فهرست مطالب yasaman rezvani

Due to incomplete development of coping skills in children, they usually cannot cope with stressful situations like dental appointments. The present study aims to evaluate the effect of intranasal midazolam with/without inhalation sedation (N2O/O2) in children with high levels of dental anxiety.

This crossover double-blinded clinical trial was conducted on 14 uncooperative children aged 3‒6, who required at least two similar dental treatment visits. Children were randomly sedated by the combination of intranasal midazolam (0.5 mg/kg) and nasal drops of lidocaine hydrochloride (2%) with or without inhalation sedation (N2O/O2) during each visit. Houpt’s scale for sedation was used to evaluate the patient`s behavior and efficacy of the sedation by an independent pediatric dentist.

The combination of midazolam and inhalation sedation was significantly more effective in overall behavior after 15 minutes and at the end of the treatment (P<0.05), but not at the time of onset and discharge (P>0.05).

To manage the behavior of the children with high levels of dental anxiety, the combination of inhalation sedation with intranasal midazolam can be efficiently used.

 Different root canal filling materials show different clinical and radiographic success rates. Since there is controversy on the best root canal filling material in primary dentition, the aim of this study was to summarize information about root canal filling materials for primary teeth in terms of biocompatibility, cytotoxicity, resorption rate, and survival rate.

 By searching online databases, studies that addressed biocompatibility, cytotoxicity, resorption, and survival rates of different root filling materials in primary teeth from 1985 to 2020 were evaluated and the required data were extracted. The results were tabulated and compared.

 Due to methodological discrepancies, different studies show different and sometimes inconsistent results, which make it hard to reach a final conclusion; but it seems that Vitapex and Maisto's paste are more biocompatible and have a good survival rate. Zinc oxide eugenol (ZOE) and calcium hydroxide have lower cytotoxicity among different filling materials. However, due to low resorption rate, ZOE can affect permanent successors.

 Based on the unique characteristics of each patient, different filling materials may be used for a clinically optimal dental treatment.

Recently, toothpastes containing herbal antimicrobial ingredients have gained popularity due to their reduced side effects. This study aimed to compare the antimicrobial efficacy of two herbal toothpastes and a nonherbal type on pathogens responsible for caries and periodontal disease.

Full and 1:3 concentrations of two herbal toothpastes (Himalaya® and Herbex®) and a nonherbal type as the positive control (Crest® cavity protection) were prepared. Sterile distilled water was considered as the negative control. Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, and Actinobacillus actinomycetemcomitans (A.a) were cultivated on agar plates and incubated after adding toothpaste preparations. The diameter of the inhibition zone was measured in millimeters. Two-way analysis of variance and Tukey Post-hoc tests were applied at P <0.05.

The mean margin diameter was higher in full concentration than the diluted 1:3 formula for all examined toothpastes (P <0.001). All three toothpaste types exerted a significant antimicrobial effect compared to the negative control (P <0.05). The antimicrobial effect of Herbex® on S. sobrinus was significantly lower than the positive control, and it was significantly less effective against S. mutans compared to Himalaya (P <0.05). Furthermore, the efficacy of Himalaya® on L. casei and A.a was significantly lower than the positive control (P <0.05). No statistically significant differences were observed in other pair comparisons.

Considering the observed efficacy of herbal toothpastes against cariogenic bacteria and periopathogens, they potentially qualify as complementary agents for self-care oral hygiene procedures.

Tracheal intubation for general anesthesia induction can be performed via oral or nasal routes. There is a controversy about nasal route especially in children with corrected coagulopathy because of the probable stimulation for bleeding. We aimed to determine naso-pharynx bleeding in patients with corrected coagulopathy after nasotracheal intubation.

This quasi-experimental study, was conducted on 23 children aged 4-16 years with history of treated coagulopathy needing extensive dental treatment scheduled for a general anesthetic session. Bleeding volume was measured by detailing absorbed amount on a 4×4 inch gauze as well as the volume collected in a nasal bleeding collecting bottle for 24 hours and recorded every four hours. Data were analyzed using Friedman test.

Scarce nasal bleeding was observed at the nasal intubation site in patients with hemophilia A. No significant differences were observed on nasal bleeding times in the these patients (P=0.583)

Nasotracheal intubation can be performed in patients with hemophilia A after stabilization of the coagulation status with no serious risk of bleeding.

Root fracture occurs less frequently in comparison with other traumatic dental injuries, and accounts for about 0.5%-7% of all dental injuries in permanent dentition. Complications associated with root fracture include pulp necrosis, root resorption, and pulp canal obliteration. Maintaining tooth vitality is the mainstay of treatment of horizontal root fracture in permanent teeth.

Case Presentation:

 In this study, a clinical case of horizontal root fractures in the middle third of maxillary right and left central incisors (teeth #11 and #21) of an 8-year-old girl is reported. The patient was followed-up for 3 years. The treatment plan was watchful waiting and after 3 years, the vitality tests were still positive, and no pathology was detected on control radiographs.

 Careful clinical examination, accurate diagnosis, and regular radiographic follow-ups are necessary for efficient treatment and successful outcome of teeth with horizontal root fractures.

Er,Cr:YSGG laser irradiation has been suggested as an effective method of cavity preparation and surface treatment to enhance the bond strength. The aim of this study was to assess the microshear bond strength of Fuji II LC glass ionomer (GI) cement to primary dentin following bur preparation and Er,Cr:YSGG irradiation.

This in vitro, experimental study was conducted on 20 extracted primary canine teeth. After debris removal, the teeth were sectioned buccolingually and divided into two groups. In group 1, the exposed dentin surface was prepared by fissure bur; while in group 2, the dentin surface was subjected to Er,Cr:YSGG laser irradiation with 2 W power and 80% air and 50% water. Fuji II LC GI cement was applied. After 24 h of storage, the samples were subjected to microshear bond strength test in a microtensile tester. The bond strength values in the two groups were compared using Student t-test.

The mean (± standard deviation) microshear bond strength of GI to dentin was 15.36±2.98 MPa in the laser and 4.86±1.36 MPa in the bur group. The mean mi-croshear bond strength in the laser group was significantly higher than that in the bur group (P<0.0001).

Irradiation of Er,Cr:YSGG laser with 2 W power increases the microshear bond strength of Fuji II LC GI to primary dentin, and is superior to bur preparation for this purpose.

In recent years, the use of herbal oral care products has been taken into consideration for reducing dental plaque accumulation. Propolis has been widely used in medicine due to its multiple biological properties. The aim of this study was to evaluate the antiplaque efficacy of an herbal toothpaste containing propolis in comparison with a control group.

This single-blind parallel clinical trial was conducted among 60 dental students. The baseline plaque index was evaluated using a plaque in-dicator one hour after brushing without toothpaste. Participants were randomly as-signed to two groups: (A) herbal toothpaste with propolis, and (B) herbal toothpaste without propolis. After four weeks, the plaque index was re-examined and recorded. Quantitative variables were analyzed by independent t-test, and the mean and standard deviation (SD) were reported. P<0.05 was considered statistically significant.

The mean plaque index differences were not significant between the two groups at the beginning of the study, while there was a significant difference after four weeks (P˂0.001). The results signify an approximate 1.7-unit reduction in the mean plaque index of subjects using toothpaste with propolis in comparison with a 0.7-unit reduction in subjects using toothpaste without propolis.

The herbal toothpaste containing propolis was more effective in reducing plaque accumulation in comparison with the control group. Considering the effect of propolis-containing toothpastes on the reduction of dental plaque accumulation, these can be used as an effective oral hygiene product.

Root fracture occurs in 0.5 to 7% of all dental injuries. Subsequent to this injury, the coronal segment is displaced, while the apical segment is rarely displaced. Emergency treatment involves repositioning of the coronal segment close to the radicular segment as much as possible to enhance the chance of pulp revascularization. If pulp necrosis occurs, the infective products cause an inflammatory response and radiolucency is seen at the fracture line. In the present case, the patient had two maxillary central incisors with horizontal middle third root fractures due to a traumatic accident four years earlier. The right central incisor showed an endodontic abscess due to pulp infection in the coronal segment. The coronal fragment was treated. In this case study all signs and symptoms resolved after treatment and three year follow-up showed a successful treatment outcome. The left central incisor had a vital pulp according to vitality tests, so “observation only” strategy was considered for this tooth.