The Journal of Contemporary Dental Practice

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2023 | May | Volume 24 | Issue 5

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Sahana Shivakumar

Veganism and Oral Health: A Way of Living

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:3] [Pages No:275 - 277]

   DOI: 10.5005/jp-journals-10024-3507  |  Open Access |  How to cite  | 



AC Smriti Aryal, Maryam Fuad Abry, Noor Sayed Majed Salman, Zainab Mohamed Ahmed

Inhibition of Silver Diamine Fluoride-induced Tooth Discoloration by Using Natural Antioxidant: In Vitro Study

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:7] [Pages No:278 - 284]

Keywords: Alpha lipoic acid, Antioxidant, Ascorbic acid, Bonding materials, Silver diamine fluoride, Tooth discoloration

   DOI: 10.5005/jp-journals-10024-3512  |  Open Access |  How to cite  | 


Aim: Silver diamine fluoride (SDF) is a well-known caries preventive aid capable of arresting carious lesions and preventing secondary caries formation. Despite having the caries prevention potential, the clinical use of SDF is limited due to the tooth discoloration caused by SDF. The objective of this study was to evaluate the efficiency of natural antioxidants to inhibit SDF-induced tooth discoloration. Materials and methods: A total of 32 bovine teeth were polished to create a 6 mm circular window on the middle 1/3 (for enamel) or on the cervical 1/3 (for dentin) of the labial surface. Specimens were treated either with SDF alone or SDF followed by ascorbic acid (AA)/alpha lipoic acid (ALA)/7th generation bonding materials. The color parameters Lightness (L*), Chroma (C*), and Hue (H*) of the tooth window were measured at pretreatment, 1-hour, 1-week, and 1-month posttreatment using a digital color chromometer. Results: Repeated measure ANOVA showed a significant tooth color alteration at 1-hour posttreatment. The L* and H* values dropped and C* value elevated significantly in 1-hour posttreatment measurement. All experimental groups showed significant tooth color alteration after treatment (p < 0.05) and were unable to reverse the discoloration even after 1-month period except the ALA group which did not show any significant (p > 0.05) color alteration compared with the pretreatment value. Conclusions: Within the limitation of the in vitro model and according to the results of this study, it can be concluded that ALA has the potential to prevent SDF-induced tooth discoloration; however, AA was unable to prevent the discoloration. Clinical significance: SDF induces discoloration of enamel and dentin can be reversed by applying Alpha lipoic acid immediacy after SDF application.



Reem Mahmoud, Noha Kabil, Mariem Wassel

Cone–Beam Computed Tomography Evaluation of Rotary MM Files vs Manual K Files in Primary Molars: An In Vitro Study

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:11] [Pages No:285 - 295]

Keywords: Cone–beam computed tomography, K files, MM rotary file, Primary molars, Primary teeth, Pulpectomy, Randomized controlled trial, Rotary instrumentation

   DOI: 10.5005/jp-journals-10024-3513  |  Open Access |  How to cite  | 


Aim: Rotary instrumentation in pediatric dentistry is an emerging concept, thus this study was performed to evaluate the remaining dentine thickness (RDT), canal transportation, centering ability, quality of obturation using cone–beam computed tomography (CBCT), and the time efficiency of rotary versus manual instrumentation in mandibular second primary molars. Materials and methods: Forty mandibular primary second molars (160 canals) were randomly and equally allocated to four groups. Instrumentation was done using K files in groups I and II; in each group, the obturation was done by two different obturation techniques; incremental technique and disposable syringe technique, respectively. MM rotary files (Innovative Material and Devices, Inc. [IMD], Shanghai, China) were used in groups III and IV; in each group, the obturation was done by incremental technique and disposable syringe technique. Preoperative and postoperative CBCT scans were performed and evaluated for the RDT, centering ability, canal transportation, and the canal filling quality, which was assessed as (underfill, optimal fill, and overfill). Instrumentation time was recorded for groups I and II collectively (manual instrumentation), and groups II and III collectively (rotary instrumentation). Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey tests, at p < 0.05). Results: The MM rotary file removed a significantly less amount of dentine at all levels specifically at the middle section (p = 0.003). The canal transportation was significantly higher in the manual group at the cervical level (p = 0.022). In all sections, the rotary group had significantly higher values of centering ratio than the manual group (p < 0.05), which means a lower deviation of rotary instruments. For both types of files, there was no significant difference between different obturation techniques (p > 0.05). Instrumentation time was significantly lower in the rotary group (p < 0.001). Conclusion: Regarding the dentine removal and the shaping ability of MM files acceptable results were obtained; however, no significant difference between the different obturation techniques. Notable time efficiency was reported in the rotary files as well. Clinical significance: The use of rotary files resulted in better conservation of tooth structure, better canal centering, and obturation quality as well as less canal transportation and less instrumentation time compared to manual K files.



Asim Ibrahim Manqari, Safieh Ahmad Kuriri, Lujain K Mokli, Shada Mohammed Alsam, Rami H Eshaq, Atlal Hassan Hussain Jaafari, Abdullah Essa Alhazmi, Satish Vishwanathaiah

Knowledge and Attitude of Undergraduate Students and Interns toward Stem Cells and Their Implications in Dentistry: A Cross-sectional Study

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:7] [Pages No:296 - 302]

Keywords: Attitude, Dental stem cells, Dental students, Interns, Knowledge

   DOI: 10.5005/jp-journals-10024-3506  |  Open Access |  How to cite  | 


Aim: The primary ideology of this research was to evaluate both the knowledge and attitude of undergraduate students and interns regarding stem cells and their use in dentistry. Materials and methods: A cross-sectional observatory study was conducted among 310 dental students of Jazan University by making use of a self-explanatory questionnaire, containing a set of 25 questions and was sent as e-mail through Google e-forms. Results: There was a good response rate of around 81.2%, of which 80.16% were aware of the fact that stem cells are unspecialized types of cells that come with the potential to turn into any cell type. Almost 65.08% of the participants considered the possibility to continue root formation post-trauma as the fundamental use of stem cells, and a majority (71.43%) of the participants showed great interest in garnering more knowledge and training in the area of stem cells. About 50% of the participants showed strong opposition to the concept of embryonic stem cells as these are basically fetched from an aborted fetus or from an embryo. There was a major section of the participants (79.76%) who were even keen on organizing more programs to create public awareness regarding stem cells. Mean knowledge and attitude scores among the participants were reported to be 7.57 ± 3.10 and 36.04 ± 6.51 respectively. Conclusion: Overall, the level of knowledge and attitude of dental students and interns at Jazan University towards stem cells and their implications in dentistry can be interpreted as adequate. Clinical significance: Advanced training and awareness campaigns on stem cells and dentistry would improve their knowledge and attitude.



Ramya Rajendran, Sudhakar Venkatachalapathy, Balavignesh Thiyagarajan, Sruthi Jeevagan, Anandadevi Chinnasamy, Muruganandam Sivanandham

Effect of Mobile Phone with and without Earphones Usage on Nickel Ion Release from Fixed Orthodontic Appliance

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:5] [Pages No:303 - 307]

Keywords: Ear-phones, Fixed orthodontic appliance, Mobile phones, Nickel, Saliva

   DOI: 10.5005/jp-journals-10024-3475  |  Open Access |  How to cite  | 


Introduction: This study is an attempt to assess whether the usage of headphones could minimize the nickel ion release from fixed orthodontic appliance compared with hand-held mobile phones. The aim of the study is to validate the hypothesis whether there is a significant variation in nickel ion release from fixed orthodontic appliance among the patients using hand-held mobile phones and patients using mobile earphones. Materials and methods: This is a cross-sectional study where a total of 60 healthy individuals who were undergoing fixed orthodontic treatment in the Department of Orthodontics and Dentofacial Orthopedics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Chennai, India, and all these individuals were bonded and banded. All of them are class I malocclusion with bimaxillary protrusion. Salivary samples were collected in their regular checkup after two months and 7th, 14th, and 21st days salivary nickel level was evaluated based on their usage of mobile phones with earphones and without earphones. Results: In this study, paired and independent t-tests were used. On basis of statistics results, the mean of nickel release in both male and female participants using mobile phones without earphones were significantly higher than the participants using mobile phone with earphones. Conclusion: By our study, we concluded that usage of mobile phones with earphones has a significant reduced effect on metal ion release from fixed orthodontic appliance when compared to usage of mobile phones without earphones.



Remmiya Mary Varghese, Subramanian Aravind Kumar, Yogesh Selvaraj

Assessment of Soft Tissue, Airway Dimension and Hyoid Bone Position in Class II Patients Treated by PowerScope Class 2 Corrector

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:6] [Pages No:308 - 313]

Keywords: Hyoid bone, Malocclusion, Oropharyngeal air spaces, PowerScope Class 2 corrector, Soft tissue

   DOI: 10.5005/jp-journals-10024-3485  |  Open Access |  How to cite  | 


Aim: This study aims to assess the changes in the soft tissue, pharyngeal airway dimensions, and hyoid bone position in patients treated with PowerScope Class 2 corrector to correct the skeletal Class II pattern. Materials and methods: This study was conducted on a sample of 20 cases diagnosed with Class II malocclusion. The lateral cephalograms were taken before (T1) and after functional appliance therapy (T2) and were traced. The outcomes were compared for the mean changes in soft tissue, airway way dimension, and hyoid bone position. The paired t-test was used for the data comparisons wherein p < 0.05 was kept for statistical significance. Results: The mean values before and after treatment for H angle, mentolabial angle, lower lip E-line, upper lip S-line, lower lip S-line, and lip strain were 19.88 ± 2.77 vs 17.13 ± 1.659, 94.09 ± 12.164 vs 101.75 ± 11.28, –2.47 ± 1.213 vs –1.38 ± 0.976, 3.99 ± 0.19 vs 2.64 ± 0.32, 9.01 ± 0.247 vs 9.43 ± 0.238, 10.24 ± 0.510 vs 10.64 ± 0.52, respectively, which were statistically significant (p < 0.05). All airway spaces (except for lower pharyngeal space) and hyoid bone parameters were significantly improved posttreatment. Conclusion: The facial convexity, upper E-line, Z-angle, nasolabial angle, and lower pharyngeal space did not show statistically significant changes. The rest of the soft tissue parameters, oropharyngeal air spaces, and hyoid positioning measured in the study showed significant improvement after treatment with the PowerScope appliance in Class II patients. Clinical significance: Class II malocclusion is the most common dental anomaly with a high degree of prevalence in the population. This study will help the clinician in understanding the improvement of soft tissue, airway dimension, and hyoid bone position changes on treatment with a fixed functional appliance for the correction of Class II cases, thereby ensuring the greater success of orthodontic therapy in the future.



Gheerthana Venkatesh, Dakshayani Balaji

Efficacy of Chitosan Scaffolded Calcium Silicate-based Cements for Treating Internal Resorption Defects with Perforation: In Vitro Study

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:6] [Pages No:314 - 319]

Keywords: Biodentine, Calcium silicate cements, Chitosan scaffold, Internal resorption, Perforating resorption, Scanning electron microscope

   DOI: 10.5005/jp-journals-10024-3504  |  Open Access |  How to cite  | 


Aim: The present study aimed to evaluate the efficacy of chitosan scaffold combined with calcium silicate cements in the management of internal resorption with perforation. Materials and methods: Internal resorption cavities were simulated in 20 human permanent maxillary incisors that were then divided into two groups: group I – biodentine and group II – chitosan scaffold combined with biodentine. The samples were evaluated for the mineralization activity at the end of the 7th day and 14th day using scanning electron microscopy–energy dispersive X-ray (SEM–EDX) analysis. The data were recorded, tabulated, and then statistically analyzed. Results: From the SEM–EDX analysis, the mean score of calcium and phosphorus ion uptake by the material was obtained. Statistical analysis by nonparametric Mann–Whitney test showed that there was statistically significant difference in calcium ion uptake at the end of the 7th day (p = 0.016) and at the end of 14th day (p = 0.043) between the group biodentine and group chitosan scaffold combined with biodentine (p < 0.05). Conclusion: In this present study, the use of chitosan scaffolds combined with biodentine showed a statistically significant difference in the mineralization activity when compared with pure biodentine. These scaffolded biomaterials exhibited greater potential for mineralization in vitro which can be efficiently used for the management of teeth with internal resorption with perforation. Further clinical trials are required for the understanding of their behavior in real-world scenarios. Clinical significance: Calcium silicate cements have often exhibited defective hard tissue barrier formation and hence there is a pressing need to search for newer biomaterials that can overcome these shortcomings. Scaffolded biomaterials provide a controlled microcellular environment for bioactivity, and they were found to be efficient in the remineralization of tooth structure. The present study findings indicate that these chitosan scaffolds can be efficiently used in combination with calcium silicate cements for the management of internal resorption with perforation to enhance the treatment outcome.



Nadia Rasool, Satwady Vidhyadhara Shetty, Prathap Mulakkal Sreekantan Nair, Nishi Jayasheelan, Jayaprakash Kukkila

Evaluation of the Effect of Different Antioxidants on Resin Bond Strength to Enamel after Bleaching: An In Vitro Study

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:5] [Pages No:320 - 324]

Keywords: α-Lipoic acid, Herbal antioxidants, Pomegranate peel extract, Propolis, Shear bond strength, Sodium ascorbate

   DOI: 10.5005/jp-journals-10024-3502  |  Open Access |  How to cite  | 


Aim: To compare and evaluate the efficacy of 10% sodium ascorbate (SA) solution, 10% alpha-lipoic acid (ALA) solution, 10% propolis solutions (PLS), and 10% pomegranate peel extract (PPE) solution on the shear bond strength (SBS) between composite resin and bleached enamel after 60 minutes. Materials and methods: Ninety extracted teeth were divided into 6 subgroups (n = 15) based on the antioxidant applied: Group I: Bleaching + application of 10% SA solution for 60 minutes. Group II: Bleaching + application of 10% ALA solution for 60 minutes. Group II: Bleaching + application of 10% PLS for 60 minutes. Group IV: Bleaching + application of 10% PPE solution for 60 min. Group V: Positive control (PC) bleaching without antioxidant application. Group VI: Negative control (NC) specimen neither subjected to bleaching nor application of an antioxidant solution. About 35% hydrogen peroxide (HP) was used for bleaching the labial surfaces in the groups considered. Labial surfaces were then bonded with composite using a customized cylindrical mold followed by storage in distilled water for 24 hours and shear bond strength was tested using universal testing machine. Results: The mean shear bond strength values for groups I, II, III, IV, V, and VI are 5.04, 2.29, 5.02, 4.07, 1.42, and 9.08 respectively. The peak shear bond strength value is obtained for the negative control group; whereas the lowest mean SBS value is obtained for the positive control group. Conclusion: All herbal extracts used in the present study have demonstrated a reversal of reduced SBS between resin composite and bleached enamel surface. Clinical significance: The reduction in bond strength of adhesive restorations was conventionally overcome by delaying the bonding procedure for a specified period resulting in prolonged treatment duration and multiple appointments. Sodium ascorbate is most commonly used but it is postulated to form a porous scaffold capable of harboring bacteria. Herbal antioxidants are gaining popularity in this regard as they are naturally derived, effective and affordable phytochemicals in addition to being viable alternatives against drug-resistant strains of microorganisms.



T Nishna, Amith Adyanthaya, Ann Meera Johnson, Jipsa Venugopal, Malini Venugopal, RV Anju

Estimation of the Efficacy of Remineralizing Agents on the Microhardness of Deciduous Teeth Demineralized Using Pediatric Formulations

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:12] [Pages No:325 - 336]

Keywords: Clinpro Tooth Crème, CPP-ACP, Dental erosion, f-TCP, GC Tooth Mousse, Pediatric syrups, Remineralizing agents

   DOI: 10.5005/jp-journals-10024-3505  |  Open Access |  How to cite  | 


Aim: This study aimed to evaluate the demineralizing effect of commonly used pediatric syrup formulations on primary teeth and the efficacy of two readily available remineralizing agents in treating this effect. Materials and methods: Ninety primary teeth were used for sample preparation and divided into three groups: antibiotic syrup (group A), cough syrup (group B), and control (group C) groups. These groups were further categorized into intragroups according to the treatment with remineralizing agents: groups A1, B1, and C1 received GC Tooth Mousse (casein phosphopeptide-amorphous calcium phosphate, CPP-ACP paste) and groups A2, B2, and C2 received Clinpro Tooth Crème. The samples were subjected to a series of demineralization cycles for 14 days, and remineralization cycles until 30 days were performed using two remineralizing agents, that is, GC Tooth Mousse (CPP-ACP paste) and Clinpro Tooth Crème and were evaluated using Vicker's microhardness test. Results: Antibiotic syrup (group A) and cough syrup (group B) showed a significant decrease in surface microhardness compared with control (group C). All intragroups showed an increase in surface microhardness after treatment with remineralizing agents, which was significantly higher in intragroups A1, B1, and C1 treated with GC Tooth Mousse (CPP-ACP paste). Conclusions: Oral liquid medications showed definite demineralization potential. CPP-ACP paste was found to be better than Clinpro Tooth Crème for demineralized teeth. Clinical significance: The use of over-the-counter drugs has increased among the average Indian population, especially for the treatment of fever, cold, and cough. Unwise use of medications by the present population without proper medical guidance will lead to irreparable changes in future generations.



Balaji Dhakshinamurthi, Manigandan Kuzhanchinathan

Cyclic Fatigue Resistance of Different Glide Path Files in Simulated Double Curved Canal in Continuous Rotary Motion: An In Vitro Study

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:5] [Pages No:337 - 341]

Keywords: Cyclic fatigue, Double curvature, Glide path files, TruNatomy files

   DOI: 10.5005/jp-journals-10024-3510  |  Open Access |  How to cite  | 


Aim: This in vitro study aimed to compare and evaluate the resistance to cyclic fatigue of a newly developed glide path file in a simulated double curvature canal in a cyclic fatigue-testing machine. Methods: In this in vitro study, a static cyclic fatigue-testing machine with a simulated double curve was created and the samples were divided into the following three groups: Group I—HyFlex EDM; group II—TruNatomy file; and group III—Aurum G files and each instrument is continued to rotate in the canal and a number of cycles to failure (NCF) was calculated and Fractographic analysis was done using scanning electron microscope (SEM), and the results were statistically analyzed. Results: Statistical analysis was done using parametric methods one-way analysis of variance (ANOVA) shows statistical significance between groups and then Tukey's HSD post hoc tests were used for multiple pairwise comparisons. TruNatomy glide path files had the highest cyclic fatigue resistance when compared to HyFlex EDM and Aurum G files. Conclusion: The selection of file systems in cleaning and shaping protocols is an enigma to endodontics. From the results of this study, it can be concluded that TruNatomy files had higher cyclic fatigue resistance than other glide path files are canals with double curvature, hence it is suitable for usage in root canals with extreme curvature. Clinical significance: The selection of file systems in cleaning and shaping protocols is an enigma to endodontics. This in vitro study explored the selection protocols for the execution of root canal preparation. Heat treatment of nickel–titanium (NiTi) endodontic files had improved the cyclic fatigue resistance significantly enhancing the clinical life of file systems.



Maram A Alahmari

Treatment of Cases with Different Grades of Fluorosis by Lithium Disilicate Glass-Ceramic CAD/CAM Materials: A Case Report of Two Cases

[Year:2023] [Month:May] [Volume:24] [Number:5] [Pages:7] [Pages No:342 - 348]

Keywords: Dental fluorosis, Fluorosis index, Lithium disilicate glass-ceramic, Microabrasion, Resin infiltration

   DOI: 10.5005/jp-journals-10024-3461  |  Open Access |  How to cite  | 


Over exposure to high amount of fluoride during the development of enamel leads to fluorosis. Dental fluorosis is considered to be the most common color disorders of the enamel. It presents with different clinical signs on the enamel of the patients. The diagnosis of dental fluorosis is very challenging in the clinical practice since the enamel defects could be confusing. This case report presented two cases and their treatment for different grades of dental fluorosis to improve the esthetic appearance of the teeth.


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