A review on preventive measures and treatment of white spot lesions in patients with fixed orthodontic appliances

Objective: One complication of fixed orthodontic treatment in patients with poor oral hygiene is development of demineralized enamel lesions compromising esthetics. This study aimed to review preventive measures and treatment of white spot lesions (WSLs) in patients with fixed orthodontic appliances.Review of Literature: In this review study, PubMed and Google Scholar databases were searched for articles published during 1964-2013 using the keywords “white spot lesions”, “demineralization”, “mastic gum”, “casein phosphopeptide amorphous calcium phosphate or CPP-ACP”, “chitosan” and “orthodontics”; 96 articles were evaluated.Conclusion: White spot lesions can be prevented by conventional plaque control and adjunct measures such as the use of fluoride-containing compounds, chlorhexidine (CHX), xylitol gums, chitosan compounds and laser. Low-concentration fluoride, CPP-ACP compounds and laser help remineralize these lesions. If not treated, bleaching, microabrasion and tooth restoration are the final solutions

Comparison of Antimicrobial Effects of Stevia Rebaudiana Extract and Xylitol on Dental Biofilm: An In Vitro Study

Objectives This study aimed to assess the antibacterial effects of xylitol and Stevia rebaudiana (S. rebaudiana) ethanolic extract on oral biofilm. Methods A total of 96 acrylic discs were divided into two main groups for inoculation with Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus). Each group consisted of 6 subgroups including a positive control subgroup and 5 subgroups of discs immersed in 1% or 3% xylitol solutions, 2 or 4 mg/mL S. rebaudiana, or a combination of 3% xylitol and 4 mg/mL S. rebaudiana. After incubation, the discs were rinsed and transferred to fluid universal medium. The solutions were cultured on specific culture media and incubated. The colony-forming units (CFUs) were counted for each disc. The structure of biofilm in each group was evaluated under a scanning electron microscope (SEM). Results ANOVA revealed significant differences between the subgroups in both S. mutans and S. sobrinus groups (P=0.03 and P=0.01, respectively). In S. mutans group, the logarithmic mean of colony count in the positive control subgroup was 6.75 while this value was significantly lower in 2 mg/mL (5.81) and 4mg/mL (5.92) S. rebaudiana subgroups using the post hoc Dunnett's test (P=0.01 and P=0.04, respectively). The three other subgroups did not show significant differences. In S. sobrinus group, all five experimental subgroups demonstrated significantly lower colony count than the positive control group (P<0.05).  Conclusion S. rebaudiana extract appears to be more potent than xylitol against dental biofilm

Antimicrobial Effects of Mass and Oral-B Mouthwashes on Streptococcus mutans and Candida albicans: An In Vitro Study

Objectives The present study aimed to compare the antimicrobial properties of Iranian Mass mouthwash and alcohol-free Oral-B mouthwash against Streptococcus mutans (S. mutans) and Candida albicans (C. albicans). Methods In this in vitro study, S. mutans and C. albicans were separately cultured on BHI agar plates. The agar well-diffusion method was used to compare the antimicrobial properties of Mass and Oral-B mouthwashes, and 0.2% chlorhexidine (CHX) as the positive control and saline as the negative control. The diameter of growth inhibition zones was then measured. The experiment was performed in triplicate. The minimum inhibitory concentration (MIC), and the minimum bactericidal concentration (MBC) of the two mouthwashes were determined for each microorganism using the broth micro-dilution method. Data were analyzed by the Kruskal-Wallis and Dunn's test (Benjamini-Hochberg). Results The mean diameter of the growth inhibition zone of S. mutans was 26.33 and 27.66 mm for Mass and Oral-B mouthwashes, respectively. These values were 18 mm and 17.66 mm, respectively for C. albicans.  There was no significant difference in the mean diameter of growth inhibition zones of the two mouthwashes against C. albicans (P=0.38) or S. mutans (P=0.23). The MIC of Mass and Oral-B mouthwash for S mutans was in 1/1024 dilution ratio and the MIC of Mass and Oral-B mouthwashes for C. albicans was in 1/512 and 1/256 dilution ratios, respectively. The MBC values were the same as the MIC values for both mouthwashes. Conclusion Mass mouthwash was as effective as Oral-B mouthwash against S. mutans and C. albicans

Evaluation of oral hygiene care of under 4 years old children by their mothers based on the Health Belief Model

Objective: Oral health is one of the basic components of preschool children's health. Young children completely depend on their parents, specially their mothers, to have an appropriate oral health. Health belief model shows the relationship between some structures related to personal perceptions, barriers and perceived self-efficiency, and behavior. This study aims to determine the oral health  care status of children under 4 by their mother according to health belief model in Tehran.Methods: In this cross-sectional (descriptive-analytic) study, 200 mothers with children under 4 who visited health care centers under the authority of Shahid Beheshti University of medical Sciences were randomly chosen. A questionnaire which was designed according to health belief  model (HBM) was used to collect data. Collected data was analyzed by SPSS software.Results: It was found that only in 10% of the cases knowledge score was favorable. Participants scored 50.85%, 75.93%, 72.23%, 92.06%, 48.2%, 86.31%, 64.07% in knowledge structures, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self efficiency  and behavior respectively. Knowledge structures (p<0.01, r=0.276), perceived barriers (p<0/01, r=0/314) and perceived self efficiency (p<0.01, r=0.269) showed positive correspondence and significant relationship with the oral and dental health behaviors by their mothers. Structures of health belief model could describe 17.9% of behavior variance. Amongst these structures, perceived barriers had more important role.Conclusion: This study estimated that the behavioral status of oral and dental health care of children under 4 by their mothers is moderate. Therefore planning an educational program using behavioral models and theories, such as health belief model is suggested, so that it can increase knowledge and self-efficiency and reduce perceptive barriers to promote children's oral health

Cervical Vertebral Maturation Method for Comparing the Onset and Duration of Pubertal Growth Spurt Between Class I and II Subjects

Objectives: The present study aimed at evaluating the onset and duration of the pubertal growth spurt in skeletal class I and II individuals, utilizing the cervical vertebral maturation (CVM) method. Methods: A total of 132 Iranian individuals (class I=68, class II=64) were evaluated retrospectively in this cross-sectional study. Subjects were between 9 and 16 years old and had never undergone orthodontic treatment. Lateral cephalograms of the subjects were independently traced by two examiners to determine their skeletal class, employing Steiner and Wits analyses. Baccetti's CVM method was employed to assess skeletal maturation. The onset and duration of the pubertal growth spurt (CS3-CS4 interval) was analyzed among the two classes and genders using the Independent Samples t-Test. Results: The duration of the pubertal growth spurt equaled 1.62 (±1.33) years in skeletal class I subjects and 1.34 (±1.21) years in skeletal class II subjects. The difference in duration between the two classes, with an average of 0.28 years (3.36 months), was statistically significant (p<0.001). The average onset age of growth spurt was estimated to be 11.91 (±1.32) years in class I subjects and 11.41 (±1.19) years in class II subjects, but this difference was insignificant (p=0.110). The onset and termination of the pubertal growth spurt occurred later by 1.49 years (p<0.001) and 1.27 years (p<0.001), respectively, in male subjects. Conclusion: Class I and II subjects had similar growth spurt onset ages, but class II spurt duration was shorter by 3.36 months. Females experienced longer and earlier growth spurts compared to males

Effects of Three Mastic Gums on the Number of Mutans Streptococci, Lactobacilli and PH of the Saliva.

In the recent years, herbal oral hygiene products have gained increasing attention. The aim of this study was to assess the effects of three types of mastic gums on the level of Mutans streptococci, Lactobacilli and pH of the saliva.Forty-two students in the age range of 20-30 years were divided into three parallel groups; each of them separately used pure mastic gum, xylitol mastic gum and probiotic mastic gum for three weeks. Number of microorganisms and pH of the saliva were assessed before and after the intervention. The data were analyzed using Wilcoxon Signed Rank, paired-sample-t, Kruskal-Wallis and Tukey's post-hoc tests and Oneway ANOVA.Level of Mutans streptococci showed a significant reduction compared to its baseline value in all three groups (

Optimization of culture media for enhancing gamma-linolenic acid production by Mucor hiemalis

Introduction: g-linolenic acid is an essential fatty acid in human nutrition. In the present study, production of g-linolenic acid by Mucor hiemalis PTCC 5292 was evaluated in submerged fermentation. Materials and methods: The fermentation variables were chosen according to the fractional factorial design and further optimized via full factorial method. Four significant variables, glucose, peptone, ammonium nitrate and pH were selected for the optimization studies. The design consisted of total 16 runs consisting of runs at two levels for each factor with three replications of the center points. Results: The analysis of variance and three-dimensional response surface plot of effects indicated that variables were regarded to be significant for production of g-linolenic acid by Mucor hiemalis. Results indicated that fermentation at the optimum conditions (100 g/l glucose concentration; 1 g/l peptone; 1 g/l ammonium nitrate, and pH of 4.5) enhanced the g-linolenic acid production up to 709 mg/l. Discussion and conclusion: The results of this study indicated that higher g-linolenic acid yield can be achieved in a simple medium at high glucose and ammonium nitrate, low peptone concentrations and acidic pH by Mucor hiemalis PTCC 5292. This simple and low cost optimization condition of culture media can be applied for g-linolenic acid production at higher scale for pharmaceutical and nutritional industries.&nbsp

Dentinogenesis imperfecta associated with osteogenesis imperfecta

This paper presents a case with dentinogenesis imperfecta (DI) associated with osteogenesis imperfecta. Systemic and dental manifestations of OI and its medical and dental treatments are discussed in this paper. A 5-year-old child with the diagnosis of OI was referred to the Dental School of Shaid Beheshti University of Medical Sciences. On clinical examination yellow/brown discoloration of primary teeth with the attrition of the exposed dentin and class III malocclusion was observed. Enamel of first permanent molars was hypoplastic. Radiographic examinations confirmed the diagnosis of DI. A histological study was performed on one of the exfoliating teeth, which showed abnormal dentin. Primary teeth with DI were more severely affected compared to permanent teeth; enamel disintegration occurred in teeth with DI, demonstrating the need for restricts recalls for these patients

Comparison of Effects of a Herbal Toothpaste with Crest Complete Toothpaste on Streptococcus Mutans and Lactobacillus of Saliva and Plaque Index: A Randomized Clinical Trial

Background and Aim: In recent years, beneficial effects of herbal hygienic products and toothpastes have significantly been emphasized. This study sought to assess the effects of Masdent toothpaste which contains Pistacia Lentiscus (PL) extract on plaque index and Streptococcus mutans(SM) and Lactobacillus (LB) count in saliva. Materials and Methods: This study was conducted on 60 students aged 18-20 years. Participants were asked to brush their teeth twice a day for four weeks with the assigned toothpaste, Masdent toothpaste which contains PL extract in the case group and Crest toothpaste in the control group. Plaque index was recorded at the onset and end of the study, and salivary samples were taken for SM and LB colony count. Mann-Whitney, independent t- and Wilcoxon tests were used for data analysis. P<0.05 was considered statistically significant. Results: Number of SM and LB colonies significantly decreased in both groups(P<0.01) at the end of the study. However, the difference in SM and LB colonies between the two groups was not significant (PMutans=0.108, PLactobacili=0.796). The reduction in plaque index after using the toothpastes was significant in both groups (P<0.001). This reduction was not statistically different between two groups (P=0.85). Conclusion: Use of herbal toothpaste containing PL extract and Crest toothpaste had similar effects and both significantly decreased SM and LB salivary counts as well as the plaque index

Assessment of Microshear Bond Strength: Self-Etching Sealant versus Conventional Sealant.

Recently, self-etching fissure sealants have been introduced to reduce technical sensitivity; however, their efficacy should be assessed. The aim of this study was to assess of the microshear bond strength of self-etching and conventional fissure sealants.Thirty non-carious third molars were randomly divided into three groups (N=10). Microcylinders of Concise fissure sealant were bonded to prepared buccal and lingual surfaces using the two following procedures. In the first group, phosphoric acid was used to prepare the substrate; whereas in group two, Concise was used in combination with Prompt L-Pop. In group 3, a self-etching fissure sealant (Enamel Loc) was utilized per se. After 24 hours, the samples were subjected to 500 rounds of thermocycling and shear bond testing using a microtensile tester machine with a crosshead speed of 0.5mm/min. Data were analyzed using one-way repeated measure ANOVA and Bonferroni Post HOC tests (SPSS version 16).THE MEAN AND STANDARD DEVIATION OF MICROSHEAR BOND STRENGTH OF THE GROUPS WERE AS FOLLOWS: Group 1: Concise+ etching (14.59 ± 1.19 MPa), Group 2: Concise+Prompt L-Pop (12.86 ± 1.98 MPa), and Group 3: Enamel Loc (5.59 ± 0.72 MPa). One-way ANOVA revealed that all the differences were significant and the conventional sealant exhibited the highest mean bond strength.Conventional sealant using phosphoric acid etch application prior to fissure sealant application demonstrated more bond strength in comparison with that of self-etch bonding and self-etch sealant