International Journal of Dentistry The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Prevalence of Dental Caries, Oral Hygiene Knowledge, Status, and Practices among Visually Impaired Individuals in Chennai, Tamil Nadu Tue, 28 Mar 2017 00:00:00 +0000 Aim. To assess the prevalence of dental caries, oral hygiene knowledge, status, and practices among visually impaired individuals in Chennai, Tamil Nadu. Materials and Methods. A cross-sectional study was conducted among 404 visually impaired individuals in Chennai city, Tamil Nadu. Four schools were randomly selected for conducting the study. The oral hygiene status, prevalence of caries, and knowledge and attitude towards oral care among visually impaired individuals were collected and analysed. Results. In the present study, whilst 42% of individuals had fair oral hygiene status, 33% had good hygiene followed by 25% having poor oral hygiene. The overall mean number of DMFT was estimated to be . The mean number of decayed teeth was , mean number of missing teeth was , and mean number of filled teeth was . Conclusion. Whilst oral hygiene status was found to be relatively fair, there was a high rate of dental caries among the sample population. This shows that there is lack of knowledge regarding oral health maintenance. Therefore, early identification of caries coupled with effective oral health promotion programs providing practical knowledge to visually impaired students would prove beneficial. James Rufus John, Breena Daniel, Dakshaini Paneerselvam, and Ganesh Rajendran Copyright © 2017 James Rufus John et al. All rights reserved. Effect of Enamel Caries Lesion Baseline Severity on Fluoride Dose-Response Mon, 27 Mar 2017 00:00:00 +0000 This study aimed to investigate the effect of enamel caries lesion baseline severity on fluoride dose-response under pH cycling conditions. Early caries lesions were created in human enamel specimens at four different severities (8, 16, 24, and 36 h). Lesions were allocated to treatment groups (0, 83, and 367 ppm fluoride as sodium fluoride) based on Vickers surface microhardness (VHN) and pH cycled for 5 d. The cycling model comprised 3 × 1 min fluoride treatments sandwiched between 2 × 60 min demineralization challenges with specimens stored in artificial saliva in between. VHN was measured again and changes versus lesion baseline were calculated (ΔVHN). Data were analyzed using two-way ANOVA (). Increased demineralization times led to increased surface softening. The lesion severity×fluoride concentration interaction was significant (). Fluoride dose-response was observed in all groups. Lesions initially demineralized for 16 and 8 h showed similar overall rehardening (ΔVHN) and more than 24 and 36 h lesions, which were similar. The 8 h lesions showed the greatest fluoride response differential (367 versus 0 ppm F) which diminished with increasing lesion baseline severity. The extent of rehardening as a result of the 0 ppm F treatment increased with increasing lesion baseline severity, whereas it decreased for the fluoride treatments. In conclusion, lesion baseline severity impacts the extent of the fluoride dose-response. Frank Lippert Copyright © 2017 Frank Lippert. All rights reserved. Combined Implant and Tooth Support: An Up-to-Date Comprehensive Overview Thu, 23 Mar 2017 08:13:45 +0000 Objectives. This article presents a review on the concerned topics and some considerations related to the concept of splinting teeth and implants in the rehabilitation of partial edentulism. Study Selection. An electronic PubMed/MEDLINE and manual search of identified articles and reviews as well as clinical, laboratory, and finite element studies was performed in this project. Due to the shortage in within-subject, long term, randomized, controlled clinical trials regarding the subject a meta-analysis was not possible. Results. Although surrounded with some controversy, joining teeth and implants during the rehabilitation of partial edentulism provides the clinicians with more treatment options where proprioception and bone volume are maintained and distal cantilevers and free end saddles are eliminated. It makes the treatment less complex, of less cost, and more acceptable for the patient. Conclusions. Whenever suitable and justified, combining implant and tooth support might be recommended as an alternative during rehabilitation of partial edentulism. Based on the literature, clinical tips and suggestions were recommended to increase the success of this treatment. Mahmoud K. Al-Omiri, Maher Al-Masri, Mohannad M. Alhijawi, and Edward Lynch Copyright © 2017 Mahmoud K. Al-Omiri et al. All rights reserved. Radix Entomolaris in the Mandibular Molar Teeth of an Iranian Population Tue, 21 Mar 2017 06:30:25 +0000 Purpose. Supernumerary roots in permanent mandibular molar teeth make endodontic treatment more complicated. The aim of this study was to determine the prevalence of Radix Entomolaris (RE) in permanent mandibular first and second molars in the population of Kerman, in the southeast of Iran. Materials and Methods. From a collection of 500 mandibular first and second molar teeth extracted over 2015-2016 at dental clinics in Kerman, teeth were scored for an additional distolingual root, and the average root length and root morphology of this extra root were determined using the De Moor classification scheme. Results. In this population, RE occurred in 6% of mandibular first molars (4% with a straight apex (Type I) and 2% with buccal apical curvature (Type III)). In all cases, RE was the shortest root, with an average root length of 18.37 mm. RE occurred in only 0.8% of mandibular second molars, with an average root length of 18.0 mm. All mandibular second molars with RE were of Type III. Fisher’s exact test showed that the difference in frequency between first and second molars was statistically significant (two-sided ). Conclusion. Radix Entomolaris occurs more frequently in mandibular first molars than in mandibular second molars in this sample of 500 mandibular molars. The reported rate of 6% in first molars is expected to be higher than reported rates in European or Caucasian populations where the prevalence is typically less than 2%. Maryam Kuzekanani, Laurence J. Walsh, Jahangir Haghani, and Ali Zeynali Kermani Copyright © 2017 Maryam Kuzekanani et al. All rights reserved. Salivary Alpha-Amylase Enzyme, Psychological Disorders, and Life Quality in Patients with Recurrent Aphthous Stomatitis Sun, 19 Mar 2017 00:00:00 +0000 Objective. The aim of this study was to evaluate stress, anxiety, and salivary alpha-amylase (SAA) activity in patients with recurrent aphthous stomatitis (RAS). The impact of this disease on the life quality was also evaluated. Design. Twenty-two patients with RAS and controls, matched by sex and age, were selected. Stress and anxiety were assessed using Lipp’s Inventory of Stress Symptoms and Beck Anxiety Inventory. Life quality was assessed through the World Health Organization Quality of Life-bref (WHOQOL-BREF) and the Oral Health Impact Profile-14 (OHIP-14). Saliva samples were collected in the morning and afternoon and the SAA activity was analyzed by enzymatic kinetic method. Results. No significant difference was observed between the groups regarding the SAA activity (). Patients with RAS had higher scores of anxiety (). The scores of WHOQOL-BREF were significantly lower in patients with RAS. The values obtained through OHIP-14 were significantly higher in these patients (). Conclusion. RAS negatively affects the life quality. Patients with the disease have higher levels of anxiety, suggesting its association with the etiopathogenesis of RAS. Juliana Andrade Cardoso, André Avelino dos Santos Junior, Maria Lucia Tiellet Nunes, Maria Antonia Zancanaro de Figueiredo, Karen Cherubini, and Fernanda Gonçalves Salum Copyright © 2017 Juliana Andrade Cardoso et al. All rights reserved. Periodontal Application of Manuka Honey: Antimicrobial and Demineralising Effects In Vitro Tue, 14 Mar 2017 07:55:13 +0000 Background. Topical application of manuka honey is effective in the treatment of burns and soft-tissue infections. The aim of this study was to assess the antibacterial activity of manuka honey against plaque-associated bacteria in vitro in order to evaluate the potential application as an adjunct to periodontal treatment. Materials and Methods. The minimum bacteriostatic and bactericidal concentrations (MIC and MBC) of manuka honey were compared to those of white clover honey against a variety of plaque-associated bacteria, at the natural and neutral pH. Dissolved calcium was measured following incubation of honeys with hydroxyapatite (HA) beads to assess their potential to demineralise oral hard tissues. Results. Both honeys inhibited most tested oral bacteria at similar MIC/MBC, but Streptococcus mutans was comparatively resistant. The honeys at pH neutral had little effect on antimicrobial activity. Incubation of HA beads in honey solutions resulted in pH-dependent calcium dissolution, and inoculation with S. mutans promoted further demineralisation by both types of honey. Conclusion. Manuka honey is antimicrobial towards representative oral bacteria. However, the relative resistance of S. mutans in association with the high concentrations of fermentable carbohydrates in honey and the direct demineralising effect at natural pH mitigate against the application of honey as an adjunct in the treatment of periodontal disease. Syarida H. Safii, Geoffrey R. Tompkins, and Warwick J. Duncan Copyright © 2017 Syarida H. Safii et al. All rights reserved. Effect of Rebonding on the Bond Strength of Orthodontic Tubes: A Comparison of Light Cure Adhesive and Resin-Modified Glass Ionomer Cement In Vitro Mon, 13 Mar 2017 00:00:00 +0000 The purpose of this study was to determine the impact of different enamel preparation procedures and compare light cure composite (LCC) and resin-modified glass ionomer (RMGI) on the bond strength of orthodontic metal tubes rebonded to the enamel. Twenty human molars were divided into two groups (). Tubes were bonded using LCC (Transbond XT) in group 1 and RMGI (Fuji Ortho LC) in group 2. The tubes in each group were bonded following manufacturers’ instructions (experiment I) and then debonded using testing machine. Then, the same brackets were sandblasted and rebonded twice. Before the first rebonding, the enamel was cleaned using carbide bur (experiment II) and before second rebonding, it was cleaned using carbide bur and soda blasted (experiment III). Mann–Whitney and Wilcoxon signed-rank tests showed no significant difference between RMGI and LCC bond strengths in case of normal bonding and rebonding, when enamel was cleaned using carbide bur before rebonding. Enamel soda blasting before rebonding significantly increased RMGI tensile bond strength value compared to LLC (). LCC and RMGI (especially RMGI) provide sufficient bond strengths for rebonding of molar tubes, when residual adhesive from previous bonding is removed and enamel soda blasted. Monika Aleksiejunaite, Antanas Sidlauskas, and Arunas Vasiliauskas Copyright © 2017 Monika Aleksiejunaite et al. All rights reserved. Cephalometric Analysis for Gender Determination Using Maxillary Sinus Index: A Novel Dimension in Personal Identification Wed, 08 Mar 2017 10:10:45 +0000 Purpose. Radiography is important in forensic odontology for the identification of humans. The maxillary sinus is the largest of the paranasal sinuses and first to develop. Sinus radiography has been used for identification of skeletal remains and determination of gender. Hence, the aim and objectives of the present study were to establish a new method for gender determination using maxillary sinus index from lateral cephalometric radiographs and to establish the reliability of maxillary sinus for gender determination. Methods. A total of 50 adult digital lateral cephalometric radiographs (25 males and 25 females) were included in the study. The maxillary sinus analysis was performed on these radiographs using the height and width measurement tools of Sidexis XG software. Maxillary sinus index was calculated, discriminant function analysis performed, and discriminant equation derived for determination of gender. Results. The mean maxillary sinus height and width were found to be higher in males, whereas the maxillary sinus index was greater in females. The discriminant function analysis derived in the study was able to differentiate the sex groups with sensitivity of 68% and specificity of 76%. Conclusions. From the results of the present study, it may be concluded that morphometric analysis of maxillary sinus can be used as a reliable tool in gender determination. Tanya Khaitan, Arpita Kabiraj, Uday Ginjupally, and Ritika Jain Copyright © 2017 Tanya Khaitan et al. All rights reserved. Root ZX Electronic Foramen Locator: An Ex Vivo Study of Its Three Models’ Precision and Reproducibility Tue, 07 Mar 2017 07:03:01 +0000 Although Root ZX is considered the gold standard electronic foramen locator (EFL), two variations of this device were launched, however without different operating mechanisms. This investigation aims to evaluate the precision of Root ZX (RZX), Root ZX II (RII), and Root ZX Mini (RM) EFLs. After access cavity preparation, 32 mandibular single rooted human premolars had their real length measured with the aid of a #15 K-type manual file under magnification (25x). Electronic measurements were performed by the devices in an alternate order until the apical foramen was reached (0.0). Each measurement was performed with adjusted file to the real length of the teeth and verified with a digital caliper. The accuracy of the EFLs was 68.8% (RZX), 65.8% (RII), and 68.8% (RM), considering ±0.5 mm as a margin of tolerance. The mean errors of the devices were  mm (RZX),  mm (RII), and  mm (RM). ANOVA and Tukey test were applied to analyze the obtained data, which showed that there were no statistically significant differences among the locators (). It can be concluded that the three tested devices demonstrated precise measurements of the real length of the canal without performance differences among them. Bernardo Almeida Aguiar, Rafael Santos Reinaldo, Luciana Maria Arcanjo Frota, Mônica Sampaio do Vale, and Bruno Carvalho de Vasconcelos Copyright © 2017 Bernardo Almeida Aguiar et al. All rights reserved. Effect of Herbal and Fluoride Mouth Rinses on Streptococcus mutans and Dental Caries among 12–15-Year-Old School Children: A Randomized Controlled Trial Thu, 02 Mar 2017 00:00:00 +0000 To assess and compare the effect of herbal and fluoride mouth rinses on Streptococcus mutans count and glucan synthesis by Streptococcus mutans and dental caries, a parallel group placebo controlled randomized trial was conducted among 240 schoolchildren (12–15 years old). Participants were randomly divided and allocated into Group I (0.2% fluoride group), Group II (herbal group), and Group III (placebo group). All received 10 ml of respective mouth rinses every fortnight for a period of one year. Intergroup and intragroup comparison were done for Streptococcus mutans count and glucan synthesis by Streptococcus mutans and dental caries. Streptococcus mutans count showed a statistically significant difference between Group I and Group III () and also between Group II and Group III (). Glucan concentration levels showed a statistically significant difference () between Group II and Group III at 12th month. Mean DMF scores showed no statistical difference between the three groups (). No difference in the level of significance was seen in the intention-to-treat and per-protocol analysis. The present study showed that both herbal and fluoride mouth rinses, when used fortnightly, were equally effective and could be recommended for use in school-based health education program to control dental caries. Trial registration number is CTRI/2015/08/006070. Vinej Somaraj, Rekha P. Shenoy, Ganesh Shenoy Panchmal, Vijaya Kumar, Praveen S. Jodalli, and Laxminarayan Sonde Copyright © 2017 Vinej Somaraj et al. All rights reserved. Radiographic Findings in Patients with Medication-Related Osteonecrosis of the Jaw Thu, 02 Mar 2017 00:00:00 +0000 A retrospective study was conducted of the records and panoramic radiographs of 35 patients treated with bisphosphonates (BP) and diagnosed with MRONJ. Panoramic radiography was used for evaluation, by two examiners, the following findings were subject of search: osteolysis (OT), cortical bone erosion (EC), bone sclerosis focal (FS) and diffuse (DS), bone sequestration (BS), thickening of lamina dura (TD), prominence of the inferior alveolar nerve canal (IAN), persisting alveolar sockets (SK), and the presence of a pathological fracture (PF). Medical information and staging were also recorded in order to correlate with radiographic findings. Bone sclerosis was the most frequent alteration, followed by OT and TD. The mandible was more affected than the maxilla. There was no significant difference between genders or significant correlation between the number of injuries with age and duration of BP usage. Considering the association between the radiographic findings and MRONJ staging, EC was predominant in stage 3 and DS in stage 2. IAN and PF demonstrated greater association with stage 3. In conclusion, the higher the clinical staging, the greater the severity of the bone alteration. Panoramic radiographic examination is a useful screening tool in patients submitted to antiresorptive therapy. Camila Lopes Cardoso, Carolina Arrabal Barros, Cláudia Curra, Luciana Maria Paes da Silva Ramos Fernandes, Solange de Oliveira Braga Franzolin, Joel Santiago Ferreira Júnior, Carlos César De Antoni, and Marcos Martins Curi Copyright © 2017 Camila Lopes Cardoso et al. All rights reserved. Randomized Clinical Trial of a Self-Adhering Flowable Composite for Class I Restorations: 2-Year Results Wed, 01 Mar 2017 07:55:04 +0000 Objectives. To compare the clinical performances of a self-adhering resin composite and a conventional flowable composite with a self-etch bonding system on permanent molars. The influence of using rubber dam versus cotton roll isolation was also investigated. Materials and Methods. Patients aged between 6 and 12 years and presenting at least two permanent molars in need of small class I restorations were selected. Thirty-four pairs of restorations were randomly placed by the same operator. Fifteen patients were treated under rubber dam and nineteen using cotton rolls isolation and saliva ejector. They were evaluated according to the modified USPHS criteria at baseline, 6 months, and 1 and 2 years by two independent evaluators. Results. All patients attended the two-year recall. For all measured variables, there was no significant difference between rubber dam and cotton after 2 years of restoration with Premise Flowable or Vertise Flow ( value > 0.05). The percentage of restorations scored alpha decreased significantly over time with Premise Flowable and Vertise Flow for marginal adaptation and surface texture as well as marginal discoloration while it did not vary significantly for color matching. After 2 years, Vertise Flow showed a similar behaviour to the Premise Flowable used with a self-adhesive resin system. J. Sabbagh, S. Dagher, N. El Osta, and P. Souhaid Copyright © 2017 J. Sabbagh et al. All rights reserved. Dental Anxiety among Medical and Paramedical Undergraduate Students of Malaysia Tue, 28 Feb 2017 09:55:51 +0000 Aim. To assess the dental anxiety level among dental, medical, and pharmacy students of MAHSA University, Malaysia. Materials and Methods. A cross-sectional questionnaire study was conducted among 1500 undergraduate students of MAHSA University. The Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety among the study population. The responses were assessed by 5-point likert scale ranging from 1 to 5. The level of anxiety was categorized into lowly anxious (5–11), moderately anxious (12–18), and severely anxious ≥19. Out of 1500 students enrolled, 1024 students (342 males and 682 females) completed and returned the questionnaire having response rate of 68.26%. Results. There was a statistically significant difference () when the mean dental anxiety scores were compared among the three faculties and dental students had lowest mean score (11.95 ± 4.21). The fifth year (senior) dental students scored significantly () lower mean anxiety score as compared to the first dental students (junior). The students were anxious mostly about tooth drilling and local anesthetic injection. Conclusions. Dental students have a significantly low level of dental anxiety as compared with medical and pharmacy students. Incorporation of dental health education in preuniversity and other nondental university curriculums may reduce dental anxiety among the students. Shilpa Gunjal, Deepak Gowda Sadashivappa Pateel, and Sujal Parkar Copyright © 2017 Shilpa Gunjal et al. All rights reserved. Microbiological Sealing Analysis of a Tapered Connection and External Hexagon System Tue, 28 Feb 2017 08:46:20 +0000 Considering the variety of implant connection systems available in the market and the contrasting literature regarding tapered connection systems in terms of bacterial leakage, the aim of this in vitro study was to compare the effectiveness of the bacterial seal at the implant/abutment interface between an external hexagon and a tapered connection system. Twelve sets of indexed tapered connection components and twelve sets of external hexagon connection components were used for microbiological analysis. In addition, for each model, an implant with its respective prosthetic abutment was used as a negative control and another as a positive control of microbial contamination. Failure of the abutment/implant interface seal was observed via turbidity or presence of deposits in the culture. Descriptive analysis of the data and relative frequency (percentage) as well as Fisher’s exact test were used at a significance level of 5%. Two of ten (20%) external hexagon specimens showed contamination against 0/10 (0%) tapered connection implants. In conclusion, both implant/abutment connections were able to prevent bacterial leakage in vitro. Gardel Nepomuceno Costa, Elizabeth Ferreira Martinez, Aluísio Martins de Oliveira Ruellas, Daiane Cristina Peruzzo, Júlio Cesar Joly, and Marcelo Henrique Napimoga Copyright © 2017 Gardel Nepomuceno Costa et al. All rights reserved. Polymorphisms of Il-10 (-1082) and RANKL (-438) Genes and the Failure of Dental Implants Tue, 28 Feb 2017 00:00:00 +0000 Background. Genetic polymorphisms in certain cytokines and chemokines have been investigated to understand why some individuals display implant flaws despite having few risk factors at the time of implant. Purpose. To investigate the association of genetic polymorphisms in interleukin- (IL-) 10 [-1082 region (A/G)] and RANKL [-438 region (A/G)] with the failure of dental implants. Materials and Methods. This study included 90 partially edentulous male and female patients who were rehabilitated with a total of 245 Straumann dental implants. An implant was considered a failure if any of the following occurred: mobility, persistent subjective complaint, recurrent peri-implant infection with suppuration, continuous radiolucency around the implant, probing depth ≥ 5 mm, and bleeding on probing. Buccal mucosal cells were collected for analysis of RANKL438 and IL-10. Results. The implant success rate in this population was 34.4%. The mutant allele (G) in RANKL had an incidence of 52.3% and mutant allele (A) in IL-10 was observed in 37.8%. No statistically significant difference was detected between the failure of the implant and the genotypes and allelic frequencies. Conclusion. No association was detected between the genetic polymorphisms of RANKL (-438) and IL-10 (-1082) and the failure of dental implants in the population studied. Rodrigo Ribeiro, Rayanne Melo, Pedro Tortamano Neto, André Vajgel, Paulo Roberto Eleutério Souza, and Renata Cimões Copyright © 2017 Rodrigo Ribeiro et al. All rights reserved. Genetic Association of MMP10, MMP14, and MMP16 with Dental Caries Tue, 28 Feb 2017 00:00:00 +0000 Matrix metalloproteinases (MMPs), which degrade extracellular proteins as part of a variety of physiological processes, and their inhibitors have been implicated in the dental caries process. Here we investigated 28 genetic variants spanning the MMP10, MMP14, and MMP16 genes to detect association with dental caries experience in 13 age- and race-stratified () samples from 6 parent studies. Analyses were performed separately for each sample, and results were combined across samples by meta-analysis. Two SNPs (rs2046315 and rs10429371) upstream of MMP16 were significantly associated with caries in an individual sample of white adults and via meta-analysis across 8 adult samples after gene-wise adjustment for multiple comparisons. Noteworthy is SNP rs2046315 () association with caries in white adults. This SNP was originally nominated in a genome-wide-association study (GWAS) of dental caries in a sample of white adults and yielded associations in a subsequent GWAS of surface level caries in white adults as well. Therefore, in our study, we were able to recapture the association between rs2046315 and dental caries in white adults. Although we did not strengthen evidence that MMPs 10, 14, and 16 influence caries risk, MMP16 is still a likely candidate gene to pursue. D. D. Lewis, J. R. Shaffer, E. Feingold, M. Cooper, M. M. Vanyukov, B. S. Maher, R. L. Slayton, M. C. Willing, S. E. Reis, D. W. McNeil, R. J. Crout, R. J. Weyant, S. M. Levy, A. R. Vieira, and M. L. Marazita Copyright © 2017 D. D. Lewis et al. All rights reserved. In Vitro Comparative Evaluation of Different Types of Impression Trays and Impression Materials on the Accuracy of Open Tray Implant Impressions: A Pilot Study Mon, 27 Feb 2017 07:21:23 +0000 Purpose. For a precise fit of multiple implant framework, having an accurate definitive cast is imperative. The present study evaluated dimensional accuracy of master casts obtained using different impression trays and materials with open tray impression technique. Materials and Methods. A machined aluminum reference model with four parallel implant analogues was fabricated. Forty implant level impressions were made. Eight groups () were tested using impression materials (polyether and vinylsiloxanether) and four types of impression trays, two being custom (self-cure acrylic and light cure acrylic) and two being stock (plastic and metal). The interimplant distances were measured on master casts using a coordinate measuring machine. The collected data was compared with a standard reference model and was statistically analyzed using two-way ANOVA. Results. Statistically significant difference () was found between the two impression materials. However, the difference seen was small (36 μm) irrespective of the tray type used. No significant difference () was observed between varied stock and custom trays. Conclusions. The polyether impression material proved to be more accurate than vinylsiloxanether impression material. The rigid nonperforated stock trays, both plastic and metal, could be an alternative for custom trays for multi-implant impressions when used with medium viscosity impression materials. Sonam Gupta, Aparna Ichalangod Narayan, and Dhanasekar Balakrishnan Copyright © 2017 Sonam Gupta et al. All rights reserved. Effect of Transplantation of Bone Marrow Derived Mesenchymal Stem Cells and Platelets Rich Plasma on Experimental Model of Radiation Induced Oral Mucosal Injury in Albino Rats Sun, 26 Feb 2017 07:43:39 +0000 Normal tissue damage following radiotherapy is still a major problem in cancer treatment. Therefore, the current work aimed at exploring the possible role of systemically injected bone marrow derived mesenchymal stem cells (BM-MSCs) and/or locally injected platelet rich plasma (PRP) in ameliorating the side effects of ionizing radiation on the rat’s tongue. Twelve rats served as control group (N) and 48 rats received a single radiation dose of 13 Gy to the head and neck region; then, they were equally divided into 4 experimental groups: irradiated only (C), irradiated + MSCs (S), irradiated + (PRP) (P), and combined group (PS). Animal scarification occurred in 3 and 7 days after radiation. Then, tongues were dissected and examined histologically and for expression of bcl-2 by RT-PCR. Histological examination of the treated groups (S), (P), and (PS) revealed an obvious improvement in the histological structure of the tongue, compared to group (C), in addition to upregulated expression of bcl-2, indicating decreased apoptotic activity. Conclusion. BM-MSCs and PRP have shown positive effect in minimizing the epithelial atrophy of normal oral mucosa after regional radiotherapy, which was emphasized by decreasing apoptotic activity in these tissues. Nevertheless, combined use of BM-MSCs and PRP did not reveal the assumed synergetic effect in oral tissue protection. Basma Elsaadany, Samar El Kholy, Dalia El Rouby, Laila Rashed, and Tarek Shouman Copyright © 2017 Basma Elsaadany et al. All rights reserved. Impacted Maxillary Canine Prevalence and Its Association with Other Dental Anomalies in a Mexican Population Thu, 23 Feb 2017 00:00:00 +0000 Objective. We quantified the prevalence of impacted maxillary canines (IMC) and their association with other dental anomalies (DAs). Materials and Methods. A retrospective study was done with 860 patients 12 to 39 years of age. The prevalence of IMC was calculated and compared by sex. The sample was divided into a control group and an impaction group, and the prevalence was calculated in both for a series of anomalies: agenesis, supernumerary teeth, shape anomalies of the upper laterals (microdontia, peg and barrel shape, and talon cusp), fusion, gemination, other impacted teeth, transposition, and amelogenesis imperfecta. The prevalence values for both groups were compared (Pearson’s test, ). Results. IMC were present in 6.04% of the sample with no difference by sex (). Other DAs occurred in 51.92% of the IMC group and in 20.17% of the controls (). Significant associations () were identified between IMC and four other DAs: microdontia, barrel shape, other impacted teeth, and transposition. The prevalence of all anomalies was lower in the control group. Conclusion. IMC were seen in 6.04% of patients. Patients with this condition also had a higher prevalence of other DAs. These other anomalies should be used as risk indicators for early diagnosis. José Rubén Herrera-Atoche, María del Rosario Agüayo-de-Pau, Mauricio Escoffié-Ramírez, Fernando Javier Aguilar-Ayala, Bertha Arelly Carrillo-Ávila, and Marina Eduviges Rejón-Peraza Copyright © 2017 José Rubén Herrera-Atoche et al. All rights reserved. Biochemical and Clinical Assessments of Segmental Maxillary Posterior Tooth Intrusion Wed, 22 Feb 2017 00:00:00 +0000 Objective. To compare chondroitin sulphate (CS) levels around maxillary second premolars, first molars, and second molars between the unloaded and the loaded periods and to measure the rates of intrusion of maxillary posterior teeth during segmental posterior tooth intrusion. Materials and Methods. In this prospective clinical study, 105 teeth (from 15 patients exhibiting anterior open bite and requiring maxillary posterior tooth intrusion) were studied. Competitive ELISA was used to detect CS levels. Dental casts (during the unloaded and loaded periods) were scanned, and posterior tooth intrusion distances were measured. Results. During the unloaded period, the median CS levels around maxillary second premolars, first molars, second molars (experimental teeth), and mandibular first molars (negative control) were 0.006, 0.055, 0.056, and 0.012 and during the loaded period were 2.592, 5.738, 4.727, and 0.163 ng/μg of total protein, respectively. The median CS levels around experimental teeth were significantly elevated during the loaded period. The mean rates of maxillary second premolar and first and second molar intrusion were 0.72, 0.58, and 0.40 mm/12 weeks, respectively. Conclusions. Biochemical and clinical assessments suggested that the segmental posterior tooth intrusion treatment modality with 50 g of vertical force per side was sufficient. Trial Registration. The study is registered as TCTR20170206006. Jintana Tasanapanont, Tanapan Wattanachai, Janya Apisariyakul, Peraphan Pothacharoen, Siriwan Ongchai, Prachya Kongtawelert, Marit Midtbø, and Dhirawat Jotikasthira Copyright © 2017 Jintana Tasanapanont et al. All rights reserved. Microbiological Study of Cast Posts before Cementation Mon, 20 Feb 2017 00:00:00 +0000 This study identifies the most common microorganisms present in type III gold cast posts related to pulpal disease and evaluates the sterilization/disinfection method before cementation in the root canal. Forty-five type III gold cast posts were aseptically collected in sterile sealed plastic bags and taken to the microbiology laboratory to carry out the study: fifteen cast posts had no treatment, fifteen were disinfected (immersion in 70% alcohol during 15 minutes), and fifteen were autoclaved at 121°C for 15 minutes by using saturated steam under 15 psi pressure. By using a two-proportion -test, the difference was statistically significant () and demonstrates that, in spite of the aseptic pattern used in the cast post collection and laboratory procedures, some cast posts arrive contaminated at the consulting office. The disinfection process worked out in a high percentage and demonstrated that the sterilization by autoclaving eliminated completely the pathogenic microbiota without affecting the cast post shape and integrity that could compromise their final fitting. Maricela Vallejo-Labrada and Juan Carlos Ojeda-Garces Copyright © 2017 Maricela Vallejo-Labrada and Juan Carlos Ojeda-Garces. All rights reserved. Is It Necessary to Prepare the Enamel before Dental Bleaching? Thu, 09 Feb 2017 10:52:07 +0000 The aim of this in vitro study was to assess the influence of distinct surface treatments on the microhardness and color of enamel that will be bleached. Surface treatments are tested, accordingly: G1, no treatment; G2, 2% sodium fluoride; G3, casein phosphopeptide paste; G4, 2% fluoride+Nd:YAG laser. Forty blocks from bovine teeth composed the sample that were tested in Knoop microhardness () and in color change (). After 24 h, bleaching with 35% hydrogen peroxide was performed for 45 min. Microhardness and color changes (using parameters , , , and ) were assessed before and after bleaching. The data were analyzed by two-way ANOVA and Tukey’s test (). Despite all surface treatments, a reduction of enamel microhardness occurred immediately after bleaching in all groups, being greater in G1. Enamel color changed in all groups. Immediately after bleaching, there was a decrease on enamel microhardness. However, after 7 days, some of those specimens previously treated before bleaching significantly recovered their initial microhardness without influencing the esthetic results of bleaching. Andréa Dias Neves Lago, Patrícia Moreira de Freitas, Erika Michele dos Santos Araújo, Adriana Bona Matos, and Narciso Garone-Netto Copyright © 2017 Andréa Dias Neves Lago et al. All rights reserved. Self-Reported Halitosis in relation to Oral Hygiene Practices, Oral Health Status, General Health Problems, and Multifactorial Characteristics among Workers in Ilala and Temeke Municipals, Tanzania Thu, 09 Feb 2017 00:00:00 +0000 Aim. To assess self-reported halitosis, oral hygiene practices, oral health conditions, general health problems, sociodemographic factors, and behavioural and psychological characteristics among workers in Ilala and Temeke municipals. Materials and Methods. This was a cross-sectional descriptive study. Four hundred workers were recruited using a self-administered structured questionnaire. Results. Self-reported tooth brushing practice was 100%, tongue cleaning 58.5%, dental flossing 4.3%, gum bleeding on tooth brushing 79.3%, presence of hard deposits on teeth 32%, mobile teeth 15.3%, and self-reported halitosis (SRH) 48.5%. Tea users were 95%, coffee users 75.8%, smokers 21%, and alcohol consumers 47%. The SRH was significantly associated with bleeding gums, hard deposits, and mobile and malaligned teeth. Tongue cleaning and regular change of toothbrush were associated with low prevalence of SRH (). Higher occurrence of SRH was significantly related to low education and smoking. Conclusion. Self-reported halitosis was prevalent among workers and was significantly associated with bleeding gums, hard dental deposits, mobile teeth, and smoking. All participants brushed their teeth and cleaned the tongue regularly but use of dental floss was extremely low. Oral health education and health promotion are recommended. C. M. Kayombo and E. G. Mumghamba Copyright © 2017 C. M. Kayombo and E. G. Mumghamba. All rights reserved. Treatment of Adults with Anterior Mandibular Teeth Crowding: Reliability of Little’s Irregularity Index Mon, 06 Feb 2017 00:00:00 +0000 The attempt of this article was to assess reliability of Little’s Irregularity Index (LII) as for stability of the treatment outcomes in adults with crowded mandibular incisors. LII was measured on a digital cast prior to an orthodontic treatment (T1) of the 302 patients thus allowing us to establish the treatment plan, which called for (a) expansion (group 1), interproximal stripping (group 2), or extraction of one of the mandibular incisors. LII was measured after debonding (T2) and a year after retention (T3). Treatment resulted in significant reduction of LII values after treatment, in T1-T2 period in all groups. As for T2-T3 period it brought significant but clinically irrelevant relapse that occurred in groups 1 and 2; group 3 presented with insignificant improvement of occlusion. Conclusively, 30 years after introducing LII it has been a reliable parameter that allows selection of optimal treatment methods, provided that the appropriate ranges of values displaying dentoalveolar discrepancy are obeyed, namely, (1) up to 3 mm: expansion, (2) from 3 to 5 mm: interproximal enamel reduction, and (3) above 5 mm: extraction. J. Antoszewska-Smith, M. Bohater, M. Kawala, M. Sarul, and M. Rzepecka-Skupień Copyright © 2017 J. Antoszewska-Smith et al. All rights reserved. Cephalometrics of Pharyngeal Airway Space in Lebanese Adults Wed, 04 Jan 2017 06:37:03 +0000 Purpose. The upper airway space is significant in orthodontic diagnosis and treatment planning. The objectives of this study are to assess the dimensions of soft tissue elements of the upper pharyngeal space and evaluate potential correlations with modifying variables such as gender, skeletal class, and anthropometric parameters. Materials and Methods. Lateral cephalograms were obtained from 117 healthy young adult Lebanese subjects. Nineteen cephalometric linear/angular measurements of the nasopharynx, oropharynx, and hypopharynx were recorded. Anthropometric parameters including body mass index and neck circumference were measured. Results. Significant differences were demonstrated for 12 out of the 19 parameters considered between genders. Uvula and tongue dimensions and the distances between epiglottis-posterior pharyngeal wall and epiglottis-posterior nasal spine were significantly larger in males. The anteroposterior inclination of the uvula and the distances between the uvula and posterior pharyngeal wall were significantly greater in females. No significant differences were found between skeletal classes relative to most of the variables. Body mass index and neck circumference were positively correlated with the dimensions of tongue and uvula. Conclusions. Sexual dimorphism relative to some cephalometric variables and anthropometric parameters may account partly for larger oronasopharyngeal spaces in females. Anthropometric data need to be accounted for in population-related comparisons. Antoine Daraze, Myriam Delatte, Giuseppe Liistro, and Zeina Majzoub Copyright © 2017 Antoine Daraze et al. All rights reserved. Accuracy of Multiple Pour Cast from Various Elastomer Impression Methods Wed, 14 Dec 2016 09:10:36 +0000 The accurate duplicate cast obtained from a single impression reduces the profession clinical time, patient inconvenience, and extra material cost. The stainless steel working cast model assembly consisting of two abutments and one pontic area was fabricated. Two sets of six each custom aluminum trays were fabricated, with five mm spacer and two mm spacer. The impression methods evaluated during the study were additional silicone putty reline (two steps), heavy-light body (one step), monophase (one step), and polyether (one step). Type IV gypsum casts were poured at the interval of one hour, 12 hours, 24 hours, and 48 hours. The resultant cast was measured with traveling microscope for the comparative dimensional accuracy. The data obtained were subjected to Analysis of Variance test at significance level <0.05. The die obtained from two-step putty reline impression techniques had the percentage of variation for the height −0.36 to −0.97%, while diameter was increased by 0.40–0.90%. The values for one-step heavy-light body impression dies, additional silicone monophase impressions, and polyether were −0.73 to −1.21%, −1.34%, and −1.46% for the height and 0.50–0.80%, 1.20%, and −1.30% for the width, respectively. Satheesh B. Haralur, Majed Saad Toman, Abdullah Ali Al-Shahrani, and Abdullah Ali Al-Qarni Copyright © 2016 Satheesh B. Haralur et al. All rights reserved. Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis Thu, 24 Nov 2016 08:22:42 +0000 Introduction. One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods. A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results. The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion. The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique. Ladan Jamshidy, Hamid Reza Mozaffari, Payam Faraji, and Roohollah Sharifi Copyright © 2016 Ladan Jamshidy et al. All rights reserved. CBCT Assessment of Mental Foramen Position Relative to Anatomical Landmarks Wed, 23 Nov 2016 12:52:35 +0000 Purpose. This study was carried out on an Iranian population aiming to investigate mental foramen position relative to inferior border of mandible and skeletal midline and its gender and age differences on CBCT projections. Materials and Methods. A number of 180 CBCT images of patients were analyzed in different planes (tangential, cross-sectional, and axial). The distances from the superior border of mental foramen to the inferior border of mandible and from the anterior border of mental foramen to the midline were calculated. Results. The mean distance from mental foramen to the inferior border of mandible in the right side was 13.26 mm (SD ± 2.34) and in the left side was 13.37 mm (SD ± 2.19). There was a statistically significant difference between genders in terms of the distance between mental foramen and inferior border of mandible ( value = 0.000). The mean distances from mental foramen to midline were 25.86 mm (SD ± 0.27) and 25.53 mm (SD ± 0.31) in the right and left sides, respectively. Conclusions. The vertical and horizontal positions of mental foramen can be determined from stable anatomical landmarks such as mandibular inferior border and skeletal midline in both dentulous and edentulous patients. The distance from the superior border of mental foramen to the inferior border of mandible exhibited sexual dimorphism. Mahnaz Sheikhi and Mitra Karbasi Kheir Copyright © 2016 Mahnaz Sheikhi and Mitra Karbasi Kheir. All rights reserved. Speech and Swallowing Data in Individual Patients Who Underwent Glossectomy after Prosthetic Rehabilitation Tue, 15 Nov 2016 10:03:18 +0000 Maintaining oral function in patients undergoing glossectomy boosts interventions such as prosthetic rehabilitation. However, current literature still fails in the presentation of results of prosthetic rehabilitation in relation to speech or swallowing. The objective of this research is to evaluate the effectiveness of prosthetic rehabilitation on voice, speech, and swallowing in patients undergoing glossectomy by performing a systematic literature review and meta-analysis of individual cases. Studies were identified by relevant electronic database and included all dates available. The criteria used were sample with any ; resection due to malignant tumors, restricted to tongue and/or floor of mouth; type of prosthetic rehabilitation; and description of the oral functions outcomes with prosthesis. For the meta-analysis of individual data, associations between the variables of interest and the type of prosthesis were evaluated. Thirty-three of 471 articles met the selection criteria. Results on speech and/or voice and swallowing were reported in 27 and 28 articles, respectively. There were improvement of speech intelligibility and swallowing in 96 patients and in 73 patients, respectively, with prosthesis. Based on the available evidences, this article showed that prosthetic rehabilitation was able to improve oral functions and can be a strategy used with surgical reconstruction in selected cases. Viviane de Carvalho and Luiz Ubirajara Sennes Copyright © 2016 Viviane de Carvalho and Luiz Ubirajara Sennes. All rights reserved. Medication-Related Osteonecrosis of the Jaws: Considerations on a New Antiresorptive Therapy (Denosumab) and Treatment Outcome after a 13-Year Experience Mon, 24 Oct 2016 12:38:50 +0000 Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients receiving antiresorptive therapies for bone neoplastic localizations and osteoporosis. The aim of this study was to evaluate the clinicopathological features of MRONJ in a cohort of patients treated by new antiresorptive drugs (denosumab) and the corresponding outcome after 13-year maximum follow-up. Overall, 244 patients affected by MRONJ were treated from 2003 to 2015. After clinical and radiological examinations, all lesions were staged according to a dimensional staging system and then surgically treated. All the denosumab-related lesions were classified as stage II or III, thus requiring a more or less invasive surgical approach, despite the results of many recent studies, which suggested a conservative medical approach with early resolution for MRONJ in patients on denosumab. In the current series, 86.9% of treated lesions showed complete clinical and radiological healing, while 13.1% recurred; all recurrences were detected in patients who could not interrupt chemotherapy, steroids, and/or antiresorptive drugs administration due to their general conditions. In conclusion, all oral specialists should be aware of the MRONJ risk among patients taking new antiresorptive drugs; moreover, our protocol based on surgical treatment guided by dimensional staging could be considered effective in view of the low recurrence rate. Gianfranco Favia, Angela Tempesta, Luisa Limongelli, Vito Crincoli, and Eugenio Maiorano Copyright © 2016 Gianfranco Favia et al. All rights reserved.