Anatomy of Permanent‎ ‎Mandibular‎ First‎ Molars in a Selected Iranian Population Using ‎Cone-beam Computed Tomography

Introduction: Knowledge of radicular anatomy has a crucial impact on endodontic practices. Since some anatomic features such as modifications of Vertucci are not evaluated adequately, this study was conducted. Methods and Materials: In this in vivo study, cone-beam computed tomography (CBCT) images of‎ 312‎ intact bilateral first‎ molars‎ from‎ 156‎ patients‎ (‎79‎ ‎males‎ and‎ 77‎ females with an average age of ‎35.58‎±‎11.17‎ years‎)‎ were‎ investigated by a trained dentist in terms of number‎ of‎ roots,‎ number‎ of‎ canals‎ in‎ each‎ root‎ and‎ in‎ ‎each‎ tooth,‎ and shapes‎ of‎ canals‎ according‎ to‎ Vertucci’s‎ classification‎ and‎ its‎ modifications.‎ Groups were compared using the Chi-square test. The level of significance was set at 0.05. Results: Of all teeth, 5.2%‎ had‎ 3‎ roots.‎‎ ‎Mesial‎ roots‎ had‎ mostly‎ 2‎ canals‎ while distal roots had a similar frequency of 1 and 2 canals.‎ ‎Of‎ all‎ teeth,‎ ‎‎39.7%‎ had‎ 3‎ canals,‎ 45.2%‎ had‎ 4‎ canals,‎ 13.8%‎ had‎ 5‎ canals,‎ and‎ 1.3%‎ had‎ 6‎ canals.‎ There were no significant differences between males and females, ‎in terms of number of roots (P=0.137), number of canals in mesial (P=0.453) or distal roots (P‎‎=0.328), and total number of canals (P=0.138).‎ The most frequent Vertucci classes in mesial and distal roots were IV ‎‎followed‎ by‎ II and I‎, respectively. There were no significant differences between males and females in terms of Vertucci classes of mesial (P=0.211) or distal (P=0.205) roots. Conclusion: In this population, there were 3 to 6 canals per tooth (mostly 4 and 3 canals).‎ Males and female’s ‎might be similar regarding the number of roots, or number of canals in each root, number of ‎canals in each tooth, or the predominant canal shape in each root.Keywords: Anatomy;‎ Cone-beam Computed Tomography; Endodontics;‎ Root Anatom

Cognitive Neuroscience of Pain

Non peer reviewe

Transportation and Centering Ability of Neoniti and ProTaper Instruments; A CBCT Assessment

Introduction: Transportation is an important iatrogenic endodontic error which might cause failure. This study evaluated the canal transportation caused by Neoniti and ProTaper instruments, using cone-beam computed tomography (CBCT) cross sections. Methods and Materials: This in vitro experimental study was performed on 40 mesiobuccal roots of maxillary first molars. The teeth were scanned with CBCT. They were randomly divided into 2 groups (n=20) that were prepared using either Neoniti or ProTaper files. An endodontist prepared the canal according to the manufacturer’s guidelines. Prepared canals were re-scanned. The pre-instrumentation and post-instrumentation CBCT volumes were sectioned at 1 to 9-mm distances from the apex. The extent of canal dentine removal in mesial and distal directions were measured in each cross-section. Canal transportation and instrument centering ability were estimated based on the extents of root wall removal and were compared in both groups. Results: The groups were rather similar in terms of transportation and centering ability (P>0.05). However, canal preparation on mesial and distal walls was statistically significantly less in the Neoniti group, at most cross-sections. Transportation of both groups was not significantly different (P>0.05). Centering ability of both instruments was not significantly different (P>0.05). Conclusion: Neoniti and ProTaper instruments might have proper centering ability and minimum transportations. Both instruments might cause similar extents of transportation and centering abilities.Keywords: Centering Ability; Nickel Titanium Instruments; Root Canal Treatment; Root Canal Preparation; Transportatio

Antibacterial Effects of Chitosan, Formocresol and CMCP as Pulpectomy Medicament on Enterococcus ‎faecalis, Staphylococcus aureus and Streptococcus ‎mutans

Introduction: During pulpectomy of primary teeth, cytotoxic medicaments such as formocresol or camphor mono-chlorophenol (CMCP) are used as medicaments. For the first time it is theorized that chitosan can substitute these traditional materials used in pulpectomy of infectious primary teeth. Methods and Materials: This preliminary in vitro study consisted of two separate phases (n=75), each of which assessed the antibacterial effects of chitosan versus formocresol and CMCP and positive/negative controls (n=15) on three bacteria types [Enterococcus ‎faecalis, Staphylococcus aureus, Streptococcus ‎mutans, (n=5 per subgroup)]. Phases 1 and 2 concerned respectively with 1- and 7-day effects of these materials. Bacteria were cultured and injected into sterilized canals and colonies were counted. Medicaments were applied and colonies were re-counted after 1 day of treatment (phase 1). Specimens were re-sterilized and re-randomized, and used for phase 2, in which the same procedures were performed for a 7-day period. Effects of agents on bacteria were analyzed statistically (Kruskal-Wallis α=0.05 and Mann-Whitney α=0.017). Results: Treatments reduced bacterial count either after 1 or 7 days (P=0.000). Their effects on different bacteria types were not significant either after 1 or 7 days (P>0.48). Antibacterial efficacies of treatments (indicated by colony reduction) were significantly different, after 7 days (P=0.045). Antibacterial efficacy of chitosan was similar to that of formocresol or CMCP, in both phases [either after 1 or 7 days of treatment (P>0.017). Formocresol and CMCP had similar efficacies in either phase (P>0.017). Conclusions: This preliminary study confirmed the appropriate antibacterial efficacy of chitosan as a medicament in pulpectomy of infectious primary teeth.Keywords: Antibacterial Agents; Camphor Mono-Chlorophenol; Chitosan; CMCP; Enterococcus ‎faecalis; Formocresol; Medicament; Pulpectomy; Staphylococcus aureus; Streptococcus ‎mutan

Effect of Deep Cryogenic Treatment on Cyclic Fatigue of Endodontic Rotary Nickel Titanium Instruments

Introduction: Cyclic fatigue is the common reason for breakage of rotary instruments. This study was conducted to evaluate the effect of cryogenic treatment (CT) in improving the resistance to cyclic fatigue of endodontic rotary instruments. Methods and Materials: In this in vitro study, 20 RaCe and 20 Mtwo files were randomly divided into two groups of negative control and CT. CT files were stored in liquid nitrogen at -196°C for 24 h, and then were gradually warmed to the room temperature. All files were used (at torques and speeds recommended by their manufacturers) in a simulated canal with a 45° curvature until breakage. The time to fail (TF) was recorded and used to calculate the number of cycle to fail (NCF). Groups were compared using independent-samples t-test. Results: Mean NCFs were 1248.2±68.1, 1281.6±78.6, 4126.0±179.2, and 4175.4±190.1 cycles, for the Mtwo-control, Mtwo-CT, RaCe-control, and RaCe-CT, respectively. The difference between the controls and their respective CT groups were not significant (P>0.3). The difference between the systems was significant. Conclusion: Deep CT did not improve resistance to cyclic fatigue of the evaluated rotary files.Keywords: Cryogenic Treatment; Cyclic Fatigue; Instrument Fracture; Rotary Nickel Titanium File

Efficacy of the Biomaterials 3 wt%-nanostrontium-hydroxyapatite-enhanced Calcium Phosphate Cement (nanoSr-CPC) and nanoSr-CPC-incorporated Simvastatin-loaded Poly(lactic-co-glycolic-acid) Microspheres in Osteogenesis Improvement

Aims The purpose of this multi-phase explorative in vivo animal/surgical and in vitro multi-test experimental study was to (1) create a 3 wt%-nanostrontium hydroxyapatite-enhanced calcium phosphate cement (Sr-HA/CPC) for increasing bone formation and (2) creating a simvastatin-loaded poly(lactic-co-glycolic acid) (SIM-loaded PLGA) microspheres plus CPC composite (SIM-loaded PLGA + nanostrontium-CPC). The third goal was the extensive assessment of multiple in vitro and in vivo characteristics of the above experimental explorative products in vitro and in vivo (animal and surgical studies). Methods and results pertaining to Sr-HA/CPC Physical and chemical properties of the prepared Sr-HA/CPC were evaluated. MTT assay and alkaline phosphatase activities, and radiological and histological examinations of Sr-HA/CPC, CPC and negative control were compared. X-ray diffraction (XRD) indicated that crystallinity of the prepared cement increased by increasing the powder-to-liquid ratio. Incorporation of Sr-HA into CPC increased MTT assay (biocompatibility) and ALP activity (P \u3c 0.05). Histomorphometry showed greater bone formation after 4 weeks, after implantation of Sr-HA/CPC in 10 rats compared to implantations of CPC or empty defects in the same rats (n = 30, ANOVA P \u3c 0.05). Methods and results pertaining to SIM-loaded PLGA microspheres + nanostrontium-CPC composite After SEM assessment, the produced composite of microspheres and enhanced CPC were implanted for 8 weeks in 10 rabbits, along with positive and negative controls, enhanced CPC, and enhanced CPC plus SIM (n = 50). In the control group, only a small amount of bone had been regenerated (localized at the boundary of the defect); whereas, other groups showed new bone formation within and around the materials. A significant difference was found in the osteogenesis induced by the groups sham control (16.96 ± 1.01), bone materials (32.28 ± 4.03), nanostrontium-CPC (24.84 ± 2.6), nanostrontium-CPC-simvastatin (40.12 ± 3.29), and SIM-loaded PLGA + nanostrontium-CPC (44.8 ± 6.45) (ANOVA P \u3c 0.001). All the pairwise comparisons were significant (Tukey P \u3c 0.01), except that of nanostrontium-CPC-simvastatin and SIM-loaded PLGA + nanostrontium-CPC. This confirmed the efficacy of the SIM-loaded PLGA + nanostrontium-CPC composite, and its superiority over all materials except SIM-containing nanostrontium-CPC

Preparation, Characterization and Evaluation of Drug Release Properties of Simvastatin-loaded PLGA Microspheres

Abstract Microspheres formulated from poly (D, L-lactic-co-glycolide) (PLGA), a biodegradable polymer, have been extensively evaluated as a drug delivery system. In this study, the preparation, characterization and drug release properties of the PLGA microspheres were evaluated. Simvastatin (SIM)-loaded PLGA microspheres were prepared by oil-in-water emulsion/solvent evaporation method. The microspheres were then frozen to −80 °C, they were freeze dried for 24 h. Characterization of SIM-loaded PLGA microspheres was evaluated by X-ray diffraction analysis, Fourier transform infrared spectroscopy analysis, and scanning electron microscopy (SEM). Drug release potential was evaluated by UV-spectrophotometry. The experimental results revealed that SIM-loaded PLGA microspheres can be successfully obtained through solvent evaporation method with appropriate morphologic characteristics and high encapsulation efficiency. The drug release pattern from polymeric microspheres in the phosphate buffered saline medium was measured during a 21-day period using UV-spectrophotometry. The correlation coefficient value (r 2 = 0.9878) of the trend lines of the graph showed that the SIM-loaded PLGA microspheres best fit with zero order release pattern. No burst release was observed with polymeric matrix. The drug release characteristic of the microspheres ascertained that the release was about 27% for SIM-loaded microspheres, which occurred within the first 6 days after maintaining the microspheres in phosphate buffer saline. Also, the microspheres successfully presented a slow release and the duration of the release lasted for more than 21 days. It can be concluded that SIM-loaded PLGA microspheres hold great promise for using as a drug-delivery system in biomedical applications, especially in drug delivery systems and tissue engineering

Pain and discomfort perceived during the initial stage of active fixed orthodontic treatment

Background and objectives: As the most common complication of orthodontic treatment, pain can negatively impact quality of life and cause patients to discontinue treatment. However, few studies have evaluated pain during orthodontic treatment, with controversial findings. This study assessed the intensity and duration of pain and discomfort caused by active orthodontic treatment. Methods: This descriptive cross-sectional study examined 67 patients (22 men, 45 females; age range: 18–32 years) undergoing fixed orthodontic treatment. Patients were interviewed after the active treatment stage to assess their perceived pain and discomfort at different sites during different activities by a visual analogue scale. Frequency and duration of pain in different areas were analyzed by the chi-squared and chi-squared goodness-of-fit tests (α = 0.05). Results: Among the 67 patients, 65.7% experienced general dentogingival pain or discomfort and 34.3% had localized dentogingival pain or discomfort (p = 0.010, chi-squared goodness-of-fit test). Masticating soft foods reduced discomfort (p = 0.000, chi-squared) in the tongue, cheeks, and in or around the teeth and gingivae. Pain and discomfort were mostly moderate while masticating sticky, fibrous, and firm foods. Mild pains were mostly reported during tooth brushing and while consuming soft foods (p < 0.05, chi-squared). Pain and discomfort tended to last for more than 4 weeks, except in the tongue, where pain and discomfort lasted less than 4 weeks (p < 0.05, chi-squared goodness-of-fit test). Conclusions: Pain and discomfort occur for more than 4 weeks after beginning fixed orthodontic treatment. Changing diets to incorporate softer foods is recommended to alleviate pain. Keywords: Orthodontic appliances, Tooth movement, Facial pai