Showing papers in "Contemporary Clinical Dentistry in 2019"
TL;DR: A case of complicated crown-root fracture in a young child that was treated by extra-oral fragment reattachment followed by the intentional reimplantation demonstrates the importance of modifying a treatment protocol to maintain esthetics up to the completion of the developmental period.
Abstract: Trauma with an accompanying fracture to the anterior teeth gives an agonizing experience for a young individual due to the physical disfigurement and the psychological impact that is imposed on them. This paper reports a case of complicated crown-root fracture in a young child that was treated by extra-oral fragment reattachment followed by the intentional reimplantation. The tooth was endodontically-treated followed by the placement of fiber-reinforced composite post. The fragments were reattached extra orally following an atraumatic extraction. The tooth was then reimplanted back into the socket followed by splinting. Clinical results were successful after 2 years. This case report demonstrates the importance of modifying a treatment protocol to maintain esthetics up to the completion of the developmental period.
159 citations
TL;DR: This single-centered cross-sectional study represents that more than 95% of type 2 diabetic patients have some periodontal destruction, which may act as baseline data to promote the collaborative integrated management of diabetes for reducing its burden on society.
Abstract: Aim: The aim of this study was to determine the prevalence of periodontal disease in type 2 diabetes mellitus (T2DM) patients of North India. Materials and Methods: A total of 500 patients fulfilling the selection criteria were initially given a health questionnaire to gather information regarding their demographic characteristics, attitude for oral hygiene, and disease status. Based on eligibility 427 patients were finally recruited for statistical analysis. A partial-mouth periodontal examination (PMPE) protocol which assessed one maxillary quadrant and one mandibular quadrant was used to examine three fixed sites per tooth (mesiobuccal, midbuccal, and distobuccal). Gingival Index, Oral Hygiene Index-Simplified, Debris Index-Simplified, Calculus Index-Simplified (CI-S), probing pocket depth, and clinical attachment level were examined. Results: More than 90% (95.1%) of the total diabetic participants had some degree of periodontal destruction. Of the total population, 27.1% of participants had good oral hygiene, 68.8% had fair oral hygiene, and 3.9% had poor oral hygiene status. The prevalence of severe periodontitis in participants with good, fair, and poor oral hygiene status was reported as 0.8%, 17%, and 29.4%, respectively. The prevalence of severe periodontitis in participants with good, fair, and poor oral hygiene status with poor glycemic control (glycated hemoglobin ≥8%) was 2.5%, 28.1%, and 30.7%, respectively. Conclusion: This single-centered cross-sectional study represents that more than 95% of type 2 diabetic patients have some periodontal destruction. These results may act as baseline data to promote the collaborative integrated management of diabetes for reducing its burden on society.
16 citations
TL;DR: There was a significant reduction in inflammation, hyperemia, and mucosal edges that resulted in the reduction of pain and discomfort to the patient, and honey can be used as an alternative for the management of dry socket.
Abstract: Background: Natural products have been used for several years in folk medicine. Honey was used to treat infected wounds as long ago as 2000 years before bacteria was discovered to be the cause of infection. It has been reported from various clinical studies on the usage of honey as a dressing for infected wounds that the wound become sterile in 3–6 days. Aim: This study aimed to find out the efficiency of naturally occurring honey in alveolar osteitis. Methodology: Fifty patients of dry socket were selected from the outpatient department of oral and maxillofacial surgery. A diagnosis of dry socket was made clinically. Honey was used as a dry socket dressing in all these patients. Parameters such as mucosal edges, pain, and formation of granulation tissue were assessed in the postoperative period for a week. Statistical Analysis Used: Analysis was done by paired t-test method using SPSS software version 17. Results: In this study, there was a significant reduction in inflammation, hyperemia, and mucosal edges that resulted in the reduction of pain and discomfort to the patient. There was no side effect of honey observed in our study, so it can be used as an alternative for the management of dry socket. Change in distance between mucosal edges when compared from the day of clinical presentation to 5th day postplacement was statistically significant (P < 0.001). Conclusions: There are no side effects of honey. Excess use of eugenol can lead to necrosis of bone. Thus, honey can be used as a medicament for the management of dry socket.
15 citations
TL;DR: The angle formed by the intersection of lines from the left and right gonion to menton (Gn-M0) helps provide anthropological data, which can be used in dental and medicolegal practices and indicate that gender can be predicted using these four variables.
Abstract: Background: Mandible is considered as one of the stronger bones of skull available for gender identification. Mandibular measurements can be used for the identification of gender either on dry mandible or through panoramic radiography or cone-beam computed tomography (CBCT). Aim: To determine the gender from mandibular measurement using CBCT. Materials and Methods: The Morphometric analysis was performed on 200 CBCT scans of the subjects using OnDemand 3D software (Seoul, Korea). Morphometry of mandibular is measured by estimation of the angles formed at different locations on mandible to predict the gender. Statistical analysis was performed; independent samples “t-” test was used to compare the mean values between males and females. Discriminant function analysis was used for gender prediction. Results: The subject's age ranged from 18 to 60 years with an equal number of males and females. The mean angle formed by the intersection of lines from the left and right gonion to menton in males was 129.9 ± 11.9 and it was 126.7 ± 12.6 in females. The mean linear distances from the right gonion to menton in both males and females were 86.8 ± 5.3 and 82.6 ± 6.2, respectively. The mean linear distances from the left gonion to menton were 49.5 ± 5.1 in males and 47.7 ± 3.9 in females. The mean linear distance from the right gonion to left gonion was 47.7 ± 4.4 in males and 46.6 ± 4.2 in females. The Box's M statistics was applied to verify the applicability of mandibular measurements in gender prediction. The values indicate that gender can be predicted using these four variables, which is statistically significant (P = 0.000). The overall prediction accuracy of this model was 67%, with 66.7% in males and 67.3% in females being correctly classified. Conclusion: The angle formed by the intersection of lines from the left and right gonion to menton (Gn-M0) helps provide anthropological data, which can be used in dental and medicolegal practices.
15 citations
TL;DR: Assessment of the RML potential of four commercially available agents so as to restore the enamel closest to its previous microhardness levels showed BAG Novamin, f-TCP, and nHAp showed considerable RML followed to a lesser extent by GSE.
Abstract: Background: Caries is highly prevalent multifactorial disease, but its progression can be prevented in the initial stage of demineralization through remineralization (RML). Various materials have been proposed for the same, successful outcome can prove to be a boon in the prevention of caries. Aim: The aim of the study is to assess the RML potential of four commercially available agents so as to restore the enamel closest to its previous microhardness levels. Materials and Methods: Sixty permanent intact premolars were randomly divided into six groups: Four test groups – (1) bioactive glass (BAG) Novamin (SHY-NM), (2) nano-hydroxyapatite (nHAp) (Acclaim), (3) functionalized tricalcium phosphate (f-TCP) (Clinpro Tooth Creme), and (4) grape seed extract (GSE); one positive control – (5) fluoride (1000 ppm) containing dentifrice (Colgate Calci-Lock); and one negative control – (6) distilled water. The samples were initially evaluated for baseline surface microhardness (SMH); later on, these samples were placed in the demineralizing solution for 48 h in an incubator at 37°C, and postdemineralization again SMH was measured. Thereafter, the samples were subjected to the pH cycling for consecutive 21 days, and SMH was recorded. The SMH was evaluated using a Vickers microhardness tester. Statistical analysis was done using a post hoc Tukey test for each group based on the stage of treatment and one-way ANOVA for comparison among different groups. Results: BAG Novamin showed SMH recovery at 96.75% followed by f-TCP at 95.83%, nHAp at 90.88%, and GSE at 48.71%. Statistically significant differences were observed between the first three groups and the rest of the groups after RML stage. Conclusion: BAG Novamin, f-TCP, and nHAp showed considerable RML followed to a lesser extent by GSE.
13 citations
TL;DR: Microabrasion followed by the remineralizing agent can improve the esthetics of white tooth discoloration with time, and this study has shown this effect in patients with Grade I MIH.
Abstract: Background: Molar incisor hypomineralization (MIH) is an esthetic setback for the patient as well as for the dentist, treatment options for MIH includes minimally invasive techniques like microabrasion which has a limited literature of its effect. Furthermore, the effect of remineralizing such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) agent on MIH-affected teeth is minimally studied. Aim: Comparative evaluation of the esthetic after microabrasion and microabrasion followed by Tooth Mousse Plus on hypomineralized incisors of MIH-affected patients. Settings and Design: The study was a randomized clinical trial. Materials and Methods: The study comprised Grade I MIH patients in the age strata of 7–16 years having lesions on incisors. As per inclusion criteria, 46 lesions were divided into two groups of microabrasion and microabrasion followed by CPP-amorphous calcium fluoride phosphate (ACFP). Photographs were obtained before treatment, just after treatment, and 6 months after treatment. The photographic evaluation was done using the CIE L*a*b* scoring method. Statistical Analysis Used: ANOVA and posthoc Tukey's test were applied to compare the difference in lightness ΔL and total color change ΔE of these two groups. Results: In microabrasion group, the overall change in ΔL of white tooth discoloration came −0.9 standard deviation (SD) 7.3. In microabrasion followed by CPP-ACFP group, statistically significant difference was found between both these groups with P value of P ≤ 0.001. Conclusions: Microabrasion followed by the remineralizing agent can improve the esthetics of white tooth discoloration with time.
12 citations
TL;DR: Low-shrinkage resin monomers seem to be beneficial for reducing PS with enhancement in the DC, while increased filler loading in BFCs had a positive effect on reducing PS, while its effect on the DC was material dependent.
Abstract: Background The effectiveness of each resin composite material composition in enabling homogeneous monomer conversion and reducing polymerization shrinkage (PS) is an important issue. Thus, this study aimed to evaluate the degree of conversion (DC) and PS of low-shrinkage bulk-fill composites (BFCs) in 4-mm thickness. Materials and Methods Four bulk fill (Tetric EvoCeram Bulk Fill, Sonic Fill, XTra Fill, and Venus Bulk Fill) and one conventional (Filtek Z350 XT) resin composites were tested in this study. Teflon molds of 4-mm depth were used to prepare resin composite specimens. All tested resin composites were packed in bulk then light cured for the recommended time by their manufacturers. DC% was determined by Fourier transform infrared spectroscopy; PS was determined using the strain gauge method. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). Results DC% results were as follows: Venus Bulk Fill > XTra Fill > Sonic Fill > Tetric EvoCeram Bulk Fill > Filtek Z350 XT with a significant difference between each others at P ≤ 0.001. For PS %, significant difference resulted between tested groups at P ≤ 0.001. Where Venus Bulk Fill < XTra Fill = Sonic Fill < Tetric EvoCeram Bulk Fill < Filtek Z350 XT. Conclusions Low-shrinkage resin monomers seem to be beneficial for reducing PS with enhancement in the DC. Increased filler loading in BFCs had a positive effect on reducing PS, while its effect on the DC was material dependent.
11 citations
TL;DR: It was shown that with an increase in bone quality, marginal bone loss was decreased at follow-up periods and CBCT is a reliable tool for assessing bone quality at implant placement sites and estimation of subsequent treatment prognosis.
Abstract: Objective: The aim of this study was to assess bone quality in patient's preoperative cone beam computed tomography (CBCT) and their relation with marginal bone loss at implant placement sites over follow-up periods. Materials and Methods: In this retrospective cross-sectional study, 100 implants were evaluated. The implants had been placed in the maxillary and mandibular edentulous areas. Bone quality at implant placement sites was measured on preoperative CBCTs and then classified by two observers according to Lekholm and Zarb classification. Marginal bone height was then measured on periapical radiographs obtained at baseline and then 6, 12, 18, 24, and 30 months' follow-up periods from a reference point (implant shoulder) to the bone-implant interface. The relation between bone quality and bone loss was assessed. ANOVA was used to compare mean difference among groups and Pearson correlation coefficient to assess the correlation between observers. All statistical analyses were performed at 0.05 significance level using Stata 11 software (StataCorp, College Station, TX, USA). Results: Of 100 implants, 48 were placed in the maxilla and 52 in the mandible. There was no significant difference between bone quality and the mean bone loss at follow-up periods. Using Pearson's correlation coefficient, it was shown that with an increase in bone quality, marginal bone loss was decreased at follow-up periods. Conclusions: The results confirmed that during the follow-up periods, less bone loss was observed in implant areas with higher bone quality and CBCT is a reliable tool for assessing bone quality at implant placement sites and estimation of subsequent treatment prognosis.
11 citations
TL;DR: Mangosteen peel extract is effective at inhibiting S. mutans and P. gingivalis biofilms, and this antibiofilm agent can be an alternative therapy in preventing caries and periodontal disease.
Abstract: Background: Streptococcus mutans and Porphyromonas gingivalis are caries and periodontal disease-related bacteria. The mangosteen fruit (Garcinia mangostana L.) peel contains flavonoids, tannins, saponins, and xanthones that have antibacterial properties. Aims: The aim of this study is to analyze mangosteen peel extracts' ability to inhibit S. mutans and P. gingivalis has biofilms growth in vitro. Materials and Methods: Mangosteen peel extract effects on the S. mutans ATCC-3198 and P. gingivalis ATCC-3327 in biofilms growth were evaluated by a crystal violet biofilm assay. Each bacterium was inoculated into a brain–heart infusion broth for 24 h at 37°C anaerobic conditions. A volume of 200 μL (107 colony-forming unit/mL) of bacterial suspension were distributed in microplate wells and incubated for 24 h. Mangosteen peel extracts with different concentrations were added into biofilm wells. Biofilm without treatment was used as negative control. Biofilm mass was calculated by 0.5% crystal violet staining, and optical density was measured at 600 nm using microplate reader. All obtained data were statistically analyzed using one-way analysis of variance test with P < 0.05 set as the level of significance. Results: The results showed that mangosteen peel extract could inhibit the growth of S. mutans and P. gingivalis in biofilms significantly compared to the negative control (P < 0.05). The most effective concentration and incubation time for inhibiting biofilm growth was 100% in 6 h for S. mutans and 100% in 24 h for P. gingivalis. Conclusion: Mangosteen peel extract is effective at inhibiting S. mutans and P. gingivalis biofilms, and this antibiofilm agent can be an alternative therapy in preventing caries and periodontal disease. Future studies are needed to explore this effect.
11 citations
TL;DR: Long-term intake of fluoridated drinking water did not show effect on the thyroid function in children with normal nutritional status and optimal iodine intake, and Serum T3, calcium, phosphate, and alkaline phosphatase levels in all children showed values falling within normal range.
Abstract: Background: Literature shows association between systemic fluorides and endocrine disorders especially related to thyroid, with lack of clarity. Aims and Objectives: The aim and objective of this study was to estimate serum triiodothyronine (T3), thyroxin, thyroid-stimulating hormone (TSH), fluoride, calcium, phosphate, and alkaline phosphatase levels among children with normal nutritional status and optimal iodine intake residing in three different ranges of drinking water fluoride levels. Materials and Methods: The present double-blinded, observational trial comprised of 293 children aged between 9 and 13 years consuming naturally fluoridated water of three different ranges: Group I: 0.01–0.6 parts per million (ppm), Group II: 0.7–1.2 ppm, and Group III: 1.3–1.8 ppm. For each child's demographic data, body mass index and Clinical Fluorosis Index were recorded along with serum T3, T4, TSH, fluoride, calcium, phosphate, and serum alkaline phosphatase levels. Data were analyzed using Chi–square test, Kruskal–Wallis test, and repeated measures ANOVA with SPSS 23. Results: For serum TSH levels, 40% of children in Group I had deranged levels followed by Group III (20%) and Group II (16%). For serum T4 levels, 24% of children of both Groups I and III had deranged levels followed by Group II (20%). Intergroup correlation of drinking water fluoride levels to the number of deranged serum T3, T4, and TSH of the children showed nonsignificant association. Serum T3, calcium, phosphate, and alkaline phosphatase levels in all children showed values falling within normal range. Conclusion: According to the present study results, long-term intake of fluoridated drinking water (0.02–1.4 ppm) did not show effect on the thyroid function in children with normal nutritional status and optimal iodine intake.
10 citations
TL;DR: It is concluded that oral cavity is possibly as important as the nasal area as a zone of SA and MRSA and dentists dealing with pediatric population should take proper precautions to prevent cross contamination in the dental clinic.
Abstract: Aim: This study aimed to investigate the oral and nasal prevalence of community-associated methicillin-resistant Staphylococcus aureus(CA-MRSA) in 4 to 13-year-old rural schoolchildren. Materials and Methods: A total of 100 children aged 4 to 13 years were randomly selected and divided into ten groups based on their age (Group 1 = 4-year-old children to Group 10 = 13-year-old children). From each participating child, sampling was done from the anterior nares and dorsum of the tongue. All samples were inoculated into Baird–Parker agar medium and HiCrome™ MeReSa agar medium for the isolation of SA and MRSA. Both the culture plates were checked for the presence of SA and MRSA and overall SA and MRSA carriage. The distribution of SA and MRSA was evaluated. Descriptive statistics were performed using SPSS software (version 17.0). Results: Overall SA in 4–13 years' age group was 47%, while CA-MRSA was 35%. On the tongue, 16 children had concomitant MRSA and SA, while only 23.8% (n = 20) of the children comprised the presence of SA when MRSA was absent (P < 0.001). In the nasal cavity, 30 children had concomitant MRSA and SA, while only 21.4% (n = 15) of the children had the presence of SA when MRSA was absent (P < 0.001). When tongue and nose were assessed, 11 children encompassed concomitant MRSA and SA, while only 16.9% (n = 13) of the children had the presence of SA when MRSA was absent in both sites (P < 0.001). Conclusion: A significant relation was found between nasal SA and CA-MRSA carriage, with oral SA and CA-MRSA carriage. The study concludes that oral cavity is possibly as important as the nasal area as a zone of SA and MRSA. Dentists dealing with pediatric population should take proper precautions to prevent cross contamination of SA and MRSA in the dental clinic.
TL;DR: PVES tested was found to be more flexible with high tensile energy and can be preferred in cases with undercut areas favoring the removal of impressions without tear and distortion.
Abstract: Background: A new elastomeric impression material which is a combination of vinyl polysiloxane (VPS) and polyether (PE) elastomers called “polyvinyl ether silicone” (PVES) has been introduced with predictable accuracy and high-quality impressions. There is insufficient data on mechanical properties of this material. Materials and Methods: A comparative study of mechanical properties of VPS, PE, and PVES was carried out using light- and heavy-body consistencies of the three materials. Three standardized stainless steel molds were made to fabricate study specimens (n = 96). The specimens were tested for elastic recovery, strain under compression, tear energy, and tensile strength (TS) using the universal testing machine. Statistical analysis was done using two-way analysis of variance test. Results: Elastic recovery was higher in VPS as compared to other two materials. Strain under compression was higher for PE followed by PVES. Tensile energy was significantly higher in PVS while TS was higher in VPS, followed by PVES and PE. Conclusion: PVES tested was found to be more flexible with high tensile energy. This material can be preferred in cases with undercut areas favoring the removal of impressions without tear and distortion.
TL;DR: It is suggested that tannins were more toxic than the xanthones derived from mangosteen pericarp.
Abstract: Objective: The objective of this study is to compare the toxicity level of xanthones and tannins derived from mangosteen pericarp extract at specific concentrations against BHK-21 fibroblast cell cultures. Methods: Mangosteen was extracted using a maceration method with ethanol 96%. Xanthones were isolated from the chloroform extract, whereas tannins were isolated using acetone alcohol and serial diluted to 100% concentration. Toxicity levels were monitored after 24 h using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay technique by ELISA reader at 620 nm. Results: Viable cells of BHK-21 against xanthone concentration began to decrease (40.24%) at 3.98% xanthones, whereas viable cells of BHK-21 against tannin concentration began to decrease (68.06%) at 2.2% tannins. Conclusion: It is suggested that tannins were more toxic than the xanthones derived from mangosteen pericarp.
TL;DR: Nano-HA-silica-GIC exhibited good biocompatibility which is comparable to cGIC and favoured the attachment of DPSCs.
Abstract: Background: Despite their lower strength, glass ionomer cements (GICs) are widely used as restorative materials because of their anti-cariogenic properties, direct adhesion to tooth structure and good biocompatibility. Recently, the addition of nano-hydroxyapatite (nano-HA)-silica to conventional GIC (cGIC) has been shown to improve the strength of cGIC. However, the biocompatibility and cell attachment properties of this material are unknown. Aims: This study aims to evaluate and compare the cytotoxicity and cell attachment properties of cGIC and nano-HA-silica-GIC on dental pulp stem cells (DPSCs). Methods and Materials: Material extracts of nano-HA-silica-GIC and cGIC were prepared into seven serial dilutions and applied to 96 well plates seeded with DPSCs. After 72 h, the cell viability was determined using MTT assay. The DPSCs cell attachment properties were examined under scanning electron microscope (SEM) after 24 and 72 h. Kruskal–Wallis test was used to analyse the data for MTT assay (P 0.05). SEM examination revealed the increasing numbers of DPSCs attached to both groups with prominent filopodia, especially after 72 h. Conclusions: Nano-HA-silica-GIC exhibited good biocompatibility which is comparable to cGIC and favoured the attachment of DPSCs.
TL;DR: The results of this meta-analysis showed that patients receiving TADs had 0.78 mm greater upper incisor intrusion than patients receiving the conventional treatment, and no clinical difference was found between Tads and the conventional method of anchorage loss.
Abstract: Aims: The aim of this systematic review was to compare the effectiveness of temporary anchorage devices (TADs) and conventional segmented arches (CSAs) during incisor intrusion in adult patients with a deep bite and their adverse effects. Settings and Design: Four electronic databases were searched. In addition, articles were manually searched for using the reference lists of relevant articles, grey literature, and peer-reviewed orthodontic journals. Subjects and Methods: Data from the retrieved articles were selected and evaluated by two independent reviewers using a new systematic review software program, DistillerSR. A meta-analysis of raw mean differences was performed. Results: Initially, we retrieved 9600 articles, but the selection process resulted in six articles. The included studies ranged from low to high in quality. Meta-analysis showed that TADs enabled 0.78 mm more upper incisor intrusion than the conventional method (95% confidence interval [CI] = 0.28–1.29). There was no significant anchorage loss difference in the CSA group compared to the TAD group (mean difference [MD] −3.68; 95% CI −7.41–0.05). Furthermore, a significant molar tipping of 1.03° was observed in the CSA group (P = 0.008) compared to the TAD group (MD −1.03; 95% CI −1.79–−0.27). Conclusions: The results of this meta-analysis showed that patients receiving TADs had 0.78 mm greater upper incisor intrusion than patients receiving the conventional treatment. This was statistically significant, but not clinically relevant. No clinical difference was found between TADs and the conventional method of anchorage loss.
TL;DR: The results of this study indicated that Triphala was as effective as chlorhexidine mouthwash in its ability in reducing plaque accumulation, gingival inflammation, and bleeding and was relatively free of side effects compared to that of chlor hexidine.
Abstract: Aim: The aim of this study was to assess the effectiveness of two herbal mouthwashes in comparison with Chlorhexidine mouthwash on gingivitis. Materials and Methods: This is a triple-blind randomized controlled clinical trial, where in 60 patients were randomly allocated into three study groups: Triphala mouthwash (Group A), Aloe vera mouthwash (Group B), and Chlorhexidine mouthwash (Group C). All groups were treated with scaling and asked to rinse with respective mouthwashes twice daily for 1 month. Clinical parameters such as plaque index (PI), gingival index (GI), and bleeding index (BI) were recorded at baseline, 15 days, and 30 days, respectively. Results: Our results suggested that Triphala group effectively demonstrated a higher reduction in GI and BI index scores compared to A. vera group (P ≤ 0.005) and the effect is equivocal to the reduction seen with Chlorhexidine group. However, no statistically significant difference was observed between the mouthwashes in reduction of PI scores (P > 0.005). Conclusion: The results of our study evidenced Triphala to be superior in the reduction of plaque, gingival inflammation, and bleeding compared to that of A. vera. However, the results of our study also indicated that Triphala was as effective as chlorhexidine mouthwash in its ability in reducing plaque accumulation, gingival inflammation, and bleeding. Furthermore, Triphala is relatively free of side effects compared to that of chlorhexidine.
TL;DR: In this article, the expression of E-cadherin with histopathological grading in oral squamous cell carcinoma (OSCC) patients was investigated. And the authors concluded that the reduced expression may be a reliable indicator of increase in the invasiveness of OSCCs.
Abstract: Objectives: The current research was undertaken with an aim to correlate the expression of E-cadherin with histopathological grading in oral squamous cell carcinoma (OSCC) patients. Further, the objectives of the study were to evaluate the qualitative and quantitative expressions of E-cadherin in OSCC and to correlate the number of tumor cells of OSCC, immunopositive for E-cadherin with histopathological grading of OSCC. Materials and Methods: Immunoexpression of E-cadherin antibody was evaluated in previously diagnosed, paraffin-embedded sections of 20 tissues each of well-differentiated and moderately differentiated OSCC, 17 tissues of poorly differentiated OSCC, and 10 tissues of normal oral mucosa; Chi-square test, analysis of variance, and Tukey's honestly significant difference test were employed for statistical analysis. Results: E-cadherin immunoreactivity was inversely correlated to the loss of cell differentiation. There was a significant decrease in expression of E-cadherin (P < 0.0001) in advanced cases of OSCC. Furthermore, there was a significant reduction in intensity of E-cadherin expression with advancing histological grades of OSCC. Conclusion: From the present study, it is concluded that the reduced expression of E-cadherin may be a reliable indicator of increase in the invasiveness of OSCCs.
TL;DR: The critical role of HSP 70 as an oncogene in the development of oral cancer is concluded and HSP70 inhibition is, therefore, a promising therapeutic approach for cancer treatment.
Abstract: Introduction: Heat shock proteins are biomarkers regulating the degree of differention and aggressiveness in oral carcinogenesis. The study was carried out to evaluate the expression of HSP 70 in histological grades of epithelial dysplasia and oral squamous cell carcinoma using immunohistochemistry. Methodology: A sample of 40, which included 10 (Normal), 15 (epithelial dysplasia) and 15 (oral squamous cell carcinoma) were selected. The biopsy samples were stained using H and E staining and HSP 70 IHC. Results: There was a statistical significant difference in expression of HSP 70 between normal oral mucosal tissue, leukoplakia and OSCC. Discussion and Conclusion: This study concludes the critical role of HSP70 as an oncogene in the development of oral cancer. HSP70 inhibition is, therefore a promising therapeutic approach for cancer treatment.
TL;DR: In an in vitro study, sealants containing 1 wt% ZnO and CaF2 NPs and their mixture exhibited significantly higher antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus when compared to control group, and the mechanical properties remained comparable to the conventional sealants.
Abstract: Context: Pit and fissure sealants (PFSs) are the most effective preventive materials in dentistry. Secondary caries around the sealed pits and fissures at the material–tooth interface and the wear of the material remains the common problems. To address these problems, efforts have been made by incorporating zinc oxide (ZnO) and calcium fluoride (CaF2) nanoparticles (NPs) into the sealants to develop caries-inhibiting and stress-bearing sealants. Aim: Evaluation of antibacterial and mechanical properties of PFS containing ZnO and CaF2 NPs. Settings and Design: This was an in vitro study. Materials and Methods: A total of 196 fissure sealant samples were divided into six test groups and a control group. The test group samples were prepared by incorporating two concentrations (0.5 wt% and 1 wt%) of ZnO and CaF2 NPs into the sealants. The antibacterial activity was evaluated by direct contact test; compressive and flexural strengths were evaluated by a universal testing machine. Statistical Analysis Used: Statistical analysis was done by one-way ANOVA and post hoc Tukey test. Results: Sealants containing 1 wt% ZnO and CaF2 NPs and their mixture exhibited significantly higher antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus when compared to control group (P
TL;DR: There was a significant improvement of periodontal conditions of the second molar and adjacent sextant after impacted third molar surgery.
Abstract: Objective: The purpose of this study was to evaluate the change in periodontal status of the adjacent second molar of the impacted mandibular third molar after surgical extraction and its association with the third molar condition in the presurgical stages, including position, eruption level, and local complications. Materials and Methods: The study was based on a 6-month follow-up of 38 patients (19 males and 19 females; Mean age: 21.89 ± 2.74) recruited consecutively after surgical extraction of an impacted lower third molar. The third molar's presurgical position, eruption level, and local complications were examined. Periodontal status, including Plaque Index (PI), Gingival Index (GI), and gingival bleeding on probing (BOP), of the teeth in the adjacent sextant was clinically evaluated. The pocket depth (PD) and the distance between the epithelial attachment and the adjacent second molar's occlusal surface were clinically measured; and the distance between the alveolar bone crest and cementoenamel junction (AC–CEJ) of the adjacent second molar was evaluated by the periapical film. All measures were recorded at the time of surgery and 1, 3, and 6 months after surgery. Results: The values of PI, GI, BOP, PD, and EA–OS were significantly reduced after 1, 3, and 6 months compared to baseline data. The AC–CEJ was decreased after 1 month but significantly increased after 3 and 6 months. Presurgical local complications of the impacted third molar mostly were significantly associated with the periodontal status of the adjacent sextant. Conclusion: There was a significant improvement of periodontal conditions of the second molar and adjacent sextant after impacted third molar surgery.
TL;DR: The mean colour difference of the three groups were found to be more than the clinically acceptable perceptibility threshold (ΔE < 3.3) indicative of reduced masking ability of all theThree groups of ceramic discs over metallic substrate used in this study.
Abstract: Purpose: The purpose of this in vitro study was to comparatively evaluate the masking ability of lithium disilicate ceramic with different core thickness on the shade match of indirect restorations over metallic substrate. Materials and Methods: A total of 30 heat pressed lithium disilicate ceramic discs of low translucency were fabricated with diameter 10mm and thickness of 1 mm, 1.3 mm and 1.6mm with each thickness consisting of 10 samples to be used in the study. Thirty Ni-Cr metal discs of diameter 10mm were used to simulate metallic substrates .The colour difference of the lithium disilicate ceramic disc before and after cementation were measured using CIE LAB system. Results: The mean colour difference (ΔE) of Group I,Group II, Group III before cementation with the Ni-Cr metal discs was 17.32,13.01 and 11.73 respectively. The mean colour difference (ΔE) of Group I,Group II, Group III after cementation with the Ni-Cr metal discs was 16.32,12.10, 11.05 respectively. Conclusion: The mean colour difference of the three groups were found to be more than the clinically acceptable perceptibility threshold (ΔE < 3.3) indicative of reduced masking ability of all the three groups of ceramic discs over metallic substrate used in this study.
TL;DR: This is the first case to be reported among ameloblastoma with different histopathological variants at recurrence, and it is presented in a 46-year-old female who previously diagnosed and treated for a case of plexiform amelOBlastoma 17 years back.
Abstract: Ameloblastoma is an uncommon locally invasive benign odontogenic tumor arising from the odontogenic epithelium. It is a slow-growing tumor with locally aggressive nature, and posterior mandible is the most common location. The recurrence rate is high even after en bloc resection. Acanthomatous ameloblastoma is one of the rare variants of ameloblastoma and is usually seen in older age group. Here, we present a case of acanthomatous ameloblastoma in a 46-year-old female who previously diagnosed and treated for a case of plexiform ameloblastoma 17 years back. This is the first case to be reported among ameloblastoma with different histopathological variants at recurrence.
TL;DR: Differences in hardness and surface roughness are due to different composition of resin matrix and different filler particles in all composite resin material tested.
Abstract: Introduction Restorative resins during their prolonged use are exposed to variety foods and beverages are subjected to wear, degradation, and staining resulting in failure of restoration and require replacement. This study is aimed to evaluate surface roughness and hardness of five commercially available posterior resin composites following exposure to various food-simulating liquids (FSLs). Materials and methods Specimens were immersed in distilled water, ethanol, citric acid, and air and later examined using a profilometer, scanning electron microscope for the surface profiles. Hardness was measured by Vickers Hardness test. Statistical analysis Results were subjected to two-way ANOVA and Tukey's multiple Post hoc test. Results There were significant differences in results among the composite resin tested. Inter comparison between materials after treating with FSLs, clear fill majesty (CFM) and Z350 showed better hardness values under the influence of ethanol, followed by Ever X, Tetric Evo Ceram and Sure fill SDR. None of the composites were unaffected by air compared to FSLs. Citric acid had reduced the hardness of CFM and had caused surface roughness on Sure fill SDR and Tetric Evo Ceram. Distilled water reduced hardness of CFM and SureFil SDR. EverX was not affected by any of the FSL either in hardness or surface roughness properties. All composites showed surface irregularities in all media. Ethanol and water had almost similar effect on all composites. Conclusions Differences in hardness and surface roughness are due to different composition of resin matrix and different filler particles in all composite resin material tested.
TL;DR: It is proved that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases.
Abstract: Introduction: The use of articaine has been claimed to obviate the need for routine palatal local anesthetic injections on account of its better diffusion through soft and hard tissues as compared to other local anesthetic agents. Objective: The objective of the study is to evaluate the efficacy of 4% articaine (with 1:100,000 adrenaline) infiltrated only buccally in the extraction of maxillary premolars for orthodontic reasons. Materials and Methods: A double-blind randomized clinical trial with a split-mouth design, where each patient (n = 100) was part of two groups, was conducted. Experimental Group 1: single buccal infiltration of 4% articaine with 1:100,000 adrenaline (Septanest™ with adrenaline 1:100,000 by Septodont). Control Group 2: routine buccal and palatal infiltrations of 2% lignocaine with 1:200,000 adrenaline (Lox™ 2% with adrenaline 1:200,000 by Neon). The parameters studied were time to onset of anesthesia, pain during the extraction procedure (not during the injecting of the local anesthetic), and frequency of extra amount of local anesthetic injected. Results: The difference was not statistically significant (P > 0.05) between the two groups with respect to all three parameters. This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases. Conclusion: This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases.
TL;DR: Green tea gel and mouthwash contribute to a significant reduction of salivary levels of S. mutans and Lactobacillus colonies, with a greater effect of mouthwash than the green tea gel, which was not statistically significant.
Abstract: Aims: Green tea is an antibacterial agent with no significant side effect. This feature makes green tea safe for children to use. The purpose of this study was to compare the effectiveness of green tea gel and mouth rinse on salivary level of Streptococcus mutans and Lactobacillus of teenagers aged 12–18 years. Subjects and Methods: In this randomized controlled clinical trial study, 30 children aged 12–18 years were included in the study according to the inclusion criteria and were randomly divided into two groups. Participants in mouth rinse group were asked to rinse their mouth with 0.5% green tea mouthwash twice a day for 2 weeks. In the gel group, participants were requested to brush their teeth with 0.5% green tea gel twice a day for 2 weeks. After 4 weeks of washout period, mouthwash group applied the gel and the gel group rinsed the mouthwash for 2 weeks and with the same instruction as mentioned. Colony count of S. mutans and Lactobacillus was determined before and after intervention and data were analyzed using t- test. Results: According to the independent t- test, there was no significant difference in the salivary levels of S. mutans before and after intervention regarding age and gender (P = 0.33). Results from paired t-test showed significant decrease in the mean count of S. mutans and Lactobacillus colonies in both groups before and after intervention (P < 0.001). Conclusions: Green tea gel and mouthwash contribute to a significant reduction of salivary levels of S. mutans and Lactobacillus colonies, with a greater effect of mouthwash than the green tea gel, which was not statistically significant.
TL;DR: Both the graft materials appear to have nearly comparable effects, with nanocrystalline hydroxyapatite (Sybograf™), displaying slightly superior effect over bioactive glass especially in relation to clinical parameters, however, long-term, controlled clinical trials are required to confirm these findings.
Abstract: Aim: The aim of this study is to compare and to evaluate clinically and radiographically the bone regeneration and the amount of bone fill (BL) between nanocrystalline hydroxyapatite (Nc-HA) (Sybograf™) and bioactive synthetic NovaBone Putty in the treatment of intrabony component of periodontal osseous defects. Materials and Methods: Twenty sites in 20 patients, within the age range of 25–55 years, showing intrabony defects were selected and divided into Group I (Nc-HA) and Group II (Bioactive synthetic NovaBone Putty). All the selected sites were assessed with the clinical and radiographic parameters such as plaque index, gingival index, sulcus bleeding index, probing pocket depth, clinical attachment level, gingival recession, and radiographic BL. All the clinical and radiographic parameter values obtained at different intervals (baseline, 3, and 6 and 9 months) were subjected to statistical analysis. Results: A statistically significant reduction in pocket depth of 4.400 ± 0.843 mm (Group I), 3.800 ± 0.789 mm (Group II) and gain in clinical attachment level of 6.2 mm (Group I), 5.9 mm (Group II) were recorded at the end of the study. A slight increase in gingival recession was observed. The mean percentage changes in the amount of radiographic BL of Group II and Group I were significant, However, when compared between the groups, there is no significant difference in BL observed. Conclusion: Both the graft materials appear to have nearly comparable effects, with nanocrystalline hydroxyapatite (Sybograf™), displaying slightly superior effect over bioactive glass especially in relation to clinical parameters. However, long-term, controlled clinical trials are required to confirm these findings.
TL;DR: Efficacy of curcumin, lycopene, and piperine as a combination in the management of oral submucous fibrosis was evaluated on the basis of improvement in clinical parameters, and highly significant improvement was observed for posttreatment reduction in VAS score for burning sensation and increase in MO.
Abstract: Context: Oral submucous fibrosis (OSMF) is a high-risk premalignant condition of the oral cavity and oropharynx. Complete regression of the disease is still not possible with available treatment modalities. Aims: The aim of the study was to evaluate the efficacy of curcumin, lycopene, and piperine as a combination in the management of OSMF. Settings and Design: Efficacy was evaluated on the basis of improvement in clinical parameters (i.e., visual Analog Scale [VAS]) score for burning sensation, mouth opening (MO), mucosal flexibility (MF), and tongue protrusion [TP]). Materials and Methods: Forty patients clinically and histopathologically diagnosed with OSMF were included in the study; patients were administered with the above-stated drug combination, and clinical parameters were evaluated at regular intervals to compare the pre- and post-treatment measurements. Statistical Analysis Used: Paired t-test was done to evaluate significance of the results. Results: Highly significant improvement was observed for posttreatment reduction in VAS score for burning sensation and increase in MO (P
TL;DR: The incorporation of PRF with synthetic bone graft (perioglas) produces effective and rapid periodontal regeneration with improved healing in intrabony osseous defects with satisfactory clinical consequences.
Abstract: Background: Platelets are richest source for cytokine and growth factors which are two important components for the re-establishment of bone and maturation of the soft tissue. Aims and Objective: The additive effect of PRF along with a synthetic bone graft material in treating human intrabony periodontal defects has been evaluated in this study. The appropriate use of platelet-rich fibrin (PRF) as an alternate comfortable graft material to restore the lost periodontal tissues has been well documented and has given clinically promising outcome. Materials and Method: Platelet-rich fibrin (PRF) is prepared from patient's own blood which is autologous in nature. Perio Glas (PG) is an easy to use synthetic absorbable osteostimulative as well as osteoconductive bone graft material. The selected 30 sites were randomly divided into two groups such as Test (15 sites using PRF) and Control (15 sites without PRF). Results: At the end of Six months, the post-operative evaluations revealed significant reduction in PPD and gain in CAL. Radiographic evidence of bone formation was also noticed. The incorporation of PRF with synthetic bone graft (perioglas) produces effective and rapid periodontal regeneration with improved healing in intrabony osseous defects. The PRF group showed a mean Radiographic Defect Fill (RDL) of 1.24 ± 0.04 compared with 0.79 ± 0.07 of control group which is statistically significant. Conclusion: This combination technique can be used as an alternate grafting modality for the treatment of intrabony periodontal defects with satisfactory clinical consequences.
TL;DR: Investigating whether the Dental Discomfort Questionnaire (DDQ) could help to identify toothaches in children with autism spectrum disorder (ASD) found a correlation was observed between the total DDQ score and the decayed, missing, and filled teeth (dmft–DMFT) score.
Abstract: Aim: The aim of this study is to investigate whether the Dental Discomfort Questionnaire (DDQ) could help to identify toothaches in children with autism spectrum disorder (ASD). Materials and Methods: This study involved sixty children between the age groups of 6–16 years, attending the day-care schools diagnosed with ASD. Five different groups of children were identified based on the presence of a toothache and/or carious teeth. The DDQ-8 was completed by parents and evaluated by a single examiner. Data were analyzed using descriptive statistics (SPSS version 17), and a correlation was observed between the total DDQ score and the decayed, missing, and filled teeth (dmft–DMFT) score. Results: Analysis of the data showed that DDQ-8 had a significant correlation with that of DMFT score in a group “with carious teeth but no toothache” (r = 0.497, P = 0.019) and group “with carious teeth and a toothache” (r = 0.682 P = 0.043). A group “without carious teeth where the parents were not sure whether or not the child had a toothache” had higher mean compared to other groups with DDQ-8 scores. Conclusion: There was a significant difference in the total mean DDQ scores when they were compared with that of the control group. Children with high DDQ-8 often had a high DMFT/dmft score. A significant correlation was found when the total DDQ-8 scores were compared with that of the DMFT score.
TL;DR: This article aims to provide an update on NHS while reporting previously unreported findings such as talon's cusp and taurodontism.
Abstract: Nance-Horan syndrome (NHS) or X-linked cataract dental syndrome is an extremely rare condition affecting multiple systems. It is characterized by ophthalmological, dental, and facial anomalies. Individuals display facial dysmorphism, mandibular prognathism, congenital cataract, and strabismus. Common dental findings include notching of incisors, supernumerary teeth, and mulberry molars. This article aims to provide an update on NHS while reporting previously unreported findings such as talon's cusp and taurodontism.