Journal of Clinical and Experimental Dentistry. 2013. Vol. 5, no. 2

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    Comparative split-mouth study of the anesthetic efficacy of 4% articaine versus 0.5% bupivacaine in impacted mandibular third molar extraction
    (2013) Pellicer Chover, Hilario; Cervera Ballester, Juan; Sanchís Bielsa, José María; Peñarrocha Diago, María; Peñarrocha Diago, Miguel; García Mira, Berta
    The purpose of this study was to compare the clinical efficacy of articaine at 4% (epinephrine 1:100,000) with bupivacaine at 0.5% (epinephrine 1:200,000) for surgical extraction of impacted mandibular third molars. Study Design: This was a randomized, double blind, split-mouth, clinical trial. Thirty-six patients took part and underwent extraction of 72 lower third molars. The variables studied were: anesthetic latency time, intra-operative bleeding, anesthetic quality, hemodynamic changes during the surgical intervention, anesthetic duration in the soft tissues, post-operative analgesia and post-operative pain at 2, 6, 12 and 24 hours using a visual analogue scale, as well as any need for additional rescue medication. Results: Latency time was 2.0 minutes for articaine and 3.1 minutes for bupivacaine, with statistically significant difference (p<0.05). Bleeding was greater when bupivacaine was used (p<0.05) and anesthetic quality was greater with articaine (p<0.05). The duration of soft tissue anesthesia was longer with bupivacaine (p<0.05). Differences in post-operative analgesia, haemodynamic changes, post-operative pain and the quantity of rescue medication consumed were not statistically significant (p>0.05). Conclusions: Articaine showed greater clinical efficacy than bupivacaine, reducing latency time, bleeding, anesthe - tic duration in the soft tissues and achieving higher anesthetic quality, requiring less reinforcement during surgery than bupivacaine.
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    Kohlschütter-Tönz Syndrome: report of an additional case
    (2013) González Arriaga, Wilfredo Alejandro; Carlos Bregni, Román; Contreras, Elisa; Almeida, Oslei Paes de; Lopes, Márcio Ajudarte
    Kohlschütter-Tönz Syndrome is a rare disorder clinically characterized by amelogenesis imperfecta, epilepsy and progressive mental deterioration. We present an additional case of this syndrome of a nine year-old boy who was referred by pigmented teeth. The mental deterioration was associated with speech delay, impulsive behavior, attention-deficit/hyperactivity disorder, and learning problems. The physical examination revealed a reduction of lower third, slightly palpebral fissures, low ear and hair implantation, coarse hair and hypertrichosis. The intraoral examination showed alteration in teeth pigmentation diagnosed as amelogenesis imperfecta. Although rare, the present case report illustrates a syndrome that has dental anomalies and systemic alterations. It is important to re - cognize this syndrome as early as possible and paediatric dentist may contribute to the diagnosis and consequently to better manage the patients.
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    Effectiveness of dental bleaching in depth after using different bleaching agents
    (2013) D'Arce, Maria Beatriz Freitas; Lima, Débora Alves Nunes Leite; Aguiar, Flávio Henrique Baggio; Bertoldo, Eduardo dos Santos; Bovi Ambrosano, Gláucia María; Lovadino, José Roberto
    Objectives: This study evaluated the effectiveness of low- and high-concentration bleaching agents on enamel and deep dentin. Study design: Stained bovine incisors fragments were randomized placed into 10 groups (n=5), according to the sample thicknesses (2.0 mm or 3.5 mm) and bleaching agent: 10% carbamide peroxide (CP) (4 h a day/21 days); 6% hydrogen peroxide (HP) with calcium (1:30 h a day/21 days); HP 20% with calcium (50 min a day/3 sessions with a 7-day interval); HP 35% (3 x 15 min a day/3 sessions with a 7-day interval); HP 35% with calcium (40 min a day/3 sessions with a 7-day interval). The samples were stored in artificial saliva during the experiment. The co - lor change was evaluated using a spectrophotometer at the initial analysis, after artificially staining with black tea and after each of the bleaching weeks, and data was expressed in CIE Lab System values. The L* coordinate data was submitted to analysis of variance and Tukey-Kramer test and the ?E values data was submitted for analysis of variance in a split-plot ANOVA and Tukey's test (?=0.05). Results: None of the bleaching agents tested differed from the reflectance values on the enamel surface. For deep dentin HP 20% and HP 35%, both with calcium, showed the lowest reflectance values, which differed from CP 10%. Conclusion: It is concluded that high concentration hydrogen peroxide with calcium was less effective in deep dentin than 10% carbamide peroxide.
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    Effects of simultaneous nicotine and alcohol use in periodontitis progression in rats: a histomorphometric study
    (2013) Pereira Vasconcelos, Daniel Fernando; Dias da Silva, Marco Antonio; Rocha Marques, Marcelo; Gibilini, Cristina; Cardoso Guimarães Vasconcelos, Any Carolina; Pereira Barros, Silvana
    The aim of this study was to evaluate the effects of alcohol and nicotine, when used alone or simulta - neously, on the alveolar bone loss area resulting from ligature-induced periodontitis in rats. Study design: Forty adult male rats received a cotton ligature in the first lower molar sulcular area, and the animals were randomly assigned to different treatments (n = 10, each group) including daily peritoneal injections of saline solution (group A), submitted to self-administration of alcohol 25% (group B), nicotine solution in concentration 0.19 ?l/ml (group C), and nicotine solution in concentration 0.19 ?l/ml plus self-administration of alcohol 25% (group D). Five weeks later, the animals were sacrificed, and the samples were routinely processed for semi-serial decalcified sections. Results: Ligated teeth showed more alveolar bone loss than unligated ones (p < 0.05). Unligated teeth showed no significant differences between each other (p > 0.05). Analyses between the ligated teeth showed that the group C (nicotine) or group B (alcohol 25%) each had increasing alveolar bone loss in the furcation area, and the simulta - neous combination alcohol and nicotine (group D) intensified these ef fects (p < 0.05). Conclusion: The results suggest that the simultaneous combination of alcohol and nicotine have a synergistic effect in the progression of periodontitis, evidenced by increased furcation region bone destruction in periodontal disease in rats.
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    Prevalence of recurrent aphthous ulceration experience in patients attending Piramird dental speciality in Sulaimani City
    (2013) Abdullah, Mustafa Jamel
    The aim of this study is to report the prevalence and risk factors of recurrent aphthous ulceration (RAU) in patients attending Piramird dental speciality for seeking dental treatment. Study design: A cross-sectional survey was carried out among patients (n=1100) who were visiting the department of oral medicine at Piramird dental speciality center in Sulaimani from December 2011-February 2012. The age range of the patients were between 10-79 years, with mean age of (34.27±14.14). 446 (44.6%) of participants were males and 554 (55.4%) were females, with male/female ratios of 0.80:1. All individuals had to answer specific questions including personal data (age, sex), level of education, occupation and smoking habit; etc. Additional questions were related to the risk factors that might be related to the condition. Chi Square test was used to analyze the data. Result: The life time prevalence of RAU experience was 28.2% (n=282). It was highly significantly more common among females (31.76%) (p<0.004). The most commonly affected age group was 20-29 years (36.28%). The hig - hest prevalence of RAU experience was seen among mere students (36.8%); Among non smokers there were highly significantly more patients with RAU experience (30%) than in heavy smoker patients (12.22%), (p=0.000). 34.4% of patients had family history of RAU. Lips and buccal mucosae were the commonest sites of ulcerations (73.10%), and the major risk factor was stress (43.3%). Conclusion: This study has provided information about the epidemiologic aspects of recurrent aphthous ulceration, Based on the finding of this study, RAU is a common, recurrent painful oral ulceration. This study point to the importance of a thorough history taking to identify the patient's main risk factors to get preventive measures, there - fore treatment will be tailored for each patient accordingly. And the author concluded that stress was the major risk factor, thus, stress-management interventions suggested to be beneficial in reducing RAU recurrence episodes.
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    The Efficacy of an Experimental Single Solution versus Alternate Use of Multiple Irrigants on Root Dentin Microhardness
    (2013) Akcay, Ilgin; Erdilek, Necdet; Sen, Bilge Hakan Sen
    Objectives: This study was carried-out to evaluate and compare the efficacy of various irrigants when used singly or in combination on the microhardness of root canal dentin. Study Design: A total of 50 root-halves were randomly divided into 5 groups immediately after the initial baseline microhardness measurements and treated with: Group-1; 7.5%Ethylenediaminetetraaceticacid (EDTA) + 2.5%sodium hypochlorite (NaOCl), Group-2; 7.5%ethyleneglycol-bis[b-aminoethylether]-N,N,N0,N0-tetraaceticacid (EGTA) + 2.5%NaOCl, Group-3; 7.5%trans1,2diaminocyclohexane NNN',N'tetraaceticacid (CDTA) + 2.5% NaOCl, Group-4; 7.5%EDTA + 2.5% Ethylenediamine (EDA), and Group-5; 1/1 (v/v) EDTA-EDA mixture + 1/1 (v/v) EDTA-EDA mixture. Fifty mL of each solution was used for 1 minute. The reference and post-treatment microhardness values were measured with a Vickers indenter under 80- gram load, 15-second dwell time. Data were analyzed by two-way ANOVA and Bonferroni tests (p=0.05). Results: All solutions decreased microhardness of dentin (p< 0.05). There was statistically significant difference between each group, except Group-1 and 4, after 1st solution application. While Group-2 resulted in a greater re - duction of dentin hardness, Group-5 caused the least change in microhardness values, after 1st solution application (p< 0.05). No statistical difference was observed between Groups 1-4, after 2nd solution application. However, Group-5 showed a significant difference compared with all other groups, after 2nd solution application (p< 0.05). Conclusions: Under the experimental conditions, all tested solutions reduced the microhardness of the root canal dentin. EGTA was the most efficient chelating agent. EDTA-EDA single mixture has led to least change on the microhardness of root dentin
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    Platform switching on wide-diameter external hex implants a finite element analysis
    (2013) Sivolella, Stefano; Guazzo, Riccardo; Bressan, Eriberto; Berengo, Mario; Stellini, Edoardo
    Objectives: The objective of this work was to use finite element analysis to compare the effect of forces coming to bear on abutments 4.1 or 5.0 mm in diameter connected to a 5.0 mm implant (i.e. with or without platform swit - ching). Study design: A 3D CAD model of a 5 x 11.5 mm external hex implant was developed, complete with a connection screw and either of two abutments, one 4.1 and the other 5 mm in diameter, to assess the influence of two loading conditions, i.e. 200 N loaded either axially or off center on the top of the abutment. Results and conclusions: In the symmetrically loaded models, greater stresses were transmitted to the bone in the area below the neck of the implant in the case of the wider-diameter abutment. When the narrower abutment was considered, the stress lines remained confined to the metal and were transferred to the bone in a more distal position. When the stresses in the bone where compared under non-symmetrical loading of the larger- and smaller-diameter abutments, the stresses reached lower values in the latter case. These findings indicate that platform switching (i.e. coupling a 4.1 mm abutment with a 5 mm implant) achieves a better, more even distribution of the peri-implant stresses deriving from simulated occlusal loads on the bone margins.
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    Factors influencing caries status and treatment needs among pregnant women attending a maternity hospital in Udaipur city, India
    (2013) Kumar, Santhosh; Tadakamadla, Jyothi; Tibdewal, Harish; Duraiswamy, Prabu; Kulkarni, Suhas
    To estimate the prevalence and severity of dental caries along with the treatment needs; to determine the factors that influence dental caries status among pregnant women attending a district maternity hospital in Udaipur, India. Study design: Study sample comprised of 206 pregnant women attending a district maternity hospital in Udaipur, India. Clinical data were collected on dental caries by DMFT and treatment needs as described in World Health Organization Dentition status and Treatment needs. Results: The overall caries prevalence was 87%. Mean caries experience differed significantly among women in various trimesters, it was found to be 3.59 and 3.00 in 1st and 2nd trimester subjects respectively while it was greatest (4.13) among those in 3rd trimester. One surface filling was the most predominant treatment need. Age and occupation of husband explained a variance of 6.8% and 4.2% for decayed and filled components respectively while the only predictor for missing teeth and DMFT that explained a variance of 9.6% and 5.7% respectively was trimester of pregnancy. Conclusions: Dental caries experience and the need for one surface restoration increased with age. Trimester of pregnancy was a significant predictor for missing teeth and DMFT, while decayed teeth and filled teeth were in - fluenced by age and socio-economic level respectively
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    Inverted ductal papilloma of the oral cavity secondary to lower lip trauma: a case report and literature review
    (2013) Sala Pérez, Sergi; España Tost, Antonio Jesús; Vidal Bel, A.; Gay Escoda, Cosme
    Inverted ductal papilloma of the oral cavity is an infrequent benign neoplasm of papillary appearance that originates in the secretory duct of a salivary gland. The etiology is unknown, though some authors have related it to human papillomavirus (HPV) infection. We present the case of a 40-year-old woman with a tumor of the lower lip mucosa. Histopathological study of the lesion diagnosed inverted ductal papilloma of the oral cavity. Human papillomavi - rus DNA detection and typing based on tumor lesion DNA amplification and posterior hybridization, revealed no presence of viral DNA. The antecedents of trauma reported by the patient could have played an important role in the development of this tumor.