Journal of Clinical and Experimental Dentistry. 2012. Vol. 4, no. 3

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    Reactive hyperplastic lesions of the oral cavity: a ten year observational study on North Indian Population
    (2012) Reddy, Vandana; Saxena, Susmita; Saxena, Sanjeev; Reddy, Munish
    Back ground: The aim of this study was to determine the frequency of focal reactive hyperplastic lesions of the oral cavity as reported in the Department of Oral Pathology and Microbiology, Subharti Dental College, Meerut and to compare these data with those of previously reported studies from other regions and countries. Material and method: Patient records of the Department of Oral Pathology were retrieved during a 10 year period from 2001 to 2010. Data of all reactive hyperplasias namely focal fibrous hyperplasia (FFH), pyogenic granuloma (PG), peripheral ossifying fibroma (POF) and peripheral giant cell granuloma (PGCG) were reviewed and analyzed for age, gender, and site of location. Results: There were 209 focal reactive hyperplastic lesions that comprised 12.8% of the 1634 accessed biopsies. FFH was the most common lesion constituting 57.4% of the cases, followed by PG (18.7%), POF (17.7%) and PGCG (6.22%). The mean age of patients at presentation was 31.56 years. The female to male ratio was 1.5:1. The most frequently involved site was the gingiva (81.8%); other sites were the buccal mucosa, lips, tongue, alveolar mucosa and palate. Conclusion: Oral lesions are often detected by Dental professionals and surgeons. Knowledge of the frequency and presentation of the most common oral lesions is beneficial in developing a clinical impression of such lesions encountered in practice and to minimize potential dentoalveolar complications.
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    Antibacterial effect of a new haemostatic agent on oral microorganisms
    (2012) Çinar, Çaðdaþ; Odabas, Mesut Enes; Akca, Gülçin; Isik, Berrin
    Objective: The purpose of this study was to determine the antibacterial effect of a newly developed haemostatic agent Ankaferd Blood Stopper® (ABS) and Ferric Sulphate (FS) on various oral microorganisms. Study design: Bacterial strains were freshly incubated in their specific broth media. For each of the strains, 3 wells per each agent, with a 5 mm diameter were made under aseptic conditions in the specific agar media. Then they were filled with a test agents or 0.2% chlorhexidine digluconate (CHX) (control group). After 24h and 48h incubation periods, inhibition zones were measured. Results: ABS showed antibacterial effect on all test microorganisms except Lactobacillus acidophilus and Lactobacillus salivarius. Ferric sulphate and CHX have antibacterial effect on all microorganisms. When the test agents compared, the inhibition zones of the ABS were found smaller than the ferric sulphate and CHX. Conclusions: Although ferric sulphate and ABS have antibacterial effect, ferric sulphate had better antibacterial activity than ABS on oral microorganisms under in vitro condition. FS and ABS not only exhibit the haemostatic activity but also antimicrobial activity.
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    Chemomechanical preparation by hand instrumentation and by Mtwo engine-driven rotary files, an ex vivo study
    (2012) Krajczár, Károly; Tigyi, Zoltán; Papp, Viktória; Marada, Gyula; Jeges, Sára; Tóth, Vilmos
    Objective: To compare the disinfecting efficacy of the sodium hypochlorite irrigation by root canal preparation with stainless steel hand files, taper 0.02 and nickel-titanium Mtwo files with taper 0.04-0.06. Study design: 40 extracted human teeth were sterilized, and then inoculated with Enterococcus faecalis (ATCC 29212). After 6 day incubation time the root canals were prepared by hand with K-files (n=20) and by engine-driven Mtwo files (VDW, Munich, Germany) (n=20). Irrigation was carried out with 2.5% NaOCl in both cases. Samples were taken and determined in colony forming units (CFU) from the root canals before and after the preparation with instruments #25 and #35. Results: Significant reduction in bacterial count was determined after filing at both groups. The number of bacteria kept on decreasing with the extension of apical preparation diameter. There was no significant difference between the preparation sizes in the bacterial counts after hand or engine-driven instrumentation at the same apical size. Statistical analysis was carried out with Mann-Whitney test, paired t-test and independent sample t-test. Conclusions: Significant reduction in CFU was achieved after the root canal preparation completed with 2.5% NaOCl irrigation, both with stainless steel hand or nickel-titanium rotary files. The root canal remained slightly infected after chemo mechanical preparation in both groups.
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    Removal of failed crown and bridge
    (2012) Sharma, Ashu; Rahul, G.R.; Poduval, Soorya T.; Shetty, Karunakar
    Crown and bridge have life span of many years but they fail for a number of reasons. Over the years, many devices have been designed to remove crowns and bridges from abutment teeth. While the removal of temporary crowns and bridges is usually very straightforward, the removal of a definitive cast crown with unknown cement is more challenging. Removal is often by destructive means. There are a number of circumstances, however, in which conservative disassembly would aid the practitioner in completing restorative/endodontic procedures. There are different mechanisms available to remove a failed crown or bridge. But there is no information published about the classification of available systems for crown and bridge removal. So it is logical to classify these systems into different groups which can help a clinician in choosing a particular type of system depending upon the clinical situation. The aim of this article is to provide a classification for various crown and bridge removal systems; describe how a number of systems work; and when and why they might be used. A PubMed search of English literature was conducted up to January 2010 using the terms: Crown and bridge removal, Crown and bridge disassembly, Crown and bridge failure. Additionally, the bibliographies of 3 previous reviews, their cross references as well as articles published in various journals like International Endodontic Journal, Journal of Endodontics and were manually searched.
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    Reconstruction of a midfacial defect using an intraoral-extraoral combination prosthesis employing magnets: a clinical report
    (2012) Nair, Anoop; Regish, K.M.; Shah, Farhan Khalid; Prithviraj, D.R.
    Radical maxillectomy frequently leads to extended defects in hard and soft tissues that result in a connection between the oral cavities and orbit. If the defect cannot be surgically reconstructed, a combination prosthesis may be necessary to remedy dysfunction in patient function, comfort, esthetics. For minor defects, enlargement of the base of the intra oral prosthesis is generally sufficient. Resections that affect more than one third of the maxilla usually require an intra oral and an extra oral prosthesis that could be assembled and retained in the patient. This clinical report describes a technique of prosthetic rehabilitation of midfacial defect with a silicone orbital prosthesis and intra oral obturator that are retained by magnets.
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    Noise levels in a dental teaching institute: a matter of concern!
    (2012) Singh, Simarpreet; Gambhir, Ramandeep Singh; Singh, Gurminder; Sharma, Sumit; Kaur, Amarinder
    Objective: To measure and assess the noise levels produced by various dental equipments in different areas of a dental institution and to recommend improvements if noise levels are not within permissible limits. Materials and methods: Sound levels were measured at three different areas of a dental institution where learning and teaching activities are organized. The sound level was measured using a sound level meter known as 'decibulolmeter'. In each area the noise level was assessed at two positions-one, at 6 inches from the operators ear and second, at the chairside instrument trolley. Noise levels were also assessed from a central location of the clinic area when multiple equipments were in operation simultaneously. Results: Dental laboratory machine, dental hand-piece, ultrasonic scalers, amalgamators, high speed evacuation, and other items produce noise at different sound levels which is appreciable. The noise levels generated varied between 72.6 dB in pre-clinics and 87.2 dB in prosthesis laboratory. The results are comparable to the results of other studies which are conducted elsewhere. Although the risk to the dentists is lesser, but damage to the hearing is possible over prolonged periods. Conclusion: Higher noise levels are potentially hazardous to the persons working in such environments especially in the laboratory areas where noise levels are exceeding the permissible limits.
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    Complications following an accidental sodium hypochlorite extrusion: A report of two cases
    (2012) Bosch Aranda, María Luisa; Canalda Sahli, Carlos; Figueiredo, Rui; Gay Escoda, Cosme
    Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae. This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it shows the long-term neurologic injuries that this type of accidents may cause and a treatment protocol for these situations will be suggested.
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    Non-surgical endodontics in retreatment of periapical lesions: two representative case reports
    (2012) Kapoor, Varun; Paul, Samrity
    This article reports non-surgical endodontic retreatment of two patients with persistent or recurrent periapical lesions, who had previously undergone surgical and non-surgical endodontic therapy respectively. It further discusses and reviews the relevance of classification of periapical lesions, the explanation behind healing of periapical lesions by endodontic therapy alone, causes of persistence of periapical lesions, choice of treatment modalities (whether surgical or non ' surgical) and materials such as intracanal medicaments and irrigants for optimal healing.
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    Sealing ability of lateral compaction and tapered single cone gutta-percha techniques in root canals prepared with stainless steel and rotary nickel titanium instruments
    (2012) Koçak, Mustafa; Darendeliler Yaman, Sis
    Objectives: The aim of this study was to evaluate the sealing ability of lateral compaction and tapered single cone gutta-percha techniques in root canals prepared with stainless steel and rotary nickel titanium root canal instruments by fluid filtration method. Study design: The root canals were prepared with stainless steel (SS) and nickel titanium (NiTi) instruments. The canals prepared with SS were obturated with lateral compaction technique using .02 tapered cones and the canals prepared with NiTi instruments were obturated with lateral compaction technique using .02 tapered cones or 06 tapered single cones. The amount of leakage was evaluated by fluid filtration model. The results were statistically analyzed with one-way ANOVA. Results: The group prepared with NiTi instruments and filled with lateral compaction technique showed significantly less coronal leakage than the group prepared with SS instruments and filled with lateral compaction technique (p<0.05). There was no statistically difference between apical leakages of groups (p>0.05). Conclusions: Obturation with lateral compaction of gutta-percha provides a superior coronal seal whilst canal instrumentation with engine-driven NiTi files reduces the extent of microleakage in root canals when compared with stainless steel hand instruments. Tapered single cone technique was comparable with lateral compaction technique because of easier application.
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    Marginal bone loss in relation to platform switching implant insertion depth: an update
    (2012) Alonso González, Rocío; Aloy Prósper, Amparo; Peñarrocha Oltra, David; Peñarrocha Diago, María; Peñarrocha Diago, Miguel
    A review is made, analyzing marginal bone loss in relation to the depth of implant insertion with platform switching, according to the position of the neck (supracrestal, crestal or subcrestal), and evaluating survival of the implants. A PubMed search was made of the studies in animals and humans published between 2005 and 2011, specifying platform insertion depth (supracrestal, crestal or subcrestal) and registering marginal bone loss from the time of prosthetic restoration to the end of follow-up (minimum 6 months). A total of 30 studies were included. The bone loss associated with implants placed at supracrestal level was slightly smaller than in the case of implants placed at subcrestal level, though statistical significance was not reached. The mean marginal bone loss values were 0.0 mm to 0.9±0.4 mm for the implants with the neck located at supracrestal level; 0.05 mm to 1.40±0.50 mm for those at subcrestal level; and 0.26±0.22 mm to 1.8±0.39 mm for those in a crestal location, after 6-60 months of follow-up. The survival rate was 88.6-100% for the implants with the neck positioned at crestal level, versus 98.3- 100% below the crest, and 100% above the crest. The heterogeneity of the studies (surgical technique, platform surface texture, radiographic measurement techniques, etc.) made it difficult to establish a relationship between marginal bone loss and the supracrestal, crestal or subcrestal location of platform switching.
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    Prevalence of tooth erosion and associated factors in 13-16-year old adolescents in Greece
    (2012) Chrysanthakopoulos, Nikolaos Andreas
    Objectives: The aim of this study was to estimate the prevalence of dental erosion and to investigate possible associations among dental erosion and medical history, dietary and lifestyle habits in a sample of adolescents in Greece. Study design: The study sample consisted of 770 adolescents, 374 boys and 396 girls aged 13 to 16 years. All individuals were clinically examined and answered questions regarding their medical history, rate and frequency of drinks and food consumption and lifestyle habits. Statistical analysis of the questionnaire items was performed by using the multiple logistic regression analysis model. Results: Two hundreds and sixty adolescents were diagnosed as having dental erosion, giving a prevalence rate 33.8%. The habit of holding drinks in the mouth before swallowing [OR=2.85, 95% CI=1.45-5.58] (p=0.002), the ingestion of acidic drinks at bedtime [OR=0.24, 95% CI=0.11-0.53] (p=0.000), the consumption of car- bonated drinks [OR=3.99, 95% CI=1.37-11.59] (p=0.011) and fruit juices [OR=0.12, 95% CI=0.04-0.38] (p=0.000) were the most important associated factors of dental erosion. Conclusions: The prevalence of dental erosion in the study sample was 33.8% while dental erosion experience was associated with frequency and habits of consumption of some dietary components.
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    Burning mouth syndrome: a diagnostic and therapeutic dilemma
    (2012) Aggarwal, Ashish; Panat, Sunil R.
    Burning mouth syndrome (BMS) has been considered an enigmatic condition because the intensity of pain rarely corresponds to the clinical signs of the disease. Various local, systemic and psychological factors are associated with BMS, but its etiology is not fully understood. Also there is no consensus on the diagnosis and classification of BMS. A substantial volume of research has been focused on BMS during the last two decades. Progress has been made but the condition remains a fascinating, yet poorly understood area, in the field of oral medicine. Recently, there has been a resurgence of interest in this disorder with the discovery that the pain of BMS may be neuropathic in origin and originate both centrally and peripherally. The aim of this paper is to explore the condition of BMS with the specific outcome of increasing awareness of the condition.