Xylitol is a sugar alcohol frequently used in the prevention of dental caries. However, the mechanism of action of xylitol on mutans streptococci is still unclear. This study evaluated the ultrastructural cellular changes in Streptococcus mutans and Streptococcus sobrinus after xylitol treatment.

S. mutans ATCC 25175 and S. sobrinus ATCC 33478 were grown separately in BHI medium plus 0.2% sucrose at 37°C under microaerophilic conditions overnight. Then, planktonic cells were harvested by centrifugation, resuspended in a fresh medium and incubated with either 0.2% glucose or 0.2% xylitol solutions for 2 hours. To prepare bacterial cells for the evaluation of morphology of cellular walls and polysaccharide capsules, cultures were subsequently fixed with 2.5% glutaraldehyde, stained with ruthenium red, post-fixed with 1% osmium tetroxide, dehydrated in acetone, embedded in Epon LX112 and analyzed by a transmission electron microscopy.

Bacterial cells incubated with glucose showed welldefined cellular walls and well-stained cytoplasmic membrane. Unlike, xylitol yielded diffuse cellular wall and irregular polysaccharide capsules in both microorganisms.

Low xylitol concentrations also can induce cellular damage to both S. mutans and S. sobrinus. Further studies are needed to provide more evidence on the anticariogenic effect of xylitol.

Pereira AFF, Silva TC, Machado MAAM, Buzalaf MAR. Low Xylitol Concentration induces Ultrastructural Cellular Changes in Streptococcus mutans and Streptococcus sobrinus. Int J Experiment Dent Sci 2015;4(1):1-3.

Several forms of periodontal disease have been associated with the development of coronary heart disease. The current retrospective study was conducted to investigate the possible relationship between periodontal disease parameters and defined coronary heart disease (CHD) in Greek adult patients.

The study sample consisted of 880 individuals, 400 males and 480 females, aged 40 to 78 years. Data were collected by means of an interviewer administered questionnaire and an oral clinical examination. Statistical analysis of the questionnaire items was performed by using multiple regression analysis model in order to assess possible associations between coronary heart disease as dependent variable and epidemiological variables, biomarkers and periodontal disease parameters as independent variables.

The occurrence of hypertension (OR = 0.01, 95% CI = 0.09-1.33), high level of triglycerides (OR = 0.08, 95% CI = 0.06-2.27) and total cholesterol (OR = 0.08, 95% CI = 0.07- 1.27), low level of high-density lipoprotein (OR = 0.12, 95% CI = 0.09-3.70) and smoking (OR = 1.83, 95% CI = 0.38-8.88) were significantly associated with the presence of coronary heart disease, whereas the periodontal parameters examined were not associated with the occurrence of it.

No associations were observed between periodontal disease parameters and defined coronary heart disease. However, the recorded associations strengthen the role of hypertension, lipids and smoking as causative risk factors of coronary heart disease.

Chrysanthakopoulos NA, Oikonomou AA, Chrysanthakopoulos PA, Saini R. Associations between Periodontal Disease Parameters and Coronary Heart Disease in Greek Adults: A Cross-sectional Study. Int J Experiment Dent Sci 2015;4(1):4-10.

Modern polyamide ‘flexible’ denture base materials have increased in popularity for use in removable partial dentures. The introduction of these new products warrants investigation of their relative potential for toxicity. The purpose of this study was to investigate three contemporary denture base materials used in fabricating definitive prosthetic restorations

Two ‘flexible’ materials (Valplast™ and Duraflex™) formed by thermoplastic injection molding technique, and one traditional heat processed, methyl methacrylate resin material (Lucitone 199) were evaluated. Cultured gingival epithelial cells and fibroblasts were treated with conditioned media prepared from denture material disks and then assayed for cell toxicity by [3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyltetrazolium bromide] (MTT) cell viability assay. Cell membrane damage was determined by measuring the release of cytoplasmic lactate dehydrogenase. Further confirmation of toxicity induced by the conditioned media was determined by staining the cells with live/dead stain and observing under a UV microscope.

Data were analyzed by means of a linear model ANOVA followed by Tukey's post hoc tests for comparison among groups. The significance level adopted was 5% (p < 0.05). The three denture materials differed in their toxicity to the cells as assessed by MTT assay. Valplast conditioned media in general, especially the media of unpolished disks, was found to be toxic to both gingival fibroblasts and epithelial cells while media obtained from polished Lucitone and Duraflex were found to be less toxic. After 7 days of incubation with Valplast unpolished conditioned media, only 1 to 2% of the cells remained viable, while the polished disk conditioned media caused significantly less (p < 0.05) toxicity, approximately 76 and 92% of fibroblasts and epithelial cells respectively, were viable. After 7 days of incubation with media obtained from the other denture materials, 35 to 92% of fibroblasts and epithelial cells were found to be viable. The data obtained from lactate dehydrogenase (LDH) assay and live/dead mammalian cell viability assay were in agreement with the MTT viability assay.

Conditioned media from unpolished Valplast denture material appeared to be significantly more toxic to gingival fibroblasts and epithelial cells when compared to the polished Lucitone disk conditioned media as well as the media obtained from Duraflex.

Ahuja S, Babu J, Wicks R, Garcia- Godoy F, Tipton D. Cytotoxic Effects of Three Denture Base Materials on Gingival Epithelial Cells and Fibroblasts: An in vitro Study. Int J Experiment Dent Sci 2015;4(1):11-16.

The purpose of this study is to evaluate the effects of different immunosuppressant agents on gingival overgrowth.

About 60 patients medicated with cyclosporin A (CsA) and 40 patients with tacrolimus (TcR) were recruited in the study. Periodontal examination (PI, GI, PBI, PPD, GO) was carried out only for maxillary and mandibular anterior teeth. Pharmacologic variables, such as daily dosage of immunosuppressant agents, TcR/CsA whole blood level were recorded.

In the group medicated with CsA, 10 patients had clinically significant GO, while none of the patients medicated with Tac had clinically significant GO. Significant differences were observed for periodontal parameters (PI, GI, PBI, PPD), post-transplant period, percentage of GO. In CsA group, significant difference was detected for periodontal parameters, percentage of GO and daily glucocorticoid dosage between responders and nonresponders.

The results from our study show that GO does not occur in patients medicated with TcR, although TcR shares same mechanism with CsA.

Bekit A, Bagis N, Arpak N. Evaluation of Effects of Different Immunosuppressant Agents on Gingival Overgrowth. Int J Experiment Dent Sci 2015;4(1):17-22.

To evaluate the degradation of strength of elastomeric chains submitted to different levels of salivary pH and exposed to mouthrinses with and without fluoride.

Seven groups of chain elastics (n = 18) mounted on test devices that remained immersed in artificial saliva were tested. Group 1 (pH 5 and without fluoride), 2 (pH 5 and with fluoride), 3 (pH 6 and without fluoride), 4 (pH 6 and with fluoride), 5 (pH 7.5 and without fluoride) and 6 (pH 7.5 and with fluoride) and 7 (control group). The test groups were exposed to mouthrinses twice a day for 30 seconds, with an interval of 12 hours between one exposure and the other. A control group was immersed in distilled water. The strength of samples was gauged with a dynamometer. Six measurements of strength were made in the following time intervals: initial (0), 1, 7, 14, 21 and 28 days. The force values were submitted to the analysis of variance (ANOVA) and Tukey's test to determine whether there were statistical differences between each group. The level of significance adopted was 5% (α = 0.05).

When the groups were evaluated individually, comparing the factor time in the initial period, the force was statistically higher than that in all the other experimental time intervals (p < 0.05). From the 7th day up to day 28, no statistical differences were found among the groups (p > 0.05). The factors pH and the presence of mouthwash with or without fluoride did not interfere in the results among the groups (p < 0.05).

The presence or absence of fluoride in the mouthrinses used in the study made no difference to the force degradation of the chain elastics, as the test groups obtained similar results among them in the studied time intervals.

Pithon MM, Andrade C, Santos AF, Campos M, Saini R. Degradation of the Strength of Elastomeric Chains subjected to Different Levels of Salivary pH associated with Exposure to Mouthrinses with and without Fluoride. Int J Experiment Dent Sci 2015;4(1):23-28.

The approach to managing the behavior of children in the dental environment must be based on empathy with a child in order to understand why the child is distressed, anxious or afraid.

Any dentist treating children needs a spectrum of behavioral techniques from the simplest—tell and show all the way through to a full general anesthetic. Its use is indicated in specific situations and used only when appropriate.

On this basis, the caring dentist discusses with the parent the likely need for various behavioral techniques in the child's management. In this study, we show our experience with oral and nasal sedation in a group of pediatric uncooperative dental patients.

How to cite this article: Cantore S, Ballini A, Saini R. Sedation of Uncooperative Pediatric Dental Patients. Int J Experiment Dent Sci 2015;4(1):29-32.

The present study was aimed to evaluate the efficacy of calculus/tartar dissolution based oral rinse as an adjunct to toothbrushing in gingivitis patients for long-term effects on new supragingival calculus formation.

After undergoing a dental prophylaxis, 60 gingivitis subjects with a moderate rate of calculus formation were stratified and randomly assigned to one of two groups: Control group (regular dentifrice alone) and experimental group (using a regular dentifrice and a calculus/tartar control mouthrinse). Subjects brushed and rinsed twice daily, unsupervised, for 6 months. All subjects were assessed with gingival index (GI), plaque index (PI) and calculus levels using the Volpe-Manhold Index (VMI) after 3 and 6 months.

Statistical analysis found that the experimental group (which used a calculus/tartar contain mouthrinse) demonstrated statistically significantly lower VMI scores (p = 0.001) than control group (which used a regular dentifrice alone). In experiment test group A, there was decline in VMI score from 3 to 6 months by 23.12% as compared to group B where there was continuous increase in VMI scores from 3 to 6 months by 22.16%.

A mouthrinse containing tetrapotassium pyrophosphate and sodium tripolyphosphate as the anticalculus agent provides a clinically relevant reduction in calculus formation in subjects with a moderate rate of such formation.

Saini R. A Prospective Experimental Comparative Study on the Clinical Effects of Calculus Dissolution based Oral Rinse in Gingivitis Patients. Int J Experiment Dent Sci 2015;4(1):33-39.

Fibrin sealant is a biological tissue adhesive mimicking the final stage of coagulation. It has a wide variety of application in the field of periodontics. The aim of this article was to review current applications and identify potential use of fibrin sealant in periodontal surgical procedures on an evidence-based conclusion.

An online search was performed in PubMed, Google Scholar and Cochrane Library databases using keywords fibrin sealant, fibrin glue, fibrin, regeneration, wound healing, tissue adhesive, gingival recession/therapy, surgical therapy, periodontal, and periodontitis in a mutually inclusive manner. The studies were evaluated by two independent reviewers for inclusion in this literature review.

Out of 196 research papers identified, 59 articles were selected by the authors for this literature review, giving preference to clinical trials related to periodontal application.

Use of fibrin sealant is a simple, safe, costeffective, and rapid way to fix flaps and grafts avoiding any postoperative bleeding. Fibrin sealant has the property for regeneration when used in conjunction with a barrier membrane for formation of new connective tissue attachment. It is effective in microsurgical procedures and closing flaps around implant site. They initiate early wound healing through collagen synthesis and fibroblast proliferation. Fibrin sealant may be an alternate biomaterial for periodontal surgery which may stimulate periodontal wound healing and regeneration.

Jacob S, Nath S. Fibrin Sealant: A Review of Its Applications in Periodontal Surgery. Int J Experiment Dent Sci 2015;4(1):40-46.

Chaikomon K, Yooprasert P, Yothasamutr K, Siribamrungwong M. Interrelationship between Cerebrovascular Disease and Periodontitis. Int J Experiment Dent Sci 2015;4(1):47-52.

Tandelilin RTC, Saini R. Dynamics of Matrix Metalloproteinases in the Oral Environment. Int J Experiment Dent Sci 2015;4(1):53-57.

Gowda KS, Vinod S. Localized Gingival Enlargement induced by Systemic Administration of Phenytoin for the Management of Epidermolysis Bullosa. Int J Experiment Dent Sci 2015;4(1):58-61.

To overcome the dilemma of fabricating a cast partial denture in patient with missing maxillary anterior teeth.

A round rest distal depression clasp is used as an esthetic alternative to a conventional clasp for maxillary anterior teeth serving as abutments for a removable partial denture

Bhat BS, Sharma D, Arora H. A Novel Technique to restore Anterior Esthetics with Cast Partial Denture. Int J Experiment Dent Sci 2015;4(1):62-64.

Aljuboori MJ, Saini R, Yi NY. Third Molar Socket Grafting after Surgical Extraction to prevent Periodontal Pocket Formation. Int J Experiment Dent Sci 2015;4(1):65-68.

Legha VS, Saini DK, Kumar KVA. Esthetic Rehabilitation of Mutilated Anterior Teeth with Custom Cast Post and Core Porcelain-Fused-to-Metal Crowns. Int J Experiment Dent Sci 2015;4(1):69-71.

Schlesinger CD, Saini R. Immediate Implant Placement by Dual Stabilization Technique. Int J Experiment Dent Sci 2015;4(1):72-76.