Role of nanotechnology in dentistry: Systematic review Muhamood Moothedath, Muhaseena Moothedath, Abhishek Jairaj, B Harshitha, Suheel Manzoor Baba, Shafait Ullah Khateeb Journal of International Society of Preventive and Community Dentistry 2019 9(6):535-541 Aim: This systematic review aimed to provide an overview of role of nanotechnology in dentistry and to evaluate its applicability in prevention and treatment of oral diseases. Materials and Methods: A systematic literature search was conducted in 2 electronic databases – PMC and Cochrane. The search was restricted to the articles published during the last 5 years. First-level screening was done to select articles for the review on the basis of title and abstract. Then, full texts of selected articles were studied, and relevant articles were selected to be included in this review. Articles selected were critically appraised to evaluate their quality. Results: Literature search revealed 837 articles in PMC, 15 in Clinical trial register of US National library, and 43 in Cochrane. Additional 6 articles were identified by hand search. Eleven clinical trials were included in this review. Conclusion: Advancement in nanotechnology has greatly influenced dental disease prevention and therapy significantly.

Comparison between iRoot BP Plus (EndoSequence Root Repair Material) and Mineral Trioxide Aggregate as Pulp-capping Agents: A Systematic Review Nasrin Mahgoub, Basema Alqadasi, Khalid Aldhorae, Ali Assiry, Zainb M Altawili, Tao Hong Journal of International Society of Preventive and Community Dentistry 2019 9(6):542-552 Introduction: iRoot BP Plus, also known as EndoSequence root repair material (EERM) is a premixed bioceramic thick/putty. According to its instruction manual, iRoot BP Plus is composed of tricalcium silicate, zirconium oxide, tantalum pentoxide, dicalcium silicate, calcium sulfate, calcium phosphate monobasic, and filler agents. This systematic review was carried out to evaluate and present the iRoot BP Plus material as a pulp-capping agent. Materials and Methods: A systematic search for articles with the scope of the selection criteria undergoing for data extraction was conducted through electronic databases. Studies on evaluation of the cytotoxicity, bioactivity, and dentinal bridge formation of iRoot BP, iRoot BP Plus, ERRM putty, or ERRM paste (ERRM) on variant human cells were selected for in vitro models, and dentinal bridge formation on human and animals teeth for in vivo models were selected. Results: A total of 22 articles were discussed in the review, 14 in vitro studies, five in vivo studies, and three articles with both studies. Methyl thiazol tetrazolium was the most used method for evaluating cytotoxicity. As for dentinal bridge formation, histological assessment and micro-Computed tomography were used. Human dental pulp cells (hDPCs) were the most investigated for in vitro models and rats for in vivo models. Except for one study, all studies involved in this review were primarily examining the material and comparing it to different types of mineral trioxide aggregate. Conclusion: iRoot BP, iRoot BP Plus, and ERRM are biocompatible materials that enhance hDPCs and other variant human cells proliferation, migration, attachment adhesion, mineralization, and dentinal bridge formation.

Validation of Arabic version of the Modified Dental Anxiety Scale (MDAS) and Kleinknecht’s Dental Fear Survey Scale (DFS) and combined self-modified version of this two scales as Dental Fear Anxiety Scale (DFAS) among 12 to 15 year Saudi school students in Riyadh city Saeed Ahmed Alamri, Sulaiman A Alshammari, Mohammad Abdul Baseer, Mansour K Assery, Navin Anand Ingle Journal of International Society of Preventive and Community Dentistry 2019 9(6):553-558 Aims: The aim of this study was to test the reliability and validity of the Arabic version of Modified Dental Anxiety Scale (MDAS), Dental Anxiety Scale (DAS), and a combined self-modified version of these scales and Dental Fear and Anxiety Scale (DFAS). We also aimed to assess the impact of dental fear and anxiety among Arabic-speaking 12-15-year-old Saudi students on their quality of life by correlating MDAS, DAS, and DFAS scores with other demographic data. Materials and Methods: A cross-sectional study was conducted among 500 individuals (250 male and 250 female) in Riyadh city using a questionnaire. An unpaired t-test was used to check the mean difference between anxiety score among males and females, and one-way analysis of variance was used to check the mean difference between percentage anxiety score among different visit groups. Scheffe post hoc test was used to check the pairwise difference between the groups, and Cronbach’s alpha was used to measure internal consistency of the questionnaire. Results: Overall mean percentage DAS score was 51.1640+6.87358 and 55.2080+8.52805 for male and females, respectively. The overall mean percentage MDAS score was 51.6640+10.9478 and 58.3200+11.62990 for males and females, respectively. The overall mean total score was found to be 64.4080+11.80776 and 100.4680+12.34840 for males and females, respectively. All the above results were statistically significant by 5% (P < 0.001). Cronbach’s alpha score for MDAS and DAS was found to be 0.843 and it was 0.960 for DFAS. It was found that removal of any item would have decreased the overall consistency, which indicated a high level of internal consistency for our scales. Conclusion: Saudi Arabian version of Arabic version of MDAS, DAS and DFAS have shown high validity and reliability, and can be used to assess the dental patient’s anxiety and fear.

Effect of smart dentin replacement, biodentine, and its combination for dentin replacement as alternatives to full-crown coverage for endodontically treated molars: An in vitro study Samrat R Magaravalli, Shamshuddin Jr. Patel, Purushothama Rangaswamy, Sujith Ramachandra, Kavitha Govindappa, Vidhya Hiremath Journal of International Society of Preventive and Community Dentistry 2019 9(6):559-565 Aim: The aim of this in vitro study was to assess newer dentin replacement restorative materials that could substitute full-crown coverage restoration. Materials and Methods: Twenty freshly extracted maxillary and mandibular molars were selected for this in vitro study and were randomly divided into four groups of five teeth each. All the teeth in the experimental groups (Groups 2–4) were subjected to access cavity preparation, mimicking class 1 deep dentinal caries without involving marginal ridges, and with approximately 1.5 mm of tooth structure remaining throughout its circumference. Group 1: sound molar teeth, which will serve as a control group. Group 2: endodontically treated molars restored with smart dentin replacement (SDR) as post-endodontic restoration. Group 3: endodontically treated molars restored with Biodentine as post-endodontic restoration. Group 4: endodontically treated molars restored with the combination of SDR and Biodentine as the post-endodontic restoration. Fracture resistance of all the teeth was then evaluated using a universal testing machine. Statistical Analysis: The results of this in vitro study were calculated statistically using one-way analysis of variance and post hoc tests such as Tukey’s, Scheffe’s, Bonferroni, and Holm tests for intragroup comparison. Results: Statistically significant results were observed among all groups, except Group 2 (SDR) and Group 4 (combination of SDR and Biodentine). The highest and lowest values were noted with Groups 2 and 3, respectively, (P = 0.05). Conclusion: SDR alone or the combination of SDR with Biodentine can be considered as a substitute for full-crown coverage restoration for endodontically treated molars.

Evaluate efficacy of desensitizing toothpaste containing zinc-carbonate hydroxyapatite nanocrystals: Non-comparative eight-week clinical study Dhafer Al Asmari, Muhammad K Khan Journal of International Society of Preventive and Community Dentistry 2019 9(6):566-570 Objective: The aim of the study was to evaluate the clinical effectiveness of desensitizing toothpaste in reducing the dentine hypersensitivity (DH). Materials and Methods: The study was a before and after clinical trial conducted to evaluate the clinical efficacy of a desensitizing toothpaste containing zinc-carbonate hydroxyapatite nanocrystals (Zn-CHA) for controlling DH. The trial involved 72 patients with DH who were evaluated four and eight weeks after using Zn-CHA toothpaste. The sensitivity was assessed by airblast method using Schiff Sensitivity Scale. Results: Repeated measures analysis of variance test was used to compare baseline score with fourth and eighth week. Statistically significant differences were observed between sensitivity scores at baseline and those at four- and eight-week intervals (P < 0.001). Conclusion: The results suggested that the use of Zn-CHA nanocrystals dentifrice might become an effective therapy to reduce DH.

Lower arch dimensions in children with anterior open bite and normal vertical overbite: A cross-sectional study Valentina Valderrama Rodríguez, Juliana Sánchez Garzón, Paola Botero-Mariaca Journal of International Society of Preventive and Community Dentistry 2019 9(6):571-575 Aim: Dental arch is a dynamic structure and its size depends on genetic and environmental factors. The aim of this study was to determine lower arch dimensions in children between 8 and 16 years with anterior open bite (AOB) and normal vertical overbite (NVO). Materials and Methods: A cross-sectional study was performed in 132 individuals with AOB and 132 with NVO between 8 and 16 years selected from public schools. Intercanine width, arch length, intermolar and interpremolar distances, and arch perimeter of the lower arch were measured in previously digitalized models using the GOM inspection program and an optical three-dimensional scanner. Results: Individuals with NVO presented smaller lower arch size with statistical differences in intercanine (P = 0.024, 95% confidence interval [CI]: 0.01, 0.02) and intermolar (P = 0.000, 95% CI: −1.76, −0.53) width and nonsignificant differences in the arch perimeter (P = 0.239, 95% CI: −1.57, 0.39) according to Mann–Whitney U-test. Conclusion: Individuals between 8 and 16 years of age with NVO showed smaller lower dental arch than individuals with AOB in most dimensions.

Remineralization potential of theobromine on artificial carious lesions Vani Taneja, Sridhar Nekkanti, Kanishk Gupta, Jyoti Hassija Journal of International Society of Preventive and Community Dentistry 2019 9(6):576-583 Background and Aims: This study aimed to investigate the remineralization potential of two concentrations of theobromine (100mg/L and 200 mmg/L) with fluoridated dentifrice, NovaMin, and nanohydroxyapatite using DIAGNOdent, scanning electron microscopy (SEM), and energy dispersive X-ray (EDX) analysis. Materials and Methods: Two sections were taken from 50 teeth each. Artificial carious lesions were induced using demineralizing solution. Evaluation using DIAGNOdent, SEM, and EDX analysis for elemental evaluation of Ca/P ratio and fluoride ion was carried out. Teeth sections were then randomly assigned to five different groups: (1) fluoridated dentifrice (ColgateTM, Colgate –Palmolive, India), Novamine- Shy NMTM, Group pharamaceuticals, India), 3. Nano-hydroxyapatite- Remin ProTM, Voco, Germany) 4. 100mg and 5. 200mg of Theobromine toothpaste (Theodent classicTM, Rennou, UK-853069003006). Remineralization was carried out for 14 days with two applications per day. Samples were reanalyzed using DIAGNOdent, SEM, and EDX. Results: A Tukey post-hoc test revealed statistically significant difference between NovaMin and all the other toothpastes (P < 0.001) for DIAGNOdent readings. On performing SEM-EDX analysis, it was seen that all agents had remineralization potential; however, no significant difference was found. Conclusion: Theobromine can be used as an effective novel remineralizing agent alternative to the already-available agents.

Radiomorphometric evaluation of the frontal sinus in relation to age and gender in Saudi population Ayesha Shireen, Saurabh Goel, Iffat M Ahmed, Abrar M Sabeh, Wafaa Mahmoud Journal of International Society of Preventive and Community Dentistry 2019 9(6):584-596 Background: Radiographs have been used for forensic identification purpose. At times when only skull remains are found and other means of identification fail, radiographs of skull may be used for identification purpose. Aim: The objective of this study was morphometric evaluation of the frontal sinus by using digital posteroanterior skull radiograph in relation to age and gender and to establish its forensic importance. Materials and Methods: The study was conducted at Alfarabi Private College for Dentistry and Nursing, Jeddah, Kingdom of Saudi Arabia. It included 400 subjects (200 males and 200 females), aged 14–70 years. Radiographs of the individuals were taken by digital radiography, and morphometric evaluation of frontal sinus was carried out by using Adobe Photoshop CS3 Extended. Results: Unilateral absence of sinus was noted in 2.5% males and 1.5% females. Bilateral absence was noticed in 2% males and 0.5% females. Right and left frontal sinus symmetry was seen in 83.20% of the individuals. The left-dominated asymmetry was observed in 6.98% individuals. The right-dominated asymmetry was observed in 9.82% individuals. Simple logistic regression analysis of gender by different variables showed right width and left width, which are most suited regressors for sex determination. The rate of accuracy in classification of males and females varied from 67.70% to 95.90%. Stepwise multiple regression analysis of estimation of age by different variables showed right sinus height is the best predictor of age. Conclusion: In this study, the radiographic images of the frontal sinus showed significant morphological difference in relation to age and gender in Saudi population. On the basis of this evidence, it is proposed that the morphologic evaluation of frontal sinus can be used for personal identification.

Comparison of sagittal condylar guidance determined by panoramic radiographs to the one determined by conventional methods using lateral interocclusal records in the Saudi Arabian population Harisha Dewan, Tariq I Akkam, Hitesh Chohan, Abdulrahmaan Sherwani, Feras Masha, Mohammed Dhae Journal of International Society of Preventive and Community Dentistry 2019 9(6):597-604 Objectives: The objectives of this study were to determine the condylar guidance by the conventional method using interocclusal records and by panoramic radiographs in healthy dentate patients and to compare the values obtained from panoramic radiographs with the values obtained by a conventional method. Materials and Methods: Thirty healthy dentulous subjects of either sex with an age range of 20–40 years visiting Jazan University, College of Dentistry, Dental Clinics for replacement of missing teeth or crowns, were selected according to the inclusion criteria. Maxillary and mandibular casts were obtained and mounted on Whipmix 2240 articulator. Right and left lateral interocclusal records were then made in patients by base plate wax (Dentsply truwax baseplate). This record was transferred to articulator, and condylar values were determined. In all the cases, articulator was programmed. Left and right condylar values were also measured on digital radiographs and readings were recorded. Condylar guidance readings obtained from interocclusal records and those obtained from panoramic radiographic images were compared and analyzed statistically using the t-test. Results: The condylar guidance values obtained from the interocclusal record method for both left and right sides were less when compared to the values obtained from tracing the panoramic radiographs (radiographic method). The difference in values of both the methods was highly significant. Conclusion: Although a significant amount of correlation was found between the two methods, better radiographic techniques should be further investigated.

Evaluation and comparison of stress distribution in restored cervical lesions of mandibular premolars: Three-dimensional finite element analysis Swathi Pai, Nithesh Naik, Vathsala Patil, Jaskirat Kaur, Swetank Awasti, Nithin Nayak Journal of International Society of Preventive and Community Dentistry 2019 9(6):605-611 Objectives: Restorative materials are used in the treatment of cervical lesions and restoration of the dental tooth. The objective of this study was to assess the suitability of the three commonly used restorative materials by dentists and the evaluation of stress distribution and deformation using Von Mises stress in cervical lesions of mandibular premolars under varying loading condition. Materials and Methods: A computerized model of restored class V cavity of mandibular premolar tooth was created using three dimensional modeling software SpaceClaim. It was subjected to occlusal pressure load of 100, 150, 200 and 250 MPa at right angle to buccal cusp and was analyzed for stress distribution and deformation in different restorative materials using Finite Element analysis, ANSYS Workbench. Results: The analysis carried on the class V restored tooth from biomechanical point of view indicates that restorative material glass–ionomer cement exhibited better bonding with the tooth structure using ionic bonds with the calcium ion present in the tooth structure. The variation of 8%–9% of stress concentration is observed in cavity region across varied pressure loads with glass–ionomer cement to Cention N. Conclusion: Glass–ionomer cement had showed better results than amalgam in terms of biomechanical property which is in agreement with the clinical findings. The stress values of Cention N were comparable to that of glass–ionomer cement.