Journal of Clinical and Experimental Dentistry. 2019. Vol. 11, no. 7

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    Differences in cyclic fatigue lifespan between two different heat treated NiTi endodontic rotary instruments : Waveone gold vs Edgeone fire
    (2019) Gambarini, Gianluca; Galli, Massimo; Di Nardo, Dario; Seracchiani, Marco; Donfrancesco, Orlando; Testarelli, Luca
    Aim of this study is to investigate the cyclic fatigue resistance of the Gold treated WaveOne Gold and the Firewire treated EdgeOne Fire instruments. The null hypotesis was that there were no differences between the lifespan of Gold treated and FireWire treated instruments when subjected to cyclic fatigue tests. 40 new NiTi instruments with a length of 25 mm were tested: 20 Wave One Gold Medium (WOG), tip size 35 and variable taper (Dentsply Maillefer, Ballaigues, Switzerland) and 20 Edge One Fire (EOF) (EdgeEndo, Albuquerque, New Mexico) tip size 35 and the same variable taper. A mobile support for the electric handpiece and a stainless-steel block containing the artificial canals were used. The same artificial root canal with a 90 degrees angle of curvature and 2 mm radius of curvature was used for all the tested instruments and the WOG counter-clock wise reciprocating motion with an engaging angle of 150° and a disengaging angle of 30° at 300 rpm, was selected for the test. All instruments were inserted at the same length (18mm) and then rotated in the same reciprocating motion until fracture occurred: the time was stopped as soon as the fracture was visible and video-recorded with a 1/100 sec chronometer. Differences among groups were statistically evaluated with an analysis of variance test ANOVA (significance level was set at p<0.05). Mean values of time to fracture (TtF) for EOF instruments were 28,00 seconds (SD +/- 2,64) and for WOG instruments were 14,67 seconds (SD +/- 2,41). Statistical analysis found significant differences between the TtF of the two instruments (p<0,05). Firewire instruments resulted to be about two times more resistant to cyclic fatigue when compared with identical instruments made with Gold treatment.
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    Dental expenditure and catastrophic dental expenditure in Eastern Saudi Arabia : pattern and associated factors
    (2019) AlBaty, Ali; AlGhasham, Hassan; Al Wusaybie, Mahdi; Tantawi, Maha El
    Dental services have one of the highest expenses among health services. The aims of the study were to assess (1) dental expenditure (DE), (2) catastrophic dental expenditure (CDE), (3) dental services payment and (4) factors associated with DE and CDE. A cross sectional study was conducted in 2018 in Saudi Arabia. Using convenience sample, participants were recruited from governmental and private dental clinics/hospitals. A questionnaire assessed (a) personal information, (b) dental background: payment methods, type of clinics visited, perceived oral health status, frequency of pain and (c) payment for dental services received. The number of remaining teeth was clinically assessed. Two outcome variables were assessed (1) total DE in linear regression and (b) CDE (DE exceeds 10% of income) in logistic regression. Personal and dental background variables were explanatory variables. The response rate was 83.8% (419/500) with 43% reporting expenditure, 16.5% facing CDE and 36.3% using multiple payment methods. The greatest DE was for crowns and bridges, root canal therapy, fillings and implants. Income, payment method and pain were associated with DE and CDE. Participants used multiple payment methods including out of pocket and faced CDE. The bulk of expenditure was for rehabilitative services. The availability and quality of health-insured primary care services may reduce the financial burden facing dental patients.
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    Influence of thermal tempering processes on color characteristics of different monolithic computer-assisted design and computer-assisted manufacturing ceramic materials
    (2019) Juntavee, Niwut; Uasuwan, Pithiwat
    The optical properties of dental restoration were influenced by the sintering parameters. This study investigated the effects of different tempering processes on optical properties of three monolithic Cad-Cam ceramics. 135 monolithic material bars (4 mm width, 14 mm length, 1.2 mm thickness) were prepared from yttria-stabilized tetragonal zirconia polycrystalline (inCoris TZI, I), zirconia-reinforced lithium silicate (Vita Suprinity, V), and lithium disilicate glass (e.max CAD, E) ceramics, with different tempering processes through slow (S), normal (N), and fast (F) cooling (n=15). The color appearance (?EW), translucency parameter (TP), contrast ratio (CR), and opalescence parameter (OP) were determined. ANOVA and Bonferroni?s multiple comparisons were determined for significant difference (?=0.05). The grain sizes were microscopically examined by scanning electron microscope. The phase transformation of zirconia was determined using X ray diffraction. The mean±sd of ?EW, TP, CR, OP were 74.15±0.46, 1.26±0.15, 0.977±0.006, 1.02±0.12 for IS; 74.00±0.83, 1.27±0.19, 0.977±0.007, 1.02±0.12 for IN; 74.44±0.64, 1.70±0.08, 0.965±0.003, 1.30±0.07 for IF; 73.35±1.32, 2.44±0.24, 0.958±0.006, 2.10±0.20 for VS; 66.37±0.88, 4.05±0.3, 0.911±0.010, 3.18±0.20 for VN; 67.02±0.65, 3.79±0.17, 0.919±0.006, 3.01±0.13 for VF; 60.01±0.30, 5.53±0.17, 0.821±0.006, 2.71±0.06 for ES; 60.18±0.23, 5.49±0.17, 0.822±0.006, 2.66±0.05 for EN; and 59.82±0.26, 5.36±0.06, 0.826±0.002, 2.64±0.07 for EF. The color parameters were significantly affected by type of materials, tempering processes, and their interactions (p<0.05). Phase transformation from t?m related with tempering procedure for zirconia. Rapid thermal tempering process of Y-TZP resulted in larger grain size and t?m phase transformation leading to higher translucency. To achieve optimum translucency, a fast thermal tempering process was suggested for inCoris TZI and IPS e.max CAD, whilst a normal tempering process was recommended for Vita Suprinity.
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    Treatment of Class III malocclusion using Hybrid Hyrax, Face Mask and Alt-RAMEC Protocol : a case report in a latin-american patient
    (2019) Castrillón-Marín, Robinson-Andrés; Barbosa-Liz, Diana-María; Ardila Medina, Carlos Martín
    The management of Class III malocclusion is one of the greatest challenges of orthodontics. Current treatments offer the possibility of using direct skeletal anchorage to improve clinical outcomes. This case shows the results of using a Hyrax hybrid palatal anchorage, Alt-RAMEC (Alternate Rapid Maxillary Expansion and Contraction protocol) and a facemask to treat a maxillary hypoplasia Class III malocclusion in a Latin-American patient. The appliance design and the protocol used are widely described. Clinical and cephalometric results suggest that it is a good treatment option for this Latino patient, with moderate malocclusion and limitations in the dental anchorage.
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    Cervical vertebral maturation and its relationship to circum-pubertal phases of the dentition in a cohort of Portuguese individuals
    (2019) Fernandes-Retto, Paulo; Matos, David; Ferreira, Margarida; Bugaighis, Iman; Delgado, Ana
    To explore the relationship between individual skeletal maturity as assessed by Cervical Vertebral Maturity method (CVM), circum-pubertal phases of the dentition (early mixed, intermediate mixed, late mixed and early permanent) and chronlogical age in a cohort of Portuguese individuals. This was a retrospective cross-sectional study. The sample comprised 300 Caucasian Portuguese subjects aged 6 to 16 years, (137 boys and 163 girls). All the participants had good quality panoramic and lateral cephalometric radiographs. Subject skeletal maturity was evaluated using the CVM method. Dental age evaluation was determined by using panoramic radiographs and dental casts. Descriptive statistics (absolute and relative frequencies) and percentages were obtained for the prevalence of the CVM stages in the various phases of the dentition and for the different ages for each of males and females. Prepubertal stage 1 (CS1) was predominently observed in the early mixed dentition phase followed by the intermediate mixed dentition phase. While, the CS1 stage was found in all the other phases of tooth development. There was a wide distribution of all CVM stages in the late mixed dentition and early permanent dentition phases. While, the CS3 stage was predominantly present in both the late mixed dentition and in the early permanent dentition phases. Moreover, the chronological age did not seem to be an accurate indicator in differentiating between the pre-pubertal and the pubertal growth spurt stages. Early mixed dentition phase could determine with a high accuracy the prepubertal skeletal maturity stage (CS1), Furthermore, the chronological age did not seem to be an accurate indicator in differentiating between the pre-pubertal and the pubertal growth spurt stages.
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    Salivary inflammatory proteins in patients with oral potentially malignant disorders
    (2019) Dikova, Valentina R.; Principe, Sara; Bagán Sebastián, José Vicente
    Cytokines are a group of small proteins involved in the regulation of infection, immune responses and inflammation. Since altered cytokine responsiveness has been linked to Oral Squamous Cell Carcinoma (OSCC), research to date indicates the possibility of using salivary pro- and anti-inflammatory proteins for screening of oral disorders. OSCC is a multistep neoplasia in which many genetic and epigenetic changes have been correlated to cancerous transformation of oral potentially malignant disorders (OPMD) such as oral leukoplakia, erythroplakia and lichen planus. The goal of the innovative salivary diagnostics is the identification of a single or multiple biomarkers that will serve as a clinical test facilitating the diagnosis of patients predisposed to develop OSCC. Based on scientific literature review, this article summarizes the results from nine articles, all of them being case-control studies where TNF-?, IL-1?, IL-6 and IL-8 were considered possible indicators of malignant transformation.
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    Cheek-splitting technique for marginal mandibulectomy : a novel approach
    (2019) Abe, Atsushi; Kurita, Kenichi; Hayashi, Hiroki; Ito, Yu
    When performing marginal mandibulectomy, ensuring complete tumor removal and preventing postoperative iatrogenic mandibular fracture are essential. Pathological fracture can result due to stress concentration at the site requiring acute angle resection. To perform marginal mandibulectomy without making acute angles in patients with a lesion in the molar or more posterior region, a submandibular or transbuccal approach is necessary. Compared to the submandibular approach, the transbuccal approach is considered useful as it reduces operative time and prevents injury to the facial and mental nerves. Additionally, this approach does not leave a scar in the surgical field, which is beneficial in subsequent neck dissection for late neck metastasis. Here, we report 2 cases of lower gingival carcinoma in which satisfactory aesthetic outcomes were achieved with an improved cheek-splitting technique for marginal mandibulectomy using a transbuccal approach, taking into consideration the angle of the mouth, design of the triangular flap, and modiolus.
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    Comparison of frictional resistance between passive self-ligating brackets and slide-type low-friction ligature brackets during the alignment and leveling stage
    (2019) Gómez Gómez, Sandra Liliana; Villarraga Ossa, Junes; Diosa Peña, Juan Gustavo; Ortiz-Restrepo, Juan-Fernando; Castrillón-Marín, Robinson-Andrés; Ardila Medina, Carlos Martín
    To compare the frictional resistance between passive self-ligating brackets and conventional brackets with low-friction ligature under bracket/archwire and root/bone interface during dental alignment and leveling. A tridimensional model of the maxilla and teeth of a patient treated with conventional brackets, and slide ligatures was generated employing the SolidWorks modeling software. SmartClip self-ligating brackets and Logic Line conventional brackets were assembled with slide low-friction ligatures, utilizing archwires with different diameters and alloys used for the alignment and leveling stage. Friction caused during the bracket/archwire interface and stress during the bone/root interface were compared through a finite element model. SmartClip and Logic Line brackets with slide elastomeric low-friction elastomeric ligature showed similar frictional stress values of 0.50 MPa and 0.64 MPa, respectively. Passive self-ligating brackets transmitted a lower load along the periodontal ligament, compared to conventional brackets with a low-friction ligature. Slide low-friction elastomeric ligatures showed frictional forces during the bracket/archwire interface similar to those of the SmartClip brackets, while the distribution of stresses and deformations during the root/bone interface were lower in the passive self-ligating brackets.
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    The efficacy of photodynamic therapy in rat tongue dysplasia
    (2019) Khozeimeh, Faezeh; Ziaei, Samaneh; Khalesi, Saeedeh; Allameh, Maryam; Jahanshahi, Gholamreza
    Photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) has previously shown promising results in cancerous cell destruction. The present study was conducted to evaluate the efficacy of this treatment option on oral epithelial dysplasia in Wistar rats. Furthermore, microscopic effects of systemic versus topical administration of ALA before laser illumination was assessed. Thirty male Wistar rats (200- 250 grams) were used in the present study. Tongue dysplasia was induced by a daily delivery of a 20 ppm solution of 4-nitroquinoline -1- oxide (4NQO) for 3 months. Then, rats were divided into 3 groups of 10 including, group 1 that was received systemic ALA-based PDT (30 mg/kg ALA), group 2 that was received topical ALA-based PDT (20% ALA solution) and group 3 (control) which was left untreated. Tongue specimens were fixed for histopathological evaluation and dysplasia was graded at microscopic level. Data was compared between various treatment groups using Mann Whitney test (p<0.05). The rate of atypical dysplastic cells was decreased significantly in both topical (p= 0.006) and systemic (p= 0.001) treatment groups compared to control group. Furthermore, systemic use of ALA resulted in a remarkable destruction of dysplastic cells compared to its topical application (p=0.045). Nevertheless, some evidence of muscle destruction was documented in systemic ALA group. It seems that ALA mediated PDT is an effective treatment option for the destruction of dysplastic cells. However, the extent of this effect depends on the mode of ALA administration before light illumination.
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    Active tactile sensibility of three-unit implant-supported FPDs versus natural dentition
    (2019) Negahdari, Ramin; Ghavimi, MohamadAli; Ghanizadeh, Milad; Bohlouli, Sepideh
    Splinting of the implants might improve the active tactile sensibility (ATS) of the pontic area due to cumulative effect of Osseo perception of two retainers; on the other hand, due to the lack of any supporting implant in the axis of occlusal force for the pontic area, ATS might be lower for this portion of FPDs. we evaluated the active tactile sensibility of natural teeth and three-unit implant-supported FPDs. The ATS of posterior 3-unit implant-supported FPD and contralateral teeth was measured in 50 patients, in a random order blinded to patients and assessor, carried out at two sessions. Based on the experimental range of 0 to 70 um, the sigmoid shape of psychometric curve was estimated to locate the 50% values as the ATS thresholds for each tooth or implant. Data were analyzed using unpaired t-tests. The ATS of the teeth and implants differed significantly and compared to teeth, implants exhibited significantly higher ATS thresholds in all the groups. The results of independent t-test showed the highest difference in the means of ATS between the pontic and the first molar tooth. Based on the equivalence testing approach, the 95% CIs indicated that the differences were clinically significant only in the Pontic/First Molar group. In multi-unit implant-supported prostheses the tactile perception of the prosthesis that are placed on fixtures is similar to the natural teeth. In pontic areas there are significant statistical and clinical differences, with much lower tactile sensibility in pontics compared to the natural teeth.
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    Miniscrew-supported distal jet versus conventional distal jet appliance : a pilot study
    (2019) Cassetta, Michele; Brandetti, Giulia; Altieri, Federica
    Maxillary molar distalization is the most frequently used nonextraction treatment in the correction of Class II malocclusion. The use of traditional intra-oral devices shows unreliable results. Nowadays the use of miniscrew-supported appliances helps prevent anchorage loss. The aim of this pilot study is to compare the amount of upper first molar distalization and the dentoalveolar side effects using traditional distal jet appliance and miniscrew-supported distal jet appliance. 20 patients were randomly assigned to receive a treatment with miniscrew-supported distal jet appliance (Group A) or with traditional distal jet appliance (Group B). To ensure a safe and minimally invasive miniscrew insertion a surgical guide was used. Digital models and lateral cephalograms were obtained and analyzed before orthodontic treatment and at 6-month follow-up. Intergroup differences were determined using T- test. The significance was set at p ?0.05. The intra-operator reliability was evaluated using a 2 sample T-test. The difference was not statistically significant (P ?0.05 ), demonstrating an intra-operator reliability. In Group A, a greater maxillary first molar distalization was recorded (P=0.002). Considering the dentoalveolar side effects, in Group A, a spontaneous distalization of the first premolars and a retroclination of central incisors were determined. In Group B, the first premolars tipped mesially with a proclination of the maxillary central incisors. Miniscrew-supported distal jet appliance achieved a greater first molar distalization at 6-month follow-up and did not cause dento-alveolar side effects, such as the mesial drift of the premolars and the incisors.
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    Effects of treatment with three types of varnish remineralizing agents on the microhardness of demineralized enamel surface
    (2019) Kooshki, Fahimeh; Pajoohan, Sahar; Kamareh, Sanaz
    Remineralization of incipient caries is one of the goals in dental health care ,especially in pediatric dentistry. The present study aimed at comparing the effects of MI varnish (3M (United states)) , Nano paste( FGM(Brezil) ), 5% sodium fluoride varnish) DuraphatColgate (united states) ) on remineralization of enamel lesions. In this in-vitrostudy, 60 intact human pre-molars, were randomly allocated to four groups of 15. Baseline surface microhardness in three points in the center of the polished area was measured. After two days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 under-went treatment with MI varnish, nano paste, 5% sodium fluoride varnish and then again microhardness was measured. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Bonfreni table was used. Duraphat varnish in comparison with control group, significantly increased surface microhardness and in comparison with Nano and MI paste varnish groups significant differences was shown between groups. (P< 0.05). MI paste varnish and Nano paste similary showed more increases in surface microhardness in comparison with Duraphat varnish and control groups (P?1). According to the results of this study, all three varnishes, Duraphat , MI paste and Nano paste increase the enamel surface microhardness and remineralization of incipient caries. MI paste and Nano paste compared to Duraphat Varnish, significantly showed more increases in enamel surface microhardness but Nano paste and MI paste were almost the same.
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    Clinical profile of 102 patients with oral lichen planus in Thailand
    (2019) Kaomongkolgit, Ruchadaporn; Daroonpan, Pissacha; Tantanapornkul, Weeraya; Palasuk, Jadesada
    Oral lichen planus (OLP) is a chronic inflammatory disease of the skin and mucous membrane presented with various clinical appearances. The aim of the present study was to elucidate the clinical profile of patients with OLP. The dental records of 102 patients who visited Oral Medicine Clinic, Dental Hospital, Naresuan University during 2002-2018 were retrospectively reviewed. There were 75 (73.5%) women and 27 (26.5%) men, giving a female to male ratio of 2.8:1. The age of OLP patients ranged 20-81 years old with the mean age of 56.4 ± 13.2 years old. Seventy-eight patients (76.5%) had the history of systemic diseases and hypertension was the predominantly one. Most patients were non-smokers (98%), non-drinkers (86.3%) and non-betel nut chewers (98%). The atrophic form (93.1%) was the most common OLP. The lesions were mainly symptomatic (92.2%) and involved multiple locations (67.6%) where the buccal mucosa (79.4%) primarily affected. Only 2% were extraoral lesions detected on the skin. Patients had no family history of OLP or malignant transformation. Ninety-one patients (89.2%) were treated with topical steroid and only 4 patients were prescribed a combination of tropical and systemic steroid. The results of the study indicated that most of characteristics are in accordance with previous studies. Since, OLP is a chronic inflammatory oral mucosal disease with high recurrence rate, early detection, accurately diagnosis, and long-term follow-up are necessary to evaluate the exacerbation and malignant transformation.
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    Improving PMMA resin using graphene oxide for a definitive prosthodontic rehabilitation - A clinical report
    (2019) Azevedo, Luis; Antonaya Martín, José Luis; Molinero Mourelle, Pedro; Río Highsmith, Jaime del
    The use of acrylic resins as a definitive material has shown some advantages comparing to other definitive materials. However, their poor mechanical properties remain a major drawback. In this case report, graphene oxide (GO) was incorporated into polymethyl methacrylate (PMMA) resin for a definitive maxillary rehabilitation, combined with an intraoral digital impression and a three-dimensional facial scan. After 8 months of the placement of the definitive prosthesis, no mechanical, aesthetic, or biologic complications were reported, and the soft tissues showed excellent health and stability. The incorporation of GO in PMMA resins seems to be a suitable option for prosthetic rehabilitation. However, further studies are needed to ensure rigorous scientific support of these techniques and materials.