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   Table of Contents - Current issue
July-August 2023
Volume 15 | Issue 4
Page Nos. 319-408

Online since Thursday, August 31, 2023

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Efficacy of EndoActivator on the postoperative pain in the teeth with symptomatic irreversible pulpitis: A systematic review and meta-analysis p. 319
Kiranmayi Govula, Gnyani Prasad, Yendluri Pavan Kumar, Maddineni Kowmudi, Sannapureddy Swapna, Niharika Mungara
Aim: Postoperative pain affects the quality of life and upsets clinicians and patients, which could cause postoperative discomforts such as pain, swelling, and persistent inflammation. Hence conventional irrigation methods are not sufficient to reduce the postoperative pain (PP). EndoActivator can reduce the risk of irrigant extrusion into periapical tissues to help patients and clinicians. The aim is to screen the clinical trials that compared the effect of activation of Irrigant by EndoActivator compared with without activation and the severity of pain after root canal treatment in the teeth with symptomatic irreversible pulpitis. Materials and Methods: Search criteria: PubMed/Medline, PubMed Central, Cochrane Library, EBSCO, EMBASE, Scopus Web of Science, DOAJ, LILAC, Manual search, Grey literature search. Randomized clinical trials, controlled clinical trials, or clinical studies were included which recruited patients with symptomatic irreversible pulpitis teeth with preoperative pain scores (moderate to severe) on a visual analogue scale and should have used activated irrigation by EndoActivator during root canal treatment and evaluated postoperative pain at different time intervals. The Risk of Bias (RoB) and meta-analysis were analyzed using review-manager software. Results: Four trials were judged to have a low RoB. There was a significant reduction in PP in the EndoActivator group at 8 and 24 h. There was a clinical significance difference between the activated and non-activated irrigation methods. Conclusion: The review has highlighted the need for irrigant activation in the regular clinical endodontic practice to increase the success rate and reduce PP, a crucial factor related to symptomatic irreversible pulpitis teeth.
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Types and effects of oral exercise on oral function in the elderly: A scoping review of interventional studies Highly accessed article p. 328
Novitasari Ratna Astuti, Lisdrianto Hanindriyo, Probosuseno, Yayi Suryo Prabandari
Aim: Currently, there have been several literature reviews on oral exercise with elderly samples, but there have been no reviews on oral exercises based on the types and effects of oral exercise improving oral function. Therefore, it is necessary to map the possibilities of prominent oral exercises which most effectively affecting the oral functions from previous studies by scoping review. This scoping review aimed to map available evidence on the types and effects of oral exercise in improving oral function among the elderly population. Methods and Materials: The research on types and effects of oral exercise among the elderly was comprehensively searched through the Cochrane, Embase, PubMed, Scopus, and Web of Science databases. This scoping review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. The inclusion criteria of this review were articles published in 2008–2021, with elderly subjects more than ≥60 years, articles describing types and effects of oral exercise, original articles, research articles or research papers, and articles with interventional studies, including randomized control trials and quasi-experimental study type. Results: The types of oral exercises were tongue exercise, masticatory muscle exercise, swallowing exercise, salivary gland massage, verbal, facial muscle exercise, lip stretching, cheek stretching, facial muscle exercise, and neck stretching. Meanwhile, the effects of oral exercise which improved oral functions were swallowing ability, masticatory ability, oral diadochokinesis, oral moisture degree, cheek expanding ability, lip–tongue motor function, increased salivary secretion, and decreased subjective oral dryness. Fifteen articles were obtained for this study, and 13 of them showed the effectiveness of tongue exercise in improving oral function. Conclusions: Oral exercises are effective to improve oral function, mostly as a way to increase the swallowing ability in the elderly. In addition, it was also revealed that the most effective type of exercise is tongue exercise.
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Uses and applications of lactoferrin in preclinical studies for successful bone regeneration process: A literature review p. 337
Flavia N León Malaga, Mary A Espinoza, Arnaldo Munive-Degregori, John Barja-Ore, Cesar Mauricio-Vilchez, Frank Mayta-Tovalino
Aim: To describe the different uses of lactoferrin for a possible implementation in dentistry. Materials and Methods: An electronic search was performed in the Scopus and PubMed databases between 1997 and 2021. The keywords included in the search were “lactoferrin”, “lactoferrin in vitro”, “osseointegration”, and “bone regeneration”. Only articles in which the osteogenic properties of lactoferrin in bone regeneration were related were selected for the present literature review. During the search, several articles were observed in this field that were included as pilot studies, retrospective cohort studies, and case–control studies that referred to the clinical process. Results: A total of 12 articles, comprising seven animal studies and five in vitro studies, were chosen for the results of this literature review. Of all the articles, eight were utilized in the introduction, of which six were excluded from the results. Conclusion: Based on the current limitations of this literature review, there is inadequate evidence to support the efficacy of lactoferrin in oral surgery. However, there is existing evidence of its potential effectiveness in bone regeneration in various fields.
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Class II division 1 malocclusion treatment trends in the last 10 years by skeletal classification: A review article p. 342
I G A W Ardani, Hanifa Aini, Ida B Narmada, Shailesh Deshmukh, Alexander P Nugraha
Aim: This study aimed to describe the various protocols for treating class II/1 malocclusion, determine the one-phase and two-phase treatment approaches, and identify the best time to provide effective and efficient treatment. Materials and Methods: An electronic search in four major databases—PubMed, Scopus, ScieLo, and Google Scholar—was completed on March 4, 2021. A search was performed on the orthodontic treatment of class II/1 over the last 10 years, and 2002 papers were obtained. Results: A total of 52 journal articles matched the inclusion criteria. Class II/1 malocclusion was more commonly found with class II/1 skeletal analysis, and one-phase treatment was preferred over two-phase treatment. One of the keys to successful treatment is the effectiveness of the treatment, which depends on the time of the treatment intervention and the appliance used. Conclusions: Determination of treatment is highly dependent on the characteristics of the malocclusion, age, and remaining growth. Due to the complexity of the case, knowledge and experience are needed in managing class II malocclusion.
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The effectiveness of an incremental approach to nonsurgical periodontal therapy with the use of adjunctive slow-release locally administered 0.02% hypochlorite formulation: A randomized clinical study p. 350
Simone Marconcini, Saverio Cosola, Enrica Giammarinaro, Giacomo Oldoini, Annamaria Genovesi
Aim: Bacterial plaque is associated with periodontal inflammation. The aim of this study was to prospectively assess the clinical effectiveness of two different agents in a staged approach for nonsurgical periodontal treatment in terms of clinical and patients related outcomes in a cohort of patients with periodontitis: NitrAdine®-based disinfectant formula (PerioTabs®) vs. Chlorhexidine (CHX) 0.12% toothpaste and mouthwash 0.20%. Materials and Methods: In the current randomized investigation, patients diagnosed with periodontal disease (stages I–III) scheduled for nonsurgical periodontal therapy were assigned at random to utilize PerioTabs®, a NitrAdine® brushing solution, or a CHX mouthwash at home. After 10–15 days of product use, active decontamination using sonic scalers and powders was carried out. The study’s outcomes were tracked at the beginning, throughout the professional intervention, and 30 and 90 days later. Assessments were made of clinical and patient-related factors. For the purposes of descriptive and inferential statistics, the chosen variables were entered into a virtual environment. Results: Forty patients were included in the final analysis. All patients showed major clinical and patient-related outcomes improvement after therapy at each time point. In the PerioTabs® group, the decrease in the bleeding score observed after the initial 10-day preparatory period (before active decontamination) was greater than in the CHX group, respectively, –45.17 ± 4.69% and –21.51 ± 2.07%. Conclusion: This study reported that the staged approach improved the clinical effectiveness of periodontal treatment in patients with periodontal disease and further suggests that PerioTabs® can be used as an efficient alternative to CHX as an adjunctive antimicrobial intervention prior to active decontamination.
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Color stability in a giomer, a conventional glass ionomer and a resin-modified glass ionomer exposed to different pigment beverages: An in vitro comparative study p. 357
Brian Alacote-Mauricio, Cindy Gihuaña-Aguilar, Leonor Castro-Ramirez, Luis Cervantes-Ganoza, Marysela Ladera-Castañeda, Giannina Dapello-Zevallos, César Cayo-Rojas
Aim: Discoloration in ionomeric materials occurs by absorption of substances, so color stability is important because these materials are of choice to restore class V. The purpose of the current study was to evaluate the color stability of a giomer, a conventional glass ionomer and a resin-modified glass ionomer exposed to different beverages with different immersion times. Materials and Methods: This in vitro experimental and longitudinal study had 135 discs were sampled in total (2 mm thick × 8 mm in diameter) distributed in three equal groups (n = 45): Beautifil II, Vitremer, and Ketac Universal. Each group was divided into three equal subgroups (n = 15 each group) and immersed in three different staining solutions: coffee, Coca-Cola®, and red wine. Color change was recorded with the Vita Easyshade® spectrophotometer after 1 h, 24 h, and 1 week of immersion. Measures of central tendency and dispersion were calculated. Kruskal–Wallis and Friedman nonparametric H tests were used to compare independent measures. The Bonferroni post hoc was used considering a significance level of P < 0.05. Results: Beautifil II (P <0.05) and Ketac Universal (P < 0.05) showed significant differences with respect to color variation (ΔE) when comparing exposure to Coca-Cola® versus exposure to coffee and red wine for 1 h, 24 h, and 1 week. Vitremer showed no significant differences when exposed to Coca-Cola®, coffee, and red wine for 1 h, 24 h, and 1 week (P = 0.607, P = 0.276, and P = 0.134, sequentially). All three restorative materials, after 1 hour immersed in Coca-Cola®, showed ΔE < 3.3 and Beautifil II obtained ΔE = 3.12 after 24 h immersed in the same beverage. Conclusion: Coffee and red wine significantly varied the color of Beautifil II and Ketac Universal over time. Beautifil II and Ketac Universal showed significantly more pigmentation with red wine and less with Coca-Cola® at 1 week immersion. Vitremer showed no significant differences when exposed to Coca-Cola®, coffee, and red wine at all times tested. There were clinically acceptable variations for all three restorative materials immersed in Coca-Cola for 1 h. This clinical threshold was only maintained for the Beautifil II giomer up to 24 h of immersion in the same beverage.
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Comparison of total antioxidant capacity level in patients with HIV/AIDS and healthy individuals p. 367
Dewi Zakiawati, Irna Sufiawati, Herry Herman
Aim: The primary aim of this study was to analyze differences in total antioxidant capacity (TAOC) levels in patients with HIV/AIDS compared with healthy individuals. The secondary aim of this study was to investigate factors that may contribute to the TAOC level in patients with HIV/AIDS including viral load, CD4 counts, and oral lesions. Materials and Methods: This research was a cross-sectional study. Fifty-eight samples from patients with HIV/AIDS and healthy individuals were calculated using the purposive sampling method. The TAOC level from the stored biological material was measured using enzyme-linked immunosorbent assay (ELISA) with the colorimetric method. The data were analyzed statistically using the chi-square to see the difference in TAOC levels between HIV and healthy individuals. Spearman’s correlation test was used to analyze the correlation between TAOC and other contributing factors. Results: The serum samples were collected from 35 patients with HIV/AIDS (74.3% men and 25.7% women) and 23 healthy individuals (65.2% men and 34.8% women). The samples were mostly obtained from healthy individuals aged 25–34 and 35–44 years old with a 47.8% and 37.1%, consecutively. Similarly, the HIV/AIDS samples are also dominated by the same age group which shares the exact percentage of both groups (37.1%). The TAOC level in patients with HIV/AIDS was lower significantly than the healthy individuals (P < 0.05). However, the TAOC level had a very weak statistical correlation with viral load (P = 0.03), CD4 (P = 0.46), and oral lesions (P = 0.44). Conclusions: In this study, the TAOC level in patients with HIV/AIDS was lower than the healthy individuals, and did not correlate to the number of viral loads, CD4 cell count, and oral lesions of patients with HIV/AIDS.
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Comparative evaluation of the surface roughness of a microhybrid and nanohybrid composites using various polishing system: A profilometric analysis p. 372
Kevin Lin Kovoor, Shruthi H Attavar
Aim: To assess the effectiveness of various polishing systems on nanohybrid and microhybrid composite restorative materials. Materials and Methods: The present study was an experimental in vitro analysis. A total of 64 cylindrical specimens were divided based on random sampling method into two groups: Group I (n = 32): micro hybrid composite Te-ecoconom Plus (IvoclarVivadent) and Group II (n = 32): nanohybrid composite Beautifil II (Shofu Inc.). The two groups were further subdivided on the basis of polishing system used into four subgroups. The control subgroup (n = 8) did not receive any finishing or polishing. Subgroup A (n = 8)—Sof-Lex XT (3M ESPE). Subgroup B (n = 8)—OneGloss (Shofu Inc.). Subgroup C (n = 8)—Super-Snap X-TREME Technique Kit (Shofu Inc.). A surface profilometer was used to evaluate the surface roughness following the finishing and polishing processes. The measured value was analyzed using independent sample t test. The findings were computed using SPSS Software version 20. Results: On comparing the composites and polishing systems using independent sample t test, it was found that Beautifil II group using Super-Snap X-TREME polishing system showed a significant difference when compared to the Beautifil II group using OneGloss system and the Te-econom Plus group using the Super-Snap X-TREME system generating P value of 0.009 and 0.004, respectively, which is <0.05 hence considered to be statistically significant. Conclusion: Within the limitations of this study, the nanohybrid composite resin showed a better polishability as compared with the micro hybrid composite. The three polishing system used significantly influenced the surface roughness with Super-Snap X-TREME, Sof-Lex multistep polishing system producing a smoother surface compared to OneGloss one step polishing system.
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Correlation between dental caries and salivary pH, mineral content, and salivary immunoglobulin levels in adult population of northern suburban region of Kolkata, India p. 377
Sagnik Bhattacharya, Paromita Mazumdar, Sayantan Mukherjee
Aim: The aim of this study was to evaluate the prevalence of dental caries in the adult population residing in West Bengal and measure the salivary pH, calcium, phosphorus, immunoglobulin A (IgA), and immunoglobulin A (IgG); and to determine a correlation between the caries experience and the variables measured. Materials and Methods: This was a correlative analytical study with a cross-sectional approach where a total of 100 patients who fit the inclusion criteria were included in the study. First, the number of caries teeth of each patient was recorded using the International Caries Detection and Assessment System II (ICDAS II) scoring system, and subsequently unstimulated saliva was collected. The saliva was measured for pH using a pH meter, calcium using the o-Cresolpthalein Complexone method, phosphorus using Molybdate UV method, and IgA and IgG using the immunoglobulin estimation kit. Chi-square test of proportions was employed to test the categorical variables. Parametric tests were carried out for inferential statistics. Pearson’s correlation test was used to correlate the number of carious teeth with that of the salivary pH, calcium levels, phosphorus levels, salivary IgA levels, and salivary IgG levels. Results: There was a strong negative correlation between the calcium levels and the number of carious teeth present, which was highly statistically significant. There was a very strong negative correlation between the salivary pH, phosphorus levels, salivary IgA levels, and the number of carious teeth, which was highly statistically significant. There was a moderately negative correlation between the IgG levels and the number of carious teeth present which was highly statistically significant. Conclusion: There is an inverse relation between the prevalence of dental caries in the adult population of the Northern Suburban area of Kolkata and salivary pH, calcium, phosphorus, IgA, and IgG.
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Cytotoxicity evaluation of three different types of intracanal medications p. 384
Soha Adel Abdou, Amira Ibrahim Mohamed, Yousra Aly
Aim: The purpose of this research was to compare the cytotoxicity effect of two naturally based intracanal medications, which are silver nanoparticles (AgNPs) and AgNPs with curcumin, to the commonly utilized calcium hydroxide (Ca(OH)2). Materials and Methods: Evaluation was done using cell line in vitro. The cell line used in our study was Gingival Fibroblast cells (ATCC PCS-201-012). After 48 h of exposure, the water soluble tetrazolium salt (WST-1) assay was used to assess the vitality of the cells by Abcam kit. Fifty-four samples were categorized randomly into three groups in accordance with the type of intracanal medicament applied: group A—18 samples of AgNPs; group B—18 samples of AgNPs with curcumin; and group C—18 samples of Ca(OH)2. Each main group was subdivided randomly into six subgroups; three samples for each subgroup according to concentrations (Conc) used, which were 0.01, 0.1, 1, 10, and 100, and normal cells as a control. Statistical analysis was done using Shapiro–Wilk and Kolmogorov–Smirnov tests, paired sample t test, and one-way analysis of variance. Results: In Conc 0.01, the highest viability percentage of living cells with the least cytotoxicity percentage was found in the control group, then in group A, and then in group C, whereas the lowest viability percentage was detected in group B. I the water soluble tetrazolium salt (WST-1) assay was used n Conc 0.1, Conc 1, Conc 10, and Conc 100, the highest viability percentage of living cells was detected in the control group, then in group C, and then in group A; however, the lowest was detected in group B. Conclusion: All three tested intracanal medications were noncytotoxic.
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Evaluation of stresses in maxillary first premolar restored with ceramic inlays and onlays by 3D finite element analysis: An in vitro study p. 391
Yellinadi Pallavi Reddy, Vemparala Bhaskara Padma Suryakumari, Sarjeev Singh Yadav
Aim: The present study evaluated the effect of different cavity configurations on stresses generated in maxillary first premolars restored with ceramic inlays and onlays using a finite element analysis (FEA). Materials and Methods: An extracted maxillary first premolar was used to generate a 3D FEA model from which three FEA models were designed for inlay designated as Group A and two FEA models for onlay designated as Group B. Further, based on the cavity design, they were subdivided into A1—mesio-occlusal, A2—disto-occlusal cavity, A3—mesio-occlusal distal cavity, and B1—conventional onlay preparation, B2—conservative onlay preparation. Leucite and lithium disilicate ceramics were the materials tested. An axial load of 200 N was applied vertically on the Occlusal surface. A static FEA was performed to analyze the stresses generated. Outputs of minimal principal stresses (MPS-compressive) on enamel, maximum von Misses stress values in MPa in dentin, and restoration were recorded and tabulated. Results: MPS recorded in enamel were in the order GrA3 > GrA2 > Gr B1 > GrB2 >GrA1. The von Mises stresses generated in dentin were highest for GrA2 (65.4 MPa), followed by Groups A3, A1, B2, and B1 (24.5MPa). The ceramic materials evaluated did not significantly influence the stresses. Conclusion: None of the cavity designs or the materials tested resulted in deleterious stresses leading to failure. Inlays and onlays prove to be reinforcing restorations in maxillary first premolars, with onlays having an embracing effect on the remaining sound tooth structure.
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Posteroanterior cephalometric immediate assessment of infrazygomatic crest mini-implants: A retrospective study p. 398
Swapna Sreenivasagan, Aravind Kumar Subramanian, Navaneethan Ramasamy
Aim: There are wide variations in placement of extra-alveolar bone screws that can occur in angulation, the height of placement, and other operator-related factors. The aim of this study is to comparatively evaluate the position of bilaterally placed infrazygomatic crest (IZC) mini-implants factors such as height, angulation, the length outside the bone, if any sinus penetration and the depth of penetration into the sinus. Materials and Methods: The study is a retrospective pilot study collected from the hospital records over the time period study was conducted. Posteroanterior cephalograms taken for patients after bilateral placement of IZC were collected. The comparison of the variations in placement for the right and left side was done. Results: There is wide variation among the sample and comparison to the right and left sides in the same sample. The height of placement above the buccal tube ranged from 7 to 8 mm. There were wide variations in angulation of the implant to the buccal bone ranging from 15° to up to 50°. Of the total size of the IZC mini-implant 6–7 mm of the implant was left outside the bone and an average of 2.5 mm of sinus penetration was commonly observed. Conclusion: Postplacement assessment of IZC can be done with a posteroanterior cephalogram. The implant was placed at a height of 6–10 mm above the buccal tube; there were wide variations in angulations between right and left side; 4–7 mm of the mini-implant did not engage the IZC, and there was a high incidence of sinus penetration ranging from 1 mm to 3.5 mm.
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Effects of incorporation of Eurycoma longifolia Jack root extract on properties of heat cured acrylic resin p. 404
Israa M Hummudi, Ghasak G Faisal, Ihab Nafea Yassen, Ahmed Hazim Kassoob, Essam Makky
Aim: Herbal treatment has recently been validated as a safe and effective alternative to antimicrobial drugs due to its safety and efficiency. Eurycoma longifolia root jack root extract (E.L.) has been documented for its antibacterial and antifungal properties. Acrylic resin is used to produce dentures. However, due to its porous nature, it is a good site for Candida albicans to adhere and cause infection. The aim of the presented study was to evaluate the effects of adding E.L. root extract to acrylic resin on the properties of heat polymerized denture material. Materials and Methods: Sixty circular-shaped (30 mm × 2 mm) specimens were prepared from heat-polymerized acrylic resin in total. Then they were divided into one control group and two experimental groups, which were prepared by adding 0.5 gm of E.L. root extract to 10 mL monomer. Polymer powder was added to the monomer. The conventional water bath method was used for mixing, packing, and processing. Specimens were polished and finished after processing, and then maintained for 48 h in distilled water. Shore D, profilometer tester and color recognition sensor were employed to measure the surface hardness, roughness and color changes. Statistical analysis was conducted via independent sample t test. Results: The results indicated no significant change in roughness values concerning the study groups. Hardness results showed a higher mean value for the experimental group in compared to the control. However, the independent sample t test showed no significant change between the study groups. In color change test, no statistically significant change between experimental and control regarding red and green colors mean values whereas blue color mean values showed significant alteration and color change tests. Conclusion: The study concluded that E. longifolia root extract showed better surface hardness and no effect on color alteration and surface roughness after incorporation to heat cure acrylic resin, which means it can be used as a natural safe antimicrobial agent incorporated into the resin.
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