Posttraumatic Stress Disorder Risk and Benzodiazepine Dependence in Older Veterans with Insomnia Symptoms.

OBJECTIVES: To measure the rate of benzodiazepine receptor agonist (BZA) dependence in older veterans with insomnia symptoms chronically using BZAs and to assess for associations between high posttraumatic stress disorder (PTSD) risk and BZA dependence. METHODS: A cross-sectional study was conducted among veterans aged 55 years and older with insomnia symptoms (current or historical) and chronic use of BZAs (≥3 months). Measurements included the Primary Care-PTSD screen (score >2 indicates high PTSD risk) and Benzodiazepine Dependence Questionnaire. Logistic regression was used to test for associations between PTSD risk and BZA dependence. RESULTS: A high PTSD risk was observed in 40% of the participants (N = 33). One-fifth (21.7%, N = 18) of participants met the criteria for benzodiazepine dependence (score ≥23 on Benzodiazepine Dependence Questionnaire). Veterans with high PTSD risk were significantly more likely to have BZA dependence (odds ratio 10.09, 95% CI [2.39, 42.54], p = .002). CONCLUSIONS: In older veterans with insomnia symptoms and chronic use of BZAs, high PTSD risk is associated with elevated risk for BZA dependence, which may make discontinuation of these medications difficult. CLINICAL IMPLICATIONS: Clinicians should consider the strong association between PTSD symptoms and benzodiazepine dependence when developing plans to taper a BZA in veterans with these symptoms.

Assessment of photobiomodulation therapy by an 8l0-nm diode laser on the reversal of soft tissue local anesthesia in pediatric dentistry: a preliminary randomized clinical trial.

During the injection of local anesthesia in pediatric dental procedures, from the injection time until the elimination of tissue anesthesia, inevitable problems were reported. According to the encouraging results of previous studies addressing the positive effects of laser therapy on increasing the microcirculation, we aimed to investigate the clinical effect of photobiomodulation therapy on the reversal of soft tissue anesthesia in children. Using a split-mouth design, 34 children aged 4 to 8 years old, candidate for receiving local infiltration injection at both right and left side in mandible, were enrolled in the study. The mandibular right and left quadrants were randomly assigned to groups of laser or sham laser: in laser side, patients received 810-nm laser irradiation, and in the sham laser group, the patients had the laser in off mode at 45 min after injection with an interval of 7-10 days between two sessions of each quadrant treatments. The degree of anesthesia was evaluated using the palpation technique alternately every 15 min. Data were analyzed using paired sample t test and multiple linear regression test. The mean duration of anesthesia expressed in minutes was equal to 145.15 ± 23.27 and 188.82 ± 12.31 for the laser group and sham laser group, respectively. There was a significant difference in duration of anesthesia between two groups (P < 0.001). Considering the results and limitations of the present study, photobiomodulation therapy by 810-nm diode laser can be proposed as a non-invasive method in order to reduce the duration of anesthesia in pediatric patients.

The effect of low-level laser therapy (810 nm) on root development of immature permanent teeth in dogs.

Traumatic injuries and dental caries can be a big challenge to immature teeth. In these cases, the main purpose of treatment is to maintain the pulp vitality. The purpose of this study was to investigate the effect of low-level laser therapy on accelerating the rate of dentinogenesis in pulpotomy of immature permanent teeth (apexogenesis). Three dogs, 4-6 months old, were used in this study. One jaw in each dog was randomly assigned to laser irradiation group. All selected teeth were pulpotomized with mineral trioxide aggregate (MTA) and restored with amalgam. In the laser group, the Ga-Al-As laser (810 nm, 0.3 W, 4 J/cm(2), 9 s) was used on buccal and lingual gingiva of each tooth in 48 h intervals for 2 weeks. In order to observe the newly formed dentine, tetracycline was injected on the 1st, 3rd, 7th, and 14th day after the operation. Then, ground sections of teeth were observed under a fluorescence microscope. The data was analyzed with Generalized Estimating Equations (GEE) test. The mean distance between the lines of tetracycline formed on the 1st and 14th day was significantly higher in the laser group (P = 0.005). Within the limitation of this study, irradiation of Ga-Al-As laser (810 nm) can accelerate the rate of dentinogenesis in apexogenesis of immature permanent teeth with MTA in dogs.

Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A Double-Blind Randomized Controlled Clinical Trial.

Introduction: This study investigated the photobiomodulation effect of an 810-nm diode laser in adjunction with topical anesthesia on pain perception during infiltration anesthesia of primary maxillary molars in children. Methods: This double-blind randomized controlled clinical trial was conducted on 64 children (aged 5-9 years) requiring extraction or stainless steel crown for their primary maxillary molars. The patients were randomly allocated into two groups (n=32) of laser and control. In the laser group, the injection site (buccal and palatal mucosa) was irradiated with an 810-nm laser (200 mW, 5.2 J/cm2) after 20% benzocaine topical anesthetic application, while the control group received a placebo laser following topical anesthesia. The pain intensity experienced by children during needle insertion into the buccal and palatal mucosa was determined using a visual analog scale (VAS) and modified behavioral pain scale (MBPS). Results: According to the results of the VAS and MBPS, no significant difference was detected in pain scores between the laser and control groups neither in the buccal nor in the palatal mucosa (P>0.05). Conclusion: Photobiomodulation therapy with an 810-nm laser with the current setting adjunct to topical anesthesia did not promote significant additional effects on the pain intensity.

Microleakage of stainless steel crowns placed on intact and extensively destroyed primary first molars: an in vitro study.

PURPOSE: The purpose of this investigation was to evaluate the effect of residual tooth structure on the microleakage of stainless steel crowns cemented with glass ionomer on primary maxillary and mandibular first molars. METHODS: Thirty extracted primary molars were divided into 2 groups: group 1 included intact teeth; and group 2 included extensively carious samples. Each tooth received standard preparation, and each crown was luted with G-CEM on its specific specimen. Teeth were loaded vertically and transferred to distilled water. After thermocycling and immersing in methylene blue solution, the teeth were sectioned and examined microscopically for microleakage. Data were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests. RESULTS: All specimens (intact and damaged teeth) had microleakage, although most of these presented only minimum microleakage. No statistically significant differences were found in the microleakage of sound and extensively carious teeth on either the buccal (P=.62) or lingual (P=.65) side. Buccal (P=.73) and lingual (P=.63) surfaces showed similar microleakage scores in primary maxillary and mandibular molars. CONCLUSIONS: There was no significant difference in the microleakage of sound or extensively carious teeth and primary maxillary or mandibular first molars.

Effect of an Educational Pamphlet on Knowledge and Performance of Fitness Trainers about Traumatic Dental Injuries.

Objectives : Traumatic dental injuries (TDIs) commonly occur in sport clubs. The knowledge and performance of fitness trainers play an important role in management of such injuries. This study sought to assess the effect of an educational pamphlet on knowledge level and performance of fitness trainers about TDIs in Tehran in 2018. Materials and Methods: In this interventional study, a pamphlet was designed to enhance the knowledge level of fitness trainers. Ninety-five fitness trainers were randomly divided into two groups of intervention and control (n=49 in the control group and n=46 in the interventional group), and were requested to fill out a valid and reliable researcher-designed questionnaire about TDIs before and 1 month after pamphlet distribution. The questionnaire consisted of three domains of demographic information, knowledge questions, and performance questions. The results were analyzed using SPSS 25 via the Chi-square test and repeated measures ANOVA considering the intervention as the between-subject factor. Results: The knowledge score of fitness trainers about TDIs was not adequately high in the intervention or the control group before the intervention. After the intervention, the performance of participants improved in both groups. This increase was significantly greater in the intervention group (P=0.035). There was no significant difference between the two groups in the knowledge domain (P=0.185). Conclusion: Educational pamphlets can effectively enhance the knowledge level of fitness trainers about TDIs. However, the magnitude of this effect was not significant in our study. Future studies are recommended to compare the efficacy of educational pamphlets with other educational tools.

The Prevalence and Correlates of Fissured Tongue Among Outpatients in Andkhoy City, Afghanistan: A Cross-Sectional Study.

BACKGROUND: Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan. AIM: The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan. PATIENTS AND METHODS: The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18-80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18-80 years. RESULTS: The studied population consisted of 1182 participants, of whom 573 (48.5%) were males and 609 (51.5%) females. The prevalence of fissured tongue was 27.2% (95% CI: 24.7-29.9%) with males having significantly higher prevalence than females (47.5%, 95% CI: 43.3-51.6% versus 8.2%, 95% CI: 6.2-10.7%, p<0.001). Male participants (OR=7.1, 95% CI: 4.8-10.3), diabetes mellitus (OR=1.6, 95% CI: 1.1-2.3) and smokeless tobacco use (OR=12.0, 95% CI: 8.1-17.6) were the only variables independently associated with fissured tongue. CONCLUSION: This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs.

Effect of photodynamic therapy on microleakage of class V composite restorations in primary teeth.

BACKGROUND: Photodynamic therapy (PDT) is a treatment by which, light sensitive chemicals are activated at a specific wavelength, generating reactive oxygen species which can be antimicrobial and assist in disinfection. However, the oxygen radicals may interfere with the bonding process. The purpose of this study was to assess the effect of PDT with different photosensitizers on microleakage of composite restorations. METHODS: Seventhy-two primary teeth with sound labial/buccal and lingual surfaces were collected for this study. The teeth were randomly divided into four groups of control, PDT with indocyanine green, PDT with methylene blue, and PDT with toluidine blue. Next, the cavities were restored with composite resin. The specimens were stained with 0.5 % Fuchsine and sectioned. The specimens were observed under a microscope to determine the microleakage score. The microleakage was compared between the groups and between the occlusal and cervical walls in each group. Data were analyzed using SPSS version 25. RESULTS: According to the kruskal-wallis test, no significant difference was observed in microleakage between the groups in the occlusal wall (p = 0.859). However, there was a significant difference in the cervical wall between the control and toluidine blue (p = 0.019), and the control and methylene blue (p = 0.008) groups. The Wilcoxon test showed a significant difference in microleakage (p < 0.05) between the occlusal and cervical walls within each group. CONCLUSIONS: PDT may be used in cavities with enamel margins to decrease the microbial load and prevent secondary caries. PDT is not recommended for cavities with cementum margins. Alternatively, it can be performed with indocyanine green as photosensitizer in such cases.

Comparison of Microleakage of Pedo Jacket Crowns and Stainless Steel Crowns Cemented with Different Cements.

OBJECTIVES: This study aimed to assess the microleakage of Pedo Jacket crowns compared to stainless steel crowns (SSCs) cemented with different luting cements. MATERIALS AND METHODS: In this in-vitro experimental study, 80 primary molars were randomly divided into four groups of 20 each. Groups 1 and 2 were subjected to standard tooth preparation for SSC. Crowns in group 1 were cemented with glass ionomer (GI), and crowns in group 2 were cemented with a resin-modified glass ionomer (RMGI) cement. In groups 3 and 4, minimal tooth preparation was performed for Pedo Jacket crowns, and the crowns were cemented with RMGI and Panavia resin cement, respectively. Microleakage was measured at mesial and distal surfaces in micrometers (µm), and the mean value for each tooth was calculated. Oneway analysis of variance (ANOVA) was applied to compare the microleakage of the four groups. RESULTS: Group 3 (Pedo Jacket cemented with RMGI) showed the highest microleakage (1523.83±250.32 µm) with significant differences with the remaining three groups (P<0.001). Microleakage in group 4 (Pedo Jacket cemented with Panavia) was significantly lower than that in the other three groups (301.25±219.53 µm, P<0.001). Groups 1 (SSCs cemented with GI) and 2 (SSCs cemented with RMGI) were not significantly different in terms of microleakage (P=0.49) although group 1 showed slightly higher microleakage than group 2 (598.43±260.85 µm versus 500.25±124.74 µm). CONCLUSION: Pedo Jacket crowns can serve as an acceptable esthetic alternative to SSCs if cemented with resin cements.

Comparative evaluation of the effects of different methods of post space preparation in primary anterior teeth on the fracture resistance of tooth restorations.

Background. Severely damaged teeth do not have adequate structure to support the composite crown; therefore, use of the canal space has been suggested to increase retention. Furthermore, the effect of post space irrigation protocols on the fracture resistance of the primary anterior teeth has not definitely been studied in postoperative modalities. This study compared the fracture resistance of restorations of primary anterior teeth following irrigation of the post space with sodium hypochlorite and chlorhexidine with and without application of burs. Methods. Ninety-four extracted primary anterior teeth were selected. Root canal treatments were carried out, 4 mm of the post space was left empty and 1 mm was regarded as a bed. The post space was prepared with and without a bur and the irrigation procedures were carried out with 0.2% chlorhexidine and 2.5% sodium hypochlorite solutions. Composite posts were inserted into the canals and the crowns were restored. Following composite etching and light-curing, the fracture resistance of the restored teeth was determined by a universal testing machine. Results. In the sodium hypochlorite group, fracture resistance of the teeth was 376.8±107.29 N and 475.5±186.89 N without and with bur preparation, respectively. For chlorhexidine protocol, the values were 370.88±175.46 N and 430.85±178.22 N without and with bur preparation, respectively. The effect of irrigating material was not significant; however, the bur and irrigating preparation significantly increased the fracture resistance of the restored teeth (P=0.02). Conclusion. Post space irrigation with 0.2% chlorhexidine or 2.5% sodium hypochlorite did not significantly affect the fracture resistance of primary anterior teeth in the post treatment modality.

Comparison of Canine Overlap in Pediatric Patients Requiring Stainless Steel Crown Placement under General Anesthesia before and after the Procedure.

OBJECTIVES: Despite the increasing popularity of pediatric dental treatments under general anesthesia, information is scarce regarding occlusal changes in patients receiving stainless steel crowns (SSCs) under general anesthesia. This study sought to compare canine overlap before and after general anesthesia in children receiving SSCs. In case of a change, the possibility of returning to the preoperative state and the time required for this process were also evaluated. MATERIALS AND METHODS: This interventional, before-and-after study was performed on 60 children between 2 to 7 years of age requiring dental treatment under general anesthesia. The contact point of the most prominent area of the maxillary primary canine and mandibular primary canine was marked before and immediately after general anesthesia and at one and two weeks postoperatively. The change in canine overlap was analyzed using repeated measures analysis of variance (ANOVA) and linear regression test. RESULTS: Canine overlap significantly decreased immediately after general anesthesia (P<0.05). The mean bite opening was 0.51±0.22 mm at the site of the right canine and 0.50±0.185 mm at the site of the left canine. These values returned to their normal preoperative state after one week (P<0.05). Repeated measures ANOVA showed significant differences in this respect between the time points (P=0.002). CONCLUSION: The occlusion and vertical dimension of pediatric patients may change following dental treatment under general anesthesia; the magnitude of change in canine overlap may vary depending on the class of occlusion and number of SSCs placed. These changes are temporary and often resolve within a week.

Efficacy of articaine infiltration versus lidocaine inferior alveolar nerve block for pulpotomy in mandibular primary second molars: A randomized clinical trial.

Background: Successful anesthesia is a major concern in during pulpotomy treatment. The aim of this study was to compare the anesthetic efficacy of inferior alveolar nerve block using 2% lidocaine and buccal infiltration using 4% articaine for pulpotomy of mandibular primary second molars. Methods: This randomized cross-over clinical trial was performed in 23 children (five to eight-year-old) from July through November 2016, referred to the Department of Pediatric Dentistry, Tehran University of Medical Sciences who needed pulpotomy treatment in both mandibular primary second molars. The Patients' feeling during injection and their behavior during pulpotomy and post-treatment complications were registered. Wilcoxon Signed Ranks test was used for analyzing the data. A significant level of differences was taken as p≤ 0.05. Results: Patients' feeling during injection and post-treatment complications did not significantly differ between two groups (p>0.05). Patients' behavior during pulpotomy was significantly better in articaine group (p=0.004). Conclusion: Articaine buccal infiltration can be used successfully in pulpotomy of mandibular primary second molars. Iranian Registry of Clinical Trial: (IRCT2015042321484N2).

Thermal Changes in Root Surface of Primary Teeth During Root Canal Treatment With Diode Lasers: An In Vitro Study.

Introduction: Increased temperature due to the application of laser during root canal disinfection may damage periodontium, alveolar bone, and permanent dental germ. The aim of this study was to evaluate the temperature increase of the external surface of primary roots due to the application of 810 nm and 980 nm diode lasers. Methods: A total of 58 extracted human primary teeth were prepared and randomly divided into two groups: (a) 810 nm diode laser and (b) 980 nm diode laser. Then, each group was divided into 4 subgroups based on the location of the temperature measurement, including subgroup 1: external root surface of primary anterior roots (A); subgroup 2: external root surface of posterior teeth at inter-root space (IS); subgroup 3: external root surface of posterior teeth at outer-root space (OS) and subgroup 4: external surface of furcation area of posterior teeth (F). Results: The mean temperature rise in group a (7.02±2.95ºC) was less than that of group b (10.62±4.59ºC) (P<0.001). Also, a significant difference was found between the laser groups in terms of the mean temperature rise of the external root surface at IS, OS and F, with higher temperature increase occurring in all points in laser b. The comparison of irradiation points in each laser showed a higher mean temperature rise for IS than OS, but this difference was only significant in group b (P<0.001). Conclusion: Within the studied parameters, 810 nm and 980 nm diode lasers should be used cautiously in primary root canals because of their temperature rise during their application.

Effect of Layering Technique on Push-Out Bond Strength of Composite Resin to Intracanal Dentin of Primary Anterior Teeth.

OBJECTIVES: This in-vitro study aimed to compare the push-out bond strength of composite resin posts packed into the root canal of primary anterior teeth using two different layering techniques. MATERIALS AND METHODS: Thirty-two primary anterior teeth were randomly divided into two groups. In group 1, after the preparation of post spaces, a posterior composite resin (Filtek P60) was packed in three horizontal layers by a composite condenser instrument with a cylindrical tip using the horizontal layering technique (HLT). In group 2, this was done using a condenser with a conical tip in three funnel-shaped layers according to the funnel-shaped layering technique (FSLT). Next, the specimens were subjected to push-out bond strength testing. Data were analyzed using t-test and the Kaplan-Meier curves. RESULTS: The mean±standard deviation (SD) bond strengths of composite resin posts were 8.46±3.45 MPa and 7.7±2.24 MPa for the HLT and FSLT, respectively; the difference was not statistically significant (P=0.46). CONCLUSIONS: The layering technique by which composite resin was packed into the root canal of primary anterior teeth (HLT versus FSLT) had no significant effect on the push-out bond strength of composite resin posts.

Effects of Laser and Fluoride on the Prevention of Enamel Demineralization: An In Vitro Study.

Introduction: Investigations have demonstrated that fluoride is an essential element in preventive dentistry. However, there are still controversies about the preventive effects of various kinds of laser. The aim of this study was to examine the effect of diode laser irradiation (810 nm) with or without fluoride therapy in the prevention of deciduous enamel demineralization. Methods: Sixty deciduous molar crowns were randomly assigned to 6 groups: C: received no treatment; F: fluoride varnish application; 2L: 2 times diode laser irradiation; 4L: 4 times diode laser irradiation; F2L: 2 times laser irradiation over fluoride varnish; F4L: 4 times laser irradiation over fluoride varnish. Teeth in all groups were subjected to a pH-cycling process to produce artificial caries-like lesions. Results: The analysis of variance (ANOVA) of microhardness values indicated a significant great effect for laser, fluoride, and the interaction of laser- fluoride on reducing the final microhardness value (P<0.001). However, the 2L group was an exception. Despite the 4L group, it did not show a significant prevention of enamel microhardness loss (P=0.125). These 2 groups exhibited different effects in the absence of fluoride (P 2L-4L=0.05) while in the presence of the fluoride varnish, no statistically significant difference was observed between them (P F2L-F4L=0.257). Moreover, no statistically significant difference was observed between the laser-fluoride combination group and the fluoride group (P F2L-F=0.133, P F4L-F=0.926). Conclusion: Our results suggest that fluoride varnish, diode laser, and their combination decrease the loss of the enamel microhardness value and potentially prevent deciduous enamel demineralization. However, the combination of laser and fluoride was not more effective than fluoride.

Effect of antimicrobial photodynamic therapy on the counts of salivary Streptococcus mutans in children with severe early childhood caries.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) is a novel technique for reduction of pathogenic microorganisms in dentistry. The aim of this study was to evaluate the effects of aPDT on Streptococcus mutans reduction in children with severe early childhood caries. METHODS: Twenty-two children with severe early childhood caries aged 3-6 years were treated with toluoidine blue O (TBO) for 1min and irradiated by a Light Emitting Diode (LED; FotoSan, CMS Dental, Denmark) with the exposure time of 150s. Saliva samples were collected at baseline, 1h and 7 days after treatment. S. mutans counts were determined using the Dentocult SM Strip mutans. RESULTS: The counts of S. mutans in saliva decreased significantly after 1h (P<0.001). However, the difference in reduction of S. mutans counts in saliva was not significant between the baseline and 7 days after treatment (P>0.05). CONCLUSION: aPDT seems to be efficient to reduce salivary S. mutans immediately after treatment in children with severe early childhood caries. However, further research is needed to evaluate different doses and frequency of irradiation in combination with restoring carious teeth to find more durable results.

Comparison of Shear Bond Strength of Composite to Stainless Steel Crowns Using Two Mechanical Surface Treatments and Two Bonding Systems.

OBJECTIVES: This study aimed to compare the shear bond strength (SBS) of composite to stainless steel crowns (SSC) using two mechanical surface treatments (MSTs) and two bonding systems. MATERIALS AND METHODS: Eighty-four SSCs were divided into six groups of 14; Group1: No MST+Scotchbond Universal adhesive (N+U), Group 2: Surface roughening by a diamond bur+Scotchbond Universal adhesive (R+U), Group 3: Sandblasting+Scotchbond Universal adhesive (S+U), Group 4: No MST+Alloy Primer+Clearfil SE Primer and Bond (N+A), Group 5: Surface roughening by a diamond bur+Alloy Primer+Clearfil SE Primer and Bond (R+A), Group 6: Sandblasting+Alloy Primer+Clearfil SE Primer and Bond (S+A). After MST and bonding procedure, composite cylinders were bonded to the lingual surface of SSCs, then the SBS of composite to SSCs was measured using a universal testing machine following thermocycling. RESULTS: The SBS of groups R+U and S+U was significantly higher than that of group N+U. No significant difference was noted in SBS of groups R+U and S+U. The SBS of group S+A was significantly higher than that of groups N+A and R+A. No significant difference was noted in the SBS of groups N+A and R+A (P>0.05). CONCLUSIONS: In Scotchbond Universal adhesive groups, sandblasting and surface roughening by diamond bur significantly increased the SBS of composite to SSCs compared to no MST. In Alloy Primer groups, sandblasting significantly increased the SBS of composite to SSC compared to surface roughening with diamond bur and no MST.

Fracture resistance of three different posts in restoration of severely damaged primary anterior teeth: An in vitro study.

BACKGROUND: Restoration of anterior primary teeth with severe caries lesion is a big challenge. The aim of this study was to compare the fracture resistance of three types of post, including composite resin, customized quartz fiber and prefabricated glass fiber in restoration of severely damaged primary anterior teeth. MATERIALS AND METHODS: Sixty extracted human primary maxillary incisors were randomly divided into three groups: Group 1: Customized quartz fiber post, Group 2: Composite post and Group 3: Prefabricated glass fiber post. Due to the effect of bonded area on the fracture resistance, the bonded surface of each sample was measured 1 mm above cementoenamel junction. An increasing force was subjected with a crosshead speed of 0.5 mm/min by a universal testing machine until fracture occurred, and the failure mode was assessed afterwards. Data were analyzed using One-way analysis of variance and Kruskal-Wallis tests. The level of significance was considered at P < 0.05. RESULTS: The mean fracture resistance values of three groups were 343.28 N, 278.70 N and 284.76 N, respectively. Although customized quartz fiber post showed the greatest fracture resistance, statistical analysis revealed no significant difference between groups (P = 0.21). The mean fracture strength values of three groups were 12.82 N/mm(-2), 11.93 N/mm(-2) and 11.31 N/mm(-2), respectively; however, the differences were not statistically significant (P = 0.72). Favorable failure mode was more frequent in all groups (P = 0.12). CONCLUSION: Within the limitations of this study, it can be concluded that all three types of studied posts can be successfully used to restore badly destructed primary anterior teeth.

Excision of epulis granulomatosa with diode laser in 8 years old boy.

INTRODUCTION: Epulis granulomatosa is a lesion which grows from an extraction socket. It can be misdiagnosed with lesions of the same clinical appearance such as: foreign body or pyogenic granuloma, or as a herniation of the maxillary sinus. The most common treatment is surgical excision. CASE REPORT: The present article reports an Epulis granulomatosa which was removed with diode laser (810 nm) due to child's fear related to traditional surgical instruments and bleeding. RESULTS AND CONCLUSION: Lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients due to the rapid and regular wound healing without sutures.