Background: The herpes simplex virus is a human pathogen which can cause skin or mucous membrane infections. Melissa, sumac, licorice, rosemary, and geranium have antimicrobial, antiviral, anti-inflammatory, and local analgesic effect. Shortening recovery period of recurrent herpes labialis and control of viral protein formation are the other effects of these herbs. The aim of this study is design, formulation, and evaluation of the gel containing extracts of these five herbs. Materials and Methods: In this experimental study after photochemical and macroscopic evaluation of these medicinal herbs, the semisolid concentrated extracts were incorporated in gel bases. Mucoadhesive gels were prepared using carbopol 940, sodium carboxymethylcellulose (Na CMC) and hydroxypropyl methylcellulose K4M as bioadhesive polymers. Physicochemical tests, viscosity, mucoadhesive strength measurement, and in vitro drug release study were carried out on formulations F₁₀ (carbopol 940, 0.5% and Na CMC, 3%) and F₁₁ (carbopol 940, 1% and Na CMC, 3%). Results: Polyphenol content of extracts mixture was measured 210.8 ± 13.68 mg GAE/g. pH of formulations was 6.0 ± 0.2. 14 gel formulations were prepared. Physical appearance, homogeneity, and consistency of F₁₀and F₁₁were good. Mucoadhesion and viscosity of F₁₁was more than F₁₀. Study of release profiles in F₁₀and F₁₁formulations showed drug release from F₁₁was slower. Conclusion: The best formulation for treatment and shortening recovery period of recurrent labial herpes infections should exhibit high value of mucoadhesion, show controlled release of drug. F₁₁with the highest viscosity and mucoadhesion and the lowest release rate was considered as the best formulation.

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Background: Stainless steel crown (SSC) is the most reliable restoration for primary teeth with extensive caries. Retention is of great importance for a successful restoration and is provided by various factors such as luting cements. The aim of this study was to evaluate the retentive strength of SSC cemented with four different luting cements. Materials and Methods: In this in vitro study, A total of 55 extracted primary first molars were selected. Following crown selection and cementation (one with no cement and four groups cemented with resin, glass ionomer, zinc phosphate, and polycarboxylate), all the specimens were incubated and thermocycled in 5°C–55°C. Retentive properties of SSCs were tested with a mechanical test machine. First dislodgement of each specimen and full crown removal were recorded. One-way ANOVA test followed by least significant difference test and Kruskal–Wallis test was used for retentive strength comparison at the level of significance of P < 0.05. Results: The results of the study showed that the specimens cemented with zinc phosphate exhibited higher retentive strength as compared to glass ionomer and polycarboxylate (P < 0.001 and P = 0.023, respectively). Conclusion: Zinc phosphate cement showed the most promising results; thus, it can be preferably used for cementation of the teeth with no grossly broken down crowns.

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Background: There has been increasing interest in the study of the association between Vitamin D receptor (VDR) gene polymorphisms and risk of chronic periodontitis. However, the results remain inconclusive. To better understand the roles of VDR polymorphisms (BsmI, TaqI, FokI, and ApaI) in chronic periodontitis susceptibility, we conducted this systematic review and meta-analysis. Materials and Methods: The PubMed, Google Scholar, and Web of Science database were systemically searched to determine all the eligible studies about VDR polymorphisms and risk of chronic periodontitis up to April 2017. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the associations between VDR polymorphisms and chronic periodontitis risk. All the statistical analyses were performed by Comprehensive Meta-Analysis. All P values were two-tailed with a significant level at 0.05. Results: Finally, a total of 38 case–control studies in 19 publications were identified which met our inclusion criteria. There are ten studies with 866 chronic periodontitis cases and 786 controls for BsmI, 16 studies with 1570 chronic periodontitis cases and 1676 controls for TaqI, five studies with 374 chronic periodontitis cases and 382 controls for FokI, and seven studies with 632 chronic periodontitis cases and 604 controls for ApaI. Overall, no significant association was observed between VDR gene BsmI, TaqI, FokI, and ApaI polymorphisms and risk of chronic periodontitis in any genetic model. Subgroup analysis stratified by ethnicity suggested a significant association between BsmI polymorphism and chronic periodontitis risk in the Caucasian subgroup under allele model (A vs. G: OR = 1.747, 95% CI = 1.099–2.778, P = 0.018). Further, no significant associations were observed when stratified by Hardy–Weinberg equilibrium status for BsmI, TaqI, and ApaI. Conclusion: Our results suggest that BsmI, TaqI, FokI, and ApaI polymorphisms in the VDR gene might not be associated with risk of chronic periodontitis in overall population.

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Background: Acidic beverages, such as soft drinks (orange juice and cola), can produce erosion of resin composites. The aim of this in vitro study was to evaluate the effect of immersion in acidic drink on the Vickers microhardness (VK) of different esthetic restorative materials (one nanohybrid Ormocer-based composite, one nanoceramic composite, one nanofilled composite, and one microfilled hybrid composite). Materials and Methods: In this in vitro study, thirty specimens of each esthetic restorative material were divided into three subgroups (n = 10): specimens of group 1 were used as control, specimens of group 2 were immersed in 50 ml of acidic drink for 1 day, specimens of group 3 were immersed in 50 ml of acidic drink for 7 days. Data were analyzed by Shapiro–Wilk test to assess the normality of the distributions followed by nonparametric Kruskal–Wallis analysis of variance and Mann–Whitney U-test comparison test among groups. A significant level of α = 0.05 was set for comparison between the groups. Results: Mann–Whitney U-test showed that each material showed lower microhardness values after immersion in acidic solution (P < 0.05). Paired t-test confirmed that microhardness for each composite did not change after immersion in distilled water (Control group) (P > 0.05). Significant changes were registered for all restorative materials after immersion in acidic solution for 1 day and 7 days (P < 0.05). Conclusion: The Filtek Supreme XTE, a nanofilled composite, and Admira Fusion, a nanohybrid ormocer-based composite, showed the best behavior. The Ceram X Universal (nanoceramic composite) although reached lower hardness values than the previous materials, but resisted well to the 1 week immersion in soft-drink. Finally, the Gradia Direct achieved the most disappointing results: Low microhardness values are justified by the nature of its filling (microfilled hybrid composite).

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Ameloblastoma is a locally invasive tumor derived from odontogenic epithelium. An uncommon variant of ameloblastoma is granular cell type, which cannot distinguish from other ameloblastoma subtypes by clinical and radiographic findings alone. Only review of it's microscopic features allows distinction from other subtypes. The purpose of this article is to present a case of granular cell ameloblastoma. This subtype should be distinguished from the other histopathologic subtypes because of it's higher recurrence rate and more aggressive biological behavior. Radiographic and histologic findings as well as treatment are also discussed.

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Background: Bacteria and their by-products are etiological factors for the failure of endodontic treatment. Reduction of root canal bacterial contamination is one of the chief aims of root canal therapy. The aim of this study was to compare the effects of different rotary file tapers and two irrigation fluids on Enterococcus faecalis counts. Materials and Methods: In this ex vivo study Root canals of 72 human upper lateral incisors were enlarged to ISO #20 K-file. Then, the samples were sterilized and inoculated with E. faecalis for 72 h, divided into six experimental groups and prepared with #30 Flexmaster files with 0.02, 0.04, and 0.06 tapers and two different irrigation solutions such as normal saline and sodium hypochlorite. The control group (n = 10) was subdivided into two groups with or without bacterial inoculation and no mechanical instrumentation. Cleaning efficacy was evaluated in terms of the reduction of colony forming units (CFUs). T-test, ANOVA, Duncan, and Tukey tests were applied to the groups. A significant level of α = 0.05 was set for comparison between the groups. Results: The canals instrumented with 0.06 taper exhibited greater significant reduction in CFUs compared to canals instrumented with 0.04 and 0.02 taper (P < 0.05); 0.04 taper also resulted in greater significant reduction in CFUs than 0.02 taper (P < 0.05). In addition, no significant differences were observed in E. faecalis counts between the two irrigation fluids (P > 0.05). Conclusion: Under the conditions of this study, root canal preparation with greater taper resulted in canal cleanliness and better debridement.

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Background: Aggregatibacter actinomycetemcomitans has been reported in higher proportions in subgingival microbiota of individuals with aggressive periodontitis (AgP) compared with those with chronic periodontitis (ChP) and healthy controls. The major virulence factors are the ones that help in colonization and evasion of host's defenses. Hence, this study was aimed to assess the prevalence of A. actinomycetemcomitans 16S rRNA and its virulent genotypes (leukotoxin [lktA] and fimbria-associated protein [fap]). Materials and Methods: In this case– control study We performed periodontal examination and measured probing depth and clinical attachment level (CAL). Subgingival plaque samples from 200 (ChP: n = 128 and AgP: n = 72) periodontitis patients and 200 healthy controls were screened for the presence of A. actinomycetemcomitans 16S rRNA, lktA, and fap genotypes by polymerase chain reaction. The prevalence of genotypes between periodontitis patients and healthy controls was compared with Pearson's Chi-square test. P < 0.05 was considered statistically significant. Results: Mean pocket probing depth and CAL were high as compared to the healthy controls. The prevalence of A. actinomycetemcomitans in ChP (n = 128), AgP (n = 72), and healthy individuals (n = 200) was 32.0%, 61.1%, and 2.5%, respectively. A. actinomycetemcomitans lktA genotype prevalence was 71.8% among periodontitis patients, while A. actinomycetemcomitans fap genotype showed 31.8% prevalence. The prevalence of these genotypes was insignificant in healthy controls. Conclusion: The high odds ratio for A. actinomycetemcomitans prevalence suggests its strong link to periodontitis. Detection of A. actinomycetemcomitans lktA + genotype may be a useful marker for AgP as its prevalence was found to be high in AgP.

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Background: Literature is controversial in regard with alterations in pharyngeal airway dimensions subsequent to maxillary protraction. The correlation between maxillary protraction and sagittal airway dimension was investigated in association with tongue and soft palate position in skeletal Class III children. The results were compared with those of an untreated Class III and a Class I malocclusion control group. Materials and Methods: In this cross-sectional study pre- and post-treatment cephalometric radiographs of 19 Class III patients (6 males, 13 females; mean age, 7.93 ± 0.96 years) treated with facemask were analyzed. The correlation between treatment changes in craniofacial morphology and those in the upper airway, tongue, and soft palate was evaluated. These results were compared with those of a group of 16 Class I malocclusion patients (1 male, 15 females; mean age, 7.31 ± 0.7 years) and a group of 15 untreated Class III patients (4 males and 11 females; mean age, 7.46 ± 0.1 years). A paired t-test, the Shapiro–Wilk test and Mann–Whitney U-test was used. The level of significance was established as P < 0.05. Results: Nasopharyngeal airway measurements PNS-ad1 and PNS-ad2 significantly increased by 2 mm and 2.1 mm, respectively. Statistical analysis revealed that maxillary protraction had a positive relationship with PNS-ad1 and PNS-ad2. Conclusion: Nasopharyngeal airway dimensions can be improved in the short term with maxillary protraction in skeletal Class III children.

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Background: By increasing the number of adults seeking orthodontic treatment bonding orthodontic brackets to the surfaces other than intact enamel has become necessary. The purpose of this study was to evaluate the effect of three different surface preparation methods associated with orthodontic bonding on porcelain color alteration. Materials and Methods: In this in vitro study forty-five porcelain discs (6- mm diameter, 2- mm thickness) were fabricated. The color of the specimens was evaluated by means of a Vita Easyshade. Commision Internationale de I'Eclairage (CIE) L* a* b* system was used for color measurement. Then, the specimens were randomly divided into three groups (n = 15) with respect to the surface preparation methods including a 9.6% hydrofluoric acid (HF) + silane, sandblasting, and sandblasting + 9.6% HF + silane. Metal orthodontic brackets were bonded. Samples were stored in 37° c water for 24 hours. Afterward, the brackets were debonded with a debonding plier and porcelain surfaces were polished with a tungsten-carbide bur. The color assessment was done, and ΔE values were measured. ΔE = 3.7 units were considered as an acceptability threshold. Data were analyzed with Paired t-test and one-way ANOVA. Level of significance was set at P < 0.05. Results: Orthodontic bonding changed the color parameters significantly. Mean L*, a* and b* difference were 1.35 ± 2.41, 0.19 ± 0.80, 0.89 ± 1.27 units, respectively (P = 0.003 for L*, P < 0.001 for a* and b*). There was not any significant difference in ΔE units between the groups (P = 0.456). In all the groups the mean ΔE values were below 3.7 units and within the clinically acceptable limit. Conclusion: Orthodontic treatment changed the CIE color parameters of porcelain surface. However, the color alteration is below the clinically acceptable threshold. With regard to color alteration, there is no difference between different surface conditioning methods.

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Background: Composite resin (CR) currently is one of the most commonly used material in restoring noncarious cervical lesions (NCCL) due to its strength and esthetics color but has microleakage problem. The aim of this study is to compare in vitro the microleakage depth between CR and porcelain in restoring NCCL. Materials and Methods: This an in vitro study was done by preparing cavities on the buccocervical surface of 62 extracted premolar teeth which randomly assigned to two groups (n = 31) where Group 1 was restored with nanocomposite and Group 2 was cemented with porcelain cervical inlays. They were then subjected to thermocycling before immersion in 2% methylene blue dye for 24 h. Dye penetration depths were measured using Leica imaging system For statistical analysis, independent t-test was used to analyze the results (P < 0.05). Results: Porcelain cervical inlay restorations demonstrated statistically lesser microleakage depth for the cervical margins (P = 0.018) when compared to CR. Deeper microleakage depth at the cervical compared to coronal margins of CR (P = 0.006) but no significant difference of both margins for porcelain cervical inlays (P = 0.600). Conclusion: Porcelain cervical inlays show lesser microleakage than CR which could be alternative treatment option in restoring NCCL with better marginal seal and esthetics.

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Among oral pathologic lesions, odontomas are the most common odontogenic tumor of the jaws and generally asymptomatic. They are mostly diagnosed as a result of routine radiographic investigation. In this report, we describe a very rare occurrence of bilateral complex odontoma in the region of the mandibular second premolar. Conservative surgical procedure was planned, and removal of the odontomas was carried out through the socket after extraction of the deciduous second molars, and the diagnosis was confirmed with a histopathological study.

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