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Language Journal of Clinical and Experimental Dentistry. 2017. Vol. 9, no. 2
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- Arthroscopic approach for treating a pigmented villonodular sinovitis of TMJ. A case report(2017) Román-Ramos, María; Cariati, Paolo; Cabello Serrano, Almudena; Garcia Martin, Miguel; García Medina, BlasThe present report describes the case of a 29-year-old man referred to our service for TMJ pain and progressive reduction of the mouth opening. Differential diagnostics included rheumatologic diseases, monoarthritis and intraarticular lumps. In this line, a face CT scan and a MRI of TMJ were carried out in order to ensure a proper diagnosis. These tests showed a solid lesion into the joint cavity. In view of that, we decided to perform a diagnostic and therapeutic arthroscopy of TMJ. Histopathological studies confirmed the diagnosis of pigmented villonodular synovitis. The main aim of this report is to describe this rare syndrome with the goal of proposing suitable treatments. Moreover, we highlight the benefits of using arthroscopic procedures in the cases which the tumor is still confined to the joint. As far as we are aware, scientific literature documents only a single case of pigmented villonodular synovitis of TMJ treated with arthroscopic approach.
- Osseous oral hyaline ring granuloma mimicking a mandible tumor in a child with congenital agenesis of the corpus callosum(2017) Neves-Silva, Rodrigo; Ferreira Gomes, Camilla Borges; Palmier, Natalia; Brum Corrêa, Marcelo; Almeida, Oslei Paes de; Lopes, Márcio Ajudarte; Vargas, Pablo Agustín; Santos Silva, Alan RogerHyaline ring granuloma (HRG) of the oral cavity is an uncommon disorder considered to be a foreign-body reaction resulting from implantation of food vegetable particles. Microscopically, it is characterized by the presence of structures of hyaline rings in an inflamed fibrous tissue background, which contains multinucleated giant cells. We present the case of a 4-year-old boy diagnosed with a mandible osseous HRG, which showed clinical and tomographic aspects suggestive of an aggressive bone tumor. The patient underwent surgical exploration and histopathologic analysis showed fragments composed predominantly of widespread dense connective tissue with an acute and chronic inflammatory infiltrate containing multinucleated giant cells and scattered areas of eosinophilic material associated with hyaline rings, strongly suggestive of vegetable particles. The eosinophilic material was positive for periodic acid-Schiff (PAS) and resistant to diastase digestion. These features led to diagnosis of osseous HRG. Scanning electron microscopy (SEM) analysis was performed for illustrative purposes and the multiple structures resembling vegetable particles were characterized in more detail. Although rare, this case highlights the importance of the clinician’s awareness regarding the existence of an osseous counterpart of HRG.
- Ewing sarcoma of the oral cavity. A review(2017) Margaix Muñoz, María; Bagán Sebastián, José Vicente; Poveda Roda, RafaelA review is made of the clinical, diagnostic, therapeutic and survival characteristics of Ewing sarcoma (ES) of the oral cavity. A systematic literature search was carried out, with restrictions referred to time (1960-2014), language (English and Spanish) and type of study (case reports, letters, datasets, reviews). The following MeSH terms and boolean operators were used: Ewing AND Sarcoma AND [tongue, jaw, maxilla, cheek, condyle OR temporomandibular, floor AND mouth, gum OR gingiva, palate OR palatal, lip, uvula, head AND neck]. Seventy-one cases of ES of the oral cavity were documented from 53 articles. The main differences versus ES of other locations were a younger age at manifestation, a shorter time from symptoms onset to diagnosis, and swelling as the most frequent clinical manifestation versus swelling and pain in the rest of disease locations. The way in which ES manifests in the oral cavity is varied and comprises dental displacement (19.7%), dental mobility (7%), root reabsorption (5.6%), destruction of the dental follicle (4.2%), premature exfoliation (4.2%) and paresthesia of the chin (2.8%). Metastatic neck adenopathies appear in 11.3% of the cases. Significant differences in survival are observed between patients with a complete diagnosis of ES (hematoxylin-eosin staining, PAS positivity, CD99 positivity) and those with an incomplete diagnosis. Ewing sarcoma of the oral cavity presents a series of specific features that distinguish it from ES of other locations.
- Non-healing tongue ulcer in a rheumatoid arthritis patient medicated with leflunomide. An adverse drug event?(2017) Kalogirou, Eleni Marina; Katsoulas, Nikolaos; Tosios, Konstantinos I.; Lazaris, Andreas C.; Sklavounou-Andrikopoulou, AlexandraLeflunomide is a member of the disease modifying anti-rheumatic drugs group used as a treatment modality in active rheumatoid and psoriatic arthritis. “Oral ulcers” are reported in 3-5% of leflunomide medicated rheumatoid arthritis patients with adverse events, but they are not described in detail in the literature. We present a case of an ulcer in the tongue of a rheumatoid arthritis patient managed with leflunomide and contemplate on its pathogenesis.
- Morphea “en coup de sabre”: an unusual oral presentation(2017) Niklander, Sven; Marín, Constanza; Martínez, René; Esguep, AlfredoMorphea, or localized scleroderma, is an inflammatory disease that leads to sclerosis of the skin and underlying tissues due to excessive collagen deposition. Oral involvement is unusual and it may produce white linear fibrotic areas with a scar-like appearance, atrophy of tongue papillae, gingival recession and alveolar bone resorption. We report a case of a 13-year-old girl who consulted for progressive recession on the attached gingiva of her upper left incisors. She also presented a hypopigmented line on the left side skin of her upper lip, which continued through the vermilion and the lip mucosa, including the gingiva of the affected teeth. Clinical examination, blood tests, computerized axial tomography, echo-Doppler ultrasound and histopathological evaluation confirmed the diagnosis of morphea. Treatment with methotrexate and systemic corticosteroids was conducted. After 24 months, no other lesions appeared. No adverse side effects have been reported so far.
- Managing patients taking edoxaban in dentistry(2017) Curto Aguilera, Adrián; Curto, Daniel; Sanchez, JorgeAnticoagulation therapy is used in several conditions to prevent or treat thromboembolism. A new group of oral anticoagulants with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. The Food and Drug Administration has approved edoxaban, dabigatran, rivaroxaban and apixaban. Their advantages include: predictable pharmacokinetics, drug interactions and limited food, rapid onset of action and short half-life. However, they lack a specific reversal agent. This paper examines the available evidence regarding rivaroxaban and sets out proposals for clinical guidance of dental practitioners treating these patients in primary dental care. A literature search was conducted through July 2016 for publications in PubMed and Cochrane Library using the keywords “edoxaban”, “dabigatran”, “rivaroxaban”, “apixaban”, “new oral anticoagulants”, “novel oral anticoagulants”, “bleeding” and “dental treatment” with the “and” boolean operator in the last 10 years. The number of patients taking edoxaban is increasing. There is no need for regular coagulation monitoring of patients on edoxaban therapy. For patients requiring minor oral surgery procedures, interruption of edoxaban is not generally necessary. Management of patients on anticoagulation therapy requires that dentists can accurately assess the patient prior to dental treatments. Their increased use means that oral care clinicians should have a sound understanding of the mechanism of action, pharmacology, reversal strategies and management of bleeding in patients taking edoxaban. There is a need for further clinical studies in order to establish more evidence-based guidelines for dental patients requiring edoxaban.
- Severe odontogenic infection: an emergency. Case report(2017) Guzmán Letelier, Marcelo; Crisosto Jara, Claudia; Diaz Ricouz, Camilo; Peñarrocha Diago, Miguel; Peñarrocha Oltra, DavidOdontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. However, some OI can spread to vital and deep structures, overcome the host immune system - especially in diabetic, immunocompromised or weakened patients - and even prove fatal. Ludwig’s angina is a severe form of diffuse cellulitis that can have an acute onset and spread very rapidly, bilaterally affecting areas of the head and neck, and may prove life threatening. A case of severe dental infection is presented in which emphasis is placed on the importance of airway maintenance, followed by surgical decompression under adequate antibiotic coverage.
- Surgical treatment vs. conservative treatment in intravenous bisphosphonate-related osteonecrosis of the jaws. Systematic review(2017) Comas Calonge, Aida; Figueiredo, Rui; Gay Escoda, CosmeTo determine the success rates of the surgical and non-surgical treatments in the management of bisphosphonate-related osteonecrosis of the jaws (BRONJ). A systematic review of the literature was made. A PubMed Medline database search was performed in order to include clinical studies published in English,between2004 and 2014 with the following key-words: “BRONJ AND treatment” and “NOT osteoporosis”. The following data was gathered: authors, title, year of publication, aim of study, level of evidence, sample size, treatment performed, treatment outcomes and follow-up. Studies including more than 20 patients with at least 6 months of follow-up, and that specify the different treatment approaches and their outcomes were included. Systematic reviews were excluded.All studies were classified according to the SORT criteria (Strength of Recommendation Taxonomy). The initial electronic search yielded 169 papers, and 13 studies were added after a manual search (total of 182 studies). After analysing the title and abstract and removing duplicates, 31 full-texts were obtained. A total of 12 papers were finally included. Two were classified as level 3 evidence and 9 as level 2. The quality of the selected studies and the risk of bias were also reported. Surgical treatments like sequestrectomy, surgical debridement and bone osteotomies provide successful treatment outcomes, with success rates ranging from 58 to 100%. Controlled randomized clinical trials with larger samples and longer follow-up are needed to support these findings.
- Dental management of patients taking novel oral anticoagulants (NOAs): dabigatran(2017) Curto Aguilera, Adrián; Albaladejo Martínez, Alberto; Alvarado Lorenzo, AlfonsoA new group of oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban) with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. Patients being treated with oral anticoagulants are at higher risk for bleeding when undergoing dental treatments. A literature search was conducted through April 2016 for publications in the ISI Web of Knowledge, PubMed and Cochrane Library using the keywords “dabigatran”, “rivaroxaban”, “apixaban”, “edoxaban”, “new oral anticoagulants”, “novel oral anticoagulants”, “bleeding” and “dental treatment”. There is no need for regular coagulation monitoring of patients on dabigatran therapy. Whether or not to temporarily discontinue dabigatran must be assessed according to the bleeding risk involved in the dental procedure to be performed. The number of patients under treatment with new oral anticoagulants will increase in the coming years. It is essential to know about the pharmacokinetics and pharmacodynamics of new oral anticoagulants and about their interactions with other drugs. It is necessary to develop clinical guidelines for the perioperative and postoperative management of these new oral anticoagulants in oral surgical procedures, and to carefully evaluate the bleeding risk of dental treatment, as well as the thrombotic risk of suppressing the new oral anticoagulant.
- The effect of different insertion techniques on the depth of cure and vickers surface micro-hardness of two bulk-fill resin composite materials(2017) Moharam, Lamiaa M.; El Hoshy, Ahmed Zohair; Abou Elenein, KarimThe aim of this study was to evaluate the Vickers surface micro-hardness and the depth of cure of two bulk-fill resin composites and one incremental-fill resin composite. Two Bulk-fill dental resin composites (X-tra Fil, Voco; Sonic-FillTM 2, Kerr Corporation) and an incremental-fill dental resin composite (Filtek™ Z250 XT, 3M ESPE) were used. Sixty cylindrical specimens of 4 mm thickness were prepared using split Teflon moulds. Specimens were divided into six groups (n=10) according to the type of the material used and according to the insertion technique applied (bulk or incremental). Prepared specimens were stored dry in complete darkness at 37°C for 24 hours. All specimens were tested for their Vickers surface micro-hardness, on their top and bottom surfaces. The depth of cure of the tested specimens was assessed by calculating the hardness ratio for each specimen. The Vickers surface micro-hardness and depth of cure data were analyzed for normality using Kolmogorov-Smirnov and Shapiro-Wilk tests. Independent sample-t test was used to compare between two groups while One-way ANOVA was used to compare between more than two groups. Significant difference in the Vickers surface micro-hardness and depth of cure values was demonstrated among the tested materials (P<0.0001). X-tra Fil recorded the highest mean Vickers micro-hardness value (94.05±1.05). Bulk-fill dental resin composites X-tra Fil and Sonic-Fill showed 0.980±0.005 and 0.921±0.020 depth of cure values (bottom/top hardness ratio) respectively while Z250 XT recorded 0.776±0.141. X-tra Fil showed highest Vickers surface micro-hardness values on both top and bottom surfaces, whether inserted in increments or bulk. Both bulk-fill resin composites showed higher depth of cure for both insertion techniques.
- Assessing the need for a protocol in monitoring weight loss and nutritional status in orthognathic surgery based on patients experiences(2017) Ruslin, Muhammad; Dekker, Hannah A.; Tuinzing, D. Bram; Forouzanfar, TymourTo investigate retrospectively the orthognathic surgery (OGS) patients experience in weight loss and the influence of gender, age, duration of the surgical procedure, length of hospital stay, location of surgery and use of intermaxillary fixation (IMF) or without IMF on postoperative weight loss. A total of 4487 patients treated by OGS where all patients visited the outpatient clinic one, three and six weeks after the surgical procedure. After six weeks, patients filled out a questionnaire in which weight loss was addressed. The patients were asked to give an estimate of their experiences weight loss. The population was first divided in two groups weight loss and no weight loss. In the weight loss group there is no significant difference in weight loss between patients with IMF and patients without IMF. In the weight loss group there were significantly more females then males. Further, in the subgroup IMF the operation time was significantly longer compared with the subgroup without IMF. The other parameters including age and hospital stay were not different in the groups. IMF in orthognathic treatment does not result in a difference self-reported loss of body weight compared to patients without IMF. Treatment protocols should include pre- and post-operative dietician consultations and possible indications for medical nutrition and vitamins.
- Differences between panoramic and Cone Beam-CT in the surgical evaluation of lower third molars(2017) Rodriguez Y. Baena, Ruggero; Beltrami, Riccardo; Tagliabo, Angelo; Rizzo, Silvana; Lupi, Saturnino MarcoThe aim of this study was to evaluate the ability to identify the contiguity between the root of the mandibular third molar and the mandibular canal (MC) in panoramic radiographs compared with Cone Beam-CT. Panoramic radiographs of 326 third molars and CBCT radiographs of 86 cases indicated for surgery and considered at risk were evaluated. The following signs were assessed in panoramic radiographs as risk factors: radiolucent band, loss of MC border, change in MC direction, MC narrowing, root narrowing, root deviation, bifid apex, superimposition, and contact between the root third molar and the MC. Radiographic signs associated with absence of MC cortical bone are: radiolucent band, loss of MC border, change in MC direction, and superimposition. The number of risk factors was significantly increased with an increasing depth of inclusion. CBCT revealed a significant association between the absence of MC cortical bone and a lingual or interradicular position of the MC. In cases in which panoramic radiographs do not exclude contiguity between the MC and tooth, careful assessment the signs and risks on CBCT radiographs is indicated for proper identification of the relationships between anatomic structures.
- Oral mucosal lesions in a Chilean elderly population: a retrospective study with a systematic review from thirteen countries(2017) Rivera, Cesar A.; Droguett, Daniel; Arenas Márquez, María JesúsThe oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services.
- Effect of two different tooth bleaching techniques on microhardness of giomer(2017) Kimyai, Soodabeh; Bahari, Mahmood; Naser Alavi, Fereshteh; Behboodi, SoodabehTooth bleaching is a safe and conservative treatment modality to improve the esthetic appearance of discolored teeth. One of the problems with the use of bleaching agents is their possible effect on surface microhardness of resin-based materials. The present study was carried out to evaluate the effect of in-office and at-home bleaching on surface microhardness of giomer. Seventy-five disk-shaped giomer samples (Beautifil II) were prepared and cured with a light-curing unit. The samples were randomly assigned to three groups (n=25). In group 1 (control), the samples were stored in distilled water for 14 days. The samples in groups 2 and 3 underwent a bleaching procedure with 15% carbamide peroxide (CP) (8 hours daily) and 45% CP (30 minutes daily), respectively, for 14 days. Finally, the microhardness of samples was measured with Vickers hardness tester using a 100-g force for 20 seconds. One-way ANOVA was used to compare the mean microhardness values among the study groups, followed by post hoc Tukey test for two-by-two comparison of the groups. Statistical significance was set at P<0.05. One-way ANOVA showed significant differences in the mean microhardness values among the study groups (P<0.001). Based on the results of Tukey test, microhardness in the bleached groups was significantly less than that in the control group (P<0.0005). In addition, microhardness in the 45% CP group was significantly less than that in the 15% CP group (P<0.0005). Use of both bleaching agents during in-office and at-home bleaching techniques resulted in a decrease in surface microhardness of giomer. The unfavorable effect of in-office bleaching (45% CP) was greater than that of at-home bleaching (15% CP).
- Repercussions of intraalveolar placement of combination of 0.2% chlorhexidine & 10 Mg metronidazole gel on the occurrence of dry sockets- A randomized control trial(2017) Kaur, Jasleen; Raval, Rushik; Bansal, Anupam; Kumawat, VinodTo evaluate the effects of intraalveolar placement of gel containing 0.2% chlorhexidine and 10gm of metronidazole on the incidence of alveolar osteitis. A total of 300 impacted third molars were extracted in 150 patients enrolled in this trial. In each subject a socket was randomly selected and packed to the crest of alveolar ridge with the gel. The contralateral socket was packed with placebo dressing. The occurrence of dry socket was assessed during 3rd and 5th postoperative days .The data was analysed using a meta analytical program. Double blind, prospective, placebo controlled trial. The combination of metronidazole + chlorhexidine gel significantly reduced dry socket incidence from 22.6% to 6.6% (P ≤ 0.001) [McNemar and chi-square tests]. The decrease in incidence of adverse reactions and complications related to local application of metronidazole and chlorhexidine gel explains its clinical use, specifically in mandibular molar extractions where the chances of dry sockets are high.
- Evaluation of conventional, protaper hand and protaper rotary instrumentation system for apical extrusion of debris, irrigants and bacteria- An in vitro randomized trial(2017) Kalra, Pinky; Rao, Arathi; Suman, Ethel; Shenoy, Ramya; Suprabha, Baranya ShrikrishnaEndodontic instrumentation carries the risk of over extrusion of debris and bacteria. The technique used and the type of instrumentation influences this risk. The purpose of this study was to evaluate and compare the K-file, ProTaper hand and ProTaper rotary instrumentation systems for the amount of apically extruded debris, irrigant solution and intracanal bacteria. Experimental single blinded randomized type of in vitro study with sample of 30 single rooted teeth. Endodontic access cavities were prepared and the root canals were filled with the suspension of E. faecalis. Myers and Montogomery Model was used to collect apically extruded debris and irrigant. Canals were prepared using K files, Hand protapers and Protaper rotary files. Non Parametric test like Kruskal-Wallis and Mann-Whitney U test were applied to determine the significant differences among the group. Tests revealed statistically significant difference between the amount of debris and number of bacteria extruded by the ProTaper hand and the K-files. No statistically significant difference was observed between the amounts of irrigant extruded by the ProTaper hand and the K-file system. Statistically significant differences were observed between the amounts of bacteria and irrigant extruded by the ProTaper rotary and the Protaper hand. No statistically significant difference was observed between the amounts of debris extruded by the ProTaper hand and the K-file system. Amount of apical extrusion of irrigant solution, bacteria and debris are significantly greater with K File instruments and least with Protaper rotary instruments.
- Evaluation of the effect of adding micro-hydroxyapatite and nano-hydroxyapatite on the microleakage of conventional and resin-modified Glass-ionomer Cl V restorations(2017) Sharafeddin, Farahnaz; Feizi, NegarPulpal reaction to restorative materials depends on marginal microleakage, which is a dynamic phenomenon that allows bacteria and fluids to traverse across the tooth-restoration interface. Glass-ionomer cement (GIC) exhibits low microleakage due to direct bonding to tooth structures. Hydroxyapatite (HAP) based on the similarity with tooth structure may decrease the microleakage. The aim of this in vitro study was to evaluate marginal microleakage of a mixture of conventional and resin-modified glass-ionomer (RMGI) with micro- and nano-HAP. In this in vitro study, 30 non-carious extracted human third molar teeth were used. Standard Cl V cavities were prepared on the buccal and lingual surfaces. The cavities were restored in six experimental groups as follows: group 1, conventional glass-ionomer cement (CGIC); group 2, CGIC with micro-HAP; group 3, CGIC with nano-HAP; group 4, RMGI; group 5, RMGI with micro-HAP; group 6, RMGI with nano-HAP. The restorations were finished and polished. The teeth were coated with nail polish, sealed with sticky wax, thermocycled and placed in a solution of 2% basic fuchsine for 24 hours. The teeth were sectioned and microleakage was measured. Kruskal-Wallis, Man-Whitney and Wilcoxon tests were used for data analysis (P<0.05). The data analysis revealed significantly lower microleakage in groups 5 and 6 at both occlusal and gingival margins. Also in these two groups the gingival microleakage was significantly lower than occlusal margin (P=0.009 and P=0.001 respectively), but in groups 1(CGIC) and 3(CGIC+ nano-HAP) and 4(RMGI) the microleakage of occlusal margin were significantly lower than that of gingival margin (P=0.001, P=0.007 and P=0.001 respectively). Mixing RMGI with nano-HAP and micro-HAP resulted in lower microleakage.
- Analytical parameters and vital signs in patients subjected to dental extraction(2017) Jané Pallí, Enric; Arranz-Obispo, Carlos; González Navarro, Beatriz; Murat, Jesús; Ayuso Montero, Raúl; Rojas, Santiago; Santamaría, Amparo; Jane Salas, Enric; López López, JoséDental consultation may provoke stress to the patient, especially when a dental surgery is going to be performed, stressful situations can cause a reaction in the sympathetic nervous system that could lead to cardiovascular alterations. Blood pressure and cardiac frequency are used often as an indirect measurement and this parameters combined can serve as good indicators of stress. Objective: Analyze the changes in vital signs and analytical parameters induced by a dental extraction. 24 healthy patients who required a simple dental extraction underwent to a blood test and motorization of their pre- and post-extraction vital signs before, at 2 and 48 hours after the procedure. Data analysis was performed by means of repeated measures one way ANOVA followed by multiple comparisons Bonferroni’s Post-hoc test. The evaluated patients were 13 women and 11 men with an average age of 35.1. Thirteen patients (54.17% of the sample) were smokers and five were regular drinkers (20.8%). No significant differences were observed in the vital signs with the exception of diastolic blood pressure and cardiac rate that were slightly lower after extraction. Only two analytical parameters showed statistical significant changes. Total bilirubin was significantly higher at 48 hours after extraction and leukocyte count was significantly lower at this time. In any case, the magnitude of the changes observed was very low. The analytical parameters and the vital signs did not show any relevant change. Eventual alterations found after simple tooth extraction should not be attributed to the procedure.
- A portable fiber-optic raman spectrometer concept for evaluation of mineral content within enamel tissue(2017) Akkus, Anna; Yang, Shan; Roperto, Renato; Mustafa, Hathem; Teich, Sorin; Akkus, OzanMeasurement of tooth enamel mineralization using a clinically viable method is essential since variation of mineralization may be used to monitor caries risk or in assessing the effectiveness of remineralization therapy. Fiber optic Raman systems are becoming more affordable and popular in context of biomedical applications. However, the applicability of fiber optic Raman systems for measurement of mineral content within enamel tissue has not been elucidated significantly in the prior literature. Human teeth with varying degrees of enamel mineralization were selected. In addition alligator, boar and buffalo teeth which have increasing amount of mineral content, respectively, were also included as another set of samples. Reference Raman measurements of mineralization were performed using a high-fidelity confocal Raman microscope. Analysis of human teeth by research grade Raman system indicated a 2-fold difference in the Raman intensities of v1 symmetric-stretch bands of mineral-related phosphate bonds and 7-fold increase in mineral related Raman intensities of animal teeth. However, fiber optic system failed to resolve the differences in the mineralization of human teeth. These results indicate that the sampling volume of fiber optic systems extends to the underlying dentin and that confocal aperture modification is essential to limit the sampling volume to within the enamel. Further research efforts will focus on putting together portable Raman systems integrated with confocal fiber probe.
- Evaluation of retention of pit and fissure sealants placed with and without air abrasion pretreatment in 6-8 year old children – An in vivo study(2017) Bhushan, Urvashi; Goswami, MridulaThe success of pit and fissure sealants is directly related to their retention. The purpose of this study was to assess and compare the retention of pit and fissure sealants placed using acid etch alone and a combination of air abrasion and acid etch techniques. 50 subjects aged 6-8 years were included in the study. Primary second molars and permanent first molars were sealed in all four quadrants using split mouth design. The right maxillary and mandibular molars (Group A) were treated by acid etching alone while the left maxillary and mandibular molars (Group B) were pretreated with air abrasion followed by acid etching before application of pit and fissure sealant. Retention of sealants was checked using Simonsen’s criteria of sealant retention after three and six months of sealant application. There was no significant difference in retention of sealants in Group A and Group B (p<0.05) after three and six months follow up. The difference in sealant retention in primary and permanent molars was not significant (p>0.05). Maxillary molars showed superior retention compared to mandibular molars, which was statistically significant at both three and six months (p<0.05). Combining air abrasion pretreatment with subsequent acid etching did not result in statistically significant difference in sealant retention compared to acid etching alone in both primary and permanent molars after 3 and 6 months follow up. An additional air abrasion pretreatment step can be avoided in pediatric patients when placing sealants and the procedure can be completed faster with better behavior management using acid etching alone.
