Erbil Dental Journal (EDJ)

Effect of Cross-Sectional Designs of Different Ni-Ti Files on Shaping Ability After Repeated Usage in Simulated Root Canals.

2024-06-12T09:43:59+00:00

Background and Objective: The study aimed was to compare the effect of cross-sectional designs of five rotary systems (One Curve, 2Shape, K3-i File, E3 Azure, Neolix), on the shaping ability of the files in simulated resin blocks under controlled conditions with five repeated use. The shaping ability of the files includes the following variables: (1) Longitudinal sectional area difference, (2) Canal wall surface area difference, (3) Canal volume difference, (4) SMI (structure material index) difference, (5) Cross-sectional area difference.

Methods: Five rotary file systems: (1) One Curve, (2) 2Shape, (3) K3-i File, (4) E3 Azure, (5) Neolix, were tested in simulated J-shaped root canal resin blocks with a 45˚ angle of curvature. 10 files from each system, each one of the 10 files were used to prepare 5 resin blocks, named R1-R2-R3-R4-R5. All the used files from the 5 systems had tip size 25 diameter, and taper (6%), and length (25 mm). The first 4 rotary systems were used with a fixed speed (350 rpm), and fixed torque (3 Ncm), except for the fifth system which was used with a speed of (500 rpm), and torque (4 Ncm). All the 250 resin blocks were prepared for Glide Path with manual reamers size 10, and 15, with a fixed working length 16 mm, then all the 250 samples were prepared with a Proglider rotary file from Dentsply (size 16 taper 3%), then finally were prepared with Edge Files (USA), with size 20 and taper 6%, reaching to the step of master preparation with the selected files of the 5 systems.

Results: In the first, second, third, and fourth variables a statistically non-significant difference (P > 0.05) was found between One curve and 2Shape, a statistically significant difference (P < 0.05) was found between One Curve, K3-i File, E3 Azure, and Neolix. About the fifth variable which is the Cross-sectional area difference: the study compared the difference between the cross-section area of the canal at the point D8, comparing the cross-section area before and after preparation using ANOVA test and Post hoc test, a statistically significant difference (P < 0.05) was found between the Neolix and (2shape, K3 i-File, and E3 Azure).

Conclusion: The cross-sectional design of the endodontic rotary instrument had an obvious effect on the shaping ability of the system.

Color Stability and Surface Roughness of Different Composite Resins after Using Different Polishing Systems.

2024-06-12T10:01:28+00:00

Background and objectives: To evaluate and compare the color stability and surface roughness of different composite resins after using different polishing systems and then submitting to accelerating artificial aging (AAA) and staining by black tea.

Method: Twenty disk-shaped specimens (were compacted into the custom-made cylindrical plastic mold that had an internal diameter of 10 mm and a depth of 2 mm) were prepared for each composite resin type (3M Z350, Tokoyama Palfique, and Shofu Beautifil II) for a total of 60 specimens, each composite group was divided into two subgroups according to the polishing system (n=10) (Shofu super-snap polishing disks and Eve Diacomp Plus Twist wheel). Color parameters (L*, a*, and b*) and surface roughness were measured before and after accelerating artificial aging (2000–4000 thermal cycles) and staining.

Results: It was observed that all resin-based materials showed an increase in color change value and surface roughness value after 2000 thermal cycles. while after 4000 thermal cycles, only the surface roughness value decreased in all resin-based materials.

Conclusion: all resin-based materials showed clinically acceptable color stability (ΔΕ < 3.7) and surface roughness >0.2 µm) after (2000 thermal cycle) and staining.

The Effect of Propolis Irrigation as an Adjunctive to Scaling and Root Surface Debridement on Periodontal Health Status, Glycemic Control and Biochemical Markers in Subjects with Type 2 Diabetes Mellitus and Chronic Periodontitis: A Randomized Clinical

2024-06-12T10:08:56+00:00

Background: Periodontitis is the inflammation of supporting tooth structures; it is one of the six complications of diabetes, Propolis a local delivery agent can be used as an adjunct to non-surgical periodontal therapy.

Aim: To assess the effect of Propolis as adjunctive to scaling and root surface debridement for the treatment of periodontitis patients with type 2 diabetes.

Methods: forty-five chronic periodontitis patients with poorly controlled type 2 diabetes (glycated hemoglobin 1 assay HbA1c≥8%) were recruited into group I; (n=15) scaling and root planing alone was performed, group II; (n=15) scaling and root planing+ chlorhexidine mouth wash twice a day for two weeks were prescribed, in the group III; scaling and root planing +Propolis irrigation was performed for two weeks, twice weekly. Clinical periodontal, haematological (fast blood sugar and glycated haemoglobin) and biochemical parameters (total antioxidant capacity and total oxidant status) were recorded at base line and three months of therapy.

Results: The results indicated that there was a highly significant improvement of the clinical parameters in group I and II (p<0.001), in group I at baseline, the correlations between probing pocket depth and clinical attachment loss with total antioxidant capacity were significant and highly significant respectively, probing pocket depth and clinical attachment loss with total oxidant status were significant. While after 3 months of therapy, the correlations between bleeding on probing and gingival index with total antioxidant capacity were significant and highly significant respectively, plaque index and gingival index with total oxidant status were significant.

Conclusion: Propolis irrigation could improve clinical periodontal parameters in chronic periodontitis patients with type 2 diabetes, with significant improvement of fast blood sugar and total oxidant status in group II and glycated haemoglobin in group III were exhibited.

The Role of Dental Implant in Maxillofacial Prosthetic Rehabilitation in Rizgari Teaching Hospital.

2024-06-12T10:21:06+00:00

Backgrounds and objectives: Loss of any maxillofacial subunit will certainly pose a functional, esthetic, and psychological problems. In addition, the mode of fixation of prosthesis is of major concern. This research aimed to study the role of dental implant in fixing maxillofacial prosthesis.

Method: A retrospective hospital-based study was designed from June 2019 to January 2023. Maxillofacial prosthetic unit is the only center in the region treating patients with lost maxillofacial subunits. Inclusion criteria were, 18 years old or above, patients who lost facial structure unit/s (mandible, maxilla, orbit, nose, auricle, etc...). Cone beam CT was used for implant site planning. All the surgeries of implant placement were done under local anesthesia through full thickness skin flaps. Implants were placed 1cm away from each other for hygienic purposes and at least 7mm away from hairy skin.

Result: A total of 28 implants were used for prosthetic rehabilitation of 10 patients (7 males and 3 females) with age range of 27-70 years. All the implants passed the period of healing and the follow up period after prosthetic rehabilitation successfully with 0% failure. No unwanted sequel like skin infection or peri implantitis or pain is reported.

Conclusion: Dental implant considered the best mode of fixation in maxillofacial rehabilitation with best functional, esthetic and psychological outcomes.

Effect of Local Simvastatin on the Healing of Surgically Created Critical-Sized Bone Defects: An experimental Study on sheep.

2024-06-12T10:28:02+00:00

Background and objective: the role of simvastatin in lowering serum cholesterol levels is well described. However, recent findings suggest they have a role in bone formation as well. The study aims to determine the effect of local simvastatin application on bone defect healing and compare the amount of new bone produced by a simvastatin-treated defect with that produced by a bone graft (biphasic calcium phosphate) and non-treated defects (left empty) histologically.

Methods: Forty-five critical-size defects were created (8mm in diameter and depth) in the iliac bone of 6 sheep. For the first three sheep (5 defects/ilium), the five defects on the right ilium were left empty as a Control group, while the five defects on the left ilium were filled with biphasic calcium phosphate as Test 1 group. For the other three sheep, 5 defects were created on the right ilium, the defects were filled with 10mg crushed simvastatin tablet with gelfoam (as a carrier) as Test 2 group. The animals were sacrificed over periods of 1, 2, and 3 months. Histopathological studies were done for all the samples. SPSS version 28 was used to analyze the results. The numerical variables were checked for normality using Smirnov – Kolmogorov test, then analyzed using ANOVA and unpaired t-test (p–values ≤ 0.05 were considered statistically significant).

Results: All 6 adult male sheep passed the scheduled periods uneventfully. During the wound healing period, there was no complication such as infection, excessive hematoma, or wound dehiscence. All 45 standardized iliac bone defects were included in the final analysis (n= 45). The histologic results showed that Test 2 group (defect filled with simvastatin) in the 1st, 2nd, and 3rd months had significantly higher bone formation at the surface and depth of the defects than Test 1 and Control group with P values (<0.0001) at all period intervals.

Conclusion: Simvastatin enhances bone formation and accelerates the healing process of the bony defect.

Mylohyoid Nerve Injection for Unsuccessful Anesthesia of Posterior Teeth with Successful Inferior Alveolar Nerve Block.

2024-06-12T10:34:41+00:00

Background and objective: variations in mylohyoid could lead to failure of an inferior alveolar nerve blockade. This study aimed to evaluate the impact of mylohyoid nerve variation on the persistence of pain following a successful inferior alveolar nerve block.

Method: This clinical study was performed at the oral and maxillofacial department/college of Dentistry, Hawler Medical University. All patients with pain following a successful inferior alveolar nerve block were enrolled in this study. An additional submucosal injection (infiltration technique) as few drops in the lingual mucosa of the offending tooth is given by the same surgeon

Results: A total of fifty patients were enrolled in this study,30 males and 20 females. age range was (16-56). Among the total only 20 patients (60%females,40% males) experienced pain on the lingual side during the attempt of dental extraction. Following lingual infiltration, all the cases were treated successfully in a pain free environment. Descriptive statistics was used to analyze the data.

Conclusion: Lingual submucosal injection of 1/3 of 1.8 ml of local anesthesia might be an effective way to block all possible nerve variation on the lingual side.

Effect of Apical Preparation on Different Needle Depth Penetration.

2024-06-12T11:10:05+00:00

Introduction: Irrigation is a fundamental part of endodontic debridement as because it allows for cleaning beyond what might be accomplished by root canal instrumentation. The flushing action produced by the irrigant and the penetration of the irrigant is not dependent only on the anatomy of the root canal system, but also on the depth of placement, system of delivery, the volume and fluid properties of the irrigant. Aim: The aim of the study was to evaluate the effect of apical preparation on the penetration depth of different types of needles.

Methods: Thirty single rooted lower premolar teeth were involved in this study. The access opening was performed by using a round diamond bur turbine (diameter 12) and Kfiles (diameter 15) were used for initial penetration in the canal. Stereo- microscope under 20 magnifications was used to determine the working length of the canal. Then the canals were prepared using protaper next in continuos rotation according to manufacture instructions with sequence files reached the WL (X1, X2, X3, X4). 4 mL of 5.25% NaOCI was used between each instrument. Three different types of endodontic needles were used. Needles size 27, 30-gauge stainless steel and IRRIFLEX endodontic irrigation needle. Each needle was inserted in the canal and its length of penetration was measured before canal preparation and after finishing files then the depth of penetration was measured.

Results: ANOVA test showed that there are significant differences among all groups also results show a significant difference when comparing 27 with 30 needle gauge irriflex but there was no significant difference between the needle gauge 30 and irriflex.

Conclusion: This study shows that the penetration depth of needles influences on apical preparation it appears that 27 -gauge needles show less depth penetration when compared to irriflex and 30- gauge needles.

Dentinal Crack Formation and Quality of Obturation Using Two Single File Systems and Two Obturation Techniques: A micro-CT Study.

2024-06-12T11:18:20+00:00

Background and objectives: Root canal preparation following obturation with rotary instruments and different obturation techniques may lead to formation of microcracks in the root canal wall, void and gaps between the canal wall and obturation material.

Aim: This study aimed to evaluate dentinal microcracks and voids formation after using two different files TruNatomy (TRN) and Genius (GN) and two obturation techniques Single Cone (SC) and GuttaCore (GC) using Microcomputed tomography scan (micro-CT).

Methods: 40 extracted mandibular premolars were decoronated, leaving 13mm roots. The roots were randomly divided into two main groups TRN and GN ((n=20)) according to instrumentation, afterwards each group subdivided into two subgroups ((n=10)) according to obturation techniques. The root canals instrumented with TRN and GN file and obturated with Single Cone (SC) and GuttaCore (GC) obturation techniques. AH Plus sealer was used in all groups. The specimens were scanned with Micro-CT before and after root canal preparation and after obturation. subsequently, all pre-and postoperative cross-sectional images of the roots were screened to identify the presence of dentinal defects. Furthermore, the percentage of voids volume calculated. Data were analyzed statistically to determine difference between groups, the level of statistical significance was at p < 0.05.

Results: GN revealed the least number of microcracks. There were no significant differences between groups in the incidence of dentinal microcracks. The highest percentage of filling material was observed in GC groups. There were significant differences between the obturation groups in the number of voids present after obturation (P < 0.001).

Conclusion: The instrumentation of root canals induces dentinal microcracks. Obturation have no effect on the formation of cracks. None of the root canal filling procedures yield fillings that are void-free.

Effect of Ozone Gel on Postoperative Sequelae after Surgical Removal of Impacted Lower Third Molars.

2024-06-12T11:28:25+00:00

Background and objectives: the study aims to evaluate the efficacy of ozone gel in reducing pain, swelling, trismus and also to evaluate soft tissue healing and dry socket after surgical removal of impacted lower third molars.

Methods: the current study enrolled 50 patients divided randomly in to two equal groups, Group I (study group) received ozone gel intra-socket and oral placebo postoperatively and Group II (control group) received a systemic antibiotic. Clinical examination includes assessment of maximal mouth opening on the day of surgery, panoramic x-ray was used for evaluation of the location and configuration of impacted lower third molars, surrounding bone, mandibular canal and adjacent tooth. Pain and swelling were assessed by visual analogue scale (VAS) and recorded daily for one week by the patients, dry socket was checked at 3^rd day postoperatively, maximal mouth opening also was checked at 3^rd and 7^th day postoperatively and soft tissue healing was checked at 7^th day postoperatively.

Results: Results showed statistical significance difference regarding pain and swelling and there was no statistically significant difference regarding maximal mouth opening (trismus), dry socket and soft tissue healing in Group I (study group).

Conclusion: This study concluded that the use of ozone gel was effective in the reduction of postoperative pain and swelling but it was not effective in reducing trismus, dry socket and soft tissue healing after surgical removal of impacted lower third molars.

Comparison of Dimensional Accuracy of (Pmma) Denture Base Material Relined with Molloplast B Soft Liner by Different Curing Methods.

2024-06-12T12:15:39+00:00

Background and objectives: The most common problem associated with the complete denture is the loss of retention after period of time therefore relining procedure is important in many cases, this study was done to compare the dimensional accuracy of PMMA before and after the application of Molloplast B Soft liner to the denture base material by different curing methods.

Methods: A total of 80 PMMA samples were used in this study, 40 (SR Triplex hot) PMMA samples polymerized in water bath, 40 (Acron MC) PMMA samples polymerized in microwave, Molloplast B soft liner (Detax, Germany) were packed between each two PMMA strip as overlap joint and cured by water bath and microwave, the dimensional accuracy of PMMA samples were measured before and after the Molloplast B soft liner application using the (DOF scan app) software device.

Results: The results showed that the dimensional accuracy of SR Triplex hot water bath polymerized PMMA samples experienced significant dimensional change after the application of Molloplast B soft liner, while in Acron MC microwave polymerized PMMA samples, non-significant dimensional changes were observed after Molloplast B soft liner application.

Conclusion: Microwave polymerized PMMA samples showed better dimensional accuracy than the water bath polymerized PMMA samples after the addition of Molloplast B Softliner.

Extraction Socket Seal Technique for Socket Preservation after Tooth Extraction: An Innovative Approach.

2024-06-12T12:27:41+00:00

Background and objectives: Tooth extraction triggers the loss of surrounding alveolar soft tissue and bone. Numerous socket preservation techniques have been used by clinical surgeons; the issue with all existing techniques is the loss of soft tissue anatomy, resulting in a flat soft tissue architecture. Our study introduces an innovative ridge preservation technique that addresses this problem; it involved using an anatomically shaped composite resin lid that acts as a graft sealant and an approach for maintaining the soft tissue cervical profile.

Material and Methods: The Extraction Socket Seal (ESS) technique was applied for 23 patients for socket preservation; atraumatic extraction of hopeless tooth was performed. The extraction socket was filled up with bone grafting material. After that, the composite resin lid, which was fabricated by the Cervico system was placed into the extraction socket. Finally, the lid was connected to the adjacent teeth with an adhesive system and composite resin material. The patients were evaluated for a three-month interval for any complications and success of Extraction Socket Seal (ESS) technique. The data were tested by descriptive data analysis using the Statistical Package for Social Sciences (SPSS, version 29).

Results: The proposed technique has been successfully performed in twenty-three cases; 13 cases were male and 10 cases were female; and the mean age of all cases was 32 years. Extraction Socket Seal (ESS) technique utilizing a composite resin lid fabricated from the Cervico system was used as socket sealant placed directly to cover the bone graft, and we found that it provided an excellent “barrier” for the graft without any unwanted complications. After three months, radiographs showed good bone healing, and the mean socket soft tissue healing score was 4 (Very good wound healing), and most importantly the soft tissue architecture and shape were well preserved.

Conclusions: We concluded that the Extraction Socket Seal (ESS) technique offers a very simple and time-saving technique for alveolar ridge preservation after tooth extraction for both anterior and posterior extraction sockets, and it provides a good seal for the graft material and the soft tissue anatomy was well preserved.

Comparison of Debonding of Different Composite Resin Bonds and Acrylic Tooth with Acrylic Denture Base after Thermocycling Regimes.

2024-06-12T14:12:06+00:00

Background and objectives: The purpose of this study was to repair detached acrylic tooth using composite resin and comparing it debonding with cold cure acrylic after thermocycilg process.

Methods: Materials used in the study include: four composite groups (Ceram, Composan, ESTELITE and Dynamic Plus) with a single group of acrylic artificial teeth bonded to acrylic (n=10). Specimens have tested the thermocycling then specimens were subjected to stress using a universal testing machine.

Results: The outcome data statistically were analyzed, results showed that (ESTELITE) Tokoyama, brand has the highest value of tensile bond strength (7.05 MPa), and the lowest one Cerama brand with the (5.12 MPa) mean composite groups, but the cold cure acrylic one with the (2.07 MPa).

Conclusion: Replacement of missing artificial teeth on the denture base with a different brand of composite can be done as an alternative to acrylic teeth and the thermocycling regime influence the debonding process.

Increasing Vertical Dimension of a Case with Full Mouth Rehabilitation: Case Report.

2024-06-12T12:08:47+00:00

Introduction: Bruxism is one of the most frequent causes for occlusal tooth wear, with the loss of tooth structure caused by mechanical wear between maxillary and mandibular tooth surfaces, case report was conducted to improve the patient oral health, and to maintain the new vertical dimension since it was lost by teeth clenching.

Case description: this paper presents a 50 years old male suffering from severe bruxism, which implicated the appearance and function of the patient, he was transferred to TIU dental hospital for full mouth rehabilitation treatment.

Discussion: The rehabilitation of patients with extensive occlusal wear is complex and difficult to solve, becoming thus one of the biggest challenges of dentistry, a proper planning of a prosthetic rehabilitation should not attribute the re-establishing of occlusal vertical dimension (OVD) to new prostheses at the risk of the patient doesn’t adapt to a new condition of vertical dimension.

Conclusion: Tooth wear causes dimensional changes in facial morphology and OVD decrease. The correct determination of occlusal vertical dimension represents a factor of success in the rehabilitation treatment.