Tukey's test ascertained that toothbrush abrasion resulted in rougher and matte surfaces for all composites tested. Filtek Z350 presented better gloss retention after abrasion. On surface roughness evaluation, there was no statistical difference between Fusio Liquid Dentin and Filtek Z350 resins (p > 0.05). Vertise Flow resin showed better color stability (ΔE), than the other two materials.

Nanofilled material presented better gloss retention but it did not produce the best results in aspects related to surface roughness and color stability compared to self-adhering composites.

A simulation of degradation process by using toothbrush abrasion produced a rougher and matte surface in all composites tested. The surface texture was not only related to filler's amount present in materials, but also with the organic matrix composition of them. The results suggested that the constant development of new materials, seeking for a technical simplification, seems an innovative attraction for dentist's clinical routine, even though larger studies are necessary to promote to everyone a better understanding and improvement of action and effectiveness of this new class of materials.

Malavasi CV, Macedo EM, da Costa Souza K, Rego GF, Schneider LFJ, Cavalcante LM. Surface Texture and Optical Properties of Self-Adhering Composite Materials after Toothbrush Abrasion. J Contemp Dent Pract 2015;16(10):775-782.

Dental problems are commonly encountered in our lives. Some of the common problems are toothache, bleeding gums and halitosis.

How the dental problems were handled, and reasons of not seeking dental treatment by the patients.

This was an observational analytical cross-sectional study on adult's age above 14 years from Madinah.

A total of 400 adults were included; 208 (52%) were males and 192 (48%) were females. Resident encountered toothache surprisingly only 49% sought dental treatment, while (41%) settled for taking medications. Among bleeding gum patients most of them (45%) went to the dentist, while (41%) settled for using the home care. And dealing with halitosis only (17%) went to the dentist. The most common reasons for not seeking dental treatment were fear and long appointments. And mostly they had fear because of dental drill and dental needle.

The most common problems for seeking treatment were toothache followed by bleeding gums and the least was halitosis. Number of people who sought treatment was still a low number. The most common reason that stopped patients from going to the dentist was fear and long appointments. There should be increase of dental clinics and patients should be given dental education.

Ahmad MS, Al-Harbi KM. Behaviors and Management of the Dental Problems by the Residents of Madinah, Saudi Arabia. J Contemp Dent Pract 2015;16(10): 783-787.

To compare the bond strength and the fracture resistance of different post systems.

Endodontically treated 60 mandibular incisor and 60 mandibular premolar teeth were used for the bond strength and fracture resistance test respectively. For each test, three groups (n = 20) were formed according to the posts used zirconia posts (ZR post), individually formed glass fiber reinforced composite posts with an (Interpenetrating Polymer Network—IPN post) and cast metal posts. Then groups were randomly assigned into two subgroups according to the post design: 1-parallel sided and 2-tapered (n = 10/group). All posts were luted with a self-adhesive luting agent. For push-out test two 1 mm thick horizontal root sections were obtained and subjected to push-out test. For fracture resistance test, the specimens were loaded vertically at 1 mm/min crosshead speed. The push out test data were analyzed with Kruskal-Wallis and Dunn's test. Analysis of variance (ANOVA) and Tukey significant difference tests were used to compare the fracture resistance.

Cast metal posts showed the highest retention (p < 0.05); however, IPN and zirconia posts showed similar results. No significant difference was found between parallel sided or tapered designs of post groups in terms of bond strength (p > 0.05). In terms of fracture resistance, IPN post groups showed lowest fracture resistance (p < 0.05). No significant difference was found between parallel sided or tapered posts in terms of fracture resistance, except zirconia post (p > 0.05). There was no relationship between the bond strength and fracture resistance of the post systems (r = – 0.015, p > 0.700).

Post type had effect both on the fracture resistance and retention of the posts used. However, post design had effect only on the fracture resistance of the post systems.

Superficial treatment of the post used can improve the retention of post systems.

Türker SA, Özçelik B, Yilmaz Z. Evaluation of the Bond Strength and Fracture Resistance of Different Post Systems. J Contemp Dent Pract 2015;16(10): 788-793.

This study evaluated the simultaneous effect of extended etching time and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing paste application on shear bond strength (SBS) of etch-and-rinse adhesive to cariesaffected- dentin (CAD).

Fifty human third molars were used; 10 normal in group 1 and 40 caries-affected teeth in groups 2 to 5. In the CAD groups, teeth were randomly assigned into four groups (n = 10). In groups 2 and 4, phosphoric acid etching for 15 and 45 seconds was used and in groups 3 and 5, after 15 or 45 seconds etching respectively, CPP-ACP containing paste (MI paste) was applied for 3 minutes. After rinsing, single bond adhesive system and Z₂₅₀ composite were used for resin composite build-up in all groups. After storage, SBS test was measured at cross head speed of 0.5 mm/min. Data were analyzed using one/two-way ANOVA and Tukey HSD test (α = 0.05).

Normal dentin groups showed the highest SBS among different groups. There was a statistically significant difference between different etching times in CAD groups (p < 0.05), but there were no significant differences between SBS of SB adhesive to CAD with or without CPP-ACP pretreated in both etching times. Most of the failure modes were adhesive except in groups 1 and 5 which cohesive failure in composite was also observed.

The results of our study indicated that extended etching time up to 45 seconds could enhance the SBS of CAD and approach nearly to SBS of normal dentin. Moreover, MI paste pretreatment had not significant effect on SBS of etchand- rinse adhesive in CAD.

Simultaneous application of extended etching time and CPP-ACP containing paste may be a suggested method in increasing the SBS of adhesive to CAD.

Doozandeh M, Firouzmandi M, Mirmohammadi M. The Simultaneous Effect of Extended Etching Time and Casein Phosphopeptide-Amorphous Calcium Phosphate containing Paste Application on Shear Bond Strength of Etch-and-rinse Adhesive to Caries-affected Dentin. J Contemp Dent Pract 2015;16(10):794-799.

The purpose of this study was to determine the effect of different solutions cola soft drink (CSD) and coffee on roughness and microleakage of composite resin restorations.

Sixty bovine incisors were prepared and restored using Filtek Z350 XT (3M/ESPE) nanoparticulate resin. The samples were divided into three groups (n = 20): A (control)-Immersion in artificial saliva (14 days); B: Immersion in coffee (14 days), for 15 minutes (3x/day) and C: Immersion in CSD for 14 days (3x/day). Then the samples were analyzed for microleakage (dye penetration) and surface roughness (atomic force microscope). The one-way analysis of variance (ANOVA) was applied to assess the surface roughness and microleakage. The Tukey's test was set at 0.05.

Group A (roughness-GA_R) presented significantly the lowest average surface roughness. Group C (microleakage- GC_M) showed significantly the highest average microleakage.

It was concluded that CSD and coffee change the surface roughness and increase the microleakage of restorations.

Nowadays there is a high consumption of artificially sweetened soft drinks, sports drinks, high-energy beverages and coffee products by people that cause problems in composite resin restorations.

da Silva MAB, Vitti RP, Sinhoreti MAC, Consani RLX, da Silva JGJ, Tonholo J. Evaluation of the Surface Roughness and Microleakage of Dental Composites Exposed to Different Beverages. J Contemp Dent Pract 2015;16(10):800-804.

Secondary or recurrent caries are located around restoration margins or under these lesions, and can lead to tooth loss. The interproximal or bite wing radiograph is the technique of choice to assist diagnosis of secondary caries.

To evaluate diagnostic accuracy of secondary caries in pulpal walls artificially created in extracted human premolars, observed in digital bitewing radiographs using variations in horizontal X-ray beam angle of incidence and application of enhancement filters.

The sample consisted of 20 healthy premolars, in which secondary caries lesions were simulated by means of subjecting the pulpal wall of the cavity to wear with spherical carbide drill half, fitted to a high speed handpiece, under constant cooling, focused perpendicular to the tooth surface. The orifices were filled with wax and all teeth were restored with composite resin Filtek Z350 XT^®. Later teeth were radiographed with a digital sensor complementary metal-oxidesemiconductor (CMOS) varying the horizontal angle at intervals of 2°, covering a range of −10 to +10°.

The results showed that in the diagnosis of secondary caries, there was no statistically significant difference between the 2 pseudocolor filters, and negative and direct digital radiography. The pseudocolor filter no. 1 showed statistically significant differences, except at a horizontal angle of 0°, thus indicating lower efficiency in the diagnosis of secondary caries.

Secondary caries with esthetic pulp wall restoration can be diagnosed irrespective of variation in the horizontal angle of incidence of the X-ray beam. The use of different radiographic enhancement filters did not result in improved diagnosis of secondary caries.

Deprá LC, Iwaki LCV, Chicarelli M, Takeshita WM. Influence of Image Filters and Variation in Horizontal Angle of Incidence of X-ray Beam in Digital Interproximal Radiographs for Diagnosis of Secondary Caries in Esthetic Restorations. J Contemp Dent Pract 2015;16(10): 805-812.

Globally, India accounts for the highest number of oral cancer cases. The survival rates are about 30% lower than those in developing countries. The main reason for these dismal figures is the late presentation of patients. In order to downstage oral cancer in such a scenario, screening and diagnosis at an early stage is warranted. A pragmatic approach is needed for an oral cancer screening program, hence a mobile health (mHealth) approach was used. In this approach, health workers were empowered with mobile phones with decision-based algorithm. Risk stratification of tobacco habit enables us to identify lesions associated with particular habits.

A specific cohort of factory employees who predominantly had pure tobacco chewing habit was chosen to examine the effect of pure tobacco on oral mucosa. One thousand three hundred and fifty-seven subjects were screened in two phases. In the first phase, habits and oral lesions were identified and photographed. The photographs were remotely diagnosed by an oral medicine specialist and those subjects requiring biopsy were recalled for phase II. Cytology and biopsy were performed in phase II.

The predominant habit was smokeless tobacco (SLT), in 582 subjects. The most commonly encountered lesion was tobacco pouch keratosis seen in 397 subjects. Biopsy was performed for 71 subjects, most cases showed hyperkeratosis and mild dysplasia. One subject had moderate dysplasia.

There was minimal alteration of tissues in our study subjects, which can be considered as low-risk. Use of mHealth empowered frontline healthcare workers to identify subjects with lesions and enabled remote diagnosis by specialist in resource-constrained settings.

Use of mHealth enabled us have an electronic record of subject details. This data shall be used for a planned follow-up of the same cohort after 3 years.

Desai R, Birur P, Bajaj S, Shubhasini AR, Bhanushree R, Shubha G, Keerthi G, Tiwari V, Patrick S, Hegde U, Shetty S, Nagabhushan V, Kankanala S, Shah S. Smokeless Tobacco-associated Lesions: A Mobile Health Approach. J Contemp Dent Pract 2015;16(10):813-818.

Optimal orthodontic forces are those which stimulate tooth movement with minimal biological trauma to the tooth, periodontal ligament (PDL) during and alveolar bone. Among various types of tooth movements, extrusion and rotational movements are seen to be associated with the least amount of root resorption and have not been studied in detail. The mechanical behavior of the PDL is known to be nonlinear elastic and thus a nonlinear simulation of the PDL provides precision to the calculated stress values. Therefore in this study, the stress patterns in the PDL were evaluated with extrusion and rotational movements using the nonlinear finite element method (FEM).

A three-dimensional (3D) FEM model of the maxillary incisors was generated using SOLIDWORKS modelling software. Stresses in the PDL were evaluated with extrusive and rotational movements by a 3D FEM using ANSYS software with nonlinear material properties.

It was observed that with the application of extrusive load, the tensile stresses were seen at the apex whereas the compressive stress was distributed at the cervical margin. With the application of rotational movements, maximum compressi vstress was distributed at the apex and cervical third whereas the tensile stress was distributed on cervical third of the PDL on the lingual surface.

For rotational and extrusion movements, stress values over the periodontal ligament was within the range of optimal stress value as proposed by Lee, with a given force system by Proffit as optimum forces for orthodontic tooth movement using nonlinear properties. During rotation there are stresses concentrated at the apex, hence due to the concentration of the compressive forces at the apex a clinician must avoid placing heavy stresses during tooth movement.

Hemanth M, Raghuveer HP, Rani MS, Hegde C, Kabbur KJ, Chaithra D, Vedavathi B. An Analysis of the Stress Induced in the Periodontal Ligament during Extrusion and Rotation Movements—Part II: A Comparison of vs Nonlinear FEM Linear Study. J Contemp Dent Pract 2015; 16(10):819-823.

Lichen planus is a premalignant condition with minimal diagnostic aids. This study is an attempt to use paraffin embedded sections of lichen planus with immunofluorescein stain and to evaluate the immunofluorescent sections to establish pattern of fibrinogen deposition.

Thirty-five paraffin embedded sections of old and new cases of oral lichen planus (study group) and five normal oral mucosa (control group) were chosen. Two sections of each (H & E) case were taken, one was stained with hematoxylin and eosin and another with fluorescein isothiocynate conjugate (FITC) polyclonal rabbit antibody against fibrinogen. Fluorescent findings were examined with a fluorescent microscope.

A high statistical significant correlation was found in respect to fluorescence positivity, intensity of fluorescence and distribution of fluorescence each with p < 0.0001 and fluorescence at blood vessel walls (p = 0.0003).

This study suggested that paraffin embedded sections can be successfully used in direct immunofluorescence staining in routine set up where only formalin fixed tissues are received.

Paraffin embedded sections can be successfully used in direct immunofluorescence staining when only formalin fixed tissues are received.

Shirol PD, Naik V, Kale A. Fibrinogen Demonstration in Oral Lichen Planus: An Immunofluorescence Study on Archival Tissues. J Contemp Dent Pract 2015;16(10): 824-828.

In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center.

A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis.

Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value <0.05 was kept as statistically significant.

The services provided in public health center should be based on the felt need of the population to increase attendance as well as utilization of dental services, thereby increasing the oral health status of the population.

Pewa P, Garla BK, Dagli R, Bhateja GA, Solanki J. Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs. J Contemp Dent Pract 2015;16(10):829-833.

This work describes clinical cases treated with a innovative single-use and single-file nickel-titanium (NiTi) system used in continuous rotation.

Nickel-titanium files are commonly used for root canal treatment but they tend to break because of bending stresses and torsional stresses. Today new instruments used only for one treatment have been introduced. They help the clinician to make the root canal shaping easier and safer because they do not require sterilization and after use have to be discarded. A new sterile instrument is used for each treatment in order to reduce the possibility of fracture inside the canal. The new One Shape NiTi single-file instrument belongs to this group.

One Shape is used for complete shaping of root canal after an adequate preflaring. Its protocol is simple and some clinical cases are presented. It is helpful for easy cases and reliable for difficult canals.

After 2 years of clinical practice, One Shape seems to be helpful for the treatment of most of the root canals, with low risk of separation. After each treatment, the instrument is discarded and not sterilized in autoclave or re-used.

This single-use file simplifies the endodontic therapy, because only one instrument is required for canal shaping of many cases. The respect of clinical protocol guarantees predictable good results.

Dagna A. Nickel-Titanium Single-file System in Endodontics. J Contemp Dent Pract 2015;16(10): 834-839.

Alshahrani FAA, Aljabab AS, Motabi IHM, Alrashed A, Anil S. Primary Diffuse Large B-cell Lymphoma involving the Mandible. J Contemp Dent Pract 2015;16(10):840-844.