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Interforaminal hemorrhage during anterior mandibular implant placement: An overview
Chandan Kumar Kusum, Pranav V Mody, Indrajeet , Deviprasad Nooji, Suhas K Rao, Bhushan Ganesh Wankhade
July-August 2015, 12(4):291-300
DOI:10.4103/1735-3327.161422  PMID:26288617
Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement.
  5,762 545 3
Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature
Najmeh Akhlaghi, Abbasali Khademi Khademi
September-October 2015, 12(5):406-417
DOI:10.4103/1735-3327.166187  PMID:26604953
Vital pulp therapy (VPT) is a biologic and conservative treatment modality to preserve the vitality and function of the coronal or remaining radicular pulp tissue in vital permanent teeth. A search was conducted via the Cochrane database, PubMed, MEDLINE, and Ovid for any articles with the criteria for "pulp-capping," or "pulp-capping materials" and "VPT outcomes" from 1978 to mid 2014. All articles were evaluated and the valid papers were selected. The outcomes of various VPT techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and complete pulpotomy in vital permanent teeth were extracted. Although various studies have different research approach, most studies noted a favorable treatment outcome. Mineral trioxide aggregate (MTA) appears to be more effective than calcium hydroxide (Ca(OH) 2 ) for maintaining long-term pulp vitality after indirect and direct pulp-capping. However, it seems that the success rate for partial pulpotomy and pulpotomy with Ca(OH) 2 is similar to MTA.
  4,868 1,353 9
Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy
Deepankar Misra, Sapna Panjwani, Shalu Rai, Akansha Misra, Mukul Prabhat, Prashant Gupta, Subrata K Talukder
May-June 2016, 13(3):217-224
DOI:10.4103/1735-3327.182180  PMID:27274341
Background: To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns. Materials and Methods: In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS. Results: Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes. Conclusion: Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.
  5,424 285 -
Oral health knowledge, behaviour and practices among school children in Qatar
Mohammed Sultan Al-Darwish
July-August 2016, 13(4):342-353
DOI:10.4103/1735-3327.187885  PMID:27605993
Background: The aim of this study was to assess the oral health knowledge behaviour and practices among school children in Qatar. Materials and Methods: A cross-sectional study was carried out in Qatar from October 2011 to April 2012. A total of 2200 school children aged 12–14 years were approached from 16 schools of different areas. The information about oral health knowledge and sources of information was obtained through a self-administrated questionnaire. Data analyses were performed. Results: The overall response rate was (96%). Only (25.8%) of children reported a high level of oral health knowledge. After each meal, tooth brushing was observed by a very low percentage of children (3.7%). About 44.6% of children recognized dental floss as a cleaning device for between the teeth. A large number of children (32.5%) thought incorrectly that one must visit the dentist only in case of pain. A great majority was not aware of cariogenic potential of soft drinks (39%) and sweetened milk (97.8%). Less than half (38.9%) of children actually had heard about fluoride. Only (16.8%) correctly answered the question about sign of tooth decay. Slightly, less than half (48.4%) could not define the meaning of plaque. Parents were the most popular (69.1%), source of oral health information for the children. Conclusion: The oral health knowledge in Qatar is below the satisfactory level. Parents were the most popular source of oral health knowledge for the children followed by dentists, school teachers, and media.
  2,900 399 1
Cyclosporine A: Novel concepts in its role in drug-induced gingival overgrowth
Deepa Ponnaiyan, Visakan Jegadeesan
November-December 2015, 12(6):499-506
DOI:10.4103/1735-3327.170546  PMID:26759584
Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. This review considers the pharmacokinetics, pharmacodynamics, and unwanted effects of cyclosporine, in particular the action of the drug on the gingival tissues. In addition, elucidates the current concepts in mechanisms of cyclosporine-induced gingival overgrowth. Clinical and cell culture studies suggest that the mechanism of gingival overgrowth is a result of the interaction between the drug and its metabolites with susceptible gingival fibroblasts. Plaque-induced gingival inflammation appears to enhance this interaction. However, understanding of the pathogenesis of gingival overgrowth is incomplete at best. Hence, it would be pertinent to identify and explore possible risk factors relating to both prevalence and severity of drug-induced gingival overgrowth. Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.
  2,811 439 6
Three-dimensional accuracy of different impression techniques for dental implants
Mohammadreza Nakhaei, Azam S Madani, Azizollah Moraditalab, Hamidreza Rajati Haghi
September-October 2015, 12(5):431-437
DOI:10.4103/1735-3327.166190  PMID:26604956
Background: Accurate impression making is an essential prerequisite for achieving a passive fit between the implant and the superstructure. The aim of this in vitro study was to compare the three-dimensional accuracy of open-tray and three closed-tray impression techniques. Materials and Methods: Three acrylic resin mandibular master models with four parallel implants were used: Biohorizons (BIO), Straumann tissue-level (STL), and Straumann bone-level (SBL). Forty-two putty/wash polyvinyl siloxane impressions of the models were made using open-tray and closed-tray techniques. Closed-tray impressions were made using snap-on (STL model), transfer coping (TC) (BIO model) and TC plus plastic cap (TC-Cap) (SBL model). The impressions were poured with type IV stone, and the positional accuracy of the implant analog heads in each dimension (x, y and z axes), and the linear displacement (ΔR) were evaluated using a coordinate measuring machine. Data were analyzed using ANOVA and post-hoc Tukey tests (α = 0.05). Results: The ΔR values of the snap-on technique were significantly lower than those of TC and TC-Cap techniques (P < 0.001). No significant differences were found between closed and open impression techniques for STL in Δx, Δy, Δz and ΔR values (P = 0.444, P = 0.181, P = 0.835 and P = 0.911, respectively). Conclusion: Considering the limitations of this study, the snap-on implant-level impression technique resulted in more three-dimensional accuracy than TC and TC-Cap, but it was similar to the open-tray technique.
  2,734 406 4
A finite element study of teeth restored with post and core: Effect of design, material, and ferrule
Viram Upadhyaya, Akshay Bhargava, Hari Parkash, B Chittaranjan, Vivek Kumar
May-June 2016, 13(3):233-238
DOI:10.4103/1735-3327.182182  PMID:27274343
Background: Different postdesigns and materials are available; however, no consensus exists regarding superiority for stress distribution. The aim of this study was to evaluate the effect of design and material of post with or without ferrule on stress distribution using finite element analysis. Materials and Methods: A total of 12 three-dimensional (3D) axisymmetric models of postretained central incisors were made: Six with ferrule design and six without it. Three of these six models had tapered posts, and three had parallel posts. The materials tested were titanium post with a composite resin core, nickel chromium cast post and core, and fiber reinforced composite (FRC) post with a composite resin core. The stress analysis was done using ANSYS software. The load of 100 N at an angle of 45΀ was applied 2 mm cervical to incisal edge on the palatal surface and results were analyzed using 3D von Mises criteria. Results: The highest amount of stress was in the cervical region. Overall, the stress in the tapered postsystem was more than the parallel one. FRC post and composite resin core recorded minimal stresses within the post but the stresses transmitted to cervical dentin were more as compared to other systems. Minimal stresses in cervical dentine were observed where the remaining coronal dentin was strengthen by ferrule. Conclusion: A rigid material with high modulus of elasticity for post and core system creates most uniform stress distribution pattern. Ferrule provides uniform distribution of stresses and decreases the cervical stresses.
  2,358 432 3
Comparison of microleakage from stainless steel crowns margins used with different restorative materials: An in vitro study
Mahtab Memarpour, Reza Derafshi, Mahshid Razavi
January-February 2016, 13(1):7-12
DOI:10.4103/1735-3327.174689  PMID:26962309
Background: Obtaining optimal marginal adaption with prefabricated stainless steel crowns (SSCs) is difficult, especially after removing dental caries or defects in cervical areas. This situation requires the use of an SSC after tooth reconstruction. This study evaluated microleakage and material loss with five restorative materials at SSC margins. Materials and Methods: One hundred and twenty primary molar teeth were randomly divided into six groups (n = 20). Class V cavities were prepared on the buccal surfaces of the teeth in groups 1-5. Cavities were restored with amalgam, resin-based composite, glass ionomer (GI), zinc phosphate, or reinforced zinc oxide eugenol (Zonalin). Group 6 without cavity preparation was used as a control. Restorations with SSCs were prepared according to standard methods. Then, SSCs were fitted so that the crown margins overlaid the restorative materials and cemented with GI. After thermocycling, the specimens were placed in 0.5% fuchsin and sectioned. The proportions of mircoleakage and material loss were evaluated with a digital microscope. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney tests. Results: The groups differed significantly (P < 0.001). Amalgam and GI showed the least microleakage. Amalgam restorations had significantly less microleakage than the other materials (P < 0.05). Microleakage was greatest with resin-based composite, followed by Zonalin. Material loss was greater in samples restored with Zonalin and zinc phosphate. Conclusion: When SSC margins overlaid the restoration materials, cavity restoration with amalgam or GI before SSC placement led to less microleakage and material loss. Regarding microleakage and material loss, resin-based composite, zinc phosphate, and Zonalin were not suitable options.
  2,300 475 2
Accuracy of different impression materials in parallel and nonparallel implants
Mahroo Vojdani, Kianoosh Torabi, Elham Ansarifard
July-August 2015, 12(4):315-322
DOI:10.4103/1735-3327.161429  PMID:26288620
Background: A precise impression is mandatory to obtain passive fit in implant-supported prostheses. The aim of this study was to compare the accuracy of three impression materials in both parallel and nonparallel implant positions. Materials and Methods: In this experimental study, two partial dentate maxillary acrylic models with four implant analogues in canines and lateral incisors areas were used. One model was simulating the parallel condition and the other nonparallel one, in which implants were tilted 30° bucally and 20° in either mesial or distal directions. Thirty stone casts were made from each model using polyether (Impregum), additional silicone (Monopren) and vinyl siloxanether (Identium), with open tray technique. The distortion values in three-dimensions (X, Y and Z-axis) were measured by coordinate measuring machine. Two-way analysis of variance (ANOVA), one-way ANOVA and Tukey tests were used for data analysis (α = 0.05). Results: Under parallel condition, all the materials showed comparable, accurate casts (P = 0.74). In the presence of angulated implants, while Monopren showed more accurate results compared to Impregum (P = 0.01), Identium yielded almost similar results to those produced by Impregum (P = 0.27) and Monopren (P = 0.26). Conclusion: Within the limitations of this study, in parallel conditions, the type of impression material cannot affect the accuracy of the implant impressions; however, in nonparallel conditions, polyvinyl siloxane is shown to be a better choice, followed by vinyl siloxanether and polyether respectively.
  2,308 401 7
Fracture resistance of three different posts in restoration of severely damaged primary anterior teeth: An in vitro study
Bahman Seraj, Sara Ghadimi, Zohreh Estaki, Mostafa Fatemi
July-August 2015, 12(4):372-378
DOI:10.4103/1735-3327.161461  PMID:26286271
Background: Restoration of anterior primary teeth with severe caries lesion is a big challenge. The aim of this study was to compare the fracture resistance of three types of post, including composite resin, customized quartz fiber and prefabricated glass fiber in restoration of severely damaged primary anterior teeth. Materials and Methods: Sixty extracted human primary maxillary incisors were randomly divided into three groups: Group 1: Customized quartz fiber post, Group 2: Composite post and Group 3: Prefabricated glass fiber post. Due to the effect of bonded area on the fracture resistance, the bonded surface of each sample was measured 1 mm above cementoenamel junction. An increasing force was subjected with a crosshead speed of 0.5 mm/min by a universal testing machine until fracture occurred, and the failure mode was assessed afterwards. Data were analyzed using One-way analysis of variance and Kruskal-Wallis tests. The level of significance was considered at P < 0.05. Results: The mean fracture resistance values of three groups were 343.28 N, 278.70 N and 284.76 N, respectively. Although customized quartz fiber post showed the greatest fracture resistance, statistical analysis revealed no significant difference between groups (P = 0.21). The mean fracture strength values of three groups were 12.82 N/mm–2 , 11.93 N/mm–2 and 11.31 N/mm–2 , respectively; however, the differences were not statistically significant (P = 0.72). Favorable failure mode was more frequent in all groups (P = 0.12). Conclusion: Within the limitations of this study, it can be concluded that all three types of studied posts can be successfully used to restore badly destructed primary anterior teeth.
  2,307 367 1
The antioxidant master glutathione and periodontal health
Vivek Kumar Bains, Rhythm Bains
September-October 2015, 12(5):389-405
DOI:10.4103/1735-3327.166169  PMID:26604952
Glutathione, considered to be the master antioxidant (AO), is the most-important redox regulator that controls inflammatory processes, and thus damage to the periodontium. Periodontitis patients have reduced total AO capacity in whole saliva, and lower concentrations of reduced glutathione (GSH) in serum and gingival crevicular fluid, and periodontal therapy restores the redox balance. Therapeutic considerations for the adjunctive use of glutathione in management of periodontitis, in limiting the tissue damage associated with oxidative stress, and enhancing wound healing cannot be underestimated, but need to be evaluated further through multi-centered randomized controlled trials.
  2,273 375 5
The effect of two remineralizing agents and natural saliva on bleached enamel hardness
Haleh Heshmat, Maryam Hoorizad Ganjkar, Yasaman Miri, Mohamad Javad Kharrazi Fard
January-February 2016, 13(1):52-57
DOI:10.4103/1735-3327.174713  PMID:26962316
Background: In order to compensate the adverse consequences of bleaching agents, the use of fluoride-containing remineralizing agents has been suggested by many researchers. The aim of this study was to compare the effect of applying two remineralizing materials on bleached enamel hardness and in comparison to natural saliva. Materials and Methods: In this experimental study, 30 enamel samples of sound human permanent molars were prepared for this study. Microhardness (MH) of all specimens was measured and 35% hydrogen peroxide was applied 3 times to the specimens. After completion of the bleaching process, MH of samples was measured and then enamel specimens were divided into three groups each of 10, specimens of groups 1 and 2 were subjected to daily application of hydroxyl apatite (Remin Pro) and casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) (MI Paste Plus) pastes, respectively, for 15 days. In group 3, the specimens were stored in the operators' natural saliva at room temperature in this period of time. Final MH of all groups was measured. The data were analyzed using repeated measures ANOVA (α = 0.05). Results: The hardness significantly decreased in all groups following bleaching. Application of either Remin Pro, CPP-ACPF or natural saliva increased the hardness significantly. The hardness of the three test groups after 15 days were statistically similar to each other. Conclusion: The hardness of enamel increases eventually after exposure to either MI Paste Plus, Remin Pro or natural saliva.
  1,881 653 3
Viscosity of endodontic irrigants: Influence of temperature
Claudio Poggio, Matteo Ceci, Riccardo Beltrami, Marco Colombo, Alberto Dagna
September-October 2015, 12(5):425-430
DOI:10.4103/1735-3327.166189  PMID:26604955
Background: The aim of this study was to assess the influence of temperature on the viscosity of different endodontic irrigants. Materials and Methods: The measurements of viscosity of 3% hydrogen peroxide, 0.9% sodium chloride, aqueous solution of 0.2% chlorhexidine (CHX) and 0.2% cetrimide, 5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) at different temperatures (22°C, 30°C, 40°C, 50°C and 60°C) were obtained using Mohr balance and Ostwald viscometer. The Shapiro-Wilk test and Mann-Whitney U-tests were used for the statistical analysis. (α = 0.05). Results: No significant differences were recorded at each temperature among 3% hydrogen peroxide, 0.9% sodium chloride and aqueous solution of 0.2% CHX and 0.2% cetrimide. 5% NaOCl and 17% EDTA showed the higher values. Viscosity statistically decreased with increasing temperature. Conclusion: Within the limitations of this study, 5% NaOCl and 17% EDTA are significantly viscous at room temperature and their viscosity reduces with elevating temperature.
  2,239 218 -
Effect of different cavity conditioners on microleakage of glass ionomer cement with a high viscosity in primary teeth
Romina Mazaheri, Leila Pishevar, Ava Vali Shichani, Sanas Geravandi
July-August 2015, 12(4):337-341
DOI:10.4103/1735-3327.161448  PMID:26288623
Background: Glass ionomer cement is a common material used in pediatric dentistry. The aim of this study was to evaluate the microleakage of high-viscosity glass ionomer restorations in deciduous teeth after conditioning with four different conditioners. Materials and Methods: Fifty intact primary canines were collected. Standard Class V cavities (2 mm × 1.5 mm × 3 mm) were prepared by one operator on all buccal tooth surfaces, including both enamel and dentin. The samples were divided into five groups with different conditioners (no conditioner, 20% acrylic acid, 35% phosphoric acid, 12% citric acid, and 17% ethylenediaminetetraacetic acid [EDTA]). Two-way - ANOVA, Kruskal-Wallis and Mann-Whitney tests were used to compare the means of microleakage between the five groups. The significance level was set at P < 0.05. Results: There was no significant difference between the means of microleakage in incisal (enamel) and gingival (dentin) margins (P = 0.34). Furthermore, there was no significant difference between the means of microleakage in enamel and dentin margins (P = 0.4). There was a significant difference between the means of microleakage in different groups (P = 0.03). Conclusion: Within the limitations of this study, it is suggested that 20% acrylic acid and 17% EDTA be used for cavity conditioning which can result in better chemical and micromechanical adhesion.
  2,087 322 1
Microbiological analysis after complete or partial removal of carious dentin using two different techniques in primary teeth: A randomized clinical trial
Deepak Kumar Singhal, Shashidhar Acharya, Arun Singh Thakur
January-February 2016, 13(1):30-37
DOI:10.4103/1735-3327.174695  PMID:26962313
Background: The management of deep carious lesions can be done by various techniques but residual caries dilemma still persists and bacterial reduction in cavities treated by either partial or complete caries removal techniques is debatable. So the objective of the present randomized clinical trial was to compare microbial counts in cavities submitted to complete caries removal and partial caries removal using either hand instruments or burs before and after 3 weeks of restoration. Materials and Methods: Primary molars with acute carious lesions in inner half of dentine and vital pulp were randomly divided into three groups of 14 each: Group A: Partial caries removal using hand instruments atraumatic restorative treatment (ART) only; Group B: Partial caries removal using bur; Group C: Complete caries removal using bur and caries detector dye. Dentine sample obtained after caries removal and 3 weeks after restoration, were subjected to microbial culture and counting (colony-forming units [CFU]/mg of dentine) for total viable bacterial count, Streptococcus spp., mutans streptococci, Lactobacillus spp. Results: Three techniques of caries removal showed significant (P < 0.05) reduction in all microorganisms studied after 3 weeks of evaluation, but there was no statistically significant difference in percentage reduction of microbial count among three groups. Conclusion: Results suggest the use of partial caries removal in a single session as compared to complete caries removal as a part of treatment of deep lesions in deciduous teeth in order to reduce the risk of pulp exposure. Partial caries removal using ART can be preferred for community settings as public health procedure for caries management.
  1,974 422 5
Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess
Lobna Abdel Aziz Aly, Nelly Ibrahim Hammouda
November-December 2016, 13(6):478-483
DOI:10.4103/1735-3327.197039  PMID:28182056
Background: Excessive gingival display (GD) is a frequent finding that can occur because of various intraoral or extraoral etiologies. This work describes the use of a mucosal repositioned flap for the management of a gummy smile associated with vertical maxillary excess (VME) and hypermobility of the upper lip followed by injection of Botox. Materials and Methods: Seven female patients in the age range of 17–25 years presented with a gummy smile. At full smile, the average GD ranged from 6 to 8 mm. A clinical examination revealed hypermobility of the upper lip. A cephalometric analysis pointed to the presence of VME. The mucosal repositioned flap surgery was conducted followed by injection with botulinum toxin type A (Botox) 2 weeks postsurgically. Results: After 4 weeks, results were definitely observed with a decrease from 8 mm gingival exposure to 3 mm, which was considered as normal GD for an adult during smiling. Conclusion: For patients desiring a less invasive alternative to orthognathic surgery, the mucosal repositioned flap is a viable alternative. Moreover, Botox is a useful adjunct to enhance the esthetics and improve patient satisfaction where surgery alone may prove inadequately in moderate VME.
  2,064 314 1
Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study
SG Damle, Hiteshwar Bhattal, Dhanashree Damle, Abhishek Dhindsa, Ashish Loomba, Sumit Singla
May-June 2016, 13(3):284-291
DOI:10.4103/1735-3327.182191  PMID:27274351
Background: To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH) 2 ) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. Materials and Methods: The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH) 2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH) 2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). Results: In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH) 2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH) 2 group. Conclusion: MTA and Ca(OH) 2 , as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.
  1,996 352 3
Evaluation of the effects of three different mouthwashes on the force decay of orthodontic chains
Maryam Omidkhoda, Roozbeh Rashed, Neda Khodarahmi
July-August 2015, 12(4):348-352
DOI:10.4103/1735-3327.161453  PMID:26288625
Background: Elastomeric chains are commonly used in orthodontics. Force decay in these materials poses clinical problems. The aim of this study was to evaluate the effects of three different mouthwashes on the force decay of orthodontic chains. Materials and Methods: In this experimental study, elastomeric chains with two different configurations were divided into eight groups (two control and six test groups). After 10 s of prestretching up to 100% of their initial length, the chains were stretched for 25 mm on jig pins and then immersed in artificial saliva, persica, chlorhexidine 0.2% and sodium fluoride 0.05% mouthwashes. Ten cycles of thermocycling between 5°C and 55°C were conducted daily during the test period. In order to reach a 200-g initial force, seven loop closed chains, and five-loop short chains were selected. Forces were recorded by digital force gauge (Lutron) at initial, 24 h, 1, 2, 3 and 4 weeks for all groups. The amount of force loss was compared among different mouthwashes and times using one-way analysis of variance (post-hoc, Tukey, α = 0.05). Results: About 20% of the force decay occurred during the first 24 h, but after that and up to the 4 th week the rate of force loss was gradual and steady. After 4 weeks, persica and chlorhexidine caused the lowest and the highest percentage of force loss, respectively. These two mouthwashes showed statistically significant differences at all points of time (P < 0.05). Conclusion: Within the limitations of this study, during the orthodontic treatment, persica is preferred to chlorhexidine for oral health control.
  2,035 300 2
The effect of buccal corticotomy on accelerating orthodontic tooth movement of maxillary canine
Mohammad Reza Jahanbakhshi, Ali Mohammad Kalantar Motamedi, Masoud Feizbakhsh, Ahmad Mogharehabed
July-August 2016, 13(4):303-308
DOI:10.4103/1735-3327.187875  PMID:27605986
Background: Selective alveolar corticotomy is defined as an intentional injury to cortical bone. This technique is an effective means of accelerating orthodontic tooth movement. The aim of this study is to evaluate the effect of buccal corticotomy in accelerating maxillary canine retraction. Materials and Methods: The sample in this clinical trial study consisted of 15 adult female patients with therapeutic need for extraction of maxillary first premolars and maximum canine retraction. By use of split-mouth design, at the time of premolars extraction, buccal corticotomy was performed around the maxillary first premolar, randomly on one side of maxilla, and the other side was reserved as the control side. Canine retraction was performed by use of friction – less mechanic with simple vertical loop. Every 2 weeks, distance between canines and second premolars was measured until complete space closure. The velocity of space closure was calculated to evaluate the effect of this technique in accelerating orthodontic tooth movement. The obtained data were statistically analyzed using independent t-test, and the significance was set at 0.05. Results: The rate of canine retraction was significantly higher on the corticotomy side than the control side by an average of 1.8 mm/month versus 1.1 mm/month in the corticotomy side and control side, respectively (P < 0.001). Conclusion: Based on result of this study, corticotomy can accelerates the rate of orthodontic tooth movement about two times faster than conventional orthodontics and it is significant in early stages after surgical porsedure. Therefore Buccal corticotomy is a useful adjunct technique for accelerating orthodontic tooth movement.
  1,860 447 3
A randomized controlled evaluation of alveolar ridge preservation following tooth extraction using deproteinized bovine bone mineral and demineralized freeze-dried bone allograft
Rokhsareh Sadeghi, Maryam Babaei, S Asghar Miremadi, Fatemeh Mashadi Abbas
March-April 2016, 13(2):151-159
DOI:10.4103/1735-3327.178202  PMID:27076830
Background: Alveolar ridge preservation could be performed immediately following tooth extraction to limit dimensional changes of alveolar process due to bone resorption. The aim of this study was to compare the clinical and histologic outcomes of socket preservation using two different graft materials; deproteinized bovine bone mineral (DBBM) and demineralized freeze-dried bone allograft (DFDBA) with absorbable collagen membrane. Materials and Methods: Twenty extraction sockets in 20 patients were randomly divided into 2 treatment groups: 10 sockets were augmented with DBBM and collagen membrane whereas 10 sockets were filled with DFDBA and covered by collagen membrane. Primary closure was achieved over extraction sockets by flap advancement. Horizontal and vertical ridge dimensional changes were assessed at baseline and after 4-6 months at the time of implant placement. For histological and histomorphometrical analysis, bone samples were harvested from the augmented sites with trephine during implant surgery. All data were analyzed using SPSS version 18 (α=0.05). Results: Clinical measurements revealed that average horizontal reduction was 2.3 ± 0.64 mm for DFDBA and 2.26 ± 0.51 mm for DBBM. Mean vertical ridge resorption at buccal side was 1.29 ± 0.68 mm for DFDBA and 1.1 ± 0.17 mm for DBBM. Moreover, mean vertical ridge reduction at lingual site was 0.41 ± 0.38 mm and 0.35 ± 0.34 mm for DFDBA and DBBM, respectively. No significant differences were seen between two groups in any of those clinical parameters. Histologic analysis showed statistically significant more new bone deposition for DFDBA compared to DBBM (34.49 ± 3.19 vs. 18.76 ± 3.54) (P < 0.01). Residual graft particles were identified significantly more in DBBM (12.77 ± 1.85) than DFDBA (6.06 ± 1.02). Conclusion: Based on the findings of this study, both materials have positive effect on alveolar ridge preservation after tooth extraction, but there was more new bone formation and less residual graft particles in DFDBA group than in DBBM group.
  1,905 380 2
Periodontal changes following molar intrusion with miniscrews
Shahin Bayani, Farzin Heravi, Mehrdad Radvar, Najmeh Anbiaee, Azam Sadat Madani
July-August 2015, 12(4):379-385
DOI:10.4103/1735-3327.161462  PMID:26288629
Background: With the introduction of skeletal anchorage system, recently it is possible to successfully intrude molar teeth. On the other hand, there have been concerns about periodontal changes associated with intrusion and there are few studies on this topic, especially for posterior teeth. Materials and Methods: Ten female patients were enrolled in this study. Maxillary molar intrusion was achieved by inserting two miniscrews and a 17 × 25 titanium molybdenum alloy spring. Crestal height changes were evaluated at three intervals including: Baseline (T0), end of active treatment (T1) and 6 months after retention (T2). Other variables including probing depth, gingival recession, attachment level and bleeding on probing were evaluated by clinical measurements in the three above mentioned intervals. One-sample Kolmogrov-Smirnov test ascertained the normality of the data. For all patients, the changes in tooth position and crestal height were evaluated using one-sample t-test. (P < 0.05) Results: Supra-erupted molars were successfully intruded a mean of 2.1 ± 0.9 mm during active treatment (T0-T1). A mean bone resorption of 0.9 ± 0.9 mm in mesial crest and 1 ± 0.8 mm in distal crest had occurred in total treatment (T0-T2). A mean of 0.6 ± 1.4 mm bone was deposited on mesial crest during the retention period (T1-T2) following tooth relapse. On average, 0.8 ± 0.4 mm attachment gain was obtained. Gingival margin coronalized a mean of 0.8 ± 0.6 mm throughout the entire treatment. Probing depth showed no significant change during treatment. Conclusion: Within the limitations of this study, these results suggest that not only periodontal status was not negatively affected by intrusion, but also there were signs of periodontal improvement including attachment gain and shortening of clinical crown height.
  1,912 343 -
A comparative evaluation of remineralizing ability of bioactive glass and amorphous calcium phosphate casein phosphopeptide on early enamel lesion
Udaya Kumar Palaniswamy, Neha Prashar, Mamta Kaushik, Surender Ram Lakkam, Shikha Arya, Swetha Pebbeti
July-August 2016, 13(4):297-302
DOI:10.4103/1735-3327.187872  PMID:27605985
Background: This study was done to evaluate remineralizing potential of bioactive glasses (BAGs) and amorphous calcium phosphate-casein phosphopeptide (ACP-CPP) on early enamel lesion. Materials and Methods: Twenty freshly extracted mandibular premolars were sectioned sagittally. The buccal half was impregnated in acrylic resin blocks and treated with 37% phosphoric acid in liquid form, to demineralize enamel surface to simulate early enamel lesion. The samples were divided into two groups. The samples in Group I were treated with ACP-CPP (GC Tooth Mousse) and in Group II with BAG (Sensodyne Repair and Protect) and stored in saliva to prevent dehydration. The samples were tested for microhardness. The data obtained was analyzed using ANOVA post hoc multiple comparison and independent sample t- test and presented as a mean and standard deviation. Results: All the samples showed a decrease in the microhardness after demineralization. After application of remineralizing agents, Group II showed a highly significant increase in the microhardness (P < 0.05) after 10 days, while Group I showed a significant increase in microhardness after 15 days (P < 0.05). Conclusion: Both the remineralizing agents tested in this study can be considered effective in repair and prevention of demineralization. BAG showed better results initially, but eventually both have similar remineralizing potential.
  1,876 317 5
Influence of different luting protocols on shear bond strength of computer aided design/computer aided manufacturing resin nanoceramic material to dentin
Claudio Poggio, Marco Pigozzo, Matteo Ceci, Andrea Scribante, Riccardo Beltrami, Marco Chiesa
March-April 2016, 13(2):91-97
DOI:10.4103/1735-3327.178193  PMID:27076822
Background: The purpose of this study was to evaluate the influence of three different luting protocols on shear bond strength of computer aided design/computer aided manufacturing (CAD/CAM) resin nanoceramic (RNC) material to dentin. Materials and Methods: In this in vitro study, 30 disks were milled from RNC blocks (Lava Ultimate/3M ESPE) with CAD/CAM technology. The disks were subsequently cemented to the exposed dentin of 30 recently extracted bovine permanent mandibular incisors. The specimens were randomly assigned into 3 groups of 10 teeth each. In Group 1, disks were cemented using a total-etch protocol (Scotchbond™ Universal Etchant phosphoric acid + Scotchbond Universal Adhesive + RelyX Ultimate conventional resin cement); in Group 2, disks were cemented using a self-etch protocol (Scotchbond Universal Adhesive + RelyX Ultimate conventional resin cement); in Group 3, disks were cemented using a self-adhesive protocol (RelyX Unicem 2 Automix self-adhesive resin cement). All cemented specimens were placed in a universal testing machine (Instron Universal Testing Machine 3343) and submitted to a shear bond strength test to check the strength of adhesion between the two substrates, dentin, and RNC disks. Specimens were stressed at a crosshead speed of 1 mm/min. Data were analyzed with analysis of variance and post-hoc Tukey's test at a level of significance of 0.05. Results: Post-hoc Tukey testing showed that the highest shear strength values (P < 0.001) were reported in Group 2. The lowest data (P < 0.001) were recorded in Group 3. Conclusion: Within the limitations of this in vitro study, conventional resin cements (coupled with etch and rinse or self-etch adhesives) showed better shear strength values compared to self-adhesive resin cements. Furthermore, conventional resin cements used together with a self-etch adhesive reported the highest values of adhesion.
  1,800 336 5
Scaffolds in regenerative endodontics: A review
Kinjal M Gathani, Srinidhi Surya Raghavendra
September-October 2016, 13(5):379-386
DOI:10.4103/1735-3327.192266  PMID:27857762
Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. 'A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria 'Platelet rich plasma', 'Platelet rich fibrin', 'Stem cells', 'Natural and artificial scaffolds' from 1982-2015'. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon.
  1,706 384 5
Effect of the processing cycle on dimensional changes of heat-polymerized denture base resins
Ghazal Savabi, Omid Savabi, Badrosadat Dastgheib, Farahnaz Nejatidanesh
July-August 2015, 12(4):301-306
DOI:10.4103/1735-3327.161423  PMID:26288618
Background: The second processing cycle for adding the artificial teeth to heat-polymerized acrylic resin denture bases may result in dimensional changes of the denture bases. The aim of this study was to evaluate the dimensional changes of the heat-polymerized acrylic resin denture bases with one and two-cycle processing methods. Materials and Methods: A metal edentulous maxillary arch was used for making 40 stone casts. Maxillary complete dentures were made with heat-polymerized acrylic resins (Meliodent and Acropars) with one and two stage processing methods (n = 10 for each group). Linear dimensional changes in anteroposterior and mediolateral distances and vertical changes in the first molar region were measured following each processing cycle, using a digital caliper. Mean percentage of the dimensional changes were subjected to two-way analysis of variance and Tukey honest significant difference tests (α = 0.05). Results: Postpolymerization contraction occurred in both anteroposterior and mediolateral directions in all studied groups; however, the vertical dimension was increased. Acropars acrylic resin showed the highest dimensional changes and the second processing cycle significantly affected the measured distances (P < 0.05). Meliodent acrylic resin was not significantly influenced by the processing method. Conclusion: Reheating of the acrylic resin denture bases for the addition of denture teeth result in linear dimensional changes, which can be clinically significant based on the acrylic resin used.
  1,842 247 2