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Language Journal of Clinical and Experimental Dentistry. 2020. Vol. 12, no. 2
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- Association between mandibular second molars calcification stages in the panoramic images and cervical vertebral maturity in the lateral cephalometric images(2020) Toodehzaeim, Mohammad-Hossein; Rafiei, Elahe; Hosseini, Seyyed-Hadi; Haerian, Alireza; Hazeri-Baqdad-Abad, MiladDetermination of maturation and evaluation of growth potential is extremely important in clinical orthodontics. The purpose of this study was to evaluate the diagnostic performance of the mandibular second molar calcification stages for identification of growth phases. In this cross-sectional descriptive study, samples were derived from panoramic radiographs and lateral cephalograms of 125 subjects (61 males and 64 females) with age ranging from 8 to 17 years and estimates of dental maturity (Demirjian Index [DI]) and skeletal maturity (Cervical vertebral maturation indicators CVMI]) were made. Correlations between DI and CVMI were shown by Spearman?s correlation. The diagnostic performance of the DI for the identification of the growth phase were evaluated using positive likelihood ratios (LHRs), with a threshold of ?10 for satisfactory performance. Correlations between second molar calcification and growth phase were 0.819 for females and 0.805 for males (P-value< 0.0001). LHR ?10 was only observed for the identification of the post-pubertal growth phase for the H stage of the second molar. In spite of the high correlation coefficients between mandibular second molar calcification stages and skeletal maturity, these stages are reliable only for the identification of the post pubertal growth phase.
- A new 3D-method to assess the inter implant dimensions in patients ? A pilot study(2020) Schmidt, Alexander; Billig, Jan-Wilhelm; Schlenz, Maximiliane Amelie; Wöstmann, BerndComplex implant treatments have steadily increased within implant prosthodontics. Based on the lower implant mobility, implant impressions need high accuracy in the model transfer to receive a high passive fit within the final prosthodontic restoration. To analyze the accurate 3-dimensional (3D) inter-implant-positions, a reference point is indispensable. However, there is no reference in the patients mouth, so the aim of the present study was to develop a new method based on a custom-made-measuring-aid (CMA) to assess the inter implant dimensions (InID) in patients. Initially an implant master model (IMM/patient equivalent) was digitized by computed tomography. A CMA was fixed on the impression posts and the inter implant dimensions (InID) were recorded with a coordinate measurement machine (CMM). For comparison to conventional and digital impression techniques, 10 impressions per technique were taken. InIDs for the IMM, the CMA and the two impression techniques were compared. To give a proof of principle, the new 3D-method was applied to three patients as pilot cases. Results for trueness and precision were analyzed by pairwise comparisons (p< .05). All data were subjected to univariate ANOVA. Mean deviation for InID ranged from 10.3±18?m(CMA) to 41.7±36?m(conventional). There were partially significant differences for InID between the CMA and the different impression techniques. There were no significant differences for InID within the CMA. The InID in the in-vivo evaluation ranged from 42.3?m to 376.7?m(digital) and from 58.3?m to 274.0?m(conventional). There were partially significant differences between the techniques. Within the limits of this study, with the developed method using a CMA it is possible to assess the true 3D-InID with a decisive higher accuracy than possible with a conventional or digital implant impression. Overall, the CMA in this study generated results that were deemed clinically useful for the investigated inter implant positions.
- Oral manifestations in drug users : a review(2020) Cossa, Federico; Piastra, Alessia; Sarrión Pérez, María Gracia; Bagán Debón, LeticiaIn the dental environment there is not much talk about the oral manifestations resulting from the use of drugs, because in general the issue of drugs is a very difficult subject to deal with. Therefore, the objective of this work is to understand what are the most obvious manifestations in the oral cavity and as the dentist can detect them. In order to carry out this bibliographical review, a scientific article search was made by consulting the PubMed database. The abstracts were read to recruit only what was consistent with the chosen topic. The 23 sources of information affirmed the relationship between a bad state of general health, and more in the specific, bad state of oral cavity. The most relevant manifestations were: decay, loss of teeth and precancerous lesions. These manifestations were present in most of the cases studied. All this is a consequence of the drug and the lifestyle acquired by the drug users studied.
- Effect of water-jet flossing on surface roughness and color stability of dental resin-based composites(2020) Alharbi, Mohammed; Farah, Ra'fat I.The purpose of this in vitro study was to investigate the effects of water-jet flossing on the color stability and surface roughness of five resin-based composites. Five commercially available composite resins were studied. Nine disc-shaped specimens (6x2mm) were fabricated from each composite. The specimens were randomly allocated into three groups and three different treatments were performed on each group: storage in water (control group), water-jet flossing using 50 Psi water pressure, and water-jet flossing using 100 Psi water pressure. The water-jet flossing was performed in a standardized manner using a Waterpik® Aquarius® water flosser. Color and roughness were measured at baseline and at the end of 30 minutes of treatment, which is approximately equivalent to 5 years of simulated water-jet flossing for 1 minute once a day. The data were statistically analyzed using two-way analysis of variance (ANOVA) with Bonferroni and Tukey?s post-hoc tests. No significant color change was found after 5 simulated years of water-jet flossing, irrespective of composite type and water-flossing pressure setting (p > 0.05). Furthermore, none of composite specimens showed any significant surface roughness changes except for the two composites with spherical filler specimens in the 100 Psi treatment group. These composites exhibited a significant increase in surface roughness compared with the nano-filled composite (p = 0.001 and p = 0.006). However, the differences were clinically acceptable (?0.2 µm). In terms of surface roughness and color, water-jet flossing is safe to be used on composite restorations within the settings of this study.
- Mechanical properties of the NiTi Memoria Leaf Spring Activated Expander (NiTi MLSAE) for maxillary transverse discrepancy correction : an in-vitro study(2020) Lowe, Ronald; Makowka, Steven; Manzella, Kevin; Warunek, Stephen; Al-Jewair, ThikriatTo determine the mechanical properties of the NiTi Memoria® Leaf Spring Activated Expander (NiTi MLSAE) in two forms, unaltered (unbent) and altered (bent) to mimic clinical use. This in-vitro pilot study was conducted using eight NiTi MLSAE expanders (American Tooth Industries, Oxnard, California) representing four force magnitudes: 10mm 500g, 10mm 900g, 6mm 450g and 6mm 900g models. Two experiments were performed: the first tested the expanders in their unbent form and the second tested them after they were bent by one experienced technician. All expanders were adapted to a standard three dimensional printed maxillary study model. A Dillion Quantrol 500N (110lbf) load cell and a custom-made fixturing apparatus was used to determine the amount of expansive forces delivered. Prior to testing, the ligation compressing the NiTi MLSAE leaves was cut to allow the appliances to expand to their original form. Emperor? (force) Software was used to measure the expansion forces. The average expansion forces generated by the expanders were: unaltered = 897.4g (8.8N) and bent = 877.0g (8.6N) for the 10mm 900g model, unaltered = 489.5g (4.8N) and bent = 479.3g (4.7N) for the 10mm 500g model, unaltered = 458.9g (4.5N) and bent = 438.5g (4.3N) for the 6mm 450g model, and unaltered = 805.6g (7.9N) and bent = 785.2g (7.7N) for the 6mm 900g model. Regardless of whether the expander was straight or bent, the forces generated by the 10mm 900g, 10mm 500g and 6mm 450g Ni-Ti MLSAEs correlated with the benchmark study conducted by the manufacturer. However, the forces generated by the 6mm 900g Ni-Ti MLSAE were less than the data published by the manufacturer. Binding was observed when the expanders were manipulated to mimic clinical use, and this may account for the reported lower expansion force.
- Antimicrobial, mechanical and biocompatibility analysis of chlorhexidine digluconate-modified cements(2020) Sampaio, Gêisa-Aiane-de Morais; de Meneses, Izaura-Helena-Chaves; de Carvalho, Fabiola-Galbiatti; Carlo, Hugo-Lemes; Münchow, Eliseu-Aldrighi; Barbosa, Taís-de Souza; Pithon, Matheus-Melo; Alves, Pollianna-Muniz; Lacerda-Santos, RogérioThe focus of this study was to evaluate the antimicrobial, mechanical properties and biocompatibility of glass ionomer (GICs) modified by Chlorhexidine (CHX). For biocompatibility, 105 male Wistar rats were used, divided into 7 groups (n=15): Group C (Control,Polyethylene), Groups M, M10, M18, and Groups RL, RL10, RL18 (M-Meron and RL-Riva Luting: conventional, and modified with 10%, and 18% CHX, respectively). The tissues were analyzed under optical microscope for different cellular events and time intervals. Antibacterial effect and Shear Bond Strength Test (SBST) were also analyzed. Biocompatibility was analyzed by the Kruskal-Wallis and Dunn tests; SBST one-way ANOVA and Tukey test (P<0.05). For the antibacterial effect, the Kruskal-Wallis and Friedman, followed by Dunn (P<0.05) tests were used. Morphological study of the tissues showed inflammatory infiltrate with significant differences between Groups C and RL18, in the time intervals of 7(P=0.013) and 15(P=0.032) days. The antimicrobial effects of the cements was shown to be CHX concentration-dependent (P=0.001). The SBST showed no significant difference between the Groups of Meron cement (P=0.385), however, there was difference between Group RL and Groups RL10 and RL18 (P=0.001). The addition of CHX did not negatively influence the SBST. Meron-CHX-10% was the most biocompatible, and Riva-CHX-18% had more influence on the inflammatory process and presented slower tissue repair.
- Periodontal condition and recurrence of periodontitis associated with alcohol consumption in periodontal maintenance therapy(2020) Costa, Fernando-Oliveira; Cortelli, José-Roberto; Costa, Adriana-Moreira; Lima, Rafael-Paschoal-Esteves; Cortelli, Sheila C.; Cota, Luis O.M.This study followed individuals in periodontal maintenance therapy (PMT) over 6 years and longitudinally evaluated the effects of the frequency of alcohol consumption on the recurrence of periodontitis (RP). From a 6-year follow-up cohort study with 268 individuals under PMT, 142 patients who attended at least one PMT visit within 12 months were determined to be eligible. Based on their alcohol consumption, participants were categorized into 3 groups: none or occasional alcohol use (NA; n=88), moderate alcohol use (MA; n=26) and intense alcohol use (IA; n=24). Complete periodontal examination and alcohol consumption were evaluated at 2 times, T1 (after active periodontal therapy) and T2 (6 years). The frequencies of RP in the NA, MA and IA groups were 46.5%, 57.6%, and 79.1%, respectively. The following variables were significantly associated with RP in final multivariate logistic regression model: age >50 years old (OR = 1.79; 95%CI 1.42-2.91; p=0.002), current smoking (OR = 2.42; 95%CI 1.33-4.31; p=0.001), and intensive alcohol use (OR = 1.96; 95%CI: 1.37-2.64; p=0.024). Interaction between intensive alcohol use and smoking showed a high OR estimate of 3.15 (95%CI 1.29-6.32) for RP. IA individuals undergoing PMT presented worse periodontal condition, higher rates of RP and tooth loss when compared to NA individuals. Additionally, the interaction between intensive alcohol use and smoking significantly increased the risk for RP.
- Dentin degradonomics ? The potential role of salivary MMP-8 in dentin caries(2020) Ashwini, Ajay; Dineshkumar, Thayalan; Rameshkumar, Annasamy; Swarnalakshmi, Raman; Shahnaz, Ahmed; Nagarathinam, A.E; Rajkumar, KrishnanDentin caries involves dissolution of minerals which eventually leads to degradation of organic matrix. This degradation which was thought to be by bacterial proteases is now considered to be orchestrated by endogenous collagenases such as Matrix Metalloproteinases (MMPs). This paper aims to estimate the salivary levels of MMP-8 in dental caries and also to asses the various risk factors that contribute to the formation of dental caries. A random sample of 75 adults aged 18-35 were included and categorized based on the number of caries lesions (MCL). Standard clinical examinations were performed, and stimulated saliva was collected and analyzed for concentrations of MMP-8 using enzyme-linked immunosorbent assay. Caries risk factors were assessed using a chair-side kit. Correlation of MMP-8 in varying MCL using Spearman?s correlation was done. Multiple linear regression analysis was done to asses the relationship between various caries risk factors with MMP-8 and MCL as dependent variable. The study results showed a statistically significant higher concentration of MMP-8 in carious group (MCL 1-2) and MCL ?3 compared to non-carious group. On correlating, the levels of MMP-8 were seen to be higher in MCL ?3 than in MCL = 0 and MCL 1-2. The mean MMP-8 of controls, MCL 1-2, and MCL ?3 were 131.34ng/ml, 230.14ng/ml, and 391.91ng/ml respectively. Multiple linear regression analysis with MMP-8 as the dependent variable revealed caries, buffer capacity and S. mutans count as significant variables. Using MCL as the dependent variable the only significant variable was MMP-8 levels. The study suggests that subjects with caries have elevated MMP-8 levels compared with subjects with no carious lesions. There is also a positive correlation between the number of carious lesions and MMP-8 levels suggesting that MMP-8 plays an important role in the degradation of dentin and causes progression of caries.
- Protocol for Low-level laser therapy in traumatic ulcer after troncular anesthesia : case report in pediatric dentistry(2020) Calazans, Thais-Apolinário; de Campos, Priscila-Hernandez; Melo, Ana-Valesca-Gurjão; Oliveira, Alba-Valeska-Alves; Amaral, Stella-Ferreira; Diniz, Michele B.; Novaes, Tatiane-FernandesThe aim of this study was to report a protocol of use for low-level laser therapy (LLLT) in traumatic ulcer in the lower lip after inferior alveolar nerve block anesthesia (IANBA). A 3-year-old patient, male, undergoing treatment of carious lesions was submitted to an indirect pulp capping in tooth 74 under IANBA. The procedure was completed without intercurrences, but on next day, the child presented extensive traumatic ulcer in the left lower lip, with complaint of pain. Two sequential applications with LLLT were applied in punctual mode under pressure around the lesion. After 1 week, the mother reported significant improvement. After 30 days, the lesion was fully healed. In conclusion, LLLT promoted rapid analgesia and healing, being a good treatment alternative for traumatic ulcer after troncular anesthesia.
- Hybrid ameloblastoma and central giant cell lesion : challenge of early diagnosis(2020) Stuepp, Rúbia-Teodoro; Marola, Luiz-Henrique-Godoi; Modolo, Filipe; Gondak, Rogério OliveiraHybrid lesions encompass the occurrence of different entities in one lesion. A 67-year-old woman was referred to the Oral and Maxillofacial Surgery Service for treatment of mandibular Central Giant Cell Lesion (CGCL) previously diagnosed. Intraoral examination revealed edentulism and a painless swelling extending from the alveolar ridge to the buccal vestibule with hard consistency covered by normal mucosae, with unknown duration. Panoramic radiograph revealed a large, multilocular and well-defined radiolucent lesion extending from the region of left mandibular lateral incisor teeth to right mandibular first molar with no evidence of osseous perforation. Initially, a treatment with intralesional injection of corticosteroids was performed. After 18 months of treatment, an increase in size of the osteolytic lesion was noted. An incisional biopsy was carried out and the microscopic examination revealed a unicystic ameloblastoma associated to CGCL. It was performed marsupialization and later the enucleation of residual lesion. The follow-up remains being performed.
- Anxiety and pain perception in patients undergoing mandibular autogenous block bone surgery(2020) Novy, Luiz-Felipe-Silva; Aguiar, Evandro Guimarães de; Arruda, José A.; Moreira, Allyson; dos Santos, Emerson-Gomes; Magalhães, Cláudia; Moreno, AmáliaThe aim of the present study was to investigate pain perception and anxiety within the context of surgery for the placement of mandibular block bone and to evaluate the causality effect between theses variables. A total of 13 patients were recruited for the study and were submitted to mandibular autogenous block bone surgery. Demographic data were collected and the anxiety level was determined using the State-Trait Anxiety Inventory (STAI). The STAI was administered on the day of surgery and on the 14th postoperative day. Pain was determined using the visual analogue scale (VAS) and limitation of daily activities and postoperative symptoms were also reported. Data were analyzed using parametric tests (?=0.05) and cross-lagged analysis was performed to verify a causality effect. Few patients reported interference with daily activities or the presence of postoperative symptoms. A significant association of bad breath/taste with STAI-State was detected on the 14th postoperative day. No evidence of causality between STAI and VAS was detected. The patient?s self-evaluation indicates that the pain and anxiety level felt during treatment was not directly associated with the clinical aspects of the surgical procedure or with postoperative activities/symptoms limitations.
- Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride : an in vitro study(2020) Kamal, Dina; Hassanein, Hassan; Elkassas, Dina; Hamza, HebaSelf-assembling peptide has been recently introduced to promote hard tissue regeneration for treating early non-cavitated carious lesions. This study investigates the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization combined with CPP-ACPF or fluoride. Artificial enamel lesions were created on buccal surface of 60 specimens and were randomly assigned to six groups according to the remineralizing agent: G1-(Control, artificial saliva), G2-(Fluoride varnish), G3-(CPP-ACPF varnish), G4-(Self-assembling peptide), G5-(Self-assembling peptide+fluoride varnish), G6-(Self-assembling peptide+CPP-ACPF varnish). All products were applied according to manufacturer?s instructions and specimens were stored in a daily renewed artificial saliva. Surface microhardness (SMH) and scanning electron microscope (SEM) were assessed at baseline, after demineralization, 1 week and 4 weeks storage. SMH values were analyzed using ANOVA and Tukey?s post-hoc test. The highest statistically significant SMH values were found in G6 followed by G5, G4, G2 and G3 while the lowest values were found in G1. No statistically significant difference was found between G5 and G6. Also, no statistically significant difference was found between G2 and G3. SEM showed that G4, G5, G6 resulted in more pronounced remineralization, reversing the demineralized enamel fish scale pattern compared to G2 and G3 after 1 week and 4 week remineralization. Complementary effect was obtained after combining self-assembling peptide with CPP-ACPF or fluoride showing the highest remineralizing potential early after 1 week and even after 4 weeks compared to when each agent used alone. Added benefits can be obtained through combining self-assembling peptide with other remineralzing agents allowing faster and enhanced regeneration of non-cavitated caries lesions.
- Effect of in-office bleaching gels with calcium or fluoride on color, roughness, and enamel microhardness(2020) Vieira, Isabele; Vieira-Junior, Waldemir-Francisco; Pauli, Maria-Cibelle; Theobaldo, Jéssica-Dias; Aguiar, Flávio Henrique Baggio; Lima, Débora Alves Nunes Leite; Leonardi, Gislaine-RicciCommercial bleaching gels with remineralizing agents were developed to reduce the adverse effects of dental bleaching. The present study evaluated the effects on teeth of in-office bleaching gels containing 35-40% hydrogen peroxide (HP) with Calcium (Ca) or Fluoride (F). Bovine enamel/dentin blocks (4x4x2.5 mm) were randomly divided into the following groups (n=12): no treatment (control); 35% HP (Whiteness HP, FGM); 35% HP with Ca (Whiteness HP Blue, FGM); 40% HP with F (Opalescence Boost, Ultradent). The specimens were analyzed for color (?L*, ?a*, ?b*, and ?E), roughness (Ra), and Knoop microhardness (KHN). The color and KHN data were submitted to ANOVA and Tukey?s test, while Ra values were analyzed using mixed models for repeated measures and Tukey-Kramer?s test (?=0.05). The bleached groups did not exhibit statistical differences among them for color. For roughness, 35% HP provided a slight increase of Ra, which was statistically different from the control. For microhardness, 35% HP and 40% HP with F presented KHN values that were statistically lower from the control, while the 35% HP with Ca did not statistically differ from the control. The presence of Ca or F in bleaching gels did not interfere with bleaching efficacy. However, only the enamel exposed to the bleaching gel containing Ca obtained microhardness values similar to unbleached enamel.
- Bond strength of lithium disilicate after cleaning methods of the remaining hydrofluoric acid(2020) dos Santos, Daniela Micheline; Bittencourt, Sandro; da Silva, Emily-Vivianne-Freitas; Matos, Adaias-Oliveira; Benez, Georgia-de Castro; Rangel, Elidiane-Cipriano; Pesqueira, Aldiéris Alves; Barão, Valentim A.R.; Goiato, Marcelo CoelhoDifferent ceramic surface cleaning methods have been suggested after the acid conditioning. The aim was to evaluate the effect of different protocols used to remove the remaining hydrofluoric acid on the shear bond strength (SBS) between lithium disilicate and resin cement. Forty-four specimens of lithium disilicate (IPS e.max Press) were divided in 4 groups (n=11): group C (control, no treatment); group HF+S (5% hydrofluoric acid + silane); group HF+US+S (5% hydrofluoric acid + ultrasound cleaning + silane); group HF+PH+S (5% hydrofluoric acid + 37% phosphoric acid + silane). Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were performed to characterize the surface morphology. The SBS test was performed on the resin/ceramic interface, and the failure mode was characterized. SBS values were submitted to 1-way ANOVA and the Tukey test (?=.05). The relation between surface treatment and failure modes was analyzed using the chi-squared test (?=.05). The surface treatment type interfered in the shear strength (p<.001) and higher SBS values were observed for the groups HF+US+S (17.87 MPa) and HF+PH+S (16.37 MPa). The surface treatment did not influence the failure mode (p=.713). No fluorsilicate salts were observed after ultrasound cleaning. The utilization of ultrasound cleaning was an effective procedure to remove remaining fluorsilicate salts, promoting the highest SBS values.
- Comparison of modified Bass, Fones and normal tooth brushing technique for the efficacy of plaque control in young adults- A randomized clinical trial(2020) Janakiram, Chandrashekar; Varghese, Naveen; Venkitachalam, Ramanarayanan; Joseph, Joe; Vineetha, KaruveettilTo compare the anti plaque efficacy of Modified Bass, Fones and Normal brushing techniques in young adults. An investigator blinded randomized controlled trial with parallel design was adopted to compare the anti plaque efficacy of three tooth brushing techniques. The study population consisted of 120 dental students aged between 18 and 30 years. At the baseline, the mean plaque scores were 0.74 ± 0.39, 0.77 ± 0.34 and 0.98 ± 0.36 respectively, for Modified Bass, Fones and Normal brushing technique. After 24 hours without any oral hygiene activity, the plaque scores increased to 1.04 ± 0.30, 1.11 ± 0.32 and 1.21 ± 0.40, respectively. After 1 week of using the intervention, the mean plaque scores were 0.78 ± 0.36, 0.94 ± 0.34 and 1.03 ± 0.43, respectively and increased to 1.13 ± 0.44, 1.14 ± 0.40 and 1.08 ± 0.34 after 28 days. The mean gingival scores were 0.23 ± 0.66, 0.02 ± 0.52 and 0.42 ± 0.74 for Modified Bass, Fones and Normal Brushing technique during baseline visit and after 28 days. There was a significant reduction in the amount of plaque with the three brushing techniques. Although the short-term outcomes with the Modified Bass method were promising, a long-term effect was not evident. Further, there was no significant difference in plaque control between the three groups.
