diode Laser, Ultrasonic Activated and Conventional Irrigation with 2.5% NaOCl during RCT: An Interventional Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:5] [Pages No:669 - 673]

Keywords: 2.5% NaOCl, Conventional needle irrigation, Diode laser intracanal disinfection, Ultrasonic irrigation

   DOI: 10.5005/jp-journals-10024-3111  |  Open Access |  How to cite  | 


Aim and objective: The aim and objective of the study was to evaluate and compare the antimicrobial efficacy of a diode laser irradiation, ultrasonic activated and conventional irrigation with 2.5% NaOCl on obligatory and facultative anaerobic bacteria in single-rooted canals. Materials and methods: Total of 60 permanent maxillary and mandibular single-rooted (single canal) anterior teeth were selected. First microbial sample (S1) was collected after access opening and working length determination, using a sterile paper point. Cleaning and shaping were performed, with each instrument change accompanied by irrigation using 2 mL 2.5% NaOCl. After cleaning and shaping, disinfection protocol using diode laser (group1), ultrasonic activated irrigation with 2.5% NaOCl (group 2) and conventional irrigation with 2.5% NaOCl (group 3) was performed and second microbial sample (S2) was obtained. The colony characters of each type of growth on each media were noted and the organisms were identified using standard biochemical reactions. Result: Gram-positive and gram-negative facultative anaerobe were predominantly isolated from the culture, and the highest reduction of the microbial count was seen in diode laser group with 60.92% followed by the ultrasonic group with 47.22% reduction and least reduction was observed in conventional irrigation with the ultrasonic group with 37.97%. The results were statistically significant with p-value <0.05. Conclusion: Diode laser disinfection showed the highest reduction of microbial count compared to ultrasonic activated and conventional needle irrigation with 2.5% NaOCl group. Clinical significance: This study will help us to choose wisely between various irrigating methods and protocols. Diode laser in our study has shown superior disinfection of the root canals compared to others.



Shreya Kohli Khanna, H Murali Rao, Nausheen Aga, Padma Chandra

Comparing Bacterial Leakage of Three Intraorifice Barrier Sealing Materials against Enterococcus faecalis and Proteus vulgaris

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:6] [Pages No:674 - 679]

Keywords: E. faecalis, Intraorifice barrier, LC-GIC, P. vulgaris, ProRoot MTA, Tetric N-Flow

   DOI: 10.5005/jp-journals-10024-3128  |  Open Access |  How to cite  | 


Aim: The purpose of this in vitro study was to evaluate the intraorifice sealing ability of light-cured glass-ionomer cement (LC-GIC), Tetric N-Flow, and ProRoot mineral trioxide aggregate (MTA) against Enterococcus faecalis and Proteus vulgaris. Materials and methods: Crowns of the eighty human mandibular teeth were decapitated. Working length determination was performed, after which cleaning and shaping were carried out. A uniform orifice diameter of 1.3 mm, at its widest point, was made. Once instrumentation was completed, the canals were irrigated and then obturated. A heat carrier was used to remove gutta-percha to the depth of 3.5 mm. Samples were then divided into a control group (Group 1) with no barrier, and three groups, namely, Group 2, Group 3, and Group 4, were restored with the LC-GIC, Tetric N-Flow, and ProRoot MTA, respectively. The groups were further subdivided into Subgroup A for checking bacterial leakage against E. faecalis and Subgroup B, against P. vulgaris. All samples were subjected to the bacterial leakage test and observed daily for the appearance of turbidity after which statistical analysis was performed. Results: Group 1 showed leakage in, as early as, 3 days. The longest time for the turbidity to appear was shown by Group 4 with an average of 31 days. The mean number of days for turbidity to appear in Group 2 and Group 3 was 23 and 24 days, respectively. Group 4 showed the best intraorifice sealing ability with a significant difference. Conclusion: The teeth with an intraorifice coronal seal had better protection against microbial leakage. Among all materials used, the ProRoot MTA showed the best intraorifice sealing ability. Clinical significance: Use of the ProRoot MTA promises long-term results in the endodontically treated teeth as compared with other materials.



Vasanthakumari Anandan, Jaiganesh Inbanathan, Parthiban Saket, Vivek Krishnamoorthy, Shanmugavadivel Gandhi, Vignesh Krishnapillai Chandrababu

Assessment of Clinical and Radiographic Success Rate of Formocresol-based Pulpotomy versus Collagen-based Pulpotomy: An In Vivo Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:6] [Pages No:680 - 685]

Keywords: Collagen-based pulpotomy, Formocresol-based pulpotomy

   DOI: 10.5005/jp-journals-10024-3117  |  Open Access |  How to cite  | 


Aim: The aim of the study is (a) To use collagen as a pulpotomy material in comparison with the gold standard formocresol-based pulpotomy, (b) to assess the clinical and radiographic success rate of formocresol pulpotomy and collagen-based pulpotomy, and (c) to compare the success rate of formocresol-based pulpotomy and collagen-based pulpotomy over a definitive interval of time. Materials and methods: Totally 30 primary first or second molars indicated for pulpotomy after confirming with the operative diagnosis were taken as samples for this study. This split-mouth technique consists of two groups: Group 1—formocresol pulpotomy (n = 15), and group 2—collagen-based pulpotomy (n = 15). Both the procedures were done in the same patient on regular appointments. Pre- and postoperative radiographs were taken. The children were recalled for clinical and radiographic follow-up at 2, 4, and 6 months. The success of the procedure was assessed based on clinical signs (pain, tenderness to percussion, abscess, swelling, fistula, and pathologic mobility) and radiographic findings (radicular radiolucency, internal and external root resorption, periodontal ligament (PDL) space widening, and furcation radiolucency). The Chi-square test was used to compare the differences between the groups. Result: The overall success rate for formocresol pulpotomy (n = 15) was 14, 13, and 10 for the second-, fourth-, and sixth-month review period, respectively. For collagen pulpotomy group (n = 15), the overall success rate was 14, 14, and 14 for the second-, fourth-, and sixth-month review period, respectively. The obtained data from the overall success rate were subjected to statistical analysis, and chi-square test was used. The p-value less than 0.1 was considered a statistically significant result. The chi-square value for the fourth- and sixth-month review was 0.37 and 3.33, respectively. Conclusion: Statistically significant value was obtained from the sixth-month review period (p <0.1), which describes that the overall success rate was better for the collagen pulpotomy group when compared with the formocresol pulpotomy group. Clinical significance: Collagen had proven to be a very good alternative for formocresol, its biocompatibility, and regenerative efficiency and is a benchmark for a better clinical success rate in dentistry. However, its implication in pulpotomy should be subjected to further comparative research study on mineral trioxide aggregate (MTA), Biodentine, etc.



Dhanasekaran Sihivahanan, Venugopal V Nandini

Comparative Evaluation of Mechanical Properties of Titanium Dioxide Nanoparticle Incorporated in Composite Resin as a Core Restorative Material

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:5] [Pages No:686 - 690]

Keywords: Composite resin, Core material, Mechanical properties, Nanoparticle, Strength, Titanium dioxide

   DOI: 10.5005/jp-journals-10024-3105  |  Open Access |  How to cite  | 


Aim: To compare and evaluate the mechanical properties of 2.5% titanium dioxide nanoparticle (TiO2 NP) incorporated as filler in an experimental composite resin with everX Flow and MultiCore Flow. Materials and methods: TiO2 was prepared and incorporated into experimental dental composite resin. The experimental and traditional composite resin was grouped as follows: Group I: The experimental composite resin with 2.5% of TiO2 fillers, Group II: everX Flow (GC EUROPE), and Group III: MultiCore Flow (Ivoclar Vivadent). Based on International Standards Organization (ISO) 4049, the samples were prepared for the compressive, diametral tensile, and flexural test. Results: Statistical analysis was done, and the results were tabulated. Compared to the other tested materials, the experimental composite resin had relatively high compressive strength, diametral tensile strength, and flexural strength. Compared to MultiCore Flow, the everX Flow showed strong mechanical properties. Conclusion: Based on the result of the study, it can be concluded that the 2.5% TiO2 NP incorporated as filler in an experimental composite resin demonstrated higher mechanical properties compared to the conventional material. Clinical significance: The unique photoactivities of TiO2 NP and their superior mechanical properties make them one of the ideal additives to enhance the performance of polymeric materials.



A Histopathology-based Assessment of Biological Behavior in Oral Hyalinizing Odontogenic Tumors and Bone Lesions by Differential Stains

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:12] [Pages No:691 - 702]

Keywords: Alcian Blue, Bone lesions, Hyaline, Odontogenic tumors, PAS, Picrosirius red, Polarizing microscopy, Safranin-O

   DOI: 10.5005/jp-journals-10024-3116  |  Open Access |  How to cite  | 


Aim: Odontogenic tumors (OTs) and bone lesions of the oral cavity present diverse histological features and varying clinical behavior that makes predicting their biologic behavior difficult. The research undertaken in the current study aims to predict the biological behavior of oral hyalinizing odontogenic and bone lesions (OHO-BL) for the first time by employing four differential stains with clinicopathologic correlation. Materials and methods: The study was performed on retrospectively diagnosed formalin-fixed paraffin-embedded cases of OTs (n = 53) and bone lesions (n = 10). The severity of hyalinization (SOH) was assessed from stained tissue sections. Polarizing microscopy was used to analyze hyalinization in tissues stained with differential special stains, namely periodic acid–Schiff (PAS), Safranin-O, Alcian Blue, and Picrosirius red. SOH was also analyzed for possible correlation with recurrence and clinicopathologic correlation in OHO-BL. Results: Intense staining was observed with PAS, Alcian Blue, and Safranin-O in OTs with increased SOH with a statistical significance. Polarizing greenish yellow color correlated significantly with the recurrence potential of the OT group. Recurrence in individual lesions of the OT group showed a statistically significant association with SOH. Such individual correlation was not observed in bone diseases. Conclusion: PAS, Alcian Blue, Safranin-O, and Picrosirius red are reliable stains to assess hyalinization in OHO-BL. Picrosirius red–polarizing microscopy is a dependable tool for identifying recurrent odontogenic lesions. Clinical significance: SOH can be considered a histological predictor of aggressive biologic behavior in oral hyalinizing odontogenic lesions that can enable the surgeon to arrive at an appropriate management protocol.



Aradhana Rathod, Sonia S Jacob, Ali MAlqahtani, Iris Valsan, Rizleena Majeed, Arya Premnath

Efficacy of Different Gingival Displacement Materials in the Management of Gingival Sulcus Width: A Comparative Study

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:4] [Pages No:703 - 706]

Keywords: Expasyl, Gingival displacement, Horizontal displacement, Magic Foam Cord, Traxodent

   DOI: 10.5005/jp-journals-10024-3112  |  Open Access |  How to cite  | 


Aim: The aim of this study was to assess the effectiveness of different gingival displacement materials in the management of the width of the gingival sulcus. Materials and methods: Totally, 60 participants who were aged 18 years and more were chosen for this study. The eligible participants were those who required fixed prosthesis with at least one abutment. A modified sectional tray was used to make impressions with elastomeric materials along with additional polysilicon using the double mix single impression technique. All participants were divided randomly into three experimental groups with each group having 20 participants as follows: group I—Expasyl, group II—Magic Foam Cord, and group III—Traxodent. Soon after retraction, impressions were made and assessed in a comparable manner to pre-retraction impressions. Image analysis software was used to measure the quantity of displacement of the gingiva, marked as the distance from the tooth to the gingival crest in the horizontal level under stereomicroscope. Results: The highest mean sulcular gingival width (0.644 ± 0.22) was found in Traxodent group followed by Expasyl group (0.590 ± 0.11) and Magic Foam Cord group (0.528 ± 0.01). A statistically significant difference (p<0.001) was found between the groups. Intergroup comparisons between the gingival displacement materials showed a statistically significant difference (p<0.05) between group II and group III. Conclusion: The present study concluded that all three gingival displacement materials lead to gingival displacement, which is needed for impression making. Slightly more retraction was seen in the Traxodent group when compared to the Expasyl group and Magic Foam Cord group. Clinical significance: The success of fixed prosthodontic treatment depends upon precision and accuracy in every step involved in the procedure. One of the most vital stepsis making precise impressions in relation to dimensional accuracy, tear strength, etc. It is essential to have an adequate thickness of the impression material along the margins to avoid distortion. This objective can be achieved by acceptable gingival retraction.



Kshipra Tamhankar, Neha S Dhaded, Preeti Kore, Jyoti M Nagmoti, Anand C Patil

Comparative Evaluation of Efficacy of Calcium Hydroxide, Propolis, and Glycyrrhiza glabra as Intracanal Medicaments in Root Canal Treatment

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:6] [Pages No:707 - 712]

Keywords: Antimicrobial, Calcium hydroxide, Glycyrrhiza glabra, Propolis

   DOI: 10.5005/jp-journals-10024-3106  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the antimicrobial efficacy of Ca(OH)2, 25% propolis, and 25% Glycyrrhiza glabra as intracanal medicaments in root canal treatment. Materials and methods: Total 60 freshly extracted permanent incisors were decoronated and chemomechanical preparation of root canal was performed. Samples were inoculated with a pure culture of Enterococcus faecalis and incubated for 21 days. Colony-forming units (CFUs) were recorded before medication. Incubated samples were randomly categorized into three groups, namely, Ca(OH)2, propolis, and G. glabra, with 20 samples in each group. Antibacterial activity was assessed by evaluating the variance in the CFUs on Day 7. Paired “t” test and Post-hoc Tukey's test were applied to analyze the data. Results: Reduction of CFUs was noticed in all the groups (p <0.001), however the reduction was more predominant in the propolis group. Conclusion: Propolis is more effective against E. faecalis, when compared to G. glabra and Ca(OH)2. Clinical significance: Propolis could be used as an effective medicament in root canal treatment.



Akiko Mino-Oka, Rie Matsuda, Ryoko Shioyasono, Mohannad Ashtar, Akihiro Yasue, Keiji Moriyama

A Long-term Follow-up of Mandibular Deviation Caused by Congenital Cervical Lymphangioma Treated with an Orthodontic Approach

[Year:2021] [Month:June] [Volume:22] [Number:6] [Pages:8] [Pages No:713 - 720]

Keywords: Cervical lymphangioma, Conventional orthodontic treatment, Long-term follow-up, Mandibular deviation

   DOI: 10.5005/jp-journals-10024-3115  |  Open Access |  How to cite  | 


Aim: To report a treatment case of mandibular deviation caused by congenital cervical lymphangioma with traditional orthodontic techniques, following-up by 10-year retention. Background: Lymphangiomas, developmental anomalies, can induce various disturbances of swallowing, mastication, speech, breathing, and skeletal deformities as well as psychological stress and anxiety for the patient and their family. Lymphangiomas are benign with virtually no possibility of turning into a malignant lesion, so clinical management aims to treat the patient functionally. Case description: A girl, aged 6 years and 4 months, complained about facial asymmetry and anterior crossbite caused by congenital cervical lymphangioma. Her facial profile was the straight type with an adequate lip position. Anterior and right-side posterior crossbites were observed. On the frontal cephalogram, the menton shifted 3.0 mm to the right. A functional appliance with an expander was placed to correct her dental midline deviation and posterior crossbite. After 2-year treatment, the anterior and right-side posterior crossbites were improved. Multibracket treatment began after the growth spurt. After 44-month active treatment, a functional occlusion, including a Class I molar relationship with a proper interincisal relationship, was achieved. A functional occlusion was maintained during a 10-year retention period, while a mandibular downward growth was observed through the retention period. Conclusion: Conventional orthodontic techniques enable functional and stable occlusion even in patients with mandibular deviation caused by congenital cervical lymphangioma, although only using early orthodontic management by itself may have some limitations. Clinical significance: The hybrid technique combining functional appliance and intermaxillary elastics proves to be an effective therapy for correcting occlusal cant and mandibular deviation caused by cervical lymphangioma.


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