Fracture Strength and Marginal Adaptation of Conservative and Extended MOD Cavities Restored with Cention N.

The aim of the present study was to compare the fracture strength and marginal adaptation of MOD cavities restored with Cention N, bonded Cention N, and resin composite, as well as to investigate the effect of cavity preparation volume on those properties. In this experimental study, 120 human maxillary premolars were randomly divided into six groups according to the type of restoration and cavity volume (n = 20): (I) conservative MOD restored with Cention N, (II) conservative MOD restored with bonded Cention N, (III) conservative MOD restored with Z250 resin composite, (IV) extended MOD restored with Cention N, (V) extended MOD restored with bonded Cention N, and (VI) extended MOD restored with Z250 resin composite. Fracture strength (MPa) was tested using a universal testing machine. To investigate marginal adaptation, polyvinyl-siloxane impressions were taken and poured with epoxy resin. Resin replicas were examined by SEM (×400) for marginal adaptation. ANOVA tests, Tukey's test, and independent t-test were used to analyze data (P ≤ 0.05). Among conservative restorations, the fracture strength of bonded Cention N was significantly greater than that of Cention N (P = 0.001), while in the extended preparations, there was no significant difference between fracture strengths of different types of restorations (P = 0.579). In terms of marginal adaptation, there was no significant difference between different types of conservative restorations (P = 0.232). However, in extended preparations, composite showed significantly lower marginal adaptation than Cention N and bonded Cention N (P = 0.004 and P = 0.045, respectively). Conservative preparations showed significantly greater fracture strength and marginal adaptation compared to extended ones in groups restored with composite. The volume of cavity preparation was shown to be effective in the materials fracture strength and marginal adaptation. Cention N showed promising results in terms of fracture strength and marginal adaptation.

Comparison of Shear Bond Strength of Three Types of Glass Ionomer Cements Containing Hydroxyapatite Nanoparticles to Deep and Superficial Dentin.

STATEMENT OF THE PROBLEM: The clinical success of glass ionomer cement (GIC) restorations depends on the strength of its bonding to dentin, yet the bond strength of nanohydroxyapatite (nHAp) added GIC to dentin needs to be investigated. PURPOSE: This study aimed to assess if the type of GIC containing nHAp and dentin depth could affect the shear bond strength (SBS). MATERIALS AND METHOD: In this experimental study, 60 freshly extracted intact third molars were randomly divided into two main groups of flat occlusal dentin with different cuts as superficial (S); just below the dentinoenamel junction (DEJ) and deep (D); 2mm below DEJ. After conditioning with 20% polyacrylic acid, each group were randomly assigned to the tested GIC (n=10) subgroups as (1) Fuji IX Extra+nHAp, (2) Fuji II LC+nHAp and (3) Zirconomer+nHAp. Plastic tubes were placed on the pre-treated surfaces and filled with one of the GIC, then stored in an incubator at 37 oC and 100% humidity for 24hr. The specimens were thermocycled at5/55 oC for 500 cycles and subjected to SBS test using a universal testing machine (1 mm/min). The data analyzed by Mann-Whitney and Kruskal-Wallis test (p< 0.05). RESULTS: The means of SBS of Fuji II LC+nHAp was significantly higher than Fuji IX+nHAp and Zirconomer+nHAp both in superficial and deep dentin (p< 0.05). The means of SBS of Fuji IX Extra+nHAp and Zirconomer+nHAp subgroups in superficial dentin were higher than deep dentin, this differences was statistically significant (p= 0.0001 and p= 0.009, respectively). CONCLUSION: It can conclude that SBS was influenced by type of GIC and depth of dentin.

The Shear Bond Strength of Porcelain Laminate to Prepared and Unprepared Anterior Teeth.

STATEMENT OF THE PROBLEM: Porcelain laminate veneer is an esthetic restoration used as an alternative to full veneer crowns and requires minimal tooth preparation. In restoration with porcelain laminate veneers, both the longevity of the laminate and conservation of the sound tooth structure are imperative. PURPOSE: The present study aimed to investigate the shear bond strength of porcelain laminates to prepared- and unprepared- anterior teeth in order to compare their longevity and success rate. MATERIALS AND METHOD: Thirty extracted maxillary central incisors were randomly divided into 3 groups regarding their preparation methods. The preparation methods were full-preparation in group A, full-preparation and finishing with fine diamond bur in group B, and no-preparation, only grinding with diamond bur in group C. After conditioning the teeth, ceramic veneers (IP S e.max) were silanated and then cemented with DuoLink luting cement. The shear bond strength was measured for each group and failure mode was determined by stereomicroscopic examination. RESULTS: Group C exhibited the highest shear bond strength. The shear bond strength was significantly different between groups C and B (p< 0.05). However, the difference between group A and C was insignificant, as was the difference between group A and B (p> 0.05). Adhesion failure mode was found to be more common than the cohesive mode. CONCLUSION: Regarding the shear bond strength of unprepared anterior teeth to porcelain laminate veneers yielded by this study, no-preparation veneers might be used when the enamel is affected by wearing, trauma, or abrasion. It can also be used in patients who refuse the treatments which involve tooth reduction and preparation.

Flexural Strength Comparison of Silorane- and Methacrylate-Based Composites with Pre-impregnated Glass Fiber.

STATEMENT OF THE PROBLEM: Sufficient adhesion between silorane/methacrylate-based composites and methacrylate impregnated glass fiber increases the benefits of fibers and enhances the mechanical and clinical performance of both composites. PURPOSE: The aim of this study was to evaluate the compatibility of silorane and methacrylate-based composites with pre-impregnated glass fiber by using flexural strength (FS) test. MATERIALS AND METHOD: A total of 60 bar specimens were prepared in a split mold (25×2×2 mm) in 6 groups (n=10). In groups 1 and 4 (control), silorane-based (Filtek P90) and nanohybrid (Filtek Z350) composites were placed into the mold and photopolymerized with a high-intensity curing unit. In groups 2 and 5, pre-impregnated glass fiber was first placed into the mold and after two minutes of curing, the mold was filled with respective composites. Prior to filling the mold in groups 3 and 6, an intermediate adhesive layer was applied to the glass fiber. The specimens were stored in distilled water for 24 hours and then their flexural strength was measured by 3 point bending test, using universal testing machine at the crosshead speed of 1 mm/min. Two-way ANOVA and post-hoc test were used for analyzing the data (p< 0.05). RESULTS: A significant difference was observed between the groups (p< 0.05). The highest FS was registered for combination of Z350 composite, impregnated glass fiber, and application of intermediate adhesive layer .The lowest FS was obtained in Filtek P90 alone. Cohesive failure in composite was the predominant failure in all groups, except group 5 in which adhesive failure between the composite and fiber was exclusively observed. CONCLUSION: Significant improvement in FS was achieved for both composites with glass fiber. Additional application of intermediate adhesive layer before composite build up seems to increase FS. Nanohybrid composite showed higher FS than silorane-based composite.

Cytotoxic effect of silorane and methacrylate based composites on the human dental pulp stem cells and fibroblasts

OBJECTIVES: The aim of this study was to compare the cytotoxic effect of a methacrylate-based and a siloranebased composite on the human dental pulp stem cells (DPSCs) versus human dental pulp fibroblasts (DPFs).Study DESIGN: Samples of the Filtek Z250 and P90 were polymerized and immersed in the culture medium to obtain extracts after incubation for one, seven and 14 days. Magnetic cell sorting based on the CD146 expression was performed to purify DPSCs and DPFs. After incubation of both cells with the extracts, cytotoxicity was determined using the MTT test. RESULTS: For the extracts of first and seventh day, both composites showed significantly lower cytotoxicity on DPSCs than DPFs (p = 0.003). In addition, there was a significant difference in the time-group interaction of both materials indicating different cytotoxic behaviours (p = 0.014). In contrast to Z250, exposure to the 14th day extract of P90 resulted in higher cell viability compared to that of day seven. CONCLUSIONS: DPSCs are less susceptible to the cytotoxic effect of the composites than DPFs. Compared to Z250, the cytotoxic effect of silorane-based composite decreases as the time passes on. This difference should be considered, particularly in deep cavities, in order to preserve the regenerative capacity of the pulp

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Fracture resistance of structurally compromised premolar roots restored with single and accessory glass or quartz fiber posts.

BACKGROUND: Glass and quartz fiber posts are used in restoration of structurally compromised roots. Accessory fiber posts are recently introduced to enhance the fiber post adaptation. This study evaluated the effectiveness of glass versus quartz accessory fiber posts. MATERIALS AND METHODS: In this experimental study, 40 mandibular premolar roots with similar dimension (radius of 3.5 ± 0.2 mm and length of 13 ± 0.5 mm) were selected and their root canals were flared until 1.5 mm of dentin wall remained. They were randomly assigned to four groups (n = 10) and restored as follows: Exacto glass fiber post (EX), Exacto glass fiber post + 2 Reforpin accessories (EXR), D. T. Light quartz fiber post (DT), and D. T. Light quartz fiber post + 2 Fibercone accessories (DTF). All posts were cemented with Duo-Link resin cement and the cores were built with the particulate filler composite. Following 1-week water storage, specimens were subjected to fracture loads in a universal testing machine. The maximum loads and failure modes were recorded and analyzed with the two-way analysis of variance (ANOVA) and Fisher's exact tests (α = 0.05). RESULTS: The mean fracture resistance values (N) were 402.8 (EX), 378.4 (EXR), 400.1 (DT), and 348.5 (DTF). Two-way ANOVA test showed neither reinforcing method (P = 0.094), nor post composition (P = 0.462) had statistically significant differences on fracture resistance of the structurally compromised premolar teeth. Fisher's exact test also demonstrated no statistically significant difference regarding two variables (P = 0.695). Core fracture was the most common failure mode (62.5%). CONCLUSION: Glass and quartz fiber posts with or without accessories restored the weakened premolar roots equally.

Cytotoxic effect of silorane and methacrylate based composites on the human dental pulp stem cells and fibroblasts.

OBJECTIVES: The aim of this study was to compare the cytotoxic effect of a methacrylate-based and a silorane-based composite on the human dental pulp stem cells (DPSCs) versus human dental pulp fibroblasts (DPFs). STUDY DESIGN: Samples of the Filtek Z250 and P90 were polymerized and immersed in the culture medium to obtain extracts after incubation for one, seven and 14 days. Magnetic cell sorting based on the CD146 expression was performed to purify DPSCs and DPFs. After incubation of both cells with the extracts, cytotoxicity was determined using the MTT test. RESULTS: For the extracts of first and seventh day, both composites showed significantly lower cytotoxicity on DPSCs than DPFs (p=0.003). In addition, there was a significant difference in the time-group interaction of both materials indicating different cytotoxic behaviours (p=0.014). In contrast to Z250, exposure to the 14th day extract of P90 resulted in higher cell viability compared to that of day seven. CONCLUSIONS: DPSCs are less susceptible to the cytotoxic effect of the composites than DPFs. Compared to Z250, the cytotoxic effect of silorane-based composite decreases as the time passes on. This difference should be considered, particularly in deep cavities, in order to preserve the regenerative capacity of the pulp.

Effects of oxalate desensitizer with different resin cement-retained indirect composite inlays on fracture resistance of teeth.

PURPOSE: This study investigated whether the tubular occluding effect of oxalate desensitizer (OX) during adhesive cementation (three resin cements) influenced fracture resistance of teeth restored with adhesive inlays. MATERIALS AND METHODS: Ninety intact maxillary premolars were randomly divided into 9 groups of 10 each. The two control groups were Gr 1, intact teeth and Gr 2, mesio-occlusodistal preparation only. In six experimental groups, the composite inlays were cemented with ED Primer II/Panavia F 2.0, Excite DSC/Variolink II, and One-Step Plus/Duolink according to manufacturers' instructions (Groups 3, 5, and 7, respectively) or with OX during cementation (Groups 4, 6, and 8, respectively). In Group 9, inlays were cemented with a resin cement without adhesive system. After thermocycling, fracture strength was tested. The data were analyzed using two-way and one-way ANOVA and LSD post hoc tests (α = 0.05). RESULTS: Fracture resistance of the six groups were significantly affected by OX (p = 0.002) but not by the resin cement type (p > 0.05). The interaction of the two factors was statistically significant (p = 0.052). A statistically significant difference between all groups was found (p < 0.001). The mean fracture resistances (N) were: Gr1 = 1168 ± 157,(a) Gr2 = 360 ± 110,(d) Gr3 = 1026 ± 188,(b) Gr4 = 887 ± 143,(c) Gr5 = 1007 ± 132,(b) Gr6 = 810 ± 164,(c) Gr7 = 1033 ± 218,(a) Gr8 = 955 ± 147,(ab) Gr9 = 780 ± 86(c) (groups with the same superscript letter indicate statistical similarity). CONCLUSIONS: Combining an OX with three resin cements had a significant negative effect on the fracture resistance of premolars restored with composite inlay cemented with Panavia F2.0 and Variolink II, but it had no significant effect when cemented with Duolink.

Effect of chlorhexidine on bonding durability of two self-etching adhesives with and without antibacterial agent to dentin.

BACKGROUND: Considering the possibility of remaining bacteria in the cavity or invading via microgaps, the use of antibacterial agents in adhesive restoration may be beneficial. This study evaluated the effect of chlorhexidine on immediate and long-term shear bond strength of adhesives with and without antibacterial agent to dentin. MATERIALS AND METHODS: In this in vitro study, the occlusal surfaces of 80 intact human premolars were removed to expose the flat midcoronal dentin. The teeth were assigned to four groups. Two adhesive systems, Clearfil SE Bond (SE) and Clearfil Protect Bond (PB) were used according to manufacturer's instructions as the control groups. In the experimental groups, 2% chlorhexidine was applied prior to acidic primer of two adhesives. Then, resin composite was applied. Half of the specimens in each group were submitted to shear bond test after 24 h without thermocycling, and the other half were submitted to water storage for 6 months and thermocycling before testing. The data was analyzed using three-way analysis of variance (ANOVA) and t-test (α = 0.05). RESULTS: Chlorhexidine application significantly decreased the initial bond strength (BS) of the two self-etch adhesives to dentin (P < 0.05). There was a significant reduction in BS of SE and PB after aging compared to initial bonding (P < 0.05). However, there was no significant difference between BS of the control and chlorhexidine-treated groups for the tested adhesives after aging. PB showed a lower BS than SE in two time periods (P < 0.05). CONCLUSION: Chlorhexidine was capable of diminishing the loss of BS of these adhesives over time. However, considering the negative effect of chlorhexidine on the initial BS, the benefits of chlorhexidine associated with these adhesives cannot possibly be used.

Povidone-iodine and bleomycin in the management of malignant pleural effusion.

Malignant pleural effusion is a common complication in certain malignancies. Pleurodesis is the best option most of the time. The purpose of this study was to compare the choice of belomycin with povidone-iodine, which is not only determined by the efficacy of the agent but also by its cost, accessibility, safety, ease of administration and the number of administrations to achieve a complete response. We performed a randomized clinical trial on 39 patients presenting with symptomatic malignant pleural effusion. Patients were selected and randomly assigned to undergo chemical pleurodesis with either bleomycin or povidone-iodine. Primary characteristics of patients were assessed and graded before and after treatment concerning pain, dyspnea, and chest radiographs. A complete response was obtained in 79% of belomycin group and 75% of povidone-iodine group which was not statistically significant. Patients on belomycin treatment had a significantly lower score for dyspnea in one month follow up. This was significant after controlling for age, pain score and dyspnea score after drainage, using general linear model. Due to similar effect and significant cost advantage between bleomycin and povidone-iodine, we conclude that povidone- iodine is the agent of choice when utilizing pleurodesis for control of symptomatic malignant pleural effusions.

Successful management of acute necrotizing mediastinitis with trans-cervical drainage.

Acute necrotizing mediastinitis (ANM) is a lethal disease which without antibiotic therapy and surgical intervention can lead to about 40% mortality. With the development of imaging technology, spiral computed tomography (CT) scanning and shortening of the time of diagnosis and surgery, the prognosis of these patients is excellently improved. This study describes the clinical presentation, management and outcome of 4 patients (mean age: 35 years) with ANM. All patients were operated on by a trans-cervical approach, and only one patient was operated on by a trans-thoracic one. After surgery, patients were transferred to the intensive care unit and underwent daily washing and debridement with antibiotic treatments. Odontogenic infection (2 cases), pharyngeal perforation and cervical esophageal perforation were the causes of the ANM. Infection of cervical space (perivisceral spaces) and superior Mediastinum were found in all patients, and Infection below the carina was found in two. All patients were discharged with a good, general condition after an average of 24 days. Early diagnosis of ANM with clinical presentation and on-time CT scanning, early drainage and careful post operation care are very important in the management of patients with ANM and can improve the outcome of trans-cervical drainage to an acceptable technique.

The effect of delayed placement of composite and double application of single-bottle adhesives on microleakage of composite restorations.

This study evaluated the effect of delayed placement of composite and double application of adhesive on microleakage of two-step, total-etch (single-bottle) adhesives. Standard Class V cavities were prepared in 140 sound premolars and randomly assigned into 10 groups (n = 14). Excite, Optibond Solo Plus, and Adper Scotchbond Multi-Purpose (as a control) were used. After the first layer of single-bottle adhesive was photocured, the adhesive was reapplied and photocured in four of the groups. A microhybrid composite was applied in five of the groups immediately after the adhesive was photocured; in the other five groups, the composite was placed after a three-minute delay. After 24 hours of storage in distilled water and thermocycling, the samples were placed in 1% methylene blue. All samples then were sectioned longitudinally and evaluated for microleakage at the occlusal and gingival margins under a stereomicroscope at 20x magnification. Data were analyzed using nonparametric tests. Delayed placement of composite significantly increased leakage at the gingival margins when single-bottle adhesives were used (p < 0.05). Double application of the single-bottle adhesives significantly reduced leakage at the gingival margin when placement of the composite was delayed. There was no significant difference between single and double application when the composite was placed immediately (p < 0.05).

Effect of resin coating and chlorhexidine on the microleakage of two resin cements after storage.

PURPOSE: This study evaluated the effect of resin coating and chlorhexidine (CH) on microleakage of two resin cements (Panavia F2.0, Nexus 2) after water storage. MATERIALS AND METHODS: Class V cavities were prepared on the facial and lingual surfaces of 120 intact human molars with gingival margins placed 1 mm below the cementoenamel junction. Indirect composite inlays were fabricated. The specimens were randomly assigned into six groups (n = 40). Indirect composite inlays (Gradia) were cemented as follows: Group 1 (control): inlays were cemented with Panavia F2.0 according to the manufacturer's instructions. Group 2: the ED-primed (ED Primer, Kuraray Dental, Tokyo, Japan) dentin was coated with a resin layer before cementation of the inlays with Panavia F2.0. Group 3: a 2% CH solution was applied before bonding with Panavia F2.0. Group 4: after CH application, the primed dentin was coated with a resin layer before cementation with Panavia F2.0. Group 5: (control) after applying Optibond Solo Plus, the inlays were cemented with Nexus 2. Group 6: after etching, CH was applied, and cementation was performed similarly to group 5. Half the specimens in each group were stored in distilled water for 24 hours, while the other half were stored in distilled water for 6 months. After storage, the teeth were placed in 1% methylene blue dye for 24 hours, sectioned, and evaluated under a 20× stereomicroscope. Dye penetration was scored using 0 to 3 criteria. Data were analyzed using nonparametric tests. RESULTS: Resin coating of ED primer for Panavia F2.0 significantly reduced microleakage at the gingival margins after 6 months (p < 0.05). CH application in Panavia F2.0 did not lead to a significant difference in the microleakage at both margins, after 24 hours and 6 months (p > 0.05). The application of CH showed significantly less microleakage than that of the control group at the gingival margins of Nexus 2 after 6 months. In general, gingival margins showed more microleakage than occlusal margins. CONCLUSION: An additional resin layer applied to a self-etch cement can improve long-term dentinal sealing for indirect restorations, while CH cannot; however, CH reduces gingival microleakage in an etch-and-rinse cement after aging.

The effect of oxalate desensitizers on the microleakage of resin composite restorations bonded by etch and rinse adhesive systems.

This in vitro study evaluated the effect of an oxalate desensitizer (OX) on the marginal microleakage of resin composite restorations bonded by two three-step and two two-step etch and rinse adhesives. Class V cavities were prepared on the buccal surfaces of 126 extracted premolars at the cementoenamel junction and randomly divided into nine groups of 14 each. In the control groups (1-4), four adhesives were applied, respectively, including Adper Scotchbond Multi-Purpose (SBMP), Optibond FL (OBFL), One-Step Plus (OS) and Excite (EX). In the experimental groups (5-8), the same adhesives, in combination with OX (BisBlock), were applied. And, in one group, OX was applied without any adhesive, as the negative control group (9). All the groups were restored with a resin composite. After 24 hours of storage in distilled water and thermocycling, the samples were placed in 1% methylene blue dye solution. The dye penetration was evaluated using a stereomicroscope. The data were analyzed using non-parametric tests. The OX application, in combination with OBFL and EX, resulted in significantly increasing microleakage at the gingival margins (p < 0.05), while it had no effect on OS and SBMP (p > 0.05). At the occlusal margins, no significant difference in microleakage was observed after OX application for each of four adhesives (p > 0.05).

Effect of light activation mode on the incompatibility between one-bottle adhesives and light-cured composites: an in vitro shear bond strength study.

This study examined the effect of different light activation modes for light-cured resin-based composites on the shear bond strength to dentin of two one-bottle adhesives with differing acidity. In this experimental study, a flat middle dentin surface was prepared on 110 extracted sound molars using a 600-grit polish paper. The teeth were then randomly divided into 10 equal groups (n = 11). One-Step Plus (OS) and Prime & Bond NT (P&B NT) were used according to the manufacturer's instruction with their respective composite (Aelite, Spectrum TPH) applied and cured using five different light-activation modes: 1. Conventional (CO): 600 mW/cm2 (40 seconds) 2. Soft-Start I (SSI): 100 mW/cm2 (10 seconds) 600 mW/cm2 (30 seconds) 3. Soft-Start II (SSII): 200 mW/cm2 (10 seconds), 600 mW/cm2 (30 seconds) 4. Pulse-Delay I (PDI): 100 mW/cm2 (3 seconds), 3-minute delay, 600 mW/cm2 (37 seconds) 5. Pulse-Delay II (PDII): 200 mW/cm2 (3 seconds), 3-minute delay, 600 mW/cm2 (37 seconds) After 24 hours storage in distilled water at room temperature, a shear bond strength (SBS) test was performed using an Instron machine at 1 mm/minute and the results were recorded in MPa. Statistical analysis included two-way ANOVA and Tukey HSD (p < 0.05). The highest SBS (MPa) was shown in the OS conventional group (19.62 +/- 2.21) and the lowest SBS was shown in P&B NT, PDII (5.93 +/- 1.79). In each group of five curing modes, the mean SBS for P&B NT was significantly lower than OS: conventional mode--P&B NT (17.27 +/- 1.98) vs OS (19.62 +/- 2.21); SSI-P&B NT (10.84 +/- 2.82) vs OS (13.09 +/- 1.24); SSII - P&B NT (14.78 +/- 1.63) vs OS (18.79 +/- 1.57); PDI-P&B NT (5.93 +/- 1.79) vs OS (11.97 +/- 2.59) and PDII-P&B NT (11.82 +/- 1.24) vs OS (16.00 +/- 1.62) (p < 0.001 for all comparisons). For each of the adhesives, the ranking of SBS was as follows: CO > SSII > PDII > SSI > PDI, with the two-paired comparisons of curing modes being significantly different (p < 0.05). The results of the current study indicated that the bond strength of P&B NT might be compromised by the higher acidity of this adhesive compared to OS during each curing mode, especially PDI. The conventional mode was least affected by the acidity of the adhesive.

The prevalence of dental caries in 5 - 18-year-old insulin-dependent diabetics of Fars Province, southern Iran.

BACKGROUND: The association of dental caries and diabetes mellitus has not received enough attention, in spite of the fact that both diseases are associated with the ingestion of dietary carbohydrates. This study was undertaken in Fars Province, southern Iran, to determine the prevalence rates of dental caries in a group of metabolically well-controlled patients with type I diabetes mellitus and in a control group. METHODS: Fifty patients (22 boys and 28 girls) with type I diabetes mellitus under follow-up of the Endocrinology and Metabolism Research Center of Shiraz University of Medical Sciences, with a mean +/- SD age of 11.72 +/- 3.36 years and mean +/- SD fasting blood sugar of 235.74 +/- 103.61 mg/dL, entered this study. A similar study was conducted to determine the prevalence of dental caries in 12-year-old school children in Shiraz, Iran who served as the control group. After completing a questionnaire, the patients were examined separately by two dentists. Before the clinical examination, bitewing radiographies were performed. Student's t- and Chi-square tests were used for statistical analysis in relation to sex, age of onset of diabetes mellitus, socioeconomic and nutritional status, family history of diabetes mellitus, and orohygiene status. RESULTS: The mean +/- SD DMFT for diabetic children was 9.64 +/- 4.64 (decayed = 8.12 +/- 3.90, missing = 0.62 +/- 1.34, and filling = 0.90 +/- 2.10). The lower permanent first molars were the most frequency decayed and the incisors were the healthiest teeth. DMFT score and the frequency of decayed teeth were higher in boys than in girls. However, the rate of filling and missing teeth were higher in girls. DMFT and the number of decayed teeth were higher in patients with poor oral hygiene. The number of healthy first permanent molars was much higher in the mixed dentition groups than in those with permanent teeth. A direct correlation was found between the health status of the first permanent molar tooth and having type I diabetes mellitus. CONCLUSION: Oral hygiene was somewhat poorer in diabetic patients than in the control group. Regular dental check-ups for preventive measures such as fluoride therapy, fissure sealant, regular medical follow-ups for proper control of metabolic abnormalities to decrease occurrence of xerostomia, omission of cariogenic substances from dietary regimen, fluoridation of drinking water, and individual and group education of diabetic patients regarding proper dental hygiene are recommended.