International Conference and Exhibition on Dentistry March 18-20, 2015 Crowne Plaza, Dubai, UAE

Assoc. Prof. Dr Wan Himratul Aznita Wan Harun received her PhD in Oral Molecular Microbiology in 2004 from the University of Malaya, Kuala Lumpur, Malaysia. She is currently an Associate Professor in The Department of Oral Biology & Biomedical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur. Her primary field is microbiology with research emphasis of virulence of oral microorganisms specifically the oral candida. Her research interest also covers the effects of medicinal plant extracts on the biological properties, adherence and molecular analysis of Candida species.

Biofilm formation is more important than planktonic growth because this mode of growth is associated with oral Candida infections and their inherent resistance to antifungal chemotherapy. Combination of antifungal drugs from different classes and mode of action are being studied in order to determine a better strategy in combating antifungal resistance. The molecular mechanisms behind the resistance in Candida spp are not yet understood. Therefore, the current study aimed to assess the expression of selected genes (MP65 and ERG3) responsible for Candida planktonic and biofilm resistance under the exposure to the combination of tunicamycin and amphotericin B. The expression of possible target genes (MP65 and ERG3) in planktonic and biofilms of C. albicans and C. dubliniensis was analyzed by reverse transcription- PCR (RT-PCR) and quantitative PCR (qPCR) to investigate the molecular mechanisms of the inhibitory effects of TM + AmB. In this experiment, we found that the expression level of genes encoding enzymes involved in ergosterol biosynthesis (ERG3) and gene encodes for putative β-glucanase mannoprotein (MP65) in C. albicans planktonic and biofilm were down-regulated after 1h exposure to the TM + AmB, but the fold changes were not particularly high in biofilm form. However, the expression level of ERG3 and MP65 genes were highly down-regulated in both planktonic and biofilm of C. dubliniensis. In vitro analysis has shown that the combination of these antifungals, showed a strong activity against C. dubliniensis in planktonic and biofilm, but have moderate antifungal activity against cells of C. albicans in biofilm as the transcription levels of the ERG3 and MP65 genes were not highly down-regulated.

Ligia Vaida has completed her PhD in 2008 from “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania. She is orthodontist and works in her private praxis in Oradea and as Assistant Professor at the University of Oradea, Faculty of Medicine and Pharmacy. She has published more than 100 papers including articles “in extenso” or abstracts in reputed journals or as scientific communications in different congresses. She has also been serving as an editorial board member of two journals indexed in the International Data Base.

Nowadays the people around the world pay special attention to dento-facial aesthetics. To optimize aesthetics frontal area of the dento-alveolar arches it is important to obtain a harmonious and symmetric gingival contour by eliminating the gummy smile and correcting the placement of smile line. In this paper we reviewed some morphological parameters defining the smile, including the number of millimeters of gingival mucosa exposed during the smile at the level of central incisors. We took into consideration a number of 900 orthodontic patients aged between 9 and 25 years. We considered, as a “gummy smile that requires therapeutic correction”, the situations where the gingival tissue visible in smile has a size of at least 3mm at the level of maxillary central incisors. The patients who inherited the gummy smile or acquired defects gum (e.g. gingival hyperplasia, gingival elephantiasis) and gingival inflammatory processes were excluded from the sample. From the 900 patients, 158 of them had gingival smile (17.55%), most of them being diagnosed with Class II/2 malocclusion. From those 158 patients with gingival smile, only 67 patients (or caregivers in case of children), representing 42.4%, included in their presentation reasons the presence of gummy smile. In other cases the doctor was the one who informed the patient about the gummy smile appearance and about the fact that it can be ameliorated, in all cases patients requiring the correction in their following therapeutic treatments. We focus on the possibility of gummy smile amelioration after orthodontic treatment.

Mustafa DAÄž graduated from Ankara University Faculty of Dentistry in 2007. He began his doctoral studies at Oral and Maxillofacial Department of Gulhane Military Medicine Academy in 2011 and is still ongoing. He is working especially on implant placement and bone augmentation topics. He has published more than 5 papers in national or international journals. He participated in many national and international congresses with oral or poster presentations.

Introduction and Aim: Penetration of the tooth fragments into the lip, cheek and tongue can be caused by accidents or trauma as gunshot. The aim of this presentation is immediate diagnosis and management of a case in which dental fragment was embedded in the adjacent soft tissues.
Case: 34 years old man injured in lower jaw via gunshot referred to our department in order to tooth extraction nearly two months after the gunshot. After the radiological and clinical examination tooth fragments into the tongue lips and cheeks were observed. Removing the particles located into the deep tissues was not easy but all fractured fragments were surgically removed under local anesthesia through tongue, lip and cheek respectively.
Discussion and conclusion: Dental fragments occasionally penetrate into soft tissue and may cause severe complications. Because of that careful clinical and radiographic examination with the surgical removal of tooth fragments could prevent undesirable complications like foreign body reaction, infection and scarring.

Objective: The aim of this study was to evaluate the effect of surface treatment of fiber post on its bond strength to resin composite core.
Methods: Total of twenty posts (Unicore fiber post system) were used in this study. Posts were sectioned and randomly divided into ten groups according to the surface treatment, where all posts were etched and bonded after treatment except in the silanated groups bonding agent was applied after silanization. The goups included: Group 1: Control. Group 2: Silane. Group 3: H2o2. Group 4: H2o2 with silane. Group 5: Sandblasting. Group 6: Sandblasting with silane. Group 7: Hydrofluoric acid. Group 8: Hydrofluoric acid with silane Group 9: Potassium Permanganat. Group 10: Potassium permanganate with silane. The treated posts were utilized to prepare one hundred composite resin discs where fiber post bonded in the center using specially milled brass mould. All samples were subjected to Push out test using computer controlled materials testing machine in a cross head speed 0.05 mm/min. Bond strength values were calculated , recorded, tabulated and statistically analyzed using two way analysis ANOVA , Tukey’s test and Student t test. Results: Results showed that there was statistical significant diffreneces between test groups and control with a very high significant influence of the type of surface treatment (ًF= 13.98; p< 0.001), while a non-significant influence of silanization (ًF =0.604; p>0.05) on shear bond strength values
Conclusions: Under the circumstances of this study we can conclude that surface treatment of fiber post surface significantly modify its surface morphological characteristics and shear bond strength to resin composite core.

Fateme Razazpour has complete her DDS at the age of 24 years in Kerman University of medical Science and PhD studies from Tehran University of Medical science. She works in Dental Biomaterials Department of Faculty of Dentistry. She published papers in International and national Journals.

Adhesion: Bonding between dissimilar materials through chemical reaction of their atoms and molecules. Adhesion: Forces or energies between atoms or molecules at an interface film of saliva between the soft tissue and the denture based that hold phase together. The creation of a strong, durable, and bonded interface with enamel or dentin provides important benefits. It significantly protects the restoration’s interface against penetration of bacteria that may cause secondary caries. It reduces the need for retentive areas in the preparation that would require removal of sound tooth structure.
First generation: Buonocore [1956] used the glycerophosphoric , acid dimethacrylate [GPDM] for etching dentin .Bond strength was only 2-3 MPa, no clinical acceptance, Bond the enamel and dentin via the calcium ion.
Second generation: Using the phosphorous esters of methacrylate derivative, Primary bond was to smear layer not to underlying dentin.
Third generation: The concept of etching dentin and remove, smear layer occur by Japanese scientist. 1982: The dentin hybrid layer was found by Nakabayashi. 1990: Dentin etching was accepted worldwide
Fourth generation : Develop multistep dentin adhesive system. Dentin hybrid layer was important. “Bonding agent” was replaced by “Adhesive system”
Fifth generation: Similar to fourth generation, Improved material, Reduce the steps.
Sixth generation: Combine etchant to primer, Combine primer to bonding, Combine etchant, primer, and bonding
New Phosphonic Acid esther acrylates and cross-linking bis(acrylamide)s enable the preparation of self-etching enamel-dentin adhesives with improved storage stability.
Late 2002 Seventh Generation: All-in-One”. Combines etching, priming and bonding, Single solution. Laboratory studies show bond strengths and margin sealing to be equal to sixth-generation systems,4 Products in this category include: iBond™ (Heraeus), Xeno® IV (Dentsply), G-Bond™ (GC), Complete(Cosmedent), and OptiBond® All-In-One (Kerr).8
Disadvantages of one-step self-etch adhesives ( due to mixtures of hydrophilic and hydrophobic components) :1- Reduced immediate bond strength 2- Lower long-term bond strength3- Increased interfacial nano-leakage 4- shelf-life problems , applying more hydrolytically resistant acrylamide monomers to overcome this problem. Universal Dental Adhesive Systems as 8th generation : Dual –Cured self-etch adhesive for direct and indirect restorations with self,light and dual-cured resin materials. -Universal Dental Adhesive Systems as 8th generation: Scotch bond Universal Adhesive from 3M ESPE -PEAK Universal Bond Light Cured Adhesive from Ultradent Products, Inc -OptiBond XTR from Kerr Corporation -Tenure Uni-Bond from DenMat -ALL-BOND Universal Dental Adhesive from Bisco, Inc.

Dr. Duaa Abo Al Samh is an endodontic and restorative consultant at Prince Sultan Military Medical City (PSMMC) in Riyadh, Saudi Arabia. She completed her master degree in endodontics in 1996 from Dental College, King Saud University, Riyadh, Kingdom of Saudi Arabia. She finished her restorative board in 2004 from Saudi Council for Health Speciality in Riyadh, Kingdom of Saudi Arabia. Currently, she is a member of the Continuous Quality Improvement and Patient Safety (CQI & PS) at PSMMC.

The root morphology including its canal anatomy vary significantly in different individuals and populations .Awareness of abnormal variation of the anatomy of the tooth is essential for clinical success . Maxillary premolars have a highly variable root canal morphology and generally presents with one or two roots and with one or two root canals but in a few cases three roots or three canals have been reported in the literature and have been documented as practically non-existent in Asia population .
Concerning first maxillary premolars with three roots three anatomic variants exists; three separated roots, interfused roots. The presence of a third root or a total of three canals is reported in the literature with percentages ranging from 0 to 9.2 %. Maxillary premolars with three root canals were sometimes called small molars or “ridiculous.” The aim of this report is to describe the clinical management of one endodontic case of a maxillary first premolar with three canals in three separate roots using rotary instrumentation technique (RACE) (FKG Dentire swiss) and obturated with lateral condensation technique .
It is concluded that Morphological variations in pulpal anatomy must be always considered before beginning treatment .Clinician should be aware of anatomical variations in maxillary premolars and be able to apply this knowledge in radiographic and clinical interpretation Access cavity refinement may be required for stress free entry to complex anatomy.

Zana Sllamniku- Dalipi graduated in Dentistry from University of Pirshitna in 1999, completed her specialization in Periodontology and Oral Medicine in 2005. She finished posgraduated studies, defending Master Thesis in Medical Faculty of Prishtina in 2007 and defending PhD thesis in 2013 in periodontogy field.

There is an increasing evidence linking dysbalance between various proinflammatory mediators, periodontitis and higher risk of cardiovascular events. Interleukin 1- beta is a potent bone resorptive cytokine that also mediates soft –tissue destruction by stimulating prostaglandin production and inducing collagenase and other protease activity.
The aim of this study was to measure and compare serum concentration of IL-1 Beta (IL-1 β )in periodontitis patients( control group) and periodontitis and coronary heart disease patients( study group).
The study involved a study group of twenty patients (n= 20), over 49 years of age with an initial diagnosis of coronary heart disease admitted at the Coronary care Unit of the Department of Cardiology of University Clinical Center of Kosovo, and control group (n=25). A 10 ml blood samples were taken during the first 24 hours of hospitalization and referred to laboratory. Serum samples were assessed using a kit with a specific high sensitivity methodology—ELISA test. Statistically results are expressed as mean values and standard deviation (SD), Quantitative variables Student’s t-test, Qualitative parameters Pearson’s chi – square test.
RESULTS The study showed raised mean values for IL-1 β in the study group compared with control group. The concentrations of protein (control group vs. study group) were as follows: IL-1β (2.1 ± 2.2 vs. 11.0 ± 10.8). The differences between the groups showed statistical significance p < 0.05.
CONCLUSION Patients with periodontitis and coronary heart disease results in higher systemic levels of IL-1 β, which may increase inflammatory activity in atherosclerotic lesions.

In therapeutic dentistry one of the main problem is endodontics, since about a third of dental patients need root canal treatment. The following errors were identified due to the complex anatomy of the root canal. In 40% of the lower incisors have two root canal in 58% of the second premolar of the upper jaw has two root canal, 31% of the first mandibular premolar has two root canal in 20% of anterior teeth have side branches from the main root canal.
According to statistics, the main reason for the inefficiency of endodontic treatment is insufficient destruction of bacteria in the root canal - 76%, incorrect determination of indications for treatment - 22%, non-radiography - one of the reasons. More than 70% of endodontic treatment of teeth to be re-treatment. The main condition is a thorough biomechanical endodontic root canal cleaning. The ability to effectively clean the tooth cavity and root canals depends on instrumentation and irrigation channel.
Objective. To identify problems with repeated endodontic treatment encountered in everyday practice and troubleshooting. In our practice, often there are cases where the indication for retreatment of root canals are nedoplombirovannye channels or unfilled channels. Perelechenivanie shown when a fistula, swelling, pain, sensitivity to percussion. Such problems often occur after root canal filling pastes, which not only fill the channel tightly enough, but over time resolve. The purpose of retreatment inadequately sealed channels is to eliminate the infection and prevent reinfection.
Material and methods. Endodontic retreatment was performed in 28 patients aged 18 to 50 years. Patients complained of pain when biting, the presence of a fistula, swelling of the cheeks and loss of dental fillings. According to X-ray chronic periodontitis fibrotic diagnosed in 6 cases, chronic granulating periodontitis - in 8 cases, chronic granulomatous periodontitis - in 2 patients, exacerbation of chronic granulating periodontitis - in 12 cases. During retreatment cases met root canal filling gutta percha without sealer, which is unacceptable in endodontics or canals were obturated poorly.
Clinical Example number 1 The patient is 35 years appealed to the clinic with complaints of pain, aggravated by biting. The survey was diagnosed with exacerbation of chronic granulating periodontitis. On the radiograph has a lower first molar with inadequate lead-sealed root canals, in the periapical region found vast area of bone loss. Treatment consists of removal of dental fillings, creating access to the mouths of the root canal, unsealing the distal channel for instrumental and medical treatment of root canals. After tooling perform endodontic root canal irrigation syringe with endo needle and 0.5% sodium hypochlorite solution for high-quality medical treatment of root canals. Treatment was carried out using a tooth temporary dressings antibacterial calcium hydroxide, which is introduced into the root canals in a liquid suspension. Temporary bandage was changed every 2 weeks as it begins to dissolve. After 3 months of temporary bandage was removed, the channel is sealed up with gutta-percha sealer.
Conclusion. Thus, in the course of analysis of problem of endodontic treatment indicated that a large percentage errors associated with poor root canal filling that leads to changes in the periapical bone area.

Introduction The administration of local anesthetic agent is a safe procedure, yet various localized, distant and systemic complications have been reported. Given that the two most common nerve blocks in Jaws are PSA and IANB, therefore, we stand to describe rare complications of these two methods.
Material and methods We studied here 31 articles in which 25 were case report and 6 were both case report and review of literature that were published from 1976 to 2013.
Conclusion Because Complications of dental anesthesia are accidental and unavoidable, It need to be control and prevented; and this control and prevention requires knowing rare complications.
MeSH key words: Complication, Dental Anesthesia/Nerve Block, Posterior Superior Alveolar (PSA), Inferior Alveolar Nerve Block (IANB)

Kevin Lopes Oliveira has completed his Master in dentistry at the age of 23 years from Faculdade de Medicina Dentária da Universidade do Porto. He is a colaborator at Occlusion Department of Faculdade de Medicina Dentária da Universidade do Porto.

Description of the case: Male patient, 29 years old and with poor oral hygiene, went to UCMDC in FMDUP for the replacement of Class II MOD amalgam restoration on tooth 46 for aesthetic reasons. Radiographically it could be observed radiolucent image of the tooth tissue and restoration, suggesting the presence of a recurrent carious lesion. Through the pulp susceptibility testing is classified as a reversible injury, and it was therefore chosen a conservative treatment.
Discussion: The current dental restorative materials used in the reconstruction are not only intended to restore form and function, but also long-term aesthetics. When there is a large loss of tooth structure, Inlay and Onlay's's are widely used in the reconstruction of the tooth and these can be of three types: metal alloys, composites or ceramics.
We chose to use a resin inlay: as compared to metal inlays have aesthetic results arguably superior, and compared to ceramic inlays, have a lower price. Since compared to the direct composite restorations have advantages such as greater resistance to wear, better marginal fit, less polymerization shrinkage, greater ease of obtaining proximal contact points due to be performed in extra-oral environment, greater longevity and beyond repair, adjustment and intra-oral polishing.
Conclusions: Composite resin indirect restorations are an alternative treatment with a high performance clinical long-term, allowing to the clinician an improve of functional and aesthetic qualities, with a shorter chair time.

Diogo Oliveira Martins has completed his Master degree at the age of 23 years (7/2014) from Dentistry Faculty of Oporto University.

Objective: A literature review to determine the state of the art with regard to antimicrobial ability of adhesive systems Materials and methods: For this work was performed a literature research for the last 10 years, in Portuguese and English languages, at the research engines: "Pubmed" and "B-on". Development: The progressive decrease in bond strength occurs due to degradation, hydrolytic and enzymatic, of the hybrid layer. The chlorhexidine is a biguanide with cationic properties. It is a stable, broad spectrum antibacterial molecule at high concentrations and bacteriostatic at low concentrations. Besides its antimicrobial properties, chlorhexidine is a potent inhibitor of MMPs. DMAE-CB is, as MDPB, a monomer composed by combining a methacrylate group, polymerizable, with a quaternary ammonium group, responsible for the antibacterial properties. Those antibacterial monomers have the same principle: Before polymerizing is bactericidal and after polymerization have a bacteriostatic effect by contact. Conclusions: Chlorhexidine is able to inhibit bacterial activity in dental treatments. With the advantage of not interfering or even improve the mechanical properties of the interface dentin/adhesive, such as higher microtensile bond strength and lower nanoleakage. Despite the positive results these statements are not completly consensual. The antibacterial monomers MDPB and DMAE-CB are shown to have an important role in the antimicrobial ability of adhesive systems because it maintains this property even after polymerization. Apart from its proven antimicrobial activity, all incorporated agents: Chlorhexidine, MDPB and DMEA-CB; have shown ability to inhibit MMPs.

Cláudia Sofia Barbosa da Costa Ribeiro finished her Master’s degree in Dental Medicine at the Oporto University School of Dental Medicine and since October 2014 is collaborating at the Occlusion, TMJ and Orofacial Pain Department from the Oporto University School of Dental Medicine.

Background: Eating disorders are a pathological psychological disturbance associated with a host of serious medical complications, either psychological or metabolic. Oral and dental manifestations are characteristic of the disease. Once that psychological factor may predispose or perpetuate symptoms of Temporomandibular Joint, it is assumed that eating disorders may contribute to an increased prevalence of oral parafunctions as bruxism.
Aim: Analysis of oral and temporomandibular manifestations of patients with eating disorders and their possible predisposition to bruxism.
Material & Method: This study included 60 volunteers (n=60), 30 of the study group diagnosed with anorexia or bulimia, from the Feeding Behavior Consultation of Psychiatry Clinic and Mental Health of St. John’s Hospital and 30 in the control group, healthy volunteers who attended the School of Dental Medicine, University of Porto. The study included the completion of questionnaires, and clinical observation, extra and intraoral assessment, general assessment of patterns of tooth wear, palpation of the Temporomandibular Joint and execution of Brux Checker ® at 7 subjects in the study group identified with bruxism.
Result: Statistically significant results were found between the study group, patients with eating disorders and the healthy control group subjects (p<0.05). Patients with eating disorders had different oral characteristics of healthy subjects, also associated with levels of anxiety and depression significantly higher. Although the results were not statistically significant, to say that patients with eating disorders had a higher prevalence of bruxism, probably replicating the study with a greater sample, could confirm a trend that seems to exist.

Francisco João Marques Maligno da Silva has completed his Master in dentistry at the age of 23 years from Faculdade de Medicina Dentária da Universidade do Porto and posgratuated on Oral Surgery and Implantology from Universidad de Ciencias Médicas Dr. Serafin Ruíz, Cuba. He is a colaborator on Occlusion Department of Faculdade de Medicina Dentária da Universidade do Porto

Introduction: Dental contacts during mandibular eccentric movements may vary in number, location and from person to person.
Objectives: To study the frequency of contact patterns during laterality and protrusion; to relate if the people who used orthodontic apparatus had interferences during protrusion movement using the Chi Square test.
Methods: It was made an oral examination of 40 people (20 males and 20 females), aged from 14 to 44 years. It was used articulation paper to observe the occlusal patterns.
Results and Conclusions: In laterality movements the pattern “canine protected guide” was the most prevalent. When interference was observed in the working side, it was generally on 16, 17, 26 and 27. Total group function seems to be a rare occlusal pattern on both laterality movements. Teeth 13 and 23 had the higher contact frequency during the laterality movements. In the protrusion, the anterior guide was the most common. The people who didn’t use orthodontic apparatus presented lower prevalence of posterior interferences during protrusion. However there was no significant statistical correlation between the use of orthodontic apparatus and the interferences during protrusion movement.

Agostinho Martins dos Santos finished his Master’s degree at the Faculty of Dental Medicine in the year 2013 and has ever since been working alongside with Associated Professor João Carlos Pinho at the occlusion, TMJ, and orofacial pain department.

The study of the mandibular cinematic has implication on different areas of dental medicine. Movement patterns are dependent on the muscles, temporomandibular joint and associated structures. What is observed in violin players is that they place the mandibula to the side in which they rest the violin to better stabilize it with the shoulder. This position can be harmful to the masticatory muscles and the temporomandibular joint. We idealized and fabricated an intra-oral device capable of providing oclusal stability and muscle tension relief referred by the violin players. Teeth casts from violinists were made as well as a register of intermaxilar relation of their most usual position in which they play violin as well as a facial arc register. The casts were assembled in the Protar articulator (KaVo) and the device was made with the Erko-Loc Pro (Erkodent) 3 mm plates. The device was made, individualized and adjusted with the T-scan device (Teskan) during violin playing. Through a visual scale of confort the musicians reported how much relief they felt with the device and without the device after a week of usage. There was a positive feedback from the musicians as the device stopped reported teeth grinding and provided a relief of facial muscle tension that followed the long hours of violin practice as well as a feeling of having all the teeth contacting as there was achieved contralateral contacts disorders due the improvements in occlusal stability given with contralateral contacts and the relief of facial muscle pain.