International Journal of Dentistry The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Effectiveness of Different Preventive Programs in Cariogram Parameters of Young Adults at High Caries Risk Mon, 29 May 2017 00:00:00 +0000 Objective. To evaluate the effectiveness of different preventive programs in young adults at high caries risk using Cariogram software. Methods. Sixty-six young adults with high caries risk were evaluated. Dental caries risk for all subjects was determined according to WHO criteria. Subjects were divided into three different preventive groups (control: OH, fluoride varnish: FV, and chlorhexidine varnish: CV). They were followed for 12 weeks (baseline: T0, 1 week: T1, 4 weeks: T2, and 12 weeks: T3). Plaque index, diet frequency, and salivary chairside tests (to record the flow rate, buffer capacity, and mutans streptococci and lactobacillus counts) were performed at each visit. Based on these data, ten caries-related variables were collected and inserted into the Cariogram software to calculate the predicted chance of avoiding caries for each subject. Results. Significant changes were obtained about the Cariogram parameters (diet, bacteria, susceptibility, circumstances, and Cariogram risk group). No significant differences were found between the three methods regarding mean Cariogram scores after 3 months (). Conclusions. The regular and effective short-term (three months) use of 1450 ppm fluoridated toothpaste, one visit application of fluoride, and chlorhexidine varnishes were effective for reducing caries risk in young adults, which can be clearly demonstrated using Cariogram software. Said Karabekiroğlu and Nimet Ünlü Copyright © 2017 Said Karabekiroğlu and Nimet Ünlü. All rights reserved. Evaluation of the Loading, Unloading, and Permanent Deformation of Newly Available Epoxy Resin Coated Ni-Ti Wires Using Self-Ligating Brackets Tue, 23 May 2017 08:47:24 +0000 Aim. The purpose of this study was to evaluate the load and unload deflection and permanent deformation of round 0.016′′ and rectangular regular and coated Ni-Ti wires. Materials and Methods. Ni-Ti archwires produced by two manufacturers were evaluated. Both regular and coated round and rectangular Ni-Ti wire segments () from each group were submitted to a three-point bending test. Both types of wires were evaluated for permanent deformation at the end of a recovery cycle. Results. The coated round 0.016′′ Ni-Ti wires produced a significantly lower force in loading () and unloading () than regular wires of the same manufacturer and size. There was no significant difference in permanent deformation between coated and regular round Ni-Ti wires from the same company. For rectangular Ni-Ti wires, there was a significant difference in the loading evaluation, but the unloading test presented no significant differences. The permanent deformation of the rectangular wires revealed no significant difference between them. Conclusion. The addition of an esthetic coating to these new Ni-Ti wires produced changes in their mechanical properties, manifested as a reduction in the applied force, which should be considered in clinical management. Hazel Garro-Piña, María Cristina Jiménez-Cervantes, Ricardo Ondarza-Rovira, Roberto Justus, and Salvador García-López Copyright © 2017 Hazel Garro-Piña et al. All rights reserved. Effect of Artificial Aging Protocols on Surface Gloss of Resin Composites Mon, 22 May 2017 06:54:50 +0000 The purpose of this study was to evaluate the effect of aging protocols on surface gloss of composites. Cylindrical resin composite specimens (6 mm in diameter, 1 mm thick) were fabricated and divided into three groups (): microfilled (MiFi), nanohybrid (NaHy), and nanofilled (NaFi). Specimens were distributed into four aging subgroups: thermocycling (5° to 55°C, 15,000 cycles); ethanol immersion (15 days); brushing (10,750 cycles); and light aging (216 h). Surface gloss readings (Novo-Curve, Rhopoint TM, England) were performed at baseline (R0) and after every one-third of aging protocols (R1 to R3). Data were submitted to one-way repeated measures ANOVA and Tukey’s test (5%). Overall, surface gloss alterations were detected over time (). Thermocycling reduced surface gloss, except for NaHy. Ethanol immersion resulted in surface gloss reduction after R1 for MiFi and NaFi, while reduction after R1 and R2 was detected for NaHy. For brushing, gloss reduction was detected after R1 and R3 for all composites. For light aging, gloss was reduced after R1 and R2 for MiFi and NaFi, while a reduction only after R1 was detected for NaHy. The studied aging protocols affect surface gloss differently, being material and aging therapy dependent. In general, the surface gloss is reduced with aging. Rafael Santos Rocha, Amanda Carvalho Oliveira, Taciana Marco Ferraz Caneppele, and Eduardo Bresciani Copyright © 2017 Rafael Santos Rocha et al. All rights reserved. Immediate Loading of Single Implants in the Anterior Maxilla: A 1-Year Prospective Clinical Study on 34 Patients Mon, 22 May 2017 00:00:00 +0000 Purpose. To present the outcomes of immediately loaded single implants placed in the anterior maxilla. Methods. Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success. Results. 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ < 60) and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%. Conclusions. In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478). Miguel Stanley, Filipa Calheiros Braga, and Beatriz Mota Jordao Copyright © 2017 Miguel Stanley et al. All rights reserved. Factors Affecting the Periapical Status of Root-Filled Canals: A Cross-Sectional Study at the Undergraduate Level Sun, 21 May 2017 08:17:17 +0000 Objective. The aim was to evaluate the influence of multiple factors on the periapical status of endodontically treated (ET) teeth. Methods. The patients were clinically and radiographically reevaluated after root canal therapy. The quality of the root-filled canals, coronal restorations, intraradicular posts, dental caries, and periodontal parameters were associated with the teeth’s periapical status. Results. The 122 patients provided 154 ET teeth; 97.4% teeth were asymptomatic, and 75.5% had a normal periapical status. The percentage of perfect, satisfactory, and deficient root-filled canals was of the order of 41.6%, 46.1%, and 12.3%, respectively. The percentage of adequate and inadequate coronal restorations was 31.2% and 68.8%, respectively. A total of 14.9% teeth had intraradicular posts, and 29.2% had cavitated carious lesions in the dentin. Gingival bleeding was observed in 31.8% of teeth, and dental biofilm was visible in 58.4%. A total of 11.7% showed pathologic tooth mobility, and 22.1% teeth were diagnosed with periodontal disease. Conclusions. Carious lesions, gingival bleeding, and tooth mobility were significantly associated with the occurrence of periapical lesions in root-filled canals. George Moreira Costa, Suelleng Maria Santos Soares, Paula Cristina Pelli Paiva, Flaviana Dornela Verli, Patrícia Furtado Gonçalves, Sangela Maria da Silva Pereira, Rudys Rodolfo De Jesus Tavarez, Janir Alves Soares, and Etevaldo Matos Maia Filho Copyright © 2017 George Moreira Costa et al. All rights reserved. An Observational Cohort Study on Delayed-Onset Infections after Mandibular Third-Molar Extractions Sun, 21 May 2017 00:00:00 +0000 Objectives. The purpose of the present study was to investigate the occurrence and clinical features of delayed-onset infections after mandibular third-molar extractions. Method and Materials. An observational cohort study was conducted on 179 patients undergoing mandibular third-molar extraction between January 2013 and December 2015, for a total of 217 extractions. Data were recorded at the time of extraction , on suture removal seven days later , and 30 days after the extraction, when patients were contacted and asked about their healing process . The statistical analysis was performed with nonparametric tests. A value lower than 0.05 was considered statistically significant. Results. Eight delayed-onset infections were recorded, amounting to 3.7% of all extractions. The median time elapsing from the extraction to the delayed-onset infection was 35 days (IQR 28–40; min 24–max 49). Younger age and longer surgical procedures seemed to be more often associated with this complication. Conclusion. Delayed-onset infections after third-molar extractions are relatively rare postoperative complications characterized by a swelling, usually with a purulent discharge. Patients should be informed of this possibility, which might develop even several weeks after the extraction. Giulia Brunello, Marleen De Biagi, Giulia Crepaldi, Fernanda Izaura Rodrigues, and Stefano Sivolella Copyright © 2017 Giulia Brunello et al. All rights reserved. LPS from P. gingivalis Negatively Alters Gingival Cell Mitochondrial Bioenergetics Tue, 16 May 2017 00:00:00 +0000 Objective. Oral inflammatory pathologies are linked to increased oxidative stress, thereby partly explaining their relevance in the etiology of systemic disorders. The purpose of this work was to determine the degree to which LPS from Porphyromonas gingivalis, the primary pathogen related to oral inflammation, altered gingival mitochondrial function and reactive oxygen species generation. Methods. Human gingival fibroblast (HGF-1) cells were treated with lipopolysaccharide of P. gingivalis. Mitochondrial function was determined via high-resolution respirometry. Results. LPS-treated HGF-1 cells had significantly higher mitochondrial complex IV and higher rates of mitochondrial respiration. However, this failed to translate into greater ATP production, as ATP production was paradoxically diminished with LPS treatment. Nevertheless, production of the reactive H2O2 was elevated with LPS treatment. Conclusions. LPS elicits an increase in gingival cell mitochondria content, with a subsequent increase in reactive oxygen species production (i.e., H2O2), despite a paradoxical reduction in ATP generation. These findings provide an insight into the nature of oxidative stress in oral inflammatory pathologies. Kiran Napa, Andrea C. Baeder, Jeffrey E. Witt, Sarah T. Rayburn, Madison G. Miller, Blake W. Dallon, Jonathan L. Gibbs, Shalene H. Wilcox, Duane R. Winden, Jared H. Smith, Paul R. Reynolds, and Benjamin T. Bikman Copyright © 2017 Kiran Napa et al. All rights reserved. A Comparison of Impact of Chronic Periodontal Diseases and Nonsurgical Periodontal Therapy on Oral Health-Related Quality of Life Sun, 14 May 2017 07:13:56 +0000 Objectives. To evaluate the impact of chronic periodontal diseases (PDs) and compare phases of nonsurgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) in patients attending a tertiary care center of eastern Nepal. Materials and Methods. Matched for socioeconomic status, participants were recruited in two groups: moderate-to-severe chronic periodontitis (, years) and chronic gingivitis (, years). The treatment modalities were scaling and root surface debridement (RSD) and supragingival scaling, respectively. The impact of periodontal disease treatment status was assessed by a self-reported questionnaire of Nepali Oral Health Impact Profile (OHIP-14) at baseline and 9–12 weeks after NSPT. Results. The median (IQR) OHIP-14 total scores for PDs reduced from 7 (3–11) to 3 (1–7.5) after NSPT. Both groups showed a significant improvement on OHRQoL ( value < 0.001). The periodontitis group showed an increased median (IQR) reduction of 52% (35.22–86.15) compared with the gingivitis group with 27% (0.00–50.00). The impact on orofacial pain, orofacial appearance, and psychosocial dimensions was observed, which improved after NSPT in both groups. Conclusion. PDs are directly associated with OHRQoL and treatment of the disease may enhance quality of life from a patient’s perspective. Scaling and RSD provided better influence on OHRQoL than supragingival scaling. Khushboo Goel and Dharnidhar Baral Copyright © 2017 Khushboo Goel and Dharnidhar Baral. All rights reserved. Correlation of Salivary Statherin and Calcium Levels with Dental Calculus Formation: A Preliminary Study Wed, 10 May 2017 00:00:00 +0000 Background. Salivary constituents have a wide range of functions including oral calcium homeostasis. Salivary proteins such as statherin inhibit crystal growth of calcium phosphate in supersaturated solutions and interact with several oral bacteria to adsorb on hydroxyapatite. Concurrently, saliva, which is supersaturated with respect to calcium phosphates, is the driving force for plaque mineralization and formation of calculus. Thus, the aim of the present study was to estimate and correlate salivary statherin and calcium concentration to the dental calculus formation. Methods. A cross-sectional study was conducted to assess the relationship between salivary statherin, calcium, and dental calculus among 70 subjects, aged 20–55 years. Subjects were divided into 3 groups based on the calculus scores as interpreted by Calculus Index which was followed by collection of whole saliva using Super•SAL™. Salivary calcium levels were assessed by calorimetric method using Calcium Assay kit (Cayman Chemical, Michigan, USA) and statherin levels by using ELISA Kit (Cusabio Biotech). Results. Statherin levels showed a weak negative correlation with the calcium levels and with calculus formation. The mean salivary statherin and calcium concentration were found to be 0.96 μg/ml and 3.87 mg/ml, respectively. Salivary statherin levels differed significantly among the three groups (). Conclusions. Our preliminary data indicates that statherin could possibly play a role in the formation of dental calculus. Deepak Gowda Sadashivappa Pateel, Shilpa Gunjal, Swarna Y. Math, Devarasa Giriyapura Murugeshappa, and Sreejith Muraleedharan Nair Copyright © 2017 Deepak Gowda Sadashivappa Pateel et al. All rights reserved. Surface Characteristics and Biofilm Development on Selected Dental Ceramic Materials Mon, 08 May 2017 07:29:46 +0000 Background. Intraoral adjustment and polishing of dental ceramics often affect their surface characteristics, promoting increased roughness and consequent biofilm growth. This study correlated surface roughness to biofilm development with four commercially available ceramic materials. Methods. Four ceramic materials (Vita Enamic®, Lava™ Ultimate, Vitablocs Mark II, and Wieland Reflex®) were prepared as per manufacturer instructions. Seventeen specimens of each material were adjusted and polished to simulate clinical intraoral procedures and another seventeen remained unaltered. Specimens were analysed by SEM imaging, confocal microscopy, and crystal violet assay. Results. SEM images showed more irregular surface topography in adjusted specimens than their respective controls. Surface roughness values were greater in all materials following adjustments. All adjusted materials with the exception of Vitablocs Mark II promoted significantly greater biofilm growth relative to controls. Conclusion. Simulated intraoral polishing methods resulted in greater surface roughness and increased biofilm accumulation. Kyoung H. Kim, Carolina Loch, J. Neil Waddell, Geoffrey Tompkins, and Donald Schwass Copyright © 2017 Kyoung H. Kim et al. All rights reserved. Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol Sun, 07 May 2017 00:00:00 +0000 The aim of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients. Materials and Methods. Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney test was used to compare accuracy between maxillary and mandibular surgical guides. A value < .05 was considered significant. Results. Mean (and standard deviation) of 3D error at the entry point was 0.798?mm (±0.52), at the implant apex it was 1.17?mm (±0.63), and mean angular deviation was 2.34 (±0.85). A statistically significant reduced 3D error was observed at entry point , at implant apex , and also in angular deviation in mandible when comparing to maxilla. Conclusions. The surgical template used has proved high accuracy for implant insertion. Within the limitations of the present study, the protocol for comparing a digital file (treatment plan) with postinsertion digital impression may be considered a useful procedure for assessing surgical template accuracy, avoiding radiation exposure, during postoperative CBCT scanning. Corina Marilena Cristache and Silviu Gurbanescu Copyright © 2017 Corina Marilena Cristache and Silviu Gurbanescu. All rights reserved. Chlorhexidine Prevents Root Dentine Mineral Loss and Fracture Caused by Calcium Hydroxide over Time Sun, 30 Apr 2017 12:36:31 +0000 Purpose. To evaluate the mineral ion loss of root dentine after treatment with 2% chlorhexidine solution (CHX) and to compare its yield and flexural strength (fs) after exposure to calcium hydroxide [Ca(OH)2]. Materials and Methods. Dentine bars (DB) were made from 90 roots of bovine incisors and randomized into three groups: : distilled/deionized water (DDW), : 2.5% sodium hypochlorite + 17% EDTA, and : CHX + DDW. The release of phosphate (PO4) and calcium (Ca) ions was measured by spectrophotometry. The DB were exposed to Ca(OH)2 paste for 0, 30, 90, and 180 days. DB were subjected to the three-point bending test to obtain yield and fs values. The fracture patterns were evaluated (20x). Data were analyzed using Kruskal-Wallis and Dunn’s post hoc tests or one- and two-way ANOVA followed by Tukey’s post hoc test (). Results. showed lower and Ca2+ ionic release than (). For yield and fs, in all periods (), except for yield strength values on 90 days (). A larger frequency of vertical fractures was observed in and that of oblique fractures in (). Conclusions. CHX prevented and Ca2+ loss and showed a tendency to preserve the yield and fs of root dentine over time following exposure to Ca(OH)2 paste. Michael Ranniery Garcia Ribeiro, Érika Bárbara Abreu Fonseca Thomaz, Darlon Martins Lima, Tarcísio Jorge Leitão, José Bauer, and Soraia De Fátima Carvalho Souza Copyright © 2017 Michael Ranniery Garcia Ribeiro et al. All rights reserved. Genetic Factors and the Risk of Periodontitis Development: Findings from a Systematic Review Composed of 13 Studies of Meta-Analysis with 71,531 Participants Wed, 26 Apr 2017 00:00:00 +0000 Purpose. This work aimed to synthesize the results of recent meta-analysis focusing on polymorphism in inflammatory mediators and its relation with the risk of periodontitis development. Materials and Methods. A systematic search was conducted using databases for publications prior to October 2016. Three examiners extracted data from articles with a clear association between polymorphisms in the inflammatory mediator gene and the development of periodontitis through meta-analysis using the fixed or randomized statistical models to calculate the Odds Ratio with values of considered significant. Results. A total of 13 meta-analysis articles with 25 polymorphisms in seven interleukins (IL-1A, IL-1B, IL-4, IL-6, IL-8, IL-10, and IL-18), three cellular receptors (Fcγ receptors: FCGR2A, FCGR3A, and FCGR3B), and five inflammatory mediators (COX-2, MMP-2, MMP-3, MMP-8, and MMP-9), with a total of 71,531 participants, approaching different classifications of the disease. Conclusion. The study demonstrated that polymorphisms in the IL-1A, IL-1B, IL-6, IL-10, MMP-3 (chronic form), and MMP-9 (chronic form) polymorphisms were significantly associated with the risk of developing periodontitis, whereas other polymorphisms in the IL-4, IL-8, IL-18, Fcγ, COX-2, MMP-2, MMP-3 (aggressive), MMP-8, and MMP-9 (aggressive) polymorphisms had no significant association with risk of developing periodontitis. Maélson Klever da Silva, Antonio Carlos Gonçalves de Carvalho, Even Herlany Pereira Alves, Felipe Rodolfo Pereira da Silva, Larissa dos Santos Pessoa, and Daniel Fernando Pereira Vasconcelos Copyright © 2017 Maélson Klever da Silva et al. All rights reserved. Food Simulating Organic Solvents for Evaluating Crosslink Density of Bulk Fill Composite Resin Wed, 12 Apr 2017 00:00:00 +0000 Objectives. To evaluate crosslink densities of two bulk fill composite resins and determine if the used Food Simulating Organic Solvent (FSOS) affected them. Methods. Forty specimens were prepared from SureFill and SonicFill bulk fill composite resins, 20 each. All specimens were stored dry for 24 h. Each group was divided into 2 subgroups: stored in ethanol (E) 75% or in methyl ethyl ketone (MEK) 100% for 24 h. Crosslink density was evaluated by calculating the difference between the Vickers hardness numbers of the specimens stored dry and after their storage in FSOS. The data were statistically analyzed using -test. Results. The means of crosslink density in E and MEK were 6.99% and 9.44% for SureFill and 10.54% and 11.92% for SonicFill, respectively. -test displayed significant differences between crosslink densities of SureFill and SonicFill: () in E and () in MEK and between crosslink densities of SureFill in E and MEK (). Conclusions. Crosslink density of bulk fill composite resin can be evaluated using E or MEK. SureFill has higher crosslink density than SonicFill in both E and MEK. Neveen M. Ayad, Hala A. Bahgat, Eman Hussain Al Kaba, and Maryam Hussain Buholayka Copyright © 2017 Neveen M. Ayad et al. All rights reserved. Comparative Assessment of Preoperative versus Postoperative Dexamethasone on Postoperative Complications following Lower Third Molar Surgical Extraction Mon, 10 Apr 2017 00:00:00 +0000 Aim. To evaluate the effect of preoperative versus postoperative administration of oral Dexamethasone on postoperative complications including pain, edema, and trismus following lower third molar surgery. Methods. 24 patients were divided into two equal groups receiving 8 mg Dexamethasone orally, one group one hour preoperatively and the other group immediately after surgery. Pain was measured using VAS, edema was measured using a graduated tape between 4 fixed points in the face, and the mouth opening was measured using a graduated sliding caliper. Results. In this study pain and trismus records were similar and statistically nonsignificant in both groups. The results had proven that preoperative administration was superior when compared to postoperative administration regarding edema (0.002). Conclusions. Preoperative oral administration of 8 mg Dexamethasone was superior to the postoperative administration of the same dose concerning edema after lower third molar surgery. Hashem M. Al-Shamiri, Maha Shawky, and Nermin Hassanein Copyright © 2017 Hashem M. Al-Shamiri et al. All rights reserved. Characterization of Chronic Mechanical Irritation in Oral Cancer Thu, 06 Apr 2017 07:59:32 +0000 Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% () presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa. Jerónimo P. Lazos, Eduardo D. Piemonte, Hector Eduardo Lanfranchi, and Mabel N. Brunotto Copyright © 2017 Jerónimo P. Lazos et al. All rights reserved. Bovine Tooth Discoloration Induced by Endodontic Filling Materials for Primary Teeth Wed, 05 Apr 2017 00:00:00 +0000 Objective. This study evaluated the discoloration potential of endodontic materials used in primary teeth. Material and Methods. Dentine-enamel blocks were prepared from 75 bovine teeth, assorted in five experimental groups (). The tested materials included an MTA-based material; zinc oxide and eugenol cement (ZOE); Vitapex; and calcium hydroxide thickened with zinc oxide (Calen + ZO). The color measurements were performed using a spectrophotometer at the following intervals: prior to (T0) and after placement of the filling (T1) and after 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5), and 9 months (T6). Data were submitted to ANOVA with repeated measures and Tukey’s test. Results. The time had a significant effect on the color variation () (). The effect of the materials on the color variation () was statistically significant (). Interactions between time and materials demonstrated a significant effect on the values () (). The ZOE cement showed the highest darkening effect (). Conclusion. The MTA-based material showed the smallest discoloration during the experimental time; however, it was similar to the other materials and to the control group. Zinc oxide and eugenol showed higher discoloration. Samantha Rodrigues Xavier, Katerine Jahnecke Pilownic, Andressa Heberle Gastmann, Mariana Silveira Echeverria, Ana Regina Romano, and Fernanda Geraldo Pappen Copyright © 2017 Samantha Rodrigues Xavier et al. All rights reserved. 3D Evaluation of Maxillary Sinus Using Computed Tomography: A Sexual Dimorphic Study Tue, 04 Apr 2017 06:41:06 +0000 Purpose. Gender determination is considered to be an important step in the reconstruction of the biological profile in forensic medicine. Maxillary sinus can be used for identification of sex when other methods are indecisive. Computed tomography (CT) provides an excellent method for examining maxillary sinuses. Hence the aim of the study was to determine the accuracy of gender determination using maxillary sinus with CT. Materials and Methods. CT images were used to measure the mediolateral, superoinferior, and anteroposterior dimensions and the volume of the maxillary sinuses in 100 patients (50 males and 50 females) to determine the gender of an individual for forensic identification. Discriminative analysis was done using the values derived and the -test for independent samples was used to compare these values in males and females. Results. The accuracy rate was found to be 84% in males and 92% in females with the mean accuracy of 88%. Conclusion. Our study concludes that gender determination can be done using measurements of maxillary sinus through CT when other methods are unavailable. The prediction rate can be increased by including volume of the maxillary sinus. Balaji Babu Bangi, Uday Ginjupally, Lakshmi Kavitha Nadendla, and Bhavana Vadla Copyright © 2017 Balaji Babu Bangi et al. All rights reserved. Medical and Periodontal Clinical Parameters in Patients at Different Levels of Chronic Renal Failure Mon, 03 Apr 2017 08:13:31 +0000 Aim. To assess the clinical periodontal and medical parameters in patients with chronic renal failure (CRF) at different levels of renal disease. Background. CRF is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues that shows high prevalence in patients with CRF. Materials and Methods. 102 CRF patients were included and divided into an early stage group (EG), predialysis group (PDG), and hemodialysis group (HDG). The medical parameters were taken from the patients’ records. Results. Periodontal clinical condition differed among the CRF groups. Clinical attachment loss was greater in the HDG and PDG group compared to the EG (); the same was observed in the Plaque Index (); the others periodontal parameters did not show any differences. Ferritin levels were significantly higher in the HDG when compared to the EG and PGD (), and fibrinogen was higher in PDG compared with the others (); the triglycerides also showed higher values in the HDG compared with the other groups (). Conclusion. The patients with renal involvement should have a multidisciplinary approach to an improvement in their oral and systemic health. Caroline Perozini, Gilson Fernandes Ruivo, Lucilene Hernandes Ricardo, Larissa Avance Pavesi, Yeon Jung Kim, and Debora Pallos Copyright © 2017 Caroline Perozini et al. All rights reserved. The Effect of Fermented Lingonberry Juice on Candida glabrata Intracellular Protein Expression Thu, 30 Mar 2017 12:47:00 +0000 Lingonberries have a long traditional use in treating fungal infections on mucosal membranes, but very little is known about the exact antifungal mechanisms. We tested the effects of fermented lingonberry juice on Candida glabrata intracellular protein expression. A Candida glabrata clinical strain was grown in the presence of fermented lingonberry juice (FLJ). Also the effect of lowered pH was tested. Intracellular protein expression levels were analyzed by the 2D-DIGE method. Six proteins detected with ≥1.5-fold lowered expression levels from FLJ treated cells were further characterized with LC-MS/MS. Heat shock protein 9/12 and redoxin were identified with peptide coverage/scores of 68/129 and 21/26, respectively. Heat shock protein 9/12 had an oxidized methionine at position 56. We found no differences in protein expression levels at pH 3.5 compared to pH 7.6. These results demonstrate that FLJ exerts an intracellular stress response in Candida glabrata, plausibly impairing its ability to express proteins related to oxidative stress or maintaining cell wall integrity. Pirjo Pärnänen, Ali Nawaz, Timo Sorsa, Jukka Meurman, and Pirjo Nikula-Ijäs Copyright © 2017 Pirjo Pärnänen et al. All rights reserved. Cavity Adaptation of Water-Based Restoratives Placed as Liners under a Resin Composite Thu, 30 Mar 2017 12:03:12 +0000 Purpose. To investigate the cavity adaptation of mineral trioxide (ProRoot MTA/MT), tricalcium silicate (Biodentine/BD), and glass ionomer (Equia Fil/EF) cements used as liners and the interfacial integrity between those liners and a composite resin placed as the main restorative material. Materials and Methods. Standardized class I cavities (: 8 per group) were prepared in upper premolars. Cavities were lined with a 1 mm thick layer of each of the tested materials and restored with Optibond FL adhesive and Herculite Precis composite resin. Cavity adaptation of the restorations was investigated by computerized X-ray microtomography. The regions of interest (ROI) were set at the cavity-liner (CL) interface and the liner-resin (LR) interface. The percentage void volume fraction (%VVF) in the ROI was calculated. The specimens were then sectioned and the interfaces were evaluated by reflection optical microscopy, to measure the % length (%LD) of the interfacial gaps. Selected samples were further evaluated by scanning electron microscopy. Statistical analysis was performed by two-way ANOVA and Student-Newman-Keuls multiple comparison test (). Results. MT showed significantly higher %VVF and %LD values in CL interfaces than BD and EF (). No significant differences were found among the materials for the same values at the LR interfaces. Conclusions. When used as a composite liner, ProRoot MTA showed inferior cavity adaptation at dentin/liner interface when compared to Biodentine and Equia Fil. Sheela B. Abraham, Maria D. Gaintantzopoulou, and George Eliades Copyright © 2017 Sheela B. Abraham et al. All rights reserved. A Community-Based Participatory Research Approach to Understand Urban Latino Parent’s Oral Health Knowledge and Beliefs Wed, 29 Mar 2017 00:00:00 +0000 The aim of this study is to describe oral health knowledge, behaviors, and beliefs of Latino parents with children under the ages of 6 years and to conduct a needs assessment with Latino families to better understand the challenges in maintaining oral health for their children. The investigator collaborated with a community serving the organization to recruit Latino primary caregivers for focus groups interviews and 30 primary caregivers were recruited. The focus groups data was transcribed and analyzed using a grounded theory approach using QDA Miner software. Findings from the focus groups demonstrate that the primary caregivers described barriers in maintaining oral health for their children including cultural barriers, child’s temperament, lack of time, and easy access to high-risk foods. All participants said that they wanted to receive information on the oral health of their children; they wanted the dentist or the hygienist to demonstrate oral hygiene practices and explain to them the reasons for oral health behaviors. Although the primary caregivers recognized some factors related to caries development, their knowledge was limited in depth. Culturally appropriate oral health education is required for this population, which could lead to more adherent oral health behavior and a higher sense of self-efficacy in Latino parents. Tamanna Tiwari, Nayanjot Rai, Eivi Colmenero, Hilda Gonzalez, and Mirna Castro Copyright © 2017 Tamanna Tiwari et al. All rights reserved. Periodontal Health Status and Associated Factors: Findings of a Prenatal Oral Health Program in South Brazil Wed, 29 Mar 2017 00:00:00 +0000 Objective. The aims of this study were to evaluate the periodontal health of pregnant women and to investigate the association of periodontal status with demographic and socioeconomic characteristics, as well as medical and dental history. Materials and Methods. A total of 311 pregnant women were interviewed to obtain sociodemographic data along with medical and dental histories. Clinical examinations were performed to record the presence of visible plaque, gingival bleeding, and caries activity. The periodontal condition was evaluated by Community Periodontal Index of Treatment Needs (CPITN) in one tooth of each sextant (16, 11, 26, 36, 31, and 46). Results. After the adjustment analysis, the presence of visible plaque remained the main determinant of gingival bleeding (OR = 2.91, CI = 1.91–4.48). First-trimester pregnancy status was also a predictor, with a lower prevalence of gingival bleeding observed in the second (OR = 0.87, CI = 0.77–0.99) and third (OR = 0.82, CI = 0.73–0.93) trimesters. Conclusion. In pregnant women, the presence of dental plaque and first-trimester pregnancy status were the main implicated factors predicting gingival bleeding. Marta Silveira da Mota Krüger, Renata Picanço Casarin, Letycia Barros Gonçalves, Fernanda Geraldo Pappen, Fernanda Oliveira Bello-Correa, and Ana Regina Romano Copyright © 2017 Marta Silveira da Mota Krüger et al. 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.