Journal of Dentistry of Tehran University of Medical Sciences最新文献

Objectives: The aim of this study was to evaluate enamel and dentinal microleakage in Class II cavities restored with silorane- and methacrylate-based resin composites using specific and nonspecific adhesives.

Materials and methods: Thirty-six caries-free human premolars were used. Two Class II cavities were prepared on each tooth. The gingival floor was set at 1 mm above (on the mesial surface) and at 1 mm below (on the distal surface) the cementoenamel junction (CEJ). The samples were randomly divided into four groups, and the cavities were restored with a methacrylate-based composite (Filtek^™ P60) and a silorane-based composite (Filtek^™ P90) with specific and nonspecific adhesives. Microleakage was tested using a standardized dye penetration method. All samples were examined under a stereomicroscope, and microleakage scores were statistically analyzed using Kruskal-Wallis and Mann-Whitney-U tests. One sample from each group was examined under a scanning electron microscope (SEM) to determine the bonding area.

Results: No significant difference was found between the groups in terms of the enamel microleakage (P=0.086). There was a significant difference between the groups with regard to dentinal microleakage (P=0.003). No significant reduction in microleakage was observed in groups restored with Filtek^™ P90 composite using its specific adhesive compared to those restored with Filtek^™ P60 composite using its specific adhesive (P=0.626).

Conclusions: The results indicated that the application of methacrylate- and silorane-based composites with specific or nonspecific adhesives had no impact on enamel microleakage, but it affected dentinal microleakage, and specific adhesives showed less microleakage. It seems that a phosphate-methacrylate-based intermediate resin is required to bond dimethacrylate adhesive to silorane-based composites.

Objectives: Studies on modeling a pre-exposure technique for the prevention of anxiety in children are rare, and there is no study on interactive modeling using computer games. We assessed the effect of playing a dental simulation game before operation on pain and anxiety in 4- to 7-year-old children during their first dental treatment session.

Materials and methods: In this double-blind randomized clinical trial, 50 children needing unilateral pulpotomy and placement of stainless-steel crowns (SSC) on mandibular primary first molars were enrolled and randomly divided into experimental (a simulation game) and control (no intervention) groups. The experimental group played the game twice a day for two weeks before the scheduled visit. At the dental session, their pre- and post-operative pains were recorded using the Wong-Baker Facial Rating Scale (W-BFRS). Also, heart rate (HR; as an indicator of anxiety) was measured using a finger pulse oximeter at six treatment stages: (1) baseline (at the initial session, two weeks before treatment) and (2-6) during different stages of treatment. Effects of playing the simulation on pain and HR were analyzed using t-test and repeated-measures two-way analysis of covariance (ANCOVA).

Results: Game playing significantly reduced the HR (P=0.031). The interaction of playing with the treatment period was also significant (P=0.004). When the groups were compared in each of the six time points, the experimental group showed reduced HR during anesthetic injection and cavity preparation using a high-speed handpiece (P<0.003).

Conclusions: Based on the results, playing certain dental simulation games before the first dental visit might reduce the anxiety felt during anesthetic injections and drilling.

Objectives: The aim was to investigate the effect of intracanal irrigants and agents on the bond strength of intraradicular fiber posts to dentin.

Materials and methods: Root canals of 72 decoronated single-rooted premolars were cleaned, shaped, and obturated with gutta-percha and AH26. The specimens were incubated at 37°C and 100% humidity for seven days. Next, the coronal 10 mm of the canals were prepared to receive size 2 D.T. Light fiber post, and the specimens were randomly allocated into six groups according to the irrigants used after post space preparation: normal saline (control group), 5.25% sodium hypochlorite (NaOCl)/15 seconds, 17% ethylenediaminetetraacetic acid (EDTA)/60 seconds, 2% chlorhexidine (CHX)/5 minutes, MTAD/5 minutes, and acid-etching/15 seconds. All canals were rinsed with normal saline and dried. Fiber posts were cemented using Panavia F2.0. After 24 hours, two mid-root slices of 1mm thickness were obtained from each specimen. Push-out bond strength test was performed in a universal testing machine at 0.5mm/minute. The maximum applied load was recorded, and the bond strength was calculated in megapascal (MPa). Data were analyzed by one-way analysis of variance (ANOVA) and Tukey's test.

Results: The mean shear bond strengths of etched (53.21±12.11 MPa), MTAD (52.47±14.75 MPa) and EDTA (49.08±10.19 MPa) groups were significantly higher than that of the control group (39.82±10.04 MPa). The difference was marginally significant for CHX group (49.8±13.57 MPa) and not significant for NaOCl group (47.15±17.64 MPa).

Conclusions: Etching or irrigating the root canals with MTAD or EDTA after post space preparation increases the bond strength of Panavia F2.0 to dentin.

Objectives: Finding predictable approaches for root surface biomodification is an important challenge in the treatment of gingival recession. This study sought to assess the root coverage percentage by subepithelial connective tissue graft (SCTG) following root surface conditioning with erbium, chromium: yttrium scandium gallium garnet (Er,Cr:YSGG) laser.

Materials and methods: In this split-mouth, randomized clinical trial, 30 teeth with Miller's Class I and II gingival recession were treated with SCTG (the Langer and Langer technique) with (case group) or without (control group) root surface conditioning with Er,Cr:YSGG laser (wavelength=2780 nm, power=0.75 W, H mode, repetition rate=20 Hz). Recession depth (RD), recession width (RW), clinical attachment level (CAL), and probing depth (PD) were assessed at the baseline (one week before surgery) and at 2 and 6 months postoperatively. The amount of root coverage was quantified in the two groups. Data were analyzed using Friedman test and Wilcoxon signed-rank test.

Results: No significant difference was noted between the case and control groups in any parameter (P>0.05). Significant improvement occurred in all the measured parameters in the two groups after surgery (P<0.05). The mean root coverage at the end of the study period was 87% and 80% in the case and control groups, respectively (P=0.244), and complete root coverage was achieved in 66% and 60% of the samples in the case and control groups, respectively.

Conclusions: Root surface conditioning by Er,Cr:YSGG laser improved the mean root coverage and the percentage of complete root coverage. However, these changes were not statistically significant.

Objectives: Periodontitis is an inflammation of periodontal tissues that is caused by the biofilm of periodontal pathogens. Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) is an opportunistic periodontopathogen that can be the cause of periodontal diseases via fimbriae as a virulence factor. In this study, we aimed to determine the expression level of A. actinomycetemcomitans rcpA gene as a virulence factor associated with biofilm formation after antimicrobial photodynamic therapy (aPDT) as a relatively new therapeutic modality.

Materials and methods: To determine sub-lethal doses of aPDT against A. actinomycetemcomitans ATCC 33384 strain, we used curcumin (CUR) as a photosensitizer at a final concentration of 40 μmol/ml, which was excited with a light-emitting diode (LED) at the wavelength of 450 nm. Quantitative real-time polymerase chain reaction (qRT-PCR) was then applied to monitor rcpA gene expression in A. actinomycetemcomitans.

Results: 10-40 μmol/ml of CUR caused a significant reduction in the growth of A. actinomycetemcomitans compared to control group (P<0.05). Also, the cell viability of A. actinomycetemcomitans was significantly decreased after more than four minutes of LED irradiation. Therefore, the sub-lethal dose of aPDT against A. actinomycetemcomitans was 5 μmol/ml of CUR with three minutes of LED irradiation at a fluency of 180-240 J/cm², which reduced the expression of the rcpA gene by approximately 8.5-fold.

Conclusions: aPDT with CUR leads to decreased cell survival and virulence of A. actinomycetemcomitans. Thus, CUR-aPDT can be used as an alternative approach for the successful treatment of periodontitis in vivo.

The management of traumatic dental injuries as well as crown-root fractures is always challenging in everyday general dental practice. A number of treatment modalities are available for crown-root fractures, depending on the position, extent and severity of the fracture. The aim of this case report was to describe a clinical case of rehabilitation of a complicated crown-root fracture of the maxillary left central incisor, successfully treated by a multidisciplinary approach including orthodontic extrusion. The final result was esthetically pleasant and periodontally sound in the follow ups.

Objectives: Obtaining an adequate ceramic thickness to mask the substructure color is not always feasible, and appropriate use of a cement may be the only solution. This study aimed to evaluate the effect of the color of Variolink II resin cement on the final color of lithium disilicate glass ceramic restorations.

Materials and methods: In this in-vitro study, 90 discs of IPS e.max Press ceramic were evaluated. The ceramic discs were cemented to composite and amalgam blocks. The effect of the cement color and substructure on the final color of ceramic was analyzed by calculating the color change (ΔE) value using a spectrophotometer. Data were analyzed via three-way analysis of variance (ANOVA) and Tukey's test.

Results: The cement color had a statistically significant effect on the final color of ceramic (P≤0.001). The white, yellow, and translucent cements caused the highest color change (ΔE=4.558, 3.308, and 2.649, respectively). The effect of composite substructure and the yellow cement on the final color was less prominent compared to other combinations of cement and substructure (ΔE=2.043). The white cement over amalgam substructure showed the greatest effect on the final color (ΔE=4.890). The ΔE in HO group was less than that of other combinations (P<0.05), and the greatest ΔE was reported in MO group with the white cement (ΔE=6.255).

Conclusions: The final color of the restoration is influenced by the cement color. Therefore, when IPS e.max Press is used over a metal core, it is recommended to use a cement with an HO ceramic.

Objectives: Successful root treatment depends on elimination of microorganisms from the root canal. Considering incomplete removal of bacteria from the canal by usual methods, lasers have been suggested as a new modality. Despite their anti-bacterial properties, lasers can cause thermal changes. This study assessed the thermal changes of root surface in pulpectomy of primary teeth following the use of Er:YAG laser.

Materials and methods: Sixty primary anterior teeth were collected and prepared by K-file up to number 50. Then, they were randomly divided into two groups and were irradiated with Er:YAG laser. The first group was irradiated with 1 W laser and the second group with 1.5 W laser. The laser irradiation time was two 10-second cycles with a 2-second interval in both groups. Thermal changes were measured by a thermometer in the apical and coronal areas per second. The results were analyzed by repeated measures ANOVA considering the laser power as between-subject variable.

Results: There was a temperature increase in the coronal and apical areas in use of 1 W power. There was a temperature rise in the coronal and apical areas in use of 1.5 W power. The temperature rise in the apical third was more than that in the coronal third; also, the average temperature rise was more in use of 1.5 W power than 1 W power.

Conclusions: As the average temperature increase was not more than 7°C in any group, this type of laser seems to be suitable for root treatment of primary anterior teeth.

Objectives: Cleft lip and palate (CLP) is the most common congenital anomaly of the head and neck region. The upper airway in CLP patients is affected by retarded maxillary growth. Small size of the nasopharynx can also lead to mouth breathing. This study aimed to compare the size of nasopharynx and adenoids in non-syndromic unilateral CLP (NSUCLP) patients and healthy controls two-dimensionally on lateral cephalograms.

Materials and methods: This retrospective study was performed on 30 children with NSUCLP (mean age of 11.3 years) and 30 sex- and age-matched healthy controls with class I skeletal relationship. The bony boundaries of the nasopharynx, nasopharyngeal airway and adenoids were outlined on lateral cephalograms and their surface area was calculated and compared between the two groups. The percentage of nasopharynx occupied by the adenoids was calculated for each individual and compared between the two groups using independent t-test.

Results: Size of nasopharynx in NSUCLP children was significantly smaller than that in healthy controls (P=0.0001). Size of adenoids was significantly larger in NSUCLP children (P=0.0001). Size of nasopharyngeal airway was smaller in NSUCLP patients than controls (P=0.0001). Percentage of nasopharynx occupied by the adenoids was significantly greater in NSUCLP patients (P=0.0001).

Conclusions: The size of nasopharynx is smaller while the size of adenoids is larger in NSUCLP children compared to healthy controls; this can lead to mouth breathing and velopharyngeal incompetence.

Objectives: The purpose of this in-vitro study was to determine and compare the shortest period needed for a triple antibiotic paste (TAP) and calcium hydroxide (Ca(OH)₂) plus 2% chlorhexidine (CHX) to eradicate the biofilm of Enterococcus faecalis (EF) from the root canal system.

Materials and methods: Sixty-five extracted single-rooted human teeth with straight root canals were selected. The crowns were cut from the cementoenamel junction (CEJ), and canal preparations were done by step-back technique. The smear layer was removed by 17% ethylenediaminetetraacetic acid (EDTA) and 5.25% sodium hypochlorite (NaOCl). Afterwards, the samples were sterilized with gamma ray and were placed inside microtubes for one week. During this week, the teeth were infected with EF. Then, a TAP and Ca(OH)₂ mixed with 2% CHX were inserted into the canals. The roots were cut longitudinally, and dentin chips were collected from the apical part of the roots by a round bur to the depth of 400 μm. The vital bacterial load was assessed by counting the numbers of colony-forming units (CFUs).

Results: The paste of Ca(OH)₂ mixed with 2% CHX was able to eradicate the EF biofilm in three days. The TAP was able to eradicate the biofilm of EF in seven days.

Conclusions: It seems that Ca(OH)₂ mixed with 2% CHX is more potent than the TAP against EF biofilm.