Assessment of knowledge, attitude, and behavior related to children's oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study.

Background: Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran. Methods: This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson's correlation tests and path analysis. Results: Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum. Conclusions: Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians' interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.

Effect of silver antibacterial agents on bond strength of fiber posts to root dentin

Abstract This study was conducted to evaluate whether antibacterial pretreatment irrigation with silver nanoparticles (SNPs) and silver diamine fluoride (SDF) has any effect on bond strength of fiber posts cemented with three types of resin cements in root canal space. Fifty-four endodontically treated maxillary central incisor roots were prepared for fiber post (FRC Postec Plus NO.3, Ivoclar Vivadent) cementation and divided into nine groups in terms of three cement types and two pretreatments with silver antibacterial agents. The cements were as follows: an etch-and-rinse cement (ER, Excite DSC/Variolink N), a self-etch cement (SE, ED Primer/Panavia F2.0), and a self-adhesive cement (SA, Panavia SA Luting Plus). For each cement, the control group was with no treatment and two experimental groups were with SNPs and SDF treatments that were used after acid-etching for ER cement and after EDTA treatment for SE and SA cements. After fiber post cementation, each bonded root was horizontally sectioned into 1-mm thickness microslices to create two slices for each root region (apical, middle and coronal) and underwent push-out bond strength (PBS) test. Data in MPa were analyzed with two-way ANOVA and Tukey test (p=0.05). The interaction of the pretreatment type and cement type was significant (p<0.001). SNPs and SDF significantly increased PBS with ER cement (p≤0.04). This positive effect was also marginally significant for SDF with SE cement (p=0.049). For SA cement, SNPs showed a significant positive effect, but SDF had a significant adverse effect on PBS (p<0.001). The effect of pretreatment with silver antibacterial agents prior to adhesive cementation of fiber posts depends on the resin cement used. Contrary to SNPs with beneficial or no significant effect on bonding for all cements, SDF exhibited a deleterious effect with self-adhesive cement.

Resumo Este estudo foi conduzido para avaliar se a irrigação de pré-tratamento antibacteriano com nanopartículas de prata (SNPs) e fluoreto de diamina de prata (SDF) tem algum efeito na resistência de união de pinos de fibra cimentados com três tipos de cimentos resinosos no espaço do canal radicular. Cinquenta e quatro raízes de incisivos centrais superiores tratadas endodonticamente foram preparadas para cimentação de pino de fibra (FRC Postec Plus NO.3, Ivoclar Vivadent) e divididas em nove grupos em termos de três tipos de cimento e dois pré-tratamentos com agentes antibacterianos de prata. Os cimentos foram os seguintes: um cimento etch-and-rinse (ER, Excite DSC / Variolink N), um cimento autocondicionante (SE, ED Primer / Panavia F2.0) e um cimento autoadesivo (SA, Panavia SA Luting Plus). Para cada cimento, o grupo controle foi sem tratamento e dois grupos experimentais foram com SNPs e SDF tratamentos que foram usados após o condicionamento ácido para o cimento ER e após o tratamento com EDTA para os cimentos SE e SA. Após a cimentação do pilar de fibra, cada raiz ligada foi seccionada horizontalmente em microclimas de 1 mm de espessura para criar duas fatias para cada região da raiz (apical, média e coronal) e submetida ao teste de resistência de união por push-out (PBS). Os dados em MPa foram analisados ​​com ANOVA de dois fatores e teste de Tukey (p = 0,05). A interação do tipo de pré-tratamento e tipo de cimento foi significativa (p<0,001). SNPs e SDF aumentaram significativamente o PBS com cimento ER (p≤0,04). Este efeito positivo também foi marginalmente significativo para SDF com cimento SE (p = 0,049). Para o cimento SA, os SNPs mostraram um efeito positivo significativo, mas o SDF teve um efeito adverso significativo no PBS (p <0,001). O efeito do pré-tratamento com agentes antibacterianos de prata antes da cimentação adesiva dos pinos de fibra depende do cimento resinoso utilizado. Ao contrário dos SNPs com efeito benéfico ou nenhum efeito significativo na adesão para todos os cimentos, o SDF exibiu um efeito deletério com o cimento autoadesivo.

Comparison of microleakage from stainless steel crowns margins used with different restorative materials: An in vitro study.

BACKGROUND: Obtaining optimal marginal adaption with prefabricated stainless steel crowns (SSCs) is difficult, especially after removing dental caries or defects in cervical areas. This situation requires the use of an SSC after tooth reconstruction. This study evaluated microleakage and material loss with five restorative materials at SSC margins. MATERIALS AND METHODS: One hundred and twenty primary molar teeth were randomly divided into six groups (n = 20). Class V cavities were prepared on the buccal surfaces of the teeth in groups 1-5. Cavities were restored with amalgam, resin-based composite, glass ionomer (GI), zinc phosphate, or reinforced zinc oxide eugenol (Zonalin). Group 6 without cavity preparation was used as a control. Restorations with SSCs were prepared according to standard methods. Then, SSCs were fitted so that the crown margins overlaid the restorative materials and cemented with GI. After thermocycling, the specimens were placed in 0.5% fuchsin and sectioned. The proportions of mircoleakage and material loss were evaluated with a digital microscope. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney tests. RESULTS: The groups differed significantly (P < 0.001). Amalgam and GI showed the least microleakage. Amalgam restorations had significantly less microleakage than the other materials (P < 0.05). Microleakage was greatest with resin-based composite, followed by Zonalin. Material loss was greater in samples restored with Zonalin and zinc phosphate. CONCLUSION: When SSC margins overlaid the restoration materials, cavity restoration with amalgam or GI before SSC placement led to less microleakage and material loss. Regarding microleakage and material loss, resin-based composite, zinc phosphate, and Zonalin were not suitable options.

Sealing of silorane-based composite in laser-prepared primary teeth: effect of acid etching.

PURPOSE: The purpose of this study was to evaluate the influence of prior etching on the sealing of silorane composite restorations in Class V cavity preparations prepared with an Er,Cr:YSGG laser compared to bur preparation in primary teeth. METHODS: Standard Class V cavity preparations were prepared on the buccal surfaces of 56 extracted primary canines and randomly divided into four groups of 14 teeth each, according to laser or bur preparation and the use of prior acid etching in the preparation. All cavity preparations were restored with silorane adhesive and silorane composite. After water storage and thermocycling, the specimens were placed in 0.5 percent basic fuchsin dye solution. Dye penetration was evaluated with a stereomicroscope. The data were analyzed with nonparametric tests (P=.05). RESULTS: Laser preparation and prior etching in bur-prepared cavity preparation had no significant effect on enamel sealing (P>.05), but significantly increased microleakage at the dentin margin (P<.001 and P=.001, respectively). Prior etching in laser-prepared cavity preparations significantly improved sealing at the enamel and dentin margins (P=.009 and P=.003, respectively). CONCLUSIONS: Prior acid etching may be necessary to ensure good marginal sealing when laser preparation is used. However, this step is not required when bur cutting is used in primary teeth.

Witkop tooth and nail syndrome: a report of three cases in a family.

Witkop tooth and nail syndrome is a rare autosomal dominant ectodermal dysplasia manifested by hypodontia and nail dysplasia. Tooth shape may vary, and conical and narrow crowns are common. Mandibular incisors, second molars, and maxillary canines are the most frequently missing teeth. Nail dysplasia affects the fingernails and especially the toenails and is often more severe in childhood. Nails may be spoon-shaped, ridged, slow-growing, and easily broken. We examined an Eastern Mediterranean family in which three siblings (two girls, one boy) had this syndrome. The severity of finger and toenail anomalies varied. The children's mother had no Witkop-related abnormalities, but their father was reported to have dental and nail anomalies. Early intervention is recommended to manage orofacial disfigurement and avoid negative social consequences for these children.

Microleakage of adhesive and nonadhesive luting cements for stainless steel crowns.

PURPOSE: This study's purpose was to compare the ability of 5 luting cements to reduce microleakage at stainless steel crown (SSC) margins on primary molar teeth. METHODS: Standard preparations were performed on 100 extracted primary molar teeth for SSC restoration. After fitting SSCs, samples were randomly divided into 5 groups of 20 teeth each, which were cemented with nonadhesive cement consisting of polycarboxylate (PC) or zinc phosphate (ZP), or with adhesive cement consisting of glass ionomer (GIC), resin-modified glass ionomer cement (RMGIC), or RMGIC with a bonding agent (RMGIC+DBA). After aging and thermocycling, the specimens were placed in 1% methylene blue, sectioned, and evaluated under a digital microscope. The data were compared between groups with the t test, analysis of variance, and the least significant difference test. RESULTS: Microleakage with adhesive cements was significantly lower than with nonadhesive cements (P<.05). Differences between cements were statistically significant at P<.001. RMGIC+DBA showed the lowest microleakage, followed in increasing order by RMGIC, GIC, and ZP. The PC cement showed the greatest microleakage. CONCLUSIONS: Adhesive cements were more effective in reducing microleakage in stainless steel crowns than nonadhesive cements. Use of a bonding agent with a resin-modified glass ionomer cement yielded better results than using the latter alone.