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   Table of Contents - Current issue
Coverpage
January-March 2018
Volume 15 | Issue 1
Page Nos. 1-61

Online since Wednesday, April 4, 2018

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ORIGINAL ARTICLES  

Marginal fit of class II cavities restored with bulk-fill composites p. 1
Hend A Ibrahim, Magda E Shalaby, Ali I Abdalla
DOI:10.4103/tdj.tdj_12_17  
Purpose To evaluate the marginal integrity of three types of bulk-fill composite resins in class II cavities. Materials and methods Simple class II cavities with parallel walls were prepared in 40 extracted human sound molars were selected. The overall dimensions and depth of the cavities were standardized as follow: 4 mm length occlusocervically, 4 mm width buccolingually and 2 mm depth axially. The teeth were randomly divided into four groups (n = 10 each): group 1: Tetric N-Bond Universal and Tetric EvoCeram Bulk Fill composite; group 2: Single Bond Universal and Filtek Bulk Fill posterior composite; group 3: Futurabond U and Admira Fusion X-Tra; group 4: Tetric N-Bond Universal and Tetric EvoCeram composite. All samples were thermocycled for 600 cycles. Impressions of the teeth were made using a polyvinyl siloxane then poured with epoxy resin. These replicas gold sputtered and examined under scanning electron microscopy. Results Group 3 recorded the lowest mean marginal gap length value, while group 4 recorded the highest mean marginal gap length value. One-way analysis of variance was used to compare the tested groups at a level of significance (P ≤ 0.001). For width of proximal gap the lowest mean marginal gap length value found in group 3, while the highest mean value of gap width proximally found in group 1. In width of cervical gap the lowest mean marginal gap length value was found in group 3, while the highest mean value of gap width cervically found in group 4. One-way analysis of variance test was used to compare the tested groups at a level of significance (P ≤ 0.05). Conclusion Admira Fusion X-Tra has good results compared to other used bulk fill and conventional composites.
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Flexural strength of four-unit implant-supported ceramic veneered zircon and full zircon fixed dental prosthesis p. 7
Ayatalla A Bedair, Amany M Korsel, Waleed M Elshahawy
DOI:10.4103/tdj.tdj_29_17  
Purpose To investigate the flexural strength and the fracture loads of bilayered and monolithic zirconia fixed dental prostheses (FDPs). Materials and methods For flexural strength test, two groups of bar-shaped (25 × 5 × 2 mm3) monolithic zirconia (n = 5) and bilayered zirconia–porcelain (n = 5) specimens were prepared using computer-aided design and manufacture system for zirconia and hand layering for porcelain. Flexural strength test was performed using universal testing machine at cross-head speed of 1 mm/min. For fracture resistance test, 20 master models composed of two implant analogues and their corresponding titanium implant abutments embedded vertically in autopolymerizing acrylic resin blocks to mimic clinical conditions for a four-unit FDPs. Twenty FDPs were fabricated and divided into two groups (n = 10): group A, bilayered zirconia four-unit implant-supported FDPs; group B, monolithic zirconia four-unit implant-supported FDPs. Samples in each group were cemented to their corresponding model and then underwent artificial ageing by thermocycling of 5000/cycle. The fracture resistance test was done using universal testing machine at cross-head speed of 1 mm/min. Statistical analysis of the results and comparison between each two groups were performed using independent t-test (significance: P ≤ 0.05). Results Monolithic zirconia group recorded statistically significant higher flexural strength and fracture resistance compared to bilayered group. Conclusion Strength of monolithic zirconia is significantly higher than bilayered zirconia.
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Cleaning efficacy of rotary versus manual system for root canal preparation in primary teeth p. 14
Momen H Elnagar, Nagwa A Ghoname, Walaa M Ghoneim
DOI:10.4103/tdj.tdj_43_17  
Introduction Primary teeth are considered natural space maintainers and should be maintained till their exfoliation is chronologically appropriate. The success of endodontic treatment is directly related to the microbial reduction in the root canal system as a result of chemomechanical preparation. Objective This study was carried out to evaluate and compare cleaning efficacy of rotary and manual systems for root canal preparation in primary teeth. Materials and methods Thirty extracted single-rooted human primary teeth were selected. In group I the root canals were instrumented manually with Ni-Ti Flex K-file. Revo-S rotary instruments were used for canal preparation in group II. Irrigation with 1% sodium hypochlorite was done at each file change. Roots were split longitudinally and processed for scanning electron microscope examination. For evaluation of cleaning efficiency two separate scores were used for evaluation of debris and smear layer at three root canal thirds. Results However, both techniques did not achieve complete clean walls, Revo-S rotary system achieved better cleanliness than that obtained by manual instrumentation at all root canal levels. Conclusion Revo-S rotary system might be an alternative method for preparing root canal in primary teeth with better cleaning efficiency.
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Centering ability and canal transportation of curved root canals after using different nickel–titanium preparation systems p. 19
Tokka M Moukhtar, Abeer M Darrag, Neveen A Shaheen
DOI:10.4103/tdj.tdj_45_17  
Purpose To evaluate centering ability and canal transportation in curved root canals after using different nickel–titanium (Ni-Ti) preparation systems including two rotary systems [Revo-S and Twisted File (TF)] and hand Ni-Ti-Flex K-files using cone-beam computed tomography. Materials and methods Seventy-five extracted human premolars with similar range of canal curvature (25–35°) were used, after crown removal and working length determination, samples were randomly divided into three groups (n = 25) according to the type of instruments used. Group I (Revo-S), group II (TF) and group III (Ni-Ti-Flex). Preinstrumentation and postinstrumentation cone-beam computed tomography images were recorded at several root canal levels (3, 5, 7, 9, and 11 mm) from the apex under the same circumstances, superimposed and then the centering ability and canal transportation were calculated using specific equations. Results Revo-S system produced less mean value of canal transportation and more centering ability than TF and Ni-Ti-Flex systems. In addition, the middle canal level (7 mm) recorded the least mean value of transportation with the highest centering ability for all used instruments. Conclusion Preparation of curved root canal using rotary systems produced less change in original canal path compared with the hand Ni-Ti files.
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TNF-α-mediated inflammation and cytotoxicity of different root canal sealers and root-end fillings in cell line culture p. 27
Mohamed I Elshinawy, Hossam A Eid, Ashraf A Khalil, Abdelnasser M Soliman, Hesham El-Refaey
DOI:10.4103/tdj.tdj_48_17  
Aim The aim was to detect the amount of tumor necrosis factor-α (TNF-α) released from Hela epithelial cells as a measure of the inflammatory and cytotoxicity impact of different root end filling and sealant materials on the apical periodontal tissues. Materials and methods Standardized discs of Amalgam (G1), composite (G2), flowable composite (G3), zinc oxide eugenol (ZOE) sealer (G4), nano-ZOE sealer (G5), and resin-modified glass ionomer (G6) were incubated with Hela cells. The inflammatory and biological cytotoxicity of the nominated materials were evaluated in terms of the amount of TNF-α released from Hela cells and its effect on cellular morphology and viability in comparison to non-treated cells (control). Results Both composite root-end filling and nano-ZOE sealer showed non-significant difference in the amount of released TNF-α compared to that of the control (P > 0.05). Accordingly, these materials showed non-significant effect on Hela-cell viability and morphology. On the other hand the remaining materials demonstrated significant increase in the amount secreted TNF-α associated and hence significant cytotoxic effects in comparison to that of the control (P > 0.05) Conclusion Composite would be the recommended filling for root-end cavities and nano-ZOE is a promising biocompatible sealer material.
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Assessment of Roods and Shehab criteria if one or more radiological signs are present in orthopantomogram and position of the mandibular canal in relation to the third molar apices using cone beam computed tomography: a radiographic study p. 33
Rajeev Pandey, Chinnaswami Ravindran, Deepak Pandiyan, Amit Gupta, Anju Aggarwal, Srikanth Aryasri
DOI:10.4103/tdj.tdj_53_17  
Aim The aim was to access Roods and Shehab criteria if one or more radiological signs are present in orthopantomogram and position of the mandibular canal in relation to the third molar apices using cone beam computed tomography (CBCT). Materials and methods A total of 25 orthopantomogram radiographs exhibiting close relationship between mandibular third molar apices and mandibular canal according to Roods and Shehab criteria were accessed for cortical integrity along with position of the canal using CBCT. Results CBCT images showed that about 63.8% of the teeth were in contact (loss of cortical integrity) with mandibular canal. All Teeth with two or more radiological signs showed contact. The position of the canal was buccal in 61.7% of cases followed by inferior placement in 23.4% of the cases. Conclusion Risk of injury to inferior alveolar nerve increases if two or more radiological signs are present. In our study buccally placed inferior alveolar nerve was seen in more often therefore operator should not gutter the bone below the middle third of the root and mesial point of application for elevation should be used in cases with radiological signs of close association between the nerve and the root apex.
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Blood flow oxygen saturation of the dental pulp for prediction of revascularization after maxillary osteotomies p. 39
Mohammad A Elshall, Emad F Essa
DOI:10.4103/tdj.tdj_59_17  
Introduction Pulse oximetry is a noninvasive method used in clinical medicine to record blood oxygen saturation levels during the administration of intravenous anesthetic agents, and it has recently been used to assess dental pulp vitality with the same objective. Objective Recording the approximate timing of revascularization of maxillary osteotomies and its impact on the healing process through measuring the dental blood flow oxygen saturation level using pulse oximetry. Patients and methods This research was carried out on eight patients collected from the outpatient clinic of Oral and Maxillofacial Surgery Department. All patients were complaining of dentofacial deformities; the maxilla was included in their surgical correction either using Le Fort I osteotomy or anterior maxillary osteotomy. In all patients, the pulpal blood flow of maxillary centrals and canines was evaluated using NellcorOximax sensor (pulse oximeter) and were compared with the reading of the index finger. The collected data were recorded and statistically analyzed. Results The mean values of the oxygen saturation levels started to be increased gradually from the third week till reaching the normal values at the sixth week without significant differences between dental pulps and the index fingers. Conclusion Pulse oximeter is a valuable, simple, noninvasive, and inexpensive tool that could be used clinically to accurately measure the oxygen saturation level of the dental pulp, and thus provides a great help in clinical evaluation of the revascularization process across the osteotomized bony segments. Accordingly, we recommend its routine use in similar situations.
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Long-term clinical and radiographic stability of anterior maxillary setback using biodegradable Inion plates for osteosynthesis p. 44
Emad F Essa, Mohammad A Elshall
DOI:10.4103/tdj.tdj_58_17  
Purpose The aim of this study was to evaluate the long-term stability of the anterior maxillary setback after anterior maxillary osteotomies and osteosynthesis using Inion biodegradable bone plates in patients with maxillary protrusion. Patients and methods Eight patients suffering from maxillary protrusion indicated and planned for anterior maxillary setback included in this study. Inion biodegradable bone-plate and screw system was used for immobilization of the anterior maxillary osteotomy. Evaluation was done both clinically and radiographically over 5 years period for detection of postsurgical stability criteria. Radiographically, panoramic and lateral cephalograph radiographs had been taken immediately, then 3 and 6 months, 1 year and 5 years postoperatively to evaluate the radiographic stability of the measurements. Results Patients' ages ranged from 18 to 32 years, with a mean of 24 years. Six (75%) patients were females and two (25%) were males. The clinical and esthetic improvement of patients during the follow-up periods that extended to 5 years were compatible with the cephalometric changes as the tipped-out upper incisors were corrected, the upper lip protrusion was greatly improved, the nasolabial angles were increased and the interincisal angles were also increased. A very minimal insignificant change was noted, and the esthetic and functional improvement were maintained throughout the follow-up periods. Conclusion The used biodegradable bone plates and screws in this study were proved to be very effective in maintaining long-term stability of the repositioned osteotomized anterior maxillary segment without reported postoperative complications.
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Rehabilitation of compromised permanent incisors with anatomically adjustable fiber post p. 52
Talat M Beltagy
DOI:10.4103/tdj.tdj_55_17  
Purpose To evaluate clinically and radiographically the rehabilitated compromised upper permanent central incisors with the everStick post. Patients and methods Thirty-six children patients aged from 10 to 16 years were divided into three equal groups (12 patients each). Group I, flared root canals of the patients were rehabilitated with the everStick post. Group II, flared root canals were rehabilitated with EasyPost/composite, and group III (control), unflared root canals were rehabilitated with EasyPost/core. The clinical parameters included the reinforced tooth, mucosa, temporary crown, and reinforcing system. The radiographical parameters were the periapical status, periodontal ligament condition, root fracture or resorption, and changes at the interfaces of the reinforcing system. All patients were followed up clinically and radiographically at 3, 6, 12 and 18 months. Results Both everStick and control group showed 100% clinical success, while EasyPost/composite group showed debonding of the reinforcing system in one patient with a clinical success rate of 91.7%, and the difference was not statistically significant (P > 0.05). Radiographic assessment showed no evidence of root fracture or external root resorption and no periodontal or periapical pathology that require crown removal for clinical interference. The radiographic findings showed 100% success rate for all studied groups. Conclusion The use of direct anatomical everStick posts in the rehabilitation of flared canals functioned well for 18 months with favorable clinical, radiographical, and aesthetic results.
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ERRATUM Top

Erratum: Evaluation of carcinoma-associated fibroblasts in oral squamous cell carcinoma: a potential role for cathepsin K p. 60

DOI:10.4103/1687-8574.229251  
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