ISRN Dentistry The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. An Insight into Internal Resorption Mon, 12 May 2014 06:57:48 +0000 Internal resorption, a rare phenomenon, has been a quandary from the standpoints of both its diagnosis and treatment. It is usually asymptomatic and discovered by chance on routine radiographic examinations or by a classic clinical sign, “pink spot” in the crown. This paper emphasizes the etiology and pathophysiologic mechanisms involved in internal root resorption. Prognosis is good for smaller lesions; however, for those with extensive resorption associated with perforation the tooth structure is greatly weakened and the prognosis remains poor. Priya Thomas, Rekha Krishna Pillai, Bindhu Pushparajan Ramakrishnan, and Jayanthi Palani Copyright © 2014 Priya Thomas et al. All rights reserved. A Survey of Standard Protocols for Endodontic Treatment in North of KSA Sun, 04 May 2014 16:36:04 +0000 The objective of this study was to collect information regarding methods, materials, and attitudes employed during the endodontic treatment by dentists in north of Saudi Arabia. A questionnaire was designed and distributed among 300 dentists in north of Saudi Arabia to collect the data about the standard protocols of endodontic treatment. The collected data was analyzed by using the SPSS 10 computer software. Out of a total of 300 surveyed dentists, the 66% response rate showed that this study was true representation of the endodontic treatment performed by the dentists in north of Saudi Arabia. 152 (76%) were general dentists and 48 (24%) were endodontists. 18 (9%) were using rubber dam as the method of isolation during endodontic treatment. 173 (86.5%) were using only measurement radiographs for working length determination and 27 (13.5%) were using both electronic apex locator and measurement radiographs. 95 (47.5%) of the respondents were using standardized technique and 25 (12.5%) were using step-down as a root canal preparation technique. 127 (63.5%) of the respondents were using lateral condensation technique, with gutta percha points for root canal obturation. Azhar Iqbal, Iftikhar Akbar, Beenish Qureshi, Mohd G. Sghaireen, and Mahmoud K. AL-Omiri Copyright © 2014 Azhar Iqbal et al. All rights reserved. Silver Binding Nucleolar Organizer Regions Dots in Oral Leukoplakia with Epithelial Dysplasia and Oral Squamous Cell Carcinoma: An In Vivo Study Wed, 30 Apr 2014 12:05:24 +0000 Silver binding nucleolar organizer regions (AgNOR) in normal oral mucosa (NOM), oral leukoplakia with epithelial dysplasia (ED), and oral squamous cell carcinoma (OSCC) were studied. The mean AgNOR count per nucleus increased from NOM to ED to OSCC. Tissue showing ED in oral leukoplakia and OSCC cases showed higher counts, wider scatter, and smaller size of AgNOR dots in the nuclei. The study seems to suggest that time method has some potential in distinguishing between NOM and oral leukoplakia with ED and OSCC. Studies of larger numbers are needed to arrive at more substantial conclusions. Fahad Mansoor Samadi, Bastain Thattil Sebastian, Anil Singh, Shaleen Chandra, Shadab Mohammad, Arun Singh, Thippeswamy Halappa, and Firoza Samadi Copyright © 2014 Fahad Mansoor Samadi et al. All rights reserved. Prevalence of Coronal Pulp Stones and Its Relation with Systemic Disorders in Northern Indian Central Punjabi Population Tue, 22 Apr 2014 11:42:49 +0000 Aim. To estimate the prevalence of coronal pulp stones in the molar teeth of dental outpatients of Sunam, Sangrur district, Punjab, India, to report any association between occurrence of pulp stones with age, gender, dental arch, side, and dental status and to find out correlation between pulp stones with dental and systemic diseases. Materials and Methods. 500 routine dental outpatients within age group of 18–67 years were involved in the study. Molar bitewing of left and right side of each patient was taken with XCP bitewing instrument and size 2 film. The presence or absence of pulp stones was recorded. Chi-square analysis was used to record the prevalence of pulp stones and to compare it with demographic and systemic factors. Results. Overall prevalence of pulp stones was 41.8%. Pulp stones were significantly higher in maxilla (11.59%) than mandible (6.54%), left side than right side, and first molar than other molars. Higher numbers of pulp stones were recorded in patients with cardiovascular disease (38.89%) than with cholelithiasis and renal lithiasis. Conclusion. Pulp stones were higher in maxillary arch than mandibular arch and in females than males. Cardiovascular patients had higher number of pulp stones than other groups. Sandeep Kumar Bains, Archana Bhatia, Harkanwal Preet Singh, Swati Swagatika Biswal, Shashi Kanth, and Srinivas Nalla Copyright © 2014 Sandeep Kumar Bains et al. All rights reserved. Effect of Healing Time on Bone-Implant Contact of Orthodontic Micro-Implants: A Histologic Study Sun, 06 Apr 2014 13:51:00 +0000 Objectives. This study aimed to evaluate the effect of immediate and delayed loading of orthodontic micro-implants on bone-implant contact. Materials and Methods. Sixty four micro-implants were implanted in dog's jaw bone. The micro-implants were divided into loaded and unloaded (control) groups. The control group had two subgroups: four and eight weeks being implanted. The loaded group had two subgroups of immediate loading and delayed (after four weeks healing) loading. Loaded samples were subjected to 200g load for four weeks. After sacrificing the animals micro-implants and surrounding tissues were observed histologically. Bone-implant contact ratios (BIC) were calculated and different groups' results were compared by three-way ANOVA. Results. Mean survival rate was 96.7% in general. Survival rates were 96.7%, 94.4% and 100% for control, immediate and delayed loaded groups, respectively. BIC values were not significantly different in loaded and control groups, immediate and delayed loading groups, and pressure and tension sides. Mandibular micro-implants had significantly higher BIC than maxillary ones in immediate loading, 4-weeks control, and 8-weeks control groups (P = 0.021, P = 0.009, P = 0.003, resp.). Conclusion Immediate or delayed loading of micro-implants in dog did not cause significant difference in Bone-implant contact which could be concluded that healing time had not significant effect on micro-implant stability. Barat Ali Ramazanzadeh, Kazem Fatemi, Mahboobe Dehghani, Nooshin Mohtasham, Arezoo Jahanbin, and Hamed Sadeghian Copyright © 2014 Barat Ali Ramazanzadeh et al. All rights reserved. Dental Extraction Can Be Performed Safely in Patients on Aspirin Therapy: A Timely Reminder Tue, 01 Apr 2014 11:56:29 +0000 Cardiac patients on aspirin therapy may require extractions for their diseased teeth. It is a common practice among physicians and treating surgeons to stop aspirin prior to tooth extraction because of fear of bleeding complications. This practice often predisposes the patient to adverse thromboembolic events. This practice is based on theoretical risk of bleeding and on isolated case reports of excessive bleeding with aspirin therapy. The current consensus and recommendations are in favor of continuing aspirin therapy during simple tooth extraction as the bleeding complication incidence is very less and if it occurs can be controlled efficiently with local hemostasis measures. Gaurav Verma Copyright © 2014 Gaurav Verma. All rights reserved. The Efficacy of Selected Desensitizing OTC Products: A Systematic Review Thu, 27 Mar 2014 08:38:22 +0000 Objectives. The aim of the present study was to review the published literature in order to identify relevant studies for inclusion and to determine whether there was any evidence on the clinical effectiveness of selected desensitizing toothpastes, calcium sodium phosphosilicate (CSPS), amorphous calcium phosphate (ACP), nanohydroxyapatite, and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) on reducing dentine hypersensitivity (DH). Materials and Methods. Following a review of 593 papers identified from searching both electronic databases (PUBMED) and hand searching of relevant written journals, only 5 papers were accepted for inclusion. Results. Analysis of the included studies (3 CSPS and 2 ACP) would suggest that there may be some benefit for patients using these products for reducing DH. No direct comparative studies were available to assess all these products under the same conditions neither were there any comparative randomised controlled studies that compared at least two of these products in determining their effectiveness in treating DH. Conclusions. Due to the small number of included studies, there are limited clinical data to support any claims of clinical efficacy of these OTC products. Further studies are therefore required to determine the efficacy of these products in well-controlled RCT studies with a larger sample size. E. Talioti, R. Hill, and D. G. Gillam Copyright © 2014 E. Talioti et al. All rights reserved. Assessment of the Feelings and Attitudes of Children towards Their Dentist and Their Association with Oral Health Thu, 27 Mar 2014 00:00:00 +0000 This study assessed the feelings and attitudes of children toward their dentists and their association with oral health. Methods. A questionnaire designed to evaluate the attitudes of children toward dentists and preferences was completed by 200 children and their families. In addition, the children were examined and the World Health Organization (WHO) method was used to obtain dmft and DMFT scores. Results. The mean dmft and DMFT scores were and , respectively. Of the children, 92.5% reported that they had visited a dentist before. Of the children who had visited dentists, approximately 71.5% reported that they enjoyed their visits. Of the children, 84% preferred female dentists, 76.5% preferred dentists that wore a colored coat, and 63% preferred a decorated dental clinic over a plain clinic. The mean dmft and DMFT values of children who were afraid of dentists were significantly higher than those of children who were not ( and , resp.). Conclusion. Children have strong perceptions and preferences regarding the appearance of their dentists and dental clinics. The results of this study might help dentists to improve their delivery of care. Aslı Patır Münevveroğlu, Beyza Ballı Akgöl, and Tuğba Erol Copyright © 2014 Aslı Patır Münevveroğlu et al. All rights reserved. Change in Surface Roughness of Esthetic Restorative Materials after Exposure to Different Immersion Regimes in a Cola Drink Sun, 23 Mar 2014 08:47:09 +0000 Context. An in vitro study carried out to evaluate and compare the effect of Cola drink on surface roughness of esthetic restorative materials. Purpose. To compare the effect of different immersion regimes in a Cola drink on surface roughness of esthetic restorative materials. Method. Two hundred samples were grouped into 4 equal groups of 50 samples each: Group I: conventional glass ionomer, Group II: resin modified glass ionomer, Group III: polyacid-modified resin composite, Group IV: Composite resin. Each group was further subdivided into 5 subgroups of 10 samples each. Subgroup A (Control Subgroup). Samples were kept immersed in artificial saliva. Subgroup B. Samples were immersed in Cola drink once a day. Subgroup C. Samples were immersed in Cola drink, 3 times a day. Subgroup D. Samples were immersed in Cola drink 5 times a day. Subgroup E. Samples were immersed in Cola drink 10 times a day. Each immersion lasted 5 minutes. The immersion protocol was repeated for 7 days. Results. Maximum surface roughness was seen in Group I conventional glass ionomer cement, followed by Group II resin modified glass ionomer, Group III polyacid modified resin composite, and Group IV composite resin samples. Conclusion. Resistance to change in surface roughness is more in resin based restorative materials as compared to glass ionomer based materials. Navroop Kaur Bajwa and Anuradha Pathak Copyright © 2014 Navroop Kaur Bajwa and Anuradha Pathak. All rights reserved. Effect of Lactic Acid Etching on Bonding Effectiveness of Orthodontic Bracket after Water Storage Mon, 17 Mar 2014 11:16:22 +0000 Objective. To determine the effect of lactic acid at various concentrations on the shear bond strength of orthodontic brackets bonded with the resin adhesive system before and after water storage. Materials and Methods. Hundred extracted human premolars were divided into 5 treatment groups and etched for 30 seconds with one of the following agents: lactic acid solution with (A) 10%, (B) 20%, (C) 30%, and (D) 50%; group E, 37% phosphoric acid (control). Metal brackets were bonded using a Transbond XT. Bonding effectiveness was assessed by shear bond strength after 24 hours and 6 months of water storage at 37°C. The data were analyzed with 2-way analysis of variance and Tukey’s Honestly Significant Difference (HSD) test (). Results. Lactic acid concentration and water storage resulted in significant differences for brackets bond strength (). 20% lactic acid had significantly higher mean bond strength values (SD) for all conditions: 24 hours [12.2 (.7) MPa] and 6 months [10.1 (.6) MPa] of water storage. 37% phosphoric acid had intermediate bond strength values for all conditions: 24 hours [8.2 (.6) MPa] and 6 months [6.2 (.6) MPa] of water storage. Also, there were differences in bond strength between storage time, with a reduction in values from 24 hours and 6 months for all experimental groups (). Conclusion. Lactic acid could be used in place of phosphoric acid as an enamel etchant for bonding of orthodontic brackets. Fahad F. Alsulaimani Copyright © 2014 Fahad F. Alsulaimani. All rights reserved. In Vitro Cytotoxicity Evaluation of Four Vital Pulp Therapy Materials on L929 Fibroblasts Mon, 03 Mar 2014 13:38:48 +0000 The aim of this study was to evaluate cytotoxicity of direct pulp capping materials such as Dycal, Life, ProRoot MTA, and Super-Bond C&B on L929 fibroblasts. Freshly mixed or set materials were prepared and eluted by incubation with cell culture medium for working time period (fresh) or for 6 hours (set). The cells were exposed to media containing elutes for 24 hours, after which the cell survival was evaluated by MTS assays. In freshly mixed materials, average ± standard deviation % cell viabilities were 40.2 ± 14.0%, 43.7 ± 16.0%, 72.9 ± 12.7%, and 66.0 ± 13.6% for Dycal, Life, ProRoot MTA, and Super-Bond C&B, respectively. There was no statistical difference in cell viabilities among material groups, whereas in set materials, the cell viabilities were 48.7 ± 14.8%, 37.2 ± 10.6%, 46.7 ± 15.2%, and 100 ± 21.9% for Dycal, Life, ProRoot MTA, and Super-Bond C&B, respectively. Super-Bond C&B showed more cell viabilities than the other three material groups . The four vital pulp therapy materials had similar cytotoxicity when the materials were fresh. Super-Bond C&B was less cytotoxic than Dycal, Life, and ProRoot MTA after the materials were set, which suggests the use of SB-C&B in future in vivo clinical investigations. Aniket S. Wadajkar, Chul Ahn, Kytai T. Nguyen, Qiang Zhu, and Takashi Komabayashi Copyright © 2014 Aniket S. Wadajkar et al. All rights reserved. Current State of Topical Antimicrobial Therapy in Management of Early Childhood Caries Wed, 19 Feb 2014 15:14:25 +0000 The treatment of early childhood caries can have a significant economical burden and treatment relapses are frequent. Effective intervention by means of topical antimicrobial agents can reduce the burden of early childhood caries. The main aim in prevention and treatment should focus on inhibition of the growth of oral bacteria. This is a comprehensive review of the literature on the various antimicrobial agents which are proven to be effective in management of this carious progression. The review identified that there is a significant data to suggest use of antimicrobial agents in management of early childhood caries. Antimicrobial agents aid in better management of patients with early carious lesion. The relapse rates are less, when the treatment is combined with the use of antimicrobial agent. JayaBaarathi Jayabal and Ramakrishnan Mahesh Copyright © 2014 JayaBaarathi Jayabal and Ramakrishnan Mahesh. All rights reserved. Salivary Diagnostics: A Brief Review Wed, 29 Jan 2014 07:33:27 +0000 Early detection of disease plays a crucial role for treatment planning and prognosis. Saliva has great potential as a diagnostic fluid and offers advantage over serum and other biological fluids by an economic and noninvasive collection method for monitoring of systemic health and disease progression. The plethora of components in this fluid can act as biomarkers for diagnosis of various systemic and local diseases. In this review paper, we have emphasized the role of salivary biomarkers as diagnostic tools. Narasimhan Malathi, Sabesan Mythili, and Hannah R. Vasanthi Copyright © 2014 Narasimhan Malathi et al. All rights reserved. The Consequences of Tongue Piercing on Oral and Periodontal Tissues Wed, 29 Jan 2014 00:00:00 +0000 This paper is discussing the potential consequences that may arise by the implementation of piercing in the oral cavity and is also categorizing the consequences according to their extent and severity. Furthermore, this paper is reviewing some possible oral hygiene methods that can prove to be auxiliary in decreasing the potential complications arising from oral piercing. This literature review is based on articles published from 1985 to 2012. Ioannis Plastargias and Dimitra Sakellari Copyright © 2014 Ioannis Plastargias and Dimitra Sakellari. All rights reserved. The Prevalence of Tonsilloliths and Other Soft Tissue Calcifications in Patients Attending Oral and Maxillofacial Radiology Clinic of the University of Iowa Wed, 22 Jan 2014 16:16:21 +0000 Objective. The purpose of this study was to determine the prevalence of tonsiliths in patients attending the oral and maxillofacial radiology clinic of The University of Iowa and to determine if there is any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Study Design. This was a two-part study. The first part was a prevalence study whereas the second was a matched pair case-control study. The matched pair case-control study commenced after the prevalence study was concluded. No new or unusual radiographs were made in this study. The study only reviewed radiographs that were made for clinical purposes. Results. A total of 1524 pantomographs were reviewed and 124 subjects (53 males and 71 females) aged 9 years and 2 months to 87 years (mean age 52.6 years) were included for data analysis. Thirty-eight subjects had single tonsiliths whereas 86 subjects had multiple tonsiliths. The prevalence of tonsiliths in the study population was 8.14%. A total of 20 subjects were included in the second part of the study, comprising 10 each for matched pair case-control groups. The observations did not indicate any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Conclusion. The prevalence of tonsiliths in our study population was 8.14%. The observations in our study do not support any correlations between tonsiliths and calcifications in other body tissues, organs, or ducts. Babatunde Olamide Bamgbose, Axel Ruprecht, John Hellstein, Sherry Timmons, and Fang Qian Copyright © 2014 Babatunde Olamide Bamgbose et al. All rights reserved. Role of Sugar and Sugar Substitutes in Dental Caries: A Review Sun, 29 Dec 2013 08:36:15 +0000 Dental caries is a chronic disease which can affect us at any age. The term “caries” denotes both the disease process and its consequences, that is, the damage caused by the disease process. Dental caries has a multifactorial aetiology in which there is interplay of three principal factors: the host (saliva and teeth), the microflora (plaque), and the substrate (diet), and a fourth factor: time. The role of sugar (and other fermentable carbohydrates such as highly refined flour) as a risk factor in the initiation and progression of dental caries is overwhelming. Whether this initial demineralization proceeds to clinically detectable caries or whether the lesion is remineralized by plaque minerals depends on a number of factors, of which the amount and frequency of further sugars consumption are of utmost importance. This paper reviews the role of sugar and sugar substitutes in dental caries. Prahlad Gupta, Nidhi Gupta, Atish Prakash Pawar, Smita Shrishail Birajdar, Amanpreet Singh Natt, and Harkanwal Preet Singh Copyright © 2013 Prahlad Gupta et al. All rights reserved. Force Transfer and Stress Distribution in an Implant-Supported Overdenture Retained with a Hader Bar Attachment: A Finite Element Analysis Thu, 26 Dec 2013 11:51:36 +0000 Background and Objectives. A key factor for the long-term function of a dental implant is the manner in which stresses are transferred to the surrounding bone. The effect of adding a stiffener to the tissue side of the Hader bar helps to reduce the transmission of the stresses to the alveolar bone. But the ideal thickness of the stiffener to be attached to the bar is a subject of much debate. This study aims to analyze the force transfer and stress distribution of an implant-supported overdenture with a Hader bar attachment. The stiffener of the bar attachments was varied and the stress distribution to the bone around the implant was studied. Methods. A CT scan of edentulous mandible was used and three models with 1, 2, and 3 mm thick stiffeners were created and subjected to loads of emulating the masticatory forces. These different models were analyzed by the Finite Element Software (Ansys, Version 8.0) using von Mises stress analysis. Results. The results showed that the maximum stress concentration was seen in the neck of the implant for models A and B. In model C the maximum stress concentration was in the bar attachment making it the model with the best stress distribution, as far as implant failures are concerned. Conclusion. The implant with Hader bar attachment with a 3 mm stiffener is the best in terms of stress distribution, where the stress is concentrated at the bar and stiffener regions. Preeti Satheesh Kumar, Kumar K. S. Satheesh, Jins John, Geetha Patil, and Ruchi Patel Copyright © 2013 Preeti Satheesh Kumar et al. All rights reserved. Feeding Practices and Early Childhood Caries: A Cross-Sectional Study of Preschool Children in Kanpur District, India Thu, 05 Dec 2013 13:50:05 +0000 Background. Early childhood caries (ECC) is a public health problem due to its impact on children’s health, development, and wellbeing. The objective of this study was to assess the caries experience in 3–5-year-old children and to evaluate the relationship with their mothers’ practices regarding feeding and oral hygiene habits in Kanpur. Method. A cross-sectional survey was undertaken on 2000 (974 boys and 1026 girls) children aged 3–5 years from a random sample of preschools in Kanpur district, India. Dental caries experience was recorded using WHO criteria. A pretested questionnaire with 9 questions was used for collecting information regarding mothers’ practices regarding feeding and oral hygiene practices. Chi-square test () and Student’s -test were used for statistical analysis. Results. The prevalence of ECC was 48% with mean dmft of 2.03 ± 2.99. Boys (57%) were affected more than girls (43%) which was found to be statistically significant (). Caries prevalence was high and statistically significant () among those who were breast fed for longer duration, during nighttime, those falling asleep with bottle, and those fed with additional sugar in milk. Conclusion. Determining the role of feeding practices on early childhood caries can help in the development of appropriate oral health promotion strategies. Santhebachalli Prakasha Shrutha, Grandim Balarama Gupta Vinit, Kolli Yada Giri, and Sarwar Alam Copyright © 2013 Santhebachalli Prakasha Shrutha et al. All rights reserved. Laser Doppler Blood-Flow Signals from Human Teeth during an Alignment and Leveling Movement Using a Superelastic Archwire Thu, 19 Sep 2013 15:49:39 +0000 Objective. The purpose of this study was to examine alterations in blood-flow signals (BFS) from human teeth during an alignment and leveling phase (superelastic wire 0.014′′) in a clinical orthodontic treatment using laser doppler flowmetry (LDF). Materials and Methods. Recordings were made in 12 maxillary left central incisors. The basal value of the BFS from each tooth (without orthodontic forces) was compared with the corresponding values of BFS during four periods of observation: 20 minutes, 48 hours, 72 hours, and one month after the activation of the orthodontic appliance. Results. Statistically significant decrease of BFS was observed at 20 minutes, 48 hours, and 72 hours . No differences were found comparing BFS on day 30 and the corresponding basal values. Conclusion. Under real clinical conditions, a significant decrease in BFS was verified during the initial phase of the treatment, followed by a recovery on day 30. Alvaro Wagner Rodrigues Salles, Adriana Mirian Cotrim Salles, and Gessé Eduardo Calvo Nogueira Copyright © 2013 Alvaro Wagner Rodrigues Salles et al. All rights reserved. Dental Enamel Development: Proteinases and Their Enamel Matrix Substrates Mon, 16 Sep 2013 08:16:55 +0000 This review focuses on recent discoveries and delves in detail about what is known about each of the proteins (amelogenin, ameloblastin, and enamelin) and proteinases (matrix metalloproteinase-20 and kallikrein-related peptidase-4) that are secreted into the enamel matrix. After an overview of enamel development, this review focuses on these enamel proteins by describing their nomenclature, tissue expression, functions, proteinase activation, and proteinase substrate specificity. These proteins and their respective null mice and human mutations are also evaluated to shed light on the mechanisms that cause nonsyndromic enamel malformations termed amelogenesis imperfecta. Pertinent controversies are addressed. For example, do any of these proteins have a critical function in addition to their role in enamel development? Does amelogenin initiate crystallite growth, does it inhibit crystallite growth in width and thickness, or does it do neither? Detailed examination of the null mouse literature provides unmistakable clues and/or answers to these questions, and this data is thoroughly analyzed. Striking conclusions from this analysis reveal that widely held paradigms of enamel formation are inadequate. The final section of this review weaves the recent data into a plausible new mechanism by which these enamel matrix proteins support and promote enamel development. John D. Bartlett Copyright © 2013 John D. Bartlett. All rights reserved. Effect of Patency File on Transportation and Curve Straightening in Canal Preparation with ProTaper System Thu, 12 Sep 2013 12:11:13 +0000 The aim of this ex vivo study was to evaluate the effect of using a patency file on apical transportation and curve straightening during canal instrumentation with the ProTaper rotary system. Seventy permanent mandibular first molars with mesiobuccal canals, measuring 18–23 mm in length and with a 25–40° curvature (according to the Schneider method), were selected. The working lengths were determined and the teeth were mounted and divided into two experimental groups: (A) prepared by the ProTaper system without using a patency file () and (B) prepared by the ProTaper system using a patency file (). Radiographs taken before and after the preparation were imported into Photoshop software and the apical transportation, and curve straightening were measured. Data were analyzed using independent t-test. Partial correlation analysis was performed to evaluate the relationship between the initial curvature, transportation, and curve straightening (). Using a patency file during canal preparation significantly decreased both apical transportation and curve straightening (). There were significant relationships between the angle of curvature, transportation and curve straightening in pairs (). Apical patency is recommended during root canal preparation with the ProTaper rotary system. Seyed Mohsen Hasheminia, Nastaran Farhadi, and Ali Shokraneh Copyright © 2013 Seyed Mohsen Hasheminia et al. All rights reserved. Synergistic Effects of Nonthermal Plasma and Disinfecting Agents against Dental Biofilms In Vitro Thu, 12 Sep 2013 09:30:07 +0000 Aim. Dental biofilms play a major role in the pathogenesis of many dental diseases. In this study, we evaluated the synergistic effect of atmospheric pressure plasma and different agents in dentistry on the reduction of biofilms. Methods and Results. We used monospecies (S. mutans) and multispecies dental biofilm models grown on titanium discs in vitro. After treatment with one of the agents, the biofilms were treated with plasma. Efficacy of treatment was determined by the number of colony forming units (CFU) and by live-dead staining. For S. mutans biofilms no colonies could be detected after treatment with NaOCl or H2O2. For multispecies biofilms the combination with plasma achieved a higher CFU reduction than each agent alone. We found an additive antimicrobial effect between argon plasma and agents irrespective of the treatment order with cultivation technique. For EDTA and octenidine, antimicrobial efficacy assessed by live-dead staining differed significantly between the two treatment orders (). Conclusions. The effective treatment of dental biofilms on titanium discs with atmospheric pressure plasma could be increased by adding agents in vitro. Ina Koban, Marie Henrike Geisel, Birte Holtfreter, Lukasz Jablonowski, Nils-Olaf Hübner, Rutger Matthes, Kai Masur, Klaus-Dieter Weltmann, Axel Kramer, and Thomas Kocher Copyright © 2013 Ina Koban et al. All rights reserved. An In Vitro Evaluation of the Biological Effects of Carbon Nanotube-Coated Dental Zirconia Tue, 20 Aug 2013 14:03:47 +0000 The purpose of this study is to evaluate functionalized multiwalled carbon nanotubes (fMWCNTs) as a potential coating material for dental zirconia from a biological perspective: its effect on cell proliferation, viability, morphology, and the attachment of an osteoblast-like cell. Osteoblast-like (Saos-2) cells were seeded on uncoated and fMWCNT-coated zirconia discs and in culture dishes that served as controls. The seeding density was 104 cells/cm2, and the cells were cultured for 6 days. Cell viability, proliferation and attachment of the Saos-2 cells were studied. The results showed that Saos-2 cells were well attached to both the uncoated and the fMWCNT-coated zirconia discs. Cell viability and proliferation on the fMWCNT-coated zirconia discs were almost the same as for the control discs. Better cell attachment was seen on the fMWCNT-coated than on the uncoated zirconia discs. In conclusion, fMWCNTs seem to be a promising coating material for zirconia-based ceramic surfaces to increase the roughness and thereby enhance the osseointegration of zirconia implants. Wen Kou, Tsukasa Akasaka, Fumio Watari, and Göran Sjögren Copyright © 2013 Wen Kou et al. All rights reserved. Long-Term Fluoride Exchanges at Restoration Surfaces and Effects on Surface Mechanical Properties Mon, 19 Aug 2013 11:01:49 +0000 Aim. The aim of the study was to determine whether three fluoride containing resin composites could maintain fluoride release, fluoride recharge, and mechanical stability over long-term (18-month) aging. Materials and Methods. Fluoride containing composites Beautifil II, Gradia Direct X, Tetric EvoCeram, and glass ionomer Fuji IX Extra were analyzed. Specimens of each material were fabricated for two test groups: Group 1: bimonthly fluoride release/recharge analysis (); Group 2: hardness and elastic modulus analysis (). Nanoindentation was employed at 24 hours and at 1, 3, 6, 12, and 18 months. After 18 months, each specimen was immersed (recharged) in 5000 ppm NaF gel, and fluoride rerelease, hardness, and elastic modulus were measured. Results. Beautifil II and Gradia Direct X maintained fluoride release and recharge capability throughout 18-month aging (Beautifil II > Gradia Direct X > Tetric EvoCeram). The fluoride rerelease from Beautifil II following a 10-minute NaF recharge (at 18 months) was comparable to the long-term fluoride release from Fuji IX Extra. Elastic modulus and hardness did not change significantly () with fluoride release, recharge, and water aging over 18 months for all three analyzed composites. Conclusions. The long-term fluoride release, fluoride recharge, and mechanical property stability of Beautifil II and Gradia Direct X render these composites suitable for load bearing restorations in high caries risk patients. Clinical Relevance. The ability for Beautifil II and Gradia Direct X to maintain fluoride release and fluoride recharge capability, despite long-term aging, raises the potential for unrestored tooth surfaces in contact with Beautifil II or Gradia Direct X restorations to demonstrate a reduced rate of caries incidence compared to unrestored surfaces adjacent to conventional nonfluoride containing composites. Steven Naoum, Elizabeth Martin, and Ayman Ellakwa Copyright © 2013 Steven Naoum et al. All rights reserved. Changes in Water Sorption and Solubility of Dental Adhesive Systems after Cigarette Smoke Sun, 28 Jul 2013 08:30:12 +0000 Aim. To evaluate the effect of cigarette smoke on water sorption and solubility of four adhesive systems. Materials and Methods. Sixteen disks of each adhesive system were prepared (Adper Scotchbond Multipurpose Adhesive (SA); Adper Scotchbond Multipurpose Adhesive System (Adhesive + Primer) (SAP); Adper Single Bond Plus (SB); Adper Easy One (EO)). Specimens were desiccated until a constant mass was obtained and divided into two groups . One-half of the specimens were immersed in deionized water, while the other half were also immersed, but with daily exposure to tobacco smoke. After 21 days, disks were measured again and stored in desiccators until constant mass was achieved. Data were calculated according to ISO specifications and statistically analyzed. Results. The tobacco smoke only significantly affected the water sorption and solubility of EO. There were significant differences in both analyses among materials tested. The SB exhibited the highest water sorption, followed by EO, which demonstrated significantly higher solubility values than SB. The SA and SAP showed low water sorption and solubility, and there were no significant differences between the two. Conclusion. Regardless of smoke exposure, both simplified adhesive systems presented an inferior performance that could be related to the complex mixture of components in such versions. Lívia Andrade Vitória, Thaiane Rodrigues Aguiar, Poliana Ramos Braga Santos, Andrea Nóbrega Cavalcanti, and Paula Mathias Copyright © 2013 Lívia Andrade Vitória et al. All rights reserved. The Performance of ICDAS-II Using Low-Powered Magnification with Light-Emitting Diode Headlight and Alternating Current Impedance Spectroscopy Device for Detection of Occlusal Caries on Primary Molars Sun, 14 Jul 2013 09:43:53 +0000 Early detection of occlusal caries in children is challenging for the dentists, because of the morphology of pit and fissures. The aim of this study was to compare in vitro the diagnostic performance of low-powered magnification with light-emitting diode headlight (LPMLED) using ICDAS-II criteria and AC Impedance Spectroscopy (ACIS) device, on occlusal surfaces of primary molars. The occlusal surfaces of 18 extracted primary molars were examined blindly by two examiners. The teeth were sectioned and examined under light microscopy using Downer’s histological criteria as gold standard. Good to excellent inter- and intraexaminer reproducibility, higher sensitivity, specificity, and AUC values were achieved by LPMLED at D1 threshold. Also the relationship between histology and LPMLED was statistically significant. In conclusion visual aids have the potential to improve the performance of early caries detection and clinical diagnostics in children. Despite its potential, ACIS device should be considered as an adjunct method in detecting caries on primary teeth. Timucin Ari and Nilgun Ari Copyright © 2013 Timucin Ari and Nilgun Ari. All rights reserved. Assessment of Gingival Health Status among 5- and 12-Year-Old Children in Yemen: A Cross-Sectional Study Wed, 26 Jun 2013 11:55:56 +0000 Purpose. There are limited data about the gingival health status in Yemeni children. The aim, therefore, was to assess oral hygiene status and prevalence and severity of gingivitis among Yemeni preschool and school children. Materials and Methods. A total of 5396 children were included from 5 representative Yemeni governorates: Sana'a, Hajjah, Hodeida, Hadramaut, and Taiz. Five-year olds (1292) were recruited from private kindergartens while 12-year olds (4104) were selected from public primary schools. Gingival health status was assessed using the plaque index (PI), calculus index (CAI), and gingival index (GI) on the 6 Ramfjord teeth. The latter index was used to categorize gingivitis severity at the subject level. Data were analyzed using simple hypothesis testing, as well as ordinal regression. Results. The 12-year old children had significantly much higher mean PI, CAI, and GI () with 78.6% presenting with gingivitis and 47.8% with moderate gingivitis. In contrast, the figures were 27.2% and 3.1% in the younger group (). There were significant variations according to gender, area of residence, and governorate. Regression analysis revealed that mean PI (), mean CAI (), male gender (), living in rural areas (), and being from Hajjah or Sana’a were independent risk factors of gingivitis severity in the older group. For the 5-year olds, the determinants were mean PI (), male gender (), and living in Sana'a or Taiz. Conclusions. Bad oral hygiene and moderate gingivitis are highly prevalent among Yemeni preschool and school children. Geographical location appeared as important independent risk factors of gingival inflammation. Khaled A. Al-Haddad, Yahia T. Ibrahim, Ahmed M. Al-Haddad, and Nezar N. Al-Hebshi Copyright © 2013 Khaled A. Al-Haddad et al. All rights reserved. Evaluation of Apical Microleakage in Open Apex Teeth Using MTA Apical Plug in Different Sessions Mon, 24 Jun 2013 14:01:15 +0000 Aim. To compare microleakage of apexification using MTA in one or two sessions. Materials and Methods. 88 single rooted teeth were prepared and divided into two groups then received MTA apical plug. In the first group, the teeth were immersed in normal saline for 24 hours and then backfilled with guttapercha and AH26 sealer. In the second group, the teeth were obturated immediately after receiving apical plug. Four positive and four negative controls were selected. All specimens were placed in 1% methylene blue and decalcified in 5% nitric acid and finally were placed in methyl salicylate until getting transparent. All teeth were visualized for assessment of dye penetration under stereo dissecting microscope. Results. 36 and 35 teeth showed dye leakage in the first and second groups. Dye penetration into the entire canal length was confirmed in the positive control group, and in the negative control group no dye penetration was seen. Mean dye penetration in the first and second group was 5813 and 9152 μm. -test revealed a significant difference between dye penetrations of two groups (). Conclusion. MTA requires adequate time for setting in the presence of the moisture, and final obturation should be delayed until final setting of MTA. Mohammad Yazdizadeh, Zeinab Bouzarjomehri, Navid Khalighinejad, and Leyli Sadri Copyright © 2013 Mohammad Yazdizadeh et al. All rights reserved. Comment on “Evaluation of Manual and Two-Rotary NiTi Retreatment Systems in Removing Gutta-Percha Obturated with Two Root Canal Sealers” Mon, 27 May 2013 14:27:24 +0000 Proper research design, appropriate evaluation and measurement methods, use of correct statistical tests, interpretation, and inference are the essentials without which any scientific research reporting is incomplete and does not serve its proposed purpose. In this communication, some common flaws in research designing, evaluation, analysis, and inference have been explained using a published article as a reference. The purpose of the paper is to help the scientific community recognize the significance of proper research designing and planning in order to achieve the results which are worthwhile. Seema K. Dixit, Varun Arora, Kapil Loomba, Ashutosh Dixit, Ridhima Birmani Gaunkar, Bhaskar Agarwal, Alok Misra, and Narendra kumar Gupta Copyright © 2013 Seema K. Dixit et al. All rights reserved. Oral Lichen Planus in Thai Patients Has a Low Prevalence of Human Papillomavirus Sun, 26 May 2013 13:43:39 +0000 Background. Oral lichen planus (OLP) is a common chronic inflammatory immune-mediated disease, with an etiopathogenesis associated with cell-mediated immunological dysfunction. Viral infection has been hypothesized as a predisposing factor in the pathogenesis of this disease. Viruses may alter host cell function by inducing the abnormal expression of cellular proteins leading to disease development. However, reports on the relationship between human papillomavirus (HPV) and OLP are inconclusive. Objective. To explore the association between HPV and OLP in Thai patients. Materials and Methods. DNA was extracted from thirty-seven fresh-frozen tissue biopsy specimens from OLP lesions, and polymerase chain reaction assay for the L1 and E1 genes covering 32 types of high- and low-risk HPV was performed. Results. HPV DNA was detected in one tissue biopsy from an atrophic-type OLP lesion. All control samples were negative. Genomic sequencing of the E1 gene PCR product demonstrated that the HPV-type 16 found in the lesion is closely related to the East Asian type. Conclusion. Our data indicate a low prevalence of HPV infection in OLP lesions in Thai patients. Pratanporn Arirachakaran, Jira Chansaengroj, Woradee Lurchachaiwong, Patnarin Kanjanabud, Kobkan Thongprasom, and Yong Poovorawan Copyright © 2013 Pratanporn Arirachakaran et al. All rights reserved.