International Journal of Dentistry The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Malocclusion in Elementary School Children in Beirut: Severity and Related Social/Behavioral Factors Mon, 26 Jan 2015 06:24:35 +0000 Aim. To assess severity of malocclusion in Lebanese elementary school children and the relationship between components of malocclusion and sociodemographic and behavioral factors. Methods. Dental screening was performed on 655 school children aged 6–11 from 2 public (PB) and 5 private (PV) schools in Beirut. A calibrated examiner recorded occlusion, overjet, overbite, posterior crossbite, midline diastema, and crowding. Another examiner determined the DMFT (Decayed/Missing/Filled Teeth) score. A questionnaire filled by the parents provided data on sociodemographic and behavioral factors. Multinomial, binomial, and multiple linear regressions tested the association of these factors with occlusal indices. Results. Malocclusion was more severe in PB students. Age and sucking habit were associated with various components of malocclusion. Crowding was more prevalent among males and significantly associated with the DMFT score. Income and educational level were significantly higher in PV pupils and deleterious habits were more frequent in PB children. Conclusions. Children of lower socioeconomic background had more severe malocclusions and poorer general dental health. Compared to Western and WHO norms, the findings prompt health policy suggestions to improve dental care of particularly public school children through regular screenings in schools, prevention methods when applicable, and cost effective practices through public and private enabling agencies. Antoine Hanna, Monique Chaaya, Celine Moukarzel, Khalil El Asmar, Miran Jaffa, and Joseph G. Ghafari Copyright © 2015 Antoine Hanna et al. All rights reserved. Improving Clinical Practice: What Dentists Need to Know about the Association between Dental Fear and a History of Sexual Violence Victimisation Mon, 12 Jan 2015 13:58:04 +0000 Anecdotal evidence suggests lack of dentist knowledge and uncertainty about how clinical practice can be improved when dealing with victims of sexual violence. This systematic review presents a synthesis of the available literature, which examined the association between dental fear and a history of sexual violence victimisation. All studies indicated, to various degrees, that dental fear is associated with a history of sexual violence victimisation. The analysis identified several common themes including a perception of lack of control, avoidance behaviours, experiences of flashbacks, feelings of embarrassment, difficulties with the physical proximity to the dentist, the sex of the dentist reminding patients of the perpetrator, being placed into a horizontal body position, the specific impact of fellatio, the smell of latex, experienced lack of knowledge of dental professionals leading to insensitive treatment as well as revictimisation experiences, and the occurrence of disproportionate dental problems among patients who had experienced event(s) of sexual violence. All these themes are discussed in detail. Specific strategies are offered to assist dental practitioners in providing sensitive treatment for patients with a history of sexual violence. Additionally, several suggestions are made that may assist both researchers and dental practitioners alike. Houman Hadad Larijani and Marika Guggisberg Copyright © 2015 Houman Hadad Larijani and Marika Guggisberg. All rights reserved. Assessment of the Correlation between Appointment Scheduling and Patient Satisfaction in a Pediatric Dental Setup Mon, 29 Dec 2014 10:10:31 +0000 Introduction. The practice of modern pediatric dentistry requires delivery of quality care in combination with adherence to excellent business as well as time management principles. A definite appointment schedule should be presented to the parents on the first or second appointment. More importantly, the prescribed schedule should be followed to the best of the professional abilities of the pediatric dentist. Aims. The aim of the study was to assess the co-relation between appointment scheduling and patient satisfaction in a pediatric dental setup with the objective of understanding the parameters related to appointment scheduling to increase patient satisfaction. Method. A total of 40 patients, who visited the Department of Pediatric and Preventive Dentistry, YMT Dental College & Hospital, for dental treatment were selected on a random basis. A questionnaire with a set of 6 questions with a rating scale of 1–5 to assess the patient satisfaction related to appointment scheduling was prepared. Results. A significant number of the patients were happy with the existing appointment scheduling system barring a few exceptions. Amar N. Katre Copyright © 2014 Amar N. Katre. All rights reserved. A Comparative Evaluation of Microleakage in Class V Composite Restorations Thu, 25 Dec 2014 00:10:15 +0000 Aim. To compare and evaluate the microleakage in class V lesions restored with composite resin with and without liner and injectable nanohybrid composite resin. Materials and Methodology. 60 class V cavities were prepared in 30 freshly extracted teeth. After etching and application of bonding agents these cavities were divided into three groups: Group A ()—restored with composite resin, Group B ()—flowable composite resin liner + composite resin, and Group C ()—restored with injectable composite resin. After curing all the specimens were subjected to thermocycling and cyclic loading. Specimens were stained with 0.5% basic fuchsin and evaluated for dye penetration. Results. Results are subjected to Kruskal Wallis and Wilcoxon test. Conclusion. Within the limitations of this study, none of the three materials were free from microleakage. All the three materials showed more microleakage at gingival margins compared to occlusal margins. Among all the groups G-ænial Flo showed the least microleakage at the gingival wall. Sujatha Gopal Sooraparaju, Pavan Kumar Kanumuru, Surya Kumari Nujella, Karthik Roy Konda, K. Bala Kasi Reddy, and Sivaram Penigalapati Copyright © 2014 Sujatha Gopal Sooraparaju et al. All rights reserved. Current Controversies in Classification, Management, and Prevention of Bisphosphonate-Related Osteonecrosis of the Jaw Sun, 21 Dec 2014 09:01:25 +0000 Giuliano Ascani, Giuseppina Campisi, and Luis Manuel Junquera Gutierrez Copyright © 2014 Giuliano Ascani et al. All rights reserved. Accelerated Tooth Movement and Temporary Skeletal Anchorage Devices (TSADs) Thu, 18 Dec 2014 05:49:54 +0000 Seong-Hun Kim, Shin-Jae Lee, Gerald Nelson, and Ki Beom Kim Copyright © 2014 Seong-Hun Kim et al. All rights reserved. Maxillary Overdentures Supported by Four Splinted Direct Metal Laser Sintering Implants: A 3-Year Prospective Clinical Study Sun, 14 Dec 2014 11:07:59 +0000 Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results. Francesco Mangano, Fabrizia Luongo, Jamil Awad Shibli, Sukumaran Anil, and Carlo Mangano Copyright © 2014 Francesco Mangano et al. All rights reserved. Conservative Approach in Patients with Pemphigus Gingival Vulgaris: A Pilot Study of Five Cases Sun, 23 Nov 2014 00:00:00 +0000 Objectives. The aim of this pilot study was to describe the clinical efficacy of a conservative oral hygiene protocol in patients affected by gingival pemphigus vulgaris (PV) applied in a case series. Methods. Subjects suffering from PV with gingival localisation and slightly responsive to conventional treatment with systemic corticosteroids and immunosuppressive drugs were selected among individuals treated in the Unit of Oral Medicine Section of the University of Turin. Five subjects received nonsurgical periodontal therapy, over a 7-day period, including oral hygiene instructions; patients were instructed about domiciliary oral hygiene maintenance and instructions were reinforced at each visit and personalised if necessary. Clinical outcome variables were recorded at baseline (before starting) and 16 weeks after intervention, including full mouth plaque score (FMPS), bleeding scores (FMBS), probing pocket depth (PPD), oral pemphigus clinical score (OPCS), and patient related outcomes (visual analogue score of pain). Results. Five patients were treated and, after finishing the proposed therapy protocol, a statistical significant reduction was observed for FMBS () and OPCS (). Conclusions. Professional oral hygiene procedures with nonsurgical therapy are related to an improvement of gingival status and a decrease of gingival bleeding in patients affected by PV with specific gingival localization. Alessio Gambino, Mario Carbone, Paolo G. Arduino, Paola Carcieri, Lucio Carbone, and Roberto Broccoletti Copyright © 2014 Alessio Gambino et al. All rights reserved. The Effect of Different Disinfecting Agents on Bond Strength of Resin Composites Thu, 13 Nov 2014 11:46:06 +0000 Objective. The aim of this study was to evaluate the effect of different disinfectant agents on bond strength of two types of resin composite materials. Methods. A total of 80 sound posterior teeth were used. They were divided into four groups according to the dentin surface pretreatment (no treatment, chlorhexidine gluconate 2%, sodium hypochlorite 4%, and EDTA 19%). Each group was divided into two subgroups according to the type of adhesive (prime and bond 2.1 and Adper easy one). Each subgroup was further divided into two subgroups according to the type of resin composite (TPH spectrum and Tetric EvoCeram). Shear bond strength between dentin and resin composite was measured using Universal Testing Machine. Data collected were statistically analyzed by t-test and one-way ANOVA followed by Tukey’s post hoc test. Results. It was found that dentin treated with EDTA recorded the highest shear bond strength values followed by sodium hypochlorite and then chlorhexidine groups while the control group showed the lowest shear bond strength. Conclusions. The surface treatment of dentin before bonding application has a great effect on shear bond strength between resin composite and dentin surface. Ahmed Mohammed Hassan, Ahmed Ali Goda, and Kusai Baroudi Copyright © 2014 Ahmed Mohammed Hassan et al. All rights reserved. The Number of Roots and Canals in the Maxillary Second Premolars in a Group of Jordanian Population Mon, 03 Nov 2014 13:28:23 +0000 Objectives. The aim of this study was to investigate the number of roots and root canals in the maxillary second premolar in a group of Jordanian population. Materials and Methods. A total of 217 patients, 100 female (46%) and 117 male (54%), received root canal treatment of maxillary second premolar from January 2012 to January 2014. The mean age of the patients was 32.7, ranging from 18 to 60 years. The teeth included in the study were examined clinically and radiographically for the number of roots and root canals using magnifying loupes. Results. Out of the total of 217 maxillary second premolars, 120 teeth had one root (55.3%), 96 teeth had two roots (44.2%), and one tooth had three roots (0.46%). Regarding root canal configuration, 30 teeth (13.8%) had one canal, 54 teeth (24.9%) had two canals shared in one apical foramen, 132 teeth (60.8%) had two canals with two separate apical foramina, and one tooth (0.46%) had three canals with separate apical foramina. Conclusion. The incidence of two canals (either with shared or separate apical foramina) is very high in the maxillary second premolars in Jordanian population; therefore inspection should be done for the presence of second canal whenever endodontic treatment is planned for this tooth. Muna M. F. Al-Ghananeem, Khattar Haddadin, Abeer Salem Al-Khreisat, Moeen Al-Weshah, and Nidal Al-Habahbeh Copyright © 2014 Muna M. F. Al-Ghananeem et al. All rights reserved. Pain Perception and Anxiety Levels during Menstrual Cycle Associated with Periodontal Therapy Sun, 12 Oct 2014 08:23:08 +0000 Objectives. To compare the pain perception and anxiety levels of female patients undergoing scaling and root planing during menstrual (perimenstrual) period with those observed during postmenstrual period. Materials and Methods. This was a single blind study, with a split-mouth design. Forty-four women with chronic periodontitis with regular menstrual cycles were subjected to complete Corah’s Dental Anxiety Scale (DAS) during their first debridement visit. Patients were randomly selected to undergo their first debridement visit during either their menstrual or postmenstrual period. Scaling was performed under local anesthesia in bilateral quadrants of patients during the periods. Visual Analogue Scale (VAS) was used to score pain levels for each quadrant after performing scaling and root planing. Results. Increase in pain perception among females during their menstrual or perimenstrual period was significantly greater than their postmenstrual period (P < 0.05). It is observed that women whose first appointment was given in perimenstrual period had more pain (VAS) (P = 0.0000) when compared to those women whose first appointment was given in postmenstrual period. Conclusion. Females in their menstrual period demonstrated higher pain responses and high anxiety levels to supra- and subgingival debridement. This increase in the pain levels of women during their menstrual period was statistically significant. If the appointments are given in postmenstrual period, women feel less pain. Nikhat Fatima, P. Raja Babu, Vidya Sagar Sisinty, and Bassel Tarakji Copyright © 2014 Nikhat Fatima et al. All rights reserved. Photoelastic Analysis of Fixed Partial Prosthesis Crown Height and Implant Length on Distribution of Stress in Two Dental Implant Systems Wed, 08 Oct 2014 12:17:28 +0000 The aim of this study was to evaluate by photoelastic analysis stress distribution on short and long implants of two dental implant systems with 2-unit implant-supported fixed partial prostheses of 8 mm and 13 mm heights. Sixteen photoelastic models were divided into 4 groups: I: long implant ( mm) (Neodent), II: long implant ( mm) (Bicon), III: short implant ( mm) (Neodent), and IV: short implants ( mm) (Bicon). The models were positioned in a circular polariscope associated with a cell load and static axial (0.5 Kgf) and nonaxial load (15°, 0.5 Kgf) were applied to each group for both prosthetic crown heights. Three-way ANOVA was used to compare the factors implant length, crown height, and implant system (). The results showed that implant length was a statistically significant factor for both axial and nonaxial loading. The 13 mm prosthetic crown did not result in statistically significant differences in stress distribution between the implant systems and implant lengths studied, regardless of load type (). It can be concluded that short implants showed higher stress levels than long implants. Implant system and length was not relevant factors when prosthetic crown height were increased. Evandro Portela Figueirêdo, Eder Alberto Sigua-Rodriguez, Marcele Jardim Pimentel, Ana Regina Oliveira Moreira, Mauro Antônio de Arruda Nóbilo, and José Ricardo de Albergaria-Barbosa Copyright © 2014 Evandro Portela Figueirêdo et al. All rights reserved. Novel Zirconia Surface Treatments for Enhanced Osseointegration: Laboratory Characterization Mon, 29 Sep 2014 06:36:54 +0000 Purpose. The aim of this study was to evaluate three novel surface treatments intended to improve osseointegration of zirconia implants: selective infiltration etching treatment (SIE), fusion sputtering (FS), and low pressure particle abrasion (LPPA). The effects of surface treatments on roughness, topography, hardness, and porosity of implants were also assessed. Materials and Methods. 45 zirconia discs (19 mm in diameter × 3 mm in thickness) received 3 different surface treatments: selective infiltration etching, low pressure particle abrasion with 30 µm alumina, and fusion sputtering while nontreated surface served as control. Surface roughness was evaluated quantitatively using profilometery, porosity was evaluated using mercury prosimetry, and Vickers microhardness was used to assess surface hardness. Surface topography was analyzed using scanning and atomic force microscopy (). Results. There were significant differences between all groups regarding surface roughness (, ), porosity (, ), and hardness (, ). Scanning and atomic force microscopy revealed a nanoporous surface characteristic of SIE, and FS resulted in the creation of surface microbeads, while LPPA resulted in limited abrasion of the surface. Conclusion. Within the limitations of the study, changes in surface characteristics and topography of zirconia implants have been observed after different surface treatment approaches. Thus possibilities for enhanced osseointegration could be additionally offered. Ola H. Ewais, Fayza Al Abbassy, Mona M. Ghoneim, and Moustafa N. Aboushelib Copyright © 2014 Ola H. Ewais et al. All rights reserved. Alveolar Ridge Preservation Using Xenogeneic Collagen Matrix and Bone Allograft Wed, 24 Sep 2014 08:57:10 +0000 Alveolar ridge preservation (ARP) has been shown to prevent postextraction bone loss. The aim of this report is to highlight the clinical, radiographic, and histological outcomes following use of a bilayer xenogeneic collagen matrix (XCM) in combination with freeze-dried bone allograft (FDBA) for ARP. Nine patients were treated after extraction of 18 teeth. Following minimal flap elevation and atraumatic extraction, sockets were filled with FDBA. The XCM was adapted to cover the defect and 2-3 mm of adjacent bone and flaps were repositioned. Healing was uneventful in all cases, the XCM remained in place, and any matrix exposure was devoid of further complications. Exposed matrix portions were slowly vascularized and replaced by mature keratinized tissue within 2-3 months. Radiographic and clinical assessment indicated adequate volume of bone for implant placement, with all planned implants placed in acceptable positions. When fixed partial dentures were placed, restorations fulfilled aesthetic demands without requiring further augmentation procedures. Histological and immunohistochemical analysis from 9 sites (4 patients) indicated normal mucosa with complete incorporation of the matrix and absence of inflammatory response. The XCM + FDBA combination resulted in minimal complications and desirable soft and hard tissue therapeutic outcomes, suggesting the feasibility of this approach for ARP. Andreas O. Parashis, Charalampos J. Kalaitzakis, Dimitris N. Tatakis, and Konstantinos Tosios Copyright © 2014 Andreas O. Parashis et al. All rights reserved. Assessment of the Mandibular Incisive Canal by Panoramic Radiograph and Cone-Beam Computed Tomography Tue, 23 Sep 2014 12:51:28 +0000 Objectives. The region between mental foramens is considered as a zone of choice for implants. However, complications may arise due to an extension anterior to the mental foramen that forms the mandible incisive canal [MIC]. Our goal is to evaluate identification of MIC by both panoramic radiograph [PAN] and cone-beam computed tomography [CBCT]. Methods. 150 cases with bilateral MIC were analyzed. Images of a radiolucent canal, within the trabecular bone, surrounded by a radiopaque cortical bone representing the canal walls, and extending to the anterior portion beyond the mental foramen, were considered by two independent radiologists as being images of MIC. PAN and CBCT of these cases were evaluated by 2 other radiologists at different times. Agreement between results of examination methods was assessed by the Kappa coefficient. The interexaminer and intramethod rates for detection of MIC were analyzed by the McNemar test. Gender, mandible side, examiner, and type of method were analyzed by the generalized estimating equations [GEE] model. Results. significant difference between examiners [PAN: ; CBCT: ] was not observed. Analysis by GEE model showed no significant difference between genders and examiners . However, significant difference was observed for identification in both mandible right side , where the identification frequency was higher, and CBCT method . Conclusions. PAN was not shown to be a safe examination to identify MIC. CBCT should always be used in preoperative planning and to reduce the number of complications in implant surgeries. Ricardo Raitz, Elisabeth Shimura, Israel Chilvarquer, and Marlene Fenyo-Pereira Copyright © 2014 Ricardo Raitz et al. All rights reserved. The Effect of an Acidic Food-Simulating Environment on the Shear Bond Strength of Self-Ligating Brackets with Different Base Designs Tue, 23 Sep 2014 09:33:53 +0000 Aim. This study aims to evaluate the effect of acidic food simulant and (acetic acid 3%) on the shear bond strength (SBS) and adhesive remnant index (ARI) scores of one conventional and three different self-ligating brackets with different base designs. Materials and Methods. Freshly extracted first maxillary premolars were embedded in resin blocks. A conventional stainless steel bracket, Equilibrium 2, and three types of self-ligating brackets, Speed, In-Ovation R, and Damon 3MX, were bonded to teeth and exposed to distilled water (groups 1, 3, 5, and 7) or acetic acid 3% (groups 2, 4, 6, 8) for 12 weeks. SBS and ARI were calculated and statistical analysis was performed with the analysis of variance (SBS) or test (ARI) to compare values between the different groups. Results. Equilibrium 2 and In-Ovation R showed a significantly lower SBS in the acidic environment than in distilled water. Significant differences in ARI scores were found for Equilibrium 2 after immersion in an acidic environment, shifting from 0 in distilled water to 2 in an acidic environment. Conclusions. Equilibrium 2 and In-Ovation R brackets showed a significant decrease in SBS after a 12-week immersion in acetic acid 3%, although all groups showed clinically acceptable SBS. Equilibrium 2 showed significant differences in ARI scores when exposed to acetic acid 3%. Ahmad Sheibaninia, Sepehr Sepasi, Mohammad Ali Saghiri, and Setareh Sepasi Copyright © 2014 Ahmad Sheibaninia et al. All rights reserved. The Prevalence of Dental Caries in Primary Dentition in 4- to 5-Year-Old Preschool Children in Northern Palestine Tue, 23 Sep 2014 08:58:17 +0000 Aim. To determine the prevalence of dental caries among a representative sample of preschool children (4-5 years old) who were accompanied by their parents to the dental centre of the Arab American University in Jenin whether they come seeking dental treatment or as visitors with adult patients. Materials and Methods. 1376 children of both sexes were investigated by three calibrated and trained examiners for dental caries using the dmft index according to the WHO method. Results. 76% of the studied children have already experienced dental caries at the age of 4-5 years (1046 children). The mean dmft score was found to be 2.46 while the other 24% of children were caries-free. There was no significant difference in caries prevalence between boys and girls (77.2% versus 74.6%). Children of highly educated and college graduated mothers were found to have more fillings (restored teeth) in comparison to those who belong to mothers who did not finish their secondary (high school) education. Conclusion. The number of caries-free children in northern Palestine is still far from numbers found in developed countries. There is a real need to make improvements at the level of parents dental health education, application of preventive measures, and dietary habits among preschool children. Zafer Azizi Copyright © 2014 Zafer Azizi. All rights reserved. The “CROMa” Project: A Care Pathway for Clinical Management of Patients with Bisphosphonate Exposure Mon, 22 Sep 2014 07:42:50 +0000 Aim. To describe 7 years of activity of “CROMa” (Coordination of Research on Osteonecrosis of the Jaws) project of “Sapienza” University of Rome. Materials and Methods. A preventive and therapeutic care pathway was created for patients with bisphosphonates (BPs) exposure. Demographic, social, behavioural, pharmacological, and clinical variables were registered in a dedicated database. Results. In the project, 502 patients, 403 females and 99 males, were observed. Bone pathologies were 79% osteometabolic diseases (OMD) and 21% metastatic cancer (CA). Females were 90% in OMD group and 41% in CA. BP administration was 54% oral, 31% IV, and 11% IM; 89% of BPs were amino-BP and 11% non-amino-BP. Consistently with bone pathology (OMD/CA), alendronate appears to be prevalent for OMD (40% relative), while zoledronate was indicated in 92% of CA patients. Out of 502 cases collected, 28 BRONJ were detected: 17 of them were related to IV BP treatment. Preventive oral assessment was required for 50% of CA patients and by 4% of OMD patients. Conclusions. The proposed care pathway protocols for BP exposed patients appeared to be useful to meet treatment and preventive needs, in both oncological and osteometabolic diseases patients. Patients’ and physicians’ prevention awareness can be the starting point of a multilevel prevention system. Mauro Capocci, Umberto Romeo, Fabio Cocco, Isabella Bignozzi, Susanna Annibali, and Livia Ottolenghi Copyright © 2014 Mauro Capocci et al. 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.