This case report describes miniature pulpotomy (MP) with calcium-enriched mixture (CEM) cement, 1 week after carious pulpal exposure of a symptomatic mature molar. A 24-year-old woman was referred with complaining of severe lingering pain on the second upper left molar; a dental history revealed that the tooth had been prepared 1 week ago, but on pulp exposure, her dentist just dressed the cavity. After anesthesia/isolation in the same session, the temporary restoration was removed, the previously pulpal exposure was observed, and MP was carried out. Hemorrhage was effectively controlled using 5.25% NaOCl, the clot free pulpal wound was completely covered employing CEM cement, and the cavity was permanently restored by resin composite. The patient's pain gradually relieved within 24 h. The tooth was functional and able to respond to vitality tests in regular clinical follow-ups. At 15-month follow-up, a dentinal bridge was observed under the capping biomaterial, radiographically; moreover, no calcification or apical pathosis was detected. MP with CEM cement might be a treatment option for the management of exposed dental pulp with a clinical diagnosis of irreversible pulpitis, although further trials with larger sample size and longer follow-ups are recommended.

Background: Incorporation of extra fillers into dental resins might enhance their physical properties. In this study, the tensile and impact strengths of modified heat-curing acrylic resin reinforced with nanoclay were investigated. Materials and Methods: In this experimental study, nanoclay-acrylic resin composite was prepared by mixing 0.5, 1, and 2 wt% of nanoclay with methacrylate monomer in an ultrasonic probe, followed by mixing with the polymethylmethacrylate (PMMA) powder. 24 cubic 20 mm × 20 mm × 200-mm specimens for each test, 18 samples containing nanoclay and 6 samples for the control group and a total of 48 samples were prepared. The tensile and impact strengths of the samples were tested according to ISO 527 and 179, respectively. One-way ANOVA was used for statistical analysis, followed by multiple comparison tests (Scheffé's test). Statistical significance was set at P < 0.05. Results: The maximum mean tensile and impact strengths were recorded in the control group, and an acrylic resin containing 2% of nanoclay demonstrated the minimum mean in all the tests. Increasing the percentage of nanoclay in PMMA compromised the tensile strength (P < 0.05) with no effect on its impact strength. Conclusion: Incorporation of nanoclay particles into acrylic resins can adversely affect the mechanical properties of the final products, and this effect is directly correlated with the concentration of nanoparticles.

Background: Nowadays, health-care companies use different antimicrobial agents in toothpastes to reduce oral microorganisms. The aim of this study was to investigate the antimicrobial effects of one Iranian herbal toothpaste in different concentrations compared with the chemical type on oral microorganisms in vitro. Materials and Methods: In this experimental study, the antimicrobial effect of one Iranian herbal toothpaste in comparison with its chemical type at three concentrations of 1, 1:1, and 1:3 on Streptococcus mutans (SM), Lactobacillus (LB), and Candida albicans (CA), respectively, were studied by agar disc diffusion method. The microorganisms were cultured on 21 plates. Then, four sterile paper discs were placed on each plate and the extracts were placed on them in prepared concentrations and incubated at 37°C ± 0°C for 24 h. The diameter of the inhibition zone around the discs was then measured in millimeters and recorded two-way ANOVA, one-way ANOVA tests, and regarding the difference variances, Tamhane supplementary tests were used at the significance level of P < 0.05. Results: According to the results of this study, the full concentration of Iranian herbal toothpaste on SM, LB, and CA microorganisms had higher antimicrobial effect than the other two concentrations. This difference was statistically significant (P < 0.05). Furthermore, all the three toothpastes at full concentration had the same antimicrobial activity (P < 0.05). The antimicrobial effect of herbal toothpaste decreased significantly compared with the chemical toothpaste while the concentration decreased (P < 0.05). Conclusion: At full concentration, herbal and chemical toothpastes have the same antimicrobial effect, but by reducing the concentration, the antimicrobial effect of herbal toothpaste is reduced compared with the chemical one.

Background: One of the most common problems in edentulous patients is the low stability of lower dentures. The most effective method to overcome this problem is implant-supported overdentures. After placing an implant, for the process of osseointegration to be complete and successful, it is better that patients do not use their denture for few months. This may be nonconvenient for patient because they are unable to speak and eat properly. The aim of this study was to evaluate the effect of low level laser (LLL) and light-emitting diode (LED) photobiomodulation on implant stability as well as their effect on interleukin-1 beta (IL-1β) and prostaglandin E2 (PGE2) biomarkers around implant in lower anterior region (over denture). Materials and Methods: In this clinical trial, 36 implants were placed in fully edentulous mandibles (12 people per person - three implants in areas of midline and canine). Each of the implants was randomly placed in one of three groups of laser, LED, and control. LLL (power of 50 mw and the amount of 20 J/cm² for each implant) and LED with dose (20 mw/cm²) were irradiated on the day of surgery (zero), 3, 7, 10, and 14 days. The stability of implants was measured on the day of surgery and weeks 3, 4, and 8 after surgery with Periotest. The inflammatory biomarkers of IL-1β and PGE2 were also collected from gingival crevicular fluid around implants in 4 and 8 weeks. The collected data were analyzed by ANOVA statistical tests.pvalue<0.05 considered significant. Results: The amounts of Periotest significantly increased 3^rd week after surgery in the control group (P < 0.001). However, the laser group and LED group were associated with minimal changes, which indicates lower stability of implant in 3^rd week in control group but no changes in stability of test groups (laser and LED). Laser and LED had no effect on the level of IL-1β and PGE2 in 4 and 8 weeks. Conclusion: The use of LLL or LED has a positive effect on the stability of the implants 3 weeks after surgery.

Background: Difficulties to maintain good oral hygiene during orthodontic treatment can cause prolonged accumulation of dental plaque, thereby increasing the risk of developing gingival inflammation and periodontal disease as well as enamel demineralization and caries. The purpose of this study was to determine the effect of chlorhexidine (CHX) gel and fluoride varnish versus placebo and control groups on plaque and gingival indices as well as their influence on enamel demineralization prevention in orthodontic patients with fixed appliances. Materials and Methods: In this clinical trial, forty patients with fixed orthodontic appliances were participated and were divided into control, CHX gel (0.2%), fluoride varnish (5%), and placebo groups. The parameters evaluated in this research were dental plaque index (DPI), index of gingival inflammation, and white spot lesion (WSL) index. For all the patients, each index was scored at the beginning of orthodontic treatment, then 3 months, 6 months, and 9 months afterward. Data were analyzed using Kruskal–Wallis and Mann–Whitney tests. The level of significance was set at 0.05. Results: All the scores showed statistically significant differences (P < 0.05) between the four groups for each of the three time points. A statistically significant decrease of DPI, WSL index, and gingival index was observed 9 months after treatment in fluoride and CHX groups. Conclusion: Adding CHX gel and fluoride varnish to the patients' oral hygiene regimen can reduce the development of plaque and gingivitis and decrease WSLs in orthodontic patients.

Background: Denture adhesives are used to improve retention, stability, and efficiency of complete dentures. Proper use of denture adhesives has benefits for patients. Evaluating the effect of denture adhesives on efficiency of complete dentures in patients with different alveolar ridges was the purpose of this study. Materials and Methods: This cross-over randomized clinical trials study was conducted on 90 patients who were wearing well fitted complete dentures. The patients were categorized into three groups based on clinical and radiographic situations of residual ridges. Group I with mild resorption, group II with moderate resorption, and group III with severe resorption. The patients who had recently received their dentures and the primary complications had been resolved were asked to use denture adhesive according to the instructions. The patients answered two different questioners in 1 week and 2 months of using denture adhesive. The answers were analyzed by means of variance and Chi-squared tests (P < 0.05). Results: Retention, chewing, talking, self-confidence, and efficiency of dentures were improved in all patients. No statistical significant differences in these parameters were observed between the three groups (P > 0.05). Increased retention and adaptation made 64.4% of these patients willing to continue using the adhesive after the study. Forty-three percent of patients reported moderate satisfaction of using this adhesive. Conclusion: Using denture adhesive in well-fitted complete dentures resulted in an improvement in retention, talking, chewing, ease of use, self-confidence, and efficiency of dentures. The use of denture adhesive is, therefore, recommended to patients wearing dentures with some problems.

Background: The aim of the study was to evaluate the adhesion of Scotchbond Universal Adhesive to primary tooth dentin by measuring shear bond strength (SBS) and observing morphological changes with scanning electron microscopy (SEM). Materials and Methods: In this in vitro study, a total of 60 primary canine teeth were randomly divided into 5 groups (n = 12). The study groups were (1) Phosphoric acid etching + Adper Single Bond 2 (control), (2) phosphoric acid etching + Scotchbond Universal (etch-and-rinse), (3) Scotchbond Universal (self-etch), (4) phosphoric acid etching + Scotchbond Universal + resin, and (5) Scotchbond Universal + resin. Composite cylinders were built on the tooth surface, and 10 samples in each group were selected for SBS testing and identification of the failure modes. Two samples from each group were observed by SEM. One-way ANOVA and Tukey honestly significant difference post hoc test were used for data analysis P value < 0.05 was considered statistically significant. Results: The results showed that SBS in Group 1 was significantly lower than in Groups 2, 3, and 4 (all P < 0.001). There was no significant difference between Groups 2 and 3 (P = 0.98), or between Groups 3 and 4 (P = 0.97). There was no significant difference between Groups 2 and 4 (P = 0.999) or between Groups 1 and 5 (P = 0.156). Mixed and cohesive failures were more frequent in Groups 2, 3 and 4. SEM observations showed that applying phosphoric acid to the dentin before Scotchbond Universal adhesive resulted in more open dentinal tubules and more resin tag impregnation. Conclusion: There was no significant difference in SBS between Scotchbond Universal Adhesive in etch-and-rinse and self-etching modes. The SBS of Scotchbond Universal Adhesive in etch-and-rinse mode was greater than Adper Single Bond 2.

Background: The purpose of the study was to evaluate and to compare the shear bond strength (SBS), adhesive remnant index, and surface roughness of the samples bonded after etching with phosphoric acid and erbium, chromium-doped: Yttrium scandium-gallium-garnet (Er, Cr: YSGG) laser. Materials and Methods: In the present analytical/descriptive study, 90 premolars extracted for orthodontic purposes were used, out of which 75 were randomly divided into five groups where five different methods were used to prepare the enamel for bonding; etching with 37% phosphoric acid for 15 s, irradiation with Er, Cr: YSGG laser at 1 watt for 10 s and 20 s, and irradiation with Er, Cr: YSGG laser at 1.5 watt for 10 s and 20 s. Following this, metal brackets were bonded with Transbond XT. Brackets were debonded 24 h, later and SBS were measured, and adhesive remnant index scores were measured. The remaining 15 teeth were used for surface evaluation of these five groups using three-dimensional optical profiler. The results of the SBS testing, adhesive remnant index) scores, and surface roughness values were analyzed by one-way analysis of variance and Tukey honestly significant difference tests with a significant level at 0.05. Results: The difference in bond strength between the laser (1.5 W/20 s) and conventional acid etching was not statistically significant (P > 0.05). For acid etch tech, it was 10.48 Mpa and Laser etch at 1.5 W/20 s 10.46 Mpa bond strength attained by the other groups (1 W/10 Hz, 1 W/20 Hz, and 1.5 W/10 Hz) was significantly less than acid etched, and laser etched (1.5 W/20 Hz) groups with P > 0.05. The surface roughness was found to be similar between the laser- (1.5 W/20 s) and acid-etched groups (P > 0.05). Conclusion: Irradiation with 1.5 W/20 s Er, Cr: YSGG laser produced bond strength comparable to acid etching.

Background: Sodium hypochlorite (5.25% NaOCl) and silver nanoparticles (70 ug/ml AgNPs) have a broad spectrum of antimicrobial efficacy for disinfecting gutta percha (GP) point, so this study was conducted to analyze the assay surface topography of GP when disinfected with AgNPs and 5.25% of NaOCl using atomic force microscopy (AFM). Materials and Methods: In this in vitro study a total of thirty cones were taken. The samples were divided into three treatment groups: Group I and II with 70 μg/ml AgNPs and 5.25% NaOCl. The time duration was 1 min. Untreated GP points served as control group. After treatment of 1 min for each solution, the samples were positioned in the AFM. For comparison, the root mean square (RMS) was used to investigate the structure of the GP points. Unpaired t-test and ANOVA test were used. The differences among the groups were tested by Tukey's honestly significant difference test and were considered significant when P < 0.05. Results: 5.25% NaOCl created RMS value of 202.48 nm at 1 min as compared to 70 μg/ml of AgNPs and control which produced RMS value of 44.48 nm and 24.1 nm, respectively (<0.0001). Conclusion: The study showed irregularity in the surface of GP with NaOCl and lesser deterioration with AgNPs which could affect the postoperative prognosis. In this study, it was found that NaOCl causes 10 times more surface topography deterioration of GP when compared to AgNPs at 700 times lesser concentration.