Showing papers in "Journal of Clinical and Experimental Dentistry in 2015"

Comparative characterization of a novel cad-cam polymer-infiltrated-ceramic-network

Abstract: The field of dental ceramics for CAD-CAM is enriched with a new innovative material composition having a porous three-dimensional structure of feldspathic ceramic infiltrated with acrylic resins.The aim of this study is to determine the mechanical properties of Polymer-Infiltrated-Ceramic-Network (PICN) and compare its performance with other ceramics and a nano-ceramic resin available for CAD-CAM systems.In this study a total of five different materials for CAD-CAM were investigated. A polymer-infiltrated ceramic (Vita Enamic), a nano-ceramic resin (Lava Ultimate), a feldspathic ceramic (Mark II), a lithium disilicate ceramic (IPS-e max CAD) and finally a Leucite based ceramic (Empress - CAD). From CAD-CAM blocks, 120 bars (30 for each material cited above) were cut to measure the flexural strength with a three-point-bending test. Strain at failure, fracture stress and Weibull modulus was calculated. Vickers hardness of each material was also measured.IPS-EMAX presents mechanical properties significantly better from the other materials studied. Its strain at failure, flexural strength and hardness exhibited significantly higher values in comparison with the others. VITA ENAMIC and LAVA ULTIMATE stand out as the next most resistant materials.The flexural strength, elastic modulus similar to a tooth as well as having less hardness than ceramics make PICN materials an option to consider as a restorative material.Ceramic infiltrated with resin, CAD-CAM, Weibull modulus, flexural strength, micro hardness.

Effect of topical application of melatonin on serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in patients with type 1 or type 2 diabetes and periodontal disease.

Abstract: Background: The present clinical trial study was designed to assess the effect of topical application of melatonin on serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) in patients with diabetes and periodontal disease in comparison with healthy controls. Material and Methods: Serum levels of TNF-α and IL-6 were measured by enzyme-linked immunosorbent assay and CRP by nephelometry by using the proper commercial kits in 30 patients with diabetes and periodontal disease, and also in a control group of 30 healthy subjects. Periodontograms were performed using the Florida Probe®. Patients with diabetes were treated with a topical application of melatonin (1% orabase cream formula) once daily for 20 days. Healthy subjects were treated with a placebo orabase cream. Results: Patients with diabetes and periodontal disease had significantly higher mean levels of serum TNF-α, IL-6 and CRP than healthy subjects ( P < 0.001). Following topical melatonin application, there was a statistically signi - ficant decrease in the gingival index and pocket depth ( P < 0.001) as well as a significant decrease in IL-6 and CRP serum levels ( P < 0.001). Local melatonin application in patients with diabetes and periodontal disease resulted in a significant decrease in CRP and IL-6 serum levels as well as an improvement in the gingival index and pocket depth. Patients with periodontal disease had significantly higher serum CRP, IL-6 and TNF-α values by comparison with healthy subjects. Conclusions: We conclude that melatonin can modulate the inflammatory action of these molecules in periodontal patients

In vitro antibacterial activity of different pulp capping materials

Abstract: Direct pulp capping involves the application of a dental material to seal communications between the exposed pulp and the oral cavity (mechanical and carious pulp exposures) in an attempt to act as a barrier, protect the dental pulp complex and preserve its vitality. The aim of this study was to evaluate and compare, by the agar disc diffusion test, the antimicrobial activity of six different pulp-capping materials: Dycal (Dentsply), Calcicur (Voco), Calcimol LC (Voco), TheraCal LC (Bisco), MTA Angelus (Angelus), Biodentine (Septodont).Streptococcus salivarius, Streptococcus sanguis and Streptococcus mutans strains were selected to evaluate the antimicrobial activity by the agar disc diffusion test of different pulp capping materials. Paper disks were impregnated whit each pulp capping materials and placed onto culture agar-plates pre-adsorbed with bacterial cells and further incubated for 24 h at 37°C. The growth inhibition zones around each pulp capping materials were recorded and compared for each bacterial strain.For the investigation of the antibacterial properties the ANOVA showed the presence of significant differences among the various materials. Tukey test showed that MTA-based materials induced lower growth inhibition zones.MTA-based products show a discrete antibacterial activity varying from calcium hydroxide-based materials which present an higher antibacterial activity.Agar disc diffusion test, antimicrobial activity, calcium hydroxide, MTA, pulp capping materials.

Evaluation of ergonomic factors and postures that cause muscle pains in dentistry students’ bodies

Abstract: Background: Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being.This study was conducted to evaluate ergonomic factors and profession-related postures and also investigate relationship between demographic factors and work condition with pain in dental students. Material and Methods: 60 freshman and sophomore dentistry students were randomly chosen as the subjects of control group, and 60 of 5th and 6th-year students were selected as the members of exposure group. Data related to the subjects such as sex, doing exercise, severity of musculoskeletal pain were obtained through questionnaire. Students’ postures were directly observed while treating patients and they were scored by REBA method. Data were analyzed by SPSS software using Man-Whitney, Kruskal-Wallis, Spearman and Kendall correlation tests. Results: 80.8% of the subjects were not aware of the correct ergonomic postures for dental procedures. Severity of musculoskeletal pain in the exposure group (15.9± 4.2) was significantly higher than the control group (10.5 ±3.2), ( p <0.001). Risk of the most subjects (84%) was at the medium level. Students who were more involved in clinical activities experienced more muscular pains. Conclusions: The musculoskeletal disorders are probable prolonged in working hours in static positions, incorrect work postures, implying more force and even tools and instruments. Therefore, students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong

Oral mucosal diseases in anxiety and depression patients: Hospital based observational study from south India.

Abstract: Objectives: The objective of this study was to evaluate the prevalence of different Oral Mucosal diseases in Anxiety and Depression patients. Material and Methods: A hospital based observational Study was conducted in the department of Psychiatry and department of Oral Medicine and Radiology. Patients who were diagnosed with Anxiety or Depression by the psychiatrists using Hamilton Anxiety and Depression scale were subjected to complete oral examination to check for oral diseases like Oral Lichen Planus (OLP), Recurrent Aphthous Stomatitis (RAS), and Burning Mouth Syndrome (BMS). Equal number of control group subjects were also included. Results: In this study statistically significant increase in the oral diseases in patients with anxiety and depression than the control group was recorded. Oral diseases were significantly higher in anxiety patients (20.86%) than in depression (9.04%) and control group patients (5.17%). In anxiety patients, the prevalence of RAS was 12%, OLP was 5.7%, and BMS was 2.87%. In depression patients, the prevalence of RAS was 4.02%, OLP was 2.01% and BMS was 3.01%. In control group the prevalence was 2.2%, 1.33% and 1.62% in RAS, OLP and BMS respectively. RAS and OLP were significantly higher in the younger age group (18-49) and BMS was seen between the age group of 50-77 years in both study and control groups. Conclusions: The results of the present study showed a positive association between psychological alterations and changes in the oral mucosa, particularly conditions like OLP, RAS and BMS. Thus psychogenic factors like anxiety and depression may act as a risk factor that could influence the initiation and development of oral mucosal diseases. Hence psychological management should be taken into consideration when treating patients with these oral diseases. Key words:Lichen planus, anxiety, depression, burning mouth syndrome, recurrent aphthous stomatitis.

Classification of impacted mandibular third molars on cone-beam CT images.

Abstract: Background Neurological involvement is a serious complication associated to the surgical removal of impacted mandibular third molars and the radiological investigation is the first mandatory step to assess the risk of a possible post-operative injury to the inferior alveolar nerve (IAN). The aim of this study was to introduce a new radiological classification that could be normally used in clinical practice to assess the relationship between an impacted third molar and mandibular canal on cone beam CT (CBCT) images.

Graft-versus-host disease affecting oral cavity. A review.

Abstract: Graft versus host disease (GVHD) is one of the most frequent and serious complications of hematopoietic stem cell transplantation, and is regarded as the leading cause of late mortality unrelated to the underlying malignant disease. GVHD is an autoimmune and alloimmune disorder that usually affects multiple organs and tissues, and exhibits a variable clinical course. It can manifest in either acute or chronic form. The acute presentation of GVHD is potentially fatal and typically affects the skin, gastrointestinal tract and liver. The chronic form is characterized by the involvement of a number of organs, including the oral cavity. Indeed, the oral cavity may be the only affected location in chronic GVHD. The clinical manifestations of chronic oral GVHD comprise lichenoid lesions, hyperkeratotic plaques and limited oral aperture secondary to sclerosis. The oral condition is usually mild, though moderate to severe erosive and ulcerated lesions may also be seen. The diagnosis is established from the clinical characteristics, though confirmation through biopsy study is sometimes needed. Local corticosteroids are the treatment of choice, offering overall response rates of close to 50%. Extracorporeal photopheresis and systemic corticosteroids in turn constitute second line treatment. Oral chronic GVHD is not considered a determinant factor for patient survival, which is close to 52% five years after diagnosis of the condition.

Comparison of the therapeutic effects of the dietary and topical forms of Zizyphus jujuba extract on oral mucositis induced by 5-fluorouracil: A golden hamster model

Abstract: Background: Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an ad verse effect of chemotherapy and radiotherapy. The aim of this study was to evaluate the effects and identify the appropriate route of administration of extract of Zizyphus jujuba in 5-flurouracile induced OM induction in golden hamster. Materials and Methods: In a prospective randomized double blind animal study, OM was induced in 56 male golden hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. On days 14-17, 300 mg/kg dietary and 20% Z. jujuba gel and gel base groups were treated and then compared with a control group. Microscopic scores and pouch content of malondialdehyde (MDA), plus activities of superoxide dismutase and myeloperoxidase in pouch tissue were evaluated. Results: Histopathology scores of mucositis were lower in the systemic and 20% Z. jujuba gel groups than the gel base and control groups ( P <0.05). Also, lower MDA level and higher activities of MPO and SOD were detected in the systemic and 20% Z. jujuba gel groups in comparison to the gel base and control groups ( P <0.001). Conclusions: The use of Z. jujuba hydroalcoholic extract in systemic and topical forms may be associated with reduced intensity of OM, diminished concentration of MDA, and increased activity of MPO and SOD on induced OM in golden hamster undergoing 5-FU consumption

Salivary gland dysfunction markers in type 2 diabetes mellitus patients

Abstract: Background: Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. Material and Methods: A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. Results: There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). Conclusions: The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients.

Indirect sinus lift without bone graft material: Systematic review and meta-analysis.

Abstract: A systematic literature review and a meta-analysis of indirect sinus lift without the use of bone graft material was performed. A PubMed search was made from January 2005 to January 2012 with keywords: "sinus lift", "osteotome", "graft" and "maxillary sinus elevation". The inclusion criteria were: maxillary sinus lift technique with osteotomes with a minimum follow-up period of 5 months after surgery without bone graft material. 11 articles were included. The mean gain in residual crestal bone height after maxillary sinus lift without bone graft material was 3,43 mm ± 0,09 (2,5 mm - 4,4 mm). The survival rate ranged from 94% to 100%. Placement of implants with sinus lift without bone graft material, is a valid surgical technique to gain residual crestal height and placed implants in an atrophic posterior maxillary with a crestal height from 5 to 9 mm. Key words:Sinus lift, osteotome, graft, maxillary sinus elevation.

Effect of resin thickness, and curing time on the micro-hardness of bulk-fill resin composites

Abstract: Bulk-fill resin composite has been introduced, their manufacturers claimed that they can be applied in bulks of 4mm, without necessitating a prolonged curing time, or a light curing unit with increased irradiance. Thus this study was conducted to evaluate the effect of resin thickness, and curing time on the micro-hardness of two bulk -fill resin composites; Tetric Evo-Ceram [TE], and X-trafil [XF].120 cylindrical specimens were prepared, and divided into 24 groups (n=5/group), representing the two bulk-fill resin composites, three different material thicknesses (2, 3 and 4 mm) and the four curing times used in the study (10, 20, 40, and 60 seconds). The specimens were light-cured from the top surface only. Specimens were stored in light proof containers in complete darkness at 37°C for 24 hours. Micro-hardness test was conducted on both top and bottom surfaces using Vickers micro-hardness tester with 500 g load and a dwell time of 15 seconds. Data were statistically analyzed by Four-way ANOVA of Variance. The significance level was set at P ≤ 0.05. Pearson Correlation used to determine significant correlations between mean micro-hardness (top) and (bottom) surfaces.Four way-ANOVA shows that different tested materials produce a statistically significant effect on mean micro-hardness (VHN) at p≤0.001, while thickness, curing time, and surface revealed statistically non significant effect on mean micro-hardness (VHN) at p≥0.05. [XF] (92.01±3.15 VHN) showed statistically significant higher mean micro-hardness than [TE] (54.13±4.96 VHN). Pearson Correlation revealed that there was a significant direct correlation between micro-hardness (bottom) and mean micro-hardness (top) (mm), r = 0.985, p (2-tailed) ≤0.001.Within the limitations of this study, the bulk-fill resin composites used in this study can be placed and cured properly in the 4 mm bulk.Bulk-fill resin composite, micro-hardness, thickness, curing time.

Comparison of clinical efficacy of methylprednisolone and serratiopeptidase for reduction of postoperative sequelae after lower third molar surgery

Abstract: Background: Surgical removal of mandibular third molars results in some degree of post-operative pain, swelling and trismus. These can be controlled by proper administration of local anesthesia, careful bone removal, minimal trauma to adjacent soft tissues and administration of methylprednisolone and serratiopeptidase drugs. The aim of the present study was to compare the efficacy of methylprednisolone and serratiopeptidase in controlling post- operative pain, swelling and trismus after surgical removal of impacted mandibular third molars. Material and Methods: The subjects were divided into two groups of 50 patients each undergoing surgical removal of mandibular third molars. Group A was given methylprednisolone 4mg orally every 8th hourly and Group B was given serratiopeptidase 10 mg every 12th hourly orally. Post-operatively pain, swelling and trismus were evaluated at the end of 1st, 3rd and 5thday. Results: The results of this study showed that methylprednisolone is an effective analgesic, while serratiopeptidase has moderate analgesic activity. Serratiopeptidase is more effective than methylprednisolone in controlling post surgical swelling and trismus. Hence combination of these two drugs would be very effective than individual drug when widespread post-operative sequelae are expected after surgical removal of impacted lower third molars. Conclusions: We conclude that methylprednisolone affords better pain relief while serratiopeptidase exerts better anti-inflammatory and anti-swelling effects in the post-operative period. Synergistic combinations of these two drugs would however prove to be more effective when extensive post-operative sequelae are expected

Microhardness of demineralized enamel following home bleaching and laser-assisted in office bleaching

Abstract: Background: There is little data regarding the effect of tooth whitening on microhardness of white spot lesions. This study was conducted to investigate the effect of home-bleaching and laser-assisted in-office bleaching on microhardness of demineralized enamel. Material and Methods: Forty bovine incisors were selected and immersed in a demineralizing solution for 12 weeks to induce white spot lesions. Enamel blocks were prepared and randomly assigned to two groups of 20 each. The first group underwent home bleaching with 15% carbamide peroxide which was applied for 8 hours a day over a period of 15 days. In the second group, in-office bleaching was performed by 40% hydrogen peroxide and powered by irradiation from an 810 nm gallium-aluminum-arsenide (GaAlAs) diode laser (CW, 2W). This process was performed for 3 sessions every seven days, in 15 days. The specimens were stored in Fusayama Meyer artificial saliva during the experiment. Surface microhardness was assessed before and after the bleaching therapies in both groups. Results: Microhardness decreased significantly following both home bleaching and laser-assisted in-office bleaching ( p <0.05). There were no significant differences in hardness values among the two groups either before ( p =0.131) or after ( p =0.182) the bleaching procedures. Conclusions: Tooth whitening through home bleaching or laser-assisted in-office bleaching can result in a significant reduction in microhardness of white spot lesions. Therefore, it is suggested to take protective measures on bleached demineralized enamel.

Clinical pain evaluation with intraoral vibration device during local anesthetic injections

Abstract: Objectives: To evaluate the clinical pain during local anesthetic injection using such intra-oral device. Study Design: A comparative split-mouth clinical study to evaluate clinical pain was conducted among the subjects who required bilateral local anesthetic intra-oral injections. Results: A total of 99 subjects participated in the study out of which 39 were female. A total of 256 local anesthetic injections were administered to all the subjects with at least one pair of similar local anesthetic injections. Comparison of mean VAS score for anticipated pain in without vibration group was significantly higher in all types of nerve blocks when compared to that of with vibration. Similarly, the comparison of mean VAS score for actual pain in without vibration group was significantly higher in all types of nerve blocks when compared to that of with vibration. No significant difference in the mean VAS score was seen between anticipated and actual pain in without vibration group with respect to inferior alveolar ( p =0.673), infra-orbital ( p =0.175) and palatal ( p =0.343) local anesthetic injections. The mean VAS score was significantly lower for actual pain when compared to anticipated pain in vibration group with respect to inferior alveolar ( p <0.001) and infra-orbital ( p =0.002) local anesthetic injections. Conclusions: There was significant reduction in the pain encountered during local anesthetic injection with the use of intra-oral vibration device.

Ectopic third molar in the mandibular sigmoid notch: Report of a case and literature review.

Abstract: Purpose: To evaluate the etiopathogenesis, clinical features and surgical approaches for removal of ectopic third molars in the mandible. Methods: We report a case of an impacted mandibular third molar dislocated on mandibular sigmoid notch. 20 cases of ectopic mandibular third molars reported in the English-language literature, identified from Pubmed and Medline databases are also reviewed. Results: Among the 20 article reported in the presented study, ectopic third molars were generally located in the condylar region. The common symptoms of the clinical examination were pain, trismus, swelling, temporomandibular joint syndroms or no symptoms. Conclusions: Ectopic third molar may be asymptomatic initially with clinical manifestations, later on as adjacent structures are affected. The surgical approach must be carefully planned for the aim of choosing the more conservative technique that produces the minimum trauma to patients. Key words:Ectopic third molar, sigmoid notch, cyst.

Evaluation of the efficacy of low-level laser in improving the symptoms of burning mouth syndrome.

Abstract: Background: Burning mouth syndrome (BMS) is common condition that affects menopause women, patients suffer from sever burning sensation. Up to now there is no definitive treatment for this disease. Present study was undertaken to evaluate the efficacy of low-level laser (LLL) in improving t he symptoms of burning mouth syndrome. Material and Methods: Twenty patients with BMS were enrolled in this study; they were divided in two groups randomly. In the laser group, in each patient, 10 areas on the oral mucosa were selected and underwent LLL irradiation at a wavelength of 630 nm, and a power of 30 mW for 10 seconds twice a week for 4 weeks. In the placebo group, silent/off laser therapy was carried out during the same period in the same areas. Burning sensation and quality of life were evaluated. Results: Burning sensation severity and quality of life in the two groups after intervention were different significant statistically, ( P = 0.004, P = 0.01 respectively) .Patients in laser group had better results. Conclusions: It can be concluded that low level laser might decrease the intensity of burning mouth syndrome

Prevalence of oral lichen planus among a sample of the Egyptian population.

Abstract: Objectives: To report on the prevalence of oral lichen planus among a sample of the Egyptian population. Study Design: 4470 Egyptian patients, aged 15-75 years, were seen at the outpatient clinic at the Faculty of Oral and Dental Medicine, Cairo University, Egypt. 31.25 % of these patients were males and 68.75% were females. Oral mucosal lesions consistent with oral lichen planus (OLP) were identified both clinically and confirmed histologically (in atypical cases) so that the prevalence of oral lichen planus in this study is 1.43%. Results: 64 patients were diagnosed with OLP (20 males and 44 females). The average age of the affected group was 48.07 years. Associated skin lesions were detected in 15/64 patients (23.44%) and tobacco habits was observed in 20/64 patients (31.25%). The average period of follow-up of the affected cases was 1-2 years, during which two cases developed squamous cell carcinoma of the oral lesion. Conclusions: Within the limitations of this study it revealed the prevalence of OLP among middle-aged women. Atrophic lesions were most frequent, followed by the erosive forms. Anti-HCV circulating antibodies were more common in patients with OLP and, notably, OLP was associated with Diabetes mellitus in 15.63% of patients. Key words:Prevalence, oral lichen planus, Egypt.

Flapless implant surgery: A review of the literature and 3 case reports

Abstract: Since the 1970s, modern Implantology is based on a concept of surgery with flap elevation. Gradually, several clinical trials demonstrated that a mid-crestal incision gives similar success rates compared to those obtained using the classical protocol. However, over the past decade in medicine it has been established the concept of minimally invasive surgery, consisting in taking advantage of advancements experienced in diagnostic techniques and specific surgical instruments, to perform surgical procedures infringing as less damage as possible to the patient The present work aims to produce a thorough review of the literature published on the field of Implantology with flapless surgery, to determine the current scientific evidence of the technique, along with illustrating the results with different clinical cases. After presenting the clinical cases, and the review of literature, we can say that flapless surgeries should be restricted to well-selected cases in which a proper clinical and radiological planning has been made. Patients treated with anticoagulant drugs or medically compromised equally can get benefitted by this minimal invasion technique. Key words:Flapless, minimally invasive surgery, dental implant.

Cartridge syringe vs computer controlled local anesthetic delivery system: Pain related behaviour over two sequential visits - a randomized controlled trial.

Abstract: Background: Local anesthetic injection is one of the most anxiety provoking procedure in dentistry. Knowledge about change in pain related behaviour during consecutive visits helps in and scheduling of treatment procedures and management of children in dental clinic. Aim: To compare the pain perception, behavioural response and the associated change in physiological parameters while receiving local anesthesia injection with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD) over two consecutive visits. Material and Methods: In this randomized controlled cross over trial, 120 children aged 7 – 11 years were randomly divided into group A: receiving injections with CCLAD during first visit; group B: receiving injections with cartridge syringe during first visit. The physiological parameters (heart rate and blood pressure) were recorded before and during injection procedure. Objective evaluation of disruptive behaviour and subjective evaluation of pain perceived were done using Face Legs Activity Cry Consolability (FLACC) scale and modified facial image scale (FIS) respectively. Results: No statistical difference in pain response ( p = 0.164) and disruptive behaviour ( p = 0.120) between cartridge syringe and CCLAD injections were seen during the first visit although the latter showed lesser scores. However, during the second visit there were significant increase in pain response ( p = 0.004) and disruptive behaviour ( p = 0.006) in cartridge syringe group with an associated increase in heart rate. Conclusions: Injections with CCLAD produced lesser pain ratings and disruptive behaviour than cartridge syringe in children irrespective of order of visit

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.

Abstract: Background: The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods: The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination – multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results: In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. Conclusions: The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency.

The staining effect of different mouthwashes containing nanoparticles on dental enamel.

Abstract: Background: This study aimed to evaluate the effects of several mouthwashes containing nanoparticles on discoloration of dental enamel, and compare the results with that of 0.2% chlorhexidine (CHX). Material and Methods: Sixty intact premolars were randomly assigned to six groups. A spectrophotometer was used to measure the color of the teeth (T1) according to the CIELAB system. The specimens in groups 1 to 4 were then immersed in colloidal solutions containing nanoTiO2 (Group 1), nanoZnO (Group 2), nanoAg (Group 3) and nanoCuO (Group 4). In groups 5 and 6, a 0.2% CHX mouthwash and distilled water were used as positive and negative controls, respectively. After 24 hours of immersion, color determination was repeated (T2). The third color assessment was accomplished after brushing (T3). The L, a, and b values were recorded and the color change (∆E) between different stages was calculated. Results: ANOVA revealed significant between-group differences in the color change between T1 and T2 stages, as well as between T1 and T3 time points ( p <0.05), whereas the color change between T2 and T3 was not signifi - cantly different among the study groups ( p =0.09). ∆ET1-T3 was significantly lower in the specimens immersed in distilled water or CHX as compared to the nanoparticle-containing mouthwashes ( p <0.05). The highest ∆E value pertained to the specimens immersed in nanoZnO-containing solution. The TiO2 nanoparticles caused the lowest staining among the tested nanoparticles. Conclusions: The mouthwashes containing nanoparticles produced comparable or even greater enamel discoloration compared to CHX. Brushing had little effect on removal of induced stains

A prospective randomized clinical trial compared the effect of various types of local anesthetics cartridges on hypertensive patients during dental extraction.

Abstract: Objectives: To evaluate hemodynamic changes of blood pressure and heart rate on hypertensive patients under - going tooth extraction using various types of local anesthesia (LA). Study Design: A prospective randomized clinical trial was conducted on 45 hypertensive patients who were divided equally into 3 parallel groups according to LA received. Group 1: Lidociane 2% with epinephrine 1: 80,000. Group 2: Prilocaine 3% with Felypressin 0.03 IU/ml. Group 3: Mepivacaine 3% plain. Inclusion criteria: hypertensive patients, under medical management with blood pressure = 159/99. Exclusion criteria: Blood pressure =160 /100 and patients receiving s blockers. Negative aspiration was mandatory before the injection of 2 cartridges of LA. Blood pressure and heart rate were evaluated by Electronic Sphygmomanometer and Pulse Oximeters in 3 different time-points; 3 minutes before LA, three minutes after LA and three minutes after extraction. Results: The mean of systolic blood pressure (SBP) had increased after LA injection, and then decreased after ex - traction in the 3 groups of patients. Increase of SBP after extraction with (Mepivacaine plain) was higher than (Li - dociane with Epinephrine) and the difference was statistically significant using ANOVA ( p =0.037). The differences in the mean heart rates and mean diastolic blood pressures in the 3 groups were not significant. Conclusions: The increase of blood pressure with Epinephrine and Felypressin is negligible. Therefore, it is safe to use 2 cartridges of Lidociane 2% with Epinephrine 1:80,000 or Prilocaine 3% with Felypressin 0.03 IU/ml for hypertensive patients whose blood pressure = 159/99 provided negative aspiration is verified before injection.

Cytotoxicity of glass ionomer cements containing silver nanoparticles.

Abstract: Background: Some studies have investigated the possibility of incorporating silver nanoparticles (NAg) into dental materials to improve their antibacterial properties. However, the potential toxic effect of this material on pulp cells should be investigated in order to avoid additional damage to the pulp tissue. This study evaluated the cytotoxicity of conventional and resin-modified glass ionomer cements (GIC) with and without addition of NAg. Material and Methods: NAg were added to the materials at two different concentrations by weight: 0.1% and 0.2%. Specimens with standardized dimensions were prepared, immersed in 400 μL of culture medium and incubated at 37°C and 5% CO2 for 48 h to prepare GIC liquid extracts, which were then incubated in contact with cells for 48 h. Culture medium and 0.78% NAg solution were used as negative and positive controls, respectively. Cell viability was determined by MTT and Trypan Blue assays. ANOVA and the Tukey test (α=0.05) were used for statistical analyses. Results: Both tests revealed a significant decrease in cell viability in all groups of resin modified cements ( p ˂0.001). There were no statistically significant differences between groups with and without NAg ( p ˃0.05). The differences in cell viability between any group of conventional GIC and the negativ e control were not statistically significant ( p >0.05). Conclusions: NAg did not affect the cytotoxicity of the GIC under evaluation

Hemodynamic changes following injection of local anesthetics with different concentrations of epinephrine during simple tooth extraction: A prospective randomized clinical trial.

Abstract: Background: Presence of epinephrine in local anesthetic cartridge increases the duration of local anesthesia (LA), decreases the risk of toxicity, and provides hemostasis. However, the unfavorable effects are increasing heart rate (HR) and raising blood pressure (BP). The aim was to evaluate hemodynamic changes in the BP, HR, and oxygen saturation (SpO2) of normal patients undergoing tooth extraction using LA with various epinephrine concentrations. Material and Methods: A prospective randomized clinical trial was conducted on 120 patients who were divided randomly into 3 parallel groups according to the LA received. Group 1: lidocaine 2% with epinephrine 1:80,000 (L80). Group 2: articaine 4% with epinephrine 1:100,000 (A100). Group 3: articaine 4% with epinephrine 1:200,000 (A200). Inclusion criteria: normal patients whose BP < 140/90. Exclusion criteria: hypertension, cardiovascular disease, hyperthyroidism, pregnancy, and allergy to LA. BP, HR, and (SpO2) were evaluated in 3 different time points: 3 minutes before LA, 3 minutes after LA, and 3 minutes after extraction. Results: Systolic blood pressure (SBP) significantly increased after injection of L80 and continued after extraction to be significant than pre-injection. SBP significantly increased after injection of A100 then decreased after extraction. In the group of A200, SBP insignificantly decreased after injection then increased after extraction. The increasing of SBP between time point 1and 2 was significantly higher in G1 than G3 ( p =0.014). Diastolic blood pressure decreased after LA in the 3 groups; however it was significant only with L80, then increased after extraction for all. Conclusions: The changings of DBP, HR and SpO2 after anesthesia and extraction showed no significant difference among the three groups. However, A200 had significant lesser effect on SBP than L80 and the least effect on other parameters. Therefore, A200 is considered safer than L80 and A100 and is recommended for LA before teeth extraction in normal patient.

Laser-Casein phosphopeptide effect on remineralization of early enamel lesions in primary teeth

Abstract: Background: The aim of this study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth. Material and Methods: Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP creme, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win. Results: The subjects of group D demonstrated a significant increase in the calcium and phosphate contents of enamel surface compared to those of groups A ( P < 0.001, P < 0.001), B ( P < 0.001, P < 0.001) and C ( P = 0.024, P = 0.04), respectively. A statistically significant difference was seen for mean VHN between groups A and B ( P = 0.002). SEM evaluations confirmed the results. Conclusions: The combination of Nd:YAG laser and CPP-ACP creme could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth.

Influence of orthodontic treatment on temporomandibular disorders. A systematic review

Abstract: Objectives: The aim of this literature systematic review was to evaluate the possible association between malocclusions, orthodontic treatment and development of temporomandibular disorders. Material and Methods: A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “ orthodontics and temporomandibular disorders ”, “ orthodontics and facial pain ” and “ malocclusion and temporomandibular disorders ”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Results: The search strategy resulted in 61 articles. After selection according to the inclusion/exclusion criteria 9 articles qualified for the final analysis. The articles which linked orthodontics and development of temporomandibular disorders showed very discrepant results. Some indicated that orthodontic treatment could improve signs and symptoms of temporomandibular disorders, but none of them obtained statistically significant dif ferences. Conclusions: According to the authors examined, there is no evidence for a cause-effect relationship between orthodontic treatment and temporomandibular disorders, or that such treatment might improve or prevent them. More longitudinal studies are needed to verify any possible interrelationship

Panoramic radiographic study of mental foramen in selected dravidians of south Indian population: A hospital based study

Abstract: Background: This study aimed at documenting information on appearance, size, horizontal and vertical locations of Mental Foramen (MF) in Panoramic Radiograph. We also analyzed the age and gender differences with radiographic appearance and location of MF. We evaluated these findings in our population and co-relate with results of previous studies. Material and Methods: 1662 panoramic radiographs were evaluated, of which 245 fulfilled the inclusion criteria. Each radiograph was traced to record the horizontal and vertical locations. The size of MF was recorded using digital caliper and its appearance was determined by visual examination. Chi-square and t-test were employed. Results: The most common appearance of MF was continuous type and the tests showed significant difference with age and gender. The most frequent horizontal location of MF was “location c” with no statistical significant difference with age and gender. The MF was most commonly positioned mesially in relation to the apex of second premolar with no significant differences with gender. The vertical location of the foramen varied drastically with no statistical significant difference in both sides. The difference in dimensions on the left and right sides were not statistically significant. Conclusions: Determining the morphological appearance and positional variation of MF is important for isolation of mental nerves and vessels when administering local anesthesia and performing surgeries. We therefore stress the importance of accurate radiographic identification of MF and interpretation. Our research findings can be used as reference material by the dental practitioners of South India while performing clinical procedures that involve MF.

Oral manifestations of HIV/AIDS in Asia: Systematic review and future research guidelines.

Abstract: OBJECTIVES: The authors have conducted a systematic review of oral manifestations of HIV from studies conducted in Asia to establish the characteristics and prevalence of individual oral manifestations in Asia, and to assess the direction of future research studies on oral manifestations of HIV in Asia. MATERIAL AND METHODS: The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE], EBSCO, and EMBASE. The search was for limited articles published in English or with an English abstract and articles published during the period January 1995 to August 2014. The authors reached a final overall sample of 39 studies that were conducted in Asia. RESULTS: The median population size among all studies was 312.7 patients. Oral candidiasis [OC] was the most common oral manifestation [37.7%] in studies conducted in Asia. The overall prevalence of oral hairy leukoplakia and melanotic hyperpigmentation was computed to be 10.1% and 22.8% respectively. Thailand and India are primarily countries with maximum research on oral manifestations. CONCLUSIONS: The research on oral manifestations of HIV in Asia has to upgrade to more interventional and therapeutic studies rather than the contemporary cross- sectional epidemiological descriptive studies. The authors have given suggestions and future directions for the implementation of clinical research of oral manifestations in HIV patients. Key words:Oral manifestations, HIV/AIDS, Asia, Systematic review.

Oral hygiene practices and dental caries prevalence among 12 & 15 years school children in Ambala, Haryana -A cross-sectional study

Abstract: BACKGROUND: Dental caries and gum disease are a major public health problem predominantly affecting children worldwide Therefore the present study was conducted to assess oral hygiene practices, prevalence of dental caries and periodontal diseases among 12 and 15 years old high school children in public and government schools of Ambala district, Haryana and to provide data for planning and evaluation of oral health care promotion programs MATERIAL AND METHODS: A cross-sectional descriptive survey of 12 and 15 years old children in government and private schools was conducted in Ambala, Haryana A sample of 992 school children was selected by a two-stage cluster sampling method Dental caries and periodontal health was examined using WHO standard criteria The student's t-test and one way ANOVA were used for statistical analysis RESULTS: The prevalence of dental caries was 343% and 465% at 12 and 15 years respectively Mean DMFT in 12 years was 082 and in 15 years it was 126 More than 90% of subjects in both the age groups were using tooth brush to clean their teeth Toothpaste was used by 967% (228) of subjects belonging to 12 year age group and 93% (703) of subjects who were of 15 years of age Gingival bleeding was found in majority of subjects CONCLUSIONS: The overall prevalence of dental caries was low but the prevalence of gingivitis was quite high The observations indicate the need for a school oral health promotion programme to sustain the healthy practices in this growing population Key words:Dental caries, periodontitis, ambala, school children, oral hygiene practices

Relationship between perception of malocclusion and the psychological impact of dental aesthetics in university students.

Abstract: Introduction and Objectives: The objectives were to assess the relationship between perceived smile aesthetics and perceived psychological impact as measured by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and their own perception of it using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a Visual Analog Scale (VAS); relate the IOTN-AC and VAS to the PIDAQ; and study the predictive capacity of the scales for psychological impact. Material and Methods: A cross-sectional study was conducted in 447 college students in Spain and Portugal (average age 20.4 years, 33.1% men and 66.9% women). The online self-completed surveys used the recently-validated Spanish and Portuguese versions of the PIDAQ to assess the self–reported psychological impact of the students’ dental aesthetics and IOTN-AC and an ad hoc 100 mm VAS for their perception of their dental aesthetics. Results: PIDAQ was linearly correlated with IOTN AC and VAS. Pearson’s coefficient was 0.55 for PIDAQ and IOTN-AC (CI 95% 0.48-0.61) and -0.72 for PIDAQ and VAS (CI 95% -0.66 - -0.76). VAS and IOTN-AC were predictive variables in a linear regression model of the total PIDAQ score. The VAS diagnosed individuals whose dental aesthetics had a self-perceived psychological impact (area under the curve 0.827, CI 95% 0.787-0.868) more precisely than the IOTN-AC (area under the curve 0.742, CI 95% 0. 696-0.788). Conclusions: In adults patients, there is a significant linear relationship between perceived smile aesthetics and self-perceived psychological impact. Key words:Visual Analog Scale, Index of Orthodontic Treatment Need, malocclusion, psychological, aesthetics.