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   Table of Contents - Current issue
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May-June 2019
Volume 16 | Issue 3
Page Nos. 131-207

Online since Tuesday, April 9, 2019

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SYSTEMATIC REVIEW  

Role of dentist in genetic counseling: A critical appraisal of the current practices and future requirements in Indian scenario Highly accessed article p. 131
Ruchika Gupta, BR Chandra Shekar, Pankaj Goel, Sudheer Hongal, Rahul Ganavadiya
DOI:10.4103/1735-3327.255746  PMID:31040867
Genetic disorders are showing an upward trend. The social and economic impact of genetic disorders on individual, family and society is enormous. There is an urgent need to explore alternate strategies to mitigate the burden of genetic disorders. This is especially true with regard to developing countries such as India where there is a shortage of health personnel adequately trained in genetic counseling at present. Dental professionals have a unique opportunity to observe the development of preadolescent and adolescent patients during periods when important growth and development changes occur. The objective of this study was to review the existing literature on the role of dentist in genetic counseling with a critical appraisal on the current practices among dentists on genetic services in India, the need, scope, and future requirements. The literature on genetic services and genetic counseling was identified by searching the biomedical databases for primary research material by one investigator over a period of 8 weeks. The articles related to dentist's role in genetic counseling were assessed and discussed in the present review. A total of 239 resource materials were retrieved in the initial search. The literature from these sources was thoroughly scrutinized by the authors, and the literature (review articles, descriptive studies, or any form of study) focusing on role of dentist in genetic counseling was finally considered for critical appraisal in the present review. The role of genetics in health and oral health care has not received due attention of the dental practitioners who otherwise are in a crucial position in identifying the patients with genetic disorders and offer requisite counseling and referral to designated genetic centers. The short training courses for practicing dentists, faculty members, and a small change in dental curriculum to make provision for teaching genetics to undergraduate students may go a long way in filling the void created by these obstacles.
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ORIGINAL ARTICLES Top

Anxiety, depression, and oral health: A population-based study in Southeast of Iran p. 139
Tayebeh Malek Mohammadi, Amin Sabouri, Salehe Sabouri, Hamid Najafipour
DOI:10.4103/1735-3327.255748  PMID:31040868
Background: Depression and anxiety are two psychosocial illnesses that mostly are comorbid. The prevalence of these diseases is increasing worldwide. Both can affect general health also oral and dental health. The effects can be physiological and behavioral. Patients with these disorders are not willing to keep oral hygiene. The purpose of this study was to investigate the association between depression/anxiety and oral health indices in the 15–75-year-old population of Kerman. Materials and Methods: This cross-sectional study recruited 5900 people aged 15–75 years through one-stage cluster sampling (Kerman coronary artery disease risk factors study, KERCADRS). Data were collected through beck questionnaires for anxiety and depression and clinical examinations. Oral health indices including decayed, missing, filled teeth, gingival index (GI), and community periodontal index (CPI) were also measured. Data were analyzed by SPSS 21 software. Chi-square, t-test and regression analysis were used to determine the relationship between the variables. P ≤0.05 was considered as the level of statistical significance. Results: In the study, 1975 (33.6%) of patients showed moderate-to-severe anxiety and 3502 (59.5%) got the scores as depressed. There was a significant difference between GI and CPI indices of the normal and depressed group (P < 0.01), but the difference in the anxious and normal group was not statistically significant (P > 0.05). Conclusion: The results of the study showed a significant relationship between depression and oral health indices but not with anxiety. Therefore, the present study suggests that more attention should be paid to the oral health of people with a history of depression.
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A three-dimensional finite element analysis of the influence of varying implant crest module designs on the stress distribution to the bone p. 145
Shweta Maruti Patil, Abhijit Suresh Deshpande, Rahul Ramesh Bhalerao, Suryakant Bhanudas Metkari, Prithviraj Maruti Patil
DOI:10.4103/1735-3327.255750  PMID:31040869
Background: The aim of this study is the effect of stress distribution within the bone with varying implant crest module designs. Materials and Methods: Finite element models of a straight two-piece 4 mm × 13 mm screw-shaped threaded implant with divergent, straight, and convergent implant crest module with their surrounding suprastructure embedded in mandibular second premolar area were created with ANSYS software. Different implant crest module designs incorporated in D2 types of bone under 100N axial and 100N at 20° oblique load were created to evaluate stress distribution in the crestal bone around implant crest module. Results: Maximum von Mises stress was observed at the crestal region of the bone and at crest module region of the implants in all the models. Divergent crest module design shows minimum von Mises stress at crestal bone during vertical loading within bone and at implant crest module. Straight crest module designs result in minimum stresses during oblique loading than vertical loading. Convergent crest module design shows maximum von Mises stress. Conclusion: Within limitations of the study, it was concluded that stress distribution in adjacent compact bone is greatly influenced by implant crest module design. Divergent crest module designs result in minimum stresses at crestal bone and in the implant crest module region, followed by straight and convergent crest module in ascending order of stress distribution.
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The antibacterial activity of “Satureja hortensis” extract and essential oil against oral bacteria p. 153
Leila Golpasand Hagh, Atefe Arefian, Ahmad Farajzade, Sana Dibazar, Neda Samiea
DOI:10.4103/1735-3327.255741  
Background: Recently, there has been an increasing growth in research on medical plant's effect on dental plaque bacteria. The aim of this study was to determine the antibacterial effects of Satureja hortensis extract and its essential oil (EO) on Streptococcus salivarius, Streptococcus sanguis, and Streptococcus mutans as important bacteria in early supragingival dental plaque formation. Materials and Methods: In this in vitro study, different concentrations of S. hortensis extract and its EO were prepared using double dilution method. The disc diffusion method was used to determine antibacterial activity. Based on these measurements, the minimal inhibitory concentration value was reported for each bacterium. Antibiotics used as positive controls in this study were erythromycin (15 μg) and tetracycline (30 μg). t-test and ANOVA were used for statistical analysis (P < 0.05). Results: Aqueous and methanolic extract did not show significant antibacterial activity, but the EO significantly inhibited the growth of the test bacteria compared to positive control (P < 0.05). High concentrations of EO processed greater antimicrobial effects against three oral bacteria than other low concentrations (P < 0.0001). For S. mutans, the inhibition effect of tetracycline 30 μg was similar with 50% (P = 0.789) and 25% (P = 0.158) dosages of the EO. For S. salivarius, the effect of tetracycline 30 μg was similar to 50% dosages of the EO (P = 0.122). For S. sanguis, the effect of erythromycin 15 μg was lower than 50% (P = 0.0006) and 25% (P = 0.003) dosages of the EO. The inhibition effects of all concentrations of EO were higher for S. sanguis. S. salivarius and S. sanguis are more sensitive than S. mutans to S. hortensis EO. Conclusion: Due to the strong antibacterial effect of S. hortensis EO on the oral bacteria growth, it can be served as herbal mouth rinse, while to confirm this antibacterial effect, further clinical studies are necessary.
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The coronal pulp cavity index: A forensic tool for age determination in adults p. 160
Swati Shrikant Gotmare, Tanmik Shah, Treville Periera, Mandavi S Waghmare, Subraj Shetty, Sushama Sonawane, Maina Gite
DOI:10.4103/1735-3327.255743  PMID:31040871
Background: Various biochemical and histological methods are available for human age determination which are invasive and may require extraction of teeth. The present study aims to assess the accuracy of age estimation from tooth-coronal index (TCI) of known age and sex individuals and to present a noninvasive method for age estimation. Materials and Methods: This retrospective study comprised 88 patients, which included 54 males and 34 females. An orthopantomogram of these individuals were taken, and premolars and molars in the same were evaluated. The height of the crown (coronal height [CH]) and the height of the coronal pulp cavity (coronal pulp cavity height [CPCH]) was digitally measured on the computer screen. The TCI given by Ikeda et al. in 1985 (TCI = [CPCH × 100]/CH.) was computed on each tooth and regressed on real age of the sample. The mean, median, range, and standard deviation of the computed index were calculated. The correlation between the actual age and the estimated age was calculated using t-test. P < 0.05 was considered significant. Results: Results revealed that there is a significant correlation between the TCI with age. Increase in TCI observed with age; however, it showed no significant sex difference. Conclusion: TCI is a precise, noninvasive and easily used reliable biomarker for age estimation and is applicable to both living and dead individuals.
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In vitro evaluation of dentin tubule occlusion by three bioactive materials: A scanning electron microscopic study p. 166
Maryam Ghafournia, Maryam Hajnorouzali Tehrani, Afsaneh Nekouei, Reyhaneh Faghihian, Mehrnaz Mohammadpour, Atiyeh Feiz
DOI:10.4103/1735-3327.255747  PMID:31040872
Background: Dentin hypersensitivity (DH) is a common problem characterized by a short, sharp pain. Reduction of dentin permeability by occluding dentin tubules is considered as a method for treating DH. Many substances are available to decrease hypersensitivity. The aim of this study is to evaluate the ability of three different remineralizing agents for occluding dentinal tubules in comparison with positive and negative controls. Materials and Methods: In this in vitro scanning electron microscopic (SEM) study, 75 extracted premolars were cut into crown and root fragments with a bur and divided into five groups: group 1: Sodium fluoride 5% varnish was applied (positive control), Group 2: No treatment (negative control), Group 3: Treated with Remin Pro (contains hydroxyapatite and fluoride), Group 4: Treated with MI paste (contains casein phosphopeptide-amorphous calcium phosphate [CPP-ACP]) and Group 5: Treated with GC tooth mousse (contains CPP-ACP). SEM images were obtained and mean tubular diameter was measured in each group. One-way ANOVA and Duncan's tests were used for statistical analysis. A significant level of α = 0.05 was set for comparison between the groups. Results: Statistically significant difference was observed between Group 2 (negative control) and other four groups (P < 0.05). There was no significant difference between Groups 1, 3, 4, and 5 (P > 0.05). Conclusion: Under the limitations of the present in vitro study, it can be concluded that the application of a CPP-ACP paste as well as a paste which contains fluoride is effective on reduction of dentin permeability.
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Effectiveness of placement of second miniplates as tension band unit in mandibular parasymphysis fractures p. 172
Javad Yazdani, MohamadAli Ghavimi, Mahsa Taghizadeh, Yousef Kananizadeh, Milad Ghanizadeh
DOI:10.4103/1735-3327.255742  PMID:31040873
Background: The ideal position of the plates and the need for additional plates are discussed continuously. In mandible, the tensile forces at the fracture line should be neutralized with a tension band. This study evaluated the role of the mandibular arch bar as a tension band eliminating the need for an upper miniplate (tension band plate) in cases of parasymphysis fractures. Materials and Methods: In this randomized control trial, a total of 90 patients with mandibular parasymphysis fractures underwent treatment in two groups. Group A was treated with one titanium miniplate along with Erich's arch bar. In Group B, two titanium miniplates were placed across the fracture site along with Erich's arch bar. Then, the complications and duration of the operation time were compared between two groups. The results were considered statistically significant when the P < 0.05. Results: No significant difference was observed between the groups regarding postoperative complication rate. 1 month after surgery in Group A, number of patients with sensory impairment (17%) was significantly lower than Group B (37%) (P = 0.029). Furthermore, the operation time of Group A was significantly shorter than Group B (P < 0.001). Conclusion: In the presence of arch bar, placing one miniplate instead of the routine technique of placing two, do not increase complication rates. Furthermore, it reduces the operation time and costs and results in a better neurosensory recovery outcome in short time.
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In vitro effect of XP-Endo finisher on the amount of residual debris and smear layer on the root canal walls p. 179
Shahrzad Azimian, Hengameh Bakhtiar, Shahram Azimi, Ehsan Esnaashari
DOI:10.4103/1735-3327.255740  PMID:31040874
Background: A successful endodontic treatment depends on efficient cleaning and shaping and effective irrigation of root canals. The irrigating solution may not be effective in some areas in the canal. The manufacturer of XP-Endo finisher claims that it can effectively clean the root canals with complex morphology. This study aimed to assess the effect of XP-Endo finisher on the amount of residual debris and smear layer on the root canal walls of mandibular second premolars. Materials and Methods: In this In vitro study Fifty extracted mandibular second premolars with a root curvature <20° were collected. Root canals were prepared using BioRaCe rotary system. The root canals were in contact with the file and different irrigating solutions for 1 min. The teeth were then randomly divided into four experimental (n = 10) and one positive control group as follows: (1) XPF + saline, (2) XPF + ethylenediaminetetraacetic acid (EDTA), (3) XPF + sodium hypochlorite (NaOCl), (4) XPF + EDTA + NaOCl and (control) EDTA + NaOCl. The teeth were longitudinally sectioned into two halves and the amount of debris and smear layer remaining in the coronal, middle, and apical thirds of the roots was quantified and scored under an electron microscope. The Kruskal–Wallis test was used to compare the groups, and P < 0.05 was considered statistically significant. Results: The highest mean amount of residual debris (2.9 ± 1.13) was noted in XPF + saline group (P < 0.05). XPF + saline and XPF + NaOCl (3.8 ± 0.60) had the lowest efficacy for smear layer removal (P < 0.05) with no significant within-group difference. No significant difference was noted between Groups 2, 3, and 4 with the positive control group regarding debris removal. Groups 2 and 4 had no significant difference with the positive control group regarding smear layer removal. Conclusion: Use of XP-Endo finisher has no superiority to the standard protocol for the use of irrigating solutions (EDTA + NaOCl) for debris and smear layer removal, but in some cases, such as second appointment of regeneration treatment we cannot use NaOCl because of its destructive effects on stem cells; thus, we can benefit from the synergistic effects of XPF and EDTA for better smear layer removal.
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Comparison of color stability and fracture resistance of two temporary fiber-reinforced fixed partial denture materials p. 185
Ramin Mosharraf, Pirouz Givehchian, Farzin Ansaripour
DOI:10.4103/1735-3327.255744  PMID:31040875
Background: Temporary crown and bridge materials have to fulfill a couple of important functions within the timeframe between tooth preparations until luting of the definitive restoration. The aim of the current study was to evaluate the color stability and fracture resistance of two fiber-reinforced provisional fixed partial denture (FPD) materials. Materials and Methods: In this in vitro study Using a plexiglass mold, 96 bar-shaped specimens (4 mm × 2 mm × 20 mm) were fabricated and divided into four groups (n = 24): nonreinforced composite (NRC) resin, glass fiber-reinforced composite resin (RC), nonreinforced polymethylmethacrylate (PMMA), and glass fiber-reinforced PMMA. Values of CIEL*a*b* were recorded for all the samples. Then, the samples were immersed in coffee, chlorhexidine mouthrinse, and distilled water. After 1 day and 1 and 4 weeks, CIEL*a*b* values were recorded again and color differences (ΔE) were calculated. All the specimens immersed in distilled water were then subjected to force to measure their fracture resistance. Data were analyzed with one-way ANOVA, honestly significant difference Tukey tests, and paired t-test (α = 0.05). Results: The NRC group, immersed in coffee for 1 month, exhibited the highest ΔE (17.1 ± 0.69) and the lowest ΔE belonged to the RC group immersed in water for 1 day. The RC group, immersed in water, exhibited the highest fracture resistance. Conclusion: Coffee is considered as one of the most important factors affecting color changes in provisional FPDs, either in composite resins or in PMMAs. Fracture resistance of both composite resin and PMMA FPDs revealed no significant differences between the groups; however, there were significant differences between the nonreinforced and fiber-reinforced FPDs in both groups.
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Effect of ceramic translucency and luting cement shade on the color masking ability of laminate veneers p. 193
Bassem S. M. Kandil, Amena M Hamdy, Ahmed K Aboelfadl, Mohamed I El-Anwar
DOI:10.4103/1735-3327.255749  PMID:31040876
Background: The aim of this study was to evaluate the effect of ceramic material types, degree of veneer translucency, and luting cement shades on masking the underlying dark dental substrate to achieve best esthetics. Materials and Methods: In this in vitro study, 56 specimens each of 0.5-mm thickness were fabricated from two esthetic veneer materials Vita Enamic and Vita Suprinity, with two different translucencies, i.e., HT and T. To simulate the color of a dark underlying dental structure, background discs with C3 shade were fabricated using resin composite. The ceramic specimens with varying translucencies were cemented on the dark background of the resin composite with A1 and opaque white shades of resin luting cement. Color difference (ΔE) values from a reference color (A1 shade) were calculated using a spectrophotometer. The results were then statistically analyzed using three-way ANOVA test (α = 0.05). Results: The ΔE values of both ceramic systems were affected by both the degree of veneer translucency (P = 0.00) and the luting agent shade (P = 0.016). The use of an opaque luting agent and T translucency resulted in a decrease in the ΔE* values for all ceramics tested, regardless to the material type. Suprinity and Enamic showed similarity in the masking ability of dark substrate after cementation. Conclusion: None of the 0.5-mm veneers of the two ceramic systems could reach A1 shade without a detectable color difference after cementation. The change in degree of veneer translucency was more effective than the change in luting agent shade in masking the underlying dark substrate.
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Effect of thread depth and implant shape on stress distribution in anterior and posterior regions of mandible bone: A finite element analysis p. 200
Falah A Hussein, Kareem N Salloomi, Besaran Y Abdulrahman, Abdulsalam R Al-Zahawi, Laith A Sabri
DOI:10.4103/1735-3327.255745  PMID:31040877
Background: The ability of modern implant dentistry to achieve goals such as normal contour, function, comfort, esthetics, and health to totally or partially edentulous patients guaranteed it to be more effective and reliable method for the rehabilitation process of many challenging clinical situations. In regard to this, the current study evaluates the effect of changing implant shape design parameters on interface stress distribution within the mandible bone. Materials and Methods: A numerical procedure based on finite element (FE) method was adopted to investigate the influence of using different body design and thread depth of the inserted implant on the final stress situation. For the purpose of evaluation, a three-dimensional realistic FE models of mandible bone and inserted implant were constructed and analyzed using a pack of engineering software (Solidworks, and ANSYS). Six different commercial implant models (cylindrical and tapered) with three different V-shaped thread depths (0.25 mm, 0.35 mm, and 0.45 mm) were designed to be used in this study. The suggested implants used in this study were threaded in two different locations of mandible bone; the anterior region (Type I model) and posterior region (Type II model). A vertical static load of 250 N was directly applied to the center of the suprastructure of the implant for each model. Results: For both models, evaluations were achieved to figure out the stress distribution patterns and maximum equivalent von Mises. The results obtained after implementation of FE dental-implant models show that the highest stresses were located at the crestal cortical bone around the implant neck. In addition, the simulation study revealed that taper body implant had a higher peak value of von Mises stress than that of cylinder body implants in all types of bones. Moreover, a thread depth of 0.25 mm showed highest peak of maximum von Mises stresses for Type I and Type II models. Conclusion: The simulation results indicate that all models have the same von Mises stress distribution pattern and higher peak von Mises stresses of the cortical bone were seen in tapered implant body in contrast to the cylindrical body.
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