MUSTANSIRIA DENTAL JOURNAL

The biological objectives of root canal treatment have not changed over the recent
decades, but the methods to attain these goals have been greatly modified. The
introduction of NiTi rotary files represents a major leap in the development of
endodontic instruments, with a wide variety of sophisticated instruments presently
available (1, 2).
Whatever their modification or improvement, all of these instruments have one
thing in common: they consist of a metal core with some type of rotating blade that
machines the canal with a circular motion using flutes to carry the dentin chips and
debris coronally. Consequently, all rotary NiTi files will machine the root canal to a
cylindrical bore with a circular cross-section if the clinician applies them in a strict
boring manner (3).

Background: The using of devices that emitted electromagnetic radiation has been
limited in many healthcare centers to prevent interference with medical devices.
The purpose of this in vitro study was to evaluate the effect of Wi-Fi Router
(Tenda FH456) on working length determination using electronic apex locator
(NSK-iPex II) in the presence of network connection with tablet (GT-N800) or
not.

Background and objective: During root canal instrumentation irrigants, necrotic
pulp tissue, microorganism and dentin debris may be extruded beyond the apex
into the periradicular tissue. These extrusions may cause flare-up. The purpose of
this study was to compare the amount of apically extruded debris with three rotary
Nickel titanium instruments.
Methods: Sixty single rooted, single canalled premolars were selected. The roots
were divided randomly into three groups; (n = 10) according to the type of
instrumentation system used, group 1“ProTaper Next” system, group 2 “One
Shape” system and group 3 “Mani Silk” system. The Debris extruded during the
instrumentation was collected and dried in preweighed vials and the amount of
extruded debris was assessed with an electronic balance.
Result: results showed that the Mani silk system extruded significantly less debris
than the ProTaper Next and One shape systems (P < .05), and there is no
significant difference in apically extruded debris between ProTaper Next group
and One Shape group but the One Shape produced more debris than ProTaper
Next.
Conclusion: the Mani silk file instrument was behaved well during instrumentation
and extruded less debris than the other groups.

The present study was aimed to evaluate and compare the compressive strength of
conventional glass ionomer cement with resin modified glass ionomer, compomer and
microhybrid composite. A total of 40 specimens of esthetic restorative materials were
fabricated using customized cylindrical teflon mould measuring 6mm height and 4mm
diameter and were grouped with ten specimens in each group, Group I: Conventional
glass ionomer cement (Fuji II). Group II: Resin modified glass ionomer (Fuji II LC).
Group III: Compomer (Dyract AP) and Group IV: Microhybrid composite resin
(Tetric Ceram).They were covered with Mylar strip and were cured using LED light
curing unit. Compressive strength was evaluated using Universal testing machine. The
result showed that there were a significant difference among the groups in which
Tetric Ceram showed highest compressive strength and Fuji II showed the least
compressive strength.

Objectives: The aim of the present study was to compare the effectiveness of
Endovac, Vibringe and needle with different irrigation solutions on removal of
smear layer and apical extrusion of irrigating solution.
Methods: Seventy-two sound human premolar teeth were used and divided into three
experimental groups (n=24) according to the type of irrigation technique used: Ingroup
1 irrigation was performed with Vibringe. In-group 2 irrigation was
performed with a 30-gauge side-vented irrigation needle. In-group 3 irrigation was
performed with Endovac. Instrumentation was performed by using the ProTaper
files. Each main group divided into three sub-groups (n=8) according to irrigation
solution used: In sub-group 1 Irrigation was performed with 5.25% Sodium
hypochlorite (NaOCL). In sub-group 2 Irrigation was performed with 17%
Ethylene Diamin Tetra Acidic Acid (EDTA). In sub-group 3 Irrigation was
performed with 5.25% NaOCL and 17 % EDTA. The amount of extruded
irrigating solution was then measured by subtracting the weight before final
irrigation from the weight after final irrigation using the electronic balance. The
cleanliness of smear layer removal was evaluated using scanning electron
microscopy.
Results: The results showed that the group that resulted in more irrigation extrusion
was as follow from highest to lowest: side-vented >Vibringe> Endovac. The
difference among all groups was significant. As for cleaning results, smear layer
collection in both EndoVac and Vibringe groups were less than side-vented group
and these differences were significant. When the three irrigating solutions
compared the differences among all the groups were significant and combination
of (5.25% NaOCL and 17 % EDTA) resulted in more smear layer removal.
Conclusion: In conclusion, the EndoVac irrigation system extruded significantly less
irrigant solution than both the Vibringe and needle irrigation systems. Smear layer
collection was least in the apical third regarding the EndoVac irrigation system
and resulted in more Smear layer removal. And combination of NaOCL and
EDTA group was more effective on smear layer removal than other two groups.

Background: In spite of advances in dentistry, anxiety about dental treatment and the
fear of pain remains public health problem and is a significant impediment to
dental treatment. The purpose of this study was to assess the levels of dental
anxiety in patients who referred to Al-Mustansiriyah dental clinics and Al-Shiekh
Omar specialized dental center in Baghdad and their relation to their gender, age,
educational level.
Materials and methods: The study was done on (800) patients, aged (20-59) years in
Baghdad. The survey form was prepared and translated from English to Arabic
languages by certified translator and were filled by patients themselves without
any help from dentists. Patients with mental retarded, those who not having
completed the survey form and those below 20 years and above 59 years were
excluded. The survey was divided into 3 parts (socio-demographic information,
Modified dental anxiety scale (MDAS) and Dental fear survey (DFS).
Results: The present study showed that females had higher anxiety (13.57, 47.38)
than males (8.98, 37.75) for Modified dental anxiety scale and Dental fear survey
respectively. The anxiety decreased with advance of age (12.31, 11.41, 10.89,
10.45 for Modified dental anxiety scale and 43.10, 41.22, 38.69, 37.93 for Dental
fear survey) in groups (1,2,3,4) respectively. The anxiety decreased with advance
of teaching, so the uneducated patients had higher mean of anxiety (14.45, 48.59)
while the postgraduate patients had lower anxiety (9.10, 36.30) for Modified
dental anxiety scale and Dental fear survey respectively than others. There was
high significant difference between males and females at P-value (≤ 0.01) for both
Modified dental anxiety scale and Dental fear survey scales.
Analysis of variance (ANOVA) test showed high significant difference among age
groups and among education level groups at P-value (≤ 0.01) for both Modified
dental anxiety scale and Dental fear survey scales. The higher percentage of
anxiety scales was appeared in minimal anxiety score in males (56%, 48%) in
Modified dental anxiety scale and Dental fear survey respectively, while lessor
percentage was appeared in very high anxiety score in males (5.1%, 5.5%) in
Modified dental anxiety scale and Dental fear survey respectively. Pearson's
correlation coefficient (R) showed that there was a positive relationship between
gender and anxiety scales, with statistically high significant at P-value (≤ 0.01).
While, there was inverse relationship between age and anxiety scales, and betweeneducation and anxiety scales with statistically high significant at P-value (≤ 0.01)
for both relations.
Conclusion: The females had higher rate of anxiety than males. The anxiety
decreased with advance of age and education level of patients. There was a strong
(positive) relationship between gender and anxiety. While, there was inverse
(negative) relationship between anxiety with age and education.

Aim: To investigate whether mode of delivery is associated with mutans streptococci
(MS) colonization and dental caries in pre school children.
Methods: This study includes 64 pairs of mothers and their children aged 3- 5 years
old (34 born vaginally and 30 born by Caesarean section).Data included a dental
examination, a questionnaire survey of mode of delivery, maternal gestational
age, as well as children's birth –weight, and laboratory assessment (by collecting
non stimulated saliva for each woman and child and homogenizing them then
Mutans Streptococci (MS) were counted ,isolated, purified and diagnosed
according to morphological characteristic .
Results: Dental caries, salivary and plaque streptococcus mutans counts were
significantly higher in children delivered by caesarean section mode than those
delivered normally (P<0.05).There was a positive linear correlation between the
mean value of DMFS, salivary and plaque streptococcus mutans count of children
and their mothers, and this association statistically significant (P<0.05). Gender,
gestational age and birth weight had no significant correlations with the dmfs of
children (P>0.05).
Conclusion: The mode of delivery is significantly correlated with MS colonization
and caries outcomes in pre-school children.

Background: Trauma to the anterior teeth is a common injury in young children. The
maxillary incisors being the most affected. Although root fractures are rare, they
do occur and were previously and often considered hopeless and were extracted.
The time between the injury and the initiation of treatment, level of the fracture
line, and stage of root development are some criteria to be considered when
choosing a treatment approach for a complicated tooth fracture. This case report
describes the management of a traumatized immature maxillary central incisor
with Elise class IV fracture with vertical oblique subgingival fracture of the root.
Materials and method: Apexification was carried out using biodentine followed by
removal of the fractured segment. A fiber post was cemented in the root canal
with resin cement. The coronal portion of the tooth was restored using anterior
light cured composite material. The tooth was examined and evaluated after 1
week and after 2 months by clinical examination and radiographical evaluation of
root development.
Results: The follow up evaluation revealed clinical and radiographical success.
Radiographic view showed continued development in the apex of the root and
showed normal periodontal ligament space and dense lamina dura.
Conclusion: Extraction should not be the first choice of treatment for extensively
damaged young permanent teeth in the anterior region; instead, alternative
treatment modalities must be considered. The traumatized immature tooth was
saved and restored.

Background: Obesity and periodontal disease are diseases of multifactorial etiology
closely related to dietary habits and sociodemographic background of the
individuals. The aim of this study was the assessment of selected salivary
antioxidants and gingival health condition among a group of obese females aged
20-22 years in comparison with normal weight females.
Materials and methods: The study group included 40 obese females, with an age
range 20-22 years old. The control group included 40 normal weight females of
the same age. Body weight was assessed by using the Body Mass Index (BMI).
Collection of unstimulated salivary samples was carried out under standardized
conditions. Plaque and gingival indices were used for recording the oral hygiene
and gingivitis. Salivary flow rate was measured then salivary samples were
analyzed to determine the concentration of salivary antioxidants (total protein and
uric acid).
Results: The data analysis of the present study found that the level of salivary total
protein was lower among the obese females compared to the normal weight
females with statistically highly significant difference (p<0.01), while salivary
uric acid was statistically highly significantly higher among the obese than the
normal weight females (p<0.01). Salivary analysis demonstrated that the salivary
flow rate was statistically highly significantly higher among the obese females
(p<0.01).
The mean values of plaque index and gingival index were lower among obese
females compared to the normal weight females with statistically highly
significant difference for plaque index (p<0.01).
Conclusions: The result of this research revealed that salivary antioxidant (uric acid)
and salivary flow rate were higher among obese females than normal weight
females which may play a role in protection oral tissue from oral diseases in
addition to the oral cleanliness effect.

Back ground: Dental caries and periodontal disease were the most common and
widely spread diseases affecting children. The nutrition may be one of the factors
affecting the severity of the oral diseases. The Aims of this study was the
assessment of the following oral diseases (dental caries, gingivitis) in addition to
assessment of oral hygiene among 4-5 years old children in Karbala city –Iraq.
Furthermore, nutritional status was assessed in relation to oral diseases.
Materials and methods: A sample of 658 children (350 males, 308 females) aged
four and five years old was selected randomly from the fourteenth kindergartens
in Karbala city. Diagnosis and recording of dental caries was followed the criteria
of WHO 1987. Dental plaque was assessed using plaque index of Silness and Loe,
1964. Gingival health condition was assessed using gingival index of Loe and
Silness, 1963. The assessment of nutritional status was performed using
anthropometric measurement (height and weight) according to Body mass index
indicator with -2SD cutoff point.
Results: Caries prevalence was found to be (83%) of the total sample the mean rank
value of dmfs was higher among boys in comparison to girls with statistically no
significant difference (P>0.05). The value of dmfs increased with age with
statistically highly significant difference (p<0.01).The mean rank values of dental
plaque and gingival indices for total boys were found to be higher than total girls
with statistically highly significant differences (P<0.01). Recording of this study
demonstrated that 100% of children had dental plaque and gingival inflammation.
Positive highly significant correlations were recorded between dental caries with
dental plaque and gingival indices. The prevalence of malnutrition described by
Body mass index indicator was (3.2%). According to nutritional status indicator
Body mass index-for-age, it was found that the wasted children had higher value
of dmfs than well nourished children with statistically no significant differences
(P>0.05). The plaque and gingival indices were higher among well nourished
children than among wasted children with statistically highly significant
differences (P<0.01).The correlation coefficient between body mass index with
dental caries, plaque index and gingival index were very weak and statistically not
significant (p>0.05).
Conclusions: High prevalence of dental caries and gingivitis was recorded indicating
the need of public and preventive programs among kindergarten children.

Background: Although they are not life threatening, dental caries and periodontal
disease are the most predominant and widely spread oral diseases throughout the
world. The aims of the study included the investigation of the prevalence and
severity of dental caries, gingivitis and dental plaque in relation to gender,
furthermore, nutritional status was assessed in relation to oral health condition
(dental caries).
Materials and Methods: This oral health survey was conducted among primary
school children aged 9 years old in Dewanyiah city in Iraq. The total sample
composed of 600 child (320 males and 280 females) selected randomly from
different school in Dewanyiah city. Diagnosis of dental caries was according to
the criteria described by WHO (1987). Plaque index of Silness and Loe (1964)
was used for plaque assessment, gingival index of Loe and Silness (1963) was
followed for recording gingival health condition. Nutritional status was assessed
according to body mass index (BMI) indicator using anthropometric measurement
(height and weight).
Results: Results showed that the prevalence of dental caries was 85% for 9 year-old
school children. Regarding primary and permanent dentition, dental caries was
higher among females compared to males with statistically significant difference
(P<0.05) for primary dentition, on the other hand, males showed higher values of
filled surfaces compared to females with statistically significant difference
(P<0.05) for primary dentition and highly significant difference (P<0.01) for
permanent dentition. Finding of this study revealed that 100% of the children had
gingival inflammation. Furthermore, the values of plaque and gingival indices
were higher among males compared to females with statistically highly significant
differences (P<0.01). In current study, the prevalence of malnutrition described by
the BMI indicator was 5.3%. For total samples no significant difference was
recorded in dmfs /DMFS values among wasting and well nourished children
(P>0.05).
Conclusion: A high prevalence of dental caries and gingivitis were recorded.
Improvement in the prevention educational programs is needed among school children.

Aim: This clinical study is to investigate the effect of fasting (Sawm) Ramadan on the
count of streptococcus mutans in plaque surrounding fixed orthodontic appliances.
Materials and Methods: Fifteen patients with orthodontic appliances were
participated in this study. Plaque specimens were collected from those patients at
two occasions, during Rmadan fasting (Sawm) and after they break there fasting
after Ramadan. The plaque Streptococcus mutans number of colony-forming
units (CFU) was analyzed by using Dentocult SM Strip mutans test.
Results: This study demonstrated highly significant difference in Streptococcus
mutans (CFU) counts in plaque between the values obtained from fasting patients
during Ramadan and when they are breaking the fast after Ramadan.
Conclusions: during Ramadan fasting, persons change timing and types of their food
and beverages consuming as well as teeth cleaning habits. Therefore orthodontist
should be aware of their patients’ oral hygiene during Ramadan by promoting and
maintaining satisfactory teeth cleaning during fasting (Sawm) and Iftar hours.

Microbes are considered as the primary etiologic agents in endodontic diseases.
Disinfection of the root canal is obtained by the combined effect of biomechanical
preparation, irrigation and intra canal medicament. The aim of the present study was
to assess the antimicrobial activity of intracanal medicaments (formocresol and
Endosepton) against two micro organisms (Streptococcus mutans and staphylococcus
aureus) isolated from 15 necrotic pulps of primary molars indicated for pulpectomy
procedure. The samples were cultured, and purified using microbiological evaluation.
Broth dilution test was performed in our study by preparing test tubes containing
10 ml of BHI broth (pH. 7) which then inoculated with strains of the tested bacteria
and incubated at 37 C° for 24 h. After over night incubaction, ten fold dilution were
made in test tubes containing 9 ml of normal saline by adding 1 ml of the inoculum to
the first tube . Then from dilution 10-1 , 0.1 ml of cell suspension was added to 9.9 ml
of formocresol and endosepton, then 0.1 ml was taken and spread on duplicates of
BHI agar plates at different intervals and incubated aerobically for 24 h. at 37 C°.
Colonies on the plates were counted after incubation and CFU/mL (colony forming
unit) was calculated. Our results indicating that there were no significant differences
between the intracanal medicaments, but there were high significant differences
between the intervals time of the study. We concluded that both materials had great
antibacterial effect against the pathogens commonly isolated from necrotic pulpal
tissue of primary teeth.

Background: Soft lining materials play an important role in modern prosthodontics
treatment because of their capability to restore the inflamed and distorted mucosa.
The purpose of the research was to estimate the influence of acrylic denture base
reinforcement with silanted nano fillers (Al2O3 and Sio2) separately on tensile and
shear bond strength of soft lining material and studying effect of thermo cycling
on bonding strength.
Materials and methods: Total 120 specimens were prepared; it divided into 60
Specimens for shear bond strength test and 6o specimens for tensile bond strength
test. Specimens were sub grouped into 30 Specimens without thermo cycling and
30 specimens with thermo cycling. Each sub group is consisted from: 10
Specimens control, 10 specimens were reinforced with 2 wt% of Al2O3 nano fillers
and 10 specimens were reinforced with 5 wt% of SiO2 nano fillers. Samples were
processed depending on test applied. Soft lining material was applied for each
testing group. Samples were immersed in distal water for 24 hours at 37°C before
testing. For thermo cycling test, specimen were thermo cycled in thermo cycling
device. Bonding strength test was done using INSTRON universal testing
machine.
Results: reinforcement of acrylic denture base with nano-fillers was significantly
increase both tensile and shear bonding of lining material and thermo cycling
decreases both bonding strength.
Conclusion: reinforcement of acrylic denture base with nano fillers could improve
bonding strength of lining material, while thermo cycling had a deleterious effect
on bonding strength.

Aim: The aimed study was to evaluate the influence of silver nitrate on surface
hardness and tensile strength of acrylic resins.
Materials and methods: A total of 60 specimens were made from heat polymerizing
resins. Two mechanical tests were utilized (surface hardness and tensile strength)
and 4 experimental groups according to the concentration of silver nitrate used.
The specimens without the use of silver nitrate were considered as control. For
tensile strength, all specimens were subjected to force till fracture. For surface
hardness, the specimens were tested via a durometer hardness tester. All
specimens data were analyzed via ANOVA and Tukey tests.
Results: The addition of silver nitrate to acrylic resins reduced significantly the
tensile strength. Statistically, highly significant differences were found among all
groups (P≤0.001). Also, the difference between control and experimental groups
was highly significant (P≤0.001). For surface hardness, the silver nitrate improved
the surface hardness of acrylics. Highly significant differences were statistically
observed between control and 900 ppm group (P≤0.001); and among all groups
(P≤0.001)with exception that no significant differences between control and
150ppm; and between 150ppm and 900ppm groups(P>0.05).
Conclusion: The addition of silver nitrate to acrylics reduced significantly the tensile
strength and improved slightly the surface hardness.

Introduction:The pulp polyp (PP), also known as chronic hyperplastic pulpitis or
proliferative pulpitis, is a type of inflammatory hyperplasia. It occurs in a vital
tooth with a good blood supply when the pulp has been exposed to caries or
trauma.
Objective: The aim of this study to evaluate different radiographic periapical changes
of primary and permanent dentition in clinically detected pulp polyp patients.
Materials and Methods: Patients who were clinically diagnosed with pulp polyp
were subjected to radiographic examination. Digital intraoral periapical
radiographs of 70 patients with pulp polyp were taken. Various periapical changes
of primary and permanent dentition in the digital radiographs were recorded . The
data obtained was subjected to statistical analysis using SPSS version 16.0.
Result: All 70 patients showed definite periapical changes. Out of which periodontal
ligament (PDL) space widening was seen in all 70 cases (100%), lamina dura
discontinuity was observed in 50 cases (71.43%), periapical rarefying osteitis was
noted in 20 cases (28.57%), condensing osteitis was accounted in ten cases
(14.29%), periapical granuloma was observed in six cases (8.57%),
hypercementosis was accounted in nine cases (12.86%) , root resorption and
periapical cyst was observed in eight cases each (11.43%).
Conclusions: The results of the present study showed that majority of the pulp polyp
patients observed at young age group in both gender and the majority of the pulp
polyp patients were associated with definite periapical changes that suggested
being a periapical lesion.

Aim: The point of the study was to assess the prevalence of apical periodontitis and
frequency of endodontic treatment in an Iraqi population.
Materials and methods: Panoramic radiographs of 300 Iraqi subjects 18-60 years
old. The periapical status of all teeth (with the exception of third molars) was
examined using periapical index scoring system (PAI). Information were
investigated statistically using the Chi-squared test at the significance level of
p<0.05.
Results: Out of 5822 examined teeth belonging to 300 patients 156 had one or more
teeth with apical periodontitis (PAI 3-5) and 253 individuals had one or more
endodontically treated teeth.
Conclusions: The discoveries of the exhibit examination come into concurred upon
with different investigations which accentuate that a worldwide improvement in
the quality of root canal treatment in general dental practice is required to promote periradicular health.

Aim: To determine the prevalence of dental anomalies in Iraqi population, and
investigate their possible association with gender and teeth.
Materials and methods: Panoramic radiographs of 800 patients out of 350 with
dental anomalies (200 females and 150 males) ,an age range of 18–30 years ( 300
: 18-25 years ; 50: 25-30 years ) were examined for anomalies in teeth number,
shape, size and position.Descriptive statistics was performed using SPSS. The
level of significance was set at 95% confidence level.
Results: Among the 800 radiographs examined, a total of 350 (43.8 %) had
developmental dental anomalies which includes 150 (42.9%) males and 200
(57.1%) females. Around 290 (82.9%) had at least one anomaly, 50 (14.2%) cases
with two anomalies and only 10 (2.9%) exhibited more than two anomalies. Both
males and females were equally affected. Of these 350 anomalies, 300 (85.7%)
occurred in the age group 18–25 years compared to 50 (14.3%) cases in 25–30
years range .
Conclusion: The high prevalence of Developmental Dental Anomalies suggests the
need to increase the understandingof their etiology and aid for better management,
intervention and prevention.