Journal of Clinical and Experimental Dentistry. 2015. Vol. 7, no. 3

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    Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid
    (2015) Marín Fernández, A.B.; García Medina, Blas; Aguilar Salvatierra, Antonio; Jiménez Burkhardt, Alberto; Gómez Moreno, Gerardo
    Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy
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    Oral manifestations of HIV/AIDS in Asia: systematic review and future research guidelines
    (2015) Sharma, Gaurav; Oberoi, Sukhvinder Singh; Vohra, Puneeta; Nagpal, Archna
    Objectives: The authors have conducted a systematic review of oral manifestations of HIV from studies conducted in Asia to establish the characteristics and prevalence of individual oral manifestations in Asia, and to assess the direction of future research studies on oral manifestations of HIV in Asia. Material and Methods: The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE], EBSCO, and EMBASE. The search was for limited articles published in English or with an English abstract and articles published during the period January 1995 to August 2014. The authors reached a final overall sample of 39 studies that were conducted in Asia. Results: The median population size among all studies was 312.7 patients. Oral candidiasis [OC] was the most common oral manifestation [37.7%] in studies conducted in Asia. The overall prevalence of oral hairy leukoplakia and melanotic hyperpigmentation was computed to be 10.1% and 22.8% respectively. Thailand and India are primarily countries with maximum research on oral manifestations. Conclusions: The research on oral manifestations of HIV in Asia has to upgrade to more interventional and therapeutic studies rather than the contemporary cross- sectional epidemiological descriptive studies. The authors have given suggestions and future directions for the implementation of clinical research of oral manifestations in HIV patients.
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    Adiponectin, leptin and TNF-α serum levels in obese and normal weight Peruvian adults with and without chronic periodontitis
    (2015) Mendoza, Gerardo; Castro, Carmen; Peña, Lizet; Guerrero, Maria Eugenia; Rosa, Manuel de la; Mendes Panutti, Cláudio; Chambrone, Leandro
    Background: TNF-α, an adipokine involved in systemic inflammation and a member of a group of cytokines that stimulate the acute phase reaction, has been related to the pathogenesis of both periodontitis and obesity. The objective of this study was to assess the serum levels of adiponectin, leptin and TNF-α of periodontally healthy normal weight (NW) patients, NW patients with chronic periodontitis (CP), periodontally healthy obese patients and obese patients with CP. Material and Methods: Ninety-three patients were enrolled in this cross-sectional study: 30 periodontally healthy NW patients; 18 NW patients with CP; 21 periodontally healthy obese patients; and 24 obese patients with CP. Analyses included clinical and anthropometric outcomes, as well as the assessment of serum levels of adiponectin, leptin and TNF-α by enzyme linked immunosorbent assay (ELISA) or fully automated chemiluminescence immunoassay. One-Way ANOVA, Kruskal-Wallis One-Way on Ranks, Dunn’s Test and multivariable logistic regression (MLR) analyses were conducted to estimate the degree of association between periodontitis and obesity. Results: Obese patients with CP showed significant more bleeding sites than the other three groups ( p <0.05). Moreover, patients from the NWCP and OPH showed similar BOP percentages, as well as OPH group showed more bleeding sites than the NWPH group ( p <0.05). The OPH group showed similar levels of adiponectin and leptin than the OCP group, but significantly higher than the NWPH and NWCP groups( p <0.05). MLR analyses showed that obesity was positively associated with the percentage of sites with bleeding on probing, with an odds ratio of 0.93 (95% confidence interval: -0.88, - 0.98; p =0.012). Conclusions: The serum levels of adiponectin, leptin and TNF-α were not influenced by CP. Obese patients showed almost 10% more sites with BoP. In chronic periodontitis patients, obese subjects presented significant more BOP sites than normal weight subjects
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    Oral hygiene practices and dental caries prevalence among 12 & 15 years school children in Ambala, Haryana -A cross-sectional study
    (2015) Goel, Richa; Vedi, Archita; Veeresha, Koratagere Lingappa; Sogi, Girish Malleshappa; Gambhir, Ramandeep Singh
    Background: Dental caries and gum disease are a major public health problem predominantly affecting children worldwide. Therefore the present study was conducted to assess oral hygiene practices, prevalence of dental caries and periodontal diseases among 12 and 15 years old high school children in public and government schools of Ambala district, Haryana and to provide data for planning and evaluation of oral health care promotion programs. Material and Methods: A cross-sectional descriptive survey of 12 and 15 years old children in government and private schools was conducted in Ambala, Haryana. A sample of 992 school children was selected by a two-stage cluster sampling method. Dental caries and periodontal health was examined using WHO standard criteria. The student’s t-test and one way ANOVA were used for statistical analysis. Results: The prevalence of dental caries was 34.3% and 46.5% at 12 and 15 years respectively. Mean DMFT in 12 years was 0.82 and in 15 years it was 1.26. More than 90% of subjects in both the age groups were using tooth brush to clean their teeth. Toothpaste was used by 96.7% (228) of subjects belonging to 12 year age group and 93% (703) of subjects who were of 15 years of age. Gingival bleeding was found in majority of subjects. Conclusions: The overall prevalence of dental caries was low but the prevalence of gingivitis was quite high. The observations indicate the need for a school oral health promotion programme to sustain the healthy practices in this growing population
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    Dentist attitudes and responsibilities concerning child sexual abuse: a review and a case report
    (2015) Garrocho Rangel, Arturo; Márquez Preciado, Raúl; Olguín Vivar, Ana Isabel; Ruiz Rodríguez, Socorro; Pozos Guillén, Amaury de Jesús
    According to the World Health Organization, child abuse and neglect is “every kind of physical, sexual, emotional abuse, neglect or negligent treatment, commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”. The aim of the present report is to inform about the most relevant aspects of child abuse and the characteristics of injuries to the head, neck, and orofacial regions, in addition to the suggested role of, and management by, the dentist for the evaluation of this condition, and also for reporting a case of a physically and sexually abused girl aged 5 years 8 months. Throughout the appointments, some type of abuse in this patient was suspected by the treating dentists at the clinic, mainly due to the initial behavior exhibited by the patient in the dental chair. Based on the clinical diagnostic an intensive preventive plan and restorative treatment was realized. The timely detection of the signs and symptoms of sexual abuse, often present in the orofacial region, place the pediatric dentist in a strategic situation, with the capacity to recognize, register, and later report those cases considered as suspect, including the dental treatment delivered and the intensive behavioral-psychological management, in order to achieve acceptation by the otherwise very anxious patient of the indicated restorative and preventive dental procedures
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    Bilateral inverted and impacted maxillary third molars: a case report
    (2015) Abu-Mostafa, Nedal; Barakat, Ali; Al Turkmani, Tareq; Al Yousef, Abdulaziz
    Bilateral inverted third molar impaction is an extremely rare condition. We reported the case of a 50-year-old female patient with bilateral inverted and impacted maxillary third molars. Both were asymptomatic and pathology free clinically and radiographically. Surgical extraction of these inverted third molars with inaccessible positions requires an aggressive bone removal on the tuberosity bilaterally. Moreover, it contains a high risk of displacement of the inverted third molar into the maxillary sinus. Conservative management was the choice, with the patient’s agreement, and the inverted third molars were left in situ
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    Coronal joint spaces of the Temporomandibular joint: systematic review and meta-analysis
    (2015) Martins, Eugénio; Silva, Joana Cristina; Pires, Carlos A.; Ponces Ramalhão, Maria João Feio; Lopes, Jorge Dias
    Introduction: The joint space measurements of the temporomandibular joint have been used to determine the condyle position variation. Therefore, the aim of this study is to perform a systematic review and meta-analysis on the coronal joint spaces measurements of the temporomandibular joint. Materials and Methods: An electronic database search was performed with the terms “condylar position”; “joint space”AND”TMJ”. Inclusionary criteria included: tomographic 3D imaging of the TMJ, presentation of at least two joint space measurements on the coronal plane. Exclusionary criteria were: mandibular fractures, animal studies, surgery, presence of genetic or chronic diseases, case reports, opinion or debate articles or unpublished material. The risk of bias of each study was judged as high, moderate or low according to the “Cochrane risk of bias tool”. The values used in the meta-analysis were the medial, superior and lateral joint space measurements and their differences between the right and left joint. Results: From the initial search 2706 articles were retrieved. After excluding the duplicates and all the studies that did not match the eligibility criteria 4 articles classified for final review. All the retrieved articles were judged as low level of evidence. All of the reviewed studies were included in the meta-analysis concluding that the mean coronal joint space values were: medial joint space 2.94 mm, superior 2.55 mm and lateral 2.16 mm. Conclusions: the analysis also showed high levels of heterogeneity. Right and left comparison did not show statistically significant differences.
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    Evaluation of ergonomic factors and postures that cause muscle pains in dentistry students’ bodies
    (2015) Shirzaei, Masoumeh; Mirzaei, Ramazan; Khaje Alizade, Ali; Mohammadi, Mahdi
    Background: Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being.This study was conducted to evaluate ergonomic factors and profession-related postures and also investigate relationship between demographic factors and work condition with pain in dental students. Material and Methods: 60 freshman and sophomore dentistry students were randomly chosen as the subjects of control group, and 60 of 5th and 6th-year students were selected as the members of exposure group. Data related to the subjects such as sex, doing exercise, severity of musculoskeletal pain were obtained through questionnaire. Students’ postures were directly observed while treating patients and they were scored by REBA method. Data were analyzed by SPSS software using Man-Whitney, Kruskal-Wallis, Spearman and Kendall correlation tests. Results: 80.8% of the subjects were not aware of the correct ergonomic postures for dental procedures. Severity of musculoskeletal pain in the exposure group (15.9± 4.2) was significantly higher than the control group (10.5 ±3.2), ( p <0.001). Risk of the most subjects (84%) was at the medium level. Students who were more involved in clinical activities experienced more muscular pains. Conclusions: The musculoskeletal disorders are probable prolonged in working hours in static positions, incorrect work postures, implying more force and even tools and instruments. Therefore, students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong
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    Incidence of mandibular fractures in black sea region of Turkey
    (2015) Bereket, Cihan; Sener, Ýsmail; Şenel, Erman; Özkan, Nilüfer; Yilmaz, Nergiz
    Background: The aim of this study is to review the incidence of mandibular fractures in the Black Sea Region of Turkey and to present our treatment protocol. Material and Methods: Data were collected regarding age, sex, etiology, time distribution, site of the fracture and the associated injuries and evaluated. These patients were treated at Ondokuz Mayıs University Department of Oral and Maxillofacial Surgery between 2003 and 2010. Data were collected from patient files in the archive and were analyzed using SPSS version 20.0 software. Results: A total of 82 patients with 133 mandibular fractures were included in this study. After the follow up period of the patients, the results were achieved from 58 (70.7%) males and 24 (29.3%) females, whose ages ranged from 5 to 72 years and the mean age was 29. Fractures were most seen in 2008 and the busiest month was August. Falls (40.2%) were the major causes of mandibular fractures followed by traffic accidents and violence. The mandibular anatomical sites of higher fracture incidence were: condyle (34.6%), body and symphysis. The number of the fractures and injuries which were seen in other places such as zygomatic arch, alveolar process, tongue, upper and lower lips, orbita, arms was 14. 53 (64.6%) patients were treated by closed reduction, whereas 13 (15.8%) patients were treated by open reduction. Conclusions: We concluded that our results were widely similar with the studies in developing countries. Socio- economic factors, cultures, geographic conditions and education could affect the etiology of the mandibular fractures and cause different results between the studies conducted in different countries.
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    Salivary apoptotic cells in oral (pre-) cancer as a potential diagnostic means
    (2015) Kaur, Jasdeep; Politis, Constantinus; Jacobs, Reinhilde
    Background: Apoptosis is a genetically programmed form of cell death which is indispensable for development and homeostasis of multi-cellular organism. Objectives: The aim of this study was to find out the salivary apoptotic cells in oral precancerous and cancerous patients and furthermore to observe the potential diagnostic value of salivary apoptotic cells in detection of oral pre-cancer and cancer. Materials and Methods: Unsimulated saliva was collected from a group of 103 subjects diagnosed with oral (pre-) cancer and a control group of 30 healthy age- and gender-matched individuals. The test group diagnosed with (pre-) cancer was further subdivided in 4 lesion groups oral squamous cell carcinoma (OSCC), oral lichen planus lesions (n=26), oral leukoplakia (n=25), oral sub-mucous fibrosis (n=24) Apoptotic cells were morphologically studied using fluorescence microscopy (TUNEL technique). Results: While the morphology of apoptotic cells in oral pre-cancer and cancer are morphological similar to the typical epithelial cells of oral cavity mucosa, the number of apoptotic cells was significantly less in OSCC as compared to precancerous and normal healthy tissues. Conclusions: It could therefore be concluded that salivary apoptotic epithelial cells might be used in early detection and diagnosis of oral pre-cancer and cancer
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    Microhardness of demineralized enamel following home bleaching and laser-assisted in office bleaching
    (2015) Ghanbarzadeh, Majid; Ahrari, Farzaneh; Akbari, Majid; Hamzei, Haniye
    Background: There is little data regarding the effect of tooth whitening on microhardness of white spot lesions. This study was conducted to investigate the effect of home-bleaching and laser-assisted in-office bleaching on microhardness of demineralized enamel. Material and Methods: Forty bovine incisors were selected and immersed in a demineralizing solution for 12 weeks to induce white spot lesions. Enamel blocks were prepared and randomly assigned to two groups of 20 each. The first group underwent home bleaching with 15% carbamide peroxide which was applied for 8 hours a day over a period of 15 days. In the second group, in-office bleaching was performed by 40% hydrogen peroxide and powered by irradiation from an 810 nm gallium-aluminum-arsenide (GaAlAs) diode laser (CW, 2W). This process was performed for 3 sessions every seven days, in 15 days. The specimens were stored in Fusayama Meyer artificial saliva during the experiment. Surface microhardness was assessed before and after the bleaching therapies in both groups. Results: Microhardness decreased significantly following both home bleaching and laser-assisted in-office bleaching ( p <0.05). There were no significant differences in hardness values among the two groups either before ( p =0.131) or after ( p =0.182) the bleaching procedures. Conclusions: Tooth whitening through home bleaching or laser-assisted in-office bleaching can result in a significant reduction in microhardness of white spot lesions. Therefore, it is suggested to take protective measures on bleached demineralized enamel.
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    In vivo study of different methods for diagnosing pit and fissure caries
    (2015) Melo Almiñana, María Pilar; Pascual Moscardó, Agustín; Camps Alemany, Isabel; Campo Rodríguez, Ángel del
    Background: In recent years the early detection of such caries has gained importance, since it may avoid unnecessary dental tissue damage and allow minimally invasive dental treatment. A study is made of 5 systems for diagnosing caries: traditional visual and tactile methods, DIAGNOdent, VistaProof and CarieScan. Material and Methods: A prospective study was made in the Department of Stomatology, Dental Pathology and Therapeutics Teaching unit of the University of Valencia (Valencia, Spain), involving the analysis of 32 teeth (molars or premolars of both arches scheduled for filling or for use as posts in dental bridges) in 28 patients. The following caries diagnostic methods were applied: visual, tactile, DIAGNOdent (KAvo, Biberach, Germany), VistaProof (Dürr Dental AG, Bietigheim-Bissingen, Germany) and CarieScan (IDMoS Dental Systems, Dundee, Scotland, United Kingdom). Fissurotomy was subsequently performed for histological validation. Results: Visual inspection showed an area under the receiver operating characteristic curve (AUC-ROC) of 0.75, with a sensitivity and specificity of 0.75. Tactile diagnosis in turn showed AUC = 0.714, with maximum sensitivity (100%) and a specificity of 42.9%. DIAGNOdent (cutoff point 22.5) and VistaProof (cutoff point 1.1) showed AUC = 0.969, while CarieScan (cutoff point 21.5) presented AUC = 0.973. These latter three methods all had a sensitivity of over 92%. The specificity of DIAGNOdent was maximum, while that of CarieScan and VistaProof was 75%. Conclusions: The emergent methods in the diagnosis of caries (DIAGNOdent, VistaProof and CarieScan) yielded similar results, and in all cases proved superior to the traditional visual and tactile methods. DIAGNOdent was seen to be the most effective technique, followed by CarieScan and VistaProof.
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    Shear bond strength of partial coverage restorations to dentin
    (2015) Román Rodríguez, Juan Luis; Agustín Panadero, Rubén; Alonso Pérez Barquero, Jorge; Fons Font, Antonio; Solá Ruiz, María Fernanda
    Background: When partial coverage restorations (veneers, inlays, onlays...) must be cemented to dentin, bond strength may not reach the same predictable values as to enamel. The purpose of this study was: 1. To compare, with a shear bond test, the bond strength to dentin of a total-etch and a self-etching bonding agent. 2. To determine whether creating microretention improves the bond strength to dentin. Materials and methods: Two bonding agents were assayed, Optibond FL® (Kerr), two-bottle adhesive requiring acid etching, and Clearfil SE Bond® (Kuraray), two-bottle self-etching adhesive. The vestibular, lingual, distal and mesial surfaces of ten molars (n=10) were ground to remove all enamel and 40 ceramic samples were cemented with Variolink II® (Ivoclar Vivadent). Half the molar surfaces were treated to create round microretention (pits) to determine whether these could influence bond strength to dentin. The 40 molar surfaces were divided into four groups (n=10): Optibond FL (O); Clearfil SE (C); Optibond FL + microretention (OM); Clearfil SE + micro retention (CM). A shear bond test was performed and the bond failures provoked examined under an optical microscope. Results: O=35.27±8.02 MPa; C=36.23±11.23 MPa; OM=28.61±6.27 MPa; CM=27.01±7.57 MPa. No statistically significant differences were found between the adhesives. Optibond FL showed less statistical dispersion than Clearfil SE. The presence of microretentions reduced bond strength values regardless of the adhesive used. Conclusions: 1. Clearfil SE self-etching adhesive and Optibond FL acid-etch showed adequate bond strengths and can be recommended for bonding ceramic restorations to dentin. 2. The creation of round microretention pits compromises these adhesives’ bond strength to dentin.
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    Apical root canal transportation of different pathfinding systems and their effects on shaping ability of ProTaper Next
    (2015) Turker, Sevinc Aktemur; Uzunoglu, Emel
    Background: This study aimed to compare glide path preparation of different pathfinding systems and their effects on the apical transportation of ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) in mesial root canals of extracted human mandibular molars, using digital subtraction radiography. Materials and Methods: The mesial canals of 40 mandibular first molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 4 groups with 10 canals each. Glide paths were created in group 1 with #10, #15 and #20 K-type (Dentsply Maillefer, Ballaigues, Switzerland) stainless steel manual files; in group 2 with Path-File (Dentsply Maillefer) #1, #2, and #3 and in group 3 with #16 ProGlider (Dentsply Maillefer) rotary instruments; in group 4 no glide paths were created. All canals were instrumented up to ProTaper Next X2 to the working length. A double digital radiograph technique was used, pre and post-instrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. Instrument failures were also recorded. The data were analyzed statistically using ANOVA and Tukey tests ( p <0.05). Results: No significant differences were found among groups regarding apical transportation ( p >0.05). Two ProTaper Next instruments failed in-group 4. Conclusions: Within the parameters of this study, there was no difference between the performance of path-finding files and ProTaper Next system maintained root canal curvature well and was safe to use either with path-finding files or alone.
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    Student evaluation of clickers in a dental pathology course
    (2015) Llena Puy, María Carmen; Forner Navarro, Leopoldo; Cueva Goig, Roger
    Background: The purpose of this study was to evaluate the degree of satisfaction of students and teachers, and to determine whether the students notice improvements in learning and in the learning environment as a result of the use of clicker. Material and Methods: Descriptive study. Fifty-one students and 8 teachers participated in the use of clicker technology in 8 preclinical seminars in dental pathology. Students and teachers filled a three-domain questionnaire at the end of the preclinical course. We used the Mann-Whitney U-test to compare the results between the two groups. Results: The domain “perception and expectation” showed the use of clickers to be simple and convenient for 80% of the students, who expressed interest in extending the practice to other teaching areas. In the domain “active learning”, over 70% of the students found the technique to be dynamic, participative and motivating. In the domain “improved learning”, over 70% considered it useful to know their level of knowledge before the seminar and found the contents of the lesson to be clear. Thirty percent considered the items of the examination to be of a complexity similar to that of the first and second tests. Only in this latter aspect were significant differences found between the teachers and students ( p =0.001). Conclusions: Participants described the use of clickers as simple and useful, motivating and participative. Both the students and teachers considered the technique to improve teaching and the learning environment
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    Dental implants with versus without peri-implant bone defects treated with guided bone regeneration
    (2015) Aloy Prósper, Amparo; Peñarrocha Oltra, David; Peñarrocha Diago, María; Peñarrocha Diago, Miguel
    Background: The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects. Material and Methods: Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bone regeneration (test group), versus the other entirely surrounded by bone (control group) were treated and monitored annually for three years. Complications with the healing procedure, implant survival, implant success and peri-implant marginal bone loss were assessed. Statistical analysis was performed with non-parametric tests setting an alpha value of 0.05. Results: Seventy-two patients and 326 implants were included (142 test, 184 control). One hundred and twenty-five dehiscences (average height 1.92±1.11) and 18 fenestrations (average height 3.34±2.16) were treated. At 3 years post-loading, implant survival rates were 95.7% (test) and 97.3% (control) and implant success rates were 93.6% and 96.2%, respectively. Mean marginal bone loss was 0.54 (SD 0.26 mm) for the test group and 0.43 (SD 0.22 mm) for the control group. No statistically significant differences between both groups were found. Conclusions: Within the limits of this study, implants with peri-implant defects treated with guided bone regeneration exhibited similar survival and success rates and peri-implant marginal bone loss to implants without those defects. Large-scale randomized controlled studies with longer follow-ups involving the assessment of esthetic parameters and hard and soft peri-implant tissue stability are needed
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    Haemostatic agents on the shear bond strength of self-adhesive resin
    (2015) Anil, Akansha; Sekhar, Anand; Thomas, Manuel S.; Ginjupalli, Kishore
    Background: Dentin surface contaminated with haemostatic agents can interfere with the bonding of self-adhesive resin cement. Therefore the purpose of this study was to evaluate the effect of various haemostatic agents such as Aluminium chloride, Ferric sulphate and Tannic acid on the shear bond strength of self-adhesive resin luting agent. Material and Methods: The buccal surfaces of extracted premolars were flattened to expose the dentine. The teeth were then randomly divided into four groups. In Group I Aluminium Chloride was applied on the flattened dentinal surface, in Group II Ferric Sulphate was applied to exposed dentin surface, in Group III tannic acid was applied on to the dentinal surface, and the control group, i.e. Group IV was rinsed with saline. After the surface treatment, all the teeth were air dried. Then a predetermined dimension of RelyX™ U200 self-adhesive resin cement was bonded to the pretreated dentin surfaces. The samples were then stored under 37 0 C in distilled water for 24 hours under 100 % humidity. Following this each sample was tested for shear bond strength with an Instron testing machine at a crosshead speed of 1mm/min. Results: There was significant difference in the shear bond strength of control and tannic acid contaminated group ( p <0.05), whereas there was no significant differences between the shear bond strength between control and aluminium chloride and ferric sulphate groups ( p >0.05). Conclusions: The usage of haemostatic agent can negatively affect the bond strength of self-adhesive resin cement (Rely X) on to the dentin surface. As per the study Tannic acid significantly weakened the bond between the self- adhesive resin and dentin
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    Integrated case scripts to enhance diagnostic competency
    (2015) Anbarasi, K.; Vijayaraghavan, Phagalvarthy; Sathasivasubramanian, Sankarapandiyan; Kandaswamy, Deivanayagam
    Background: The overwhelmingly high burden of disease and disorder especially in developing countries requires oral physicians to provide optimal dental treatment without complicating individuals’ general health. The opportunity for learners to extract the multiple aspects of a systemic condition and to relate them with the presenting complaint in order to devise an appropriate dental treatment plan is limited by time in chair- side teaching. To overcome the necessity of exposing students to real patients with varying degrees of underlying disease, those in medical and nursing education unanimously employ imaginary scenarios similar to real cases. However, such clinical scripts are seldom practiced in dental education, and the prospect of structured integration is almost never addressed. Objectives: To evaluate the effectiveness of applying systematic and integrated case-based discussion in dental education in terms of enhancing five essential skills to novice Indian dental students. Methods: A mixed- methods study was carried out with thirty graduating third-year students in 5focus groups. The integrated case-based focused group training occurred in 6 weeks and lasted approximately 90 minutes per discussion. Ten case scripts of hypothetical situations were discussed and five integrated modules were organized as a part of this program. Revised Bloom’s taxonomy was adopted to achieve the expected level of competency. Results: Students performance following integrated case-based discussions was improved and their acceptance to this practice is positive. Conclusions: The present study supports the need for course specific, basic science integrated seminars with concurrent case scripts discussion to enhance students’ competencies.