Even with the evolution of chemotherapeutic procedures and agents, chemotherapy may cause certain side effects that impair the patients’ quality of life. The aim of this review is to isolate and describe the oral side effects arising only from chemotherapy and focus on the dentist’s contribution to their management. This paper comprises an extensive literature review of the main side effects affecting the oral health status of patients’ undergoing chemotherapy procedures. In addition, it describes the dentist’s contribution in the treatment of such patients before, throughout and after antineoplastic therapy. In conclusion, the oral cavity is a usual site of discomfort and pain caused by chemotherapy, making the dentist’s contribution to the patient’s relief imperative.

Aim: To evaluate a novel approach for reinforcing 2 types of provisional restoration materials [polymethylmethacrylate (PMMA) and bis-acryl resin] with different concentrations of silica gel powder (0%, 0.5%, 1%, 1.5%, 3%, 5%, 10% by weight).

Methods: A total of 60 rectangular fracture toughness specimens were prepared in this study according to the ISO 13586 Standard with dimensions of 2 mm × 5 mm × 25 mm. The specimens were divided into 2 groups according to the materials used PMMA or bis-acryl. Each subgroup was divided into 6 subgroups according to the different silica gel concentrations (0%, 0.5%, 1.5%, 3%, 5%, and 10% by weight) added where the 0% subgroup was used as a control group. Fracture toughness for the specimens was determined by loading the specimens in a universal testing machine.

Results: The results showed that addition of 0.5% by weight of the silica gel powder for PMMA recorded the highest mean value (2.69 ± 0.08 MPa•m^1/2) and this was statistically significant.

Conclusion: Within the limitation of this study it was concluded the addition of 0.5% by weight silica powder gel could increase the fracture toughness of PMMA.

This paper reports a case of a recurrent periapical cyst treated with enucleation of the lesion, apicoectomy, and root end obturation on a lower left first molar. In the case of conventional root canal treatment failure, non-surgical retreatment is the preferred option in most of the cases. Several factors such as a complex root canal system or previous procedural accidents may impede the success of non-surgical retreatment. The authors have performed root-end resection and preparation under local anesthesia on a lower left first molar; The root canal filling is placed within the new cavity to close the path of communication between the infected root canal system and periradicular structures with an intermediate restorative material. The lesion was fully enucleated and sent for histopathology. The 29-year-old female patient was followed up at 2 weeks, 3 and 6 months presenting as a functional and symptomless tooth. Radiographic findings showed a clear and progressive refilling of the cavity with bone. All these factors highlight a positive prognosis for the tooth after periradicular surgery, which is now considered a valid treatment to keep the tooth as a functional unit in the oral cavity.

Aim: The aim of this study was to evaluate the effect of asthma on dentoalveolar morphology in the developing child.

Methods: This study was conducted on 50 asthmatic Egyptian children and 50 non-asthmatic Egyptian children. Each child’s dental casts of the maxilla and mandible were analyzed. The upper and lower intercanine width, the upper and lower inter-molar width (UIMW-LIMW), the upper and lower arch length, and the palatal depth were determined.

Results: Children with asthma demonstrated higher mean values in more than one of the parameters measured when compared with the mean values of non-asthmatic children for both genders. In general, the UIMW of asthmatic children had lower mean values when compared with the mean value of non-asthmatic children, except when compared regarding gender. A Student t-test noted a significant difference in UIMW and LIMW in male children.

Conclusion: Asthma has an effect on upper and lower dental arch dimensions in both genders.

Aim: To introduce bifocal distraction osteogenesis (BDO) and subsequent endosseous dental implant placement as an overall method for reconstruction of complete maxillary and mandibular segmental defects.

Methods: Within the authors' whole series, 29 patients showing bony segmental defects within the maxillofacial skeleton underwent BDO. The authors focus on 3 patients who were further rehabilitated with endosseous dental implants into the distracted bone.

Results: The overall BDO success rate was 79%. The 3 reported cases underwent dental implant rehabilitation with 4, 6, and 5 endosseous dental implants, respectively. No relevant complications were observed, except for intraoral scarring in one patient, and pain at the end of the distraction phase in another patient. Adequate attached gingival tissue was obtained for maxillary and mandibular distracted bone in all the cases.

Conclusion: Three cases of segmental maxillo-mandibular defects that have been reconstructed by bifocal distraction osteogenesis and further rehabilitated with endosseous dental implants. Surgeons must keep in mind this technique as an alternative to bone microsurgical reconstruction in cases in which free flaps are contraindicated or extended surgical time has to be avoided.

Aim: The purpose of this in vitro study was to determine the optimum margin thickness which allows more conservative tooth preparation, thus giving space for the veneer material and to evaluate the effect of the processing technique on fracture resistance of IPS e.max^® copings.

Methods: Forty all lithium disilicate copings were divided into 2 equal groups according to the construction technique; twenty copings each (n = 20) per group. Each group was further subdivided into 2 equal subgroups according to the coping margin thickness; 0.5 mm and 0.7 mm (n = 10/subgroup). Two dies were prepared with 5 mm cervical diameter, 60° axial taper, and 5 mm occluso-cervical height with the non-anatomical occlusal table. Copings were constructed using heat pressing and CAD/CAM milling techniques, and were cemented on epoxy dies using RelyX™ Unicem resin cement. Samples underwent pre-loading in a cyclic manner equivalent to the average masticatory cycle. Afterward, samples were loaded until fracture using the same computer controlled material testing machine. Data were analyzed for each group using one-way analysis of variance (ANOVA) followed by a Tukey’s pairwise post-hoc test between the 2 coping thicknesses. P values which were 0.05 or less were considered statistically significant. Separate student t-tests was performed to detect the significance between the main groups. Finally, a two-way ANOVA was done to evaluate the effect of the processing technique, and the coping thickness on the fracture resistance.

Results: Effect of the construction technique revealed significant (P < 0.05) influence on the fracture resistance mean values of the ceramic copings (CAD > Press). Effect of thickness showed significant (P < 0.05) influence on fracture resistance mean values as well (0.7 mm > 0.5 mm).

Conclusion: Within the limitations of this study, the following conclusions could be drawn: the CAD/CAM technique showed improved strength over the heat pressed technique, regardless of the margin thickness of the ceramic coping, 0.5 mm thickness coping, constructed using both pressing and milling techniques, has sufficient strength to withstand the average masticatory forces in the premolar region (222 to 445 N).

Even with the evolution of chemotherapeutic procedures and agents, chemotherapy may cause certain side effects that impair the patients’ quality of life. The aim of this review is to isolate and describe the oral side effects arising only from chemotherapy and focus on the dentist’s contribution to their management. This paper comprises an extensive literature review of the main side effects affecting the oral health status of patients’ undergoing chemotherapy procedures. In addition, it describes the dentist’s contribution in the treatment of such patients before, throughout and after antineoplastic therapy. In conclusion, the oral cavity is a usual site of discomfort and pain caused by chemotherapy, making the dentist’s contribution to the patient’s relief imperative.

This paper reports a case of a recurrent periapical cyst treated with enucleation of the lesion, apicoectomy, and root end obturation on a lower left first molar. In the case of conventional root canal treatment failure, non-surgical retreatment is the preferred option in most of the cases. Several factors such as a complex root canal system or previous procedural accidents may impede the success of non-surgical retreatment. The authors have performed root-end resection and preparation under local anesthesia on a lower left first molar; The root canal filling is placed within the new cavity to close the path of communication between the infected root canal system and periradicular structures with an intermediate restorative material. The lesion was fully enucleated and sent for histopathology. The 29-year-old female patient was followed up at 2 weeks, 3 and 6 months presenting as a functional and symptomless tooth. Radiographic findings showed a clear and progressive refilling of the cavity with bone. All these factors highlight a positive prognosis for the tooth after periradicular surgery, which is now considered a valid treatment to keep the tooth as a functional unit in the oral cavity.

Aim: The purpose of the study was to evaluate the effect of artificial accelerated aging on surface roughness and color stability of three recently introduced CAD/CAM materials. The hypothesis was that artificial accelerated aging would have an effect on surface roughness and color stability of tested materials.

Methods: A total of 21 ceramic discs were fabricated in this study, including translucent zirconia (InCoris TZI) and resin nano ceramic (Lava Ultimate) ceramic blocks for CAD/CAM and a set of bi-layered discs made of a zirconia CAD/CAM substructure (inCoris ZI) with VM9 hand-layered feldspathic veneering. Initial surface roughness measurements using a stylus profilometer and color measurements using a spectroradiometer were carried out. All specimens were subjected to artificial aging by means of a weathering process in a Weather-O-meter for 300 h. Additional surface roughness and color measurements were again carried out after artificial aging of the specimens. The Wilcoxon Signed Rank Test was conducted to determine significant differences in surface roughness among the 3 groups (α = 0.05).

Results: Lava ultimate specimens showed a statistically significant difference in surface roughness before and after artificial accelerated aging (P = 0.028). There was no statistical significance in surface roughness of both the translucent zirconia TZ1 (P = 0.499) and the InCoris ZI with VM9 veneering (P = 0.398) specimens before and after aging. The amount of color change in the 3 ceramic groups was also not significant.

Conclusion: Artificial accelerated aging did not affect the color stability of any of the 3 ceramic groups, however, it caused a significant decrease in the surface roughness of the resin nano ceramic group.

For thousands of years, humans have been using herbal remedies to cure and prevent various illnesses. Out of many herbal products, neem has numerous properties which have promoted its use in both the medical and dental fields. Use of neem has been mentioned in alternative medical specialties, such as Ayurveda, Unani and Homeopathic medicine. Endodontic therapy aims to eliminate microorganisms from the root canal system. In endodontics, irrigating solutions play a significant role because of their antimicrobial activity. Their use becomes even more significant when handling infected endodontic cases where a plethora of microbes is invading the root canal system. However, one has to be extremely cautious while using irrigating chemicals in endodontics, owing to their toxic effects, in case they extrude into periradicular tissue. For this very reason, the use of herbal irrigating solutions such as neem is being advocated worldwide. This article highlights the origin, taxonomy, chemical composition, and medicinal properties of the neem tree and its potential use as an irrigating solution in the field of endodontics.

Aim: The aim of this study was to compare the shear bond strength (SBS) of various adhesive systems to a bioactive dentin substitute Biodentine^® with different time intervals.

Methods: Three hundred and fifty cylindrical acrylic blocks with a hole (4 mm diameter and 2 mm height) were prepared. The holes were filled with Biodentine^®, and the specimens were allocated into 5 main groups according to waiting times (group 1, 12 min; group 2, 24 h; group 3, 48 h; group 4, 72 h; and group 5, 96 h). All specimens were stored at 37 °C with 100% humidity during the waiting time. Then each group was divided into 7 subgroups of 10 units each: subgroup 1, Prime&Bond NT™; subgroup 2, Single Bond Universal (self-etch mode); subgroup 3, Single Bond Universal (etch and rinse mode); subgroup 4, All-Bond Universal™ (self-etch mode); subgroup 5, All-Bond Universal™ (etch and rinse mode); subgroup 6, G-aenial Universal Bond™ (self-etch mode); and subgroup 7, G-aenial Universal Bond™ (etch-and-rinse mode). After the application of adhesive systems, compomer Dyract XP Bond^® was applied over Biodentine^® SBSs were measured using a universal testing machine. After the SBS test, the fractured surfaces were examined under a stereomicroscope at 25× magnification, and the data were analyzed with Kruskal-Wallis and Mann-Whitney U (with Bonferroni correction) tests.

Results: Biodentine^® exhibits lower shear bond strength values in the 12 min groups. No significant differences were observed between self-etch or etch-and-rinse bonding modes.

Conclusion: A 24-h waiting period after the mixing of Biodentine^® could be useful to obtain higher SBS measurements. Also, similar SBS values were observed for the universal adhesives regardless of application mode.

Even with the evolution of chemotherapeutic procedures and agents, chemotherapy may cause certain side effects that impair the patients’ quality of life. The aim of this review is to isolate and describe the oral side effects arising only from chemotherapy and focus on the dentist’s contribution to their management. This paper comprises an extensive literature review of the main side effects affecting the oral health status of patients’ undergoing chemotherapy procedures. In addition, it describes the dentist’s contribution in the treatment of such patients before, throughout and after antineoplastic therapy. In conclusion, the oral cavity is a usual site of discomfort and pain caused by chemotherapy, making the dentist’s contribution to the patient’s relief imperative.

Papillon-Lefévre syndrome (PLS) is a very rare autosomal recessive trait characterized by palmoplantar hyperkeratosis and severe generalized early-onset periodontitis leading to premature loss of both primary and permanent dentitions. The etiopathogenesis of the disorder is multifactorial with genetic, immunological, and microbial factors playing a major role. Other significant factors involved are environmental and reduced host defense mechanism. Consanguinity is a contributing factor because of its relevance to clinical genetics. The genetic defect underlying etiology of PLS is mutations of the gene 11q14-q21 encoding for cathepsin C, an enzyme involved in a variety of inflammatory and immune processes. Virulent pathogens and their toxins in the subgingival plaque play a major factor in the initiation and progression of PLS periodontitis. Dysfunction of leukocytes is secondary causative factor. Variable clinical expression, late onset of symptoms, and frequent gene mutations reflect the complexity of the syndrome. Today, over 300 cases been reported in dental and medical literature with more cases discovered among Arabs, Indians, and Africans. About 20%-25% of patients with PLS have increased susceptibility to infections besides overwhelming destructive periodontitis. Management of the disorder directed toward halting periodontal destruction by eliminating the reservoir of causative organisms; using conventional periodontal treatment, oral hygiene instructions, antiseptic mouth rinses; and systemic antibiotic. Skin lesions usually treated with topical application of emollients, keratolytic agents, steroids, and oral retinoid. Any attempt to achieve and preserve healthy oral conditions will improve quality of life in patients with this intriguing syndrome.

The purpose of this review article is to examine the etiology, clinical properties and treatment alternatives of tooth agenesis. A comprehensive literature review is realized by using widespread database sources. Disorders in early stages of dental formation may cause congenital or developmental absence of teeth. Both genetic and environmental factors are responsible for tooth agenesis. Skeletal and dental anomalies accompany absence of teeth most of the time. Management of tooth agenesis can be realized by either closing or opening the spaces of congenitally missing teeth and by correction of dentoskeletal problems with orthodontic mechanics. Restorative dentistry procedures accompany orthodontic treatment when filling the spaces of missing teeth or when reshaping the teeth substituting missing teeth. As a conclusion, treatment of problems related with mild or severe tooth agenesis requires multidisciplinary treatment approaches. Early diagnoses of congenitally missing teeth and comprehensive treatment planning have great importance in multidisciplinary approach to prevent or reduce complications which cause both aesthetic and functional disorders and decrease quality of life.

Chronic sclerosing sialadenitis (CSS) is a chronic inflammatory condition of uncertain etiology, primarily affecting the submandibular glands. It has recently been proposed that CSS belongs to the immunoglobulin G4 (IgG4)-related disease spectrum, although the exact relationship between these two entities requires further elucidation. Our aim is to present a case of bilateral CSS of the sublingual glands and discuss the possible underlying pathogenetic mechanisms. A 66-year-old woman presented with a 7-month history of an asymptomatic firm swelling of the floor of the mouth. Clinically, a diffuse, multinodular swelling of elastic to firm consistency was observed across the sublingual folds bilaterally. An incisional biopsy revealed a lymphoplasmacytic infiltrate with lymphoid follicle formation, along with acinar degeneration, fibrosclerosis and ductal dilation. Immunohistochemical investigation ruled out lymphoproliferative diseases revealing a polyclonal lymphoplasmacytic population with only a few scattered IgG4-positive plasma cells. IgG4 serum levels were also normal. No treatment was administered with progressive spontaneous resolution of the swelling and no evidence of recurrence at 2 years follow-up. CSS is a benign salivary gland disorder, which, at least in a subset of cases, may represent an IgG4-associated disorder. Therefore, immunohistochemical evaluation of the IgG4/IgG plasma cell ratio and the IgG4 serum levels is a recommended investigation in the diagnostic work-up of CSS cases.

Ameloblastic fibro-odontoma (AFO) is a rare, benign mixed odontogenic tumor. A 9-year-old Japanese boy was referred to Okayama University Hospital in December 2013 for the evaluation of an unerupted tooth in his right lower mandible. A panoramic radiograph showed a well-defined multilocular radiolucent lesion extending from the right first molar to the ramus of the mandibular, containing radiopaque foci. The first molar was impacted by the lesion. The tumor was easily enucleated from the cortical bone, and the follicle of the first molar was removed. The first molar was preserved in the hope that it would erupt to the occlusal plane. At the 3-year follow-up there was no evidence of recurrence, and the right first molar had erupted to the occlusal plane.