To evaluate the frequent use of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) systems on shaping ability of root canal utilizing Solidworks (2014, Dassault Systèmes) software.

Thirty-six root canals in clear resin blocks (Dentsply-Maillefer) were allocated into six experimental groups (n = 36). Six new sets of PTN instruments (Dentsply Maillefer, Ballaigues, Switzerland) were used six times to shape the resin blocks. A #15 K-file was inserted to the working length (WL), followed by ProGlider (PG) to create a glide path. Sequential use of PTN instrumentation in a crown-down technique was used to reach size (30/07) apically. Macroscopic photos of the blocks were taken before and after instrumentation, layered by Paint Shop Pro 9 from JascSoftware^®, and then canal transportation was measured using Solidwork 2014. The data were analyzed by SPSS software version 22. Multivariate statistical analysis general linear model (GLM) was also applied. Bonferroni correction test was used in multiple comparisons and the statistical significance was set to 0.05.

There was no difference in canal transportation resulted from utilizing PTN files after six multiple uses; in addition, the PTN files showed ability to maintain the original canal anatomy, especially in the apical level, where lowest total mean value of canal center displacement was seen (3 mm level) (0.019 ± 0.017).

ProTaper Next files can be used to prepare single and multiple canals in a single furcated tooth.

ProTaper Next nickel-titanium (NiTi) file system is a safe instrument that respects the canal shape, allows practitioners to treat difficult cases with good results, and low risk of separation.

Elemam RF, Capelas JA, Vaz MAP, Viriato N, Pereira ML, Azevedo A, West J. Evaluating Transportation by Comparing Several uses of Rotary Endodontic Files. J Contemp Dent Pract 2015;16(12):927-932.

This study aimed to evaluate the repeatability of color measurements of an intraoral spectrophotometer with the use of three different methods by two operators.

A total of 60 teeth were obtained, comprising 30 human maxillary teeth [central incisors (n = 10); canines (n = 10); molars (n = 10)] and 30 artificial teeth [lateral incisors (n = 10); premolar (n = 20)]. Multiple repeated color measurements were obtained from each tooth using three measuring methods by each of the two operators. Five typodonts with alternating artificial and human teeth were made. Measurements were taken by two operators with the Vita EasyShade spectrophotometer using the custom tray (CT), custom jig (CJ) and free hand (FH) method, twice, at an interval of 2 to 7 days. Friedman test was used to detect difference among the three color measuring methods. Post hoc Wilcoxon signed-rank test with Bonferroni correction applied was used for pair-wise comparison of color measurements among the three methods. Additionally, a paired-sample t-test was used to assess a significant difference between the two duplicated measurements made on the same tooth by the same operator for each color parameter and measuring method.

For operator A, mean (SD) overall color change-ΔE* (SD) perceived for FH, CT and CJ were 2.21(2.00), 2.39 (1.58) and 2.86 (1.92), respectively. There was statistically significant difference in perceived ΔE* in FH vs CJ (p = 0.0107). However, there were no significant differences between FH and CT (p = 0.2829) or between CT and CJ (p = 0.1159). For operator mean ΔE* (SD) for FH, CT and CJ were 3.24 (3.46), 1.95 (1.19) and 2.45 (1.56), respectively. There was a significant difference between FH and CT (p = 0.0031). However, there were no statistically significant differences in ΔE* in FH vs CJ (p = 0.3696) or CT vs CJ (p = 0.0809).

The repeatability of color measurements was different among the three measuring methods by operators. Overall, the CT method worked well for both operators.

The use of a custom tray with apertures can improve the repeatability of color measurements of an intraoral spectrophotometer.

Hemming M, Kwon SR, Qian F. Repeatability in Color Measurements of a Spectrophotometer using Different Positioning Devices. J Contemp Dent Pract 2015;16(12):933-938.

To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain.

After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients.

Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402).

Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens.

Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.

Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

To evaluate the effect of 37% carbamide peroxide on the bond strength of conventional or resin-modified glass-ionomer cements when used as a cervical barrier in endodonticallytreated teeth.

After root canal instrumentation and obturation, 40 specimens of the cement-enamel junction were obtained after transversal root canal sectioning from human extracted canines. The root canal specimens were standardized and filled with the following materials (n = 10, each group): G1: zinc phosphate (control), G2: Ketac glass-ionomer, G3: vitrebond glass-ionomer or G4: GC GL glass-ionomer. After 24 hours, the specimens were subjected to an application of 37% carbamide peroxide for 21 days, changed each 7 days and stored in an artificial pulp chamber. The specimens were then submitted to push-out bond strength testing with an electromechanical test machine (EMIC) and the failure mode in each specimen was analyzed with confocal microscopy (LEXT).

G3 and G4 showed higher bond strengths values than the other groups (p < 0.05), and were similar to each other (p > 0.05). G1 showed the lowest bond strength value (p < 0.05).

Glass-ionomer cements showed higher bond strength values than the zinc phosphate cement, and resinmodified glass-ionomer cements presented the highest push-out values to root canal dentin (GC, GL and Vitrebond).

Glass ionomer cements are recommended to use as cervical barrier materials before the internal dental bleaching, but its efficiency is questionable.

Lima SNL, Venção AC, Kuga MC, Magro MG, Guiotti AM, Segalla JCM, Jordão-Basso KCF, Ricci WA, Tonetto MR, Bandéca MC. Effect of Carbamide Peroxide on the Push-out Bond Strength of Different Composition Glass-Ionomer Cement to Root Canal Dentin when used as Cervical Barrier. J Contemp Dent Pract 2015;16(12):944-949.

Periodontal diseases are associated with systemic health and health behaviors; the purpose of this study was to investigate periodontal health status and its association with systemic health and health behaviors in the elderly.

Data was collected from 300 random Case Western Reserve University (CWRU) dental school patient charts, aged 65 or higher. A modified WHO form was used to collect the date on: periodontal conditions using the community periodontal index (CPI), demographics, systemic health and certain health behaviors. Community periodontal index collected data for six sextants. Descriptive tests and bivariate analytic tests, Chi-square test and computation of odds ratio, investigated any association between certain periodontal conditions and demographic as well as systemic health attributes.

In the study cohort, the average age was 73.7 ± 6.8 years. Moderate periodontitis (38.9%) was the most prevalent periodontal health condition, while severe periodontitis was the least prevalent periodontal health (6.1%). Nearly 30% of the cohort had healthy periodontium. Only insurance status was associated with healthy periodontium (p < 0.05).

Moderate periodontitis was the most prevalent among the studied subjects. A positive association was found with the insurance status of the subjects and the healthy periodontium. No association was found between periodontal disease and smoking, alcohol consumption, diabetes and cardiovascular disease.

Jafer M. The Periodontal Status and Associated Systemic Health Problems among an Elderly Population Attending the Outpatient Clinics of a Dental School. J Contemp Dent Pract 2015;16(12):950-956.

Postoperative pain, swelling and trismus are the most common outcome after third molar surgery. Many methods have been tried to improve postoperative comfort after surgery. Ketamine is a phencyclidine derivative that induces a state of dissociative anesthesia. It is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist and has a distinct suppression effect on central nervous system (CNS) sensitization. Ketamine in a subanesthetic dose is set to produce analgesic and anti-inflammatory effect.

Sixty patients, between the age group of 18 and 38 years, undergoing the extraction of impacted mandibular third molar, reporting to the department of oral and maxillofacial surgery were included in the study.

Patients were divided randomly into two groups: local anesthetic alone (LAA) and local anesthetic and ketamine (LAK).

Statistical analysis was performed using the Mann-Whitney U/unpaired—t-test and Wilcoxon signedrank test.

There was a significant difference in mouth opening in the LAA and LAK group in the immediate postoperative period. There was a significant difference between the two groups after 1 hour (LAA: 2.37; LAK: 1.40), and 4 hours (LAA: 2.37; LAK: 1.40).

There was a significant difference in terms of facial swelling in the immediate postoperative period and day 1 between the LAA and LAK group.

Use of subanesthetic dose of ketamine is not only safe but also valuable in reducing patient morbidity after third molar surgery.

Combination of a local anesthetic and subanesthetic dose of ketamine during surgical extraction of third molars provides good postoperative analgesia with less swelling and significantly less trismus.

Kumar A, Kale TP. A Comparative Study between the Effect of Combined Local Anesthetic and Low-dose Ketamine with Local Anesthetic on Postoperative Complications after Impacted Third Molar Surgery. J Contemp Dent Pract 2015;16(12):957-962.

The purpose of this in vitro study was to evaluate the bond strength of the laser-etched base bracket, site of bond failure, and evaluate for enamel remnants on the bracket base after debonding, when compared to foil mesh base bracket.

Sixty noncarious, human premolar extracted for the orthodontic treatment were used for this study. The teeth were randomly divided into two groups containing 30 teeth each, which were bonded with laser-etched base bracket and mesh base bracket using light cure resin. The tensile and mechanical bond strength was tested after 24 hours using TIRA. The forces recorded during debonding were measured in Newton and final readings were tabulated in megapascals (MPa).

After debonding, the amount of residual adhesive and enamel detachment on the bracket base were assessed according to adhesive remnant index (ARI) and enamel detachment index (EDI) using stereomicroscope and energy dispersive X-ray spectrometer.

The laser-etched base bracket showed statistically significant higher results than mesh base bracket. Mann-Whitney test indicated that laser-etched base bracket had significantly higher tensile bond strength of 8.47 MPa (SD ± 0.84), fatigue strength of 7.75 MPa (SD ± 0.79) compared to mesh base bracket with tensile bond strength of 5.53 Mpa (SD ± 0.89) and fatigue strength of 5.17 MPa (SD ± 1.15).

Adhesive remnant index score indicated that laser-etched base bracket had ARI score of 3 for most of the bracket, when compared to mesh base bracket. This was statistically significant.

Enamel detachment index scores indicated that less than 10% of enamel detachment occurred in both the types of brackets, which was not statistically significant.

Laser-etched base bracket showed superior bond strength, when compared to the foil mesh base bracket. The site of bond failure of these laser-etched base bracket was at the interface of enamel-adhesive and did not induce any significant enamel detachment. Thus, we can conclude that laser-etched base bracket is a promising step toward achieving an ideal bracket base design for successful bonding.

Rajesh RNG, Girish KS, Sanjay N, Scindhia RD, Kumar SG, Rajesh S. Comparison of Bond Strength of Brackets with Foil Mesh and Laser Structure Base using Light Cure Composite Resin: An in vitro Study. J Contemp Dent Pract 2015;16(12):963-970.

Single cell gel electrophoresis (SCGE) assay also known as comet assay is a rapid and highly sensitive fluorescent molecular technique for detecting various forms of deoxyribonucleic acid (DNA) damage at individual cellular level.

The present study was done to detect the extent of DNA damage in oral leukoplakia (OL) and compare with normal individuals. The sample population was obtained from an outpatient clinic of a tertiary teaching dental institute. A total of 36 consecutive patients with leukoplakia and 10 healthy normal volunteers were recruited for the study and assessed for the extent of DNA damage using SCGE following clinical diagnosis and histological grading. Peripheral blood was obtained by venipuncture and SCGE assay was performed. Mean comet tail length was recorded and analyzed statistically to compare the extent of damage in each group.

The mean comet tail length seen in leukoplakia patients with moderate to severe dysplasia was 1.25 ± 0.14 mm while for the control subjects, it was 0.31 ± 0.10 mm. The difference was statistically significant (p = 0.000). On comparing within the grades of leukoplakia, a progressive trend of increasing tail length was observed with increasing grades of dysplasia.

Deoxyribonucleic acid damage as measured by SCGE is seen in leukoplakia. A stepwise increase in DNA damage levels from healthy controls, through patients with non-dysplastic epithelium to varying grades of dysplasia has been observed indicating the extent of DNA damage in this high risk group.

Vellappally S, Binmgren MA, Huraib SB, Hashem MI, Patil S, Anil S. Assessment of DNA Damage in Leukoplakia Patients with Different Degrees of Dysplasia. J Contemp Dent Pract 2015;16(12):971-976.

Keine KC, Kuga MC, Pereira KF, Diniz ACS, Tonetto MR, Galoza MOG, Magro MG, de Barros YBAM, Bandéca MC, de Andrade MF. Differential Diagnosis and Treatment Proposal for Acute Endodontic Infection. J Contemp Dent Pract 2015;16(12):977-983.

Awan KH, Patil S. The Role of Transcutaneous Electrical Nerve Stimulation in the Management of Temporomandibular Joint Disorder. J Contemp Dent Pract 2015;16(12):984-986.