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ANESTHETIC EFFICACy OF 2% MEPIVACAINE VERSUS 4% ARTICAINE FOR INFERIOR ALVEOLAR NERVE BLOCKS IN PATIENTS wITH SyMPTOMATIC IRREVERSIBLE PULPITIS IN MANDIBULAR MOLARS: A RANDOMIZED CLINICAL TRIAL (PART 6)

Mohamed Fouad El Marakby, Manar yehia Fouda and Marwa Mahmoud Bedier

ABSTRACT

Objectives: The aim of this prospective randomized clinical trial was compare between 2% Mepivacaine and 4% Articaine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis in mandibular molars as regards to their anesthetic efficiency; during access cavity preparation and instrumentation.

Subjects and Methods: Sixty-six patients diagnosed clinically and radiographically with symptomatic irreversible pulpitis in mandibular posterior teeth received single-visit root canal treatment using ProTaper Universal rotary system for canal preparation, they were randomly divided into two groups (n=33) according to the anesthetic solution used, either Group M (3.6 ml Mepivacaine hydrochloride 2% with 1:100000 epinephrine) or Group A (3.4 ml Articaine hydrochloride 4% with 1:100000 epinephrine). The pain was assessed using numerical rating scale (NRS) during access cavity preparation and instrumentation, then the need for supplemental anesthesia was also recorded.

Results: there was no statistically significant difference in pain level between both groups at the different observation times. The success rates were similar in both groups (39.4% and 45.5% in Mepivacaine and Articaine groups respectively) with no difference in the need for supplemental anesthesia in both groups.

Conclusion: the  anesthetic efficacy of Mepivacaine and articaine  seemed to be similar, although both did not provide acceptable rate of anesthetic success.

KEywORDS: articaine, anesthetic efficacy, inferior alveolar nerve blocks, Mepivacaine

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EVALUATION OF SHEAR BOND STRENGTH OF COMPOSITE RESIN USED TO REPAIR ZIRCONIA wITH TwO DIFFERENT CHEMICAL SURFACE TREATMENT METHODS VERSUS SANDBLASTED ZIRCONIA (AN IN-VITRO STUDy)

Aya Ezzat ElShimy*, Omnia El-Sheihy** and Maha Taymour***

ABSTRACT

Statement of the problem: Opposite to silica-based ceramics, zirconia has no silica in their structure, so they cannot be effectively conditioned using hydrofluoric acid. Zirconia exhibits weaker bond strength to resin than other types of ceramic materials, so repair of zirconia with resin composite is considered to be technique sensitive and questionable procedure.

Purpose: The aim of this in-vitro study was to assess the effect of two different priming agents on the shear bond strength (SBS) of composite resin used to repair treated zirconia compared to sandblasted zirconia.

Materials and methods: A total of 24 zirconia specimens (12 ×10 ×3 mm) were sliced from presintered ICE Zirkon Translucent zirconia blank using an Isomet 98 cutting machine then all the specimens were sintered according to the manufacturer’s instructions. The specimens were randomly divided into three groups according to the surface treatment performed (n=8) : (1) sandblasting with 110µm Al2O3  particles (control group); (2): chemical treatment with Relyx Ceramic Primer (Relyx group); and (3): chemical treatment with Monobond Plus primer (Monobond Plus group).

All specimens were bonded to two resin composite cylinders with a universal adhesive system according to the manufacturer’s recommendations. The samples were stored for 24 hours in an incubator at 37°C and 100% humidity, followed by thermal cycling (500 cycles at 5ºC and 55ºC). The shear bond strength was measured by the Universal testing machine with 500 N load cell and speed of 0.5 mm/min. Two representative specimens were randomly selected from each group to be examined using scanning electron microscope x1000 magnification to characterize the surface morphology of each surface treatment method. Mean SBS (MPa) were analyzed with one-way analysis of variance (anova) followed by pair-wise tukey’s post-hoc tests to detect significance between groups. Shear strength was calculated through the equation: ( T = F (force) / A (area) ).

Results: The sandblasted specimens of the control group showed the highest mean shear bond strength with a statistically significant difference while the specimens of the relyX group showed higher mean shear bond strength than that of the Monobond Plus group with statistically non-significant difference between them. the sEM showed that the sandblasted zirconia had the roughest surface with multiple and deep micro-irregularities. while for the Relyx and Monobond Plus specimens, there were mild and shallow irregularities.

Conclusions: from the findings of our study, sandblasting of zirconia with 110µm alumina particles enhances the shear bond strength of resin composite used to repair zirconia-cored restorations after chipping of the veneer layer. Sandblasting has a better effect on the shear bond strength compared to the chemical surface treatment of zirconia with Relyx and Monobond Plus primers. Both of Relyx and Monobond Plus primers have nearly the same effect on the shear bond strength.

KEywORDS: Primer, zirconia ceramic, resin composite, shear bond strength, dental restoration repair, adhesion.

Vol. 64, 197:206, January, 2018

I.S.S.N  0070-9484

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CLINICAL AND RADIOGRAPHIC EVALUATION OF AMNION CHORION MEMBRANE VERSUS ALLOGRAFT BONE PUTTy FOR THE MANAGEMENT OF INTRABONy DEFECTS IN PATIENTS wITH CHRONIC PERIODONTITIS: A RANDOMIZED CLINICAL TRIAL

Amr Temraz, Omnia Abu El-Dahab, Noha A. Ghallab and Riham Hamdy

ABSTRACT

Objectives: This study is meant to evaluate clinically and radiographically the possible predictable results regarding the use of amnion chorion allograft barrier, versus the use of allograft bone putty in the treatment of periodontal intrabony defects.

Methods: This randomized clinical trial was performed on patients suffering from severe chronic periodontitis with 22 intrabony defects, the defects were randomly assigned in two equal parallel groups. The periodontal intrabony defects were treated by OFD with amnion chorion membrane (Bioxclude™) as guided tissue regeneration versus demineralized freeze-dried bone allograft putty (C-Blast™) as bone graft for treatment of intrabony defects.  Clinical parameters including plaque index, gingival index, probing pocket depth and clinical attachment level were recorded at baseline, 3 and 6 months post-surgery, while radiographic assessment of bone defect area was recorded at baseline and 6 months postoperatively.

Results: The clinical parameters recorded in this trial, in terms of gingival index, probing pocket depth reduction and gain in clinical attachment level, were statistically significant at 3 and 6 months post-surgically compared to baseline measurements. Furthermore, radiographic improvements were observed at 6 months follow up, while no change was recorded for plaque index reported scores. however, no statistically significant difference was detected between the two treatment modalities when compared to each other at different time intervals.

Conclusion: Both Bioxclude™ and C-Blast™ as regenerative techniques provided promising regenerative potentials in management of periodontal intrabony defects. Moreover, the uneventful healing process associated with their use and predictable results suggest further implementation of them into other studies in the field of periodontal regeneration.

KEywORDS: Periodontal regeneration, amnion-chorion, intrabony defects, periodontitis, DFDBA, bone allograft putty.

Vol. 64, 181:196, January, 2018

I.S.S.N  0070-9484

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THE EFFECT OF AGE AND GENDER ON CHILDREN’S BEHAVIOR DURING DENTAL TREATMENT IN CHILDREN AGED BETwEEN 5 AND 7 yEARS AN OBSERVATIONAL STuDy

Nada Ashraf Ali Elmeligy, Amr Ezzat and Hany Saber

ABSTRACT

Aim: The study was conducted to explore the relationship between the children’s age and gender and their preoperative fear level as measured by the Children’s Fear Survey Schedule- dental subscale (cfss-ds), their behavior during treatment as measured by the Modified venham Scale and their postoperative fear level as measured by the Children’s Fear Survey Schedule-Dental subscale (cfss-ds) in the first dental visit.

Methods: This study was conducted on 46 children aged between 5 and 7 years. questionnaires used were the children’s fear survey schedule-dental subscale (cfss-ds) and the Modified Venham Scale. Behavior was registered on a video recorder and scored by independent observers using the modified venham scale. treatment consisted of pulpotomy followed by zinc oxide and eugenol dressing.

Results: an insignificant correlation was found between each of age and gender and each of the preoperative fear score, the intraoperative behavior and the postoperative fear score.

Conclusion: Age and gender have no effect on preoperative or postoperative fear scores or on behavior during treatment.

Vol. 64, 175:180, January, 2018

I.S.S.N  0070-9484

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IMPACT OF CAD-CAM DESIGNED TELESCOPIC CROwN RETAINERS VErsus cOnVEntIOnal clasP On tHE QualIty Of lIfE anD MUSCLE ACTIVITy FOR PATIENTS RESTORED By MANDIBULAR DISTAL EXTENSION REMOVABLE PARTIAL DENTURES (RANDOMIZED CLINICAL TRAIL)

Ahmed Mohamed Keshk, Ahmed Emad Fayyad, Eman Ahmed Maher and Amal Fathy Kaddah

ABSTRACT

Background: Posterior distal extension partial denture present a number of design challenges. Especially the equitable distribution of forces that may become adverse during functional and parafunctional activities. So to maintain remaining alveolar ridges and teeth in an optimal state of health and to provide the patient with improved comfort and function, these forces are often compensated for to some extent by framework and denture base design variation. Purpose: The aim of this study was to evaluate the quality of life and muscle activity for patients restored by mandibular distal extension removable partial dentures (MDERPD) that retained either by CAD- CAM designed telescopic crown retainers or CAD-CAM designed conventional clasp. Materials and Methods: 42 partially edentulous patients were selected and randomly allocated into two identical groups. Group (1) Received a (MDERPD) retained with CAD-CAM designed telescopic crown retainers. Group (2) Received a (MDERPD) retained with CAD-CAM designed conventional clasp. Each group evaluated as regarding the quality of life through the Arabic version of OHIP- EDENT questionnaire. The digital electromyography (EMG) is used to record the muscle activity of anterior temporalis and masseter muscles. Conclusion: CAD-CAM designed telescopic crown retained RPD improved the quality of life and muscle activity of partially edentulous patients more than CAD-CAM designed clasp retained RPD.

KEy wORDS: Telescopic attachment, ball, bar, CAD-CAM, Electromyograph, quality of life and distal extension.

Vol. 64, 169:174, January, 2018

I.S.S.N  0070-9484

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EFFECTIVENESS OF DIODE LASER ON NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS

Abdel Rahman Abu Shamleh , Nahed Attia and Rima Abdallah

ABSTRACT

lasers have been used in many different fields in medicine and dentistry since their introduction in the 1960s. They demonstrated bactericidal effects which are promising for periodontal therapy. For this reason, they are used as an adjunct to conventional therapy. Diode lasers have been proposed as a novel treatment option in controlling the subgingival microorganisms and studying the shift in inflammatory mediators. the purpose of the study was to reveal the activation profiles of inflammatory cytokines in response to diode laser.

Material and Methods: This study was carried out as a prospective randomized split mouth clinical trial. Twenty patients having generalized chronic periodontitis with moderate clinical attachment loss, were treated using conventional treatment (control site) or conventional treatment with application of diode laser (test site).

Blood panel and collection of GCF were taken before starting the treatment for each patient and 2,6 months for follow up in order to compare the effect of diode laser as an adjunctive therapy to scaling and root planing (SRP) in addition to comparing the clinical parameters. Data was collected for statistical analysis using the iBM spss® 20.0 statistical package. statistical significance was set at 0.05.

Results: in this study, significant differences were found on the three gingival crevicular fluid (gcf) cytokine levels tested before and after periodontal therapy. c-reactive protein (crp) and tumor necrosis factor (TNF) alpha were the only cytokines that decreased immediately after treatment and remained at significantly lower levels until the end of the study period. at two weeks following treatment of either scaling and root planing alone or in conjunction of laser disinfection gingival index (GI) level in the test site ranged between 0.1 to 0.5 whereas in the control site it was 0.5 to 1.25. as for the inflammatory mediators il-1β ranged between 20.12 to 24.48 in comparison to 21.22 to 26.78 in control site. TNFa ranged from (1.01-3.7) in comparison with (1.21 – 1.89) and CRP level was (0.39-0.67) in comparison with (0.23-67). In all parameters the test sites showed better decrease in the inflammatory mediators and clinical parameters.

Conclusion: Soft tissue laser in adjunct to scaling and root planing enables a decrease in the inflammatory response. Effective disinfection becomes possible during initial periodontal therapy by introducing the laser beam to the periodontal pocket. soft tissue diode laser maybe beneficial as an adjunct to initial periodontal treatment.

Vol. 64, 157:167, January, 2018

I.S.S.N  0070-9484

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EVALUATION OF TEMPOROMANDIBULAR JOINT INVOLVEMENT IN RHEUMATOID ARTHRITIS PATIENTS USING MAGNETIC RESONANCE IMAGING

AbdelAziz R. and EshaK M.

ABSTRACT

Aim: the aim of this study was to investigate characteristic Mri findings of rheumatoid arthritis (RA) in the temporomandibular joint (TMj).

Patients and methods: 40 TMjs from 20 RA patients who have TMj complain were examined by MRI. All MRI images were evaluated separately by two experienced oral radiologists with regard to the presence or absence of soft tissue and/or osseous abnormalities, the radiologists were blinded to the clinical symptoms and prior TMj disease. The following joint abnormalities were noted, synovial membrane thickening, pannus formation, bone marrow edema, disk distortion and disk displacement, bone erosion, flattening of the articular surfaces, sub-cortical and generalized sclerosis, sub-cortical cyst, osteophyte, joint space reduction and abnormal position of the condylar head within the temporal fossa. all these findings were tabled and analyzed.

Results: MRI clearly detected all joint abnormalities with the most frequent soft tissue abnormality was synovial membrane thickening 85% and the least frequent abnormality was disk distortion 15%, where the most frequent osseous abnormality was condylar head erosion 52.5% and the least frequent was loose joint body  5%.

Conclusion:  bony  erosion  in  the  condyle  and  synovial  proliferation  were  considered characteristic Mri findings of ra in the tMJs.

Vol. 64, 151:156, January, 2018

I.S.S.N  0070-948

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MANDIBULAR ADVANCEMENT DEVICES ; ARE THEy EFFECTIVE IN OSA PATIENTS ?

Islam Hassan, Iman Radi and Amal Kaddah

ABSTRACT

Background: The intolerance of patients with obstructive sleep apnea to continuous positive airway pressure has lead to emergence of oral appliances, the effectiveness of which is still doubtful. Objective: To compare between the mandibular advancement device ((MAD) as an intervention)) and (continuous positive air way pressure (CPAP) as a comparator)) in the treatment of ((patients with OSA) as a population) regarding the following outcomes, which are primarily snoring index and secondarily apnea hypopnea index (AHI). Data sources: The following databases were searched electronically; Cochrane Library (CENTRAL), LILACS, and PubMed and grey literature with dates (17-19 march 2016).Hand searching of nine journals was done electronically with dates (1-5 march 2016), study bibliographies were reviewed and authors were contacted. Study selection: RCTs comparing the effect of CPAP or MAD on AHI and snoring index in patients with OSA were selected by consensus. results: of 5737 studies initially identified, 12 were included in this review. a meta-analysis using random and fixed-effect models to estimate pooled differences between each intervention was performed. 12 studies (7 of parallel design RCTs, 5 of crossover RCTs), comparing between MAD and CPAP, were included in this review reporting results of 553 subjects. Seven studies of one outcome (AHI) were assigned to meta-analysis. As a result of different study designs and time, three comparisons were carried out; comparison 1 for parallel design after 3 months of treatment, comparison 2 for crossover design after 4 months and comparison 3 for parallel design after 12 months. Fixed effect model was used for comparison 1 and 2, while random effect model was used for comparison 3. Conclusions: The prolonged use of MAD (more than one year) is as effective as CPAP in reducing the AHI. quality of evidence, however, is very low, which might weaken the recommendations. Properly conducted RCTs with follow up periods longer than one year, reporting snoring, apnea hypopnea index, excessive daytime sleepiness and health quality of life score outcomes are still needed.

Vol. 64, 127:150, January, 2018

I.S.S.N  0070-9484

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MICRO-LEAKAGE AND PENETRATION OF A RESIN INFILTRANT VERSUS TwO CONVENTIONAL FISSURE SEALANTS IN INDUCED OCCLUSAL FISSURE CARIES

Amr Abd El-Baeth yadak, Hussein yahya EL-Sayed and Thuraia Mohamed Genaid

ABSTRACT

The aim of the study was to evaluate and compare the microleakage and penetration of a resin infiltrant material (icon®) to that of a resin based fissure sealant rBs (fisseal) and a resin modified glass ionomer RMGI (VitremerTM) in induced occlusal fissure caries.

Materials and Methods:  Sixty extracted human sound premolars were utilized where initial fissure caries was created by a ph cycling procedure. samples were randomly divided into 3 equal groups (n = 20) according to the type of the sealing material (group I: Icon®, group II: Fisseal, group III: (VitremerTM). Samples in each group were then divided randomly into two equal subgroups A and B where samples in subgroup A were not thermocycled while those in subgroup B were thermocycled in water for 500 cycles between 5 and 550C. All samples were immersed in 1% methylene blue dye solution for 24 hours, sectioned into two halves along bucco-lingual aspect and inspected under stereomicroscope. Microleakage at the sealant \ tooth interface was scored and sealant penetration into the fissure lesions was rated either complete or incomplete penetration. Data were analyzed using Kruskal wallis and Mann-whitney U tests (P<0.05).

Results: Kruskal wallis test revealed a statistically significant difference among the groups (p<

0.05) in the degree of microleakage and penetration, where group I (Icon®) revealed the best results followed by group II (Fisseal), however the worst results were found in group III (VitremerTM). Mann-whitney  u test revealed no statistically significant difference between the microleakage recorded in group i and group ii (p> 0.05), while a highly statistically significant difference (p=0.000) was found between group III versus both groups I & II. Thermocycling did not have a

significant effect on microleakage of any of the tested materials (p> 0.05).

Conclusion: Icon®  and Fisseal provided better sealing and penetration into the non-cavitated fissure caries lesion compared to vitremerTM.

KEywORDS: fissure caries, fissure sealants, Microleakage, resin infiltrant (icon®), Resin penetration.

Vol. 64, 119:126, January, 2018

I.S.S.N  0070-9484

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CANAL TRANSPORTATION, CENTERING ABILITy AND CANAL VOLUMETRIC CHANGES OF wAVEONE VERSUS PROTAPER UNIVERSAL ROTARy NICKEL TITANIUM FILES IN PREPARING CURVED ROOT CANALS (AN IN VITRO STUDy)

Eman Nabil Elezaby, Siza yacoub Zakhary and Reham Saeed Seyam

ABSTRACT

Introduction: This study compared the effect of 2 rotary nickel-titanium (NiTi) systems; waveOne  and ProTaper Universal on transportation, centering ability and volumetric changes of curved root canals.

Methods: Thirty-four mesiobuccal root canals of mandibular molars (with angles of curvature ranging from 25º – 35º) were randomly divided into two groups (n=17); wO and PU groups. Canals were scanned using a Cranex® 3Dx machine (Soredex, Tuusula, Finland)  before and after preparation. Root canal transportation and centering ratio were evaluated at 3, 5, 8 mm from the apex. amount of removed dentin was evaluated as well. the significance level was set at p ≤ 0.05.

Results: there  was no significant difference between both systems in canal transportation, centering ability and volumetric changes.

Conclusions: Both systems can effectively shape curved root canals, while preserving original canal curvature, and without excessive removal of dentin.

KEYWORDS: Canal transportation, Cone Beam Computed Tomography, ProTaper Universal, waveOne.

Vol. 64, 111:118, January, 2018

I.S.S.N  0070-9484

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