Awan KH, Hegde R. Electronic Cigarette: A Savior or a Lure? World J Dent 2017;8(3):155-156.

This study aims to evaluate the impact of soft skills’ formal assessment on the students’ interpersonal competency as evaluated by their own patients.

A validated eight-item questionnaire with a 5-point Likert rating scale addressing relevant soft skills and rated by patients was used for two different cohorts of final year dental undergraduate students at the Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. The first cohort (class of 2009) did not receive a formal daily assessment during their clinical work, while the second batch (class of 2011) did. The daily assessment was used as a formative evaluation and included aspects of professionalism, patient empathy and education, organization of work area, and time management.

For all the eight items in the questionnaire, more than 97% (total = 340) of the patients responded positively for both batches (2009 and 2011) of dental students. As for the scores related to specific items, there was improvement in the proportions of patients who were satisfied with all the items for the batch of students who had the formal assessment for their clinical work. These improvements, however, did not demonstrate any statistical significance (p > 0.05).

Patients were equally satisfied with the soft skills among two groups of final year dental students during clinical encounters. The formal assessment of soft skills did not have any impact on the measured outcomes.

Soft skills are a learning experience for every dental student, which is useful in personal and professional life. An increase in health service and competitive dental practices emphasizes the need for soft skills to understand the dynamics of workplace and use of soft skills.

Mohamed AM, Abdullah D, Dom TNM. Soft Skills of Dental Students’ Competence: What is Important for Patients and How do Students Fare? World J Dent 2017;8(3):157-163.

The aim of this study is to evaluate the minimum inhibitory concentration (MIC) of cinnamon bark oil against Lactobacillus acidophilus and incorporate it in the liquid component of glass ionomer cement (GIC) followed by determination of its effect on the compressive strength.

Antibacterial effect of various concentrations of cinnamon bark oil was evaluated using broth microdilution method with 96-well tissue culture plate. Minimum inhibitory concentration of the cinnamon bark oil against L. acidophilus was determined and that concentration was then incorporated into the liquid component of the GIC, and its compressive strength was evaluated. For compressive strength testing, teflon mold of 4 mm diameter and 6 mm height was used for the preparation of samples. The prepared specimens were stored in distilled water at 37°C for 24 hours in an incubator. After 24 hours, the samples were subjected to the universal testing machine at a speed of 1 mm/minute for compressive strength evaluation. The maximum load required to fracture the specimen was recorded.

A volume of 20 ìL/mL was found to be the MIC of the cinnamon bark oil against L. acidophilus. The mean compressive strengths of conventional and cinnamon bark oil-incorporated GIC revealed no significant difference.

Cinnamon bark oil has antibacterial property against L. acidophilus. Incorporation of 2% v/v cinnamon bark oil did not adversely affect the compressive strength of GIC.

By incorporating this bacteriostatic agent to GIC, the progress of caries and failure of restorations can be prevented by inhibiting the growth of L. acidophilus. Clinically, it can be used in cases of deep dentinal caries, early childhood caries, rampant caries, and patients with high caries index.

Bhanushali S, Srilatha KT, Girish MS. Antimicrobial Efficacy of Cinnamon Bark Oil on Lactobacillus acidophilus and its Effect on Compressive Strength of Glass Ionomer Cement. World J Dent 2017;8(3):164-170.

Functional reconstruction of jaw defects due to surgical resection is a challenge in maxillofacial surgery. The fibula free flap in combination with dental implants has exhibited growing popularity for such reconstructions. This study aimed at evaluating the clinical and functional outcome of dental implants inserted in fibula free flaps and dental implants used for orofacial reconstruction following ablation of tumors.

A clinical follow-up study of 10 patients was conducted after oral surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 12-year period. The follow-up protocol included a clinical examination and radiological evaluation and interview using a questionnaire. Information on postoperative recovery after the surgical reconstruction phase and implant placement, type of diet, swallowing problems, speech intelligibility, lip competence, and perceived facial appearance was collected and analyzed.

The survival rate of fibula free flap was 100%. The survival and success rates of implants placed in the fibula flaps at the end of the follow-up period were 100 and 94% respectively.

Implants placed in fibula bone grafts have been shown to integrate normally. Surgical reconstruction with vascularized fibula bone grafts followed by placement of dental implants after jaw resection can provide good clinical and functional outcomes for oral rehabilitation with a prosthesis.

A riga P, N arayanan V, J ain A R, Philip JM, Nathan S. Clinical and Functional Outcomes of Implant Prostheses in Fibula Free Flaps. World J Dent 2017;8(3):171-176.

The present study was primarily designed to evaluate the outcome of guided bone graft regeneration in peri-implant defects by combining recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and granules of beta-tricalcium phosphate (B-TCP) mounted by resorbable biomesh membrane. Secondary objective was to determine the value of resorbable barrier membrane to improve the efficacy of the growth factormediated regeneration.

A randomized controlled study comprised 14 participants (8 males and 6 females, mean age 37 years, range 19—55 years), in which a total of 15 implants (10 in maxilla and 5 in the mandible) were placed. Fifteen implant sites were randomly divided by picking a code into three groups: Test group I (n = 5) ß-TCP + rhPDGF (0.3 mg/mL) + biomesh, test group II (n = 5) ß-TCP + rhPDGF, and control (n = 5) ß-TCP + biomesh. The experimental site was examined clinically for the gingival status and radiographically for the bone status.

Statistically significant difference in preoperative and postoperative measurements was observed for test groups I and II in all the parameters except width; in contrast, there was no significant difference observed for the control group from baseline to 5 months postoperatively. On intergroup comparison, statistically significant difference was observed between test group I vs control group and test group II vs control group, but it was not significant between test groups I and II, which was further confirmed using global performance scale score.

It concluded that rhPDGF-BB and ß-TCP mounted by resorbable biomesh membrane played a synergistic role in the management of peri-implant defects.

Bone regenerated using ß-TCP with rhPDGF-BB in the reversal of peri-implant defects.

Arora R, Verma UP, Dixit J, Lal N. Synergistic Effects of Growth Factor, Bone Graft, and Resorbable Barrier Membrane in Management of Dehiscence and Fenestration of Dental Implants. World J Dent 2017;8(3):177-182.

Osteoporotic patients require particular attention to their implant site bone quality as an indication of prognosis and may require modified surgical technique Insertion Torque (IT).

It is the purpose of this study to test whether IT is significantly correlated with bone density or not, as assessed by the cone-beam computed tomography (CBCT) in a group of osteopenic and osteoporotic patients.

A total of 30 patients were included in the study. The mandibular second premolar region was chosen as the site of investigation to prevent variability in surgical implant placement technique in different locations affecting bone mineral density (BMD). Partially, edentulous female patients between 51 and 60 years of age who were scheduled to receive implant placement were recruited for the study. CBCT (Master Series 3D Dental Imaging) was used for preoperative evaluation of the jaws for each patient. Materialise's Interactive Medical Image Control System (MIMICS) was used to process stacks of 2D images from CBCT. Finite element analysis were carried out on bone using Ansys software. Maximum displacement and maximum stress—strain patterns were compared in normal, osteoporotic, and osteopenic groups.

The difference in mean bone density in all three groups were statistically significant (p < 0.05) (Table 1). FEA at 32, 36, 40 N in all 3 groups was statistically significant. (Table 2).

Within the limitations of the study, the amount of stress—strain that exhibits at 40 N load in normal bone will be almost the same stress—strain given at 32 N load in osteoporotic bone. Normal IT load analysis exhibits more stress/strain in osteoporotic patients when compared with other groups, showing that IT must be achieved to an optimum level to avoid further complication and failures.

Venkatakrishnan CJ, Bhuminathan S, Chandran CR. Implant Insertion Torque Load Analysis for Mandible using CBCT Images. World J Dent 2017;8(3):183-189.

This study was conducted to assess the cariogenic potential of pediatric liquid medicaments (PLMs) of Allopathic, Homeopathic, Ayurvedic, and Unani formulations specifically in Ahmedabad.

Four commonly used PLMs were selected based on a survey. Thirty-nine exfoliated deciduous teeth samples were placed in selected PLM for 1 minute, 10 minutes, and 8 hours and observed under scanning electron microscope to check the erosive potential. Their endogenous pH, calcium dissolution potential, viscosity, and type and amount of sugar were checked.

In all the four groups, a specific type of enamel prism pattern was seen in all the samples irrespective of magnification and immersion time. However, the degree of erosion increases with the increase in immersion time. All the four syrups were acidic in nature. Lowest pH (3.73) and highest calcium dissolution (7.106) were seen in Saduri®. Viscosity was higher with Benadryl® mainly due to high sugar content (36.10), especially glucose (27.21).

All the PLMs used in this study showed an erosive effect on the primary enamel surface though major effect was seen with Saduri®.

With respect to this study, Unani medications are most cariogenic for the teeth among all the four types of medications in children.

Shah V, Venkataraghavan K, Choudhary P, Trivedi K, Shah S, Bhandi S. Comparative Evaluation of the Four most commonly used Pediatric Liquid Formulations in Ahmedabad City: An in vitro Study. World J Dent 2017;8(3):190-195.

The aim was to compare the effect of 10 and 20% carbamide peroxide (CP) on microhardness (MHN) and surface roughness of two commercially available bulk fill composites (X-tra fill Bulk Fill and Tetric EvoCeram Bulk Fill).

A total of 50 specimens with both type composites were prepared using brass molds of inner diameter 10 mm and a height of 4 mm. Each type of composite was further divided into three groups, control group stored in artificial saliva for 14 days, other groups bleached with 10 and 20% CP respectively, for 14 days. Microhardness of the composite resin was tested with a Vickers hardness tester, whereas surface roughness was tested with profilometer.

All the analysis was performed using Statistical Package for the Social Sciences version 18. The value of p < 0.05 was considered statistically significant. Both 10 and 20% CP significantly reduced MHN of experimental composite resins. However, the mean surface roughness was significantly higher in X-tra fill Bulk Fill than Tetric EvoCeram Bulk Fill at 20% CP concentration. The mean MHN of Tetric EvoCeram was reduced when compared with X-tra fill at 20% CP.

There was a significant reduction in the MHN of restorative materials observed after exposure to CP under a clinically simulated bleaching regimen. However, increase in surface roughness was seen only at 20% CP.

The physical properties, such as MHN and surface roughness have a crucial effect on the longevity of restorations and, moreover, on the esthetic demands of patients, but they may be compromised by bleaching treatments. The aim of this research paper was to assess the reaction of home bleaching agents on the physical properties of two Bulk Fill composite resin restorative materials.

Francis G, Pradeep K, Ginjupalli K, Saraswathi V. Effects of Bleaching Agents on the Microhardness and Surface Roughness of Bulk Fill Composites. World J Dent 2017;8(3):196-201.

The aim of the study was to evaluate the relation between height of an individual with the circumference of skull and combined mesiodistal width (CMDW) of the permanent maxillary anterior teeth in forensic and medicolegal investigations.

In this study, 100 persons were evaluated. Mesiodistal widths of the permanent maxillary anterior teeth and height and circumference of the skull were measured. Linear regression analysis was used for the known heights of the combined data and data for males and females against the odontometric and anthropometric variables.

Highly significant correlation was observed between height and other parameters for combined data and data for males. There was statistically significant difference between equation relating height to the CMDW of the maxillary anterior teeth and equation relating height to head circumference.

It can be stated that the skull with teeth may provide accurate clues to stature from an individual's fragmentary remains and thus provide a reliable method of estimation of height from skeletal remains during forensic investigations.

Odontometric parameters along with regression equations may be used as a supplementary approach for stature estimation, especially in situations of unavailability of extremities. In the advancement of field of forensic odontology, skull anthropometry including maxillary extent, mesiodistal dimension of anteriors, and circumference of the skull are beneficial for stature estimation.

Gondivkar SM, Gadbail AR, Vedpathak PR, Sarode S, Sarode G, Mankar M, Patil S. Odontometric and Skull Anthropometric Parameters as a Forensic Tool in Stature Estimation: A Cross-sectional Analysis. World J Dent 2017;8(3):202-206

The aim is to compare the extent of irrigant penetration into root canals up to the working length and in simulated lateral canals after passive ultrasonic irrigation (PUI) and manual dynamic agitation (MDA).

Root canals of 36 single-rooted extracted teeth were shaped using rotary files. Irrigation was done with 5.25% sodium hypochlorite and 17% ethylenediaminetetraaceticacid. Teeth were decalcified in 5% nitric acid. Lateral canals were created by inserting 10 K-files and then, the teeth were cleared using methyl salicylate. Samples were randomly divided into three groups of 12 teeth each: Group I — Control, group II — PUI, and group III — MDA. A contrast solution was delivered to the root canals during final irrigation and activation. Specimens were photographed using dental operating microscope, and the mean length of dye penetration was measured.

Data were analyzed using analysis of variance (ANOVA), Tukey test, and repeated measures ANOVA. Passive ultrasonic irrigation group showed the highest penetration of the irrigant upto the working length followed by MDA. Manual dynamic agitation and PUI groups had equivocal results in lateral canal irrigation.

Passive ultrasonic irrigation technique is the most effective in delivering the irrigants up to the working length. The effectiveness of PUI and MDA is equivocal in lateral canal irrigation, and hence, MDA can be considered an alternative to PUI, in the case of nonavailability of PUI.

The clinician can consider the use of MDA technique for irrigant agitation in root canals as an alternative to PUI, based on the extent of irrigant penetration.

Khare M, Suprabha BS, Yadav A, Shenoy R, Boaz K, Rao A. Effectiveness of Ultrasonic and Manual Dynamic Agitation Techniques in Irrigant Penetration: An in vitro Study. World J Dent 2017;8(3):207-212.

Oral disease creates a major public health burden worldwide and receives inadequate attention in many low- and middle-income countries (WHO 2003).

The aim of this study was to estimate the prevalence of tooth loss and treatment needs of a rural adult population in South India.

A descriptive point prevalence survey was conducted in three rural districts of Tamil Nadu, South India. A total of 3,000 subjects with a mean age of 36.2 (standard deviation 13.02) years participated in a clinical examination and interview. They were divided into three groups based on age: Group I — 18 to 30 years, group II — 31 to 50 years, and group III — 51 to 80 years.

The overall prevalence of tooth loss was 48.7%. The most commonly occurring type of partial edentulousness was Kennedy's class III in maxilla comprising 23.3% followed by mandible 22.1%. Mandibular first molar was the most common missing tooth. The prevalence of tooth loss was more in males (58.2%) than females (41.8%). Group III subjects had the highest incidence of tooth loss.

The prevalence of tooth loss in South Indian rural population was 48.7%. The most common reason for tooth loss was dental caries which accounted for 50% followed by periodontal reasons 30% and others 10%. Fixed type of prosthesis was the preferred type of restoration for all the individuals with tooth loss, but affordability was the major factor that determined the treatment of the patients.

Ashraf J, Jain AR, Ariga P, Nallaswamy D. Prevalence of Partial Edentulousness and Treatment needs in Rural Population of South India. World J Dent 2017;8(3):213-217.

This study was designed to evaluate knowledge and awareness toward orthodontic treatment among treated subjects as compared with untreated subjects and to correlate the communications between treated subjects and their practicing orthodontists.

Self-reported questionnaires were distributed to be completed by the consent subjects. They were 340 untreated subjects (220 males and 120 females) and 102 subjects (57 males and 45 females) who recently received orthodontic treatment in the age range 19 to 28 years. Subjects that received orthodontic treatment were selected among the attendees of clinics of College of Dentistry, Jazan University, Kingdom of Saudi Arabia. The data were analyzed using Statistical Package for the Social Sciences (version 21, Institute Inc., USA).

Subjects who received orthodontic treatment scored higher mean of total scores of awareness 14.74 and knowledge 11.18. The difference of awareness and knowledge between treated and untreated subjects was highly significant (p = 0.000). The female treated subjects scored higher than male treated subjects in attitude toward thumb sucking as a cause of malocclusion (91.3 and 70.2% respectively). Early primary teeth extraction as a cause of malocclusion was scored by 76.1% females and 42.1% males. The male treated subjects show significant (p > 0.05) correlation between the total items of knowledge of orthodontic treatment and total items of orthodontist—patient communications.

Orthodontic treated subjects have more knowledge and awareness about orthodontic treatment than untreated subjects. A significant association was found between communications and knowledge of orthodontic treatment in male as compared with female patients.

Knowledge and awareness toward orthodontic treatment and the communications of orthodontic patients with treating orthodontist can significantly increase the orthodontic treatment outcome.

Essamet M, Darout IA. Knowledge and Attitude toward Orthodontic Treatment among treated Subjects compared with Untreated Subjects and Correlation with Patient—Orthodontist Communication. World J Dent 2017;8(3):218-223.

Pavithra V, Sowmya SV, Rao RS, Patil S, Augustine D, Haragannavar VC, Nambiar S. Tumorassociated Collagen Signatures: An Insight. World J Dent 2017;8(3):224-230.

The aim of this case report was to reconstruct the alveolar buccal bone plate lost in consequence of a root fracture in the maxillary central incisor area after immediate implant placement (IIP). A 48-year-old patient was referred to our office with the chief complaint of spontaneous bleeding in his left central incisor. After careful examination, the following comprehensive treatment approach was carried out: (1) Atraumatic tooth extraction, (2) IIP, (3) provisional prosthesis installation, (4) alveolar buccal bone plate reconstruction with autologous bone collected from the maxillary tuberosity, (5) gingival augmentation procedure with connective tissue graft removed from the palate, and finally (6) adjustment of the provisional restoration. After 1-year postoperative, an adequate esthetic outcome was achieved with lower cost, reduced morbidity to the patient, and lower treatment time. This approach was able to improve gingival architecture and bone volume with adequate thickness and width, enhancing patient esthetics and satisfaction. In conclusion, when proper diagnosis, precise surgical techniques, and appropriate multidisciplinary approach are employed, IIP followed by immediate dentoalveolar restoration might be considered a safe procedure to restore the peri-implant bone and gingival recession favoring the achievement of appropriate esthetic outcomes.

The treatment planning employed was able to improve gingival architecture and bone volume with sufficient width and thickness enhancing patient esthetics and satisfaction in one single-stage procedure.

de Molon RS, de Avila ED, Barros- Filho LAB, Cirelli JA, Borelli-Barros LA. Immediate Implant Placement with Simultaneous Regenerative Procedure in Fresh Extraction Socket. World J Dent 2017;8(3):231-238.

This clinical case report demonstrates the successful management of a complex endodontic-periodontal iatrogenic lesion following a critical evaluation and decision-making process with interdisciplinary treatment strategies.

Defective dental restorations can affect the periodontal and endodontic health of the teeth.

An endodontic-periodontal lesion that resulted from a faulty restoration in a 30-year-old male patient is reported. The management of the case is done through periodontal and endodontic treatment. The detailed method of managing of this type of cases is discussed.

In conclusion, the use of a systematic diagnosis process will help in the identification and treatment of iatrogenic endodontic-periodontal lesions.

The correct management of endodonticperiodontal lesions can impede the loss of the involved teeth.

Alfawaz Y. Management of an Endodontic- periodontal Lesion caused by Iatrogenic Restoration. World J Dent 2017;8(3):239-246.