ISRN Dentistry

Pain Sensation and Postsurgical Complications in Posterior Mandibular Implant Placement Using Ridge Mapping, Panoramic Radiography, and Infiltration Anesthesia

Ali Saad Thafeed AlGhamdi — Tue, 21 May 2013 13:11:55 +0000

Objectives. The aim of this study was to investigate intrasurgical and after surgical, pain and the incidence of after surgical alteration of sensation in the mandible and lower lip when placing implants in the posterior mandible using ridge mapping, panoramic radiography, and infiltration anesthesia. Methods. This was a longitudinal clinical study of healthy patients needing implant placement in the posterior mandible. After thorough examination and treatment plan using ridge mapping and panoramic radiography, all patients received dental implants under local infiltration anesthesia. The patients were then given a questionnaire to assess the pain during anesthesia and implant surgery. Change of sensation in the lower lip was evaluated by standard neurosensory examination tests at 7 days and 1 and 4 months. Prosthetic treatment was carried out 4 months postsurgery and the patients were followed for an average of 28.5 months afterwards. Results. A total of 103 implants were placed in 62 patients. Patients reported very minor pain during injection. No pain was reported during either implant placement or bone grafting procedures. No alteration of sensation in the mandible or lower lip was recorded postsurgery. Conclusion. In most cases, ridge mapping, panoramic radiography, and infiltration anesthesia are sufficient for posterior mandibular implant placement without pain or complications.

Relationship between Subjective Oral Health Status and Lifestyle in Elderly People: A Cross-Sectional Study in Japan

Mon, 13 May 2013 17:01:02 +0000

Objective. The aim of this study was to assess the relationship between subjective oral health status and lifestyle in elderly people living in Japan. Methods. Subjects were 5383 inhabitants of the Kagawa Prefecture, Japan, at the age of 75–100. Records of the number of remaining teeth and the data from self-reported questionnaire were analyzed statistically. Results. Remaining teeth were significantly correlated to “no current smoking,” while not related to other lifestyle. On the other hand, “subjective masticatory ability” defined as a condition allowing chewing all foods well was related to favorable lifestyles. “Subjective masticatory ability” was also related to “not feeling stress,” “no deviated food habit” as well as to other good oral health conditions. A logistic regression analysis for “remaining teeth more than 20” revealed a significant relationship between “no current smoking” (OR = 1.582) and “no alcohol drinking” (OR = 0.851). Regarding “subjective masticatory ability,” all favorable lifestyles analyzed in this study were found to be significant positive factors. Conclusions. “Subjective masticatory ability” seems to be strongly associated with favorable lifestyles. Therefore, it can be suggested that “subjective masticatory ability” might be a good landmark for quality of life of elderly people in addition to the number of remaining teeth.

Biomechanics and Load Resistance of Short Dental Implants: A Review of the Literature

Istabrak Hasan, Christoph Bourauel, Torsten Mundt, and Friedhelm Heinemann — Wed, 08 May 2013 16:07:00 +0000

This paper was aimed to review the studies published about short dental implants. In the focus were the works that investigated the effect of biting forces of the rate of marginal bone resorption around short implants and their survival rates. Bone deformation defined by strain was obviously higher around short implants than the conventional ones. The clinical outcomes of 6 mm short implants after 2 years showed a survival rate of 94% to 95% and lower survival rate (<80%) for 7 mm short implants after 3 to 6 years for single crown restorations. The short implants used for supporting fixed partial prostheses had a survival rate of 98.9%. Short implants can be considered as a good alternative implant therapy to support single crown or partial fixed restorations.

Comment on “Computed Tomography Evaluation of Craniomandibular Articulation in Class II Division 1 Malocclusion and Class I Normal Occlusion Subjects in North Indian Population”

Wed, 08 May 2013 15:18:23 +0000

Clear statement of objective, appropriate location of landmarks and removal of subjective bias in measurement is essential in all kinds of research, especially, orthodontics. The research design should be rationalistic, purposeful, and in accordance with the objectives of the study. In this communication, we highlight the errors in research design, measurement, analysis, and inferences drawn with the help of a published article as the primary source to explain these simple but useful points.

Oral Health Behavior of Parents as a Predictor of Oral Health Status of Their Children

Elham Bozorgmehr, Abolghasem Hajizamani, and Tayebeh Malek Mohammadi — Wed, 08 May 2013 10:26:25 +0000

Introduction. It is widely acknowledged that the behavior of parents affects their children’s health. This study aimed to evaluate the relationship between oral health behavior of parents and oral health status and behavior of their children in a sample of preschool children in Iran. Method and Material. A random sample of over-five-year-old preschool children and their parents were enrolled in the study. Selection of schools was by clustering method. Parents were asked to fill a piloted questionnaire which included demographic characteristics, socioeconomic status, oral health behaviors of children and their parents. Oral health status of children was examined. The parent and their children oral health relationship were tested using regression and correlation analysis. Results. About 222 parents and children participated in the study. There was a significant relationship between history of having dental problems in parents and dmft index in their children (). There was a significant relationship between parental frequency of tooth brushing and child frequency of tooth brushing (); however, there was no significant relationship between parental frequency of dental visits and those of their children (). Conclusion. The study concluded that some important health behaviors in parents, such as tooth brushing habits are important determinants of these behaviors in their young children. So promoting parent knowledge and attitude could affect their children oral health behavior and status.

Comment on “Dental Prosthetic Status and Prosthetic Need of the Institutionalized Elderly Living in Geriatric Homes in Mangalore: A Pilot Study”

Thu, 02 May 2013 13:49:43 +0000

Public Health Dentistry is a speciality which is targeted towards the larger benefit of community and society. Dental health surveys in specific population groups should be planned adequately and the data should be analyzed in such a way so that it may help in making strategies for the intervention to improve the existing status. This could be only done with the help of proper planning, analysis and interpretation of a sample survey. The present study highlights the research design, statistical and inferential errors in a published work of public health dentistry in order to bring about the common mistakes and errors made. The renewed suggested approach helps in interpreting the results in a better way and makes them objective-oriented.

Survey of Impression Materials and Techniques in Fixed Partial Dentures among the Practitioners in India

Mon, 22 Apr 2013 09:59:49 +0000

Objective. Anecdotal evidence suggests that impression materials and techniques used in general dental practice for fixed partial dentures vary from those taught in dental schools. The aim of this survey was to integrate impression techniques evolved all over the years for fixed partial dentures and to know the techniques and materials which are used in the present day by the practitioners. Materials and Methods. A total of 1000 questionnaires were sent to various practitioners in India, out of which 807 questionnaires were filled. Results. The results showed that 84.8% of prosthodontists (65.56%, urban areas) use elastomeric impression materials as well as irreversible hydrocolloids and 15.2% use irreversible hydrocolloid only. Amongst other practitioners, 55.46% use irreversible hydrocolloid (45%, rural and semiurban areas) and 44.54% use elastomeric impression materials. Elastomeric impression technique practiced most commonly is putty reline with/without spacer (77.2%); other techniques are multiple-mix and monophase techniques. Conclusion. The ideal materials, technique, and armamentarium are required for the long-term success of the treatment for fixed partial denture. Also, if the ideal procedure is not followed, it will lead to a compromised fit of the final prosthesis and failure of the treatment.

The Role of Interleukin-1 Genotype in the Association between Coronary Heart Disease and Periodontitis in a Syrian Population

Lina Bashour, Razan Khattab, and Elham Harfoush — Sun, 14 Apr 2013 18:55:54 +0000

Objective. To determine whether differences exist between periodontitis subjects with and without Coronary Heart Disease (CHD) in a Syrian population in the distribution of IL-1 alleles at positions IL-1+4845, IL-1+3954, IL-1−511, and IL-1RN VNTR. Background. The role of Interleukin-1 genes in the association between periodontitis and CHD has been demonstrated in previous studies. No study has been carried out on the Syrian population to asses for such a role. Methods. 200 Syrian Arab periodontitis patients (184 males, 16 females; mean age 52.61) were divided into two groups: cases group 100 subjects with CHD (92 males, 8 females; mean age 52.06); controls group 100 subjects without CHD (92 males, 8 females; mean age 53.16). Probing depth (PD), clinical attachment loss (CAL), and alveolar bone loss (ABL) were performed for patients. Blood samples were collected for genotyping analysis of IL-1+4845, IL-1+3954, and IL-1−511 using PCR-RFLP technique and IL-1RN VNTR using normal PCR. Results. An association between both (CAL and ABL) and CHD was shown after adjustment for other confounders (OR: 7.659, ; OR: 3.645, , resp.). Also, an association between allele 2 of IL-1+4845, IL-1+3954, and IL-1−511 and ABL was shown. Allele 2 of IL-1+4845 and IL-1−511 was associated with ABL among individuals with and without CHD. But after adjustment for other confounders, the association remained only between allele 2 of IL-11+4845 and both CHD and severe ABL (OR: 0.189, ). Conclusion. Allele 2 of IL-11+4845 may be considered a risk indicator for having both CHD and severe ABL in the investigated Syrian population.

The Effect of Different Storage Conditions on the Physical Properties of Pigmented Medical Grade I Silicone Maxillofacial Material

Ayman A. Al-Dharrab, Seham B. Tayel, and Mona H. Abodaya — Thu, 28 Mar 2013 17:09:00 +0000

Objective. This study aimed to evaluate the effect of different storage solutions that simulate acidic, alkaline, and sebum conditiions on the physical properties of pigmented (colorant elastomer) cosmesil M511 maxillofacial prosthetic material. Materials and Methods. Sixty specimens were prepared according to the manufacturer's instructions and were tested before and after immersion of different storage conditions for six months at 37 °C. The following tests were performed: color changes (group I), solution absorption (group II), surface roughness (group III), and scanning electron microscopy (group IV). Results. There were no significant changes observed in the color and solution absorption tests while surface roughness revealed significant difference between control group and other testing storage medium groups, and this result was supported by SEM analysis that revealed limited surface changes. Conclusions. Cosmaseil material is an acceptable cross-linked formulation that withstands storage in different solutions with variable pH. The addition of pigment cannot vary the physical properties of these materials. Surface roughness test as well as SEM microscopic study showed moderate changes indicating a limited effect on the surface of the material.

Determinants of Oral Health: Does Oral Health Literacy Matter?

Wed, 13 Mar 2013 15:44:06 +0000

Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 participants (mean age 36.3 (SD 12.9); 51% female), women reported brushing their teeth more frequently () and scored higher for oral health literacy (mean 10.9 versus 10.2, ). In the adjusted model, high age (OR = 1.01, 95% CI 1.003–1.034), low education (OR = 1.88, 95% CI 1.23–2.87), small living area in square meters per person (OR = 1.85, 95% CI 1.003–3.423), poor tooth brushing behavior (OR = 3.35, 95% CI 2.02–5.57), and low oral health literacy scores (OR = 1.58, 95% CI 1.02–2.45) were significant risk indicators for poor self-reported oral health. Conclusions. Low oral health literacy level, independent of education and other socioeconomic determinants, was a predictor for poor self-reported oral health and should be considered a vital determinant of oral health in countries with developing health care systems.

Dental Maturity in Saudi Children Using the Demirjian Method: A Comparative Study and New Prediction Models

Ziad D. Baghdadi — Tue, 26 Feb 2013 16:05:46 +0000

A sample of 422 dental panoramic radiographs from individuals of known age (from 4 to 14 yrs), sex (males: 217, females: 205), and ethnicity (Saudi) was collected. A dental maturation score for each individual was calculated using the Demirjian method. Age was then estimated using the original Demirjian curves and tables based on French-Canadian population and population-specific curves and tables for Arab (Saudi and Kuwaiti) and European (Belgian) populations. The differences between dental age and chronological age were analyzed and compared using paired t-tests, one-way ANOVA test, and a post hoc Scheffé’s test. The Demirjian method utilizing French-Canadian standards presented significant difference between dental age and chronological age for the total sample and in the vast majority of age groups in both sexes. The mean overestimation of age was about 10 months (). The tables designed specifically for Arab populations had a significantly lower error than the tables designed for French-Canadian and Belgian populations. The latter had the largest error in age predication. New age prediction models and maturation scores for Saudi population were developed based on the Demirjian method using multinomial functions.

Dimensional Accuracy of Stone Casts Obtained with Multiple Pours into the Same Mold

Mon, 24 Dec 2012 14:17:15 +0000

Aim. The aim of the present study was to compare the dimensional accuracy of stone casts obtained with vinyl polysiloxane molds through the double-impression technique with three pours into the same mold. Methods. A stainless steel master model was constructed simulating a three-unit fixed prosthesis. Twelve impressions were taken of this master model with addition silicone, using the double-impression technique. Three pours of type IV gypsum were then made into each mold, thus producing 36 casts. The pours were made 1 hour, 6 hours and 24 hours after the impression procedure. Next, intra- and interabutment measurements were made in a coordinate measuring machine. Results. Comparative analysis of the dimensional accuracy of stone casts resulting from multiple pours was not statistically significant in pours first and second (). These values, however, were statistically significant at third pour in the height in abutment 1 and upper distance interabutment. Conclusion. The wait time (1 hour, and 6 hours) observed before pouring the stone into the same molds did not cause significant dimensional accuracy of the casts.

Temperature Rise during Primer, Adhesive, and Composite Resin Photopolymerization of a Low-Shrinkage Composite Resin under Caries-Like Dentin Lesions

Sayed-Mostafa Mousavinasab, Maryam Khoroushi, and Mohammadreza Moharreri — Mon, 24 Dec 2012 14:01:11 +0000

Objective. This study evaluated temperature rise of low-shrinkage (LS) self-etch primer (P), LS self-etch adhesive (A), and P90 silorane-based composite resin systems, photopolymerized under normal and artificially demineralized dentin. Methods. Forty 1.5 mm-thick dentin discs were prepared from sound human molars, half of which were demineralized. Temperature rise was measured during photopolymerization using a K-type thermocouple under the discs: 10 s and 40 s irradiation of the discs (controls/groups 1 and 2); 10 s irradiation of primer (P), 10 s irradiation of adhesive (A), 40 s irradiation of P90 without P and A, and 40 s irradiation of P90 with P and A (groups 3 to 6, resp.). The samples were photopolymerized using an LED unit under 550 mW/cm2 light intensity. Data was analyzed using repeated measures ANOVA and paired-sample -test (). Results. There were no significant differences in temperature rise means between the two dentin samples for each irradiation duration (), with significant differences between the two irradiation durations (). Temperature rise measured with 40 s irradiation was significantly higher than that of 10 s duration for undemineralized and demineralized dentin ). Conclusions. Light polymerization of P90 low-shrinkage composite resin resulted in temperature rise approaching threshold value under artificially demineralized and undemineralized dentin.

Biocompatibility of Intracanal Medications Based on Calcium Hydroxide

Tue, 18 Dec 2012 07:47:52 +0000

Objective. The aim of this study was to evaluate the rat subcutaneous tissue reaction to calcium hydroxide-based intracanal medicaments, UltraCal XS (calcium hydroxide, barium sulphate, aqueous matrix), Hydropast (calcium hydroxide, barium sulphate, and propyleneglycol), and Calen (Calcium hydroxide, zinc oxide, colophony, and polyethyleneglycol), used as a control. Methods. Forty-eight rats (Rattus Norvegicus Holtzman) were distributed in three groups: Calen, UltraCal XS, and Hydropast. Polyethylene tubes filled with one of the medicaments were implanted in the dorsal subcutaneous. After 7 and 30 days, the implants were removed and the specimens were fixed and embedded in paraffin. Morphological and quantitative analyses were carried out in the HE-stained sections. The numerical density of inflammatory cells in the capsule was evaluated and statistical analyses were performed (). Results. At 7 days, all materials induced an inflammatory reaction in the subcutaneous tissue adjacent to the implants. In all groups, a significant reduction in the number of inflammatory cells and giant cells was verified in the period of 30 days. Conclusion. These results indicate that the calcium hydroxide-based medicaments evaluated present biocompatibility similar to Calen.

Evaluation of the Periodontal Status in Acromegalic Patients: A Comparative Study

Thu, 06 Dec 2012 11:28:09 +0000

Aim. The aim was to compare the periodontal status of the acromegalic patients with healthy subjects from a large population-based cohort (Study of Health in Pomerania, SHIP). Materials and Methods. We studied 32 acromegalic patients (16 females) and 128 randomly selected SHIP subjects (controls) using a 1 : 4 matching. Serum IGF-I and IGFBP-3 levels were measured using the Immulite 2500 system. Periodontitis was assessed by clinical attachment loss (CAL), probing depth (PD), and number of missing teeth. Linear and logistic regression models were used to assess differences in periodontal variables between acromegalic patients and controls. Results. IGF-I levels were comparable in acromegalic patients and controls, whereas IGFBP-3 levels were significantly higher in acromegalic patients (). In multivariate modelling, both groups did not differ significantly with respect to mean CAL () and high tooth loss (). Mean PD was higher in acromegalic patients by trend ( (−0.00; 0.56)). Conclusion. In acromegalic patients, periodontal disease severity did not differ from their healthy SHIP controls.

Accuracy of Four Tooth Size Prediction Methods on Malay Population

Belal Khaled Mahmoud, Saifeddin Hamed I. Abu Asab, and Haslina Taib — Wed, 14 Nov 2012 11:31:47 +0000

Objective. To examine the accuracy of Moyers 50%, Tanaka and Johnston, Ling and Wong and Jaroontham and Godfrey methods in predicting the mesio-distal crown width of the permanent canines and premolars () in Malay population. Materials and Methods. The study models of 240 Malay children (120 males and 120 females) aged 14 to 18 years, all free of any signs of dental pathology or anomalies, were measured using a digital caliper accurate to 0.01 mm. The predicted widths () in both arches derived from the tested prediction equations were compared with the actual measured widths. Results. Moyers and Tanaka and Johnston methods showed significant difference between the actual and predicted widths of () for both sexes. Ling and Wong method also showed statistically significant difference for males, however, there was no significant difference for females. Jaroontham and Godfrey method showed statistical significant difference for females, but the male values did not show any significant difference. Conclusion. For male Malay, the method proposed by Jaroontham and Godfrey for male Thai proved to be highly accurate. For female Malay, the method proposed by Ling and Wong for southern Chinese females proved to be highly accurate.

Antimicrobial or Subantimicrobial Antibiotic Therapy as an Adjunct to the Nonsurgical Periodontal Treatment: A Meta-Analysis

Ana Patricia Moreno Villagrana and José Francisco Gómez Clavel — Mon, 22 Oct 2012 09:22:55 +0000

The use of antibiotics in nonsurgical periodontal treatment is indicated in cases in which scaling and root planing present important limitations. However, their use is controversial due to the secondary effects associated with them and the disagreements regarding their prescription. The aim of this study is to determine the effectiveness of systemic antibiotics in the management of aggressive and chronic periodontitis. The study was based on a search of randomized, controlled clinical trials. Common data were concentrated and evaluated by means of an analysis of variance (ANOVA), and a meta-analysis of the results was performed. The meta-analysis (, 95% confidence interval, post hoc Bonferroni) determined that the supplementation of nonsurgical periodontal therapy with a systemic antibiotic treatment—amoxicillin with clavulanic acid and metronidazole or subantimicrobial dose doxycycline—provides statistically significant results in patients with aggressive or chronic periodontitis under periodontal treatment, whilst increasing the clinical attachment level of the gingiva and reducing periodontal probing depth.

pH and Antimicrobial Activity of Portland Cement Associated with Different Radiopacifying Agents

Tue, 16 Oct 2012 09:17:41 +0000

Objective. The aim of this study was to evaluate the antimicrobial activity and pH changes induced by Portland cement (PC) alone and in association with radiopacifiers. Methods. The materials tested were pure PC, PC + bismuth oxide, PC + zirconium oxide, PC + calcium tungstate, and zinc oxide and eugenol cement (ZOE). Antimicrobial activity was evaluated by agar diffusion test using the following strains: Micrococcus luteus, Streptococcus mutans, Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans. After 24 hours of incubation at 37°C, inhibition of bacterial growth was observed and measured. For pH analysis, material samples () were placed in polyethylene tubes and immersed in 10 mL of distilled water. After 12, 24, 48, and 72 hours, the pH of the solutions was determined using a pH meter. Results. All microbial species were inhibited by the cements evaluated. All materials composed of PC with radiopacifying agents promoted pH increase similar to pure Portland cement. ZOE had the lowest pH values throughout all experimental periods. Conclusions. All Portland cement-based materials with the addition of different radiopacifiers (bismuth oxide, calcium tungstate, and zirconium oxide) presented antimicrobial activity and pH similar to pure Portland cement.

In Vitro Effects of External Pressure Changes on the Sealing Ability under Simulated Diving Conditions

Mon, 15 Oct 2012 08:49:10 +0000

Aim. To measure and validate the permeability of pressure changes in correlation to different root filling techniques. Methods. Eighty extracted single-rooted teeth were randomly assigned to one of eight groups of ten teeth. Following standardized instrumentation and irrigation, root canal fillings were performed using either cold lateral condensation, a warm carrier-based gutta-percha obturation technique, a warm carrier-based Resilon, or warm gutta-percha compaction with the downpack/backfill technique. After insertion of a pressure sensor within the pulp chamber ten teeth of each group then underwent simulated dives with pressure measurement and the other ten a dye penetration test during simulated dives to 5.0 bar. Differences were analyzed statistically () using one-way analysis of variance (ANOVA). Results. When the warm carrier-based gutta-percha obturation technique and vertical gutta-percha obturation techniques were used, there was significant lower intrapulpal pressure to experimental chamber pressure (). When cold lateral condensation or carrier-based Resilon as used, pressure was sometimes almost completely equalized. Conclusions. Warm gutta-percha obturation techniques provide a largely pressure-tight seal whereas the Resilon obturation technique and cold lateral condensation appear to be unsuitable to pressure changes.

Hydroxyapatite Formation on a Novel Dental Cement in Human Saliva

Johanna Engstrand, Erik Unosson, and Håkan Engqvist — Thu, 27 Sep 2012 09:53:18 +0000

Dental materials have to meet high standards regarding mechanical strength and handling properties. There is however only a limited amount of research that has been devoted to natural formation of hydroxyapatite (HA) in contact with the materials. The objective of the current investigation was to study the surface reactions occurring in human salvia on a novel dental cement. Ceramir Crown & Bridge, a bioceramic luting agent intended for permanent cementation of conventional oral prosthetics, was evaluated by immersing discs made from the cement in human saliva and phosphate buffered saline (PBS) for seven days, after which they were dried and analyzed. The analytical methods used in order to verify HA formation on the surface were grazing incidence X-ray diffraction (GI-XRD), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS). All results showed that HA was formed on the surfaces of samples stored in saliva as well as on samples stored in PBS. The possibility of a dental luting cement to promote natural formation of HA at the tooth interface increases the stability and durability of the system and could help prevent secondary caries.

Lymphotoxin-Alpha Gene Polymorphism +252A/G (rs909253, A/G) Is Associated with Susceptibility to Chronic Periodontitis: A Pilot Study

Tue, 25 Sep 2012 12:14:43 +0000

Background. Periodontal disease leading to clinical findings such as increased periodontal probing depth involves a complex interaction between invading pathogenic microorganisms and the patient's immune system. Lymphotoxin alpha (LT-α) is a potent multifunctional immune modulator that contributes toward susceptibility to immune regulation disorders, including periodontal disease. Objective. In this study, we tested the hypothesis that chronic periodontitis (CP) is associated with polymorphisms of the LT-α gene. Materials and Methods. A total of 126 subjects, 44 healthy subjects, and 82 subjects with CP, were evaluated for periodontal disease by measuring clinical attachment loss and separation. Samples of epithelial cells were obtained for DNA analysis by scraping of the buccal mucosa. The LT-α gene was analyzed by polymerase chain reaction followed by endonuclease digestion with NcoI to analyze restriction fragment length polymorphisms. Results. The LT-α gene (+252A/G) polymorphism was associated with CP. LT-α allele frequencies were significantly different () between patients with CP and healthy individuals, with an odds ratio of 2.67 for patients with CP with the G allele. Conclusions. These findings suggest the LT-α gene genotype is a risk indicator for susceptibility to chronic periodontal disease in the Brazilian population studied.

Integration of Digital Dental Casts in Cone-Beam Computed Tomography Scans

Sun, 23 Sep 2012 13:18:10 +0000

Cone-beam computed tomography (CBCT) is widely used in maxillofacial surgery. The CBCT image of the dental arches, however, is of insufficient quality to use in digital planning of orthognathic surgery. Several authors have described methods to integrate digital dental casts into CBCT scans, but all reported methods have drawbacks. The aim of this feasibility study is to present a new simplified method to integrate digital dental casts into CBCT scans. In a patient scheduled for orthognathic surgery, titanium markers were glued to the gingiva. Next, a CBCT scan and dental impressions were made. During the impression-taking procedure, the titanium markers were transferred to the impression. The impressions were scanned, and all CBCT datasets were exported in DICOM format. The two datasets were matched, and the dentition derived from the scanned impressions was transferred to the CBCT of the patient. After matching the two datasets, the average distance between the corresponding markers was 0.1 mm. This novel method allows for the integration of digital dental casts into CBCT scans, overcoming problems such as unwanted extra radiation exposure, distortion of soft tissues due to the use of bite jigs, and time-consuming digital data handling.

Common Perceptions of Periodontal Health and Illness among Adults: A Qualitative Study

M. Gholami, A. Pakdaman, and J. I. Virtanen — Mon, 17 Sep 2012 10:16:17 +0000

Objective. Our aim was to explore perceptions of periodontal health and illness and to examine attitudes and beliefs regarding prevention of gum diseases among Iranian adults. Methods. Our qualitative approach included focus-group discussions among adults aged 18 and above based on convenient and purposive sampling in Tehran. Transcripts of the four focus-group discussions were analyzed by two independent reviewers using a content analysis method. Results. Two major themes in the analyses emerged: the common perception of periodontal health and illness and the attitude towards prevention. The study demonstrated the subjects’ good understanding of prevention of periodontal disease, but their lack of knowledge of the aetiology of the diseases, and an inability to differentiate aetiology, symptoms, and prevention of dental caries and periodontal disease. Conclusion. This study revealed a need for oral health education among Iranian adults to improve their knowledge and change their attitudes to achieve deeper understanding of the aetiology and prevention of periodontal disease. Health promotion programs should address misconceptions about prevention of gum disease.

Radiopacity Evaluation of Contemporary Luting Cements by Digitization of Images

Thu, 13 Sep 2012 14:18:07 +0000

Objective. The aim of this study was to evaluate the radiopacity of two conventional cements (Zinc Cement and Ketac Cem Easymix), one resin-modified glass ionomer cement (RelyX Luting 2) and six resin cements (Multilink, Bistite II DC, RelyX ARC, Fill Magic Dual Cement, Enforce and Panavia F) by digitization of images. Methods. Five disc-shaped specimens (10×1.0 mm) were made for each material, according to ISO 4049. After setting of the cements, radiographs were made using occlusal films and a graduated aluminum stepwedge varying from 1.0 to 16 mm in thickness. The radiographs were digitized, and the radiopacity of the cements was compared with the aluminum stepwedge using the software VIXWIN-2000. Data (mmAl) were submitted to one-way ANOVA and Tukey's test (𝛼=0.05). Results. The Zinc Cement was the most radiopaque material tested (𝑃<0.05). The resin cements presented higher radiopacity (𝑃<0.05) than the conventional (Ketac Cem Easymix) or resin-modified glass ionomer (RelyX Luting 2) cements, except for the Fill Magic Dual Cement and Enforce. The Multilink presented the highest radiopacity (𝑃<0.05) among the resin cements. Conclusion. The glass ionomer-based cements (Ketac Cem Easymix and RelyX Luting 2) and the resin cements (Fill Magic Dual Cement and Enforce) showed lower radiopacity values than the minimum recommended by the ISO standard.

Evaluation of Manual and Two-Rotary Niti Retreatment Systems in Removing Gutta-Percha Obturated with Two Root Canal Sealers

Athikesavan Jayasenthil, Emmanuel Solomon Sathish, and Prashanth Prakash — Mon, 10 Sep 2012 08:51:43 +0000

Objective. The objective of this study was to evaluate the efficacy of two retreatment NiTi systems (protaper universal retreatment files, R-Endo), when compared to manual technique in removing Gutta-percha obturated with two sealers. Study Design. Sixty extracted single-rooted premolars were instrumented with Protaper rotary files till F3. The specimens were divided into six groups. Groups 1, 2, 3 were obturated with Gutta-percha and zinc oxide eugenol and Groups 4, 5, 6 were obturated with Gutta-percha and AH-plus. The retreatment was carried out in groups 1 and 4 with H-files and GGdrills, groups 2 and 5 with R-endo retreatment files and groups 3 and 6 with Protaper retreatment files. The roots were sectioned and evaluated under optical stereomicroscope. Statistical analysis was performed with one-way ANOVA and Newman-Keul's test at 𝑃<0.05. Results. The manual technique resulted in cleaner canal walls when compared with both rotary retreatment systems. Conclusion. NiTi rotary retreatment files can be used to remove the filling material quickly, but it should be followed by hand instruments to obtain better canal wall cleanliness.

The Antibacterial Efficacy of Biopure MTAD in Root Canal Contaminated with Enterococcus faecalis

Thu, 06 Sep 2012 12:06:07 +0000

Aim. The purpose of this in vitro study was to assess the antimicrobial efficacy of Biopure MTAD against E. faecalis in contaminated root canals. Materials and Methods. Forty-two single rooted extracted human teeth were inoculated with E. faecalis and incubated for four weeks. The samples were divided in two control and five experimental groups irrigated with 1.5% sodium hypochlorite solution (NaOCl); 3% NaOCl; BioPure MTAD; 1.5% NaOCl/17% EDTA; or 3% NaOCl/17% EDTA. After a one-week incubation, complete disinfection was confirmed by the absence of turbidity in the incubation media. Dentin shavings were taken from samples with no turbidity to verify whether E. faecalis was present in dentin tubules. Results were analyzed statistically using Fisher's exact test, with the level of significance set at 𝑃<0.05. Results. Statistical analysis of the data obtained at Day 7 and after dentin shaving analysis showed that BioPure MTAD had significantly greater antibacterial activity than 1.5% NaOCl, 1.5% NaOCl/17% EDTA and 3% NaOCl/17% EDTA. No significant difference was detected between MTAD and 3% NaOCl. Conclusions. These findings suggest that BioPure MTAD possesses superior bactericidal activity compared with NaOCl and EDTA against E. faecalis.

Compressive Strength and Setting Time of MTA and Portland Cement Associated with Different Radiopacifying Agents

Thu, 23 Aug 2012 13:14:39 +0000

Objective. The aim of this study was to evaluate the compressive strength and setting time of MTA and Portland cement (PC) associated with bismuth oxide (BO), zirconium oxide (ZO), calcium tungstate (CT), and strontium carbonate (SC). Methods. For the compressive strength test, specimens were evaluated in an EMIC DL 2000 apparatus at 0.5 mm/min speed. For evaluation of setting time, each material was analyzed using Gilmore-type needles. The statistical analysis was performed with ANOVA and the Tukey tests, at 5% significance. Results. After 24 hours, the highest values were found for PC and PC + ZO. At 21 days, PC + BO showed the lowest compressive strength among all the groups. The initial setting time was greater for PC. The final setting time was greater for PC and PC + CT, and MTA had the lowest among the evaluated materials (𝑃<0.05). Conclusion. The results showed that all radiopacifying agents tested may potentially be used in association with PC to replace BO.

Computed Tomography Evaluation of Craniomandibular Articulation in Class II Division 1 Malocclusion and Class I Normal Occlusion Subjects in North Indian Population

Thu, 16 Aug 2012 13:44:37 +0000

Objective. The purpose of this study is to investigate the Craniomandibular articulation morphology and position of condyle in mandibular fossae in Angle’s class I normal occlusion and Angle’s class II division 1 malocclusion. Materials and Methods. The present study was conducted on 40 subjects with 20 subjects in each group, and the computed tomography images were obtained using spiral computed tomography technique. Each measurement was compared by two-factor analysis of variance (ANOVA) while changes in anterior and posterior joint spaces were done by paired t-test. Results. Statistically significant anterior positioning of condyle (𝑃>0.05) was observed in class I normal malocclusion, and it was significant only on right side in class II division 1 malocclusion. Conclusions. There was no difference found in the condylar process and joint morphology between right and left sides of both Angle’s Class I normal occlusion and Angle’s class II division 1 malocclusion. Evaluation of the position of the condyles in their respective mandibular fossae showed concentric position with a tendency towards anterior positioning for both right and left sides of the subjects with Angle’s Class I normal occlusion as well as subjects with Angle’s class II division 1 malocclusion.

Orthodontic Tooth Movement with Clear Aligners

Tue, 14 Aug 2012 08:20:51 +0000

Clear aligners provide a convenient model to measure orthodontic tooth movement (OTM). We examined the role of in vivo aligner material fatigue and subject-specific factors in tooth movement. Fifteen subjects seeking orthodontic treatment at the University of Florida were enrolled. Results were compared with data previously collected from 37 subjects enrolled in a similar protocol. Subjects were followed prospectively for eight weeks. An upper central incisor was programmed to move 0.5 mm. every two weeks using clear aligners. A duplicate aligner was provided for the second week of each cycle. Weekly polyvinyl siloxane (PVS) impressions were taken, and digital models were fabricated to measure OTM. Initial and final cone beam computed tomography (CBCT) images were obtained to characterize OTM. Results were compared to data from a similar protocol, where subjects received a new aligner biweekly. No significant difference was found in the amount of OTM between the two groups, with mean total OTM of 1.11 mm. (standard deviation (SD) 0.30) and 1.07 mm. (SD 0.33) for the weekly aligner and biweekly control groups, respectively (𝑃=0.72). Over eight weeks, in two-week intervals, material fatigue does not play a significant role in the rate or amount of tooth movement.

Tooth Surface Loss and Associated Risk Factors in Northern Saudi Arabia

Bader K. Al-Zarea — Tue, 07 Aug 2012 08:25:05 +0000

Aim. To evaluate tooth surface loss (TSL) severity and associated risk factors in a representative sample of Saudi adults. Materials and Methods. Four hundred TSL patients (200 females and 200 males) participated in this study. Each patient completed a comprehensive questionnaire interview (using a modified Tooth wear Assessment Questionnaire) and then examined for the severity of TSL (using ordinal scale). Results. Seventy-five percent of participants demonstrated attrition, 90% had erosion, 15% had abrasion, and 95% had more than one type of TSL. The most common risk factors were consumption of acidic food/drinks (78%), parafunctional habits (70%), and unilateral chewing (50%). 77% of participants demonstrated grade 2 TSL. Males demonstrated greater TSL severity (𝑃≤0.05). Age, systemic disease, number of remaining teeth, acidic food/drinks, bruxism/parafunction, biting objects, facial pain/tenderness, sour taste, exposure to dust, unilateral chewing, using dental abrasives, and brushing frequency/technique had significant relationship with TSL severity (𝑃≤0.05). Conclusions. TSL has a multifactorial aetiology. Parafunction, gastrointestinal problems, and diet were the most common aetiological factors reflecting changes to stressful modern life-styles, eating/drinking habits, and behaviours. Gender didn’t influence the aetiology of TSL; however males demonstrated more TSL severity. Patients’ age had significant correlation to TSL severity.