Except for the occasional case report, there are no studies evaluating the success rate of osseointegrated dental implants in individuals infected with the human immunodeficiency virus (HIV). This study investigated the short-term clinical outcome of implant placement in a group of HIV-positive and HIV-negative individuals who required complete dentures.

Edentulous subjects were recruited from an HIV-dedicated clinic and a dental school clinic. Two BioHorizons® dental implants were placed in the anterior mandible to support an overdenture opposing a maxillary denture. Outcome measurements obtained six months after activation of implants were presence of pain, mobility, soft tissue status, and radiographic bone level. Descriptive statistics were used.

Twenty-nine edentulous adults, including 20 HIV-positive subjects (test) and nine HIV-negative subjects (control), participated. The test group had six females, 14 males; 13 Whites, four African-Americans, and three Hispanics with a mean age of 48.9 years (range: 35-59). The mean CD4 count was 467 cells/mm3 (range: 132-948). The control group had six females, three males; seven Whites, and two Hispanics with a mean age of 65.3 years (range: 50-82). Short-term success rate was 100% for both groups. No difference in clinical outcome was found between the groups.

This study demonstrated dental implants are well tolerated and have predictable outcomes for HIV-infected individuals for the duration of the study and probably over an even longer term.

Stevenson GC, Riano PC, Moretti AJ, Nichols CM, Engelmeier RL, Flaitz CM. Short-term Success of Osseointegrated Dental Implants in HIV-positive Individuals: A Prospective Study. J Contemp Dent Pract 2007 January;(8)1:001-010.

The aims of this in vitro study were to evaluate debris and smear layer elimination capability effectiveness of 5.25% sodium hypochlorite (NaOCl) after calcium hydroxide removal from the root canal and to determine if ethylenediaminetetraacetic acid (EDTA) and citric acid have any additional effects on debris and smear layer removal.

All irrigation regimens are associated with ultrasonics. Thirty-six pulpless single-rooted teeth were divided into three groups on the basis of the irrigation regimen, namely 5.25% NaOCl alone, 5.25% NaOCl with 17% EDTA pH 7 (NaOCl-EDTA), and 5.25% NaOCl with 50% citric acid (NaOCl-CA). All root canals were instrumented with the Protaper® rotary system (Dentsply-Maillefer, Ballaigues, Switzerland) using a crowndown approach. The apical foramen of each tooth was enlarged to a size 30 with a 0.09 taper. After longitudinal sectioning, the dentin walls were microphotographed using scanning electron microscopy (SEM) at a 1500X magnification. Using a grid and a 5-step scale these microphotographs were scored by three investigators in order to evaluate debris and smear layer residuals. Data were statistically evaluated using Kruskal-Wallis and Mann-Whitney tests.

In the coronal third the lowest score obtained with NaOCl-CA was similar to NaOCl-EDTA. When using NaOCl-EDTA, mean debris scores were similar to the control group (NaOCl) and lower than NaOCl-CA in the middle and apical thirds. Regarding the mean smear layer score, NaOCl-CA was the lowest in the coronal, middle, and apical thirds with a statistically significant difference (p< 0.001).

When the total surface of the root was evaluated, NaOCl-EDTA was superior in removing debris, but the association of NaOCl-CA enabled the most effective removal of the smear layer.

Naaman A, Kaloustian H, Ounsi HF, Naaman-Bou Abboud N, Ricci C, Medioni E. A Scanning Electron Microscopic Evaluation of Root Canal Wall Cleanliness after Calcium Hydroxide Removal Using Three Irrigation Regimens. J Contemp Dent Pract 2007 January;(8)1:011-018.

The purpose of this in vitro study was to investigate the marginal accuracy and internal fit of complete cast crowns and three-unit fixed partial dentures (FPDs) cast with commercially pure titanium (CPTi) and Titanium-Aluminum-Vanadium alloy (Ti-6Al-4V).

CPTi and Ti-6Al-4V alloy were used to cast twelve single crowns and twelve three-unit FPDs. A traveling microscope was used to measure marginal gap and discrepancies in internal fit. Two and oneway analysis of variance (ANOVA) analyses were used to determine the effects of the marginal and internal fit discrepancies.

The Ti-6Al-4V alloy demonstrated a significantly smaller marginal gap than CPTi (P<0.0001). The recorded marginal discrepancies for both metals were within a clinically accepted range (<100 ìm). The single crown fit discrepancy was significantly smaller than the three-unit FPD for both the CPTi and the Ti-6Al-4V alloy (P<0.0001). For the internal fit discrepancy, the occlusal surface showed the greatest gaps.

The Ti-6Al-4V alloy demonstrated a better fit than CPTi. Single crowns showed an improved fit when compared with the three-unit FPD. Mid-occlusal internal gap demonstrated greater values than the axial internal gap.

This in vitro study suggested marginal fit of complete crowns and three-unit FPDs cast by CPTi or Ti-6Al-4V alloy were within the range of what is clinically acceptable for longevity of restorations.

Al Wazzan KA, Al-Nazzawi AA. Marginal and Internal Adaptation of Commercially Pure Titanium and Titanium-Aluminum-Vanadium Alloy Cast Restorations. J Contemp Dent Pract 2007 January;(8)1:019-026.

The aims of this study were to evaluate the effect of various finishing and polishing procedures on the surface roughness of six different composite resin materials (Artemis Enamel, TPH Spectrum, Filtek A–110, Filtek Supreme Enamel, Solitaire 2, and Filtek P–60) as well as to evaluate the effectiveness of the surface sealant application (BisCover) on the surface roughness after finishing and polishing procedures of tested composites.

Specimens (n=168) measuring 5 mm in diameter x 2 mm in thickness were fabricated in a plexiglass well covered with a Mylar strip using six composite resins. A control group of seven specimens of each material received no polishing after being cured under the Mylar strip. Twenty-one specimens for each composite were randomly divided among three finishing and polishing groups (n=7). Each group was polished using a different system: Carbide bur/Sof-Lex disc, Carbide bur/Enhance disc with polishing paste, and Carbide bur/Edenta composite finishing kit. The average surface roughness (Ra, ìm) of the control and treated specimens were measured with the Mitutoyo Surftest–402 Surface Roughness tester. After a surface sealant (BisCover) was applied to all treated specimens, according to manufacturer's instructions, the average roughness (Ra) was measured again. Results were statistically analyzed using analysis of variance (ANOVA) and the post-hoc Scheffe's test at a p<0.05 significance level.

Significant differences were found for the surface roughness (p<0.05) with interaction among composite resins and the finishing systems used (p<0.05). Enhance/Biscover finishing and polishing procedure surface was not significantly different from the Mylar strip surface groups (p>0.05). The Mylar strip group was not significantly different from the Sof-Lex/BisCover and Edenta/BisCover groups. The ranking of mean Ra values by materials was as follows: Filtek Supreme Enamel < Filtek A110 < TPH Spectrum < Artemis <Filtek P–60 < Solitaire 2. The ranking of mean Ra values by polishing systems was as follows: Enhance/BisCover < Mylar Strip < Sof-Lex/BisCover < Edenta/BisCover < Sof-Lex < Enhance < Edenta.

Smoother surfaces were recorded for the Enhance/BisCover and the Mylar strip-formed surface groups. The composite finishing kit Edenta significantly increased the Ra for all tested composites (p<0.05). But after finishing with Edenta, the use of a surface sealant (BisCover) significantly improved the surface smoothness of all tested composites (p<0.05). Use of BisCover surface sealant on anterior and posterior resin composite restorations after finishing and polishing procedures is recommended.

Attar N. The Effect of Finishing and Polishing Procedures on the Surface Roughness of Composite Resin Materials. J Contemp Dent Pract 2007 January;(8)1:027-035.

A unique characteristic of some new bonding systems in operative dentistry is they combine conditioning and priming agents into a single acidic primer solution for simultaneous use on both enamel and dentin. Combining conditioning and priming into a single treatment step results in improvement in both time and costeffectiveness to the clinician and, indirectly, to the patient. The purpose of this study was to determine the effects of the use of a self-etching primer on the bond strength of orthodontic brackets and on the bracket/ adhesive failure mode.

Thirty-six fresh bovine incisors were collected and stored in a solution of 0.1% (weight/volume) thymol. The criteria for tooth selection included intact buccal enamel, no cracks caused by the presence of the extraction forceps, and no defects. The teeth were cleansed and polished with pumice and rubber prophylactic cups for ten seconds. Brackets were bonded to the teeth according to one of three protocols following the manufacturers’ instructions - Group 1: Conventional multistep bonding system (control group) (n=12); Group 2: Self-etching primer system (n=12); and Group 3: Acid+self-etching primer system (n=12). Specimens were loaded to failure in a Zwick test machine (Zwick GmbH & Co, Ulm, Germany). Shear bond strengths were measured at a crosshead speed of 5 mm/min.

The mean shear bond strength in megapascals (Mpa) (standard deviation) were 11.7 (4.2), 10.5 (4.4), and 10.9 (4.8) for Groups 1, 2, and 3, respectively. The analysis of variance (ANOVA) was used to compare the three groups. The results indicated no significant difference in the bond strength between the three groups (P=0.800). The results of the Chi square test, evaluating the residual adhesives on the enamel surfaces, revealed no significant difference between the three groups (P=0.554).

Results of the present in vitro study indicate the use of self-etching primers may be an alternative to conventional phosphoric acid pre-treatment in orthodontic bonding.

Davari AR, Yassaei S, Daneshkazemi AR, Yosefi MH . Effect of Different Types of Enamel Conditioners on the Bond Strength of Orthodontic Brackets. J Contemp Dent Pract 2007 January;(8)1:036-043.

The aim of this study was to evaluate the fracture resistance of various provisional crown materials using an in vitro model test system.

In the present study polycarbonate crowns, prefabricated by the manufacturer (3M Polycarbonate Crown), and the temporary crowns, fabricated in the dental laboratory environment, were fabricated using bis-acryl composite (Protemp II), autopolymerizing PMMA resin (BISICO Temp S), and heatpolymerized PMMA resin (Major C&B-V Dentine). All temporary crowns were stored in distilled water for 24 hours at room temperature prior to testing. The crowns were seated on metal dies, fabricated from Cr-Co alloy (AZ Dental, Konstanz, Germany), and then tested using the indenter of a Hounsfield testing machine (Hounsfield Tensometer, Hounsfield Test Equipment, Raydon, England). The tip of the indenter was located at a position one-third of the way down the inciso-palatine surface at 135°. The data were statistically analyzed for differences using one-way analysis of variance (ANOVA) and the Tukey HSD test (P<.05). Additionally, the types of failure obtained from the fracture load test were examined using 10X magnification with a stereo microscope.

The results of the present study indicated polycarbonate crowns were significantly different from the BISICO Temp S, Protemp II, and Major C&B-V Dentine (P<.05) groups.

This in vitro study shows polycarbonate crowns may be preferable to the other types of temporary crowns used in this study.

Yilmaz A, Baydaş S. Fracture Resistance of Various Temporary Crown Materials. J Contemp Dent Pract 2007 January;(8)1:044-051.

Extraction healing complications have been attributed to several factors. The influence of trans-operative complications on an extraction site wound healing was the focus of this investigation.

This prospective study was conducted at the Oral Surgery Clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (LUTH) in Nigeria . Subjects selected were those referred for one or two adjacent extractions and who satisfied the inclusion criteria for the study. The relevant pre-operative information recorded for each patient were age and sex of patient, indications for extraction, time taken to extract the tooth, tooth/teeth removed, and any trans-operative complications. Extractions were performed with dental forceps, elevators, or both under local anaesthesia. Patients were blindly evaluated on the third and seventh post-operative day for socket healing assessment without reference to preoperative information on the patients.

Seventy-three (24.25%) of 301 teeth considered for socket healing assessment had various transoperative complications due to accidental crown, root, or alveolar bone fractures. Of the 73 extractions with trans-operative complications during extraction, 18 developed a socket healing complication, while 17 of the 228 extractions without trans-operative complications developed socket healing complications (p = .000). The mean (SD) time taken to extract teeth developing healing complications was also found to be significantly longer than those without healing complications (p < .01).

The study demonstrated the combination of tooth/bone fragments in the socket and increased time of extraction due to trans-operative complications and accidents predispose to the development of extraction site wound healing disturbance.

Adeyemo WL, Ladeinde AL, Ogunlewe MO. Influence of Trans-operative Complications on Socket Healing Following Dental Extractions. J Contemp Dent Pract 2007 January;(8)1:052-059.

This study was conducted to estimate the prevalence of self reported medical conditions among dental patients attending dental teaching clinics in north Jordan.

A total of 1,509 patients were included, of which 46.1% were males and 53.9% were females. All age groups were included and ranged between 14 and 78 years. The findings were analyzed in relation to age and gender.

Overall, gastrointestinal disease was most prevalent (11.9%), followed by bleeding tendencies (9.3%), renal disorders (8.7%), respiratory disease (8.3%), and hypertension (6.4%). Only 3.2% of the participants reported having antibiotics prescribed for them prior to a dental procedure for prophylactic purposes.

Due to the high frequency of medical conditions, thorough evaluation of patients’ medical and dental care histories should be a mandatory first step in their management.

Khader YS, Alsaeed O, Burgan SZ, Amarin ZO. Prevalence of Medical Conditions Among Patients Attending Dental Teaching Clinics in Northern Jordan. J Contemp Dent Pract 2007 January;(8)1:060-067.

This study was conducted to test the null hypothesis that no difference exists in the oral hygiene knowledge and practices of university students in different courses when they have equal opportunity to access health-promotive dental care.

The study was conducted using 120 students each from the medical and engineering colleges at the University of Manipal Academy of Higher Education who had easy access to the dental college within the campus which provides health-promotive dental care to all its patients. A self-administered structured questionnaire consisting of questions on demographic data, oral hygiene knowledge and practices, and dental service utilization patterns was distributed among the students. The data collected was analyzed using SPSS 10 version.

Statistically significant differences were found between the two groups with respect to the knowledge of fluoridated toothpastes, frequency of toothbrush renewal, use of dental floss, and a tongue cleaner (p<0.001). The groups were similar in all other practices including the utilization of dental services. There were no significant differences between the self-reported oral hygiene knowledge and practices among medical and engineering university students, but the knowledge levels of the students were considerably lower than expected.

Doshi D, Baldava P, Anup N, Sequiera PS. A Comparative Evaluation of Self-Reported Oral Hygiene Practices Among Medical and Engineering University Students with Access to Health-promotive Dental Care. J Contemp Dent Pract 2007 January;(8)1:068-075.

Abidia RF. Oral Care in the Intensive Care Unit: A Review. J Contemp Dent Pract 2007 January;(8)1:076-082.

Shinohara EH, Horikawa FK, Ruiz MM, Shinohara MT. Tongue Piercing: Case Report of a Local Complication. J Contemp Dent Pract 2007 January;(8)1:083-089.

Şengün D, Hatipoğlu H, Hatipoğlu MG. Long-term Uncontrolled Hereditary Gingival Fibromatosis: A Case Report. J Contemp Dent Pract 2007 January;(8)1:090-096.