International Journal of Dentistry The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Biological Effects of Medicinal Plants on Induced Periodontitis: A Systematic Review Wed, 21 Sep 2016 10:06:48 +0000 Objective. The aim of this systematic review was to investigate the advances in the study of medicinal plants and their biologic effects on periodontitis in animal models. Study Design. A systematic search was conducted by three independent researchers, who screened articles published up to March/2016, to identify the studies that contained sufficient and clear information on the association of the medicinal plants and periodontitis in murine models. The searches were performed using PubMed, Cochrane, and Science Direct databases. Results. After a critical analysis of titles and abstracts, 30 studies were finally eligible for analysis. The studies presented a great diversity of the experiment designed regarding the methods of induced periodontitis and the evaluation of the medicinal plants efficacy. None of the studies described the possible toxic effects associated with the administration of the plant material to animals and whether they could prevent damage to organs caused by systemic effect of induced periodontitis. Gel-based formulations containing plant substances are seen as an interesting strategy to treat periodontitis. Conclusions. In this systematic review, the state-of-the-art knowledge on the medicinal plants and the induced periodontitis was critically evaluated and discussed from the experiment designed to the possible clinical application. Jefferson Soares de Oliveira, Moara e Silva Conceição Pinto, Lucas de Araújo de Bastos Santana, Antonione Santos Bezerra Pinto, David di Lenardo, and Daniel Fernando Pereira Vasconcelos Copyright © 2016 Jefferson Soares de Oliveira et al. All rights reserved. Correlation between Microleakage and Absolute Marginal Discrepancy in Zirconia Crowns Cemented with Four Resin Luting Cements: An In Vitro Study Sun, 18 Sep 2016 14:24:50 +0000 Objectives. To evaluate microleakage and absolute marginal discrepancy (AMD) and to assess correlation between AMD and microleakage with four resin luting cements. Material and Methods. 20 extracted human third molars were prepared for full-coverage crowns. 20 zirconia copings were made (LAVA, 3M ESPE) and cemented. Specimens were randomly allocated for each used type of cement into 4 groups, RelyX® (Rx), Multilink® (Mk), PANAVIA 2.1® (P), and Maxcem® (Mx) and immersed in 10% safranin for 72 hours. 20x magnification lenses were used to observe microleakage areas (μm2) and images software was used to measure AMD areas (μm). Discrepancy and microleakage between the cements were compared with one-way ANOVA test with confidence interval of 95%. Results. Rx Group showed microleakage has lowest value and AMD has highest value. P Group showed microleakage has the highest value and Mk Group presented AMD has lowest value. There were no significative differences between the cements. There were no linear correlations between microleakage and AMD; however a complex regression statistical model obtained allowed formulating an association between both variables (microleakage = ). Conclusions. No significative differences were found among 4 types of cements. No linear correlations between AMD and microleakage were found. Clinical Significance. AMD is not easily related to microleakage. Characteristics of cements are fundamental to decreasing of microleakage values. Abad-Coronel Cristian, Li Jeanette, Martínez-Rus Francisco, and Pradíes Guillermo Copyright © 2016 Abad-Coronel Cristian et al. All rights reserved. Corrigendum to “A Study of Success Rate of Miniscrew Implants as Temporary Anchorage Devices in Singapore” Sun, 18 Sep 2016 07:39:24 +0000 Yi Lin Song, Mimi Yow, Ming Tak Chew, Kelvin Weng Chiong Foong, and Hung Chew Wong Copyright © 2016 Yi Lin Song et al. All rights reserved. PCR-Based Identification of Oral Streptococcal Species Wed, 14 Sep 2016 11:57:48 +0000 The microbial etiology of dental caries is still debated. Among the hypothesized contributors are the “low pH streptococci,” a designation given to unusually acid proficient strains among the primary plaque colonizers S. oralis, S. mitis, S. gordonii, and S. anginosus. However, accurate assignment of species is difficult among the oral streptococci. Our objective was to develop a streamlined method for identifying strains of S. oralis and S. mitis from plaque samples so that they could be analyzed in a separate study devoted to low pH streptococci and caries. Two independent PCR amplifications of a locus highly conserved among streptococci were used for presumptive species identification. Multilocus sequence analysis (MLSA) was used to measure accuracy. Sensitivity was 100% for selecting S. oralis and S. mitis among the clones sampled. Specificity was good except for the most closely related species that could not be reliably distinguished even by MLSA. The results with S. oralis and S. mitis were used to identify new primer sets that expanded the utility of the approach to other oral streptococcal species. These novel primer sets offer a convenient means of presumptive identification that will have utility in many studies where large scale, in-depth genomic analyses are not practical. Jeffrey A. Banas, Min Zhu, Deborah V. Dawson, Huojun Cao, and Steven M. Levy Copyright © 2016 Jeffrey A. Banas et al. All rights reserved. Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints Sun, 21 Aug 2016 10:02:11 +0000 Objective. To provide a comprehensive overview of published evidence on the impact of erythritol, a noncaloric polyol bulk sweetener, on oral health. Methods. A literature review was conducted regarding the potential effects of erythritol on dental plaque (biofilm), dental caries, and periodontal therapy. The efficacy of erythritol on oral health was compared with xylitol and sorbitol. Results. Erythritol effectively decreased weight of dental plaque and adherence of common streptococcal oral bacteria to tooth surfaces, inhibited growth and activity of associated bacteria like S. mutans, decreased expression of bacterial genes involved in sucrose metabolism, reduced the overall number of dental caries, and served as a suitable matrix for subgingival air-polishing to replace traditional root scaling. Conclusions. Important differences were reported in the effect of individual polyols on oral health. The current review provides evidence demonstrating better efficacy of erythritol compared to sorbitol and xylitol to maintain and improve oral health. Peter de Cock, Kauko Mäkinen, Eino Honkala, Mare Saag, Elke Kennepohl, and Alex Eapen Copyright © 2016 Peter de Cock et al. All rights reserved. “Digitally Oriented Materials”: Focus on Lithium Disilicate Ceramics Thu, 18 Aug 2016 14:14:02 +0000 The present paper was aimed at reporting the state of the art about lithium disilicate ceramics. The physical, mechanical, and optical properties of this material were reviewed as well as the manufacturing processes, the results of in vitro and in vivo investigations related to survival and success rates over time, and hints for the clinical indications in the light of the latest literature data. Due to excellent optical properties, high mechanical resistance, restorative versatility, and different manufacturing techniques, lithium disilicate can be considered to date one of the most promising dental materials in Digital Dentistry. Fernando Zarone, Marco Ferrari, Francesco Guido Mangano, Renato Leone, and Roberto Sorrentino Copyright © 2016 Fernando Zarone et al. All rights reserved. Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial Sun, 14 Aug 2016 13:42:50 +0000 The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing. Material and Methods. This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively. Results. Test and control sites were compared using paired t-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results. Conclusion. Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar. Hani Arakji, Mohamed Shokry, and Nayer Aboelsaad Copyright © 2016 Hani Arakji et al. All rights reserved. Frequency and Influencing Factors of Rubber Dam Usage in Tianjin: A Questionnaire Survey Sun, 31 Jul 2016 06:30:09 +0000 Objective. To investigate the frequency and influencing factors of rubber dam usage for endodontic procedures among general dentistry practitioners and specialized practitioners (endodontist) in Tianjin. Methods. Three hundred questionnaires were distributed among practitioners from 3 different types of medical institutions in Tianjin. Data were collected and analysed using Chi-square tests. Results. There were 63.3% of respondents who have used rubber dam (response rate 82.7%, valid response rate 76.3%). However, only 0.4% and 3.1% of them recognized using rubber dam “every time” during caries direct restoration and root canal therapy, respectively. There was no significant difference in rubber dam usage between male and female practitioners. Among the respondents, practitioners with working experience between 5 and 10 years showed the highest usage rate (76.3%), while practitioners working more than 20 years showed the lowest (53.2%). The endodontists gained the highest and the most frequent usage rate and the best rubber dam technique mastering skills. Practitioners working in those stomatological departments of general hospitals showed the lowest rubber dam usage rate. Conclusions. The prevalence of rubber dam usage in Tianjin city is still low. The practitioner’s gender, years of professional experience, general or specialized field, and the type of dental setting they work for are the factors that need to be considered during making policy and executing training. Huiru Zou, Yanni Li, Xiaoli Lian, Yan Yan, Xiaohua Dai, and Guanhua Wang Copyright © 2016 Huiru Zou et al. All rights reserved. Estimate of Impact on the Oral Health-Related Quality of Life of Older Thai People by the Provision of Dentures through the Royal Project Tue, 26 Jul 2016 14:16:52 +0000 Purpose. To estimate the impact of the provision of dentures to Thai older people by the Royal Project on their oral health-related quality of life. Methods. A purposive cross-sectional study of a sample of 812 subjects was conducted. The Oral Impacts on Daily Performances (OIDP) measure was used to assess the oral health-related quality of life. Results. Four groups of older people with different tooth types were studied. 216 (26.6%) had natural teeth (NT). 189 (23.3%) had natural and replaced teeth (NRT). 167 (20.6%) had below the minimum number of teeth but had no dentures (Edent) and 240 were edentate with complete dentures provided by the Royal Project (ECD) (29.6%). Overall, 36.5% had at least one oral impact. Eating was the most affected oral impact. When compared to the group with natural teeth (NT), the Edent group was significantly more likely to report having impacts on eating OR = 6.5 (3.9–10.9), speaking clearly OR = 43.7 (12.7–15.07), emotional stability OR = 16.5 (6.0–45.6), and social contacts OR = 4.6 (2.2–9.5) (). Conclusion. Those who are edentulous are much more likely to have an oral impact on their daily performances than those provided dentures. Provision of dentures may lead to improvement of considerable oral impacts. Patcharawan Srisilapanan, Narumanas Korwanich, Sutha Jienmaneechotchai, Supranee Dalodom, Nontalee Veerachai, Warangkana Vejvitee, and Jeffrey Roseman Copyright © 2016 Patcharawan Srisilapanan et al. All rights reserved. Prevalence of Dental Caries in Kosovar Adult Population Tue, 19 Jul 2016 12:42:37 +0000 Objectives. The aim of this study was to assess the prevalence of dental caries in the Kosovar adult population. Materials and Methods. A cross-sectional study in Kosovo was conducted examining 9387 patients, aged 18 upwards, between January 2010 and December 2011. Clinical evaluation was done using WHO criteria for evaluation of dental health status and data collection. Results. The prevalence of caries for the whole study was 72.80%. The mean DMFT index was 9.61 (±5.12) in the 18–34-year age group, 11.6 (±6.42) in the 35–44-year age group, 13.68 (±8.12) among the 45–64-year age group, 17.98 (±9.81) in the 65–74-year age group, and 23.19 (±9.41) in the age group of 75+ years, respectively. A significant difference of mean DMFT and its each component was observed between the ages (). Conclusion. This study comes out with the significant levels of dental caries among young Kosovar population (18–34 years old). Blerim Kamberi, Ferit Koçani, Agim Begzati, Jeta Kelmendi, Donika Ilijazi, Nora Berisha, and Lumnije Kqiku Copyright © 2016 Blerim Kamberi et al. All rights reserved. Bacterial Adhesion and Surface Roughness for Different Clinical Techniques for Acrylic Polymethyl Methacrylate Tue, 19 Jul 2016 08:59:46 +0000 This study sought to assess the effect of different surface finishing and polishing protocols on the surface roughness and bacterial adhesion (S. sanguinis) to polymethyl methacrylates (PMMA). Fifty specimens were divided into 5 groups () according to their fabrication method and surface finishing protocol: LP (3 : 1 ratio and laboratory polishing), NF (Nealon technique and finishing), NP (Nealon technique and manual polishing), MF (3 : 1 ratio and manual finishing), and MP (3 : 1 ratio and manual polishing). For each group, five specimens were submitted to bacterial adhesion tests and analyzed by scanning electron microscopy (SEM). Two additional specimens were subjected to surface topography analysis by SEM and the remaining three specimens were subjected to surface roughness measurements. Data were compared by one-way ANOVA. The mean bacterial counts were as follows: NF, ; MP, ; NP, ; MF, ; and LP, (CFU). The mean surface roughness values were as follows: NF, ; MP, ; NP, ; MF, ; and LP, (m). A reduction in the surface roughness was observed to be directly related to a decrease in bacterial adhesion. It was verified that the laboratory processing of PMMA might decrease the surface roughness and consequently the adhesion of S. sanguinis to this material. Lucas Costa de Medeiros Dantas, João Paulo da Silva-Neto, Talita Souza Dantas, Lucas Zago Naves, Flávio Domingues das Neves, and Adérito Soares da Mota Copyright © 2016 Lucas Costa de Medeiros Dantas et al. All rights reserved. From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients Thu, 14 Jul 2016 16:15:13 +0000 Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT), the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA) temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy) and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results. Giorgio Andrea Dolcini, Marco Colombo, and Carlo Mangano Copyright © 2016 Giorgio Andrea Dolcini et al. All rights reserved. A New Total Digital Smile Planning Technique (3D-DSP) to Fabricate CAD-CAM Mockups for Esthetic Crowns and Veneers Sun, 10 Jul 2016 10:20:19 +0000 Purpose. Recently, the request of patients is changed in terms of not only esthetic but also previsualization therapy planning. The aim of this study is to evaluate a new 3D-CAD-CAM digital planning technique that uses a total digital smile process. Materials and Methods. Study participants included 28 adult dental patients, aged 19 to 53 years, with no oral, periodontal, or systemic diseases. For each patient, 3 intra- and extraoral pictures and intraoral digital impressions were taken. The digital images improved from the 2D Digital Smile System software and the scanner stereolithographic (STL) file was matched into the 3D-Digital Smile System to obtain a virtual previsualization of teeth and smile design. Then, the mockups were milled using a CAM system. Minimally invasive preparation was carried out on the enamel surface with the mockups as position guides. Results. The patients found both the digital smile design previsualization (64.3%) and the milling mockup test (85.7%) very effective. Conclusions. The new total 3D digital planning technique is a predictably and minimally invasive technique, allows easy diagnosis, and improves the communication with the patient and helps to reduce the working time and the errors usually associated with the classical prosthodontic manual step. F. Cattoni, F. Mastrangelo, E. F. Gherlone, and G. Gastaldi Copyright © 2016 F. Cattoni et al. All rights reserved. Incidental Findings on Cone Beam Computed Tomography Studies outside of the Maxillofacial Skeleton Mon, 04 Jul 2016 09:44:56 +0000 Objective. To define the presence and prevalence of incidental findings in and around the base of skull from large field-of-view CBCT of the maxillofacial region and to determine their clinical importance. Methods. Four hundred consecutive large fields of view CBCT scans viewed from January 1, 2007, to January 1, 2014, were retrospectively evaluated for incidental findings of the cervical vertebrae and surrounding structures. Findings were categorized into cervical vertebrae, intracranial, soft tissue, airway, carotid artery, lymph node, and skull base findings. Results. A total of 653 incidental findings were identified in 309 of the 400 CBCT scans. The most prevalent incidental findings were soft tissue calcifications (29.71%), followed by intracranial calcifications (27.11%), cervical vertebrae (20.06%), airway (11.49%), external carotid artery calcification (10.41%), lymph node calcification (0.77%), subcutaneous tissue calcification and calcified tendonitis of the longus colli muscle (0.3%), and skull base finding (0.15%). A significant portion of the incidental findings (31.24%) required referral, 17.76% required monitoring, and 51% did not require either. Conclusion. A comprehensive review of the CBCT images beyond the region of interest, especially incidental findings in the base of skull, cervical vertebrae, pharyngeal airway, and soft tissue, is necessary to avoid overlooking clinically significant lesions. Sevin Barghan, Mehrnaz Tahmasbi Arashlow, and Madhu K. Nair Copyright © 2016 Sevin Barghan et al. All rights reserved. Esthetic Concerns and Acceptability of Treatment Modalities in Primary Teeth: A Comparison between Children and Their Parents Wed, 29 Jun 2016 10:44:44 +0000 Background and Aim. Esthetic concerns in primary teeth have been studied mainly from the point of view of parents. The aim of this study was to study compare the opinions of children aged 5–8 years to have an opinion regarding the changes in appearance of their teeth due to dental caries and the materials used to restore those teeth. Methodology. A total of 107 children and both of their parents (), who were seeking dental treatment, were included in this study. A tool comprising a questionnaire and pictures of carious lesions and their treatment arranged in the form of a presentation was validated and tested on 20 children and their parents. The validated tool was then tested on all participants. Results. Children had acceptable validity statistics for the tool suggesting that they were able to make informed decisions regarding esthetic restorations. There was no difference between the responses of the children and their parents on most points. Zirconia crowns appeared to be the most acceptable full coverage restoration for primary anterior teeth among both children and their parents. Conclusion. Within the limitations of the study it can be concluded that children in their sixth year of life are capable of appreciating the esthetics of the restorations for their anterior teeth. Sharat Chandra Pani, Abdulrahman Al Saffan, Sultan AlHobail, Fares Bin Salem, AlBara AlFuraih, and Mohammad AlTamimi Copyright © 2016 Sharat Chandra Pani et al. All rights reserved. Radiological Evaluation of Penetration of the Irrigant according to Three Endodontic Irrigation Techniques Tue, 28 Jun 2016 15:05:41 +0000 Introduction. This experimental study is to compare radiographs based on the penetration depth of the irrigant following three final irrigation techniques. Material and Method. A sample of sixty teeth with single roots were prepared with stainless steel K files followed by mechanized Ni-Ti files iRace® under irrigation with 2.5% sodium hypochlorite. Radiopaque solution was utilized to measure the penetration depth of the irrigant. Three irrigation techniques were performed during this study: (i) passive irrigation, (ii) manually activated irrigation, and (iii) passive irrigation with an endodontic needle CANAL CLEAN®. Radiographs were performed to measure the length of irrigant penetration in each technique. Results. In comparison, passive irrigation with a conventional syringe showed infiltration of the irrigant by an average of , whereas the manually activated irrigation technique indicated an average of infiltration. Irrigation with an endodontic syringe showed an average infiltration of . The results revealed highly significant difference between the three irrigation techniques (%). Conclusion. Adding manual activation to the irrigant improved the result by 20%. This study indicates that passive irrigation with an endodontic needle has proved to be the most effective irrigation technique of the canal system. Said Dhaimy, Sara Imdary, Sara Dhoum, Imane Benkiran, and Amal El Ouazzani Copyright © 2016 Said Dhaimy et al. All rights reserved. The Antimicrobial Photodynamic Therapy in the Treatment of Peri-Implantitis Sun, 26 Jun 2016 12:01:40 +0000 Introduction. The aim of this study is to demonstrate the effectiveness of addition of the antimicrobial photodynamic therapy to the conventional approach in the treatment of peri-implantitis. Materials and Methods. Forty patients were randomly assigned to test or control groups. Patients were assessed at baseline and at six (T1), twelve (T2), and twenty-four (T3) weeks recording plaque index (PlI), probing pocket depth (PPD), and bleeding on probing (BOP); control group received conventional periodontal therapy, while test group received photodynamic therapy in addition to it. Result. Test group showed a 70% reduction in the plaque index values and a 60% reduction in PD values compared to the baseline. BOP and suppuration were not detectable. Control group showed a significative reduction in plaque index and PD. Discussion. Laser therapy has some advantages in comparison to traditional therapy, with faster and greater healing of the wound. Conclusion. Test group showed after 24 weeks a better value in terms of PPD, BOP, and PlI, with an average pocket depth value of 2 mm, if compared with control group (3 mm). Our results suggest that antimicrobial photodynamic therapy with diode laser and phenothiazine chloride represents a reliable adjunctive treatment to conventional therapy. Photodynamic therapy should, however, be considered a coadjuvant in the treatment of peri-implantitis associated with mechanical (scaling) and surgical (grafts) treatments. Umberto Romeo, Gianna Maria Nardi, Fabrizio Libotte, Silvia Sabatini, Gaspare Palaia, and Felice Roberto Grassi Copyright © 2016 Umberto Romeo et al. All rights reserved. Color Stability of the Bulk-Fill Composite Resins with Different Thickness in Response to Coffee/Water Immersion Tue, 14 Jun 2016 09:10:22 +0000 We aimed to evaluate the color stability of bulk-fill and conventional composite resin with respect to thickness and storage media. Twenty specimens of a conventional composite resin (6 mm diameter and 2 mm thick) and 40 specimens of the bulk-fill Tetric EvoCeram composite resin at two different thicknesses (6 mm diameter and 2 mm thick or 4 mm thick, ) were prepared. The specimens were stored in distilled water during the study period (28 d). Half of the specimens were remained in distilled water and the other half were immersed in coffee solution 20 min/d and kept in distilled water between the cycles. Color changes () were measured using the CIE color space and a digital imaging system at 1, 7, 14, and 28 days of storage. Data were analyzed using Two-way ANOVA and Tukey’s HSD post hoc test (). Composite resins showed significant increase in color changes by time (bulk-fill > conventional; ). Coffee exhibited significantly more staining susceptibility than that of distilled water (). There was greater color changes with increasing the increment thickness, which was significant at 14 () and 28 d (). Color change of bulk-fill composite resin was greater than that of the conventional one after coffee staining and is also a function of increment thicknesses. Sayna Shamszadeh, Seyedeh Mahsa Sheikh-Al-Eslamian, Elham Hasani, Ahmad Najafi Abrandabadi, and Narges Panahandeh Copyright © 2016 Sayna Shamszadeh et al. All rights reserved. 3D-Printed Scaffolds and Biomaterials: Review of Alveolar Bone Augmentation and Periodontal Regeneration Applications Sun, 05 Jun 2016 13:30:02 +0000 To ensure a successful dental implant therapy, the presence of adequate vertical and horizontal alveolar bone is fundamental. However, an insufficient amount of alveolar ridge in both dimensions is often encountered in dental practice due to the consequences of oral diseases and tooth loss. Although postextraction socket preservation has been adopted to lessen the need for such invasive approaches, it utilizes bone grafting materials, which have limitations that could negatively affect the quality of bone formation. To overcome the drawbacks of routinely employed grafting materials, bone graft substitutes such as 3D scaffolds have been recently investigated in the dental field. In this review, we highlight different biomaterials suitable for 3D scaffold fabrication, with a focus on “3D-printed” ones as bone graft substitutes that might be convenient for various applications related to implant therapy. We also briefly discuss their possible adoption for periodontal regeneration. Farah Asa’ad, Giorgio Pagni, Sophia P. Pilipchuk, Aldo Bruno Giannì, William V. Giannobile, and Giulio Rasperini Copyright © 2016 Farah Asa’ad et al. All rights reserved. The Reinforcement Effect of Nano-Zirconia on the Transverse Strength of Repaired Acrylic Denture Base Thu, 02 Jun 2016 06:14:00 +0000 Objective. The aim of this study was to evaluate the effect of incorporation of glass fiber, zirconia, and nano-zirconia on the transverse strength of repaired denture base. Materials and Methods. Eighty specimens of heat polymerized acrylic resin were prepared and randomly divided into eight groups (): one intact group (control) and seven repaired groups. One group was repaired with autopolymerized resin while the other six groups were repaired using autopolymerized resin reinforced with 2 wt% or 5 wt% glass fiber, zirconia, or nano-zirconia particles. A three-point bending test was used to measure the transverse strength. The results were analyzed using SPSS and repeated measure ANOVA and post hoc least significance (LSD) test (). Results. Among repaired groups it was found that autopolymerized resin reinforced with 2 or 5 wt% nano-zirconia showed the highest transverse strength (). Repairs with autopolymerized acrylic resin reinforced with 5 wt% zirconia showed the lowest transverse strength value. There was no significant difference between the groups repaired with repair resin without reinforcement, 2 wt% zirconia, and glass fiber reinforced resin. Conclusion. Reinforcing of repair material with nano-zirconia may significantly improve the transverse strength of some fractured denture base polymers. Mohammed Gad, Aws S. ArRejaie, Mohamed Saber Abdel-Halim, and Ahmed Rahoma Copyright © 2016 Mohammed Gad et al. All rights reserved. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up Sun, 29 May 2016 14:08:30 +0000 This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. Samy Tunchel, Alberto Blay, Roni Kolerman, Eitan Mijiritsky, and Jamil Awad Shibli Copyright © 2016 Samy Tunchel et al. All rights reserved. Correlation Assessment between Three-Dimensional Facial Soft Tissue Scan and Lateral Cephalometric Radiography in Orthodontic Diagnosis Sun, 29 May 2016 11:53:06 +0000 Purpose. The aim of the present prospective study was to investigate correlations between 3D facial soft tissue scan and lateral cephalometric radiography measurements. Materials and Methods. The study sample comprised 312 subjects of Caucasian ethnic origin. Exclusion criteria were all the craniofacial anomalies, noticeable asymmetries, and previous or current orthodontic treatment. A cephalometric analysis was developed employing 11 soft tissue landmarks and 14 sagittal and 14 vertical angular measurements corresponding to skeletal cephalometric variables. Cephalometric analyses on lateral cephalometric radiographies were performed for all subjects. The measurements were analysed in terms of their reliability and gender-age specific differences. Then, the soft tissue values were analysed for any correlations with lateral cephalometric radiography variables using Pearson correlation coefficient analysis. Results. Low, medium, and high correlations were found for sagittal and vertical measurements. Sagittal measurements seemed to be more reliable in providing a soft tissue diagnosis than vertical measurements. Conclusions. Sagittal parameters seemed to be more reliable in providing a soft tissue diagnosis similar to lateral cephalometric radiography. Vertical soft tissue measurements meanwhile showed a little less correlation with the corresponding cephalometric values perhaps due to the low reproducibility of cranial base and mandibular landmarks. Piero Antonio Zecca, Rosamaria Fastuca, Matteo Beretta, Alberto Caprioglio, and Aldo Macchi Copyright © 2016 Piero Antonio Zecca et al. All rights reserved. Soft Tissue Stability around Single Implants Inserted to Replace Maxillary Lateral Incisors: A 3D Evaluation Thu, 19 May 2016 14:14:33 +0000 Purpose. To evaluate the soft tissue stability around single implants inserted to replace maxillary lateral incisors, using an innovative 3D method. Methods. We have used reverse-engineering software for the superimposition of 3D surface models of the dentogingival structures, obtained from intraoral scans of the same patients taken at the delivery of the final crown (S1) and 2 years later (S2). The assessment of soft tissues changes was performed via calculation of the Euclidean surface distances between the 3D models, after the superimposition of S2 on S1; colour maps were used for quantification of changes. Results. Twenty patients (8 males, 12 females) were selected, 10 with a failing/nonrestorable lateral incisor (test group: immediate placement in postextraction socket) and 10 with a missing lateral incisor (control group: conventional placement in healed ridge). Each patient received one immediately loaded implant (Anyridge®, Megagen, Gyeongbuk, South Korea). The superimposition of the 3D surface models taken at different times (S2 over S1) revealed a mean (±SD) reduction of 0.057 mm (±0.025) and 0.037 mm (±0.020) for test and control patients, respectively. This difference was not statistically significant (p = 0.069). Conclusions. The superimposition of the 3D surface models revealed an excellent peri-implant soft tissue stability in both groups of patients, with minimal changes registered along time. F. G. Mangano, F. Luongo, G. Picciocchi, C. Mortellaro, K. B. Park, and C. Mangano Copyright © 2016 F. G. Mangano et al. All rights reserved. The Use of Narrow Diameter Implants in the Molar Area Wed, 11 May 2016 12:53:19 +0000 Implant rehabilitations in the posterior jaw are influenced by many factors such as the condition of the remaining teeth, the force factors related to the patient, the quality of the bone, the maintenance of the hygiene, the limited bone height, the type and extent of edentulism, and the nature of the opposing arch. The gold standard is to place a regular diameter implant (>3.7 mm) or a wide one to replace every missing molar. Unfortunately, due to horizontal bone resorption, this option is not possible without lateral bone augmentation. In this situation, narrow diameter implant (NDI < 3.5 mm) could be the alternative to lateral bone augmentation procedures. This paper presents a clinical study where NDIs were used for the replacement of missing molars. They were followed up to 11 years. Special considerations were observed and many parameters were evaluated. NDI could be used to replace missing molar in case of moderate horizontal bone resorption if strict guidelines are respected. Yet, future controlled prospective clinical trials are required to admit their use as scientific evidence. M. Saad, A. Assaf, and E. Gerges Copyright © 2016 M. Saad et al. All rights reserved. ATP Bioluminometers Analysis on the Surfaces of Removable Orthodontic Aligners after the Use of Different Cleaning Methods Sun, 08 May 2016 08:46:59 +0000 Purpose. The aim was to quantify the bacteria concentration on the surface of orthodontic clear aligners using three different cleaning methods. Furthermore the objective was to validate the efficacy of the bioluminometer in assessing the bacteria concentration. Materials and Methods. Twenty subjects (six males and fourteen females) undergoing orthodontic therapy with clear aligners (Invisalign® Align Technology, Santa Clara, California) were enrolled in this study. The observation time was of six weeks. The patients were instructed to use different cleaning methods (water, brushing with toothpaste, and brushing with toothpaste and use of sodium carbonate and sulphate tablet). At the end of each phase a microbiological analysis was performed using the bioluminometer. Results. The highest bacteria concentration was found on aligners cleaned using only water (583 relative light units); a value of 189 relative light units was found on aligners cleaned with brushing and toothpaste. The lowest bacteria concentration was recorded on aligners cleaned with brushing and toothpaste and the use of sodium carbonate and sulfate tablet. Conclusions. The mechanical removal of the bacterial biofilm proved to be effective with brushing and toothpaste. The best results in terms of bacteria concentration were achieved adding the use of sodium carbonate and sulfate tablet. Luca Levrini, Alessandro Mangano, Silvia Margherini, Camilla Tenconi, Davide Vigetti, Raffaele Muollo, and Gian Marco Abbate Copyright © 2016 Luca Levrini et al. All rights reserved. A Patient Specific Biomechanical Analysis of Custom Root Analogue Implant Designs on Alveolar Bone Stress: A Finite Element Study Wed, 04 May 2016 11:22:10 +0000 Objectives. The aim of this study was to analyse by means of FEA the influence of 5 custom RAI designs on stress distribution of peri-implant bone and to evaluate the impact on microdisplacement for a specific patient case. Materials and Methods. A 3D surface model of a RAI for the upper right canine was constructed from the cone beam computed tomography data of one patient. Subsequently, five (targeted) press-fit design modification FE models with five congruent bone models were designed: “Standard,” “Prism,” “Fins,” “Plug,” and “Bulbs,” respectively. Preprocessor software was applied to mesh the models. Two loads were applied: an oblique force (300 N) and a vertical force (150 N). Analysis was performed to evaluate stress distributions and deformed contact separation at the peri-implant region. Results. The lowest von Mises stress levels were numerically observed for the Plug design. The lowest levels of contact separation were measured in the Fins model followed by the Bulbs design. Conclusions. Within the limitations of the applied methodology, adding targeted press-fit geometry to the RAI standard design will have a positive effect on stress distribution, lower concentration of bone stress, and will provide a better primary stability for this patient specific case. David Anssari Moin, Bassam Hassan, and Daniel Wismeijer Copyright © 2016 David Anssari Moin et al. All rights reserved. Applicative Characteristics of a New Zirconia Bracket with Multiple Slots Sun, 24 Apr 2016 15:32:48 +0000 We have developed a new orthodontic bracket with three slots with lubricative properties on the working surfaces and proposed a new orthodontic treatment system employing 0.012−0.014-inch Ni-Ti arch wires. We recruited 54 patients, of which 27 received treatment with the new zirconia bracket with multiple slots system (M group), and the others received treatment with standard edge-wise appliances (control group [C group]). We compared the (1) tooth movement rate at the early stage of leveling; (2) changes in the dental arch morphology before and after leveling; and (3) pain caused by orthodontic treatment. Student’s -test was used in all assessments. The tooth movement rate in the maxillomandibular dentition was higher in the M group. The basal arch width, anterior length, and the intercanine width in the maxillary dentition were not significantly different in the two groups; however, the intercanine width in the mandibular dentition was higher in the C group. In assessments of treatment-related pain, the visual analogue pain score was 56.0 mm and 22.6 mm in the C and M groups, respectively. A new zirconia bracket with multiple slots system provided better outcomes with respect to tooth movement rate, treatment period, and postoperative pain, thus indicating its effectiveness over conventional orthodontic systems. Koutaro Maki, Katsuyoshi Futaki, Satoru Tanabe, Mariko Takahashi, Yuta Ichikawa, and Tetsutaro Yamaguchi Copyright © 2016 Koutaro Maki et al. All rights reserved. Detection of Carious Lesions and Restorations Using Particle Swarm Optimization Algorithm Wed, 20 Apr 2016 06:59:25 +0000 Background/Purpose. In terms of the detection of tooth diagnosis, no intelligent detection has been done up till now. Dentists just look at images and then they can detect the diagnosis position in tooth based on their experiences. Using new technologies, scientists will implement detection and repair of tooth diagnosis intelligently. In this paper, we have introduced one intelligent method for detection using particle swarm optimization (PSO) and our mathematical formulation. This method was applied to 2D special images. Using developing of our method, we can detect tooth diagnosis for all of 2D and 3D images. Materials and Methods. In recent years, it is possible to implement intelligent processing of images by high efficiency optimization algorithms in many applications especially for detection of dental caries and restoration without human intervention. In the present work, we explain PSO algorithm with our detection formula for detection of dental caries and restoration. Also image processing helped us to implement our method. And to do so, pictures taken by digital radiography systems of tooth are used. Results and Conclusion. We implement some mathematics formula for fitness of PSO. Our results show that this method can detect dental caries and restoration in digital radiography pictures with the good convergence. In fact, the error rate of this method was 8%, so that it can be implemented for detection of dental caries and restoration. Using some parameters, it is possible that the error rate can be even reduced below 0.5%. Mohammad Naebi, Eshaghali Saberi, Sirous Risbaf Fakour, Ahmad Naebi, Somayeh Hosseini Tabatabaei, Somayeh Ansari Moghadam, Elham Bozorgmehr, Nasim Davtalab Behnam, and Hamidreza Azimi Copyright © 2016 Mohammad Naebi et al. All rights reserved. Consecutive Case Series of Healed Single-Molar Sites Immediately Restored with Wide-Diameter Implants: A 1-Year Evaluation Mon, 18 Apr 2016 11:00:23 +0000 Introduction. To evaluate outcomes of wide-diameter (6 mm) implants immediately provisionalized with cement-retained single crowns in posterior molar sites. Materials and Methods. Forty-eight consecutive patients received a total of 53 moderately rough-surface, 6 mm diameter implants in healed sites. All implants were immediately provisionalized with a cement-retained provisional crown. Final prosthesis with cement-retained porcelain fused to metal crowns was delivered 3–6 months later. Patients were followed up for 1 year. Outcome measures were implant failures and success rate, complications, marginal bone levels, bone level changes, papilla index, bleeding on probing, and inflammation. Results. One patient was lost to follow-up. At one year, the implant survival and success rate were 98.1%. The mean marginal bone loss after 1 year was − mm. Ideal papilla score was recorded at 83.8% of the sites. More than 95.6% of the sites showed no bleeding or inflammation. No procedure-related or device-related adverse events were reported. Conclusion. Wide-diameter (6 mm) implants can safely and successfully replace single posterior molars. Longer follow-up studies are necessary to evaluate the long-term success of these implants. Hadi Antoun, Pierre Cherfane, and Bouchra Sojod Copyright © 2016 Hadi Antoun et al. All rights reserved. Minimally Invasive Alveolar Ridge Preservation Utilizing an In Situ Hardening β-Tricalcium Phosphate Bone Substitute: A Multicenter Case Series Thu, 14 Apr 2016 11:34:40 +0000 Ridge preservation measures, which include the filling of extraction sockets with bone substitutes, have been shown to reduce ridge resorption, while methods that do not require primary soft tissue closure minimize patient morbidity and decrease surgical time and cost. In a case series of 10 patients requiring single extraction, in situ hardening beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) were utilized as a grafting material that does not necessitate primary wound closure. After 4 months, clinical observations revealed excellent soft tissue healing without loss of attached gingiva in all cases. At reentry for implant placement, bone core biopsies were obtained and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological and histomorphometrical analysis revealed pronounced bone regeneration (24.4 ± 7.9% new bone) in parallel to the resorption of the grafting material (12.9 ± 7.7% graft material) while high levels of primary implant stability were recorded. Within the limits of this case series, the results suggest that β-TCP coated with polylactide can support new bone formation at postextraction sockets, while the properties of the material improve the handling and produce a stable and porous bone substitute scaffold in situ, facilitating the application of noninvasive surgical techniques. Minas D. Leventis, Peter Fairbairn, Ashish Kakar, Angelos D. Leventis, Vasileios Margaritis, Walter Lückerath, Robert A. Horowitz, Bappanadu H. Rao, Annette Lindner, and Heiner Nagursky Copyright © 2016 Minas D. Leventis et al. All rights reserved.