September/October 2015

Table of Contents


  • Editorial Foundation

    Roger D. Winland, DDS, MS, MAGD
    2015 Sep/Oct; 63(5):8. 
    Full Article (PDF)
  • Letter to the Editor A scientifically weak method

    Ron Jackson, DDS, FAACD, FAGD, FACD
    2015 Sep/Oct; 63(5):10-12
    Full Article (PDF)
  • Prosthodontics Guided surgical/prosthetic treatment in the esthetic zone

    Samuel M. Strong, DDS
    2015 Sep/Oct; 63(5):14-16. 
    Full Article (PDF)
  • Pediatrics Diagnosis and management of mesiodentes

    Jane A. Soxman, DDS
    2015 Sep/Oct; 63(5):18-19
    Full Article (PDF)
  • Public Health One Health and dentistry

    Larry Williams, DDS
    2015 Sep/Oct; 63(5):20-22.
    Full Article (PDF)
  • Oral Diagnosis Yellow mass of lower lip and White lesion of tongue

    Douglas D. Damm, DDS
    2015 Sep/Oct; 63(5):78. 
    Full Article (PDF)
  • Answers Oral Diagnosis; Self-Instruction exercises No. 355, 356, and 357

    2015 Sep/Oct; 63(5):80.  
    Full Article (PDF)

Clinical Articles

  • Computer Designed/Fabricated Crowns Microwave processing of a dental ceramic used in computer-aided design/computer-aided manufacturing

    Martin Pendola, DDS, MS
    Subrata Saha, PhD
    2015 Sep/Oct; 63(5):24-28.  
    The objective of this study was to test the mechanical properties of a dental ceramic used in computer-aided design/computer-aided manufacturing after the specimens were processed with microwave hybrid sintering. When ceramic specimens were sintered with microwaves, the processing times were shorter, the protocols were simpler, and hardness and flexural strength values were greater than those for conventionally processed specimens.
    Full Article (PDF)
  • Prevention of Medical Errors Accidental ingestion of a hypodermic needle during root canal treatment: a case report

    Vaibhav Jain, BDS
    Abhishek Dubey, BDS
    Jitendra Kumar, BDS
    Sonal Srivastava, BDS
    Manaswita Tripathy, BDS
    2015 Sep/Oct; 63(5):30-32.  

    This atypical case report describes the accidental swallowing of a hypodermic needle by a patient during root canal treatment. The needle was safely removed by gastrointestinal endoscopy after 24 hours, but the incident emphasizes the need for rubber dam placement and proper vigilance during all endodontic and restorative procedures to prevent such events, which can be life-threatening or fatal.
    Full Article (PDF)

    Anatomy Microcomputed tomographic evaluation of mandibular molars with single distal canals

    Arthur F. Lamia, DDS, MS
    N.J. McDonald, BDS, MS
    2015 Jul/Aug; 63(4):33-37. 

    This study used microcomputed tomography to evaluate the frequency of conjoined mesial canals in 206 first and second mandibular molars with a single distal canal. Examination revealed 129 teeth (62.6%) with conjoined mesial canals with a single portal of exit (71 second molars and 58 first molars). Conjoined mesial canals exhibited a mean interorifice distance of less than 3.00 mm.
    Full Article (PDF)
    Self-Instruction Exercise No. 373
  • Anesthesia and Pain Control Effect of hydralazine on duration of soft tissue local anesthesia following dental treatment: a randomized clinical trial

    Omid Fakheran Esfahani, DDS
    Mohammad Fazel Pouraboutaleb, PharmD
    Behnam Khorami, DDS, MSc
    2015 Sep/Oct; 63(5):39-42.  

    This study evaluated the effect of submucosal injection of hydralazine hydrochloride on the duration of oral soft tissue anesthesia after routine dental treatment. On completion of dental treatment, 50 patients who had received inferior alveolar nerve block (2% lidocaine with 1:100,000 epinephrine) randomly received a hydralazine or sham injection. Median recovery times in the hydralazine and sham groups were 81.4 (SD, 3.6) and 221.8 (SD, 6.3) minutes, respectively, a statistically significant difference (P < 0.0001).
    Full Article (PDF)
  • Endodontic Microbiology Antifungal activity of 4% chlorhexidine and 2% sodium hypochlorite against Candida albicans biofilms

    Maria Clara Maneira Gama, DDS
    Denise Gusmao de Oliveira, DDS, MSc
    Paulo Mauricio Batista da Silva, DDS, MSc
    Ronald Ordinola-Zapata, DDS, MSc, MD
    Marco Hungaro Duarte, DDS, MSc, MD
    Vinicius Carvalho Porto, DDS, MSc, MD
    2015 Sep/Oct; 63(5):43-47.  

    The purpose of this study was to determine the antifungal efficacy of 4% chlorhexidine (CHX) and 2% sodium hypochlorite (NaOCl) on 24-hour Candida albicans biofilms. The 4% CHX solution showed antifungal activity against C albicans biofilms but failed to decrease the biovolume to the levels of 2% NaOCl, which eliminated viable cells more effectively and appeared to be more effective in disrupting the attached biofilms.
    Full Article (PDF)
  • Dental Materials Resin infiltration of early carious lesion in early childhood: a case report

    Catarina Ribeiro Barros de Alencar, DDS, MSc
    Gabriela Cristina de Oliveira, DDS, MSc
    Fernanda Lyrio Mendonca, DDS, MSc
    Marcelo Juliano Moretto, DDS, MSc, PhD
    Franciny Querobim Ionta, DDS, MSc
    Maria Aparecida de Andrade Moreira Machado, DDS, MSc, PhD
    Daniela Rios, DDS, MSc, PhD
    2015 Sep/Oct; 63(5):48-51.  

    If dietary and hygiene measures fail to arrest early childhood caries, resin infiltration may slow or arrest progression of white-spot lesions. In resin infiltration, the porous lesion body is penetrated by a low-viscosity resin, blocking the diffusion of cariogenic acids into the lesion. This case report describes the use of a resin infiltrant to treat white-spot lesions in a 24-month-old boy.
    Full Article (PDF)

    Tooth Whitening/Bleaching In vitro evaluation of calcium and phosphorus concentrations in enamel submitted to an in-office bleaching gel treatment containing calcium

    Roberta Tarkany Basting, DDS, MS, PhD
    Edina Veloso Goncalves Antunes, DDS, MS
    Cecilia Pedroso Turssi, DDS, MS, PhD
    Flavia Lucisano Botelho do Amaral, DDS, MS, PhD
    Fabiana Mantovani Gomes Franca, DDS, MS, PhD
    Flavia Martao Florio, DDS, MS, PhD
    2015 Jul/Aug; 63(4):52-56.  

    This in vitro study evaluated calcium and phosphorus concentrations in enamel surfaces before, during, and after treatment with in-office 35% hydrogen peroxide bleaching agents containing 2% calcium gluconate (WCa) or no calcium gluconate. In both groups, there was a statistically significant decrease in calcium concentration 7 days after the last treatment, but there was a recovery to baseline values at 14 days. The phosphorus concentration in the WCa group decreased after the third application but increased to baseline values posttreatment.
    Full Article (PDF)
    Self-Instruction Exercise No. 374
  • Dentistry for the Medically Compromised Local levels of biomarkers after surgical and nonsurgical debridement of residual pockets and nonresidual sites in diabetic patients: a 12-month follow-up

    Joyce Pinho Bezerra, DDS, MS, PhD
    Luciana Machion Shaddox, DDS, MS, PhD
    Adriana Cutrim de Mendonca, DDS, MS, PhD
    Marta Ferreira Bastos, BMSc, MS, PhD
    Tamires Szeremeske de Miranda, DDS, MS
    Vanessa Renata Santos, DDS, MS, PhD
    Poliana Mendes Duarte, DDS, MS, PhD
    2015 Sep/Oct; 63(5):58-64.  

    This split-mouth, randomized controlled trial assessed the effects of surgical debridement (SD) and nonsurgical debridement (NSD), in association with amoxicillin and metronidazole, on residual pockets and adjacent healthy sites in patients with type 2 diabetes. SD and NSD resulted in similar clinical benefits at 12 months. In SD sites, a short-term increase in the levels of proinflammatory biomarkers probably can be attributed to tissue trauma and healing, and a long-term decrease in the levels of chemotactic factors may reflect remission of infection and stable wound healing.
    Full Article (PDF)
  • Dental Materials A new methodology for fluorescence analysis of composite resins used in anterior direct restorations

    Liliane Motta de Lima, DDS
    Jessica Dantas Abreu, DDS
    Flavia Cohen-Carneiro, PhD
    Diego Ferreira Regalado, PhD
    Danielson Guedes Pontes, PhD
    2015 Sep/Oct; 63(5):66-69.  

    A new methodology was used to evaluate the fluorescence of 3 microhybrid and 3 nanohybrid composite resins and compare it to that of natural tooth control specimens. The specimens were photographed inside a box with ultraviolet light and the red-green-blue color space of each image was quantified. The fluorescence of Amelogen specimens was statistically similar to that of the control group and significantly greater than those of the other groups.
    Full Article (PDF)

    Pharmacotherapeutics What every dentist should know about metformin, diabetes, and cancer

    Matthew R. Frykenberg
    Abraham Schneider, DDS, PhD
    Nasir Bashirelahi, PhD
    2015 Jul/Aug; 63(4):70-72.  

    Metformin has long been the drug of choice for treating patients with type 2 diabetes. Emerging evidence indicates that metformin might also have antineoplastic effects. This article reviews studies that examine the potential mechanisms underlying the anticancer properties of metformin and discusses the possible use of this antidiabetic biguanide in the chemoprevention and treatment of head and neck cancer.
    Full Article (PDF)
    Self-Instruction Exercise No. 375
  • Digital Radiology Mixed radiopaque and radiolucent lesion of the maxillary sinus: a radiographic challenge

    Adepitan A. Owosho, BChD
    Joanne L. Prasad, DDS
    Marion A. Hughes, MD
    Elizabeth A. Bilodeau, DMD, MD, MSEd
    Anitha Potluri, BDS, DMD, MDSc
    2015 Sep/Oct; 63(5):74-77.  

    Three patients each presented with an asymptomatic mixed radiopaque and radiolucent lesion of the maxillary sinus associated with a nonvital tooth. A radiographic diagnosis of a collapsed (ruptured) radicular cyst was rendered in each case. Results of histological analysis of 1 lesion supported the diagnosis. The radiographic and histopathological features, etiology, pathophysiology, and differential diagnosis of this condition are discussed.
    Full Article (PDF)
  • Appliance Therapy Interdisciplinary treatment of bruxism with an occlusal splint and cognitive behavioral therapy

    Marilene Trindade, PhD
    Silvana Orestes-Cardoso, PhD
    Teresa Cristina de Siqueira, NPTS
    2015 Sep/Oct; 63(5):e1-e4.

    The aim of the present study was to compare 2 groups of patients with bruxism (11 in each group) treated for 4 months with either an occlusal splint combined with cognitive behavioral therapy or an occlusal splint alone. The combination of occlusal splint and psychological therapy was more effective at achieving muscle relaxation than occlusal splint use alone.
    Full Article (PDF)
  • Amalgam Restorations Bond strength of repaired amalgam restorations

    Rosalia Rey, DDS
    Eduardo Mondragon
    Chiayi Shen, PhD
    2015 Sep/Oct; 63(5):e5-e9.  

    This in vitro study investigated the interfacial flexural strength of amalgam repairs and the optimal combination of repair materials and mechanical retention required for a consistent and durable repair bond. Amalgam-amalgam repair with adequate condensation yielded the most consistent and durable bond.
    Full Article (PDF)
  • Case Presentations Inadvertent self-torectomy: a case report

    Wayne W. Maibaum, MA, DMD, FAGD
    2015 Sep/Oct; 63(5):e10-e11.  

    An unusual lesion that posed a diagnostic challenge was found on the lingual surface of the right mandible of a 52-year-old man. The lesion was asymptomatic, and the patient was unaware of its presence. The lesion was ultimately diagnosed as an oral ulceration with sequestration, which the patient removed himself.
    Full Article (PDF)
  • Posterior Composite Restorations A cost-effective treatment for severe generalized erosion and loss of vertical dimension of occlusion: laboratory-fabricated composite resin restorations

    Michael J. Metz, DMD, MSD, MS, MBA
    Brandon M. Stapleton, DMD
    Bryan T. Harris, DMD, CDT
    Wei-Shao Lin, DDS
    2015 Sep/Oct; 63(5):e12-e17.  

    This report describes treatment of a patient with severe, chronic, poorly controlled GERD and resulting loss of vertical dimension of occlusion (VDO). First, the demineralization process was controlled and measures were taken to restore adequate stimulated salivary flow, and then indirect laboratory-fabricated composite resin restorations were adhesively bonded to replace lost tooth structure and reestablish the patient’s collapsed VDO.
    Full Article (PDF)
  • Cracked Tooth & Restorations Crown-root fracture with pulp exposure: a case report with 16-year follow-up

    Lucia de Fatima Almeida de Deus Moura, DDS, PhD
    Valeria Leopoldino de Area-Leao, DDS, PhD
    Marcoeli Silva de Moura, DDS, PhD
    Carmem Dolores Vilarinho Soares de Moura, DDS, PhD
    Alessandro Ribeiro Goncalves, DDS, PhD
    Cacilda Castelo Branco Lima, DDS, MSc
    Marina de Deus Moura de Lima, DDS, PhD
    2015 Sep/Oct; 63(5):e18-e22.  

    A longitudinal crown-root fracture with pulp exposure in a maxillary left central incisor was treated by autogenous bonding of the tooth fragment with self-curing composite resin, and a calcium hydroxide intracanal dressing was placed. The calcium hydroxide was replaced at 45-day intervals and the canal was definitively obturated after 1 year. The 16-year follow-up revealed satisfactory clinical conditions and no resorption or periapical changes.
    Full Article (PDF)
  • Physiology Analysis of masseter and temporal muscles during surgical extraction of impacted third molars

    Michelle B. Moraes, PhD
    Maria G. Naclerio-Homem, PhD
    Rodrigo D. Nascimento, PhD
    Jose Benedito O. Amorim, PhD
    Fernando V. Raldi, PhD
    2015 Sep/Oct; 63(5):e23-e27.  

    This study compared the electromyographic activity of the superficial masseter and temporal muscles before, during, and after extraction of impacted mandibular third molars. No patients showed alterations in muscle tone, and no statistically significant differences were observed between the muscles at any time at either mandibular rest or isometric contraction position. However, the degree of mouth opening increased 11.76% from presurgery to 30 days postsurgery.
    Full Article (PDF)
  • Dental Materials Depth of cure of bulk-fill flowable composite resins

    Inaam Pedalino, DDS, MS
    Grant R. Hartup, DDS
    Kraig S. Vandewalle, DDS, MS
    2015 Sep/Oct; 63(5):e28-e34.  

    The purpose of this study was to evaluate the depth of cure of bulk-fill flowable composite resins (SureFil SDR Flow, Grandio Flow,and Venus Bulk Fill) and a conventional flowable composite resin (Revolution Formula 2). The overall results for depth of cure showed that Venus Bulk Fill ≥ SureFil SDR ≥ Grandio Flow ≥ Revolution Formula 2.
    Full Article (PDF)
  • Diagnosis and Medications Evaluation and endodontic management of a patient with 6 single-rooted molars: a case report

    Jaikrishnan S., BDS
    Jojo Kottoor, MDS
    Joy Mathew, MDS
    Sanjana Ravi Kumar, MDS
    Saira George, MDS
    Krishna Hari, MDS
    2015 Sep/Oct; 63(5):e35-e37.  

    This case report describes a patient with unusual tooth morphology involving the bilateral presence of 6 first and second molars with a single root and a single canal. The article also discusses the endodontic management of a single-rooted maxillary molar and the use of CBCT for evaluation and diagnosis of these anatomical variations.
    Full Article (PDF)