The Journal of Contemporary Dental Practice

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2023 | March | Volume 24 | Issue 3

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Filomeni Anagnostou, Efthymia Chalvatzoglou, Aristidis Arhakis, Vasiliki Boka, Konstantinos Arapostathis, Nikolaos Kotsanos

Do Maternal Beliefs, Knowledge and Practices for Own and Young Child Oral Care Reflect on Actual Child Oral Health?

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:6] [Pages No:147 - 152]

Keywords: Child oral health, Dental caries, Family income, Gingivitis, Maternal education

   DOI: 10.5005/jp-journals-10024-3476  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to evaluate whether mother's oral health habits and knowledge for child oral care actually reflect on her young child's oral health and hence sought for direct evidence for this association. Materials and methods: One hundred mothers accompanied their children, aged 2–5 years to a University Pediatric Dentistry Clinic and completed a three-arm questionnaire. Child dental caries (decayed, missing, filled surfaces–dmfs) and gingival bleeding index (GBI) were recorded. Correlations were sought by the analysis of variance (ANOVA). Results: A negative correlation was observed between maternal education and family income with child dmfs (p < 0.01). Additionally, other maternal factors such as age and correct knowledge of the appropriate age for a child's first dental visit, the initiation of toothbrushing, and fluoride exposure were positively associated with lower dmfs and GBI. Additionally, some maternal practices also contributed to these results. Conclusion: Maternal practices and knowledge are predictors of child oral health. Clinical significance: Mothers-to-be, especially those with low socioeconomic characteristics, should be involved in dental education and motivation interventions in order to practice proper oral hygiene for their children.



Nirupama Sahoo, Basil Joy, Niva Mahapatra, Joy Mathew, Feby Kuriakose, Kumari Lucy Bhola

A SEM Evaluation of the Permeability of Different Desensitizing Methods on Occlusion of Dentinal Tubules: An In-vitro Study

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:4] [Pages No:153 - 156]

Keywords: Dentinal hypersensitivity, Dentinal tubules, Desensitizing methods scanning electron microscope

   DOI: 10.5005/jp-journals-10024-3459  |  Open Access |  How to cite  | 


Aim: The purpose of the current research was to assess the permeability of three various desensitizing techniques on dentinal tubule occlusion using a scanning electron microscope (SEM). Materials and methods: For this research, 100 human sound premolar teeth that were extracted for orthodontic purposes were gathered. With the aid of a water-cooled diamond saw, the teeth were divided in a mesiodistal (vertically) orientation. A sectioned sample (5 mm long by 5 mm wide by 3.5 mm deep), including the cervical region, was taken from each buccal side. To fully open the dentinal tubules, these samples were then kept in 17% ethylenediaminetetraacetic acid (EDTA) for 40 minutes. The samples were divided into four groups (n = 25), each receiving the following dentin surface treatments: Group I: Control, Group II: Samples received NaF 5% varnish treatment, Group III: Samples received diode laser treatment, and Group IV: Samples received CPP–ACP treatment. An SEM was used to inspect each specimen at a magnification of about × 3000 and photomicrographs was assessed. Results: The maximum occlusion of dentinal tubules was found in samples were treated with Diode laser (2.96 ± 0.14) followed by samples treated with NaF 5% varnish (3.38 ± 0.10), samples were treated with CPP–ACP (3.42 ± 0.06) and control group (4.26 ± 0.19). There was a statistically significant difference found between the groups. Conclusion: In conclusion, all three desensitizing methods used in the present study were successful in the occlusion of dentin tubules. But the application of the Diode laser was effective in the reduction of dentin permeability compared to NaF 5% varnish and CPP–ACP. Clinical significance: Dentin hypersensitivity (DH) is characterized by a brief period of intense discomfort. One approach to managing DH is to obstruct dentin tubules in order to decrease dentin permeability. There are many substances that can reduce hypersensitivity, but the finest commercially available substance for treating the condition by occluding the tubes should be acknowledged.



Sudha Ravi, Hemasathya Bahavathi Ananthan, Bharath Naga Reddy, Sriram Sankar, Senthil Nathan Natarajan, Sathish Sankar

Evaluation of Antibacterial Efficacy of Two Commercially Available Probiotics as Intracanal Medicament against Enterococcus faecalis: An In Vitro Study

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:5] [Pages No:157 - 161]

Keywords: Antimicrobial, Bacteriotherapy, Bifidobacterium, Endodontics, Innovative, Lactobacillus rhamnosus, Probiotics, Zone of inhibition

   DOI: 10.5005/jp-journals-10024-3466  |  Open Access |  How to cite  | 


Aim: This study was performed to evaluate the antibacterial efficacy of two commercially available probiotics (BIFILAC and VSL 3) as intracanal medicament against Enterococcus faecalis in endodontic therapy. Materials and methods: Microorganisms from commercially available probiotics (BIFILAC and VSL 3) were extracted via the manufacturer's recommendations and mixed by weight. About 30 microliters were then placed on sterile discs. The pathogenic test organism was E. faecalis set to a 1 McFarland standard challenge. A two-probiotic disc template on blood agar plates was inoculated with E. faecalis and incubated at 37°C for 48 hours and 1 week respectively. Phase-1 of the study was conducted by a disc diffusion assay test to evaluate zones of inhibition (ZOI) in millimeters (mm). Phase-2 was conducted by mixing 9 mL of 30% poloxamer 407 and MRS broth in a test tube, together with the two probiotic mixtures and E. faecalis, set at a 2 McFarland standard. Serial dilutions up to 108 were done and the mixture was placed inside root canals and incubated at 37°C for 36 hours and evaluated for colony-forming unit (CFU)/mL counts. Results: The results of phase-1 showed that probiotics Lactobacillus rhamnosus and Bifidobacterium species are effective in fighting against E. faecalis with the acceptable zone of inhibition. The results of phase-2 showed that both the probiotics are effective against E. faecalis with a reduction in the number of CFU after probiotic usage. Conclusion: Commercially available probiotics can be used effectively as an intracanal medicament to fight against E. faecalis, Poloxamer 407 is a promising vehicle for delivering probiotics inside the root canal system. Further in vitro and in vivo studies are needed to determine the full potential of “Bacteriotherapy” with an application of probiotics. Clinical significance: If probiotics are proved to be an effective intracanal medicament against E.faecalis they can be used as an alternative to calcium hydroxide as intracanal medicament with no side effects to the host.



Soniya Hatila, Banibrata Lahiri, Gowrish Sunnanguli, Mahesh Jayachandran, Rethi Gopakumar, Konsam Bidya Devi, Mona Awad Kamil

Comparative Assessment of the Effect of Three Various Local Drug Delivery Medicaments in the Management of Chronic Periodontitis

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:6] [Pages No:162 - 167]

Keywords: Chronic periodontitis, Local drug delivery, Nonsurgical periodontal therapy, Scaling and root planing

   DOI: 10.5005/jp-journals-10024-3455  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the efficacy of three different local drug delivery medications in the treatment of chronic periodontitis. Materials and methods: Sixty participants, aged 30–55 years, were involved in the current research. Participants who fulfilled the inclusion criteria entered the study and were allocated at random to one of the three groups, each comprising 20 patients as: group A: Scaling and root planing (SRP) with local application of doxycycline gel, group B: SRP with local application of tetracycline fibers, and group C: SRP with local application of chlorhexidine gel. The plaque index (PI), the gingival index (GI), and periodontal pocket depth (PPD) were documented at baseline visit (prior to local drug delivery), and these indices were again documented 30 and 90 days post-local drug delivery. Results: At baseline, GI score for doxycycline gel use decreased from 1.38 ± 0.05 to 0.94 ± 0.02, 1.36 ± 0.11 to 0.76 ± 0.19 for tetracycline fibers use, as well as from 1.38 ± 0.10 to 0.84 ± 0.21 for chlorhexidine gel use post 90 days. The PI value at baseline for doxycycline gel use lessened from 1.26 ± 0.01 to 1.02 ± 0.06, 1.30 ± 0.14 to 0.82 ± 0.16 for tetracycline fibers use, as well as 1.30 ± 0.22 to 0.98 ± 0.11 for chlorhexidine gel use post 90 days. At baseline, PPD values for doxycycline gel use decreased from 5.88 ± 0.24 to 3.72 ± 0.11, tetracycline fibers use lessened from 5.90 ± 0.09 to 3.02 ± 0.06, as well as for chlorhexidine gel group from 5.82 ± 0.18 to 3.44 ± 0.16 post 90 days. Conclusion: Within the limitations of the current research, it may be inferred that tetracycline fibers exhibited somewhat superior enhancement to chlorhexidine as well as doxycycline gel. Clinical significance: Local administration of antibacterial agents in continued or regulated delivery arrangement is employed to augment the actions of nonsurgical periodontal management, and it may be likely to attain gingival well-being by eliminating the requirement for invasive methods with the aid of local drug delivery arrangements. Chosen elimination or prohibition of microbial pathogens with locally administered antibacterial agents coupled with SRP is an efficient move toward treatment of chronic periodontitis.



Rufida Mohamed Suliman, Fadia Awadalkreem

Knowledge and Practice of Radiation Stents for Oral Cancer Patients among the Sudanese's Maxillofacial Surgeons, Prosthodontists, Oncologists, and Radiotherapists

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:8] [Pages No:168 - 175]

Keywords: Knowledge, Oral cancer, Practice, Radiation stent, Treatment

   DOI: 10.5005/jp-journals-10024-3491  |  Open Access |  How to cite  | 


Aim: To assess the knowledge and practice of radiation stents for oral cancer patients among the Sudanese's maxillofacial surgeons, prosthodontists, oncologists, and radiotherapists in Khartoum state. Materials and methods: A self-administered questionnaire composed of three sections, including the participant's sociodemographic, knowledge, and practice data, was conducted and distributed among the specialists and Registrars of maxillofacial surgery, prosthodontics, oncology, and radiotherapy who were working at the Khartoum Teaching Dental Hospital, the Faculty of Dentistry (University of Khartoum), and the Khartoum Oncology Hospital, respectively, during the study's duration. A cluster sampling technique was used, and within the cluster group, simple randomization was used. The sample size was 137 participants. The participant's knowledge and practice scores were calculated as percentages achieved by dividing the numbers of the accurate answers of the participants by the total number of questions and categorized as good (66.6%–100%), average (33.3%–66.6%), and poor (less than 33.3%). Result: The response rate was 80%. Forty five (40.9%) of the respondents were males, and 65 (59.1%) were females. The high-frequency age-group was 30–40 years (59 subjects, 53.6%). Thirty-eight participants (75.5%) were unfamiliar with the radiation stent. The overall knowledge score was poor, with a significant difference between the different groups (p = 0.0001*). Only the prosthodontists reported a good level of knowledge about the radiation stent (73%), while the oncologists and the radiologists showed a zero level of knowledge. Despite this, the practice score of the radiation stent was poor among all groups. The level of knowledge regarding the complications of radiation and the different protective measures among the maxillofacial surgeons, oncologists, and radiotherapists was 55%, 60%, and 50%, respectively, while the prosthodontists reported 70%. Only 27 (24.5%) participants reported a multidisciplinary treatment approach. At the same time, the majority, 59.1%, declared that they do not follow a formal clinical guideline and/or protocol for dental treatment in oral cancer patients. The lack of knowledge and communication between the different health providers were the main barriers preventing the use of radiation stents. Conclusion: The knowledge and practice of the radiation stent were poor. A highlighted need was strengthened to improve the training and communication among the multidisciplinary oral cancer team members, and standard clinical guidelines and protocols need to be conducted and followed to improve patient treatment outcomes. Clinical significance: Radiation stents have a significant role in reducing the complications of radiation therapy. Improving the knowledge and practice of radiation stents will have a substantial influence on the quality of health services provided for the oral cancer patients and their quality of life.



ST Shruthi

Effect of Heated Sodium Hypochlorite Irrigant on Structural Changes and Microhardness of Radicular Dentin: An In Vitro Study

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:5] [Pages No:176 - 180]

Keywords: Fourier-transform infrared spectroscopy, Heated sodium hypochlorite, Intracanal heating, Root dentin microhardness, Root canal irrigant

   DOI: 10.5005/jp-journals-10024-3467  |  Open Access |  How to cite  | 


Aim: This study is aimed to evaluate the combined effect of sodium hypochlorite at varied concentrations and temperatures on radicular dentin microhardness along with its surface structural changes using an FTIR spectrometer. Materials and methods: Mandibular premolars were cleaned and shaped up to F3 Protaper gold rotary files, after which they were subjected to five experimental conditions – group I – neutral saline as negative control, group II – 3% NaOCl solution, group III – 5% NaOCl solution, group IV – 3% intracanal-heated NaOCl solution, and group V – 5% intracanal-heated NaOCl solution. Following this, the microhardness of radicular dentin at 100 µm and 300 µm from the canal lumen and Fourier-transform infrared (FTIR) spectroscopic analysis were performed. Results: The results showed that intracanal-heated sodium hypochlorite group reduced root dentin microhardness at 300 µm than its nonheated counterpart. No difference in microhardness values was observed between 3% intracanal-heated and room-temperature sodium hypochlorite groups at 100 µm. Reduction in amide/phosphate ratio was noted in all the groups treated with sodium hypochlorite irrespective of temperature and concentration. Conclusion: Thus, considering that the level of alteration in physical and structural changes of root dentin with or without heating is insignificant, intracanal-heated low-concentration sodium hypochlorite solutions could be used as an alternative to high-concentration sodium hypochlorite. Clinical significance: Intracanal-heated low-concentration sodium hypochlorite enables the clinicians to achieve maximum disinfection while keeping the structural and physical properties of the dentin similar to room-temperature sodium hypochlorite.



Shruti Satish Shetty, Sridhar Nekkanti

Remineralization Potential of a Novel Biomimetic Material (Self-assembling Peptide P11-4) on Early Enamel Caries: An In Vitro Study

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:7] [Pages No:181 - 187]

Keywords: Demineralization, Fluoride varnish, Remineralization, Self-assembling P11-4, White spot lesions

   DOI: 10.5005/jp-journals-10024-3490  |  Open Access |  How to cite  | 


Aim: To assess the remineralizing potential of self-assembling peptide P11-4 and compare it to the remineralizing potential of fluoride varnish using DIAGNOdentTM, as well as the amount of mineral gain after application of fluoride varnish and self-assembling peptide P11-4. Materials and methods: This study included 20 premolars extracted during orthodontic therapy with all surfaces intact and free of hypoplastic regions, white spot lesions (WSL) and dental caries. The teeth sample for Curodont RepairTM (self-assembling P11-4) and Bifluorid 10® (fluoride varnish) was equally divided. On each tooth surface, a 2 × 2 mm window was created. The samples were immersed in a demineralizing solution for 96 hours before being subjected to DIAGNOdentTM pen reading, ICDAS-II scoring, and scanning electron microscopy–energy-dispersive X-ray (SEM–EDX) analysis on one half of the sample. The remineralizing agents were applied to the second half of the sample according to the manufacturer's instructions and placed in artificial saliva for 21 days, with the artificial salvia being replaced every 24 hours. After 21 days, the second half of the sample was subjected to DIAGNOdentTM pen reading, ICDAS-II score, and SEM–EDX analysis. Results: Following remineralization, the DIAGNOdentTM pen and ICDAS-II score values differed statistically between the two groups, with the Bifluorid 10® group reporting higher mean values (p > 0.05) using t-test analysis. Energy-dispersive X-ray analysis using the t-test revealed a statistically significant result for remineralization (p < 0.05), with CurodontTM Repair group (55.150.84) reporting better mean values than Bifluorid 10® for phosphorus and calcium, but Bifluorid 10® reporting a higher result in remineralization (p < 0.05) than CurodontTM Repair for fluoride. Conclusion: CurodontTM Repair showed better remineralizing potential compared with Bifluorid 10® varnish. In terms of the mineral gain, CurodontTM Repair showed better results for calcium and phosphorus post-remineralization. Whereas Bifluorid 10® showed a higher gain in terms of fluoride. Self-assembling peptide P11-4 can be used as an alternative to fluoride varnish for remineralizing WSL. Clinical significance: Self-assembling polypeptide P11-4 is a novel remineralizing agent for initial enamel lesions, which is the least-invasive method of enamel remineralization.



Georgia Asproudi, Panagiotis Galiatsatos, Aristidis Galiatsatos

Research on the Role of Surface Treatment of the Metal Surface on the Strength of the Metal–Ceramic Bond

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:7] [Pages No:188 - 194]

Keywords: Co–Cr alloy, Metal–ceramic bond, Metal substrate, Ni–Cr alloy, Surface treatment

   DOI: 10.5005/jp-journals-10024-3492  |  Open Access |  How to cite  | 


Aim: The aim of the present study is to investigate the metal–ceramic bond strength as a result of three different surface treatment methods: (1) oxidation, (2) oxidation and sandblasting, and (3) double oxidation on the metal substrate. Materials and methods: A total of 72 metal substrates were made from two different types of metal–ceramic alloys (n = 36): group I, Ni–Cr and group II, Co–Cr alloys. Each group was further divided and subjected to three different surface treatments (n = 12): (1) oxidation in accordance with the manufacturer's instructions; (2) oxidation according to the manufacturer's instructions and then sandblasting with Al2O3, with a grain size of 110 μm, a pressure of 75 psi for 10 sec with a distance of 5 cm and steam cleaning; and (3) double oxidation. The bond strength of the specimens was evaluated with the three-point bending process. The data were recorded, tabulated, and statistically analyzed. Results: For group I, the materials with oxidation based on the specifications, show mean value of 64.02 Nt. The oxidation and sandblasting materials have mean 55.92 Nt. The double oxidation materials have mean 55.47. For group II, the materials with oxidation based on the specifications, show mean value of 58.46 Nt. The oxidation and sandblasting materials have a mean value of 42.56 Nt. The double oxidation materials have mean 42.96 Nt. Conclusion: The best method of treatment of the metal substrate is specification oxidation, in terms of the strength of the metal–ceramic bond. Further treatment of the metal substrate reduces the strength of the metal–ceramic bond. Clinical significance: A prerequisite for clinical success of metal–ceramic prosthetic restorations is the increased strength of the bond between ceramic material and metal substrate. With that in mind, the present research gives important insight into best practices for prosthetic restorations.



Sushma Bommanavar, Sujata R Kanetkar, Kailas D Datkhile

Comparative Study of Immunohistochemical Expression of Moesin and FLOT 1 in OSCC and Their Correlation with Histopathological Prognostic Factors

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:7] [Pages No:195 - 201]

Keywords: Biomarkers, FLOT 1, Moesin, Oral squamous cell carcinoma, Prognostic

   DOI: 10.5005/jp-journals-10024-3483  |  Open Access |  How to cite  | 


Aim: To study immunohistochemical (IHC) expression patterns of Moesin and FLOT 1 in oral squamous cell carcinoma (OSCC) and to correlate it with histopathological prognostic factors. Materials and methods: A cross-sectional study design was conducted on histopathologically diagnosed cases of OSCC. The inclusion criteria were carcinoma of buccal mucosa, tongue, alveolar mucosa, palate, gingiva, the floor of the mouth, retromolar area, and soft palate. The exclusion criteria included cases of squamous cell carcinoma from sites other than the oral cavity, potentially malignant disorders (PMDs), and any pseudomalignancies of the head and neck. Tissue sections were subjected to IHC staining for Moesin and FLOT 1 and the results were subjected to statistical analysis. Results: Moesin showed strong positivity and was significantly associated with the histopathological variables such as lymph nodes and the worst pattern of invasion, whereas FLOT 1 was not associated with any clinical, histopathological, or demographical variable in this study. Conclusion: Cytoplasmic detection of Moesin (35.19%) was higher than FLOT 1 (15.74%). There was no statistically significant relationship between the grade of the lesion and Moesin and FLOT 1. Clinical significance: New emerging prognostic biomarkers can aid to assess the rate of malignant transformation (epigenetic and molecular changes), thereby resulting in early prophylactic conciliation of the disease progression in OSCC. There is an urgent need for introducing these as an interventional therapy for effectively addressing OSCC at an early stage, thus preventing it from further proceeding to the advanced severe stage.



Efthimia Chalvatzoglou, Filomeni Anagnostou, Konstantinos Arapostathis, Vasiliki Boka, Aristidis Arhakis

Assessment of Young Mothers’ Oral Hygiene Practices during Pregnancy and Their Knowledge of Children's Oral Health in Northern Greece

[Year:2023] [Month:March] [Volume:24] [Number:3] [Pages:5] [Pages No:202 - 206]

Keywords: Children, Early childhood caries, Oral health, Oral hygiene practices, Pregnancy, Young mothers

   DOI: 10.5005/jp-journals-10024-3494  |  Open Access |  How to cite  | 


Aim: The aim of the study was to assess maternal knowledge about oral health practices for children along with oral hygiene perceptions of mothers during pregnancy in the city of Thessaloniki, Greece. Materials and methods: This cross-sectional study was conducted among 300 newly delivered mothers who were admitted to the obstetrician/gynecological (OB/GYN) University Clinic in Thessaloniki, Greece, to give birth. A three-part, self-reported, 40-item questionnaire was designed, collecting socioeconomic data, perceptions, and practices regarding maternal oral hygiene during pregnancy and their knowledge in relation to children's oral health. Collected data were recorded, tabulated, and statistically analyzed with SPSS (Version 24.0), and p < 0.05 was accepted as statistically significant. Results: The sample consisted of mainly Greek, married, university alumni mothers less than 35 years of age. Self-reports of oral hygiene practices during gestation were sufficient but an inadequate level of regular dental visits was recorded. Poor knowledge was equally noted, regarding children's oral health, in the domains of fluoride toothpaste usage, the age of the first dental visit, supervised toothbrushing, nighttime breastfeeding, potential hazards of pacifier use, and thumb sucking. All factors were significantly associated with the mothers’ education level (p < 0.05). Conclusion: Newly-delivered mothers presented with a lack of knowledge regarding mother/caregiver-related risk factors associated with early childhood caries (ECC), the timing of establishing a dental home, and misconceptions about the safety of dental visits during pregnancy. Clinical significance: Healthcare professionals interacting with pregnant women or young mothers are a vital element to bridge the existing gap in knowledge and assist those socially and educationally deprived.


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