March/April 2019

Table of Contents


  • Editorial Friendship

    2019 March/April; 67(2):5

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  • Letter to the Editor Carbs and caries

    John A. Sorrentino
    Glenn Canares 
    Kuei-Ling Hsu 
    Vineet Dhar 
    Bina Katechia

    2019 March/April; 67(2):6

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  • Pharmacology Chlorhexidine allergy: raising awareness about rare but potentially life-threatening reactions

    Mark Donaldson
    Jason H. Goodchild

    2019 March/April; 67(2):7-10

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  • Minimally Invasive Dentistry Immediate replacement of an extracted anterior tooth: a minimally invasive approach

    Mark I. Malterud

    2019 March/April; 67(2):11-13.

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  • Public Health Treating dental patients with autism spectrum disorder

    Ahmed El-Maghraby
    Larry Williams

    2019 March/April; 67(2):14-16.

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  • Pediatric Dentistry Indirect pulp therapy for the primary dentition

    Jane A. Soxman

    2019 March/April; 67(2):17-18.

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  • 2018 Reviewers General Dentistry expresses its gratitude for 2018 peer reviewers

    2019 March/April: 67(2):76-79.

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  • Self-Instruction Answers Exercises No. 417, 418, and 419 from the March/April 2018 issue

    2019 March/April; 67(2):80.

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Clinical Articles


    Fixed Prosthodontics A new protocol and standard of care for managing open crown margins

    David B. Miller

    Judging restorative margins is a subjective undertaking. This article presents a new management protocol for open crown margins. Unless margins are grossly open, restorations with marginal defects can and should be treated conservatively with repair or resealing of margins and close monitoring.

    2019 March/April; 67(2):19-22.

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    Self-Instruction Exercise No. 435

    Oral Medicine, Oral Diagnosis, Oral Pathology Burning mouth syndrome: a review of etiology, diagnosis, and management

    Antonia Teruel
    Seena Patel

    Burning mouth syndrome (BMS) is a chronic condition characterized by a burning sensation of the oral cavity. Primary BMS is a diagnosis of exclusion and can only be reached after all potential causes of secondary burning pain have been eliminated. Management strategies include reassurance of the patient as well as pharmacologic agents such as clonazepam, supplements such as α-lipoic acid, and psychological therapy. 

    2019 March/April; 67(2):24-29.
    Full Article (PDF)
    Self-Instruction Exercise No. 436
  • Oral Medicine, Oral Diagnosis, Oral Pathology What every dentist needs to know about liquid biopsies

    Stephanie L. Bosshard 
    Christopher L. Hackett 
    John K. Brooks
    Nasir Bashirelahi

    A potentially revolutionary technology, liquid biopsy, involves the harvesting of fragments of DNA or RNA for surveillance of an array of pathological processes from various body fluids, such as blood, plasma, and saliva. This article provides a general review of this developing diagnostic field.

    2019 March/April; 67(2):31-33.

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  • Basic Science Sex-related differences in the distance of the mental foramen to the cementoenamel junction in adults: a study using cone beam computed tomography

    Emanouela D. Carlson 
    Andrew Stubbs
    Sangeetha Chandrasekaran 
    Beatriz Robles
    Richard Kolanda 
    Anita Gohel
    Ramzi Sarkis

    This retrospective study utilized cone beam computed tomography to investigate variations between men and women in the vertical position of the mental foramen. There was a statistically significant difference in the location of the mental foramen between the sexes. Within-sex asymmetry between right and left sides was also observed.

    2019 March/April; 67(2):34-37.

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    Practice Management and Human Relations Dental radiography–prescribing practices: a nationwide survey of dental hygienists

    Kathleen B. Muzzin
    Diane J. Flint
    Emet Schneiderman

    The results of a survey of US dental hygienists suggest that some dental practices are not strictly following the 2012 American Dental Association/Food and Drug Administration guidelines for prescribing dental radiographs. In particular, contrary to guidelines, the majority of dental practices obtain bitewing radiographs annually for children, adolescents, and adult recare/recall patients regardless of their risk for developing caries. 

    2019 March/April; 67(2):38-53.

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    Self-Instruction Exercise No. 437
  • Oral Medicine, Oral Diagnosis, Oral Pathology Botulinum toxin: a review of applications for the head and neck

    Lara M. Seidman
    John K. Brooks
    Nasir Bashirelahi

    The ability of botulinum toxin (BTX) to locally paralyze muscles has led to its use as a potential therapy for a variety of medical conditions. This article will discuss the current head and neck applications of BTX and provide a brief review of other potential clinical benefits.

    2019 March/April; 67(2):55-58.
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  • Special Patient Care Surgical periodontal treatment of a patient with dentinal hypersensitivity after bariatric surgery: a case report

    Isis Henriques de Almeida Bastos
    Marcelo de Azevedo Rios
    Gabriela Botelho Martins
    Elisângela de Jesus Campos
    Carla Daltro

    A patient experienced pain in her teeth that was associated with gingival recession and dentinal hypersensitivity after bariatric surgery. Subepithelial connective tissue grafting using coronally displaced flap and tunnel-type approaches was performed at the sites of gingival recession and dentinal hypersensitivity, resulting in pain regression.

    2019 March/April; 67(2):59-63.
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  • Periodontics Effect of vitamin D level on periodontal treatment outcomes: a systematic review

    Omid Fakheran
    Zahra Khodadadi-Bohlouli
    Abbasali Khademi

    A systematic search of the literature was performed to collect and evaluate scientific evidence identifying a correlation between vitamin D administration and healing after periodontal surgery. Evidence in the literature suggests that vitamin D deficiency at the time of periodontal treatment negatively affects treatment outcomes. However, large-scale, longitudinal clinical trials are required.

    2019 March/April; 67(2):64-67.
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  • Basic Science Microscopic evaluation of luting techniques for a fiber-reinforced post system

    Jeffrey G. Phebus 
    Barry M. Owens 
    Jan M. O’Dell 
    Daranee Tantbirojn
    In an in vitro study assessing application techniques for cementation of fiber-reinforced posts, specimens received syringe application of cement on the post only; in the canal only; both on the post and in the canal; in the canal with distribution by a Lentulo spiral; or both on the post and in the canal with distribution by a Lentulo spiral. In terms of percentages of cement void area, the most efficient method of application was the injection of cement into the canal space with a syringe. The use of a Lentulo spiral instrument was found to be unnecessary.

    2019 March/April; 67(2):68-72.
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  • Endodontics The impact of a dental operating microscope on the identification of mesiolingual canals in maxillary first molars

    Luis Otávio de Oliveira
    Mauro Henrique Chagas Silva
    Hugo José Santos Bastos
    Adriana de Jesus Soares
    Marcos Frozoni

    The aim of this study was to assess the impact of a dental operating microscope on the identification and localization of a second canal in the mesiobuccal root, also known as the mesiolingual canal. Use of a microscope significantly improved the identification of mesiolingual canals in maxillary first molars.

    2019 March/April; 67(2):73-75.

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  • Periodontics The effect of nonsurgical periodontal therapy on pentraxin 3 levels in smokers and nonsmokers with chronic periodontitis

    Rudra Mohan 
    Jothi Varghese 
    Vinutha Bhat
    Yousef Rezaei Chianeh

    The purpose of this study was to determine the pentraxin 3 (PTX3) levels in the gingival crevicular fluid (GCF) and saliva of smokers and nonsmokers with chronic periodontitis and to compare these levels before and after initial nonsurgical periodontal therapy. Forty subjects were divided into 2 groups with chronic periodontitis (smokers and nonsmokers) and 2 clinically healthy groups (smokers and nonsmokers). At baseline, clinical periodontal parameters, including plaque index, gingival index, probing depth, and clinical attachment levels, were assessed. Saliva and GCF samples were procured to quantify the PTX3 levels. All subjects with periodontitis, smokers and nonsmokers, received scaling and root planing. The 2 treated groups were examined 2 weeks after therapy, and any changes in the clinical parameters or PTX3 levels were recorded. At baseline, PTX3 levels in both groups of patients with chronic periodontitis were found to be significantly higher (smokers had the highest level, followed by nonsmokers) than levels in both groups of clinically healthy subjects (nonsmokers, followed by smokers) (P < 0.05). Five patients with chronic periodontitis (3 smokers and 2 nonsmokers) were lost to follow-up and therefore excluded from the statistical analysis. Scaling and root planing led to an improvement in the clinical parameters and a statistically significant reduction of PTX3 levels (P < 0.05) in both chronic periodontitis groups at the 2-week follow-up, but the changes were greater in the smokers than in the nonsmokers. In the present study, smoking was found to play a contributory role in the alteration of PTX3 levels in GCF and saliva in patients with chronic periodontitis. The role of PTX3 as a prognostic tool for resolution of periodontal inflammation still remains obscure.

    2019 March/April; 67(2):e1-e6.

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  • Restorative Dentistry Influence of depth of mesio-occlusodistal preparation and mechanical cycling on fracture resistance of restored premolars

    Silvia Sbeghen Sábio
    Clóvis Lamartine de Moraes Melo Neto
    José Mondelli
    Maria Teresa Atta

    The purpose of this in vitro study was to evaluate the influence of depth (3.0 vs 5.0 mm) of mesio-occlusodistal (MOD) cavity preparation and mechanical cycling on fracture resistance of maxillary premolars restored with resin-based composite (RBC). Seventy premolars were randomly divided into 7 groups (n = 10): NP, no cavity preparation (control); MOD3, 3.0-mm-deep MOD preparation, not restored; MOD3R, 3.0-mm-deep MOD preparation restored with RBC; MOD5, 5.0-mm-deep MOD preparation, not restored; MOD5R, 5.0-mm-deep MOD preparation restored with RBC; MOD3RC, 3.0-mm-deep MOD preparation restored with RBC and subjected to mechanical cycling; and MOD5RC, 5.0-mm-deep MOD preparation restored with RBC and subjected to mechanical cycling under the same conditions as MOD3RC. All specimens were tested using a universal testing machine, resulting in the following mean (SD) values: NP, 224.65 (35.66) kgf; MOD3, 58.92 (15.48) kgf; MOD3R, 95.58 (13.88) kgf; MOD5, 68.06 (10.12) kgf; MOD5R, 98.49 (13.16) kgf; MOD3RC, 83.68 (14.39) kgf; and MOD5RC, 54.25 (11.56) kgf. Analysis of variance and Tukey test showed no statistically significant difference among MOD3, MOD5, and MOD5RC; between MOD5 and MOD3RC; or among MOD3R, MOD5R, and MOD3RC (P > 0.05). MOD3RC had significantly greater fracture resistance than MOD5RC (P < 0.05). NP had the highest fracture resistance of all groups (P < 0.05). The results showed that the depth of the cavity preparation only influenced fracture resistance after mechanical cycling of the specimens.

    2019 March/April; 67(2):e7-e10.

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