Comparative evaluation of microleakage of composite restorations using fifth and seventh generations of adhesive systems

Introduction: Simultaneous etching of enamel and dentin using the novel generation of adhesive systems with contracted operational steps, has shown a good clinical efficacy. The aim of this study was to evaluate the microleakage of composite restorations using the V and VII generations of adhesive systems on primary teeth. Methods: This study was performed on 45 human intact extracted primary teeth. Following class V cavity preparation, the samples were randomly divided into three groups included 15 teeth based on the type of bonding agent; Single Bond 2, Clearfil S3 Bond or G Bond. After applying the bonding agents, the teeth filled with composite Z250. The microleakage values of incisal and gingival margins were separately scored by 2% basic fuchsine staining based on a 0-3 ordinal ranking system. The data were analyzed by using Kruskal Wallis and Mann_whitney U tests. Results: In overall, the score of microleakage at incisal (0.58±0.94) and gingival (1.06±0.19) edges did not have significant difference. Also, there was no significant difference between incisal and gingival microleakage considering the different types of bonding. Conclusion: Regarding to less operational steps and lower risk of salivary contamination, the VII generation of dentin bonding agents can be applied for filling the class V cavities of primary teeth

Analgesic effects of gabapentin and ibuprofen on the pain in post therapy of root canal; a randomized double-blind clinical trial

Introduction: Inhibiting the pain which affects both the patients and dentists is an important factor during treating dental patients. The aim of this study was to assess the analgesic effect of two medications ibuprofen and gabapentin on the post-endodontic-therapy pain. Methods: Forty patients who need root canal therapy with Visual Analog Scale (VAS)>40, participated in this double-blind randomized clinical trial study and randomly divided into two groups. The ibuprofen group received 800 mg ibuprofen 1 hour before the treatment and 400 mg at 6, 12 and 24 hours after the treatment procedure, and the other group received 600 mg gabapentin 1 hour before the treatment and 300 mg at 6, 12 and 24 hours after treatment. Patients recorded the intensity of pain via VAS before treatment and every hour for the first 6 h after taking the medication and then every 6 h thereafter for a total of the 48-hour period. (Two tablets of acetaminophen codeine (325mg/20mg) were given to the patients as a rescue dose. Results: The analgesic effect of gabapentin was significantly higher than ibuprofen in 12h (p=0.035), 24h (p<0.001), and 48 h (p=0.012) after analgesic intake. It has been also shown that both medicines had analgesic effect significantly. (p<0.0001) Conclusions: Gabapentin had greater analgesic effects on the sample group from 12 h until 48h after taking in comparison with ibuprofen so; it seems that it could be an appropriate option for postoperative pain inhibition

Evaluation of the Possible Antioxidative Role of Bilirubin Protecting from Free Radical Related Illnesses in Neonates

There are disparate data regarding whether bilirubin is protective or toxic during free radical related illness among neonates. Seventy one infants with gestational age (GA) of <32 weeks and/or birth weight (BW) of <1500 g, who survived beyond 4 weeks and completed physical examinations were enrolled in this study. The infants were divided into two groups based on the presence or absence of advanced retinopathy of prematurity (ROP), grade III intraventricular hemorrhage (IVH), grade III necrotizing enterocolitis (NEC), respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), sepsis or severe fungal infection (SFI). The mean of total serum bilirubin (TSB) of the first 14 days of life were measured and compared between these two groups. A significant lower TSB were found in severe form of ROP (P<0.001), grade III NEC (P=0.008), grade III IVH (P=0.021), SFI (P=0.003) and sepsis (P=0.007) in comparison to mild or disease free status. Moreover, the cut-off point of 5.1 mg/dl for the mean of TSB had the sensitivity of 88.1% and specificity of 84.6% to detect severe grades of ROP. Also the cut-off point of 3.25 mg/dl had 97.2% sensitivity and 100% specificity in order to distinguish SFI. It is concluded that bilirubin may play an antioxidant role in vivo as in vitro; and protect preterm infant against these free radical related disorders. Our findings suggest that not only the upper limits of serum bilirubin, but also the lower limits must be taking into account in order to both preventing from neurotoxic effects and free radical based illnesses, respectively

New Predictors for Advanced Retinopathy of Prematurity among Neonates in Tehran/Iran

Objective: Since a new epidemic (third wave) of retinopathy of prematurity (ROP) sensed throughout the world in recent years, we aimed to assess newer risk factors for advanced ROP which needs treatment in Iranian neonates as a new target output of various neonatal care for this serious disease of newborn infants especially those born prematurely. Methods:In an analytic cross-sectional study all neonates <1500 g birth weight and/or <32 weeks gestational age admitted to our NICU as a tertiary level intensive care unit in Milad Hospital, Tehran, Iran during June 2006-June 2007 were included. All data were extracted from medical records and compared in two groups with or without treatment. Findings:Seventy one neonate infants entered our study. Twelve neonates (16.9%) progressed to advanced ROP. Final multivariate analysis model revealed that mean leukocyte counts during first 14 days of life (P=0.04), transfusions number (P=0.01) and hypocapnic episodes during first 14 days of life (P=0.02) were significantly different between the two groups of infants independently, even after simultaneous adjustment. Conclusion:Based on our findings, more amenable risk factors should be approached regarding more careful modulation of such overlooked risk factors which may lessen the burden of prematurity

Surgical orodental implications in ankylosing spondylitis

Temporomandibular joint and the pelvic complex are bidirectionally related. Ankylosing spondylitis (AS) is a seronegative arthropathy with the key feature of bony fusion of lumbar vertebrae. A 39 year old known case of AS was presented to private office for left lower impacted third molar surgical removal. Previously, he was rejected to receive oral care for pulpectomy and extraction due to limited mouth opening. Prior to the surgery, lateral neck radiography was obtained to exclude any subluxation of fracture of cervical vertebrae. Neck was supported to insure neck stability during surgical forces. In addition, considering consumption of immunosuppressive medications including corticosteroids, procedure was performed with a great care, with attention to higher possibility of infection and fracture. Access to the surgical site was not desirable, though surgery accomplished without any significant event and the patient discharged with routine analgesic and antibiotics recommendation. Sometimes, impaired access to the oral cavity in patients with AS leads to receive suboptimal or minimal orodental care. Long list of dental implications in these patients may be simplified by considering of careful neck and jaw support, applying at least possible forces and great attention to the infection control rules. It is wised to be performed under patient and skilled hands

Effect of Acidulated Phosphate Fluoride (APF) on the Mcroleakage of Composite Flow and Fssure Sealant Restorations

Background and Aims: A large number of investigations have revealed that physical and chemical alterations and weight loss could occur in composite materials exposed to acidic phosphate fluoride (APF) gel. The purpose of this study was to assess the microleakage of a fissure sealant and a flow composite exposed to acidulated phosphate fluoride (APF) gel. Materials and Methods: In this in vitro study, 60 intact human extracted premolar teeth were used. After preparing the occlusal groove, the teeth were divided into two groups (n=30). Teeth were filled with either Helioseal fissure sealant (Vivadent, Germany) or Tetric flow composite (Vivadent, Germany). After that, each group was divided into two subgroups (n=15): 1.23% APF gel (Sultan, U.S.A) was applied in the case subgroups, while control subgroups were preserved in normal saline solution. All of teeth were covered with 2 layers of nail varnish except for the filling zone and 1mm around the border of filling. After submerging in 0.5% fushin solution, specimens were sectioned bucco-lingually. Then dye penetration through the filling and fissure sealant was assessed by means of a stereo-microscope. The depth of dye penetration was scored. The data were analyzed using One-way ANOVA and Levene test. Results: The mean values of dye penetration were 1.26±1.09, 1.4±1.05, 1.2±1.37, and 1.4±1.35 for fissure sealant+gel, composite+gel, composite+normal saline, and normal saline groups, respectively. No significant difference was found in inter-groups (P=0.96). Conclusion: Considering the result of the present research, APF gel had no significant effect on the microleakage of Tetric flow composite filling and Helioseal fissure sealant and thus, it can be applied for routine usage