Efficacy of mental-incisive nerve block in root canal treatment of mandibular first molars with asymptomatic irreversible pulpitis: a randomized controlled trial.

The aim of this study was to evaluate the effect of mental-incisive nerve block (MINB) along with finger pressure following inferior alveolar nerve block (IANB) on anesthetic success in mandibular first molars with asymptomatic irreversible pulpitis. In this randomized controlled trial, 70 patients were randomly divided into 2 groups (n = 35). Each patient in the control group received only a standard IANB injection of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. The injection was administered within 1 minute, using a standard aspirating dental cartridge fitted with a 27-gauge dental needle. In the intervention group, 15 minutes after injection of the standard IANB as described for the control group, each patient received a standard MINB injection of 1 mL of 2% lidocaine containing 1:100,000 epinephrine, administered by an operator not involved in assessing the outcomes. After the MINB injection, the patient applied firm finger pressure to the soft tissue of the mental foramen region for 1 minute using the hand on the side opposite to the injection. Objective assessment of tooth anesthesia was carried out with electric pulp tests (EPTs). In addition, the patients rated their pain during the initial steps of endodontic treatment based on a visual analog scale (VAS). The Mann-Whitney U and Wilcoxon tests were used for the analysis of data. Of the 35 patients in each group, 20.0% (7 patients) in the control group and 71.4% (25 patients) in the intervention group had no response to EPTs 15 minutes after injections; this difference was statistically significant (P < 0.05). The VAS pain scores were significantly higher in the control group than in the intervention group (P = 0.001). The administration of MINB with pressure following IANB significantly improved the success of anesthesia in mandibular first molars with asymptomatic irreversible pulpitis.

A review on potential toxicity of dental material and screening their biocompatibility.

OBJECTIVES: A wide range of compounds are utilized in dentistry such as dental composites, resins, and implants. The successful clinical use of dental materials relies on theirm physiochemical properties as well as biological and toxicological reliability. Different local and systemic toxicities of dental materials have been reported. Placement of these materials in oral cavity for a long time period might yield unwanted reactions. An extensive variety of materials is used in dentistry including filling materials, restorative materials, intracanal medicines, prosthetic materials, different types of implants, liners, and irrigants. The increasing rate in development of the novel materials with applications in the dental field has led to an increased consciousness of the biological risks and tempting restrictions of these materials. The biocompatibility of a biomaterial used for the replacement or filling of biological tissue such as teeth always had a high concern within the health care disciplines for patients. MATERIALS AND METHODS: Any material used in humans should be tested before clinical application. There are many tests evaluating biocompatibility of these materials at the point of in vitro, in vivo, and clinical investigations. RESULTS: The current review discusses the potential toxicity of dental material and screening of their biocompatibility. CLINICAL RELEVANCE: It is essential to use healthy and safe materials medical approaches. In dentistry, application of different materials in long-term oral usage demands low or nontoxic agents gains importance for both patients and the staff. Furthermore, screening tests should evaluate any potential toxicity before clinical application.

The Antibacterial Effect of Tetracycline-loaded Mesoporous Silica Nanoparticles in the Gingival Fluid at Implant-abutment Junction: A Randomized Clinical Trial Study.

INTRODUCTION: Dental implant failure due to periodontal disease caused by anaerobic pathogens occurs, especially in the first year of implant placement. The aim of this clinical trial study was to compare the antibacterial effect of tetracycline gel and gel containing tetracyclineloaded mesoporous silica nanoparticles (MSNs) in the gingival crevice fluid of the implantabutment junction as a randomized clinical trial study. MATERIALS AND METHODS: Fourteen patients applying for implants in the posterior mandibular region were included in the study. During the uncovering session, tetracycline gel and gel containing tetracycline-loaded MSNs were placed in two implants and no substance was placed in the control group. Then, in three sessions, including molding, prosthesis delivery, and one month after delivery, the patient's gingival fluid was sampled and the number of bacteria in the gingival fluid was measured by colony-forming units (CFU/mL). RESULTS: The results of this study showed that in all three stages of sampling, the use of tetracycline gel and gel containing MSNs loaded with tetracycline significantly reduced the CFU/mL of gingival crevice fluid compared to the control group. Tetracycline-loaded MSNs gel showed significantly lower CFU/mL than tetracycline gel. The release of tetracycline from nanoparticles keep continue for a longer time compared to tetracycline gel. CONCLUSION: The use of nano-based delivery systems containing antibiotics inside the implant fixture can reduce the bacterial count of the implant-abutment junction and then improve implant stability.

Effect of Incorporating Titanium Dioxide Nanoparticles into White Portland Cement, White Mineral Trioxide Aggregate, and Calcium Enriched Mixture Cement on the Push-out Bond Strength to Furcal Area Dentin.

Statement of the Problem: Bond strength of furcation repair materials is an essential factor in clinical success. Studies on the effect of adding titanium dioxide (TiO2) nanoparticles on the push-out bond strength of commonly used endodontic cements for furcation perforation repair is limited. Purpose: This study aimed to evaluate the effect of adding TiO2 nanoparticles to white Portland cement (PC), white mineral trioxide aggregate (MTA), and calcium enriched mixture cement (CEM) on their push-out bond strengths. Materials and Method: In this in vitro study, 120 endodontically treated molars were assigned to six groups (n=20) based on the material used to repair the perforation. In three groups, the cements (white PC, white MTA, and CEM) were placed in pure form, and in the three remaining groups, 1 weight % of TiO2 was added. The push-out bond strength was measured using a universal testing machine at a strain rate of 0.5 mm/min. Data were analyzed using one-way ANOVA and post hoc Games-Howell test (p< 0.05). Results: One-way ANOVA showed significant differences in the mean bond strength values between the six groups (p= 0.002). The post hoc Games-Howell test showed that the bond strengths in MTA+TiO2 and PC+TiO2 groups were significantly higher than those in MTA and PC groups, respectively. However, there was no significant difference in the bond strength between CEM and CEM+ TiO2 groups. Conclusion: The incorporation of TiO2 into MTA and PC increased their push-out bond strength. However, it did not affect the push-out bond strength of CEM cement.

Synthesis, characterization, and evaluation of Hesperetin nanocrystals for regenerative dentistry.

Hesperetin (HS), a metabolite of hesperidin, is a polyphenolic component of citrus fruits. This ingredient has a potential role in bone strength and the osteogenic differentiation. The bone loss in the orofacial region may occur due to the inflammation response of host tissues. Nanotechnology applications have been harshly entered the field of regenerative medicine to improve the efficacy of the materials and substances. In the current study, the hesperetin nanocrystals were synthesized and characterized. Then, the anti-inflammatory and antioxidative effects of these nanocrystals were evaluated on inflamed human Dental Pulp Stem Cells (hDPSCs) and monocytes (U937). Moreover, the osteoinduction capacity of these nanocrystals was assessed by gene and protein expression levels of osteogenic specific markers including RUNX2, ALP, OCN, Col1a1, and BSP in hDPSCs. The deposition of calcium nodules in the presence of hesperetin and hesperetin nanocrystals was also assessed. The results revealed the successful fabrication of hesperetin nanocrystals with an average size of 100 nm. The levels of TNF, IL6, and reactive oxygen species (ROS) in inflamed hDPSCs and U937 significantly decreased in the presence of hesperetin nanocrystals. Furthermore, these nanocrystals induced osteogenic differentiation in hDPSCs. These results demonstrated the positive and effective role of fabricated nanocrystal forms of this natural ingredient for regenerative medicine purposes.

Postoperative pain after endodontic treatment of mandibular molars with two different instrumentation techniques: A randomized clinical trial.

Background: This study compared postoperative pain after endodontic treatment of mandibular molars with asymptomatic irreversible pulpitis with the RaCe rotary system and the crown-down versus the step-down technique. Materials and Methods: In this randomized clinical trial, 70 mandibular 1st and 2nd molars with asymptomatic irreversible pulpitis and normal periradicular state were randomly assigned to two groups for single-visit endodontic treatment with RaCe rotary system and the crown-down and the step-down technique (n = 35). Postoperative pain was assessed at 6, 12, 24, 48, 72, and 168 h postoperatively, using a Visual Analog Scale. Data were analyzed using SPSS 17 by repeated measures ANOVA, Chi-square test, independent sample t-test, and lLeast sSignificant Ddifference test. P < 0.05 was considered statistically significant. Results: The two groups were not significantly different regarding the pain scores at any time point (P > 0.05). Within-group comparisons showed a significant reduction in pain score over time, starting from 12 to 168 h, postoperatively (P < 0.05). Conclusion: The crown-down and step-down techniques had no significant difference regarding postoperative pain after endodontic treatment of mandibular molars with asymptomatic irreversible pulpitis with the RaCe rotary system.

Nanoparticle Formulations of Antioxidants for the Management of Oxidative Stress in Stroke: A Review.

Stroke is currently one of the primary causes of morbidity and mortality worldwide. Unfortunately, there has been a lack of effective stroke treatment. Therefore, novel treatment strategies are needed to decrease stroke-induced morbidity and promote the patient's quality of life. Reactive oxygen species (ROS) have been recognized as one of the major causes of brain injury after ischemic stroke. Antioxidant therapy seems to be an effective treatment in the management of oxidative stress relevant to inflammatory disorders like stroke. However, the in vivo efficacy of traditional anti-oxidative substances is greatly limited due to their non-specific distribution and poor localization in the disease region. In recent years, antioxidant nanoparticles (NPs) have demonstrated a clinical breakthrough for stroke treatment. Some NPs have intrinsic antioxidant properties and act as antioxidants to scavenge ROS. Moreover, NPs provide protection to the antioxidant agents/enzymes while effectively delivering them into unreachable areas like the brain. Because of their nanoscale dimensions, NPs are able to efficiently pass through the BBB, and easily reach the damaged site. Here, we discuss the challenges, recent advances, and perspectives of antioxidant NPs in stroke treatment.

In vitro apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc and Reciproc Blue instruments and a novel stainless steel rotary system (Gentlefile) versus manual instrumentation.

Background: This study compared apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc, Reciproc Blue, and Gentlefile (GF) rotary instruments versus the manual step-back technique. Methods: This in vitro study was conducted on 80 extracted mandibular premolars with mature apices and a root curvature of<10°. The teeth were randomly assigned to 4 groups (n=20), standardized regarding working length, and placed in pre-weighed vials. The root canals were instrumented with Reciproc, Reciproc Blue, and GF systems and the manual step-back technique in the four groups. The vials containing the collected debris were then dried and weighed. The instrumentation time was also recorded for each group. Data were analyzed with one-way ANOVA and post hoc Games-Howell test (α=0.05). Results: Minimum apical debris extrusion was noted in Reciproc, followed by Reciproc Blue, GF, and manual technique (P<0.05). Pairwise comparisons showed significantly lower apical extrusion of debris in the Reciproc compared with GF (P=0.015) and manual instrumentation (P=0.011) groups. The Reciproc system also had the shortest instrumentation time, followed by Reciproc Blue, GF, and manual instrumentation (P<0.05). Pairwise comparisons showed significant differences between all the systems (P<0.05) except between Reciproc and Reciproc Blue (P>0.05) in this respect. Conclusion: Although all systems caused apical extrusion of debris, manual instrumentation caused maximum extrusion of debris. In contrast, the Reciproc system was superior to others regarding minimal apical extrusion of debris and the shortest instrumentation time.

Extracorporeal Shock Wave Therapy as a Helpful Method for Rapid Osseointegration of Dental Implants: Animal Study.

The aim of this study was to assess the multi-phasic use of extracorporeal shock wave therapy (ESWT) as an adjuvant treatment to accelerate the osseointegration of titanium dental implants. Initially, twelve titanium mini-screws were inserted in femur bones of six New Zealand rabbits in three groups; the one-time treated group, the three-time treated group, and the control group (without ESWT). Then, 1800 focused shockwaves with an energy flux density of 0.3 mJ/mm2 in every phase were used. Fourteen days after the last phase of ESWT, the animals were sacrificed to assess the osseointegration of screws via micro-computed tomography scan (micro-CT scan), biomechanical pull-out test, and histopathological analysis. Pull-out and histopathology analysis showed that the ESWT significantly increased bone regeneration and osseointegration around the implants compared to the control group (p < 0.05). Moreover, the pull-out test confirmed that the three-time treated screws needed more force to pull the bone out compared to the other two groups (p < 0.05). The mean bone volume fraction between the control group, the one-time treated group, and the three-time treatment group were not statistically significant (p > 0.05) according to the micro-CT scan results. Based on our results, ESWT can be suggested as a non-invasive and cost-effective adjuvant for osseointegration of dental implants. However, more in vivo studies and clinical trials are needed for validation of this finding.

The Effect of Low-Frequency Pulsed Electromagnetic Fields on the Differentiation of Permanent Dental Pulp Stem Cells into Odontoblasts.

Introduction: Exposure to pulsed electromagnetic field (PEMF) has been revealed to affect the differentiation and proliferation of human mesenchymal stem cells derived from dental pulp multipotent stromal stem cells (DP-MSCs). This study aimed to investigate the differentiation effect of electromagnetic fields (EMFs) on the DP-MSC. Materials and Methods: PEMF was produced by a system comprising a multi-meter autotransformer, solenoid coils, and teslameter. This study included 10 groups of DP-MSCs which underwent different electromagnetic radiation time and beam intensity. Three samples tested for each group. The effect of PEMF with the intensity of 0.5 and 1 mT (mili Tesla) and 50 Hz on the proliferation rate of DP-MSC was evaluated at 20 and 40 minutes per day for seven days. MTT assay was applied to determine the growth and proliferation of DP-MSC. Gene expression of DMP1 for differentiation of DPSCs to odontoblasts was confirmed by Real Time PCR., ANOVA statistical analysis and Kruskal-Wallis test were used to analyze the data. Results: The survival in all exposure groups was significantly higher than that in control except in the group of 40 minutes, 1 mT (P<0.05). In 20 minutes, 0.5 mT exposure, the survival intensity is significantly more than others (P<0.05). In general, the intensity of survival was recorded, 20, 0.5 mT≥20, 1 mT≥40, 0.5 mT≥40, 1 mT respectively. Therefore, according to the obtained results, ELF-EMF increases the survival of cells except for one case (40 minutes, 1 mT), even though the effective underlying mechanisms in this process are still unclear. Conclusions: The results obtained promise that in the future, by placing an important part of the pulp next to the electromagnetic field, the lost part of the pulp can be reconstructed and the dentin barrier can be created.

Osseous reaction to implantation of two endodontic cements: Mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM).

AIM: The aim of the present in vivo study was to determine bone tissue reaction to calcium enriched mixture (CEM) and mineral trioxide aggregate (MTA) using a rat femur model. STUDY DESIGN: Sixty-three rats were selected and randomly divided into three groups of 21 each [experimental groups (n=15), control (n=6)]. Implantation cavities were prepared in each femoral bone and randomly filled with the biomaterials only in the experimental groups. The animals in three groups were sacrificed 1, 4, and 8 weeks postoperatively. Histologic evaluations comprising inflammation severity and new bone formation were blindly made on H&E-stained decalcified 6-µm sections. RESULTS: At 1, 4, and 8 weeks after implantation number of inflammatory cells had decreased in the CEM, MTA and control groups, respectively, with no statistically significant differences. Conversely, new bone formation had increased in all the experimental and control groups, without statistically significant differences. CONCLUSION: The results suggest that biocompatibility of MTA, as gold standard, and CEM cement as a new endodontic biomaterial are comparable.

Safety issues of nanomaterials for dermal pharmaceutical products.

Nanomaterials (NMs) have favorable application in the medicine area, specifically in regard to the carry of pharmaceutical ingredients to provide targeted drug delivery systems. The skin is an excellent route for the delivery of pharmaceutical nano-transporters for skin-related applications. The physicochemical properties of nanomaterials such as size, hydrophobicity, loading capacity, charge and weight are vital for a skin penetrating system. Many nanocarriers such as polymeric nanoparticles, inorganic nanomaterials and, lipid nanostructures have been utilized for dermal delivery of active ingredients and others such as carbon nanotubes and fullerenes require more examination for future application in the skin-related area. Some negative side effects and nano-cytotoxicity of nanomaterials require special attention while investigating different nanomaterials for medicinal applications. Then, in the current review, we had a view on the safety issues of nanomaterials for dermal pharmaceutical products.

Antimicrobial Benefits of Flavonoids and their Nanoformulations.

Nowadays, there is an urgent need to discover and develop long-term and effective antimicrobial and biofilm-inhibiting compounds. Employing combination therapies using novel drug delivery systems and also natural antimicrobial substances is a promising strategy in this field. Nanoparticles (NPs)-based materials have become well appreciated in recent times due to their function as antimicrobial agents or carriers for promoting the bioavailability and effectiveness of antibiotics. Flavonoids belong to the promising groups of bioactive compounds abundantly found in fruits, vegetables, spices, and medicinal plants with strong antimicrobial features. Flavonoids and NPs have the potential to work as alternatives to the conventional antimicrobial agents, when used alone as well as in combination. Different classes of flavonoid NPs may be particularly advantageous in treating microbial infections. The most important antimicrobial mechanisms of flavonoid NPs include oxidative stress induction, non-oxidative mechanisms, and metal ion release. However, the efficacy of flavonoid NPs against pathogens and drug-resistant pathogens changes according to their physicochemical characteristics as well as the particular structure of microbial cell wall and enzymatic composition. In this review, we provide an outlook on the antimicrobial mechanism of flavonoid-based NPs and the crucial factors involved in it.

Portland Cement: An Overview as a Root Repair Material.

Portland cement (PC) is used in challenging endodontic situations in which preserving the health and functionality of pulp tissue is of considerable importance. PC forms the main component of mineral trioxide aggregate (MTA) and demonstrates similar desirable properties as an orthograde or retrograde filling material. PC is able to protect pulp against bacterial infiltration, induce reparative dentinogenesis, and form dentin bridge during the pulp healing process. The biocompatibility, bioactivity, and physical properties of PC have been investigated in vitro and in animal models, as well as in some limited clinical trials. This paper reviews Portland cement's structure and its characteristics and reaction in various environments and eventually accentuates the present concerns with this material. This bioactive endodontic cement has shown promising success rates compared to MTA; however, considerable modifications are required in order to improve its characteristics and expand its application scope as a root repair material. Hence, the extensive chemical modifications incorporated into PC composition to facilitate preparation and handling procedures are discussed. It is still important to further address the applicability, reliability, and cost-effectiveness of PC before transferring into day-to-day clinical practice.

Effect of intraradicular reinforcement strategies on the fracture strength of endodontically treated anterior teeth with overflared canals.

BACKGROUND: This study is done to evaluate the effect of different reinforcement techniques of overflared root canals with fiber posts on the fracture resistance of endodontically treated anterior teeth. It also introduces a new technique for simultaneous reinforcement and cementation of fiber posts using dual-cured core build-up composite resin. MATERIAL AND METHODS: The crowns of 48 single-rooted maxillary anterior teeth were cut and randomly divided into 4 groups (n=12) based on root reinforcement techniques after root canal treatment and post space preparation: Group 1: self-adhesive resin cement (SARC), Group2: dual-cure composite resin (DCC), Group3: Composite resin reinforcement (CRR), Group 4: Direct anatomical post (DAP). Then a core was made for the roots. The periodontal ligament was simulated using a thin layer of PVC impression material. A universal testing machine applied a compressive force to the lingual surface at an angle of 135 ° and 1 mm/min speed. Data were analyzed using One-Way ANOVA and a post-hoc Tukey test. Fracture patterns were analyzed using the Chi-square test (p<0.05). RESULTS: The difference between the control and DAP group was statistically significant (p=0.01), but there were no significant differences between other groups (p>0.05). Regarding fracture patterns, there were no significant differences between groups. CONCLUSIONS: All reinforcement techniques increased the fracture strength compared to the control group. However, DAP was the only group that had a statistically significant difference. CRR and DCC presented intermediate values without significant differences. Key words:Fiber post, endodontically treated teeth, root canals, reinforcement, fracture strength.

The Antimicrobial and Anti-Biofilm Effects of Hypericum perforatum Oil on Common Pathogens of Periodontitis: An In Vitro Study.

The antibacterial and anti-biofilm effects of Hypericum perforatum oil against the common pathogens of periodontitis (Escherichia coli, Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, Porphyromonas gingivalis) was investigated. Disk diffusion (DD), minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) approaches were applied to test the antimicrobial effects. In order to determine the anti-biofilm effects, the amount of bacterial biofilm formation was assessed using the microtiter plate technique. The anti-biofilm effects were then confirmed by determining the minimum biofilm inhibitor concentration (MBIC). The MIC, MBC, MBIC, and DD values were 64, 256, 512 µg/mL, and 14 mm for Staphylococcus aureus; 128, 256, 512 µg/mL, and 16 mm for Streptococcus mutans; 256, 512, 256 µg/mL, and 20 mm for Escherichia coli; 32, 128, 512 µg/mL, and 16 mm for Enterococcus faecalis; and 64, 128, 256 µg/mL, and 15 mm for Porphyromonas gingivalis, respectively. According to our results, Hypericum perforatum oil has antibacterial and anti-biofilm properties against the common bacteria associated with periodontitis.

The Link between Stroke Risk and Orodental Status-A Comprehensive Review.

One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person's general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. Stroke risk has long been linked to oral and dental conditions. The risk of stroke and its cost impact on the healthcare systems appear to be significantly reduced as a result of the decline in the incidence and prevalence of oral and dental illnesses. Hypothetically, better management of oral hygiene and dental health lead to reduced stroke risk. To the authors' best knowledge, for the first time, the potential link between dental health and stroke were cross-examined. The most typical stroke symptoms, oral and dental illnesses linked to stroke, and the role of oral healthcare professionals in stroke prevention are revealed. The potential mediating processes and subsequent long-term cognitive and functional neurological outcomes are based on the available literature. It must be noted that periodontal diseases and tooth loss are two common oral health measures. Lack of knowledge on the effects of poor oral health on systemic health together with limited access to primary medical or dental care are considered to be partially responsible for the elevated risk of stroke. Concrete evidence confirming the associations between oral inflammatory conditions and stroke in large cohort prospective studies, stratifying association between oral disease severity and stroke risk and disease effects on stroke survival will be desirable. In terms of clinical pathology, a predictive model of stroke as a function of oral health status, and biomarkers of systemic inflammation could be useful for both cardiologists and dentists.

Application of Nano-based Drug Loading Systems in the Treatment of Neurological Infections: An Updated Review.

Infection of the central nervous system (CNS) is a global healthcare concern with high rates of death and disease. CNS infections mainly include meningitis, encephalitis, and brain abscesses. Bacteria, viruses, fungi, protozoa, and parasites are the most common causes of neuroinfections. There are many types of medications used in the treatment of CNS infections, but drug delivery through the blood-brain barrier (BBB) is a major challenge to overcome. The BBB is a specialized multicellular barrier separating the neural tissue from the peripheral blood circulation. Unique characteristics of the BBB allow it to tightly control the movement of ions and molecules. Thus, there is a critical need to deal with these conditions with the aim of improving novel antimicrobial agents. Researchers are still struggling to find effective drugs to treat CNS infections. Nanoparticle (NP)-mediated drug delivery has been considered a profound substitute to solve this problem because NPs can be tailored to facilitate drug transport across the BBB. NPs are colloidal systems with a size range of 1-1000 nm, which can be used to encapsulate therapeutics, improve drug transport across the BBB, and target specific brain areas in CNS infections. A wide variety of NPs has been displayed for the CNS delivery of therapeutics, especially when their surfaces are coated with targeting moieties. This study aimed to review the available literature on the application of NPs in CNS infections.

Antimicrobial effects of nanocurcumin gel on reducing the microbial count of gingival fluids of implant‒abutment interface: A clinical study.

Background. This clinical study aimed to prepare and evaluate the effect of antimicrobial nanocurcumin gel on reducing the microbial counts of gingival fluids of the implant‒abutment interface in patients referred to the Tabriz Faculty of Dentistry for the placement of two dental implants. Methods. Fifteen patients applying for at least two dental implants were included in the study. During the uncovering session, nanocurcumin gel was placed in one implant, and no substance was placed in another (the control group). Then, in three sessions, implantation sessions (10 days after the repair abutment closure session), prosthesis delivery (15 days after the implantation session), and one month after prosthesis delivery, the patients' gingival fluid was sampled and cultured to determine bacterial counts in the gingival fluid by colony-forming units (CFU/mL). T-test was used for statistical analysis of data, and statistical significance was set at P<0.05. Results. This study showed that nanocurcumin gel significantly reduced the CFU/mL of gingival fluid in all three sampling stages compared to the control group. Conclusion. According to the results of this study, the application of antimicrobial nanocurcumin gel inside the implant fixture could reduce the microbial counts of gingival fluids.

Effect of RaCe, ProTaper, and V-Taper rotary systems on dentinal crack formation during endodontic treatment: An in vitro study.

Background. Prevention of dentinal crack formation is of utmost importance in endodontic treatment. This study aimed to evaluate the effect of RaCe, ProTaper, and V-Taper rotary systems on dentinal crack formation in three root regions during endodontic treatment. Methods. Seventy human mandibular first molars were selected randomly, and their distal roots were used. Ten samples were assigned to the control group, and sixty samples were assigned to three groups (n=20). Each group was prepared with RaCe, ProTaper, or V-Taper rotary files according to the manufacturers' instructions. A stereomicroscope was used to view cracks at ×40 magnification. Friedman's, chi-squared, and Kruskal-Wallis tests were used for statistical analysis of data (P < 0.05). Results. A comparison of the three rotary systems did not reveal any significant differences in the number of cracks between the three root thirds evaluated (P > 0.05). A comparison of the number of cracks in the coronal, middle, and apical thirds in each rotary system showed that the number of cracks in the middle third was fewer than that in the two other thirds only in the V-Taper group (P < 0.05), with no significant differences in the ProTaper and RaCe groups between the different root regions (P > 0.05). Conclusion. The application of RaCe, ProTaper, and V-Taper rotary files resulted in a similar rate of crack formation in endodontic treatment. V-Taper files created the minimum number of cracks in the middle third.