Journal of Clinical and Experimental Dentistry. 2015. Vol. 7, no. 1

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    Cleaning and retreatment protocol for a debonded ceramic restoration
    (2015) Román Rodríguez, Juan Luis; Alonso Pérez Barquero, Jorge; Bruguera Alvarez, August; Agustín Panadero, Rubén; Fons Font, Antonio
    Objectives: The aim of this article is to propose a resin cement cleaning protocol for use before recementing a debonded restoration. Study Design: Ceramic samples were fabricated from IPS d.sign® and IPS e.max Press® and were treated with hydrofluoric acid etching (HF), or HF+silane (S), or HF+S+adhesive or HF+S+A+resin cement. All samples were placed in a furnace at 650º for one minute in order to attempt to pyrolyze the composite. Each step was examined under scanning electron microscopy (SEM). Results: When the cleaning protocol had been performed, it left a clean and retentive surface. Conclusions: If the restoration is placed in a furnace at 650º for one minute, the composite cement will burn or pyrolyze and disappear, allowing conventional retreatment of the ceramic before rebonding.
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    Perceived barriers to the provision of preventive care among dentists of Udaipur, India
    (2015) Nagarajappa, Ramesh; Sanadhya, Sudhanshu; Batra, Mehak; Daryani, Hemasha; Ramesh, Gayathri; Aapaliya, Pankaj
    Aim: To investigate the practice-, patient- and dentist related barriers to the provision of preventive dental care as perceived by dentists of Udaipur city, Rajasthan, India. Settings and Design:- A cross sectional descriptive survey was conducted among 120 dentists of Udaipur city, Rajasthan. Material and Methods: Mean Content Validity Ratio (CVR) was calculated as 0.87 based on the opinions expressed by a panel of total six academicians. Cronbach's coefficient was found to be 0.88, which showed a high internal reliability of the questionnaire. The questionnaire consisted of demographic questions and 12 specific research questions. Statistical analysis used:- Student's t-test and ANOVA test were applied for the statistical evaluation of means. Level of significance was set at 0.05. Results: The barriers correlated strongly with each other (0.60 to 0.85). A significant gender difference was observed in mean sums of scores of practice and patient related barriers. Practice, dentist and patient related barriers for very much hindrance were reported by 8 to 13%, 5 to19% and 0 to 29% of the dentists respectively. A significant difference was observed among mean of sum scores of practice and patient related barriers with age and experience. Qualification was significantly related to practice related barriers. Conclusions: Perception of dentists showed that patient related barriers were found to be the foremost to the provision of preventive care. Also, dentist's attitude towards health promotion and disease prevention needs a radical transformation.
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    Cemented and screw-retained implant-supported single-tooth restorations in the molar mandibular region: a retrospective comparison study after an observation period of 1 to 4 years
    (2015) Ferreiroa Navarro, Alberto; Peñarrocha Diago, Miguel; Pradíes Ramiro, Guillermo; Solá Ruiz, María Fernanda; Agustín Panadero, Rubén
    Objectives: The aim of this study was to evaluate the survival and compare the appearance of different mechanical and biological complications, in screw-retained and cemented-retained single-tooth implant-supported restorations localized in the molar mandibular region, over a period of 1 to 4 years. Material and Methods: A retrospective study was carried out with a total of eighty implant-supported restorations, which were placed in eighty patients for prosthetic rehabilitation of a mandibular molar. Forty patients were rehabilitated with a cemented-retained restoration and the other forty with a screw-retained restoration. The presence of the following complications was recorded for both types of prostheses: Fractures of the ceramic veneering, loosening screws, mucositis and peri-implantitis. Debonding of the restoration was analyzed in the cemented-retained restoration group. The clinical survival of crowns was analyzed with a Kaplan-Meier test and the clinical complications were compared, using a Student t test and Log-rank test. Results: 27 patients registered some complication. The average rate of complications was 37,5% for cemented- retained restorations and 30% for screw-retained restorations. The complications more common in the cemented- retained restoration were the presence of mucositis (14,87%), while in the screw-retained restorations was the loosening screw (20%). Student t test and Log-Rank test found significant differences ( p =0,001) between the screw loosening and presence of mucositis. Conclusions: The cemented-retained restorations seem to prevent screw loosening, but the presence of cement seem to increase the complications around the soft tissues, however in the screw-retained restorations the presence of mucositis and peri-implantitis are lower than cemented-retained restorations. The incidence of fracture of ceramic veneering was similar in both groups.
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    A prospective randomized clinical trial compared the effect of various types of local anesthetics cartridges on hypertensive patients during dental extraction
    (2015) Abu-Mostafa, Nedal; Aldawssary, Abdullah; Assari, Ahmad; Alnujaidy, Suliman; Almutlaq, Abdulrahman
    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 ß 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.
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    The effect of passive ultrasonic activation of 2% chlorhexidine or 3% sodium hypochlorite in canal wall cleaning
    (2015) Llena Puy, María Carmen; Garcia Cuesta, Carla; Forner Navarro, Leopoldo; Mozo, Sandra; Segura-Egea, Juan J.
    Objectives: the purpose of this study was to compare debris removal and open tubules effectiveness of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) applied as final irrigation in dif ferent protocols Study Design: sixty extracted premolars were divided into six groups according to the final irrigation technique: A and B 3 % NaOCl or 2 % CHX with the Miraject needle and no agitation; C and D, passive ultrasonic irrigation (PUI) with Irrisafe 20 tips and 3 % NaOCl or 2 % CHX; E and F, PUI with Irrisafe 25 tips and 3 % NaOCl or 2% CHX. The remaining dentine debris and opened tubules were evaluated by SEM at three root levels by two blinded investigators. The Kruskal Wallis and the Mann-Whitney U test was used to compare groups and levels, with a significance of p <0.05. Results: Debris elimination was significantly higher in PUI groups ( p <0.05). PUI groups showed a higher capability to open tubules, compared to groups A and B. In the coronal third, groups D to F eliminated more debris and opened more tubules than conventional irrigation ( p <0.05). In medium third, group E eliminated significantly more debris (1.60) than group A (2.60). No differences were obtained among groups in apical third. Both NaOCl and CHX applied with PUI showed no differences in debris elimination or opened tubules. Conclusions: Final PUI with Irrisafe tips was the most effective procedure for eliminating the debris and opening up dentinal tubules, independent of the irrigant solution or Irrisafe type size.
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    Oral mucosal diseases in anxiety and depression patients: Hospital based observational study from south India
    (2015) Suresh, Kandagal V.; Shenai, Prashanth; Chatra, Laxmikanth; Ronad, Yusuf-Ahammed A.; Bilahari, Naduvakattu; Pramod, Redder C.; Kumar, Sreeja P.
    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 psy - chiatrists 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 respecti - vely. 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.
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    Analgesic and physiological effects in conscious sedation with different nitrous oxide concentrations
    (2015) Bonafé Monzó, Neus; Rojo Moreno, Juan; Catalá Pizarro, Montserrat
    Objectives: to study the physiological changes, as well as the psychosedative and analgesic effects of nitrous oxide, in experimental conditions. Study Design: 101 dental students volunteers participated in a single nitrous oxide sedation session without dental treatment. Signs and symptoms were registered during and after the procedure. Pulse rate and hemoglobin oxygen saturation were monitored at: 100 per cent O 2 , 30 per cent N 2 O, 50 per cent N 2 O and 5 minutes after 100 per cent O 2 . A Likert scale was used to evaluate pain perception. The analgesic effects of nitrous oxide were evaluated at: 30 per cent N 2 O, 50 per cent N 2 O, and five minutes postoperatively. Results: Pulse rate and hemoglobin oxygen saturation decreased significantly through all the procedure and after recovery. However, oxygen saturation recovered after the final oxygenation. Only 8.2% of subjects reported the pain stimulus as being quite annoying when they inhaled 30 per cent N 2 O, while this percentage was of 15.8 % when inhaling 50 per cent N 2 O, and of 32.7 % during the recovery period. The most common effects of nitrous oxide sedation were bright eyes (99%), voice change (98%) and smiling (91%). Most of the subjects reported tingling (98%) and relax (91.1%) Conclusions: nitrous oxide causes a significant decrease in heart rate and oxygen saturation, but always within safety limits. Maintaining an appropriate level of consciousness was confirmed as a feature in 50 per cent dose in this study. The analgesic effect of nitrous oxide was confirmed but a dose dependency could not be established.
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    Influence of surface preparation on fracture load of resin composite-based repairs
    (2015) Agustín Panadero, Rubén; Mateos Palacios, Rocío; Román Rodríguez, Juan Luis; Solá Ruiz, María Fernanda; Fons Font, Antonio
    The purpose of the present study is to evaluate the fracture load of composite-based repairs to fractured zirconium oxide (Z) crowns and to ceramic-fused-to-metal (CM) crowns, comparing different mechanical surface preparation methods. A total of 75 crowns were repaired; samples then underwent dynamic loading and thermocycling. Final fracture load values for failure of the repaired crowns were measured and the type of fracture registered. Group I: CM: Surface preparation with a diamond bur + 9.5% Hydrofluoric Acid (HF) etching; Group II): CM: air-particle (Al 2 O 3 ) + 9.5% HF; Group III: CM: Silica coating (SiO 2 ); Group IV): Z: air-particle (Al 2 O 3 ) + HF 9.5%; Group V) Z: Silica coating (SiO 2 ). Of the three CM groups, Group I (CM-diamond bur) showed the highest mean failure value, with significant difference in comparison with Group III (CM-silica coating). For the zirconia groups, the highest value was obtained by Group V (silica coating).
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    Prevalence of oral lichen planus among a sample of the Egyptian population
    (2015) Mostafa, Basma; Ahmed, Enji
    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 histo - logically (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.
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    Rotational panoramic radiographs-unusual triple images
    (2015) Valai-Kasim, Shakeel-Ahmed; Krishnaswamy, Nathamuni-Rengarajan; Biju, Tom; Thavarajah, Rooban
    Currently clinicians advice rotational panoramic radiography (RPR) for preliminary investigation. Despite few inherent limitations, rotational panoramic radiography still remains the diagnostic tool of choice. Abnormal structures such as a supernumerary tooth or a device falling within the certain central regions in conventional RPR images may mislead the clinicians towards an inaccurate diagnosis by producing multiple ghost images. Such cases must be treated with circumspect, and apart from RPR, additional imaging modalities need be employed to provide a judicious interpretation of the clinical situation. Thus this manuscript, we present a case where a paramedian supernumerary tooth which exhibited double ghost images on a conventional RPR. This prompted us to elicit the use of a CBCT and 3 dimensional images to determine the true nature of the problem. We outline the working of the diamond principle behind a conventional RPR which cause the appearance of multiple ghost images. The discerning clinician must be cognizant of the possible positional and analytical errors which may be prevalent in a conventional RPR when viewing structures lying in the palatal region, specifically in the midline while making diagnosis.
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    Closure of oroantral communications with Bichat's buccal fat pad. Level of patient satisfaction
    (2015) Alonso González, Rocío; Peñarrocha Diago, María; Peñarrocha Oltra, David; Aloy Prósper, Amparo; Camacho Alonso, Fabio; Peñarrocha Diago, Miguel
    Purpose: To report the closure of oroantral communications with the pedicled buccal fat pad in a series of patients, and to determine the level of patient satisfaction after the surgery. Study Design: A prospective study of patients diagnosed of unilateral or bilateral oroantral communication (OAC) closed using the buccal fat pad between May 2012 and January 2013 was performed. Data analysis extended to: age, sex, and cause, location and size of oroantral communication. Complications and success related to buccal fat pad surgery were evaluated. Also, patient satisfaction was assessed after six months of surgery. Results: Nine patients (3 men and 6 women) with a mean age of 50.5 years and 11 OAC treated with buccal fat pads were included. The most common cause of oroantral communication was the extraction of molars. The average widest diameter of the oroantral communication was 7.1 mm. One week after the surgeries no complications were found. One month after surgery, one patient presented persistence of the oroantral communication; in this patient, the buccal fat pad technique was considered a failure, and a second intervention was performed using a buccal mucoperiosteal flap to achieve primary closure of soft tissues. After six months, patient showed closure of the communication and complete healing. All the other communications had been solved with Bichat ´s ball technique, yielding a success rate of 90.9%. Mean patient overall satisfaction was 9.1 out of 10; patients were satisfied with phonetics (9.4), aesthetics (9) and chewing (9). Conclusions: The buccal fat pad technique was successful in closing 10 out of 11 oroantral communications and few complications were found. Patients were highly satisfied in overall with the treatment and with phonetics, aesthetics and chewing.
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    Clinical pain evaluation with intraoral vibration device during local anesthetic injections
    (2015) Nasehi, Amin; Bhardwaj, Savita; Kamath, Abhay-Taranath; Gadicherla, Srikanth; Pentapati, Kalyana-Chakravarty
    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.
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    Indirect composite restorations luted with two different procedures: a ten years follow up clinical trial
    (2015) Barabanti, Nicola; Preti, Alessandro; Vano, Michele; Derchi, Giacomo; Mangani, Francesco; Cerutti, Antonio
    Objectives: The aim of this clinical trial was to evaluate posterior indirect composite resin restoration ten years after placement luted with two different procedures. Study Design: In 23 patients 22 inlays/onlays (Group A) were luted using a dual-cured resin composite cement and 26 inlays/onlays (Group B) were luted using a light cured resin composite for a total of 48 Class I and Class II indirect composite resin inlays and onlays. The restorations were evaluated at 2 time points: 1) one week after placement (baseline evaluation) and 2) ten years after placement using the modified USPHS criteria. The Mann- Whitney and the Wilcoxon tests were used to examine the difference between the results of the baseline and 10 years evaluation for each criteria. Results: Numerical but not statistically significant differences were noted on any of the recorded clinical parameters ( p >0.05) between the inlay/onlays of Group A and Group B. 91% and 94 % of Group A and B respectively were rated as clinically acceptable in all the evaluated criteria ten years after clinical function. Conclusions: Within the limits of the study the results showed after ten years of function a comparable clinical performance of indirect composite resin inlays/onlays placed with a light cure or dual cure luting procedures.
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    A retrospective study of 72 cases diagnosed with idiopathic trigeminal neuralgia in indian populace
    (2015) Yadav, Sunil; Mittal, Hitesh-Chander; Sachdeva, Akash; Verma, Ajay; Dhupar, Vikas; Dhupar, Anita
    Context: Trigeminal neuralgia is as a chronic, debilitating condition, which can have a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental populations. Objectives: To evaluate the retrospective data of the patients diagnosed with idiopathic trigeminal neuralgia and to understanding the disorder in the Indian populace. Methods: The retrospective data of 72 patients with typical idiopathic trigeminal neuralgia regarding age of onset, gender, site of involvement, clinical presentations and treatment received during three years of the follow up was collected and analyzed. Results: In the present retrospective study, the mean age was 54.9 years; female to male ratio was 2.13:1; rural to urban ratio 1.76:1 with 62.5% suffered trigeminal neuralgic pain on the right side. Carbamazepine was found to be highly effective in 60.8% of the cases on long-term basis with maintenance doses. Other treatment modalities were employed in more refractory cases including add-on of gabapentin, which relieved the symptoms for an additional duration of 13±3months. The neurolytic alcohol bloc was given in 30% of patients who stopped responding to com - bination of carbamazepine and gabapentin and relieved pain for a mean duration of 17.25±2.95 months. Twenty three percent of the patients (23%) required peripheral neurectomy. Conclusions: Carbamazepine was found to be highly effective in trigeminal neuralgia. Other treatment modality includes add-on of gabapentin, neurolytic alcohol blocs and peripheral surgical intervention in more refractory cases. Only limited cases needed further neurological consideration.
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    Relationship between perception of malocclusion and the psychological impact of dental aesthetics in university students
    (2015) Bellot Arcís, Carlos; Montiel Company, José María; Pinho, Teresa; Almerich Silla, José Manuel
    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.
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    Diagnosis of simulated condylar bone defects using panoramic radiography, spiral tomography and cone-beam computed tomography: a comparison study
    (2015) Salemi, Fatemeh; Shokri, Abbas; Mortazavi, Hamed; Baharvand, Maryam
    Objectives: Radiographic examination is one of the most important parts of the clinical assessment routine for temporomandibular disorders. The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography(CBCT) with panoramic radiography and spiral computed tomography for the detection of the simulated mandibular condyle bone lesions. Study Design: The sample consisted of 10 TMJs from 5 dried human skulls. Simulated erosive and osteophytic lesions were created in 3 different sizes using round diamond bur and bone chips, respectively. Panoramic radiography, spiral tomography and cone-beam computed tomography were used in defect detection. Data were statistically analyzed with the Mann-Whitney test. The reliability and degrees of agreement between two observers were also determined by the mean of Cohen's Kappa analysis. Results: CBCT had a statistically significant superiority than other studied techniques in detection of both erosive and osteophytic lesions with different sizes. There were significant differences between tomography and panoramic in correct detection of both erosive and osteophytic lesions with 1mm and 1.5 mm in size. However, there were no significant differences between Tomography and Panoramic in correct detection of both erosive and osteophytic lesions with 0.5 mm in size. Conclusions: CBCT images provide a greater diagnostic accuracy than spiral tomography and panoramic radiography in the detection of condylar bone erosions and osteophytes.
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    Prevalence of xerostomia in patients attending Shorish dental speciality in Sulaimani city
    (2015) Abdullah, Mustafa Jamel
    Objectives: The aim of this study was to investigate the prevalence of xerostomia among dental patients and explo - re the possible risk factors and symptoms associated with this condition. Study Design: The prevalence of xerostomia and its associations were investigated among patients (n=1132) who were visiting the department of oral medicine at shorish dental speciality in sulaimani city. The age range was bet - ween 10-79 years. 512 (45.2%) of participants were males and 620 (54.8%) were females. The data collected were age, sex, systemic diseases, medications and habit of smoking. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association of xerostomia with age, systemic diseases and medications and Chi Square test was also used to analyze the data. Results: Prevalence of xerostomia was 16.07%. Prevalence of xerostomia was significantly higher among females (19.51%) than males (11.91%) ( P =0.001). The most common diseases with the highest prevalence of xerostomia were psychological disorders (57.14%) followed by diabetes mellitus (53.84%), neurological disorders (40%), thyroid disorders (37.5%) and hypertension (36.48%). The most common medication with the highest prevalen - ce of xerostomia was antihistamine (66.66%) followed by psychotherapeutic medications (60%), pain medica - tions (55.88%), endocrinologic agents (51.21%), antidyslipidic agents (50%) and antihypertensive medication (38.98%). Xerostomia was significantly associated with ageing (OR: 1.02, P =0.000), systemic diseases (OR: 2.80, P =0.000) and medications (OR: 5.17, P =0.000). There was a high prevalence of reported symptoms of xerostomia and these symptoms were more prevalent among females, prevalence of xerostomia was higher in heavy smoker patients (19.48%) than non smoker patients but not significantly (16.14%) ( p = 0.44). Conclusions: There was a high prevalence of xerostomia among dental patients; xerostomia was significantly more prevalent among females and significantly associated with age, systemic diseases and medications; xerostomia adversely affects oral functions; dentist must be familial with sign and symptoms of xerostomia and can have an active role in the management of xerostomia and preventing or treating complications.
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    Oral non-Hodgkin’s lymphoma in a patient with rheumatoid arthritis treated with etanercept and methotrexate
    (2015) Georgakopoulou, Eleni A.; Achtari, Marina D.; Evangelou, Kostas; Kittas, Christos
    Oral non-Hodgkin’s lymphomas (O-NHLs) are a rare group of diverse lymphoid tissue malignancies and represent less than 5% of the oral cavity malignancies and 2% of all extra-nodal NHLs. Oral-NHLs affect the Waldeyer’s- ring, the salivary glands, the bone of the jaws and the oral mucosa, their clinical appearance is very heterogeneous. Among the risk factors for NHLs are immunosuppression (primary or secondary), autoimmunity and inflammation. O-NHLs share the same risk factors. This case report describes a patient with O-NHL which was possibly linked to the combination of methotrexate and etanercept for the treatment of her rheumatoid arthritis. To our knowledge this is probably among the first cases of O-NHL with possible relation to the use of a Tumor Necrosis Factor (TNF) antagonist biological agent (etanercept). This case could contribute to the sensitization of the dentists for the signs and symptoms of this rare malignancy. It also underlines the need for thorough medical history and medication recording for all the dental patients.
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    Immediate placement of single implant simultaneously with immediate loading in a fresh socket associated to periapical infection: a clinical case report
    (2015) Agustín Panadero, Rubén; Serra Pastor, Blanca; Chust López, Cesar; Fons Font, Antonio; Ferreiroa Navarro, Alberto
    Early restoration of the masticatory function, phonatory and aesthetics is some of the current goals of the therapy based on endosseous implants. Facing the classic protocols of implant insertion, which recommend a period of several months between extraction and implant placement, alternatives have been developed that demonstrate that immediate implant placement after tooth extraction permits adequate osseointegration, even in those cases where there is a periapical disease. The immediate restoration of implants after placement is a possibility where aesthetic requirements are high. This article presents a case with immediate implant placement and immediate loading of a first upper premolar with prior periapical pathology due to a vertical fracture. The immediate prosthetic was performed using the extracted crown, which is adapted to be attached to a titanium temporary abutment using a resin cement. After a 4 month healing period work began on the final prosthetic crown. The screw crown was made of zirconium oxide with a covering feldspathic ceramic. At the 12-month follow-up, there were no mechanical or biological complications. The patient gave high satisfaction marks for the overall treatment, giving visual analogue scale score of nine. Immediate post-extraction implants have arisen as an alternative to traditional implants on completely healed bone. Their main aim is to reduce treatment time and number of surgical procedures, along with other objectives such as reduced bone re-absorption and improved aesthetics.
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    Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: a case report and 6-month follow-up
    (2015) Peñarrocha Oltra, David; Alonso González, Rocío; Pellicer Chover, Hilario; Aloy Prósper, Amparo; Peñarrocha Diago, María
    The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient.