International Journal of Dentistry The latest articles from Hindawi © 2017 , Hindawi Limited . 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. Chlorhexidine Prevents Root Dentine Mineral Loss and Fracture Caused by Calcium Hydroxide over Time Sun, 30 Apr 2017 12:36:31 +0000 Purpose. To evaluate the mineral ion loss of root dentine after treatment with 2% chlorhexidine solution (CHX) and to compare its yield and flexural strength (fs) after exposure to calcium hydroxide [Ca(OH)2]. Materials and Methods. Dentine bars (DB) were made from 90 roots of bovine incisors and randomized into three groups: : distilled/deionized water (DDW), : 2.5% sodium hypochlorite + 17% EDTA, and : CHX + DDW. The release of phosphate (PO4) and calcium (Ca) ions was measured by spectrophotometry. The DB were exposed to Ca(OH)2 paste for 0, 30, 90, and 180 days. DB were subjected to the three-point bending test to obtain yield and fs values. The fracture patterns were evaluated (20x). Data were analyzed using Kruskal-Wallis and Dunn’s post hoc tests or one- and two-way ANOVA followed by Tukey’s post hoc test (). Results. showed lower and Ca2+ ionic release than (). For yield and fs, in all periods (), except for yield strength values on 90 days (). A larger frequency of vertical fractures was observed in and that of oblique fractures in (). Conclusions. CHX prevented and Ca2+ loss and showed a tendency to preserve the yield and fs of root dentine over time following exposure to Ca(OH)2 paste. Michael Ranniery Garcia Ribeiro, Érika Bárbara Abreu Fonseca Thomaz, Darlon Martins Lima, Tarcísio Jorge Leitão, José Bauer, and Soraia De Fátima Carvalho Souza Copyright © 2017 Michael Ranniery Garcia Ribeiro et al. All rights reserved. Genetic Factors and the Risk of Periodontitis Development: Findings from a Systematic Review Composed of 13 Studies of Meta-Analysis with 71,531 Participants Wed, 26 Apr 2017 00:00:00 +0000 Purpose. This work aimed to synthesize the results of recent meta-analysis focusing on polymorphism in inflammatory mediators and its relation with the risk of periodontitis development. Materials and Methods. A systematic search was conducted using databases for publications prior to October 2016. Three examiners extracted data from articles with a clear association between polymorphisms in the inflammatory mediator gene and the development of periodontitis through meta-analysis using the fixed or randomized statistical models to calculate the Odds Ratio with values of considered significant. Results. A total of 13 meta-analysis articles with 25 polymorphisms in seven interleukins (IL-1A, IL-1B, IL-4, IL-6, IL-8, IL-10, and IL-18), three cellular receptors (Fcγ receptors: FCGR2A, FCGR3A, and FCGR3B), and five inflammatory mediators (COX-2, MMP-2, MMP-3, MMP-8, and MMP-9), with a total of 71,531 participants, approaching different classifications of the disease. Conclusion. The study demonstrated that polymorphisms in the IL-1A, IL-1B, IL-6, IL-10, MMP-3 (chronic form), and MMP-9 (chronic form) polymorphisms were significantly associated with the risk of developing periodontitis, whereas other polymorphisms in the IL-4, IL-8, IL-18, Fcγ, COX-2, MMP-2, MMP-3 (aggressive), MMP-8, and MMP-9 (aggressive) polymorphisms had no significant association with risk of developing periodontitis. Maélson Klever da Silva, Antonio Carlos Gonçalves de Carvalho, Even Herlany Pereira Alves, Felipe Rodolfo Pereira da Silva, Larissa dos Santos Pessoa, and Daniel Fernando Pereira Vasconcelos Copyright © 2017 Maélson Klever da Silva et al. All rights reserved. Food Simulating Organic Solvents for Evaluating Crosslink Density of Bulk Fill Composite Resin Wed, 12 Apr 2017 00:00:00 +0000 Objectives. To evaluate crosslink densities of two bulk fill composite resins and determine if the used Food Simulating Organic Solvent (FSOS) affected them. Methods. Forty specimens were prepared from SureFill and SonicFill bulk fill composite resins, 20 each. All specimens were stored dry for 24 h. Each group was divided into 2 subgroups: stored in ethanol (E) 75% or in methyl ethyl ketone (MEK) 100% for 24 h. Crosslink density was evaluated by calculating the difference between the Vickers hardness numbers of the specimens stored dry and after their storage in FSOS. The data were statistically analyzed using -test. Results. The means of crosslink density in E and MEK were 6.99% and 9.44% for SureFill and 10.54% and 11.92% for SonicFill, respectively. -test displayed significant differences between crosslink densities of SureFill and SonicFill: () in E and () in MEK and between crosslink densities of SureFill in E and MEK (). Conclusions. Crosslink density of bulk fill composite resin can be evaluated using E or MEK. SureFill has higher crosslink density than SonicFill in both E and MEK. Neveen M. Ayad, Hala A. Bahgat, Eman Hussain Al Kaba, and Maryam Hussain Buholayka Copyright © 2017 Neveen M. Ayad et al. All rights reserved. Comparative Assessment of Preoperative versus Postoperative Dexamethasone on Postoperative Complications following Lower Third Molar Surgical Extraction Mon, 10 Apr 2017 00:00:00 +0000 Aim. To evaluate the effect of preoperative versus postoperative administration of oral Dexamethasone on postoperative complications including pain, edema, and trismus following lower third molar surgery. Methods. 24 patients were divided into two equal groups receiving 8 mg Dexamethasone orally, one group one hour preoperatively and the other group immediately after surgery. Pain was measured using VAS, edema was measured using a graduated tape between 4 fixed points in the face, and the mouth opening was measured using a graduated sliding caliper. Results. In this study pain and trismus records were similar and statistically nonsignificant in both groups. The results had proven that preoperative administration was superior when compared to postoperative administration regarding edema (0.002). Conclusions. Preoperative oral administration of 8 mg Dexamethasone was superior to the postoperative administration of the same dose concerning edema after lower third molar surgery. Hashem M. Al-Shamiri, Maha Shawky, and Nermin Hassanein Copyright © 2017 Hashem M. Al-Shamiri et al. All rights reserved. Characterization of Chronic Mechanical Irritation in Oral Cancer Thu, 06 Apr 2017 07:59:32 +0000 Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% () presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa. Jerónimo P. Lazos, Eduardo D. Piemonte, Hector Eduardo Lanfranchi, and Mabel N. Brunotto Copyright © 2017 Jerónimo P. Lazos et al. All rights reserved. Bovine Tooth Discoloration Induced by Endodontic Filling Materials for Primary Teeth Wed, 05 Apr 2017 00:00:00 +0000 Objective. This study evaluated the discoloration potential of endodontic materials used in primary teeth. Material and Methods. Dentine-enamel blocks were prepared from 75 bovine teeth, assorted in five experimental groups (). The tested materials included an MTA-based material; zinc oxide and eugenol cement (ZOE); Vitapex; and calcium hydroxide thickened with zinc oxide (Calen + ZO). The color measurements were performed using a spectrophotometer at the following intervals: prior to (T0) and after placement of the filling (T1) and after 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5), and 9 months (T6). Data were submitted to ANOVA with repeated measures and Tukey’s test. Results. The time had a significant effect on the color variation () (). The effect of the materials on the color variation () was statistically significant (). Interactions between time and materials demonstrated a significant effect on the values () (). The ZOE cement showed the highest darkening effect (). Conclusion. The MTA-based material showed the smallest discoloration during the experimental time; however, it was similar to the other materials and to the control group. Zinc oxide and eugenol showed higher discoloration. Samantha Rodrigues Xavier, Katerine Jahnecke Pilownic, Andressa Heberle Gastmann, Mariana Silveira Echeverria, Ana Regina Romano, and Fernanda Geraldo Pappen Copyright © 2017 Samantha Rodrigues Xavier et al. All rights reserved. 3D Evaluation of Maxillary Sinus Using Computed Tomography: A Sexual Dimorphic Study Tue, 04 Apr 2017 06:41:06 +0000 Purpose. Gender determination is considered to be an important step in the reconstruction of the biological profile in forensic medicine. Maxillary sinus can be used for identification of sex when other methods are indecisive. Computed tomography (CT) provides an excellent method for examining maxillary sinuses. Hence the aim of the study was to determine the accuracy of gender determination using maxillary sinus with CT. Materials and Methods. CT images were used to measure the mediolateral, superoinferior, and anteroposterior dimensions and the volume of the maxillary sinuses in 100 patients (50 males and 50 females) to determine the gender of an individual for forensic identification. Discriminative analysis was done using the values derived and the -test for independent samples was used to compare these values in males and females. Results. The accuracy rate was found to be 84% in males and 92% in females with the mean accuracy of 88%. Conclusion. Our study concludes that gender determination can be done using measurements of maxillary sinus through CT when other methods are unavailable. The prediction rate can be increased by including volume of the maxillary sinus. Balaji Babu Bangi, Uday Ginjupally, Lakshmi Kavitha Nadendla, and Bhavana Vadla Copyright © 2017 Balaji Babu Bangi et al. All rights reserved. Medical and Periodontal Clinical Parameters in Patients at Different Levels of Chronic Renal Failure Mon, 03 Apr 2017 08:13:31 +0000 Aim. To assess the clinical periodontal and medical parameters in patients with chronic renal failure (CRF) at different levels of renal disease. Background. CRF is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues that shows high prevalence in patients with CRF. Materials and Methods. 102 CRF patients were included and divided into an early stage group (EG), predialysis group (PDG), and hemodialysis group (HDG). The medical parameters were taken from the patients’ records. Results. Periodontal clinical condition differed among the CRF groups. Clinical attachment loss was greater in the HDG and PDG group compared to the EG (); the same was observed in the Plaque Index (); the others periodontal parameters did not show any differences. Ferritin levels were significantly higher in the HDG when compared to the EG and PGD (), and fibrinogen was higher in PDG compared with the others (); the triglycerides also showed higher values in the HDG compared with the other groups (). Conclusion. The patients with renal involvement should have a multidisciplinary approach to an improvement in their oral and systemic health. Caroline Perozini, Gilson Fernandes Ruivo, Lucilene Hernandes Ricardo, Larissa Avance Pavesi, Yeon Jung Kim, and Debora Pallos Copyright © 2017 Caroline Perozini et al. All rights reserved.