International Journal of Dentistry The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Soft Tissue Stability around Single Implants Inserted to Replace Maxillary Lateral Incisors: A 3D Evaluation Thu, 19 May 2016 14:14:33 +0000 Purpose. To evaluate the soft tissue stability around single implants inserted to replace maxillary lateral incisors, using an innovative 3D method. Methods. We have used reverse-engineering software for the superimposition of 3D surface models of the dentogingival structures, obtained from intraoral scans of the same patients taken at the delivery of the final crown (S1) and 2 years later (S2). The assessment of soft tissues changes was performed via calculation of the Euclidean surface distances between the 3D models, after the superimposition of S2 on S1; colour maps were used for quantification of changes. Results. Twenty patients (8 males, 12 females) were selected, 10 with a failing/nonrestorable lateral incisor (test group: immediate placement in postextraction socket) and 10 with a missing lateral incisor (control group: conventional placement in healed ridge). Each patient received one immediately loaded implant (Anyridge®, Megagen, Gyeongbuk, South Korea). The superimposition of the 3D surface models taken at different times (S2 over S1) revealed a mean (±SD) reduction of 0.057 mm (±0.025) and 0.037 mm (±0.020) for test and control patients, respectively. This difference was not statistically significant (p = 0.069). Conclusions. The superimposition of the 3D surface models revealed an excellent peri-implant soft tissue stability in both groups of patients, with minimal changes registered along time. F. G. Mangano, F. Luongo, G. Picciocchi, C. Mortellaro, K. B. Park, and C. Mangano Copyright © 2016 F. G. Mangano et al. All rights reserved. The Use of Narrow Diameter Implants in the Molar Area Wed, 11 May 2016 12:53:19 +0000 Implant rehabilitations in the posterior jaw are influenced by many factors such as the condition of the remaining teeth, the force factors related to the patient, the quality of the bone, the maintenance of the hygiene, the limited bone height, the type and extent of edentulism, and the nature of the opposing arch. The gold standard is to place a regular diameter implant (>3.7 mm) or a wide one to replace every missing molar. Unfortunately, due to horizontal bone resorption, this option is not possible without lateral bone augmentation. In this situation, narrow diameter implant (NDI < 3.5 mm) could be the alternative to lateral bone augmentation procedures. This paper presents a clinical study where NDIs were used for the replacement of missing molars. They were followed up to 11 years. Special considerations were observed and many parameters were evaluated. NDI could be used to replace missing molar in case of moderate horizontal bone resorption if strict guidelines are respected. Yet, future controlled prospective clinical trials are required to admit their use as scientific evidence. M. Saad, A. Assaf, and E. Gerges Copyright © 2016 M. Saad et al. All rights reserved. ATP Bioluminometers Analysis on the Surfaces of Removable Orthodontic Aligners after the Use of Different Cleaning Methods Sun, 08 May 2016 08:46:59 +0000 Purpose. The aim was to quantify the bacteria concentration on the surface of orthodontic clear aligners using three different cleaning methods. Furthermore the objective was to validate the efficacy of the bioluminometer in assessing the bacteria concentration. Materials and Methods. Twenty subjects (six males and fourteen females) undergoing orthodontic therapy with clear aligners (Invisalign® Align Technology, Santa Clara, California) were enrolled in this study. The observation time was of six weeks. The patients were instructed to use different cleaning methods (water, brushing with toothpaste, and brushing with toothpaste and use of sodium carbonate and sulphate tablet). At the end of each phase a microbiological analysis was performed using the bioluminometer. Results. The highest bacteria concentration was found on aligners cleaned using only water (583 relative light units); a value of 189 relative light units was found on aligners cleaned with brushing and toothpaste. The lowest bacteria concentration was recorded on aligners cleaned with brushing and toothpaste and the use of sodium carbonate and sulfate tablet. Conclusions. The mechanical removal of the bacterial biofilm proved to be effective with brushing and toothpaste. The best results in terms of bacteria concentration were achieved adding the use of sodium carbonate and sulfate tablet. Luca Levrini, Alessandro Mangano, Silvia Margherini, Camilla Tenconi, Davide Vigetti, Raffaele Muollo, and Gian Marco Abbate Copyright © 2016 Luca Levrini et al. All rights reserved. A Patient Specific Biomechanical Analysis of Custom Root Analogue Implant Designs on Alveolar Bone Stress: A Finite Element Study Wed, 04 May 2016 11:22:10 +0000 Objectives. The aim of this study was to analyse by means of FEA the influence of 5 custom RAI designs on stress distribution of peri-implant bone and to evaluate the impact on microdisplacement for a specific patient case. Materials and Methods. A 3D surface model of a RAI for the upper right canine was constructed from the cone beam computed tomography data of one patient. Subsequently, five (targeted) press-fit design modification FE models with five congruent bone models were designed: “Standard,” “Prism,” “Fins,” “Plug,” and “Bulbs,” respectively. Preprocessor software was applied to mesh the models. Two loads were applied: an oblique force (300 N) and a vertical force (150 N). Analysis was performed to evaluate stress distributions and deformed contact separation at the peri-implant region. Results. The lowest von Mises stress levels were numerically observed for the Plug design. The lowest levels of contact separation were measured in the Fins model followed by the Bulbs design. Conclusions. Within the limitations of the applied methodology, adding targeted press-fit geometry to the RAI standard design will have a positive effect on stress distribution, lower concentration of bone stress, and will provide a better primary stability for this patient specific case. David Anssari Moin, Bassam Hassan, and Daniel Wismeijer Copyright © 2016 David Anssari Moin et al. All rights reserved. Applicative Characteristics of a New Zirconia Bracket with Multiple Slots Sun, 24 Apr 2016 15:32:48 +0000 We have developed a new orthodontic bracket with three slots with lubricative properties on the working surfaces and proposed a new orthodontic treatment system employing 0.012−0.014-inch Ni-Ti arch wires. We recruited 54 patients, of which 27 received treatment with the new zirconia bracket with multiple slots system (M group), and the others received treatment with standard edge-wise appliances (control group [C group]). We compared the (1) tooth movement rate at the early stage of leveling; (2) changes in the dental arch morphology before and after leveling; and (3) pain caused by orthodontic treatment. Student’s -test was used in all assessments. The tooth movement rate in the maxillomandibular dentition was higher in the M group. The basal arch width, anterior length, and the intercanine width in the maxillary dentition were not significantly different in the two groups; however, the intercanine width in the mandibular dentition was higher in the C group. In assessments of treatment-related pain, the visual analogue pain score was 56.0 mm and 22.6 mm in the C and M groups, respectively. A new zirconia bracket with multiple slots system provided better outcomes with respect to tooth movement rate, treatment period, and postoperative pain, thus indicating its effectiveness over conventional orthodontic systems. Koutaro Maki, Katsuyoshi Futaki, Satoru Tanabe, Mariko Takahashi, Yuta Ichikawa, and Tetsutaro Yamaguchi Copyright © 2016 Koutaro Maki et al. All rights reserved. Detection of Carious Lesions and Restorations Using Particle Swarm Optimization Algorithm Wed, 20 Apr 2016 06:59:25 +0000 Background/Purpose. In terms of the detection of tooth diagnosis, no intelligent detection has been done up till now. Dentists just look at images and then they can detect the diagnosis position in tooth based on their experiences. Using new technologies, scientists will implement detection and repair of tooth diagnosis intelligently. In this paper, we have introduced one intelligent method for detection using particle swarm optimization (PSO) and our mathematical formulation. This method was applied to 2D special images. Using developing of our method, we can detect tooth diagnosis for all of 2D and 3D images. Materials and Methods. In recent years, it is possible to implement intelligent processing of images by high efficiency optimization algorithms in many applications especially for detection of dental caries and restoration without human intervention. In the present work, we explain PSO algorithm with our detection formula for detection of dental caries and restoration. Also image processing helped us to implement our method. And to do so, pictures taken by digital radiography systems of tooth are used. Results and Conclusion. We implement some mathematics formula for fitness of PSO. Our results show that this method can detect dental caries and restoration in digital radiography pictures with the good convergence. In fact, the error rate of this method was 8%, so that it can be implemented for detection of dental caries and restoration. Using some parameters, it is possible that the error rate can be even reduced below 0.5%. Mohammad Naebi, Eshaghali Saberi, Sirous Risbaf Fakour, Ahmad Naebi, Somayeh Hosseini Tabatabaei, Somayeh Ansari Moghadam, Elham Bozorgmehr, Nasim Davtalab Behnam, and Hamidreza Azimi Copyright © 2016 Mohammad Naebi et al. All rights reserved. Consecutive Case Series of Healed Single-Molar Sites Immediately Restored with Wide-Diameter Implants: A 1-Year Evaluation Mon, 18 Apr 2016 11:00:23 +0000 Introduction. To evaluate outcomes of wide-diameter (6 mm) implants immediately provisionalized with cement-retained single crowns in posterior molar sites. Materials and Methods. Forty-eight consecutive patients received a total of 53 moderately rough-surface, 6 mm diameter implants in healed sites. All implants were immediately provisionalized with a cement-retained provisional crown. Final prosthesis with cement-retained porcelain fused to metal crowns was delivered 3–6 months later. Patients were followed up for 1 year. Outcome measures were implant failures and success rate, complications, marginal bone levels, bone level changes, papilla index, bleeding on probing, and inflammation. Results. One patient was lost to follow-up. At one year, the implant survival and success rate were 98.1%. The mean marginal bone loss after 1 year was − mm. Ideal papilla score was recorded at 83.8% of the sites. More than 95.6% of the sites showed no bleeding or inflammation. No procedure-related or device-related adverse events were reported. Conclusion. Wide-diameter (6 mm) implants can safely and successfully replace single posterior molars. Longer follow-up studies are necessary to evaluate the long-term success of these implants. Hadi Antoun, Pierre Cherfane, and Bouchra Sojod Copyright © 2016 Hadi Antoun et al. All rights reserved. Minimally Invasive Alveolar Ridge Preservation Utilizing an In Situ Hardening β-Tricalcium Phosphate Bone Substitute: A Multicenter Case Series Thu, 14 Apr 2016 11:34:40 +0000 Ridge preservation measures, which include the filling of extraction sockets with bone substitutes, have been shown to reduce ridge resorption, while methods that do not require primary soft tissue closure minimize patient morbidity and decrease surgical time and cost. In a case series of 10 patients requiring single extraction, in situ hardening beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) were utilized as a grafting material that does not necessitate primary wound closure. After 4 months, clinical observations revealed excellent soft tissue healing without loss of attached gingiva in all cases. At reentry for implant placement, bone core biopsies were obtained and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological and histomorphometrical analysis revealed pronounced bone regeneration (24.4 ± 7.9% new bone) in parallel to the resorption of the grafting material (12.9 ± 7.7% graft material) while high levels of primary implant stability were recorded. Within the limits of this case series, the results suggest that β-TCP coated with polylactide can support new bone formation at postextraction sockets, while the properties of the material improve the handling and produce a stable and porous bone substitute scaffold in situ, facilitating the application of noninvasive surgical techniques. Minas D. Leventis, Peter Fairbairn, Ashish Kakar, Angelos D. Leventis, Vasileios Margaritis, Walter Lückerath, Robert A. Horowitz, Bappanadu H. Rao, Annette Lindner, and Heiner Nagursky Copyright © 2016 Minas D. Leventis et al. All rights reserved. Influence of the Cement Film Thickness on the Push-Out Bond Strength of Glass Fiber Posts Cemented in Human Root Canals Sun, 10 Apr 2016 15:57:15 +0000 The present study evaluated the influence of the cement film thickness on the push-out bond strength of glass fiber posts in the cervical, medium, and apical thirds of root canal spaces. Thirty roots were randomly divided into three groups, according to the fiber post system’s drills: (G1) #2; (G2) #3; (G3) #4. The posts were cemented using a self-adhesive cement, and a small amount of powdered Rhodamine B was used as a stain. Images of both sides of each slice were obtained before and after the push-out test. To determine the cement thickness, a macro routine was developed using the software KS 400. The data were analyzed statistically using Kruskal-Wallis and Dunn’s test. G2 ( MPa) showed statistically higher bond strength values than G1 ( MPa) and G3 ( MPa). All groups presented higher bond strength values in the apical third. The bur diameter significantly influenced the results of the shear bond strength for the push-out test. The slight increase in the cement thickness allowed an increase in the values of shear bond strength when compared to very thin or very thick cement films. Natália Araújo Silva Prado, Reinaldo de Souza Ferreira, Marcos Henrique de Pinho Maurício, Sidnei Paciornik, and Mauro Sayão de Miranda Copyright © 2016 Natália Araújo Silva Prado et al. All rights reserved. Effect of Different Denture Base Materials and Changed Mouth Temperature on Dimensional Stability of Complete Dentures Thu, 07 Apr 2016 13:36:29 +0000 Background. Type of materials used in fabrication of denture base has an effect on dimension during denture base material processing and other factors related to clinical use. Objective. The study aims were to assess the dimensional stability including thermal changes of three different denture base materials. Methods. Ninety patients were selected to construct complete dentures with different denture base materials. They were randomly divided into three groups: group 1, patients with cobalt chrome metallic base; group 2, patients with heat curing acrylic resin fabricated by injection moulding technique; and group 3, patients with denture bases fabricated by conventional heat curing acrylic resin. The dimensional changes were assessed using digital caliper. Results. After the twelfth month, injection moulding acrylic resin had significantly the highest dimensional change followed by the conventional heat curing acrylic resin. There were no significant differences in the dimensions between the three types of denture base materials at normal mouth temperature, while, after hot tea drinking at 45°C, the dimensional change was significantly the highest in cobalt chrome metallic denture base group. Conclusion. Cobalt chrome metallic denture base has stable dimension compared to denture bases fabricated of acrylic resin but it was more affected by altered mouth temperature. The study was registered in the International Standard Randomized Controlled Trials Number (ISRCTN) registry with study ID (ISRCTN94238244). Khalid A. O. Arafa Copyright © 2016 Khalid A. O. Arafa. All rights reserved. Computer-Assisted Technique for Surgical Tooth Extraction Mon, 28 Mar 2016 11:29:58 +0000 Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut). Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome). In addition, the conventional surgical cutting tools (surgical burs) are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures. Hosamuddin Hamza Copyright © 2016 Hosamuddin Hamza. All rights reserved. Effect of Subject Rotation on Assessment of Esthetic Dental Ratios: A Simulation Study Tue, 22 Mar 2016 08:23:56 +0000 Objective. This study aimed to find out the change in esthetic ratios during rotation of patient’s head using a simulation. Materials and Methods. A plaster study model was photographed placing its midline along the long axis of the camera. Then a series of photographs were taken by rotating the model each degree till 10° on both right and left sides. These photographs were digitally measured and the ratio of the maxillary anterior teeth at zero-degree rotation was compared with that at various degrees of rotation. Results. As the model was rotated to the right side till 10°, the ratio of the right lateral to central incisor gradually decreased while the ratio of the left lateral to central incisor gradually increased. However, the ratio of the canine to lateral incisor on both sides gradually increased. Similar results were obtained when the model was rotated to the left side. The ratio of the lateral to central incisor deviated from the acceptable range (±10%) when there was rotation of more than 7°, whereas the ratio of the canine to lateral incisor was within the acceptable range till 10° rotation on either side. Conclusions. Rotation of the model by more than 7° leads to a substantial change in the esthetic ratio. Rajesh Gyawali, Prabhat Ranjan Pokharel, and Jamal Giri Copyright © 2016 Rajesh Gyawali et al. All rights reserved. Epstein-Barr Virus and Its Association with Oral Hairy Leukoplakia: A Short Review Mon, 07 Mar 2016 14:04:29 +0000 In immunocompromised subjects, Epstein-Barr virus (EBV) infection of terminally differentiated oral keratinocytes may result in subclinical productive infection of the virus in the stratum spinosum and in the stratum granulosum with shedding of infectious virions into the oral fluid in the desquamating cells. In a minority of cases this productive infection with dysregulation of the cell cycle of terminally differentiated epithelial cells may manifest as oral hairy leukoplakia. This is a white, hyperkeratotic, benign lesion of low morbidity, affecting primarily the lateral border of the tongue. Factors that determine whether productive EBV replication within the oral epithelium will cause oral hairy leukoplakia include the fitness of local immune responses, the profile of EBV gene expression, and local environmental factors. Razia Abdool Gafaar Khammissa, Jeanine Fourie, Rakesh Chandran, Johan Lemmer, and Liviu Feller Copyright © 2016 Razia Abdool Gafaar Khammissa et al. All rights reserved. National Economic Burden Associated with Management of Periodontitis in Malaysia Mon, 07 Mar 2016 06:47:55 +0000 Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted. Tuti Ningseh Mohd Dom, Rasidah Ayob, Khairiyah Abd Muttalib, and Syed Mohamed Aljunid Copyright © 2016 Tuti Ningseh Mohd Dom et al. All rights reserved. A Randomized Case-Series Study Comparing the Stability of Implant with Two Different Surfaces Placed in Fresh Extraction Sockets and Immediately Loaded Thu, 03 Mar 2016 15:13:08 +0000 Background. Hydrophilic and moderately rough implant surfaces have been proposed to enhance the osseointegration response. Aim. The aim of this study was to compare early changes of stability for two implants with identical macrodesign but with different surface topographies. Materials and Methods. In 11 patients, a total of 22 implants (11 bimodal (minimally rough, control) and 11 proactive (moderately rough and hydrophilic, test), Neoss Ltd., Harrogate, UK) were immediately placed into fresh extraction sockets and immediately loaded. The peak insertion torque (IT) was measured in Ncm at placement. Resonance Frequency Analysis (RFA) measurements were made at baseline and 2, 4, 6, and 12 weeks after surgery. Results. The two implant types showed similar IT and RFA values at placement (NS). A dip of RFA values after 2 weeks followed by an increase was observed, where the test implant showed a less pronounced decrease and a more rapid recovery than the control implant. The test implants were significantly more stable than the control ones after 12 weeks. Conclusions. The results from the present study indicated that the hydrophilic and rougher test implant was more resistant to immediate loading and showed a significantly higher stability than the smoother control implant after 12 weeks. Leonardo Vanden Bogaerde and Lars Sennerby Copyright © 2016 Leonardo Vanden Bogaerde and Lars Sennerby. All rights reserved. Experimentally Induced Pulpal Lesion and Substance P Expression: Effect of Ketoprofen—A Preliminary Study Mon, 29 Feb 2016 18:48:01 +0000 Objectives. To evaluate substance P (SP) and the effect of ketoprofen administration, a nonsteroidal anti-inflammatory drug (NSAID), on SP in the pulp of upper third molars with experimentally induced pulpal lesion. Materials and Methods. A sample of 20 young systemically healthy adults of both sexes, nonsmokers, with a healthy upper third molar to extract for orthodontic purposes, was selected. Prior to the procedure, an inflammatory process was generated by mechanical exposure of the pulp. After 15 minutes, the pulp was collected using a sterile barbed broach. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration. The patients were asked to complete a diary on the postoperative pain. Results. No statistically significant difference could be detected in SP expression between the two groups. In group 1, pain manifestation was significantly delayed in comparison with group 2. Conclusions. Preventive administration of ketoprofen did not significantly affect the pulpal levels of SP but resulted in a significantly postponed manifestation of pain after extraction. Gian Marco Abbate, Paola Sacerdote, Giada Amodeo, Alessandro Mangano, and Luca Levrini Copyright © 2016 Gian Marco Abbate et al. All rights reserved. Oral Gingival Cell Cigarette Smoke Exposure Induces Muscle Cell Metabolic Disruption Mon, 29 Feb 2016 16:48:59 +0000 Cigarette smoke exposure compromises health through damaging multiple physiological systems, including disrupting metabolic function. The purpose of this study was to determine the role of oral gingiva in mediating the deleterious metabolic effects of cigarette smoke exposure on skeletal muscle metabolic function. Using an in vitro conditioned medium cell model, skeletal muscle cells were incubated with medium from gingival cells treated with normal medium or medium containing suspended cigarette smoke extract (CSE). Following incubation of muscle cells with gingival cell conditioned medium, muscle cell mitochondrial respiration and insulin signaling and action were determined as an indication of overall muscle metabolic health. Skeletal muscle cells incubated with conditioned medium of CSE-treated gingival cells had a profound reduction in mitochondrial respiration and respiratory control. Furthermore, skeletal muscle cells had a greatly reduced response in insulin-stimulated Akt phosphorylation and glycogen synthesis. Altogether, these results provide a novel perspective on the mechanism whereby cigarette smoke affects systemic metabolic function. In conclusion, we found that oral gingival cells treated with CSE create an altered milieu that is sufficient to both disrupted skeletal muscle cell mitochondrial function and insulin sensitivity. Andrea C. Baeder, Kiran Napa, Sarah T. Richardson, Oliver J. Taylor, Samantha G. Andersen, Shalene H. Wilcox, Duane R. Winden, Paul R. Reynolds, and Benjamin T. Bikman Copyright © 2016 Andrea C. Baeder et al. All rights reserved. Association between Self-Reported Bruxism and Sleeping Patterns among Dental Students in Saudi Arabia: A Cross-Sectional Study Mon, 29 Feb 2016 11:09:15 +0000 Objectives. The aim of this cross-sectional study was to identify sleeping patterns among dental students and their association with self-reported bruxism in Riyadh Colleges of Dentistry and Pharmacy (RCsDP). Methods. A cross-sectional study was performed including 549 students (67 men and 482 women). A structured questionnaire was adopted from The PSQI (The Pittsburgh Sleep Questionnaire Index) used for data collection. It included questions which are categorized into sleeping habits, sleep-related symptoms, and additional questions concerning bruxism. This questionnaire was randomly distributed among all college preclinical and postclinical students. Sleep bruxism diagnosis was based on self-reported data. The data were analyzed using Chi-square tests through SPSS software for Windows. Results. Statistical analyses revealed significant correlations between self-reported bruxism and sleeping habits including sleep initiation (, ), continuous sleep until morning (, ), nighttime sleep duration (, ), and length of daytime naps (, ). There was an association between self-reported bruxism and sleeping-related symptoms including awakening early in the morning before the usual time without a cause (, ) and increased nightmares (, ). Conclusions. Poor sleeping pattern was an important factor among dental students, who reported sleep bruxism. Shereen M. Shokry, Eman E. El Wakeel, Nassr Al-Maflehi, Zaheera RasRas, Nida Fataftah, and Enam Abdul Kareem Copyright © 2016 Shereen M. Shokry et al. All rights reserved. Nitric Oxide Concentration and Other Salivary Changes after Insertion of New Complete Dentures in Edentulous Subjects Mon, 29 Feb 2016 09:37:21 +0000 Objective. To assess changes in levels of salivary nitric oxide (NO) after insertion of new complete dentures and its association with clinical and salivary parameters. Methods. Nineteen fully edentulous subjects were included, mean age 64.4. Unstimulated whole saliva was collected before and after insertion of the dentures, at follow-up visits, and after 12 months. The concentration of the final stable NO product (nitrite) was measured by a colorimetric assay based on the Griess reaction. Clinical parameters were assessed during all clinical visits. Results. Functional adaptation to the dentures progressively improved, with no complaints at the long-term follow-up. NO concentration was not influenced by the level of functional adaptation, presence of injuries to the mucosa, salivary flow, and saliva viscosity. Pairwise comparison showed a reduction in NO concentration at the first follow-up compared to baseline values but differences were not statistically significant. Significant differences were observed in NO concentrations at the long-term follow-up when compared to the first () and second () visits. Conclusion. NO concentration reduced after denture insertion and returned to baseline levels in the long-term follow-up. This appears to be an autonomic response of the body and provides valuable complementary information for the management of the edentulous patient. Maria de Lourdes Breseghelo, Lídia Andreu Guillo, Túlio Eduardo Nogueira, and Cláudio Rodrigues Leles Copyright © 2016 Maria de Lourdes Breseghelo et al. All rights reserved. Pittsburgh as a High Risk Population: The Potential Savings of a Personalized Dental Care Plan Tue, 23 Feb 2016 12:28:21 +0000 Objectives. Little evidence exists for the current standard of two annual preventative care visits. The purpose of this study was investigate this claim by modeling the potential savings of implementing a personalized care plan for high risk individuals in the Pittsburgh region. Methods. Using radiographs from 39 patients in the University of Pittsburgh Dental Registry and DNA Repository database, two models were created to analyse the direct savings of implementing a more aggressive preventative treatment plan and to view the longitudinal cost of increased annual yearly visits. Results. There is a significant decrease () between original and modeled treatment cost when treatment severity is reduced. In addition, there is a significant decrease in adult lifetime treatment cost () for up to four annual visits. Conclusions. Patients in high risk populations may see significant cost benefits in treatment cost when a personalized care plan, or higher annual preventative care visits, is implemented. Andrew J. Ng and Alexandre R. Vieira Copyright © 2016 Andrew J. Ng and Alexandre R. Vieira. All rights reserved. Influence of Type 2 Diabetes on Prevalence of Key Periodontal Pathogens, Salivary Matrix Metalloproteinases, and Bone Remodeling Markers in Sudanese Adults with and without Chronic Periodontitis Wed, 17 Feb 2016 09:48:06 +0000 This study compared the influence of type 2 diabetes on the occurrence of six periodontal pathogens in plaque samples of patients with and without chronic periodontitis. Levels of salivary MMP-8, MMP-9, RANKL, and OPG were also investigated. The study enrolled 31 patients with type 2 diabetes and chronic periodontitis (DM + CP), 29 with chronic periodontitis (CP), and 20 with type 2 diabetes (DM). Questionnaire-guided interviews were conducted and plaque index, bleeding on probing, and pocket depth were recorded. Polymerase chain reaction (PCR) was utilized to determine the prevalence of the bacteria. The levels of salivary molecules were determined by enzyme immunosorbent assay (ELISA). The CP group had the highest prevalence of P. gingivalis (81.5%), followed by the DM + CP (59.3%) and DM (55.0%) groups (). Similar trends were observed for P. intermedia and T. denticola. The prevalence of T. forsythia was 100% in both periodontitis groups compared to 90% in the DM group. There were no significant differences between the groups regarding the concentrations of MMP-8, MMP-9, or OPG. RANKL concentrations were below the detection limit. Our data show that type 2 diabetes has no significant influence on the prevalence of the investigated periodontal pathogens, or the levels of salivary MMP-8, MMP-9, and OPG. Hasaan Gassim Mohamed, Shaza Bushra Idris, Manal Mustafa, Mutaz Faisal Ahmed, Anne Nordrehaug Åstrøm, Kamal Mustafa, and Salah Osman Ibrahim Copyright © 2016 Hasaan Gassim Mohamed et al. All rights reserved. Surface Roughness, Microhardness, and Microleakage of a Silorane-Based Composite Resin after Immediate or Delayed Finishing/Polishing Tue, 09 Feb 2016 12:29:39 +0000 Objective. This study evaluated the effect of immediate or delayed finishing/polishing using different systems on the surface roughness, hardness, and microleakage of a silorane-based composite. Material and Methods. Specimens were made with silorane-based composite (Filtek P90, 3M ESPE) and assigned to the treatments: control (light-cured); aluminum oxide discs (Sof-Lex, 3M ESPE); diamond-impregnated silicone tips (Astropol, Ivoclar Vivadent); aluminum oxide-impregnated silicone tips (Enhance, Dentsply). Half of the specimens were finished/polished immediately and the rest after 7 days. Surface roughness (Ra, μm; ) and Vickers microhardness (50 g; 45 s; ) were measured. Cavities were prepared in bovine incisors and filled with Filtek P90. The fillings received immediate or delayed finishing/polishing () and were subjected to dye penetration test (0.5% basic fuchsin, 24 h). Data were analyzed by ANOVA and Scheffe, Kruskal-Wallis, and Mann-Whitney tests (). Results. The finishing/polishing system significantly influenced roughness and microhardness (). For enamel, microleakage was not affected by the finishing/polishing system (). For dentin, Sof-Lex discs and Astropol points promoted greater microleakage than Enhance points (). Conclusion. Considering roughness, microhardness, and microleakage together, immediate finishing/polishing of a silorane-based composite using aluminum oxide discs may be recommended. Fernanda Carvalho Rezende Lins, Raquel Conceição Ferreira, Rodrigo Richard Silveira, Carolina Nemésio Barros Pereira, Allyson Nogueira Moreira, and Claudia Silami Magalhães Copyright © 2016 Fernanda Carvalho Rezende Lins et al. All rights reserved. Materials and Bioactive Factors in Dental Restoration and Periodontal Therapy Tue, 09 Feb 2016 07:42:27 +0000 Vesna Miletic, Tihana Divnic-Resnik, Natasa Nikolic Jakoba, Andrija Petar Bosnjak, and Paulo Henrique Perlatti D’Alpino Copyright © 2016 Vesna Miletic et al. All rights reserved. Impact of Orthodontic Treatment on Periodontal Tissues: A Narrative Review of Multidisciplinary Literature Tue, 19 Jan 2016 13:49:29 +0000 The aim of this review is to describe the most commonly observed changes in periodontium caused by orthodontic treatment in order to facilitate specialists’ collaboration and communication. An electronic database search was carried out using PubMed abstract and citation database and bibliographic material was then used in order to find other appropriate sources. Soft and hard periodontal tissues changes during orthodontic treatment and maintenance of the patients are discussed in order to provide an exhaustive picture of the possible interactions between these two interwoven disciplines. Angelina Gorbunkova, Giorgio Pagni, Anna Brizhak, Giampietro Farronato, and Giulio Rasperini Copyright © 2016 Angelina Gorbunkova et al. All rights reserved. A Three-Dimensional Finite Element Study on the Biomechanical Simulation of Various Structured Dental Implants and Their Surrounding Bone Tissues Tue, 19 Jan 2016 08:50:49 +0000 Background/Purpose. This three-dimensional finite element study observed the stress distribution characteristics of 12 types of dental implants and their surrounding bone tissues with various structured abutments, implant threads, and healing methods under different amounts of concentrated loading. Materials and Methods. A three-dimensional geometrical model of a dental implant and its surrounding bone tissue was created; the model simulated a screw applied with a preload of 200 N or a torque of 0.2 N·m and a prosthetic crown applied with a vertical or an inclined force of 100 N. The Von Mises stress was evaluated on the 12 types of dental implants and their surrounding bone tissues. Results. Under the same loading force, the stress influence on the implant threads was not significant; however, the stress influence on the cancellous bone was obvious. The stress applied to the abutment, cortical bone, and cancellous bone by the inclined force applied to the crown was larger than the stress applied by the vertical force to the crown, and the abutment stress of the nonsubmerged healing implant system was higher than that of the submerged healing implant system. Conclusion. A dental implant system characterised by a straight abutment, rectangle tooth, and nonsubmerged healing may provide minimum value for the implant-bone interface. Gong Zhang, Hai Yuan, Xianshuai Chen, Weijun Wang, Jianyu Chen, Jimin Liang, and Peng Zhang Copyright © 2016 Gong Zhang et al. All rights reserved. Comparison of the Mechanical Properties of Early Leukocyte- and Platelet-Rich Fibrin versus PRGF/Endoret Membranes Wed, 06 Jan 2016 11:35:39 +0000 Objectives. The mechanical properties of membranes are important factors in the success of treatment and clinical handling. The goal of this study was to compare the mechanical properties of early leukocyte- and platelet-rich fibrin (L-PRF) versus PRGF/Endoret membrane. Materials and Methods. In this experimental study, membranes were obtained from 10 healthy male volunteers. After obtaining 20 cc venous blood from each volunteer, 10 cc was used to prepare early L-PRF (group 1) and the rest was used to get a membrane by PRGF-Endoret system (group 2). Tensile loads were applied to specimens using universal testing machine. Tensile strength, stiffness, and toughness of the two groups of membranes were calculated and compared by paired -test. Results. The mean tensile strength and toughness were higher in group 1 with a significant difference (). The mean stiffness in group 1 was also higher but not statistically significant (). Conclusions. The results showed that early L-PRF membranes had stronger mechanical properties than membranes produced by PRGF-Endoret system. Early L-PRF membranes might have easier clinical handling and could be a more proper scaffold in periodontal regenerative procedures. The real results of the current L-PRF should be in fact much higher than what is reported here. Hooman Khorshidi, Saeed Raoofi, Rafat Bagheri, and Hodasadat Banihashemi Copyright © 2016 Hooman Khorshidi et al. All rights reserved. Knowledge of Future Dental Practitioners towards Oral Cancer: Exploratory Findings from a Public University in Malaysia Tue, 29 Dec 2015 12:33:46 +0000 Objective. To assess knowledge and awareness of oral cancer in the early identification of risk factors among undergraduate dental students. Methods. A total of 162 undergraduate (third, fourth, and fifth year) dental students at International Islamic University, Malaysia, were approached to participate in the study, and those who agreed were administered. A 9-item pretested questionnaire contains questions on oral examination, oral cancer risk factors, and requests for further information. Descriptive statistics were conducted using chi-square testing. Results. The response rate of the study was 70.3% (114/162), with 26 (22.8%) males and 88 (77.2%) females. All undergraduate dental students were familiar with examining the oral mucosa of their patients and most were likely to advise patients about the risk factors for developing oral cancer (98.2%). Nearly one-third (32.4%) of students reported examining patients with oral lesions as early signs for oral cancer () and nearly 70% agreed that they did not have sufficient knowledge regarding the prevention and detection of oral cancer (). In addition, more than 95.6% agreed that there is a need for additional information/teaching regarding oral cancer. Further, 61.3% and 14.1% identified tobacco smoking and drinking alcohol as major risk factors for developing oral cancer. Conclusion. This study demonstrated lack of awareness about risk factors among undergraduate dental students regarding oral cancer. Reinforcing awareness and enhancing the benefits of early detection on prevention of oral cancer should be done through training and/or educational intervention. Akshaya Srikanth Bhagavathula, Nazrin Bin Zakaria, and Shazia Qasim Jamshed Copyright © 2015 Akshaya Srikanth Bhagavathula et al. All rights reserved. Association between IFN-γ +874A/T and IFN-γR1 (-611A/G, +189T/G, and +95C/T) Gene Polymorphisms and Chronic Periodontitis in a Sample of Iranian Population Mon, 28 Dec 2015 12:49:29 +0000 Background. Interferon gamma (IFN-γ) is an immune regulatory cytokine that acts through its receptor and plays important role in progression of inflammatory disease such as chronic periodontitis (CP). The purpose of this study was to determine the differences in the distribution of IFN-γ (+874A/T) and IFN-γR1 (-611A/G, +189T/G, and +95C/T) gene polymorphisms among CP and healthy individuals and to investigate relationships between these polymorphisms and susceptibility to CP. Materials and Methods. 310 individuals were enrolled in the study including 210 CP patients and 100 healthy controls. Single nucleotide polymorphisms at IFN-γ (+874A/T) and IFN-γR1 (-611A/G, +189T/G, and +95C/T) were analyzed by ARMS-PCR and PCR-RFLP methods. Results. The significant difference was found in genotype and allele frequency of IFN-γ (+874A/T) gene polymorphism in chronic periodontitis patients and healthy controls. The distribution of genotypes and allele frequencies for IFN-γR1 (-611A/G, +189T/G, and +95C/T) were similar among the groups and no differences in the frequencies of alleles or genotypes of IFN-γR1 genetic polymorphisms variants between case and control groups were detected. Conclusion. The finding of this study showed that IFN-γ +874A/T gene polymorphism may affect susceptibility to CP, whereas IFN-γR1 genetic polymorphisms at -611A/G, +189T/G, and +95C/T were not associated with this disease. Zahra Heidari, Hamidreza Mahmoudzadeh-Sagheb, Mohammad Hashemi, Somayeh Ansarimoghaddam, Bita Moudi, and Nadia Sheibak Copyright © 2015 Zahra Heidari et al. All rights reserved. Photodynamic Antimicrobial Chemotherapy for Root Canal System Asepsis: A Narrative Literature Review Thu, 10 Dec 2015 12:08:23 +0000 Aim. The aim of this comprehensive literature review was to address the question: Does photodynamic therapy (PDT) improve root canal disinfection through significant bacterial reduction in the root canal system? Methodology. A comprehensive narrative literature review was performed to compare PDT effect with sodium hypochlorite as the comparative classical irrigant. Two reviewers independently conducted literature searches using a combination of medical subject heading terms and key words to identify relevant studies comparing information found in 7 electronic databases from January 2000 to May 2015. A manual search was performed on bibliography of articles collected on electronic databases. Authors were contacted to ask for references of more research not detected on the prior electronic and manual searches. Results. The literature search provided 62 titles and abstracts, from which 29 studies were related directly to the search theme. Considering all publications, 14 (48%) showed PDT to be more efficient in antimicrobial outcome than NaOCl (0.5–6% concentration) used alone and 2 (7%) revealed similar effects between them. Toluidine blue and methylene blue are the most used photosensitizers and most commonly laser has 660 nm of wavelength with a 400 nm diameter of intracanal fiber. Conclusions. PDT has been used without a well-defined protocol and still remains at an experimental stage waiting for further optimization. The level of evidence available in clinical studies to answer this question is low and at high risk of bias. P. Diogo, T. Gonçalves, P. Palma, and J. M. Santos Copyright © 2015 P. Diogo et al. All rights reserved. Pyogenic Granuloma/Peripheral Giant-Cell Granuloma Associated with Implants Tue, 01 Dec 2015 11:35:49 +0000 Introduction. Pyogenic granuloma (PG) and peripheral giant-cell granuloma (PGCG) are two of the most common inflammatory lesions associated with implants; however, there is no established pathway for treatment of these conditions. This paper aims to illustrate the successful treatment of PG and PGCG and also report a systematic review of the literature regarding the various treatments proposed. Methods. To collect relevant information about previous treatments for PG and PGCG involving implants we carried out electronic searches of publications with the key words “granuloma”, “oral”, and “implants” from the last 15 years on the databases Pubmed, National Library of Medicine’s Medline, Scielo, Scopus, and Cochrane Library. Results. From the electronic search 16 case reports were found showing excision and curettage as the main successful treatment. As no clinical trials or observational studies were identified the authors agreed to present results from a review perspective. Conclusion. This is the largest analysis of PG and PGCG associated with implants published to date. Our review would suggest that PGCG associated with implants appears to have a more aggressive nature; however the level of evidence is very limited. Further cohort studies with representative sample sizes and standard outcome measures are necessary for better understanding of these conditions. Enric Jané-Salas, Rui Albuquerque, Aura Font-Muñoz, Beatríz González-Navarro, Albert Estrugo Devesa, and Jose López-López Copyright © 2015 Enric Jané-Salas et al. All rights reserved.