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Language Journal of Clinical and Experimental Dentistry. 2017. Vol. 9, no. 10
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- Composition and physicochemical properties of calcium silicate based sealers : a review article(2017) Jafari, Farnaz; Jafari, SanazBackground: Recently a new generation of endodontic sealers has been developed based on calcium silicate as MTA Fillapex, Endoseal MTA, Total Fill BC Sealer, EndoSequence BC Sealer, iRoot SP, Endo CPM sealer, MTA- Angelus and ProRoot Endo Sealer. A review of literature was conducted to discuss the composition, physicochemical properties, and clinical perspectives of calcium silicate based sealers. Material and Methods: A literature search was conducted in PubMed and web of knowledge databases with appropriate MeSh terms and keywords. A total of 71 studies were reviewed for data extraction. Results and Conclusions: Calcium silicate based sealers showed suitable physical properties to be used as an endodontic sealer. However, its high solubility remains an important issue. They show good performance regarding calcium ion release, film thickness, and fowability. More researches are required about features of calcium silicate based sealers before recommending them for clinical applications.
- Solubility and pH of bioceramic root canal sealers : a comparative study(2017) Poggio, Claudio; Dagna, Alberto; Ceci, Matteo; Meravini, Maria-Vittoria; Colombo, Marco; Pietrocola, GiampieroBackground: This study compared the solubility and the pH of different root canal sealers in vitro . Material and Methods: BioRoot?RCS, TotalFill BC Sealer, MTA Fillapex, SealapexTM, AH Plus, EasySeal, Pulp Canal Sealer? and N2 were tested. Similar specimens were prepared using ring molds with an internal diameter of 20 ± 0,1 mm and a height of 1,5 ± 0,1 mm and digitally weighted to register the mass of each specimen before and after immersion in distilled water. Solubility was determined after 24 hours and statistically analysed using a one-way ANOVA test and post-hoc Tukey test. The pH value was measured by a digital pH meter after 3 and 24 hours from manipulation. Results: BioRoot?RCS and TotalFill BC Sealer showed significantly higher solubility ( P < 0.05). All the remnant root canal sealers fulfilled the requirements of solubility of the International Standard Organization 6876 demonstrating a weight loss of less than 3%. BioRoot?RCS and Totalfill BC Sealer exhibited high alkaline pH over time ( P < 0.05); the alkalinity of the other tested cements was significantly lower . Conclusions: The prolonged alkalinity of bioceramic sealer matched the increase in solubility. This may encourage their biological and antimicrobial effects, but the ongoing solubility may impact their ability to prevent apical leakage.
- Is Khat (Catha edulis) chewing a risk factor for periodontal diseases? : a systematic review(2017) Kalakonda, Butchibabu; Al-Maweri, Sadeq A.; Al-Shamiri, Hashem M.; Ijaz, Anum; Gamal, Shukry; Dhaifullah, EsamBackground: Khat (Catha edulis) chewing is a highly prevalent habit in the Arabian Peninsula and East Africa, and has recently spread to Western countries. The association between khat chewing and oral mucosal lesions is well documented in the literature. However, there is no concrete evidence on the association between khat chewing and periodontal disease. The purpose of this systematic review was to analyze the influence of khat chewing on periodontal health. Material and methods: A literature search of PubMed, Scopus and Web of Sciences databases was carried out to identify relevant articles published from 1990 to May 2017. The inclusion criteria were all clinical studies that assessed the relationship between khat chewing and periodontal disease. Results: The search yielded 122 articles, of which 10 were included in this systematic review. Most of the studies exhibited a positive correlation between khat chewing and periodontal disease. Conclusions: Altogether, the analysis of the current evidence reveals that khat chewing is destructive to the periodontium and enhances the risk of periodontal disease progression. However, due to variability of studies, more longitudinal case-controlled studies are highly warranted to establish a causal relation between khat chewing and periodontal disease.
- Clinical and radiographic features of pycnodysostosis : a case report(2017) Rodrigues, Cleomar; Gomes, Fernando-Antônio; Arruda, José A.; Silva, Luciano; Alvares, Pâmella; da Fonte, Priscila; Sobral, Ana-Paula; Da Silveira, Márcia María FonsecaPycnodysostosis is a rare disorder that was first described in 1962; however, it was only in 1996 that the defective gene was discovered, which led to a better understanding of this disease. This study reports and discuss a case of pycnodysostosis. In addition, a search of articles published in PubMed-Medline was performed. The case was a 13-year-old girl who was referred to a private clinic for dental treatment. Clinical examination showed midface hypoplasia, prominent cheeks, a high nasal bridge, beaked nose, spoon-shaped fingers, frontal bossing, open fontanelles and dental alterations, findings compatible with pycnodysostosis. Patients with this disease also suffer from fractures because of bone hardness with almost no elasticity, a fact that requires special care particularly in the case of children and adolescents. The diagnosis of pycnodysostosis is made based on clinical and radiographic findings. Clinicians should be aware of this disorder to provide adequate dental treatment.
- Tooth abnormalities in individuals with unilateral alveolar clefts : a comparison between sides using cone-beam computed tomography(2017) Bezerra, Bruno-Torres; Pinho, John-Nadson-Andrade; Silva, Luiz Carlos F.Background: Tooth abnormalities are most often present in individuals with oral clefts than general population, and lead to a long-term impact on facial anatomy and self-esteem. The purpose of this study was to compare the proportion of dental anomalies between the cleft side and non-cleft side in individuals with non-syndromic unilateral alveolar clefts (AC). Material and Methods: Twenty cone beam computed tomography (CBCT) scans were converted into threedimensional (3D) virtual models. The dental anomalies considered were: tooth agenesis; supernumerary teeth; giroversion; and microdontia. Statistical analysis was performed using the McNemar?s test and Fisher?s exact test ( p < 0.05). Results: Statistically significant differences were not found either between the prevalence of individuals with dental abnormalities on the non-cleft side and the sides of the AC ( p = 1.00), or sex ( p = 0.36). Tooth agenesis was the most prevalent dental anomaly (55.6%). On the cleft side the lateral incisor was tooth most involved by dental anomalies; and the second premolar was the most affected on the non-cleft side. Conclusions: This study showed a high frequency of dental anomalies in the cleft individuals and indicated that the side of AC and sex do not interfere in the proportion of dental anomalies on non-cleft side.
- Peek polymer in orthodontics : a pilot study on children(2017) Ierardo, Gaetano; Luzzi, Valeria; Lesti, Michela; Vozza, Iole; Brugnoletti, Orlando; Polimeni, Antonella; Bossù, MaurizioThe purpose of the study has been making the orthodontic space maintainers in PEEK polymer (Polyetheretherketone) through a digital workflow. New digital technologies are taking hold in diagnosis, therapy and in dental laboratories. The digital world can help dentist in diagnosis and therapy: -diagnosis through the acquisition of radiographic images (CBCT) or scanners which allow the creation of 3D digital models ? about therapy thanks to dental CAD CAM system. It consists of design devices through an dedicated software CAD and then realize devices through CAM system. We used digital system to improve the quality of the treatment and reduce costs. Peek polymer, subject of studies in recent years, thanking to its characteristics, resulted useful for this study. According to a nine month- follow up the devices were found comfortable, satisfying, personalized and minimally visible for the patients. These devices were found suitable to maintain the space. About material, thanks to its dimensional stability, mechanical strength but specially, thanks to its biocompatibility, PEEK was found as a very good material to build space maintainers. The workflow allowed a simulation of the treatment plan with a better collaboration and acceptance of the patient. Digital system reduced the systematic mistakes during the various phases and the production time. The digital system saved space creating a virtual plaster casts collection.
- The effect of oxalate-based desensitizers on the microleakage and shear bond strength of resin modified glass ionomer(2017) Firouzmandi, Maryam; Valipour, Fereshteh; Roshanzamir, Maryam; Mobaleghi, TayebehBackground: The first line of intervention to alleviate tooth sensitivity is to use dentin desensitizers such as oxalate-based desensitizers. When the dentin sensitivity continues even after application of desensitizers the next intervention would be restoration of the lesion. The aim of this in vitro study was to investigate the effect of prior application of oxalate-based desensitizer on the marginal microleakage and shear bond strength of resin modified glass ionomer (RMGI) restorations. Material and Methods: In order to prepare the specimens for microleakage test standard class v cavities were prepared on buccal surfaces of 45 teeth. The specimens were randomly divided into three equal groups. In control group, the cavities were restored with RMGI. In group 2, oxalate-based desensitizer was applied and the specimens were kept in distilled water for 14 days before restoration. In group 3 the specimens were prepared similar to group 2 and the surface of the cavities were slightly cut with bur before restoration. Methyleneblue penetration was evaluated using stereomicroscope. The data were analyzed using non-parametric tests. For shear bond strength test cervical dentin specimens were prepared and were divided into 3 groups. Surface treatments were similar to microleakage test. RMGI was packed into cylindrical plastic molds which were placed on the cut surface of the tooth and light cured. The data were analyzed by one-way ANOVA. Results: There was not any significant difference in dye penetration in dentin margins among the groups, but microleakage in enamel margins of group 2 and 3 was higher than group 1. There was no significant difference in shear bond strength among the groups ( p =0.285). Conclusions: Non carious cervical lesions which were treated for hypersensitivity with oxalate-based desensitizers could be restored with resin modified glass ionomer if the hypersensitivity persists.
- Preparation prerequisites for effective irrigation of apical root canal : a critical review(2017) Tziafas, Dimitrios; Alraeesi, Dana; Al Hormoodi, Reem; Ataya, Maamoun; Fezai, Hessa; Aga, NausheenBackground: It is well recognized that disinfection of the complex root canal system at the apical root canal remains the most critical therapeutic measure to treat apical periodontitis. Materials and Methods: Observational and experimental data in relation to the anatomy of the apical root canal in different tooth types and the cross sectional diameters of the apical part of the most commonly used hand and rotary files are critically reviewed. Results: The present data analysis confirm that the challenging issue of antibacterial efficacy of modern preparation protocols in non-surgical endodontics requires more attention to apical root canal irrigation as a balance between safety and effectiveness. Ex vivo investigations clearly indicate that a specific design of the chemo-mechanical preparation is needed at the onset of RCT, more particularly in infected teeth. Design should be based on specific anatomical parameters, and must determine the appropriate size and taper of preparation as pre-requirements for effective and safe apical irrigation. Conclusions: The optimal irrigation protocols might be designed on the basis of technical specifications of the preparations procedures, such as the penetration depth, the type of the needle, the required time for continuous irrigant flow, the concentration of NaOCl, and the activation parameters.
- The effect of social geographic factors on the untreated tooth decay among head start children(2017) Heima, Masahiro; Ferretti, Margaret; Qureshi, Mehveen; Ferretti, GeraldBackground: Disparities among untreated dental caries exist for children from low-income families in the United States. Understanding of the mechanism of the disparities is required to reduce it and social geographic factors are one of the important influences. Although the effect of fluoridated water has been well reported, studies of other sociogeograpic factors, such as the density of available dentists, are still very limited. The objective of this study is to explore the effect of sociogeographic factors on the number of primary teeth with untreated dental caries among children from low-income families who are enrolled in Head Start programs throughout Northeast Ohio of the United States. Material and Methods: This was a cross-sectional chart review study. Three hundred-eighty-eight charts were reviewed, and the number of primary teeth with untreated dental caries (dt) and the children?s addresses were re trieved. The sociogeographic variables, including fluoridated water availability and the density of available dentists who accept a government-supported insurance (Medicaid dentists), were collected. Results: The mean (standard deviation) of children?s age was 3.51 (1.14) years with a range of 7 months to 5 years. A negative binomial regression model analysis, which used dt as a dependent variable and children?s characteristic factors (i.e. age, gender, insurance type, and total number of primary teeth) and sociogeographic factors (i.e. Po pulation, total number of Medicaid dentists, density of Medicaid dentist, and Fluoride water availability) of cities, as independent variables, demonstrated that only the density of Medicaid dentist in the sociogeographic factors indicated a significant effect (Estimated ß-Coefficients (Standard Errors)=-0.003 (0.002), p =0.030). Conclusions: This study demonstrated a significant negative association between the density of available dentists and untreated dental caries among children from low-income families in Head Start programs in Northeast Ohio. Increasing available dentists may be a strategy to reduce the number of early childhood caries.
- Oral manifestations of gastrointestinal disorders(2017) Jajam, Martin; Bozzolo, Patricia; Niklander, SvenBackgroud: A considerable number of gastrointestinal disorders (GIDs) of varied nature (inflammatory, infectious, genetic and other etiology) may produce alterations in the hard and soft oral tissues. Among these are Crohn?s disease, ulcerative colitis, celiac and gastroesophageal reflux disease. Material and Methods: Article search was done using the National library of medicine (PubMed) database using different search terms and analyzed according to their importance. Results: A large variety of GIDs can give rise to oral lesions, including: RAS like ulceration, mucosal tags, cobblestoning, mucogingivitis, labial and facial swelling, pyostomatitis vegetans, disgeusia and dental abnormalities, among others. Although in most cases the gastrointestinal signs and symptoms highlight in the clinical picture, a considerable percentage of these patients are affected by oral manifestations before the onset of gastrointestinal symptoms. This lesions can cause significant functional and aesthetics damages as well deteriorate the patient quality of life. Conclusions: Although the frequency of oral manifestations is variable across GIDs and in most cases is non-specific, these alterations may precede the underlying disease and therefore can facilitate an opportune diagnosis
- Trends over Time in Dental Caries status in Urban and Rural Thai Children(2017) Srisilapanan, Patcharawan; Nirunsittirat, Areerat; Roseman, JeffreyBackground: Historically, the prevalence of dental caries was higher in urban areas than rural areas of Thailand. This study aim to examine the time trends in caries status in children in Thailand. Material and Methods: Linear regression was used to examine trend of dental caries prevalence and mean number of teeth with caries, filled and missing due to caries (dmft/DMFT) in urban and rural, of 3-, 5-6 and 12-year olds from seven Thailand National Oral Health Surveys conducted approximately every 5 years from 1977 to 2012. Results: There were declines in the caries prevalence and mean dmft/DMFT in every age group. Significant results were observed in the mean dmft of 3 year-olds and the mean DMFT of 12 year-olds ( p = 0.03 and p=0.05, respectively). A significant trend of declining prevalence of dental caries was observed in urban children ages 5-6 ( p =0.002), along with urban 12 year-olds ( p <0.001). A declining trend of mean dmft for 3 and 5-6 year-olds, and mean DMFT for 12 year-olds was observed in both rural and urban areas, but significant results were shown in urban 3 and 5-6 year-olds ( P =0.04, and p <0.001, respectively), and urban 12 year-olds ( p =0.001). For restoration outcome, both urban and rural of all age groups have an increasing trend of mean ft/FT index. Conclusions: There have been differences over time in the prevalence and quantity of dental caries between urban and rural school children. A significant reduction was observed in urban areas. More effort needs to be given to supply rural areas in order to have fair and equal access of all citizens to oral health care.
- Micro-CT study of the root canal anatomy of maxillary canines(2017) Plascencia, Hugo; Cruz, Álvaro; Palafox Sánchez, Claudia Azucena; Díaz Haro, Ana; Lopez, Claudia; Bramante, Clovis Monteiro; Moldauer, Bertram I.; Ordinola Zapata, RonaldBackground: This study aimed to describe the anatomy of maxillary canines from a Western Mexican sub-population using micro-computed tomography (micro-CT). Material and methods: Maxillary canines (n=32) were scanned at 19.6?m voxel resolution. Number and location of canals, the distance between the cemento-enamel junction and apex, occurrence of accessory and lateral canals, presence of oval canals, number of foraminas as well as two- (area, perimeter, roundness, aspect ratio, major and minor diameters) and three-dimensional (volume, surface area, and SMI) analysis were performed. Data of two- dimensional analyses at 5 different apical levels was statistically compared using Kruskal-Wallis tests (?=0.05). Results: Overall, 31 specimens had one root with a main canal (Vertucci type I). Mean distance from the apex to the cemento-enamel junction was 16.32±2.27. Apical foraminas were present in 14 specimens (43.75%). No statistical differences were found in the two-dimensional analyses between the foramen and the 1 and 2mm apical levels ( P >0.05). Conclusions: Maxillary canines presenting one root canal were present in a high percentage of cases (96%). The prevalence of long oval canals was <12% at the apical third and at least 37% of the sample showed more than one point of exit in the last apical 3mm
- Vertical Root Fracture initiation in curved roots after root canal preparation : a dentinal micro-crack analysis with LED transillumination(2017) Miguéns Vila, Ramón; Martín Biedma, Benjamín; Varela Patiño, María Purificación; Ruíz Piñón, Manuel; Castelo, PabloBackground: One of the causative factors of root defects is the increased friction produced by rotary instrumentation. A high canal curvature may increase stress, making the tooth more susceptible to dentinal cracks. The purpose of this study was to evaluate dentinal micro-crack formation with the ProTaper NEXT and ProTaper Universal systems using LED transillumination, and to analyze the micro-crack generated at the point of maximum canal curvature. Material and Methods: 60 human mandibular premolars with curvatures between 30?49° and radii between 2?4 mm were used. The root canals were instrumented using the Protaper Universal® and Protaper NEXT® systems, with the aid of the Proglider® system. The obtained samples were sectioned transversely before subsequent analysis with LED transillumination at 2 mm and 8 mm from the apex and at the point of maximum canal curvature. Defects were scored: 0 for no defects; and 1 for micro-cracks. Results: Root defects were not observed in the control group. The ProTaper NEXT system caused fewer defects (16.7%) than the ProTaper Universal system (40%) ( P <0.05). The ProTaper Universal system caused significantly more micro-cracks at the point of maximum canal curvature than the ProTaper NEXT system ( P <0.05). Conclusions: Rotary instrumentation systems often generate root defects, but the ProTaper NEXT system generated fewer dentinal defects than the ProTaper Universal system. A higher prevalence of defects was found at the point of maximum curvature in the ProTaper Universal group.
- The effect of pre-cure bracket movement on shear bond strength during placement of orthodontic brackets, an in vitro study(2017) Tam, Byron; Bollu, Prashanti; Chaudhry, Kishore; Subramani, KarthikeyanBackground: The purpose of this study was to determine the influence of linear and rotational pre-cure bracket displacement during the bonding procedure on shear bond strength (SBS) of orthodontic brackets. Material and Methods: Stainless steel orthodontic premolar brackets were bonded to the buccal surfaces of 50 human pre-molars with a conventional two-step bonding protocol. Extracted human pre-molars were divided into 5 groups (n=10/group). In the Control Group, the brackets were bonded with no pre-cure bracket displacement or rotation. The Rotation Group was bonded with 45 degrees of pre-cure rotation. The Displacement Group was bonded with 2mm pre-cure linear displacement. The Rotation-Displacement Group was bonded with pre-cure movements of 45º counter-clockwise rotation and 2mm displacement. The Slippage Group was bonded with 2mm each of mesial and distal pre-cure linear displacement. Photo-activation was carried out on the lateral sides of the bracket. Shear debonding force was measured, 24 hours after initial bonding, with an Instron universal testing machine using a knife-edged chisel. Data was analyzed using one-way ANOVA test. Adhesive Remnant Index (ARI) was scored under 15x magnification. The ARI data was analyzed using the Chi-square test ( p -value < 0.05). Results: No statistically significant differences were detected among the control and experimental groups ( p = 0.331). The rotation and displacement group showed the highest mean SBS than all other groups. Mean SBS for all groups were above the clinically acceptable range. No statistically significant differences were detected in ARI scores among groups ( p = 0.071). Conclusions: Linear and rotational pre-cure bracket displacements do not appear to effect the shear bond strength of orthodontic brackets.
- Influence of nicotine on machined- and anodized-surface implants. Histometric analysis(2017) Linden, Maria-Salete-Sandini; Paranhos, Luiz-Renato; De Carli, João-Paulo; Trentin, Micheline-Sandini; Bittencourt, Marcos Eugenio; dos Santos, Pamela Leticia; Groppo, Francisco Carlos; Ramacciato, Juliana CamaBackground: The nicotine may generate a influence on bone repair and longevity of dental implants. This fact makes studies to improve the surface of the implants are constantly conducted. This study aimed to evaluate the influence of subcutaneous nicotine injection in the osseointegration process on different implant surfaces, through histomorphometric analysis. Material and Methods: Therefore, twenty-two male rabbits were randomly distributed into two groups according to the subcutaneous injections: (1) nicotine, 3 mg/day/kg and (2) 0.9% NaCI, 3 mL/day/kg, three times a day. Subgroups were then designated - machined and anodized dental implants were installed in the right and left tibia bones, respectively. The animals were subjected to euthanasia after periods of eight weeks for histomorphometric analysis. The bone samples with implants were removed and the routine histological processing was performed. Next, the images obtained from the blades were evaluated by the Image Tool? software, assessing the osseointegrated areas of implants (BIC), in pixels. Data obtained were subjected to intergroup statistical analysis through the Kruskal-Wallis non-parametric test (?=5%). Results: The test result showed no statistically significant difference among the groups studied ( p =0.446). Conclusions: Based on the methodology studied, it is concluded that the daily application of low doses of nicotine did not interfere with the osseointegration of machined and anodized implants.
- Comparative analysis of impacted upper canines : panoramic radiograph vs cone beam computed tomography(2017) Pico, Catarina-Luís-Vicente-Rodrigues; do Vale, Francisco-José-Fernandes; Caramelo, Francisco; Corte-Real, Ana; Pereira, Sónia-Margarida-AlvesBackground: The use of CBCT exam in the study of IMC is not new. However, it?s still not known in what specific aspects CBCT exam shows a better result than then conventional exams. The aim of this study was to compare and conclude in what way the opinion regarding upper canine impaction differed when observing a panoramic image compared to the observation of a set of CBCT reconstructions. Materials and Methods: Twenty patients (10 males and 10 females) with a total of 28 impacted maxillary canines were identified from the database of the Department of Dentistry, Faculty of Medicine, University of Coimbra. For each canine, two different images were available: a panoramic image and a set of CBCT reconstructions. After a random distribution of both groups images, nine orthodontists completed a questionnaire where they were asked to evaluate ten different questions regarding canine impaction. Statistic analysis was performed using Cronbach?s alpha statistics, Kappa statistics and McNemar test, considering p<0,05 statistically significant. Results: This study showed differences between the two images regarding tooth position. A statistical significant poor agreement was found between the two methods for the mesio-distal position of the apex (k=0,388, p<0,001) and for the labio-palatal tip cusp position (k=0,035, p=0,114). The adjacent root resorption showed a poor and very poor agreement between the two methods. Every other items were scored with an agreement between modalities ranging from moderate to strong. Conclusions: The analyses of panoramic images versus CBCT images reconstructions provided different information regarding tooth position (especially concerning the mesio-distal apex position and the labio-palatal cusp position) but also in the assessment of root resorption. Further investigation should be done to determine in what cases CBCT exam has a clear advantage over conventional 2D exams, justifying its use
