Frontiers in Dentistry最新文献

Objectives: The aim of the present investigation was to evaluate the possible anxiolytic effect of jasmine aromatherapy in pediatric dental procedures. Materials and Methods: A parallel randomized single-blinded placebo-controlled clinical trial was designed and conducted from February 19 until April 19, 2020, on children aged 7 to 12 years-old requiring class 1 restorative treatment of primary or permanent tooth with infiltration anesthesia. Interventions were defined as 15 minutes of aromatherapy using 2mL of jasmine extract for the intervention group, and with water for the control group. Outcomes were defined as child's anxiety and pain perception, measured by modified child dental anxiety scale (MCDAS), visual analogue scale (VAS) and changes of vital signs. After the patients received interventions based on their groups, their data was collected and analyzed. We used parametric tests and linear regression for outcome comparisons. Results: 56 patients were randomized and allocated in two groups, 28 to each. The groups did not differ significantly regarding age, sex, heart rate and O2 saturation before, during, and after procedures. Based on multivariable regression, the intervention group showed a significantly reduced MCDAS (B (95% CI) =-2.11 (-4.09, -0.13), P=0.04) and VAS (B (95% CI) =-2.30 (-3.50, -1.10), P<0.001) scores. Conclusion: Jasmine aromatherapy showed to be effective in reducing children's anxiety and pain perception during dental procedures and therefore, can be suggested as a cheap and practical complementary method in dental practice.

Objectives: Despite the successful tobacco smoking cessation counseling (TSCC) efforts of dental professionals, Iranian primary care dentists have not fully utilized their potential for TSCC provision. Thus, this study assessed the TSCC practices and their associations with socio-professional attributes, knowledge, and attitude, and explored the TSCC barriers and their socio-professional determinants in a sample of Iranian primary care dentists. Materials and Methods: This cross-sectional study was conducted at Comprehensive Healthcare Centers (CHCs) in Tehran Province, Iran from March to June 2019. All dentists practicing in these centers (n=190) completed self-administered questionnaires regarding TSCC-related knowledge, attitude, practice, and barriers. Simple and multiple linear regression and multiple logistic regression tests were used for statistical analyses. Results: The respondents (n=180, response rate=93%) were predominantly females (81.6%), recent graduates (69.6%), and non-cigarette smokers (90.2%), with a mean age of 34±9.98 years. Most performed 'Ask' (90.6%) and 'Advise' (69.1%), while a few were engaged in 'Assess' (33.7%) and fewer in 'Assist,' with 21.3% making physician referrals and 31.5% making psychologist referrals. Non-smokers (B=0.80, 95% CI: 0.19 to 1.40; P=0.01), and those with a more positive attitude (B=0.06, 95% CI: 0.04 to 0.08; P< 0.001) were more likely to provide TSCC. The main identified barriers included "absence of educational resources for patients", "time constraints", and "lack of patient cooperation. Conclusion: Although the selected sample of Iranian primary care dentists performed "Ask" and "Advise" more frequently than their peers, their TSCC practice required further improvement through simplified guidelines, customized pathways, training, team work, and resource advocacy.

Objectives: This study aimed to assess the effect of surface treatment with plasma on surface roughness (SR) and fracture resistance (FR) of monolithic zirconia, and its microtensile bond strength (MTBS) to resin cements. Materials and Methods: This in vitro, experimental study was conducted on 40 monolithic zirconia crowns for FR test, 100 zirconia rods for MTBS test, and 40 zirconia blocks for profilometry. According to the surface treatment type, the samples were randomly assigned to 4 groups of (I) control (no surface treatment), (II) argon-oxygen plasma (AOP), (III) argon plasma (AP), and (IV) sandblasting (SB). FR of crowns and MTBS of zirconia rods to Allcem Dual and Panavia SA resin cements were measured by a universal testing machine, surface texture was evaluated by atomic force microscopy (AFM), and SR was measured by a profilometer. Data were analyzed by one-way and two-way ANOVA, Tukey's test, and independent t-test (alpha=0.05). Results: There was a significant difference in SR among the groups (P=0.003). The AP group had significantly lower SR than other groups (P=0.01). FR was not significantly different among the four groups. The MTBS in the SB and AOP groups was significantly higher than that in the control and AP groups for both resin cements. MTBS was not significantly different between the two resin cements within each group. Conclusion: None of the surface treatments affected the FR of zirconia crowns. AOP and sandblasting techniques increased the MTBS of zirconia to resin cements with unnoticeable change in SR.

Objectives: The goal of this investigation was to see how a dentin pretreatment with 5% DMSO affected the microtensile bond strength (μTBS) of universal adhesives. Materials and Methods: In terms of adhesive kind and etching procedure, 32 healthy third human molars were randomly separated into eight groups. Three universal adhesives with etch-and-rinse and self-etch strategies (G-Premio Bond: GPB.ER/SE, All-Bond Universal: ABU.ER/SE, Prime & Bond Elect: PBE.ER/SE), one two-stage self-etch adhesive (Clearfil SE Bond: CSB), and one two-stage etch-and-rinse adhesive (Adper Single Bond 2: ASB) were employed in with and without DMSO modes (group/N=16). Dentin pretreatment was conducted with 50 μl of 5% DMSO, followed by the use of an adhesive. The μTBS of samples was tested. The influence of adhesive type and DMSO application on bond strength was evaluated using a two-way analysis of variance (ANOVA) ( $\alpha$ =0.05). Results: The dentin-adhesive μTBS was significantly affected by DMSO administration (P=0.003), type of adhesive (P=0.001), and the combination of DMSO application and type of adhesive (P=0.027). In the DMSO application mode, the average bond strength of universal adhesives with etch and rinse mode was significantly higher than in the non-application mode, but in the self-etch technique, there was no significant difference pattern between DMSO applications and non-application modes in terms of adhesive bond strength. Conclusion: The use of DMSO in an etch-and-rinse technique can dramatically enhance the universal adhesive-dentin μTBS and has promise benefits for clinicians in terms of enhancing dentin bond performance.

Objectives: Surface roughness is one of the important properties of composite restorations. Different polishing systems are used to provide an appropriate composite restoration surface. The aim of this study was to evaluate the effects of Sof-Lex, Eve, and Astropol polishing systems on composite resin surface roughness after aging. Materials and Methods: In this in vitro study, 36 composite discs (8×2mm) were fabricated. The specimens were randomly divided into three groups (N=12) for polishing with (I) Sof-Lex (3M ESPE), (II) Eve (Ernst Vetter GmbH), and (III) Astropol (Ivoclar/Vivadent) polishing systems. The specimens were then subjected to thermocycling. Surface roughness of the specimens was measured before and after polishing, and after thermocycling by a contact profilometer. Repeated Measures ANOVA was used to analyze the data (α=0.05). Results: Although Astropol showed slightly higher surface roughness in comparison to Sof-Lex and Eve, the level of surface roughness before and after polishing and after aging was not significantly different among the three polishing systems (P=0.704). Conclusion: Within the limitations of this in vitro study, Sof-Lex, Eve, and Astropol showed similar acceptable results with regard to composite resin surface roughness.

Objectives: The main purpose of this study was to compare the remineralizing effects of casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and tricalcium phosphate (TCP) on artificially induced enamel white spot lesions (WSLs). Materials and Methods: In this in vitro study, 45 sound extracted premolars were immersed in a demineralizing solution (pH=4.5) for 96 hours, and were randomly divided into 3 groups of TCP, MI Paste Plus, and control. They were exposed to the remineralizing agents for 5 minutes once a day for 30 days. After mounting the teeth in resin blocks and polishing, they underwent a microhardness test at 3 different depths from the enamel surface. Data were analyzed by Prism software, two-way ANOVA, and Tukey's test (α=0.05). Results: The volume percentage of mineral content (VPM) was significantly different among the three groups at 30-, 60- and 90µm depths (P<0.0001). At 30µm depth, CPP-ACPF was significantly more effective than TCP (P<0.0001). At 60- and 90µm depths, there was no significant difference between CPP-ACPF and TCP (P>0.05). Conclusion: Both CPP-ACPF and TCP had significant efficacy for remineralization of artificially induced enamel WSLs under in vitro conditions.

Objectives: We aimed to evaluate ceramic-alloy interface and emphasize the alteration of alloy microstructure after ceramic layering. Materials and Methods: Thirty-two discs made from a ceramic-alloy combination of pre-sintered cobalt-chromium (CoCr), cast CoCr, cast nickel-chromium (NiCr), or pre-sintered zirconia were prepared with eight discs in each group. Four specimens were examined as manufactured and four were ceramic-layered. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-Ray diffractometer (XRD), and an atomic force microscope were used for analysis. Non-layered specimens received ceramic fire-heating without adding any ceramic. Alloy microstructure was compared before and after ceramic veneering or heating within the same group. Mean differences in grain size and surface roughness were compared among groups. P<0.05 was considered significant. Results: SEM showed a close bonding interface between alloys and ceramics. EDX demonstrated differences compared to the manufacturer's composition. Ceramic-layering reduced grain size for both milled alloys (P<0.05), whereas grain size increased in cast groups (P=0.011). Heat treatment did the same for the CoCr groups (P=0.013). Ceramic veneering increased the surface roughness of the cast CoCr (Gi) (P=0.029) and NiCr (Wi) (P=0.005) groups, whereas zirconia roughness average (Ra) showed a slight decrease (P=0.282). XRD showed no differences among zirconia, NiCr, and milled CoCr groups before and after veneering. Crystallite size differed between monoclinic and tetragonal phases in zirconia. Conclusion: The study highlights that ceramic-layering induces significant microstructural changes in alloys, enhancing bonding potential and mechanical stability. Pre-sintered materials show a fine homogeneous surface, optimizing ceramic adherence and potentially improving clinical outcomes.

Objectives: This study evaluated the effect of a flipped oral health educational program for primary healthcare providers (PHCPs) on their knowledge, attitude, and practice. Materials and Methods: This field trial was conducted on PHCPs (N=118; 61 cases and 57 controls) in District Health Centers (DHCs) of Tehran, Iran in 2012. The participants filled out a self-report questionnaire with questions on knowledge (N=34), attitude (N=8), and oral health practice (N=14). The intervention included an educational booklet delivered to the staff followed by a brief educational session using the flipped approach and a reminder pamphlet after 1 month. After 4 months, the questionnaire was completed again by the participants. Statistical analysis included paired sample t-test, ANCOVA, and linear and logistic regression. Results: Most participants were females (N=114), and the mean age was 37±8 years. The scores of the three domains of knowledge and also the total knowledge score, the attitude score, and the practice score significantly improved in the intervention group compared to the control group (P<0.001). Knowledge about the oral health of children (P=0.001) and the total knowledge score (P<0.05) significantly increased in the control group, but the increase in other domains was not statistically significant (P>0.05). Conclusion: The oral health knowledge of PHCPs was insufficient, and their practice and attitude were not desirable. The oral health educational program with the flipped approach had a positive impact on the PHCPs' knowledge, attitude and practice, and may be utilized in the academic curriculum or continuing medical education (CME) courses.

Ectopic eruption of molars occurs more frequently in developing permanent dentition, and requires immediate intervention. Herein, two cases are discussed with ectopic eruption of permanent maxillary first molars which were diagnosed and managed conservatively using a modified Humphrey's appliance, named the NR's appliance. The appliance was fabricated by band adaptation and using wire components of a 21-gauge stainless-steel wire. Also, the Nance palatal arch was used as the anchorage unit. The molars were uprighted and distalized within 3 months. Early diagnosis and prompt treatment could result in prevention of malocclusion in the early mixed dentition period.