November/December 2019

Table of Contents

Clinical Articles

  • Oral Medicine, Oral Diagnosis, Oral Pathology Asymptomatic and painful ulcerated lesions on the lip and tongue

    Isadora Luana Flores
    Vinicius Coelho Carrard
    Márcia Gaiger de Oliveira
    The presence of multiple primary oral squamous cell carcinomas (SCCs) in a single patient is rare in dental practice. A 63-year-old man was referred for evaluation of a single tongue lesion. No lymphadenopathy was detected on extraoral examination. However, multiple asymptomatic ulcerated and crusted lesions were observed on the vermilion border of the lower lip. The intraoral examination revealed an extensive, painful endophytic ulcer of 3 months’ duration on the right lateral border of the tongue. No additional findings were observed. Incisional biopsies were performed, and the histopathologic analysis confirmed the diagnosis of SCCs. The patient was referred for oncologic therapy. Surgery was the treatment of choice for both the extraoral and intraoral lesions. No disease was found after 5 months of follow-up. Although uncommon, multiple oral SCCs can appear to be clinically similar to deep infectious disease. Metachronous tumors were diagnosed in this patient in light of the probable course of onset of the lesions. A rigorous clinical examination that includes the lips is essential to make an accurate diagnosis and refer the patient for appropriate treatment.

    2019 November/December; 67(6):e6-e8.
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  • Basic Science Simplified ethanol wet-bonding technique: an alternative strategy for resin-dentin bonding in root canals

    Cíntia Tereza Pimenta de Araújo
    Lúcia Trazzi Prieto
    Gabriel Abuna
    Ricardo Lopes Rocha
    Erick Kamiya Coppini
    Dayane Carvalho Ramos Salles de Oliveira
    Luís Alexandre Maffei Sartini Paulillo
    The objective of this study was to evaluate the effect of the simplified ethanol wet-bonding technique on luting of posts to intraradicular dentin. The effect was assessed by push-out bond strength testing and confocal laser scanning microscopic analysis. Thirty endodontically treated roots were distributed into 3 groups (n = 10): water wet-bonding; stepwise ethanol wet-bonding; and simplified ethanol wet-bonding. After cementation of the posts, the roots were sectioned. Specimens were stored for 24 hours or 1 year before they were stressed to failure. Specimens from each group were processed for microscopic analysis. Data were analyzed using a 2-way analysis of variance and the Tukey test (α = 0.05). Statistically significant differences in push-out bond strength values were observed between the technique groups (P < 0.001) and between the storage periods (P = 0.009). The bond strength results in the group bonded using the simplified ethanol wet-dehydration approach did not differ from those in the group bonded using the stepwise ethanol technique at either storage time interval (P > 0.05). From 24 hours to 1 year, there was a similar decrease in bond strength for specimens prepared with the simplified and stepwise techniques. The microscopic results confirmed that the ethanol wet-bonding technique improved the quality of the interface. The simplified ethanol wet-dehydration protocol achieved bond strengths and stability over time that were similar to those obtained with the stepwise ethanol technique and may be considered an alternative strategy to accomplish resin cement–root dentin bonding.

    2019 November/December; 67(6):e1-e5.
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  • Multidisciplinary Topics Surgical and orthodontic treatment after incidental radiographic discovery of a severely infraoccluded primary molar

    Amanda Valentim Caldeira
    Andressa Cardoso Amorim Souza
    Maísa Araújo Trindade Miguel 
    Indiara Porto Ribeiro
    Luciano Aparecido de Almeida Júnior
    Vivien Thiemy Sakai
    Ana Beatriz da Silveira Moretti
    Dentoalveolar ankylosis, the fusion of a tooth with the alveolar bone, is often associated with primary molars and is the main cause of infraocclusion. An uncommon case of a severely infraoccluded primary first molar associated with loss of space in the maxilla was treated with surgical extraction and interceptive orthodontics. After 18 months of appliance use, the maxillary first premolar erupted normally.

    2019 November/December; 67(6):72-75.
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  • Basic Science The effect of nanohydroxyapatite and silver nanoparticles on the microhardness and surface roughness of composite resins

    Marzieh Moradian
    Dorna Abbasfard
    Zahra Jowkar
    The incorporation of 2 wt% nanohydroxyapatite (nanoHAP) into composite resin increased its microhardness and negatively affected the surface roughness value. The incorporation of 1 wt% silver nanoparticles AgNPs decreased the microhardness of the composite resin but had no adverse effect on surface roughness. However, the combined incorporation of 2 wt% nanoHAP and 1 wt% AgNPs increased microhardness while having no adverse effect on the material’s surface roughness.

    2019 November/December; 67(6):68-71.

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  • Basic Science The effect of artificial ultraviolet light on the gloss of composite resin surface sealants

    Aaron Brooksbank
    Barry M. Owens
    Jeffrey G. Phebus
    Bernard J. Blen
    Brian R. Morrow
    Waletha Wasson
    In a study of the effect of ultraviolet (UV) light on the gloss of composite resins following application of resin-based surface sealants (SSs), results suggested that application of SSs to composite resin discs increases the gloss on a short-term basis; however, long-term exposure of SSs to an artificial UV light source might have a negative effect on the surface properties. 

    2019 November/December; 67(6):62-66.

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  • Endodontics Fused tooth: clinical approach to endodontic treatment

    Amanda Mourão Ley
    Francisca Lívia Parente Viana
    Suyane Maria Luna Cruz
    Bruno Carvalho de Vasconcelos
    A case report describing endodontic treatment performed in a maxillary incisor fused to a supernumerary tooth serves as a reminder that teeth with morphologic abnormalities must be treated with a multidisciplinary approach to ensure a better prognosis for the patient.

    2019 November/December; 67(6):59-61.
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  • Self-Improvement International volunteer activities of US dentists: results of a survey

    Karl F. Woodmansey
    Francis G. Serio
    Although several recent studies have gauged the participation of US dental schools and dental students in international volunteer programs, no study of US dentists’ international dental volunteer activities has been published to date. The goal of this study was to quantify that participation and explore dentists’ motivation for involvement.

    2019 November/December; 67(6):55-58.

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  • Multidisciplinary Topics Association of dental foci of infection and rosacea: a case report

    Mirlinda Sopi 
    Kastriot Meqa

    Rosacea, a chronic inflammatory disease of the skin, is characterized by rash, pustules, papules, and dilated blood vessels. Among the proposed causes are dental foci of infection. The aim of this case report is to examine the possible relationship between periapical lesions and rosacea.

    2019 November/December; 67(6):52-54.

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  • Restorative Dentistry Effect of diode laser and topical fluoride applications on white-spot lesions in bovine enamel

    Mohammad A. Alqahtani
    Sebastiano Andreana
    Joseph L. Rumfola
    Elaine Davis

    In an in vitro study using bovine enamel, diode laser irradiation combined with topical fluoride application significantly increased the hardness and improved the esthetic appearance of white-spot lesions compared to no treatment or fluoride treatment alone. Intrapulpal temperature changes indicated that a 2-W setting is safer than a 5-W setting for diode laser irradiation.

    2019 November/December; 67(6):45-51.

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  • Special Patient Care Special care dentistry for patients diagnosed with sickle cell disease: an update for dentists

    Hassan Abed
    Sanjeev-Paul Sharma
    Ahmed Balkhoyor
    Khalid Aljohani
    Chris Dickinson
    Dental care providers should update their knowledge regarding the management of patients with sickle cell disease to reduce the risk of triggering sickling events and potential damage to the patient’s body. Adherence to clinical guidelines for preventive dentistry, effective pain and anxiety control, and stress reduction protocols is crucial. Conscious sedation techniques can help reduce episodes of stress and the potential for sickling. Intravenous sedation should be provided only in a secondary care setting.

    2019 November/December; 67(6):40-44.

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    Anesthesia and Pain Management Migration and surgical retrieval of a broken dental needle: a literature review and case report

    Bruno Henrique Marinheiro
    Rafael Tajra Evangelista Araújo
    Thales Fabro Vanzela Sverzut
    Alexandre Elias Trivellato
    Cassio Edvard Sverzut
    This case report describes the surgical removal of a dental needle that fractured during an attempt at local anesthesia and subsequently migrated. Identifying the precise location of the broken needle fragment and its relationship with the surrounding bones, vessels, and nerves is essential to designing an adequate treatment plan. If surgical retrieval is indicated, it should be performed immediately.

    2019 November/December; 67(6):34-37.

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    Self-Instruction Exercise No. 449

    Oral Medicine, Oral Diagnosis, Oral Pathology Primary intraosseous carcinoma of the maxilla arising from an odontogenic keratocyst: a case report and review of the literature

    Jussara Maria Gonçalves
    Luiz Henrique Godoi Marola
    Filipe Modolo
    Daniella Serafin Couto Vieira
    Gustavo Philippi de Los Santos
    Jorge Esquiche León
    Rogério Gondak
    This case report describes the malignant transformation of an odontogenic keratocyst to primary intraosseous carcinoma and the subsequent treatment of the tumor. Previously published case reports of this rare neoplasm are also reviewed.

    2019 November/December; 67(6):26-32.

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    Self-Instruction Exercise No. 448

    Pediatric Dentistry The association of secondhand smoke exposure and dental caries in children and adolescents: a literature review

    Shreyans Dhanuka
    Ramprasad Vasthare

    Secondhand smoke (SHS) not only affects the physiology of children who are exposed to it but also has adverse effects on their general and oral health. Research shows that there is an independent association between SHS exposure and dental caries, especially in primary teeth. However, the association in permanent teeth must be explored further because statistically significant evidence is lacking.

    2019 November/December; 67(6):20-24.

    Full Article (PDF)
    Self-Instruction Exercise No. 447


  • Self-Instruction Answers Exercises No. 429, 430, and 431 from the November/December 2018 issue

    2019 November/December; 67(6):80.

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  • Oral Diagnosis Expansile pericoronal radiolucency and Calcified cervical mass

    Galal Omami

    2019 November/December; 67(6):76, 78.

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  • Pharmacology Not all nonsteroidal anti-inflammatory drugs are created equally

    Mark Donaldson
    Jason H. Goodchild
    2019 November/December; 67(6):12-18.

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  • Public Health Vaccines and immunization: protecting our patients and practices

    Mario Ramos
    Larry Williams
    2019 November/December; 67(6):8-11.

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  • Editorial Things

    Roger D. Winland

    2019 November/December; 67(6):6.

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