Evaluation of anthropometric indices and their relationship with maternal nutritional literacy and selected socio-economic and demographic variables among children under 5 years old.

BACKGROUND: Considering the destructive effects of malnutrition on the growth, development, and health of children and the importance of identifying the factors affecting it, the present study aimed to investigate the status of anthropometric indices and their relationship with maternal nutritional literacy and selected socio-economic and demographic variables among children under 5 years old. METHODS: This cross-sectional study was conducted on 405 mothers with children under 5 years old in Urmia, Iran. The data collection tool consisted of two parts. The first part was the demographic and socio-economic information of mother and child and the second part was the Evaluation Instrument of Nutrition Literacy on Adults; EINLA. RESULTS: There was statistically significant relationship between maternal nutritional literacy with weight-for-age, height-for-age, and weight-for-height indices; between weight-for-age index with maternal education, gestational weight gain, and mean weight, as well as mean height of the mother; between weight-for-age and weight-for-height indices with child gender, type of milk consumed, status of starting complementary foods, and history of acute respiratory infection, as well as diarrhea; and finally between height-for-age with family income status. CONCLUSIONS: It is suggested that mothers with low nutritional literacy, mothers whose gestational weight gain was not normal, children whose family income is low, boy child, children with a history of disease, children who consume powdered milk and children who have not started complementary foods at the right time be given priority when designing and implementing educational interventions to enhance nutritional status and anthropometric indices of children.

Does the application of GaAlAs laser and platelet-rich plasma induce cell proliferation and increase alkaline phosphatase activity in human dental pulp stem cells?

Blood extracts containing platelet products are gaining popularity in promoting healing and pulp regeneration. This study was designed to evaluate the effect of platelet-rich plasma (PRP) and gallium-aluminum-arsenide (GaAlAs) laser on proliferation and differentiation of human dental pulp stem cells (hDPSCs). In this ex vivo study, hDPSCs isolated from impacted mandibular third molars were cultured in Dulbecco's Modified Eagle's medium )DMEM(with 10% fetal bovine serum (FBS). After reaching the desired confluence, the cells were distributed into 4 groups, namely, control, PRP, laser, and PRP+laser for MTT assay and alkaline phosphatase (ALP) test. In the PRP and PRP+laser groups, 10% PRP was added to each well on the plate. In the laser and PRP+laser groups, as for the proliferation test, laser irradiation was carried out for 45 s, while 135 s was designated for ALP test. After 1, 3, and 5 days, cell proliferation and ALP activity were assessed using MTT and ALP colorimetric assay, respectively. Two-way ANOVA was utilized to analyze data. In PRP and PRP+laser groups, cell proliferation and viability increased until day 3 but began to decline afterwards until the 5th day. In the laser group, the increase in proliferation and viability was observed till day 5 which was less than the control group. Laser and control groups exhibited significantly higher cell viability and proliferation than both PRP and PRP+laser groups. ALP activity was more pronounced in PRP+laser, PRP, and laser in descending order; however, all were less than that of the control group. Only in the control group did the ALP activity augment during the 5-day period. Laser irradiation could induce pulp cell proliferation and demonstrated a better performance than PRP in this regard.

Personal, Interpersonal, and Organizational Predictors of the Mode of Delivery Among Urban Women: A Prospective Study With Socio-Ecological Approach.

The aim of this prospective study was to investigate the predictors of choosing mode of delivery (MOD) among Iranian urban women applying the socio-ecological model. In 2015, a convenient sample of 530 pregnant women in urban regions of Urmia, Iran, was recruited to complete a socio-ecological approach-based questionnaire. Then, 1 week after childbirth, the women were followed up by telephone to be asked about their MOD (response rate = 81.88%). Logistic regression analysis showed that the odds of cesarean section (CS) among the women with university education, whose husbands were an employee in a governmental organization, who preferred a private hospital for delivery, and who selected the CS as the preferred MOD during pregnancy were significantly higher than their counterparts. Among all the factors, the socioeconomic status of the families was more influential in predicting the MOD among women. The cognitive factors like fear of childbirth may not be determinants for MOD if women are from privileged families.

Comparison of Effect of Oral Premedication with Ibuprofen or Dexamethasone on Anesthetic Efficacy of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Prospective, Randomized, Controlled, Double-blind Study.

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of preoperative oral administration of ibuprofen or dexamethasone on the success rate of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Seventy-eight patients with irreversible pulpitis were randomly divided into 3 groups (26 per group) and given one of the following at 1 hr prior to performing local anesthesia: a placebo; 400 mg ibuprofen; or 4 mg dexamethasone. Each patient recorded their pain level on a visual analog scale before taking the medication or placebo, at 15 min after completion of IANB, and during treatment if pain occurred. The success of the anesthesia was defined as no or mild pain at any stage during the endodontic procedure. The success rate of the IANB was 38.5, 73.1, and 80.8% with the placebo, ibuprofen, and dexamethasone, respectively. Both ibuprofen and dexamethasone were significantly more effective than the placebo. No significant difference was observed, however, between the two experimental medications in terms of effectiveness. The results of the present study suggest that premedication with ibuprofen or dexamethasone increases the success rate of an IANB in patients with symptomatic irreversible pulpitis in the mandibular molars.

The Effect of Low Level Laser Therapy on Direct Pulp Capping in Dogs.

Introduction: The aim of this study was to determine the histologic effect of low level laser therapy (LLLT) with or without the use of mineral trioxide aggregate (MTA) on exposed pulp tissues of dogs. Methods: Twenty-five premolar teeth in three healthy mature dogs were randomly divided into five groups. In group 1, the pulp tissue was capped with MTA. In groups 2 and 3, before capping with MTA, the exposure site was irradiated by low power lasers at 630 nm (20 mW, 150 seconds, 7.5 J/cm2) and 810 nm (peak power 80 W, average power 50 mW, 1500 Hz, 50 seconds, 6.25 J/cm2) wavelengths, respectively. In groups 4 and 5, the exposure site was irradiated similar to that described in groups 2 and 3, but the pulp tissue was covered by gold foil instead of MTA. After 2 months, the animals were sacrificed and the samples were prepared for histologic evaluation. Results: There were differences in pulpal response and dentinal barrier formation among the study groups. The morphology of pulpal tissue and the integrity of dentinal barrier and formation of odontoblastic layer were more favorable in the first three groups. The occurrence of extensive and intense inflammation and necrosis was more frequent in groups 4 and 5. Conclusion: Under the conditions used in this study, the presence of MTA as a pulp capping material was more important than laser therapy in the success of direct pulp capping (DPC) treatment. MTA proved to be an effective material either alone or in combination with laser irradiation in vital pulp therapy.

Conservative Treatment of an Invaginated Maxillary Lateral Incisor with a C-shaped Canal Using Cone-Beam Computed Tomography.

This report describes the non-surgical treatment of an invaginated maxillary lateral incisor with two fused roots. The mesial root had a C-shaped canal, while the distal one had a type III dens invagination. Cone-beam computed tomography (CBCT) was used to help with the diagnosis and treatment decision making. Clinical and radiographic follow-up revealed satisfactory periapical repair and absence of symptoms after 15 months.

A Survey over the Dentists' and Endodntists' Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran.

INTRODUCTION: Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. METHODS AND MATERIALS: In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. RESULTS: There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. CONCLUSION: Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies.

The effect of different concentrations of chlorhexidine gluconate on the compressive strength of mineral trioxide aggregate.

Background and aims. Substituting chlorhexidine (CHX) for water has been shown to enhance antimicrobial activity of mineral trioxide aggregate (MTA). The purpose of this study was to compare the compressive strength of MTA mixed with distilled water, 0.12% and 0.2% chlorhexidine. Materials and methods. MTA was mixed according to manufacturer's instructions in group I (n = 20). In groups II & III, 0.12% and 0.2% CHX liquid was substituted for water, respectively. Samples were condensed with moderate force into 20 tubes with 1.5×5 mm dimensions and were allowed to set for 72 hours at 37°C in 100% humidity. After being removed from the molds, their compressive strength was determined using Instron testing machine. Each group was divided into two subgroups according to the time of testing (at 72 hours, and one week). Fractured surfaces of 4 specimens in each group were then evaluated under Scanning Electron Microscope (SEM) to determine their microstructure. One-way ANOVA, Tukey, and paired sample t-test was used for statistical analysis. P < 0.05 was set as significant. Results. There was no significant difference between three groups in terms of their compressive strength after 72 hours. However, the compressive strength of group II was significantly higher than group I (P = 0.034) and group III (P = 0.021) after one week. Crystalline microstructure was similar in all groups. Conclusion. Substitution of 0.012% chlorhexidine for water significantly increased the compressive strength of MTA at 1 week without significant change in crystalline structure.

Mineral trioxide aggregate and portland cement for direct pulp capping in dog: a histopathological evaluation.

Background and aims. Mineral trioxide aggregate and calcium hydroxide are considered the gold standard pulp-capping materials. Recently, Portland cement has been introduced with properties similar to those of mineral trioxide aggregate. Histopathological effects of direct pulp capping using mineral trioxide aggregate and Portland cements on dog dental pulp tissue were evaluated in the present study. Materials and methods. This histopatological study was carried out on 64 dog premolars. First, the pulp was exposed with a sterile bur. Then, the exposed pulp was capped with white or gray mineral trioxide aggregates and white or gray Portland cements in each quadrant and sealed with glass-ionomer. The specimens were evaluated under a light microscope after 6 months. Statistical analysis was carried out using Kruskal-Wallis test. Statistical significance was defined at α=5%. Results. There was no acute inflammation in any of the specimens. Chronic inflammation in white and gray mineral trioxide aggregates and white and gray Portland cements was reported to be 45.5%, 27.3%, 57.1% and 34.1%, respectively. Although the differences were not statistically significant, severe inflammation was observed mostly adjacent to white mineral trioxide aggregate. The largest extent of increased vascularization (45%) and the least increase in fibrous tissue were observed adjacent to white mineral trioxide aggregate, with no significant differences. In addition, the least calcified tissue formed adjacent to white mineral trioxide aggregate, although the difference was not significant. Conclusion. The materials used in this study were equally effective as pulp protection materials following direct pulp capping in dog teeth.

Effect of the smear layer on apical seals produced by two calcium silicate-based endodontic sealers.

We compared the apical seals of two new calcium silicate-based sealers (iRoot SP and MTA Fillapex) in the presence and absence of a smear layer. Eighty-two human premolars were prepared and randomly divided into four groups. In groups 1 and 3, the smear layer was retained. In groups 2 and 4, the root canals were irrigated with EDTA to remove the smear layer. Canals were filled using gutta-percha/iRoot SP (in groups 1 and 2) or obturated with gutta-percha/MTA Fillapex (in groups 3 and 4). Fluid filtration was used to evaluate apical microleakage. The presence of the smear layer had no significant effect on the sealing properties of the filling materials, except for iRoot SP at 2 weeks (P = 0.007). There was significantly less microleakage with iRoot SP than with MTA Fillapex (P = 0.025 at 2 weeks; P < 0.001 at 3 months). Leakage decreased significantly over time in all specimens, except in group 2 (P = 0.473). In conclusion, removal of the smear layer had no adverse effect on the sealing properties of calcium silicate-based sealers. In addition, the sealing ability of iRoot SP was superior to that of MTA Fillapex.

Effect of MTA and Portland Cement on Fracture Resistance of Dentin.

Background and aims. It is important to evaluate the effects of endodontic materials on tooth structures to avoid endodontic treatment failure. The aim of the present study was to investigate the effect of mineral trioxide aggregates (MTA) and Portland cement (PC) on fracture resistance of dentin. Materials and methods. Thirty-six freshly extracted human single-rooted premolar teeth were selected. The crowns were removed and the roots were randomly divided into two experimental groups and one control group. The root samples were longitudinally divided into two halves and a dentin bar (2×2×10 mm) was cut from each root section for short-term (2weeks) and long-term (12 weeks) evaluations. The root sections in the experimental groups were exposed to MTA or PC, while keeping the control group specimens in physiologic saline. The fracture resistance of each specimen was measured using an Instron testing machine. The results were statistically analyzed using ANOVA, a post hoc Tukey test and paired t-test at 5% significance level. Results. The fracture resistance of MTA-treated specimens significantly increased between 2 and 12 weeks (P<0.05). After 12 weeks, MTA-treated specimens had the highest fracture resistance. In the PC group, the fracture resistance of specimens did not change significantly over time (P>0.05). Conclusion. The results showed that MTA increased the fracture resistance of root dentin, while PC had no significant effect on dentin fracture resistance.

Comparative study of the antimicrobial effect of three irrigant solutions (chlorhexidine, sodium hypochlorite and chlorhexidinated MUMS).

AIM: To compare the antimicrobial effect of 2% chlorhexidine, 2.5% sodium hypochlorite and MUMS containing 2% chlorhexidine. MATERIALS AND METHODS: All of the above irrigants were examined on Enterococcus faecalis, Streptococcus mutans, Candida albicans, Lactobacillus casei and E. coli. A total of 0.5 CC of each solution and 0.5 CC of McFarland solution bacterium were added to each examination tube. After 15, 30 and 45 minutes, colony count was performed for each tube. The difference in the number of bacteria indicated the effect taken by disinfectant material. RESULTS: MUMS containing chlorhexidine showed the antimicrobial properties just like chlorhexidine's effect against E. coli, Streptococcus mutans, Candida albicans, Enterococcus faecalis and Lactobacillus casei in preventing these entire microorganisms to incubate. Sodium hypochlorite was not effective against Enterococcus faecalis and Candida albicans incubated in 15, 30 and 45 minutes and Enterococcus faecalis in 15 minutes. CONCLUSION: MUMS has antimicrobial properties similar to chlorhexidine. CLINICAL SIGNIFICANCE: As MUMS containing chlorhexidine can transfer chlorhexidine through its own surfactant around apical area and it can open the dentinal tubules by its own chelator for more penetration of chlorhexidine, it may be a choice for canal irrigation.

The effects of different concentrations of chlorhexidine gluconate on the antimicrobial properties of mineral trioxide aggregate and calcium enrich mixture.

BACKGROUND: The aim of this study was to evaluate the antimicrobial activity of Mineral Trioxide Aggregate (MTA) and Calcium Enrich Mixture) CEM (mixed with different concentrations of chlorhexidine (CHX). MATERIALS AND METHODS: Cements used in this in vitro study included Gray proRoot MTA and CEM with the microorganisms being entrococcus faecalis, streptococcus muntas, Candida albicans, Actinomyces, Escherichia coli, and a mixture of these microorganisms. CHX was used in the form of liquid at 0.2%, 2%, and 0.12% concentrations. Contact dilution and colony count method was used to evaluate the antibacterial activity of these cements. After 0, 24, 48, 72, and 96-hour intervals, we cultured the samples on blood agar medium. Colonies were counted after incubation at 37°. Data were statistically analyzed by a Kruskal-Wallis test to compare the antimicrobial activity of MTA and CEM. RESULTS: All concentrations of CHX were mixed with MTA and the CEM had antibacterial activities on all microorganisms' strains except for the Enterococcus faecalis and the mixture group. MTA had better antibacterial activity than the CEM, but this difference was not significant (P = 0.13). The mixing of MTA and the CEM with CHX significantly increased the antibacterial properties of both cements (P < 0.03). There was no statistically significant difference between the different concentrations of CHX. The antibacterial activity of the materials increased through time. CONCLUSION: The mixture of MTA and CEM with different concentration of CHX significantly increased the antibacterial activity.

Effect of calcium hydroxide premedication on the marginal adaptation of calcium-enriched mixture cement apical plug.

BACKGROUND: This study was to evaluate the effects of calcium hydroxide premedication on the marginal adaptation of the calcium-enriched mixture (CEM) cement as an apical plug. MATERIALS AND METHODS: In this in vitro study, forty single rooted teeth were prepared and apical portion of the roots were immersed in sulfuric acid to produce open apices. The teeth were divided into 2 experimental groups. In medicated group, calcium hydroxide was placed in all canals for 1 week and in non-medicated group no dressing was used. Then, a 4-mm apical plug of CEM cement was placed in canals; each root was prepared for observation using scanning electron microscope and the maximum distance between CEM cement and surrounding dentin was measured. The data were analyzed by t-test, and significance level was set at α = 0.05. RESULTS: The mean width of gap in medicated and non-medicated groups was 158/1 µm and 147/1 µm, respectively. There was no significant difference between the two groups (P > 0.05). CONCLUSION: Calcium hydroxide premedication had no adverse effect on the marginal adaptation of CEM cement apical plug.

Effect of previous calcium hydroxide dressing on the sealing properties of the new endodontic cement apical barrier.

OBJECTIVES: Using the fluid filtration method, an in vitro study was conducted to evaluate the effects of medication with calcium hydroxide on the sealing ability of the New Endodontic Cement (NEC) apical barrier in the short and long terms. METHODS: Fifty extracted single rooted teeth were prepared and apical resorption produced using acid sulfuric for four days. The teeth were randomly divided into two experimental groups (n=20) and two control groups. In group 1, calcium hydroxide was placed into all canals for one week and in group 2, no medication was used. In both groups, a 4 mm NEC apical plug was placed in the canals and the remaining portion of the canals was filled with gutta-percha. The amount of microleakage of all samples was evaluated after one week and three months. The data were statistically analyzed using two-way ANOVA. RESULTS: There was no significant difference between the two groups in either time period (P>.05). In both group 1 and group 2, microleakage increased after three months but this increase was not statistically significant (P>.05). CONCLUSIONS: According to the result of this study, medication with calcium hydroxide had no adverse effect on the short- and long-term sealing properties of an NEC apical plug.

The Effect of Calcium Hydroxide on the Short and Long-Term Sealing Properties of MTA Apical Barrier.

INTRODUCTION: The aim of this study was to evaluate the effects of remnant root canal medicament, calcium hydroxide on the short and long term sealing ability of mineral trioxide aggregate (MTA) apical barrier. MATERIALS AND METHODS: Fifty single-rooted teeth were prepared and apical resorptions were made using sulfuric acid. The teeth were allocated into two experimental groups and two control groups. In group 1, calcium hydroxide was placed into canals for one week. In group 2, no medication was placed. In both groups, a 4-mm MTA plug was placed in the root canals. The remaining portion of the canal was filled with gutta-percha/sealer. The microleakage was evaluated after 7 days and 3 months using fluid filtration technique. Repeated measurement ANOVA was used for statistical analysis. RESULTS: There was no significant difference in sealing ability between the two groups in either time periods. In both groups, microleakage decreased after three months but this decrease was not statistically significant. CONCLUSION: Medication with calcium hydroxide had no adverse effect on the short and long-term sealing properties of MTA plug.

Osteoblastic cytokine response to gray and white mineral trioxide aggregate.

INTRODUCTION: The materials used for root-end filling and perforation repair are in direct contact with live tissues e.g. bone and connective tissue; their effects however, are uncertain. The aim of this ex vivostudy was to evaluate the osteoblastic secretory activity adjacent to gray and white mineral trioxide aggregate (MTA) and Intermediate Restorative Material (IRM). MATERIALS AND METHODS: The studied materials were prepared and placed in 24-wells plate. Human MG-63 osteoblasts were introduced to materials after their initial set. The supernatant fluid was collected after 1, 3, and 7 days and the level of interleukin-1ß was measured by ELISA test. A microscopic exam was also performed to assess proliferation and viability of the cells. Kruskal-Wallis and Tukey tests were used for analysis. RESULTS: T here were significant higher levels of interleukin-1ß in the gray and white MTA groups compared to IRM group (P<0.05). The difference in interleukin-1ß secretion level between two mineral trioxide aggregate groups was not significant (P>0.05).Morphologic appearance of osteoblasts adjacent to gray and white MTA was similar to normal osteoblasts in all observation periods, however cells adjacent to IRM were round, signifying cytotoxicity of the adjacent material. CONCLUSION: Human osteoblasts' has a favorable biologic response to white and gray MTA compared to IRM.

Medication with calcium hydroxide improved marginal adaptation of mineral trioxide aggregate apical barrier.

INTRODUCTION: The purpose of this study was to evaluate the effect of calcium hydroxide premedication on the marginal adaptation of the mineral trioxide aggregate (MTA) apical barrier. METHODS: Forty single-rooted teeth were prepared and apically resorbed using sulfuric acid for 4 days. Teeth were allocated into two groups according to whether calcium hydroxide was placed in the canals for 1 week (medicated group) or not (nonmedicated group) before placing a 4-mm MTA apical plug in the canals. The roots were mounted on aluminum stubs, the root apex was viewed from the top under scanning electron microscopy, and the maximum distance between MTA and the surrounding dentin was measured. RESULTS: The mean gap widths in the medicated and nonmedicated groups were 70.2 µm and 130.0 µm, respectively (p < 0.05). CONCLUSIONS: Calcium hydroxide treatment improves marginal adaptation of the MTA apical plug.

Microscopic evaluation of cleaning efficiency of three different nickel-titanium rotary instruments.

INTRODUCTION: This study compared the cleaning efficiency of Mtwo, Race and Medin Nickel-Titanium (NiTi) rotary instruments. MATERIALS AND METHODS: Sixty mandibular molar mesial roots were selected with angle curvatures between 25-35 degrees and divided into three groups; each containing 20 teeth. Canals were prepared with the rotary files and irrigated with 2.5% NaOCl solution after each instrument. Total of 5mL of normal saline was used as the final rinse; subsequently the canals were dried with paper points. The amount of debris and smear layer in three parts of the root canal walls was evaluated using SEM and the data were analyzed by using the Kruskal-Wallis test and the Mann-Whitney U test. RESULTS: The results for remnant debris in the coronal part of root canals were similar, whereas in the middle third, Mtwo instruments achieved significantly better results compared to Race and Medin instruments. In the apical third of the root canals more debris was created by Race instruments. CONCLUSION: Overall, Mtwo instruments had greater success in producing clean canals.

In vitro comparison of apical leakage in root canals obturated with 0.04 and 0.02 tapered gutta-percha.

INTRODUCTION: Gutta-percha is the most commonly used material for root canal obturation; it has been recently manufactured with different tapers. The aim of this in vitro study was to compare microleakage of canals obturated with standard gutta-percha (0.02 taper) or the new 0.04 taper gutta-percha master cone using the cold lateral condensation technique. MATERIALS AND METHODS: Forty-four extracted single rooted teeth were selected. The crowns were removed and all the canals were prepared using RaCe rotary files. The teeth were then divided into experimental (n=2) and control (n=2) groups. In the first study group, the teeth were obturated with 0.02 taper gutta-percha master cone and lateral condensation. In the second study group, the canals were obturated by 0.04 tapered master cones and the same obturation method. The degree of leakage was measured using fluid filtration method. Data were analyzed statistically by student t-test. RESULTS: There was no significant difference between the mean microleakage of two experimental groups (P=0.558). CONCLUSION: Lateral condensation technique using 0.04 tapered master cones can provide an effective apical seal similar to 0.02 gutta-percha cones.