Role of reinforcement methods in retention of composite restorations of primary anterior teeth

Objectives This study aimed to evaluate the retention of composite restorations of primary anterior teeth reinforced with composite posts, glass fiber posts, para-pulpal pins with composite posts, and para-pulpal pins alone.Methods Forty freshly extracted sound primary canine teeth with at least two-third of the root length remaining were selected. After disinfection, the tooth crown was cut perpendicular to the longitudinal axis. Root canals were prepared and filled using zinc oxide eugenol paste. The teeth were randomly allocated into four groups and restored using one of the following: Composite posts, glass fiber posts, para- pulpal pins with composite posts, and para-pulpal pins alone. Composite cores were constructed while a preformed U-shaped orthodontic wire was placed in the composite tip, samples were then placed in a universal testing machine for measurement of retention. The minimum force required to dislodge the restoration or cause fracture was considered as the retentive strength. The collected data were analyzed using one-way ANOVA and Tukey’s test (P < 0.05).Results There were statistically significant differences between groups (P = 0.011). The mean retention in the para-pulpal pins with composite post group (131.72 ± 32.35N) was greater than that in composite posts (93.65 ± 24.45N), glass fiber post (95.92 ± 25.35N), and the para-pulpal pin group (95.34 ± 29.56N) (P < 0.05). Other differences were not significant (P > 0.05).Conclusion para-Pulpal pin alone may not help in improving the retention of full crown restoration of primary anterior teeth. However, when used along with a composite post, it appears to improve the retention of restoration

Attitude of Parents Referred to the Department of Pediatric Dentistry towards Different Behavioral Management Techniques Used in Pediatric Dentistry

Objective: Behavior management of uncooperative children is an important principle in pediatric dentistry. By adopting an appropriate behavior management technique, pediatric dentists can treat patients more effectively and create a positive attitude towards dentistry in them. This study aimed to assess the attitude of parents presenting to the Department of Pediatric Dentistry at Isfahan University, School of Dentistry towards different behavior management techniques used for uncooperative children.Methods: This cross-sectional study was conducted in the Department of Pediatric Dentistry at Isfahan University, School of Dentistry. Fifty-four parents watched a film regarding seven popular behavior management techniques namely tell-show-do, voice control, use of passive restraint devices, active restraint (physical restraint by dental personnel or the parents), use of oral sedatives, hand over mouth and general anesthesia. After watching each technique, the parents expressed their opinion regarding the level of acceptability of the respective technique using visual analog scale (VAS). Data were analyzed using the Tukey’s HSD test, repeated measures ANOVA, paired t-test and the Student’s t-test.Results: Of 54 parents, 36 were females and 18 were males aged 23 to 68 years. Of the mentioned techniques, the tell-show-do technique had the highest acceptability (94%). Hand over mouth and use of passive restraint devices had the lowest acceptance (30% and 35%, respectively). Except for the mentioned two, the remaining techniques were well accepted by the parents (52%). No significant association was found between any of the behavior management techniques and age,  level of education or occupation of parents.Conclusion: It appears that acceptability of the behavior management techniques has significantly changed over time and advanced pharmaceutical management techniques have gained increasing acceptance

Crazing level after pin insertion in anterior primary teeth: a preliminary in vitro study

Objectives This study aimed to investigate dentinal crack rate following parapulpal pin insertion in anterior primary teeth.Methods Thirteen sound freshly extracted primary canine teeth were horizontally sectioned 1 mm above the cementoenamel junction (CEJ). All samples were thoroughly inspected to ensure that the teeth had no cracks. The teeth were then mounted in acrylic blocks, and subjected to drilling and insertion of a single parapulpal pin in the prepared hole. The teeth were then sectioned perpendicular to the already prepared surface at 1, 2 and 3 mm depths for further evaluation under a stereomicroscope (x12 and x25 magnifications).Results No crack or crazing was observed in teeth in the control group while one out of 11 teeth in the case group had a crack.Conclusion The use of 0.53 mm diameter self-threading pin did not increase the risk of crack formation in dentin of anterior primary teeth prior to composite restoration

Effect of a Combination of Photodynamic Therapy and Chitosan on Streptococcus mutans (An In Vitro Study)

Introduction: This study aimed to assess the effect of photodynamic therapy (PDT) and chitosan separately and in combination with Streptococcus mutans.Materials and Methods: This in vitro experimental study evaluated 216 microbial samples in 6 groups. First, 5 μL of 0.5 McFarland standard suspension of S. mutans was added to each well of an ELISA microplate; 100 μL of Mueller Hinton broth was also added to each well; 180 wells contained S. mutans suspension while 36 wells were devoid of bacteria. Group 1 served as the negative control and had no bacteria. Group 2 served as the positive control and S. mutans in the positive control wells did not undergo any intervention. In groups 3 and 4, PDT with a 50 mW low-level laser was performed for 30 and 40 seconds respectively. In group 5, 3 mg/mL of chitosan (100 μL) was used. In group 6, 3 mg/mL (100 μL) of chitosan was used in combination with PDT (50 mW laser for 30 seconds). The laser was irradiated under aseptic conditions at a 660 nm wavelength with 50 mW power. Data were analyzed using one-way ANOVA and Tukey’s test.Results: PDT combined with chitosan showed maximum bactericidal effect followed by PDT for 40 seconds and chitosan groups (P < 0.05). PDT for 30 seconds showed a minimum bactericidal effect (P < 0.05). All pairwise comparisons revealed significant differences (P < 0.001).Conclusion: Chitosan and PDT alone can be used to decrease the S. mutans count. However, their combined use has a greater bactericidal effect on S. mutans

In-Vitro Investigation of the Fracture Strength of Pulpotomized Primary Molars Restored with Glass Ionomer, Amalgam and Composite Resin with and without Cusp Reduction

Objective: Resistance to fracture is a critical issue when it comes to tooth restoration. The purpose of this study was to evaluate the fracture resistance of pulpotomized primary molars restored with glass ionomer (GI), amalgam and composite resin with and without cusp reduction.Methods: In this in-vitro experimental study, 60 extracted primary teeth were randomly divided into 6 groups of 10. In all groups except for the control group, conventional pulpotomy and MOD cavity preparation were performed in a way that the cavity isthmus width was equal to two-third of the inter cuspal distance. Group 1 teeth were restored with Kerr amalgam and underwent 1.5 mm cusp reduction, group 2 received Z250 composite resin onlay with 1.5 mm cuspal coverage, group 3 was restored similar to group 2 but without cusp reduction, group 4 was restored as group 3 but with Quixfil composite and group 5 was restored just like the former two groups but with GI. The  restored teeth underwent thermocycling and were subjected to Universal Testing Machine with a crosshead speed of 0.5 mm/min. The recorded fracture resistance of specimens was compared. One- way ANOVA was used for statistical analysis.Results: The mean fracture resistance was 2001.929 in the control group, 904.749 in the amalgam group, 1101.736 in Z250 composite with no cusp reduction group, 1036.185 in the Quixfil  composite with no cusp reduction, 945.096 in the Z250 composite with cusp reduction and 850.313 in the GI group. The difference between the control group and other understudy groups was statistically significant (p<0.0001) but other differences were not statistically meaningful.Conclusion: Although in none of the groups the fracture strength was equal to that of intact primary teeth, the obtained values were within the normal range of masticatory forces

Remineralizing Effect of Child Formula Dentifrices on Artificial Enamel Caries Using a pH Cycling Model.

Although fluoridated toothpastes are among the most accessible fluoride sources for caries prevention, their remineralization potential remains questionable. This study sought to compare the effects of 5 different child formula dentifrices on remineralization of artificial primary enamel caries using a pH cycling model.Twenty sound primary canine teeth were immersed in demineralizing solution for 96 hours to produce 100μm-deep artificial caries. The teeth were then longitudinally sectioned into 100-150 μm-thick slices and randomly divided into 5 groups and treated as follows: group A. Calcium phosphate toothpaste, group B. Pooneh children's toothpaste, group C. Biotin toothpaste, group D. Crest children's toothpaste and group E. Darougar children's toothpaste. The specimens underwent a pH cycling model for 10 days. The degree of demineralization before and after treatment and its changes were evaluated under a polarized light microscope and a stereomicroscope and data were statistically analyzed using repeated measures ANOVA and post-hoc test.Stereomicroscopic analysis showed that only group C had a significant difference with other groups (P0.05). Polarized light microscopic analysis revealed that in addition to group C, a significant difference was detected between groups A and B (P=0.02) and calcium phosphate toothpaste showed higher efficacy.All the understudy toothpastes had remineralizing effect but calcium phosphate children's toothpaste had the highest and biotin toothpaste had the lowest efficacy