Current Issue Volume 9, Number 4 , July-August 2018

EDITORIAL
DB Nandini, Roopa S Rao, Shankargouda B Patil, A Thirumal Raj

Assessing the Potential Role of Calcitonin in Cancer

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:253-254]



Parafollicular cells of the thyroid gland produce calcitonin (CT) which is responsible for regulating the calcium metabolism. Apart from its physiological functions, recent studies have shown that CT plays a major role in carcinogenesis.1-4 The role of CT in carcinogenesis varies significantly according to the type of cancer.3 The present text summarizes the varying effects of CT in cancer.

How to cite this article: Nandini DB, Rao RS, Patil SB, Raj AT. Assessing the Potential Role of Calcitonin in Cancer. World J Dent 2018;9(4):253-254.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Janos Kollar, Miklós Pamula, Dániel Veres, Anita Beck

The Use of Photoacoustic Stimulation for reducing Dental Fear in Patients living with Down Syndrome

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:255-259]



Aim: Although people living with Down syndrome have high demand for dental care treatment, dissolving dental fear makes the choice of proper methods extremely difficult. The aim of the study was finding a new method for solving this problem.

Materials and methods: In the present study, a 10-minute-long photo-acoustic stimulation with rhythmic sounds or relaxation music was used for tranquilizing the patients before a dental examination. Thirty volunteers living with Down syndrome participated in the study. They were divided into three groups (rhythmic sound, relaxation music, and control groups). A piece of Johan Sebastian Bach (Bach Cello Suite No. 1 in G major BWvi007) was applied as a relaxing music. Spielberger State- Trait Anxiety Inventory (STAI) Child version, Dental Anxiety Scale (DAS), and Dental Anxiety Question (DAQ) were used for measuring the anxiety level of the participants.

Results: The results confirm the first hypothesis, namely that photo-acoustic stimulation with rhythmic sounds or relaxation music is suitable for decreasing the level of fear of dental patients living with Down syndrome. The other hypothesis that the anxiety-suppressing effect of light stimulation with classical music would be larger than that of light stimulation with rhythmic sounds was not proven statistically.

Conclusion: The results suggest that application of photoacoustic method by using either relaxing music or rhythmic sounds is able to reduce dental fear of patients although some contraindications should be respected (e.g., the presence of epilepsy).

Clinical significance: The importance of photo-acoustic stimulation in dental fear reduction is underestimated and deserves higher attention, especially in case of people living with Down syndrome.

Keywords: Dental anxiety, Dental fear, Down syndrome, Photo-acoustic.

How to cite this article: Kollar J, Pamula M, Veres D, Beck A. The Use of Photoacoustic Stimulation for reducing Dental Fear in Patients living with Down Syndrome. World J Dent 2018;9(4):255-259.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Alessandra N Porto, Andreza MF Aranha, Alexandre M Borba, Evanice VM Menezes, Cieila C Machado, Mariane M Dias, Orlando A Guedes, Matheus C Bandéca, Álvaro H Borges, Luiz ER Volpato

Prevalence of Malocclusion in Students in a Subpopulation of Mato Grosso, Brazil

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:260-264]



Aim: To determine the prevalence of malocclusion in children and students enrolled in public schools and in the Araguaia Family Health Strategy in the municipality of Guarantã do Norte, Mato Grosso, Brazil.

Materials and methods: A cross-sectional study was conducted with randomly selected children and adolescents from 6 to 16 years. The students were examined at the selected institutions under natural light by a trained examiner. The sample size was calculated using a 95% confidence interval and data were analyzed by descriptive statistics using absolute and relative frequencies.

Results: A total of 400 children and adolescents were selected, 176 (44%) males and 224 females (56%). At facial analysis, the most prevalent facial patterns were mesofacial (43%), dolichofacial (41%), and brachyfacial (16%). In facial profile, 48% were convex, 39% straight, and 13% concave. The occlusal relationship found was 44% class I, 36% class II, and 20% class III; 62% vertical malocclusions, 54% horizontal and 66% harmful habits (bucconasal breathing, finger sucking, and pacifier sucking) were also found.

Conclusion: The prevalence of malocclusion was high; over 50% had some type of occlusal changes.

Clinical significance: Cross-sectional studies have their importance, as they show the disease situation in different places, subsiding decision-making for prevention and treatment strategies, adapting to the regional financial reality in an attempt to reduce health inequalities among the various social and economic strata of the population.

Keywords: Malocclusion, Prevalence, Students.

How to cite this article: Porto AN, Aranha AMF, Borba AM, Menezes EVM, Machado CC, Dias MM, Guedes OA, Bandéca MC, Borges AH, Volpato LER. Prevalence of Malocclusion in Students in a Subpopulation of Mato Grosso, Brazil. World J Dent 2018;9(4):260-264.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Mohammed R Hameed, Ahmed H Ali, Mirvet M Rashad

Obturation of Lateral Canals by a New Reciprocating Spreader and a Conventional Finger Spreader by Lateral Condensation Technique: in vitro Comparative Study

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:265-269]



Aim: The aim was to evaluate post-obturation extensions of the gutta-percha/sealer in apical/coronal simulated lateral canals using a new manufactured nickel-titanium (NiTi) reciprocating spreader (experimental) compared with a conventional finger spreader (control).

Materials and methods: Ten endodontic plastic training blocks were divided into two groups (I and II), each block containing two main, two coronal, and two apical lateral canals. All main canals were prepared from size 10 to 30 using K-file and rotary handpiece (W&H; Austria) with a torque 1:4 at 15 mm working length using a surveyor to position the file perpendicular to the surface of the block. The preparation time for each size was 1 minute with 15-second irrigation with isopropyl alcohol. The prepared main canals were filled with size 30 master gutta-percha and sealer (Endofill, PD, Switzerland) and condensed using the control and experimental spreaders for 30 seconds in groups I and II respectively, followed by insertion and condensation of auxiliary gutta-percha till no more auxiliary can be applied. The lateral extension of gutta-percha/sealer within the apical/coronal lateral canals was measured from the base of attachment of lateral canal with the main canal using digital stereomicroscope (Leica MZ 12.5, Heerbrugg, Germany). Analysis of variance (ANOVA) and paired t-test were used to assess the results statistically at significance level α = 0.05.

Results: The highest extension of gutta-percha/sealer was in the coronal lateral canal in group II, while the lowest extension of gutta-percha and sealer was in the apical and coronal lateral canals in group I. There was a significantly higher extension of gutta-percha/sealer in the coronal/apical lateral canals in group II compared with that in group I (p < 0.05).

Conclusion: The use of the new NiTi reciprocating spreader results in a higher extension of gutta-percha/sealer in lateral canals compared with the use of the conventional finger spreader.

Clinical significance: Application of the new NiTi reciprocating spreader may result in a more precise three-dimensional obturation of root/lateral canal space.

Keywords: Gutta-percha, Lateral canals, Reciprocating, Spreader.

How to cite this article: Hameed MR, Ali AH, Rashad MM. Obturation of Lateral Canals by a New Reciprocating Spreader and a Conventional Finger Spreader by Lateral Condensation Technique: in vitro Comparative Study. World J Dent 2018;9(4):265-269.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Ali A Abdulkareem, Hayder R Abdulbaqi, Ahmed K Nayyef, Saif S Saliem

Differential Expression of Toll-like Receptor 4 and Nuclear Factor κB of Primary Rat Oral Keratinocytes in Response to Stimulation with Fusobacterium nucleatum

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:270-274]



Aim: Gram-negative anaerobic periodontal pathogens are well known for their ability to stimulate innate immune response once being recognized by special receptors of epithelial pocket lining. The aim of this study was to investigate the expression of toll-like receptor 4 (TLR4) and nuclear factor kappa-lightchain- enhancer of activated B cells (NF-κB) following exposure to Fusobacterium nucleatum.

Materials and methods: Primary oral keratinocytes were collected from gingiva of Wistar Han rat and cultured to confluency. Then, the epithelial cells were stimulated with heat-killed F. nucleatum and 20 μg/mL Escherichia coli lipopolysaccharide (E. coli LPS). Expression of NF-κB was assayed by immunocytochemistry in addition to semi-quantitative reverse transcriptase (RT)-polymerase chain reaction (PCR), which was also used to determine transcription of TLR4 in comparison with unstimulated control.

Results: Immunocytochemical analysis indicated that nuclear translocation of NF-κB was significantly increased (p < 0.05) in cultures stimulated with bacteria as compared with control. In addition, the expression of TLR4 and NF-κB in stimulated keratinocytes was also significantly increased (p < 0.05) 3- and 2.5-fold respectively, in comparison with unstimulated cultures.

Conclusion: Fusobacterium nucleatum potentially triggers NF-κB signaling pathway through activation of TLR4 in oral epithelial cells.

Clinical significance: Recognition of early immune response against pathogenic periodontal bacteria would highlight new aspects in pathogenesis of periodontal diseases that could provide potential therapeutic opportunity for these conditions.

Keywords: Fusobacterium nucleatum, Gingival epithelium, Nuclear factor κB, Toll-like receptor 4.

How to cite this article: Abdulkareem AA, Abdulbaqi HR, Nayyef AK, Saliem SS. Differential Expression of Toll-like Receptor 4 and Nuclear Factor κB of Primary Rat Oral Keratinocytes in Response to Stimulation with Fusobacterium nucleatum. World J Dent 2018;9(4):270-274.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Haydar Barakat, Suleiman Dayoub, Rabeea Alarkan

A Porcine Collagen Matrix (Mucograft®) vs Connective Tissue Graft in the Treatment of Multiple Gingival Recessions: A Comparative Clinical Study

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:275-279]



Aim: The aim of this study was to compare the use of porcine collagen matrix (PCM) (Mucograft®) with coronally advanced flap (CAF) and connective tissue graft (CTG) with CAF in the treatment of multiple gingival recessions (MGRs).

Materials and methods: Ten patients with 48 multiple recessions were enrolled in this study and divided into test group (PCM + CAF) and control group (CTG + CAF). Clinical parameters, such as gingival recession (GR), probing depth (PD), clinical attachment level (CAL), and width of keratinized tissue (WKT) were recorded at baseline and at 6 months follow-up. Root coverage (RC %) and complete root coverage (CRC) were evaluated at 6 months postsurgery.

Results: The mean of GR at baseline was 3.23 ± 0.49 in the PCM + CAF group and 3.25 ± 0.53 in the CTG + CAF group. At 6 months, the mean of GR reduction was 0.17 and 0.08 mm for PCM + CAF and CTG + CAF respectively, and CRC was obtained in 83% in the test group and 71% in the control group. The mean WKT gain was 1.58 mm in the test group and 1.42 mm in the control group (p < 0.001).

Conclusion: Within the limitations of this study, using PCM + CAF in the treatment of MGRs is a successful option and could serve as an alternative to CTGs.

Clinical significance: The PCM with CAF represents a clinical and esthetic treatment of MGRs.

Keywords: Collagen matrix, Connective tissue graft, Coronally advanced flap, Multiple gingival recessions.

How to cite this article: Barakat H, Dayoub S, Alarkan R. A Porcine Collagen Matrix (Mucograft®) vs Connective Tissue Graft in the Treatment of Multiple Gingival Recessions: A Comparative Clinical Study. World J Dent 2018;9(4):275-279.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Abdulaziz S AbuMelha, Amal S Alshahrani, Noura A AbuMelha

Effect of Ketones on the Onset of Local Anesthesia among Diabetic Patients in the Kingdom of Saudi Arabia

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:280-283]



Aim: To evaluate the effect of blood ketones on the onset of local anesthetic (LA) effect among diabetic patients in Abha, Kingdom of Saudi Arabia.

Materials and methods: A convenient sample of 34 subjects was taken for the study. All those who were suffering from diabetes mellitus (types I or II), aged 40 to 70 years, having vital maxillary anterior teeth and who were willing to participate, were enrolled for the study. Moreover, 15 nondiabetic (healthy) patients who had visited the Department of Restorative Dental Sciences for undergoing endodontic treatment of maxillary anterior teeth were also included in the study. The subjects were checked for blood glucose level and blood ketone values. All the participants were given infiltration in maxillary central incisor teeth using 2% lidocaine with epinephrine for all the participants. The onset of the effect of LA was checked using thermal test (cold Endo Ice) and Electron Pulp tester (EPT).

Results: The average blood ketone value among the controlled type I and controlled and uncontrolled type II was found to be 0.1 mmol/L, while it was 0.2 mmol/L among the subjects with uncontrolled type I diabetes.

Conclusion: The onset of LA effect was found to be within 3 minutes in all cases except those with type I uncontrolled diabetes wherein it was found to be 4 minutes. The difference was not found to be statistically significant.

Clinical significance: Due to long-term hyperglycemic condition in diabetic patients, their body cells are unable to get energy from carbohydrates due to lack of insulin and it thus results in the utilization of the body fats as source of energy, producing ketones as by-product. Hence, knowing the effect of ketones, if any, on the onset of LA would be quite beneficial.

Keywords: Blood glucose, Diabetes, Ketones, Local anesthesia.

How to cite this article: AbuMelha AS, Alshahrani AS, AbuMelha NA. Effect of Ketones on the Onset of Local Anesthesia among Diabetic Patients in the Kingdom of Saudi Arabia. World J Dent 2018;9(4):280-283.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Asavari L Desai, Nandita Shenoy, Srikant Natarajan, Supriya Nambiar

Comparison of Analgesic Effect of Piroxicam and Transcutaneous Electrical Nerve Stimulation Therapy on Pain associated with Orthodontic Separator Placement: A Single Blind Randomized Controlled Trial.

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:284-290]



Aims and objectives: To assess and compare the efficacy of transcutaneous electrical nerve stimulation (TENS) therapy and preemptive piroxicam administration in reducing the severity of pain after orthodontic separator placement.

Materials and methods: It was a randomized, single-blind, parallel arm trial. Subjects of either gender between 18 and 30 years of age, scheduled to undergo regular orthodontic therapy with placement of two separators in each arch, were selected for this trial. The sample size consisted of 60 patients from whom prior informed consent was obtained. They were assigned randomly into two categories of 30 subjects each.
• Group I: Subjects were given piroxicam (20 mg) 1 hour before separator placement.
• Group II: Subjects were given TENS therapy immediately after separator placement.
The treatment was administered by the coinvestigator, so as to blind the principal investigator to the treatment group. Perceived pain was evaluated on chewing and fitting back teeth together at 2-, 6-, 24-, and 48-hour intervals, using the visual analog scale (VAS).

Results: Descriptive statistical analysis revealed that the VAS scores in the piroxicam group were marginally higher than the TENS group at all intervals, except at 2 hours. The difference was, however, statistically insignificant.

Conclusion: The findings of this single blind randomized, controlled trial (RCT) suggest that TENS therapy is as effective as 20 mg piroxicam administered preemptively, in controlling pain felt due to separator placement. The TENS offers several advantages over piroxicam, as it is devoid of the inherent side effects of nonsteroidal antiinflammatory drugs (NSAIDs) like an inhibitory effect on orthodontic tooth movement and also gastric irritation.
Therefore, the use of TENS is recommended over NSAIDs for the successful management of orthodontic pain, which is so critical both from the patient’s and from the clinician’s perspective.

Keywords: Pain, Piroxicam, Transcutaneous electrical nerve stimulation.

How to cite this article: Desai AL, Shenoy N, Natarajan S, Nambiar S. Comparison of Analgesic Effect of Piroxicam and Transcutaneous Electrical Nerve Stimulation Therapy on Pain associated with Orthodontic Separator Placement: A Single Blind Randomized Controlled Trial. World J Dent 2018; 9(4):284-290.

Source of support: Nil

Conflict of interest: None

Key message: Transcutaneous Electrical Nerve Stimulation Therapy is more effective than Piroxicam in controlling pain due to orthodontic separator placement.


ORIGINAL RESEARCH
Narula Khyati, Asavari L Desai, Supriya Nambiar, Srikant Natarajan, Siddarth Shetty

Correlation of Mandibular Incisor Inclination to Marginal Bone Levels and Cortical Bone Thickness in Different Skeletal Patterns: A Retrospective, Cone Beam Computed Tomography Study

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:291-296]



Introduction: Biologic factors, such as the cortical bone thickness and supporting bone as well as biomechanical factors, such as proclined teeth are closely interrelated. These factors often determine the potential deleterious effects of orthodontic treatment, such as gingival recession, dehiscence, fenestration, and external root resorption. The alveolar bone thickness and bone levels vary in different facial patterns and here in this study, we are finding if there is any correlation of these to tooth inclinations.

Aims and objectives: To assess the influence of mandibular incisor inclination on cortical bone thickness and alveolar bone levels in different skeletal patterns.

Materials and methods: Thirty cone beam computed tomography (CBCT) scans and lateral cephalograms of pretreatment patients were analyzed with different skeletal patterns (10 each) for their alveolar bone height, alveolar bone thickness, and cortical bone thickness at mid root level and mandibular incisor inclination. Inclination and thickness were compared among the three groups and were correlated.

Results: Although there are wide variations, cortical bone thickness at mid root level in vertical, horizontal, and average growth pattern lingually and labially were 2.3 ± 0.29 mm, 2.4 ± 0.42, 2.2 ± 0.39, and 0.69 ± 0.12, 0.65 ± 0.23, and 0.59 ± 0.37 respectively, and these values were not statistically significant. The vertical alveolar bone height did not hold any significance in our study. The incisor-mandibular plane angle (IMPA) for evaluating growth patterns was found to be significant.

Clinical significance: The inclination of the mandibular incisors is an important diagnostic consideration and has to be kept in mind during treatment planning. Excessive proclination of the incisors can lead to dehiscence, fenestration, as well as recession. Therefore, it becomes important to know the thickness of the bone as well as the marginal bone level to help us to use appropriate biomechanics.

Conclusion: The mandibular incisor inclination and growth pattern of the patient appear to have no significant impact on the alveolar bone levels and cortical bone thickness. However, studies with a larger sample size and with high-dose CBCT are warranted.

Keywords: Cortical bone thickness, Incisor inclination, Skeletal growth patterns.

How to cite this article: Khyati N, Desai AL, Nambiar S, Natarajan S, Shetty S. Correlation of Mandibular Incisor Inclination to Marginal Bone Levels and Cortical Bone Thickness in Different Skeletal Patterns: A Retrospective, Cone Beam Computed Tomography Study. World J Dent 2018;9(4):291-296.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Asok Mathew, Zahraa M Ali, Ghaya Y Almadhani, Ahmed Al Radeideh, Ahmed J Taleb

Comparison of Canal Transportation and Centering Ability of Rotary I-Race and BT-Race Systems using Cone Beam Computed Tomography: An in vitro Study

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:297-303]



Aim: The aim of the present study was to compare the canal transportation and centering ability of Rotary I-Race and BT-Race systems using cone beam computed tomography (CBCT) in curved root canals (40°) to find better instrumentation technique for maintaining root canal geometry.

Materials and methods: Thirty endodontic training blocks, with angle of curvature 40°, were selected into two groups of 15 samples each: BT-Race (group I), I-Race (group II). The blocks were placed in mold made by silicon impression material to facilitate instrumentation and to enable the reproducibility of pre- and postoperative CBCT images.

Preinstrumentation and postinstrumentation images were obtained at three levels, 1, 3, and 5 mm above the apical foramen and were compared using CBCT software. Amount of transportation and centering ability were assessed. The two groups were statistically compared with one-way analysis of variance (ANOVA).

Results: The mean transportation for group I at 1, 3, and 5 mm apical was 0.160, 0.080, and 0.046 mm respectively. The mean transportation for group II at 1, 3, and 5 mm apical was -0.096, 0.050, and -0.080 mm respectively. The mean centering ratio for group I at 1, 3, and 5 mm apical was 0.401, 0.481, and 0.533 mm respectively. The mean centering ratio for group II at 1, 3, and 5 mm apical was 0.428, 0.540, and 0.598 mm respectively.

Conclusion: Under the condition of this study, the two groups showed significant difference and it was found that BT-Race files (group I) have better centering ability and less canal transportation than I-Race (group II).

Clinical significance: The CBCT study will be a more accurate way of estimation of centering ability and canal transportation and hence, will reduce the clinical complications while performing biomechanical preparations.

Keywords: Apical transportation, Centering ability, Cone beam computed tomography, Rotary system.

How to cite this article: Mathew A, Ali ZM, Almadhani GY, Al Radeideh A, Taleb AJ. Comparison of Canal Transportation and Centering Ability of Rotary I-Race and BT-Race Systems using Cone Beam Computed Tomography: An in vitro Study. World J Dent 2018;9(4):297-303.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Shivani Kohli, Christopher D Philip, Cassamally M Aadil, Aaron LW Vun, Mahenthiran Ramalingam

Association between Depression and Dentition: A Study among Geriatric Patients in Kuala Langat, Malaysia

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:304-309]



Aim: The aim of this study was to determine association between depression and dentition and others covariates among the elderly in Kuala Langat region, Malaysia.

Materials and methods: A cross-sectional study was conducted among elderly subjects aged 60 years and above. Geriatric depression scale (GDS) was used to classify the subjects into different grades of depression: 0 to 4 (no depression), 5 to 9 (mild depression), and 10 to 15 (moderateto- severe depression). Demographic data and details of the subjects’ dentitions were collected using a self-administered questionnaire.

Results: There was a statistically significant association between dentition and depression, with p = 0.0000881 where p < 0.05. Difficulty in performing daily activity was also significantly associated with depression, with p = 0.0477 where p < 0.05. Participants who cannot chew well had higher percentage of depression compared with subjects who can chew well.

Conclusion: According to the results obtained, there was a statistically significant association between dentition and depression. Oral health awareness may help to reduce the severity of depression among the elderly.

Clinical significance: The importance of this study was to highlight that maintaining a proper dentition either natural or artificial may reduce the incidence of depression among the elderly; as loss of teeth is a vital risk factor, it can be prevented by use of dentures or other forms of prosthesis. On the other end of the spectrum, physiological consequences of depression may lead to decline in oral health as well.

Keywords: Age, Cross-sectional study, Depression, Older, Teeth.

How to cite this article: Kohli S, Philip CD, Aadil CM, Vun ALW, Ramalingam M. Association between Depression and Dentition: A Study among Geriatric Patients in Kuala Langat, Malaysia. World J Dent 2018;9(4):304-309.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Wagner A Calado, Geraldo AP de Carvalho, Simone Kreve, Aline BG Franco, Iury M Ribeiro, Sergio C Dias, Fabiano Perez

Dimension of Gingival Papillae between External Hexagon Dental Implants in Superior Anterior Sites

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:310-315]



Aim: The aim of this study is to assess the height of the papillae located in interproximal, superior anterior rehabilitated areas between external hexagon implants and its relation with Jemt index, as well as correlate the height of the papillae with the distances between adjacent implants, distances from the tip of the papilla to the dental contact point, rehabilitation time, and patient’s age.

Materials and methods: Twenty superior anterior, inter-implant areas were evaluated using clinical and radiographic exams.

Results: Positive correlation was found between the papilla size and the distance from the contact point to the bone crest. No significant correlation was revealed between the papilla size and the Jemt index; between the distances from the tip of the papilla to the contact point; or between the adjacent implants. In addition, there was no association between the papilla size with rehabilitation time or patient’s age. No expressive difference was identified by comparing the mean papilla height measure in this study with the measures reported in the literature. However, a considerable result was found by assessing the papilla size and the distance from the bone crest to the dental contact point.

Conclusion: The present study did not reveal significant correlations between the papilla size and other investigated factors, such as Jemt index, inter-implant distance, contact point distance, and patient’s age. The only significant association reported was a positive correlation between the papilla size and the distance from the bone crest to the contact point.

Clinical significance: It is of utmost importance to observe the gingival papilla behavior over time and not only at the moment of prosthesis installation.

Keywords: Dental implants, Dental papilla, Gingiva, Periapical tissue.

How to cite this article: Calado WA, de Carvalho GAP, Kreve S, Franco ABG, Ribeiro IM, Dias SC, Perez F. Dimension of Gingival Papillae between External Hexagon Dental Implants in Superior Anterior Sites. World J Dent 2018;9(4):310-315.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Sudhir R Varma, Maher al Shayeb, Abed el Kaseh, Syed Kuduruthullah, Awad Ashekhi, Esam al Khader

Effectiveness of Low-level Laser Therapy in the Management of the Temporomandibular Joint Disorders: A Placebo-controlled Trial

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:316-320]



Objective: The purpose of this clinical study is to assess the capability of low-level laser therapy (LLLT) in the treatment of temporomandibular joint disorders (TMJDs).

Materials and methods: Twenty-four temporomandibular disorder (TMD) patients were selected based on TMD pain screening, Wong and Baker pain scale, and clinical evaluation for signs of TMJDs. Sixteen patients were randomly selected and placed in an experimental group, and a placebo group comprised of eight patients. Painful muscular areas were identified by digital pressure, and laser was applied to these areas for an average of 300 seconds for each patient. The laser device was directed to painful areas without emission in the placebo group. Patients were evaluated before and immediately after each session and after 1 month.

Results: Before and after treatment, the changes in pain levels in group I were statistically significant (p < 0.0001). The changes in pain levels before and after treatment in group II did not show any statistical significance (p = 1.000). The results were statistically significant (p = 0.000), on comparing the pain levels after 1 month in groups I and II.

Conclusion: The results revealed a significant amount of pain reduction after LLLT on a short-term basis, the majority of patients reported a decrease in clicking frequency, and a softer mandibular movement compared with the placebo group.

Clinical significance: The LLLT can be advocated as an adjunct in reducing pain levels in most TMJDs on a short-term basis. Observations from this study second this view.

Keywords: Laser, Low-level laser therapy, Pain, Temporomandibular joint, Temporomandibular joint disorders.

How to cite this article: Varma SR, al Shayeb M, el Kaseh A, Kuduruthullah S, Ashekhi A, al Khader E. Effectiveness of Low-level Laser Therapy in the Management of the Temporomandibular Joint Disorders: A Placebo-controlled Trial. World J Dent 2018;9(4):316-320.

Source of support: Nil

Conflict of interest: None


ORIGINAL RESEARCH
Hayder R Abdulbaqi, Ali A Abdulkareem, Ali JB Al-Sharqi

Compliance of Referred Patients with Periodontitis to Active Periodontal Therapy: A Retrospective Study

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:321-326]



Aim: Periodontitis is an inflammatory, destructive condition of supporting tissues of the teeth. Nonsurgical treatment approach is relatively a long process that requires full compliance of the patient to ensure success of this treatment. This study aimed to evaluate compliance of patients with periodontitis referred to the Department of Periodontics, University of Baghdad, Baghdad, Iraq.

Materials and methods: Data were collected from records of 1,161 patients attending periodontology clinics at teaching dental hospital, Baghdad, Iraq. Patients with periodontitis were only included in the study. Set of factors potentially interfering with compliance were recorded, in addition to periodontal parameters including plaque index (PI), probing pocket depth (PPD), and bleeding on probing (BOP).

Results: Data showed significant difference in the number of referred patients according to different criteria selected in this study, such as gender, smoking, previous periodontal treatment, and history of systemic disease. The proportion of compliant patients was 30%, which is significantly lower than that of noncompliant patients (70%). In addition, results did not show any association between the degree of compliance and different factors that potentially affect compliance in the current study.

Conclusion: Degree of compliance was poor, which indicates general lack of public knowledge about the importance of periodontal therapy in controlling periodontal disease.

Clinical significance: This study highlighted the importance of increasing public knowledge about the significance of complying with periodontal treatment. This can be achieved through governmental motivational programs in Baghdad city, which will significantly improve periodontal health and reduce the overall dental cost that results from unsuccessful periodontal therapy.

Keywords: Compliance, Nonsurgical periodontal therapy, Periodontitis, Supportive periodontal therapy.

How to cite this article: Abdulbaqi HR, Abdulkareem AA, Al- Sharqi AJB. Compliance of Referred Patients with Periodontitis to Active Periodontal Therapy: A Retrospective Study. World J Dent 2018;9(4):321-326.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Shashibhushan K Kamalaksharappa, Shreya Dasgupta

Effectiveness of Silver Diamine Fluoride in Children with Early Childhood Caries: A Systematic Review and Meta-analysis.

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:327-332]



Aim: Silver diamine fluoride (SDF) has been used globally in several countries and there are many published reports stating its effectiveness against dental caries. However, dosage and timing of application are controversial, as many authors have recommended various treatment protocols. The objective of this review was to evaluate the effectiveness of SDF in children with early childhood caries (ECC).

Materials and methods: Literature searches involved PubMed, ScienceDirect, and Cochrane Library from January 2005 to December 2016. The search generated 146 articles for screening (69 from PubMed, 71 from ScienceDirect, and 6 from Cochrane Library). From the imported references, 133 were screened against title and abstract by the two reviewers after duplicates were removed. Out of these, 126 studies were excluded based upon the inclusion criteria and seven were assessed for full-text eligibility in which one study was excluded (ex vivo study). Finally, six articles were selected for the fulltext analysis and quality assessment. The meta-analysis was performed with Review Manager (version 5.3). Only studies that reported the results as dichotomous data were analyzed with Cochran-Mantel-Haenszel test.

Results: In the overall meta-analysis, there was an association between caries arrest in the groups using SDF and the other control groups [odds ratio = 0.66 (0.5-0.78)]. Subgroup analysis showed the following associations at 3 months interval [odds ratio = 0.55 (00.43-0.73)] and 6 months interval [odds ratio = 0.56 (00.43-0.74)]. At 18 months and above, however, there was no association seen [odds ratio = 1.01 (0.75-1.36)].

Conclusion: Early childhood caries is a global health issue that should be addressed in the primitive stages. Silver diamine fluoride is a material that is effective in caries arrest and progression and thus is useful in halting the spread of the disease. Its rationale is justified as compared with other materials used in the treatment of ECC due to the higher percentage of caries arrest seen.

Clinical significance: At concentrations of 30 and 38%, SDF shows potential caries arrest in children suffering from ECC.

Keywords: Caries arrest, Early childhood caries, Metaanalysis, Silver diamine fluoride, Silver diammine fluoride, Systematic review.

How to cite this article: Kamalaksharappa SK, Dasgupta S. Effectiveness of Silver Diamine Fluoride in Children with Early Childhood Caries: A Systematic Review and Meta-analysis. World J Dent 2018;9(4):327-332.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Vanishri C Haragannavar, Shankargouda B Patil, Roopa S Rao, Shwetha K Nambiar, Dominic Augustine, SV Sowmya

Troubleshooting in Immunohistochemistry with their Remedies

[Year:2018] [Month:July-August] [Volumn:9 ] [Number:4] [Pages:88] [Pages No:333-341]



Aim: The aim of the present study was to review the importance of various steps involved in immunohistochemistry (IHC) and highlight the troubleshootings encountered at each phase of the procedure with possible remedies.

Introduction: Immunohistochemistry is often employed to explore tissue/cell antigens that vary from amino acids, proteins, infectious agents, and specific cellular group in health and disease. It is a vital tool for scientific research and also an adjunct technique for the exclusion of differential diagnosis that may be missed by routine stains. Although IHC is well practiced, there are several hurdles that could be encountered during each step of immunohistochemical procedure, i.e., preparation of slide to incubation with antibodies, interpretation and quantification of the desired expression that finally influences the staining of tissue.

Clinical significance: An accurate and proper diagnosis of a pathology is key for the successful treatment by a clinician/ surgeon, as IHC acts as an adjunct in the diagnosis of challenging lesions. Hence, it is absolute necessary for a pathologist to have a thorough knowledge of immunohistochemical procedure and remedies to overcome the hurdles encountered during the procedure to obtain an ideal IHC-stained slide for diagnosis.

Keywords: Analytical phase, Antigen retrieval, Immunohistochemistry, Postanalytical phase, Preanalytical phase, Remedies, Troubleshooters.

How to cite this article: Haragannavar VC, Patil SB, Rao RS, Nambiar SK, Augustine D, Sowmya SV. Troubleshooting in Immunohistochemistry with Their Remedies. World J Dent 2018;9(4):333-341.

Source of support: Nil

Conflict of interest: None


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