Friday, 1 September 2017 ‐ Free Communication Sessions 73‐96 and Poster Sessions 68–81

An important role of the process of attention and stress for students – dentists. Aim or purpose: To set the level of attention and stress and check for significant correlations between this process. Materials and methods: In the course of the study, the following methods were used: G. Munsterberg’s test, PSM-25 psychological stress scale (in the adaptation of N.E. Vodopyanova). For determining the correlation between attention and stress was taken rank method of Ch. Spearman in the SPSS. The study involved 83 students a 2-year medical student. Results: Applying rank correlations, an inverse significant correlation was established at the level of statistical significance: between “attention level” and “stress” (r = 0.016 p = 0.05). This means that as the level of stress increases, the concentration of attention decreases and, conversely, if the concentration of attention increases the indicator of the level of stress goes to a decline. Conclusions: These studies show that the development of attention and stress resistance for dental students is of great importance, since Students do not yet have the resources to maintain attention and skills of stress resistance.

was sent to participants. Five-level Likert scale, free-text boxes and closed-ended and multiple-choice questions were used to collect data from respondents. Results: (87%) believed that abrasion is the main cause of NCCLs while (31%) believed that occlusal factors (abfraction) is related to NCCLs. (44%) of dentists will monitor NCCLs rather than restoring them and composite is the material of choice to restore (57%), followed by (30%) for GI-based restorations. Conclusions: There is a strong agreement between dentists that toothbrushing abrasion is the main causes of NCCLs. While the majority of NCCLs are managed conservatively, composite is the most frequent restorative material used by dentists to restore NCCLs followed by GIC. Dentists are more likely to restore NCCLs to improve sensitivity or to preserve remaining tooth structure, than to improve patients' aesthetics. The size of the cavity, the anatomical position of the tooth, the nature of the cause, the aesthetic consideration and the materials' technicality, have an effect on deciding the choice of restorative material. Aim or purpose: The aim of this in vitro study was to investigate the effect of sugar-free chewing gums enriched with hydroxyapatites, CPP-ACP and xylitol against carbonated beverage erosion. Materials and methods: Four types of sugar-free chewing gums were prepared: P1: CPP-ACP (3%) + isomalt; P2: Hydroxyapatite (2.5 %) + isomalt; P3: CPP-ACP (3%) + xylitol; P4: Hydroxyapatite (2.5%) + xylitol. Forty-two human permanent, non-fluoride teeth, free of caries and hypocalcification, were collected. Roots were cut and the half of the enamel surfaces were covered with a protective varnish. The specimens were immersed in Coca Cola solution during 4 h, five times a day. They underwent thirty six thermocycles as follow: 20 min with artificial saliva and chewing gums at 37°C followed by 40 min with artificial saliva at 37°C. Assessment of the effects of gums was evaluated using scanning electron microscopy (SEM) and microscopic measurements on polarized light microscopy. Results: The mean of the enamel thickness difference between varnished and unvarnished surfaces was significantly higher for the specimens treated with P2 compared to all the other groups and significantly lower for the groups treated with CPP-ACP compared to the groups treated with hydroxyapatite. SEM showed a nonhomogeneous deposits structure recovering the enamel surfaces treated with xylitol enriched chewing gums. Conclusions: The sugar-free chewing gums enriched with xylitol and CPP-ACP showed the best remineralizing effect on the eroded enamel. However, adding hydroxyapatite to isomalt chewing-gums didn't promote tooth remineralization Aim or purpose: To evaluate the healing of periapical infected lesions in dogs' teeth when using calcium hydroxide or ceramic based sealers for obturation. Materials and methods: All animal procedures were performed according to the protocols reviewed and approved by the Ethical Committee. Sixty roots in 6 animals were divided into 3 groups (n = 20) according to post evaluation period (1 month, 2 months and 3 months). Each group was further subdivided into 2 experimental groups (n = 8) according to sealer used for obturation; Group 1: Calcium Hydroxide based sealer and Group 2: Bioceramic based sealer, a positive control group where no treatment was applied (n = 2) and a negative control group with no periapical lesion (n = 2). Apical periodontitis was induced in the 2 experimental and the positive control groups. The animals were sacrificed at the end of each evaluation period and the maxillas were subjected to histological processing. The sections were stained with hematoxylin and eosin and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis (p = 0.05). Results: No statistically significant difference was found between the 2 experimental groups at the 3 evaluation periods, but Group 2 showed more mineralized tissue formation at the 3 months evaluation period. Conclusions: Bioceramic based sealers have more favorable though insignificant effect on periapical healing than calcium hydroxide based sealers. apical periodontitis and a biofilm remaining in a lateral canal or other ramifications was suggested. Case Description: 31 years old man with swelling, tooth mobility, normal bone level around the adjacent tooth came in the office. Endodontic treatment (Files-hand and rotary system Revo-S; Ca (OH)2 was placed for 7 days; Permanent filling-hydraulic condensation with bioceramic sealer; Irrigation in both appointmentsheated 2.5% NaCLO, citric acid, activation with Endoactivator and Vibringe) was performed and the patient was referred back to her dentist. At 6 years follow up the case showed periradicular health. Discussion: Sonic activation has shown to be an effective method to disinfect the root canals. Most actual systems have smooth plastic tips of different sizes activated at sonic frequency by a hand piece. This system seems to be able to effectively clean the main canal, to remove the smear layer and to promote the filling of a greater number of lateral canals. Conclusions/Clinical significance: The primary goal of all treatment efforts must be to rid the canals from the infection. Irrigant activation/agitation techniques that create a flow in the lateral direction could improve the flow into lateral canals and tubules. Correct diagnosis and adequate treatment resulting in greater chances of obtaining the success in endodontic treatment.

FC299
Influence of XP-endo Following Retreatment of MTA-and Bioceramic-based Obturated Root Canals Eleftherios Terry Farmakis, Taxiarchis Kontogiannis, Nikolaos Kerezoudis National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece Aim or purpose: To assess in vitro the retreatability of root canals obturated with single cone technique and either an MTA-based or a bioceramic-based sealer and the influence of XP-endo on the cleanness of the retreated canals. Materials and methods: 80 extracted single-rooted premolars were instrumented using BTRaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and obturated with a single cone of guttapercha (40.04) and either MTA Fillapex (Angelus, Londrina, PR, Brazil) or Total Fill BC Sealer (FKG Dentaire, La Chauxde-Fonds, Switzerland). During retreatment, four groups were formed: (A1) MTA Fillapex retreated with D-Race (n = 20), (A2) MTA Fillapex retreated with D-Race and XP-endo finisher (n = 20), (B1) Total Fill retreated with D-Race (n = 19), (B2) Total Fill retreated with D-Race and XP-endo finisher. Working length and patency regaining were recorded. The teeth were then split longitudinally and observed for residuals under an optical microscope. Serial photo-micrographs were taken and placed adjacent to each other forming a continuous strip. The software Helicon Focus (Helicon Soft Ltd.) was used for focus stacking. The strips were evaluated by a blinded observer for residuals. Chi-square tests and one-way ANOVA were carried out statistical analyses. Results: Residuals of MTA Fillapex were significantly less than those of Total Fill in the apical and middle third; no difference This paper reports a severe case of Xeroderma Pigmentosum in a two-and-a-half-year-old patient presenting with dermatological, orofacial and ophthalmic manifestation. Case description: A four-and-a-half-year-old child presented with severe scaling of the face and limbs, loss of hair, reduced vision on the right eye and severe oral pain. She had difficulty in speaking and feeding. Small papules had begun developing on the scalp four months earlier. Once infected, they developed into larger papules with purulent discharge. An intraoral examination revealed two nodular swellings on the dorsum of the tongue. Oral hygiene was poor. Her twin sister had succumbed to the condition at the age of two. There was no report of the condition in the extended family. Discussion: The cure for Xeroderma Pigmentosum is unknown. Morbidity and mortality rates are markedly high. The use of UV visor, sunscreen and protective clothing, minimal exposure to sunlight and tumour excision in the case of oral manifestation is key in improvement of the quality of life of patients. Genetic counselling is also important in the management of the patient especially in a family that has an affected child. Conclusion: Despite early diagnosis and management of Xeroderma pigmentosum, increased morbidity and mortality rates remains a major challenge in our low resource setup.

FC302
Nosocomial Oral Myiasis in a Heart Failure Unit Patient: A Case Report Georgia Trifylli 1 , Ioannis Malamas 2 , Christos Christophoridis 2 , George Christophoridis 3 1 General State Hospital of Nikaia-Piraeus "Agios Panteleimon", Athens, Greece, 2 Department of Oral Surgery, General State Hospital of Nikaia-Piraeus "Agios Panteleimon", Athens, Greece, 3 Private Dental Practice, Nikaia-Piraeus, Greece Introduction: Myiasis is a disease caused by infestation of living mammal's tissue by larvae of flies. It is an uncommon disease in humans and occurs more frequently in rural than urban areas. The incidence of oral myiasis is less than the one of other anatomical sites as the oral tissues are not permanently exposed to the environment. Introduction will include a reference to the definition, etiopathogenesis and classification of the disease. Case description: A case of Nosocomial Oral Myiasis in an 80year-old female is reported. The patient was hospitalized in the Heart Failure Unit of a General Hospital in Athens. She had a tracheal and nasogastric intubation, and had poor oral hygiene. Myiasis was caused by larvae of blowfly group (family Calliphoridae). Discussion: The case is discussed in relation to its clinical presentation, management, and prognosis. Myiasis-related predisposing factors with respect to the patients and their hospitals are discussed. Conclusions/Clinical significance: Prevention of myiasis is important. Necessary protocols that must be followed especially in managing high risk patients are discussed. Education of medical and paramedical teams about preventive myiasis measures should be performed.

FC303
Therapeutic Use of Melatonin and 5-Methoxytryptophol Induced TMJ Rheumatoid Arthritis Gokce Savtekin 1 , S ßule C ß etinel 2 , Can Erzik 2 , Ahmet € Ozer S ßehirli 1 1 Near East University, Lefkos ßa, Cyprus, 2 Marmara University, Istanbul, Turkey Aim or purpose: This study was evaluated the effects of Melatonin (MEL) and 5-Methoxytryptophol (5-MTX) on Cyclooxygenase-1 (COX-1), Cyclooxygenase-2 (COX-2), Rapid Accelerated Fibrosarcoma-1 (Raf-1) and Signal Transducer and Activator of Transcription 3 (STAT3) which are involved in the pathogenesis of Temporomandibular Joint Rheumatoid Arthritis (TMJ RA). Materials and methods: 200-250 g Wistar albino rats of both sexes were used. Arthritis model was created by intraarticularly (i.a.) injecting 2 mg Zymosan dissolved in 40 ll saline solution into the left TMJ of the rats while the sham group was created by only injecting 40 ll saline (i.a.). Intraperitoneal (i.p.) applications of MEL (15 min before zymosan) and 5-MTX (30 min before zymosan) were carried out for therapeutic. The animals were decapitated 6 h after the administrations. COX-1, COX-2, Raf-1 and STAT3 levels were examined with Real Time-Polymerase Chain Reaction technique. The parameters were determined by one way analysis of variance (ANOVA) and the Tukey test was used for binary comparisons (p < 0.05). Articular structural damage was assessed histologically. Results: Zymosan administration, increased the activity of COX-2, Raf-1 and STAT3 in TMJ tissues, administration of MEL and 5-MTX brought these values closer to the sham group. However, no significant difference observed in COX-1. In the histological evaluation, obvious articular degeneration and disc congestion in the arthritis group regressed with therapy. Conclusions: In this study, COX-2, Raf-1 and STAT3, which play a role in the pathogenesis of TMJ RA, have been suppressed by the therapeutic effect of the dark hormone MEL and the day light hormone 5-MTX.

FC304
The Efficacy of Turmeric in Inhibiting Oral Cancer Growth Indra Hadikrishna 1 , Harmas Yazid Yusuf 1 , Alwin Kasim 1 , Bambang Pontjo Priosoeryanto 2 , Mantra Nandini 1 , Andri Hardianto 1 , Endang Syamsudin 1 , Tantry Maulina 1 , Aulia Iaskandarsyah 3 , Nurul Ramadhanty 4 in inhibiting the immunoexpression rate of NFjB and Cyclin D1 at epithelial dysplasia stage. Materials and methods: The current study was an experimental study that was performed on forty Sprague Dawley rats that were divided into treatment group and control group. Dysplasia stage of OSCC was induced by using 7.2-dimethylbenz (a) anthracene for 4 weeks. After the diagnosis of dysplasia was confirmed from hematoxylin and eosin (HE) staining, the rats in the treatment group were given a dose of curcumin of 80 mg/kg/bw/day for 4 consecutive weeks, orally. The evaluation of NFjB and Cyclin D1 IHC staining was assessed by histoscore. All data were tested by using Wilcoxon-Mann Whitney test, and Kendall correlation coefficient of concordance.
Results: There were significant decreases in immunoexpression rate of NFjB (p < 0.01) and Cyclin D1 (p < 0.01) between the treatment group compared to the control group. A positive significant (p < 0.05) correlation between immunoexpression rate of NFjB and Cyclin D1 with epithelial dysplasia rate of the oral cavity was also revealed.
Conclusions: It is concluded that an oral consumption of turmeric is effective in inhibiting oral cancer growth at epithelial dysplasia stage.
Free Communication Session 77 | 01.09.2017, 10:15 -11:15 | Room A9.9 Theme: General Dentistry Okan University, Istanbul, Turkey, 2 Istanbul University, Istanbul, Turkey Aim or purpose: Our aim is to investigate the time course of apoptotic process in rat model of orthodontic tooth movement (OTM) with light and heavy forces. Materials and methods: Two groups of 56 male Wistar rats were used as experimental animals. Each group (10 cN light, 60 cN heavy force) had 4-time related sub groups (1, 7, 21, 42 days) to investigate all the phases of OTM. Appliances were placed on maxillary molars at randomly chosen side and activated to mesially. OTM measurements were calculated for experimental and control sides. Immunohistochemical (IHC) examinations were performed on the maxillary 2. molar's mesiobuccal root and positive staining cells were counted both for resorption and apposition sides. Caspase 9 as initiator, caspase 3 as executioner caspases, Bax and Bcl-2L1 as regulation for apoptotic process were chosen as IHC examinations.
Results: No statistical significant difference was found at any period of time for OTM measurements. While apoptotic activity evaluated via Bax IHC technique for 60 cN group was more severe than 10 cN group, Bcl-2L1 was found more active for 10 cN groups than 60 cN in the initial phase.
Conclusions: Although there was no difference for rate of tooth movement with light and heavy forces, apoptotic process was more active at heavy forces especially in the initial phase. As a result of this, 10 cN force magnitude that could cause experimental tooth movement showed minimal adverse effects for supporting tissue.
Aim or purpose: Age-related legal problems are especially common in underdeveloped parts of Turkey. Age determination is important in terms of both penalties and laws in the legal process. The aim of this study is to compare the validity of the Demirjian and Willems' methods in southern Turkish children. Materials and methods: In this retrospective study, digital panoramic radiographs of 745 healthy southern Turkish children (363 girls and 382 boys) aged between 4 and 15.99 years were examined by one investigator. According to Demirjian and Willems' method, the mean difference between dental and chronological age was calculated for each age and sex group. The Wilcoxon test was used to compare all data. Statistical analysis was performed to test the validity of investigated methods by comparing the mean chronological and mean estimated age.
Results: The Demirjian's method overestimated age with a mean accuracy of 0.832 in females and by 0.923 in males, while Willems' method overestimated of 0.202 in females and by 0.434 in males.
Conclusions: In summary, the dental age estimation by Willems' method is found to be more accurate than Demirjian' method in contemporary Turkish children population.

FC307
Conscious Sedation in the Dental Office: What, Why and How Jean-Frederic Andre Andre & Milhe Dental Sedation Clinic, Geneva, Switzerland Aim: Standards for conscious sedation techniques for the dental office have been developed for decades, and numerous publications have proven their need, efficacy and safety. Yet, patient management techniques still have trouble making their way inside the ambulatory office setting. Conscious sedation offers a wide spectre of possibilities from behavioral techniques, hypnosis to drug induced moderate sedation techniques provided by adequately trained professionals. This presentation describes two safe, accessible and efficient techniques: nitrous oxide inhalatory sedation, and single drug intravenous sedation.
Materials and methods: Conscious sedation has been defined as: A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. Consciousness is preserved, as well as protective reflexes. Nitrous oxide must be administered using a titrating machine in order to achieve optimal patient sedation. Benzodiazepines are also titrated intravenously, throughout the procedure. All patients are monitored, every procedure is documented. Results: Titration is the key to safety and efficiency. Success is achieved when treatment has been completed according to plan, and patient satisfaction is confirmed. Materials and methods: This in vitro study used specimens of canine and premolar with no history of caries and fractures. The teeth were cut approximately at the Cemento-Enamel Junction (CEJ) and then planted on resin. Twenty-four samples were generated from the above procedures and were divided into two groups: the control group, and the experimental group. Teeth samples were then immersed in acidic solution with 5.0 pH for 6 h to induce demineralization followed by an immersion in artificial saliva with a 7.0 pH for 17 h to induce remineralization. The teeth in the experimental group were then received fluoride application for 4 min, before another immersion in artificial saliva for another 30 min. The remineralization and fluoride applications were then repeated for seven consecutive days for both groups. Remineralization and demineralization were assessed by evaluating enamel micro hardness tested by Vickers hardness test.

Results:
The results of the current study showed that enamel micro hardness of the teeth in the experimental group was improved up to 80% whilst those in the control group showed an improvement of 48.7%.
Conclusions: From the current study, it was concluded that fluoride application improved enamel micro hardness of a demineralized tooth. Nevertheless, further study in this area is needed.

FC310
The Efficacy of Curcuminoid in Treating Odontogenic Origin Orofacial Pain Tantry Maulina 1 , Dewi Nugrahani 2 , Anna Muryani 3 , Arif Cahyanto 4 , Amaliya Amaliya 5 complained dental problems. The aim of the current study was to compare the efficacy of Curcuminoid to Ibuprofen, as analgesic agent in treating acute irreversible pulpitis. Materials and methods: Sixty-four patients (35 males; 29 females) who visited dental triage installation at Unpad Dental Hospital, Bandung, Indonesia, due to excruciating pain caused by acute irreversible pulpitis were recruited. Patients were randomly divided into two groups, the treatment group that received curcuminoid to treat the pain, and the control group, that received ibuprofen for pain control. At the time of visitation, all patients took either ibuprofen or curcuminoid right after tooth irrigation. All patients were then sent home with an instruction to take the curcuminoid or ibuprofen capsule every 8 h to treat the pain. Pain level evaluation was performed by using Numeric Rating Scale (NRS) and was performed exactly 2 h after the first medication, second medication, and third medication. All data were analyzed by using the Mann-Whitney test.

Results:
The current study showed that the treatment groups showed a more significant (p < 0.01) pain level decrease compared to the control group. It was also revealed that female patients showed greater pain level decrease (p < 0.01) compared to male patients within both groups.
Conclusions: Despite of the promising preliminary result of the efficacy of curcuminoid as an analgesic agent for treating orofacial pain, further study that evaluates this particular matter is of important.

FC311
The Foundation of Possibility of Caries Arrest using ClinPro XT Varnish Alexandr Butvilovsky Belarusian State Medical University, Minsk, Belarus Aim or purpose: To found the possibility of caries arrest using ClinPro XT Varnish. Materials and methods: The research was conducted on the extracted (due to physiological replacement) deciduous teeth having cavitary carious lesions at the level of mantle dentin. The teeth were brushed with paste without fluorine, washed and dried. Then there was done an application of ClinPro XT Varnish ("3M ESPE") according to manufacturer's instructions. Then the teeth were sawed in sagittal direction and analyzed on the X-ray energy dispersive spectrometer "INCA 350" ("Oxford Instruments", Great Britain). The results were statistically processed.
Results: In all the samples material showed homogeneous structure and good adaptation to bottom and walls of cavities due to its low viscosity. The content of fluorine in ClinPro XT Varnish has been varying from 2.8 up to 22.7%; the median value has been equal to 12.3% (9.7; 16.7). The release of fluorine well-known agent for caries arrest inside the dentin has been detected in all the samples up to the 100 microns depth. We have also detected the highest concentration of fluorine in dentin contacting the fillings (2.0% (1.1-4.9)) and gradual decrease of fluorine content in pulp direction. Materials and methods: Eighty single-rooted mandibular premolars were selected based on predetermined criteria. Twenty teeth were left unprepared and served as a negative control. The remaining sixty teeth were divided into three groups: Group I (2 shape files), group II (Hyflex EDM) and group III (ProTaper Universal). Biomechanical preparation was carried out as per the manufacturer's instructions. After root canal preparation, all of the roots were sectioned perpendicular to the long axis at 3, 6, and 9 mm from the apex. These sections were visualized under stereomicroscope to evaluate the dentinal defects using predetermined criteria. The absence/ presence of cracks was recorded, and the data were analyzed with a chi-square test. The significance level was set at p = 0.05. Results: Roots prepared with ProTaper Universal showed more number of defects, whereas no significant difference was found in dentinal defects in roots prepared with Hyflex EDM and 2 shape files. There was statistically significant difference between the Pro-Taper group and other two groups (p < 0.05).

Conclusions:
All of the NiTi files tested in the present study were found to cause dentinal defect on root canal dentine. Statistical analysis showed no significant difference in root dentinal crack formation between 2 shapes and Hyflex EDM rotary systems. Introduction: The buccal fat pad (BFP) has been the subject of numerous publications regarding its anatomy and clinical implications; however, lipoma of the BFP is an exceedingly rare case and just a few cases were previously reported in the English literature.
Case description: A 50-year-old man with 2 years history of painless swelling in the left cheek. The patient did not undergo any treatment. Clinical examination revealed a clearly visible, painless, tender, and mobile swelling with a diameter of approximately 6 cm. The lesion was palpated in the left cheek around the anterior ramus of the mandible and situated anterior to the masseter muscle. These findings, especially the location of the lesion, led to the suspicion of BFP lipoma. Surgical excision was performed through transoral approach, the lipoma was over 5 cm in diameter and was completely removed. The histological examination confirmed the diagnosis. The facial symmetry was restored after removal of the lipoma. Accordingly, the overall result of the surgery was satisfactory. Discussion: The aims of this work was to introduce our clinical report of this rare pathologic entity, describe the surgical technique of the transoral approach, and discuss the potential pitfalls regarding the preoperative diagnosis and the close interrelation among the lipoma of the BFP and the surrounding anatomical structures.
Conclusions/Clinical significance: Lipoma of the BFP is very rare and little is known about its biological behavior. This work would be helpful in reaching a conclusion about the correct diagnosis and adequate treatment for the BFP lipoma. In addition, anterior and overall ratios also showed significant differences between male and female individuals. The incidence of difference between symmetrical teeth in men was found to be higher than in women. Conclusions: Developing more specific norms according to gender and living area will make significant contributions to orthodontists in the treatment planning stage for a more perfect treatment results.

FC322
Evaluation OST group (n = 10), LLLT group (n = 10), and placebo group (n = 10). LLLT (940 nm, 6 j/cm 2 , 30 mW) was applied two times per week, for a total of eight sessions. For the placebo group, treatment was similar, but patients were not irradiated. Patients in the OST group were instructed to wear occlusal splints 12 h/day for 3 months. Mandibular movements evaluation was based on RDC/TMD, and pain values were obtained with the Visual Analog Scale. The measurements were performed at baseline; 1, 2 and 3 months after the baseline. Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze the data.
Results: A reduction in pain values (p < 0.05) and an increase in mandibular movements' ranges (p < 0.05) were seen in both LLLT and OST group when comparing the placebo group. There was no significant difference between LLLT and OST groups after treatment (p > 0.05).
Conclusions: This particular type of LLLT is as effective as OST for pain relief and mandibular movement improvement in MPDS.

FC323
The Metaphorical Perceptions of Dental Students Regarding Dentist Burak Buldur, Ozge Nur Guvendi Department of Pediatric Dentistry, Faculty of Dentistry, University of Cumhuriyet, Sivas, Turkey Aim or purpose: The identification of the dental students' (DSs) image of "dentist" is important for their dental education and professional career. The purpose of this study was to determine the perception of DSs regarding the concept of dentist through the use of metaphors.
Materials and methods: The study group consisted of 420 dental students by convenience sampling. In order to determine DSs perceptions of "dentist", participants filled the semi-structured form consisting of the expression "A dentist is like . . .. . .. . .. Because . . .. . .. . ..", thus transferring their thoughts by concentrating on only one metaphor. The participants produced 311 valid metaphors. These metaphors were categorized under conceptual themes and the significance between the conceptual themes, and variables such as gender and family income were also investigated. A mixed-methods: Qualitative (metaphor analysis) and quantitative (chi-square) data analysis was used for statistical analysis.
Results: The results of the study showed that dentist metaphors for dental students were classified under five conceptual categories: Dentist as; 1) Physician, 2) Artist, 3) Authority, 4) Workingman, 5) Respected, and 6) Helpful. The six conceptual categories were not associated with the participants' genders and family income (p > .05).
Conclusions: It was concluded that the image of dentist showed a great diversity in the views of the DSs, and that the personal beliefs of DSs had dominant effect on these perceptions. This study showed that metaphors can be used as an effective measurement tool in the determination of perception. Further studies need to investigate on the relationship between this perception and different variables.

FC324
Investigation of Reparative Dentinogenesis as Histologic in Dental Organ Culture Di̇de Odabas ßi, Sibel Yıldırım Selcuk University, Konya, Turkey Aim or purpose: The ethical problems of histological studies on humans about reparative dentin and animal studies which require technical precision and do not reflect human teeth, are limiting the histological studies. By the use of the tooth organ culture model modified within the scope of this thesis, it is aimed to histologically examine the reparative dentin. Materials and methods: After the extraction of the premolars and third molar teeth, transferred to the laboratory conditions on ice. Following the preparation of the occlusal cavity, a 1 mm 3 perforation area was created on the tooth. Perforated pulp was washed with sterile saline. As a pulp coating agent, mineral trioxide aggregate or calcium hydroxide was used. Pulp coating with a Teflon strip was performed in the negative control group. Then the teeth were restored with glass ionomer cement. Teeth were followed for 1, 2, 3 and 4 weeks in the prepared medium and the CO 2 etuve. The teeth those follow up is completed were passed through the routine histological follow-up stages and then blocked with paraffin. Then sections were taken and stain with hematoxylin eosin and Masson's trichrome. The stained tissue was assessed by light microscopy in terms of pulp tissue status and reparative dentin. Conclusions: Reparative dentin was observed in different thicknesses and structures in all three groups including mineral trioxide aggregate, calcium hydroxide and Teflon strip. It is considered that the modified tooth organ culture system may be useful in the future as a model for studying the mechanisms underlying reparative dentin formation. Aim or purpose: Dental caries is highly prevalent and a significant public health problem among worldwide. Epidemiological information about dental caries amongst Pakistani pre-school children is very limited. Therefore, the aim of this study was to assess the frequency of early childhood caries (ECC) in preschool children and its relationship with socio-demographics, oral hygiene and dietary practices. Materials and methods: A cross-sectional study of 277 preschool children was conducted in central and east districts, Karachi. Sample was selected through simple random sampling. Structured questionnaire was used to collect socio demographic variables. Clinical dental information obtained by experienced dentist using dental caries criteria set by World Health Organization. Binary and multiple logistic regression analysis (p-value < 0.1) were computed using dmft cut off i.e., < 1 = no caries to investigate factors associated with dental caries. Results: Caries prevalence was 54.8% with a mean dmft score 1.99 (AE2.79). A significant association (p-value <0.1) was found between dental caries and following variables in univariate analysis: children with middle and upper middle class (COR = 1.41), habit of tooth brushing once daily (COR = 1.6), clean their teeth with index finger (COR = 2.5), having snacks once a day (COR = 1.9). In multivariate logistic regression, only habit snacking from canteen showed significance association with the presence of dental caries (p-value = 0.03, AOR = 1.8, 95% CI = 1.03-3.13).
Conclusions: More than half of the study sample had dental caries coupled with a high prevalence of unmet dental treatment needs. Association between caries experience and age of child, consumption of non-sweetened milk, dental plaque and poor oral hygiene was seen. Aim or purpose: This study was undertaken to show the presence of immune components in the dental pulp and to determine how and which immunocompetent cells infiltrate the pulp in association with the development of carious lesions. Materials and methods: In this study, we have analysed 150 teeth with different stages of progression of the carious lesion. The condition of the pulp was classified into five groups according to the progression of the carious lesions from stages S0 (non-carious teeth) to S4 (exposed pulp). Cells were identified with indirect immunoperoxidase technique using monoclonal antibodies reactive to pan-T lymphocytes, helper (CD4), suppressor (CD8) lymphocytes and B-lymphocytes.
Results: T lymphocytes were observed in unaffected pulp with suppressor (CD8) lymphocytes being predominant. In S1 and S2 a focal accumulation of mononuclear inflammatory infiltrate can be detected, with the ratio of CD4/CD8 0.22 and 0.23, respectively. The ratio of B/T lymphocytes was 0.21 and 0.24. Higher numbers of T, CD4, CD8 and B-lymphocytes were observed in S3 with a CD4/CD8 ratio of 0.84 and B/T lymphocytes ratio was 0.57. In the group with exposed pulp a high ratio of CD4/CD8 and B/T lymphocytes was observed ( Aim or purpose: To determine the effect of antioxidants, namely 10% sodium ascorbate, 10% alpha-tocopherol, 10% green tea and 10% aloe vera extract on the shear bond strength of composite resin to enamel following extra-coronal bleaching using 40% hydrogen peroxide. Materials and methods: Thirty-five premolars were randomly assigned into 7 groups of 5 each. Group 1: bleaching treatment and no antioxidants application. Group 2: composite was built-up immediately after bleaching. Group 3: bleached specimens received composite build-up delayed by 2 weeks. Group 4, 5, 6 and 7: bleached specimens received an application of 10% sodium ascorbate, 10% alpha-tocopherol, 10% green tea, and 10% aloe vera before composite build-up. Specimens were immersed in artificial saliva, stored in an incubator 37°C (24 h), thermocycling, and tested using a universal testing machine. Data were analyzed by one-way ANOVA and Tukey's test.
Conclusions: Application of antioxidants influenced the shear bond strength of composite resin to enamel following extra-coronal bleaching using 40% hydrogen peroxide. 10% sodium ascorbate, 10% alpha-tocopherol, 10% green tea and 10% aloe vera extracts produced the same effect on the shear bond strength of composite resin to enamel following extra-coronal bleaching using 40% hydrogen peroxide. Aim or purpose: This study is to assess the level of knowledge of the dental surgeons in a city regarding mechanical techniques of endodontics with a developing country environment. Materials and methods: A survey was carried out among 145 practitioners in modern city during three months in a random selection from the list of private practitioners maintained by the national dental board of the country. The data obtained referred to professional seniority, kind of practice, frequency of weekly endodontic treatments and the systems used. Results: More than half of the practitioners perform an average of five root canal treatments per a week. Even though 73% know about mechanical root canal treatment, only 22% use it. The basic concepts on mechanical root canal shaping with rotatory files were acquired for most of them through undergraduate teaching and also during scientific meetings. Among the various mechanical systems, the HERO is the most used (40%). This study reveals that mechanical root canal shaping with rotatory files is mostly known to recent practitioners educated over the past decade.
Conclusions: It highlights that the basic theoretical concepts are known by practitioners yet very few use them on a frequent basis. Aim or purpose: To investigate the reliability and accuracy of Magnetic Resonance Imaging (MRI) as a pre-treatment diagnostic tool to differentiate peri-apical endodontic lesions in comparison with histopathological data. Materials and methods: 34 radiolucent peri-apical lesions of the jaw that required surgical enucleation in 34 subjects were prospectively enrolled. Two radiologists, using the same six objective criteria, independently interpreted the MRI images and categorized the lesions as granulomas, radicular cysts, or other conditions. After apicoectomies, two oral pathologists, blinded to the radiologists' diagnoses, analyzed all specimens by reference to seven specific parameters, and also diagnosed granulomas, radicular cysts, or other conditions. The inter-rater agreements between radiologists and pathologists were calculated in terms of MRI and histological diagnoses, respectively, along with the accuracies of MRI assessments in comparison with histopathologic ones.
Results: The inter-rater reliabilities between both radiologists (k = 0.86, p = 0.0001) and both pathologists (k = 0.88, p = 0.0001) were strong. The accuracies (true-positives plus truenegatives) of the two radiologists compared to pathologists as measured by ROC analysis were high (AUC = 0.87 and 0.91). In spite of the objective criteria adopted to differentiate cysts from granulomas, a poor discriminant power of these resulted (Cronbach's ɑ coefficient < 0.5).
Conclusions: A pre-operative diagnosis of a cyst from a granuloma can clarify the real capability of a non-surgical endodontic approach in treating these lesions. Even if the selection of discriminant criteria should be improved, MRI, a completely harmless exam, demonstrated a high reliability and accuracy to differentiate the two lesions comparable to histopathological assessments. Introduction: Revascularization is a paradigm shift in the treatment of immature necrotic teeth that has occurred with biologically based principles and regenerative endodontic protocols replacing traditional apexification procedures.
Case description: This study presents case reports of revascularization procedure with MTA opted as a choice of treatment for immature spices with over a period of one and half year follow up utilising CBCT. Discussion: Clinical and radio graphic evaluation revealed the resolution of periapical radiolucencies along with continued root formation in length and width which is impossible to achieve Otherwise. Conclusions/Clinical significance: Our paper highlights the importance of minimal invasive procedures through these case reports and reviews the advantages of revascularization procedure signifying the importance of biomimetic materials to achieve the best possible outcomes Aim: The objective of the study was to assess awareness and knowledge of undergraduate medical and dental students pertaining to early detection of oral cancer. Materials and methods: A cross-sectional questionnaire based study was conducted among 566 undergraduate medical and dental students from 5 different medical and dental universities in Karachi, Pakistan. The participating candidates were predominantly females (70%). Data was analyzed by SPSS Software Version 22.
Results: Risk factors for oral cancer such as tobacco was correctly identified by an overwhelming majority of participating undergraduate medical (95.4%) and dental (94.7%) students. Clinical changes of oral cancer such as erythroplakia, leukoplakia were better discerned by dental students (66.5%) when compared to medical students (53.7%).
Conclusion: This survey identifies an existing gap in knowledge among undergraduate medical and dental students and underscores the need to enhance oral cancer education among both professional groups.
The following conclusions summarize the findings of the conducted study: Undergraduate medical students were less likely to examine patient's oral mucosa and diagnose lesions which implied they had inadequate knowledge about signs and symptoms leading to potentially malignant disorders. Dental students had better knowledge in prevention and early detection of oral cancer as compared to medical students.
Undergraduates from both programs opted for a dentist referral (99.6%) in case of an oral lesion. Malignancies were referred to Oncologists by MBBS students whereas BDS students referred malignancies to Maxillofacial Surgeons with adequate knowledge of oral lesions. Aim: To investigate whether Neutrophil Elastase (NE) induces IL-8 via trans-activation of EGFR in human oral epithelial cells by demonstrating that in vitro and in vivo samples containing high levels of NE can induce IL-8 via EGFR. EGFR binds to TGF-a and sustains neutrophil infiltration hence, effects of NE on epithelial damage were observed. Materials and methods: Normal human oral keratinocytes (NHOK/OKF6) obtained and were cultured at 37°C, in the serum free medium Keratinocyte SFM. Cells were passaged at 70-80% confluency while the doubling time of 72.6 h. Cells cytotoxicity was assessed using MTT assay following treatment with NE and LPS. Cells were treated with NE, LPS, AGF14789 and EGFR to detect cytokine levels (IL-8 and TGF-a) by using ELISA kits in culture supernatants. Results: Statistical analysis was done using student t-test to compare the difference between treatments. Viability data showed at higher concentrations of NE viability was significantly decreased (p > 0.05). IL-8 release was increased at lower NE concentration and on treatment with EGFR inhibitors and results were statistically insignificant. LPS also upregulated levels of IL-8. TGF-a levels were low at all treatments with NE and EGFR inhibitors and results proved to be statistically significant (p < 0.05). Conclusions: This is the first study to report NE induced IL-8 production in OKF6. EGFR transactivation in response to NE over expressed these receptors which increases cytokine production and inflammation. Since high levels of NE lead to mucosal instability, IL-8 production and further neutrophil recruitment thereby contributes to pathology as observed in oral ulceration. Aim or purpose: The current study is focused on the identification of distinguished biomarker metabolites of oral cancer tissue samples in comparison with precancerous and control tissue samples using gas chromatography coupled with triple quadrupole tandem mass spectrometry and chemometric analyses. Materials and methods: Samples were collected from Oral and Maxillofacial department of Dow University of Health Sciences, Karachi, consist of 4-6 mm punch biopsies of total 51 tissue samples: 15 samples of potentially malignant disorder of oral cavity that is of oral sub-mucous fibrosis (OSF), 21 of diagnosed OSCC patients and 15 from the healthy individuals. GC-MS-based metabolite profiling and chemometric analysis of tissue samples has been performed at H.E.J. International Center for Chemical and Biological Sciences, University of Karachi. Metabolites obtained were identified through National Institute of Standards and Technology (NIST) mass spectral (Wiley registry) library. Mass Profiler Professional (MPP) software was used for the alignment and for all the statistical analysis. Results: 31 compounds out of 735 found distinguishing among oral cancer, precancerous and control group samples using p-value ≤ 0.05. Partial Least Square Discriminant Analysis (PLSDA) model was generated using statistically significant metabolites gave an overall accuracy of 90.2%. Down-regulated amino acid levels appear to be the result of enhanced energy metabolism or up-regulation of the appropriate biosynthetic pathways, and required cell proliferation in cancer tissues. Conclusions: Our study has shown that a GC-MS-based metabolite profiling and extensive chemometric analysis of tissue is able to identify biomarker metabolites which can significantly differentiate oral cancer from the control groups. Introduction: A mucocele is a benign, mucus-containing cystic lesion of the minor salivary gland. Mucocele occur either due to rupture of salivary gland duct or by blockade of salivary gland duct. The floor of the mouth is a less common site of occurrence. Case description: A 24-year-old patient complained of swelling in the floor of the mouth evolving for the past 15 days. History revealed that she had a laceration during her last dental care in that site which healed on its own. Then she developed a small swelling which gradually increased in size. She also gave a history of traumatizing the swelling, followed by its recurrent development; and no associated pain. Intraoral examination showed a mild swelling in the left side close to of the floor mouth with bluish purple changes. The treatment consisted of a marsupialisation of the mucocele to prevent any iatrogenic lesion of the adjacent structures. The healing was without recurrence. Discussion: The aims of this work was to introduce our clinical report of this common pathology, describe the surgical technique of marsupialisation and it's interest especially in this location, and discuss the potential role of the uncontrolled dental care in the occurrence of this pathology. Conclusions/Clinical significance: Marsupialisation proved to be a simple, low cost, relatively non-invasive, painless, and low recurrence technique to treat mucus extravasations or retention phenomena. Marsupialisation can be recommended primarily to treat oral mucoceles. A correct maneuver during dental care is a key word in preventing traumatic iatrogenic mucocele lesions. Compare the success rate of PRF Pulpotomy with mineral trioxide aggregate in pulpotomy procedures for pulp exposures with pulpitis in vital mature permanent teeth. Methods: Total 100 patients aged 10-40 years attending OPD, presented with vital carious expose permanent mature molars with pulpitis were selected for the study. Patients with presence of apical radiolucency and periodontal disease were excluded. Patients were randomly divided into 2 groups of 50 each using sealed envelope technique. Group A pulpotomy using PRF, Group B pulpotomy using MTA, the assessment was carried out at 3, 6 and 12 months appointments. The outcome of clinical success or failure was determined by subjective symptoms including pain and objective signs including abscess, swelling, sinus tract, and tenderness. The outcomes of radiographic success were determined by normal contour and width of periodontal ligament (PDL) of teeth in radiograph. Teeth with presence of radiographic signs of internal root resorption and apical periodontitis was recorded as "failure". The recorded data were analyzed by using the statistical software.
Results: The results of the study showed clinical success in all both groups and radiographic success was found to be 68%, 60 % and 55% in MTA pulpotomy group and 92%, 84% and 78 % in PRF pulpotomy group at 3, 6 and 12 months intervals with p value<0.05 and 95% confidence interval. Conclusion: There was significant difference found in the clinical and radiographic outcome between PRF pulpotomy and MTA pulpotomy for pulpotomy procedures of carious expose vital permanent 1st molars with pulpitis.

Management of Endodontic Emergencies and Use of Antibiotics in Teaching Hospitals of Karachi Sara Ikram Khan, Syed Muhammad Faizan, Shama Asghar Bahria University Medical and Dental College, Karachi, Pakistan
Aim or purpose: To gather information about endodontic emergency treatment approaches in different cases and antibiotic prescribing habits of dentists in teaching dental hospitals. Materials and methods: A cross sectional study was done in 4 different teaching based dental hospitals of Karachi. 175 dentists consented to participate which included BDS (Bachelors of Dental Surgery) graduates, Post Graduate Residents and Post graduates. Questionnaires were distributed which included questions regarding emergency treatment approaches and antibiotic prescribing habits. Data analysis was done on IBM Statistics SPSS version 20.
Results: For irreversible pulpitis cases in vital teeth, most of the dental practitioners (50.3%) preferred two-visit root canal treatments. For teeth presenting in an emergency case of pulpitis, the preferred treatment approach was pulpectomy in combination with analgesics (49.7%) whereas (44%) preferred pulpectomy in combination with analgesics as well as antibiotics. 80% of the dentists prescribed medications if RCT required multiple visits. The rate of prescription of analgesics and antibiotics was 25.1% in untreated acute apical periodontitis cases. 66.3% preferred drainage by opening pulp chamber with systemic antibiotics in acute apical abscess cases. Frequently prescribed antibiotics were amoxicillin-clavulanate (83.4%), amoxicillin (46.9%) and Metronidazole (44.6%). Most common analgesic prescribed was Naproxen Sodium (53.1%) and Ibuprofen (34.9%).
Conclusions: There is a difference in methods taught and practiced by the practitioners. Over prescription of antibiotics was seen in cases where local treatment would have been sufficient. Seminars and educational programs should be conducted more frequently to keep dentists up to date with proper treatment methods. Aim or purpose: The goal of this study is to assess the incidence of TMJ degenerative changes in CBCT scans made for routine dental assessment in a period of 4 years. The radiologic reports of 9,374 CBCT scans included and reviewed retrospectively (over a period of 4 yrs). Materials and methods: CBCT scans were extended FOV (the vast majority of the scans included both articulations) and were acquired by a variety of CBCT scanners. All scans were prescribed for routine dental assessment (impacted teeth, implants, jaw pathology etc). Scans which were prescribed for TMJ assessment were excluded. Results: The incidence rate of TMJ degenerative changes is high TMJ should be included in the standardized review of a CBCT scan despite the prescription of the exam. Conclusions: The radiologist should be alert for the appropriate recommendations if the observed findings are out of the ordinary. Aim or purpose: Head and neck squamous cell carcinoma (HNSCC) is the 6th most common cause of cancer mortality throughout the world affecting some 50 000 people in the US and 600 000 worldwide each year. Previous studies have demonstrated that a point-of-care (POC) assay measuring CD44 and total protein (TP) was able to aid in the diagnosis of HNSCC. We sought to better understand performance of this assay in a hospital-based high risk oral clinic in Denmark. Materials and methods: Oral rinse was obtained from 130 consecutive patients presenting for physical exam and biopsy in a highrisk ENT clinic (Rigshospitalet, Copenhagen, Denmark). Operators were provided visual tools to record assay results. A positive test is a visible CD44 band or level of TP (i.e. 0-5 scale, recommended cut-off ≥2 or adjusted ≥3), with Sensitivity (Se), Specificity (Sp), NPV and PPV to evaluate correlation with biopsy outcome. Results: 86 of 130 (66%) patients had HNSCC by biopsy. Average age 56 years, 40% male, 100% white and 65% smokers. Using levels of CD44 or a TP cut-off of 3, the assay achieved a Se of 71%, and Sp 55%. Applying a TP level of 2 for non-smokers and 4 for smokers further improved assay performance: Se 81% and Sp 49%. With 15% prevalence, the NPV was >90%, and PPV 22%. Conclusions: Preliminary results from an easy to administer POC assay measuring salivary levels of either CD44 or TP performed well for discriminating HNSCC. Additional studies are underway to confirm and validate these results. Introduction: Miescher's cheilitis granulomatosa is known as a rare inflammatory disorder of unknown aetiology that consists of the persistent swelling of one or both lips. It has been considered as a monosymptomatic manifestation of the Melkersson-Rosenthal syndrome. This work aims to present the diagnostic approaches and therapeutic dilemma of a case observed in the department of medicine and oral surgery. Case description: Authors report the case of a 53-year-old woman, complaining of a chronic asymptomatic swelling of the right lower hemi-lip. Neither fissuring tongue nor facial paralysis was noticed. Multiple epithelioid granulomatous and giant cells without caseous necrosis were revealed by a labial mucosa biopsy. An evaluation of the gastrointestinal system, a chest radiograph, serum levels of angiotensin-converting enzyme, C1 esterase inhibitor, a complete hemogram, sedimentation rate, serum folate, iron and vitamin B12 levels were done, they all report a normal range. Thus, the diagnostic of a Miescher's cheilitis granulomatosa was retained. The treatment consists on intralesional betamethasone injections in the lower lip associated to doxycycline (200 mg). A six months follow-up shows a good response to treatment with a visible symptom regression. Discussion: The diagnosis of a Miescher's cheilitis granulomatosa is a diagnosis of exclusion. All the investigations have to be done in order to eliminate other differential diagnoses including Melkersson-Rosenthal syndrome, Crohn's disease, sarcoidosis, tuberculosis, soft-tissue tumours, and angioneurotic edema. The treatment of Miescher's cheilitis granulomatosa is only symptomatic and recurrences are frequent. Conclusions/Clinical significance: Diagnostic approach and treatment of Miescher's cheilitis granulomatosa is a real therapeutic challenge. Aim or purpose: Compare the depth of penetration of the nanosilver solution of poviargol into the dentinal tubules under the influence of ultrasound and free penetration. With the purpose of increasing the effectiveness of treatment of apical periodontitis, an antiseptic treatment of the root canals of the teeth uses an aqueous solution of nanowireber poviargol with particle sizes 4-20 nm, which have high antibacterial activity. Materials and methods: 50 extracted human teeth were divided equally into the main and control groups. A mechanical cleaning of the root canals was carried out, which was filled with a 2.5% Poviargol nanosilver colored with a tint. In the main group, the solution in the channel was activated by ultrasound at a frequency of 28 kHz, 1.8 W for 60 s, and the control solution was left for 4 days on a cotton pin. To obtain the samples, transverse root canals were made and the staining zone around the channel opening was measured under a microscope. Results: The depth of penetration of the nanosilver solution into the dentin in the main group was on the average 780 lm, and in the control group about 20 lm.

Conclusions:
The results of the study show that under the influence of ultrasound, a deeper penetration of the nanosilver solution into the dentin occurs than with free penetration. Obviously, when the nanosilver solution is activated by acoustic ultrasonic waves, its heating occurs, and, consequently, the diffusion of the solution into the dentinal tubules increases.

FC346
Effectiveness of Ozone Gas on E. faecalis biofilms Viviana Clelia Lü di Etchevarren, Rafael Seoane Prado, Antonio P erez Est evez, Yanina Ledesma L€ udi Universidad Santiago de Compostela, Santiago de Compostela, Spain Aim or purpose: To test the bactericidal ability of ozone gas onto mature E. faecalis biofilms generated in polypropylene microtubes. This new experimental model eliminates the possible significant differences found in extracted teeth experiments. Materials and methods: Biofilms formation. Aliquots (50 ll) of Enterococcus faecalis (ATCC29212) cultures were incubated into polypropylene microtubes for 5 days at 37°C without shaking. Then, the supernatant was carefully removed and the microtubes were washed four times. Control group: After washing, 50 ll of medium were added to the microtube, vigorously vortexed for 60 s and CFU counted. Ozonated group: After the last wash, 20 ml of ozone (20 lg/ml; recommended therapeutic dose) were directly applied onto biofilms for 60 s. Samples were processed as described in control group. Results: Biofilms generated on the microtube tubular surface are similar to found in the root canals in infected teeth. The amount of CFUs recovered from control group was very similar in all samples (p > 0.05). Direct ozonation of biofilms showed a reduction of 99.9% in the recovered CFUs when compared with control group (p < 0.01). Conclusions: The model presented here showed high reproducibility and eliminates variability due to anatomical variations present in extracted teeth. Ozone gas has proved a high bactericidal effect on mature E. faecalis biofilms generated in our standardized model. Ozone gas therapy is a very promising therapy in endodontics due to its effectiveness, anti-inflammatory and angiogenic properties and could be used in antibiotic allergic patients. Aim or purpose: The present study aimed to compare the tooth discoloration induced by MTA Plus, ProRoot wMTA, MTA Angelus and Biodentine over the 1-year course and to present chemical characterization of materials using X-ray diffraction analysis (XRD), scanning electron microscope and energy-dispersive X-ray analysis (SEM EDX). Materials and methods: Eighty-five human maxillary incisor teeth were assigned to 1 control (n = 5) and 4 experimental (n = 20) groups as MTA Plus (Avalon Biomed Inc, Bradenton, FL, USA), ProRoot wMTA (Dentsply, Tulsa, OK, USA), MTA Angelus (Angelus, Londrina, PR, Brazil) and Biodentine (Septodont, Saint Maur des Fosses, France). Materials were compacted via apical access preparation, which was then sealed with glass ionomer cement. Color measurements were performed after the placement (t1), the first month (t2), the third month (t3), the sixth month (t4) and the twelfth month (t5). Cylindrical discs of each specimen were also prepared and subjected to SEM EDX analysis. The powder and hydrated specimens were also analyzed using XRD. Data were analyzed using one-way ANOVA and Tukey tests (p = 0.05). Results: At the end of 1-year tooth discoloration induced by Biodentine and MTA Plus was significantly lower than ProRoot wMTA and MTA Angelus (p < 0.05). Discoloration induced by MTA Plus was significantly greater than Biodentine (p < 0.05). Biodentine induced the least discoloration at these time intervals (p < 0.05). Conclusions: All materials induced clinically perceptible discoloration. Biodentine exhibited the least tooth discoloration among the tested materials. Aim: To assess the deproteinizing effect of Bromelain enzyme, 10% Ca(OCl) 2 , 5.25% NaOCl on microleakage (ML) and shear bond strength (BS) before application of the adhesive system. Materials and methods: 80 extracted human 3rd molars were divided into 2 groups. For ML analysis, 40 teeth with class V cavities were divided into 4 groups according to dentin treatment protocol: ML1: Bromelain enzyme for 20 s; ML2: 5.25% NaOCl for 20 s; ML3: 10% Ca(OCl) 2 for 20 s and ML4: Control group. Samples restorated with composite resin were subjected to thermal cycling for 500 cycles, immersed in methylene blue for 4 h, sectioned into 1 mm thick slabs and assigned the degree of infiltration by two examiners. For BS analysis 40 teeth's occlusal surfaces were wet ground to expose superficial dentin and divided into 4 groups according to dentin treatment protocol: BS1: Bromelain enzyme for 20 s, BS2: 5.25% NaOCl for 20 s; BS3: 10% Ca (OCl) 2 for 20 s and BS4: Control group. Upon completion of the adhesive procedures, resin composite was inserted into the plastic tube and light-polymerized. All specimens were stored at 37°C in water for 24 h, and the specimens were transferred to the universal testing machine, and then subjected to shear bond strength analysis at a crosshead speed of 1.0 mm/min. The data were analyzed using the Kruskal-Wallis (p < 0.05). Results: The bond strength and microleakage results were significantly influenced by the application of the protocols compared with the control whereas there was no significant difference between the experimental groups (p = 50.533).
Conclusions: Within the limitations of the present study, it was concluded that removal of unsupported collagen fiber with deproteinizing agents results in improved bond strength and decreased microleakage.

FC349
Clinical Evaluation of Composite Onlays/Overlays Aylin Cilingir Trakya University, Faculty of Dentistry, Department of Restorative Dentistry, Edirne, Turkey Aim or purpose: The aim of our study was to evaluate the clinical performance of indirect composite onlay and overlay restorations. Materials and methods: In total 29 patients (15 males, 14 females, mean age; 38.17 AE 12.37 years) 38 indirect composite onlays/ overlays (Gradia, GC) were luted using a dual-cured cement (Panavia F2.0). The restorations were evaluated using the modified USPHS criteria. The observation periods involved 2 recalls during 12 months. After baseline recordings, patients were followed at 6 months and 1 year. The data were collected and analyzed at a level of significance (p < 0.05) using Friedman, Bonferroniadjusted Wilcoxon, Cochran Q, Bonferroni-adjusted McNemar tests to examine the restorations. Results: All restorations assessed were rated clinically acceptable in USPHS criteria. Regarding the clinical performance of the tested materials there were no statistical significant difference among the fracture of restoration, postoperative sensitivity between baseline and the 1 year recall. Adaptation, color match, marginal discoloration, surface roughness, fracture of tooth, wear of restoration showed a significant difference between baseline and the 1-year recall. Conclusions: Within the limitations of this study, composite onlays/overlays demonstrated adequate clinical performance after 1 year of function. Monitoring this study further will give more descriptive data.

FC350
Shear Bond Strengths Between Resin Cement and All-Ceramics Fabricated by Using Different Techniques Fehmi Gonuldas, Pelin Atalay, Dogan Derya Oztas Faculty of Dentistry, Department of Prosthodontics, Ankara University, Ankara, Turkey Aim or purpose: There are many ways to produce all-ceramic restorations which include powder/liquid building, slip casting, hot-ceramic pressing and computer-aided design/computer-aided manufacturing (CAD/CAM). CAD/CAM procedures compete against conventional fabricated restorations. As different methods of production may produce variable results, this study aims to compare CAD/CAM systems to hot-pressed ceramics regarding their shear bond strength using resin cement. Materials and methods: Twenty specimens were prepared from leucite-reinforced glass-ceramic blocks (IPS Empress CAD) sectioned in dimensions of 2-mm thickness, 12-mm length, 10-mm wide with a diamond slicer. Twenty leucite-reinforced pressable ceramic specimens (IPS Empress Esthetic) were constructed by the hot-pressing technique in the same dimensions. The obtained fragments were then embedded in autopolymerizing acrylic resin. Subsequently, self-adhesive resin cement was applied to the surface of the specimens using a Teflon mold and photopolymerization was carried out. All specimens were stored in distilled water for 24 h. The shear bond strength measurements were accomplished with a universal testing machine and the failure modes (adhesive, cohesive or mixed) were determined. The data were statistically analyzed using by SPSS software. Prior to the Anova test, the Shapiro-Wilk test for normality and Levene's Test for Equality of variances was performed.
Results: Regarding to the results, IPS Empress Esthetic group showed higher bond strength values than IPS Empress CAD, that was not statistically significant. Additionally, cohesive type fractures occurred entirely within the porcelain were seen. Conclusions: Material selection must be considered cautiously by clinicians, because bond strength between all-ceramic restoration and resin cement may be affected by fabrication techniques of restorations. Materials and methods: 135 bulkfill resin composite discs (BF) were fabricated, finished/polished and thermocycled for 5000 rounds (5-55°C). All specimens were surface roughened by diamond bur (except cohesive group) and divided into 8 groups with respect to repair procedures (n = 15): Group A: Universal adhesive system in self-etch mode (TSE)+BF; Group B: Universal adhesive in etch&rinse mode (TER)+BF; Group C: TSE+Nanohybrid resin composite (NH); Group D: TER+NH; Group E: Self-etch adhesive system (CSE)+BF; Group F: CSE+NH; Group G: Etch&rinse adhesive system (SB)+BF; Group H: SB+NH; Group I: BF (cohesivecontrol). After repair procedure, all specimens were thermocycled 5000 times. Shear bond strength (SBS) test was accomplished with a universal test machine at a cross head speed of 1 mm/min. Fractured surfaces were observed with a stereomicroscope under 10x magnification to determine mode of failure of samples. SBS data of all groups was statistically analyzed by two-way ANOVA and post hoc test. Aim or purpose: The aim of the present study was to evaluate the bone quality in conical beam computed tomography (CBCT), by means of the attenuation coefficient measurements, and the values of the helical computed tomography (TCH) as gold standard. Materials and methods: After approval by the Research Ethics Committee, ten human dry jaws were scanned standardized by TCFC (with three different sizes of voxel) and single TCH and four-channel multislice equipment. The images were exported in DICOM format and evaluated in a software in which panoramic reconstructions of the jaws were performed. In each reconstruction, the attenuation coefficient of the bone tissue was measured at four predetermined points in the various CT scans. A single expert investigator performed all the analyses twice, with an interval of one week between assessments. The intraobserver agreement was determined by the Student t test. The difference between the groups was tested by ANOVA, followed by the Tukey test for Multiple Comparisons. The level of significance was 5%. Results: There was a statistical difference in the bone attenuation coefficient between TCFC and TCFL. There was no difference of this coefficient between the CBCTs with different voxel sizes, as there was no significant difference between the measurements of the single and multislice TCFL. Conclusions: The differences found can determine potential failures in planning in Implantology and, therefore, information to be used with caution when obtaining CBCT.

FC353
Atypical Odontalgia Due to Birth Control Pill (Oral Contraceptives) Consumption Tantry Maulina 1 , Ika Destina Ulfa 2 , Sheylla Edu September Anita 3 complex yet difficult dental disorders to diagnose. This particular dental disorder is usually preceded by dental measurement, with dental extraction and root canal treatment being the most common dental treatment that might initiate atypical odontalgia. Case description: A 24-year-old woman came to the dental triage installation due to excruciating pain (VAS=8) on the molar region of the upper and lower jaw. About eight months prior to the visit, the 36 tooth was filled due to superficial caries. The patient experienced sharp intermittent pain due to the caries, but the pain immediately disappeared once the tooth was filled. About one week prior to the visit, the patient experienced sharp-throbbing pain in all molar region, especially during eating. Clinical as well as panoramic examination exhibited no abnormalities. From the anamnesis, it was revealed that the patients started to feel the tooth pain one week after birth pills consumption. Ibuprofen was given as pain control therapy. VAS score reduced to 6, but remained at that level. Once the birth pills consumption stopped, the pain disappeared completely. Discussion: As birth control pills works by changing hormonal balance, the effect of these hormonal changes might somehow affect oral health condition. The possible involvement of hormonal factors in atypical odontalgia should be taken into account. Conclusions/Clinical significance: The involvement of hormonal changes in atypical odontalgia is rare and might be a potential research topic in the future. Aim or purpose: The aim of this research was to assess the proliferative potential of periodontal ligament stem cells and gingival stem cells derived from controlled type II diabetic patients in comparison to those derived from normal patients. Materials and methods: Impacted third molars indicated for extraction were collected as well as 1 mm 3 of interdental papilla from human type II diabetics (n = 50) and age-matched control subjects (n = 50). Stem cells were isolated by enzymatic digestion of periodontal ligament (PDL) scraped from the middle third of the extracted molars and the gingival stem cells were similarly isolated from the interdental papilla. After propagation and maintenance for two weeks, proliferation of stem cells was assessed by MTT assay and RT-PCR for Survivin gene, an inhibitor of apoptosis. Results: Proliferation of diabetic derived stem cells relative to control subjects was decreased by 81% (p < 0.001). Similarly, Survivin gene expression significantly decreased in the diabetic derived stem cells. Proliferation and Survivin expression were significantly correlated (p < 0.001). Conclusions: We conclude that PDL and gingival derived stem cells proliferation are significantly affected by diabetic changes. Given the impairments to the stem cells due to diabetes, the impact of hyperglycemic reversal on cell functionality is crucially important for designing targeted therapeutics. Finally, this study demonstrated the impact of diabetes on stem cells for regenerative medicine.

FC355
Forensic Procedures for Age Assessment in the Living: The Dentist's Role Gwénola Drogou Saout 1 , Guy Collet 2 1 AFIO French Forensic Odontology Association, Ploemeur, France, 2 AFIO French Forensic Odontology Association, Orleans, France Introduction: Europe is facing a huge influx of young migrants and asylum seekers. Age determination is key to establishing their status as a child or adult in penal and judicial matters. These medico-legal methods are only used in cases of questionable identity documents. Case description: There is no existing method which allows to determine a person's exact age and procedures vary from country to country and even within a single country. The most widely used methods in France and in Europe in general are multi-disciplinary. There are three key methods: puberty tests, bone tests, and dental tests involving three medical specializations: a physical examination to assess pubertal development and detect possible pathologies influences an x-ray examining the clavicle and/or the carpal bone panoramic x-ray analyzed by a dental surgeon (Demirjian method). Discussion: These methods have brought up ethical questions and have led to many discussions. The reasons are manifold: the lack of reliability of the methods, the lack of data on the analyzed populations, and the fact that those who undergo testing must be able to give informed consent, be informed of the method, of the possible consequences of the test results, as well as the consequences of refusing a medical test. This information must be given free of charge and communicated in a language which is understood. Conclusions/Clinical significance: This presentation will expose the Dentist's role within forensic procedures for age assessment. Materials and methods: Thirty-six children patients aged from 10-16 years were divided into three equal groups (12 patients each). Group I, flared root canals of the patients were rehabilitated with everStick post. Group II, flared root canals were rehabilitated with EasyPost/composite, and Group III (Control), unflared root canals were rehabilitated with EasyPost/core reinforcement. The clinical parameters included the reinforced tooth, mucosa, temporary crown, and reinforcing system. The radiographical parameters were the periapical status, periodontal ligament condition, root fracture and root resorption. All patients were recalled clinically and radiographically at 3, 6, 12 and 18 months. Results: Both everSick and control group showed 100% clinical success, while EasyPost/composite group showed debonding of the reinforcing system in one patient with a clinical success rate 91.7%, and the difference was not statistically significant (p > 0.05). Radiographic assessment showed no evidence of root fracture or external root resorption and no periodontal or periapical pathology that require crown removal for clinical interference. The radiographic findings showed 100% success rate for all studied groups. Conclusions: The use of direct anatomical everStick posts in the rehabilitation of flared canals functioned well for 18 months with favorable clinical, radiographical, and aesthetic results.

Clinical and Radiographic Assessment of Pulpotomy Materials in Primary Molars
Gihan Abuelniel, Sherif Eltawil Cairo University, Cairo, Egypt Aim or purpose: Clinical and radiographic evaluation of four different materials utilized in vital pulpotomy in mandibular primary molars. Materials and methods: One hundred and sixty mandibular primary molars in forty children were included in split mouth design. Patients were medically free with an age range from 4-6 years. Inclusion criteria: patients presented with deep carious lesions including the first and second primary molars bilaterally, no evidence of any clinical pathology, or mobility and had no tenderness to percussion. Pre-operative radiographs showed no evidence of external or internal root resorption, absence of furcal, periapical radiolucency or widened periodontal ligament space and not more than one-third root resorption detected. The included molars undergone vital pulp therapy and bilaterally randomly divided into four equal groups, group (1) formocresol, group (2) ferric sulphate, group (3) MTA (mineral trioxide aggregate) and group (4) Metapex (calcium hydroxide & iodoform). All treated molars were evaluated both clinically and radiographically at 3, 6, 9 and 12 months. Data were collected and analysed statistically. Results: It was shown that, at base line, there was no statistical significant difference between clinical and radiographic success rates among the four groups. At 3 and 6 months, Ferric Sulphate, MTA (Mineral trioxide aggregate) and Metapex (calcium hydroxide and iodoform) groups showed higher clinical and radiographic success rates than Formocresol group. Introduction: Decision if a case is easy or not is done for every new patient to determine the complicity and duration. Case description: A 35 years old female came after an accident. Swollen and lacerations of the lips Lateral 12 avulsed in the and the two Centrals were broken at the third upper part of the roots, to be extracted. Treatment diverted from partial thru fixed bridge or implants. Implants were chosenas an EASY case, and there started a cascade of misfortunes that were corrected as we advanced in the treatment. Discussion: This lecture is all about failures that happened in the course of treatment. The main problem of was the swelling of the lips that camouflaged the patient's-Gummy Smile! The X rays drove to the conclusion that extraction, immediate implantation combined with immediate loading will solve the problem as an Easy one. After the swelling has moved, the lip discovered the gummy smile and there started really the rehabilitation. Conclusions/Clinical significance: One shouldn't rush into conclusions before having evaluated thoroughly all the data of the case. The rehabilitation should be postponed until the soft tissue, including lips, are at their final position. Aim or purpose: The objective of this study was the determination and comparison of colorimetric characteristics of the upper frontal teeth in subjects of the different gender and age. Materials and methods: The measurements were made in 255 patients in the intercanine sector of maxilla. There were analyzed left teeth of the intercanine sector of maxilla. Patients' tooth color measurements were performed using an intraoral spectrophotometer Vita Easyshade â (Vita Zahnfabrik, H Rauter GmbH & Co. KG, Bad Sackingen, Germany). From the spectrophotometer were collected the data of 3D Master shades.
Results: In the central incisors, the most frequent shade was registered 2M1 in 62 subjects (8.10%), in lateral incisors 1.5M1.5 in 65 (8.50%) and in canines 2M3 in 142 subjects (18.56%). The Pearson Chi-square test results, showed that there was a significant statistical difference in relation gender and age, as concern the colorimetric characteristics. In central incisors, the results were as follow: v 2 = 73.12 and p < 0.01/gender and v 2 = 287.02 and p < 0.001/age. In lateral incisors for 99.01. df = 41. p = 0.001/ gender and v 2 = 231.76 and p < 0.001 (p = 0.001)/age. In canines v 2 = 89.44 p < 0.001 (p = 0.001)/gender and 221.14. df = 90. p = 0.001/age. Conclusions: The colorimetric characteristics in the upper frontal teeth showed that there is a significant statistical difference between gender and age. Introduction: A cutaneous sinus tract of dental origin is relatively uncommon and may easily be misdiagnosed, owing to its uncommon occurrence and absence of dental symptoms. Such a lesion continues to be a diagnostic dilemma. The cases described here presented with a persistent cutaneous sinus tract of dental origin that was misdiagnosed by a general physician but which showed complete resolution following dental treatment. Case description: We will present five cases of facial lesions that were initially misdiagnosed as lesions of non odontogenic origin. The correct diagnosis in each case was cutaneous sinus tract secondary to pulpal necrosis and suppurative apical periodontitis. All facial sinus tracts resolved after the patients received both surgical and nonsurgical root canal therapy. Discussion: Extraoral manifestations of pulpoperiradicular pathosis, cutaneous sinus tract and fistulization of the facial skin have a wide range of etiologies. Because patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, a possible dental etiology may be overlooked. If dental origin is suspected, the diagnosis is easily confirmed by dental examination and dental roentgenograms of the involved area. Early correct diagnosis, based on radiologic evidence of a periapical root infection and treatment of these lesions can help prevent unnecessary and ineffective antibiotic therapy or surgical treatment, reducing the possibility of further complications such as sepsis and osteomyelitis. Conclusions/Clinical significance: Knowing this condition proves to be of paramount importance for dentists and physicians to correctly conduct the diagnosis and treatment of the disease. Aim or purpose: The aim of this research was to analyze the general smile characteristics and to identify if there exists statistically significant sexual dimorphism in smile patterns and smile parameters of undergraduate students. Materials and methods: A cross sectional study conducted in Bahria University Medical and Dental College. Study population comprised of 100 undergraduate dental students of 18-24 years. The photographs were shot from DSLR. A proforma was filled by the investigators for assessing the smile pattern and other features in the smile such as; smile arc, buccal corridors, incisal display and gingival show. Data was analyzed on SPSS version 15. p-value of less than 0.05 was considered significant. Ethical approval was taken.
Results: 77 individuals participated in the study. In majority of the subjects, the smile pattern was cuspid (59.7%) while 40.3% showed commissure pattern of smile. The smile arc was found to be consonant in 53.2% subjects. Mean buccal corridor was ascertained to be 18.78% with a Standard Deviation of AE5.82. Sexual Dimorphism in smile patterns was found to be statistically insignificant (p value = 0.221). Gender difference in smile arc (p value = 0.030) and Buccal Corridor (p value = 0.009) was found to be statistically significant. Conclusions: Our study concluded that the values of general smile characteristics of our population varied from the results of other studies and sexual dimorphism was found to be statistically significant. Although, the sexual dimorphism in smile patterns was found to be statistically insignificant. Aim or purpose: The aim of this in vitro study is using chitosan, a natural material, instead of carbopol carrier whitening gel for to achieve effective bleaching and to minimize enamel surface changing during whitening process at the same time. Materials and methods: Forty-four extracted human maxillary central incisors were selected and divided into four groups. Their enamels examination with SEM-EDX (Energy-dispersive x-ray spectroscopy) and teeth is going to record using a dental contact spectrophotometer. Two groups are going to bleach with used in routine gels %16 carbamide peroxide gel (Opalescence home bleaching kit, Ultradent Products) and %6 hydrogen peroxide (Opalescence Go home bleaching kit) gel (n = 11), third group is going to bleach with our preparations which contain % 6 hydrogen peroxide and chitosan, fourth group is going to bleach with our preparations which contain %16 carbamide peroxide and chitosan. And same procedure is going to use same beginning which examination with SEM-EDX and is going to record using dental contact spectrophotometer. Values are going to calculate as DE, L*, a*, b* and the data is statistically analyzed (p < 0.05).
Results: There is no statistically difference among other groups about colour change and demineralization values. On the other hand, carbamide peroxide + chitosan has the best results on colour change and has less demineralization values. Conclusions: As a result of this study, chitosan delivery system included home-bleaching agents can be used due to acceptable whitening and minimal enamel surface changes. Aim or purpose: The aim of this in vitro study was to compare the bleaching efficacy of different concentrations of bleaching agents containing chitosan delivery system on human primary maxillary incisors. Materials and methods: Thirty extracted maxillary incisors tooth which color with A3 or over, randomly divided into 3 test groups; Group 1 was carbopol with Whiteness Super Endo (37% carbamide peroxide) Group 2 was chitosan with 37% carbamide peroxide, Group 3 was chitosan with 16% carbamide peroxide. After finishing canal preparation and root canal filling, the root fillings were removed to a level 2 mm apical to the cementoenamel junction. Glass ionomer base was placed approximately 2-mm thick. Bleaching agents was placed into the rest of the cavity for 3-4 days at 3 times. Bleaching efficiency was measured a spectrophotometer. Groups were compared by using one way analysis of variance (ANOVA) and Tukey's HSD post hoc tests (a = 0.05). Results: According to the spectrophotometer analysis, statistically no significant color changes were found in all groups. Bleaching agents containing chitosan were similar whitening efficiency (p > 0.05). Conclusions: According to the results of this in vitro study it can be concluded that chitosan can be used as an alternative delivery system for non-vital bleaching. Materials and methods: A total of 60 glass-ceramic discs in two different shades (VITA shades A2 and A4) were selected for this study. Ceramic slices of 1 mm in thickness were prepared from the CAD/CAM blocs. All specimens were distributed into 6 groups each and composed of 10 specimens. Total-etch, self-etch and selfadhesive resin cement systems from different manufacturers in A3 shades were chosen for cementation. Firstly, color values of all the ceramic groups specimens were measured according to the CIE L*a*b* system by a spectrophotometer before applying resin cement. After than color measurements of resin-cemented ceramic specimens were performed under the same conditions. ΔE values between the "ceramic" and "ceramic-resin" groups were calculated. All specimens were subjected to thermocycling (5,000 cycles) then shear bond strength test was performed. The fractured surface was assessed by examination of the debonded surfaces with a stereomicroscope. Results: The highest ΔE values were observed for the total-etch resin cement with A2 shade ceramic group (p ˂ 0.05), and the lowest ΔE values were obtained for self-etch resin cement with A4 shade ceramic group statistically (p ˂ 0.05). The highest bond strengths were observed for the self-adhesive resin cement with A4 shade ceramic group (p ˂ 0.05), and the lowest bond strength was obtained for the self-etch resin cement with A4 shade ceramic group statistically (p ˂ 0.05). Conclusions: Ceramic shade and resin cement type significantly effect to the final color and bond strength of CAD/CAM ceramics.  Conclusions: These findings suggest that there was considerable difference in the maximum mouth opening, lateral and protrusive movement among the function malocclusion classification.
Materials and methods: Balb/C mouse gingiva (male, 8 weeks) was collected and primary cultures of gingival fibroblast were established trough the explant methodology. Briefly, tissue fragments were digested with trypsin and type I collagenase and plated. When an 80% of confluence was reached, 100 000 cells/ml were plated on 12 wells plates and left overnight. Experimental groups were: (1) negative control, untreated cells, (2) vehicle control, 5 lΜ DMSO; (3) 5 lΜ DA without medium change; (4) 5 lΜ DA applied daily without medium change and (5) 5 lΜ DA applied daily with medium renewal. After 96 h cells were analyzed regarding morphology (optical microscopy of live and crystal violet stained cells), cell number, clonogenic efficiency (clonogenic assay) and cell cycle analysis (flow cytometry with propidium iodide labeling).
Results: DA 5 lΜ application without (group 4) or with (group 5) medium renewal promoted an increase in cell size and morphological changes, namely spherical appearance and some characteristics of cell death. DA application promoted a dosedependent decrease in cell proliferation and clonogenic efficiency. However, DA leads to a G2/M increase and the appearance of a population with double DNA amount, probably due to tetraploid formation. Conclusions: These preliminary results point that DA succeeds in promoting gingival fibroblast dedifferentiation, with morphological and genetic changes compatible with stem-like phenotype. Soon, International Society for Cellular Therapy Criteria characterization will be completed and cells used for regenerative dentistry research. Purpose: The purpose of this triple arm parallel group randomized clinical trial was to evaluate and compare clinical and radiographic success rates of Mineral Trioxide Aggregate (MTA), Nano-hydroxyapatite (NHA) and Nanohydroxyapatite-calcium hydroxide (NHA-CH) biphasic cements as pulpotomy medicaments in primary molars. Materials and methods: 69 carious primary molars indicated for pulpotomy in children aged 4-8 years irrespective of gender were treated with the conventional pulpotomy technique. The teeth were randomly assigned to three groups with 23 teeth in each group based on pulpotomy medicament used: Group I (MTA) as control group, Group II (NHA) and Group III (NHA-CH biphasic cement) as two experimental groups. The treated teeth were clinically and radiographically evaluated every 3 months up to 9 months. The Institutional Ethics Committee approved the research protocol (76 ECM II-B/P38).

Results:
The clinical success rate in all the three groups at 3 and 6 months was 100%. However, at 9 months, it was 100%, 95.7% and 87% in group I, II and III respectively which was non-statistically significant (p = 0.26). In group I, II and III, radiographic success rate at 3 months was 100%, 95.7% and 87% (non-statistically significant); at 6 months 95.7%, 91.3% and 73.9% (non-statistically significant) and at 9 months 95.7%, 82.6%, and 65.2% respectively which was found to be statistically significant (p = 0.030).
Conclusions: NHA showed similar (non-statistically significant) clinical and radiographic success as MTA, and can be recommended as its replacement because NHA is cost effective than MTA. The NHA-CH biphasic cement performed significantly worse than MTA.

FC375
Comparison of 0.5% Centbucridine with 2% Lignocaine in Pediatric Dentistry Nikhita Gune, Amar Katre YMT Dental College, Mumbai, India Aim or purpose: Pain management, entailing the use of local anesthetics, is considered a crucial part of successful behavior guidance in pediatric dentistry [i]. Centbucridine, an Indian molecule with proven local anesthetic action and novel anti-allergic properties could prove to be an effective anesthetic agent [ii]. The aim of this study was to compare 0.5% centbucridine and 2% lignocaine (with adrenaline) as local anesthetic agents for dental treatment procedures in 12 to 14 year old children. Materials and methods: Post institutional approval, a split mouth, triple blind randomized controlled trial design was adopted. 56 children between 12 to 14 years of age requiring bilateral administration of IANB were selected. The mandibular quadrants were randomly allotted the drug to be administered and a similar protocol for IANB was used in both sessions. The primary outcomes assessed were onset and duration of anesthesia, depth of anesthesia using the Visual Analog scale and effect on peri-operative pulse rate using a pulse oximeter.
Results: There was no significant difference between centbucridine and lignocaine with respect to their mean onset {(105.181 and 99.727 seconds respectively), (p = 0.647)} and duration of action {(91.931 and 91.613 min respectively), (p = 0.931)}. Centbucridine showed a statistically significant drop in the pulse rate at 10 min (p < 0.001) and 30 min (p < 0.001).
Conclusions: Centbucridine could be considered as an alternative local anesthetic agent by clinicians in children with hypersensitivity reactions to lignocaine. Aim or purpose: The purpose of this study was to find correlation between the shape of maxillary central incisor and face form in a sample taken from Pakistani subjects. Materials and methods: A total of 180 subjects ranging from 17-25 years of age were selected. Digital photographic records were made; a full-face photograph with the closed lips was obtained. An intraoral photograph of the maxillary central incisor was obtained using cheek retractor, with the lens parallel to the labial surface of the teeth. The outline tracings were printed in distinct transparencies, and 3 general dentists determined if there was correspondence between the tooth and the face forms by superimposition of the transparencies. The experts also classified the central incisor forms into square, ovoid and tapering. A non-parametric Chi-Square test was applied in the statistical analysis (p < 0.05).
Results: Results showed by visual method the correlation between maxillary central incisor tooth form and face form, a predominance of the Ovoid shape (100%) in relation to the squarish shape (98%), and the tapering (97.3%), p-value < 0.001, r = 0.99 (Highly correlated).
Conclusions: There was a defined correlation between maxillary central incisor tooth form and face form among the male and the female Pakistani subjects.

Comparison of Different Techniques in Treatment of Excessive Gingival Display
Hasan Guney Yilmaz Near East University, Faculty of Dentistry, Department of Periodontology, Mersin, Turkey Aim or purpose: The aim of this clinical study was to investigate the outcomes of a lip repositioning surgery (LPS) technique with diode laser for the treatment of excessive gingival display (GD). Materials and methods: 36 patients were included. Patients were assigned to an experimental group (n = 18) and treated with LPS with diode laser. In the control group (n = 18) LPS was done with conventional method. The clinical dimensions of GD were measured at baseline, 6 and 12 months post-operatively.
Patients completed surveys to evaluate their satisfaction.
Results: The baseline GD of 9.8 AE 1.6 mm and 9.2 AE 1.4 mm at laser and control group, respectively. GD significantly decreased to 1.6 AE 1.1 mm and 1.8 AE 1.3 mm at 6 months and was maintained until 12 months (1.8 AE 1.2 mm 1.9 AE 1.5 mm) at laser and control group respectively. There were no significance differences for GD between the groups at any time point. Patients were satisfied with their smile after surgery (96% and 94%). The disadvantage part of LPS was the inability to move the lip during the early healing (88% at laser group and 62% at control group p < 0.05).
Conclusions: Treatment of excessive GD by LPS with or without diode laser results in high level of patient satisfaction and predictable outcomes that are stable in the long term. Treatment of excessive GD by LPS with or without diode laser results in high level of patient satisfaction and predictable outcomes that are stable in long term. Materials and methods: One hundred and thirty-five human maxillary central teeth were assigned to groups of 1a-control, 1b-laser treated, 1c-fluoride treated, 1d-laser+fluoride treated for shear-bond testing and to groups of 2a-positive control (non demineralised), 2b-laser treated, 2c-fluoride treated, 2d-laser+fluoride treated, 2e-negative control (demineralised) for micro-hardness testing (n = 15, N = 135). Demineralization solutions of microhardness measurements were used for the ICP-OES elemental analysis. The parameters for laser irradiation were; power output: 0.25W, total energy density: 62.5 J/cm 2 , energy density per pulse: 4.48 J/cm 2 with an irradiation time of 20 seconds and with no water cooling. 5 % NaF varnish was used as fluoride preparate. ANOVA and Tukey HSD tests were performed (a=5%). Results: Surface treatments showed no significant effects on shearbond strength values (p = 0.579). However, significant differences were found in micro-hardness measurements and in elemental analysis of Ca and P amounts (p < 0.01 Aim or purpose: The aim of this study was to investigate the staining susceptibility of various aesthetic restorative materials and the ability of different toothpastes in removing stains from these materials. Materials and methods: Discs shaped specimens (2 x 8 mm) were prepared for Gradia Direct Anterior, Filtek Ultimate, Tetric N-Flow, Fuji IX GP (n = 90). The specimens were polished and randomly divided into 6 brushing groups (n = 15): 1: Distilled water; 2: Toothbrush; 3: Clinomyn; 4: Sensodyne; 5: Curasept ADS 712; and 6: _ Ipana Pro-Expert. Except for distilled water group, the specimens in other groups were immersed in tea for 14 days and then were subjected to a brushing test of 14 600 cycles with only toothbrush or one of four different toothpastes. Color changes (DE*) were measured using spectrophotometer according to CIE L* a* b* color system; at baseline, after tea immersion and after brushing. Results were statistically analyzed using one-way ANOVA and Tukey HSD test. Results: After immersion in tea for 14 days, the color change of the other restorative materials are clinically unacceptable except for the Gradia Direct Anterior (DE*˃3.3). After brushing, the color change of materials is clinically acceptable except for Fuji IX. There was no statistically significant difference in the ability to remove stains among the toothpastes (p > 0.05). Conclusions: Tea causes different levels of staining in the restorative materials. Brushing with or without toothpaste is effective on stain removal in composite resins.

Double-Application Effect of Universal Adhesive on Tooth Substrates' Bond Strength
Meltem Nermin Dursun 1 , Aybuke Uslu 1 , Cansu Atalay 1 , A. Ruya Yazici 1 , Atilla Ertan 2 , Gul Ozgunaltay 1 1 system (6 groups; n = 12). For each tooth substrate, the universal adhesive system, Adhese Universal was applied in self-etch mode either following the manufacturers' recommendations or with double application. Following the application of the adhesive, resin composite, Tetric N-Ceram was bonded on enamel, coronal and radicular dentin. After storage of samples in distilled water at 37°C for 24 h, they were subjected to shear bond strength (SBS) test. SBS measurements were performed using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using two-way ANOVA (a = 0.05).
Results: There were no statistically significant differences in shear bond strengths between the single-and double-application of the universal adhesive for each tooth substrate (p > 0.05). While no difference was observed between the tooth substrates in single application (p > 0.05), double-application for coronal dentin showed significantly higher bond strength than enamel (p < 0.05).
Conclusions: Application of the tested universal adhesive either single or double did not affect the bond strength of different tooth substrates.

POSTER SESSIONS 68-81
Poster Aim or purpose: To evaluate the effect of low-level laser therapy (LLLT) on the pain, trismus and swelling of patients whose impacted lower third molar tooth was extracted compared to placebo or "sham" treatment and measure volumetrically to the edema with 3dMD face system. Materials and methods: Forty-five patients 18 years of age or older were included into the study. The study was approved by the Human Ethics Committee of Inonu University. Patients were randomized into three groups (n = 15); Group 1, the control group, received only routine management (ice application); Group 2 received single-dose LLLT immediately after surgery; and Group 3, placebo group, received sham therapy immediately after surgery. In this study, a gallium-aluminum-arsenide diode laser device was used. The laser was applied extraorally (0.3 W, 40 s, 4 J/ cm 2 ). The mouth opening, pain and facial swelling evaluated. 3dMD imaging system was used to evaluate volumetric changes of the swelling. IBM SPSS statistics 22.0 program was used in the statistical assessment. p < 0.05 was considered significant. Results: There was no statistically significant difference in the edema and trismus between the groups. The pain level in Group 2 was significantly lower than in Group 3 at all-time points.
Furthermore, the pain level in Group 2 was significantly lower than in Group 1 on day 7. Conclusions: LLLT reduced the intensity of pain following third molar surgery by single dose compared to placebo group and control group. Furthermore, we used a different method (three-dimensional system) to evaluate objectively volume changes of the swelling. Aim or purpose: This study aimed to assess the vertical relationship between the maxillary sinus floor (MSF) and maxillary posterior teeth (MPT) roots using cone beam computed tomography in a Tunisian population. Materials and methods: In this cross-sectional study, 60 CBCT were selected including 33 males and 27 females. Totally 100 Maxillary sinuses were analyzed; enclosing 500 MPT i.e. 1256 root tips. The vertical relationship between each root of the MPT and the MSF was classified into three types: type 1; the roots were in contact with the MSF, type 2; the roots penetrated into the MSF and type 3; the roots were distant from the MSF. Results: For the vertical relationships according to the maxillary teeth, type 3 occurred most frequently in the first premolar (94%). Type 2 was most frequently observed with the second molar (32%). For the vertical relationships according to each root of these teeth and the MSF, the results were as follow: Type 3 occurred most frequently in the first premolar buccal root (98%). For the type 2, the mesio-buccal root of the second molar had the closest proximity with the MSF with 48%. No statistically significant difference was found between the right and left side assessments (p = 0.19) but several differences were found between males and females (p = 0.011). Conclusions: This relationship between MPT and MSF should be considered in order to prevent an iatrogenic procedure and minimize the risks from an infectious disease within the sinus. Fibrin (PRF) clots were used for immediate closure of acute oroantral communications after the extraction of posterior maxillary molars. Materials and methods: Acute oroantral perforations of more than 3 mm in diameter in 21 patients were treated uneventfully by using of PRF clots. None had systemic diseases or sinus disease. After tooth extraction, the diagnosis of acute oroantral communication was examined by Valsalva's maneuver test (compression of nostrils with the fingers and 28 blowing out the air). After the detection of air leak, modification of a ball burnisher instrument which was 3 mm in diameter used to determine whether the size of perforation was greater than 3 mm diameter. The post-extraction socket of the tooth was cleaned with sterile physiologic saline solution and cavity was filled with PRF. PRF clots were sutured to the gingiva to prevent them from migrating to the sinus and for stabilization. Results: At the 7th day follow-up, healthy granulation tissue and at the third week follow-up, epithelialized oral mucosa was observed at the extraction side of all cases. Conclusions: This technique (PRF) enables the closure of OACs without a primary flap closure or any other surgical interventions. So, the use of PRF in immediate closure of acute OACs will make the treatment of OACs easier and also will eliminate the need for special surgical expertise.

P345
Immediate Autotransplantation of a Tooth Impacted by an Odontoma: A Case Report Ö znur Tuncay, G€ oksel S ßims ßek Kaya Akdeniz University, Antalya, Turkey Introduction: The failures of dental implants for many reasons, autotransplantation has recently a focus of interest in dentistry. The success of autotransplantation has become more consistent compared to that of earlier studies owing to a better knowledge of healing mechanisms of the alveolar bone and periodontal tissues. However, the procedure is technique sensitive and strict regard to certain factors is critical for its success. Meanwhile, Platelet Rich Fibrin (PRF) is popular as a biomaterial which helps in the regeneration of bone and periodontal tissues. Case description: We are presenting a case where PRF and bone graft (Bios) are used in same surgical treatment duration, as well as improve the treatment outcome in a single procedure of transplanting an impacted tooth in the alveolar region previously occupied by an odontoma. Discussion: The clinical and radiological findings at 1.5 year-follow-up showed good result and promise. Conclusions/Clinical significance: Use of PRF with grafts in singlestep autotransplantation warrants many trials and comparative studies to fully realise its potential. Also, it is important for patient and physician comfort that the healing process can not needed without two-stage surgery. Aim or purpose: Study the interrelationships between prosthetic factors and ATM disorders in a partially edentulous patient population within the CHUOran prosthesis department. Materials and methods: Case study was carried out. An investigation form was completed with general information, clinical and prosthetic examination. We looked for a possible association between ATM disorders and prosthetic factors using the logistic regression model. The statistical test used is the chi-square test under SPSS. Results: Our sample (106 patients) represents a female predominance of 77.64% and an average age of 39.19 years AE 1.18 years. The prosthesis involved 64 patients (60.4% of the population). We observed a rate of 49.1% without a prosthesis for the upper jaw, 34.9% for a removable prosthesis, 16% for a joint prosthesis and 72% without a prosthesis, 24% for the removable prosthesis and 4% for the lower jaw. In the univariate analysis, several factors had a significant relationship, however the final model obtained had only one explanatory variable adjusted for the other variables with a statically significant association to DAM (adjusted OR = 3.075 with 95% CI = [1.973-9.715], p = 0.04) The description of the clinical profile concluded that the most common sign in the "cases" was lateral pterygoid pain with a value of 81% (43 of 53), pain 'ATM 69.8% (37 of 53), and joint noise for 35.8 (19 out of 53). Conclusions: There is no association between ATM disorders and prosthetic factors in this population.

P347
Influence of Canine Inclination to Sagittal Plane on Smile Aesthetics Janina Pavlova, Georgi Iliev Faculty of Dental Medicine, Medical University-Sofia, Sofia, Bulgaria Aim: Establishing the influence of upper canine inclination relative to sagittal plane on profile and full-face smile aesthetics. Materials and methods: 114 surveyed persons, of them 63 dental students and 51 patients with partially or completely removable dentures. The CorelDRAW Graphics Suite X6 software performed the upper canine inclination relative to sagittal plane simulations. Five types of inclinations were reproduced, 7°, 9°, 11°, 13°, and 15°. The respondents assessed the aesthetics of two setups of different profile and full face canine angulation images using a six-point scale. Results: Canine inclination introduces different levels of aesthetics evaluation. The patients showed a significantly higher tolerance to canine angulation changes than the dental students.

Conclusions:
The inclination of the canine tooth to the sagittal plane has a greater impact on profile aesthetics than on the frontal view. Smiles with canine inclination of 9°were considered as the most aesthetic. They are preferred by 70% of respondents among the full-face images, while pictures in profile -by 48.45%. Smiles with canine inclination of 15°were assessed as unaesthetic. In full face images by 1/3 of respondents, while in profile by 2/3 of them. According to 1/2 of the dental students, the smiles with canines inclination of 7°are unesthetic, while the patients don't share this. To achieve good aesthetics of prosthetics, the inclination of the canine tooth relative to the sagittal plane should vary between 9°a nd 13°to comply with patients' preferences.

Multidisciplinary Oral Rehabilitation of a Patient with Synthetic Cannabinoids Addiction
Gulce Alp 1 , Serap Karakis Akcan 2 , Ozge Aydog 2 , Meryem Gulce Subasi 2 1 Faculty of Dentistry, Department of Prosthodontics, Okan University, Istanbul, Turkey, 2 Istanbul Aydin University, Istanbul, Turkey Introduction: Addiction to synthetic cannabinoids has many oral manifestations such as erosion of teeth. This case report described the multidisciplinary approach of a patient whose teeth and dental appearance were severely compromised as a result of synthetic cannabinoids addiction. Case description: A 27-year-old male patient with a one-year history of synthetic cannabinoids addiction referred to our clinic for esthetic rehabilitation. He had 2 mm reduced vertical dimension of occlusion and deep acid erosion of enamel and dentin on maxillary and mandibular anterior teeth surfaces due to vomiting after synthetic cannabinoids usage. Following the clinically, radiographic and diagnostic casts examination; periodontal, endodontic and prosthodontic treatments were planned. Crown lengthening was applied to the maxillary incisors and endodontic treatment was performed to the teeth that had exposed pulp chambers and extensively deep caries. After 6 weeks healing period, provisional restorations were fabricated using wax-up and mock-up models for adapting new vertical dimension. 2 months later, anterior mandibular teeth were restored with direct composite resin restorations and 15-unit metal-ceramic crowns were prepared for all the maxillary teeth and mandibular left second premolar. The crowns were cemented and followed-up a period of 1 year. Discussion: This clinical report described a multidisciplinary approach using composite resin provisional for adaptation of new occlusal vertical dimension and rehabilitation of loss of tooth structure. Metal-ceramic restorations may be an economic treatment alternative in such cases. Conclusions/Clinical significance: The restoration of esthetics and function in patients with synthetic cannabinoids addiction may be achieved with multidisciplinary approach. Aim or purpose: The treatment of choice in reconstruction procedure of endodontically treated teeth is a combination of fiber posts systems, resin cements and core materials. The success of the final restoration treatment depends of mechanical properties of restorative materials. A significant is the bond strength of the posts and cement materials. The aim of this study was to determine the bond strength of dual cure cements using the push-out test. Materials and methods: Ten extracted human maxillary central incisors and two dual cure resin cements were used in the study. Three root segments of 1 mm thickness were obtained from each tooth in accordance with the region of the root (the cervical, the middle and the apical). The push-out test was performed in a universal testing device. Aim or purpose: In the last decade, Dysfunctional Syndrome of Stomatognathic System (SDSS) became an important problem of public health in the domain of Dental Medicine due to the increasing trend of this pathology of prevailing once with aging. The purpose of our study was focused on the realization of functions of stomatognathic system that's relies primarily on neuromuscular activity. The specific objectives were the evaluation of muscle and rehabilitation through methods of balneo-physio-kinetotherapy will be done by raising the patient's awareness of changes in the cephalic extreme. Materials and methods: Our study was developed on a sample of 63 (77.78%) patients which presented the affliction of muscular activity as a result of decreasing or increasing of muscular tonus. In our study, a clinic experiment type, we have applied various methods of treatment, in single or multiple therapy, through physical factors, addressed to stomatognathic system and cephalic extremity, along with other systemic elements, as a result of interconnections established at systemic and oversystemic level. Results: Kinetotherapy was administered in 28 (45.16%) patients, the effect of augmentation on the local metabolic processes, the analgesia of painful zones and muscular relaxation have positive effects on long, and short term. Also, in the treatment of muscular-joint disorders at the level of stomatognathic system we use the ultrasonotherapy (30.65%) procedures. Conclusions: The establishment of stomatognathic system functions is based mainly on the neural muscular activity that ensures the mandible, relaxation, re-equilibration, and functional re-education being mandatory for complex rehabilitation of stomatognathic system. Aim or purpose: To assess the attitude, understanding and practice concerning infection control measures among dental students and dentists of Fatima Jinnah Dental College, Karachi, Pakistan. Materials and methods: A cross-sectional study was carried out to collect data from 117 dental students and dentists using convenience sampling from Fatima Jinnah Dental College, Karachi, Pakistan. All the individuals were interviewed using a questionnaire based on different questions regarding knowledge, attitude & practice related to different aspects of infection control. Data was analyzed using SPSS version 16.0. Results: Majority (77.8%) of the individuals were dental students mainly females (69.2%) of which 74.4% belonged to 3rd and 4th/ final year. When asked about infection control almost all individuals have a thorough understanding of the different techniques that are important for infection control. 95.7% of the individuals washed their hands after examining/treating the patients with 85.5% using either a hand wash or antiseptic solution. 97.4% of the sample considered isolation using rubber dams a key factor in infection control while treating patients. 93.2% of the sample considers instrument sterilization using autoclaving as an important factor in infection control, majority having complete knowledge of the process involved. Regarding preventive measures, 66.7% of the sample was vaccinated against Hep. B, TB and Tetanus/BCG and 93.2% took protective measures required for disease transmission prevention. Conclusions: The education & enlightenment of dental students and dentists in terms of preventive measures particularly vaccinations should be emphasized as an obligatory requirement for joining dental school.

Workshop for Caregivers of Dependent Elderly in Rural Areas
Jose Manuel Gonzalez-Perez, Mª Esther Rodriguez-Priego, Rocio Mateos-Palacios Andalusian Health Service, C ordoba, Spain Aim or purpose: To improve the knowledge of caregivers at home for dependent elderly people on oral health and prevention of oral diseases. Materials and methods: A dentist, a nursing assistant and a social worker conducted a workshop for a group of 12 caregivers from a rural area. Prior knowledge test was performed. Then, a session on preventive measures (hygiene, healthy eating, etc.) and oral symptoms or findings which require the dentist to carry out an assessment were given. After that, attendees passed a new test of knowledge. 6 months later, a remembrance session was held and doubts were resolved. Finally, the acquired knowledge was reassessed.
Results: An improvement in oral health and oral disease knowledge and preventive measures was found in the caregivers evaluated. The improvements were maintained over time.
Conclusions: The delivery of workshops on oral hygiene and health aimed at caregivers improves their knowledge. Further studies are needed to assess whether this acquisition of knowledge will, in turn, improve the oral health of these dependent elderly.

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Improving Oral Health of Indigenous Children Through Community Partnerships Ramini Shanmugananthakumar, Parul Marwaha Monash Health, Melbourne, Vic., Australia Aim: Using outreach model to increase oral health knowledge and awareness of Indigenous children and parents and improve access to dental services, through community partnerships. Materials/Methods: The dental team liaised with local community services and programs conducted for Indigenous children, to conduct oral health education and screening sessions within existing settings. These sessions included oral health education delivered in an age appropriate manner, dental story books and information about dental visit. Pictorial goal setting to encourage ongoing commitment to good oral health practices and a showbag for each child were also included. Dental screenings were offered to children and those at high risk of dental caries had a re-mineralising agent applied to their teeth. Results: This project engaged 125 Indigenous children at Healthy Koori event, 70 children at Back to School Day event, 60 parents were educated at Kick the Butt event and 60 families during Aboriginal week. 300 children received showbags. Feedback forms received from parents and carers reported the session was useful, practical and filled with new and relevant information. Number of Indigenous children accessed dental services: Conclusions: The outreach model was effective in engaging a hard to reach community and increasing oral health knowledge of Indigenous children and parents. The project provided information about dental services and the positive experience encouraged further engagement with services leading to increased access. The results of this initiative were used to secure Department of Health funding of $100 000 to replicate this model across the region.

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Engage, Educate and Improve Oral Health for Patients and Staff Ramini Shanmugananthakumar, Parul Marwaha Monash Health, Melbourne, Vic., Australia Aim: To conduct screening and education of patients, supporting the maintenance and improvement of oral health while on the waitlist, for the timely provision of services to high risk groups and to improve oral health knowledge across the organisation. Materials and methods: The organisation's catchment area is characterised by high oral disease burden, resulting in long waiting lists. Waitlisted patients were invited to participate in the screening and education program as part of World Oral Health Day 2016. The oral health education session explained the effects of poor oral health on overall health. This was followed by a dental assessment, where patients with more than six decayed teeth or comprised medical conditions were removed from waiting lists. Staff booths were placed at organisational sites to provide information about oral health. Posters were displayed to explain effects of oral health on general health to non-oral health professionals within the organisation. Results: 468 patients participated in the program and were provided with oral health education and assessment. A quantitative and qualitative assessment indicated that patients were immensely satisfied with the program and found the education sessions useful. A fluoride application was done for 24% of patients at high risk and 19% of patients were prioritised and given an emergency appointment. Conclusion: The promotion of oral health knowledge and preventative care provides the opportunity to up skill staff, reduce waiting lists and reduce treatment complexity, improving oral health outcomes of patients and working towards a 'preventative model of care'.

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The Oral Hygiene Status of Visually Impaired and Healthy Individuals Aditi Dhoble, Amey Patil Terna Dental College, Mumbai, India Aim: The objective of this study is to compare the oral health status amongst blind subjects and healthy controls of same age and sex adults by evaluating Simplified Oral Hygiene Index (OHI-S). Materials and methods: A total of 80 adults (aged 18-60 years) were included in this study into two groups. Complete Visual Impairment Adults (CVIA) Group, n = 40 and Healthy Adults (HA) Group, n = 40. In the first visit, OHI-S was obtained from all participants. Oral hygiene instructions by audio recordings in unambiguous language and instructions in Braille were given to the CVIA Group and were instructed to practice the same. Audiovisual oral hygiene instructions in unambiguous language were given to HA Group. All participants were asked to practice oral hygiene measures following the instructions provided for one month. In the second visit, after one month, the OHI-S was recorded and compared with the baseline. Statistical power of 90% and alpha at 0.05 was set for all analyses. Results: OHI-S at baseline was statistically significant (p < 0.0001) between CVIA Group and HA group. OHI-S after one month was statistically not significant when compared between both groups. OHI-S at baseline and OHI-S after one month was statistically significant in CVIA Group (p < 0.0001) and HA Group (p 0.0454).
Conclusion: The present study shows improvement of oral hygiene in both the study population by the decrease in the OHI-S. Therefore, the combination of audio recordings and oral hygiene instructions in Braille is one of the effective methods of oral hygiene educational aid for visually impaired individuals. Aim or purpose: To study the survival rate of primary molars after pulpotomy in 1-7-year-old children. Materials and methods: The retrospective study was conducted in 2009-2014 years. The records of 34655 children aged 1-7 years who visited municipal dental clinics were studied. The cases of reversible pulpitis treatment by vital (N = 7858) and non-vital pulpotomy (N = 7550) in primary molars were included into the study. Pulpotomy was provided by 38 dentists in 2009-2011 and after treatment all children visited their dentists annually for 3 years. The criterion of success was based on the survival of a tooth after pulpitis treatment. The primary molars naturally exfoliated on time were not taken into account. The proportions (%) of surviving teeth and 95% confidence intervals (CI) were calculated in 1, 2 and 3 years after pulpotomy. The differences in proportions were assessed by Student's t-test at p-value < 0.05. Results: The proportions of primary molars surviving after vital pulpotomy were 94.0% (CI 93.5%-94.5%) after 1 year, 87.6% (CI 86.9%-88.3%) after 2 years, and 79.8% (CI 78.9%-80.7%) after 3 years. The survival rates after non-vital pulpotomy were 89.2% (CI 88.5%-89.9%), 69.8% (CI 68.8%-70.8%) and 45.7% (CI 44.6%-46.7%) after 1, 2 and 3 years respectively. The differences in proportions were statistically significant (p < 0.001). Conclusions: In routine dental practice, the survival rates of primary molars decreased from 1 to 3 years after reversible pulpitis treatment in 1-7 years old children. The 3-years survival rates of primary molars were significantly higher after vital pulpotomy than non-vital pulpotomy. Aim or purpose: High viscosity encapsulated glass-ionomer cement system (GICs) and bulk-fill resin composites (BRC) materials are the latest developments in restorative materials both of which do not require polymerization devices and incremental filling. This study compared the clinical performance of GICs and BRC up to 2 years. Materials and methods: In total, 35 patients (10-12 years of age), who had caries in mandibular molars (n = 70 Class I/II cavities), were enrolled in the study. After caries removal, impressions were made and cavity sizes were determined. Each patient received two restorations randomly, either with GIC with a self-adhesive nanofilled coating or BRC after using a self-etch adhesive. Two calibrated observers evaluated the restorations at baseline and up to 2 years using modified USPHS criteria. Chi Square, Kaplan Meier and long rank tests were used to analyze the survival rates (alpha = 0.05). Results: After two years, 68 restorations were evaluated in 34 patients (recall rate: 97.1%). Depth of cavities ranged between 2.5 to 6 mm (mean: 3.7 mm). While 3 chippings were observed with GICs, no failures were observed for BRC. Secondary caries was observed in 2 GIC fillings (1 Charlie score) and 1 BRC. Marginal deterioration (10 GICs (1 Charlie), 2 BRC), anatomical form change (7 GICs (1 Charlie/Delta), 0 BRC), and surface porosity (10 GICs (2 Charlie/Delta), 3 BRC) were more frequent with the GICs. Conclusions: Both bulk-fill resin composite and encapsuled glassionomer cement system showed similar clinical performance where the latter showed more frequent surface deteriorations up to 2 years. Introduction: The prognosis of dental traumas is affected by the initial management. We had been using a semi-rigid splint method for various dental traumas in clinical practice. The purpose of this presentation is to introduce this simple and effective splint method. We present the following cases. Case description: Case 1: A 14-year-old girl visited our clinic two hours later after her #11 tooth was horizontally displaced to labial side. We repositioned and splinted the tooth by the semi-rigid splint method which uses flowable composite resin and elastomeric chain. One week later, pulpectomy was performed for this tooth. After one month follow up, we performed a root canal filling for this tooth and removed the splint. After one year follow up, the tooth was asymptomatic without inconvenient findings. Case 2: A 4-yearold boy visited our clinic two hours later after his #61 and #62 teeth were displaced to lingual side. We repositioned and splinted these teeth by the semi-rigid splint method. One month later, we performed root canal treatment for the teeth and removed the splint. Then, his injured teeth were keeping in a favorable outcome. Three years later, the successor permanent teeth erupted normally. Discussion: By using the semi-rigid splint method, dentists can confirm the healed status of injured teeth without splint removal. We consider that this is one of the important advantages of this method. Conclusions/Clinical significance: From the prognoses of the 2 cases in the present study, this method seems to be effective for severe dental traumas with alveolar bone fracture.

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Oral Health State and Treatment Needs of Children with Down Syndrome Hind Boufdil, Maria Mtalsi, Aya Amorri, Samira Elarabi Faculty of Dentistry, Casablanca, Morocco Aim or purpose: Down Syndrome is the most common congenital genetic disorder in the world affecting many organs including the orofacial region. The aim of this study is to evaluate the oral health status and treatment needs of children affected with Down syndrome. Materials and methods: A transversal and descriptive study with a sample of 111 children was performed. The children were aged between 4 and 14 years. The oral status and treatment needs were recorded. Results: The dental caries severity is evaluated as moderate. The DMFT index was 0.62 and dmft index was 3.38. The gingival inflammation was found in 46.84% and 62.2% of the children present a need for a prophylactic. Conclusions: Based on our results, we can conclude that the Moroccan child with Down syndrome had a special oral health status requiring an adapted oral dental preventive program.

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Prosthetic Rehabilitation of a Child Suffering from Ectodermal Dysplasia Emine Sen Tunc, Zeynep Sahin Ondokuz Mayis University, Samsun, Turkey Introduction: Ectodermal dysplasia (ED) is an inherited disorder that affects ectodermally derived organs, such as teeth.
Pathogenesis is thought to involve an altered epithelium-mesenchymal interaction. ED patients have oligodontia (or sometimes anodontia) and malformed teeth in addition to other abnormalities involving the skin, sweat glands, or hair. The quality of life is greatly impaired very early, with major difficulty for feeding and the drawbacks of dental anomalies. Case description: This case report outlines the oral rehabilitation treatment of a 9-year-old girl with ectodermal dysplasia. The patient exhibited only the permanent maxillary and mandibular first molars bilaterally and maxillary central incisors. The treatment to improve his appearance and oral function included a removable prosthesis. The extraction of the central teeth was performed, followed by acquisition of maxillary and mandibular impressions for fabrication of acrylic removable partial dentures with circumferential clasps on the firs molars. The dentures allowed recovery of the vertical dimension and excellent esthetics. Discussion: Early prosthetic rehabilitation is an alternative, which could become a first line treatment. It makes the subsequent treatment steps easier. In this case a prosthetic rehabilitation in the form of a removable acrylic prosthesis was made, achieving excellent esthetics, functionality and adaptation, thanks to which a considerable improvement in self-esteem has been obtained. Conclusions/Clinical significance: The prosthetic rehabilitation is an appropriate technique for ED diseases, and it may further psychologically motivate child patients in the social environment during the growing period.  Aim or purpose: The study aims the evaluation of the implications of functional disorders generated by complete edentulism correlated to the behavioural type of the complete edentulous patients, related to age. Materials and methods: The study was conducted between 2015 and 2016, on a lot of 33 patients, aged between 38 and 81, 19 of them women and 14 men, with 59.5 years average age, which was divided in 4 age groups: under 40, 40-59, 60-79 and over 80. To a better understanding of the psychological component of patient's behaviour profile 2 questionnaires were conceived combining functional and psychological aspects. Results: The 40-59 group had most interest in esthetics. Regarding the masticatory efficiency, the predominant group was 40-59, 65%, followed in hierarchy by the 60-79 group (28%), over 80 (12%) and at last under 40 group (4%). For the behavioural types, in decreasingly order, the upper limit is the philosophical behaviour (42%), 29 % the pretentious one, histrionic one 17%, and the lowest limit, 12 % the indifferent one.

Conclusions:
The psychological evaluation of the complete edentulous patient becomes essential for the optimum prosthetic treatment and also for the consolidation of the patientdoctor relationship. The psychosocial behavioural analysis will bring benefits in all directions P362 Aesthetic Smile Design with Full Ceramics for Congenital Unilateral Deficiency Begü m Karademi̇, Burcu Kanat-Ert€ urk Faculty of Dentistry, Department of Prosthodontics, Kocaeli University, Kocaeli, Turkey Introduction: The rehabilitation of the congenital unilateral tooth deficiency can be clinically challenging because of asymmetry and teeth alignment disorder. In this case report, the rearrangement of the smile line and pink/white aesthetics by using full ceramic crown and laminate veneers, in a case with #12 as congenital missing, is described. Case description: 47-years-old female patient referred to our clinic with aesthetic complaints, and metal ceramic restoration on #11, 21 and congenital missing tooth #12 were observed. Following clinical and radiographic examinations, crown lengthening operation was performed to rearrange the smile line. For prosthetic treatment, crown restorations were decided for #13, 11, 21, 22, 23, 24, 31, 32, 41, 42 due to need for dentin level preparations, whereas laminate veneers were planned for #14, 15, 25, 33, 43 for minimally invasive approach. Diagnostic wax-up was conducted on model and mock-up was transferred to mouth. The preparations were performed on mock-up and impressions were obtained with polyether impression material (Impregum, 3M ESPE). The restorations were fabricated by using pressable lithium-disilicate glass-ceramic (IPS e-max Press, Ivoclar Vivadent). The adaptation and aesthetic of restorations were checked intraorally, and restorations were cemented with total-etch resin cement (Variolink II, Ivoclar Vivadent), following glaze procedure. Discussion: In the case with congenital unilateral tooth deficiency, laminate veneers based on minimal invasive principle may be used successfully to replace the missing teeth by shaping teeth forms. Conclusions/Clinical significance: According to preliminary results, smile design and symmetric aesthetic is provided successfully with full ceramic crown and laminate veneers in cases with congenital unilateral tooth deficiency. Aim or purpose: The purpose of this study was to investigate by finite element method the biomechanical behaviour of two-implant mandibular overdenture retained with ball attachments, assessing tension and strain in mandibular prosthesis.

Materials and methods:
The geometric model has been achieved by 3D scanning of a mandibular overdenture on two implants that has been imported than into the ANSYS program for performing numerical study. In the study were analysed stress, displacement and deformation amplitudes of the model after applying forces. 16 clinical cases were simulated varying interimplant distance, the site of force application (frontal or lateral side), unilateral or bilateral, implants being positioned symmetrical or asymmetrical to the centre line, while keeping the force constant (100 N). Results: The effects of the simulation were displacement of the overdenture with different amplitudes and torsion of the denture base relative to the site of the force and of the position of the implants. Stress distribution caused by masticatory forces become more even with increase of the interimplant distance. Thus, if the implants are positioned closer to the force application, the stress transmitted through the prosthesis to support tissue, both in the working as well as the non-working side, are lower, that being due to a less displacements of the denture as well.
Conclusions: The most favourable situation regarding an even force distribution correlated with a low displacement of the denture and reduced stress on implant-prosthetic connection was the position of the implants distal from canine area with a correct occlusion on lateral site. Aim: White zirconia blocks are often colored for achieving better esthetic appearance. The aim of this in-vitro study was to determine if zirconia liners used for coloring of the zirconia blocks have influence on the adhesion strength to veneering ceramic material. Materials and methods: We made two groups of twenty-four zirconia Cercon, DEGUDENT specimens. The specimens from the first group were abraded with aluminum oxide and colored with liner Cercon Ceram Kiss Liner, while control group was baked without liner. Veneering material Duceram Kiss was placed on the top using special bonding clamp. The samples were positioned in acrylic mold and tested, with the piston positioned as close to the bonded interface. The piston was moving vertically down until the zirconia/ceramic interface fractured. Results: The results were expressed as the strength of the connection (MPa), and compared with the control samples without liner. According to descriptive statistical analysis in the group of samples without surface treatment the strength of the adhesion for p > 0.05 (p = 0.25), was slightly lower compared to the strength of adhesion in the group of samples with surface treatment liner.
The resulting values of the strength of adhesion in first group vary in the interval 36.03 AE 15.33 MPa. Conclusions: The strength of the adhesion zirconium-ceramic veneer is significantly higher than the minimum force required in conventional metal-ceramic restorations. It can be concluded that the application of porcelain liners is procedure that besides coloring has positive impact on shear bond strength.

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Examination of Stresses of Mandibular Overdenture Prothesis on Implants Mustafa Yıldırım, Murat Alkurt Recep Tayyip Erdogan University, Rize, Turkey Aim or purpose: The aim of this study is the compare the surface tension of four-element implant-supported with 4 different types of overdenture around the implant by using strain gauge analysis. Materials and methods: Polyurethane structures were prepared to reflect the full toothiness human mandibula situation. A parallel hole was drilled at a depth of 12 mm, 11 mm distance between each other on polyurethane structures. In these drilled holes, four cylindrical implants we replaced according to the surgical procedure applied during implant placement. Implant structures were numbered in clockwise. Four strain gauges were bonded onto surface of each block tangential to the implant. Axial and nonaxial loads of 30 kg were applied at different points. The stress distribution of 4 attachment types (are ball, bar, locator and TC-snap) were examined by the strain gauge analysis. All data were analyzed statistically by using ANOVA and Tukey's test (a = 0.05).
Results: There was a significant difference for attachment type (p < 0.05). Also, statistically measurement showed that the loading point effect was significantly important (p < 0.05). Conclusions: The design and retention types of implant protheses significantly affected the stress and tension around the implant. Introduction: We encountered an elderly patient who developed an episode of hyperventilation upon entry into the operating room. We report this case in this paper, with some discussion. Case: The patient was a 91-year-old man who was 150 cm tall and weighed 38 kg. He was scheduled to undergo multiple tooth extractions and cyst-removal surgery under intravenous sedation. The patient had been diagnosed as having hepatitis C and nephritis when he was in his 60 s. The patient also had dementia, although it was mild, and there were no problems in communicating with him. Clinical progress: Supplemental oxygen at the rate of 3 l/min was delivered via nasal prongs, and the patient's eyes were covered with gauze for protection. Since respiratory rate had increased to 42 breaths/min and the event was considered to be a hyperventilation attack, the patient was instructed to rest. The patient's condition however did not improve and the tachypnea persisted; therefore, midazolam 2 mg was administered intravenously. Within a few minutes, the respiratory rate decreased significantly, and optimal sedation was obtained. Discussion: In this case, the patient had dementia and the people around him did not adequately understand his stress or anxiety level before the surgery, which was considered as the possible cause of the event. Furthermore, this case serves to underscore the fact that the diagnosis of a hyperventilation attack can be difficult, since elderly patients are also at a high risk for structural heart disease, such as ischemic heart disease. Introduction: Odontomas are one of the most common benign odontogenic tumors of epithelial and mesenchymal origin. They are considered to be hamartomatous malformation rather than neoplasm. Case description: We describe the case report of a 12-year-old male patient with no notable medical history; refereed by the pediatric dentistry department for bone swelling in relation to 12. The intraoral examination revealed the presence of a vestibular arch next to the 12 who has been in palato-position and 13 which is during the eruption. The panoramic radio shows the presence of a dense superficial image superimposed with 12. Anatomopathological examination of the specimen confirmed the diagnosis of peripheral compound odontoma. Discussion: Odontomas are consisted essentially of enamel and dentine, but they may also contain varying amounts of cementum and pulp tissues. Odontoma commonly occur in permanent dentition and rarely reported associated with primary teeth. They can occur at any age, but are most common in the first two decades of life. The World Health Organization defines odontomas as being of two types: complex and compound odontomas. Clinically, they may be classified as central and peripheral odontomas. The extraosseous or peripheral odontomas occurring in the soft tissue covering the tooth bearing portions of the jaws, having a tendency to exfoliate. They are rare, judging from the paucity in the literature. They are usually asymptomatic and are often discovered during routine radiography, yet these are often associated with tooth eruption disturbances. Conclusions/Clinical significance: Odontoma in an extraosseous location represents a challenge for diagnosis. Case description: We describe a case report of 38 year-old-male who consult for ulcerated lesion localized in the mandibular gingiva. The patient had the habit of chewing Neffa since 16 years. A biopsy was performed for this suspicious lesion and the anatomopathological examination confirmed the diagnosis of squamous cell carcinoma. The patient was referred to oncological department. We also continued the followed of this patient during and after the period of treatment. We also describe intend to highlight the association of gingival carcinoma with tobacco chewing habit. Discussion: Frequently, carcinoma of the gingiva does not have the clinical appearance of a malignant neoplasm, and manifests initially as an area of ulceration with may be a purely erosive lesion and this leads to misdiagnoses. Several risk factors such as tobacco, human papilloma virus, alcohol have been described in the literature as causative agents for head and neck squamous cell carcinoma. Neffa is the predominant form of chewing tobacco in Tunisia. The consumption of smokeless tobacco was more widespread in rural than in urban areas and was relatively high among poorly educated men from economically deprived backgrounds. Neffa tobacco chewing has long been a social habit in Tunisia. Conclusions/Clinical significance: All of the major forms of tobacco use like cigarettes, cigars, pipes and smokeless tobacco (chewing tobacco and snuff) are known to cause oral cancer.

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Inverted Left Maxillary Central Incisor: A Case Report Neziha Kececioglu 1 , Erdinc Sulukan 1 , Aysenur Nergiz Tanıdır 1 , Mehmet Seyrek 2 1 left maxillary central incisor through the nasal cavity. Due to the inversion and inadequate space, it was decided to remove the impacted tooth under local anesthesia. Discussion: Inverted teeth have been reported in both maxilla and mandible, and most of them are invertedly impacted third molars and premolars. The intraoral or extraoral ectopic tooth position was frequently encountered in patients with a trauma history or the presence of an impacted supernumerary tooth. In the present case neither a supernumerary tooth nor any history of trauma was reported. The inversion thought to be caused by other extraordinary factors. Conclusions/Clinical significance: Early diagnosis of an impacted tooth is substantial. Annual visits should be made by patients even in early ages in order to prevent undesired situations.
Aim or purpose: The aim of the study was to assess the knowledge of undergraduate students at University of Technology with regard to assess awareness, knowledge and attitude towards oral cancer. Materials and methods: A questionnaire-based survey of oral cancer awareness study was performed on undergraduate students in different study groups. Data were entered by Microsoft â Excel 2007 and analyzed using SPSS (version 20) using Chi squared test with p value <0.05. Results: Of most concern is the inability to identify potentially malignant lesions, which could be treated early to avoid progression to cancer. The awareness about oral cancer in an aid to early detection of oral cancer. This knowledge is essential to implement an effective health education program to reduce the incidence and mortality from oral cancer. Conclusions: Dental trainees undergraduate students had a significantly better understanding of the risk factors for oral cancer when compared to other undergraduate students. Further research is required to identify areas to be addressed in targeted education of undergraduates. Aim or purpose: To determine the degree of intraradicular wear in flattened channels as a consequence of rotating and reciprocating files instrumentation, by means of analytical weighing. Materials and methods: Ninety-six lower incisor teeth were selected and stratified into 4 groups (n = 24 teeth per group). The specimens had their crowns sectioned horizontally with the aid of a carborundum disc, respecting 2 mm limit of the coronary portion remainder. Thereby, the average length of 16 mm of the dental roots was obtained. The samples were exposed in a table at room temperature for 7 days. After that, the initial weighing (P0) was carried out on a digital analytical balance. The radicular channels were instrumented using 2 rotary systems PROTAPER NEXT and iRACE and 2 reciprocating systems RECIPROC and WAVE ONE according to each group. After instrumentation, the specimens were exposed to room temperature for 7 days and afterwards the second weighing (P1) was performed. Results: The difference found among the values ascribed to the two weighings of the specimens were statistically analyzed using analysis of variance (ANOVA) and the Tukey test. When the rotary and reciprocating systems were compared, the tests showed that the reciprocating limbs increased significantly the intraradicular dentine wear related to the rotating files, in the following order (p < 0.05): WAVE ONE, RECIPROC, PROTAPER NEXT, and IRACE. Conclusions: Wave One reciprocating file was considered to be the most effective system for flattened root channel wear.
Discussion: The applications of regenerative approaches in dental clinics have potential to dramatically improve patients' quality of life. This work also offers a detailed overview of present regenerative endodontic approaches aiming to revitalize teeth and also outlines the problems to be dealt before this emerging field contributes to clinical treatment protocols. It conjointly covers the basic trilogy elements of tissue engineering. Conclusions/Clinical significance: Regenerative Endodontics provides the hope of converting the non-vital tooth into vital once again in comparison with apexification but we should outline the problems to be dealt before this emerging field contributes to clinical treatment protocols.

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The Aim or purpose: To prove a novel mesoporous calcium-silicate (MesoCS) nanoparticles that induced odontogenesis, drug-delivery and existed antibacterial characteristics as endodontic material and to develop apatite-mineralization. Materials and methods: The MesoCS nanoparticles were prepared using sol-gel methods. In addition, the mesoporous structure, specific surface area, pore volume and morphology of the MesoCS nanoparticles were analyzed. The apatite-mineralization ability, in vitro odontogenic differentiation, drug delivery and antibacterial properties of the MesoCS nanoparticles were further investigated. Results: The results indicated that the 200 nm-sized MesoCS nanoparticles, synthesized using a facile template method, exhibited a high specific surface area and pore volume, with internal mesopores (average pore size: 3.05 nm). Furthermore, the MesoCS nanoparticles can be used as drug carriers to maintain sustained release of gentamicin and fibroblast growth factor-2 (FGF-2). The MesoCS-loaded FGF-2 might stimulate more odontogenic-related protein than CS due to the FGF-2 release. Conclusions: It is to infer that MesoCS nanoparticles might be one potentially useful regenerative material in dental. Aim or purpose: Although, temporomandibular disorders (TMD) have become a considerable health problem of individuals in modern societies, especially among women and emotional burden sufferers, their etiopathogenesis still comes into question. The study aimed to determine the prevalence of TMD and their correlation with psychoemotional factors among young Polish adults. Materials and methods: This epidemiological study was carried out in 456 students aged from 19 to 30 (58% females) in the years 2012-2014. First part of examination comprised a survey concerning demographic data, emotional burden, oral parafunctions, subjective symptoms of TMD, and headaches. During second part, that is clinical examination, patients were divided into three groups: (1) with muscle disorders, (2) with disc displacements, and (3) other joint disorders, according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I. The chisquare test was used to test data and 5% significance level was established. Results: Generally, 246 participants exhibited at least one TMD symptom and among them women were significantly predominant (n = 164, p < 0.05). Muscles disorders were observed in 82 (77% females), disc displacements in 202 (65% females) and arthralgia in 81 (77% females) participants. Excitable and/or emotionally burdened students reported more often fatigue and tightness of facial muscles, cervical muscle pain and headaches (p < 0.05), and these complaints were more frequent in women (p < 0.05). Conclusions: TMD are a considerable health problem among young Polish adults. Women are more predisposed to TMD. The psychoemotional factors, such as excitably and emotional burden are related to muscular disorders.

Estimation and Projection of Dental Manpower-A Case Study
Srinivas Pachava SIBAR Institute of Dental Sciences, Guntur, India Aim or purpose: To find out dental personnel working and to forecast the same for the year 2027 in a defined geographic area. Materials and methods: Data on number of dental personnel that are delivering services to the public in a defined geographic area i.e., Southern Indian State, Andhra Pradesh was obtained through multiple sources due to lack of official information and a consensus was obtained. Demand and utilization aspects were considered for projection of dental personnel. SPSS 20 version was used for statistical analyses and the tests applied are Pearson correlation, Spearmen correlation coefficient and one way ANOVA. Statistical significance was set for p < 0.05. Results: The total number of dental personnel working currently in the study area are 3300 spread over 160 205 square kilometers across 13 administrative areas for a population of 49.67 million. There is strong positive correlation (p = 0784) between the ratio of urban and rural population to the number of dental personnel availability (p = 0.002). Considering WHO and FDI method of estimating man power requirement based on effective demand the total number of dentists required for the year 2027 are 3600 for the study area. Conclusions: Dental public health programs, oral health care services delivery and policy in dental education need estimation and projection of dental work force. Aim or purpose: Extended edentation is a frequent diagnosis in dentistry, addressing to a variety of age groups, linked to a variety of factors that can influence the choice of therapeutic solution. An alternative to the classical thermo-baro-polymerization technique is considered to be the denture injection, this one being a new method for improving the clinical performances of removable prosthetic appliances. The aim of the study is the presentation of some actual practical possibilities of complex oral rehabilitation in patients with different types of edentations by using thermoplastic materials. Materials and methods: Was selected a group made up of 27 patients (18 women and 9 men), aged between 40-71 years with different types of partial edentations, treated by removable partial dentures. For the manufacturing of the frameworks of removable partial dentures, clasps and attachments it was used a technopolymer material based on poly-oxy-methylene, highly crystalline, with linear structure. Results: The prosthetic appliances made of thermoplastic materials presented a very good physiognomy, the color of the support and stability elements being similar to the teeth; a high degree of accuracy; the material was well tolerated by the tissues; the elements of support and stability presented a good elasticity, a good resistance in time and a good stability, being comfortable to the patient; the material presented a increased resistance to aging. Conclusions: The thermoplastic materials, due to their superior properties and their precision of manufacturing in the dental lab represent a better alternative used for partial removable dentures, comfortable and very well accepted by patients. Aim or purpose: The purpose of the study was to evaluate the effect of different surface treatment methods on the flexural strength of a lithium disilicate ceramic, a resin nano-ceramic, a hybrid nano-ceramic and a polymer-infiltrated ceramic network (PICN) material. Materials and methods: Fifty bar-shaped specimens (4 9 1 9 14 mm) from each material (totally 200 specimens) were milled from CAD/CAM blocks and divided into 5 groups according to the surface treatment method as control (no treatment), hydrofluoric acid (5%) etching, Al 2 O 3 sandblasting, 2W and 3W Er,Cr:YSGG laser irradiation (n = 10). Specimens were subjected to 3-point bending test and flexural strength values were statistically analyzed. Results: Flexural strength values of the specimens in control groups revealed that lithium disilicate ceramic showed the highest and PICN material showed the lowest strength values, statistically. All surface treatment methods decreased the flexural strength of all tested materials (p < 0.05) except for 2W laser irradiated and sandblasted PICN material and 2W laser irradiated resin nanoceramic of which flexural strengths were not statistically different from control groups (p > 0.05). For lithium disilicate ceramic and hybrid nano-ceramic the lowest strength values were found at sandblasting group, whereas the lowest values were detected at 3W laser and acid etching groups of PICN and resin nano-ceramic materials (p < 0.05). Conclusions: Surface treatment methods affected the mechanical strength of CAD/CAM materials. Er,Cr:YSGG laser application with 2 W output power may be an alternative surface conditioning method to acid etching and sandblasting for chairside CAD/CAM materials.

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The Effect of Surface Treatments on Translucency of Monolithic Zirconia Sevcan Kurtulmus-Yilmaz, Oguz Ozan, Huseyin Aktore Near East University Faculty of Dentistry, Mersin, Turkey Aim or purpose: The purpose of this study was to evaluate the effect of mechanical surface treatment methods on the translucency of monolithic zirconia treated at pre-sintered and sintered stage. Materials and methods: Seventy square-shaped specimens with dimensions of 0.8 9 10 9 10 mm were milled from zirconia discs. Specimens were divided into 7 groups according to the surface treatment method (4W Er,Cr:YSGG laser irradiation; sandblasting with 120 lm Al 2 O 3 ; grinding with diamond bur) and whether the treatments applied before or after sintering (pre-sintered and postsintered) and a group was served as control with no treatment (n = 10). All specimens were immersed into coloring liquid (A2) prior to sintering and sintered at 1450°C for 8 h. CIE L*a*b* values were recorded at black and white backgrounds with a spectrophotometer and translucency parameter (TP) was calculated for each specimen. Data were statistically analyzed. Results: There was no significant translucency difference between control group and the post-sinter groups (p > 0.05) while pre-sintered groups showed significantly higher TP values (p < 0.05). The highest TP value was detected at pre-sintered Er,Cr:YSGG laser group. No statistically significant difference was found among the surface treatment methods for post-sinter groups. Conclusions: Application of surface treatments at pre-sintered zirconia increased the translucency of the specimens. Mechanical treatment methods at pre-sintered stage might remove material from the surface which causes a decrease in thickness and an increase in translucency. Clinicians should take into consideration that material removal due to surface treatments at pre-sintered stage may also affect the mechanical strength of zirconia. Introduction: The reconstruction of the highly dilapidated, endodontically treated teeth continues to represent a clinical challenge integral to the daily work of any practitioner active in dental prothesis. In this field, it is not only a matter of taking into account the various aspects, both biological, but also aesthetic considerations. Cast post and core used in combination with different false stump techniques serve for the preprosthetic reconstruction of the lost hard tissues, at the same time restoring a sufficient retention surface for the prosthetic part to be sealed. Case description:

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First case: realization of two cast post and core with a direct method. Second case: realization of two cast post and core with indirect method. Third case: realization of a cast post and core reinforced by composite. Discussion: Perception, decision making and implementation of coronal root reconstruction have evolved over the past 20 years. Improved techniques associated intra bonding into a root with maximum economy of dental tissues offers the possibility to achieve a reinforced composite post and core. However, cast post and core still retain specific information, especially when the number of residual coronal walls is deficient. Conclusions/Clinical significance: A modern dental medicine with the current knowledge must be biocompatible, functional, aesthetic and reliable. path or lack of space. Maxillary premolars were reported to have a low incidence of impaction, especially the second premolars. Consequently, second premolar may either erupt ectopically or not erupt at all and become impacted. Position of an impacted tooth is important due to anatomical considerations such as neurovascular structures. Case description: A 12-year-old male was referred to orthodontic treatment. Panoramic radiography revealed the presence impacted second premolar in the left maxillary side. Occlusal radiography was taken to understand the position of the tooth. Since there was not enough space for orthodontic retraction and it was an obstacle to orthodontic treatment, surgical removal of impacted premolar was planned. A full thickness palatal flap was raised carefully. Impacted tooth was removed, no hemorrhage occurred and flap replaced back and sutured. Discussion: Most of the cases of impacted premolars are reported accidentally on routine screening of patients or when the patients report to the dental clinic with some other problem. Few of the impacted premolars are also advised for removal by the orthodontists before the start of fixed mechanotherapy. Conclusions/Clinical significance: Great care is required during elevating the flap and extracting the impacted tooth from the palate to avoid damaging the neurovascular bundle, which contains the palatal artery, vein and nerve, to prevent complications such as hemorrhage.

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Mucocele of the Hard Palate Aysa Ayali, Kani Bilginaylar Near East University Faculty of Dentistry, Nicosia Cyprus, Mersin, Turkey Introduction: Oral mucoceles are benign lesions that can appear as blisters or lumps at any site of the oral cavity where minor salivary glands are present. Their etiology is associated with local trauma and consequent rupture of salivary gland duct. Clinically they are characterized by single or multiple, soft, fluctuant nodule, ranging from the normal color of the oral mucosa to deep blue. The treatment for OM shall be either complete excision, marsupialization, dissection, cryosurgery, carbon dioxide lasers, electrocautery, intra-lesional injection of sclerosing agent or steroid injection. However, recurrence can occur and a new surgical intervention is necessary. Case description: A 67-year-old man presented with a 2-month history of painless swelling in the palate. The clinical examination revealed a 0.5 cm diameter bluish-purple submucosal swelling on the left hard palate. There was no evidence on orthopantomography. The clinical diagnosis was mucocele. After a mucosal incision with diode laser was performed we realized that the cystic lesion was greater than clinical appearance and had grown into the bone. 1x1.5 cm cyst was removed and Protein Rich Fibrin (PRF) used to fill and close the wound. The histopathologic examination confirmed the diagnosis. The patient was healed and advised to undergo regular follow-up examinations. Discussion: Mucoceles need to be surgically excised or removed by laser or cryotherapy. Other therapies that are of less well-proved efficacy.
Conclusions/Clinical significance: Oral mucoceles of minor salivary glands are rarely larger than 1.5 cm in diameter and are always superficial. Mucoceles found in deeper areas are usually larger.

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Mechanical Loading Improves Sealing Between Glass Ionomer Cements and Dentin Inmaculada Cabello, Raquel Osorio, Estrella Osorio, F atima S. Aguilera, Manuel Toledano, Manuel Toledano-Osorio University of Granada, Granada, Spain Case description: A 45-year-old man, non-smoker, was referred to orthodontic practice for concerns related to his Class II div. II bite and dental mobility in 12, 11, 21 and 22 teeth. To improve it, we used fixed multibracket appliances. After 18 months, we carried out temporary composite reconstructions in 12, 11, 21, 22, and proceed with implant (AVINENT â ) placement in 36 and 46 position. After two years, due to orthodontic treatment, a periodontal regeneration was observed; it is when we placed connective tissue grafts in 12 and 21. We ended with tooth-bleaching and esthetic composite reconstructions in 12,11,21,22,32,31,41,42, alumina tooth crowns in 43, 44 and 45 and crowns on implants 36 and 46. Discussion: Initially the periodontal defects from cementumenamel junction to the sulcus were: 12 (8 mm), 11 (1 mm) and 21 (9 mm); after two years, a periodontal regeneration was observed, and the defects were: 12 (2 mm), 11 (0 mm) and 21 (1 mm). With proper motivation, orthodontic treatment made possible to continue with an interdisciplinary approach. Periodontal tissue regeneration was achieved, providing surgical and restorative conditions to complete the treatment plan. Conclusions/Clinical significance: This case report demonstrates, by means of interdisciplinary approach, a pleasing treatment outcome for a patient with dental mobility and aesthetic concerns. Introduction: When it comes to frequency, the maxillary canine is the second most impacted tooth, after the third molars. The most common position to find them is palatally. Case description: A 65-year-old male patient refers mobility in a fixed prosthesis of 22-23-24. Clinically and radiographically the presence of the 23 that is erupting trough the palate, causing mobility of the prosthesis. A total thickness flap was made, scalloped without discharges from 21 to 25 respecting the papillae, to be as atraumatic as possible. After the flap was removed, a tooth section of the coronal part of the piece was performed, followed by a longitudinal tooth section of the root, in the buccal-palatine direction. At the time of luxating the fragments, pressure was maintained on the pillars of the fixed prosthesis to prevent any damage; and an apex forceps was used to extract both fragments. The alveolus was irrigated with 0.12% chlorhexidine and the flap was sutured. A week later, we observed that healing was being performed correctly and the fixed prosthesis had a minimal movement. Discussion: This surgical technique was chosen to avoid the removal of the fixed prosthesis, meeting the aesthetic and functional expectations demanded by the patient. In this case, implant treatment was discarded due to the defect left by the canine.
Conclusions/Clinical significance: The fixed prosthesis presented an uncertain prognosis, but thanks to the surgical extraction performed the prosthesis could be preserved.

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Unusual Case of Inflammatory Myofibroblastic Tumor presenting as a jaw swelling Raouâ a Belkacem Chebil 1 , Dorsaf Touil 1 , Fatma Hedhli 1 , Abd El Fattah Slama 2 , Badreddine Sriha 2 , Lamia Oualha 1 , Nabiha Douki 1   1 Monastir University School of Dentistry, Sousse-Sahloul Hospital, Tunisia, 2 Sousse University Sousse University of Medicine, Sousse-Sahloul Hospital, Tunisia Introduction: Inflammatory myofibroblastic tumor (IMT) is a benign lesion composed of myofibroblasts and inflammatory cells. It can be benign and nonrecurring, benign but locally recurring, of low-grade of malignancy or fully malignant. The diagnosis and treatment of these lesions can be difficult. Case description: A 33-year-old man presented to dental unit with a swelling of the right cheek of 1 month duration. Intraoral examination showed a solid swelling at the site of the first and second premolars which tested positive to sensitivity test. Cone-beam computed tomographic imaging showed osteolytic lesions, suggesting an aggressive neoplasm requiring incisional biopsy. Histopathological examination indicated an IMT. The lesion was entirely removed under general anesthesia. Discussion: The distinction between inflammatory myofibroblastic and malignant tumors is of paramount clinical importance because of the rapid growth of the tumor. Complete surgical excision is the treatment of choice because of its unpredictable clinical behavior. The patients with oral IMTs require periodic postsurgical follow-up to detect local recurrence. Conclusions/Clinical significance: Although it is very rare, IMT should be included as a differential diagnosis in patients with compact masses in the upper jaw.

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Comprehensive Periodontal Treatment of a Patient with Severely Advanced Chronic Periodontitis Fadime Kaya Dadas, Serhat Koseoglu Katıp Celebi University, Izmir, Turkey Introduction: Chronic periodontitis, the most common form of periodontal disease, is an infectious disease characterized by loss of periodontal attachments and alveolar bone destruction. The base treatment of chronic periodontitis is mechanical debridement of tooth surfaces. The aim of this case report is to describe the steps taken in the long-term rehabilitation of a patient with severely advanced chronic periodontitis. Case description: A 26-year-old, systemically healthy, nonsmoker female patient admitted to our clinical with complaints of swinging in the teeth and bleeding in gums. Initial periodontal therapy was performed after clinical measurements were recorded. The patient was called to the monthly inspections. All pathological pockets were eliminated at the third month.
Intracoronal splint was performed to keep the 2nd and 3rd degree mobile teeth in the anterior regions of upper and lower jaw in the mouth. Subsequently, the patient was followed up every 3 months. One year later, free gingival grafts were performed due to inadequate keratinized tissue in the lower anterior region. After this procedure, the patient was called to the 1st, 3rd and 6th month controls. Discussion: Conservative approaches to advanced chronic periodontitis may provide more promising results than extraction of teeth. In this study, successful periodontal treatments were obtained in a patient with severely advanced chronic periodontitis. Conclusions/Clinical significance: Patients with advanced chronic periodontitis can be rehabilitated very well with meticulous periodontal treatment. In this study, because of patient's own teeth were protected, patient satisfaction was achieved and a better aesthetic results were obtained. Aim or purpose: This study aims to explore the hydric behavior of two composite resins under the effect of different mouthwashes. Materials and methods: An in vitro study was conducted to determine the values of one-week solubility and absorption of two composite resins: the Filtek TM Z350 (3M ESPE, St Paul, MN, USA) and Amelogen â Plus (Ultradent, United States) after immersion in different solutions: artificial saliva, Paroex â (SUNSTAR GUM â ), Aftamed â (SUNSTAR GUM â ) and Listerine â . Data were submitted to analysis of variance (ANOVA). Results: The solubility and absorption values of samples immersed in Listerine were superior than the different samples immersed in Aftamed â and Paroex â . The absorption and solubility of the Z350 XT composite resin is higher than that of the Amelogen â Plus in artificial saliva (p = .013, p = .115 respectively). The value of the solubility of the resin Z350 XT after immersion in Listerine â remains high compared to the value of the solubility of the resin Amelogen â Plus. Conclusions: Using a mouthwash can change the oral conditions and therefore influence the properties of composite resins. The alcohol-free mouthwash; Paroex â and Aftamed â affect less the hydric behavior of composite resins.

Necrotizing Sialometaplasia of Hard Palate Mucosa in A Heavy Smoker
Tara Ghorian Jagiellonian University, Krakow, Poland Introduction: Necrotizing sialometaplasia is a rare pathology of the minor salivary glands and it is thought to result from ischemia of vasculature supplying the salivary glands. Clinically, it usually presents as a painless ulceration of the oral cavity mucosa. Case description: A 41-year-old, otherwise healthy male patient was reported to the Department of Oral Surgery because of a painless ulceration on the right side of the hard palate. He was a heavy smoker which can be a predisposing factor for the necrotizing process on the minor salivary glands of the hard palate. The ulceration was biopsied and the histopathological examination revealed necrotizing sialometaplasia. Additionally, systemic and local antibiotics of metronidazole were introduced. After two weeks of antimicrobial treatment, the lesion began to decrease in size, therefore the treatment was limited to local metronidazole only. Discussion: Necrotizing sialometaplasia is often misdiagnosed as squamous cell carcinoma. Hence biopsy must be performed to confirm the diagnosis. In the presented case, the histopathological examination revealed necrotizing sialometaplasia and ruled out squamous cell carcinoma. According to the literature, necrotizing sialometaplasia heals by itself and no treatment is usually required. The lesion should be treated symptomatically, if pain, fever or other signs and symptoms are present. Antibiotics or steroids are usually prescribed. Conclusion: Necrotizing sialometaplasia is a rare lesion of the oral mucosa and it is often misdiagnosed as squamous cell carcinoma. Thus, histopathological examination is essential to differentiate between the two entities. Introduction: Complex odontomas are relatively benign rare tumors. They are most of the time asymptomatic. In some cases, these tumors become large, causing bone expansion associated with facial asymmetry. Case description: A 35-year-old male patient, reported to our department with a painless swelling on the left lower jaw lasting since 2 weeks. His medical history was unremarkable. Clinically, there was gross facial asymmetry with diffuse smooth swelling in the left mandibular angle. The buccal and lingual cortices were expanded and hard. There was no evidence of any abnormality in other teeth in the left mandibular region. The Orthopantomogram incidence showed a spectacular well-defined radiopacity, surrounded by a radiolucent halo, associated to a dentigerous cyst with secondary inferior tooth displacement. The clinical and radiographic diagnosis evoked a complex odontoma. The treatment was based on the excision of the whole impacted teeth and the lesion all around. Which was sent to anatomopathological study and concluded a complex odontoma. Discussion: Odontomas are considered as a developmental tumors rather than true neoplasm. Odontomas are generally asymptomatic, usually remain small. Occasionally it does become large and may produce expansion of bone with consequent facial asymmetry. The treatment of complex odontoma is excision of lesion and allowing impacted tooth to erupt. Conclusions/Clinical significance: Despite their benign nature, large complex odontomas can cause cortical expansion facial asymmetry and traumatic ulcers. Therefore, it is important to diagnose these lesions as soon as possible and treat them appropriately so as to avoid the possible complications. Aim or purpose: Assess the micro-hardness and color stability of the new bulk-fill (BF) composite restorative materials. Materials and methods: Five types of composite materials (3M Filtek Z350, 3M Filtek Bulk-Fill, Tetric N-Ceram Bulk Fill, smart dentine replacement, sonic fill 2 kerr) were investigated. Samples from each composite material (n = 20; 10 mm in diameter and 2 mm in thickness) were assigned to one of four different solutions: Tea (G1), Turkish-Coffee (G2), Vimto (G3), and distilled water (control; G4). Baseline (T1) shade of all specimens was recorded using a spectrophotometer as well as after 10 days (T2), 1 month (T3) and 2 months (T4) of immersion. Measurements were obtained against a black background spectrophotometer and CIE L*a*b data was used to calculated DE for each group. Vickers Micro-hardness values were obtained by testing the same specimens before and after immersion. One-way analysis of variance (ANOVA) followed by Tukey's post hoc test were utilized for all comparisons at 0.05 significance level. Results: At T2, all BF materials showed more discoloration compared to universal composite (Z350) with G2 had the most discolored specimens. Smart dentin replacement was the most discolored at T3 and tea produced the height DE values except for smart dentin composite where coffee was the most. G1 was associated with the highest DE values at T4. There is no significant difference in micro-hardness between 1 st and 2 nd values. Conclusions: Bulk-fill composite materials have more tendency for discoloration with tea and coffee solutions. No significant difference micro-hardness. Aim or purpose: The oral biofilm is a sine qua non-factor in the development of dental caries in children. The aim of this study was to evaluate the oral biofilm microbiome of children with dental caries. Materials and methods: A cross-sectional descriptive study was carried out with 75 children between 5 to 9 years old from public schools in Cartagena-Colombia. All participants were diagnosed with dental caries according to the criteria of the International Caries Detection and Assessment System (ICDAS II) by a calibrated examiner. Biofilm samples were collected from dental surfaces with caries lesions. Bacterial DNA was extracted and used for analysis by HOMINGS (Human Oral Microbe Identification using Next Generation Sequencing) based on sequencing of the V3-V4 region of 16S rRNA gene using Illumina MiSeq platform. The microbiological diversity was estimated by the Shannon diversity index. Results: 379 species-specific and 68 genus-specific probes were identified. The most predominant genera were Streptococcus, Lactobacillus, Fusobacterium, Leptotrichia, Veillonella and Neisseria; these representing 28% of all bacterial DNA present. The bacterial species with higher relative abundance in the oral biofilm microbiome were Streptococcus sanguinis, Streptococcus mutans, Lactobacillus salivarius, Leptotrichia sp. HOT 417, Lautropia mirabilis, Lachnospiraceae [G-2] sp. HOT 096, Veillonella dispar, Leptotrichia wadei, Parascardovia denticolens; these species representing 21.3% of all bacterial DNA present. The Shannon diversity index was 3.02 (SD = 0.35). Conclusions: These findings show a high microbiological diversity in samples of oral biofilm present in dental surfaces with caries lesions. Aim: There is strong evidence showing the association of Streptococcus spp. with the onset and development of dental decay. The aim of this study was to evaluate and compare the presence of Streptococcus spp. in oral biofilm of children with dental caries and caries-free through Next Generation Sequencing technique. Materials and methods: A case-control study was carried out with 108 children between 5 to 8 years old from Cartagena-Colombia. The study groups had a 1:1 ratio and were matched by age and gender. The diagnosis of caries was performed according to the criteria of the International Caries Detection and Assessment System (ICDAS II) by a calibrated examiner. Biofilm samples were collected from dental surfaces with caries lesions (case group) and supragingival plaque samples from caries-free tooth surfaces (control group). Bacterial DNA was extracted and used for analysis by Illumina MiSeq platform (v3-v4 primers). Statistical analysis was performed using Mann-Whitney test with Benjamini-Hochberg's correction for multiple comparisons. Results: S. sanguinis, S. intermedius, S. mutans, S. anginosus, S. constellatus and S. sobrinus were present in both groups. S. sanguinis is the most abundant species 13.1% (cases) and 16.1% (controls). However, S. mutans had a relative abundance associated with caries (10.3% -Case and 0.49% -Control) (p = 0.000). The species mentioned above represent 26.2% of all bacterial DNA present. S. gordonii, S. mitis, S. oralis among others were identified with genus-specific probes. Conclusions: These findings show the association of S. mutans with dental caries and the diversity of Streptococcus spp. in oral biofilm.

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Prevalence of Dental Caries on The Two Permanent Molars Kenza Jabrane, Sara Dhoum, Hafsa El Merini Faculty of Dentistry, Dental Clinic and Treatment of Casablanca, Casablanca, Morocco Aim or purpose: The purpose of this work is to estimate the prevalence of caries of the first and the second permanent upper and lower molars and to identify sites and stages of dental caries concerning an adult population. Materials and methods: A transversal epidemiological study was conducted on 462 adults aged between 20 and 64 years, over a period of two months from December first 2014 to the 31 January 2015. Using a 4 parts survey: 1st part: Examined adults' Free general information. 2nd: Oral hygiene and lifestyle information. 3rd part: Periodontal status. 4th part: Dental examination of the first and the second permanent molars. The analysis was done using SPSS software version 10.0. Results: The prevalence of dental caries in the first and the second permanent molars was 48.9%. 35.7% of the patients still had the 4 first permanent molars, and 49.6% still had the 4 second permanent molars. Conclusions: The prevalence of caries on the first and second molars was high, due to poor oral hygiene, high consumption of cariogenic foods and irregular visits to the dentist.

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Oral rehabilitation of a Patient with Osteopetrosis: Case Report Yoomin Choi, Namki Choi, Seonmi Kim, Jaehwan Kim, Minkyoung Cheon Department of Pediatric Dentistry, College of Dentistry, Chonnam National University, Gwangju, Korea Introduction: Osteopetrosis is a disorder that includes impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form and has characteristics such as diffusely sclerotic skeleton, monocyclic anemia, and infection susceptibility caused by granulocytopenia. Most patients with infantile osteopetrosis often experience developmental delay or dwarfism. Case description: A 14-month-old girl diagnosed with osteopetrosis was referred from her pediatrician. Initiative caries on deciduous anterior teeth were observed in clinical examination. Oral hygiene management was performed. The patient revisited for caries control at age of 4. Several problems including skeletal asymmetry, growth retardation, narrow upper arch, crowding dental caries, missing teeth, and abnormal tooth development were observed. Endodontic and restorative treatments were performed on deciduous molars under sedation after prophylactic antibiotics injection. At a periodic follow-up, multiple deciduous teeth were reinfected and extracted. Oral rehabilitation with removable partial denture was conducted. Discussion: In osteopetrosis patients, active involvement at medical and dental clinics for sugar intake management and oral hygiene care is obligatory. They are highly susceptible to infection due to compromised immune system along with problems associated development of osteomyelitis and sepsis. In this report, early extraction was conducted due to reinfection. Therefore, cooperation with a pediatrician and prophylactic antibiotics are mandatory before beginning therapeutical procedures for the child and a dentist should always put efforts to prevent space loss. Conclusions/Clinical significance: The management of patient with osteopetrosis requires comprehensive approach to characteristic clinical problems including hematological and metabolic abnormalities, recurrent infections, bone complications, and neurological sequela.

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Comparative Study of The Tightness of Two Coronal Filling Techniques Sara Dhoum, Kenza Labrane, Hafsa Elmerini School of Dentistry of Casablanca, Casablanca, Morocco Group 4: oblique obturation using the nanohybrid composite. After the cavities were filled, the specimens were immersed in a 1% methylene blue solution for 18 h and then rinsed with running water. The teeth were cut longitudinally, removing the buccal face of the tooth. The tooth-composite joint was photographed using a digital SLR camera. The statistical analysis of the results was done by the software Epi Info 6.0. Results: Group 1 has an average infiltration of 0.900 mm lower than group 2 and group 3. Group 1 has an average infiltration of 0.900 mm superior than group 4. Conclusions: Filling using the bulkfill composite is more efficient than the oblique obturation using the hybrid composite. The oblique obturation using the microhybrid and nanohybrid composites showed a similar tightness to that using the bulkfill composite.

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Correlating Dental Caries with Oral Bacteria and the Buffering Capacity of Saliva Ajola Nasti Aldent University, Tirana, Albania Aim or purpose: The aim of this study is to assess the possible relationship among the number of colony forming units (CFUs) of MS and LB, the saliva buffering capacity (BC) and the prevalence of dental caries in patients at Aldent University. Materials and methods: A total of 62 patients (54% women and 46 % men, mean age 42 years) were examined. They were randomly selected from 500 dental examination records; 8% were caries free. This was an analytical cross-sectional study on patients at Aldent University. Caries was recorded using dmft/DMFT (decayed, missing, filled teeth). The scores for MS, LB and the BC of saliva were calculated using the Caries Risk Test (CRT) â . The data was coded and keyed into the Statistical Package for the Social Sciences (SPSS). Results: Saliva was collected and the majority had high MS and LB scores (69 and 78%, respectively) while 36% had a low saliva BC. Those with multiple risk factors were more likely to have caries compared to those with single or no risk factors present. Conclusions: There was a strong correlation between high MS, high LB, and low BC and the high prevalence of caries.