Erbil Dental Journal (EDJ)

Association of Arginase-1 Gene and Immunoglobulin E Levels with Asthma Severity in Erbil City Patients

Jihad Abdulrazzaq Sulaiman — 2025-12-30

Background and Objectives: Asthma is a chronic respiratory disease that affects the airways and is a major health issue worldwide. We aimed to examine some of these factors.

Methods: The arginase-1 gene detected in 50 healthy individuals and 50 in the patients group. Then the level of arginase-1 enzyme examined by using Enzyme-linked immunosorbent assay (ELISA) and immunoglobulin E (IgE) by Cobas e 411.

Results: This study found substantial differences in arginase-1 and IgE means between controls and asthmatics. The severe group had the highest mean AGR1 2.35±0.45, whereas the control group had the lowest 0.52±0.27. The severe group had the greatest mean IgE 1285±518.6, whereas the control group had the lowest 53.27±30.45. The arginase gene was found in all participants, but BMI did not affect asthma severity.

Conclusions: ARG1 gene found in both patients and healthy people. ARG1 enzyme and IgE significantly associated with the severity of asthma in Erbil city.

Exploring The Link Between TSHR Gene Polymorphism and Thyroid Function Parameters in Thyroid Disorder Patients

Hawzhin Hussein Hayder — 2025-12-30

Background and Objectives: Most common autoimmune thyroid diseases are Hashimoto's thyroiditis and Graves' disease which are caused by immune system and genetic factors. In this study the association between the thyroid function test (TFT) values and the TSHR gene polymorphism c.1349G>T will be investigated, which leads to a p.Arg450Leu amino acid change, in patients with thyroid disorders.

Methods: A cross-sectional study investigating, 50 thyroid dysfunction patients and 50 samples of healthy controls participated. The immunoassay was used to measure the serum levels of TSH, FT3, and FT4. Allele-specific ARMS-PCR was used to genotype the TSHR c.1349G>T (p.Arg450Leu) polymorphism.

Results: Hyperthyroid patients displayed suppressed TSH and raised FT3/FT4 levels, and hypothyroid patients displayed considerably elevated TSH and decreased FT3/FT4 levels. The hyperthyroid group had a higher frequency of the c.1349G>T variation of the TSHR gene (p.Arg450Leu) than the hypothyroid and control groups. The T allele was found to be statistically significantly associated with a higher incidence of hyperthyroidism (P<0.01). Serum TSH levels did not significantly differ between homozygous and heterozygous carriers of the mutation.

Conclusion: The research suggests a possible relationship between thyroid dysfunction, specifically hyperthyroidism, and the TSHR c.1349G>T (p.Arg450Leu) polymorphism. Thyroid disease risk prediction and diagnosis accuracy may be improved by performing genetic screening.

Assessing The Prevalence of Anatomical Variations in Root Canals of Maxillary Molars and Premolars Using Cone Beam Computed Tomography in Erbil City: Retrospective CBCT Study

Ranjdar Tawfeeq Asaad — 2025-12-30

Background and objective: Root canal variations can be a challenge to detect and manage when performing root canal therapy, and failure to detect these variations in the root canals of the teeth will lead to unsatisfactory results of the treatment. An important tool for observing the root canal anatomy of teeth that are indicated for root canal treatment is cone beam computed tomography (CBCT). The objective of this study is to find out the rate of anatomical variations in the root canals of maxillary premolars and molars using CBCT among a Kurdish subpopulation in Erbil, Iraq.

Materials and method: Data were collected from five dental clinics and radiographic centers in Erbil City. A total of about 690 CBCT images were used for the study, after applying the exclusion criteria, 205 CBCT images were included for the study. maxillary premolars and molars were examined for the number of roots, number of canals, and presence of root canal variations.

Results: The prevalence of the second mesiobuccal (MB2) canal in maxillary first molars (MFM) was 47.8%, while in maxillary second molars (MSM), it was 18.05%. The prevalence of the second distobuccal (DB2) canal in (MFM) was 1.46%, with three recorded cases, while none of the (MSM) had a (DB2) canal. Additionally, only 2 cases (0.98%) in MSM had two palatal canals, whereas no such cases were recorded in MFM. A single case of MFM (0.49%) was recorded with two roots and canals, whereas in (MSM), 10 cases (4.88%) had two canals. In maxillary first premolars, five cases (2.44%) were reported with three roots and canals (molarized premolars). Similarly, five cases (2.44%) had a single canal, while 195 cases (95.12%) had two canals: one buccal and one palatal. In maxillary second premolars, 135 cases (65.85%) had two canals (buccal and palatal), and 70 cases (34.15%) had a single canal.

Conclusion: There is a wide range of variations among maxillary molars and premolars, which need careful diagnostic evaluation to prevent missing canals during root canal treatment.

Prevalence of The Second Mesio-buccal Canal and Second Distobuccal Canal in The Maxillary First Molars Among a Sample of Erbil –Kurdistan Region Population Using CBCT

Laween Nzar Hassan — 2025-12-30

Background and Objectives: Adequate knowledge of anatomic variations in root canal morphology is essential for improving the outcome of root canal treatment. The maxillary first molars commonly require endodontic treatment; however, they are known to have the most complex root canal systems.

Aim: To evaluate the frequency of the second mesiobuccal (MB2) canal and the second distobuccal (DB2) canal in maxillary first molars, as well as the bilateral symmetry of the maxillary first molars (MFM) with the second mesiobuccal canal, and the association of gender and age to their occurrence using cone beam computed tomography (CBCT).

Methods: This retrospective study investigated 140 maxillary first molars from 80 CBCT scans collected from a private dental imaging centre in Hawler over 4 months from May to August 2024. The patients were aged 13 to 57 years (mean age: 29.1 years). Data were analysed using SPSS (version 25) with descriptive statistics and the Chi-Square test.

Results: The prevalence of the MB2 canal in MFM was 53.6%. Both males and females have a similar prevalence of MB2 canals in their MFM. In 75 MFM with MB2 canals, a single apical exit was found in 51.9% of the cases. No significant correlation was found between the prevalence of the MB2 canal and gender or age. In the 41 patients with MB2 canals in their MFM, the likelihood of bilateral MB2 canals was high (82.9%). The frequency distribution of the second distobuccal canal was low (7.9%); however, the age group 21-30 showed the highest occurrence of second distobuccal canals in MFM.

Conclusion: The use of CBCT is a valuable tool in detecting MB2 canals, therefore improving the outcomes of root canal treatment. A high prevalence of MB2 canals was found in the study. The prevalence of bilateral MB2 was high.

Gingival Health Status among Pregnant Women Attending Maternity Hospital in Erbil City: A Cross-Sectional Study

Maysam Jasm Murad — 2025-12-30

Background and Objectives: The notable changes in circulating hormones during pregnancy are known to detrimentally affect the oral cavity detrimentally, leading to the manifestation of conditions like gingival overgrowth and inflammatory periodontal disease. This investigation specifically evaluated the state of gingival health among expectant mothers receiving care at the Erbil City Maternity Hospital and analyzed their reported dental care routines.

Methods: The cross-sectional data collection took place over three months, from November 2024 through January 2025, enrolling 90 pregnant women across all trimesters. Data collection included clinical oral examinations and a structured questionnaire addressing oral hygiene habits, supplement intake, and gingival health. The Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), and Gingival Overgrowth (GOG) were utilized to evaluate oral health. Statistical analyses comprised one-way ANOVA and descriptive statistics.

Results: Plaque accumulation remained stable across trimesters (PI: p=0.934), whereas gingival inflammation increased significantly as pregnancy advanced (GI: p=0.040). Bleeding on probing (BOP) was present in over half of participants, with higher prevalence in the second and third trimesters (BOP: p=0.144). Gingival overgrowth (GOG) increased gradually, though not to a statistically significant degree (GOG: p=0.129). Oral hygiene practices were generally inadequate: 86.6% reported daily brushing, but only 31.1% used dental floss, and 40% used a tongue scraper. Supplement use was prevalent, with 75.5% of women regularly taking folic acid and vitamins.

Conclusion: There is a high prevalence of gingival inflammation and periodontal diseases among pregnant women, with severity escalating as pregnancy progresses. Enhanced oral hygiene practices and increased awareness of oral care during pregnancy are necessary to prevent oral health complications. Regular dental checkups should be promoted to support the health of both mother and fetus.

Evaluation of Compressive Strength Among Different Types of Composite Resin: An in Vitro Study

Pinar Khalis Bilal — 2025-12-30

Background and Objectives: Wearing of composite is a major challenge in resin-based restoration, the aim of this study was to evaluate the compressive strength of different types of composite resin based on their filler content.
Material and Methods: Forty specimens of resin composite have been used in a cylindrical shape with height of four millimeter and a diameter of five millimeter. The 40 specimens were divided into two main groups according to the type of composite brand, each group consisted of 20 specimens, with further subdivision into two subgroups according to the filler content of composite. Group A: Charisma, Group B: Bisico. In Subgroups A1 and A2: Micro and Nano Charisma were used. In Subgroups B1 and B2 Micro and Nano of Bisico were used. A universal testing machine was used to determine the compressive strength of each specimen. Statistical analysis was performed using SPSS to compare between the groups.

Results: There was a significant difference between B1 (Microfiller Bisico Composite) and B2 (Nanofiller Bisico Composite), B1 had higher compressive strength. While there was no significant difference between A1 (Microfiller Charisma composite) and A2 (Microfiller Charisma composite).

Conclusion: Within the limitation of this study, it was found (A1) Microfiller Charisma composite, (B1) Microfiller Bisico composite, and (A2) Nanofiller Charisma composite, has the highest compressive strength resistance, so they can withstand greater compressive stress and are recommended for use in posterior teeth.

Evaluation of Fracture Resistance of Indirect Ceramic Overlay Used with Different Fiber-incorporated Base Materials

Abdullah Majid Bazrgan — 2025-12-30

Background and Objectives: Adhesive ceramic overlay restorations have become a popular, conservative alternative to full-coverage crowns, with Computer-aided design and Computer-aided Manufacture technology improving fabrication efficiency. Advances in 3D- printing show promise in replacing milled restorations. In addition to the overlay material, the base material plays a critical role in restoration performance. Current study investigates the fracture resistance of fiber-reinforced core materials with various indirect restorations and examines their correlation in failure modes and fracture behavior.

Methodology: This in vitro study was conducted at Hawler Medical University / Erbil in November 2024. 100 freshly extracted maxillary premolars were included in the study. Following Mesio-Occlusal-Distal cavity preparations, teeth were restored using a range of fiberreinforced base and overlay restorative materials. Fracture resistance was evaluated using a universal testing machine at a rate of 1 mm/min, and failure mode were examined using a stereomicroscope. Statistical analysis was conducted using one-way ANOVA and the Tukey test.

Results: The study showed that zirconium and Emax overlays had significantly higher fracture resistance than indirect composite overlays, with no notable difference in resistance between the various base materials (Short fiber-reinforced composite, Polyethylene fiber core, Particulate filled composite) within the zirconium and Emax groups. While indirect composite overlay demonstrated low fracture resistance values, it exhibited the lowest tooth fracture rate compared to other restorative groups. From all of the analyzed groups, Emax+ Polyethylene ribbond core, Zirconium+ Polyethylene fiber core, Emax+ Particulate filled composite) groups showed the most promising fracture behavior and improved fracture resistance.

Conclusion: Materials with higher fracture resistance often exhibit unfavorable or catastrophic fracture patterns, whereas materials with lower fracture resistance present more favorable and repairable failure modes.

A Comparative Study of Cyclic Fatigue Resistance of Different Types of Endodontic Instruments: An in Vitro Study

Odet Sabah Rassam — 2025-12-30

Background and Objectives: Nickel-titanium (NiTi) rotary files are routinely utilized in root canal instrumentations for their flexibility and competency. However, they are susceptible to fracture due to cyclic fatigue, particularly in curved canals. The objective of the current study is to investigate and compare the cyclic fatigue resistance of different nickel-titanium (NiTi) rotary instruments. The tested instruments were Protaper Gold (PTG), HyFlex EDM (HEDM), 2Shape (TS1) and TruNatomy (TN).

Materials and Methods: A total of forty NiTi endodontic rotary instruments were split into four study groups (n = 10 each). Group 1: Protaper Gold (F2 25/.08), group 2: HyFlex EDM (25/.08), group 3: 2Shape (25/.04) and group 4: Trunatomy (26/.04). A custom-made stainless-steel block having simulated canal with 60° angle of curvature and 5 mm radius of curvature was used to test the cyclic fatigue resistance. The number of cycles required for fracture with the length of the fractured segment were calculated and the data were statistically analyzed utilizing one-way analysis of variance (p < 0.05).

Results: The results demonstrated that HyFlex EDM had the highest statistically significant mean cyclic fatigue value, followed by 2Shape, Protaper Gold and Trunatomy respectivly.

Conclusion: The alloy properties and manufacturing processes of the evaluated rotary nickel–titanium systems had a direct influence on their capability to resist cyclic fatigue. HyFlex EDM files demonstrated greater fatigue resistance compared to 2 Shape, Protaper Gold and TruNatomy.

Evaluation of The Topical Effect of Calendula Officinalis Oral Paste in The Treatment of Recurrent Aphthous Stomatitis: A Randomized Double-Blind Controlled Trial

Asma Qasim Rahman — 2025-12-30

Background and Objectives: Recurrent aphthous stomatitis is the most common recurrent ulceration in the oral mucosa. The anti-inflammatory and wound-healing properties of Calendula officinalis make it a medicinal plant. This study aims to evaluate Calendula Officinalis 10% and 15% oral pastes compared with triamcinolone acetonide 0.1% and placebo oral pastes, and to evaluate salivary Irisin as an inflammatory marker before and after treatment.

Materials and Methods: A randomised, double-anonymised case-control clinical study included 60 patients with minor recurrent aphthous stomatitis (age range: 16-50 years. Patients used (Calendula officinalis in 10 % and 15 %, triamcinolone acetonide 0.1 % and placebo) oral pastes for one week. Clinical observation for (ulcer size, pain and erythema) was done on days (0, 4 and 7). Salivary irisin level was measured before and after treatment.

Results: Significant differences were noted by topical treatment with 10% and 15% calendula officinalis and triamcinolone acetonide 0.1% oral pastes at the 4th and 7th day in reducing ulcer size, erythema and pain (P<0.001). The most significant reduction was achieved with 15% Calendula officinalis on the 4th day. A significant difference in salivary irisin levels was observed before and after treatment with all four group pastes (P<0.001).

Conclusion: Calendula officinalis 15% oral paste showed a significant effect on reducing ulcer size, pain, and erythema in Recurrent Aphthous Stomatitis patients over 4 days.

Shear Bond Strength of MDP-Containing Adhesives with and without HEMA: An in Vitro Study

Ahmed S. Hasan — 2025-12-30

Background and Objectives: The primary role of dental adhesives is to deliver a good bond between the filling material and the tooth. Universal adhesive (UA) systems brought a novel concept by adding active resin monomers that facilitate both micromechanical and chemical adhesion. 10-methacryloyloxydecyl dihydrogen phosphate (MDP) is a vital component of these adhesives, noted for its strong ionic interaction with hydroxyapatite (HAp) in both enamel and dentin, which leads to the formation of nanolayers of MDP-calcium salts. Evidence suggests that 2-hydroxyethyl methacrylate (HEMA), a monomer that is hydrophilic and improves the adhesive's wetting ability on dental surfaces, may affect MDP’s interaction with hydroxyapatite powder. In view of this, the present study aimed to assess the differences in shear value of bond strength between two MDP-containing multi-mode bonding systems: Futurabond M+ (VOCO, Germany), which contains HEMA, and G-Premio Bond (GC, Japan), a HEMA-free alternative.

Materials and Method: Forty extracted human maxillary premolars were separated into two groups (n=20). The occlusal portion was removed to gain a smooth dentin surface. Adhesives were applied per manufacturers’ instructions, followed by composite resin build-up (Palfique LX5, Tokuyama, Japan). After 24-hour water storage at 37°C, using a universal testing machine (TERCO, MT 3037, Sweden) at 1.0 mm/min, shear bond strength was tested. To analyze the data, an independent t-test (p < 0.01) was used.

Results: Futurabond M+ (HEMA-containing) exhibited significantly higher shear bond strength (19.74 ± 4.80 MPa) than G-Premio Bond (HEMA-free) (14.33 ± 5.80 MPa) (p = 0.001). The mean difference (5.41 MPa) and large effect size (Cohen’s d = 1.017) show that the greater bond strength attained with VOCO Futurabond M+ is statistically important and expressive in a practical, clinical situation.

Conclusion: HEMA-containing Futurabond M+ produced higher shear bond strength to dentin compared to HEMA-free G-Premio Bond, probably due to HEMA, ethanol, and higher pH. The adhesive act is dependent on numerous factors; therefore, additional investigations are necessary.

Impact of Various File Systems on Apical Debris Extrusion in Single Canal Teeth: An in Vitro Study

Ribwar Aman Ferman — 2025-12-30

Background and Objectives: This study aims to analyze and correlate the quantity of debris extruded from apical foramen amid root canal instrumentation applying Mtwo, ProTaper Next, and Race Evo file systems.

Materials and Method: A collection of sixty single-rooted, single-canal premolars were selected. The roots were divided randomly into three different groups (n = 20 each) based on the type of instrumentation system used: Group 1 – “ProTaper Next,” Group 2 – “RACE EVO,” and Group 3 – “Mtwo.” The debris extruded during instrumentation was collected, dried in pre-weighed vials, and measured using an electronic balance.

Results: There was a highly significant difference in apically extruded debris among the three file systems. Mtwo had the lowest debris extrusion (0.00054 ± 0.00018), while Protaper Next had the highest mean debris extrusion (0.00101 ± 0.00020), followed by RACE EVO (0.00077 ± 0.00024).

Conclusion: Mtwo with continuous rotation exhibited the most advantageous performance of the evaluated systems due to its S-shaped cross-section and effective debris removal capabilities.

Effectiveness of Insulin Syringe Versus Conventional Dental Syringe in Managing Dental Trypanophobia: A Clinical Study

Dilman Mufti — 2025-12-30

Background and Objectives: Pain management during dental procedures is of utmost importance. Extreme fear of dental injections can significantly interfere with dental health status. This study aims to demonstrate the efficacy of an insulin syringe loaded with local anesthetics for the management of dental trypanophobia.

Method: forty-seven patients with an age range of (6-70 years old), 55% female and 45% male, have been enrolled randomly in this study. Each patient was delivered local anesthesia (lidocaine 2%-epinephrine) for two different sites in two different visits by a standard dental syringe (the length and gauge of the needle were 27 G/L) and an insulin syringe. The insulin syringes (1ml, 30G x 8) were loaded with local anesthesia (lidocaine 2%-epinephrine). The infiltration technique is used to deliver Local anesthesia.

Results: Forty-seven patients participated in the study; their mean age (SD) was 30.86 (29) years, the median was 29 years, and the age range was 5-75 years. More than half (53.2%) of the patients were aged 20-39, and 57.4% were females. The median VAS score with the dental syringe was 4, compared with 0 with the insulin syringe. The mean rank of the first group was significantly higher than that of the second group (p < 0.001).

Conclusion: Insulin syringe attempts could be a better and more efficient way of managing dental trypanophobia in pediatric patients as well as adults. The mean rank of the dental syringe was significantly higher than that of the insulin syringe. (p < 0.001).

Structure Model Index Parameter for Shaping Effectiveness Difference Between Expanded and Reduced Taper Design Files: An in Vitro Study

Payam I. Taha — 2025-12-30

Background and objectives: To prepare root canal systems, the complex endodontic space must be shaped, enlarged, and disinfected. The taper design significantly influences the shaping efficacy of the instruments. This study attempts to assess the performance of decreased taper endodontic instrument systems (Bassi Logic .03 taper) compared to expandable heat-treated systems (XP-endo Shaper) in shaping simulated canal resin blocks in both straight and curved canals.

Materials and methods: Sixty simulated canal resin blocks have been used, comprising thirty blocks with straight canals and thirty blocks with curved canals featuring a 30° curvature. Each group was divided into three subgroups and pre-instrumentation photographs were obtained. Afterwards the resin blocks were prepared to an apical size of 25 utilizing various file systems: 1- reduced taper design (Bassi Logic .03 taper), 2- enlarged taper design (XP-endo Shaper), and 3- ProTaper Next (control group). Following instrumentation with the specified files, post-instrumentation photos were generated, and surface area and volume fluctuations were assessed utilizing AutoCAD software to determine the Structure Model Index (SMI). Statistical analysis was performed using non-parametric tests (Mann-Whitney Test and Kruskal-Wallis Test) with a significance level of p<0.01.

Results: The results of these investigations indicated that the ProTaper Next group exhibited the highest mean SMI, succeeded by the Bassi Logic. 03 taper group, whilst the XP-endo Shaper group demonstrated the lowest mean SMI relative to the other groups. In terms of the canal configuration, there is a statistically significant difference between straight canals and curved canals. In comparison to the curved group, the straight group displayed higher mean SMI, which suggests that the shaping effect in the straight group results in a more structured and possibly more conical canal morphology. On the other hand, the curved group demonstrates a more conservative shaping approach with less pronounced structural modification during the shaping process.

Conclusion: XP-endo Shaper group were more conservative and specific in reshaping the simulated root canals than other systems. The three systems used were respecting the internal anatomy of simulated root canals, other than non-conservative shaping of the straight canals, even they were within acceptable limits.

Correlation Between Periodontal Health Status with Some Salivary Inflammatory Biomarkers in Pregnant and Lactating Women

Mivan Kawa Majid — 2025-12-30

Background and Objectives: Periodontal health may be influenced by the hormonal and immunological shifts that occur during pregnancy and lactation. This study aimed to assess and compare the periodontal status and salivary concentrations of matrix metalloproteinase 8 (MMP-8) and tumor necrosis factor-alpha (TNF-α) among pregnant, post-partum lactating, and non-pregnant/non-lactating (control) women.

Methods: A case-control study was performed on 90 systemically healthy women, with an average age ranging from 25-35 years, equally divided into pregnant, postpartum lactating, and control groups. Clinical periodontal parameters, including bleeding on probing (BOP), gingival index (GI), probing pocket depth (PPD), and plaque index (PI), were examined, and salivary levels of MMP-8 and TNF-α were assessed via enzyme-linked immunosorbent assay (ELISA).

Results: The mean level of GI, BOP, PPD, MMP-8, and TNF-α were significantly elevated in pregnant women, followed by lactating and control groups, with significant differences between each two groups and among the three groups (P < 0.001), except for non-significant differences between lactating and control groups regarding MMP-8 (P =1.000). All the correlations between clinical and inflammatory biomarkers were weak and non-significant (rho < 0.4), whereas a significant negative correlation was found between GI and MMP-8 in the pregnant group (rho = -0.544, p = 0.002).

Conclusion: Pregnancy is associated with increased gingival inflammation and biochemical inflammatory markers, indicating a heightened risk for periodontal disease. Lactating women displayed intermediate changes, emphasizing the need for periodontal monitoring and preventive care throughout the peripartum period.

Maxillary Rehabilitation with Pterygoid Implants: Evaluating Success and Complications in 58 Clinical Cases

Jodal M. Ahmed — 2025-12-30

Background and Objective: The rehabilitation of the posterior maxilla is often hindered by unfavorable bone quality, sinus pneumatization, and anatomical constraints. Pterygoid implants are a desirable alternative to traditional techniques by engaging dense pterygoid plate, thereby circumventing sinus augmentation. The objective of this study was to retrospectively evaluate clinical outcomes of unilateral versus bilateral pterygoid implant placements regarding implant success and rate of complications.

Methods: This retrospective clinical study included 58 patients treated between February 2018 and August 2024. Data were retrieved from patient records and split based on the implant site placement: unilateral (posterior Maxillary one side rehabilitation) (n=29) or bilateral (full arch Maxillary rehabilitation) (n=29). All the patients underwent treatment with pterygoid implants placed with a standardized surgical procedure. Success was considered as absence of mobility, pain, infection, and lack of peri-implant radiolucency.

Results: The age range of the patients in the study is from 29 to 77 years with Mean Age of 56.8 years. All 58 cases demonstrated a 100% implant survival rate. Only one patient was with complications, while minor, non-critical complications were reported in the remaining cases. There were no statistically significant differences between the unilateral and bilateral groups in terms of complication or success rates.

Conclusion: Both unilateral and bilateral pterygoid implant placements yielded good clinical outcomes with minimal complications. It is evident from this research that both methods can be used successfully in prosthetic rehabilitation of the atrophied posterior maxilla depending on the specific anatomical and clinical condition.

Correlation Between Cadmium Level and Iron Regulatory Markers in Hypothyroid Patients

Jwan Tamr Agha — 2025-12-30

Background and Objectives: The insufficient production of thyroid hormones (THs) is called hypothyroidism. Thyroid hormone reduction in the blood causes an elevated secretion of thyroid stimulating hormone (TSH). Naturally occurring environmental pollutants, like heavy metals, have numerous effects on ecosystems. Their bioaccumulation results in a variety of harmful consequences on various body tissues and organ systems, including the thyroid gland. The study aimed to evaluate the main relationships between levels of cadmium (Cd) with hepcidin hormone, ferritin and other iron markers in hypothyroid patients.

Methods: The study carried out on 90 female subjects in Galiawa Diabetes and Endocrinology Teaching Center in Erbil city and Kawrgosk laboratory. The data collection for the study was started from November 2024 to February 2025. The study included hypothyroid patients compared with healthy persons by analyzing the samples of blood parameters including hematological, iron regulatory markers and blood Cd level.

Results: There were significant differences in the hematological, iron regulatory markers and cadmium in the patients when compared to controls at (p < 0.001). Pearson correlation analysis revealed statistically significant correlations between Cd level and Hb, MCV and ferritin. While there was no statistical correlation between Cd with other iron parameters. ROC curve analysis for Cd indicated that Cd was a risk factor of hypothyroidism.

Conclusion: From the ROC and Pearson correlation analysis we conclude that cadmium is a significant marker in alteration of the studied iron regulatory marker and hematological parameters.

A Pilot in Vitro Comparison of Compressive Resistance Among Selected Dental Restorative Materials

Nahida Salh Hamad — 2025-12-30

Background and Objectives: To demonstrate the inherent variations between various brand products, a first-time report on the compressive strength of a few commercially available dental restorative materials of particular interest is provided.

Methods: The compressive strength of three different types of materials (zinc phosphate cement, amalgam, and resin composite) was measured using a universal testing machine. By using laboratory molds to fabricate specimens in compliance with manufacturer specifications, unstandardized dimensional variations were produced that closely resembled the original experimental conditions. The analysis was conducted using descriptive statistics and ANOVA.

Results: Zinc phosphate cement (1010 N) and amalgam (527.5 N) had significantly lower average compressive strengths than composite resin (3560.8 N). The most significant difference between the amalgam and resin composite groups was demonstrated by the significant standard deviations.

Conclusion: The results seem to support notable performance variability within material classes and, more significantly, their remarkable versatility within the limited parameters of this pilot study.

That is to say that the specific commercial formulation and material are equally potent as the material class itself. These early results emphasize the requirement for adequate product selection and suggest worthwhile directions for more controlled future work.

Effect of Blood Lead Levels on Hepcidin and other Iron Regulatory Markers in Iron Deficient Pregnant Women

Lajan Kakil Hassan — 2025-12-30

Background and Objectives: Increasing prevalence of pregnancy iron deficiency poses significant health risk that links to the exposure to heavy metals like lead (Pb) which may further complicate this condition. To investigate such a relationship, hepcidin alongside other iron regulatory markers, also, oxidative stress marker Malondialdehyde (MDA) was estimated in relation to Pb in iron deficient (ID) pregnant women.

Methods: The study included 84 pregnant women, blood parameters including hematological, iron markers and blood lead level in ID pregnant women compared with normal pregnant women at 2nd and 3rd trimesters. Lead was measured using ICP- technique, ELISA used for estimation of hepcidin and MDA.

Results: The comparison of the main blood parameters regarding hematological and iron regulatory markers showed significant differences between patient and control groups. Also, blood Pb and MDA concentrations were significantly different. As a feature of lead toxicity, most of the studied blood films revealed that red cell morphology did not exhibit uniformity in size and shape (poikilocytes) which showed significant morphological abnormalities. Pearson correlation analysis revealed statistically significant correlations between Pb level and RBC, HCT, hepcidin, MDA. From the ROC curve analysis of Pb level the result indicated that Pb was a risk factor of ID in patient groups.

Conclusion: The findings suggest an association with significant alterations in hematological parameters and iron metabolism. Concerning the statistical analysis of the ROC curve, as evidenced by the significant correlations observed Pb exposure plays risk factor for ID in pregnant women.

Three-dimensional Assessment of Nasopalatine Canal Using CBCT in A Sample of The Kurdish Population

Parez Mustafa Hamza — 2025-12-30

Background and Objectives: The nasopalatine canal (NPC) is one of the crucial anatomical components of the maxillary arch. The prognosis of dental and surgical operations is determined by the nasopalatine canal location and anatomical variances. This research aimed to investigate the size, shape, and impact of sex and age on the nasopalatine canal in a sample of the Kurdish people employing cone-beam computed tomography (CBCT).
Materials and Method: 380 CBCT scans from people aged 20 to 59, of both sexes, were examined retrospectively. The radiographic images were thoroughly examined regarding the nasopalatine canal shape in sagittal, coronal, and axial slices, and anatomical dimensions were assessed in the sagittal plane. All variables were examined in regard to sex and age. Statistical analyses assumed significance at p < 0.05.
Results: The funnel shape was most prevalent (27.9%) in the sagittal slice, while the Y canal was most prevalent in the coronal plane (54.5%). The most common direction of the canal was vertically straight in (43.4%). The NPC was 11.4 mm long, whereas the incisive foramen diameter was 4.63 mm. Males displayed larger dimensions in every parameter that was assessed, apart from angle, which was greater in females. The morphology of NPC did not significantly correlate with either sex or age.
Conclusion: This study found significant variation of NPC in different planes; gender and age significantly affect most of the dimensional parameters. Based on these findings, we recommend the CBCT evaluation of the anterior maxilla prior to surgical procedures.

Effect of Local Dexamethasone on Pain, Swelling, and Trismus After Extraction of Impacted Lower Third Molar

Zain Mohsin Hamzah — 2025-12-30

Background and Objectives: This study concluded that postoperative extraction of impacted lower third molars is often followed by complications such as pain, swelling, or limited jaw opening.

Aim of Study: This study aimed to assess whether intramuscular dexamethasone administration in or through the masseter muscle is an effective measure in alleviating postoperative pain, swelling, or limited jaw opening that occurs after lower third molar extraction.

Patient and Method: In total, 20 patients underwent a split mouth randomized surgical removal of impacted lower third molar teeth., distributed on two groups, each group presented with 10 patients, as follows: Group A: (study group) patients received local dexamethasone Group B: (control group) patients did not receive any drug intraoperatively.

Results: 20 individuals had a total of 40 affected lower third molars extracted, split mouth design, for 4 males and 16 females, A statistically significant difference was detected between groups in pain scoring during third day assessment according to sex distribution, but for swelling and maximum mouth opening, in seventh day assessment there were no differences (P = 0.034, by independent t-test

Conclusion: This study found that local dexamethasone injection after impacted lower third molar removal, leads to significant reduction in postoperative pain, swelling, and limited mouth opening.

Comparative Study of Serum Zinc and Key Hematinic (Vitamin B12, Ferritin, Folate) in Patients with Minor Aphthous Stomatitis and Ulcerative Oral Lichen Planus

Suzi Sharazad Muhammed — 2025-12-30

Background and Objectives: Minor aphthous stomatitis (MAS) and ulcerative oral lichen planus (OLP) are chronic oral conditions with recurrent painful ulceration that significantly affects patients' quality of life. Despite extensive research, the precise etiopathogenesis of these conditions remains incompletely understood. Recent studies have found that a lack of micronutrients and key hematinics, such as zinc, vitamin B12, ferritin, and folate, may be associated with the start, severity, and recurrence of MAS and OLP. This study aimed to assess the association between these deficiencies and the occurrence of MAS and OLP compared with healthy controls.

Materials and Method: A cross-sectional, case-control study was conducted at Hawler Medical University/College of Dentistry in Erbil City, Iraq. From November 2024 to June 2025, a total of 160 participants were included: 40 patients with MAS, 40 with OLP, and 80 age- and gender-matched healthy controls. Serum levels of zinc, vitamin B12, ferritin, and folate were measured alongside hematologic indices (Hb, HCT, MCV). Data were analyzed using appropriate statistical tests.

Results: Both the MAS and OLP groups had much lower levels of zinc, vitamin B12, ferritin, and folate (p<0.05). Hematologic indices (Hb, HCT, MCV) were also lower in patients but still within the low-normal range. This finding suggests that subclinical hematinic deficiencies may exist, despite the absence of overt anemia. A female predominance and middle-age distribution were noted in both patient groups. When directly comparing MAS and OLP patients, the OLP group exhibited more pronounced deficiencies across all measured micronutrient and hematinic parameters, except folate, which showed higher levels of deficiency in MAS cases.

Conclusion: Subclinical micronutrient deficiencies may play a role in the pathogenesis of MAS and OLP. Routine nutritional assessment of zinc and key hematinics may improve diagnosis and management strategies for these chronic oral conditions.

The Effect of Previous Dental Visits and Socioeconomic Level on Dental Fear and Anxiety Among Duhok City Primary School Children and its Relation to Oral Health Status

Sandra Wasfi Sulimany — 2025-12-30

Background: Dental fear and anxiety (DFA) are common emotional challenges among children. These psychological responses can persist into adulthood and impact oral health by discouraging regular dental visits, leading to disease progression, and reliance on emergency treatment.

Aim: This study assessed dental fear and anxiety among Duhok primary school children and their association with oral health, socioeconomic status, and dental visit history.

Material and Methods: A cross-sectional study was conducted involving 420 randomly selected students from 10 primary schools located in socioeconomically diverse areas of Duhok city. DFA was assessed using the Index of Dental Anxiety and Fear (IDAF-4C+, a standardized child dental anxiety questionnaire and its relation to previous dental visits and socioeconomic level. Oral health status was evaluated based on WHO criteria for DMFT (Decayed, Missing, and Filled Teeth) in permanent teeth and DMFT (decayed, missing, filled teeth) in primary teeth, along with the Plaque Index. Data analysis was performed using SPSS software.

Results: 62.6% of children had no or little DFA, 26.4% had low fear, 6.9% had moderate, and 4.0% had high fear. No statistically significant differences were found between DFA and DMFT (p = 0.126), DMFT (p = 0.956), or plaque index (p = 0.439). DFA was significantly associated with school location (p = 0.046) and prior dental visits (p = 0.027). Children attending western (higher socioeconomic) schools and those who had never visited a dentist before exhibited higher levels of DFA.

Conclusion: Low to moderate levels of DFA were found among children in Duhok city. Which related to school location and previous dental visits, with no effect on the oral health status. These findings highlight the effect of socioeconomic environment and dental visit experience on the DFA level.

Marginal Adaptation and Surface Roughness of Indirect Composite Veneers: A Comparative Study of 3D Printing and Conventional Techniques

Ranoo Hunar Abdullatif — 2025-12-30

Background and Objectives: Indirect composite veneers in restorative dentistry depend on precise marginal fit and ideal surface roughness for long-term success. Marginal fit refers to how closely the edge of the veneer adapts to the tooth margin, where smaller gaps indicate better accuracy. Comparing 3D printing to conventional manufacturing techniques, the growing usage of digital technology may result in improvements in surface quality and accuracy. This study aimed to evaluate how traditional methods compare with 3D printing in terms of the fit and surface texture of indirect composite veneers.

Materials and Method: Twenty extracted human teeth were used for the marginal fitness test and twenty composite discs for the surface roughness test in this in vitro study. Each set was divided into two groups (n=10 per group): One group for 3D printed composite veneers and the other for conventional indirect composite veneers. For marginal fit, the extracted teeth were prepared and ten veneers were fabricated for each group, and a stereomicroscope was used to measure the vertical marginal gaps at twelve reference points per each fabricated veneer. To measure surface roughness, disc-shaped specimens per group were fabricated. A contact profilometer was used to measure surface roughness both before and after polishing.

Results: Both groups' marginal gaps fell into clinically acceptable limits. With a mean gap of 56.07 µm for the 3D-printed group and 59.61 µm for the conventional group, the difference in marginal gaps between the two groups was not statistically significant, indicating that both methods provided similar results (p = 0.457). Surface roughness was significantly reduced in both groups after polishing (p < 0.0001). The 3D-printed group demonstrated superior surface characteristics, showing significantly lower roughness values both before polishing (p = 0.039) and after polishing (p < 0.0001).

Conclusion: Indirect techniques for fabrication of veneers from 3D printed composite can provide clinically acceptable marginal fit, and smoother surface than traditional composite. These results support the potential of using 3D printing to create indirect composite veneers.

Primary Hydatid Cyst of the Submental Neck Region in a Child: A Rare Case Report with Surgical Management

Khurshid A. Kheder Khrwatany — 2025-12-30

Hydatid cyst of the neck considered rare condition. In literature there are few published case reports, but none involved the submental region. This report is about a 11 years old boy who had a swelling at the submental region of few months duration. Examination revealed a swelling that extended to anterior part submandibular region, red overlying skin, no discharge, sound teeth. Radiology revealed multilobulated cystic mass. Surgery done under general anesthesia, the cyst completely removed and sent to histopathology examination which concluded as hydatid cyst. Albendazole was prescribed with subsequent follow-up for 6 months with no recurrence.