Effects of Rinsing Water Temperature and Preheated Composites on Microleakage of Composite Restorations with Two Bonding Agents

Objectives: The aim of this study was to evaluate the effects of rinsing water temperature and preheated composites on microleakage of class V restorations with two different bonding agents. Materials and Methods: Eighty class V cavities were prepared in the buccal and lingual surfaces of 40 molars. Single Bond and Prime and Bond NT bonding agents were used. The teeth were divided into four groups of 10. G1: After acid etching, cavities were rinsed with 23˚C water and filled with 23˚C composite resin. G2: Rinsing water and composite resin had 55˚C temperature. G3: Rinsing water had 55˚C and composite resin had 23˚C temperature. G4: Rinsing water had 23˚C and composite resin had 55˚C temperature. The specimens were immersed in 0.5% basic fuchsine dye. Microleakage scores were analysed with the Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests. Results: There were significant differences in microleakage of specimens prepared with Single Bond and Prime and Bond NT only in group 1 (P<0.05). There were no significant differences between the microleakage of groups rinsed with different water temperatures (P>0.05). There were significant differences between the unheated and preheated composite groups (P<0.05). Conclusion: Preheating of composite is a valuable method to increase its adaptability and decrease microleakage of composite restorations.

Survival of Dyna Implants: A Retrospective Study with 1 to 6 Years of Follow Up

Objectives: Dental implants are a prominent scientific breakthrough and are frequently applied for replacement of the missing teeth. From the clinicians’ point of view, long-term studies are essential to find out the predictability of dental implant systems. Materials and Methods: In this retrospective study, 1,626 patients who received 4,389 Dyna implants in a private office between 2013-2019 were evaluated. All statistical analyses were performed using SPSS 25 for Windows. P values less than 0.1 were considered significant for regression analysis. Results: Dyna implantts (4389) placed from 2013 to 2019 were evaluated in this study. One-hundred and thirty-three (3.03%) implants failed during the healing period or recall visits. Eighty-nine implants (2.03%) failed immediately and 44 (1%) failed after 3 months. Conclusion: The present study showed that the Dyna dental implant system had high implant survival, and it had all the survival criteria similar to world-class dental implant systems.

Central Odontogenic Fibroma Accompanied by a Central Giant Cell Granuloma-Like Lesion: Report of a Case and Review of Literature

Central giant cell granuloma (CGCG) is a benign non-neoplastic intraosseous lesion mainly found in the anterior mandible. It is characterized by multinucleated giant cells, representing osteoclasts or macrophages. Central odontogenic fibroma (COF) is an uncommon benign lesion of the jaws. It originates from the odontogenic ectomesenchyme. In rare cases, COF may accompany a CGCG. To date, 49 cases of COF accompanied by CGCG-like lesions have been reported in the literature. In this paper, we present another case of COF-CGCG in a 46-year-old female. The lesion was located in the posterior mandible. Excisional biopsy was carried out, and histopathological analysis revealed multinucleated giant cells with numerous strands of odontogenic epithelium. A literature review of previously reported cases was also performed.

Conflicts and Challenges of Truth-Telling in Dentistry: A Case-Based Ethical Analysis

Objectives: The basis of truth-telling is respecting the autonomy of patients and developing an ability to make informed decisions with valid consent. The purpose of this study was to ethically analyze the conflicts about truth-telling in dentistry. Materials and Methods: This case analysis focused on the issues of truth-telling in medicine and dentistry. The challenges encountered by dentists with respect to ethical issues related to truth-telling were discussed and analyzed by the research team. Results: The literature review showed that the issue of truth-telling in dentistry has been addressed from three aspects: Truth-telling about other dentists’ medical errors, truth-telling about dangerous, refractory, or incurable diseases, and truth-telling to children or incompetent individuals for decision-making. Conclusion: When the duty of the dentist in truth-telling is conflicted with some other moral obligations, the conflict between the prima facie duties arises. The principle-based ethical theories provide a suitable conceptual framework for moral judgement in such conflicts. In cases of conflicts related to truth-telling, a balance should be maintained between principles and rules such as fidelity, respect for autonomy, maintaining trust in dentist-patient relation, and best interest of patients. The decision in truth-telling should be made individually for each patient based on the specific contextual conditions.

Effect of Thickness on Fluorescence of Some Clinical Dental Ceramics

Objectives: This study aimed to develop a new method for measurement of florescence and compare the fluorescence of some clinical dental ceramics in different thicknesses. Materials and Methods: Forty-eight samples of feldspathic (Vita VM9, A2), IPS e.max (Ivoclar HT, A2), zirconia (Korox Zircostar, A2) and Enamic (Vita A2) ceramics were used in this study in 0.5 and 1 mm thicknesses. The fluorescence of the samples was measured by using a developed technique. The results were analyzed by two-way ANOVA and Duncan post-hoc test. P<0.05 was considered significant. Results: Enamic, feldspathic and e.max ceramics had significantly different fluorescence in descending order (P=0.000). Fluorescence of ceramics increased with an increase in their thickness from 0.5 to 1 mm (P=0.007). Conclusion: The results confirmed the applicability of the presented method for measurement of fluorescence of dental ceramics. While, the thickness of restoration determines the concentration of the fluorescent agent, some additional technical information is required for justification of the observed trend in the studied ceramics.

Endodontic Management of a Maxillary Lateral Incisor with Dens Invagination and Periapical Lesion: A Case Report and Mini Review of the Literature

Dens invagination (DI) is a dental anomaly that can cause pulpal and periapical pathoses of the affected tooth. We describe the treatment of a healthy 18-year-old female with a chief complaint of recurrent facial swelling pertaining to a peg-shaped maxillary lateral incisor with DI. Examinations showed necrosis of the involved tooth with symptomatic apical periodontitis. Cone-beam computed tomography corresponded to Oehlers type II DI. Orthograde endodontic treatment was performed. To completely debride the canal and resolve the persistent purulent discharge, various methods and medicaments were used in separate sessions including passive ultrasonic activation of 5.25% sodium hypochlorite solution, calcium hydroxide mixed with 2% chlorhexidine, and double antibiotic paste as intracanal medicament. After resolution of the symptoms, the root canal and the invaginated space were filled by a mineral trioxide aggregate plug and backfilled with thermoplasticized gutta-percha. At the one-year follow-up, complete bone healing was noted in the affected periradicular area.

Integration of Oral Health Interventions in the Health Promoting Schools Program in Iran: A Multi-Stakeholder Feasibility Assessment

Objectives: Based on the recommendations of the World Health Organization, we investigated the feasibility of oral health interventions (OHIs) as part of Health Promoting Schools (HPS) program in Karaj city elementary schools. Materials and Methods: OHIs were accepted to be integrated into the components of HPS program by using the nominal group technique (NGT) and semi-structured interviews. Three NGT meetings were held with the faculty members of the School of Dentistry, Tehran University of Medical Sciences, and Karaj elementary school health care providers. Semi-structured interviews were held with school health executives of the Ministry of Health and Medical Education. The expert panel edited the OHIs and corrected the fragmentations, overlaps, and duplications. OHIs were sent to 24 individuals in six multi-stakeholder groups (faculty members of pediatric dentistry and community oral health departments, elementary school administrators, executive managers of Ministry of Health and Medical Education, elementary school dean and school healthcare providers). They were asked to score the feasibility of each intervention on a scale of 0 to 10. Results: Based on the mean score of feasibility (threshold: 8) the OHIs were divided into two groups of feasible and infeasible. Eighty-six interventions were feasible, with a total mean score of 8.83±0.59 out of 10. The highest feasibility score was related to “comprehensive school health education”. Conclusion: Integration of OHIs in HPS program is acceptable and feasible. The results can help policy-makers support the integration of OHIs in HPS program and encourage them to implement the program at the national level.

Intraoral Bone Regeneration Using Stem Cells - What a Clinician Needs to Know: Based on a 15-Year MEDLINE Search

The choice of an appropriate autogenous source of stem cells has not been adequately addressed especially for intraoral bone regeneration. The current review aims to assess the clinical success of various human stem cells in oral bone regeneration. Articles studying the potential of various stem cells utilized for reconstruction of intraoral bone defects in humans were included in this review. Relevant articles were electronically searched in MEDLINE-PubMed database using keywords with different combinations. Only the articles published in English between 2006 and 2020 were included in this review. It was concluded that intra and extraoral stem cells can be successfully used for bone regeneration of various jaw defects. Depending on the origin, quantity, and quality, each cell type has its own advantages and disadvantages. Also, it brings to the fore the need for more clinical studies to validate and adopt the use of stem cells in regular clinical practice.

Efficacy of Low-Intensity Pulsed Ultrasound for Orthodontic Pain Control: A Randomized Clinical Trial

Objectives: This study aimed to assess the efficacy of low-intensity pulsed ultrasound (LIPUS) for orthodontic pain control. Materials and Methods: This spilt-mouth randomized controlled clinical trial was performed on 44 mandibular first molars of 22 orthodontic patients at the Orthodontics Department of Shahid Beheshti Dental University. Elastomeric separators were placed at the mesial and distal of mandibular right and left first molars by separating pliers. Randomly, LIPUS was used at one side for 7 min and the same device with 0-degree intensity was used as sham for the other side on the facial skin. The same procedure was repeated after 24 h. Patients recorded their level of pain at 1, 6, and 24 h, and also on days 2 to 7 after, using a visual analog scale (VAS). Results: The effect of type of treatment (P=0.019), time of assessment (P<0.000) and the interaction effect of type of treatment and time of assessment (P=0.055) on the pain score were all significant. The mean pain score in the LIPUS group was significantly lower than that in the control group at 24 h (P=0.002), 4 days (P=0.031) and 5 days (P=0.035). Conclusion: LIPUS can be safely used during orthodontic treatment for pain control since it is safe, non-invasive, low-cost, and easy to use.

Effect of Chemical and Mechanical Degradation on Surface Roughness, Topography, Gloss, and Polish Retention of Three Composites Polished with Five Polishing Systems

Objective: Finishing and polishing (F/P) of composites is a fundamental step influencing the clinical service of restorations. The aim of this study was to evaluate the effect of different F/P systems on surface roughness, gloss, and polish retention of composite resins. Materials and Methods: One-hundred and five disc-shaped specimens (4×4 mm) were made from nanofilled, microhybrid, and microfilled composites (n=35). The specimens were divided into five subgroups (n=7) for F/P with Sof-Lex (4-step), Shofu (4-step), Cosmedent (3-step), Diacomp Composite-Pro (2-step), and Opti1Step systems. The surface roughness values (Ra and Rz) were measured before and after pH-cycling and simulated toothbrushing. Surface topography was assessed by using a scanning electron microscope (SEM) at three magnifications. For assessment of surface gloss, 45 rectangular specimens (10×8×2 mm) were fabricated from three composites (n=15) and randomly allocated to five subgroups (n=3). Surface gloss was measured before and after aging. The mean values were calculated and analyzed by two-way ANOVA, Tukey, and t-test. Level of significance was set at 0.05. Results: The composite type had no significant effect on surface roughness (P>0.05); however, the type of F/P system significantly affected it (P<0.05). The pH-cycling and simulated toothbrushing had no significant effect on gloss or polish retention of the three composites (P>0.05). Conclusion: Type of F/P system had a greater effect on surface roughness and gloss of composite resins than the type of composite.