The aim of this study was to evaluate the minimum bactericidal concentrations (MBC) of root-end filling materials ProRoot MTA, MTA Angelus and IRM.

Macrodilution broth method was used. Microorganisms used were: Staphylococcus aureus (ATCC 29213), Enterococcus faecalis (ATCC 29212) and Streptococcus mutans. Serial two-fold dilutions of root-end filling samples were prepared in macrodilution tubes with concentrations ranging from 1/2 to 1/512. The samples dilutions were incubated for 24 hours. After incubation, 0.1 ml of diluted culture was inoculated onto the surface of supplemented sheep blood agar (Merck, Germany) and all plates were incubated at 37°C in aerobic condition for 24 hours. The MBC was defined as the lowest concentration of root-end filling samples where no growth was recorded.

MBC of both mineral trioxide aggregate (MTA) products against S. aureus were recorded as 15.62 mg/ml and for IRM 31.25 mg/ml MBC for both MTA groups against E. faecalis were recorded as 31.25 mg/ml and for IRM 62.5 mg/ml. MBC of all root-end filling samples against S. mutans were recorded as 62.5 mg/ml.

All tested root-end filling materials showed acceptable MBC against S. aureus and E. faecalis.

All tested materials can be used safely for filling of a root-end cavity.

Koçak MM, Koçak S, Oktay EA, Kiliç A, Yaman SD. In vitro Evaluation of the Minimum Bactericidal Concentrations of Different Root-End Filling Materials. J Contemp Dent Pract 2013;14(3):371-374.

Trichloroacetic acid (TCA) is a soft tissue cauterizing agent applied to gingival margins prior to cervical tooth-colored restorations. The present in vitro study evaluated the effects of two different concentrations of TCA hydrogel as a hemostatic/preconditioning agent on the shear bond strength (SBS) of a self-etch adhesive to tooth structures.

Thirty-six flat enamel and 36 flat dentin surfaces were prepared using human molars; each group was subdivided into three subgroups (n = 12). The groups were made ready as follows: In groups 1 (E1 and D1), the enamel (E) and dentin (D) surfaces were designated as control groups and remained intact. In groups 2 (E2 and D2), 35% TCA gel was applied to enamel and dentin surfaces for 30 seconds. In groups 3 (E3 and D3), 50% TCA gel was applied to enamel and dentin surfaces for 30 seconds. Clearfil SE Bond and Z100 composite resin were applied to the surfaces according to manufacturers¡¦ instructions. After 24 hours of incubation and thermocycling, the composite cylinders underwent an SBS test in a DARTEC test machine. Data were analyzed using the ANOVA and Scheffé's test (α = 0.05).

The mean SBS ± SD in the study groups were 34.73 ± 5.66, 35.32 ± 7.3, 23.75 ± 9.67, 20.94 ± 9.84, 19.32 ± 6.20, 23.50 ± 6.63 MPa in the E1, E2, E3, D1, D2 and D3 groups, respectively. ANOVA revealed significant differences between the SBS values of enamel groups (p = 0.001). There were no significant differences between the dentin groups (p = 0.425).

Application of 35 and 50% concentrations of TCA to dentin had no detrimental effect on the bond produced by two-step self-etch adhesive under study; however, application of only 35% TCA to enamel did not result in a detrimental effect on the same adhesive.

Fathpour K, Khoroushi M. Effect of Trichloroacetic Acid Hydrogel on Self-Etch Adhesive Bond Strength to Dental Tissues. J Contemp Dent Pract 2013; 14(3):375-380.

The purpose of the present study was to determine the influence of glass ionomer cement and amalgam restoration on the level of Streptococcus mutans in the interproximal plaque at periodic intervals and also to compare these values.

Seventeen adult patients having two proximal carious lesions on any quadrant of the jaw (either opposing or contralateral) were selected for this study. Carious lesions were diagnosed clinically and from bitewing radiographs. Of the two carious lesions, one was restored with glass ionomer cermet cement and another with amalgam. Plaque samples were collected from interproximal areas before and at 1 month and 3 months post-treatment in a test tube containing 5 ml of modified Stuart's liquid transport fluid. Identification of organisms in the colony was done after Gram staining.

Comparison of values before restoration and after restoration at 1 month interval showed a statistically significant decrease (p < 0.001). Similarly, comparison of values before and after restorations at 3 months also showed statistically significant decrease (p < 0.02). But comparison of restorations of 1 and 3 months intervals showed no statistical significant difference (p > 0.05).

Glass ionomer restorations have definite advantage over the amalgam, as the tunnel preparation is more conservative and fluoride release from the glass ionomer inhibits the growth of S. mutans in the plaque.

Glass ionomer cement should be preferred over amalgam in conservatively prepared restorations as it reduces the microbial activities due to fluoride release.

Tegginmani VS, Goel B, Uppin V, Horatti P, Kumar LSV, Nainani A. Comparison of Antibacterial Activity of Glass-ionomer Cement and Amalgam in Class Two Restorations by Streptococcus mutans Count Analysis at Fixed Intervals: An in vivo Study. J Contemp Dent Pract 2013;14(3):381-386.

Leukocytes play a key role in maintaining the balance between an effective host defence response to microorganisms and periodontal tissue destruction. Neutrophil dysfunction has been associated with increased susceptibility to periodontal diseases. We undertook this study to determine to what extent neutrophil dysfunction constitutes to the pathogenesis of aggressive periodontitis (AgP) in tropical country like ours.

Age- and sex-matched groups consisting of 20 subjects each of generalized aggressive periodontitis (GAP)–cases and nonperiodontitis (NP)–controls. diabetes mellitus, HIV infection, prolonged antibiotic use and smoking were excluded.

Each neutrophil function was assessed using the chemotactic assay using case in, phagocytosis assay, candidacidal assay (for intracellular killing) and NBT assay (for respiratory burst failure).

Student's t-test, Fisher's exact test and Chi-square test.

In the study 17 out of 20 subjects (85%) had at least one abnormal neutrophil assay either hypofunctional or hyperfunctional of which 16 (80%) had hypofunctional assays and 8 (40%) had hyperfunctional assays. Defective phagocytosis was the commonest (50%) followed by chemotactic defect (45%), defective respiratory burst (40%) and defective intracellular killing (30%). Mean of chemotaxis assay was significantly less in AgP when compared to controls (103 vs 129 £gm, p = 0.002), similarly for phagocytic defect (3.45 vs 4.65, p „T 0.001) and with candidacidal assay (26.80 vs 37.35, p < 0.001).

The prevalence of neutrophil dysfunction, predominantly hypofunctional, was significantly very high in GAP patients with few even having hyperactive respiratory burst function. Multiple level neutrophil defects could account for the aggressive nature of AgP even in apparently healthy subjects.

Tapashetti RP, Sharma S, Patil SR, Guvva S. Potential Effect of Neutrophil Functional Disorders on Pathogenesis of Aggressive Periodontitis. J Contemp Dent Pract 2013;14(3):387-393.

The present double blind study has been designed to evaluate the efficacy of local application of hemocoagulase solution as compared to a placebo in wound healing following dental extraction.

A total of 20 patients who required dental extraction for orthodontic intervention were included. The hemocoagulase solution and a placebo were locally applied to the extraction sockets and the efficacy of the solution in terms of bleeding control, anti-inflammatory responses, its antiseptic properties and efficacy in wound healing were evaluated.

The mean time required to achieve hemostasis was found to be 1.37 minutes in side A (test) and 2.33 minutes in side B (control) indicating that side A achieved faster hemostasis when compared to side B. At the 6th hour postoperatively, bleeding was not evident on either sides, and the amount of pain in side A was found to be less compared to side B. The number of RBCs, polymorphs, chronic inflammatory cells were not different in both the groups, whereas at 3rd postoperative day epithelial cells were greater in side A (test) compared to side B (control). Biopsy reports on the 12th postoperative day indicated that the number of fibroblasts, epithelial cells, collagen count was found to be greater in side A (test) compared to side B (control).

The topical hemocoagulase solution may be advocated in the field of oral and maxillofacial surgery, as a hemostatic agent and promoter of wound healing. However, further studies, with large number of cases and different clinical situations should be considered to authenticate the efficacy of this hemocoagulase solution in the practice of oral and maxillofacial surgery.

Wound healing plays an important role in the success of any surgical procedure, such as extractions, and the hemocoagulase system may act as a hemostatic agent and a promoter of wound healing.

Aslam S, Francis PG, Rao BHS, Ummar M, Issac JK, Nair RB. A Double Blind Study on the Efficacy of Local Application of Hemocoagulase Solution in Wound Healing. J Contemp Dent Pract 2013;14(3):394-400.

To evaluate the relative ability of 4 mg dose of intraoperative dexamethasone, administered submucosally, to reduce the postoperative discomfort after third molar surgery.

A total of 100 patients requiring surgical removal of a single mandibular third molar were included. The experimental group (50) received dexamethasone 4 mg as submucosal injection and control group (50) received no drugs. The maximum interincisal distance and facial contours were measured at baseline and at postsurgery days 2 and 7. The measurement of pain was done using visual analog scale (VAS).

None of the patients developed wound infection or any serious postoperative complications. Postoperative edema tended to be less severe on the second postoperative day in the experimental group and the result was statistically significant. There were no significant differences in the reduction of pain and trismus between the two groups studied.

Submucosal administration of dexamethasone sodium phosphate (4 mg) results in reduction of postoperative edema, comparable with or greater than other routes of administration. Presumably, a higher effective drug concentration at the site of injury without loss due to distribution to other compartments may be achieved, and the submucosal route is convenient for both the surgeon and the patient.

Submucosal route of administration of dexamethasone (4 mg) is effective in reducing postoperative discomfort after third molar surgeries.

Nair RB, Rahman NMM, Ummar M, Hafiz KAA, Issac JK, Sameer KM. Effect of Submucosal Injection of Dexamethasone on Postoperative Discomfort after Third Molar Surgery: A Prospective Study. J Contemp Dent Pract 2013;14(3):401-404.

The aim of the study was to evaluate retrospectively maxillary sinus functions and complications by using generally accepted diagnostic criteria with lateral window and osteotome sinus floor elevation (OSFE) procedures followed by dental implants placement.

A group of 60 patients in whom a SFE with the two procedures (lateral window and OSFE) followed by dental implants placement had been performed were evaluated retrospectively for sinus functions and complications from the time of procedure up to 24 months using a questionnaire, conventional clinical and radiographic examination.

Number of patients suffered dizziness accompanied by nausea immediately after OSFE was more than the lateral window procedure and the symptoms disappeared within 2 to 4 weeks. Maxillary sinus membrane perforations occurred and small for 4 out of 79 procedures, two cases for OSFE and two for lateral window procedure had been repaired. No more complications had been detected for all the patients up to 24 months.

Based on the results of this study, SFE with lateral window and osteotome procedures followed by dental implants placement did not interfere with maxillary sinus function and no obvious complications had been detected up to 24 months.

The clinician performs SFE with either lateral window or osteotome procedures needs to understand the difficulties and morbidity arising in the event of complications and must be able to correctly judge the individual risk and the presence of modifying factors that may cause these complications.

Al-Almaie S, Kavarodi AM, Al Faidhi A. Maxillary Sinus Functions and Complications with Lateral Window and Osteotome Sinus Floor Elevation Procedures Followed by Dental Implants Placement: A Retrospective Study in 60 Patients. J Contemp Dent Pract 2013;14(3):405-413.

The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency.

A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit.

10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p > 0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p > 0.05).

One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asymptomatic molar teeth with periapical radiolucency.

Akbar I, Iqbal A, Al-Omiri MK. Flare-up Rate in Molars with Periapical Radiolucency in One-Visit vs Two- Visit Endodontic Treatment. J Contemp Dent Pract 2013; 14(3):414-418.

Retraction of maxillary canines after first premolar extractions is a very common orthodontic task in cases of crowding or for the correction of large overjet. Many studies have been done to increase the rate of retraction. The aim is to compare the rate of canine retraction into recent extraction site with and without circumferential supracrestal fiberotomy.

The rate of movement of the canines into the recent extraction site of the first premolar with or without circumferential supracrestal fiberotomy was measured in 14 patients aged 13 to 22 years. The study was done on 9 maxillary and 5 mandibular arches. The appliance used in the present study was the preadjusted edgewise (0.022 inch Roth prescription) and retraction performed by frictionless mechanics using Composite T Loop. The distalization of canines was measured at regular intervals (T1, T2, T3 and T4). Recordings of the positions of the canines at the beginning and at different intervals were made from dental casts.

The mean difference between the two sides for the total time span T1-T4, for maxillary arch was 0.36 mm and for mandibular arch was 0.60 mm respectively.

There can be various factors that affect the rate of tooth movement. Factors like bone density, bone metabolism, and turnover in the periodontal ligament, amount of force applied may be responsible for the variation.

No clinically significant increased rate of retraction of cuspids in the recent extraction site with fiberotomy was found in comparison to the retraction in recent extraction site without fiberotomy.

Kalra A, Jaggi N, Bansal M, Goel S, Medsinge SV, Abraham R, Jasoria G. Comparison of Rate of Canine Retraction into Recent Extraction Site with and without Gingival Fiberotomy: A Clinical Study. J Contemp Dent Pract 2013;14(3):419-426.

Khurana PRS, Thomas PV, Rao SV, Balamuragan R, Singh MP. A Clinical Study to Correlate Maxillary Anterior Natural Teeth with that of the Commercially Available Acrylic and Porcelain Shade Guides. J Contemp Dent Pract 2013;14(3):427-433.

The primary goal of periodontal therapy is to restore the tooth supporting tissues lost due to periodontal disease. The aim of the present study was to compare the efficacy of combination of GTR membrane and alloplastc bone graft with open flap debridement (OFD) in treatment of periodontal intrabony defects.

Twenty paired intrabony defects were surgically treated using split mouth design. The defects were randomly assigned to treatment with OFD, GTR membrane + bone graft (test) or OFD alone (control). The clinical efficacy of two treatment modalities was evaluated at 6 months postoperatively by clinical, radiographical parameters. The measurements included probing pocket depth (PD), clinical attachment level (CAL), gingival recession (GR), bone fill (BF), bone density (BD).

The mean reduction in PD at 0 to 6 months was 3.20 ± 0.82 mm and CAL gain of 3.10 ± 1.51 mm occurred in the GTR membrane + bone graft (test) group; corresponding values for OFD (control) were 2.10 ± 0.63 mm and 1.90 ± 0.57 mm. Similar pattern of improvement was observed when radiographically postoperative evaluation was made. All improvement in different parameters was statistically significant (p < 0.01).

Treatment with a combination of collagen membrane and bone graft led to a significantly more favorable clinical outcome in intrabony defects as compared to open flap debridement alone.

Mopur JM, Devi TR, Ali SM, Srinivasa TS, Gopinath V, Salam ART. Clinical and Radiographic Evaluation of Regenerative Potential of GTR Membrane (Biomesh®) along with Alloplastic Bone Graft (Biograft®) in the Treatment of Periodontal Intrabony Defects. J Contemp Dent Pract 2013;14(3):434-439.

To evaluate and compare the efficacy, cleaning ability of hand and two rotary systems in root canal retreatment.

Sixty extracted premolars were retreated with following systems: Group 1—ProTaper Universal retreatment files, Group 2—ProFile system, Group 3—H-file. Specimens were split longitudinally and amount of remaining gutta-percha on the canal walls was assessed using direct visual scoring with the aid of stereomicroscope. Results were statistically analyzed using ANOVA test.

Completely clean root canal walls were not achieved with any of the techniques investigated. However, all three systems proved to be effective for gutta-percha removal. Significant difference was found between ProTaper universal retreatment file and H-file, and also between ProFile and H-file.

Under the conditions of the present study, ProTaper Universal retreatment files left significantly less guttapercha and sealer than ProFile and H-file.

Rotary systems in combination with gutta-percha solvents can perform superiorly as compared to the time tested traditional hand instrumentation in root canal retreatment.

Shivanand S, Patil CR, Thangala V, Kumar PR, Sachdeva J, Krishna A. To Evaluate and Compare the Efficacy, Cleaning Ability of Hand and Two Rotary Systems in Root Canal Retreatment. J Contemp Dent Pract 2013;14(3):440-444.

Realize the surgery of sinus lifting floor to allow the installation of osseointegrated implants for oral rehabilitation, with the combination of different biomaterials, autogenous bone and lyophilized bovine bone.

Oral rehabilitation using the installation of osseointegrated implants is an alternative surgical approach that results in the satisfactory form, function and esthetics of the dental units.

After clinical, dental and laboratory assessment, a 47-year-old female patient underwent full maxillary oral rehabilitation involving the installation of osseointegrated implants to allow her to meet the physiological demands of occlusion and mastication. It was found that the patient had fully pneumatized maxillary sinuses with insufficient height to anchor implants, with a loss of the vertical dimension of the occlusal and masticatory functions due to general dental loss, compounded by the use of ill-fitting dentures; hence, the choice was made to take autogenous bone from the patient's chin area and supplement it with lyophilized bovine bone as collateral for larger areas to be grafted. It was also decided to avulse the remaining tooth units due to their impairment by periodontal disease.

Bone grafts do not constitute suitable alternatives in the cosmetic and functional rehabilitation of the maxilla in patients requiring bilateral sinus elevation. The chin region provides bone tissue that, when complemented by lyophilized bovine bone grafts, ensures greater volume and less invasive surgery. In the case described here, a height gain of approximately 550% was obtained, making it possible to anchor seven implants.

In this study, the surgical procedures used for grafting a combination of autogenous and lyophilized bovine bone, aimed to elevate the maxillary sinus floor to allow the installation of osseointegrated implants for oral rehabilitation.

Araujo DB, de Jesus Campos E, Oliveira MAM, Lima MJP, Martins GB, Araujo RPC. Surgical Elevation of Bilateral Maxillary Sinus Floor with a Combination of Autogenous Bone and Lyophilized Bovine Bone. J Contemp Dent Pract 2013;14(3):445-450.

To assess and compare the shaping potential of manual NiTi K-files and Rotary ProTaper instruments in narrow canals using CT.

To assess the shaping potential of manual NiTi K-files and Rotary ProTaper and analyzing the final outcome of shaped canals using CT and determining different variables, like

• Working time

• Change in volume

• Change in cross-sectional area.

From a pool of fifty freshly extracted permanent maxillary molars (1st and 2nd), 30 were selected with curvatures (20 to 40°) (Schneider 1971). Tissue fragments and calcified debries were removed from the teeth by scaling. The teeth were then stored in normal saline until used.

All the mesiobuccal canals were scanned by CT to obtain preinstrumented images. Teeth were scaled and stored in normal saline. This study was divided in two groups with 15 samples each.

Canals were instrumented with Protaper Rotary instruments using crown down technique according to manufacturer's instructions.

Were instrumented by NiTi K-files using step back technique with a quarter turn/pull motion.

Comparative evaluations of working time was done for both the experimental groups.

The samples were analyzed and evaluated for:

• Postinstrumentation change in volume.

• Postinstrumentation change in cross-sections area.

From the observations and statistical analysis carried out in this study, it was found that:

There was a statistically significant difference between all the parameters judged for the present study that is:

1. Instrumentation with ProTaper Rotary system took significantly less time than instrumentation with manual NiTi K-file.

2. Change in the canal volume following instrumentation with ProTaper Rotary was significantly greater than that produced by manual NITi K-file.

3. a. Change in cross-section area at 2 and 3 mm from the apex was significantly greater with manual NiTi K-file as compared to ProTaper Rotary.

b. Change in cross sections at 4.5, 6 and 7.5 mm from the apex with ProTaper Rotary was significantly greater than that produced by manual NITi K-file.

This clearly establishes that there is a drastic difference in the shaping ability of manual and Rotary NiTi instruments used with step back and crown down technique respectively with the rotary instrumentation being faster and producing greater changes in the canal anatomy.

Kakar S, Dhingra A, Sharma H. Shaping Potential of Manual NiTi K-File and Rotary ProTaper and Analyzing the Final Outcome of Shaped Canals using CT. J Contemp Dent Pract 2013;14(3):451-455.

The aim of this in vitro study was to investigate whether mixing with calcium hydroxide [Ca(OH)₂] affects the antimicrobial action of Octenidine hydrochloride (Octenisept), MTAD and chlorhexidine against Enterococcus faecalis and Candida albicans.

Freshly grown cultures of Enterococcus faecalis, Candida albicans and a mixture of both strains were incubated in agar plates containing brain-heart infusion broth (BHIB). Zones of inhibition were measured at 24 and 48 hours. Statistical analysis was performed using Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance (ANOVA, both p = 0.05).

Mixing with Ca(OH)₂ significantly increased the antibacterial effect of Octenisept (p < 0.05), but did not alter its antifungal activity. Only chlorhexidine showed more antibacterial and antifungal efficiency compared to its Ca(OH)₂-mixed version (both p < 0.05). Mixing with Ca(OH)₂ decreased the antibacterial efficacy of MTAD, but increased its antifungal effect (both p < 0.05).

These results demonstrate the differential effects of Ca(OH)₂ addition on the antimicrobial action of the tested endodontic medicaments in vitro. Ca(OH)₂ was as effective as its combination with all of the tested medicaments.

Tirali RE, Gulsahi K, Cehreli SB, Karahan ZC, Uzunoğlu E, Elhan A. Antimicrobial Efficacy of Octenidine Hydrochloride, MTAD and Chlorhexidine Gluconate Mixed with Calcium Hydroxide. J Contemp Dent Pract 2013;14(3):456-460.

This study aimed to evaluate the microleakage of Class V restorations filled with a 7th-generation self-adhesive composite.

In 40 permanent premolars and 80 primary canines, 160 Class V cavities were prepared, which were filled with four restorative materials (n of each material = 20 permanent and 20 primary restorations): control: nonbonded composite (Heliomolar), GI: glass ionomer (Fuji IX GP), BC: bonded Heliomolar, SC: self-adhesive composite (Embrace WetBond). Dye penetration was scored 0 to 4 at 160 coronal and 160 gingival margins under 40× magnification by two examiners. The data were analyzed with Mann-Whitney U test (α = 0.01).

The mean microleakages of the materials (in the order of ‘control, GI, BC, SC’) at each margin-dentition (n = 20 margins) were: coronal-permanent (3.25 ± 0.72, 2.75 ± 0.72, 0.35 ± 0.59, 2.7 ± 0.73), coronal-primary (3.3 ± 0.66, 2.85 ± 0.88, 0.55 ± 0.76, 2.65 ± 1.14), gingival-permanent (3.35 ± 0.67, 0.85 ± 0.67, 2.95 ± 0.83, 1.55 ± 1.23), and gingival-primary (3.25 ± 0.72, 0.85 ± 0.59, 2.85 ± 0.89, 2.85 ± 0.93). Compared with the control microleakage at each margin-dentition (each group's n = 20 margins), BC microleakage was significantly lesser at coronal margins only (p = 0.000), GI microleakage was lower at gingival margins only (p = 0.000), and SC microleakage was smaller at gingival margins of permanent teeth only (p = 0.000). After combining coronal/gingival margins, only SC microleakage in primary dentition (n = 40 margins) was not significantly lesser than the control in primary teeth (p = 0.018); and microleakage of all other material-dentitions were lesser than corresponding control-dentitions (p = 0.000). Permanent and primary teeth had similar results for all material-margins (p > 0.5) except for SC at gingival margins (p = 0.001).

SC should be used only at gingival margins of permanent teeth.

Application of self-adhesive composite should be limited to gingival margins of permanent teeth.

Shafiei L, Mojiri P, Ghahraman Y, Rakhshan V. Microleakage of a Self-Adhesive Class V Composite on Primary and Permanent Dentitions. J Contemp Dent Pract 2013;14(3):461-467.

Enamel matrix-derived proteins (Emdogain) stimulate the proliferation of periodontal ligament cells, contributing to their regeneration.

This study was to perform histometric assessment of root surface resorption in replanted teeth with the use of Emdogain®.

Male Wistar rats (Rattus norvegicus), weighing 180 to 200 gm, were anesthetized, subjected to extraction of the upper right incisor tooth, which was then replanted into the alveoli with the following treatment: (a) control group - tooth with root canal filled with calcium hydroxide paste and (b) treated group - tooth with root canal filled with enamel matrix-derived protein. The animals were sacrificed 25 days after tooth replantation. The maxilla was processed to obtain thin sections (6 ì) and stained with hematoxylin and eosin. The resorption volume percentage of each dental element was calculated from the cementoenamel junction to the apex.

Quantification of resorption revealed that Emdogaintreated teeth showed a lower percentage of resorption (31.58%) compared to controls (80.48%) (statistically significant values – t-test p-value = 0.0431).

It was concluded that Emdogain used as root canal filling has properties capable of showing a lower percentage of resorption in replanted teeth.

de Oliveira MT, Bentregani LG, Pasternak B, Cancelier FD, de Jesus DR, Molina GO. Histometric Study of Resorption on Replanted Teeth with Enamel Matrix-derived Protein. J Contemp Dent Pract 2013;14(3):468-472.

The aim of this study was to evaluate the effects of eugenol-free temporary cement's remnants on the retentive strength of full metal crowns luted via zinc phosphate and resin cement (Maxcem) to the tooth structure.

Forty complete standardized Ni-Cr crowns in four groups were cemented by two types of permanent cements: zinc phosphate cement and resin cement (Maxcem). In the two groups before permanent cementation of crowns, temporary acrylic crowns were cemented by eugenol-free temporary cement. Crowns¡¦ retention was evaluated by Universal testing machine. All data were analyzed by means of one-way ANOVA test in SPSS software version 11.5 (α = 0.05).

There was no significant difference in groups with prior using eugenol-free temporary cement and groups with just using two permanents cement (p-value ≥ 0.05).

The application of temporary cement before permanent cementation of full metal crowns does not have any adverse effect on retention of full metal crowns, when temporary cements are removed properly.

Sabouhi M, Nosouhian S, Davoudi A, Nourbakhshian F, Badrian H, Nabe FN. The Effect of Eugenol- Free Temporary Cement's Remnants on Retention of Full Metal Crowns: Comparative Study. J Contemp Dent Pract 2013; 14(3):473-477.

To compare the efficacy of gutta-percha removal achieved with simple mechanical technique using two different solvents.

It was an in vitro experimental study conducted at the Aga Khan University Hospital, Karachi, Pakistan on 27 extracted human molars divided into two groups by alternate sampling technique.

The teeth were prepared by manual filing and obturated with gutta-percha and calcium hydroxide sealer. Two drops of the assigned solvent were placed on the orifice of the obturated canal and Gates Glidden drills #1, 2 and 3 were used for removal of coronal gutta-percha. Manual filing was done for removal of remaining gutta-percha and the solvent was used in drops until needed. Postoperative periapical radiographs were taken to visualize the remaining gutta-percha left in the canals.

Descriptive statistics (mean and SD) of the variables such as tooth type, obturation length and canal curvatures were determined. Chi-square and independent sample t-tests were applied and level of significance was set at 0.05.

There was 5.19 (3.8) mm of remaining gutta-percha in the orange oil group and 5.37 (4.2) mm in the chloroform group (p = 0.90).

There is no statistically significant difference between the orange oil and chloroform when used as solvent for removing gutta-percha.

Rehman K, Khan FR, Aman N. Comparison of Orange Oil and Chloroform as Gutta-Percha Solvents in Endodontic Retreatment. J Contemp Dent Pract 2013;14(3):478-482.

Autoclave sterilization and microwave sterilization has been suggested as the effective methods for the disinfection of elastomeric impressions, but subjecting elastomeric impressions to extreme temperature may have adverse effects on critical properties of the elastomers.

To evaluate the effect of chemical disinfection as well as autoclave and microwave sterilization on the surface roughness of elastomeric impression materials.

The surface roughness of five commercially available polyvinyl siloxane impression materials (Coltene President, Affinis Perfect impression, Aquasil, 3M ESPE Express and GC Exafast) were evaluated after subjecting them to chemical disinfection, autoclaving and microwave sterilization using a Talysurf Intra 50 instrument. Twenty specimens from each material were fabricated and divided into four equal groups, three experimental and one control (n = 25). The differences in the mean surface roughness between the treatment groups were recorded and statistically analyzed.

No statistically significant increase in the surface roughness was observed when the specimens were subjected to chemical disinfection and autoclave sterilization, increase in roughness and discoloration was observed in all the materials when specimens were subjected to microwave sterilization.

Chemical disinfection did not have a significant effect but, since it is less effective, autoclave sterilization can be considered effective and autoclaving did not show any specimen discoloration as in microwave sterilization. Microwave sterilization may be considered when impressions are used to make diagnostic casts. A significant increase in surface roughness may produce rougher casts, resulting in rougher tissue surfaces for denture and cast restorations.

Autoclave sterilization of vinyl polysiloxane elastomeric impressions for 5 minutes at 134°C at 20 psi may be considered an effective method over chemical disinfection and microwave sterilization, because chemical disinfection does not eliminate all disease-causing microorganisms and microwave sterilization leads to a rougher impression surface.

Al Kheraif AA. Surface Roughness of Polyvinyl Siloxane Impression Materials Following Chemical Disinfection, Autoclave and Microwave Sterilization. J Contemp Dent Pract 2013;14(3):483-487.

The aim of the study is to investigate the galvanic corrosion potential of metal injection molding (MIM) brackets to that of conventional brackets under similar in vitro conditions with nickel-titanium and copper nickel-titanium archwires.

Twenty-five maxillary premolar MIM stainless steel brackets and 25 conventional stainless steel brackets and archwires, 0.16 inch, each 10 mm length, 25 nickeltitanium wires, 25 copper nickel-titanium wires were used. They were divided into four groups which had five samples each. Combination of MIM bracket with copper nickel-titanium wire, MIM bracket with nickel-titanium wire and conventional stainless steel brackets with copper nickel-titanium wire and conventional stainless steel brackets with nickel-titanium wires which later were suspended in 350 ml of 1 M lactic acid solution media. Galvanic corrosion potential of four groups were analyzed under similar in vitro conditions. Precorrosion and postcorrosion elemental composition of MIM and conventional stainless steel bracket by scanning electron microscope (SEM) with energy dispersive spectroscope (EDS) was done.

MIM bracket showed decreased corrosion susceptibility than conventional bracket with copper nickeltitanium wire. Both MIM and conventional bracket showed similar corrosion resistance potential in association with nickel-titanium archwires. It seems that both brackets are more compatible with copper nickel-titanium archwires regarding the decrease in the consequences of galvanic reaction. The EDS analysis showed that the MIM brackets with copper nickel-titanium wires released less metal ions than conventional bracket with copper nickeltitanium wires.

MIM brackets showed decreased corrosion susceptibility, copper nickel-titanium archwires are compatible with both the brackets than nickel-titanium archwires.

Clinically MIM and conventional brackets behaved more or less similarly in terms of corrosion resistance. In order to decrease the corrosion potential of MIM brackets, more precise manufacturing technique should be improved to get a more smoother surface finish.

Varma DPK, Chidambaram S, Reddy KB, Vijay M, Ravindranath D, Prasad MR. Comparison of Galvanic Corrosion Potential of Metal Injection Molded Brackets to that of Conventional Metal Brackets with Nickel-Titanium and Copper Nickel-Titanium Archwire Combinations. J Contemp Dent Pract 2013;14(3):488-495.

This research project sought to explore the issue of what constitutes effective clinical teaching in the minds of both students and teachers.

As stakeholders of the dental clinical setting, teachers and students have valuable practical insights to share with the academic and professional community as to what constitutes effective dental teaching.

An explorative qualitative study of dental teachers’ and students’ perceptions of clinical teaching was carried out at the Faculty of Dentistry of Sydney University. Thirty-one clinical teachers and 12 students participated in this case study through an online questionnaire survey and a focus group, respectively. Responses were categorized in three major clusters, namely, instructional, curricular or organizational.

The findings reveal that both groups hold similar opinions on what constitutes effective clinical instruction including a shared passion for learning and teaching, being clear and organized, demonstrating clinical competencies as well as engaging in professional self-reflection. Most of the issues fell into the instructional cluster where establishing a positive relationship with students including providing constructive feedback at the clinical session came up as key factors contributing to the student experience.

There is a demand from both students and teachers to standardize clinical procedures and protocols as well as having a greater synchronization in time and content between lectures and clinical work.

Groenlund C, Handal B. Contemporary Issues in Clinical Dental Teaching. J Contemp Dent Pract 2013;14(3):501-510.

To assess and compare the knowledge of basic life support (BLS) among third, fourth and fifth (III, IV and V) year Bachelor of Dental Surgery (BDS) clinical students, dental interns, postgraduate students and Bachelor of Dental Surgery (BDS) and Master of Dental Surgery (MDS) faculty of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India.

A BLS questionnaire consisting of 22 questions was used to assess the levels of III, IV and V years BDS clinical students, dental interns, postgraduate students and BDS and MDS faculty of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. Statistical Package for Social Sciences software (SPSS version 12.0) was used to analyze the statistical data. The p < 0.05 was considered statistically significant.

A total of 338 respondents took part in the study. When gender comparison was done with correct knowledge responses, statistically significant differences were noted for Q6, Q9, Q12, Q13, Q15 and Q17. For age groups and educational qualifications, significant difference was observed for all questions. It was noted that III, IV and V year undergraduate clinical students and half of interns had adequate knowledge when compared to postgraduate students (6.9%), BDS tutors (0.00%) and MDS staff (10.7%).

The study concludes that there is a significant lack of knowledge among postgraduates students BDS and MDS faculty, regarding BLS when compared to III, IV and V year's clinical BDS students and dental interns. This study emphasizes the need for all health care professionals to regularly update the knowledge and skills regarding BLS.

Reddy S, Doshi D, Reddy P, Kulkarni S, Reddy S. Awareness of Basic Life Support Among Staff and Students in a Dental School. J Contemp Dent Pract 2013;14(3):511-517.

To determine the prevalence of permanent tooth anomalies in patients attending the graduate orthodontic clinic at the State University of New York at Buffalo.

Charts of 496 subjects (310 females and 186 males) met the inclusion criteria for this study. The mean ages were 16 years and 3 months for the combined gender sample that received orthodontic treatment in the graduate orthodontic clinic between 2007 and 2010. Full pretreatment records (intraoral photographs, digital study models, lateral cephalograms and panoramic radiographs) were used for the assessment. Charts were examined for these anomalies: agenesis, supernumerary, impaction and delayed tooth eruption. Subjects were categorized by gender and ethnicity. The percentages of the anomalies were assessed according to type of malocclusion, gender, race, location, tooth class and region in the dental arches.

Sixty-four subjects (12.9%) had at least one occurrence of delayed eruption and impaction (DEI), followed by 47 subjects (9.5%) who had at least one occurrence of agenesis, and seven (1.4%) had a supernumerary condition. Approximately 80% of the subjects had no dental anomalies. The presence of more than one anomaly was observed in 61 subjects. Twelve subjects (2.4%) had both agenesis and DEI. Agenesis tended to be more common in class II malocclusions (p = 0.012).

The prevalence of permanent tooth anomalies was (20.4%). The percentage occurrence of DEI was the highest (12.9%) followed by dental agenesis (9.5%) and supernumerary teeth (1.4%) in the orthodontic patients at the State University of New York at Buffalo.

Al-Amiri A, Tabbaa S, Preston CB, Al-Jewair T. The Prevalence of Dental Anomalies in Orthodontic Patients at the State University of New York at Buffalo. J Contemp Dent Pract 2013;14(3):518-523.

The objective of this study was to investigate the problems faced by patients having complete dentures and the cleanliness of dentures by the patients.

This cross-sectional study is done with a sample of 178 patients having complete prosthesis since 1 year. A self-administered structured questionnaire pretested through a pilot survey was used in the study. The data were analyzed using the SPSS version 16.0. The Student's t-test, ANOVA and post hoc test were used as test of significance.

Mastication discomfort and looseness of denture were the most common complaints followed by lack of retention 35.4%), bad breath (29.8%), tongue restriction (26.4%) and food accumulation (24.7%). There was a significant relationship of complaints with age groups (p = 0.00).

This study concluded that most of the patients were present with complaints due to dentures. So, dental professionals should pay serious attention to their patients for subjective acceptable result of the dentures and also advice them to properly maintain hygiene of dentures.

Gosavi SS, Ghanchi M, Malik SA, Sanyal P. A Survey of Complete Denture Patients Experiencing Difficulties with their Prostheses. J Contemp Dent Pract 2013;14(3):524-527.

The percentage of general dental practitioners is very common in India, so the purpose of this study was to assess attitude of general dental practitioners toward root canal treatment (RCT) procedures.

In a cross-sectional study, 178 dentists (96 males and 82 females) were surveyed using a selfadministered, structured questionnaire pretested through a pilot survey. The questionnaire collected information regarding RCT procedures among participants. Data were analyzed using SPSS version 15. Frequency and percentage distributions were calculated.

In the present study most of the participants, i.e. 86.4% reported that they perform (RCT) procedures in posterior teeth. Isolation is mainly done with cotton rolls only (74.6%) and very few are using rubber dam in their practice (3.2%). Radiographs were not taken after every step in most of the cases. Rotary instruments were used in less number of cases and K-files were the most popular instruments (66.2%). Also single sitting RCT was not commonly seen.

This study indicates that most of the general dental practitioners’ do not comply with quality standards guidelines such as use of rubber dam as isolation. So dentist should update their knowledge and practices with current techniques and materials through CDE programs.

Gaikwad A, Jain D, Rane P, Bhondwe S, Taur S, Doshi S. Attitude of General Dental Practitioners toward Root Canal Treatment Procedures in India. J Contemp Dent Pract 2013;14(3):528-531.

To compare and evaluate the perceptions of esthetics among dentists and patients regarding the final esthetic outcome of a dental treatment.

Esthetics is a matter of perception and is associated with the way different people look at an object. What constitutes esthetic for a particular person may not be acceptable for another. Hence it is subjective in nature. This becomes more obvious during the post-treatment evaluation of esthetics by dentist and the concerned patient. Opinion seldom matches. Hence, the study is a necessary part of the process of understanding the mind of dentist and patient regarding what constitutes esthetics.

A survey has been conducted by means of a questionnaire consisting of 10 questions, on two groups of people. First group consists of 100 dentists picked at random in Kanyakumari district of Tamil Nadu, India. Second group consisted of 100 patients who required complete denture prosthesis. The second group was divided into two subgroups A and B. Subgroup A consisting of 50 men and subgroup B consisting of 50 women. In each subgroup 25 patients were selected in age group of 40 to 50 and 25 patients were selected in the age group of 50 to 60. The questionnaire was given to both the groups and asked to fill up, which was then statistically analyzed to look for patterns of thought process among them.

Results were subjected to statistical analysis by Student's t-test.

Perceptions of esthetics differs from dentist who is educated regarding esthetic principles of treatment and a patient who is not subjected to such education. Since, the questions were formulated such that patients could better understand the underlying problem, the final outcome of survey is a proof that dentists need to take into account what the patient regards as esthetics in order to provide a satisfactory treatment.

The current study helps the dentist to better educate the patient regarding esthetics so that patient appreciates the final scientifically based esthetic outcome of treatment. It also helps the dental students to understand the underlying patient's thought process regarding esthetics.

Reddy SV, Madineni PK, Sudheer A, Gujjarlapudi MC, Sreedevi B, Reddy PSK. Comparative Analysis of Rationale used by Dentists and Patient for Final Esthetic Outcome of Dental Treatment. J Contemp Dent Pract 2013;14(3):532-535.

To treat mucogingival problems palatal masticatory mucosa is used as a donor material. This study aimed to determine the thickness of donor palatal mucosa and associations of age and gender in Indian subjects aged 14 to 60 years by direct clinical technique.

Forty systemically and periodontally healthy Indian subjects (20 males; 20 females; age range of 14 to 60 years) enrolled in this study. Under local anesthesia bone sounding technique was performed at 15 defined and predetermined points. The Wilcoxon test was used to determine the difference in mucosal thickness between the age groups and between genders. Significance of the difference between individuals of different body mass index (BMI) was assessed by independent t-test.

With mean thickness of 2.0 to 3.7 mm, the younger age group demonstrated significantly thinner donor mucosa (mean 2.8 ± 0.3 mm) than the older age group (mean 3.1 ± 0.3 mm). Within the same age group though statistically not significant; males had thicker mucosa than females. From the canine to second premolar areas and in the sites furthest from the gingival margin mucosa thickness increased. When correlated with subject's BMI, in all probed sites males demonstrated significantly a thicker mucosa than females. Within each group subjects with high BMI demonstrated thicker donor mucosa.

Current study showed that in both adult and young individuals, premolar and canine areas can be the right site for harvesting donor tissue. Even in young subjects subepithelial connective tissue (CT) graft can be harvested in adequate volume. Donor tissue thickness can be influenced by factors like genetics and race, which need to be further evaluated.

Premolar and canine areas serve as appropriate choice to harvest palatal masticatory mucosa. Even in young patients the volume of donor tissue available is sufficient enough to consider the subepithelial CT graft procedure. Donor tissue thickness can be influenced by factors like genetics and race, which need to be further evaluated.

Anuradha BR, Shankar BS, John B, Prasad KARV, Gopinadh A, Devi KNN. Assessment of Palatal Masticatory Mucosa: A Cross-sectional Study. J Contemp Dent Pract 2013;14(3):536-543.

Oral rehabilitation of a child with Johanson-Blizzard syndrome (JBS).

JBS is an extremely rare inherited disorder characterized by unusually small nose that appears ‘beak shaped’ due to the absence (aplasia) or underdevelopment (hypoplasia) of the nostrils (nasal alae), abnormally small, malformed primary (deciduous) teeth and misshapen or absent secondary (permanent) teeth, hearing disorder, hypothyroidism, dwarfism, malabsorption and mental retardation. It is sometimes described as a form of ectodermal dysplasia.

Oral findings in JBS are very obscure in the literature. The present report describes oral findings in an 8 years old boy with JBS and his oral rehabilitation.

JBS has an emotional consequence for the affected individuals at early ages. Oral rehabilitation in this case had a very positive impact on the child's mind.

Early identification and treatment of this disease is of great importance to rehabilitate the patient on functional, esthetic and psychological front.

Santhosh BP, Jethmalani P. Johanson- Blizzard Syndrome: Dental Findings and Management. J Contemp Dent Pract 2013;14(3):544-547.

This is to report a rare case of ameloblastic fibrodentinoma (AFD), including detailed history, histopathologic as well as radiographic findings. Her condition, a mixed odontogenic tumor, has rarely been reported in publications. We also included the gist of theories put forward regarding the histogenesis of this lesion.

AFD is a rare and controversial entity; it boasts a variety of classifications and terminology based on its unique biological nature as well as histopathological features.

The patient was a 13-year-old girl with a chief complaint of central unerupted tooth on the left mandible. Cone beam computed tomographic images revealed a mixed pericoronal and multilocular lesion surrounding the crown of the aforementioned tooth, displacing it apically to a large extent.

It is important to differentiate AFD from other benign mixed odontogenic tumors with similar radiographic appearance because of different therapeutic approaches in some of these tumors.

From the clinical point of view, it is of paramount significance for dental practitioners to assess any delayed tooth eruption (more than 6 months and in comparison with its counterpart on the opposite side) radiographically to ascertain or rule out any such similar lesions.

Salehinejad J, Langaroodi AJ, Shahakbari R, Yazdani N. Ameloblastic Fibrodentinoma: Report of a Rare Case. J Contemp Dent Pract 2013;14(3):548-551.

To report a rare case of arrested root formation of permanent incisors in a young boy with mixed dentition and its management.

Traumatic injury to a primary tooth may damage the underlying permanent tooth germ and affect its development. The extent of the malformation depends upon the developmental stage of the permanent tooth and the intensity of trauma. Discoloration and hypoplasia of the crown, dilaceration, root angulation and disturbances in eruption are commonly seen developmental disturbances following trauma. However, partial or complete arrest of root formation is a rare developmental sequela of trauma to primary teeth. Attempt should be made to retain these natural teeth during the mixed dentition period.

A case is presented of a young boy with rare occurrence of arrested root formation of permanent mandibular incisors, following trauma to the primary predecessors. Clinically these teeth exhibited mobility and radiographic examination showed absence of root formation in relation to the incisors. The treatment plan was to retain the natural permanent teeth for a maximum period and to stabilize them until a more permanent replacement could be carried out. As the patient had mixed dentition, immediate stabilization was done using fiber reinforced splint until further definitive treatment is carried out.

Early diagnosis of developmental disturbances in permanent teeth resulting from trauma at a young age is necessary. Regular follow-up appointments, through clinical and radiographic examination and timely intervention may minimize or even avoid harm to the developing tooth.

Subramaniam P, Gupta M, Gona H. Arrest of Root Formation in Relation to Permanent Mandibular Incisors: A Rare Case Report. J Contemp Dent Pract 2013; 14(3):552-555.

de Jesus Tavarez RR, Malheiros AS, Benatti BB, Tonetto MR, Bandéca MC. Preoperative Gingival Conditioning as a Guide for Implant Installation and to achieve Proper Dentogingival Contours. J Contemp Dent Pract 2013;14(3):560-566.

The aim of this study is to evaluate through a literature review, the soft tissue response in contact with zirconia abutments, including case reports comparing prosthetics rehabilitations with zirconia and titanium abutments upto 3 years of follow-up as well as the factors that should be considered on implant's abutment selection.

Metallic abutments can provide grayish color when in contact with thin soft tissues which may lead the implant prosthetic treatment to failure. In this context, the abutments of zirconia stand out because there is an excellent linking between esthetics and the health of peri-implant soft tissues.

A consult of the published researches was made on the PubMed database from 2000 to September 2012. The including criteria were: literature reviews, clinical studies and case reports in English that focused on the response of the soft tissue in contact with zirconia implant abutments. The studies that were not in English and did not match the tackled issue were excluded.

A total of 32 articles were found. According to the search strategy, just 16 articles were selected for this review. Three studies affirmed that zirconia abutments have an excellent soft tissue response; one study showed increased gingival recession with zirconia abutments and nine studies do not stand out any difference on biological behavior between titanium and zirconia abutments. Three studies affirmed that zirconia abutments provide natural gingival appearance, anatomic contour and greater esthetics.

The use of zirconia abutments is recommended for anterior regions because of their greater optical properties and esthetic results and more studies should be performed and analyzed longitudinally regarding their biological response.

The zirconia abutments have been established to be essential in order to achieve great esthetic results in cases of thin peri-implant soft tissues and in regions where the three-dimensional placement of implants is more superficial.

de Medeiros RA, Vechiato-Filho AJ, Pellizzer EP, Mazaro JVQ, dos Santos DM, Goiato MC. Analysis of the Peri-implant Soft Tissues in Contact with Zirconia Abutments: An Evidence-based Literature Review. J Contemp Dent Pract 2013;14(3):567-572.