Evaluation of Bacteriological Profile in the Apical Root Segment of the Patients with Primary Apical Periodontitis.

INTRODUCTION: Apical periodontitis usually results from bacterial accumulation and contamination occurring in the root-canal system, and extending beyond the apical foramen to involve the periapical tissues. Literature has a paucity of the studies that stress on the division and analysis of the pulp canal segments. The reason for this disparity might be the technique used for collecting the samples from the pulp canals. Hence, we carried out the present study to evaluate the microbial flora in the apical part of the roots with necrotic pulp canals. MATERIALS AND METHODS: The present study included the assessment of 40 freshly extracted teeth that had necrotized pulpal tissue along with the presence of periapical periodontal lesions. Removal of the soft tissue lesions attached to the root portion of the teeth along with apical periodontal lesions was done with the help of scalpel blade, after rinsing them with a sterile solution of saline. Thorough cleaning of the root surfaces was done with hydrogen peroxide followed by rapid disinfection with the help of sodium hypochlorite at varying concentrations. Sectioning of the root portion of all the specimens with the help of a disk was done perpendicular to the long axis of the teeth at a distance of roughly 5 to 6 mm from the teeth's apicalmost point. Cryotubes were used for transferring the specimens of apical portions containing 1 mL of buffer and were subjected to immediate frozen processing at a temperature of -20°C. A 10 K-type file was used for the initial collection of the samples followed by subsequent incubation of the files and paper pints in the incubation cabinet. Subsequent deoxyribonucleic acid (DNA) extraction from the samples was done following the procedure described by Siqueira et al. Paster et al's modification of the reverse-capture checkerboard assay was used in the present study. Semiquantitative data were used for overcoming the difficulties arising due to obtaining the counts of the polymerase chain reaction (PCR)-based analysis of specimens. RESULTS: A positive result for the 16S ribosomal ribonucleic acid (rRNA) gene primer was observed only in two examined specimens of all the samples of the apical portion of the root canals in the present study. Negative result was shown by all the control group specimens, which were sterile samples. Presence of bacteria was confirmed by PCR in 38 out of 40 examined specimens. Amount of bacterial taxa, out of these 24 samples, ranged up to 6. Pseudoramibacter alactolyticus, Porphyromonas endodontalis, Dialister oral species, Bacteroidetes species, Streptococcus species, Olsenella uli, Synergistes species, Fusobacterium nucleatum, Parvimonas micra, Treponema denticola, and Filifactor alocis were the specific species detected. Bacteroidetes species was the only species that were detected at levels at or above 105. Heavy bacterial infections were noticed in more than 45% of the cases at the periradicular part of the root canals. CONCLUSION: Microbial flora of the apical segment of the root with necrotized pulp tissue comprises a vast variety of pathogenic bacteria. CLINICAL SIGNIFICANCE: For better prognosis of the treatment of such cases, adequate knowledge of the microbial flora of the root, especially the apical portion is necessary.

In vitro Comparison of Impact of Different Bleaching Agents on the Microhardness of Enamel.

BACKGROUND: Various agents are used these days for increasing the esthetics. One such procedure is bleaching that offers various advantages, as it is minimal invasive and cheap option to color the teeth and remove stain. The altered enamel after the bleaching process shows surface demineralization and porosities. The present study aimed to evaluate the effect of different bleaching agents on the microhardness of enamel. MATERIALS AND METHODS: A total of 100 freshly human extracted maxillary premolar teeth were selected for the study. Teeth with sound tooth structure were included for the study. All the specimens were randomly divided into four groups with 25 specimens in each group depending upon the type of bleaching agent used: Group A, artificial saliva (Control group); Group B, 35% hydrogen peroxide (HP); Group C, 25% HP; Group D, 10% carbamide peroxide (CP). Knoop Hardness Number (KHN) was calculated at 24, 48-hour, and 7-week interval. RESULTS: Results showed no statistical significant differences between the microhardness of enamel of different groups (p < 0.005). A slight fall in the value of KHN was seen in all the groups, except for the control group, although the results were statistically nonsignificant (p > 0.005). CONCLUSION: Although nonsignificantly, all the bleaching solutions produced some amount of alterations in the microstructure of enamel. More studies with higher study groups and more advanced estimation technologies are required to minimize microstructure alterations and promote for better outcome of bleaching procedures.

Comparative Evaluation of C-reactive Proteins in Pregnant Women with and without Periodontal Pathologies: A Prospective Cohort Analysis.

INTRODUCTION: Inflammation of tooth supporting structures is referred to as periodontitis. C-reactive proteins (CRP) levels are usually increased in case of chronic inflammatory process like periodontitis. Association of CRP with pregnancy has been observed in the past, which includes most commonly preterm delivery, preeclampsia, etc. Therefore, it can be hypothesized that CRP may act as a link between periodontitis and adverse pregnancy outcomes. Hence, we aim to evaluate the plasma CRP levels in pregnant women with and without periodontal pathologies. MATERIALS AND METHODS: The study included 210 pregnant women who reported to the hospital with periodontal problems and for routine checkups. All the patients were divided into three groups based on the presence and absence of periodontal pathologies. Russell's Periodontal Index Score was used for the evaluation of periodontal status of the subjects. RESULTS: While comparing the mean CRP levels in all the three study groups, statistically significant results were obtained. Statistically significant results were obtained while comparing the mean CRP levels in group C patients before treatment and after treatment therapy. The CRP levels were estimated by taking blood samples. Paired t-test and one-way analysis of variance was used to assess the correlation between the two parameters. CONCLUSION: Casual association might exist between the CRP levels and periodontal diseases in pregnant women and the CRP levels may also get elevated in pregnant women.

Effects of commonly consumed beverages on surface roughness and color stability of the nano, microhybrid and hybrid composite resins: an in vitro study.

BACKGROUND: Consumption of certain beverages may affect the esthetic and physical properties of the resin composite, thereby undermining the quality of restorations. AIM: To analyze the effect of three beverages (cola, coffee, tea) on color stability and surface roughness of three different types of resin composites at various time intervals in vitro. MATERIALS AND METHODS: Nano, microhybrid and hybrid resin composites were used. Each material was randomly divided into four equal subgroups of 10 samples each according to the beverages used (cola, coffee, tea, distilled water). The samples were immersed in each beverage for 1, 15 and 30 days. Surface roughness and color changes measurements were noted at the baseline-the first, fifteenth and thirteenth day. RESULTS: It was found that nanoresin composite followed by microhybrid and hybrid showed least surface roughness and color change. The Coke beverage subgroup showed more surface roughness and the subgroup coffee has shown more color changes with respect to other subgroups. CONCLUSION: All specimens showed discoloration after completion of the test period which was visually perceptible and clinically unacceptable. At the end of 30th day, among the materials, nanofilled composite resin showed comparatively less surface roughness and color change than microhybrid and hybrid composite resins.

Assessment of the Survival of Dental Implants in Irradiated Jaws Following Treatment of Oral Cancer: A Retrospective Study.

BACKGROUND: In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasing widely used. Therefore, we evaluated the success of dental implants in the irradiated jaws of patients following treatment of oral cancer oral cancer treated patients. MATERIALS AND METHODS: Data of oral cancer treated patients was collected retrospectively from 2002 to 2008. We took 46 oral cancer treated patients in which implants were placed in irradiated jaws for rehabilitation. RESULTS: It was found that out of 162 dental implants placed, 52 failed. Furthermore, there was no variation in the implant survival rate in between both the jaws. Radiation dose of <50 Gy units also showed significantly increased amount of implant survival rate. CONCLUSIONS: Implant survival is multifactorial and depends upon a number of factors like level of radiation exposure in that area, time gap between last radiation doses etc., Further research is required in this field to improve the esthetics and quality of life of cancer treated patients.

A pioneering study of dental fluorosis in the libyan population.

BACKGROUND: Fluorosis is a condition resulting from excessive ingestion of fluoride during early childhood leading to the formation of defective enamel. The increased fluoride content is thought to result in a metabolic alteration of ameloblasts, which results in defective matrix, and improper calcification of teeth. MATERIALS AND METHODS: A total of 6244 patients between the ages of 6yrs to 60yrs, who presented to our outpatient clinic from October 2009 to December 2010 were included in the study. The study subjects were grouped according to their age into the following groups- 6-14 yrs, 15-25 yrs, 26-40 yrs, and 40-60yrs. Only permanent dentition was taken into consideration in this study. RESULTS: The overall prevalence of fluorosis in this study was 63.34% (3955 of 6244 patients). Men had a slightly higher prevalence of 64.27% compared to 62.28% among women. CONCLUSION: Prevention of fluorosis would require efforts at raising awareness among the people about the harmful effects of their dietary choices on their teeth. They also need to be educated about adequate and proper oral hygiene, such as brushing their teeth at least two times daily. How to cite this article: Sunil T K L, Shetty S, Annapoorna B M, Pujari S C, Reddy P S, Nandlal B. A Pioneering Study of Dental Fluorosis in the Libyan Population. J Int Oral Health 2013; 5(3):67-72.