Journal of Clinical and Experimental Dentistry. 2019. Vol. 11, no. 5

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    The impact of oral rehabilitation with implants in nutrition and quality of life : a questionnaire-based survey on self-perception
    (2019) Bugone, Érica; Vicenzi, Cristina-Balensiefer; Cardoso, Moisés-Zacarias; Berra, Luana; De Carli, João-Paulo; Franco, Ademir; Paranhos, Luiz-Renato; Linden, Maria-Salete-Sandini
    The association between tooth loss and masticatory problems may influence on food choices and consequently impact nutrition and quality of life. This study aimed to evaluate impact of oral rehabilitation with implants in nutrition and quality of life. A prospective study was performed. The Questionnaire for Healthy Habits (QHH) and the Oral Health Impact Profile-14 (OHIP-14) tools were used to assess nutrition and oral health status, respectively. Oral implants were placed and the adjacent the bone was radiographically assessed. The mean outcomes of the QHH between pre- and post-rehabilitation periods were assessed with the Wilcoxon Signed Rank test. The OHIP-14 was assessed using Fisher?s exact test. The implant surfaces showed a significant bone loss after six and 24 months of rehabilitation (p<0.001). There was no significant change in the masticatory pattern of patients (p>0.05). Nevertheless, the patients perceived a significant reduction in discomfort (p<0.02) when eating, after 24 months of the rehabilitation. These findings confirm the hypothesis that oral rehabilitation with implants may not trigger direct improvement in nutrition. However, it plays an especial role improving quality of life.
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    Efficacy of chlorhexidine, hydrogen peroxide and tulsi extract mouthwash in reducing halitosis using spectrophotometric analysis : a randomized controlled trial
    (2019) Sharma, Kriti; Acharya, Shashidhar; Verma, Eshan; Singhal, Deepak; Singla, Nishu
    To evaluate the efficacy of tulsi extract mouthrinse in reducing halitosis as compared to chlorhexidine and hydrogen peroxide mouthrinses using spectrophotometric analysis. It was a parallel, single center, double blinded randomized controlled trial of 15 days duration. A total of 300 participants were screened, out of which 45 subjects those fulfilled inclusion criteria of age range 17-35 years were included in the trial. The participants were randomly provided with tulsi, hydrogen peroxide or chlorhexidine mouthwashes (control group) to use 10 ml twice daily for 15 days. Clinical measurements were taken at baseline and 15 days using arbitrary 0-5 scale for organoleptic odor assessments, spectrophotometric analysis for Volatile Sulphide Compounds (VSCs) from saliva samples, Löe & Silness gingival index and Silness & Löe plaque index. After intervention, organoleptic, VSCs, gingival and plaque scores showed statistically significant decrease in all the three study groups. The mean percentage reduction in VSC and organoleptic scores was significantly greater in chlorhexidine and hydrogen peroxide groups than in the tulsi group and the mean percentage reduction in plaque and gingival scores was significantly greater in chlorhexidine group than in hydrogen peroxide and tulsi group. Tulsi may not have the efficacy of chlorhexidine and hydrogen peroxide mouthrinses. But, Tulsi is effective in reducing halitosis, plaque and gingivitis and with its lack of side effects & cost effectiveness, can be an effective & economic tool to deal with halitosis. The spectrophotometric technique appears to be a promising method for evaluation of oral malodor.
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    Conical connection adjustment in prosthetic abutments obtained by different techniques
    (2019) Camós-Tena, Roser; Escuin Henar, Tomás; Torné-Duran, Sergi
    The goal of this study is to compare the misfit (>150µm) generated once the restoration, made by different techniques, is retained to a single conical implant. 15 internal connection implants (MIS C1 4?20x10mm) are embedded each one perpendicularly to an horizontal surface of the 1x1x2cm poliuretan resin model. The 15 samples obtained are divided in 5 groups depending on the framework process (n=3): 1/casting, 2/overcasting, 3/Ti-base, 4/milling and 5/laser sintering. The cobalt-chromium alloy frameworks are screw-retained to their respective implants to a 30-Ncm torque. Once it is retained the framework to the implant, the next step is to section the sample in half with a diamond saw and verify the correct fit with a stereomicroscope, measuring 4 distances in each side (A, B, C and D). Data is submitted to one-way analysis of variance (ANOVA). According to equality of variances, significant differences are found in A and B measures (p=0,000 in left side in both groups and, p=0,007 and p=0,001 in right side). In C and D, there are not statistical differences (p=0,586 and p=0,110 in left side and, p=0,101 and p=0,089 in right side). However, once it has realized ANOVA test, only C retains the hypothesis and accepts independence. More samples are needed to conclude reliable statements. However, what it is observed is that milled group presents the best marginal fit. Overcasted and Ti-Base abutments also have good results above casted ones, and, sintered groups has the lowest result. Although, all systems have gaps below 150 µm, so all of them are good options for prosthetic rehabilitation.
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    Which factors influence orthodontists in their decision to extract? A questionnaire survey
    (2019) Evrard, Astrid; Tepedino, Michele; Cattaneo, Paolo M.; Cornelis, Marie A.
    To evaluate the relative influence of different criteria in the choice between extraction and nonextraction treatment in current orthodontics, and to assess how the percentage of extractions has evolved over time. Pre-treatment records (panoramic radiograph, lateral cephalogram, study casts and photographs) of fourteen cases in permanent dentition (adult or adolescent) with class I molar relationship and moderate anterior crowding were evaluated by 28 orthodontists. For each case, each orthodontist filled out a questionnaire reporting his treatment plan proposal (extraction or nonextraction) and the importance of specific parameters in his decision-making process, using categorical scales. Orthodontists practicing for more than 15 years were also asked to compare this decision with the one they would have taken at the beginning of their professional career. The two most important factors in the decision-making were the soft tissue profile and the amount of crowding. The least important factor was the presence of third molars. In cases of nonextraction treatment, the lack of space was managed mostly by dental expansion and stripping. Twenty percent of the case evaluations revealed extraction(s) decisions. Among the orthodontists practicing for more than 15 years, the current extraction rate reached 24%, whereas the same orthodontists reported they would have extracted in 39% of the cases in the past. The present study suggests that soft tissue profile has a higher impact than traditional criteria such as cephalometric measurements in the extraction decision. This is associated with a decreased extractions rate compared to the past.
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    Influence of different veneering techniques and thermal tempering on flexural strength of ceramic veneered yttria partially stabilized tetragonal zirconia polycrystalline restoration
    (2019) Juntavee, Niwut; Serirojanakul, Pitsinee
    Different technique for ceramic veneering and thermal tempering process are expected to be a reason for alteration in strength of ceramic veneered zirconia. This study evaluates the effect of different veneering technique and varied thermal tempering process on flexural strength of ceramic veneered zirconia. Ceramic veneered zirconia bars (25 mm length, 4 mm width, 0.7&1.0mm of zirconia & ceramic thickness) were prepared from zirconia block (e.max® ZirCAD), sintered at 1500°C for 4 hours, and veneered with ceramics with different techniques including CAD-fused using e.max CAD® (C), Pressed-on using e.max® Zirpress (P), and layering using e.max® ceram (L), with different tempering process through fast (F), medium (M), and slow (L) cooling (n=15). The specimens were determined for flexural strength on a universal testing machine. ANOVA and Bonferroni?s multiple comparisons were used to determine for significant difference (?=0.05). Weibull analysis was applied for survival probability, Weibull modulus (m), and characteristics strength (?c). The interfaces were microscopically examined. The phase transformation of zirconia was determined using X ray diffraction. The mean±sd (MPa), m, ?c of flexural strength were 922.06±83.45, 12.78, 958.32 for CF, 924.26±74.64, 14.28, 959.62 for CM, 930.25±92.42, 11.83, 970.83 for CS, 518.29±59.97, 10.11, 542.97 for PF, 516.50±67.51, 8.75, 539.17 for PM, and 520.51±42.38, 14.59, 544.51 for PS, 604.36±64.09, 11.28, 630.67 for LF, 583.81±56.95, 11.67, 609.81 for LM, 547.33±52.23, 12.19, 569.36 for LS. The flexural strength was significantly affected by veneering technique (p<0.05). No significant effect on flexural strength upon tempering process was evidenced (P >0.05). Phase transformation from t?m related with veneering and tempering procedure. Strength of ceramic veneered zirconia associated with different veneering techniques, but not directly related with tempering process. CAD-on ceramic veneering zirconia is benefit for enhancing the strength of ceramic bilayer and was recommended as a method for ceramic veneering zirconia.
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    Comparison of frictional forces during the closure of extraction spaces in passive self-ligating brackets and conventionally ligated brackets using the finite element method
    (2019) Gómez Gómez, Sandra Liliana; Sánchez-Obando, Natalia; Álvarez-Castrillón, María-Antonia; Montoya Goéz, Yesid; Ardila Medina, Carlos Martín
    This study compared the frictional force resulting from the bracket/archwire interface and the stress at the root/periodontal ligament/bone interface, between passive self-ligating brackets and conventionally ligated brackets, during the space closure stage. A cone beam tomography was taken to a female patient that required extraction of upper first premolars and passive self-ligating system; three months after its activation, a cone beam tomography was taken again. The designs of the maxillary bone and the entire system were possible through tomography images and stereomicroscopic photographs. Validation of the Finite Element Method (FEM) was achieved comparing the amount of movement seen through tomography images and the FEM. Space closure was simulated for each system through the FEM and a comparison was made between the frictional force at the bracket/archwire interface, and the root/periodontal ligament/bone interface. The most significant representation of frictional force at bracket/archwire interface and bone stress was found at the conventionally ligated system, while the passive self-ligating system accounted for the highest distribution of stress over the root. The FEM is an accurate tool used to quantify frictional force and stress concentration during the orthodontic closure. The passive self-ligating system was seen less frictional during the closure state compared to conventional brackets.
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    Evaluation of the force generated by gradual deflection of 0.016-inch NiTi and stainless steel orthodontic wires in self-ligating metallic and esthetic brackets
    (2019) Francisconi, Manoela-Fávaro; Janson, Guilherme; Henriques, José Fernando; Freitas, Karina-Maria-Salvatore; Francisconi, Paulo-Afonso-Silveira
    The purpose of this study was to evaluate the deflection forces of 0.016-inch Nitinol and stainless steel orthodontic wires, in association to different self-ligating brackets. Specimens were mounted in a clinical simulation model and evaluated in a Universal Testing Machine (INSTRON 3342), using a 10N load cell and ISO 15,841, as a protocol. Eight of these models were prepared, each one for the bonding of each set of self-ligating accessories to be tested: Damon Q, Damon Clear (Ormco), In-Ovation R, In-Ovation C (GAC), BioQuick, QuickClear (Forestadent), SmartClip and Clarity SL (3M). Data were subjected to One-way ANOVA, followed by Tukey tests (P<0.05). Elastic deflection results showed that the deactivation forces increased with increase in wire deflection in the different brackets evaluated. For the different combinations, Clarity SL generated the greatest force and Damon Clear presented the lowest force when compared to the other brackets in all alloys and deflections. BioQuick and QuicKlear were those with the most similar behavior with each other. Strength values increased with gradual increase in wire deflection in all evaluated brackets. Clarity SL generated the greatest and Damon Clear the lowest force when compared to the other brackets in all alloys and deflections tested.
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    Remineralization potential of grape seed extract hydrogels on bleached enamel compared to fluoride gel : an in vitro study
    (2019) Nagi, Shaymaa M.; Hassan, Shahinaz N.; Abd El-Alim, Sameh H.; Elmissiry, Mostafa M.
    Remineralizing of bleached enamel is a common procedure that aims to compensate enamel mineral lose. This study aimed to evaluate the remineralization effectiveness of experimentally prepared grape seed extract hydrogels (GSE) compared to fluoride gel on bleached enamel. Thirty extracted maxillary incisor were bleached using white smile bleaching agent. Bleached specimens were divided into three groups (10/group) according to the remineralizing agents tested: [GSE 6%, GSE 10%, or fluoride gel]. After bleaching and remineralization procedure, the specimens were stored in artificial saliva at 37°C. Micro-hardness and Energy-Dispersive X-ray and ultra-morphological evaluation were tested at baseline, after bleaching and after remineralization. Statistical significant decrease on mean micro-hardness values had resulted after bleaching procedure compared to baseline, followed by a significant increase in GSE (10%) and fluoride groups. GSE (6%) application showed the least statistical significant mean micro-hardness, which was statistically insignificant different compared to bleaching procedure. Elemental analysis results revealed a statistical significant decrease on Ca, and Ca/P ratios (At%) values after bleaching compared to baseline, followed by a significant increase after treatment with all tested remineralizing gels. SEM photomicrograph of sound enamel shows smooth uniform appearance with few pores. Bleached enamel showed irregular pitted disorganized enamel surface. Bleached enamel exposed to GSE and fluoride gel showed occlusion of enamel surface porosities and precipitates of different sizes. The specially prepared GSE hydrogels has positive effects on the remineralization process of bleached enamel making it an effective natural agent with remineralizing potential.
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    Spontaneous eruption of severely impacted teeth : the report of two cases
    (2019) Andrade Jr., Ildeu; Paschoal, Marco-Aurélio-Benini; Santos, Tamiris-de Oliveira
    The unerupted and impacted tooth is a common problem and the reason for many orthodontic and pediatric dental referrals, yet the approach to their management is still an area of controversy. This article presents two cases of severely impacted teeth that spontaneously erupted in the maxillary and mandibular arches. The first patient, a 9-year-old girl, presented a severe impaction of mandibular right and left second premolars. The second patient, a 7-year-old girl, presented with a severely impacted maxillary central incisor. In both cases, the teeth spontaneously erupted into excellent positions without surgical procedures and orthodontic traction. This raises important questions concerning the possible treatment options for such teeth as well as the timing of any interceptive treatment. In cases of unerupted or impacted teeth, a multidisciplinary approach is indicated involving orthodontics, paedodontics and oral surgery to establish the optimal treatment plan.
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    Unusual microscopic changes of Ameloblastic Fibroma and Ameloblastic Fibro-odontoma : a systematic review
    (2019) Atarbashi-Moghadam, Saede; Ghomayshi, Mojtaba; Sijanivandi, Soran
    Ameloblastic fibroma (AF) and ameloblastic fibro-odontoma (AFO) are uncommon benign mixed odontogenic neoplasms. Although unusual microscopic changes including hybrid tumors have been documented in publications, their clinical outcome prediction and treatment modality selection are still challenging due to scarcity. Objective: Analysis of AF/AFO?s unusual microscopic variants in order to improve histopathologic diagnosis and to help clinicians in making informed treatment choices. An electronic search was performed in PubMed?s database using keywords: ?ameloblastic fibroma?, ?ameloblastic fibroodontoma?, ?ameloblastic fibro-odontoma?. The search scheme was limited to articles in English, dated ?January 1998? to ?October 2018?, with full texts (case reports and series) and human studies. Eligibility criteria included publications having enough clinical, radiological, and histological data to confirm their diagnosis. Age, sex, lesions? location, radiologic features, signs, symptoms, treatment approaches, and recurrences were recorded and analyzed. In this systematic review, 11 articles (reporting 14 cases) were selected. Patients? mean age was 13.75 years (male/female = 1.8). The posterior region of the mandible was the lesions? commonest location (57.14%). Swelling was reported in 78.57% of the cases, pain in 28.57% but 21.42% were asymptomatic. Radiolucent unilocular appearance was the commonest radiographic feature, but 28.57% of the cases showed a mixed radiolucent-radiopaque appearance. Other reported radiographic findings were impacted tooth (78.57%), root resorption (28.57%), tooth mobility (35.71%), and cortical perforation (14.28%). No recurrences were reported. Calcifying odontogenic cyst (COC) was the commonest lesion associated with AF/AFO (53.33%). Unicystic ameloblastoma and cystic changes without prominent epithelial lining were other reported hybrid lesions. Reported microscopic variations were pigmentation and ghost cell differentiation. COC was the commonest lesion associated with AF/AFO. Although COC commonly occurs in the jaws? anterior region, hybrid cases were more common in the posterior area. No malignant transformations were reported. The treatment modality is mostly chosen based on the lesion?s most aggressive part.
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    Influence of delay between dental bleaching with 35% hydrogen peroxide and orthodontic brackets on the bond strength at the enamel/adhesive interface
    (2019) de Almeida, Antônio-Augusto-Lima; Lima, Darlon-Martins; Pereira, Adriana-de Fátima-Vasconcelos; Sousa, Soraia-de Fátima-Carvalho; Alves, Cláudia M.C
    The aim of this study was to evaluate the influence of waiting time between the bleaching with 35% hydrogen peroxide and orthodontic brackets bonding on shear bond strength (SBS) in enamel. Eighty bovine teeth were randomly divided into four groups (G): G1(negative control) and G2, G3 and G4 (experimental groups). The experimental groups were submitted to bleaching. Prior to orthodontic brackets bonding to enamel the procedure was adopted different waiting times, as follows: G2 (1 day); G3 (7 days) and G4 (14 days). It was performed enamel etching (30s), washing water (30s), application of adhesive system followed by photoactivation (20s). A thin layer of composite resin was placed between the adhesive and the brackets. The applied pressure was measured by tensiometer (300N/40s). The composite resin was light-cured (40s). After 24 hours the shear test was held (0.5mm/min). To compare the SBS it was used ANOVA one-way followed by Tukey test (? = 0.05). The Adhesive Remaining Index (ARI) was analyzed using the Kruskal-Wallis test. The SBS values were significantly lower in G2 (15.51 MPa) and G3 (17.77 MPa) compared to G1 (30.14 MPa) and G4 (28.50 MPa) (p<0.05). The ARI revealed significant difference between the G3 and the other groups (p<0.05). It was concluded that the bond strength in enamel in the interfaces/adhesive system/composite resin/orthodontic brackets was more effective 14 days after the bleaching with 35% hydrogen peroxide.
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    Dystrophic calcification vs sialolithiasis in a pediactric parotid gland : a case report
    (2019) Júnior, Valdir-Meirelles; Netto, Rafael; Janini, Maria-Elisa-Rangel; Azevedo, Alexandro B.; de Andrade, Vitor-Marcello
    Calcinosis is a connective tissue disorder characterized by ectopic calcification in soft tissues. It is subdivided into: dystrophic, metastatic, idiopathic and iatrogenic calcification. The formation of mineralized material in the salivary glands is a common finding in the daily practice of dentists and other specialists. In most cases, this calcification is a sialolith. However, a type of ectopic calcification termed dystrophic calcification is characterized by inappropriate biomineralization in soft tissues and may be associated with trauma, chronic and localized infection or inflammatory diseases. We report a case of a 9-year-old female patient who complained of small nodules in the left parotid region, which begun two years before. Her main complaint was of recurring periods of worsened symptoms characterized by the exacerbation and symptomatic remission of the gland volume with occasional otolaryngologic infections. This study aims to discuss ectopic dystrophic calcification in the parotid gland associated with recurrent infection in children.
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    Zimmermann-Laband syndrome : clinical and cytogenetic study in two related patients
    (2019) Shirian, Sadegh; Shahabinejad, Hassan; Saeedzadeh, Abolfazl; Daneshbod, Khosrow; Khosropanah, Hengameh; Mortazavi, Mostafa; Daneshbod, Yahya
    Zimmermann?Laband Syndrome (ZLS) is an extremely rare autosomal dominant congenital disorder. It is a craniofacial malformation syndrome with predominant intraoral involvement consisting of gingival fibromatosis diffusion in early development. The molecular basis of ZLS is still unknown. Although familial aggregation with different inheritance patterns is detected in ZLS patients, most of the cases are sporadic. We report on two sibling patients with clinical manifestations of ZLS. Blood samples of both patients were obtained in EDTA-tubes followed by performing cytogenetic study using Cyto2.7M array. Analysis of the copy number was performed using the Chromosome Analysis Suite Software (version 1.0.1, annotation file na 30, Affymetrix) and interpreted with recourse to the UCSC genome browser (; Human Mar. 2006NCBI Build 36.1/hg18 assembly). The array analysis revealed overlapping regions of chromosomal aberrations in both patients. We detected a 258-kb deletion at 3q13.13, a 89-kb duplication at 1q25.2 as well as two 67-kb duplications at 1p12 and 19q12. These altered regions do not contain any known genes and protein-coding sequences. In conclusion, the findings of this report revealed new chromosomal aberrations, including a deletion at 3q13.13 and duplications at 1q25.2, 1p12 and 19q12, in the two patients with ZLS. Such findings indicate that whole genome screening for genomic rearrangements is fruitful in typical and atypical patients with ZLS.
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    Assessment of the electrochemical behaviour of Nickel-Titanium-based orthodontic wires : effect of some natural corrosion inhibitors in comparison with fluoride
    (2019) Fatene, Nassiba; Mansouri, Said; Elkhalfi, Bouchra; Berrada, Mohamed; Mounaji, Khadija; Soukri, Abdelaziz
    The aim of this study is to assess the corrosion resistance behaviour of Nickel-Titanium-based orthodontic wires (NiTi) in different concentrations of Sodium Fluoride (NaF) and the corrosion?s inhibitory effect of the extracts of some medicinal plants (essential oils, hydrosols and extract). In this study we used NiTi (3M) and CuNiTi (ORMCO, 35°C, California) orthodontic wires. The following electrolytes were prepared: Lactate Ringer solution with additions of 0.1%, 0.5% or 1% of Sodium Fluoride and the extracts of different plants: Artemisia, Syzygium aromaticum (Clove) and Celtis australis. Corrosion resistance was studied using anodic potentiodynamic polarisation and electrochemical impedance spectroscopy measurements. At the end of the experiment, microscopic images of wires were performed. ANOVA test with the comparison of Bonferroni and Tukey tests were performed to elucidate comparisons among all groups. The higher sodium fluoride concentration is related to negative corrosion potential for both NiTi and CuNiTi orthodontic wire. Hydrosols are associated to positive values of corrosion potential. CuNiTi has a lower corrosion resistance than NiTi. The prescription of toothpastes containing sodium fluoride should be reduced especially for patients wearing fixed orthodontic appliances. Eugenol may be considered as alternative of sodium fluoride for orthodontic patients for its anti-microbial and anti-corrosive effects.
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    Orthodontic brackets friction changes after clinical use : a systematic review
    (2019) Cury, Sérgio-Elias-Neves; Aliaga-Del Castillo, Aron; Pinzan, Arnaldo; Sakoda, Karine-Laskos; Bellini-Pereira, Silvio-Augusto; Janson, Guilherme
    To evaluate the bracket-wire friction force after clinical use. A systematic search of several electronic databases (PubMed, Embase, Web of Science, Scopus, The Cochrane Library, Lilacs and Google Scholar) without limitations regarding publication year or language, was performed. In-vitro studies analyzing the changes in friction force of orthodontic brackets before/after their clinical use were considered. Risk of Bias was assessed with Downs and Black checklist. All methodological features that could interfere in the results were specifically described. Seven studies satisfied the inclusion criteria and were included in the review. All 7 studies reported at least two groups (before and after clinical use). Friction force increased after intraoral aging in most of the studies. However, there is lack of good quality evidence in this research area. Brackets present increased surface roughness after clinical use, and consequently increased coefficient of friction (COF) and Friction Force. Further studies are necessary to obtain more reliable results.
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    Retraction : evaluation of periimplant bone neoformation using different scanning electron microscope methods for measuring BIC. A dog study
    (2019) Calvo Guirado, José Luis; Aguilar-Salvatierra Raya, Antonio; Guardia Muñoz, Javier; Delgado Ruiz, Rafael Arcesio; Ramírez Fernández, Piedad; Pérez Sánchez, Cristina; Gómez Moreno, Gerardo
    In relation to the article of the Journal of Clinical and Experimental Dentistry ?Calvo-Guirado JL, Aguilar-Salvatierra A, Guardia J, Delgado-Ruiz R, Ramírez-Fernández MP, Pérez-Sánchez C, Gómez-Moreno G. Evaluation of periimplant bone neoformation using different scanning electron microscope methods for measuring BIC. A dog study. J Clin Exp Dent. 2012 Feb 1;4(1):e8-e13?, the authors have used three figures that are the same as those published in three different publications (J Pineal Res 2010; COIR 2010; COIR 2012). The copyright of the mentioned publications was consequently not respected. Retraction of the article is therefore decided.