The Journal of Contemporary Dental Practice

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2022 | June | Volume 23 | Issue 6

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Umarevathi Gopalakrishnan, Sumathi Felicita, BSM Ronald, Elamurugan Appavoo

Microbial Corrosion in Orthodontics

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:3] [Pages No:569 - 571]

   DOI: 10.5005/jp-journals-10024-3290  |  Open Access |  How to cite  | 



Mohammed Ahmed Naji, Hamdy Abd El Mageed Marzook, Rana Mohamed Nagah El Qashty, Fakhreldin Hassan Abdel–Rahman

Comparison between Effect of Bisphosphonates, Concentrated Growth Factors or Combination on Rabbits’ Tibial Bone Defects Healing: An Experimental Study

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:10] [Pages No:572 - 581]

Keywords: Histochemical, Histological, Masson trichrome

   DOI: 10.5005/jp-journals-10024-3348  |  Open Access |  How to cite  | 


Aim: This study was designed to evaluate the effect of bisphosphonates (BIS) or concentrated growth factors (CGF) or a combination of them on bone defect healing. Materials and methods: Bone defects of 3-mm width and 6-mm depth were prepared in 24 rabbit tibias unilaterally, then randomly divided into the following four equal groups: 1. Group I: No treatment 2. Group II: Treated by BIS 3. Group III: Treated by CGF 4. Group IV: Treated by BIS + CGF Animals were equally sacrificed at 4 weeks, and at 6 weeks then tibias were processed for hematoxylin and eosin (H&E) and Masson's trichrome (MTC) staining. The data were subjected to one-way analysis of variance (ANOVA) followed by post hoc Tukey test and unpaired Student's t-test. Results: In group IV, the quality of newly formed bone was better than any other group with increased mineralization and decreased collagen, followed by group III, then group I, while group II showed the least favorable results. The statistical analysis showed a significant difference between groups. Conclusion: Mixing BIS with CGF showed the best healing, and bone quality results, followed by CGF-treated group, then control, and finally, BIS-treated group. Clinical significance: Using CGF as a scaffold and mixing it with BIS could help accelerate the healing of bone defects, reduce healing time, and minimize the risk of infection.



Srinidhi Bhat

Effect of Cissus quadrangularis Hydrogel on Enhancing Osseointegration of Titanium Implant to Bone: An In Vivo Study

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:7] [Pages No:582 - 588]

Keywords: Cissus quadrangularis, Hydrogel, Osseointegration

   DOI: 10.5005/jp-journals-10024-3363  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate the osteogenic potential of Cissus quadrangularis (CQ) hydrogel in enhancing the osseointegration of titanium to the bone in an experimental rabbit model. Materials and methods: Six adult male New Zealand white rabbits were used in this study. A total of 24 implants (12 coated test implants and 12 uncoated control implants) were placed in these 6 rabbits. A polyethylene glycol (PEG) hydrogel was prepared with the C. quadrangularis hydrogel in which the test implants were coated. Each rabbit was operated on both hind legs and one implant, each, was placed in the femur and tibia. Hence, one rabbit received four implants [two test implants (HG coated) and two control implants (uncoated)]. The animals were sacrificed after 4 weeks, and the specimens were histomorphometrically analyzed. The bone-to-implant contact (BIC) and the bone area fraction occupancy (BAFO) were calculated using Image J analysis. Results: The statistically analyzed values which were obtained by paired t-test, revealed that the average mean values were higher in the test implants (coated) than the control implants (uncoated). The BIC values of the test implants were not significantly different from the control implants in the case of both femur and tibia (p >0.05). The test implants showed significantly increased BAFO values in femur (p <0.05). However, the BAFO values of test implants in tibia did not vary significantly from the control implants. Conclusion: Based on the findings of the study, the authors conclude that the coating of C. quadrangularis hydrogel enhances the osseointegration of titanium implants to bone. The further studies need to be designed to check the osseointegrative potential of C. quadrangularis. Clinical significance: The findings of this study suggest that the C. quadrangularis hydrogel is a potent osteogenic material that can reduce the osseointegration period and thus enhance the patient compliance toward implant treatment.



M Remya, Prabath Singh, Anju Varughese, Asha Joseph, Pallavi Chandran, Deepthy Subramanian, S Vijay Kumar

Comparative Evaluation of Root Canal Centering Ability of ProTaper, Mtwo, WaveOne, and Reciproc Using Cone-beam Computed Tomography: In Vitro Study

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:4] [Pages No:589 - 592]

Keywords: Centering ability, Cone-beam computed tomography, Nickel–titanium rotary files

   DOI: 10.5005/jp-journals-10024-3360  |  Open Access |  How to cite  | 


Aim: To compare the centering ability of rotating (ProTaper and Mtwo) and reciprocating (WaveOne and Reciproc) file systems using cone-beam computed tomography (CBCT). Materials and methods: Eighty extracted human mandibular molars with curvature within 15–45° were selected and randomly divided into four groups (n = 20): group I (ProTaper), group II (Mtwo), group III (WaveOne), and group IV (Reciproc). The selected teeth were arranged in a template, and pre-instrumentation and post-instrumentation CBCT scans were taken using Kodak Carestream CS 9300 machine. The centering ability was measured in four planes namely, at furcation, 3 mm apical to furcation (coronal), 6 mm apical to furcation (middle), and 3 mm coronal to the apex (apical), wherein dentin thickness was measured from pre- and post-instrumentation CBCT scans and recorded for each canal (mesiobuccal and mesiolingual) separately and statistically analyzed. Results: Mtwo and Reciproc remained better centered followed by WaveOne and least by ProTaper in different-level comparisons. In the mesiodistal dimension (MD) at the 3 mm, 6 mm, and 3 mm apical level, Mtwo and Reciproc showed better centering, meanwhile, in the buccolingual dimension, only in the 3 mm apical level, Mtwo and Reciproc remain better centered. A significant difference was seen between the group and type of canal. Conclusion: Mtwo and Reciproc showed better centered preparation than ProTaper and WaveOne. Significant differences were seen between the groups and types of canal. Clinical significance: Root canal instrumentation should maintain the original canal anatomy. The proper enlargement keeping in mind the remaining strength in the tooth structure is essentially decided by how the selected instrument is centered. The alloy used for instrument manufacture and its design (taper, cross-section, and tip) will influence the centered preparation. The type of instrument and the instrumentation techniques should be chosen based on root canal anatomy.



TR Prasanna Arvind, Ravindra Kumar Jain, Ravleen Nagi, Akriti Tiwari

Evaluation of Alveolar Bone Microstructure around Impacted Maxillary Canines Using Fractal Analysis in Dravidian Population: A Retrospective CBCT Study

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:8] [Pages No:593 - 600]

Keywords: Bone density, Cone-beam computed tomography, Fractal dimension, Impaction, Maxillary canine

   DOI: 10.5005/jp-journals-10024-3343  |  Open Access |  How to cite  | 


Aim: The aim of this study was to assess alveolar bone microstructure around impacted maxillary canines derived from fractal analysis. Materials and methods: The present study was a retrospective cone-beam computed tomography (CBCT) study. In total, 61 scans (25 males, 36 females; age range – 12–28 years) were analyzed. About 64 × 64-pixel regions of interest (ROI) in the maxillary alveolar process containing trabecular bone between the premolars were selected. ImageJ software was utilized to process images and bone density was assessed by determining bone surface area (BSA) and bone marrow surface area (BMSA) for the impacted and nonimpacted sides separately. Selected fractals were plotted in a histogram using box-counting method and the results were tabulated. Paired t-tests were used to determine significant differences between the groups and gender differences. Results: For both buccally and palatally impacted maxillary canines, BSA was increased, BMSA decreased in the region of the impacted canine and the difference was statistically significant (p <0.05) in both genders. Bone fractal dimension (FD) values were greater in the region of the impacted canine for both buccally (1.47 > 1.21) and palatally (1.53 > 1.43) displaced canines, while bone marrow FD values were greater in the region of the nonimpacted canine for both buccally (1.37 > 1.28) and palatally displaced canines (1.41 > 1.33). Females had significantly higher BMSA than males around impacted canines (p <0.05). Conclusion: Denser bone microstructure was noted around impacted canines when compared with fully erupted canines. No gender-related differences were noted for BSA, whereas BMSA was higher in females implying lower bone density when compared with males. Clinical significance: Retrospective evaluation of bone microstructure surrounding unerupted/impacted canines can provide analytical information about treatment prognosis and anchorage considerations. With FD analysis of CBCT images, BSA and BMSA can be measured and bone density estimated in a reliable manner.



Saravana Dinesh, Arvind Sivakumar, B Nivethigaa, Abdulrahman Alshehri, Wael Awadh, Mohammad Khursheed Alam, Shilpa Bhandi, A Thirumal Raj, Shankargouda Patil

Reliability of Frankfort Horizontal Plane with True Horizontal Plane in Cephalometric Measurements

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:5] [Pages No:601 - 605]

Keywords: Cephalometrics, Frankfort horizontal plane, FACAD software, Natural head position, True horizontal plane

   DOI: 10.5005/jp-journals-10024-3344  |  Open Access |  How to cite  | 


Introduction: The purpose of the study is to determine reliability of true horizontal (TH) plane with Frankfort horizontal (FH) plane in cephalometric measurements. Materials and methods: One hundred lateral cephalograms were collected and traced using FACAD software, all cephalometric measurements which included FH plane as reference planes were used in this study. Cephalometric tracing was done with FH plane as reference plane and another set of measurements with TH plane as reference plane was done. Statistical tests were done using independent sample t-test (p <0.05). Results: Results of an independent t-test revealed a statistically insignificant difference that was observed for all the parameters assessed (p <0.05). Both angular and linear measurements showed an insignificant difference between FH and TH. Conclusion: Within the limitations of the study, the results show that the FH plane is closest and as reliable as the TH plane. The variation of FH was least for all the parameters assessed.



Amit Shah, Sarika Sharma, Sarmishtha Boruah, Abhik Mukherjee, Garima Tyagi, Archana Singh

Comparing Expansion of Maxillary Antrum between Periapical Surgery and Extraction of Permanent Maxillary First Molar in Pediatric Patients Using CBCT

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:7] [Pages No:606 - 612]

Keywords: Cone-beam computed tomography, Expansion, Extraction, Maxillary antrum periapical surgery

   DOI: 10.5005/jp-journals-10024-3332  |  Open Access |  How to cite  | 


Aim: To compare the expansion of maxillary antrum between periapical surgery and extraction of permanent maxillary first molar in pediatric patients using cone-beam computed tomography (CBCT). Materials and methods: In this study, 136 participants in the age-group of 11–18 years were included. The participants were divided into two groups. Group A consisted of patients who underwent extraction of the permanent maxillary first molars. Group B consisted of patients who underwent endodontic microsurgery in the periapical area. Group A included 68 participants while group B also included 68 study subjects. The expansion of the maxillary antrum was obtained after evaluating the change in volume of maxillary antrum at 6 months and 24 months in relation to the volume of maxillary antrum at the time of the procedure (baseline). For calculating the volume of the maxillary antrum, three parameters were taken into consideration. These parameters were an anteroposterior (AP) dimension, mesiodistal dimension (MD), and superoinferior (SI) dimension. Cone-beam computed tomography was used for carrying out these measurements with the help of Dolphin software. Results: An expansion of 675.27 ± 32 mm3 was observed in group A between baseline and 6 months of extraction, while the expansion of 765.47 ± 24 mm3 was observed between 6 months and 24 months of extraction. This intragroup difference was statistically significant (p = 0.001). On the other hand, an expansion of 652.28 ± 43 mm3 was observed in group B between baseline and 6 months after periapical surgery and expansion of 969.43 ± 12 mm3 was observed between 6 months and 24 months after periapical endodontic surgery. This intragroup difference was statistically significant. In the control group, an expansion of 152.11 ± 12.101 mm3 was observed between baseline and 6 months after procedures while an expansion of 347.01 ± 6.781 mm3 was observed between 6 months and 24 months of procedures. The intragroup difference was significant statistically. Conclusion: In this study, expansion of maxillary antrum was observed in both extraction of the maxillary permanent first molar in pediatric patients and the periapical endodontic surgery, and the expansion of maxillary antrum was more in cases of periapical endodontic surgery; however, the difference was non-significant statistically. Clinical significance: Maxillary antrum expansion is clinically important during maxillary permanent tooth extraction or endodontic periapical surgery in pediatric patients because the growth of maxillary bones is in the growing stage in these patients. There are certain limitations of conventional two-dimensional (2D) radiographic techniques such as shortening, elongation, and superimposition of images. Recently, three-dimensional technique (3D) such as CBCT has been introduced in which these disadvantages have been eliminated.



Turki Almuraikhi

Assessment of Tensile Bond Strength of a Soft Liner to the Denture Base Resin with Different Surface Treatments: An In Vitro Study

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:5] [Pages No:613 - 617]

Keywords: Denture base resin, Soft liners, Surface treatments, Tensile strength

   DOI: 10.5005/jp-journals-10024-3351  |  Open Access |  How to cite  | 


Aim: The aim of the current research was to evaluate the tensile bond strength of a soft liner to the denture base resin with different surface management techniques. Materials and methods: Dies made up of stainless steel and having dimensions of 40 × 10 × 10 were used to fabricate polymethyl-methacrylate resinous blocks. To make sure of the regularity of the soft liner in the test, dies made up of stainless steel and having dimensions of 10 × 10 × 3 were fabricated to serve as spacers. These acrylic resinous blocks were allocated to three groups depending upon the particular surface management technique as: group I—Absence of surface treatment (Control), group II—Surface management with methyl methacrylate (MMA) monomer, and group III—Surface management with Phosphoric acid. All the samples underwent thermocycling at 5° centigrade and 55° centigrade in two water baths for 500 cycles at a dwell tenure of 30 seconds in every bath to reproduce the oral circumstances. The samples were then subjected to testing in the universal testing machine for evaluation of the tensile strength. Results: The highest tensile strength was noted in the soft liner with denture base resin that was subjected to treatment with a monomer having a mean score of 1.88 ± 0.11 in pursuit by surface management using phosphoric acid at 1.16 ± 0.90 as well as the control group at 0.94 ± 0.02 in that order. There was a statistically noteworthy disparity amid the three dissimilar surface management techniques with a p-value <0.001. There was a statistically noteworthy differentiation amid group I vs group II as well as group II vs group III with a p-value <0.001. However, there was no statistically significant disparity amid group I vs group III with p-value >0.001. Conclusion: The current research arrived at the conclusion that the samples subjected to treatment with MMA monomer exhibited higher and noteworthy bond strength than those attained by additional surface management techniques for soft lining of the denture base resins. Clinical significance: Soft denture lining materials play a pivotal position in contemporary prosthodontic practice as they possess the ability to restore the health of swollen as well as deformed mucosal tissues. They are comfortable in those individuals who are unable to endure pressure from occlusal forces, like in a situation of residual ridge resorption, sore tissues, and ridges that attain a knife-edge shape. Failing bond causes delamination of the reliner and therefore lack of adaptability of the denture to the oral mucosal tissues. For this reason, superior bonding to the denture base beneath is critical for the clinical triumph of relining agents.



Samantha Parad, Henrique Hadad, Henrique R Matheus, Katherine P Klein, Fernando PS Guastaldi

Post-legalization Consumption of Cannabis at Massachusetts General Hospital Dental Group

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:5] [Pages No:618 - 622]

Keywords: Cannabis, Dental care, Dental public health, Legalization, Questionnaire survey

   DOI: 10.5005/jp-journals-10024-3353  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the profile of patients undergoing dental treatment in relation to cannabis use. Materials and methods: A comprehensive questionnaire was used to address the type of cannabis preparations, route of intake, frequency of usage, and potential reasoning for use (recreational vs medical use) of patients from the MGH Dental Group. Results: Seventy-six adult patients completed the survey. Sixty-one percent of the participants were female, with the majority (59%) of the participants being ≥51 years or older. Twelve of the 76 participants (16%) were 18–30 years old. The remaining 19 patients (25%) who participated in the study were 31−50 years old. The sample included participants who were predominately non-Hispanic (63 patients, 83%) and White (59 patients, 78%). The majority of patients either had their first use of cannabis prior to 18 years of age (36%) or did not respond to this question (34%) at all. The predominant age at consistent cannabis use was 18–30 years (13%). The most common method of cannabis intake in the preceding year for participants was smoking, followed by ingesting, using cannabidiol (CBD), and vaping (least common). Recreational cannabis use was reported in 47% of the participants vs 28% of participants who reported cannabis intake for medical use. Conclusion: This preliminary study characterized the profile of patients undergoing dental treatment in relation to marijuana use. Diminishing restraints to cannabis use may affect the dental profession. Clinical significance: It is important for dentists to understand cannabis-related oral health conditions to provide customized patient treatments.



Puja Chatterjee, R Shashikala, Anuradha Navneetham

Comparative Study of the Crestal vs Subcrestal Placement of Dental Implants via Radiographic and Clinical Evaluation

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:5] [Pages No:623 - 627]

Keywords: Crestal bone levels, Crestal bone loss, Dental implants, Equicrestal, Prosthetic loading, Radiographic evaluation, Subcrestal

   DOI: 10.5005/jp-journals-10024-3350  |  Open Access |  How to cite  | 


Aim: The study aims at using the level/depth of implant placement (equicrestal or cretsal) as the key parameter in measuring the vertical crestal bone loss (CBL) mesially and distally, using periapical radiographs (IOPARs) taken at 1-, 3-, and 6-months interval, postprosthetic loading. Materials and methods: Patients (n = 40; 18–65 years), with edentulous space anteriorly or posteriorly, were randomly divided into two groups, namely, group I (equicrestal) and group II (subcrestal) with 20 patients in each group. Implants were placed at an edentulous site (delayed implants), after obtaining cone-beam computed tomography (CBCT) scans. Prosthetic loading (following osseointegration) was done within 3 months of implant placement. The patients were followed up and IOPAR were taken to measure CBL at 1-, 3-, and 6-months interval, postloading. The CBL between the two groups was compared using IOPARs. The data obtained was compiled and unpaired Student's t-test was done for statistical analysis. Results: After the statistical analysis of the data obtained during follow-up, CBL was measured radiographically. Mesial and distal vertical bone loss was charted and compared between the two groups. The mean bone loss on the mesial aspect for group I implants is 0.39 mm and for group II implants, it is 0.27 mm, 6 months postloading, determined radiographically. Conclusion: Subcrestally placed implants are conducive to the overall oral rehabilitation, as it has been seen to preserve marginal peri-implant bone for longer durations than their equicrestally placed counterparts, within the limitations of the current study. Clinical significance: The study prospectively relates the level of implant shoulder with respect to alveolar crestal bone, postloading. Following radiographic comparison between the two groups, significant clinical findings indicated that better esthetics and stability were seen in the subcrestally placed implants. This proves that implant placement level directly influences crestal bone levels; hence, indirectly affects esthetics and function.



Freah Alshammary, Thamer Alhur, Khalid N Alshammari, Ammar A Siddiqui, Malik Zain Ul Abideen, Khalid S Alghaythi, Muhammad Ilyas, Mohammad K Alam

Prevalence and Risk Factors of Dental Trauma in Ha'il, Saudi Arabia

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:6] [Pages No:628 - 633]

Keywords: Children, Dental trauma, Ha il, Prevalence, Risk factors, Saudi Arabia, Traumatic dental injuries

   DOI: 10.5005/jp-journals-10024-3354  |  Open Access |  How to cite  | 


Aim: This study will aid in determining the prevalence and risk factors for dental trauma. This will assist in developing a treatment budget plan, thereby, fend off complications. Materials and methods: This study was an observational study, having a cross-sectional design, in which information was obtained from 555 participants. Data were obtained using a non-probability convenient sampling technique. A validated questionnaire was used as a study tool. Data were analyzed using the statistical package for the social sciences (SPSS, version 20). Descriptive and inferential statistics were used. Data were displayed as numbers and percentages, and the Chi-squared test was used to measure the association. Results: Dental trauma was found to be 44% prevalent. Most of the injuries occurred in the 6–9-years age-group (19.1%) and were more common in boys (54.13%) than in girls. The majority of respondents (61%) identified “falls” as the most common cause of dental trauma, and the frequent location for the occurrence of dental injuries was found to be “home” (64.44%). Only 18% of parents reported that their kid's experienced nail-biting concerns, with the majority claimed that their kids never developed oral habits. Most dental injuries occurred during the summer season (48%). Conclusion: Young aged group and male gender group were more prone to dental injuries; dental injuries along with fall were found as the most common cause of dental trauma, whereas most of the dental traumas were reported to have occurred at home. Clinical significance: The study evaluated risk factors and the prevalence of dental trauma in the population of Hail, Saudi Arabia. It will be an effective tool for determining the need for treatment facilities.



Henpu Kamki, Ritesh R Kalaskar, Shruti Balasubramanian

Evaluation of Effectiveness of Graphics Interchange Format and Wong–Baker FACES Pain Rating Scale as Pain Assessment Tool in Children

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:5] [Pages No:634 - 638]

Keywords: Graphic interchange format pain scale, Self-reporting pain scale, Wong–Baker FACES pain rating scale

   DOI: 10.5005/jp-journals-10024-3365  |  Open Access |  How to cite  | 


Aim: The objective of this preliminary study was to evaluate the validity and reliability of the graphics interchange format (GIF) as a self-reporting pain assessment tool in children. Materials and methods: In this in vivo observational study, pain assessment of 42 children aged 7–13 years with a chief complaint of dental pain reporting the first time to the Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital, Nagpur, Maharashtra, India, were included. Informed consent was obtained from the parents or guardians. All the responses were obtained by a single practitioner, after showing the respective self-reporting pain scale, that is, Wong–Baker FACES Pain Rating Scale (WBFPRS) and GIF pain scale. A questionnaire study was performed at the end of the study. The data were recorded, and then statistical analyses were performed. Results: Both scales showed significant differences (p = 0.001*) when scales were individually compared to the actual pain intensity experienced by the patient. Both WBFPRS and GIF pain scales have shown non-significant differences (p = 0.155). The GIF pain scale has shown very strong relationship (r = 0.936, p = 0.001*), while WBFPRS showed strong relationship (r = 0.725, p = 0.001*). The GIF pain scale has shown almost perfect agreement (k = 0.911) whereas WBFPRS has shown substantial agreement (k = 0.710) with actual pain intensity. In the questionnaire study, most children strongly agreed that the GIF pain scale is easier to understand than WBFPRS. Conclusion: The GIF pain scale is a very promising self-report pain assessment tool for children. Further research on improving the GIF pain scale is very important. Clinical significance: The newly devised GIF pain scale seems to be a very promising self-report pain scale for effective determination of pain experienced by the patient.



Khadijah M Baik

The Opinions and Practices of Saudi Arabian Dentists about Cervical Margin Relocation

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:7] [Pages No:639 - 645]

Keywords: Cervical margin relocation, Crown lengthening surgery, Deep margin elevation, Deep proximal carious lesions

   DOI: 10.5005/jp-journals-10024-3364  |  Open Access |  How to cite  | 


Aim: The aim of this study was to assess the opinions and practices of different dentists about the cervical margin relocation (CMR) concept. Materials and methods: A total of 432 general dentists, advanced general dentists (AGDs), periodontists, restorative dentists, and prosthodontists practicing in Saudi Arabia were approached in person or asked to complete an electronic survey (Google Forms) assessing demographic data and their opinions and practice of CMR. Differences between groups were assessed using the Chi-squared test, and binary regression models were constructed to identify predictors of opinions and practice of CMR. Results: About half of the surveyed dentists practiced CMR when indicated, but many felt that it represents an invasion of the biological width and might affect crown survival. Participants had several, often concurrent concerns about CMR. The opinions and practices of CMR were influenced by several factors including educational degree, work setting, country of clinical training, years of experience, and specialty. Conclusion: The relatively conservative attitude of dentists towards CMR is justifiable, as it is a relatively new concept with little long-term clinical data. Clinical trials with sufficient follow-up periods are now needed to evaluate outcomes from CMR to provide further confidence to dentists to implement the procedure. Clinical significance: Deep proximal carious lesions extending subgingivally is a common clinical scenario. Assessing the opinion and practice of dentists towards conservative treatment with CMR provides the basis for encouraging practitioners to use the procedure both clinically and in clinical trials.



Anupriya Singh, Anuj Bhargava, Jyothis Mathew, Merin K Joseph, Shreya Gupta

Spectrophotometric Evaluation of Translucency of Various Commercially Available Zirconium Oxide Ceramic Systems: An In Vitro Study

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:6] [Pages No:646 - 651]

Keywords: Absorbance, Spectrophotometer, Transmittance, Zirconium oxide ceramic

   DOI: 10.5005/jp-journals-10024-3352  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the translucency of various commercially available zirconium oxide ceramic systems, i.e., Ceramill® Zolid Classic, Ceramill® Zi, and DD Bio ZX271 by using a dual beam UV-visible spectrophotometer. Materials and methods: The present study comprised of 21 disk-shaped samples of zirconia for every group, i.e., group I-Ceramill® Zolid Classic, group II-Ceramill Zi®, and group III-DD Bio ZX271. Furthermore, each group was split into three subgroups and every subgroup had seven samples each one of 0.7, 0.8, and 0.9 mm thickness. The samples were prepared by computer-aided design/computer-aided manufacturing (CAD/CAM) system devised by Amann Girrbach AG in accord with the steps provided by the manufacturer. The entire sample was designed having 10 mm in diameter with 0.7, 0.8, and 0.9 mm thickness for every group. The UV-visible dual beam spectrophotometer equipped with D2 lamp and W lamp was used for the measurement of absorbance and transmittance in order to assess the translucency of the fabricated zirconia samples. Results: The mean value of transmittance % for Ceramill® Zi at 0.8 mm came out to be 0.849 ± 0.024, i.e., the least among all, whereas the mean value of Ceramill® Zolid Classic was 1.408 ± 0.033, being the highest for the same thickness. DD Bio ZX271 had an intermediate value of 1.274 ± 0.012. The mean value of absorbance for Ceramill® Zi at 0.8 mm came out to be 2.086 ± 0.013, i.e., the maximum among all, whereas the mean value of Ceramill® Zolid Classic was, being the lowest for the same thickness. DD Bio ZX271 had an intermediate value of 1.902 ± 0.004. Conclusion: The present study data suggest that all the materials subjected to evaluation exhibited a substantial translucency. We attempted to study few of the desirable properties, these materials should possess when used for prosthetic rehabilitation with esthetic contentment a clinical setup. There has been an ambiguous distinction that Ceramill® Zi Zirconia supersedes the Ceramill® Zolid Classic and DD Bio ZX271. Furthermore, 0.8 mm thickness substantiates to be the most ideal among 0.7, 0.8, and 0.9 mm. Clinical significance: The desired outcome of the procedure becomes dependent solely on the clinician's judgment to opt for the material whose properties are most fitting as per the demands of the esthetics. While a clinician should always be ambitious, but a good clinician should also bear in mind that the success of any treatment procedure not only depends on the assortment of properties of these materials but also the host response and satisfaction evoked by these materials.



Ahmad H Jabali

Management of Multiple Idiopathic Root Resorption in a Rheumatoid Arthritis Patient: A Case Report with 4-year Follow-up

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:7] [Pages No:652 - 658]

Keywords: External root resorption, Inflammatory markers, Multiple root resorption, Rheumatoid arthritis, Resorption repair

   DOI: 10.5005/jp-journals-10024-3349  |  Open Access |  How to cite  | 


Cervical root resorption is a rare destructive disease that originates from the external cervical root surface. It has a multifactorial etiology. Cervical root resorption may affect several teeth and its treatment can be complicated due to the size, location, and extension of the resorptive defect. Rheumatoid arthritis is a chronic inflammatory autoimmune disease that has systemic effects. The objective of this article was to report a rare case of multiple idiopathic cervical resorptions in a patient with rheumatoid arthritis. A 52-year-old male patient with a 20-year history of rheumatoid arthritis was diagnosed with multiple idiopathic cervical resorptions through cone-beam computed tomography (CBCT) and clinical examination. All known causes for cervical resorption were ruled out after a detailed anamnesis. This report details inflammation due to rheumatoid arthritis as a possible cause of idiopathic cervical resorption. The systemic alterations wrought by rheumatoid arthritis could be related to the etiopathogenesis of cervical root resorption. Non-surgical endodontic treatment was done for the maxillary left canine. The defect was surgically repaired using bioceramic putty. The 12-month recall revealed the good healing of the periodontal and periradicular conditions with no obvious clinical symptoms. At the 36-month recall visit, clinical and radiographic evidence of deterioration in the repair material was observed. At the 54-month follow-up, deterioration of repair material was observed with an increase in the extension of resorption in tooth 14 was detected. Reasons for this deterioration remain unclear. Ruling out all other factors for cervical root resorption, how rheumatoid arthritis contributes to cervical root resorption is still lacking/unclear. Dental care providers must be vigilant for signs of cervical root resorption in vulnerable patients with rheumatoid arthritis for early diagnosis and prompt treatment.



Sandhya Kizhakke Neelamana, Chandrashekar Janakiram

Characterizing the Literature on Validity and Assessment Tool of Oral Frailty: A Systematic Scoping Review

[Year:2022] [Month:June] [Volume:23] [Number:6] [Pages:10] [Pages No:659 - 668]

Keywords: Geriatric, Older adults, Oral and maxillofacial frailty, Oral frailty, Oral health-related quality of life

   DOI: 10.5005/jp-journals-10024-3346  |  Open Access |  How to cite  | 


Aim: To systematically review all studies on assessment tools used to diagnose oral frailty in older adults. Materials and methods: A systematic search of PubMed, Google Scholar, and Scopus for articles yielded the tools published from January 2010 to January 2022. The search included articles reporting the use of the Oral Frailty risk assessment tool in older adults. A standardized protocol Joanna Briggs Institute (JBI) was used for data extraction. Flowchart and tables were used to demonstrate the results. Results: A total of 19 studies were eligible out of 58 studies retrieved from selected databases. A total of three tools were structured for oral frailty assessment in older adults as follows: Oral and maxillofacial frailty index, oral frailty index-8 (OFI-8), and oral frailty checklist. The most critical parameter in assessing oral frailty was tongue pressure and dryness of the mouth. Other parameters for assessing oral frailty include the number of remaining teeth, oral diadochokinesis (ODK), masticatory performance, pain, dysphagia, taste alteration, use of dentures, bacterial count in the tongue coat, and presence or absence of periodontitis. The predictive validity of tools for differentiating high and low risks for oral frailty did not explore yet. Conclusion: There has not been much research into assessment tools for oral frailty. This comprehensive review of the available literature identified only three structured assessment tools as follows: The oral frailty checklist, the oral and maxillofacial frailty index, and OFI-8. The oral frailty checklist is the only available validated oral frailty assessment tool despite the disproportionately high prevalence of oral frailty and the projected increase. Clinical significance: Because an oral function examination for the elderly in their 60s is required to promote effective oral frailty countermeasures, an oral frailty assessment tool appropriate for the setting must be developed. This tool can be used as a population-wide standard of practice for screening oral frailty.


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