International Journal of Dentistry The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Challenges Faced in Engaging American Indian Mothers in an Early Childhood Caries Preventive Trial Tue, 19 May 2015 06:24:38 +0000 Objective. This study explores the challenges faced by the research implementation team in engaging new mothers in a community oral health prevention intervention in an American Indian (AI) reservation community. Methods. Qualitative methods in the form of in-depth interviews were used in the study. Qualitative data were collected from research staff workers at a field site, who were involved in the implementation of a culturally tailored, randomized controlled trial of a behavioral intervention utilizing Motivational Interviewing (MI). Results. Several challenges were described by the field staff in engaging new mothers, including low priority placed on oral health, lack of knowledge, and distractions that reduced their ability to engage in learning about oral health of their child. Other difficulties faced in engaging the mothers and the AI community at large were distrust related to racial differences and physical and environmental barriers including poor road conditions, lack of transportation and communication, and remoteness of data collection sites. The field staff developed and applied many strategies, including conducting home visits, applying new communication strategies, and interacting with the community at various venues. Conclusion. Prevention interventions for ECC need to target AI mothers. Strategies developed by the field staff were successful for engaging mothers in the study. Tamanna Tiwari, Judith Albino, and Terrence S. Batliner Copyright © 2015 Tamanna Tiwari et al. All rights reserved. Oral Health in a Sample of Pregnant Women from Northern Appalachia (2011–2015) Mon, 18 May 2015 13:42:26 +0000 Background. Chronic poor oral health has a high prevalence in Appalachia, a large region in the eastern USA. The Center for Oral Health Research in Appalachia (COHRA) has been enrolling pregnant women and their babies since 2011 in the COHRA2 study of genetic, microbial, and environmental factors involved in oral health in Northern Appalachia. Methods. The COHRA2 protocol is presented in detail, including inclusion criteria (healthy, adult, pregnant, US Caucasian, English speaking, and nonimmunocompromised women), recruiting (two sites: Pittsburgh, Pennsylvania, and West Virginia, USA), assessments (demographic, medical, dental, psychosocial/behavioral, and oral microbial samples and DNA), timelines (longitudinal from pregnancy to young childhood), quality control, and retention rates. Results. Preliminary oral health and demographic data are presented in 727 pregnant women, half from the greater Pittsburgh region and half from West Virginia. Despite similar tooth brushing and flossing habits, COHRA2 women in West Virginia have significantly worse oral health than the Pittsburgh sample. Women from Pittsburgh are older and more educated and have less unemployment than the West Virginia sample. Conclusions. We observed different prevalence of oral health and demographic variables between pregnant women from West Virginia (primarily rural) and Pittsburgh (primarily urban). These observations suggest site-specific differences within Northern Appalachia that warrant future studies. Katherine Neiswanger, Daniel W. McNeil, Betsy Foxman, Manika Govil, Margaret E. Cooper, Robert J. Weyant, John R. Shaffer, Richard J. Crout, Hyagriv N. Simhan, Scott R. Beach, Stella Chapman, Jayme G. Zovko, Linda J. Brown, Stephen J. Strotmeyer, Jennifer L. Maurer, and Mary L. Marazita Copyright © 2015 Katherine Neiswanger et al. All rights reserved. Computer-Guided Implant Surgery in Fresh Extraction Sockets and Immediate Loading of a Full Arch Restoration: A 2-Year Follow-Up Study of 14 Consecutively Treated Patients Tue, 12 May 2015 07:37:55 +0000 Statement of Problem. Low scientific evidence is identified in the literature for combining implant placement in fresh extraction sockets with immediate function. Moreover, the few studies available on immediate implants in postextraction sites supporting immediate full-arch rehabilitation clearly lack comprehensive protocols. Purpose. The purpose of this study is to report outcomes of a comprehensive protocol using CAD-CAM technology for surgical planning and fabrication of a surgical template and to demonstrate that immediate function can be easily performed with immediate implants in postextraction sites supporting full-arch rehabilitation. Material and Methods. 14 subjects were consecutively rehabilitated (13 maxillae and 1 mandible) with 99 implants supporting full-arch fixed prostheses followed between 6 and 24 months (mean of 16 months). Outcome measures were prosthesis and implant success, biologic and prosthetic complications, pain, oedema evaluation, and radiographic marginal bone levels at surgery and then at 6, 12, 18, and 24 months. Data were analyzed with descriptive statistics. Results. The overall cumulative implant survival rate at mean follow-up time of 16 months was 97.97%. The average marginal bone loss was 0,9 mm. Conclusions. Within the limitations of this study, the results validate this treatment modality for full-arch rehabilitations with predictable outcomes and high survival rate after 2 years. M. Daas, A. Assaf, K. Dada, and J. Makzoumé Copyright © 2015 M. Daas et al. All rights reserved. Index of Orthodontic Treatment Need in Obese Adolescents Sun, 05 Apr 2015 08:10:04 +0000 Aim. This case-control retrospective study is aimed at assessing if obese adolescents need more orthodontic treatment in comparison with normal-weight patients of the same age. Methods. The test group included 100 obese subjects (50 males and 50 females; average age: 13.09 ± 1.19 years old) and the control group included 100 normal-weight patients matched for age and sex (50 males and 50 females; average age: 13.07 ± 1.26 years old). Clinical examinations were conducted on dental casts to assess the need of orthodontic treatment, by using the Index of Orthodontic Treatment Need (IOTN) (DHC, dental health component; AC, aesthetic components). Results. No statistically significant difference () was observed between the two groups with regard to AC. Obese females showed a significant () higher percentage of DHC 3 (32%) in comparison to the normal-weight girls (22%); for the other grades of DHC and for the single kind of malocclusion, no significant difference was found. Conclusions. Obese adolescents showed a similar need for orthodontic treatment compared to normal-weight patients of the same age. However, in obese females, a slightly greater need for orthodontic treatment was observed, compared to normal-weight patients. Maria Rita Giuca, Marco Pasini, Silvia Caruso, Simona Tecco, Stefano Necozione, and Roberto Gatto Copyright © 2015 Maria Rita Giuca et al. All rights reserved. A Comparative Evaluation of Static Frictional Resistance Using Various Methods of Ligation at Different Time Intervals: An In Vitro Study Tue, 31 Mar 2015 11:34:41 +0000 Aim. To compare and evaluate the static frictional resistance offered by the four different types of ligation methods in both dry and wet conditions and at different durations when immersed in artificial saliva. Material and Methods. Alastik Easy to Tie modules, Super Slick Mini Stix elastomeric modules, Power “O” modules, and 0.009″ Stainless Steel ligatures were used to compare the static friction using maxillary canine and premolar Preadjusted Edgewise brackets with 0.022″ × 0.028″ slot and 0.019″ × 0.025″ stainless steel wires. Results. The mean frictional resistance for Alastik modules was the lowest and that of Stainless Steel ligatures was found to be highest among the four groups compared and the difference among the four groups was statistically significant (). The mean static frictional resistance in all groups under dry conditions was lower than that under wet conditions. No statistical significant differences were found when the groups were compared at different time periods of immersion in artificial saliva. Conclusion. This study concludes that the Alastik modules showed the lowest mean static frictional forces compared to any other ligation method, though no significant difference was found for different time periods of immersion in the artificial saliva. Amanpreet Singh Natt, Amandeep Kaur Sekhon, Sudhir Munjal, Rohit Duggal, Anup Holla, Prahlad Gupta, Piyush Gandhi, and Sahil Sarin Copyright © 2015 Amanpreet Singh Natt et al. All rights reserved. Spectrogram Analysis of Complete Dentures with Different Thickness and Palatal Rugae Materials on Speech Production Thu, 26 Mar 2015 13:08:51 +0000 Objective. To investigate the influence of reproduction of different thickness and palatal rugae materials on complete dentures speech using Computerized Speech Lab (CSL) (spectrogram). Materials and Methods. Three completely edentulous male patients (aged 50–60 years) were selected for reading a paragraph. Twelve upper dentures were constructed, four for each patient. The patients’ speech groups were divided into five groups, Group I: patients without dentures; Group II: patients rehabilitated with conventional acrylic dentures; Group III: patients with conventional acrylic dentures with rugae reproduction; Group IV: patients with dentures with metallic framework of minimal thickness and direct ragged metallic palatal surface at rugae area; Group V: patients with dentures with palatal rugae constructed from resilient acrylic resin material with thickness less than conventional denture. Speech samples were recorded after insertion of each denture for groups using Computerized Speech Lab (CSL) (spectrogram). The sounds selected were lingopalatal /s/z/sh/t/d/ and /l/. Results. Group III produced high mean significant difference with /sh/t/ sound. For Group IV, the difference was noticed with /s/z/sh/t/ and /d/ sounds, while for Group V the difference was shown with /z/l/ sound (). Conclusion. It is recommended to reproduce the rugae area in complete denture because the phonetic quality of complete denture with rugae is superior to the conventional denture. Hamada Zaki Mahross and Kusai Baroudi Copyright © 2015 Hamada Zaki Mahross and Kusai Baroudi. All rights reserved. Quantitative Analysis of Salivary TNF-α in Oral Lichen Planus Patients Sun, 15 Mar 2015 11:21:37 +0000 Objective. The aim of this study was to quantitatively evaluate the salivary tumor necrosis factor-alpha (TNF-α) level in oral lichen planus patients and to compare the levels of TNF-α between saliva and serum of OLP and controls. Methods. Serum and whole saliva from 30 patients with active lesions of oral lichen planus (OLP) and 30 healthy persons were investigated for the presence of TNF-α by enzyme immunoassay. Student’s independent t-test and two-sample binomial proportion test were used to calculate significance of the mean values of TNF-alpha in serum and saliva and to determine the proportions of the detected and nondetected samples in both groups. Results. Proportion of detection and the mean of detectability between saliva and serum of Group B show an almost equal value, which suggests that saliva can be a good alternate to serum to analyze TNF-α in oral lichen planus patients. T. Malarkodi and S. Sathasivasubramanian Copyright © 2015 T. Malarkodi and S. Sathasivasubramanian. All rights reserved. A Study of Success Rate of Miniscrew Implants as Temporary Anchorage Devices in Singapore Tue, 10 Mar 2015 06:29:06 +0000 Objective. To find out the success rate of miniscrew implants in the National Dental Centre of Singapore (NDCS) and the impact of patient-related, location-related, and miniscrew implant-related factors. Materials and Methods. Two hundred and eighty-five orthodontic miniscrew implants were examined from NDCS patient records. Eleven variables were analysed to see if there is any association with success. Outcome was measured twice, immediately after surgery prior to orthodontic loading (T1) and 12 months after surgery (T2). The outcome at T2 was assessed 12 months after the miniscrew’s insertion date or after its use as a temporary anchorage device has ceased. Results. Overall success rate was 94.7% at T1 and 83.3% at T2. Multivariate analysis revealed only the length of miniscrew implant to be significantly associated with success at both T1 () and T2 (). Miniscrew implants with lengths of 10–12 mm had the highest success rate (98.0%) compared to other lengths, and this is statistically significant (). At T2, lengths of 10–12 mm had significantly () higher success rates (93.5%) compared to 6-7 mm (76.7%) and 8 mm (82.1%) miniscrew implants. Conclusion. Multivariate statistical analyses of 11 variables demonstrate that length of miniscrew implant is significant in determining success. Song Yi Lin, Yow Mimi, Chew Ming Tak, Foong Kelvin Weng Chiong, and Wong Hung Chew Copyright © 2015 Song Yi Lin et al. All rights reserved. One-Year Clinical Evaluation of the Bonding Effectiveness of a One-Step, Self-Etch Adhesive in Noncarious Cervical Lesion Therapy Wed, 25 Feb 2015 13:33:44 +0000 This study evaluated the one-year clinical performance of a one-step, self-etch adhesive (Optibond All-in-One, Kerr, CA, USA) combined with a composite (Herculite XRV Ultra, Kerr Hawe, CA, USA) to restore NCCLs with or without prior acid etching. Restorations performed by the same practitioner were evaluated at baseline and after 3, 6, and 12 months using modified USPHS criteria. At 6 months, the recall rate was 100%. The retention rate was 84.2% for restorations with prior acid etching, but statistically significant differences were observed between baseline and 6 months. Without acid etching, the retention rate was 77%, and no statistically significant difference was noted between 3 and 6 months. Marginal integrity (93.7% with and 87.7% without acid etching) and discoloration (95.3% with and 92.9% without acid etching) were scored as Alpha or Bravo, with better results after acid etching. After one year, the recall rate was 58.06%. Loss of pulp vitality, postoperative sensitivity, or secondary caries were not observed. After one year retention rate was of 90.6% and 76.9% with and without acid conditioning. Optibond All-in-One performs at a satisfactory clinical performance level for restoration of NCCLs after 12 months especially after acid etching. Babacar Faye, Mouhamed Sarr, Khaly Bane, Adjaratou Wakha Aidara, Seydina Ousmane Niang, and Abdoul Wakhabe Kane Copyright © 2015 Babacar Faye et al. All rights reserved. Relationship between Body Mass Index and Tooth Decay in a Population of 3–6-Year-Old Children in Iran Wed, 18 Feb 2015 07:14:41 +0000 The aim of the present study was to evaluate the relationship between BMI and tooth decay in a population of Iranian children. In this cross-sectional descriptive/analytical study, 1482 children were selected from kindergartens and preschool centers in Kerman, Iran. The children underwent examination of deciduous teeth (using the dmft index) after determination of height and weight for calculation of BMI. The relationship between BMI (after adjustment for age) and dmft was determined using Poisson’s regression model. The mean of dmft in children with normal BMI was 1.5-fold that in subjects with extra body weight. Age had a significant effect on dmft. In addition, dmft was higher in boys compared to girls. The results of the present study showed that caries rate in the deciduous teeth of 3–6-year-old children decreases with an increase in body weight. Leila Shafie Bafti, Maryam Alsadat Hashemipour, Hamidreza Poureslami, and Zeinab Hoseinian Copyright © 2015 Leila Shafie Bafti et al. All rights reserved. Morphological Study of Palatal Rugae in a Sudanese Population Sun, 08 Feb 2015 13:23:58 +0000 Palatal rugae patterns have unique characteristics and have been proposed as an alternative method to establish identity when other means, such as fingerprints and dental records, are not attainable. This study was conducted to determine the morphological characteristics of palatine rugae and to assess the existence of side asymmetry in them in Sudanese Arabs. It also assesses the possibility of determining sex using logistic regression. One hundred dental casts for 50 males and 50 females aged between 18 and 23 were studied for palatal rugae dimensions, shapes, and orientations, as well as sexual dimorphism and side symmetry. The most predominant rugae were primary, and the most prevalent shapes in both sexes were wavy, curved, and straight forms. The predominant orientation was forward. Side asymmetry existed more in the orientations than in the shapes, but no side asymmetry was recorded in the dimensions. There was no significant sexual dimorphism in the rugae dimensions, shapes, and orientations, except for forward-directed rugae . A predictive value of 60% was obtained in assigning sex using dimensions and orientations and of 58% using shapes alone. Therefore, the palatal rugae are not recommended for assigning sex effectively among Sudanese Arabs unless it is the only means available. Altayeb Abdalla Ahmed and Awrad Hamid Copyright © 2015 Altayeb Abdalla Ahmed and Awrad Hamid. 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.