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   Table of Contents - Current issue
October-December 2017
Volume 14 | Issue 4
Page Nos. 169-230

Online since Thursday, December 21, 2017

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Role of combination therapy/composite graft in periodontal regeneration: A mini review Highly accessed article p. 169
Deepa Dhruvakumar, Chandni Gupta
Bone grafts are necessary to provide support, fill voids, and enhance biologic repair of skeletal defects. They are desired to be bioresorbable in nature and also to present no antigen-antibody reaction. Despite of the tremendous number of bone-graft substitutes that can be used in, there is no ideal bone graft that has the function capabilities and the potentiality to reduce the need for autograft. This paper reviews the role of the combination therapy for periodontal regeneration.
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Bite force and oral health impact profile in completely edentulous patients rehabilitated with two different types of denture bases p. 173
Hassan M Sakr, Mostafa Fayad
Purpose The aim of this study was to evaluate bite force and oral health impact profile (OHIP) in completely edentulous patients rehabilitated with two different types of denture bases. Patients and methods A total of 26 patients were selected from outpatient clinic, Removable Prosthodontic Department, Al-Azhar University. For each patient two types of complete dentures were made: (a) a heat-polymerizing hard Polymethyle-methacrylate (PMMA) and (b) thermoplastic PMMA. Bite force were evaluated 1 month and 6 months after denture insertion. Oral health-related quality of life was measured after 6 months of denture use using modified OHIP scale for edentulous patients. The data were statistically analyzed using statistical package for the social sciences V21 software. Results After 6 months of denture insertion, the bite force with a thermoplastic PMMA was better than that of heat-polymerizing hard PMMA with statistically significance difference. After 6 months, the OHIP for thermoplastic PMMA recorded better values more than a heat-polymerizing hard PMMA. Conclusion A thermoplastic PMMA denture was found to significantly has better maximum bite force values and OHIP after 6 months of denture use as compared to heat-polymerizing hard PMMA complete dentures.
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Effect of different root canal disinfection protocols on push-out bond strength of two endodontic sealers p. 181
Neveen A Shaheen, Walaa M Ghoneim
Introduction The purpose of this study was to evaluate push-out bond strength of two endodontic sealers (MetaSeal, Endosequence BC) to radicular dentin following different disinfection protocols [sodium hypochlorite (NaOCl), photoactivated disinfection, and ozonated olive oil]. Materials and methods A total of 60 freshly extracted human single rooted premolars with single root canals were selected. The crowns were removed to obtain a standardized root length of 15 mm and working length was determined. Root canals were prepared using ProTaper Universal rotary instruments up to F4 and irrigation throughout instrumentation was performed using 3 ml of 0.9% sodium chloride. Roots were randomly divided into six groups (n=10). In groups 1 and 2, root canals were finally irrigated with 3 ml of 2.5% NaOCl (as control groups), in groups 3 and 4, final disinfection protocol was performed with photoactivated disinfection, but in groups 5 and 6, root canals were finally disinfected by coating ProTaper F4 file with ozonated olive oil. In groups 1, 3, and 5, root canals were obturated with gutta-percha/MetaSeal sealer while in groups 2, 4, and 6, obturation was performed using gutta-percha/Endosequence BC sealer. Three horizontal sections were prepared in a thickness of 2 mm each corresponding to apical, middle, and coronal parts of the root. Each section was subjected to a compressive load to evaluate push-out bond strength and the data were statistically analyzed using two-way analysis of variance and post-hoc Tukey test. Results PAD groups recorded the highest values while ozonated olive oil groups recorded the lowest values. Bond strength of Endosequence BC was significantly higher than MetaSeal (P ≤ 0.05). The bond strength in the coronal sections was higher than that in the middle and apical sections. Conclusion PDA final disinfection protocol performed similarly to NaOCl and does not negatively affect bond strength as ozonated olive oil. Endosequence BC was better than MetaSeal in terms of bond strength.
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Immunohistochemical expression of osteonectin/SPARC in oral epithelial dysplasia, carcinoma in situ and squamous cell carcinoma p. 187
Ahmed A Essa, Omneya M Wahba
Aim This study demonstrated the immunohistochemical expression of secreted protein acidic and rich in cysteine (SPARC) in oral epithelial dysplasia, carcinoma in situ and different grades of oral squamous cell carcinoma (OSCC). Materials and methods This study used 28 OSCC; 11 well differentiated OSCC, 10 moderate differentiated OSCC and seven poorly differentiated OSCC that simultaneously contained dysplastic epithelium and carcinoma in situ were subjected to immunohistochemical staining for SPARC. Results All cases of OSCC showed positivity to SPARC. There was a significant correlation between SPARC expression and grades of OSCC (P < 0.01). The high expression was noted in poorly differentiated OSCC in addition to the expression of some stromal cells. No SPARC expression was noted in normal oral epithelium. Conclusion The results of this study showed that SPARC may be useful in early stages of cancerization and may be used as a marker for predicting the progression of OSCC. In addition, stromal SPARC expression is an effective indicator for targeted stromal therapy.
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Effect of cyclic loading on marginal fit of implant–abutment interface for three different connections with telescopic attachment: in-vitro study p. 193
Wafaa Y El-Ashry, Eman A Shakal, Mohamed M El-Sheikh
Objective The objective of this article was to evaluate the effect of dynamic cyclic loading on marginal fit at implant–abutment interface with three different implant connections using scanning electron microscope. Materials and methods Thirty implant fixtures were divided equally into three groups (N = 10): group I external hex fixture, group II internal hex fixture, group III conical hybrid fixture. Each fixture was vertically placed in the center of epoxy resin block using modified dental surveyor. Matched prefabricated titanium abutments were screwed to the implant and metal coping was adapted onto abutment. The samples were subjected to eccentric cyclic loading (at a distance 2–3 mm) away from center of abutment at three different intervals 10 000, 100 000, 500 000 cycles. Marginal fit was evaluated before and after each cycles by measuring microgap size in (μm) using scanning electron microscope with a magnification ×700. The values of microgap size in um before and after each cyclic loading were collected, tabulated and statistically analyzed using analysis of variance and Tukey's post-hoc test at 0.05 level of significance. Results After cyclic loading the microgap size was measured in all groups and high value was recorded to group I external hex connection 60.64 ± 4.3μm, while minimum value recorded to group III internal conical connections 0.94 ± 0.11 μm and internal hex connection in between 17.98 ± 2.07 μm. Two way analysis of variance showed significant effect upon marginal fit for both connection and cyclic loading. Conclusion The geometric factors of implant–abutment connection and dynamic cyclic loading have effect on marginal fit at implant–abutment interface. Internal conical connections showed a better marginal fit than internal and external hex connection so use of conical implants can be promoted as it has better sealing abilities compared to other systems.
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Cell viability and apoptotic changes of dental pulp stem cells treated with propolis, chitosan, and their nano counterparts p. 198
Abeer A Elgendy, Dalia M Fayyad
Aim Biocompatibility of materials used in regenerative endodontics is of prime importance. Thus, this study was conducted to evaluate and compare cytotoxicity and apoptotic changes of propolis, chitosan, and their nano counterparts on dental pulp stem cells. Materials and methods Aqueous and ethanolic extract of propolis, chitosan, propolis nanoparticles, and chitosan nanoparticles were prepared. Dental pulp stem cells were isolated from human third molars and characterized. Cultured cells were incubated with each extract of each material used for 24 and 72 h. Thereafter, cellular viability was assessed using MTT assay and DNA fragmentation using DNA fragmentation laddering assay. Control samples containing only medium were treated similarly. Differences in mean values of cell viability and DNA fragmentation between materials were assessed by using the one-way analysis of variance and Tukey's test. Results Nanoparticles of both materials expressed higher cell viability and lower DNA fragmentation in comparison to their original particles counterpart. Chitosan nanoparticles recorded a lower cytotoxicity and DNA fragmentation after 24 h, which increased by time, meanwhile that of propolis nanoparticles were decreased by time. Type of vehicle was a factor affecting the results of chitosan nanoparticles, while time was the factor affecting propolis nanoparticles. Conclusion Both propolis and chitosan nanoparticles displayed an acceptable biocompatibility and can be used in endodontic regeneration purposes.
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Evaluation of carcinoma-associated fibroblasts in oral squamous cell carcinoma: a potential role for cathepsin K p. 208
Basant H Abou Zaid, Nahed E Abo-Azma, Eman M Megahed, Elsayed M Deraz
Aim The aim of this work was to identify carcinoma-associated fibroblasts (CAFs) in the stroma of oral squamous cell carcinoma (OSCC), through examining α-smooth muscle actin (α-SMA) expression immunohistochemically. Also, to investigate the immunohistochemical expression pattern of cathepsin K (CTSK) in CAFs as well as to assess the expression level of CTSK mRNA in CAFs, by real-time reverse transcription PCR (RT-PCR) technique. Furthermore, to correlate CTSK expression in different histopathological grades of OSCC, in order to identify its potential role in tumor progression and aggressiveness. Materials and methods Paraffin-embedded OSCC specimens were stained immunohistochemically using antibodies against α-SMA and CTSK. At the same time, level of CTSK mRNA expression was evaluated in fibroblasts indirectly cocultured with OSCC cells by means of real-time RT-PCR technique. Results In addition to CTSK coimmunolocalization with α-SMA in stromal CAFs, its expression by OSCC cells was significantly correlated with increased malignant criteria. Stromal CAFs showed upregulated CTSK expression in poorly differentiated OSCC. Real-time RT-PCR results revealed enhanced CTSK mRNA expression by fibroblasts in indirect coculture. Conclusion Collectively, the results propose an evolving role for CTSK in OSCC progression.
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Fracture resistance of premolars teeth restored by silorane, nanohybrid and two types of fiber-reinforced composite: an in-vitro study p. 216
Mostafa S Mohamed Ata
Objective The objective was to evaluate and compare the fracture resistance of human maxillary premolars teeth restored with low shrinkage microhybrid composite Silorane-based; Filtek P90 LS, conventional methacrylate-based nanohybrid composite; Ceram X Mono, and two types of fiber-reinforced composites (FRCs); Alert and XENIUS base, micro glass fibers and short glass fibers, respectively in mesio-occluso-distal cavities. Materials and methods A total of 45 human maxillary premolars were selected. Standardized mesio-occluso-distal cavities were prepared in all teeth. Five prepared teeth received no treatment and served as controls (group 1). A total of 40 teeth were randomly divided into four experimental groups (n = 10); group 2: low shrinkage Silorane-based composite, group 3: nanohybrid resin composite, group 4: microfibers reinforced resin composite, and group 5: short fibers reinforced resin composite. Restorations were done for all groups. After being stored 24 h at 37°C, fracture resistance was measured in a universal Instron testing machine by using a 4 mm diameter steel sphere which was applied on tooth buccal and lingual cusps at a cross-head speed of 2 mm/min until fracture occurred. Statistical analysis One-way analysis of variance and Tukey's post-hoc test. Results Highest mean fracture resistance was observed with FRC, nanohybrid, Silorane and lastly with control respectively. Statistically Significant difference was revealed by analysis of variance (P ≤ 0.0001) and Tukey's post-hoc test (P ≤ 0.0001). Conclusion Among the experimental groups, FRC showed the highest fracture resistance.
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An evaluation of mandibular molars root canal morphology using cone-beam computed tomography in an Egyptian subpopulation p. 220
Marwa E Sharaan, Ahmad M Elrawdy
Introduction The aim of this study was to assess the root canal (RC) anatomy of mandibular permanent molars using cone-beam computed tomography (CBCT) in an Egyptian Ismailia population. Materials and methods Four hundred and thirty-six mandibular molars were included in this study. CBCT scans were evaluated by an oral radiologist and an endodontist. Root morphology and number as well as RC number were evaluated. RC configurations were classified according to Vertucci's method. Sex and bilateral symmetry were recorded. For RC configurations, sex and bilateral sides, Pearson's χ2-test was used (P ≤ 0.05). Results Two hundred and seventeen mandibular first molars demonstrated two roots configuration. Only one case had an extradistolingual root with type I RC. For the mandibular second molars, majority of the 218 were two roots configuration. Only four cases showed single root configuration. Regarding mandibular first molars, the frequency of Vertucci's classification for the mesial root were type IV (83.94%), type II (11.93%), type III (3.21%) and type VII (0.92%). For the distal root, were type I (62.84%), type II (19.72%), type III (10.55%), type IV (2.75%), type V (3.67%) and type VII (0.46%). Regarding mandibular second molars, the highest frequency of Vertucci's classification for the mesial root were type II (57.71%) then type IV (28.86%), type III (7.46%), type I (5.47%) and type V (0.5%). For the distal root, the most common of Vertucci's classification were type I (95.02%) followed by type II (3.48%), type III (0.99%) and type IV (0.5%). C-shaped canals were noticed in mandibular second molars only. Bilateral symmetry was displayed significantly regarding extra canal. There was significant difference between females and males (<0.05). Conclusion Preassessment of the mandibular molars using CBCT imaging provides clear data for the RC morphology that might increase the prognosis of the RC treatment.
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Oral rehabilitation by semi-adjustable articulator p. 225
Mohammad Sultan, Mohammad A Sarraj
Many patients attend to clinics and suffer of disease of tooth loss, partially or completely. Prosthodontics is the dental specialty that cares with the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of these patients. A 39-years-old patient needs rehabilitation because she has a deep bite and the collapse of the occlusal vertical dimension, where it was processed using a semi-adjustable articulator, it have been used method of preparation on the gypsum for provisional fixed partial denture, then we began treatment with patient after take observations of the preparation on gypsum, we has been used of the metal ceramic as a restoration.
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