Alexandria Dental Journal (2019) Vol.44 Issue (1)

IMPACT OF ORAL HEALTH BEHAVIOURS ON DENTAL CARIES IN CHILDREN WITH CEREBRAL PALSY: A CASE-CONTROL STUDY

Sara M. Quritum, Karin M. Dowidar, Amel M. Ahmed, Tarek E. Omar.

> Show Abstract

ABSTRACT

INTRODUCTION: Dental caries is consistently reported as one of the primary medical needs of children with Cerebral palsy (CP). It has negative impact on the overall health of these children and increase burden on their parents
OBJECTIVES: The aim of the study was to assess the influence of socio-economic profile, previous dental visits, oral hygiene practices, and dietary habits on dental caries experience in children with CP in Alexandria, Egypt.
MATERIALS AND METHODS: This case control study included 80 children with CP, who were 3 to 11 years old. Equal number of cases (children with CP who had caries lesions) and controls (caries free children with CP) were included. Data were collected using an interview based questionnaire and clinical examination. Questionnaire assessed socio-economic characteristics, medical history, previous dental visits, oral health behaviours and dietary habits. Clinical examination assessed caries experience and oral hygiene index (OHI-S). Multiple regression analysis was used to examine the factors associated with dental caries.
RESULTS: The average age of children in the study was 6.75 years, 68.8% of them were males. Caries experience was expressed through dmft for the primary teeth and dft/DMFT for mixed dentition. The mean values were 6.72± 2.52, 5.64 ±2.98 and 1.32 ±1.73, respectively. Children with CP with caries lesions had statistically significant poorer oral hygiene (p <0.0001), which is highly associated with high caries experience (Regression Coefficient=4.45, 95% CI= 3.75, 5.14). Other factors associated with DMF in children with CP included daily sugary snaking habits and food consistency. CONCLUSIONS: The level of oral hygiene status reflecting the efficiency of oral health behaviours, is considered the main factor associated with caries experience in children with CP. However, eating solid food and less than two sugary snacks per day were considered caries protective factors. KEYWORDS: Cerebral palsy, caries, plaque, oral health behaviours, oral hygiene, dietary habits.


> PDF
1

OCCLUSAL CHARACTERISTICS IN A GROUP OF CHILDREN WITH CEREBRAL PALSY IN ALEXANDRIA EGYPT

Sara H. El Rouby, Karin M.L. Dowidar, Amel M. Ahmed, Tarek E.I. Omar

> Show Abstract

ABSTRACT

INTRODUCTION: Cerebral palsy is the term given for a range of non-progressive syndromes of posture and motor impairment that results from an insult to the developing central nervous system.
OBJECTIVES: Assess the occlusal characteristics in children with cerebral palsy and relate them to the degree of their neuromuscular deficit.
MATERIALS AND METHODS: The study included 87 children with cerebral palsy and 84 healthy children from Alexandria, Egypt. Data were collected using a questionnaire and clinical examination. Questionnaire assessed socio-demographics and medical history. Clinical examination assessed facial profile, posterior occlusion, cuspid relationships, posterior crossbite and anterior incisor relationships.
RESULTS: Class II cuspid relationship was statistically higher in cerebral palsy children than healthy control (P=0.02 for both sides). 29.9% of cerebral palsy children and 15.5% of healthy children had convex facial profile with significant difference (P=0.04). Cerebral palsy children were more likely to have open bite than healthy children (31.1% and 14.8% respectively) with a statically significant difference between both groups (P=0.02). The mean overjet (mm) was higher in cerebral palsy children than healthy children (2.87 and 2.23 mm respectively) with a statically significant difference (P=0.03) and the mean overbite (%) was also higher in cerebral palsy children than healthy children (40.65% and 25.47% respectively) with a significant difference(P=0.001).
CONCLUSIONS: Cerebral palsy children had a convex facial profile with class II cuspid relationship in comparison to the healthy children. Anteriorly, cerebral palsy children exhibited an increased open bite with a higher significant mean number of overbite and overjet than healthy children. The posterior occlusal relationships in children with cerebral palsy were similar to that in healthy children. The severity of the neuromuscular deficit is a risk factor for the development of malocclusion in cerebral palsy children.
KEYWORDS: Cerebral Palsy, Occlusion, neuromuscular deficit, Gross Motor Function Classification System


> PDF
7

REMINERALIZATION EFFECT OF FLUORIDE VARNISH CONTAINING CASEIN PHOSPHOPEPTIDE AMORPHOUS CALCIUM PHOSPHATE ON CARIES-LIKE LESIONS IN PRIMARY TEETH (IN VITRO STUDY)

Nehal R. Salman, Magda M. El-Tekeya, Niveen Bakry, Samia Soliman

> Show Abstract

ABSTRACT

INTRODUCTION: Fluoride containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) varnishes are now available as (MI Varnish). It has an effect on the remineralization process of demineralized enamel, since it has the highest release of calcium and fluoride ions.
OBJECTIVES: To study the remineralizing effect of fluoride varnish containing casein phosphopeptide amorphous calcium phosphate (MI varnish) on the remineralization of caries-like lesions in primary teeth compared to sodium fluoride varnish.
MATERIALS AND METHODS: Twenty-four freshly extracted primary maxillary incisors with standardized 4x4 windows were immersed in demineralizing solution for four days. Teeth were divided into two groups, group I (n=12 teeth); MI varnish and group II (n=12 teeth); Prevident varnish. They were sectioned into two halves in a buccolingual direction (48 specimens). One half was treated with the remineralizing agent and the other half remained untreated and served as its control. Specimens were assigned into subgroup I A (MI varnish) n=12 specimens, subgroup I B (untreated) n=12 specimens, subgroup II A (Prevident varnish) n=12 specimens and subgroup II B (untreated) n=12 specimens. Specimens were subjected to pH cycling for ten days. The specimens were evaluated quantitatively using energy dispersive x-ray spectrometer (EDX).
RESULTS: MI varnish treated specimens (subgroup I A) showed significant high mean Ca, Ca/P ratio than the untreated specimens. Also, Prevident varnish treated specimens showed significant high mean Ca, Ca/P ratio than the untreated specimens. Median percent change of Ca/P ratio of MI varnish treated specimens was significantly higher than Prevident varnish treated specimens.
CONCLUSIONS: Fluoride varnish containing CPP-ACP has a higher remineralization potential of the caries-like lesion in primary teeth in comparison to sodium fluoride varnish.
KEYWORDS: (MI varnish), casein phosphopeptide amorphous calcium phosphate (CPP-ACP), remineralization, fluoride varnish, primary teeth, energy dispersive x-ray spectrometer.


> PDF
13

THERAPEUTIC EFFECT OF PACLITAXEL LOADED ON GOLD NANOPARTICLES IN TREATMENT OF INDUCED ORAL SQUAMOUS CELL CARCINOMA

Sagy L. Asar, Sahar M. El-Sheikh, Fatma H. El-Didi, Marwa M. Essawy, Heba S. Ramadan, Marwa M. Afifi

> Show Abstract

ABSTRACT

INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the sixth most common cancer worldwide with high mortality rate. Conventional treatment strategies have improved but remain far from optimal. Cancer research is focused on improving cancer diagnosis and treatment methods using nanotechnology, by the production and application of nanoscale drug delivery systems. In medicine, several types of nanoparticles have evolved, gold nanoparticle (AuNPs) are an excellent candidate as drug delivery vehicle due to their favorable chemical and optical properties. Paclitaxel (PTX) is an effective antineoplastic drug that has a wide spectrum of antitumor activity, against head and neck malignancies. The encapsulation of PTX in nanodelivery systems can protect the drug from degradation during circulation and protect the body from its toxic side effects.
OBJECTIVES: To study the therapeutic efficacy of PTX-functionalized AuNPs versus the free form of the drug. Also the study will evaluate the treatment, by the use of proliferative immune-histochemical marker (PCNA).
MATERIAL AND METHODS: Squamous cell carcinoma will be chemically induced in sixty Syrian hamsters. Then they will be divided into three groups, 20 in each. One group will be treated with free PTX, another group will be treated with PTX-AuNPs, and the last group will be given saline as negative control group.
RESULTS: Group treated by PTX loaded on AuNPs showed significant results over group treated by free PTX.
CONCLUSIONS: The unique AuNPs properties in combination to the chemotherapeutic drug target cancer cells while maintaining no adverse effects on the surrounding normal cells.
KEYWORDS: OSCC, AuNPs, PTX, PCNA.


> PDF
17

KNOWLEDGE, ATTITUDE, AND REPORTED PRACTICES OF A GROUP OF MINISTRY OF HEALTH DENTISTS TOWARDS PATIENTS WITH DIABETES MELLITUS IN ALEXANDRIA, EGYPT

Myriam A. Saad1 BDS Susan M. Saleh2 PhD, Wafaa Essam Eldin2 PhD

> Show Abstract

ABSTRACT

INTRODUCTION: Diabetes and its acute complications have become a significant health hazard worldwide. To date, there are no data on the awareness of dental professionals regarding the management of diabetic patients.
OBJECTIVES: The objective of this study was to assess the knowledge, attitude and reported practices of Ministry of Health dentists (MOH) regarding the oral complications associated with Diabetes Mellitus.
MATERIALS AND METHODS: This study was a cross sectional descriptive survey of a sample of dentists working in the Egyptian Ministry of Health facilities, in Alexandria. The 349 participants were asked to complete a comprehensive, close-ended questionnaire, to assess the knowledge, attitude, and reported practices regarding diabetic patients. The first section was concerned with the demographic variables of the participating dentists. The second and third sections enquired about the participants’ knowledge and attitudes regarding diabetic symptoms, while the forth section of the questionnaire assessed the respondents’ reported practices concerning diabetic patients and actions taken toward the disease.
RESULTS: Dentists participated in the study (n= 349 from 400 with a response rate of 87.25%) showed that Ministry of Health dentists had a good knowledge and favorable attitude toward diabetic patients visiting the Ministry of Health clinics, however, they had inadequate reported practices toward the same issue.
CONCLUSIONS: THE present study showed relatively high level of awareness of dental practitioners regarding diabetes. Therefore, designing appropriate training programs for oral health care providers in order to enhance their practices towards the diagnosis and management of oral complications of Diabetes is mandatory.
KEYWORDS: Diabetes Mellitus, knowledge, attitude, practice, dentists, Ministry of Health, Egypt.


> PDF
24

ORAL HEALTH STATUS OF CHILDREN UNDERGOING RENAL DIALYSIS IN ALEXANDRIA, EGYPT

Maryam M Quritum, Maha A Hamza, Wafaa E Abdelaziz.

> Show Abstract

ABSTRACT

INTRODUCTION: Advances in pediatric nephrology have resulted in increased survival rates of children on renal dialysis. Renal failure is characterized by multiple organ involvement, including complications in the soft and hard tissues of the oral cavity. Yet, data regarding the oral health status of Egyptian children on renal dialysis is scarce.
OBJECTIVES: The aim of this study was to assess the oral health conditions (dental caries, oral hygiene, gingival condition, calculus and enamel hypoplasia) of children undergoing renal dialysis, in Alexandria, Egypt compared to matched healthy controls.
MATERIALS AND METHODS: This study was conducted on all available (70) end-stage renal disease children undergoing dialysis, aged 6–18 years recruited from Alexandria University Children’s Hospital (AUCH) and its outpatient-clinics (nephrology medicine) and from Sporting Student’s hospital (Health Insurance). The data were compared with that of a gender and age matched control group. Data were collected using an interview questionnaire and clinical examination. The mean df, DMF, GI, Pl.I and CSI scores were recorded. Enamel hypoplasia recorded according to Alaluusa et al criteria was also assessed.
RESULTS: Dialysis children had significantly higher plaque, gingival, CSI and enamel hypoplasia scores whereas mean DMFT was higher among healthy children. No significant differences were observed between groups regarding dft.
CONCLUSIONS: Children undergoing renal dialysis showed significantly worse oral health conditions than healthy controls except for dental caries status. The results of the study suggest a need for dental advice and supervision, and indicate that dental and medical care should be closely integrated for children with renal failure
KEYWORDS: Renal dialysis, Egyptian children, oral health, Alexandria


> PDF
32

EFFECT OF INCREASED CROWN-IMPLANT RATIO ON THE STRAIN DEVELOPED AROUND SHORT DENTAL IMPLANTS (IN VITRO STUDY)

Ala'a M. Khalifa, Ahmed M. Abdelhamid, Mohammed S. Nassif, Sherif M. Eldakkak.

> Show Abstract

ABSTRACT
INTRODUCTION:Implants in atrophic posterior regions of the jaw often require short dental implants leading to increased crown-implant ratio and mechanical stress. Short and small diameter dental implants have been associated with higher risk of biomechanical complications and implant failure. However the use of short implants has become increasingly common due to anatomic limitations and need to avoid surgical rehabilitation of the reduced ridge. .
OBJECTIVES: Evaluation of the effect of increased crown-implant ratio on the strain developed around short dental implants compared to conventional implants length.
MATERIALS AND METHODS: A bounded saddle replica was simulated using polyurethane test blocks where fourteen dental implants have been placed. Specimens were divided into two parallel groups (n=7) according to implant length, Group (I) - implants of conventional length, Group (II) implants of short length. Strain gauges were connected to a strain meter to record the developed strain. A universal testing machine was used for load application up to 100 N. The data were statistically analyzed (p≤0.05).
RESULTS: Group I exhibited the lower mean micro-strain values (512.26 ± 427.39µε) than Group II (804.05 ± 487.37µε). There was no statistically significant difference between both groups (p > 0.05). There was a statistical significance between oblique loads and vertical loads for each group.
CONCLUSIONS: Increasing the crown implant ratio had no significant effect on the strains developed around dental implants.
KEYWORDS: Short Implants, Long Implants, Crown Implant Ratio, Strain gauge.


> PDF
38

VALIDATION OF THE CHILD –ORAL IMPACTS ON DAILY PERFORMANCES QUESTIONNAIRE AMONG GROUP OF11-12YEAR-OLD EGYPTIAN CHILDREN

Mona E. Zaghloul, Hala A. Amer, Amel M. Ahmed

> Show Abstract

ABSTRACT

INTRODUCTION: Oral health related quality of life measure has a great importance at all levels of dental research, it helps to plan evidence based public health policies and indicates how resource allocation should be done.
OBJECTIVES: The aim of this study was to assess the Child-OIDPQ reliability and validity for application among Egyptian children aged 11-12-year-old, as well as determining the prevalence and causes of oral impacts on daily performances in public and private school children in Alexandria.
MATERIALS AND METHODS: Cross-sectional survey performed on 410 randomly selected student aged 11–12 years in the middle district of Alexandria city, Egypt. Data were collected through a self-administered questionnaire; Child-Oral Impacts on Daily Performances questionnaire (Child-OIDP).
RESULTS: The instrument showed acceptable psychometric properties and is considered as a valid, reliable and practical inventory for use among the Egyptian sample. (Cronbach's alpha 0.71 for severity and 0. 70 for frequency). The prevalence of oral impacts was high (85.4 %) of children experiencing some kind of oral conditions affecting their daily life during the past three months. The highest impact was reported on eating (61.9%) followed by cleaning (46.3%) and the lowest impact was on speaking (21.0%). Tooth pain was one of the main perceived causes of impacts on the following 5 performances: duties (35.9%), emotional status (11.1%), sleeping (42.2%), eating (32.0%) and speaking (16.7%). there was no statistically significant difference detected by Mont Carlo exact probability test in the intensity effect of impact between public and private schools
CONCLUSIONS: It was concluded that the Child-OIDP questionnaire can be applied to Egyptian children as a valid measure of oral health related quality of life.
KEYWORDS: oral health; C-OIDP; validity; quality of life


> PDF
45

ESTIMATION OF SALIVARY TUMOR NECROISIS FACTOR-ALPHA LEVEL IN PATIENTS WITH EROSIVE ORAL LICHEN PLANUS (A CASE CONTROL STUDY)

Mona N Elsayed, Naguiba M Elsayed, Sahar E Riad, Sabah A Mahmoud

> Show Abstract

ABSTRACT

INTRODUCTION: Oral lichen planus (OLP) is a relatively common chronic inflammatory and a potentially malignant disorder of oral mucosa. Tumor necrosis factor-alpha (TNF- α) has been pointed as a key cytokine in OLP.
OBJECTIVES: To evaluate whether the salivary levels of TNF- α were changed in patients with erosive oral lichen planus (EOLP).
METHODOLOGY: A total of fourteen cases of EOLP with and without dysplastic changes, along with seven age matched healthy controls were included in this study. Samples of unstimulated saliva was collected, centrifuged and analyzed with enzyme linked immunosorbent assay (ELISA).
RESULTS: There was a statistically significant increase in the salivary levels of TNF- α in patients of the two study groups when compared to the control group.
CONCLUSIONS: TNF- α plays a role in pathogenesis and carcinogenesis of EOLP, and can be used as a useful marker and indicator for subjects at high risk to develop OLP as a potentially malignant lesion.
KEYWORDS: Oral lichen planus, Potentially malignant, Tumor necrosis factor, Saliva.


> PDF
52

THE EFFECT OF TOPICALLY APPLIED HYALURONIC ACID GEL VERSUS TOPICAL CORTICOSTEROID IN THE TREATMENT OF EROSIVE ORAL LICHEN PLANUS

Mohamed I. Youssef, Naguiba M. El Sayed, Zeinab E. Darwis, Rania A. Fahmy

> Show Abstract

ABSTRACT
INTRODUCTION: Oral lichen planus is a common chronic inflammatory muco-cutaneous disease. Although the cause of oral lichen planus is not well known, T-lymphocyte infiltrate suggests a cell mediated immunological damage to basal cell layer of the epithelium. Its suggested treatment is topical corticosteroid. A promising new treatment for oral lichen planus [OLP] is the topical application of hyaluronic acid [HA], which has shown beneficial effect on wound healing.
OBJECTIVES: to evaluate the effect of hyaluronic acid gel in the treatment of erosive oral lichen planus in comparison with topically applied corticosteroids.
MATERIALS AND METHODS: a randomized, parallel, controlled clinical study was conducted on twenty patients who were randomly divided into two groups. Group I received topical application of corticosteroid (triamcinolone acetonide) 4-5 daily, for 28 days and Group II was similarly treated using hyaluronic acid 0.2% gel. Subjective symptom and Visual Analogue Scale (VAS) were recorded at base line, after 10 days and at 3 months. The objective sign clinical score was recorded at baseline, 1 and 3 months post –treatment.
RESULTS: Both groups showed decrease in the lesion size and symptoms of OLP. The HA treated group showed a significantly higher decrease in the pain score in comparison to the corticosteroid treated group. Regarding the healing score, the corticosteroid group showed superior results than that shown with the HA.
CONCLUSIONS: HA 0.2% gel is effective in the treatment of OLP, it resulted in a decrease in symptoms and signs of the disease. HA resulted in more control of pain when compared to topical corticosteroid.
KEYWORDS: Hyaluronic acid gel, topical corticosteroid, oral lichen planus.


> PDF
57

LASER DIODE NEAR-INFRARED TRANSILLUMINATION (DIAGNOCAM) AS A DIAGNOSTIC TOOL IN EARLY DETECTION OF CARIES (IN VITRO STUDY)

Amir N. El-Kholi, Samir A. Koheil, Mona M. Ghoneim

> Show Abstract

ABSTRACT

INTRODUCTION: The importance of early detection before the development of irreversible damage is now generally accepted. Most studies do not report the presence of non cavitated lesions, though they have been shown to have predictive value.
OBJECTIVES: Validate LASER diode near-infrared transillumination (DIAGNOcam) as a diagnostic instrument in the early detection of noncavitated carious lesions.
MATERIALS AND METHODS: Thirty three extracted sound premolars were examined on both approximal surfaces by (D1) EDX to determine Ca/P ions ratio (1.8≤), (D2) Periapical Digital Radiography, and (D3) LASER diode near-infrared transilluminated using DIAGNOcam. Any defect that indicated cavities by any of the mentioned methods discarded the tooth. To confirm that the selected sound teeth were intact, three teeth were randomly selected and invasively imaged by Scanning Electron Microscopy. The remaining thirty teeth were covered with acid resistant varnish except in 3x3mm in approximal areas and were immersed in a demineralizing solution for 72H Then, the teeth were then re-examined using D1, D2 & D3. To confirm that the results obtained, three teeth were randomly selected and invasively imaged by Scanning Electron Microscopy.
RESULTS: D1 detected (100%) Ca/P ions ratio less than 1.8 (demineralized), D2 detected (6.67%) with enamel radiolucency and (93.33%) without any radiolucency, while D3 detected (100%) demineralized enamel. Pearson’s Chi square test as well as validity tests showed that there is a statistically significant difference between D2 and the other diagnostic means (D1 and D3). SEM showed evidence of enamel demineralization in the three randomly selected teeth.
CONCLUSIONS: LASER diode near-infrared transillumination (DIAGNOcam) is a reliable and valid method in detecting early enamel caries demineralization.
KEYWORDS: DIAGNOcam, LASER diode near-infrared transillumination, early detection, noncavitated lesions.


> PDF
64

COMPARATVE EVALUATION OF FAILURE LOAD OF TWO DESIGNS CAD/CAM ZIRCONIA FIXED PARTIAL DENTURES USING LASER SCANNING CONFOCAL MICROSCOPY

Hesham A. Shaheen, Yousrya A. Shalaby, Fayza H. Abbassy.

> Show Abstract

ABSTRACT

INTRODUCTION: Chipping of the porcelain veneer was a common failure of zirconia based restorations, especially in the presence of high occlusal loads. The development of full-contour monolithic zirconia (MZ) restorations promises an end to the heartbreak of fractured esthetic porcelain on posterior restorations. The clinical recommended thickness of zirconia monolithic restorations has not been reported. It is essential to find out a proper thickness guarantee not only the load bearing capacity but also conservation of dental hard tissues.
OBJECTIVES: was to evaluate the failure load of two different preparation designs – (classical and conservative) – in three units monolithic zirconia fixed partial dentures.
MATERIALS AND METHODS: 2 parallel groups (n = 5/group) examined in this study. Group I: Classical tooth preparation design with occlusal reduction of 1.5 mm and rounded 1 mm finish line. Group II: Conservative tooth preparation design with occlusal reduction 0.5 mm and rounded 0.2 mm finish line. All fixed partial dentures (FPDs) adhesively luted on epoxy resin dies and subjected to thermal cycling and cyclic loading corresponding to 6 months of clinical service. Specimens then loaded till failure in a universal testing machine. The load of failure recorded in Newton. Fractographic analysis was done using stereomicroscope, scanning electron microscope (SEM) and confocal laser scanning microscope (CLSM). Data statistically analyzed using Student t-test.
RESULTS: None of the FPDs failed during the aging process. Mean of failure load of Group I was 1317.36 ± 186.11 N and for Group II was 1215.92 ± 217.03 N without significant difference between the groups (P =0.450).
CONCLUSIONS: The conservative tooth preparation design of the posterior three units FPDs was a very good alternative to the classical one. Aging behavior, translucency testing, color reproduction and long-term clinical performance need to be further assessed before recommending this conservative FPDs design for daily practice.
KEYWORDS: Fixed Partial Denture, Zirconia, Monolithic, Preparation Design.


> PDF
70

ACCURACY OF CONE BEAM COMPUTED TOMOGRAPHY (CBCT) IN ASSESSMENT OF MANDIBULAR MOLAR FURCATION DEFECTS AS COMPARED TO THE INTRA-OPERATIVE FINDINGS

Hisham M. Warda, Yousria S. Gaweesh, Adel M. Rizk, Rania A. Fahmy

> Show Abstract

ABSTRACT

INTRODUCTION: The precise assessment of mandibular molar furcation defects is crucial before a prognosis and a treatment strategy can be established. The use of CBCT in periodontology has led to an increased precision in diagnosis of bone morphology.
OBJECTIVES: The aim of this study is to determine the accuracy of cone beam computed tomography (CBCT) in the assessment of mandibular molar furcation defects when compared to intra-surgical assessment.
MATERIALS AND METHODS: The study included 19 mandibular molar furcation defects. Three different CBCT measurements were taken: (bone loss in the horizontal direction – ‘BL-H’), degree of bone loss in vertical direction (BL-V) and width of the furcation entrance (FW). Measurements were compared to the intra-surgical measurements and results were statistically analysed.
RESULTS: There was no significant difference between measurements taken using CBCT and measurements taken intra-surgically giving a p value of 0.101, 0.201 and 0.910 for FW, BL-V and BL-H respectively.
CONCLUSIONS: CBCT is an accurate way in assessing mandibular molar furcation defects
KEYWORDS: CBCT, Furcation, Mandibular molar.


> PDF
75

MINIMALLY INVASIVE IMPLANT MANDIBULAR OVERDENTURE FOR TYPE-1 DIABETIC PATIENTS

Lubna M. Eldidi, Ahmad M. Abdelhamid, Ahmed M. Hommos, Sherif M. Eldakkak, Hanaa T. El Zawawy

> Show Abstract

ABSTRACT

INTRODUCTION: Diabetes Mellitus (DM) is a systemic disease that affects large part of the population and is considered a relative contraindication to implant therapy. However, there are studies showing that the survival rate of implants in type-2 diabetic patients is approximately 90%, approaching that of non-diabetic patients. It is also shown that these results are strictly correlated with the importance of glycemic control to provide predictability of success rates and improve osseointegration of the implants inserted. There is no evidence whether controlled type-1 diabetes is or is not a risk factor for implant failure.
OBJECTIVES: The objective of this study was to clinically and radiographically evaluate the success of implant overdenture in controlled type-1 diabetic patients.
MATERIALS AND METHODS: Ten completely edentulous well controlled type-1 and ten non-diabetic patients were selected and divided into group I and II respectively. All patients received three implant assisted mandibular overdentures through minimally invasive flapless technique. Clinical evaluation of implant stability was performed using Osstell ISQ immediately after implant placement (base line), four months and one year after prosthesis insertion. Level of alveolar bone loss around each abutment was also evaluated using Cone Beam Computed Tomography (CBCT) at the time of final prosthesis insertion (base line), four months and one year after insertion.
RESULTS: Of the ten patients in the study group, two patients were lost yielding a success rate of 80 % in group I. Clinical results of implant stability test showed significant decrease in stability in the study group as compared to the control group, also radiographical results revealed significant increase in amount of average crestal bone loss in the diabetic patients.
CONCLUSIONS: Within the limitations of this study, and based on the clinical level, the implant overdenture may be recognized as being predictable treatment option for controlled type-1 diabetic patients.
KEYWORDS: Diabetes, Type 1, Implant overdenture, Minimally Invasive.


> PDF
81

RELATION OF CONE BEAM COMPUTED TOMOGRAPHY ASSESSMENT OF MANDIBULAR BONE DENSITY TO DUAL ENERGY X-RAY ABSORPTIOMETRY IN TYPE 2 DIABETES MELLITUS PATIENTS

Lobna M. El Saadawy, Rania A. Fahmy, Khaled A. Matrawy, Mohammed H. Zeitoun, Yousria S. Gaweesh.

> Show Abstract

ABSTRACT

INTRODUCTION: One of the complications associated with diabetes mellitus is decrease in bone mineral density (BMD). Therefore, quantification of BMD for these patients before a dental implant procedure is essential. Cone beam computed tomography (CBCT) is an important tool that can be used for qualitative and quantitative bone assessment for treatment planning of dental implants.
OBJECTIVES: Evaluation of mandibular bone mineral density measured by CBCT and its correlation to T-score obtained by dual energy x-ray absorptiometry (DEXA) in relation to blood glycemic control as detected by glycosylated hemoglobin (HbA1c) in type 2 diabetic patients (T2DM).
MATERIALS AND METHODS: The study was conducted clinically on twenty-four patients having T2DM, referred for CBCT examination as a part of implant planning. BMD was measured for each edentulous mandibular space using CBCT scan. The patients were grouped according to the level of HbA1c into 4 groups; control group, well-controlled group, moderately controlled group and poorly controlled group. Additionally, each candidate was examined radio-graphically using DEXA. Then, a statistical correlation between HbA1c values in relation to mandibular BMD values and T-score values was investigated.
RESULTS: there was a statistically significant correlation between HbA1c values and BMD variables including: mandibular edentulous quad BMD and T-score values (p <0.001), and a statistically significant correlation between T-score value and Mandibular edentulous quad BMD (p <0.001). CONCLUSIONS: Osteoporosis is a commonly underestimated problem in diabetes patients. Osteoporosis can be predicted using CBCT, so it’s the dentist responsibility to refer osteoporotic patients once being suspected. KEYWORDS: CBCT, BMD, DEXA, type 2 diabetes, Osteoporosis.


> PDF
87

Shear Bond Strength of different resin-based materials Processed on Poly-ether-ether ketone frameworks (IN VITRO STUDY)

Mohamed A. Eltombakshy, Mohamed S. Elattar, Dawlat M. Ahmed

> Show Abstract

ABSTRACT

INTRODUCTION: Removable partial dentures (RPDs) are fabricated to replace the lost teeth of a partially edentulous individual. The serviceability of an RPD is dependent on the bond strength at the resin–framework interface. The esthetically unacceptable display of metal clasps, the increased weight of the prosthesis, the potential for metallic taste, and allergic reactions to metals led to the introduction of a number of thermoplastic materials in clinical practice such as nylon and acetal resins. An alternative restoration material (poly-ether-ether-ketone [PEEK]) has been successfully used over the last years.
OBJECTIVES: to evaluate the shear bond strength and the effect of aging on bond strength of two different resin based materials to poly-ether-ether-ketone [PEEK].
MATERIALS AND METHODS: Fifty two PEEK cylinders was prepared. Specimens was randomly assigned into two parallel groups, 26 specimens each according to the resin materials used. The bond strength and aging of resin material to poly-ether-ether-ketone [PEEK] was evaluated.
RESULTS: the initial shear bond strength of PMMA to PEEK was significantly higher than that of composite resin to PEEK. However, after aging process the shear bond strength of PMMA to PEEK decreased while that of composite resin to PEEK remained unchanged. There was no significant difference between the shear bond strength of both PMMA and composite resin to PEEK after aging.
CONCLUSIONS: PMMA can be used as a veneering material with PEEK with comparable results to traditionally used composite resin. Moreover, owing to the adequate bond strength between PEEK and PMMA, PEEK frameworks could be relined in the traditional method similar to metal frameworks
KEYWORDS: PEEK, PMMA, Composite resin, Shear bond strength, Thermocycling, in vitro.


> PDF
93

VENEERING THICKNESS EFFECT ON THE OPTICAL PROPERTIES OF PEEK RESTORATIONS (IN VITRO STUDY)

Mohamed G. El-Sawaf, Yehia S. Aboushady, El-Shabrawy S

> Show Abstract

ABSTRACT

INTRODUCTION: Polyetheretherketone (PEEK) can be used as a core material for fixed prosthodontics. However, information about the optimum veneer thickness of veneered PEEK restorations is still scarce.
OBJECTIVES: To evaluate the effect of different composite veneer thickness on the optical properties of PEEK restorations.
MATERIALS AND METHODS: Twenty four (n=24) PEEK (BioHPP granules) core disc-shape specimens of 15 mm diameter and 0.8 mm thickness were fabricated and veneered with composite resin (crea-lign, shade A3). The specimens were divided into three groups according to the veneering thickness: core/veneer thickness (mm) of 0.8/1.0, 0.8/1.5, and 0.8/2.0 for groups I, II, and III, respectively. The clinical spectrophotometer (VITA Easyshade) was used for color comparison with the reference color data of the selected shade stored in the device. Statistical analysis was performed with one-way analysis of variance (ANOVA) and student (Unpaired-sample) “t” test.
RESULTS: The veneering thickness significantly influenced the ΔE values (p < 0.001). The mean color difference (ΔE) values for groups I, II and III were found to be 8.22(±0.41), 5.13(±0.43) and 3.23(±0.34), respectively. CONCLUSIONS: Color of PEEK restorations was significantly affected by the veneer thickness. The veneer thickness of 2.0 mm showed the best color match with perfect masking ability of the underling PEEK core(ΔE<3.3). In contrast, the veneer thickness of 1.0 and 1.5 mm showed a poor color match with poor masking ability of the underling PEEK core (ΔE>3.3).
KEYWORDS: PEEK, veneering thickness, color difference.


> PDF
99

EVALUATION OF A NEWLY FORMULATED AUTO-POLYMERIZED ACRYLIC RESIN PERMANENT DENTURE BASE MATERIAL (In Vitro Study)

Najat A. Mohamed, Ahmed M. Abdelhamid, Sonia M. El Shabrawy.

> Show Abstract

ABSTRACT

INTRODUCTION: Auto-polymerizing acrylic resin with pour technique provides an alternative method to conventional compression-molding processing for denture base resin. This technique offered improved adaptation, dimensional stability, reduced cost and simplicity of procedure.
OBJECTIVES: To investigate some of the physico-mechanical properties of a newly formulated auto-polymerized pour resin permanent denture base material and compare them with conventional heat cured resin.
MATERIALS AND METHODS: The study was conducted on two parallel groups according to the denture base material used Group (I) conventional heat cured resin (control group), Group (II) newly formulated auto-polymerized pour resin (study group) of 35 specimens each (14 for impact strength test, 14 for flexural strength test, 7 for warpage test and grinded powder from the cured material for estimation of residual monomer test). Will be examined in this in vitro study. Each group was divided into 2 subgroups: (A) Zero-thermo-cycling (no thermo-cycling) and (B) Thermo-cycling, then subjected to 4 different tests, impact strength, flexural strength, warpage and quantitative analysis for estimation of residual monomer test. All data from both groups in this in-vitro study was gathered, tabulated and statistically analyzed. RESULTS: The results showed that denture bases processed from auto-polymerized pour resin exhibit high adaptation (low warpage) comparable to those heat cured, and this adaptation significantly increased after thermo-cycling, on other hand, results revealed significantly high amounts of residual monomer of pour resin in both condition (before & after thermo-cycling) in comparison with heat cured resin with significant reduction in these levels after thermo-cycling for both materials. While the impact strength of pour resin was significantly lower than heat cured with no significant increase of flexural strength.
CONCLUSIONS: Auto-polymerized pour resin exhibit high adaptation accuracy which is related to the investing medium & technique of processing. On the other hand, containing high amount of residual monomer affecting the physico-mechanical properties. Generally, thermal-cycling improve the mechanical and bio-compatibility of the material.
KEYWORDS: Auto-polymerized, pour resin technique, impact strength, flexural strength, warpage, residual monomer.


> PDF
103

MICROLEAKAGE EVALUATION OF BULK-FILL COMPOSITE IN CLASS II RESTORATIONS OF PRIMARY MOLARS

Najla A. Eltoum, Niveen S. Bakry, Dalia M. Talaat, Sonia M. Elshabrawy

> Show Abstract

ABSTRACT

INTRODUCTION: Bulk-fill composites are promising restorative materials which may minimize placement time yet provide successful, durable esthetic restoration.
OBJECTIVES: The purpose of this in vitro study was to evaluate marginal microleakage of nano-hybrid bulk-fill composite, and compare it to incrementally placed conventional nano-hybrid composite when used to restore proximal cavities in primary molars.
MATERIALS AND METHODS: The sample consisted of 44 freshly extracted sound primary molars. Standardized proximal cavity preparations were prepared and the sample was divided randomly into 2 equal groups: Group I (n=22): Teeth were restored with nano-hybrid bulk-fill composite, Group II (n=22): Teeth were restored with incrementally placed conventional nano-hybrid composite. All specimens were thermocycled and immersed in 2% methylene blue dye at 37C˚ for 24 hours. Methylene blue penetration was assessed on a 4 point grading scale (0 to 3) using a stereomicroscope to evaluate the microleakage of the restorations. Data were statistically analyzed using Mann-Whitney test and Wilcoxon Signed Ranks test.
RESULTS: No statistically significant difference has been found in the microleakage scores of group I at occlusal and cervical margin (p=1.000). In group II, no statistically significant difference has been found in the microleakage scores between occlusal and cervical margins (P=0.366). Comparing the microleakage scores of group I and group II, no statistically significant difference has been found (p=0.240). Although no significant difference was detected, bulk- fill composite showed lower microleakage scores than incrementally placed conventional composite.
CONCLUSIONS: Bulk-fill composite restoration marginal integrity was comparable to incrementally placed conventional composite in proximal cavities of primary molars.
KEYWORDS: composite, bulk-fill, microleakage, class II, primary molars.


> PDF
111

EXPRESSION OF Ki-67 AND CD105 MARKERS IN ORAL SQUAMOUS CELL CARCINOMA

Raghda M. Abdelbary, Mohamed S. Elzarka, Hamed A. Fouad, Mohammed M. Fata.

> Show Abstract

ABSTRACT

INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the commonest malignancy in the oral cavity. It is influenced by genetic modifications; as well as numerous environmental factors, such as smoking, tobacco chewing, alcohol consumption, infection by oncogenic viruses, and low intake of fruits and vegetables. CD105 has been introduced as a marker for angiogenesis which stains vessels that are in the proliferating stage. Ki-67is a nuclear protein that is recognized as a nuclear antigen present in proliferating cells, but absent in resting cells.
OBJECTIVES: To evaluate and correlate the expression of Ki-67 and CD105 in different histopathological grades of OSCC.
MATERIALS AND METHODS: Immunohistochemical (IHC) study using the Ki-67 and CD105 antibody was done on 20 surgical specimens and 5 normal mucosal tissues taken from OSCC patients and healthy individuals respectively.
RESULTS: Remarkable improvement in the histology and the ultrastructure of the alveolar bone of rats in Group III was observed. Moreover, hematological values revealed significant decrease in the inflammatory condition of rats with induced RA after fish oil treatment.
CONCLUSIONS: Ki-67 and CD105 are expressed in OSCC biopsies. Additionally, the fraction of Ki-67positive tumor cells (the Ki-67 labeling index) is often correlated with the clinical course of OSCC. CD105 microvessel density can be a useful factor for predicting the course of oral squamous cell carcinoma
KEYWORDS: Oral Squamous Cell Carcinoma, Ki-67, CD105, Imunohistochemistry, Angiogenesis.


> PDF
117