Double Antibiotic Paste for Management of External Inflammatory Root Resorption

External inflammatory root resorption (EIRR) is one of the common complications following dental trauma which when remained untreated, may lead to tooth loss. Successful treatment outcomes depend on elimination of bacteria from root canal system and apical sealing. This case presents the endodontic management of an EIRR that was nonresponsive to calcium hydroxide (CH) therapy. An 11-year-old boy was referred for management of a traumatized maxillary central incisor. Tooth #8 was symptom-free, nonresponsive to vitality pulp tests and had an immature root with sever EIRR. Using chemomechanical debridement and CH dressing, the treatment was initiated. The tooth was remained asymptomatic; however, after five weeks the size of periradicular lesion increased and intracanal exudate was present, signifying a resistant endodontic infection. In second appointment, double antibiotic paste (DAP; ciprofloxacin/metronidazole) was applied to the canal. Eight weeks later, the tooth continued to be asymptomatic and the size of the lesion decreased. Finally, the root canal was entirely obturated with calcium-enriched mixture (CEM). At 18-month follow-up, the tooth was asymptomatic/functional, EIRR did not further progress and tooth discoloration was not observed. Based on the results, DAP has the potential to be used to manage the CH-resistant endodontic infection. Furthermore, CEM root filling/sealing seems to be an applicable choice in EIRR management.Keywords: Antibiotics; Calcium-Enriched Mixture; CEM Cement; Dental Trauma; Endodontics; Intracanal Medicament; Root Resorption

Outcomes of Different Vital Pulp Therapy Techniques on Symptomatic Permanent Teeth: A Case Series

In modern endodontics, vital pulp therapy (VPT) has been considered an ultra-conservative treatment modality. Based on the level of pulp preservation, VPT includes stepwise excavation, indirect pulp capping (IDPC), direct pulp capping (DPC), miniature pulpotomy (MP), partial/Cvek pulpotomy and coronal/complete pulpotomy (CP). The present article reviews the treatment outcomes of 94 permanent teeth with irreversible pulpitis treated with either IDPC (n=28), DPC (n=28), MP (n=29) or CP (n=9) using calcium-enriched mixture (CEM) cement. After a mean follow-up time of 12.3 months, 93 treated teeth were radiographic/clinically successful; only one radiographic failure was observed in the DPC group

Vital Pulp Therapy of a Symptomatic Immature Permanent Molar: A Case Report

Vital pulp therapy (VPT) is the preferred conservative treatment for preservation of symptomatic pulps in immature permanent teeth. The present case report summarizes VPT of an immature permanent molar with irreversible pulpitis associated with apical periodontitis in a 9-year-old boy. Cervical pulpotomy was performed and radicular pulp stump were covered with calcium-enriched mixture (CEM) cement; the tooth was then restored with stainless steel crown. After a 50-month follow-up period, the pulpotomized molar was clinically functional and asymptomatic. Moreover, radiographic evaluation revealed evidence of complete root development as well as normal periodontal ligament around the roots. The successful outcome achieved through VPT using CEM biomaterial in the reported case suggests that this method may produce favorable outcome for vital immature permanent teeth with irreversible pulpitis and periapical diseasekeywords: Apexogenesis; Calcium-Enriched Mixture; Immature Tooth; Irreversible Pulpitis; Pulpotomy; Vital Pulp Therap

Diagnostic accuracy of tele‐dentistry in screening children for dental caries by community health workers in a lower‐middle‐income country

Background: Tele-dentistry can be useful for dental caries screening of children, especially in lower-middle-income countries (LMICs).Aim: To evaluate the diagnostic accuracy of mobile phone photographs taken by a community health worker (CHW) for caries detection in Iran.Design: Children aged 6–12 years were visually examined by a paediatric dentist. Following dental examinations, intraoral photographs were taken by a trained CHW. Two remote dentists assessed intraoral photographs for dental caries. Diagnostic accuracy of tele-dentistry for caries detection was evaluated. In addition, the questionnaire about oral health and parents' views towards tele-dentistry was prepared.Results: One hundred thirty-one children aged 8.74 ± 1.62 years participated. The caries prevalence was 30% for the whole dentition. Tele-dentistry demonstrated high accuracy, with a sensitivity exceeding 80% and specificity exceeding 90%. The inter-rater reliability for remote dentists' assessments to the gold standard dental examination ranged from substantial to almost perfect (kappa: 75%–93%). Additionally, 80% of parents whose children participated in this study had positive views towards tele-dentistry.Conclusion: Tele-dentistry was shown to be an alternative approach to clinical examinations for caries detection among school children. Employing non-dental care professionals in tele-dentistry has been emerged as a reliable and cost-effective approach, especially in LMICs

PubMed-Indexed Dental Publications from Iran: A Scientometric Study

Objectives: Scientometric methods and the resulting citations have been applied to investigate the scientific performance of a nation. The present study was designed to collect the statistical information of dental articles by Iranian authors published in PubMed. Materials and Methods: We searched the PubMed database for dental articles of Iranian authors until June 31, 2015. All abstracts were manually reviewed in order to exclude false retrievals. The number of articles per dental subspecialties, distribution of research designs, Scopus/Google Scholar citation of each article, number of authors and affiliation of the first/corresponding author were extracted and transferred to Microsoft Excel. The data were further analyzed to illustrate the related scientometric indicators. Results: A total of 3,835 articles were retrieved according to the selection criteria. The number of PubMed-indexed publications between 2008 and 2015 showed a seven-fold increase. The majority of articles were written by four authors (24.56%). Systematic reviews and clinical trials constituted 9.20% of all publications. The number and percentage of articles with ≥4 citations from Google Scholar (n=2024; 52.78%) were higher than those from Scopus (n=1015; 26.47%). According to affiliated departments of the first authors, the top three dental subspecialties with the highest number of publications belonged to endodontics (19.82%), orthodontics (11.13%) and oral and maxillofacial surgery (10.33%). Moreover, the majority of articles originated from Shahid Beheshti- (14.47%), Tehran- (13.72%) and Mashhad- (12.28%) University of Medical Sciences.  Conclusions: Analysis of PubMed-indexed dental publications originating from Iran revealed a growing trend in the recent years.