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Objective The aim of this study was to evaluate the influence of different marginal designs (deep chamfer, vertical, and modified vertical with reverse shoulder) on the fracture strength and failure modes of monolithic zirconia crowns. Materials and Methods Thirty sound human maxillary first premolar teeth with comparable size were used in this study. The teeth were divided randomly into three groups according to the preparation design (n = 10): (1) group A: teeth prepared with a deep chamfer finish line; (2) group B: teeth prepared with vertical preparation; and (3) group C: teeth prepared with modified vertical preparation, where a reverse shoulder of 1 mm was placed on the buccal surface at the junction of middle and occlusal thirds. All samples were scanned by using an intraoral scanner (CEREC Omnicam, Sirona, Germany), and then the crowns were designed by using Sirona InLab 20.0 software and milled with a 5-axis machine. Each crown was then cemented on its respective tooth with self-adhesive resin cement by using a custom-made cementation device. A single load to failure test was used to assess the fracture load of each crown by using a computerized universal testing machine that automatically recorded the fracture load of each sample in Newton (N). Statistical Analysis The data were analyzed statistically by using one-way analysis of variance test and Bonferroni test at a level of significance of 0.05. Results The highest mean of fracture load was recorded by chamfer (2,969.8 N), which followed by modified vertical (2,899.3 N) and the lowest mean of fracture load was recorded by vertical (2,717.9 N). One-way ANOVA test revealed a significant difference among the three groups. Bonferroni test showed a significant difference between group A and group B, while a nonsignificant difference was revealed between group C with group A and group B. Conclusion Within the limitations of this in vitro study, the mean values of fracture strength of monolithic zirconia crowns of all groups were higher than the maximum occlusal forces in the premolar region. The modification of the vertical preparation with a reverse shoulder placed at the buccal surface improved the fracture strength up to the point that it was statistically nonsignificant with the chamfer group.

Purpose: This study was carried out to evaluate Three-Dimensional marginal bone resorption with flap and flapless placement of immediately loaded implants retaining mandibular overdentures with locator attachments. Materials and methods: Ten edentulous patients (6 males and four females, with an average age of 59 years) complaining of lack of retention of mandibular dentures received two implants in the canine positions of the mandible using either flap (group 1) or flapless (group 2) surgical approach. All implants were immediately loaded with locator retained mandibular overdentures. Cone beam CT was used to measure Three-Dimensional bone loss at mesial, distal, buccal and lingual surface of each implant. Measurements were made at baseline, six and 12 months later after delivery. Results: The survival rate was 90% and 100% for flap and flapless groups respectively. For all implant surfaces, flap group showed significant higher bone resorption than flapless group. After 12 months, the highest bone loss occurred at the mesial surface and the lowest bone loss occurred at the buccal surface in the flap group. For flapless group, the highest bone loss occurred at buccal surface and the lowest bone loss located at lingual surface. For all implant surfaces in both groups, marginal bone loss after 12 months was significantly higher than the values after six months. Conclusion: Within the limitations of this study, the flapless surgical approach is recommended for locator retained mandibular overdentures than the flap approach as it was associated with reduced marginal bone loss after 12 months.

AIM AND OBJECTIVE This study aimed to compare microleakage of resin-modified glass ionomer cement (RMGIC) and alkasite with and without adhesive system in class V cavity. MATERIALS AND METHODS Thirty class V cavities were prepared on the buccal surface. All prepared samples were randomly divided into three groups. Group I was restored with RMGIC, group II was restored with Cention N after the application of adhesive system, and group III was restored with alkasite. Samples were subjected to 200 thermocycles between temperature baths at 5oC and 55oC. Samples were stained with 2% methylene blue. The teeth were sectioned longitudinally, and the sections were then observed under stereomicroscope at a magnification of 20×. RESULTS Statistical analysis showed that there was less microleakage in Cention N using adhesive system in both occlusal margin and gingival margin. CONCLUSION There were significant differences between RMGIC, alkasite with adhesive system, and alkasite without adhesive system in class V cavity. Least microleakage at the occlusal margin and gingival margin was seen with Cention N using adhesive system and highest microleakage at the RMGIC. CLINICAL SIGNIFICANCE Cention N using the adhesive system affects the microleakage in the class V restoration. The study theorizes that the material restorations showed less microleakage in the occlusal margin than in the gingival margin.

This double-blind randomized clinical trial compared the effectiveness and bleaching sensitivity (BS) of at-home dental bleaching performed on the buccal surface and on the lingual surface. Using a split-mouth design, 25 patients were assigned to two bleaching groups: 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the buccal surface (BSB) and 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the lingual surface (LSB), both for 14 days. The color was evaluated before bleaching, after the first and second weeks, and 1 month after the bleaching using Vita Classical and Vita Bleachedguide scales and a Vita Easyshade spectrophotometer. BS was recorded daily using a 0–4 numerical rating scale and a 0–10 visual analogue scale. The following statistical tests were used: color changes (Mann–Whitney), absolute risk of BS (McNemar’s exact), and the intensity of BS (Mann–Whitney). In all statistical tests, the significance level was 5%. Significant bleaching was observed after the end of bleaching in both groups, with higher bleaching effectiveness for BSB when compared to LSB (p

Background New direction in dentistry has been developed to increase the minimal-invasive approach, especially in younger children. Therefore, needs has arise to find new techniques to replace the restorative and surgical treatments of dental caries with more conservative therapies. So that remineralization therapies has taken place in the last few years. Materials and methods A total of 84 teeth with white-spot lesions in 18, three-to-five-year-old children were included in the study. All of the selected teeth had no yellow or brown discoloration, no carious cavities or developmental defects, and gave the value of 5–17 when measured using DIAGNOdent. Clinpro Tooth Creme was applied for 3 min after cleaning and drying on each tooth, a photograph was taken after every application with intervals of one week, two weeks, four weeks and six weeks. The laser fluorescence intensity was measured using DIAGNOdent before every application and 10 min after. The clinical appearance change was evaluated by calculating the ratio of the area of white-spot lesion to the whole area of buccal surface of each tooth using AutoCAD 2015. Results were statistically analyzed using Mann-Whitney and Kruskal-Wallis tests. Results Statistical analysis showed that there was an important significant differences between DIAGNOdent values of Clinpro group and the other group (p 0.05). Conclusions Clinpro Tooth Creme improved white-spot lesions remineralization but did not prettify clinical appearance after its application within the used protocol.

Objective This study aimed to evaluate the volume, amount, and localization of root resorption in the maxillary first premolars using micro-computed tomography (micro-CT) after expansion with four different rapid maxillary expansion (RME) appliances. Methods In total, 20 patients who required RME and extraction of the maxillary first premolars were recruited for this study. The patients were divided into four groups according to the appliance used mini-implant-supported hybrid RME appliance, hyrax RME appliance, acrylic-bonded RME appliance, and full-coverage RME appliance. The same activation protocol (one activation daily) was implemented in all groups. For each group, the left and right maxillary first premolars were scanned using micro-CT, and each root were divided into six regions. Resorption craters in the six regions were analyzed using special CTAn software for direct volumetric measurements. Data were statistically analyzed using Kruskal–Wallis one-way analysis of variance and Mann–Whitney U test with Bonferroni adjustment. Results The hybrid expansion appliance resulted in the lowest volume of root resorption and the smallest number of craters (p < 0.001). In terms of overall root resorption, no significant difference was found among the other groups (p > 0.05). Resorption was greater on the buccal surface than on the lingual surface in all groups except the hybrid appliance group (p < 0.05). Conclusions The findings of this study suggest that all expansion appliances cause root resorption, with resorption craters generally concentrated on the buccal surface. However, the mini-implant-supported hybrid RME appliance causes lesser root resorption than do other conventional appliances.

AIM AND OBJECTIVE To evaluate and compare the ability of three commercially available remineralizing agents on the surface microhardness (SMH) of enamel after induction of white spot lesions (WSLs) by demineralization. MATERIALS AND METHODS About 80 sound mandibular human premolars that were later removed as a part of orthodontic treatment were employed in this research under the inclusion criteria. After cleaning and disinfecting the teeth, their crowns were mounted in acrylic resin and painted with nail varnish, not including a 3 mm × 3 mm window in the middle of the buccal surface. Each tooth was soaked in 15 mL of a demineralizing solution at a pH of 4.5 that was prepared for this study and left in a place for 10 subsequent days to permit the formation of WSLs after which the SMH was again assessed. The premolar teeth were then randomly allocated and equally divided into one of the four groups of 20 each depending on the treatment they received as Group 1: control group, Group 2: Colgate sensitive Pro-Relief toothpaste group, Group 3: Amflor group, and Group 4: Enafix group. After 15 days, the microhardness of all samples was estimated and alterations in the same were noted. Scanning electron microscopy (SEM) was used to evaluate the surface morphology. RESULTS Enhanced and highest mean SMH was present in the Colgate sensitive Pro-Relief group (53.26 ± 0.10) followed by Enafix group (47.72 ± 0.21), Amflor group (44.84 ± 0.66), and control group (39.52 ± 0.32), respectively after application of remineralizing agents. Except for Group 3 vs Group 4, statistically significant differences (p < 0.05) were noted in all the groups. CONCLUSION All the three agents employed in this study, that is, Colgate sensitive Pro-Relief toothpaste, Amflor, and Enafix improved the SMH of teeth after the therapy given over 15 days compared to the microhardness following demineralization. CLINICAL SIGNIFICANCE White spot lesions often occur on labial surfaces of teeth after orthodontic treatment. Hence, these lesions pose esthetic challenges thereby affecting treatment satisfaction perceived by the patient. As esthetics and appearance are of foremost significance after orthodontic treatment, elimination protocols for remineralization of WSLs are of utmost importance employing economic means. How to cite this article: Nalawade VA, Jeri SY, Dash BP, et al. Effectiveness of Various Remineralizing Agents on White Spot Lesions after Orthodontic Treatment: A Comparative Study. J Contemp Dent Pract 2021;22(5):545-548.

Aim: Comparative evaluation of the effectiveness of 10% sodium ascorbate solution and delayed treatment on the microtensile bond strength of nanocomposite to bleached enamel using two step etch and rinse and self-etch adhesive technique. Materials and methods: Forty extracted human maxillary central incisors were decoronated, and the crown portion was embedded in acrylic resin with the buccal surface facing upwards. The specimens were randomly allocated to four groups which were further sub-divided into two groups according to the adhesion protocol. Group I- (control group): No bleaching followed by restoration. Group II: Bleaching followed by immediate restoration. Group III: Bleaching followed by surface treatment with 10 % sodium ascorbate for 30 mins followed by restoration. Group IV: Bleaching followed by restoration after 14 days. Result: Statistically significant differences were found between microtensile bond strength of bleached enamel with surface treatment with 10% sodium ascorbate solution and no surface treatment group. Conclusion: Bleaching followed by surface treatment with 10 % sodium ascorbate for 30 mins followed by restoration showed similar strength as compared the control group.

Objectives. The aim of this study was to evaluate the protective effect of using four different fluoride bioactive enamel sealers against an acidic erosion challenge. Materials and Methods. A sample of 50 freshly extracted sound upper premolars had their buccal surface bonded to 50 orthodontic brackets using Transbond PLUS color change adhesive; the first four groups had four compositions of fluoride bioactive glasses based on 37 mol% SiO2, 43.9-53.9 mol% CaO, 6.1 mol% P2O5 and CaF2, and 0-10 mol% of Na2O applied to their surfaces and the fifth group served as control (which was not treated by any bioactive sealer). All specimens were challenged by 1% citric acid for 18 minutes which was stirred by a magnetic stirrer. The enamel surfaces next to the orthodontic brackets were examined by SEM. The Wilcoxon signed-rank test was used to compare the area covered by the fluoride bioactive pastes before/after erosion ( p < 0.05 ). Samples from the layer formed on top of the examined teeth were tested before/after erosion to be examined by the attenuated total reflectance Fourier-transform infrared spectroscopy (FTIR/ATR). Results. The FTIR/ATR test showed that fluoride bioactive pastes’ applications resulted in the formation of a hydroxyapatite-rich layer; the SEM analysis showed that the aforementioned layer significantly resisted erosion challenge when compared to the control group ( p < 0.05 ). Conclusions. Fluoride bioactive pastes can efficiently protect the enamel surfaces next to orthodontic brackets from acidic erosion challenges.

It is claimed that a hydrophilic primer, called the moisture insensitive primer (MIP), can be used with both dry and wet enamel surfaces. This study sought to assess the shear bond strength (SBS) of APC Plus adhesive coated appliance system to enamel using MIP in wet and dry conditions.This in vitro experimental study evaluated 24 extracted maxillary premolars with intact buccal enamel. The teeth were randomly divided into two groups (n=12), and APC Plus premolar brackets were bonded to their buccal surface using moisture insensitive primer (MIP) under wet and dry enamel conditions. The SBS values were measured by a universal testing machine. The adhesive remnant index (ARI) score was also determined under a stereomicroscope. Data were analyzed using t-test and Mann-Whitney test at P0.05 level of significance.The SBS in wet condition was significantly lower than that in dry condition (mean value of 18.37MPa versus 25.5MPa, P0.001). The two groups had no significant difference regarding the ARI scores (P0.05). However, in both groups, less adhesive was left on the tooth surface. This suggests that bond failure occurred at the adhesive-enamel interface.APC Plus adhesive coated appliance system in combination with hydrophilic MIP can be effective in clinical conditions with high risk of moisture contamination.

Objective Buccal cells are an ideal surrogate tissue for studying biologic effects of carcinogens or drugs, however inherent fragility and salivary RNAses limit RNA yield. We conducted healthy volunteer trials to optimize collection conditions. Methods We conducted: (a) a single‐arm crossover study evaluating four test conditions on RNA yield by buccal cytobrush; (b) a single‐arm prospective study evaluating RNA yield by investigator vs self‐collection. Results Antecedent toothbrushing, time of day, and number of cytobrush strokes did not significantly impact RNA yield. RNA yield was doubled by using 2 vs 1 cytobrush per buccal surface (P = .0054). Self‐collection of buccal cells for RNA was feasible; 36 of 50 (72%) samples passed quality control. Conclusion RNA yield was doubled by using two cytobrushes per buccal surface. Healthy volunteers can self‐collect sufficient buccal RNA for gene expression studies. Techniques from these pragmatic trials could enhance availability of a limited tissue for serial biomarker measurements. Level of Evidence 1b—Prognosis Study (Individual prospective cohort study)., Buccal cells are an ideal surrogate tissue for studying biologic effects of carcinogens or drugs, however inherent fragility and salivary RNAses limit RNA yield. We conducted two clinical trials evaluating various collection conditions to optimize RNA yield. We observed that yield is doubled by using 2 cytobrushes per buccal surface and that self‐collection is both feasible and sufficient for buccal mRNA for gene expression studies.

Objectives To evaluate the volume, amount, and localization of root resorption in the upper first premolars by micro–computed tomography (micro-CT) after three different rapid maxillary expansion appliances and two different activation rhythms. Materials and Methods The patients were divided into three groups; Hyrax, acrylic cap splint (ACS), and full coverage acrylic bonded (FCAB) appliances. Each group was then divided into the following two subgroups: rapid maxillary expansion (RME) and semirapid maxillary expansion (SRME). After expansion was completed, the appliances were stabilized for 12 weeks during the retention period. For each group, 10 premolars (for a total of 60 premolars) were scanned with the micro-CT (SkyScan). The reconstructed 3D images of each root sample were divided into six regions. The resorption craters on these six different root surfaces were analyzed by special CTAn (SkyScan) software for direct volumetric measurements. Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests were used for statistical analysis. Results The total volume of root resorption was less with FCAB than with ACS and Hyrax (P < .001). In all groups, a greater volume of resorption was found on the buccal surface than on the lingual surface (P < .001). No significant differences were found between the RME and SRME groups (P > .05). Conclusions All expansion appliances caused root resorption in the upper first premolar teeth, but FCAB may be safer in terms of root resorption. The resorption craters were generally concentrated on the buccal surface. There was no effect of activation rhythm on root resorption.

Enamel demineralization and white-spot lesions (WSLs) around the orthodontic brackets are common clinical complications after orthodontic fixed appliance therapy. WSLs form mainly due to plaque deposition around the brackets during the orthodontic treatment period. This study was designed to compare and evaluate the efficacy of two different remineralization agents on WSLs, which are “Clinpro 5000 and Colgate Sensitive Pro-Relief”. 27 caries-free human premolar teeth were collected after extraction for orthodontic purposes. The crowns were set in acrylic resin, and the entire surfaces were coated with nail varnish apart from an area of 4 × 4 mm on the buccal surface. The surface microhardness (SMH) was measured using the Vickers microhardness testing machine at baseline, after demineralization, and after treatment. Then, the different SMH values were statistically analyzed using mixed-effects linear regression. All samples were immersed in demineralizing solution for ten days to create WSLs, and then the teeth were allocated randomly into one of the three groups: Group 1 (control group-immersed in artificial saliva), Group 2 (treated with Colgate sensitive Pro-Relief toothpaste), and Group 3 (Clinpro 5000 toothpaste). Cycles of treatment were done for 5 minutes every 12 hours for 14 days. The samples were stored in freshly prepared artificial saliva between cycles. The mixed-effects model was used to quantify the effect of different remineralization agents. All statistics were computed using STATA software (version14.1; Stata, College Station, TX). All statistical tests were two-tailed and interpreted at the 0.05 significance level. Both agents improved the surface hardness. Clinpro 5000 improved the surface hardness by 12.7 ( P value 0.012), and Colgate Sensitive Pro-Relief improved surface hardness by 18.2 ( P value

Background: Microleakage is a concern while restoring cervical lesions. Many products have attempted to minimize the interfacial gap between the tooth and restoration, the main pathway of microleakage. Aims and Objective: To compare and evaluate the microleakage in Class V cavity restored with nanohybrid flowable composite, Resin modified Glass Ionomer and Cention N. Method: Class V cavities were prepared on mandibular premolars on buccal surface with their occlusal margin placed in enamel and the gingival margin in dentin. The teeth were randomly assigned to three groups of 20 teeth each and restored with Flowable composite , Resin Modified GIC and Cention N. Samples were immersed in 0.5% Rhodamine dye, sectioned and microleakage measured using Confocal Laser Scanning Microscopy. Statistical analysis was done using Oneway ANOVA Bonferroni's test and Kruskal Waliis test. Results: The average depth of penetration of dye and scoring of depth were noted. On comparing dye penetration values between groups, RMGIC is compared with Flowable composite and Cention N, statistically significant result was obtained suggesting lesser dye penetration in RMGIC group (P < 0.001) where other comparison did not. Conclusion: RMGIC showed significantly less microleakage compared to the other two restorative materials used in the study and enamel margin of all restorations showed lesser microleakage than dentin margin.

Introduction: This study aimed to assess the effects of CO2 and erbium-doped yttrium aluminum garnet (Er:YAG) lasers with and without fluoride varnish on demineralization around composite restorations. Methods: This in vitro experimental study evaluated 96 extracted human premolars. After preparation and restoration of class V cavities in the buccal surface of the teeth with composite resin, they were randomly divided into 8 groups of control, CO2 laser (L1), CO2 laser-NaF (L1F), NaF-CO2 laser (FL1), Er:YAG laser (L2), Er:YAG laser-NaF (L2F), NaF-Er:YAG laser (FL2) and NaF (F). The entire surface of the teeth, except for the restored cavity in the buccal surface and 1 mm around the margin, was coated with two layers of nail varnish. The teeth then underwent pH cycling for 10 days (3 hours in demineralizing solution and 21 hours in remineralizing solution) to artificially induce demineralization. The amount of calcium and phosphorous released into the cariogenic solution was quantified using atomic absorption spectroscopy and spectrophotometry. The Vickers hardness tester was used to measure the hardness of the tooth structure adjacent to composite restoration. Data were analyzed using one-way ANOVA and Tukey’s test. Results: The four groups of L1F, FL1, FL2 and L2F showed minimum loss of calcium and phosphorous ions, and the mean hardness of FL1 and FL2 groups was higher than that of other groups. Conclusion: The CO2 and Er:YAG lasers alone have no significant effect on the resistance of tooth structure to cariogenic solution. However, they can exert a synergistic effect when used along with NaF varnish. Fluoride varnish applied prior to laser irradiation confers further resistance to the tooth structure and positively affects its hardness.

Color matching between the resin composite and the teeth is the most aimed target by the patient to evaluate the quality of the treatment. The aim was to investigate the ability of the uni-shade restorative material to match the tooth shade and the blending effect of the single shade structurally colored universal resin composite. Materials and methods disc shaped specimen (6×2 mm) were prepared from Omnichroma® single shade resin composite. Color shade was recorded for 10 freshly extracted premolars by Easyshade® according to CIE Lab system. Standardized class V cavities (4×2×1.5 mm) were prepared on the buccal surface of each tooth away 0.5mm from the CEJ. Cavities were then restored with resin composite, cured for 40s, and their color was recorded after 24 hours storage in distal water. Two tests have been done, the first was to determine the differences of the color parameters between disc and resin composite in teeth (T1). The second was to record the change in color between the sound teeth and the resin composite in teeth (T2). The color change data statistically analyzed using paired t-test. It was considered statistically significant at(a=0.05). Results All color parameters in the two tests showed significant changes except (ΔL) in T2 which showed nonsignificant differences. The specimens showed decrease in lightness and showed shifting toward the green and yellow direction, while in T2 they became lighter than the teeth and directed toward the green and blue scale. Conclusion OMNICHROMA single shade resin composite matches the shade of enamel.

Debonding of ceramic brackets can cause problems such as bracket fracture and enamel damage due to high bond strength and low fracture toughness. Laser irradiation, aiming to decrease the bond strength, may be able to enhance ceramic bracket debonding. Nonetheless, temperature rise following laser therapy can adversely affect the dental pulp. The aim of this study is to assess enamel damage and intrapulpal temperature change after debonding ceramic brackets with or without Er,Cr:YSGG irradiation. In this experimental study, 80 Fascination ceramic brackets were bonded to the buccal surface of extracted human premolars. The teeth were randomly divided into two groups of 40. In group 1 (control), polycrystalline brackets were debonded using the pliers recommended by the manufacturer. In group 2, brackets were irradiated by Er,Cr:YSGG (Waterlase iPlus, Biolase, USA, 12/2013), gold handpieces, and tip MZ8 and were operated at 50 Hz, 4.5 W, H-Mode (60 μs), 80% water, and 60% air. After laser irradiation, the brackets were debonded as in group 1. Before bracket bonding and after debonding, the buccal surface of the teeth was inspected under a stereomicroscope to assess the presence of enamel cracks. The number and length of enamel cracks before bonding and after debonding were compared using Scope Image version 9.0. A K-type thermocouple with 0.2-mm diameter was used to assess the intrapulpal temperature change following laser irradiation. Data were analyzed using SPSS version 22. No enamel fracture was noted in the control or laser group. Bracket debonding with the help of laser decreased the number and length of enamel cracks compared with the control group. Temperature rise in the laser group (2.63 ± 1.3 °C) was significantly lower than the critical threshold of 5.5 °C. The two groups showed significant differences regarding the adhesive remnant index (ARI) scores (P

Solitary fibrous tumor (SFT), an uncommon spindle cell neoplasm is believed to be of mesenchymal origin and usually presents as pleural based mass. SFT are rare in the head-neck region but are extremely uncommon intra-orally. The patient was a young male who presented with difficulty in mouth opening. Examination revealed a submucosal nodule on the buccal surface which was histologically and immunohistochemically proven to be SFT. Authors wish to discuss the case due to its rarity and diagnostic difficulties due to many common histological mimickers at that site.

Objective: This study was directed to evaluate the regenerative potential of simvastatin (SIM) on dental pulp stem cells (DPSCs) in non-vital immature dogs’ teeth both histologically and radiographically. Methods: The present study was carried out on 6 adult healthy male mongrel dogs aged from 4 to 6 months and their weight ranged from 12 to 17 kg. Three premolars (two rooted) in each quadrant were included in this study summing up the total number of teeth to 72 (12 premolars x 6 dogs). Endodontic access cavities were prepared in all experimental teeth in the buccal surface and the vital pulps of teeth were exposed till confirmation of radiolucency. Then triple antibiotic paste was used for disinfection of root canals for 3 weeks. After disinfection period, the teeth were divided into two groups: group 1; treated with dental pulp stem cells and simvastatin while group 2; was treated with dental pulp stem cells only. Both groups were evaluated histologically and radiographically after 1 week, 1 month and 3 months. Results: Better radiographic and histologic findings were found in the group treated with dental pulp stem cells with simvastatin than groups treated with dental pulp stem cells only after 1 week, 1 month and 3 months of evaluation periods. Conclusions: Under the condition of this study, simvastatin aids in regeneration of infected immature dog’s teeth with the ability of producing functional dentin-pulp complex and inclusion of a stem cells seemed to improve the outcomes of attempted regeneration.

Objective The present study aimed to evaluate the effect of MOP over a 3-month period and to determine the influence of the number of perforations on the rate of canine retraction. In addition, the amount of pain and discomfort caused by the MOP method was evaluated. Trial design A single-center, split-mouth, triple-blind, randomized, controlled trial was conducted. Methods The clinical trial was conducted from December 2018 to July 2019 in the Orthodontic Clinic, Shiraz Dental School. Twenty-eight patients (range from16.3 to 35.2 years) who need fixed orthodontic treatment were recruited and randomly assigned to MOP1 and MOP2 groups. In each patient one side of the mouth worked as a control side which received no MOPs. Four months after first premolars extraction, patients in MOP1 group received 3 MOPs on the buccal surface of alveolar bone in the experimental side to accelerate canine retraction whereas patients in MOP2 group received 3 buccal MOPs and 3 palatal MOPs in the experimental side. The amount of canine retraction was measured every 28 days at three intervals on both sides of the mouth. Pain perception was also measured on the day of MOP procedure and subsequently at 24 h. Randomization was performed using online software RANDOM.ORG; the recruited patients were divided into two parallel groups with a 1:1 allocation ratio then the side of MOPs intervention in each subject was randomly determined with coin tossing. Triple blinding design was employed. Results The result of the intra-examiner reliability using ICC was 0.97 (P P > 0.05). There was a significant difference in the rate of canine retraction between the MOP groups and the contralateral control sides, as well as between the MOP1 and MOP2 groups (P Conclusion The MOP procedure was effective in accelerating orthodontic tooth movement, although the amount of acceleration was not clinically significant in the case of canine retraction. An increase in the number of MOPs resulted in a significant acceleration of the canine retraction. Trial registration The trial was registered 30 November 2018 at the Iranian Registry of Clinical Trials (IRCT20181121041713N1).

Title: Spectrophotometric assessment of tooth discoloration induced by various Antibiotic pastes. Aim: To evaluate tooth discoloration induced by various Antibiotic pastes using spectrophotometer. Materials and Methods: Sixty extracted upper front tooth were selected for the study. Access opening was done and root canal of each tooth was instrumented with hand files. The tooth were then randomly divided into 3 groups: Group A (Triple antibiotic paste: Ciprofloxacin+ Metronidazole+Minocycline), Group B (Modified Triple antibiotic paste: Ciprofloxacin+ Metronidazole+ Clindamycin) and Group C (Double antibiotic paste: Ciprofloxacin+ Metronidazole). In all the groups, medicaments were only applied inside the root canals of the teeth and access cavity was sealed with cotton pellet and temporary restoration. Spectrophotometric readings were obtained from buccal surface of the teeth immediately after placing the medicaments (Baseline data) and at 1 week and after 2 months. Based on spectrophotometric readings at different time interval, ∆E was then calculated. Data were analyzed using 2-way (ANOVA) tests. Results: The maximum color change (ΔE) was observed at 2 months with Triple antibiotic paste (p < 0.0001) followed by Modified Triple antibiotic paste. No significant color change was noted with Double antibiotic paste. Conclusion: Antibiotic paste should be used judiciously inside the root canals of teeth to eliminate chronic root canal infection due to risk of tooth discoloration. Double antibiotic paste is a more promising option.

The purpose of this clinical study was to compare the effects of the gingival displacement techniques of retraction cord, cordless paste system, and Er,Cr:YSGG laser troughing on the periodontal tissues around the crown restoration produced using a digital scan. This was analyzed by recording the probing depth (PD), plaque index, gingival index (GI), mobility, sensitivity, and bleeding on probing (BOP) index. This study included 60 mandibular 1(st) molars from 52 participants (20 males and 32 females) requiring crown restoration. The margin lines of the crown preparations were placed 1 mm subgingivally. Based on the gingival displacement technique used, the patients were divided into three groups: retraction cord, cordless paste system, and Er,Cr:YSGG laser troughing. A digital scan of the prepared tooth was performed. Follow-up appointments were scheduled at five different times: 1(st) day, 1(st) month, 3(rd) month, 6(th) month, and 1(st) year. Six periodontal indices were used to assess the periodontal health. The chi-square test was used to compare categorical variables depending on the groups. There was a significant difference in the PD, GI, and BOP index scores among the three techniques during the 1-year clinical monitoring (p < 0.001). The PD in the three zones of the buccal surface showed a significant increase with time in the retraction cord and cordless paste system groups (p < 0.001). The highest GI scores were observed in the retraction cord group on the 1(st) day. The Er,Cr:YSGG laser troughing procedure produced lower PD, GI, and BOP index scores as compared to the retraction cord and cordless paste system procedures in the 1-year period.

Aim The study was conducted to evaluate and compare the effect of various placement techniques of composite restoration on microleakage. Materials and methods Forty extracted premolars were selected and a rectangular-shaped cavity was prepared on the buccal surface of cervical third of each tooth. Thereafter, teeth were randomly divided into four groups equally and were restored with the composite restorative material with different placement techniques, i.e., bulk placement technique, horizontal incremental technique, split incremental technique, and newly introduced Mat incremental technique. Samples were thermocycled and immersed in methylene blue dye for 24 hours. The samples were then sectioned and evaluated under a stereomicroscope for microleakage. Results Microleakage was present least in the Mat incremental group and maximum in the bulk placement group while intercomparison revealed statistically significant difference between all the groups except for split incremental and Mat incremental groups. Conclusion The recently introduced Mat incremental placement technique showed least microleakage when compared to conventional techniques. How to cite this article Somani R, Som NK, Jaidka S, et al. Comparative Evaluation of Microleakage in Various Placement Techniques of Composite Restoration: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(3):264-268.

Wearing a mouthguard reduces the risk of sports-related injuries, but a more comfortable design is required in order to increase the wearing rate. The aim of this study was to investigate a thermoforming method that decreases palatal thickness while maintaining labial and buccal thickness. Mouthguards were fabricated from an ethylene-vinyl acetate sheet (thickness: 4.0 mm) by using a vacuum forming machine. Four working models were prepared: 1) the anterior height was 25-mm and the posterior height was 20-mm (model A), 2) model A with the palate trimmed (model B), 3) heights 5 mm greater than model A (model C), and 4) model C with the palate trimmed (model D). The two forming conditions were as follows: 1) The sheet was formed when it sagged 15 mm below the level of the sheet frame at the top of the post under ordinary use (control); 2) The sheet frame at the top of the post was lowered and the sheet covered the model when it sagged by 15 mm. The rear side of the model was pushed to move the model forward 20 mm, and then the sheet was formed (MP). Differences in mouthguard thickness due to forming conditions and model forms were analyzed by two-way analysis of variance and Bonferroni’s multiple comparison tests. Difference in forming conditions was similar for all model forms; for the MP, the thickness of the incisal edge, labial surface, cusp and buccal surface were greater, and the palatal surface was thinner than the control. On the labial and buccal surface, the thickness difference due to the model form was observed only for the MP, and models A and B were thicker than models C and D. The palatal thickness tended to be thin in the models with the trimmed palate. This study suggested that the labial and buccal thickness of the mouthguard can be maintained, and the palatal thickness can be decreased by using the model with the palate trimmed with the forming method in which the model position is moved forward immediately before the vacuum formation.

Purpose The aim of this pilot study is to investigate bone regeneration in a three wall defect during immediate implant placement, using porous biphasic calcium phosphate (BCP) granules with or without recombinant human bone morphogenetic protein – 2 (rhBMP-2). Materials and Methods Alveolar defects were created in the mandible of five female, adult micropigs. The lower right 4th premolar was extracted and the buccal cortex removed. Immediate implants were placed and the defect was grafted. Control group (n = 2), received BCP granules and fibrin sealant. The test group (n = 3) received BCP granules in combination with fibrin sealant and rhBMP-2. A collagen membrane was placed over the graft and primary closure of the wound was achieved. The pigs were all euthanized at 6 months after the first surgery. Histology evaluation and histomorphometry analyses calculating % bone implant contact (%BIC) and % bone area (%BA) were performed. Results One pig in the BMP group died prematurely at 3 months after the first surgery. At specimen harvest, there were no dehiscence of all surgical sites and implant survival rate was 100%. The control group demonstrated no new bone formation at the buccal surface of the dental implants at 6 months. The mean %BIC for the BMP group at 6 months was 75.53 ± 12.52%. The mean %BA for the BMP group 6 months was 52.82 ± 3.27%. Conclusion Within the limitations of this pilot study, the use of rhBMP-2 resulted in significant new bone formation in a non-contained defect around an immediate implant.

Background: Periodontal regeneration using complementary and alternative medicine has gained considerable attention recently. Propolis is a resinous hive product collected by honey bees from exudates and buds of plants and mixed with wax and bee enzymes.Objective: The aim of this study was to evaluate the effect of propolis as bone graft substitute in the management of experimental grade II furcation defects, and to compare its effect to nanobone and to Propolis/nanobone mixture. Material and Methods: Sixteen critical-sized furcation defects on the buccal surface of mandibular third and fourth premolars were surgically created in twelve dogs and divided into three groups. Group I; defects were filled with Propolis, Group II; defects were filled with nanohydroxyapatite graft and Group III; defects were filled with a combination of Propolis/ nanohydroxyapatite graft. Histologically and histomorphometric analysis of newly formed interradicular bone height and percentage were performed after one and three months. Results: After one month; the three experimental groups revealed the features of early periodontal tissues regeneration including cementum, newly formed bone with inserted newly formed PDL fibers. The propolis group showed the highest bone height and bone surface area. After three months; denser bone occupying larger surface area of the furcation defect were noted especially in the propolis group. Conclusion: The addition of nanobone to propolis showed better results than nano bone alone especially at early healing stage. However, it didn’t show better results than the use of propolis alone.

Aim: To histopathologically evaluate the pulpal healing after direct pulp capping with TotalFill and compared it with Neo MTA Plus in human tooth cultures. Methods: Forty sound human premolars freshly extracted for orthodontic reasons were randomly assigned to two experimental groups; group I: TotalFill and group II: Neo MTA Plus. Standardized Class V cavities were prepared on the buccal surface of each tooth where the pulp exposure was performed with a dental explorer. The pulp-exposed teeth were immediately capped with one of the tested materials. The prepared cavities were then finally restored with glass-ionomer cement. Teeth were cultured for three weeks and three months. Then, the cultured teeth were demineralized, sectioned and stained for histopathological evaluation. Data collected and statistically analyzed by using Fisher's exact test. The significance level was set at P ≤ 0.05. Results: Histopathological analysis showed complete dentin bridge formation and an absence of inflammatory pulp response. Statistical analysis showed no significant differences between the TotalFill and Neo MTA Plus groups during the observation periods. However, a significantly higher thickness of the dentin bridge was found in the group of teeth treated with TotalFill at three months. Conclusions: TotalFill produced similar favorable pulp healing and repair, and were comparable to Neo MTA Plus. Furthermore, TotalFill can form a thicker dentin bridge compared with Neo MTA Plus. Keywords: Bioceramics, Direct pulp cap, Histology, Human, Neo MTA Plus, TotalFill

Aim:The aim of study to evaluate both occlusal and gingival microleakage levels ofclass V cavıties prepared by using different type cavite preparation method andby restorated with different glass ionomer cements.Material and Methods: In this study were used molar teeth (n = 90) which were planned to forextraction due to orthodontic or periodontal and which did not contain anycaries, restorations and cracks. Standard class V-cavities were prepared at thebuccal surface of each tooth to be 3 mm wide, 2 mm high and 1.5 mm deep. Teethwere divided into 3 main groups (n = 30) according to cavitation preparationmethod (Er:YAG laser, Er,Cr:YSGG laser and conventional method) and thesegroups were divided into 3 subgroups (n = 10) according to the restorativematerial. Samples were examined in stereomicroscopy at X16 magnification andSEM. Datas were analyzed using with statistically evaluated by Kruskal-Wallisand Wilcoxon tests at 5% significiant level.Results: In both SEM and microscopy groups, the gingival margin showed moreleakage than the occlusal margin. There was a statistically significantdifference (p, Amaç: Bu çalışmanın amacı; farklı kavite preparasyon tekniği kullanılarakprepare edilen sınıf V kavitelerin, cam iyonomer materyali ile restorasyonusonrası okluzal ve gingival bölge de oluşan mikrosızıntı seviyelerinibelirlemektir.Gereç ve Yöntemler: Bu çalışmada; ortodontik veya periodontal sebeplerle çekilmiş ve herhangibir çürük, restorasyon ya da yapısal bir bozulma olmayanlar molar dişler (n:90)kullanılmıştır. Her bir dişin bukkal yüzeyinde standart sınıf V kaviteler 3 mmgenişliğinde, 2 mm yüksekliğinde ve 1,5 mm derinliğinde olacak şekilde açılmıştır.Kavite preparasyon tekniğine (Er:YAG lazer, Er,Cr:YSGG lazer ve konvansiyonelyöntem) göre 3 ana gruba (n:30) ayrılan dişler, kendi aralarında da 3 farklıticari markalı konvansiyonel cam iyonomer siman ile restore edilerek 3 altgruba (n:10) ayrılmıştır. Örnekler stereomikroskopta X16 büyütmede ve SEM deincelenmiştir. Veriler Kruskal-Wallis ve Wilcoxon testleri ile istatikselolarak 0.05 anlamlılık düzeyinde değerlendirilmiştir.Bulgular: Hem SEM hem de mikroskop ile incelenen tüm gruplarda gingival kenar,okluzal kenara göre daha fazla sızıntı göstermiştir. Kavite preparasyonyöntemleri arasında hem SEM hem de mikroskop incelemelerinde istatistikselolarak anlamlı fark (p

Background Tooth mobility assessment is subjective and current techniques require the translation of a continuous variable to a categorical variable based on the perception of the examiner. The aim of this study was to evaluate the reliability of a novel technique to assess tooth mobility. Methods Three experienced periodontists were asked to push tooth #16 into a buccal position to in a typodont model with different mobility (M1-M2). Tooth position was obtained using an intraoral scanner and files were compared in metrology software. Mobility was calculated at three reference points at the cervical (C), middle (M), and occlusal (O) regions of the buccal surface of the tooth to determine the linear deviation in the three axes (x, y, and z). Reliability was determined by intraclass-correlation coefficient, differences between M1 and M2 determined by t test, and the analysis of variance (ANOVA) was used to compare the data at the C-M-O regions. Results Excellent reliability was assessed by Cronbach alpha >0.9 on the x-y-z axes for both mobility tested, except for M1-C X (0.85), M1-M Y (0.89), and M2-M Z (0.89). The correlation between the examiners demonstrated excellent (˃0.90) or good (0.75˃ x ˂0.90) consistency, except for M1-C Y (0.73; examiner 1 to 2) and M1-M X (0.69; examiners 1 to 3). Significant changes were detected in all axes at the three reference points comparing M1 and M2, and a similar proportional change was observed between O-M-C reference points for M1 and M2. Conclusion A novel technique to assess tooth mobility based on intraoral scanner measurements provided reliable data in an in vitro experiment.

INTRODUCTION: Fluoride-releasing restorative materials can be used as a reservoir releasing small amounts of fluoride to the teeth over a long time.Giomer represents a new class of dental materials that uses the pre reacted glass technology (PRG) with excellent mechanical and esthetic properties. OBJECTIVES: The aim of this study is to evaluate the fluoride release ability of Giomer (Beautifil II) compared to Compomer (Dyract XP) and their fluoride recharge ability after exposure to topical fluoride varnish. MATERIALS AND METHODS: The sample consisted of 80 freshly extracted primary anterior teeth. Standardized buccal class V cavities were prepared. Sample was randomly divided into 2 groups: Group I: included 40 teeth restored with Beautiful II. Group II: included 40 teeth restored with Dyract XP following the manufacturer’s guidelines. Fluoride release was evaluated in the artificial saliva on 1st, 7th, 14th and 21st days. After 21days of release, 5%NaF varnish was applied on buccal surface of all specimens. The amount of fluoride release after recharge was measured in the artificial saliva after 1st, 7th, 14th and 21st days using fluorine ion- specific electrode. Data were analyzed using Friedman’s two-way analysis of variance by ranks, Dunn-Sidak method, Mann-Whitney U test and Wilcoxon Signed Ranks to achieve the aim of the study. RESULTS: Beautiful II released significantly higher amount of fluoride compared to Dyract XP in first 7 days at p0.0125. CONCLUSIONS: Fluoride release (ppm) was found to be significantly higher in Beautiful II than Dyract XP in the first week. Giomer could be considered a suitable class V restoration of primary teeth in high caries risk children.

Background The cold test is a specific test of pulp sensitivity and is part of the endodontic diagnosis. The aim of this study was to identify the diagnostic accuracy including sensitivity, specificity, accuracy, positive predictive value and negative predictive value in three sites for the cold test in teeth with a need for endodontic treatment within different age groups from both genders. Methods A cross-sectional study was performed, evaluating 425 subjects. Two hundred and fifty-eight subjects from both genders from the ages of 17–27, 28–39, 40–50, and 51–65 years-old participated in the study. The cold test studied was 1, 1, 1, 2-tetrafluoroethane, and the gold standard was established through direct pulp inspection. The sites evaluated in the study were: The sites evaluated in the study were: a) the middle third of the buccal surface; b) the cervical third of the buccal surface, and c) the middle third of the lingual surface. Results The highest diagnosted accuracy was observed on the middle third buccal surface with an accuracy of = 0.97, a sensitivity of = 1.00, a specificity of 0.95, a predictive value of = 0.95 and a negative predictive value of = 1.00. This was in the female group aged from 40 to 50 years old. Conclusion The tables of this study can be used as an auxiliary for pulp sensitivity tests.

Introduction: This double-blind, placebo-controlled, clinical trial aimed to investigate the analgesic efficacy of low-level laser therapy (LLLT) with two different locations, and their comparison, in postoperative endodontic pain (PEP) levels in molars diagnosed with symptomatic irreversible pulpitis. Methods: Seventy-five patients with a molar tooth, diagnosed with symptomatic irreversible pulpitis, were divided into three groups of placebo, buccal only irradiation (BI), and buccal and lingual irradiation (BLI), with 25 cases being in each group. The participants received similar singlevisit nonsurgical endodontic treatments. Then, a sham laser was used in the control group instead of LLLT. Individuals in BI and BLI groups received 80-second irradiation on the buccal surface and 80-second irradiation on each of the buccal and lingual surfaces respectively. A laser with an 808 nm wavelength, power of 100 mW, a fiber diameter of 600 μm, and a dose of 70 J/cm2 was used. PEP was assessed using a 0-100 mm VAS 4, 8, 24, and 48 hours after the treatment. Results: BLI showed a significantly higher reduction of PEP compared to placebo in all time intervals of this study. BLI was significantly more effective than BI 8 hours after the treatment. However, intragroup differences between BLI and BI groups at other time intervals and between BI and placebo groups in all time intervals were not significant. The number of taken analgesics in the BLI group was significantly lower than the placebo group and was on a statistical borderline compared to the BI group. Conclusion: LLLT with BLI was an effective measure as a supplement to oral analgesics in the reduction of PEP compared to the placebo.

BACKGROUND/AIM Using mouthguards can reduce the risk of injury when playing sports, but the sheet material and thickness have a large effect on their efficacy and safety. The aim of this study was to investigate the effect of moving the model position just before formation in the pressure forming technique to maintain the thickness of a single-layer mouthguard. MATERIALS AND METHODS A 4.0-mm-thick ethylene vinyl acetate (EVA) mouthguard sheet (diameter: 125 mm) and a pressure forming machine were used. The working model was placed with its anterior rim positioned 40 mm from the front of the forming table. The sheets were placed in the forming table with the sheet extrusion direction either vertical (V) or parallel (P) to the model's centerline. Two molding methods were compared: (a) The sheet was formed when it sagged 15 mm (control) and (b) the sheet was covered on the model when it sagged 15 mm, next the model was pushed forward 20 mm, and the sheet was then formed (MP). Mouthguard thickness was measured for the labial surface, palatal surface, cusp, and buccal surface using a specialized caliper. Thickness differences according to molding methods and sheet extrusion directions were analyzed by two-way ANOVA. RESULTS The thicknesses of the labial surface, cusp, and buccal surface were significantly larger in MP than in the control (P

Background Orthodontic bonding and debonding procedures involve risk of damaging the enamel surface and changing its original morphology. The rough surface inhibits proper cleaning, invites plaque deposition, bacterial retention, and stain formation thus dampening the esthetic appearance of the teeth. Restoring the enamel to its original morphology is a challenge. Researches on better adhesive removal methods which can effectively remove the residual resin and restore it best to its original form are continuing till date. No study has compared four contemporary finishing systems for their efficiency on a single platform. Aim The objective of this study is to evaluate and compare enamel surface roughness after debonding using four different finishing and polishing systems. Material and methods Adhesive resin was removed from the buccal surface of 88 premolars after debonding with 4 groups. It included 22 teeth per group: group 1—One gloss system; group 2—Enhance finishing and polishing system; group 3—fiber reinforced stainbuster bur; and group 4—Soflex discs with wheels. Roughness was measured quantitatively and qualitatively with the help of surface roughness tester and scanning electron Microscope (SEM) respectively. Results No significant difference was found in baseline roughness in four groups. Highest post-polishing roughness was observed in Soflex group (4.62 μm) followed by One gloss system (3.36 μm), Enhance system (3.17 μm), and stainbuster bur (1.99 μm) (p value

Objectives: To study influence of different designs of zirconia substructures on color and fracture resistance in bilayered zirconia CAD CAM restorations.Materials and Methods: Fifty identical PMMA dies were 3D printed using stereolithography, to mimic a prepared maxillary first molar with chamfer finish line of 1 mm, axial reduction of 1.5 mm and occlusal preparation of 2 mm. CAD CAM (Wieland dental) was used to digitally scan the fifty dies in order to fabricate 50 zirconia copings. They were assigned to 5 groups according to coping design (n=10): Gp FV (control): full-veneer coping covering to finish line, Gp CS: 1mm cervical-shoulder, GP BW: monolithic zirconia with window cut-back on the buccal surface, GP 3W: monolithic zirconia with window cut-back on buccal, lingual and mesial surfaces and Gp MM: circular projections of 1 mm on palatal cusps and mid-palatal surface. All copings were then veneered, air-abraded using 50μm- Al2O3, primed and cemented to their matching dies using resin cement (Rely X U200, 3M-ESPE). Specimens were tagged and thermo-cycled for 10000 cycles. Spectrophotometer (Easy Shade V, VITA Zahnfabrik) was used to digitally analyze the color for all groups. Delta E was calculated in-comparison to the control group. Compressive load was applied to all specimens in the central fossa, parallel to long axis of each die at a crosshead speed of 0.5 mm/min till failure. Level of significance between groups was calculated using One Way ANOVA (P

Evaluate the influence of enamel pre-treatment using Biosilicate, associated or not to other treatments; on the bond strength (BS) of pit-and-fissure sealant, with or without saliva contamination.Ninety slices (4 mm × 4 mm) were obtained from 30 bovine incisors. Each slice was embedded in acrylic resin with their buccal surface exposed and polished to obtain a flat enamel surface. Half of them were contaminated with human saliva. All specimens were randomly divided into five groups (n = 9) according to the surface pre-treatment tested: acid etching (AE); AE + Biosilicate (B); AE + B + total-etch adhesive (Ad); Biosilicate; control (no treatment). Then, a 1 mm layer of sealant (Clinpro XT Varnish, 3M ESPE) was applied; and to provide support, a composite resin (Opallis, FGM) block was built up over it. Samples were thermocycled (500 cycles/5-55 °C) and sectioned obtaining sticks (1 × 1 × 10 mm) for microtensile BS testing (0.5 mm/min). Data were analysed with two-way ANOVA, Bonferroni test, p 0.05. Failure patterns were evaluated using a stereomicroscope.There was no difference among contaminated and non-contaminated groups, and between non-contaminated groups (p 0.05). When contaminated, AE + B + Ad Group showed the highest BS values, differing (p 0.05) from B Group and Control; similar between them (p 0.05). Cohesive fractures were found in AE + B + Ad Group, submitted or not to contamination.Since a surface pre-treatment was used, whether Biosilicate was applied or not, the sealant/enamel BS was the same in saliva-contaminated or non-contaminated enamel.

OBJECTIVE(S) To evaluate the potential of spectral domain optical coherence tomography (SD-OCT) as a tool for detecting subgingival cervical lesions and to characterize 2 different types of cervical lesions—noncarious cervical lesion (NCCL) and root caries lesion (RC)—based on tissue properties using signal intensity (SI). STUDY DESIGN A total of 30 human extracted teeth were collected: teeth with no cervical lesion (n = 10), RC (n = 10), and NCCL (n = 10). Micro-CT imaging was performed as the gold standard to confirm the status of the teeth in each group. In order to examine the efficacy of SD-OCT in the detection of subgingival lesions, a thin layer (0.5 mm) of dental baseplate wax was used as simulated gingival tissue to cover the cervical region, where NCCL or RC is present. Teeth were then mounted on custom-made cylindrical blocks made of vinyl polysiloxane with the buccal surface facing toward the SD-OCT probe. The probe was set at a fixed distance from the specimen with the scanning beam oriented perpendicular to the root surfaces. Cross-sectional images were obtained along the long axis of the teeth. SI of the root surfaces was used to quantitatively characterize the root surface changes among the 3 study groups. Morphologic profiles of the root surface in RC and NCCL were also examined. RESULTS The pilot study showed that the presence of the simulated gingiva reduced the clarity of the cross-sectional images only marginally; SI profiles of the root surfaces in all 3 groups did not change significantly in the presence of simulated gingiva compared with no gingiva. In addition, SI and morphologic profiles of the root surfaces among the 3 groups were statistically different. DISCUSSION/CONCLUSIONS The result suggests that SD-OCT can be used to detect subgingival RC and further distinguish between RC and NCCL based on SI and morphologic profiles.

Background and objectives Differences in dental maturation may affect the prognosis and clinical management of traumatized teeth. However, evaluation of the outcomes of dental trauma to the tooth and support structures in an in vivo model involves major methodological and ethical implications. Thus, the aim of the present study was to perform a three-dimensional finite element analysis of permanent maxillary central incisors in different stages of root development under different trauma settings. Methods The study factors included two trauma conditions (B, buccal; I, incisal) on upper permanent central incisors showing three different stages of root development (CR, complete rhizogenesis; IRA; incomplete rhizogenesis in the apical third of the root; and IRM, incomplete rhizogenesis in the middle third of the root) to yield six models. The complete rhizogenesis model was obtained with a cone-beam computed tomography examination of an extracted tooth. The two incomplete rhizogenesis models were modeled on the basis of similar examinations of patients. Trauma was simulated by applying a 300 N static surface to surface load on the incisal edge or perpendicular to the buccal surface of the tooth. The displacement and equivalent von Mises (σvM) stress values were obtained for alveolar bone, periodontal ligament, apical papilla, and dentin for the quantitative analysis. A σvM color-coded scale was used for qualitative analysis. Results The force direction had a greater influence on the stress than the root-formation stage. Buccal forces resulted in higher stress concentration in the bone and periodontal ligament, especially in B-CR. Lower stress was found on the periodontal ligament as the root formation progressed (decrease of 8% from B-IRA to B-CR and 11% from B-IRM to B-CR). The incomplete rhizogenesis models showed higher σvM stress peak values in dentin in comparison with complete rhizogenesis (increase of 52% from B-CR to B-IRA and 56% from B-CR to B-IRM). Conclusions Buccal forces yielded greater stress values regardless of the stage of rhizogenesis. Teeth with fully formed roots showed a higher stress concentration in the alveolar bone and periodontal ligament in comparison with immature teeth, with the latter presenting high stresses in the tooth crown.

Introduction: Er: YAG laser is contemplated as a preventive dental caries strategy when combined with topical fluoride varnish. Information regarding their combined effect on the enamel of primary teeth is still not established. Objectives: The present study aimed to evaluate the effect of combined treatment by Er: YAG laser irradiation prior to topical fluoride varnish application on the acid resistance of enamel in primary teeth compared to fluoride varnish by elemental analysis. Materials and Methods: Twenty caries-free exfoliated human primary molars were painted with nail varnish, leaving one window 4 x 4 mm on the buccal surface. The samples were assigned to 2 groups (10 each), according to the surface treatment: (G I) 5% sodium fluoride varnish (Enamel Pro® Varnish) only and (G II) Er: YAG laser irradiation followed by sodium fluoride varnish. The baseline value for each specimen was recorded before the test procedure. The enamel specimens underwent pH changes over 14 days. EDX was used to assess the mineral content of the specimens after pH challenge. Results: A significant increase occurred in the mean values of the Ca at%, P at%, and Ca/P ratio in the enamel in both groups compared to the baseline values (p≤0.001). No significant difference was found in the mean percent change (p ≥ 0.05) of the mineral content between the study groups. Conclusions: The combined treatment by laser and fluoride is as efficient as fluoride varnish alone for increasing the acid resistance of enamel in primary teeth.

Aim The longevity of restorative materials depends on the resistance to masticatory forces. The present study was undertaken to evaluate the mechanical and microleakage properties of Cention-N with glass ionomer cement (GIC) and composite restorative materials. Materials and methods A total of 45 specimen blocks were prepared with 15 samples of each type of restorative material, namely Cention-N, GIC, and hybrid composite. Samples were subjected to load at crosshead speed of 0.75 ± 0.25 mm/min till the fracture of sample. Class V cavities were prepared on the buccal surface of orthodontically extracted premolars followed by restoration of each test material. All the surfaces of the tooth were coated with clear nail varnish except 1 mm around the margins of the restorations. These samples were immersed in 0.5% basic fuchsine dye and longitudinally sectioned and observed under stereomicroscope to check microleakage. The obtained data were statistically evaluated. Results We found the highest mean compressive and flexural strength for hybrid composite followed by Cention-N and least for GIC which is statistically significant (p Conclusion Mean microleakage was least for Cention-N. Cention-N is a newer restorative material having higher mechanical properties with lesser microleakage. Clinical significance Cention-N is a newer restorative material having promising properties. This material can be used as an alternative restorative material.

“AIM: To assess the effect of three lining materials; flowable composite, flowable compomer, and light-curing glass ionomer cement (LCGIC) on microleakage in Class V restoration using packable composite restorations. MATERIALS AND METHODS: A standardized class V cavity was prepared on buccal surface of 40 young premolar teeth with the cervical margin extending 0.5 mm below the cementoenamel junction, into the dentin. All the samples were randomly divided into 4 groups according to the lining material used: Group I- Control; Group II- flowable composite; Group III- LCGIC and Group IV- flowable compomer. The restored teeth were thermocycled and immersed in 2% methylene blue solution for 24 hours. Each tooth was then sectioned along buccolingual direction. The dye penetration of the occlusal and gingival margins of each section was evaluated by a single observer using a stereomicroscope and statistically analyzed using Kruskal Walis Test and Mann-Whitney U Test. RESULT: Maximum dye penetration score for Group 1, Group 2 was 3 and Group 3, Group 4 was 1. (p

This study examined the effectiveness of resin infiltration in inhibiting microleakage from artificial white-spot lesions (AWL) in enamel. Fifty sound extracted premolars were selected and randomly divided into five groups (n = 10 each). Group 1 included sound teeth. In contrast, an AWL was created in all specimens in groups 2 to 5, as follows-Group 2: AWL with no treatment; Group 3: AWL treated with resin infiltration; Group 4: AWL treated with resin infiltration and 5,000 cycles of thermocycling; Group 5: AWL treated with resin infiltration and 10,000 cycles of thermocycling. All specimens were then coated with nail varnish, except for a 4 × 4 mm2 area on the buccal surface (the measurement area), immersed in 2% methylene blue solution, and sectioned buccolingually. Microleakage was evaluated with a stereomicroscope. Data were analyzed by using the Kruskal-Wallis test and Bonferroni post-hoc correction. Application of resin infiltrant reduced microleakage in AWL. No microleakage was seen in Group 3, and differences between Groups 3, 4, and 5 were not significant (P > 0.05). The resin infiltration technique appears to aid in sealing enamel AWL and may help provide long-term protection against microleakage in enamel AWL.

Background It has been demonstrated in non-oral tissues that the locally evoked vasoconstriction could elicit remote vasoconstriction. This study aimed to investigate the spreading vasoconstrictor effects of epinephrine in the gingiva. Methods Gingival blood flow (GBF) was measured by laser speckle contrast imager in 21 healthy volunteers. In group A, two wells were fabricated from orthodontic elastic ligature and placed 2 mm apically to the free gingival margin at the mid buccal line of 12 (test side) and 21 (control side) teeth. The GBF was measured in the wells and tightly apical, coronal, distal and mesial to the wells. In group B, the wells were made on the buccal surface of the same teeth, including the gingival sulcus. Four regions were selected for measurement from the gingival margin reaching the mucogingival line (coronal, midway1, midway2 and apical). After the baseline recording, 3 µg epinephrine was applied into the test, and physiological saline into the control well. The GBF was recorded for 14 min. The gingival thickness was measured with a PIROP Ultrasonic Biometer. Results In group A, the GBF did not increase or decrease after the application of epinephrine. In group B, the GBF significantly decreased in all regions of the test side and remained low for the observation period. The vasoconstriction appeared with delays in more apical regions (at min 1 in the coronal and the midway1, at min 2 in the midway2, at min 4 in the apical region). Similarly, the amount of the decrease at 14 min was the largest close to sulcus (− 53 ± 2.9%), followed by the midway1 (− 51 ± 2.8%) and midway2 (− 42 ± 4.2%) and was the lowest in the apical region (− 32 ± 5.8%). No correlation was found between GBF and gingival thickness. Conclusion Epinephrine could evoke intense vasoconstriction propagating to the mucogingival junction, indicating the presence of spreading vasoconstriction in the human gingiva. The attached gingiva is impermeable to epinephrine, unlike the gingival sulcus. This trial was registered in ClinicalTrials.gov titled as Evidence of Spreading Vasoconstriction in Human Gingiva with the reference number of NCT04131283 on 16 October 2019. https://clinicaltrials.gov/show/NCT04131283

Aim: To determine the prevalence of erosion of schoolchildren, and to reveal the relationship between the dental caries, gingival health statuses, dental plaque levels and dental erosion. Materials and methods: A cross-sectional analysis was performed on a representative sample of 473 children (aged 7─14 years). The O’Sullivan, Decayed-Missing-Filled (DMF), Plaque, and Gingival indices were used during the examination of the children. The values were evaluated using chi-square test, Tukey’s test, and multivariate logistic regression analysis. Results: Dental erosion was observed in 21.8% of the children. Lesions were mostly observed in the enamel but less than a half of the buccal surface was affected. Erosion was found to be statistically higher in older children (p=0.001). There was no statistically significant relationship between the children’s sexes and erosion (p=0.157). A higher level of erosion was observed in children with high DMFT and DMFS values and low dft and dfs values (p

Objective: The present study assessed the fracture strength of teeth subjected to endodontic access cavity preparation on buccal surfaces, or with the aid of operating microscopy when compared to the conventional technique. Material and methods: Sixty mandibular incisors were split into four groups (n=15): conventional access cavity preparation (CCP); conservative (C); buccal surface (BS); and control. The canals were prepared and filled and the cavities were restored. A static compressive strength test was conducted until crown fracture. The force data were compiled and assessed statistically. Kolmogorov-Smirnov and Shapiro-Wilk tests were performed to assess normality, Levene’s test to assess variance homogeneity, the one-way ANOVA to compare fracture strength in the assessed groups. Tukey’s HSD test was used to determine whether the differences in the means were significant between the groups.Results: The experimental groups did not show any statistically significant differences in mean fracture strength (CCP = 585.65 N±107.64 N)(BS = 530.52 N±129.35 N) (C = 517.83 N±114.68 N). Conclusion: Therefore, the selection of surface or size of access cavity proposed did not influence the fracture strength of mandibular incisors when compared to conventional cavity preparation. KeywordsDental pulp cavity; Dental stress analysis; Root canal therapy.

This study was carried out to evaluate the effect of acid etching versus laser etching of dentin surface on the bonding of Composite and Compomer restorative materials to dentin surface by studying microleakage at the dentin-filling interface, compositional analysis of dentin surface, and Scanning Electron Microscopic (SEM) study of the bonding area. 120 freshly extracted premolar teeth were divided according to surface treatment into three groups. Group I (Acid etching group) contained thirty teeth. Twenty teeth were selected to assess microleakage by forming standardized class V cavity on the buccal surface of the selected teeth. Then, teeth were subdivided into two subgroups with 10 teeth in each. Subgroup (i) delivered composite filling while subgroup (ii) delivered compomer filling according to manufacturer instructions. microleakage at the dentin-filling interface of teeth was examined using dye penetration method. dye penetration scores at occlusal and gingival margins were recorded and tabulated. Five dentin surfaces of five teeth from group I were etched by acid then prepared for compositional analysis of dentin surface by Infra-Red (IR) Spectroscopy. Another Five dentin surfaces were etched by acid then prepared for (SEM) assessment. Group II (Laser etching group) contained ninety teeth, twenty teeth were used for assessing microleakage after laser etching taking similar steps to that of acid etching. Thirty dentin surfaces of thirty teeth were etched by laser with different parameters then prepared for compositional analysis of dentin surface by IR Spectroscopy. Thirty dentin surfaces of thirty teeth were etched by laser with different parameters then prepared for SEM assessment. Group III (Untreated group) contained ten teeth that were left untreated. Five dentin surfaces of five teeth were subjected to IR Spectroscopy assessment. Five dentin surfaces of five teeth were prepared for SEM assessment. The results revealed that acid etching of dentin surface resulted in significant less leakage compared to laser etching. IR Spectroscopy revealed changes in dentin surface structure indicating that there was a reaction occurred by the acid and laser etching. SEM assessment showed more openings of dentinal tubules in case of acid etching, while in case of laser etching, there were a surface structural changes with a melting and fusion dentin surface. Acid etching of dentin gives better results on the bonding of Composite and Compomer filling materials than laser etching and thus gives more successful clinical condition. Further investigations are needed by using different types of laser to get more benefit from applications of laser clinically.