majid mehran

The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide‑amorphous calcium phosphate (CPP‑ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups.

In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP‑ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated‑measures ANOVA (α = 0.05).

All samples’ microhardness reduced considerably after immersion in liquid pharmaceuticals(amoxicillin [84.9 kgf/mm2 ] and ibuprofen [75.1 kgf/mm2 ]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin‑cheese and amoxicillin‑CPP‑ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen‑CPP‑ACP subgroup (P = 0.499).

As a result, cheese and CPP‑ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure.

Periodontal diseases are resulted from gum infections and dental plaques, which are mainly caused by the bacterial agents. Since dental monitoring includes important prognostic roles, the aim of this study was to detect the most common periodontal pathogenic bacteria in children.

A total of 200 clinical samples were collected from dental plaques and gingival grooves. Tar- get-specific primers were designed for hbpA in Aggregatibacter actinomycetemcomitans, fimA in Porphyromonas gingivalis and 16S rRNA in Prevotella intermedia, Tannerella forsythia and Treponema denticola. Then, a multiplex polymerase chain reaction method was optimized for the highlighted bacterial agents.

In general, the highest and the lowest bacterial prevalence rates belonged to Tannerella forsythia (88%) and Por- phyromonas gingivalis (13%), respectively. Furthermore, prevalence rates of Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Treponema denticola were 25, 21 and 45% in samples, respectively.

There were significant associations between dental/oral health and microbial community. Metabolism of the oral bacteria, including biofilm formation, can affect gums and develop dental plaques and hence dental caries, especially in children. Early diagnosis of dental caries in children via rapid, accurate molecular methods can increase the diagnostic capacity in clinical cases and therefore prevent periodontal infections in adulthood.

The increasing population of the world, the change of style and the limited number of natural resources and energy all make freshwater industrial productions the main contenders for the cost-effective production of freshwater. In this research, the combination of combined cycle power plant (CCPP) using multiple effect distillation (MED) and reverse osmosis (RO) desiccation techniques is investigated through normal and advanced exergy, exergy-economic and exergy-environmental comprehensive analysis. First, CCPP thermodynamic modeling is done using mathematical programming method. Then, a mathematical model is presented to integrate the existing CCPP with MED and RO desalination plants. Finally, the aforementioned normal and advanced analyzes are performed to evaluate the main performance parameters of the integrated CCPP system and MED-RO desalination system, and to identify potential technical, economic, and environmental improvements. A case study is also presented about the Shahid Salimi Neka power plant located in the north of Iran along the Caspian Sea.The mathematical modeling method for this integrated system is solved in "MATLAB" program and its results are validated by "Thermoflex" software. The results show a 3.79% increase in fuel consumption after combining CCPP and water desalination facilities. The exergy efficiency of the advanced system is 42.7% and the highest combustion chamber exergy destruction cost is $1.09 per second. Economic and environmental analyzes of the integrated system also show that gas turbines have the highest investment cost ($0.047 per second). At the same time, the MED system has the highest environmental impact rate, i.e. 0.025 points per second.

The purpose of this in vitro study is to ascertain how NovaMin and Er,Cr:YSGG laser radiation affect the remineralization of primary tooth enamel lesions.

40 main teeth served as the study’s sample size. These teeth were allocated into five groups at random. The first group served as a negative control (artificial saliva); the second group served as a positive control (APF gel 1.23%); the third group NovaMin, the fourth group Er,Cr:YSGGlaser, the fifth group Er,Cr:YSGG laser and finally, the application of NovaMin. For the purpose of measuring microhardness, all samples were submitted to the dental materials laboratory three times.

The collected data were compared using the SPSS 28 program between the baseline measurement, after demineralization, and after remineralization. The data were analyzed using ANCOVA and Bonferroni tests. All groups demonstrated a considerable increase in microhardness as compared to the negative control group (P < 0.05). With the exception of the third and fourth groups, there was no discernible difference in the rise in microhardness between the other groups. The third and fourth groups were compared, and the results revealed that NovaMin had a greater impact than laser therapy alone (P = 0.023). Scanning electron microscopy (SEM) analysis backed up the findings.

In comparison to using the Er,Cr:YSGG laser alone, using NovaMin alone can speed up the remineralization of erosion lesions on the surface of primary teeth.

Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth.

This randomized, controlled, clinical trial was performed on a group of children with at least two symptom‑free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow‑up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance.

The clinical success rate was 100% in both groups after all follow‑ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow‑up points. The difference between the two groups was not statistically significant.

According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Dental caries is among the most common chronic diseases of the childhood. This study sought to assess the effect of caries experience in primary molars on caries development in the adjacent permanent first molars.

This cross-sectional study evaluated 413 students aged 7 and 8 years. Clinical dental examination was performed by two independent examiners using disposable dental instruments and a head light. Dental caries was evaluated using the International Caries Detection and Assessment System (ICDAS) for all four permanent first molars and the decayed, missing, and filled teeth (dmft) index for the primary molars. Data were analyzed using the Pearson’s Chi-squared test and Fisher’s exact test.

When primary first molars were sound, 22.9% of the permanent first molars of the same quadrant were sound. When primary second molars were sound, 25.7% of the adjacent permanent first molars were sound. A carious primary second molar had a stronger correlation with development of dentin caries in the adjacent permanent first molar than a carious primary first molar (P<0.001).

The current results confirmed that carious primary molars can significantly affect caries development in the adjacent permanent first molars, and a carious primary second molar has a significantly greater effect than a carious primary first molar in this respect. Thus, special attention should be paid to oral hygiene and proper tooth brushing of primary molars, particularly second molars.

Most children get a lot of anxiety while they visit a dentist. The most important factor in the child's fear at the beginning of treatment is the syringe and needle. Ways to cope with this anxiety include behavioural control techniques such as mental regeneration, distraction, and induction. The purpose of this study was to compare the pain and anxiety in children when using a syringe and toy- shape syringe needle. This study was the first study that used a toy-shape needle cover.

This clinical trial study was conducted on 20 children age from 5 to 8 years. More than half of them were anxious with Cfss-Ds (Dental Subscale of the Children's Fear Survey Schedule) and FIS
(Facial Image Scale) anxiety diagnostic tests, and the rest of them were not anxious. Patients were randomly divided into two groups. The first group received local anesthesia with conventional syringe and the second group, by syringe with toy shape needle cover. Following, the first group received local anesthesia by syringe with toy shape needle cover, and the second group, by a conventional syringe. Heart rate measuring and pain evaluating test was performed. Analysis of heart rate and anxiety data was performed by non-parametric wilcoxonsianed Ranks T-test (P-value was considered significant at 0.001).

The mean amount of pain measured after using a syringe with a toy shape needle cover and using conventional syringe had a significant difference of 5.20% between the two groups. The pain was reduced in children who received local anesthesia by syringe with toy shape needle cover (P<0.001).

The physical appearance of the injection device plays an important role in reducing the anxiety and pain of injection in the children.

Identifying the best species of medicinal plants and extracting effective substances can be effective in preventing oral and dental illness. The Malva sylvestris L. is among these plants. Malva sylvestris L. belongs to Malvaceae family from which A great deal of (Malvone A: 2-methyl-3-methoxy-5,6-di- hydroxy-1,4-naphthoquinone) anthocyanin and important natural pigments have been extracted. Anthocyanins and other substances of Malva sylvestris own antibacterial properties. Antibacterial properties of Malva sylvestris were investigated on the bacterial species. The purpose of this study was to investigate the antibacterial effects of the Malva sylvestris L. extract on the Streptococcus mutans and compare it with the effect of chlorohexidine (0.12%). This experimental study was carried out at the Shahed University of Medical Sciences, Tehran, Iran in the field of microbiology in January 2016 to September 2016. Methanolic aqueous extract of Malva sylvestris L. was prepared by decoction extraction method. The presence of polyphenol trepnoid, saponine, anthocyanins compounds in the extract was approved by high performance thin layer chromatography. Chromatographic and spectral fingerprint analysis plays an important role in the quality control of complex herbal medicines. The antimicrobial effect of the Malva sylvestris L. on the growth of Streptococcus mutans was evaluated. Extract at different concentrations (16.8-4.2 mg/ml) had an antibacterial effect and compared with commonly used chlorohexidine in dentistry. The non-growth halo against Streptococcus mutans showed an average of 1.66 mm. The minimum inhibitory concentration against Streptococcus was 2 mg/ml. The presence of polyphenols, troponides of saponin, was characterized by high performance thin-layer chromatography (HPTLC). However, antibiotics play an important role in human health, with the increasing occurrence of bacterial resistance against available antibiotics. The results of this study showed that the aqueous-methanolic extract of the Malva sylvestris L. plant has antimicrobial activity affecting Streptococcus mutans. The flowers extract also showed high antibacterial effects against some human pathogen bacteria strains. This property of polyphenolic compounds of the plant, identified by fingerprint analysis, was less susceptible to chlorohexidine than gold standard.

In this study, the results of using MTA and propolis in the pulpotomy of primary molar teeth are evaluated clinically and radiographically. Methods and Methods: A total of 25 healthy 4 to 8 year old children each having two carious primary molar teeth in one arch, based on inclusion criteria were selected. In each child, random assignment of the pulpotomy medicaments was done as follows: Group I, MTA in one side; Group II, Propolis in another side. All the pulpotomized teeth were evaluated at 3, 6, and 9 month clinically and radiographically, based on the scoring criteria system. Finally data was analyzed using GEE analysis. Results showed that the effects of treatment and time on two scores were tested. Based on the results of this model, the chances of having clinical score 2, versus score 1 are about 2.7 times higher in MTA treatment than in propolis (P=0.001). Similarly, the chance of having a clinical score 2 relative to its one, at 9th month is approximately 6.8 times higher than the 3th month (P=0.000) and at 6th month is approximately 2.8 times higher than the 3th month (P=0.005). The chance of having higher scores of radiographies in treatment of propolis is approximately 6.5 times than that of MTA (P=0.000). Also, the chance of having higher scores of radiographic index at 6th month is approximately 5 times and at 9th month is approximately 27 times more than the 3th month (P=0.00). Based on the results of this experimental study, teeth treated with MTA showed more suitable clinical and radiographic results as compared to propolis at 9 months follow-up.

The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and mid-azolam/promethazine combinations on fearful children needing dental treatment. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received. This was to overcome the sequence effect. Group I received oral midazolam (0.4 mg/kg/chloral hydrate (50 mg/kg) at the first visit while they received midazolam (0.4 mg/kg)/promethazine (5 mg/kg) in their second visit. Group II received the premed-ication in the opposite sequence. The operator and child were blinded to the medication administered. Sedative efficacy of the two combinations were assessed and judged by two independent pediatric dentists based on the Wilson scale. Data were analyzed with ANOVA and paired t-test. Only 10% of children who received chloral hydrate with midazolam exhibited high improvement in their behavior while 53% showed reasonable positive changes and 12% had no change or even deterioration of behavior. The difference between the effect of the two combination drugs was statistically significant (P<0.05) in favor of the chloral hydrate group. The results showed a significant difference in the sedation level induced between the two groups. Midazo-lam/chloral hydrate combination more effectively improved the co-operation for dental treatment.

The aim of the present study was to compare the effects of intranasal ketamine and midazolam on behavior of 3-6 year-old children during dental treatments.
In this randomized cross-over clinical trial, 17 uncooperative children requiring at least two dental treatments were selected and randomly received ketamine (0.5mg/kg) or midazolam (0.2mg/kg) prior to treatment. The other medication was used in the next visit. The children’s behavioral pattern was determined according to the Houpt's scale regarding sleep, movement, crying and overall behavior. Physiological parameters were also measured at different time intervals. The data were subjected to Wilcoxon Signed Rank test and two-way repeated measures ANOVA.
The frequency of crying decreased significantly following ketamine administration compared to midazolam (P=0.002); movement of children decreased with fewer incidence of treatment interruption (P=0.001) while their sleepiness increased (P=0.003). Despite higher success of sedation with ketamine compared to midazolam, no significant differences were found between the two regarding patients’ overall behavior (P>0.05). The patients had higher heart rate and blood pressure with ketamine; however, no significant difference was found regarding respiratory rate and oxygen saturation (P>0.05).
Ketamine (0.5mg/kg) led to fewer movements, less crying and more sleepiness compared to midazolam (0.2mg/kg). No significant differences were found between the two drugs regarding children’s overall behavior and sedation efficiency. Both drugs demonstrated positive efficacy for sedation of children during dental treatments.

Providing a safe and efficient dental treatment for a young patient is a challenge for the dentist and the child. The purpose of this study was to investigate the effectiveness, safety and acceptability of buccal midazolam in dental pediatric patients and to compare it with oral Midazolam. Eighteen uncooperative healthy children aged 2.5-6 years were randomized to each of buccal midazolam (0.3mg/kg) or oral midazolam (0.5mg/kg) at the first visit, the alternative has been used at the second visit in a cross-over manner. The study took place at pediatric dentistry clinic of Shahed University, Tehran, from November 2011 to June 2012. The patients` vital signs and behavioral scores were recorded. The patient, the operator and the observer were blinded to the applied medication. Post operatively, patients` and parents` satisfaction were assessed by Visual Analogue Score and a questionnaire respectively. The P-value was set at 0.05 for significance level. There were no significant differences in physiologic factors in the medication groups at time 0, 10, 20, 30 minutes and discharge. There was also no significant difference between the two groups in behavioral parameters. The majority of parents rated both sedative agents as “effective” or “very effective” and their children mostly were without anxiety or with minor anxiety. Buccal midazolam may be safely and efficiently used in sedation of pediatric dental patients.

Application of self-etching bonding systems to primary and permanent teeth has increased due to the simplicity of work and fewer steps. This experimental study aimed to compare the effect of conventional acid etching and single-bottle and self-etching bonding systems on shear bond strength (SBS) of light-cured fissure sealant to primary and permanent enamel. In this experimental study، the smoothest unprepared proximal enamel surfaces of 30 primary molars (groups 2، 4 and 6) and 30 permanent premolar teeth (groups 1، 3 and 5) were divided into 6 groups of 10. Groups 1 and 2 (control) were acid-etched and received light-cured fissure sealant (Concise 3M-ESPE). Groups 3 and 4 (SB) were subjected to acid etching + Single Bondadhesive + fissure sealant. Groups 5 and 6 (PLP) received self-etching bonding system (Prompt L-Pop، 3M، ESPE) + fissure sealant. Specimens were then subjected to 500 thermal cycles with the dwell time of 30 seconds. Shear bond strength was determined using Universal Testing Machine (Zwick، Germany). Mode of fracture was determined under stereomicroscope and data were analyzed using ANOVA، (between-subjects effect) and LSD. SBS was not significantly different between the control and PLP or SB and PLP groups (P>0. 05). However، the difference in SBS between the control and SB groups was statistically significant (P=0. 022). The SBS in primary teeth was less than in permanent teeth in all groups (P<0. 05). Self-etching bonding system (PLP)، similar to conventional acid etching technique، provides adequate bond between the light-cured fissure sealant and unprepared enamel. Application of Single Bond Adhesiveeffectively increased the fissure sealant bond strength.

Fluoride has an important role in the prevention of caries. This study assessed the efficacy of three types of topical fluoride: fluoride varnish, APF gel (sultan), APF gel (Kimia) in protecting the enamel from demineralization in an in vitro environment. Sixty human caries-free premolars where randomly assigned into four groups of 15 specimens. The control group was washed with deionized/distilled water. Weekly gel (Kimia) was treated with APF gel (1/23%) for 2 minutes weekly, weekly gel (Sultan) was treated with APF gel (1/23%) for 60 seconds weekly, weekly varnish fluoride was treated with Durashield (2/26%). Specimens were then placed in a cycle of demineralization (pH= 4.3) for 6 hours and remineralization (pH= 7) for 17 hours. This pH- cycle was repeated for 3 weeks (21days). The teeth were sectioned buccolingually and evaluated under polarized light microscope. Then the depth of each lesion was measured from the deepest demineralization point of the lesion. The data were analyzed using Kruskal-Wallis and Dunn test for pairwise comparison. The control group had the deepest lesions (mean depth, 140±37micrometer). The varnish group had the shallowest lesions (mean depth, 60±37 micrometer) with a 75.3% reduction percent. However, there was no significant difference in the depth of demineralization between all fluoride treated groups. The difference between fluoride groups and the control group were significant. Treatment of the enamel of permanent teeth with various topical fluorides significantly inhibited demineralization, but there was no significant difference between varnish or gel application.

Formocresol is a popular pulpotomy medicament in primary dentition. Because of its systemic and local side effects, it may be essential to use another material instead of formocresol. The purpose of this study was to assess the pulpal response after pulpotomy histologically with two different agents; namely, formocresol and SUAB2.

In this randomized clinical trial study, 14 teeth of seven children that should had been extracted because of orthodontic treatment were selected. These teeth were randomly divided into two formocresol and SUAB2 (Shahed University Anti Bleeding2) groups. Seven teeth were pulpotomized with formocresol and seven teeth with SUAB2. These teeth were extracted after 2 months and the pulpal response was evaluated. Finally, the data were analyzed with exact fisher and Mann-Whitney tests.

In the formocresol group, severe inflammation was seen in four teeth, mild inflammation in three teeth, abscess in four teeth, necrosis in two teeth, fibrosis in three teeth and internal resorption in four teeth. In the SUAB2 group, severe inflammation was not seen. Moderate and mild inflammation was seen in four teeth, abscess in two teeth, necrosis in two teeth, fibrosis in three teeth and internal resorption in four teeth. Mann-Whitney test revealed that inflammation is significantly less in the SUAB2 group compared with the formocresol group (p<0/05).

Based on the results of this study, SUAB2 may be used in primary teeth pulpotomy.

Dental materials that are used for fixation in deciduous pulpotomy have adverse reactions such as toxicity and carcinogenic and mutaginic effects. Severe efforts are focused on substitution of these materials with safer ones. It has been reported that herbal medicines have useful clinical effects. It has been shown that the SUAB1 and SUAB2 had a lower cytotoxicity than formocresol.To compare the in vivo histocompatibility of SUAB1 and SUAB2 in subcutaneous tissue of rat. The study design was descriptive- analytical. Twenty-one rats with an average weight of 350 grams were used. SUAB1 and SUAB2 were separately placed in polyethylene tubes and implanted in the dorsal subdermal tissue. After intervals of one, two, and four weeks, animals were sacrificed. The implant materials with surrounding tissue were removed and collected in 10% buffered formalin solution for histopathologic evaluation. Capsule thickness, inflammation intensity, angiogenesis, necrosis and calcification were studied on paraffin-embedded sections. Data were analyzed by SPSS software (version 11.5). The Friedman and kruskall-wallis statistical tests were used. Statistically significant difference in capsule thickness, intensity and extent of inflammation, angiogenesis, necrosis and calcification was observed between SUAB1 and SUAB2 groups. Capsule thickness, intensity of inflammation and calcification was higher in SUAB1 group than SUAB2.

Pulpectomy of primary teeth is commonly carried out with hand files and broaches; a tricky and time consuming procedure. The purpose of this in vitro study was to compare the cleaning efficacy and time taken for instrumentation of deciduous molars using hand K-files and Flex Master rotary system. In this study, 68 canals of 23 extracted primary molars with at least two third intact roots and 7-12 mm length were selected. After preparing an access cavity, K-file size #15 was introduced into the root canal and India ink was injected with an insulin syringe. Sixty samples were randomly divided in to experimental groups in group I (n=30), root canals were prepared with hand K-files; in group II (n=30), rotary Flex Master files were used for instrumentation, and in group III 8 remained samples were considered as negative controls. After clearing and root sectioning, the removal of India ink from cervical, middle, and apical thirds was scored. Data was analyzed using student''s T-test and Mann-Whitney U test. There was no significant difference between experimental groups cleaning efficacy at the cervical, middle and apical root canal thirds. Only the coronal third scored higher in the hand instrumented group (P<0.001). Instrumentation with Flex Master rotary files was significantly less time consuming (P<0.001). Although there was no difference in cleanliness efficacy at the apical and middle thirds, the coronal third was more effectively cleaned with hand files. Predictably, time efficiency was a significant advantage with rotary technique.

The baby bottle tooth decay is a prevalent type of caries, affecting most of the teeth in deciduous dentition, and it is mostly caused by overnight bottle feeding. Given the importance of implementing preventive procedures, the aim of this study was to determine the effect of varnish fluoride on prevention of baby bottle tooth decay in deciduous dentition. This experimental study was carried out on 52 kindergarten children aged one to three years-old in Tehran. The right maxillary centrals and laterals were considered as cases and the left counterparts as control group. Bifluoride-12 varnish (Voco, Germany) was applied twice over a 6 months period on the buccal and palatal surfaces of 104 case teeth. The results were compared with equal number of control teeth. Cochran–Q, Chi–square and Fisher's exact tests were used for data analysis. After fluoride therapy, 3 (5.77%), 11 (21.16%), and 8 (15.38%) teeth developed new caries in laterals of case groups, centrals and laterals of control groups respectively. None of the centrals in the case group developed new caries. The observed group differences were statistically significant (P<0.001). According to Chi–square and Fisher’s exact tests, factors such as patients’ age, gender, geographic region, nutrition habits, oral hygiene and antibiotic consumption had no effect on caries prevalence (P>0.05). According to the findings of this study, it can be concluded that, fluoride varnish may be considered as effective preventive procedure in nursing bottle caries reduction in children with primary dentition. Key words: Baby bottle tooth decay - Nursing caries - Fluoride varnish. Corresponding Author: Dr. Mehran M., Assistant Professor, Pedodontics Department, Faculty of Dentistry, Shahed University. Tehran, Iran.