September/October 2019

Table of Contents

Clinical Articles

  • Basic Science Effect of operator skill on the dentin bonding ability of a self-adhesive resin cement after different adhesive treatments

    Fereshteh Shafiei
    Zahra Fattah
    Solmaz Barati

    This study evaluated the influence of operator skill on the shear bond strength of a self-adhesive resin cement to dentin after different adhesive treatments. Flat dentin surfaces were prepared on 160 extracted molars. The teeth were distributed evenly (n = 80) to 2 groups based on the operator’s skill (undergraduate dental student vs operative dentistry specialist). The teeth in each operator group were distributed into 5 groups based on pretreatments used before they were cemented to indirect composite resin cylinders with Panavia SA Luting Plus resin cement. The operators prepared the dentin surfaces for bonding according to the following pretreatment groups: 1, no treatment; 2, phosphoric acid etching; 3, Clearfil Universal Bond in etch-and-rinse mode; 4, Clearfil Universal Bond in self-etching mode; and 5, Clearfil SE Bond 2-step adhesive. After cementation was performed by the 2 operator groups, shear bond strength testing was performed, and data were analyzed with 2-way analysis of variance. The effects of operator skill and surface pretreatment and their cumulative effect were statistically significant (< 0.05). The shear bond strength of the control group in the student group was significantly greater than that of the specialist group (P = 0.02). In group 5 (2-step adhesive), the shear bond strength of the specialist group was significantly greater than that of the student group (< 0.001). The use of acid etching and the 3 adhesive treatments improved the bonding ability of resin cement for the expert group. This positive effect was observed only in the etch-and-rinse and self-etching modes for the student group. Extensive clinical experience did not have a positive effect on the bonding effectiveness of resin cement with no pretreatment, while the expert group showed better results in applying this cement with a 2-step adhesive pretreatment.

    2019 September/October; 67(5):e1-e6.
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  • Restorative Dentistry The influence of composite resin restoration radiopacity on radiographic diagnosis and decision-making

    Joseane Delfino de Albuquerque Canto
    Luciana Sarmento de Mendonça
    José Alcides Almeida de Arruda
    Pamella Recco Alvares
    Amália Moreno
    Maria Luiza dos Anjos Pontual
    Marcia Maria Fonseca da Silveira

    The objective of this study was to evaluate the influence of the radiopacity of 3 composite resin materials on the interpretation of radiographic images and to correlate the diagnosis with clinical management. The radiopacity of the 3 materials was statistically similar (P = 0.413). However, the radiopacity of the materials influenced diagnosis and decision-making. A restorative material may be within the established requirements regarding radiopacity, but on radiographic evaluation it might not be differentiated from mineralized dental tissues.

    2019 September/October; 67(5):72-76.
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  • Esthetics/Cosmetic Dentistry Combining different ceramic systems and periodontal microsurgery in maxillary esthetic areas: a case report

    Joel Oliveira Barreto
    Ivo de Souza Albuquerque
    Flávia Jucá Alencar Silva
    Lívia Maria Sales Pinto-Fiamengui
    Rômulo Rocha Regis

    A 36-year-old man with an esthetically compromised maxillary anterior region was treated by means of periodontal microsurgery, an implant-supported dental prosthesis, and tooth-supported crowns. Five years after cementation of the restorations, the results remained stable. Careful treatment planning allowed the achievement of a satisfactory, predictable, and long-lasting esthetic result.

    2019 September/October; 67(5):68-71.

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  • Basic Science Prevalence and anatomical characteristics of the accessory mental foramen: a study using cone beam computed tomography

    Thomas Y.H. Yoon
    Alexander G. Ahmadi
    Nathaniel A. Saed
    Nathan E. Estrin
    Donald E. Millner
    Thanhphuong N. Dinh

    Cone beam computed tomograms (CBCT) were studied to determine the prevalence and locations of accessory mental foramina (AMFs) and analyze whether the morphologic characteristics of the AMFs were associated with patient sex, patient race/ethnicity, or the side of the mandible. Two hundred CBCT scans were examined, and AMFs were identified in 11.5% of patients and 6.5% of all hemimandibles. Analysis revealed that 30.0% of AMFs were located anterosuperiorly and 23.3% posterosuperiorly to the mental foramen. Statistical analyses showed no association between the occurrence of AMFs and the sex of the patient, race/ethnicity of the patient, or side of the mandible, highlighting the importance of using CBCT before any mandibular surgery.

    2019 September/October; 67(5):62-67.

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  • Basic Science How to accurately measure blood pressure

    Mea A. Weinberg
    Stuart L. Segelnick
    Dena M. Sapanaro

    Many experienced clinicians and healthcare students take shortcuts or lack knowledge regarding the appropriate technique for measuring blood pressure. This article examines guidelines for proper blood pressure measurement to ensure accurate results.

    2019 September/October; 67(5):58-61.
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  • Endodontics Effect of a chitosan final rinse on the bond strength of root canal fillings

    Jardel Francisco Mazzi-Chaves
    Cecília Valente Martins
    Aline Evangelista Souza-Gabriel
    Manoel Brito-Júnior
    Antônio Miranda da Cruz-Filho
    Liviu Steier
    Manoel Damião de Sousa-Neto

    In an in vitro study to evaluate the effect of a final canal rinse with 0.2% chitosan on the bond strength of resin sealer in root canals, 30 canine root canals were prepared and distributed into 3 groups according to the final rinsing solution: 0.2% chitosan, 17% ethylenediaminetetraacetic acid (EDTA), or 1% sodium hypochlorite (NaOCl). A final rinse with chitosan or EDTA resulted in significantly greater push-out bond strength of root fillings to root canal than did NaOCl. Adhesive failure was the most frequent type in all groups.

    2019 September/October; 67(5):54-57.
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  • Oral and Maxillofacial Surgery Unintentional removal of a developing permanent premolar during primary molar extraction: a 10-year case report

    James F. Jenkins
    Henry A. St. Germain, Jr

    When a developing mandibular premolar was unintentionally removed during extraction of an ankylosed primary molar, the premolar was handled carefully and reimplanted within 20 seconds. Close monitoring of the tooth over the next 10 years revealed that the premolar erupted normally, the tooth was asymptomatic, root formation was complete, and the results of pulp testing were within normal limits.

    2019 September/October; 67(5):50-53.

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  • Basic Science Double mandibular canal and triple mental foramina: detection of multiple anatomical variations in a single patient

    Eliana Dantas Costa
    Priscila Dias Peyneau
    Maria Augusta Visconti
    Karina Lopes Devito
    Gláucia Maria Bovi Ambrosano
    Francielle Silvestre Verner

    Cone beam computed tomographic images taken prior to implant surgery showed bilateral bifurcation of the mandibular canal, from the mandibular foramen to the gonial angle, in a 45-year-old patient. In addition, there were 3 distinct mental foramina. Clinicians must be aware of anatomical variations in the mandibular region to avoid complications such as difficulty in obtaining anesthesia or postoperative sensory dysfunction.

    2019 September/October; 67(5):46-49.

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    Esthetics/Cosmetic Dentistry Effectiveness of combined internal-external bleaching for nonvital teeth: case reports

    Renata Vasconcelos Monteiro 
    Carolina Mayumi Cavalcanti Taguchi
    Iane Souza Nery Silva 
    Ludmilla de Azevedo Linhares 
    Jussara Karina Bernardon

    This article describes the successful use of the internal-external home bleaching technique in 2 patients, each of whom had a single darkened nonvital tooth. This technique is simple, low cost, and conservative and provides excellent esthetic results.

    2019 September/October; 67(5):40-44.

    Full Article (PDF)
    Self-Instruction Exercise No. 446
  • Restorative Dentistry Direct composite resin restorations for teeth with dental erosion: a case report

    Márcio Grama Hoeppner
    Fabio Martins Salomão
    Marcia Cristina Hirose
    João Felipe Besegato
    Daniel Sundfeld Neto
    Renato Herman Sundfeld

    This case report describes treatment of tooth wear caused by daily intake of acidic beverages. After the teeth were temporarily restored with glass ionomer cement, the patient underwent basic periodontal therapy and received guidance regarding daily oral hygiene and dietary habits. After adequate clinical oral conditions were reestablished, composite resin restorations were placed on the maxillary anterior teeth that displayed dental erosion, improving form, esthetics, and function.

    2019 September/October; 67(5):36-39.

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    Basic Science Effect of high-speed sintering on the properties of a zirconia material

    McKinley D. Soult
    Wen Lien
    Daniel Savett
    Francisco F. Gallardo
    Kraig S. Vandewalle

    A new high-speed sintering furnace reportedly sinters zirconia in minutes rather than the hours typically required for traditional fabrication of zirconia materials. The flexural strength/modulus, translucency/opalescence, and grain size of a full-contour zirconia material were evaluated after sintering in a high-speed or conventional zirconia furnace. The zirconia sintered in the high-speed furnace showed a significant decrease in grain size and no significant difference in strength or optical properties compared to specimens sintered in the conventional zirconia furnace.

    2019 September/October; 67(5):30-34.

    Full Article (PDF)
    Self-Instruction Exercise No. 445

    Restorative Dentistry Management of dental caries guided by the ICDAS-LAA: a 28-month follow-up

    Marilia Mattar de Amoêdo Campos Velo
    Cassiana Koch Scotti 
    Isabela Toledo Teixeira da Silveira 
    Rafael Francisco
    Lia Mondelli
    Maria Teresa Atta
    Juliana Fraga Soares Bombonatti

    Caries is a continuum of disease stages during which tooth damage may be reversed or controlled, depending on lesion progression. The International Caries Detection and Assessment System (ICDAS) was used in conjunction with the Lesion Activity Assessment (LAA) to assess caries progression and guide treatment decisions for a teenaged patient with untreated lesions. Treatment of different tooth surfaces involved a minimally invasive dentistry approach that consisted of remineralization, placement of a composite resin restoration, microabrasion, and periodic maintenance. The 28-month follow-up revealed satisfactory results.

    2019 September/October; 67(5):24-28.

    Full Article (PDF)
    Self-Instruction Exercise No. 444


  • Self-Instruction Answers Exercises No. 426, 427, and 428 from the September/October 2018 issue

    2019 September/October; 67(5):80.

    Full Article (PDF)
  • Oral Diagnosis Red gingiva and Retromolar pad mass

    Tanya M. Gibson

    2019 September/October; 67(5):77-78.

    Full Article (PDF)
  • Endodontics Fins, fissures, and hidden canals

    Nathan Dinsbach

    2019 September/October; 67(5):20-22.

    Full Article (PDF)
  • Pain Management CBCT imaging of degenerative joint disease of the temporomandibular joints

    John J. Frazier
    Christopher J. Spencer

    2019 September/October; 67(5):17-19.

    Full Article (PDF)
  • Minimally Invasive Dentistry Dental knowledge is an evolution

    Mark I. Malterud

    2019 September/October; 67(5):14-16.

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  • Pharmacology Ibuprofen: a review for dentists

    Sahand Eslaamizaad
    Elliot V. Hersh
    Mana Saraghi

    2019 September/October; 67(5):8-12.

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  • Editorial Invest in the new

    Timothy F. Kosinski

    2019 September/October; 67(5):6.

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