A Novel Developed Bioactive Composite Resin Containing Silver/Zinc Oxide (Ag/ZnO) Nanoparticles as an Antimicrobial Material against Streptococcus mutans, Lactobacillus, and Candida albicans.

AIM: The objectives of this study were to develop a new bioactive composite resin containing silver/zinc oxide (Ag/ZnO) nanoparticles and investigate the effects on mechanical, cytotoxic, biocompatibility, and antimicrobial properties. MATERIALS AND METHODS: Disc-shaped specimens were prepared from composite with and without nanoparticles in separate culture media containing Streptococcus mutans, Lactobacillus, and Candida albicans. Bracket bonding evaluation was performed on composite without nanoparticles (O), composite containing ZnO (Z) nanoparticles, composite containing ZnO nanoparticles and silver ions (A&Z), and composite containing Ag/ZnO nanoparticles (AZ) synthesized using optical precipitation. RESULTS: Composite resin with nanoparticles (AZ, A&Z, and Z) showed significant antimicrobial properties (P < 0.05). The mean shear bond strength of A&Z composite resin (13.61 ± 0.73 MPa) was significantly less than that of conventional composite resin (19.03 ± 4.12 MPa) (P < 0.05). In addition, the mean shear bond strength of AZ composite resin (20.49 ± 1.03 MPa) was significantly higher than that of Z (16.35 ± 1.03 MPa) and A&Z composite resins. CONCLUSIONS: Incorporation of ZnO nanoparticles and their compounds into orthodontic composite resins induced antibacterial properties against oral pathogens, and of all these nanoparticles, the AZ group exhibited the best antimicrobial activity and highest shear bond strength.

Comparison of analgesic effects of intravenous and intranasal ketorolac in patients with mandibular fracture-A Randomized Clinical Trial.

BACKGROUND: Similarity of pharmacokinetics of intranasal ketorolac to the intravenous form and other advantages have promoted its application. This study compared the analgesic effects of intravenous and intranasal ketorolac in patients undergoing mandibular fracture surgery. MATERIAL AND METHODS: In this clinical trial study, Sixty-four patients with unilateral mandibular fracture were divided randomly into two groups. In group 1, 30 mg of intravenous (IV) ketorolac was injected every 8 hours and in group 2, intranasal (IN) ketorolac spray was used as a 100-µL puff in each nostril (31.5 mg) every 6 hours. After each patient regained consciousness, pain intensity was measured based on visual analogue scale for 48 hours. Finally, the total dose of the opioid analgesic agent (pethidine) and the time for the first request for an analgesic agent were recorded for each patient, and their means were compared in each group with proper statistical tests. RESULTS: Mean pain intensity of patients at baseline was significantly higher than that at other intervals and then, it decreased significantly (P<0.001). Furthermore, 2, 4, 6 and 8 hours after surgery, mean pain intensity in the IN group was significantly lower than that in the IV group (P<0.05). In the IN group, dose of antinociceptive medicine was slightly higher and the time to request it was shorter than the other group, but it was not statistically significant (P >0.05). CONCLUSIONS: Application of intranasal ketorolac spray decreased pain after mandibular fracture surgery, especially at 8-hour interval after surgery, decreasing the need for opioids. Key words:Ketorolac, intranasal, intravenous, mandibular fracture.

Active tactile sensibility of three-unit implant-supported FPDs versus natural dentition.

BACKGROUND: Splinting of the implants might improve the active tactile sensibility (ATS) of the pontic area due to cumulative effect of Osseo perception of two retainers; on the other hand, due to the lack of any supporting implant in the axis of occlusal force for the pontic area, ATS might be lower for this portion of FPDs. we evaluated the active tactile sensibility of natural teeth and three-unit implant-supported FPDs. MATERIAL AND METHODS: The ATS of posterior 3-unit implant-supported FPD and contralateral teeth was measured in 50 patients, in a random order blinded to patients and assessor, carried out at two sessions. Based on the experimental range of 0 to 70 um, the sigmoid shape of psychometric curve was estimated to locate the 50% values as the ATS thresholds for each tooth or implant. Data were analyzed using unpaired t-tests. RESULTS: The ATS of the teeth and implants differed significantly and compared to teeth, implants exhibited significantly higher ATS thresholds in all the groups. The results of independent t-test showed the highest difference in the means of ATS between the pontic and the first molar tooth. Based on the equivalence testing approach, the 95% CIs indicated that the differences were clinically significant only in the Pontic/First Molar group. CONCLUSIONS: In multi-unit implant-supported prostheses the tactile perception of the prosthesis that are placed on fixtures is similar to the natural teeth. In pontic areas there are significant statistical and clinical differences, with much lower tactile sensibility in pontics compared to the natural teeth. Key words:Active tactile sensibility, dental implants, interdental perception, osseoperception.

Effectiveness of placement of second miniplates as tension band unit in mandibular parasymphysis fractures.

BACKGROUND: The ideal position of the plates and the need for additional plates are discussed continuously. In mandible, the tensile forces at the fracture line should be neutralized with a tension band. This study evaluated the role of the mandibular arch bar as a tension band eliminating the need for an upper miniplate (tension band plate) in cases of parasymphysis fractures. MATERIALS AND METHODS: In this randomized control trial, a total of 90 patients with mandibular parasymphysis fractures underwent treatment in two groups. Group A was treated with one titanium miniplate along with Erich's arch bar. In Group B, two titanium miniplates were placed across the fracture site along with Erich's arch bar. Then, the complications and duration of the operation time were compared between two groups. The results were considered statistically significant when the P < 0.05. RESULTS: No significant difference was observed between the groups regarding postoperative complication rate. 1 month after surgery in Group A, number of patients with sensory impairment (17%) was significantly lower than Group B (37%) (P = 0.029). Furthermore, the operation time of Group A was significantly shorter than Group B (P < 0.001). CONCLUSION: In the presence of arch bar, placing one miniplate instead of the routine technique of placing two, do not increase complication rates. Furthermore, it reduces the operation time and costs and results in a better neurosensory recovery outcome in short time.

Compatibility of Clinical and Histopathological Diagnosis of Oral Lesions in Iranian Patients

Objective: To determine compatibility between clinical diagnosis and the pathological reports of biopsies from oral lesions. Material and Methods: In this descriptive study, 1146 clinical files of patients referring to Tabriz Faculty of Dentistry from 2004 to 2016 were retrieved and evaluated. The kappa coefficient was calculated for each file for compatibility of clinical and pathological diagnosis. Results: In relation to clinical (40.2%) and pathological (39.2%) diagnosis, irritational lesions of soft tissues exhibited the highest frequency. In 72.3% of cases, the clinical and pathological diagnosis were compatible and in 27.7% of cases these diagnosis were not compatible. The highest compatibility rates were detected for irritational lesions of soft tissues (81.5%) and mucocutaneous lesions (76.9%). There was no compatibility for osseous malignant tumors, inflammatory tissues, granulation tissues, metastatic lesions and hematologic disorders. Conclusion: Approximately one-third of clinical and histopathological diagnosis were not compatible. Therefore, to reach a correct diagnosis, the clinical, radiographic and histopathological views should be evaluated simultaneously.

Salivary Transferrin Levels in Patients with Oral Lichen Planus

Objective: To compare salivary transferrin levels between patients with oral lichen planus (OLP) and healthy subjects. Material and Methods: In this descriptive, analytical, crosssectional study, 11 patients with OLP and 22 healthy subjects were selected after matching in terms of age and gender. OLP was confirmed by two oral medicine specialists based on clinical and histopathological criteria. Salivary samples were collected by spitting. The patients were asked to collect their saliva in their oral cavity and then evacuate it into sterilized Falcon tubes. The procedure was repeated every 60 seconds for 5-15 minutes. A total of 5 mL of saliva was collected using this method. The samples were collected from 8 to 9 in the morning in a fasting state to avoid circadian changes. The collected salivary samples were immediately placed next to ice and transferred to the laboratory to be centrifuged at 4°C at 800 g to isolate squamous cells and cellular debris. Then the samples were frozen at -80°C until the samples were prepared. An ELISA kit was used to determine salivary transferrin levels. Data were analyzed with descriptive statistics (means and standard deviations) and t-test for independent groups using SPSS 17. Statistical significance was set at p<0.05. Results: The mean salivary transferrin concentrations in patients with OLP and healthy subjects were 0.9055±0.28229 and 1.5932±0.80041 mg/dL, respectively (p<0.05). Conclusion: The salivary transferrin levels in patients with OLP were significantly lower than those in healthy subjects.

Evaluation of Salivary Levels of Plasminogen Activator Inhibitor-2 in Patients with Moderate Generalized Chronic Periodontitis: A Case- Control Study

Objective: To compare salivary levels of PAI-2 in patients with moderate generalized chronic periodontitis before and after treatment and healthy subjects. Material and Methods: The present case-control study evaluated patients with generalized moderate chronic periodontitis (the case group) and subjects with healthy gingiva (the control group). The healthy subjects were evaluated once and the cases were evaluated twice (before and after treatment) by collecting their salivary samples. ELISA technique was used to determine PAI-2 salivary levels. Data were analyzed with the use of SPSS 17. The level of significance was set at 5%. Results: The mean salivary levels of PAI-2 in the case and control groups were 45.63 ± 8.63 and 22.01 ± 9.77 ng, respectively (p<0.0001). In addition, PAI-2 salivary levels in the case group subjects after treatment was 27.43 ± 5.79 ng, which was lower than that before treatment (45.63 ± 8.63 ng) (p<0.0001). The mean salivary level of PAI-2 in subjects with periodontitis after treatment (27.43 ± 5.79) was not significantly different from that in healthy subjects (22.01 ± 9.77) (p>0.05). Conclusion: The salivary levels of PAI-2 in patient with moderate generalized chronic periodontitis were higher than these in healthy subjects. However, the salivary levels of PAI-2 decreased in the case group subjects after treatment, with no significant difference from the healthy subjects.

Effect of Supplementary Administration of Anaheal on Reducing Pain, Swelling and Trismus after Mandibular Third Molar Surgery: A Splitmouth Controlled Randomized Clinical Trial

Objective: To evaluate the effect of supplementary administration of Anaheal capsule in reducing pain, swelling and trismus after surgical removal of impacted mandibular third molars. Material and Methods: This single-blind controlled randomized clinical trial was conducted on 36 patients referring to Tabriz University of Medical Sciences. Each of the 36 patients had bilateral surgical removal of mandibular third molars in two sessions, with at least a 4-week interval between sessions. In the same individual, one of the sites randomly received a test medication whereas the other site was used as a control. In the test subgroup (test medication side), the first dose of Anaheal capsule was given as a 200-mg dose of bromelain immediately after surgery according to manufacturer's instructions and the subsequent doses were given at 6-hour intervals after the first dose. The medication was administrated for 3 days. In the control subgroup (control side), Anaheal was not administered. The severities of pain, swelling and maximum mouth opening (MMO) were recorded one and three days postoperatively. Paired t-test and t-test for independent samples were used. Statistical significance was defined at p<0.05. Results: A total of 72 surgical extractions were performed; 36 procedures served as control and 36 cases received Anaheal. Pain, swelling and trismus of the patients were at the highest levels one day after surgery, which decreased on day 3. However, independent t-test showed no significant differences in pain, swelling and trismus after surgery between the study subgroups (p>0.05). Conclusion: Supplementary administration of Anaheal (800 mg bromelain daily) had no significant effect on decreasing pain, swelling and trismus at 1- and 3-day intervals after surgical removal of mandibular third molars.

Comparison of Salivary Bacterial Flora in Iranian Patients with Hiatal Hernia and Healthy Subjects

Objective: To evaluate salivary microbial flora of patients with hiatal hernia and compare it with that of healthy subjects. Material and Methods: In this cross-sectional study, 50 patients with hiatal hernia measuring >1 cm and 50 healthy subjects (as the controls) were selected using simple random technique. One mL of salivary sample was taken from each patient, transferred into 50-mL Falcon tubes and immediately carried to the microbiology Laboratory of Tabriz Faculty of Medicine. The salivary samples were cultured on specific Streptococcus viridans (S. mitis, S. mutans, S. salivarius and S. sanguis), Enterococcus spp. and Lactobacillus culture media. Then the samples were incubated at 37°C for 7 days, followed by evaluation of the bacterial colonies. Statistical significance was defined at p<0.05. Results: A total of 34% of subjects with hiatal hernia and 26% healthy subjects exhibited Lactobacillus gasseri in their salivary samples; 16% of subjects with hernia and 6% of healthy subjects exhibited Enterococci spp. in their salivary samples. In addition, 82% of subjects with hernia and 72% of healthy subjects exhibited S. mutans in their salivary samples; 74% and 4% of subjects with hernia and 76% and 4% of healthy subjects exhibited gram-positive and gram-negative bacilli in their salivary samples, respectively. Furthermore, 98% of subjects with hernia and 86% of healthy subjects exhibited gram-positive cocci in their salivary samples, however without significant difference between the groups (p>0.05). Conclusion: No significant differences in the counts of Lactobacillus spp., Enterococcus spp., Streptococcus viridans and gram-positive and gram-negative bacterial species between healthy controls and subjects with hiatal hernia.

Comparing Serum and Salivary Levels of Vitamin D in Patients with Recurrent Aphthous Stomatitis and Healthy Individuals.

STATEMENT OF THE PROBLEM: Recurrent aphthous stomatitis (RAS) is the most prevalent ulcerative condition of the oral mucosa. Many studies have emphasized on immunologic factors as the reason of inducing RAS; however, the exact etiologic cause of RAS has not been identified yet. Vitamin D has an endocrine function and regulatory effects on the immune system. It has potential therapeutic effects on autoimmune diseases, psoriasis, and neoplasms. Vitamin D deficiency has been detected in some autoimmune diseases such as rheumatoid arteritis. PURPOSE: The aim of the present study was to compare the serum and salivary levels of vitamin D in patients with RAS and healthy individuals. MATERIALS AND METHOD: In this cross sectional study, patients with RAS, referring to the Department of Oral Medicine, Tabriz Faculty of Dentistry, were evaluated after taking medical history, clinical examinations, and completing an informed consent form. The serum and salivary vitamin D levels were compared between case (n=26) and control (n=26) groups. RESULTS: The mean serum vitamin D levels in the case and control groups were 33.0.7±12.41 and 50.89±9.30 (ng/dL), respectively, with a statistically significant difference (p<0.001). On the other hand, the mean salivary vitamin D levels in the case and control groups were 17.36± 8.01 and 20.79±6.31 (ng/dL), respectively, with no statistically significant difference (p= 0.09). In addition, the correlation between the serum and salivary levels of vitamin D was 56%, being statistically significant (p< 0.001). CONCLUSION: The serum levels of vitamin D in patients with RAS were significantly less than that in healthy individuals; however, there were no significant differences in salivary vitamin D levels between patients with RAS and healthy individuals. In addition, there was a significant and positive correlation between serum and salivary levels of vitamin D in all patients.

Comparison of Pain Relief from Different Intravenous Doses of Ketorolac after Reduction of Mandibular Fractures.

INTRODUCTION: Pain is an unpleasant feeling due to tissue destruction, which disturbs an individual's daily routines even at its lowest levels. The majority of surgeons and anaesthesiologists are increasingly trying to administer non-opioid analgesics because excessive use of opioids after surgery results in patient dissatisfaction. AIM: To evaluate the analgesic effect of intravenous injection of different doses of ketorolac at different intervals in patients undergoing surgery for unilateral fractures of the mandible. MATERIALS AND METHODS: In the present randomized clinical trial (March 2016 to January 2017, in Tabriz Imam Reza Treatment/Educational Center), 50 patients were assigned to five groups with simple randomization method. In Group 1 and 2, immediately before the induction of general anaesthesia 30 and 60 mg of ketorolac and in Group 3 and 4, immediately before termination of surgery 30 and 60 mg of ketorolac was injected intravenously. In Group 5, ketorolac was not administered. After each patient regained complete consciousness, the severity of pain was determined using VAS up to 24 hours at baseline and at 2, 4, 6, 12 and 24-hours intervals. The total dose of the opioid analgesic agent (morphine-pethidine) and the time for the first request for an analgesic agent were recorded for each patient and their means were compared in each group with suitable statistical tests. RESULTS: The patients in Group 5 and 4 exhibited the highest and lowest mean pain scores (5.03±0.9 and 3.5±1), respectively. ANOVA for repeated measures and post-hoc Tukey tests showed significant differences only between Group 3 and 5 (p=0.002) and Group 4 and 5 (p=0.001), with no significant differences between the other groups (p>0.005). The highest dose of the analgesic agent was in Group 5 (5.3±1.4 mg) and the lowest dose was recorded in Group 4 (1.6±0.6 mg). Patients in the control group received significantly higher doses compared to the other groups (p<0.05). The patients in Group 1 and 2 received higher doses of analgesics compared to Group 3 and 4 (p<0.05). The longest time for the request for the first dose of analgesic agent after surgery was 73.4±12.03 minutes in Group 4 The patients in the control group had requested analgesics after surgery at a significantly shorter time compared to the patients in all the study groups (p<0.05). The patients in Group 1 and 2 had requested analgesics at a shorter time after surgery compared to the subjects in Group 3 and 4 (p<0.05). CONCLUSION: Intravenous administration of 30 and 60 mg of ketorolac, immediately before termination of surgery, decreases the pain severity and the need for opioid analgesics after surgery.

Evaluation of adjunctive effect of low-level laser Therapy on pain, swelling and trismus after surgical removal of impacted lower third molar: A double blind randomized clinical trial.

BACKGROUND AND AIM: Wisdom teeth remains impacted in the jaw due to several reasons and surgery of impacted wisdom teeth is one of the most common surgeries in dental clinics. Pain, swelling and trismus are the common complications after this surgery which affect quality of life. In articles, various methods are introduced to control immediate inflammatory-response associated with third-molar surgery. The aim of this study is to evaluate the adjunctive effect of low-level laser Therapy on pain, swelling and trismus after surgical removal of impacted lower third molar. MATERIALS AND METHODS: This double-blind randomized controlled trial (RCT) was conducted on two groups of 24 patients (age range of 18-35) that had referred to surgical ward of Faculty of Dentistry, Tabriz University of Medical Sciences for surgery of their mandibular third molar(2015-16). All the subjects were systemically healthy and had at least one impacted mandibular third molar. After surgery, in experimental group, the laser was applied intraorally (inside the tooth socket) and extraorally (at the insertion point of the masseter muscle) immediately after surgery in contact with the target area for 25 seconds each. The laser energy was 2.5 J per area with an energy density of 5 J/ cm2 at the surface of the probe (spot size= 0.5 cm2). In the other group, as the control group, it was pretended to radiate. Trismus, pain, and swelling were evaluated on the first and seventh days after surgery. The obtained data were evaluated using SPSS 16 software and independent samples T-test. FINDINGS: In the group where LLLT had been used, P> 0.05 was calculated for pain, swelling, and trismus on days 1 and 7 after surgery that was not statistically significant. CONCLUSION: Under limitations of this study, using low-power laser with mentioned parameters, clinically reduces pain, swelling and trismus after surgical removal of impacted mandibular wisdom, but not statistically significant.

Effect of 2% Nasal Mupirocin Ointment on Decreasing Complications of Nasotracheal Intubation: A Randomized Controlled Trial.

INTRODUCTION: In oral and maxillofacial surgeries, nasotracheal intubation is carried out to increase the surgeon's access to the oral cavity. During nasotracheal intubation the risk of trauma is higher than that in orotracheal intubation as there is passage of the tube through the mucosa of the nasal tract due to which bacteria might get transported into the trachea. AIM: To evaluate the effect of 2% nasal mupirocin ointment before and after nasotracheal intubation on decreasing the complications of intubation for oral and maxillofacial surgeries. MATERIALS AND METHODS: In the present single blinded randomised controlled clinical trial, 44 patients were randomly assigned to two equal groups. A sterile swab was used, eight to 10 hours before nasotracheal intubation, to take a sample for culturing from the vestibule of nostrils and the anterior septum of the patients. In Group 1, 2% nasal mupirocin ointment was applied to the vestibules of both nostrils and the anterior septum. In Group 2, no intervention was carried out. After general anaesthesia and extubation, microbial cultures were prepared from the 4 cm distal end of the tube and antibiogram test was carried out. Also, the patients were compared in terms of the severity of nasal bleeding, the ease of breathing through the nose after nasotracheal intubation. Data were analysed with suitable statistical tests. RESULTS: In the mupirocin group, 27.2% of the subjects were carriers of Staphylococcus aureus in the nasal cavity but no S. aureus was detected at the distal end of nasotracheal tube after extubation. In the control group, 18.2% of the subjects were carriers of Staphylococcus aureus in the nasal cavity but there was no change in the number of S. aureus counts at the distal end of nasotracheal tube (p-value<0.001). After extubation, in the mupirocin and control groups, 18.2% and 22.7% of the subjects, respectively, exhibited severe bleeding (p-value=0.001). In the mupirocin and control groups, 86.4% and 59.1% of the subjects had easy extubation, respectively (p-value=0.044). In the mupirocin and control groups, 9.1% and 63.7% of the subjects immediately after regaining consciousness and 9.1% and 54.6% three hours after extubation had difficulty in breathing, respectively (p-value=0.001). CONCLUSION: Use of mupirocin before nasotracheal intubation decreased the complications of nasal intubation in addition to decreasing the risk of colonization of S. aureus and other gram-negative bacteria.

The Efficacy of Buccal Infiltration of 4% Articaine and PSA Injection of 2% Lidocaine on Anesthesia of Maxillary Second Molars.

INTRODUCTION: During the early mixed dentition period, the location of the deciduous maxillary second molar results in ineffectiveness of the infiltration technique in this area. In such cases, administration of posterior superior alveolar (PSA) nerve block is recommended; however, such a technique has some complications. The present study was undertaken to compare the effects of buccal infiltration of 4% Articaine and PSA technique with 2% Lidocaine on the success of anesthesia of maxillary deciduous second molars in 6 to 9-year old children. METHODS AND MATERIALS: In the present double-blind randomized clinical trial, 56 children aged 6-9 years requiring vital pulp therapy of deciduous maxillary second molar were included. In group 1, 4% Articaine was injected using a buccal infiltration technique. In group 2, 2% Lidocaine was injected using the PSA nerve block technique. After 10 min, the caries was removed and access cavity preparation was instituted. The patients were asked to report the presence or absence of pain during the procedure. Therefore, the existence of pain was measured by the patient's self-report. Data were analyzed with descriptive statistical methods and the chi-squared test. RESULTS: Pain was reported by 6 (21.4%) and 9 (32.1%) subjects in the Articaine and Lidocaine groups, respectively. Chi-squared test did not reveal any significant differences between the two groups (P=0.54). CONCLUSION: Under the limitations of the present study, there was no significant differences between the results of Articaine buccal infiltration and Lidocaine PSA technique, so Articaine buccal infiltration can be used as a substitute for the PSA technique.

Antibacterial Effects of Garlic Extracts and Ziziphora Essential Oil on Bacteria Associated with Peri-Implantitis.

INTRODUCTION: Peri-implantitis is an inflammatory process, characterized by loss of bone around implants and bleeding on probing. Colonization of bacteria in the pocket created around the implant is one of the most important aetiologic factors involved. Although antibiotics are routinely used and are effective agents against this bacterial infection, due to the side effects and drug resistance of these medications, researchers are more interested in using herbal derivatives. There are relatively limited number of studies in this respect. AIM: To evaluate and compare the antibacterial effects of the extracts of Allium sativum and Ziziphora clinopodioides essential oil on S. aureus and P. aeruginosa. MATERIALS AND METHODS: In this in vitro study conducted at Tabriz University of Medical Sciences between March 2016 and July 2016, aqueous and methanolic extracts of garlic and ziziphora essential oil were prepared and then their effects on one standard strain of P. aeruginosa and two standard strains of S. aureus and 18 clinical strains, (nine strains of P. aeruginosa and nine strains of S. aureus) which had been isolated from wound and blood cultures, were evaluated using the reference broth macro dilution method and disk diffusion technique. Data were evaluated with descriptive statistical techniques and t-test for independent groups, using SPSS 17. RESULTS: Aqueous and methanolic extracts of garlic did not exhibit inhibitory effects on S. aureus and P. aeruginosa. Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) for ziziphora essential oil against S. aureus were 0.25 and 0.5 µg/mL, respectively. The mean diameter of growth inhibition zone for S. aureus in the ziziphora essential oil group (0.25µg/mL) and Vancomycin group (10 µg/mL) were 26.09±5.8 and 14.63±1.20 mm respectively (p<0.001). Growth inhibition zone for P. aeruginosa were observed in only one (35 mm) and three cases (12.5±3.4 mm) in the ziziphora essential oil group (0.5 µg/mL) and Nalidixic acid group (10 µg/mL) respectively. CONCLUSION: The essential oil of ziziphora exhibited a favourable antibacterial effect on S. aureus; therefore, its extract can be used as an effective antimicrobial agent alone or in association with other antibiotics in the treatment of infections due to S. aureus.

Comparison of Total Antioxidant Capacity of Saliva in Women with Gestational diabetes mellitus and Non-diabetic Pregnant Women.

BACKGROUND: Pregnancy is considered a stressful event, results in higher levels of oxidative stress and considerable changes in physiological and metabolic functions such as gestational diabetes mellitus (GDM). Due to the cumulative effect of antioxidants and considering the controversies in this area, this study was undertaken to investigate the total antioxidant capacity (TAC) of saliva in pregnant women whit gestational diabetes in comparison to non-diabetic pregnant women. MATERIAL AND METHODS: In this cross-sectional study (2015-16), a total of 31 women with a diagnosis of GDM and 59 non-diabetic pregnant women were included in the diabetic and control groups, respectively. Salivary samples were collected by spitting method. When all samples were collected, total antioxidant capacity (TAC) was measured with the use of a commercial kit following the manufacturer's instructions. Data were analyzed with descriptive statistics and Mann-Whitney test using SPSS 18. RESULTS: Average TAC level in the saliva of women with gestational diabetes was 0.10 ± 0.14, with 0.04 ± 0.11 in non-diabetic pregnant women. Nonparametric Mann-Whitney test showed that this difference was statistically significant (P=0.024). CONCLUSIONS: Under the limitations of the present study it can be concluded that there is an increase in oxidative stresses during pregnancy, followed by an increase in the total levels of salivary antioxidants to counteract such stresses. Therefore, it is expected that determining the salivary antioxidant levels during pregnancy can be an alternative technique for the early diagnosis of diabetes. Key words:Gestational diabetes mellitus, pregnancy, saliva, total antioxidant capacity.

Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children?

INTRODUCTION: Pain control is one of the most important aspects of behavior management in children. The most common way to achieve pain control is by using local anesthetics (LA). Many studies describe that the buccal nerve innervates the buccal gingiva and mucosa of the mandible for a variable extent from the vicinity of the lower third molar to the lower canine. Regarding the importance of appropriate and complete LA in child-behavior control, in this study, we examined the frequency of buccal gingiva anesthesia of primary mandibular molars and canine after inferior alveolar nerve block injection in 4- to 6-year-old children. STUDY DESIGN: In this descriptive cross-sectional study, 220 4- to 6-year-old children were randomly selected and entered into the study. Inferior alveolar nerve block was injected with the same method and standards for all children, and after ensuring the success of block injection, anesthesia of buccal mucosa of primary molars and canine was examined by stick test and reaction of child using sound, eye, motor (SEM) scale. The data from the study were analyzed using descriptive statistics and statistical software Statistical Package for the Social Sciences (SPSS) version 21. RESULTS: The area that was the highest nonanesthetized was recorded as in the distobuccal of the second primary molars. The area of the lowest nonanesthesia was also reported in the gingiva of primary canine tooth. CONCLUSION: According to this study, in 15 to 30% of cases, after inferior alveolar nerve block injection, the primary mandibular molars' buccal mucosa is not anesthetized.How to cite this article: Pourkazemi M, Erfanparast L, Sheykhgermchi S, Ghanizadeh M. Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children? Int J Clin Pediatr Dent 2017;10(4):369-372.

Efficacy of Hypozalix spray and propolis mouthwash for prevention of chemotherapy-induced oral mucositis in leukemic patients: A double-blind randomized clinical trial.

Background. Oral mucositis is the chief complication of head and neck chemotherapy. This study was conducted to evaluate Hypozalix artificial saliva and propolis mouthwash efficacy for the prevention of chemotherapy-induced oral mucositis in leukemic patients. Methods. The present double-blind clinical trial was carried out on 72 patients undergoing chemotherapy. The patients were assigned to 3 groups. In the control group, CHX mouthwash and fluconazole were used by the subjects. In groups 1 and 2, Hypozalix and propolis mouthwashes were added to the combination therapy used in the control group. The results were compared between the three groups after 14 days. Results. Mean score A was significantly higher than mean score B in children (P = 0.001). In contrast, mean score A was significantly lower than mean score B in young adults (P = 0.003). Conclusion. Use of Hypozalix spray or propolis mouthwash in association with CHX mouthwash and fluconazole simultaneously at the start of chemotherapy resulted in a decrease in chemotherapy complications after 14 days. In many cases the use of propolis mouthwash yielded better results and the patients exhibited a greater tendency to continue to use it.