International Journal of Dentistry The latest articles from Hindawi © 2018 , Hindawi Limited . All rights reserved. Soft Lithography and Minimally Human Invasive Technique for Rapid Screening of Oral Biofilm Formation on New Microfabricated Dental Material Surfaces Sun, 14 Jan 2018 00:00:00 +0000 Introduction. Microfabrication offers opportunities to study surface concepts focused to reduce bacterial adhesion on implants using human minimally invasive rapid screening (hMIRS). Wide information is available about cell/biomaterial interactions using eukaryotic and prokaryotic cells on surfaces of dental materials with different topographies, but studies using human being are still limited. Objective. To evaluate a synergy of microfabrication and hMIRS to study the bacterial adhesion on micropatterned surfaces for dental materials. Materials and Methods. Micropatterned and flat surfaces on biomedical PDMS disks were produced by soft lithography. The hMIRS approach was used to evaluate the total oral bacterial adhesion on PDMS surfaces placed in the oral cavity of five volunteers (the study was approved by the University Ethical Committee). After 24 h, the disks were analyzed using MTT assay and light microscopy. Results. In the present pilot study, microwell structures were microfabricated on the PDMS surface via soft lithography with a spacing of 5 µm. Overall, bacterial adhesion did not significantly differ between the flat and micropatterned surfaces. However, individual analysis of two subjects showed greater bacterial adhesion on the micropatterned surfaces than on the flat surfaces. Significance. Microfabrication and hMIRS might be implemented to study the cell/biomaterial interactions for dental materials. Marta Alvarez-Escobar, Sidónio C. Freitas, Derek Hansford, Fernando J. Monteiro, and Alejandro Pelaez-Vargas Copyright © 2018 Marta Alvarez-Escobar et al. All rights reserved. The Role and Impact of Salivary Zn Levels on Dental Caries Sun, 14 Jan 2018 00:00:00 +0000 Introduction. Minimal attention has been given to the role of salivary microelements, the importance they have in reducing the intensity of caries, and the effect of caries prophylaxes. Aim. This research aimed to determine the concentration and quantity of Zn and its impact on the prevention and the reduction of the intensity of caries in schoolchildren aged 12-13 years with permanent dentition. Methods. For this research, we analyzed the stimulated and nonstimulated full saliva of 106 schoolchildren divided into three groups by mean decayed, missing, and filled teeth (DMFT) index. The control group consisted of 25 caries-free children, the second group had 47 children with mean DMFT index of 1 to 6, and the third group had 34 children with DMFT index of ≥ 6. Complete saliva was collected from all children in a sterile test tube. Results. The concentration of Zn in saliva before stimulation in caries-free children has variations of the order of 0.001+ to 0.01 mmol/l. The maximum concentration after stimulation is 6.72 mmol/l, while the maximum value is 64.38 mmol/l. Conclusion. The Zn concentration in the stimulated saliva showed a significant increase in the group of caries-free children and could be described as a positive value for the reduction of caries. Milaim Sejdini, Agim Begzati, Sami Salihu, Sokol Krasniqi, Nora Berisha, and Nora Aliu Copyright © 2018 Milaim Sejdini et al. All rights reserved. Application of D-Amino Acids as Biofilm Dispersing Agent in Dental Unit Waterlines Sun, 14 Jan 2018 00:00:00 +0000 Aim and Purpose. Biofilms in dental unit waterlines (DUWLs) are extremely difficult to eliminate. Aim of this study is to evaluate the efficacy of a mixture of four D-amino acids on biofilm dispersion in DUWLs. Materials and Methods. A mixture of four D-amino acids (D-methionine, D-tryptophan, D-leucine, and D-tyrosine, 10 mM each), distilled water (control), and 0.1 M hydrochloric acid (HCl) was used in the experiment. In laboratory, pieces of DUWLs covered with biofilms were submerged in different solutions for 5 days, flushed, and measured OD600 of the dispersed biofilms. Remnants of biofilms on the DUWLs were evaluated by SEM. In clinic, fifteen DCUs were incubated with test and control solutions, flushed, and measured OD600 of the dispersed biofilms. Microbial count of DUWL output water was enumerated twice a week for four weeks. Results. There was a slight, but not significant, increase in OD600 of flushing water in D-amino acids group. D-amino acids effectively reduced bacterial plaque as demonstrated by SEM. Incubation with D-amino acids significantly reduced biofilms especially after the first day of flushing. Bacterial count in DUWL output water was significantly reduced after treatment with D-amino acids. Conclusion. D-amino acids are applicable as biofilm dispersing agents in DUWLs. Ruchanee Salingcarnboriboon Ampornaramveth, Nilada Akeatichod, Jesita Lertnukkhid, and Nichakorn Songsang Copyright © 2018 Ruchanee Salingcarnboriboon Ampornaramveth et al. All rights reserved. Relationship between the Apical Preparation Diameter and the Apical Seal: An In Vitro Study Wed, 10 Jan 2018 00:00:00 +0000 Objectives. The aim of the study is to define the relationship between the apical preparation diameter and the apical sealing ability to highlight the importance of the preservation of the diameter and the original position of the apical foramen. Materials and Methods. 50 extracted maxillary incisors were randomly allocated into three groups of 15 teeth each (n = 15) according to the apical preparation size: Group 1: finishing file F1 corresponding to size 20 reached the working length (ProTaper Universal system Dentsply®); Group 2: prepared up to size 30 corresponding to finishing file F30; Group 3: prepared up to size 50 corresponding to finishing file F5. Five teeth were assigned to positive and negative control groups. After the filling of the root canals, the teeth were isolated and immersed in a dye solution, then cut longitudinally, photographed, and the dye penetration were calculated using a computer software. Results. Comparison of the three different apical preparation sizes showed no statistically significant differences regarding the apical microleakage. Conclusion. The most important value of the dye penetration was observed in the group with the largest apical diameter. Kaoutar Laslami, Sara Dhoum, Amine El Harchi, and Iman Benkiran Copyright © 2018 Kaoutar Laslami et al. All rights reserved. Efficacy of a Rinse Containing Sea Salt and Lysozyme on Biofilm and Gingival Health in a Group of Young Adults: A Pilot Study Tue, 19 Dec 2017 00:00:00 +0000 Objectives. To evaluate new mouth rinse containing sea salt, xylitol, and lysozyme on biofilm formation and gingival health in a group of young adults. Methods. The subjects were divided into two groups of 15 subjects each: control (A) and experimental group (B). The Turesky modification of Quigley-Hein plaque index was used to evaluate plaque scores while the presence or absence of gingival bleeding was used to determine gingival health. Measurements were done at baseline and at the end of the one-month trial period by one blinded examiner on six representative teeth. Group (A) maintained standardized oral health practices for the duration of the experiment. In addition, group (B) rinsed with a tablespoon of the provided sea salt mouth rinse for 30 seconds once in the morning and at night. After the 30-day trial period, subjects in both groups were reassessed as per baseline. Results. There were no statistically significant differences in the overall reduction from baseline in the mean plaque and gingivitis scores on all surfaces or on individual surfaces. Conclusion. Within the limitations of the study, rinsing with sea salt for thirty days did not affect the gingival and plaque scores in a group of young adults. Jeyaraj Hoover, Eduardo Tovar, Trevor Zlatnik, and Chandima Karunanayake Copyright © 2017 J. Hoover et al. All rights reserved. Osseointegration of a 3D Printed Stemmed Titanium Dental Implant: A Pilot Study Sun, 19 Nov 2017 06:24:28 +0000 In this pilot study, a 3D printed Grade V titanium dental implant with a novel dual-stemmed design was investigated for its biocompatibility in vivo. Both dual-stemmed (n = 12) and conventional stainless steel conical (n = 4) implants were inserted into the tibial metaphysis of New Zealand white rabbits for 3 and 12 weeks and then retrieved with the surrounding bone, fixed, dehydrated, and embedded into epoxy resin. The implants were analyzed using correlative histology, microcomputed tomography, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The histological presence of multinucleated osteoclasts and cuboidal osteoblasts revealed active bone remodeling in the stemmed implant starting at 3 weeks and by 12 weeks in the conventional implant. Bone-implant contact values indicated that the stemmed implants supported bone growth along the implant from the coronal crest at both 3- and 12-week time periods and showed bone growth into microporosities of the 3D printed surface after 12 weeks. In some cases, new bone formation was noted in between the stems of the device. Conventional implants showed mechanical interlocking but did have indications of stress cracking and bone debris. This study demonstrates the comparable biocompatibility of these 3D printed stemmed implants in rabbits up to 12 weeks. James Tedesco, Bryan E. J. Lee, Alex Y. W. Lin, Dakota M. Binkley, Kathleen H. Delaney, Jacek M. Kwiecien, and Kathryn Grandfield Copyright © 2017 James Tedesco et al. All rights reserved. The Effect of Number of Teeth and Chewing Ability on Cognitive Function of Elderly in UAE: A Pilot Study Tue, 14 Nov 2017 09:03:26 +0000 Cognitive decline is one of the major causes of disability among the aging population. The aim of this study was to explore the relationship between oral health parameters (number of teeth, chewing ability, and presence of a denture) and cognitive function in the elderly across the UAE. Fifty persons (age ≥ 60; 71.26 ± 10.23) were enrolled in the study. Cognitive status was assessed using the standardized mini-mental state examination (SMMSE) and accordingly, cognitively normal subjects scoring ≥24 were considered as the control group and cognitively impaired individuals scoring ≤23 were considered as the low scoring group. Chewing ability was examined, number of teeth was noted, and demographical data was collected. The results of this pilot study showed that individuals with low SMMSE scores were significantly less educated () and had fewer number of remaining teeth () and impaired chewing ability (). These results demonstrate a significant link between the number of teeth, chewing ability, and cognitive function. However, this pilot study had its limitations and was the first of its kind in the UAE and Gulf region; therefore, future research addressing the limitations is needed to further explore this association. Zahra Seraj, Dana Al-Najjar, Mohammed Akl, Noorelrahman Aladle, Yousif Altijani, Ahmed Zaki, and Sausan Al Kawas Copyright © 2017 Zahra Seraj et al. All rights reserved. Relative Efficacy of Quercetin Compared with Benzydamine Hydrochloride in Minor Aphthae: A Prospective, Parallel, Double Blind, Active Control, Preliminary Study Mon, 13 Nov 2017 00:00:00 +0000 Background and Objectives. Recurrent aphthous stomatitis is an inflammatory condition present since ancient era wherein numerous treatment modalities have been tried. But complete eradication of the disease has not been possible and hence newer agents are being introduced. One such agent is a flavonoid named quercetin with proven antioxidant, anti-inflammatory, and ulcer healing properties. Methods. 40 patients with minor aphthous ulcers were divided equally into two groups: A and B. Group A patients were advised to apply quercetin gel and Group B patients were advised to take benzydamine hydrochloride mouth wash. Clinical evaluation including assessment of ulcer size and pain score and questionnaire about the acceptability of both the drugs in terms of taste and ease of application was carried out. Each criterion was compared and statistically analyzed. Results. There was statistically significant reduction in the mean score of pain sensation and ulcer area in both the groups. Quercetin showed statistically highly significant ulcer size reduction as compared to benzydamine hydrochloride. Conclusion. From the present study, it is evident that quercetin is safe, well tolerated, and effective therapy which promotes complete ulcer healing in a short duration of time. Maitreyi Pandya, Anupama N. Kalappanavar, Rajeshwari G. Annigeri, and Dhanya S. Rao Copyright © 2017 Maitreyi Pandya et al. All rights reserved. Survey of Screw-Retained versus Cement-Retained Implant Restorations in Saudi Arabia Mon, 30 Oct 2017 07:08:42 +0000 Introduction. Implant-supported prostheses are currently the standard treatment for the replacement of missing teeth and deficiencies. Implant restorations can either be screw-retained, cement-retained, or both. The implant retention system type is typically chosen during the treatment plan. The primary purpose of this study is to investigate the frequency of implant restoration retention systems. Materials and Methods. A five-page questionnaire was sent to private institutes, educational institutes, and governmental hospitals that provide dental services. The data were analyzed using descriptive statistics. Results. Prior to distribution, the surveys were proofread and pilot-tested at the Faculty of Dentistry at Umm Al-Qura University. The surveys were mailed to three groups: private institutes, educational institutes, and governmental hospitals. In total, 120 surveys were distributed and 87 surveys were returned, for a response rate of 73%. This included thirty-six surveys (41.4%) from private institutes, twenty-two surveys (25.3%) from educational institutes, and twenty-nine surveys (33.3%) from governmental hospitals. Conclusions. In general, Astra was cited as the most widely used implant system. In addition, cement-retained restorations were more frequently used than screw-retained restorations. However, dental implant failure was more frequently associated with cement-retained restorations than with screw-retained restorations. Alaa Makke, Abdulwahed Homsi, Montaha Guzaiz, and Abdulrahman Almalki Copyright © 2017 Alaa Makke et al. All rights reserved. A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study Thu, 26 Oct 2017 08:05:10 +0000 Introduction. A playful competition was launched in a primary dental health care system to improve the recording of diagnoses into an electronic patient chart system and to study what diagnoses were used in primary dental care. Methods. This was a longitudinal follow-up study with public sector primary dental care practices in a Finnish city. A one-year-lasting playful competition between the dental care teams was launched and the monthly percentage of dentists’ visits with recorded diagnosis before, during, and after the intervention was recorded. The assessed diagnoses were recorded with the International Classification of Diseases (ICD-10). Results. Before the competition, the level of diagnosis recordings was practically zero. At the end of this intervention, about 25% of the visits had a recorded diagnosis. Two years after the competition, this percentage was 35% without any additional measures. The most frequent diagnoses were dental caries (K02, 38.6%), other diseases of hard tissues of teeth (K03, 14.8%), and diseases of pulp and periapical tissues (K04, 11.4%). Conclusions. Commitment to the idea that recording of diagnoses was beneficial improved the recording of dental diagnoses. However, the diagnoses obtained did not accurately reflect the reputed prevalence of oral diseases in the Finnish population. Jouko Kallio, Timo Kauppila, Lasse Suominen, and Anna Maria Heikkinen Copyright © 2017 Jouko Kallio et al. All rights reserved. Superfast Set, Strong and Less Degradable Mineral Trioxide Aggregate Cement Thu, 19 Oct 2017 10:19:11 +0000 Purpose. Despite the good sealing ability and biocompatibility of mineral trioxide aggregate (MTA), its slow setting, high degradation, and weakness limit its use in surgical endodontics and high stress-bearing areas. This study aimed to develop two new liquids to control these drawbacks. They were prepared from calcium chloride, fumed silica, and hydroxyapatite or calcium phosphate and coded “H” and “P,” respectively. Methods. Portland cement, Grey ProRoot® MTA, and white ProRoot MTA were mixed with distilled water (control) or liquid “H” or “P.” The pH, setting time, degradation rate, leachant/precipitate’ composition, compressive strength, and morphology were assessed. Results. Both liquids maintained MTA’s high alkalinity and reduced the setting time by 1-2 orders of magnitude. Both liquids, H in particular, significantly reduced the degradation rate of Grey ProRoot and White ProRoot MTA®. Calcite has been identified as the main phase of the leachant or precipitate formed during the cement’s degradation. Calcium hydroxide or hydroxyapatite was also identified with Grey ProRoot MTA mixed with H liquid. These liquids also significantly increased the compressive strength with no statistical differences between them; this was associated with the production of dense, consolidated structures. Conclusions. The modified MTA could be used in surgical endodontics and high stress-bearing areas. Abdullah Alqedairi, Carlos A. Muñoz-Viveros, Eugene A. Pantera Jr., Marc Campillo-Funollet, Hussam Alfawaz, Ensanya Ali Abou Neel, and Tariq S. Abuhaimed Copyright © 2017 Abdullah Alqedairi et al. All rights reserved. Antibacterial Effects of Natural Herbal Extracts on Streptococcus mutans: Can They Be Potential Additives in Dentifrices? Thu, 19 Oct 2017 08:19:39 +0000 Background. Many plants or herbs exhibit potent antimicrobial activity against various microorganisms. They have no side effects and presumably act against and modulate the factors that are crucial for microbial survival or their activity. Streptococcus mutans is a pioneer bacteria implicated in dental caries. This study aims to evaluate the antimicrobial activity of garlic bulbs, pudina leaves, and mango and eucalyptus twig extracts on Streptococcus mutans by evaluating their zone of inhibition and determining their minimum inhibitory concentration (MIC). Methods. Microbiological assay (well diffusion method) to determine zone of inhibition against pure forms of Streptococcus mutans was performed. The antibacterial effects of methanolic extracts of mango twigs, eucalyptus twigs, pudina leaves, and garlic bulbs were studied. Test compounds were further evaluated for their MIC. Results. Extracts derived from mango and eucalyptus twigs showed significant antibacterial effects at test concentrations. Pudina and garlic extracts did not show any significant antibacterial effects at similar concentrations. Upon further evaluation of the 2 positive compounds for their MIC, mango twigs demonstrated more antimicrobial potential than eucalyptus twigs at a lower concentration. Conclusion. Our observations indicated that the mango twig extracts possess higher antibacterial effects against Streptococcus mutans than other compounds at specific test concentration. Spoorthi Banavar Ravi, Sudarshini Nirupad, Prashanthi Chippagiri, and Rohit Pandurangappa Copyright © 2017 Spoorthi Banavar Ravi et al. All rights reserved. Detection of Bone Defects Using CBCT Exam in an Italian Population Tue, 17 Oct 2017 00:00:00 +0000 Background. The aim of this study was to evaluate the in vivo incidence and the location of fenestrations in a young Italian population by using CBCT. Materials and Methods. Fifty patients who had previously performed CBCT for planning third molar extraction or orthodontic therapy were selected for the study. No previous dental treatment had been performed on these patients. Overall, 1,395 teeth were evaluated. Root fenestrations were identified according to the definition of Davies and the American Association of Endodontists. Data was collected and statistically analyzed. Results. Fenestrations were observed in 159 teeth out of 1,395 (11% of teeth). In the lower jaw, we found 68 fenestrations (5%) and 91 in the maxilla (6,5%). Incisors were the teeth with the highest incidence of fenestrations. Conclusion. The relative common finding (11%) of fenestration supports the need for CBCT exams before any surgical/implant treatment to avoid complications related to the initial presence of fenestrations. CBCT was found to be an effective and convenient tool for diagnosing fenestration. Gianluca Gambarini, Gabriele Miccoli, Gianfranco Gaimari, Deborah Pompei, Andrea Pilloni, Lucila Piasecki, Dina Al-Sudani, Dario Di Nardo, and Luca Testarelli Copyright © 2017 Gianluca Gambarini et al. All rights reserved. Forensic Age Estimation of Chinese Malaysian Adults by Evaluating Occlusal Tooth Wear Using Modified Kim’s Index Tue, 10 Oct 2017 00:00:00 +0000 Background and Objective. Evaluation of dental attrition is an easy and relatively accurate approach to estimating the age of an adult either ante- or postmortem for some specific population. Dental attrition represents a progressive physiological age change that can be measured using variety of indices to aid as an adjunct in forensic age estimation. Some of the previously proposed indices have their own practical limitations. This paper focuses on using modified Kim’s criteria to score dental attrition to estimate the age of Chinese Malaysian adults and validate it. Methodology. Tooth wear was evaluated on 190 dental models of Chinese Malaysian adults (age range: 20–60 years) using modified Kim’s index to custom-derive a population specific linear equation. The same equation was validated further on new 60 dental casts. Results and Conclusion. Regression analysis revealed good correlation between age and teeth wear and lower standard error of estimate. Test of regression on a test sample ( pairs, age range: 20–60 years) showed insignificant difference between predicted versus the actual age with statistically acceptable mean absolute difference. These data suggest that modified Kim’s index can be used effectively in forensic age estimation. Chai Kit Lu, Margaret Chia Soo Yee, Spoorthi Banavar Ravi, and Rohit Pandurangappa Copyright © 2017 Chai Kit Lu et al. All rights reserved. Validity of Digital Imaging of Fiber-Optic Transillumination in Caries Detection on Proximal Tooth Surfaces Sun, 01 Oct 2017 08:31:46 +0000 Objective. The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI) method in comparison with clinical visual examination (CV) and bitewing (BW) radiography on detecting caries lesions on proximal surfaces of teeth. Materials and Methods. Proximal tooth surfaces of premolars and molars () of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. Results. DIFOTI detected more initial and manifested caries lesions compared with CV and BW. Of the analyzed tooth surfaces, 69.8% were classified as sound by DIFOTI, 80.3% by BW, and 91.6% by CV. Initial caries lesions were found in 21.2% of the surfaces by DIFOTI, in 14.1% by BW, and in 6.2% by CV, whereas the proportions for manifested dental caries lesions were 9.0%, 5.6%, and 2.2%, respectively. The interexaminer agreement regarding the DIFOTI findings between an experienced clinician and a fifth-year dental student was high: for initial and for manifested caries lesions. Conclusions. The noninvasive DIFOTI method seems to offer a potential tool for everyday clinical practice. In clinical use, DIFOTI finds well even initial caries lesions on proximal surfaces, thus providing an instrument for detecting lesions potential for arresting as well as for monitoring the outcome after preventive measures. Marja-Liisa Laitala, Liina Piipari, Noora Sämpi, Maria Korhonen, Paula Pesonen, Tiina Joensuu, and Vuokko Anttonen Copyright © 2017 Marja-Liisa Laitala et al. All rights reserved. Impact of Orthognathic Surgery on Quality of Life in Patients with Dentofacial Deformities Wed, 27 Sep 2017 00:00:00 +0000 The aim of this investigation was to determine the impact of orthognathic surgery on quality of life in patients with dentofacial deformities at immediate presurgery and at 3-week, 3-month, and 6-month intervals following the surgery. Subjects included forty-three 18–40-year-old Iranian orthognathic patients who were referred to private offices in Isfahan. Data collection was performed using the 22-item Orthognathic Quality of Life Questionnaire (OQLQ). Participants completed the questionnaire prior to surgery and 3 weeks, 3 months, and 6 months after it. Differences and correlations were calculated by the two-tailed -test, ANOVA with Repeated Measure test, and the Pearson correlation coefficient. The results showed significant reduction returned to baseline in OQLQ mean scores and aesthetic, awareness, and social subdomains in all 3 intervals after surgery. However oral function domain showed an increase at and then a decrease at next intervals. Maximum and minimum effect size were observed in aesthetic (ES = 0.7) and oral function (ES = 0.3) domain, respectively. Based on the finding of this study, in 6-month interval after surgery, orthognathic surgery causes significant improvements in quality of life in patients with dentofacial deformities as assessed in emotional, psychological, oral function, and social domains and maximum changes occurred in emotional domain. Faezeh Eslamipour, Arash Najimi, Azade Tadayonfard, and Zeinab Azamian Copyright © 2017 Faezeh Eslamipour et al. All rights reserved. Assessment of Elementary School Teachers’ Level of Knowledge and Attitude regarding Traumatic Dental Injuries in the United Arab Emirates Thu, 14 Sep 2017 00:00:00 +0000 Introduction. In this cross-sectional study, the level of knowledge and attitude of elementary school teachers regarding traumatic dental injuries (TDI) were assessed. Materials and Methods. A questionnaire was distributed to 330 elementary school teachers in 30 randomly selected schools in the Emirates of Sharjah and Dubai. The questionnaire collected information on participants’ demographic characteristics, first aid training, and attitude about emergency management of TDI. Results. 292 teachers (88%) completed the questionnaires; of these, 95% were females, and 50% of the participants had first aid training. Knowledge about tooth avulsion was inadequate, and first aid training was not associated with correct responses to management of avulsed teeth . A significantly higher percentage of younger teachers expressed the need for future education on TDI management. A significantly higher percentage of participants who had an educational position (95%) indicated that they did not have enough knowledge regarding TDI compared to physical education teachers (79%) and administrators (87%) . Conclusions. Elementary school teachers in the UAE have a low level of knowledge regarding the management of dental trauma. Educational programs that address TDI are needed and could improve the elementary school teachers’ level of knowledge in emergency management of TDI. Manal A. Awad, Eman AlHammadi, Mariam Malalla, Zainab Maklai, Aisha Tariq, Badria Al-Ali, Alaa Al Jameel, and Hisham El Batawi Copyright © 2017 Manal A. Awad et al. All rights reserved. Demineralized Freeze-Dried Bovine Cortical Bone: Its Potential for Guided Bone Regeneration Membrane Tue, 29 Aug 2017 09:02:57 +0000 Background. Bovine pericardium collagen membrane (BPCM) had been widely used in guided bone regeneration (GBR) whose manufacturing process usually required chemical cross-linking to prolong its biodegradation. However, cross-linking of collagen fibrils was associated with poorer tissue integration and delayed vascular invasion. Objective. This study evaluated the potential of bovine cortical bone collagen membrane for GBR by evaluating its antigenicity potential, cytotoxicity, immune and tissue response, and biodegradation behaviors. Material and Methods. Antigenicity potential of demineralized freeze-dried bovine cortical bone membrane (DFDBCBM) was done with histology-based anticellularity evaluation, while cytotoxicity was analyzed using MTT Assay. Evaluation of immune response, tissue response, and biodegradation was done by randomly implanting DFDBCBM and BPCM in rat’s subcutaneous dorsum. Samples were collected at 2, 5, and 7 days and 7, 14, 21, and 28 days for biocompatibility and tissue response-biodegradation study, respectively. Result. DFDBCBM, histologically, showed no retained cells; however, it showed some level of in vitro cytotoxicity. In vivo study exhibited increased immune response to DFDBCBM in early healing phase; however, normal tissue response and degradation rate were observed up to 4 weeks after DFDBCBM implantation. Conclusion. Demineralized freeze-dried bovine cortical bone membrane showed potential for clinical application; however, it needs to be optimized in its biocompatibility to fulfill all requirements for GBR membrane. David B. Kamadjaja, Achmad Harijadi, Pratiwi Soesilawati, Eny Wahyuni, Nurul Maulidah, Akhsanal Fauzi, Fika Rah Ayu, Roberto Simanjuntak, R. Soesanto, Djodi Asmara, Andra Rizqiawan, Peter Agus, and Coen Pramono Copyright © 2017 David B. Kamadjaja et al. All rights reserved. A Novel Approach to Determine the Prevalence of Type of Soft Palate Using Digital Intraoral Impression Tue, 29 Aug 2017 00:00:00 +0000 Aim. To determine the prevalence of type of soft palate in targeted population. Materials and Methods. Using computer technology in dentistry, intraoral digital scanner, and 3D analysis software tool, study was conducted. 100 patients selected from the outpatient clinics were divided into two groups based on the ages of 20–40 years and 41–60 years with equal ratio of males and females. Each selected patient’s maxillary arch was scanned with intraoral scanner; images so obtained were sectioned in anteroposterior cross section and with the 3D analysis software; the angulation between hard and soft palate was determined. Results. The prevalence of type II soft palate (angulation between hard and soft palate is between 10 and 45 degrees) was highest, 60% in group 1 and 44% in group 2. The difference between genders was statistically significant with value in both the groups, although females had higher angulation compared to the males in all classes of both groups. Conclusions. In targeted population of Aseer Province, Saudi Arabia, the prevalence of type II soft palate was more common, with higher soft palate angulation among females. The advanced age had no effect in the type of soft palate in the region. Saurabh Chaturvedi, Mohamed Khaled Addas, Abdullah Saad Ali Al Humaidi, Abdulrazaq Mohammed Al Qahtani, and Mubarak Daghash Al Qahtani Copyright © 2017 Saurabh Chaturvedi et al. All rights reserved. Analysis of the Chemical Modification of Dental Enamel Submitted to 35% Hydrogen Peroxide “In-Office” Whitening, with or without Calcium Mon, 28 Aug 2017 06:36:13 +0000 Purpose. The purpose of this study was to evaluate changes in calcium and phosphorus content in dental enamel when subjected to “in-office” whitening for an extended time by using a 35% hydrogen peroxide solution, with and without calcium. Materials and Methods. 10 human teeth, from which the roots had been removed, were embedded in epoxy resin, and their surfaces were smoothed. The specimens were divided into two groups; in group 1, a whitening solution without calcium was used, while in group 2, the solution included calcium. Each specimen was evaluated at 6 different points before the bleaching treatment, and these points were reassessed after each session. A total of five sessions were carried out. Concentrations of calcium and phosphorus were measured by using the technique of X-ray fluorescence. Results. After performing a statistical analysis, it was found that there was no statistically significant loss of calcium and phosphorus during the whitening treatment, and the groups showed no statistical differences. Conclusion. Excessive use of hydrogen peroxide, with or without calcium, causes no loss of calcium and phosphorus. Rudá França Moreira, Fábio Pinheiro Santos, Estevão Antero Santos, Ramon Silva dos Santos, Marcelino José dos Anjos, and Mauro Sayão de Miranda Copyright © 2017 Rudá França Moreira et al. All rights reserved. The Influence of Sweet Taste Perception on Dietary Intake in Relation to Dental Caries and BMI in Saudi Arabian Schoolchildren Mon, 21 Aug 2017 06:29:50 +0000 Objectives. The aim of the study was to evaluate the influence of sweet taste perception on dietary habits in Saudi schoolchildren. In addition, the relationship between dietary habits and both caries and BMI was studied. Methods. A cross-sectional observational study comprising 225 schoolchildren aged 13–15 years from Jeddah, Saudi Arabia, was conducted. The consumption frequency of certain food items was analysed from a beverage and snack questionnaire and a three-day estimated dietary record was obtained. The sweet taste perception level was determined as sweet taste threshold (TT) and sweet taste preference (TP). Children were grouped into low, medium, and high, according to their sweet taste perception level. ICDAS and DMFS indices were used for caries registration and anthropometric measurements using BMI were collected. Results. Sweet taste perception was found to be negatively correlated to the number of main meals and positively correlated to both snack and sweet intake occasions. Statistically significant differences were found between the TT and TP groups with regard to the number of main meals and sweet intake (). No significant correlation between the dietary variables and caries or BMI was found. Conclusions. The dietary habits and sweet intake were found to be influenced by the sweet taste perception level, while the relation between the dietary habits and the caries and BMI was found insignificant. Heba Ashi, Guglielmo Campus, Heléne Bertéus Forslund, Waleed Hafiz, Neveen Ahmed, and Peter Lingström Copyright © 2017 Heba Ashi et al. All rights reserved. Influence of the Smile Line on Smile Attractiveness in Short and Long Face Individuals Tue, 08 Aug 2017 08:10:24 +0000 Objectives. The study assessed the impact of facial height on attractiveness of smile, in association with the maxillary gingival display. This research was performed by dental professionals and laypersons. Materials and Methods. Frontal extraoral photographs were captured for both short and long faces. The photographs were modified using software for image-processing and three rater groups (orthodontists, dentists, and laypersons) evaluated the smile attractiveness, with 30 subjects in each group. Differences in ratings of the different smiles among the different experimental groups were examined using the Kruskal-Wallis test. The Mann–Whitney U test was performed for pairwise comparisons between the experimental groups. Results. Dentists and laypeople were most likely to agree. For the short face, laypeople and dentists both rated the +2 mm gingival display smile as the most attractive smile whilst orthodontists ranked the 0 mm gingival display smile as the most attractive smile. For the long face, laypeople and dentists ranked the 0 mm gingival display smile as the most attractive smile, whilst orthodontists ranked the +2 mm gingival display as the most attractive. Conclusion. Smile line of both short and long face subjects was found to influence the smile attractiveness rating by the three rater groups. Amjad Al Taki, Thar Hayder Mohammed, and Ahmad Mohammad Hamdan Copyright © 2017 Amjad Al Taki et al. All rights reserved. An Analysis of Patient Perceptions and Expectations to Dental Implants: Is There a Significant Effect on Long-Term Satisfaction Levels? Tue, 08 Aug 2017 06:30:59 +0000 Here we present an analysis of patient perceptions and expectations to dental implant placement and their prosthetic reconstruction, to then consider whether they have an effect on long-term satisfaction levels. A Post-Treatment Completion Questionnaire was designed to analyse whether patient satisfaction is influenced by age and/or gender; has an effect on patient-reported self-confidence levels; contributes to increased levels of oral hygiene; provides further insight into the average pain levels during and after the surgical intervention; or influences further acceptance of dental implant surgery. And then whether relationships exist between any of these factors. 182 consecutive patients completed the survey: 68 males and 114 females (age mean 64.68 years ± 11.23 SD); the average number of months since treatment completion was 37.4 (males) and 62.6 (females). There is a significant relationship between comfort rating and “how well informed” the patient was (). A significantly positive relationship exists between “considering dental implants in the future” and “overall experience” (). A significantly positive relationship exists between “overall satisfaction with appearance” and “satisfaction with comfort” (). A significant relationship exists between “overall satisfaction with appearance,” “satisfaction with comfort,” and “overall satisfaction with experience” (). The results amplify the need to transmit logical, truthful information to patients when dental implant treatment is being considered. The “fully informed” patient will have realistic expectations that lead to high degrees of satisfaction. Shane J. J. McCrea Copyright © 2017 Shane J. J. McCrea. All rights reserved. Morse Taper Connection Implants Placed in Grafted Sinuses in 65 Patients: A Retrospective Clinical Study with 10 Years of Follow-Up Mon, 07 Aug 2017 09:07:34 +0000 Purpose. To investigate the 10-year survival and complication rates of Morse taper connection implants (MTCIs) placed in grafted sinuses. Methods. This study reports on patients treated with maxillary sinus augmentation (with the lateral window technique (LWT) or the transalveolar osteotomy technique (TOT)) and installed with MTCIs supporting fixed restorations (single crowns (SCs) and fixed partial dentures (FPDs)), in two dental clinics. The outcomes of the study were the 10-year implant survival and complication rates. Results. Sixty-five patients (30 males and 35 females) with a mean age of 62.7 (±10.2) years were installed with 142 MTCIs: 79 fixtures were inserted with the LWT and 63 were placed with the TOT. After ten years, five implants failed, for an overall survival rate of 96.5%. Three implants failed in the LWT group, for a survival rate of 96.3%; two implants failed in the TOT group, for a survival rate of 96.9%. The 10-year incidence of biologic complications was 11.9%. Prosthetic complications were all technical in nature and amounted to 7.6%. Conclusions. MTCIs seem to represent a successful procedure for the prosthetic restoration of the grafted posterior maxilla, in the long term. This study was registered in the ISRCTN registry with number ISRCTN30772506. Francesco Mangano, Renata Bakaj, Irene Frezzato, Alberto Frezzato, Sergio Montini, and Carlo Mangano Copyright © 2017 Francesco Mangano et al. All rights reserved. Analyzing Menton Deviation in Posteroanterior Cephalogram in Early Detection of Temporomandibular Disorder Sun, 06 Aug 2017 00:00:00 +0000 Introduction. Some clinicians believed that mandibular deviation leads to facial asymmetry and it also had a correlation with temporomandibular disorders (TMDs). Posteroanterior (PA) cephalogram was widely reported as a regular record in treating facial asymmetry and craniofacial anomalies. The objective of this study was to analyze the relationship of menton deviation in PA cephalogram with temporomandibular disorders (TMDs) symptoms. Materials and Methods. TMJ function was initially screened based on TMD-DI questionnaire. PA cephalogram of volunteer subjects with TMDs () and without TMDs () with mean age of years was taken. The menton deviation was measured by the distance (mm) from menton point to midsagittal reference (MSR) horizontally, using software digitized measurement, and categorized as asymmetric if the value is greater than 3 mm. The prevalence and difference of menton deviation in both groups were evaluated by unpaired -test. Result. The prevalence of symmetry group showed that 65.9% had no TMDs with mean of 1,815 ± 0,71 mm; in contrast, the prevalence of asymmetry group showed that 95.5% reported TMDs with mean of 3,159 ± 1,053 mm. There was a significant difference of menton deviation to TMDs () in subjects with and without TMDs. Conclusion. There was a significant relationship of menton deviation in PA cephalogram with TMDs based on TMD-DI index. Trelia Boel, Ervina Sofyanti, and Erliera Sufarnap Copyright © 2017 Trelia Boel et al. All rights reserved. The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses Tue, 01 Aug 2017 00:00:00 +0000 Purpose. To present a new intraoral welding technique, which can be used to manufacture screw-retained, mandibular fixed full-arch prostheses. Methods. Over a 4-year period, all patients with complete mandibular edentulism or irreparably compromised mandibular dentition, who will restore the masticatory function with a fixed mandibular prosthesis, were considered for inclusion in this study. The “Ball Welding Bar” (BWB) technique is characterised by smooth prosthetic cylinders, interconnected by means of titanium bars which are adjustable in terms of distance from ball terminals and are inserted in the rotating rings of the cylinders. All the components are welded and self-posing. Results. Forty-two patients (18 males; 24 females; mean age years) were enrolled and 210 fixtures were inserted to support 42 mandibular screw-retained, fixed full-arch prostheses. After two years of loading, 2 fixtures were lost, for an implant survival rate of 97.7%. Five implants suffered from peri-implant mucositis and 3 implants for peri-implantitis. Three of the prostheses (3/42) required repair for fracture (7.1%): the prosthetic success was 92.9%. Conclusions. The BWB technique seems to represent a reliable technique for the fabrication of screw-retained mandibular fixed full-arch prostheses. This study was registered in the ISRCTN register with number ISRCTN71229338. Danilo Bacchiocchi and Andrea Guida Copyright © 2017 Danilo Bacchiocchi and Andrea Guida. All rights reserved. Missing Teeth and Prosthetic Treatment in Patients Treated at College of Dentistry, University of Dammam Sun, 30 Jul 2017 07:51:56 +0000 The percentage of completely and partially edentulous patients and their prosthetic treatment at the Department of Substitutive Dental Sciences (SDS), College of Dentistry, University of Dammam, were investigated. Panoramic radiographs and medical records of adult patients (, mean age 45.9 years, and range 25–96 years) treated in 2011–2014 were examined. 6% of the patients were completely edentulous, 8% had single jaw edentulousness, and 74% were partially edentulous. Edentulousness was significantly correlated with age and the number of missing teeth was significantly higher among males (). Diabetes was significantly associated with complete edentulousness, single edentulous jaw ( value 0.015), and partial edentulousness ( value 0.023). Kennedy class III was the most frequent class of partial edentulousness in single and/or both jaws (). Patients having class I and/or class II were treated most often with removable partial dentures (RPD) (), while patients having class III were treated with fixed partial dentures (FPD). It was found that complete edentulousness increases in older age and the number of missing teeth was significantly higher among males. Kennedy class III was most common in both upper and lower jaw and was treated more often with FPD than with RPD. Shaimaa M. Fouda, Fahad A. Al-Harbi, Soban Q. Khan, Jorma I. Virtanen, and Aune Raustia Copyright © 2017 Shaimaa M. Fouda et al. All rights reserved. How Intraday Index Changes Influence Periodontal Assessment: A Preliminary Study Sun, 30 Jul 2017 07:17:06 +0000 It is reputed that periodontal indices remain unchanged over a 24-hour period, with great clinical significance. This preliminary study analyzes daily index changes. In 56 selected patients, full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), periodontal screening and recording (PSR) indices, and periodontal risk assessment (PRA) were recorded at baseline and three times per day (check-I: 08.30, check-II: 11.30, and check-III: 14.30), after appropriate cause-related therapy. Correlation between variables was statistically analyzed by Stata. All periodontal indices improved at the examination phase. Statistical differences were detected for FMPS comparing all thrice daily checks. Statistical differences were detected for FMBS and PRA comparing check-III with check-I and check-II. PSR showed no significant changes. The worst baseline indices produced the widest daily fluctuation at the examination phase. Significant variation of indices is directly related to clinical severity of periodontal conditions at baseline. Patients affected by severe periodontal disease may show significantly greater index changes. As indices are routinely recorded only once per day, the index daily variation has clinical significance. This greatly affects therapeutic strategy as correct periodontal assessment requires multiple evaluations at standardized times, particularly when baseline conditions are severe. Carlo Bertoldi, Andrea Forabosco, Michele Lalla, Luigi Generali, Davide Zaffe, and Pierpaolo Cortellini Copyright © 2017 Carlo Bertoldi et al. All rights reserved. Diagnosis of Oral Hairy Leukoplakia: The Importance of EBV In Situ Hybridization Mon, 17 Jul 2017 07:18:09 +0000 Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV), which has been related to HIV infection. In situ hybridization (ISH) is the gold-standard diagnosis of OHL, but some authors believe in the possibility of performing the diagnosis based on clinical basis. The aim of this study is diagnose incipient lesions of OHL by EBV ISH of HIV-infected patients and the possible correlations with clinical characteristics of the patients. Ninety-four patients were examined and those presenting with clinical lesions compatible to OHL were submitted to biopsy prior to EBV ISH. Twenty-eight patients had lesions clinically compatible to the diagnosis of OHL, but only 20 lesions were confirmed by EBV ISH. The patients with OHL had a mean age of 41.9 years and were HIV-infected for 11.2 years, on average, including CD4 count of 504.7 cells/mm3 and log10 viral load = 1.1. Among the quantitative variables, there was a statistically significant correlation with age only (). In conclusion, the presence of OHL in patients with HIV/AIDS results in changes in the epidemiological characteristics of the disease, and this fact allied with subtle clinical-morphological features makes clinical diagnosis very difficult. Therefore, EBV ISH is important for a definitive diagnosis of OHL. Luana L. Martins, José Henrique F. Rosseto, Natália Silva Andrade, Juliana Bertoldi Franco, Paulo Henrique Braz-Silva, and Karem L. Ortega Copyright © 2017 Luana L. Martins et al. All rights reserved. Specific Central Nervous System Medications Are Associated with Temporomandibular Joint Symptoms Sun, 16 Jul 2017 00:00:00 +0000 Aims. There is evidence of association between bruxism and the increasingly common central nervous system stimulants prescribed for attention deficit hyperactivity disorder (ADHD), as well as the selective serotonin reuptake inhibitors (SSRIs) often prescribed for depression or anxiety. However, the evidence is not clear on whether these medications inducing bruxism are directly associated with temporomandibular joint disorder (TMD). The aim of this work is to evaluate whether these medications are associated with TMD symptoms. Methods. Medical history and participant data were obtained for 469 patients from the University of Pittsburgh School of Dental Medicine, Dental Registry and DNA Repository, dating back to 2006. The chi-square test was used to determine any statistically significant associations. Results. There were no statistically significant associations between ADHD stimulant medications or SSRIs and reported TMD symptoms. However, there were significant differences seen between specific brands of medications and reported TMD symptoms. Individuals prescribed methylphenidate (Concerta) were less likely to report temporomandibular joint discomfort (). Conversely, individuals prescribed citalopram (Celexa) were more likely to report temporomandibular joint discomfort (). Conclusion. Signs and symptoms of temporomandibular joint dysfunction may be influenced by the use of certain medications prescribed for depression or attention deficit hyperactive disorder. John K. Drisdale III, Monica G. Thornhill, and Alexandre R. Vieira Copyright © 2017 John K. Drisdale III et al. All rights reserved.