Journal of Baghdad College of Dentistry

Background: Gastroesophageal reflux disease, is a quite prevalent gastrointestinal disease, among which gastric content (excluding the air) returns into the oral cavity.
Many 0ral manifestations related t0 this disease include tooth wear, dental caries also changes
in salivary flow rate and pH. This study was conducted among gastroesophageal reflux disease patients in order to assess tooth wear in relation to salivary flow rate and pH among
these patients and the effect of gastroesophageal reflux disease duration on this relation. Materials and methods: One hundred patients participate in this cross-sectional study for both
genders and having an age range of 20-40 years old, patients had been endoscopically identified as having gastroesophageal reflux disease using the classification of Los Angeles (LA),
who were attending the Gastroenterology and Hepatology Teaching Hospital in Baghdad.
and divided into two groups: group A with grade severity mucosal breakage not longer than
5 mm and Group B with grade severity mucosal breakage more than 5 mm long, Smith and
Knight (1984) tooth wear index criteria were used for the assessment of tooth wear. For measurement of salivary flow rate and pH, saliva sample (unstimulated) had been collected. Results: Of the entire sample (90%) were having tooth wear. Tooth wear was higher in grade B
severity than in grade A severity among patients with gastroesophageal reflux disease duration of two years or less, while it was higher in grade A than in grade B among patients with
a duration of more than two years but all these results were statistically non-significant. Salivary flow rate and pH showed a non-significant reduction with increasing gastroesophageal
reflux disease severity for both of groups concerning disease duration. The correlation of total
tooth wear with salivary flow rate and pH was a significantly weak negative correlation in
grade A, while a nonsignificant weak negative correlation in grade B. Conclusions: The findings of the present study concluded that patients with gastroesophageal reflux disease recorded a high occurrence of tooth wear and there was a negative correlation of tooth wear with
salivary flow rate and pH among patients with gastroesophageal reflux disease.

Background:The technology of nanoparticles has been expanded to many aspects of modern life. Titanium dioxide nanoparticles were of many nanomaterials utilized in
biomedical applications. The interactions between nanoparticles and proteins are believed to
be the base for the biological effect of the nanoparticles. The oxidation reaction of many substances is catalyzed by oxidizing enzymes called peroxidases. The activity of salivary peroxidase is elevated with periodontal diseases. the aim ofthis study is to examine the action of
titanium dioxide nanoparticles on salivary peroxidase activity.Material and method75 participants were enrolled in this study—Periodontitis group with 44 participants and the non-periodontitis group with 31 participants. The participants' age range was 35 to 50 years for both
groups. The clinical parameters of plaque index, gingival index, probing pocket depth and
clinical attachment level were used in this study to determine the presence or absence of the
periodontal disease. Unstimulated saliva was collected from all participants and analyzed for
the activity of peroxidase enzyme under the effect of titanium dioxide nanoparticles. ResultsThe Periodontitis group showed higher peroxidase enzyme activity than the non-periodontitis group and the activity of salivary peroxidase showed no correlation with the clinical
parameters. Titanium dioxide nanoparticles increased salivary peroxidase activity. ConclusionThis study demonstrated that the solid surface of nanoparticles could induce changes in
the attached protein molecule which in turn causes changes in the effect of the nanoparticles
on living tissue or organism. The titanium dioxide nanoparticles Play a role in increasing the
activity of salivary peroxidase within the saliva of chronic periodontitis patients.

Background: Environmental tobacco smoking is produced by active smokers
burning the tip of a cigarette and breathed by nonsmokers and measured by cotinine level. It
has the potential to raise the risk of periodontal disease. One of the most frequent chronic
diseases in adults is periodontal disease. The lower maternal-fetal attachment has been found
to predict smoking status in previous studies, but no research has examined whether maternal-fetal attachment predicts environmental tobacco smoking. This study assessed the effects of maternal environmental tobacco smoke exposure on periodontal health and mother-infant bonding concerning salivary cotinine levels. Materials and methods: This is a
comparative cross-sectional study comparing environmental tobacco smoke on exposed and
non-exposed mothers aged between 20-35 years with their infants aged up to one year who
attended primary health care centers in rural areas of AL-Karkh sector/Baghdad. Along with
the essential socio-demographic data, a secondhand smoke exposure scale and postpartum
bonding questionnaire were employed. Collection of unstimulated saliva from mothers was
done according to Navazesh and Kumer in 2008. After that, the clinical Assessment of gingival bleeding and periodontal pockets was performed by using Community Periodontal
Index according to the world health organization in 1997. Results: Out of 150 subjects,67(44.66%) were exposed to environmental tobacco whereas the non-exposed mothers
were composed of 83 (55.33%). The highest mean number of CPI0(healthy gingiva) and
CPI1(gingival bleeding) were among the non-exposed mothers while the highest mean
number of CPI2(dental calculus), CPI3 (shallow pocket 4-5mm) and CPI4(deep pocket 6mm
or more) were among the exposed mothers. The mean value of cotinine level among the
non-exposed mothers was lower than exposed mothers with significant results. A higher
salivary cotinine level was linked to a lower maternal-fetal bonding score. Conclusions:
Mother’s exposure to environmental tobacco smoke significantly negatively impacts periodontal disease. Furthermore, mothers who have a stronger sense of attachment and affiliation
to their fetus have lower salivary cotinine concentrations than mothers who have a less sense
of fetal attachment.

Background: A great dental and biomedical interest had been paid to silver nanoparticles
because of their antimicrobial activity. Objective: To evaluate the antimicrobial and cytotoxic
activity of a newly developed Nano-silver fluoride that was synthesized from moringa oleifera
leaf extract against S. mutants. Material and method: The green synthesis method was used
to prepare Nano-silver fluoride from moringa oleifera leaf extract. The minimum inhibitory
concentration and the minimum bactericidal concentration were evaluated using brain heart
infusion plates, while the cytotoxicity was evaluated by the hemolytic activity. Results: Nanosilver fluoride had a bactericidal and bacteriostatic effect (MIC was 60 ppm and MBC was 120
ppm) the diameter of the inhibition zone increased as the concentration increased. It was toxic
at high concentrations and nontoxic at low concentrations. Conclusion: Nano-silver fluoride is
a good material to be used in arresting and preventing dental caries and it is safe to be used on
humans.

Background: Periodontal diseases are inflammatory disorders caused by
the accumulation of oral biofilm and the host response to this accumulation which
characterized by exaggerated leukocytes and neutrophils attraction to the sites of
inflammation by chemoattractants which are a very important part of the
pathogenesis of periodontal diseases. This study aimed to determine and compare the
clinical periodontal parameters and the leukocyte cell types in the peripheral blood
between patients with gingivitis and periodontitis with different severities compared
to healthy controls. Materials and methods: This study included 150 male subjects
aged between 35-50 years. They were divided into three groups: gingivitis group
(n=30), periodontitis patients (n=90) which subdivided into Mild =30 patients,
Moderate =30 patients, Severe =30 patients and a control group (n=30) with clinically
healthy periodontium. Clinical periodontal parameters were recorded ((plaque index
(PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD)
and clinical attachment level (CAL)). Blood samples were collected then an automated
blood analyzer evaluated leukocyte cell types. Results: Significant differences in The
counts of neutrophils and lymphocytes exhibited significant differences among the
study groups and subgroups. On contrary, differences in monocytes, eosinophils, and
basophils counts were not significant. Additionally, severity of periosontitis was
significantly correlated with the mean counts of the various leukocyte cell types;
however, clinical periodontal characteristics did not show such correlation with these
inflammatory cells. Conclusion: This study demonstrated that periodontal disease
with different severities is associated with possible episodes of bacteremia that
originate from periodontal lesions which mediate inflammatory conditions that in
turn causing changes in the systemic markers especially leukocytes cells types

Background: Orthodontic therapy often causes external root resorption. Serum
vitamin D (VD) level is important for tooth mineralization and bone remodeling. This study
aimed to test the impact of vitamin D (VD) supplements on bone and root remodeling in a
vitamin D (VD) deficient rat model following orthodontic retention. Methods and Material:
30 male Wistar rats were divided into three groups: a control group of 10 rats and two experimental groups of 10 rats, each with vitamin D deficiency (VDD) induced by a VD-free diet
for 21 days. And a third group with VD supplement. All groups received active orthodontic
treatment using a modified orthodontic appliance that applied 50 gm of force for 14 days to
move the maxillary right first molar mesially, followed by seven days of retention and relapse.
The VDD group received no intervention, while the VDS group received 40,000 IU/kg of systemic VD3 by intramuscular injection on the first and fifteenth day of orthodontic treatment.
Histomorphometric analysis was performed to assess bone and cementum resorption and
deposition. Results: The VDD group exhibited a significant increase in bone and root resorption and decreased bone deposition and cementum deposition ratio. In addition, bone deposition and the ratio of cementum deposition were substantially greater in the VDS group compared to the control group. Conclusion: VDD may increase bone and root cementum resorption and decrease deposition after orthodontic retention, which may play a significant role in
relapse after retention. Before beginning orthodontic treatment, routine VD screening may be
beneficial.

Background: The access cavity is a critical stage in root canal therapy and it
may influence the subsequent steps of the treatment. The new minimally invasive endodontic
access cavity preparation concept aims to preserve sound tooth structure by conserving as
much intact dentine as possible including the pulp chamber's roof, to keep the teeth from
fracturing during and after endodontic treatment. While there is great interest in such access
opening designs in numerous publications, still there is a lack of scientific evidence to support
the application of such modern access cavity designs in clinical practice. This review aims to
critically examine the literature on minimal access cavity preparations, explain the effect of
minimally invasive access cavity designs on various aspects of root canal treatment, and
identify areas where additional research is required. Data: An electronic search for Englishlanguage articles was performed using the following databases: Google Scholar, PubMed, and
Research Gate. The following keywords were used: "minimally invasive access cavity",
"conservative endodontic cavity ", and "classification of access cavity". Study selection: 64
papers that were the most relevant to the topics in this review were selected between 1969 to
26 February 2022. Conclusions: Minimally invasive access cavities can be classified into
conservative, ultraconservative, truss access, caries and restorative-driven cavities. There is a
deficiency of proof that a minimally invasive access cavity maintains the resistance to fracture
of endodontically treated teeth greaterthan traditional access cavities. There was no difference
in the percentage of untouched walls and debris removal in teeth with conservative vs
traditional access cavities, however, truss and ultraconservative access cavities resulted in
poor irrigation efficacy compared to traditional ones. Also, the lower cyclic fatigue resistance
of rotary instruments and root canal obturation with voids were associated with minimally
invasive access cavities. The studies about minimally invasive access cavities still have a wide
range of methodological disadvantages or register unsatisfactory or inconclusive results.
Therefore, further research on this topic is needed especially with the everyday advancement
of techniques and armamentarium used in endodontics.

Objectives: To review the failure rates of molar tubes and the effect of molar
tube base design, adhesive type, and bonding technique on the failure rates of molar tubes.
Data: The revolution of molar bonding greatly impacted fixed orthodontic appliance treatment by reducing chair-side time and improving patient comfort. Even with the many advantages of molar bonding, clinicians sometimes hesitate to use molar tubes due to their
failure rates. Sources: Internet sources, such as Pubmed and Google Scholar. Study selection:
studies testing the bond failure rate of molar tubes. Conclusions: The failure rate of the molar tubes can be reduced and the bond strength of the molar tubes can be improved by
changing the design of the molar tube base, the adhesive type, and the bonding technique.