Comparative evaluation of circumferential crestal bone loss after 1 year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using cone-beam computed tomography: A randomized controlled trial.

Aim: The study was aimed to evaluate circumferential crestal bone level after one year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using CBCT. Setting and Design: The study was designed as a Randomized controlled trial. Material and Methods: 32 implants were placed in single edentulous spaces in the mandibular posterior region after random allocation into two groups: Flap surgery (Group A) and Flapless surgery (Group B). Virtual implant planning was performed using Blue Sky Bio software, and static CBCT guided 3D printed surgical templates were fabricated for all participants of both the groups. Immediate non-functional temporization was performed. Circumferential crestal bone levels were assessed after surgery and one-year follow-up using CBCT and XELIS software. Vertical bone loss (VBL) and horizontal bone loss (HBL) was assessed on four sides: buccal, lingual, mesial and distal. Statistical Analysis Used: Data was analyzed using Statistical Package for Social Sciences IBM Corp. Released 2017, IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp.) and Graph Pad Prism 7.0 version. The level of significance was chosen <0.05. Chi square test was performed to assess the difference in the age in the two groups. Mann-Whitney U test was performed to compare the two groups for outcome measure. Graphically, quantile-quantile (Q-Q) plot was made using mean and standard deviation for normality verification of data. Results: 100% survival rate and patient compliance was observed along the one-year follow-up duration. By using Mann-Whitney U test, statistically significant difference was found in the vertical bone loss among participants of Flap surgery (Group A) and Flapless surgery (Group B) on all the four sides after one year of implant placement. However, significant results were not obtained for the difference in the horizontal bone level. Conclusion: Within the limitations of this study, vertical bone loss measured circumferentially was more positively correlated with the implants placed with flap surgery compared to flapless surgery after immediate loading in the posterior mandibular region after one year.

Comparative evaluation of crestal bone level by flapless and flap techniques for implant placement: Systematic review and meta-analysis.

Aim: :To compare the crestal bone level of flapless technique of dental implant placement with the flap technique. Setting and Design: This Systematic review and Meta-analysis was conducted according to the Preferred Reporting Items For Systematic Review and Meta-Analyses (PRISMA) Guidelines and registered with PROSPERO. Materials and Methods: Electronic search of Medline and Google scholar databases for articles from 2010 till March 2020 was performed. Studies comparing the crestal bone level with both the techniques were included. After the collection of data, the risk of bias was assessed for each study. Statistical Analysis Used: Meta-analysis was executed using RevMan 5 software version 5.3. Results: 23 studies were included. Statistically significant difference in crestal bone level was found between flapless and flap surgery with mean difference of -0.14 (flapless placement versus flap surgery; 95% CI: -0.24 to -0.03; P = 0.01FNx01). The difference in crestal bone level between the 2 groups was not statistically significant with a mean difference of -0.05(Guided flapless placement versus flap surgery; 95% CI: -0.10 to 0.00; P=0.06). Meta-analysis of the freehand flapless surgery with flap surgery generated a mean difference of -0.20 which was found to be statistically significant (Freehand flapless placement versus flap surgery; 95% CI: -0.37 to -0.03; P=0.02FNx01). Conclusions: Flapless placement of implant can positively influence crestal bone loss in comparison with conventional flap technique.

In vitro evaluation of remineralization efficacy of different calcium- and fluoride-based delivery systems on artificially demineralized enamel surface.

BACKGROUND: Caries is the most common dental disease facing the world population. Caries can be prevented by remineralizing early enamel lesions. AIM: To evaluate remineralization efficacy of stannous fluoride (SnF2), casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and calcium sucrose phosphate (CaSP). MATERIALS AND METHODS: Fifty enamel samples were taken; they were divided into five groups (n = 10). Demineralization was carried out with Groups A, B, C, and E. Remineralization was carried out with Groups A, B, and C for 7 days using SnF2, CPP-ACPF, and CaSP, respectively. In Group D, no surface treatment was carried out, to mark as positive control whereas Group E was kept as negative control with only surface demineralization of enamel. Enamel microhardness was tested using Vickers's microhardness tester after 7 day remineralization regime. STATISTICAL ANALYSIS: One-way analysis of variance and post hoc Tukey tests were performed. RESULTS: The mean microhardness values in descending order: Positive control > SnF2> CaSP > CPP-ACPF > negative control. CONCLUSION: All remineralizing agents showed improved surface remineralization. However, complete remineralization did not occur within 7 days. SnF2 showed the highest potential for remineralization followed by CaSP and CPP-ACPF.

Comparison of the effect of shear bond strength with silane and other three chemical presurface treatments of a glass fiber-reinforced post on adhesion with a resin-based luting agent: An in vitro study.

BACKGROUND: Loss of retention has been cited to be the most common cause of the failure of postretained restoration with irreversible consequences when materials with different compositions are in intimate contact at the post/adhesive interface. With this background, a study was conducted to improve the adhesion at the resin phase of fiber posts using silane and other chemical pretreatments. MATERIALS AND METHODS: Hundred glass fiber-reinforced posts were tested with 4 different protocols (n = 25) using silane as a control (Group A) and other three experimental groups, namely, Group B-20% potassium permanganate, Group C-4% hydrofluoric acid, and Group D-10% hydrogen peroxide were pretreated on the postsurface followed by silanization. These specimens were bonded with dual-polymerizing resin-based luting agent, which were then loaded at the crosshead speed of 1 mm/min to record the shear bond strength at the post/adhesive interface. The data were analyzed using one-way ANOVA test for multiple group comparisons and the post hoc Bonferroni test for pairwise comparisons (P < 0.05). RESULTS: Group B showed more influence on the shear bond strength when compared to other protocols, respectively (P < 0.001). CONCLUSION: Alone silanization as a surface treatment did not improve the bond strength. Combination of chemical presurface treatments followed by silanization significantly enhanced the bond strength at the post/adhesive interface.

Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography.

The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and clinically challenging. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these aberrant variations. A mandibular first molar with seven canals represents a rare anatomical variant, particularly when four canals are found in distal root. Based on in vitro studies, its incidence is reported to be between 0.2% and 3%. With the advent of cone-beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with complex canal configurations has become more precise. The present case report discusses successful nonsurgical management of radix entomolaris along with middle mesial canal and middle distal canal in mandibular first molar with seven canals (four canals in distal and three in mesial) employing CBCT as an adjunctive diagnostic aid to conventional radiography.

Stress analysis at bone-implant interface of single- and two-implant-retained mandibular overdenture using three-dimensional finite element analysis.

PURPOSE: The purpose of this research was to compare stress distribution on the bone between single implant-retained and two-implant-retained mandibular overdentures using three-dimensional (3D) finite element analysis. MATERIALS AND METHODS: Two 3D finite element models were designed. The first model included single implant-supported mandibular overdenture placed in the midline of the mandible while the second model included two-implant-supported mandibular overdenture placed in the intra-foramen region, retained by ball attachment of the same diameter. The bone was modeled on the D2 bone depending on the classification given by Misch. A computed tomography scan of the mandible was used to model the bone by plotting the key points on the graph and generating the identical key points on the ANSYS Software (ANSYS, Inc., USA). The implant was modeled using appropriate dimensions as provided by the manufacturer. Stresses were calculated based on the von Mises criteria. RESULTS: Stresses produced in the hard bone (HB) and soft bone (SB) were higher in single implant-retained mandibular overdenture while stresses produced around the denture as well as implant were higher in two-implant-retained mandibular overdenture. CONCLUSION: Within the limitations of the study, it had been seen that stresses produced were the highest on HB and SB in single implant-retained mandibular overdenture while stresses produced across the denture as well as implant were the highest in two-implant-retained mandibular overdenture.

Evaluation of push-out bond strength of endosequence BC sealer with lateral condensation and thermoplasticized technique: An in vitro study.

AIMS: To evaluate and compare the push-out bond strength of root filled with Endosequence BC, AH Plus and Endomethasone N sealers using lateral condensation and thermoplasticized technique. MATERIALS AND METHODS: Thirty mandibular premolars with completely formed roots were selected. Teeth were decoronated, working length was determined. Instrumentation and irrigation were performed. Teeth were then obturated with Group 1-Cold lateral compaction (n = 15) or Group 2-Thermoplasticized technique (n = 15). Each group was again subdivided into three depending on the sealers used. Teeth in each subgroup were then sectioned perpendicularly to the long axis to obtain a disc of 2 mm each, which were then subjected to micro push-out test. Data was analyzed with ANOVA. RESULTS: AH Plus sealer in Group 1 showed the maximum (4.77 ± 1.67 MPa) push-out bond strength among the three sealers and between two groups. The mean strength of Bioceramic sealer was lower in Group 1 (2.62 ± 0.76 MPa) and higher in Group 2 (3.52 ± 0.69 MPa). CONCLUSIONS: The push-out bond strength of Endosequence BC sealer was lower than the AH Plus root canal sealer with cold lateral condensation technique.

Comparative evaluation of debris removal from root canal wall by using EndoVac and conventional needle irrigation: An in vitro study.

CONTEXT: Microbial control is of paramount importance in Clinical Endodontics. Therefore, cleaning and disinfection of root canals are essential to achieve endodontic success. AIMS: The purpose of this study is to compare the efficacy of EndoVac irrigation system and conventional needle (30 gauges side venting needle) irrigation for removal of debris from the root canal walls at coronal, middle and apical third by using the scanning electron microscopy (SEM). SETTINGS AND DESIGN: An in vitro randomized control trial study. MATERIALS AND METHODS: A total of 20 mandibular premolars with completely formed roots were selected and randomly divided into two groups - Group 1: Irrigation with the Conventional system and Group 2: EndoVac irrigation. After access opening and working length determination biomechanical preparation completed up to a rotary protaper F4 file. Groupwise irrigation with sodium hypochlorite and ethylenediaminetetraacetic acid was done with each canal in between instrumentation. Then, the teeth were sectioned in buccolingual direction and the halves were sputter-coated with gold palladium and coronal, middle and apical third were examined by SEM at x2000 magnification. STATISTICAL ANALYSIS: Mann-Whitney test for comparison between methods, Kruskal-Wallis test for comparison among thirds and Miller test for individual comparisons. RESULTS: The apical, middle and cervical root canal thirds were evaluated and the results were analyzed statistically by the Mann-Whitney test for comparison between methods, Kruskal-Wallis test for comparison among thirds and Miller test for individual comparisons. CONCLUSIONS: EndoVac group resulted in significantly less debris at apical third compared with the conventional needle irrigation group. There was no statistical significant difference found in debris removal at coronal and middle third of root canal wall between the EndoVac group and conventional needle irrigation group.

Student apathy for classroom learning and need of repositioning in present andragogy in Indian dental schools.

BACKGROUND: In the world of technology, when today's student is approaching the on-line /distance learning in the open universities and doing on-line self-assessment, the classroom learning is vanishing slowly. Globally, teachers are taking efforts to improve the pedagogy by implementing effective methods to retain the classroom teaching and student attendance. The present study aims at shedding some light on the need of changing the adult education strategies (andragogy), which can effectively improve the student attendance for lectures. METHODS: It is an observational study, and the conceptual framework of it is based on beliefs, opinions and personal experiences of the respondents. Triangulation method is used for collecting the data. The data is achieved from three groups of concerned population who could provide valid results to support the study. It is collected by interviewing 10 senior faculty members who are/were the 'education experts' in the universities, while the main concerned groups of present educational stream, i.e. 'institution-teachers' and the 'students', were given questionnaires. 570 teacher respondents and 200 student respondents are the main participants of this study. RESULTS: As per data, it has been observed that senior faculty (90%) and students (93.25%) feel need of student motivation more than the institutional teachers (52.44%). P-values were obtained using Chi-Square test for testing the significance of difference between agreement and disagreement for a specific question. CONCLUSIONS: In India, Universities have already sensed the need of 'teacher development programmes'. But teachers in dental colleges, demand more efforts to be taken by universities and managements in this regard and expect better educational policies to give them accessibility to prove themselves.