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Language Journal of Clinical and Experimental Dentistry. 2020. Vol. 12, no. 6
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- The effective and safe method for preventing and treating bacteria-induced dental diseases by herbal plants and a recombinant peptide(2020) Tanhaieian, Abbas; Pourgonabadi, Solmaz; Akbari, Majid; Mohamadipour, HamidehThis study was conducted aimed at evaluating the antibacterial property of the recombinant peptide of bacteriocin entrocin P (EnP), the essential oil of Cuminum cyminum, and the extract of Ferulago angulata on some oral pathogens. Besides, the cytotoxicity of EnP was evaluated. The antimicrobial property was tested on streptococcus mutans (ATCC 35668), streptococcus salivarius (ATCC 9222), streptococcus oralis (ATCC 35037), and Enterococcus faecalis (ATCC 29212), using the microbroth dilution method. The 0.2% Chlorhexidin (CHX) mouthwash was used as the control group. Besides, the cytotoxicity analysis was done on gingival fibroblasts by the MTT colorimetric method. The data were reported using descriptive methods, and analyzed by one-way ANOVA, and Tukey?s HSD test. The strongest bacteriostatic and bactericidal effects of C. cyminum and F. angulata were observed for S.mutans and S. oralis, respectively (with the MIC and MBC value being 62.5 ?g/mL). The antibacterial properties of EnP were comparable to those of CHX, being several times stronger than medicinal plants (1-14 ?g/mL). Based on the cytotoxicity evaluation, there was no statistically significant difference observed between the cytotoxicity of the control group and that of Enp for three evaluations, except after 72 hours when the cell viability at the concentration of 3.75 µg/ml was significantly lower than that of the control group (P=0.05). However, no concentration of EnP was observed to be over 50% of the growth inhibition (IC50) of the fibroblasts for the three evaluations. EnP could be utilized in dental materials as a natural and safe antimicrobial agent against oral streptococci and E. faecalis, being as effective as CHX mouthwash.
- Treatment of snoring disorder with a non-ablactive Er:YAG laser dual mode protocol : an interventional study(2020) Monteiro, LuÃs Silva; Macedo, Ana; Corte-Real, Luis; Salazar, Filomena; Pacheco, José JúlioSnoring disorder is a common problem among world population. Treatment modalities may involve surgical and non-surgical procedures. As main objective we proposed to evaluate the efficacy of non-ablative Er:YAG laser in the treatment of snoring disorder. We performed an interventional study in 30 patients with snoring disorders. Three sessions were performed with Er:YAG laser 2940nm in long pulse mode (2J/cm2) and smooth mode (10-8J/cm2) in oropharynx region. We analyzed the efficacy of this protocol using questionnaires for snoring intensity, snoring related characteristics of quality of life (including the Epworth sleepness scale and OHIP-14), the satisfaction of the patients and existence of adverse effects comparing the results before and after the treatment using Wilcoxon Signed Rank test. There was a 96.7% satisfaction rate after one month of treatment, and 96.4% after 6 months. A reduction of the severity of snoring from 8±1.9 before the treatment to 1.6±1.1 one month after treatment was observed (p<0.001). Decrease in mean values of Epworth sleepness scale (9.97±5.3 to 6.54±4.3) (p=0.002), and OHIP-14 score (10.9±6.2 to 5.9±5) (p<0.001) were also noted. A significant decrease in the Mallampatti and Friedman classification scores were observed (p=0.001 and p<0.001, respectively). No anesthesia was required, nor adverse effects were observed. Non-ablative Er:YAG laser treatment is a safe, painless, and can be an effective treatment option to reduce snoring and is well accepted by the patient. However, further controlled studies with longer follow-up are required.
- Cytotoxicity, antibacterial and physicochemical properties of a new epoxy resin-based endodontic sealer containing calcium hydroxide(2020) Silva, Emmanuel J.; Hecksher, Fernanda; Vieira, Victor T.; Vivan, Rodrigo R.; Duarte, Marco Antonio; Brasil, Sabrina C.; Antunes, HenriqueThis study evaluated the cytotoxicity, antibacterial and physicochemical properties of a new epoxy resin-based endodontic sealer containing calcium-hydroxide Sealer Plus. AH Plus was used as a reference for comparison. Cytotoxicity evaluation was performed according to ISO-10993-5 specifications using MTT assay to check the 3T3 cells viability at 1- to 4-week periods. Antibacterial activity was evaluated using a direct contact test against Enterococcus faecalis. Radiopacity, solubility and flow evaluations were performed according to ISO-6876/2012 specifications. Setting time was assessed following the ANSI/ADA-standard-n.57. The pH level was measured at 3,24,48,72, and 168 hours. Data were statistically analyzed using t-test. The signi?cance level adopted was P<0.05. AH Plus and Sealer Plus showed cytotoxic effects after 24 hours and 1 week of manipulation and become noncytotoxic after 2 weeks. No differences were observed in the cytotoxicity of both tested sealers (P>0.05). Direct contact results revealed that both freshly prepared sealers has antibacterial effects against Enterococcus faecalis. However, after 7 days both sealers had lost much of their antibacterial effects. Although AH Plus presented higher radiopacity and flow than Sealer Plus (P<0.05), both sealers showed minimum required values. No differences were observed in the solubility of both sealers (P>0.05). AH Plus showed a higher setting time when compared to Sealer Plus (P<0.05). AH Plus and Sealer Plus showed a neutral pH during all tested periods (P<0.05). It can be concluded that Sealer Plus showed suitable properties to be used as an endodontic sealer, comparable with those obtained by AH Plus.
- Evaluating the additive effect of Persica and chlorhexidine mouthwashes on oral health status of children receiving chemotherapy for their hematomalignancy : a randomized clinical trial(2020) Bahrololoomi, Zahra; Sadat-Hashemi, Azam; Hassan-Akhavan-Karbassi, Mohammad; Khaksar, YasaminNo definitive protocol has been introduced for treatment or prevention of chemotherapy induced mucositis. The aim of this study was to assess the additive effect of Persica and chlorhexidine on chemotherapy induced mucositis of children with hematomalignancies. This randomized clinical trial was performed on 44 children aged 6 to 12 years who were under a similar maintenance chemotherapy protocol for their hematomalignancies. The clinician instructed oral hygiene cares to the patients and their parents and the severity of the mucositis and oral health status of patients were evaluated according to Oral Assessment Guide index. Then, the patients were randomly assigned to one of two experimental groups and were instructed to rinse either with Persica oral drops or normal saline, twice a day for two weeks. Subsequently, the patients in both groups were educated to rinse with chlorhexidine for 30 seconds and avoid eating for an hour. Second and third oral examinations were performed on the 8th and 15th day using the same questionnaire. Comparing severity of mucositis and oral health status of patients did not show any significant difference between treatment groups in either of examination sessions (p>0.05). However, both treatment groups showed statistically significant oral health improvement, in terms of mucositis, plaque accumulation and gingival condition, in 14 days following mouthrinses administration (p<0.05). Both mouth-rinse combinations were effective on mucositis, plaque and gingival status of children receiving chemotherapy. However, Persica does not seem to pose additional effect on chlorhexidine in decreasing severity of chemotherapy induced mucositis.
- Surgical and orthodontic rapid palatal expansion in adults using a modified palatal partial osteotomy technique (ppot) : technique description and clinical experience(2020) Galli, Massimo; Federici, Francesca-Romana; Di Nardo, Dario; Yusef, Marco; Morese, Antonio; Manenti, Rebecca-Jewel; Testarelli, LucaTransversal hypoplasia of the upper maxilla is a frequent condition between malocclusions. The rapid maxillary expansion (RME) is an already consolidated technique for these types of defects. This case report analyzes the outcome of a novel surgical technique that we named TOPP (Partial Palatal osteotomy technique) aiming to provide scientifically proven data over the percentage of relapse and the long-term stability of this type of surgical assisted palatal expansion. A 24 year old male patient with a hyperdivergent class III, presenting the absence of 1.1 due to a teenage trauma and a transversal contraction of the upper arch was selected for the surgery. The mucoperiosteal flap was performed at a palatal level with a paramarginal arch shape (from region 1.4 to 2.4) due to preserve the nasal-incisal vascular bundle and the mucoperiosteum was detached from the floor of the nose. A horizontal osteotomy was performed at 4-5 mm above the roots apexes; a sagittal osteotomy in a posterior direction was done at the level of the midline to divide the mesiopalatine suture and separate the maxilla in two halves. The only bony attachment that remained was represented by the perpendicular lamina of the palatal bone. The TOPP technique showed that it is possible to have a better control of both the intercanine and intermolar expansion, that is more difficult in the case of a conventional SARME. Other goals were a greater view and access to the site and the reduction of the risk of damaging the palatine fibromucosa. The incision of the archform paramarginal flap improves certainly the conditions of the palatal fibromucosa in the post operative and allows the reduction of the soft tissues? elastic return.
- Peripheral ameloblastoma : a case report(2020) Ãœlker, Ersin; Kirtilo?lu, Tu?rul; Taban, BurcuAmeloblastoma is a rare tumor which develops from odontogenic epithelium and its remnants and it occurs in the jaws. Peripheral ameloblastomas are rare and benign extraooseous ameloblastomas which effects soft tissues. This case report declares a peripheral ameloblastoma which is a rare type of ameloblastoma. 34 year old female patient referred with a complaint of a gingival growth at right lower premolar area. A firm and granular surfaced gingival growth with the color of pink and red and having 1.5x1 cm sizes was observed at the mentioned area. With an incision from lower right second incisor tooth to lower right second molar tooth a flap from bone was made and lesion was excised. After then specimen was submitted to histopathologic examination. After clinical, radiological and pathological examinations lesion was described as peripheral ameloblastoma. At the control examination after three months of excision there was no recurrence and patieant has no complaint. Although reccurens rate of peripheral ameloblastomas are low, long-term follow-ups are suggested Patient was informed about the importance of regular controls for early diagnosis of possible reccurenses and regular controls were made during one year after excision.
- Histological study of human periodontal tissue following biologically oriented preparation technique (BOPT)(2020) AgustÃn Panadero, Rubén; MartÃn de Llano, José Javier; Fons Font, Antonio; Carda Batalla, MarÃa del CarmenThe aim of this study was to conduct histological analysis of a human tooth resected with the periodontal insertion apparatus intact following treatment using biologically oriented preparation technique (BOPT). This descriptive histological dento-periodontal study used an anterior tooth extracted with the surrounding periodontal tissues intact, following prosthetic restoration with BOPT. The sample patient was recruited from among those attending the Department of Dental Medicine at the Faculty of Medicine and Dentistry, University of Valencia (Spain). Eight serial sections of the restored tooth were processed. The relative location and histological characteristics of the cemented prosthetic crown, the dental tissues of the tooth prepared by BOPT technique, and the periodontal tissues were analyzed. Structural analysis of the neoformed junctional epithelium showed that the number of layers decrease apically until there was a single row of cells perfectly adhered to the acellular cementum, and beneath the epithelium a connective tissue evidently free from inflammation. The tissues of the neoformed periodontium (gingival ligament, sulcular epithelium, junctional epithelium) presented histologic normality. Biologically oriented preparation technique is a reliable alternative to conventional horizontal finish lines.
- Laser therapy as treatment for oral paresthesia arising from mandibular third molar extraction(2020) Fernandes-Neto, José-de Alencar; Simões, Thamyres-Maria-Silva; Batista, Ana-Luzia-Araújo; Lacerda-Santos, Jhonatan-Thiago; Palmeira, Pettely-Thaise-de Souza-Santos; Catão, Maria-Helena-Chaves-de VasconcelosOral paresthesia is a localized condition of sensory abnormality that occurs in the presence of injury in one of the nerves in the region after certain dental procedures. The aim of this study was to present a case report of a patient who received low-level laser therapy as treatment for inferior alveolar nerve paresthesia due to mandibular third molar extraction surgery. A 25-year-old female patient reported lack of sensitivity for 6 months in various regions of the bucomaxillofacial complex after surgery. Laser therapy (808 ± 10nm, 100 mW, 3J per point and 30 seconds per point) was indicated twice a week. The degree of sensitivity was evaluated using a Visual Analog Scale (VAS) and with the aid of a microbrush. Prior to laser therapy, the patient reported VAS = 10, i.e., total lack of sensitivity. After 72 hours of the first session, the patient reported improvement of sensitivity in the chin (VAS = 5) and oral regions (VAS = 5), reporting recovery of sensitivity and that the area of paresthesia decreased. After 8 sessions, the patient reported total recovery of sensitivity in the chin, oral and gum regions (VAS = 0), with paresthesia being limited only to the left lower lip region and below it. After 26 sessions, the patient reported recovery of sensitivity in all affected regions (VAS = 0), with positive responses to the brush touch. Within the parameters used, laser therapy was effective in the treatment of inferior alveolar nerve paresthesia after third molar tooth extraction.
- Efficacy of infiltrative local anesthesia and inferior alveolar nerve block in periapical surgery of lower premolars and molars : a preliminary report(2020) Menéndez-Nieto, Isabel; Peñarrocha Diago, Miguel; Cervera Ballester, Juan; Peñarrocha Diago, MarÃa; Peñarrocha Oltra, DavidThe aims of this study were: 1) compare the amount of anesthesia used with the anesthetic technique; 2) relate the quantity of anesthesia needed with the level of anxiety of the patient; 3) study the relationship between the anesthetic technique and the level of hemostasis; 4) correlate the amount of anesthesia with patient and tooth dependent variables. A randomized controlled trial was designed with two parallel groups according to the anesthetic technique: infiltrative local anesthesia (infiltrative group) and inferior alveolar nerve block (block group). The following variables were collected: sex, age, smoking habits, plaque index, symptoms, signs, position of the tooth and amount of anesthesia. Before surgery, all patients were asked to assess their anxiety on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The analysis of the hemorrhage control of aluminum chloride was judged by the surgeon and two examiners independently and recorded it as: 0 (no hemorrhage control), 1 (slight but apparent intermittent bleeding persisted after application of the material), or 2 (complete hemorrhage control). Twenty patients were included in this preliminary report. The amount of anesthesia used was lower in block group and in less anxious patients, although these results did not reach statistical significance. A relationship was found between the quantity of anesthesia used and a good hemostasis of the bony crypt before the application of the hemostatic agent (p<.05); and between elderly patients and a lower amount of anesthetic reinforcement (p<.05). Based on these preliminary results, we can conclude that no statistical significance difference was found between the amount of anesthesia used and the anesthetic technique or the anxiety. A relationship was found between hemostasis of the bony crypt and the quantity of anesthesia used; and between younger patients and a greater amount of anesthetic reinforcement.
- Prevalence of sleep-related breathing disorders in children with malocclusion(2020) Vázquez-Casas, Ivette; Sans Capdevila, O.; Moncunill, Jordi; Rivera Baró, AlejandroThe paediatric population has a high incidence of sleep-related breathing disorders (SRBD). A notable risk factor is the presence of craniofacial abnormalities. The objective of the study was therefore to survey the prevalence of SRBD in patients presenting for interceptive treatment. Prospective study with a sample of 249 healthy patients. The ?Paediatric Sleep Questionnaire? and ?Sleep Disturbance Scale for Children? were completed by the children?s parents and the results were evaluated. All patients had their medical records reviewed and underwent orthodontic diagnosis by oral examination, as well as dental cast and cephalometric analysis. Finally, we compared the results of the pre- and post-treatment questionnaires of 50 patients in the sample. Based on the results of the questionnaires, 22.8% of the study sample had SRBD. No statistically significant correlation was found between SRBD and the anthropometric characteristics and occlusal variables assessed. According to the cast analysis, patients with SRBD had a smaller maxillary width (p<0.003), and according to the cephalometric study, less overbite (p<0.003). Furthermore, the prevalence of SRBD was higher among patients with a history of adenotonsillectomy (p<0.02). Comparison of the results of pre- and post-treatment questionnaires revealed significant differences after orthodontic treatment (p<0.0005). It is necessary to identify the presence of SRBD in orthodontic patients given its high prevalence. Patients with SRBD have a smaller maxillary width and less overbite.
- Extraoral surgical removal of an ectopic impacted third molar of the mandible. Report of a case(2020) Goutzanis, Lampros; Chatzichalepli, Chara; Avgoustidis, Dimitrios; Papadopoulos, Panagiotis; Donta, CatherineIntraoral approach for the removal of impacted third molars represents a common surgical procedure for the specialized clinician. However, in some cases such as ectopic third molars, extraoral surgical removal seems to be inevitable. We present a step by step case of a 56 year old woman with an ectopic third molar of the lower jaw along with a cystic lesion, which were surgically removed by a submandibular approach. Postoperative clinical course was uneventful and there were no signs of facial nerve paresis. In such cases, appropriate preoperative planning must be made based on careful study of radiographic imaging and clinical examination. The more conservative technique that would minimize adjacent anatomic structures risk should be the surgical technique of choice.
- Assessment of fractures in endodontically treated teeth restored with and without root canal posts using high-resolution cone beam computed tomography(2020) Aristizabal-Elejalde, David; Arriola-Guillén, Luis-Ernesto; Aliaga-Del Castillo, Aron; RuÃz-Mora, Gustavo-Armando; RodrÃguez-Cárdenas, Yalil-AugustoRoot fractures are a diagnostic challenge for dentists in endodontic treatment. This study aimed to determine the relationship between the characteristics of tooth fractures and the presence of root canal posts in endodontically treated teeth using high-resolution cone beam computed tomography (CBCT). Fifty high-resolution CBCT scans of endodontically treated teeth with a diagnosis of fracture were obtained, of which 30 were from women and 20 were from men. These scans were acquired with three Veraviewepocs 3D units and one 3D Accuitomo 170 unit, with a 40 × 40-mm field of view and 125 ?m voxel size. The variables assessed included the type of fracture, extent of fracture, type of retention, post length, cause of endodontic failure, location of the lesion, and time required to detect the fracture (difficulty score). For data analysis, the chi-squared test, Student?s t-test, and multiple linear regression (? <0.05) were used. No association was found between the type of fracture and type of retention or between the type of fracture and its extent (P>0.05). On the other hand, the type of fracture significantly influenced the time required for its detection. Additionally, the most difficult plane for detecting the fracture and the difficulty score were associated, with statistically significant results. The type of fracture in endodontically treated teeth was not associated with the type of post used for restoration. All of the CBCT systems used to detect tooth fracture showed the same efficiency.
- Oral leukoplakia, a clinical-histopathological study in 412 patients(2020) Rubert, A.; Bagán Debón, Leticia; Bagán Sebastián, José VicenteA retrospective clinical-histopathological study was made of the evolution of oral leukoplakia over time, staging the disease according to the classification of van der Waal. A study was made of 412 patients with oral leukoplakia, analyzing the corresponding clinical factors and histopathological findings; assessing associations between the different clinical presentations and epithelial dysplasia; and evaluating the factors influencing malignant transformation of the lesions. Clinically, homogeneous presentations were seen to predominate (n = 336, 81.6%), while histologically most of the lesions exhibited no dysplastic changes (n = 271; 65.7%). Stage 1 of the van der Waal classification was the most common presentation (n = 214; 51.9%). The lesion malignization rate was 8.3%, and the factors associated to a significantly increased malignization risk were non-homogeneous OL lesions (p=0.00), lesion location in the tongue (p=0.00), and the presence of epithelial dysplasia (p=0.00). In our series of patients with oral leukoplakia, malignization was associated to the less common clinical presentations of the disease, i.e., non-homogeneous lesions, and the latter tended to exhibit high grade epithelial dysplasia.
- Comparative evaluation of Stevia and Xylitol chewing gum on salivary Streptococcus mutans count ? A pilot study(2020) Shinde, Mitali R.; Winnier, JasminStevia is a natural sweetener which is used as sugar substitute. It has been suggested that stevia may be anticariogenic. However, there is limited research in this regard. Hence, the present study was designed to assess reduction in S. mutans in stevia and xylitol chewing gums. The aim of this study is to evaluate the effectiveness of stevia and xylitol chewing gums on salivary Streptococcus mutans count. A randomized triple blinded clinical study with a crossover design included twenty healthy children aged 8-13 years with decayed, missing, and filled teeth (dmft)/DMFT index score ? 3. Before the test, unstimulated saliva was collected. Children divided into Group I and II were given Stevia and Xylitol chewing gums respectively. Saliva samples were then collected at 15 min (just after spitting) and after 1 h. The amount of S. mutans in saliva was evaluated using a selective media (TYCSB). The data were subjected to statistical analysis using statistical software IBM SPSS statistics 20.0 (IBM Corporation, Armonk, NY, USA) Reduction in S. mutans was seen from baseline to 1 hour in both groups in trial and crossover design though intergroup comparison was not statistically significant. There was reduction seen from baseline to 15 minutes and 15 minutes to 1 hour in xylitol and stevia group both in trial and crossover design which was statistically significant. Stevia containing chewing gum is equally effective to Xylitol chewing gum in reducing salivary S. mutans counts.
- Effect of LASER therapy Vs conventional techniques on clinical and radiographic outcomes of deciduous molar pulpotomy : a systematic review and meta-analysis(2020) Chandran, Vennila; Ramanarayanan, Venkitachalam; Menon, Medhini; Varma, Balagopal; Sanjeevan, VinitaTo systematically review the effectiveness primary molar pulpotomy based on the clinical and radiographic outcomes using lasers over the conventional therapies. This systematic review and meta-analysis included Randomized or Quasi-randomized trials comparing LASER with conventional pulpotomy therapies (formocresol, ferric sulphate, MTA or calcium hydroxide) with atleast 6-month follow-up period was included. Risk of bias of included studies was assessed and metanalysis was done using RevMan software. Of the 1383 articles that were searched, only 14 studies were included for qualitative synthesis and 10 for meta- analysis. There was no statistically significant difference in clinical success rate [OR 0.99, 95%CI (0.19,5.22)] or radiographic success rate [OR 0.77, 95%CI (0.31,1.87)] of LASER therapy compared to Formocresol in primary molar pulpotomy for 6 months. No statistically significant difference were found in clinical success rate [OR 1.04, 95%CI (0.35,3.07)] and radiographic success rate [OR 0.71, 95%CI (0.37,1.35)] at 12 month follow-up also. Comparison of LASER with Ferric Sulphate also did not show a statistically significant difference. Meta-analysis showed no statistically significant difference in clinical and radiographic outcomes of LASER pulpotomy with conventional pulpotomy (formocresol and ferric sulphate) at 6 and 12 months follow-up. However, there was considerable risk of bias in the included studies.
