2015 Jul-Sep; Vol 6, No 3
Efficacy of Reciproc® and Profile® Instruments in the Removal of Gutta-Percha from Straight and Curved Root Canals ex Vivo
J Oral Maxillofac Res 2015;6(3):e1
Objectives: To compare the efficacy of Reciproc® (VDW GmbH) and ProFile® (Dentsply Maillefer) instruments at removing gutta-percha from straight and curved root canals ex vivo filled using the cold lateral condensation and GuttaMaster® (VDW GmbH) techniques.
Material and Methods: Forty mesial roots of mandibular molars with two curved canals and 80 single-rooted teeth with straight root canals, a total of 160 root canals, were randomly assigned to eight groups (canals per group = 20) according to filling technique, retreatment instrument and root canal curvature as follows: Group I, cold lateral condensation/ProFile®/straight; Group II, cold lateral condensation/ProFile®/curved; Group III, cold lateral condensation/Reciproc®/straight; Group IV, cold lateral condensation/Reciproc®/curved; Group V, GuttaMaster®/ProFile®/straight; Group VI, GuttaMaster®/ProFile®/curved; Group VII, GuttaMaster®/Reciproc®/straight; and Group VIII, GuttaMaster®/Reciproc®/curved. The following data were recorded: procedural errors, retreatment duration and canal wall cleanliness. Means and standard deviations were calculated and analysed using the Kruskal-Wallis test, one-way analysis of variance and Tukey’s test (P < 0.05).
Results: Reciproc® instruments were significantly faster than ProFile® instruments at removing GuttaMaster® from both straight (P = 0.0001) and curved (P = 0.0003) root canals. Reciproc® were statistically more effective than ProFile® instruments in removing GuttaMaster® from straight root canals (P = 0.021). Regardless of filling technique or retreatment instrument, gutta-percha was removed more rapidly from curved than from straight root canals (P = 0.0001).
Conclusions: Neither system completely removed filling material from the root canals. Compared with ProFile® instruments, Reciproc® instruments removed GuttaMaster® filling material from straight and curved root canals more rapidly.
Keywords: endodontics; retreatment; root canal.
Effectiveness of a Motivation and Practical Skills Development Methods on the Oral Hygiene of Orphans Children in Kaunas, Lithuania
J Oral Maxillofac Res 2015;6(3):e2
Objectives: The aim of this study was to evaluate the effect of a motivation and practical skills development methods on the oral hygiene of orphans.
Material and Methods: Sixty eight orphans aged between 7 and 17 years from two orphanages in Kaunas were divided into two groups: practical application group and motivation group. Children were clinically examined by determining their oral hygiene status using Silness-Löe plaque index. Questionnaire was used to estimate the oral hygiene knowledge and practices at baseline and after 3 months. Statistical analysis included: Chi-square test (χ2), Fisher‘s exact test, Student‘s t-test, nonparametric Mann-Whitney test, Spearman’s rho correlation coefficient and Kappa coefficient.
Results: All children had a plaque on at least one tooth in both groups: motivation 1.14 (SD 0.51), practical application 1.08 (SD 0.4) (P = 0.58). Girls in both groups showed significantly better oral hygiene than boys (P < 0.001). After 3 months educational program oral hygiene status improved in both groups significantly 0.4 (SD 0.35) (P < 0.001). Significantly better oral hygiene was determined in practical application group 0.19 (SD 0.27) in comparison with motivation group 0.55 (SD 0.32) (P < 0.001). By comparing results of first and second questionnaire surveys on use of soft drinks, the statistically significant decline of their use was in both groups (P = 0.004).
Conclusions: Educational programs are effective in improving oral hygiene, especially when they’re based on practical skills training.
Keywords: adolescent; child; oral hygiene; oral hygiene index; orphanages; motivation.
Impact of Dentofacial Deformity on Quality of Life: Age and Gender Differences Evaluated Through OQLQ, OHIP and SF36
J Oral Maxillofac Res 2015;6(3):e3
Objectives: The aim of this study was to verify the impact of dentofacial deformity on quality of life and explore gender and age differences.
Material and Methods: The impact of dentofacial deformity (DD) on quality of life was evaluated through questionnaires; Short Form Health Survey (SF36), Oral Health Impact Profile Questionnaire (OHIP), Orthognathic Quality of Life Questionnaire (OQLQ) and a single question answered by a Visual Analogue Scale.
Results: Significant differences between male and female patients were observed in domains of OQLQ (oral function, P = 0.006; awareness of facial deformity, P = 0.018; and facial aesthetics, P < 0.001) and OHIP (physical pain, P = 0.006; psychological discomfort, P = 0.007; psychological disability, P = 0.006; and handicap, P = 0.01).
Conclusions: The impact of dentofacial deformity was more pronounced in female Brazilian population. Age of patients with dentofacial deformity produced impacts over quality of life in different ways and according to the applied questionnaire and the interaction between age and gender may also produce different impacts in patients with dentofacial deformity. The domains of Orthognathic Quality of Life Questionnaire, Oral Health Impact Profile Questionnaire and Short Form Health Survey showed unaccepted distances in the pattern of answer rising doubts of their ability to assess quality of life as a generic and broad concept. There is a necessity to create a single quality of life instrument capable to measure impacts with sensitivity and specificity and from a generic concept to condition-specific health problem.
Keywords: dentofacial deformities; quality of life; oral health; questionnaires.
Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?
J Oral Maxillofac Res 2015;6(3):e4
Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction.
Material and Methods: We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula) transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units. Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test.
Results: Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001). There was a statistical significant increase in bone density in cortical (P < 0.001) and cancellous (P = 0.004) bone.
Conclusions: Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time.
Keywords: bone; bone transplantation; dental implants; free tissue transfer flap; mandibular reconstruction.
Development of a Titanium Plate for Mandibular Angle Fractures with a Bone Defect in the Lower Border: Finite Element Analysis and Mechanical Test
J Oral Maxillofac Res 2015;6(3):e5
Objectives: The aim of the present study was to develop a plate to treat mandibular angle fractures using the finite element method and mechanical testing.
Material and Methods: A three-dimensional model of a fractured mandible was generated using Rhinoceros 4.0 software. The models were exported to ANSYS®, in which a static application of displacement (3 mm) was performed in the first molar region. Three groups were assessed according to the method of internal fixation (2 mm system): two non-locking plates; two locking plates and a new design locking plate. The computational model was transferred to an in vitro experiment with polyurethane mandibles. Each group contained five samples and was subjected to a linear loading test in a universal testing machine.
Results: A balanced distribution of stress was associated with the new plate design. This plate modified the mechanical behavior of the fractured region, with less displacement between the fractured segments. In the mechanical test, the group with two locking plates exhibited greater resistance to the 3 mm displacement, with a statistically significant difference when compared with the new plate group (ANOVA, P = 0.016).
Conclusions: The new plate exhibited a more balanced distribution of stress. However, the group with two locking plates exhibited greater mechanical resistance.
Keywords: facial injuries; finite element analysis; jaw fixation technics; fracture osteosynthesis.