Microtensile Bond Strength of Self-Etch Adhesives on Dentin Treated with Chlorhexidine

AIM

To evaluate the microtensile bond strength of self-etching adhesive systems in dentin treated with 2% chlorhexidine digluconate (CHX).

MATERIALS AND METHODS

The occlusal surfaces of 20 human molars were removed and divided into eight groups: 1A, Clearfil SE adhesive (SE) with self-etching technique (TS); 1B, SE with TS and previous application of CHX; 2A, Scotchbond Universal (SBU) adhesive with TS; 2B, SBU adhesive with TS and previous application of CHX; 1C, SE with total-etching technique (TT); 1D, SE with TT and previous application of CHX; 2C, SBU with TT; 2D SBU with TT and previous application of CHX. Composite resin (5mm) was applied on the hybridized surface. Samples were subjected to microtensile test and evaluated on Scanning Electron Microscope (SEM) and with energy-dispersive X-ray (EDX).

RESULTS

Low values of bond strength were observed in groups 1A (39,77±11,56) and 2A (40,84±12,49) comparing with 1B (22,86±5,18) and 2B (27,02±5,58). TS group presented adhesive type remover fracture while TT groups presented cohesive at the top of hybrid layer. EDX revealed the presence of CHX crystals for TS, which was not found in the TT.

CONCLUSION

The previous application of chlorhexidine on dentin decreased the bond strength of adhesive systems on self-etching technique.

New adhesive protocol improves shear bond strength of Polyetherketoneketone (PEKK)

OBJECTIVE

Inert surface of Polyetherketoneketone (PEKK) jeopardizes resin bonding. This study aimed to present a new adhesive protocol to improve PEKK bonding.

METHODS

A total of 360 PEKK blocks were milled, polished (maximum roughness of 0.20 µm), and randomly assigned to groups. The new protocol was applied (n = 36) and compared to conventional treatments (no treatment; sandblasting (110-µm Al2O3 and silica); no adhesive; Visiolink (Bredent); and PEKKbond (AnaxDent)) (n = 36). For the new protocol, the surface was blasted (110 µm Al2O3 and 96% isopropyl alcohol at 60 psi), followed by 96% isopropyl alcohol washing, and air drying. PEKKbond was applied (dried for 3 min at 77 °C), followed by Visiolink (dried for 3 min at 60 °C); both light-cured for 3 min (800 mW/cm2). Preopaque (GC Europe) and Opaque (AnaxDent) were applied and light-cured (5 min). Morphological topography was analyzed, and flowable gingiva-colored composite (AnaxGum, AnaxDent) was bonded. All specimens were aged for 24 h and thermocycled (5000 cycles, 5-55 °C). Shear bond strength (SBS) was measured (MPa) and data were analyzed by two-way ANOVA, Tukey, and Weibull moduli estimation (α = 0.05).

RESULTS

The highest SBS values were found in the new protocol (p < 0.05), regardless of aging. Thermocycling reduced SBS (p < 0.05), while Al2O3 and PEKKbond produced higher SBS values than silica and Visiolink, respectively (p < 0.05).

SIGNIFICANCE

The new protocol strongly improves PEKK adhesiveness, and this can reflect in the longevity of prostheses.

Physical analysis of an acrylic resin modified by metal and ceramic nanoparticles

BACKGROUND

Nanoparticles (NPs) have gained significant attention in various fields due to their unique properties and potential applications. Polymethyl methacrylate (PMMA) is an acrylic resin widely used in dentistry and medicine. However, the effect of different types of NP fillers on the physical properties of PMMA-based resins has not been thoroughly explored in the literature.

OBJECTIVES

The present study aimed to evaluate the effects of 3 different types of NP fillers on the physical properties of an experimental PMMA-based resin as a function of the NP content and concentration.

MATERIAL AND METHODS

Ten groups (n = 10) were designed. The specimens were composed of an acrylic resin, silicon dioxide (SiO2), cerium dioxide (CeO2), and titanium dioxide (TiO2) at the following ratios (wt%): group 1 (G1) - control; group 2 (G2) - 0.5% SiO2; group 3 (G3) - 1% SiO2; group 4 (G4) - 3% SiO2; group 5 (G5) - 0.5% CeO2; group 6 (G6) - 1% CeO2; group 7 (G7) - 3% CeO2; group 8 (G8) - 0.5% TiO2; group 9 (G9) - 1% TiO2; and group 10 (G10) - 3% TiO2. Transmission electron microscopy (TEM) was used to assess the quality of NP dispersion. Thermal stability was assessed with thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The effects of the abovementioned NPs on the properties of the resin were evaluated using the Archimedes principle for density, the Vickers hardness (VH) test and the impact strength (IS) test. Data analysis employed the oneand two-way analysis of variance (ANOVA), followed by Duncan's post hoc test at a significance level of 0.05.

RESULTS

Transmission electron microscopy showed partial NP dispersion. All types of NPs enhanced the mechanical properties of the acrylic resin except for IS, which was similar to that of the control group. Among the types of NPs, irrespective of the weight percentage, CeO2 showed higher thermal stability and higher IS for 0.5 wt% and 1 wt% as compared to other groups, as well as the highest values of density at 0.5 wt%, 1 wt% and 3 wt%. Titanium oxide at 1 wt% presented a higher VH as compared to other groups. The fracture pattern was the same for all groups.

CONCLUSIONS

Incorporating the tested NPs into the acrylic resin resulted in enhanced physical properties, primarily attributed to a lower NP content.

Bond Strength and Surface Roughness of Two Ceramics After Metal Bracket Debonding

Objective

The aims of this study were to compare the bond strength between metallic brackets and two different glass ceramics and to evaluate the ceramic surface roughness after different finishing protocols.

Methods

The surface roughness of lithium disilicate and resin matrix ceramic samples was measured (initial). All samples were treated with hydrofluoric acid and silane and bonded to metallic brackets with orthodontic cement adhesive. Shear bond strength tests were performed using a universal testing machine (n=12). The surface roughness was measured again (intermediate, n=6) after removing the remaining cement adhesive from the ceramic surfaces with a diamond or 24-blade bur after polishing the ceramic surfaces (final, n=6).

Results

The resin matrix ceramic had the highest bond strength. The rotatory instrument used for the removal of cement adhesive did not affect the surface roughness of the resin matrix ceramic or lithium disilicate (p=0.985 and p=0.504, respectively), but did affect the evaluation time (p<0.001) for both restorative materials. The intermediate roughness was the highest. For the resin matrix ceramic, polishing promoted a final surface roughness similar to the initial condition; however, changes in the surface shape of this ceramic could be visibly observed when using a 24-blade bur.

Conclusion

The bond strength of metallic brackets bonded on resin-matrix ceramics is higher than bonding on lithium disilicate. The use of diamond burs for the removal of the remaining adhesive from the resin matrix ceramics is highly recommended.

Post-fatigue fracture load, stress concentration and mechanical properties of feldspathic, leucite- and lithium disilicate-reinforced glass ceramics

Objective

To evaluate the mechanical properties of different CAD/CAM ceramic systems and the post-fatigue fracture and stress distribution when used as cemented crowns.

Materials and methods

Sixty (60) CAD/CAM monolithic crowns were milled using three different ceramic materials (FD - Feldspathic [Vita Mark II]), LE - Leucite-based ceramic [IPS Empress CAD] and LD - Lithium Disilicate [IPS e.max CAD]) and adhesively cemented on resin composite dyes. Specimens were stored in distillated water (37 °C) for 7 days. After, half of the crowns were submitted to immediate fracture load test while the other half was submitted to fatigue cycling. The average cement layer of approximately 80 μm was assessed using scanning electron microscopy (SEM). The average thickness was used in the three-dimensional (3D) Finite Element Analysis (FEA). For each ceramic material, the density, Poisson ratio, shear modulus, Young modulus, fracture toughness, and true hardness were assessed (n = 3). The data was used to assess the Maximum Principal Stress throughout 3D-FEA according to each material during load to fail and post-fatigue. Data were submitted to two-way ANOVA and Tukey test (α = 0.05).

Results

LD showed the highest compression load, density, shear modulus, Young modulus, fracture toughness and true hardness values. While LE presented the lowest mechanical properties values. There is no difference in the Poisson ratio between the evaluated ceramics.

Conclusion

LD was susceptible to aging process but presented stronger physicomechanical properties, showing the highest post-fatigue fracture load and highest stress magnitude.

Evaluation of the Antimicrobial Effect on Enterococcus Faecalis of Bioceramic Cements with and without Silver Nanoparticles

OBJECTIVE

To compare the antimicrobial effect of bioceramic endodontic cements with and without silver nanoparticles on Enterococcus faecalis.

MATERIALS AND METHODS

Six groups were evaluated (n=8), and divided according to the materials: MTA Flow + AgNP ; MTA Flow Group; Bio C Repair + AgNP; Bio C Repair; PBS Cimmo + AgNP; PBS Cimmo. The groups were maintained for 72 h in the suspension of Enterococcus faecalis in Simulated Body Fluid (SBF). Samples of 100 μL were removed from the suspension at 0, 24, 48 and 72 h and seeded in triplicate in a Petri dish. Colony forming units (CFU) were counted using a colony counter. All procedures described were performed in a laminar flow chamber. Two-way ANOVA followed by Tukey's post hoc test and paired t-test were used for statistical analyses (α = 0.05).

RESULTS

The addition of silver nanoparticles resulted in a statistically significant difference for MTA and CIMMO PBS cements (p⟨0.05), with the lowest bacterial growth being shown by the MTA group. For all groups, only the times of 48 and 72 h presented results without differences.

CONCLUSION

The addition of silver nanoparticles to bioceramic cements was efficient to promote an acceleration of bacterial death.

Longevity of Resin Composite and Amalgam Posterior Restorations: A Systematic Review

OBJECTIVES

The objective of this systematic review was to compare the longevity of direct amalgam and composite resin restorations, in posterior teeth, through clinical, prospective or retrospective studies, with at least 5 years of follow-up.

MATERIALS AND METHODS

Studies published in the last 15 years (from 2006 to 2021) were collected using the PubMed and Medline databases.

RESULTS

The search strategy associated with the established inclusion and exclusion criteria resulted in a total of 17 articles. Factors related to failures in the performance of restorations were analyzed together with the clinical performance results of each material over the years of study, according to the methodology of each article.

CONCLUSIONS

Regardless of the restorative material, the successful results over more than 5 years are due much more to the correct application of the technique, the operator's skill/knowledge and factors related to the patient, such as the type of tooth, number of faces involved in the restoration and oral hygiene.

Adhesive systems applied to dentin substrate under electric current: systematic review

Objectives

The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current.

Materials and Methods

The first search strategy was based on data available at PubMed, LILACS, Scielo, Scopus, and Cochrane Library, using a combination of descriptors such as “dentin bond agents OR adhesive system AND electric current OR electrobond” or “dentin bonding agents OR dentin bonding agent application OR adhesive system AND electric current OR electrobond”, with no limit regarding the publication year. The second search strategy was based on the articles' references found previously. An additional search strategy was applied that concerned the proposed theme in the SBU-UNICAMP (Unicamp's Library System Institutional Repository).

Results

Twelve studies published between 2006 and 2020 were found. The analyses of the selected studies showed that the use of electric current during adhesive systems application on dentin, whether conventional or self-conditioning, increases resinous monomer infiltration in the dentin substrate, which improves the hybridization processes and the bond strength of the restorative material to dentin.

Conclusions

Despite the favorable results related to the use of this technique, there is still no specific protocol for the application of adhesive systems under electric current.

Effect of Cement Layer Thickness on the Immediate and Long-Term Bond Strength and Residual Stress between Lithium Disilicate Glass-Ceramic and Human Dentin

This study tested whether three different cement layer thicknesses (60, 120 and 180 μm) would provide the same bonding capacity between adhesively luted lithium disilicate and human dentin. Ceramic blocks were cut to 20 blocks with a low-speed diamond saw under cooling water and were then cemented to human flat dentin with an adhesive protocol. The assembly was sectioned into 1 mm² cross-section beams composed of ceramic/cement/dentin. Cement layer thickness was measured, and three groups were formed. Half of the samples were immediately tested to evaluate the short-term bond strength and the other half were submitted to an aging simulation. The microtensile test was performed in a universal testing machine, and the bond strength (MPa) was calculated. The fractured specimens were examined under stereomicroscopy. Applying the finite element method, the residual stress of polymerization shrinkage according to cement layer thickness was also calculated using first principal stress as analysis criteria. Kruskal–Wallis tests showed that the ‘‘cement layer thickness’’ factor significantly influenced the bond strength results for the aged samples (p = 0.028); however, no statistically significant difference was found between the immediately tested groups (p = 0.569). The higher the cement layer thickness, the higher the residual stress generated at the adhesive interface due to cement polymerization shrinkage. In conclusion, the cement layer thickness does not affect the immediate bond strength in lithium disilicate restorations; however, thinner cement layers are most stable in the short term, showing constant bond strength and lower residual stress.

Mechanical Properties of Experimental Composites with Different Photoinitiator

Objective  The effect of different photoinitiators on mechanical properties of experimental composites was evaluated.

Materials and Methods  Resin composites were formulated by using a blend of bisphenol A-glycidyl and triethylene glycol (50/50 wt%) dimethacrylate monomers, and 65 wt% of barium aluminium silicate and silica filler particles. Photoinitiators used were 0.2% camphorquinone (CQ) and 0.8% co-initiator (DMAEMA); 0.2% phenyl-propanedione and 0.8% DMAEMA; 0.1% CQ + 0.1% phenyl propanedione and 0.8% DMAEMA; 0.42% mono(acyl)phosphine oxide (MAPO); and 0.5% bis(acyl)phosphine oxide (BAPO). Specimens ( n = 10) were light cured by using a multiple-emission peak light-emitting diode for 20 seconds at 1,200 mW/cm ² of irradiance and Knoop hardness and plasticization, depth of cure, flexural strength, and elastic modulus were evaluated. Data were statiscally analyzed at significance level of α = 5%.

Results  Experimental composites containing MAPO and BAPO photoinitiators showed the highest values of flexural strength, elastic modulus, top surface hardness, and lower hardness reduction caused by alcohol compared with CQ. Composites containing CQ and PPD showed similar results, except for depth of cure and hardness of bottom surface.

Conclusion  BAPO and MAPO showed higher flexural strength, elastic modulus, hardness on top surface, and lower polymer plasticization to CQ.

Effect of different fabrication methods of occlusal devices on periradicular stress distribution: A photoelastic analysis

STATEMENT OF PROBLEM

Investigations on the effectiveness of new methods for optimizing the fabrication of oral devices are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate stress distribution with photoelastic analysis in the periradicular area of teeth supporting occlusal devices fabricated by 5 different processes.

MATERIAL AND METHODS

The occlusal devices were fabricated by vacuum thermoforming, heat-polymerized acrylic resin, chemical polymerized acrylic resin, 3-dimensional printing, and milling (computer-aided manufacturing). The devices were evaluated regarding initial fit, number of adjustments for passive fit, and stress distribution under 100-N and 400-N loads in the periradicular locations of posterior teeth.

RESULTS

The 3-dimensional printing device did not require any adjustment for initial adaptation to the photoelastic model and presented a little friction with the model. The heat-polymerized acrylic resin device did not seat initially, requiring more sites of adjustment until passive adaptation. At 100-N and 400-N loads, the use of the computer-aided manufacturing occlusal device resulted in the lowest stresses in periradicular areas (0.744 and 1.583, respectively), and the 3-dimensional printing occlusal device produced the highest stresses with a 400-N load application (2.427). The lowest mean of fringe pattern was observed for the computer-aided manufacturing device, and the highest mean of fringe pattern was observed for the vacuum thermoforming device.

CONCLUSIONS

The computer-aided design and computer-aided manufacturing milled occlusal device presented the best initial adaptation and transferred lower stresses to the periradicular areas than the other evaluated devices.

Influence of Flat Occlusal Splint on Stresses Induced on Implants for Different Fixed Prosthetic Systems

OBJECTIVE

The flat occlusal plate has been recommended to reduce stress concentration in implant prosthesis treatments. The purpose was to investigate the influence of the occlusal splint on three-element implant-supported fixed prosthesis.

MATERIALS AND METHODS

A three-dimensional virtual model was created consisting of a cortical and spongy bone block simulating the region from first premolar to the maxillary first molar using two HE or MT implants (4 x 11mm) with Ti and/or Y-TZP abutments. The second premolar was the pontic of the prosthesis. The three-element fixed prosthesis with a zirconia infrastructure and Y-TZP coating were cemented, in addition to using a flat occlusal splint made of acrylic resin in the region. Combined axial and oblique loads of 100N and 300N were applied.

RESULTS

The tensile stresses on MT implant bone tissue produced values of 4-19% lower than those of HE implants. The lowest differences were observed for oblique loading with an occlusal splint, with a 4% (Ti-Y-TZP) and 9% (Ti-Ti) decrease. When the compressive stresses were evaluated, HE implants produced lower values than MT implants.

CONCLUSION

A significant increase was observed in the oblique loading stresses in the absence of occlusal splints, regardless of the applied load.

Tooth Discoloration Using Calcium Silicate-Based Cements For Simulated Revascularization in Vitro

The endodontic revascularization may be an alternative treatment for necrotic immature teeth, however, several treatment steps may cause tooth discoloration. This study evaluated the use of three calcium silicate-based cements with different radiopacifying agents on the color alteration (∆E) of extracted premolars after simulation of revascularization. Forty single rooted extracted premolars were shaped with #1-6 gates Glidden drills, rinsed with sodium hypochlorite, and filled with fresh human blood. Three calcium silicate-based cements with different radiopacifying agents (bismuth oxide - CSBi, calcium tungstate - CSW, and zirconium oxide - CSZr) were applied over the blood clot (n=10). The control group received the application of a temporary zinc oxide-based cement (TFZn) (n=10). ∆E was measured with a spectrophotometer, using the L*a*b* color system of the International Commission on Illumination (CIELab), in different times: prior to the preparation of the access cavity (t0); right after treatment (t1); and after one (t2), two (t3), three (t4) and four (t5) months. The tooth site for color evaluation was standardized by silicon matrix, the color reading was performed 3 times per tooth, and the teeth were stored in 37º water between evaluations. ∆E, whiteness (WID index) and yellowness (b*) were evaluated. Data were subjected to one-way ANOVA and repeated measures ANOVA, followed by Tukey's post hoc test (α=0.05). All groups were similar in ∆E1 (t0-t1). The ∆E was the lowest and constant in the control group. In all evaluation times, CSBi presented the highest ∆E (p<0.01). CSW and CSZr were similar in all evaluated times and presented intermediate ∆E values. WID index from CSBi and CSW presented more distancing from 'white' reference. CSBi presented the greatest decrease in yellowness (b* value). The cement containing bismuth oxide presented the highest color alteration values. All tested calcium silicate-based cements presented clinically perceptible discoloration. Calcium tungstate and zirconium oxide may be used as alternative radiopacifiers to decrease tooth discoloration after endodontic tooth revascularization.

Improving the bonding stability between resin cements and zirconia-based ceramic using different surface treatments

PURPOSE

To evaluate the effects of airborne-particle abrasion with alumina particles or silicamodified alumina particles on the bond strength between zirconia and conventional MDP-based (Ph; Panavia F 2.0, Kuraray) or self-adhesive (SA; RelyX U200, 3M ESPE) resin cements.

MATERIALS AND METHODS

Five surface treatments were evaluated: C = no surface treatment; AB = airborne-particle abrasion with alumina particles (BIO-ART Dental Supplies and Equipment); ABP = AB combined with MDP-based primer (Alloy Primer, Kuraray); SS = airborne-particle abrasion with silica-modified alumina particles (CoJet, 3M ESPE) combined with silane (RelyX Ceramic Primer, 3M ESPE); and SSP = SS combined with MDP-based primer. The surface roughness (Ra) of the airborne particle-abraded samples (n = 5) was measured by a contact profilometer (Mitutoyo Surftest SJ-401, Mitutoyo). Cylinders of the resin cements tested were bonded to the surface-treated zirconia. The microshear test was performed by the application of a load with a wire loop parallel to the adhesive interface until debonding of the resin cement cylinders. The microshear bond strength (μSBS) of the samples was measured before and after being subjected to thermocycling (TC; 5°C to 55°C, 60 seconds dwell time for 3,000 cycles; MSCT, Marcelo Nucci). One-way (Ra) and two-way (μSBS) analysis of variance followed by Tukey post hoc test (α = .05) were used.

RESULTS

The SS (Ph: 12.6 MPa; Ph-TC: 6.37 MPa; SA: 11.8 MPa; SA-TC: 9.37) and SSP (Ph: 10.4 MPa; Ph-TC: 5.82 MPa; SA: 10.4 MPa; SA-TC: 10.0) surface treatments produced the highest surface roughness values (P < .001). The SS samples achieved the highest immediate bond strength for both resin cements. However, after TC, SA resin cement associated with any surface treatment produced the highest bond strength values.

CONCLUSION

The self-adhesive resin cement promoted higher and more stable bond strength values when associated with a surface roughening method.

Resin composite adhesion to dentin using different curing lights and adhesive systems applied under electric current

OBJECTIVES

To evaluate the effect of electric current application on the resin composite-tooth bond strength and hybrid layer of three adhesive systems light-cured by two light-curing units (LCUs).

MATERIALS AND METHODS

Human molar teeth were distributed into 12 groups (n=6). Three adhesive systems were used: two-step etch-and-rinse (SB2; Adper Single Bond 2, 3M ESPE); two-step self-etch (CSE; Clearfil SE Bond, Kuraray); and one-step self-etch (SBU; Single Bond Universal, 3M ESPE) applied with (50μA) and without (control; conventional application) electric current, and light-cured with different LCUs. Resin composite blocks (Filtek Z350XT, 3M ESPE) were produced and cut into sticks (~1mm²) for microtensile bond strength (μTBS). Fracture patterns were analyzed on stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive, or mixed. Specimens were prepared for scanning electron microscope observation. The hybrid layer analysis was carried out using a confocal laser scanning microscopy (n=2). Data were submitted to three-way ANOVA followed by Tukey's post hoc test (α=0.05).

RESULTS

The electric current increased the μTBS for all adhesive systems light-cured with single-emission peak and multiple-emission peak LCUs. Both LCUs presented similar μTBS values. CSE applied under electric current showed the highest μTBS mean values. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems.

CONCLUSIONS

The adhesive systems applied under electric current increased the bond strength using single-emission peak and multiple-emission peak LCUs.

CLINICAL RELEVANCE

Electric current at 50μA applied throughout the dentin is a safe mode and results in better impregnation of the adhesive systems.

Mechanical performance of experimental acrylic resins modified by nanoparticles after chemical and mechanical degradation

Background

Different materials have been incorporated into the polymethylmethacrylate matrix to improve its performance. The aim of this study was to evaluate the degree of conversion (DC), the flexural strength (FS), the elasticity modulus (EM), and the effect of exposure to food-simulating liquids prior to brushing simulation on the gloss loss (GL) of experimental acrylic resins modified by nanoparticles.

Material and Methods

Three different types of nanoparticles; silicon oxide (SiO2), cerium oxide (CeO2) and titanium oxide (TiO2) were added to a poly (methylmethacrylate) matrix, in proportions of 0.5wt%, 1wt% and 3wt% each, forming nine experimental groups. The acrylic resin was also tested as a control group. DC was investigated using Fourier transform infrared spectroscopy (FTIR). A three-point bending test was used for FS and EM. GL after chemical degradation and simulated brushing was evaluated using a glossmeter. Data were submitted to one and two-way ANOVA followed by Duncan’s post hoc test (α=0.05).

Results

All nanoparticle-modified groups showed higher values of DC. Ce1% showed higher values of FS and EM. All other groups showed similar or lower physical-mechanical properties (FS, EM, GL). Regarding type and wt%, CeO2 and TiO2 groups had better performances and were similar to each other.

Conclusions

Incorporating metal nanoparticles, especially CeO2, could improve the physical properties of the dental materials.

Key words:Polymethylmetacrylate, degree of conversion, flexural strength, elasticity modulus, gloss loss.

Retention of Provisional Intraradicular Retainers Using Fiberglass Pins

Objectives:

The purpose of this study was to compare the retention properties between fiberglass pins with chemically activated acrylic resin and metallic intraradicular retainers often used for the purpose of temporary prosthetic retention.

Materials and Methods:

Two mechanical tests, pushout and traction, were performed on specimens distributed in three groups (n = 10) for each test; two metal pins G1: Metalpin Ângelus and G2: Provisional Pivot Jon in addition to one fiberglass pin G3: Whitepost DC-E, FGM. One-way analysis of variance (ANOVA) followed by Tukey’s post hoc test was used at the level of significance α = 0.05.

Results:

The fiberglass pins (G3) showed higher values in the traction test than the metal pins (G1 and G2) with a statistically significant difference (P < 0.05); however, they performed similarly to the metal pin groups in the pushout test (P > 0.05). They also presented a lower occurrence of failure in the relining acrylic resin.

Conclusion:

The study pointed out the use of fiberglass pins as suitable alternatives for provisional intracanal metallic retainers.

The effect of repeated surface treatment of zirconia on its bond strength to resin cement

PURPOSE

The aim of this study is to evaluate the influence of repeated surface treatments on wettability and surface roughness for zirconia surface and bond strength of zirconia-based ceramics to resin cement.

MATERIALS AND METHODS

Seventy blocks (10 × 10 × 3 mm) of zirconia-based ceramics were fabricated and divided into two groups according to the surface treatments: (A) 110 µm Al₂O₃ airborne-particle abrasion and (R) 110 µm silica modified Al₂O₃ airborne-particle abrasion. At stage 2, each group was subdivided into 5 groups according to the surface retreatments: (a) 110 µm Al₂O₃ airborne-particle abrasion, (r) 110 µm silica modified Al₂O₃ airborne-particle abrasion, (D) diamond bur, (Da) diamond bur + 110 µm Al₂O₃ airborne-particle abrasion, and (Dr) diamond bur + 110 µm silica modified Al₂O₃ airborne-particle abrasion. Cylinders of self-adhesive resin cement were cemented onto each treated ceramic surface and subjected to micro-shear bond strength test. Additional specimens were prepared for roughness and wettability analyses. The data were subjected to t-test and One-way ANOVA followed by Tukey's post hoc test (α=.05).

RESULTS

At stage 1, group R presented higher bond strength values than group A (P=.000). There was a statistically significant increase of bond strength at stage 2 for group A (P=.003). The diamond bur influenced the surface roughness, increasing the values (P=.023). Group R provided better wettability. Regardless of the applied surface treatment, most of failures were adhesive.

CONCLUSION

The combination of application and reapplication of Rocatec Plus showed the best results of bond strength. Surface retreatment and recementation might be an indicated clinical strategy.

Influence of Surface Treatment of Lithium Disilicate on Roughness and Bond Strength

PURPOSE

To evaluate the effect of different concentrations of hydrofluoric acid (HF) on the surface roughness of a ceramic reinforced by lithium disilicate and on the bond strength formed between the ceramic and self-adhesive resin cement.

MATERIALS AND METHODS

A total of 100 disks of IPS e.max Press ceramic (Ivoclar Vivadent) reinforced by lithium disilicate were prepared as follows: group 1 remained untreated (control group); in groups 5-20, 5-40, and 5-60, the surfaces were etched with 5% HF for 20, 40, and 60 seconds, respectively; in groups 10-20, 10-40, and 10-60, the surfaces were etched with 10% HF for 20, 40, and 60 seconds, respectively; and in groups 10-20P, 10-40P, and 10-60P, the surfaces were etched with 10% HF for 20, 40, and 60 seconds, respectively, followed by treatment with 37% phosphoric acid for 5 seconds. Surface roughness and bond strength were analyzed with confocal microscopy and microshear testing, respectively. The values obtained were statistically analyzed using paired t test and two-way ANOVA followed by Tukey post hoc test at a 5% significance level.

RESULTS

Surface roughness was influenced by the concentration and exposure time of acid applied (P < .05) and by the combination of these two factors (P < .05). Treatment with 10% HF for 40 seconds (group 10-40) achieved the highest roughness value. In contrast, bond strength was affected only by the acid exposure time (P < .05).

CONCLUSION

Conditioning of lithium disilicate ceramics can change the surface morphology, thereby affecting bond strength with resin cement.

Effect of Implant Platform Connection and Abutment Material on Removal Torque and Implant Hexagon Plastic Deformation

Objectives  The aim of this study was to evaluate the plastic deformation of the hexagonal connection, and the removal torque of the implant-abutment joint of two dental implants combined with internal or external hexagonal connection implants after mechanical cycling.

Materials and Methods  Twenty-four dental implants were used in the study. Half of the implants had internal hexagonal connections (IH; Titamax II Plus) and the other half had external hexagonal connections (EH; Titamax Ti Ex). Four groups of two types of dental implant abutments (titanium: Ti, UCLA II Plus and zirconia: Zr, fabricated by CAD/CAM; n = 6) were investigated. The abutments received a metallic crown and the settings were submitted to mechanical cycling (MC; 10 ⁶ cycles, axial load, 120N). The connection surface area was measured by scanning electron microscope (SEM) images. The removal torque was evaluated and the plastic deformation of the hexagonal surface of the implant was measured by comparing the images before and after MC.

Statistical Analysis  Paired- t test was used to analyze the data statistically at a significance level of α = 0.05.

Results  The torque values decreased for all groups after MC, and the hexagonal surface area decreased due to plastic deformation for IH and EH associated with Zr abutments.

Conclusions  Zirconia abutments showed the worst plastic deformation of the implant connection surface and torque loosening when associated with IH implant.

Comparing Laser and Scalpel for Soft Tissue Crown Lengthening: A Clinical Study

Crown lengthening procedure is aimed at exposure of sufficient crown structure accomplished by a gingivectomy, an apically positioned flap with osseous resection or the use of lasers. Our present clinical study is aimed to assess the clinical effectiveness of a diode laser for functional crown lengthening procedure and to compare it with the conventional procedure using the scalpel. Fourteen patients including males and females, aged 20- 40 years were recruited and divided into two groups to undergo crown lengthening either with the scalpel or the laser. The data obtained was analyzed for intergroup comparison with an Unpaired t-test and intragroup comparison was determined by ANOVA.Analysis of the intergroup results for pain showcased that there was a significant difference (P<0.002) in VAS scores of pain on the 3rd day as well as on the 7th day (P<0.044), with patients in the laser group displaying significantly lower VAS scores compared to the scalpel group, but when both the groups were compared on the 10th day, there was no significance (P<0.14).Intergroup comparison of the mean VAS scores for discomfort observed on the 3rd, 7th and the 10th day of the study suggested that there was a significant difference of the VAS scores of discomfort on the 3rd and the7thdays, with the patients in the laser group displaying significantly lower VAS scores for discomfort compared with the scalpel.Observations from the study emphasize that laser can be a safe and effective alternative to traditional crown lengthening performed with the scalpel.

Nanoleakage Evaluation of Posterior Teeth Restored with Low Shrinkable Resin Composite- An invitro Study

INTRODUCTION

The effect of nanoleakage on the integrity of resin-dentin bond has been in interest for long-term adhesion.

AIM

This study evaluated the nanoleakage in premolar teeth restored with low shrinkable resin composite.

MATERIALS AND METHODS

A total of 40 human premolars were used for nanoleakage evaluation in this study. Each group was divided into four equal groups; Group A: using silorane with its adhesive system. Group B: using silorane with G-bond. Group C: using Filtek supreme composite with G-bond. Group D: using Filtek supreme composite with AdheSE adhesive. Nanoleakage analysed using Scaning Electron Microscope (SEM) and Energy Dispersive X-Ray Spectrometery (EDX).

RESULTS

The amount of silver present in hybrid layer depend on the adhesive used; this indicated different nanoleakage expressions in different adhesive systems. Filtek Z350 composite with G-bond showed clear silver uptake in both the adhesive and hybrid layer. Low shrinkable resin composite (silorane) with its adhesive system showed less silver penetration and slight silver peak on the elemental energy spectroscopy of energy dispersive X-Ray spectrometry (EDS) as compared to other samples.

CONCLUSION

Adhesives used between different groups, influence the location and degree of nanoleakage. There is difference in nanoleakage patterns between two-step and one-step adhesives and also among the one-step adhesives themselves.

Sealing Ability of MTA Used in Perforation Repair of Permanent Teeth; Literature Review

There were several materials used to seal different types of perforation defects. MTA is one of these restorative materials that is considered the most effective, biocompatible, non-toxic, and non-irritant; promote bone healing and cementum regeneration. The objective of this article was to review and summarize the sealing ability of MTA compared with the other materials used for sealing different types of root perforations of permanent teeth. A literature search was conducted using Medline, accessed via the National Library of Medicine Pub Med from 2005 to 2015 searching for articles related to sealing ability of MTA. This study found that factors affecting prognosis are the size, site of the perforation and time elapsed as well as the repair material. MTA is an important filling material to be used for sealing different types of perforations when perforated sites sealed immediately with MTA.

Effect of hyperbaric oxygen profiles on the bond strength of repaired composite resin

OBJECTIVE

This study was performed to evaluate the bond strength of repaired three types of composite resins under various hyperbaric oxygen (HBO) profiles with various session numbers.

MATERIALS AND METHODS

Sixty specimens of three types of composite resin (nanofilled composite, nanohybrid composite and microfilled composite) each type of composite was divided into four group according to various profiles of HBO treatment (control, 2bar, 3 bar and 5 bar). Then, the specimens were repaired; thermocycled, the tensile bond strength were measured. Then the data were analyzed by One-way ANOVA followed by Tukey's post hoc test (α = 0.05).

RESULTS

The highest bond strength was obtained for the repaired nanofilled composite resin specimens while; the lowest bond strength was obtained for the repaired microfilled composite resin specimens. The highest tensile bond strength was recorded for the specimens who treated with the highest pressure of HBO.

CONCLUSION

The bond strength of repaired nanofilled composite resins is better than the other types of composite resin. The highest pressure of HBO, the highest bond strength of repaired composite resins.

Effect of anodization and alkali-heat treatment on the bioactivity of titanium implant material (an in vitro study)

OBJECTIVE

This study was aimed to assess the effect of anodized and alkali-heat surface treatment on the bioactivity of titanium alloy (Ti-6Al-4V) after immersion in Hank's solution for 7 days.

MATERIALS AND METHODS

Fifteen titanium alloy samples were used in this study. The samples were divided into three groups (five for each), five samples were anodized in 1M H3PO4 at constant voltage value of 20 v and another five samples were alkali-treated in 5 M NaOH solution for 25 min at temperature 60°C followed by heat treatment at 600°C for 1 h. All samples were then immersed in Hank's solution for 7 days to assess the effect of surface modifications on the bioactivity of titanium alloy. The different treated surfaces and control one were characterized by X-ray diffraction, atomic force microscopy, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and Fourier transformation infra-red spectroscopy. Statistical analysis was performed with PASW Statistics 18.0(®) (Predictive Analytics Software).

RESULTS

Anodization of Ti-alloy samples (Group B) led to the formation of bioactive titanium oxide anatase phase and PO4 (3-) group on the surface. The alkali-heat treatment of titanium alloy samples (Group C) leads to the formation of bioactive titania hydrogel and supplied sodium ions. The reaction between the Ti sample and NaOH alkaline solution resulted in the formation of a layer of amorphous sodium titania on the Ti surface, and this layer can induce apatite deposition.

CONCLUSIONS

The surface roughness and surface chemistry had an excellent ability to induce bioactivity of titanium alloy. The anodization in H3PO4 produced anatase titanium oxide on the surface with phosphate originated from electrolytes changed the surface topography and allowed formation of calcium-phosphate.

Evaluation of Patient Perceptions After Vestibuloplasty Procedure: A Comparison of Diode Laser and Scalpel Techniques

INTRODUCTION

Inadequate vestibular depth results in poor plaque control owing to an insufficient width of keratinized gingiva. Vestibuloplasty provides the necessary vestibular depth and can be performed either with a scalpel, electrocautery or lasers.

AIM

To evaluate the patient perceptions related to pain and discomfort on the 1(st), 3(rd) and the 7(th) day post vestibuloplasty and also assess the healing outcomes related to the treatment of inadequate vestibular depth either with the diode laser or the scalpel.

MATERIALS AND METHODS

Twenty patients who had inadequate vestibular depth and required vestibuloplasty were assigned randomly to undergo the procedure either with the scalpel or the laser. The data obtained was analysed for intergroup comparison with an independent paired t-test and intragroup comparison was determined by a paired t-test.

RESULTS

Intragroup comparison within the laser group for VAS scores of pain and discomfort within all the reported days exhibited a significant difference (p<0.05). Inter group comparison revealed that the patients in the laser group had lower VAS cores for pain and discomfort compared to the scalpel group (p<0.05). Analysis of the three pointer scale for healing revealed that the patients in the laser group exhibited better healing outcomes on the 1(st), 3(rd) and the 7(th) day compared to the scalpel group.

CONCLUSION

Observations from the study highlight the opinion that laser can be a safe and effective alternative to traditional vestibuloplasty performed with the scalpel.

Prevalence of oro-dental anomalies among schoolchildren in Sana'a city, Yemen

Practitioners and policy-makers need information about the relative frequency of dental anomalies among children in their region. This study investigated the prevalence of different oral anomalies among schoolchildren in Sana'a city, Yemen. A sample of 1000 private and public schoolchildren aged 4-12 years were examined by the same examiner using disposable tongue blades. The total prevalence of oral anomalies was 15.1%, most commonly in boys (male:female ratio 3.2:1) aged 7-12 years. The most prevalent dental anomaly related to hard tissues was tooth hypoplasia (2.8%), followed by hypocalcification (2.6%), then microdontia (0.5%), macrodontia (0.4%), hypodontia (0.4%), supernumerary teeth (0.3%), tooth transposition (0.3%), dental fusion (0.2%) and gemination (0.2%). The most prevalent soft tissues anomaly was fissured tongue (4.0%), followed by ankyloglossia (1.8%), geographic tongue (0.9%), macroglossia (0.4%) and hairy tongue (0.3%). Appropriate measures need to be taken early to mitigate the negative impact and later costs of treatment of anomalies.

Periodontal Systemic Connections-Novel Associations-A Review of the Evidence with Implications for Medical Practitioners

Periodontal diseases, considered as inflammatory diseases have proved to have a spectrum of systemic implications. Earliest research has associated periodontal disease with common systemic aliments such as hypertension, diabetes, osteoporosis, rheumatoid arthritis to name a few. The evolution of advanced diagnostic aids let researchers make vast inroads in linking periodontal diseases to systemic diseases like Alzheimer's disease (AD) and even Schizophrenia. Our aim was to review and critically evaluate comprehensive literature and provide knowledge to medical practitioners on these associations so as to pave way for closer interactions between medical and dental practitioners in implementing better health care. Electronic databases such as PubMed, Google Scholar and Cochrane databases were used as source of the data for relevant studies published from 2005 up to 2015 with the following keywords, "'Periodontal disease", "systemic conditions", "periodontal disease and Alzheimer's", "Periodontal disease and Schizophrenia", "Periodontal disease and Psoriasis" and "Periodontal disease and erectile dysfunction". The evidence presented ascertains that a reasonable and modest association does exist between Periodontal disease and Alzheimer's, Schizophrenia, Erectile dysfunction, as well as Psoriasis and thus establishes periodontal disease as a potential risk factor.

The effect of plasma surface treatment on the bioactivity of titanium implant materials (in vitro)

BACKGROUND

The surface of an implantable biomaterial plays a very important role in determining the biocompatibility, osteoinduction, and osteointegration of implants because it is in intimate contact with the host bone and soft tissues.

OBJECTIVE

This study was aimed to assess the effect of plasma surface treatment on the bioactivity of titanium alloy (Ti-6Al-4V).

MATERIALS AND METHODS

Fifteen titanium alloy samples were used in this study. The samples were divided into three groups (with five samples in each group). Five samples were kept untreated and served as control (group A). Another five plasma samples were sprayed for nitrogen ion implantation on their surfaces (group B) and the last five samples were pre-etched with acid before plasma treatment (group C). All the investigated samples were immersed for 7 days in Hank's balanced salt solution (HBSS) which was used as a simulating body fluid (SBF) at pH 7.4 and 37°C. HBSS was renewed every 3 days. The different surfaces were characterized by X-ray diffraction (XRD), Atomic Force Microscopy (AFM), Scanning Electron Microscopy (SEM), Energy-dispersive X-ray spectroscopy (EDXA), and Fourier Transformation Infrared Spectroscopy (FTIR).

RESULTS

Nitriding of Ti-alloy samples via plasma nitrogen ion implantation increased the bioactivity of titanium. Moreover, the surface topography affected the chemical structure of the formed apatite. Increasing the surface roughness enhanced the bioactivity of the implant material.

CONCLUSIONS

Nitridation can be exploited as an effective way to promote the formation of bone-like material on the implant surface.

Comparison of efficacy among various topical anesthetics: An approach towards painless injections in periodontal surgery

Background and Aims:

Local anesthetics (LAs) are most commonly used agents in dentistry. They are used to prevent the pain and nociception generated during dental procedures. Since pain associated at the time of injection of LA is uncomfortable, most of the dentists are on pursuit of painless administration of LA injection and use of topical anesthetics prior to the injection has proven effective in reducing anxiety and pain to the patient. The aim of this study is to compare pain responses after application of three types of topical anesthetics with control in the patients referred for periodontal full mouth flap surgery.

Materials and Methods:

A total of 83 patients (42 males and 41 females) participated in the study with age group ranging from 30 to 50 years. The present study is to evaluate the efficacy of three topical anesthetics (Precaine gel, Benzocaine topical paste and Lignocaine spray) before infiltration in altering visual analog scale (VAS) scores of pain during LA injection. The statistical analysis was performed using SPSS version 15.0 software. Repeated analysis of variance was performed to know the effect of each variable and reveal statistical significance.

Results:

Results revealed that Precaine gel had least VAS score compared with other topical anesthetics.

Conclusion:

From the present study, it can be concluded that procaine gel is a better than other topical LA agents, as the number of studies on this subject is rare and clinical results are mixed, further studies are required with a larger sample before its routine application in our field.

The effect of pomegranate mouthrinse on Streptococcus mutans count and salivary pH: An in vivo study

Herbal mouthwashes have been considered to be a more advantageous option to their chemical counterparts, for a long-time. The use of pomegranate fruit dates from ancient times and reports of its therapeutic abilities have echoed throughout the ages. To evaluate the effect on the salivary pH and the Streptococcus mutans count in healthy subjects before and after pomegranate mouthrinse. Fifty healthy patients were randomly divided into two groups of 25 subjects each. Group A was treated with 0.2% chlorhexidine mouthrinse; while Group B was treated with pomegranate peel extract (PPE) mouthrinse and the saliva samples were collected at three different intervals: Prerinse, after 10 min, and 60 min. The salivary pH was measured using a digital pH meter and the S. mutans count was determined by the commercial system Dentocult SM. The statistical analyses used in this study are Mann–Whitney U-test and t-test. PPE mouthrinse had an inhibitory effect on S. mutans count in adults. There was also an increase in the salivary pH after 10 min of the mouthrinse. PPE mouthrinse may be considered as a potential anticariogenic mouthrinse.

Effect of neutral zone technique on marginal bone loss around implant-supported overdentures

Aim:

The aim of this study was to compare changes in marginal bone height around immediately loaded implants supporting a mandibular overdenture constructed according to the neutral zone technique with changes around overdentures constructed according to the conventional methods.

Materials and Methods:

Twelve completely edentulous male patients were randomly allocated to two equal groups of patients. Patients in the first group received conventionally constructed complete dentures and patients in the second group received complete dentures constructed using the neutral zone record. All the patients received two single-piece titanium implants placed bilaterally in the mandibular canine regions using flapless surgery, which were then immediately loaded by the dentures. Marginal bone height was radiographically evaluated at baseline and 6, 12, and 18 months after implant loading.

Results:

There was a significant loss in marginal bone height around the supporting implants in each study group. However, no significant differences in marginal bone height were recorded between the study groups over the observation period (P > 0.05).

Conclusion:

Marginal bone height changes induced by overdentures constructed with neutral zone technique on immediately loaded implants are not different from those changes induced by overdentures constructed with a conventional method.

Differences in tooth shade value according to age, gender and skin color: A pilot study

Purpose of the Study:

The purpose was to investigate the differences in tooth shade value according to age, gender and skin color among a sample of the local population in Bengaluru, India.

Methodology:

The study comprised 100 subjects belonging to both gender between the age groups of 16 years to 55 years. Tooth shade values of permanent maxillary left or right central incisors were recorded using the Vitapan 3D-Master shade guide. Skin color was matched using the Radiance compact makeup shades as a guide.

Results:

Chi-square statistical test demonstrated that younger subjects have lighter tooth shade values. No statistically significant differences were recorded in tooth shade value according to gender or skin color.

Conclusion:

Within the limitations of the current study, it can be concluded that tooth shade value is significantly influenced by age. Gender and skin color appear not to have a significant relation to tooth shade value.

Evaluation of cuspal deflection in premolar teeth restored with low shrinkable resin composite (in vitro study)

Objectives:

This study evaluated cuspal deflection in premolar teeth restored with low shrinkable resin composite.

Materials and Methods:

A total of 40 human premolars were used for cuspal deflection evaluation in this study. Each group was divided into four equal groups according to the type of resin composite and the adhesive used as follows: group A: Using low shrinkable resin composite (silorane) with its adhesive system; group B: Using low shrinkable composite (silorane) with G-bond; group C: Using Filtek Z350 composite with G-bond; and group D: Using Filtek Z350 composite with AdheSE. Cusp deflection was detected using Universal measuring microscope and laser horizontal metroscope.

Results:

This study was done to investigate the effect of polymerization shrinkage stresses of two resin composite materials (Filtek Z350 and Filtek P90) on cuspal deflection of mesio-occluso-distal restoration. For this study, the extracted non-carious maxillary second premolars were selected. Forty teeth that showed no more than 5% variation in their dimensions were used. A significant increase in cuspal deflection of cavities restored with the methacrylate-based (Filtek Z350) compared with the silorane (P90) resin-based composites was obtained.

Conclusion:

The change in the organic matrix or materials formulation of the resin composite using silorane has a positive effect on controlling the cusp deflection.

Oral Microbial Shift: Factors affecting the Microbiome and Prevention of Oral Disease

BACKGROUND

Recently, oral microbiome has gained popularity among scientists. Microorganisms are no longer considered as disease-producing pathogens, rather they are now considered as partners of human in maintaining health. Since ancient times, changes in our lifestyle have affected our microbiome and the balance with their human host has been perturbed. The present review includes the description about factors affecting oral microbiome and establishing symbiosis with the human host so that they contribute in maintaining health rather than eliciting diseases.

MATERIALS AND METHODS

A comprehensive literature search was performed on databases such as Google Scholar, PubMed and Medline until April 2015. First, articles were selected on the basis of their titles and then abstracts were screened and unwanted articles were excluded. Articles obtained from all the databases were checked and duplicate articles were removed. Articles obtained from various databases: PubMed = 35, Google Scholar=8. Out of these 43 articles, total 29 articles were finally selected for this review.

RESULTS

The published literature suggests that the modern oral microbiome is less biodiverse, and possess more pathogenic bacterial species and lesser beneficial bacteria. The possible factors mainly responsible for this shift in microbiome were found to be change in diet, industrial revolution and indiscriminate use of antibiotics.

CONCLUSION

Various changes in lifestyles have affected oral microbiome adversely and perturb the symbiosis between the microbiome and their hosts. The present oral microbiome is found to be less diverse and more pathogenic. The present review may be helpful in understanding the relationship between the microbiome and their human hosts so that microbiome contributes in maintaining healthy state of the body.

Stress and professional burnout among newly graduated dentists

BACKGROUND

Dentists encounter numerous professional stressful situations, beginning from education to day-to-day practice. The resulting stress tends to have a negative impact on their personal as well as professional lives.

OBJECTIVES

To measure daily burnout, and to investigate the extent of expectations from dental career and the feeling of being unqualified new dental practitioner.

MATERIALS AND METHODS

A close-ended questionnaire, i.e., "the Copenhagen Burnout Inventory," was utilized for evaluation. A total of 121 dentists with an experience ranging between 6 months and 5 years were included. The period was considered initiating from graduation to dental practicing in urban or rural areas. Ninety-seven dentists replied with filled questionnaires (80.16%). The multivariant analysis was done using SPSS 11.0 ver. (Chicago, USA).

RESULTS

Using measures analysis, the mean scores for dentists on the basis of age and sex (n = 97) were calculated. The factors most commonly considered responsible for professional burnout were emotional exhaustion (39.27%), frustrations (47.83%), feeling worn out at the end of the day (35.05%), feeling worn out at the end of the working day (46.80%), exhaustion in the morning at the thought of another day at work (35.05%), feeling that every working hour is tiring (46.80%), less energy and less time for family and friends (47.83%). The most common cause for stress was professional burnout that was recorded commonly in females in the age range of 26-28 years.

CONCLUSIONS

Dentists are more prone for professional burnout, anxiety, and depression. The main reason for this is the nature of their practice and their personality traits, especially while pursuing dentistry as a carrier. Stress may lead to negative impact on dentists' personal as well as professional lives.

Periodontal Health Condition and Associated Factors among University Students, Yemen

INTRODUCTION

Studies on oral health status among Yemeni population are scarce.

AIM

This study aimed to evaluate the periodontal health among advantaged section of Yemeni society, university students, in health and non-health fields.

MATERIALS AND METHODS

Periodontal health status of a sample of 360 students from dental, medical and literature faculties (120 each with equal gender distribution) at Sana'a University was evaluated by two calibrated examiners using CPI index. Data regarding tooth-brushing practices and smoking and khat chewing habits were obtained using a structured interview questionnaire.

RESULTS

Only 45 students (12.5%) had healthy periodontium, while 113 (31.4%), 186 (51.7%) and 16 (4.4%) had bleeding, calculus and shallow pocket, respectively, with no significant differences between faculties. Females revealed significantly better periodontal health compared to males, though their bleeding score was higher. Dental and medical students and female students in general were significantly more interested in tooth-brushing and significantly less interested in practicing the deleterious habits such as smoking and khat chewing.

CONCLUSION

The overall periodontal health of Sana'a University students is still unsatisfactory even among students in health field. Females and students in health field revealed better periodontal health and oral health practices (tooth-brushing) in comparison to male students and those in non-health field. The negative effects of the highly prevalent smoking and khat chewing habits deserve further reliable researches and proper educational programs at the national level.

Effect of Brahmyadi Churna (Brahmi, Shankhapushpi, Jatamansi, Jyotishmati, Vacha, Ashwagandha) and tablet Shilajatu in essential hypertension: An observational study

Hypertension (HTN) is one among the fiery health problems of the present era. Since it does not cause symptoms usually for many years until a vital organ is damaged. The present study was carried out on 40 patients of essential HTN with Brahmyadi Churna and tablet Shilajatu for a period of 1 month with milk as Anupana. Observation was done before the treatment, 3 mid test assessments on 7^th, 14^th, and 21^st day, posttest assessment was done on 30^th day. Intervention revealed that 19 had marked improvement, 14 had moderate improvement, 5 had mild improvement, and no improvement was noticed in 2 individuals. Reduction in blood pressure was observed markedly with P < 0.000.

Assessment of the Potential of CFC (Calcium hydroxide Flagyl Ciprofloxacin) for the Rapid Disinfection of Resilon and Gutta-Percha

INTRODUCTION

Obturating materials exposed to the dental operating environment has been shown to be contaminated, making rapid chair side disinfection mandatory to ensure the sterility of the root canals.

OBJECTIVE

The purpose of this study was to investigate the effectiveness of CFC (combination of Calcium hydroxide, Flagyl and Ciprofloxacin) for the rapid disinfection of Gutta-percha and Resilon cones.

MATERIALS AND METHODS

Seventy new Gutta-percha and Resilon cones were randomly selected, contaminated with Enterococcus faecalis and divided into 4 group according to the irrigant used for disinfection {Group I: 5.25% Sodium Hypochlorite (NaOCl), Group II: MTAD, Group III: 2% Chlorhexidine (CHX), Group IV: CFC (a combination of Calcium hydroxide, Flagyl and Ciprofloxacin)}. All the samples were placed in a centrifuge tube with BHI broth after being washed with sterile water. The samples were then incubated for 7 days at 37(o)C. Samples were randomly plated on Mac Conkey agar plate and the colony count was recorded and the observations were drawn.

RESULTS

A 5.25% NaOCl required 1 minute exposure for effective disinfection of all the samples. MTAD could eliminate E.faecalis from gutta-percha samples in 30 seconds whereas it required 1 minute of exposure for Resilon cones. Both 2% CHX and CFC could not disinfect the samples with 1 minute exposure and a minimum of 5 minute exposure was required.

CONCLUSION

A 5.25% NaOCl and Biopure MTAD required less chair side time to disinfect all the samples effectively when compared with 2% CHX and CFC.

Evaluation of remineralization capacity of casein phosphopeptide-amorphous calcium phosphate on the carbamide peroxide treated enamel

Objective:

The aim of this study was to evaluate the potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in remineralizing the bleached enamel surface using micro-hardness.

Materials and Methods:

Thirty human enamel slabs were randomly divided into three groups (n = 10). Groups A and B were exposed to 20% carbamide peroxide and 35% carbamide peroxide gel, respectively. After the exposure to the bleaching agent, the slabs were kept in artificial saliva for 1-week. Group C (control group) were kept in artificial saliva for 1-week. Vickers micro-hardness test was performed by Leica VMHT-Mot micro-hardness tester. CPP-ACP (Gc Tooth Mousse, Melbourne, Australia) was then applied to specimens of Groups A and B for 3 min for 2 weeks. Micro-hardness values of postbleach Group A (Ar) and Group B (Br) were recorded and statistically analyzed by paired t-test and one-way analysis of variance at the significance level of α =0.05.

Results:

There was a significant decrease in micro-hardness of enamel in carbamide peroxide bleached groups. However, there was a significant increase in micro-hardness after the remineralization by CPP-ACP and the extent of remineralization is more for the Group B.

Conclusions:

That bleaching agents reduced enamel micro-hardness and the use of CPP-ACP after bleaching can significantly enhance the micro-hardness of bleached enamel.

Essential oils, their therapeutic properties, and implication in dentistry: A review

Background:

Antibacterial treatments currently used for treatment cause several side effects, and bacterial resistance to the antibiotics is also increasing. Therefore, there is need to find better alternatives. Essential oils (EOs) have been used for treatment of various ailments since ancient times and have gained popularity over the years. Safety and efficacy of EOs have been proved by several clinical trials. This review gives an overview on the EOs, their uses, and adverse effects.

Materials and Methods:

A literature search was performed in the PubMed for clinical trial studies and review articles on EOs published up to February 2015. The search was performed during March 2015. The following keywords were used: “Lavender essential oil,” “cinnamon oil,” “clove oil,” “eucalyptus oil,” “peppermint oil,” “lemon EOs,” and “tea tree oil.”

Results:

Total 70 relevant articles were found in PubMed database. After screening of abstracts, 52 articles were selected to be included in the present review.

Conclusion:

On the basis of the available information, it can be concluded that EOs have the potential to be developed as preventive or therapeutic agents for various oral diseases, but further clinical trials are required to establish their safety and efficacy.

Effectiveness of lidocaine Denti patch® system versus lidocaine gel as topical anesthetic agent in children

BACKGROUND

New methods have been introduced to facilitate dental procedures, but the administration of local anesthesia is still necessary to perform pain control during several dental procedures.

AIM

To evaluate the effectiveness of the lidocaine Denti-patch® system versus the lidocaine topical anesthetic gel in children concerning pain reaction during injection.

MATERIALS AND METHODS

One hundred 9-12-year-old cooperative children weighing more than 29 kg in need of bilateral dental treatment requiring maxillary and mandibular injection and not suffering from acute pain as a result of pulpits on the day of treatment were selected. The children were then divided into two groups: Group 1 comprising of 50 children in need of bilateral maxillary treatment and Group 2 compromising of 50 children requiring bilateral mandibular treatment. These groups were further subdivided into subgroups A and B; those receiving Denti-patch® on one side and lidocaine gel on the contralateral side, respectively. Pain or comfort was evaluated during injection using sound, eye, motor (SEM) scale (objective method) while, using faces pain rating scale (FPS) scale (subjective method) after injection by a trained assistant blinded to the procedure.

STATISTICAL ANALYSIS USED

Comparison of the results was performed using Mann-Whitney U-test and Wilcoxon signed-ranks test for SEM and FPS score.

RESULT

There was a statistically significant difference between the patch and the gel group for maxilla (P < 0.0001), as well as mandible (P = 0.01) with respect to SEM score given by the children. Similarly, with FPS scale, there was a statistically significant difference between the patch and the gel groups in both maxilla and mandible (P < 0.0001). However, there was no statistical difference between the patch Groups 1A and IIA or the gel Groups 1B and II B.

CONCLUSION

The Denti-patch® system can significantly reduce the needle injection pain more than the gel.

Effect of Cigarette Smoke on Surface Roughness of Different Denture Base Materials

BACKGROUND

Surface roughness is an important property of denture bases since denture bases are in contact with oral tissues and a rough surface may affect tissues health due to microorganism accumulation. Therefore, the effect of cigarette smoke on the surface roughness of two commercially available denture base materials was evaluated to emphasize which type has superior properties for clinical use.

MATERIALS AND METHODS

A total numbers of 40 specimens were constructed from two commercially available denture base materials; heat-cured PMMA and visible light cured UDMA resins (20 for each). The specimens for each type were randomly divided into: Group I: Heat cured resin control group; Group II: Heat cured acrylic resin specimens exposed to cigarette smoking; Group III: Light cured resin control group; Group IV: Light cured resin specimens exposed to cigarette smoking. The control groups used for immersion in distilled water and the smoke test groups used for exposure to cigarette smoking. The smoke test groups specimens were exposed to smoking in a custom made smoking chamber by using 20 cigarettes for each specimen. The surface roughness was measured by using Pocket SurfPS1 profilometer and the measurements considered as the difference between the initial and final roughness measured before and after smoking.

RESULTS

The t-test for paired observation of test specimens after exposure to smoking was indicated significant change in surface roughness for Group II (p< 0.05) but has no significance with Group IV. Otherwise, there were no significant differences with control groups (Group I and III).

CONCLUSION

The surface roughness of the dentures constructed from heat cured acrylic resin had been increased after exposure to cigarette smoke but had no impact on the dentures constructed from visible light cured resin.

Improving Composite Resin Performance Through Decreasing its Viscosity by Different Methods

The aim of this work was to present the different current methods of decreasing viscosity of resin composite materials such as (using flowable composites, lowering the viscosity of the monomer mixture, heating composites and applying sonic vibration) and furnish dentists with a basis that can provide criteria for choosing one or another to suit their therapeutic requirements. The four discussed methods proved that lowering composite viscosity improves its handling and facilitates its application to cavities with complicated forms, decreasing time for procedure and improving marginal adaptation. Other properties improved by decreasing composite resin viscosity were controversial between the four methods and affected by other factors such as composite brand and light cure unit.