International Journal of Dentistry The latest articles from Hindawi © 2017 , Hindawi Limited . 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. Effect of Anatomical Customization of the Fiber Post on the Bond Strength of a Self-Adhesive Resin Cement Thu, 13 Jul 2017 09:17:36 +0000 Aim. The aim of the study was to evaluate, by means of the push-out test, the effect of the anatomical customization of the fiber post on the bond strength of a self-adhesive resin cement. Methods. Twelve endodontically treated, human, upper central incisors were randomly divided into two groups (): control (glass fiber posts cemented with Relyx® U200) and customized (glass fiber posts anatomically customized with translucent composite resin cemented with Relyx U200). The roots were sectioned into three slices, cervical, middle, and apical, and photographed with a digital camera attached to a stereomicroscopic loupe. The images were analyzed by software, for evaluation of the cement line. The slices were subsequently submitted to the push-out test until the post had completely extruded, and the fracture mode was analyzed with a stereomicroscopic loupe. Results. The results showed significant differences between the groups in the different root thirds in relation to the area occupied by air bubbles (). Bond strength, when all the thirds are considered, was 8.77 ± 4.89 MPa for the control group and 16.96 ± 4.85 MPa for the customized group. Conclusion. The customized group showed greater bond resistance than the control group and a more uniform cement layer. Adricyla Teixeira Rocha, Leticia Machado Gonçalves, Ana Júlia de Carvalho Vasconcelos, Etevaldo Matos Maia Filho, Ceci Nunes Carvalho, and Rudys Rodolfo De Jesus Tavarez Copyright © 2017 Adricyla Teixeira Rocha et al. All rights reserved. Incidence of Tooth Loss in Adults: A 4-Year Population-Based Prospective Cohort Study Wed, 12 Jul 2017 08:13:16 +0000 Objective. To verify the incidence of tooth loss in extended age group of adults in 4 years. Materials and Methods. The prospective cohort study assessed adults (20–64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20–44 years old) and older (45–64 years old) adults. Mann–Whitney U test () was used to compare the means of incidence of tooth loss between age groups. Results. After four years, 57.7% () of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (). Conclusion. There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated. Manoelito Ferreira Silva-Junior, Marília Jesus Batista, and Maria da Luz Rosário de Sousa Copyright © 2017 Manoelito Ferreira Silva-Junior et al. All rights reserved. Estimation of Antioxidant Levels in Saliva and Serum of Chronic Periodontitis Patients with and without Ischemic Heart Disease Tue, 11 Jul 2017 10:22:17 +0000 Objective. To investigate whether there is a relationship between periodontitis and ischemic heart disease by estimation of total antioxidant status in saliva and serum. Materials and Methods. A total of 80 samples were collected and divided equally into 4 groups of healthy controls, chronic periodontitis patients, ischemic heart disease patients with periodontitis, and ischemic heart disease patients without periodontitis. Saliva and venous blood samples were collected and analyzed for levels of total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and catalase. Results. There were significant () differences in the mean serum levels of total antioxidant capacity (), superoxide dismutase (), glutathione peroxidase (), and catalase () within the 4 groups, whereas the mean salivary levels were significant only for glutathione peroxidase (). Both of these serum and salivary antioxidant levels were lower in disease groups of IHD + CP, IHD + H, and CP as compared to healthy controls, with different patterns. Conclusion. Antioxidant capacity is significantly hampered in chronic periodontitis and ischemic heart disease patients with or without periodontitis as compared to healthy controls. The salivary and serum antioxidants may not follow the same increase or decrease as a result of increased oxidant stress due to disease. Anahita Punj, Santhosh Shenoy, N. Suchetha Kumari, and Priyanka Pampani Copyright © 2017 Anahita Punj et al. All rights reserved. Peripheral Exophytic Oral Lesions: A Clinical Decision Tree Wed, 05 Jul 2017 06:59:08 +0000 Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method. Hamed Mortazavi, Yaser Safi, Maryam Baharvand, Somayeh Rahmani, and Soudeh Jafari Copyright © 2017 Hamed Mortazavi et al. All rights reserved. Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease Sun, 02 Jul 2017 10:01:04 +0000 Background. Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatments is supported by strong clinical evidence. Objective. This systematic review aims to determine the clinical efficacy and safety of topical corticosteroids for the management of the mucosal alterations of oral cGVHD. Data Sources. Electronic search of different databases was conducted: PubMed, Cochrane library, Grey literature, WHO, and clinical for clinical trial registration as well as hand search in the references of relevant articles up to November 2016. Data Extraction. Extracted pieces of information were intervention, population, sample sizes, and outcomes. Data Synthesis. Six studies were included: 2 randomized clinical trials (RCTs), 3 cohort studies, and 1 pre-post clinical trial. Results. There is a limited evidence concerning clinical efficacy of topical corticosteroids. Clobetasol, dexamethasone, and budesonide were the topical corticosteroid of choice. The highest level of evidence score was given to clobetasol followed by budesonide with a lower evidence level. Conclusion. All three topical corticosteroid preparations are effective for management of oral chronic GVHD with minimal easily avoided side effects. Basma Abdelaleem Elsaadany, Eman Magdy Ahmed, and Sana Maher Hasan Aghbary Copyright © 2017 Basma Abdelaleem Elsaadany et al. All rights reserved. Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study Sun, 02 Jul 2017 08:26:40 +0000 Aim. To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. Patients and Methods. We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. Results. 61.54% of patients were female and mean overall age was years old. Overall CSR was 97.1% (95% CI: 92.4–98.9): 97.9 and 95.1% for short and ultrashort, respectively ( value: 0.33). Four implants failed. Covariates were not associated with CSR ( value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant ( values > 0.05). Conclusions. Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region. Giorgio Lombardo, Jacopo Pighi, Mauro Marincola, Giovanni Corrocher, Miguel Simancas-Pallares, and Pier Francesco Nocini Copyright © 2017 Giorgio Lombardo et al. All rights reserved. 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. 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. 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.