Al-Rafidain Dental Journal

Abstract: The current study aimed to assess the cell viability and cytotoxicity of bioceramic-based root canal sealers by comparing them to a zinc oxide-eugenol-based sealer (Endovit) in the set state of human periodontal ligament fibroblasts for one day, three days and seven days. Materials and Methods: Sealers were prepared following the manufacturer's directions and inserted in cylindrical rubber molds (5 mm diameter, 2 mm height) to get uniform sealer specimens, the specimens were kept for 24 hours at 37Cº. Human periodontal ligament fibroblasts were cultured with extracts from the tested sealers. Cell viability and Cytotoxicity were assessed for extracts of one-day, three-day days, and seven-day immersion. The cell viability of all root canal sealers was determined using an MTT test and cytotoxicity was determined using an LDH test. Data were statistically evaluated with One way-analysis of variance ANOVA followed by Duncan’s MRT to determine if group variance was significant. Results: Each tested sealer demonstrated a statistically significant variance in cell viability and cytotoxicity at various time intervals. NeoSEALER Flo had the highest cell viability and lowest cytotoxicity percentages followed by Cerafill RCS, MTA fillapex, and Endovit respectively at each evaluation time interval. Conclusions: NeoSEALER Flo was the least cytotoxic while ENDOVIT was the most cytotoxic root canal sealer. Cell viability decreased over time.

Aims: The present study aims to investigate the effect of insulin on the healing of rabbits' dental sockets. Evaluating oral mucosa healing and bone regeneration of the healing process during three intervals 3-, 10- and 30-days post-extraction. Materials and Methods: Twelve male albino rabbits were used in this study, randomly subdivided into three sub-groups (N=4) for the histological and immunohistochemistry evaluation at 3, 10, and 30 days post-extraction and compared to the controls. The rabbits were euthanized at the corresponding time interval, each rabbit represented a control and treated sample. Bilateral maxillary first premolar extraction (treated side and control side) was performed, followed by treatment injection into the socket. A gel foam cylindrical insert of (3*5 mm) dimensions was placed in both sockets. For the treated groups; a standardized dose 10 IU in 0.1 ml from a solution of 100 IU/ml concentration of Insulin; for each corresponding group was injected into the gel foam whilst in the socket of the treated side, while for the control side (was kept plain without injection). A secondary post-extraction standardized dose was split equally and injected buccally and palataly around the gingival margins of the studied socket on the 2nd, 4th, and 6th-day post extraction only for the treated side. For each study interval, rabbits in each group were euthanized. Specimens from the oral mucosa and maxillary alveolar bone from the extraction sockets with sufficient margins were immediately harvested and arranged for laboratory examination. Assessment of inflammatory response, granulation tissue formation, re-epithelialization, bone healing, and the expression of CD34 and Ki67 was performed. Non-parametric statistical analysis was performed, and significance was recorded at p≤0.05. Results: Histological evaluation results revealed a significantly reduced inflammation response, reduced granulation tissue formation, higher and quicker re- epithelialization and enhanced bone formation for treated group when compared to the control at certain time intervals within the total period of the study. The Immunohistochemistry results revealed a significantly increased expression of CD34 and Ki67 markers in the treated group as compared to the control groups at certain study intervals. Conclusions: Within the limits of the present study, local application of Insulin demonstrated a positive effect on the healing process of oral mucosa as well as bone regeneration of the dental socket. The local injection of Insulin would be a suitable candidate to be used in the enhancement of post-extraction healing.

Aims: The study aimed to compare the accuracy and reliability of the measurement of the anterior and overall Bolton ratio between plaster models (by silicone impressions) and intraoral scanner (IOS) images (by TRIOS scanner). Materials and Methods: Fifty-one patients were selected from the Duhok University College of Dentistry - Prevention, Orthodontic & Pedodontics Department auditors. Their ages ranged between 18 and 35 years. Each one underwent a silicone impression of the jaws to obtain the plaster models and IOS digital images to obtain the digital models. Both records formed the two study groups: the plaster model group (PMG) and the IOS group (IOSG). Measurements (the anterior and overall Bolton's ratio) were made on plaster and IOS digital images. The Bolton ratios were re-measured on 5 samples for each group by the same researcher a month after the first measurement to determine the accuracy of the re-measurement, and the inter-examiner intraclass correlation coefficients (ICCs) were applied. A paired T-test was conducted to compare the two groups and to study the reliability of the measurement. Results: When performing the intraclass correlation (ICC), the results showed the reliability of Bolton ratio measurements in the plaster models and IOS digital images (ICC = 0.998, 0.991 respectively). There were no statistically significant differences between the plaster models and IOS groups concerning the anterior Bolton ratio p = 0.999. There were no statistically significant differences between the plaster models and IOS groups concerning the overall Bolton ratio p = 0.971. Conclusions: Plaster models (by silicone impressions) or IOS digital images (by TRIOS scanner) can be used in orthodontic diagnosis to measure the Bolton ratio (anterior and overall) with the same accuracy and reliability.

Abstract: This study aimed to compare the surface roughness between different combinations of epoxy-coated and stainless-steel arch wires in ceramic and stainless-steel brackets. Materials and methods: Two types of arch wires with a gauge of 0.019x0.025″ were used in this study: Fantasia non-coated stainless steel arch wire (SSA) (n=18) and tooth tone Epoxy-coated stainless steel arch wires (ECSSA) (n=18). The two types of arch wires were slid on two types of brackets of premolars of slot size 0.022x0.030″ roth prescription (n=36) divided equally into monocrystalline sapphire clear aesthetic ceramic brackets (CB) and Razor stainless steel bracket (SSB). The Ra surface roughness was measured using an atomic force microscope AFM to assess the wires before and after sliding them into ceramic and steel brackets. Six samples of wires received from the manufacturer were examined; additionally, six samples from each group of wires were taken after the friction test to examine the changes to the surface of the wires caused by the effect of the frictional force. For the statistical analysis, One-way ANOVA and Pairwise comparisons between groups, using the DUNCAN test at level of significance 0.05, by using SPSS software version 24. Results: ECSSA in CB had the highest value Ra (97± 60.1), followed by epoxy wire in steel brackets Ra (96.1 ± 52.9), followed by epoxy wire as received Ra (79 ± 60.1), followed by steel wire in ceramic bracket Ra (50.6 ± 24.3), followed by steel wire in steel bracket Ra (44.7 ± 23.4), the lowest values shown in steel wire as received Ra (28.2±13.3). One-way ANOVA showed a significant difference between the tested groups (P=value: 0.05). Duncan’s test demonstrated significant differences among groups. Conclusion: Epoxy-coated SS arch wire combined with ceramic bracket shows the highest roughness properties, while SS arch wire combined with SS bracket and SS as received shows the lowest roughness properties.

The aim of this study was to investigate the role of Co-Q10 in reducing the SMG toxicity caused by Trastuzumab and Doxorubicin. The materials and methods were employed to study histopathological measurements by using H&E stains, and serological tests include T-AOC and MDA, in addition to BW. twenty white albino rats were employed, the experiment performed over 20 days, rats divided into 4 groups: G1 in which rats received pure corn oil 1ml/kg orally, over 20 days. G2 in which rats received TRZ+DOX, single dose of 10mg/kg IP at 10th day of the experiment. G3 in which rats received Co-Q10 orally, 10mg/kg daily from day1 to 10th day and TRZ+DOX single dose of 10mg/kg IP of both drugs at 10th day. And G4 in which rats received TRZ+DOX single dose of 10mg/kg IP at 10th day and Co-Q10 orally of 10mg/kg daily from 10th day to the 20th day. In our results; the group in which rats received TRZ+DOX, the histopathological examination revealed many changes comparing with control group, and there was increased serum level of MDA with slight increase in the serum level of T-AOC. In contrast, a vast benefit had obtained from Co-Q10 as protection except for BW which still declined in all groups. The necrosis and degeneration of the submandibular salivary gland cell, and inflammatory cells infiltration, all these findings found to be reduced in groups where rats received Co-Q10 but the benefit was greater in the group that received Co-Q10 before TRZ+DOX, while circulatory disturbances and cell adaptation found to show less benefit from Co-Q10. T-AOC showed higher serum level in groups received Co-Q10, on the other hand, the serum level of MDA was lower in groups administered Co-Q10. Generally, our results concluded for greater benefits from Co-Q10 in reducing SMG toxicity when administered before TRZ+DOX.

Aims: This study aimed to determine the most effective bonding system of sapphire brackets bonded to composite restoration. Materials and Method: Thirty composite discs (3M Filtek™ Z250) were stored in deionized water for nine days then conditioned with 37% phosphoric acid and divided into three groups based on the bonding agent: group (A) conventional bonding agent (Transbond XT™), group (B) Scotchbond™ and group (C) Assure Plus® were used, then the conventional adhesive (Transbond XT™) was applied to the base of sapphire brackets then bonded to composite discs. After bonding the composite discs, they were thermocycled for 5000 cycles, the shear bond strength (SBS) was measured, and the adhesive remnant index (ARI) was determined. Results: One-way ANOVA revealed no significant difference, although Assure Plus and Scotchbond showed higher SBS than Transbond, and the Kruskal-Wallis test revealed no significant difference in the ARI scores between the groups. Conclusion: All bonding agents produced more than the clinically acceptable shear bond strength (SBS), and all groups caused composite restoration surface fracture, indicating high SBS.

Aims: The current study aimed to evaluate the impact of hydroxyapatite (HA) toothpaste, synthesized from chicken eggshell powder (CESP) on the surface roughness of artificially demineralized enamel, in comparison to sodium fluoride paste via profile projector machine. Materials and Methods: Fifty sound premolars had been split into five groups at random, and artificial caries lesion was made by soaking the samples in the demineralizing solutions, and demineralized surface was cured with: G1 (base line group n=10) without any thing, G2 (control negative group n=10) immersed in demineralizing solution only, G3 (HA paste group n=10) treated with HA paste, G4: (Naf n=10) treated with sodium fluoride paste as control positive, G5: (combination group n=10) treated with HA paste and Naf paste alternatively. The enamel surface roughness was evaluated (at base line, after demineralization, and after treatment. Results: All teeth samples exhibited increased surface roughness after demineralization, in comparison with surface roughness of baseline group, then all treatment groups showed decrease in surface roughness after treatment, except control negative where was deionized water used for storing teeth. Conclusion: HA paste, Naf toothpaste (Flurokin), and a combination of them have remineralizing ability; a decrease in the surface roughness of demineralized enamel surface reflects this.

Background: Management of dental caries is the most challenging disease since it needs an innovative approach for treatment or preventive measures. Recently professionals have been using silver diamine fluoride as an arresting agent for dental caries. Aims: Comparing the effect ofthe application of 38% Silver diamine fluoride (SDF)on the microhardness of artificially induced enamel surface caries of permanent teeth, with sodium fluoride and de-ionized water by Vickers micro-hardness, and scanning electron microscope (SEM), also testing whether the depigmented agent added to 38% silver diamine fluoride affecting the microhardness of artificially induced caries. Materials and methods: The samples consisted of 45 sound maxillary first premolars; the sample was divided randomly into five groups after they were subjected to a freshly prepared demineralizing agent for 4 successive days, each group consisted of 9 teeth. Group1: demineralization then treated with 38% of SDF with potassium iodide (kl) for 1 hour, Croup2: demineralization then treated with 38% of SDF with glutathione (20% GSH) for 1 hour, Group3: demineralization then treated with 38% of SDF alone for 1 hour, Group4: demineralization then treated with 5% of sodium fluoride for 1 hour (positive control), Group5: demineralization then socked in de-ionized water for the rest of the experiment (negative control). Result: There were statistical differences among all groups after treatment with a remineralizing agent. The microhardness value shows statistically significant differences in which the highest increase was in the SDF alone group, followed by Silver diamine fluoride with potassium iodide, silver diamine fluoride with glutathione, and sodium fluoride respectively, and finally, the deionized water group which has the least means of microhardness. Conclusion: SDF material is effective in arresting initial enamel caries of permanent teeth.

The current study aimed to evaluate the enamel density after applying an orthodontic primer containing nanotheobromine powder. Materials and methods: The sample consisted of 24 lower premolar teeth distributed into three groups (eight teeth in each group). After demineralization, the specifically prepared enamel area was covered either with a 3MTM Transbond orthodontic primer for control and with the same primer incorporated with 10% or 15% nanotheobromine powder for the experimental groups. The crowns were sectioned horizontally and longitudinally creating 48 right and left segments. Teeth were subjected to radiological densitometry analysis in horizontal and vertical directions to evaluate the enamel density and subsequent remineralization. Results: A significant change in enamel density values was recorded in teeth covered with a primer containing 15% nano-theobromine (p>0.05), with values higher than that of the baseline (105.00±22.59, 96±23.8 grayscale). Conclusion: Both incorporating groups particularly 15% nanotheobromine showed an increase in enamel density and subsequent remineralization. This modified orthodontic adhesive may be useful for preventing early enamel demineralization and supporting clinicians with minimally invasive procedures.

The current study aimed to assess the modulation effect of 1% and 2% topical nifedipine ointment on IL-6 and CRP during facial skin wound healing in rabbits. Materials and Methods: Nifedipine ointments of 1% and 2% were prepared. Fifty healthy male rabbits were included and divided equally into two groups based on the research period: group A (7 days) and group B (14 days). Each group was divided into five groups, each with five rabbits. Group I (normal), Group II (negative control), Group III (positive control), Group IV(NFD1%), and Group V (NFD 2%). All animals except group I were anesthetized. A circular, full-thickness excisional wound of 1 cm in diameter was surgically induced on each rabbit's forehead. The wounds were left open; group II did not receive any treatment. Group III, Group IV, and Group V were treated topically twice daily with white petrolatum jelly, nifedipine ointment 1%, and nifedipine ointment 2%, respectively, until the day of euthanasia. Blood samples (5 mL) were collected on the 7th and 14th days from all animals via the jugular vein during euthanasia. The serum was separated for measurement of IL-6 and CRP. Results: On the 7th day, there was a significant rise in IL-6 and CRP levels in the NFD1% and NFD2% groups compared to the other groups, but the increase will be greater in the NFD2% group. On the 14th day, there was no significant difference in IL-6 levels among the normal, negative control, and NFD1% groups, but there was a significant difference between the NFD2% group and the other groups. There was no significant difference in the CRP level between the NFD1% and NFD2% groups. Conclusions: Topical application of NFD1% ointment improves facial skin wound healing in rabbits by moderately modulating the inflammatory response and accelerating wound closure, whereas the modulating effect of NFD2% ointment delayed healing.

The present study aims to assess the density of bone with Concentrated growth factors and advanced plasma-rich fibrin in the bone defects that were created surgically in the sheep’s mandible by the use of radiographic assessment. Materials and methods: Seven defects were made in the bone with 4 mm depth and width on every side of the mandible of the eight sheep, The defects were filled in the following manner: from the proximal to the distal orientation; 1st, 2nd, 3rd, 4th, and the 5th defect was full of CGF on the right side and A-FRF is in the left side, the 6th, and 7th left empty to filled with physiological clot. Densitometric analysis of the defects of the bone was made to measure the bone density of the 4 intervals (3 days, 7 days, 21 days, 28 days), after the surgery. Results: The result of the Densitometric analysis revealed a major distinction between the CGF group and the A-PRF group when compared to the control group at all four intervals with the density of the bone being the highest in the CGF group followed by the A-PRF group and the control group was the least one show improvement in the bone density. Conclusions: The CGF group increased the density of the bone throughout the entire study period as found by densitometric analysis data.

The present study aims to evaluate and compare the effect of β-tri-calcium phosphate granules and Putty on the healing of bony defects after induced injury on the tibia bone of sheep. Materials and Methods: Four healthy local breed male sheep all the sheep from the same farm. Four intervals were performed (2 weeks, 4 weeks, 6 weeks, 8 weeks). One tibia in each sheep was operated on at two two-week interval periods between each surgery (one surgery on each sheep making a total observation period of eight weeks). After two weeks of the last operation, the animals were euthanized based on a scheduled timeline. Results: The study reveals significant changes in osteoblasts, osteocytes, new capillaries, and histomorphometric measurements of bone marrow space over time, The study presents histological sections of sheep treated with granules and putty, revealing changes in bone marrow space histomorphometry and the presence of bone cells and capillaries. Conclusion: Although both kinds of β-TCP putty and granules considerably improved bone fracture healing, the β-TCP putty demonstrated a better and faster healing ability than the granules, with a marked improvement in the bone marrow area.

The current study aimed to diagnose and understand the role of various periapical granulomas and radicular cysts and their relationship to age and gender, as well as CD68 and TNF proteins. Materials and Methods: 26 patients were diagnosed with RCs, 14 cases with PGs, and 10 cases served as a control group, for a total of 40 cases. A sample size of 40 could provide preparatory information, and increasing the sample size greatly enhances the reliability and toughness of the study’s findings. The necessary information on the patients' age, gender, and anatomical site of the infection was obtained. Results: 35% of cases had radicular cysts, and 65% had granulomas. This reflects the increased prevalence of granulomas among patients. The percentage of females in the cysts group was greater, at 71.4%, compared to 50% in the granulomas group. While the proportions of males and females in the granulomas group were close. The periapical lesions were more common between the ages of 13 and 20 years, with 42.3% of PGs and 35.7% of RCs occurring between these ages. CD68 protein expression was substantially higher in the PG group, with a mean score of 3.27, than in the RC group, with a mean score of 2.36. TNF was substantially higher in the PG group. Conclusion: The patients in the study have a higher prevalence of granulomas, and gender and age differences play a role in the kind of infection. TNF-α plays distinct roles in the pathophysiology of PGs and RCs. In PGs, it sustains a strong inflammatory response leading to tissue damage, while RCs show less inflammatory response dominated by epithelial proliferation and cyst growth. These differences influence remedy. High CD68 expression in PGs indicates a robust immunological response mediated by macrophages, which may aid in tissue repair and remodeling. Lower expression of CD68 and TNF alpha in RCs may explain the cysts' delayed growth and encapsulation.

Aims: The current study aimed to evaluate how the color stability of the composite resins was affected by the duration of light-curing time using light-emitting diode (LED) curing units and various composite shades. Materials and methods: The LED curing unit was used in different durations (10s), (20s), and (40s) for each shade (A1, A2) to prepare and polymerize samples in two shades of two different types of composite resin. The initial color parameters (L*, a*, b*, and E*) were determined using a spectrophotometer. After that, every sample was exposed to a thermocycling regimen that included 500 cycles in water at 55°C and 5°C. The final color readout was then obtained, and the Tukey-Kramer post-hoc test and ANOVA were used to ascertain the color changes. Results: Following the thermocycling regimen, the specimens' mean delta E* ranged from 0.055 to 4.151. The specimens' mean delta a*, delta L*, and delta b* were primarily negative. Most of the specimens showed noticeable color changes, shifting toward green discoloration (negative delta a*), blueish discoloration (negative delta b*), and a generally darker value (negative delta L*). Conclusion: Since the effect was more likely to depend on the composition of the constituent materials than on the actual shade categorization, the color change that the specimens experienced could not be predicted in connection to curing duration and types of composite shades. The degree of color change in composite resins was not significantly impacted by the time of the light cure or the variation in hues.

Abstract: The current study aimed to compare the tensile bond strength (TBS) between different types of fiber posts and resin cement. Materials and methods: Sixty-three human lower premolars with similar root dimensions were randomly assigned to three groups, each consisting of 21 teeth belonging to a specific type of fiber post. The teeth were prepared by removing the coronal portion and mounted in acrylic blocks, leaving 2mm of the coronal tooth exposed. Endodontic therapy and post-space preparation were performed on the root canals of all specimens. The text describes a study where groups were divided into subgroups based on the type of resin cement used for luting fiber posts. Each subgroup consisted of 7 teeth. The bond strength between the fiber post and resin cement was measured using a universal testing machine, and the mode of failure was analyzed using a stereomicroscope. Results: The results of the study indicated significant differences among the groups and showed that the group using quartz fiber posts and RelyX U200 resin cement had the highest mean TBS (387.43±6.924), while the group using glass fiber posts and TOTAL C-RAM resin cement had the lowest mean TBS (176.29±3.039). Conclusion: The type of fiber post used in conjunction with a specific luting agent has an impact on the bond strength between the post and the resin cement. The study suggests that higher bond values can be achieved when using quartz fiber posts luted with RelyX U-200 cement. However, it is important to note that these findings are based on the limitations of the study.