The Journal of Contemporary Dental Practice

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2023 | October | Volume 24 | Issue 10

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Luis Eduardo Almeida

Temporomandibular Disorders and Physiotherapy

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:2] [Pages No:723 - 724]

   DOI: 10.5005/jp-journals-10024-3575  |  Open Access |  How to cite  | 



Elise Kaylene Andrews, Joseph Lee Gedge

Bond Strength of a Novel Universal Resin Cement to Dentin with or without an Adhesive Bonding Agent: An In Vitro Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:4] [Pages No:725 - 728]

Keywords: Bonding agent, Bond strength, Universal resin cements

   DOI: 10.5005/jp-journals-10024-3568  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate the bond strength and fracture mode of universal resin cement to dentin compared to self-adhesive and adhesive resin cement with and without an adhesive bonding agent. Materials and methods: Seventy-two molar teeth were sectioned to expose coronal dentin, divided into three groups, and assigned to RelyX UNIVERSAL (universal), RelyX ULTIMATE (adhesive), or RelyX UNICEM 2 (self-adhesive) cements from 3M. The 3 groups were further subdivided into 2 subgroups of 12 specimens each, with or without the use of an adhesive bonding agent. Lithium-disilicate discs were bonded to the dentin surface using the cements, stored for 24 hours in distilled water, and subjected to 2,000 thermocycles before shear bond strength testing and fracture mode analysis. Results: Significant differences in bond strength and fracture mode were found between groups based on cement or the use of a bonding agent. Both the universal and adhesive cements had significantly greater bond strengths to dentin with the use of a bonding agent versus no bonding agent. With the self-adhesive cement, there was no significant increase in bond strength to dentin with the use of a bonding agent. Conclusion: The novel universal resin cement had similar bond strengths to dentin as the adhesive cement with the use of a bonding agent, and similar bond strengths as the self-adhesive cement without the use of a bonding agent. The adhesively bonded universal cement had the greatest percentage of mixed and cohesive fractures. Clinical significance: When greater adhesion is needed clinically, the novel universal resin cement may be used with an adhesive bonding agent. However, when less adhesion is needed, it could be used without a bonding agent in self-adhesive mode.



Corinne Atiga, Jingwei Cai, Esther Forde, Eun-Hwi Euni Cho, Udochukwu Oyoyo, So Ran Kwon

Impact of Dental Institutions’ Values on Students’ Intent to Practice in Underserved Communities: A Cross-sectional Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:4] [Pages No:729 - 732]

Keywords: American dental education association senior survey, Career choices, Dental institution, Underserved population, Values

   DOI: 10.5005/jp-journals-10024-3585  |  Open Access |  How to cite  | 


Aim: To evaluate how an institution's values can impact students’ intent to practice in underserved areas. Materials and methods: The values of 71 accredited dental schools in the United States were searched and tabulated. The American Dental Education Association (ADEA) survey results were used to tabulate the desire to serve the underserved population before entering dental school and upon graduation. Additionally, responses on the total amount of educational debt on graduation was compiled for LLUSD and all other dental schools. Fisher's exact test was performed to compare the difference between the two cohorts and Wilcoxon test was used to assess difference within the groups. Tests were conducted at an alpha level of 0.05 with SAS v 9.1.3 (SAS Institute, Cary, NC, USA). Results: The top five values of US dental institutions based on frequency were excellence, diversity/inclusion, integrity, innovation, and respect. There was no statistically significant difference between LLUSD and all other dental schools in their desire to serve the underserved community upon graduation (p > 0.05, in all instances). Overall, there was a trend that upon graduation, the desire to serve the underserved had less impact on students’ decision-making on their career choices. This drop in the desire to serve the underserved was statistically significant within both cohorts in the year 2021 (p < 0.001). Conclusions: Dental institutions should focus on better understanding of how their values impact their students’ career choices so that they can develop strategies to better align their values with the mission of addressing the dentist shortage in underserved areas. Clinical significance: Dental institutions’ values play a major role in impacting students’ career choices upon graduation and should be assessed using metrics that are measurable.



Amna Y Siddiqui

Influence of Embedding Medium on iPex Electronic Apex Locator Accuracy: An Ex Vivo Comparative Study Using Alginate, Saline, and Gelatin Models

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:6] [Pages No:733 - 738]

Keywords: Apex locators, Electronic apex locator, Electronic working length, Embedding medium, Endodontics, iPex, Working length determination

   DOI: 10.5005/jp-journals-10024-3583  |  Open Access |  How to cite  | 


Aim: Accurate working length determination during root canal treatment is essential for achieving successful outcomes. This study aimed to evaluate the impact of embedding medium on the accuracy of iPex electronic apex locator (EAL). Materials and methods: Sixty-one extracted single-rooted teeth were decoronated and coronally flared with Gates-Glidden burs. Actual canal length (ACL) was obtained by introducing a size 8 K-file until its tip reached the most coronal border of the apical foramen. This step was performed thrice and then averaged. Deducting 0.5 mm from the ACL provided the working length (WL). The teeth were randomly placed in plastic containers filled with freshly mixed alginate, gelatin, or saline, with the lip clip placed in the medium. The blinded operator obtained electronic measurements using iPex by advancing a K-file with a size compatible with the canal attached to the file clip and advanced until the 0.0 mark, then withdrawn to the 0.5 mark. This step was performed thrice and then averaged. Data were analyzed using ANOVA and Tukey's post hoc test, with significance level set at 5% (α = 0.05). Results: The mean difference between WL and iPex length obtained in the gelatin model was significantly longer than the difference with mean iPex length in alginate (p = 0.005) and in saline (p < 0.001). There was no significant difference between iPex readings obtained in alginate and saline (p = 0.249). Conclusion: The use of freshly mixed alginate or saline for ex vivo assessment of iPex is recommended, whereas the use of gelatin could increase the chances of readings longer than looked for. Clinical significance: Identifying the optimum embedding medium for ex vivo testing of EALs permits the comparison and assessment of several factors affecting EALs’ precision under standardized conditions. This helps in understanding EAL performance in vivo and in optimizing its clinical utilization.



Srishty Goyal, Lucy Bhola, Ashwini Tumukur Shivkumar, Aparna Manningal, Upasana Reddy, Muhamood Moothedath, Debasish Mishra

Influence of Different Mouthwashes on the Efficacy of Fluoridated Dentifrices in Prevention of Enamel Erosion: An In Vitro Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:4] [Pages No:739 - 742]

Keywords: Enamel erosion, Fluoride dentifrices, Mouthwash, Scanning electron microscope

   DOI: 10.5005/jp-journals-10024-3539  |  Open Access |  How to cite  | 


Aim: The purpose of the current study was to evaluate the impact of three various mouthwashes on the effectiveness of fluoride dentifrices in preventing enamel erosion. Materials and methods: A total of 120 sound intact human premolar teeth which were extracted for orthodontic treatment were selected for the study. A 3 × 3 mm window section was positioned in the middle of the coronal surface of the tooth in order to define the study area. Each sample was placed in a solution of 1% citric acid (pH 3.5) for 10 minutes in order to produce an eroded surface. All samples were divided into two main groups (60 samples each) as follows: Group A for sodium fluoride dentifrices and group B for stannous fluoride dentifrices, again it is subdivided into: CHX: Chlohex ADS®, EO: Listerine®, CPC: Colgate® Plax (20 samples in each subgroup). After that, samples underwent the pH cycling model for 5 days. Samples were examined for surface loss using a scanning electron microscope. Results: In sodium fluoride dentifrices group, before intervention, the surface loss was 3.12 ± 1.03 in CHX group, 3.08 ± 1.20 in EO group, and 3.09 ± 0.96 in CPC group. After intervention, the less surface loss found with CHX group (2.18 ± 0.84), followed by CPC (2.34 ± 0.74) and EO group (2.46 ± 0.97). In stannous fluoride dentifrices group, before intervention, the surface loss in CHX group was 3.26 ± 1.19, in EO group, it was 3.18 ± 1.31, and in CPC group, it was 3.22 ± 1.06. After intervention, the less surface loss found with CHX: group (1.90 ± 0.54), followed by CPC (2.24 ± 0.28) and EO group (2.38 ± 0.20). Conclusion: The present study concluded that the fluoride dentifrices’ preventive effects against tooth surface loss were unaffected by a different mouthwashes with varying compositions and major constituents. In terms of erosion, fluoridated toothpaste containing stannous fluoride was found to provide better surface loss protection than sodium fluoride. Clinical significance: Primary prevention and the eradication of contributing causes are the greatest strategies for preventing erosion. Simultaneously, antibacterial agent in the mouthwashes may help in enhancing the effect of fluoride in the enamel, owing to their high affinity for teeth structures. Therefore, in addition to cause-related treatment, further efforts to reduce tooth tissue loss are also necessary.



Justiniano Sotomayor Camayo, Margot Gutiérrez-Ilave, William Cardenas-Silva, Adrian Mallma-Medina, Katia Luz Medina Calderón, Fran Espinoza-Carhuancho, Frank Mayta–Tovalino

A Bibliometric Study of Trends, Indicators, and Characteristics in the Global Scientific Production on Fluorosis

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:7] [Pages No:743 - 749]

Keywords: Bibliometrics, Children, Fluorosis

   DOI: 10.5005/jp-journals-10024-3579  |  Open Access |  How to cite  | 


Aim: To perform an analysis of the trends, indicators, and characteristics of the world scientific production on fluorosis, and to evaluate its impact on scientific research in this field. Materials and methods: A descriptive, cross-sectional study was conducted with a bibliometric approach of the worldwide scientific production on fluorosis published during the years 2018–2023. All metadata were extracted from the Scopus database. The articles were exported in .csv format to SciVal (Elsevier). Of the collected articles, 69 were original, 17 were reviews, 2 were conference papers, 6 were book chapters, among others. Results: It was found that among the journals with the highest number of articles were Biological Trace Element, Caries Research, Children, Fluoride, and Indian Journal of Forensics. In addition, the highest percentage of authors have published between 1 and 2 articles, with a smaller proportion having 3–4 publications. Among the journals with the highest number of articles are Biological Trace Element, Caries Research, Children, Fluoride, and Indian Journal of Forensics. The Universidade de São Paulo has the most publications, although it is also one of those with the lowest citation-weighted impact in relation to the global average (FWCI: 0.9). Conclusion: The collaboration map shows a wide international cooperation network, with an active participation of Brazil among Latin American countries. Scientific production in fluorosis has a negative trend from 2018 to 2023 and is mainly concentrated in high-impact scientific journals. Clinical significance: The study shows a wide network of international cooperation on fluorosis, so the results provide important information to guide future clinically focused research on fluorosis and its impact on public health.



Abdulwahed Alghamdi, Sawaher Haddad, Alya Aljumaiah, Mohammed A Barayan, Esra A Attar

The Incidence of Devitalization of Vital Teeth Associated with Pathologies of the Jaws Following Surgical Intervention: A Mixed-case Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:7] [Pages No:750 - 756]

Keywords: Non-odontogenic cyst, Odontogenic cyst, Postoperative complications, Prognosis, Pulp necrosis, Root canal treatment, Surgical intervention

   DOI: 10.5005/jp-journals-10024-3567  |  Open Access |  How to cite  | 


Aim: The purpose of this mixed-case study is to explore the incidence of pulp necrosis of vital teeth after surgical treatment of adjacent lesions of the jaws. Materials and methods: The records of 341 biopsies submitted to the institute's histopathology laboratory were reviewed to include cases that met the inclusion criteria. About 84 biopsies collected from patients during surgical enucleation of lesions in proximity to healthy vital teeth were included of which 22 patients were recalled. Adjacent teeth were examined clinically and radiographically to assess their pulpal and periapical status after at least 8 months of follow-up. Results: There were 7 different pathological lesions diagnosed histologically. The follow-up period ranged between 8 and 72 months; 12 cases (54.6%) have developed pulpal necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal responses to sensibility testing for all the teeth adjacent to the lesion. Ten out of the 12 cases (83%) that underwent pulpal necrosis were associated with odontogenic cysts, whereas the remaining 2 were associated with periapical granuloma and fibrous dysplasia. Conclusion: Pulp necrosis is high in vital teeth associated with lesions without pulpal involvement. These teeth may benefit from root canal treatment prior to surgical enucleation of the lesion, which may prevent impaired healing or recurrence of infection. Clinical significance: Careful treatment planning and thorough discussion should take place between the surgeons, endodontists, and patients prior to executing the treatment. The patient should be aware that there is a possibility that they may need root canal treatment as a preventative measure to enhance the chances of healing following the surgical procedures and in case the patients opted not to perform root canal treatment beforehand, close follow-up in the future should take place to monitor the vitality of the teeth in the follow-up visits.



Lucy Bhola, KK Ridhun Unnikrishnan, Sangamesh Ningappa Chinnannavar, Sahana Maben, Nirupama Sahoo, Leelamma Kuruvilla, Muhamood Moothedath, Debasish Mishra

In Vitro Assessment of Different Toothbrush Designs on Enamel Surface Abrasion: A Profilometric Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:4] [Pages No:757 - 760]

Keywords: Enamel surface abrasion, Profilometer, Toothbrushing, Toothbrush abrasion

   DOI: 10.5005/jp-journals-10024-3542  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate the impact of three different toothbrush designs on enamel surface abrasion. Materials and methods: Sixty intact freshly extracted maxillary central incisors were considered for the study. All of the extracted teeth's surfaces were severely trimmed, leaving only the labial surface intact. In the trial, a conventional teeth-whitening dentifrice slurry was utilized. A brushing model was created to deliver uniform force in unidirectional motion. Dontrix Gauge was used to control the tension of the spring. The force was kept constant at 180 ± 20 g. The mounted enamel samples were separated into three groups (20 samples each) at random: group A: toothbrushes have a flat trim bristle design, group B: toothbrushes have a zigzag pattern, and group C: toothbrushes have a bi-level bristle design. For 2 weeks, each sample was brushed twice daily for 2 minutes. A profilometer was used to measure the average surface roughness. Results: After toothbrushing, the maximum mean surface roughness score was found in zigzag pattern group (2.10 ± 0.23), followed by bi-level bristle design group (2.06 ± 0.12) and the least was in the flat trim bristle design group (1.96 ± 0.09). There was a significant difference between the different toothbrush bristle pattern groups (p < 0.001). Conclusion: On conclusion, the results of this study showed that, in comparison to toothbrushes with zigzag patterns and bi-level bristle designs, flat trim toothbrush bristle designs cause the least amount of surface abrasion and are relatively safe to use. Clinical significance: Toothbrushing with toothpaste contributes significantly to dental abrasion. A variety of parameters, including toothpaste abrasivity and concentration, brushing frequency, brushing length, brushing force, and toothbrush bristle stiffness, have the potential to influence the abrasion process of dental hard tissue.



Mohamed Abd EL-Rahman Abdou Ata, Hamdy Abd-Elmegeed Mohammed Marzook, Mohamed Abdel-Monem Tawfik, Ziad Mohamed Amr Elmissiry

Z-shaped Miniplates vs Conventional Miniplates for Fixation of Mandibular Parasymphyseal Fractures

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:10] [Pages No:761 - 770]

Keywords: Conventional miniplate, Parasymphseal fractures, Three-dimensional plate, Z-shaped miniplate

   DOI: 10.5005/jp-journals-10024-3578  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate a clinically and radiographically Z-shaped miniplate for the fixation of the parasymphyseal fractures. Patients and methods: Twenty patients (10 patients in each group) who had parasymphseal mandibular fractures were randomly selected for this study. In this study, open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using two miniplates as group I, and open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using a newly designed Z-shaped miniplate as group II. Clinical and radiographic evaluations were made. Each patient was evaluated: (1) clinically evaluated preoperatively and postoperatively for operating time, ease of placement of the miniplate, and occlusion and (2) radiological: postoperative reduction of fracture was evaluated radiologically at 5-day, 1-month, 2-month, and 3-month intervals with orthopantomogram, and lingual splaying was evaluated by cone-beam computed tomography (CBCT) immediately postoperatively and at an interval of 3 months. The collected data were subjected to statistical analysis. Data analysis was performed by SPSS software, version 25 (SPSS Inc., PASW statistics for Windows version 25). Chicago: SPSS Inc. Results: There was a statistically significant difference (p < 0.001) between the mean intraoperative time. This indicates that group I had a longer time for fracture fixation than group II. Group I had a longer time elapsed for plate adaptation and definitive fixation than group II. Occlusion and reduction stability in both groups were similar. There was a statistically significant difference in postoperative lingual display control after 5 days and 3 months between the studied groups. This indicates that lingual display control in group II is better than in group I. Conclusion: The Z-shaped miniplate is effective and provides three-dimensional stability for the fixation of parasymphyseal fractures, ease of use, easily adapted in cases of fractures near the mental nerve reduced operative time, and better control of lingual splaying than conventional miniplates. Clinical significance: The newly designed Z-shaped miniplate is a valuable option for fixation parasymphysis fractures that need open reduction and internal fixation instead of using conventional miniplates, which are less successful in controlling lingual splaying.



Salma Musa Adam Abduljalil, Nada Hashim, Muhammed Mustahsen Rahman, Nallan CSK Chaitanya, Moawia Mohamed Mukhtar, Bakri Gobara Gismalla

Soluble Receptor Activator of Nuclear Factor Ligand and Osteoprotegerin Levels in Gingival Crevicular Fluid among Cigarette Smokers and Non-smokers with and without Periodontitis

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:8] [Pages No:771 - 778]

Keywords: Gingival crevicular fluid, Grading, OPG, Periodontitis, RANKL, Smoking, Staging

   DOI: 10.5005/jp-journals-10024-3580  |  Open Access |  How to cite  | 


Aim: This study aimed to measure and compare the levels of soluble receptor activator of nuclear factor ligand (RANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF), as well as their ratio, in smokers and nonsmokers with periodontitis. Materials and methods: Gingival crevicular fluid samples were collected using PerioPaper strips, from 150 individuals, who were categorized into three groups: current smokers with periodontitis stage III grades C and B (n = 50), nonsmokers with periodontitis stages I and II grade A (n = 50), and control healthy individuals (n = 50). The concentrations (pg/mL) of sRANKL and OPG in the GCF were measured by enzyme-linked immunesorbent assays (ELISA). Result: The smokers’ group exhibited the highest sRANKL (pg/mL) concentration as a subsequent lead to a higher sRANKL/OPG ratio. The healthy control group exhibited higher OPG and lower sRANKL concentration, subsequently, the sRANKL/OPG ratio was reduced compared with the other study groups. However, there was no statistical significance of sRANKL and its relative ratio between periodontitis stage III grades C and B, periodontitis stages I and II grade A, and healthy control individuals. There was a statistically significant positive moderate correlation between smoking duration (years) and the sRANKL (pg/mL) concentration and a statistically significant negative moderate correlation between OPG (pg/mL) concentration and cigarettes smoked per day. Conclusion: As a result, compared to the other research groups, smokers with periodontitis stage III grades C and B had greater GCF concentrations of sRANKL, lower OPG, and a higher sRANKL/OPG ratio. The difference in OPG (pg/mL) level was statistically significant. However, there was no statistically significant difference in sRANKL (pg/mL) or its relative ratio, sRANKL/OPG, across the groups. Clinical significance: A characteristic that sets periodontitis apart is alveolar bone loss. Resorption is induced by RANKL and inhibited by OPG, resulting in a relative ratio. In light of this, the levels of RANKL and OPG may be helpful indicators for monitoring the activity of periodontal disease in both smokers and nonsmokers with and without periodontitis.



Prasanna Chandraseharan, S Nagarajan MP Sockalingam, Zaleha Shafiei, Ahmad Shuhud Irfani Zakaria, Alida Mahyuddin, Mariati Abdul Rahman

The Efficacy of Apple Cider Vinegar at Different pH Values as an Antimicrobial Agent: An In Vitro Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:8] [Pages No:779 - 786]

Keywords: Acetic acid, Antimicrobial activity, Apple cider vinegar, pH, Pulp canal disinfection

   DOI: 10.5005/jp-journals-10024-3581  |  Open Access |  How to cite  | 


Aims and background: This study evaluates the antimicrobial activities of commercially available 5% apple cider vinegar (ACV) against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei. Materials and methods: Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were conducted using the broth microdilution method. Sodium hypochlorite (NaOCl) of 5.25% was used as a positive control, and comparisons were also made with acetic acid (AA) as the main ingredient in ACV. The three test bacteria treated with the most effective ACV dilution were visualized under a transmission electron microscope (TEM) for structural changes. Results: Minimal inhibitory concentration was determined at 0.625% of the concentration of ACV against S. mutans and E. faecalis and 1.25% of the concentration of ACV against L. casei with two-fold serial dilutions. A concentration of 5 × 10–1% with 10-fold serial dilutions was found to be the MIC value for all three bacteria. No significant differences were found when compared with the positive control (NaOCl) (p = 0.182, p = 0.171, and p = 0.234), respectively, for two-fold serial dilutions and (p = 1.000, p = 0.658, and p = 0.110), respectively for 10-fold serial dilutions. MBC was observed to be 5% ACV for both E. faecalis and S. mutans. However, positive microbial growth was observed on the agar plate when cultured with L. casei. An independent sample t-test showed no significant differences (p > 0.05) in the antimicrobial activities between 5% ACV and 5% pure AA. TEM revealed cell wall and cytoplasmic membrane disruptions on all three bacteria at MIC value. Conclusion: Apple cider vinegar has antimicrobial activities against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei at their respective MIC values. Clinical significance: Apple cider vinegar can be an alternative antimicrobial dental pulp disinfectant to sodium hypochlorite. Apple cider vinegar can be used safely, especially in children's dental pulp therapy and deep caries management, when adequate tooth isolation is not readily achievable. Thus, adverse reactions commonly associated with other frequently used chemical disinfectants can be avoided.



Nahla Abdelmonem, Rania Salama, Dina H Mostafa

Can an Alginate-based Wound Dressing Modified with Garden Cress Substitute for COE-PAK as a Wound Dressing? An In Vitro Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:11] [Pages No:787 - 797]

Keywords: Alginate, Antibacterial, COE-PAK, Cytotoxicity, Garden cress, In vitro wound healing

   DOI: 10.5005/jp-journals-10024-3584  |  Open Access |  How to cite  | 


Aim: The aim of the current study was to prepare a natural oral wound dressing from alginate modified with garden cress (GC), a rich source of antibacterial phytochemical compounds essential for wound healing. Materials and methods: Sodium alginate (SA) dressing (negative control group), was prepared and modified with GC seeds extracts (25 µg/mL and 50 µg/mL) as the intervention groups, and COE-PAK was the positive control group. Cytotoxicity was measured using WST-1 assay (n = 15) after 24 and 48 hours. The in vitro wound healing assay (n = 15) was assessed in terms of wound width, and cell migration rate (0, 24, 48, and 72 hours). Agar diffusion test was performed to investigate the antibacterial action (n = 15) of the groups against Streptococcus mutans and Lactobacillus casei strains. Results were significant at p ≤ 0.05. Results: There was no statistically significant difference in cytotoxicity in all groups (p = 0.24 at 24 hours and 0.1 at 48 hours). Garden cress-containing groups revealed the lowest mean value of wound width (0.27 mm ± 0.01 and 0.23 mm ± 0.01 for 25 µg/mL and 50 µg/mL, respectively at 48 hours) and the highest mean value of cell migration rate (0.013 mm/hour ± 0.004 and 0.014 mm/hour ± 0.004 for 25 µg/mL and 50 µg/mL, respectively at 48 hours), in addition to the highest antibacterial action (1.49 mm ± 0.05 and 2.14 mm ± 0.09 for 25 µg/mL and 50 µg/mL, respectively against S. mutans, 1.43 mm ± 0.07 and 2.55 mm ± 0.09 for 25 µg/mL and 50 µg/mL, respectively against L. casei). Conclusion: Alginate wound dressing modified with GC extract could be considered a promising wound dressing material in terms of wound healing and antibacterial action. Clinical significance: Ready-to-use alginate-based wound dressing modified with GC extract may represent a promising natural alternative to the most commonly used oral wound dressing (COE-PAK).



Aishwarya Rathod, Priyanka Jaiswal, Bhairavi Kale, Deepika Masurkar

Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:4] [Pages No:798 - 801]

Keywords: Chlorhexidine, Full-mouth disinfection, Probing pocket depth, Root planing, Scaling, Triphala

   DOI: 10.5005/jp-journals-10024-3573  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients. Materials and methods: A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed. Results: The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed. Conclusion: Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results. Clinical relevance: Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.



Anbarasu Subramanian, Ramaprabha Balasubramanian, Srilekha Jayakumar, Shalini Harikrishnan, Raja Chandrasekaran

Evaluation of Canal-centering Ability and Apical Transportation of Hyflex-EDM, OneShape, WaveOne Gold, and Reciproc Files: An Ex Vivo Study

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:7] [Pages No:802 - 808]

Keywords: Apical transportation, Canal-centering ability, Cone-beam computed tomography, Dentinal cracks

   DOI: 10.5005/jp-journals-10024-3571  |  Open Access |  How to cite  | 


Aim: To evaluate and compare canal-centering ability (CCA), canal transportation (CT), and dentinal crack formation by using Hyflex-electrical discharge machining (EDM), OneShape, WaveOne Gold, and Reciproc single file system in the mesiobuccal root of maxillary first molar at coronal, middle, and apical third using cone-beam computed tomography (CBCT) and scanning electron microscopy (SEM). Materials and methods: Mesiobuccal roots of 120 freshly extracted maxillary molar teeth were divided into four experimental groups; Hyflex-EDM, OneShape, WaveOne Gold, and Reciproc (n = 30/group). Preinstrumentation scanning was done using CBCT for all samples at coronal one-third (4 mm), middle one-third (8 mm), and apical one-third (12 mm). After cleaning and shaping with standard irrigation protocol, the specimens were again scanned. Canal-centering ability and CT were calculated using pre- and postinstrumentation CBCT values. A scanning electron microscope was used to identify dentinal crack formation. Results: No significant difference was found for CCA by any of the systems at coronal, middle, and apical third, respectively. However, OneShape was found to have better CCA at the coronal third and WaveOne Gold at the middle and apical third. There was a significant difference in canal transportation at the apical third (p = 0.004) with WaveOne Gold having the least CT followed by Reciproc at the apical third. OneShape resulted in more dentinal cracks in the coronal and middle thirds. Also, Hyflex-EDM was better in the apical third. Conclusion: No difference in CCA was observed between the groups. The lowest values for CT were obtained for WaveOne Gold (similar to Reciproc) whereas both rotary files showed higher values for CT. Also, OneShape showed the most dentinal at all levels. Furthermore, Hyflex-EDM and WaveOne Gold produced the least dentinal cracks at all levels. Clinical significance: Given that the Reciprocating file system had the least CT and least dentinal cracks, the clinical success rate of root canal treatment (RCT) with the Reciprocating file system can be a better choice to improve the longevity of root canal-treated teeth.



Sruthi T Sundaran, Roshni Abida, Sachin A Aslam, Mathew P Cherian, Sooraj Soman, Tom Thomas

An Observational Study on Cystic Alterations in Normal Dental Follicles Associated with Impacted Lower Third Molar for Early Intervention

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:4] [Pages No:809 - 812]

Keywords: Cystic changes, Dental follicle, Pathologic alterations, Pericoronal radiolucency, Radiographically normal impacted teeth

   DOI: 10.5005/jp-journals-10024-3552  |  Open Access |  How to cite  | 


Aim: To evaluate the cystic changes in the radiographically normal dental follicle associated with impacted mandibular third molar. Materials and methods: This study was conducted on 80 patients. Samples were selected using a convenient sampling technique from the patients who had impacted mandibular third molars in Pell and Gregory's positions B and C, with follicular space less than 2.5 mm in diameter. After surgical removal of an impacted tooth, the dental follicle was sent for histopathologic evaluation. Results: Pathologic alterations were found in 19% of cases out of 80 samples. Odontogenic keratocystic and dentigerous cystic changes were found in 7% of cases. A statistically significant cystic alteration was found in female patients and distoangular impacted teeth. Conclusion: This study shows a significant cystic alteration in the radiologically normal dental follicles. Clinical and radiographic features alone may not be a reliable indicator of the absence of pathology. Early intervention of impacted teeth will help to reduce morbidity due to the development of pathology. Clinical significance: This study will help educate patients on the risks of retaining impacted teeth, based on scientific facts, in order to minimize the risks and to assess the correlation of pathologic alterations with the depth of impaction and angular position of the impacted tooth.



Ebenezer Mani, Irudhaya Nirmala, P Sivasankar, Parthiban Saketharaman, Shobana Pannnerselvam, Lakshmi Priyanka

Salivary Amylase and Mucin in Chronic Periodontitis: Pre/Post-therapy

[Year:2023] [Month:October] [Volume:24] [Number:10] [Pages:5] [Pages No:813 - 817]

Keywords: Amylase, Chronic periodontitis, Clinical attachment level, Mucin, Oral hygiene index-simplified

   DOI: 10.5005/jp-journals-10024-3549  |  Open Access |  How to cite  | 


Aim: The study aims to investigate the potential of salivary amylase as a reliable biochemical marker for assessing periodontal disease progression, establishing a potential correlation between salivary amylase levels and periodontal disease severity. Materials and methods: The study included 40 participants, aged 25–65, equally divided into a control and study group of 20 individuals each. Clinical parameters, such as oral hygiene index, gingival index, probing depth, and clinical attachment level were recorded. Saliva samples were collected and analyzed for amylase and mucin levels using a semi-auto analyzer and spectrophotometer, respectively. These clinical parameters and salivary biomarkers were evaluated before and after 45 days of phase I periodontal therapy. Statistical analysis, including independent samples t-test, paired samples t-test, and correlation analysis were performed to assess the treatment effectiveness and explore associations between clinical parameters and salivary biomarkers. Results: The study group with chronic generalized periodontitis showed significantly higher salivary amylase (27022.5 ± 8598.9) and mucin levels (3258 ± 724.2) and worse clinical parameters than the control group at baseline. However, after phase I periodontal therapy, the study group exhibited reduced salivary biomarkers amylase (17924.0 ± 4703.6) and mucin (1828.45 ± 314.07) and improved clinical parameters, indicating the effectiveness of the treatment in enhancing periodontal health compared with the control group. Positive correlations were found between clinical parameters and salivary amylase/mucin levels both before and after therapy (p < 0.001). Conclusion: Salivary amylase and mucin levels hold promise as valuable biomarkers for diagnosing active periodontal disease and evaluating treatment outcomes after phase I therapy. Clinical significance: Salivary biomarker comparison offers a noninvasive diagnostic tool for periodontal disease, improving early detection and personalized treatment planning. Further research is required to validate its clinical value fully.


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