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   2016| October-December  | Volume 7 | Issue 4  
    Online since December 21, 2016

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Lasers in Dentistry: Is It Really Safe?
Hamed Mortazavi, Maryam Baharvand, Maede Mokhber-Dezfuli, Niloofar Rostami-Fishomi, Maryam Doost-Hoseini, Orkideh Alavi-Chafi, Shalaleh Nourshad
October-December 2016, 7(4):123-127
Introduction: Lasers are used in various disciplines in dentistry such as restorative dentistry, endodontics, periodontics, pedodontics, and oral and maxillofacial surgery. Despite many advantages of dental lasers, this method might have some adverse effects. The aim of this review article is to debate about the impacts of lasers on orodental tissues. Methods: An electronic search was accomplished using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “laser”, “dentistry”, “adverse effect”, and “side effect”. Results: Several adverse effects of laser were identified such as impacts on dental pulp, effects on tooth surface, subcutaneous and submucosal effects, histopathological changes, and infection transmission due to laser smoke. During dental procedures, necrosis of the pulp, periodontal ligament and odontoblasts, cemental lysis, bone resorption, hypo/hyperpigmentation, burns, itching, and scarring might occur. In addition, laser can weaken the dentin by inducing surface cracks. Restorative procedures by laser might increase microleakage and decrease shear bond strength, as well as microhardness of tooth walls. Meanwhile, laser surgery might cause emphysema after abscess incision and drainage, frenectomy, flap elevation, and gingivoplasty. Conclusion: Practitioners should be very cautious in treatment planning and case selection during laser-based therapeutic procedures.
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Articles for the Student Forum
Edward F Rossomando, Jafar Kolahi, Francesco Chiappelli, David G Dunning, Heejung Bang, Saber Khazaei, Luca Giacomelli, Gunnar Hasselgren, Vuokko Anttonen
October-December 2016, 7(4):121-122
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Comparison of the Efficacy and Side Effects of Chlorhexidine Mouthrinses with (Hexidine) and without (Epimax) Alcohol
Ahmad Mogharehabed, Parichehr Behfarnia, Naeimeh Nasri, Pedram Iranmanesh, Seyed Alisaleh Gholami, Jaber Yaghini
October-December 2016, 7(4):137-141
Introduction: Chlorhexidine mouthrinses have widely been recognized for their contribution in maintaining plaque control. Most of them contain alcohol that makes them impractical for many patients. Alcohol-free mouthwashes may have fewer side effects but may be less efficient. The current study was aimed to compare the effectiveness and side effects of chlorhexidine mouthrinses with and without alcohol. Materials and Methods: In this double-blind clinical trial, 32 patients with moderate and severe gingivitis were recruited. For all patients, full prophylactic procedures, such as removal of plaque, calculus, and stains on the teeth, were performed. Each patient was asked to use 15 mL of the mouthrinse for 60 s twice daily. The patients were divided into two groups, one group used Hexidine (0.12% chlorhexidine and 10% ethanol) mouthwash and the other group used Epimax (0.12% chlorhexidine and 0.05% sodium fluoride) mouthwash. After 14 days, plaque (PI), gingival (GI), and stain indices were analyzed. The obtained data were analyzed by using SPSS 16 using covariance [Analysis of covariance (ANCOVA)] and t-test. Results: Both mouthwashes significantly reduced the mean scores of plaque (P < 0.0001) and gingival (P < 0.032) indices after 2 weeks; however, Hexidine mouthrinse was shown to be more effective. The extent of stain was the comparable in both groups. While Epimax mouthrinse caused severe stains on the teeth, Hexidine mouthrinse caused burning mouth. Conclusion: Although Epimax mouthwash did not show any side effects, it was less suitable and caused more dental stain. Ethanol-free Hexidine mouthwash seems to be more proper for gingivitis, but its side effects are required to be taken into consideration.
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A New System for Choosing the Form and Size of Complete Denture Anterior Teeth
Dario Melilli, Fabio Calandra, Pietro Messina, Giuseppe A Scardina
October-December 2016, 7(4):147-151
Introduction: In the absence of pre-extraction records, the choice of the size an form of anterior complete denture teeth can be extremely subjective. Several clinical and statistical parameters are usually used for choosing the correct size and form of the complete denture anterior teeth. Clinical Innovation: The technique consists of a system that allows the dentist to choose and, if necessary, easily change the dental mold during maxillomandibular recording session. The unique feature of the system is that six teeth of each mold are represented by veneers, which are connected to each other on the lingual surface by a fiber that allows each veneer some degree of movement. Discussion: This technique allows the three-dimensional verification of the patient’s esthetics and realistic phonetic test during the session of maxillomandibular records; if necessary, the dentist may easily replace the mold with a different one in form or size, without working the wax to move or replace a tooth.
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The Role and Implications of “Do It Yourself” Tooth Movement
Sydney A Schneider
October-December 2016, 7(4):157-159
“Do It Yourself” (DIY) tooth movement has gained widespread attention recently in the United States. Options ranging from kits that consumers can purchase online to straighten their teeth without stepping a foot out of their homes to online instructional videos are readily available. These options offer the consumer convenience as well as a way to save a significant amount of money while promising to provide the desired end product of a beautiful smile. Unfortunately, most of the general population is unaware of the implications of such methods of orthodontic tooth movement. It is the responsibility of dental professionals to put their educational background to use and uphold the ethical principles of clinical practice by educating the public regarding the consequences of using these methods to straighten their teeth. DIY orthodontics is undoubtedly a threat and an opportunity for the orthodontic community, and its potential to impact the field should not be underestimated.
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Effect of Local and Application of Amitriptyline and Imipramine on Teeth with Irreversible Pulpitis Failed Pulpal Anesthesia: A Randomized, Double-blind, Controlled Trial
Mohsen Aminsobhani, Naghmeh Meraji, Abdollah Ghorbanzadeh, Majid Ajami, Seied Ali Seiedi Hoseini, Mohammad J Kharazifard
October-December 2016, 7(4):128-132
Introduction: To evaluate the analgesic effect of amitriptyline and imipramine after local application on the dentine of “hot teeth” with failed pulpal anesthesia. Materials and Methods: This study was a randomized, double-blind clinical trial that was performed on 33 consenting adult patients who were referred to us and had mandibular molars diagnosed with symptomatic irreversible pulpitis and experienced pain during access cavity preparation after receiving successful inferior alveolar nerve block with lidocaine. Either amitriptyline, imipramine or placebo was administered locally on the exposed dentine of the teeth. Pre and post-application pain levels were evaluated by McGill visual analog scale. Results: Amitriptyline significantly reduced the pain experienced by patients (P = 0.032). Imipramine also reduced the experienced pain but the pain relief was not statistically significant when compared with the placebo. Conclusion: Local administration of amitriptyline on exposed dentine can reduce the pain experienced by patients with a “hot tooth.”
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Effect of Bracket Base Sandblasting on Bonding of Orthodontic Brackets on Enamel Surface
Mohammad Farahani, Sattar Kabiri, Saeed Reza Motamedian, Mona Hajighadimi
October-December 2016, 7(4):133-136
Introduction: In evaluating bond failure, considerable attention has been paid to the various factors that affect bond strength. The bracket–resin interface is the site of usual bond failure. Therefore, many efforts have been accomplished on this interface. The aim of this study was to compare the effects of sandblasting on shear bond strength of three different metal brackets. Materials and Methods: For this experimental study, 180 human maxillary first and second premolars teeth were cleaned and stored in 0.1% thymol solution. The teeth were randomly assigned to either the control (n = 90) or experimental group (n = 90). Each group was subdivided into three equal groups (n = 30). In the control group, three different non-sandblasted metal brackets (American Orthodontics, Dentarum, and 3M Unitek) were bonded with 3M (Unitek) no-mix resin. In the next stage of the experiment, similar brackets were sandblasted and bonded. All samples were pumiced and etched with 37% phosphoric acid for 15 s. The teeth were embedded in blocks of autopolymerization polymethyl methacrylate, utilizing a special device to make their slots parallel to the horizontal. Samples were stored in distilled water for 24 h before testing. Shear bond testing was carried out with UTM Instron machine. Results: Mean shear bond strength of untreated groups was 15.51, 16.60, and 18.58 MPa for American Orthodontics, Dentarum, and 3M Unitek brackets, respectively. Mean shear bond strength of sandblasted brackets was 15.8, 19.36, and 18.66 for American Orthodontics, Dentarum, and 3M Unitek brackets, respectively. Conclusion: This study showed that there was a significant difference in the mean shear bond strength between untreated and sandblasted specimens only in the Dentarum bracket groups.
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Resorption of Lateral Incisors during Canine Eruption: Two Clinical Cases with Focus on Root Lengths and Heredity
Mostafa Zargham, Inger Kjær
October-December 2016, 7(4):152-156
Introduction: It is well-known that pressure from orthodontic appliance can provoke root resorption in dentitions with short roots. The purpose of this case report is to demonstrate two clinical cases with focus on root length in dentitions exposed due to pressure from erupting teeth. This is a pilot study aimed to improve diagnostics for avoiding the resorption of lateral maxillary incisors by pressure from erupting canines. Case Report: The first reported case is of a girl who was 11 years and 7 months old when radiographs showed severe resorption of the lateral incisors, along with malformed central incisors and short roots. The intraoral photos demonstrated light crowding in the maxilla. The orthopantomogram of the girl’s mother demonstrated several short roots. The second reported case is of a girl who was 9 years and 5 months old when radiographs demonstrated nearly complete resorption on her lateral incisor roots, extremely short roots in the central incisors, and short roots. The intraoral photos demonstrated light crowding in the maxilla. The orthopantomogram of the girl’s mother demonstrated extremely short roots in general. Conclusion: This pilot study indicates that short root length in general and abnormal incisor morphology are phenotypic traits that were characteristic for both girls who presented with severe lateral incisor resorption due to erupting canines. Furthermore, short roots were also demonstrated in the mothers. Accordingly, short root length in general could be a phenotypic trait, which should be diagnosed early for preventing severe resorption of lateral incisors during canine eruption.
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Evaluating Electromagnetic Interference of Communication Devices with Root ZX Mini Apex Locator
Marzieh Shafieibavani, Pedram Iranmanesh, Foad Iranmanesh
October-December 2016, 7(4):142-146
Introduction: The correct determination of working length is a critical factor in the success of endodontic treatment. Nowadays, the electronic apex locators (EALs) is more used because of their ease of use, high accuracy, and the uncertainty of other methods. Because EALs use the electronic method, it is likely that electromagnetic waves (EMWs) affect their performance. This study aims to investigate the possibility of this interference. Materials and Methods: The visual canal length (CL) of 12 maxillary incisors (Vertucci’s type I) was measured with a K-file and magnifying glass. Root ZX mini apex locator is used to measure CL in the absence/presence of EMWs in both the second (2G) and third generations (3G) of mobile communication network at the mode of ringing and conversation at direct contact and the distances of 25 and 50 cm. Results: The mean CL at presence of EMWs in all conditions and distances (by removing the conversation with 2G at direct contact group) were not significantly difference with CL and EAL and absence of investigated EMWs group (Repeated-Measures Analysis of Variance (ANOVA), P = 0.083). The indicator of EAL were unstable on apex sign at least 5 seconds for 5 teeth (41.7% of samples) in conversation with 2G at the direct contact group. Conclusion: EMWs of 2G and 3G not causes malfunctions of the Root ZX mini apex locator except conversation with 2G at the direct contact.
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Preventative Dentistry Delivery to Children in Rural Communities in the United States
Lauren K Dulieu
October-December 2016, 7(4):160-161
New models in the delivery of healthcare such as mobile clinics, retail clinics, and telehealth have helped to bring care to patients who might not otherwise receive care due to geographic limitations. Such alternatives may help to address the need for dental care in rural communities in the United States. In addition to these solutions, dental therapists can increase the available provider base to deliver preventative dental services to children.
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