Effects of different concentrations of bromelain and papain enzymes on shear bond strength of composite resin to deep dentin using an etch-and-rinse adhesive system.

BACKGROUND: The dentin substrate can be modified by proteolytic agents, which may affect the bonding strength of adhesive systems to the treated dentin surface. Papain, a cysteine protease enzyme with antibacterial and anti-inflammatory properties, can be used for deproteinization of dentin. An alternative deproteinizing enzyme is bromelain. OBJECTIVES: This study aimed to evaluate the impact of deproteinization on the shear bond strength (SBS) of composite resin to deep dentin using different concentrations of bromelain and papain. MATERIAL AND METHODS: Sixty upper premolars were extracted and randomly divided into 5 groups (n = 12 per group). In all groups, the dentin surface was etched with 37% phosphoric acid. Group 1 did not receive any enzyme treatment, group 2 was treated with a 10% papain solution, group 3 was treated with a 15% papain solution, group 4 was treated with a 6% bromelain solution, and group 5 was treated with a 10% bromelain solution. After applying an etch-and-rinse adhesive system, the specimens were restored with composite resin and the SBS was measured. RESULTS: Statistically significant differences were found between groups 2 and 3 (10% papain and 15% papain, p = 0.004), groups 2 and 4 (10% papain and 6% bromelain, p = 0.017), groups 4 and 5 (6% bromelain and 10% bromelain, p = 0.021), and groups 3 and 5 (15% papain and 10% bromelain, p = 0.005). CONCLUSIONS: Deproteinization with papain and bromelain at different concentrations after acid etching did not affect the SBS of composite resin to deep dentin when using an etch-and-rinse adhesive system. However, the group deproteinized with 15% papain demonstrated a higher SBS than the group deproteinized with 10% papain, and the group deproteinized with 6% bromelain showed a higher SBS compared to the group deproteinized with 10% bromelain.

Synthesis and characterization of mesoporous zinc oxide nanoparticles and evaluation of their biocompatibility in L929 fibroblasts.

OBJECTIVES: This study aimed to synthesize and characterize mesoporous zinc oxide nanoparticles (ZnO NPs) and also to evaluate the cytotoxicity of mesoporous ZnO NPs on L929 mouse fibroblast cell lines using 3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. MATERIALS AND METHODS: The synthesized mesoporous ZnO NPs were extensively characterized using X-ray diffraction analysis (XRD), transmission electron microscopy (TEM), Brunauer-Emmett-Teller (BET) analysis, field emission scanning electron microscopy (FESEM), energy dispersive X-ray spectra (EDAX), Fourier-transform infrared spectroscopy (FTIR), and dynamic light scattering (DLS). The cytotoxicity of mesoporous ZnO NPs was assessed by MTT assay. The study groups for cytotoxicity assay were normal saline, 0.1% calcined mesoporous ZnO NP solution, 1% calcined mesoporous ZnO NP solution, 0.1% noncalcined mesoporous ZnO NP solution, 1% noncalcined mesoporous ZnO NP solution, 0.1% ZnO NP solution, 1% ZnO NP solution, 2% chlorhexidine, and phosphate-buffered saline (PBS). The percentages of mean ± standard deviation of viable cells were analyzed. RESULTS: Characterization of mesoporous ZnO NPs revealed that all the particles were in a more or less spherical shape with a wide particle size distribution of 70-100 nm. TEM image showed the uniformed and aggregated ZnO NPs with a typical size of 10-15 nm. BET analysis showed a mesoporous structure for the prepared mesoporous ZnO NPs. According to the MTT assay, chlorhexidine had the lowest cell viability percentage. Cell viability percentages of 0.1% mesoporous ZnO NP solutions (calcined and noncalcined) were statistically, significantly higher than 0.1% ZnO NP solution (p < .05). Cell viability percentages of 0.1% calcined and noncalcined mesoporous ZnO NP solutions and 0.1% ZnO NP solution were statistically, significantly higher than the 1% solutions (p < .05). CONCLUSION: Mesoporous ZnO NPs exhibited less cytotoxicity against L929 mouse fibroblast cell lines compared to CHX and ZnO NPs, hence are safe to use.

Evaluation of the Effects of Different Types of Resin Cement Systems on the Push-Out Bond Strength of the Fiber Post to Intracanal Dentin in Anterior Primary Teeth.

Background: This study aimed to evaluate the effects of using three different resin cements on push-out bond strength (PBS) of fiber posts to root canal dentin of primary teeth. Methods: Fifty primary canines were randomly divided into five experimental groups according to the type of the luting agent used for fiber post cementation after endodontic treatment and post space preparation as the following: Group 1: glass ionomer cement (GIC), Group 2: flowable resin composite, Group 3: etch and rinse (E&R) resin cement, Group 4: self-etch (SE) resin cement, Group 5: self-adhesive (SA) resin cement. The PBS values of the cemented fiber posts to root canals were measured. The data were statistically analyzed using a one-way analysis of variance, followed by Tukey's post hoc test. Results: The highest mean PBS value was observed in Group 4 (SE resin cement), followed by Group 3 (E&R resin cement), and the lowest PBS value belonged to Group 1 (GIC), followed by Group 5 (p-values < 0.05). The mean PBS of Group 3 (E&R resin cement) was significantly higher than those of Groups 1 (GIC), 2 (flowable resin composite), and 5 (SA resin cement) (p-values < 0.05). However, no significant difference was found between the mean PBS of GIC and SA resin cement (p-value >0/05). Conclusion: Using SE resin cement for fiber post cementation in primary anterior teeth showed the best results, followed by E&R resin cement. The lowest PBS was observed for GIC, followed by SA resin cement.

Stress, Sleep Quality, and Academic Performance among Dental Students in Shiraz, Iran.

Background: Quality of sleep and stress level can affect the health, capacity of learning, and academic performance of the students. This study aimed to investigate the association between stress and sleep quality with academic performance among undergraduate clinical dental students in Shiraz, Iran. Methods: This cross-sectional study was conducted during the second semester of the academic year 2020-2021 among clinical dental students at Shiraz Dental School, Iran. A total of 138 students completed Pittsburgh Sleep Quality Index (PSQI) and dental environment stress (DES) questionnaire. The grade point averages (GPAs) of the previous terms of the participants were also collected. Data analysis was performed using Kolmogorov-Smirnov test, the one-way ANOVA, post hoc Duncan's test, nonparametric Kruskal-Wallis H test, Wilcoxon-Mann-Whitney test, and the chi-squared test. The p values of less than 0.05 were considered statistically significant. Results: Clinical dental students participated in this study experienced moderate levels of stress and poor sleep quality. Mean total DES and PSGI scores did not differ by sex, year of study, marital status, and place of residence (p values >0.05). Most of the students (52.9%) had moderate GPAs. A significant relationship was observed between sex and GPA as well as between place of residence and GPA (p values <0.05). No significant differences were found between DES total score or PSQI score and GPA categories (p values >0.05). A significant direct relationship between DES total score and PSQI score was observed (p < 0.05). Conclusion: Dental undergraduates in Shiraz, Iran, experienced moderate levels of stress and poor sleep quality. The results showed no significant difference between sleep quality or DES and academic achievement. However, a significant direct correlation was observed between sleep quality and dental environment stress.

Is the Presence of Helicobacter Pylori in the Colonic Mucosa, Provocative of Activity in Ulcerative Colitis?

Background: Epidemiologic studies have shown world-wide increasing incidence of ulcerative colitis (UC) as an autoimmune disease of intestine. In the meantime, gastrointestinal H. Pylori infection is being decreased. Objectives: There are very few studies about comparing the presence of H. Pylori in the colon and the disease activity of UC. There is no study form Iran. In this study, we tried to investigate the presence of H. Pylori in the mucosa of colon by molecular and microbiological as well as pathological methods to find any association between the presence of this organism in the colon and the presence and activity of UC. Patients and Methods: In 100 patients who referred to colonoscopy clinic, colonoscopy was performed. Fifty-seven patients with the new diagnosis of UC were considered as cases and 43 patients with normal screening colonoscopy for polyps were considered as controls. Colon biopsies were evaluated according to histopathology, clinical findings, and laboratory results to confirm the diagnosis and the degree of activity in the cases of UC. Molecular studies were also performed to evaluate the presence of H. Pylori genome in the colon biopsies. A sample of colon was also cultured for H. Pylori. ELISA test was performed in a sample of blood to evaluate the level of IL-10 and IL-17 as regulatory cytokines of inflammation. Results: Cases with the diagnosis of UC showed significantly higher number of positive colonic H. Pylori comparing to normal colonic mucosa. Also, the presence of H. Pylori genome in the colon was associated with higher activity in the cases with UC and higher levels of inflammatory mediators especially IL17 and lower levels of inhibitory mediators such as IL-10. Conclusion: Colonic colonization of H. Pylori was higher in the patients with UC and higher activity of this disease comparing with normal control colonic mucosa.

Comparison between the effect of adding microhydroxyapatite and chitosan on surface roughness and Microhardness of resin modified and conventional glass ionomer cements.

BACKGROUND: This study aimed to compare the effect of chitosan (CH) and hydroxyapatite (HP) on the surface roughness and microhardness of a conventional glass ionomer cement (CGIC) and a resin modified glass ionomer cement (RMGIC). MATERIAL AND METHODS: 60 disk-shaped specimens (2mm x 6mm) were prepared in 6 groups; group I: CGIC, group II: RMGIC, group III: CGIC + 15% volume CH solution in liquid, group IV: CGIC +10% weight micro-HP in powder, group V: RMGIC + 15% volume CH, group VI: RMGIC + 10% weight micro-HP. After storage in deionized water at room temperature for 24 hours, the surface roughness and microhardness of the specimens were measured using a surface profilometer and Vickers microhardness (VHN) tester, respectively. Data were analyzed using two-way ANOVA, Tukey HSD test and paired t-test (P<0.05). RESULTS: The microhardness values of RMGIC and CGIC decreased significantly with the addition of micro-HP (P<0.001). None of the CH-containing GICs showed significant changes in microhardness (P = 0.552). The VHN values of CGIC were higher than RMGIC, regardless of the added substance (P<0.001). The surface roughness (Ra) values (µm) of both RMGIC and CGIC decreased significantly with the addition of CH (P = 0.004). The incorporation of micro-HP into GICs did not have a significant effect on surface roughness values (P = 0.700). The RMGIC showed less Ra values compared to the CGIC regardless of the added substance (P<0.001). The lowest and highest Ra values were observed in RMGIC + CH and CGIC + micro-HP groups, respectively. CONCLUSIONS: The addition of CH to GIC and RMGIC reduced the surface roughness and did not have an adverse effect on the microhardness. Mixing GIC and RMGIC with micro-HP resulted in microhardness reduction and did not affect the surface roughness. Key words:Glass ionomer, hydroxyapatite, chitosan, hardness, surface roughness.

Evaluation of the Effects of Bromelain and Papain Enzymes on Shear Bond Strength of Composite Resin to Enamel.

AIM: This study aimed to evaluate the effects of 6% bromelain and 10% papain enzymes on shear bond strength (SBS) of composite resin to enamel compared to conventional 37% phosphoric acid etching. MATERIALS AND METHODS: 50 human maxillary premolar teeth were randomly divided into 5 groups (G1-G5/n = 10). In G1 and G2, after etching enamel with 37% phosphoric acid for 15 seconds and washing the surface, 10% papain and 6% bromelain enzymes were used, respectively. In G3 and G4, 6% bromelain or 10% papain enzymes were applied on enamel. In G5, the enamel surface was etched with 37% phosphoric acid for 15 seconds. A two-step etch-and-rinse adhesive system (Adper Single Bond 2) was applied. A nanohybrid composite (Z350) was placed using Teflon molds. All the samples were then subjected to the SBS test using a universal testing machine. Data analysis was performed using a one-way ANOVA test followed by the Tukey test. p values less than 0.05 were considered significant. RESULTS: Comparison of the mean SBS between G1, G2, and G5 shows no significant differences (p > 0.05); however, they had higher mean SBS compared with G3 and G4 (p < 0.0001). CONCLUSIONS: The shear bond strength of composite to enamel was not affected significantly using either 6% bromelain or 10% papain enzymes after 37% phosphoric acid application. Moreover, 6% bromelain and 10% papain enzymes were not as effective as 37% phosphoric acid alone.

Microsatellite Instability and Colorectal Cancer, Immunohistochemical and Molecular Evaluation by Using DNA Sequencing: A Single Center Experience.

BACKGROUND & OBJECTIVE: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite unstable (MSI) colorectal cancers from Iran. In this study, we aimed to evaluate the clinicopathological and immuno-histochemical findings of MSS and MSI colorectal cancers in our Center as the largest Center of gastrointestinal surgery and oncology in the South of Iran. We also compared the immunohistochemical method vs. molecular study using DNA sequencing. METHODS: For 5 years (2015-2019), 34 patients who underwent operation in the affiliated Hospitals of Shiraz University of Medical Sciences were clinically suspected to microsatellite instability (MSI). The molecular diagnostic tests with DNA sequencing were performed. Clinicopathological and immunohistochemical findings of MSI colorectal cancers were compared with those who were stable. RESULTS: In the South of Iran, MSI colorectal cancers were more common in males. These tumors were more common in the right side with more tendencies to produce mucin with lymphocytic infiltration. CONCLUSION: Immunohistochemistry would be a specific method for diagnosis of MSI colorectal cancers but may be associated with high rate of false negative results and of low sensitivity. Therefore, we recommend performing molecular studies by DNA sequencing in those colon cancers with clinical suspicion for MSI and negative immunohistochemical findings.

The Effects of Various Restorative Techniques on the Fracture Resistance of Pulpotomized Permanent Premolars.

AIM: This study aimed to evaluate the effects of various restorative techniques on the fracture resistance of pulpotomized premolars with mesioocclusodistal (MOD) cavities treated with mineral trioxide aggregate (MTA) or calcium enriched mixture (CEM) cement. MATERIALS AND METHODS: One hundred and eight sound extracted maxillary premolars were randomly assigned to nine experimental groups (n = 12). The teeth in group 1 did not receive any preparation. Class II MOD cavities were prepared in the other experimental groups. In groups 2, 4, 6, and 8, tooth-colored MTA was used for pulpotomy. In groups 3, 5, 7, and 9, CEM cement was used for pulpotomy. Groups 2 and 3 were left unrestored. Groups 4 and 5 were restored with amalgam. Groups 6 and 7 were restored with a conventional composite resin, and groups 8 and 9 were restored with bulk-fill giomers. Fracture resistance was measured, the fracture pattern of each specimen was assessed, and the results were statistically analyzed. RESULTS: The fracture resistance of group 1 was significantly higher than those of the other groups (p < 0.05). The fracture resistance of group 2 (MTA + amalgam) was statistically lower than those of all experimental groups (p values < 0.05) except groups 3, 4, and 5 (p values > 0.05). No statistically significant differences were found between the groups restored with amalgam, conventional composite resin, and bulk-fill giomer (groups 4, 5, 6, 7, 8, and 9) (p values < 0.05). The highest rate of mode 1 fracture (restorable fracture) was observed in group 1 followed by groups 8 and 9. CONCLUSION: No significant differences were found among the fracture resistances of the restored teeth using various restorative techniques. Bulk-fill giomers followed by conventional composite resin were better able to prevent unfavorable fractures compared to amalgam. Therefore, they seem to be more reliable for the restoration of pulpotomized teeth with MOD cavities.

The influence of the operator's experience on the microleakage of two universal adhesives.

OBJECTIVES: This study aimed to investigate the influence of the operator's experience on the microleakage of two universal adhesives applied in self-etch (SE) and etch-and-rinse (E&R) modes. MATERIALS AND METHODS: Two class V cavities were prepared on the buccal and lingual surfaces of 112 caries-free extracted human molars and were divided into eight groups based on the combination of the factors "adhesive system" (Tetric N-Bond Universal Adhesive [TNU]; Scotchbond Universal Adhesive [SBU]), "adhesive strategy" (SE or E&R), and "the operators performing the procedures" (specialists in operative dentistry or intern students). After 24 h of water storage and thermocycling, the marginal microleakage was evaluated using the dye penetration technique and the data were analyzed. RESULTS: In the SE mode, microleakage at the enamel margin for both adhesives was higher in the student group than in the specialist group (p values < 0.05). The operator's skill did not affect the microleakage scores of both adhesives applied in the E&R mode at the dentin and enamel margins or in the SE mode at the dentin margins (p > 0.05). The microleakage score was significantly higher at the dentin margins than the enamel margins for both universal adhesives applied in the E&R mode (p values <0.05). CONCLUSION: The microleakage values of the universal adhesives applied in the SE mode at the enamel margins were affected by the operator's skill. However, the operator's experience did not affect the microleakage scores of the two universal adhesives applied in the E&R mode at the enamel and dentin margins or in the SE mode at the dentin margins.

Conditional disease-free survival rates and their associated determinants in patients with epithelial ovarian cancer: A 15-year retrospective cohort study.

BACKGROUND: The most common type of ovarian cancer (OC) is epithelial ovarian cancer (EOC) which is the most lethal gynecologic malignancy in adult women. AIM: This study aimed to determine the conditional disease-free survival (CDFS) rates and their associated determinants in patients with EOC. METHODS AND RESULTS: The clinical and demographic data of 335 patients with confirmed EOC at Motahari Clinic (Shiraz, Iran) were retrospectively reviewed and analyzed. Traditional DFS (TDFS) and CDFS were calculated using the Kaplan-Meier method and cumulative DFS estimates, respectively. To evaluate the effects of the prognostic determinants on the DFS of the patients, a multiple covariate Cox analysis using the landmarking method was applied. The 1- and 3-year TDFSs were 81.1% and 47.0%, respectively, and decreased over time. At baseline, a higher stage tumor and endometrioid histology were associated with a higher risk of recurrence when compared to stage I and other histological subtypes, respectively. The hazard of recurrence for older women (age ≥55 years) was approximately twice and three times more than that of women aged <45 years at 1- and 3-year landmark time points, respectively. CONCLUSION: The age at diagnosis, defined by a cut-off of 55 years, was a prognostic factor for the CDFS of EOC women. Moreover, patients with advanced-stage EOC (ASEOC) (stages III and IV) and endometrioid histology had poorer CDFSs compared to those with early-stage EOC (ESEOC) (stages I and II) and other histological types. In ESEOC patients with age at diagnosis of >55 years, CDFS gradually decreased in 3 years after remission which should be considered for follow-up care decision-making.

Microshear Bond Strength of Nanoparticle-Incorporated Conventional and Resin-Modified Glass Ionomer to Caries-Affected Dentin.

The purpose of this study was to assess the influence of three different types of nanoparticles (silver (SNPs), titanium dioxide (TNPs), and zinc oxide (ZNPs)) on the microshear bond strength of conventional glass ionomer cement (CGIC) and resin-modified glass ionomer cement based on whether CGIC or RMGIC is used with four subgroups (based on the incorporation of SNPs, ZNPs, and TNPs in addition to a control subgroup) (n = 12) as follows: CGIC, CGIC + TNP, CGIC + ZNP, CGIC + SNP, RMGIC, RMGIC + TNP, RMGIC + ZNP, and RMGIC + SNP. After 24 hours, the µSBS of specimens was tested and the obtained data were analyzed using two-way ANOVA and Tukey's HSD test. The obtained results showed that the incorporation of TNPs in two glass ionomers was not statistically significant compared with the control subgroups (p > 0.05). In the first group, the highest and lowest mean µSBS were, respectively, observed in the CGIC + SNP subgroup and CGIC + ZNP subgroup. In the second group, RMGIC + ZNP and RMGIC + SNP, respectively, showed the highest and lowest mean µSBS compared to the other subgroups. According to the results, it can be concluded that TNPs can be incorporated into both CGIC and RMGIC without compromising the bond strength of glass ionomers. SNPs and ZNPs can be, respectively, added to CGICs and RMGICs to improve the bond strength of the restoration.

The effect of proanthocyanidin and casein phosphopeptide-amorphous calcium phosphate on the bond strength durability to caries-affected dentin.

OBJECTIVES: The aim of this study was to evaluate the effect of proanthocyanidin (PA) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on the micro-shear bond strength (µSBS) durability of an etch-and-rinse adhesive to caries-affected dentin (CAD). MATERIALS AND METHODS: The occlusal surfaces of 80 human molars with occlusal caries were ground to expose flat dentin surfaces with CAD. Then, they were randomly divided into four groups (n = 20) according to the CAD pretreatment. The study groups included no pretreatment, pretreatment with CPP-ACP for 3 min, pretreatment with PA for 1 min, and pretreatment with PA for 1 min followed by CPP-ACP for 3 min before adhesive application. After restoring the specimens with composite resin, µSBS testing was performed for half of the bonded surfaces in each group after 24 h and the other half was tested after 6 months of water storage and failure mode analysis was performed. RESULTS: The PA group was associated with a higher µSBS than the control and CPP-ACP groups after 24 hours (p < 0.05). No significant difference was observed regarding the µSBS of the control and the other groups after 24 h (p > 0.05). No significant difference was observed regarding the µSBS of the PA and PA + CPP-ACP groups (p > 0.05). The µSBS of the 6-month specimens was significantly lower than those of the 24-h specimens for all the groups (p < 0.05) except for the PA group which did not exhibit a significant difference between the two times (p > 0.05). The most common type of failure was mixed failure. CONCLUSION: PA pretreatment could stabilize the CAD-resin interface and protect degradation over time. The same effect was not observed for CPP-ACP or PA + CPP-ACP.

Effect of Silver Antibacterial Agents on Bond Strength of Fiber Posts to Root Dentin.

This study was conducted to evaluate whether antibacterial pretreatment irrigation with silver nanoparticles (SNPs) and silver diamine fluoride (SDF) has any effect on bond strength of fiber posts cemented with three types of resin cements in root canal space. Fifty-four endodontically treated maxillary central incisor roots were prepared for fiber post (FRC Postec Plus NO.3, Ivoclar Vivadent) cementation and divided into nine groups in terms of three cement types and two pretreatments with silver antibacterial agents. The cements were as follows: an etch-and-rinse cement (ER, Excite DSC/Variolink N), a self-etch cement (SE, ED Primer/Panavia F2.0), and a self-adhesive cement (SA, Panavia SA Luting Plus). For each cement, the control group was with no treatment and two experimental groups were with SNPs and SDF treatments that were used after acid-etching for ER cement and after EDTA treatment for SE and SA cements. After fiber post cementation, each bonded root was horizontally sectioned into 1-mm thickness microslices to create two slices for each root region (apical, middle and coronal) and underwent push-out bond strength (PBS) test. Data in MPa were analyzed with two-way ANOVA and Tukey test (p=0.05). The interaction of the pretreatment type and cement type was significant (p<0.001). SNPs and SDF significantly increased PBS with ER cement (p≤0.04). This positive effect was also marginally significant for SDF with SE cement (p=0.049). For SA cement, SNPs showed a significant positive effect, but SDF had a significant adverse effect on PBS (p<0.001). The effect of pretreatment with silver antibacterial agents prior to adhesive cementation of fiber posts depends on the resin cement used. Contrary to SNPs with beneficial or no significant effect on bonding for all cements, SDF exhibited a deleterious effect with self-adhesive cement.

The Effects of Silver, Zinc Oxide, and Titanium Dioxide Nanoparticles Used as Dentin Pretreatments on the Microshear Bond Strength of a Conventional Glass Ionomer Cement to Dentin.

AIM: This study was conducted to evaluate the effects of three nanoparticle solutions used as dentin pretreatments on the microshear bond strength (µSBS) of a conventional glass ionomer cement (GIC) to dentin. MATERIALS AND METHODS: Ninety intact human molars were used after sectioning their occlusal surfaces to expose flat dentin surfaces. The specimens were randomly assigned to nine groups (n = 10). Group A was the control group (without using the cavity disinfectant). In groups B, C, D, and E, the prepared dentin surfaces were treated with 1 cc 2% chlorhexidine (CHX), 0.1% silver nanoparticle (SNP), 0.1% titanium dioxide nanoparticle (TNP), and 0.1% zinc oxide nanoparticle (ZNP) solutions for 1 minute, respectively, before applying the conditioner. CHX, SNPs, TNPs, and ZNPs were applied for 1 minute after applying the conditioner in groups F, G, H, and I, respectively. The specimens were restored with a conventional GIC and underwent µSBS testing after 24 hours. The data were analyzed using the one-way analysis of variance and Tukey's test (p=0.05). RESULTS: The applications of the nanoparticles (SNP, TNP, and ZNP) after the conditioner were associated with significantly greater µSBS values compared to that of the control group (p values < 0.05). Significantly higher µSBS values were observed when TNP or ZNP was applied after the conditioner compared to their applications before the conditioner (p values < 0.05). The highest µSBS values were observed when TNP was applied after the conditioner. CONCLUSION: Dentin pretreatment with the nanoparticles after applying the conditioner enhanced the bond strength of the GIC to dentin compared with the control group. The best results were obtained for the TNPs applied after the conditioner.

Effect of silver antibacterial agents on bond strength of fiber posts to root dentin

Abstract This study was conducted to evaluate whether antibacterial pretreatment irrigation with silver nanoparticles (SNPs) and silver diamine fluoride (SDF) has any effect on bond strength of fiber posts cemented with three types of resin cements in root canal space. Fifty-four endodontically treated maxillary central incisor roots were prepared for fiber post (FRC Postec Plus NO.3, Ivoclar Vivadent) cementation and divided into nine groups in terms of three cement types and two pretreatments with silver antibacterial agents. The cements were as follows: an etch-and-rinse cement (ER, Excite DSC/Variolink N), a self-etch cement (SE, ED Primer/Panavia F2.0), and a self-adhesive cement (SA, Panavia SA Luting Plus). For each cement, the control group was with no treatment and two experimental groups were with SNPs and SDF treatments that were used after acid-etching for ER cement and after EDTA treatment for SE and SA cements. After fiber post cementation, each bonded root was horizontally sectioned into 1-mm thickness microslices to create two slices for each root region (apical, middle and coronal) and underwent push-out bond strength (PBS) test. Data in MPa were analyzed with two-way ANOVA and Tukey test (p=0.05). The interaction of the pretreatment type and cement type was significant (p<0.001). SNPs and SDF significantly increased PBS with ER cement (p≤0.04). This positive effect was also marginally significant for SDF with SE cement (p=0.049). For SA cement, SNPs showed a significant positive effect, but SDF had a significant adverse effect on PBS (p<0.001). The effect of pretreatment with silver antibacterial agents prior to adhesive cementation of fiber posts depends on the resin cement used. Contrary to SNPs with beneficial or no significant effect on bonding for all cements, SDF exhibited a deleterious effect with self-adhesive cement.

Resumo Este estudo foi conduzido para avaliar se a irrigação de pré-tratamento antibacteriano com nanopartículas de prata (SNPs) e fluoreto de diamina de prata (SDF) tem algum efeito na resistência de união de pinos de fibra cimentados com três tipos de cimentos resinosos no espaço do canal radicular. Cinquenta e quatro raízes de incisivos centrais superiores tratadas endodonticamente foram preparadas para cimentação de pino de fibra (FRC Postec Plus NO.3, Ivoclar Vivadent) e divididas em nove grupos em termos de três tipos de cimento e dois pré-tratamentos com agentes antibacterianos de prata. Os cimentos foram os seguintes: um cimento etch-and-rinse (ER, Excite DSC / Variolink N), um cimento autocondicionante (SE, ED Primer / Panavia F2.0) e um cimento autoadesivo (SA, Panavia SA Luting Plus). Para cada cimento, o grupo controle foi sem tratamento e dois grupos experimentais foram com SNPs e SDF tratamentos que foram usados após o condicionamento ácido para o cimento ER e após o tratamento com EDTA para os cimentos SE e SA. Após a cimentação do pilar de fibra, cada raiz ligada foi seccionada horizontalmente em microclimas de 1 mm de espessura para criar duas fatias para cada região da raiz (apical, média e coronal) e submetida ao teste de resistência de união por push-out (PBS). Os dados em MPa foram analisados ​​com ANOVA de dois fatores e teste de Tukey (p = 0,05). A interação do tipo de pré-tratamento e tipo de cimento foi significativa (p<0,001). SNPs e SDF aumentaram significativamente o PBS com cimento ER (p≤0,04). Este efeito positivo também foi marginalmente significativo para SDF com cimento SE (p = 0,049). Para o cimento SA, os SNPs mostraram um efeito positivo significativo, mas o SDF teve um efeito adverso significativo no PBS (p <0,001). O efeito do pré-tratamento com agentes antibacterianos de prata antes da cimentação adesiva dos pinos de fibra depende do cimento resinoso utilizado. Ao contrário dos SNPs com efeito benéfico ou nenhum efeito significativo na adesão para todos os cimentos, o SDF exibiu um efeito deletério com o cimento autoadesivo.

Caries Color, Extent, and Preoperative Pain as Predictors of Pulp Status in Primary Teeth.

AIM: This study aimed to assess the relationship between preoperative pain status, caries extent, and caries color and the ability to achieve hemostasis at the canal orifices during pulp therapy access in primary teeth. STUDY DESIGN: Eighty primary molar teeth with extremely deep caries extending to the pulp (based on bitewing radiography) were investigated in 66 children. The teeth with clear radiographic and clinical signs indicating the involvement of the radicular pulp were excluded. The history of preoperative pain status, the color of dental caries by visual inspection, and the extent of caries lesion measured in bitewing radiographs were recorded. After preparing the access cavities, the hemostasis achievement at the canal orifices was assessed and considered as the final factor in determining the type of treatment (pulpotomy or pulpectomy). The data were analyzed using Fisher's exact test, the independent t-test, and Cohen's unweighted kappa statistic. P<0.05 was considered statistically significant. RESULTS: Hemostasis was achieved in 78.1% of the teeth with black dental caries, whereas in most of the teeth with light brown dental caries (64.3%), hemostasis was not achieved (p=0.015). The extent of dental caries in the teeth needing pulpotomy was statistically significantly lower than that of those needing pulpectomy (p=0.024). Mesial side dental caries was more related to the irreversible pulpitis compared to the distal one (p=0.01). In 78.1% of the teeth without pain, hemostasis was achieved, and in most of the teeth with nocturnal pain (64.3%), hemostasis did not occur (p=0.034). CONCLUSION: The caries color, caries extent, and preoperative pain have the potential to be used as clinical diagnostic tools to determine the pulpal status in primary teeth.

The Effect of Silver, Zinc Oxide, and Titanium Dioxide Nanoparticles Used as Final Irrigation Solutions on the Fracture Resistance of Root-Filled Teeth.

AIM: This study was conducted to evaluate the effect of three nanoparticle solutions used as final root canal irrigants on the fracture resistance of endodontically treated roots. MATERIALS AND METHODS: Sixty intact single-rooted premolar teeth were used after removing the crowns below the cementum-enamel junction to standardize the length of the remaining roots to 13 mm. After instrumenting the roots using ProTaper Universal rotary instruments up to size F4, the roots were randomly divided into six groups (n=10) according to the final irrigating solutions: Group 1: normal saline; Group 2: 2% chlorhexidine (CHX); Group 3: 17% EDTA+2.5% NaOCl; Group 4: 17% EDTA+0.1% silver nanoparticle (SNP) solution; Group 5: 17% EDTA+0.1% titanium dioxide nanoparticle (TNP) solution; Group 6: 17% EDTA+0.1% zinc oxide nanoparticle (ZNP) solution. After filling the root canals with gutta-percha and AH Plus sealer, the fracture resistance (FR) values were measured. The data were subjected to the one-way analysis of variance and the Tamhane post hoc test (p=0.05). RESULTS: EDTA + NaOCl had the lowest FR value, followed by normal saline and CHX (p values < 0.05). No significant difference was found between the FR of roots irrigated with CHX and normal saline (p > 0.05). The application of nanoparticles (SNP, TNP, and ZNP) was associated with a significantly greater FR than that of other irrigation solutions (p values < 0.05). CONCLUSION: The final irrigation of root canals with nanoparticles enhanced the fracture resistance of the endodontically treated roots. The lowest FR value was observed for NaOCl.

Effect of proanthocyanidin mediated immediate and delayed dentin sealing on the strength of premolars restored with composite resin inlay.

BACKGROUND: Immediate dentin sealing (IDS) with proanthocyanidin (PA) could be used before cementation with a self-adhesive (SA) cement. The aim of this study was to assess the effect of PA treatment on acid-etched dentin before adhesive application, in IDS and delayed dentin sealing (DDS), on the strengthening property of SA-cemented composite resin inlay in premolars. MATERIAL AND METHODS: Eighty-four maxillary premolars were divided into 7 groups (n=12): 1) (Intact) Sound teeth served as controls; groups 2-7) After cavity preparation and fabrication of composite resin inlay, temporary inlays were made and cemented. After one week, the inlays were removed and composite inlays were luted with a self-adhesive resin cement as follows: 2) (SA) Without dentin- pretreatment; 3) (DDS) Etch-and-rinse adhesive before the cementation; 4) (DDS/PA) PA treatment of acid-etched dentin before the adhesive, followed by the cementation; 5) (Etch/PA) PA treatment of acid-etched dentin before the cementation; 6 and 7) (IDS and IDS/PA) Application of IDS without or with PA treatment, respectively, one week before the cementation. After thermo-mechanical aging, fracture resistance (FR) was tested. Data were analyzed using one-way ANOVA and Tamhane tests (α=0.05). RESULTS: There was a significant difference between the study groups (P<0.001). The IDS and IDS/PA groups yielded significantly higher FR compared to the SA group (P ≤ 0.003), but the DDS, DDS/PA and Etch/PA groups did not differ from the SA group (P>0.05). The effect of PA on FR in the IDS and DDS techniques was not significant. CONCLUSIONS: IDS with or without PA treatment considerably improved the strength of premolars with self-adhesive-cemented inlay, while the value of only IDS with PA treatment reached the level of the sound teeth. Key words:Delayed dentin sealing, fracture resistance, immediate dentin sealing, proanthocyanidin.