Journal of Baghdad College of Dentistry

Abstract: Background: Osseointegrated dental implants have become increasingly common as a treatment option for missing teeth. Peri-implant infections are caused by bac-terial plaque that may initiate an inflammatory release of cytokines, enhance accumulation of neutrophils in implant lesion, and trigger the production of matrix metalloproteinase-8 (MMP-8). MMP-8 is essential in inflammatory and degenerative processes of periodontal tissues and produced by activated cells. The purpose of this study was to detect the role of MMP-8 as a biomarker of active and aggressive peri-implant mucositis. Material and meth-od: Eighty subjects (40 with peri-implant mucositis and 40 with successful and healthy pe-ri-implant mucosa) were enrolled in this study. The 42 male and 38 female subjects were at-tended at AL-Karama and AL-Ma'amoun Specialized Dental Centers in Baghdad, Iraq from November 24, 2021 to May 25, 2022. Follow-up examinations were performed on patients to monitor the progression of disease. Peri-implant sulcular fluid was examined and identi-fied using enzyme-linked immunosorbent assay technique for MMP-8. Results: Results showed that MMP-8 levels continue to rise after 3 weeks and are significantly higher in the patient group (P=0.00000) than the group with successful implants. Conclusion: MMP-8 can be used to reflect, associate, and predict clinical disease activity and progression of pe-ri-implant mucositis properly.

Abstract: Background: Zirconia restoration attracted great attention because of its high mechanical and esthetic properties that meet the requirements of anterior and posterior res-toration. This study aimed to evaluate the micro-shear bond strength between resin cement and zirconia surfaces coated with different nanooxides with different dipping time frequen-cies. Materials and Methods: HT Zirconia blocks (n=55) were divided into 5 groups according to the coating suspensions and the frequency of dipping times. Group A: dip in 50% SiO2+50%ZrO2 for 1min in frequency 4 times, group B: dipping in 50% SiO2+50% ZrO2 for 4min in frequency of 1 time, group C: dipping in 50% SiO2+50%Al2O3 for 1min in frequency of 4 times group D: dipping in 50%SiO2+50%Al2O3 for 4min in frequency of 1 times, group E: nontreated zirconia (control group). The coated surfaces were characterised using Field Emission Scanning Electron Microscopy (FESEM), X-ray diffraction (XRD), Energy Dispersive Spectroscopy (EDS), and atomic force microscopy (AFM). Resin cylinders were cemented onto the treated zirconia surfaces, and micro shear bond strength testing was performed. One-way ANOVA and Tukey's post hoc test analyzed differences in bond strength between groups (p<0.05). Results: FESEM showed nanosilica-nano-zirconia coatings full coverage with po-rosity within the coating, and nanosilica-nano-alumina shows full coverage with crosslinking of the silica-alumina on the surface of Zirconia with creating a high ratio of porosity within the coating. XRD detected only a tetragonal phase in coated and nontreated zirconia, indi-cating no phase transformation in the coated zirconia surface by the dipping technique. The microshear bond strength was higher for all coating groups versus controls (p<0.05). Con-clusion: The dip coating with the nanoparticle suspension consists of 50%SiO2+50%Al2O3 with a dip frequency of 1min for 4 times better than continuous dipping

Abstract: Background: Gingival pigmentation is a type of gum pigment caused by a range of endogenous and exogenous Factors . Melanin granules occur in the oral environment and aid in periodontal integrity by neutralizing reactive oxygen species produced by dento-gingival plaque-induced inflammation in the periodontal micro-environment. Objectives: The purpose of this study was to determine the prevalence of gingival pigmentation and its relation to periodontal health. Materials and methods: This study utilises a comparative cross-sectional design and recruits students between the ages of 19 and 22 from Diyala University's College of Physical Education and Sport Science. Gingival pigmentation, age, and gender were correlated among the participants. In order to quantify the severity of gingival pigmentation, Kumar et al.'s (2012) gingival pigmentation index was utilized. WHO's Community Periodontal Index (CPI) from 1997 was utilized to assess periodontal health. Results: Gingival pigmentation was present in 9.11% of the cases. Students with healthy gums and calculus were more prevalent in the group with gingival pigmentation, while students with bleeding gums were more prevalent in the group with free gingival pigmentation. Conclusions: Gingival pigmentation may help reduce susceptibility to gingival inflammation.

Abstract: Background: The development of additive manufacturing technology facilitated the advancement of 3D-printed denture resins, though these materials show limitations in their physical and mechanical properties. Aims: This study investigated the effects of add-ing yttria-stabilized zirconia nanoparticles to 3D-printed denture resin to improve its per-formance at weights of 1% and 3%. The focus was on impact strength, surface hardness, and roughness. Materials and methods: 90 specimens of 3D-printed acrylic were divided into three groups, then further divided each group into three subgroups based on the re-sults of each test. Charpy's Impact Strength Tester was used to evaluate impact strength. Surface characteristics were assessed by Vickers microhardness (HV) tester (microhard-ness) and non-contact profilometer (roughness). Fourier transform infrared spectroscopy (FTIR) was utilized for the chemical analysis. The experimentation's data guided the statis-tical analysis, which included descriptive statistics, analysis of variance (ANOVA), and multiple comparison tests based on the significance of each test's outcomes. Results: The results verified that adding 1 wt.% and 3 wt.% YSZ NPs to the 3D-printed denture resin significantly enhanced its mechanical and surface characteristics (p < 0.05) compared to unmodified resin. Conclusion: The addition of YSZ NPs enhanced the impact strength, surface hardness, and roughness. FTIR analysis showed that the polymer and YSZ nano-particles did not interact chemically. This suggests that a new 3D-printed nanocomposite denture base with better performance is possible.

Abstract: Background: Dental implants have been used to replace lost teeth over the past ten years because of their high success rate. Studies have shown that both Gram-positive and Gram-negative bacteria can colonize and form biofilms on the surface of an implant. Chlorhexidine acts on the inner cytoplasmic membrane to reduce plaque accumulation, making it an antiplaque and antigingivitis agent. The current study aims at elucidating and comparing Quercitrin with the well-known antibacterial chlorhexidine in their antibacterial ability to improve the dental implant procedure. Materials and methods: From each primary positive culture on blood, UTI chromogenic agar, and Mannitol salt agar media, a single colony was taken and identified, stained with Gram's stain, and examined under a light microscope. Results: The results revealed that the minimum bactericidal concentration (MBC) and the minimum inhibition concentration (MIC) of chlorohexidine were the same as 3.12 µg/mL for all isolated bacteria that have been used in this study, which was the lowest concentration used that showed a statistically significant difference. The MIC of Quercitrin for the bacteria Streptococcus. mutans, S. aureus, and P. gingivalis was 1600 µg.ml-1 and 800 µg.ml-1 for the E. faecalis, while the MBC for S. mutans, S. aureus, and P. gingivalis was 3200 µg.ml-1 and for the E. faecalis was 1600 µg.ml-1. Conclusion: In comparison with chlorhexidine, Quercitrin in a certain concentration has the same antibacterial effect, which could be a novel discovery to be used as a part of the dental implant industry as a peri-implant’s vital item for inflammation's control and prevention

Abstract: Background: Silver diamine fluoride (SDF) has attracted increasing attention.
since it is a conservative method that can prevent weakening of the tooth structure, post-operative pain, and the need for extensive restoration. This study aimed to investigate the knowledge, attitudes, and barriers of Iraqi dentists toward the use of SDF in children. Methods: In a cross-sectional study conducted among 406 Iraqi dentists, a Google form was used to collect data on their knowledge, attitudes and barriers to the use of SDF for children. The survey consisted of three sections: the first section collected demographic data from the participants, the second section focused on their knowledge and attitudes towards this ma-terial, and the third section identified possible barriers to its use. Statistical analysis was performed using Fisher’s exact test and the chi-square with a significance level of 5%. Results: The research revealed that 61.58% of the participants knew about this material and their knowledge was significantly related to age, sex, and speciality. Scientific lectures, discussions, and workshops were the primary sources of information (33.25%). The majority (67.9%) agreed to use this material for caries arrest, with more than 60% expressing a positive attitude toward it as a viable alternative treatment for children with behavioural issues. The primary barrier to its use was the potential for permanent black staining (77.6%). Conclusions: Alt-hough not a common practice among dentists, most of the participants agreed that using this material to treat dental caries in children is a promising method, as it requires simple in-struments and does not require special training.

Abstract: Background: Bone defect is a lack of bone tissue continuity, bone defects may be caused by trauma, tumor, or infection. The aim of study to evaluate the expression transforming growth factor beta three (TGF-β3) in intra bony defects treated with chitosan and beta tricalcium phosphate and their com-bination. Materials and methods: A total of thirty two male New Zealand rabbits were weighed about(1.5-2kg) assigned randomly into four groups, each rabbits received bilateral defect in each femur, these bony defects were divided into four groups: Control group (8 bony defects): these bony defect were left to heal normally without treatment, chitosan hydrogel group (8 bony defects), beta tricalcium phos-phate group (β-TCP): (8 bony defects , Combination group (8) bony defects): these bony defects were treated with both of chitosan hydrogel and β-TCP powder . All animals had been sacrificed after 2,4 weeks and the specimens were processed routinely for a serial decalcified sections for the immunohisto-chemical study on TGF-β3. Result: The immunohistochemical findings had shown a higher immunore-activity of the bone cells of the experimental group than the control groups. Conclusion: The study re-vealed that local application of chitosan hydrogel and their combination with TCP accelerate bone for-mation by increased the expression of TGFβ3 in intra bony defect more than that in normal physiological process.

Abstract: Background: Post obturation discoloration, is an undesirable outcome of endodontic treatment and is particularly burdensome on clinicians managing anterior teeth. Objectives: This review examines the discoloration potential of a plethora of historical and currently used endodontic sealers with the aim of providing clinicians with a guide on material selection, with the most minimal esthetic impact. Method: A PICO framework was employed to identify relevant data, focusing on discoloration associated with different sealers. A literature search was conducted across PubMed, ScienceDirect, and Google Scholar. Relevant studies published between January 2000 and January 2024 were selected based on pre-defined inclusion and exclusion criteria. The findings revealed that most of the included studies were ex vivo and in vitro, with limited in vivo evidence available. Insufficient long-term follow-up was noted and direct comparisons between the various sealer brands was limited. Conclusion: Zinc oxide-based sealers should be avoided by the clinician in areas of high esthetic concern. The strict confinement of the sealers to the canal space, is the best strategy to minimize discoloration. There is a need for improved materials, and more robust long-term studies to generate evidence-based guidelines as it relates to sealers.

Abstract: Background: Orthodontic treatment with fixed appliances is frequently associated with difficulties in maintaining good oral hygiene and creation of plaque-retentive areas on tooth surfaces that are typically more prone to the development of caries; such drawbacks may result in white spot lesion (WSL) development that affects the esthetic outcome following bracket debonding. This review article focuses on orthodontic WSLs development, prevention, and remineralization potential via incorporating various remineralizing/ antibacterial additives into orthodontic adhesives. Results: Unbalanced enamel demineralization and remineralization processes, along with rapid alterations in the dental plaque bacterial ecology, particularly acidogenic bacteria, are the causes of the start and progression of a carious lesion. Without significantly compromising an adhesive mechanical performance, several antibacterial and remineralizing substances have been added to orthodontic adhesives in an effort to reduce bacterial colonization and promote remineralization. Conclusions: Antibacterial and/or remineralizing substances were utilized as additives in the creation of innovative orthodontic adhesive systems to address white spot lesions (WSLs) and improve the ability of enamel remineralization. Compared to adding only one agent, including multiple agents in an orthodontic adhesive system may have a greater impact on lowering enamel demineralization and improving enamel remineralization during orthodontic therapy.