Dental Research Journal
Volume:10 Issue: 3, May 2013

Salivary diagnostics has fascinated many researcheres and has been tested as a valuable tool in the diagnosis of many systemic conditions and for drug monitoring. Advances in the field of molecular biology, salivary genomics and proteomics have led to the discovery of new molecular markers for oral cancer diagnosis, therapeutics and prognosis. Oral cancer is a potentially fatal disease and the outcome of the treatment and prognosis largely depends on early diagnosis. Abnormal cellular products elucidated from malignant cells can be detected and measured in various body fluids including saliva and constitute tumor markers. This article discusses the various salivary tumor markers and their role in oral pre‑cancer and cancer.

In recent years, clinician and dentist’s esthetic demand in dentistry have increased rapidly, driven by an enhanced awareness of beauty and esthetics. The ultimate goal in modern restorative dentistry is to achieve “white” and “pink” esthetics in esthetically important zones. “White esthetics” is the natural dentition or the restoration of dental hard tissues with suitable materials. “Pink esthetics” refers to the surrounding soft‑tissues, which includes the interdental papilla and gingiva that can enhance or diminish the esthetic result. Reconstruction of the lost interdental papilla is one of the most challenging and least predictable problems. Restoration and maintenance of these tissues with adequate surgical and prosthetic techniques are a real challenge in modern esthetic dentistry.Treatment of marginal tissue recession, excessive gingival display, deficient ridges, ridge collapse, and esthetic defects around teeth and implants are some of the esthetic problems associated with the interdental papilla that have to be corrected in todays scenario which has been discussed in this review.

Probiotics are dietary supplements, which have been advocated for the prevention and the treatment of a wide range of diseases. These products consist of beneficial micro‑organisms, which stimulate health promoting flora thus, suppressing the pathologic colonization and disease spread. Since, probiotics are now widely used in both medical (such as cancer risk reduction, gastrointestinal tract health, and urinary tract health) and dental specialties (reduction in caries development, in achieving periodontal health, reducing oral malodor, etc.), a thorough understanding of their risks and benefits are essential. This review focuses on the recent trends in use of probiotics in dentistry as well as the potential risks associated with them.

Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD). The purpose of this article is to review the AqualizerTM, an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient’s pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world‑wide web and pubmed/medline.

The oral cavity harbors a diverse and abundant number of complex oral pathogens causing different oral diseases. The development of dental caries and periodontal diseases has been found to be closely associated with various gram positive and gram negative microrganisms. Miswak, a natural toothbrush, has been documented as a potent antibacterial aid and its use is encouraged in different countries because of its good taste, texture, availability, cost and beneficial effect on teeth and supporting tissues. Different researches have been carried out to evaluate the antimicrobial effects of Miswak. This review encompasses the efficacy of Miswak on suppression of oral pathogens with respect to conducted on fungi as well as cariogenic, periodontal and endodontic bacteria.

Syndecan‑1 is abundant in normal tissues and reduced in squamous cell carcinomas. Leukoplakia and oral submucous fibrosis (OSF) are oral pre‑cancerous disorders that have potential for malignant transformation. The aim of this study was to evaluate the expression of syndecan‑1 in leukoplakia and OSF and to identify its role as a reliable marker for predicting malignant changes. Expression of syndecan‑1 was examined immunohistochemically in 42 cases of oral leukoplakia with or without epithelial dysplasia, 28 cases of OSF and 10 cases of normal oral epithelia as control. Mann-Whiteny ‘U’ test was used for statistical analysis and the level of significance was fixed at P < 0.05. Intense syndecan‑1 expression was observed in nine cases with normal epithelium. Immunopositivity was lost gradually as the extent of epithelial dysplasia increased. The significant reduction in syndecan‑1 expression was observed in leukoplakia as epithelial dysplasia progressed from moderate or severe. Similarly, significant reduction was observed in staining intensities in OSF with dysplasia. The results reveal that down‑regulation of syndecan‑1 expression is associated with dysplastic changes in leukoplakia and OSF. Thus syndecan‑1 can be considered as marker for predicting malignant changes.

Polymerization of resin‑modified glass‑ionomers (RMGIs) is mediated through two competing mechanisms: An acid‑base reaction and a light‑dependent resin polymerization. Furthermore, pre‑conditioning with acid has resulted in an increase in enamel bond strength of some RMGIs. This in vitro study evaluated the effect of pre‑conditioning and/or delayed irradiation on bond strength of three RMGIs to enamel. In this in vitro study, 144 flat enamel surfaces of human molars were ground using consecutively finer abrasives up to 600‑grit silicon carbide paper. Each surface was rinsed and gently air‑dried (n = 12). The RMGIs (Fuji II LC Improved; Ionolux and Vitremer) were bonded to enamel surfaces using the following protocols: Groups 1: Based on manufacturers’ instructions; Groups 2: Pre‑conditioning with phosphoric acid for 30 s; groups 3: A 2‑min delay in irradiation; groups 4: Pre‑conditioning with acid for 30 s plus a 2‑min delay in light activation. After 24‑h storage at 37°C and 500 rounds of thermocycling, the samples underwent shear bond strength (SBS) test. Data was analyzed with 3‑way ANOVA and Tukey HSD test (α =0.05). There were significant differences between the study groups (P < 0.001). Acid‑pre‑conditioning increased Fuji II LC SBS values; it significantly decreased SBS values of Vitremer but had no effect on SBS values of Ionolux. Ionolux and Vitremer exhibited decreased enamel bond strength after a delay in light activation (P < 0.05). A 2‑min delay in light activation combined with acid pre‑conditioning increased RMGI SBS values only for Fuji II LC. Within the limitations of the present study, the effect of acid pre‑conditioning, delaying irradiation and both on enamel bond strength of RMGIs was material‑dependent. Further investigations are recommended.

Tramadol is an opioid agonist that has the potential of being abused. The aim of this study was to compare the effect of different doses of tramadol on orthodontic tooth movement (OTM) and bone resorption in rats. Forty‑two male rats were assigned randomly to two experimental groups and one control group. Nickel–titanium coil springs were used to exert orthodontic force. The rats in the control group and experimental group‑1, respectively, received a daily injection of 0.1 ml of normal saline and 10 mg/kg of tramadol for 14 days. The rats in experimental group‑2 received 10 mg/kg of the same drug on days 1-4, 20 mg/kg on days 5-8, 40 mg/kg on days 9-12 and 60 mg/kg on days 13 and 14. OTM was measured on days 4, 8, 12, and 14. At the end of the experimental period, the rats were sacrificed. Histological analysis was also performed to evaluate the number of osteoclasts, osteoblasts, and Howship’s lacunae. Statistical analysis with analysis of variance tests showed that the rats in experimental group‑2 had significantly decreased OTM compared with the other two groups (P < 0.05), whereas OTM for the rats in experimental group‑1 was comparable to that in the control group (P > 0.05). The histological evaluations did not show any significant difference among the groups (P > 0.05). The effect of tramadol hydrochloride on OTM depends on the dosage used. High doses of the drug reduce the extent of OTM significantly.

Detection of cancer at an early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, non‑invasive methods like analysis of serum and saliva may provide cost‑effective approach for screening a large population. Tumor markers are a major part of secondary prevention and thus, the detection of malignancies. The aim of this study was to evaluate total sialic acid (TSA), total protein and total sugar (TS) in serum and saliva of oral squamous cell carcinoma (OSCC) and controls to assess their role as a diagnostic marker. Unstimulated whole saliva and sera were collected from 40 squamous cell carcinoma patients and 20 controls. Serum and salivary TSA, total protein and TS estimation was carried out. This was correlated with clinical stages and histopathological grades of OSCC. The data obtained was analyzed statistically using Chi‑square test, ANOVA and Student’s t‑test with SPSS statistical software. A highly significant rise in the salivary sialic acid, serum sialic acid and serum protein was noted in OSCC subjects compared to controls. Salivary protein, serum and salivary sugar did not show any significance. Furthermore, serum and salivary sialic acid levels were found to be significantly increased with increasing level of histopathological grading. The present study showed a significant increase in serum sialic acid, salivary sialic acid and serum protein from control to OSCC and suggests that these markers may be reliable in diagnosis and predicting prognosis.

The aim of this study was to compare the effects of diode laser irradiation on wound healing in oral rat mucosa and also to measure the amount of inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) on oral wound healing. Healing was assessed by histology and the amounts of eNOS and iNOS were measured by real‑time polymerase chain reaction (PCR). Twenty‑four standardized incisions were carried out on the buccal mucosa of 12 male Wistar rats; each rat received two incisions on the opposite sides of the buccal mucosa by using a steel scalpel. On the right side (test side), a diode laser (660 nm) was employed on the incision for 10 seconds on days 1‑4 and 6‑9. The left side (control side) did not receive any laser. Histological and real‑time PCR analysis were done on tissue samples after 2, 7, 14, and 21 days. Histological analysis showed that the tissue healing after seven days on the laser irradiated side was better than the control side, but there was no significant difference between the two sides on days 2, 14, and 21 after surgery. Paired t-test analysis showed that there was no significant difference in the amount of eNOS between the groups. The difference in the amounts of iNOS between the groups was significant; it was more in the laser‑irradiated side than the control side. Histological findings showed that diode laser needs several repeated irradiations for the acceleration of wound healing. The iNOS amount showed that increases are associated with better healing.

The patterns of facial growth, jaw and tooth size are inherited and are likely to differ among population and races. Aim of this study is to evaluate and compare the pattern of third molar (3M) impaction among three different ethnic groups (Chinese, Indian, Malay) of patients attending AIMST Dental Institute, Malaysia. Dental records and orthopantomographs of 2200 patients aged between 20 and 40 years were retrieved and examined retrospectively. Wherever impacted 3Ms were present, the status of 3Ms, their location, the level of impaction and angulations were recorded and analyzed using STATDISK (version 10.4) and the values obtained were compared with least square distance of 0.05 level. About 667 radiographs met with the inclusion criteria and showed the presence of 1008 impacted 3Ms. On overall comparison the incidence of level B impactions were found to be higher in our study. Level A impactions were frequently seen in Chinese (41.9%), level B in Indian (36.4%) and level C impactions had an equal distribution among Chinese and Malays (34.1%). The difference was highly significant (P ≥ 0.05). Mesioangular impaction (49.8%) followed by distoangular (22.9%) were the most common impactions among all the three races. On comparison, mesioangular impaction was found to be the most frequent among all the three races whereas differences were seen in levels of impaction to some extent among theethnic groups. But as a limitation, our findings and results reflected the status of 3Ms of patients attending AIMST Dental Institute, not entire Malaysia. Therefore more similar studies have to be carried out in other parts of Malaysia to substantiate our present findings.

During endodontic procedures, the smear layer is formed as a result of mechanical instrumentation of the canal. Combination of ethylenediamine tetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) is widely used for removal of the smear layer. Application of Mixture of tetracycline, acid, and detergent (MTAD) as final irrigant subsequent to initial irrigation of 1.35% NaOCl has been proposed to increase clinical efficiency, biocompatibility and prolonged intra‑canal antibacterial activity. Considering the importance of adhesion of endodontic sealers to the dentin walls of a prepared root canal, the present study evaluated push‑out bond strength of AH26 sealer using final irrigation of MTAD and EDTA + NaOCl. Sixty five single‑rooted teeth were prepared endodontically with the same chemomechanical technique and were randomly divided into three groups based on their final irrigation regimen: 17% EDTA + 5.25% NaOCl group (n = 30), MTAD group (n = 30) and control group (n = 5). Obturation of the canals was performed with gutta‑percha and AH26 sealer. All teeth were sectioned in order that two specimens of 1 mm thickness were obtained from the coronal and the middle one third of each root resulting in 60 specimens for each experimental group and 10 specimens for control group. For push‑out test, universal‑testing machine was used to exert a constant compressive apico‑coronal load at a speed of 0.5 mm/min. Minimum amount of compressive load caused dislodgement was measured and converted into megapascal (MPa) scale. One‑way analysis of variance and the post hoc Tukey test were used for statistical analysis of the data (α = 0.05). In MTAD group, mean micro‑push‑out bond strength of AH26 sealer to dentin walls was obtained 2.23 MPa compared to 2.0 MPa for EDTA + NaOCl group. The mean bond strength of AH26 sealer to dentin walls was significantly greater using MTAD compared with combination of EDTA and NaOCl or saline. MTAD final rinse significantly increased micro‑push‑out bond strength of AH26 sealer to canal dentin walls compared with EDTA + NaOCl.

The main stay of primary and secondary prevention of periodontal diseases has been the control of supra gingival plaque. Acceptable plaque control by mechanical means is difficult to achieve by most individuals, so mouth rinses represent one form of attack on oral microbes and the malodor. Chlorhexidine (CHX) is a broad‑spectrum antimicrobial agent known to cause damage to the cell membrane of microorganisms and at higher concentrations causes precipitation and coagulation of the proteins in the cytoplasm of the exposed microbes. The aim of this study is to evaluate and compare the efficacy of 0.12% and 0.2% concentration of CHX gluconate clinically as well as microbiologically. The single blind placebo controlled randomized study design comprising of 75 males with an age between 25 years and 50 years were selected from out‑patient Department of Periodontics. The subjects were randomly divided into five groups. After baseline clinical and microbiological examination, the groups were subjected to mechanical plaque control with or without mouthwashes containing various concentrations of CHX and placebo. After 90 days the data pertaining to clinical and microbiological parameters were compared to the baseline data so as to compare the efficacy of different concentrations of mouthwashes. The results achieved with the use of 0.2% and 0.12% concentrations of CHX were comparable; taking into consideration of various clinical and microbiological parameters. The study recommends the use of low concentration of (0.12%) CHX for better patient compliance with the optimum clinical results

Although composite restorations are really valuable for esthetic zones, they have shown less longevity rather than amalgam restorations. Since it may be related to the method used for curing the composite, postcuring could increase the degree of conversion and result in more long‑lasting composite restorations. This study was planned to evaluate the effect of two different postcuring techniques on microhardness of indirect composite resin after wet‑aging and comparing them with the direct type. In this experimental study, 99 composite disk‑shaped (6.5 × 2.5 mm) specimens of composite (Gradia GC, Japan) were prepared in split mold. The indirect composite specimens were postcured by laboratory light source (Labolite LV‑III GC Corp, Japan) or microwave unit (MC 2002 JR, LG, Korea). Then, the aging procedure was done for 24 h, 30 and 180 days in distilled water. The Vicker’s Hardness test (VHN) on surface of specmens was measured by Wolpert microhardness tester and the data were analyzed by the two‑way analysis of variance (ANOVA) and Tukey’s post hoc tests. (P ≤ 0.05). The statistical analysis revealed that surface microhardness of postcured composite by microwave and laboratory light source was more than that of direct composite (P = 0.0001) and postcuring by microwave was more effective than postcuring by laboratory light source (P = 0.004). The 30 days stored composite demonstrated significant decrease of VHN compared with the 24‑h stored samples (P = 0.0001), with a more significant VHN decrease after 180 days of aging (P = 0.045). Postcuring increased the surface microhardness and aging reduced the surface microhardness of indirect composite.

Cone beam computed tomography (CBCT) is an alternative to a computed tomography (CT) scan, which is appropriate for a wide range of craniomaxillofacial indications. The long‑term use of metallic materials in dentistry means that artifacts caused by metallic restorations in the oral cavity should be taken into account when utilizing CBCT and CT scanners. The aim of this study was to quantitatively compare the beam hardening artifacts produced by dental implants between CBCT and a 64‑Slice CT scanner. In this descriptive study, an implant drilling model similar to the human mandible was used in the present study. The implants (Dentis) were placed in the canine, premolar and molar areas. Three series of scans were provided from the implant areas using Somatom Sensation 64‑slice and NewTom VGi (CBCT) CT scanners. Identical images were evaluated by three radiologists. The artifacts in each image were determined based on pre‑determined criteria. Kruskal‑Wallis test was used to compare mean values; Mann‑Whitney U test was used for two‑by‑two comparisons when there was a statistical significance (P < 0.05). The images of the two scanners had similar resolutions in axial sections (P = 0.299). In coronal sections, there were significant differences in the resolutions of the images produced by the two scanners (P < 0.001), with a higher resolution in the images produced by NewTom VGi scanner. On the whole, there were significant differences between the resolutions of the images produced by the two CT scanners (P < 0.001), with higher resolution in the images produced by NewTom VGi scanner in comparison to those of Somatom Sensation. Given the high quality of the images produced by NewTom VGi and the lower costs in comparison to CT, the use of the images of this scanner in dental procedures is recommended, especially in patients with extensive restorations, multiple prostheses and previous implants.

Connective tissue attachment following periodontal regenerative surgery is directly related to the attachment of fibrin clot on to the root surface during early wound healing events. The adhesion of fibrin clot to the root surface affected by periodontal disease depends on the biologic acceptance of the root surface which can be accomplished by various root conditioning procedures during periodontal therapy. The present in vitro study has been designed to evaluate and compare the degree of fibrin clot adhesion to root surfaces treated with root conditioning agents tetracycline hydrochloride and ethylenediaminetetraacetic acid (EDTA). A total of 30 dentin blocks are divided into three groups and treated with tetracycline hydrochloride, EDTA and phosphate buffered saline and a drop of blood is added to each dentin block. The dentin blocks are then prepared for scanning electron microscopic analysis and examined for the degree of fibrin network frmation and entrapped erythrocytes. The degree of fibrin clot adhesion was highest with tetracycline hydrochloride group, then with control group and least with EDTA treated group. According to the results of the present study, root conditioning with tetracycline hydrochloride produces a biologically acceptable root surface with enhanced fibrin clot adhesion, which is a critical step in early wound healing process. EDTA gel appears less effective in producing a root surface necessary for the adhesion of fibrin clot. The control without any root conditioning procedure showed poor fibrin clot adhesion when compared to tetracycline treated group, but when compared to EDTA treated group the fibrin clot adhesion was slightly better.

The aim of this study was to determine if glycosylated hemoglobin is elevated in patients with chronic periodontitis who have not been diagnosed with diabetes and also to compare the HbA1c levels that were obtained with lab and chairside test kit. A Case control study was designed. Glycosylated hemoglobin (HbA1c) was assessed using a chairside kit and laboratory method in 70 subjects without diabetes but with chronic periodontitis [having at least 10 teeth (at least one site around each tooth) with probing depth (PD) ≥ 5 mm, bleeding on probing (BOP) ≥15% and clinical attachment level (CAL) ≥ 1 mm] and 70 healthy controls (PD ≤ 4 mm and BOP ≤ 15%). Groups were compared using the t‑test and multiple linear regression model analysis. Karl Pearson’s correlation coefficient was used to compare the relationship between different variables. In this case control study HbA1c (Lab and Kit) were slightly higher and statistically significant in chronic periodontitis cases than in healthy controls. Chronic periodontitis is associated with a slight elevation in glycosylated hemoglobin (lab and chair side kit) and that the clinical significance of this difference remains to be determined. This preliminary finding is consistent with earlier reports that chronic periodontitis is associated with elevated blood glucose in adults without diabetes and may increase one’s risk for type‑2 diabetes.

This case reports a rare condition of scurvy which posed a diagnostic difficulty. However, a thorough medical and diet history, along with clinical and histopathological examination aided in prompt diagnosis and successful management of the case. Occurrence of scurvy in today’s contemporary society is said to be rare. Lack of fresh fruits and vegetables in the diet can lead to this condition.Diagnosis may be difficult due to its rarity and presence of non specific symptoms, which may pose a challenge to the clinician. A comprehensive history, clinical examination along with clinical and histopathological features led to arrive at a proper diagnosis. Local procedures and systemic therapy aided in the successful management of the case. A marked improvement in the gingival status and in the physical well being of the patient resulted after treatment. This case report describes the various manifestations of scurvy that posed a diagnostic challenge to the clinician. This condition which can be fatal if untreated can be easily prevented with inclusion of healthy food in the diet and modification in the lifestyle.

MacInnis and Baig modified Altemirs’ original technique for sub‑mental intubation. Instead of a lateral entry, they described a central entry just anterior to the sub‑mental crease that does not carry the risk of damage to the lingual nerves, submandibular ducts and sublingual glands. We describe here our experience with this modified sub‑mental intubation that also allows the operating surgeon to provide for a correct midline and optimal esthetics in case of panfacial trauma.

Malignant melanoma is a potentially aggressive tumor of melanocytic origin. Primary oral malignant melanoma is a rare neoplasm, accounting for 0.5% of all oral malignancies. The present case occurred in a 60‑year‑old female patient, as a pedunculated growth involving the palate and alveolar ridge and histologically showing a desmoplastic differentiation. The article discusses the distinct clinico‑pathologic presentation of this case and emphasizes on the need to identify and report such cases for further understanding of their biologic behavior.