The purpose of this study was to assess in vitro the tooth color alterations associated with two commonly used endodontic irrigants, the chlorhexidine gluconate (CHX) and the sodium hypochlorite (NaOCl) up to 15 days post-treatment. Additionally, the possible influence of endodontic access preparation on tooth color was investigated.

Thirty intact human anterior teeth were used. Black adhesive tape with a 4 mm diameter window was used to standardize the enamel surface intended for color analysis. After the access cavity, preparation and the initial root canal negotiation with stainless steel hand files, the root canal shaping was completed with rotary nickel-titanium files. The teeth were divided into three groups (n = 10). Conventional syringe irrigation was performed with one irrigant for each group. The enamel surfaces were colorimetrically evaluated before access cavity, after cavity preparation and at 1, 3, 7 and 15 days post-treatment. The CIE color parameters (L*, a*, b*) were recorded and averaged for each material and the corresponding color differences (ΔE) were calculated and statistically analyzed.

The most significant factor in tooth color alteration, during the endodontic treatment, was the access preparation. CHX and NaOCl caused tooth color changes comparable with the saline. CHX and NaOCl did not increase the tooth color changes relative to the values induced by the access preparation.

The two endodontic irrigants were not able to induce tooth color alteration to a greater extent than the access preparation.

Chlorhexidine and NaOCl cannot be considered as discoloring endodontic materials. The most contributing factor in tooth color alteration during endodontic treatment in the anterior teeth is access preparation.

Koursoumis AD, Kerezoudis NP, Kakaboura A. In vitro Assessment of Tooth Color Alteration by Two Different Types of Endodontic Irrigants. J Contemp Dent Pract 2014;15(5):529-533.

This study evaluated the antibiofilm effect of an experimental solution of 2% Ricinus communis (R. communis) on a silicone-based denture liner by means of a randomized clinical trial, as well as the integrity of such liner following a cleansing regimen with such solution.

About 30 complete denture wearers had their lower dentures relined with a silicone-based denture liner and randomly allocated to cleanse their dentures by means of: (A) a specific toothbrush for complete dentures and dentifrice; (B) soaking in an experimental 2% R. communis solution; and (C) association of A and B. Considered outcomes were biofilm coverage area (%), microbial counts by means of the deoxyribonucleic acid (DNA) checkerboard hybridization technique and physical integrity of the soft liner, assessed during a time interval of 60 days. Mean group values were compared by analysis of variance (ANOVA) and Tukey tests or generalized linear method (α = 0.05).

The mechanical method presented the lowest biofilm percentage (1.45 ± 1.03) if compared to the chemical method (2.96 ± 1.98) and the associated one (2.71 ± 1.76). After 60 days (3.37 ± 2.04), biofilm accumulation was higher than at 15 days (1.28 ± 0.77) and 30 days (2.46 ± 1.54). The denture liner was less deteriorated and kept its physical integrity when the mechanical method was applied. The chemical method presented higher effectiveness against microorganisms, including some Candida species.

The 2% R. communis solution presented stronger antimicrobial capacity than brushing on a silicone-based denture liner after immersion. However, it was not superior to the mechanical method in preserving the physical integrity of the material and in biofilm removal.

Soft denture liners hygiene is a very important issue and not conclusive in the literature. The experimental solution of 2% R. communis evaluated presented promising antimicrobial potential and should be more explored to be recommended as cleanser.

de Luna Malheiros Segundo A, Pisani MX, do Nascimento C, Souza RF, de Freitas Oliveira Paranhos H, Silva-Lovato CH. Clinical Trial of an Experimental Cleaning Solution: Antibiofilm Effect and Integrity of a Silicone-based Denture Liner. J Contemp Dent Pract 2014;15(5):534-542.

To evaluate and compare the frictional resistance produced by Super Slick modules during sliding with four different types of brackets and four ligature types both in conventional and figure-of-8 ligation method with saliva as lubricant.

The frictional resistance was evaluated by using four different ligatures on 0.019” × 0.025” stainless steel (SS) archwires using four different brackets using an universal testing machine with unstimulated saliva as a lubricant. Mean and SD values were calculated. Data was statistically analyzed using analysis of variance ANOVA with post hoc test.

The results showed that self-ligating brackets produced least frictional forces. Among all other tested combinations, Teflon-coated SS ligatures in ceramic with metal slot brackets produced least coefficient of static and kinetic friction and full ceramic brackets ligated with Super Slick elastomeric modules demonstrated the highest, with other combinations falling in between.

Super Slick elastomeric modules, produced highest coefficient of both static and kinetic friction with the conventional and figure-of-8 ligation technique even in wet conditions using natural fresh human saliva.

Both static and kinetic frictional resistance play an important role during sliding mechanics. Various factors have been attributed for friction. However, bracket type, archwire material, type of ligature and method of ligation are important variables. Recently polymeric coated slick elastomeric modules were introduced with the claim that they produce very low frictional forces in wet condition. Contrary to the claim made by the manufacturers of Super Slick elastomeric modules, they produced highest coefficient of both static and kinetic friction with the conventional and figure-of-8 ligation technique.

Pattan SK, Peddu R, Bandaru SK, Lanka D, Mallavarapu K, Pathan AB. Efficacy of Super Slick Elastomeric Modules in reducing Friction during Sliding: A Comparative in vitro Study. J Contemp Dent Pract. 2014; 15(5):543-551.

Berger SB, Pazenhagen R, Martinelli N, Moura SK, de Carvalho RV, Guiraldo RD. Effect of Bleaching Agents on the Flexural Strength of Bovine Dentin. J Contemp Dent Pract 2014;15(5):552-555.

The aim was to compare the effect of chronic stress on ligature-induced periodontitis in inbred and noninbred female rats by means of a radiographic study.

Adult Lewis (inbred) and Wistar (noninbred) rats were used and divided into the following groups: Ligature/Stress Lewis Group (LSLG, n = 8); Ligature/Stress Wistar Group (LSWG, n = 8); Ligature Lewis Group (LLG, n = 8) and Ligature Wistar Group (LWG, n = 8). The animals were anesthetized and a silk thread was continuously kept around their second upper right molar. Then, groups LSLG and LSWG were subjected to physical stress test (physical restraint for 12 hours). After 15 days of ligature placement, the animals were euthanized. The right hemimaxilla was kept in formalin solution for 48 hours. Radiographs of the hemimaxillae were obtained using the parallelism technique and subsequently submitted to a standardized radiographic processing. The examiner was blinded to the groups and calibrated. The bone height level was measured and the data were subjected to statistical analysis (ANOVA, Tukey, p < 0.05).

LSWG showed bone destruction significantly higher than that of LSLG (32.1 ± 1.45 mm and 23.6 mm ± 2.13, respectively). Similarly, LWG showed bone destruction significantly higher than that of LLG (28.6 ± 1.18 mm and 25.2 ± 2.76 mm, respectively).

Inbred rats (Lewis) are less susceptible to the effects of chronic stress than are noninbred rats (Wistar) in relation to ligature-induced periodontitis.

Epidemiological studies have shown a relationship between stress and periodontitis. One of the major difficulties of this type of research is the bias of the exact diagnosis of the patient's emotional state. Inbred lines animals have standards-specific neuroendocrine, this allows answers about the susceptibility of periodontal disease, making knowledge applicable in future clinical trials.

Semenoff-Segundo A, Borges AH, Bandeca MC, Porto AN, Pedro FLM, dos Santos RSS, Tonetto MR, Semenoff TADV. Effect of Chronic Stress on Ligatureinduced Periodontitis in Inbred and Noninbred Rats: A Radiographic Study. J Contemp Dent Pract 2014;15(5):556-560.

No randomized controlled trial has tried to compare transverse dental arch changes between the lingual and labial orthodontic fixed appliances in the early stage of treatment.

To compare upper dental arch changes between lingual and labial fixed orthodontic appliances after leveling and alignment.

Parallel-groups randomized controlled trial on patients with class I moderate crowding teeth treated at the University of Al-Baath Dental School in Hamah, Syria.

About 102 patients with crowded teeth and class I malocclusion were evaluated and 58 patients fulfilled the inclusion criteria. Randomization was performed using computer generated tables; allocation was concealed using sequentially numbered opaque and sealed envelopes. About 52 participants were analyzed (mean age 21.5 ± 3.2 years). They were randomly distributed into two groups with 26 patients in each (1:1 allocation ratio).

Lingual vs labial fixed orthodontic appliances were used.

Intercanine width, interpremolar width, intermolar width, and arch length were measured on study models before brackets’ placement (T1), at the end of leveling and alignment stage (T2).

Statistically significant increase was detected in the intercanine width in the lingual group (1.99 mm, p < 0.001) and in the labial group (1.22 mm, p < 0.001). The interpremolar width had a significant decrease in the lingual group (–0.70 mm, p < 0.001), whereas there was a significant increase in this width in the labial group (1.73 mm, p < 0.001). A significant decrease in intermolar width was detected in the lingual group (–0.79 mm, p < 0.001) whereas a significant increase was observed in the labial group (0.81 mm, p < 0.001). The differences between the two groups were significant for all comparisons (p < 0.001).

The labial appliance produced a significant increase in all horizontal transverse arch dimensions, whereas in the lingual appliance group the intercanine width increased significantly in conjunction with a significant narrowing of posterior segments.

The University of Al-Baath Postgraduate Research Budget (UBDS-00786223-PG).

Khattab TZ, Hajeer MY, Farah H, Al-Sabbagh R. Maxillary Dental Arch changes following the Leveling and Alignment Stage with Lingual and Labial Orthodontic Appliances: A Preliminary Report of a Randomized Controlled Trial. J Contemp Dent Pract 2014;15(5):561-566.

This study evaluated the in vitro effect of 35% hydrogen peroxide (HP) on surface enamel change when activated with different light curing units (LCUs).

Enamel blocks (4 × 4 × 2 mm) were obtained from bovine incisors. The initial microhardness of the enamel was determined for each specimen. After this enamel blocks were randomly divided into four groups (n = 10) and treated as follows: Control, no bleaching procedure performed; HP – LCU, application of 35% HP gel without light activation; HP + QTH, application of 35% HP gel and light activation with a Quartz Tungsten-Halogen (QTH); and HP + Light Emitting Diode, application of 35% HP gel and light-activation with a LED. New microhardness measurements were obtained, immediately, 7 and 14 days after treatment. The percentage of surface mineral change was calculated according to the baseline and post-treatment microhardness values. Additionally, six samples from each group were randomly selected and prepared for scanning electron microscopy (SEM) characterization. The data were analyzed using an analysis of variance (ANOVA) to detect differences between the three time periods, and an ANOVA and Tukey's test with a confidence level of 95%.

There was no significant difference between the initial hardness values and hardness values after treatment in any of the groups or time periods (p > 0.05). No major surface alterations were detected with SEM when comparing control groups to those undergoing bleaching treatments.

The use of 35% HP in combination to QTH or LED light curing units LCU does not have detrimental effect on the enamel surface topography or in the mineral content, when compared with unbleached enamel or enamel submitted to 35% HP treatment alone.

da Silva AF, Demarco FF, Meereis CTW, Cenci MS, Piva E. Light-activated Bleaching: Effects on Surface Mineral change on Enamel. J Contemp Dent Pract 2014;15(5):567-572.

Tebloeva LM, Revazova ZE, Fabrikant KG, Dmitrieva LA, Gurevich KG. Differences in Immune Response to Porphyromonas gingivalis. J Contemp Dent Pract 2014;15(5):573-575.

Bisphenol A (BPA) elution from baby bottles into content has been of great public interest and debate in recent year. Uncontrolled BPA elution due to temperature increase may create a risk factor for human health. However, dental resins that are used in pediatric dentistry also have BPA derivatives. The aim of this study is to evaluate BPA elution from dental resins and to determine the effect of temperature increase on this elution.

Four dental resins containing BPA derivatives (Filtek Z250, Filtek Supreme XT, Fissurit FX, and Admira) and a control group (BPA free G-aenial) were used in this study. Each specimen was stored in 2 ml of 75% ethanolwater solution at 37°C. Water at a temperature of 59°C ± 1°C (preferred temperature of hot drinks) was added to the study samples at certain time intervals (1, 6, 24 hours and 2, 3, 4, 5 and 6 days). The methanol samples were analyzed using high-performance liquid chromatography (HPLC). Data was analyzed using multivariate and repeated measures analysis of variance (p < 0.05).

The study samples generally eluted more BPA than the control samples (p < 0.05). The greatest amount of BPA for an individual time period was measured after 6 hours for the groups A to D; the same was found after 24 hours for group E.

While the BPA elution levels evaluated in the study samples were more than control samples, all measured values were under the reference levels and the amounts do not constitute a risk.

Resin-based dental materials can act as a source of BPA (within safety margins), especially when they react with hot water.

Atabek D, Aydintug I, Alaçam A, Berkkan A. The Effect of Temperature on Bisphenol: An Elution from Dental Resins. J Contemp Dent Pract 2014;15(5):576-580.

This study evaluated the push-out bond strength of cemented fiber posts after deproteinization of root canal dentin walls with NaOCl. The effect of the application of an antioxidant solution (sodium ascorbate) was also evaluated.

A three-step etch-and-rinse (Scotchbond - 3M Espe) and a one-step self-etching adhesive (Xeno III - Dentsply Caulk) were evaluated. Thirty bovine incisor roots were divided into 3 groups:

a. Irrigation with physiologic solution (control).

b. Deproteinization with 10 minutes irrigation of 5% NaOCl.

c. Deproteinization with NaOCl followed by 10 minutes irrigation with 10% ascorbic acid. Fiber posts were cemented with a dual-cured cement (Rely X ARC - 3M ESPE). The push-out bond strength was evaluated after 24 hours of storage in distilled water. The data were analyzed with three-way ANOVA, one-way ANOVA and Tukey's test (á = 0.05).

There were significant differences between groups (p < 0.05). The bond strength of Scotchbond was not influenced by the deproteinization. Xeno III showed a decrease in bond strength when deproteinized with 5% NaOCl (p < 0.05). For Xeno III, the subsequent irrigation with ascorbic acid was able to reverse the effect of the deproteinization. Considering the radicular thirds, the bond strength varied in the sequence—apical < middle < coronal.

Only the all-in-one adhesive was influenced by the deproteinization. Considering the respective control groups, both systems showed similar bond strength results.

The decreased bond strength of the selfetching adhesive following deproteinization seams to be related to the oxidant effect of the NaOCl solution and the subsequent irrigation with ascorbic acid was able to reverse the effect of the deproteinization.

Furuse AY, Cunha LF, Baratto SP, Leonardi DP, Haragushiku GA, Gonzaga CC. Bond Strength of Fiber-reinforced Posts to Deproteinized Root Canal Dentin. J Contemp Dent Pract 2014;15(5):581-586.

The aim of this study was to evaluate the color stability of two commercially available bleach-shade resin composites (RC) after exposure to 3 storage solutions and the effect of 3 bleaching agents on the color stability and stain removal from stained RC.

Two bleach-shade RC were evaluated in this study, including a nanofilled RC, Filtek^TM Z350 XT (FZ), and a nanohybrid RC, Tetric® N-Ceram (TC), in the extra-white body (shade) (XWB) and L shades, respectively. Twenty-seven disk-shaped specimens, each measuring 12 mm in diameter and 2 mm in thickness, were prepared for each RC, with a total of 54 specimens. Specimens were randomly allocated into 3 groups of 9 specimens each and immersed in 3 storage solutions (distilled water, tea and coffee) for 7 days period. The 9 specimens in each staining group were further divided into 3 subgroups. Specimens in each subgroup (n = 3) were bleached using one of the bleaching agents (10 and 16% Zoom NiteWhite amorphous calcium phosphate (ACP), and Zoom 2 chairside with light activation) for 5 days period. The specimen colors were measured with spectrophotometer. The measurements were performed on each sample three times at baseline, after staining, and after bleaching. Color was expressed using the commission international de I'Eclairage (CIE) L*a*b* color space. The color differences (ÄE) between the three measurements were calculated and the results were statistically analyzed using Two-way and Three-way analysis of variance (ANOVA) and Tukey's posthoc tests. Level of significance was set at p < 0.05.

Tetric® N-ceram materials demonstrated significantly less color change than the FZ and the color change, which was greater after storage in coffee compared to tea, was statistically significant. The bleaching agents significantly influence the color changes of composite specimens. All groups showed (ÄE) values below 3.3 after bleaching, except for ‘Zoom 2 chairside’ with light activation groups, which is shown clinically unacceptable lighter shade (ÄE >3.3).

Bleach-shade composites showed significant discoloration (ÄE > 3.3) after being immersed into coffee and tea solutions. Nanofilled composites discolored more than nanohybrid composites, and carbamide peroxide-based bleaching agents were effective in reducing the discoloration to a clinically acceptable value (ÄE > 3.3).

Farah RI, Elwi H. Spectrophotometric Evaluation of Color Changes of Bleach-shade Resin-based Composites after Staining and Bleaching. J Contemp Dent Pract 2014;15(5):587-594.

Bioactive glass air abrasion is a conservative technique for removal of initial decalcified enamel superficial layer and caries vs alumina air abrasion. This study evaluated shear bond strength of composite resin to sound and decalcified deciduous enamel using etch-and-rinse and self-etch adhesives after alumina and bioactive glass air abrasion.

Ninety-six flat enamel surfaces, mounted in acrylic resin, were prepared from 48 deciduous molars. Half of the specimens were decalcified with a demineralizing solution. Both intact and decalcified specimens were assigned to two groups for alumina and bioactive glass air abrasion. In each group, the specimens were subdivided into two groups for application of Clearfil SE Bond or Optibond FL adhesives (n = 12). After composite resin bonding, the specimens underwent shear bond test. Data were analyzed using three-way analysis of variance (ANOVA), linear regression model and independentsample t-test (á = 0.05).

No significant differences were noted in bond strength of composite resin after alumina or bioactive glass air abrasion (p = 0.272). Optibond FL adhesive and enamel decalcification produced higher bond strength (p = 0.000, p = 0.001 respectively).

In this study, bioactive glass air abrasion produced bond strength comparable to the conventional method. This technique might be an alternative method for preparation of normal and/or decalcified enamel of deciduous teeth for resin bonding.

Eshghi A, Khoroushi M, Rezvani A. Resin Bonding using Etch-and-Rinse and Self-etch Adhesives to Decalcified Deciduous Enamel after Bioactive Glass Air Abrasion. J Contemp Dent Pract 2014;15(5):595-602.

To evaluate the antibacterial activity of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) alone or associated with cetrimide (CTR), and QMiX against biofilm and planktonic Enterococcus faecalis (E. faecalis) [American type culture collection (ATCC) 29212].

The solutions 2.5% NaOCl, 2.5% NaOCl + 0.2% CTR, 2% CHX, 2% CHX + 0.2% CTR, 0.2% CTR, and QMiX were evaluated. E. faecalis biofilms were induced for 14 days on bovine dentin blocks. The irrigants were evaluated after contact with E. faecalis suspension and biofilm for 1 and 3 minutes. After that, serial decimal dilutions were made and plated on tryptic soy agar (TSA) medium. Plates were incubated for 24 hours at 37°C and the colony-forming unit (CFU) 1 ml was determined. Data were subjected to ANOVA and Tukey's tests at 5% significance.

All microorganisms were eliminated by direct contact of the irrigants with planktonic cells. Only NaOCl and NaOCl + CTR were able to completely eliminate the microorganisms by direct contact with E. faecalis biofilm. CHX presented effectiveness similar to CHX + CTR CTR, and QMiX after 1 minute of contact and similar to NaOCl and NaOCl + CTR after 3 minutes (p > 0.05), but was unable to completely eliminate the microorganisms. CTR and QMiX did not differ from each other.

CTR addition to CHX and NaOCl solutions did not improve the antimicrobial activity against biofilm. All evaluated irrigants and associations presented activity against planktonic E. faecalis. Only NaOCl and NaOCl + CTR eliminated biofilm after 1 and 3 minutes of direct contact.

Addition of CTR does not modify the antibiofilm effectiveness of CHX and NaOCl.

Nascimento CA, Tanomaru-Filho M, Faria-Junior NB, Faria G, Guerreiro-Tanomaru JM. Antimicrobial Activity of Root Canal Irrigants associated with Cetrimide against Biofilm and Planktonic Enterococcus Faecalis. J Contemp Dent Pract 2014;15(5):603-607.

The aim of this study was to assess the level of knowledge, awareness and attitude about research ethics and research ethics committees (RECs) among dental faculties.

This cross-sectional questionnaire study incorporated a self administered questionnaire. Descriptive, Chi-square and logistic regression analysis was used to analyze the data.

The overall response rate to the study was 85%. More than half were familiar with research ethics, principles and functions of the research ethics committee. Though there were some faculties whose attitude regarding research ethics principle was not optimal.

The present study revealed a broad acceptance among the faculties acceptance toward RECs and training in research ethics, though there existed certain gap in knowledge about research among the faculties.

This will help us to understand the knowledge, awareness and attitudes of dental faculties toward research ethics, which will help the institutional officials to develop better educational programs in the field of research ethics in order to help them conduct better research henceforth.

MG Nithin, John J, Senthilkumar E, Nagappan N. Knowledge Awareness and Attitude about Research Ethics among Dental Faculties in India. J Contemp Dent Pract 2014;15(5):608-613.

Leukemia is a malignancy of the bone marrow and constitutes 30% of all childhood cancers. The leukemic condition itself and its therapy cause oral signs and symptoms with significant morbidity.

The aim of this study was to review the oral health status in children with leukemia and relate the gingival and periodontal findings to the changes in their hematological values.

The oral health status in 47 pediatric leukemic patients in the age group of 6 to 14 years was assessed using the dmft/DMFT index, OHI(S) index and modified gingival index (MGI). Their hematological reports on the day of examination were obtained. The patients were divided into three groups based on the status of treatment. The relation between the platelet count and the WBC count with the MGI score was checked.

The highest dmf and DMF scores were seen in patients who were currently under treatment. Though an inverse relation was seen between the platelet count and the MGI score, a statistically significant value was not obtained.

A longitudinal follow-up of patients should be carried out in order to establish a relation between the hematological parameters and the gingival inflammation score.

Venkataraghavan K, Majithia U, Choudhary P, Trivedi K, Shah S. Relationship between Oral Health Status and Hematological Values in Pediatric Leukemic Patients: An Evaluative Survey. J Contemp Dent Pract 2014; 15(5):614-617.

This study was conducted to assess the vertical and horizontal relationship between the maxillary sinus floor and maxillary posterior teeth roots using cone beam computed tomography.

In this cross-sectional study, the CBCT images presented in the radiology department of Hamadan dental school was used. From 450 observed CBCT, 340 of them did not have the inclusion criteria of the study and ultimately 110 CBCT were selected. Totally 214 first premolars, 217-second premolars, 220 first molars and 220-second molars were included. For evaluating the relationship between the maxillary sinus floor and the posterior maxillary teeth, the classification implemented in the study of Jung in 2009 was used. The relation was evaluated by two radiologists twice with a 2-week time interval.

One hundred and ten patients with a mean age of 31.06 ± 9.7 years were assessed. Type 0 relationship (the maxillary sinus floor is located above the root tip) was most frequently observed with the first and second premolars. The most common type observed in the first and second molars was type 3 (apical protrusion is seen over the maxillary sinus floor). The relation between different types and gender was statistically meaningful, while no statistically significant difference was found between the right and left side assessments.

This study showed that although most of the teeth did not have contact with the sinus floor, but the more posterior the maxillary teeth, the more probability for root protruding into the maxillary sinus. It also confirmed that protrusion of teeth roots into the maxillary sinus is more common in male than female.

Knowing the anatomical relation between the posterior teeth and the maxillary sinus, help the clinician in preoperative treatment planning of the posterior maxillary teeth and avoid problems that may occur during dental practice.

Shokri A, Lari S, Yousefi F, Hashemi L. Assessment of the Relationship between the Maxillary Sinus Floor and Maxillary Posterior Teeth Roots using Cone Beam Computed Tomography. J Contemp Dent Pract 2014;15(5): 618-622.

Recently, there has been growing interest in the role of salivary nitrate and nitrite in caries protection. Nitrate is a natural compound found in fruits and vegetables and when secreted in saliva, is reduced to nitrite through bacterial respiration and subsequently reduced to nitric oxide in acidic condition. Nitric oxide takes part in oral non-specific immune system and prevents bacterial growth. The aim of present study was to determine the concentration of nitrite and nitrate in saliva of children with different caries activity.

Ninety three children, 4 to 6 years old, enrolled in this case-control study and were divided into 3 groups; 31 caries free children, 31 with 5 <DFS ≤ 10 and 31 with DFS >10. Unstimulated saliva was collected and stored in 4°C. Measurement of nitrate and nitrite concentration was performed using Griess reaction. Data were analyzed by T-test, Chi-square, ANOVA and multiple comparisons using SPSS 18. p < 0.05 was considered significant.

Mean value of DFS in the first, second and third were 0, 7.12 and 12.61 respectively. Mean value of nitrite and nitrate in the third group was significantly higher than two others (p < 0.05), but the difference between first and second group was not significant.

Increase in DFS was associated by increase in salivary nitrite and nitrate concentration.

High concentration of nitrate and nitrite is not enough for caries prevention.

Ghasempour M, Qujeq D, Rabiee M, Hamzeh M. Measurement of Nitrite and Nitrate in Saliva of Children with Different Caries Activity. J Contemp Dent Pract 2014;15(5):623-625.

Sterilization of critical and semicritical instruments used in patient care must undergo a terminal process of sterilization. Use of chemical and physical indicators are important in providing information on the sterilizer's performance during each cycle. Regular and periodic monitoring of sterilizers using biological indictors is necessary in periodically validating performance of sterilizers. Data loggers or independent digital parametric indicators are innovative devices that provide more information than various classes chemical indicators. In this study we evaluated a prototype of an independent digital parametric indicator's use in autoclaves.

The purpose of this study was to evaluate the performance of an independent digital indictor/data logger prototype (DS1922F) that could be used for multiple cycles within an autoclave. MG

Three batches of the DS1922F (150 samples) were used in this study that was conducted in a series. The first batch was challenged with 300 sterilization cycles within an autoclave and the data loggers evaluated to study failures and the reason for failure, make corrections and improve the prototype design. After changes made based on studying the first batch, the second batch of the prototype (150 samples) were challenged once again with 300 sterilization cycles within an autoclave and failure studied again in further improvement of the prototype. The final batch (3rd batch) of the prototype (150 samples) was challenged again but with 600 cycles to see how long they would last. Kaplan-Meier survival analysis analyses of all three batches was conducted (α = 0.05) and failed samples qualitatively studied in understanding the variables involved in the failure of the prototype, and in improving quality.

Each tested batch provided crucial information on device failure and helped in improvement of the prototype. Mean lifetime survival of the final batch (Batch 3) of prototype was 498 (480, 516) sterilization cycles in an autoclave.

In this study, the final batch of the DS1922F prototype data logger was found to be robust in withstanding the challenge of 600 autoclave cycles, with a mean lifetime of more than 450 cycles, multiple times more than prescribed number of cycles.

Instrument reprocessing is among the important aspects of infection control. While stringent procedures are followed in instrument reprocessing within the clinic in assuring patient safety, regular use of sterilization process indicators and periodic biological validation of the sterilizer's performance is necessary. Chemical indicators for use in Autoclaves provide information on whether the particular cycle's parameters were achieved but do not provide at what specific point in time or temperature the failure occurred. Data loggers and associated reader software as the tested prototype in this evaluation (DS1922F), are designed to provide continuous information on time and temperature of the prescribed cycle. Data loggers provide immediate information on the process as opposed to Biological Indicators that take from days to a week in obtaining a confirmatory result. Further, many countries do not have the sterilization monitoring service infrastructure to meet the demands of the end users. In the absence of sterilization monitoring services, use of digital data loggers for each sterilization cycle is more pragmatic.

Puttaiah R, Griggs J, D'Onofrio M. A Preliminary Evaluation of a Reusable Digital Sterilization Indicator Prototype. J Contemp Dent Pract 2014;15(5):626-635.

Fibrous dysplasia is a benign fibro-osseous disorder of unknown etiology that may affect the craniofacial region causing significant impairment of facial esthetics and function. This paper reports a case of a 21-year-old male, which was investigated and diagnosed with craniofacial fibrous dysplasia involving an overgrowth over right maxillary and mandibular region associated with facial asymmetry, severe occlusal cant and anterior open bite. Management of the case included surgical excision, cosmetic contouring and orthodontic intervention. The case was reviewed over a period of two years, which demonstrate stable treatment outcome.

Gupta S, Jain S, Newaskar V, Ali M. Craniofacial Fibrous Dysplasia with Facial Asymmetry, Canted Occlusion and Open Bite: A Case Report with 2 Years Followup. J Contemp Dent Pract 2014;15(5):636-645.

To report cases with morphologic variations in mandibular premolars.

Mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate (type V, Vertucci) foramina in mandibular premolars is very rare. In this report, three cases are presented involving the root canal treatment of mandibular premolars with three different root and canal configurations. The present report also emphasizes the use of the dental operating microscope to enhance visualization.

Correlation between radiographic findings, use of dental operating microscope and knowledge of aberrant anatomy helps to identify, locate and treat the aberrant anatomy of the tooth.

The treatment was successful as all canals were identified and filled and also as evidenced by relief of symptoms.

Success is largely dependent on the use of magnification, which aided in identifying the location of the three individual root canal orifices; thus emphasizing the need to familiarize ourselves with dental microscopy, to obtain maximal anatomic information in endodontic practice.

Bhardwaj A, Kottoor J, Albequerque DV, Velmurugan N. Morphologic Variations in Mandibular Premolars: A Report of Three Cases. J Contemp Dent Pract 2014;15(5): 646-650.

Tavares da Silva RHB, Paleari AG, de Assis Barros Brito C, Rocha JFSS, Massucato EMS, Quishida CCC. A Clinical Report of an Oral Lichen Planus associated to Epidermoid Carcinoma in Contact with Metallic Restorations. J Contemp Dent Pract 2014;15(5):651-653.

This case report describe a resin layering restorative technique based on biomimetic concept to improve esthetics in a patient with dental defects that affected both enamel and dentin in anterior teeth.

Severe structural defect in anterior teeth compromises esthetics and it is a high challenge to become the defect imperceptible after the restoration.

A clinical sequence of applying different composite resin layers allowed the reproduction of the interaction between hard dental tissues and the restorative material.

This technique achieved a satisfactory final esthetic outcome, preserving sound teeth structure and at same time, improved the quality of life of the young patient.

The utilization of the biomimetic concept to increase a disharmonic smile with dental defects is based in a conservative approach, which reached a satisfactory and esthetic outcome.

Paschoal MA, Santos-Pinto L, Nagle M, Ricci WA. Esthetic and Function Improvement by Direct Composite Resins and Biomimetic Concept. J Contemp Dent Pract 2014;15(5):654-658.

Patil S, Rao RS, Majumdar B. Single Gene Disorders with Craniofacial and Oral Manifestations. J Contemp Dent Pract 2014;15(5):659-671.

This clinical report describes a time-saving recording procedure for implant prosthesis.

In implant prosthodontics, a few procedures have been suggested to record jaw relationships. Record bases with occlusion rims supported by healing abutments, or screw retained bases are the conventional methods used for mounting definitive implant casts in the articulator.

This article describes a simple method that enables the clinician to transfer the existing occlusal vertical dimension (OVD) and centric relation (CR) of acceptable complete denture to final fixed prostheses. Advantages and disadvantages of this procedure are also discussed.

The method described in this article reduces the chair time and is comfortable for both the patient and clinician.

In this article, a chair side technique is presented for articulating the definitive implant casts that maintains the established OVD and CR of the patient's existing complete dentures.

Parnia F, Moslehifard E, Motayagheni N, Pournasrollah A. A Time-saving method for Transferring Occlusal Vertical Dimension and Centric Relation of Complete Denture to a Full Arch Implant Prosthesis. J Contemp Dent Pract 2014;15(5):672-675.