Dental Research Journal
Volume:11 Issue: 6, Nov 2014

There is abundance of literature delving into whether periodontal infection contributes to changes in serum lipid profi les. Whole saliva is an important physiologic fl uid that contains a highly complex mixture of substances. Research on salivary lipid profi les and chronic periodontitis remains unexplored and limited. This study was designed with an aim to investigate the association between the chronic periodontitis and salivary lipid levels and to make use of saliva as a non-invasive diagnostic aid. This case-control study included 60 subjects of which, 40 were diagnosed as having chronic periodontitis based on the probing depth and clinical attachment levels and 20 healthy subjects as control group. Whole saliva was collected and lipid concentrations (total cholesterol (TC), triglycerides (TG), low density lipoprotein [LDL] and high density lipoprotein [HDL]) were assessed by enzymatic methods and the values were read in ultraviolet- Spectrophotometer. Data was analyzed using student’s t test for equality of means. P < 0.05 was considered to be statistically signifi cant. The mean difference in the concentrations of TC and TG in saliva of chronic periodontitis patients were statistically signifi cant (P = 0.02) when compared to the healthy. HDL and LDL concentrations were not statistically signifi cant, but there was a difference in their means. LDL was higher in chronic periodontitis and HDL mean levels were high among the healthy. Increased salivary lipids in chronic periodontitis patients suggest an association between hyperlipidemia and periodontitis. The relatively easy and non-invasive nature of saliva can be used as a diagnostic tool to assess the lipid status. Further research is needed to determine its specifi city as a surrogate to serum lipid profi les.

In dental practical classes, the acoustic environment is characterized by high noise levels in relation to other teaching areas. The aims of this study were to measure noise levels produced during the different dental learning clinics, by equipments used in dental learning areas under different working conditions and by used and brand new handpieces under different working conditions. The noise levels were measured by using a noise level meter with a microphone, which was placed at a distance of 15 cm from a main noise source in pre-clinical and clinical areas. In laboratories, the microphone was placed at a distance of 15 cm and another reading was taken 2 m away. Noise levels of dental learning clinics were measured by placing noise level meter at clinic center. The data were collected, tabulated and statistically analyzed using t-tests. Signifi cance level was set at 5%. In dental clinics, the highest noise was produced by micro motor handpiece while cutting on acrylic (92.2 dB) and lowest noise (51.7 dB) was created by ultrasonic scaler without suction pump. The highest noise in laboratories was caused by sandblaster (96 dB at a distance of 15 cm) and lowest noise by stone trimmer when only turned on (61.8 dB at a distance of 2 m). There was signifi cant differences in noise levels of the equipment’s used in dental laboratories and dental learning clinics (P = 0.007). The highest noise level recorded in clinics was at pedodontic clinic (67.37 dB). Noise levels detected in this study were considered to be close to the limit of risk of hearing loss 85 dB.

Oral health in Down syndrome (DS) children has some peculiar aspects that must be considered in the follow-up of these patients. The objective of the present study was to assess the prevalence of dental caries and treatment needs among children with DS in Yemen and also to investigate the association between these outcomes with various socio-demographic and clinical variables. This cross-sectional study involved 96 children with DS aged between 6 and 15 years. Data were gathered through the use of a questionnaire and clinical observation. The dentition status and the treatment needs were recorded according to World Health Organization recommendations. ANOVA, Chi-square test, t-test and multiple regression analyses were applied using the statistical package for the social sciences (SPSS, Chicago, IL, USA) version 20.0 software, with P < 0.05 considered as signifi cant. The results showed that 93.8% of the subjects had dental caries; overall, decayed missing filled surfaces (dmfs), decayed missing fi lled teeth (dmft), DMFS, DMFT were 10.35, 4.44, 4.32 and 2.45, respectively. Stepwise linear regression analysis has revealed that age was the most important predictor for DMFT and DMFS, while early age and less frequent teeth brushing were the most predictors for dmft and dmfs. Restorative care and extractions were the most needed specifi ctreatments. The fi ndings of this study demonstrate that children with DS in Yemen have a high prevalence of dental caries and extensive unmet needs of dental treatment. They would benefi t from frequent oral health assessment.

Failures such as marginal discoloration and composite chipping are still the problems of tooth-colored restorations on the substrate of enamel and porcelain, which some of these problems are consequently as a result of failures in the bonding layer. Using fi lled resin has been recently introduced to increase the bond strength of this layer. The aim of this study was to compare the microshear bond strength (μ-SBS) of composite resins to enamel incubated in periods of 24 h and 9 months and porcelain with unfi lled resin and fl owable composites (fi lled resin). In this in vitro study, two groups of 75 enamel samples with different storage times (24 h and 9 months) and a group of 75 porcelain samples were used. They were divided into 5 experimental groups of 15 samples in each. Composite cylinders in tygon tubes were bonded on the surface of acid-etched enamel and pretreated porcelain. Wave, Wave MV, Wave HV, Grandiofl ow and Margin Bond were used as bonding agents. The μ-SBS was measured at the speed of 1.0 mm/min. The bond strengths were analyzed with one-way analysis of variance (ANOVA) test followed by Tukey test. P < 0.05 was selected as the level of statistical signifi cance in this study. The results showed that for enamel (24 h), the μ-SBS of the Wave MV and Wave HV groups were signifi cantly lower than the Margin Bond group. Tukey test indicated the absence of a signifi cant difference between the μ-SBS of the Wave group and the Margin Bond group. However, the μ-SBS of the Grandiofl ow group was signifi cantly higher than the one for the Margin Bond as a bonding agent. In enamel (9 months), there was a signifi cant difference between the Grandiofl ow and Margin Bond groups. Regarding bonding to the porcelain the one-way ANOVA test did not show a signifi cant difference among the groups. This study revealed that fl owable composites (fi lled resins) can be used instead of unfi lled resins in bonding composite resins to enamel and porcelain substrates.

A strong antimicrobial synergism between chlorhexidine (CHX) and hydrogen peroxide (H2O2) has been reported, but there is not enough data on the cytotoxicity of this combination. The primary aim of this study was to evaluate the cytotoxicity of CHX-H2O2 combination in different concentrations and secondary aim is to assess the infl uence of H2O2 on cytotoxicity of CHX on cultured human periodontal ligament (PDL) fi broblasts. The PDL cells were cultured from healthy human third molar teeth and were exposed to six prepared solutions (0.2% and 2% CHX separately and in combination with 1% and 3% H2O2). The MTT assay was applied to assess their effects on the viability of the PDL cells. Two-way analysis of variance approach and subgroup analysis was performed to evaluate the differences in mean cell viability values. A level of P < 0.05 was considered as statistically signifi cant. All tested solutions were toxic to PDL cells. There was a signifi cant interaction effect between CHX and H2O2. The 2% CHX combined with 3% H2O2 was the most and 0.2% CHX was the least cytotoxic solutions. The 2% CHX was signifi cantly more toxic than 0.2% CHX and H2O2 combinations. The cytotoxicity of 0.2% CHX and H2O2 combinations did not signifi cantly rise by increasing the concentration of H2O2 from 1% to 3%. H2O2 affected the cytotoxicity of CHX in a variable concentration-dependent manner. Based on the results of this study, it can be concluded that 2% CHX alone and in combination with either 1 or 3% H2O2 are signifi cantly more toxic than 0.2% CHX alone and in combination with 1 and 3% H2O2. Therefore, to benefi t from the synergistic antimicrobial effect between CHX and H2O2, with a minimal cytotoxicity, it is recommended to use 0.2% concentration of CHX combined with 3% H2O2.

Histopathological diagnosis of lesions arising from the intake of tobacco is based on subjective evaluation of morphological alterations within the lesional tissue. Oral exfoliative cytology is a non-invasive diagnostic technique for early detection of oral premalignant and malignant lesions. Morphometric techniques have been advocated as objective and reproducible methods of detecting changes before they are visible by routine microscopy and can facilitate differentiation of normal and abnormal epithelium. This study was conducted to assess the morphometric parameters (cell diameter, nuclear diameter and nuclear cytoplasmic ratio [N:C ratio]) in tobacco smokers and chewers and to evaluate the variations, if any. The study was conducted on cytological smears obtained from oral lesions of patients with habit of tobacco smoking (Group B) and tobacco chewing (Group C). Group A comprised of subjects free from oral lesions and not using tobacco in any form. Patients with both the habits were excluded. The smears were stained using Papanicoloaou staining method. For morphometric analysis, Microimage 3.0 image analysis software was employed. The statistical test employed was an analysis of variance and P < 0.05 was considered as signifi cant. The results of this study showed that the cellular diameter was progressively reduced and nuclear diameter progressively increased from Group A to Group B to Group C. The N:C ratio also showed a progressive increase from Group A to Group C. The results confirmed that tobacco chewing and smoking influenced the cytomorphology of normal appearing buccal mucosa and the degree of these changes were found to be greater in chewers as compared to smokers.

The accuracy and reproducibility of measurements in a locally made three dimensional (3D) simulator was assessed and compared with manual caliper measurements. A total of 20 casts were scanned by our laser scanner. Software capabilities included dimensional measurements, transformation and rotation of the cast as a whole, separation and rotation of each tooth and clip far. Two orthodontists measured theintercanine width, intermolar width and canine, molar and arch depth on the casts and in 3D simulator. For calculating the reliability coeffi cient and comparing random and systematic errors between the two methods, intra-class correlation coeffi cient of reliability (ICC), Dahlberg and paired t-test were used, respectively. The ICC and Dahlberg’s formula were also applied to assess intra-examiner and inter-examiner reliability of measurements on the casts and in the simulator (P < 0.05). Canine and molar depth measurements had low reliability on the casts. Reliability between methods for the remaining three variables was 0.87, 0.98 and 0.98 in the maxilla and 0.92, 0.77 and 0.94 in the mandible, respectively. The method error was between 0.31 and 0.48 mm. The mean intra-observer difference were 0.086 and 0.23 mm in the 3D method and caliper. The inter-observer differences were 0.21 and 0.42 mm, respectively. The maximum average absolute difference between the two methods was <0.5 mm, indicating that the new system is indeed clinically acceptable. The examiner reliability was higher in 3D measurements.

The intensity and duration of speech diffi culty inherently associated with lingual therapy is a signifi cant issue of concern in orthodontics. This study was designed to evaluate andto compare the duration of changes in speech between labial and lingual orthodontics. A prospective longitudinal clinical study was designed to assess speech of 24 patients undergoing labial or lingual orthodontic treatment. An objective spectrographic evaluation of/s/sound was done using software PRAAT version 5.0.47, a semiobjective auditive evaluation of articulation was done by four speech pathologists and a subjective assessment of speech was done by four laypersons. The tests were performed before (T1), within 24 h (T2), after 1 week (T3) and after 1 month (T4) of the start of therapy. The Mann-Whitney U-test for independent samples was used to assess the signifi cance difference between the labial and lingual appliances. A speech alteration with P < 0.05 was considered to be signifi cant. The objective method showed a signifi cant difference to be present between the two groups for the/s/sound in the middle position (P < 0.001) at T3. The semiobjective assessment showed worst speech performance in the lingual group to be present at T3 for vowels and blends(P < 0.01) and at T3 and T4 for alveolar and palatal consonants (P < 0.01). The subjective assessment also showed a signifi cant difference between the two groups at T3 (P < 0.01) and T4 (P < 0.05). Both appliance systems caused a comparable speech diffi culty immediately after bonding (T2). Although the speech recovered within a week in the labial group (T3), the lingual group continued to experience discomfort even after a month (T4).

The use of transcutaneous electrical nerve stimulation (TENS) in dentistry was fi rstdescribed in 1967, by Shane and Kessler, but it has yet to gain widespread acceptance in dentistry.A study was undertaken to evaluate the effectiveness of TENS therapy as an adjuvant modality and to compare it with the conventional medication in controlling pain in temporomandibular disorder (TMD) patients. The study was carried out in the Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Mangalore. A total of 40 patients with the clinical symptom of pain associated with TMDs were randomly divided into two groups. Group A (control) patients were treated with medication (analgesics and muscle relaxants) alone, while group B patients were treated with TENS therapy in combination with medication. The intensity of the painwas assessed using the Visual Analog Scale (VAS). The results were analyzed with the student’s ‘t’ test. A P-value < 0.05 was considered as signifi cant. A signifi cant improvement was observed in both the TENS and the control group in terms of pain control. On comparative analysis, adjuvant TENS therapy was found to be more effective than medication alone, in controlling pain. (P value = 0.019). The observed data suggest that TENS therapy can be used as an adjuvant modality in the management of pain associated with TMDs. This study justifi es the use of TENS therapy in the management of TMD.

The advantages of coated orthodontic wires such as esthetic and their effectson reduced friction, corrosion and allergic reaction and the signifi cant consequences of plaque accumulation on oral health encouraged us to assess bacterial colonization on these wires. A total of 18 (9 upper and 9 lower) epoxy resin coated 16 × 22 nickeltitanium wires (Spectra, GAC, USA) and 18 (9 upper and 9 lower) non-coated 16 × 22 nickel-titanium wires (Sentalloy, GAC, USA) with isolated packages were selected and sterilized before application.The samples were divided randomly between upper and lower arches in 18 patients and hence that every patient received one coated and one uncoated wire at the same time. Samples were removed and cut in equal lengths after 3 weeks and placed in phosphate buffered saline buffer. After separation of bacteria in trypsin and ethylenediaminetetraacetic acid solution, the diluted solution was cultured in blood agar and bacterial colony forming units were counted. Finally, the data was analyzed using the paired t-test and the signifi cance was set at 0.05. Mean of bacterial colonization on uncoated wires was more than that of coated wires (P < 0.001). Bacterial plaque accumulation on epoxy resin coated nickel-titanium orthodontic wires is signifi cantly lower than uncoated nickel-titanium wires.

The aim of this study was to determine the impact of malocclusions on oral healthrelated quality of life (OHRQOL) among female adolescents. This is an observational cross-sectional descriptive study. A total of 129 female students with age ranges between 14 and 17 years old were randomly selected from Mashhad (Iran) high schools and were asked to fi ll out an OHRQOL questionnaire included in four parts: Oral symptoms, functional limitations, emotional well-being and social well-being. Each participant was clinically examined to assess her malocclusion according to the index of complexity, outcome and need (ICON) and fi nally the data were entered to SPSS 11.5 and the relation between these two variables was assessed with Pearson correlation test. P < 0.05 was considered as statistically signifi cant. There was statistically signifi cant correlation between ICON scores and quality of life (P = 0.0176). Being separately assessed, among four parts of the questionnaire, only emotionalwell-being was signifi cantly correlated with the ICON score (P < 0.05). Malocclusions play a vital role in OHRQOL. However, in female adolescents among four parts of OHRQOL, emotional well-being had signifi cant relationship with malocclusions.

Dental surfaces prepared with different Er:YAG laser distance may have different characteristics compared with those prepared with conventional instruments. The aim of this study was to investigate the effect of Er:YAG laser irradiation distance from enamel and dentin surfaces on the shear bond strength of composite with self-etch and etch and rinse bonding systems compared with conventional preparation method. Two hundred caries-free human third molars were randomly divided into twenty groups (n = 10). Ten groups were designated for enamel surface (E1-E10) and ten for dentin surface (D1-D10). Er: YAG laser (2940 nm) was used on the E1-E8 (240 mJ, 25 Hz) and D1-D8 (140 mJ, 30 Hz) groups at four different distances of 0.5 (standard), 2, 4 and 11 mm.Control groups (E9, E10, D9 and D10) were ground with medium grit diamond bur. The enamel and dentin specimens were divided into two subgroups that were bonded with either Single Bondor Clearfi l SE Bond. Resin composite (Z100) was dispensed on prepared dentin and enamel.The shear bond strengths were tested using a universal testing machine. Data were analyzed by SPSS12 statistical software using three way analysis of variance, Tukey and independent t-test. P < 0.05 was considered as signifi cant. There was a signifi cant difference between enamel and dentin substrates (P < 0.001) and between lased and un-lased groups; the un-lased group had signifi cantly higher bond strength (P < 0.001).Shear bond strength increased signifi cantly with an increase in the laser irradiation distance (P < 0.05) on enamel surfaces (in both bonding agent subgroups) and on dentin surfaces (in the Single Bond subgroup). Laser irradiation decreases shear bond strength. Irradiation distance affects shear bond strength and increasing the distance would decrease the negative effects of laser irradiation.

This case report refers to the esthetic and functional restorations of extensively damaged maxillary central incisors with dental caries in a 32-year-old woman, with the use of posts and crowns made from natural extracted teeth. Proper restoration of such teeth with the use of natural teeth fragments are known as “biological restoration.” Biological restorations can be done by using the fragments of the patients own tooth and if that is not available, tooth fragment can be obtained from an extracted tooth. These biological posts and crowns present a low cost option and an alternative technique for the morphofunctional recovery of extensively damaged teeth. There are limitations with the use of natural extracted teeth (homogenous bonding) for restoration such asthe diffi culty of fi nding teeth with a similar color and shape as that of the destroyed element, or patient may refuse to accept a tooth fragment from another patient, which prevents execution of the restoration.

The presence of three root canals in the distal root of the mandibular fi rst permanent molars is rare; based on in vitro studies its incidence is reported to be between 0.2% and 3%. With the advent of cone beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with extra canals and complex canal confi gurations has become more precise. CBCT provides three dimensional visualization of the pulp canal space, allowing the clinician in determining the spatial relationships of the root canals with each other at various cross sectional levels along the length of the root. The present report discusses the endodontic management of a mandibular fi rst permanent molar with three canals in the distal root, employing CBCT as an adjunctive diagnostic aid to conventional radiography.

Tooth transplantation can be considered a valid and predictable treatment option for rehabilitating young patients with permanent teeth loss. This study presents several cases of successful autogenous tooth transplantation with a 6-9 months follow-up. Tooth auto-transplantation can be considered a reasonable option for replacing missing teeth when a donor tooth is available. The auto-transplantation of a right mandibular third molar with compromised function and esthetics to replace the residual roots resulting from coronal destruction due to extensive carious lesion of the second molar in the same quadrant as shown in the presented cases can result a viable treatment alternative especially in a young patient that cannot undergo dental implant therapy. Transplantation of mature third molar seems to be a promising method for replacing a lost permanent molar tooth and restoring esthetics and function. This clinical procedure showed excellent functional and esthetical long-term results in the analyzed cases.