MUSTANSIRIA DENTAL JOURNAL

The aim of this study was to evaluate the sealing ability and the time required to
complete obturationof three different obturation techniques.The palatal roots of sixty
maxillary first molar teeth were selectedfor this study. The root canals prepared using
ProFile rotary instruments to an apical dimension of size 40 (.06 taper). Thespecimens
were then randomly divided into 3 experimental groups (20 sample of each) and filled
with gutta-percha and sealer byusing either cold lateral compaction, Thermafil, or the
Easy & Quick Master system.For the first parameter(Time of obturation), the results showed that Thermafil technique required the least time to complete obturation and it was significantly lower than other twogroups.The second measurement
(Microleakage) showed that the lateral condensation technique leaked apically and significantly higher than other test groups, while the Thermafil group exhibited the least value of apical microleakage.
The aim of this study was to evaluate the sealing ability and the time required to complete obturationof three different obturation techniques.The palatal roots of sixty
maxillary first molar teeth were selectedfor this study. The root canals prepared using
ProFile rotary instruments to an apical dimension of size 40 (.06 taper). Thespecimens
were then randomly divided into 3 experimental groups (20 sample of each) and filled
with gutta-percha and sealer byusing either cold lateral compaction, Thermafil, or the Easy & Quick Master system.For the first parameter(Time of obturation), the results showed that Thermafil technique required the least time to complete obturation and it was significantly lower than other twogroups.The second measurement (Microleakage) showed that the lateral condensation technique leaked apically and significantly higher than other test groups, while the Thermafil group exhibited the least value of apical microleakage.

The purpose of this study was to compare dentinal defect formation while using
hand files (HFs), two brands of nickel-titanium (NiTi) rotary files and the WaveOne
file. Eighty mandibular first molars were selected and divided into 4 groups. Hand file
(HFs), WaveOne reciprocating file (WO), EndoSequence file (ES), ProTaper file
(PT), were used to prepare the 2 mesial canals. Roots were then sectioned 3, 6, and 9
mm from the apex, and the cut surface was observed under a microscope and checked
for the presence of dentinal defects. HF group showed the lowest percentages of
dentinal defects (5%). In roots prepared with the WO, ES, and PT, dentinal defects
were observed in 25%, 10%, and 50% of teeth, respectively. There was a significant
difference between HFs group and both of WO group and PT group (P <0.05).
However, no significant difference was found between HFs group and ES group (P ≥
0.05). Also a non significant difference was found between WO group and ES group
(P ≥ 0.05). All rotary files created defects in the root dentin, whereas hand
instrumentation presented with satisfactory results.

Bleaching the discolored teeth may affect the tooth/composite interface. This
action found to be differing when different bonding agents were used.
Aim of the study was to evaluate the effect of vital tooth bleaching on
microleakage of existent class V composite resin restorations bonded with three dental
bonding agents.
Class V cavities were prepared on buccal surfaces of 60 intact, extracted human
mandibular premolar teeth with gingival margins in cementum and occlusal margins
in enamel, then these 60 teeth were randomly divided into 3 groups. Cavities in each group were treated with one of the following bonding agents: AdperTM Single Bond Pluse Adhesive (3M-ESPE) [group A], Tetric N-Bond (ivoclar, vivadent) [group T] and Stae (SDI) [group S]. All teeth were restored with Tetric N-Ceram light activated composite material. Each group was equally subdivided into control [AC, TC and SC]
and bleached [AB, TB and SB] subgroups (n = 10). The bleached subgroups were
bleached with 8% carbamide peroxide (Pola Paint, SDI, Australia) for 30 minutes twice a day for 14 days (according to the manufacturer's instruction). Microleakage
scores were evaluated on the incisal and cervical walls. Data were analyzed using Paired –Samples t- test.
Bleaching with carbamide peroxide paint significantly increased the microleakage
of composite restorations in Stae group at dentinal walls (P ≤0.05). Bleaching had no
effect on microleakage of restorations in the AdperTM Single Bond Plus Adhesive and Tetric N-Bond groups.
Vital tooth bleaching with carbamide peroxide paint has an adverse effect on marginal seal of dentinal walls of existent composite resin restorations bonded with Stae adhesive.

Background: The esthetic application of bleaching materials has gained popularity,
with consequences for teeth and restorative materials. The purpose of this an in
vitro study was to investigate the effect of in-office bleaching agent (38%
hydrogen peroxide) on the color change of three composite resins after staining
with tea and coffee beverages.
Materials and Methods: Sixty disc-shaped samples from three different composite
resins (Tetric Ceram, Tetric Flow and Tetric Evo Ceram) were used in this study.
The samples of each group were randomly divided into two subgroups according to type of beverages (tea and coffee) used for staining of samples. After staining of composite resins the total color change (ΔE1 ) was calculated using spectrophotometer, then the samples immersed in WHITEsmile® office bleaching agent for 15 min x 3 times with a 7 days interval followed by ΔE2 calculation.
Data were subjected to the ANOVA, LSD and student t-test at 0.05 significance
level.
Results: The results revealed that, there was clinically significant color change ΔE> 3.3 with a statistically highly significant differences (P=0.000) for all the groups.
Coffee causes more discoloration than tea. After bleaching, the samples became whiter in color and only appreciable by skillful operator but considered clinically acceptable ΔE1 - ΔE2 < 3.3.
Conclusion: Tea and coffee beverages causes discoloration in composite but this effect was depended on the type of beverages and composite resins. The most of color change occurred with Tetric Flow composite resin after immersion in coffee beverage. The bleaching agent (38% hydrogen peroxide) can remove the staining of composite resins and make its color clinically acceptable.

The purpose of this in-vitro study was to evaluate the effect of eugenol-containing
temporary fillings on shear bond strength of composite to dentin and determine the
efficiency of dual bonding technique in improving the bond strength using Adper
Single Bond 2 adhesive with 3M composite. Thirty sound human upper first
premolars were used in this study. The occlusal surface of each tooth was ground to
expose superficial dentin layer, and then dentin bonding agent was directly applied
onto freshly prepared dentin together with cylinder of 3M composite and light cured
(group I, control group). Dentin surface pre-treated with zinc oxide eugenol temporary
filling, then dentin bonding agent together with a cylinder of 3M composite (group II,
single bonding technique). While in group III dentin bonding agent was applied first
on the dentin surface and light cured, then zinc oxide eugenol temporary filling was
added for one week, after removal of temporary filling dentin bonding agent together with 3M composite was applied and light cured (dual bonding technique). The shear
bond strength of all the specimens was determined using Zwick universal testing machine. The results showed that all temporary filling treated groups (II and III) had lower mean shear bond strength compared to control group (group I), whereas compared to single bonding technique, dual bonding technique significantly increased the shear bond strength.

The aim of this study was to compare the effect of two professional bleaching products (in-office Opalescence Boost hydrogen peroxide 38%) and (home bleaching Opalescence carbamide peroxide 35%) on enamel microhardness.
The sample consist of thirty maxillary first premolars teeth (freshly extracted),
caries free obtained from children aged 12 years old under routine orthodontic
treatment. The teeth were sectioned mesiodistally parallel to the long axis of tooth and
mounted on acrylic mold. The specimens were divided into two halves buccal and
palatal as per treatment, the buccal half served as experimental, while the palatal half
served as control (1) and kept in artificial saliva at 37c0 for two weeks. Microhardness
test were obtained before and after bleaching.
Results indicated that teeth specimens submitted to Opalescence carbamide peroxide 35% showed highly significant reduction in enamel microhardness P<0.01,
while no-significant difference in enamel microhardness in specimens submitted to Opalescence Boost 38% hydrogen peroxide P>0.05.
In this study Opalescence carbamide peroxide 35% leads to the significant
decrease in enamel microhardness compared to Opalescence Boost hydrogen peroxide 38%.

This study aimed to determine the sagittal lip position and some of the factors
affecting it regarding the gender differences, and their correlations in a sample of Iraqi
adults.
Sixty two participants (37 females and 25 males) collected among dental students
having Cl I skeletal and occlusal relations and full permanent dentition regardless the
third molars were chosen for this study. Each person was subjected to clinical
examination and digital true lateral cephalometric radiograph. The radiographs were
analyzed by using AutoCAD 2007 computer program to measure the sagittal lip
position using the soft tissue analyses of Steiner, Burstone, Ricketts, Sushner,
Holdaway, and Merrifield. Descriptive statistics were obtained from the
measurements of both genders; independent samples t-test was performed to evaluate
the gender differences and Pearson’s correlation coefficient test was used to find the
contributing factors to the sagittal lip position.
Sagittal jaw angles were significantly higher in males than females, while vertical
jaw angle was higher in females. Lower incisors showed slight proclination in both
genders. The mean values of H-angle and revised H-angle in males were nonsignificantly
higher than that of females, while the mean value of Z-angle was nonsignificantly
higher in females. Upper and lower lips thickness mean values were
significantly higher in males. Females had non-significantly more projected nose
compared to males. Regarding the sagittal lip position, upper and lower lip
measurements were non-significantly higher in males than females in Ricketts,
Steiner, Burstone, and Holdaway analyses, but it was significant in Sushner analysis,
while Z-angle of Merrilfield was non-significantly higher in female sample. Pearson’s
correlation coefficient test revealed that upper and lower lip thickness was
significantly positively correlated with sagittal lip position, while nose projection was
significantly negatively correlated.
Sagittal position values of the upper and lower lips in a sample of Iraqi adults are
close to the norms of Ricketts, Steiner, Sushner, Burstone, and Holdaway analyses
with a slight tendency of upper lip toward retrusion and lower lip toward protrusion
with the exception of that when compared with Sushner norms. In addition to the chin
position, lips thickness and nose projection are the most important factors that influence the sagittal lip position and compensate for the variations in the jaw bases between genders.

Dental careis & periodontal disease ,the most widespread diseases affecting
mankind ,involve the adherence of bacteria & development of biofilms on both the
natural & restored tooth surface .within this context, a biofilm can be Classed as an
aggregate of micro-organisms in which cell adhere to each other & to a surface.
Nanotherapeutics offers the possibilitiy to control the formation of these & other oral
biofilms through the use of nanoparticles with biocidal ,anti-adhesive & delivery
capabilities.
In this study, we investigated the antimicrobial activity of silver nanoparticles
(Ag-NPs) using medicinal plant extracts (Stem bark of Juglans regia ) against,
Streptococcus mutans, Streptococcus. Sanguis, and Porphyromonas gingivalis.
Extracellular biosynthesis of silver nanoparticles was carried out by using
medicinal plant extracts for the reduction of aqueous silver ions in short period. The
silver nanoparticles formation was confirmed by the color change of plant extracts
(SNPs) and further confirmed with the help of UV-Vis spectroscopy. Antimicrobial
effect of Ag-NPs against, Strep.mutans, Strep. sanguis , and Porph. gingivalis was
investigated by using disc diffusion method.
The growth of Gram-positive Strep.mutans, Strept. sanguis (the causative agents
of careis) , and Porph. Gingivalis (the causative agents of Periodontitis) were
inhibited by Ag-NPs. The highest antimicrobial activity was observed against Strep.
mutans (15.6mm SD± 1.6), Strept. sanguis (13.3mm SD±1.4) and the least was
noticed against Porph. gingivalis (12mm SD± 1.0).
It is confirmed that silver nanoparticles are capable of rendering high antibacterial efficacy and hence has a great potential in the preparation of drugs used against oral bacterial diseases.

Facial asymmetry is a normal finding in clinically symmetrical faces. The
asymmetry in general was either functional and/or structural in nature. The objective
of this study was to investigate the relationship of the amount and direction of facial
asymmetry in clinically symmetrical faces with class I normal occlusion to
handedness, and to discover if there is any relation of occlusal bite force with
handedness and facial asymmetry in Iraqi Arab adult sample.
The sample was 60 untreated Iraqi adult persons, 30 right handers, 30 left handers
and each group consisted of 15 males and 15 females, with age range 18-25 years. For
each subject a posteroanterior radiograph was taken, and then a maximum molar bite
force was measured digitally in the first molar area on each side.
All subjects of the sample showed skeletal asymmetry although they have normal
occlusion and it was significantly greater in right handers than in left handers
(P<0.05).
Skeletal asymmetry was greater in males than females for both right and left
handers. In right-handers, the mean facial area on the left side was significantly greater than that on the right side (P=0.000). In left handers, the mean facial area on the right side was found to be significantly greater than that on the left side only in females (P=0.004).
The bite force, in both right and left handed groups, was larger in males than in females, with significant difference in right handers (P=0.03) and highly significant difference in left handers (P=0.001).
Facial dimensions tend to be larger in males than in females. Skeletal asymmetry was present even in clinically symmetrical faces with teeth in normal occlusion and it was highly correlated to handedness. Bite force was independent of handedness with significantly greater molar bite force in males than females.

Objective: To analyzes and determines the prevalence of type of denture fracture in
four hospitals.
Method: Data were collected from patients who attended prosthodontic clinics for
denture repairs at four hospitals. For each patient requiring of a fractured complete
and partial denture, the variables were recorded: causes of denture fracture, the
type of fracture and the history of previous recurrent fractures.
Results: Of 560 repaired denture 330 (59%) were complete dentures, 160 (30%) were
removable partial denture, which were excluded from the study, and 70
(10%) involved replacement of the teeth that had debonded from the denture
bases. The ratio of upper to lower complete denture fractures was approximately
2:1, most of the fractured dentures (65%) were those of males.
Poor fit appeared to be the main cause of denture fracture 120 (20%), and poor
occlusion was the second most common case recorded 50 (8%) .Midline fracture
was the most common type of fracture during the period of study 210(40%). Most
of fracture the fractured dentures 180 (32%) had previously been repaired once or more.
Conclusion: The total number of complete denture fractures was considerably enhanced by repetitive fractures, which can be reduced by the application of prosthetic principles in constructing and maintaining dentures particular during the laboratory stages. Improvements in the processing techniques and the type of resin can reduce the incidence of denture fracture .Various polymers have been developed for use as denture base resins to overcome some of the mechanical deficiencies of polymethylmethacrylate .

The aim of our study was to analyze the stress and anxiety in patients undergoing
routine dental extraction, by the assessment of cortisol in saliva, which can be
considered as one of the major hormones that is released during stressful events.
After obtaining the ethical approval and the patients were consented for their role
in this study, we examined 26 patients (13 males, and 13 females).The age ranged
from 29-42 with mean age of 36.2. We collected three salivary samples from each
patient after asking him to chew on a cotton roll to stimulate salivary secretion. The
first sample was obtained 10 minutes prior to local anesthetic injection, the second
sample collected 6-8 minutes after the local anesthetic injection, and third sample
acquired 10-15 minutes post-extraction. The samples were assessed and analyzed
using ELISA immunoassay (competitive inhibition enzyme immunoassay technique).
Statistical analysis was performed using SPSS statistical software (version
19).ANOVA and t-test were applied to obtain the significance and correlation
between the examined samples.
Significant difference was shown among the three samples (P-Value =0.002).
The mean value in the third sample (post-extraction salivary sample) was
considerably high when compared to the other samples (Mean ± SD = 0.184± 0.184,
0.307 ± 0.121 and 0.357 ± 0.141) respectively, which positively correlates with the
patient’s level of stress. Cortisol concentration in μg/dl in percentages between each
sample and the percentages, 50%, were0.105 μg/dl, 0.295 μg/dl and 0.410 μg/dl, (75
%) were0.348 μg/dl, 0.410 μg/dl and 0.443 μg/dl and (90%), 0.443 μg/dl, 0.468 μg/dl and 0.518 μg/dl. Our study revealed that salivary cortisol is within its highest levels after extraction in 15 minutes.

Bisphosphonate-associated osteonecrosis of the jaw (BONJ) is an emerging oral
complication that occur secondary to cancer therapy in approximately 5% of cancer
patients that are treated with high dosages of intravenous (IV) bisphosphonates and
can be associated with significant health-care associated costs.
A retrospective electronic medical record based on review of ninety-four cancer
patients with BONJ. All health care related resources were abstracted using a
structured chart abstraction tool, including medications, imaging, pathology,
procedures, and visits. Standardized references were used to assign costs.
The median cost of a case of BONJ in our cohort was $1,546 (interquartile range
from $869-$3,166). Medication costs comprise 48%, visits 23%, procedures 16%,
imaging 10% and pathology 2%. The major contributing factors that affect BONJ
treatment cost were long term medication and follow up visits
Long term medication, sequestrectomy and debridement are a bit expensive but could be a part of evidence-based successful clinical outcome. The cost of BONJ treatment is modest compared with the cost of cancer care.

Objectives:This retrospective cephalometric study was carried to evaluate and correlate the coronoid process morphology in three groups of subjects exhibiting different vertical jaws discrepancies
Materials and Methods: Each group consisted of 25 subjects, five cephalometric
measurements for coronoid procress and 9 linear and angular measurements were
used to evaluate coronoid process, craniofacial and mandibular rotation
morphology.
Results:There were statistically significant differences in coronoid process
morphology between normodivergent subjects and both hypodivergent and hyperdivergent subjects(P<0.05),and coronoid process measurements were significantly correlated with mandibular rotation measurements
Conclusion: coronoid process morphology was found to be related to mandibular morphology and to the function of the temporal muscle.

The mandibular canal appears below or superimposed over the apices of the mandibular molar teeth but it has some variations regarding its distance to both lower first molar and the base border of the mandible that may make a problem specially for the oral surgeon in his work during operations like implantation, so, this study was
done to estimate the position of the mandibular canal and its relation to the lower first molar and the base border of the mandible by the aid of digital panoramic radiographs.
The sample of this study was collected from patients who attended Al-Karama specialized center for dentistry. Forty patients were selected in this study with the age range between 20-60 years (males and females) that divided in to four groups according to a special criteria. Forty digital views (OPG) were taken for Iraqi patients,
using computerized digital panoramic x-ray machine. All radiographs were examined and then the position of the mandibular canal for each patient was estimated.
The results revealed that the mandibular canal is most commonly located away
from the root apices of lower first molar, and the distance between the mandibular
canal and the base border of the mandible is indirectly proportional with age.

Metronidazole has been used successfully as an adjunctive antimicrobial drug in the treatment of periodontal diseases. The aim of this study was to determine if two subgingival applications of 25% metronidazole (MET) gel of one week interval alone or adjunct to root planing (RP) have a significant effect on the following periodontal
parameters: plaque index (PLI), bleeding on probing (BOP), Probing pocket depth (PPD), relative attachment level (RAL).
A metronidazole 25 % dental gel has been developed for application locally into the periodontal pocket, the gel disintegrates in the periodontal pocket and releases
metronidazole. A total of 20 patients with an age range of (30-40) yr, each patient with at least 4 sites with PPD ≥ 4mm and clinical attachment loss (1-2) mm participated in this study. The study protocol included a pretreatment phase of plaque
control instructions followed by scaling and polishing until the oral hygiene status
reached to mean PLI (0.4).An alginate impression was taken and an occlusal stent was
constructed for each patient to measure the relative attachment level. A total of 270
sites were randomly assigned to receive either 25% MET gel alone (group 1) or root
planing plus 25% MET gel (group 2). Clinical periodontal parameters which include: PLI, BOP, PPD and RAL were recorded at day zero, after 2 weeks, 4 weeks, 6 weeks and 8 weeks.
Statistical analysis of data of the two groups revealed significant improvements in
all periodontal parameters (PPD, RAL, BOP) at all subsequent visits when compared with the base line, the same result was demonstrated when the two groups were compared with each other at week 8 except (group 1) which did not show a significant gain in RAL at week 2 only. Mean plaque scores were improved in the two groups at all visits and non significant differences were demonstrated when the two groups were compared with the baseline and at week 8.
In conclusion, double applications of 25% MET gel subgingivally have a positive effect on reducing the clinical signs of periodontal disease.