Post-BSSO condylar position stability: a comparison of miniplate and lag screw fixation.

BACKGROUND: This study was conceived to assess the postoperative stability of condylar position following fixation with miniplates and lag screws after bilateral sagittal split osteotomy (BSSO). METHODS: This retrospective study included a cohort of 20 patients undergoing BSSO using the Obwegeser-Dal Pont modification. The bony segments were stabilized using either miniplates with two 2.0-mm monocortical screws per segment or three 2.0-mm bicortical lag screws along the mandible's superior border. Pre- and postoperative (7-day interval) spiral computed tomography scans were conducted to assess skeletal changes across both groups. Data analysis employed Wilcoxon signed-rank and Wilcoxon rank-sum tests (α = 0.05). RESULTS: No statistically significant difference was observed between the pre-and postoperative condylar position parameters (P>0.05). However, the lag screw group showed a marginal significant increase in the left condyle's angulation (preoperative: 24.83 ± 6.37 vs. postoperative: 32.5 ± 4.93; P = 0.04). Changes in condylar height, length, and width were not statistically significant before and after BSSO in either groups (P>0.05). Nor was any statistically significant difference found between the miniplates and lag screws groups regarding condylar position parameters (P>0.05). CONCLUSION: The results indicated that both lag screw and miniplate fixation methods can be effectively employed in BSSO procedures without impacting condylar position parameters. Thus, either fixation method can be chosen depending on factors such as the surgeon's preference and clinical outcomes.

The current techniques in dorsal augmentation rhinoplasty: a comprehensive review.

BACKGROUND: An essential aspect of rhinoplasty is the enhancement of the nasal dorsal contour by performing dorsal augmentation (DA) rhinoplasty. A wide range of techniques are available for DA as the demand for aesthetic nasal refinement grows. This review aims to provide a comprehensive overview of the current techniques used in DA rhinoplasty. MAIN BODY: Research articles on DA rhinoplasty techniques were identified through a comprehensive literature search. Scopus, PubMed, and Web of Science were used as electronic databases. Each database was searched for articles published since its inception. DA rhinoplasty techniques were examined in this literature review. Methodological quality was assessed for the selected studies, and data was extracted to examine materials used, surgical approaches, and reported outcomes for each technique. Various DA methods, including autologous grafts and synthetic implants, are examined in-depth in this review. Comparing approaches can help better understand their respective advantages and limitations. CONCLUSION: A wealth of techniques is available for DA rhinoplasty, each with advantages. Patients' nasal anatomy, desired outcomes, and potential risks must be considered by surgeons when determining their surgical approach. DA methods continue to evolve rapidly, creating a need for a thorough understanding of the current landscape to make informed decisions.

Sustained antibacterial activity of orthodontic elastomeric ligature ties coated with a novel kombucha-derived bacterial nanocellulose: An in-vitro study.

Incipient carious lesions, the most common complication in orthodontic patients with fixed appliances, call for the development of novel preventive dental materials that do not rely on patient adherence. The present study aimed to assess the ability of elastomeric ligatures coated with bacterial nanocellulose (BNC) to deliver sustained antibacterial activity, during the standard 28-day interval between orthodontic appointments, without compromising their mechanical properties. Kombucha membrane was used to produce cellulose as a secondary product from the fermentation of tea broth with symbiotic bacteria and yeast culture. Characterization of BNC-coated elastomeric ligatures was performed using Fourier Transform Infrared Spectroscopy and Energy Dispersive Spectroscopy analysis. The samples were pre-treated by immersion first in isopropyl alcohol, then in 8 mL nanocellulose solution for 7 days. Tensile strain and strength of the BNC-coated and conventional ligatures were evaluated using a tensile testing machine. Direct contact and agar diffusion tests were performed to assess the antibacterial activity of nanocellulose. In addition, the release profile of BNC was evaluated. Data analysis was performed by one-way analysis of variance (ANOVA) followed by post-hoc Tukey's test and Wilcoxon signed-rank test. P values less than 0.05 was regarded as significant. There was no statistically significant difference in tensile strain and strength between the BNC-coated and conventional ligatures. The coated ligatures provided sustained antibacterial activity during the required 28 days. The use of BNC-coated elastomeric ligatures in patients with fixed orthodontic appliances might be a promising solution to plaque formation and subsequent enamel decalcification.

Evaluation of BIRC6 Expression in Oral Squamous Cell Carcinoma, Epithelial Dysplasia, Lichen Planus with and without Dysplasia, and Hyperkeratosis.

BACKGROUND: BIRC6, regarded as the pivotal member of the inhibitor of the apoptosis (IAP) family, has been linked to the development of different types of cancer in humans. The objective of this study was to examine the expression of BIRC6 in various oral conditions, including OLP with dysplasia (OLPD), hyperkeratosis (HK), OLP, epithelial dysplasia (ED), and oral squamous cell carcinoma (OSCC), to investigate its potential involvement in the development of OSCC and the pathogenesis and malignant transformation of OLP, which is known as a precancerous condition. METHODS: In this retrospective cross-sectional study, 99 cases, consisting of 19 cases of OSCC, 21 cases of ED, 23 cases of OLP, 20 cases of OLPD, and 16 cases of HK as the control group, were investigated regarding BIRC6 expression by immunohistochemical staining. After that, the immunohistochemical expression of BIRC6 in the epithelial compartment was analyzed. Statistical analysis was performed to investigate the relationship between the expression of BIRC6 and clinicopathological variables. The statistical analysis of the data involved the use of one-way ANOVA, post hoc Tukey, Kruskal-Wallis, Chi-square, Spearman's correlation, and Mann-Whitney tests. The significance level was set at p < 0.05. RESULTS: Positive BIRC6 staining was found in 91.7% of the subjects of OLP, 88.1% of HK, 86.1% of ED, 93% of OLPD, and 94.7% of OSCC. OSCC showed the highest BIRC6 expression (p = 0.00). The average total staining score was remarkably greater in OSCC and dysplastic lesions compared with HK (p = 0.00, p = 0.00). CONCLUSIONS: While the current study suggested that BIRC6 may play a role in the tumorigenesis of OSCC, its role in the malignant transformation of OLP has yet to be definitively established.

The effect of nanobased irrigants on the root canal dentin microhardness: an ex-vivo study.

BACKGROUND: Given the favorable antimicrobial properties of zinc oxide (ZnONPs), standard silver (AgNPs), and imidazolium-based silver (Im-AgNPs) nanoparticles, this study aimed to evaluate their influence on the microhardness of root canal dentin. METHODS: In this experimental study, 40 mandibular premolars were decoronated at the cementoenamel junction and longitudinally sectioned into halves to create 80 specimens. They were randomly allocated to 5 groups (n = 16) and irrigated with ZnONPs, AgNPs, Im-AgNPs, NaOCl, or normal saline (as the negative control) for 15 min. The Vickers Hardness Number (VHN) was measured on each root canal third before and after being soaked in irrigants. Statistical analysis was performed using paired t-test, one-way ANOVA, and post hoc Tukey's test (α = 0.05). RESULTS: Im-AgNPs and ZnONPs irrigants improved the microhardness of root dentin, whereas, AgNPs and NaOCl decreased it. ZnONPs yielded the highest VHN at the coronal third (P˂0.001), while the Im-AgNPs provided the highest VHN at the middle and apical thirds (P˂0.001). The AgNPs group showed the lowest VHN at the apical third. CONCLUSIONS: The irrigants containing Im-AgNPs and ZnONPs significantly enhanced the root dentin microhardness. However, the use of AgNPs resulted in decreased microhardness.

Bringing resistance modulation to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) strains using a quaternary ammonium compound coupled with zinc oxide nanoparticles.

Nowadays, there are concerns about the inadequacy of new antimicrobials and the rise of antimicrobial resistance. Hence, novel antibacterial agents need to be discovered. In this respect, the use of nanoparticles (NPs) seems promising. Zinc oxide nanoparticles (ZnONPs) are functional and inexpensive NPs that possess antimicrobial characteristics, stability, microbial selectivity, and an easy manufacturing procedure. Imidazolium is one of the quaternary ammonium compounds (QACs) frequently employed as antimicrobial materials in industrial and clinical fields. The present study successfully employed imidazolium to couple with ZnONPs to improve their antimicrobial properties. The antimicrobial activities of ZnONPs doped with imidazolium (IM@ZnONPs) compared to ZnONPs and zinc (Zn) ions against some pathogen microorganism species including Streptococcus aureus (S. aureus), Enterococcus faecalis (E. faecalis), methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Candida albicans (C. albicans) were evaluated by the microdilution method. The minimum inhibitory concentration (MIC) results revealed that the antimicrobial activities of Zn ions, ZnONPs, and IM@ZnONPs were concentration-dependent. Moreover, we found that the nanoparticulate forms of Zn had considerably stronger antibacterial activities, particularly against VRE and MRSA, compared to Zn ions which failed to restrain the microbial strains at the tested microdilutions of this experiment (MIC: ≥512 µg/mL). Interestingly, the incorporation of imidazolium into ZnONPs resulted in significant inhibition of microbial growth in antimicrobial-resistant pathogens at low concentrations (MIC: 32 µg/mL) and effectively improved the monodispersity of the final coated NPs in terms of size and morphology. To sum up, IM@ZnONPs can be a favorable substitute for conventional antimicrobial agents to combat antimicrobial resistance in many fields, including pharmaceuticals, dental materials, and cosmetic products.

The antimicrobial efficacy of nanographene oxide and double antibiotic paste per se and in combination: part II.

BACKGROUND: Finding strategies to overcome the rising trends of antimicrobial resistance against currently available antimicrobial agents has become increasingly relevant. Graphene oxide has recently emerged as a promising material due to its outstanding physicochemical and biological properties. This study aimed to validate previous data on the antibacterial activity of nanographene oxide (nGO), double antibiotic paste (DAP), and their combination (nGO-DAP). METHODS: The antibacterial evaluation was performed against a wide range of microbial pathogens. Synthesis of nGO was achieved using a modified Hummers' method, and loading it with ciprofloxacin and metronidazole resulted in nGO-DAP. The microdilution method was utilized to assess the antimicrobial efficacy of nGO, DAP, and nGO-DAP against two gram-positive bacteria (S. aureus and E. faecalis), two gram-negative bacteria (E. coli, and S. typhi), and an opportunistic pathogenic yeast (C. albicans). Statistical analysis was conducted using one-sample t-test and one-way ANOVA (α = 0.05). RESULTS: All three antimicrobial agents significantly increased the killing percent of microbial pathogens compared to the control group (P < 0.05). Furthermore, the synthesized nGO-DAP exhibited higher antimicrobial activity than nGO and DAP per se. CONCLUSION: The novel synthesized nGO-DAP can be used as an effective antimicrobial nanomaterial for use in dental, biomedical, and pharmaceutical fields against a range of microbial pathogens, including gram-negative and gram-positive bacteria, as well as yeasts.

The antimicrobial efficacy of graphene oxide, double antibiotic paste, and their combination against Enterococcus faecalis in the root canal treatment.

BACKGROUND: Inter-appointment medication of the root canals with appropriate intracanal medicaments has been advocated to improve root canal disinfection. Graphene oxide (GO) has shown promising antimicrobial activity against a wide range of microorganisms, besides the capability of carrying antibiotics. The current study aimed to compare the antibacterial activity of double antibiotic paste (DAP) and GO per se and in combination (GO-DAP) against Enterococcus faecalis (E. faecalis). METHODS: A total of 108 extracted human mandibular premolars were contaminated with three-week-old E. faecalis and subjected to a primary microbial assessment. The samples were categorized into 15 groups concerning the intracanal medicament (DAP, GO, GO-DAP, and control) and contact time (1, 7, and 14 days). Then, the root canals were medicated, incubated, and resubjected to a secondary antimicrobial evaluation. The colony-forming units (CFU) were counted to calculate the antimicrobial efficacy. The data were analyzed via the Kruskal-Wallis test (α = 0.05). RESULTS: GO-DAP was the only medicament that completely eradicated E. faecalis in 1 day. The percentage reduction of CFU/ml in the GO-DAP and DAP groups was higher than that in the GO group at all allocated contact times. Furthermore, a significant decrease of the CFU/ml was seen in the GO and DAP groups after 7 and 14 days of being medicated (P < 0.05). CONCLUSION: Since GO-DAP improved root canal disinfection, this novel material can be introduced as a promising intracanal medicament against E. faecalis even in the short run.

The efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from root canals: an in-vitro study.

BACKGROUND: This study aimed to compare the efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from the artificial grooves in root canal walls. METHODS: The root canals of 50 extracted human maxillary incisors were instrumented by using the ProTaper rotary system up to #F4 (size 40/0.06 ProTaper) and the teeth were split longitudinally. Lateral grooves were created in the apical and coronal parts of one half and the middle part of the other half. Calcium hydroxide paste was applied to the grooves and the root halves were reassembled. After seven days, the calcium hydroxide was removed from the canal by using one of the EndoActivator, passive ultrasonic irrigation, and Ultra X devices; one group went without irrigation (control group). The CH remnants in the grooves were scored at 20× magnification. The data were analyzed by using the Kruskal-Wallis, Dunn's post hoc, and Friedman tests. P < 0.05 was considered to be statistically significant. RESULTS: No statistically significant difference existed among the experimental groups at the coronal and middle grooves (P > 0.05). However, Ultra X was significantly more effective than passive ultrasonic irrigation at the apical grooves (P = 0.023). CONCLUSION: Within the limitations of this study, Ultra X can be reported to remove the calcium hydroxide from the apical third more efficiently than passive ultrasonic irrigation.

An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy.

Regarding the common use of calcium silicate cements (CSCs) in root canal therapy, their position in the context of past and present dentistry agents can provide a better understanding of these materials for their further improvement. In this context, the present review article addresses a wide range of recent investigations in the field of CSC-based products and describes details of their composition, properties, and clinical applications. The need for maintaining or reconstructing tooth structure has increased in contemporary endodontic treatment approaches. This research thus discusses the attempts to create comprehensive data collection regarding calcium ion release, bond strength, alkalinizing activity and bioactivity, and the ability to stimulate the formation of hydroxyapatite as a bioactive feature of CSCs. Sealing ability is also highlighted as a predictor for apical and coronal microleakage which is crucial for the long-term prognosis of root canal treatment integrity. Other claimed properties such as radiopacity, porosity, and solubility are also investigated. Extended setting time is also mentioned as a well-known drawback of CSCs. Then, clinical applications of CSCs in vital pulp therapies such as pulpotomy, apexification, and direct pulp capping are reviewed. CSCs have shown their benefits in root perforation treatments and also as root canal sealers and end-filling materials. Nowadays, conventional endodontic treatments are replaced by regenerative therapies to save more dynamic and reliable hard and soft tissues. CSCs play a crucial role in this modern approach. This review article is an attempt to summarize the latest studies on the clinical properties of CSCs to shed light on the future generation of treatments.

Effect of Calcium Hydroxide and Nano Calcium Hydroxide on Push-out Bond Strength of Epoxy Resin Sealer to Root Canal Dentin.

Introduction: The goal of this paper was to determine the impact of calcium hydroxide (CH) and nano-calcium hydroxide (NCH) on the push-out bond strength of an epoxy resin-based sealer. Materials and Methods: A total of 48 mandibular premolars were decoronated in vitro and instrumented by a ProTaper rotary system up to F4. The specimens then were randomly allocated into 3 groups (n=16). The two intervention groups were treated with either CH or NCH and one control group which did not receive any intracanal medicament. After one week of medicament placement, the specimens were irrigated by 10 mL 17% EDTA, followed by 10 mL 2.5% NaOCl and an ultimate flushing by 5 mL sterile saline. The samples were obturated using AH-Plus Jet sealer and gutta-percha by lateral condensation technique. Push-out test was done by a universal test machine to evaluate the bond strength among the sealer and the root canal dentin. Repeated measurement analysis followed by Tukey's HSD and Bonferroni post-hoc tests were used for data analysis. Results: The control group showed a higher push-out bond strength in comparison to the specimens in the CH and NCH groups (P<0.05). In spite of the greater push-out bond strength of the samples treated with NCH in comparison to those in CH group, no statistically notable difference was found among them (P>0.05). Additionally, irrespective of the kind of medicament, the bonding at the apical level of the root canal was stronger compared to the coronal third (P<0.001). Conclusion: According to the present in vitro study, application of CH and NCH resulted in a significant reduction of the bond strength between the epoxy resin-based sealer and dentinal walls. Although, application of these medicaments resulted in reduction of bonding of epoxy resin-based sealers root canal dentin significantly.

Maintaining a Hopeless Traumatized Maxillary Central Incisor as a Transient Treatment Option: A Case Report with a 3-Years Follow-Up.

An open apices tooth is among the rare types of traumatic dental injuries is horizontal root fracture. Many factors may affect the treatment and prognosis of root fractures, like the time between trauma and treatment, degree of dislocation and mobility, stage of tooth development, fracture site, and patient's age. This case presents a horizontal root fracture of a maxillary central incisor in an 8-year-old boy. The tooth was considered for extraction due to excessive mobility and deep probing depth, but the patient's parents refused to extract the tooth. After one year, during the follow-up examination, we noticed an unprecedented healing process had been initiated. Due to the weak crown-to-root ratio, the traumatized tooth was splinted to the surrounding teeth to reduce the wrecking forces and promote healing. In a three-year follow-up, the cone-beam computed tomography examination showed that the coronal and apical fragments continued to develop separately. Also, it was observed that the mobility and probing depth were reduced significantly.

Familial aggregation of the metabolic syndrome: Tehran Lipid and Glucose Study.

AIMS: Familial aggregation of the metabolic syndrome has been reported in some nations. The aim of this study was to evaluate familial aggregation of the metabolic syndrome in Tehranian families. METHODS: In a cross-sectional study, anthropometry, blood pressure and biochemical data were collected for 4,558 individuals in the Tehran Lipid and Glucose Study. Variables of the metabolic syndrome in offspring were correlated with those of their parents. RESULTS: There were 1,274 fathers, 1,576 mothers, 802 sons and 906 daughters. Prevalence of metabolic syndrome was 24.4% for fathers, 39.7% for mothers, 9.0% for sons and 7.6% for daughters. Triglycerides and HDL-C of children whose fathers had metabolic syndrome, and BMI, triglycerides and HDL-C of those whose mothers had it were significantly different from those adolescents whose parents were free of metabolic syndrome. Compared with children whose parents did not have metabolic syndrome, the odds ratio (confidence interval) for children with both parents having metabolic syndrome was 4.53 (2.42-8.8) for metabolic syndrome, 2.22 (1.17-4.19) for abdominal obesity, 1.90 (1.15-3.13) for high blood pressure, 2.66 (1.77-4.00) for low HDL-C and 3.16 (2.10-4.75) for high triglyceride levels. CONCLUSION: This survey provides evidence suggesting that there is a familial aggregation of the metabolic syndrome among Iranian families.