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   Table of Contents - Current issue
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April-June 2018
Volume 15 | Issue 2
Page Nos. 63-126

Online since Monday, June 25, 2018

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ORIGINAL ARTICLES  

Effect of position of single implant with two different attachments on stress distribution of mandibular complete overdenture (in-vitro study) Highly accessed article p. 63
Merhan F El-Abd, Mohamed M El-Sheikh, Mohammed N El-Gendy
DOI:10.4103/tdj.tdj_22_17  
Objective The aim of this in-vitro study was to evaluate the effect of position of single implant with two different attachments on stress distribution of mandibular complete overdenture using electrical resistance strain gauge. Materials and methods One acrylic mandibular edentulous model was constructed with 2 mm thickness of artificial mucosa. Four finished denture were obtained one denture for each group. Group 1: single implant at midline region with ball attachment. Group 2: single implant at midline region with locator attachment. Group 3: single implant at left canine region with ball attachment. Group 4: single implant at left canine region with locator attachment. Four strain gauges were cemented at distal, buccal, mesial, lingual aspect of midline and canine single implant to monitor the effect of the applied 50 N static. Unilateral vertical and oblique loads at three different sites central fossa of right first molar, midline and central fossa of left first molar over each implant inserted in the acrylic model. Results Midline single implant with locator attachment (group 2) during vertical and oblique load had lower stresses than ball attachment (group 1), but when implant at canine area with locator attachment (group 4) during vertical and oblique load had lower stresses than ball attachment (group 3). Comparing between midline and canine implant the lowest stresses obtained with (group 2). Conclusion (a) The locator attachment showed reducing stress on implant body ability to distribute the load than ball attachment in midline and canine region. (b) Single implant at midline region showed less stress than implant at canine region with both attachments. (c) Vertical load applied over mandibular overdenture retained by single implant showed less stress than oblique force for both attachments. Less strain value were recorded with the locator attachment in the midline region.
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Clinical and radiographic evaluation of platelet-rich fibrin as a pulpotomy agent in primary molars p. 70
Anhar A. A. H. Mostafa, Amina M El Hosary, Mohamed K Zahra
DOI:10.4103/tdj.tdj_30_17  
Objective This study was carried out to evaluate clinical and radiographic effect of platelet-rich fibrin (PRF) as a pulpotomy agent in primary molars. Patients and methods In this randomized-controlled clinical trial, 20 children aged from 4 to 8 years old, each one had at least two lower primary carious molars. Forty selected molars were assigned randomly to one of the two treatment groups: group I (study group): the pulp treated using PRF. Group II (positive control group): the pulp treated using formocresol (FC). All pulpotomized teeth were restored with preformed stainless steel crowns. Then all the patients were evaluated every 3 months over a period of 12 months with clinical and radiographic examination. Results At the end of this study, the clinical success rate of the PRF group showed 89.5%, whereas FC group showed 94.7%. In contrast, the radiographic success results of the PRF group showed (78.9%), whereas FC group displayed success rate of 84.1%. There was no statistically significant differences between the two groups regarding to their clinical performance (P = 0.547) and radiographic performance (P = 0.676). Conclusion PRF is considered an acceptable pulpotomy agent that can be used as an alternative to FC.
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Evaluation of simultaneous secondary cheilorhinoplasty and alveolar bone grafting p. 76
Mohamed A. M. Hussein, Rafic R Beder, Abdelfattah A Sadakah
DOI:10.4103/tdj.tdj_35_17  
Background Correction of cleft lip nasal deformity is very challenging for any surgeon especially when complicated with hypoplastic maxilla and open alveolar defect. Secondary cheilorhinoplasty and alveolar grafting are essential parts in correction of such deformity. The aim of this study was to assess both clinically and radiologically the outcome of simultaneous cheilorhinoplasty and alveolar cleft grafting in unilateral CLND cases. Patients and method 8 patients aged between 14 and 25 years were selected randomly for correction of unilateral CLND and alveolar bone grafting with autogenous bone graft simultaneously. Patients were assessed preoperatively and postoperatively both clinically regarding nasal function using NOSE scale, photographic evaluation of lip and nose esthetics, and radiologically regarding alveolar cleft graft density. Data were statistically analysed. Results The results of this study showed statistically significant difference between pre and postoperative records regarding nasal obstruction, nasal and lip aesthetics and symmetry, and success of alveolar cleft grafting except one case revealed alveolar graft loss and recurrence of oronasal fistula. Conclusion Secondary cheilorhinoplasty can be done successfully in the same time with late secondary alveolar bone grafting to avoid several surgical distresses for the patient, to improve facial aesthetic and function in one surgical step, and to reduce risk of psychological consequences. Alveolar bone grafting is an important part for augmentation of alar base. Autogenous bone graft provides good grafting material for repair of alveolar cleft and augmentation of alar base. Standardised photographs can be used for evaluation of aesthetics of the lip and nose. 3d CT scan is a valuable instrument in assessment and follow up of alveolar cleft grafting procedures.
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Evaluation of fracture resistance of premolars restored with packable composite resin using different types of adhesive systems p. 82
Hasan Q Issa, Hussein Y El Sayed, Magda E Shalby
DOI:10.4103/tdj.tdj_39_17  
Purpose The aim of this study was to evaluate the fracture resistance of human extracted premolars restored with packable composite resin by using three types of adhesive systems: two-step etch-and-rinse system, two-step self-etch primer adhesive system, and one-step self-etch adhesive system. Materials and methods Fifty sound maxillary second premolars were selected. Forty specimens received class II mesio-occluso-distal cavities with a 2 ± 0.2 mm pulpal depth, 1.5 ± 0.2 mm gingival width, 2 ± 0.2 mm axial height, and parallel proximal walls with 3 ± 0.2 mm buccolingual width. All samples were divided into five groups (10 each): group I: positive control group (intact teeth), group II: negative control group (prepared unrestored), groups III, IV, and V: prepared and restored with Filtek Z350 XT packable composite resin by using three types of adhesive systems; Adper Single Bond, Clearfil liner Bond F, Single Bond Universal Adhesives respectively. After thermocycling, Specimens were subjected to compressive axial loading, and were tested individually in a universal testing machine. Peak loads at fracture were recorded. Statistical analysis was performed using SPSS, version 20.0. Results All groups were significantly higher than prepared but unrestored teeth with no significant difference was recorded between the three types of adhesives. Conclusion Restoring with packable composite using adhesive system had improved the fracture resistance of teeth subjected to class II mesio-occluso-distal preparations. Using the adhesive systems, insignificantly affect fracture resistance of premolars.
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Microshear bond strength of universal adhesives to dentin used in total-etch and self-etch modes p. 91
Ayad A Ahmed, Mustafa M Hassan, Ali I Abdalla
DOI:10.4103/tdj.tdj_52_17  
Purpose To determine the dentin bonding ability of three new universal adhesive systems under different etching modes using microshear bond strength (μSBS). Materials and methods Futurabond U, Single Bond Universal, and Tetric N-Bond Universal were used in this study. Sixty noncarious human molars were assigned to three groups based on the type of the universal adhesives. Two etching modes (total-etch and self-etch) were employed for each adhesive group. The adhesives were applied on dentin surfaces according to the manufacturer's instructions then composite resin (Z350 XT, nanocomposite) was condensed through a polyethylene tube with a 1 mm internal diameter and 2 mm height attached firmly to dentin surfaces and light cured. All samples were thermocycled for 500 cycles from 5 to 55°C. The μSBS was measured by using universal testing machine at cross-head speed of 0.5 mm/min. The bonded surfaces were examined under a stereomicroscope at magnification ×50 to determine the mode of failure. Dentin slices were prepared for each group to evaluate the resin–dentin interface a resin composite with each adhesive were placed 2 mm thick to form composite core. The segments were sectioned longitudinally and prepared to be examined under scanning electron microscope. Results Among the universal adhesives, Futurabond U and Tetric N-Bond Universal in total-etch mode showed significantly higher μSBS values than in self-etch mode. Single Bond Universal did not show any significant difference in μSBS between the total-etch mode and self-etch mode. Conclusion Performance of universal adhesives was shown to be material-dependent. The results indicate that universal adhesives used on dentine performed better in total-etch mode than self-etch mode.
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An analysis of Bcl-2 and Bax markers expression in polymorphous low-grade adenocarcinoma and epithelial–myoepithelial carcinoma of salivary gland p. 99
Mohamed A Mohamed, Kamal A Kamal, Galal A Nasr, Ali A AlQarni
DOI:10.4103/tdj.tdj_57_17  
Aim To study the evaluation of the expression of Bcl-2 and Bax markers in polymorphous low-grade adenocarcinoma (PLGA) and epithelial–myoepithelial carcinoma. Materials and Methods Hematoxylin and eosin and streptavidin–biotin immunoperoxidase staining techniques was used to detect the expression of Bcl-2 and Bax protein in five cases of PLGA and five cases of epithelial–myoepithelial carcinoma. Evaluation of immunostaining was done by image analysis computer system. Results Showed that there was a statistically significant difference (P < 0.001) in means of Bcl-2 and Bax expression between PLGA and epithelial–myoepithelial carcinoma. Conclusion The expression of Bcl-2 and Bax could be used as an effective biomarker to predict aggressive biologic behavior of PLGA and epithelial–myoepithelial carcinoma.
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Apically extruded debris associated with different instrumentation systems and irrigation needles p. 105
Walaa M Ghoneim, Neveen A Shaheen
DOI:10.4103/tdj.tdj_7_18  
Aim Of this study is to compare apically extruded debris associated with canal shaping using 2Shape, ProTaper Universal and Reciproc systems using two different irrigation needle tips, open-ended and side-vented. Patients and methods Sixty freshly extracted human mandibular premolars were randomly divided into six groups (n = 10) as follows; group 1 and 2, 2Shape system was used in root canal preparation, in groups 3 and 4, ProTaper Universal preparation system was used, but In groups 5 and 6, Reciproc preparation was performed. In groups 1, 3 and 5 irrigation was done with open-ended needle while in groups 2, 4 and 6 side-vented needle was used. One Eppendorf tube for each tooth was weighed with an electronic weighing machine before instrumentation procedures. During instrumentation, irrigation was performed after every instrument with 1 ml distilled water. On completion of the preparation, teeth were removed from the Eppendorf tubes. All of the tubes were incubated at 37°C for 15 days, to evaporate the irrigant. After the incubation period, the tubes were weighed again. The difference between initial and final tubes weights was calculated, and statistical evaluation was performed using two-way analysis of variance at 5% level of significance. Results A statistically significant difference was observed between all groups (P≤0.05). The highest mean extruded debris value was recorded with group 3 while the lowest value was recorded with group 6. Open-ended needles were associated with significantly more extruded debris than side-vented needles regardless of the instrumentation system used (P≤0.05). Conclusion All the tested rotary instruments resulted in extrusion of debris beyond the apical foramen to an extent but Reciproc system is associated with less amount of apically extruded debris in comparison with 2Shape, ProTaper Universal systems. Side-vented needles extruded significantly less debris than open-ended needles.
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Effect of two intracanal medicaments on the sealing ability and push-out bond strength of Biodentine apical plug p. 111
Neveen A Shaheen, Walaa M Ghoneim
DOI:10.4103/tdj.tdj_10_18  
Introduction The purpose of this study was to evaluate the effect of calcium hydroxide (CH) and modified-triple antibiotic paste (mTAP) intracanal medicaments on the sealing ability and push-out bond strength of Biodentine (BD) apical plug. Materials and methods A total of 36 human maxillary central incisors were used in this study. Coronal access cavities were made, 3 mm slice of the root tip was resected and root canals were instrumented to simulate immature teeth. Teeth were randomly divided into three groups (n = 12) according to the type of medication used as follow: group 1, CH; group 2, mTAP; and group 3, control group with no medication. After removal of medicaments, BD apical plug was formed in 10 specimens of each group. The sealing ability was evaluated in eight experimental samples of each group while negative and positive samples (n = 4) were used to determine the efficacy of the fluid filtration device by mounting each specimen's root in the fluid transport device and measured by monitoring air bubble displacement in the capillary tube and volume of fluid movement was recorded in μl/min. Then the apical portion of each specimen (n = 8) in all groups was horizontally sectioned to produce 2 mm thick section. Each section was subjected to a compressive load to evaluate push-out bond strength. Data were statistically analyzed using one-way analysis of variance and Tukey test at 5% significance level then Pearson's correlation between sealing ability and push-out bond strength values was performed. Results Group 2 showed maximum leakage and the least leakage was recorded for control group with statistically significant difference (P < 0.0001). mTAP recorded the least bond strength value but with no significant difference among three groups (P > 0.05). Conclusion The bond strength of BD apical plug to radicular dentine is less affected by medication with CH or mTAP while its sealing ability is significantly affected.
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Laboratory and clinical evaluation of uncomplicated fragment reattachment using pinholes p. 117
Talat M Beltagy
DOI:10.4103/tdj.tdj_11_18  
Purpose To evaluate laboratory and clinically the uncomplicated fragment reattachment using pinholes. Materials and Methods A total of 40 extracted human intact upper permanent central incisors with close similarity were selected and randomly divided into four groups (n = 10) according to the technique of reattachment. The incisal third of 30 specimens were sectioned horizontally. Group I: pinholes, group II: internal dentinal groove, group III: simple reattachment, and group IV (control group): intact teeth. Each fragment was reattached to its sectioned tooth using adhesive bond and resin cement. All specimens were tested for fracture strength under standard conditions in an Instron testing machine. The clinical study was performed on 20 patients, aged 8–16 years, presented with uncomplicated fragments of fractured upper central incisors, and divided into two groups (10 patients each). Group I: pinholes and group II: internal dentinal groove. All patients were followed-up clinically and radiographically at 3, 6, 12, and 18 months. Data were analyzed using one-way analysis of variance and post-hoc test with the significant level P less than 0.05. Results The laboratory study showed that the control group recorded the high strength value followed by pinholes, internal groove, and simple reattachment and the difference was statistically significant. However, the clinical results showed no significant differences between the two techniques. Conclusion It was concluded that the pinholes technique had only a significant effect on fragment reattachment success in the in-vitro study.
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