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ORIGINAL ARTICLES
Effectiveness of the damon system in the treatment of nonextraction orthodontic cases
Yasmine M Sayed, Safaa M Gaballah, Eman M El Shourbagy
January-March 2016, 13(1):18-27
DOI:10.4103/1687-8574.186942  
Objectives The purpose of this study was to evaluate the dental, skeletal, and soft-tissue change in crowding cases treated with nonextraction approach using the Damon system. Materials and methods The sample included 20 patients, with an average age of 17.8 ± 3.7 years, selected on the basis of pretreatment class I skeletal and molar relationships with an acceptable soft tissue facial profile, and a moderate crowding range between 4.0 and 9.0 mm for the maxilla and 2.0 and 6.0 mm for the mandible. None of them had received any orthodontic treatment before, or had extraction or any congenital anomalies such as supernumerary teeth. Results The evaluation of the study was performed by detecting the dental, skeletal, and soft tissue changes between pretreatment and post-treatment study models and lateral cephalometric radiographs. The paired t-test was used for statistical analysis. The treatment required 20.7 ± 2.2 months to be finished, with an average of 13.8 ± 1.5 appointments. Conclusion The results of this study revealed that the correction of crowding was achieved through expansion of the dental arches and mandibular incisors proclination.
  845 152 -
Sealing ability and obturation quality of root canals filled with gutta-percha and two different sealers
Rabab A Gad, Ali M Farag, Hatem A El-Hediny, Abeer M Darrag
October-December 2016, 13(4):165-170
DOI:10.4103/1687-8574.195703  
Aim To evaluate sealing ability and quality of obturation when canal filled with gutta-percha and either mineral trioxide aggregate (MTA), or AH Plus sealer with detection of any possible correlation between microleakage and voids. Materials and methods Human freshly extracted 30 maxillary one-rooted teeth were prepared and assigned to experimental groups (n = 10), designated as group I: gutta-percha/AH Plus, group II: gutta-percha/MTA sealer, group III positive control group (n = 5) teeth unobturated, group IV: negative control group (n = 5) teeth obturated with gutta-percha, AH Plus sealer. After obturation, each tooth was prepared for fluid filtration assessment. Voids detection was performed through cross-sectional analysis at three root levels. Data were analyzed using one-way analysis of variance at a level of confidence of 95%. Results None of the tested obturation systems was able to provide leak proof filling. The sealing ability of MTA FillApex sealer showed higher parameters than AH Plus sealer even if it was not significant. The lowest percent of voids was recorded at the apical third for both tested sealers. The correlation between leakage and voids percentage was nonsignificant. Conclusion Calcium silicate root canal sealer (MTA FillApex) and AH Plus sealer can provide adequate seal with low voids percent. None of the root canal filled teeth were gap-free. Voids percentage cannot be used as an indicator for sealing ability.
  285 333 -
Shaping ability of single versus multi file rotary Ni-Ti systems in curved root canals
A Ghobashy, MM Nagy, MF Obeid
April-June 2016, 13(2):68-72
DOI:10.4103/1687-8574.188910  
Objectives The aim of this study is to compare the shaping ability (straightening of curved root canals, apical transportation, preparation time) of single and multi-file rotary systems during the preparation of curved root canals in extracted human molar teeth. Methods Sixty mandibular molars were divided according to the instrument used into three groups of 20 teeth each: group PTU (ProTaper Uneiversal), group PTN (ProTaper Next) and group OS (One Shape). Using standardized pre- and post-instrumentation radiographs, straightening of canal curvature was determined using image analysis software. A double-digital standardized radiographic technique was used to determine apical transportation. Preparation time was also recorded. Data were analysed using one-way analysis of variance (ANOVA) and post hoc Tukey's test, and significance was set at P < 0.05. Results During root canal preparation, no instruments fractured. The use of PTN resulted in significantly less canal straightening followed by OS then PT. There were no significant differences between the three groups with respect to apical transportation. PTN were significantly faster than PTU and OS. Conclusion Under the conditions of this study, ProTaper Next Protaper Universal and One Shape instruments respected original canal curvature and were safe to use. Protaper Next was the fastest among them.
  416 121 -
The diagnostic utility of pan-cytokeratin, CK19, CEA, CD10, and p63 in differentiating clear cell odontogenic carcinoma from hyalinizing clear cell carcinoma
Omneya M Wahba
April-June 2016, 13(2):73-82
DOI:10.4103/1687-8574.188907  
Background Clear cell carcinoma (CCC), or hyalinizing CCC, and clear cell odontogenic carcinoma (CCOC) are rare and typically indolent malignancies that can be diagnostically challenging. Aim The aim of this study was to determine the diagnostic utility of p63, carcinoembryonic antigen (CEA), CD10, pan-cytokeratin (pan-CK), and cytokeratin 19 (CK19) in the diagnosis of CCOC and hyalinizing CCC. Material and Methods The study groups comprised patients with CCOC (n = 15) and CCC (n = 10). The blocks of CCOC and CCCs were prepared for immunohistochemical staining for p63, CEA, CD10, pan-CK, and CK19. Results The results of this study revealed significant differences between the expression of pan-CK, CK19, and CEA between CCOC and hyalinizing CCC, with no significant value of p63 and CD10 expression. In conclusion, CCOC and hyalinizing CCC are malignant, locally aggressive tumors with the capacity to metastasize. Conclusion Based on the current observations and immunostains, it can be concluded that they are difficult, and, in some cases, impossible to distinguish morphologically and immunohistochemically despite a different cell of origin. Pan-CK, CK19, and CEA may have slight significant difference between CCOC and hyalinizing CCC but the diagnosis of these tumors mainly depends on the exclusion of other tumors. In addition, histological and immunohistochemical analyses of neoplasm features have limited value.
  435 44 -
Effect of different desensitizing adhesive systems on the shear bond strength of composite resin to dentin surface
Ahlam Abd El-Galil Nassar, Hussien Y El-Sayed, Wedad M Etman
April-June 2016, 13(2):109-117
DOI:10.4103/1687-8574.188913  
Objective The aim of this study was to evaluate the effect of different desensitizing agents, oxalate desensitizer and I-Bond, on the shear bond strength of composite resin to dentin surface. Materials and methods Occlusal surfaces of 80 sound human molars extracted were trimmed to expose a flat dentin surface. Each prepared sample was inserted in a metallic mold, which was designed with a Teflon mold having a hole (4 mm diameter ×3 mm height) for filling the restorative material. The samples were divided into four groups (20 each): group I (the control group), in which Adper Single Bond 2 and composite were applied; group II, in which oxalate desensitizer (D/Sense Crystal) was applied followed by Adper Single Bond 2 and composite; group III, in which oxalate desensitizer was applied, followed by re-etching and application of Adper Single Bond 2 and composite; and group IV, in which I-Bond and composite were used. All samples were thermocycled for 500 cycles (5–55°C). The samples in each group were subdivided into two subgroups (10 each) (A and B) according to storage time (24 h or 6 months, respectively). Shear bond strength of eight samples from each subgroup was measured. Debonded surfaces were examined under a stereomicroscope at magnification ×40 to determine the mode of failure. The remaining two samples were prepared to be examined under scanning electron microscope to reveal the resin penetration. Results Group I (the control group) recorded the highest shear bond strength values (11.838 ± 3.141 and 6.842 ± 3.912, respectively) in the two subgroups, followed by group IV (6.695 ± 3.164 and 6.217 ± 3.276, respectively) and group III (7.707 ± 3.845 and 3.681 ± 1.743, respectively), whereas the lowest values were found in group II (6.347 ± 3.208 and 3.240 ± 1.804, respectively). The incidence of adhesive mode of failure was higher in all tested groups, followed by mixed mode. Scanning electron microscope results confirmed the obtained statistical analysis of collected data. Clinical significance Both desensitizing agents and storage time had a negative significant effect on the shear bond strength of composite restoration to dentin surface.
  404 63 -
Coenzyme Q10 as a dietary supplement combined with topical corticosteroids in the treatment of erosive lesions of oral lichen planus
Malak Y Shoukheba, Enas A Elgendy
July-September 2016, 13(3):133-138
DOI:10.4103/1687-8574.191436  
Introduction: Oral lichen planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of coenzyme Q10 (CoQ10) as an adjunctive to topical corticosteroids in the treatment of erosive–ulcerative lichen planus. Materials and methods: A total of 30 patients with a confirmed clinical diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of two groups and treated as follows: group I received topical corticosteroids and group II received CoQ10 combined with topical corticosteroids. Assessment of outcome measures including clinical score and pain was carried out at the time of initial visit (baseline) and at 2, 4, 8, and 12 weeks following treatment protocol. All recorded data were analyzed using paired t-test and independent t-test. The level of significance was established at a P value of 0.05 or less. Results: The two studied groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period. However, healing and decrease in the size of the lesions were effective in group II, and a significant difference was found between the two groups favoring group II over group I. Conclusion: CoQ10 in combination with topical corticosteroids was found to be effective in managing ulcerative lesions of OLP; however, more studies with a larger sample sizes and longer duration with evaluation of the adjunctive effect of CoQ10 on inflammatory markers expressed in OLP are recommended.
  394 34 -
Clinical and radiographic evaluation of implant-supported removable partial overdenture in the lower Kennedy class IV cases
Wesam M El-Rashedy, Eman A Shakal, Mohammed N El Gendy, Hussein I Saudi
January-March 2016, 13(1):1-10
DOI:10.4103/1687-8574.186940  
Introduction The objective of the present study was to evaluate the effect of implant-supported partial overdenture design in restoring mandibular long class IV Kennedy's classification on the supporting structure, both clinically and radiographically. Materials and methods Ten partially edentulous patients with lower six anterior teeth missing were selected. Their ages ranged from 40 to 50 years. Each patient received two dental implants placed in the lower edentulous span at the canine area bilaterally. Ball-and-socket attachment (polycarbonate housing with rubber O-ring) was used between the implant and the overlay removable partial denture for retention. Periodic evaluation was carried out for every patient before denture insertion and then after 3, 6, and 9 months. As regards the clinical evaluation, the probing depth, gingival level, and attachment level around the implants were recorded. The radiographic evaluation included the use of specially developed software for measuring the alveolar bone density in gray scales and the bone height in pixels for the implants and the residual alveolar ridges. Results All implants were highly successfully osseointegrated at the end of this study. There was a statistically nonsignificant increase in the clinical parameters (probing depth, gingival level, and attachment level) around the dental implants throughout the 9-month follow-up period after denture insertion. Radiographically, there was a nonsignificant increase in bone loss, but a significant increase in bone density around the dental implants and the alveolar ridge throughout the follow-up period. Conclusion From the previous results, it was found that the concept of immediate loaded dental implant was efficient to be used successfully in the mandibular long Kennedy class IV to retain the partial overdenture.
  333 52 -
Clinical and radiographic comparative study between two different types of clasps materials used in unilateral maxillary Kennedy class II removable partial denture cases
Fatma A Elhadad, Fadel A Abd Elfatah, Nahed A Kashef
July-September 2016, 13(3):119-126
DOI:10.4103/1687-8574.191431  
Objective: The objective of the present study was to compare between two different clasp materials for the treatment of maxillary class II Kennedy classification clinically, radiographically. Materials and methods: Twenty male patients were selected for this study. The patients were divided into two groups. Each group consists of 10 patients. For group I each patient have maxillary removable partial denture that was constructed and retained by cobalt–chromium RPI clasp on the maxillary first premolar with cross arch stabilization (using double Aker clasp) on the other side. For group II each patient has the same except that the retentive I bar of RPI clasp was made of acetal resin. Patient satisfaction, clinical, and radiographic evaluations were carried out for every patient at insertion, 3, 6, and 9 months, the data were collected, tabulated, and statistically analyzed using t-test. Results: Satisfaction for the treatment. Group II patients were more satisfied of the treatment regarding aspects of the patients' comfort and esthetics. No significant difference in the aspects of phonetics, the ability to eat, prosthesis loosening, the gingival health, general satisfaction and food impaction between the two groups were found, also there were insignificant increase in the gingival recession, pocket depth, and plaque index around the abutments tooth in both groups. Radiographically, there was significant decrease in the bone height around the abutments in both groups. Conclusion: Removable partial denture with acetal resin clasp is better for esthetic and patient comfort. Good periodontal condition of the abutment tooth of both groups is maintained. Acetal resin clasp is the clasp of choice when esthetic is of primary concern to the patient.
  305 76 -
Laboratory comparative study of three different types of clasp materials
Nahla Y Abdel-Rahim, Fadel E Abd El-Fattah, Mohamed M El-Sheikh
January-March 2016, 13(1):41-49
DOI:10.4103/1687-8574.186936  
Purpose The objective of this in vitro study was to evaluate the retentive strength of 3 clasp materials Acetal resin (Ac), Cobalt- Chrome (Co-Cr) alloy and Nickel-Chrome (Ni-Cr) alloy before and after cyclic loading. Materials and methods A total of 72 clasps (24 clasps for each material) were fabricated on standardized metallic molar models. The clasps of each material were divided into 3 groups 8 clasps each according to degree of undercuts (0.01, 0.02 & 0.03 inch). Each clasp assembly was subjected to 730, 1460, 2190 and 2920 cycles of insertion and removal of a removable partial denture. Retentive strength was measured before and after each cyclic period. Retentive strength values were analyzed using ANOVA and Fisher's PLSD multiple comparison test at the 0.05 level of significance. Results Ac clasps had significantly lower retentive strength than Co-Cr and Ni-Cr clasps. Clasps with 0.01 inch undercut showed significantly less retention than clasps with 0.02 inch undercut and the latter showed significantly less retention than clasps with 0.03 inch undercut. All clasps exhibited continuous significant decrease in retentive strength from the first period of cyclic loading till the end of the cycling except for Acetal resin at 0.01 inch undercut which show no significant difference after 730 cyclic loading. Conclusion There was significant decrease in retentive strength of the 3 clasp materials.
  256 47 -
Remineralization effect of low-level laser and amorphous sodium–calcium–phosphosilicate paste in teeth with fixed orthodontic appliances
Edith Lara-Carrilloa, Carlos Doroteo-Chimalb, Sarai Lopez-Gonzaleza, Raul A Morales-Luckiec, Oscar F Olea-Mejiac, Toshio Kubodera-Itoa, Carlo E Medina-Solisd
January-March 2016, 13(1):55-62
DOI:10.4103/1687-8574.186939  
Purpose The aim of the present study was to evaluate enamel remineralization with NovaMin (amorphous sodium–calcium–phosphosilicate paste) and low-level laser (LLL) for white spot lesions after orthodontic therapy. Materials and methods A total of 20 premolars divided into four groups were submitted to three phases: (i) placement fixed orthodontic appliances; (ii) demineralizing solution; and (iii) remineralization for groups (group A, control; group B, NUPRO Sensodyne with NovaMin; group C, LLL; and group D, NovaMin and LLL). In each stage, elemental analysis (calcium, phosphorus, and sodium) was measured under a scanning electron microscope; the data were tested to find significant differences between mineral changes during phases by using the Bonferroni test and Tukey's test between groups. Results Calcium and sodium decreased and phosphorus ions increased in all groups at stage 2. In stage 3, all minerals increased for all the tested groups, recording greater values in group B. Calcium showed a statistically significant difference on comparing stage 1 with stage 2 (P = 0.025) and stage 2 with stage 3 (P = 0.019). On the other hand, using the Bonferroni analysis, phosphorous recorded a significant difference on comparing stage 1 with stage 3 (P = 0.013). Applying Tukey's test, a statistical significant difference between groups A and B was recorded as regards the calcium level (P = 0.004) and the phosphorus level (P = 0.003), which also showed a significant difference between group A and group C (P = 0.052). As regards the sodium distribution, no significant differences were found. Conclusion According to the results obtained in the current study, using NUPRO Sensodyne with NovaMin than using LLL proved to be the better treatment for white spot lesions, leading ion incorporation and providing an effective alternative for dental demineralization.
  233 59 -
Solvent-free self-etch adhesive as a breakthrough in bonding technology: Fact or fiction?
Emad A Abo-Alazm, Rehab K Safy, Mohamed M Zayed
April-June 2016, 13(2):83-88
DOI:10.4103/1687-8574.188908  
Objective The aim of this study was to compare the microshear bond strength (μSBS) and adhesive dentin interfacial ultramorphology of a solvent-free self-etch adhesive with those of a solvent-containing adhesive. Materials and methods Twenty caries-free third molars were used to prepare specimens of dentin surfaces. Ten specimens were prepared for each material. Specimen surfaces were further divided according to the prepared dentin surface into superficial and deep. The adhesives were applied on dentin surfaces according to the manufacturer's instructions, after which Filtek Z250 XT composite resin was condensed through a polyethylene tube with a 0.75-mm internal diameter and 1-mm height attached firmly to the dentin surfaces and light cured. The bonded specimens were stored in distilled water at 37°C for 24 h before being tested. The μSBS values of the adhesives to dentin were evaluated and the collected data were analyzed statistically using one-way analysis of variance. In addition, in each experimental group, three specimens were prepared for analysis under scanning electron microscopy. Results There was a significant difference in μSBS between solvent-free self-etch adhesives and solvent-containing adhesives. Scanning electron microscopic findings confirmed the results. Conclusion Elimination of the solvent from a self-etch adhesive systems hindered the infiltration of adhesive components into dentin, which affects the bonding quality of resin composite to dentin.
  224 47 -
Effect of fluoride agents on the color stability of esthetic restorative materials
Nazish Fatima, Talha Nayab, Waqas Ahmed Farooqui
April-June 2016, 13(2):63-67
DOI:10.4103/1687-8574.188911  
Objective The aim of the study was to estimate the effect of acidulated phosphate fluoride (APF) gel and fluoride varnish on the color stability of esthetic restorative materials. Methodology The materials included were glass ionomer cement, resin-modified glass ionomer cement, and composite resin. A Teflon matrix (12×2 mm) mold was used to fabricate 108 specimens from all restorative materials. Further, 36 disks of each restorative material were then randomly divided into three groups (n = 12) according to the fluoride application: deionized water (control), APF (1.23%), and fluoride varnish. Color change was measured by means of a spectrophotometer using a CIE L*a*b* (Comission International l´Eclairage) system before and 24 h after fluoride treatment. Statistical comparisons were made using first mixed model repeated measure analysis of variance on the transform ranked data under the assumption of non-normal data and to see which main or interaction effect was significant. Results In control groups, when the baseline and final readings of glagg ionomer cement, resinmodified glass ionomer cement, and composite materials were compared for color changes, similar values were observed and hence results were nonsignificant. When all materials were compared for color changes before and after the application of APF, highly significant mean differences were found among the groups. Hence, application of APF results in a highly significant color change in all materials compared with varnish application. Conclusion Topical fluoride agents – either fluoride varnish or APF gels – cause discoloration in all esthetic restorative materials. However, this discoloration is not visually perceptible.
  196 58 -
Changes in surface roughness of bleached enamel by using different remineralizing agents
Reham M Attia, Mohammed M Kamel
October-December 2016, 13(4):179-186
DOI:10.4103/1687-8574.195707  
Objectives The purpose of this study was to determine the effect of fluoride gel, Remin Pro, and GC tooth mousse plus in changing surface roughness of enamel after bleaching procedures. Materials and methods Dental enamel blocks measuring 2 × 3 × 4 mm were prepared from nonerupted human third molars. The 38% hydrogen peroxide in-office bleaching protocols were performed. The specimens were randomly divided into three groups (n = 10 samples per group) according to the remineralizing agent used: group 1: using fluoride gel, group 2: using Remin Pro, and group 3: using GC tooth mousse plus. Measurements of surface roughness were carried out using a contact stylus profilometer before bleaching, after bleaching, and after remineralization. Results Data were analyzed using analysis of variance and Tukey's test. There was a highly significant difference of enamel surface roughness measurements among initial, after bleaching, and final regarding the three tested groups (P < 0.001). There was no significant difference among the three tested groups in relation to enamel surface roughness before and after bleaching (P = 0.739 and 0.341, respectively). There was a highly significant difference in relation to final measurements (P < 0.001) among the three tested groups. The difference in Ra value of enamel between the group used fluoride gel and that used Remin Pro and GC tooth mousse plus was highly significant and that between groups 2 and 3 was not significant. Conclusion GC tooth mousse plus and Remin Pro are more effective in reducing enamel surface roughness after bleaching than fluoride product.
  205 47 -
Dental age assessment among a group of children in Tanta city
Abdrhman M Azzawi, Amina M El Hosary, Amal M Ezzat
April-June 2016, 13(2):89-95
DOI:10.4103/1687-8574.188906  
Objectives The aim of this study was to assess dental age among a group of children in Tanta city by using the Demirjian method. Materials and methods A sample of 400 children aged 5–13 years were selected from the Pedodontic and Orthodontic clinics, Faculty of Dentistry, Tanta University. All patients had to undergo panoramic radiography during their course of treatment. Dental maturity was assessed. Results Both boys and girls showed advanced dental age compared with their chronological age, which was found to be statistically significant. Boys were 0.208 years and girls were 0.294 years ahead. Conclusion The Demirjian standard is not applicable to Egyptian children and a new adapted dental score for Egyptians must be established for each sex and age separately.
  185 53 -
Clinical and radiographic evaluation of the influence of antihyperglycemic drug (metformin) on healing of bone and periodontal defects after impacted mandibular third molar surgery
Shereen W Arafat, Rania F Abdulmaguid, Mohamed H Abou Ghaly
October-December 2016, 13(4):187-192
DOI:10.4103/1687-8574.195709  
Objectives The purpose of the current study was to clinically and radiographically assess the regenerative potential of metformin in enhancement of bone healing in third molar extraction sites. Patients and methods The present study included 40 healthy volunteers (27 females and 13 males) aged 21-27 years who had been scheduled for surgical removal of their impacted mandibular third molars. Volunteers were randomly assigned to either groups A or B. Twenty patients of group A (test) underwent surgical removal of impacted mandibular third molar followed by application of metformin gel in the surgical site. Twenty patients of group B (control) underwent surgical removal of impacted mandibular third molar only. Clinical and radiographic evaluation (cone beam computed tomography) was performed immediately after operation and at 6 months postoperatively in terms of the probing pocket depth, the bone defect length at the distal side of second lower molars, and bone density. Data were collected and statistical analysis was performed. Results At 6 months postoperatively group A (test) showed significantly higher (P ≤ 0.001) mean bone density compared with group B (control). On the other hand, there was nonsignificant (P ≥ 0.001) difference in the periodontal pocket depth and defect length between the test and control groups after 6 months. Conclusion There was a significant improvement regarding bone density at the surgical site using metformin after impacted mandibular third molar removal. Thus bone-formative effects of the common oral antihyperglycemic agent MF can provide a new direction in the field of bone healing.
  188 42 -
Comparative study of two types of attachments for mandibular implant-retained single complete overdenture
Maha M Abo Shady, Ibrahim R Eltorky, Zeinb M Abd Eaal
July-September 2016, 13(3):157-161
DOI:10.4103/1687-8574.191434  
Objective: The aim of this work is to compare between balls versus locator attachment systems for mandibular implant-retained single complete overdenture, as regards to clinical and radiographic evaluation. Materials and methods: Fourteen patients had lower edentulous jaw opposing almost natural dentition in the upper jaw was selected with their age ranging from 55 to 65 years. The patients were divided into two groups. Group I received single mandibular complete overdenture constructed over two implants, retained by ball attachments. Group II received single mandibular complete overdenture constructed over two implants, retained by locator attachments. Evaluation was carried out at regular appointments up to 1 year from time of loading of the implants. Each patient was presented to a questionnaire regarding retention, stability, comfort, chewing ability, esthetics, and speech. Clinically, the patients were evaluated as regards to gingival recession, pocket depth and implant stability. Radiographically, the patients were examined to determine the amount of marginal bone loss. Results: All fixtures were successfully osseointegrated all over the follow-up period. The results showed no significant difference in patient satisfaction between both groups (P = 0.827). Slight increase in the gingival recession was found in both groups throughout the time of observations, with no significant difference between both groups (P = 0.166). There was insignificant increased of the probing depth around the implants in both groups (P = 0.600). There was insignificant increase in implant stability in both groups throughout the follow-up periods (P = 0.839). No significant differences in bone loss were observed between both groups throughout the follow-up periods (P = 0.524 and <0.05). Conclusion: Two implants were sufficient to retain a single mandibular complete overdenture opposing maxillary natural dentition without hazardous effect on the implants.
  177 49 -
Clinical and biochemical assessment of different injection materials following arthrocentesis for the treatment of internal derangement of the temporomandibular joint: A comparative study
Shereen Wagdy Arafat, Ingy Mohamed Chehata
April-June 2016, 13(2):102-108
DOI:10.4103/1687-8574.188909  
Objectives The present study was performed to evaluate and compare the effect of ozonized water lavage followed by ozone injection with that of lactated Ringer lavage followed by either corticosteroid or sodium hyaluronate injection. Materials and methods A total of 27 patients suffering from internal derangement of the temporomandibular joint and not responding to conservative therapy were randomly classified into three groups. In group A joint lavage was performed using ozonized water followed by injection of ozone. In group B joint lavage was performed using lactated Ringer solution followed by corticosteroid injection. In group C joint lavage was performed using lactated Ringer solution followed by sodium hyaluronate injection. The treatment outcome was evaluated biochemically by measuring the change in tumor necrosis factor-α (TNF-α) level in the synovial fluid preoperatively and 1 week postoperatively. Clinical measurements of maximal mouth opening and lateral and protrusive excursions were taken preoperatively and at 1 week, 1, and 3 months postoperatively. Pain was measured using the Visual Analogue Scale at the study intervals. These data were statistically analyzed. Results The three groups showed significant improvement (P ≤ 0.05) in all biochemical and clinical measurements. However, joint lavage using ozonized water followed by ozone injection provided more favorable results compared with treatment with sodium hyaluronate, which in turn was more superior to corticosteroid treatment with respect to maximal mouth opening. All of the study groups showed significant reduction (P ≤ 0.05) in TNF-α level in the synovial fluid. Group A had the highest reduction of TNF-α level with significant difference (P ≤ 0.05) between its results and those of groups B and C, whereas groups B and C showed nonsignificant difference between their results (P ≥ 0.05). Conclusion Data from our study suggested more favorable outcomes from ozonized water lavage followed by ozone injection with regard to the clinical and biochemical parameters.
  168 44 -
Biologic reinforcement of compromised permanent incisors in children
Talat M Beltagy
July-September 2016, 13(3):147-156
DOI:10.4103/1687-8574.191437  
Purpose: The aim of this study was to evaluate the clinical and radiographic success of biologic primary incisors as intraradicular post–core reinforcement in management of compromised permanent incisors in children. Patients and methods: Twenty-four children patients aged 10–15 years old were selected from Outpatients Clinic of Pedodontic Department, Faculty of Dentistry, Tanta University. The patients had upper permanent central incisors with flared canal indicated for intraradicular reinforcement. The patients were randomly divided into two groups, 12 patients each; biologic group were reinforced by human extracted primary incisors, and fiber post group that their compromised teeth were reinforced by fiber posts (EasyPost) with RelyX Unicem. Clinical assessment of jacket crowns, gingival health, reinforced permanent teeth, and intraradicular reinforcing system was recorded. The healthy periapical area (no pathosis), pathosis did not require immediate treatment and pathosis required immediate treatment were recorded as radiographic assessment. The children were followed up clinically and radiographically at 3, 6, 12, and 18 months after treatment. Results: The overall clinical success rate of biologic group was 75 and 100% for fiber post group. There were no statistically significant differences in clinical assessment between the two groups (P > 0.05). The overall radiographic success rate of biologic group was 77.8 and 83% for fiber post group at the end of study. There were no statistically significant differences in radiographic assessment between the two groups (P > 0.05). Conclusion: The use of extracted primary incisors as biologic post–core in rehabilitation of compromised flared upper central incisors have continued to function well for 1.5 years with overall clinical and radiographic success rate of 75 and 77.8%, respectively.
  176 31 -
Efficacy of EndoVac system and needle irrigation on root canal debridement
Saleh A Abdelglil, Ali M Farag, Hatem A El-Hediny, Abeer M Darrag
October-December 2016, 13(4):171-178
DOI:10.4103/1687-8574.195705  
Introduction The aim of this study is to compare the debridement efficacy of the EndoVac irrigation system versus needle irrigation with different irrigant solutions using scanning electron microscope. Materials and methods Eighty human freshly extracted single rooted teeth with fully developed, single root canals were collected. The teeth were divided randomly into two equal main groups according to the method of irrigation system used: group A, EndoVac system; and group B, needle irrigation. Each group was further subdivided into four equal subgroups according to the type of irrigant solution used: subgroup 1; sodium hypochlorite (NaOCl), subgroup 2; EDTA, subgroup 3; mixture of tetracycline, acid and detergent (MTAD), subgroup 4; saline. The canals were instrumented to a master apical file size #40/0.02 taper. Roots were split longitudinally in a buccolingual direction and examined under scanning electron microscope. Result At all tested root canal levels, group A recorded lower mean rank of score percentage compared to group B with statistical significant difference between them (P = 0.001 and 0.039 at the middle and the apical root level, respectively), while there was no statistical significant difference between both groups (P = 0.053) at the coronal root level. Conclusion The debridement efficacy of NaOCl only, NaOCl+EDTA, NaOCl+MTAD or even saline increased when using EndoVac system rather than conventional needles especially in the apical third.
  172 33 -
Retrospective study of maxillofacial trauma in Alexandria University: Analysis of 177 cases
Lydia N Melek, Ahmed A Sharara
January-March 2016, 13(1):28-33
DOI:10.4103/1687-8574.186943  
Purpose The aim of the present study was to analyze retrospectively the age and sex distribution, etiology, and location of mandibular and midface fractures in a sample of patients from the Oral and Maxillofacial Surgery Department, Alexandria University, Egypt. Patients and methods The data for this study were obtained from the medical records of 177 cases treated at the Oral and Maxillofacial Surgery Department, Alexandria University, from April 2010 to August 2011. Results The total number of patients with maxillofacial trauma presenting to the Oral and Maxillofacial Surgery Department, during the period from April 2010 to August 2011 was 177 patients. The male population was more frequently affected compared with the female population, males were more frequently affected than females, where males accounted for 82% (145 patients) and females accounted for 18% (32 patients) of the study population with a ratio of 4.5:1. The ages of the patients in the study population ranged from 1.5 to 75 years, with a mean of 25.56 ΁ 14.04 years. Road traffic accident (RTA) was the most common cause of trauma, accounting for 77.97% (138) of cases. A total of 103 cases had isolated mandibular fractures, 54 cases had midface fractures only, and 20 patients had mandibular fractures associated with midface fractures. The most common site in mandibular fractures was the parasymphysis (40.64%; 63 fractures), and zygomaticomaxillary complex fractures were the most common, accounting for 70.13% (54 fractures) of midface fractures. Most of the fractures were treated by means of open reduction and internal fixation using plates (144 cases; 81.36%), whereas the remaining 33 (18.64%) cases were treated conservatively by means of closed reduction. The duration of hospital stay ranged from 0 to 26 days, with an average of 7.34 ΁ 4.64 days. Conclusion RTAs are the main etiological factor in maxillofacial injuries occurring in Alexandria, with men between 21 and 45 years of age being affected predominantly. Preventive strategies remain the best way to reduce the sequelae of RTAs.
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REVIEW ARTICLES
Piezowave in periodontology and oral implantology - an overview
Mrinalini A Bhatnagar, D Deepa
January-March 2017, 14(1):1-6
DOI:10.4103/1687-8574.202054  
Ultrasound has been used for many years in periodontics to remove tartar, debride root surfaces, and to degranulate periodontal defects. In the last two decades, dental surgical techniques have developed rapidly. Piezosurgery is a novel surgical approach which was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional surgery. It is based on the basic principles of 'piezoelectricity' discovered by Pierre Curie and Jacquesin 19th century. Over the past two decades, piezoelectric devices have emerged as an innovative tool in the field of dentistry. There has been extensive research on indications of piezosurgery in the field of periodontology and implantology.
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ORIGINAL ARTICLES
Calvarial thickness in relation to sagittal and vertical malrelations in Egyptians
Dina M Tawfik, Eman M El Shourbagy, Safaa A Ghobashy
January-March 2016, 13(1):34-40
DOI:10.4103/1687-8574.186944  
Objectives The purpose of this study was to evaluate the relationship between skull thickness and different skeletal patterns in both sexes. Materials and methods A total of 120 pretreatment lateral cephalometric radiographs of adult patients seeking orthodontic treatment at the orthodontic clinic in the Faculty of Dentistry, University of Tanta, were evaluated. The patients' ages ranged between 18 and 25 years. All radiographs had been classified into two categories according to the anteroposterior and vertical relationships as follows: normodivergent facial pattern with an FH-MP angle between 22 and 28° and a normal sagittal pattern with an ANB angle between 2 and 4°. The thickness of the frontal, parietal, and occipital bones was measured on lateral radiographs of patients with skeletal class II and class III, both high-angle and low-angle cases, and compared with the control group. Results Female patients with skeletal class II malocclusion had a significantly thicker frontal bone and thinner occipital bones compared with male patients. Conclusion The frontal bone and occipital bones are important key bones for understanding the calvarial phenotype and sexual dimorphism in different skeletal patterns.
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Effect of two-flap palatoplasty on growth and speech in patients with a cleft palate
Alaa A Altaweel, Ashraf Abdelkader, Rana S Mohamed
April-June 2016, 13(2):96-101
DOI:10.4103/1687-8574.188912  
Objective This study aimed to evaluate the outcomes of two-flap palatoplasty in improving the growth rate and repairing speech abnormalities in patients with an isolated cleft palate. Patients and methods In 30 patients with an isolated cleft palate, two-flap palatoplasty was used for correction. The immediate postoperative gain in palatal length was assessed and the incidence of postoperative oronasal fistula was also observed. All patients received speech and nutritional therapy. Speech parameters were obtained preoperatively and at 6, 18 and 30 weeks postoperatively. Patients' height was recorded 6 months preoperatively, at the time of surgery and 6 months postoperatively, whereas patients' weight was recorded 6 and 3 months preoperatively, at the time of surgery, and 3 and 6 months postoperatively. Results There was a significant increase in palatal length (the mean palatal length gain was 6.09 ± 0.15 mm). The incidence of oronasal fistula was reported in three patients. A significant improvement was recorded in speech outcome at different follow-up periods. There was a significant gain in children's weight and height postoperatively. Conclusion Two-flap palatoplasty is a reliable technique for correction of an isolated cleft palate, with a limited incidence of oronasal fistula. Palatoplasty combined with proper nutrition has a positive effect on the catch-up growth rate. Speech therapy after palatoplasty is essential to achieve good speech outcomes.
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The effect of plasma surface treatment on push-out bond strength of fiber-reinforced posts to root canal dentin
Usama M Abdel-Karim, Hatem A Alhadainy
July-September 2016, 13(3):127-132
DOI:10.4103/1687-8574.191433  
Objectives: This study evaluated the effect of surface treatment with plasma or sandblasting on push-out bond strength of fiber post bonded to root canal dentin. Methods: Crowns of 50 teeth were sectioned and their root canals were instrumented, obturated and received post-space preparations. The roots were equally divided into five groups according to post surface treatment. Posts were surface treated with oxygen plasma in Group 1 and argon plasma in Group 2. Post surfaces were treated with sandblasting in Group 3 and silanized after sandblasting in Group 4. In control group (Group 5), posts were cemented to the canal wall without surface treatment. After post cementation, push-out test was used to evaluate the bond strength of fiber post bonded to root canal dentin. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (α = 0.05). Results: Oxygen plasma revealed the significantly highest push-out bond strength of all groups (P < 0.01). No significant difference was found between argon plasma and control group. Sandblasting significantly improved the bond strength compared to control group. The difference between sandblasted and sandblasted-silanized groups was not significant. Conclusions: Oxygen plasma treatment of fiber post recorded the highest bond strength to root canal dentin followed by sandblasting. Silanization and Argon plasma did not play a significant role in enhancing bond strength of fiber posts to canal dentin. Clinical significance: Oxygen plasma surface treatment offered the highest resistance to displacement of fiber posts. Clinical trials involving plasma technique are indicated.
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Fracture resistance of roots obturated with a single expandable polymer cone
Mohamed A Elayed, Abeer A Elgendy
January-March 2017, 14(1):25-29
DOI:10.4103/tdj.tdj_57_16  
Endodontically treated teeth are considered to be more susceptible to fracture than vital teeth, therefore various obturation materials and methods have been used to reinforce them and decrease the incidence of vertical root fractures. The aim of this study was to compare root fracture resistance after filling either with smartseal system (PropointPT cone and Smart-paste Bio sealer) or with gutta-percha in combination with either MTA Fillapex or AH Plus sealers. Sixty single-canal extracted teeth were selected. The crowns were removed and the roots were prepared with ProTaper rotary system to size F4, roots were divided into four groups according to obturation system (n = 15). Group 1: smartseal system, specimens were filled with a bioceramic sealer (Smart-paste Bio), and F4 PropointPT. Group 2: were filled with MTA Fillapex and F4 gutta-percha single cone. Group 3: were filled with AH Plus sealer and F4 gutta-percha single cone. In group 4, the roots were neither shaped nor filled and served as negative control. All specimens were tested in a universal testing machine as the force at the time of fracture was recorded in Newtons. Data were analyzed using the one-way analysis of variance. Roots in the negative control group and smartseal group showed significantly higher values (380.7 ± 59 N) and (347.2 ± 56 N) respectively. There was no significant difference between the MTA Fillapex/gutta-percha and AH Plus/gutta-percha groups (227.4 ± 43 N) and (254.4 ± 55 N), respectively. It can be concluded that the smartseal system did improve the fracture resistance of the endodontically treated roots more than MTA Fillapex/gutta-percha or AH Plus/gutta-percha combinations.
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