International Journal of Dentistry The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Diagnosis of Oral Hairy Leukoplakia: The Importance of EBV In Situ Hybridization Mon, 17 Jul 2017 07:18:09 +0000 Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV), which has been related to HIV infection. In situ hybridization (ISH) is the gold-standard diagnosis of OHL, but some authors believe in the possibility of performing the diagnosis based on clinical basis. The aim of this study is diagnose incipient lesions of OHL by EBV ISH of HIV-infected patients and the possible correlations with clinical characteristics of the patients. Ninety-four patients were examined and those presenting with clinical lesions compatible to OHL were submitted to biopsy prior to EBV ISH. Twenty-eight patients had lesions clinically compatible to the diagnosis of OHL, but only 20 lesions were confirmed by EBV ISH. The patients with OHL had a mean age of 41.9 years and were HIV-infected for 11.2 years, on average, including CD4 count of 504.7 cells/mm3 and log10 viral load = 1.1. Among the quantitative variables, there was a statistically significant correlation with age only (). In conclusion, the presence of OHL in patients with HIV/AIDS results in changes in the epidemiological characteristics of the disease, and this fact allied with subtle clinical-morphological features makes clinical diagnosis very difficult. Therefore, EBV ISH is important for a definitive diagnosis of OHL. Luana L. Martins, José Henrique F. Rosseto, Natália Silva Andrade, Juliana Bertoldi Franco, Paulo Henrique Braz-Silva, and Karem L. Ortega Copyright © 2017 Luana L. Martins et al. All rights reserved. Specific Central Nervous System Medications Are Associated with Temporomandibular Joint Symptoms Sun, 16 Jul 2017 00:00:00 +0000 Aims. There is evidence of association between bruxism and the increasingly common central nervous system stimulants prescribed for attention deficit hyperactivity disorder (ADHD), as well as the selective serotonin reuptake inhibitors (SSRIs) often prescribed for depression or anxiety. However, the evidence is not clear on whether these medications inducing bruxism are directly associated with temporomandibular joint disorder (TMD). The aim of this work is to evaluate whether these medications are associated with TMD symptoms. Methods. Medical history and participant data were obtained for 469 patients from the University of Pittsburgh School of Dental Medicine, Dental Registry and DNA Repository, dating back to 2006. The chi-square test was used to determine any statistically significant associations. Results. There were no statistically significant associations between ADHD stimulant medications or SSRIs and reported TMD symptoms. However, there were significant differences seen between specific brands of medications and reported TMD symptoms. Individuals prescribed methylphenidate (Concerta) were less likely to report temporomandibular joint discomfort (). Conversely, individuals prescribed citalopram (Celexa) were more likely to report temporomandibular joint discomfort (). Conclusion. Signs and symptoms of temporomandibular joint dysfunction may be influenced by the use of certain medications prescribed for depression or attention deficit hyperactive disorder. John K. Drisdale III, Monica G. Thornhill, and Alexandre R. Vieira Copyright © 2017 John K. Drisdale III et al. All rights reserved. Effect of Anatomical Customization of the Fiber Post on the Bond Strength of a Self-Adhesive Resin Cement Thu, 13 Jul 2017 09:17:36 +0000 Aim. The aim of the study was to evaluate, by means of the push-out test, the effect of the anatomical customization of the fiber post on the bond strength of a self-adhesive resin cement. Methods. Twelve endodontically treated, human, upper central incisors were randomly divided into two groups (): control (glass fiber posts cemented with Relyx® U200) and customized (glass fiber posts anatomically customized with translucent composite resin cemented with Relyx U200). The roots were sectioned into three slices, cervical, middle, and apical, and photographed with a digital camera attached to a stereomicroscopic loupe. The images were analyzed by software, for evaluation of the cement line. The slices were subsequently submitted to the push-out test until the post had completely extruded, and the fracture mode was analyzed with a stereomicroscopic loupe. Results. The results showed significant differences between the groups in the different root thirds in relation to the area occupied by air bubbles (). Bond strength, when all the thirds are considered, was 8.77 ± 4.89 MPa for the control group and 16.96 ± 4.85 MPa for the customized group. Conclusion. The customized group showed greater bond resistance than the control group and a more uniform cement layer. Adricyla Teixeira Rocha, Leticia Machado Gonçalves, Ana Júlia de Carvalho Vasconcelos, Etevaldo Matos Maia Filho, Ceci Nunes Carvalho, and Rudys Rodolfo De Jesus Tavarez Copyright © 2017 Adricyla Teixeira Rocha et al. All rights reserved. Incidence of Tooth Loss in Adults: A 4-Year Population-Based Prospective Cohort Study Wed, 12 Jul 2017 08:13:16 +0000 Objective. To verify the incidence of tooth loss in extended age group of adults in 4 years. Materials and Methods. The prospective cohort study assessed adults (20–64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20–44 years old) and older (45–64 years old) adults. Mann–Whitney U test () was used to compare the means of incidence of tooth loss between age groups. Results. After four years, 57.7% () of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (). Conclusion. There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated. Manoelito Ferreira Silva-Junior, Marília Jesus Batista, and Maria da Luz Rosário de Sousa Copyright © 2017 Manoelito Ferreira Silva-Junior et al. All rights reserved. Estimation of Antioxidant Levels in Saliva and Serum of Chronic Periodontitis Patients with and without Ischemic Heart Disease Tue, 11 Jul 2017 10:22:17 +0000 Objective. To investigate whether there is a relationship between periodontitis and ischemic heart disease by estimation of total antioxidant status in saliva and serum. Materials and Methods. A total of 80 samples were collected and divided equally into 4 groups of healthy controls, chronic periodontitis patients, ischemic heart disease patients with periodontitis, and ischemic heart disease patients without periodontitis. Saliva and venous blood samples were collected and analyzed for levels of total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and catalase. Results. There were significant () differences in the mean serum levels of total antioxidant capacity (), superoxide dismutase (), glutathione peroxidase (), and catalase () within the 4 groups, whereas the mean salivary levels were significant only for glutathione peroxidase (). Both of these serum and salivary antioxidant levels were lower in disease groups of IHD + CP, IHD + H, and CP as compared to healthy controls, with different patterns. Conclusion. Antioxidant capacity is significantly hampered in chronic periodontitis and ischemic heart disease patients with or without periodontitis as compared to healthy controls. The salivary and serum antioxidants may not follow the same increase or decrease as a result of increased oxidant stress due to disease. Anahita Punj, Santhosh Shenoy, N. Suchetha Kumari, and Priyanka Pampani Copyright © 2017 Anahita Punj et al. All rights reserved. Peripheral Exophytic Oral Lesions: A Clinical Decision Tree Wed, 05 Jul 2017 06:59:08 +0000 Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method. Hamed Mortazavi, Yaser Safi, Maryam Baharvand, Somayeh Rahmani, and Soudeh Jafari Copyright © 2017 Hamed Mortazavi et al. All rights reserved. Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease Sun, 02 Jul 2017 10:01:04 +0000 Background. Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatments is supported by strong clinical evidence. Objective. This systematic review aims to determine the clinical efficacy and safety of topical corticosteroids for the management of the mucosal alterations of oral cGVHD. Data Sources. Electronic search of different databases was conducted: PubMed, Cochrane library, Grey literature, WHO, and clinical for clinical trial registration as well as hand search in the references of relevant articles up to November 2016. Data Extraction. Extracted pieces of information were intervention, population, sample sizes, and outcomes. Data Synthesis. Six studies were included: 2 randomized clinical trials (RCTs), 3 cohort studies, and 1 pre-post clinical trial. Results. There is a limited evidence concerning clinical efficacy of topical corticosteroids. Clobetasol, dexamethasone, and budesonide were the topical corticosteroid of choice. The highest level of evidence score was given to clobetasol followed by budesonide with a lower evidence level. Conclusion. All three topical corticosteroid preparations are effective for management of oral chronic GVHD with minimal easily avoided side effects. Basma Abdelaleem Elsaadany, Eman Magdy Ahmed, and Sana Maher Hasan Aghbary Copyright © 2017 Basma Abdelaleem Elsaadany et al. All rights reserved. Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study Sun, 02 Jul 2017 08:26:40 +0000 Aim. To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. Patients and Methods. We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. Results. 61.54% of patients were female and mean overall age was years old. Overall CSR was 97.1% (95% CI: 92.4–98.9): 97.9 and 95.1% for short and ultrashort, respectively ( value: 0.33). Four implants failed. Covariates were not associated with CSR ( value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant ( values > 0.05). Conclusions. Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region. Giorgio Lombardo, Jacopo Pighi, Mauro Marincola, Giovanni Corrocher, Miguel Simancas-Pallares, and Pier Francesco Nocini Copyright © 2017 Giorgio Lombardo et al. All rights reserved. Periapical Status and Quality of Root Canal Fillings in a Moroccan Subpopulation Wed, 21 Jun 2017 00:00:00 +0000 Aim. The aim of the study was to assess the prevalence of apical periodontitis (AP) and quality of root canal fillings in an adult Moroccan subpopulation. Methods. In the study 508 patients were included, attending the Conservative Dentistry Clinic at the Faculty of Dentistry of Casablanca. 508 panoramic and 709 periapical radiographs were observed. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik’s periapical index. The statistical analysis was performed with the software Epi Info Version 6.04dfr, April 2001. Results. A total of 12719 teeth were examined. 45.3% of patients had apical periodontitis. 4.2% of teeth were treated endodontically and 70.4% of these treatments were inadequate. 91,5% with inadequate endodontic treatment presented apical periodontitis, while only 8,2% with adequate endodontic treatment had apical periodontitis. The lower molars and the upper premolars were the most affected teeth. The presence of apical periodontitis was correlated significantly with insufficient root canal fillings (). Conclusions. The present study found a high prevalence of apical periodontitis in this Moroccan population. Inadequate root canal fillings were associated with an increased prevalence of apical periodontitis. Hafsa El Merini, Hind Amarir, Amine Lamzawaq, and Mouna Hamza Copyright © 2017 Hafsa El Merini et al. All rights reserved. 3D Morphology Analysis of TMJ Articular Eminence in Magnetic Resonance Imaging Wed, 21 Jun 2017 00:00:00 +0000 Purpose. The objective of this study was to evaluate the computational reconstruction of the articular eminence of the temporomandibular joint (TMJ) based on magnetic resonance imaging (MRI) and semiautomatic volumetric segmentation techniques for morphological classification of the TMJ structure. Materials and Methods. A total of 36 MRI scans of TMJ individuals were selected and formatted by using the ITK-SNAP software, consisting of MRI segmentation and generation of 3D models. The TMJ articular eminences were also classified according to the morphology analysis of the articular eminence in 3D reconstructions. Two independent trained and calibrated investigators performed the image analysis, which was repeated after thirty days. Results. There was no association between sex and eminence shape (). Fisher’s test revealed no statistically significant association between disc classification and eminence shape on both sides (). Chi-square test showed a significant statistically association between disc classification and disc displacement (). Intra- and interrater correlation coefficients showed excellent reproducibility values. Conclusions. Anatomical variability of the sample investigated was found, with predominantly round shape and presence of correlation between this shape and normal disc position. The correlation of flattened and convex shapes with disc position reduction indicated that type of disc derangement is more prevalent. Izabella Nascimento Falcão, Maria Beatriz Carrazzone Cal Alonso, Lucas Hian da Silva, Sérgio Lúcio Pereira de Castro Lopes, Lívia Pichi Comar, and André Luiz Ferreira Costa Copyright © 2017 Izabella Nascimento Falcão et al. All rights reserved. A Three-Year Retrospective Study on Survival of Ceramic-Veneered Zirconia (Y-TZP) Fixed Dental Prostheses Performed in Private Practices Tue, 20 Jun 2017 00:00:00 +0000 Objectives. The aim of this retrospective study was to evaluate the three-year clinical outcome for ceramic-veneered zirconia fixed dental prostheses (FDPs). Methods. All patients who were treated with ceramic-veneered zirconia FDPs, in three private practices in Sweden, during the period June 2003 to April 2007 were included. Case records from 151 patients, treated with a total of 184 zirconia FDPs (692 units), were analysed for clinical data. All complications noted in the charts were registered and compared to definitions for success and survival and statistical analysis was performed using the Kaplan-Meier method and a Cox regression model. Results. In total, 32 FDPs in 31 patients experienced some type of complication (17.4% of FDPs, 20.5% of patients). Core fractures occurred in two (1.1%) FDPs. Two (1.1%) FDPs or 0.6% of units showed adhesive veneer fractures. Cohesive veneer fractures occurred in 10 (5.4%) FDPs (1.6% of units). The three-year cumulative success and survival rates (CSR) were 82.3% and 95.2%, respectively. Conclusions. Ceramic-veneered zirconia is a promising alternative to metal-ceramic FDPs, even in the posterior area. However, the higher survival rate of metal-ceramic FDPs should be noted and both dentists and patients must be aware of the risks of complications. Veronika Norström Saarva, Göran Bjerkstig, Anders Örtorp, and Per Svanborg Copyright © 2017 Veronika Norström Saarva et al. All rights reserved. Evaluation of Sensibility Threshold for Interocclusal Thickness of Patients Wearing Complete Dentures Sun, 18 Jun 2017 06:45:32 +0000 Objective. The aim of this study was to evaluate sensibility threshold for interocclusal thickness in experienced and nonexperienced denture wearers after the insertion of new complete dentures. Materials and Methods. A total of 88 patients with complete dentures have participated in this study. The research was divided into two experimental groups, compared with the previous experience prosthetic dental treatment. The sensibility threshold for interocclusal thickness was measured with metal foil with 8 μm thickness and width of 8 mm, placed between the upper and lower incisor region. Statistical analysis was performed using standard software package BMDP (biomedical statistical package). Results. Results suggest that time of measurement affects the average values of the sensibility threshold for interocclusal thickness ( = 242.68, = 0.0000). Gender appeared to be a significant factor when it interacted with time measurement resulting in differences in sensibility threshold for interocclusal thickness (gender: = 9.84, = 0.018; = 4.83, = 0.0003). Conclusion. The sensibility threshold for interocclusal thickness was the most important functional adaptation in patient with complete dentures. A unique trait of this indicator is the progressive reduction of initial values and a tendency to reestablish the stationary state in the fifteenth week after dentures is taken off. Kujtim Sh. Shala, Linda J. Dula, Teuta Pustina-Krasniqi, Teuta Bicaj, Enis F. Ahmedi, Zana Lila-Krasniqi, and Arlinda Tmava-Dragusha Copyright © 2017 Kujtim Sh. Shala et al. All rights reserved. Effect of Mouthwashes on Solubility and Sorption of Restorative Composites Thu, 08 Jun 2017 00:00:00 +0000 Objective. Composites sorption and solubility can be precursors of several chemical and physical processes, which lead to deleterious effects on the polymer structure. This study evaluated the effect of mouthwashes on solubility and sorption of composite resins. Materials and Methods. Forty-two specimens of each evaluated composite (Filtek Bulk Fill Flow, Opallis Flow, Durafill VS, and Filtek Z350) were prepared and randomized into seven groups for each solution (mouth rinses with and without alcohol and distilled water) and stored for seven days. Solubility and sorption tests were performed according to ISO4049. Data were analyzed using 2-way-ANOVA followed by Tukey’s test for means comparison (). In addition, paired -test was performed to analyze the alcohol effect on the studied composite resin properties. Results. Listerine Cool Mint (containing alcohol in its composition) caused the greatest degree of sorption for all composites tested in comparison to other rinses, while for solubility this behavior was observed for Opallis Flow and Durafill VS composite resins (). Regarding the composites, Opallis Flow showed the highest sorption and solubility values in general (). Conclusion. Overall, the sorption and solubility of composites were higher in mouthwashes containing alcohol in its composition, with Opallis Flow being the most affected composite resin. José Pereira Leal, Jaqueline Damasceno da Silva, Rafaelle Fernanda Melão Leal, Carlos da Cunha Oliveira-Júnior, Vera Lúcia Gomes Prado, and Glauber Campos Vale Copyright © 2017 José Pereira Leal et al. All rights reserved. Lymphangiogenesis in Oral Squamous Cell Carcinoma: Correlation with VEGF-C Expression and Lymph Node Metastasis Wed, 07 Jun 2017 00:00:00 +0000 Background. Oral squamous cell carcinoma (OSCC) is the most common oral malignancy that preferentially spreads to the cervical lymph node which, when involved, complicates the anticancer therapy and threatens the patient life. It was suggested that lymph node metastasis may be facilitated by lymphangiogenesis. VEGF-C is one of the most important lymphangiogenic inducers that promotes the lymphatic vessels growth and supports the survival of adult lymphatic endothelial cells. Methods. Lymphatic vessels density (LVD) and LV morphometry were digitally evaluated using D2-40. The expression of VEGF-C was also assessed using immunohistochemistry and real-time polymerase chain reaction in 6 normal oral mucosa cases and 72 cases of OSCC. The correlation between LVD and LV morphometry, VEGF-C, and lymph node metastasis was statistically assessed. Results. A positive cytoplasmic expression of VEGF-C was detected in both epithelial and connective tissue cells in 97% of OSCC, while all normal tissues reacted negatively. A greater expression of VEGF-C was associated with larger and more dilated LV and lymph node metastasis but not with LVD. Conclusion. VEGF-C is actively involved in the invasion and metastasis of OSCC via inducing morphological changes in LV. VEGF-C may be a promising target for anticancer therapy. Manar A. Abdul-Aziz, Amina K. Amin, Dalia H. El-Rouby, and Olfat G. Shaker Copyright © 2017 Manar A. Abdul-Aziz et al. All rights reserved. Subchronic Infection of Porphyromonas gingivalis and Tannerella forsythia Stimulates an Immune Response but Not Arthritis in Experimental Murine Model Tue, 06 Jun 2017 00:00:00 +0000 Studies have proposed that Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf) promote a nonspecific inflammatory response that could produce systemic disease. Oral inoculation of Pg and Tf on the immune and arthritis response was evaluated in BALB/C mice divided into four groups: (1) sham; (2) food contaminated with Pg/Tf; (3) complete Freund’s adjuvant (CFA) + Pg/Tf; and (4) CFA alone. CFA was administered subcutaneously on days 1 and 14. The arthritis response was monitored for 21 days after day 14 of CFA administration. IL-1β and IL-6 were determined in serum. T cell activation was evaluated by CD25 in salivary lymph nodes or mouse spleen. Pad inflammation appeared by day 19 in the CFA group, but animals with bacteria inoculation presented a delay. A significant increase in IL-6 was found in Groups 3 and 4, but not with respect to IL-1β. We observed an increase in CD25 in cells derived from cervical nodes and in animals with bacteria inoculation and CFA. A local immune response was observed in mice inoculated with Pg and Tf (T cell activation); a systemic response was observed with CFA. Since pad inflammation was delayed by bacterial inoculation this suggests that local T cell activation could decrease pad inflammation. Jorday Hernández-Aguas, José Luis Montiel-Hernández, Myriam A. De La Garza-Ramos, Rosa Velia Ruiz-Ramos, Erandi Escamilla García, Mario Alberto Guzmán-García, Esperanza Raquel Ayón-Haro, and Mario Alberto Garza-Elizondo Copyright © 2017 Jorday Hernández-Aguas et al. All rights reserved. Facial Mobility after Maxilla-Mandibular Advancement in Patients with Severe Obstructive Sleep Apnea Syndrome: A Three-Dimensional Study Sun, 04 Jun 2017 00:00:00 +0000 Introduction. The functional results of surgery in terms of facial mobility are key elements in the treatment of patients. Little is actually known about changes in facial mobility following surgical treatment with maxillomandibular advancement (MMA). Objectives. The three-dimensional (3D) methods study of basic facial movements in typical OSAS patients treated with MMA was the topic of the present research. Materials and Methods. Ten patients affected by severe obstructive sleep apnea syndrome (OSAS) were engaged for the study. Their facial surface data was acquired using a 3D laser scanner one week before (T1) and 12 months after (T2) orthognathic surgery. The facial movements were frowning, grimace, smiling, and lip purse. They were described in terms of surface and landmark displacements (mm). The mean landmark displacement was calculated for right and left sides of the face, at T1 and at T2. Results. One year after surgery, facial movements were similar to presurgical registrations. No modifications of symmetry were present. Conclusions. Despite the skeletal maxilla-mandible expansion, orthognathic surgical treatment (MMA) of OSAS patients does not seem to modify facial mobility. Only an enhancement of amplitude in smiling and knitting brows was observed. These results could have reliable medical and surgical applications. Laura Verzé, Francesca Antonella Bianchi, Niccolò Barla, Serena Maria Curti, Giovanni Gerbino, and Guglielmo Amedeo Ramieri Copyright © 2017 Laura Verzé et al. All rights reserved. Infection Control Measures in Private Dental Clinics in Lebanon Wed, 31 May 2017 07:09:38 +0000 Purpose. Evaluate infection control knowledge, attitude, and practice in Lebanese private dental clinics. Materials and Methods. A survey including 46 questions related to routine safety procedures was sent to 1150 Lebanese dentists between July 1st and 2nd, 2015. The study sample was selected from the database of registered dentists based on a proportional random sampling ensuring equitable representation of the 5 geographic regions of Lebanon. A subset of 29 questions was used to generate an overall score of compliance (excellent, good, fair, and poor). Comparisons according to gender, type, region, and years of practice were performed. Results. 417 dentists returned the completed questionnaires. 96% expressed concern about infection transmission, 90.6% were vaccinated against Hepatitis B, and 61.8% asked routinely about patients medical history. Only 43% used protective eyewear. Although most dentists (65%) used autoclaves, dry heat was still used. Significant correlations were found between gender and use of personal protective equipment. Less compliance was shown by clinicians with fewer years of experience. In the overall compliance questionnaire, the mean percentage of correct answers was roughly 54% with <5% of the practitioners scoring “excellent.” Conclusions. The study found inadequacy of compliance in private Lebanese dental clinics necessitating improved educational training and sustained monitoring by regulatory bodies. Jihad Dagher, Charles Sfeir, Ahmad Abdallah, and Zeina Majzoub Copyright © 2017 Jihad Dagher et al. All rights reserved. Regular Dental Visits: Influence on Health-Related Quality of Life in 1,607 Patients with Oral Squamous Cell Carcinoma Tue, 30 May 2017 07:40:20 +0000 Background. The incidence of oral squamous cell carcinoma (OSCC) is in the top 10 of all cancer entities. Regular oral examinations by dentists play an important role in oral cancer prevention. Methods. Patients with OSCC (,607) and physicians (,489) completed questionnaires during the DÖSAK Rehab Study. The psychosocial and functional factors collected in these questionnaires were assessed in the present study. We compared patients who visited their dentist at least once a year (group A) with those who visited their dentist less than once a year (group B). Results. Patients in group A had significantly better health-related quality of life after tumor treatment than patients in group B. Patients in group A also had a smaller tumor size and less lymph node metastasis and lost fewer teeth during the treatment. This resulted in better prosthetic rehabilitation and better psychological status after tumor treatment. Conclusions. Dentists play an important role in the early recognition of oral cancer. This study should encourage dentists to take a more active role in oral cancer prevention. Simon Spalthoff, Henrik Holtmann, Gertrud Krüskemper, Rüdiger Zimmerer, Jörg Handschel, Nils-Claudius Gellrich, and Philipp Jehn Copyright © 2017 Simon Spalthoff et al. All rights reserved. Low Survival Rates of Oral and Oropharyngeal Squamous Cell Carcinoma Tue, 30 May 2017 06:09:30 +0000 Aim. To assess the epidemiological and clinical factors that influence the prognosis of oral and oropharyngeal squamous cell carcinoma (SCC). Methods. One hundred and twenty-one cases of oral and oropharyngeal SCC were selected. The survival curves for each variable were estimated using the Kaplan-Meier method. The Cox regression model was applied to assess the effect of the variables on survival. Results. Cancers at an advanced stage were observed in 103 patients (85.1%). Cancers on the tongue were more frequent (23.1%). The survival analysis was 59.9% in one year, 40.7% in two years, and 27.8% in 5 years. There was a significant low survival rate linked to alcohol intake (), advanced cancer staging (), and procedures without surgery (). When these variables were included in the Cox regression model only surgery procedures () demonstrated a significant effect on survival. Conclusion. The findings suggest that patients who underwent surgery had a greater survival rate compared with those that did not. The low survival rates and the high percentage of patients diagnosed at advanced stages demonstrate that oral and oropharyngeal cancer patients should receive more attention. Anna Carolina Omena Vasconcellos Le Campion, Camila Maria Beder Ribeiro, Ronir Raggio Luiz, Francisco Feliciano da Silva Júnior, Herbert Charles Silva Barros, Karine de Cássia Batista dos Santos, Stefania Jeronimo Ferreira, Lucio Souza Gonçalves, and Sonia Maria Soares Ferreira Copyright © 2017 Anna Carolina Omena Vasconcellos Le Campion et al. 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.