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Showing papers in "European Journal of Dentistry in 2015"


Journal ArticleDOI
TL;DR: The Invisalign® group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group, and should be considered as afirst treatment option in patients with risk of developingperiodontal disease.
Abstract: Objective: The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign® system (Align Technology, Santa Clara, California). Materials and Methods: Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign® group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann–Whitney test for independent groups. Results: After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign® group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P

79 citations


Journal ArticleDOI
TL;DR: The cytotoxic consequences of denture base acrylic resins and clinical recommendations for their use are outlined.
Abstract: Denture base resins are extensively used in dentistry for a variety of purposes. These materials can be classified as chemical, heat, light, and microwave polymerization materials depending upon the factor which starts the polymerization reaction. Their applications include use during denture base construction, relining existing dentures, and for fabrication of orthodontic removable appliances. There have been increased concerns regarding the safe clinical application of these materials as their biodegradation in the oral environment leads to harmful effects. Along with local side effects, the materials have certain occupational hazards, and numerous studies can be found in the literature mentioning those. The purpose of this article is to outline the cytotoxic consequences of denture base acrylic resins and clinical recommendations for their use.

77 citations


Journal ArticleDOI
TL;DR: ST can be an important component of a distinctive disorder and an important clue for early diagnosis and also it is important for making well-informed decisions about long-term medical care and treatment.
Abstract: Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico-Rhino-Phalangeal syndrome ST can be an important component of a distinctive disorder and an important clue for early diagnosis Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment In this review, the genetic syndromes that are related with ST were discussed

63 citations


Journal ArticleDOI
TL;DR: Recognition of morphology and anatomy of the root canal system is one of the most important factors for successful endodontic treatment and helps clinicians in root canal treatment.
Abstract: Objective: The aim of the present study is to assess the root and root canal morphology of maxillary and mandibular premolars in a Turkish population by using cone beam computed tomography (CBCT). Materials and Methods: In this study, CBCT images of 2134 premolars (987 maxillary, 1147 mandibular) were obtained from 404 patients. Details of gender, age, number of roots and canals, and canal configuration in each root were recorded. The canal configuration was classified and evaluated according to Vertucci's criteria. Results: The majority of maxillary premolars had two separate roots; although, three roots were identified in 1% of maxillary first premolars. However, most of the mandibular premolars had a single root. The two canals (69.9%) and type I (62.6%) and type II (34.1%) configuration for upper first premolar, one canal (82.1%) and type I (77.6%) canal configuration for second premolar was the most prevalent root canal frequency. The most prevalent root canal frequency was the one canal (96.2%) and type I (94.2%) and type V (3.2%) configuration for mandibular first premolar, one canal (98.9%) and type I (98.9%) canal configuration for second premolar. There was no difference in the root canal configurations and the numbers of canals between the left and the right side of both females and males (P > 0.05). Conclusions: Recognition of morphology and anatomy of the root canal system is one of the most important factors for successful endodontic treatment. Preoperative CBCT examination allows determination of root canal configuration of premolar teeth and helps clinicians in root canal treatment.

62 citations


Journal ArticleDOI
TL;DR: It can be concluded that the bleaching protocols caused a slight enamel surface alteration, however, the remineralization process minimized these effects.
Abstract: Objective: Tooth bleaching tends to increase enamel roughness and porosity, in addition to reducing surface microhardness. The aim of this in vitro study was to evaluate the effects of bleaching treatments using different hydrogen peroxide (HP) concentrations, with and without light activation on bovine enamel microhardness. Materials and Methods: The buccal surfaces of sixty bovine incisors were flattened and polished and the enamel specimens were divided into six groups: G1 : c0 ontrol, exposed to artificial saliva; G2: 35% HP applied in two sessions (45' each); G3: 35% HP applied in two sessions (3 × 15' each); G4: 35% HP applied in one session (3 × 7'30) plus hybrid light (HL); G5: 25% HP applied in one session (3 × 7'30) plus HL; and G6: 15% HP applied in one session (3 × 7'30) plus HL. After the treatment, the enamel specimens were stored in artificial saliva. The surface microhardness (Knoop) was measured at the baseline, 24 h and 7 days after bleaching. The data was analyzed using the ANOVA test, followed by the Tukey-Krummer test ( P Results: All bleaching procedures lead to a decrease in surface microhardness when compared with the control group after 24 h. The lowest change in surface microhardness was found in the specimens treated with 15% HP plus HL. However, 35% HP plus HL induced the highest decrease in surface microhardness. After 7 days of remineralization, the surface microhardness returned to normal levels for all bleached specimens. Conclusion: Therefore, it can be concluded that the bleaching protocols caused a slight enamel surface alteration. However, the remineralization process minimized these effects.

61 citations


Journal ArticleDOI
TL;DR: Microhardness of enamel and dentin was in an acceptable range when teeth were stored for 2 months in de-ionized water, glutaraldehyde, HBSS, NaOCl or in thymol; thus, teeth kept up to 2 weeks in these solutions can be used for mechanical in vitro tests.
Abstract: Objective: The aim of this study was to determine alterations in microhardness of crown dentin and enamel, after 2 and 12-month storage in de-ionized water, 0.2% glutaraldehyde, Hanks’ Balanced Salt Solution (HBSS), 0.1% sodium hypochlorite (NaOCl) or 0.1% thymol. Materials and Methods: Freshly extracted, nonsterile 60 intact human premolars were distributed to five groups. Six teeth from each group were evaluated after two, and other six teeth were evaluated after 12 months storage. After grinding and polishing of teeth, Vickers hardness was evaluated with making indentations on enamel and dentin, using a pyramid diamond indenter tip exerting 100 g load for 15 s. Results: After 2 months storage in solutions, range of the hardness values (HV) of enamel and dentin were in between 315–357 and 64–67, respectively. However, 12 months storage of the teeth resulted in a statistically significant decrease in microhardness when compared to microhardness of teeth stored for 2 months (P = 0.001). Although the differences were not significant regarding solutions, all solutions decreased the microhardness both in enamel and dentin (P > 0.05). However, decrease in microhardness was relatively less in de-ionized water and thymol solutions while glutaraldehyde decreased microhardness the most: 63% for enamel and 53% for dentin. Conclusions: Microhardness of enamel and dentin was in an acceptable range when teeth were stored for 2 months in de-ionized water, glutaraldehyde, HBSS, NaOCl or in thymol; thus, teeth kept up to 2 months in these solutions can be used for mechanical in vitro tests. However, 12 months storage significantly decreased the microhardness of enamel and dentin.

60 citations


Journal ArticleDOI
TL;DR: The Percentage of symmetry observed in the present study varied from 70% to 98% with least percentage of symmetry in maxillary second molars, which should alert the clinicians while treating homonymous teeth of the same patient.
Abstract: Objective: To investigate the anatomic symmetry of maxillary and mandibular posteriors in Indian subpopulation using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of 246 patients that had at least one noncarious, posterior tooth free of restorations in each quadrant were enrolled for retrospective analysis. A total of 3015 teeth (811 maxillary premolars, 845 mandibular premolars, 738 maxillary molars, and 621 mandibular molars) were analyzed for number of roots and root canals, canal morphology and anatomic symmetry, and concurrent types between the maxilla and mandible. Results: There was no difference in the percentage of symmetry for maxillary first (81.5%) and second (81.5%) premolars. Mandibular second premolars (98.3%) exhibited greater symmetry than mandibular first premolars (96.1%). First molars (77.5% and 82.1%) showed greater symmetry than second molars (70.8% and 78.6%), in both maxillary and mandibular arches, respectively. The most common anatomy observed were: maxillary first premolars – 2 roots with 2 canals, maxillary second premolars – 1 root with 2 canals, mandibular first and second premolars – 1 root with 1 canal, maxillary first and second molars – 3 roots with 4 canals, and mandibular first and second molars – 2 roots with 3 canals. When compared with any other teeth, maximum asymmetry was observed in maxillary second molar (29.2%). Conclusion: The percentage of symmetry observed in the present study varied from 70% to 98% with least percentage of symmetry in maxillary second molars. These data should alert the clinicians while treating homonymous teeth of the same patient.

53 citations


Journal ArticleDOI
TL;DR: The bivariate correlation results revealed that any of the two radiographic techniques (IOPA and OPG) can be used for analysis of the regenerative therapy in IBDs.
Abstract: Objective: The primary objective of this study was to compare clinically and radiographically the efficacy of autologous platelet rich fibrin (PRF) and autogenous bone graft (ABG) obtained using bone scrapper in the treatment of intrabony periodontal defects. Materials and Methods: Thirty-eight intrabony defects (IBDs) were treated with either open flap debridement (OFD) with PRF or OFD with ABG. Clinical parameters were recorded at baseline and 6 months postoperatively. The defect-fill and defect resolution at baseline and 6 months were calculated radiographically (intraoral periapical radiographs [IOPA] and orthopantomogram [OPG]). Results: Significant probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, defect fill and defect resolution at both PRF and ABG treated sites with OFD was observed. However, inter-group comparison was non-significant (P > 0.05). The bivariate correlation results revealed that any of the two radiographic techniques (IOPA and OPG) can be used for analysis of the regenerative therapy in IBDs. Conclusion: The use of either PRF or ABG were effective in the treatment of three wall IBDs with an uneventful healing of the sites.

53 citations


Journal ArticleDOI
TL;DR: The article explores what biomechanical factors help to facilitate the development of cracks in teeth, and under what circumstances a full coverage crown may be indicated for preventing further propagation of a fracture plane.
Abstract: This article reviews the diagnosis and treatment of cracked teeth, and explores common clinical examples of cracked teeth, such as cusp fractures, fractures into tooth furcations, and root fractures. This article provides alternative definitions of terms such as cracked teeth, complete and incomplete fractures and crack lines, and explores the scientific rationale for dental terminology commonly used to describe cracked teeth, such as cracked tooth syndrome, structural versus nonstructural cracks, and vertical, horizontal, and oblique fractures. The article explains the advantages of high magnification loupes (×6-8 or greater), or the surgical operating microscope, combined with co-axial or head-mounted illumination, when observing teeth for microscopic crack lines or enamel craze lines. The article explores what biomechanical factors help to facilitate the development of cracks in teeth, and under what circumstances a full coverage crown may be indicated for preventing further propagation of a fracture plane. Articles on cracked tooth phenomena were located via a PubMed search using a variety of keywords, and via selective hand-searching of citations contained within located articles.

45 citations


Journal ArticleDOI
TL;DR: In conclusion, except the hand file and control group, all experimental groups showed microcrack formations and there were no significant differences among the groups.
Abstract: Objective: The aim of the present study was to investigate the incidence of dentinal microcracks caused by different preparation techniques. Materials and Methods: 120 extracted human mandibular incisor teeth were divided into five experimental groups and one control group ( n = 20): Group 1: Hand preparation with balanced force technique up to #25 K-file. Group 2: Preparation with only ProTaper F2 instrument in a reciprocating movement. Group 3: Preparation with Reciproc R25 instrument in a reciprocating movement. Group 4: Preparation with ProTaper instruments up to F2 instrument. Group 5: Preparation with ProTaper Next instruments up to X2 instrument. No procedure was applied to control group. The roots were sectioned horizontally at 3, 6 and 9 mm from the apex and examined. Absence or presence of dentinal microcracks was noted. Results: The Chi-square test was performed to compare the appearance of cracked roots between all groups. There were no significant differences among the groups ( P > 0.05). Conclusions: In conclusion, except the hand file and control group, all experimental groups showed microcrack formations.

43 citations


Journal ArticleDOI
TL;DR: Creating awareness on the burnout of dental students from the preclinical period may be useful for prevention and more compatible dental education environment.
Abstract: Objective: The aim of this study is to investigate the prevalence of burnout among a group of Turkish preclinical dental students, to compare the level of burnout and to determine the consequences in structural equation model. Materials and Methods: Preclinical dental students ( n = 329, 50.5% of females and 49.5% of males) aged between 18 and 24 took part in the study. Maslach burnout inventory student version, academic satisfaction scale, and personal information sheet were used to gather data. Pearson correlation analyses, t -test, and one-way ANOVA were used for statistical analysis. The proposed theoretical model was tested via observed variable path analysis using maximum likelihood parameter estimation with AMOS 7.0. Results: About 22.3% of students had high level of emotional exhaustion, 16.7% of students had high level of cynicism, and 17.9% of students suffered from high level of reduced academic efficacy. While the students attending thefirst grade reported higher level of reduced academic efficacy, the students in the third grade reported higher level of emotional exhaustion. Academic workload played an important role in the development of burnout. As consequences of burnout, students with high levels of burnout intended to change their current major and did not to plan to continue to postgraduate education. Students with high level of burnout reported less level of academic satisfaction and academic achievement. Conclusions: Creating awareness on the burnout of dental students from the preclinical period may be useful for prevention and more compatible dental education environment.

Journal ArticleDOI
TL;DR: While freshly mixed MTA showed the best antibacterial activity over time, Biodentine had shown similar antib bacterial activity to MTA.
Abstract: Objective: The aim of this in vitro study was to evaluate antimicrobial activities of three different pulp capping materials; Biodentine, mineral trioxide aggregate (MTA) Angelus, and Dycal against Enterococcus faecalis and their durability with time. Materials and Methods : Direct contact test was used for the assessment. Three sets of sealers were mixed and placed on microtiter plate wells: One set was used within 20 min of recommended setting time while others were used after 24-h and 1-week. E. faecalis suspension was placed directly on the materials for 1 h and then transferred to another plate with fresh media. Nine wells of bacteria without the tested cements served as the positive control. One well of the tested cements without bacteria served as the negative control. Bacterial growth was evaluated by a temperature-controlled microplate spectrophotometer for 1-h intervals among 24 h. Data were analyzed using Kruskal-Wallis test. Results: All tested materials showed less bacterial density than the control group. MTA, Biodentine, and Dycal showed significantly higher bacterial density than the control group in freshly mixed samples ( P P P > 0.05). MTA and Biodentine samples showed significant differences than Dycal; MTA also showed higher antibacterial activity than control in 1-week samples ( P Conclusion: While freshly mixed MTA showed the best antibacterial activity over time, Biodentine had shown similar antibacterial activity to MTA.

Journal ArticleDOI
TL;DR: In conclusion, most common classical shade was A3, women′s teeth were lighter than men′s, there was a relation between ethnic background and tooth shade.
Abstract: Objective: The aim of the present investigation is to identify tooth shade among a group of Sudanese patients. Materials and Methods: Total number of patients was 227. Participant's age ranged from 15 to 72 years, which, was divided into four groups. The tooth included in the study was either right or left sounds maxillary central incisor. Vita Easyshade was used to select the tooth shade. Investigation of the differences of Commission International de l'Eclairage (CIELab) coordinates among gender and state of origin was conducted together with an examination of the relationship between CIELab coordinates and age. One-way analysis of variance was used to test the differences in L*, a* and b* according to state of origin. Results: Results showed that A3 was the most common classical tooth shade respectively. There was highly significant difference in L* between males and females (P = 0.002). There was a significant relation between tooth shade and age (P = 0.026). There was a high significant association between classical tooth shade and Sudan regions (P = 0.00). Conclusion: In conclusion, most common classical shade was A3, women's teeth were lighter than men's. There was a relation between ethnic background and tooth shade.

Journal ArticleDOI
TL;DR: There is significant (P < 0.001) variation of expression of E-cad with the histopathological dysplasia of the oral precancerous lesions and conditions, and the tumor differentiation of the Oral cancers.
Abstract: Objective: The aim of the present study was to assess the expression of E-cad in oral precancerous lesions and conditions and oral carcinomas in comparison with normal mucosa. Materials and Methods: Total of 50 samples were selected for the study and were categorized into five groups and 10 samples in each group as Group I-oral leukoplakia (OL), Group II-oral lichen planus (OLP), Group III-oral submucous fibrosis (OSMF), Group IV-oral squamous cell carcinoma (OSCC) and Group V-normal oral mucosa (NOM) as control group. All the samples were assessed for the expression of E-cad by immunohistochemical study. Results: Upon assessing the expression of E-cad in OL, OSMF, OLP and OSCC, as majority of the samples with OSCC (90%), OL (80%), OLP (70%) and OSMF (60%) showed mild to moderate expression of E-cad staining, which was suggestive of reduction in dysplastic cells on comparison to NOM cells. This difference in expression and variation of E-cad upon comparison with normal mucosa was statistically significant ( P Conclusion: There is significant ( P < 0.001) variation of expression of E-cad with the histopathological dysplasia of the oral precancerous lesions and conditions, and the tumor differentiation of the oral cancers. However, there was no correlation of the degree of loss of expression of E-cad with the degree of dysplasia or the tumor differentiation of oral cancers. We conclude with our study that, there is a variation in the expression of E-cad but its value as a prognostic marker is questionable.

Journal ArticleDOI
TL;DR: An insufficient knowledge concerning dental trauma management among dental students in Saudi Arabia is demonstrated, highlighting the need to improve the knowledge of dental students regarding dental trauma and its management using a variety of educational methods such as problem-based learning and powering the curriculum concerning those topics of dental trauma.
Abstract: OBJECTIVE: The aim of this study was to assess the level of knowledge and attitude of Saudi dental students in the management of dental trauma in children. MATERIALS AND METHODS: A self-administered questionnaire comprising 17 close-ended questions was used in this survey. The questions were divided into three parts including: Personal and professional profile; knowledge assessment; attitude toward dental trauma. Data of 307 respondents were analyzed using SPSS (Statistical Package for Social Studies) version 22.0 (IBM Corporation, Chicago, IL, USA). RESULTS: The response rate was 76.8%. Around 40.3% of students reported attending additional courses about dental trauma with a significant difference between males (57.2%) and females (19.4%). The vast majority of students (95.7%) stressed the importance of dental trauma education. While 77% could correctly identify the media of transportation of an avulsed tooth, only 26.9% of the students knew the proper method of transportation. Regarding the knowledge of immediate replantation, only 67.5% of students responded correctly. CONCLUSION: The present study demonstrates an insufficient knowledge concerning dental trauma management among dental students in Saudi Arabia. This highlights the need to improve the knowledge of dental students regarding dental trauma and its management using a variety of educational methods such as problem-based learning and powering the curriculum concerning those topics of dental trauma. Language: en

Journal ArticleDOI
TL;DR: The novel calcium silicate-based sealers are negotiable under simple root canal anatomy, however, the conventional retreatment techniques are not able to fully remove them.
Abstract: Objective: Aim of the present study was to evaluate the retreatability and reestablishment of apical patency of two calcium silicate-based sealers, TotalFill BC Sealer (BCS) and mineral trioxide aggregate Fillapex (MTA F), versus AH Plus, when used in combination with Gutta-percha (GP). Materials and Methods: The canals of 54 single-rooted anterior teeth were instrumented and filled with GP/AH Plus (Group A), GP/MTA F (Group B), or GP/BCS (Group C) using continuous wave obturation technique. The groups were subdivided into subgroups with the master-GP cone placed to the working length (WL) or intentionally 2 mm short. The retreatment procedures were performed using ultrasonics, chloroform, rotary, and hand files. The ability to establish the patency and reach WL was determined as well as the time taken to reach WL was calculated in minutes. Furthermore, the samples were observed under a dental, optical microscope, after vertically splitting them. Results: The WL and patency were reestablished in 100% of specimens in all groups. The Mann–Whitney U-test indicated that there was a significant difference in the amount of time required to reach WL between the groups ( P Conclusion: The novel calcium silicate-based sealers are negotiable under simple root canal anatomy. However, the conventional retreatment techniques are not able to fully remove them.

Journal ArticleDOI
TL;DR: It was observed remaining filling material in all teeth, irrespective of the system used; however, root canal retreatment was faster when reciprocating motion was used.
Abstract: Objective: The complete filling material removal during endodontic retreatment is a clinical procedure difficult to achieve. The aim of this study was to evaluate the efficacy of reciprocating and continuous rotary nickel-titanium instruments used in root canal retreatment. Materials and Methods: Forty freshly extracted human premolars were cleaned and shaped by the crown-down technique, followed by filling by the lateral compaction technique. The teeth were randomly separated into two groups ( n = 20), according to the system used for filling material removal: G1 - Reciproc and G2 - ProTaper Universal Retreatment System. The teeth were photographed under operating microscope at ×8 magnification; and the total area of the root canal and remaining filling material were quantified. Results: No statistically significant difference ( P > 0.05) in residual filling material was observed between groups; however, the time required for filling removal was significantly shorter for Reciproc system ( P Conclusions: It was observed remaining filling material in all teeth, irrespective of the system used; however, root canal retreatment was faster when reciprocating motion was used.

Journal ArticleDOI
TL;DR: The study has identified for the first time a unique co-prevalence pattern of bacteria in caries patients that may be explored as distinct caries specific bacterial signature to predict cariogenesis in high-risk primary and mixed dentition age groups.
Abstract: Objective: To identify the prevalence of acidogenic and nonacidogenic bacteria in patients with polycaries lesions, and to ascertain caries specific bacterial prevalence in relation to noncaries controls. Materials and Methods: Total genomic DNA extracted from saliva of three adults and four children from the same family were subjected to 16S rRNA gene sequencing analysis on a next generation sequencer, the PGS-Ion Torrent. Those bacterial genera with read counts > 1000 were considered as significant in each of the subject and used to associate the occurrence with caries. Results and Conclusion: Sequencing analysis indicated a higher prevalence of Streptococcus, Rothia, Granulicatella, Gemella, Actinomyces, Selenomonas, Haemophilus and Veillonella in the caries group relative to controls. While higher prevalence of Streptococcus, Rothia and Granulicatella were observed in all caries samples, the prevalence of others was observable in 29-57% of samples. Interestingly, Rothia and Selenomonas , which are known to occur within anaerobic environments of dentinal caries and subgingival plaque biofilms, were seen in the saliva of these caries patients. Taken together, the study has identified for the first time a unique co-prevalence pattern of bacteria in caries patients that may be explored as distinct caries specific bacterial signature to predict cariogenesis in high-risk primary and mixed dentition age groups.

Journal ArticleDOI
TL;DR: The AgNPs incorporation within the acrylic denture base material can improve its viscoelastic properties.
Abstract: Objective: The objective was to investigate the effect of silver nanoparticles (AgNPs) incorporation on viscoelastic properties of acrylic resin denture base material. Materials and Methods: A total of 20 specimens (60 × 10 × 2 mm) of heat cured acrylic resin were constructed and divided into four groups (five for each), according to the concentration of AgNPs (1%, 2%, and 5% vol.) which incorporated into the liquid of acrylic resin material and one group without additives (control group). The dynamic viscoelastic test for the test specimens was performed using the computerized material testing system. The resulting deflection curves were analyzed by material testing software NEXYGEN MT. Results: The 5% nanoparticles of silver (NAg) had significantly highest mean storage modulus E' and loss tangent Tan δ values followed by 2% NAg ( P P > 0.05). Conclusion: The AgNPs incorporation within the acrylic denture base material can improve its viscoelastic properties.

Journal ArticleDOI
TL;DR: It was clearly demonstrated that female gender and children more than 6 years were more likely to have gingivitis and tooth brushing frequency and diet were not significant predictors.
Abstract: Objectives: The present study evaluated the gingival condition among school going children in Sharjah, United Arab Emirates and determined its relationship with tooth brushing frequency, diet and dental caries. Materials and Methods: Four hundred and five children participated in the study. There were 232 boys (57%) and 173 (43%) girls. Children were grouped based on age as ≤6 years ( n = 84) mean age 4.72 ± 0.50 and >6 years ( n = 321) mean age 8.47 ± 1.65. The amount of dental plaque and gingival condition were assessed on the inner and outer surface of six index teeth using Silness and Loe and Loe and Silness criteria. Dental caries status was assessed using WHO 1997 criteria. Dental examination, tooth brushing frequency and 24 h diet chart were recorded by calibrated dentists. Logistic regression analysis was used to determine the predictors of gingivitis. Results: Increase in decayed, missing, and filled teeth values corresponds to increase in plaque index and gingival index scores ( P ≤ 0.05). A logistic regression analysis of the predictors of gingivitis showed that males were 2.11 times less likely to have gingivitis compared with females (odds ratio [OR]: 0.47,95% confidence interval [CI]: 0.24-0.93, P = 0.03) and children aged ≤6 years were 3.06 times less likely to have gingivitis than those aged >6 years (OR: 0.33, 95% CI: 0.17-0.62, P = 0.00). Tooth brushing frequency and diet were not significant predictors. Conclusion: Current study clearly demonstrated that female gender and children more than 6 years were more likely to have gingivitis.

Journal ArticleDOI
TL;DR: Implant restorations splinting lead to a better distribution of stresses in implant bodies and bone in comparison with nonsplinted restoration, especially when the load is applied off center to implant body.
Abstract: Objective: The aim of this study was to investigate the influence of implant crown splinting and the use of angulated abutment on stress distribution in implant body and surrounding bone by three-dimensional finite element analysis. Materials and Methods: For this study, three models with two implants at the site of mandibular right second premolar andfirst molar were designed (1): Both implants, parallel to adjacent teeth, with straight abutments (2): Anterior implant with 15 mesial angulations and posterior implant were placed parallel to adjacent tooth, (3): Both implants with 15 mesial angulations and parallel to each other with 15° angulated abutments. Restorations were modeled in two shapes (splinted and nonsplinted). Loading in tripod manner as each point 50 N and totally 300 N was applied. Stress distribution in relation to splinting or nonsplinting restorations and angulations was done with ABAQUS6.13. Results: Splinting the restorations in all situations, led to lower stresses in all implant bodies, cortical bone and spongy bone except for the spongy bone around angulatedfirst molar. Angulated implant in nonsplinted restoration cause lower stresses in implant body and bone but in splinted models more stresses were seen in implant body in comparison with straight abutment (model 2). Stresses in nonsplinted and splinted restorations in cortical bone of angulated molar region were more than what was observed in straight molar implant (model 3). Conclusion: Implant restorations splinting lead to a better distribution of stresses in implant bodies and bone in comparison with nonsplinted restorations, especially when the load is applied off center to implant body. Angulations of implant can reduce stresses when the application of the load is in the same direction as the implant angulation.

Journal ArticleDOI
TL;DR: The mean length of distance until the canal reached a round shape correlated with the patient′s age, and the new theoretical model could be beneficial to determine orifice configurations.
Abstract: Objective: The purposes of this retrospective study were to represent a newly designed theoretical model for determining orifice shape and morphologic properties of mandibular premolars and to correlate these findings with each other. Materials and Methods: A total of 287 mandibular premolar images obtained from 88 patients by cone-beam computed tomography were included in this study. The measurements were performed below the cementoenamel junction, and different orifice configurations were defined in accordance with various ratios. The age and gender of the patient, the tooth type and position, the number of roots, orifice configuration, root canal configuration, presence of C-shaped canal, and the presence of radicular groove were recorded. It was also recorded whether the root canal becomes round or not and if any, length of the root canal from the orifice to the section in which it becomes round. Furthermore, the theoretical model for determining orifice shape was defined after measurements. The orifice shape was determined as round, oval, flat, keyhole-shaped, and T-shaped, and orifices with short, normal length, and long isthmus. Statistical analyses were performed using Chi-square and Spearman's rank correlation tests ( P = 0.05). Results: Orifice configurations were, usually, flat (37%), or keyhole-shaped (23%). The prevalence of T-shaped was found to be 3.8%. The prevalence of C-shaped canals was found to be 2.1%. The percentage of root canals that became round in the middle or apical thirds was 95.1%. Radicular grooves were detected in 37 (24%) of first premolars and six (4.5%) of second premolars. Statistical analysis revealed that the mean length of distance until the canal reached a round shape varied according to age group ( r = −0.270; P P Conclusions: The mean length of distance until the canal reached a round shape correlated with the patient's age. The new theoretical model could be beneficial to determine orifice configurations.

Journal ArticleDOI
TL;DR: It was demonstrated that the propolis mouthwash was more effective than the propoli chewing gum on the plaque inhibition and the gingival inflammation.
Abstract: Objective: In general, chemical plaque agents have been used in mouthwashes, gels, and dentifrices. In some situations, application of mouthwashes and dentifrices can be difficult. Therefore, different approaches for oral health-care have been needed. The aim of this study was to evaluate the effect of propolis chewing-gum compared to propolis-containing mouthwash on gingival inflammation and plaque accumulation on patients that refrained from daily oral hygiene procedures for 5 days. Materials and Methods: 10 college students with systemically healthy and very good oral hygiene and gingival health were included in this randomized, single-blind, crossover 5-day plaque regrowth with a 3-day washout period clinical study. After plaque scores were reduced to zero, participants were asked to refrain from oral hygiene procedures and allocated to either propolis mouthwash or chewing-gum group. Chewing-gum was performed after meals 3 times a day for 20 min mouthwash group was instructed to rinse mouthwash 2 times a day for 1 min. On day 5, the clinical periodontal measurements containing plaque and gingival indexes were taken from the participants. Results: The both plaque and gingival indexes of propolis mouthwash group were significantly lower than that of the propolis chewing-gum group (P = 0.005). Conclusion: It was demonstrated that the propolis mouthwash was more effective than the propolis chewing gum on the plaque inhibition and the gingival inflammation.

Journal ArticleDOI
TL;DR: Within the limits of this study, the TFA system caused less cracks then the full reciprocating system (Reciproc and WaveOne), and single-file reciprocating files produced significantly more incomplete dentinal cracks than full-sequence adaptive rotary motion.
Abstract: Objective: This study aimed to compare the frequency of dentinal microcracks after root canal shaping with 2 reciprocating (Reciproc and WaveOne) and 1 combined continuous reciprocating motion twisted files adaptive (TFA) rotary system. Materials and Methods: Ninety molars were chosen and divided into three groups of 30 each. Root canal preparation was achieved by using Reciproc R25, Primary WaveOne and TFA systems. All the roots were horizontally sectioned at 15, 9, and 3 mm from the apex. The slices were then viewed each under a microscope at × 25 magnification to determine the presence of cracks. The absence/presence of cracks was recorded, and the data were analyzed with a Chi-square test. The significance level was set at P Results: Instrumentation with Reciproc produced significantly more complete cracks than WaveOne and TFA ( P = 0.032). The TFA system produced significantly less cracks then the Reciproc and WaveOne systems apically ( P = 0.004). Conclusions: Within the limits of this study, the TFA system caused less cracks then the full reciprocating system (Reciproc and WaveOne). Single-file reciprocating files produced significantly more incomplete dentinal cracks than full-sequence adaptive rotary motion.

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TL;DR: These case reports suggest that implant-supported hybrid prostheses can be a reliable alternative treatment procedure when a porcelain-fused metal fixed restoration does not satisfy a patient′s requirements for esthetics, phonetics, oral hygiene, and oral comfort.
Abstract: An implant-supported hybrid prosthesis is an acrylic resin complete fixed dental prosthesis and supported by implants might be a solution in extreme cases that the need of the restoration for esthetics, function, lip support, and speech. This clinical report aims to present the esthetic and functional prosthetic rehabilitation of three borderline cases with implant-supported hybrid prostheses. Patient 1 (62-year-old man) and Patient 2 (61-year-old man) presented a chief complaint of a compromised esthetic. After clinical evaluations, in Patient 1, 8 implants in the maxilla and 7 implants in mandibula were observed. Patient 2 had 7 implants in the maxilla and 7 implants in mandibula, which were previously placed. The intra-arch dimension of both patients was excessive and an insufficient peri-oral soft tissue support was observed. Patient 3 was a 61-year-old man had 2 implants with a history of previously implanted graft infection and implant loss on his maxillary posterior jaw. An excessive intra-arch dimension was observed in clinical examination. In addition, massive bone defect and insufficient soft tissue support were examined. In all patients, implant-supported hybrid prostheses were successfully performed. The clinical and radiologic findings were satisfactory. After 3 years of follow-up, no functional, phonetic, or esthetic problems with the restorations were noted. These case reports suggest that implant-supported hybrid prostheses can be a reliable alternative treatment procedure when a porcelain-fused metal fixed restoration does not satisfy a patient's requirements for esthetics, phonetics, oral hygiene, and oral comfort.

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TL;DR: The toothpastes with natural compounds have therapeutic potential and need more detailed searches for the correct clinic therapeutic application.
Abstract: Objectives: This in vitro study evaluated the antimicrobial effects of commercial toothpastes containing natural compounds. Materials and Methods: The study groups were divided based on the natural compound present in the toothpaste composition: Sorbitol (I), tocopherol (II), mint (III), cinnamon/mint (IV), propolis/melaleuca (V), mint/acai (VI), mint/guarana (VII), propolis (VIII), negative control (IX), and the positive control (X). The antimicrobial properties of the toothpastes were tested using the disk diffusion method against oral pathogens: Streptococcus mutans, Pseudomonas aeruginosa, and Enterococcus faecalis. The resulting inhibition halos were measured in millimeters. Results: The data indicated that the bacteria responded differently to the toothpastes (P mint/guarana > mint/acai > sorbitol > tocopherol > cinnamon/mint > propolis > mint (P propolis > sorbitol > mint/acai > tocopherol > cinnamon/mint > mint = propolis/melaleuca = negative control. The product with the highest antimicrobial activity was mint/guarana, which was significantly different than propolis/melaleuca, mint, cinnamon/mint, and tocopherol and negative control (P 0.05) and positive control (P > 0.05). P. aeruginosa was resistant to all dental gels tested including positive control. Conclusion: The toothpastes with natural compounds have therapeutic potential and need more detailed searches for the correct clinic therapeutic application. The results from this study revealed differences in the antimicrobial activities of commercial toothpastes with natural compounds.

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TL;DR: A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars of South Asian Indian Maxillary m teeth using a tooth clearing technique.
Abstract: Objective: The objective was to study the root canal morphology of South Asian Indian Maxillary molars using a tooth clearing technique. Materials and Methods: Hundred teeth each comprising of first, second, and third molars collected from different dental schools and clinics in India were subjected to standard dye penetration, decalcification and clearing procedure before being studied. Results: The first molar mesiobuccal roots exhibited 69% Type I, 24% Type II, 4% Type IV, 2% Type V, and 1% exhibited a Vertuccis Type VIII canal anatomy. In the group with three separate roots the second molar mesiobuccal roots in exhibited 80.6% Type I, 15.3% Type II, 2.7% Type IV, and 1.4% Type V canal anatomy while the third molars mesiobuccal roots exhibited 57.4% Type I, 32% Type II, 2.1% Type III, 8.5% Type IV, 1% had a Type V canal anatomy in the similar group. Conclusion: A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars.

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TL;DR: The effect of formulations containing Biosilicate (Biosilicates dentifrice and paste) was significant in the MH of enamel bleached with 16% CP, and comparisons between desensitizing agents on dentin treated with both bleaching gels showed no statistical differences.
Abstract: Objective: This study aimed to evaluate in vitro the effect of formulations containing Biosilicate to treat enamel and dentin bovine samples exposed to dental bleaching agents. Materials and Methods: On enamel and dentin bleached with commercial gels containing 16% carbamide peroxide (CP) (14 days/4 h) or 35% hydrogen peroxide (single session/45 min), desensitizing dentifrices (Sensodyne ® ; experimental dentifrice of Biosilicate ® ; Odontis RX ® ; Sorriso ® ) were applied along 14 days and desensitizing pastes (Biosilicate ® /water 1:1; Dessensebilize NanoP ® ; Bioglass type 45S5/water 1:1) were applied on days 1, 3, 7, 10 and 14. Distilled water was the control. Microhardness (MH) and roughness measurements were the variables measured on the samples before and after the treatments. Student's t -test analyzed differences before and after the treatments. Two-way analysis of variance and post-hoc Tukey test analyzed differences among the factors desensitizing, bleaching agents and substrate. Results: Tukey test showed no differences in roughness for both bleaching treatments and among the desensitizing agents ( P > 0.05). Differences in MH appeared on enamel treated with in-home bleaching when control group (lower values) was compared with Sensodyne, Biosilicate dentifrice, Biosilicate paste, and Bioglass paste (higher values). Comparisons between desensitizing agents on dentin treated with both bleaching gels showed no statistical differences. Conclusions: The effect of formulations containing Biosilicate (Biosilicate dentifrice and paste) was significant in the MH of enamel bleached with 16% CP.

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TL;DR: The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children.
Abstract: Objectives: The aim of this study is to assess the effectiveness of audiovisual distraction technique with video eyewear and computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in phobic pediatric patients undergoing pulp therapy of primary molars. Materials and Methods: This randomized, crossover clinical study includes 60 children, aged between 4 and 7-year-old (31 boys and 29 girls). Children were randomly distributed equally into two groups as A and B. This study involved two treatment sessions of pulp therapy, 1-week apart. During treatment session I, group A had an audiovisual distraction with video eyewear, whereas group B had audiovisual distraction using projector display only without video eyewear. During treatment session II, group A had undergone pulp therapy without video eyewear distraction, whereas group B had the pulp treatment using video eyewear distraction. Each session involved the pulp therapy of equivalent teeth in the opposite sides of the mouth. At each visit scores on the Modified Child Dental Anxiety Scale (MCDAS) (f) were used to evaluate the level of anxiety before treatment. After the procedure, children were instructed to rate their pain during treatment on the Wong Bakers' faces pain scale. Changes in pulse oximeter and heart rate were recorded in every 10 min. Results: From preoperative treatment session I (with video eyewear) to preoperative treatment session II (without video eyewear) for the MCDAS (f), a significant ( P > 0.03) change in the mean anxiety score was observed for group A. Self-reported mean pain score decreases dramatically after treatment sessions' with video eyewear for both groups. Conclusion: The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children.

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TL;DR: Despite technological development of GI materials, mainly the nano-particles use, better results have not been achieved for both investigations, when compared to RMGI, independent of tooth substrate.
Abstract: Objective: This study was conducted to evaluate the microshear bond strength (μSBS) and ultramorphological characterization of glass ionomer (GI) cements; conventional GI cement (Fuji IX, CGI), resin modified GI (Fuji II LC, RMGI) and nano-ionomer (Ketac N100, NI) to enamel, dentin and cementum substrates. Materials and Methods: Forty-five lower molars were sectioned above the cemento-enamel junction. The occlusal surfaces were ground flat to obtain enamel and dentin substrates, meanwhile the cervical one-third of the root portion were utilized to evaluate the bonding efficacy to cementum substrate. Each substrate received microcylinders from the three tested materials; which were applied according to manufacturer instructions. μSBS was assessed using a universal testing machine. The data were analyzed using two-way analysis of variance (ANOVA) and Tukey ' s post - hoc test. Modes of failure were examined using stereomicroscope at ×25 magnification. Interfacial analysis of the bonded specimens was carried out using environmental field emission scanning electron microscope. Results: Two-way ANOVA revealed that materials, substrates and their interaction had a statistically significant effect on the mean μSBS values at P values; ˂0.0001, 0.0108 and 0.0037 respectively. RMGI showed statistically significant the highest μSBS values to all examined tooth substrates. CGI and RMGI show substrate independent bonding efficiency, meanwhile; NI showed higher μSBS values to dentin and cementum compared to enamel. Conclusion: Despite technological development of GI materials, mainly the nano-particles use, better results have not been achieved for both investigations, when compared to RMGI, independent of tooth substrate.