Apical Debris Extrusion with Conventional Rotary and Reciprocating Instruments.

Introduction: The aim of the present study was to compare the amount of apical debris extrusion after preparation using hand files, reciprocating files, and full rotary nickel-titanium systems. Methods and Materials: One hundred extracted human mandibular molars with two separated canals in mesial root were divided into five groups and prepared using reciprocating systems (Reciproc file and Safesider endodontic reamers file), full rotary systems (Mtwo and Neoniti A1 files) and hand instrumentation systems. Endodontic access was prepared and a #15 K-file was passed beyond the apex of the mesiobuccal canal by 1 mm to ensure the canal patency. All mesiobuccal canals were prepared 1 mm shorter than the anatomic apex. In each case, extruded debris was collected in an Eppendorf tube and weighed after desiccation. The mean weight of extruded material was calculated in each group. The analysis was carried out using the Kruskal-Wallis test followed by two tailed and Mann-Whitney U test at a significance level of 0.05. The Bonferroni correction was also applied to correct multiple comparisons. Results: There was a statistically significant difference between the reciprocal and other techniques in debris extrusion (P<0.05). The order of groups ranked in terms of debris extrusion from the lowest to highest was as follows: 1) Hand instrumentation group (with crown down technique), 2) Mtwo group, 3) Neoniti A1 group, 4) Safesider endodontic reamer group, and 5) Reciproc group. Conclusion: Based on this in vitro study, all systems have some apical debris extrusion; however, using the hand instrumentation system resulted in extrusion of significantly less debris compared to the Reciproc group. It seems that hand and rotary instrumentation systems are better than reciprocating instrumentation systems in terms of the amount of debris extrusion.

Apical Extrusion of Intracanal Bacteria with Single File and Multifile Rotary Instrumentation Systems.

AIMS AND OBJECTIVES: Instrumentation techniques may cause extrusion of microorganisms and their products into the periapical region resulting inflammation and treatment failure. The aim of this ex vivo study was comparing the apical bacterial extrusion in canals prepared with single file versus multiple file rotary systems. MATERIALS AND METHODS: Ninety-two human single-rooted mandibular first premolars were used. Endodontic access cavities were prepared, and root canals were contaminated with an Enterococcus faecalis (E. faecalis) suspension. The samples were incubated at 37°C for 30 days; the contaminated teeth were divided into four groups of 20 specimens each (1: Reciproc, 2: Mtwo, 3: Neoniti A1, 4: Safesider). Six teeth were not infected and each were prepared with one of the above instruments were considered as negative and six teeth which had been previously infected, were used as positive control groups. Extruded bacteria from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbial samples were taken from the vials and incubated in brain heart agar medium for 24 h. The resulting bacterial titer, in colony-forming units per mL, was determined. The data entered into SPSS 18 software and were analyzed by Kruskal-Wallis and Mann-Whitney U-tests at 0.05 significance level. RESULTS: Mtwo multifile system showed significantly less bacterial extrusion than Safesider (P = 0.015) and Neoniti A1 (P = 0.042) but did not show significant difference with Reciproc system (P = 0.25). CONCLUSIONS: All instrumentation systems extruded bacteria beyond the apical foramen. However, this study showed that Mtwo multifile rotary system extruded fewer bacteria.

Comparison of Coronal Leakage in Tooth Preparation with Two Single File Systems and Three Obturation Techniques.

AIMS AND OBJECTIVES: Root canal preparation and obturation are of great importance in endodontics. Its purpose is to eliminate pulpal and periradicular disease. The aim of this study was to compare coronal bacterial microleakage in prepared root canals using Neoniti A1 and Reciproc files that obturated with lateral compaction, single cone gutta-percha, and hybrid (tapered cone/lateral compaction) methods. MATERIALS AND METHODS: In this ex vivo study, a total of 110 single-rooted mandibular first premolars were choose and randomly divided into two study groups A and B (each 45) that one group was prepared with Reciproc and another with Neoniti A1 and negative and positive control groups (each 10). Each group divided into three subgroups of 15 each and obturated using a single cone, lateral compaction, and hybrid (tapered cone/lateral compaction) techniques. For evaluation of coronal leakage, "two-chamber setup" was used. The solution of enterococcus faecalis culture was injected in the upper chamber and incubated. If the bacteria pass through the canal and obturation materials, the lower chamber becomes turbid. TSB medium in the lower chamber (apex) were investigated every day in terms of occurrence of turbidity, and the duration of occurrence of leakage was recorded. The data were analyzed using Chi-square test. RESULTS: Data analysis showed that in each group the difference in percentages between subgroups was statistically significant (P = 0.003). So that the highest and the lowest amount of leakage in both groups were related to lateral compaction and hybrid techniques, respectively. CONCLUSION: Under the conditions of this study, independent of the instrument used for canal preparation, hybrid method and then single-cone technique, however, were more effective in the prevention of coronal leakage than lateral condensation technique.

Comparison of Salivary Antioxidants in Children with Primary Tooth Abscesses before and after Treatment in Comparison with Healthy Subjects

Aim: The aim of this study was to compare the total antioxidant capacity (TAC) of children with primary molar abscesses before and two weeks after extraction of the infected tooth. Materials and methods: Forty one children aged between 3-6 years participatesd in this cross sectional study. The antioxidant activity of saliva was investigated in 20 patients with tooth abscesses affecting one of the first primary molars before and after tooth extraction in the case group and once in 21 children with no caries or dental problems in the control group. The FRAP (ferric reduction antioxidant power) method was used to measure the antioxidant power of salivary samples and TAC values were calculated. Data were analyzed with SPSS Version 16 using the paired t-test at a significance level of 0.05. Results: The mean antioxidant index increased in children after (509.2 ± 138.4) treatment (before 483.4 ± 183.6), but this difference was not significant (P=0.61). Also, there was no difference in the mean antioxidant index in control group (494.5±147.9) compared the study group before (P=0.83) and after (P=0.75) treatment. Conclusion: Under the conditions of this study the total antioxidant capacity of saliva was not compromised in children with abscessed teeth.

Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian Population.

OBJECTIVES: The objective of this study was to evaluate the prevalence of dental developmental anomalies in digital panoramic radiographs of the patients referred to the Zahedan medical imaging center and to evaluate the frequency of anomalies regarding the disorders in shape, position and number in the Southeast of Iran. MATERIALS AND METHODS: A total of 1172 panoramic radiographs from 581 males and 586 females aged over 16 years were obtained from the files of the Zahedan medical imaging center between the years of 2014 and 2015. The selected radiographs were evaluated in terms of the anomalies such as dilacerations, taurodontism, supernumerary teeth, congenitally missing teeth, fusion, gemination, tooth impaction, tooth transposition, dens invagination, and peg lateral. Then, the anomalies were compared to each other regarding the frequency of the anomaly type (morphological, positional and numerical). Data were evaluated using descriptive statistics such as frequency and percent, and statistical tests such as X(2) at 0.05 significant level using the Statistical Package for the Social Sciences version 16.5. RESULTS: The prevalence of dental anomaly was 213 (18.17%), which was higher in females (9.90) than male, (8.28), however, this difference was not statistically significant (P > 0.05). The prevalence of dilacerated teeth was 62 (5.29%), taurodontism 63 (5.38%), supernumerary teeth 6 (0.51%), congenitally missing teeth 13 (1.11%), fusion 1 (0.09%), gemination 1 (0.09%), impaction 40 (3.41%), transposition 2 (0.18%), dens invagination 16 (1.37) and peg lateral was 9 (0.77%). The prevalence of morphological anomaly was 152 (71.36%), malposition 42 (19.72%) and numerous anomaly was 19 (8.92%). CONCLUSIONS: Dental anomalies are relatively common; although their occurrence is not symptomatic, they can lead to several clinical problems in patients. Detailed clinical and radiographic assessment and counseling during patient visits is a critical factor in assessing the patient's degree of difficulty to help the dentist for better preparedness for the treatment.

In-vitro evaluation of coronal microbial leakage after post space tooth preparation.

BACKGROUND: The aim of this in-vitro study was to determine the occurrence of coronal microbial leakage in endodontically treated teeth that have been prepared for post space, and also determine the minimum and maximum time required for the permanent restoration of the teeth after post space preparation. METHODS: This experimental study was conducted using a simple random sampling. Fifty extracted single-root teeth with approximately the same length were selected for this study. In order to assimilate the samples length, the crowns of all teeth were cut perpendicular to the long axis of the teeth at a distance of 15 mm from the apex. The canals of 40 teeth were filled with gutta-percha and sealer and prepared for post placement. The teeth were divided randomly into two equal groups of 20 each. In one group, temporary dressing (Cavisol) was used while in the other group, no dressing was used. Five of the teeth were considered as a positive and 5 as a negative control group. For evaluation of microbial leakage, "two-chamber setup" was used. The solution of Proteus mirabilis with fresh culture was injected in the upper chamber and incubated. If the bacteria pass through the dressing and obturation, the trypticase soy broth (TSB) media become turbid. TSB medium in the lower chamber (apex) were investigated every day in terms of occurrence of turbidity and the duration of occurrence of coronal leakage was recorded. The data were analyzed using independent t-test. RESULTS: The leakage time in the group without temporary filling was within 7-21 days and it was within 28-47 days in group with temporary filling (P<0.001). CONCLUSIONS: The minimum time required for microorganisms to enter the canal in group with and without dressing was 28 and 7 days respectively. It is suggested that the teeth with post space preparation receive permanent restoration after RCT in the shortest possible time, to reduce the need for retreatment.

Effect of education based on the theory of planned behavior on adoption of oral health behaviors of pregnant women referred to health centers of Birjand in 2016.

OBJECTIVE: Oral health of pregnant women is very important because of the adverse effects of pregnancy on the oral hard and soft tissues and vice versa. The aim of this study was to evaluate the effect of education on oral health behaviors of pregnant women based on the theory of planned behavior in Birjand. MATERIALS AND METHODS: This quasi-experimental study was carried out among 150 pregnant women admitted to health centers, who were selected using simple sampling (75 females in each case and control group). Educational program through face-to-face training was performed in the case group, and the control group received only usual training through leaflet distribution. Data were collected using a questionnaire and analyzed by the Statistical Package for the Social Sciences version 18 software at 0.05 significance level. RESULTS: The most frequent age group was 26-30 years. Before the intervention, the mean scores of knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention, and performance of the intervention and control groups showed no significant difference (P ≥ 0.05). After the intervention, the average of all scores in the intervention group showed significant increase compared to the control group (P ≤ 0.05). CONCLUSION: Face-to-face training using the theory of planned behavior has positive impact on oral health behaviors of pregnant women. Accordingly, training sessions in order to raising awareness and positive attitude and controlling healthcare behaviors can improve oral health behaviors of pregnant women.

Histologic and histomorphometric evaluation of two grafting materials Cenobone and ITB-MBA in open sinus lift surgery.

AIMS AND OBJECTIVES: Alveolar ridge reduction caused after tooth extraction can be minimized through ridge preservation and application of graft materials. The aim of this study was to compare the histologic and histomorphometric aspects of bone particulated allografts, Cenobone and ITB-MBA, in the reconstruction of vertical alveolar ridge after maxillary sinus augmentation. MATERIALS AND METHODS: This clinical trial was performed among 20 patients. The participants were randomly divided into two groups of 10 participants. The first group received Cenobone and the second group received ITB-MBA. Tissue samples were prepared 6 months later at the time of implant installation and after successful maxillary sinus floor augmentation. Tissue sections were examined under a light microscope. The data were analyzed by Chi-square and t-test. RESULTS: The mean trabecular thickness of the samples in the Cenobone group was 13.61 ± 7.47 µm compared to 13.73 ± 7.37 µm in the ITB-MBA group (P = 0.93). A mild inflammation process (Grade 1) was detected in both the groups. The amount of remaining biomaterial in the Cenobone group was estimated to be 8 ± 19% vs. 7 ± 12% in the ITB-MBA group (P = 0.30). Bone formation was reported 49.71% in the Cenobone group vs. 40.76% in the ITB-MBA group (P = 0.68). The mean newly formed vessel in the Cenobone group was 0.64 ± 0.7 vs. 1.5 ± 2.3 in the ITB-MBA group (P = 0.14). CONCLUSIONS: There was no significant difference between the two groups of patients regarding trabecular thickness, remaining biomaterial allograft, and the density of blood vessels after sinus floor elevation; hence, there was no difference between the two groups regarding implant outcome. More designed studies as randomized controlled trials and controlled clinical trials, which evaluate the long-term implant outcome; comparing the different bone graft materials is also required to improve evidence on survival and success rate.

Evaluation of General Dentists' and Dental Specialists' Knowledge about Oral Cancer in South Khorasan-Iran 2014.

BACKGROUND: Oral cancer is one of the most prevalent cancers and one of the top ten causes of death in the whole world. Most oral cancers are diagnosed at late stages. Since dentists play a critical role in early detection of oral cancer, they should be knowledgeable and skillful in oral cancer diagnosis. The aim of this study was to survey dentist knowledge about oral cancer in Southern Khorasan Province. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted with dentists who participated in an in-service educational program at the Faculty of Dentistry of Birjand University of Medical Sciences in spring 2014. A questionnaire including demographic information with 11 questions regarding oral cancer was prepared. The participants were required to be complete the questionnaires within a specific time span. The data were analyzed using SPSS 15 software by t-test and one-way ANOVA at 0.05 confidence level. RESULTS: A total of 73 dentists out of 80 answered the questionnaires - 36 (49.3%) were females and 37 (50.7%) were males. Total mean score of knowledge was 7.91 ± 1 of 11. Mean scores of knowledge of male and female participants were 7.70 ± 1.83 and 8.13 ± 1.94 respectively. Mean knowledge score of general dentists was 7.41 ± 1.79 and of dental specialists was 9.44 ± 1.0 In spite of higher knowledge score of women compared to men and general dentists compared to dental specialists, these differences were not statistically significant (p=0.09). Tukey testing showed a significant difference between groups with 1-4 years of experience (8.74) and over twenty years of experience (6.50) ( p=0.001). CONCLUSIONS: Considering the good knowledge level of young dentists and the specialists and the importance of early diagnosis of oral cancer, it seems necessary to pay more attention to academic education for dentistry students, as well as holding retraining courses for experienced dentists, so that their knowledge not be reduced over time.