Background: This study was done to evaluate remineralizing potential of bioactive glasses (BAGs) and amorphous calcium phosphate-casein phosphopeptide (ACP-CPP) on early enamel lesion. Materials and Methods: Twenty freshly extracted mandibular premolars were sectioned sagittally. The buccal half was impregnated in acrylic resin blocks and treated with 37% phosphoric acid in liquid form, to demineralize enamel surface to simulate early enamel lesion. The samples were divided into two groups. The samples in Group I were treated with ACP-CPP (GC Tooth Mousse) and in Group II with BAG (Sensodyne Repair and Protect) and stored in saliva to prevent dehydration. The samples were tested for microhardness. The data obtained was analyzed using ANOVA post hoc multiple comparison and independent sample t- test and presented as a mean and standard deviation. Results: All the samples showed a decrease in the microhardness after demineralization. After application of remineralizing agents, Group II showed a highly significant increase in the microhardness (P < 0.05) after 10 days, while Group I showed a significant increase in microhardness after 15 days (P < 0.05). Conclusion: Both the remineralizing agents tested in this study can be considered effective in repair and prevention of demineralization. BAG showed better results initially, but eventually both have similar remineralizing potential.

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Background: The aim of this study was to assess the oral health knowledge behaviour and practices among school children in Qatar. Materials and Methods: A cross-sectional study was carried out in Qatar from October 2011 to April 2012. A total of 2200 school children aged 12–14 years were approached from 16 schools of different areas. The information about oral health knowledge and sources of information was obtained through a self-administrated questionnaire. Data analyses were performed. Results: The overall response rate was (96%). Only (25.8%) of children reported a high level of oral health knowledge. After each meal, tooth brushing was observed by a very low percentage of children (3.7%). About 44.6% of children recognized dental floss as a cleaning device for between the teeth. A large number of children (32.5%) thought incorrectly that one must visit the dentist only in case of pain. A great majority was not aware of cariogenic potential of soft drinks (39%) and sweetened milk (97.8%). Less than half (38.9%) of children actually had heard about fluoride. Only (16.8%) correctly answered the question about sign of tooth decay. Slightly, less than half (48.4%) could not define the meaning of plaque. Parents were the most popular (69.1%), source of oral health information for the children. Conclusion: The oral health knowledge in Qatar is below the satisfactory level. Parents were the most popular source of oral health knowledge for the children followed by dentists, school teachers, and media.

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Background: Periodontal disease has a multifactorial etiology. A combination of microbial agents and environmental, habitual, systemic, and genetic risk factors is responsible for the development of periodontal disease. Host immune response causes the destruction of tooth-supporting structure and eventual tooth loss. This study aimed to assess the correlation of interleukin 6 (IL-6) -174-GC and IL-6-572-GC gene polymorphisms with periodontal disease in an Iranian population. Materials and Methods: This case–control analytical study was conducted on 129 subjects presenting to the laboratory of Taleghani Hospital. Subjects underwent clinical and periodontal examinations and divided into five groups of healthy, gingivitis and mild, moderate and severe periodontitis. Blood samples (2 ml) were obtained. Genomic DNA was extracted manually using the salting-out method. IL-6 sequence amplification was performed using polymerase chain reaction with three thermal protocols. Digested products were analyzed by electrophoresis through 2% agarose gel using Gel Red staining. Data were analyzed using Chi-square, Kruskal–Wallis, and Mann–Whitney tests, and P < 0.05 was considered significant. Results: The frequency of GG polymorphism at IL-6-174 and IL-6-572 genomic regions was 51.2% and 71.3%, respectively. The frequency of IL-6-572-GG polymorphism was significantly greater than that of IL-6-572-GC polymorphism (P < 0.001). Comparison of the mean and maximum pocket depth and clinical attachment level, as well as bleeding on probing percentage, revealed significant differences between the healthy controls and periodontitis patients (P < 0.001). The frequency percentages of GC and GG polymorphisms were almost equal in the healthy, gingivitis, and periodontitis groups. In other words, the frequency of the two polymorphisms was not significantly different between the health and disease states (P = 0.065 for IL-6-572 and P = 0.63 for IL-6-174). Conclusion: This study found no association between IL-6-174 and IL-6-572 gene polymorphisms and periodontitis in the studied population.

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Background: Selective alveolar corticotomy is defined as an intentional injury to cortical bone. This technique is an effective means of accelerating orthodontic tooth movement. The aim of this study is to evaluate the effect of buccal corticotomy in accelerating maxillary canine retraction. Materials and Methods: The sample in this clinical trial study consisted of 15 adult female patients with therapeutic need for extraction of maxillary first premolars and maximum canine retraction. By use of split-mouth design, at the time of premolars extraction, buccal corticotomy was performed around the maxillary first premolar, randomly on one side of maxilla, and the other side was reserved as the control side. Canine retraction was performed by use of friction – less mechanic with simple vertical loop. Every 2 weeks, distance between canines and second premolars was measured until complete space closure. The velocity of space closure was calculated to evaluate the effect of this technique in accelerating orthodontic tooth movement. The obtained data were statistically analyzed using independent t-test, and the significance was set at 0.05. Results: The rate of canine retraction was significantly higher on the corticotomy side than the control side by an average of 1.8 mm/month versus 1.1 mm/month in the corticotomy side and control side, respectively (P < 0.001). Conclusion: Based on result of this study, corticotomy can accelerates the rate of orthodontic tooth movement about two times faster than conventional orthodontics and it is significant in early stages after surgical porsedure. Therefore Buccal corticotomy is a useful adjunct technique for accelerating orthodontic tooth movement.

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Background: Nitric oxide (NO), a highly reactive radical, participates in the nonspecific natural defense mechanism of the oral cavity. The present study was attempted to evaluate the salivary NO levels in 4–5 year-old children with early childhood caries (ECC). The objective of the present study was to assess the salivary NO concentration in children with different caries activity. Materials and Methods: The study included 120 healthy 4–5 year-old children and they were equally divided into three groups based on decayed, missing, filled surfaces (dmfs) score; forty caries-free children (control group), forty children with dmfs 1–5 (ECC group), and forty with dmfs ≥6 (severe ECC group). Saliva collected was measured for NO concentration by Griess reaction method. The obtained data were analyzed by ANOVA and Pearson's correlation coefficient. Results: The mean level of NO in the saliva of the control group was 51.2 ± 8.3457 and that of ECC and severe ECC were 47.1 ± 5.2614 and 33.625 ± 4.6942, respectively. The mean salivary NO concentration was significantly higher in healthy controls when compared to children with ECC and severe ECC. Moreover, a negative correlation (r = −0.6658) was observed between the salivary NO level and the mean dmfs, suggesting that as the salivary NO level decreases, the caries incidence increases. Conclusion: The obtained results support the antimicrobial activity of salivary NO and also suggest that an increase in NO production might contribute to lower the caries occurrence in children.

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Background: Orthodontic therapy has oral ecological changes causing increased numbers of mutans streptococci in saliva and plaque. The purpose of this study was to estimate counts and colonization pattern of Streptococcus mutans after application of fixed orthodontic appliances. Materials and Methods: Plaque samples of randomly selected sixty patients were collected before placement of orthodontic appliances from buccal and labial aspects of the anterior teeth and four first molars and readings were recorded as T₀. After placement of appliances (0.22 MBT preadjusted Gemini), i.e., 2^nd and 3^rd month, the plaque samples were collected again from same site and readings were recorded as T₁and T₂, respectively. Counts of S. mutans in these patients were determined by using DM Strips (Orion Diagnostic, Espoo, Finland). Kruskal–Wallis test and Mann–Whitney U-test were used to find out significant differences between different time interval for Dentocult score for S. mutans in orthodontic patients (P < 0.001). Results: Prior to the treatment, 46 patients (76%) showed mild and 14 patients (24%) showed moderate colonization of S. mutans. After treatment, the severity of colonization increased showing fifty patients (84%) moderate and six patients (10%) showing severe colonization of S. mutans at T₁, which further increased in severity at T₂with 54 patients (90%) showing severe colonization with S. mutans. Conclusion: Results showed that fixed orthodontic appliance increases colonization of S. mutans during orthodontic treatment.

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Background: Tonsilloliths are calcified concretions that develop in tonsillar crypts. They are usually small and asymptomatic, so they are found accidentally during routine dental radiogrphy procedure. Large tonsilloliths can occur with clinical signs and symptoms. The purpose of this study was to evaluate the prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography (CBCT) images. Materials and Methods: In this cross-sectional study, 0.5-mm axial and coronal slices of 134 CBCT images were evaluated to determine the presence of palatine and adenoid calcifications. Their patterns such as being unilateral or bilateral as well as single or multiple and their largest linear sizes were reported. Results: Fifty-four (40.3%) patients with palatine tonsilloliths and 17 (12.7%) with adenoid calcifications were found. Thirty (55.6%) palatine tonsilloliths were unilateral, 19 (35.2%) were detected in the left tonsils. Approximately, 54 cases of 78 palatine calcifications were multiple. Seventeen patients had adenoid calcifications that 41.1% of them were unilateral. Fourteen adenoid calcifications were single. The mean ages of patients with palatine tonsilloliths and adenoid calcifications were 45.59 years and 46.53 years, respectively. The range of linear measurements of palatine tonsil calcifications was 0.9–4.2 mm (2.47-mm mean size) while adenoid calcifications ranged from 0.5 to 2.2 mm (0.95-mm mean size). The level of statistical significant difference was <0.05. Conclusion: Gender did not affect total prevalence, the pattern of tonsilar calcifications and their linear sizes. The prevalence of tonsilloliths increased with aging, but this variable did not have an effect on their linear size.

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Background: Direct observation cannot detect caries under restorations; therefore, the aim of this study was to compare the accuracy of radiographs and DIAGNOdent in detecting caries under restorations in primary teeth using histologic evaluation. Materials and Methods: A total of 74 previously extracted primary molars (37 with occlusal caries and 37 without caries) were used. Class 1 cavity preparations were made on each tooth by a single clinician and then the preparations were filled with composite resin. The accuracy of radiographs and DIAGNOdent in detecting caries was compared using histologic evaluation. The data were analyzed by SPSS version 21 using Chi-square, Mc Namara statistical tests and receiver operating characteristic curve. The significance was set at 0.05. Results: The sensitivity and specificity for DIAGNOdent were 70.97 and 83.72, respectively. Few false negative results were observed, and the positive predictive value was high (+PV = 75.9) and the area under curve was more than 0.70 therefore making DIAGNOdenta great method for detecting caries (P = 0.0001). Two observers evaluated the radiographs and both observers had low sensitivity ( first observer: 48.39) (second observer: 51.61) and high specificity (both observers: 79.07). The +PV was lower than DIAGNOdent and the area under curve for both observers was less than 0.70. However, the difference between the two methods was not significant. Conclusion: DIAGNOdent showed a greater accuracy in detecting secondary caries under primary molar restorations, compared to radiographs. Although DIAGNOdent is an effective method for detecting caries under composite restorations, it is better to be used as an adjunctive method alongside other detecting procedures.

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Background: There is no conclusive evidence on the effect of orthodontic force application on dental pulp tissue. The aim of this study was to compare early and delayed histological effects of intrusive forces on dental pulp of adolescents and adults. Materials and Methods: Patients referred to the Department of Orthodontics of Mashhad University of Medical Sciences participated in this study. They were assigned to adult (25–32-year-old) and adolescent (13–18-year-old) Groups. A cantilever spring made of 16 × 22 steel wire was used to apply intrusive force to upper first premolars (11 teeth in adolescents and 11 teeth in adults) and the opposing teeth were considered as control group. In each group, 6 pairs of teeth were extracted after one week, and the remaining 5 pairs were extracted after one month of intrusion. Histologic changes were compared between the control and intrusive groups and also between the adults and adolescents after 7 days and 1 month. Statistical analysis was performed using Statistical Package for the Social Sciences and Wilcoxon and Mann–Whitney U-tests. P ≤ 0.05 was set as statistically significant. Results: Significant difference was not found in any histological parameters between intrusive and control groups 1 week and 1 month after intrusion in adolescents and adults (P > 0.05). One month after intrusion, inflammatory cell response intensity (P = 0.032) and frequency of chronic inflammation (P = 0.032) were significantly higher in adults compared to adolescents. Conclusion: Mild intrusive force in closed apex teeth causes no significant histologic changes in adolescents and adults. However, it seems that inflammatory-related histologic pulpal changes are more severe in adults after one month of intrusion.

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Wisdom tooth operations are sometimes accompanied by complications. This case report shows complications during upper jaw third molar removal. Expectable problems during oral surgery should be planned to be solved in advance. Displacement of the third molar during oral surgeries as a considerable complication is rarely discussed scientifically. A good design of flap, adequate power for extraction, and clear view on the surgical field are crucial. Three-dimensional radiographic diagnostics in terms of cone beam computed tomography is helpful after tooth displacement into the infratemporal fossa.

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Background: The metabolic syndrome and periodontitis coincide with systemic inflammation and glucose tolerance disorder, which indicate the common pathophysiologic pathway of these diseases. The main goal of this study was to determine the effects of the metabolic syndrome on the periodontal indices of hemodialysis (HD) patient. Materials and Methods: In this descriptive-analytical study, 75 persons were selected by the simple method, 50 of them were HD patients, and 25 of them were healthy people. They were divided into three groups each of which included 25 persons. The periodontal conditions of the selected persons were determined by radiography, gingival index, probing pocket depth, and bleeding index. Then, the periodontal indices of the patients suffering from metabolic syndrome and the persons not affected by metabolic syndrome were compared. At the end, the data were analyzed by SPSS software (version 20) using Mann–Whitney and Kruskal–Wallis tests at the meaningful level of α = 0.05. Since the condition of the unilateral variance test could not be provided for this study, the Kruskal–Wallis test was used. To complete the test, the Mann–Whitney test was used in the binary form among the groups being studied. Results: The obtained results showed a meaningful difference among the groups under study (P < 0.001). The results of the test showed a meaningful difference among the obtained indices of the groups being studied in the binary form (P < 0.001) too. Conclusion: The results of the present study revealed when the severity of chronic systemic disease increased the health of the periodontal tissues would decrease.

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Background: Root morphology is of utmost importance to endodontic sciences. Since there are a few studies on the morphology of mandibular second molars' roots, and some anatomical variables are not evaluated before, the aim of this study was to investigate thoroughly radicular anatomy of this tooth. Materials and Methods: This ex vivo study was performed on 150 intact mandibular second molars. After access cavity preparation and ensuring canal patency, Indian ink was injected into root canals from the orifices. The teeth became transparent using methyl salicylate storage. Then, they were inspected by an endodontist under a ×10 stereomicroscope regarding numerous root morphological variables. Data were analyzed using chi-square test and analysis of variance (α = 0.05). Results: About 86.7% of teeth had two roots and 13.3% were single-rooted (P = 0.0001), of which, 50% were C-shaped (6.7% of all teeth, P = 0.0001). 86.7% of mesial roots were double canalled, whereas 75.3% of distal roots were single canalled (P = 0.0001). 71.45% and 95.3% of the mesial and distal roots had one apical foramen, respectively (P = 0.0001). Apical foramens were mostly central followed by lingual in most cases. Distances between apical foramen and apical constriction ranged between 0.27 and 0.40 mm (P = 0.0545). Distances between apical foramen and root apices ranged between 0.30 and 0.47 mm (P = 0.0001). Vertucci classifications of mesial canals were Type II in 62.6% and Type IV in 37.4%. 86.2% of single-canal distal roots were Type I. 66.7% of double-canal distal roots were Type II and 33.3% were Type IV (P = 0.0001). The mean root lengths from cervical to apex of mesial, distal, and single roots were 14.02 ± 0.85 (95% confidence interval [CI] = 13.87–14.17), 13.35 ± 0.91 (95% CI = 13.19–13.50), and 14.25 ± 0.72 mm (95% CI = 13.91–14.58), respectively. The extents of canal curvatures varied between 20° and 31° buccolingually (P = 0.0000), and between 19° and 27° mesiodistally (P = 0.0000). Conclusion: There was a considerable rate of eccentric apical foramen in mandibular second molars.

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Background: The purpose of this study was to investigate of radiographic pattern and relative frequency of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in panoramic radiographs. Materials and Methods: Totally 411 panoramic radiographies were randomly selected from patients referred to Radiology Department of Faculty of Dentistry, Tabriz University of Medical Sciences. Descriptive characteristics of radiopacities, including shape, border, localization, and dental relationship, were recorded. The Chi-squared test was used. Results: IO was detected in 31 (7.5%) patients and 22 (68.8%) lesions had exact border while their shape was mostly irregular. About 17 (53.1%) lesions were apical, and 13 (40.6%) lesions had no relation to the teeth. The most involved teeth were the second premolar (28.1%) and first molar (25%). Moreover, CO was detected in 32 (7.8%) patients. 17 (53.1%) lesions had an ill-defined border, and their shape was mostly irregular (65.6%) with ill-defined border. Around 18 (56.3%) lesions were apical, and 11 (34.4) lesions were apical and interradicular. The most involved teeth were the second premolar (59.4%) and the first molar (21.9%). Conclusion: The results demonstrated that relative frequency of IO in the selected population was 7.5% and for CO, it was 7.8%.

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Adenoid ameloblastoma with dentinoid is a rare odontogenic tumor. Granular cell ameloblastoma also is a less common histological subtype of ameloblastoma. In this report, the patient was a 31-year-old male. The lesion was located in the right mandible and was unicystic with well-defined borders. The tumor tissue was showing a combination of follicular, plexiform, and desmoplastic patterns of ameloblastoma with wide areas of granular cells, fibrous stroma, glandular pattern, and dentinoid calcified. Very few cases of distinct forms of ameloblastoma that show the formation of dentinoid has been reported. However, there are no cases of adenoid granular cell ameloblastoma with dentinoid reported.

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