International Journal of Dentistry The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. A Novel Rat Model of Orthodontic Tooth Movement Using Temporary Skeletal Anchorage Devices: 3D Finite Element Analysis and In Vivo Validation Wed, 10 Sep 2014 07:51:08 +0000 The aim of this animal study was to develop a model of orthodontic tooth movement using a microimplant as a TSAD in rodents. A finite element model of the TSAD in alveolar bone was built using μCT images of rat maxilla to determine the von Mises stresses and displacement in the alveolar bone surrounding the TSAD. For in vivo validation of the FE model, Sprague-Dawley rats () were used and a Stryker 1.2 × 3 mm microimplant was inserted in the right maxilla and used to protract the right first permanent molar using a NiTi closed coil spring. Tooth movement measurements were taken at baseline, 4 and 8 weeks. At 8 weeks, animals were euthanized and tissues were analyzed by histology and EPMA. FE modeling showed maximum von Mises stress of 45 Mpa near the apex of TSAD but the average von Mises stress was under 25 Mpa. Appreciable tooth movement of 0.62 ± 0.04 mm at 4 weeks and 1.99 ± 0.14 mm at 8 weeks was obtained. Histological and EPMA results demonstrated no active bone remodeling around the TSAD at 8 weeks depicting good secondary stability. This study provided evidence that protracted tooth movement is achieved in small animals using TSADs. Neelambar Kaipatur, Yuchin Wu, Samer Adeeb, Thomas Stevenson, Paul Major, and Michael Doschak Copyright © 2014 Neelambar Kaipatur et al. All rights reserved. Risk Assessment of BRONJ in Oncologic Patients Treated with Bisphosphonates: Follow-Up to 18 Months Mon, 01 Sep 2014 06:55:31 +0000 Objectives. Bisphosphonates related osteonecrosis of the jaw (BRONJ) is a pathological condition characterized by bone exposure or latent infection in patients treated with the drug. The aim of the study is to monitor the BRONJ level of risk health in patients with cancer, according to a preventive clinical protocol, which is firstly aimed at reducing risk factors such as the periodontal infections. Materials and Methods. 10 patients participated in the protocol and were evaluated at baseline and after 3 and 18 months of treatment with bisphosphonates, through full mouth plaque and bleeding scores (FMPS and FMBS), clinical attachment level (CAL) measurement, and the occurrence of osteonecrosis. Results. The mean plaque and bleeding were reduced and the CAL has not shown significant changes and in no cases was there manifestation of BRONJ. Conclusion. The protocol proved crucial for the maintenance of good oral health conditions by eliminating the risk of BRONJ during the observation period. Scilla Sparabombe, Lucia Vitali, Alessandra Nori, Ricarda Sara Berlin, Marta Mazur, Giovanna Orsini, and Angelo Putignano Copyright © 2014 Scilla Sparabombe et al. All rights reserved. Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment Mon, 01 Sep 2014 00:00:00 +0000 Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly. Lars Rasmusson and Jahan Abtahi Copyright © 2014 Lars Rasmusson and Jahan Abtahi. All rights reserved. Epidemiology and Diagnosis of Periodontal Diseases: Recent Advances and Emerging Trends Mon, 25 Aug 2014 11:01:43 +0000 S. Al-Mubarak, S. Ciancio, and J. K. Baskaradoss Copyright © 2014 S. Al-Mubarak et al. All rights reserved. The Detection of Candida Species in Patients with Halitosis Sun, 24 Aug 2014 06:06:37 +0000 To examine the effects of Candida on halitosis, the carrier state of Candida was examined in patients who made a visit with a chief complaint of halitosis. Methods. Subjects were 123 patients (42 males and 81 females) who visited our clinic, with a chief complaint of halitosis. Their average age was 45.8 years. To examine halitosis, an organoleptic test was conducted, and volatile sulfur compounds (VSCs) were measured by gas chromatography. Tongue-coating samples collected at the initial visit were cultured in CHROMagar Candida medium. The results of a Candida culture test, an organoleptic test, and VSC measurements were examined. Results. The male-to-female ratio of the patients was about 1 : 2. Patients with severe halitosis accounted for less than 20%. In the Candida culture test, the positive rate was about 25.2%, and C. albicans was the most frequently detected. Two kinds of Candida species were detected in 75% (6/8) of the strongly Candida-positive group. The VSC measurements were correlated with the Candida culture test results. Methyl mercaptan concentration was higher in the strongly C. albicans-positive group or the subjects having two kinds of Candida species. Conclusion. We suggest that imbalance of oral microbial community exists in the strongly Candida-positive group. Chihiro Koga, Masahiro Yoneda, Keisuke Nakayama, Satoru Yokoue, Mariko Haraga, Tomoko Oie, Arisa Suga, Fumiko Okada, Hiroshi Matsuura, Fumitake Tsue, Nao Suzuki, and Takao Hirofuji Copyright © 2014 Chihiro Koga et al. All rights reserved. The Need for Orthodontic Treatment among Vietnamese School Children and Young Adults Mon, 21 Jul 2014 07:11:45 +0000 Objective. The aim of this study was to evaluate the need for orthodontic treatment among 12-year-old school children and 18-year-olds from Da Nang, Vietnam. Basic Research Design. A random representative sample of 200 12-year-old children from primary schools in Da Nang city was gathered. In addition, 200 18-year-old students were randomly selected from among the 4000 students studying at Da Nang University of Medical Technology and Pharmacy, Vietnam. All the subjects were evaluated according to Angle’s molar relationship, the presence of malocclusion, and the components of the Index of Orthodontic Treatment Need (Dental Health Component, DHC, and Aesthetic Component, AC). Results. The DHC of index of orthodontic treatment need (IOTN) for 12-year-olds was in 60% of cases no or little, in 21% of cases moderate, and in 19% of cases definitive, while the prevalence of moderate and definitive need for treatment among the 18-year-olds was 24% and 30.5%, respectively. The prevalence of class III malocclusion, contact point displacement, and crossbite was higher in 18-year-olds than among the 12-year-olds, while the prevalence of increased overjet and increased overbite had decreased in 18-year-olds compared to the group of 12-year-olds. Conclusions. There is a strong need for orthodontic treatment in Vietnam’s population. The need for orthodontic treatment was determined by contact point displacement, crossbite, increased overjet, and increased overbite. Son Minh Nguyen, Minh Khac Nguyen, Mare Saag, and Triin Jagomagi Copyright © 2014 Son Minh Nguyen et al. All rights reserved. Effect of Recycling Protocol on Mechanical Strength of Used Mini-Implants Thu, 17 Jul 2014 12:42:41 +0000 Purpose. This study evaluated the influence of recycling process on the torsional strength of mini-implants. Materials and Methods. Two hundred mini-implants were divided into 4 groups with 50 screws equally distributed in five diameters (1.3 to 1.7 mm): control group (CG): unused mini-implants, G1: mini-implants inserted in pig iliac bone and removed, G2: same protocol of group 1 followed by sonication for cleaning and autoclave sterilization, and G3: same insertion protocol of group 1 followed by sonication for cleaning before and after sandblasting (Al2O3-90 µ) and autoclave sterilization. G2 and G3 mini-implants were weighed after recycling process to evaluate weight loss (W). All the screws were broken to determine the fracture torque (FT). The influence of recycling process on FT and W was evaluated by ANOVA, Mann-Whitney, and multiple linear regression analysis. Results. FT was not influenced by recycling protocols even when sandblasting was added. Sandblasting caused weight loss due to abrasive mechanical stripping of screw surface. Screw diameter was the only variable that affected FT. Conclusions. Torsional strengths of screws that underwent the recycling protocols were not changed. Thus, screw diameter choice can be a more critical step to avoid screw fracture than recycling decision. Sérgio Estelita, Guilherme Janson, Kelly Chiqueto, and Eduardo Silveira Ferreira Copyright © 2014 Sérgio Estelita et al. All rights reserved. Erratum to “A Proposed New Index for Clinical Evaluation of Interproximal Soft Tissues: The Interdental Pressure Index” Wed, 09 Jul 2014 10:28:46 +0000 Luigi Checchi, Marco Montevecchi, Gianluca Marucci, and Vittorio Checchi Copyright © 2014 Luigi Checchi et al. All rights reserved. Effect of Patient’s Personality on Satisfaction with Their Present Complete Denture and after Increasing the Occlusal Vertical Dimension: A Study of Edentulous Egyptian Patients Tue, 08 Jul 2014 12:37:05 +0000 Complete denture wearers often find it difficult to accept a new denture. Personality traits are among the factors that possibly affect patient satisfaction with a complete denture. Our aim was to investigate the influence of patients’ personality on satisfaction with their present denture and after an increase in the occlusal vertical dimension (OVD). Sixty edentulous patients with complete dentures (22 men and 38 women, mean age 66 years, and range 50–75 years) participated in the study. The age of their complete dentures ranged from 5 to 16 years. Patients’ personalities were evaluated using the Arabic version of the Eysenck Personality Questionnaire. Their satisfaction with their dentures before and after restoration of the OVD and relining of the mandibular denture was evaluated using two questionnaires (I and II), Patients with a high score of neuroticism were less satisfied with their original dentures and after relining and an increase of OVD compared with patients with an average score in that trait. The personality trait of psychoticism was significant to patients’ acceptance of an increase in OVD; that is, patients with a high score were less satisfied with their dentures after increase of OVD than patients with an average score. It is concluded that personality traits affect patients’ acceptance of their complete dentures. Shaimaa M. Fouda, Mohamed S. Al-Attar, Jorma I. Virtanen, and Aune Raustia Copyright © 2014 Shaimaa M. Fouda et al. All rights reserved. Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review Mon, 07 Jul 2014 09:12:38 +0000 Background. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability. Purpose. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants. Materials and methods. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs) conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated. Results. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias. Conclusions. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability. Rola Muhammed Shadid, Nasrin Rushdi Sadaqah, and Sahar Abdo Othman Copyright © 2014 Rola Muhammed Shadid et al. All rights reserved. A Modified Intraoral Resin Mouthguard to Prevent Self-Mutilations in Lesch-Nyhan Patients Wed, 02 Jul 2014 00:00:00 +0000 Lesch-Nyhan syndrome, described in 1964 by Lesch and Nyhan, is a X-linked recessive disorder, occurring in 1 : 100000 to 1 : 380000 live births. LNS is characterized by a decrease in activity of hypoxanthine guanine phosphoribosyl transferase, an enzyme involved in purine metabolism, resulting in overproduction of uric acid. Hyperuricemia and neurological features including choreoathetoid spasticity, self-mutilation, and mental retardation clinically characterize this syndrome. In LNS patients the typical feature is loss of tissue from biting themselves with partial or complete amputation of fingers, lips, and tongue. The self-mutilation compares with the eruption of the deciduous teeth. Several drugs trials have been administered to improve self-destructive behavior and invasive treatment approaches, such as extractions of teeth and orthognathic surgery, have been suggested with variable effectiveness. Nowadays prevention is, therefore, the standard of care. The role of dentistry is essential in the management of the self-mutilating behavior, because the teeth represent the main self-injury instrument. This report presents a revision of various therapeutic approaches to manage self-destruction, highlighting the effectiveness of a preventive treatment. It describes a new technique: a resin mouthguard, realized at Gaslini Hospital, to obtain immediate healing of the oral lesions, confirmed in the follow-up period. Giulia Ragazzini, Alessia Delucchi, Enrico Calcagno, Roberto Servetto, and Gloria Denotti Copyright © 2014 Giulia Ragazzini et al. All rights reserved. The Tooth and Skin Colour Interrelationship across the Different Ethnic Groups Tue, 01 Jul 2014 11:02:08 +0000 Objectives. The purpose of the study was to investigate the relation between skin and tooth colour parameters in various ethnic groups. Materials and Methods. Saudi Arabian, Indian, African, and East Asian ethnic groups of 75 each were included in the study. The tooth colour was determined by spectrophotometer in CIELAB parameters. The skin colour was measured at earlobe, forehead, and malar locations by clinical skin photography. The data was statistically analysed by one-way ANOVA and correlation tests. Results. The “” vale for the Saudi Arabian group had a strong correlation at earlobe location (), while correlation was found at forehead () and malar region () with Indian ethnic group. A strong negative correlation was observed in African ethnic group at all three locations for “” parameter. The redness value “” is found to have strong negative linear correlation between the earlobe and tooth for Saudi Arabian () and Indian ethnic groups (). The “” showed no correlation with skin location in all groups except positive correlation in African ethnic groups. Conclusions. The strong correlation was found between the skin and tooth colour parameters; hence the skin colour can be used as a guide for artificial tooth selection in edentulous patients. Satheesh B. Haralur, Ahmed Mohammed Dibas, Nabil Abdullah Almelhi, and Dhafer Ali Al-Qahtani Copyright © 2014 Satheesh B. Haralur et al. All rights reserved. Common Periodontal Diseases of Children and Adolescents Thu, 26 Jun 2014 06:42:49 +0000 Background. Since 2000, studies, experiments, and clinical observations revealed high prevalence of periodontal diseases among children and adolescents. Therefore, this paper was designed to provide an update for dental practitioners on epidemiology, microbiology, pathology, prevention, diagnosis, and treatment of periodontal diseases in children and adolescents. Methods. This paper reviews the current literature concerning periodontal diseases in pediatric dentistry. It includes MEDLINE database search using key terms: “periodontal diseases in children,” “Periodontal diseasesin adolescents,” “periodontal diseases risk factors,” “microbiology of periodontal diseases,” “classification of periodontal diseases,” “epidemiology of periodontal diseases,” and “treatment of periodontal diseases.” Articles were evaluated by title and/or abstract and relevance to pediatric dentistry. Sixty-five citations were selected by this method and by the references within the chosen articles. A review of the comprehensive textbooks on pediatric dentistry and periodontology was done. Some recommendations were based on the opinions of experienced researchers and clinicians, when data were inconclusive. Hayat Al-Ghutaimel, Hisham Riba, Salem Al-Kahtani, and Saad Al-Duhaimi Copyright © 2014 Hayat Al-Ghutaimel et al. All rights reserved. Is Bisphosphonate-Related Osteonecrosis of the Jaw an Infection? A Histological and Microbiological Ten-Year Summary Tue, 24 Jun 2014 07:14:12 +0000 The role of infection in the etiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is poorly understood. Large-scale epidemiological descriptions of the histology and microbiology of BRONJ are not found in the literature. Herein, we present a systematic review of BRONJ histology and microbiology (including demographics, immunocompromised associations, clinical signs and symptoms, disease severity, antibiotic and surgical treatments, and recovery status) validating that infection should still be considered a prime component in the multifactorial disease. A. M. Hinson, C. W. Smith, E. R. Siegel, and B. C. Stack Jr. Copyright © 2014 A. M. Hinson et al. All rights reserved. Apical Dimension of Root Canal Clinically Assessed with and without Periapical Lesions Tue, 24 Jun 2014 00:00:00 +0000 To clinically evaluate the dimension of the more apical extent of the root canal after appropriate preflaring in the case of primary treatment and retreatment with and without the presence of periapical radiolucency, 392 single-rooted teeth with only one canal were evaluated during endodontic therapy. The canals were divided in two groups depending on the presence or absence of periapical radiolucency. After preflaring of the root canal the size of the root canal terminus (apical canal dimension) was gauged with hand-held Light Speed LS1 files inserted at the estimated working length and established with the use of an electronic apex locator. The dimension recorded in the computer database was represented by the largest instrument able to reach the electronically established working length. The differences between the treatment groups were assessed using the Mann-Whitney U test and the significance level was set at . Teeth with lesions had a significantly greater diameter in the apical region than teeth without lesions (). The dimension of the apical portion of the root canal is larger in the case of periapical radiolucency. This involves verifying this parameter in order to use the correct sized instruments and to obtain an efficient cutting action at the apical level. Andrea Gesi, Paolo Mareschi, Tiziana Doldo, and Marco Ferrari Copyright © 2014 Andrea Gesi et al. All rights reserved. Conservative Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw in Multiple Myeloma Patients Tue, 17 Jun 2014 05:45:17 +0000 The use of intravenous bisphosphonates (pamidronate or zoledronic acid) is the cornerstone for the management of multiple myeloma-(MM-) related bone disease. However, osteonecrosis of the jaw (ONJ) is a rare, but sometimes difficult to manage, adverse effect of bisphosphonates therapy. A retrospective review of all MM patients who were treated with bisphosphonates in our department, from 2003 to 2013, and developed ONJ was performed. According to inclusion criteria, 38 patients were studied. All these patients were treated as conservatively as possible according to the American Association of Oral and Maxillofacial Surgeons criteria. Patients were managed with observation, oral antibacterial mouth rinse with chlorhexidine, oral antibiotics, pain control with analgesics, nonsurgical sequestrectomy with or without simultaneous administration of antibiotics, or major surgery with or without antibiotics. Healing of the lesions was achieved in 23 (60%) patients who were treated with conservative measures; the median time to healing was 12 months (95% CI: 4–21). The number of bisphosphonates infusions influenced the time to healing: the median time to healing for patients who received <16 infusions was 7 months and for those with >16 infusions was it 14 months . We conclude that a primarily nonsurgical approach appears to be a successful management strategy for bisphosphonate-related ONJ. Pelagia I. Melea, Ioannis Melakopoulos, Efstathios Kastritis, Christina Tesseromatis, Vasileios Margaritis, Meletios A. Dimopoulos, and Evangelos Terpos Copyright © 2014 Pelagia I. Melea et al. All rights reserved. Comparison of Maxillary Molar Distalization with an Implant-Supported Distal Jet and a Traditional Tooth-Supported Distal Jet Appliance Wed, 11 Jun 2014 12:39:16 +0000 Aim. To investigate and compare the efficiency of two appliances for molar distalization: the bone-anchored distal screw (DS) and the traditional tooth-supported distal jet (DJ) for molar distalization and anchorage loss. Methods. Tests (18 subjects) were treated with a DS and controls (18 subjects) were treated with a DJ. Lateral cephalograms were obtained before and at the end of molar distalization and were analysed. Shapiro Wilk test, unpaired -test, and Wilcoxon rank-sum test were applied according to values distribution. The level was fixed at 0.05. Results. Maxillary first molars were successfully distalized into a Class I relationship in all patients. The mean molar distalization and treatment time were similar in both groups. The DS group exhibited a spontaneous distalization ( mm) of the first premolar with control of anchorage loss, distal tipping, extrusion, and skeletal changes. Conclusions. The DS is an adequate compliance-free distalizing appliance that can be used safely for the correction of Class II malocclusions. In comparison to the traditional DJ, the DS enables not only a good rate of molar distalization, but also a spontaneous distalization of the first premolars. Mauro Cozzani, Marco Pasini, Francesco Zallio, Robert Ritucci, Sabrina Mutinelli, Laura Mazzotta, Maria Rita Giuca, and Vincenzo Piras Copyright © 2014 Mauro Cozzani et al. All rights reserved. Imaging Findings of Bisphosphonate-Related Osteonecrosis of the Jaws: A Critical Review of the Quantitative Studies Wed, 11 Jun 2014 08:19:28 +0000 Objectives. This paper offers a critical review of published information on the imaging strategies used for diagnosing bisphosphonate-associated osteonecrosis of the jaw (BRONJ) in patients taking intravenous bisphosphonates, pointing at the different methodologies and results of existing literature. Methods. Electronic literature search was performed in order to identify as many quantitative studies that discussed the imaging findings of BRONJ up to February 2014. Initially, the search for articles was based on the following four types of imaging modalities for evaluating BRONJ: computed tomography, plain film radiographs, magnetic resonance imaging, and nuclear bone scanning. Results. Eleven out of the 79 initially selected articles met the inclusion criteria. Most of the selected articles were cross-sectional studies. Regarding the selected studies, 54.5% have used plain films radiographs and 54.5% were based on computed tomography findings. All of the selected studies showed a small number of patients and none of the selected studies have tested the accuracy of the imaging examination for evaluating BRONJ. Conclusions. This critical review showed a scarcity of quantitative studies that analyzed the typical imaging findings related to BRONJ. Further studies are necessary in order to analyze the role of different imaging techniques in the assessment of BRONJ. André Ferreira Leite, Fernanda dos Santos Ogata, Nilce Santos de Melo, and Paulo Tadeu de Souza Figueiredo Copyright © 2014 André Ferreira Leite et al. All rights reserved. Platelet Rich Plasma in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw: Personal Experience and Review of the Literature Tue, 10 Jun 2014 06:01:08 +0000 Bisphosphonates (BPs) are a class of synthetic drugs commonly used to treat bone metastasis and various bone diseases that cause osseous fragility (such as osteoporosis). Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a common complication in patients who received BPs, especially intravenously. Recently, osteonecrosis of the jaw (ONJ) caused by chemotherapeutic not belonging to BPs drug class has been reported. For this reason, it has been proposed recently to rename BRONJ in antiresorptive agents related osteonecrosis of the jaw (ARONJ), to include a wider spectrum of drugs that may cause osteonecrosis of the jaw. The most debated topic about ARONJ/BRONJ is therapy. The most adequate procedure is far from being standardized and prevention seems to play a pivotal role. In our study, we considered 72 patients with BRONJ with nonsurgical therapy, surgical therapy, and surgical therapy with platelet rich plasma (PRP) gel to evaluate its therapeutic effect in promoting ONJ wounds healing. Good results showed by PRP in improving wound healing give away to case-control randomized studies that could give definitive evidence of its effectiveness. F. Longo, A. Guida, C. Aversa, E. Pavone, G. Di Costanzo, L. Ramaglia, and F. Ionna Copyright © 2014 F. Longo et al. All rights reserved. New Dimensional Staging of Bisphosphonate-Related Osteonecrosis of the Jaw Allowing a Guided Surgical Treatment Protocol: Long-Term Follow-Up of 266 Lesions in Neoplastic and Osteoporotic Patients from the University of Bari Thu, 05 Jun 2014 12:35:45 +0000 Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is the most serious side effect in patients receiving bisphosphonates (BPs) for neoplastic disease and osteoporosis. The aim of this study is to propose a new dimensional stage classification, guiding the surgical treatment of BRONJ patients, and to evaluate the success rate of this new management. From 2004 to 2013, 203 neoplastic and osteoporotic patients with 266 BRONJ lesions were referred to the Odontostomatology Unit of the University of Bari. All patients underwent surgery after suspension of BPs therapy and antibiotic treatment. The surgical procedure was complemented by piezosurgery and followed by the application of hyaluronate and amino acids. The new dimensional staging suggests the choice of the surgical approach, and allows the prediction of postoperative complications and soft and hard tissues healing time, guiding the surgical treatment protocol. This protocol could be a successful management strategy for BRONJ, considering the low recurrences rate and the good stabilisation of the surgical sites observed after a long-term follow-up. Simonetta Franco, Simona Miccoli, Luisa Limongelli, Angela Tempesta, Giorgio Favia, Eugenio Maiorano, and Gianfranco Favia Copyright © 2014 Simonetta Franco et al. All rights reserved. Bonding Effectiveness of Two Adhesive Luting Cements to Glass Fiber Posts: Pull-Out Evaluation of Three Different Post Surface Conditioning Methods Mon, 02 Jun 2014 09:04:06 +0000 The purpose of this study was to evaluate the bond strength at the post/resin-cement interface with 3 different surface treatments of glass fiber posts and with 2 different luting resin cements. Sixty glass fiber posts (RelyX Fiber Post) were randomly divided into 3 groups () and were luted with a dual-polymerizing self-adhesive universal resin cement (RelyX Unicem) and with a dual-polymerizing resin cement (RelyX ARC). This was carried out in association with a dual-polymerizing adhesive (Scotchbond Multi-Purpose Plus) in simulated plexiglass root canals after receiving three different pretreatment procedures. A pull-out test was performed on each sample to measure bond strengths. Data were analyzed with two-way ANOVA. Two samples from each group were processed for SEM observations in order to investigate the morphologic aspect of the post/cement interface. Both resin cements demonstrated significant different bond strength values (). The surface treatment result was also statistically significant (). SEM examination showed a modification of the post surface after pretreatment with methyl methacrylate. The dual-polymerizing self-adhesive universal resin cement achieved higher MPa bond strength values. The use of methyl methacrylate as a surface treatment of glass fiber posts provided a significant increase in bond strengths between the posts and both luting materials. Lorenzo Graiff, Laura Rasera, Marco Calabrese, and Paolo Vigolo Copyright © 2014 Lorenzo Graiff et al. All rights reserved. Dry Socket: Incidence, Clinical Features, and Predisposing Factors Mon, 02 Jun 2014 05:43:01 +0000 Background. Dry socket is a global phenomenon. The purpose of the study was to investigate the incidence of dry socket in recent times in a Nigerian Tertiary Hospital. Methods. Patients who were referred for dental extractions were included in the study. The case files of patients were obtained and information retrieved included biodata, indication for extraction, number and type of teeth extracted, oral hygiene status, compliance to oral hygiene instructions, and development of dry socket. Results. One thousand, one hundred and eighty two patients with total of 1362 teeth extracted during the 4-year period of the study were analyzed, out of which 1.4% teeth developed dry socket. The mean age (SD) was 35.2 (16.0) years. Most of the patients who presented with dry socket were in the fourth decade of life. Mandibular teeth were affected more than maxillary teeth. Molars were more affected. Retained roots and third molars were conspicuous in the cases with dry socket. Conclusion. The incidence of dry socket in our centre was lower than previous reports. Oral hygiene status, lower teeth, and female gender were significantly associated with development of dry socket. Treatment with normal saline irrigation and ZnO eugenol dressings allowed relief of the symptoms. Babatunde O. Akinbami and Thikan Godspower Copyright © 2014 Babatunde O. Akinbami and Thikan Godspower. All rights reserved. The Effect of Orthodontic Therapy on Periodontal Health: A Review of the Literature Thu, 29 May 2014 13:16:58 +0000 Objectives. This review aims to evaluate the effect of orthodontic therapy on periodontal health. Data. Original articles that reported on the effect of orthodontic therapy on periodontal health were included. The reference lists of potentially relevant review articles were also sought. Sources. A literature search was conducted using the databases, Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies. The search was carried out by using a combined text and the MeSH search strategies: using the key words in different combinations: “periodontal disease,” “orthodontics” and “root resorption.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Articles published only in English language were included. Letters to the Editor, historical reviews and unpublished articles were not sought. Conclusions. Within the limitations of the present literature review, it was observed that there is a very close inter-relationship between the periodontal health and the outcome of orthodontic therapy. Samah Alfuriji, Nora Alhazmi, Nasir Alhamlan, Ali Al-Ehaideb, Moatazbellah Alruwaithi, Nasser Alkatheeri, and Amrita Geevarghese Copyright © 2014 Samah Alfuriji et al. All rights reserved. Evaluation of Stability of Surface-Treated Mini-Implants in Diabetic Rabbits Wed, 28 May 2014 09:03:38 +0000 Introduction. The purpose of this study was to investigate effects of surface treatment of mini-implants in diabetes-induced rabbits by comparing osseointegration around mini-implants. Methods. Twelve New Zealand white rabbits were divided into two groups (alloxan-induced diabetic group and control group). A total of 48 mini-implants were placed after four weeks of diabetic induction. 24 mini-implants were surface-treated with SLA (sandblasted with large grit, and acid etched) and the remaining 24 mini-implants had smooth surfaces. Four weeks after placement, 32 mini-implants were removed from 4 control and 4 diabetic rabbits. Insertion and removal torques were measured. The remaining 16 mini-implants from the two groups were histomorphometrically analyzed. Results. Maximum insertion torque showed no difference between diabetic and control groups, but total insertion energy was higher in control group. In surface-treated mini-implants, maximum removal torque was higher in both diabetic and control groups. Bone-implant contact (BIC) was increased in the control group when compared to the diabetic group. Surface-treated group had higher BIC than smooth surface group in both control and diabetic groups. However, there was no significantly statistical difference. Conclusions. Type 1 diabetes mellitus and surface treatment method of mini-implant affected primary stability of mini-implants. In addition, the use of orthodontic mini-implants in a diabetic patient is likely to show results similar to the healthy patient. Nam-Hee Oh, Eun-Young Kim, Janghyun Paek, Yoon-Ah Kook, Do-Min Jeong, Il-Sik Cho, and Gerald Nelson Copyright © 2014 Nam-Hee Oh et al. All rights reserved. Altered Passive Eruption and Familial Trait: A Preliminary Investigation Tue, 20 May 2014 12:57:14 +0000 Altered passive eruption is described as a condition in which the relationship between teeth, alveolar bone, and the soft tissues creates an excessive gingival display and, in turn, in some circumstances, it may reveal a clinical aspect also known as the “gummy smile.” The surgical management of such cases is well understood and has been widely described, with mucogingival and osseous resective procedures being predictable surgical means leading to more balanced aesthetics and proper display of the teeth anatomy. The possible familial trait in case of passive eruption and therefore the possibility of recurrence of the same condition in families of siblings or parents of affected patients have been investigated in this study. 20 patients have been selected and treated in both a private practice and university settings and their immediate family trees were evaluated in order to understand the incidence of the condition. 65% of the treated patients had one or more family members with the same condition leading to seeking further investigation on the possible genetic correlation. Roberto Rossi, Giorgio Brunelli, Vincenzo Piras, and Andrea Pilloni Copyright © 2014 Roberto Rossi et al. All rights reserved. A Systematic Review of Individual Motivational Factors in Orthodontic Treatment: Facial Attractiveness as the Main Motivational Factor in Orthodontic Treatment Tue, 20 May 2014 07:26:53 +0000 Introduction. Physical, mental, and social consequences of malocclusion may impact the quality of life. The aim of this review is to describe main factors motivating parents for orthodontic treatment for their children. Methods. A systematic review study design was used to identify articles analyzing different motivational factors in orthodontic treatment appearing in Medline database, EMBASE, and Google Scholar. The search terms used were teasing, motivating factors, orthodontics, malocclusion, quality of life, smile attractiveness, and perception of malocclusion. Papers selected up to May 2013 included retrospective and prospective longitudinal studies, randomized control trials, cross-sectional studies, reviews, and meta-analyses. Results. 13 articles included in this review identified aesthetics as the main motivational factor in orthodontic treatment. Children mention teeth crowding, large overbite, missing teeth, and largest maxillary anterior irregularities also as motivational factors. Parents want their children to look nice and worry of being accused of neglecting parental duties. Conclusions. Dissatisfaction with one’s appearance, dentist recommendation, interest and worries of parents, and the impact of peers who wear braces rank among the main motivation factors of seeking orthodontic treatment. Understanding these factors allows better planning of resources and better assessment of the requirements and priorities of treatment. Lusine Samsonyanová and Zdenek Broukal Copyright © 2014 Lusine Samsonyanová and Zdenek Broukal. All rights reserved. Risk Factors of Periodontal Disease: Review of the Literature Tue, 20 May 2014 00:00:00 +0000 Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: “periodontal disease,” “periodontitis,” “risk factors,” and “causal.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors. Yousef A. AlJehani Copyright © 2014 Yousef A. AlJehani. All rights reserved. Comparison between an Acrylic Splint Herbst and an Acrylic Splint Miniscrew-Herbst for Mandibular Incisors Proclination Control Mon, 19 May 2014 13:07:27 +0000 Aim. The aim of this study is to compare dental and skeletal effects produced by an acrylic splint Herbst with and without skeletal anchorage for correction of dental class II malocclusion. Methods. The test group was formed by 14 patients that were treated with an acrylic splint miniscrew-Herbst; miniscrews were placed between mandibular second premolars and first molars; controls also consisted of 14 subjects that were treated with an acrylic splint Herbst and no miniscrews. Cephalometric measurements before and after Herbst treatment were compared. The value of for significance was set at 0.05. Results. All subjects from both groups were successfully treated to a bilateral Class I relationship; mean treatment time was 8,1 months in the test group and 7.8 in the controls. Several variables did not have a statistical significant difference between the two groups. Some of the variables, instead, presented a significant difference such as incisor flaring, mandibular bone base position, and skeletal discrepancy. Conclusions. This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater mandibular skeletal effect. Antonio Manni, Marco Pasini, Laura Mazzotta, Sabrina Mutinelli, Claudio Nuzzo, Felice Roberto Grassi, and Mauro Cozzani Copyright © 2014 Antonio Manni et al. All rights reserved. Primary Stability of Self-Drilling and Self-Tapping Mini-Implant in Tibia of Diabetes-Induced Rabbits Sun, 11 May 2014 14:21:20 +0000 Objective. This study aimed to evaluate effects of type 1 diabetes mellitus and mini-implant placement method on the primary stability of mini-implants by comparing mechanical stability and microstructural/histological differences. Methods. After 4 weeks of diabetic induction, 48 mini-implants (24 self-tapping and 24 self-drilling implants) were placed on the tibia of 6 diabetic and 6 normal rabbits. After 4 weeks, the rabbits were sacrificed. Insertion torque, removal torque, insertion energy, and removal energy were measured with a surgical engine on 8 rabbits. Remaining 4 rabbits were analyzed by microcomputed tomography (micro-CT) and bone histomorphometry. Results. Total insertion energy was higher in self-drilling groups than self-tapping groups in both control and diabetic groups. Diabetic groups had more trabecular separation in bone marrow than the control groups in both SD and ST groups. Micro-CT analysis showed deterioration of bone quality in tibia especially in bone marrow of diabetic rabbits. However, there was no statistically significant correlation between self-drilling and self-tapping group for the remaining measurements in both control and diabetic groups. Conclusions. Type 1 diabetes mellitus and placement method of mini-implant did not affect primary stability of mini-implants. Jea-Beom Park, Eun-Young Kim, Janghyun Paek, Yoon-Ah Kook, Do-Min Jeong, Il-Sik Cho, and Gerald Nelson Copyright © 2014 Jea-Beom Park et al. All rights reserved. Computer-Aided Designing and Manufacturing of Lingual Fixed Orthodontic Appliance Using 2D/3D Registration Software and Rapid Prototyping Sun, 11 May 2014 12:44:47 +0000 The availability of 3D dental model scanning technology, combined with the ability to register CBCT data with digital models, has enabled the fabrication of orthognathic surgical CAD/CAM designed splints, customized brackets, and indirect bonding systems. In this study, custom lingual orthodontic appliances were virtually designed by merging 3D model images with lateral and posterior-anterior cephalograms. By exporting design information to 3D CAD software, we have produced a stereolithographic prototype and converted it into a cobalt-chrome alloy appliance as a way of combining traditional prosthetic investment and cast techniques. While the bonding procedure of the appliance could be reinforced, CAD technology simplified the fabrication process by eliminating the soldering phase. This report describes CAD/CAM fabrication of the complex anteroposterior lingual bonded retraction appliance for intrusive retraction of the maxillary anterior dentition. Furthermore, the CAD/CAM method eliminates the extra step of determining the lever arm on the lateral cephalograms and subsequent design modifications on the study model. Soon-Yong Kwon, Yong Kim, Hyo-Won Ahn, Ki-Beom Kim, Kyu-Rhim Chung, and Seong-Hun Kim (Sunny) Copyright © 2014 Soon-Yong Kwon et al. All rights reserved.