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  • ISSN: 2333-7133
    Early Online
    Volume 6, Issue 1
    Research Article
    Fatema Al Muheiri and Carolina Duarte*
    Supernumerary teeth are teeth that exceed the normal dental formula. They have variable characteristics and may cause a number of clinical complications. In the Middle East, a prevalence of 0.3 - 2.14% has been observed; however, the number of studies of this condition is limited in the region. This study examined the prevalence and characteristics of supernumerary teeth in patients from RAK College of Dental Sciences Dental Clinic. A total of 2,925 panoramic radiographs were analyzed and demographic-clinical data was extracted from patient files. A prevalence of 0.75% was observed. Affected patients were predominantly South Asian males. The teeth were mostly supplemental, Para-premolars and impacted with low incidence of disto-molars and no difference in occurrence in the maxilla or mandible. Occurrence of multiple supernumerary teeth was low and restricted to one jaw. This study suggests that one of every 133 patients will have impacted supernumerary teeth that can be expected in the premolar area of the maxilla/mandible, which should be considered when planning community oral health diagnosis and dental treatment strategies.
    Granados JM, Rifaey H, Safavi K, Tadinada A, and Chen IP*
    Aims: Conservative endodontic access (CEA), which removes the least tooth structure necessary, has become a popular alternative to traditional endodontic access (TEA). This study aims to examine whether CEA affects endodontic referrals and whether CBCT can guide CEA. Methodology: A survey of general dentists (n=129) was conducted to determine the impact of CEA on endodontic referrals. To assess the effects of CBCT on CEA, 45 extracted molars were accessed by TEA (group A), CEA (group B) or CEA with pre-operative CBCT images provided (group C). The ratios of surface areas of coronal access to pulp floor were quantified and the time for access preparation was recorded. Statistics was performed using Graph Pad Prism 5. Results: While 81% of general dentists preferred CEA, only 33% considered it a determining factor for their endodontic referrals. TEA resulted in statistically significantly more coronal dentin removed than CEA with or without CBCT (surface area ratio: groups A: B: C= 1.37±0.38*: 0.88±0.42: 0.65±0.14; mean ± SD, *p<0.05, one-way ANOVA). There was no difference in operation time among three groups.
    Conclusions: CBCT has great potential to guide CEA preparation for beginners and CEA is a preferred access form to general dentists but is not a determining factor on endodontic referrals.
    Abeer Basunbul* and Stanley A. Alexander
    Purpose: The purpose of this in vitro study is to evaluate the efficacy of fluoride varnish in preventing enamel demineralization lesions adjacent to orthodontic brackets.
    Methods: Brackets were bonded to 60 extracted human premolars with traditional composite resin and resin modified glass ionomer cement (Both without fluoride) and 15 teeth were randomly assigned to four equal test groups. Demineralization of enamel was evaluated in longitudinal buccolingual tooth sections using polarized light microscopy.
    Results: ANOVA (P < 0.05) indicated significant differences in depth and area of demineralized enamel in all the groups. Those teeth treated with fluoride varnish exhibited 50% less demineralization than the control teeth in both the composite and the resin modified glass ionomer cement groups.
    Conclusion: Fluoride varnishes should be considered for use as a preventive adjunct to reduce enamel demineralization adjacent to orthodontic brackets, particularly in patients who exhibit poor compliance with oral hygiene and home fluoride use.
    Review Article
    Michel Goldberg*
    The anatomy and biology of dentin tissues vary according their different location in the teeth. Beneath the thin mantle dentin, distinct layers include a primary dentin (tubular or orthodentin), a secondary dentin (reparative osteodentin), and a tertiary dentin (or reactionary dentin) [1-3]. Depending on the coronal and radicular parts of the tooth, substantial differences have been actually identified. In the dental pulp chamber, cell-free and cell-rich zones constitute two superficial layers located at the periphery of the central pulp. These outer layers are lining the roof, floor, mesial, distal, labial, and buccal surfaces. In the crown, fibrosis of the pulp, true and false dental stones and dystrophic calcifications contribute to pulp inflammation and repair. In the root canal, pulp cells (also called pulpoblasts) and fibers have structural incidences (e.g. Type I and type III collagens) [1,2]. Adhesive molecules, including fibronectin, laminine, vitronectine and thrombospondin are determining factors implicated in the root canal composition. Elastase and cathepsin G contribute to serine proteases and metalloproteinase's (MMP-2, MMP-9, MMP-3). Altogether, they are implicated in the biological parameters of the pulp canal. Proteolytically cleaved into DSP, DGP and DPP, DSPP is synthesized by secretory odontoblasts. Cbfa-1 is critical for the root canal biology. Proteoglycans such as HSP90, KS, CS are modulating the root canal response. Osteocalcin is a non-phosphorylated molecule contributing to the root canal condition. In addition, stem cells (DPSCs, SHED and SCAP) are involved in the recruitment and differentiation of cells located in the pulp root canal [4]. The anatomic complexity and the biology of the root canal have therapeutic occurrences.
    Ferraz LN, Oliveira ALBM, Grigoletto M, and Botta AC*
    The residual oxygen can negatively interfere with the adhesive polymerization, and reduce the bond strength to bleached enamel. The aim of this study was to review the literature on methods for reversing the bond strength to bleached enamel, efficacy and clinical feasibility. A waiting period, the use of dental adhesives containing organic solvents and application of organic solutions or antioxidant agents are the most used methods in an attempt to reverse bond strength to bleached enamel. Delaying bonding for 1 week after bleaching is sufficient to remove any residual oxygen and reverse the bond strength to enamel, regardless the bleaching agent used. Alcohol and acetone used as organic solutions or solvents in dental adhesives are able to increase the enamel bond strength, but not reestablish it completely. Enzymatic agents such as catalase and, peroxidase; and non-enzymatic agents such as sodium ascorbate, flavonoids and vitamin E have antioxidant properties. However, the high cost and proven efficacy only in prolonged use hamper the clinical application of antioxidant agents. The most established method for reversing the decreased bond strength to bleached enamel is the waiting period of at least one week. Further studies should be conducted to evaluate the application of alcohol, acetone, and antioxidant agents in different concentrations and for a short period of time to be clinically feasible and efficient in a short and long term.
    Case Report
    Marina Goncalves de Andrade*, Daniel Miranda de Paula, Paloma Heine Quintas, Mariana Machado Mendes de Carvalho, Braulio Carneiro Junior, and Roberto Almeida de Azevedo
    Objective: The aim of this study is to describe a case of cementoblastoma associated with a lower second molar, with its clinical features, differential diagnosis, treatment instituted and determinants of treatment success.
    Case description: A 60year-old female presented at the Maxillofacial Surgery clinic, from Dentistry School of Federal University of Bahia claiming to have an injury in the jaw, there was no significant facial asymmetry, imaging exams (CT Cone Bean) were analyzed and showed a hyperdense image associated with the roots of the tooth 37. The imaging findings suggested a cementblastoma. The lesion was excised and it was performed curettage with the extraction of the tooth 37. The histopathological analysis conclusion was cementoblastoma. After a follow-up of 12 months, the patient had no complaints and a good standard of healing.
    Discussion and conclusion: Despite being a benign tumor, with low recurrence rate and associated in most cases to the first molar, the cementoblastoma can affect any age, gender, race and teeth. Therefore, the dentist should perform an accurate diagnosis of the pathology; the lesion should be completely excised with the extraction of the associated teeth. And in order to prevent further complications such as a reoccurrence of the tumor, it is recommended a follow up the patient.
    Research Article
    Wisesphon Sutthidechanai, Nopawun Viriyasiri, and Smorntree Viteporn*
    Background: Anterior crossbite and concave facial profile are common problems in unilateral cleft lip and palate (UCLP) and skeletal Class III patients. The objectives of the study were to scrutinize the effect of early orthodontic treatment with different treatment modalities on the cleft and non-cleft patients and to compare the significant differences between the two groups.
    Material and methods: The sample was comprised 64 subjects (32 non-syndromic UCLP subjects with mean age 10.91 ± 2.00 years and 32 skeletal Class III non-cleft subjects with mean age 10.52 ± 1.65 years who were treated as a non-extraction case, main treatment mechanics were arch expansion and Class III traction in the cleft patients and protraction headgear in the non-cleft patients. Dento-skeletal and soft tissue profile changes were evaluated from lateral cephalograms before and after treatments. Paired t test and independent t test were utilized to evaluate the significant changes within and between groups, respectively.
    Results: The initial characteristics of UCLP patients were skeletal Class III maxillary retrusion and relative mandibular prognathism, retroclination and retrusion of the maxillary incisors. Treatment effects in both groups were mainly dento-alveolar effect. Significant proclination of the upper incisors following anterior crossbite correction attributed to the increase of upper lip protrusion and soft tissue convexity in both groups. Significant lower lip retrusion was found only in the non-cleft group.
    Conclusion: Early orthodontic treatment of the anterior crossbite could improve facial profile of the cleft and non-cleft patients, the cleft patients exhibited less favorable response to the treatment especially the lower lip area.
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