Journal of Clinical and Experimental Dentistry. 2017. Vol. 9, no. 8

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    Evaluation of the orthodontic treatment need in a paediatric sample from Southern Italy and its importance among paediatricians for improving oral health in pediatric dentistry
    (2017) Luzzi, Valeria; Ierardo, Gaetano; Corridore, Denise; Di Carlo, Gabriele; Di Giorgio, Gianni; Leonardi, Emanuele; Campus, Guglielmo; Vozza, Iole; Polimeni, Antonella; Bossù, Maurizio
    Data from epidemiological studies investigating the prevalence and severity of malocclusions in children are of great relevance to public health programs aimed at orthodontic prevention. Previous epidemiological studies focused mainly on the adolescence age group and reported a prevalence of malocclusion with a high variability, going from 32% to 93%. Aim of our study was to assess the need for orthodontic treatment in a paediatric sample from Southern Italy in order to improve awareness among paediatricians about oral health preventive strategies in pediatric dentistry. The study used the IOTN-DHC index to evaluate the need for orthodontic treatment for several malocclusions (overjet, reverse overjet, overbite, openbite, crossbite) in a sample of 579 children in the 2-9 years age range. The most frequently altered occlusal parameter was the overbite (prevalence: 24.5%), while the occlusal anomaly that most frequently presented a need for orthodontic treatment was the crossbite (8.8%). The overall prevalence of need for orthodontic treatment was of 19.3%, while 49% of the sample showed one or more altered occlusal parameters. No statistically significant difference was found between males and females. Results from this study support the idea that the establishment of a malocclusion is a gradual process starting at an early age. Effective orthodontic prevention programs should therefore include preschool children being aware paediatricians of the importance of early first dental visit.
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    A comparative evaluation of smear layer removal using apical negative pressure (EndoVac), sonic irrigation (EndoActivator) and Er:YAG laser - an in vitro SEM study
    (2017) Suman, Sanghamitra; Verma, Promila; Prakash Tikku, Aseem; Bains, Rhythm; Kumar Shakya, Vijay
    This study aimed to compare the smear layer removing efficacy of the EndoActivator, EndoVac and Er:YAG laser in extracted mandibular premolars, at the apical, middle and coronal third of root canal, through scanning electron microscopy. 40 extracted mandibular premolars were decoronated to a standardized length of 12 mm. Specimens were shaped to ProTaper F4 size and irrigated with 5.25% sodium hypochlorite at 370C between instrumentation. Teeth were divided into four groups (n=10), one control (needle irrigation) and three experimental, according to the irrigant activation technique used i.e. sonic irrigation (EndoActivator), apical negative pressure (EndoVac) or laser (Er:YAG). The final irrigants used were 10ml,17% ethylenediaminetetraacetic acid (EDTA) and 10ml, 5.25% sodium hypochlorite. Root canals were then split longitudinally and observed under a scanning electron microscope. The presence of smear layer at the apical, middle and coronal third of root canal was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Intraexaminer and interexaminer reliability were determined by Kappa test. The EndoVac system was significantly more effective in removing debris from the apical third than all other groups. EndoActivator performed better than laser at the apical third. All three experimental groups (EndoVac, EndoActivator, and laser) were better than needle irrigation at the middle and apical third. At the coronal third, no significant difference was seen between the four groups. None of the activation systems completely removes the smear layer from the dentine walls; nevertheless, EndoVac is significantly better in removing debris from the apical third of canal.
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    Socioeconomic factors and severity of periodontal disease in adults (35-44 years). A cross sectional study
    (2017) Almerich Silla, José Manuel; Almiñana Pastor, Pedro J.; Boronat Catalá, Montserrat; Bellot Arcís, Carlos; Montiel Company, José María
    Periodontal disease or periodontitis is an inflammatory disease with a hight prevalence. According to the last oral health survey of the Spanish population, between 24% and 37% of Spaniards aged over 35 years have periodontitis and 6% to 10% of the adult population have deep periodontal pockets. The aim of this study was to determine the association between risk factors and the presence of periodontal pockets in the adult population. A cross sectional or prevalence study of a representative sample of the adult population of the Valencia region was designed. The sample was recruited at 35 health centres, The study was conducted in November and December 2006 under standardized conditions as regards light sources, equipment and instruments and the position of the three previously calibrated dentist examiners. The sample examined consisted of 733 individuals (220 men and 513 women). Measured by the CPI, 13% were healthy and 5.5% presented bleeding. The prevalence of calculus was 59.3%, that of 3.5-5.5 mm pockets was 15.8% and that of pockets deeper than 5.5 mm was 4.6%. Almost half the sextants were healthy (2.89), 0.61 presented bleeding and 1.74 presented calculus. The mean number of sextants affected by 3.5-5.5 mm pockets was 0.46 and 0.07 presented deep pockets (>5.5 mm). An adjusted multiple logistic regression model with the presence of periodontal pockets as the dependent variable showed that the significant independent variables were low social class (OR=1.81), smoking (OR=1.68), primary education (OR=1.57), male gender (OR=1.56) and age (OR=1.08). The other study variables were not significant in this model. Socioeconomic factors such as primary education and low social class, as well as gender, age and smoking, were found to be associated to a significant degree with greater prevalence of periodontal disease in the adult population.
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    Evaluation of orthognathic surgery on articular disc position and temporomandibular joint symptoms in skeletal class II patients : a magnetic resonance imaging study
    (2017) Firoozei, Gholamreza; Shahnaseri, Shirin; Momeni, Hasan; Soltani, Parisa
    The purpose of orthognathic surgery is to correct facial deformity and dental malocclusion and to obtain normal orofacial function. However, there are controversies of whether orthognathic surgery might have any negative influence on temporomandibular (TM) joint. The purpose of this study was to evaluate the influence of orthognathic surgery on articular disc position and temporomandibular joint symptoms of skeletal CI II patients by means of magnetic resonance imaging. For this purpose, fifteen patients with skeletal CI II malocclusion, aged 19-32 years (mean 23 years), 10 women and 5 men, from the Isfahan Department of Oral and Maxillofacial Surgery were studied. All received LeFort I and bilateral sagittal split osteotomy (BSSO) osteotomies and all patients received pre- and post-surgical orthodontic treatment. Magnetic resonance imaging was performed 1 day preoperatively and 3 month postoperatively. Descriptive statistics and Wilcoxon and Mc-Nemar tests were used for statistical analysis. P<0.05 was considered significant. Disc position ranged between 4.25 and 8.09 prior to surgery (mean=5.74±1.21). After surgery disc position range was 4.36 to 7.40 (mean=5.65±1.06). Statistical analysis proved that although TM disc tended to move anteriorly after BSSO surgery, this difference was not statistically significant (p value<0.05). The findings of the present study revealed that orthognathic surgery does not alter the disc and condyle relationship. Therefore, it has minimal effects on intact and functional TM joint.
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    Influence of thermal and mechanical fatigue on the shear bond strength of different all-ceramic systems
    (2017) Vidotti, Hugo Alberto; Pereira, Jefferson Ricardo; Insaurralde, Elizeu; Plaça, Luiz F.; Delben, José R.; Valle, Accácio Lins do
    To evaluate the influence of thermal and mechanical fatigue on the shear bond strength of different all-ceramic cores and veneering porcelain interfaces. All-ceramic systems tested were lithium disilicate and zirconia veneered by layering technique. Sixty specimens (n=20) were subjected to shear bond strength. Ten of them were thermal and mechanical cycled. Fracture analysis was performed with stereomicroscopy and scanning electron microscopy. Energy dispersive X-ray spectroscopy analysis was performed across core/veneer interfaces. Thermal and mechanical cycling did not influence on bond strength. However, there was significant difference among systems (<0.01). CoCr group presented the highest values, followed by lithium disilicate, and zirconia. Failure modes were predominantly adhesive for CoCr, cohesive in core for lithium disilicate, and cohesive in veneer for zirconia. Energy dispersive X-ray showed interaction zone for CoCr and lithium disilicate groups and was inconclusive for zirconia. Fatigue had no influence on bond strength of groups tested. The results suggest that there is a chemical bond between core and veneer materials for CoCr and lithium disilicate groups.
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    Effect of thermocycling and surface treatment on repair bond strength of composite
    (2017) Kiomarsi, Nazanin; Saburian, Pardis; Chiniforush, Nasim; KharaziFard, Mohammad J.; Hashemikamangar, Sedighe Sadat
    Repair of composite restorations is a conservative method that can increase the longevity and durability of restorations while preserving the tooth structure. Achieving a suitable bond between the old and new composite is difficult. To overcome this problem, some methods have been recommended to increase the repair bond strength of composite.This study aimed to assess the effect of aging by thermocycling (5,000 and 10,000 cycles) and mechanical surface treatments (Er,Cr:YSGG laser and bur) on repair shear bond strength of composite resin. Totally, 120 composite blocks measuring 6x4x4 mm were fabricated of Filtek Z250 composite and were randomly divided into three groups (n=40) based on initial aging protocol: (a) no aging: storage in distilled water at 37°C for 24 hours, (b) 5,000 thermal cycles, (c) 10,000 thermal cycles. Each group was then randomly divided into two subgroups (n=20) based on mechanical surface treatment (laser and bur). The laser and bur-prepared surfaces were silanized and Adper Single Bond 2 was then applied. The repair composite was bonded to surfaces. Half of the samples in each subgroup (n=10) were subjected to 5,000 thermal cycles to assess durability of bond. The remaining half were stored in distilled water at 37°C for 24 hours and all samples were then subjected to shear bond strength testing in a universal testing machine with a crosshead speed of 1mm/min. Data (in megapascals) were subjected to one-way ANOVA and Tukey?s test (P=0.05). Mode of failure was determined under a stereomicroscope. Bur preparation significantly improved the bond strength compared to laser (P<0.001). Aging by 10,000 thermal cycles significantly decreased the repair bond strength of composite (P<0.001). No significant difference was noted in this regard between distilled water and 5,000 thermal cycles groups (P=0.699). Primary bond strength and bond strength after 5,000 thermal cycles in the same subgroups were not significantly different either (P=0.342). Aging by 10,000 thermal cycles significantly decreases the repair bond strength of composite and surface preparation by bur provides a higher bond strength compared to laser.
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    Relationship of salivary CD14 concentration with dental caries in young children
    (2017) Kumar, Saurabh; Tandon, Shobha; Nayak, Rashmi; Saran, Runki; Pentapati, Kalyana-Chakravarty
    Dental caries is a chronic disease among children and there is need for studies assessing the caries risk factors using saliva. This study aimed to evaluate the association of salivary soluble CD14 and dental caries in young children. A cross-sectional study was done among 300, 3-6 year old school children of Udupi district. A total of 40 children who were caries free, with no past systemic illness or craniofacial anomalies and 40 children with dental caries with no history of dental treatment for caries, with no past systemic illness or craniofacial anomalies were included in control and test groups respectively. Salivary CD14 was evaluated using ELISA test. The mean salivary soluble CD14 concentration was significantly higher in caries free (1.34±0.35 µg/ml) children than caries experienced (0.54±0.36 µg/ml) (p<0.001). There was significant strong negative correlation between number of decayed teeth and soluble salivary CD14 (r = -0.868, P< 0.001) among all the children. Similarly, sub-group analysis of caries experienced children also showed significant strong negative correlation between number of decayed teeth and soluble salivary CD14 (r = -0.774, P<0.001). Results obtained in our study suggested that salivary CD14 can be a indicator of dental caries in young children.
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    The relationship of mandibular radiomorphometric indices to skeletal age, chronological age and skeletal malocclusion type
    (2017) Tayebi, Ali; Tofangchiha, Maryam; Fard, Mahsa Arian; Gosili, Armin
    The present study was performed with the following aims: (1) to assess the relationship between skeletal age, measured using the cervical vertebral maturity (CVM) method, and chronological age; (2) to determine the correlation of skeletal and chronological age to the cortical thickness of the lower border of the mandible using the linear radiomorphometric; and (3) to explore the relationship between these indices and skeletal malocclusion type. The data were collected from the records of 180 patients, including 57 males (31.7%) and 123 females (68.3%). The data were based on the panoramic and lateral cephalograms of each patient. The CVM stages were determined on the basis of the patients? lateral cephalograms. Three radiomorphometric indices were measured: AI, MI and GI. The patients were divided up into three groups of skeletal malocclusion: Class I, II, and III. For all the tests, statistical significance was set at P<0.05. The relationship between chronological age and skeletal age was 0.496. Furthermore, with an increase in chronological and skeletal age, the cortical thickness of the lower border of the mandible and consequently the radiomorphometric indices increase, except for the GI (P > 0.05). Lastly, the relationship between GI and skeletal malocclusion type proved significant. AI and MI were found to increase significantly with increasing age, so the assessment of mandibular radiomorphometric indices could be clinically useful in estimating of the growth and maturation of the mandible.
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    Clinical and radiological outcome of arthrocentesis followed by autologous blood injection for treatment of chronic recurrent temporomandibular joint dislocation
    (2017) Patel, Jinesh; Nilesh, Kumar; Parkar, Mushtaq I.; Vaghasiya, Alpesh
    This study was conducted to evaluate the functional outcome and MRI findings of arthrocentsis followed by autologous blood injection (ABI) into the joint space for management of chronic recurrent TMJ dislocation. Total ten patients with bilateral chronic recurrent condylar dislocation were included in the study. Arthrocentesis of both TMJ was performed on each patient, followed by the injection of 2 ml of autologous blood into the superior joint compartment and 1 ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included; thorough history, clinical examination of TMJ, maximal mouth opening, frequency of dislocation, TMJ radiographs (open and closed mouth position), MRI, recurrence and presence of facial nerve paralysis. At the end of 3 months follow-up 8 patients (80%) had successful outcome with no further episodes of dislocation, whereas two patients reported with recurrence. Post-operative MRI showed significant improvement after ABI, compared to pre-operative MRI. There were no degenerative changes to the bony and soft tissue components of TMJ. ABI is a simple, safe, minimally invasive and cost-effective technique for treatment of chronic recurrent TMJ dislocation. MRI evaluation showed an improvement in the anatomical and spatial relationship of the osseous and soft tissue components of the TMJ.
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    Comparison of the root canal debridement ability of two single file systems with a conventional multiple rotary system in long oval-shaped root canals : in vitro study
    (2017) khoshbin, Elham; Shokri, Abbas; Donyavi, Zakieh; Shahriari, Shahriar; Salehimehr, Golsa; Farhadian, Maryam; Kavandi, Zeinab
    This study sought to compare the root canal debridement ability of Neolix, Reciproc and ProTaper rotary systems in long oval-shaped root canals. Eighty five extracted single-rooted human teeth with long oval-shaped single root canals were selected and divided into three experimental groups(n=25) and one control group (n= 10). Root canals were filled with Vitapex radiopaque contrast medium and prepared with Neolix, Reciproc or ProTaper systems. The control group only received irrigation. Digital radiographs were obtained at baseline and postoperatively and subjected to digital subtraction. The percentage of reduction in contrast medium was quantified at 0-5 mm and 5-10 mm distances from the apex. The data were analyzed using one-way ANOVA and t-test. The mean percentage of the contrast medium removed was not significantly different in the 0-5mm segment among the three groups (P=0.6). In the 5-10mm segment a significant difference was found in this regard among the ProTaper and Reciproc groups (P=0.02) and the highest mean percentage of contrast medium was removed by ProTaper. But, difference between ProTaper and Neolix as well as Neolix and Reciproc was not significant. In Neolix (P=0.024) and Reciproc (P=0.002) systems, the mean percentage of the contrast medium removed from the 0-5mm segment was significantly greater than that in 5-10mm segment; however, this difference was not significant in ProTaper group (P=0.069). Neolix single-file system may be a suitable alternative to ProTaper multiple-file system in debridement of long oval shaped canals.
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    Evolution of oral cancer treatment in an andalusian population sample : rehabilitation with prosthetic obturation and removable partial prosthesis
    (2017) Flores Ruiz, Rafael; Castellanos Cosano, Lizett; Serrera Figallo, María Angeles; Gutiérrez Corrales, Aida; González Martín, Maribel; Gutiérrez Pérez, José Luis; Torres-Lagares, Daniel
    Radical surgical resection as a treatment modality for oral cancer often leads to an extensive deficit in both the maxillary and mandibular levels, where the use of a palatal obturator prosthesis (POP) or removable partial denture (RPP). The aim of this study was to evaluate the treatment with POP and RPP in patients treated for oral cancer in the Unit of Prosthetic Rehabilitation of the University Hospital Virgen del Rocío in a period of 20 years. Retrospective descriptive study during the years 1991 and 2011 analyzing oral cancer type, characteristics, treatment and follow-up. The sample consisted of patients whose tumor had previously been removed and who had been referred to the Oncological Rehabilitation Unit of the Oral and Maxillofacial Surgery Unit of the ?Virgen del Rocío? University Hospital for rehabilitation. The inclusion criteria were patients whose underlying pathology was any type of neoplasia, which after its treatment had been referred to the aforementioned Oncological Prosthetic Rehabilitation unit. Of the 45 patients included in our study, 15 patients were rehabilitated with palatal obturator (33.3%) and 5 patients with removable partial denture (11.1%). The mean age of the sample of patients with POP was 57.3 ± 9.23, while the mean age of the sample of patients with RPP was 58 ± 13.5. The most common underlying pathology in patients with POP was squamous cell carcinoma (60%), whereas in patients with RPP it was 100%. The most frequent location found among POP patients was the upper jaw, while in the PRP patients there was no predominant location. The univariate and multivariate logistic regressions did not show any statistically significant association between the independent variables age, sex, smoking habit and alcoholic habit with the dependent variable type of rehabilitating prosthesis. Based on our data, we can conclude that RPP is used in few cases of oncological rehabilitation. The POP has a greater use, as long as the defect in the bones of the facial middle third is limited.
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    Casein phosphopeptide-amorphous calcium phosphate effects on brackets shear bond strength and enamel damage
    (2017) Naseh, Roya; Fallahzadeh, Farnoosh; Atai, Mohammad; Mortezai, Omid; Setayeshrad, Raheleh
    The aim of study was to evaluate the application of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride regarding their effect on the shear bond strength (SBS), bond failure pattern of brackets using the adhesive remnant index (ARI) and assessing the quality of enamel surface using the enamel damage index (EDI). Sixty extracted premolar teeth were randomly divided into four groups regarding pretreatment application of CPP-ACP and fluoride. Brackets were bonded using the conventional method. Specimens were thermocycled for 1000 cycles and were subsequently tested for the SBS in a universal testing machine. After debonding, the teeth were examined under a stereomicroscope to evaluate the ARI. Then, The EDI was assessed using a scanning electron microscope (SEM). Data were analyzed using ANOVA and the Chi-square test. Evaluation of SBS, ARI and EDI scores showed no significant difference among the study groups. However, a correlation was found between the ARI and EDI scores, indicating that with more adhesive remnants on enamel surface, enamel damage was lower. The use of CPP-ACP and fluoride can be considered a prophylactic application since these agents did not compromise bracket bond strength although they did not reduce iatrogenic damage to the enamel.