Showing papers in "The journal of contemporary dental practice in 2016"

Antimicrobial and Cytotoxic Activity of Cinnamomum zeylanicum, Calcium Hydroxide, and Triple Antibiotic Paste as Root Canal Dressing Materials.

Abstract: Objective The aim of this article was (i) to define the chemical constituents of Cinnamomum zeylanicum essential oil (CEO), (ii) to compare the antimicrobial activity of CEO with triple antibiotic paste (TAP) and calcium hydroxide [Ca(OH)2] on planktonic and biofilm Enterococcus faecalis; and (iii) to compare the cytotoxicity of these medicaments on L929 fibroblasts. Materials and methods Gas chromatography-mass spectrometry was used to define the constituents of CEO. Zone of inhibition, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill tests were performed. Further, 108 human teeth were infected with E. faecalis and treated with the medicaments for 1, 7, and 14 days. Cytotoxicity was assessed by exposing L929 fibroblasts to the medicaments. Results Cinnamaldehyde was the main component of CEO. Triple antibiotic paste had the greatest zone of inhibition and the smallest MIC and MBC. Triple antibiotic paste and CEO eradicated planktonic E. faecalis after 4 and 24 hours, while Ca(OH)2 failed to achieve 100% killing after 24 hours. Cinnamomum zeylanicum essential oil and TAP eradicated biofilm E. faecalis after 7 and 14 days, but Ca(OH)2 could not eliminate E. faecalis after 14 days. Cinnamomum zeylanicum essential oil was the most biocompatible medicament. Conclusion Cinnamomum zeylanicum essential oil is an efficient antibacterial agent against planktonic and biofilm E. faecalis and it was cytocompatible to L929 fibroblasts. Therefore, CEO has the potential to be used as an antimicrobial agent in root canal treatment.

New Single-bottle Ceramic Primer: 6-month Case Report and Laboratory Performance.

Abstract: INTRODUCTION This article presents a 6-month case report and an in vitro evaluation of the performance of the new self-etching glass-ceramic monobond etch and prime (MEP) when applied in a lithium disilicate (LD). The MEP contains in the same bottle, along with acid conditioner and silanes. This simplifies the bonding procedures by reducing not only the number of steps, but also the working time. A 42-year-old female patient sought for esthetic treatment, and the main complaint was the darkened appearance of the upper lateral incisor. The esthetic treatment includes dental bleaching and gingivectomy, all-ceramic zirco-nia crowns, and all-ceramic crown and laminate veneer LD. After 6 months of esthetic treatment, marginal staining, gap, or chip fracturing damaging margins after sharp explorer in the margins was not observed. Furthermore, the inferior etching pattern of MEP was compared with traditional hydrofluoric acid (HF) conditioning. The microshear bond strength to the intaglio surface of LD was statistically similar when HF was compared with MEP. This new self-etching glass-ceramic showed good in vitro and 6 months clinical results in this case report. Future long-term clinical studies with more clinical case need to be done to confirm the performance of the use of this new conditioner. CLINICAL SIGNIFICANCE The use of a new self-etching glass-ceramic showed a good in vitro and 6 months clinical results. This new product can be an easy, simple, and alternative approach for esthetics bonding procedure.

Effects and Effectiveness of Cavity Disinfectants in Operative Dentistry: A Literature Review

Abstract: The degree of success in the elimination of bacteria during cavity preparation and prior to the insertion of a restoration may increase the longevity of the restoration and therefore the success of the restorative procedure. The complete eradication of bacteria in a caries-affected tooth, during cavity preparation, is considered a difficult clinical task. In addition to weakening the tooth structure, attempts to excavate extensive carious tissue completely, by only mechanical procedures, may affect the vitality of the pulp. Therefore, disinfection of the cavity preparation after caries excavation can aid in the elimination of bacterial remnants that can be responsible for recurrent caries, postoperative sensitivity, and failure of the restoration. However, the effects of disinfectants on the restorative treatment have been a major concern for dental clinicians and researchers. This review aims to explore existing literature and provide information about different materials and techniques that have been used for disinfecting cavity preparations and their effects and effectiveness in operative dentistry and, therefore, helps dental practitioners with clinical decision to use cavity disinfectants during restorative procedures. Antimicrobial effectiveness and effects on the pulp and dental restorations, in addition to possible side effects, were all reviewed in this paper.

Glass-ionomer Cements in Restorative Dentistry: A Critical Appraisal.

Abstract: Glass-ionomer cements (GICs) are mainstream restorative materials that are bioactive and have a wide range of uses, such as lining, bonding, sealing, luting or restoring a tooth. Although the major characteristics of GICs for the wider applications in dentistry are adhesion to tooth structure, fluoride releasing capacity and tooth-colored restorations, the sensitivity to moisture, inherent opacity, long-term wear and strength are not as adequate as desired. They have undergone remarkable changes in their composition, such as the addition of metallic ions or resin components to their composition, which contributed to improve their physical properties and diversified their use as a restorative material of great clinical applicability. The light-cured polymer reinforced materials appear to have substantial benefits, while retaining the advantages of fluoride release and adhesion. Further research should be directed towards improving the properties, such as strength and esthetics without altering its inherent qualities, such as adhesion and fluoride releasing capabilities.

Nonsurgical Periodontal Therapy decreases the Severity of Rheumatoid Arthritis: A Case-control Study.

Abstract: Introduction Rheumatoid arthritis (RA) and periodontitis are common chronic inflammatory conditions. Several studies suggested a relationship between RA and periodontitis. Recent studies have shown a beneficial effect of periodontal treatment on the severity of active RA. So the aim of this study was to examine the effect of nonsurgical periodontal therapy on the clinical parameters of RA. Materials and methods A total of 60 subjects with moderate-to-severe chronic generalized periodontitis and active RA in the age range 18 to 65 were selected for the study. They were divided into two groups. Group A (control group) consisted of 30 subjects with chronic generalized periodontitis and RA, and group B of 30 subjects with chronic generalized peri-odontitis and RA and they received nonsurgical periodontal therapy (scaling, root planning, and oral hygiene instructions). Evaluation of clinical observations of Simplified Oral Hygiene Index (OHI-S), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), number of swollen joints (SJ), number of tender joints (TJ), values of erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) for patient's global assessment, 3 months disease activity score (DAS) index, and C-reactive protein (CRP) was done at baseline and 3 months. Statistical evaluation of clinical observations was carried out. Results Group B subjects who received nonsurgical periodon-tal therapy showed statistically significant improvement in all periodontal and RA parameters at 3 months, compared with group A who did not receive periodontal therapy. Conclusion It can be concluded from the result that nonsurgical periodontal therapy may contribute to reduction in severity and symptoms of RA. Clinical significance Rheumatoid arthritis patients should be evaluated for periodontitis and treated for the same in order to reduce its severity level.

Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain.

Abstract: Aim To evaluate the effect of intracanal cryotherapy with negative pressure irrigation (EndoVac) on postendodontic pain after vital single-visit root canal treatment (RCT). Materials and methods A total of 75 single-rooted teeth with single root canal were treated endodontically. After root canal preparation with Protaper Universal rotary system and irrigation, teeth were divided randomly into three groups (n = 25) according to additional irrigation protocol as follows: Group I: No additional irrigation was applied (control); group II: A 20 mL of room temperature saline was irrigated during 5 minutes using EndoVac, and group III: A 20 mL of 2 to 4°C cold saline was irrigated during 5 minutes using EndoVac. Pain levels were assessed by visual analog scale (VAS) and verbal evaluation of pain questionnaire after 6, 12, 24, 48 hours, and 7 days of canal obturation. The data were then analyzed using Statistical Package for the Social Sciences (SPSS) 13.0 using Kruskal-Wallis and Mann-Whitney U tests at p-value of 0.05. Results The results showed that pain levels were high in groups I and II after 6 hours that decreased with time to almost diminish after 1 week, and on the other hand, group III showed no pain among different monitoring periods. Also pain levels in groups II were lower compared with group I after only 6 hours, with significance p Conclusion Postendodontic pain presented with highest values after 6 hours of treatment and reduced to almost nil after 1 week. Intracanal cryotherapy eliminated postendodontic pain clinically. Negative pressure reduced postendodontic pain after 6 hours of treatment. Clinical significance The outcome of this study indicates that the use of intracanal cryotherapy technique with negative pressure irrigation eliminates postendodontic pain after single-visit RCTs.

Chemical Plaque Control Strategies in the Prevention of Biofilm-associated Oral Diseases.

Abstract: Dental plaque is a biofilm that forms naturally on the surfaces of exposed teeth and other areas of the oral cavity. It is the primary etiological factor for the most frequently occurring oral diseases, such as dental caries and periodontal diseases. Specific, nonspecific, and ecologic plaque hypothesis explains the causation of dental and associated diseases. Adequate control of biofilm accumulation on teeth has been the cornerstone of prevention of periodontitis and dental caries. Mechanical plaque control is the mainstay for prevention of oral diseases, but it requires patient cooperation and motivation; therefore, chemical plaque control agents act as useful adjuvants for achieving the desired results. Hence, it is imperative for the clinicians to update their knowledge in chemical antiplaque agents and other developments for the effective management of plaque biofilm-associated diseases. This article explores the critical analysis of various chemical plaque control strategies and the current trends in the control and prevention of dental plaque biofilm.

Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review.

Abstract: Aim Many studies have suggested that a lesion originally diagnosed as oral lichen planus (OLP) has different possibilities of undergoing malignant transformation in time, although these findings remain a controversial issue; for example, some studies reported different values of potential malignancy of OLP Introduction World Health Organization (WHO) classifies OLP as a "potentially malignant disorder" with unspecified malignant transformation risk, and suggests that OLP patients should be closely monitored Numerous studies have attempted to confirm the malignant transformation potential of OLP Review results The Cochrane Controlled Trials Register, Medline and EMBASE databases, PubMed, Google Scholar, Ovid, Up To Date, BMJ Clinical Evidence, MD Consult, and Science Direct were searched for papers published between 1997 and 2015 The medical subject heading search terms were "lichen planus," "oral lichen planus," "erosive oral lichen planus," "dysplasia," "oral precancerous condition," "oral premalignant condition," oral cancer, oral squamous cell carcinoma (OSCC), and atrophic lichen planus A total of 120 English language abstracts were reviewed, and 50 relevant articles identified Because of the extensive literature on the association between OLP and SCC, we have divided the data into genetic and non-genetic factors for more accurate assessment Conclusion In this evidence base, malignant transformation ranges from 0 to 37% with a mean of 459% The highest rate of malignancy was noted in erythematosus and erosive lesions In this way, follow-up of OLP patients could be carried out more efficiently and appropriately Clinical significance Oral lichen planus is a premalignant lesion All types of OLP in any site of oral mucosa must be monitored regularly

The Effect of Coconut Oil pulling on Streptococcus mutans Count in Saliva in Comparison with Chlorhexidine Mouthwash.

Abstract: Objectives Oil pulling is an age-old practice that has gained modern popularity in promoting oral and systemic health. The scientific verification for this practice is insufficient. Thus, this study evaluated the effect of coconut oil pulling on the count of Streptococcus mutans in saliva and to compare its efficacy with that of Chlorhexidine mouthwash: in vivo. The null hypothesis was that coconut oil pulling has no effect on the bacterial count in saliva. Materials and methods A randomized controlled study was planned and 60 subjects were selected. The subjects were divided into three groups, Group A: Study group Oil pulling, Group B: Study group Chlorhexidine, and Group C: Control group Distilled water. Group A subjects rinsed mouth with 10 ml of coconut oil for 10 minutes. Group B subjects rinsed mouth with 5 ml Chlorhexidine mouthwash for 1 minute and Group C with 5 ml distilled water for 1 minute in the morning before brushing. Saliva samples were collected and cultured on 1st day and after 2 weeks from all subjects. Colonies were counted to compare the efficacy of coconut oil and Chlorhexidine with distilled water. Results Statistically significant reduction in S. mutans count was seen in both the coconut oil pulling and Chlorhexidine group. Conclusion Oil pulling can be explored as a safe and effective alternative to Chlorhexidine. Clinical significance Edible oil-pulling therapy is natural, safe and has no side effects. Hence, it can be considered as a preventive therapy at home to maintain oral hygiene.

Remineralizing Effect of Topical NovaMin and Nano-hydroxyapatite on caries-like Lesions in Primary teeth

Abstract: Introduction NovaMin is a synthetic mineral compound composed of calcium, sodium, phosphorus, and silica It releases crystalline hydroxyl-carbonate apatite (HCA), which structurally resembles the minerals naturally found in the teeth Nano-hydroxyapatite (NHA) is a biocompatible compound with high affinity for tooth enamel NHA particles morphologically resemble dental enamel apatite crystals Considering the efficacy of remineralizing agents and the importance of conservative preventive measures, this study aimed to compare the remin-eralizing effects of NovaMin and NHA on caries-like lesions in primary teeth Materials and methods This in vitro experimental study was conducted on 30 sound human primary anterior teeth with no cracks or fractures The surface microhardness (SMH) of each tooth was measured at baseline using a Vickers microhard-ness tester The teeth were then subjected to remineralization/ demineralization cycles, and artificial caries lesions were created in them The SMH of each tooth was measured again and the teeth were then randomly treated with toothpastes containing NovaMin or 10% NHA powder for 2 minutes daily for a period of 5 days The SMH of each was again measured afterward Data were statistically analyzed using independent t-tests and Mann-Whitney U tests Results The mean SMH was found to be higher in the teeth treated with NovaMin toothpaste (42267 kgf/mm(2)) than in the teeth treated with NHA (3842 kgf/mm(2)); However, this difference was not statistically significant Conclusion Both NHA and NovaMin were effective for reminer-alization of caries-like lesions of primary teeth and no significant difference was detected in their efficacy

Oral Microbial Shift: Factors affecting the Microbiome and Prevention of Oral Disease.

Abstract: Background Recently, oral microbiome has gained popularity among scientists. Microorganisms are no longer considered as disease-producing pathogens, rather they are now considered as partners of human in maintaining health. Since ancient times, changes in our lifestyle have affected our microbiome and the balance with their human host has been perturbed. The present review includes the description about factors affecting oral microbiome and establishing symbiosis with the human host so that they contribute in maintaining health rather than eliciting diseases. Materials and methods A comprehensive literature search was performed on databases such as Google Scholar, PubMed and Medline until April 2015. First, articles were selected on the basis of their titles and then abstracts were screened and unwanted articles were excluded. Articles obtained from all the databases were checked and duplicate articles were removed. Articles obtained from various databases: PubMed = 35, Google Scholar=8. Out of these 43 articles, total 29 articles were finally selected for this review. Results The published literature suggests that the modern oral microbiome is less biodiverse, and possess more pathogenic bacterial species and lesser beneficial bacteria. The possible factors mainly responsible for this shift in microbiome were found to be change in diet, industrial revolution and indiscriminate use of antibiotics. Conclusion Various changes in lifestyles have affected oral microbiome adversely and perturb the symbiosis between the microbiome and their hosts. The present oral microbiome is found to be less diverse and more pathogenic. The present review may be helpful in understanding the relationship between the microbiome and their human hosts so that microbiome contributes in maintaining healthy state of the body.

Influence of Different Etching Modes on Bond Strength to Enamel using Universal Adhesive Systems.

Abstract: INTRODUCTION The adhesive systems and the techniques currently used are designed to provide a more effective adhesion with reduction of the protocol application. The objective of this study was to evaluate the bond strength of universal adhesive systems on enamel in different etching modes (self-etch and total etch). MATERIALS AND METHODS The mesial and distal halves of 52 bovine incisors, healthy, freshly extracted, were used and divided into seven experimental groups (n = 13). The enamel was treated in accordance with the following experimental conditions: FUE-Universal System - Futurabond U (VOCO) with etching; FUWE - Futurabond U (VOCO) without etching; SB-Total Etch System - Single Bond 2 (3M); SBUE-Universal System - Single Bond Universal (3M ESPE) with etching; SBUWE - Single Bond Universal (3M ESPE) without etching; CLE-Self-etch System - Clearfil SE Bond (Kuraray) was applied with etching; CLWE - Clearfil SE Bond (Kuraray) without etching. The specimens were made using the composite spectrum TPH (Dentsply) and stored in distilled water (37 ± 1°C) for 1 month. The microshear test was performed using the universal testing machine EMIC DL 2000 with the crosshead speed of 0.5 mm/minute. The bond strength values were analyzed using statistical tests (Kruskal-Wallis test and Mann-Whitney test) with Bonferroni correction. RESULTS There was no statistically significant difference between groups (p < 0.05), where FUE (36.83 ± 4.9 MPa) showed the highest bond strength values and SBUWE (18.40 ± 2.2 MPa) showed the lowest bond strength values. The analysis of adhesive interface revealed that most failures occurred between the interface composite resin and adhesive. CONCLUSION The universal adhesive system used in dental enamel varies according to the trademark, and the previous enamel etching for universal systems and the self-etch both induced greater bond strength values. CLINICAL SIGNIFICANCE Selective enamel etching prior to the application of a universal adhesive system is a relevant strategy for better performance bonding.

Comparison of Shear Bond Strength and Microleakage of Various Bulk-fill Bioactive Dentin substitutes: An in vitro Study.

Abstract: Introduction Various bulk-fill materials depending on their composition, viscosity, and flow ability have different physical and mechanical properties. The aim of this in vitro study was to determine and compare the shear bond strength and microleakage properties of activa restorative with other bulk-fill restorative materials surefil (SDR), Biodentine, ever X posterior. Materials and methods Forty permanent premolars were selected for shear bond strength, and 20 permanent premolars were selected with class II cavities on mesial and distal side for microleakage. Universal testing device was used to assess the shear bond strength. Microleakage was checked using dye penetration method under a stereomicroscope. Mean and standard deviation values were calculated from the recorded values. Intergroup comparison was done by one-way analysis of variance (ANOVA) followed by pairwise comparison using Tukey honestly significant difference (HSD) post hoc test. Results The mean shear bond strength was highest for SDR surefil followed by Ever X posterior, Bioactive restorative, and Biodentine respectively. In this study, SDR (surefil) showed better shear bond strength and better microleakage properties compared with the other test materials (F = 186.7157, p Conclusion The result of this study showed that flowable and fiber-reinforced composites have better shear bond strength and microleakage properties. Clinical significance Flowable bulk-fill composite resins can be used as dentin substitutes because of its superior properties.

Zirconia Crown as Single Unit Tooth Restoration: A Literature Review.

Abstract: Ceramics has become increasingly popular as a dental restorative material because of its superior esthetics, as well as its inertness and biocompatibility. Among dental ceramics, zirconia is used as a dental biomaterial and it is the material of choice in contemporary restorative dentistry. Zirconia ceramics has both clinical popularity and success due to its outstanding mechanical properties and ease of machining in the green stage via computer-aided design and computer-aided manufacturing technology. Zirconia is one of the most promising restorative biomaterial because it has favorable mechanical and chemical properties suitable for medical application. Zirconia ceramics is becoming a prevalent biomaterial in dentistry. Clinical evaluations also indicate a good success rate for zirconia with minimal complications. This article reviews the current literature on dental zirconia with respect to basic properties, biocompatibility, and clinical applications in aesthetic dentistry as single unit crown.

Evaluation of Antimicrobial Photodynamic Therapy against Streptococcus mutans Biofilm in situ.

Abstract: Aim This study investigated the effect of antimicrobial photo-dynamic therapy (aPDT) over Streptococcus mutans biofilm. Materials and methods Eighteen (n = 18) patients were selected and one palatine device with dental blocks was used. The biofilm was treated by curcumin and Photogem® with a LED and the effect was analyzed by CFU/ml. Results Although, statistical analysis showed significant reductions for aPDT mainly with Photogem® (p = 0.02), these were low. Conclusion The results suggest a low antimicrobial effect of aPDT over S. mutans biofilm. Some parameters used need to be improved. Clinical significance This technique can be a promising in Dentistry.

Antibiotic Prescription Knowledge of Dentists in Kingdom of Saudi Arabia: An Online, Country-wide Survey.

Abstract: Aim Dentists are probably contributing to the development of bacterial resistance to certain antibiotics. Campaigns to promote prudent use of antibiotics in dentistry are, thus, needed but require proper identification of dentists' knowledge gaps. The objective here was to comprehensively evaluate antibiotic prescription knowledge of dentists in Saudi Arabia. Material and methods A link to an online, previously validated questionnaire was emailed to 5199 dentists registered with the Saudi Dental Society. The questionnaire comprised 42 scorable items measuring antibiotics prescription knowledge in five different domains in addition to nonscorable questions regarding first-choice antibiotics and previous attendance of a course/workshop about antibiotic prescription. Each correct answer was given one mark. Mean scores were calculated as percentages and categorized as good (> 80%), intermediate (60-80%), or poor ( Results The response rate was 9.4%; however, only 373 (7.2%) fully completed the questionnaire. Around half of the participants (52%) reported prescribing amoxicillin/clavulanate as the first-choice antibiotic; 62% reported attending a course/workshop in the last 5 years. The average knowledge score was 69%, being highest for nonclinical indications (79%) and lowest for prophylactic use (56%). The worst per-item scores were noted for rheumatic heart disease (19%), trismus (28%), surgical extraction (30%), apicectomy (31%), and periodontal abscess (33%). Female dentists, dentists in governmental sector, and those with higher qualifications had significantly better knowledge. Conclusion The level of knowledge was hardly intermediate and several deficits were identified, indicating an urgent need for educational campaigns and provision of guidelines promoting rational use of antibiotics by dentists. Clinical significance Irrational use of antibiotics by dentists can contribute to the problem of antibacterial resistance.

Satisfaction with Dental Appearance and Attitude toward improving Dental Esthetics among Patients attending a Dental Teaching Center.

Abstract: AIM The aim of this study was to evaluate the factors influencing the satisfaction of dental appearance and attitude toward treatments to improve dental esthetics among patients attending a dental teaching center. METHODS A questionnaire was used to collect data of four background variables among 450 patients attended a dental teaching center in the city of Irbid in Jordan. The questionnaire enclosed self-reported questions about the appearance of anterior teeth, received esthetic treatment and desired treatment for improving esthetics. Descriptive, multiple logistic regression and Chi-square tests were used for data analysis (p ≤ 0.05). RESULTS The 450 participants consisted of (66.2%) male and (33.8%) female. Of these, 69.3% were satisfied with their dental appearance and 58.0% with the color of their teeth. Esthetic restorations were the most received treatment (39.8%) and whitening of teeth was the most desired treatment (55.3%). The patients' satisfaction with dental appearance was influenced by teeth color, crowding and receiving whitening (p < 0.05. r = 0.561, r(2) = 0.315). The most desired esthetic treatments influenced by the satisfaction with dental appearance were esthetic restorations and orthodontics (p < 0.05. r = 0.223, r(2) = 0.05). Significantly more female reported having esthetic restorations and orthodontics (p = 0.008, 0.000) and desired to have orthodontic, crowns or veneers and esthetic restorations (p = 0.000, 0.015, 0.028). CONCLUSION Satisfaction with dental appearance was affected by teeth color, feeling teeth are crowded, desire for esthetic restorations and orthodontic treatment. A high percentage of patients were not satisfied with the color of their teeth. CLINICAL SIGNIFICANCE Recognizing the factors that affect patients' satisfaction with their present dental appearance and attitude toward treatments to improve dental esthetic can guide clinicians to strategies to improve esthetics.

A Clinicopathologic Study of Oral Changes in Gastroesophageal Reflux Disease, Gastritis, and Ulcerative Colitis.

Abstract: Objectives The aim and objectives of this study are to identify oral changes in certain gastrointestinal (GI) diseases, namely gastroesophageal reflux disease (GERD), ulcerative colitis, gastritis, and to evaluate these oral symptoms as indicators for assessing GI disorders. Materials and methods In this study, the oral manifestations of various GI disorders were assessed in a varying age group of 250 patients in Government Stanley Medical College and Hospital, Chennai. Out of 250 patients, 142 were affected by GERD, 99 were affected by gastritis, and 9 patients were affected by ulcerative colitis. Of these patients, 177 were males and 73 were females. Results Evaluation of patients with gastritis revealed that 66.7% affected with gingivitis, 19.2% with dental erosion on the palatal and lingual aspects of maxillary and mandibular teeth predominantly in the anterior region, 10.1% with periodontitis, 2% with gingival erythema. Among the patients with GERD, 44% of the cases showed dental erosion, 25.5% periodontitis, 9.9% gingivitis, 5.7% gingival erythema, 2.8% palatal erythema, 2.1% gingival ulcers, glossitis 2%, 1.4% floor of the mouth erythema, and 0.7% erythema of the tongue. Patients with ulcerative colitis showed 44.4% of gingival erythema, 33.3% of dental erosions, and 22.2% of gingival ulcers and periodontitis. Conclusion In our study of 250 patients, oral manifestations were observed in 88% of the patients. Both soft tissue and hard tissue changes were evident. There was a high correlation between various GI disease and dental erosion, erythema at various sites of the oral cavity, oral ulcers, gingivitis, periodontitis, and glossitis. Careful evaluation of oral cavity may unveil many GI disorders and help the patient by providing early diagnosis, which further facilitates the prognosis.

Burning Mouth Syndrome: A Review of the Etiopathologic Factors and Management.

Abstract: Burning mouth syndrome (BMS) is characterized by pain in the mouth with or with no inflammatory signs and no specific lesions. Synonyms found in literature include glossodynia, oral dysesthesia, glossopyrosis, glossalgia, stomatopyrosis, and stomatodynia. Burning mouth syndrome generally presents as a triad: Mouth pain, alteration in taste, and altered salivation, in the absence of visible mucosal lesions in the mouth. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during evening and at night. The etiopathogenesis seems to be complex and in a large number of patients probably involves interactions among local, systemic, and/or psychogenic factors. The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Management is always based on the etiological agents involved. If burning persists after local or systemic conditions are treated, then treatment is aimed at controlling neuropathic symptoms. Treatment of BMS is still unsatisfactory, and there is no definitive cure. As a result, a multidisciplinary approach is required to bring the condition under better control. The aim of this review was to discuss several aspects of BMS, update current knowledge, and provide guidelines for patient management.

The Influence of Dental Shade Guides and Experience on the Accuracy of Shade Matching.

Abstract: AIM There is limited and inconsistent information on some factors affecting visual shade selection. The aim of this study was to evaluate the influence of shade guide type and professional experience on shade-matching results. MATERIALS AND METHODS Thirty Dental students (DS), 30 General dentists (GDs) and 30 Dental specialists (S) participated in this study. The participants were asked to match six target tabs using two dental shade guides: Vitapan Classical (VC) and Vitapan 3D-Master (3D). An intraoral spectrophotometer was used for color measurement of target tabs and selected tabs. The color difference (ΔE) values between the target tab and selected tab were calculated. Data were analyzed using analysis of variance (ANOVA) and paired f-test (α = 0.05). Results of the first five best matches for each target tab were expressed as ΔE1 to ΔE5. Differences in the mean values of ΔE1 to ΔE5 between VC and 3D were compared using descriptive statistics. RESULTS There were no significant differences among the three participating groups in ΔE values when the 3D was used (p = 0.389). However, significant differences were found with VC (p < 0.001). The ΔE values achieved from the 3D were significantly lower than those from VC for DS and S (p = 0.001 and p < 0.001, respectively). For each of the first five best matches, the mean ΔE values from the 3D were smaller than the corresponding values of VC. CONCLUSION The type of dental shade guide affected the shade-matching results. The level of experience was not found to be an influential factor in shade matching when 3D-Master shade guide was used. CLINICAL SIGNIFICANCE Compared with Vitapan Classical shade guide, use of the Vitapan 3D-Master shade guide improves shade-matching results. KEYWORDS Color, Experience, Gender, Selection, Shade, Visual. How to cite this article: Nakhaei M, Ghanbarzadeh J, Amirinejad S, Alavi S, Rajatihaghi H. The Influence of Dental Shade Guides and Experience on the Accuracy of Shade Matching. J Contemp Dent Pract 2016;17(1):22-26. Source of support: This study was supported by a grant (No. 920903) from the Vice Chancellor for Research of Mashhad University of Medical Sciences. The results presented here are based on undergraduate thesis (No. 2686) submitted to Mashhad School of Dentistry and Dental Research Center. CONFLICT OF INTEREST None.

Oral Cancer-related Inherited Cancer Syndromes: A Comprehensive Review.

Abstract: Oral squamous cell carcinoma is the most common malignancy of the oral cavity, which is usually preceded by a myriad of oral potentially malignant disorders (OPMDs). In the classification of OPMDs, inherited cancer syndromes (ICSs) were proposed as one of the categories. Inherited cancer syndromes are genetic disorders in which inherited genetic mutation in one or more genes predispose the affected individuals to the development of cancer and may also cause its early onset. Many of these syndromes are caused by mutations in tumor suppressor genes, oncogenes, and genes involved in angiogenesis. General dental practitioners frequently come across OPMDs in their day-to-day practice. It becomes of paramount importance to have knowledge about these rare but prognostically important OPMDs. With this view in mind, in this article, efforts have been made to comprehensively discuss about various ICSs that have higher potential of transformation into oral cancer. The ICSs discussed in this article are xeroderma pigmentosum (XP), ataxia telangiectasia (AT), Bloom syndrome (BS), Fanconi's anemia (FA), and Li-Fraumeni syndrome (LFS), with special emphasis on signs, symptoms, and genetic considerations.

450 nm Blue Laser and Oral Surgery: Preliminary ex vivo Study.

Abstract: Introduction Dental diode lasers were started to be used at the end of the 1990s and were shown to possess several important characteristics, such as small size and low cost, as well as the advantage of optic fibers delivering system. Although only two wavelengths (810 and 980 nm) had been the most used dental diode lasers, a wavelength emitting in the blue portion of the spectrum has recently been proposed. Aim The aim of this ex vivo study was to compare the effectiveness of five different fiber-delivered laser wavelengths (450, 532, 808, 1064, and 1340 nm) in the oral soft tissue ablation. Materials and methods Specimens were surgically collected from the dorsal surface of four bovine tongues and, while deep thermal increase was measured by two thermocouples at 0.5 and 2 mm depth, surface temperature was recorded by an infrared thermometer. Subsequently, specimens were fixed in 10% buffered formalin solution, cut into slices, and embedded in paraffin blocks, and a pathologist made a morphological analysis by optic microscope assigning a score based on the quality of the cut and tissue damage. Results The analysis showed the best quality of the cut and the lowest temperature increase on the specimens obtained with the shortest laser wavelength (450 nm). Conclusion Even considering this as preliminary study, the use of 450 nm blue diode laser in oral surgery may be suggested to the clinician in their daily practice. Clinical significance This study opens a new perspective in oral surgery. Blue diode laser has demonstrated a good quality of the cut with a low energy causing a minimal thermal damage to the tissue, promising a better comfort to patients.

Association between Body Mass Index and Dental Caries among Anganwadi Children of Belgaum City, India.

Abstract: Introduction Body mass index (BMI) is an index that measures height for weight, which is commonly used to categorize underweight, overweight, and obese individuals Deviation from normal weight results from an imbalance between caloric consumption and energy expenditure Childhood obesity and childhood dental caries are coincidental in many populations, probably due to common confounding risk factors, such as intake frequency, cariogenic diet, and poor oral hygiene So the aim of the present study was to assess the BMI status and to corelate between dental caries and BMI among the Anganwadi children of Belgaum city, Karnataka, India Materials and methods Four hundred and thirty three children from 20 Anganwadi's belonging to the age group of 2 to 6 years of both sexes were measured for BMI and dental caries status The caries index was measured as the number of decayed (d) and filled (f) teeth (t) (dft) The BMI in units of kg/m2 was determined and children were categorized according to age-and gender-specific criteria as underweight ( 95th percentile) The data were subjected to statistical analysis using Student's t-test, analysis of variance (ANOVA), and Karl Pearson's correlation coefficient test with the help of Statistical Package for the Social Sciences (SPSS) version 180 Results The proportion of subjects in Centre for Disease Control (CDC) weight categories was: 5% underweight, 79% normal, 9% under the risk for overweight, and 6% overweight Conclusion A significant association was found between children with normal BMI and those who were underweight, overweight, and under the risk for overweight Children with overweight/obese or underweight/malnourished children had higher decayed and filled surfaces compared to children with normal weight Clinical significance Nutritional status has a profound effect on dental caries Both underweight/malnutrition and overweight/ obesity have significant adverse implications for health Childhood obesity and childhood dental caries are coincidental in many populations

The Effect of Using Self-ligating Brackets on Maxillary Canine Retraction: A Split-mouth Design Randomized Controlled Trial.

Abstract: INTRODUCTION The results of previous studies about the efficacy of using self-ligating brackets (SLBs) in controlling canine movement during retraction are not in harmony. Therefore, the current study aimed to compare the effects of using new passive SLBs on maxillary canine retraction with sliding mechanics vs conventional ligating brackets (CLBs) tied with metal ligatures. MATERIALS AND METHODS The sample comprised 15 adult patients (4 males, 11 females; 18-24 years) requiring bilateral extraction of maxillary first premolars. Units of randomization are the left or right maxillary canines within the same patient. The two maxillary canines in each patient were randomly assigned to one of the two groups in a simple split-mouth design. The canines in the SLBs group (n = 15) were bracketed with SLBs (Damon Q™), while the canines in the CLBs group (n = 15) were bracketed with conventional brackets (Mini Master Series). Transpalatal bars were used for anchorage. After leveling and alignment, 0.019 × 0.025" stainless steel working archwires were placed. Canines were retracted using a nickel-titanium close-coil springs with a 150 gm force. The amount and rate of maxillary canine retraction, canine rotation, and loss of anchorage were measured on study models collected at the beginning of canine retraction (T0) and 12 weeks later (T1). Differences were analyzed using paired-samples t-tests. RESULTS The effect differences were statistically significant (p < 0.001). Using Damon Q™ SLBs, the amount and rate of canine retraction were greater, while canine rotation and anchorage loss were less. CONCLUSION From a clinical perspective, extraction space closure can be accomplished more effectively using SLBs. CLINICAL SIGNIFICANCE Self-ligating brackets gave better results compared to the CLBs in terms of rate of movement, amount of canine rotation following extraction, and anchorage loss.

Study of the Mechanical Properties of the Novel Zirconia-reinforced Glass lonomer Cement.

Abstract: OBJECTIVES The purpose of this in vitro study is to compare the compressive strength (CS) and diametral tensile strength (DTS) of the zirconia-reinforced restorative material (Zirconomer®) with conventional glass ionomers (Fuji 1X) and amalgam. MATERIALS AND METHODS Specimens (n = 120) were fabricated from silver amalgam, reinforced glass ionomer cement (GIC) (glass ionomer, Fuji 1X GC Corp.), and zirconia-reinforced glass ionomer (Zirconomer, Shofu Inc.) for testing the CS and DTS. The results were analyzed using analysis of variance, followed by a Tukey post hoc test. RESULTS Both CS and DTS were found to be significantly higher for the zirconia-reinforced GIC and silver amalgam compared with GIC (p < 0.001). CONCLUSION A newer class of restorative material like Zirconomer helps to overcome the potential hazard of mercury, but retains the strength and durability of amalgam as well as the sustained high-fluoride release of GICs. Furthermore, long-term studies are required to confirm its use as an alternative to the currently available posterior restorative material.

Clinical and Radiographic Evaluation of Success of Two commercially Available Pulpotomy Agents in Primary Teeth: An in vivo Study.

Abstract: Aim The aim of this study is to evaluate and compare Biodentine and mineral trioxide aggregate (MTA) as pulpotomy agents by clinical and radiological assessments in primary teeth. Materials and methods In this study, 90 decayed primary molars indicated for pulpotomy were chosen and are divided into two groups. Soft enamel and dentinal caries were removed using spoon excavator. Access opening was done using highspeed cool water handpiece. Normal saline was used to irrigate pulp chamber, later saline moistened cotton pellet was used to obtain hemostasis in both groups. Restorations were placed in respective groups and immediate postoperative radiographs were taken. Follow-ups were done at every 3 months intervals, i.e., 3, 6, 9, and 12 months respectively. Results Statistical evaluation was carried out by using paired t-test which showed no significant difference between the two groups (p ≥ 0.05) with high success rate of 95.5%. Conclusion Pulpotomy with MTA and Biodentine is a reliable biological method for pulp treatment of primary teeth. Clinical significance Mineral trioxide aggregate and Biodentine could be considered as a reliable biological method for pulp-otomy of primary teeth.

Micromovement Evaluation of Original and Compatible Abutments at the Implant-abutment Interface.

Abstract: Introduction Use of compatible abutments may increase micromovements between the abutments, and the inner part of the implant may increase the stress on marginal bone level. Also micromovement will change the volume of the inner space of the implant-abutment complex. The resulting pumping effect can transport even initially immobile microorganisms from the exterior to the interior and vice versa. Objectives The purpose of the study was to evaluate the mechanical comportment of OsseoSpeed™ Tx implants connected with original and compatible abutments in vitro under simulated clinical loading conditions. Materials and methods A total of 15 OsseoSpeed™ TX implants (4 × 11 mm) were used and divided into three groups (n = 5). Three types of abutments were used in the study; group I: Five original Ti Design™ abutments, group II: Five Natea™ abutments, and group III: Implanet™ abutments. Abutments used in groups II and III were all compatible with Astra Tech Implant System™. Implants were embedded into resin. Simulating the human masticatory cycle, the axial force vector was increased up to a defined maximum (25, 50, 75, 100, 125, 150, 175, and 200 N) and inclined 30° to the implant axis. A radiograph amplifier was used to convert the X-ray projection into a picture. The visual evaluation of the frames and the provided X-ray videos were evaluated for an existing microgap in width and length between the implant and the abutment. Results An initial width gap was observed in groups II and III in four of the five samples with an average of 6.5 and 5 μm respectively. When the axial forces reach 75 N, only groups II and III demonstrated a gap width of 5.2 ± 3.63 and 4.8 ± 3.03 μm, and a gap length of 5.2 ± 3.63 and 94 ± 125.3 μm respectively. At 200 N, group I showed a gap width of 8.4 ± 1.67 μm and a gap length of 187.6 ± 43.6 μm, while groups II and III showed a gap width of 12.4 ± 3.29 and 22.8 ± 5.76 μm, and a gap length of 387.2 ± 84.36 and 641.2 ± 122.6 μm respectively. Conclusion Within the limitations of this study and under the parameters used and from the resulting data collected, we can presume that the use of compatible components leads to significant micromovement when compared with the use of original ones. Clinical significance The use of compatible prosthetic components with original implants showed significant micromovements when compared with the use of abutment and implant from the same manufacturer. Clinically, the micromovements when associated with leakage leads to bone loss around the neck of the implant and later to peri-implantitis.

Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis

Abstract: Background Oral submucous fibrosis (OSMF) is a well-established precancerous condition affecting the oral mucosa. It is a disease that causes significant morbidity (in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult) and mortality (when transformation into squamous cell carcinoma occurs). Aim The aim of the study is to compare the efficacy of Aloe vera with antioxidant when given along with physiotherapy in the management of OSMF. Materials and methods Forty patients presenting with clinical signs and symptoms of OSMF were included for the study after informed consent. Group A included 20 patients who received Aloe vera gel (forever living gel) along with physiotherapy. Group B included 20 patients who received antioxidant capsules twice daily for 3 months along with physiotherapy exercises four times in a day. The following parameters, that is, burning sensation, mouth opening, tongue protrusion and cheek flexibility were recorded at each visit. Results Majority of the participant enrolled were in the age range of 30 to 35 years. Improvement in all the parameters was seen with the individuals receiving Aloe vera gel in comparison to antioxidants. Conclusion So, Aloe vera being a soothing, simple and safe mode of treatment along with proper habit restriction can be considered to be an effectual protocol in the management of OSMF. The analgesic effects of Aloe vera with the physiotherapy exercises provide better results in reducing burning sensation and improving mouth opening, tongue protrusion and cheek flexibility in comparison to antioxidants.

Assessing the Risk of Oral Cancer associated with Gutka and Other Smokeless Tobacco Products: A Case-control Study.

Abstract: INTRODUCTION Tobacco and tobacco-related products have been attributed to be causative factors for oral cancer. Newer, chewable, and commercially available smokeless tobacco (ST) products, such as gutka pose further threat in this direction. The aim of the study was to evaluate the risk of oral cancer associated with gutka and other ST products. MATERIALS AND METHODS A case-control study of 134 cases and 134 controls, over a period of 6 months (July-December 2014), was carried out at the Baqai University, Karachi, Pakistan. An interview-based questionnaire was used to collect data on sociodemographic characteristics, oral hygiene practices and type, duration, and frequency of use of tobacco-related products. Data were analyzed using the Pearson's chi-square (χ2) test with the level of significance set as p < 0.05. RESULTS Gutka showed the highest odds ratio toward developing oral cancer ratio among all the tobacco-related products [odds ratio (OR) 5.54; 95% CI 2.83-10.83; p < 0.001)]. Participants who consumed other ST products also showed 2 to 4 times higher odds ratio of developing oral cancer than compared to those who did not consume these products. CONCLUSION The study provided strong evidence that gutka and other ST products are independent risk factors for oral cancer. CLINICAL SIGNIFICANCE This study highlights the strong association of different types of ST and oral cancer. This results in identification of high-risk groups for targeted screening for potential oral cancer lesions.

Status of Endodontic Treatment and the Correlations to the Quality of Root Canal Filling and Coronal Restoration.

Abstract: Introduction This cross-sectional study evaluated the prevalence and quality of root canal treatment in 1,977 digital radiological files. Materials and methods Data were statistically analyzed using descriptive analysis, and the chi-square test was performed with a 5% significance level. Results The mean age of the study population was 34.9 years. The endodontic treatment frequency was 6.14%, significantly higher in premolars. Adequate endodontic treatment was observed in 39.7% of analyzed cases. Molars were significantly more frequent with regard to inadequate filling quality. In 47.6% of cases, the filling's apical limit was classified as adequate, and there was a higher incidence of molars that were inadequate. Restorations were classified as adequate in 79.0% of cases, and molars were responsible for the highest frequency of inadequate restorations. The frequency of teeth with endodontic treatment that showed no periapical changes was 47.7%. There was no significant difference in the presence of periapical change according to gender. An increased presence of periapical change was observed with increasing age. The periapical lesions were observed in 45% of cases and related to inadequate filling quality. The apical limit was considered inadequate and related to periapical changes in 42% of cases. Periapical changes were present in 52% of cases, regardless of the quality of the filling and apical limit. Such changes were present in 42% of cases with adequate coronal restoration. Conclusion It can be concluded that apical periodontitis (AP) is associated with the quality of endodontic treatment. The coronal restoration affects significantly the success rate of endodontic treatment. Clinical significance The quality of the root filling and coronal restoration is closely related to periapical health.