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Language Journal of Clinical and Experimental Dentistry. 2018. Vol. 10, no. 5
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- Papilla and pontic area regeneration in patient with gingival smile : a clinical case(2018) Gómez Meda, Ramón; Torres-Sanchez, Carlos; Mareque Bueno, Santiago; ZufÃa González, Juan; Torres Lagares, Daniel; Gutiérrez Pérez, José LuisConnective tissue grafts are widely documented as a predictable technique for treating Miller Class I and II recessions, as well as procedures in which soft tissue augmentation is required for aesthetic reasons. This article aims to explore the resolution of a clinical case with this type of problema. This case describes a technique for reconstructing a pontic area and adjacent papilla by means of two consecutive connective tissue grafts. The first graft served to increase the amount of tissue in the horizontal direction, and the second promoted vertical reconstruction of the defect. In cases with aesthetic requirements, restorative intervention may be able to mask tissue loss, but it can hardly achieve optimal aesthetic results. Periodontal plastic surgery techniques can be used to achieve that ideal result. The clinician must diagnose conditions in order to select correct treatment regimen for each individual case.
- Three steps to maintain predictable interdental papilla and gingiva emergence profiles in immediate implant placement. A 3-year follow-up case report(2018) Gómez Meda, Ramón; Montoya Salazar, Vanessa; Dalmau, Santiago; Torres Lagares, DanielWe present a case that describes a three-step clinical technique to provide guidelines to replace fractured teeth with immediate implant placement using the same dental structure as a temporary crown and a regenerative approach. This approach predictably maintains the interdental papilla and gingiva emergence profile to ensure a favorable cosmetic result. A 3-year follow-up has shown good clinical outcomes and stability in crestal bone levels. Consequently, this is an innovative way to do temporary crown and design restorations in everyday clinical practice.
- A successful approach to conrol burning mouth syndrome using matricaria recutita and cognitive therapy(2018) Milani, Alessandra-Maria-Ceolin; Macedo, Carmen-Lúcia-Rodrigues; Bello, Mariana-De-Carlo; Klein-Júnior, Celso-Afonso; dos Santos, Rubem-BeraldoThe burning mouth syndrome (BMS) has no specific clinical and laboratory signs. Its etiology is yet to be elucidated, but it is considered to be affected by multifactorial, psychological, and local and systemic factors. This condition is considered of great morbidity, and the main complaint of patients maybe associated with xerostomia, thirst, and altered taste. The present study aims to report two cases of BMS and to evaluate the outcome of cognitive therapy (CT) plus phytotherapy in the control of BMS. The patients were female, Caucasian, and aged between 58 and 69 years. The most BMS-affected anatomical parts were the lips and the tongue. In the clinical approach, oral and systemic evaluation, and disease management with CT plus chamomile tea were done. The patients were reassured, and their response to therapy one year after was found to be excellent despite few exacerbations in periods of great emotional stress. Thus, we conclude that psychological treatment is vital in the management of BMS, as CT, along with Matricaria recutita phytotherapy, displayed excellent results in the control of BMS.
- In vitro evaluation of shear bond strength of orthodontic stainless steel brackets using transillumination(2018) Dobrin, Keith R.; Bollu, Prashanti; Chaudhry, Kishore; Subramani, KarthikeyanThe objective of this study was to compare the effect of transillumination techniques to conventional light curing on shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic stainless steel brackets. 240 extracted human maxillary incisors, canines and premolars were randomly separated into four control and four experimental groups, based on tooth type. Labio-lingual thickness was measured. Control groups were light cured from buccal surface and experimental groups from lingual surface (transillumination) from four directions (mesial-distal, incisal-direct, direct, mesial-distal-incisal). SBS was measured using an Instron machine and ARI evaluated by microscopic inspection. Mean SBS on maxillary central incisors was lower when cured from lingual side in comparison with buccal side for three light cure directions, but direct cure direction showed nearly equal SBS. Statistical significance was observed for mesial-distal cure direction only. In contrast to central incisors, lateral incisors showed a higher mean SBS when treated from lingual side, for two cure directions (mesial-distal and incisal-direct) with statistical significance observed only for mesial-distal light cure direction. Mean SBS was lower when cured from lingual direction in comparison with buccal direction for all cure directions for canines and premolars. For canines statistical significance was observed for all directions, except incisal-direct; whereas for premolars statistical significance was observed for direct and mesial-distal-incisal directions only. Transillumination is an effective and clinically acceptable light curing technique for bonding orthodontic stainless steel brackets to maxillary central and lateral incisors. For the other teeth groups (canines and premolars) tested, the mean SBS values, using transillumination light curing fell below the acceptable clinical SBS values, indicating that transillumination is not beneficial in light curing brackets on these teeth.
- Association between oral findings and laboratory tests in children and adolescents undergoing dialysis : a cross- sectional study(2018) Esmaeeli, Aida; Esmaeeli, Mohamad; Ebrahimi, Masoumeh; Nasehi, AtefehDiagnosis of oral complications in the dialysis patients is important to prevent potential infections. The aim of this cross-sectional study was to compare oral findings in dialysis patients with healthy individuals and determination of the correlation of these findings and laboratory tests. In this cross-sectional study, DMFT, dmft, DI , CI , OHIS , PI, GI and enamel defects were evaluated in 25 hemodialysis patients, 30 peritoneal dialysis patients and 26 healthy individuals. Then the correlation of laboratory tests (including Hemoglobin, Urea, Creatinine, Ca, Na, Ph, K and ALP) and oral findings was determined in each groups using SPSS (Version 16). Data analyzed with One-way ANOVA test, Chi-Square , Kruskal-Wallis , Tukey?s test and Fisher?s-Exact test. Findings revealed significant differences in dmft, DI, CI, OHIs, PI and GI between study groups. A positive correlation between Ca and DI was found in hemodialysis group. In peritoneal dialysis group positive significant correlations between DMFT index and Urea, Cr , ALP and K , between OHIs and K , between PI and Cr and negative correlations between Na and CI and OHIs were found. Presence of oral problems in dialysis patients, especially hemodialysis, indicate the necessity of appropriate therapeutic considerations in these patients. The correlation of blood biochemical compounds and oral status in dialysis patients may warn clinicians to control the level of the biochemical blood compounds for oral health improvement.
- CBCT assessment of radicular volume loss after rapid maxillary expansion : a systematic review(2018) Lo Giudice, Antonino; Galletti, Cosimo; Gay Escoda, Cosme; Leonardi, RosaliaThe present systematic review analyzed the current literature to investigate whether rapid maxillary expansion (RME) causes radicular resorption, assessed by cone-beam computed tomography (CBCT). Eighteen electronic databases and reference lists of studies were searched up to November 2017. Grey literature was also screened. To be included, articles must be human studies on growing subjects with transversal maxillary deficiency treated with maxillary expansion protocol and with 3-D radiographic assessment of radicular volume by CBCT images. Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics (study design, sample size, age, sex, skeletal maturity, type of appliance, daily activation, teeth evaluated, CBCT settings), and study outcomes (radicular volume loss) were reported according to the PRISMA statement. Only 3 articles were considered eligible and an individual analysis of the selected articles was undertaken. The risk of bias assessment revealed low methodological quality for all the studies included. In all the considered studies, significant radicular volume loss was observed in posterior teeth, following RME. When reported in percentage, the radicular volumetric loss was similar between anchored (first molars and first premolars) and unanchored teeth (second premolars). A preliminary evaluation of the patient-related risk factors for RR is warmly advisable when administering RME.
- Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession(2018) Jenabian, Niloofar; Motallebnejad, Mina; Zahedi, Ehsan; Sarmast, Nima D.; Angelov, NikolaSeveral researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession. Twenty-two teeth with Miller Class I gingival recession in 6 patients 26 ? 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA. After 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months. Both CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect.
- The efficacy of 1% Betadine mouthwash on the incidence of dry socket after mandibular third molar surgery(2018) Hasheminia, Dariush; Moaddabi, Amirhossein; Moradi, Saeid; Soltani, Parisa; Moannaei, Mahsa; Issazadeh, MaryamDry socket or alveolar osteitis is a delayed healing of alveolar bone after exodontia causing moderate to severe pain 2-4 days after extraction of teeth. Antibacterial agents such as antibiotics and chlorhexidine have been previously proved to prevent or reduce the incidence of dry socket. Betadine is a mixture of iodine and povidone which has bactericidal, antifungal and antiviral effects. The aim of the present study was to evaluate the effect of preoperative povidone iodine 1% mouthwash before surgical extraction of impacted mandibular third molar, however age, gender and oral hygiene were also considered. 189 patients who needed surgical extraction of Pell and Gregory class A and B mandibular third molars were included in this study. The patients who were not willing to participate in the study, took, women who took oral contraceptives or were in the first 22 days of menstrual cycle were excluded. Patients were randomly assigned to control or test group. 97 patients in the test group took preoperative povidone iodine 1% mouthwash and 92 patients in the control group didn?t take any antibiotic or mouthwash. Patients were examined in days 3 and 7 postoperatively for incidence of alveolar osteitis. Chi-square test didn?t show any significant relation between dry socket incidence and gender (p value: 0.848) and Oral hygiene (p value: 0.866). However, it revealed a significant relation between age and dry socket incidence (p value: 0.003) and patients older than 30 were reported to have higher incidence of dry socket. Independent T-Test showed a significant difference between the test and control group in incidence of dry socket (p value: 0.036). Based on the results of this study povidone iodine 1% mouthwash can decrease dry socket incidence also as the age increases, the incidence of dry socket becomes higher.
- Influence of different restorative materials on the stress distribution in dental implants(2018) Datte, Carlos-Eduardo; Tribst, João Paulo Mendes; Dal Piva, Amanda-Maria-de Oliveira; Nishioka, Renato Sussumu; BOTTINO, Marco Antônio; Evangelhista, Alexandre-Duarte M.; Monteiro, FabrÃcio M de M.; Borges, Alexandre- Luiz-SoutoTo assist clinicians in deciding the most suitable restorative materials to be used in the crowns and abutment in implant rehabilitation. For finite element analysis (FEA), a regular morse taper implant was created using a computer aided design software. The implant was inserted at the bone model with 3 mm of exposed threads. An anatomic prosthesis representing a first maxillary molar was modeled and cemented on the solid abutment. Considering the crown material (zirconia, chromium-cobalt, lithium disilicate and hybrid ceramic) and abutment (Titanium and zirconia), the geometries were multiplied, totaling eight groups. In order to perform the static analysis, the contacts were considered bonded and each material was assigned as isotropic. An axial load (200 N) was applied on the crown and fixation occurred on the base of the bone. Results using Von-Mises criteria and micro strain values were obtained. A sample identical to the CAD model was made for the Strain Gauge (SG) analysis; four SGs were bonded around the implant to obtain micro strain results in bone tissue. FEA results were 3.83% lower than SG. According to the crown material, it is possible to note that the increase of elastic modulus reduces the stress concentration in all system without difference for bone. Crown materials with high elastic modulus are able to decrease the stress values in the abutments while concentrates the stress in its structure. Zirconia abutments tend to concentrate more stress throughout the prosthetic system and may be more susceptible to mechanical problems than titanium.
- Mucocele of the dorsal surface of the tongue : a case report(2018) Titsinides, Savvas; Kalyvas, Demos; Tosios, Konstantinos I.Mucoceles represent one of the most common lesions of the oral cavity, developing as a result of saliva accumulation. The most frequent affected area is the lower lip, followed by floor of mouth, ventral tongue and buccal mucosa. Despite numerous reports of mucoceles originating on the ventral surface of the tongue, only scarce cases of such a lesion identified on the dorsal tongue surface have been described. In this report a mucocele developed on the dorsal tongue of a 74-year-old woman is described. Additionally a review of previously published mucoceles of the dorsal surface of the tongue is provided and discussed. A 74-year-old female patient was referred for a painless swelling on the dorsal surface of the tongue of 1 month duration. Possible clinical diagnosis included granular cell tumor and lingual thyroid gland. Proper blood testing for TSH, T3 and T4 as well as ultrasonography were requested, found to be within normal limits. An excisional biopsy was performed and tumor was removed with no intra-operative complications. Histopathological examination was consistent with a mucocele, exhibiting an amorphous material surrounded by granular connective tissue without epithelial lining on the periphery. Patient was examined on regular follow-up basis, with no signs of recurrence for the last 1 year. Mucoceles of the dorsal tongue surface represent rare clinical entities, necessitating the need for further case reports to be published in order to widen our understanding of their clinical features.
- The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects(2018) El Assal, Dina-Wahied; Saafan, Ali-Mohamed; Mostafa, Dina; Al-Sayed, Marwa-AdelThe aim of this study was to evaluate the effect of combining fractional CO2 LASER and nanohydroxy apatite on surface microhardness and color of enamel with initial defects. Two types of nano hydroxylapatite (nHAP) was prepared; Pure hydroxyapatite (nHA) and Fluoro hydroxyapatite (nFHA), Sixty extracted premolar teeth without visible caries or structural defects on enamel surface were used, immersed in 10 ml of a demineralizing solution for 2 weeks to create artificial white spot lesions, they were randomly allocated into two groups; Group 1: nHA, Group 2: nFHA, each group is then subdivided into 2 subgroups (A and B) where two different in vitroremineralization procedures have been performed, the first procedure utilizes a 10?wt% nHA aqueous slurries only, the second was first exposed to irradiation from a fractional CO2 laser then (nHAP) was applied. Microhardness and color were measured using a micro-Vickers hardness tester and spectrophotometer respectively. Laser treated teeth in both groups showed the highest mean hardness and lowest color difference where ?E was less than 3.3 units, in both tests the pure type of nanohydroxyapatite gave better results than the nanofluroapatite type. Nano-hydroxyapatite has remarkable remineralizing effects on initial lesions of enamel, certainly higher when combined with laser application.
- Evaluation of a fluorosis prevention educational program : a randomized field trial(2018) Aguilar DÃaz, Fátima del Carmen; Irigoyen Camacho, MarÃa Esther; Borges Yañez, AÃda S.A 2-group randomized field trial was conducted to evaluate the impact of a fluorosis educational preventive program in mother´s knowledge and practices, and on the urine fluoride concentration of their preschool children. A group of 139 mother-child pairs participated in the study. Randomly, children were assigned to an intervention group, their mothers were participants of an educational program, or a control group (CG); including 69 and 70 child-mother pairs, respectively, the follow-up period was six months. Mother´s knowledge and practices were evaluated and children´s first urine sample was used to measure fluoride concentration at the beginning of the study and at the end of the follow-up period. The mean age of the children was 4.18 (sd 0.62) years-old at baseline. Mothers in the IG improved their knowledge and practices associated with fluorosis risk factors. Adequate knowledge about the amount of toothpaste to use for brushing improved in the IG (p=0.006). In 82.1% of the children in the IG showed decrease in urine fluoride concentration was observed (p< 0.001), no significant differences were shown in the CG. Mothers participating in an education program improved their knowledge and practices, reducing the risk of dental fluorosis in their children who showed a decreased on their urine F concentration.
- Utilization of pedicled buccal fat pads for coverage of the lateral relaxing wound : a review of literature and a case series of 15 patients(2018) Ruslin, Muhammad; Hajrah-Yusuf, Andi S.; Tajrin, Andi; Lo, Lun-Jou; Forouzanfar, TymourThe buccal fat pad (BFP) is an encapsulated mass originated from a specific fat tissue in various volume throughout the life of each person and BFP has been used in various surgeries as a source of useful graft material due to its easy accessibility and rich vascularization. This report describes fifteen patients who were treated with buccal fat pads (BFP) as a pedicled graft for lateral relaxing wound closure in primary cleft palate surgery. A review of relevant literature is also presented. All patients had a mean follow-up of 3.7 weeks with a minimum follow-up time of three weeks and a maximum follow-up of four weeks. All patients who had an uneventful immediate postoperative period showed signs of BFP epithelialization characterized by a yellowish tissue beginning in the first week and ending within 3?4 weeks after surgery. The use of BFP for the small to medium-sized defects reconstruction in palatoplasty is a safe and reliable method with fast healing. Even older patients who would not be able to tolerate time-consuming flap reconstruction procedures had good results.
- On the search of the ideal barrier membrane for guided bone regeneration(2018) Caballé-Serrano, Jordi; Munar-Frau, Antonio; Ortiz Puigpelat, Octavi; Soto-Peñaloza, David; Peñarrocha Diago, Miguel; Hernández-Alfaro, FedericoGBRs are essential procedures in implant dentistry and periodontology where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes function the same way, as they differ from their origin and structure, it is important to understand how membranes behave and differ one from others in order to achieve a predictable treatment. A systematic search on Medline by two independent reviewers was performed for articles published until July 2017 reporting the characteristics or properties of barrier membranes. The question that preceded the search was designed according to PICO rules. A total of 124 articles were initially identified from electronic searching. After abstract/full-text review, 21 were included for a systematic review. According to the extracted data and article analysis, barrier membranes should fulfill the following criteria in order to success: biocompatibility, space maintaining, occlusive function, easy - handling and a bioactivation friendly property. With the development of new biomaterials and surfaces, a great advance in this area is expected. It has been clearly described that biocompatibility is the most important requirement to take into account when choosing a membrane, but other factors such as space maintaining capacity, cell oclusiveness, easy handling and bioactivation friendly materials are the ones that will fulfill our necessities.
- Temperature changes in 2% chlorhexidine gluconate using two activation methods with different intensity levels(2018) González, Carlos; Forner Navarro, Leopoldo; Llena Puy, MarÃa Carmen; Lozano Alcañiz, AdriánChlorhexidine is an irrigant solution widely used in root canal treatment because of its good antimicrobial properties. However, its mixture with sodium hypochlorite results in the appearance of substance called p-chloroaniline, a cytotoxic substance. This is also found when chlorhexidine is heated. The use of passive ultrasonic irrigation is related to an irrigant thermal increase, which can cause the appearance of p-chloroaniline. Thus, the objective is to establish the influence of ultrasonic and sonic activation, with the use of different intensities, upon the temperature of chlorhexidine gluconate (CHX). The following groups were established: control (without activation), ultrasonic activation and sonic activation. A 0.5-ml volume of CHX was placed in an Eppendorf tube in a thermo-static bath at 37ºC. Both methods resulted in immediate CHX activation. The temperature was recorded every 30 seconds between 60 and 180 seconds. The statistical analysis was performed based on the Mann-Whitney U-test. Both groups subjected to activation showed higher temperatures than the control group, and increased activation intensity was associated to greater temperature increments in both activated groups. Both ultrasonic and sonic activation are correlated to temperature increase in CHX.
- Effect of laser heat treatment on Pull-out bond strength of fiber posts treated with different silanes(2018) Shafiei, Fereshteh; Saadat, Maryam; Jowkar, ZahraThis study evaluated the effect of three different silanes and post-silanization treatments on the retentive strength of fiber posts luted with an etch-and-rinse resin cement. One hundred intact maxillary central incisors were randomly divided into 10 groups after endodontic treatment and post space preparation (n=10). The fiber posts were etched using 24% hydrogen peroxide. Posts of the control group did not receive silane. In nine experimental groups, each of the three silanes used, Scotchbond Universal adhesive, Bis-Silane and Porcelain Primer, was subjected to three treatments: air-drying at 25°C, warm air-drying and CO2 laser heat treatment. After cementation of the treated posts using One-Step Plus/Duo-Link cement, the specimens were stored for one weak and then subjected to pull-out bond strength (PBS) testing. The data in Newton (N) were analyzed using two-way ANOVA and Tukey tests (?=0.05). PBS was significantly affected by silane type and post-silanization treatment (p<0.001). The interaction of the two factors was not statistically significant (p=0.15). The effect of Porcelain Primer on PBS was significantly higher than those of universal adhesive (p<0.001) and Bis-Silane (p=0.01), with similar results for the two latter. Warm air-drying and laser treatment significantly increased PBS (p<0.001). The lowest and highest PBS was obtained in the control (no silane) group (190.9±31) and laser-treated/ Porcelain Primer group (377.1±50), respectively. Warm air-drying and CO2 laser heat treatment had a significantly beneficial effect on retentive strength of fiber posts. Porcelain Primer was significantly more effective than universal adhesive and Bis-Silane.
- Evaluation of salivary parameters and dental status in adult hemodialysis patients in an indian population(2018) Shetty, Preethesh; Hedge, Mithra N; Eraly, Sunil M.Renal failure is a process that expresses a loss of functional capacity of the nephrons, independently of its etiology. The most widely used technique to combat renal failure is hemodialysis. Renal failure causes various systemic alterations including oral complications such as variations in the flow and composition of the saliva. Caries is a multifactorial disease and impaired stimulated salivary flow rate and buffering capacity are the best-known risk factors. The present study aims to evaluate the salivary pH, buffering capacity and the flow rate of saliva to the DMFT status in adult hemodialysis patients among the Indian population. Twenty healthy individuals and sixty patients undergoing hemodialysis were divided into four groups based on the following criteria: Group 1: Control group; healthy individuals,Group 2: Patients before undergoing dialysis or undergoing dialysis<3 months, Group 3: Patients undergoing dialysis since 6 months-2 years, Group 4: Patients undergoing dialysis>2 years. Dental examinations were performed according to the modified WHO oral health survey 2013 criteria and DMFT index. Saliva was collected after pre-stimulation to measuring the flow rate, buffering capacity and pH. The results exhibited a decrease in the salivary flow rate and buffering capacity with the increase in the time interval of hemodialysis, but salivary pH was found to be increasing with time. A direct relationship was seen between the DMFT scores with the increasing time interval. There was a significant correlation between DMFT index, stimulated salivary flow rate, and buffering capacity in the patients. Oral health impairment can beacon to grave problems in infection-prone hemodialysis patients. Hence, the patients on hemodialysis should have regular dental examinations and treatment. Regular dental examination and instruction in patients awaiting a renal transplantation is of vital importance to ensure optimal oral health.
