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  • ISSN: 2333-7133
    Bisphenol A in Dental Materials: A Review
    Authors: Liang Chen* and Byoung In Suh
    Abstract: Objective: To review scientific literature on BPA in dental materials, introducing the chemistry of BPA and its derivatives, and evaluating the BPA release and exposure from dental materials and the potential human health risks. Materials & methods: A search of English peer-reviewed dental literature from Pub Med and MEDLINE databases was conducted, and the key words included bisphenol A and BPA.
    Clinical Case Presentation: Challenging the American Board of Operative Dentistry Certification Examination
    Authors: Michael J. Metz1* and Cynthia J. Miller2
    Challenging The American Board of Operative Dentistry Certification (ABOD) was one of the most humbling, challenging and gratifying experiences of my dental career. To say that it is an honor to join the elite names on that list would be a serious understatement.
    Applications of Cone Beam Computed Tomography (CBCT) in Implant Treatment Planning
    Authors: Vandana Kumar1* and Keerthana Satheesh2
    The objective of this article is to review the literature which describes the evolving role of cone-beam computed tomography in dental implant treatment planning. The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements.
    Effect of Light Curing Tip Distance and Immersion Media on the Degree of Conversion, Sorption and Solubility of Methacylate and Silorane-Based Composites
    Authors: Diogo de Azevedo Miranda1*, Nubia Pavesi Pini2, Glaucia Maria Bovi Ambrosano3, Flavio Henrique Baggio Aguiar3, Debora Alves Nunes Leite Lima3 and Jose Roberto Lovadino4
    The Effect of Home-Bleaching Agents on Surface Roughness of Restorative Materials
    Authors: Dionysopoulos D*, Koliniotou-Koumpia E, Gerasimou P and Papadopoulos C
    The purpose of this study was to evaluate the effect of two home-bleaching agents (10 and 20% carbamide peroxide) on the surface roughness of four tooth-colored restorative materials over time.
    Latest Articles
    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.
    Isaac Vieira Queiroz*, Pedro Tapioca, Daniel Farias, Roberto Almeida de Azevedo, Ieda Margarida Crusoe Rebello, and Mariana Conceicao Andre de Lima Oliveira
    A rare case of inadvertent placement of naso-enteral tube (NGT) at the base of the skull in a 74-year-old masculine patient, with impact on the sphenoid sinus without a history of trauma that had an acute ischemic stroke is reported. Despite the extensive and recognized benefits of naso-enteric tube feeding, complications resulting from malpositioning of the naso-enteral tube are often described. Currently, naso-enteral intubation can be directly visualized. The endoscopy nasoendoscopy and fluoroscopy pathways can be used in the placement of the naso-enteral tube in sedated or anesthetized patients where blind intubation is difficult or contraindicated. It is concluded that Naso-enteral intubation should only be initiated by professionals who recognize difficult introduction and the degrees of complications that may result from trauma or malposition of the naso-enteral tube. It is recommended not to insert, in daily routine, tubes through the noses of critically ill patients, with severe decline in the level of consciousness, victims of ischemic cerebral vascular accident, without confirmation of proper placement or visualization of its path during installation.
    Marina Goncalves de Andrade*, Ana Carolina Fraga Fernandes, Bruna Pedral Sampaio de Souza Dantas, Larissa Oliveira Ramos Silva, Mariana Machado Mendes de Carvalho, Paloma Heine Quintas, and Roberto Almeida de Azevedo
    Papillon-Lefevre is a rare syndrome, autosomal recessive, which shows dermatological and periodontal tissue manifestations. The main oral manifestation is aggressive periodontitis that happen even in primary or permanent dentition. Radiography shows the loss of bone insertion identified as floating teeth. Skin lesions are presented as palmoplantar keratosis, plaques and white, light yellow, brown or red spots that develop crusts, crevices or deep fissures. The aim of this study is to present a rare case report of a child-juvenile patient with Papillon-Lefevre syndrome and its ways of recognition and treatment.
    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.
    Mahmoud Nabil Helaly*, Ahmed Mohammed Alam-Eldein, and Ali Mohamed El-Sheikh
    Aim: Some patients experience adverse reactions to acrylic resin (PMMA) denture base material. Polyamide (PA) as an alternative to PMMA has however not been well documented regarding color stability. The aim of this in vitro study was to evaluate the effect of two different cleansing agents (corega and fitty dent), on color stability of two thermoplastic denture base materials (vertex thermosens and breflex).
    Materials and methods: A total of 60 samples were fabricated from two different thermoplastic denture base materials (vertex thermosens and vreflex). The samples were divided into 3 groups. Each group was including twenty samples, ten samples each for vertex thermosens and 10 from breflex denture base materials. Samples of Group I were subjected to the distilled water as a control group. While samples of Group II were subjected to the corega as a cleansing agent and samples of group III were subjected to fittydent as the other cleansing agent. Effect of the two cleansing agents on the two-different thermoplastic denture base materials were evaluated and compared with regards to color stability.
    Results: Regarding (vertex thermosens and breflex) both materials were relatively color stable in the two cleansing agents. "corega had less effect on color change than fittydent)
    Conclusion: Corega and fittydent cleansing agents could be used safely for disinfecting denture base materials (vertex thermosens and breflex) as they had non-significant effect on color stability.
    Research Article
    Hisham Kamal Mohamed, Hasaan Gasim Mohamed, Asim Alsadig Satti, Bakri Gobara Gismalla, and Nada Tawfig Hashim*
    Chronic periodontitis is an infectious inflammatory disease initiated and propagated by bacteria and host factors and characterized by the destruction of the tooth supporting structures. Smoking is considered as an environmental factor that act together with host cells and affect inflammatory responses to the microbial challenge. Increased salivary MMP-8 levels are associated with progressive loss of attachment in periodontitis.
    The present study was conducted to investigate the association of the levels of salivary MMP-8 with commonly used periodontal clinical indices of groups of chronic periodontitis patients accounting for their smoking habits.
    A convenience sample of eighty-one subjects (53 males and 28 females) was recruited for this study. The mean age of the study population was (36.6±9.2) years. The sample population was categorized into three groups: 26 non-smoker subjects with chronic periodontitis, 26 smoker subjects with chronic periodontitis and 29 periodontally healthy subjects. The clinical periodontal parameters were assessed at six sites and it included Plaque Index (PI), Gingival Index (GI), Pocket Depth (PD) and clinical attachment loss (CAL).
    MMP-8 level was analyzed in salivary samples using Biolegend's ELISA MAX™ standard set which is a quantitative sandwich Enzyme-Linked Immunosorbent Assay (ELISA). The MMP-8 level expressed in nano-gram per milliliter (ng/ml).
    The results of this study showed significant differences in clinical periodontal parameters among the three groups (PI, PD and CAL) with p values of (0.001, 0.02, 0.001 respectively). Statistical analysis using one-way ANOVA showed a significant difference between the three groups in salivary MMP-8 levels with the highest value among the smokers with chronic periodontitis. On the other hands, no significant correlations were detected between the levels of the salivary MMP-8 and the other clinical periodontal parameters (GI, PD and CAL) among each of the study groups.
    The present study clearly shows a profound effect of smoking on salivary MMP-8 in chronic periodontitis subjects in comparison to non-smokers and periodontally healthy subjects.
    Hirata A*, Imura H, Sugahara T, Natsume N, Nakamura H, and Kondo Y
    Serotonin transporter (SERT) is one of the most critical regulators of the orchestration of serotonin (5-hydroxytryptamine; 5-HT) signaling through removal of extracellular 5-HT. Early studies have shown that 5-HT regulates craniofacial morphogenesis through interaction with 5-HT receptors or SERT. To determine the characteristics of 5-HT and SERT in palate development, we examined their localization immunohistochemically during secondary palate formation in mice. We also examined the immunolocalization of monoamine oxidase (MAO), a major metabolic enzyme of 5-HT, and tryptophan hydroxylase (TPH), a synthetic enzyme of 5-HT, to clarify their relationship with 5-HT in palatogenesis. Immunohistochemically, in the palatal shelves in the vertical position, diffuse localization of 5-HT was observed in the palatal mesenchyme, whereas SERT, MAO, and TPH immune reactivities were weak. When the palatal shelves were oriented horizontally, similar immune reactivities of 5-HT, SERT, MAO, and TPH were observed in the cells of the outer epithelial layer of the palatal shelf. In addition, 5-HT, SERT, MAO, and TPH immunoreactivities were detected in the medial epithelial seam (MES) of fused palatal shelves, and with the progression of palate formation, these immunoreactivities were subsequently observed in the basal and middle layers of the palatal epithelium. These findings suggest that serotonergic regulation via SERT is involved in palatogenesis, particularly in the development of the palatal epithelium. Our findings imply that altered 5-HT metabolism increases the risk of congenital craniofacial anomalies, such as clefting, in the children of women who are exposed to selective serotonin reuptake inhibitors (SSRIs) during pregnancy.
    Review Article
    Publio J, Burga-Sanchez J, Ferraz LN, Groppo FC, Aguiar FHB, and Lima DANL*
    Dental sensitivity after in-office bleaching is the most common adverse effect produced by the hydrogen peroxide (H2O2) bleaching agents. Inflammatory processes induced by chemical mediators and direct activation of ion channels by H2O2 and oxidative products have been related to this side effect. However, current data suggest that production and release of inflammatory mediators may not play an important role in the development of tooth sensitivity induced by bleaching. Possible mechanisms of dental sensibility after in-office whitening are discussed in this literature review.
    Case Report
    Yuji Sato, Akio Isobe*, and Noboru Kitagawa
    X-ray examination is important in implant treatment, particularly at the time of abutment mounting in order to assess the condition of the peri-implant bone. On the other hand, there are various pigmented oral mucosal lesions, with metal tattoo being one of the most common. Here, we describe a case with radiopaque findings in the gingival area at the time of abutment placement, and after review of the pre- and post-surgical oral photographs and X-ray images, it confirmed that metal tattoo was the cause of radiopaque findings. Therefore, it is necessary to distinguish such radiopaque findings from those indicating separation of the bone or remaining dentin. When a metal tattoo is present in the oral mucosa, it may lead to radiopaque findings similar to separation of the bone or remaining dentin.
    Mariana Machado Mendes de Carvalho*, Marina Goncalves de Andrade, Cesar FeitozaBassi Costa, Lorran de Andrade Pereira, Tagna de Oliveira Brandao, and Fatima Karoline Araujo Alves Dultra
    Soft tissues injuries in orofacial region resulting from high-energy impacts are frequent records in the emergency services. They have varying degrees of complexity and are treated according to their extent, depth, etiologic agent and degree of contamination. This article is a case report of an adult male patient with orofacial transfixing laceration after an accident with a barbed wire fence. He underwent surgery under general anesthesia and it was performed aesthetic and functional rehabilitation of the lesion. The aim of this article is to discuss the steps involved in the management of extensive wounds, based on the knowledge of the surgical principles related to the adequate treatment of these lesions. It is essential that the oral and maxillofacial surgery team launches a well-founded protocol that assists in the orientation of an efficient treatment in order to minimize sequelae and to enable a satisfactory aesthetic and functional result.
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