Frontiers in Dentistry
Volume:11 Issue: 2, Mar 2014

The aim of this animal study was to evaluate the possible effects of Carbonated Soft Drink consumption on the rate of orthodontic tooth movement in rats. Thirty-six adult male Sprague-Dawley rats were randomly divided into two experimental groups and one control group. In the experimental groups (A&B), the water in the dietary regimen was replaced with soft drinks (Fanta® in group A and Cola® in group B) two weeks before placement of orthodontic appliances. Then 5-mm nickel-titanium closed-coil springs were placed between the maxillary right first molars and first incisors under general anesthesia. This regimen continued for two weeks more and animals drank soft drink ad libitum. At the end of the experimental period, the rats were sacrificed, and interproximal tooth movements were measured. The mean amounts of tooth movement were 0.19mm in group A, 0.22mm in group B and 0.37mm in group C. Statistical analysis with analysis of variance (ANOVA) test showed significant differences between all groups. The least movement occurred in group A that had received Fanta® drink. CSDs consumption decreases the rate of orthodontic tooth movement. The role of soft drinks in decreasing tooth movement might be related to its effects on bone metabolism.

The growing demand for enhanced esthetic appearance has led to great developments in bleaching products. The exposure of hard tissues of the tooth to bleaching agents can affect the roughness of the enamel surface. The freshly bleached enamel surface exposed to various surface treatments such as fluoride and other remineralizing agents have been assessed in this study.The aim of this experimental study was to compare the effect of Casein Phosphopeptide- Amorphous Calcium Phosphate with Fluoride (MI Paste Plus) and Remin Pro on the enamel surface roughness after bleaching. Thirty enamel samples of sound human permanent molars were prepared for this study. After initial roughness measurement with profilometer, the samples were exposed to 37% carbamide peroxide bleaching agent 20 minutes twice, and randomly divided into three groups of ten. In group 1, a CPP-ACPF containing paste (MI Paste Plus) and in group 2, Remin Pro were applied to the teeth during a 15 day period for 5 minutes, twice a day. Samples of group 3 (control) were immersed in artificial saliva for 15 days. The roughness of all samples were measured at the beginning, after bleaching and after the study intervention and statistically analyzed. The surface roughness significantly increased in all groups following bleaching, and then it showed a decrease after application of both Remin Pro and CPP-ACPF in comparison to using bleaching agent (P<0.005). The surface roughness after using Remin Pro and CPP-ACPF was statistically similar to each other (P>0.05). There was no difference between surface roughness of MI Paste Plus and Remin Pro groups.Also the surface roughness was decreased compared to theinitial enamel surface roughness.

Recently, self-etching fissure sealants have been introduced to reduce technical sensitivity; however, their efficacy should be assessed. The aim of this study was to assess of the microshear bond strength of self-etching and conventional fissure sealants. Thirty non-carious third molars were randomly divided into three groups (N=10). Microcylinders of Concise fissure sealant were bonded to prepared buccal and lingual surfaces using the two following procedures. In the first group, phosphoric acid was used to prepare the substrate; whereas in group two, Concise was used in combination with Prompt L-Pop. In group 3, a self-etching fissure sealant (Enamel Loc) was utilized per se. After 24 hours, the samples were subjected to 500 rounds of thermocycling and shear bond testing using a microtensile tester machine with a crosshead speed of 0.5mm/min. Data were analyzed using one-way repeated measure ANOVA and Bonferroni Post HOC tests (SPSS version 16). The mean and standard deviation of microshear bond strength of the groups were as follows: Group 1: Concise+ etching (14.59 ± 1.19 MPa), Group 2: Concise+Prompt L-Pop (12.86 ± 1.98 MPa), and Group 3: Enamel Loc (5.59 ± 0.72 MPa). One-way ANOVA revealed that all the differences were significant and the conventional sealant exhibited the highest mean bond strength. Conventional sealant using phosphoric acid etch application prior to fissure sealant application demonstrated more bond strength in comparison with that of self- etch bonding and self- etch sealant.

The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate (MTA) and Intermediate Restorative Material (IRM), as a root end filling material, using Scanning Electron Microscopy (SEM). Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated. Three millimetres of the root end were resected and 3mm retro cavity preparation was done using ultrasonic retrotips. The samples were randomly divided into three groups (n=10) and were restored with root end filling materials: Group I– MTA, Group II – Biodentine, Group III –IRM. The root ends were sectioned transversely at 1mm and 2mm levels and evaluated for marginal adaptation using SEM. The gap between dentin and retro filling material was measured at four quadrants. The mean gap at 1mm level and 2mm level from the resected root tip and combined mean were calculated. The data were statistically analyzed, using one-way ANOVA and Tukey’s HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis. The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine. At 1mm level there was no statistically significant difference among any of the tested materials. At 2mm level MTA was superior to both IRM and Biodentine. In overall comparison, MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation, when used as retrograde filling material.

Ethanol wet-bonding (EWB) technique has been stated to decrease degradation of resin-dentin bond. This study evaluated the effect of two EWB techniques on composite resin-to-enamel bond strength. Silicon carbide papers were used to produce flat enamel surfaces on the buccal faces of forty-five molars. OptiBond FL (OFL) adhesive was applied on enamel surfaces in three groups of 15 namely:1. Enamel surface and OFL (control);2. Protocol 1 of the EWB technique: absolute ethanol was applied to water-saturated acid-etched enamel surfaces for 1 minute before the application of ethanol-solvated hydrophobic adhesive resin of OFL 3 times;3. Protocol 2: progressive ethanol replacement; water was gradually removed from the enamel matrix using ascending ethanol concentrations before OFL application.Composite build-ups were made and the specimens were stored for 24 hours at 37°C and 100% relative humidity. Shear bond strength test was performed using a universal testing machine at 1 mm/min crosshead speed. Fracture patterns were evaluated microscopically. Data were analyzed with one-way ANOVA and Fisher’s exact test (α=0.05). There were no significant differences in bond strength between the groups (P=0.73). However, regarding failure patterns, the highest cohesive enamel fractures were recorded in groups 2 and 3. In this study, although both methods of EWB did not influence immediate bond strength of composite resin to enamel, the majority of failure patterns occurred cohesively in enamel.

The aim of this study was to compare the effect of an acidic environment on dislocation resistance (push-out bond strength) of EndoSequence Root Repair Material (ERRM putty and ERRM paste), a new bioceramic-based material, to that of mineral trioxide aggregate (MTA). One-hundred twenty root dentin slices with standardized canal spaces were divided into 6 groups (n = 20 each) and filled with tooth-colored ProRoot MTA (groups 1 and 2), ERRM putty (groups 3 and 4), or ERRM paste (groups 5 and 6). The specimens of groups 1, 3, and 5 were exposed to phosphate buffered saline (PBS) solution (pH=7.4) and those of groups 2, 4, and 6 were exposed to butyric acid (pH= 4.4). The specimens were then incubated for 4 days at 37°C. The push-out bond strength was then measured using a universal testing machine. Failure modes after the push-out test were examined under a light microscope at ×40 magnification. The data for dislocation resistance were analyzed using the t-test and one-way analysis of variance. In PBS environment (pH=7.4), there were no significant differences among materials (P=0.30); but the mean push-out bond strength of ERRM putty was significantly higher than that of other materials in an acidic environment (P<0.001). Push-out bond strength of MTA and ERRM paste decreased after exposure to an acidic environment; whereas ERRM putty was not affected by acidic pH. The bond failure mode was predominantly cohesive for all groups except for MTA in an acidic environment; which showed mixed bond failure in most of the specimens. The force needed for dislocation of MTA and ERRM paste was significantly lower in samples stored in acidic pH; however, push-out bond strength of ERRM putty was not influenced by acidity.

Recurrent aphthous stomatitis (RAS) is the most common and painful oral inflammatory lesion with an unknown etiology. This study aims to determine the therapeutic effects of ibuprofen, diphenhydramine and aluminum magnesium simethicone (AlMgS) syrup on reducing oral aphthous ulcer pain. Thirty-one patients with RAS participated in this double-blind clinical trial. Subjects were randomly divided into two groups. The control group (n=14) received drug mixture as drug A (diphenhydramine and AlMgS) and the case group (n=17) received drug B (ibuprofen, diphenhydramine and AlMgS). Drugs were topically applied on ulcers by the patients three times a day for 3 days. Patients were re-examined for the symptoms on the fourth day following their first visits using VAS (Visual Analogue Scale) tool. Statistical analysis was performed using paired t-test, independent t-test and chi-square test. The mean of pain reduction was 3.17±2 (P<0.001) and 3.82±1.79 (P<0.001) in the case and control group, respectively. The difference in pain reduction between both groups was not statistically significant. In addition, no significant difference was detected between the two groups regarding the duration of pain or burning sensation (P=0.57). The results of this study demonstrate that in comparison with diphenhydramine and AlMgS syrup, the studied mixture did not effectively reduce the level of pain, duration and burning sensation.

Microleakage can be responsible for tooth hypersensitivity, secondary caries, and the possibility of pathological pulp alterations in restored teeth.Recently, alternative methods for tooth preparation such as laser irradiation have been studied; but there are limited studies on primary teeth. The aim of this in vitro study was to compare the degree of microleakage of composite restorations prepared by Er:YAG laser and conventional bur preparation with two adhesive systems in primary teeth. Eighty primary canine teeth were randomly divided into 4 groups. Class V cavities were prepared by Er:YAG laser or diamond bur on buccal surface. The groups were as follows: group1: High speed drill + self-etching adhesive Adper Prompt-L-Pop, group 2: Er:YAG laser + etch & rinse adhesive Adper Single Bond, group 3: High speed drill + Adper Single Bond, group 4: Er:YAG laser + Adper Prompt-L-Pop. Cavities were restored with Filtek Z250 composite resin. Then all of the specimens were polished, thermocycled, immersed in 2% methylene blue solution and sectioned longitudinally. Degree of microleakage was evaluated by two evaluators who assigned the micrleakage score (0 to 3). The original data were analyzed by the Kruskal-Wallis and Dunn’s tests. There were significant differences between bur-prepared cavities in the Adper Single Bond and other groups. There were no statistically significant differences between other groups. Laser-prepared cavities showed higher microleakage scores than cavities prepared with diamond bur with etch and rinse adhesive system. No significant difference was revealed between the laser and bur-prepared cavities using self-etch primers.

To evaluate the interfacial morphology and the bond strength produced by the three- step, two- step and single-step bonding systems in primary teeth. Occlusal surfaces of 72 extracted human deciduous teeth were ground to expose the dentin. The teeth were divided into four groups: (a) Scotchbond Multipurpose (3M, ESPE), (b) Adh Se (Vivadent), (d) OptiBond All-in-One (Kerr) and (e)Futurabond NR (VOCO, Cuxhaven, Germany). The adhesives were applied to each group following the manufacturer’s instructions. Then, teeth from each group were divided into two groups: (A) For viewing interfacial morphology (32 teeth), with 8 teeth in each group, and (B) For measurement of bond strength (40 teeth), with 10 teeth in each group. All the samples were prepared for viewing under SEM. The statistical analysis was done using SPSS version 15.0 software. Observational measurement of tag length in different adhesives revealed that Scotchbond had the most widely spread values with a range from 12.20 to 89.10µm while OptiBond AIO had the narrowest range (0 to 22.50). The bond strength of Scotchbond Multipurpose was significantly higher (7.4744±1.88763) (p<0.001) as compared to Futurabond NR (3.8070±1.61345), Adhe SE (4.4478 ± 1.3820) and OptiBond-all-in-one (4.4856±1.07925). The three-step bonding system showed better results as compared to simplified studied bonding systems

Canal preparation generates a substantial amount of debris and smear layer (SL). The size and taper of the Master Apical File (MAF) affects on penetration of irrigants and subsequently canal cleaning efficacy.The aim of this study was to evaluate the effect of MAF size and taper on penetration of irrigants to the apical third of curved mesiobuccal (MB) canals of mandibular first molars.

Eighty-nine human mandibular first molars were divided into one control group (n=5) without rotary instrumentation and 6 experimental groups (n=14 each) that were prepared with the following RaCe rotary files as MAF: 25.04 (group1), 25.06 (group 2), 30.04 (group 3), 30.06 (group 4), 35.04 (group 5) and 35.06 (group 6). All the experimental groups were rinsed with 2 ml of 17 % EDTA followed by 2 ml of 5.25% NaOCl. Debridement of the MB canals was evaluated using scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests (P<0.05).

Group 6 (MAF=35.06) showed 100% acceptable debridement. This rate was 92.9% for MAF=35.04. In group 4 (MAF=30.06) smear layer (SL) was removed in the three-forth of the samples and debris was removed in 92.9% of them. Acceptable debridement was not achieved in most samples of groups 1 and 2 (25.04 and 25.06, respectively) and the mentioned two groups had statistically significant difference in this respect with the other groups (P<0.05).

Based on this study, 30.06 may be considered as the minimum MAF size for acceptable debridement.

The aim of this study was to determine the effects of 40% hydrogen peroxide and 15% carbamide peroxide on microhardness and color change of a silorane-based composite resin in comparison with two methacrylate-based composites. Fifty-four disc-shaped specimens (A3 shade) were fabricated of Filtek P90 (P90), Filtek Z350XT Enamel (Z350) and Filtek Z250 (Z250) (3M-ESPE) (n=18). The samples of each composite were randomly divided into three subgroups of 6. The control subgroups were immersed in distilled water; the test groups were exposed to Opalescence Boost (OB) once; and Opalescence PF (OP) (Ultradent) for two weeks. Vickers microhardness testing and a spectrophotometric analysis of the color of samples were performed before and after each intervention. The baseline microhardness of P90 was significantly lower than that of the other two composites (P=0.001), but no difference was found between Z250 and Z350 in this respect (P=0.293). Bleaching treatments significantly decreased the microhardness of Z250 and Z350 (P< 0.001), but no change was observed in P90 test and control subgroups (P> 0.05). No significant difference was detected between the two types of bleaching (P>0.05). After bleaching with OB, E value was measured to be 3.12(1.97), 3.31(1.84) and 3.7(2.11) for P90, Z250 and Z350, respectively. These values were 5.98(2.42), 4.66(2.85) and 4.90(2.78) after bleaching with OP with no significant difference. Bleaching decreased the microhardness of methacrylate-based but not silorane-based composites. Although no significant differences were found in E of composites, E of all groups did not remain in the clinically acceptable range after bleaching except for P90 after bleaching with 40% H2O2 (E < 3.3).

Peri-implantitis is one of the most common reasons for implant failure. Decontamination of infected implant surfaces can be achieved effectively by laser irradiation; although the associated thermal rise may cause irreversible bone damage and lead to implant loss. Temperature increments of over 10ºC during laser application may suffice for irreversible bone damage.Purpose of Study: The purpose of this study was to evaluate the temperature increment of implant surface during Er:YAG laser irradiation with different cooling systems. Three implants were placed in a resected block of sheep mandible and irradiated with Er:YAG laser with 3 different cooling systems namely water and air spray, air spray alone and no water or air spray. Temperature changes of the implant surface were monitored during laser irradiation with a K-type thermocouple at the apical area of the fixture. In all 3 groups, the maximum temperature rise was lower than 10̊°C. Temperature changes were significantly different with different cooling systems used (P<0.001). Based on the results, no thermal damage was observed during implant surface decontamination by Er:YAG laser with and without refrigeration. Thus, Er:YAG laser irradiation can be a safe method for treatment of peri-implantitis.

Increased number of adult patients requesting orthodontic treatment result in bonding bracket to ceramic restorations more than before. The aim of this study was to evaluate and compare the shear bond strength of orthodontic brackets bonded to two types of ceramic bases with conventional orthodontic bonding resin and a new nano-filled composite resin. Twenty four feldespathic porcelain and 24 lithium disilicate ceramic disks were fabricated. All of the samples were conditioned by sandblasting, hydrofluoric acid and silane. Maxillary incisor metal brackets were bonded to half of the disks in each group by conventional orthodontic bonding resin and the other half bonded with a nano-filled composite. The samples then were thermocycled for 2000 cycle between 5-55° C. Shear bond strength was measured and the mode of failure was examined. Randomly selected samples were also evaluated by SEM. The lowest bond strength value was found infeldespathic ceramic bonded by nano-filled composite (p<0.05). There was not any statistically significant difference between other groups regarding bond strength. The mode of failure in the all groups except group 1 was cohesive and porcelain damages were detected. Since less damages to feldspathic porcelain was observed when the nano-filled composite was used to bond brackets, the use of nano-filled composite resins can be suggested for bonding brackets to feldspathic porcelain restorations.

There is evidence indicating that pomegranate juice contains many of the essential properties necessary to retain cell viability and cell proliferation. These properties indicate that pomegranate juice is a suitable storage medium for avulsed teeth. However, this idea has not yet been tested. In this study, the capacity of pomegranate juice (PJ) as a storage medium for retaining avulsed teeth was evaluated. PDL fibroblasts were obtained from healthy human premolars and cultured in Dulbecco’s Modified Eagle’s Medium (DMEM). Cultured cells were subjected to different concentrations of pomegranate juice (PJ), 1% Hank`s balanced salt solution (HBSS) and tap water for 1, 3, 6 and 24 hours. PDL cell viability was assessed by the neutral red uptake assay. The results indicated that 7.5% PJ was the most effective solution for maintaining PDL cell viability amongst all the experimental solution sand time intervals (P<0.05). The results also showed that 1% PJ was as effective as HBSS for maintaining PDL cell viability. The amount of cell viability increased with increasing concentration of PJ at all time intervals (P<0.001). This effect is suggestive of the proliferative potential of PJ solution. In conclusion, PJ can be recommended as a suitable transport medium for avulsed teeth.

The aim of this study was to assess the surface of yttrium-stabilized tetragonal zirconia (Y-TZP) after surface treatment with lasers and airborne-particle abrasion. First, 77 samples of presintered zirconia blocks measuring 10 × 10 × 2 mm were made, sintered and polished. Then, they were randomly divided into 11 groups (n=7) and received surface treatments namely, Er:YAG laser irradiation with output power of 1.5, 2 and 2.5 W, Nd:YAG laser with output power of 1.5, 2 and 2.5 W, CO2 laser with output power of 3, 4 and 5 W, AL2O3 airborne-particle abrasion (50μ) and no treatment (controls). Following treatment, the parameters of surface roughness such as Ra, Rku and Rsk were evaluated using a digital profilometer and surface examination was done by SEM. According to ANOVA and Tukey’s test, the mean surface roughness (Ra) after Nd:YAG laser irradiation at 2 and 2.5 W was significantly higher than other groups. Roughness increased with increasing output power of Nd:YAG and CO2 lasers. Treated surfaces by Er:YAG laser and air abrasion showed similar surface roughness. SEM micrographs showed small microcracks in specimens irradiated with Nd:YAG and CO2 lasers. Nd:YAG laser created a rough surface on the zirconia ceramic with many microcracks; therefore, its use is not recommended. Air abrasion method can be used with Er:YAG laser irradiation for the treatment of zirconia ceramic.

Glanzmann’s thrombasthenia (GT) is a rare, genetically inherited platelet disorder in which the platelet glycoprotein IIb/IIIa (GP IIb/IIIa) complex is either deficient or, dysfunctional. The incidence is about 1 in 1,000,000. This case report deals with a 4 year-old girl diagnosed with GT presenting with dental caries and periapical lesions in the primary mandibular first molars. To provide the best care, an interdisciplinary approach was followed by a team consisting of pediatric dentists, pediatricians and anesthesiologists. Complete oral rehabilitation was planned under general anesthesia which included extractions, multiple esthetic restorations and space maintainers with the utmost care to prevent unwarranted bleeding.