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  1. Thomas B, Gupta K
    J Esthet Restor Dent, 2017 Nov 12;29(6):435-441.
    PMID: 28703476 DOI: 10.1111/jerd.12317
    OBJECTIVE: Nano-hydroxyapatite-added GIC has been developed to improve the physical properties of conventional GIC. However, biological response of periodontal cells to this potentially useful cervical restorative material has been unexplored. The aim of this study was to investigate the in vitro response of human periodontal ligament fibroblasts to hydroxyapatite-added GIC.

    MATERIALS AND METHODS: Three categories of materials, namely, test group 1 (cGIC or type IX GIC), test group 2 (HA-GIC or hydroxyapatite-added GIC), and positive control (glass cover slips) were incubated with human periodontal ligament fibroblasts. The samples were viewed under scanning electron microscope to study the morphological characteristics of fibroblasts. Additionally, elemental analysis was performed to differentiate between the two test groups based on surface chemical composition.

    RESULTS: Test group 1 (cGIC) exhibited cells with curled up morphology, indicative of poor attachment to the substrate. Test group 2 (Ha-GIC) exhibited cells with flattened morphology and numerous cellular extensions such as lamellipodia and blebs, indicative of good attachment to the substrate. The test group 2 (Ha-GIC) demonstrated higher surface elemental percentages of calcium and phosphorus.

    CONCLUSION: Within the limitations of this study, it may be concluded that hydroxyapatite-added GIC is more biocompatible than conventional GIC (type IX), probably attributed to high elemental percentages of calcium and phosphorus.

    CLINICAL SIGNIFICANCE: The search for an ideal cervical restorative dental material has been ever elusive. Hydroxyapatite-added GIC is a simple and economical dental material to fabricate from basic conventional GIC. The results from this study strengthen its candidature for cervical and root surface restorations which may later require soft tissue augmentation. The possibility of connective tissue adhesion to this material is an exciting prospect in the field of periorestorative dentistry.

  2. Ching HS, Luddin N, Kannan TP, Ab Rahman I, Abdul Ghani NRN
    J Esthet Restor Dent, 2018 11;30(6):557-571.
    PMID: 30394667 DOI: 10.1111/jerd.12413
    OBJECTIVE: The aim of this review was to provide an insight about the factors affecting the properties of glass ionomer cements and provides a review regarding studies that are related to modification of glass ionomer cements to improve their properties, particularly on physical-mechanical and antimicrobial activity.

    METHODS: PubMed and Science Direct were searched for papers published between the years 1974 and 2018. The search was restricted to articles written in English related to modification of glass ionomer cements. Only articles published in peer-reviewed journals were included. The search included literature reviews, in vitro, and in vivo studies. Articles written in other languages, without available abstracts and those related to other field were excluded. About 198 peer-review articles in the English language were reviewed.

    CONCLUSION: Based on the finding, most of the modification has improved physical-mechanical properties of glass ionomer cements. Recently, researchers have attempted to improve their antimicrobial properties. However, the attempts were reported to compromise the physical-mechanical properties of modified glass ionomer cements.

    CLINICAL SIGNIFICANCE: As the modification of glass ionomer cement with different material improved the physical-mechanical and antimicrobial properties, it could be used as restorative material for wider application in dentistry.

  3. Alammar A, Heshmeh O, Mounajjed R, Goodson M, Hamadah O
    J Esthet Restor Dent, 2018 11;30(6):523-531.
    PMID: 30412347 DOI: 10.1111/jerd.12433
    AIM: The aim of this study was to evaluate and compare conventional and modified lip repositioning surgical techniques used for management of gummy smile involving hyperactive lip elevator muscles.

    METHODS AND MATERIALS: A prospective study was conducted between April 2016 and May 2017. Twenty two adult patients aged 18-38 years with gummy smile ranging from 4 to 6 mm because of soft tissue disorders were included in the study. All patients were treated in the oral and maxillofacial department at Damascus University. The sample was divided into two groups of 11 patients. The first group was treated by the conventional standard technique, and the second group treated by a modified study technique. The amount of gingival display in full smile was evaluated in both groups following each intervention.

    RESULTS: Both groups exhibited a statistically significant reduction in the measurement of gummy smile at month 1 and 6 postoperatively (P  .05). The recent study showed a significant difference in gingival display between 3 and 6 months postoperatively in group 1, but no significant difference in group 2.

    CONCLUSION: This study showed that the modified technique utilized in treating gummy smile has less relapse after surgery, shows excellent cosmesis and compared to the conventional technique, greater sustainability.

    CLINICAL SIGNIFICANCE: The recent increase in demand for an esthetic smile has led to the development a modification of conventional lip repositioning for correcting gummy smile by myotomy of lip elevator muscles. This modified technique offers less relapse and greater stability post-operatively than the conventional technique.

  4. Alhabashneh R, Alomari S, Khaleel B, Qinawi H, Alzaubi M
    J Esthet Restor Dent, 2021 04;33(3):531-537.
    PMID: 33174355 DOI: 10.1111/jerd.12680
    The objective of this study was to assess the efficacy of Hyaluronic Acid (HA) on interdental papilla (IDP) loss in the esthetic zone. Twenty one subjects (14 females and 7 males) from those referred for treatment of IDP loss at Periodontics postgraduate clinics at the Jordan University of Science and Technology. A total of 86 interdental sites (58 sites in the maxillary jaw and 28 sites in the mandibular jaw) were treated and followed up. A 0.2 ml of Hyaluronic acid was injected in each receded IDP site and injections were repeated after 21 days. Papilla sites were evaluated and statistically analyzed. At the 3 week interval the mean reduction of black triangle (BT) height was 0.17 mm (8% reduction) (P-value <0.001), at the 3 month interval there was a mean reduction of BT height of 0.83 mm (39% reduction) (P-value <0.001). At 6 months however, the reduction in BT height was 0.62 mm (29% reduction) (P-value <0.001). Within the limitations of this study, it can be concluded that the use of commercially available HA gel for the treatment of interdental papillae loss may have promising results over the first 6 months after injection. The maximum improvement in black triangles was at 3 months after injection with a reduction of improvement between 3 and 6 months. Clinical Relevance Helping clinician to take evidence based decision while considering Hyaluronic acid injection as a short term nonsurgical treatment modality for interdental papilla loss.
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