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Essam Abdelalim Nassar – Ahmad Mohammad Hafez – Yasser Lotfy Abdelnaby

Objective: This study was conducted to evaluate the dento-skeletal effects of hard and soft chin cup in treatment of class III cases. Also, their effect on the skin of the chin was assessed.

Methods: The sample consisted of fifty five growing children and was randomly allocated into three groups. In group 1 (n=22) hard chin cup applying 300 g force/side was used, group 2 (n=22) soft chin cup was utilized, while in group 3 (n = 11) no treatment was performed. Lateral cephalograms were taken for all participants before and after 12 months of treatment. The skin of the chin was evaluated using Skin Irritation Index (SII). Cephalometric data was statistically analyzed using one-way ANOVA and Tukey test while Chi-square test was utilized to evaluate the SII.

Results: There were significant reduction in SNB, 1-MP angles and Ar-Go and an increase in the ANB, SN-MP angles, Wits appraisal and N-Me measurements in the treatment groups compared to control group (P ≤ 0.05). In addition, 1-MP angle was significantly decreased with soft chin cup than the hard chin cup (P ≤ 0.05). Erythema of the skin was the common effect for both chin cup type. There was no significant differences between hard and soft chin cup (X2 =2.59, P=0.28) although laceration was grater with hard chin cup.

Conclusions: Hard and soft chin cups are effective in treatment of class III malocclusions. Erythema of the chin skin was the main effect of both types and lacerations were greater with hard chin cup.

KEY WORDS: Class III treatment, Chin cup, Skin irritations.

Volume 64, No 1, January 2018, Page 93-100

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Rasha Al-Dabaan – Rehab Allam

Introduction: Dental practitioners have ethical and legal responsibilities toward protecting children from child abuse and neglect (CAN). Training the dental team in safeguarding children is recommended, to be able to detect and report suspected child maltreatment. Therefore, the purpose of this study was to assess training experience of dental students in CAN and assess their attitudes towards the importance of safeguarding children.

Methodology: A self – administered structured questionnaire was distributed by hand to both fourth and fifth year students in the College of Dentistry, King Saud University in Riyadh. The questionnaire included demographic questions, questions related to previous training in CAN, and attitudes of dental students towards CAN.

Results: Only 141 dental students participated in this study. Around 7% of participants have had previous training in child protection. Only 5.5% from male students and 9% from female students had previous training in CAN. There were no significant differences between genders or between academic years in terms of having previous CAN training. However, 80.4% of dental students agreed that more training is required in this field.

Conclusion: The results of this study show that there is an insisting need to include CAN training in undergraduate University courses for dental students.

Volume 64, No 1, January 2018, Page 87-91

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Ahmad Mohammad Hafez – Essam Abdelalim Nassar

Purpose: This study was aimed to evaluate the effect of saliva and blood contamination on shear bond strength of metal brackets bonded with light cured cyanoacrylate adhesive.

Material and methods: The study was conducted on 75 extracted upper first premolars. Metal orthodontic brackets were bonded to the buccal surfaces of the premolars using Smart bond LC adhesive. The teeth were divided into 5 equal groups. In group I no the teeth were not subjected to contamination. In Group II and III the same procedures were done as in in group I except that the etched enamel was contaminated by saliva and blood respectively for 15 seconds. In group IV and V the same procedures were followed as in group II and III except that the saliva and blood contamination were washed with water for 10 seconds. The shear bond strengths were recorded using universal testing machine. The amount of adhesive remaining on the tooth was evaluated after debonding. The collected data were statistically analyzed using One-way analysis of variance (ANOVA) and LSD tests.

Results: The results revealed that no significant differences were found in the bond strength between the control group (without contamination), saliva contamination group without washing and saliva contamination group with washing (P>0.05). On the other hand, blood contamination significantly reduced the bond strength in comparison the saliva contamination or control groups (P<0.05). In addition, washing after blood contamination provided significantly higher bond strength than without washing (P<0.05).

Conclusion: Saliva contamination had no pronounced deleterious effect on the bond strength of Smart bond LC. On the other hand, blood contamination had pronounced deleterious effect on the bond strength. However, washing with water significantly reduced this effect.

Volume 64, No 1, January 2018, Page 79-85

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Hany Salah Eldin Eid – Sahar Ahmed Abd El Halim

Objectives: Comparing effect of surface enamel conditioning when irradiated with Er,Cr:YSGG laser versus typical phosphoric acid etching on shear bond strength of orthodontic brackets and their effect on esthetics of enamel surfaces after debonding.

Methods: Forty freshly extracted premolars were used in this study. Sample was divided into two groups (n=20), group I; enamel etched with 37% phosphoric acid (3M Unitek, Monrovia, USA) for 15 s. Group II; enamel was irradiated with Er,Cr:YSGG laser ablated with an energy output of 4.5 watt/20hz (2.78 μm wavelength) used for 15 sec. Orthodontic brackets (NU-EDGE.022” ROTH RX.TP orthodontics) were bonded to enamel surface of all specimens (Feltik Supreme XT Flowable, 3M/ESPE). The teeth were placed in Lloyd universal testing machine at crosshead speed of 0.5 mm/minute, and the shear force to remove the brackets was recorded. The bracket bases and enamel surfaces were examined after debonding under a light stereomicroscope at 20 x magnification and the adhesive remnant index (ARI) scores were assigned to each specimen. Statistical analysis was conducted using SPSS. The SBS data were compared with an unpaired t test. Statistical significance for both tests was defined as p < 0.05. The distributions of ARI scores were compared with an unpaired t test.

Results: A higher shear bond strength mean value was recorded in acid etching group (14.71±0.82) Mpa, where unpaired t test revealed that the difference between groups was statistically significant (P<0.0001). Higher (ARI) mean value was recorded in laser etching group (2.3±0.47), where unpaired t test revealed that the difference between groups was statistically significant (P<0.0001).

Conclusions: Er:YAG laser is capable of obtaining optimal bond strength for orthodontic brackets when used as a surface conditioning agent though have lower bond strength, In addition, it leaves the enamel with a rougher surface upon debonding versus typical acid etching techniques. KEY WORDS: Lasers, Orthodontics, Enamel, Adhesives, Bonding, Demineralization.

Volume 64, No 1, January 2018, Page 71-78

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Nada H. Jaafar – Sherine B. Y. Badr

Objectives: To assess the knowledge, attitude and oral hygiene practice of expectant mothers regarding infant’s oral health and their own oral hygiene practices, in Beirut, Lebanon.

Material and methods: Questionnaires were randomly distributed to 390 expectant mothers, in their 12-40 weeks of pregnancy, aged above18 years in the department of gynecology of 2 private hospitals, and 4 private maternity clinics in the Beirut and its suburbs. The questionnaire was divided into two parts. The first was concerned with the demographic background, and the second part included 18 close-ended questions.

Results: The overall score revealed that majority of expected mothers had fair knowledge, attitude and oral hygiene practices towards their infants and their own oral hygiene. Expected mothers’ educational qualification had a significant influence on the mentioned parameters. However, no significant differences were found in these parameters in relation to age, trimester of pregnancy and number of pregnancies.

Conclusion: Within the limitation of this study, it was concluded that prior to or during pregnancy, most pregnant women do not receive adequate education or information about the importance of maintaining good dental care and proper oral health practices.

KEY WORDS: Knowledge, Attitude, Practice, Expected mothers, Infant’s oral health.

Volume 64, No 1, January 2018, Page 63-70

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Rehab H. Allam

Aim: Knowledge and oral health behavior of dental students play an important role in oral health education of patients and community at large. It is therefore important that their own oral health behavior conforms to expectations of the population. Hence, the aim of this study was to evaluate the awareness of future dental graduates towards preventive dentistry regarding gender and level of education.

Materials and methods: The self-administered English- language structured questionnaire had two parts: The first part included gender and year of study. The second part included 9 questions to evaluate knowledge about preventive dentistry. The data were recorded and analyzed using the SPSS software. The level of statistical significance was set at P<0.05. Results: This cross-sectional study was performed on 207 dental students of King Saud University, dental college, Riyadh with a response rate of 80.5%.

Majority of dental students were aware about the role of sugar in caries process. Generally, female students were more knowledgeable than male students in preventive dentistry. Fifth year students were more knowledgeable about the three fundamental issues of preventive dentistry, in comparison to fourth year students.

Conclusions: Dental students of King Saud University Riyadh had a sufficient level of awareness about preventive dentistry but female students were not aware enough about the role of fluoride in the prevention of dental caries.

KEY WORDS: Preventive dentistry, knowledge, dental students, caries, fluoride.

Volume 64, No 1, January 2018, Page 57-61

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Talat Mohamed Beltagy – Marwa Ezzat Abd-Elmonsef

The antibacterial efficacy of restorative materials had an important role in preventing the recurrent caries. The objective of this study was to evaluate in-vitro the antibacterial and mechanical assays of Vitremer containing ethanolic extract of propolis (EEP). Materials and methods: I-Antibacterial Assay: The standard strain of Streptococcus mutans and Lactobacillus acidophilus were used for determination of minimum inhibitory concentration (MIC) of EEP/Vitremer. II-Mechanical Assay: A-Shear bond strength (SBS): sixty half-crowns of non-carious extracted 2nd primary molars were placed at standard moulds containing Teflon disc that had 4mm x 3mm central hole and divided into 4 groups (n=15) according to the different EEP concentrations. Group I: 10%, group II: 25%, group III: 50% EEP-Vitremer mixture, and group IV (control): 0% EEP/ Vitremer and SBS was assessed using Instron machine. B-Microhardness: Sixty standard disc-shaped specimens were prepared from mixture 0%, 10%, 25%, and 50%, n=15 and nanoindentation value was recorded. Data were analyzed using one-way ANOVA and post-hoc test. Results: Only MIC of 10%, 25%, and 50% mixture showed growth inhibition against S. mutans, compared to 25% and 50% against L. acidophilus. SBS showed that 0% EEP recorded the highest value followed by10% mixture but the difference was not significant (p>0.05), while 25% and 50% reported the lowest values and the differences were significant (p< 0.05). 25% and 50% mixtures recorded the highest significant microhardness (p<0.05). 0% EEP and 10% mixtures displayed no significant differences between them (P>0.05). Conclusions: 25% EEP-Vitremer mixture was the most suitable concentration as it exhibits positive significant antibacterial and mechanical assays.

KEYWORDS: Propolis extract, fluoride-releasing restoratives, inhibition of recurrent caries, antibacterial and mechanical assays.

Volume 64, No 1, January 2018, Page 43-55

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Fatma AbdelAziz – Naglaa ElKilany – Olfat Shaker

Background: the aim of the present study was to evaluate the levels of some biological markers; interleukin 1B (IL1B), interleukin 6 (IL6), interleukin 8 (IL8) and prostaglandin(PG) in the gingival crevicular fluids (GCF) in patients with periodontal disease during early stage of orthodontic tooth movement.

Subjects and methods: The study included 9 subjects with age range 23-45 years, with periodontally affected teeth submitted to orthodontic treatment at the orthodontic department faculty of dentistry, Al-azhar University,Girls branch. Fixed appliances were inserted, nickel titanium light archwires were used for levelling and alignment. Gingival crevicular fluid (GCF) samples were collected from the healthy and periodontally affected teeth with paper points at base line, 3 days, 1,2,3,4 weeks from starting of orthodontic treatment.

Results: during the test period, the levels of IL 6 in healthy teeth and periodontally affected teeth gradually increased after 3 days and 1 week, then gradually decreased after 2 and 3 weeks, Comparing healthy and periodontally affected teeth revealed a higher levels in periodontally affected teeth.. The mean value of IL 8 gradually increased after 3 days and 1 week, then gradually decreased after 2 and 3 weeks. the mean value of IL 1B was gradually increased after 3 days and 1 week, then gradually decreased after 2 and 3 week. PG showed gradual increase after 3 days and 1 week, then gradually decreased after 2, 3 and 4weeks. Comparing healthy and periodontally affected teeth revealed a higher levels in periodontally affected teeth.

Conclusion: Our findings suggested that the orthodontic movement of periodontally compromised teeth result in significant changes in the levels of certain biological markers in the GCF as compared to healthy teeth.

Volume 64, No 1, January 2018, Page 33-41

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Dalia M Fayyad – Ghada A ElBaz

Introduction: Direct pulp-capping is an alternative procedure to extraction or endodontic therapy, in which a medicament is placed directly over the exposed pulp to maintain pulp vitality and facilitate the formation of protective barrier. Aim of study: The purpose of this study was to evaluate and compare the histological response of dog’s pulp after direct pulp capping with 3 different materials; MTA, Bioactive glass, CEM and their nanoparticles, at 1 month and 3 month time intervals.

Materials & Methods: A total of 112 teeth in 8 dogs were used for this study, where 96 teeth were pulp capped with the investigated materials and 16 teeth were serving as negative control. The 14 teeth of each dog were classified into 6 experimental groups and one control (2 teeth each) as follows: Group A: was capped with MTA, Group B: was capped with NMTA, Group C: was capped with CEM, Group D: was capped with NCEM, Group E: was capped with Bioactive glass, Group F: was capped with Nano Bioactive glass and Group G: unprepared tooth (negative control). Dogs were randomly divided into 2 groups (4 dogs each), relative to the observation periods tested, 1 month and 3 months for histomorphological evaluation of pulp response after direct pulp capping with tested materials.

Results: Regarding the dentin bridge formation, both NMTA and NCEM groups induced thick dentin bridge with irregular dentin pattern in 1 and 3 months evaluation time period while MTA and CEM induced thinner dentin bridge with regular dentin pattern. BG and NBG groups showed the lowest mean dentin bridge thickness values with no tubular dentin pattern. About the inflammatory reaction of the dental pulp to materials with conventional particle size; MTA displayed the highest prevalence of no inflammation followed by CEM while BG showed the highest prevalence of moderate inflammation and the highest inflammatory cell counts. All nanomaterials showed the highest mean inflammatory cell counts at both evaluations time periods.

Conclusion: MTA and CEM can be considered favorable materials for direct pulp capping, while BG and NBG produced the worst inflammatory cell reaction, dentin bridge thickness and quality. Nanoparticles although increased dentin bridge thickness, they also increased the inflammatory cell reaction.

Volume 64, No 1, January 2018, Page 19-32

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Ahmed Elkhadem

Restoration of badly decayed primary incisors is challenging. Esthetics crowns present a solution to this problem. Pompedo esthetic crown is made of polyoxymethylene. The clinical performance of Pompedo crowns have not been tested before. Thus, the aim of this study is to compare the effectiveness of Pompedo (PC) versus NuSmile zirconia crowns (NSZ) in terms of retention, discoloration and fracture. Methods: Records from a private practice was screened for children conforming with eligibility criteria. Twelve children in both groups were recalled for follow-up. Two assessors examined the children and the records. Consensus resolved differences between examiners.

Results: The relative risk for crown dislodgement was 1.25 (95% CI: 0.4 to 3.8), with no significant statistical difference (P<0.05). The relative risk for crown discolouration was 2.43 (95%CI: 0.67 to 8.85) with one and a half time more chance for crown discolouration in PC compared to NSZ, but this result is not statistically significant (P<0.05). Finally, the risk of crown fracture in the NSZ was 8% (95% CI: 3 to 18), while none of the PC was broken. Conclusion: In conclusion, both NSZ and PC showed good clinical performance with NSZ slightly better in resisting colour changes and PC being better in resisting crown fracture. PC can be recommended for use as an aesthetic replacement for zirconia crowns in primary teeth due to its lower cost and comparable clinical performance over two years post placement KEYWORDS: NuSmile crown, Pompedo crown, Esthetic anterior crown, Dental caries.

Volume 64, No 1, January 2018, Page 11-17

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