The Journal of Contemporary Dental Practice

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2023 | November | Volume 24 | Issue 11

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Enis Veseli, Marcos Roberto Tovani-Palone, Argjira Veseli, Lum Kastrati

Should ChatGPT Have Some Applicability in the Management of Emergency Dental Care for Emigrant Adults and Children?

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:2] [Pages No:819 - 820]

Keywords: Artificial intelligence, Dental care, Dentistry, Emigrants and immigrants, Public health

   DOI: 10.5005/jp-journals-10024-3576  |  Open Access |  How to cite  | 



José Renatto Bazán-Mendoza, Paula Betzabe Arias-Modesto, Gustavo Armando Ruíz-Mora, Yalil Augusto Rodríguez-Cárdenas, Aron Aliaga-Del Castillo, Vinicius Dutra, Luis Ernesto Arriola-Guillén

Sagittal Position of the Upper Incisor in Relation to the Forehead in Peruvian Individuals with Different Skeletal Relationships

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:5] [Pages No:821 - 825]

Keywords: Forehead, Skeletal relationship, Upper central incisor

   DOI: 10.5005/jp-journals-10024-3590  |  Open Access |  How to cite  | 


Aim: The aim of this study was to determine the sagittal position of the upper incisor considering Andrews’ analysis based on the position of the forehead in Peruvian individuals with different skeletal relationships. Materials and methods: This retrospective, cross-sectional study included 212 lateral head radiographs of Peruvian individuals (males: 85, mean age 21.38 ± 6.88, and females: 127, mean age 21.18 ± 6.95), with different skeletal relationships (Class I group = 96, Class II group = 57, Class III group = 59). The values of the ANB, SNA, SNB angles as well as the forehead anterior limit line (FALL) and goal anterior limit line (GALL) points were identified in the radiographs, and then a vertical line was drawn in each point to determine if the upper incisor was positioned forward (protruded), backward (retruded) or within (adequate) these lines. Two trained and calibrated investigators performed all the measurements. The Chi-square test was used to evaluate associations. A p-value < 0.05 was considered statistically significant. Results: Overall, the sagittal position of the upper incisor showed a significant association with the sagittal skeletal relationship (p = 0.001). The upper incisors showed an adequate position (41.7%), protruded position (56.10%), and retruded position (42.40%), for Class I, II, and III skeletal relationships, respectively, as highest percentages in each Class. Statistical significance was found for females only (p = 0.005). Conclusion: Skeletal Class I mainly showed an adequate position of the upper central incisor, whereas for Class II a protruded position was most frequently found, and Class III presented a retruded position. Clinical significance: Andrews’ analysis based on the position of the forehead in Peruvian individuals is a valuable tool for orthodontic diagnosis.



Mohsen Ziaei, Farshad Bajoghli, Mahmoud Sabouhi, Mohammad Jowkar, Farshad Nadian, Farbod Manshaei

Evaluating the Marginal and Internal Discrepancy of Nickel–Chrome Copings Made on Fixed Partial Denture Implants with Conventional and 3D Printing Techniques

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:8] [Pages No:826 - 833]

Keywords: Internal discrepancy, Internal gap, Marginal discrepancy, 3D printing

   DOI: 10.5005/jp-journals-10024-3586  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the marginal and internal discrepancy of nickel–chrome (Ni–Cr) copings made on implant bridges with conventional and 3D printing techniques. Materials and methods: 30 three-unit Ni–Cr FDPs (60 copings) were made by 3D-printing technique (PolyJet group), lost-wax method with die spacer technique (die spacer group), and lost-wax method with burn-out the cap (burn-out cap group). Then, the frames obtained from the three methods were checked to examine the marginal discrepancy by stereomicroscope after preparation and polishing. The silicon replica method was used to investigate the internal discrepancy at 6 points (buccal portion of occlusal surface, lingual portion of occlusal surface, middle area of the axial surface in the lingual, middle area of the axial surface in the buccal, cervico-buccal area, and cervico-lingual area). Kolmogorov–Smirnov test was performed first to estimate the normality of data distribution. A one-way ANOVA and post hoc Tukey test were done for comparing marginal and internal discrepancies between groups. The significant level was considered p < 0.05. Results: The mean ± standard deviation of marginal discrepancy in the PolyJet group, die spacer group, and burn-out cap group was 37.9 ± 15, 68.8 ± 31.8 and 42.7 ± 3.6 µm for buccal margins and 40.4 ± 12.3, 64 ± 21.7, and 42.4 ± 2.1 µm for lingual margins, respectively. The means of buccal and lingual marginal discrepancy in the burn-out cap group and PolyJet group were significantly lower than the die spacer group (p < 0.001). Marginal discrepancy was not statistically different between the burn-out cap group and the PolyJet group. The mean ± standard deviation of overall internal discrepancy in the PolyJet group, die spacer group, and burn-out cap group was 64.6 ± 3.7, 72 ± 22.2, and 58.7 ± 2 µm, respectively. There was a significant difference between the mean of internal discrepancy between three groups (p = 0.001). The mean of internal discrepancy of the burn-out cap group was significantly lower than the die spacer group (p = 0.001) and PolyJet group (p = 0.005). Internal discrepancy was not significantly different between the PolyJet group and the die spacer group (p = 0.168). Conclusion: The marginal and internal gap rates of the three groups were within clinically acceptable limits. The 3D printing technique and lost-wax method with burn-out the cap had the lowest buccal and lingual marginal discrepancies. The burn-out cap method had better fitness and less internal discrepancy than 3D printing and die spacer groups. Clinical significance: Lower marginal discrepancy of copings fabricated by using 3D printed patterns may improve clinical success of implant restoration.



Marwa A Helmy, Noha H El-Shaheed, Fatma A El Waseef, Wael S Ahmed, Salah A Hegazy

Effect of Ridge Splitting of Mandibular Knife Edge Ridges with Two-implant Retained Overdenture with Locator Attachments on Peri-implant Bone Level and Posterior Ridge Resorption: A One-year Preliminary Study

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:6] [Pages No:834 - 839]

Keywords: Knife edge ridge, Locator, Polyetheretherketone, Ridge splitting

   DOI: 10.5005/jp-journals-10024-3592  |  Open Access |  How to cite  | 


Aim: This study was conducted to evaluate peri-implant bone height changes and posterior ridge resorption by using two-implant retained polyetheretherketone (PEEK) overdentures with locator attachments following expansion of mandibular knife edge ridges by ridge splitting. Materials and methods: Eighteen patients were selected for ridge splitting followed by expansion, implant placement, and bone graft application. Six months later, the fabrication of PEEK overdentures retained by locator attachments was accomplished. Friedman test, Wilcoxon signed-rank test, and Spearman correlation were used to evaluate the changes over time. Results: Peri-implant bone height loss increased significantly with the advance of time between 6 and 12 months following denture insertion. Posterior area index changes were significant over time when measured at the time of denture insertion and twelve months following denture insertion. Conclusion: The effect of using PEEK as overdenture base material retained with two locator attachments allowed sharing the load between the peri-implant bone anteriorly and residual ridge posteriorly in cases with ridge splitting technique. Clinical significance: Using PEEK as an overdenture base material is a successful means of bone preservation.



Mohammad Rayyan, Ali Mohammad Hujeiry, Ghada Ayash

Comparison of Fracture Resistance between Implant-supported Bis-acryl Interim 3-unit FDPs Using Six Different Strengthening Mechanisms: An In Vitro Study

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:7] [Pages No:840 - 846]

Keywords: Bis-acryl, Fracture resistance, Interim, Kevlar, Retraction cord

   DOI: 10.5005/jp-journals-10024-3587  |  Open Access |  How to cite  | 


Aim: To investigate six different strengthening mechanisms for three-unit implant-supported provisional restorations. Materials and methods: Six techniques of provisional fixed prostheses (PFP) reinforcement were investigated and were assigned to different groups (n = 10): group (ZP) zirconia powder, group (SK8) silk thread wrapped as a figure-of-8 pattern around middle third of abutment, group (RC8) size 00 retraction cord wrapped as a figure-of-8 pattern around middle third of abutment, group (RF8) Resin impregnated glass fiber ribbon wrapped as a figure-of-8 pattern around abutment, group (KV8) Kevlar 29 cord wrapped as a figure-of-8 pattern around middle third of abutment, group (KV) Kevlar 29 strands incorporated in resin mix. Compared against unenforced bis-acryl as control group (CL). Seventy Metal Dies were 3D printed having Soft Tissue Gingiva Mask. Using a custom-made silicone Index, 70 PFP were fabricated (10 of each group) and were cemented to their corresponding metal dies using zinc polycarboxylate cement. All specimens were thermal cycled for 1000 cycles using order of 20 seconds at 55°C and 20 seconds at 5°C with 10 seconds transport. Fracture resistance test was done using universal testing machine. All specimens were loaded to failure. Data were collected, tabulated and statistically analyzed. Results: Kolmogorov–Smirnov normality test showed no significant difference between data in each group. So, data are normally distributed in each group. Descriptive statistics showed higher mean values of CL group (780.8 ± 164) followed by RF8 group (614.2 ± 158.2), followed by RC8 group (550.2 ± 339.2), followed by KV8 group (442.1 ± 198.4), followed by KV group (403.9 ± 306), followed by SK8 group (175.9 ± 90.8), and finally ZP group (136.5 ± 135.7). One-way ANOVA revealed significant difference between the tested groups (p = 0.036). Conclusion: Bis-acryl provisional restorations had better mean fracture resistance values than all other strengthening mechanisms. Bis-acryl provisional restorations did not gain more strength by any of the added materials. One-way ANOVA revealed significant difference between all tested groups. Clinical significance: Provisional restorations over implant should be strong enough to serve for the long period of bone and tissue healing. Current materials alone cannot survive for long. It serves as temporization between steps of fixed restorations construction.



Rahma EL Hussany Mohammed, Osama Mohammed Askar, Fatma Ahmad EL-Waseef, Mohammed Mohammed Fouad

Radiographic Assessment of Three-implant-retained Mandibular Overdentures: A Clinical Study of Alveolar Bone Height Changes (Randomized Clinical Trial)

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:6] [Pages No:847 - 852]

Keywords: Block-out spacer, Digital radiograph, Locator attachment, Pick-up

   DOI: 10.5005/jp-journals-10024-3588  |  Open Access |  How to cite  | 


Aim: To evaluate the residual alveolar ridge bone height changes regarding the impact of the block-out spacer used during the pick-up procedures of implant-assisted mandibular complete overdentures. Materials and methods: This study was a randomized clinical trial conducted on 18 patients. All patients received three mandibular dental implants with definitive locator attachments which were directly picked up with two different techniques. Patients were classified randomly without any bias into two equal groups (Group I block-out spacer) and (Group II without block-out spacer). Over a year, the digital radiographic technique with new technique of reference points was employed to evaluate the changes in the residual alveolar ridge bone heights. The data were statistically analyzed to test the significance difference between groups. Results: Concerning the residual alveolar ridge resorption RRR, group I exhibited a significantly higher RRR than group II. Conclusion: In terms of residual alveolar ridge preservation, not using the block-out spacer was more beneficial than using it. Clinical significance: Alveolar bone heights can be affected by the use of block-out spacer during pick-up procedure within accepted physiologic values. The removal of the block-out spacer could be more beneficial with respect to the preservation of the residual alveolar ridge.



Ezatollah Jalalian, Farzan Younesi, Shaghayegh Golalipour, Sotude Khorshidi, Seyed Hamed Mahdavisaedabadi, Maryam Sayyari

Assessment of Marginal and Internal Adaptation in Provisional Crowns Utilizing Three Distinct Materials

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:6] [Pages No:853 - 858]

Keywords: Composite resins, Computer-aided design, Crowns, Dental marginal adaptation, Polymethyl methacrylate

   DOI: 10.5005/jp-journals-10024-3589  |  Open Access |  How to cite  | 


Aims: This study aimed to assess the marginal and internal adaptation of provisional crowns fabricated from polymethyl methacrylate (PMMA) blocks by the computer-aided design/computer-aided manufacturing (CAD/CAM) system, autopolymerizing PMMA, and acrylic base composite resin. Materials and methods: In this in vitro experimental study, a brass die was obtained, and provisional crowns were fabricated in three groups using Teliocad PMMA blocks by the CAD/CAM system, Tempron GC auto-polymerizing PMMA, and Bisico acrylic base composite resin (n = 7 in each group). The provisional crowns were coded and randomly placed on the die. Their marginal adaptation was evaluated under a stereomicroscope at 40× magnification, while their internal adaptation was assessed by the replica technique. Data were analyzed by one-way analysis of variance (ANOVA) (α = 0.05). Results: The mean marginal gap was the highest in autopolymerizing PMMA and the lowest in the CAD/CAM PMMA group (p < 0.05). The mean marginal gap in the autopolymerizing PMMA group was significantly higher than that in the resin material (p = 0.014) and CAD/CAM PMMA (p = 0.000) groups. The difference between the resin material and CAD/CAM PMMA groups was not significant (p = 0.13). The mean internal gap was the highest in autopolymerizing PMMA group and the lowest in CAD/CAM PMMA group (p < 0.05). The mean internal gap in autopolymerizing PMMA group was significantly higher than that in composite resin (p = 0.002) and CAD/CAM PMMA (p = 0.00) groups. The difference between the resin material and CAD/CAM PMMA groups was not significant (p = 0.322). Conclusion: Computer-aided design/Computer-aided manufacturing PMMA provisional crowns showed the highest marginal and internal adaptation followed by acrylic base resin material crowns. Clinical significance: Computer-aided design/computer-aided manufacturing PMMA crowns demonstrate superior marginal and internal adaptation compared with autopolymerizing PMMA and acrylic base composite resin crowns, suggesting CAD/CAM technology's potential for enhancing clinical outcomes.



Natsuko Aida, Kiyono Koi, Silvia Patricia Amaya-Pajares, Masahiro Furusawa, Hidehiko Watanabe

Bond Strength of Two Resin Cements with Leucite-reinforced Ceramic Using Different Bonding Agents

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:5] [Pages No:859 - 863]

Keywords: Adhesive bond strength, Bonding agents, CAD/CAM restorations, Leucite-reinforced ceramic, Resin cements

   DOI: 10.5005/jp-journals-10024-3591  |  Open Access |  How to cite  | 


Aim: To compare the bond strength of two resin cements to leucite-reinforced ceramics using three different boding agents and evaluate the compatibility of bonding agents. Materials and methods: Twenty extracted sound human molars were sectioned horizontally 2–3 mm above the cementoenamel junction (CEJ). CAD/CAM ceramic blocks for inLab were also sectioned to create 4 mm thick and bonded to the dentin. The adhesive groups assigned were divided into four adhesive groups: Group I: Variolink II dual-cure resin cement and Scotchbond Multi-Purpose Plus adhesive, group II: Multilink Automix dual-cure resin cement and Multilink primers, group III: Multilink Automix and Clearfil SE bond 2 (CSE2) adhesive, group IV: Multilink Automix and CSE2 with light curing after adhesive application. Five specimens of each group were sectioned perpendicular to obtain six microsticks of 1 × 1 mm width from each sample. Microtensile bond strength data were expressed in MPa. Fracture modes (FrMs) analyzed for the surfaces were divided into six patterns. Microtensile bond strength data were statistically analyzed with one-way ANOVA and Tukey post hoc tests (α = 0.05). T-test was performed at the 5% significance level to analyze groups III and IV with and without light curing. Results: Group I showed the highest μTBS average of 13.67 MPa, group IV showed 12.26 MPa, group III showed 12.15 MPa, and group II showed the lowest average of 10.84 MPa. No significant differences were found between the bonding agents. However, the six types of failure modes, although all observed, were characterized by the adhesive system: Type I: adhesive failure of laminated dentin and ceramic; type II: adhesive failure of laminated ceramic; type III: adhesive failure of laminated dentin; type IV: cohesive failure of luting agent; type V: cohesive failure of dentin, and type VI: mixed failure of adhesion and cohesion. As a result, the FrM most commonly observed was the adhesive failure at the luting cement-ceramic block interface. Conclusion: The combination of resin cements and bonding agents did not significantly affect the bond strength of CAD/CAM ceramic restorations and dentin. Clinical significance: Several universal bonding agents are currently available for direct and indirect bonding, and using the same bonding agent for direct and indirect restorations could simplify inventory and benefit routine clinical practice.



Valéria Custódio dos Santos, Prescila Mota de Oliveira Kublitski, Bruno Marques da Silva, Marilisa Carneiro Leão Gabardo, Flávia Sens Fagundes Tomazinho

Periapical Lesions Associated with Demographic Variables, Dental Conditions, Systemic Diseases, and Habits

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:7] [Pages No:864 - 870]

Keywords: Apical periodontitis, Endodontics, Panoramic radiograph, Root canal treatment, Systemic diseases

   DOI: 10.5005/jp-journals-10024-3596  |  Open Access |  How to cite  | 


Aim and background: The aim of this study was to analyze the prevalence of periapical lesions and possible associations with demographic, dental conditions, systemic diseases, and habit variables in patients from a private Brazilian university. Materials and methods: Data from 452 patients of both sexes, aged 18–78 years, from a Brazilian university were evaluated. Panoramic radiographs were analyzed, and the presence of periapical lesions was recorded. In these cases, the dental condition was assessed for the presence or absence of endodontic treatment. Medical records provide information related to general health (diabetes, cardiovascular diseases, altered cholesterol, autoimmune diseases, gallstones, or kidney stones) and habits (smoking or alcoholism). The data were descriptively analyzed, and then logistic regression and the Wald test were performed in Stata/SE v.14.1. Results: A rate of 58.4% of participants were women, and the mean age was 36.4 (±14.6) years. Periapical lesions prevailed in 193 (42.7%) patients, and 281 (72.4%) teeth were not previously endodontically treated. Mandibular first molars (19%) and men (48.9%) were the most affected. The adjusted model showed that the age group of 26–45 years was 5 times more likely [odds ratio (OR) = 5.01; 95% confidence interval (CI): 2.85–8.82] to have lesions than those aged ≤25 years. Participants aged above 46 years were 19.1 times more prone (OR = 19.1; 95% CI: 10.2–36.0) to morbidity than younger ones (≤25 years). Conclusion: The studied sample showed that periapical lesions were more prevalent in males, in mandibular molars, and without prior endodontic treatment. There was no observed association between periapical lesions and comorbidities or habits; however, a significant correlation occurred with advancing age. Clinical significance: Comorbidities and habits were not associated with the presence of periapical lesions. However, aging has been identified as a significant risk factor for the development of periapical lesions. This finding is clinically relevant as it highlights the importance of monitoring and maintaining oral health in patients with advanced age.



Maria Rafaat Reslan, Mohammad Rayyan

Evaluation of Antibacterial Effect of New Sealer “Neoseal” and Two Commercially Used Endodontic Sealers against Enterococcus faecalis: An In Vitro Study

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:6] [Pages No:871 - 876]

Keywords: Antibacterial, CeraSeal, Endodontic sealer, Modified direct contact test, Neoseal

   DOI: 10.5005/jp-journals-10024-3599  |  Open Access |  How to cite  | 


Aim: To evaluate the antibacterial activity of three endodontic sealing materials, Neoseal, CeraSeal, and AH Plus against Enterococcus faecalis bacteria in vitro. Materials and methods: The antibacterial activity of three endodontic sealing materials including two bioceramic sealers; NeoSEALER Flo (group I), CeraSeal (group II), and one epoxy resin sealer; AH Plus (group III) was investigated against E. faecalis bacteria American Type Cell Culture Collection (ATCC) 29212 (ATCC, Rockville, Maryland, USA). Using modified direct contact test (MDCT). The endodontic sealers were tested in contact with bacterial suspension when unset (20 minutes after mixing) and after setting, assessing the antibacterial activity of aged sealers after 1, 3, 7, and 14 days. Analyzing the collected data has been done with version 25.0 of the statistical package for the social sciences (SPSS) IBM software (SPSS, Chicago, Illinois, USA). Descriptive analyses were calculated using standard deviation (SD) and mean. Shapiro–Wilk test was done to detect the normality of the result values. Kruskal–Wallis test was then performed to test the level of significance between groups. Results: After 20 minutes – Group I showed higher bacterial count mean values (5,500 ± 500) and 0 values for groups II and III groups. After 1 day, the highest bacterial count mean values were in group III (54,333.3 ± 4,041.5) and 0 values for groups I and II. After 3 days – group III again recorded the highest bacterial count mean values (45,000 ± 5,000) and 0 values for I and II groups. After 7 days – Group III still recorded the highest bacterial count mean values (53,333.3 ± 1,527.5) and 0 values for groups I and II. After 14 days – Group III recorded the highest bacterial count mean values (56,000 ± 1,000) followed by group II (6,333.3 ± 577.4), and the least was group I (2,000 ± 500). Kruskal–Wallis test showed significant values between groups in all tested durations, p > 0.05. Conclusion: The sealing material AH Plus showed a strong bactericidal effect at the beginning but lost its ability after 24 hours. CeraSeal showed strong bactericidal activity from the beginning till the end of the first week but showed bacterial count at 14 days. Neoseal took 24 hours to show bactericidal effect and similar to CeraSeal showed bacterial count at 14 days; CeraSeal recorded the best results within the study. Clinical significance: Silicate-based (bioceramic) endodontic sealers can be the best available endodontic sealing material that is clinically beneficial in removing residual microbes which had survived irrigation protocols and chemomechanical preparation.



Nancy Soliman Farghal, Md Sofiqul Islam, Shahistha Parveen Dasnadi, Shaikha Omar Alteneiji, Ali Mohammed Awheed

The Impact of Social Media on Professional Learning among Undergraduate Dental Students: A Cross-sectional Study

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:10] [Pages No:877 - 886]

Keywords: Dental students, Education, Evidence-based, Internet addiction disorder, Questionnaire, Social media, Survey analysis, YouTube

   DOI: 10.5005/jp-journals-10024-3597  |  Open Access |  How to cite  | 


Aim: To explore the advantages and drawbacks of social media (SM) use in undergraduate dental students’ education. Materials and methods: This cross-sectional study was conducted among 202 undergraduate students at RAK College of Dental Sciences. A questionnaire of 15 questions explored demographic information, the nature of SM used by the participants, the use of SM for educational purposes, and the negative impacts of SM use. Frequencies, percentages, and significant variables were analyzed using Chi-square test at a 95% confidence level (CI) using statistical software [Statistical Package for the Social Sciences (SPSS), version 26.0]. Results: Among the participants, 95% were SM users, and 80% had been using it for more than 5 years. 95% use SM regularly, and 70% spend 2–6 hours daily using SM. The primary purpose of using SM was entertainment and communication, mostly Instagram (82.38%), followed by Snapchat (58.49%) and YouTube (47.15%). Furthermore, SM is effective in obtaining new information (85%), and 90% consider clinical procedures on YouTube to be a helpful learning tool. Moreover, 75% of the participants recommended using SM as a learning tool, and 85% of the participants considered SM tutorial videos to be evidence-based. However, 70% of users are concerned about their addiction to using SM during lecture, laboratory, clinic, and examination periods, and 37% of them think spending time on SM can negatively affect their academic performance. Conclusion: Undergraduate dental students frequently use SM for entertainment, communication, and educational purposes. Nevertheless, the addiction to SM negatively affects the students learning progress. Clinical significance: The use of SM has both a positive and negative impact on undergraduate dental education. Incorporating evidence-based learning components into SM platforms can be useful in dental education.



Lin Jacob Varghese, Banibrata Lahiri, Narendra Varma Penumatsa, Crystal Runa Soans, Aswini Sekar, Fazil Arshad Nasyam

Effectiveness of Topical Ozone Gel Application in the Management of Postextraction Wound Healing: An In Vivo Study

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:4] [Pages No:887 - 890]

Keywords: Complications, Extraction, Ozone gel, Wound healing

   DOI: 10.5005/jp-journals-10024-3557  |  Open Access |  How to cite  | 


Aim: The purpose of the current study was to determine the effectiveness of topical ozone gel application in the management of postextraction wound healing. Materials and methods: The current study involved a total of 40 participants. The patients were randomly placed into two groups with sample size estimated as n = 20 in each group. Group A: Control: patients received only saline irrigation and group B: patients receiving topical ozone gel. The surgical procedure was standardized for all groups, and local anesthesia was used during the procedure. After the removal of the mandibular third molar, the control group irrigated the socket with saline, whereas in the study group, the socket was filled with ozone gel. On the first, third, fifth, and seventh postoperative days, a single examiner evaluated each participant for postoperative mouth opening, discomfort, and patient satisfaction. The t-test was used to analyze quantitative data, whereas the Fisher exact test was employed to analyze qualitative data. Statistical significance was defined as a p value less than 0.05. Results: On comparison of patient satisfaction, in the ozone gel group, 13 patients were very satisfied but in the control group, 8 patients were very satisfied. On comparison of pain intensity, on the 5th day, the complete absence of pain patients was more in the ozone gel group (12 patients) compared with the control group (4 patients). There was a statistically significant difference found between these two groups (p < 0.001). On comparison of mouth opening, on the 3rd and 5th day, mouth opening was better in the ozone gel group (29.22 ± 1.28 and 34.06 ± 0.09) compared with the control group (27.38 ± 1.03 and 31.14 ± 0.82), respectively. And there was a statistically significant difference found between these two groups (p < 0.001) on both the days. Conclusion: The current study came to the conclusion that using ozone gel significantly improves postoperative pain, mouth opening range, and promotes faster wound healing. Clinical significance: The primary goals of postoperative care for exodontia patients have always been pain management and infection control. The most frequent postoperative consequences are pain and edema. Hence, ozone therapy can be used as an effective topical agent to manage postextraction pain and swelling in healthy patients without the need for excess medications.



Karthik Kannaiyan, Pinaki Rakshit, Murali Patla Shivarama Bhat, Sreelakshmy Kammath Korattiparambil Sadasiva, Sreeja Chandra Babu, Haseena Ummer

Effect of Different Disinfecting Agents on Surface Roughness and Color Stability of Heat-cure Acrylic Denture Material: An In Vitro Study

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:4] [Pages No:891 - 894]

Keywords: Color stability, Disinfecting agents, Heat-cure acrylic material, Surface roughness

   DOI: 10.5005/jp-journals-10024-3563  |  Open Access |  How to cite  | 


Aim: The current study aimed to determine the impact of three different disinfectants on the surface roughness and color stability of heat-cure acrylic denture material. Materials and methods: Using a stainless-steel mold, disc-shaped wax patterns with dimensions of 10 mm in diameter and 2 mm thick (in accordance with ADA Specification No. 12) were created and prepared for a total of 75 acrylic samples. Dimensions of all 75 acrylic samples were checked with a digital Vernier caliper. About 25 samples of denture base material were immersed in three different chemical disinfectants: Group I: immersed in chlorhexidine gluconate solution, group II: immersed in sodium hypochlorite solution, and group III: immersed in glutaraldehyde solution. All samples were scrubbed daily for 1 minute with the appropriate disinfectant and submerged for 10 minutes in the same disinfectant. Between disinfection cycles, samples were kept in distilled water at 37°C. Color stability was measured using a reflection spectrophotometer. Surface roughness values were measured by a profilometer at baseline following 15 days and 30 days. Results: After 15 days, the color stability was better in chlorhexidine gluconate solution group (4.88 ± 0.24) than sodium hypochlorite solution (4.74 ± 0.18) and glutaraldehyde solution group (4.46 ± 0.16). The mean surface roughness was less in glutaraldehyde solution group (2.10 ± 0.19), followed by chlorhexidine gluconate solution group (2.48 ± 0.09) and sodium hypochlorite solution group (2.64 ± 0.03). After 30 days, the color stability was significantly better in chlorhexidine gluconate solution group (4.40 ± 0.02), followed by sodium hypochlorite solution (4.06 ± 0.16) and glutaraldehyde solution group (3.87 ± 0.17). The mean surface roughness was significantly lesser in glutaraldehyde solution group (2.41 ± 0.14), followed by chlorhexidine gluconate solution group (2.94 ± 0.08) and sodium hypochlorite solution group (3.02 ± 0.13). Conclusion: In conclusion, the color stability was significantly better in chlorhexidine gluconate solution group than sodium hypochlorite solution and glutaraldehyde solution group. But the surface roughness was significantly lesser in the glutaraldehyde solution group, followed by the chlorhexidine gluconate and sodium hypochlorite solution group. Clinical significance: The maintenance of the prosthesis requires the use of a denture disinfectant; therefore, it is crucial to select one that is effective but would not have a negative impact on the denture base resin's inherent characteristics over time.



Mohammed A Alharbi, Batool A Alghamdi, Wafa A Alswajy, Sereen A Kattan, Obadah Austah, Bader Othman, Hosam A Baeshen

A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:7] [Pages No:895 - 901]

Keywords: Case report, Intentional replantation, Miniscrew, Orthodontic luxation

   DOI: 10.5005/jp-journals-10024-3566  |  Open Access |  How to cite  | 


Aim: This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN). Background: Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome. Case description: A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots. Conclusion: This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures. Clinical significance: Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth.



SK Aziz Ikbal, Surendra Kumar Yadav, Roopanshi Mehrotra, Tasneem Fatima, Anjusha Sharda, Srashti Gupta

Oral Microbiota as a Diagnostic Biomarker of Digestive Cancer: A Systematic Review

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:10] [Pages No:902 - 911]

Keywords: Digestive cancer, Gastrointestinal cancer, Microbial dysbiosis, Oral microbiota, Systematic review

   DOI: 10.5005/jp-journals-10024-3598  |  Open Access |  How to cite  | 


Aim: This article aimed to review the association of oral microbiota with digestive cancer (DC). Background: Oral microbiota is one of the most complex ecosystems in our body. The mouth, from which the digestive system starts, may be a source of an abundant taxonomic group of microbiotas that travel to the digestive system followed by growth, reproduction, and settlement, forming a complex microecological environment causing systemic and gastrointestinal (GI) disease. Review results: A total of 14 articles were chosen for review. Most studies were case–control. Both positive and negative associations were seen between oral microbiome and DC. Conclusion: Digestive cancer may be associated with distinctive oral microbial character. Clinical significance: The present systematic review enlightens the risk of digestive carcinoma with oral microbiota that may act as a biomarker for early diagnosis of DC in a more comfortable, acceptable, and noninvasive way.



Zeeshan Heera Ahmed, Abdullah Muharib Almuharib, Abdulrahman Abdullah Abdulkarim, Abdulaziz Hassoon Alhassoon, Abdullah Fahad Alanazi, Muhannad Abdullah Alhaqbani, Mohammed Saif Alshalawi, Abdullah Khalid Almuqayrin, Mohammed Ibrahim Almahmoud

Artificial Intelligence and Its Application in Endodontics: A Review

[Year:2023] [Month:November] [Volume:24] [Number:11] [Pages:6] [Pages No:912 - 917]

Keywords: Artificial intelligence, Comprehensive review, Endodontics, Advantages and disadvantages of AI in endodontics, Future of AI in endodontics

   DOI: 10.5005/jp-journals-10024-3593  |  Open Access |  How to cite  | 


Aim and background: Artificial intelligence (AI) since it was introduced into dentistry, has become an important and valuable tool in many fields. It was applied in different specialties with different uses, for example, in diagnosis of oral cancer, periodontal disease and dental caries, and in the treatment planning and predicting the outcome of orthognathic surgeries. The aim of this comprehensive review is to report on the application and performance of AI models designed for application in the field of endodontics. Materials and methods: PubMed, Web of Science, and Google Scholar were searched to collect the most relevant articles using terms, such as AI, endodontics, and dentistry. This review included 56 papers related to AI and its application in endodontics. Result: The applications of AI were in detecting and diagnosing periapical lesions, assessing root fractures, working length determination, prediction for postoperative pain, studying root canal anatomy and decision-making in endodontics for retreatment. The accuracy of AI in performing these tasks can reach up to 90%. Conclusion: Artificial intelligence has valuable applications in the field of modern endodontics with promising results. Larger and multicenter data sets can give external validity to the AI models. Clinical significance: In the field of dentistry, AI models are specifically crafted to contribute to the diagnosis of oral diseases, ranging from common issues such as dental caries to more complex conditions like periodontal diseases and oral cancer. AI models can help in diagnosis, treatment planning, and in patient management in endodontics. Along with the modern tools like cone-beam computed tomography (CBCT), AI can be a valuable aid to the clinician.


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