Objectives: This study compared the penetration depth of three different root canal sealers—AH Plus resin-based, Apexit Plus calcium hydroxide (CH)-based, and BioRoot RCS bioceramic-based sealers—into dentin after removal of CH intracanal medicament. Materials and Methods: In this in vitro study, 60 extracted single-rooted mandibular premolars were decoronated with a diamond disc under water cooling to a standard length of 16mm; 12 samples were selected as control, and the rest received CH mixed with rhodamine dye as an intracanal medicament. Two weeks later, CH was removed by manual filing and irrigant activation using EndoActivator. Samples were then divided into 3 groups (n=12) depending upon the sealer used as AH Plus, Apexit Plus, and Bioroot RCS sealer. All sealers were combined with fluorescein dye, and obturation was performed using F3 gutta-percha with lateral compaction technique. After 2 weeks, the teeth were transversally sectioned into coronal, middle, and apical thirds. The penetration depth of sealers was measured via an imaging software. Statistical analysis was performed using ANOVA followed by the Tukey’s post-hoc test (alpha=0.05). Results: A statistically significant difference was observed among the groups (P<0.05). The penetration depth of sealers was the lowest in the apical third, and the highest in the coronal third in all three groups. BioRoot RCS showed the highest penetration depth at all three levels, despite CH medicament remnants. Conclusion: Bioroot RCS bioceramic sealer was superior to AH Plus resin-based and Apexit Plus CH-based sealers regarding penetration depth into dentin after removal of CH intracanal medicament.
Objectives: This study evaluated the reliability of panoramic radiography in comparison with lateral cephalometry for angular measurements in different skeletal classes. Materials and Methods: In this retrospective study, the gonial angle, the angle formed between the palatal plane and the Frankfort plane (palatal plane inclination), and the angle formed between the incisal edge of the upper incisor and the Frankfort plane (upper incisor vertical index) were measured on panoramic and lateral cephalometric radiographs of 278 patients in three skeletal classes. Intraclass correlation coefficient (ICC) was calculated to compare panoramic and lateral cephalometric radiographs. Paired t-test was used for comparison of the right- and left-side angles on panoramic radiographs. Results: The ICCs were 0.941, 0.927, and 0.954 for the gonial angle, 0.650, 0.605, and 0.320 for the palatal plane inclination, and 0.812, 0.810, and 0.758 for the maxillary incisor vertical index in skeletal Class I, II and III patients, respectively. The ICCs were all statistically significant (P<0.05) except for the palatal plane inclination in Class III patients (P>0.05). There was a significant difference in the gonial angle of Class II patients between the right and left sides (P<0.05). The upper incisor vertical index in the right and left sides showed significant differences in all three skeletal classes (P<0.05). The difference between the right and left sides in other angles and skeletal classes was not statistically significant (P>0.05). Conclusion: Skeletal class does not affect the reliability of panoramic radiographs for angular measurements, except for the palatal plane inclination in Class III patients.
Objectives: This study assessed the association of dental care utilization with individual and contextual characteristics, and measured disparities based on age and contextual deprivation. Materials and Methods: This cross-sectional study recruited 1,510 randomly selected adults residing in Tehran by phone-based interviews between January 2023 and June 2023. A questionnaire that consisted of questions about predisposing (sociodemographic), enabling (economic status, insurance coverage, neighborhood deprivation, and dental knowledge), and needs characteristics (oral health-related problems, and time loss) influencing dental care utilization was used for data collection. Dental care utilization was assessed using a dichotomized variable. The hierarchical logistic regression model and concentration indices were applied for data analysis using STATA 16 (alpha=0.05). Results: The participants' mean age was 46.21±18.43 years. Approximately 48.0% of the participants reported no dental care utilization. Enabling sources [dental insurance (P<0.001) and neighborhood deprivation (P<0.001)], and need factors [time loss due to oral conditions (P<0.001) and not wearing dentures P<0.001)] were significantly associated with dental care utilization. Age as a predisposing factor had a significant association with dental care utilization with a concentration index of -0.27 (P<0.001). Conversely, the concentration index of socioeconomic status was 0.03 (P=0.005). Conclusion: Disparities in dental care utilization were evident in more affluent groups and among younger age groups. Dental care utilization was associated with psychosocial loss, productivity loss, and contextual deprivation barriers. Moreover, Andersen’s model revealed that social structure, time loss, and enabling sources, rather than the other indicators, determined dental care utilization.
Objectives: This study aimed to examine the impact of social media oral health interventions, using storytelling and text-based education, on the knowledge, practice, and satisfaction of toddlers’ mothers. Materials and Methods: This controlled clinical trial was conducted in 2020 and involved 118 Iranian mothers with toddlers who were active Instagram users. The participants were randomly assigned to two groups storytelling (n=35) and text-based education (n=83). After two weeks, the mothers’ knowledge (n=8 questions), practice (n=7 questions), and satisfaction (n=5 questions) were assessed using an online questionnaire. The Mann-Whitney test and generalized linear model were used for statistical analyses (alpha=0.05). Results: The mean scores of knowledge, practice of mothers regarding their children, and their practice regarding themselves were 34.71±6.85, 10.54±5.05, and 8.65±1.84 in the storytelling group, and 34.87±6.80, 10.32±3.97, and 9.18±1.76 in the text-based education group, respectively. Of all, 71.4% of those in the storytelling group and 72.3% of the text-based education group described the received content as very good. Mothers’ knowledge (P=0.002, β=0.094) and practice regarding their children (P=0.041, β=0.099) were directly correlated with their satisfaction. The satisfaction score was significantly lower in mothers with a higher educational level (P=0.003, β=-1.3). Conclusion: While mothers displayed a relatively desirable level of knowledge, their oral health practice fell short. However, it is worth noting that mothers expressed high satisfaction with both interventions. Hence, online learning should be considered and promoted alongside traditional methods to effectively accelerate oral health practices. Implementing these methods over an extended period will help establish more sustainable effects Objectives: This study aimed to examine the impact of social media oral health interventions, using storytelling and text-based education, on the knowledge, practice, and satisfaction of toddlers’ mothers. Materials and Methods: This controlled clinical trial was conducted in 2020 and involved 118 Iranian mothers with toddlers who were active Instagram users. The participants were randomly assigned to two groups storytelling (n=35) and text-based education (n=83). After two weeks, the mothers’ knowledge (n=8 questions), practice (n=7 questions), and satisfaction (n=5 questions) were assessed using an online questionnaire. The Mann-Whitney test and generalized linear model were used for statistical analyses (alpha=0.05). Results: The mean scores of knowledge, practice of mothers regarding their children, and their practice regarding themselves were 34.71±6.85, 10.54±5.05, and 8.65±1.84 in the storytelling group, and 34.87±6.80, 10.32±3.97, and 9.18±1.76 in the text-based education group, respectively. Of all, 71.4% of those in the storytelling group and 72.3% of the text-based education group described the received content as very good. Mothers’ knowledge (P=0.002, β=0.094) and practice regarding their children (P=0.041, β=0.099) were directly correlated with their satisfaction. The satisfaction score was significantly lower in mothers with a higher educational level (P=0.003, β=-1.3). Conclusion: While mothers displayed a relatively desirable level of knowledge, their oral health practice fell short. However, it is worth noting that mothers expressed high satisfaction with both interventions. Hence, online learning should be considered and promoted alongside traditional methods to effectively accelerate oral health practices. Implementing these methods over an extended period will help establish more sustainable effects
Objectives: Using computers from a young age can affect cognitive development and social behavior of children. This study aimed to assess the effect of digital gaming habit on anxiety and behavior of children in a dental setting. Materials and Methods: A total of 137 children between 4 to 6 years seeking their first dental treatment were selected for this cross-sectional study. In the first session, the children were familiarized with the dental setting. In the second session, the parents received a questionnaire regarding the digital gaming habit of their children to fill out. Then, the children underwent dental treatment. The behavior of children during the procedure was video-taped, observed, and scored according to the Frankl behavior rating scale (FBRS) and the Venham clinical anxiety scale (VCAS). Data were analyzed by the Pearson’s correlation coefficient at 0.05 level of significance, and multiple linear regression-backward method at 0.1 level of significance. Results: The mean score of the gaming questionnaire was 44.21 out of 100. The coefficient for the correlation of VCAS and FBRS scores with the gaming questionnaire score was 0.556 and -0.496, respectively. The FBRS and VCAS scores had no significant correlation with demographic variables (P>0.1). But the gaming questionnaire score had a significant correlation with mothers’ occupation (P=0.072). Conclusion: The present results revealed that digital gaming habit increased dental anxiety and negative behavior of children. It is imperative to educate the parents and children at the community level regarding selection of appropriate games and duration of playing.
Objectives: This study assessed the mandibular ramus for safe miniscrew placement in an Iranian population using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study was conducted on 212 CBCT scans. The mandibular ramus thickness and depth were measured as the distance between the buccal and lingual surfaces, and the distance between the anterior border of the ramus and the mandibular canal, respectively, at the occlusal plane level and 5mm and 10mm above it. Two-way ANOVA was applied to analyze the effects of gender and presence of third molars on ramus depth and thickness. The right and left sides were compared by paired t-test (alpha=0.05). Results: As moving from the occlusal plane to 5 and 10mm above it, ramus depth increased while its thickness decreased. In presence of third molars, ramus thickness and depth in males were greater than those in females at both sides. Ramus depth was significantly greater in the right side than the left side at all levels (P<0.001). Presence of third molars (P=0.001, P=0.053) and gender (P<0.001, P=0.052) significantly affected the left-side ramus depth at the occlusal level and 5mm above it. Gender significantly affected the right-side ramus depth at 5 and 10mm levels (P=0.013). Conclusion: Presence of third molars increased ramus depth and thickness. Ramus depth and thickness were greater in males than females. Miniscrew placement is recommended at 5mm above the occlusal level due to sufficient depth and thickness of the ramus at this region.
Objectives: This study evaluated the impact of different cleaning methods on microshear bond strength (µSBS) of contaminated yttria-stabilized tetragonal zirconia polycrystal ceramic to self-adhesive resin cement, and surface wettability. Materials and Methods: In this in vitro study, sandblasted zirconia plates measuring 10×10×3mm were randomly divided into 6 groups: a non-contaminated (NC) negative control group and 5 experimental groups that were contaminated with human blood and saliva, and cleaned with (c) air-water spray (CW) as positive control, (c) 70% ethanol (CE), (d) 1.0wt% sodium hypochlorite (SHC), (e) Zirclean (CZ), and (f) nonthermal atmospheric plasma (NTAP) (air plasma type). Surface wettability was then calculated. Sixteen Tygon tubes (0.8×2mm) filled with Theracem self-adhesive resin cement were bonded to the zirconia specimens, and underwent µSBS testing after one week of storage. Data were analyzed by one-way ANOVA and Tukey’s test (α=0.05). Results: SHC and NTAP yielded the highest µSBS values, with no significant difference with the NC group (P>0.05). CW produced the lowest µSBS, which was not significantly different from the CE and CZ (P>0.05). CE showed the highest contact angle, which was not significantly different from the NC and CZ (P>0.05); SHC produced the lowest contact angle. There was no significant difference in contact angle between NTAP and CW (P>0.05), but their contact angle was larger than that of SHC (P=0.014). Conclusion: Cleaning zirconia with SHC and NTAP controlled the impact of saliva and blood contamination, and produced a µSBS to self-adhesive resin cement comparable to the positive control.
Objectives: Increased consumption of non-alcoholic carbonated soft drinks, diet sodas, and fruit juices greatly contributes to dental erosion. This study aimed to compare the microhardness of primary tooth enamel before and after exposure to fresh and industrial (commercial) orange juices. Materials and Methods: In this in vitro experimental study, 30 enamel blocks were obtained from primary teeth, and randomly divided into three groups (n=10). The pH levels of fresh and commercial orange juices were measured. The enamel blocks were immersed in fresh and industrial orange juices for 10 minutes, 4 times a day, over a period of 15 days. Specimens in the third group were stored in artificial saliva to serve as the control group. Enamel microhardness was assessed using the Vickers hardness test both before and after immersion in orange juices. Data were analyzed using paired t-test and ANOVA (alpha=0.05). Results: There was a significant decrease in enamel microhardness in both the fresh and commercial orange juice groups (P<0.001), with no significant difference in this regard between the two orange juice groups (P=0.209). Conclusion: The microhardness of primary enamel can decrease following exposure to both fresh and commercial orange juices, but no significant difference was found between the two types regarding the enamel microhardness reduction.
Objectives: This study evaluated the effect of different surface treatments of nickel-chromium (Ni-Cr) alloy on its shear bond strength (SBS) to composite resin. Materials and Methods: In this in vitro study, 45 Ni-Cr discs were fabricated and randomly assigned to three groups (n=15). Group 1 underwent sandblasting with 50µm aluminum oxide (Al₂O₃) particles at 60psi for 10 seconds. Group 2 was treated with Er:YAG laser (500mJ, 10Hz, 5W for 20 seconds). Group 3 received sandblasting followed by Er:YAG laser irradiation. A universal adhesive containing 10-MDP monomer was applied on all specimens, and composite resin cylinders were bonded to the treated metal surfaces. After 10,000 thermal cycles (5°C/55°C), SBS was measured using a universal testing machine. Failure modes were examined under a stereomicroscope at ×40 magnification. Data were analyzed by one-way ANOVA (alpha=0.05). Results: Significant differences in the mean SBS was observed among the groups (P<0.001). Sandblasting + Er:YAG laser exhibited the highest mean SBS (14.32±1.83MPa), which was significantly greater than that of the sandblasting group (12.73±1.62MPa; P=0.036) and the Er:YAG laser group (6.85±1.60MPa; P<0.001). The sandblasting group also showed significantly higher SBS than the Er:YAG laser group (P<0.001). No significant difference was found in the mode of failure among the groups (P=0.999), with mixed failure predominating in all groups. Conclusion: Surface treatment of Ni-Cr alloy by a combination of sandblasting with Al₂O₃ particles and Er:YAG laser irradiation produced significantly higher SBS to composite resin than either sandblasting or Er:YAG laser treatment alone.
Objectives: A common inflammatory condition affecting oral health is periodontitis, which can lead to tooth loss if not treated early, as it destroys the supporting structures of the teeth. Fusobacterium nucleatum is an orange-pigmented bacterium commonly referred to as "the bridging species" between early and late colonizers in the oral microbiota, and it is associated with the progression of periodontal disease. This study aimed to develop an effective and precise multi-epitope vaccine against F. nucleatum, as there is currently no approved vaccine for periodontal disease. Materials and Methods: This study employed a computational method to design a multiple epitope-based vaccine against F. nucleatum using an immunoinformatics reverse vaccinology approach. FadA, a novel adhesin unique to F. nucleatum, was a suitable peptide for vaccine development. B- and T-cell epitopes were identified and assessed to design a multi-epitope vaccine. The developed vaccine construct was analyzed for potency based on its allergenicity, antigenicity, solubility, and stability. Results: The vaccine structure was non-allergenic and exhibited high antigenicity, stability, and solubility. This vaccine may be a candidate for eradicating F. nucleatum, based on predictions of immunogenicity responses. Conclusion: The designed vaccine construct could generate an effective immune response against F. nucleatum, owing to its high antigenicity and non-allergenicity
Objectives: Oral potentially malignant disorders may present as white, red, or mixed red-white lesions and require accurate early recognition. This study evaluated whether texture-analysis features extracted from clinical digital images could distinguish oral precancerous lesions from other oral mucosal lesions and normal mucosa using gray-level co-occurrence matrix (GLCM), gray-level run-length matrix (GLRLM), and wavelet analysis. Materials and Methods: Sixty-four clinical digital images were selected according to predefined inclusion and exclusion criteria. The dataset included leukoplakia, erythroplakia, oral submucous fibrosis, candidiasis, lichen planus, leukoderma, frictional keratosis, white spongy nevus, and normal mucosa. Regions of interest were extracted from each image, and texture features were derived using GLCM, GLRLM, and wavelet analysis. A support vector machine (SVM) classifier was then used to categorize images as oral precancerous lesions or non-precancerous/normal mucosa. Results: GLCM yielded the highest classification accuracy (88%), followed by GLRLM (81%) and wavelet analysis (79%). The corresponding sensitivity values were 77%, 64%, and 60%, and the specificity values were 93%, 90%, and 89%, respectively. The positive predictive values were 83% for GLCM, 75% for GLRLM, and 75% for wavelet analysis. Conclusion: GLCM-based texture features provided the best diagnostic performance in this dataset. These image-analysis methods may be useful as non-invasive adjuncts to conventional clinical examination and histopathological diagnosis; however, larger datasets and external validation are required before clinical implementation.
Objectives: Linear measurements play a pivotal role in determining bone quantity. This study aimed to assess the accuracy of cone-beam computed tomography (CBCT) in measuring the height of buccal bone in the maxillary anterior teeth, relative to the cementoenamel junction (CEJ). Materials and Methods: This Original Research study evaluated 33 maxillary anterior teeth (11 central incisors, 11 lateral incisors, and 11 canines) of 20 patients. Following surgical exposure, the distance between the CEJ and the buccal alveolar bone crest was measured with a digital caliper. Measurements were made by an oral radiologist twice with a 3-week interval on CBCT images. Data were analyzed using SPSS, and P≤0.05 was considered statistically significant. Results: The mean difference in buccal bone height between CBCT and clinical measurements was 0.45±0.38mm for central incisors, 0.26±0.29mm for lateral incisors, 0.52±0.42 mm for canines, and 0.41±0.37mm overall. No significant difference was detected between the CBCT and direct measurements (P>0.05). The frequency of inaccurate measurements (defined as differences greater than 0.5mm) was 36.4% for central incisors, 9.1% for lateral incisors, and 36.4% for canines. The intraclass correlation coefficient (ICC) between the twice-taken CBCT measurements (with a 3-week interval) was 0.972; while the ICC was 0.824 between the CBCT and direct measurements. Conclusion: CBCT may not be accurate enough to assess the position and height of thin buccal bone relative to the CEJ in the anterior maxilla. However, CBCT demonstrated sufficient accuracy in assessing the position of buccal bone crest for lateral incisors.
Objectives: The interaction of mouthwashes with orthodontic elastomeric materials may alter their mechanical properties. The main purpose of this study was to evaluate the impact of 0.05% sodium fluoride Oral-B PRO-Expert Multi Protection and fluoride-free Listerine Advanced with Tartar Protection mouthwashes on the force decay behavior of memory elastomeric chains. Materials and Methods: In this in vitro study, 90 pieces of closed gray memory elastomeric chains were randomly allocated to three distinct groups (n=30): control, sodium fluoride, and Listerine. The control samples remained fully submerged in artificial saliva over the course of the experiment. Test samples were placed daily for 1 minute in either sodium fluoride or Listerine mouthwash, then in a solution consisting of equal parts of mouthwash and artificial saliva for 30 minutes, followed by a thorough rinse with distilled water, and then placed back in the artificial saliva. Tensile tests were conducted at various time points (baseline, 1 hour, and 1, 7, and 28 days) (n=6). Data were analyzed by one-way and two-way ANOVA, and Tukey's post-hoc test (alpha=0.05). Results: All groups exhibited a continuous force decay over time (P<0.001). The experimental groups demonstrated significantly greater force decay compared to the control group (P<0.001). The sodium fluoride group exhibited significantly greater force decay compared to the Listerine group at all measured time points (P<0.001) except on day 28 (P=0.970). Conclusion: Both mouthwashes accelerated the force degradation of memory elastomeric chains, with sodium fluoride causing a greater reduction except on day 28.
Objectives: Proximal enamel stripping is one way to create space in orthodontic treatments that leaves grooves on the enamel surface and predispose teeth to caries. The aim of this study was to compare the two common stripping systems and the effect of polishing after the stripping process on the level of surface roughness. Materials and Methods: Twenty-five extracted teeth were randomly divided into five groups:untreated control (C), mechanical stripping (Sn), mechanical stripping and polishing (Sp), manual stripping (Dn), manual stripping and polishing (Dp). Mechanical stripping used a SWISS denta care Quality oscillating system, manual stripping used Dentaurum hand tapes, and polishing used Soflex disks. Teeth underwent pH-cycling and the amount of released calcium was measured by spectrometry. Samples were examined under atomic force microscopy (AFM) before and after demineralization. Baseline and post-demineralization surface roughness values (Ra, Rq, Rz) were calculated. Finally, scanning electron microscopy (SEM) images were obtained from two samples of each group. data analysis was done by One-way ANOVA. P-value<0.05 was considered statistically significant. Results: There was no significant difference between the stripping methods in terms of surface roughness parameters, but there was a significant difference between the polished and unpolished groups (P<0.05). Calcium release was significantly lower in the Sp group compared to the other groups (P<0.05). In SEM images, the least amount enamel damage was related to the Sp group. Conclusion: Unlike stripping systems, polishing is considerably useful in decreasing enamel roughness. Totally, mechanical stripping and polishing has shown the best consequences on enamel structure.
Objectives: This study assessed the impact of rinsing water temperature on microleakage of dental composite restorations. Materials and Methods: This in vitro study was conducted on 72 extracted premolars. Buccal and lingual Class V cavities were prepared with gingival margins 1 mm beneath the cementoenamel junction (CEJ) and occlusal margins 2 mm above the CEJ. The specimens were classified into three groups (n=24) for rinsing with water at 23°C, 4°C, and 45°C before the bonding procedure. Lingual cavities were bonded with a self-etch adhesive, and buccal cavities were bonded with a total-etch adhesive. After composite restoration, the specimens underwent 1000 thermal cycles between 5-55°C. They were then divided into two groups for storage for either 24 hours or 2 months. Optical and electron microscopic assessments were performed to score microleakage at the occlusal and gingival margins of the specimens. The Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests were run to analyze the data (alpha=0.05). Results: Regardless of the bonding system and storage time, microleakage was significantly higher in the 4°C rinsing water group (P<0.05). Gingival margins bonded with the total-etch adhesive had a significantly higher microleakage than the occlusal margins in both 23°C and 45°C groups (P<0.05), but the self-etch adhesive showed no significant difference (P>0.05). Conclusion: According to the results of this in vitro study, rinsing the cavity with warm water (23°C and 45°C) appears to be an effective method to reduce the rate of microleakage.
Objectives: This study evaluated the effects of 660 and 940nm lasers on viability and proliferation of stem cells from human exfoliated deciduous teeth (SHED). Materials and Methods: SHED were cultured and divided into six groups for laser irradiation: 660nm laser at 25mW with energy densities of 1 and 2J/cm2 for 8 and 16 seconds, and 940nm laser at 100mW with the same energy densities and durations. Two additional groups served as controls with no laser exposure. Cell viability was evaluated by the methyl thiazolyl tetrazolium (MTT) assay, and cell proliferation was measured by cell counting with a Neubauer chamber and qualitatively evaluated by 4',6-diamidino-2-phenylindole (DAPI) staining at 24 and 72 hours post- irradiation. Data were analyzed using one-way ANOVA, followed by Tamhane's and Tukey's tests. Results: Irradiation with 940nm laser enhanced cell proliferation compared to both 660nm laser and control groups at 24 and 72 hours (P<0.05), as confirmed by DAPI staining. At 24 hours, all laser-treated groups showed increased cell viability relative to the control, although the increase in the 660nm/2J/cm² group was not statistically significant (P>0.05). At 72 hours, only 940nm laser group showed significantly higher cell viability and proliferation than the control group (P<0.05). Conclusion: These findings suggest low-level laser therapy, particularly at the wavelength of 940nm enhances the viability and proliferation of stem cell, supporting its potential as a promising tool in regenerative medicine and tissue engineering.
Objectives: The objective of this study was to investigate tooth discoloration caused by different calcium silicate-based cements (CSCs), and assess the efficacy of two bleaching techniques in restoring the original tooth color. Materials and Methods: In this in vitro study, 54 sound teeth were divided into three groups (n=18) of Endocem, MTA Angelus, and calcium-enriched mixture (CEM) cement. Baseline color assessments were conducted using a spectrophotometer, with subsequent color evaluation after 3 months. Each group was divided into two subgroups of internal bleaching and internal/external bleaching. The bleaching procedure was performed over a 2-week period. Two-way ANOVA was applied to investigate the interaction effect of bleaching technique and time on color change (∆E). The Tukey’s test was used as post-hoc for pairwise comparisons. P≤0.05 was considered significant. Results: The results indicated noticeable color change in all test groups, surpassing the perceptibility threshold (ΔE>3.3). Endocem exhibited the maximum discoloration, while CEM cement displayed the minimum. Significant differences were observed between Endocem and other groups (P<0.05). Regarding the L*, a*, and b* parameters, no significant differences were found between the two subgroups except in Endocem group, where internal/external bleaching caused a significantly greater increase in color parameters compared to internal bleaching (P=0.001). Conclusion: Endocem induced more discoloration than MTA Angelus and CEM cement. However, there was no difference in efficacy between the internal and internal/external bleaching techniques (except in Endocem), both proving effective in restoring the original color of discolored teeth.
Objectives: Hypericum perforatum (H. perforatum) has natural anti-inflammatory properties when used as a dressing on ulcers and burn wounds. The aim of this study was to investigate the effect of topical application of hydroethanolic gel of H. perforatum on soft tissue healing in tooth extraction sockets. Materials and Methods: This split-mouth randomized controlled clinical trial was performed on 30 patients aged 18-30 years who required simultaneous extraction of maxillary premolars bilaterally for orthodontic reasons. After tooth extraction, 2mL of 3% H. perforatum gel was injected into the extraction socket in the intervention side. Pain was measured based on a Numeric Rating Scale (NRS). Socket healing was assessed using the standardized Landry, Turnbull, and Howley index. Repeated measures ANOVA and generalized estimating equations (GEE) were employed to compare different indices between the two groups (alpha=0.05). Results: The mean age of the participants was 23.53 years. Of all, 25 were females and 5 were males. The intervention side had a significantly lower pain than the control side (P<0.05). The wound size decreased at 3 and 7 days, and it was smaller in the intervention side than the control side (P<0.05). The healing index score was significantly higher in the intervention side than the control side (P<0.001). Conclusion: The results showed that 3% H. perforatum hydroethanolic gel was effective for promoting soft tissue healing in tooth extraction sockets, decreasing pain, and improving the wound healing index.
Molarincisor hypomineralization (MIH) poses major restorative challenges due to compromised enamel and its reduced bonding capacity. This scoping review evaluated treatment options for MIHaffected young permanent teeth following PRISMAScR guidelines. A systematic search in PubMed, Cochrane, Science Direct and gray literature identified 21 eligible studies published between 2013 and 2025, including invitro and clinical studies. Laboratory findings demonstrated lower bond strengths in MIH enamel compared with the sound enamel. Etchandrinse adhesives performed more reliably than that of selfetch systems, while pretreatment procedures improved adhesion in some settings. Clinical studies showed resinbased sealants and composites bonded with etchandrinse adhesives achieved higher retention. Glass ionomer and glass hybrid restorations offered mostly short-term success and are best used as an interim option. Investigated indirect restorations provided superior longevity in severe cases. Preventive adjuncts such as applying varnishes reduced hypersensitivity and caries risk. Finally, this review highlights the central role of adhesive performance in MIH management.
This case report describes guided pulpal regeneration (GPR) of two immature permanent molar teeth with chronic apical abscess, thin dentinal walls, and open apices. Both teeth were treated with an identical protocol in two sessions, with minimum instrumentation with hand files, irrigation with 1.5% sodium hypochlorite (NaOCl), and application of 1:1 mixture of ciprofloxacin and metronidazole as an intracanal medicament, blood clot as a scaffold, and mineral trioxide aggregate (MTA) as the capping material. At the one-year follow-up, both treated teeth were asymptomatic. However, the root development procedure was different even in different roots of the same tooth, varying from only an increased thickness of dentinal walls to complete closure of the apex along with an increase in root length and dentinal wall thickness. It is concluded that the outcome of GPR is not completely predictable, and may vary among teeth with similar initial conditions and treatment approaches.
