International Journal of Dentistry The latest articles from Hindawi © 2017 , Hindawi Limited . 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. 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.